Landfill leachate from Municipal Solid Waste: Multi-technique approach for its fine characterization and determination of the thermodynamic and sequestering properties towards some toxic metals.

Landfill leachate is a multicomponent aqueous matrix generated by the percolation of rainwater into the body of a landfill. Considering its content of natural and xenobiotic components, it must be considered as a waste, whose composition depends on type of waste, biodegradation processes, rainwater, composition and compaction of waste and their age; these factors influence the transport, absorption, toxicity, bioaccumulation of the contaminants. Leachates sampled from landfill and downhill piezometers, in periods characterized by different rainfall, were studied by ATR-FTIR and SEM-EDX techniques; analyses were carried out on dried and calcinated residues obtained at T = 383 and 923 K, respectively. The chemical-physical characterization of all the leachates was carried out by using the official methods of analysis, obtaining for many metals and some organic contaminants exceedance of the concentrations with respect to the limits established by the Italian Legislative Decree 152/2006. From potentiometric titrations carried out at T = 298.15 K in NaCl(aq) and applying the Polyprotic Like model, each leachate resulted to have a different composition in terms of COOH and OH groups and various acid-base properties. The interacting ability of leachates with metal cations (Cd2+, Zn2+, Cu2+) was studied by potentiometric and voltammetric (only for Pb2+) techniques in NaCl (NaNO3 for Pb2+) aqueous solutions, at I = 0.15 mol dm-3 and T = 298.15 K, obtaining diverse speciation models and complexes of very different stability. The leachates sequestering ability towards the metal cations was quantified at various pH values using the pL0.5 parameter, proving that each leachate has a different strength of interaction towards the metals, that tends to increase with the pH and confirming that they behave as carriers of contaminants through the soil and towards groundwater, with the consequent problems of contamination and/or environmental disaster and risks for the human health.

Lowe syndrome identified in the offspring of an oocyte donor who was an unknown carrier of a de novo mutation: a case report and review of the literature.

BACKGROUND: Oculocerebrorenal syndrome of Lowe is an X-linked disorder with very low prevalence in the general population. The OCRL gene encodes the protein phosphatidylinositol 4,5-bisphosphate-5-phosphatase, a lipid phosphatase, located in the trans-Golgi network. Point mutations in the OCRL gene cause Lowe syndrome and Dent disease, which are characterized as a multisystemic disorder. The symptoms of Lowe syndrome are expressed primarily as dysfunction of the eyes, kidneys, and the central nervous system. CASE PRESENTATION: This report describes a case of a 31-year-old Georgian woman with a de novo pathogenic mutation causing oculocerebrorenal syndrome of Lowe, who was a volunteer in an oocyte donation program for in vitro fertilization purposes, and the outcome of the treatments of this particular donor's oocyte receivers, describing the implications of the mutation for the children born as a result of the treatments. It raises important medical and ethical issues about the necessity of genetic testing of oocyte donors and the possibility of rare genetic disorders being inherited by the offspring of donors. CONCLUSION: This particular case indicates the legal, medical, and emotional risks of utilizing donor oocytes from phenotypically healthy women, whose genetic constitution is unknown in terms of being silent carriers of rare diseases. In addition, all the necessary actions were followed; the further examinations that are required are mentioned. The donor and the offspring should be further tested. The remaining cryopreserved embryos should be destroyed or preimplantation genetic testing should be performed before they are utilized. Finally, all the people involved, the treated couples and the donor, alongside her family, should follow genetic and psychological counselling.

Electrocatalytic conversion of CO2 to produce solar fuels in electrolyte or electrolyte-less configurations of PEC cells.

The electrocatalytic reduction of CO2 is studied on a series of electrodes (based on Cu, Co, Fe and Pt metal nanoparticles deposited on carbon nanotubes or carbon black and then placed at the interface between a Nafion membrane and a gas-diffusion-layer electrode) on two types of cells: one operating in the presence of a liquid bulk electrolyte and the other in the absence of the electrolyte (electrolyte-less conditions). The results evidence how the latter conditions allow productivity of about one order of magnitude higher and how to change the type of products formed. Under electrolyte-less conditions, the formation of >C2 products such as acetone and isopropanol is observed, but not in liquid-phase cell operations on the same electrodes. The relative order of productivity in CO2 electrocatalytic reduction in the series of electrodes investigated is also different between the two types of cells. The implications of these results in terms of possible differences in the reaction mechanism are commented on, as well as in terms of the design of photoelectrocatalytic (PEC) solar cells.

Quaternary cytoreductive surgery in ovarian cancer: does surgical effort still matter?

