Clinical outcomes in men of diverse ethnic backgrounds with metastatic castration-resistant prostate cancer.

BACKGROUND: We have shown previously in multivariable analysis that black men had 19% lower risk of death than white men with metastatic castration-resistant prostate cancer (mCRPC) treated with a docetaxel and prednisone (DP)-based regimen. The primary goal of this analysis was to compare progression-free survival (PFS), biochemical PFS, ≥50% decline in prostate-specific antigen (PSA) from baseline and objective response rate (ORR) in white, black and Asian men with mCRPC treated with a DP-based regimen. PATIENTS AND METHODS: Individual patient data from 8820 mCRPC men randomized on nine phase III trials to a DP-containing regimen were combined. Race used in the analysis was based on self-report. End points were PFS, biochemical PSA, ≥50% decline in PSA from baseline and ORR. The proportional hazards and the logistic regression models were employed to assess the prognostic importance of race in predicting outcomes adjusting for established prognostic factors. RESULTS: Of 8820 patients, 7528 (85%) were white, 500 (6%) were black, 424 were Asian (5%) and 368 (4%) had race unspecified. Median PFS were 8.3 [95% confidence interval (CI) 8.2-8.5], 8.2 (95% CI 7.4-8.8) and 8.3 (95% CI 7.6-8.8) months in white, black and Asian men, respectively. Median PSA PFS were 9.9 (95% CI 9.7-10.4), 8.5 (95% CI 8.0-10.3) and 11.1 (95% CI 9.9-12.5) months in white, black and Asian men, respectively. CONCLUSIONS: We observed no differences in clinical outcomes by race and ethnic groups in men with mCRPC enrolled on these phase III clinical trials with DP.

Impact of microaeration bioreactor on dissolved sulfide and methane removal from real UASB effluent for sewage treatment.

Two bioreactors were investigated as an alternative for the post-treatment of effluent from an upflow anaerobic sludge blanket (UASB) reactor treating domestic sewage, aiming at dissolved sulfide and methane removal. The bioreactors (R-control and R-air) were operated at different hydraulic retention times (HRT; 6 and 3 h) with or without aeration. Large sulfide and methane removal efficiencies were achieved by the microaerated reactor at HRT of 6 h. At this HRT, sulfide removal efficiencies were equal to 61% and 79%, and methane removal efficiencies were 31% and 55% for R-control and R-air, respectively. At an HRT of 3 h, sulfide removal efficiencies were 22% (R-control) and 33% (R-air) and methane removal did not occur. The complete oxidation of sulfide, with sulfate formation, prevailed in both phases and bioreactors. However, elemental sulfur formation was more predominant at an HRT of 6 h than at an HRT of 3 h. Taken together, the results show that post-treatment improved the anaerobic effluent quality in terms of chemical oxygen demand and solids removal. However, ammoniacal nitrogen was not removed due to either the low concentration of air provided or the absence of microorganisms involved in the nitrogen cycle.

Performance and bacterial diversity of bioreactors used for simultaneous removal of sulfide, solids and organic matter from UASB reactor effluents.

Two bioreactors were investigated as an alternative to post-treatment of effluent from an upflow anaerobic sludge blanket (UASB) reactor treating domestic sewage, with an aim of oxidizing sulfide into elemental sulfur, and removal of solid and organic material. The bioreactors were operated at different hydraulic retention times (HRTs) (6, 4, and 2 h) and in the presence or absence (control) of packing material (polypropylene rings). Greater sulfide removal efficiencies - 75% (control reactor) and 92% (packed reactor) - were achieved in both reactors for an HRT of 6 h. Higher organic matter (COD) and solid (TSS) removal levels were observed in the packed reactor, which produced effluent with low COD (100 mg CODL-1) and TSS concentrations (30 mg TSSL-1). Denaturing gradient gel electrophoresis results revealed that a metabolically diverse bacterial community was present in both bioreactors, with sequences related to heterotrophic bacteria, sulfur bacteria (Thiocapsa, Sulfurimonas sp., Chlorobaculum sp., Chromatiales and Sulfuricellales), phototrophic purple non-sulfur bacteria (Rhodopseudomonas, Rhodocyclus sp.) and cyanobacteria. The packed reactor presented higher extracellular sulfur formation and potential for elemental sulfur recovery was seen. Higher efficiencies related to the packed reactor were attributed to the presence of packing material and higher cell retention time. The studied bioreactors seemed to be a simple and low-cost alternative for the post-treatment of anaerobic effluent.

