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AIMS: Toxaphene is a persistent organic pollutant, composed of approximately 1000 highly chlorinated bicyclic terpenes. The purpose of this study was to evaluate if camphor, a structural analogue of toxaphene, could stimulate aerobic biotransformation of weathered toxaphene. METHODS AND RESULTS: Two enrichment cultures that degrade camphor as the sole carbon source were established from contaminated soil and biosolids. These cultures were used to evaluate aerobic transformation of weathered toxaphene. Only the biosolids culture could transform compounds of technical toxaphene (CTTs) in the presence of camphor, while no transformation was observed in the presence of glucose or with toxaphene as a sole carbon source. The transformed toxaphene had lower concentration of CTTs with longer retention times, and higher concentration of compounds with lower retention times. Gas chromatography with electron capture negative ion mass spectrometry (GC/ECNI-MS) showed that aerobic biotransformation mainly occurred with Cl8 - and Cl9 -CTTs compounds. The patterns of Cl6 - and Cl7 -CTTs were also simplified albeit to a much lesser extent. Seven camphor-degrading bacteria were isolated from the enrichment culture but none of them could degrade toxaphene. CONCLUSION: Camphor degrading culture can aerobically transform CCTs via reductive pathway probably by co-metabolism using camphor as a co-substrate. SIGNIFICANCE AND IMPACT OF THE STUDY: Since camphor is naturally produced by different plants, this study suggests that stimulation of aerobic transformation of toxaphene may occur in nature. Moreover plants, which produce camphor or similar compounds, might be used in bioremediation of contaminated soils.

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AIMS: This study evaluated the effects of DNA extraction method, DNA purification and pooling of PCR amplification products on the description of bacterial and archaeal diversity. METHODS AND RESULTS: Soil DNA was extracted by the Power Soil DNA extraction kit and a customized Griffiths' protocol. Both methods are based on cell disruption by bead beating. In total, we used three soils and six independent extractions from each soil obtained by each of the two methods. Then, three of the six extracts of each treatment were further purified by spin columns filled with Sepharose 2B and polyvinylpolypyrrolidone (PVPP). The V4 hypervariable region of the 16S rRNA gene was amplified from each extract using the 515F/806R primer pair in four independent reactions. Three amplification products were combined and sequenced as a pooled sample, while the additional amplification product was sequenced individually. The resulting 72 amplification products were sequenced by Illumina MiSeq platform. DNA extraction method had a statistically significant effect on the estimation of the composition of microbial communities that might overwhelm differences in microbial communities from distinct soils. On the other hand, a further DNA purification step or pooling of PCR amplification products had a minor effect on the description of bacterial and archaeal communities. CONCLUSIONS: DNA extraction had the strongest effect on the description of bacterial and archaeal communities; low concentration of impurities, which allow PCR amplification, can still generate a minor additional bias, while PCR stochastic variability had the lowest effect. SIGNIFICANCE AND IMPACT OF THE STUDY: Although it is well known that methodological factors affect the description of microbial communities, the relative importance of each step is still unknown. The present study determined that of the factors tested, the DNA extraction method had the strongest effects on the description of bacterial and archaeal communities.

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Resumen: En la degradación del cartílago articular, la limitación funcional y el dolor se asocian a la alteración cuantitativa y cualitativa del ácido hialurónico en un proceso fisiopatológico sobre el que influye una amplia variedad de factores cuyo impacto agrava la enfermedad y disminuye la calidad de vida del paciente. El manejo farmacológico convencional para la osteoartritis es a menudo insuficiente. Por fortuna, en el mundo actual se cuenta con viscosuplementos capaces de mejorar, restituir y promover la producción endógena del ácido hialurónico degradado en los cuadros de osteoartritis. El uso de estos compuestos exige el apego a un conjunto de técnicas específicas, diseñadas para la correcta infiltración intraarticular del viscosuplemento sin necesidad de infligir una carga traumática adicional al paciente; estas técnicas -con referencia especial al paciente afectado por la osteoartritis de rodilla (gonartritis)- se describen en el presente artículo, en el que además se destacan los criterios para la elección del viscosuplemento idóneo, el más semejante al ácido hialurónico nativo de personas jóvenes y sanas y aquel cuyo uso terapéutico reporta mayores beneficios clínicos a corto y a largo plazo.

