Severe Lactic Acidosis in a Patient with B-Cell Lymphoma: A Case Report and Review of the Literature

Lactic acidosis is commonly observed in clinical situations such as shock and sepsis, as a result of tissue hypoperfusion and hypoxia. Lymphoma and leukemia are among other clinical situations where lactic acidosis has been reported. We present a case of a 59-year-old female with lactic acidosis who was found to have aggressive B-cell lymphoma. There have been 29 cases of lymphoma induced lactic acidosis reported thus far; however all reported cases have abnormal vital signs or concomitant medical conditions that may lead to lactic acidosis. The pathogenesis of malignancy-induced lactic acidosis is not well understood; however associated factors include increased glycolysis, increased lactate production by cancer cells, and decreased hepatic clearance of lactate. When it occurs, lactic acidosis is a poor prognostic sign in these patients. Prompt diagnosis and treatment of underlying lymphoma or leukemia remains the only way to achieve complete resolution of lactic acidosis in these patients

Evidence for operative treatment of talar osteochondral lesions: a systematic review.

Purpose Operative treatment of talar osteochondral lesions is challenging with various treatment options. The aims were (i) to compare patient populations between the different treatment options in terms of demographic data and lesion size and (ii) to correlate the outcome with demographic parameters and preoperative scores. Methods A systemic review was conducted according to the PRISMA guidelines. The electronic databases Pubmed (MEDLINE) and Embase were screened for reports with the following inclusion criteria: minimum 2-year follow-up after operative treatment of a talar osteochondral lesion in at least ten adult patients and published between 2000 and 2020. Results Forty-five papers were included. Small lesions were treated using BMS, while large lesions with ACI. There was no difference in age between the treatment groups. There was a correlation between preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score and change in AOFAS score (R = -0.849, P < 0.001) as well as AOFAS score at follow-up (R = 0.421, P = 0.008). Preoperative size of the cartilage lesion correlates with preoperative AOFAS scores (R= -0.634, P = 0.001) and with change in AOFAS score (R = 0.656, P < 0.001) but not with AOFAS score at follow-up. Due to the heterogeneity of the studies, a comparison of the outcome between the different operative techniques was not possible. Conclusion Patient groups with bigger lesions and inferior preoperative scores did improve the most after surgery. Level of evidence IV

Cationic surfactants for demulsification of produced water from alkaline-surfactant-polymer flooding

In this research, demulsification of produced water (which is an oil-in-water emulsion) from alkaline–surfactant–polymer flooding, containing sodium alkyl sulfate, was evaluated using five different surfactants from the classes of nonionic, amphoteric, and cationic. It was observed that only single-tail cationic surfactants, namely, dodecyltriemthylammonium chloride (DTAC) and alkyltrimethylammonium bromide (ATAB), with a concentration of 1000 ppm, were capable of attaining transparent separated water phases following 3 h separation at room temperature with relative separation efficiencies, determined using fluorescence spectroscopy, of 89.4 and 59%, respectively. However, the cationic surfactant dimethyldioctadecylammonium chloride (DDOAC) could achieve a relative separation efficiency of only 28.4% after 13 days, in contrast to nonionic and amphoteric surfactants that did not reveal any progress in demulsification. Similarly, given the demulsifier concentration of 1000 ppm, only DTAC and ATAB reduced the negative surface charge of oil droplets in the produced water after 3 h separation, and large droplets were formed owing to their coalescence after the addition of the respective demulsifiers as viewed by optical microscopy. The dominant emulsification mechanism is believed to be electrostatic stabilization. Consequently, the proposed demulsification mechanism is the formation/adsorption of cationic–anionic pairs at the oil–water interface. When comparing the demulsification performances of various demulsifying surfactants, although high interfacial activity (low interfacial tension (IFT)) is an essential feature for a demulsifier to be considered effective, it was concluded that lower equilibrium IFT does not necessarily result in superior separation efficiency, and other parameters such as type, tail branch number (i.e., single-tail or double-tail), and purity of surfactant may have profound effects on both separation efficiency and demulsification speed of the emulsion. From the dynamic IFT data, it was realized that DTAC and ATAB caused faster demulsification than DDOAC. The undesirable demulsification performance of DDOAC might have been due to its double-tail structure, which confined its interfacial adsorption. The operational variables, including salinity, pH, and temperature, in the demulsification process by DTAC were optimized with respect to the changes of IFT, and the optimum values were found to be 2 wt %, 7.0, and 35 °C, respectively

A biosensor for the determination of high density lipoprotein cholesterol employing combined surfactant-derived selectivity and sensitivity enhancements

High density lipoprotein cholesterol (HDL-C) is a modifiable risk factor in cardiovascular disease and devices suitable for its determination at the point of care are critical to the future management of hypercholesterolaemia. An electrochemical biosensor for measuring HDL-C was developed. The biosensor was based on a homogeneous assay methodology for selective determination of HDL-C in combination with a printed electrochemical sensor for measuring the reduction of hydrogen peroxide at a silver paste electrode. The polyoxyethylene alkylene tribenzylphenyl ether surfactant (Emulgen B-66) was found to be capable of both the selective dissolution of HDL particles, as well as the enhanced electrocatalytic reduction of hydrogen peroxide. The resulting biosensor was shown to have a linear response to HDL-C from 0.5 to 4 mM (r2=0.998) with an average r.s.d. of 7%. The biosensor was also used to analyse HDL-C in thirteen serum samples and had good agreement with a commercial spectrophotometric precipitation-based assay (r=0.7222; p < 0.058)

The Major Surface-Associated Saccharides of Klebsiella pneumoniae Contribute to Host Cell Association

