Automated clean-up, separation and detection of polycyclic aromatic hydrocarbons in particulate matter extracts using a 2D-LC/2D-GC system: a method translation from two FIDs to two MS detectors.

An online two-dimensional (2D) liquid chromatography/2D gas chromatography system with two mass-selective detectors has been developed on the basis of a previous system with two flame ionization detectors. The method translation involved the change of carrier gas from hydrogen to helium, column dimension and detectors. The 2D system with two mass-selective detectors was validated with use of polycyclic aromatic hydrocarbon (PAH) standards and two standard reference materials from air and diesel exhaust. Furthermore, the system was applied to a real sample, wood smoke particulates. The PAH values determined correlated well with the previous data and those from the National Institute of Standards and Technology. The system enhanced the benefits of the previous system, which were limited by the low detectability and lack of mass selectivity. This study shows an automated 2D system that is valid for PAH analysis of complex environmental samples directly from crude extracts. Graphical Abstract Schematic illustration showing on-line clean-up, separation and detection using 2D-LC/2D-GC/MS.

Ancient water bottle use and polycyclic aromatic hydrocarbon (PAH) exposure among California Indians: a prehistoric health risk assessment.

BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are the main toxic compounds in natural bitumen, a fossil material used by modern and ancient societies around the world. The adverse health effects of PAHs on modern humans are well established, but their health impacts on past populations are unclear. It has previously been suggested that a prehistoric health decline among the native people living on the California Channel Islands may have been related to PAH exposure. Here, we assess the potential health risks of PAH exposure from the use and manufacture of bitumen-coated water bottles by ancient California Indian societies. METHODS: We replicated prehistoric bitumen-coated water bottles with traditional materials and techniques of California Indians, based on ethnographic and archaeological evidence. In order to estimate PAH exposure related to water bottle manufacture and use, we conducted controlled experiments to measure PAH contamination 1) in air during the manufacturing process and 2) in water and olive oil stored in a completed bottle for varying periods of time. Samples were analyzed with gas chromatography/mass spectrometry (GC/MS) for concentrations of the 16 PAHs identified by the US Environmental Protection Agency (EPA) as priority pollutants. RESULTS: Eight PAHs were detected in concentrations of 1-10 µg/m3 in air during bottle production and 50-900 ng/L in water after 2 months of storage, ranging from two-ring (naphthalene and methylnaphthalene) to four-ring (fluoranthene) molecules. All 16 PAHs analyzed were detected in olive oil after 2 days (2 to 35 µg/kg), 2 weeks (3 to 66 µg/kg), and 2 months (5 to 140 µg/kg) of storage. CONCLUSIONS: For ancient California Indians, water stored in bitumen-coated water bottles was not a significant source of PAH exposure, but production of such bottles could have resulted in harmful airborne PAH exposure.

Determination of oxygenated and native polycyclic aromatic hydrocarbons in urban dust and diesel particulate matter standard reference materials using pressurized liquid extraction and LC-GC/MS.

The objective of this study was to develop a novel analytical chemistry method, comprised of a coupled high-performance liquid chromatography-gas chromatography/mass spectrometry system (LC-GC/MS) with low detection limits and high selectivity, for the identification and determination of oxygenated polycyclic aromatic hydrocarbons (OPAHs) and polycyclic aromatic hydrocarbons (PAHs) in urban air and diesel particulate matter. The linear range of the four OPAHs, which include 9,10-anthraquinone, 4H-cyclopenta[def]phenanthrene-4-one, benzanthrone, and 7,12-benz[a]anthraquinone, was 0.7 pg-43.3 ng with limits of detection (LODs) and limits of quantification (LOQs) on the order of 0.2-0.8 and 0.7-1.3 pg, respectively. The LODs in this study are generally lower than values reported in the literature, which can be explained by using large-volume injection. The recoveries of the OPAHs spiked onto glass fiber filters using two different pressurized liquid extraction (PLE) methods were in the ranges of 84-107 and 67-110 %, respectively. The analytical protocols were validated using the following National Institute of Standards and Technology standard reference materials: SRM 1649a (Urban Dust), SRM 1650b (Diesel Particulate Matter), and SRM 2975 (Diesel Particulate Matter, Industrial Forklift). The measured mass fractions of the OPAHs in the standard reference materials (SRMs) in this present study are higher than the values from the literature, except for benzanthrone in SRM 1649a (Urban Dust). In addition to the OPAHs, 44 PAHs could be detected and quantified from the same particulate extract used in this protocol. Using data from the literature and applying a two-sided t test at the 5 % level using Bonferroni correction, significant differences were found between the tested PLE methods for individual PAHs. However, the measured mass fractions of the PAHs were comparable, similar to, or higher than those previously reported in the literature.

