Altered directed functional connectivity in temporal lobe epilepsy in the absence of interictal spikes: A high density EEG study.

OBJECTIVE In patients with epilepsy, seizure relapse and behavioral impairments can be observed despite the absence of interictal epileptiform discharges (IEDs). Therefore, the characterization of pathologic networks when IEDs are not present could have an important clinical value. Using Granger-causal modeling, we investigated whether directed functional connectivity was altered in electroencephalography (EEG) epochs free of IED in left and right temporal lobe epilepsy (LTLE and RTLE) compared to healthy controls. METHODS Twenty LTLE, 20 RTLE, and 20 healthy controls underwent a resting-state high-density EEG recording. Source activity was obtained for 82 regions of interest (ROIs) using an individual head model and a distributed linear inverse solution. Granger-causal modeling was applied to the source signals of all ROIs. The directed functional connectivity results were compared between groups and correlated with clinical parameters (duration of the disease, age of onset, age, and learning and mood impairments). RESULTS We found that: (1) patients had significantly reduced connectivity from regions concordant with the default-mode network; (2) there was a different network pattern in patients versus controls: the strongest connections arose from the ipsilateral hippocampus in patients and from the posterior cingulate cortex in controls; (3) longer disease duration was associated with lower driving from contralateral and ipsilateral mediolimbic regions in RTLE; (4) aging was associated with a lower driving from regions in or close to the piriform cortex only in patients; and (5) outflow from the anterior cingulate cortex was lower in patients with learning deficits or depression compared to patients without impairments and to controls. SIGNIFICANCE Resting-state network reorganization in the absence of IEDs strengthens the view of chronic and progressive network changes in TLE. These resting-state connectivity alterations could constitute an important biomarker of TLE, and hold promise for using EEG recordings without IEDs for diagnosis or prognosis of this disorder.

A Model Study of the Circulation in the Pearl River Estuary (PRE) and Its Adjacent Coastal Waters: 2. Sensitivity Experiments

The Princeton Ocean Model is used to study the circulation in the Pear River Estuary (PRE) and the adjacent coastal waters in the winter and summer seasons. Wong et al. [2003] compares the simulation results with the in situ measurements collected during the Pearl River Estuary Pollution Project (PREPP). In this paper, sensitivity experiments are carried out to examine the plume and the associated frontal dynamics in response to seasonal discharges and monsoon winds. During the winter, convergence between the seaward spreading plume water and the saline coastal water sets up a salinity front that aligns from the northeast to the southwest inside the PRE. During the summer the plume water fills the PRE at the surface and spreads eastward in the coastal waters in response to the prevailing southwesterly monsoon. The overall alignment of the plume is from the northwest to the southeast. The subsurface front is similar to that in the winter and summer except that the summer front is closer to the mouth and the winter front closer to the head of the estuary. Inside the PRE, bottom flows are always toward the head of the estuary, attributed to the density gradient associated with the plume front. In contrast, bottom flows in the shelf change from offshore in winter to onshore in summer, reflecting respectively the wintertime downwelling and summertime upwelling. Wind also plays an essential role in controlling the plume at the surface. An easterly wind drives the plume westward regardless winter or summer. The eastward spreading of the plume during the summer can be attributed to the southerly component of the wind. On the other hand, the surface area of the plume is positively proportional to the amount of discharge.

An evaluation of the Cypress Creek watershed for inorganic chemical load as it flows into Lake Houston