Abstract: In the degradation of articular cartilage, functional limitation and pain -cardinal signs of osteoarthritis- underlies, as a central factor, the quantitative and qualitative alteration of hyaluronic acid, the main component of synovial fluid and cartilage, in a pathophysiological process influenced by a wide variety of risk factors whose impact complicates the disease and radically reduces the quality of life of the patient. Conventional pharmacological management for osteoarthritis is often insufficient. Fortunately, in our days, there are viscosupplements capable of improving, replacing and promoting the endogenous production of degraded hyaluronic acid in osteoarthritis. The use of these compounds requires the adherence to a set of specific techniques, designed for the correct intra-articular infiltration of the viscosupplement without the need to inflict an additional traumatic load on the patient; these techniques -with special reference to the patient affected by knee osteoarthritis (gonarthritis)- are described in this article, which also highlights the criteria for choosing the ideal viscosupplement, the one most similar to hyaluronic acid native in healthy young people, and one whose therapeutic use reports greater clinical benefits in the short and long term.

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AIMS: To isolate and identify TNT-transforming cultures from explosive-contaminated soils with the ability to produce biosurfactants. METHODS AND RESULTS: Bacteria (pure and mixed cultures) were selected based on their ability to transform TNT in minimum media with TNT as the sole nitrogen source and an additional carbon source. TNT-transforming bacteria were identified by 16S rRNA gene sequencing. TNT transformation rates were significantly lower when no additional carbon or nitrogen sources were added. Surfactant production was enabled by the presence of TNT. Fourteen cultures were able to transform the explosive (>50%); of these, five showed a high transformation capacity (>90%), and six produced surfactants. CONCLUSIONS: All explosive-transforming cultures contained Proteobacteria of the genera Achromobacter, Stenotrophomonas, Pseudomonas, Sphingobium, Raoultella, Rhizobium and Methylopila. These cultures transformed TNT when an additional carbon source was added. Remarkably, Achromobacter spanius S17 and Pseudomonas veronii S94 have high TNT transformation rates and are surfactant producers. SIGNIFICANCE AND IMPACT OF THE STUDY: TNT is a highly toxic, mutagenic and carcinogenic nitroaromatic explosive; therefore, bioremediation to eliminate or mitigate its presence in the environment is essential. TNT-transforming cultures that produce surfactants are a promising method for remediation. To the best of our knowledge, this is the first report that links surfactant production and TNT transformation by bacteria.

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In the degradation of articular cartilage, functional limitation and pain cardinal signs of osteoarthritis underlies, as a central factor, the quantitative and qualitative alteration of hyaluronic acid, the main component of synovial fluid and cartilage, in a pathophysiological process influenced by a wide variety of risk factors whose impact complicates the disease and radically reduces the quality of life of the patient. Conventional pharmacological management for osteoarthritis is often insufficient. Fortunately, in our days, there are viscosupplements capable of improving, replacing and promoting the endogenous production of degraded hyaluronic acid in osteoarthritis. The use of these compounds requires the adherence to a set of specific techniques, designed for the correct intra-articular infiltration of the viscosupplement without the need to inflict an additional traumatic load on the patient; these techniques with special reference to the patient affected by knee osteoarthritis (gonarthritis) are described in this article, which also highlights the criteria for choosing the ideal viscosupplement, the one most similar to hyaluronic acid native in healthy young people, and one whose therapeutic use reports greater clinical benefits in the short and long term.

En la degradación del cartílago articular, la limitación funcional y el dolor se asocian a la alteración cuantitativa y cualitativa del ácido hialurónico en un proceso fisiopatológico sobre el que influye una amplia variedad de factores cuyo impacto agrava la enfermedad y disminuye la calidad de vida del paciente. El manejo farmacológico convencional para la osteoartritis es a menudo insuficiente. Por fortuna, en el mundo actual se cuenta con viscosuplementos capaces de mejorar, restituir y promover la producción endógena del ácido hialurónico degradado en los cuadros de osteoartritis. El uso de estos compuestos exige el apego a un conjunto de técnicas específicas, diseñadas para la correcta infiltración intraarticular del viscosuplemento sin necesidad de infligir una carga traumática adicional al paciente; estas técnicas con referencia especial al paciente afectado por la osteoartritis de rodilla (gonartritis) se describen en el presente artículo, en el que además se destacan los criterios para la elección del viscosuplemento idóneo, el más semejante al ácido hialurónico nativo de personas jóvenes y sanas y aquel cuyo uso terapéutico reporta mayores beneficios clínicos a corto y a largo plazo.

