Tracking the sources of Leptospira and nutrient flows in two urban watersheds of Puerto Rico.

This study investigated the relationship between nutrient levels, source of fecal contamination, and pathogenic Leptospira in Puerto Rico's northern coast and San Juan Bay Estuary (SJBE) aquatic ecosystems. Microbial source tracking (MST) was also used to investigate the connections between sources of feces contamination and the presence of Leptospira. Eighty-seven water samples were collected during the June (n=44) and August (n=43) in 2020. To quantify phosphorus and nitrogen concentrations, standard USEPA protocols were utilized, specifically Methods 365.4 for total and dissolved phosphorus, 351.2 for total Kjeldahl nitrogen and ammonium, and 353.2 for nitrate. Lipl32 gene-specific quantitative polymerase chain reaction (qPCR) was used to detect the presence of Leptospira. Human (HF183), canine (BacCan-UCD), and equine (HoF597) MST assays were utilized to trace the origins of fecal contamination. Forty one percent of the locations exceeded Puerto Rico's authorized total phosphorus limit of 160 g L-1, while 34% exceeded the total nitrogen limit of 1700 g L-1. Nearly half of the streams examined are affected by eutrophication. The MST analysis identified human and canine feces as the most prevalent contaminants, affecting approximately 50% of the sites. In addition, Leptospira was detected in 32% of the June samples. There was a significant correlation (r = 0.79) between the incidence of pathogenic Leptospira and the human bacterial marker (HF183). This study illuminates the central role of anthropogenic inputs in nutrient enrichment and pathogen proliferation in Puerto Rico's aquatic ecosystems.

Cholecystoduodenal fistula, an infrequent complication of cholelithiasis: Our experience in its surgical management. / Fístula colecistoduodenal, complicación infrecuente de litiasis vesicular: nuestra experiencia en su manejo quirúrgico.

INTRODUCTION: Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases. These fistulas can cause diverse clinical consequences and in some cases be life-threatening to the patient. AIM: To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical management, postoperative complications, and follow-up. MATERIALS AND METHODS: A retrospective study was conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to cholelithiasis, cholecystitis, or cholangitis, within a 3-year time frame. RESULTS: Four patients, 2 men and 2 women, were identified with cholecystoduodenal fistula. Their mean age was 81.5 years. Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. All the patients underwent surgical treatment and the diagnostic and therapeutic management of each of them was analyzed. CONCLUSIONS: The incidence of cholecystoduodenal fistula was similar to that reported in the medical literature. It is a rare complication of gallstones and its diagnosis is difficult due to its nonspecific symptomatology. It should be contemplated in elderly patients that have a contracted gallbladder with numerous adhesions.

[Secondary chondrosarcoma: radiopathological correlation]. / Condrosarcoma secundario: correlación radiopatológica.

Chondrosarcomas are malignant bone tumors originating in cartilage. Chondrosarcoma is the third most common malignant bone tumor after multiple myeloma and osteosarcoma. About 75% of chondrosarcomas are primary lesions. The remaining 25% belong to special categories such as histologic variants and secondary forms. A secondary chondrosarcoma is one that appears in a pre-existing benign chondral lesion; the different types of secondary chondrosarcomas include solitary osteochondroma, multiple osteochondromatosis, enchondroma, the different types of enchondromatosis, and primary synovial chondromatosis. The incidence of this malignant transformation varies widely in function of the type of lesion. In this article, we discuss and illustrate the different types of secondary chondrosarcomas, placing special emphasis on the imaging findings that should alert to these lesions and give radiologists a key role in the diagnosis, management, and follow-up of these patients.

Hydrodynamic cavitation pre-treatment of urban waste: Integration with acidogenic fermentation, PHAs synthesis and anaerobic digestion processes.

