Acute toxicity of anionic and non-ionic surfactants to aquatic organisms.

The environmental risk of surfactants requires toxicity measurements. As different test organisms have different sensitivity to the toxics, it is necessary to establish the most appropriate organism to classify the surfactant as very toxic, toxic, harmful or safe, in order to establish the maximum permissible concentrations in aquatic ecosystems. We have determined the toxicity values of various anionic surfactants ether carboxylic derivatives using four test organisms: the freshwater crustacean Daphnia magna, the luminescent bacterium Vibrio fischeri, the microalgae Selenastrum capricornutum (freshwater algae) and Phaeodactylum tricornutum (seawater algae). In addition, in order to compare and classify the different families of surfactants, we have included a compilation of toxicity data of surfactants collected from literature. The results indicated that V. fischeri was more sensitive to the toxic effects of the surfactants than was D. magna or the microalgae, which was the least sensitive. This result shows that the most suitable toxicity assay for surfactants may be the one using V. fischeri. The toxicity data revealed considerable variation in toxicity responses with the structure of the surfactants regardless of the species tested. The toxicity data have been related to the structure of the surfactants, giving a mathematical relationship that helps to predict the toxic potential of a surfactant from its structure. Model-predicted toxicity agreed well with toxicity values reported in the literature for several surfactants previously studied. Predictive models of toxicity is a handy tool for providing a risk assessment that can be useful to establish the toxicity range for each surfactant and the different test organisms in order to select efficient surfactants with a lower impact on the aquatic environment.

Study of association of CTLA4 gene variants to non-anterior uveitis.

This study was undertaken to investigate the possible genetic association of functional CTLA4 polymorphisms with susceptibility to non-anterior uveitis. Four hundred and seventeen patients with endogenous non-anterior uveitis and 1517 healthy controls of Spanish Caucasian origin were genotyped for the CTLA4 polymorphisms rs733618, rs5742909 and rs231775, using predesigned TaqMan(©) allele discrimination assays. PLINK software was used for the statistical analyses. No significant associations between the CTLA4 polymorphisms and susceptibility to global non-anterior uveitis were found. It was also the case when the potential association of these genetic variants with the anatomical localization of the disease, such as intermediate, posterior or panuveitis, was assessed. Our results do not support a relevant role of these CTLA4 polymorphisms in the non-anterior uveitis genetic predisposition.

Acute toxicity of alkylpolyglucosides to Vibrio fischeri, Daphnia magna and microalgae: a comparative study.

In this paper, toxicity values of alkylpolyglucosides have been determined by applying the 24-h immobilization test with Daphnia magna, the LumiStox(®) 300 test which employs the luminescent bacteria Photobacterium phosphoreum and the test with Selenastrum capricornutum. Three alkylpolyglucosides with different alkyl chain and degree of polymerisation have been tested. For all tests, the results indicated that Vibrio fischeri was more sensitive to toxic effects from alkylpolyglucosides than was D. magna or S. capricornutum. The results demonstrate considerable variation in toxicity responses within structurally related glucose-based surfactants regardless of the species tested. The toxicity increased as the critical micelle concentration decreased, and as the alkyl chain length and resultant hydrophobicity increased.

Emergency transvaginal hybrid natural orifice transluminal endoscopic surgery.

In a clinical series, 10 consecutive female patients with intra-abdominal infections were successfully treated with natural orifice transluminal endoscopic surgery (NOTES) performed transvaginally. The surgery, which consisted of a hybrid NOTES procedure using a transvaginal approach, was performed on an emergency basis by the surgical team on call. The indications for surgery were acute cholecystitis (n = 6), acute appendicitis (n = 2), and pelvic peritonitis (n = 2) with intra-abdominal infection. The procedure was successfully performed in all patients using a dual-channel endoscope and mini-laparoscopy assistance. This is the first clinical series in which NOTES has been performed on an emergency basis to treat intra-abdominal infections. Transvaginal surgery for intra-abdominal infection is a feasible procedure for groups experienced in the elective NOTES approach.

