Factors associated with vertical transmission of syphilis in a city in the State of São Paulo / Fatores associados à transmissão vertical de sífilis em um município do Estado de São Paulo / Factores asociados a transmisión vertical de sífilis en una ciudad del Estado de São Paulo

Background and Objectives: Syphilis is a sexually transmitted infection with low-cost and accessible treatment; however, it is considered a public health problem. Further studies are needed to improve knowledge about the factors that may contribute to the mother-to-child transmission of syphilis. Given its high detection rate in pregnant women and the possible adverse events of syphilis in Brazil, the objective was to evaluate the association of individual and clinical characteristics of syphilis with the incidence of congenital syphilis in pregnant women. Methods: This retrospective study was performed in a medium-size municipality in the State of São Paulo. Notification forms from the Notifiable Diseases Information System were used and the occurrence of congenital syphilis was the outcome of the study. Bivariate analyses and logistic regression were performed with variables that obtained p values <0.25. Results: Most pregnant women were 20-34 years old (62.2%) and had white skin (63.2%) and incomplete elementary schooling (35.4%). The occurrence of congenital syphilis was associated with the maternal syphilis diagnosis (p<0,001) and with not performing the treponemal test during the prenatal examination (p =0.014). There was a greater risk for the occurrence of congenital syphilis in cases with late diagnosis during pregnancy (OR=16.48; 95%CI 3.22-84.26) and tertiary/latent clinical classification (OR=7.62; 95%CI 1.40-41.54). Conclusion: Maternal diagnosis in the third trimester of pregnancy and tertiary/latent clinical classification were the main risk factors for the occurrence of congenital syphilis, reinforcing the importance of a quality prenatal examination performed timely.(AU)

Justificativa e Objetivos: A sífilis é uma Infecção Sexualmente Transmissível, com tratamento de baixo custo e acessível; porém, ela é considerada um problema de saúde pública. Para aprimorar o conhecimento sobre os fatores que podem contribuir para transmissão vertical da sífilis, mais estudos são necessários. Diante da elevada taxa de detecção em gestantes e dos possíveis eventos adversos da sífilis no Brasil, o objetivo foi avaliar a associação das características individuais e clínicas de sífilis com a incidência de sífilis congênita em gestantes. Métodos: Este estudo retrospectivo foi realizado em um município de médio porte no Estado de São Paulo. Foram usadas as fichas de notificação do Sistema de Informação de Agravos de Notificação e o desfecho do estudo foi a ocorrência de sífilis congênita. Foram realizadas análises bivariadas e regressão logística com as variáveis que obtiveram valores de p<0,25. Resultados: As maioria das gestantes tinha 20-34 anos (62,2%), era branca (63,2%), com escolaridade fundamental incompleta (35,4%). A ocorrência de sífilis congênita esteve associada ao diagnóstico de sífilis materno no terceiro trimestre de gestação (p<0,001) e com a não realização de teste treponêmico durante o pré-natal (p=0,014). Houve maior risco para a ocorrência de sífilis congênita os casos com diagnóstico tardio na gestação (OR=16,48; IC95% 3,22-84,26) e classificação clínica terciária/latente (OR=7,62; IC95% 1,40-41,54). Conclusão: Os principais fatores de risco para ocorrência de sífilis congênita foram o diagnóstico materno no terceiro trimestre de gestação e classificação clínica terciária/latente, reforçando a importância de um exame pré-natal de qualidade e em tempo oportuno.(AU)