Urban waste can be valorized within a biorefinery approach, producing platform chemicals, biopolymers and energy. In this framework, hydrodynamic cavitation (HC) is a promising pre-treatment for improving biodegradability due to its high effectiveness and low cost. This paper deals with the effect of HC pre-treatment on the acidogenic co-fermentation process of thickened sewage sludge from a WWTP and seasonal vegetable waste from a wholesale market. Specifically, HC was assessed by testing two sets of parameters (i.e., treatment time of 30 and 50 min; vacuum pressure 1.4 and 2.0 bar; applied power 8 and 17 kW) to determine its effectiveness as a pre-treatment of the mixture. The highest increase in sCOD (+83%) and VFAs (from 1.93 to 17.29 gCODVFA L-1) was gained after 50 min of cavitation. Fermentations were conducted with not cavitated and cavitated mixtures at 37 °C on 4 L reactors in batch mode, then switched to semi-continuous with OLR of 8 kgTVS m-3 d-1 and HRT of 5-6.6 d. Good VFAs concentrations (12.94-18.27 gCODVFA L-1) and yields (0.44-0.53 gCODVFA gVS(0)-1) were obtained, which could be enhanced by pre-treatment optimization and pH control. The organic acid rich broth obtained was then assessed as a substrate for PHAs storage by C. necator. It yielded 0.37 g g-1 of polyhydroxybutyrate, such biopolymer resulted to have analogous physicochemical characteristics of commercial equivalent. The only generated side-stream would be the solid-rich fraction of the fermented effluent, which valorization was assessed through BMP tests, showing a higher SGP of 0.42 Nm3 kgTVS-1 for the cavitated.

A pilot study on the identification of human papillomavirus genotypes in tongue cancer samples from a single institution in Ecuador.

The relationship between human papillomavirus (HPV) and oropharyngeal squamous cell carcinoma has been established. However, data from Ecuador is limited. The objective of this study was to characterize HPV infection in Ecuadorian patients with tongue cancer. Fifty-three patients with tongue cancer treated at the tertiary referral center Sociedad de Lucha Contra el Cancer (SOLCA), Guayaquil, between 2006 and 2011 were identified. Linear Array® HPV genotyping was used to identify the presence and types of HPV on formalin-fixed paraffin-embedded biopsy samples from these patients with tongue cancer. HPV was identified in 42% (n=22) and high-risk (HR) HPV in 17% (n=9), with 18 different HPV types identified. The most common types were the HR HPV 33 (14%) and low-risk HPV 67 (14%), followed by the HR HPV 58. More than one HPV type was identified in 27.3% of cases. HPV 33 was frequently associated with other HPV types. No statistically significant differences in gender (P=0.58) and age (P=0.12) were observed between HPV-positive and HPV-negative cases. HPV was identified in almost half of the tongue cancer samples, with subtypes 33 and 67 being the most common. This suggested that HPV played an important role in this disease in the population studied. Given these results, current HPV vaccines may not be as effective in reducing tongue cancer rates in this population.

One-day protocol versus two-day protocol in acquisition of scintigraphy with "in vitro" labelled white blood cells for diagnosis of osteoarticular infection. / Protocolo de un día vs protocolo de dos días de adquisición mediante gammagrafía con leucocitos marcados in vitro para el diagnóstico de infección osteoarticular.

INTRODUCTION: It is difficult to determine osteoarticular infection and differentiate inflammation from infection with laboratory and imaging procedures (CT, MRI, US). Labelled white-blood-cell scintigraphy (WBCS) is the nuclear medicine test of choice but it takes two days, sometimes finds it difficult to differentiate soft tissue from bone infection and therefore causes interobserver variability, which decreases its specificity. OBJECTIVE: To demonstrate the usefulness of the one-day protocol with time decay-corrected acquisition in WBCS to diagnose osteoarticular infection and to reduce interobserver variability. The role of SPECT/CT in WBCS in locating the infected focus was also evaluated. METHODS: 110 patients with suspected osteoarticular infection were studied prospectively. Planar images were obtained with time decay-corrected acquisition at 30min, 4h, 8h and 24h. WBCS planar images were grouped in two protocols: One-day protocol: experts evaluated 30min, 4h and 8h images. Two-day protocol: experts evaluated 30min, 4h and 24h images. Both protocols were classified as: SPECT/CT was performed in 72 patients. Kappa index was calculated to evaluate interobserver variability. RESULTS: Infection was confirmed in 34 cases. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 97.1%, 97.4%, 94.3%, 98.7%, and 97.3% for the one-day protocol and 94.1%, 97.4%, 94.1%, 97.4%, and 96.4% for two-days-protocol. SPECT/CT contributed to diagnosis in 45/50 patients with planar WBCS positive. Kappa index: 0.8 for one-day protocol and 0.79 for two-day protocol, respectively. CONCLUSION: One-day protocol with time decay-corrected acquisition WBCS and SPECT/CT enables early and accurate diagnosis of osteoarticular infection.