Effect of concentration on the primary and ultimate biodegradation of alkylpolyglucosides in aerobic biodegradation tests.

This study examines the primary and ultimate biodegradation of a non-ionic surfactant, an alkylpolyglucoside, in ready biodegradability tests. The surfactant concentration was tested by the anthrone method, while the ultimate biodegradation (mineralization) was analyzed by the total organic carbon determinations. The influence of the concentration on the extent of primary and ultimate biodegradation and the kinetics of degradation also were determined. The primary and ultimate biodegradation was studied at different initial concentrations-15, 25, 50, 75, and 100 mg/L. The increasing concentration of test chemical from 15 to 100 mg/L resulted in a decrease in the relative maximum mineralization rate and longer estimated lag times by a factor of approximately 4.3. During the degradative process, two different stages were noted; these are better described with Quiroga and first-order kinetic models, respectively. For the study of the influence of concentration, the parameters characteristic of the biodegradation profiles in the different biodegradation assays were evaluated.

Acute toxicity and relationship between metabolites and ecotoxicity during the biodegradation process of non-ionic surfactants: fatty-alcohol ethoxylates, nonylphenol polyethoxylate and alkylpolyglucosides.

The toxicity values of fatty-alcohol ethoxylates, nonylphenol polyethoxylate, and alkylpolyglucosides have been determined by applying assays with luminescent bacteria. Also, the relation between metabolites and ecotoxicity during the biodegradation process has been determined. The biodegradation tests were carried out according to the OECD 301 E test for ready biodegradability. In these tests a solution of the surfactant, representing the sole carbon source for the microorganisms, was tested in a mineral medium, inoculated and incubated under aerobic conditions in the dark. The toxicity of surfactants is related to their molecular structure (Quantitative Structure Activity Relationships, QSAR). For the alkylpolyglucosides, toxicity expressed as EC(50) is related with the critical micelle concentration (CMC), the hydrophilic-lipophilic balance (HLB) of the surfactant, and the hydrophobic alkyl chain (R). The results indicate that toxicity increased as the CMC decreased and as the hydrophobicity increased and R rose. For fatty-alcohol ethoxylates, parameters characteristic studied have been HLB, number of units of ethylene oxide and the alkyl chain length. Relationships found are in agreement with the fact that increasing the alkyl chain length leads to a lower EC(50), whereas increasing ethoxylation leads to a lower toxicity. An analysis of the behaviour of the toxicity and HLB again indicates that the toxicity was greater for surfactants with a smaller HLB. The evolution of the toxicity was studied over the biodegradation process, expressed as a percentage of inhibition. For all the non-ionic surfactants assayed, except for the nonylphenol polyethoxylate, a major decline was found in toxicity during the first days of the biodegradation assay and at all the concentrations tested.

Transvaginal liver resection (NOTES) combined with minilaparoscopy.

OBJECTIVE: to report on the first liver resection performed on a human being by a transvaginal NOTES approach combined with minilaparoscopy. PATIENTS AND METHODS: a sixty-one-year-old woman with a history of Wertheim s hysterectomy for endometrial carcinoma 10 years ago, and malignant melanoma correctly treated in 2006, had suspected segment-V liver metastasis near the gallbladder by CT-scan and MRI. The indication for a laparoscopic approach was made, and a combined transvaginal and minilaparoscopic resection was offered and accepted by the patient. The procedure was performed by a multidisciplinary team composed of surgeons and gastroenterologists. It involved creating a pneumoperitoneum by placing a Veres needle in the umbilical fundus, followed by the insertion of a 5-mm trocar. A second, 3-mm trocar was placed in the right upper quadrant. A lot of pelvic adhesions were found in the major pelvis, and it was necessary to place a third, 5-mm trocar in the left abdominal side. It was employed only for the adhesions, not for liver resection. Adhesions were removed to reveal the minor pelvis and the vaginal fornix. A colpotomy was performed with a 12-mm trocar placed inside the vagina, which allowed the insertion of the videogastroscope as far as the liver hilum. RESULTS: liver resection (segment-V partial resection) and cholecystectomy were performed by using a combination of working tools inserted through the entry port for the minilaparoscopy and the videogastroscope. The en bloc resection was removed transvaginally through the videogastroscope. There were no postoperative complications, and the patient was discharged after 48 hours. CONCLUSIONS: transvaginal liver resection is possible and safe when performed by a multidisciplinary team. Natural orifice transluminal endoscopic surgery (NOTES) is an emerging modality that seeks to be less invasive, better tolerated, and more respectful of esthetics. It will probably open the way for very important medical and technological innovations.

