Influence of temperature on the start-up of membrane bioreactor: kinetic study.

The start-up phase of a membrane bioreactor (MBR) for municipal wastewater treatment was studied to determine the effect of temperature on the organic matter removal and heterotrophic kinetics. The MBR system was analyzed during four start-up phases with values of hydraulic retention time (HRT) of 6 h and 10 h, mixed liquor suspended solids (MLSS) concentrations of 4,000 mg L-1 and 7,000 mg L-1 in the steady state, and temperature values of 11.5, 14.2, 22.9 and 30.1 °C. The influence of temperature on the biological process of organic matter removal was determined through the Arrhenius equation and Monod model. At the most favorable operation conditions of HRT (10 h) and MLSS (7,000 mg L-1) corresponding to phase 4, the effect of these variables dominated over the temperature. Heterotrophic biomass from phase 2 (HRT = 10 h, MLSS = 4,000 mg L-1 and T = 30.1 °C) had the highest values of chemical oxygen demand (COD) degradation rate (rsu,H), implying less time to remove organic matter and shorter duration of the start-up phase.

[Recommendations on making decisions and end of life care in neonatology]. / Recomendaciones sobre toma de decisiones y cuidados al final de la vida en neonatología.

Healthcare-professionals who work in neonatal units believe that a very important part of their work is the care of sick newborns, and their families if the neonate has an incurable disease or will die. The effort is focused on preventing disproportionate and unnecessary treatments that result in pain and discomfort, and also separate the child from his family. These situations usually occur when the infant has a terminal illness, extreme immaturity with complications, or severe birth defects. In this paper, the Ethics Working Group of the Spanish Society of Neonatology reflects on decision making at this time of life. The ethical aspects are reviewed, including, limiting treatment, the basis of decision-making process (that should include adequate information), the relationship of trust, and deliberation between parents and professionals to make the right decision. It highlights the importance of caring for the family in a complex situation and of great suffering, when faced with the recommendation of professionals to limit treatment because their child suffers from a disease with a poor prognosis. The care of the sick neonate care at the end of life, and their families requires a considerable effort, dedication and training of all health personnel. The repeated experience of being close to suffering and death can adversely affect the professionals involved. Finally, there is mention of the legal aspects of limiting treatment, how to perform and document decision process, the withdrawal of life support, assessment of symptoms and pain control and sedation.

Advanced methods for the elimination of microorganisms in industrial treatments: potential applicability to wastewater reuse.

Because of the growing need to eliminate undesirable microorganisms in different industrial treatments, mainly in the food and agricultural sector and the pharmaceutical industry, a number of increasingly effective systems for disinfection to eliminate microorganisms have been devised. This article analyzes different methods to eliminate and/or significantly reduce the number of microorganisms in industrial contexts and in environmental engineering. Although, in the past, thermal treatments had been used most frequently for microbial elimination, the method is costly and has the disadvantage of modifying the organoleptic and/or physicochemical properties of the food products. For this reason, new technologies rapidly are being developed, such as high-intensity pulsed electric fields, high-pressure systems, ultrasounds, and irradiation, which effectively eliminate microorganisms without deteriorating the properties of the product. These emerging technologies are potentially applicable in the field of environmental engineering.

Rotavirus: vieja enfermedad, nuevas vacunas / No disponible

El rotavirus es la causa más importante de diarrea en la infancia. En países en vías de desarrollo presenta una gran morbimortalidad, siendo responsable de casi 500.000 muertes en niños menores de 5 años cada año. Por otro lado, en Europa y Norteamérica cerca de la tercera parte de todos los ingresos hospitalarios por gastroenteritis se deben a este microorganismo. La infección por rotavirus afecta prácticamente a la totalidad de los niños hasta los 5 años de edad, aunque las formas graves de la enfermedad ocurren sobre todo entre los 3 meses y los 3 años. El virus aparece en altas concentraciones en las heces de los niños enfermos y tiene una gran capacidad de transmisión entre individuos. La carga de la enfermedad y el costo social y económico son muy elevados, alcanzando los 1.600 euros por cada ingreso. En 2006 se han comercializado en nuestro país dos nuevas vacunas orales. Ambas demuestran un muy buen perfil de seguridad y una elevada eficacia en la prevención de enfermedad grave, deshidratación y hospitalizaciones por gastroenteritis en población infantil

