Expert consensus on the diagnosis and treatment of neonatal hyperammonemia / 中国当代儿科杂志

Neonatal hyperammonemia is a disorder of ammonia metabolism that occurs in the neonatal period. It is a clinical syndrome characterized by abnormal accumulation of ammonia in the blood and dysfunction of the central nervous system. Due to its low incidence and lack of specificity in clinical manifestations, it is easy to cause misdiagnosis and missed diagnosis. In order to further standardize the diagnosis and treatment of neonatal hyperammonemia, the Youth Commission, Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association formulated the expert consensus based on clinical evidence in China and overseas and combined with clinical practice experience,and put forward 18 recommendations for the diagnosis and treatment of neonatal hyperaminemia.

Uso de quitina e quitosana como adsorventes de amônia de efluentes aquícolas: revisão de literatura / Use of chitin and quitosan as adsorvents of ammonia of aquaculture effluents: a literature review / Uso de quitina y quitosana como adsorbentes de amonia de efluentes acuícolas: revisión de literatura

Os resíduos provenientes da aquicultura são derivados da ração e da excreção dos peixes e podem estar sedimentados, suspensos ou dissolvidos, ocasionando elevados valores de DBO, DQO, nitrogênio e fósforo. A produção de camarões no Brasil tem gerado elevadas quantidades de resíduos sólidos, tendo em vista que os exoesqueletos dos camarões correspondem a cerca de 40% do seu peso total, resultando num forte impacto ambiental. Diversas pesquisas envolvendo a quitina estão sendo desenvolvidas na área de tratamento de água, devido principalmente a sua capacidade de formar filme, sendo utilizada em sistemas filtrantes. Este polissacarídeo também pode ser utilizado como agente floculante no tratamento de efluentes, como adsorvente na clarificação de óleos, e principalmente na produção de quitosana. Atualmente a quitosana possui aplicações multidimensionais, desde áreas como a nutrição humana, biotecnologia, ciência dos materiais, indústria farmacêutica, agricultura, terapia genética e proteção ambiental. A quitosana é muito eficiente na remoção de poluentes em diferentes concentrações. Apresenta alta capacidade e grande velocidade de adsorção, boa eficiência e seletividade tanto em soluções que possuem altas ou baixas concentrações. O uso da biotecnologia, através do processo de adsorção utilizando adsorventes naturais e baratos, como a quitina e quitosana, minimiza os impactos ambientais da aquicultura tanto em relação aos provocados pelo lançamento de efluentes no meio ambiente quanto aos causados pelo descarte inadequado dos resíduos do processamento de camarões.(AU)

Aquaculture residues are derived from fish feed and excretion and may be sedimented, suspended or dissolved, resulting in high BOD, COD, nitrogen and phosphorus values. Shrimp production in Brazil has generated high amounts of solid waste, since shrimp exoskeletons account for about 40% of their total weight, resulting in a strong environmental impact. Several researches involving chitin are being developed in the area of water treatment, mainly due to its ability to form film, being used in filter systems. This polysaccharide can also be used as a flocculating agent in the treatment of effluents, as an adsorbent in the clarification of oils, and especially in the production of chitosan. Currently, chitosan has multidimensional applications, from areas such as human nutrition, biotechnology, materials science, pharmaceutical industry, agriculture, gene therapy and environmental protection. Chitosan is very efficient in the removal of pollutants at different concentrations. It presents high capacity and high adsorption velocity, good efficiency and selectivity both in solutions that have high or low concentrations. The use of biotechnology, through the adsorption process using natural and cheap adsorbents such as chitin and chitosan, minimizes the environmental impacts of aquaculture both in relation to those caused by the release of effluents into the environment and those caused by the inappropriate disposal of processing residues of shrimps.(AU)

Los residuos procedentes de la acuicultura se derivan de la ración y de la excreción de los peces y pueden estar sedimentados, suspendidos o disueltos, ocasionando elevados valores de DBO, DQO, nitrógeno y fósforo. La producción de camarones en Brasil ha generado grandes cantidades de residuos sólidos, teniendo en cuenta que los exoesqueletos de los camarones corresponden a cerca del 40% de su peso total, resultando en un fuerte impacto ambiental. Varias investigaciones involucrando la quitina se están desarrollando en el área de tratamiento de agua, debido principalmente a su capacidad de formar película, siendo utilizada en sistemas filtrantes. Este polisacárido también puede ser utilizado como agente floculante en el tratamiento de efluentes, como adsorbente en la clarificación de aceites, y principalmente en la producción de quitosana. Actualmente la quitosana posee aplicaciones multidimensionales, desde áreas como la nutrición humana, biotecnología, ciencia de los materiales, industria farmacéutica, agricultura, terapia genética y protección ambiental. La quitosana es muy eficiente en la eliminación de contaminantes en diferentes concentraciones. Presenta alta capacidad y gran velocidad de adsorción, buena eficiencia y selectividad tanto en soluciones que poseen altas o bajas concentraciones. El uso de la biotecnología, a través del proceso de adsorción utilizando adsorbentes naturales y baratos, como la quitina y quitosana, minimiza los impactos ambientales de la acuicultura tanto en relación a los provocados por el lanzamiento de efluentes en el medio ambiente en cuanto a los causados por el descarte inadecuado de los residuos del procesamiento de camarones.(AU)

