Drug-degrading bacteria isolated from the effluent water of a sewage plant.

Endocrine disruptors are potential environmental contaminants that can cause toxicity in aquatic ecosystems, so the Water Framework Directive has established limits for these compounds. During our research, 41 bacterial strains were isolated and identified from sewage effluent and tested for their degradation capacities for bisphenol A, 17ß-estradiol, and nonylphenol. All the isolated bacteria belonged to the Gammaproteobacteria class of Pseudomonadota phylum (members of Citrobacter, Enterobacter, Escherichia, Klebsiella, Kluyvera, Leclercia, Raoultella, Shigella. Acinetobacter, Aeromonas, and Pseudomonas genera). During the experiments, only strains HF17, HF18 (Pseudomonas aeruginosa), and HF31 (Citrobacter freundii) were unable to grow on these compounds, all other bacterial strains could grow in the presence of the investigated endocrine disruptors. Based on the genomic analysis of the type strains, a set of genes involving aromatic compound degradation was detected, among the peripheral metabolic pathways, the quinate and benzoate degradation pathways proved to be widespread, among the central aromatic intermediates metabolism, the catechol branch of the beta-ketoadipate pathway was the most dominant. Pseudomonas fulva HF16 strain could utilize the investigated endocrine disruptors: bisphenol A by 34%, 17ß-estradiol by 52%, and nonylphenol by 54%.

Clinical Evaluation of a Chairside Amalgam Separator to Meet Environmental Protection Agency Dental Wastewater Regulatory Compliance.

OBJECTIVES: The aim of this study was to evaluate the performance of a commercially available chairside amalgam separator (CAS) in a clinical setting in which a relatively high number of amalgam restorations are placed. Performance parameters investigated included service life, amalgam collected, mercury concentrations in effluent, and solids retention efficiency. METHODS AND MATERIALS: CASs were tested per International Organization of Standardization (ISO) 11143:2008 prior to installation in a military dental treatment facility and after removal from service (n=4) in order to confirm compliance with the recently enacted United States Environmental Protection Agency (EPA) Effluent Limitations Guidelines and Standards for the Dental Category. During the units' time in service, biweekly effluent grab samples were collected from the high-volume evacuation system of each chair (n=6) and analyzed for total mercury concentration by inductively coupled plasma mass spectrometry (ICP-MS). The mean total accumulated solids at the end of service life (n=6) was determined for potential design optimization. The service life expectancy in a military dental treatment facility was determined in terms of calendar and workdays. Procedural data were collected to determine the daily mean number of amalgam surfaces placed during the service life of each chairside amalgam separator (n=9). RESULTS: The CAS evaluated met minimum EPA compliance requirements when used in a military dental treatment facility. The solids removal efficiency at the end of service life was 99.82% ± 0.14% (n=4). The mean service life (n=8) was 131.6 ± 45.1 calendar days (67.1±37.6 workdays). Effluent mercury concentrations ranged from 0.05 to 11.93 mg/L. Total solids accumulated in each CAS (n=6) at the end of service life was 195.4 ± 63.4 g. The mean number of amalgam surfaces placed per workday during the service life span of each CAS was 8.4 ± 1.4.

Bridging the gap between climate models and impact studies: the FORESEE Database.

Studies on climate change impacts are essential for identifying vulnerabilities and developing adaptation options. However, such studies depend crucially on the availability of reliable climate data. In this study, we introduce the climatological database called FORESEE (Open Database for Climate Change Related Impact Studies in Central Europe), which was developed to support the research of and adaptation to climate change in Central and Eastern Europe: the region where knowledge of possible climate change effects is inadequate. A questionnaire-based survey was used to specify database structure and content. FORESEE contains the seamless combination of gridded daily observation-based data (1951-2013) built on the E-OBS and CRU TS datasets, and a collection of climate projections (2014-2100). The future climate is represented by bias-corrected meteorological data from 10 regional climate models (RCMs), driven by the A1B emission scenario. These latter data were developed within the frame of the ENSEMBLES FP6 project. Although FORESEE only covers a limited area of Central and Eastern Europe, the methodology of database development, the applied bias correction techniques, and the data dissemination method, can serve as a blueprint for similar initiatives.

Thyroid antigen associated immune complex glomerulonephritis in Graves' disease.