Background. The Cypress Creek is one of the main tributaries of Lake Houston, which provides drinking water to 21.4 million customers. Furthermore, the watershed is being utilized for contact and non-contact recreation, such as canoeing, swimming, hiking trail, and picnics. Water along the creek is impacted by numerous wastewater outfalls from both point and non-point sources. As the creek flows into Lake Houston, it carries both organic and inorganic contaminants that may affect the drinking water quality of this important water source reservoir. Objective. This study was carried out to evaluate the inorganic chemical load of the water in Cypress Creek along its entire length, from the headwaters in Waller County and up to the drainage into Lake Houston. The purpose was to determine whether there are hazardous concentrations of metals in the water and what would be the likely sources. Method. Samples were collected at 29 sites along the creek and analyzed for 29 metals, 17 of which were on the Environmental Protection Agency priority pollution list. Public access sites primarily at bridges were used for sample collection. Samples were transported on ice to the University Of Texas School Of Public Health laboratory, spiked with 2 ml HNO3 kept overnight in the refrigerator, and the following day transported to the EPA laboratory for analysis. Analysis was done by EPA Method 200.7-ICP, Method 200.8ICP/MS and Method 245.1-CVAAS. Results. Metals were present above the detection limits at 65% of sites. Concentrations of aluminum, iron, sodium, potassium, magnesium, and calcium, were particularly high at all sites. Aluminum, sodium, and iron concentrations greatly exceeded the EPA secondary drinking water standards at all sites. ^ Conclusion. The recreational water along Cypress Creek is impacted by wastewater from both permitted and non-permitted outfalls, which deposit inorganic substances into the water. Although a number of inorganic contaminants were present in the water, toxic metals regulated by the EPA were mostly below the recommended limits. However, high concentrations of aluminum, sodium, and iron in the Cypress Creek bring forward the issue of unauthorized discharges of salt water from mining, as well as industrial and domestic wastewater.^

Fate and effects of drilling wastes in a shallow estuarine mesocosm

To address concerns expressed about the possible effect of drilling mud discharges on shallow, low-energy estuarine ecosystems, a 12 month study was designed to detect alterations in water quality and sediment geochemistry. Each drilling mud used in the study and sediments from the study site were analyzed in the laboratory for chemical and physical characteristics. Potential water quality impacts were simulated by the EPA-COE elutriation test procedure. Mud toxicity was measured by acute and chronic bioassays with Mysidopsis bahia, Mercenaria mercenaria, and Nereis virens.^ For the field study, a relatively pristine, shallow (1.2 m) estuary (Christmas Bay, TX) without any drilling activity for the last 30 years was chosen for the study site. After a three month baseline study, three stations were selected. Station 1 was an external control. At each treatment station (2, 3), mesocosms were constructed to enclose a 3.5 m$\sp3$ water column. Each treatment station included an internal control site also. Each in situ mesocosm, except the controls, was successively dosed at a mesocosm-specific dose (1:100; 1:1,000; or 1:10,000 v/v) with 4 field collected drilling muds (spud, nondispersed, lightly-treated, and heavily-treated lignosulfonate) in sequential order over 1.5 months. Twenty-four hours after each dose, water exchange was allowed until the next treatment. Station 3 was destroyed by a winter storm. After the last treatment, the enclosures were removed and the remaining sites monitored for 6 months. One additional site was similarly dosed (1:100 v/v) with clean dredged sediment from Christmas Bay for comparison between dredged sediments and drilling muds.^ Results of the analysis of the water samples and field measurements showed that water quality was impacted during the discharges, primarily at the highest dose (1:100 v/v), but that elevated levels of C, Cr (T,F), Cr$\sp{+3}$ (T, F), N, Pb, and Zn returned to ambient levels before the end of the 24 hour exposure period or immediately after water exchange was allowed (Al, Ba(T), Chlorophyll ABC, SS, %T). Barium, from the barite, was used as a geochemical tracer in the sediments to confirm estimated doses by mass balance calculations. Barium reached a maximum of 166x background levels at the high dose mesocosm. Barium levels returned to ambient or only slightly elevated levels at the end of the 6 month monitoring period due to sediment deposition, resuspension, and bioturbation. QA/QC results using blind samples consisting of lab standards and spiked samples for both water and sediment matrices were within acceptable coefficients of variation.^ In order to avoid impacts on water quality and sediment geochemistry in a shallow estuarine ecosystem, this study concluded that a minimal dilution of 1:1,000 (v/v) would be required in addition to existing regulatory constraints. ^

