Hématome des muscles ilio-psoas: rappel des éléments diagnostiques

Introduction: La survenue d'une hémorragie dans les muscles iliopsoasconstitue une pathologie grave, dont le diagnostic est souventtardif et grevé d'une morbidité importante. Sa présentation cliniquedoit être reconnue précocement, en particulier par les médecins depremier recours.Cas clinique: Un patient de 65 ans est admis aux urgences en raisonde douleurs invalidantes de la jambe droite, prédominant sur la faceantérieure de la cuisse. Les douleurs irradient dans le pli inguinal, leflanc, la région lombaire, ainsi que la hanche droite. Elles sont associéesà une parésie du quadriceps droit. Le patient a bénéficié en2006 d'un remplacement de valve aortique, avec implantation d'unevalve mécanique motivant une anticoagulation par acenocoumarol.Il présente par ailleurs une parésie sur le territoire du nerf sciatiquedroit, après fracture du bassin en 1970. Le diagnostic est évoqué auvu d'une antioagulation supra-thérapeutique (INR 5).Un CT-scan de l'abdomen confirmera un important hématome(11 x 7 cm) du muscle iliaque droit (fig. 1) qui sera drainé chirurgicalement,après réversion partielle de la crase, permettant une évolutionfavorable.Discussion: Les hématomes des muscles ilio-psoas surviennentclassiquement de manière spontanée. Les symptômes sont peu spécifiques,à type de douleurs diffuses abdominales, lombaires ou crurales,de paresthésies, de limitation fonctionnelle ou de chute isoléede l'hémoglobine (Hb). Les patients sous anticoagulants (héparine,acenocoumarol) ou présentant des troubles de la coagulation (hémophilie,thrombopathie, maladie de von Willebrand) sont particulièrementà risque. Les complications sont fréquentes: compressions dunerf fémoral (avec hypoesthésie, parésie du quadriceps ou abolitiondu réflexe rotulien), anémie, état de choc. Le traitement implique lacorrection des troubles de la coagulation, ainsi qu'un suivi clinique,radiologique et biologique (Hb) régulier. Le traitement conservateurest proposé lors d'hématome de petite taille, si le patient est stable etpeu symptomatique. Dans les autres cas, un drainage chirurgical parvoie ouverte ou par voie percutanée est recommandé. L'embolisationartérielle s'affiche comme une future option thérapeutique.Conclusions: Ce cas illustre les différents éléments cliniques etbiologiques qui orientent précocement vers le diagnostic d'hématomedes muscles ilio-psoas. Il devrait favoriser l'évocation d'une pathologierare, permettant de garantir un diagnostic précoce.

Sellu ja paperiteollisuuden jätevesien tertiäärikäsittelyn kemikaloinnin optimointi

Kuluneen vuosikymmenen aikana metsäteollisuuden päästöt ympäristöön ovat pienentyneet huomattavasti tuotantomäärien kasvustahuolimatta. Lainsäädännön myötä lupa-arvot tiukentuvat edelleen joten olemassa olevia puhdistus prosesseja on parannettava ja niiden rinnalle on kehitettävä uusia, yhä tehokkaampia menetelmiä. Aquaflow Oy suunnittelee jäteveden puhdistamoja sellu- ja paperiteollisuuteen. Kilpailun kiristyessä kilpailuetua haetaan jatkuvan kehittymisen kautta. Yhä useammilla jäteveden puhdistamoilla tarvitaan teriäärikäsittely biohajoamattoman aineksen poistamiseen. Tertiäärikäsittely on käyttökustannuksiltaan kallis kemikaali kulutuksensa vuoksi. Tässä työssä pyrittiin optimoimaan tertiääriprosessin kemikaalien syöttöä. Lisäksi selvitettiin millaisissa oloissa keskeiset saostus ja flokkaus prosessit toimivatparhaiten, sekä mitkä tekijät vaikuttavat merkittävästi jäteveden kemiallisen käsittelyn tulokseen. Saatujen tulosten perusteella kemikaalien sekoituksen tehostuksen seurauksena kemikaali määriä voidaan pienentää, samalla puhdistustulos paranee ja jäännöskemikaalien määrä pienenee. pH:n säätö on olennainen osa prosessin toiminnan kannalta, jos pH ei ole kemikaalien toiminta alueella ei puhdistusta tapahdu ja kemikaalit kulkeutuvat luontoon. Tertiäärikäsittelyyn tulevan jäteveden online seurannan avulla juuri oikea kemikaaliannos olisihelpompaa määrittää kuin päivän viiveellä tulevien laboratorio analyysien perusteella ja yli-/ali annostukselta vältyttäisiin

