Community ecology and functional potential of bacteria, archaea, eukarya and viruses in Guerrero Negro microbial mat.

In this study, the microbial ecology, potential environmental adaptive mechanisms, and the potential evolutionary interlinking of genes between bacterial, archaeal and viral lineages in Guerrero Negro (GN) microbial mat were investigated using metagenomic sequencing across a vertical transect at millimeter scale. The community composition based on unique genes comprised bacteria (98.01%), archaea (1.81%), eukarya (0.07%) and viruses (0.11%). A gene-focused analysis of bacteria archaea, eukarya and viruses showed a vertical partition of the community. The greatest coverages of genes of bacteria and eukarya were detected in first layers, while the highest coverages of genes of archaea and viruses were found in deeper layers. Many genes potentially related to adaptation to the local environment were detected, such as UV radiation, multidrug resistance, oxidative stress, heavy metals, salinity and desiccation. Those genes were found in bacterial, archaeal and viral lineages with 6477, 44, and 1 genes, respectively. The evolutionary histories of those genes were studied using phylogenetic analysis, showing an interlinking between domains in GN mat.

[Prognosis in elderly patients with falls treated in emergency departments: The EDEN-3 study]. / Pronóstico en pacientes ancianos con caídas atendidos en servicios de urgencias: estudio EDEN-3.

OBJECTIVE: To investigate whether falls in people ≥65 years old are a prognostic factor for adverse events compared to the rest of older patients who consult emergency departments, and identify factors related to a worse long-term evolution. METHOD: EDEN cohort that included patients ≥65 years old. Those patients who consulted for fall and the rest were distinguished. Twelve variables were collected. For comparison: two groups matched by fall propensity score. We compared mortality at one year and combined adverse event post-discharge at one year. In patients with falls, variables independently related to evolution were identified. RESULTS: Two thousand seven hundred and forty-five patients treated for falls and 22,920 for other reasons. Mortality at one year was 14.4% (9.5% vs. 15.0%, respectively, P<.001) and the combined post-discharge adverse event at one year was 60.6% (52.2% vs. 61.7%, respectively, P<.001). In 4748 patients matched by fall propensity score (2372 in each group), the inverse association between consultation for fall and mortality (HR: 0.705, 95% CI: 0.5880.846) and post-discharge combined adverse event (0.758, 0.701-0.820) remained significant. Factors associated with mortality in patients with falls were ≥80 years (2.097, 1.521-2.891) and comorbidity (2.393, 1.574-3.636) while being female was a protective factor (0.758, 0.584-0.985). Between the factors associated with post-discharge combined adverse hospitalization in the index event was a protective factor (0.804, 0.685-0.943). CONCLUSIONS: Patients over 65 years of age treated in the emergency room for falls have a better prognosis. Hospitalization was a protective factor of combined postdischarge adverse event.

Microbial indicators of efficient performance in an anaerobic/anoxic/aerobic integrated fixed-film activated sludge (A2O-IFAS) and a two-stage mesophilic anaerobic digestion process.

An analysis of the community structure, diversity and population dynamics of Bacteria and Archaea in the suspended and attached biomass fractions of a pilot-scale anaerobic/anoxic/aerobic integrated fixed-film activated sludge (A2O-IFAS) was executed. Along with this, the effluents of the acidogenic (AcD) and methanogenic (MD) digesters of a two-stage mesophilic anaerobic (MAD) system treating the primary sludge (PS) and waste activated sludge (WAS) generated by the A2O-IFAS were also analyzed. Non-metric multidimensional scaling (MDS) and Biota-environment (BIO-ENV) multivariate analyses were performed to link population dynamics of Bacteria and Archaea to operating parameters and removal efficiencies of organic matter and nutrients, in search of microbial indicators associated with optimal performance. In all samples analyzed, Proteobacteria, Bacteroidetes and Chloroflexi were the most abundant phyla, while the hydrogenotrophic methanogens Methanolinea, Methanocorpusculum and Methanobacterium were the predominant archaeal genera. BIO-ENV analysis disclosed strong correlations between the population shifts observed in the suspended and attached bacterial communities of the A2O-IFAS and the removal rates of organic matter, N and P. It is noteworthy that the incorporation of carriers combined with a short sludge retention time (SRT = 4.0 ± 1.0 days) enhanced N removal performance of the A2O by favoring the enrichment of bacterial genera able to denitrify (Bosea, Dechloromonas, Devosia, Hyphomicrobium, Rhodobacter, Rhodoplanes, Rubrivivax, and Sulfuritalea) in the attached biomass fraction. In addition, operation at short SRT enabled the generation of a highly biodegradable WAS, which enhanced the biogas and methane yields in the two-stage MAD. An increase in the relative abundance of Acetobacteroides (uncultured Blvii28 wastewater-sludge group of Rikenellaceae family) correlated positively with the volatile solids removal rate (%VSR), CH4 recovery rate and %CH4 in the biogas (r > 0.8), supporting their relevance for an efficient methanogenesis in two-stage systems.

