The aim of this study was the evaluation of the occurrence of pathogenic
Campylobacter
,
Escherichia coli
O157:H7,
E. coli
virulence genes and
Salmonella
spp. in different wastewater treatment plants ...(WWTPs) using a method based on an enrichment step and PCR. This method was sensitive enough to detect low levels (∼2 CFU100 ml
-1
of raw sewage) of all the investigated pathogens. In the WWTP samples,
E. coli
O157:H7 DNA and the
eae
gene were never found, but 33 % of influents and effluents exhibited amplicons corresponding to Shiga-like toxin I. Twenty-five percent of the influent and 8 % of the effluent exhibited the presence of Shiga-like toxin II.
Campylobacter jejuni
and
C. coli
DNA were identified in 50 and 25 % of the influents and in 8 and 25 % of the effluents, respectively.
Salmonella
spp. DNA was present in all the samples. Considering the results obtained, the method tested here offers a reliable and expeditious tool for evaluating the efficiency of the effluent treatment in order to mitigate contamination risk. Influent contamination by
Salmonella
spp. and
Campylobacter
spp. provides indirect information about their circulation; moreover, their presence in effluents underlines the role of WWTPs in the contamination of the receiving surface waters, which affects public health directly or indirectly.
Human enteric viruses are a major cause of waterborne diseases, and can be transmitted by contaminated water of all kinds, including drinking and recreational water. The objectives of the present ...study were to assess the occurrence of enteric viruses (enterovirus, norovirus, adenovirus, hepatitis A and E virus) in raw and treated wastewaters, in rivers receiving wastewater discharges, and in drinking waters. Wastewater treatment plants’ (WWTP) pathogen removal efficiencies by adenovirus quantitative real-time PCR and the presence of infectious enterovirus, by cell culture assays, in treated wastewaters and in surface waters were also evaluated. A total of 90 water samples were collected: raw and treated wastewaters (treated effluents and ultrafiltered water reused for industrial purposes), water from two rivers receiving treated discharges, and drinking water. Nested PCR assays were used for the identification of viral DNA/RNA, followed by direct amplicon sequencing. All raw sewage samples (21/21), 61.9 % of treated wastewater samples (13/21), and 25 % of ultrafiltered water samples (3/12) were contaminated with at least one viral family. Multiple virus families and genera were frequently detected. Mean positive PCRs per sample decreased significantly from raw to treated sewage and to ultrafiltered waters. Moreover, quantitative adenovirus data showed a reduction in excess of 99 % in viral genome copies following wastewater treatment. In surface waters, 78.6 % (22/28) of samples tested positive for one or more viruses by molecular methods, but enterovirus-specific infectivity assays did not reveal infectious particles in these samples. All drinking water samples tested negative for all viruses, demonstrating the effectiveness of treatment in removing viral pathogens from drinking water. Integrated strategies to manage water from all sources are crucial to ensure water quality.
Background
Reconstruction of posttraumatic bone defects represents a difficult challenge. The induced membrane technique is an effective two-stage procedure for bone defect reconstruction. To ...overcome the problems of autologous bone grafting, different graft substitutes have been investigated. The aim of the present study is to evaluate our clinical experience in reconstruction of critical posttraumatic bone defects using an induced membrane technique based on a combination of autologous graft and allograft (cancellous bone) enriched with platelet-rich plasma (PRP) and bone marrow concentrate aspirate (BMCA).
Materials and methods
Between 2009 and 2014, we reconstructed 18 posttraumatic bone defects in 16 patients. Their average length was 6.4 cm (range 1.6–13.2 cm). The defect location was the femur in nine cases (50%), the tibia in eight (44%) cases, and the humerus in one (6%) case. In all cases, we used a combination of autologous and cancellous allograft graft enriched with PRP and BMCA. Bone fixation was achieved using intramedullary nailing in 2 cases (11%), plating in 15 cases (66%), and external fixation in 1 case (6%).
Results
Both clinical and radiographic union were achieved in 13 (72%) cases (13 patients). Five (28%) cases (four patients) developed nonunion. Nonunion was observed in two of eight (25%) tibial defects and in three (33%) of nine femoral defects (ns). Three of 4 (75%) double defects had delayed union, whereas 2 of 14 (14%) single defects did not heal (
p
= 0.016). The average length of the 13 defects that united was 6 cm (range 1.6–11.8 cm), while the length of the 5 defects that did not unite was 10.3 cm (range 6–13.2 cm) (
p
= 0.009).
Conclusions
In this series using an induced membrane technique based on a combination of autograft and allograft enriched with BMCA and PRP, the healing rate was lower than in other series where autologous bone graft alone was employed. Nonunion was more frequent in longer and double defects. Further research aimed at developing effective alternative options to autogenous cancellous bone graft is desirable.
