Heterogeneous dermatitis complaints after change in drinking water treatment: a case report

BACKGROUND: The disinfectant monochloramine minimizes the formation of potentially hazardous and regulated byproducts, and many drinking water utilities are shifting to its use. CASE PRESENTATION: After a drinking water utility serving 2.4 million people switched to monochloramine for residual disinfection, a small number of residents complained of dermatitis reactions. We interviewed 17 people about their symptoms. Skin appearance, symptoms, and exposures were heterogeneous. Five respondents had history of hives or rash that preceded the switch to monochloramine. CONCLUSION: The complaints described were heterogeneous, and many of the respondents had underlying or preexisting conditions that would offer plausible alternative explanations for their symptoms. We did not recommend further study of these complaints

A Fibreoptic Endoscopic Study of Upper Gastrointestinal Bleeding at Bugando Medical Centre in Northwestern Tanzania: a Retrospective Review of 240 Cases.

Upper gastrointestinal (GI) bleeding is recognized as a common and potentially life-threatening abdominal emergency that needs a prompt assessment and aggressive emergency treatment. A retrospective study was undertaken at Bugando Medical Centre in northwestern Tanzania between March 2010 and September 2011 to describe our own experiences with fibreoptic upper GI endoscopy in the management of patients with upper gastrointestinal bleeding in our setting and compare our results with those from other centers in the world. A total of 240 patients representing 18.7% of all patients (i.e. 1292) who had fibreoptic upper GI endoscopy during the study period were studied. Males outnumbered female by a ratio of 2.1:1. Their median age was 37 years and most of patients (60.0%) were aged 40 years and below. The vast majority of the patients (80.4%) presented with haematemesis alone followed by malaena alone in 9.2% of cases. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking prior to the onset of bleeding was recorded in 7.9%, 51.7% and 38.3% of cases respectively. Previous history of peptic ulcer disease was reported in 22(9.2%) patients. Nine (3.8%) patients were HIV positive. The source of bleeding was accurately identified in 97.7% of patients. Diagnostic accuracy was greater within the first 24 h of the bleeding onset, and in the presence of haematemesis. Oesophageal varices were the most frequent cause of upper GI bleeding (51.3%) followed by peptic ulcers in 25.0% of cases. The majority of patients (60.8%) were treated conservatively. Endoscopic and surgical treatments were performed in 30.8% and 5.8% of cases respectively. 140 (58.3%) patients received blood transfusion. The median length of hospitalization was 8 days and it was significantly longer in patients who underwent surgical treatment and those with higher Rockall scores (P < 0.001). Rebleeding was reported in 3.3% of the patients. The overall mortality rate of 11.7% was significantly higher in patients with variceal bleeding, shock, hepatic decompensation, HIV infection, comorbidities, malignancy, age > 60 years and in patients with higher Rockall scores and those who underwent surgery (P < 0.001). Oesophageal varices are the commonest cause of upper gastrointestinal bleeding in our environment and it is associated with high morbidity and mortality. The diagnostic accuracy of fibreoptic endoscopy was related to the time interval between the onset of bleeding and endoscopy. Therefore, it is recommended that early endoscopy should be performed within 24 h of the onset of bleeding

Reproduction in Heteroteuthis dispar (Rüppell, 1844) (Mollusca: Cephalopoda): a sepiolid reproductive adaptation to an oceanic lifestyle

Small cephalopods of the genus Heteroteuthis are the most pelagic members in the family Sepiolidae. This study examines the reproductive biology of Heteroteuthis dispar (Rüppell, 1844), the first such study on any member of the genus, based on 46 specimens (27 females and 19 males) collected during the Mar-Eco cruise in the North Atlantic in the region of the Mid-Atlantic Ridge in 2004, and compares it with reproductive features in the less pelagic members of the family. The unusually large spermatophores of the males have a very small ejaculatory apparatus and cement body, relative to the size of the sperm mass. Females first mate when they are still maturing: a large sperm mass (up to 3.4% of the female body mass), consisting of one to several spermatangia, was found in an internal seminal receptacle of the majority of the females examined regardless of their maturity state. The seminal receptacle has a unique form and position in this species. The receptacle is a thin-walled sac at the posterior end of the visceral mass that is an outpocketing of, and opens into, the visceropericardial coelom. Spermatangia and sperm from the spermatangia apparently enter into the visceropericardial coelom (which is mostly occupied by the ovary) from the seminal receptacle indicating that ova are fertilised internally, a strategy unknown for decapodiform cephalopods (squid and cuttlefish), but present in most octopods. Fecundity of Heteroteuthis dispar (1,100–1,300 oocytes) is much higher than in other sepiolids whereas the egg size (mean max. length ∼1.6 mm) is the smallest within the family. Spawning is continuous (sensu Rocha et al. in Biol Rev 76:291–304, 2001). These and other reproductive traits are discussed as being adaptations to an oceanic lifestyle

