Multi-residue analysis of fifty pesticides in river waters and in wastewaters.

Three sampling campaigns were performed in the Lis River (Leiria, Portugal) in February of 2018, November of 2018, and May of 2019. River water and wastewater (influent and effluent) samples of two wastewater treatment plants were target of the study. A total of 25 samples were collected and 50 pesticides were monitored, including organochlorines, triazines, pyrethroids, and organophosphorus, among others. Most of the detected pesticides were insecticides and mainly organochlorines. Concentrations between 1.29 and 2134 ng/L were found. Aldrin, γ-HCH, and cypermethrin were detected in some samples in µg/L, being γ-HCH the pesticide most frequently detected with concentration in µg/L level. The pesticides with the highest detection frequency were (i) cypermethrin, HCB, methoxychlor, and ζ-HCH in river waters; (ii) isoproturon, cypermethrin, methoxychlor, pyrimethanil, γ-HCH, dieldrin, diuron, α-HCH, and α-endosulfan in effluents; and (iii) diuron and isoproturon in influents. The detection of the organochlorides and their degradation products is a consequence of their persistence in the environment, as their usage has long been prohibited in the European Union. Pesticides were grouped by their types in herbicides, insecticides, or fungicides and the detection and concentration for each type were discussed with the climatic conditions. Pesticide toxicity index was determined in the samples collected in the river.

Monitoring survey of caffeine in surface waters (Lis River) and wastewaters located at Leiria Town in Portugal.

Investigation during 11-month period was performed to study the presence of caffeine in the Lis River in Leiria Town in Portugal, and a monitoring during 9-month period was realized to check the contribution of the human pollution of two wastewater treatment plants (WWTPs) that discharge their effluents to the studied river. The samples were collected in five sampling points along the river and in two influents and two effluents of the studied WWTPs. Caffeine was detected in all ninety-one collected samples. The caffeine concentration ranged from 25.3 to 321 ng/L in the river samples, from 112 to 1927 ng/L in the WWTP effluents, and from 9478 to 83,901 ng/L in the WWTP influents. The highest concentration in the river was detected in the two sampling points located after the effluent discharge points and reached 315 and 321 ng/L. Risk assessment was performed for three trophic levels using the risk quotient calculation and revealed that caffeine do not cause toxic effect on Daphnia magna and on fish but could be possibly toxic to algae. The results proved that caffeine can be an effective indicator of human-born pollution.

Assessment of 83 pharmaceuticals in WWTP influent and effluent samples by UHPLC-MS/MS: Hourly variation.

The removal efficiency of pharmaceuticals in wastewater treatment plants (WWTPs) is variable and some of these compounds pass these plants almost intact and others presenting a removal efficiency close to 100%. Their incomplete removal results in a continuous discharge of pharmaceuticals into the environment. To assess the profile of contamination of influents and effluents over a day, a set of 83 pharmaceuticals were evaluated hourly in a WWTP in Leiria, Portugal. The composite samples of the influent and effluent were also collected. Concentrations varied from 1 in WWTP influents, and carbamazepine, fluoxetine, sertraline the pharmaceuticals with an RQ > 1 in WWTP effluents.

Presence of pharmaceuticals in the Lis river (Portugal): Sources, fate and seasonal variation.

The occurrence of 33 pharmaceuticals and metabolites was evaluated along the Lis river and in the influents and effluents of two wastewater treatment plants (WWTPs) located along the river. Results indicate that pharmaceuticals, such as ibuprofen, ketoprofen, carbamazepine and fluoxetine, and the metabolite salicylic acid are widespread along the Lis river, showing 100% of detection frequency, at levels up to 1.3µgL-1. The number of molecules detected increased along the river, with 11 molecules in the source, 15 upstream WWTP 1, 16 downstream WWTP 1 and upstream WWTP 2 and 19 downstream WWTP 2. The highest concentrations were often found downstream near the river mouth. Different possible sources of contamination of the Lis river were identified, namely WWTP effluents, untreated wastewaters and livestock production. Nevertheless, the discharge of WWTP effluents appeared to be the most pronounced, given that, in general, it was noticed an increase in the concentration of pharmaceuticals downstream of the WWTPs. WWTP effluents contributed with a total mass load of pharmaceuticals into the Lis river between 470 and 2317mg/d/1000 inhabitants. Non-steroidal anti-inflammatory drugs/analgesics were the therapeutic group with a high contribution to the total mass load of pharmaceuticals entering the Lis river, followed by psychiatric drugs and antibiotics. No seasonal variation was observed for the detected concentrations of pharmaceuticals. At the levels detected in the Lis river, sulfamethoxazole, clarithromycin, azithromycin and ibuprofen showed to have potential risk for aquatic organisms. These findings show that further studies embracing different environmental compartments (water, sediment and biota) are needed, in order to evaluate the partition/distribution of pharmaceuticals, their metabolites and transformation products in the environment as well as to predict their possible impact to non-target organisms and, in a last instance, to human health.