Analysing the pathogenic mechanisms of a bacterium requires an understanding of the composition of the bacterial cell surface. The bacterial surface provides the first barrier against innate immune mechanisms as well as mediating attachment to cells/surfaces to resist clearance. We utilised a series of Klebsiella pneumoniae mutants in which the two major polysaccharide layers, capsule and lipopolysaccharide (LPS), were absent or truncated, to investigate the ability of these layers to protect against innate immune mechanisms and to associate with eukaryotic cells. The capsule alone was found to be essential for resistance to complement mediated killing while both capsule and LPS were involved in cell-association, albeit through different mechanisms. The capsule impeded cell-association while the LPS saccharides increased cell-association in a non-specific manner. The electrohydrodynamic characteristics of the strains suggested the differing interaction of each bacterial strain with eukaryotic cells could be partly explained by the charge density displayed by the outermost polysaccharide layer. This highlights the importance of considering not only specific adhesin:ligand interactions commonly studied in adherence assays but also the initial non-specific interactions governed largely by the electrostatic interaction forces

Funcionamiento hidrol&#243;gico de un humedal ribere&#241;o, el Masegar, en el conjunto de los humedales de La Mancha H&#250;meda de la cuenca alta del ri&#243; Cig&#252;ela

Fifteen years ago &#194;&#171;La Mancha H&#250;meda&#194;&#187; was deelared Biosphere Reserve by UNESCO, at the request of the Spanish Government. According to a recent deelaration by UNESCO in 1995, such title could be lost if the degradation processes of the wetlands of &#194;&#171;La Mancha H&#250;meda&#194;&#187; continue. &#194;&#171;La Mancha H&#250;meda&#194;&#187; was formed by a hundred of small lakes or wetlands that in area totalled about 200-300 km² and they were distributed over an area of about 25.000 km². These are different types of wetlands (saltwater and freshwater, permanent and ephimeral, riparian and closed basins, etc.). It is estimated that the actual surface of all the wetlands is about 20-30% of that occupied 20 or 30 years ago. The most famous degradation case is that of the &#194;&#171;Tablas de Daimiel National Park&#194;&#187; that has shrinked fram an area of about 15-20km² to less than 1 km²<p> This article presents the general situation of the riverine wetlands of the Cig&#252;ela river and the results of the hydrological functioning of a wetland of modest dimensions, less than 1 km², El Masegar. It is a riparian wetland located in the Cig&#252;ela River basin which has been severely affected by man actions. El Masegar can be considered as an artificial wetland. From an ecological point of view, this wetland seems to have been functioning in a proper way until 1988, when the so called &#194;&#171;Plan de Regeneraci&#243;n H&#237;drica del Parque Nacional de las Tablas de Daimiel&#194;&#187; began. This Plan has not regenerated the Natural Park but has degradated or destroyed the riparian wetlands that existed along the Cig&#252;ela River valley which is about ISO km long. The surface of these wetlands all together was larger than that of Tablas de Daimiel National Park. The study shows that it could be feasible to restore or maintain most of the riparian wetlands of the &#194;&#171;La Mancha H&#250;meda&#194;&#187; without a great economic investment and without social conflicts with the farmers.<br><br>En 1981, a petici&#243;n del Gobierno espa&#241;ol, la UNESCO declar&#243; Reserva de la Biosfera &#194;&#171;La Mancha H&#250;meda&#194;&#187;. En 1995 la UNESCO ha indicado que este t&#237;tulo puede ser retirado si contin&#250;a la degradaci&#243;n del conjunto de humedales que integran esa Reserva de la Biosfera. La &#194;&#171;Mancha H&#250;meda&#194;&#187; estaba formada por un centenar de peque&#241;as lagunas o humedales que totalizaban una superficie de unos 200-300 km² y se repart&#237;an en un &#225;rea de unos 20.000-25.000 km². Las lagunas tienen unas caracter&#237;sticas muy diversas (salinas y dulces, permanentes y ef&#237;meras, ribere&#241;as y endorreicas, etc.). Se estima que la superficie actual conjunta de esas lagunas apenas alcanzan el 20-30% de la que ocupaban hace 20 &#243; 30 a&#241;os. El caso de degradaci&#243;n m&#225;s conocido es el del Parque Nacional de las Tablas de Daimiel, que ha pasado de ocupar una extensi&#243;n de 15-20 km² a menos de 1 km².<p> En este trabajo se analiza la situaci&#243;n general de los humedales del r&#237;o Cig&#252;ela y se presentan los resultados del an&#225;lisis del funcionamiento de un humedal de modestas dimensiones, algo menor de 1 km², El Masegar. Se trata de un humedal ribere&#241;o ubicado en la cuenca del r&#237;o Cig&#252;ela que puede considerarse como un humedal artificial, creado por el hombre. Desde el punto de vista ecol&#243;gico, este humedal parece haber funcionado muy bien hasta que en 1988 comenz&#243; el denominado &#194;&#171;Plan de Regeneraci&#243;n H&#237;drica del Parque Nacional de las Tablas de Daimiel&#194;&#187;. Este plan no s&#243;lo no ha regenerado ese Parque, sino que ha degradado o destruido los humedales ribere&#241;os existentes a lo largo de unos 150 km del valle del r&#237;o Cig&#252;ela. La superficie conjunta de esos humedales era ampliamente superior a la superficie del PNTD. El estudio realizado indica que es posible restaurar o conservar gran parte de los humedales del r&#237;o Cig&#252;ela, sin un gasto econ&#243;mico excesivo y sin conflictos sociales con los agricultores