Assessing Patient's belief on HIV testing before elective surgery: place for improvements in Switzerland

Background and aim of the study: In Switzerland no HIV test is performed without the patient's consent based on a Voluntary Counseling and Testing policy (VCT). We hypothesized that a substantial proportion of patients going through an elective surgery falsely believed that an HIV test was performed on a routine basis and that the lack of transmission of result was interpreted as being HIV negative. Material and method: All patients with elective orthopedic surgery during 2007 were contacted by phone in 2008. A structured questionnaire assessed their belief about routine preoperative blood analysis (glycemia, coagulation capacity, HIV serology and cholesterol) as well as result awareness and interpretation. Variables included age and gender. Analysis were conducted using the software JMP 6.0.3. Results: 1123 patients were included. 130 (12%) were excluded (i.e. unreachable, unable to communicate on the phone, not operated). 993 completed the survey (89%). Median age was 51 (16-79). 50% were female. 376 (38%) patients thought they had an HIV test performed before surgery but none of them had one. 298 (79%) interpreted the absence of result as a negative HIV test. A predictive factor to believe an HIV test had been done was an age below 50 years old (45% vs 33% for 16-49 years old and 50-79 years old respectively, p <0.001). No difference was observed between genders. Conclusion: In Switzerland, nearly 40% of the patients falsely thought an HIV test had been performed on a routine basis before surgery and were erroneously reassured about their HIV status. These results should either improve the information given to the patient regarding preoperative exams, or motivate public health policy to consider HIV opt-out screening, as patients are already expecting it.

Molecular tracking of coagulase-negative staphylococcal isolates from catheter-related infections

Three molecular typing methods (pulsed-field electrophoresis, localization of the mecA gene, and probing the vicinity of mec) have been used for the characterization of 40 catheter-related isolates of coagulase-negative staphylococci (CNS) in 14 patients admitted to the same hospital. The 40 isolates yielded 14 different SmaI banding patterns and corresponding unique localizations of mecA, each associated with a unique ClaI mecA polymorph. In 6 of the 14 patients the contaminated skin at the catheter entry site was the source of 4 local infections and 2 cases of bacteremia. A contaminated hub was the origin of 2 local infections and 4 cases of bacteremia in 6 more patients. The remaining 2 patients had positive cultures from both skin and catheter hub. In each bacteremic patient, the CNS recovered from catheter-related sites (tip, skin, and/or hub) and the CNS recovered from blood were identical, but each of these matching isolates was unique to the particular patient, indicating a low rate of cross-infection from patient to patient. Although classical methods for typing CNS (e.g., biotype and antibiotype) are readily available for most hospital laboratories, they have limitations concerning reproducibility and discriminatory power. Molecular epidemiologic techniques can provide powerful support to traditional techniques in determining the etiologic role of CNS in the disease process

Development of fluid conduits in the auriferous shear zones of the Hutti Gold Mine, India: evidence for spatially and temporally heterogeneous fluid flow

