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Objective The aim was to describe the microbiology of surgically treated infective native (mycotic) aortic aneurysms (INAAs), and associated survival and development of infection-related complications (IRCs). Methods Data were pooled from 2 nationwide studies on surgically treated patients with INAAs in Sweden, between 1994 – 2016. Patients were grouped and analyzed according to culture results: 1) Staphylococcus aureus, 2) Streptococcus species (sp.), 3) Salmonella sp., 4) Enterococcus sp., 5) Gram-negative intestinal bacteria, 6) Other sp. (all other species found in culture), and 7) Negative cultures. Results A sum of 182 patients were included, mean age 71 years (standard deviation; SD: 8.9). The median follow-up was 50.3 months (range 0 – 360). 128 (70.3%) patients had positive blood and/or tissue culture; Staphylococcus aureus n = 38 (20.9%), Streptococcus sp. n = 37 (20.3%), Salmonella sp. n = 19 (10.4%), Enterococcus sp. n = 16 (8.8%), Gram-negative intestinal bacteria n = 6, (3.3%), Other sp. n = 12 (6.6%) and Negative cultures n = 54 (29.7%). The estimated survival for the largest groups at 2-years after surgery was: Staphylococcus aureus 62% (95% Confidence interval 53.9 – 70.1), Streptococcus sp. 74.7% (67.4 – 82.0), Salmonella sp. 73.7% (63.6 – 83.8), Enterococcus sp. 61.9% (49.6 – 74.2), and Negative cultures 89.8% (85.5 – 94.1), P = .051. There were 37 IRCs (20.3%), and 19 (51.4%) were fatal, the frequency was insignificant between the groups. The majority of IRCs, 30/37 (81%), developed during the first postoperative year. Conclusion In this assessment of microbiological findings of INAAs in Sweden, 50% of the pathogens were Staphylococcus aureus, Streptococcus sp., or Salmonella sp.. The overall 20%-frequency of IRCs, and its association with high mortality, motivates long-term antibiotic treatment regardless of microbial findings.

Paracetamol (acetaminophen, APAP) overdose is a leading cause of acute drug-induced liver failure. APAP hepatotoxicity is mediated by the reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI). NAPQI is inactivated by conjugation with glutathione (GSH) to APAP-GSH, which is further converted into its cysteine derivative APAP-CYS. Before necrosis of hepatocytes occurs, APAP-CYS is measurable in plasma of the affected patient and it has been proposed as an early biomarker of acetaminophen toxicity. APAP-GSH and APAP-CYS can be extruded by hepatocytes, but the transporters involved are unknown. In this study we examined whether ATP-binding cassette (ABC) transporters play a role in the cellular efflux of APAP, APAP-GSH, and APAP-CYS. The ABC transport proteins P-gp/ABCB1, BSEP/ABCB11, BCRP/ABCG2, and MRP/ABCC1-5 were overexpressed in HEK293 cells and membrane vesicles were produced. Whereas P-gp, BSEP, MRP3, MRP5, and BCRP did not transport any of the compounds, uptake of APAP-GSH was found for MRP1, MRP2 and MRP4. APAP-CYS appeared to be a substrate of MRP4 and none of the ABC proteins transported APAP. The results suggest that the NAPQI metabolite APAP-CYS can be excreted into plasma by MRP4, where it could be a useful biomarker for APAP exposure and toxicity. Characterization of the cellular efflux of APAP-CYS is important for its development as a biomarker, because plasma concentrations might be influenced by drug-transporter interactions and upregulation of MRP4. Electronic supplementary material The online version of this article (10.1007/s00204-020-02793-4) contains supplementary material, which is available to authorized users.

