High aluminum content in bone of marine mammals and its relation with source levels and origin.

Although aluminum is widely distributed in the earth's crust, its environmental availability and wildlife assimilation rates are only partially known. Here we analyze aluminum concentrations in bone from 10 species of marine mammals inhabiting 3 geographic areas subject to different aluminum inputs: the Río de la Plata estuary (Uruguay), the coastal waters of Mauritania and the Galapagos archipelago (Ecuador). Overall, concentrations were unusually high as compared to those of terrestrial animals, with lowest concentrations in the Galapagos archipelago, then the Río de la Plata estuary and finally Mauritania. The aluminum source varied between regions, prevailing anthropogenic sources in the Río de la Plata Estuary and natural sources (wind-blown dust) in Mauritanian waters. The type of source determined contamination levels: anthropogenic sources were most significant for coastal species and showed a decline with distance of habitat from shoreline, while natural sources had a higher influence on open waters because of the dearth of biogenic silica that eliminates aluminum from the water column. Since aluminum remains in bone for several decades, marine mammal bone reflects historical levels of aluminum and therefore is a good bioindicator of the aluminum concentration of the marine environment.

Static magnetic field on behavior, hematological parameters and organ damage in spontaneously hypertensive rats.

Previous studies showed contradictory results of static magnetic field (SMF) influence on behavior, hematological parameters and organ damage. The aim of this study was to investigate influence of subchronic continuous exposure to upward and downward oriented SMF of moderate intensity on behavior, hematological characteristics, heart and kidney tissue of spontaneously hypertensive rats. SH rats exposed to downward oriented SMF demonstrated lack of anxious-like behavior. SMF of either orientation caused decrease in the number of platelets in peripheral blood, granulocytes in the spleen and bone marrow and increase in the number of erythrocytes in the spleen, in both exposed groups. We also demonstrated that spontaneously hypertensive rats exposed to upward oriented SMF exhibited decreased lymphocytes count in blood, decreased bone marrow erythrocytes count and rats exposed to downward oriented SMF had increased lymphocytes count in bone marrow. The results showed adverse effect of differently oriented SMF on hematological parameters of spontaneously hypertensive rats. Also, exposure to different oriented SMF didn't affect their heart and kidney morphological characteristics.

Landmark versus ultrasound-guided insertion of femoral venous catheters in the pediatric intensive care unit: An efficacy and safety comparison study / Inserción tradicional versus eco-dirigida de catéteres venosos femorales en la unidad de cuidados intensivos pediátricos: un estudio comparativo de eficacia y seguridad

Background: Central venous cannulation (CVC) is common and necessary in pediatric intensive care. However, this procedure is not without risks or complications. Although CVCs have classically been placed following anatomical landmarks, the use of ultrasound guidance has largely replaced the latter, given its better profile of efficacy and safety, demonstrated at least in adult populations. Objectives: To compare the effectiveness and safety in the insertion of femoral central venous catheters guided by ultrasound (US) versus the anatomical method (LM) in critical care pediatric patients. Methods: 100 patients were randomized: 50 were assigned to the US group and 49 to the LM group. In the LM group the traditional method consisted in palpating the femoral artery pulse as a; in the US group the CVC was inserted using a real time technique. Success at the first attempt, overall success in cannulation, number of attempts and arterial puncture were the variables studied in both groups. Results: Success at the first attempt and overall success in cannulation were significantly higher in the US group versus the LM (US 42% vs. LM 18%, p 0.011, US 84% vs. LM 51% p <0.001, respectively). The incidence of puncture of the femoral artery was lower in the US group (LM 12 vs. US 5, p 0.056) without achieving statistical significance. Conclusions: According to our results, the placement of central venous access via the femoral approach should be preferably performed under ultrasound guidance, however, further studies in larger populations are needed to confirm this findings

