Efficacy of i3.1 Probiotic on Improvement of Lactose Intolerance Symptoms: A Randomized, Placebo-controlled Clinical Trial.

GOAL: The aim of this study was to assess the efficacy of probiotic i3.1 in improving lactose intolerance symptoms compared with placebo after 8 weeks of treatment. BACKGROUND: Probiotics are promising strategies to prevent and improve lactose intolerance symptoms, but previous studies have provided conflicting results. MATERIALS AND METHODS: This randomized, prospective, placebo-controlled study was conducted at the Hospital Juárez de México. We recruited adult patients with lactose intolerance confirmed by a lactose hydrogen breath test (LHBT) ≥20 parts per million (ppm) and a lactose intolerance symptom score ≥6 both upon lactose challenge. We compared the change from baseline in the scores of a validated symptom questionnaire and the LHBT after 8 weeks of probiotic or placebo treatment. RESULTS: We included 48 patients: 33 receiving the probiotic and 15 receiving placebo (2:1 randomization). Demographic characteristics were homogeneous between groups. The reduction in total symptom score after a lactose challenge was significantly higher in the probiotic group versus the placebo group (-5.11 vs. -1.00; P<0.001). All the subscores significantly decreased from baseline in the probiotic group, except for vomiting, with significant differences between the probiotic and placebo groups for abdominal pain (P=0.045) and flatulence (P=0.004). The area under the curve of the LHBT was significantly reduced from baseline in the probiotic group (P=0.019), but differences between groups were not significant (P=0.621). Adverse events were mild without differences between groups, and no serious adverse event was registered. CONCLUSION: The i3.1 probiotic was safe and efficacious in reducing lactose intolerance symptoms in patients with lactose intolerance, but did not change the LHBT.

Adapting the low-cost pre-disinfection column PREDICO for simultaneous softening and disinfection of pore water.

In previous works, a low-cost predisinfection column that combined coagulation-flocculation and GAC filtration was proposed for combination with electrodisinfection in the successful treatment of highly faecal polluted surface water. In this work, this column is adapted for the treatment of pore water by transforming the coagulation chamber into a chemical reactor with lime and replacing the GAC of the filter with ion exchange resins. This adapted system can soften water, remove nitrate and condition water for very efficient electrochemical disinfection, where 4 logs and 3 logs in the removal of E. coli and P. aeruginosa, respectively, were reached using commercial electrochemical cells, i.e., CabECO ® or MIKROZON®. The availability and low cost of the technology are strong points for usage in poor areas of developing countries.

How to avoid the formation of hazardous chlorates and perchlorates during electro-disinfection with diamond anodes?

This work focuses on disinfection of water using electrolysis with diamond coatings avoiding or minimizing the formation of hazardous chlorates and perchlorates using a special type of commercial cells designed by CONDIAS (Itzehoe, Germany) in two different sizes: the CabECO and the MIKROZON cells. In these cells, the electrolyte that separates the anode and cathode is a proton exchange membrane. This helps to minimize the production of perchlorate and this behavior is enhanced in the smallest cell for which the very low contact times between the electrodes and the water allows to avoid the production of perchlorates when operating in a single-pass mode, which becomes a really remarkable point. In this paper, we report tests in which we demonstrate this outstanding performance and we also explain the differences observed in the two cells operating with the same water.

Testing the use of cells equipped with solid polymer electrolytes for electro-disinfection.

This work focuses on disinfection of water using electrolysis with boron doped diamond (BDD) coatings and faces this challenge by comparing the performance of two different cells manufactured by CONDIAS GmbH (Izehoe, Germany): CONDIACELL® ECWP and CabECO cells. They are both equipped with diamond electrodes, but the mechanical design is completely different, varying not only by geometry but also by the flow conditions. ECWP is a flow-through cell with perforated electrodes while the CabECO cell is a zero-gap cell with a proton exchange membrane as a solid polymer electrolyte (SPE) separating the anode and cathode. At 0.02 Ah dm-3 both cells attain around 3-5 logs pathogen removal, but design and sizing parameters give an advantage to the CabECO: it can minimize the production of chlorates and perchlorates when operating in a single-pass mode, which becomes a really remarkable point. In this paper, we report tests in which we demonstrate this outstanding performance and we also explain the differences observed in the two cells operating with the same water.

Pre-disinfection columns to improve the performance of the direct electro-disinfection of highly faecal-polluted surface water.