MEASURING THE EFFECT OF ILLNESS ON THE EXPECTED REMAINING SERVICE TIME FOR THE ACTIVE DUTY ARMY: A LIFE TABLE APPROACH

A life table methodology was developed which estimates the expected remaining Army service time and the expected remaining Army sick time by years of service for the United States Army population. A measure of illness impact was defined as the ratio of expected remaining Army sick time to the expected remaining Army service time. The variances of the resulting estimators were developed on the basis of current data. The theory of partial and complete competing risks was considered for each type of decrement (death, administrative separation, and medical separation) and for the causes of sick time.^ The methodology was applied to world-wide U.S. Army data for calendar year 1978. A total of 669,493 enlisted personnel and 97,704 officers were reported on active duty as of 30 September 1978. During calendar year 1978, the Army Medical Department reported 114,647 inpatient discharges and 1,767,146 sick days. Although the methodology is completely general with respect to the definition of sick time, only sick time associated with an inpatient episode was considered in this study.^ Since the temporal measure was years of Army service, an age-adjusting process was applied to the life tables for comparative purposes. Analyses were conducted by rank (enlisted and officer), race and sex, and were based on the ratio of expected remaining Army sick time to expected remaining Army service time. Seventeen major diagnostic groups, classified by the Eighth Revision, International Classification of Diseases, Adapted for Use In The United States, were ranked according to their cumulative (across years of service) contribution to expected remaining sick time.^ The study results indicated that enlisted personnel tend to have more expected hospital-associated sick time relative to their expected Army service time than officers. Non-white officers generally have more expected sick time relative to their expected Army service time than white officers. This racial differential was not supported within the enlisted population. Females tend to have more expected sick time relative to their expected Army service time than males. This tendency remained after diagnostic groups 580-629 (Genitourinary System) and 630-678 (Pregnancy and Childbirth) were removed. Problems associated with the circulatory system, digestive system and musculoskeletal system were among the three leading causes of cumulative sick time across years of service. ^

Effects of overweight and obesity on economic outcomes among U.S. adults with kidney disease

Background. Kidney disease is a growing public health phenomenon in the U.S. and in the world. Downstream interventions, dialysis and renal transplants covered by Medicare's renal disease entitlement policy in those who are 65 years and over have been expensive treatments that have been not foolproof. The shortage of kidney donors in the U.S. has grown in the last two decades. Therefore study of upstream events in kidney disease development and progression is justified to prevent the rising prevalence of kidney disease. Previous studies have documented the biological route by which obesity can progress and accelerate kidney disease, but health services literature on quantifying the effects of overweight and obesity on economic outcomes in the context of renal disease were lacking. Objectives . The specific aims of this study were (1) to determine the likelihood of overweight and obesity in renal disease and in three specific adult renal disease sub-populations, hypertensive, diabetic and both hypertensive and diabetic (2) to determine the incremental health service use and spending in overweight and obese renal disease populations and (3) to determine who financed the cost of healthcare for renal disease in overweight and obese adult populations less than 65 years of age. Methods. This study was a retrospective cross-sectional study of renal disease cases pooled for years 2002 to 2009 from the Medical Expenditure Panel Survey. The likelihood of overweight and obesity was estimated using chi-square test. Negative binomial regression and generalized gamma model with log link were used to estimate healthcare utilization and healthcare expenditures for six health event categories. Payments by self/family, public and private insurance were described for overweight and obese kidney disease sub-populations. Results. The likelihood of overweight and obesity was 0.29 and 0.46 among renal disease and obesity was common in hypertensive and diabetic renal disease population. Among obese renal disease population, negative binomial regression estimates of healthcare utilization per person per year as compared to normal weight renal disease persons were significant for office-based provider visits and agency home health visits respectively (p=0.001; p=0.005). Among overweight kidney disease population health service use was significant for inpatient hospital discharges (p=0.027). Over years 2002 to 2009, overweight and obese renal disease sub-populations had 53% and 63% higher inpatient facility and doctor expenditures as compared to normal weight renal disease population and these result were statistically significant (p=0.007; p=0.026). Overweigh renal disease population had significant total expenses per person per year for office-based and outpatient associated care. Overweight and obese renal disease persons paid less from out-of-pocket overall compared to normal weight renal disease population. Medicare and Medicaid had the highest mean annual payments for obese renal disease persons, while mean annual payments per year were highest for private insurance among normal weight renal disease population. Conclusion. Overweight and obesity were common in those with acute and chronic kidney disease and resulted in higher healthcare spending and increased utilization of office-based providers, hospital inpatient department and agency home healthcare. Healthcare for overweight and obese renal disease persons younger than 65 years of age was financed more by private and public insurance and less by out of pocket payments. With the increasing epidemic of obesity in the U.S. and the aging of the baby boomer population, the findings of the present study have implications for public health and for greater dissemination of healthcare resources to prevent, manage and delay the onset of overweight and obesity that can progress and accelerate the course of the kidney disease.^

