Combining Passive Sampling and Dosing to Unravel the Contribution of Hydrophobic Organic Contaminants to Sediment Ecotoxicity.

Contaminated sediments are ubiquitous repositories of pollutants and cause substantial environmental risks. Results of sediment bioassays remain difficult to interpret, however, as observed effects may be caused by a variety of (un)known stressors. This study aimed therefore to isolate the effects of hydrophobic organic contaminants from other (non)chemical stressors present in contaminated sediments, by employing a newly developed passive sampling-passive dosing (PSPD) test. The results showed that equilibrium partitioning between pesticides or polyaromatic hydrocarbons (PAHs) in contaminated sediments and a silicone rubber (SR) passive sampler was achieved after 1-3 days. Chlorpyrifos concentrations in pore water of spiked sediment matched very well with concentrations released from the SR into an aqueous test medium, showing that SR can serve as a passive dosing device. Subjecting the 96 h PSPD laboratory bioassay with nonbiting midge (Chironomus riparius) larvae to field-collected sediments showed that at two locations, concentrations of the hydrophobic organic contaminant mixtures were high enough to affect the test organisms. In conclusion, the developed PSPD test was able to isolate the effects of hydrophobic organic contaminants and provides a promising simplified building block for a suite of PSPD tests that after further validation could be used to unravel the contribution of hydrophobic organic chemicals to sediment ecotoxicity.

[Nasal toilet in infants with rhinitis: nasal passage crucial, so treat with xylometazoline]. / Neustoilet bij zuigelingen met rinitis.

A good nasal passage is crucial for neonates and infants, as they rely on obligate nasal breathing. Feeding problems and dyspnoea are commonly seen in infants with nasal obstruction.In this article, we emphasize the importance of relieving nasal congestion caused by an infection. An effective therapy to reduce nasal obstruction, caused by mucus, is rinsing with saline. Xylometazoline can be added if the effect of saline is insufficient. However, guidelines are often cautious with prescribing nasal decongestants in infants. These recommendations are mainly based on case reports, and often concern overdoses or other medication than xylometazoline. The risk of severe side effects with xylometazoline in young children is low if the dosage is adequate.

Smarter Sediment Screening: Effect-Based Quality Assessment, Chemical Profiling, and Risk Identification.

Sediments play an essential role in the functioning of aquatic ecosystems but simultaneously retain harmful compounds. However, sediment quality assessment methods that consider the risks caused by the combined action of all sediment-associated contaminants to benthic biota are still underrepresented in water quality assessment strategies. Significant advancements have been made in the application of effect-based methods, but methodological improvements can still advance sediment risk assessment. The present study aimed to explore such improvements by integrating effect-monitoring and chemical profiling of sediment contamination. To this end, 28 day life cycle bioassays with Chironomus riparius using intact whole sediment cores from contaminated sites were performed in tandem with explorative chemical profiling of bioavailable concentrations of groups of legacy and emerging sediment contaminants to investigate ecotoxicological risks to benthic biota. All contaminated sediments caused effects on the resilient midge C. riparius, stressing that sediment contamination is ubiquitous and potentially harmful to aquatic ecosystems. However, bioassay responses were not in line with any of the calculated toxicity indices, suggesting that toxicity was caused by unmeasured compounds. Hence, this study underlines the relevance of effect-based sediment quality assessment and provides smarter ways to do so.

The association of early combined lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients.

BACKGROUND: The development of renal and liver dysfunction may be accompanied by initially subtle derangements in the gluconeogenetic function. Discrepantly low glucose levels combined with high lactate levels might indicate an impaired Cori cycle. Our objective was to examine the relation between early lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients. METHODS: Over a 4-year period (2011 to 2014), all adult patients admitted to our adult 48-bed teaching hospital intensive care unit (ICU) for at least 12 h were retrospectively analyzed. Lactate and glucose were regularly measured with point-of-care analyzers in all ICU patients. Lactate and glucose measurements were collected from 6 h before to 24 h after ICU admission. Patients with fewer than four lactate/glucose measurements were excluded. Patients received insulin according to a computer-guided control algorithm that aimed at a glucose level <8.0 mmol/L. Renal dysfunction was defined as the development of acute kidney injury (AKI) within 7 days, and liver function was based on the maximal bilirubin in the 7-day period following ICU admission. Mean lactate and mean glucose were classified into quintiles and univariate and multivariate analyses were related with renal and liver dysfunction and hospital mortality. Since glucose has a known U-shaped relation with outcome, we also accounted for this. RESULTS: We analyzed 92,000 blood samples from 9074 patients (63% males) with a median age of 64 years and a hospital mortality of 11%. Both lactate quintiles (≤1.0; 1.0-1.3; 1.3-1.7; 1.7-2.3; >2.3 mmol/L) and glucose quintiles (≤7.0; 7.0-7.6; 7.6-8.2; 8.2-9.0; >9.0 mmol/L) were related with outcome in univariate analysis (p < 0.001). Acute Physiology and Chronic Health Evaluation (APACHE) IV, lactate, and glucose were associated with renal and liver dysfunction in multivariate analysis (p < 0.001), with a U-shaped relationship for glucose. The combination of the highest lactate quintile with the lowest glucose quintile was associated with the highest rates of renal dysfunction, liver dysfunction, and mortality (p < 0.001) with a significant interaction between lactate and glucose (p ≤ 0.001). CONCLUSIONS: Abnormal combined lactate and glucose measurements may provide an early indication of organ dysfunction. In critically ill patients a 'normal' glucose with an elevated lactate should not be considered desirable, as this combination is related with increased mortality.

The extended reconstruction of the pubocervical layer appears superior to the simple plication of the bladder adventitia concerning anterior colporrhaphy: a description of two techniques in an observational retrospective analysis.

AIMS: This observational retrospective analysis was done to compare the plication of the bladder adventitia with the reconstruction of the pubocervical layer concerning the reoperation rate for recurrent cystocele. METHODS: Sixty-five patients underwent an anterior vaginal wall repair using traditional techniques. In 11 patients, the prolapse was corrected by simply plicating the adventitia of the posterior bladder wall (group A), and in 54 patients the pubocervical layer was rebuilt using structures of the endopelvic fascia following far lateral dissection of the vaginal flaps (group B). The anatomical state was documented via the Pelvic Organ Prolapse Quantification system. RESULTS: The overall reoperation rate of cystoceles was 6% after a mean follow-up of 2 years. Three out of 11 patients of group A and 1/54 patients of group B underwent repeat surgery (p < 0.005). No complications were observed in group A (0/11). In contrast, seven complications were related to the reconstruction of the pubocervical layer (7/54, p > 0.05). Two patients presented with ureteral obstruction, one of them requiring temporary nephrostomy. CONCLUSION: Compared with the plication of the bladder adventitia, the reoperation rate after reconstruction of the pubocervical layer is diminished. However, because of potential risks of ureteral injury, the procedure demands serious precaution.