Nitrogen removal in a shallow maturation pond with sludge accumulated during 10 years of operation in Brazil.

Accumulated sludge in polishing (maturation) ponds reduces the hydraulic retention time (smaller useful volume), and this could potentially lead to a decrease in performance. However, settled biomass, present in the sediments, can contribute to nitrogen removal by different mechanisms such as nitrification and denitrification. This study investigated the influence of the bottom sludge present in a shallow maturation pond treating the effluent from an anaerobic reactor on the nitrification and denitrification processes. Nitrification and denitrification rates were determined in sediment cores by applying ammonia pulses. Environmental conditions in the medium were measured and bacteria detected and quantified by real-time polymerase chain reaction (real-time PCR). The pond showed daily cycles of mixing and stratification and most of the bacteria involved in nitrogen removal decreased in concentration from the upper to the lower part of the sludge layer. The results indicate that denitrifiers, nitrifiers and anammox bacteria coexisted in the sludge, and thus different metabolic pathways were involved in ammonium removal in the system. Therefore, the sediment contributed to nitrogen removal, even with a decrease in the hydraulic retention time in the pond due to the volume occupied by the sludge.

Bacterial community involved in the nitrogen cycle in a down-flow sponge-based trickling filter treating UASB effluent.

The bacterial community composition of a down-flow sponge-based trickling filter treating upflow anaerobic sludge blanket (UASB) effluent was investigated by pyrosequencing. Bacterial community composition considerably changed along the reactor and over the operational period. The dominant phyla detected were Proteobacteria, Verrucomicrobia, and Planctomycetes. The abundance of denitrifiers decreased from the top to the bottom and it was consistent with the organic matter concentration gradients. At lower loadings (organic and nitrogen loading rates), the abundance of anammox bacteria was higher than that of the ammonium-oxidizing bacteria in the upper portion of the reactor, suggesting that aerobic and anaerobic ammonium oxidation occurred. Nitrification occurred in all the compartments, while anammox bacteria prominently appeared even in the presence of high organic carbon to ammonia ratios (around 1.0-2.0 gCOD gN(-1)). The results suggest that denitrifiers, nitrifiers, and anammox bacteria coexisted in the reactor; thus, different metabolic pathways were involved in ammonium removal in the post-UASB reactor sponge-based.

Diversity and dynamics of ammonia-oxidizing bacterial communities in a sponge-based trickling filter treating effluent from a UASB reactor.

Changes in ammonia-oxidizing bacterial (AOB) population dynamics were examined in a new sponge-based trickling filter (TF) post-upflow anaerobic sludge blanket (UASB) reactor by denaturating gradient gel electrophoresis (DGGE), and these changes were linked to relevant components influencing nitrification (chemical oxygen demand (COD), nitrogen (N)). The sponge-based packing media caused strong concentration gradients along the TF, providing an ecological selection of AOB within the system. The organic loading rate (OLR) affected the population dynamics, and under higher OLR or low ammonium-nitrogen (NH4(+)-N) concentrations some AOB bands disappeared, but maintaining the overall community function for NH4(+)-N removal. The dominant bands present in the upper portions of the TF were closely related to Nitrosomonas europaea and distantly affiliated to Nitrosomonas eutropha, and thus were adapted to higher NH4(+)-N and organic matter concentrations. In the lower portions of the TF, the dominant bands were related to Nitrosomonas oligotropha, commonly found in environments with low levels of NH4(+)-N. From a technology point of view, changes in AOB structure at OLR around 0.40-0.60 kgCOD m(-3) d(-1) did not affect TF performance for NH4(+)-N removal, but AOB diversity may have been correlated with the noticeable stability of the sponge-based TF for NH4(+)-N removal at low OLR. This study is relevant because molecular biology was used to observe important features of a bioreactor, considering realistic operational conditions applied to UASB/sponge-based TF systems.