Justificación y objetivos: La sífilis es una Infección de Transmisión Sexual con tratamiento accesible y de bajo coste, sin embargo, es considerada un problema de salud pública. Se necesitan más estudios para mejorar el conocimiento sobre los factores que pueden contribuir a la transmisión maternoinfantil de la sífilis. Dada su alta tasa de detección en gestantes y los posibles eventos adversos de la sífilis en Brasil, el objetivo fue evaluar la asociación de las características individuales y clínicas de la sífilis con la incidencia de sífilis congénita en gestantes. Métodos: Estudio retrospectivo realizado en una ciudad de mediano porte del Estado de São Paulo. Fueran utilizados formularios de notificación obligatoria del Sistema de Información de Enfermedades de Declaración Obligatoria y el desenlance fue la ocurrencia de sífilis congénita. Se realizaron análisis bivariados y regresión logística con las variables que obtuvieron p-value<0,25. Resultados: La mayoría de las mujeres embarazadas tenían entre 20 y 34 años (62,2%), eran blancas (63,2%), con instrucción primaria incompleta (35,4%). La aparición de sífilis congénita se asoció con el diagnóstico de sífilis materna en el tercer trimestre del embarazo (p<0,001) y con la no realización de prueba treponémica durante el prenatal (p=0,014). Hubo un mayor riesgo de sífilis congénita en los casos diagnosticados tardíamente en el embarazo (OR=16,48; IC95% 3,22-84,26) y clasificación clínica terciaria/latente (OR=7,62; IC95% 1,40-41,54). Conclusiones: Los principales factores de riesgo de aparición de sífilis congénita fueron el diagnóstico materno en el tercer trimestre de gestación y la clasificación clínica terciaria/tardía, lo que refuerza la importancia de una atención prenatal de calidad y oportuna.(AU)

Analgesia em pacientes de trauma no serviço de emergência / Analgesia in trauma patients in emergency department / Analgesia en pacientes de trauma en el servicio de emergencia

Objetivo avaliar a eficácia da analgesia e a concordância entre as escalas Numérica e de Faces em pacientes de trauma no serviço de emergência. Método: estudo transversal com 173 pacientes, realizado de fevereiro-2013 a setembro-2014. A dor foi avaliada na admissão e uma hora após analgesia, pelas escalas Numérica e de Faces. Para comparar a dor antes e após analgesia, utilizou-se o Coeficiente de Correlação de Spearman e, para analisar a concordância entre as escalas, o Índice Kappa. Resultados: na admissão, a maioria dos pacientes relatou dor moderada e intensa. Houve melhora da dor, porém 36,0% dos pacientes permaneceram com dor leve e 33,7% moderada, necessitando de complementação analgésica. A concordância entre as escalas foi considerável antes da analgesia (Kappa = 0,31; p-valor <0,0001) e moderada após (Kappa = 0,56; p-valor <0,0001). Conclusão: a maioria dos pacientes obteve melhora da dor após analgesia, sendo que houve concordância entre as escalas.

Objective: to evaluate the effectiveness of analgesia and the agreement between the Numerical and Faces scales in trauma patients in the emergency department. Method: a cross-sectional study with 173 patients, performed from February 2013 to September 2014. Pain was evaluated at admission and one hour after analgesia, using the Numerical and Faces scales. To compare pain before and after analgesia, the Spearman Correlation Coefficient was used and, to analyze the agreement between the scales, the Kappa Index. Results: At admission, the majority of patients reported moderate and severe pain. There was pain relief, but 36.0% of patients remained with mild pain and 33.7% moderate pain, requiring analgesic supplementation. The agreement between the scales was considerable before analgesia (Kappa = 0.31, p-value <0.0001) and moderate after (Kappa = 0.56, p-value <0.0001). Conclusion: the majority of patients obtained pain relief after analgesia, and there was agreement between the scales.

Objetivo: evaluar eficacia de analgesia y concordancia entre las escalas Numérica y de Faces en pacientes de trauma en servicio de emergencia. Método: Estudio transversal con 173 pacientes, realizado de febrero-2013 a septiembre-2014. Dolor fue evaluado en admisión y una hora después de analgesia, por escalas Numérica y de Faces. Para comparar dolor antes y después de analgesia, se utilizó el Coeficiente de Correlación de Spearman, para analizar la concordancia entre las escalas, el Índice Kappa. Resultados: en admisión, la mayoría de pacientes relató dolor moderado e intensa. Se ha mejorado el dolor, pero el 36,0% de pacientes permanecieron con dolor leve y el 33,7% moderado, necesitando de complementación analgésica. La concordancia entre las escalas fue considerable antes de analgesia (Kappa = 0,31; p-valor <0,0001) y moderada después (Kappa = 0,56; p-valor <0,0001). Conclusión: la mayoría de pacientes obtuvo mejora del dolor después de analgesia, y hubo concordancia entre las escalas.