Overexpression of the carbohydrate binding module from Solanum lycopersicum expansin 1 (Sl-EXP1) modifies tomato fruit firmness and Botrytis cinerea susceptibility.

Firmness, one of the major determinants of postharvest quality and shelf life of fruits is determined by the mechanical resistance imposed by the plant cell wall. Expansins (EXP) are involved in the non-hydrolytic metabolic disassembly of plant cell walls, particularly in processes where relaxation of the wall is necessary, such as fruit development and ripening. As many carbohydrate-associated proteins, expansins have a putative catalytic domain and a carbohydrate-binding module (CBM). Several strategies have been pursued to control the loss of fruit firmness during storage. Most of the approaches have been to suppress the expression of key enzymes involved in the cell wall metabolism, but this is the first time that a CBM was overexpressed in a fruit aimed to control cell wall degradation and fruit softening. We report the constitutive overexpression of the CBM of Solanum lycopersicum expansin 1 (CBM-SlExp1) in the cell wall of tomato plants, and its effects on plant and fruit phenotype. Overexpression of CBM-SlExp1 increased the mechanical resistance of leaves, whereas it did not modify plant growth and general phenotype. However, transgenic plants showed delayed softening and firmer fruits. In addition, fruits were less susceptible to Botrytis cinerea infection, and the "in vitro" growth of the fungus on media containing AIR from the pericarp of transgenic fruits was lower than controls. The possibility of overexpressing a CBM of a fruit-specific expansin to control cell wall degradation and fruit softening is discussed.

Analysis of the carbohydrate-binding-module from Fragaria x ananassa α-L-arabinofuranosidase 1.

α-L-arabinofuranosidases (EC 3.2.1.55) are enzymes involved in the catabolism of several cell-wall polysaccharides such as pectins and hemicelluloses, catalyzing the hydrolysis of terminal non-reducing α-L-arabinofuranosil residues. Bioinformatic analysis of the aminoacidic sequences of Fragaria x ananassa α-L-arabinofuranosidases predict a putative carbohydrate-binding-module of the family CBM_4_9, associated to a wide range of carbohydrate affinities. In this study, we report the characterization of the binding affinity profile to different cell wall polysaccharides of the putative CBM of α-L-arabinofuranosidase 1 from Fragaria x ananassa (CBM-FaARA1). The sequence encoding for the putative CBM was cloned and expressed in Escherichia coli, and the resultant recombinant protein was purified from inclusion bodies by a Nickel affinity chromatography under denaturing conditions. The refolded recombinant protein was then subjected to binding assays and affinity gel electrophoresis, which indicated its ability to bind cellulose and also high affinity for homogalacturonans.

Numb chin syndrome as a manifestation of jaw metastasis diagnosed in a bone scan.

In many cases, numb chin syndrome (NCS) may represent a banal pathology. However, as it can be associated with malignant processes, its presence should alert the clinician of a possible occult disease. In patients already diagnosed with cancer, it often represents an ominous sign that indicates poor prognosis, due to the rapid progress of the disease. The case is presented of a 62-year-old man diagnosed with synchronous lung and bladder cancer, who suddenly complained of numbness in the chin. The bone scan confirmed the suspicion of metastastic bone disease, and the patient died two months after the appearance of this sign.

The recent trend in breast-feeding.

This study presents results of surveys conducted on a continuous basis over a period of years to determine the trend in the incidence of breast-feeding. Questionnaires were mailed to large samples of mothers, representative of the national distribution of births, asking them what type of milk they fed their infants over a period of time. Demographic characteristics of mothers who breast-fed were also obtained. From 1955 to 1971, there was a progressive decline in breast-feeding, followed by a resurgence in its incidence through 1978. Not only are more mothers breast-feeding, more are continuing to do so for a longer period of time throughout the months of their infants' most rapid growth and high nutritional requirements. It is also apparent that the increased incidence of breast-feeding has not been limited to higher income, better educated mothers. From 1971 to 1978, the incidence at two months postpartum more than doubled among mothers in lower-income families. The incidence of breast-feeding almost tripled among mothers whose education did not extend beyond elementary or high school and among those attending public clinics.

