Injuries among children and adolescents in a rapidly growing urban African metropolis: a cross-sectional survey of 1,968 households in Dar es Salaam, Tanzania.

OBJECTIVES: To assess the patterns and incidence of child and adolescent injury and explore associations with household deprivation and child characteristics in a low-income urban setting. STUDY DESIGN: Cross-sectional household survey in Dar es Salaam, Tanzania. METHODS: Data collection took place during July 2009. Injuries requiring medical attention were recorded with a one month period of recall. A total of 1,968 households representing 3,927 children and adolescents were visited by health workers. Gender-, age-, and type-specific injury incidence was compiled. Odds ratios were calculated to measure associations with child injury, perceived deprivation, household characteristics and child characteristics. RESULTS: One household in five reported injuries. The estimated incidence was 3.2 per 10,000 child-years. The most common identifiable injuries were falls (41%), cuts (22%) and burns (16%). Male and younger children aged 1-4 years were at higher risk (respectively OR = 1.36; p = 0.004; OR = 1.47; p ≤ 0.001). CONCLUSIONS: In Dar e Salaam injuries are common. Future investigations should take into account both subjective and objective measurements of relative household deprivation and a clear criteria for the assessment of injury severity in community-based survey contexts.

Bullous lupus as the first manifestation of systemic lupus erythematosus in the pediatric population: A diagnostic challenge in daily practice.

INTRODUCTION: In the GLADEL cohort, the bullous lupus (BSLE) prevalence was 0.41%. However, literature on pediatric BSLE is scarce. This study described the clinical, histological, and immunological characteristics and the treatment response in a series of children with BSLE as the first clinical manifestation of pediatric SLE. METHODS: The clinical, histological, and immunological characteristics of a series of 5 cases of BSLE between 2010-2019 from two reference centers in Colombia were analyzed. RESULTS: All cases had bullous lesions that resolved with residual hypopigmentation. One had a focal seizure, and another arthritis with thrombocytopenia. Two had transient proteinuria with normal urinalysis. Anti-nuclear antibody titers ranged from 1:160 to 1:2560, and four were anti-dsDNA (+). Five patients had anti-RNP antibodies, and four anti-Sm antibodies. All had low C3, and 80% low C4 counts; 80% had erythrocyte sedimentation rate (ESR) ≥20 mm/hour and 60% had C-reactive protein (CRP) ≥0.5 mg/dL. All patients responded to glucocorticoids and dapsone. Histology reports and direct immunofluorescence (DIF) test showed subepidermal blisters with neutrophils in the papillary dermis and linear deposits of Igs/complement proteins in 80% of the skin biopsies. IgG/IgM was present in 5 samples. IgA was positive in 60% and C3 in 80%. CONCLUSIONS: In this pediatric series, BSLE tends to have a monophasic behavior associated with neuropsychiatric, skeletal, and hematological involvement in 40% of the patients, and with good prognosis.

Draft Genome Sequence of Paenibacillus sp. Strain OT2-17, a Triclosan-Degrading Rhizobacterium.

We report the draft genome sequence of a strain (OT2-17) of Paenibacillus isolated from the rhizosphere of onions irrigated with triclosan. Strain OT2-17 demonstrated the use of triclosan as the sole carbon source. A genome assembly of approximately 5.8 Mb was generated with a calculated G+C content of 45.5%.

Zika Virus Infection Associated With Severe Thrombocytopenia.

We report two patients that developed severe thrombocytopenia after Zika virus (ZIKV) infection. The first patient had 1000 platelets/µL and died after multiple hemorrhages. The second patient had 2000 platelets/µL, had melena and ecchymoses, and recovered after receiving intravenous immunoglobulin. ZIKV may be associated with immune-mediated severe thrombocytopenia.

Fate of Triclosan in Irrigated Soil: Degradation in Soil and Translocation into Onion and Tomato.