BACKGROUND: To evaluate surgical outcome and survival benefit after quaternary cytoreduction (QC) in epithelial ovarian cancer (EOC) relapse. METHODS: We systematically evaluated all consecutive patients undergoing QC in our institution over a 12-year period (October 2000-January 2012). All relevant surgical and clinical outcome parameters were systematically assessed. RESULTS: Forty-nine EOC patients (median age: 57; range: 28-76) underwent QC; in a median of 16 months (range:2-142) after previous chemotherapy. The majority of the patients had an initial FIGO stage III (67.3%), peritoneal carcinomatosis (77.6%) and no ascites (67.3%). At QC, patients presented following tumour pattern: lower abdomen 85.7%; middle abdomen 79.6% and upper abdomen 42.9%. Median duration of surgery was 292 min (range: a total macroscopic tumour clearance could be achieved. Rates of major operative morbidity and 30-day mortality were 28.6% and 2%, respectively.Mean follow-up from QC was 18.41 months (95% confidence interval (CI):12.64-24.18) and mean overall survival (OS) 23.05 months (95% CI: 15.5-30.6). Mean OS for patients without vs any tumour residuals was 43 months (95% CI: 26.4-59.5) vs 13.4 months (95% CI: 7.42-19.4); P=0.001. Mean OS for patients who received postoperative chemotherapy (n=18; 36.7%) vs those who did not was 40.5 months (95% CI: 27.4-53.6) vs 12.03 months (95% CI: 5.9-18.18); P<0.001.Multivariate analysis indentified multifocal tumour dissemination to be of predictive significance for incomplete tumour resection, higher operative morbidity and lower survival, while systemic chemotherapy subsequent to QC had a protective significant impact on OS. No prognostic impact had ascites, platinum resistance, high grading and advanced age. CONCLUSION: Even in this highly advanced setting of the third EOC relapse, maximal therapeutic effort combining optimal surgery and chemotherapy appear to significantly prolong survival in a selected patients 'group'.

Feasibility of surgery after systemic treatment with the humanized recombinant antibody bevacizumab in heavily pretreated patients with advanced epithelial ovarian cancer.

BACKGROUND: The aim of this study was to assess operative feasibility and outcome after bevacizumab treatment (BT) in ovarian cancer (OC) patients. PATIENTS AND METHODS: We retrospectively identified all OC patients operated between April 2006 and September 2010 after BT. RESULTS: We identified 733 OC operations, 10 of which (1.36%) were performed in a mean time of 134 days (range, 10-288) after BT. Indication was secondary cytoreduction in 3 patients (mean days after BT, 181; range, 82-256) and palliation in 7 due to bowel obstruction and/or intestinal perforation or fistula (mean days after BT, 114; range, 10-288). All but 1 acutely operated patients developed a secondary wound healing, but none of the 3 patients after planned cytoreduction did. Of these 3 patients, 1 suddenly died on the 36th postoperative day, presumably of thromboembolism. None of the patients developed postoperatively a gastrointestinal morbidity; however, in 1 patient operated 21 days after BT due to a vesicointestinal fistula the bladder reconstruction could not heal and developed a permanent fistula. CONCLUSIONS: Emergency surgery after BT due to bowel obstruction and/or fistulas seems to be associated with an impaired wound healing in advanced heavily pretreated platinum-resistant OC patients, while this does not appear the case in planned cytoreduction. Prospective evaluations are warranted to assess surgical safety after BT in this special patients' collective.

Application of Glottal Disturbogram as a novel tool for the description of vocal disturbances.

The paper introduces "Glottal Disturbogram" as a new tool for the discrimination, evaluation and representation of glottal disturbances which may be met in pathological voicing or singing. The "Glottal Disturbogram's" principles and related features also suit similar applications such as the acoustics of some families of musical instruments. Disturbogram's computational and display characteristics are presented with the use of both synthetic glottal patterns and real signals obtained from subjects with voice disorders. Results show that Disturbogram may efficiently discriminate and quantify perturbation types, offering a valuable tool in clinical or laboratory investigation of both voice disorders and normal voicing types.

Glucose metabolism, insulin secretion and insulin sensitivity in juvenile hemochromatosis. A case report and review of the literature.

Among specific diabetes subtypes secondary to pancreatopathies, hereditary hemochromatosis is an inherited disorder of iron metabolism resulting in excessive iron overload and tissue damage in various organs. We here report the case of a man with the young-onset form of the disease and describe his glycaemic status before and during venesection therapy. A 25-year old man visited our clinic in Athens, Greece, with hypogonadotropic hypogonadism due to hereditary hemochromatosis. Genetic analysis revealed that he was suffering from the juvenile aggressive form and treatment was initiated with frequent phlebotomies in conjunction with androgen substitution. Within 18 months of therapy ferritin level was normalized and hypogonadism was fully restored. Despite severe iron overload, glucose tolerance remained normal during the various stages of the disease, although alterations in both insulin secretion and sensitivity were detected. Present data indicate that in juvenile hemochromatosis, the efficacy of the chelation therapy and probably the chronic interval required to restore normal iron concentration both play important roles in the formation of glucose metabolism characteristics.