Calidad de vida relacionada con la salud del niño y del adolescente con obesidad / Health-related quality of life in obese child and adolescent

Objetivo Estimar la calidad de vida relacionada con la salud (CVRS) en un grupo de niños y adolescentes con obesidad de la ciudad de Hermosillo, Sonora, México. Métodos Se realizó un estudio transversal utilizando el cuestionario PedsQL® para comparar la CVRS de 200 niños y adolescentes con obesidad al igual que a sus padres, con dos grupos de control, uno de la comunidad (n=400) y otro grupo de usuarios (n=200) del Hospital Infantil del Estado de Sonora. Las diferencias en la CVRS fueron evaluadas mediante una prueba de Kruskal-Wallis, y su relación con variables sociodemográficas y de estatus corporal se examinó con regresión logística. Resultados La CVRS fue menor en los sujetos obesos y las funciones más deterioradas fueron la emocional y la social; la percepción de los padres acerca de la CVRS fue inferior a la de sus hijos. El 37.5% de los sujetos obesos percibe su CVRS como "muy mala", una cifra inferior a los otros grupos. El riesgo de mala CVRS fue 2.2 veces mayor en el grupo de obesos. Conclusiones En nuestra población, la obesidad se asoció negativamente con la CVRS de niños y adolescentes. El PedsQL ® es un instrumento útil para la evaluación sistemática de la CVRS en niños con obesidad.

Objective To estimate the health-related quality of life (HRQoL) in a group of obese children and adolescents from the city of Hermosillo, Sonora, Mexico. Methods A cross sectional study was performed using the PedsQL® questionnaire to compare the HRQoL of 200 children and adolescents with obesity as well as their parents, with two control groups: one from the community (n=400) and another group of users (n=200) from the Hospital Infantil del Estado de Sonora. The differences in HRQoL were assessed using a Kruskal-Wallis test and their relationship with sociodemographic variables and physical status was examined with logistic regression. Results HRQoL was lower in obese patients. Social and emotional QoL were lower in obese subjects. Perception of parents on HRQoL was lower than that of their children. 37.5% of obese subjects perceived their HRQoL as "very bad", which was lower than control groups. The risk of poor HRQoL was 2.2 times higher in the obese group. Conclusions Obesity impairs HRQoL in children and adolescents. PedsQL® is a useful tool for the systematic assessment of HRQoL in children with obesity.

KCNH2 gene mutation: a potential link between epilepsy and long QT-2 syndrome.

Long QT syndrome (LQTS) is closely associated with syncope, seizure, and sudden death but LQTS is frequently misdiagnosed as epilepsy. LQTS and epilepsy both belong to the group of ion channelopathies that manifest in the heart and brain. Therefore, genetic analysis of genes associated with potassium and sodium homeostasis and electrical disorders may reveal a link between epilepsy and lethal cardiac arrhythmia. Here, the authors report a young woman who suffered recurrent seizure episodes and syncopes that occurred while walking and also during rest. She showed electroencephalogram abnormalities and a pathological prolonged QTc interval in electrocardiogram. The patient and the patient's asymptomatic family members underwent genetic screening of the three genes most frequently associated with LQTS: KCNQ1, KCNH2, and SCN5A. The patient and the family members did not show DNA alterations in the genes KCNQ1 and SCN5A associated with LQT-1 and LQT-3, respectively. However, the patient showed a de novo mutation 2587T→C in exon 10 of KCNH2 gene associated with LQT-2. The mutation caused a stop codon substitution (R863X) in the HERG channel, leading to a 296-amino acid deletion. The patient's asymptomatic relatives did not show the KCNH2 gene mutation. R863X alteration in HERG channel may be involved in both prolonged QTc interval and epilepsy. This fact raises the possibility that R863X alteration in KCNH2-encoded potassium channel may confer susceptibility for epilepsy and cardiac LQT-2 arrhythmia.

Tetany caused by chronic diarrhea in a child with celiac disease: A case report.