Sediment traps deployed in Buenos Aires sewage outfall area collected a substantial amount of material (average mass flux 22 ± 12 g cm² year⁻¹) with very high metal concentrations, mostly in the range of hazardous exposition for organisms (Zn: 138–671, Cu: 41–273, Cr: 44–255 and Pb: 26–260 μg g⁻¹). The combination of high mass fluxes and concentrations results in huge metal fluxes (0.005–0.7 to 3.6–31 g m⁻² day⁻¹ for minor elements and Fe, respectively). Metal concentrations were correlated to the total mass flux and total organic carbon but with different trends for redox-sensitive Fe and Mn (negative) and anthropogenic elements (positive). This reflects the key role of organic discharges promoting anoxia with Fe and Mn evasion, and also contributing toxic metals., Facultad de Ciencias Naturales y Museo

In order to evaluate the impact of intensive agriculture on air quality in the most productive and populated Argentina's Pampas, a comprehensive assessment of airborne Endosulfan (∑Endo) was performed using polyurethane passive samplers deployed from 2010 to 2013 covering the critical period of Endosulfan restrictions at twenty nine sites in the Rural Pampa and Great Buenos Aires Metropolitan Area (GBA: Horticultural and Urban subareas). ∑Endo concentrations were very high and variable (0.01-63 ng m-3), exceeding worldwide reported maxima at Horticultural GBA and Rural Pampa with lowest values at Urban GBA (geometric means: 3.1, 1.1 and 0.53 ng m-3, respectively). The composition was relatively fresh with strong predominance of Endo I (72 ± 18%) over Endo II (23 ± 15%) and Endo SO4 (5 ± 10%). Airborne ∑Endo was significantly correlated to annual soybean crop in Rural Pampa. ∑Endo concentrations showed a temporal pattern defined by consistent peaks enriched in Endo I during summer application periods, cold temperature minima with higher proportions of Endo SO4 and a general exponentially declining trend over time related to incipient control policies. Fil: Astoviza, Malena. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Química Ambiental y Biogeoquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina Fil: Cappelletti, Natalia Elsa. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Química Ambiental y Biogeoquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina Fil: Bilos, Claudio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Química Ambiental y Biogeoquímica; Argentina Fil: Migoya, Maria Carolina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Química Ambiental y Biogeoquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina Fil: Colombo, Juan Carlos. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Química Ambiental y Biogeoquímica; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina

Contains fulltext : 170844.pdf (Publisher’s version ) (Closed access) Digitalis-like compounds (DLCs), the ancient medication of heart failure and Na,K-ATPase inhibitors, are characterized by their toxicity. Drug-drug interactions (DDIs) at absorption and excretion levels play a key role in their toxicity, hence, knowledge about the transporters involved might prevent these unwanted interactions. In the present study, the transport of fourteen DLCs with human P-glycoprotein (P-gp; ABCB1) was studied using a liquid chromatography-mass spectrometry (LC-MS) quantification method. DLC transport by P-gp overexpressing Madin-Darby canine kidney (MDCK) and immortalized human renal cells (ciPTEC) was compared to vesicular DLC transport. Previously, we identified convallatoxin as a substrate using membrane vesicles overexpressing P-gp; however, we could not measure transport of other DLCs in this assay (Gozalpour et al., 2014a). Here, we showed that lipophilic digitoxin, digoxigenin, strophanthidin and proscillaridin A are P-gp substrates in cellular accumulation assays, whereas the less lipophilic convallatoxin was not. P-gp function in the cellular accumulation assays depends on the entrance of lipophilic compounds by passive diffusion, whereas the vesicular transport assay is more appropriate for hydrophilic substrates. In conclusion, we identified digitoxin, digoxigenin, strophanthidin and proscillaridin A as P-gp substrates using cellular accumulation assays and recognized lipophilicity as an important factor in selecting a suitable transport assay.

The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach.

Superficial sediments and settling material collected in Buenos Aires coastal area were analyzed to evaluate the accumulation and sources of trace metals. Residual elements showed homogeneous sedimentary concentrations (Fe: 23,846 +/- 4,367; Ni: 10 +/- 2.7; Mn: 706 +/- 314 μg g(-1)) whereas anthropogenic metals presented exponentially decreasing offshore gradients (Zn: 98 +/- 69; Cr: 28 +/- 21; Cu: 19 +/- 15; Pb: 18 +/- 13 μg g(-1)). Anthropogenic impact was evaluated through metal-Fe relationships, Fe-normalized enrichment factors and sediment quality guidelines. The slopes of metal-Fe regressions from background sites were comparable to upper crust metal ratios, excepted Cr which is impoverished, and Mn which is diagenetically enriched. Metal-Fe relationships also hold for most 2.5 km offshore sites but with higher slopes denoting human influence, and are completely lost in 1-2.5 km sediments and trap material which plot over the regressions and exceed sediment quality guidelines.