1984 milk-feeding patterns in the United States.

This paper presents results of surveys conducted continuously during a period of years to assess the trend in the incidence of breast-feeding. From 1955 to 1984, questionnaires were mailed to a large nationally representative sample of mothers to determine the use of various milks for feeding infants during the first 6 months of life. Data from these surveys demonstrated the resurgence of breast-feeding both in incidence and duration through 1982. From 1982 through 1984, these increases continued but at a markedly reduced level.

Breast-feeding and the working mother: a profile.

Based on a survey of a nationally representative sample of new mothers, this study compares the incidence and duration of breast-feeding among mothers who were employed full-time outside the home with those not employed. Results indicated that the same proportion of mothers (55%) who were employed full-time as those not employed reported breast-feeding their infants in the hospital. Working full-time seemed to have a substantial impact on breast-feeding duration. Only 10% of full-time employed mothers breast-fed their infants at 6 months of age compared with 24% of those not employed. Analyses of breast-feeding by demographic characteristics indicated that in-hospital breast-feeding was relatively high among mothers who were not working outside the home and who were 30 years of age and older, in high family income groups, college educated, white, and living in the Mountain or Pacific region of the United States. Breast-feeding patterns among white and black mothers showed that a relatively high incidence of in-hospital breast-feeding was reported by black mothers who returned to work full time. Many more blacks than whites who were working full time were in those demographic subgroups that reported the highest incidence of breast-feeding: mothers who were 25 years of age and older, in high-income groups, and college educated. Ways to increase the level of breast-feeding among employed mothers are outlined.

1981 milk feeding patterns in the United States during the first 12 months of life.

From 1955 to 1981, questionnaires were mailed to a nationally representative sample of mothers to determine the use of various milks for feeding infants during the first 6 months of life. Data from these surveys demonstrated the resurgence of breast-feeding both in incidence and duration, and this increase has occurred across all levels of income and education. Statistical analysis indicated that the trends were significant (P less than .01) for all demographic categories surveyed. In 1981, as in 1980, a bimonthly telephone survey of mothers of infants 8, 10, and 12 months of age determined milk use during later infancy. A combination of data from the mail and telephone surveys for 1981 provided information on milk feeding patterns and demographic characteristics for the first 12 months of life. Maternal employment was shown to reduce the incidence and duration of breast-feeding.

1980 update: the recent trend in breast-feeding.

This study presents results of surveys conducted on a continuous basis over a period of years to determine the trend in the incidence of breast-feeding. Questionnaires were mailed to large samples of mothers, representative of the national distribution of births, asking them what type of milk they fed their infants over a period of time. Demographic characteristics of mothers who breast-fed were also obtained. From 1955 to 1971, there was a progressive decline in breast-feeding, followed by a resurgence of its incidence through 1979. Not only are more mothers breast-feeding, more are continuing to do so for a longer period of time throughout the months of their infants' most rapid growth and high nutritional requirements. It is also apparent that the increased incidence of breast-feeding has not been limited to higher income, better educated mothers.

Nutrient intakes of formula-fed infants and infants fed cow's milk.

Twenty-four-hour dietary intake data from the second National Health and Nutrition Examination Survey (NHANES II), 1976-1980, were analyzed to compare nutrient intakes among infants 7 to 12 months of age who were fed mixed diets containing solid foods and either infant formula or cow's milk. Solid foods fed to the infants in both groups were low in iron and linoleic acid, and high in sodium, potassium, and protein, relative to Recommended Dietary Allowances. Infants who were fed cow's milk received lower median intakes of iron (7.8 mg v 14.9 mg), linoleic acid (1.8 g v 6.1 g), and vitamin C (39 mg v 64 mg), and higher median intakes of protein (41 g v 25 g), sodium (1,000 mg v 580 mg), and potassium (1,630 mg v 1,020 mg) than formula-fed infants. Seventy-five percent of the infants fed cow's milk had iron intakes below the Recommended Dietary Allowance; 69% had sodium intakes above the range of estimated safe and adequate daily dietary intake. Linoleic acid provided less than 3% of energy intake for 74% of the infants fed cow's milk. Differences in nutrient intakes were due not only to different concentrations of nutrients in each of the milk feedings but also to the different amounts and types of solid foods fed to the two groups of infants.

