Characterization of semen quality, testicular marker enzyme activities and gene expression changes in the blood testis barrier of Kunming mice following acute exposure to zearalenone

Abstract

A total of 95 8-week-old male Kunming mice were randomly assigned into five groups and exposed to zearalenone (ZEA) at doses of 25, 50, and 75 mg/kg delivered by intra-peritoneal (i.p.) injection for 5 days. The testis and epididymis indices involving sperm quality and morphology, testis enzyme activities, serum concentrations of testosterone and estrogen, and the expression levels of the three gene and protein of N-cadherin, vimentin, and claudin 11 related to the blood testis barrier (BTB) were analyzed. Results showed that ZEA significantly decreased body weight and semen quality compared to the control group along with increased activity of alkaline phosphatase (ALP), acid phosphatase (ACP), lactate dehydrogenase (LDH), and reduced serum concentrations of testosterone and estrogen. At the mRNA and protein levels, expression of N-cadherin, vimentin, and claudin 11 significantly increased; however, the mRNA and protein of N-cad expression decreased. These data suggest acute exposure to ZEA reduces sperm quality and significantly decreases the concentration of serum testosterone and estradiol. In addition, the activities of the testis marker enzymes and associated mRNA and protein expressions of the BTB were also significantly affected. Our results demonstrated that ZEA has a significant impact on the reproductive parameters of male mice which showed compensatory response to strengthen the barrier function of the BTB following ZEA exposure.

Variation in foliar uptake of polycyclic aromatic hydrocarbons in six varieties of winter wheat

Abstract

To investigate intraspecific variations of foliar uptake of polycyclic aromatic hydrocarbons (PAHs) of winter wheat (Triticum aestivum L.), leaves of six varieties including Changwu 521 (CW), Hedong TX-006 (HD), Jiaomai 266 (JM), Xiaoyan 22 (XY), Yunong 949 (YN), and Zhongmai 175 (ZM) were exposed to three levels of (0, 0.25, and 1.5 mg L⁻¹) mixture of six selected PAHs (phenanthrene, anthracene, pyrene, benz[a]anthracene, benzo[a]pyrene, and benzo[g,h,i]perylene). After 10 consecutive days of application, all the six selected PAHs (Σ₆ PAHs) were determined in the leaves of the six varieties of the winter wheat. There were apparent intraspecific differences in foliar uptake of PAHs in the winter wheat. The highest concentrations of Σ₆ PAHs in the leaves of YN variety (64.6 mg kg⁻¹) were approximate two times of the lowest concentrations in the leaves of HD variety (29.6 mg kg⁻¹). Both individual PAHs and Σ₆ PAHs in the cuticular waxes were significantly (p < 0.01) higher than those in leaves and far higher than those in roots, indicating that the cuticular waxes could play significant role in foliar uptake of PAHs. The present results also showed that the concentrations PAHs in leaves were positively (p < 0.05) correlated with the water solubility of the six selected PAHs. In addition, the present study suggested that there was basipetal translocation of PAHs in the winter wheat after foliar application of PAHs, although the mechanism was yet to be further studied.

The average concentration function of dissolved copper in Hun River, Liaoning province, Northeastern China

Abstract

Water samples were collected from Hun River to research the change in the concentration of dissolved copper and its distribution as well as accumulation during the dry season in 2013. The mean concentrations of dissolved copper in Hun River were 0.1057–0.1533 mg/l during the dry season. The results indicated that the most severe dissolved copper pollution were associated with the mining area, industrial area, and living area along the Hun River. The results also indicated that controlling the sources of copper pollution effectively reduced the concentration of dissolved copper in Hun River. The concentration function about time and spatial coordinate, average concentration function about time coordinate, average concentration function about spatial coordinate, and bounded mean oscillation space were used to evaluate the extent of copper pollution in Hun River. The error function, quartiles, and curve fitting tool were performed to determine the stations with high concentration of dissolved copper in Hun River. We furthermore obtained the upper and lower bounds of the error between two kinds of bounded mean oscillation spaces to explore the migration of copper pollution in Hun River. The results of the average concentration function and bounded mean oscillation space revealed that the long-term control measures of copper pollution and short-term control measures of copper pollution, the control of copper pollution in large watershed, and the control of copper pollution in small watershed in Hun River should be combined with each other. The strict policy and pollution control strategy should be implemented to ensure that the water of the Hun River meets the natural environment standard for the growth of aquatic life and human.

Influence of rapid rural-urban population migration on riverine nitrogen pollution: perspective from ammonia-nitrogen

Abstract

China is undergoing a rapid transition from a rural to an urban society. This societal change is a consequence of a national drive toward economic prosperity. However, accelerated urban development resulting from rapid population migration from rural to urban lands has led to high levels of untreated sewage entering aquatic ecosystems directly. Consequently, many of these regions have been identified as hot spots of riverine nitrogen (N) pollution because of the increasing level of urban point-source discharge. In order to address this concern, we assessed effects of urban development on ammonia-nitrogen (AN) loads using a panel data regression model. The model, expressed as an exponential function of anthropogenic N inputs multiplied by a power function of streamflow, was applied to 20 subwatersheds of the Huai River Basin for the years 2003–2010. The results indicated that this model can account for 81% of the variation in annual AN fluxes over space and time. Application of this model to three scenarios of urban development and sewage treatment (termed urbanization priority, sustainable development, and environmental priority) suggests that future N pollution will inevitably deteriorate if current urban environmental management and investment are not significantly improved. Stronger support for environmental management is very critical to alleviate N pollution and improve water quality. More effort should focus on improving sewage treatment and the N removal rate of the current sewage system in light of the increasing degree of urbanization.

