Ecological Status of Algeciras Bay, in a Highly Anthropised Area in South-West Europe, through Metal Assessment-Part I: Abiotic Samples.

The ecological status of Algeciras Bay (South-west Europe), highly influenced by anthropogenic activities, was assessed by monitoring Zn, Cd, Pb, and Cu in water and sediment samples. Total contents and metal fractions with different availabilities and their spatial-seasonal distribution were determined. The trend in water and sediment contents were Zn > Pb ≈ Cu > Cd, without significant seasonal variations. Sites 3 and 4, closest to industrial activities, had the highest metal concentrations, mainly in sediments. Cd showed low partition coefficient in water, indicating higher bioavailability. Total metal content in sediments exceeded the threshold effect level for Cu and were close to Pb. The BCR procedure revealed the highest availabilities for Cd and Pb, due to its higher content in exchangeable and reducible fractions. Higher Pb levels (21.4 ± 5.1 mg/kg) were found in sediments of this bay compared with other ecosystems. Pollution indexes for sediment quality revealed that site 3 was the most polluted (CF = 7.12 and Igeo = 2.25). For an integrative study of the ecological status of this significant bay, these results have been complemented with the metal evaluation in benthic and benthopelagic fish tissues in Ecological status of Algeciras Bay, in a highly anthropised area in south-west Europe, through metal assessment-Part II: Biotic samples.

Ecological Status of Algeciras Bay, in a Highly Anthropised Area in South-West Europe, through Metal Assessment-Part II: Biotic Samples.

Biotic samples from Algeciras Bay (South-west Europe) were studied to assess its ecological status, complementing the previous abiotic monitoring of trace metals in water and sediments. This bay is a densely populated area with intense port traffic and is highly industrialised with metal inputs. To study the impact of this, Zn, Cd, Pb, and Cu contents were determined in tissues of benthic (Solea senegalensis) and benthopelagic species (Scorpaena porcus, Trigloporus lastoviza, and Diplodus sargus sargus). Notable levels of Zn and Cu were found in the liver and gills of all fish species. Compared to international muscle guidelines, Pb sometimes exceeded the most restrictive values, outstanding S. porcus with 27% of samples above the permissible value. Metal pollution indexes revealed that the liver and gills of benthic species were more affected by metal pollution than benthopelagic species, especially in most industrialised sites. Particularly, S. senegalensis presented a higher accumulation factor from sediment of Cd and Cu in the liver (30.1 and 345.1), probably due to the close interaction as benthic species. Among the species studied, S. senegalensis and D. sargus sargus proved to be the best representative and useful bioindicators of metal-polluted environments as this bay. The results were consistent with the findings from the abiotic samples.

A Novel Polymer Inclusion Membrane-Based Green Optical Sensor for Selective Determination of Iron: Design, Characterization, and Analytical Applications.

The design, characterization, and analytical application of a green optical sensor for the selective determination of Fe(II) ions is proposed. The sensor is based on the immobilization of the chromogenic reagent picolinaldehyde salicyloylhydrazone (SHPA) within a polymer inclusion membrane. To reduce solvent usage, the reagent was synthesized using a green mechanochemical procedure. The components for sensor preparation were optimized with a sequential simplex method and the optimal composition was found to be 0.59 g cellulose triacetate (base polymer), 0.04 g SHPA (chemosensor reagent), 4.9 mL dibutyl phthalate (plasticizer), and 38 mL dichloromethane (solvent). The conditions of iron analysis were also optimized resulting in pH 6 for aqueous solution, 90 min exposure time and 10 min short-term stability. The optical sensor showed a linear range from the limit of detection (0.48 µmol L-1) to 54 µmol L-1 Fe(II). The precision of the method was found to be 1.44% and 1.19% for 17.9 and 45 µmol L-1 Fe(II), respectively. The characteristics of the sensor allowed the design of a Fe(II)/Fe(III) speciation scheme. The methodology was successfully applied to the determination of iron in food preservatives, food additives, and dietary supplement. Additionally, the Fe speciation scheme was successfully applied to an agricultural fertilizer.