This work presents the design and evaluation of a new concept of pre-disinfection treatment that is especially suited for highly polluted surface water and is based on the combination of coagulation-flocculation, lamellar sedimentation and filtration into a single-column unit, in which the interconnection between treatments is an important part of the overall process. The new system, the so-called PREDICO (PRE-DIsinfection Column) system, was built with low-cost consumables from hardware stores (in order to promote in-house construction of the system in poor countries) and was tested with a mixture of 20% raw wastewater and 80% surface water (in order to simulate an extremely bad situation). The results confirmed that the PREDICO system helps to avoid fouling in later electro-disinfection processes and attains a remarkable degree of disinfection (3-4 log units), which supplements the removal of pathogens attained by the electrolytic cell (more than 4 log units). The most important sizing parameters for the PREDICO system are the surface loading rate (SLR) and the hydraulic residence time (HRT); SLR values under 20 cm min-1 and HRT values over 13.6 min in the PREDICO system are suitable to warrant efficient performance of the system.

On the Contact Geometry and the Poisson Geometry of the Ideal Gas.

We elaborate on existing notions of contact geometry and Poisson geometry as applied to the classical ideal gas. Specifically, we observe that it is possible to describe its dynamics using a 3-dimensional contact submanifold of the standard 5-dimensional contact manifold used in the literature. This reflects the fact that the internal energy of the ideal gas depends exclusively on its temperature. We also present a Poisson algebra of thermodynamic operators for a quantum-like description of the classical ideal gas. The central element of this Poisson algebra is proportional to Boltzmann's constant. A Hilbert space of states is identified and a system of wave equations governing the wavefunction is found. Expectation values for the operators representing pressure, volume and temperature are found to satisfy the classical equations of state.

On the van der Waals Gas, Contact Geometry and the Toda Chain.

A Toda-chain symmetry is shown to underlie the van der Waals gas and its close cousin, the ideal gas. Links to contact geometry are explored.

Scale-up of the electrokinetic fence technology for the removal of pesticides. Part II: Does size matter for removal of herbicides?

This work reports results of the application of electrokinetic fence technology in a 32 m3 -prototype which contains soil polluted with 2,4-D and oxyfluorfen, focusing on the evaluation of the mechanisms that describe the removal of these two herbicides and comparing results to those obtained in smaller plants: a pilot-scale mockup (175 L) and a lab-scale soil column (1 L). Results show that electric heating of soil (coupled with the increase in the volatility) is the key to explain the removal of pollutants in the largest scale facility while electrokinetic transport processes are the primary mechanisms that explain the removal of herbicides in the lab-scale plant. 2-D and 3-D maps of the temperature and pollutant concentrations are used in the discussion of results trying to give light about the mechanisms and about how the size of the setup can lead to different conclusions, despite the same processes are occurring in the soil.

Scale-up of the electrokinetic fence technology for the removal of pesticides. Part I: Some notes about the transport of inorganic species.

This work describes the application electrokinetic fence technology to a soil polluted with herbicides in a large prototype containing 32 m3 of soil. It compares performance in this large facility with results previously obtained in a pilot-scale mockup (175 L) and with results obtained in a lab-scale soil column (1 L), all of them operated under the same driving force: an electric field of 1.0 V cm-1. Within this wide context, this work focuses on the effect on inorganic species contained in soil and describes the main processes occurring in the prototype facility, as well as the differences observed respect to the lower scale plants. Thus, despite the same processes can be described in the three plants, important differences are observed in the evolution of the current intensity, moisture and conductivity. They can be related to the less important electroosmotic fluxes in the larger facilities and to the very different distances between electrodes, which lead to very different distribution of species and even to a very different evolution of the resulting current intensity. 2-D maps of the main species at different relevant moments of the test are discussed and important information is drawn from them. Ions depletion from soil appears as a very important problem which should be prevented if the effect of natural bioremediation and/or phytoremediation on the removal or organics aims to be accounted.

Molecular and epidemiologic study of Clostridium difficile reveals unusual heterogeneity in clinical strains circulating in different regions in Portugal.

