HSP or not HSP... that is the question.

The authors report on the case of a 10-year-old girl who presented with a vasculitic process primarily involving the skin, joints and kidneys, which was initially presumed to be a variant of Henoch-Schonlein purpura. When the disease process behaved in a more aggressive way than expected, with the rapid onset of acute renal failure, further investigation revealed the underlying diagnosis to be that of Wegener's granulomatosis.

Human influences on water quality in Great Lakes coastal wetlands.

A better understanding of relationships between human activities and water chemistry is needed to identify and manage sources of anthropogenic stress in Great Lakes coastal wetlands. The objective of the study described in this article was to characterize relationships between water chemistry and multiple classes of human activity (agriculture, population and development, point source pollution, and atmospheric deposition). We also evaluated the influence of geomorphology and biogeographic factors on stressor-water quality relationships. We collected water chemistry data from 98 coastal wetlands distributed along the United States shoreline of the Laurentian Great Lakes and GIS-based stressor data from the associated drainage basin to examine stressor-water quality relationships. The sampling captured broad ranges (1.5-2 orders of magnitude) in total phosphorus (TP), total nitrogen (TN), dissolved inorganic nitrogen (DIN), total suspended solids (TSS), chlorophyll a (Chl a), and chloride; concentrations were strongly correlated with stressor metrics. Hierarchical partitioning and all-subsets regression analyses were used to evaluate the independent influence of different stressor classes on water quality and to identify best predictive models. Results showed that all categories of stress influenced water quality and that the relative influence of different classes of disturbance varied among water quality parameters. Chloride exhibited the strongest relationships with stressors followed in order by TN, Chl a, TP, TSS, and DIN. In general, coarse scale classification of wetlands by morphology (three wetland classes: riverine, protected, open coastal) and biogeography (two ecoprovinces: Eastern Broadleaf Forest [EBF] and Laurentian Mixed Forest [LMF]) did not improve predictive models. This study provides strong evidence of the link between water chemistry and human stress in Great Lakes coastal wetlands and can be used to inform management efforts to improve water quality in Great Lakes coastal ecosystems.

Integrated measures of anthropogenic stress in the U.S. Great lakes basin.

Integrated, quantitative expressions of anthropogenic stress over large geographic regions can be valuable tools in environmental research and management. Despite the fundamental appeal of a regional approach, development of regional stress measures remains one of the most important current challenges in environmental science. Using publicly available, pre-existing spatial datasets, we developed a geographic information system database of 86 variables related to five classes of anthropogenic stress in the U.S. Great Lakes basin: agriculture, atmospheric deposition, human population, land cover, and point source pollution. The original variables were quantified by a variety of data types over a broad range of spatial and classification resolutions. We summarized the original data for 762 watershed-based units that comprise the U.S. portion of the basin and then used principal components analysis to develop overall stress measures within each stress category. We developed a cumulative stress index by combining the first principal component from each of the five stress categories. Maps of the stress measures illustrate strong spatial patterns across the basin, with the greatest amount of stress occurring on the western shore of Lake Michigan, southwest Lake Erie, and southeastern Lake Ontario. We found strong relationships between the stress measures and characteristics of bird communities, fish communities, and water chemistry measurements from the coastal region. The stress measures are taken to represent the major threats to coastal ecosystems in the U.S. Great Lakes. Such regional-scale efforts are critical for understanding relationships between human disturbance and ecosystem response, and can be used to guide environmental decision-making at both regional and local scales.