Macular Choroidal Thickness: Evaluation of Variability among Measurements and Assessment of Predictive Value of Glaucomatous Visual Field Damage.

INTRODUCTION: This study aimed to investigate the relationship between the choroidal circulation and glaucoma, assessing macular choroidal thickness (MCT) as a predictive value of glaucomatous visual field damage. METHODS: Twenty primary open-angle glaucoma patients were recruited. Patients underwent 2 SS-OCT scans: one with DRI OCT (Topcon) and the other with PLEX Elite 9000 (Zeiss). Standard OCT parameters were acquired by DRI OCT, while MCT was manually measured in 5 points on Plex ELITE 9000 images. The relationship among MCT, standard OCT parameters, and visual field indices was evaluated. Pearson's r correlation was calculated to evaluate these relationships. Reproducibility of measurements was analyzed. RESULTS: MCT measurements showed a good intra- and interobserver repeatability. A negative correlation appeared between MCT and BMI (r = -0.518, p = 0.023). Mean deviation showed a statistically significant correlation with MCT measured at subfoveal and at 1,000 µm nasally (r = 0.50, p = 0.03, and r = 0.52, p = 0.023). A correlation was found between the 2 MCT (Zeiss vs. Topcon) measurements and between MCT and peripapillary choroidal thickness (r = 0.944 and r = 0.740, p < 0.001, respectively). CONCLUSIONS: A good intra- and interobserver reproducibility was found. MCT showed a weak predictive value of glaucomatous visual field damage. A significant correlation was found between MCT and BMI.

Sensing Cd(II) Using a Disposable Optical Sensor Based on a Schiff Base Immobilisation on a Polymer-Inclusion Membrane. Applications in Water and Art Paint Samples.

A disposable colour-changeable optical sensor based on an interesting polymer inclusion-membrane (PIM) was designed to determine Cd(II) ions in aqueous medium. The Schiff base 2-acetylpyridine benzoylhydrazone (2-APBH) immobilised on the polymer membrane was used as a sensing molecule. The amounts of the PIM components were optimised by a 32 fractional factorial design with two central points and two blocks. The best optical sensor composition consisted of 2.5 g of poly(vinylchloride) (PVC) as a base polymer, 3 mL of tributyl phosphate (TBP) as a plasticiser, and 0.02 g of 2-APBH as a reagent. The sensor showed a good linear response in the range from 0.02 mg L-1 (limit of detection) to 1 mg L-1 of Cd(II) under the following experimental conditions: pH 9.5 (adjusted using ammonium chloride buffer solution at 0.337 mol L-1), 60 min of exposure time plus 2 min of sonication (pulses at 2 s intervals), and 10 min of short-term stability. The relative standard deviation of the method was determined to be 4.04% for 0.4 mg L-1 of Cd(II). The optical sensor was successfully applied to the determination of Cd(II) in natural-water and art-paint samples.

Peribulbar anesthesia for strabismus surgery in adult patients.

PURPOSE: To evaluate the efficacy and safety of peribulbar anesthesia during strabismus surgery. METHODS: Medical records of patients undergoing strabismus surgery and peribulbar anesthesia were reviewed. The overall efficacy of peribulbar anesthesia was evaluated as requirement of supplemental peribulbar anesthesia, impossibility to perform eye muscles surgery due to inadequate efficacy of the block and peribulbar block complications that occurred up to 6 weeks postoperatively. Presence of oculocardiac reflex (OCR) and presence of decreased visual acuity and afferent pupillary defect postoperatively were reported. RESULTS: A total of 510 patients comprised our study group. The total amount of peribulbar injections was 717. Four patients (0.7%) required supplemental injection in the superonasal quadrant. Five of 510 (0.9%) required an anesthesiologic intervention with intravenous atropine. Eighty patients of 510 (15.6%) complained about transitory complete ptosis and/or amaurosis postoperatively. No complications were observed up to 6 weeks postoperatively. CONCLUSION: Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients.