Total suspended particles (TSP), particulate- (ALIp) and semi-volatile aliphatic hydrocarbons (ALIsv) were measured in air sampled during the day and night over 7–8 months in industrial, commercial and residential sectors of La Plata, Argentina. TSP, ALIp and ALIsv ranges were 23–219 μg/m3, 11–447 and 12–719 ng/m3, respectively. Maximum values were recorded at a downtown site whereas the residential station showed lower levels. Concentrations were usually higher during the day and during fall and winter. Two- and three-way ANOVA were performed to evaluate the day-night, inter-station, and inter-month variability. The amount of total variability accounted by these factors was 14, 25 and 23% (p

Aliphatic (ALI) and aromatic (ARO) hydrocarbon concentrations, composition and sources were evaluated in waters, sediments, soils and biota to assess the impact of approximately 1000 tons of oil spilled in Rio de la Plata coastal waters. Total ALI levels ranged from 0.4-262 microg/l in waters, 0.01-87 microg/g in sediments, 5-39 microg/g in bivalves, 12-323 microg/g in macrophytes to 948-5187 microg/g in soils. ARO varied from non-detected 10 microg/l, 0.01-1.3 mug/g, 1.0-16 microg/g, 0.5-6.9 microg/g to 22-67 microg/g, respectively. Offshore (1, 5, 15 km) waters and sediments were little affected and contained low background hydrocarbon levels reflecting an effective wind-driven transport of the slick to the coast. Six months after the spill, coastal waters, sediments, soils and biota still presented very high levels exceeding baseline concentrations by 1-3 orders of magnitude. UCM/resolved aliphatic ratio showed a clear trend of increasing decay: coastal waters (3.3)macrophytes (6.7)soils (9.4)offshore sediments (13)coastal sediments (17)clams (52). All environmental compartments consistently indicated that the most impacted area was the central sector close to Magdalena city, specially low-energy stream embouchures and bays which acted as efficient oil traps. The evaluation of hydrocarbon composition by principal component analysis indicated the predominance of biogenic (algae, vascular plant cuticular waxes), background anthropic, pyrogenic and diagenetic hydrocarbons, offshore and in non-impacted coastal sites. In contrast, polluted stations presented petrogenic signatures characterized by the abundance of isoprenoids, low molecular weight n-alkanes and methylated aromatics in different stages of alteration. The petrogenic/biogenic ratio (n-C22 + isoprenoids/n-C15 + n-C17 +n-C23) and petrogenic/pyrogenic relationship (methylated/unsubstitued PAH) discriminated the samples according to the different degree of impact. The following paper present the results of the study of the progress of hydrocarbon disappearance in sediments and soils 13 and 42 months after the spill.

The 6-month assessment of the oil spill impact in the Rio de la Plata described in the preceding paper [Colombo, J.C., Barreda, A., Bilos, C., Cappelletti, N., Demichelis, S., Lombardi, P., Migoya, M.C., Skorupka, C., Suarez, G., 2004. Oil spill in the Rio de la Plata estuary, Argentina: 1 - biogeochemical assessment of waters, sediments, soils and biota. Environmental Pollution] was followed by a 13- and 42-month campaigns to evaluate the progress of hydrocarbon decay. Average sediment hydrocarbon concentrations in each sampling include high variability (85-260%) due to contrasting site conditions, but reflect a significant overall decrease after 3 years of the spill: 17 +/- 27, 18 +/- 39 to 0.54 +/- 1.4 microg g(-1) for aliphatics; 0.44 +/- 0.49, 0.99 +/- 1.6 to 0.04 +/- 0.03 microg g(-1) for aromatics at 6, 13 and 42 months, respectively. Average soil hydrocarbon levels are 100-1000 times higher and less variable (61-169%) than sediment values, but display a clear attenuation: 3678 +/- 2369, 1880 +/- 1141 to 6.0 +/- 10 microg g(-1) for aliphatics and 38 +/- 26, 49 +/- 32 to 0.06 +/- 0.04 microg g(-1) for aromatics. Hydrocarbon concentrations modeled to first-order rate equations yield average rate constants of total loss (biotic+abiotic) twice as higher in soils (k = 0.18-0.19 month(-1)) relative to sediments (0.08-0.10 month(-1)). Individual aliphatic rate constants decrease with increasing molecular weight from 0.21 +/- 0.07 month(-1) for isoprenoids andn-C22 to 0.10 +/- 0.08 month(-1) forn-C27, similar to hopanes (0.10 +/- 0.05 month(-1)). Aromatics disappearance rates were more homogeneous with higher values for methylated relative to unsubstituted species (0.17 +/- 0.05 vs. 0.12 +/- 0.05 months(-1)). Continued hydrocarbon inputs, either from biogenic (algal n-C15,17; vascular plant n-C27,29) or combustion related sources (fluoranthene and pyrene), appear to contribute to reduced disappearance rate. According to the different loss rates, hydrocarbons showed clear compositional changes from 6-13 to 42 months. Aliphatics disappearance rates and compositional changes support an essentially microbiologically-mediated recovery of coastal sediments to pre-spill conditions in a 3-4 year period. The lower rates and more subtle compositional changes deduced for aromatic components, suggest a stronger incidence of physical removal processes.