Rotavirus is a major cause of diarrhoea in childhood. It shows an enormous morbidity and mortality in developing countries, being responsible for approximately half a million deaths per year among children aged less than five years. In the other hand in Europe and United States of America nearly one third of admissions by gastroenteritis are due to this microorganism. Rotavirus infects almost all infants by the age of five years, although severe disease appears almost always in children of three to thirty-six months. Rotavirus appears in high concentrations in the stools of infected children having an increasing capacity of transmission person to person. Burden of the disease and its social and economic cost are extremely high reaching one thousand and six hundred euros by each hospitalization. Two new oral vaccines have been commercialized in our country last year. Both of them report an excellent profile of security and a high efficacy in the prevention of severe disease, dehydration and admissions to hospital because of gastroenteritis in the childhood population (AU)

Cytoreduction combined with intraperitoneal hyperthermic perfusion chemotherapy in advanced/recurrent ovarian cancer patients: The experience of National Cancer Institute of Milan.

AIMS: We report the effects of cytoreductive surgery (CRS) and intraperitoneal hyperthermic perfusion (IPHP) in the treatment of advanced/recurrent epithelial ovarian cancer (EOC) on survival, morbidity and mortality. PATIENTS: Forty EOC patients were studied. Median age was 52.5 years (range: 30-68) and median follow-up 26.1 months (range: 0.3-117.6). Most patients presented advanced disease (stage III/IV). Previous systemic chemotherapy included cisplatin-based, taxol-based or taxol/platinum containing regimens. RESULTS: After the CRS, 33 patients presented no macroscopic residual disease. Five-year overall survival was 15%; the mean overall and progression-free survivals were 41.4 and 23.9 months, respectively. The morbidity, toxicity and mortality rates were 5%, 15% and 0%, respectively. CONCLUSION: Our results suggest that CRS + IPHP merits further evaluation by a formal prospective trial.

Atypical glandular cells: criteria to discriminate benign from neoplastic lesions and squamous from glandular neoplasia.

OBJECTIVE: To evaluate the presence of some criteria in cervical smears with atypical glandular cells and their correlation with histological patterns to identify pre-neoplastic and neoplastic lesions. METHODS: Seventy-three women referred with an atypical glandular cell smear, who had undergone conization or hysterectomy, were included in this study. Referral Pap smears were reviewed using the set of 27 cyto-morphological criteria that was correlated with the histological diagnosis. RESULTS: Histological results showed intraepithelial or invasive neoplasia in 35 (48%) cases and benign lesions in 38 (52%) cases. After logistic regression and decision tree analysis an increased nuclear/cytoplasmic ratio and the presence of dyskeratotic cells were strongly associated with intraepithelial or invasive neoplasia and the differential cyto-morphological criteria for glandular lesions were decreased cytoplasm, irregular nuclear membranes and the presence of nucleoli. CONCLUSION: The analysis of individual cyto-morphological criteria can better predict intraepithelial or invasive neoplasia and differentiate glandular from squamous lesions.

Regions of allelic imbalance in the distal portion of chromosome 12q in gastric cancer.

