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Abstract Background Alterations in the feet of patients with rheumatoid arthritis (RA) are a cause of disability in this population. The purpose of this research was to evaluate the impact that foot impairment has on the patients' global quality of life (QOL) based on validated scales and its relationship to disease activity. Methods This was a cross-sectional study in which 95 patients with RA were enrolled. A complete physical examination, including a full foot assessment, was done. The Spanish versions of the Health Assessment Questionnaire (HAQ) Disability Index and of the Disease Activity Score (DAS 28) were administered. A logistic regression model was used to analyze data and obtain adjusted odds ratios (AORs). Results Foot deformities were observed in 78 (82%) of the patients; hallux valgus (65%), medial longitudinal arch flattening (42%), claw toe (lesser toes) (39%), dorsiflexion restriction (tibiotalar) (34%), cock-up toe (lesser toes) (25%), and transverse arch flattening (25%) were the most frequent. In the logistic regression analysis (adjusted for age, gender and duration of disease), forefoot movement pain, subtalar movement pain, tibiotalar movement pain and plantarflexion restriction (tibiotalar) were strongly associated with disease activity and disability. The positive squeeze test was significantly associated with disability risk (AOR = 6,3; 95% CI, 1.28–30.96; P = 0,02); hallux valgus, and dorsiflexion restriction (tibiotalar) were associated with disease activity. Conclusion Foot abnormalities are associated with active joint disease and disability in RA. Foot examinations provide complementary information related to the disability as an indirect measurement of quality of life and activity of disease in daily practice.

Butyltins have been measured for the first time in sediments from the deeper waters of the Santa Monica and San Pedro (SM/SP) basins of Southern California borderland. Core samples were collected from waterdepths ranging from 458 m in the shelf to 906 m in the central basin. Surficial and a few subsurface sections from selected cores were analyzed for butyltins. The dominant components are generally dibutyl and monobutyltins (DBT and MBT, respectively). Microbial degradation of Tributyltin (TBT, the most toxic of the butyltin species) to DBT and MBT during the long range transport to deeper basins, as well as a lack of continuing inputs of TBT in the present times could justify the butyltins signatures found in the region. The levels of butyltins are in the lower range (below detection level, <1, to 14 ng of Sn g-1) relative to nearshore sediments. However, the results demonstrate that the butyltins are, indeed, found even in the sedimentsof the central basins of the Southern California borderland suggesting that deeper global oceanic regimes need to be further investigatedfor these compounds. [ABSTRACT FROM AUTHOR]

The prognosis for patients with ventricular arrhythmias has improved dramatically with the aid of implantable cardioverter-defibrillators (ICDs). Although infection is a serious complication that frequently causes dysfunction and loss of ICDs, the frequency, predisposing risk-factors, and clinical and microbiological features are only partially understood. This study describes a retrospective review of 423 procedures in 278 patients with ICD primary implants and replacements performed at a tertiary-care hospital. Generators were placed in either a pectoral (68%) or abdominal (32%) site, and electrodes were placed transvenously in 97% of the patients. Most (95%) interventions were performed in a one-stage procedure. Infection developed with ten (2.4%) implanted devices. Four cases occurred within 30 days of surgery (‘early infections’) and six occurred > 1 month after surgery (‘late infections’). In univariate analysis, factors associated with the development of an early infection were: two-stage surgery, a sub-costal approach, and abdominal generator placement. In patients with late infections, a significant association was found with trauma or decubitus ulcer in the generator area. Infection presented with local signs without systemic complications. Seven of the ten patients required complete removal of the system. [ABSTRACT FROM AUTHOR]