Odor emission assessment of different WWTPs with Extended Aeration Activated Sludge and Rotating Biological Contactor technologies in the province of Cordoba (Spain).

In this study, five urban WWTPs (Wastewater Treatment Plant) with different biological treatment (Extended Aeration Activated Sludge - EAAS; Rotating Biological Contactor - RBC), wastewater type (Urban; Industrial) and size, were jointly evaluated. The aim was twofold: (1) to analyze and compare their odor emissions, and (2) to identify the main causes of its generation from the relationships between physico-chemical, respirometric and olfactometric variables. The results showed that facilities with EAAS technology were more efficient than RBC, with elimination yields of organic matter higher than 90%. In olfactometric terms, sludge managements facilities (SMFs) were found to be the critical odor source in all WWTPs compared to the Inlet point (I) or Post primary treatment (PP), and for seasonal periods with ambient temperature higher than 25 °C. Moreover, the global odor emissions quantified in all SMFs revealed that facilities with EAAS (C-WWTP, V-WWTP and Z-WWTP) had a lower odor contribution (19,345, 14,800 and 11,029 ouE/s·m2, respectively) than for those with RBC technology (P-WWTP and NC-WWTP) which accounted for 19,747 ouE/s·m2 and 80,061 ouE/s·m2, respectively. In addition, chemometric analysis helped to find groupings and differences between the WWTPs considering the wastewater (71.27% of total variance explained) and sludge management (64.52% of total variance explained) lines independently. Finally, odor emissions were adequately predicted from the physico-chemical and respirometric variables in the wastewater (r2 = 0.8738) and sludge (r2 = 0.9373) lines, being pH, volatile acidity and temperature (wastewater line), and pH, moisture, temperature, SOUR (Specific Oxygen Uptake Rate) and OD20 (Cumulative Oxygen Demand at 20 h) (sludge line) the most influential variables.

Antha-Guided Automation of Darwin Assembly for the Construction of Bespoke Gene Libraries.

Protein engineering through directed evolutison is facilitated by the screening and characterization of protein libraries. Efficient and effective methods for multiple site-saturation mutagenesis, such as Darwin Assembly, can accelerate the sampling of relevant sequence space and the identification of variants with desired functionalities. Here, we present the automation of the Darwin Assembly method, using a Gilson PIPETMAX™ liquid handling platform under the control of the Antha software platform, which resulted in the accelerated construction of complex, multiplexed gene libraries error-free and with minimal hands-on time, while maintaining flexibility over experimental parameters through a graphical user interface rather than requiring user-driven library-dependent programming of the liquid handling platform. We also present an approach for barcoding libraries that overcomes amplicon length limitations in next generation sequencing and enables fast reconstruction of library reads.

Millimeter-scale vertical partitioning of nitrogen cycling in hypersaline mats reveals prominence of genes encoding multi-heme and prismane proteins.