Embolización de colaterales portosistémicas espontáneas como tratamiento de la encefalopatía hepática refractaria / Embolization of spontaneous portosystemic shunts as treatment for refractory hepatic encephalopathy

BACKGROUND: Hepatic encephalopathy (HE) is a common complication of cirrhosis associated with a reduced survival. The presence of high-flux spontaneous porto-systemic shunts can induce HE even in patients with preserved liver function. AIM: To evaluate the effect of spontaneous porto-systemic shunt embolization (SPSE) over HE and its long-term evolution. MATERIAL AND METHODS: Retrospective analysis of 11 patients (91% males) with severe HE non-responsive to medical treatment in whom a SPSE was performed. The grade of HE (employing West Haven score), survival, MELD and Child-Pugh score, ammonia levels, degree of disability (employing the modified Rankin scale (mRs)) were evaluated before and at thirty days after procedure. RESULTS: The most common etiology found was non-alcoholic steatohepatitis (63.6%). A reduction of at least two score points of HE was observed in all patients after thirty days. There was a significant reduction on median (IQR) West Haven score from 3 (2-3) at baseline to 1 (0-1) after the procedure (p < 0.01). Twelve months survival was 63.6%. There was a decrease in median ammonia level from 106.5 (79-165) (ug/dL) to 56 (43-61) after SPSE (p = 0.006). The median mRS score before and after the procedure was 3 (3-5) and 1 (1-2.5), respectively (p < 0.01). Conclusions: According to our experience, SPSE is a feasible and effective alternative to improve HE and functionality of patients with refractory EH.

Emergency psychological intervention of acute ammonia leakage event / 中华劳动卫生职业病杂志

Objective: To analyze the situation of emergency psychological intervention in an acute ammonia leakage event, and to provide reference for emergency response. Methods: In August 2020, the emergency treatment of 65 patients admitted by Zhangqiu District People's Hospital Affiliated to Jining Medical College of Shandong Province in June 2019 in the ammonia tank car leakage incident was analyzed, the psychological intervention in emergency after the incident was collected, the anxiety and depression were evaluated by symptom checklist 90 (SCL-90) , and targeted psychological intervention was implemented according to the psychological evaluation results, And analyze the intervention efficiency. Results: Among the 65 patients, there were 52 cases of ammonia stimulation reaction, 11 cases of mild poisoning and 2 cases of moderate poisoning. There were 60 cases of chest tightness and dyspnea, 11 cases of bloody sputum, 58 cases of sore throat, 43 cases of hoarseness, 28 cases of photophobia and tears, 13 cases of blurred vision, 18 cases of nausea and vomiting, and 2 cases of dry and wet rales in the lungs. The scores of somatization, depression, anxiety, hostility, phobia, paranoia and negative coping in patients with mild and moderate poisoning were higher than those in patients with stimulus response (P<0.05) . The effective rate of intervention was 98.7%. Conclusion: Emergency psychological evaluation and intervention in mass public health events are helpful to the treatment of patients.

Ammonia levels during broiler rearing cycle

The evaluated ammonia volatilization rates and its association with humidity, temperature, and pH in broiler litter in conventional and dark house rearing systems. Evaluations were performed at 0.01, 1.00, and 1.50 m high, using a completely randomized design, at a weekly frequency for 12 weeks­from the sanitary void to the end of the 42-day cycle. Litter temperature had no significant difference for different types of house. Humidity and pH levels varied according to houses and evaluation periods. No ammonia volatilization was detected during initial periods. However, up from the 21st day of rearing, rates started to increase, showing higher concentrations at 0.01 m height. At 1.00 and 1.50 m, values around 20 mL·m­3, were obtained and considered an acceptable exposure level for the broilers and employees directly working in this sector. Yet, broiler breeders should target lower levels due to environmental impacts.

