Experimental sulphide inhibition calibration method in nitrification processes: A case-study.

Sulphide is one of the inhibitors in the nitrification process in WWTP in regions with sulphate rich soils. As little information is currently available on sulphide nitrification inhibition, the aim of this study was to develop a method based on a modification of the Successive Additions Method to calibrate the effect of sulphide on the activity of ammonia-oxidising bacteria (AOB) and nitrite-oxidising bacteria (NOB). The developed method was then applied to activated sludge samples from two WWTPs with different influent sulphide concentrations. In both cases, sulphide had a greater inhibitory effect on NOB than AOB activity. The sulphide inhibition was found to be lower in the activated sludge fed with sulphide-rich wastewater. The AOB and NOB activity measured at different sulphide concentrations could be accurately modelled with the Hill inhibition equation.

Resource recovery from sulphate-rich sewage through an innovative anaerobic-based water resource recovery facility (WRRF).

This research work proposes an innovative water resource recovery facility (WRRF) for the recovery of energy, nutrients and reclaimed water from sewage, which represents a promising approach towards enhanced circular economy scenarios. To this aim, anaerobic technology, microalgae cultivation, and membrane technology were combined in a dedicated platform. The proposed platform produces a high-quality solid- and coliform-free effluent that can be directly discharged to receiving water bodies identified as sensitive areas. Specifically, the content of organic matter, nitrogen and phosphorus in the effluent was 45 mg COD·L-1, 14.9 mg N·L-1 and 0.5 mg P·L-1, respectively. Harvested solar energy and carbon dioxide biofixation in the form of microalgae biomass allowed remarkable methane yields (399 STP L CH4·kg-1 CODinf) to be achieved, equivalent to theoretical electricity productions of around 0.52 kWh per m3 of wastewater entering the WRRF. Furthermore, 26.6% of total nitrogen influent load was recovered as ammonium sulphate, while nitrogen and phosphorus were recovered in the biosolids produced (650 ± 77 mg N·L-1 and 121.0 ± 7.2 mg P·L-1).

Historical landmarks in vascular neurosurgery "On July 10th 2006, at the 70th Anniversary of the Department of Neurosurgery of Zürich Medical School".

Direct aneurysm surgery started more than 70 years ago. Introduction of cerebral angiography by Moniz in 20s and operating microscope by Yasargil in 60s were the real cornerstones in vascular neurosurgery. Since then the development of neuroanestesiology and further development of non-invasive imaging (MRA and CTA) together with the latest development of operating microscopes with intraoperative ICG angio have shifted vascular microneurosurgery to a different level to still compete with the 'non-invasiness' of endovascular therapy. There is an increasing demand to perform the already forgotten bypasses mastered only by few and with the high-flow techniques (e.g. ELANA) we can treat lesions that some time ago were considered impossible. Endovascular embolization to reduce the flow in AVM before surgery is very helpful in those cases that can not be treated by embolization or radiosurgery alone. We still need to find a way to detect aneurysms before they rupture and especially those thin-walled that are in an increased risk of rupture. Recent data on the pathobiology of the aneurysm wall may help us to better understanding of the growth mechanisms and it might be possible to develop more potent local or systemic pharmaceutical therapy to induce myo-intimal hyperplasia occluding the aneurysm and strengthening the wall to prevent rupture.

The transcription factor PLA-1/SKN-1A is expressed in human placenta and regulates the placental lactogen-3 gene expression.

Here we report the selective expression of two POU transcription factor genes, PLA-1 and OCT-1, in human placenta and choriocarcinoma cell lines JAR, JEG-3 and BeWo. Pla-1 protein binds to a POU-consensus DNA sequence in the human placental lactogen-3 (PL-3) promoter and it is capable of trans-activating its transcription up to 18-fold. Other tissue-specific or ubiquitous POU transcription factors such as Pit-1/GHF-1 or Oct-1 showed none or low levels of trans-activation of the PL-3 promoter. In addition, we identified an unique and highly charged region in the N-terminal portion of Pla-1 protein required for full trans-activation of the PL-3 promoter.