Milk feeding patterns in the United States during the first 12 months of life.

From 1955 to 1980, mail questionnaires were administered to a nationally representative sample of mothers to determine the use of various milks for feeding infants during the first 6 months of life. Data from these surveys have demonstrated the resurgence of breast-feeding both in incidence and duration, and this increase has occurred across all income and educational levels. Statistical analysis indicated that the trends were significant (P less than .01) for all demographic categories surveyed. In January 1980, a bi-monthly telephone survey of mothers of infants 8, 10, and 12 months of age was initiated to determine milk use during later infancy. A combination of data from the mail and telephone surveys for 1980 provided information on milk feeding patterns for the first 12 months of life.

Short-wavelength automated perimetry without lens density testing.

Three experiments determined whether an estimate of localized short-wavelength visual field loss could provide enough specificity and sensitivity for glaucoma diagnosis, without correcting the fields for lens density. We used 100 normal, 53 glaucoma suspect, and 95 glaucoma eyes (or a subset of these, where noted). The first two experiments showed that lens density has a diffuse effect on the visual field, which is more linear than the effect of age. The third experiment showed that, with the glaucoma hemifield test, comparable results were obtained for short-wavelength fields either corrected or uncorrected for lens density (sensitivities of 81% and 76% and specificities of 82% and 90%, respectively). We conclude that it is possible to eliminate the lens density measurement with this approach, thereby reducing test time by 40 minutes. This should improve substantially the clinical utility of short-wavelength automated perimetry.

Asymmetries in the normal short-wavelength visual field: implications for short-wavelength automated perimetry.

PURPOSE: To quantify short-wavelength sensitivity in normal eyes by hemifield location, eccentricity, and age. METHODS: We measured achromatic and short-wavelength thresholds across visual fields covering a radius of 21 degrees of visual angle in 115 normal eyes in subjects aged 17 to 77 years and out to 30 degrees of eccentricity in an additional 57 eyes in subjects aged 22 to 80 years. RESULTS: Results indicated significantly greater sensitivity for the inferior visual field compared with the superior field (P = .001). The amount of asymmetry increased with eccentricity (P = .001) but not with age (P = .357). A temporonasal field asymmetry was noted at the most eccentric points of the 30-degree field (P = .001) but not at 21 degrees (P = .821). CONCLUSIONS: In addition to increasing our understanding of normal retinal function, these results have implications for basic research in comparison with results of studies using different retinal locations to assess short-wavelength sensitivity and for clinical practice, where short-wavelength sensitivity is used to diagnose and manage a number of diseases, including glaucoma, diabetic retinopathy, and acquired immunodeficiency syndrome (AIDS)-related vision loss.

Comparison of high-pass resolution perimetry and standard automated perimetry in glaucoma.

PURPOSE: We sought to ascertain whether high-pass resolution perimetry would provide results comparable to those of standard perimetry. METHODS: Thirty-four eyes with primary open-angle glaucoma, 37 eyes suspected of having glaucoma, and 36 normal control eyes were matched for age and lens density. We controlled for refraction, pupil size, and learning effects. Standard and ring visual fields were obtained with the Humphrey perimeter and the Frisén ring perimeter, respectively. Each test was judged according to the Glaucoma Hemifield Test (a statistical visual field analysis method) to be outside normal limits (abnormal) or not outside normal limits (normal or borderline). RESULTS: Under these conditions, both tests identified 19 of 34 (56%) glaucoma eyes as outside normal limits. High-pass resolution perimetry determined that 34 of 36 (94%) normal eyes were not outside normal limits; standard perimetry determined that all 36 normal eyes were not outside normal limits. High-pass resolution perimetry determined 12 of 37 (32%) eyes that were glaucoma suspects were outside normal limits; standard perimetry determined three of the 37 (8%) glaucoma suspect eyes were outside normal limits. Overall agreement between the two tests was 65%. CONCLUSION: With the Glaucoma Hemifield Test, high-pass resolution perimetry was comparable to standard perimetry in sensitivity and specificity, and identified a slightly higher percentage of patients at risk for glaucoma as abnormal. These results suggest that high-pass resolution perimetry should continue to be explored as an alternative to standard perimetry for the diagnosis and treatment of glaucoma.