Clostridium difficile infection (CDI) represents a great healthcare burden in developed countries. The emergence of the epidemic PCR ribotype (RT) 027 and its acquired fluoroquinolones resistance have accentuated the need for an active surveillance of CDI. Here we report the first countrywide study of CDI in Portugal with the characterization of 498 C. difficile clinical isolates from 20 hospitals in four regions in Portugal regarding RT, virulence factors and antimicrobial susceptibility. We identified 96 RTs with marked variations between and within regions, as only six RTs appeared in all four regions. RT027 was the most frequent RT overall (18.5%) and among healthcare facility-associated isolates (19.6%), while RT014 was the most common among community-associated isolates (12%). The north showed a high RT diversity among isolates and a low moxifloxacin (MXF) resistance rate (11.9%), being the only region in which RT027 was not predominant. In contrast, the isolates from the centre presented the highest RT027 frequency, and 53.4% were resistant to MXF. Overall, MXF resistance (33.2%) was associated (p <0.001) with the presence of binary toxin genes and mutations in tcdC regardless of the RT. Both traits appeared in almost 30% of the strains. RT027 showed a reduced susceptibility to metronidazole (p <0.01), and RT126 had higher minimum inhibitory concentrations to vancomycin (p = 0.03) compared to other RTs. The present study highlights an unusual heterogeneity of RTs in Portugal, with a high frequency of hypervirulent RTs and the emergence of virulence factors in non-027 RTs, emphasizing the need for a surveillance system for CDI in Portugal.

Intense cold and mortality in Castile-La Mancha (Spain): study of mortality trigger thresholds from 1975 to 2003.

Studies on temperature-mortality time trends especially address heat, so that any contribution on the subject of cold is necessarily of interest. This study describes the modification of the lagged effects of cold on mortality in Castile-La Mancha from 1975 to 2003, with the novelty of also approaching this aspect in terms of mortality trigger thresholds. Cross-correlation functions (CCFs) were thus established with 15 lags, after application of ARIMA models to the mortality data and minimum daily temperatures (from November to March), and the results for the periods 1975-1984, 1985-1994 and 1995-2003 were then compared. In addition, daily mortality residuals for the periods 1975-1989 and 1990-2003 were related to minimum temperatures grouped in 2°C intervals, with a cold threshold temperature being obtained in cases where such residuals increased significantly (p < 0.05) with respect to the mean for the study period. A cold-related mortality trigger threshold of -3°C was obtained for Ciudad Real for the period 1990-2003. The significant number of lags (p < 0.05) in the CCFs declined every 10 years in Toledo (5-2-0), Cuenca (4-2-0), Albacete (4-3-0) and Ciudad Real (3-2-1). This meant that, while the trend in cold-related mortality trigger thresholds in the region could not be ascertained, it was possible to establish a reduction in the lagged effects of cold on mortality, attributable to the improvement in socio-economic conditions over the study period. Evidence was shown of the effects of cold on mortality, a finding that renders the adoption of preventive measures advisable in any case where intense cold is forecast.

Efectos de los extremos térmicos en los planes de contingencia de los sistemas de salud / Effects of thermic extremes on the contingency plans of health systems

No disponible

[Heat health warning systems: possibilities of improvement]. / Posibilidades de mejora en los planes de prevención frente al exceso de temperaturas.

In the summer of 2003 the temperatures reached were responsible for a large number of deaths in Europe. A year after this fact, many countries had implemented some sort of plan of prevention against excessive temperatures. Plans that had already shown its ability to prevent a large proportion of avoidable mortality in other latitudes. Since then, a lot of papers have been published providing new data on health effects of a heat wave, which can help increase the efficiency of these prevention plans. Knowing the weather conditions at risk, defining "heat wave" or to take into account the time that the plan should be active from the study of the relationship between temperature and their effects on health, to identify weather patterns that modulate the relationship between temperature and mortality, locate the profile of people at risk or to develop protocols for action as accurately as possible and based on scientific knowledge are elements drawn from studies carried on in recent years that should be taken into account.