[Early prognosis in chronic subdural hematomas. Multivariate analysis of 137 cases]. / Pronóstico precoz en hematomas subdurales crónicos. Análisis multivariante de 137 casos.

INTRODUCTION: In the literature there is evidence relating different factors such as age and preoperative clinical condition with prognosis in patients treated surgically for chronic subdural haematoma. OBJECTIVE: To clarify and quantify the magnitude of the factors which determine early prognosis (during hospital admission) of these patients. PATIENTS AND METHODS: We made a prospective study of 137 patients who had been operated on in our centre and found the relationship between different clinical and therapeutic variables with the clinical course and morbidity-mortality by means of multivariate and survival analysis. RESULTS: A high Markwalder functional score (3-4) is an independent factor of poor prognosis (OR = 13.15; CI 95% 6.1-28.4; p = 0.01), as is the presence of a coexisting coagulopathy (OR = 27.2; CI 95% 9.3-79.5; p = 0.01). Advanced age tended to increase the risk (OR = 1.104) but did not reach statistical significance (p = 0.0654). A multivariate logistic model, which included the functional score and presence of coagulopathy, correctly classified 94.7% of the cases studied. Analysis of survival showed two groups with different early mortality as a function of the Markwalder score (high: 3-4 and low: 0-1-2), which could be differentiated statistically (Log-Rank chi squared test: 3.95; p = 0.0468). CONCLUSIONS: The preoperative clinical state classified by functional scores and the presence of underlying coagulopathy are the main prognostic factors in chronic subdural haematoma during hospital admission. Advanced age is probably not in itself an independent factor for bad prognosis.

[Effect of hypoxia on gastric secretion of hypovolemic rats]. / Efectos de la hipoxia sobre la secreción de ratas hipovolémicas.

Gastric secretion was checked in two groups of rats with pyloric ligature and experimental hypovolemia subjecting one of the groups to acute hypoxia; in this group there was significant decrease in volume, acid and pepsin secretion and potassium concentration in gastric contents. In gastric mucosa pepsinogen was increased. We wish to emphasise in these changes, the importance of water and hypoxia in electrolytic balance.

[Comparative study of the gastric response in rats with pyloric ligation -- normovolemic rats and rats made hypovolemic by acute hemorrhage -- subjected to hypoxia]. / Estudio comparativo de la respuesta gástrica en ratas con piloro ligado, normovolémicas e hipovolémicas por hemorragia aguda, sometidas a hipoxia.

Gastric secretion was studied in two groups of rats in which pyloric ligature was made according to Dai's method. Both groups were put in a hypopressure chamber. One of the groups was normovolemic. The other group was made hypovolemic by acute bleeding. The following parameters were checked in gastire contents: volumen, acid and pepsin secretion, U.P./g. of stomach, chloride, potassium and sodium; in gastric mucosa total U.P. and pepsinogen concentration were measured. In the rats subjected to acute hypovolemia and hypoxia it was found a significant decrease in acid secretion, chloride and potassium mEq/1; there were no statistically significant changes in volume, pepsin secretion; U.P./g. of stomach and sodium mEq/1. Total U. P. and U.P./. of stomach increased in the gastirc mucosa.

[Gastric secretion in hypovolemic rats caused by acute hemorrhage]. / Secreción gástrica en ratas hipovolémicas por hemorragia aguda.

Gastric secretion was studied in two groups of rats in which pyloric ligature with wire was previously peformed. One of the groups was acutely bled until hypovolemia. The following parameters were checked: gastric volume, acid and pepsin secretion, Pu/g of stomach, chloride, potassium, and sodium. A significant decrease in volume, acid and pepsin secretion, Pu/g of stomach and chloride and increase in potassium in the hypovolemic rats found. There was no significant change in sodium concentration. There was no significant difference in the pepsinogen concentration in gastric mucous between both groups of rats.