Microbial mats are modern analogues of the first ecosystems on the Earth. As extant representatives of microbial communities where free oxygen may have first been available on a changing planet, they offer an ecosystem within which to study the evolution of biogeochemical cycles requiring and inhibited by oxygen. Here, we report the distribution of genes involved in nitrogen metabolism across a vertical oxygen gradient at 1 mm resolution in a microbial mat using quantitative PCR (qPCR), retro-transcribed qPCR (RT-qPCR) and metagenome sequencing. Vertical patterns in the presence and expression of nitrogen cycling genes, corresponding to oxygen requiring and non-oxygen requiring nitrogen metabolism, could be seen across gradients of dissolved oxygen and ammonium. Metagenome analysis revealed that genes annotated as hydroxylamine dehydrogenase (proper enzyme designation EC 1.7.2.6, hao) and hydroxylamine reductase (hcp) were the most abundant nitrogen metabolism genes in the mat. The recovered hao genes encode hydroxylamine dehydrogenase EC 1.7.2.6 (HAO) proteins lacking the tyrosine residue present in aerobic ammonia oxidizing bacteria (AOB). Phylogenetic analysis confirmed that those proteins were more closely related to ɛHao protein present in Campylobacterota lineages (previously known as Epsilonproteobacteria) rather than oxidative HAO of AOB. The presence of hao sequences related with ɛHao protein, as well as numerous hcp genes encoding a prismane protein, suggest the presence of a nitrogen cycling pathway previously described in Nautilia profundicola as ancestral to the most commonly studied present day nitrogen cycling pathways.

Eyelid nodules in idiopathic facial aseptic granuloma.

Idiopathic facial aseptic granuloma (IFAG) is a recently described and rare condition. It is considered a form of infantile granulomatous rosacea. IFAG with facial and eyelid nodules is very rare. A description is presented of three cases of IFAG eyelid nodules. They concern healthy children with no history of trauma. Biopsy examination revealed non-caseating inflammatory granulomas. Different medical treatments have been tried that seem to accelerate its healing, although its tendency is spontaneous resolution within several months. Painless recurrent eyelid nodules can be confused with chalazion. The diagnosis of IFAG should be considered in chronic eyelid nodules.

Influence of packing material on the biofiltration of butyric acid: A comparative study from a physico-chemical, olfactometric and microbiological perspective.

The influence of bed material on the odor removal performance of a biofilter was studied. A compost-wood biofilter and a wood biofilter were treated with a gaseous stream contaminated with butyric acid and comparatively evaluated at pilot scale using olfactometric, physico-chemical and microbiological approaches. The variables analyzed in both biofilters were correlated with specific families of their microbiota composition. In addition to a higher nutrients content (nitrogen and phosphorus), the compost-wood biofilter registered maximum values in number of aerobic microorganisms (3.6·108 CFU/g) and in aerobic microbiological activity (≈40 mg O2/g VS of cumulative oxygen demand at 20 h). This may explain the higher performance of this biofilter compared to the wood biofilter, withstanding odor loads of up to 1450 ouE/m2·s with odor removal efficiencies close to 100%. The analysis of the microbial community showed that Actinobacteria, particularly the mostly aerobic Microbacteriaceae family, might play an important role in butyric acid degradation and hence reduce odor impact. The multidisciplinary analysis carried out in this work could be a very useful strategy for the optimal design of biofiltration operations.

Insights into the removal of pharmaceutically active compounds from sewage sludge by two-stage mesophilic anaerobic digestion.

