106 research outputs found

    Developmental effects and genotoxicity of ten water disinfection by-products in zebrafish

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    Disinfection by-products are contaminants produced during drinking water disinfection. Several DBPs have been implicated in a variety of toxic effects, mainly carcinogenic and genotoxic effects. Moreover, DBPs exposure has also been associated with an increased risk of developmental effects. In this study, the developmental toxicity and genotoxicity of 10 DBPs (4 trihalomethanes [THMs], 5 haloacetic acids [HAAs] and sodium bromate) in the zebrafish embryo model were evaluated. Embryos exposed for 72 hours were observed for different endpoints such as growth, hatching success, malformations and lethality. THMs exposure resulted in adverse developmental effects and a significant reduced tail length. Two HAAs, tribromoacetic acid and dichloroacetic acid, along with sodium bromate were found to cause a significant increase in malformation rate. Chloroform,chlorodibromomethane and sodium bromate produced a weak induction of DNA damage to whole embryos. However, developmental effects occurred at a range of concentrations (20 100 ÎŒg/mL)several orders of magnitude above the levels that can be attained in fetal blood in humans exposed to chlorinated water. In conclusion, the teratogenic and genotoxic activity observed by some DBPs in zebrafish reinforce the view that there is a weak capacity of disinfection products to cause developmental effects at environmentally relevant concentrations

    Compliance with Guidelines-Recommended Processes in Pneumonia: Impact of Health Status and Initial Signs

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    Initial care has been associated with improved survival of community-acquired pneumonia (CAP). We aimed to investigate patient comorbidities and health status measured by the Charlson index and clinical signs at diagnosis associated with adherence to recommended processes of care in CAP. We studied 3844 patients hospitalized with CAP. The evaluated recommendations were antibiotic adherence to Spanish guidelines, first antibiotic dose 65 (OR, 1.51) and COPD (OR, 1.80) were protective factors. The combination of antibiotic adherence and timing <6 hours was negatively associated with confusion (OR, 0.69) and a high Charlson score (OR, 0.92) adjusting for severity and hospital effect, whereas age was not an independent factor. Deficient health status and confusion, rather than age, are associated with lower compliance with antibiotic therapy recommendations and timing, thus identifying a subpopulation more prone to receiving lower quality care

    Cholangiocarcinoma in Magnetic Resonance Cholangiopancreatography and Fascioliasis in Endoscopic Ultrasonography

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    Fascioliasis is a worldwide zoonotic infection with Fasciola hepatica and Fasciola gigantica. The zoonoses are particularly endemic in sheep-raising countries and are also endemic in Iran. Typical symptoms that may be associated with fascioliasis can be divided by phases of the disease, including the acute or liver phase, the chronic or biliary phase, and ectopic or pharyngeal fascioliasis. Cholestatic symptoms may be absent, and in some cases diagnosis and treatment may be preceded by a long period of abdominal pain, eosinophilia and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 4 years, with imaging suggesting cholangiocarcinoma. Considering a new concept of endoscopic ultrasonography, at last F. hepatica was extracted with endoscopic retrograde cholangiography