PCR cuantitativa en tiempo real para la amplificación de ADN de Burkholderia mallei: comparación con el método molecular recomendado por la OIE / Quantitative PCR in real time to Burhholderia mallei ADN amplification: A comparison with the molecular method recommended by OIE

Objetivo principal: Comparar dos PCRs en tiempo real cuantitativas para la identificacion de Burkholderia mallei, en terminos de sensibilidad y especificidad analiticas. Metodología: Amplificacion parcial de genes de B. mallei:- orf11 y orf13 del sistema de secreción de tipo III TTS1 del genero Burkholderia mediante qPCR con sondas de hibridacion. - fliP que codifica para la flagelina P de B. mallei mediante qPCR con sonda TaqMan. Calculo de parametros de validez. Resultados: El ensayo desarrollado en el laboratorio obtuvo un limite de deteccion del orden del obtenido con el metodo recomendado por la OIE (70,4 fg/reaccion) y permitio la amplificación especifica de ADN de B. mallei. Conclusión: El metodo desarrollado por el laboratorio de Biologia Molecular del INTA permite una rapida amplificacion de ADN de B.mallei con unas elevadas sensibilidad y especificidad analiticas. Ademas, posibilita la diferenciacion entre B. mallei y B. pseudomallei (AU)

Objective: Comparison of two quantitative real-time PCRs for identification of Burkholderia mallei, on analytical sensitivity and specificity terms. Methods: Partial amplification of Burkholderia mallei gene: - orf11 and orf13 targeting the type III secretion TTS1 system cluster from Burkholderia genus by qPCR using hybridisation probes. - fliP targeting flageling P from B. mallei by qPCR by using TaqMan probe. Validity parameters determination. Results: The duplex test developed by the Molecular Biology Laboratory at INTA obtained a limit of detection similar to that reached by the molecular method recommended by the OIE and permitted the specific amplification of B. mallei DNA. Conclusions: The duplex test developed by the Molecular Biology Laboratory at INTA provides a rapid amplification of B. mallei DNA. It also shows high analytical sensitivity and specificity. Furthermore, this test permits the differentiation between B. mallei and B. pseudomallei (AU)

A pilot study to assess the relationship between behavioral manifestations and self-report of pain in postanesthesia care unit patients.

The Chambers and Price Pain Rating Scale was adapted to measure the relationship between behavioral manifestations and self-report of pain in PACU patients. This article discusses the result of a pilot study of the adapted tool. The internal consistency of the tool using coefficient alpha was 0.92. Interrater reliability for each category of the scale, using Pearson's correlation, ranged from 0.71 to 1.0. Thirty subjects were observed by the investigators at two times. In the first observation, frowning or grimacing was the only behavior significantly related to self-reported pain. In the second observation, muscle tension and patient sounds were significantly related to self-report of pain. The results suggest a sequence of pain behaviors in patients recovering from anesthesia. Thus, careful attention to certain behaviors in the recovery period, with a broader focus of assessment in the recovery period, may be necessary for accurate pain assessment.

[Diagnostic imaging in Lemierre's+ syndrome]. / Diagnóstico por imagen en el síndrome de Lemierre.

BACKGROUND: The Lemierre syndrome is a septic picture with jugular thrombophlebitis and secondary septic embolisms usually produced by Fusobacterium necrophorum. In previous reports published in the literature, imaging techniques are seldom referred to report the presence of jugular thrombophlebitis. A case of the Lemierre syndrome is presented with the aim of calling attention to this process and its current diagnostic possibilities. METHODS: The case of a patient who was diagnosed of having a Lemierre syndrome with sepsis by Fusobacterium is presented, with radiologic pulmonary embolisms. The echo-Doppler exam showed the presence of internal jugular involvement in absence of signs and symptoms leading to suspicion. A review of 6 cases is also made with special attention being given to the data on jugular vein involvement. RESULTS: Only in 2 of the 6 patients reviewed were imaging techniques used on the internal jugular view (in one 2D echography and in the other computerized axial tomography) with the diagnosis being performed on the base of symptomatic and physical exam data in the remaining 4 cases. CONCLUSIONS: The Lemierre syndrome should be suspect in all patients with bacteremia by Fusobacterium and radiologic imaging of pulmonary embolism, even in the absence of signs and symptoms of oropharyngeal and jugular involvement. Modern imaging techniques, particularly echo-Doppler, may play an important diagnostic role.