Sarcopenia in elderly hospitalized coronary patients / Sarcopenia en pacientes coronarios hospitalizados

ABSTRACT Sarcopenia is a syndrome characterized by the progressive and widespread loss of skeletal muscle mass and strength, with a risk of adverse outcomes such as disability, reduced quality of life and death. Objective: To investigate the prevalence of sarcopenia and its associated factors in cardiac patients. Methods: We performed a cross-sectional study in a public hospital in northeast Brazil, involving patients aged ≥60 years with coronary artery disease. Sarcopenia was determined by muscle mass (bioelectrical impedance analysis) and skeletal muscle mass index by a predictive equation, muscle strength (measured by grip strength) and physical performance (driving speed test). We tested relationships between sarcopenia and socioeconomic, demographic, clinical, nutritional and lifestyle variables. Results: We evaluated 148 patients, with an average age of 73.9±7.4years. We observed a prevalence of sarcopenia of 62.8%; of which 72% were classified as having severe sarcopenia. The variables associated with sarcopenia were male sex (p= 0.014), age >80 years (p= 0.005), and being malnourished according to BMI (p< 0.001), arm circumference (p= 0.006) and calf circumference (p= 0.045); the other variables were not statistically significant. Conclusion: The prevalence of sarcopenia in our sample was high. We found that sarcopenia related to sex, age, and nutritional status.

RESUMEN La sarcopenia se define como un síndrome caracterizado por una pérdida progresiva y generalizada de la masa muscular y la fuerza del esqueleto, con un riesgo de resultados adversos como la discapacidad, la reducción de la calidad de vida y de muerte. Objetivo: Investigar la prevalencia de sarcopenia y sus factores asociados en pacientes cardíacos Métodos: Se realizó un estudio transversal en el hospital público del noreste de Brasil, en el que participaron pacientes mayores de 60 años con enfermedad coronaria. La sarcopenia fue determinada por la masa muscular (análisis de impedancia bioeléctrica y ecuación predictiva para determinar el índice de masa muscular esquelético), la fuerza muscular (medida por la fuerza de agarre) y el rendimiento físico (prueba de velocidad de conducción). Entre la asociación de variables se consideraron aspectos socioeconómicos, demográficos, clínicos, nutricionales y de estilo de vida. Resultados: Fueron evaluados 148 pacientes, con una edad promedio de 73,9±7,4 años. Se observó una prevalencia de sarcopenia del 62,8%; incluyendo un 72% clasificado como severamente sarcopénico. Las variables asociadas a sarcopenia fueron sexo masculino (p= 0,014), edad > 80 años (p= 0,005) y desnutrida según IMC (p< 0,001), CB (p= 0,006) y CP (p= 0,045); las otras variables no fueron estadísticamente significativas. Conclusión: La prevalencia de sarcopenia fue mayor, se encontró en una asociación con el género, un aumento en la edad, y el estado nutricional desfavorable.

Sarcopenia and sarcopenic obesity as prognostic predictors in hospitalized elderly patients with acute myocardial infarction / Relação entre sarcopenia e obesidade sarcopênica como preditores de prognóstico em pacientes idosos hospitalizados com infarto agudo do miocárdio

ABSTRACT Objective: To investigate the potential value of sarcopenia and sarcopenic obesity as prognostic predictors in hospitalized elderly patients with acute myocardial infarction. Methods: A cross-sectional study based on data collected from elderly patients with acute myocardial infarction, admitted to a public hospital located in the Northeastern region of Brazil, from April to July 2015. The diagnosis of sarcopenia was based on muscle mass, muscle strength and physical performance measurements. Cardiovascular risk and prognostic markers, such as troponin and creatine kynase MB isoenzyme values, acute myocardial infarction classification according to ST segment elevation, and thrombolysis in myocardial infarction score were used. Results: The sample comprised 99 patients with mean age of 71.6 (±7.4) years. Prevalence of sarcopenia and sarcopenic obesity was 64.6% and 35.4%, respectively. Sarcopenia was more prevalent among males (p=0.017) aged >80 years (p=0.008). Thrombolysis in myocardial infarction was the only marker of cardiovascular risk significantly associated with sarcopenia (p=0.002). Conclusion: Prevalence of sarcopenia was high and associated with thrombolysis in myocardial infarction risk score. Sarcopenic obesity affected approximately one-third of patients and was not associated with any of the prognostic predictors.