The gold mineralization of the Hutti Mine is hosted by nine parallel, N - S trending, steeply dipping, 2 - 10 m wide shear zones, that transect Archaean amphibolites. The shear zones were formed after peak metamorphism during retrograde ductile D, shearing in the lower amphibolite facies. They were reactivated in the lower to mid greenschist facies by brittle-ductile D-3 shearing and intense quartz veining. The development of a S-2-S-3 crenulation cleavage facilitates the discrimination between the two deformation events and contemporaneous alteration and gold mineralization. Ductile D, shearing is associated with a pervasively developed distal chlorite - sed cite alteration assemblage in the outer parts of the shear zones and the proximal biotite-plagioclase alteration in the center of the shear zones. D3 is characterized by development of the inner chlorite-K-feldspar alteration, which forms a centimeter-scale alteration halo surrounding the laminated quartz veins and replaces earlier biotite along S-3. The average size of the laminated vein systems is 30-50 m along strike as well as down-dip and 2-6 m in width. Mass balance calculations suggest strong metasomatic changes for the proximal biotite-plagioclase alteration yielding mass and volume increase of ca. 16% and 12%, respectively. The calculated mass and volume changes of the distal chlorite-sericite alteration (ca. 11%, ca. 8%) are lower. The decrease in 6180 values of the whole rock from around 7.5 parts per thousand for the host rocks to 6-7 parts per thousand for the distal chlorite-sericite and the proximal biotite-plagioclase alteration and around 5 parts per thousand for the inner chlorite-K-feldspar alteration suggests hydrothermal alteration during two-stage deformation and fluid flow. The ductile D-2 deformation in the lower amphibolite facies has provided grain scale porosities by microfracturing. The pervasive, steady-state fluid flow resulted in a disseminated style of gold-sulfide mineralization and a penetrative alteration of the host rocks. Alternating ductile and brittle D3 deformation during lower to mid greenschist facies conditions followed the fault-valve process. Ductile creep in the shear zones resulted in a low permeability environment leading to fluid pressure build-up. Strongly episodic fluid advection and mass transfer was controlled by repeated seismic fracturing during the formation of laminated quartz(-gold) veins. The limitation of quartz veins to the extent of earlier shear zones indicate the importance of preexisting anisotropies for fault-valve action and economic gold mineralization. (C) 2003 Elsevier B.V. All rights reserved.

Wet Oxidation of Concentrated Wastewaters: Process Combination and Reaction Kinetic Modeling

The accumulation of aqueous pollutants is becoming a global problem. The search for suitable methods and/or combinations of water treatment processes is a task that can slow down and stop the process of water pollution. In this work, the method of wet oxidation was considered as an appropriate technique for the elimination of the impurities present in paper mill process waters. It has been shown that, when combined with traditional wastewater treatment processes, wet oxidation offers many advantages. The combination of coagulation and wet oxidation offers a new opportunity for the improvement of the quality of wastewater designated for discharge or recycling. First of all, the utilization of coagulated sludge via wet oxidation provides a conditioning process for the sludge, i.e. dewatering, which is rather difficult to carry out with untreated waste. Secondly, Fe2(SO4)3, which is employed earlier as a coagulant, transforms the conventional wet oxidation process into a catalytic one. The use of coagulation as the post-treatment for wet oxidation can offer the possibility of the brown hue that usually accompanies the partial oxidation to be reduced. As a result, the supernatant is less colored and also contains a rather low amount of Fe ions to beconsidered for recycling inside mills. The thickened part that consists of metal ions is then recycled back to the wet oxidation system. It was also observed that wet oxidation is favorable for the degradation of pitch substances (LWEs) and lignin that are present in the process waters of paper mills. Rather low operating temperatures are needed for wet oxidation in order to destruct LWEs. The oxidation in the alkaline media provides not only the faster elimination of pitch and lignin but also significantly improves the biodegradable characteristics of wastewater that contains lignin and pitch substances. During the course of the kinetic studies, a model, which can predict the enhancements of the biodegradability of wastewater, was elaborated. The model includes lumped concentrations suchas the chemical oxygen demand and biochemical oxygen demand and reflects a generalized reaction network of oxidative transformations. Later developments incorporated a new lump, the immediately available biochemical oxygen demand, which increased the fidelity of the predictions made by the model. Since changes in biodegradability occur simultaneously with the destruction of LWEs, an attempt was made to combine these two facts for modeling purposes.