The removal efficiencies (REs) of twenty-seven pharmaceutically active compounds (PhACs) (eight analgesic/anti-inflammatories, six antibiotics, four ß-blockers, two antihypertensives/diuretics, three lipid regulators and four psychiatric drugs) were evaluated in a pilot-scale two-stage mesophilic anaerobic digestion (MAD) system treating thickened sewage sludge from a pilot-scale A2O™ wastewater treatment plant (WWTP) which was fed with wastewater from the pre-treatment of the full-scale WWTP Murcia Este (Murcia, Spain). The MAD system was long-term operated using two different sets of sludge retention times (SRTs) for the acidogenic (AcD) and methanogenic (MD) digesters (phase I, 2 and 12 days; and phase II, 5 and 24 days, in AcD and MD, respectively). Quantitative PCR (qPCR) and Illumina MiSeq sequencing were used to estimate the absolute abundance of Bacteria, Archaea, and Fungi and investigate the structure, diversity and population dynamics of their communities in the AcD and MD effluents. The extension of the SRT from 12 (phase I) to 24 days (phase II) in the MD was significantly linked with an improved removal of carbamazepine, clarithromycin, codeine, gemfibrozil, ibuprofen, lorazepam, and propranolol. The absolute abundances of total Bacteria and Archaea were higher in the MD regardless of the phase, while the diversity of bacterial and archaeal communities was lower in phase II, in both digesters. Non-metric multidimensional scaling (MDS) plots showed strong negative correlations among phyla Proteobacteria and Firmicutes and between genera Methanosaeta and Methanosarcina throughout the full experimental period. Strong positive correlations were revealed between the relative abundances of Methanospirillum and Methanoculleus and the methanogenesis performance parameters (volatile solids removal, CH4 recovery rate and %CH4 in the biogas), which were also related to longer SRT. The REs of several PhACs (naproxen, ketoprofen, ofloxacin, fenofibrate, trimethoprim, and atenolol) correlated positively (r > 0.75) with the relative abundances of specific bacterial and archaeal groups, suggesting their participation in biodegradation/biotransformation pathways.

Aplicación de protocolos ERAS (Enhanced Recovery After Surgery) en pacientes cistectomizados: el camino hacia la estandarización. Una revisión sistemática / Implementation of ERAS (Enhanced Recovery After Surgery) protocols for radical cystectomy patients: The pathway to standardization. A systematic review

CONTEXTO: El desarrollo de protocolos ERAS (Enhanced Recovery After Surgery) en pacientes sometidos a cirugía mayor ha aportado beneficios perioperatorios en diversas disciplinas. En urología, su principal aplicación se centra en pacientes sometidos a cistectomía radical. OBJETIVO: Revisión sistemática de la literatura disponible de protocolos ERAS aplicados a pacientes intervenidos de cistectomía radical, tanto a nivel de resultados perioperatorios como en el análisis de su implementación. Adquisición de la evidencia: Se realizó búsqueda bibliográfica en base de datos electrónicas Pubmed, Embase, Cochrane y Scopus, utilizando los términos «Cystectomy», «Enhanced Recovery After Surgery» y «Fast-Track». Se seleccionaron estudios aleatorizados y no aleatorizados que comparasen la implementación de un protocolo ERAS en pacientes sometidos a cistectomía radical frente a un protocolo tradicional. Síntesis de la evidencia: Se identificaron 869 artículos; 25 fueron seleccionados para el análisis final: 22 estudios no aleatorizados y 3 aleatorizados. No se detectaron diferencias en cuanto a características demográficas entre los distintos estudios. Se identificaron diferencias estadísticamente significativas a favor del protocolo ERAS en tiempo de estancia hospitalaria, tasa de complicaciones mayores, tiempo a primera deambulación y recuperación intestinal. En el análisis de protocolos se detectó una alta variabilidad, tanto en número de ítems como en método de implementación. CONCLUSIONES: El carácter multidisciplinar y el número de ítems de los protocolos ERAS conlleva una alta heterogeneidad en su implementación. Se requieren más estudios aleatorizados, estandarización a la hora de reportar y analizar resultados, así como un análisis sistemático de la adherencia posterior para aumentar la comparabilidad entre grupos