Bacterial cellulose skin masks—Properties and sensory tests

Summary

Background

Bacterial cellulose (BC) is a versatile material produced by microorganisms in the form of a membranous hydrogel, totally biocompatible, and endowed with high mechanical strength. Its high water-holding capacity based on its highly porous nanofibrillar structure allows BC to incorporate and to release substances very fast, thus being suitable for the preparation of skincare masks.

Aims

The preparation and characterization of cosmetic masks based on BC membranes and active cosmetics.

Methods

The masks were prepared by the simple incorporation of the cosmetic actives into BC membranes, used as a swelling matrix. The masks were characterized by Fourier transform infrared (FTIR), scanning electron microscopy (SEM), sensory tests, and skin moisture tests on volunteers.

Results

The results of sensory tests revealed the good performance of BC, being considered effective by the panel of volunteers, specially for adhesion to the skin (7.7 at the score scale), and improvement of the skin moisture (the hydration effect increased 76% in 75% of the volunteers that used vegetable extract mask formulation [VEM]), or a decrease in skin hydration (80% of the volunteers showed 32.6% decrease on skin hydration using propolis extract formulation [PEM] treatment), indicating the BC nanofiber membranes can be used to skincare applications.

Conclusion

The results demonstrate the BC can be used as an alternative support for cosmetic actives for skin treatment.

La dermatología pediátrica española en el punto de mira internacional

Publication date: October 2017
Source:Actas Dermo-Sifiliográficas, Volume 108, Issue 8
Author(s): A. Martín-Santiago

Nuevos avances de tratamiento inmunobiológico en el melanoma avanzado

Publication date: October 2017
Source:Actas Dermo-Sifiliográficas, Volume 108, Issue 8
Author(s): M.C. Pérez Gago, O. Saavedra Santa Gadea, L. de la Cruz-Merino
El melanoma irresecable localmente avanzado y metastásico es una situación clínica asociada a una elevada tasa de morbimortalidad. En los últimos años, sin embargo, han acontecido notables avances en el ámbito del tratamiento sistémico de esta enfermedad, con la irrupción de la terapia dirigida con inhibidores tirosincinasa que actúan bloqueando la vía de las MAPKinasas, y de la moderna inmunoterapia con anticuerpos monoclonales inmunomoduladores. En la presente revisión se realiza una actualización sobre los datos disponibles con los nuevos inmunoterápicos, así como un repaso del desarrollo clínico que ha permitido la aprobación para su uso en la práctica clínica habitual.Metastatic or locally advanced unresectable melanoma carries a high morbidity and mortality. However, notable advances have been made in recent years in the systemic treatment of this disease, with the appearance of targeted therapy using tyrosine kinase inhibitors that block the mitogen activated protein kinase pathway, and of modern immunotherapy with immune-modulating monoclonal antibodies. In this paper, we provide an update of available data on new immune therapies and we review the clinical development that led to their approval for use in routine clinical practice.

Ecological risk assessment of heavy metals in salt-affected soils in the Natura 2000 area (Ciechocinek, north-central Poland)

Abstract

This paper aimed to evaluate the ecological risk posed by the accumulation of heavy metals in the salt-affected soils of the habitat covered by the EU Natura 2000 program in relation to the activity of soil redox enzymes. The research was carried out in the halophyte reserve in Ciechocinek (north-central Poland) which is a very specific habitat as it undergoes a long-term human impact related to both the operation of the medical spa town and the agricultural use of soils in the adjacent areas. The obtained results showed that the content of Zn, Cu, Pb, and Cd in the studied soils exceeded the Polish standards. Based on the obtained data and statistical analysis, it was found that metals may come from two different sources: emission from household boiler rooms (Pb, Cd) and corroded brine sewage pipeline (Zn, Cu).They are characterized by limited mobility due to alkaline environment and strong sorption properties of the clay fraction and organic matter. The correlation analysis indicates that the dehydrogenase activities were negatively correlated with soil electrical conductivity (EC_1:5) (r = − 0.665, P < 0.05). Taking into account the protective status of the area, it is difficult to indicate definitely the solution concerning the land management. However, according to the authors, one should pay special attention to a possibility of using halophytes which occur within the reserve for phytoremediation.

Assessment and modeling of E-waste generation based on growth rate from different telecom companies in the State of Kuwait

Abstract

The present work assesses the production rate of cell phone e-waste in Kuwait by comparing the number of clients in three telecommunication service providers like Zain, Ooredoo, and Viva in the state of Kuwait over a period of 7 years from 2008 to 2015. An online survey was conducted to evaluate the growth in the number of clients in three cell phone companies, and the data analysis was carried out using statistical package for the social sciences (SPSS) software. The prediction of the growth percentage of the number of clients in each telecommunication company was analyzed using analysis of variance (ANOVA) test and followed by the regression model. The study shows that there is an increase in the number of clients in all three companies (Zain, Ooredoo, and Viva) between year 2008 and 2015, and it was estimated that approximately 7.9 million cell phone users would be achieved in the first quarter of 2015. Based on this predicted number of cell phone users, the production of e-waste would be 3 kt per year with an average growth of 12.7%.