Ammonia gas for bacterial control in poultry litter / Gás amônia para controle bacteriano em cama aviária

The current techniques used in the disinfection of reused poultry litter, such as lime addition, windrowing and plastic cover on the surface, do not guarantee the elimination of pathogenic microorganisms, causing damage to the environment and animal health. Gram negative bacteria, i.e., Salmonella and Escherichia coli, can be transmitted from one batch to another through reused litter, causing health damage to broilers and humans that consume food contaminated by these agents. Our study assessed the effectiveness of the methods plastic cover on the surface (PCS) and plastic cover on the surface with ammonia gas injection (PCSAI) in the control of Gram negative bacteria. The results obtained, both in laboratory conditions (Experiment 1) and in the field (Experiment 2), demonstrate that the method PCSAI with 0.22% ammonia gas had a significant reduction (P<0.05) of Gram negative bacteria in the period of 48 hours This new methodology for disinfecting poultry litter will allow its reuse in a practical and safe way, improving the preservation of the environment, of the health of broilers and consumers of poultry products.

O reaproveitamento de camas aviárias na criação de frangos de corte é uma prática muito utilizada no Brasil. Essa prática reduz custos de produção e contribui na conservação do meio ambiente. As técnicas atuais utilizadas na desinfecção de camas aviárias reaproveitadas, como adição de cal, enleiramento e lona na superfície, não garantem a eliminação de microrganismos patogênicos porque não geram quantidade suficiente de amônia. O gás amônia, em concentrações elevadas, tem efeito biocida. Bactérias Gram negativas, como as Salmonelas e Escherichia coli, podem ser transmitidas de um lote para outro através do reaproveitamento da cama, ocasionando prejuízos para a saúde das aves e dos humanos que consomem alimentos contaminados por estes agentes. Este trabalho avaliou a eficácia do método lona na superfície com injeção de gás amônia no controle de microrganismos Gram negativos. Os resultados obtidos demostraram que esse método controlou os microrganismos Gram negativos num período de 48 horas em camas de frangos de corte reaproveitadas. Assim, essa nova metodologia de desinfecção de camas de aviário permitirá sua reutilização de forma prática e segura, melhorando a saúde das aves e dos consumidores dos produtos avícolas.

Calidad del aire interior mediante indicadores ecológicos y sociales asociados a la inmisión de material particulado (PM10) en la zona este 2 / Indoor air quality through ecological and social indicators associated with the immission of particulate matter (PM10) in the eastern zone 2

El material particulado (PM) es uno de los contaminantes más importantes presentes en el aire, representando un riesgo medioambiental para la salud. Las partículas con un diámetro de 10 micrones o menos (PM10), al ser inhalables, pueden penetrar y alojarse profundamente en los pulmones, contribuyendo al riesgo de desarrollar enfermedades cardiovasculares y respiratorias, así como cáncer de pulmón, enfermedades mentales, dermatitis, daño ocular e incluso al aumento en las tasas de mortalidad. Se estableció como objetivo determinar la calidad del aire interior asociada a la inmisión de material particulado (PM10) en la zona este 2, un sector industrial ubicado en los distritos san juan de Lurigancho y Lurigancho-Chosica, Perú. Para tal fin, se propone el uso de indicadores duales: ecológicos y sociales. De acuerdo a los indicadores ecológicos explorados, la concentración media de PM10 en el aire exterior (CME) superó el límite de 100 µg/m3 establecido por MINAM. Aunque la mediana de CME (93,7µg/m3; IC 95%=89,07-98,33) estuvo por debajo de este límite, el cuartil superior lo superó, entendido por elevaciones puntuales de hasta 131 µg/m3 (Figura 2), potencialmente dañinos para la salud humana. El coeficiente de correlación de Spearman de 0,921, obtenido del análisis bivariado entre los valores de concentración media diaria de PM10 exterior e interior, previo a la instalación de filtros en los sistemas de ventilación, es sugerente del efecto que puede tener la inmisión de aire ambiental con material particulado como vector de la contaminación del aire interior. al considerar los valores de la concentración media diaria, obtenidos en los 15 días posteriores a la instalación de los filtros (CMIFI), se observa que la concentración media de PM10 en el interior disminuyó en relación a la quincena anterior. El coeficiente de correlación de Spearman de 0,869 entre los indicadores CMIFI y CME, permite proponer que, en esta segunda fase, la calidad del aire interior fue influenciada en menor proporción por la contaminación de material particulado del aire ambiental, es decir que se presentó menos inmisión de PM10, gracias al proceso de filtrado, lo que disminuye el riesgo para la salud de los trabajadores(AU)

