Hydro-climatic changes of wetlandscapes across the world.

Assessments of ecosystem service and function losses of wetlandscapes (i.e., wetlands and their hydrological catchments) suffer from knowledge gaps regarding impacts of ongoing hydro-climatic change. This study investigates hydro-climatic changes during 1976-2015 in 25 wetlandscapes distributed across the world's tropical, arid, temperate and cold climate zones. Results show that the wetlandscapes were subject to precipitation (P) and temperature (T) changes consistent with mean changes over the world's land area. However, arid and cold wetlandscapes experienced higher T increases than their respective climate zone. Also, average P decreased in arid and cold wetlandscapes, contrarily to P of arid and cold climate zones, suggesting that these wetlandscapes are located in regions of elevated climate pressures. For most wetlandscapes with available runoff (R) data, the decreases were larger in R than in P, which was attributed to aggravation of climate change impacts by enhanced evapotranspiration losses, e.g. caused by land-use changes.

Modification of the Perinatal PTSD Questionnaire to enhance clinical utility.

OBJECTIVE: To enhance the clinical utility of the Perinatal Post-Traumatic Stress Disorder (PTSD) Questionnaire (PPQ), the current study sought to refine the measure by changing the item response options from dichotomous choices to a likert scale format. STUDY DESIGN: Using a convergent/divergent validity design and two data sources (traditional survey and World Wide Web), 58 high-risk and 86 low-risk mothers answered four questionnaires. RESULTS: Principal components analysis of items on the modified PPQ revealed three components conceptually similar to the diagnostic criterion associated with PTSD. In addition, convergent and divergent validity of the modified measure was supported. The clinical utility of the modified PPQ was established with a strong positive likelihood ratio. CONCLUSION: The modified PPQ is a useful clinical tool for identifying mothers experiencing significant emotional distress during the postnatal period so they may be referred for mental health services.

Myocardial damage after inhalation of chloramines.

The objective of this case report was to document a rare case of myocardial damage, in the context of an accidental inhalation of chloramines, demonstrated by electrocardiogram and myocardium-specific enzymes.

Registro español de inmunodeficiencias primarias. (REDIP). Informe de actualización. Noviembre-1999 / Spanish register for primary immunodeficiencies (REDIP). Update to niovember-1999

El Registro Español de Inmunodeficiencias Primarias (REDIP) fue creado en 1993. Se admitieron los pacientes diagnosticados a partir de enero de 1980 hasta la actualidad. Los casos registrados hasta octubre de 1999 han sido 1695. Las inmunodeficiencias remitidas han sido diagnosticadas de acuerdo con los riterios de la OMS (1977). Los síndromes más registrados son, en orden de mayor a menor, en primer lugar la deficiencia selectiva de IgA (659 registros), las inmunodeficiencias combinadas severas y deficiencias de células T(233), las deficiencias de complemento (106), la agammaglobulinemia ligada al sexo (69), la deficiencia de subclases de IgG (63) y la enfermedad granulomatosa crónica (59). Los tratamientos específicos aplicados han sido fundamentalmente dos. El trasplante de médula ósea en 53 pacientes y la gammaglobulina endovenosa en 570 pacientes, de éstos últimos el 76 por ciento pertenecen al grupo de deficiencias predominantes de anticuerpos. La participación en el registro es constante y regular, existen variaciones importantes en la contribución al mismo entre las distintas comunidades autónomas. Se establece la necesidad de la actualización de la base de datos con referencia al estado actual de los pacientes registrados (AU)

Primary immunodeficiency syndrome in Spain: first report of the National Registry in Children and Adults.

The Spanish Registry for Primary Immunodeficiency Diseases (REDIP) was organized in 1993. One thousand sixty-nine cases of primary immunodeficiency diseases (PID) were registered in patients diagnosed between January 1980 and December 1995. PID diagnosis was made according to the World Health Organization criteria. The most frequent disorders were IgA deficiency (n = 394) and common variable immunodeficiency (n = 213), followed by severe combined immunodeficiency (n = 61), C1 inhibitor deficiency (n = 52), X-linked agammaglobulinemia (n = 49), IgG subclass deficiency (n = 48), and chronic granulomatous disease (n = 32). A comparative study between REDIP and data recently obtained from the European registry (ESID Report, 1995) revealed important differences between phagocytic disorders and complement deficiencies reported in both registries, 4.9 vs 8.7 and 6.0 vs 3.6, while percentages of predominantly antibody deficiencies and T cell and combined deficiencies concurred with those reported in the European registry, 69.3 vs 64.7 and 14.7 vs 20.2, respectively. The heterogeneous nature of the geographical distribution of cases submitted may indicate underdiagnosis of PID in some country areas; surprisingly, the interval between the onset of clinical symptoms and diagnosis was significant, even in immunodeficiency diseases, such as IgA deficiency, which are easy to diagnose.

A human infection with Paragonimus kellicotti (lung fluke) in the United States.

A first case of Paragonimus kellicotti infection, in the United States, involving a nonimmigrant adult, is reported. Diagnosis was made on sputum cell block sections and demonstration of the characteristic operculated ova of the parasite by direct sputum smear preparation. The patient had never been outside the United States. He responded favorably to praziquantel and was asymptomatic after therapy.

Malignant melanoma of the gallbladder. Report of a case.

A case of malignant melanoma in a 31-year-old man is described to add to the eight cases previously reported in the literature. The tumor in this case shares many common gross and microscopic features with those previously reported. These similarities, in addition to the clinical absence of any primary melanoma in the more common site of occurrence, indicate that the tumor in this case is primary in the gallbladder.