[Thrombopenia and the nature of the microorganism in infected critically ill children]. / Thrombopénie et nature des germes infectants en réanimation pédiatrique.

BACKGROUND: Thrombopenia is correlated with sepsis and mortality in pediatric intensive care units. The purpose of this study was to find an association between thrombopenia and the microorganism type to guide the choice of empiric antibiotic therapy in infected critically ill children. MATERIALS AND METHODS: We conducted a prospective descriptive study, including all newborns, infants, and children admitted to a pediatric surgical intensive care unit from 1st January to 31st December 2009. We identified patients who developed an infection and/or thrombopenia (platelet count less than 100,000/mm(3)) during hospitalization. RESULTS: One hundred ninety-seven patients were included (57 newborns, 41 infants, 99 children). Ninety patients developed 100 infectious episodes during the study period. Of the 57 newborns enrolled in the study, 31 (54%) developed 37 infections. Seventy-six microorganisms (55 Gram-negative bacilli [GNB], 17 Gram-positive cocci, two Gram-negative cocci, two fungal pathogens) were identified during 65 infectious episodes in 55 patients. Thirty-four episodes of thrombopenia were observed in 30 patients. Thrombopenia was observed only in infected patients (P<0.001). Thrombopenia was associated with infections caused by GNB (26/28 vs 20/37, P=0.001) and by Klebsiella (16/28 vs 6/37, P=0.001) and may be associated with infections caused by GNB producing extended-spectrum beta-lactamases (P=0.07). Gram-positive cocci infections were correlated to the non-occurrence of thrombopenia (P=0.02). Postoperative peritonitis was also significantly associated with thrombopenia (P=0.03). The mortality rate in our patients was 12.7% (22.8% in neonates). There was an association between thrombopenia and death in univariate analysis (11/25 vs 19/172, P<0.001). Multivariate logistic regression analysis did not confirm thrombopenia as an independent predictive factor of mortality in children. CONCLUSION: Because of the relatively high proportion of resistant GNB, an empiric antibiotic therapy combining a carbapenem and an aminoglycoside may be indicated in infected critically ill children developing thrombopenia.

Automated clean-up, separation and detection of polycyclic aromatic hydrocarbons in particulate matter extracts from urban dust and diesel standard reference materials using a 2D-LC/2D-GC system.

A multidimensional, on-line coupled liquid chromatographic/gas chromatographic system was developed for the quantification of polycyclic aromatic hydrocarbons (PAHs). A two-dimensional liquid chromatographic system (2D-liquid chromatography (LC)), with three columns having different selectivities, was connected on-line to a two-dimensional gas chromatographic system (2D-gas chromatography (GC)). Samples were cleaned up by combining normal elution and column back-flush of the LC columns to selectively remove matrix constituents and isolate well-defined, PAH enriched fractions. Using this system, the sequential removal of polar, mono/diaromatic, olefinic and alkane compounds from crude extracts was achieved. The LC/GC coupling was performed using a fused silica transfer line into a programmable temperature vaporizer (PTV) GC injector. Using the PTV in the solvent vent mode, excess solvent was removed and the enriched PAH sample extract was injected into the GC. The 2D-GC setup consisted of two capillary columns with different stationary phase selectivities. Heart-cutting of selected PAH compounds in the first GC column (first dimension) and transfer of these to the second GC column (second dimension) increased the baseline resolutions of closely eluting PAHs. The on-line system was validated using the standard reference materials SRM 1649a (urban dust) and SRM 1975 (diesel particulate extract). The PAH concentrations measured were comparable to the certified values and the fully automated LC/GC system performed the clean-up, separation and detection of PAHs in 16 extracts in less than 24 h. The multidimensional, on-line 2D-LC/2D-GC system eliminated manual handling of the sample extracts and minimised the risk of sample loss and contamination, while increasing accuracy and precision.

[Intravenous antibiotic therapy for acute hematogenous osteomyelitis in children: short versus long course]. / Antibiothérapie intraveineuse des ostéomyélites aiguës : traitement long versus court.