Clostridium difficile infection (CDI) in HIV-positive patients

The main aim of this study was to look at the association of Clostridium difficile infection (CDI) and HIV. A secondary goal was to look at the trend of CDI-related deaths in Texas from 1999-2011. To evaluate the coinfection of CDI and HIV, we looked at 2 datasets provided by CHS-TDSHS, for 13 years of study period from 1999-2011: 1) Texas death certificate data and 2) Texas hospital discharge data. An ancillary source of data was national level death data from CDC. We did a secondary data analysis and reported the age-adjusted death rates (mortality) and hospital discharge frequencies (morbidity) for CDI, HIV and for CDI+HIV coinfection.^ Since the turn of the century, CDI has reemerged as an important public health challenge due to the emergence of hypervirulent epidemic strains. From 1999-2011, there has been a significant upward trend in CDI-related death rates; in the state of Texas alone, CDI mortality rate has increased 8.7 fold in this time period at the rate of 0.2 deaths per year per 100,000 individuals. On the contrary, mortality due to HIV has decreased by 46% and has been trending down. The demographic groups in Texas with the highest CDI mortality rates were elderly aged 65+, males, whites and hospital inpatients. The epidemiology of C. difficile has changed in such a way that it is not only staying confined to these traditional high-risk groups, but is also being increasingly reported in low-risk populations such as healthy people in the community (community acquired C. difficile), and most recently immunocompromised patients. Among the latter, HIV can worsen the adverse health outcomes of CDI and vice versa. In patients with CDI and HIV coinfection, higher mortality and morbidity was found in young & middle-aged adults, blacks and males, the same demographic population that is at higher risk for HIV. As with typical CDI, the coinfection was concentrated in the hospital inpatients. Of all the CDI-related deaths in USA from 1999-2010, in the 25-44 year age group, 13% had HIV infection. Of all CDI-related inpatient hospital discharges in Texas from 1999-2011, in patients 44 years and younger, 17% had concomitant HIV infection. Therefore, HIV is a possible novel emerging risk factor for CDI.^

Geochemistry and sea-surface temperature reconstruction for sediment cores of the Iberian Margin

Biogenic records of the marine palaeoproductivity (carbonates, organic carbon, and C37 alkenones) and the molecular stratigraphy of past sea surface temperatures (SSTs; UK'37) were studied at high resolution in two cores of the Iberian Margin. The comparison of these records indicates that the oceanographic conditions switched abruptly during the past 160 kyr between three kinds of regimes. A first regime with high (17-22°C) SST and low productivity typifies the interglacial periods, marine isotopic stages (MIS) 5 and 1. Several periods during MIS 6, 2, and the terminations II and I are characterised by about 4-5°C colder SST and a higher organic matter accumulation, both of which define the second regime. This anticorrelation between SST and marine productivity suggests that these variations are related to the intensity of the coastal upwelling. By contrast with this upwelling behaviour, extremely low biological productivity and very cold SST (6-12°C) occurred during short phases of glacial MIS 6, 4, and 2, and as abrupt events (~1 kyr or less) during MIS 3. The three oceanographic regimes are consistent with micropalaeontological changes in the same cores based on foraminifera and diatoms. The general trend of these hydrologic changes follows the long-term glacial/interglacial cycle, but the millennium scale variability is clearly related to Heinrich events and Dansgaard-Oeschger cycles. Strengthening of the upwelling corresponds probably to an intensification of the subtropical atmospheric circulation over the North Atlantic which was influenced by the presence of continental ice sheets. However, extreme glacial conditions due to massive discharges of icebergs interrupted the upwelling. Interestingly, both terminations II and I coincided with strong but transient intensification of the upwelling.

Sedimentology, magnetics and chemistry on palaeolake core D100 from the Gobi Desert

The Gaxun Nur Basin in arid China is tectonically influenced by the left-lateral displacements along the Gobi-Altay and Qilian Shan shear zones, resulting in a large pull-apart basin with strong subsidence in the interior. The up to 300 m thick basin fills consist of fluvio-lacustrine fine-grained deposits mainly transported by river discharges from the Tibetan Plateau. They led to a large depositional area of more than 28,000 qkm in size with presently dry terminal lakes at the outer edges. This vast area serves as a main source for loess transport to south-eastern regions of China (Loess Plateau) caused by the variable winter monsoon. Based on geochemical and sedimentological analyses of the sediment core D100 retrieved from a deep drilling in the centre of the Gaxun Nur Basin following questions have to be answered: 1. Reconstruction of the water balance and determination of hydrological cycles during interglacial and glacial periods. 2. Reconstructing variations in lacustrine environment and aeolian activities with respect to transitional phases fro, warm to cold stages (MIS 4 to 5 and older stages). 3. Establishing a sustainable chronology for the last 250 ka.

