Dose-associated pulmonary complication rates after fresh frozen plasma administration for warfarin reversal.

UNLABELLED: ESSENTIALS: Fresh frozen plasma (FFP) may be associated with a dose-based risk of pulmonary complications. Patients received FFP for warfarin reversal at a large academic hospital over a 3-year period. Almost 20% developed pulmonary complications, and the risk was highest after > 3 units of FFP. The risk of pulmonary complications remained significant in multivariable analysis. BACKGROUND: Fresh frozen plasma (FFP) is often administered to reverse warfarin anticoagulation. Administration has been associated with pulmonary complications, but it is unclear whether this risk is dose-related. Aims We sought to characterize the incidence and dose relationship of pulmonary complications, including transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI), after FFP administration for warfarin reversal. METHODS: We performed a structured retrospective review of patients who received FFP for warfarin reversal in the emergency department (ED) of an academic tertiary-care hospital over a 3-year period. Logistic regression was used to explore the relationship between FFP dose and risk of pulmonary events. RESULTS: Two hundred and fifty-one patients met the inclusion criteria. Overall, 49 patients (20%) developed pulmonary complications, including 30 (12%) with TACO, two (1%) with TRALI, and 17 (7%) with pulmonary edema not meeting the criteria for TACO. Pulmonary complications were significantly more frequent in those who received > 3 units of FFP (34.0% versus 15.6%, 95% confidence interval for risk difference 7.9%-8.9%). After stratification by subtype of complication, only the risk of TACO was statistically significant (28.3% versus 7.6%, 95% confidence interval for risk difference 8.2%-16.6%). In multivariable analysis controlling for age, sex, initial systolic blood pressure, and intravenous fluids given in the ED, > 3 units of FFP remained a significant risk factor for pulmonary complications (odds ratio 2.49, 95% confidence interval 1.21-5.13). CONCLUSIONS: Almost 20% of patients who received FFP for warfarin reversal developed pulmonary complications, primarily TACO, and this risk increased with > 3 units of FFP. Clinicians should be aware of and prepared to manage these complications.

DNA barcoding discriminates freshwater fishes from southeastern Nigeria and provides river system-level phylogeographic resolution within some species.

BACKGROUND AND AIMS: Fishes are the main animal protein source for human beings and play a vital role in aquatic ecosystems and food webs. Fish identification can be challenging, especially in the tropics (due to high diversity), and this is particularly true for larval forms or fragmentary remains. DNA barcoding, which uses the 5' region of the mitochondrial cytochrome c oxidase subunit I (COI) as a target gene, is an efficient method for standardized species-level identification for biodiversity assessment and conservation, pending the establishment of reference sequence libraries. MATERIALS AND METHODS: In this study, fishes were collected from three rivers in southeastern Nigeria, identified morphologically, and imaged digitally. DNA was extracted, PCR-amplified, and the standard barcode region was bidirectionally sequenced for 363 individuals belonging to 70 species in 38 genera. All specimen provenance data and associated sequence information were recorded in the barcode of life data systems (BOLD; www.barcodinglife.org ). Analytical tools on BOLD were used to assess the performance of barcoding to identify species. RESULTS: Using neighbor-joining distance comparison, the average genetic distance was 60-fold higher between species than within species, as pairwise genetic distance estimates averaged 10.29% among congeners and only 0.17% among conspecifics. Despite low levels of divergence within species, we observed river system-specific haplotype partitioning within eight species (11.4% of all species). CONCLUSION: Our preliminary results suggest that DNA barcoding is very effective for species identification of Nigerian freshwater fishes.

Seasonal variations of species composition and abundance of zooplankton in Ehoma Lake, a floodplain lake in Nigeria.

Ehoma Lake is among the important breeding sites of the major fishes in the Mid-Cross River, Nigeria. The juveniles of these fishes are solely dependent on zooplankton, which has not been studied previously. I studied monthly the lake's physico-chemical variables and zooplankton composition in three stations (littoral, sub-littoral and pelagic) from March 2005 to August 2006. Sixty-seven zooplankton species (42 rotifers, 19 cladocerans and 6 copepods) were identified. Daphnia obtusa Kurz, Keratella valga Ehrenberg, Keratella ticinensis Callerrio, Keratella hiemalis Carlin, Brachionus dimidiatus Bryce and Lecane candida Hauer and Murray are new records for Nigeria The dominant zooplankters were Diaphanosoma excisum Kurz and Moina micrura Kurz. There was an inverse relationship between species richness and abundance. Richness was highest in the dry season while peak zooplankton abundance was recorded in the rainy season. Zooplankton abundance and species richness decreased progressively from the littoral to the pelagic station while the Shannon-Weaver diversity index varied from 0.68 to 1.28 without a clear seasonal trend. There is a succession pattern: rotifers that are dominant in the dry season are replaced by cladocerans in the rainy season. This succession was greatly influenced by seasonal flooding of the lake. As no previous information on the zooplankton of the lake is available, this study provides baseline data on the lake's zooplankton.