The aim of this study was to evaluate the results of two antibiotic therapy protocols for osteomyelitis with different durations of intravenous treatment. This was a prospective randomized study of children treated for acute hematogenous osteomyelitis. Patients in group 1 (G1) received 7 days of intravenous antibiotics, whereas patients in group 2 (G2) received 14 days. Treatment was deemed effective if there were no signs of chronic osteomyelitis at the last follow-up. Fifty-three patients were included in the study (G1=27, G2=26). After a mean follow-up of 11.5 months, none of the patients in either group showed signs of chronic osteomyelitis. In conclusion, a shortened treatment of 7 days of intravenous antibiotic therapy is as effective as a longer treatment.

[Risk factors for nosocomial infection in pediatric burn patients]. / Facteurs de risque d'infection nosocomiale chez l'enfant brûlé

OBJECTIVE: The aim of our study was to determine risk factors associated with nosocomial infections in children hospitalized for skin burn. STUDY DESIGN: Prospective study including children hospitalized for skin burn. METHODS: We collected demographic characteristic, mode of admission, mechanism of burn, extent of burn surface by the tables of Lund and Browder, depth of the lesions according to clinical criteria and evolution, type of invasive care (urinary catheterization, central catheterization or mechanical ventilation), nosocomial infection and its time of occurrence, prescription of empirical antibiotic therapy and evolution during hospitalization. The criteria for "American Burn Association" were used to define a severe burn in children. RESULTS: One hundred eighty-two children were included. In univariate analysis, six risk factors were significantly associated with the occurrence of nosocomial infection: extent of burn surface, severe burn, urinary catheterization and its duration and central catheterization and its duration. Extent of burn surface greater than 10% of total body surface is an independent factor of the occurrence of nosocomial infection (P=0.009) in Multivariate analysis. CONCLUSION: In our study, extent of burn surface greater than 10% of total body surface is as an independent risk factor for the occurrence of nosocomial infection.

Microbiological profile of haematogenous osteoarticular infections in children.

INTRODUCTION: Staphylococcus aureus, Kingella kingae and ß-hemolytic streptococcus are presently the most frequently identified bacteria in child haematogenous osteoarticular infection. OBJECTIVE: To determine the microbiological profile (bacteria and antibiotic susceptibility) of osteoarticular infections in a paediatric hospital, so as to adapt treatment protocols to the ecology of the bacteria isolated. PATIENTS AND METHODS: Prospective descriptive study, including children admitted for acute osteomyelitis or septic arthritis. A series of blood cultures was performed systematically on admission. In case of surgery, local samples were taken for bacteriology. Antibiotherapy was initiated and subsequently adapted to the bacteriological findings. RESULTS: One hundred and six children were included. Thirty-five were under (Group 1) and 71 over 3 years of age (Group 2). Ninety-five underwent surgery. Peroperative samples were positive in 61 cases and blood culture in 23. Bacteria were isolated in 22 patients in G1. Extended-spectrum ß-lactamase-producing Klebsiella pneumoniae was isolated in five neonates who had passed through intensive care. Staphylococcus aureus was the most frequently isolated bacterium in G2 (n=40), and was methicillin-resistant (MRSA) in six children. DISCUSSION: Methicillin-susceptible Staphylococcus aureus was the most frequently isolated microorganism. Other than neonates who had passed through intensive care and the six patients with community-acquired MRSA infection, all isolated bacteria were susceptible to second-generation cephalosporins. LEVEL OF EVIDENCE: II, prospective descriptive prognostic study.

Deep venous thrombosis associated with acute hematogenous osteomyelitis in children.

INTRODUCTION: Deep venous thrombosis (DVT) is rare in children. It may complicate acute hematogenous osteomyelitis (AHO). OBJECTIVE: The present study assessed the incidence of DVT in community-acquired AHO, and compared clinical and laboratory characteristics with AHO without DVT. PATIENTS AND METHODS: A prospective study included patients treated for community-acquired AHO between April 2007 and December 2009. RESULTS: Seventy patients were included: mean age, 7.7 years. Seven developed DVT. All involved Staphylococcus aureus. The isolated Staphylococcus aureus was significantly more often methicillin-resistant than methicillin-susceptible (p=0.04). C-reactive protein, erythrocyte sedimentation rate, positive blood culture and incidence of pulmonary staphylococcus were significantly higher in patients with DVT. These patients also had significantly more febrile days. One patient with DVT died from severe refractory respiratory failure. DISCUSSION: DVT was observed in 10% of cases of community-acquired AHO. DVT was associated with more severe onset, with extensive local disease. Surgery was often needed to drain a subperiosteal abscess. DVT can cause invasive and life-threatening infection through septic emboli, particularly to the lungs. LEVEL OF EVIDENCE: Level III.

