Surfactant-enhanced mobilization of persistent organic pollutants: Potential for soil and sediment remediation and unintended consequences.

This review aims to provide an overview of the sources and reactions of persistent organic pollutants (POPs) and surfactants in soil and sediments, the surfactant-enhanced solubilisation of POPs, and the unintended consequences of surfactant-induced remediation of soil and sediments contaminated with POPs. POPs include chemical compounds that are recalcitrant to natural degradation through photolytic, chemical, and biological processes in the environment. POPs are potentially toxic compounds mainly used in pesticides, solvents, pharmaceuticals, or industrial applications and pose a significant and persistent risk to the ecosystem and human health. Surfactants can serve as detergents, wetting and foaming compounds, emulsifiers, or dispersants, and have been used extensively to promote the solubilization of POPs and their subsequent removal from environmental matrices, including solid wastes, soil, and sediments. However, improper use of surfactants for remediation of POPs may lead to unintended consequences that include toxicity of surfactants to soil microorganisms and plants, and leaching of POPs, thereby resulting in groundwater contamination.

Transcriptional and immunohistological assessment of immune infiltration in pancreatic cancer.

Pancreatic adenocarcinoma is characterized by a complex tumor environment with a wide diversity of infiltrating stromal and immune cell types that impact the tumor response to conventional treatments. However, even in this poorly responsive tumor the extent of T cell infiltration as determined by quantitative immunohistology is a candidate prognostic factor for patient outcome. As such, even more comprehensive immunophenotyping of the tumor environment, such as immune cell type deconvolution via inference models based on gene expression profiling, holds significant promise. We hypothesized that RNA-Seq can provide a comprehensive alternative to quantitative immunohistology for immunophenotyping pancreatic cancer. We performed RNA-Seq on a prospective cohort of pancreatic tumor specimens and compared multiple approaches for gene expression-based immunophenotyping analysis compared to quantitative immunohistology. Our analyses demonstrated that while gene expression analyses provide additional information on the complexity of the tumor immune environment, they are limited in sensitivity by the low overall immune infiltrate in pancreatic cancer. As an alternative approach, we identified a set of genes that were enriched in highly T cell infiltrated pancreatic tumors, and demonstrate that these can identify patients with improved outcome in a reference population. These data demonstrate that the poor immune infiltrate in pancreatic cancer can present problems for analyses that use gene expression-based tools; however, there remains enormous potential in using these approaches to understand the relationships between diverse patterns of infiltrating cells and their impact on patient treatment outcomes.

Effect of a region-wide incorporation of an algorithm based on the 2012 international consensus guideline on the practice pattern for the management of pancreatic cystic neoplasms in an integrated health system.

AIM: To examine the practice pattern in Kaiser Permanente Southern California (KPSC), i.e., gastroenterology (GI)/surgery referrals and endoscopic ultrasound (EUS), for pancreatic cystic neoplasms (PCNs) after the region-wide dissemination of the PCN management algorithm. METHODS: Retrospective review was performed; patients with PCN diagnosis given between April 2012 and April 2015 (18 mo before and after the publication of the algorithm) in KPSC (integrated health system with 15 hospitals and 202 medical offices in Southern California) were identified. RESULTS: 2558 (1157 pre- and 1401 post-algorithm) received a new diagnosis of PCN in the study period. There was no difference in the mean cyst size (pre- 19.1 mm vs post- 18.5 mm, P = 0.119). A smaller percentage of PCNs resulted in EUS after the implementation of the algorithm (pre- 45.5% vs post- 34.8%, P < 0.001). A smaller proportion of patients were referred for GI (pre- 65.2% vs post- 53.3%, P < 0.001) and surgery consultations (pre- 24.8% vs post- 16%, P < 0.001) for PCN after the implementation. There was no significant change in operations for PCNs. Cost of diagnostic care was reduced after the implementation by 24%, 18%, and 36% for EUS, GI, and surgery consultations, respectively, with total cost saving of 24%. CONCLUSION: In the current healthcare climate, there is increased need to optimize resource utilization. Dissemination of an algorithm for PCN management in an integrated health system resulted in fewer EUS and GI/surgery referrals, likely by aiding the physicians ordering imaging studies in the decision making for the management of PCNs. This translated to cost saving of 24%, 18%, and 36% for EUS, GI, and surgical consultations, respectively, with total diagnostic cost saving of 24%.

Las periodontopatías como factor de riesgo de la cardiopatía isquémica, 2008 / Periodontopathies as a risk factor for ischemic heart failure, 2008

Se realizó una investigación descriptiva, longitudinal y prospectiva, con una muestra constituida por 120 pacientes, pertenecientes al área de salud Turcios Lima y atendidos en la Clínica Estomatológica "Guamá", del municipio Pinar del Río, durante el año 2008, con el objetivo de determinar la relación entre la enfermedad periodontal y la cardiopatía isquémica. Los pacientes fueron divididos en dos grupos etarios: grupo A(Control) integrado por 60 pacientes escogidos aleatoriamente que asistían a nuestra consulta y sin historia de infarto agudo del miocardio, y el grupo B (pacientes infartados) de 60 pacientes que fueron remitidos desde los consultorios médicos para ser incluidos en esta investigación. Al total se aplicó el índice de necesidad de tratamiento periodontal de la comunidad. Todos los pacientes infartados grupo B sufrieron periodontopatías, mientras que entre los no infartados solo la mitad padecieron de afecciones parodontales. Se utilizaron los métodos de la Estadísticos descriptiva y la comparación de frecuencias de Ji cuadrado al 95 % de certeza. El hábito de fumar, la edad mayor de 50 años, el sexo masculino y la mala higiene bucal se identificaron como factores comunes de riesgo para ambas enfermedades. Los estadios más avanzados de la enfermedad periodontal (bolsas de 6 mm o más), aumentaron su incidencia con la edad y fue más frecuente en los pacientes infartados, con mayor necesidad de cirugía periodontal. Todos los pacientes afectados tenían necesidad de adiestramiento en cepillado dental.