Antecedentes: La instalación de un catéter venoso central (CVC) es una práctica común y necesaria en cuidados intensivos pediátricos. Sin embargo, dicho procedimiento no se encuentra carente de riesgos ni de complicaciones. Si bien clásicamente los CVC se han colocado siguiendo referencias anatómicas, el uso de la guía ecográfica ha reemplazado a este método, dado su mejor perfil de eficacia y seguridad, demostrado al menos en poblaciones adultas. Objetivos: Comparar la efectividad y seguridad en la inserción de catéteres venosos centrales femorales guiados por ecografía (US) versus mediante el método anatómico (LM) en pacientes críticos pediátricos. Métodos: Se aleatorizaron 100 pacientes: 50 se destinaron al grupo US y 49 al LM. En el grupo LM se usó el método tradicional palpando pulso femoral; en el grupo US se colocó el CVC guiado por ecografía en tiempo real. El éxito al primer intento, éxito global en la canulación, número de intentos y la punción arterial fueron las variables de estudio entre ambos grupos. Resultados: El éxito al primer intento y el éxito global en la canulación fueron significativamente mayores en el grupo US versus LM (US 42% vs. LM 18%, p=0,011; US 84% vs. LM 51%, p<0,001, respectivamente). La incidencia de punción de la arteria femoral fue menor en el grupo US (LM 12 vs. US 5, p=0,056) sin lograr significación estadística. Conclusiones: De acuerdo con nuestros resultados, la colocación del acceso venoso central por vía femoral debiera realizarse bajo guía ecográfica, aunque se necesitan estudios en poblaciones más numerosas que confirmen dichos resultados

Landmark versus ultrasound-guided insertion of femoral venous catheters in the pediatric intensive care unit: An efficacy and safety comparison study.

BACKGROUND: Central venous cannulation (CVC) is common and necessary in pediatric intensive care. However, this procedure is not without risks or complications. Although CVCs have classically been placed following anatomical landmarks, the use of ultrasound guidance has largely replaced the latter, given its better profile of efficacy and safety, demonstrated at least in adult populations. OBJECTIVES: To compare the effectiveness and safety in the insertion of femoral central venous catheters guided by ultrasound (US) versus the anatomical method (LM) in critical care pediatric patients. METHODS: 100 patients were randomized: 50 were assigned to the US group and 49 to the LM group. In the LM group the traditional method consisted in palpating the femoral artery pulse as a; in the US group the CVC was inserted using a real time technique. Success at the first attempt, overall success in cannulation, number of attempts and arterial puncture were the variables studied in both groups. RESULTS: Success at the first attempt and overall success in cannulation were significantly higher in the US group versus the LM (US 42% vs. LM 18%, p 0.011, US 84% vs. LM 51% p <0.001, respectively). The incidence of puncture of the femoral artery was lower in the US group (LM 12 vs. US 5, p 0.056) without achieving statistical significance. CONCLUSIONS: According to our results, the placement of central venous access via the femoral approach should be preferably performed under ultrasound guidance, however, further studies in larger populations are needed to confirm this findings.

Prise en charge de l'hyperprolactinemieà l'hôpital du Mali

Introduction:L'hyperprolactinémie, qui est une sécrétion supra physiologique de prolactine est en clinique le désordre hypophysaire antérieur le plus fréquemment rencontré. Son incidence et sa prévalence sont peu définies, en Afrique et dans le reste du Monde.Les objectifs étaient d'étudier les aspects cliniques, paracliniques, étiologiques et thérapeutiques de l'hyperprolactinémie à l'hôpital du Mali.Méthodologie :Il s'agissait d'une étude transversale de 5 ans. La collecte des données a été rétrospective (juillet 2011 à octobre 2015) et prospective (décembre 2015 à juillet 2016).Résultats:Nous avons colligés 37 cas d'hyperprolactinémie. Le sex ratio était de 0,85. L'âge moyen était 37,32ans avec des extrêmes allant de 15 à 74 ans. Le tableau clinique était dominé chez les femmes par l'aménorrhée (80%), la galactorrhée (70%), les céphalées (55%), l'hypofertilité (50%), les troubles visuels (25%) et chez les hommes par la baisse de la libido (64,7%), la gynécomastie (47,1%), lescéphalées (47,1%), les troubles visuels (41,2%) et les troubles de l'érection (29,4%). La prolactinémie basale était supérieure à 100ng/mlchez 45,9% des patients. La tomodensitométrie cérébrale avait objectivé : 11 cas de macroadénomes et 5 cas demicroadénomes hypophysaires. Les principals causes de l'hyperprolactinémie étaient : l'adénome hypophysaire à prolactine (43,24%) ;l'hypothyroïdie(5,40%) et la prise d'oestroprogestatifs chez 5,40%. Pour le traitement, 64,9% des patients étaient mis sous cabergoline ; 27% sous bromocriptine et8,10% sous simple surveillance clinique et biologique.Conclusion:L'hyperprolactinémie est une pathologie qui existe dans nos structures de santé. Les cliniciens doivent y penser devant une aménorrhée galactorrhée ou une baisse de la libido. Il est aussi nécessaire d'améliorer le plateau technique pour une meilleure prise en charge

Modulation of rat synaptosomal ATPases and acetylcholinesterase activities induced by chronic exposure to the static magnetic field.