Level of evidence
: III
Abstract
The global action plan on antimicrobial resistance reports the necessity to develop standards and guidance for the presence of antimicrobial agents in the environment, especially in ...wastewater, highlighting its possible role in the antibiotic resistance spreading. In addition, the New European One Health Action Plan against Antimicrobial Resistance underlines the need to support research into knowledge gaps on the release of resistant microorganisms into the environment and their dissemination. The aim of this study was to evaluate the presence of Antibiotic Resistance Bacteria (ARB) and Antibiotic Resistance Genes (ARG) in wastewater treatment plants (WWTPs). At this scope, untreated sewage and treated effluents of three different WWTPs (A, B and C) were sampled for one year. Sample dilutions were plated on R2Agar added/not-added with 4 different antibiotics (ampicillin 32mg/L; tetracycline 16 mg/L; chloramphenicol 32 mg/L; sulfamethoxazole 50,4 mg/L) to evaluate the percentage of antibiotic resistant bacteria and their WWTPs removal rate (%). DNA extraction on the filter used to concentrate the wastewater samples was performed to reveal the ARG presence; subsequently specific PCRs for ARG (blaTEM, tetA, sul II, sul III) were carried out. ARB were detected in all samples analysed. The highest antibiotic resistance percentage was revealed in the sewage (mean 21,7%±4,8) and effluent (mean 21,1%±3,0) of the three wastewater treatment plants for sulfamethoxazole. Moreover, sul II was the most present gene in the samples (81% of all samples, 89 % of sewages and 72% of effluents). The lower WWTPs removal was recovered in the plant B for the tetracycline (95, 7%). The results obtained underlines the need to monitor WWTP as critical hot spot for the antibiotic resistance spreading also considering the One Health approach. Furthermore, the results obtained could suggest interventions to reduce the spread of the antibiotic resistance in the integrated urban water cycle.
Key messages
The information obtained could provide usefulness information about the role of wastewater treatment plant in the antibiotic resistance spreading. The results could contribute to suggest the interventions targeted to reduce the antibiotic resistance phenomenon in the integrated urban water cycle.
Celiac disease, an immune reaction to gluten causing nutrient malabsorption, and long-term glucocorticoid therapy adversely affect bone metabolism and increase fracture risk.
A patient with ...long-standing celiac disease on a strict gluten-free diet and long-term glucocorticoid therapy status post kidney transplant for Sjögren syndrome–induced interstitial nephritis presented for management of osteoporosis. Initial evaluation was notable for secondary hyperparathyroidism, which resolved after switching to a gluten-free calcium citrate supplement. Given normal serum total alkaline phosphatase (ALP) and parathyroid hormone (PTH), she began treatment of osteoporosis with abaloparatide. Two months later, she reported abrupt onset of diarrhea with significant weight loss. Biochemical investigation revealed a threefold increase in serum ALP level. As a precaution, abaloparatide was suspended, yet symptoms persisted with elevated ALP and PTH levels. Endoscopy revealed a celiac flare. The clinic-based pharmacist found that her pharmacy had inadvertently dispensed prednisone tablets containing wheat starch. A switch to a gluten-free formulation led to rapid resolution of the diarrhea with weight regain. Serum ALP and PTH levels normalized, and abaloparatide was resumed without biochemical abnormalities.
An unintended switch to a gluten-containing prednisone formulation resulted in uncontrolled celiac disease causing calcium malabsorption, secondary hyperparathyroidism, elevated ALP levels, and an interruption in osteoporosis therapy. Common supplements and drugs can be a hidden source of gluten. Collaboration with a clinic-based pharmacist enhances the detection and prevention of medication-induced adverse reactions.
This case highlights the importance of a careful review of gluten-containing medications and supplements in patients with celiac disease.
A simple method suitable for the first estimation of the presence of volatile (inert) impurities in physical vapour transport systems is reported. The method, which is based on the use of a ...one-dimensional steady-state model, allows to calculate the overall pressure in the system when experimental and calculated mass transport rates are matched.
When applied to the physical vapour transport of polycrystalline urotropine, the method proved suitable for evidencing the presence of volatile impurities whose partial pressures can be estimated to exceed the partial pressure of urotropine vapours of about one order of magnitude.
The PHOBOS detector at RHIC Back, B.B; Baker, M.D; Barton, D.S ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
03/2003, Letnik:
499, Številka:
2
Journal Article
Recenzirano
This manuscript contains a detailed description of the PHOBOS experiment as it is configured for the Year 2001 running period. It is capable of detecting charged particles over the full solid angle ...using a multiplicity detector and measuring identified charged particles near mid-rapidity in two spectrometer arms with opposite magnetic fields. Both of these components utilize silicon pad detectors for charged particle detection. The minimization of material between the collision vertex and the first layers of silicon detectors allows for the detection of charged particles with very low transverse momenta, which is a unique feature of the PHOBOS experiment. Additional detectors include a time-of-flight wall which extends the particle identification range for one spectrometer arm, as well as sets of scintillator paddle and Cherenkov detector arrays for event triggering and centrality selection.
The "osteoporosis disease" Guido, Giulio; Scaglione, Michelangelo; Fabbri, Luca ...
Clinical cases in mineral and bone metabolism,
05/2009, Letnik:
6, Številka:
2
Journal Article
Recenzirano
The authors analyze the reason that make osteoporosis a complex, widespread and poorly controlled "disease". In their work the authors take into account etiopathogenesis, epidemiology, risk factors, ...diagnosis and therapy. Author's attention is focused on management both of patient whit osteoporotic fractures and preventive therapy, which are aspects of the osteoporotic desease that should not be exclusive problems for the orthopaedic's sourgeon.
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