CONTEXT: The development of ERAS (Enhanced Recovery After Surgery) protocols in patients undergoing major surgery has brought perioperative benefits in several disciplines. Its main application in urology is focused on patients undergoing radical cystectomy. OBJECTIVE: Systematic review of the available literature on ERAS protocols applied to patients undergoing radical cystectomy in terms of perioperative outcomes as well in the analysis of their implementation. Evidence acquisition: A bibliographic search was conducted in the electronic databases PubMed, Embase, Cochrane and Scopus, using the terms «Cystectomy», «Enhanced Recovery After Surgery» and «Fast-Track». Randomized and non-randomized studies that compared the implementation of an ERAS protocol versus a traditional protocol in patients undergoing radical cystectomy were selected. Evidence synthesis: 869 articles were identified; 25 were selected for final analysis: 22 non-randomized and 3 randomized studies. No differences were observed in terms of demographic characteristics between studies. Statistically significant differences were identified in favor of the ERAS protocol: length of hospital stay, major complication rate, time to first ambulation and return of bowel function. In the analysis of protocols, a high variability was detected in the number of items and in the implementation method. CONCLUSIONS: The multidisciplinary nature and the number of items of the ERAS protocols imply a high heterogeneity in their implementation. Further randomized studies, standardized reporting and analyzing results, as well as a systematic analysis of subsequent adherence are required to increase comparability between groups

Implementation of ERAS (Enhanced Recovery After Surgery) protocols for radical cystectomy patients: The pathway to standardization. A systematic review. / Aplicación de protocolos ERAS (Enhanced Recovery After Surgery) en pacientes cistectomizados: el camino hacia la estandarización. Una revisión sistemática.

CONTEXT: The development of ERAS (Enhanced Recovery After Surgery) protocols in patients undergoing major surgery has brought perioperative benefits in several disciplines. Its main application in urology is focused on patients undergoing radical cystectomy. OBJECTIVE: Systematic review of the available literature on ERAS protocols applied to patients undergoing radical cystectomy in terms of perioperative outcomes as well in the analysis of their implementation. EVIDENCE ACQUISITION: A bibliographic search was conducted in the electronic databases PubMed, Embase, Cochrane and Scopus, using the terms «Cystectomy¼, «Enhanced Recovery After Surgery¼ and «Fast-Track¼. Randomized and non-randomized studies that compared the implementation of an ERAS protocol versus a traditional protocol in patients undergoing radical cystectomy were selected. EVIDENCE SYNTHESIS: 869 articles were identified; 25 were selected for final analysis: 22 non-randomized and 3 randomized studies. No differences were observed in terms of demographic characteristics between studies. Statistically significant differences were identified in favor of the ERAS protocol: length of hospital stay, major complication rate, time to first ambulation and return of bowel function. In the analysis of protocols, a high variability was detected in the number of items and in the implementation method. CONCLUSIONS: The multidisciplinary nature and the number of items of the ERAS protocols imply a high heterogeneity in their implementation. Further randomized studies, standardized reporting and analyzing results, as well as a systematic analysis of subsequent adherence are required to increase comparability between groups.

Integral evaluation of granular activated carbon at four stages of a full-scale WWTP deodorization system.

Odor emissions from wastewater treatment plants (WWTPs) have always been a public concern. In this work, the physico-chemical, olfactometric and textural characterization of granular active carbon (GAC) used by an urban WWTP as a deodorization system, as well as the chromatographic quantification of the retained odoriferous compounds, have been carried out. These techniques have allowed an integral evaluation of the contaminated GAC and the characterization of the retained gaseous emission from four different stages of the wastewater treatment (pretreatment header: GAC-1; sand and fat removal: GAC-2; sludge thickening: GAC-3; sludge dehydration: GAC-4). A larger amount and variety of retained odoriferous compounds were found in GAC samples from the wastewater line deodorization (GAC-1 and GAC-2) after the same operation time (one year), GAC-1 being the adsorbent bed that retained the highest mass of volatile compounds (approximately 150µg/g GAC). Furthermore, some variables such as the removed specific odor concentration and free micropore volume were inversely correlated (R2=0.9945). The analysis of odor contribution showed that sulfur-containing compounds were the major odor contributors (61-97%). However, hydrogen sulfide cannot be considered a key odorant in this particular WWTP, since the elimination of this compound does not reduce the significant contribution of other (organic) sulfur compounds to the global odor (especially dimethyl disulfide). Consequently, multi-technical analysis might be a suitable alternative to better understand odor removal by GAC adsorption.

