Acute health effects after accidental exposure to styrene from drinking water in Spain.

OBJECTIVES: We studied subjective health symptoms in a population accidentally exposed to high styrene concentrations in drinking tap water. The contamination occurred during the reparation of a water tank. METHODS: Residents of 27 apartments in two buildings using the contaminated water were contacted. A questionnaire on subjective symptoms was administered to 84 out of 93 persons living in the apartments at the time of the accident. Styrene concentration was measured in samples of water collected two days after the accident. The means of exposure associated with appearance of symptoms were examined through case-control analyses. RESULTS: Styrene in water reached concentrations up to 900 microg/L. Symptoms were reported by 46 persons (attack rate 55 %). The most frequent symptoms were irritation of the throat (26%), nose (19%), eyes (18%) and the skin (14%). General gastrointestinal symptoms were observed with 11% reporting abdominal pain and 7% diarrhea. The factors most strongly associated with symptoms were drinking tap water (OR = 7.8, 95% CI 1.3-48), exposure to vapors from the basement (OR = 10.4, 2.3-47) and eating foods prepared with tap water (OR = 8.6, 1.9-40). All residents in the ground floor reported symptoms. CONCLUSIONS: This accidental contamination led to very high styrene concentrations in water and was related to a high prevalence of subjective symptoms of the eyes, respiratory tract and skin. Similar exposures have been described in workers but not in subjects exposed at their residence. Various gastrointestinal symptoms were also observed in this population probably due to a local irritative effect

The seasonality of tuberculosis, sunlight, vitamin D, and household crowding.

BACKGROUND: Unlike other respiratory infections, tuberculosis diagnoses increase in summer. We performed an ecological analysis of this paradoxical seasonality in a Peruvian shantytown over 4 years. METHODS: Tuberculosis symptom-onset and diagnosis dates were recorded for 852 patients. Their tuberculosis-exposed cohabitants were tested for tuberculosis infection with the tuberculin skin test (n = 1389) and QuantiFERON assay (n = 576) and vitamin D concentrations (n = 195) quantified from randomly selected cohabitants. Crowding was calculated for all tuberculosis-affected households and daily sunlight records obtained. RESULTS: Fifty-seven percent of vitamin D measurements revealed deficiency (<50 nmol/L). Risk of deficiency was increased 2.0-fold by female sex (P < .001) and 1.4-fold by winter (P < .05). During the weeks following peak crowding and trough sunlight, there was a midwinter peak in vitamin D deficiency (P < .02). Peak vitamin D deficiency was followed 6 weeks later by a late-winter peak in tuberculin skin test positivity and 12 weeks after that by an early-summer peak in QuantiFERON positivity (both P < .04). Twelve weeks after peak QuantiFERON positivity, there was a midsummer peak in tuberculosis symptom onset (P < .05) followed after 3 weeks by a late-summer peak in tuberculosis diagnoses (P < .001). CONCLUSIONS: The intervals from midwinter peak crowding and trough sunlight to sequential peaks in vitamin D deficiency, tuberculosis infection, symptom onset, and diagnosis may explain the enigmatic late-summer peak in tuberculosis

Leaf water δ18O reflects water vapour exchange and uptake by C3 and CAM epiphytic bromeliads in Panama

The distributions of CAM and C3 epiphytic bromeliads across an altitudinal gradient in western Panama were identified from carbon isotope (δ13C) signals, and epiphyte water balance was investigated via oxygen isotopes (δ18O) across wet and dry seasons. There were significant seasonal differences in leaf water (δ18Olw), precipitation, stored 'tank' water and water vapour. Values of δ18Olw were evaporatively enriched at low altitude in the dry season for the C3 epiphytes, associated with low relative humidity (RH) during the day. Crassulacean acid metabolism (CAM) δ18Olw values were relatively depleted, consistent with water vapour uptake during gas exchange under high RH at night. At high altitude, cloudforest locations, C3 δ18Olw also reflected water vapour uptake by day. A mesocosm experiment with Tillandsia fasciculata (CAM) and Werauhia sanguinolenta (C3) was combined with simulations using a non-steady-state oxygen isotope leaf water model. For both C3 and CAM bromeliads, δ18Olw became progressively depleted under saturating water vapour by day and night, although evaporative enrichment was restored in the C3 W. sanguinolenta under low humidity by day. Source water in the overlapping leaf base 'tank' was also modified by evaporative δ18O exchanges. The results demonstrate how stable isotopes in leaf water provide insights for atmospheric water vapour exchanges for both C3 and CAM systems

