Biofilm composition in the Olt River (Romania) reservoirs impacted by a chlor-alkali production plant.

Freshwater biofilms can be useful indicators of water quality and offer the possibility to assess contaminant effects at the community level. The present field study examines the effects of chlor-alkali plant effluents on the community composition of biofilms grown in the Olt River (Romania) reservoirs. The relationship between ambient water quality variables and community composition alterations was explored. Amplicon sequencing revealed a significant modification of the composition of microalgal, bacterial and fungal communities in the biofilms collected in the impacted reservoirs in comparison with those living in the uncontaminated control reservoir. The abundance corrected Simpson index showed lower richness and diversity in biofilms collected in the impacted reservoirs than in the control reservoir. The biofilm bacterial communities of the impacted reservoirs were characterized by the contaminant-tolerant Cyanobacteria and Bacteroidetes, whereas microalgal communities were predominantly composed of Bacillariophyta and fungal communities of Lecanoromycetes and Paraglomycetes. A principal component analysis revealed that major contaminants present in the waste water of the chlor-alkali production plant, i.e. Na+, Ca2+, Cl- and Hg, were correlated with the alteration of biofilm community composition in the impacted reservoirs. However, the biofilm composition was also influenced by water quality variables such as NO3-, SO42-, DOC and Zn from unknown sources. The results of the present study imply that, even when below the environmental quality standards, typical contaminants of chlor-alkali plant releases may affect biofilm composition and that their impacts on the microbial biodiversity might be currently overlooked.

Influence of chemical speciation and biofilm composition on mercury accumulation by freshwater biofilms.

Mercury (Hg) is a pollutant of high concern for aquatic systems due to the biomagnification of its methylated form along the food chain. However, in contrast to other metals, gaining knowledge of its bioavailable forms for aquatic microorganisms remains challenging, making Hg risk assessment difficult. Ubiquitous and sessile freshwater biofilms are well known to accumulate and to transform Hg present in their ambient environment. The present study thus aims to evaluate whether non-extractable (proxy of intracellular) Hg accumulated by biofilms could be a good indicator of Hg bioavailability for microorganisms in freshwater. To that end, the link between Hg concentration and speciation, as well as biofilm composition (percentage of abiotic, biotic, chlorophyll and phycocyanin-fractions and abundance of dsrA, gcs, merA and hgcA bacterial genes) and biofilm Hg accumulation was examined. The studied biofilms were grown on artificial substrata in four reservoirs along the Olt River (Romania), which was contaminated by Hg coming from chlor-alkali plant effluents. The 0.45 µm-filterable Hg concentrations in ambient waters were measured and inorganic IHg speciation was modelled. Biofilms were analyzed for their non-extractable IHg and methylmercury (MeHg) contents as well as for their composition. The non-extractable IHg content was related, but not significantly, to the concentration of total IHg (r2 = 0.88, p = 0.061) whereas a significant correlation was found with the predicted IHg concentration that is not bound to dissolved organic matter (r2 = 0.95, p = 0.027), despite its extremely low concentrations (10-25 M), showing a limitation of the thermodynamic Hg modelling to predict Hg bioavailability. The studied biofilms were different in biomass and composition and a principal component analysis showed that the non-extractable IHg content correlated with the abundance of the merA and hgcA genes, while MeHg accumulation was only linked with the abundance of the rRNA 16S gene. The present study suggests that non-extractable IHg concentrations in biofilms are a useful proxy of IHg bioavailable forms in waters whereas the hgcA and merA genes are good biomarkers of both biofilm IHg exposure and bioavailability.

Integral multidisciplinary approach in a patient with chronic complete spinal cord injury and hip disarticulation.

STUDY DESIGN: Case report. OBJECTIVES: To highlight the importance of the integral multidisciplinary management of a patient with complete chronic spinal cord injury and hip disarticulation secondary to pressure ulcers (PU). SETTING: Mexico City. METHODS: The case of a 40-year-old male violinist with a spinal cord injury, American Spinal Injury Association Impairment Scale A and neurological level T4, is reported. The patient initiated with bilateral ischiatic, left trochanteric and sacral PU. The ulcers were complicated with infection with sluggish evolution. Thus, it was decided a multidisciplinary management by means of left hip disarticulation and elaboration of a cosmetic prosthesis and the manufacture of a viscous elastic foam cushion for the prevention of new PU. The patient was quickly included in his professional and social activities. CONCLUSION: This study proves that multidisciplinary management of patients with spinal cord injury with complications such as the presence of PU that are resistant to noninvasive treatment can be the solution for the patient's reintegration into their normal life with adequate quality of life.

Peroxidases have more functions than a Swiss army knife.