Identification of a delta5-like fatty acyl desaturase from the cephalopod Octopus vulgaris (Cuvier 1797) involved in the biosynthesis of essential fatty acids

Long-chain polyunsaturated fatty acids (LC-PUFA) have been identified as essential compounds for common octopus (Octopus vulgaris), but precise dietary requirements have not been determined due in part to the inherent difficulties of performing feeding trials on paralarvae. Our objective is to establish the essential fatty acid (EFA) requirements for paralarval stages of the common octopus through characterisation of the enzymes of endogenous LC-PUFA biosynthetic pathways. In this study we isolated a cDNA with high homology to fatty acyl desaturases (Fad). Functional characterisation in recombinant yeast showed the octopus Fad exhibited ∆5 desaturation activity towards saturated and polyunsaturated fatty acyl substrates. Thus, it efficiently converted the yeast&rsquo;s endogenous 16:0 and 18:0 to 16:1n-11 and 18:1n-13, respectively, and desaturated exogenously added PUFA substrates, 20:4n-3 and 20:3n-6, to 20:5n-3 (EPA) and 20:4n-6 (ARA), respectively. Although the ∆5 Fad enables common octopus to produce EPA and ARA, the low availability of its adequate substrates 20:4n-3 and 20:3n-6, either in the diet or by limited endogenous synthesis from C18 PUFA, might indicate that EPA and ARA are indeed EFA for this species. Interestingly, the octopus ∆5 Fad can also participate in the biosynthesis of non-methylene interrupted FA, PUFA that are generally uncommon in vertebrates but that have been found previously in marine invertebrates including molluscs, and now also confirmed to be present in specific tissues of common octopus

Genotoxic Effects in Swimmers Exposed to Disinfection By-products in Indoor Swimming Pools

37 páginas, 1 figura, 4 tablas.-- PDF con material suplementario.[BACKGROUND]: Exposure to disinfection by-products (DBPs) in drinking water has been associated with cancer risk. A recent study found an increased bladder cancer risk among subjects attending swimming pools relative to those not attending.[OBJECTIVES]: To evaluate whether swimming in pools is associated with biomarkers of genotoxicity.[METHODS]: We collected blood, urine, and exhaled air samples from 49 non-smoking adult volunteers before and after they swam for 40 min in an indoor chlorinated pool. We estimated associations between the concentrations of four trihalomethanes in exhaled breath and changes in the following biomarkers: micronuclei and DNA damage (comet assay) in peripheral blood lymphocytes before and 1 h after swimming, urine mutagenicity (Ames assay) before and 2 h after swimming, and micronuclei in exfoliated urothelial cells before and 2 weeks after swimming. We also estimated associations and interactions with polymorphisms in genes related to DNA repair or DBP metabolism.[RESULTS]: After swimming, the total concentration of the four trihalomethanes in exhaled breath was seven times higher than before swimming. The change in the frequency of micronucleated lymphocytes after swimming increased in association with exhaled concentrations of the brominated trihalomethanes (p = 0.03 for CHCl2Br, p = 0.05 for CHClBr2, p = 0.01 for CHBr3) but not chloroform. Swimming was not associated with DNA damage detectable by the comet assay. Urine mutagenicity increased significantly after swimming in association with the concentration of exhaled CHBr3 (p = 0.004). No significant associations with changes in micronucleated urothelial cells were observed.[CONCLUSIONS]: Our findings support potential genotoxic effects of exposure to DBPs from swimming pools. The positive health effects gained by swimming could be increased by reducing the potential health risks of pool water.Research supported by Plan Nacional Grant SAF2005-07643-C03-01/02/03, Spain and FIS CP06/00341, Spain. CM Villanueva supported by the ISCIII (CP06/00341), Spain, L Font-Ribera by a predoctoral fellowship (FI06/00651), Spain, and D Liviac by a postgraduate fellowship UAB (PIF409-009), Barcelona.Peer reviewe