Organotin (OT) compounds, namely butyl and phenyl, were measured in 38 recent sediments collected in harbours of the Western Mediterranean Sea and domestic and industrial sewage disposal sites. Butyltins were the predominant tin species identified being tributyltin (TBT) widespread in the whole area, which suggests recent inputs of OTs. The highest levels of TBT were detected in commercial harbours associated with inputs from large vessels (mean value: 2000 ng g[sup-1] as Sn). Moreover, relatively high TBT values were also detected in fishing and recreational boating areas (mean level ca. 400 mg g[sup-1] as Sn). Phenyltin derivatives occurred at lower levels than butyltins, being the monophenyltin the predominant compound (mean values: 27-573 ng g[sup-1] as Sn). The large predominance of the phenyltin degradation products (i.e. mono and diphenyltin) over their parent compound (i.e. triphenyltin) suggests that there are almost no recent inputs of these compounds. Furthermore, a comparative study of the OT occurrence in the sewage sludge disposal sites offshore Barcelona and Almería (domestic) and into the Tarragona harbour (industrial) shows that domestic primary sewage sludge effluents can contribute to coastal OT pollution (100 ng g[sup-1] of TBT as Sn). Nevertheless, sewage sludge is a secondary source of OT contamination in the coastal environment in comparison to commercial harbours. In a comparative study with previous data collected in the late 1980s, the present study reveals that OT regulations established in the Mediterranean region in 1991 on the use of TBT-based antifouling paints have been effective in marinas, but reveals a significant TBT contamination in commercial and fishing harbours. [ABSTRACT FROM AUTHOR]

Deals with a study which demonstrated the isolation and taxonomic characterization of a bacterial strain that uses 3,6-dimethyl-phenanthrene as its sole source of carbon and energy. Materials and methods; Results; Discussion.bac

Cultivation practice using organic amendments is plausible to ensure global food security. However, plant abiotic stress due to the presence of metals and organic microcontaminants (OMCs) in fertilization products cannot be overlooked. In this study, we monitored lettuce metabolism and phenotypic response following the application of either sewage sludge (SS), the organic fraction of municipal solid waste, swine manure (SM), chemical fertilizers (CF), or no amendment (C) in a greenhouse facility. The experimental set-up consisted of five treatments with five replicates (25 experimental units randomly distributed). All fertilizers were supplied at the equivalent agronomic total nitrogen dose, but the occurrence of trace metals and/or OMCs was greater in the SS and SM than the rest. Non-target metabolomic analysis (high-resolution mass spectrometry coupled with partial least squares regression) identified more than 300 plant metabolites (amino acids, organic acids, sugar alcohols, and sugars), 55 of which showed significant changes in their relative abundances depending on the type of amendment. Functional analysis indicated that the use of CF or SS increased the levels of metabolites involved in carbohydrate and nitrogen metabolism. Therefore, although SS and SM fertilizers had a greater presence of heavy metals and/or OMCs, our results indicate that they did not induce measurable adverse effects in the lettuce phenotype or metabolism. Metabolic changes between fertilizers (CF and SS vs. C and SM) were mainly due to nitrogen availability. [ABSTRACT FROM AUTHOR]

The importance of new alternative fuels has assumed great relevance in the last decades to face the issues of global warming and pollutant emissions from energy production. The scientific community is responsible for developing solutions to achieve the necessary environmental restriction policies. In this context, ammonia appears as a potential fuel candidate and energy vector that may solve the technological difficulties of using hydrogen (H 2) directly in internal combustion engines. Its high hydrogen content per unit mass, higher energy density than liquid hydrogen, well-developed infrastructure and experience in handling and storage make it suitable to be implemented as a long-term solution. In this work, a virtual engine model was developed to perform prospective simulations of different operating conditions using ammonia and H 2 -enriched ammonia as fuel in a spark-ignition (SI) engine, integrating a chemical kinetics model and empirical correlations for combustion prediction. In addition, specific conditions were evaluated to consider and to understand the governing parameters of ammonia combustion using computational fluid dynamics (CFD) simulations. Results revealed similar thermal efficiency than methane fuel, with considerable improvements after appropriate H 2 -enrichment. Moreover, increasing the intake temperature and the turbulence intensity inside the cylinder evinced significant reductions in combustion duration. Finally, higher compression ratios ensure efficiency gains with no evidence of abnormal combustion (knocking), even at high compression ratios (above 16:1) and low engine speeds (800 rpm). Numerical simulations showed the direct influence of the flame front surface area and the turbulent combustion velocity on efficiency, reflecting the need for optimizing the SI engines design paradigm for ammonia applications. • The performance of NH 3 -powered engines is comparable to methane-fuelled engines. • The design of the SI combustion system needs to be reformulated for NH 3 operation. • The compression ratio should be optimized to maximize efficiency when using NH 3. • Increasing tumble intensity resulted in a 30% faster combustion. • Marginal efficiency gains are observed when enriching NH 3 with 2.5% H 2 by mass. [ABSTRACT FROM AUTHOR]