Entropy-based Model for Gully Erosion - A combination of probabilistic and deterministic components.

Gullies are a major threat to ecosystems, potentially leading to land degradation, groundwater depletion, crop loss, debris flow, and desertification. Gullies are also characterized by having a fast development and turning into primary sediment sources. Despite their impact, we have but scarce understanding of how gully erosion evolves and how to model it. In this paper, we propose a new gully erosion model that is based on the classical premise of net shear stress, i.e., hydraulic shear stress minus critical (resistant) shear stress, to calculate detachment rates. In order to calculate hydraulic shear stress, we developed a new equation derived from the principle of minimum cross-entropy; it was validated with laboratory measures from the literature with a Nash-Sutcliffe Efficiency of 0.95. Soil samples were analysed in the laboratory to assess critical shear stress and other soil properties. The novel gully erosion model was implemented in three gully impacted locations with catchment areas ranging from 10-2 to 10+1 ha. To assess channel geometry and eroded volumes, we used Unmanned Aerial Vehicle and Structure-from-Motion technique. The model successfully estimated long-term erosion rates, its efficiency was 0.77, and it is recommended for catchments up to 8 ha. Therefore, the new model provides planners and stakeholders with a tool to assess gully erosion, sediment yield and geometry in most areas.

Exploring the microbiome, antibiotic resistance genes, mobile genetic element, and potential resistant pathogens in municipal wastewater treatment plants in Brazil.

Wastewater treatment plants (WWTPs) have been widely investigated in Europe, Asia and North America regarding the occurrence and fate of antibiotic resistance (AR) elements, such as antibiotic resistance genes (ARGs), mobile genetic elements (MGEs) and antibiotic resistant bacteria and pathogens. However, monitoring data about AR elements in municipal WWTPs in Brazil are scarce. This study investigated the abundance of intI1, five ARGs (sul1, tetA, blaTEM, ermB and qnrB) and 16S rRNA in raw and treated wastewater of three WWTPs, using different sewage treatments named CAS (Conventional activated sludge), UASB/BTF (UASB followed by biological trickling filter) and MAS/UV (modified activated sludge with UV disinfection stage). Bacterial diversity and the presence of potentially pathogenic groups were also evaluated, and associations between genetic markers and the bacterial populations were presented. All WWTPs decreased the loads of genetic markers finally discharged to receiving water bodies and showed no evidence of being hotspots for antimicrobial resistance amplification in wastewater, since the abundances of intI1 and ARGs within the bacterial population were not increased in the treated effluents. UASB/BTF showed a similar performance to that of the CAS and MAS/UV, reinforcing the sanitary and environmental advantages of this biological treatment, widely applied for wastewater treatment in warm climate regions. Bacterial diversity and richness increased after treatments, and bacterial communities in wastewater samples differed due to catchment areas and treatment typologies. Potential pathogenic population underwent considerable decrease after the treatments; however, strong significant correlations with intI1 and ARGs revealed potential multidrug-resistant pathogenic bacteria (Aeromonas, Arcobacter, Enterobacter, Escherichia-Shigella, Stenotrophomonas and Streptococcus) in the treated effluents, although in reduced relative abundances. These are contributive results for understanding the fate of ARGs, MGEs and potential pathogenic bacteria after wastewater treatments, which might support actions to mitigate their release into Brazilian aquatic environments in the near future.

The use of microsensors to study the role of the loading rate and surface velocity on the growth and the composition of nitrifying biofilms.

