Abatement of pesticides residues in commercial farm soils by combined ozonation-solarization treatment.

The widespread use of pesticides against agricultural pest and diseases introduces these pollutants and their transformation products into soils. The toxicity and permanence of these substances make it necessary for the development of remediation strategies in order to mitigate contamination and to further protect consumers. This work was aimed to evaluate the applicability of ozonation-solarization technology in the degradation of pesticide residues in commercial farm soils. The trial was conducted in two exploitations devoted during decades to tomato cultivation under greenhouse and net systems. Treatments were carried out using a pipping network (both superficial and sub-superficial) that delivered ozone in gaseous state after covering the soil with gas-tight plastic film to avoid ozone leaks to atmosphere. Control soil treatments, without ozone exposure, were also conducted. After 40 days of treatment, mean degradation percentages of about 55-61% for both cultivation systems were obtained, when the reduction of these pollutants in the control soils was about 8-15%. Ozonation-solarization impact was also assessed by changes on soil physical-chemical properties. Results suggest that ozonation in combination with solarization technique could be considered as a feasible approach for the remediation of pesticide-polluted farm soils.

Universal screening for hepatitis C - in for a penny, in for a pound.

Infection with hepatitis C virus (HCV) is a major public health problem. In fact, chronic HCV is a leading cause of cirrhosis, hepatocellular carcinoma, and death from liver disease in most countries. The advent of highly effective oral direct-acting antiviral therapy is the most significant advance in the treatment of HCV in decades and now allows us to cure chronic HCV. However, a large number of infected patients have not been diagnosed since hepatitis C is a largely asymptomatic disease. Thus, it is fundamental to improve the screening system in order to identify individuals who are currently infected and to treat them. Risk-based hepatitis C testing and birth cohort screening have had limited success and many patients living with the infection are not aware of their status. Universal screening for HCV is a tremendous improvement compared with the previous strategies. Indeed, global screening leads to the appropriate identification and treatment of all individuals chronically infected with HCV and prevents the progression of liver disease and the associated morbidity and mortality. In addition, universal HCV testing appears to be cost-effective. In this article, we review the current barriers to HCV eradication and the different strategies for HCV infection screening.

Trastuzumab Emtansine-Induced Nodular Regenerative Hyperplasia: Is Dose Reduction Enough as a Preventable Measure?

INTRODUCTION: Trastuzumab emtansine (T-DM1) is a novel antibody-drug conjugate targeting the human epidermal growth factor receptor 2, used in some recurrent metastatic cancers. It was linked to modest increases in serum aminotransferase elevations and bilirubin. More recently, some cases of noncirrhotic portal hypertension have been described in patients on long-term T-DM1. The underlying liver condition is usually nodular regenerative hyperplasia (NRH) with elements of sinusoidal obstruction. CASE REPORT: We report the case of a 52-year-old woman who started T-DM1 therapy for recurrent metastatic lung adenocarcinoma. Although a progressive reduction in lung nodules was noticed, there was a new-onset cytocholestasis and elevation in bilirubin. A reduction in platelet count was also apparent over several months during the T-DM1 therapy. Liver biopsy revealed NRH and so the dose of T-DM1 was reduced. Thereafter, the patient had normalization of liver tests and platelet count. T-DM1 was continued for more than 9 months with no signs of portal hypertension or cancer progression. CONCLUSIONS: We presented a rare case of NRH induced by T-DM1 in a patient with lung adenocarcinoma. A high index of suspicion for liver injury and NRH must be maintained for patients who develop liver test abnormalities and/or signs of portal hypertension during treatment with T-DM1. This is the first report of a successful dose reduction in a patient with NRH induced by T-DM1, suggesting that it is possible to maintain the drug while it is being effective for lung cancer treatment.

Free and glycosylated aroma compounds in grapes monitored by solid-liquid extraction and dispersive liquid-liquid microextraction combined with gas chromatography-mass spectrometry.

Fifteen aroma compounds have been determined in their free and glycosylated forms in grapes using dispersive liquid-liquid microextraction with gas chromatography-mass spectrometry. The sample treatment includes a previous solid-liquid extraction stage and subsequent parallel microextraction approaches to preconcentrate total aroma content and the free fraction. Thus, the extraction of the total content of analytes requires previous enzymatic hydrolysis of the bound forms. For preconcentration, chloroform (250 µl) and acetonitrile (1.5 ml) were added to 10 ml of the sample extract in the presence of 0.5 g sodium chloride. The absence of matrix effect in the samples allowed quantification against aqueous external standards. Limits of detection ranged between 5 and 30 ng/g, depending on the compound. Method accuracy was studied through recovery assays, with recoveries in the 82-115% range being obtained. Relative standard deviations for repeatability studies were lower than 12%. Four different samples of grapes were analyzed, being quantified linalool in its free form at concentrations in the 359-470 ng/g range, and benzyl alcohol, 2-phenylethanol, and linalool oxide I and II in their bound forms between 52 and 464 ng/g.

The long life of a hemoclip.