Water and sediment samples were collected in the lower Parana delta at four sites with different levels of exposure to pollution to evaluate the anthropogenic impact through chemical analyses and mortality bioassays. Individual polychlorinated biphenyls, chlorinated pesticides, aliphatic hydrocarbons, polycyclic aromatic hydrocarbons, and heavy metals were measured in waters, porewaters and sediments. The same three phases were also subjected to toxicity assays with straight-hinged juveniles of Corbicula fluminea. Concentrations of several pollutants were above levels recommended for the protection of aquatic life: in waters, Zn, Cu and Cr were 1.6–4.9 times higher, whereas in the sediments Cr was 1.8–3.6, and benzo(a)pyrene was 2.8–5.6 times higher. Pollutant concentrations followed a clear geographic pattern with highest values in the densely populated area of the Reconquista and Lujan rivers, lower levels in the San Antonio, and lowest loadings in the remote Parana de las Palmas. This gradient was adequately matched by the pattern of mortality rates of C. fluminea early juveniles, which were highest in the Reconquista-Lujan (40–93%) and lowest (and not significantly different from the control) in the Parana (3.3–23%). Mortality rates also increased from surface waters (3.3–53%), to porewaters (12–73%), to sediments (23–93%). Although toxicity was probably mainly due to dissolved contaminants, agreement between chemical and biological evidence of pollution was best for the sediment compartment, whereas porewater and surface water showed a higher degree of variability.

Airborne particulate trace metals have been measured bimonthly during day and night hours in four permanent stations located in residential, industrial and commercial sectors of La Plata City region, to characterize the sources and variability of atmospheric inputs. Airborne trace metal regional averages (Pb 64 +/- 62, Cu 30 +/- 27, Mn 26 +/- 20, Zn 273 +/- 227, Fe 1183 +/- 838, Ca 5343 +/- 3614, Mg 1472 +/- 967, Cr 4.3 +/- 2.4, Ni 3.2 +/- 3.5 and Cd 0.41 +/- 0.42 ng/m3) are comparable to the values reported for not grossly polluted cities and below the general trend described for urban particulates. Two- and three-way analysis of variance and variance components tests (P < 0.05) were performed to assess the contribution of the diurnal (day vs. night), spatial (inter-station) and temporal (inter-month) components of variability. Trace metal concentrations followed the behavior of total suspended particles with higher concentrations during the day and at the Downtown station and lower at the Residential site. In general, spatial and temporal variations prevailed over diurnal differences. Spatial differences were clearly most significant for Pb, which presented higher values at the Downtown site reflecting the importance of motor exhaust inputs. In contrast, diurnal differences were more important for Mn due to increased dust resuspension during day hours. A seasonal trend with concentrations usually increasing during winter months and decreasing in spring-summer was also detected. Enrichment factors (EF) were calculated to evaluate anthropogenic versus natural element sources. High EF (21-376) were obtained for Pb, Zn, Cd and Cu reflecting the importance of anthropic inputs. The comparison with EF calculated for high-emitting vehicle particle emissions indicated that motor exhausts are the most important source of these elements in La Plata region. In contrast, the EF calculated for Mn, Cr, Ni, Ca and Mg were low (1.3-7.5) suggesting chiefly natural sources, i.e. soil-derived dusts.