The good composition and activity of biofilms are very important for successful operation and control of fixed-film biological reactors employed in liquid effluents treatment. During the last decade, microsensors have been applied to study microbial ecology. These sensors could provide information regarding the microbial activity concerning nitrification and denitrification that occur inside biofilms. Other techniques of molecular biology, such as fluorescence in situ hybridization (FISH), have also contributed to this matter because their application aids in the identification of the bacterial populations that compose the biofilms. The focus of this paper was to study the loading rate and surface velocity to promote the development of nitrifying biofilms in three distinct flow cells that were employed in the post treatment of a synthetic wastewater simulating the effluent from a UASB (Upflow Anaerobic Sludge Blanket) reactor. Using the FISH technique, it was found that the population of ammonia-oxidizing-bacteria was greater than that of nitrite-oxidizing-bacteria; this was also supported by the lower production of nitrate determined by physicochemical and microsensor analyses. It was verified that the loading rate and surface velocity that promoted the greatest nitrogen removal were 0.25 g N-amon m(-2)biofilm day(-1) and 1 m h(-1), respectively.

Anammox bacteria enrichment and characterization from municipal activated sludge.

A sustainable option for nitrogen removal is the anaerobic ammonium-oxidizing (anammox) process in which ammonium is oxidized to nitrogen gas with nitrite as electron acceptor. Application of this process, however, is limited by the availability of anammox biomass. In this study, two Brocadia-like anammox phylotypes were successfully enriched, detected and identified from an activated sludge taken from a domestic wastewater treatment plant (Minas Gerais, Brazil) employing a Sequencing Batch Reactor (SBR). The dominant phylotype was closely related to 'Candidatus Brocadia sinica', but one clone seemed to represent a novel species for which we propose the name 'Candidatus Brocadia brasiliensis'. Based on Fluorescence in situ hybridization (FISH) analysis, this enrichment led to a relative population size of 52.7% (±15.6) anammox bacteria after 6 months of cultivation. The cultivation process can be divided into three phases: phase 1 (approximately 25 days) was characterized by heterotrophic denitrification metabolism, phase 2 was the propagation phase and phase 3 (from the 87th day onwards), in which significant anammox activity was detected. A long-term performance of the SBR showed a near perfect removal of nitrite based on the influent NO(2)(-)-N concentration of 61-95 mg L(-1). The average ammonia removal efficiency was 90% with the influent NH(4)(+)-N concentration of 55-82 mg L(-1). Therefore, anammox cultivation and enrichment from activated sludge was possible under a controlled environment within 3 months.

Magnetic nanoparticles hyperthermia in a non-adiabatic and radiating process.

We investigate the magnetic nanoparticles hyperthermia in a non-adiabatic and radiating process through the calorimetric method. Specifically, we propose a theoretical approach to magnetic hyperthermia from a thermodynamic point of view. To test the robustness of the approach, we perform hyperthermia experiments and analyse the thermal behavior of magnetite and magnesium ferrite magnetic nanoparticles dispersed in water submitted to an alternating magnetic field. From our findings, besides estimating the specific loss power value from a non-adiabatic and radiating process, thus enhancing the accuracy in the determination of this quantity, we provide physical meaning to a parameter found in literature that still remained not fully understood, the effective thermal conductance, and bring to light how it can be obtained from experiment. In addition, we show our approach brings a correction to the estimated experimental results for specific loss power and effective thermal conductance, thus demonstrating the importance of the heat loss rate due to the thermal radiation in magnetic hyperthermia.

Investigation of aerobic and anaerobic ammonium-oxidising bacteria presence in a small full-scale wastewater treatment system comprised by UASB reactor and three polishing ponds.

This work applied PCR amplification method and Fluorescence in situ hybridisation (FISH) with primers and probes specific for the anammox organisms and aerobic ammonia-oxidising beta-Proteobacteria in order to detect these groups in different samples from a wastewater treatment system comprised by UASB reactor and three polishing (maturation) ponds in series. Seven primer pairs were used in order to detect Anammox bacteria. Positive results were obtained with three of them, suggesting that Anammox could be present in polishing pond sediments. However, Anammox bacteria were not detected by FISH, indicating that they were not present in sediment samples, or they could be present but below FISH detection limit. Aerobic ammonia- and nitrite-oxidising bacteria were verified in water column samples through Most Probable Number (MPN) analysis, but they were not detected in sediment samples by FISH. Ammonia removal efficiencies occurred systematically along the ponds (24, 32, and 34% for polishing pond 1, 2, and 3, respectively) but the major reaction responsible for this removal is still unclear. Some nitrification might have occurred in water samples because some nitrifying bacteria were present. Also Anammox reaction might have occurred because Anammox genes were detected in the sediments, but probably this reaction was too low to be noticed. It is important also to consider that some of the ammonia removal observed might be related to NH(3) stripping, associated with the pH increase resulting from the intensive photosynthetic activity in the ponds (mechanism under investigation). Therefore, it can be concluded that more than one mechanism (or reaction) might be involved in the ammonia removal in the polishing ponds investigated in this study.