An 87-year-old male with frequent episodes of food impaction underwent esophageal high-resolution manometry, which revealed type-I achalasia. Due to his advanced age and the presence of comorbidities, botulinum toxin injection was proposed and accepted by the patient. In June 2021, esophagogastroduodenoscopy revealed an esophageal dilatation with liquid and food retention and narrowing of the esophagogastric junction. An injection of 25 units of botulinum toxin diluted in 10 mL of saline was administered in each of the 4 lower esophageal sphincter quadrants, with no complications.

Kaposi's sarcoma with atypical gastrointestinal involvement.

A 31-year-old human immunodeficiency virus (HIV) positive male presented with weight loss, asthenia and anorexia of three weeks evolution. On physical exam, the patient had painless purple-colored papules on the trunk and upper limbs. Laboratory studies showed severe immunosuppression, with an absolute CD4 cell count of 114 cell/ul and HIV1-RNA level of 180,000 copies/ml. Esophagogastroduodenoscopy showed an exophytic lesion in the distal esophagus composed of three polyps and multiple flat and nodular maculopapular erythematous lesions in the gastric body, antrum and duodenum. Colonoscopy was also performed and identified several flat erythematous lesions in the colorectal mucosa. A neoplasm composed of small irregular vascular channel proliferation and spindled endothelial cells with minimal atypia was observed in all the esophageal, gastric, duodenal, colic and skin biopsies.

Gastroduodenal ischemia in a patient with severe SARS-CoV-2 infection.

A 54-year-old male with a past medical history of hypertension, dyslipidemia, obesity, and diastolic heart failure, was admitted due to COVID-19 pneumonia. Respiratory failure gradually deteriorated and the patient was transferred to the intensive care unit (ICU), where mechanical ventilation and veno-venous extracorporeal membrane oxygenation (VV-ECMO) were started. On the second day in the ICU, he went into septic shock due to ventilator-associated pneumonia. Five days later, the patient had new-onset melena and laboratory data showed a hemoglobin level of 7.8 g/dL. He required blood transfusions and vasopressor requirements increased.

Duodenal-type follicular lymphoma: a silent tumor.

A 79-year-old male, with a past medical history of hypertension, dyslipidemia and type 2 diabetes, underwent routine esophagogastroduodenoscopy and colonoscopy. The patient was asymptomatic, with unremarkable blood tests. Upper gastrointestinal endoscopy showed multiple whitish nodular lesions in the first part of the duodenum.

Autoimmune hepatitis after COVID-19 vaccine - more than a coincidence.

The COVID-19 pandemic is still raging across the world and vaccination is expected to lead us out of this pandemic. Although the efficacy of the vaccines is beyond doubt, safety still remains a concern. We report a case of a 65-year-old woman who experienced acute severe autoimmune hepatitis two weeks after receiving the first dose of Moderna-COVID-19 vaccine. Serum immunoglobulin G was elevated and antinuclear antibody was positive (1:100, speckled pattern). Liver histology showed a marked expansion of the portal tracts, severe interface hepatitis and multiple confluent foci of lobular necrosis. She started treatment with prednisolone, with a favorable clinical and analytical evolution. Some recent reports have been suggested that COVID-19 vaccination can lead to the development of autoimmune diseases. It is speculated that the vaccine can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. Therefore, healthcare providers must remain vigilant during mass COVID-19 vaccination.

Self-expandable metal stents in esophageal cancer before preoperative neoadjuvant therapy: efficacy, safety, and long-term outcomes.

BACKGROUND: Self-expandable metal stent (SEMS) placement for malignant dysphagia before preoperative neoadjuvant therapy (NT) is controversial. AIM: Evaluate SEMS placement impact on clinical and oncologic outcomes in patients with esophageal cancer who underwent surgery after NT. METHODS: Retrospective study of esophageal cancer patients referred for esophagectomy after NT. A propensity score was built consisting of the conditional probability of having had a SEMS given a set of baseline variables. In the SEMS group, patients underwent SEMS placement followed by NT and esophagectomy, whereas in the non-SEMS group, patients underwent only NT and esophagectomy. RESULTS: One hundred patients were included, 29 in the SEMS group and 71 in the non-SEMS group. Median follow-up was 18 months. SEMS-related adverse events occurred in 20.7% of the patients. After propensity score analysis, SEMS use decreased delta dysphagia score (regression coefficient [RC]: - 2.69, 95% CI - 3.18 to - 2.21), dysphagia grade before surgery (RC: - 0.74, 95% CI - 1.22 to - 0.27), hospital readmissions at 1 month (OR 0.18; p = 0.019), but increased overall morbidity after surgery (OR 3.02; p = 0.045). No significant differences were found regarding delta albumin levels and albumin levels before surgery, delta weight and weight before surgery, death related to surgery, number of lymph nodes harvested, R0 resection rate, tumor recurrence, recurrence-free survival, overall survival, and 30-day, 6-month, and 3-year mortality. CONCLUSION: SEMS placement improved dysphagia and allowed patients to maintain an equal nutritional status compared to patients without dysphagia during NT. Although postsurgical morbidity was higher in patients with SEMS placement, postsurgical mortality and oncological outcome were not different.

Unexpected diagnosis for nodular hepatic lesions.