PURPOSE: It is considered that exposure to static magnetic fields (SMF) may have both detrimental and therapeutic effect, but the mechanism of SMF influence on the living organisms is not well understood. Since the adenosine triphosphatases (ATPases) and acetylcholinesterase (AChE) are involved in both physiological and pathological processes, the modulation of Na+/K+-ATPase, ecto-ATPases and AChE activities, as well as oxidative stress responses were followed in synaptosomes isolated from rats after chronic exposure toward differently oriented SMF. MATERIAL AND METHODS: Wistar albino rats were randomly divided into three experimental groups (six animals per group): Up and Down group - exposed to upward and downward oriented SMF, respectively, and Control group. After 50 days, the rats were sacrificed, and synaptosomes were isolated from the whole rat brain and used for testing the enzyme activities and oxidative stress parameters. RESULTS: Chronic exposure to 1 mT SMF significantly increased ATPases, AChE activities, and malondialdehyde (MDA) level in both exposed groups, compared to control values. The significant decrease in synaptosomal catalase activity (1.48 ± 0.17 U/mg protein) induced by exposure to the downward oriented field, compared to those obtained for Control group (2.60 ± 0.29 U/mg protein), and Up group (2.72 ± 0.21 U/mg protein). CONCLUSIONS: It could be concluded that chronic exposure to differently oriented SMF increases ATPases and AChE activities in rat synaptosomes. Since brain ATPases and AChE have important roles in the pathogenesis of several neurological diseases, SMF influence on the activity of these enzymes may have potential therapeutic importance.

Static magnetic field reduces blood pressure short-term variability and enhances baro-receptor reflex sensitivity in spontaneously hypertensive rats.

PURPOSE: It has been shown that chronic exposure of young spontaneously hypertensive rats (SHR) to static magnetic field (SMF) delays the development of overt hypertension. Therefore the aim of the present work was to investigate the effects of SMF on autonomic cardiovascular control in adult spontaneously hypertensive rats. MATERIALS AND METHODS: Experiments were performed in freely moving spontaneously hypertensive rats equipped with femoral arterial catheter for blood pressure recording. Spontaneously hypertensive rats were exposed for 30 days to upward-oriented SMF (n = 17) or downward-oriented SMF (n = 17) of 16 mT intensity. A control group of spontaneously hypertensive rats (n = 17) was not exposed to SMF. Neurogenic cardiovascular control was evaluated by spectral analysis of arterial blood pressure and heart rate short-term variability and baro-receptor reflex sensitivity using the sequence method. RESULTS: Exposure of spontaneously hypertensive rats to both upward- and downward-oriented SMF significantly reduced arterial blood pressure and enhanced baro-receptor reflex sensitivity. Downward-oriented SMF reduced heart rate, too. SMF of either orientation reduced systolic blood pressure variability in very low frequency domain while downward-oriented SMF also reduced low-frequency and increased high frequency domains. CONCLUSION: It follows that prolonged exposure to SMF is beneficial for neurogenic cardiovascular control in hypertension.

Subchronic exposure to static magnetic field differently affects zinc and copper content in murine organs.

PURPOSE: Static magnetic fields (SMF) have been widely used in research, medicine and industry. Since zinc and copper play an important role in biological systems, we studied the effects of the subchronic continuous SMF exposure on their distribution in murine tissues. MATERIALS AND METHODS: For 30 days, mice were exposed to inhomogeneous, vertical, downward or upward oriented SMF of 1 mT averaged intensity with spatial gradient in vertical direction. RESULTS: SMF decreased the amount of copper and zinc in liver. In brain, zinc levels were increased and copper levels were decreased. In spleen, zinc content was reduced, while copper amount remained unchanged. CONCLUSIONS: Subchronic exposure to SMF differently affected copper and zinc content in examined organs, and the changes were more pronounced for the downward oriented field. The outcome could be attributed to the protective, rather than the harmful effect of SMF.