[Treatment of retinal angiomatous proliferation (RAP). A retrospective study]. / Tratamiento de la proliferación angiomatosa retiniana (RAP). Estudio retrospectivo.

PURPOSE: To assess the follow-up and response to treatment in patients with RAP. METHODS: A retrospective follow-up study of patients with RAP diagnosed between March 2002 and August 2005. Baseline and subsequent angiograms and optical coherence tomography results were reviewed and RAP classified according to the 3 stages described by Yannuzzi. The changes observed and the best visual acuity were assessed separately for each of the 4 different treatments used: Transpupillary thermotherapy (TTT), Photodynamic therapy (PDT), combined treatment with PDT and Intravitreal triamcinolone (IVT), and combined treatment with PDT, IVT and direct laser photocoagulation of the vascular intraretinal lesion (DLPh.). RESULTS: Fifteen eyes of 14 patients with RAP were studied (mean age, 77.5 years). The mean follow-up was 15.9 months and the mean number of treatments was 2.5. The final visual acuity was worse in 7 (46.7%), stable in 7 (46.7%) and better in 1 (6.6%). Visual acuity improvement, in regard to the treatment used, was: TTT group: 2 out of 14 (14.2%): PDT group: 1 out of 5 (20%); PDT + IVT group: 2 out of 5 (40%) and DLPh. + PDT + IVT group: 3 out of 5 (60%). CONCLUSIONS: The final prognosis for RAP, in terms of visual acuity, was generally poor. However the best treatment was the combined treatment with DLPh + PDT + IVT, while the worst was TTT.

Endophthalmitis after intravitreal injections. Incidence, management and prognosis. / Endoftalmitis tras inyecciones intravítreas. Incidencia, manejo y pronóstico.

OBJECTIVE: To assess the rate of endophthalmitis after intravitreal injection (IVI) in a «clean room¼ of a single health centre, following the guidelines of the Spanish Vitreo-Retinal Society (SERV). An analysis was performed on the culture specimens, response to treatment, and final outcomes (guidelines). MATERIAL AND METHODS: A retrospective, observational study was conducted on a consecutive case series of patients diagnosed with infectious endophthalmitis after IVI in a single health centre between 2010 and 2015. Intravitreal and systemic treatment was given following the SERV guidelines. The patients were followed up the case was resolved. RESULTS: There were 5 cases of endophthalmitis out of 9467 IVI (incidence 0.053%). Positive cultures were obtained in aqueous and/or vitreous fluid in all cases, with Staphylococcus epidermidis being involved in 4 out of 5 cases. In 2 cases, final visual acuity was non-light perception due to intractable retinal detachments after resolution of the infectious process. CONCLUSIONS: IVI performed in a «clean room¼ have a low incidence of endophthalmitis. The most common infectious agent was Staphylococcus species. In 2 cases the functional prognosis was poor.

Simplified spectrophotometric method using methylene blue for determining anionic surfactants: applications to the study of primary biodegradation in aerobic screening tests.