Patents in the Information and Communications Technology Sector - Development Trends, Problem Areas and Pressures for Change

The patent system was created for the purpose of promoting innovation by granting the inventors a legally defined right to exclude others in return for public disclosure. Today, patents are being applied and granted in greater numbers than ever, particularly in new areas such as biotechnology and information andcommunications technology (ICT), in which research and development (R&D) investments are also high. At the same time, the patent system has been heavily criticized. It has been claimed that it discourages rather than encourages the introduction of new products and processes, particularly in areas that develop quickly, lack one-product-one-patent correlation, and in which theemergence of patent thickets is characteristic. A further concern, which is particularly acute in the U.S., is the granting of so-called 'bad patents', i.e. patents that do not factually fulfil the patentability criteria. From the perspective of technology-intensive companies, patents could,irrespective of the above, be described as the most significant intellectual property right (IPR), having the potential of being used to protect products and processes from imitation, to limit competitors' freedom-to-operate, to provide such freedom to the company in question, and to exchange ideas with others. In fact, patents define the boundaries of ownership in relation to certain technologies. They may be sold or licensed on their ownor they may be components of all sorts of technology acquisition and licensing arrangements. Moreover, with the possibility of patenting business-method inventions in the U.S., patents are becoming increasingly important for companies basing their businesses on services. The value of patents is dependent on the value of the invention it claims, and how it is commercialized. Thus, most of them are worth very little, and most inventions are not worth patenting: it may be possible to protect them in other ways, and the costs of protection may exceed the benefits. Moreover, instead of making all inventions proprietary and seeking to appropriate as highreturns on investments as possible through patent enforcement, it is sometimes better to allow some of them to be disseminated freely in order to maximize market penetration. In fact, the ideology of openness is well established in the software sector, which has been the breeding ground for the open-source movement, for instance. Furthermore, industries, such as ICT, that benefit from network effects do not shun the idea of setting open standards or opening up their proprietary interfaces to allow everyone todesign products and services that are interoperable with theirs. The problem is that even though patents do not, strictly speaking, prevent access to protected technologies, they have the potential of doing so, and conflicts of interest are not rare. The primary aim of this dissertation is to increase understanding of the dynamics and controversies of the U.S. and European patent systems, with the focus on the ICT sector. The study consists of three parts. The first part introduces the research topic and the overall results of the dissertation. The second part comprises a publication in which academic, political, legal and business developments that concern software and business-method patents are investigated, and contentiousareas are identified. The third part examines the problems with patents and open standards both of which carry significant economic weight inthe ICT sector. Here, the focus is on so-called submarine patents, i.e. patentsthat remain unnoticed during the standardization process and then emerge after the standard has been set. The factors that contribute to the problems are documented and the practical and juridical options for alleviating them are assessed. In total, the dissertation provides a good overview of the challenges and pressures for change the patent system is facing,and of how these challenges are reflected in standard setting.

Value Processingin Organizations - Individual Perceptions in Three Case Companies