Particulate matter (PM) is one of the most important pollutants present in the air, representing an environmental risk to health. Particles with a diameter of 10 microns or less (PM10), being inhalable, can penetrate and lodge deep in the lungs, contributing to the risk of developing cardiovascular and respiratory diseases, as well as lung cancer, mental illness, dermatitis, eye damage and even increased mortality rates. The objective was to determine the indoor air quality associated with the immission of particulate matter (PM10) in East Zone 2, an industrial sector located in the districts of San Juan de Lurigancho and Lurigancho-Chosica, Peru. To this end, the use of dual indicators is proposed: ecological and social. According to the ecological indicators explored, the average concentration of PM10 in outdoor air (CME) exceeded the limit of 100 µg/m3 established by MINAM. Although the CME median (93.7µg/m3; 95% CI=89.07-98.33) was below this limit, the upper quartile exceeded it, understood as point elevations of up to 131µg/m3 (Figure 2 ), potentially harmful to human health. Spearman's correlation coefficient of 0.921, obtained from the bivariate analysis between the daily average concentration values of outdoor and indoor PM10, prior to the installation of filters in the ventilation systems, is suggestive of the effect that the immission of ambient air can have with particulate matter as a vector of indoor air pollution. When considering the values of the average daily concentration, obtained in the 15 days after the installation of the filters (CMIFI), it is observed that the average concentration of PM10 in the interior decreased in relation to the previous fortnight. Spearman's correlation coefficient of 0.869 between the CMIFI and CME indicators allows us to propose that, in this second phase, indoor air quality was influenced to a lesser extent by particulate matter contamination in the ambient air, that is, there was less PM10 immission, thanks to the filtering process, which reduces the risk to the health of workers(AU)

Effects of different extracts of Dendrobium officinale on rats with chronic pharyngitis induced by pepper water combined with ammonia / 中国中药杂志

Dendrobium officinale can serve as Chinese medicinal material effective in nourishing yin, clearing heat, and producing fluid, and is used to treat throat diseases, but its active substances and mechanism are not clear. To clarify the active fraction and underlying mechanism of D. officinale against chronic pharyngitis(CP), the present study induced a CP model in rats by pepper water combined with low-concentration ammonia, and crude polysaccharides of D. officinale(DOP), non-polysaccharides of D. officinale(DON), and total extract of D. officinale(DOT)(0.33 g·kg~(-1), calculated according to the crude drug) were administered by gavage for six weeks. The changes in oral secretions and pharyngeal conditions of rats with CP were observed and rated. The hematological indicators were determined by an automatic hematology analyzer. The serum levels of pro-inflammatory factors, such as tumor necrosis factor-alpha(TNF-α), interleukin 1β(IL-1β), and interleukin 6(IL-6), and T-lymphocyte cytokines, including interferon γ(IFN-γ), interleukin 4(IL-4), interleukin 17(IL-17), and transforming growth factor β1(TGF-β1) were detected by the enzyme-linked immunosorbent assay(ELISA). The proportions of CD3~+, CD4~+, and CD8~+cells in peripheral blood T lymphocyte subsets were determined by the flow cytometry. The histomorphological changes of the pharynx were observed by hematoxylin-eosin(HE) staining. The protein expression of nuclear factor-κB P65(NF-κB P65), cyclooxygenase-2(COX-2), F4/80, and monocyte chemoattractant protein-1(MCP-1) in the pharynx were detected by immunohistochemistry and Western blot. The results showed that DOP and DON could significantly relieve pharyngeal lesions, reduce white blood cells(WBC) and lymphocytes(LYMP), decrease the levels of pro-inflammatory factors TNF-α, IL-6, and IL-1β, and inhibit the protein expression of NF-κB P65, COX-2, F4/80, and MCP-1 in the pharynx. DOP was superior in reducing oral secretions and serum IL-17 level and inferior in increasing CD4~+/CD8~+ratio to DON. It is suggested that both polysaccharides and non-polysaccharides of D. officinale have anti-PC effects and the anti-inflammatory mechanism may be related to the regulation of T lymphocyte distribution and inhibition of the inflammatory signaling pathways mediated by NF-κB P65. The anti-inflammatory effect of DOP may be related to the regulation of Th17/Treg balance, while that of DON may be related to the regulation of the Th/Tc ratio.

