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Gout flares are an important concern for people with gout and an understanding of patients' experiences with gout flares is central in developing meaningful outcome measures for clinical trials. This study aimed to systematically review and thematically synthesize the qualitative literature reporting the patient experience of gout flares, to inform the development of flare-specific outcome measures. MEDLINE, EMBASE, CINAHL Plus and PsycINFO electronic databases were searched in October 2019 to identify original qualitative research articles reporting on the patient experience of gout flares. Methodological quality of all included papers was assessed using the Critical Appraisal Skills Program (CASP) tool. Following data extraction, coding and synthesis was undertaken using reflexive thematic analysis. Sixteen papers reporting the patient experience of gout flares were included. The majority of CASP criteria were met by most studies, indicating good methodological quality. Four predominant and overlapping themes were identified from the thematic analysis: gout flare characteristics (pain, swelling, location, duration and frequency); impact on function and activities of daily living (walking, housework and yard work, self-care, exercise and sports, driving, sleep); effects on social and family life (social participation, inability to plan, employment, dependency, relationships, intimacy); and psychological impact (boredom, irritability, fear, shame and embarrassment, isolation, financial worry, depression and anxiety). Gout flares impact many aspects of patients' lives, including physical and psychological and social and family life. The patient experience of gout flares goes beyond what is routinely measured in research settings. Measurement and reporting methods that capture these aspects of patients' experiences with gout flares would provide more meaningful outcome measures in clinical trials of flare prevention. [ABSTRACT FROM AUTHOR]

Drug abuse by nursing mothers is an ongoing concern because it may cause many adverse effects to the newborns. The development of analytical methods to analyze drugs of abuse in colostrum (first milk produced after birth) has a huge importance, because it enables the monitoring and the correct follow-up to users and newborns. A liquid chromatography mass spectrometry (LC–MS) method was developed and validated for the determination of cocaine and smoked cocaine (crack) biomarkers in colostrum. Cocaine (COC) and its major metabolite benzoylecgonine (BZE), the pyrolytic products anhydroecgonine methyl ester (AEME) and anhydroecgonine (AEC) were analyzed after a simple protein precipitation procedure using atropine (ATP) as internal standard (IS). Applying a chemometric approach study, all peaks were chromatographically separated at isocratic condition with a Kinetex HILIC column for polar compounds, at 30 °C in 12 min. One ion was detected for the quantification and three ions for confirmation of each analyte. The method was linear for all analytes in the concentration range of 5–300 ng/mL with correlation coefficients ( r ) between 0.9983 and 0.9996. The lower limit of quantification (LLOQ) was 5 ng/mL with acceptable validation parameters. Matrix effect was assessed by post-extraction addition approach and showed good results, demonstrating that protein precipitation cleaning procedure is fast, reliable and demand small quantities of organic solvent. The LC–MS method is fast and cheap compared to other equipments and was also successfully applied to assess real samples of colostrum from nursing mothers who were suspect of cocaine/crack abuse. [ABSTRACT FROM AUTHOR]

Mercury (Hg) in soils has increased by a factor of 3 to 10 in recent times mainly due to combustion of fossil fuels combined with long-range atmospheric transport processes. Other sources as chlor-alkali plants, gold mining and cement production can also be significant, at least locally. This paper summarizes the natural and anthropogenic sources that have contributed to the increase of Hg concentration in soil and reviews major remediation techniques and their applications to control soil Hg contamination. The focus is on soil washing, stabilisation/solidification, thermal treatment and biological techniques; but also the factors that influence Hg mobilisation in soil and therefore are crucial for evaluating and optimizing remediation techniques are discussed. Further research on bioremediation is encouraged and future study should focus on the implementation of different remediation techniques under field conditions. [ABSTRACT FROM AUTHOR]

The present study demonstrates that species-specific isotope tracing is an useful tool to precisely measure Hg accumulation and transformations capabilities of living organisms at concentrations naturally encountered in the environment. To that end, a phytoplanktonic green alga Chlamydomonas reinhardtii Dangeard (Chlamydomonadales, Chlorophyceae) was exposed to mixtures of 199-isotopically enriched inorganic mercury (199IHg) and of 201-isotopically enriched monomethylmercury (201CH3Hg) at a concentration range between less than 1 pM to 4 nM. Additionally, one exposure concentration of both mercury species was also studied separately to evaluate possible interactive effects. No difference in the intracellular contents was observed for algae exposed to 199IHg and 201CH3Hg alone or in their mixture, suggesting similar accumulation capacity for both species at the studied concentrations. Demethylation of 201CH3Hg was observed at the highest exposure concentrations, whereas no methylation was detected. [ABSTRACT FROM AUTHOR]