Planes de prevención frente al exceso de temperaturas. Posibilidades de mejora / Heat health warning systems. Possibilities of improvement

En el verano de 2003 las temperaturas alcanzadas fueron responsablesde un gran número de muertes en el continente europeo. Unaño después muchos países habían implantado algún tipo de plan deprevención frente al exceso de temperaturas. Planes que ya habíanmostrado su capacidad de prevenir una buena parte de la mortalidadevitable en otras latitudes.Desde entonces, son numerosos los estudios publicados ofreciendonuevos datos sobre los efectos en salud pública de una ola decalor, que pueden contribuir a aumentar la eficiencia de estos planesde prevención. Conocer las situaciones meteorológicas de mayorriesgo, definir ola de calor o tener en cuenta el tiempo que el plandebe estar activo a partir del estudio de la relación entre la temperaturay sus efectos en salud, identificar las características meteorológicasque modulan la relación entre la temperatura y la mortalidad,localizar el perfil de las personas de mayor riesgo o diseñar protocolosde actuación con la mayor precisión posible y basado en el conocimientocientífico son elementos extraídos de numerosos trabajosrealizados en los últimos años que deben ser tenidos en cuenta(AU)

In the summer of 2003 the temperatures reached were responsiblefor a large number of deaths in Europe. A year after this fact,many countries had implemented some sort of plan of preventionagainst excessive temperatures. Plans that had already shown its abilityto prevent a large proportion of avoidable mortality in other latitudes.Since then, a lot of papers have been published providing newdata on health effects of a heat wave, which can help increase theefficiency of these prevention plans. Knowing the weather conditionsat risk, defining "heat wave" or to take into account the timethat the plan should be active from the study of the relationship betweentemperature and their effects on health, to identify weather patternsthat modulate the relationship between temperature and mortality,locate the profile of people at risk or to develop protocols foraction as accurately as possible and based on scientific knowledgeare elements drawn from studies carried on in recent years thatshould be taken into account(AU)

Efectos de los extremos térmicos sobre la mortalidad diaria en Castilla-La Mancha: evolución temporal 1975–2003 / Effects of temperature extremes on daily mortality in Castile-La Mancha (Spain): trends from 1975 to 2003

ObjetivosDeterminar la evolución y la distribución geográfica de la temperatura umbral de disparo de la mortalidad por extremos térmicos en Castilla-La Mancha entre 1975 y 2003.MétodosEl análisis se divide en tres periodos (1975–1984, 1985–1994 y 1995–2003) para cada provincia de la región. Se modeliza la mortalidad diaria por causas orgánicas (variable dependiente) utilizando procedimientos ARIMA. Los residuos diarios de mortalidad resultantes se relacionan con las temperaturas máximas diarias agrupadas en intervalos de 2°C, obteniendo una temperatura umbral por frío o por calor si esos residuos aumentan de forma significativa (p<0,05) respecto a la media de todos los residuos del periodo de estudio.ResultadosLas temperaturas umbral de disparo de la mortalidad por calor en Castilla-La Mancha han descendido en estos años. En Toledo disminuye de 40°C a 38°C. En Cuenca y Guadalajara no se obtenía temperatura umbral por calor en las primeras décadas y sí en las últimas. Los umbrales varían entre el percentil 92 de Cuenca y el percentil 98 de Albacete en la última década. No se observa temperatura umbral de disparo de la mortalidad por frío en ninguna provincia en ningún periodo de tiempo.ConclusionesSe ha producido una evolución creciente de la relación entre las altas temperaturas y la mortalidad en Castilla-La Mancha, probablemente atribuible al envejecimiento de la población. El aumento en la frecuencia de días muy calurosos puede haber influido en esta evolución. Los planes de prevención deben ser revisados periódicamente(AU)

ObjectivesTo determine time trends and the geographical distribution of mortality trigger temperature thresholds due to extreme temperatures in Castile-La Mancha (central Spain) between 1975 and 2003.MethodsThe analysis was divided into three periods (1975–1984, 1985–1994 and 1995–2003) for each province of the region. Daily mortality due to organic causes (dependent variable) was modelled using autoregressive integrated moving average (ARIMA) procedures. The resulting residual series was related to the maximum temperature series grouped in 2°C intervals to obtain a threshold temperature for cold or heat when the residuals rose significantly (p<0,05) above the mean residual mortality value of the corresponding study period.ResultsMortality trigger temperature thresholds decreased over time in Castile- La Mancha. In Toledo, the trigger temperature diminished from 40°C to 38°C. In Cuenca and Guadalajara, threshold temperatures for heat events were obtained in the last few decades but not in the first. These thresholds varied from the 92nd percentile in Cuenca to the 98th percentile in Albacete in the last decade. No threshold temperatures for cold spells were observed in any province or period.ConclusionsCastile-La Mancha registered an upward trend in the relationship between high temperatures and mortality, probably due to population aging. This trend could have been influenced by the increased frequency of extremely hot days. Prevention plans should be periodically reviewed(AU)

[Effects of temperature extremes on daily mortality in Castile-La Mancha (Spain): trends from 1975 to 2003]. / Efectos de los extremos térmicos sobre la mortalidad diaria en Castilla-La Mancha: evolución temporal 1975-2003.