This study determined the fate of triclosan, a prevalent wastewater contaminant in recycled waters and surface streams, when soil and crop plants were irrigated at environmentally relevant concentrations. Soil triclosan concentrations were monitored in an 8-wk and in a 16-wk study without plants to determine triclosan degradation. Onion ( O. Fedtsch.) and tomato ( L.) were assessed for growth and triclosan accumulation at four levels of triclosan exposure (0, 0.015, 0.15, and 1.5 µg L) in irrigation waters within ranges of those found in recycled waters and associated receiving streams. Onions were grown for 8 wk and tomatoes were grown for 8 wk (short-term study) and 12 wk (long-term study) in potting soil. Soil triclosan concentrations increased (5-fold) with triclosan levels applied to soils alone. With repeated application, the half-life of triclosan was 18 d, with low-level accumulation in soil. Bioaccumulation of triclosan was observed in all edible portions of onions (115-435 ng g), primarily in bulbs, with no discernible impact on biomass. In both short- and long-term tomato studies, triclosan translocated to shoots and fruits (approaching a translocation factor of 1) at the highest level examined. Even at low triclosan concentrations typically found in recycled waters and receiving streams, agricultural irrigation presents an additional exposure route for organic contaminants to humans via commercial crops. Our study indicates that bulb crops, in particular, would likely accumulate high levels of triclosan. However, concentrations detected in both onions and tomato fruits determined here are below current human exposure limits.

Venous endothelin guides sympathetic innervation of the developing mouse heart.

The mechanisms responsible for establishing correct target innervation during organ development are largely unknown. Sympathetic nerves follow blood vessels--typically arteries--to reach their endorgans, suggesting the existence of vascular guidance cues that direct axonal extension. The sinoatrial node and the ventricle of the heart receive sympathetic innervation from the stellate ganglia (STG). Here we show that STG axons follow veins, specifically the superior vena cavae and sinus venosus, to reach these targets. We find that election of these routes is determined by venous endothelium-derived endothelin-1, acting through its specific receptor Ednra expressed within a subpopulation of STG neurons. Furthermore, we demonstrate that Edn1-Ednra signalling is essential for functional regulation of the heart by sympathetic nerves. Our findings present venous Edn1 as a sympathetic guidance cue, and show how axon guidance mechanisms are coordinated with endorgan morphogenesis.

Actividad antiviral contra el virus de la fiebre amarilla, cepa vacunal 17D, de extractos de hojas de Taraxacum officinale GH Weber ex Wiggers / Phytochemicaland antiviral activity against yellow fever virus, 17D vaccine strain, of extracts from leaves of Taraxacum officinale GH Weber ex Wiggers

Taraxacum officinale leaves were collected at two and 5 months of growth, for antiviral activity against flavivirus, using the 17D vaccine strain of yellow fever virus as a model. Using spectroscopy technique, a total of twelve (12) compounds were identified in the chloroform (C) and hexane (H) extracts of two and five months (2M and 5M) of recollection., The antiviral activity against the yellow fever 17D virus was evaluated with the plaque assay and the concentrations used (50 - 1,5 ug/mL) were no cytotoxic to Vero cells as determined using the MTT(3-(4,5-Dimetiltiazol-2yl)-2,4-difenilbromuro de tetrazolium) assay. The phytochemical composition of leaves growing for 5 months is different and more complex than leaves growing for 2 months. From the four extracts, only C5M inhibited the viral replication in a dose depend manner, with 100 percent viral inhibition at 50 ug/mL (p=0,0124) and the effective doses 50 (ED50: 10,2 +/- 8,7 ug/mL), meanwhile, ED50 of C2M extract was 93,5 +/- 23,5 ug/mL, thus, the extract C5M is 8 times more effective than extract C2M. The identified compounds in extract C5M were: Psi taraxasteryl acetate, cafeic acid, taraxasteryl acetate, taraxerol, taraxerilo acetate and Psi-taraxasterol. One of these compounds or the combinations of them is responsible for the reported high antiviral activity.