Estructura organizacional del policlínico Julián Grimau para la respuesta médica ante emergencias químicas por amoníaco / Organizational structure of Julián Grimau polyclinic for medical response to chemical emergencies by ammonia

Introducción: El amoníaco constituye riesgo de emergencia química en el Policlínico Docente Julián Grimau del municipio Arroyo Naranjo, lo que hace necesario asumir una estructura organizacional que viabilice la respuesta médica frente a este tipo de eventos. Objetivo: Diseñar una propuesta de estructura organizacional del policlínico Julián Grimau para la respuesta médica ante emergencias químicas por amoníaco. Métodos: Se realizó una investigación en sistemas y servicios de salud, entre septiembre de 2017 y diciembre de 2018, en el Policlínico Docente Julián Grimau. Se analizaron documentos relacionados con las acciones médicas en las emergencias químicas en la atención primaria de salud. Se empleó el método sistémico estructural-funcional para diseñar la estructura organizacional, y el informante clave para su concreción. Resultados: Se propone una estructura organizacional de la respuesta médica a emergencias químicas por amoníaco en el Policlínico Docente Julián Grimau que se conformó por nueve áreas: punto de recepción (1), tratamiento especial (2), clasificación (3), tratamiento de urgencia al intoxicado grave (4), tratamiento de urgencia al intoxicado leve (5), aseguramiento al diagnóstico (6), aseguramiento médico material (7), el área de fallecidos (8) y asintomáticos (9). Conclusiones: La estructura organizacional de la respuesta médica a emergencias químicas por amoníaco en el Policlínico Docente Julián Grimau quedó conformada en áreas con sustento en los principios clínicos, evolutivos y de tratamiento del paciente intoxicado agudo, donde se aprovechan las potencialidades orgánicas y funcionales de la institución. Se caracteriza por ser sistémica, flexible, objetiva, participativa, oportuna, adecuada y selectiva(AU)

Introduction: At Julián Grimau Teaching Polyclinic in Arroyo Naranjo municipality, ammonia is a risk of chemical emergency. Hence, it is necessary for the medical response to these situations to implement an organizational structure. Objective: Design a proposal of organizational structure in Julián Grimau Polyclinic for the medical response to chemical emergency by ammonia. Methods: A research was carried out on health systems and services, from September 2017 to December 2018, in Julián Grimau Teaching Polyclinic. A documentary analysis related to medical actions in chemical emergencies was conducted in primary health care's level. In addition, the following methods were used: structural-functional system for the design of the organizational structure and the key informant for its concretion. Result: It is proposed an organizational structure of the medical response to chemical emergencies by ammonia in the Polyclinic, that was formed by nine areas: reception point (1), special treatment (2), classification (3), emergency treatment to severe poisoned patient (4), emergency treatment to slightly poisoned patient (5), logistics for the diagnosis (6), medical-material logistics (7), deceased´s area (8), and asymptomatic patients (9). Conclusions: The organizational structure of the medical response to chemical emergencies by ammonia in Julián Grimau Teaching Polyclinic was formed of areas secured by principles of clinical, evolutive and of acute poisoned patient´s treatment where the organic and functional potentials of the institution are seized. Hence, this proposal is flexible, objective, participatory, timely, adequate and selective(AU)

Aerobic stability of tifton 85 silage with and without pre-drying in the sun

The objective of this study was to evaluate pH, ammoniacal nitrogen, and aerobic stability of silage of Tifton 85 grass silage with two dry matter contents at different silos opening times. The experimental design was completely randomized, in a subdivided plots scheme, in which the silages constituted the plots and aerobic exposure times the subplots, with four replications. To verify the aerobic stability of the silages, the temperature and pH were analyzed at seven hours after the silos were opened (1, 24, 48, 72, 96, 120, and 144 hours). The pH reached adequate levels for conservation only after 90 days of fermentation for the silages with and without pre-drying in the sun. Ammoniacal nitrogen remained below the recommended limits in both silages. As for the silage temperature, no loss of aerobic stability was observed. However, the observed pH revealed a break instability after 72 hours when the silos were opened at 28 days, with no changes for the remaining silage periods. It is possible to obtain suitable silages from Tifton 85 with or without pre-warming in the sun, however, a minimum fermentation period of 90 days should be adopted. The studied silages presented high aerobic stability, but when kept silage for only 28 days, they should be consumed by the animals within 48 hours after the supply.

Effect of Fluoxetine Hydrochloride on Routine Metabolism of Lambari (Deuterodon iguape, Eigenmann, 1907) and Phantom Shrimp (Palaemon pandaliformis, Stimpson, 1871)

HIGHLIGHTS Fluoxetine increases the metabolic rate and excretion of ammonia in both species. O:N ratio in fish showed higher values in the highest concentrations of fluoxetine. The LC50 - 96 hour values of Palaemon pandaliformis represented greater toxicity. Both species are a good biological model for fluoxetine exposure studies.