Prevalence of anaemia in HIV-infected children at the University of Abuja Teaching Hospital, Gwagwalada.

BACKGROUND: Use of highly active antiretroviral therapy (HAART) has remained the only regimen potent enough to reduce viral replication in HIV-infected individuals. Its combination with cotrimoxazole has also been recommended in those with CD4% of less than 15%. The use of HAART containing zidovudine (ZDV) in combination with co-trimoxazole carries the risk of anaemia in already anaemic predisposed individuals from HIV infections, opportunistic infections, parasitic infestations, sickle cell anaemia, and malnutrition. The aim of the study is to document the effect of use of combination of HAART containing ZDV with cotrimoxazole in haemoglobin profile of HIV-infected children after one year of its administration at the University of Abuja Teaching Hospital (UATH), Gwagwalada. It is also aimed at comparing the result obtained with those on stavudine containing HAART with co-trimoxazole. METHOD: A two year prospective study of HIV-infected children on treatment with HAART in combination with co-trimoxazole, and attending the paediatric outpatient special treatment clinic (POSTC) for HIV infected children at the UATH, Gwagwalada from November 2006 to October 2008, was carried out to determine effect of these drug combinations in the haemoglobin profile of infected children. Three monthly PCV level was carried out using haematocrit centrifuge and reader. RESULTS: A total of 173 patients were started on HAART during the first year recruitment period, 90 (52.0%) were males, while 83 (48.0%) females, giving a male to female ratio of 1.1:1. One hundred and seventeen (67.7%) of patients were on ZDV containing HAART, while 56 (32.3%) were on stavudine containing combination. All patients were started on co-trimoxazole prophylaxis with the exception of 6 (3.5%) patients because of drug reaction. The mean PCV of patients on ZDV containing combination with cotrimoxazole decreased from 30.2 +/- 5.5% to 29.0 +/- 2.3%, with a net decrease of 1.2% after one year treatment, those on stavudine containing combination with co-trimoxazole instead showed an increased from initial PCVof 28.3 +/- 4.2% to 34.2 +/- 3.0% with a net increase of 5.9% after the same duration of treatment, (p > 0.05). While patients on ZDV combination alone without co-trimoxazole prophylaxis had a minimal decrease of 0.9% in their PCV level after one year treatment, those on stavudine combination alone without any prophylaxis instead showed an increase of 6.8% in their PCV after the same duration of treatment. CONCLUSION: A combination of HAART containing ZDV plus co-trimoxazole carries risk of anaemia than that of stavudine containing combination with co-trimoxazole. Such combination should therefore not be given to anaemic patients. Regular check in PCV of patients on HAART combination with ZDV and additional cotrimoxazole prophylaxis is required for early detection of significant drop in PCV level.

Seasonal variations of species composition and abundance of zooplankton in Ehoma Lake, a floodplain lake in Nigeria

Ehoma Lake is among the important breeding sites of the major fishes in the Mid-Cross River, Nigeria. The juveniles of these fishes are solely dependent on zooplankton, which has not been studied previously. I studied monthly the lake’s physico-chemical variables and zooplankton composition in three stations (littoral, sub-littoral and pelagic) from March 2005 to August 2006. Sixty-seven zooplankton species (42 rotifers, 19 cladocerans and 6 copepods) were identified. Daphnia obtusa Kurz, Keratella valga Ehrenberg, Keratella ticinensis Callerrio, Keratella hiemalis Carlin, Brachionus dimidiatus Bryce and Lecane candida Hauer and Murray are new records for Nigeria. The dominant zooplankters were Diaphanosoma excisum Kurz and Moina micrura Kurz. There was an inverse relationship between species richness and abundance. Richness was highest in the dry season while peak zooplankton abundance was recorded in the rainy season. Zooplankton abundance and species richness decreased progressively from the littoral to the pelagic station while the Shannon-Weaver diversity index varied from 0.68 to 1.28 without a clear seasonal trend. There is a succession pattern: rotifers that are dominant in the dry season are replaced by cladocerans in the rainy season. This succession was greatly influenced by seasonal flooding of the lake. As no previous information on the zooplankton of the lake is available, this study provides baseline data on the lake`s zooplankton. Rev. Biol. Trop. 58 (1): 171-182. Epub 2010 March 01.