Las hojas de Taraxacum officinale fueron colectadas a dos y cinco meses de crecimiento, para determinar actividad antiviral contraflavivirus, utilizando como modelo el virus de fiebre amarilla cepa vacunal 17D. Se identificaron por métodos espectroscópicos, un total de doce (12) compuestos provenientes de los extractos de hexano (H) y cloroformo (C) a dos y cinco meses (2M y 5M) de recolección La actividad antiviral se determinó mediante un ensayo de placa y las concentraciones de extractos utilizadas (50-1,5 ug/mL) fueron no citotóxica en células Vero, determinadas por el método colorimétrico del MTT (3-(4,5-Dimetiltiazol-2yl)-2,4-difenilbromuro de tetrazolio). La composición fitoquímica de los extractos de 5 meses es distinta y más compleja que la de dos meses de crecimiento. De los cuatro extractos sólo el C5M inhibió la replicación del virus en una manera dosis dependiente, con una inhibición del 100 por ciento a 50 ug/mL (p=0,0124) y una dosis efectiva 50 (DE50) de 10,2 +/- 8,7 ug/mL, mientras que el DE50 del extracto C2M es de 93,5 +/- 23,5 ug/mL, lo que hace al extracto clorofórmico de 5 meses aproximadamente 8 veces más efectivo que el C2M. Los compuestos presentes en el extracto C5M son Psi taraxasterilo, ácido cafeíco, acetato de taraxasterilo, taraxerol, acetato de taraxerilo y Psi-taraxasterol. Uno o más de estos compuestos son responsables de alta actividad antiviral reportada.

Rituximab en población pediátrica: experiencia en el tratamiento de enfermedades reumatológicas, en unhospital infantil de Medellín, Colombia / Rituximab in pediatric population: Experience of rheumatic diseases treatment in a children's hospital in Medellín, Colombia

Introducción: En niños, diferentes series han encontrado que rituximab es eficaz y seguro entrombocitopenia y anemia hemolítica autoinmunes; no obstante, los estudios en lupus eritematososistémico (LES) de inicio temprano, dermatomiositis juvenil (DMJ) y en vasculitis sistémicasson escasos.Objetivo y métodos: Describir la respuesta clínica a rituximab en pacientes ≤18 años conenfermedad reumatológica, evaluados en un hospital infantil de Medellín, Colombia. Serie decasos en la que se revisó la historia clínica de pacientes con LES, síndrome antifosfolípido, DMJy vasculitis sistémicas que recibieron rituximab entre enero de 2006 y julio de 2011.Resultados: En el tiempo establecido 19 pacientes ≤18 años recibieron rituximab. La indicaciónmás frecuente fue nefritis lúpica (NL) (47,4%), seguida por trombocitopenia autoinmune (26,3%).En pacientes con NL se lograron reducir los esteroides en 58% y el control de la proteinuria en lamayoría de los casos. En trombocitopenia o anemia hemolítica autoinmune se observó respuestaadecuada en el 83%. En los casos de vasculitis se encontró respuesta a la terapia pero la pacientecon DMJ fue refractaria. No se presentaron eventos adversos.Conclusiones: con rituximab se observó mejoría en anemia hemolítica asociada a LES y trombocitopeniaasociada a LES o síndrome antifosfolípido, que no habían respondido a terapia de primeralínea. Aunque en NL mostró efecto clínico favorable y permitió ahorro de dosis de esteroides, serequieren estudios prospectivos para evaluar la utilidad en pacientes con NL ≤18 años.