[Effects of hydroxyzine on tolerance of facial mask during induction in children]. / Effets de l'hydroxyzine sur l'acceptation du masque à l'induction de l'enfant.

OBJECTIVE: To evaluate the effectiveness of hydroxyzine as a premedication agent for the acceptance of facial mask during induction of general anaesthesia in children. STUDY DESIGN: Prospective randomized single-blind study including ASA 1 and 2 children, aged between 1 and 9 years and undergoing outpatient surgery. PATIENTS AND METHODS: Patients were randomly allocated to receive orally either 1mg/kg hydroxyzine (G1) or water 0.1 ml/kg (G2) one hour before induction of standardized inhalational anaesthesia. Tolerance of facial mask was assessed with a 3-points scale (good, moderate or poor). Chi-square and Student's t-test were used in statistical analysis; p values less than 0.05 were considered statistically significant. RESULTS: One hundred patients were included (G1 = 49, G2 = 51). Demographic data were similar in both groups. Acceptance of facial mask was significantly better in G1 than in G2 (p = 0,002). CONCLUSION: Hydroxyzine provided better acceptance of facial mask than placebo during induction of general anaesthesia in children.

[Aerobic bacteria associated with acute appendicitis in children]. / Bactéries aérobies associées aux appendicites aiguës de l'enfant.

OBJECTIVE: The aim of the study was to determine the microbiological profile of acute appendicitis in children. STUDY DESIGN: Prospective descriptive study including children hospitalized for acute appendicitis. METHODS: A specimen of the appendice and the peritoneal exudates (if exists) was performed intraoperatively for aerobe bacteriological examination. Anaerobic incubation was not possible in our study. RESULTS: Eighty children were included. The specimen culture isolated aerobic bacteria in 56 patients (70%). Polymicrobial infection was found in 14 children. Gram-negative bacilli were the most frequently isolated microorganisms (64/70). Escherichia coli was found in 48 children. The resistance rate to amoxicilline-clavulanic acid and to cefazolin was 35%. Pseudomonas aeruginosa susceptible to ticarcillin was detected in seven patients. CONCLUSION: In our study, the specimen culture found aerobic bacteria in 70% of cases, especially Gram-negative bacilli. Empiric antibiotherapy in acute complicated appendicitis in children should be efficient against these microorganisms.

[Renal cell adenocarcinomas. Report of 64 cases]. / Adénocarcinomes du rein. A propos de 64 cas.

The authors report 64 renal cell carcinomas observed in 64 patients over a period of 14 years (1982-1995). The mean age was 58 years (range: 20 to 80 years). Male involvement was observed in 34 cases (53%). The clinical symptoms were nonspecific, consisting of haematuria (26 cases), back pain (33 cases) and tumour (8 cases). Twenty patients presented with paraneoplastic syndromes and 4 presented with metastases. The tumour was an incidental finding in 6 cases. Fifty two patients were treated by radical nephrectomy and two by partial nephrectomy. The tumour was associated with venous involvement in 2 cases, lymphatic involvement in 4 cases and distant metastases in 2 cases. The overall 5-year survival was 37% with a poor prognosis in the case of lymph node involvement or metastases and in the case of secondary local recurrence (4 cases) or distant metastases (2 cases).

[Kidney contusions and traffic accidents. Apropos of the Tunisian experience]. / Contusion rénale et accidents de la voie publique. A propos d'une expérience tunisienne.

The authors report a retrospective series of 45 cases of blunt renal trauma from a total of 685 cases of blunt abdominal trauma observed between 1989-1993. This multicentre trial was designed to illustrate the severity of this type of trauma and to place it in the context of road accidents in Tunisia.

[Contusions to the pathologic kidney. A retrospective study, apropos of 34 cases]. / Les contusions sur rein pathologique. Etude rétrospective, à propos de 34 cas.