Evaluating the Correlation between Alzheimer's Amyloid-ß Peptides and Glaucoma in Human Aqueous Humor.

Purpose: Recent studies suggest that glaucoma may share common pathogenic mechanisms with Alzheimer's disease. To test this hypothesis, we investigated the correlation between glaucoma and amyloid-ß42 (Aß42) concentration in human samples of aqueous humor (AH). Methods: Eighty-one candidates for cataract or glaucoma surgery were consecutively enrolled, with a median age of 77 years; of these, 32 subjects were affected by glaucoma and 49 were controls. Before surgery, each patient received an ophthalmological examination including biometry, intraocular pressure (IOP) measurement, fundus photography, and determination of the mean thickness of the ganglion cell complex (GCC) and/or retinal nerve fiber layer. During the surgical procedure, an AH sample was collected and immediately processed for total protein (TP) and Aß42 evaluation. Results: Aß42 levels were not statistically different between the glaucomatous and control samples, but a significant increase in TP concentration was found in the AH of glaucoma patients compared with controls (P = 0.02). In addition, positive correlations were observed between TP and Aß42 (r = 0.51; P < 0.0001), between TP and IOP (r = 0.44; P < 0.0001), and between Aß42 and IOP (r = 0.22; P = 0.033). Conclusions: Our results indicate that an increased protein concentration in the AH could play a role in the pathogenesis of glaucomatous disease. Translational Relevance: This study strongly supports the hypothesis that increased TP in the AH may have a pathogenic role in glaucoma. Further investigations are needed to clarify whether the protein enhancement represents a causative factor and whether it can be used as a marker of disease or as a novel therapeutic target.

Real-Life Management of Diabetic Macular Edema with Dexamethasone Intravitreal Implant: A Retrospective Analysis of Long-Term Clinical Outcomes.

PURPOSE: Inflammation plays a key role in the pathogenesis of diabetic macular edema (DME), and intravitreal corticosteroids are among the recommended therapies. The goal of this retrospective analysis was to describe outcomes with dexamethasone intravitreal implant (DEX implant) in real life. METHODS: Medical digital records of DME patients treated with DEX implant and followed up for 3 years were analyzed. Treatment with DEX implant was started either as first-line therapy in pseudophakic patients and in patients with cardiovascular comorbidities or as second-line therapy in patients refractory to the inhibitor of the vascular endothelial growth factor (anti-VEGF) therapy. Analyzed outcomes included central macular thickness (CMT) and best-corrected visual acuity (BCVA). Mean number of implant injections per patient and mean duration of the interval between injections were also estimated. RESULTS: Seventy-five patients (mean age 65.7 (±12.3) years; 53 phakic and 22 pseudophakic) with DME were included. Overall, 84 eyes were treated. Mean CMT improved from 380.1 (±100.3) µm at baseline to 306.8 (±77.0) µm at 36 months (p=0.0003). Mean BCVA improved for up to 6 months (p=0.08) and then started to decrease reaching values lower than baseline after 24 months. In pseudophakic patients, BCVA improvements were more pronounced and sustained up to 36 months (p=0.6). Over 36 months, each patient received on average 2.4 (±1.6) intravitreal injections of DEX implant. The time interval between consecutive injections was included between 180 and 240 days. No unexpected safety issues were reported. CONCLUSIONS: With fewer than 3 injections per patient over a 3-year period, DEX implant was able to improve anatomic outcomes in DME patients. Only pseudophakic eyes showed also a long lasting functional benefit at 36 months.

Immediate Choroidal Expansion after Bleb Needling.

The purpose was to report a case of immediate choroidal expansion after a needling procedure. This is a retrospective case report of an 80-year-old male with pseudoexfoliative glaucoma who underwent Xen 45 Gel stent implantation and then trabeculectomy in the right eye. During follow-up, several bleb needling procedures were required to treat bleb fibrosis. Before and after the last bleb needling, spectral-domain optical coherence tomography (SD-OCT) was performed to investigate choroidal changes. SD-OCT was also repeated 1 week later. SD-OCT showed instant choroidal expansion (both in the macular and peripapillary area) that was quite sustained throughout the 1 week-follow-up and after 5 months. Bleb needling can cause immediate choroidal expansion that can be quite sustained throughout several months of follow-up. SD-OCT is essential for detecting choroidal changes.