Values and value processes are said to be needed in every organization nowadays, as the world is changing and companies have to have something to "keep it together". Organizational values, which are approvedand used by the personnel, could be the key. Every organization has values. But what is the real value of values? The greatest and most crucial challenge is the feasibility of the value process. The main point in this thesis is tostudy how organizational members at different hierarchical levels perceive values and value processes in their organizations. This includes themes such as how values are disseminated, the targets of value processing, factors that affect the process, problems that occur during the value implementation and improvements that could be made when organizational values are implemented. These subjects are studied from the perspective of organizational members (both managers and employees); individuals in the organizations. The aim is to get the insider-perspective on value processing, from multiple hierarchical levels. In this research I study three different organizations (forest industry, bank and retail cooperative) and their value processes. The data is gathered from companies interviewing personnel in the head office and at the local level. The individuals areseen as members of organizations, and the cultural aspect is topical throughout the whole study. Values and cultures are seen as the 'actuality of reality' of organizations, interpreted by organizational members. The three case companies were chosen because they represented different lines of business and they all implemented value processing differently. Sincethe emphasis in this study is at the local level, the similar size of the local units was also an important factor. Values are in 'fashion' -but what does the fashion tell us about the real corporate practices? In annual reports companies emphasize the importance and power of official values. But what is the real 'point' of values? Values are publicly respected and advertised, but still it seems that the words do not meet the deeds. There is a clear conflict between theoretical, official and substantive organizational values: in the value processing from words to real action. This contradiction in value processing is studied through individual perceptions in this study. I study the kinds of perceptions organizationalmembers have when values are processed from the head office to the local level: the official value process is studied from the individual's perspective. Value management has been studied more during the 1990's. The emphasis has usually been on managers: how they consider the values in organizations and what effects it has on the management. Recent literature has emphasized values as tools for improving company performance. The value implementation as a process has been studied through 'good' and 'bad' examples, as if one successful value process could be copied to all organizations. Each company is different with different cultures and personnel, so no all-powerful way of processing values exists. In this study, the organizational members' perceptions at different hierarchical levels are emphasized. Still, managers are also interviewed; this is done since managerial roles in value dissemination are crucial. Organizational values cannot be well disseminated without management; this has been proved in several earlier studies (e.g. Kunda 1992, Martin 1992, Parker 2000). Recent literature has not sufficiently emphasized the individual's (organizational member's) role in value processing. Organizations consist of differentindividuals with personal values, at all hierarchical levels. The aim in this study is to let the individual take the floor. Very often the value process is described starting from the value definition and ending at dissemination, and the real results are left without attention. I wish to contribute to this area. Values are published officially in annual reports etc. as a 'goal' just like profits. Still, the results/implementationof value processing is rarely followed, at least in official reports. This is a very interesting point: why do companies espouse values, if there is no real control or feedback after the processing? In this study, the personnel in three different companies is asked to give an answer. In the empirical findings, there are several results which bring new aspects to the research area of organizational values. The targets of value processing, factors effecting value processing, the management's roles and the problems in value implementation are presented through the individual's perspective. The individual's perceptions in value processing are a recurring theme throughout the whole study. A comparison between the three companies with diverse value processes makes the research complete

The year in cardiology 2014: peripheral circulation.

In 2014, the debate on the indication of revascularization in case of asymptomatic carotid disease continued, while another one regarding the use of surgery vs. stenting addressed some new issues regarding the long-term cardiac risk of these patients. Renal arteries interventions trials were disappointing, as neither renal denervation nor renal artery stenting was found associated with better blood pressure management or outcome. In contrast, in lower-extremities artery disease, the endovascular techniques represent in 2014 major alternatives to surgery, even in distal arteries, with new insights regarding the interest of drug-eluting balloons. Regarding the aorta, the ESC published its first guidelines document on the entire vessel, emphasizing on the role of every cardiologist for screening abdominal aorta aneurysm during echocardiography. Among vascular wall biomarkers, the aorta stiffness is of increasing interest with new data and meta-analysis confirming its ability to stratify risk, whereas carotid intima-media thickness showed poor performances in terms of reclassifying patients into risk categories beyond risk scores. Regarding the veins, new data suggest the interest of D-dimers and residual venous thrombosis to help the decision of anti-coagulation prolongation or discontinuation after the initial period of treatment for deep vein thrombosis.

Impacts des technologies de l'information sur les modes de coordination à travers quatre études en systèmes d'information