A 60 year old hyperthyroid black woman with long-standing Graves' disease treated with methimazole presented with anasarca and congestive heart failure. She was found to have the nephrotic syndrome with a urinary protein excretion of 32 g/day. Light and electron microscopy revealed a stage II membranous glomerulopathy. Direct and indirect immunofluorescence demonstrated immunoglobulin G (IgG), immunoglobulin M (IgM), third component of complement and thyroglobulin in a granular diffuse pattern consistent with an immune complex glomerulonephritis. Total thyroidectomy led to a decrease in proteinuria with little change in glomerular filtration rate during an 11 month follow-up period. We believe this to be the first report of immune complex glomerulonephritis associated with thyroid antigen in Graves' disease.

[Cystic changes in the femoral neck following decompression (author's transl)]. / Zystenartige strukturelle Abweichungen des Femurhalses infolge Dekompression.

Routine radiographs on Caisson workers have shown a rare form of osteopathy in the femoral neck due to decompression and which is not associated with symptoms. The changes appear on the radiograph as a cystic area with a sclerotic surround.

[Arthrosis of the distal radio-ulnar joint in workers using motorised saws (author's transl)]. / Arthrose des distalen radioulnaren Gelenkes bei Motorsägenbetreibern.

Vibration-induced changes in the distal radio-ulnar joint were analysed by comparing workers using motorised saws (978 cases) and a control group. The following are the essential findings: 1. Exposure to vibration causes characteristic changes in the distal radio-ulnar joint, particularly on the left, consisting of osteophytosis, deformity and cystic rarefaction. 2. The frequency of the arthrosis is related in a statistically significant manner to a) length of exposure, b) age. 3. The subjective complaints of numbness, weakness and pain can, to some extent, be related to the radio-ulnar arthrosis. 4. Vibration is not the only factor in the genesis of the degenerative process of the distal radio-ulnar joint; ordinary use and stress can cause similar changes, although to a much less marked extent. The aetiological role of local vibration as a factor in causing the arthrosis has been confirmed.

[High kv films of the lungs with slight dorsal flexion for lesions in the upper lobes (author's transl)]. / Hartstrahlaufnahme der Lungen in leichter Dorsalflektion des Patienten bei Veränderungen in den Oberlappen.

A high kv technique--145 kv--and dorsal flexion in the a.p. projection has proved advantageous for the demonstration of the lung apices and subclavicular regions. If suitable apparatus is available, the routine use of this method is recommended, particularly for institutes which deal with a high number of pulmonary problems.

Hungarian multicentre epidemiologic study of the warning and initial symptoms (prodrome, aura) of epileptic seizures.

We carried out a Hungarian multicentre study to assess the frequency of the occurrence of warning symptoms preceding epileptic seizure. The data of 562 patients with epilepsy out of a total of 1124 were analysed on the basis of questionnaires filled in under standard conditions. About 50% of the patients experienced warning symptoms before a smaller or greater part of their seizures. Their appearance was fairly consistent and became mainly manifested in the form of headache, epigastric sensation and dysphoria. In relation to epileptological basic data, it was found that warning symptoms appeared primarily in focal epilepsies and among them they mainly preceded generalized tonic clonic and complex partial seizures. Between the warning symptom and the onset of the seizure there was usually a longer interval during which (and generally also during the warning symptom) the patient remained able to act. About 20% of the patients enrolled in the study tried to inhibit the onset or mitigate the course of the seizure and about 10% judged their spontaneous activity carried out in that direction to be successful. The frequency of the occurrence of independent prognostic symptoms not followed by a seizure was relatively low, and among epileptics with warning symptoms the incidence of seizures occurring without a preceding event was not high either. Based on our experiences, we have drawn the conclusion that, in a significant part of epileptic patients, the warning symptoms render possible the supplementation of the therapy by the development of seizure-inhibiting or seizure-avoiding behaviour or activity.

Degenerative deformations of the acromioclavicular joint in the elderly.

The authors performed radiological and locomotor examinations of the acromioclavicular joint in relatively high numbers of unselected elderly patients. Data are presented on the incidence, distribution by age, localization and clinical symptoms of arthrosis. Finally the gerontological importance of this particular region is stressed.

Alpha lipoic acid (ALA) protects proteins against the hydroxyl free radical-induced alterations: rationale for its geriatric topical application.