Abstract: We examined mercury (Hg) biogeochemistry and biomagnification in the Babeni Reservoir, a system strongly affected by the release of Hg from a chlor-alkali plant. Total mercury (THg) concentrations in river water reached 88 ng L−1 but decreased rapidly in the reservoir (to 9 ng L−1). In contrast, monomethylmercury (MMHg) concentrations increased from the upstream part of the reservoir to the central part (0.7 ng L−1), suggesting high methylation within the reservoir. Moreover, vertical water column profiles of THg and MMHg indicated that Hg methylation mainly occurred deep in the water column and at the sediment–water interface. The discharge of Hg from a chlor-alkali plant in Valcea region caused the highest MMHg concentrations ever found in non-piscivorous fish worldwide. MMHg concentrations and bioconcentration factors (BCF) of plankton and macrophytes revealed that the highest biomagnification of MMHg takes place in primary producers. [Copyright &y& Elsevier]

Elderly patients may represent an important group when considering new stroke treatments, particularly in developing countries. The aim of this study was to analyze the use of recombinant tissue plasminogen activator (rtPA) in elderly Brazilian patients with acute ischemic stroke. Clinical and neuroimaging parameters at admission, frequency of symptomatic intracranial hemorrhage, and outcome were compared between elderly (≥80 years) and nonelderly (<80 years) stroke patients treated with rtPA in the Porto Alegre Stroke Network. We evaluated 183 nonelderly patients (mean age, 63 ± 12 years) and 55 elderly patients (mean age, 84 ± 3 years). Female sex, hypertension, congestive heart failure, atrial fibrillation, and previous history of stroke or transient ischemic attack were more frequent in the elderly patients. Elderly patients also presented with higher mean systolic blood pressure (P = .03) and National Institutes of Health Stroke Scale (NIHSS) score (P < .0001), whereas the nonelderly patients had a higher serum glucose level (P = .03). The rate of symptomatic intracranial hemorrhage was 10.9% in the elderly patients and 6.6% in the nonelderly patients (P = .28), and a substantial proportion of the elderly patients achieved a favorable outcome (modified Rankin Scale score ≤1) at 90 days, although this proportion was lower than that in the nonelderly patients (42% vs 58%; P = .04). Pooer outcomes were generally seen in elderly patients with an anterior circulation stroke, a higher NIHSS score, hypoattenuation in ≥1/3 lf the middle cerebral artery territory, and an Alberta Stroke Program Early CT score of ≤7 on an initial computed tomography scan. Our results support the administration of intravenous rtPA in selected elderly stroke patients presenting early to the hospital in developing countries. [Copyright &y& Elsevier]

Abstract: Previous studies suggest that macrophytes might participate in bioaccumulation and biomagnification of toxic mercury (Hg) in aquatic environment. Hg bioaccumulation and uptake mechanisms in macrophytes need therefore to be studied. Amongst several macrophytes collected in an Hg contaminated reservoir in Romania, Elodea nuttallii showed a high organic and inorganic Hg accumulation and was then further studied in the laboratory. Tolerance and accumulation of Hg of this plant was also high in the microcosm. Basipetal transport of inorganic Hg was predominant, whereas acropetal transport of methyl-Hg was observed with apparently negligible methylation or demethylation in planta. Hg concentrations were higher in roots>leaves>stems and in top>middle>bottom of shoots. In shoots, more than 60% Hg was found intracellularly where it is believed to be highly available to predators. Accumulation in shoots was highly reduced by cold, death and by competition with Cu+. Hg in E. nuttallii shoots seems to mainly originate from the water column, but methyl-Hg could also be remobilized from the sediments and might drive in part its entry in the food web. At the cellular level, uptake of Hg into the cell sap of shoots seems linked to the metabolism and to copper transporters. The present work highlights an important breakthrough in our understanding of Hg accumulation and biomagnifications: the remobilization of methyl-Hg from sediments to aquatic plants and differences in uptake mechanisms of inorganic and methyl-Hg in a macrophyte. [Copyright &y& Elsevier]