Cerebellar Integrity in the Amyotrophic Lateral Sclerosis - Frontotemporal Dementia Continuum

Amyotrophic lateral sclerosis (ALS) and behavioural variant frontotemporal dementia (bvFTD) are multisystem neurodegenerative disorders that manifest overlapping cognitive, neuropsychiatric and motor features. The cerebellum has long been known to be crucial for intact motor function although emerging evidence over the past decade has attributed cognitive and neuropsychiatric processes to this structure. The current study set out i) to establish the integrity of cerebellar subregions in the amyotrophic lateral sclerosis-behavioural variant frontotemporal dementia spectrum (ALS-bvFTD) and ii) determine whether specific cerebellar atrophy regions are associated with cognitive, neuropsychiatric and motor symptoms in the patients. Seventy-eight patients diagnosed with ALS, ALS-bvFTD, behavioural variant frontotemporal dementia (bvFTD), most without C9ORF72 gene abnormalities, and healthy controls were investigated. Participants underwent cognitive, neuropsychiatric and functional evaluation as well as structural imaging using voxel-based morphometry (VBM) to examine the grey matter subregions of the cerebellar lobules, vermis and crus. VBM analyses revealed: i) significant grey matter atrophy in the cerebellum across the whole ALS-bvFTD continuum; ii) atrophy predominantly of the superior cerebellum and crus in bvFTD patients, atrophy of the inferior cerebellum and vermis in ALS patients, while ALS-bvFTD patients had both patterns of atrophy. Post-hoc covariance analyses revealed that cognitive and neuropsychiatric symptoms were particularly associated with atrophy of the crus and superior lobule, while motor symptoms were more associated with atrophy of the inferior lobules. Taken together, these findings indicate an important role of the cerebellum in the ALS-bvFTD disease spectrum, with all three clinical phenotypes demonstrating specific patterns of subregional atrophy that associated with different symptomology

The assessment of population exposure to chlorination by-products: a study on the influence of the water distribution system

<p>Abstract</p> <p>Background</p> <p>The relationship between chlorination by-products (CBPs) in drinking water and human health outcomes has been investigated in many epidemiological studies. In these studies, population exposure assessment to CBPs in drinking water is generally based on available CBP data (e.g., from regulatory monitoring, sampling campaigns specific to study area). Since trihalomethanes (THMs) and haloacetic acids (HAAs) are the most documented CBP classes in drinking water, they are generally used as indicators of CBP exposure.</p> <p>Methods</p> <p>In this paper, different approaches to spatially assign available THM and HAA concentrations in drinking water for population exposure assessment purposes are investigated. Six approaches integrating different considerations for spatial variability of CBP occurrence within different distribution systems are compared. For this purpose, a robust CBP database (i.e., high number of sampling locations selected according to system characteristics) corresponding to nine distribution systems was generated.</p> <p>Results and conclusion</p> <p>The results demonstrate the high impact of the structure of the distribution system (e.g., presence of intermediary water infrastructures such as re-chlorination stations or reservoirs) and the spatial variability of CBPs in the assigned levels for exposure assessment. Recommendations for improving the exposure assessment to CBPs in epidemiological studies using available CBP data from water utilities are also presented.</p

Freezing of Enkephalinergic Functions by Multiple Noxious Foci: A Source of Pain Sensitization?

BACKGROUND:The functional significance of proenkephalin systems in processing pain remains an open question and indeed is puzzling. For example, a noxious mechanical stimulus does not alter the release of Met-enkephalin-like material (MELM) from segments of the spinal cord related to the stimulated area of the body, but does increase its release from other segments. METHODOLOGY/PRINCIPAL FINDINGS:Here we show that, in the rat, a noxious mechanical stimulus applied to either the right or the left hind paw elicits a marked increase of MELM release during perifusion of either the whole spinal cord or the cervico-trigeminal area. However, these stimulatory effects were not additive and indeed, disappeared completely when the right and left paws were stimulated simultaneously. CONCLUSION/SIGNIFICANCE:We have concluded that in addition to the concept of a diffuse control of the transmission of nociceptive signals through the dorsal horn, there is a diffuse control of the modulation of this transmission. The "freezing" of Met-enkephalinergic functions represents a potential source of central sensitization in the spinal cord, notably in clinical situations involving multiple painful foci, e.g. cancer with metastases, poly-traumatism or rheumatoid arthritis