Abstract Fluoxetine is an emerging pollutant that acts as a selective serotonin reuptake inhibitor (SSRI) and being a hydrolytic molecule that is photolytically stable and accumulaties in biological tissues, its disposal in the aquatic environment can interfere with the physiology of fish and shrimp. Thus, the objective of this study was to analyze the effects of fluoxetine on routine metabolism (metabolic rate, specific ammonia excretion and O:N ratio) of Deuterodon iguape and Palaemon pandaliformis. For this, five groups of each species, were exposed to different concentrations of fluoxetine for 24 hours (D. iguape) and 2 hours (P. pandaliformis). The results demonstrated that in D. iguape exposure to fluoxetine significantly increased both the metabolic rate by 75%, 85%, 55% and 50% for concentrations of 0.05; 0.1; 0.5 and 1.0 mgL-1, respectively, and the specific ammonia excretion by 40%, 48% and 20% for concentrations of 0.05; 0.1 and 0.5 mgL-1, respectively, when compared with their control. The O:N ratio was statistically greater in concentrations of 0.5 and 1.0 mgL-1. Concerning P. pandaliformis, exposure to fluoxetine increased metabolic rate at concentrations 30.0 and 60.0 µgL-1, and also increased specific ammonia excretion at concentrations 10.0, 30.0 and 60.0 µgL-1, when compared with the control group. It was concluded that exposure to fluoxetine increases the routine metabolism of both species and that at the concentration 1.0 mgL-1, Deuterodon iguape required different energy substrates.

Aquaponic System with White Shrimp Litopenaeus vannamei Rearing and Production of the Plants Batis maritima, Sarcocornia neei and Sporobolus virginicus

Abstract Aquaponics is a system that integrates aquaculture with plant production in which two species are benefited, and there is water saving. In this study was carried out with an aquaponic system to verify the interaction between the growth of the halophytes Batis maritime, Sarcocornia neei, and Sporobolus virginicus associated with white shrimp Litopenaeus vannamei rearing. We also investigated if there were different responses of physicochemical variables of the water in the experimental shrimp culture ponds integrated into the growth of plants and control ponds, without plants, throughout a 56-day period. The treatment experiment and control presented a statistically significant difference in total dissolved solids, salinity, total suspended solids, ammonia, orthophosphate, and nitrite. In the experimental treatment, with the presence of plants and recirculating water, a reduction of total suspended solids, ammonia and orthophosphate was observed. The rate of shrimp production was not significantly different between treatments, and the performance was similar to that of other studies. The biomass gain of the halophyte B. maritima was 876.6 grams in 0.5 m² and of S. neei was 48.8 grams in 0.16 m². All plants of the species S. virginicus died during the experiment.

Rapid Determination of Ammonia in Biological Samples by GC-MS Derivatization Method / 法医学杂志

Objective To establish a qualitative and quantitative method to determine ammonia in biological samples by gas chromatography-mass spectrometry （GC-MS）. Methods A heptafluorobutyryl chloride derivatization method was used. GC-MS was used for determination. The effects of different pH conditions, derivatization temperature, time and different extraction solvents on the test results were investigated. The pretreatment conditions were optimized. Results This method could accurately detect the ammonia content in blood, and the limit of detection was determined to be 0.1 μg/mL. The target component showed good linearity in the range of 0.5-200.0 μg/mL （R2=0.987 7）. The relative standard deviation range of intra-day precision was 2.59%-3.88%. The relative standard deviation range of inter-day precision was 3.21%-3.76%. Conclusion The method showed good sensitivity, stability and specificity, therefore can be used for forensic toxicology analysis and clinical biochemical detection.

Volatilization of ammonia in systems of treatment of swine manure with aquatic macrophytes / Volatilização de amônia em sistemas de tratamento de dejetos de suínos com macrófitas aquáticas

Abstract The usage of aquatic plants represents an alternative in the treatment of residues originating from swine. In these systems, one of the N removal methods is the ammonium (NH4 +) uptake and volatilization of ammonia (NH3). In this way, the objective of this work was to evaluate the volatilization rates of NH3 in waste treatment systems swine fluids (SSF) with aquatic macrophytes, as well as the concentration of NH 4+ present in the swine fluids. The experiment was carried out at Campus II/UNOESTE. The treatment systems were composed of 16 boxes of PVC and characterized as: T1 = Control sample 50% of SSF/50% of water; T2 = 50% SSF/50% water + Eichhornia crassipes (Mart.) Solms; T3 = 50% SSF/50% water + Pistia stratiotes L.; T4 = 50% SSF/50% water + Salvinia auriculata Aubl. The design was randomized blocks, with 4 treatments and 4 replicates. The hydrogen potential (pH) and the NH4 + content of the effluent were analyzed weekly, and the volatilization of NH 3 by means of collectors installed in each treatment unit. The presence of aquatic macrophytes promoted the reduction of NH4+ concentration and of the pH values ​​of swine fluids, and this resulted in the reduction of NH3 volatilization rates to the environment, with emphasis on the system with Eichhornia crassipes (Mart.) Solms, which presented the lowest rate of volatilization.