Results of modelled Arctic river discharge trends since 7 ka BP

The Arctic hydrological cycle throughout the Holocene is analyzed based on the results of transient simulations with the coupled atmosphere-ocean circulation model ECHO-G. The results suggest a ~ 2 % increase of mid-Holocene to preindustrial Arctic river discharges for the Eurasian continent. However, rivers of the North America Arctic realm show a moderate runoff decline of approximately 4 to 5 % for the same period. The total river discharge into the Arctic Ocean has remained at an approximately constant preindustrial level since the mid Holocene. The positive discharge trend within Eurasia is caused by a more rapid decrease in local net evaporation compared to a smaller decline in advected moisture and hence precipitation. This effect is neither recognized within the North American Arctic domain nor in the far eastern part of the Eurasian Arctic realm. A detailed comparison of these model findings with a variety of proxy studies is conducted. The collected proxy records show trends of continental surface temperatures and precipitation rates that are consistent with the simulations. A continuation of the transient Holocene runs for the 19th and 20th century with increased greenhouse gases indicates an increase of the total river influx into the Arctic Ocean of up to 7.6 %. The Eurasian river discharges increase by 7.5 %, the North American discharges by up to 8.4 %. The most rapid increases have been detected since the beginning of the 20th century. These results are corroborated by the observed rising of Arctic river discharges during the last century which is attributed to anthropogenic warming. The acceleration of the Arctic hydrological cycle in the 20th century is without precedence in the Holocene.

Prioridades de manejo del riesgo de contaminación del recurso hídrico por efluentes

En el presente trabajo se propone y desarrolla una herramienta de "Gestión del riesgo de contaminación del recurso hídrico", inspirada en métodos comúnmente utilizados en las evaluaciones de impacto ambiental tales como la Matriz de importancia y la Evaluación de riesgo. Dicha herramienta se aplica en el oasis del río Tunuyán Inferior, cuya cuenca se localiza en el sector E de la Cordillera de Los Andes, provincia de Mendoza, Argentina. El método propuesto consiste en la determinación, en cada Unidad de Manejo (UM)3 de: 1. la vulnerabilidad del territorio; 2. la peligrosidad del efluente; 3. las clases de riesgo; 4. el índice prioridad de manejo del riesgo, variables que luego se traducen cartográficamente. Las bases de datos generadas pueden ser analizadas desde distintos enfoques y, a su vez, actualizadas a medida que se van profundizando los conocimientos acerca de los atributos que hacen a la peligrosidad del vertido (ej.: tipo de efluente, tiempo, caudal y lugar de descarga) y a la vulnerabilidad de la UM (ej.: tipo de acuífero, profundidad de nivel freático, permeabilidad del terreno, calidad del suelo, etc.). Esta herramienta de gestión genera un diagnóstico dinámico de la situación, ya que puede ser perfeccionado a través de la investigación de las variables que intervienen en el proceso de contaminación del agua por efluentes. Además, es una herramienta práctica porque jerarquiza las prioridades de gestión, de acuerdo con un orden de aplicación gradual de medidas de manejo del riesgo de contaminación. Teniendo en cuenta la tendencia mundial de reducción de glaciares por efecto del calentamiento global y su impacto negativo en los caudales de los ríos, es indispensable y urgente establecer prioridades de gestión para preservar la calidad del recurso hídrico.