Impact of an invasive weed, Parthenium hysterophorus , on a pasture community in south east Queensland, Australia

Abstract

Parthenium weed is a highly invasive alien species in more than 40 countries around the world. Along with severe negative effects on human and animal health and crop production, it also causes harm to ecosystem functioning by reducing the native plant species biodiversity. However, its impacts on native plant species, especially in pasture communities, are less known. Given parthenium weed causes substantial losses to Australian pastures' productivity, it is crucial to estimate its impact on pasture communities. This study evaluates the impact of parthenium weed upon species diversity in a pasture community at Kilcoy, south east Queensland, Australia. Sub-sites containing three levels of parthenium weed density (i.e. high, low and zero) were chosen to quantify the above- and below-ground plant community structure. Species richness, diversity and evenness were all found to be significantly reduced as the density of parthenium weed increased; an effect was evident even when parthenium weed was present at relatively low densities (i.e. two plants m⁻²). This trend was observed in the summer season as well as in winter season when this annual weed was absent from the above-ground plant community. This demonstrates the strong impact that parthenium weed has upon the community composition and functioning throughout the year. It also shows the long-term impact of parthenium weed on the soil seed bank where it had displaced several native species. So, management options used for parthenium weed should also consider the reduction of parthenium weed seed bank along with controlling its above-ground populations.

Finding a Place for Buddhism in the Ethics of the Future: Comments on Shannon Vallor’s Technology and the Virtues: A Philosophical Guide to a Future Worth Wanting

Hematohidrosis: A rare case of a female child who sweat blood

Geeta Kiran Arakkal, Srishilpa Poojari, G Narasimha Rao Netha, B Udaya Kumar

Indian Journal of Paediatric Dermatology 2017 18(4):327-329

Hematohidrosis is a rare clinical entity characterized by excretion of blood in the sweat. Hematohidrosis presents as unpredictable, recurrent episodes of spontaneous and self-limited bloody discharge from the intact skin. Diagnosis of hematohidrosis is confirmed by testing the secretions for the presence of blood components. It is an extremely rare condition, with very few case reports in literature. Herein, we describe a case of hematohidrosis in an 11-year-old female child with pain and tenderness who responded to propranolol.

Drug reaction with eosinophilia and systemic symptoms mimicking Kawasaki disease

Kunnummal Muhammed, Sabitha Saidharan Pillai, Shermin Nazrin, Deepthi N Sureshan, Minu Nagesh

Indian Journal of Paediatric Dermatology 2017 18(4):349-351

Inherited epidermolysis bullosa: A multisystem disease of skin and mucosae fragility

Guadalupe Maldonado-Colin, Carolina Hernández-Zepeda, Carola Durán-McKinster, María Teresa García-Romero

Indian Journal of Paediatric Dermatology 2017 18(4):267-273

Epidermolysis bullosa (EB) is a blistering disorder that can be autosomic or dominantly inherited and has a wide spectrum of clinical presentations. The most recent classification divides EB into four basic subtypes: (1) EB simplex, (2) junctional EB, (3) dystrophic EB and (4) Kindler syndrome; depending on the level of the epidermal-dermal junction where the formation of blisters is present. With the use of immunohistochemistry and molecular biology, new mutation genes and proteins have been identified and more than thirty subtypes of EB have been described according to text phenotype, each affecting different key proteins for the structural integrity of the skin. The phenotype can be a mild one where blisters occur after minor trauma, but quality of life is preserved or a severe one with multisystemic manifestations affecting skin, mucous membranes, bones, joints, nutritional status, and cancer development leading to early death. We describe the clinical manifestations, diagnostic approach, and multidisciplinary management of EB subtypes.

Bullous Henoch–Schonlein purpura with involvement of face

Devdeep Mukherjee, Ishita Majumdar, Priyankar Pal, Sandipan Dhar, Ritabrata Kundu

Indian Journal of Paediatric Dermatology 2017 18(4):338-340

Henoch–Schonlein purpura (HSP) with facial involvement with bullous rashes are extremely rare. A 12-year-old boy presented with abdominal pain and features of arthritis. He also had multiple purpuric rashes over his lower limbs. Gradually, he developed bullous rashes which were seen on his legs and hands and progressed to involve the face. He was confirmed to be suffering from HSP from clinical presentation and skin biopsy. The child responded well to oral steroids. Bullous lesions may be seen in HSP. However, there is neither prognostic significance of this nor does it alter the management. Other causes of bullous lesions should be ruled out. As facial involvement is associated with renal and gastrointestinal involvement, these children should be monitored for sequelae.

Treatment guidelines for atopic dermatitis by Indian Society for Pediatric Dermatology task force 2016 - Part-2: Topical therapies in atopic dermatitis

Deepak Parikh, Sandipan Dhar, Sahana Srinivas, Ramkumar Rammoorthy, Rashmi Sarkar, Arun Inamadar, Manish Shah, Raghubir Banerjee, Amrinder Jit Kanwar, Vibhu Mendiratta, Renu George, Ram Gulati

Indian Journal of Paediatric Dermatology 2017 18(4):274-280

Subcutaneous panniculitis-like lymphoma in a 3-year-old child

Sudharani Chintagunta, Geetakiran Arakkal, Shahana Mohammed, Premajyothi Gopidi

Indian Journal of Paediatric Dermatology 2017 18(4):321-323

Panniculitis-like T-cell lymphoma is a rare cytotoxic T-cell lymphoma of the skin involving the subcutaneous tissue. We report panniculitis like lymphoma occurring in a 3 year old female child.She presented with multiple erythematous tender nodules and plaques on face,right thigh and genital region associated with systemic symptoms.The histopathology revealed lobular panniculitis composed of atypical lymphocytes . Immunophenotypic studies showed that the atypical lymphocytes are positive for CD3&CD8 and negative for CD20. The child improved with systemic antibiotics and supportive therapy. Now child is on regular follow up for the past four months without any new lesions.