Nódulos palpebrales en el granuloma aséptico facial idiopático / Eyelid nodules in idiopathic facial aseptic granuloma

El granuloma aséptico facial idiopático (GAFI) es una entidad recientemente descrita y poco frecuente. Se considera una forma de rosácea granulomatosa infantil. Es menos frecuente el GAFI con nódulos faciales y palpebrales asociados. Describimos 3casos GAFI que presentan esta asociación. Son niños sanos sin ningún antecedente traumático. El examen de la biopsia realizada en uno de los pacientes reveló granulomas inflamatorios no caseificantes. Se han ensayado distintos tratamientos médicos que parecen acelerar su curación, aunque su tendencia es la resolución espontánea en el plazo de varios meses. Los nódulos palpebrales indoloros de repetición se pueden confundir con el chalazión. Debemos pensar en GAFI ante nódulos palpebrales de larga evolución (AU)

Idiopathic facial aseptic granuloma (IFAG) is a recently described and rare condition. It is considered a form of infantile granulomatous rosacea. IFAG with facial and eyelid nodules is very rare. A description is presented of 3cases of IFAG eyelid nodules. They concern healthy children with no history of trauma. Biopsy examination revealed non-caseating inflammatory granulomas. Different medical treatments have been tried that seem to accelerate its healing, although its tendency is spontaneous resolution within several months. Painless recurrent eyelid nodules can be confused with chalazion. The diagnosis of IFAG should be considered in chronic eyelid nodules (AU)

Eyelid nodules in idiopathic facial aseptic granuloma. / Nódulos palpebrales en el granuloma aséptico facial idiopático.

Idiopathic facial aseptic granuloma (IFAG) is a recently described and rare condition. It is considered a form of infantile granulomatous rosacea. IFAG with facial and eyelid nodules is very rare. A description is presented of 3cases of IFAG eyelid nodules. They concern healthy children with no history of trauma. Biopsy examination revealed non-caseating inflammatory granulomas. Different medical treatments have been tried that seem to accelerate its healing, although its tendency is spontaneous resolution within several months. Painless recurrent eyelid nodules can be confused with chalazion. The diagnosis of IFAG should be considered in chronic eyelid nodules.

Seguimiento y características clínicas de los pacientes con nódulos tiroideos en nuestra práctica clínica antes de 2015 / Follow-up and clinical characteristics of patients with thyroid nodules in our clinical practice before 2015

INTRODUCCIÓN: Los nódulos tiroideos son una consulta muy prevalente en Endocrinología. Las guías de la Asociación Americana de Tiroides (2015) animaban a realizar estudios a largo plazo. El objetivo de este estudio fue revisar las características, el seguimiento y la evolución de los nódulos de tiroides seguidos en nuestras consultas hasta 2015. MATERIAL Y MÉTODOS: Estudio retrospectivo de pacientes con al menos dos ecografías o cirugía. Los datos clínicos, ecográficos y de punción, así como la evolución y los resultados histológicos de aquellos operados, se analizaron con métodos descriptivos, bivariados y de regresión. RESULTADOS: 1.420 pacientes seguidos en Endocrinología a largo plazo fueron incluidos. 20 se excluyeron por tener una sola ecografía. El 71,2% presentaban normofunción, 9,6% hipertiroidismo subclínico, 9,5% hipotiroidismo subclínico, 5,7% hipotiroidismo clínico y 4% hipertiroidismo clínico. Del total de nódulos seguidos (n= 1400), 64,1%, 15,6% y 20,3% permanecieron estables, aumentaron y disminuyeron respectivamente. Los que crecieron no tuvieron más características sospechosas en las ecografías. De los intervenidos (457 casos (32,6% del total), 207 fueron malignos (45,2%). 57% de ellos fueron diagnosticados e intervenidos durante el primer año, en la primera evaluación. La aparición de nódulos malignos en el resto de pacientes fue de 89 casos (6,3% de todos los nódulos seguidos, 38,3% de ellos, incidentalomas). La ecografía y la citología empleadas antes de la homogenización de los criterios diagnósticos tuvieron una baja sensibilidad y especificidad en nuestro medio. CONCLUSIONES: Más de la mitad de los cánceres de tiroides fueron diagnosticados en la evaluación inicial del nódulo tiroideo. Más de la mitad de los nódulos no operados en el primer año mantienen el mismo tamaño a largo plazo. No encontramos predictores clínicos del aumento de tamaño. El valor diagnóstico de la ecografía y PAAF sin unos criterios estandarizados homogéneos es bajo.