Uveal melanoma is the most common primary ocular tumor and has a significant predilection for metastasis to the liver. Nevertheless, metastatic uveal melanoma usually occurs in the first years after the initial treatment, and late recurrence is extremely rare.

M-CHAT-R/F Validation as a screening tool for early detection in children with autism spectrum disorder. / Validación del M-CHAT-R/F como instrumento de tamizaje para detección precoz en niños con trastorno del espectro autista.

INTRODUCTION: Screening for Autism Spectrum Disorders (ASD) using the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) increases early detection, allowing early interventions and improving prognosis. This tool is part of the management in case of suspected ASD in several clinical guidelines. The objective of this article was to conduct the concurrent and discrimi nant validation and the reliability analysis of M-CHAT-R/F in the Chilean population. PATIENTS AND METHOD: This is the second stage of the cross-cultural adaptation of cross-sectional design. M-CHAT- R/F was applied to a sample of 20 children with suspected ASD and 100 randomly selected healthy control children, aged between 16-30 months. Autism Diagnostic Observation Schedule (ADOS-2), considered as reference, was applied to the 20 patients of the clinical sample, to 20 children of the healthy control sample and to those cases of the healthy control sample with M-CHAT-R/F positive. Cronbach alpha was calculated, as well as M-CHAT-R/F and ADOS-2 correlation, sensitivity, and specificity analyses. RESULTS: In the healthy sample, M-CHAT-R/F was positive in two patients, with one of them positive and the other one negative for ASD with ADOS-2 test. In the clinical sample, M- CHAT-R/F was positive in all cases, three of them were negative in the ADOS-2 test. The Alfa relia bility of M-CHART-R/T was 0,889, the discriminant sensitivity and specificity were 100% and 98%, and the concurrent ones were 100% and 87.5% respectively. CONCLUSIONS: The Chilean M-CHAT- R/F version was reliable, sensitive and specific, similar to the original test, which opens the possibility for its use in clinical samples and for research. Validating M-CHAT-R/F is an ongoing process which must be further developed.

Magnetic solid-phase extraction or dispersive liquid-liquid microextraction for pyrethroid determination in environmental samples.

The determination of 15 pyrethroids in soil and water samples was carried out by gas chromatography with mass spectrometry. Compounds were extracted from the soil samples (4 g) using solid-liquid extraction and then salting-out assisted liquid-liquid extraction. The acetonitrile phase obtained (0.8 mL) was used as a dispersant solvent, to which 75 µL of chloroform was added as an extractant solvent, submitting the mixture to dispersive liquid-liquid microextraction. For the analysis of water samples (40 mL), magnetic solid-phase extraction was performed using nanocomposites of magnetic nanoparticles and multiwalled carbon nanotubes as sorbent material (10 mg). The mixture was shaken for 45 min at room temperature before separation with a magnet and desorption with 3 mL of acetone using ultrasounds for 5 min. The solvent was evaporated and reconstituted with 100 µL acetonitrile before injection. Matrix-matched calibration is recommended for quantification of soil samples, while water samples can be quantified by standards calibration. The limits of detection were in the range of 0.03-0.5 ng/g (soil) and 0.09-0.24 ng/mL (water), depending on the analyte. The analyzed environmental samples did not contain the studied pyrethroids, at least above the corresponding limits of detection.

Evaluation of the Leaching Potential of Anthranilamide Insecticides Through the Soil.

The mobility of two relatively new antranilic diamide insecticides, cyanantraniliprole (CY) and cholantraniliprole (CH) in soil was examined, by means of disturbed columns loaded with a typical semiarid Mediterranean soil (Calcaric fluvisol) under laboratory conditions. Both insecticides appeared in leachates, with 52% of CY and 41% of CH of the initial mass added (1 µg g-1) present. For CY, 21% and 19% were recovered from the upper and bottom layers of the soil, respectively, while for CH, 33% and 22% were recovered from the upper and bottom layers respectively. Based on the calculated half-lives (29 and 27 days for CY and CH, respectively) and their log K OC (about 2.5 for both), the calculated Groundwater Ubiquity Score (GUS) index was higher than 5 for both, indicating they have the potential to leach. Two transformation products, C13H9Cl2N2O (IN-ECD73) and C19H12BrClN6O (IN-J9Z38) corresponding to the degradation of CH and CY, respectively were also identified and detected in leachates and soil.

Use of different organic wastes in reducing the potential leaching of propanil, isoxaben, cadusafos and pencycuron through the soil.

In this study, we examined the effect of four different organic wastes (OW)-composted sheep manure (CSM), spent coffee grounds (SCG), composted pine bark (CPB) and coir (CR)-on the potential groundwater pollution of propanil and isoxaben (herbicides), cadusafos (insecticide) and pencycuron (fungicide) under laboratory conditions. For this purpose, leaching studies were conducted using disturbed soil columns filled with a clay loam soil (Hipercalcic calcisol). The addition of organic matter (OM) drastically reduced the movement of the studied pesticides. The results obtained point to the interest in the use of agro-industrial and composted OW in reducing the groundwater pollution by pesticide drainage.