The well known OH* free radical scavenging properties of alpha-lipoic acid (ALA) cannot be easily utilized for biological experiments, because the compound is practically insoluble in water. We elaborated a simple method of preparing its Na-salt (Na-ALA) which proved to be water soluble. It has been demonstrated by ESR spin trapping experiments with DMPO, using the Fenton reaction as the source of OH* free radicals that Na-ALA maintains its OH* free radical scavenging ability: it reacts nearly an order of magnitude faster with these radicals than the spin trap itself. It was tested in two different systems to determine whether Na-ALA was able to protect bovine serum albumin (BSA) against the OH* free radical-induced polymerization and protein oxidation. (i) OH* free radicals were generated by Fenton reaction in the presence of BSA. This protein is polymerized by these radicals shown by the loss of its water solubility; Na-ALA exerted a considerable protective effect against this type of protein damage. (ii) BSA oxidation was induced by Co-gamma irradiation of 80 krad, resulting in a strong increase in the protein carbonyl content. Na-ALA inhibited this carbonyl formation very efficiently. The data suggest that the interaction of the OH radical with Na-ALA takes place on the disulfide group, yielding thiosulfinate or thiosulfonate. The results indicate that the geriatric topical application of Na-ALA may have an established rationale.

Choline levels in human peritoneal dialysate.

The average free choline level was determined to be 14 mumol/L in peritoneal dialysates and 22 mumol/L in the plasma of 30 patients on continuous ambulatory peritoneal dialysis (CAPD). Daily choline loss via dialysate averaged 129 mumol with 32 mumol choline lost per dwell. Daily choline loss via the dialysate was positively correlated with plasma choline concentrations. Choline levels in dialysate during CAPD exceed plasma levels of choline 9 mumol/L in healthy individuals.

Choline levels in human peritoneal dialysate.

The average free choline level was determined to be 14 M in peritoneal dialysates and 22 M in plasma of thirty patients on continuous ambulatory peritoneal dialysis (CAPD). Daily choline loss via dialysate averaged 129 moles with 32 moles choline lost per dwell. Daily choline loss via the dialysate was positively correlated with plasma choline concentrations. Choline levels in dialysate during CAPD exceed plasma levels of choline (9 M) in healthy individuals.

Detecting deception: the promise and the reality of voice stress analysis.

Within the past decade a number of so-called voice stress analyzers have been marketed for law enforcement and forensic science purposes. These devices are said to extract from the vocal spectrum a subaudible microtremor signal that is useful in detecting stress in a speaker's voice; thus, it is claimed these devices have great utility as lie detectors and are as accurate as the traditional polygraph instrument. A review of the evidence now accumulated about these devices shows that the evidence for the existence of a microtremor in the voice is problematic and that the capability of these devices in detecting stress is equally questionable. Without exception, however, the scientific evidence reported to date shows that voice stress analyzers are not effective in detecting deception; none of these devices has yet been shown to yield detection rates above chance levels in controlled situations. A brief comparison of voice stress analysis and polygraphic testing as methods of lie detection is made.

A content analysis of textbooks on criminal investigation: an evaluative comparison to empirical research findings on the investigative process and the role of forensic evidence.

A content analysis of textbooks on criminal investigation was carried out to determine the degree to which their coverage corresponded to empirical findings on the investigative process and the role of forensic evidence. The results showed that the texts overemphasize forensic evidence relative to its actual use. They underemphasize the role of patrol officers, detective post-arrest activities and the importance of interpersonal communication in investigations. Moreover, the texts are virtually silent on a number of key points such as detective evidence collection activities and how detectives use and give meaning to physical evidence. An analysis of material in newer texts, those available after research findings became widely known, showed little changed in emphasis from older volumes. The findings are discussed in relation to training needs for those in the justice system who collect, use and make practical and policy decisions about forensic evidence and investigative outcomes.

Differentiation of truthful and deceptive criminal suspects in Behavior Analysis Interviews.

The Behavior Analysis Interview (BAI) is a commonly used procedure designed to assist investigators in distinguishing between suspects who are concealing their involvement in a criminal event (deceptive) from those who are not (truthful). During a BAI a protocol of questions is asked and suspects' verbal responses and accompanying nonverbal behaviors and attitudinal characteristics are assessed. Based on this assessment the likelihood of involvement in the criminal event is determined. The purpose of this study was to determine the effectiveness with which trained evaluators were able to distinguish between truthful and deceptive suspects undergoing BAIs. Sixty videotaped interviews, 30 of truthful and 30 of deceptive suspects, were observed by four evaluators, each of whom independently scored suspect's behaviors and attitudes and judged the suspect's truthfulness. The results showed that, excluding inconclusive decisions, evaluators' average accuracy on truthful suspects was 91% and on deceptive suspects, 80%. Suspects' status did not affect confidence of evaluators' decisions but confidence was greater when correct as opposed to incorrect calls were made. Deceptive suspects manifested "theoretically" predicted behaviors and attitudes of "deceptiveness" to a significantly greater degree than did truthful suspects. The BAI appears to be useful for investigative purposes in order to differentiate between suspects who are concealing involvement in a criminal offense from those who are not.

