Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation that includes Crohn´s disease (CD) and ulcerative colitis (UC). Although the etiology is still unknown, some ...specific factors have been directly related to IBD, including genetic factors, abnormal intestinal immunity, and/or gut microbiota modifications. Recent findings highlight the primary role of the gut microbiota closely associated with a persistent inappropriate inflammatory response. This gut environment of dysbiosis in a susceptible IBD host can increasingly worsen and lead to colonization and infection with some opportunistic pathogens, especially Clostridium difficile. C. difficile is an intestinal pathogen considered the main cause of antibiotic-associated diarrhea and colitis and an important complication of IBD, which can trigger or worsen an IBD flare. Recent findings have highlighted the loss of bacterial cooperation in the gut ecosystem, as well as the pronounced intestinal dysbiosis, in patients suffering from IBD and concomitant C. difficile infection (CDI). The results of intestinal microbiota studies are still limited and often difficult to compare because of the variety of disease conditions. However, these data provide important clues regarding the main modifications and interrelations in the complicated gut ecosystem to better understand both diseases and to take advantage of the development of new therapeutic strategies. In this review, we analyze in depth the gut microbiota changes associated with both forms of IBD and CDI and their similarity with the dysbiosis that occurs in CDI. We also discuss the metabolic pathways that favor the proliferation or decrease in several important taxa directly related to the disease.
Chronic inflammatory neuropathies can present with a sensory ataxia due to involvement of dorsal root ganglia (DRG) or sensory nerves. Selective inflammatory involvement of sensory nerve roots ...proximal to the DRG has been postulated.
The authors identified 15 patients with a sensory syndrome and normal nerve conduction studies. Sensory nerve root involvement was suggested by either somatosensory evoked potential (SSEP) or imaging abnormalities. CNS disease was excluded.
All patients had gait ataxia, large fiber sensory loss, and paresthesias, and nine had frequent falls. The disease course was chronic and progressive (median duration 5 years, range 3 months to 18 years). Sural sensory nerve action potential amplitudes were preserved and SSEP abnormalities were consistent with sensory nerve root involvement. Five patients had enlargement of lumbar nerve roots on MRI with enhancement in three. The CSF protein was elevated in 13 of 14 patients tested. Three patients had lumbar sensory rootlet biopsies that showed thickened rootlets, decreased density of large myelinated fibers, segmental demyelination, onion-bulb formation, and endoneurial inflammation. Six patients who required aids to walk were treated with immune modulating therapy and all had marked improvement with four returning to normal ambulation.
Based on the described clinical features, normal nerve conduction studies, characteristic somatosensory evoked potential (SSEP) abnormality, enlarged nerve roots, elevated CSF protein, and inflammatory hypertrophic changes of sensory nerve rootlet tissue, we suggest the term chronic immune sensory polyradiculopathy (CISP) for this syndrome. This condition preferentially affects large myelinated fibers of the posterior roots, may respond favorably to treatment, and may be a restricted form of chronic inflammatory demyelinating polyradiculoneuropathy.
Airborne and ground‐based measurements during the CalNex (California Research at the Nexus of Air Quality and Climate Change) field study in May/June 2010 show a weekend effect in ozone in the South ...Coast Air Basin (SoCAB) consistent with previous observations. The well‐known and much‐studied weekend ozone effect has been attributed to weekend reductions in nitrogen oxide (NOx = NO + NO2) emissions, which affect ozone levels via two processes: (1) reduced ozone loss by titration and (2) enhanced photochemical production of ozone due to an increased ratio of non‐methane volatile organic compounds (VOCs) to NOx. In accord with previous assessments, the 2010 airborne and ground‐based data show an average decrease in NOx of 46 ± 11% and 34 ± 4%, respectively, and an average increase in VOC/NOxratio of 48 ± 8% and 43 ± 22%, respectively, on weekends. This work extends current understanding of the weekend ozone effect in the SoCAB by identifying its major causes and quantifying their relative importance from the available CalNex data. Increased weekend production of a VOC‐NOxoxidation product, peroxyacetyl nitrate, compared to a radical termination product, nitric acid, indicates a significant contribution from increased photochemical production on weekends. Weekday‐to‐weekend differences in the products of NOx oxidation show 45 ± 13% and 42 ± 12% more extensive photochemical processing and, when compared with odd oxygen (Ox = O3 + NO2), 51 ± 14% and 22 ± 17% greater ozone production efficiency on weekends in the airborne and ground‐based data, respectively, indicating that both contribute to higher weekend ozone levels in the SoCAB.
Key Points
A weekend ozone effect is observed in the South Coast Air Basin
Reductions in NOx emissions drive weekday and weekend differences in ozone
Photochemical ozone production contributes to observed weekend ozone levels
Background and aims: Anal sphincter weakness and rectal sensory disturbances contribute to faecal incontinence (FI). Our aims were to investigate the relationship between symptoms, risk factors, and ...disordered anorectal and pelvic floor functions in FI. Methods: In 52 women with “idiopathic” FI and 21 age matched asymptomatic women, we assessed symptoms by standardised questionnaire, anal pressures by manometry, anal sphincter appearance by endoanal ultrasound and magnetic resonance imaging (MRI), pelvic floor motion by dynamic MRI, and rectal compliance and sensation by a barostat. Results: The prevalence of anal sphincter injury (by imaging), reduced anal resting pressure (35% of FI), and reduced squeeze pressures (73% of FI) was higher in FI compared with controls. Puborectalis atrophy (by MRI) was associated (p<0.05) with FI and with impaired anorectal motion during pelvic floor contraction. Volume and pressure thresholds for the desire to defecate were lower, indicating rectal hypersensitivity, in FI. The rectal volume at maximum tolerated pressure (that is, rectal capacity) was reduced in 25% of FI; this volume was associated with the symptom of urge FI (p<0.01) and rectal hypersensitivity (p = 0.02). A combination of predictors (age, body mass index, symptoms, obstetric history, and anal sphincter appearance) explained a substantial proportion of the interindividual variation in anal squeeze pressure (45%) and rectal capacity (35%). Conclusions: Idiopathic FI in women is a multifactorial disorder resulting from one or more of the following: a disordered pelvic barrier (anal sphincters and puborectalis), or rectal capacity or sensation.