Suspended particulate matter (SPM), sandy sediments and Asiatic clams were collected at seven sites along 150 km of the Rio de la Plata coast to assess the magnitude of trace metal pollution in the area. Metal concentrations in SPM (Cu: 7.4-109; Cr: 75-408; Mn: 525-1341 microg(-1)), sediments (Cr: 16-27; Zn: 26-99; Mn: 221-489 microg(-1)) and bivalves (Cd: 0.5-1.9; Ni: 1.3-6.4; Cr: 1.3-11; Mn: 15-81; Cu: 28-89; Zn: 118-316 microg g(-1)) are comparable to those reported for other moderately polluted world rivers. Cu levels in Asiatic clams are among the highest, similar to those reported for heavily polluted sites. SPM Cu and Cr concentrations displayed a clear geographical trend with values increasing with proximity to major urban centers. Sediments showed a less clear pattern possibly due to their coarse nature (>98% sand) and higher proportion of mineral-associated residual metals. The clams showed a complex pattern due to the variability introduced by size-related factors and the natural dynamics of SPM in the estuary. Cr and Mn showed an apparent reverse industrial trend with higher concentrations in clams collected at distant stations near the turbidity maximum zone, possibly reflecting enhanced particle retention. Cu, Cd and Ni showed no clear geographical pattern, whereas Zn increased in the clams collected in the most industrialized area. A significant relationship with clam size was observed for Cu (positive) and Zn (negative) suggesting different physiological requirements for both metals with age. A principal component analysis confirmed these geographical and size-related trends.

showed olygoclonal distributions (12%) and even absence of TCRBV families (3%). Before treatment, patients showed a higher expression of BV7 andBV23 families compared with healthy individuals. At baseline, healthy donors showed a significantly higher complexity score (170.8±5.6) compared to CAD patients (141.6±15.3) (P=.01). Three months after BMC injection, all patients showed an improvement in the complexity score (152.4±14.3) thus abolishing the difference previously found with healthy donors. Conclusion: Intramyocardial injection of autologous BMC may have a systemic effect on the immune system favoring the recovery of TCR BV repertoire diversity and profile in patients with advanced CAD undergoing TMLR.

The topography of the intraneural fascicular groups must be understood if the treatment of acute lacerations of the major nerves in the forearm is to be successful. Most lacerations in the upper extremity occur at the wrist and in the distal half of the forearm. With microsurgical longitudinal dissections and serial sections, we studied the intraneural topography of the fascicular groups of the median and ulnar nerves utilizing forty-five fresh frozen or refrigerated specimens. We devised a new technique of light photography to demonstrate the distinct boundaries of the fascicular groups. The intraneural fascicular groups provide the anatomical basis for the recommended surgical techniques of group fascicular repair and nerve-grafting.

In five patients with fracture-dislocation of a radiocarpal joint, the wrist injury was severe and associated with injuries to other systems. Typically there was neurovascular impairment and closed reduction was performed as soon as possible to relieve pressure to tension on vessels and nerves. Fracture of the radial and ulnar styloid processes, fracture of the dorsal rim of the radial articular surface, and a multitude of carpal and intercarpal injuries were present in all cases. Early open reduction, internal fixation of the fractures, and repair of all torn ligaments appeared to be the treatment of choice.

An uncommon cause of trigger finger, caused by partial laceration of superficialis flexor tendon is illustrated in two patients.

Eikenella corrodens, a gram negative rod, was cultured in about one third of 24 patients with human bite wounds. The organism was sensitive to penicillin but not to methicillin. Clinically the infections in which Eikenella corrodens were found were not different from other infections. Because of the variety of possible pathogens in human bite infections, we start the patients on a broad spectrum antibiotic while awaiting the results of the culture and sensitivity. However, antibiotics alone are not sufficient treatment in HBI; 20 of 24 patients in this series required surgical drainage. Surgical treatment consists of thorough exploration, exteriorization and excision of devitalized tissues. Complications were more frequent in sutured wounds, or when surgical drainage was delayed.