[The treatment of benign lesions of the liver. Indications and surgical approach]. / Il trattamento delle formazioni benigne del fegato. Indicazioni e strategia chirurgica.

Benign formations in the liver constitute a heterogeneous group of pathology lesions that are rarely found clinically. In the period between January 1985 and June 1992, 81 patients, affected by benign formations of the liver, were observed at the Institute of the III Surgical Clinic of Rome "La Sapienza". Most of these lesions are asymptomatic and their diagnosis is mostly casual. Among these we found 48 cases of echinococcus cystis, 13 cases of congenital cystic formations, 2 amoebiasis cases, and 1 case the ecografic exam, which shows an hepatic formation to the fifth segment, was not in conformity with the cytologic exam which proved negative because of cellular abnormalities of any nature, therefore it's constituted by normal parenchyma. Consequently the patient was discharged. We operated on 65 patients. The complications found in the patient operated on were not important and we had the death of only 1 patient affected by hepatic abscess on the 3rd day after surgery because of septicemia and cardio-circulatory problems. The follow-up made after a certain time has resulted negative because of relapses if we exclude 1 case of echinococcus cystis wherein we found a serological relapsing. In our experience and according to most of the authors, the operation must take place always in cases such as: adenoma, cystoadenoma, hemangiomas having a diameter higher than 3 cm, echinococcus cysts, syntomatic formations and when we have complications. For all other cases we must limit ourselves to observation over a certain period both the dimensions and morphological modification of the lesions.

[Preoperative diagnosis of thyroid nodule. Ultrasonography-guided fine-needle aspiration]. / In tema di diagnosi di natura preoperatoria del nodulo tiroideo. L'FNA ecoguidata.

Nodular thyroid pathology weighs heavily for 4-5% of the general population, being the most common among the endocrinopathies. Because of this these diagnostic methods have gained more and more importance as FNA able to select already in the pre-operation phase the malignant nodules from the benign ones and to decide on the most suitable surgical intervention. In the period of time between January 1989 and June 1992 in the Institute of the III Surgical Clinic in Rome there have been performed 403 FNA. From the whole total we have extrapolated 221 patients. In this study we stressed how the FNA method has a sensibility of 80%, a specificity of 93% and afterwards an accurate diagnosis of 92%. Besides we have verified that sonography and radionuclide scanning have a truth worthiness respectively of 64% and 52%. The FNA in our opinion allows us to have in the pre-operation phase a much more accurate diagnosis as regards that obtained with only sonography and radionuclide scanning therefore the latter methods must be considered complementary to FNA.

[Autotransfusion in general surgery]. / L'autotrasfusione in chirurgia generale.

Self-transfusion represents a clinical method used for the restoration of haematic losses that, in recent years has been employed more and more widely in the surgical ambit. The utilisation of this method has become increasingly frequent because of the high diffusion of haemotransmitted diseases, and of the incidences, not negligible, of complications relative to the transfusions of homologous blood. The techniques that are currently used are: self-donation with predeposit; inter-surgery recovery; hemodilution normal blood volume. From 1989 until now 260 patients have been performed, in the Institute of III Surgical Clinic of University of Rome, to self-transfusional method with predeposit and intersurgery recovery. In practice this technique did not present any complications.

Rights and responsibilities in the accreditation process.

This article is the text of a presentation for the plenary session of the October 1981 meeting of the Committee on Allied Health Education and Accreditation (CAHEA) and its panel of consultants and special advisors. The legal, philosophical, and practical aspects of rights and responsibilities in the accreditation process are examined from the institutions' perspective. Excerpts from the various CAHEA review committee's Essentials and Guidelines are cited as examples of how accrediting agencies unwittingly infringe on institutional prerogatives. The article suggests the need for institutions, allied health professions, and accrediting agencies to collaborate and to establish more realistic accreditation standards.

[Report on surgical strategy in reoperation of esophageal achalasia]. / Cenni di strategia operatoria nei reinterventi per acalasia esofagea.

Surgical therapy for achalasia of the esophagus gives good results in only 80-90% of cases. Several reasons could be responsible for this 10-20% failure; the most frequent causes are inadequate cardiomyotomy and reflux esophagitis. We report our experience and our procedure in the management of recurrent achalasia. The most important controversies are also discussed.