Airborne measurements of methane (CH4) and carbon dioxide (CO2) were taken over the rice growing region of California's Sacramento Valley in the late spring of 2010 and 2011. From these and ancillary ...measurements, we show that CH4 mixing ratios were higher in the planetary boundary layer above the Sacramento Valley during the rice growing season than they were before it, which we attribute to emissions from rice paddies. We derive daytime emission fluxes of CH4 between 0.6 and 2.0% of the CO2 taken up by photosynthesis on a per carbon, or mole to mole, basis. We also use a mixing model to determine an average CH4/CO2 flux ratio of −0.6% for one day early in the growing season of 2010. We conclude the CH4/CO2 flux ratio estimates from a single rice field in a previous study are representative of rice fields in the Sacramento Valley. If generally true, the California Air Resources Board (CARB) greenhouse gas inventory emission rate of 2.7 × 1010 g CH4/yr is approximately three times lower than the range of probable CH4 emissions (7.8–9.3 × 1010 g CH4/yr) from rice cultivation derived in this study. We attribute this difference to decreased burning of the residual rice crop since 1991, which leads to an increase in CH4 emissions from rice paddies in succeeding years, but which is not accounted for in the CARB inventory.
Key Points
CH4 levels in Sacramento Valley higher during rice growing season than before
Rice CH4 fluxes between 0.6 and 2.0% of CO2 taken up by photosynthesis
Inventoried emission rate is a factor of three lower than probably CH4 emissions
Single-footprint retrievals of carbon monoxide from the Atmospheric Infrared Sounder (AIRS) are evaluated using aircraft in situ observations. The aircraft data are from the HIAPER Pole-to-Pole ...Observations (HIPPO, 2009-2011), the first three Atmospheric Tomography Mission (ATom, 2016-2017) campaigns, and the National Oceanic and Atmospheric Administration (NOAA) Global Monitoring Laboratory (GML) Global Greenhouse Gas Reference Network aircraft program in years 2006-2017. The retrievals are obtained using an optimal estimation approach within the MUlti-SpEctra, MUlti-SpEcies, MUlti-SEnsors (MUSES) algorithm. Retrieval biases and estimated errors are evaluated across a range of latitudes from the subpolar to tropical regions over both ocean and land points.
An Aerodyne tunable infrared laser direct absorption spectrometer with a multipass cell with a 413 m pathlength for the detection of ethylene oxide (EtO) is presented (TILDAS-FD-EtO). This monitor ...achieves precisions of <75 ppt or <0.075 ppb s−1 and <20 ppt in 100 s (1σ). We demonstrate precisions averaging down to 4 ppt h−1 (1σ precision) when operated with frequent humidity-matched zeroes. A months-long record of 2022 ambient concentrations at a site in the eastern United States is presented. Average ambient EtO concentration is on the order of 18 ppt (22 ppt standard deviation, SD). Enhancement events of EtO lasting a few hours are observed, with peaks as high as 600 ppt. Back-trajectory simulations suggest an EtO source nearly 35 km away. This source along with another are confirmed as emitters through mobile near-source measurements, with downwind concentrations in the 0.5 to 700 ppb range depending on source identity and distance downwind.
Intraneural ganglia (IG) are an underappreciated but treatable cause of common peroneal neuropathy (CPN). This study was designed to determine if there are clinical measures that distinguish CPN ...caused by IG from CPN without a clear proximate cause.
Clinical and electrodiagnostic features of 22 cases of IG were compared in a case-control study to 11 cases of CPN with imaging negative for IG.
The IG group had a greater body mass index (30 vs 24; p < 0.005), more pain at the knee (52% of 22 vs 0% of 11; p < 0.005) or in the peroneal distribution (76% of 21 vs 27% of 1; p < 0.02), more frequent fluctuating weakness (48% of 21 vs 4% of 29; p < 0.01) with weight bearing (38%, p < 0.05), or a palpable mass (47% of 20, p < 0.01) at the fibular head. The IG group was less likely to present with a history of weight loss (0% vs 36%; p < 0.01), immobility (0% vs 21%; p < 0.03), or leg crossing (0% vs 80%; p < 0.05). There were no significant electrophysiologic differences.
Presenting clinical features increase the likelihood of intraneural ganglia and may assist selection of patients with common peroneal neuropathy for diagnostic peroneal nerve imaging.
Measurements of stratospheric carbon dioxide (CO$_2$) and nitrous oxide (N$_2$O) concentrations were analyzed to investigate stratospheric transport rates. Temporal variations in tropospheric CO$_2$ ...were observed to propagate into the stratosphere, showing that tropospheric air enters the lower tropical stratosphere continuously, ascends, and is transported rapidly (in less than 1 month) to both hemispheres. The mean age A of stratospheric air determined from CO$_2$ data is approximately 5 years in the mid-stratosphere. The mean age is mathematically equivalent to a conserved tracer analogous to exhaust from stratospheric aircraft. Comparison of values for A from models and observations indicates that current model simulations likely underestimate pollutant concentrations from proposed stratospheric aircraft by 25 to 100 percent.
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