    PrevenciĂł de la infecciĂł respiratĂČria

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    InfecciĂł respiratĂČria; PrevenciĂł; AtenciĂł sanitĂ riaInfecciĂłn respiratĂłria; PrevenciĂłn; AtenciĂłn sanitĂĄriaRespiratory infection; Prevention; Health careMonografia sobre temes concrets relacionats amb la prevenciĂł de la infecciĂł respiratĂČria relacionada amb l‟atenciĂł sanitĂ ria. Ha estat elaborada per un comitĂš d‟experts amb una Ă mplia trajectĂČria en el camp de l'atenciĂł a pacients amb problemes respiratoris. El document comença fent una posada al dia de l‟epidemiologia i l‟etiopatogĂšnia de les infeccions respiratĂČries nosocomials i, sense voler repetir capĂ­tols de la monografia d'aĂŻllaments, continua fent una pinzellada de les mesures que cal dur a terme per evitar la transmissiĂł de les infeccions respiratĂČries dins dels centres sanitaris. Tot seguit, s‟aborden de manera prĂ ctica situacions quotidianes, com el maneig de la via aĂšria, i es fan algunes recomanacions sobre com dur-les a terme. Una part important i poc coneguda per molts professionals Ă©s la prevenciĂł de la infecciĂł respiratĂČria de causa instrumental, motiu pel qual en el darrer capĂ­tol es fa una revisiĂł minuciosa de com procedir per reutilitzar aquests aparells.MonografĂ­a sobre temas concretos relacionados con la prevenciĂłn de la infecciĂłn respiratoria con la atenciĂłn sanitaria. Ha sido elaborada por un comitĂ© de expertos con una amplia trayectoria en el campo de la atenciĂłn a pacientes con problemas respiratorios. El documento empieza haciendo una puesta al dĂ­a de la epidemiologia y la etiopatogenia de las infecciones respiratorias nosocomiales y, sin querer repetir capĂ­tulos de la monografĂ­a de aislamientos, continua haciendo una pincelada de las medidas que son necesarias para evitar la transmisiĂłn de las infecciones respiratorias dentro de los centros sanitarios. Seguidamente se tratan de manera prĂĄctica situaciones cotidianas, como el manejo de la vĂ­a aĂ©rea y se hacen algunas recomendaciones sobre como llevarlas a cabo. Una parte importante y poco conocida para muchos profesionales es la prevenciĂłn de la infecciĂłn respiratoria de causa instrumental, motivo por el cual en el Ășltimo capĂ­tulo se hace una revisiĂłn minuciosa de como proceder para reutilizar estos aparatos

    Influence of genetic variability at the surfactant proteins A and D in community-acquired pneumonia : a prospective, observational, genetic study

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    Introduction: Genetic variability of the pulmonary surfactant proteins A and D may affect clearance of microorganisms and the extent of the inflammatory response. The genes of these collectins (SFTPA1, SFTPA2 and SFTPD) are located in a cluster at 10q21-24. The objective of this study was to evaluate the existence of linkage disequilibrium (LD) among these genes, and the association of variability at these genes with susceptibility and outcome of community-acquired pneumonia (CAP). We also studied the effect of genetic variability on SP-D serum levels. Methods: Seven non-synonymous polymorphisms of SFTPA1, SFTPA2 and SFTPD were analyzed. For susceptibility, 682 CAP patients and 769 controls were studied in a case-control study. Severity and outcome were evaluated in a prospective study. Haplotypes were inferred and LD was characterized. SP-D serum levels were measured in healthy controls. Results: The SFTPD aa11-C allele was significantly associated with lower SP-D serum levels, in a dose-dependent manner. We observed the existence of LD among the studied genes. Haplotypes SFTPA1 6A2 (P = 0.0009, odds ration (OR) = 0.78), SFTPA2 1A0 (P = 0.002, OR = 0.79), SFTPA1-SFTPA2 6A2-1A0 (P = 0.0005, OR = 0.77), and SFTPD-SFTPA1-SFTPA2 C-6A2-1A0 (P = 0.00001, OR = 0.62) were underrepresented in patients, whereas haplotypes SFTPA2 1A10 (P = 0.00007, OR = 6.58) and SFTPA1-SFTPA2 6A3-1A (P = 0.0007, OR = 3.92) were overrepresented. Similar results were observed in CAP due to pneumococcus, though no significant differences were now observed after Bonferroni corrections. 1A10 and 6A-1A were associated with higher 28-day and 90-day mortality, and with multi-organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) respectively. SFTPD aa11-C allele was associated with development of MODS and ARDS. Conclusions: Our study indicates that missense single nucleotide polymorphisms and haplotypes of SFTPA1, SFTPA2 and SFTPD are associated with susceptibility to CAP, and that several haplotypes also influence severity and outcome of CAP

    Global Boundary Stratotype Section and Point (GSSP) for the Anthropocene Series: Where and how to look for potential candidates

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