Choroidal Congestion after Trabeculectomy.

The aim of this study is to report a case of choroidal congestion after trabeculectomy. This is a retrospective case report. An 85-year-old male with advanced open-angle glaucoma underwent trabeculectomy in both eyes and during follow-up he complained of visual impairment in the right eye. Thus, spectral domain optical coherence tomography (OCT) was performed and showed choroidal congestion in one eye 1 month after surgery together with a decrease of visual acuity. Symptoms and exam findings resolved with systemic steroids after a 6-month follow-up. OCT is essential for detecting choroidal congestion. This finding can be a possible complication after trabeculectomy and can benefit from steroid treatment.

Post-surgical recurrence of hepatocellular carcinoma along resection margin treated by percutaneous US-guided ablation.

BACKGROUND: The aim of this study was to evaluate the safety and efficacy of percutaneous ablation for hepatocellular carcinoma (HCC) hepatic recurrence along surgical resection margins to achieve complete cure or bridge for additional treatment. No current recommendations exist for these lesions. METHODS: Retrospective review of post-surgical recurrent HCC located along surgical margins treated by percutaneous ultrasound-guided ablation from 2006-2014. Ablation was performed by radiofrequency ablation (RFA) or percutaneous ethanol injection (PEI), selected for recurrence in proximity to extrahepatic organs. RESULTS: In total, nine patients (49-82 y, mean 73.8±8.3) were treated for 13 recurrent HCC nodules (9-35 mm, mean 21.5±8.1) located along resection margins by RFA (11 nodules) and PEI (2 nodules). Mean time between surgery and percutaneous ablation was 64 months (range 10-149). At a mean follow-up of 17 months (±9), complete ablation was achieved in 9 nodules (69.2%, 8 after RF, 1 after PEI) and partial ablation was achieved in 4 nodules (3 after RFA, 1 after PEI). Complications were limited to minor abdominal pain in 2 patients requiring medical therapy (15.3%). Of the 4 partially ablated nodules, subsequent therapy achieved complete response in 3 nodules (1 patient with TACE, 1 patient with stereotactic radiotherapy, and one with liver transplantation), while the last nodule progressed despite subsequent TACE. CONCLUSIONS: HCC recurrence along the surgical margin can be safely and effectively treated by percutaneous therapy, despite the misconception of the surgical margin as a hostile location. Percutaneous treatment may bridge the patient for additional therapy.

EXIT procedure in twin pregnancy: a series of three cases from a single center.

BACKGROUND: Indications for the ex utero intrapartum therapy (EXIT) procedure have evolved and nowadays in addition to secure the airway, obtain vascular access, administer surfactant and other resuscitation medications, EXIT is used to resect cervical or thoracic masses, for extracorporeal membrane circulation (ECMO) cannulation, as well as to rescue maximum intra-thoracic space for ventilation of the remaining functional lung tissue or in cases in which resuscitation of the neonate may be compromised. EXIT procedure in twin pregnancy has been rarely reported and some doubts have been raised about its strategy and safety in such cases. METHODS: We reviewed the medical records of 3 twin pregnancy cases where the EXIT procedure have been performed in our center. RESULTS: The mean gestational age at EXIT procedure was 34 + 4 weeks. In two out the three EXIT procedures, the affected twin was delivered first. The average time on placental bypass was 9 minutes. There were no fetal or maternal complications related to the EXIT procedure. All newborns are currently doing well. CONCLUSION: In twin pregnancies, prenatal diagnosis combined with the EXIT procedure permits the formulation of a controlled delivery strategy to secure both newborns outcome. In those pregnancies, if intervention can be accomplished without compromise of the normal twin, EXIT can be considered. Our results support that EXIT procedure, if properly planned, safely provides a good outcome for both the fetuses as well as the mother.