Plant peroxidases (class III peroxidases) are present in all land plants. They are members of a large multigenic family. Probably due to this high number of isoforms, and to a very heterogeneous regulation of their expression, plant peroxidases are involved in a broad range of physiological processes all along the plant life cycle. Due to two possible catalytic cycles, peroxidative and hydroxylic, peroxidases can generate reactive oxygen species (ROS) (*OH, HOO*), polymerise cell wall compounds, and regulate H2O2 levels. By modulating their activity and expression following internal and external stimuli, peroxidases are prevalent at every stage of plant growth, including the demands that the plant meets in stressful conditions. These multifunctional enzymes can build a rigid wall or produce ROS to make it more flexible; they can prevent biological and chemical attacks by raising physical barriers or by counterattacking with a large production of ROS; they can be involved in a more peaceful symbiosis. They are finally present from the first hours of a plant's life until its last moments. Although some functions look paradoxical, the whole process is probably regulated by a fine-tuning that has yet to be elucidated. This review will discuss the factors that can influence this delicate balance.

Outcome in children receiving continuous venovenous hemofiltration.

OBJECTIVE: Continuous venovenous hemofiltration (CVVH) alone or with dialysis (D) has become an important supportive therapy for critically ill children with acute renal failure. Previous reports of pediatric patient outcome either mix CVVH/D with other renal replacement modalities or do not examine severity of illness. The current study examines only outcomes of children receiving CVVH/D using Pediatric Risk of Mortality (PRISM) scores to control for severity of illness. PATIENTS: Twenty-one patients (mean age: 8.8 +/- 6.3 years; mean weight: 28.3 +/- 20.8 kg) received 22 courses of CVVH/D. OUTCOMES: Nine (42.8%) of 21 patients survived. Nine (75%) of 12 deaths occurred within 25 days of pediatric intensive care unit (PICU) admission. Mean PRISM score at PICU admission and CVVH initiation were 13.1 +/- 5.8 and 15.4 +/- 8.9, respectively. Mean patient weight, age, PRISM score at PICU admission and at CVVH/D initiation, maximum pressor number, estimated glomerular filtration rate at CVVH/D initiation and change in mean airway pressure did not differ between survivors and nonsurvivors. The degree of fluid overload at CVVH/D initiation was significantly lower in survivors (16.4% +/- 13.8%) compared with nonsurvivors (34.0% +/- 21.0%), even when controlled for severity of illness by PRISM score. Mean cost of providing CVVH/D accounted for only 1% of total PICU cost per patient. CONCLUSIONS: The pattern of early multiorgan system failure and death, minimal relative cost of CVVH/D provision, and potential for improved outcome with initiation of CVVH/D at lesser degrees of fluid overload are factors that may support early initiation of CVVH/D in critically ill children with acute renal failure.

The C-terminal domains of the GABA(b) receptor subunits mediate intracellular trafficking but are not required for receptor signaling.

GABA(B) receptors are G-protein-coupled receptors that mediate slow synaptic inhibition in the brain and spinal cord. These receptors are heterodimers assembled from GABA(B1) and GABA(B2) subunits, neither of which is capable of producing functional GABA(B) receptors on homomeric expression. GABA(B1,) although able to bind GABA, is retained within the endoplasmic reticulum (ER) when expressed alone. In contrast, GABA(B2) is able to access the cell surface when expressed alone but does not couple efficiently to the appropriate effector systems or produce any detectable GABA-binding sites. In the present study, we have constructed chimeric and truncated GABA(B1) and GABA(B2) subunits to explore further GABA(B) receptor signaling and assembly. Removal of the entire C-terminal intracellular domain of GABA(B1) results in plasma membrane expression without the production of a functional GABA(B) receptor. However, coexpression of this truncated GABA(B1) subunit with either GABA(B2) or a truncated GABA(B2) subunit in which the C terminal has also been removed is capable of functional signaling via G-proteins. In contrast, transferring the entire C-terminal tail of GABA(B1) to GABA(B2) leads to the ER retention of the GABA(B2) subunit when expressed alone. These results indicate that the C terminal of GABA(B1) mediates the ER retention of this protein and that neither of the C-terminal tails of GABA(B1) or GABA(B2) is an absolute requirement for functional coupling of heteromeric receptors. Furthermore although GABA(B1) is capable of producing GABA-binding sites, GABA(B2) is of central importance in the functional coupling of heteromeric GABA(B) receptors to G-proteins and the subsequent activation of effector systems.

Pulmonary infiltrates with eosinophilia syndromes in children.

