Elevated atmospheric carbon dioxide effects on soybean and sorghum gas exchange in conventional and no-tillage systems.

Increasing atmospheric CO(2) concentration has led to concerns about potential effects on production agriculture. In the fall of 1997, a study was initiated to compare the response of two crop management systems (conventional tillage and no-tillage) to elevated CO(2). The study used a split-plot design replicated three times with two management systems as main plots and two atmospheric CO(2) levels (ambient and twice ambient) as split plots using open-top chambers on a Decatur silt loam soil (clayey, kaolinitic, thermic Rhodic Paleudults). The conventional system was a grain sorghum [Sorghum bicolor (L.) Moench.] and soybean [Glycine max (L.) Merr.] rotation with winter fallow and spring tillage practices. In the no-tillage system, sorghum and soybean were rotated, and three cover crops were used [crimson clover (Trifolium incarnatum L.), sunn hemp (Crotalaria juncea L.), and wheat (Triticum aestivum L.)]. Over multiple growing seasons, the effect of management and CO(2) concentration on leaf-level gas exchange during row crop (soybean in 1999, 2001, and 2003; sorghum in 2000, 2002, and 2004) reproductive growth were evaluated. Treatment effects were fairly consistent across years. In general, higher photosynthetic rates were observed under CO(2) enrichment (more so with soybean) regardless of residue management practice. Elevated CO(2) led to decreases in stomatal conductance and transpiration, which resulted in increased water use efficiency. The effects of management system on gas exchange measurements were infrequently significant, as were interactions of CO(2) and management. These results suggest that better soil moisture conservation and high rates of photosynthesis can occur in both tillage systems in CO(2)-enriched environments during reproductive growth.

Mineralization enhancement of a recalcitrant pharmaceutical pollutant in water by advanced oxidation hybrid processes.

Degradation of the biorecalcitrant pharmaceutical micropollutant ibuprofen (IBP) was carried out by means of several advanced oxidation hybrid configurations. TiO(2) photocatalysis, photo-Fenton and sonolysis - all of them under solar simulated illumination - were tested in the hybrid systems: sonophoto-Fenton (FS), sonophotocatalysis (TS) and TiO(2)/Fe(2+)/sonolysis (TFS). In the case of the sonophoto-Fenton process, the IBP degradation (95%) and mineralization (60%) were attained with photo-Fenton (FH). The presence of ultrasonic irradiation slightly improves the iron catalytic activity. On the other hand, total removal of IBP and elimination of more than 50% of dissolved organic carbon (DOC) were observed by photocatalysis with TiO(2) in the presence of ultrasound irradiation (TS). In contrast only 26% of mineralization was observed by photocatalysis with H(2)O(2) (TH) in the absence of ultrasound irradiation. Additional results showed that, in the TFS system, 92% of DOC removal and complete degradation of IBP were obtained within 240 min of treatment. The advanced oxidation hybrid systems seems to be a promising alternative for full elimination/mineralization for the recalcitrant micro-contaminant IBP.

Ultrasonic treatment of water contaminated with ibuprofen.

The application of ultrasound (US) waves for remediation of wastewater is an area of increasing interest and promising results. The aim of this paper is to evaluate the influence of several parameters of the US process on the degradation of ibuprofen (IBP), a widely used non-steroidal anti-inflammatory recalcitrant drug found in water. Applied US power, dissolved gas, pH and initial concentration of IBP were the parameters investigated under sonication (300 kHz). Ultrasound increased the degradation of IBP from 30 to 98% in 30 min. Initial rate of IBP degradation was evaluated in the range of 1.35 and 6.1 micromolL(-1)min(-1) for initial concentrations of 2 to 21 mgL(-1) or 9.7 micromolL(-1) to 101 micromolL(-1), respectively. Under air and oxygen the degradation rate of IBP was 4 micromolL(-1)min(-1) being higher than that when argon was used. The most favorable degradation pH was acidic media. Complete removal of IBP was achieved but some dissolved organic carbon (DOC) remained in solution showing that long-lived intermediates were recalcitrant to the US irradiation. However, chemical and biological oxygen demands (COD and BOD(5)) indicated that the process oxidize the ibuprofen compound to biodegradable substances removable in a subsequent biological step.