RESUMO Objetivo: Verificar a relação entre sarcopenia e obesidade sarcopênica como preditores de prognóstico em pacientes idosos com infarto agudo do miocárdio internados. Métodos: Estudo transversal envolvendo pacientes idosos com infarto agudo do miocárdio, hospitalizados no período de abril a julho de 2015, em serviço público, no Nordeste brasileiro. A sarcopenia foi determinada por meio das medidas de massa muscular, força muscular e desempenho físico. Foram utilizados os marcadores de risco cardiovascular e de prognóstico, como os valores de troponina e da isoenzima MB da creatinina quinase, classificação do infarto agudo do miocárdio de acordo com a elevação do segmento ST e o escore de risco de trombólise em infarto do miocárdio. Resultados: Foram avaliados 99 pacientes, com média de idade de 71,6 (±7,4) anos. Verificou-se prevalência de sarcopenia de 64,6% e 35,4% de obesidade sarcopênica. A sarcopenia foi mais prevalente no sexo masculino (p=0,017), na faixa etária >80 anos (p=0,008). Dentre os marcadores de risco cardiovascular, apenas o escore de risco trombólise em infarto do miocárdio esteve estatisticamente associado à sarcopenia (p=0,002). Conclusão: A prevalência da sarcopenia foi elevada e se associou com o escore de risco de trombólise em infarto do miocárdio. A obesidade sarcopênica acometeu cerca de um terço dos pacientes e não se associou a nenhum parâmetro preditor prognóstico.

Eichhornia azurea decomposition and the bacterial dynamic: an experimental research

Abstract Organic decomposition is a complex interaction between chemical, physical and biological processes, where the variety of aquatic vascular plants is essential for the trophic dynamics of freshwater ecosystems. The goal of this study was to determine the aquatic macrophyte Eichhornia azurea (Sw.) Kunth decomposition rate, the time relation with the limnological parameters, and whether this relationship is a result of decomposition processes. To that end, we collected water and leaves of E. azurea in Surf Leopoldo, PR. The experiment consisted of two treatments: 25 containers with 450 mL of water and 0.8 g of biomass dry weight were used with or without the addition of macrophytes. Samples were collected in triplicate at times 0, 3 h, 6 h, 12 h, 24 h, 72 h, 120 h, 168 h and 240 h. When the container was removed, the plant material was dried in an oven. After 48 h, the material was measured to obtain the final dry weight. Analyses of pH, conductivity, dissolved oxygen, total phosphorus N-ammonia (NH4), soluble reactive phosphorus (PO4) and dissolved organic carbon were performed, and the decomposition rate was calculated. The results showed significant temporal variation of limnological parameters in the study. Additionally, dissolved oxygen, conductivity, dissolved organic carbon and total phosphorus were correlated with the dry weight of the biomass, suggesting that E. azurea decomposition significantly interferes with the dynamics of these variables.

Anticardiolipin antibodies and recurrent spontaneous abortion in Brazilianwomen / Anticardiolipin antibodies and recurrent spontaneous abortion in Brazilianwomen

Aims: To determine the frequency of anti-cardiolipin antibodies (aCL) in women with previous history of recurrent spontaneous abortion (RSA).Methods: Medical records from pregnant women seen from April 2005 to December 2008 at the High-Risk Pregnancy Unit at the Hospital de Base from FUNFARME (Fundação Faculdade Regional de Medicina), in São José do Rio Preto, São Paulo, Brazil, were revised. Patients olderthan 18 years who had at least two spontaneous abortions and who were tested for aCL wereincluded in the study. Data on maternal age, number of miscarriages and the results of serological tests for aCL were recorded. The exact Fisher's test was used to compare the results. A p value less than 0.05 was considered significant.Results: During the study period a total of 294 pregnant women were seen, from whom 44 consecutive women fulfilled the inclusion criteria. The overall mean age was 33.8±5.4 years (range: 22 to 44; median: 34). Eighteen (40.9%) patients were reagent for aCL and 26 (59.1%) non-reagent,and the difference between their mean age was not statistically significant (reagent: 34.6±5.8 years; non reagent: 33.2±5.2 years, p=0.4001). Fourteen (77.8%) patients presented IgM aCL and six (33.2%), IgG aCL. Two patients (11%) were reagent for both IgM and IgG aCL. In the most of cases the aCL antibody titers were compatible with low risk for pregnancy morbidity. The number of abortions ranged from two to six. The average number of abortions among those reagent for aCL was 3.5±1.1 and in those non-reagent was 2.9±1.1 (p=0.0813). Conclusions: The frequency of aCL was elevated among patients with a history of RSA,especially those having higher number of fetal losses. Among women with at least two spontaneousabortions, the mean number of abortions was not significantly different between those reagent for aCL and those non reagent.