The clinico-epidemiological profile of atopic dermatitis in residential schoolchildren: A study from South Chhattisgarh, India

Yasha Upendra, Naveen Keswani, Sampreeti Sendur, Abhishek Pallava

Indian Journal of Paediatric Dermatology 2017 18(4):281-285

Introduction: Atopic dermatitis is a chronic, inflammatory, relapsing skin disorder with early age of onset in infancy and early childhood. Objective: The present study was conducted to study the clinico-epidemiological profile of atopic dermatitis among children of residential schools of naxal-infested South Chhattisgarh. Materials and Methods: Ninety children (4.6%) of atopic dermatitis were pooled out from a previous study by the same authors on 1943 children of eight residential schools. The various clinico-epidemiological factors were studied and analyzed using relevant statistical tools. Results: Out of ninety children having atopic dermatitis, boys:girls ratio was 1:1.73. The mean age of onset was 2.14 ± 0.52 years, and the mean duration of illness was 1.71 ± 0.38 years. The personal history of atopy was present in 34 (37.8%) children whereas a family history of atopy was seen in 47 (52.2%) children. Among clinical presentation, chronic type (n = 56, 62.2%) was most common, followed by subacute (n = 24, 26.2%) and acute (n = 10. 11.1%). Flexor (n = 42, 46.7%) was the most common site affected followed by extensor and face (n = 24, 26.7%) each. Mild severity was seen in 76 (84.4%) children followed by moderate severity (n = 12, 13.4%) and severe (n = 2, 2.2%) children. Sweating (n = 53, 58.9%) was the most common aggravating factor followed by seasonal (n = 51, 56.7%), wool (n = 24, 26.7%), stress (n = 15, 16.7%), dust (n = 10, 11.1%), physical exercise (n = 8, 8.9%), and food (n = 2, 2.2%). Conclusions: Atopic dermatitis of chronic type with mild in severity is more common in community.

Kerion in a neonate

S Balasubramanian, K Vindhiya, K Dhanalakshmi, R Ramkumar

Indian Journal of Paediatric Dermatology 2017 18(4):333-334

Tinea capitis is predominantly an infection of children but extremely rare in neonates. Kerion is a T-cell mediated, severe pattern of an inflammatory fungal infection. It is characterized by tender, boggy nodular swelling with regional lymphadenopathy. There might be pus discharge and sinus formation that mimics bacterial folliculitis or an abscess of the scalp. Thick crusting with matting of hairs is common. Usually, area affected is limited, but multiple lesions are not rare. We report a 25-day-old neonate who presented with scalp swelling of 5 days duration. Baseline investigations were normal. Dermatological consult was obtained. Light and fluorescent microscopy along with fungal culture of the infected hair confirmed kerion due to Trichophyton mentagrophyte var. mentagrophyte. The infant was treated with griseofulvin and recovered completely.

Pattern of pediatric dermatoses in Northeast India

Karthick Nagarajan, Nandakishore Singh Thokchom, Khaidem Ibochouba, Kapila Verma, NA Bishurul Hafi

Indian Journal of Paediatric Dermatology 2017 18(4):286-291

Background: The prevalence of pediatric skin diseases varies worldwide. Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment, and prognosis. Aims and Objectives: To study the clinical and etiological presentation of dermatoses in the pediatric population in Northeast India. Materials and Methods: The study was carried out at a tertiary care center in Northeast region for 18 months (from December 2012 to May 2014). Cases under the age of 12 years were selected based on purposive sampling method. Results: Infections (36.25%) were the most common cause of skin diseases in the study group comprising 400 patients. Eczematous diseases (14.5%), pigmentary disorders (14.25%), and infestations (13.25%) were the other common causes. Varicella (6%), impetigo contagiosum (5%), and candidiasis (4.5%) were the most common viral, bacterial, and fungal diseases, respectively. Scabies (12.25%) was the most common individual disease in the present study. The prevalence of hand, foot, and mouth disease was high constituting 4% of the study group. Dyshidrotic eczema (6.5%), pityriasis alba (7.5%), and vitiligo (3.5%) were also common. Miliarial dermatitis and polymorphic light eruption also contributed significantly (5.25%) reflecting the typical pattern of the tropical skin diseases. Atopic dermatitis, genetic disorders, and nutritional deficiency disorders had a very low prevalence. Conclusion: The study finding that the majority of the diseases could be grouped into fewer than 8 disease categories may help in more accurate diagnosis. Significant proportions of the dermatoses are infections followed by eczematous and pigmentary diseases. Age, sex, locality, the income of the parents, family history, and season of presentation have an influential role in the pattern of distribution of the pediatric skin diseases.

Bullous pilomatricoma overlying a Bacillus Calmette–Guérin scar: A rare presentation

Ramchander , Pravesh Yadav, Puneet Pratap, Rubina Jassi

Indian Journal of Paediatric Dermatology 2017 18(4):344-345

Pilomatricoma is a benign hamartoma of hair matrix and the most commonly occurring hair follicle tumor. It classically presents as skin colored to erythematous, smooth, deep-seated nodule of firm consistency. Rarely, a bullous presentation of a pilomatricoma has also been reported. Herein, we illustrate a case of bullous pilomatricoma occurring over the Bacillus Calmette–Guérin scar site.

