Viability and removal assessment of Escherichia coli and Salmonella spp. by real-time PCR with propidium monoazide in the hygienization of sewage sludge using three anaerobic processes.

Sewage sludge should be stabilized for its beneficial use and pathogens, among other factors, should comply with environmental regulations. Three sludge stabilization process were compared to assess their suitability for producing Class A biosolids: MAD-AT (mesophilic (37 °C) anaerobic digestion (MAD) followed by an alkaline treatment (AT)); TAD (thermophilic (55 °C) anaerobic digester); and TP-TAD (mild thermal (80 °C, 1 h) pretreatment (TP) followed by a TAD). E. coli and Salmonella spp. were determined, differentiating three possible states: total cells (qPCR), viable cells using the propidium monoazide method (PMA-qPCR), and culturable cells (MPN). Culture techniques followed by the confirmative biochemical tests identified the presence of Salmonella spp. in PS and MAD samples, while the molecular methods (qPCR and PMA-qPCR) showed negative results in all samples. The TP + TAD arrangement reduced the concentration of total and viable E. coli cells in a greater extent than the TAD process. However, an increase of culturable E. coli was observed in the corresponding TAD step, indicating that the mild thermal pretreatment induced the viable but non-culturable state in E. coli. In addition, the PMA technique did not discriminate viable from non-viable bacteria in complex matrices. The three processes produced Class A biosolids (fecal coliforms < 1000 MPN/gTS and Salmonella spp, < 3 MPN/gTS) maintaining compliance after a 72 h storage period. It appears that the TP step favors the viable but not culturable state in E. coli cells, a finding that should be considered when adopting mild thermal treatment in sludge stabilization process arrangements.

Screening de primer trimestre de preeclampsia tardía en gestantes de bajo riesgo en un centro de bajo volumen obstétrico: validación externa de un modelo predictivo / First trimester screening of late-onset preeclampsia in a low risk and low volume obstetrical setting: external validation of a predictive model

Fundamento: La validación externa de un modelo predictivo de predicción de preeclampsia tardía en un centro de bajo volumen obstétrico en gestantes de bajo riesgo obstétrico. Métodos: Estudio prospectivo de 174 gestaciones únicas de 11+0 a 13+6 semanas de gestación en la Clínica Universidad de Navarra desde septiembre 2011 a marzo de 2013, que fue considerado como una cohorte de validación de un modelo descrito anteriormente para preeclampsia tardía en el hospital Clínic de Barcelona). Resultados: Un total de 7 (4%) mujeres desarrollaron PE tardía. En la cohorte de validación el área bajo la curva del modelo fue de 0,69 (IC del 95% 0,45 a 0,93). Las tasas de detección para un 5, 10 y 15% de tasas de falsos positivos fueron 21,9, 31,4 y 38,6%. Al comparar las áreas bajo la curva de la cohorte de validación con la cohorte de la construcción, no se encontraron diferencias estadísticamente significativas (p = 0,68). Conclusión: La combinación de la historia clínica materna, la proteína placentaria A-asociada al embarazo y presión arterial media es moderadamente útil para predecir preeclampsia tardía en gestantes de bajo riesgo y en un centro de bajo volumen obstétrico. El modelo predictivo del hospital Clinic de Barcelona es una herramienta válida para predecir preeclampsia tardía en este entorno (AU)

Background: The external validation of predictive model of late preeclampsia in a low volume and low risk obstetrical setting. Methods: A cohort was created of 174 singleton pregnancies of 11+0-13+6 gestational weeks at Clinica Universidad Navarra from September 2011 to March 2013, which was considered as a validation cohort of a previously described model for late PE (Hospital Clinic, Barcelona). Results: A total of 7 (4%) women developed late PE. In the validation cohort the area under the curve of the model was 0.69 (95% CI 0.45-0.93). Detection rates for a 5, 10 and 15% of false positive rates were 21.9, 31.4% and 38.6% respectively. When comparing the areas under the curve of the validation cohort with the construction cohort, no statistical differences were found (p=0.68). Conclusion: The combination of maternal history, pregnancy associated plasma protein-A and mean arterial pressure is moderately useful to predict preeclampsia in a low risk and low volume obstetrical setting. The predictive model of the Clinic Hospital of Barcelona is a valid tool in predicting late preeclampsia in this setting (AU)

[First trimester screening of late-onset preeclampsia in a low risk and low volume obstetrical setting: external validation of a predictive model]. / Screening de primer trimestre de preeclampsia tardía en gestantes de bajo riesgo en un centro de bajo volumen obstétrico: validación externa de un modelo predictivo

BACKGROUND: The external validation of predictive model of late preeclampsia in a low volume and low risk obstetrical setting. METHODS: A cohort was created of 174 singleton pregnancies of 11+0-13+6 gestational weeks at Clinica Universidad Navarra from September 2011 to March 2013, which was considered as a validation cohort of a previously described model for late PE (Hospital Clinic, Barcelona). RESULTS: A total of 7 (4%) women developed late PE. In the validation cohort the area under the curve of the model was 0.69 (95% CI 0.45-0.93). Detection rates for a 5, 10 and 15% of false positive rates were 21.9, 31.4% and 38.6% respec-tively. When comparing the areas under the curve of the validation cohort with the construction cohort, no statistical differences were found (p=0.68). CONCLUSION: The combination of maternal history, pregnancy associated plasma protein-A and mean arterial pressure is moderately useful to predict preeclampsia in a low risk and low volume obstetrical setting. The predictive model of the Clinic Hospital of Barcelona is a valid tool in predicting late preeclampsia in this setting.

Seroprevalencia de anticuerpos IgG anti Toxoplasma gondii en receptorespretrasplante renales cubanos, Holguin, 2005: [carta al editor] / Seroprevalence of IgG antibodies against Toxoplasma gondii in cuban receptors: [letter to the editor]

Estudios recientes han permitido observar que entre un 30-50% de los pacientes infectadosdesarrolla una toxoplasmosis cerebral durante su evolución7,8 siendo los de mayor riesgo los quetienen cifras de CD4+ por debajo de 100/mm3. Si bien es cierto que las contraindicaciones para larealización de un trasplante renal son pocas, no podemos negar que buena parte del éxito de estaopción terapéutica radica en una correcta selección de los receptores, donde la toxoplasmosispuede estar asociada5. En Cuba se ha reportado hasta un 65,4% de prevalencia de anticuerposanti-Toxoplasma gondii en pacientes con insuficiencia renal crónica9

[Angiodysplasia of the colon]. / Angiodisplasia de colon.

The authors present a case review of a congenital abnormality of the inferior mesenteric blood vessels which resulted in ischemia of the descending colon and rectosigmoid area. The resulting colitis is only very rarely secondary to a vascular congenital abnormality. In this case, rectosigmoidoscopy, barioum study of the large bowel and a biopsy of the rectal mucosa pointed towards the ischemic nature of the lesion. This led to the selective angiographic study of the inferior mesenteric vessels with findings of a dilated inferior mesenteric artery and angiodysplasia. Surgical treatment included tying off of the inferior mesenteric artery and resection of the descending and rectosigmoid colon followed by transverse colon-rectum anastomosis. The angiographic and histopathologic studies were of great importance in establishing the true nature of the patient's clinical syndrome. One must keep in mind that the rectosigmoidoscopic findings may be seen in other disease states which do not have a vascular origin. These include Crohn's disease, severe amoebiasis and penumatosis of the intestine.