L'évolution de l'environnement économique, des chaînes de valeur et des modèles d'affaires des organisations augmentent l'importance de la coordination, qui peut être définie comme la gestion des interdépendances entre des tâches réalisées par des acteurs différents et concourants à un objectif commun. De nombreux moyens sont mis en oeuvre au sein des organisations pour gérer ces interdépendances. A cet égard, les activités de coordination bénéficient massivement de l'appui des technologies de l'information et de communication (TIC) qui sont désormais disséminées, intégrées et connectées sous de multiples formes tant dans l'environnement privé que professionnel. Dans ce travail, nous avons investigué la question de recherche suivante : comment l'ubiquité et l'interconnec- tivité des TIC modifient-elles les modes de coordination ? A travers quatre études en systèmes d'information conduites selon une méthodologie design science, nous avons traité cette question à deux niveaux : celui de l'alignement stratégique entre les affaires et les systèmes d'information, où la coordination porte sur les interdépendances entre les activités ; et celui de la réalisation des activités, où la coordination porte sur les interdépendances des interactions individuelles. Au niveau stratégique, nous observons que l'ubiquité et l'interconnectivité permettent de transposer des mécanismes de coordination d'un domaine à un autre. En facilitant différentes formes de coprésence et de visibilité, elles augmentent aussi la proximité dans les situations de coordination asynchrone ou distante. Au niveau des activités, les TIC présentent un très fort potentiel de participation et de proximité pour les acteurs. De telles technologies leur donnent la possibilité d'établir les responsabilités, d'améliorer leur compréhension commune et de prévoir le déroulement et l'intégration des tâches. La contribution principale qui émerge de ces quatre études est que les praticiens peuvent utiliser l'ubiquité et l'interconnectivité des TIC pour permettre aux individus de communi-quer et d'ajuster leurs actions pour définir, atteindre et redéfinir les objectifs du travail commun. -- The evolution of the economic environment and of the value chains and business models of organizations increases the importance of coordination, which can be defined as the management of interdependences between tasks carried out by different actors and con-tributing to a common goal. In organizations, a considerable number of means are put into action in order to manage such interdependencies. In this regard, information and communication technologies (ICT), whose various forms are nowadays disseminated, integrated and connected in both private and professional environments, offer important support to coordination activities. In this work, we have investigated the following research question: how do the ubiquity and the interconnectivity of ICT modify coordination mechanisms? Throughout four information systems studies conducted according to a design science methodology, we have looked into this question at two different levels: the one of strategic alignment between business and information systems strategy, where coordination is about interdependencies between activities; and the one of tasks, where coordination is about interdependencies between individual interactions. At the strategic level, we observe that ubiquity and interconnectivity allow for transposing coordination mechanisms from one field to another. By facilitating various forms of copresence and visibility, they also increase proximity in asynchronous or distant coordination situations. At the tasks level, ICTs offer the actors a very high potential for participation and proximity. Such technologies make it possible to establish accountability, improve common understanding and anticipate the unfolding and integration of tasks. The main contribution emerging from these four studies is that practitioners can use the ubiquity and interconnectivity of ICT in order to allow individuals to communicate and adjust their actions to define, reach and redefine the goals of common work.

Médecine d'urgence [Emergency medicine: updates 2013].

New evidences published this year are susceptible to change the management of several medical emergencies. Combined antiplatelet therapy might be beneficial for the management of TIA or minor stroke and rapid blood pressure lowering might improve the outcome in patients with intracerebral hemorrhage. A restrictive red cell transfusion strategy is indicated in case of upper digestive bleeding and coagulation factors concentrates are superior to fresh frozen plasma for urgent warfarin reversal. Prolonged systemic steroid therapy is not warranted in case of acute exacerbation of BPCO, and iterative physiotherapy is not beneficial after acute whiplash. Finally, family presence during cardiopulmonary resuscitation may reduce post-traumatic stress disorder among relatives.