A study of clinico-epidemiological and dermoscopic patterns of vitiligo in pediatric age group

Sneha Gandhi, Murugesh Shamanur, AR Shashikiran, Mamatha Kusagur, Sugareddy , Vijay Bhaskar

Indian Journal of Paediatric Dermatology 2017 18(4):292-298

Context: Childhood vitiligo although similar to adult vitiligo has several distinct epidemiological, clinical, therapeutic and prognostic profile when compared with adult onset vitiligo. Aims: This study was conducted in an attempt to ascertain the clinico-epidemiological profile of patients in pediatric vitiligo patients (<18 years) and to conduct a dermoscopic analysis of the vitiligo patches. Subjects and Methods: This study was designed to study the clinic-epidemiological characteristics of childhood vitiligo between July 2015 and December 2015. A total of eighty childhood vitiligo patients were examined. In addition, 160 patches were studied for dermoscopic patterns to correlate with clinical stability and pattern of pigmentation. Results: Female to male ratio was 2.2:1. Average duration of the disease was 2.2 years. The mean age of onset was 7.6 years. A positive family history was seen in 18 patients. The pattern of viltigo in descending order of frequency was vitiligo vulgaris, segmental distribution, focal vitiligo, and acral vitiligo. The most common site was trunk. Dermatological associations were, history of atopy in 32 patients, alopecia aearata (1 patient) halo nevi (1 patient), and lichen nitidus (1 patient). The dermoscopic features of disease activity in order of frequency in our study were as follows: Trichrome pattern, nebulous pattern, star burst pattern, comet tailing of the lesion, and amoeboid pattern. 69 patients (43.12%) showed leukotrichia on dermoscopy, 74 (46.25%) showed perifollicular pigmentation, 32 patients (20%) showed marginal pigmentation, 26 (16.25%) showed both patterns whereas the rest did not show the signs of repigmentation. Under ultraviolet light examination, a diffuse white glow was seen in 147 (91.87%) of the patients. Conclusions: Vitiligo prevalence among children is on the rise and clinicoepidemiological data on this disease in between far and few. We found that dermoscopy was able to pick up disease activity earlier than the clinical onset of disease instability. This is the first study analyzing the dermoscopic pattern in pediatric vitiligo to the best of our knowledge.

Alopecia areata: Update on management

Julie S Kranseler, Robert Sidbury

Indian Journal of Paediatric Dermatology 2017 18(4):261-266

Alopecia areata (AA) is a common autoimmune nonscarring alopecia. AA presents heterogeneously and is influenced by both environmental and genetic factors. Diagnosis is clinical after ruling out other local or systemic causes of alopecia. Standard first-line therapy is typically topical steroids, but the response can be frustrating. Novel treatment options have shown great promise in the management of the refractory disease. We review initial data on topical and systemic Janus kinase inhibitors (tofacitinib, ruxolitinib, and baricitinib), topical bimatoprost, simvastatin/ezetimibe, and excimer laser therapy among others within the context of a general approach to AA management.

Servelle-martorell syndrome with severe orthostatic hypotension in a pediatric patient

Yuri Igor Lopez-Carrera, Max Bernal-Moreno, Oscar Colin, María Teresa García-Romero, Carola Durán-McKinster

Indian Journal of Paediatric Dermatology 2017 18(4):299-302

Servelle-Martorell syndrome (SMS) is an extremely uncommon vascular malformation characterized by venous malformations (VMs), limb overgrowth, and bone hypotrophy. The most common complications are venous thrombosis and pathological fractures. Ectasia and aneurysmal dilatations of the superficial veins may result in overgrowth of soft tissues but shortening of the affected limb. We report an 11-year-old Hispanic boy with an enlarged lower limb and VM. The patient suffered a fall at 9 years of age resulting in ankylosis of the knee without the possibility of limb extension or walking. When he tried to stand up, a severe orthostatic hypotension and almost loss of consciousness were present. An angio computed tomography and an arteriography demonstrated a complete absence of the deep venous system and bony hypotrophy compatible with SMS.

A pediatric case of primary cutaneous anaplastic large cell lymphoma: An unusual presentation

Gunjan Verma, Mukesh Manjhi, HK Kar

Indian Journal of Paediatric Dermatology 2017 18(4):324-326

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare form of ALCL, usually seen in elderly patients which is clinically characterized by single or multifocal nodules that ulcerate, autoregressive, and recurrent. Extracutaneous dissemination may occur, especially to regional lymph nodes. In this report, we present an unusual case of an 8-year-old boy with a noduloulcerativelesion present on the upper back with axillary painful lymphadenopathy, initially mimicking as scrofuloderma which was later histopathologically and immunohistochemically diagnosed as CD30+ PCALCL.

An unusual case of familial trichomegaly

Joydeep Das, Debalina Sarker, Debes Pal, Sanjib Mondal, Balram Gupta

Indian Journal of Paediatric Dermatology 2017 18(4):303-305

Trichomegaly is an unusual disorder of abnormally long eyelashes. Although the abnormality in itself does not cause any problems, except the cosmetic issues, however, it may be associated with syndromes, in which case it requires detailed investigations. Here, we describe a case of familial trichomegaly, involving mother and two siblings, which is an unusual entity.