AIMS: To define regions of loss on the distal portion of chromosome 12q in gastric adenocarcinoma. METHODS: Microsatellite analysis on chromosome 12 was performed on 19 human gastric cancer cell lines using 77 markers, 71 of which were within or distal to 12q21; some portions of this region showed extended regions of homozygosity (ERHs) in 10 of 19 gastric cancer cell lines. In addition, microdissected tumour cells from 76 primary gastric adenocarcinomas were examined using 13 markers of interest implicated by the cell line data; 70% of these showed allelic imbalance (AI) at one or more markers in or distal to 12q21. RESULTS: Mapping ERHs in the cell lines and sites of AI in the tumours identified three regions that contain putative tumour suppressor genes: region A is located within 2.8 Mb between markers D12S1667 and D12S88; region B, within 1.9 Mb between markers D12S1607 and D12S78; and region C, in 0.74 Mb between markers D12S342 and D12S324. Fluorescence in situ hybridisation (FISH) analysis in two cell lines confirmed that two of the ERHs reflected deletions, not amplifications, of D12S81 in region A and D12S340 in region C. FISH analysis of marker D12S1075 within an ERH containing region B in one cell line showed neither amplification nor deletion. AI on 12q was not associated with prognosis, but was associated with ethnicity of the patient. CONCLUSIONS: These results identify regions on chromosome 12 that appear to contain tumour suppressor genes important in the development of gastric cancer.

Extracts of Anacardium occidentale (cashew) pollen in patients with allergic bronchial asthma.

Allergic reactions to the pollen of trees is among the most prevalent allergic sensitivities. The cashew tree grows in abundance in the northeast region of the Brazil, mainly in Fortaleza city, in state of the Ceará. It flowers once a year between August and October. This is the first study conducted to establish the possible role of the cashew pollen extract in causing skin test reactivity in patients with allergic asthma. A stock solution of pollen extract was prepared with the standard weight/volume method for intradermal skin tests and for the protein content of the extract, estimated with the use of Folin phenol reagent and a spectrophotometer. Ten nonallergic volunteers and 80 subjects with allergic asthma, as documented by previous positive skin test reactions to various pollens, were studied. All of the 80 patients (100%) had positive test reactions (grade III and grade IV reactions). None of the control subjects (n = 10) had positive responses to the intradermal tests. This study provided us with knowledge of an additional pollen extract of the Anacardium occidentale, which could provoke skin test reactivities in asthmatic individuals from the northeastern area of Brazil. The results suggest a relationship between the period of flowering of the cashew tree and the increased number of allergic asthma cases.

4-Iodo-2-methyl-5-nitroaniline exhibits neither strong hydrogen bonding nor intermolecular I...nitro interactions.

In the title compound, C(7)H(7)IN(2)O(2), the O atoms of the nitro group are disordered over two sets of sites and there is evidence that the intramolecular I...nitro interaction is repulsive. In the crystal structure, there are neither strong hydrogen bonds, nor intermolecular I...nitro interactions, nor aromatic pi-pi-stacking interactions.

Triclinic and orthorhombic polymorphs of 2-iodo-4-nitroaniline: interplay of hydrogen bonds, nitro...I interactions and aromatic pi-pi-stacking interactions.

In the triclinic polymorph of 2-iodo-4-nitroaniline, C(6)H(5)IN(2)O(2), space group P-1, the molecules are linked by paired N-H...O hydrogen bonds into C(8)[R(2)(2)(6)] chains of rings. These chains are linked into sheets by nitro...I interactions, and the sheets are pairwise linked by aromatic pi-pi-stacking interactions. In the orthorhombic polymorph, space group Pbca, the molecules are linked by single N-H...O hydrogen bonds into spiral C(8) chains; the chains are linked by nitro...O interactions into sheets, each of which is linked to its two immediate neighbours by aromatic pi-pi-stacking interactions, so producing a continuous three-dimensional structure.

A cluster of pediatric metallic mercury exposure cases treated with meso-2,3-dimercaptosuccinic acid (DMSA)

Nine children and their mother were exposed to vapors of metallic mercury. The source of the exposure appears to have been a 6-oz vial of mercury taken from a neighbor's home. The neighbor reportedly operated a business preparing mercury-filled amulets for practitioners of the Afro-Caribbean religion Santeria. At diagnosis, urinary mercury levels in the children ranged from 61 to 1,213 microg/g creatinine, with a geometric mean of 214.3 microg/m creatinine. All of the children were asymptomatic. To prevent development of neurotoxicity, we treated the children with oral meso-2,3-dimercaptosuccinic acid (DMSA). During chelation, the geometric mean urine level rose initially by 268% to 573.2 microg mercury/g creatinine (p<0.0005). At the 6-week follow-up examination after treatment, the geometric mean urine mercury level had fallen to 102.1 microg/g creatinine, which was 17.8% of the geometric mean level observed during treatment (p<0.0005) and 47.6% of the original baseline level (p<0.001). Thus, oral chelation with DMSA produced a significant mercury diuresis in these children. We observed no adverse side effects of treatment. DMSA appears to be an effective and safe chelating agent for treatment of pediatric overexposure to metallic mercury.