Objetivos: Avaliar a frequência de anticorpos anticardiolipina (aCL) em mulheres comhistória prévia de aborto espontâneo recorrente (AER).Métodos: No período de abril de 2005 a dezembro de 2008 foram avaliados os dados deprontuários de gestantes atendidas no Ambulatório de Gestação de Alto Risco do Hospital de Baseda Fundação Faculdade Regional de Medicina (FUNFARME), em São José do Rio Preto, SãoPaulo, Brasil. Foram incluídas neste estudo pacientes com idade acima de 18 anos que tiveram pelomenos dois abortos espontâneos e foram avaliadas para aCL. O teste exato de Fisher foi usado paracomparar os resultados. Valor de p menor que 0,05 foi considerado significante.Resultados: Um total de 294 mulheres gestantes foram avaliadas durante o período doestudo, das quais 44 atendiam aos critérios de inclusão. A média de idade foi 33,8±5,4 anos(variação: 22 a 44; mediana: 34). Dezoito pacientes (40,9%) foram reagentes para aCL e 26 (59,1%)não reagentes, e a diferença entre a média de idade não foi estatisticamente significante (reagentes:34,6±5,8 anos; não reagentes: 33,2±5,2 anos, p=0,4001). Quatorze (77,8%) pacientes apresentaramaCL IgM e seis (33,2%) aCL IgG. Duas pacientes (11%) foram reagentes para ambas as classes deaCL, IgM e IgG. Na maioria dos casos os títulos de anticorpos aCL foram compatíveis com baixorisco para morbidade na gravidez. O número de abortos variou de dois a seis. O número médio deabortos entre as reagentes para aCL foi de 3,5±1,1 e entre as não reagentes foi de 2,9±1,1(p=0,0813).Conclusões: A frequência de aCL foi alta entre as pacientes com história de AER,especialmente entre aquelas que tiveram um maior número de perdas fetais. Entre as mulheres compelo menos dois abortos espontâneos, a média do número de abortos não foi significativamentediferente entre aquelas reagentes e não reagentes para aCL.

Relationship between bacterial density and abiotic factors at different sediment depths of lakes in the Upper Paraná River floodplain / Relação entre densidade bacteriana e fatores abióticos em diferentes profundidades do sedimento em lagoas da planície de inundação do Alto Rio Paraná

River-floodplain systems are known for their heterogeneity of habitats and the hydrological pulse, the main driving force, which increases nutrient concentrations at the onset of the flood due to leaching from the littoral region and decomposition. This decaying organic matter tends to be deposited in the sediment, where occur biogeochemical processes associated with microorganisms. This study aimed to characterize the vertical distribution of bacterial density in the sediment strata of six environments of the Upper Paraná River floodplain, checking similarity as for bacterial density and physical and chemical conditions. To this end, we analyzed the following factors: total phosphorus, total Kjeldahl nitrogen, levels of organic and inorganic material, oxidation potential and particle size. The results evidenced a gradient of vertical distribution of bacterial density, with predominance of cocci, which possibly indicates no nutrient limitation in this limnic compartment. The analysis of variance was applied to determine significant differences between the layers of the sediment and environments. It can be observed a tendency of deposition of total-P and MI within the upper layers of all environments. More reducing potentials in the initial layers indicate a higher bacterial activity, since this region possesses a greater availability of most easily decomposable material.

Sistemas rios-planície de inundação são conhecidos pela sua heterogeneidade de habitats e pelo pulso hidrológico, principal função de força atuante, que aumenta as concentrações de nutrientes no início devido à lixiviação da região litorânea e à decomposição. Essa matéria orgânica tende a ser depositada no sedimento, onde ocorrem processos biogeoquímicos associados a microrganismos. O objetivo deste estudo foi caracterizar a distribuição vertical da densidade bacteriana em estratos do sedimento de seis ambientes da planície de inundação do Alto Rio Paraná, verificando a similaridade entre os mesmos em relação à densidade bacteriana e condições físicas e químicas. Foram analisados os seguintes fatores: Fósforo total (P-total), nitrogênio total Kjeldahl (NTK), material orgânico (MO) e inorgânico (MI), potencial oxidativo e granulometria. Os resultados mostraram um gradiente de distribuição vertical da densidade bacteriana, com predomínio da forma cocos, possivelmente indicando que não há limitação de nutrientes nos estratos. Análise multivariada mostrou grupamentos por ambientes, ressaltando a grande heterogeneidade de condições limnológicas e de habitats. Pôde-se observar uma tendência de deposição de P-total e MI nas ultimas camadas de todos os ambientes. Potenciais mais redutores nas camadas iniciais indicam maior atividade bacteriana, visto que nesta região há maior disponibilidade material mais facilmente decomponível.