The authors report a retrospective study of 34 cases of blunt renal trauma affecting a pathological kidney out of a total of 156 cases of renal trauma. The patients were between the ages of 3 and 60 years, with a male predominance (sex-ratio: 2.4). The predominant cause of trauma was a household accident, in 15 cases (44%). The clinical features were dominated by haematuria and pain. The underlying renal disease was dominated by renal stones (15 cases, 44%) and ureteropelvic junction (UPJ) abnormality (10 cases, 29%). Twelve patients with benign trauma and minimal underlying renal disease were treated conservatively. Surgery was indicated in the remaining 22 patients, but only 20 were actually operated. Nephrectomy was performed in 9 patients and partial nephrectomy was performed in 3 patients. Treatment consisted of UPJ plasty in 2 cases, uretero-caliceal anastomosis in one case, stone surgery in 4 cases and suture of ruptured renal pelvis in one case. The postoperative course was marked by the development of a urinary fistula in 1 patient, cured by drainage and deterioration of hydronephrosis in one patient. Lastly, one patient died from Wilms' tumour. This disease therefore tends to have a fairly benign course, which nevertheless depends on the underlying renal disease.

[Kidney injuries in children. Apropos of 65 cases]. / Le traumatisme du rein chez l'enfant. A propos de 65 cas.

The authors report a retrospective series of 65 cases of renal contusion in children affecting 45 boys and 20 girls between the ages of 10 months and 15 years (mean age: 10 years). The causes of renal trauma were dominated by household accidents (53.8%) and road accidents (33.8%). Associated extrarenal lesions were observed in 21.5% of cases. 55.4% of the 65 contusions were considered to be benign, 27.7% of moderate severity and 16.9% were serious. The blunt trauma affected a pathological kidney in 19 cases. Exclusively medical treatment was recommended in 31 patients, while surgery was indicated in the other 34 patients. Apart from one death in a context of multiple trauma, few complications were observed in the group of operated patients and consisted of 4 cases of urinary fistula and 4 cases of infection, all of which resolved.

[Traumatic rupture of the anterior urethra. Apropos of 18 cases]. / Les ruptures traumatiques de l'urèthre antérieur. A propos de 18 cas.

The authors report a retrospective series of 18 cases of rupture of the anterior urethra, with a mean age of 25 years (range: 10 to 45 years). The mechanism of the lesion was trauma by falling onto the perineum (12 cases), road accident (4 cases) and sexual intercourse (2 cases). Urine drainage was ensured by suprapubic catheter (15 cases) or urethral catheter (1 case). The two cases of rupture of the urethra associated with lesions of the corpora cavernosa required urgent surgical repair. In the other cases, simple urine drainage was sufficient to treat partial ruptures of the urethra (11 cases) with only one case of urethral structure. However, end-to-end urethrorraphy was performed in the 4 patients with total rupture of the urethra, with early failure in 3 cases, attributed to delayed surgery. Finally, the course of urethral rupture associated with rupture of the corpora, cavernosa was favourable in terms of both micturition and sexual function.

[Impact of weight difference between donor and recipient on the function of the transplanted kidney]. / Effet de la différence de poids entre donneur et receveur sur la fonction du rein greffé.

OBJECTIVE: The objective of this retrospective study was to determine whether the difference between the donor's weight (wd) and the recipient's dry weight (wr) could influence the function of renal transplants. METHODS: Between 1987 and 1994, 185 patients with a mean age of 43.3 years +/- 12 were transplanted with a locally harvested cadaver kidney, corresponding to 120 men (42.2 years +/- 1.4) and 65 women (45 years +/- 12.8). The weight variation between donors and recipients (wd - wr) was 0.06 for men and 0.22 for women. The serum creatinine of recipients at 1 year was 147 mumol +/- 41.7. We used analysis of variance for univariate statistical analysis and multiple linear regression for multivariate analysis. RESULTS: On univariate analysis, the serum creatinine at 1 and 2 years was significantly higher (p < 0.02 and p < 0.035 respectively) when the donor's weight was 10% lower than the recipient's weight. Multivariate analysis, taking into account the donor's age and sex and the recipient's serum creatinine, confirmed the influence of the donor-recipient weight difference on serum creatinine at 2 years (p0.03), but also the role of the donor's age at 1 and 2 years (p < 0.0001 and p < 0.0004, respectively). CONCLUSION: In our study, the donor-recipient weight difference was a factor influencing the recipient's serum creatinine at 2 years. The donor's age also influences the recipient's serum creatinine, 1 and 2 years after renal transplantation.