Homogeneous static magnetic field of different orientation induces biological changes in subacutely exposed mice.

It has been shown that static magnetic field (SMF) of moderate intensity produces considerable impact on biological systems. SMF can be homogeneous or inhomogeneous. In many studies, inhomogeneous SMF was employed. Aware that inhomogeneous SMF could result in experimental variability, we investigated the influence of a vertical homogeneous SMF of different orientation. Male Swiss-Webster 9- to 10-week-old mice were subacutely exposed to upward- and downward-oriented SMF of 128 mT generated by a cyclotron for 1 h/day during a 5-day period. We found that SMF affected various organs and that these effects were, to some degree, dependent on SMF orientation. Both upward- and downward-oriented SMF caused a reduction in the amount of total white blood cells (WBC) and lymphocytes in serum, a decrease of granulocytes in the spleen, kidney inflammation, and an increase in the amount of high-density lipoprotein (HDL). In addition, upward-oriented SMF caused brain edema and increased spleen cellularity. In contrast, downward-oriented SMF induced liver inflammation and a decrease in the amount of serum granulocytes. These effects might represent a specific redistribution of pro-inflammatory cells in blood and among various organs. It appears that homogeneous SMF of 128 mT affected specific organs in the body, rather than simultaneously and equally influencing the entire body system.

Use of epidermis for the monitoring of tissular trace elements in Mediterranean striped dolphins (Stenella coeruleoalba).

Trace elements accumulate in epidermis, liver, kidney and muscle tissues in cetaceans. However, contrarily to internal tissues, epidermis can be sampled using minimally-invasive techniques. We investigate the patterns of trace element tissue concentrations in relation to individual sex and length and the degree of inter-tissue equilibrium between epidermis and the main internal organs of the Mediterranean striped dolphin. With it, we aim to test whether epidermis is a suitable tissue to predict trace element concentrations of internal tissues in cetaceans. We focused on trace elements with high potential toxicity (mercury and cadmium) or biological significance (zinc, copper and selenium). In contrast to what was found for Cu and Zn, the concentrations of Hg, Cd and Se in epidermis were positively correlated with the levels found in the internal tissues sampled probably due to their capacity to bioaccumulate. Thus, we conclude that sampling and analysing epidermis is appropriate to monitor and predict the concentrations of Hg, Cd and Se in internal tissues but not for Cu and Zn.

Insights on the design of free-spanning pipelines.

The design of free-spanning pipelines is performed with the aim of ensuring their integrity against permanent loads generated by seabed roughness, functional loads induced by internal pressure and temperature, and dynamic loads induced by marine currents and direct wave action. In particular, a load and resistance factored design is applied that focuses on extreme environmental loads, and a fatigue limit state approach is applied as a consequence of free-span dynamics due to vortex shedding-induced vibration and direct wave action. The pipeline free-span scenario can be permanent, when generated by seabed roughness, or characterized by short- to long-term evolution, when generated by seabed mobility and scouring in shallow waters. Free-span analysis is generally a task involving a number of disciplines and should be carried out using a multidisciplinary approach. The paper illustrates various themes related to free-span analysis: (i) free-span scenarios, (ii) characterization of the environment from deep to shallow water related to proper seabed properties, (iii) hydrodynamic load regimes, (iv) pipeline free-span design assessment aiming to reduce overstress and fatigue damage, (v) erodible seabed mobility and local scour, and (vi) some experiences of inspection surveys chosen as representative of a free-spanning pipeline in sandy soils.

Concentrations of mercury in tissues of striped dolphins suggest decline of pollution in Mediterranean open waters.

