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Differences in cell wall components between two BNF-contrasting sugarcane genotypes might result from genetic variations particular to the genotype and from the efficiency in diazotrophic bacteria association. Sugarcane is a plant of the grass family (Poaceae) that is highly cultivated in Brazil, as an important energy resource. Commercial sugarcane genotypes may be successfully associated with beneficial endophytic nitrogen-fixing bacteria, which can influence several plant metabolic pathways, such as cell division and growth, synthesis of hormones, and defense compounds. In this study, we investigated how diazotrophic bacteria associated with sugarcane plants could be involved in the regulation of cell wall formation pathways. A molecular and structural characterization of the cell wall was compared between two genotypes of sugarcane with contrasting rates of Biological Nitrogen Fixation (BNF): SP70-1143 (high BNF) and Chunee (low BNF). Differentially expressed transcripts were identified in transcriptomes generated from SP70-1143 and Chunee. Expression profiles of cellulose and lignin genes, which were more expressed in SP70-1134, and callose genes, which were more expressed in Chunee, were validated by RT-qPCR and microscopic analysis of cell wall components in tissue sections. A similar expression profile in both BNF-contrasting genotypes was observed in naturally colonized plants and in plants inoculated with G. diazotrophicus. Cell walls of the high BNF genotype have a greater cellulose content, which might contribute to increase biomass. In parallel, callose was concentrated in the vascular tissues of the low BNF genotype and could possibly represent a barrier for an efficient bacterial colonization and dissemination in sugarcane tissues. Our data show a correlation between the gene profiles identified in the BNF-contrasting genotypes and a successful association with endophytic diazotrophic bacteria.

Although the incidence of perforation after endoscopic procedures of the colon is low, the rising number of procedures could pose relevant health problems. Recognizing risk factors and optimizing treatment may reduce perforation incidence and the probability of (severe) complications. This study aimed to determine perforation frequency and the management of endoscopic colonoscopic perforation. A retrospective review of patient records was performed for all patients with iatrogenic colonic perforations after sigmoido/colonoscopy between 1990 and 2005. The patients’ demographic data, endoscopic procedural information, perforation location, therapy, and outcome were recorded. In the 16-year period, 30,366 endoscopic colonic procedures were performed. In total, 35 colonic perforations occured (0.12%). All the patients underwent a laparotomy: for primary repair in 18 cases (56%), for resection with anastomosis in 8 cases (25%), and for resection without anastomosis in 6 cases (19%). In three patients (8.6%), no perforation was found. The postoperative course was uncomplicated in 21 cases (60%) and complicated in 14 cases (40%), including mortality for 3 patients (8.6% resulting from perforations and 0.01% resulting from total endoscopic colon procedures). The relative risk ratio of colonoscopic and sigmoidoscopic procedures for perforations was 4. Therapeutic procedures show a delay in presentation and diagnosis compared with diagnostic procedures. Of the 35 perforations, 26 (74%) occurred in the sigmoid colon. Iatrogenic colonic perforation is a serious but rare complication of colonoscopy. A perforation risk of 0.12% was found. The perforation risk was higher for colonoscopic procedures than for sigmoidoscopic procedures. The sigmoid colon is the area at greatest risk for perforation. Immediate operative management, preferably primary repair and sometimes resection, appears to be a good strategy for most patients.

Ons doel was evaluatie van de frequentie en de manier van overleg tussen bedrijfs-/verzekeringsartsen enerzijds en fysiotherapeuten anderzijds. Tevens werd in beide groepen de persoonlijke ervaring van genoemde aspecten geevalueerd. In het totaal zonden 64 bedrijfs-/verzekeringsartsen en 407 fysiotherapeuten in de regio Rijnmond een vragenlijst betreffende bovenstaande aspecten ingevuld terug. De vragenlijst werd gevalideerd, gebruikmakend van constructvaliditeit en contentvaliditeit. Bovendien werd de test interne consistentie verricht om de betrouwbaarheid van de vragenlijst te verzekeren. Beide groepen stellen onderling overleg op prijs. Fysiotherapeuten hebben echter behoefte aan meer overleg. Het initiatief om de andere groep te benaderen ligt veelal bij de artsen. De bijdrage van de therapeuten aan reintegratie in arbeid van hun clienten wordt door de therapeuten hoger geschat dan door de artsen. De frequentie van overleg tussen bedrijfs-/verzekeringsartsen enerzijds en fysiotherapeuten anderzijds is vrij gering. De kwaliteit daarvan wordt door de meerderheid van beide groepen als vrij goed aangegeven. In tegenstelling tot de fysiotherapeuten zijn de artsen van mening dat de fysiotherapeutische interventie geen positieve invloed heeft op hervatting van werk en dat er voldoende overleg plaatsvindt.