Resumo A utilização de plantas aquáticas representa uma alternativa no tratamento de resíduos oriundos da suinocultura. Nestes sistemas, uma das formas de remoção de nitrogênio (N) é a absorção de amônio (NH4+) pelas plantas, entretanto, também ocorre a volatilização de amônia (NH3). Dessa forma, o objetivo do trabalho foi avaliar as taxas de volatilização de NH3 em sistemas de tratamentos de dejetos líquidos de suínos (DLS) com macrófitas aquáticas, bem como a concentração de NH4+ presente nos dejetos. O experimento foi realizado em área de ambiente aberto no Campus II/UNOESTE. Os sistemas de tratamento foram constituídos de 16 caixas de PVC e caracterizados como: T1 = Testemunha 50% de DLS/50% de água; T2 = 50% de DLS/50% de água + Eichhornia crassipes (Mart.) Solms; T3 = 50% de DLS/50% de água + Pistia stratiotes L.; T4 = 50% de DLS/50% de água + Salvinia auriculata Aubl. O delineamento adotado foi em blocos casualizados, com 4 tratamentos e 4 repetições. Foram analisados o potencial hidrogeniônico (pH) e o teor de NH4 + do efluente semanalmente, e a volatilização de NH3 por meio de coletores instalados em cada unidade de tratamento. A presença das macrófitas aquáticas proporcionou a redução da concentração de NH4+ e dos valores de pH dos dejetos líquidos de suínos, e isto resultou na redução das taxas de volatilização de NH 3 ao meio ambiente, com destaque ao sistema com Eichhornia crassipes (Mart.) Solms, que apresentou a menor taxa de volatilização.

Ammonia volatilization in response to coated and conventional urea in maize crop field / Volatilização de amônia utilizando ureia convencional e revestida na cultura do milho

The properly measurement of gas emissions and nutrient availability to crops using technologies such as polymer-coated urea are required to monitored the possible nitrogen (N) fertilizer pollution in the environment. This study aimed to evaluate N loss through ammonia volatilization from polymer-coated and conventional urea in maize field trials under two different environments. The study was carried out in Chapadão do Sul and Selvíria State of Mato Grosso do Sul evaluating the first and second harvest of maize plants. Nitrogen fertilizers were applied as polymer-coated, conventional urea and control plots were used as reference to evaluate N loss through volatilization (3, 6, 9, 12, and 15 days after fertilizer application). The peak of ammonia volatilization was observed during the first three days after fertilizer application corresponding up to 44% of total N supplied. Polymer-coated urea had promising results showing less ammonia volatilization during the first crop. However, the same result was not observed for second crop.

A necessidade de mensurar adequadamente a emissão de gases e também o fornecimento de nutrientes às culturas por tecnologias como o revestimento da ureia com polímeros são necessários para monitar a possível poluição de fertilizantes nitrogenados no ambiente. Assim, o objetivo desse trabalho foi determinar as perdas de nitrogênio (N) por volatilização pela ureia convencional e ureia revestida compolímero, em duas épocas de cultivo do milho (Zea mays L.), em duas regiões do cerrado brasileiro. Os trabalhos foram desenvolvidos em Chapadão do Sul e Selvíria, Mato Grosso do Sul - Brasil, na cultura do milho "primeira safra" e "segunda safra", respectivamente. Os tratamentos foram constituídos pela ureia e ureia revestida por polímero aplicada em cobertura além de um tratamento controle (sem N) em função de épocas de monitoramento das perdas de N por volatilização (3, 6, 9, 12 e 15 dias após a adubação) com 5 repetições. Foi mensurado as perdas de N por volatilização nas respectivas épocas e o total acumulado no período. O pico de volatilização ocorreu durante os três primeiros dias, atingindo patamares de até 44% do total de N fornecido. O revestimento da ureia com polímeros apresentou resultados promissores, diminuindo as perdas de N-NH3 por volatilização no milho "primeira safra". Todavia, os resultados obtidos no milho "segunda safra" não permitem generalizar tais benefícios.