A descriptive, longitudinal and prospective research was conducted with a sample of 120 patients belonging to the primary care health area of "Turcios Lima" Outpatient Clinic attending to "Guama" Dentist's Clinic in Pinar del Rio municipality during 2008, and was aimed at determining the relation between periodontal diseases and ischemic heart failure. The patients were divided into two groups: A (control) comprised of 60 patients randomly chosen from those attended to the dentist office without medical history of acute myocardial infarction, and group B- (patients who suffered from infarction) 60 patients referred from the family medical office. The total of the sample was examined and the rate of need for periodontal treatment of the community was applied. Descriptive statistic methods were used, and Ji squared test for 95 % of certainty was used to compare frequencies. All patients of the group-B suffered from periodontopathies, meanwhile those belonging to group-A only the half of them suffered from parodontal affections. The smoking habit, over 50 years, male sex and poor oral hygiene were identified as common risk factors for both diseases. The most advanced stages for periodontal disease (bursas of 6mm or more) increased with age being more frequent in patients of group-B having a greater need of periodontal surgery. All the patients affected had to be trained in teeth brushing.

Intervención educativa en salud buco-dental a pacientes diabéticos / Educative intervention for oral-dental health in diabetic patients

La diabetes mellitus es una enfermedad endocrina metabólica que afecta a varios órganos de la economía, y la cavidad bucal no está exenta de ella. Se presentan los resultados de una investigación de intervención, longitudinal y prospectiva desarrollada en la Clínica Estomatológica "Guamá" del municipio Pinar del Río, durante el año 2008, con una muestra de 137 pacientes diabéticos, pertenecientes a los Consultorios Médicos 272, 264 y 265 atendidos en la Clínica Estomatológica "Guamá" a los que se les constató un nivel de conocimientos sobre salud bucal insuficiente, lo que motivó aplicar un programa educativo con el objetivo de elevar el nivel de conocimientos sobre salud bucal. Para ello se elaboró una encuesta de 10 preguntas que se aplicó, antes y después del desarrollo del programa, el cual se fue cumplimentando semanalmente a través de la aplicación de técnicas afectivas participativas. Los resultados obtenidos fueron registrados en una base de datos del sistema estadístico STATISTIC, aplicándoseles estimaciones puntuales de frecuencias relativas para el análisis estadístico descriptivo y la prueba Chi cuadrado en su variante tabla de contingencia para el análisis estadístico inferencial. Se corroboró que el nivel de conocimientos sobre salud bucal de los pacientes diabéticos incluidos en la investigación antes de la aplicación del programa educativo era insuficiente (51%) con predominio de personas con niveles primario (29.1%), y posteriormente a ello se logró elevar significativamente (90,5%) constatándose una gran aceptación del programa por parte de los pacientes.

Diabetes Mellitus is an endocrine-metabolic disease which affects several organs and oral cavity is not an exception. At "Guama" Dentist's Clinic an intervention, descriptive, longitudinal and prospective research was conducted in 2008, Pinar del Rio municipality and the results were presented. The sample was comprised of 137 diabetic patients belonging to Medical Offices No-272, 264 and 265 attending to "Guama" Dentist Clinic, their level of knowledge about oral health was insufficient; thus a survey of 10 questions was applied before and after the development of the program. This program was implemented weekly by means of participative techniques. Corroborating that the level of knowledge about oral health of diabetic patients included in the research before the application of the educative program was insufficient, and after putting the program into practice the level of knowledge increased significantly, verifying that it was very successful with the patients. The results obtained were recorded in a database of the statistical system, score estimations of relative frequencies to perform the descriptive and the chi square test in its variable of contingency table to the inferential statistical analysis.

Sphingolipids function as downstream effectors of a fungal PAQR.

The Izh2p protein from Saccharomyces cerevisiae belongs to the newly characterized progestin and adipoQ receptor (PAQR) superfamily of receptors whose mechanism of signal transduction is still unknown. Izh2p functions as a receptor for the plant PR-5 defensin osmotin and has pleiotropic effects on cellular biochemistry. One example of this pleiotropy is the Izh2p-dependent repression of FET3, a gene involved in iron-uptake. Although the physiological purpose of FET3 repression by Izh2p is a matter of speculation, it provides a reporter with which to probe the mechanism of signal transduction by this novel class of receptor. Receptors in the PAQR family share sequence similarity with enzymes involved in ceramide metabolism, which led to the hypothesis that sphingolipids are involved in Izh2p-dependent signaling. In this study, we demonstrate that drugs affecting sphingolipid metabolism, such as d-erythro-MAPP and myriocin, inhibit the effect of Izh2p on FET3. We also show that Izh2p causes an increase in steady-state levels of sphingoid base. Moreover, we show that Izh2p-independent increases in sphingoid bases recapitulate the effect of Izh2p on FET3. Finally, our data indicate that the Pkh1p and Pkh2p sphingoid base-sensing kinases are essential components of the Izh2p-dependent signaling pathway. In conclusion, our data indicate that Izh2p produces sphingoid bases and that these bioactive lipids probably function as the second messenger responsible for the effect of Izh2p on FET3.