There is no awareness about celiac disease (CD) in Mexico. A 2.9 year old mestizo boy was admitted to a Mexican hospital with muscle cramps and fine tremors. He suffered chronic diarrhea, abdominal distention, hypotrophic limbs, stunting and wasting, and presented hypocalcemia, anemia and high titers of serological markers. Diagnosis of CD was confirmed by a duodenal biopsy. After replacement of calcium and a gluten-free diet, the symptoms resolved within 6 weeks. After 2-months, serum analyses, anthropometric data as well as antibodies titers were normal after 4 years. CD screening tests are needed in chronic diarrhea for any ethnicity patients.

[Poisoning caused by Latrodectus Mactans (Black Widow) spider bite among children. Clinical features and therapy]. / Envenenamiento en niños por mordedura de la araña "Latrodectus Mactans" (Viuda Negra). Características clínicas y tratamiento.

INTRODUCTION: Poisoning caused by "black widow" spider bite, is not commonly observed during childhood, it is not exempt from complications, and must be treated in time or the patient can die. In Mexico we do not have accurate data on the exact number of accidents due to this condition. OBJECTIVE: Identify the signs and characteristic symptoms of children treated at the Children's Hospital from the state of Sonora with the aim of starting early treatment. MATERIAL AND METHODS: We reviewed 43 clinical records of hospitalized patients admitted for "black widow " spider bite between 1978 - 2004. Demographic variables were: age, gender, place of origin, place where accident took place, treatment given prior to hospital admittance, degree of envenomation measured by signs and symptoms, treatment and clinical evolution. RESULTS: 69.7% of cases were male, we did not find differences in the number of patients between infant, pre-school, elementary school children and teenagers. During summer and afternoon hours we registered 44% and 37% cases respectively; 74% patients were poisoned by the spider at home; the anatomical areas most affected were: arms, hands and thorax. Signs and symptoms in infants were: irritability, constanty cry, sialorrea, agitation erythema on wounded areas and seizures. Among elementary school children and teenagers signs included pain in wounded area, abdominal and thoracic, muscle spasms, fine tremor and residual signs. Patients who received fabotherapic treatment had better evolution and less time of hospitalization. No deaths were reported. CONCLUSIONS: The different signs and symptoms between infants, preschool, elementary school children and teenagers allowed us to clearly identify evenommation and differentiate it form confounding diseases. In our study, specific fabotherapy constituted the best treatment choice.

Envenenamiento en niños por mordedura de la araña Latrodectus Mactans (Viuda Negra): características clínicas y tratamiento / Poisoning caused by Latrodectus Mactans (Black Widow) spider bite among children: clinical features and therapy

Introducción: El envenenamiento por mordedura de araña viuda negra es poco frecuente en edades pediátricas sin embargo no está exento de complicaciones y si no se trata a tiempo puede causar la muerte. En México se desconoce el número exacto de estos accidentes. Objetivo: Identificar los signos y síntomas característicos, evolución y tratamiento de los niños atendidos por morderua de araña en el Hospital Infantil del Estado de Sonora, con el propósito de establecer el tratamiento oportuno. Material y Métodos: Se revisaron 43 expedientes de niños hospitalizados por mordedura de araña viuda negra entre 1978-2004, las variables consideradas fueron: edad, género, lugar de origen, sitio del accidente, área corporal afectada, tratamiento previo; grado de envenenamiento por signos y síntomas, tratamiento, evolución clínica. Resultados: Predominó el género masculino 69.7%; sin diferencias entre el número de menores de seis años, escolares y adolescentes. El 44 y 37% de los casos se presentaron en el verano y en horas de la tarde, respectivamente. El 74% de los pacientes tuvieron el contacto con el arácnido dentro del domicilio; las áreas anatómicas más afectadas fueron, miembros superiores y tronco; los signos y síntomas más notables en lactantes y preescolares fueron: irritabilidad, llanto constante, sialorrea, agitación, eritema en área de lesión convulsiones. En escolares y adolescentes fueron los signos y sínotmas dolor en sitio de lesión, dolor abdominal, dolor torácico, ansiedad, espasmos musculares y temblor fino. Los pacientes que recibieron tratamiento con faboterapia específica tuvieron mejor evolución y menor tiempo de hospitalización, cabe señalar que no se presentó mortalidad. Conclusiones: La adecuada identificación de los signos y síntomas ocasionados por la morderura de araña en lactantes y preescolares permite el diagnóstico oportuno y ofrece la mejor alternativa de tratamiento.