Case report: A novel case of parental mosaicism in SMC1A gene causes inherited Cornelia de Lange syndrome

Ultimate advances in genetic technologies have permitted the detection of transmitted cases of congenital diseases due to parental gonadosomatic mosaicism. Regarding Cornelia de Lange syndrome (CdLS), up to date, only a few cases are known to follow this inheritance pattern. However, the high prevalence of somatic mosaicism recently reported in this syndrome (∼13%), together with the disparity observed in tissue distribution of the causal variant, suggests that its prevalence in this disorder could be underestimated. Here, we report a new case of parental gonadosomatic mosaicism in SMC1A gene that causes inherited CdLS, in which the mother of the patient carries the causative variant in very low allele frequencies in buccal swab and blood. While the affected child presents with typical CdLS phenotype, his mother does not show any clinical manifestations. As regards SMC1A, the difficulty of clinical identification of carrier females has been already recognized, as well as the gender differences observed in CdLS expressivity when the causal variant is found in this gene. Currently, the use of DNA deep-sequencing techniques is highly recommended when it comes to molecular diagnosis of patients, as well as in co-segregation studies. These enable us to uncover gonadosomatic mosaic events in asymptomatic or oligosymptomatic parents that had been overlooked so far, which might have great implications regarding genetic counseling for recurrence risk

Patient profile and management of delirium in older adults hospitalized due to COVID-19

SARS-CoV-2 can cause neurologic symptoms, as well as respiratory ones. Older adults are at risk of developing acute delirium in older persons (ADOP). The combination of experiencing respiratory isolation due to COVID-19, as well as other associated risk factors for older adults, may have had an impact on ADOP and ADOP management in the acute hospital setting. This study aimed to analyze the characteristics of ADOP in patients admitted to a COVID-19 unit. An observational prospective study on a sample of 108 patients was carried out between November 2020 and May 2021. The following data were collected: sociodemographic characteristics, risk factors for ADOP, management of ADOP, and impact on ADOP on both functional and cognitive deteriora-tion. A 29.6% proportion of older adults admitted to an acute COVID-19 unit presented hyperactive ADOP, mainly during the night. Management of ADOP in our sample involved mainly pharmaco-logical treatment and had a serious impact on hospital stay and both functional and cognitive dete-rioration. Preventive strategies and being accompanied by a relative or a carer may be useful to manage ADOP during hospital admission due to COVID-19

How to Determine the Pion Cloud of the Constituent Quark

We calculate the differential cross section for semi-inclusive pion production in electron proton reactions using a model where the physical quark fluctuates with some probability to quark plus pion. The kinematic regions for a determination of this `pion cloud' are evaluated.Comment: 28 pages, including 10 figures; gzipped, uuencoded postscrip

High rate of autonomic neuropathy in Cornelia de Lange Syndrome

Background: Cornelia de Lange Syndrome (CdLS) is a rare congenital disorder characterized by typical facial features, growth failure, limb abnormalities, and gastroesophageal dysfunction that may be caused by mutations in several genes that disrupt gene regulation early in development. Symptoms in individuals with CdLS suggest that the peripheral nervous system (PNS) is involved, yet there is little direct evidence. Method: Somatic nervous system was evaluated by conventional motor and sensory nerve conduction studies and autonomic nervous system by heart rate variability, sympathetic skin response and sudomotor testing. CdLS Clinical Score and genetic studies were also obtained. Results: Sympathetic skin response and sudomotor test were pathological in 35% and 34% of the individuals with CdLS, respectively. Nevertheless, normal values in large fiber nerve function studies. Conclusions: Autonomic nervous system (ANS) dysfunction is found in many individuals with Cornelia de Lange Syndrome, and could be related to premature aging