Sarcopenia: Ammonia metabolism and hepatic encephalopathy

Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or reverse sarcopenia include dietary interventions (supplemental calorie and protein intake), increased physical activity (supervised resistance and endurance exercises), hormonal therapy (testosterone), and ammonia lowering agents (L-ornithine L-aspartate, branch chain amino acids) as well as mechanistic approaches that target underlying molecular and metabolic abnormalities. Besides other factors, hyperammonemia has recently gained attention and increase sarcopenia by various mechanisms including increased expression of myostatin, increased phosphorylation of eukaryotic initiation factor 2a, cataplerosis of α ketoglutarate, mitochondrial dysfunction, increased reactive oxygen species that decrease protein synthesis and increased autophagy-mediated proteolysis. Sarcopenia contributes to frailty and increases the risk of minimal and overt hepatic encephalopathy.

Renal replacement therapy in neonates with an inborn error of metabolism / 소아과

Hyperammonemia can be caused by several genetic inborn errors of metabolism including urea cycle defects, organic acidemias, fatty acid oxidation defects, and certain disorders of amino acid metabolism. High levels of ammonia are extremely neurotoxic, leading to astrocyte swelling, brain edema, coma, severe disability, and even death. Thus, emergency treatment for hyperammonemia must be initiated before a precise diagnosis is established. In neonates with hyperammonemia caused by an inborn error of metabolism, a few studies have suggested that peritoneal dialysis, intermittent hemodialysis, and continuous renal replacement therapy (RRT) are effective modalities for decreasing the plasma level of ammonia. In this review, we discuss the current literature related to the use of RRT for treating neonates with hyperammonemia caused by an inborn error of metabolism, including optimal prescriptions, prognosis, and outcomes. We also review the literature on new technologies and instrumentation for RRT in neonates

Hepatoprotective effect of sodium hydrosulfide on hepatic encephalopathy in rats

Hydrogen sulfide is well-known to exhibit anti-inflammatory and cytoprotective activities, and also has protective effects in the liver. This study aimed to examine the protective effect of hydrogen sulfide in rats with hepatic encephalopathy, which was induced by mild bile duct ligation. In this rat model, bile ducts were mildly ligated for 26 days. Rats were treated for the final 5 days with sodium hydrosulfide (NaHS). NaHS (25 µmol/kg), 0.5% sodium carboxymethyl cellulose, or silymarin (100 mg/kg) was administered intraperitoneally once per day for 5 consecutive days. Mild bile duct ligation caused hepatotoxicity and inflammation in rats. Intraperitoneal NaHS administration reduced levels of aspartate aminotransferase and alanine aminotransferase, which are indicators of liver disease, compared to levels in the control mild bile duct ligation group. Levels of ammonia, a major causative factor of hepatic encephalopathy, were also significantly decreased. Malondialdehyde, myeloperoxidase, catalase, and tumor necrosis factor-α levels were measured to confirm antioxidative and anti-inflammatory effects. N-Methyl-D-aspartic acid (NMDA) receptors with neurotoxic activity were assessed for subunit NMDA receptor subtype 2B. Based on these data, NaHS is suggested to exhibit hepatoprotective effects and guard against neurotoxicity through antioxidant and anti-inflammatory actions.

Acute Necrotizing Encephalopathy in Children: a Long Way to Go

BACKGROUND: Acute necrotizing encephalopathy (ANE) is a rare, but potentially life threatening neurological condition in children. This study aimed to investigate its clinical spectrum, diagnostic and therapeutic dilemma, and prognosis. METHODS: Twelve children with ANE were included in the study. The diagnosis was made by clinical and radiological characteristics from January 1999 to December 2017 and their clinical data were retrospectively analyzed. RESULTS: A total of 12 children aged 6 to 93 months at onset (5 male: 7 female) were evaluated. The etiology was found in 4 of them (influenza A, H1N1; coxsackie A 16; herpes simplex virus; and RANBP2 gene/mycoplasma). The most common initial presentations were seizures (67%) and altered mental status (58%). The majority of the subjects showed elevation of aspartate aminotransferase/alanine aminotransferase with normal ammonia and increased cerebrospinal fluid protein without pleocytosis. Magnetic resonance imaging revealed increased T2 signal density in bilateral thalami in all patients, but the majority of the subjects (67%) also had lesions in other areas including tegmentum and white matter. Despite the aggressive immunomodulatory treatments, the long-term outcome was variable. One child and two sisters with genetic predisposition passed away. CONCLUSION: ANE is a distinctive type of acute encephalopathy with diverse clinical spectrum. Even though the diagnostic criteria are available, they might not be watertight. In addition, treatment options are still limited. Further studies for better outcome are needed.

A Study of Predicting the Severity Following Glufosinate Ammonium Containing Herbicide Poisoning Experienced in Single Emergency Medical Institution

PURPOSE: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. METHODS: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. RESULTS: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. CONCLUSION: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.