Nefropatía full house no lúpica, aspectosclínicos e histológicos. Experiencia en dos centroshospitalarios de Medellín, Colombia / Non-lupus full house nephropathy, clinical and histological aspects. Experience in two hospitals in Medellín, Colombia

Introducción: La mayoría de los pacientes con nefropatía y patrón de inmunofluorescencia “fullhouse” (definida como la detección simultánea de depósitos de IgA, IgM, IgG, C1q y C3) tienenlupus eritematoso sistémico (LES), sin embargo, otras enfermedades pueden manifestarse connefritis “full house”, principalmente: hepatopatías, diabetes mellitus, glomerulopatías primarias,nefropatía C1q, nefropatía IgA e infecciones.Objetivo: Describir las características clínicas, histopatológicas y el comportamiento en el tiempode la nefropatía “full house” no lúpica (NFHNL), en pacientes de dos centros hospitalarios deMedellín, Colombia.Métodos: Estudio descriptivo de corte transversal. Se incluyeron 20 historias clínicas de pacientescon NFHNL, con 6 meses o más de seguimiento, evaluados entre 2004 y 2010, en dos centrosespecializados de Medellín, Colombia: Hospital Universitario San Vicente Fundación y HospitalPablo Tobón Uribe. Se analizaron variables clínicas, de laboratorio e histopatológicas. Los resultadosse muestran como medidas de resumen y dispersión.Resultados: Se incluyeron 20 historias (12 niños y 8 adultos). Las edades oscilaron entre 10-54años, (media: 23,2 ± 14,5 años), predominó el sexo femenino (80%). El diagnóstico histopatológicomás frecuente fue la glomerulonefritis membranosa (50%). Durante el seguimiento, dos pacientesdesarrollaron anticuerpos antinucleares (ANA), sin reunir criterios de clasificación para LES.Conclusiones: La NFHNL puede relacionarse con otras enfermedades sistémicas, con nefropatíasprimarias o con infección, tiene una expresión clínica variable y los hallazgos histológicos sondiversos. En el seguimiento siempre se debe estar atento al posible desarrollo de LES.

Assessment of DDT levels in selected environmental media and biological samples from Mexico and Central America.

Taking into account the environmental persistence and the toxicity of DDT, the Pan American Health Organization (PAHO) organized a surveillance program in Mesoamerica which included the detection of residual DDT in environmental (soil) and biological samples (fish tissue and children's blood). This program was carried out in communities from Mexico, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panama. This paper presents the first report of that program. As expected, the results show that the levels for [summation operator] DDT in soil (outdoor or indoor) and fish samples in the majority of the locations studied are below guidelines. However, in some locations, we found children with high concentrations of DDT as in Mexico (mean level 50.2 ng/mL). Furthermore, in some communities and for some matrices, the DDT/DDE quotient is higher than one and this may reflect a recent DDT exposure. Therefore, more efforts are needed to avoid exposure and to prevent the reintroduction of DDT into the region. In this regard it is important to know that under the surveillance of PAHO and with the support of UNEP, a regional program in Mesoamerica for the collection and disposal of DDT and other POPs stockpiles is in progress.

Plant growth-promoting bacteria for phytostabilization of mine tailings.

Eolian dispersion of mine tailings in arid and semiarid environments is an emerging global issue for which economical remediation alternatives are needed. Phytostabilization, the revegetation of these sites with native plants, is one such alternative. Revegetation often requires the addition of bulky amendments such as compost which greatly increases cost. We report the use of plant growth-promoting bacteria (PGPB) to enhance the revegetation of mine tailings and minimize the need for compost amendment. Twenty promising PGPB isolates were used as seed inoculants in a series of greenhouse studies to examine revegetation of an extremely acidic, high metal contenttailings sample previously shown to require 15% compost amendment for normal plant growth. Several isolates significantly enhanced growth of two native species, quailbush and buffalo grass, in tailings. In this study, PGPB/compost outcomes were plant specific; for quailbush, PGPB were most effective in combination with 10% compost addition while for buffalo grass, PGPB enhanced growth in the complete absence of compost. Results indicate that selected PGPB can improve plant establishment and reduce the need for compost amendment. Further, PGPB activities necessary for aiding plant growth in mine tailings likely include tolerance to acidic pH and metals.

Characterization of a bacterial community in an abandoned semiarid lead-zinc mine tailing site.