INTRODUCTION: Thyroid nodules are a very prevalent consultation in endocrinology. Guidelines from the American Thyroid Association (2015) encouraged to conduct follow-up studies in the long term. This study object was to review the clinical characteristics, follow-up and evolution of thyroid nodules visited in our consultations till 2015. MATERIAL AND METHODS: Retrospective study of patients that had at least two thyroid ultrasounds or had been operated. Clinical, ultrasound and FNA (fine needle aspiration) data as well as the evolution and histology results of those operated, were analyzed with descriptive, bivariated and regression analyses. RESULTS: 1.420 patients followed in Endocrinology in the long term were included. 20 were excluded for having only one ecography. 71,2% had normal function, 9,6% subclinical hyperthyroidism, 9,5% subclinical hypothyroidism, 5,7% clinical hypothyroidism and 4% clinical hyperthyroidism. Of all the nodules followed (n=1400), 64,1%, 15,6% and 20,3% remained the same size, grew and decreased respectively. Nodules that grew didn´t have more suspicious sonographic characteristics. Of the operated nodules (457 cases (32,6% of all), 207 were cáncer (45,2%). 57% of them were diagnosed and intervened during the first year, in the first evaluation. Malignant nodules were detected in the rest of patients in 89 cases (6,3% of all the followed nodules, 38,3% of them were incidental cases). The ultrasound and citology diagnoses used before the homogenization of diagnoses criteria had a low senitivity and specificity in our clinical environment. CONCLUSIONS: More than half of the thyroid cancers were diagnosed in the initial evaluation of the thyroid nodule. More than half of nodules non operated in the first year remained the same size long term. We could not find clinical predictors of growth. The diagnostic value of the ultrasound and FNA is low without standardized and homogenous criteria.

Linking microbial diversity and population dynamics to the removal efficiency of pharmaceutically active compounds (PhACs) in an anaerobic/anoxic/aerobic (A2O) system.

The removal efficiencies (REs) of nineteen pharmaceutically active compounds (PhACs) (six antibiotics-clarithromycin, ofloxacin, sulfadiazine, sulfamethazine, sulfamethoxazole and trimethoprim -, four ß-blockers -atenolol, metoprolol, propranolol and sotalol-, two antihypertensives/diuretics -furosemide and hydrochlorothiazide-, three lipid regulators -bezafibrate, fenofibrate and gemfibrozil-, and four psychiatric medications -carbamazepine, diazepam, lorazepam and paroxetine) were ascertained in a pilot-scale anaerobic/anoxic/aerobic (A2O) system treating urban wastewater, long term operated during two experimental phases using different sets of environmental conditions and operating parameters. Illumina MiSeq sequencing was used to investigate the structure, diversity and population dynamics of bacteria, archaea and fungi communities in the activated sludge. The results showed that mixed liquor suspended solids (MLSS) and food-to-microorganisms ratio (F/M) were operational parameters significantly influencing the REs of five of the analyzed PhACs in the A2O system. Biota-environment (BIO-ENV) analysis revealed strong correlations between population shifts of the activated sludge community and the REs of PhACs of the different pharmaceutical families. Increased REs of clarithromycin, furosemide, bezafibrate and gemfibrozil were concomitant to higher relative abundances of bacterial phylotypes classified within the Rhodobacteraceae and Sphingomonadaceae (Alphaproteobacteria), while those of Betaproteobacteria, Chloroflexi and Methanomethylovorans (Euryarchaea) correlated positively with the REs of up to seven PhACs belonging to different therapeutic groups.