A program evaluation study of a nursing home operated as a modified therapeutic community for chemically dependent persons with AIDS. Project Samaritan AIDS Services, Inc.'s Residential Health Care Facility, Highbridge Section, Bronx, NY.

An interagency evaluation of the treatment effectiveness of a speciality nursing home (NH) run as a therapeutic community (TC) for residents diagnosed with acquired immunodeficiency syndrome (AIDS) and substance abuse/dependence (SA/D) was conducted. A total of 79 chemically dependent men and women with AIDS were: (a) administered the Tennessee Self-Concept Scale (TSCS; Roid & Fitts, 1991) at initial testing (T(1)) and 8 months after their initial testing (T(2)); and (b) assessed on specific physical health indicators (i.e. , weight, CD-4 count, and viral load) and other treatment outcomes (e.g., abstinence) over the same two time periods. The TSCS results identified a valid and invalid TSCS test group and further distinguished among three subgroups of invalid responders. Significant improvements were observed from T(1) testing to T(2) testing on the TSCS, on the physical health indicators, and on other treatment outcomes. The need for additional and continued mental health services for this population was noted.

Ovarian germ cell cancer: clinicopathologic analysis and outcome of 31 cases.

AIMS: The aim of the study was to evaluate some clinicopathologic characteristics and the outcome of patients with ovarian germ cell cancer (OGCC) treated with cisplatin-based chemotherapy. METHODS: It was a clinical retrospective study. The clinical charts of 31 patients with OGCC assisted at the Department of Obstetrics and Gynecology of the State University of Campinas, Brazil, from January 1986 to June 1997 were reviewed. RESULTS: Ten patients had dysgerminoma and 21 patients nondysgerminomatous tumors. Women with dysgerminoma and nondysgerminomatous tumors did not present differences regarding surgical staging, age, ascites or residual tumor after the initial surgery. Frozen section, performed in 16 patients, showed some discrepancy with paraffin histology diagnosis in 8 patients. Platinum-based chemotherapy was used in 5/10 patients with dysgerminoma and in 17/21 patients with nondysgerminomatous tumors, with a 5-year survival of 100% for the dysgerminoma and 53% for the nondysgerminomatous group. CONCLUSIONS: Women with dysgerminoma and nondysgerminomatous tumors did not present differences regarding clinicopathologic characteristics. The prognosis for patients with dysgerminoma was better than for those with nondysgerminomatous tumors. Frozen section had a high error rate in diagnosing OGCC intraoperatively.

[The influence of coronary flow on atrio-ventricular transmission and ventricular contraction in the isolated guinea pig heart]. / Influencia del flujo coronario sobre la conducción auriculoventricular y la contracción ventricular en corazón aislado de cobayo.

UNLABELLED: It has been demonstrated that coronary flow, through hemodynamic forces, stimulates ventricular contraction and atrio-ventricular transmission; however, the mechanisms involved in these effects remain unknown. A possibility to explain the transduction mechanism, from a mechanical stimulus into a physiological response, could be the stretch-activated ion channels. Additionally we explored the role of nitric oxide as mediator of these actions. METHODS: We used the isolated perfused guinea pig heart according to the method of Langendorff, perfused with Krebs solution. We recorded the ventricular contraction by development of left ventricular pressure and the atrio-ventricular transmission. We studied the effects of the stretch activated ion channel blocker; gadolinium. Synthesis of nitric oxide was inhibited by L-NAME and induced with L-arginine. RESULTS: Gadolinium inhibited the stimulating effect of flow on atrio-ventricular transmission and ventricular contraction. Verapamil, a specific blocker of calcium channels, had no effect in the stimulatory effect of flow indicating that this type of calcium channel, do not play significant role in the effects of flow. L-NAME and L-arginine did not have effects on the effects of flow. CONCLUSION: The stimulating effect of coronary flow in these parameters is regulated by stretch-activated ionic channels. This effect is independent of nitric oxide.