The Mediterranean is a semi-enclosed sea subject to high mercury (Hg) pollution from both natural and anthropogenic sources. With the objective of discerning temporal changes in marine Hg pollution in the oceanic waters of the northwestern Mediterranean Sea, we analysed liver and kidney from striped dolphins (Stenella coeruleoalba) collected during 2007-2009 and compared them with previous results from a similar sample from 1990-1993. The effect of body length and sex on tissue Hg concentrations was investigated to ensure an unbiased comparison between the periods. The Hg concentrations did not show significant sex-related differences in any tissue or period but were correlated positively with body length. Using body length as a covariate, Hg concentrations in liver and kidney were higher in 1990-1993 than in 2007-2009. This result suggests that measures to reduce emissions in Western European countries have been effective in reducing mercury pollution in Mediterranean open waters.

Hematological parameters' changes in mice subchronically exposed to static magnetic fields of different orientations.

Static magnetic fields (SMFs) are time independent fields whose intensity can be spatially dependent. This study investigates influence of subchronic continuous exposure to upward and downward directed SMF on hematological parameters and spleen cellularity in mice. The experiment is performed on the Northern hemisphere; consequently, the vertical component of geomagnetic field is directed downward. Male, Swiss-Webster, 6 weeks old mice were exposed to the vertically declining SMF. Mice were divided in three groups and continuously exposed or not exposed for 28 days to the SMF characterized by the averaged field of 16 mT and averaged field gradient of 10 mT/cm. Differently oriented SMF did not alter hemoglobin and hematocrit content among the groups. However, the groups exposed to the upward and downward fields had statistically significant higher levels of serum transferrin compared to the control. Moreover, spleen cellularity in animals in the downward group was significantly higher compared to the upward and control group. In addition, spleen lymphocytes in both of the exposed groups were significantly higher than in the control group. In contrast, spleen granulocytes in the exposed groups were significantly lower than in the control group. Significant decrease was also observed in brain and liver iron content with concomitant increase of iron in serum and spleen in exposed animals. Subchronic continuous exposure to 16 mT SMF caused lymphocyte and granulocyte redistribution between spleen and blood. This distribution is typical for stress induced hematological changes. These results suggest that observed changes were not due to an unspecific stress response, but that they were rather caused by specific adaptation to subchronic SMF exposure.

In vitro activity (MIC and MFC) of voriconazole, amphotericin B, and itraconazole against 192 filamentous fungi: the GISIA-2 study.

We evaluated the in vitro activity of voriconazole, amphotericin B, and itraconazole against 192 clinical mould isolates recovered in twenty Italian microbiology laboratories. The vast majority of isolates belonged to the genus Aspergillus (94.2%) with A. fumigatus (58.3%) being the most frequently isolated species. Antifungal susceptibility testing was performed using the broth microdilution method defined by the CLSI M38-A standard, and results were compared to those obtained with Sensititre panels. Aspergillus flavus ATCC 204304 was employed as reference strain and results were within all expected ranges. Voriconazole's activity against the 192 mould isolates was comparable to that of amphotericin B and itraconazole: voriconazole MIC90 (CLSI 1 microg/ml, Sensititre 1 microg/ml), itraconazole MIC90 (CLSI 0.5 microg/ml, Sensititre 0.5 microg/ml), amphotericin B MIC90 (CLSI 1 microg/ml, Sensititre 1 microg/ml). In conclusion, these in vitro data highlight voriconazole's broad spectrum activity against filamentous fungi and support its use as a first line agent for the treatment of fungal diseases.

[Column and upper limb muscoloskeletal disorders in drivers helpers]. / Valutazione dei disturbi e delle patologie muscolo- scheletriche del rachide e degli arti superiori in autisti soccorritori.

The past two decades have witnessed a sharp rise in the incidence of work-related musculoskeletal disorders (WMSD) off the upper extremities and low back pain. The high frequency of these Pathologies and the estimated costs induced a large number of searcher to indentify causes etiological and preventive measure. Epidemiological surveys have inquired people mainly devoted to health clinic, where nurses and health assistants partner; are few data on the rescuers drivers and operators of emergencies. In the sample considered the 3.9% presented abnormalities in at least one section of the column, the 3.8% presented borne disorders of the cervical spine and backbone for the past 12 months. No major disturbances emerged dependents of the upper limbs, pain in the wrist, paraesthesia day and night; No subject also reported disturbances hands as evidenced from examination goal. The 2.3% reported having had an accident at work with prognosis of less than 30 days and 06% over 30 days. The results showed that, through prevention program it is possible to reduce musculoskeletal disorders in specific occupations such as drivers and operators of emergencies.