Fetal cardiomegaly: A rare presentation of parkes weber syndrome

Niraj Kumar Dipak, Ruchi Nimish Nanawati, Saumil Desai, Anita Ananthan

Indian Journal of Paediatric Dermatology 2017 18(4):330-332

Vascular malformations (VMs) are developmental abnormalities of the vascular system. VM can be divided into high flow (predominantly arteriovenous malformations) and low flow (capillaries, venous, lymphatic, and mixed). VMs may present antenatally, at birth, or may develop during childhood. The presence of high-flow lesion on Color Doppler favors the diagnosis of Parkes Weber syndrome (PWS) over Klippel-Trenaunay syndrome. The management of high output failure, skin, and orthopedic care remains the mainstay of therapy in PWS. We report a fetus with highly vascular swelling over left upper limb, which was detected when fetal cardiomegaly was alerted and looked out for its possible etiology. Fetal cardiomegaly demands meticulous sonographic screening of extremities of fetus as they often get missed.

Erythroderma: An association or a manifestation extraordinary of hyper-immunoglobulin E

Virendra N Sehgal, Deepa Sehgal, Nazim Hussain Syed, Sonal Sharma

Indian Journal of Paediatric Dermatology 2017 18(4):306-309

Erythroderma/generalized exfoliative dermatitis, presenting with intensely itchy, dry, scaly, widespread erythema covering whole of the skin surface is reported, the diagnosis of which was primarily clinical but was supplemented by histopathology. Other investigations such as hemogram, immunoglobulin E (IgE), and serum fluorescent enzyme immunoassay (FEIA) were supportive; while IgE was high, serum FEIA was extraordinary high. Identifying it as a clinical pearl of hyper-IgE syndrome, recovery of heavy coloniz ation of Klebsiella pneumoniae, anaerobic Gram-negative bacteria, was contrastingly unique responding affectively to metronidazole, a drug specific for the purpose.

A sporadic case of epidermodysplasia verruciformis in a young boy

Rita V Vora, Rahulkrishna Sureshkumar Kota, Rochit R Singhal, Shailee S Gandhi

Indian Journal of Paediatric Dermatology 2017 18(4):335-337

Epidermodysplasia verruciformis (EV) is a rare disorder that is usually transmitted in an autosomal recessive manner, caused by human papillomavirus which presents with tinea versicolor-like or flat wart-like lesions. It has propensity for malignant transformation, especially squamous cell carcinoma. Here, we present a case of 7 year boy with complaints of asymptomatic hypopigmented macular lesions over the face, neck, and forearms. Histopathology was suggestive of EV and was given oral zinc, advised strict photoprotection.

Giant nevus unius lateralis: Two cases

Ajay Govindrao Ovhal, Shruthi Vasanth Kumar Deshkulakarani, Viraj Jitendra Sadrani

Indian Journal of Paediatric Dermatology 2017 18(4):310-313

Verrucous epidermal nevus is a common type of keratinocyte hamartoma present at birth or occurring later in life. Widespread multiple epidermal nevi (EN) may reflect genetic or chromosomal mosaicism. Blaschko has documented characteristic linear, zosteriform, unilateral or systematized patterns with streaks and swirls. They are resistant to treatment with the risk of recurrence. Giant congenital nevus unius lateralis (NUL) is known for its benign course with good supportive treatment however one particular case had a fatal neonatal outcome due to associated complications. Two interesting rare cases will be reviewed here.

Habitual biting of a finger in a child

KN Sarveswari, M Riswana Jasmine, N Mahesh

Indian Journal of Paediatric Dermatology 2017 18(4):341-343

A 3-year-old male child was brought by his parents with a nonhealing ulcer on the right middle finger having no significant history except for an injury sustained to the right elbow in December 2013. On further probing, the mother revealed that the child used to indulge in habitual biting of his right middle finger while watching TV. Initially he was investigated extensively by a vascular surgeon and no abnormality was detected. He was later referred to the dermatology department and on examination, the patient was attentive with normal behaviour. The right upper limb was slightly larger than left. There was no deformity of the right elbow. The right third fingertip was enlarged and mutilated. There was no nerve thickening or hypopigmented patch. There was loss of sensation on the right hand and arm. Differential diagnosis of Lesch–Nyhan syndrome and congenital sensory neuropathy were considered. The patient was referred to a neurologist who investigated further with magnetic resonance imaging (MRI), and the final diagnosis of syringomyelia was made based on MRI findings.

Safety and allergic reaction profiles of children undergoing baked milk and egg challenges: a 6-year experience from a pediatric tertiary referral center

Publication date: Available online 29 September 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Mohammad Al Enezi, Gideon Lack, Adam T. Fox, Katherine Anagnostou

A Case of Flagellate Dermatitis After Ingestion of Shiitake Mushrooms

Publication date: Available online 29 September 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Natacha Santos, Pedro Morais Silva, Maria Antónia São Bráz

Use of a disposable valved-holding chamber (spacer) in a school-based asthma trial

Publication date: Available online 29 September 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): James L. Goodwin, Lynn B. Gerald, Jennifer L.H. Johnson, Joe K. Gerald

Where do children die from asthma? National data from 2003 to 2015

Publication date: Available online 29 September 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Anna J. Chen Arroyo, Christine Pal Chee, Carlos A. Camargo, N. Ewen Wang

Expert Perspectives on Management of Moderate-to-Severe Atopic Dermatitis: A Multidisciplinary Consensus Addressing Current and Emerging Therapies