Autoimmune hemolytic anemia following allogeneic hematopoietic stem cell transplantation in adult patients.

Autoimmune hemolytic anemia (AIHA) after allogeneic hematopoietic stem cell transplantation (HSCT) is still not well characterized. The aim of this study was to analyze the incidence and risk factors for the development of AIHA, as well as its prognosis and response to treatment in a series of patients undergoing allogeneic HSCT at a single institution. Between 1996 and 2004, 272 adult patients with a variety of malignant hematopoietic disorders underwent allogeneic HSCT. Direct antiglobulin testing was performed in routine pretransfusion compatibility testing or after clinical suspicion of AIHA. Twelve patients developed AIHA after HSCT at a median time of 147 days (range, 41-170). The 3-year cumulative incidence of AIHA was 4.44%. Eight cold antibodies and four warm antibodies were detected. Multivariate analysis shows that HSCT from unrelated donors (P=0.02) and the development of chronic extensive graft-versus-host disease (GVHD) (P=0.0004) were the only independent factors associated with AIHA. Two patients are still alive. AIHA was never the primary cause of death but added morbidity in patients with other concomitant complications. Patients undergoing HSCT from unrelated donors and those who develop chronic extensive GVHD are especially predisposed for this complication.

Role of methylene blue-treated or fresh-frozen plasma in the response to plasma exchange in patients with thrombotic thrombocytopenic purpura.

Twenty patients with thrombotic thrombocytopenic purpura (TTP) underwent plasma exchange using either standard fresh-frozen plasma (Group A, n = 13) or methylene blue-treated plasma (Group B, n = 7). Both groups presented similar characteristics except that bilirubin values were higher in Group A (P < 0.05). The complete remission rate was higher in Group A than B (69% versus 57%). The mean number of procedures was higher in Group B (21 +/- 7 versus 11 +/- 3, P < 0.01) and the mean duration of hospitalization was also longer (37 +/- 12 d versus 22 +/- 11 d; P < 0.01). Our study shows that the use of methylene blue-treated fresh-frozen plasma to treat TTP is associated with a higher number of plasma exchanges and greater transfusion requirements without improving clinical results.

Development of non-ABO RBC alloantibodies in patients undergoing allogeneic HPC transplantation. Is ABO incompatibility a predisposing factor?

BACKGROUND: Data from the appearance of RBC antibodies other than ABO in patients undergoing HPC transplantation are limited. STUDY DESIGN AND METHODS: The incidence and specificity of non-ABO RBC alloantibodies are described in a series of 217 patients undergoing allogeneic HPC transplantation because of various hematologic malignancies. RESULTS: Eight patients (3.7%) developed 10 antibodies after transplant. None of these patients had previously been immunized. Seven patients had one RBC antibody and one patient had three RBC antibodies. Antibody specificity were anti-Jk(b) (2 patients), -Kell (2), -M (2), -Le(b) (1), and -D (1). Finally, two patients had a panagglutinin. The mean time between transplant and antibody detection was 23 days (range, 16-672). The source of the HPCs, the conditioning regimen administered, and the type of GVHD prophylaxis administered did not influence the rate of antibody formation. On multivariate analysis, ABO blood group incompatibility (p = 0.005) and patient's age (p = 0.02) were the only two variables significantly associated with the development of RBC alloantibodies. CONCLUSION: Patients undergoing allogeneic HPC transplantation are at risk of developing RBC-specific antibodies despite the immunosuppressive therapy administered. Antibody formation was more frequently observed in ABO-mismatched cases, which suggests a potential role of this incompatibility in facilitating antibody production.