Clinical Impact of Surgical Complications in Kidney Transplant Recipients in a Reference Hospital in Salvador, Bahia, Brazil.

BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment. We analyzed the demographics, clinical indicators, surgical techniques, and postoperative complications. RESULTS: In the analysis of 147 transplantations, there was a higher incidence of transplantation in female recipients, average age of 37 years with a predominance of cadaveric transplantation. Of all pretransplantation comorbidities, hypertension was the most frequent. The overall incidence of surgical complications was 29.9%, with an incidence of vascular complications of 12.7%, 13.4% of surgical site complications, 8.2% of urologic complications, and 3% of hemorrhagic complications. DISCUSSION: Vascular complications are serious complications and are associated with increased risk of graft loss (relative risk, 8.4), particularly arterial thrombosis. Patients with ureteral anastomosis using Lich-Gregoir technique showed lower urologic complications compared with patients with anastomosis by Leadbetter-Politano technique. CONCLUSION: Surgical complications have different clinical effects, depending on their category. The vascular complications are associated with graft lost.

Cell lines containing and expressing the human herpesvirus 6A ts gene are protected from both H-ras and BPV-1 transformation.

Human herpesvirus 6A (HHV-6A) strain U1102 was previously shown to contain a 1473 bp transformation suppressor gene (ts) (Araujo et al., 1995). Ts inhibited transformation of NIH3T3 cells by H-ras and transcription of the H-ras and human immunodeficiency type 1 (HIV-1) promoters in transient transfection experiments. In the current study, stable NIH3T3 cell lines expressing ts protein were established by transfection with pRc-ts containing the ts gene under the control of the Rous sarcoma virus (RSV) long terminal repeat (LTR) and a neomycin selectable marker. Selected cell lines contained approximately one to two copies per cell of intact ts sequences, expressed ts protein and grew at approximately the same rate as parental NIH3T3 cells. These cell lines were protected from H-ras transformation while parental and NIH3T3 cells containing the ts gene cloned in the antisense orientation were not. Expression of the chloramphenicol acetyl transferase (CAT) gene under the control of the EJ-H-ras promoter was also suppressed in the ts cell lines but not when the CAT gene was under the control of the murine osteosarcoma virus LTR or human cytomegalovirus immediate early promoter. When NIH3T3 cell lines expressing ts protein were established by infection with the retrovirus, LNCts, the cells expressed ts protein and were protected from H-ras transformation. Furthermore, bovine papillomavirus type 1 (BPV-1) transformation was also suppressed in cells co-transfected with BPV-1 plus ts and in ts expressing cell lines transfected with BPV-1. The BPV-1 p89 and p2443 promoters were down-regulated in 3T3-ts lines. Because the human papillomavirus type 16 (HPV-16) p97 promoter has similarity to the BPV-1 p89 promoter, the ability of ts to suppress p97 was also tested. Like the H-ras and BPV-1 promoters, HPV-16 p97 was down-regulated in 3T3-ts lines. The data indicate the utility of ts against H-ras, BPV-1 and HPV-16 promoters and their respective oncogenes.

Relative distribution of gastrin-, CCK-8-, NPY- and CGRP-immunoreactive cells in the digestive tract of dorado (Salminus brasiliensis).