Allogeneic hematopoietic cell transplantation offers improved survival in patients with ALL, but with regimens containing TBI, the nonrelapse mortality is 20-40%. Efforts to lessen transplant toxicities by reducing conditioning regimen intensity have led to increased relapse risk. Therefore, there is a need for less toxic regimens that maintain an anti-leukemia effect. We report here a retrospective review of 65 patients with ALL in first remission receiving grafts from allogeneic donors after fludarabine 40 mg/m2/day for 4 days and i.v. BU targeted to a median daily area under the concentration-time curve below 6000 μmoles min/L. At 2 years after transplantation, OS was 65% (95% confidence interval (CI): 52-77%), relapse-free survival was 61% (95% CI: 48-73%), cumulative incidence of relapse was 26% (95% CI: 17-39%) and cumulative incidence of nonrelapse mortality was 14% (95% CI: 8-26%). Age over 35 years, Ph chromosome positivity and minimal residual disease at transplant did not adversely affect outcomes. Pharmacokinetically targeted BU and fludarabine can provide intensive pre-transplant conditioning for adults with ALL in first remission, with promising relapse-free and OS rates. [ABSTRACT FROM AUTHOR]

The effect of irrigation water quality was investigated in a commercial mandarin orchard during four growing seasons using fresh water (EC ≈ 1 dS m), irrigators' association water (EC = 1-3 dS m) and reclaimed water (RW) (EC ≈ 3 dS m). RW had higher concentration of macro- and micronutrients, especially potassium, and the phytotoxic elements, boron, sodium and chlorides. The microbiological load in the different irrigation water sources showed a high seasonal variability, and all water sources occasionally exceeded health standards to irrigate fruit trees. In the RW treatment, an increase in soil salinity and leaf boron concentration was observed. The nutritional contribution of RW was high, providing 24 and 15 % of the annual nitrogen and phosphorus (N and PO) fertilizer requirement for mandarin oranges, respectively, and RW treatment satisfied the entire potassium requirement (KO). An important fluctuation in the crop production was observed during the 4 years in the different water quality treatments. In general, quality parameters of mandarins were not affected. The results provide additional evidence that long-term effects must be studied to test sustainability when using RW irrigation on fruit trees. [ABSTRACT FROM AUTHOR]

Acute GVHD (aGVHD) is a major cause of morbidity and mortality in hematopoietic allograft recipients. The best therapy for patients failing to respond, or not tolerating, systemic glucocorticoids remains undefined. We evaluated the efficacy of sirolimus in 34 patients, median age of 49 (23–67) years, with steroid-refractory (n=31) or steroid-intolerant (n=3) aGVHD. aGVHD was diagnosed at a median of 34 (7–1042) days post allografting, and confirmed by biopsy in all cases. Initial aGVHD treatment consisted of prednisone up to 2 mg/kg. Sirolimus was initiated at a median of 9 (1–255) days after glucocorticoid initiation. A sirolimus loading dose was administered to 19 (56%) of 34 patients, median 6 (3–8) mg, followed by maintenance of 1–2 mg/day to target therapeutic trough levels between 4 and 12 ng/ml. Overall response rate was 76%. Fifteen (44%) of 34 patients achieved CR, defined as complete resolution of aGVHD sustained for at least 1 month, after sirolimus initiation without additional immunosuppressive agents. CR was achieved in 11 (42%) of 31 steroid-refractory and 2 (67%) of 3 steroid-intolerant patients. Median OS after initiation of sirolimus was 5.6 months, and 1-year OS was 44% (95% CI: 27–60%). Sirolimus is effective in controlling steroid-refractory aGVHD. [ABSTRACT FROM AUTHOR]