INTRODUCTION: Poisoning caused by black widow spider bite, is not commonly observed during childhood, it is not exempt from complications, and must be treated in time or the patient can die. In Mexico we do not have accurate data on the exact number of accidents due to this condition. OBJECTIVE: Identify the signs and characteristic symptoms of children treated at the Children's Hospital from the state of Sonora with the aim of starting early treatment. MATERIAL AND METHODS: We reviewed 43 clinical records of hospitalized patients admitted for black widow spider bite between 1978 - 2004. Demographic variables were: age, gender, place of origin, place where accident took place, treatment given prior to hospital admittance, degree of envenomation measured by signs and symptoms, treatment and clinical evolution. RESULTS: 69.7% of cases were male, we did not find differences in the number of patients between infant, pre-school, elementary school children and teenagers. During summer and afternoon hours we registered 44% and 37% cases respectively; 74% patients were poisoned by the spider at home; the anatomical areas most affected were: arms, hands and thorax. Signs and symptoms in infants were: irritability, constanty cry, sialorrea, agitation erythema on wounded areas and seizures. Among elementary school children and teenagers signs included pain in wounded area, abdominal and thoracic, muscle spasms, fine tremor and residual signs. Patients who received fabotherapic treatment had better evolution and less time of hospitalization. No deaths were reported. CONCLUSIONS: The different signs and symptoms between infants, preschool, elementary school children and teenagers allowed us to clearly identify evenommation and differentiate it form confounding diseases. In our study, specific fabotherapy constituted the best treatment choice.

Púrpura trombocitopénica autoinmune. Informe de 108 casos

Introducción. La púrpura trombocitopénica autoinmune (PTA) es un padecimiento hemorragíparo de presentación cada vez más frecuente en la infancia. Se puede manifestar con sangrados a todos los niveles. Se divide en 2 grandes grupos: púrpura trombocitopénica aguda (PTA-A) y la crónica (PTC-A). Objetivos: identificar las formas de presentación, evolución clínica y modalidades terapéuticas empleadas en pacientes con PTA-A. Material y métodos. Se realizó un estudio retrospectivo en el Servicio de Medicina Interna del Hospital Infantil del Estado de Sonora, reuniendo 108 egresos con diagnóstico de PTA en los últimos 10 años. Las variables analizadas fueron: edad, sexo, época del año, cuadro clínico, complicaciones, tratamiento y evolución. Resultados. El padecimiento fue más frecuente en niños menores de 6 años de edad, no hubo diferencias significativas en cuanto al género; los síntomas más frecuentes fueron: hemorragias en los tejidos cutáneos y en mucosas; la mayoría tuvo tratamiento con prednisona (89%); una minoría recibió gammaglobulina y danazol (4.5%); se les realizó esplenectomía a 11 pacientes (14.5%), sin encontrar en este grupo mortalidad por hemorragia del sistema nervioso central; 85% remitieron y 15% evolucionaron a la cronicidad. No se realizó esplenectomía de urgencia a ningún paciente y de aquellos con PTC-A esplenectomizados la remisión ocurrió en 91%. Conclusiones. La PTA-A puede presentar remisión, aún sin tratamiento; sin embargo, se observaron mejores resultados con incremento plaquetario y de forma más rápida con el uso de esteroides, reduciéndose el tiempo de hospitalización. En esta serie no se presentaron complicaciones graves.

Introduction. Autoimmmune thrombocytopenic purpura (ATP) is a hemorrhagic disease with a more frequent presentation in infancy. Could appear with an all level of bleeding and sometimes involves the central nervous system (CNS). It is divided in 2 groups: the acute thrombocytopenic purpura (A-ATP) and the chronic form (C-ATP). Objectives. To identify the presentation, evaluation and therapeutic modalities applied to patients with A-ATP. Material and methods. We realized a retrospective study in the Internal Medicine. Unit at the Children's Hospital in the State of Sonora, detecting 108 patients with the diagnosis of ATP in the last 10 years. The variables studied were: age gender, clinical features, complications, treatment and evolution. Results. We observed that the disease was more frequent in children under 6 years of age; there were no significant differences regarding gender, and the most common symptoms were bleeding of mucocutaneous tissues: 89% of the patients received treatment with prednisone; gammaglobulin and danazol in 4.5% and splenectomy 11 cases (14.5%); no evidence of mortality due to CNS hemorrhage; 85% presented remission and 15% went to chronicity. Urgent splenectomy was not required in our group, but these who underwent this type of surgery were cured in 91%. Conclusions. Being ATP an autoimmune disease the majority of patients may go under remission even without treatment; however, we have observed better results in the use of steroids, shortening their hospital stay; in this series we did not had any of the most severe complications of ATP.