P9 23. Seudoaneurisma aórtico con infeción de prótesis en aorta ascendente. ¿Es necesario retirar siempre la prótesis? ¿Cuánto tiempo con tratamiento antibiótico?

IntroducciónEl seudoaneurisma aórtico con infección de prótesis en aorta ascendente (PIPAA) tras cirugía cardíaca es una entidad infrecuente (0,9-2%) pero grave (mortalidad intrahospitalaria > 40%). El tratamiento más extendido es la cirugía con recambio protésico y terapia antibiótica adecuada a antibiograma; pero el recambio protésico en ocasiones es técnicamente inviable e incluso puede aumentar la mortalidad perioperatoria. Existen casos en los que se ha preservado la prótesis infectada con éxito terapéutico, realizándose limpieza/reparación quirúrgica local apoyada con omentoplastia. No existe consenso en la duración de la terapia médica, y el tratamiento «supresor a largo plazo» en ocasiones se complica por efectos adversos de los antibióticos.ObjetivosAportar dos nuevos casos y evaluar el tratamiento realizado tras un seguimiento a largo plazo.MétodoAnálisis descriptivo de aspectos microbiológicos, farmacológicos y resultados de la terapia realizada, en dos casos de PIPAA de pacientes intervenidos por disección de aorta (prótesis de dacrón en posición supracoronariana) y por insuficiencia y anuloectasia aórtica (tubo valvulado). Se realiza tratamiento quirúrgico conservador de la prótesis aórtica (limpieza quirúrgica, reparación del seudoaneurisma y omentoplastia), asociándose terapia antibiótica prolongada ajustada a antibiograma.ConclusiónAmbos casos presentan, tras más de 1 año de seguimiento, según criterios clínicos, microbiológicos y pruebas de imagen, ausencia de signos de recidiva infecciosa, resultando la terapia adecuada. Aun sin poder establecer tiempo óptimo de tratamiento, serían razonables 6 semanas de tratamiento endovenoso seguidas de 24 semanas de terapia supresora, a ser posible oral, y valorar su retirada siempre que no existan signos de recidiva

ABPgame+ o cómo hacer del último curso de ingeniería una primera experiencia profesional

Algunos de los aspectos clave en el desarrollo profesional de un ingeniero son su capacidad para trabajar en equipo, para integrar diferentes puntos de vista y para desarrollar grandes proyectos con un alto nivel de incertidumbre. Los planes de estudio de las titulaciones que preparan a estos futuros ingenieros no pueden permanecer ajenos a estas necesidades y deben plantear situaciones lo más cercanas posible a la realidad que se encontrarán nuestros egresados en su vida laboral. Estas razones, nos han llevado a plantear una experiencia innovadora en una titulación de nueva implantación como es el Grado en Ingeniería Multimedia. Hemos elegido, para ello, la metodología del Aprendizaje Basado en Proyectos (ABP), aplicada al itinerario de Creación y Entretenimiento Digital en cuarto curso, donde los estudiantes, agrupados en equipos, desarrollan un único gran proyecto durante el año, que es un videojuego. Queremos destacar dos consecuencias de esta experiencia: primero, el papel fundamental de la asignatura Proyectos Multimedia, sirviendo de apoyo al resto de asignaturas al llevar el peso de la gestión de los equipos y del seguimiento del proyecto. Y después, que los estudiantes pueden obtener un producto terminado al final del curso que les permita inaugurar su portafolio profesional