In the present work, we propose a simplified spectrophotometric method for determining anionic surfactants, based on the formation of the ionic pair anionic surfactant-methylene blue (AS-MB). This method, in relation to the conventional analytic procedure, considerably reduces not only the quantity of chloroform used in extracting the ionic pair formed, but also the time and the quantity of sample necessary to perform the assay, eliminating the filtration stage. The method has been simplified by displacing the transfer equilibrium of the ionic pair AS-MB towards the organic phase, augmenting the volumetric relationship of chloroform/sample. The method proposed has been applied in the study of primary biodegradation kinetics of linear alkylbenzenesulfonate (LAS).

Early graft thrombosis after endovascular aortic aneurysm repair with aortouni-iliac endografts.

Endovascular repair of aortic aneurysm has become a viable treatment option in selected patients. However, despite the minimally invasive nature ot this treatment a significant incidence of vascular complications has been reported. Here, we report two cases of acute limbs ischemia due to endograft thrombosis in patients treated with aortouni-iliac devices and we review the etiologic factors related with these events and the treatment options. We suggest that the presence of atherosclerotic plaques within the outflow arteries and coexistent infrainguinal arterial occlusive disease (poor runoff) is an underestimated factor in the risk of graft thrombosis, especially in patients treated with aortouni-iliac devices and we advocate the use in the early follow-up surveillance after endovascular repair of aortic aneurysm of noninvasive test such duplex scanning, segmental pressures and ankle-brachial indices to asses the presence or progress of coexistent occlusive disease. We also suggest that some adverse outcomes ascribed to device failure might be more properly charged to inappropriate patient selection.

Effect of starvation on lipoprotein lipase activity in different tissues during gestation in the rat.

This study was addressed to determine whether the tissue-specific LPL activity response to fasting differs between nonpregnant and pregnant rats over the course of pregnancy. Fed and 24-h fasted rats were studied at days 12, 15 or 20 of gestation and were compared to virgin controls. In fed rats at days 15 and 20 of gestation LPL activity decreased in lumbar adipose tissue and the heart and liver, and increased in mammary gland tissue. Fasting decreased LPL activity in lumbar adipose tissue in 12 day pregnant and virgin rats and in mammary gland tissue in pregnant rats at 15 and 20 days of gestation and in virgin rats, whereas it increased LPL activity in heart tissue in rats at day 15 and 20 and in liver at day 20 of gestation. Plasma triacylglycerols were higher in 20 day pregnant rats than in the other groups when fed and this difference was even more noticeable in the fasting condition where the plasma beta-hydroxybutyrate level also reached the highest value in the 20 day pregnant rats. Since tissue LPL activity controls the hydrolysis and uptake of circulating triacylgylcerols, the present results indicate that in fed rats after the 15th day of gestation circulating triacylglycerols are preferentially taken up by the mammary gland instead of being taken up by adipose tissue and heart. However, after fasting, circulating triacylglycerols are driven to the heart and liver in the late pregnant rat, and become a major source for fatty acid oxidation, an effect that seems to be specially evident in the liver of the 20 day pregnant rat where there is an intense increase in LPL activity and the triacylglycerols become preferential substrates for ketone body production.

[Eleven years experience in the management of retinopathy of prematurity in the Balearic Islands]. / Once años de experiencia en el manejo de la retinopatía del prematuro en las Islas Baleares.

PURPOSE: To evaluate the incidence and effectiveness of the treatment of Retinopathy of Prematurity (ROP) in preterm births in the Balearic Islands. MATERIALS AND METHODS: Protocol of prospective and consecutive study. We included preterm infants whose birth weights were under 1,501 g, or heavier infants requiring assisted oxygen therapy. Data for the 12 years between January 1992 and December 2003 were analyzed. We evaluated gestational age, birth weight, ROP stage and the effect of treatment following CRYO-ROP Study indications. A descriptive study was undertaken. RESULTS: We evaluated 446 babies. Average age and weight were 30.4 weeks and 1,178.4 g respectively. ROP was found in 93 infants (63.1%) weighing less than 1,000 g, in 50 (19.6%) weighing 1,000-1,500 g and in 5 (11.4%) weighing > 1,500 g. In regard to gestation, ROP was found in 27 (86.2%) babies born at < 27 weeks of gestation, in 87 (35.6%) born at 27-30 weeks of gestation and in 19 infants (12.7%) born at > 30 weeks gestation. There were 75 babies with stage III disease and 73.3% needed treatment. Retinal ablation was performed at 62.9 days. CONCLUSIONS: ROP incidence is inversely related to birth weight and gestational age. Three out of four babies who reached stage III disease needed treatment. The effectiveness of photocoagulation was over 90% when performed at 2 months of age.