[Anticipation and quality of life in depression: 2 cognitive concepts?]. / Antecipação e qualidade de vida na depressão: dois conceitos cognitivos?

This study purports to investigate the relation between negative predictions and quality of life occurring in dysthymia and non-melancholic depression according DSM-IV, in the absence of any personality disorders. The relation between anticipation and quality of life (QoL) is also examined. The results suggest that both anticipatory cognitions and the QoL discriminate the two depressive entities and may have some nosological prediction potential. It is curious to observe the similar behaviour of the two concepts, anticipation and QoL, when implemented with the chosen scales. Moreover, their strong mutual correlation suggests a conceptual proximity or even a concurrent criteria validity. In conclusion, the possibility that both concepts belong to a cognitive sphere should not be ruled out.

Response to plasma exchange and steroids as combined therapy for patients with thrombotic thrombocytopenic purpura.

We describe our experience in the management of 11 consecutive patients with thrombotic thrombocytopenic purpura (TTP) treated with a combined therapy of plasma exchange (PE) and steroids. Nine patients (82%) achieved complete remission (CR) after a median of 6 rounds of PE (range 2-22). There were 3 early relapses managed in the same way as the initial episode. One patient relapsed 23 months after diagnosis achieving CR with standard therapy; another patient suffered several relapses, and splenectomy was performed after the last one. Three patients died, 2 of them with resistant disease 9 and 38 days after diagnosis, and the remaining one died due to AIDS-related complications while he was in CR. Eight patients are alive in CR with a median follow-up of 38 months (range 8-74). The combination of PE and steroids is a well-tolerated and effective treatment of TTP, but improvements in therapy are needed to manage refractory patients.

Severe hemolytic anemia due to multiple red cell alloantibodies after an ABO-incompatible allogeneic bone marrow transplant.

BACKGROUND: A patient who received an ABO-incompatible allogeneic bone marrow transplant experienced three episodes of immune hemolytic anemia due to multiple red cell (RBC) alloantibodies. CASE REPORT: A 41-year-old man with chronic myeloid leukemia received an ABO-incompatible bone marrow graft from his HLA-identical brother. Selective removal of RBCs from donor marrow before transfusion was performed by centrifugation using a continuous-flow blood cell separator. The patient was given group O Rh-positive RBCs and group A Rh-positive platelets. Prophylaxis for graft-versus-host disease consisted of cyclosporine and methotrexate. The patient experienced three hemolytic episodes, on Days 21, 35, and 160 which were due to different RBC alloantibodies (anti-K, anti-Jk(b), anti-M, IgG anti-A) produced by host lymphocytes surviving the conditioning regimen. RESULTS: The patient was group O, Jk(b-), and the marrow donor was group A, Jk(b+). After the first hemolytic episode (Day 21), immunohematologic studies showed group O RBCs and a positive direct antiglobulin test (IgG+, C3d+). Antibody screening test and eluate studies detected anti-M, anti-Jk(b), and anti-K. During the second hemolytic episode (Day 35), the patient's blood group showed a mixed population of group A and group O RBCs. The direct antiglobulin test was positive (IgG+, C3d+). Anti-M, anti-Jk(b), and IgG anti-A were detected in the serum. Eluates made from the recipient's RBCs showed the same specificity as serum antibodies. During the third hemolytic episode (Day 160), a mixture of group O and group A RBCs was still present, the direct antiglobulin test was positive (IgG+, C3d-), and anti-Jk(b) and IgG anti-A were observed in the serum and in an eluate made from the patient's RBCs. CONCLUSION: This is the first reported case of severe immune hemolytic anemia due to multiple RBC alloantibodies after an allogeneic bone marrow transplant. The time of appearance and the specificity of the antibodies strongly suggest that they were produced by residual recipient lymphoid cells.

[The concept of dysthymia. Its clinical usefulness and nosological status]. / Conceito de distimia. Utilidade clínica e estatuto nosológico.