In the last 25 years, human immunodeficiency virus (HIV) has become the leading infectious killer of adults globally, with an estimated 44 million people infected with the virus worldwide. Most of these individuals live in poor regions of the world, particularly sub-Saharan Africa. Although a great deal of work has been done in identifying and treating individuals with the disease, there has been little action to date to address the complex socioeconomic factors that lie at the heart of this global pandemic. Understanding and responding to such factors is of paramount importance if HIV infection is to be managed in a meaningful way. This article explores the social context of people living with HIV in three different geographic and epidemiologic settings and highlights the social factors that shape and define an individual's risk of acquiring HIV. It also discusses unique programs aimed at addressing the complex realities of the world in which HIV thrives. These programs can act as models of HIV prevention and treatment. [ABSTRACT FROM AUTHOR]

Diarrhea is a major cause of morbidity and discomfort for patients undergoing high-dose chemotherapy and autologous peripheral blood stem cell transplantation (APBSCT). There are multiple causes of diarrhea in patients undergoing transplantation including antineoplastic chemotherapy, antimicrobials and infection, including Clostridium difficile as the most common pathogen involved. The purpose of this study was to determine the incidence of C. difficile-associated diarrhea (CDAD) 1 week before and 30 days after APBSCT, and to identify risk factors for the development of CDAD including diagnosis. Two hundred and forty-two patients underwent APBSCT for multiple myeloma and lymphoma between October 1996 and October 2001 in two teaching hospitals. Diarrhea was reported in 157 (64.9%) subjects. One hundred and thirty-five out of the 157 subjects were tested for the presence of C. difficile toxin A. These subjects constitute the study group. The incidence of CDAD was 15%. Two thirds of the patients who developed CDAD had multiple myeloma and one third had lymphoma; this difference did not attain statistical significance. The use of cephalosporins (P=0.03) and the use of intravenous vancomycin (P=0.02) were the only identified risk factors associated with the development of CDAD. Patients treated with paclitaxel as part of the mobilization regimen had a lower incidence of CDAD than patients who received hematopoietic growth factor only (P=0.01).Bone Marrow Transplantation (2006) 37, 517–521. doi:10.1038/sj.bmt.1705269; published online 23 January 2006 [ABSTRACT FROM AUTHOR]

Infrared optical fibers based on chalcogenides are investigated to optimize their response and they are used for in situ detection of pollutant in groundwater. The pilot scale measurements proved that a Te2As3Se5 (TAS) glass fiber permits access to the absorption line positions of classic pollutants like tetrachloroethylene or dichlorobenzene. Moreover, it has been shown that the original design of the fiber enables detection of weak concentrations of pollutants down to 1 ppm. For experiments in ‘real world’ conditions, optical fibers must be durable under various natural working conditions in ground water. The preliminary mechanical tests demonstrate that efforts have to be done while drawing the fiber to improve their resistance. Nevertheless, at this time, a polymer coated TAS glass fiber is already a useful tool to collect some infrared spectra in landfill. [Copyright &y& Elsevier]

The article presents a study related to the addition of drugs including sirolimus, tacrolimus and antithymocyte globulin as transplantation graft-versus-host disease (GVHD) prophylaxis in HLA-mismatched unrelated donor hematopoietic cell. Topics discussed include testing the efficacy of the drug, using descriptive statistics to summarize Baseline characteristics, and analysing negative post-transplant outcomes.