[Minimally invasive surgery of the inguinal hernia]. / Cirugía mínimamente invasiva de la hernia inguinal.

The minimally invasive approach to the inguinal hernia shows advantages with respect to previous conventional approaches in bilateral and recurrent inguinal hernias; while the initial results were bad, new problems were added deriving from the laparoscopic approach. The aim of this article is to describe the surgical technique and analyse the preliminary results of our series of 600 totally extra-peritoneal hernioplasties, performed at the University Clinic of Navarra. The most frequent complication (25.7%) was the accidental rupture of the peritonea. There were no associated intra-abdominal complications. In the follow-up there were 9 relapses (1.5%) and 13 reinterventions. Eleven (1.8%) of the patients developed transitory neuropathic pain in the femoral cutaneous area. In our experience the totally extra-peritoneal approach is a technique that is especially indicated in relapsed and bilateral hernias. The advantages present, in terms of pain and postoperative discomfort, recovery of physical and labour activity, and the good results with respect to relapses and neuropathic pains, encourage us to indicate it not only in relapsed or bilateral inguinal hernias but also in primary ones.

Enhancement of blood pressure response to dopamine by angiotensin II.

The interaction of dopamine and angiotensin II (AII) on blood pressure and heart rate was studied in rats. The influence of reserpine pretreatment and vagotomy was also studied. Inbred rats anesthetized with urethane received intravenous (i.v.) doses of 50, 100, 200, or 400 micron g (per 100 g body weight) of dopamine HCI, before and after a single i.v. dose of 0.025 micron g of AII. The same doses of dopamine were tested in vagotomized rats and in rats pretreated with reserpine. The effect of dopamine alone on blood pressure was biphasic, since 16 of 38 rats showed an early fall followed by a later rise. The early fall decreased significantly with the dose and was absent with the highest dose tested (400 micron g). The late rise was observed in all experiments, and it increased significantly with the dose. Parallel to hypotension, a decrease of heart rate was observed, but both phenomena appeared not to be linked by a sauce-effect relationship. Vagotomy prevented both hypotension and bradycardia induced by dopamine. Angiotensin II inhibited the early fall and increased the late rise of blood pressure induced by dopamine but had no effect on the bradycardia. Reserpine retreatment prevented the hypotensive and enhanced the hypertensive response to dopamine, and in this situation dopamine induced cardiac arrhythmia. The interaction between dopamine and AII is inhibited by pretreatment with reserpine. The early hypotensive phase and bradycardia caused by dopamine appeared to be the consequence of a vagal reflex.

Congestive heart failure due to hypertensive ventricular diastolic dysfunction.

Left ventricular (LV) diastolic dysfunction is the first discernible manifestation of heart disease in hypertensive patients. Arterial hypertension with LV hypertrophy leads to reduced preload followed by impaired cardiac output (systolic dysfunction stemming from primary diastolic dysfunction). Diastolic dysfunction leads more often than systolic dysfunction to hypertensive heart failure and is in many cases clearly distinguishable from heart failure with low ejection fraction (EF). Mortality due to heart failure from impaired inotropism is higher than mortality due to diastolic dysfunction, but morbidity is lower. Hypertensive cardiomyopathies can be divided into 4 ascending categories, according to the pathophysiologic and clinical impact of hypertension on the heart: Degree I: LV diastolic dysfunction with no associated LV hypertrophy Degree II: LV diastolic dysfunction with echocardiographic LV hypertrophy Degree IIA: Normal exercise capacity in terms of maximal oxygen consumption Degree IIB: Impaired exercise capacity in terms of maximal oxygen consumption Degree III: Congestive heart failure (severe dyspnea and radiographically determined pulmonary edema with normal (> or = 50%) EF Degree IIIA: LV mass/volume ratio > 1.8 with little or no myocardial ischemia Degree IIIB: LV mass/volume ratio < 1.8 with significant myocardial ischemia Degree IV: Profile of dilated cardiomyopathy; LV hypertrophy and impaired EF (< 50%).