OBJECTIVES: To determine time trends and the geographical distribution of mortality trigger temperature thresholds due to extreme temperatures in Castile-La Mancha (central Spain) between 1975 and 2003. METHODS: The analysis was divided into three periods (1975-1984, 1985-1994 and 1995-2003) for each province of the region. Daily mortality due to organic causes (dependent variable) was modelled using autoregressive integrated moving average (ARIMA) procedures. The resulting residual series was related to the maximum temperature series grouped in 2 degrees C intervals to obtain a threshold temperature for cold or heat when the residuals rose significantly (p<0,05) above the mean residual mortality value of the corresponding study period. RESULTS: Mortality trigger temperature thresholds decreased over time in Castile- La Mancha. In Toledo, the trigger temperature diminished from 40 degrees C to 38 degrees C. In Cuenca and Guadalajara, threshold temperatures for heat events were obtained in the last few decades but not in the first. These thresholds varied from the 92nd percentile in Cuenca to the 98th percentile in Albacete in the last decade. No threshold temperatures for cold spells were observed in any province or period. CONCLUSIONS: Castile-La Mancha registered an upward trend in the relationship between high temperatures and mortality, probably due to population aging. This trend could have been influenced by the increased frequency of extremely hot days. Prevention plans should be periodically reviewed.

Fluorescence lifetime imaging distinguishes basal cell carcinoma from surrounding uninvolved skin.

BACKGROUND: Fluorescence lifetime imaging (FLIM) is a novel imaging technique that generates image contrast between different states of tissue due to differences in fluorescence decay rates. OBJECTIVES: To establish whether FLIM of skin autofluorescence can provide useful contrast between basal cell carcinomas (BCCs) and surrounding uninvolved skin. METHODS: Unstained excision biopsies of 25 BCCs were imaged en face with FLIM following excitation of autofluorescence with a 355 nm pulsed ultraviolet laser. RESULTS: Using FLIM we were able to distinguish areas of BCC from surrounding skin in an ex vivo study. Significant reductions in mean fluorescence lifetimes between areas of BCC and areas of surrounding uninvolved skin were demonstrated (P < 0.0001). These differences were apparent irrespective of the decay model used to calculate the fluorescence lifetimes (single vs. stretched exponential) or the long-pass filter through which the emitted autofluorescence was collected (375 vs. 455 nm). Conversely, there was no significant difference between the BCC and uninvolved areas of each sample when mean autofluorescence intensities were examined. Moreover, wide-field false-colour images of fluorescence lifetimes clearly discriminated areas of BCC from the surrounding uninvolved skin. CONCLUSIONS: We therefore believe that FLIM has a potential future clinical role in imaging BCCs for rapid and noninvasive tumour delineation and as an aid to determine adequate excision margins with best preservation of normal tissue.

Time trends in minimum mortality temperatures in Castile-La Mancha (Central Spain): 1975-2003.

The relationship between air temperature and human mortality is described as non-linear, with mortality tending to rise in response to increasingly hot or cold ambient temperatures from a given minimum mortality or optimal comfort temperature, which varies from some areas to others according to their climatic and socio-demographic characteristics. Changes in these characteristics within any specific region could modify this relationship. This study sought to examine the time trend in the maximum temperature of minimum organic-cause mortality in Castile-La Mancha, from 1975 to 2003. The analysis was performed by using daily series of maximum temperatures and organic-cause mortality rates grouped into three decades (1975-1984, 1985-1994, 1995-2003) to compare confidence intervals (p<0.05) obtained by estimating the 10-yearly mortality rates corresponding to the maximum temperatures of minimum mortality calculated for each decade. Temporal variations in the effects of cold and heat on mortality were ascertained by means of ARIMA models (Box-Jenkins) and cross-correlation functions (CCF) at seven lags. We observed a significant decrease in comfort temperature (from 34.2 degrees C to 27.8 degrees C) between the first two decades in the Province of Toledo, along with a growing number of significant lags in the summer CFF (1, 3 and 5, respectively). The fall in comfort temperature is attributable to the increase in the effects of heat on mortality, due, in all likelihood, to the percentage increase in the elderly population.