Evaluation of knowledge on oral health, malocclusions and non- nutritive habits of daycare educators

AIM: The purpose of this study was to evaluate daycare educators' knowledge on oral health, malocclusions and non-nutritive habits and how to address these issues. Educators were also investigated on whether or not they had received previous instructions on oral health and the quality of such information. MATERIAL AND METHODS: A survey was conducted using a questionnaire, given to daycare educators of Araraquara (SP, Brazil). The structured questionnaire had close-ended questions, and was divided into three sections according to subject matter. RESULTS: Based on the analyzed questionnaires (n=143), most educators showed reasonable knowledge on oral health (72%) and non-nutritive habits (52.4%), although 89.5% of them had received previous instructions on the subject. Chi-square test showed no association between the level of knowledge among educators and the variables: age, type of school and self assessment of knowledge. CONCLUSIONS: These professionals need additional information about oral health in order to address these topics through educational practices, since educators are the best suited professionals to teach and motivate children.

Divergências de Tratamento do Cisto Dentígero: Revisão Sistemática / Differences in the treatment of a dentigerous cyst: a systematic review

Objetivo: Analisar o tratamento adequado para o cisto dentígero em função da idade. Método: Uma busca na base de dados Pubmed foi realizada, e o resumo de todos os artigos da busca eletrônica foram avaliados de acordo com a pertinência para o estudo. Resultados: Oito artigos foram selecionados, e a grande maioria destes relacionava a marsupialização como forma de tratamento para o cisto dentígero. Os estudos mostraram que normalmente os dentes erupcionam espontaneamente em até 100 dias após a realização da marsupialização, porém é necessário considerar alguns fatores, como idade do paciente, angulação, estágio de formação radicular e se há espaço interdental suficiente. Conclusões: Nos estudos analisados, o protocolo de tratamento do cisto dentígero para os indivíduos adultos é a enucleação, e, para crianças e adolescentes, a preferência é a marsupialização devido à preservação da estrutura dental.

Objective: To analyze what is the proper treatment for a dentigerous cyst. Methods: A search of the Pubmed database was performed and the summary of all the resulting articles were evaluated on the basis of their relevance to the study. Results: Eight papers were selected and the vast majority of these dealt with marsupialization as a form of treatment for a dentigerous cyst. Studies have shown that teeth usually erupt spontaneously within 100 days of marsupialization, but it is necessary to consider factors such as patient age, angle, stage of root formation and whether there is enough interdental between. Conclusion: In the studies examined the treatment protocol for a dentigerous cyst is enucleation. However, for children and adolescents the preferred treatment is marsupialization, owing the preservation of tooth structure.

Bacterioplankton features and its relations with doc characteristics and other limnological variables in Paraná river floodplain environments (PR/MS-Brazil)

Since the introduction of the Microbial Loop concept, many studies aimed to explain the role of bacterioplankton and dissolved organic carbon (DOC) in aquatic ecosystems. Paraná River floodplain system is a very complex environment where these subjects were little explored. The aim of this work was to characterize bacterial community in terms of density, biomass and biovolume in some water bodies of this floodplain and to verify its temporal variation and its relation with some limnological variables, including some indicators of DOC quality, obtained through Ultraviolet-visible (UV-VIS) and fluorescence spectroscopic analysis. Bacterial density, biomass and biovolume are similar to those from other freshwater environments and both density and biomass were higher in the period with less rain. The limnological and spectroscopic features that showed any relation with bacterioplankton were the concentrations of N-NH4 and P-PO4, water transparency, and some indicators of DOC quality and origin. The analysis of these relations showed a possible competition between bacterioplankton and phytoplankton for inorganic nutrients and that the DOC used by bacterioplankton is labile and probably from aquatic macrophytes.