El lago Ehoma, situado en la mitad del río Cross, es uno de los lugares de reproducción de las principales especies de peces del río. Los juveniles de estos peces dependen exclusivamente del zooplancton, sin embargo poco se sabe sobre este recurso en el lago. En este estudio, las variables físico-químicas y del zooplancton del lago fueron estudiadas mensualmente en tres estaciones (litoral, sub-litoral y pelágica), de marzo de 2005 a agosto de 2006. Fueron identificadas 67 especies de zooplancton (42 rotíferos, 19 cladóceros y 6 copépodos). Daphnia obtusa Kurz, Keratella valga Ehrenberg, Keratella ticinensis Callerrio, Keratella hiemalis Carlin, Brachionus dimidiatus Bryce y Lecane candida Hauer y Murray son nuevos registros para Nigeria. Las especies dominantes fueron Diaphanosoma excisum Kurz y Moina micrura Kurz. Hubo una relación inversa entre la riqueza de especies y la abundancia. La riqueza de especies fue mayor en la estación seca, mientras que la abundancia de zooplancton registró su mayor valor en la estación lluviosa. La abundancia y riqueza de especies de zooplancton disminuyó progresivamente desde la estación del litoral a la pelágica, mientras que el índice de diversidad de Shannon-Weaver varió de 0.68 a 1.28, sin una clara tendencia estacional. Se encontró un patrón de sucesión: los rotíferos, dominantes en la estación seca, fueron reemplazados por cladóceros en la estación lluviosa. Esta sucesión estuvo fuertemente influenciada por las inundaciones estacionales del lago. Al no haber información disponible sobre el zooplancton de este lago, este estudio proporciona los primeros datos de referencia.

Cyanobacteria abundance and its relationship to water quality in the Mid-Cross River floodplain, Nigeria.

The physicochemical variables and cyanobacteria of Mid-Cross River, Nigeria, were studied in six stations between March 2005 and August 2006 to determine the relationship between water quality and cyanobacteria abundance. Canonical Correspondence Analysis (CCA) showed that biological oxygen demand (BOD), dissolved oxygen, pH, water velocity, width and depth were important environmental factors that influenced cyanobacteria abundance. Trace metals, phosphate and nitrate increased significantly from values of previous studies indicating increased eutrophication of the river but were weakly correlated with cyanobacteria abundance and could be scarcely regarded as regulating factors. A higher cyanobacteria abundance was recorded during the wet season in most of the sampled stations. The dominant cyanobacteria included Microcystis aeruginosa, Aphanizomenon flos-aquae, Oscillatoria limnetica and Anabaena spiroides. The toxins produced by these species could degrade water quality. The factors favouring cyanobacteria abundance were identified as increased pH, width and depth. Increase in cyanobacteria abundance was associated with reduction in dissolved oxygen and increase in BOD values.

Cyanobacteria abundance and its relationship to water quality in the Mid-Cross River floodplain, Nigeria

The physicochemical variables and cyanobacteria of Mid-Cross River, Nigeria, were studied in six stations between March 2005 and August 2006 to determine the relationship between water quality and cyanobacteria abundance. Canonical Correspondence Analysis (CCA) showed that biological oxygen demand (BOD), dissolved oxygen, pH, water velocity, width and depth were important environmental factors that influenced cyanobacteria abundance. Trace metals, phosphate and nitrate increased significantly from values of previous studies indicating increased eutrophication of the river but were weakly correlated with cyanobacteria abundance and could be scarcely regarded as regulating factors. A higher cyanobacteria abundance was recorded during the wet season in most of the sampled stations. The dominant cyanobacteria included Microcystis aeruginosa, Aphanizomenon flos-aquae, Oscillatoria limnetica and Anabaena spiroides. The toxins produced by these species could degrade water quality. The factors favouring cyanobacteria abundance were identified as increased pH, width and depth. Increase in cyanobacteria abundance was associated with reduction in dissolved oxygen and increase in BOD values. Rev. Biol. Trop. 57 (1-2): 33-43. Epub 2009 June 30.

Las variables físico-químicas y la abundancia de cianobacterias del río nigeriano Mid-Cross fueron estudiadas en seis estaciones entre marzo del 2005 y agosto del 2006. El Análisis de Correspondencia Canónica (CCA) demostró que la demanda biológica de oxígeno (DBO), oxígeno disuelto, pH, velocidad de agua, anchura y profundidad son factores ambientales importantes que influyen en la abundancia de cianobacterias. Los mayores valores de trazas de metales, fosfatos y nitratos, en comparación con estudios previos, indican mayor eutrofización, pero tienen poca correlación con la abundancia de las cianobacterias. La mayor abundancia de cianobacterias se registró durante el periodo más húmedo de la estación seca en la mayoría de las estaciones de muestreo. Las cianobacterias dominantes incluyen Microcystis aeruginosa, Aphanizomenon flos-Aquae, Oscillatoria limnetica y Anabaena spiroide. Las toxinas producidas por estas especies podrían degradar la calidad del agua. Los factores que favorecen la abundancia de cianobacterias fueron identificados como el aumento de pH, ancho y profundidad. El aumento de la abundancia se asoció con una reducción de oxígeno disuelto y un aumento de los valores de DBO.