Publication date: Available online 29 September 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Mark Boguniewicz, Andrew F. Alexis, Lisa A. Beck, Julie Block, Lawrence F. Eichenfield, Luz Fonacier, Emma Guttman-Yassky, Amy S. Paller, David Pariser, Jonathan I. Silverberg, Mark Lebwohl
Atopic dermatitis (AD) is a common, chronic, relapsing, inflammatory skin disease that affects children and adults. Until recently, the only Food and Drug Administration–approved systemic treatment option for patients with moderate-to-severe AD was systemic steroids, which are not recommended by current guidelines and are commonly associated with disease rebound. Instead, clinicians choose from several off-label immunosuppressants, which can have serious adverse effects. A significant number of these patients go untreated. Research on the immunopathogenesis of AD has paved the way for new, targeted, systemic therapies for moderate-to-severe AD. In early 2017, the Food and Drug Administration approved dupilumab for adults with moderate-to-severe AD whose disease is not adequately controlled with topical therapies. Although the national guidelines can be very helpful to clinicians, the process for updating them does not allow for timely incorporation of novel therapies. A steering committee of AD experts, including dermatologists, allergists, and a patient advocacy group representative, developed recommendations on the basis of a literature review and expert opinion to help clinicians understand how new therapies fit into the current treatment paradigm and to provide practical recommendations for assessing AD severity, treatment response, and treatment failure.

Waste rice straw and coal fly ash composite as a novel sustainable catalytic particle electrode for strengthening oxidation of azo dyes containing wastewater in electro-Fenton process

Abstract

A novel catalytic particle electrode (CPE) was synthesized from waste rice straw and coal fly ash which was employed to strengthen electro-Fenton treating actual azo dyes containing wastewater. Results showed that the prepared CPE exhibited excellent electro-catalytic activity and significantly improved performance of pollutants removal at near-neutral pH condition, achieving over 73.5 and 90.5% of chemical oxygen demand (COD) and color removal percentages, respectively, allowing discharge criteria to be met. And the electro-Fenton with CPE improved the biodegradability of wastewater in terms of BOD₅/COD, resazurin dehydrogenase activity, and toxicity, indicating the potential application of integrated biosystem for this type of wastewater. On the basis of inhibition of different radical scavengers and fluorescence test, it was deduced that the main contribution of the novel CPE was responsible for catalyzing electro-generate H₂O₂ to produce more hydroxyl radicals in electro-Fenton, and the positive role of generation of superoxide anion at near-neutral pH was also proved, further the possible reaction mechanism was proposed. Moreover, CPE showed the advantages of superior stability and low cost at successive runs and the results offered new insights for sustainable use of waste materials.

Mutagenic and genotoxic effects and metal contaminations in fish of the Amambai River, Upper Paraná River, Brazil

Abstract

The present study evaluated mutagenic and genotoxic effects and metal accumulation in the liver and musculature of Pterygoplichthys ambrosetti and Prochilodus lineatus in the Amambai River, a tributary of the Upper Paraná River in Brazil. We also evaluated the potential for these fish species as environmental bioindicators and performed risk assessment for conservation purposes. We found that P. ambrosetti had a higher frequency of micronuclei compared to P. lineatus (p < 0.0001). There were no significant differences between species in other erythrocyte nuclear abnormalities (ENA) (p > 0.05). For both species, the liver contained a higher concentration of metals (Cd, Pb, Cr, Cu, Fe, Zn, and Ni) than the musculature did (p < 0.0001). Of the two species, P. ambrosetti was more suitable to evaluate mutagenic and genotoxic effects and metal accumulation in the liver and musculature, likely due to its resident behavior; hence, we highlight the potential of this species for use as an environmental bioindicator. The concentrations of non-essential metals observed in the fish confirm conditions of environmental stress in the Amambai River, possibly related to the discharge of pollutants and exacerbated by lack of native vegetation cover along the watercourse.

Transcriptomic responses of the endangered freshwater mussel Margaritifera margaritifera to trace metal contamination in the Dronne River, France

Abstract

The freshwater pearl mussel Margaritifera margaritifera is one of the most threatened freshwater bivalves worldwide. In this study, we aimed (i) to study the processes by which water quality might affect freshwater mussels in situ and (ii) to provide insights into the ecotoxicological significance of water pollution to natural populations in order to provide necessary information to enhance conservation strategies. M. margaritifera specimens were sampled in two close sites located upstream or downstream from an illegal dumping site. The renal transcriptome of these animals was assembled and gene transcription determined by RNA-seq. Correlations between transcription levels of each single transcript and the bioaccumulation of nine trace metals, age (estimated by sclerochronology), and condition index were determined in order to identify genes likely to respond to a specific factor. Amongst the studied metals, Cr, Zn, Cd, and Ni were the main factors correlated with transcription levels, with effects on translation, apoptosis, immune response, response to stimulus, and transport pathways. However, the main factor explaining changes in gene transcription appeared to be the age of individuals with a negative correlation with the transcription of retrotransposon-related genes. To investigate this effect further, mussels were classified into three age classes. In young, middle-aged and old animals, transcription levels were mainly explained by Cu, Zn and age, respectively. This suggests differences in the molecular responses of this species to metals during its lifetime that must be better assessed in future ecotoxicology studies.