Fructose 2,6-bisphosphate levels and modulation of glycolysis by histamine, cholecystokinin, and forskolin in isolated rabbit gastric glands.

In isolated rabbit gastric glands incubated in the presence of 1 mmol/L glucose, the content of fructose 2,6-bisphosphate (F-2,6-P2) was 5.7 +/- 0.5 pmol/mg dry weight. This value was progressively incremented by increasing glucose concentration in the incubation medium, and was almost doubled at 10 mmol/L glucose. Under these conditions, a close correlation could be established between the levels of F-2,6-P2 and the rate of L-lactate formation (r = .98; P less than .05). Both histamine (0.1 mmol/L) and cholecystokinin octapeptide (CCK-OCT; 0.1 mumol/L) increased L-lactate production, without significant changes in either F-2,6-P2 concentration or the amount of 6-phosphofructo-2-kinase in active form. In contrast, forskolin, which markedly increased the glandular content of cyclic adenosine monophosphate (cAMP), partially blocked glucose consumption and caused a significant reduction in both F-2,6-P2 levels and the proportion of 6-phosphofructo-2-kinase in active form. Furthermore, forskolin partially blocked the rate of glucose uptake by isolated gastric glands. Our results suggest a regulatory role of F-2,6-P2 in the control of the glycolytic flux in response to glucose, but not in its response to histamine or CCK-OCT.

Influence of reserpine pretreatment on cardiovascular effects of angiotensin II in rabbits.

Angiotensin II induced a dose-related increase in the amplitude of contraction of preparations of isolated atria and aortic strip of rabbit. These effects were significantly higher in organs obtained from reserpine pretreated animals (4 mg/kg i.p. 24 hr before experiments) than in controls. After reserpine, the effect of four doses of angiotensin II on the blood pressure of rabbits under pentobarbital anesthesia was also significantly higher than in untreated controls.

Influence of reserpine pretreatments on cardiovascular effects of angiotensin II in rabbits.

Angiotensin II induced a dose-related increase in the amplitude of contraction of preparations of isolated atria and aortic strip of rabbit. These effects were significantly higher in organs obtained from reserpine pretreated animals (4 mg/kg i.p. 24 hr before experiments) than in controls. After reserpine, the effect of four doses of angiotensin II on the blood pressure of rabbits under pentobarbital anesthesia was also significantly higher than in untreated controls.

Sulfonylurea effects on acid and pepsinogen secretion in isolated rabbit gastric glands.

The influence of different sulfonylureas on the rate of acid and pepsinogen secretion was studied in isolated rabbit gastric glands. Neither tolbutamide (10-500 microM), chlorpropamide (10-500 microM), glibenclamide (1-50 microM) nor glipizide (1-50 microM) exerted a secretory effect. In contrast, gliquidone caused a marked and dose-dependent stimulation of acid production in gastric glands incubated under basal conditions and potentiated the stimulatory effect of both histamine and carbachol. Gliquidone also increased the rate of pepsinogen release in gastric glands incubated either under basal conditions or in the presence of cholecystokinin-octapeptide or isoproterenol. The secretory effects of gliquidone were associated with a significant increase in the glandular content of cyclic AMP, caused by a competitive inhibition of low-Km cyclic AMP phosphodiesterase. Our results indicate that, among the assayed sulfonylureas, only gliquidone, in the micromolar range, stimulates acid and pepsinogen secretion through a cyclic AMP-dependent mechanism.