Dysthymia is currently conceived as an independent diagnostic category in the area of mood disorders, but the concept is controversial, both from a theoretical and clinical point of view. This article reviews the concept of dysthymia as well as its history. The clinical usefulness and validity are examined, taking into special consideration the influential classificatory notions of DSM-IV.

[Immunohematologic study and transfusion approach to patients with public antibodies]. / Estudio inmunohematológico y actitud transfusional en pacientes con anticuerpos públicos.

OBJECTIVES: To analyze the different immunohematologic studies required to identify anti-red cell antibodies directed against high incidence antigens and comment the best tranfusion management. PATIENTS AND METHODS: Five patients with suspected anti-red cell alloantibodies directed against high frequency antigens are reported. After a positive antibody screening test (AST), an agglutination test with a commercial panel of 24 red cells was performed. Red cells were treated with proteolytic enzymes and AET to try to identify the circulating antibody. However, it was necessary to send the samples to reference laboratories for definitive identification. In order to evaluate the haemolytic potential of the antibody serum samples were treated with DTT and immunoglobulin subtype was studied with the capillary agglutination test. Finally, we analyze the half life of Cr51 labelled red cells. To obtain compatible blood for transfusion, autologous transfusion and cross-match with blood from direct relatives were performed. RESULTS: AST was positive in every case. A decrease in the agglutination test was observed after ficin treatment in two patients, and an increase in the remaining. The treatment of red cells with ZZAP and AET resulted in a decrease of agglutination in three cases and an increase in the remaining two. Specificity of the antibodies was as follows: anti-Cellano (two cases), anti-Ku (one case) and anti-Yta (two cases). Anti-Kell antibodies were IgG1 and anti-Cartwright antibodies were IgG4. One patient was transfused with autologous blood alone, another patient received compatible blood from direct relatives. A third patient was transfused both with autologous and allogeneic compatible blood. The fourth patient did not need red cell transfusion and, finally the last patient had to be transfused with incompatible blood but no postransfusion haemolysis was observed. CONCLUSIONS: In patients with anti-red cell antibodies against high-frequency antigens, red blood cells treatment with proteolytic enzymes (ZZAP, ficin) and AET are useful techniques to approach to their identification. Beside this, the study of type and subtype of Ig are necessary to know the haemolytic activity of the antibody. Regarding the transfusional management, autologous transfusion, crossmatch with blood from direct relatives and cryopreservation of compatible blood are the most adequate attitudes to cover future needs.

Effects of trazodone on insomnia and anxiety in depressed patients: a clinical and sleep EEG study.

Clinical and sleep EEG effects of trazodone in major depression were investigated using a 5-week single-blind study design. Nine patients with DSM-N major depression were selected. Trazodone (50-250 mg) was given following a 2-week placebo run-in period. Both sleep and psychiatric evaluations were performed at different time points. Early and persistent sleep-inducing effects were detected, including the improvement of objective insomnia features and increased amounts of slow wave sleep. However, no significant changes of REM sleep measures were found. The sleep EEG changes seem to be related to the clinical improvement of both anxiety and insomnia, but there is no apparent relationship with the antidepressant action, which occurs at a later stage of the treatment. Trazodone may be useful in depressed patients, either as a hypnotic-like agent or as an effective antidepressant drug with beneficial effects on sleep.

[The applications of sleep studies in psychiatry]. / Aplicações dos estudos do sono em psiquiatria.

In the last two decades considerable progress has been made in defining sleep changes in mental disorders, as well as in studying the relationship between sleep and psychiatric treatments. The pathophysiological significance of those changes has also been investigated, with some theoretical models of mental disorders indicating a direct role of sleep. In psychiatric research, sleep studies have contributed to the clarification of a variety of issues in relation to taxonomy, aetiology, pathogenesis and treatment. Furthermore, clinical and EEG aspects of sleep have proven useful for practical diagnostic and treatment purposes. This article aims to provide a systematic and critical review of current applications of sleep studies in psychiatry, both in research and clinical fields.