[Myopathy and zidovudine]. / Miopatía y zidovudina.

BACKGROUND: The aim of this study was to evaluate the frequency of appearance of myopathy in a group of patients treated with zidovudine. METHODS: A prospective study of 37 patients with positive serology for HIV treated over 180 days with zidovudine was carried out with evaluation of the clinical history, physical examination and analytical data. RESULTS: The initial mean value of creatine kinase of 76.4 U/l and 83.3 U/l following 6 months of treatment was not statistically significant. Of the 37 patients, 2 (5.4%) showed no variations in CK values, while in 4 (10.8%) there was a decrease and in 30 (81%) an increase. There was an elevation in 11 of the 15 patients (73%) who received doses equal to or lower than 90 g, 11 out of 13 (84.6%) of those who received between 90 and 145 g and 8 out of 8 (100%) of those having received doses higher than 145 g. This increase was minimum in 27 cases (92%) and important with final values of pathologic CK in 3 (8%). Two patients (5.4%) developed clinical manifestations. CONCLUSIONS: Not only the frequency and range of creatine kinase elevation but also the appearance of clinical manifestations in this study are lower than those found in the literature, probably because of the relation with the use of lower doses of zidovudine. These results do not demonstrate any relation with sex, age, risk group for the immunodeficiency status.

[Intensive care for patients with the human immunodeficiency virus]. / Cuidados intensivos para pacientes con el virus de la inmunodeficiencia humana.

BACKGROUND: HIV infection is of special importance in Spain, occasionally requiring the use of intensive care units (ICU) in the management of these cases. METHODS: A retrospective review of the seropositive HIV patients was carried out of those requiring ICU admission in the authors' center over a three year period. Twenty-five patients were included, with the cause for admission into ICU, the clinical features, mortality and prognostic factors being reported. RESULTS: Most of the patients presented as a risk behavior by intravenous drug addiction and did present AIDS prior to hospitalization. The most frequent cause for admission in the ICU was respiratory failure produced by germs other than Pneumocytis carinii, placing this microorganism in second place. The mean time of admission in the ICU was 10.8 days, with 88% requiring mechanical ventilation and 56% the use of vasoactive drugs. The ICU mortality was 48%. No survivor died posteriorly on the ward. Factors of bad prognosis were: less than 200 CD4 lymphocytes/mm3, low albumin levels and high creatinine in addition to the need for vasoactive drugs with no evidence of other data presenting statistical significance. Fourty-four percent of the survivors remain alive at 12 months of hospital discharge. CONCLUSIONS: Respiratory failure produced by Pneumocystis carinii or by other germs is the most frequent cause for ICU admission of patients with HIV infection. Renal failure, lymphopenia, and hypoalbuminemia are predictors of mortality in almost 50% of the cases.

Simultaneous Cerebral Aneurysms and Carotid Disease Should the Symptomatic Lesion always be the first to be Treated? A Case Report.

SUMMARY: Simultaneous presentation of carotid stenosis and cerebral aneurysms is rare and it is conventionally accepted that symptomatic lesions need to be treated first. Our purpose was to describe our experience in managing patients who simultaneously presented significant carotid stenosis and cerebral aneurysm.