Paraoxonase 1 and its relationship with pesticide biomarkers in indigenous Mexican farmworkers.

OBJECTIVE: Biomarkers of pesticide toxicity and paraoxonase 1 (PON1) phenotype and genotypes were evaluated in indigenous Mexican farmworkers exposed mainly to organophosphate (OP) pesticides. METHODS: Acetylcholinesterase, butyrylcholinesterase, and PON1 activities--arylesterase and CMPAase activities--were evaluated spectrophotometrically. PON1 55 and 192 polymorphisms were determined by real-time polymerase chain reaction. Hematological parameters were evaluated using a cytometer. RESULTS: Butyrylcholinesterase and arylesterase activities were lower in farmworkers, who also showed lower levels of leukocytes but higher percentages of lymphocytes when compared with the nonexposed group. Our results showed a high frequency of OP, high hydrolysis-related PON1 alleles (LL/QR and LL/RR) in the study population. An association was observed between CMPAase activity and PON1Q192R polymorphism. CONCLUSIONS: Our results suggest that pesticide exposure modifies biochemical and hematological biomarkers in the study population, and that the phenotype of PON1 (CMPAase) is a sensible susceptibility biomarker of OP pesticide toxicity.

Morbidity of breast cancer and cervico-uterine cancer in women from the occidental region of Mexico.

BACKGROUND: The incidences of breast cancer (BC) and cervico-uterine cancer (CC) vary widely from country to country. In Mexico, BC mortality has doubled in the last 20 years to become the second leading cause of death for women aged 30 to 54 years. CC is the most common cause of death from neoplasia in women over 25 years old. In 2006, the state of Nayarit had one of the highest mortality rates for these types of cancers in Mexico. OBJECTIVE: To analyze and characterize the current demographics and morbidities associated with BC and CC in the state of Nayarit. MATERIAL AND METHODS: In this retrospective study, the clinical histories of patients who were diagnosed with BC or CC at the State Cancer Center from January 2006 to December 2010 were analyzed. RESULTS: A total of 406 patients with BC and 328 patients with CC were registered. The most common clinical stage for both cancer types was IIB. The municipalities of San Pedro Lagunillas and El Nayar presented the highest prevalences of BC and CC, respectively. CONCLUISION: Our results suggest that women living in poorer and more marginalized regions have a higher possibility of developing BC and CC. Because BC and CC are preventable and treatable in their early stages, demographic information from population records for these cancers is helpful in determining the incidence rates and patterns and improving decision-making processes.

A new fluorescent sensor for the determination of iron(III) in semi-aqueous solution.

A simple fluorescent sensor 1 has been developed for the recognition of Fe(III) in semi-aqueous solution at pH 7.0. The sensor, containing two Schiff base type receptors directly connected to naphthalene fluorophores, shows a concentration dependent decrease in emission intensity upon Fe(III) addition. The sensor was selective for Fe(III) over other metal ions and can measure Fe(III) ion concentration between 0.05 and 0.12 mM. The binding stoichiometry was established as 1:1 (host: guest) with a binding constant (Logß) of 4.01. Furthermore, the addition of Fe(III) to a solution of 1 caused a colour change from light yellow to colourless meaning 1 is also capable of detecting Fe(III) by the naked eye.

Hematological, biochemical effects, and self-reported symptoms in pesticide retailers.

OBJECTIVE: This study evaluates the effects of exposure to pesticides on the health of pesticide retailers. METHODS: The study population comprised 83-male pesticide retailers and 98 controls. Serum butyrylcholinesterase levels and complete blood analysis were performed in a certified laboratory and each subject completed a structured questionnaire. RESULTS: Butyrylcholinesterase activity and hematological parameters such as hemoglobin and hematocrit were significantly lower in pesticide retailers than in control subjects. In contrast, platelet count as well as hepatic parameters such as glutamic-pyruvate transaminase and gamma-glutamyl transpeptidase activities was higher in pesticide retailers. Furthermore, pesticide retailers experienced burning sensations in the skin more frequently than controls. CONCLUSIONS: These preliminary results suggest the importance of evaluating further toxicological biomarkers in these populations.