Pulmonary infiltrates with eosinophilia (PIE) are a group of heterogeneous disorders having the common findings of lung disease and eosinophilia in the peripheral blood, bronchoalveolar lavage fluid, or pulmonary interstitium. Eleven cases of PIE syndromes were identified through a retrospective and prospective chart review: drug-induced (2), acute eosinophilic pneumonia (3), infant pulmonary eosinophilia (2), parasite-induced (2), Churg-Strauss syndrome (1), and atypical chronic PIE (1). Patient demographics, clinical presentation, and disease severity varied considerably among groups. Therapeutic interventions included bronchodilators (10), oxygen (7), corticosteroids (9), and mechanical ventilation (3). A single patient with acute eosinophilic pneumonia died. Our experience suggests that PIE syndromes are rare in childhood and that clinical presentation can vary widely. Because of the potential for significant morbidity and mortality, aggressive diagnostic evaluations are warranted, particularly in children with respiratory failure of unknown etiology.

Prevención de la Hipoxia al administrar oxígeno por boquilla durante el estudio Endoscópico con sedación / Hypoxia prevention with a modified piece mouth during sedation in Endoscopy studies

Antecedentes: La hipoxia, producida por la sedación durante el estudio endoscópico es capaz de producir taquicardia, sufrimiento miocárdico y cambios del segmento ST en la electrocardiografía. En un paciente joven, de condición física adecuada, quizá no tenga ninguna consecuencia. Sin embargo, la desaturación sostenida a menos del 90 por ciento es el punto en el cual la curva de disociación de la oxihemoglobina se hace muy empinada y puede traer consecuencias serias en ancianos o en pacientes con cardiopatía isquémica. Objetivo: Corroborar que la aplicación de oxígeno por boquilla durante el estudio endoscópico, corrige la hipoxia producida por la sedación. Material y métodos: Se realizó un estudio en forma abierta, longitudinal, prospectivo, aleatorio y comparativo entre noviembre de 1997 y febrero de 1998, en el que se valoraron dos grupos de 50 pacientes cada uno, sometidos a endoscopia diagnóstica del tubo digestivo alto, bajo sedación con diazepan y nalbufina a dosis respuesta, hasta llevarlos al nivel III de la escala de Wilton modificada. Se monitoreó la frecuencia cardiaca y la SpO2 en el pre, trans y post estudio con oxímetro de pulso, evaluándose los cambios en la saturación de oxígeno arterial. Grupo A con aplicación de oxígeno por boquilla, Grupo B sin oxígeno. Resultados: Con el método estadístico de la prueba "t" de Student aplicado a nuestro estudio, se encontró un aumento significativo en la sturación de oxígeno arterial en el trans y post estudio (p< 0.01) en el grupo A. Conclusiones: El suministro sistémico de oxígeno con flujo bajo por boquilla, evita la hipoxia duante e inmediatamante espués del estudio endoscópico diagnóstico del tubo digestivo alto

Experiencia de 5 años en plastia de hiato y técnica antirreflujo por medio de cirugía endoscópica / Years experience in surgical endoscopic treatment with antirreflux procedures and hernioplasty

Se han elaborado diversas técnicas quirúrgicas para manejar el reflujo gastroesofágico con excelentes resultados, y otros han hecho variantes de estas técnicas. Con el advenimiento de la cirugía laparoscópica, con un poco más de 10 años, ésta se ha convertido en el "estándar de oro" en este padecimiento. Se reporta la experiencia en 170 casos de cirugía antirreflujo por vía laparoscópica durante el período de enero de 1993 a junio de 1998, mediante un estudio retrospectivo, longitudinal, observacional y descriptivo. Se operaron 93 femeninos, 77 masculinos. Rango edad de 14 a 72 años, promedio de 41. Técnica utilizada en 120 casos con cuatro a cinco puertos de 10mm. 15 casos con cuatro puertos de 5mm. Otros 15 con tres puertos de 5mm y uno de 10mm. En 18 utilizamos puertos de mayor calibre y dos más con puertos de 3 y 5mm. A 87 se le realizó funduplicatura Nissen y a 83 Funduplicatura Toupet. A 30 se les realizó colecistectomía, dos vagotomía selectiva, siete plastía de pared, cinco plastía inguinal (una bilateral) y una oclusión tubaria bilateral. Conversión a cirugía abierta en nueve casos. Morbilidad en 16 casos. Disfagia en seis, hemorragia dos, recidiva reflujo cuatró, derrame pleural dos, diarrea dos. Reoperaciones en seis casos. Los resultados obtenidos son comparables con los de otras publicaciones en donde la cirugía antirreflujo por vía laparoscópica es método seguro

Prevalence of IgG and IgM anti-Toxoplasma antibodies in patients with HIV and acquired immunodeficiency syndrome (AIDS)