Octreotide in the management of postoperative chylothorax.

Chylothorax (KT) may be a complication of thoracic surgery. Its management is not well established and may comprise dietary interventions and surgery. The effectiveness of somatostatin and its analogues has been reported, although their mechanism(s) of action is unclear. We report our experience with octreotide in a series of patients with postoperative chylothorax. Eight patients with KT were treated with a continuous intravenous infusion of octreotide (OCT) at a starting dose of 0.5 microg/kg/hr. They were compared with four additional patients with KT who were treated according to the conventional approach. After a mean of 3.3 +/- 1.9 days of treatment, fluid discharge diminished dramatically. In all patients, fluid losses stopped by postoperative day 10.5 +/- 2.9 and chest tubes could be removed after 12.8 +/- 4.1 days. Compared to a small group of historical controls, OCT reduced significantly the total fluid losses (141.1 +/- 89.3 vs 396.7 +/- 151.0 ml/kg; p = 0.003) and the postoperative length of stay (p = 0.05). No patients in the group treated with OCT required parenteral nutrition (compared to all four of the controls; p = 0.002) and/or thoracenteses (compared to two of four controls). In postoperative KT, OCT seems to be at least as effective as the conventional approach. Furthermore, OCT may reduce total fluid losses and postoperative length of stay. This may have a beneficial effect on the risk of complications and on hospital costs.

In vitro testing of Aspergillus fumigatus clinical isolates for susceptibility to voriconazole, amphotericin B and itraconazole: comparison of sensititre versus NCCLS M38-A using two different inocula.

Voriconazole, amphotericin B and itraconazole were tested in vitro against 18 strains of Aspergillus fumigatus isolated from cystic fibrosis patients. Susceptibility was tested with the broth microdilution method (M38-A protocol-NCCLS). Results of this reference method were compared with those of an experimental commercial microdilution broth method (Sensititre). Two different inocula, prepared from 2- and 7-day cultures, were used. Minimum inhibitory concentrations (MICs) of the reference method ranged from 0.25 to 2 microg/ml for voriconazole, 0.06 to 1 microg/ml for amphotericin B, 0.016 to >16 microg/ml for itraconazole. There were no significant differences in the MIC ranges or MIC90 values obtained with the two testing methods or with the two types of inocula. These findings confirm the good in vitro activity of voriconazole, itraconazole and amphotericin B against A. fumigatus. They also indicate that reliable susceptibility data can be generated more rapidly by commercial systems and use of 2-day cultures for inoculum preparation.

In vitro activity of voriconazole and other antifungal agents against clinical isolates of Candida glabrata and Candida krusei.

The antifungal susceptibility of 309 Candida glabrata and 63 Candida krusei clinical isolates was tested via the Sensititre YeastOne-3 system (Trek Diagnostic Systems, East Grinstead, UK) to compare the in vitro activity of voriconazole with that of five other antifungal agents (amphotericin B, fluconazole, itraconazole, ketoconazole, and flucytosine). Voriconazole was highly active (MIC90, 0.5 microg/ml) against isolates of both species, including those for which the MICs of itraconazole and fluconazole were high (MIC90s of itraconazole, 2 microg/ml for C. glabrata and 0.5 microg/ml for C. krusei; MIC90s of fluconazole, 32 microg/ml for C. glabrata and 64 microg/ml for C. krusei). Ketoconazole MIC90 values for both species were identical to those of voriconazole. The MIC90 of amphotericin B was similar for both species (0.125 microg/ml for C. glabrata and 0.25 microg/ml for C. krusei). As expected, flucytosine was only moderately active against C. krusei isolates (MIC90, 16 microg/ml) but was highly active against C. glabrata isolates (MIC90, 0.03 microg/ml). Potential cross-resistance within the azole class was noted for some strains of C. glabrata (5.5%) that presented high MIC values for all the azoles tested. In order to consider voriconazole a viable alternative to other triazoles for the treatment of infections caused by Candida species, susceptibility testing of all clinically significant isolates of C. glabrata and C. krusei is recommended because of the potential for azole cross-resistance. The Sensititre YeastOne-3 seems to be a suitable commercial tool for this purpose.

Inmigrante con elevación de la IgE y eosinofilia / Immigrant with increased IgE and eosinophilia

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