Pronóstico precoz en hematomas subdurales crónicos. Análisis multivariante de 137 casos / Early prognosis in chronic subdural haematomas multivariante analysis of 137 cases

Introduction. In the literature there is evidence relating different factors such as age and preoperative clinical condition with prognosis in patients treated surgically for chronic subdural haematoma. Objective. To clarify and quantify the magnitude of the factors which determine early prognosis (during hospital admission) of these patients. Patients and methods. We made a prospective study of 137 patients who had been operated on in our centre and found the relationship between different clinical and therapeutic variables with the clinical course and morbidity-mortality by means of multivariate and survival analysis. Results. A high Markwalder functional score (3-4) is an independent factor of poor prognosis (OR= 13.15; CI 95% 6.1-28.4; p= 0.01), as is the presence of a coexisting coagulopathy (OR= 27.2; CI 95% 9.3-79.5; p= 0.01). Advanced age tended to increase the risk (OR= 1.104) but did not reach statistical significance (p= 0.0654). A multivariate logistic model, which included the functional score and presence of coagulopathy, correctly classified 94.7% of the cases studied. Analysis of survival showed two groups with different early mortality as a function of the Markwalder score (high: 3-4 and low: 0-1-2), which could be differentiated statistically (Log-Rank chi squared test: 3.95; p= 0.0468). Conclusions. The preoperative clinical state classified by functional scores and the presence of underlying coagulopathy are the main prognostic factors in chronic subdural haematoma during hospital admission. Advanced age is probably not in itself an independent factor for bad prognosis (AU)

Introducción. Existen evidencias en la literatura que relacionan diversos factores, como la edad o el estado clínico preoperatorio, con el pronóstico del paciente intervenido quirúrgicamente porhematoma subdural crónico. Objetivo. Clarificar y cuantificar lamagnitud de aquellos factores que determinan el pronóstico precoz (durante el ingreso hospitalario) de dichos pacientes. Pacientes y métodos. Se estudiaron prospectivamente 137 pacientes intervenidosen nuestro centro y se relacionaron diversas variables clínicas y terapéuticas con la evolución clínica y morbimortalidad, mediante análisis multivariantes y de supervivencia. Resultados. Un grado funcional alto de Markwalder (3-4) es factor independiente de mal pronóstico (OR= 13,15; IC 95% 6,1-28,4; p= 0,01), así como la presencia decoagulopatía de base (OR= 27,2; IC 95%: 9,3-79,5; p= 0,01). La edad avanzada tiende a incrementar el riesgo (OR= 1,104), aunque sin significación estadística (p= 0,0654) El modelo logístico multivariante, que incluye el grado funcional y la presencia de coagulopatía, clasifica correctamente al 94,7% de los casos estudiados. El análisis de supervivencia extrajo dos grupos con distinta mortalidad precoz en función del grado de Markwalder (alto: 3-4, y bajo: 0-1-2), y estadísticamente diferenciables (χ2 del test de Log-Rank: 3,95; p= 0,0468). Conclusiones. El estado clínico prequirúrgico clasificado en grados funcionales y la presencia de coagulopatía de base son los principales factores pronósticos del hematoma subdural crónico durante el ingreso hospitalario. La edad avanzada per se probablemente no constituya un factor de mal pronóstico independiente (AU)

Estudios electrofisiológicos en pacientes glaucomatosos / Electrophysiological studies as glucomatous patients

Se estudió un total de 21 pacientes (42 ojos) con glaucoma crónico simple, todos tonométricamente compensados. Fueron divididos en 2 grupos: el primero (GL-1) con discreta o sin afectación de campo visual y el segundo (GL-II)con severa afectación de éste. Se realizaron estudios clínicos y electrofisiológicos. Estos últimos mostraron diferencias significativas entre ambos grupos. Las variables electrofisiológicas (ERG, PEV) en los que se evidencia una mayor afectación para el segundo grupo fueron: el incremento de la latencia y disminución de la amplitud de las ondas a y b del electrorretinograma (ERG), así como un incremento de la latencia de la onda P2 (P100) del potencial evocado visual (PEV) a patrón. Los resultados fueron comparados con las normas de nuestro laboratorio para estas variables y procesados de acuerdo con el diseño estadístico