Com a aparição do vírus de inmunodeficiência humana (VIH), a prevalência de toxoplasmosis tem aumentado demais. Em dos pacientes com o síndrome de inmunodeficiência, a toxoplasmosis é a principal causa de morte. A incidência, de anticorpos nesse tipo de pacientes depende da prevalência da população onde se apresenta a doença. O método de Enzima Inmuno Ensaio absorvemnte (ELISA) foi aplicado a 92 pacientes para determinar si eram positivos a anticorpos anti-Toxoplasma IgG e IgM. O resultado foi: 46 (50.5%) foram seropositivos e un caso apresentou anticorpos IgM. D estos 92 pacientes, 53 apresentavam o virus de inmunodeficiência humana (HIV) y 39 tinham SIDA. A determinação e o "monitoreo" de anticorpos anti-Toxoplasma em pacientes com HIV é indispensável, pois uma taxa elevada destos pacientes pode desenvolver a toxoplasmosis cerebral, a causa principal de morte nessos pacientes.

With the emergence of the human immunodeficiency virus (HIV), in patients with acquired immunodeficiency syndrome (AIDS), Toxoplasma gondii has arisen as an important opportunist pathogenic agent, especially in the central nervous system, being the most common cause of intracerebral lesions. The incidence of Toxoplasma gondii in HIV-infected patients depends principally on the existence of latent Toxoplasma parasitosis in the population affected. Through the enzyme-linked immunosorbent assay (ELISA), IgG and IgM anti-Toxoplasma antibodies were found in 92 patients of which 46 (50.0%) were IgG seropositive, and only one case (1.0%) had IgM antibodies. Of the 92 patients: 53 were HIV seropositives and 39 had AIDS. The detection and monitoring of anti-Toxoplasma antibodies in HIV patients is essential, since in this group there is a high percentage risk of developing cerebral toxoplasmosis, which is the second cause of death in this type of patients.

Safety and efficacy of Virend for topical treatment of genital and anal herpes simplex lesions in patients with AIDS.

Virend (SP-303), a new topical antiviral agent with activity against herpesvirus, was evaluated in a multicenter, double-blind, placebo-controlled Phase II study for safety and effectiveness against recurrent genital herpes lesions in patients with AIDS. The primary endpoints of this study were complete healing of lesions and time to healing. Patients had a history of recurrent genital or anogenital herpes with at least one lesion and positive HSV culture at enrollment. Participants received Virend (15% ointment; 24 patients) or matching placebo (21 patients) three times a day for 21 days. Excluding two patients in the Virend group who received an initial treatment but were lost to follow-up, 9 of 22 (41%) patients treated with Virend experienced complete healing of their lesions compared with three (14%) patients in the placebo group (P = 0.053). Viral culture revealed that 50% of Virend-treated patients and 19% of placebo-treated patients became culture-negative during treatment (P = 0.06). Based on these preliminary clinical findings, further evaluation of Virend for topical treatment of genital herpes in patients with AIDS is planned.

Prevalence of IgG and IgM anti-Toxoplasma antibodies in patients with HIV and acquired immunodeficiency syndrome (AIDS).

With the emergence of the human immunodeficiency virus (HIV), in patients with acquired immunodeficiency syndrome (AIDS), Toxoplasma gondii has arisen as an important opportunist pathogenic agent, especially in the central nervous system, being the most common cause of intracerebral lesions. The incidence of Toxoplasma gondii in HIV-infected patients depends principally on the existence of latent Toxoplasma parasitosis in the population affected. Through the enzyme-linked immunosorbent assay (ELISA), IgG and IgM anti-Toxoplasma antibodies were found in 92 patients of which 46 (50.0%) were IgG seropositive, and only one case (1.0%) had IgM antibodies. Of the 92 patients: 53 were HIV seropositives and 39 had AIDS. The detection and monitoring of anti-Toxoplasma antibodies in HIV patients is essential, since in this group there is a high percentage risk of developing cerebral toxoplasmosis, which is the second cause of death in this type of patients.

Structure of tris(pentafluorophenyl)phosphine.

C18F15P, Mr = 532.1, monoclinic, P2(1)/c, a = 7.194 (2), b = 17.930 (4), c = 13.834 (2) A, beta = 94.29 (2) degrees, V = 1779 A3, Z = 4, Dm = 2.00, Dx = 1.99 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 3.3 cm-1, F(000) = 1032, T approximately equal to 296 K, final R = 0.055 for 2352 unique observed reflections. The three planar C6F5 groups are twisted about the C-P bonds to give extensive deviations from molecular C3 symmetry similar to those in the crystal structure of triphenylphosphine. The P-C bond lengths and C-P-C bond angles are 1.834 (4), 1.832 (4), 1.824 (4) A and 104.4 (2), 106.0 (2), 99.6 (1) degree, respectively. There are two short C...F non-bonded distances in the structure (2.99, 2.79 A).