Bacterial diversity in mine tailing microbial communities has not been thoroughly investigated despite the correlations that have been observed between the relative microbial diversity and the success of revegetation efforts at tailing sites. This study employed phylogenetic analyses of 16S rRNA genes to compare the bacterial communities present in highly disturbed, extremely (pH 2.7) and moderately (pH 5.7) acidic lead-zinc mine tailing samples from a semiarid environment with those from a vegetated off-site (OS) control sample (pH 8). Phylotype richness in these communities decreased from 42 in the OS control to 24 in the moderately acidic samples and 8 in the extremely acidic tailing samples. The clones in the extremely acidic tailing sample were most closely related to acidophiles, none of which were detected in the OS control sample. The comparison generated by this study between the bacteria present in extremely acidic tailing and that in moderately acidic tailing communities with those in an OS control soil provides a reference point from which to evaluate the successful restoration of mine tailing disposal sites by phytostabilization.

Phytostabilization of mine tailings in arid and semiarid environments--an emerging remediation technology.

OBJECTIVE: Unreclaimed mine tailings sites are a worldwide problem, with thousands of unvegetated, exposed tailings piles presenting a source of contamination for nearby communities. Tailings disposal sites in arid and semiarid environments are especially subject to eolian dispersion and water erosion. Phytostabilization, the use of plants for in situ stabilization of tailings and metal contaminants, is a feasible alternative to costly remediation practices. In this review we emphasize considerations for phytostabilization of mine tailings in arid and semiarid environments, as well as issues impeding its long-term success. DATA SOURCES: We reviewed literature addressing mine closures and revegetation of mine tailings, along with publications evaluating plant ecology, microbial ecology, and soil properties of mine tailings. DATA EXTRACTION: Data were extracted from peer-reviewed articles and books identified in Web of Science and Agricola databases, and publications available through the U.S. Department of Agriculture, U.S. Environmental Protection Agency, and the United Nations Environment Programme. DATA SYNTHESIS: Harsh climatic conditions in arid and semiarid environments along with the innate properties of mine tailings require specific considerations. Plants suitable for phytostabilization must be native, be drought-, salt-, and metal-tolerant, and should limit shoot metal accumulation. Factors for evaluating metal accumulation and toxicity issues are presented. Also reviewed are aspects of implementing phytostabilization, including plant growth stage, amendments, irrigation, and evaluation. CONCLUSIONS: Phytostabilization of mine tailings is a promising remedial technology but requires further research to identify factors affecting its long-term success by expanding knowledge of suitable plant species and mine tailings chemistry in ongoing field trials.

Phytostabilization potential of quailbush for mine tailings: growth, metal accumulation, and microbial community changes.

Abandoned mine tailings sites in semiarid regions remain unvegetated for extended periods of time and are subject to eolian dispersion and water erosion. This study examines the potential phytostabilization of a lead-zinc mine tailings site using a native, drought-tolerant halophyte, quailbush [Atriplex lentiformis (Torr.) S. Wats.]. In a greenhouse study germination, growth, and metal uptake was evaluated in two compost-amended mine tailings samples, K4 (pH 3) and K6 (pH 6) at 75, 85, 90, 95, and 100% mine tailings, and two controls, off-site and compost. Microbial community changes were monitored by performing MPN analysis of iron- and sulfur-oxidizing bacteria as well as heterotrophic plate counts. Results demonstrate that germination is not a good indicator for phytostabilization since it was only inhibited in the unamended K4 treatment. Plant growth was significantly reduced in 95 and 100% mine tailings, while growth in 75, 85, and 90% treatments was similar to the off-site control. Quailbush accumulated elevated levels of the nutrient metals Na, K, Mn, and Zn in the shoot tissues; however, metal accumulation was generally below the domestic animal toxicity limit. Initially, autotrophic population estimates were four to six logs higher than heterotrophic counts, indicating extremely stressed conditions. However, post-harvest, heterotrophic bacterial counts increased to normal levels (approximately 10(6) CFU g-1 dry tailings) and dominated the rhizosphere. Therefore, with compost amendment, quailbush has good potential as a native species candidate for phytostabilization of mine tailings in semiarid environments.