Calidad del agua en el área regadía del Río Mendoza (Argentina)

El río Mendoza conforma el oasis norte que es el más importante de la provincia. El crecimiento urbano ha avanzado sobre áreas originalmente agrícolas, rodeando la red de canales y desagües, que también recibe los desagües pluviales urbanos, producto de tormentas convectivas. La actividad antropogénica utiliza el recurso para bebida, saneamiento, riego, recreación, etc., y vuelca sus excedentes a la red, contaminándola. Para conocer la calidad del agua de esta cuenca se seleccionaron, estratégicamente, 15 sitios de muestreo: 3 a lo largo del río y a partir del dique derivador Cipolletti (R_I a R_III), 5 en la red de canales (C_I a C_V) y 7 ubicados en los colectores de drenaje (D_I a D_VII). Se realizaron los siguientes análisis físico-químicos y microbiológicos; en el río y en la red de canales: conductividad eléctrica, temperatura, pH, aniones y cationes (cálculo de RAS), oxígeno disuelto (OD), sólidos sedimentables, demanda química de oxígeno (DQO), bacterias aerobias mesófilas (BAM), coliformes totales y fecales y metales pesados. En la red de drenaje sólo se realizaron los cuatro primeros. Los resultados de los análisis, se incorporaron a una base de datos y se sometieron a un análisis estadístico descriptivo e inferencial. Este último consistió en la aplicación de diversas pruebas en busca de posibles diferencias entre los sitios de muestreo, para cada variable respuesta, a un α = 0.05. Se realizó el análisis de la varianza de efectos fijos y de efectos aleatorios y se probaron los supuestos de homocedasticidad y de normalidad de los errores. En el caso de violación de los supuestos, se utilizó la prueba de Kruskal- Wallis. Se compararon los siguientes sitios de muestreo entre sí: ríos, R_I-canales y drenajes. Se concluyó que hay un aumento significativo de la salinidad y la sodicidad en R_II, que los cambios de calidad ocurridos entre R_II y R_III podrían deberse al aporte de otras aguas. Con respecto a la comparación de los parámetros entre la cabeza del sistema (R_I) y la red de canales se puede decir que los aportes realizados por los escurrimientos urbanos ubicados hacia el oeste del canal Cacique Guaymallén, sumados a los vuelcos de Campo Espejo (detectados en C_II), incrementan significativamente la salinidad (+55 %) y sodicidad del agua (+95 %) respecto del punto R_I, aunque el valor de sodicidad sigue siendo bajo. También se han encontrado incrementos de salinidad (+80 %), de DQO (+1159 %) y BAM (+2873 %) con lógica disminución de OD (-58 %) en el punto C_V (canal Auxiliar Tulumaya) respecto del punto R_I, ocasionados por aportes urbanos (Gran Mendoza) sumados a la carga contaminante del canal Pescara. Los metales pesados no presentan grandes diferencias entre sitios de muestreo.

Impacto clínico de la pancitopenia en pacientes hospitalizados

Objetivo: Determinar etiología, manifestaciones clínicas, morbimortalidad y recursos diagnósticos y terapéuticos utilizados en pacientes internados con pancitopenia. Material y métodos: Estudio protocolizado, descriptivo y observacional de 14 meses. Criterios de inclusión: pacientes internados con pancitopenia definida por hemoglobina (Hb) <12 g/dL; plaquetas <150.000/ mL y leucocitos <3.800/mL. Los datos fueron analizados con Epi Info 6.04. Resultados: Se diagnosticaron 54 casos de pancitopenia. Prevalencia: 22/1.000 egresos. Edad media: 48,72 años (DS±20,64); 29,63% fueron > 65 años y 53,70% hombres. Permanencia media: 17,13 días (DS±13,22) vs 7,25 días (DS±5,4) del Servicio (p<0.0001). Charlson medio: 7,16 (DS±2,96) y APACHEII medio: 12 (DS±5,04). El 83,33% (45/54, IC95%70,71-92,08) de las pancitopenias fueron secundarias a compromiso medular, 22 casos (40,74%; IC95%27,57-54,97) postquimioterapia (15 en neoplasias oncohematológicas y 7 en sólidas), 11 (20,37%; IC95%10,63-33,53) por mieloptisis y 4 casos (7,41%; IC95%2,06-17,89) por megaloblastosis. El 16,66% (9/54; IC95%7,92- 29,29) fue secundaria a hiperesplenismo y el 16,66% asociadas a infecciones (3 casos por SIDA). Se realizó estudio de médula ósea en 19 casos (35,18%). El 96,29% (IC95%87,25-99,55) presentó comórbidas. El síndrome de respuesta inflamatoria sistémica (85,19%), síndrome anémico (77,8%) y púrpura (50%) fueron las manifestaciones clínicas más frecuentes. Presentó sepsis el 81,48% (IC95%68,57-90,75) y el 29,63% (IC95%17,98-46,31) hemorragias. El 81,48% tuvo infecciones; el 50% de origen nosocomial y el 65,91% clínicamente documentadas. El 34,09% (IC95%20,49-49,92) tuvo aislamiento microbiológico, con hemocultivos positivos en 29,55%. El 51,85% (IC95%37,84-65,66) desarrolló neutropenia febril (75% postquimioterapia). El 64,81% recibió hemoderivados y factores estimulantes de colonias (G-CSF) el 46,34% (IC95%32,62-60,39). La mortalidad fue mayor a la media global del Servicio (16,66 vs 8,65%)(p=0.07).- Conclusiones: Las pancitopenias en pacientes hospitalizados se caracterizaron por ser secundarias a compromiso medular, hiperesplenismo e infecciones, asociarse a permanencia prolongada, altos índices de comorbilidad, complicaciones infecciosas, y mayor mortalidad que la media global del Servicio.