The endocrine cells (ECs) of the gastrointestinal mucosa form the largest endocrine system in the body, not only in terms of cell numbers but also in terms of the different produced substances. Data describing the association between the relative distributions of the peptide-specific ECs in relation to feeding habits can be useful tools that enable the creation of a general expected pattern of EC distribution. We aimed to investigate the distribution of ECs immunoreactive for the peptides gastrin (GAS), cholecystokinin (CCK-8), neuropeptide Y (NPY), and calcitonin gene-related peptide (CGRP) in different segments of the digestive tract of carnivorous fish dorado (Salminus brasiliensis) by using immunohistochemistry procedures. The distribution of endocrine cells immunoreactive for gastrin (GAS), cholecystokinin (CCK-8), neuropeptide Y (NPY), and calcitonin gene-related peptide (CGRP) in digestive tract of dorado S. brasiliensis was examined by immunohistochemistry. The results describe the association between the distribution of the peptide-specific endocrine cells and feeding habits in different carnivorous fish. The largest number of endocrine cells immunoreactive for GAS, CCK-8, and CGRP were found in the pyloric stomach region and the pyloric caeca. However, NPY-immunoreactive endocrine cells were markedly restricted to the midgut. The distribution pattern of endocrine cells identified in S. brasiliensis is similar to that found in other carnivorous fishes.

Unusual computed tomographic presentation of cerebral toxoplasmosis.

The computed tomographic appearance of three cases of cerebral toxoplasmosis is described. Two of the patients were children with Hodgkin disease and the third was an adult with systemic lupus erythematosus. All patients were severely immunosuppressed. Computed tomography showed single or multiple hypodense rounded areas with peripheral annular contrast enhancement, suggesting pyogenic cerebral abscesses. Pathologic correlation is presented. The importance of diagnosis and early treatment is emphasized.

South American blastomycosis presenting as a posterior fossa tumor. Case report.

An unusual case of infection of the central nervous system by Paracoccidioides braziliensis, presenting as posterior fossa tumor, is discussed and the pertinent literature reviewed.

Meningiomas of Meckel's cave.

A retrospective review of 12 cases of meningioma of Meckel's cave involving the Gasserian ganglion or the trigeminal posterior root (or both) seen at the Mayo Clinic during a 20-year period suggested three clearly defined clinical groups. One group (the largest) had typical trigeminal neuralgia and an excellent prognosis after the removal of the easily detachable mass that was impinging on the ganglion. A second group, with meningiomas en plaque embedded in the ganglion, had a history of atypical trigeminal face pain without neurological deficit, but the prognosis for pain relief was not as good as in the previous group. A third group had a history of face dysesthesias and pain, objective trigeminal sensory loss, and multiple cranial nerve deficit; these patients had meningiomas with histological signs of mitotic activity and a poor prognosis, with return of intractable pain and recurrence of the tumor.

Posterior approach for soft cervical disc herniation: a neglected technique?

BACKGROUND: The ideal approach to the treatment of soft cervical disc herniation remains controversial. Recent reports emphasize several variations of anterior cervical approaches, including the introduction of instrumentation techniques. New issues have been raised and modern neurosurgeons seem to be less familiar with the posterior approach. The objective of this study was to analyze the results obtained by surgical treatment via a posterior approach of soft cervical disc herniation. METHOD: Fifty-one patients who underwent laminectomy/flavectomy and disc removal for the treatment of soft cervical disc herniation in the period of 1990 to 1999 were analyzed retrospectively. Relief of pain and motor and sensory improvement were the criteria used to measure the success of the procedure. RESULTS: Most of the patients presented with acute radiculopathy. Radicular involvement was as follows: 25 cases-C7 root, 19 cases-C6 root, 4 cases-C5 root, and 3 cases-C8 root. Total relief of pain was obtained in 49 of 51 patients (96%). Motor improvement was obtained in 35 of 46 patients (76%) and sensory improvement in 22 of 35 patients (62.8%) in the short term. The mean time of hospitalization was 3 days. There was no mortality and no morbidity. CONCLUSION: The advantage of this method, in selected cases, over the classical anterior approach, is that there is no need for grafting, thus avoiding the additional pain and possible complications at the donor and receptor sites, while obtaining similar results.