Prevalencia de falla ovárica y factores de riesgo en pacientes con Lupus Eritematoso Sistémico tratadas con ciclofosfamida intravenosa / Prevalence of ovarian failure and risk factor in patients with systemic lupus erythematosus

Introducción: la falla ovárica prematura es una consecuencia del manejo a largo plazo con ciclofosfamida, su prevalencia en pacientes con LES ha sido informada entre el 11 y el 59%, dependiendo de la ruta y dosis de administración. Estudios sobre la toxicidad gonadal con el régimen propuesto por el NIH son escasos en la literatura, por lo cual se realizó este estudio para determinar la prevalencia y los factores de riesgo asociados al desarrollo de falla ovárica en una población latinoamericana. Métodos: se tomaron 56 pacientes con LES tratadas con bolos de CFM mensuales, menores de 40 años y con menstruación normal al momento de iniciar la terapia y se compararon con respecto a la frecuencia de amenorrea con 43 pacientes con LES sin tratamiento con ciclofosfamida como grupo control. Posteriormente estudiamos en el grupo de CYC, las diferencias entre aquellas que hicieron amenorrea y las que continuaron con ciclos regulares. Este es un estudio descriptivo de corte transversal. Se aplicó chi-cuadrado, test exacto de Fisher y Mann-Withney según estuviese indicado. P menor de 0,05 se consideró significativo. Resultados: el 16,1% de los pacientes con CYC desarrollaron falla ovárica frente al 4,3% del grupo control. Con respecto al grupo que recibió CYC, se encontró un promedio de edad mayor en el grupo que desarrolló amenorrea que en aquellas con ciclos regulares, 35,2 frente a 26,7 años (p= 0,003), determinándose como punto de corte de riesgo ser mayor de 28 años al inicio de la CFM. La evolución de la enfermedad fue mayor en el grupo de amenorrea en comparación con las que continuaban con menstruación normal con una p= 0,003 (10,2 frente a 4,4 años). No se encontró diferencia en la dosis acumulativa, duración de la terapia o perfil inmunológico de las pacientes. Conclusión: la prevalencia de falla ovárica en mujeres colombianas tiende a presentarse a una edad más temprana y con mayor tiempo de evolución de la enfermedad a pesar de dosis acumuladas inferiores a las informadas en la literatura planteando una mayor labilidad al efecto tóxico de la CFM.

Background: premature ovarian failure is a cyclophosphamide (CYC) treatment adverse effect. The report of prevalence is among 11% and 59%, the variability depend on the route and dosage of CYC. There are few studies about gonadal toxicity with NHI CYC treatment protocol. We decided to establish the prevalence and risk factors associated with premature ovarian failure in a group of Latin-American lupus patients. Methods: 56 SLE patients under 40 years treated with intravenous CYC, with regular menstrual cycle at the beginning of the treatment, were compared with respect to the frequency of amenorrhea with 43 SLE patients without treatment with CYC as a control group. After that, we studied in the CYC group the differences between those who made amenorrhea and those that continued with regular cycles. This is a cross sectional and descriptive study. The data were analyzed by chi-square, Fisher’s exact test and Mann-Withney when it was necessary. P < 0.05 was considered significant. Results: 16.1% of SLE patients under intravenous CYC treatment get premature ovarian failure vs. 4.3% in the control group. With respect to CYC group, the mean age in the amenorrhea group was higher than the age in patients with regular menstrual cycles 35.2 vs. 26.7 years (p=0.03). We found than patients older than 28 years have a mayor risk for amenorrhea induced by intravenous CYC. The mean disease duration was higher in the amenorrhea group than in the regular menstrual cycle patients, p= 0.003 (10.2 vs. 4.4 years). No significant differences were observed in cumulative dosage, treatment duration or immunologic findings between groups. Conclusion: the prevalence of ovarian failure in Colombian women tends to appear at an early age and with a greater time of evolution of the disease in spite of inferior accumulated doses than those that are informed in the Literature, suggesting a mayor susceptibility to toxic effect of CYC.