Contaminación por fosfatos en el oasis bajo riego del río Mendoza

El oasis bajo riego del río Mendoza, en la provincia argentina del mismo nombre -al igual que casi todas las ciudades en la actualidadpresenta problemas de avance de la urbanización sobre las tierras agrícolas, multiplicidad de usuarios y disminución de la disponibilidad del recurso hídrico, tanto en cantidad como en calidad. Si bien se destinan esfuerzos e inversiones tendientes a asegurar la disponibilidad de agua (mejora de eficiencias, ahorro de agua) no pasa lo mismo en relación con la preservación de su calidad. La agricultura mendocina resulta víctima de la contaminación producida por la urbanización y la industria a través del vuelco (puntual y/o difuso) de sus efluentes a la red de riego. Estudios realizados en el Oasis Norte de Mendoza pusieron de manifiesto la existencia de altos niveles de contaminación fosfatada en las aguas del río Mendoza. El presente trabajo tuvo como objetivo evaluar la evolución espacio-temporal y detectar las fuentes de esta contaminación. Los resultados del diagnóstico basado en una serie de muestreos realizados en 2003 - 2009 ponen de relieve la existencia de una moderada contaminación por fosfatos en las aguas del río Mendoza que riegan el Oasis Norte provincial. Asimismo, se detectaron niveles considerablemente altos de fosfatos en tres sitios específicos del oasis: 1. la superficie regadía servida por los canales Cacique Guaymallén y Jocolí -se observa un incremento de seis veces el contenido de fosfatos del agua: de 0,2 mg L-1 (R I) a 1,2 mg L-1 (C II)-; en este último sitio sólo se riega un pequeño sector que se aproxima a las 7.300 ha; 2. la superficie regada por el Colector Pescara aguas abajo del punto D VIII (1.250 ha), en la que los valores medios arrojaron un contenido diecisiete veces mayor (8,5 mg L-1 ) que los del sitio D I (0,49 mg L-1 ) que recibe desagües agrícolas y urbano pluviales; 3. la zona del Bajo río Mendoza (en esta zona se registró un aumento de dieciséis veces más fosfatos entre la parte media y la cola del sistema, con valores medios de 0,2 mg L-1 en el sitio R II y de 3,25 mg L-1 en R III).

Image analysis from TEM and AFM micrograph, Table S1, S2, S3, Figure S1, Figure S2

We report on metal enrichment along a natural pH gradient owing to increased CO2 degassing at cold, shal- low seeps of Vulcano Island in the Mediterranean Sea, off Sicily. We assessed composition of unfiltered and filtered seawater (b100 nm) along acidic zones ranging between ambient and pH 5, and showed that most seep derived elements are present as nanoclusters which then aggregate into larger colloids while mixing with ambient seawater along a pH gradient. Size and elemental composition of such naturally occurring nanoparticles assessed by modern characterisation methods were in good agreement with the results from conventional analytical methods. We provide analytical evidence for the presence in the water column of a large fraction of seep derived ele- ments (e.g. approximately 50% of iron, over 80% of Mn, 100% of Cr, S and Zn) in the form of nano sized par- ticles (e.g. b100 nm) even at typical open ocean pHs. We launch in situ sampling protocols and sample preparation procedures for multi-method suitable to obtain accurate measurements on nanoparticles from environmental samples. Based on our results a first insight to the formation of natural nanoparticles at cold CO2 seeps is presented and the persistence of such nano-clusters in the surrounding seawater is stipulated.