Long-term signal detection, segmentation and summarization using wavelets and fractal dimension: a bioacoustics application in gastrointestinal-motility monitoring.

The current paper describes a wavelet-based method for long-term processing and analysis of gastrointestinal sounds (GIS). Windowing techniques are used to select sequential blocks of the prolonged multi-channel recordings and proceed to various wavelet-domain processing stages. De-noising, significant-activity detection, automated segmentation and extraction of summary curves are applied in an integrated mode, allowing for enhanced content manipulation and analysis. The proposed analysis scheme combines flexible long-term graphical representation tools, while maintaining the ability of quick browsing via visualization and auralization of the detected short-term events. This work is part of a project aiming to implement non-invasive diagnosis over gastrointestinal-motility (GIM) physiology. However, the proposed techniques might be applied to any study of long-term bioacoustics time series.

Iron metabolism and toxicity.

Iron is an essential nutrient with limited bioavailability. When present in excess, iron poses a threat to cells and tissues, and therefore iron homeostasis has to be tightly controlled. Iron's toxicity is largely based on its ability to catalyze the generation of radicals, which attack and damage cellular macromolecules and promote cell death and tissue injury. This is lucidly illustrated in diseases of iron overload, such as hereditary hemochromatosis or transfusional siderosis, where excessive iron accumulation results in tissue damage and organ failure. Pathological iron accumulation in the liver has also been linked to the development of hepatocellular cancer. Here we provide a background on the biology and toxicity of iron and the basic concepts of iron homeostasis at the cellular and systemic level. In addition, we provide an overview of the various disorders of iron overload, which are directly linked to iron's toxicity. Finally, we discuss the potential role of iron in malignant transformation and cancer.

Genetic heterogeneity underlies juvenile hemochromatosis phenotype: analysis of three families of northern Greek origin.

Hereditary hemochromatosis is a genetically heterogeneous disease. Common HFE mutations (C282Y and H63D) are related to the majority of hereditary hemochromatosis cases in populations of Northern European ancestry (HFE1). Juvenile hemochromatosis (JH) is a more severe iron overload disorder, usually presenting at the second decade of life. The gene responsible for JH lies on a genetic locus at chromosome 1q. We have performed a genetic linkage study in three families of Northern Greek origin with typical clinical features of JH. In two families results were in accordance with linkage to chromosome 1q. In one family linkage of the disease to the genetic loci at 1q21, 7q22, and 6p22 was excluded. We suggest that more than one gene may underlie the JH phenotype. This genetic type of hemochromatosis may be designated 1q unlinked juvenile hemochromatosis. Family studies are necessary to establish the genetic diagnosis of JH.

Reporting of conflicts of interest in guidelines of preventive and therapeutic interventions.

BACKGROUND: Guidelines published in major medical journals are very influential in determining clinical practice. It would be essential to evaluate whether conflicts of interests are disclosed in these publications. We evaluated the reporting of conflicts of interest and the factors that may affect such disclosure in a sample of 191 guidelines on therapeutic and/or preventive measures published in 6 major clinical journals (Annals of Internal Medicine, BMJ, JAMA, Lancet, New England Journal of Medicine, Pediatrics) in 1979, 1984, 1989, 1994 and 1999. RESULTS: Only 7 guidelines (3.7%) mentioned conflicts of interest and all were published in 1999 (17.5% (7/40) of guidelines published in 1999 alone). Reporting of conflicts of interest differed significantly by journal (p=0.026), availability of disclosure policy by the journal (p=0.043), source of funding (p < 0.001) and number of authors (p=0.004). In the entire database of 191 guidelines, a mere 18 authors disclosed a total of 24 potential conflicts of interest and most pertained to minor issues. CONCLUSIONS: Despite some recent improvement, reporting of conflicts of interest in clinical guidelines published in influential journals is largely neglected.

Linkage to chromosome 1q in Greek families with juvenile hemochromatosis.