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BACKGROUND: Infective endocarditis (IE) occurs with significant frequency in patients with congenital heart disease. The complications leading to increased morbidity and mortality may be detected by echocardiographic examination. This study was undertaken in order to identify echocardiographic findings that influence the outcome of patients with congenital heart disease and IE. METHODS: Twenty-five patients with an average age of 28 years were selected and divided into two groups according to evolution. Group I included patients who survived the infectious process, while Group II included patients who died during hospitalization or after release. RESULTS: Aortic valve disease was the most frequent anomaly. The clinical finding of most relevance for evolution during hospitalization was heart failure. Acute kidney failure and multiple organ failure from sepsis were the most common complications in patients who died. Echocardiograms established the diagnosis in all cases. Transesophageal studies revealed all periaortic abscesses. CONCLUSIONS: Echocardiography makes it possible to identify and evaluate complications associated with elevated morbidity and mortality in patients with congenital heart disease and IE.

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We evaluated the hemodynamic response of patients with chronic aortic regurgitation and decreased ejection fraction (EF), mean value +/- SD (37 +/- 9), to dobutamine stress echocardiography (DSE). Eleven patients were studied with DSE. Nine patients were in New York Heart Association (NYHA) Class II and two in NYHA Class III. Ten patients received medical treatment in the only other periodic evaluation. With DSE in nine patients, a significant decrease in left ventricular end-diastolic and end-systolic diameters (LVEDD and LVESD) as well as LV end-diastolic and end-systolic volumes (LVEDV and LVESV) was documented in comparison to resting values. EF and fractional shortening (FS) improved significantly with DSE. Systolic wall stress (SWS) and pulmonary arterial systolic pressure (PASP) did not change. Average follow-up was 6.7 months. Three patients underwent valve replacement with mechanical prostheses. Two of them are in NYHA Class I and the other died of LV failure 3 days after surgery. One patient deteriorated beyond surgical treatment and was in NYHA Class II. The other seven patients remain in NYHA Class II and await valve replacement. In patients with chronic aortic regurgitation and depressed EF, the variables relevant to myocardial reserve appear to be EF, FS, LVEDD, LVESD, LVEDV, and LVESV.

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UNLABELLED: The potential cardioembolic sources for ischemic stroke in patients younger than 40 years could be asymptomatic. The purpose of this study is to justify routine implementation of transesophageal echocardiography (TEE) in the study of young patients with ischemic stroke. MATERIAL AND METHODS: 34 patients younger than 40 years with ischemic stroke were studied with TEE complemented with contrast study, looking for potential cardioembolic sources or intracardiac shunts. RESULTS: 19 patients were male and 15 female with ages between 18-40 years (average 31 years). None had cardiac signs or symptoms. Eleven anomalies were detected in 20 patients (58.8%); of these, only 3 were considered as probably coursing with cardioembolic sources: patent foramen ovale (PFO), mitral valve prolapse, and ventricular enlargement, which were found in 12 patients (35.29%). In patients with cardiovascular anomalies, we found a hypercoagulable state, associated in eight patients with PFO (four patients), two with valvular thickening, and two with valvular nodules. CONCLUSIONS: In patients younger than 40 years with ischemic stroke, TEE is useful in detecting direct and indirect cardiac sources of embolism, even in those patients with unsuspected cardiac disease.

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OBJECTIVE: Three-dimensional echocardiography represents a new era in the contemporary cardiology, because depicts the cardiac structures in their realistic forms. This information can not be obtained using a two-dimensional perspective. Although two-dimensional (2D) and M-mode echocardiography has greatly enhanced the ability to visualize the functioning heart for more than 30 years, 3D interpretative mental skills are necessary to compile the 2D slices of the complex 3D anatomy, particularly in congenital heart disease. CONCLUSIONS: At present, its additional morphological and functional information in surgical decision-making and the increasing number of clinical questions than can be answered justify the clinical use of this technique. In the future it will the study of "virtual" pathologic anatomy.

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The adequate study of the left atrial appendage is an echocardiographic challenge. The purpose of this study was to assess the ability of 3-dimensional echocardiography in reconstructing this potentially complex structure.

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