Flokkulaation seuraaminen partikkelikokoanalysaattorilla

Tässä työssä tutkittiin kahden erilaisen partikkelikokoanalysaattorin, PSyA:n ja PIA:n soveltuvuutta flokkuloinnin online-seurantaan. Kummallekin menetelmälle määritettiin raja-arvot, kuten lietteen maksimisakeus. Lisäksi tutkittiin flokkulanttiannostuksen, sekoitusnopeuden, sekoitusajan ja lietteen kiintoainepitoisuuden vaikutusta flokkikokojakaumaan. Kirjallisuusosassa tarkasteltiin kolloidisen suspension ominaispiirteitä, koaguloinnin ja flokkuloinnin teoriaa, flokkulaation kokeellista tutkimista sekä prosessin jatkuvatoimiseen seurantaan soveltuvia laitteita. Lisäksi esitettiin taustaa hydrometallurgisesta prosessista, johon työ liittyy. Flokkauskokeissa käytettiin jätevettä, jonka koostumus vastasi metalliteollisuuden peittausjätevesien tyypillistä koostumusta. Tutkittava jätevesimäärä käsiteltiin ensin kalkkimaidolla, jonka jälkeen saostunut kiintoaine flokattiin synteettisellä polymeeriflokkulantilla. Lietteen keskimääräinen kiintoainepitoisuus oli n. 10 g/l. Esikokeiden perusteella PSyA:lla voitiin mitata ilman laimennusta, mutta PIA:lla tuloksia ei saatu ilman laimentamista kiintoainepitoisuuteen n. 2,5 g/l. Kokeiden aikana havaittiin, että flokit muodostuivat erittäin nopeasti. Flokkien hajoaminen alkoi pian sen jälkeen, kun flokkulantin annostelu lopetettiin. Sekoitusnopeudella 40 r/min tai alle flokit alkoivat laskeutua astian pohjalle sekoituksesta huolimatta ja ne pysyivät pitempään koossa kuin suuremmilla sekoitusnopeuksilla. 5 - 10 minuutin kuluttua flokkulantin lisäämisestä saavutettiin tasapaino, jolloin flokkien kokojakauma ei enää muuttunut. Sekoitusnopeuksilla 80 r/min ja 120 r/min tasapainotilanteen koko-jakauma oli selvästi kapeampi kuin pienimmällä sekoitusnopeudella. Alkuperäisessä lietteessä flokit olivat suurempia kuin laimennetussa lietteessä. PSyA:lla jännepituusjakaumien määrittäminen oli varsin hidasta prosessissa tapahtuviin muutoksiin verrattuna, ja tuloksissa oli suurta hajontaa. PIA:lla saadut partikkelikokojakaumat sitä vastoin olivat johdonmukaisempia, vaikka suurimpien flokkien määrittäminen osoittautuikin epämääräiseksi. Menetelmän suurimmaksi puutteeksi todettiin soveltumattomuus sakeiden lietteiden analysointiin. Kumpikaan menetelmä ei ilman modifiointia sovellu tutkitun lietteen kaltaisten prosessilietteiden flokkuloinnin seurantaan.

Newly described human polyomaviruses Merkel Cell, KI and WU are present in urban sewage and may represent potential environmental contaminants

Recently, three new polyomaviruses (KI, WU and Merkel cell polyomavirus) have been reported to infect humans. It has also been suggested that lymphotropic polyomavirus, a virus of simian origin, infects humans. KI and WU polyomaviruses have been detected mainly in specimens from the respiratory tract while Merkel cell polyomavirus has been described in a very high percentage of Merkel cell carcinomas. The distribution, excretion level and transmission routes of these viruses remain unknown. Here we analyzed the presence and characteristics of newly described human polyomaviruses in urban sewage and river water in order to assess the excretion level and the potential role of water as a route of transmission of these viruses. Nested-PCR assays were designed for the sensitive detection of the viruses studied and the amplicons obtained were confirmed by sequencing analysis. The viruses were concentrated following a methodology previously developed for the detection of JC and BK human polyomaviruses in environmental samples. JC polyomavirus and human adenoviruses were used as markers of human contamination in the samples. Merkel cell polyomavirus was detected in 7/8 urban sewage samples collected and in 2/7 river water samples. Also one urine sample from a pregnant woman, out of 4 samples analyzed, was positive for this virus. KI and WU polyomaviruses were identified in 1/8 and 2/8 sewage samples respectively. The viral strains detected were highly homologous with other strains reported from several other geographical areas. Lymphotropic polyomavirus was not detected in any of the 13 sewage neither in 9 biosolid/sludge samples analyzed. This is the first description of a virus isolated from sewage and river water with a strong association with cancer. Our data indicate that the Merkel cell polyomavirus is prevalent in the population and that it may be disseminated through the fecal/urine contamination of water. The procedure developed may constitute a useful tool for studying the excreted strains, prevalence and transmission of these recently described polyomaviruses.