Hereditary hemochromatosis (HH) is a genetically heterogeneous disease. The HFE gene resides on chromosome 6 and its mutations account for the majority of HH cases in populations of northern European ancestry. Recently, two new types of hemochromatosis have been identified: Juvenile hemochromatosis (JH or HFE2), which maps to chromosome 1q21, and an adult form defined as HFE 3, which results from mutations of the TFR 2 gene, located at 7q22. We have performed a linkage study in five unrelated families of Greek origin with non-HFE hemochromatosis. Linkage at the chromosome 1q21 JH locus was detected in affected members with the use of polymorphic markers. Comparison of haplotypes between Greek and Italian JH patients revealed the presence of a common haplotype. However, the fact that many other haplotypes carrying the JH defect were observed in the two populations indicates that the respective mutations may have occurred in different genetic backgrounds. We suggest that hemochromatosis patients without HFE mutations should be evaluated for other possible types of hemochromatosis since hemochromatosis type 3 (HFE3) has a clinical appearance similar to HFE 1, and JH may have a late onset in some cases.

Hereditary hemochromatosis: HFE mutation analysis in Greeks reveals genetic heterogeneity.

Hereditary hemochromatosis (HH) is common among Caucasians; reported disease frequencies vary from 0.3 to 0.8%. Identification of a candidate HFE gene in 1996 was soon followed by the description of two ancestral mutations, i.e., c.845G-->A (C282Y) and c.187C-->G (H63D). To these was recently added the mutation S65C, which may represent a simple polymorphism. The incidence of HH in Greece is unknown but clinical cases are rare. Also unknown is the carrier frequency of the two mutant alleles. A first estimate of the latter is given in the present report. It is based on data from the genetic analysis of 10 unrelated patients of Greek origin who were referred to our center for genotyping and 158 unselected male blood donors. The allele frequencies for the C282Y and H63D mutations were 0.003 and 0.145, respectively. The C282Y allele was detected in 50% of HH patients. This is considerably lower than the frequencies reported for HH patients in the U.S.A. (82%) and France (91 %) and closer to that reported in Italy (64%). Five patients did not carry any known HFE mutation; three may represent cases of juvenile hemochromatosis, given their early onset with iron overload, hypogonadism, and heart disease. We suggest that genetic heterogeneity is more prominent in Southern Europe. It is also possible that the penetrance of the responsible genes is different across the Mediterranean.

Micrococcus luteus: a putative cause of hepatic abscess?

Micrococcus luteus was repeatedly isolated in blood cultures during a prolonged feverish syndrome in a patient who presented with multiple hepatic abscesses as well. In contrast to the literature, this case is not related to prosthetic devices; an untreated limb wound may have been the site of microbial entry.

Tamm-Horsfall protein in reflux nephropathy.

The distribution of Tamm-Horsfall protein, the main protein in normal urine, was studied immunohistologically in the kidneys of 70 pigs with unilateral vesico-ureteric reflux but without outflow obstruction. Strains of Escherichia coli were inoculated in the bladder. Inflammatory changes of reflux nephropathy (chronic pyelonephritis) were found in 52 pigs. There were extra-tubular deposits of Tamm-Horsfall protein in the kidneys of only 26 pigs. These deposits were small, increased in prevalence as the size of inflamed areas increased, and were not associated with deposits of the protein in glomeruli. These findings suggest that escape of Tamm-Horsfall protein from tubules and backwash into glomeruli are not major features of low pressure reflux nephropathy, unlike the findings in outflow obstruction of the lower urinary tract. There was no evidence that a reaction to Tamm-Horsfall protein was important in the pathogenesis of reflux nephropathy.

Hashish smoke interfers with Sidman avoidance in mice.

Hashish smoke has been proved to be active in the Sidman avoidance. Its activity is similar to that of hallucinogens.

Cannabis interferes with nest-building behavior in mice.

Nest-building, a behavioral model shown to be disrupted by hallucinogens, has never been used to answer questions concerning the psychotomimetic effects of delta9-THC. Several fractions of cannabis and tobacco pyrolysis products were tested consecutively in the same procedure. The following drugs were injected i.p. under a saline-drug-saline schedule: d-amphetamine (6 mg/kg), pentobarbital (25 mg/kg), delta9-THC (10 mg/kg, 5 mg/kg, 2.5 mg/kg), the cannabis fractions designated Is (water soluble products), IIs (nonsoluble, nonvolatile products, IIIs (it comprises what is inhaled by a common hashish smoker), and analogous fractions of tobacco pyrolysis products designated IIIB (what is inhaled by a common tobacco smoker), IIB and IB. The effects of delta9-THC (10 mg/kg), IIs, and IIIs were quite similar as far as the disruption of the normal behavioral pattern is concerned. d-Amphetamine, delta9-THC (5 mg/kg), and IIB disrupted the normal behavioral pattern as well. The similarity of the effects of IIs and IIIs was unexpected in view of the different contents of cannabinoids in these fractions. Also unexpected was the similarity of the effects of delta9-THC (10 mg/kg) and IIIs (40 mg/kg containing 7% delta9-THC) as well as the activity of fraction IIIB.