Diagnosis and management of fetal intrapericardial Morgagni diaphragmatic hernia with massive pericardial effussion.

Herniation of the liver into the fluid-filled pericardial sac resulting in a thoracic mass is a particularly rare form of Morgagni hernia (congenital diaphragmatic hernia of Morgagni). We report an early antenatal diagnosis of congenital diaphragmatic hernia of Morgagni with pericardium effussion at 21 weeks' gestation. Two pericardiocentesis were performed at 21 and 22 4/7 weeks' gestation because of recurrence of pericardial effussion. Regular ultrasound assessments showed progressive herniation of the liver to practically fill the right hemithorax. An ex utero intrapartum treatment procedure was performed at 37 weeks' gestation to rescue maximum intrathoracic space for ventilation of the remaining functional lung tissue and to establish an airway for postnatal support. After birth, the patient successfully underwent early correction of the hernia. Postoperative course was uneventful, and the newborn girl was discharged 18 days later without complications and is currently doing well.

[Clinical and biological characteristics of a group of 54 pregnant women with HELLP syndrome]. / Características clinicobiológicas de un grupo de 54 gestantes con síndrome HELLP.

BACKGROUND AND OBJECTIVE: The HELLP syndrome is a rare form of preeclampsia with a variable presentation with substantial maternal and perinatal morbidity and mortality. The aim of this study was to determine its clinical and biological characteristics in our hospital. PATIENTS AND METHOD: An observational study of all cases of confirmed HELLP syndrome from 1999 to 2002 was carried out. RESULTS: There were 54 cases of HELLP syndrome. Mean maternal age was 30.06 (16-41) years. 57.4% were primiparous. Mean gestational age at diagnosis of HELLP syndrome was 31.75 (20-41) weeks. Symptoms and signs were dominated by the digestive ones. Hypertension was observed in all cases. 77.8% pregnancies were delivered by caesarean section. Mean birth weight was 1674.52 g (150-3800 g). There were 12 perinatal deaths and one maternal death. CONCLUSIONS: HELLP syndrome is an uncommon but potentially serious complication of pregnancy which is associated with an increased risk of adverse maternal and fetal outcomes. Management should be multidisciplinary and based on strict control by maternal and fetal symptoms.

Características clinicobiológicas de un grupo de 54 gestantes con síndrome HELLP / Clinical and biological characteristics of a group of 54 pregnant women with HELLP syndrome

FUNDAMENTO Y OBJETIVO: El síndrome HELLP es una forma rara de preeclampsia de presentación variable que asocia un incremento de la morbilidad y mortalidad materna y perinatal. El objetivo de este estudio fue determinar las características clínicas y biológicas de los casos asistidos en nuestro hospital. PACIENTES Y MÉTODO: Estudio observacional de todas las pacientes con síndrome HELLP atendidas en un solo centro entre 1999 y 2002. RESULTADOS: Hubo 54 casos de síndrome HELLP. La edad materna fue de 30,06 años (extremos, 16-41) y el 57,4 por ciento eran primíparas. La edad gestacional al diagnóstico fue de 31,75 semanas (extremos, 20-41). Los síntomas y signos fueron predominantemente digestivos. La presencia de hipertensión fue común en todos los casos. En el 77,8 por ciento de los casos fue necesario practicar una cesárea. El peso medio de los recién nacidos fue de 1.674,52 g (150-3.800 g). Hubo 12 muertes perinatales y una muerte materna. CONCLUSIONES: Este síndrome es una complicación rara pero potencialmente grave del embarazo que asocia un riesgo aumentado de problemas maternos y fetales. Por consiguiente, su manejo debe ser multidisciplinario y basado en un control estricto de la clínica materna y fetal (AU)