[Making ethical decision of limiting vital support to critical newborns]. / Toma de decisiones éticas y limitación del soporte vital en recién nacidos críticos.

OBJECTIVE: To know the cause of death and the criteria used in the vital support limitation decisions in the critical newborn who eventually died. PATIENTS AND METHODS: A retrospective review of the medical records for all newborns who died in the NICU between 1987-1994 was performed. The following actions were defined: total vital support, do not resuscitate order (DNR), vital support withdrawal (VSW). RESULTS: The mortality rate in the NICU was 7.3% (55/753), with a neonatal mortality rate of 2.98 per thousand live births. Medical records of 53 patients were reviewed. In 67.9% of the patients (36/53; p < 0.001) the therapeutical effort was limited. The most frequent way of action was the VSW (35.8%) and the support most frequently interrupted was mechanical ventilation (89%). DNR was established in 32%. Only 42% of the parents were involved in the decision making process to limit support. In three patients (6%), there was evidence of disagreement between the medical team and the family and the parents of two opting for a more aggressive care. In the three cases, the family determined the course of action. In general, the decision of support limitation was justified based on "bad prognosis". Retrospectively, the criteria were: not viable (11%), eminent death (14%), no response to treatment (22%) and quality of life judgments (53%). CONCLUSIONS: It is very frequent to take decisions on vital support limitation in neonates when they are in a critical situation. We consider that the individual evaluation of each patient's prognosis, combined with standards of ethical criteria, the "child's best interest" and the "potential for relation", pondered in a rational way, constitute an adequate guideline for making conflictive ethical decisions together with the child's parents.

A mutant phosphofructokinase produces a futile cycle during gluconeogenesis in Escherichia coli.

Strains of Escherichia coli bearing different forms of phosphofructokinase were used to assess the occurrence of futile cycling in cell resuspensions supplied with glycerol as gluconeogenic carbon source. A model was used to simulate results of different kinds of experiments for different levels of futile cycle. The main predictions of the model were experimentally confirmed in a strain with a mutant phosphofructokinase-2 (phosphofructokinase-2*) which is not inhibited by MgATP. The intracellular fructose 1, 6-bisphosphate concentration reaches significantly higher levels in the mutant-bearing strain than in strains with either phosphofructokinase-1 or -2. Also, this strain showed a higher rate and level of in vivo radioactive labelling of fructose 1, 6-bisphosphate, from a trace of [U-14C]glucose supplied during gluconeogenesis, indicating higher kinase activity in these conditions. Cell resuspensions of the mutant-bearing strain produced higher levels of radioactively labelled CO2 when supplied with [U-14C]glycerol as the only carbon source. Simultaneously, fewer glycerol carbons were incorporated into HClO4-insoluble macromolecules. Finally, radioactive CO2 output was measured in resuspensions supplied with glycerol as the major carbon source with traces of either [1-14C]glucose or [6-14C]glucose. It was found that, whereas in the strains with either of the wild-type phosphofructokinase isoenzymes, radioactive CO2 output from [1-14C]glucose was higher than with [6-14C]glucose, the reverse is found for the strain with phosphofructokinase-2*. This result also agrees with the corresponding prediction of the model. Using the radioactivity flux rates predicted by the model, an explanation linking the futile cycle to the differential labelling of CO2 is advanced. Finally, on the basis of these results it is proposed that strains bearing phosphofructokinase-2* sustain higher rates of futile cycling during gluconeogenesis than strains bearing either of the wild-type isoforms of phosphofructokinase. The kinetic equations and parameter values used for the model simulations are given in Supplementary Publication SUP 50183 (8 pages), which has been deposited at the British Library Document Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1997) 321, 8.