Occurrence and source identification of perfluoroalkyl acids (PFAAs) in the Metedeconk River Watershed, New Jersey

Abstract

The Brick Township Municipal Utilities Authority (BTMUA), which relies on the Metedeconk River as its primary source of water supply, initiated a perfluoroalkyl acid (PFAA) source trackdown study in collaboration with the New Jersey Department of Environmental Protection (NJDEP) after discovering that the concentration of one PFAA, perfluorooctanoic acid (PFOA), was elevated at their raw surface water intake. Water samples were collected over eight sampling events between September 2011 and July 2014. Samples included surface water, groundwater, stormwater, sanitary sewer water, and commercial/industrial process water. Each sample was analyzed for ten PFAAs. Results from a set of samples collected from the 80 km² South Branch Metedeconk River watershed directed the focus of this study to a 7.5-km² area of interest. Within this area, a high concentration of PFAA contamination was documented in a localized zone. Subsequent groundwater sampling led to the identification of a plume of groundwater contamination emanating from an industrial/business park. The suspected source of PFAA detected in the river and drinking water intake was identified to a small industrial facility that used materials containing PFOA. Groundwater PFOA concentrations as high as 70,000 ng/L were found in samples taken within 200 m of the parcel and surface water concentrations as high as 130 ng/L were observed in the river. While various PFAAs were detected in the samples, particularly in groundwater samples, PFOA was identified as the primary contaminant of concern with respect to the river and the BTMUA water supply.

Enhancement of anaerobic digestibility of waste activated sludge using photo-Fenton pretreatment

Abstract

Biological treatments, such as activated sludge process, are common methods to treat municipal and industrial wastewaters. However, they produce huge amounts of waste activated sludge (WAS). The excess sludge treatment and disposal are a challenge for wastewater treatment plants due to economic, environmental, and regulatory factors. In this study, photo-Fenton pretreatment (oxidation using hydrogen peroxide and iron catalyst aided with UV light) was optimized using response surface methodology (RSM) and central composite design (CCD) to determine the effects of three operating parameters (H₂O₂ dosage, H₂O₂/Fe²⁺ molar ratio, and irradiation time) on disintegration and dewaterability of WAS. MLVSS removal, capillary suction time (CST) reduction, sCOD, and EPS were obtained as 70%, 25%, 12,000 mg/L, and 500 mg/L, respectively, at the optimal conditions, i.e., 725 g H₂O₂/kg TS, H₂O₂/Fe²⁺ molar ratio 80, and irradiation time 40 min. Two batch-fed completely mixed mesophilic anaerobic digesters were then operated at 15-day solid retention time (SRT) and 37 ± 0.5 °C to compare the digestibility of untreated and photo-Fenton pretreated sludge in terms of volatile solids (VS) reduction, COD removal, and biogas production at steady-state operations. Photo-Fenton pretreatment followed by anaerobic digestion of WAS was very effective and yielded 75.7% total VS reduction, 81.5% COD removal, and 0.29–0.31 m³/kg VS_fed·d biogas production rate, compared to 40.7% total VS solid reduction, 54.7% COD removal, and 0.12–0.17 m³/kg VS_fed·d biogas production rate for control. Thus, photo-Fenton can be a useful pretreatment step in sludge management.

A study on removing nitrogen from paddy field rainfall runoff by an ecological ditch–zeolite barrier system

Abstract

Ecological ditches and zeolite have been widely applied in the removal of farmland nonpoint source pollution separately; little research has been done on the effects of combining the two methods. Specifically, few studies have focused on the in situ regeneration of zeolite. A 2-year field experiment using an ecological ditch–zeolite barrier system was conducted in a paddy field of summer rice–winter wheat rotation in the Taihu Lake area. The system consisted of two zeolite barriers positioned at one third and two thirds of the length of the ditch. This study focused on the effect of the system on in situ nitrogen removal during the rice-growing season. Simultaneous laboratory kinetics experiments with natural zeolite and a series of adsorbed zeolites taken from the ditch at different time were also conducted. The concentration removal efficiencies of total nitrogen are averaged 24.66% in 2014 and 30.39% in 2015. Meanwhile, the cumulative adsorption quantity of ammonia nitrogen by the two barriers accounted for 49.27% of the ammonia nitrogen removed in 2014 and 54.35% of that in 2015. The amount of nitrogen adsorbed by plants was larger than that adsorbed by zeolite. The breakthrough curves of the zeolite and the characteristics of the zeolite surface structures from different periods all demonstrated that the zeolite can be regenerated in situ in the case of unsaturated zeolite within the ecological ditch. It can be concluded that an ecological ditch–zeolite barrier system is a realistic option for removing nitrogen from agricultural rainfall runoff in the Taihu Lake area.

The effect of vitamin E, l -carnitine, and ginger on production traits, immune response, and antioxidant status in two broiler strains exposed to chronic heat stress

Abstract

The present study was designed to find the effect of natural and synthetic antioxidants on the performance of two broiler strains under high ambient temperature. A total of 320 day-old chicks of Hubbard and Cobb were reared for a period for 21 days under the same nutritional and management systems. On day 21 onward, one subgroup was kept as control while other subgroups were provided with vitamin E (250 mg/kg), ginger (2 g/kg), and l-carnitine (500 mg/kg) in basal diets. Body weight and feed conversion ratio (FCR) were significantly (P < 0.05) high in vitamin E-supplemented birds, while feed intake was significantly (P < 0.05) higher in l-carnitine supplemented birds irrespective of the strain. Antibody titer against infectious bursal disease (IBD) and paraoxonase (PON1) was significantly (P < 0.05) higher in vitamin E-supplemented birds compared to the other treatments. The number of heterophils and toal oxidant status (TOS) were significantly (P < 0.05) lower in vitamin E-supplemented birds. Blood glucose was significantly (P < 0.05) lower in vitamin E-supplemented birds, while total protein was significantly (P < 0.05) higher in vitamin E-supplemented group. In conclusion, the supplementation of vitamin E at the rate of 250 mg/kg improved the antioxidant status and immune response in the two broiler strains. Further, the two strains perform similarly in terms of performance and other health status parameters with no significant difference.

Utilization of calcium-based and aluminum-based materials for the treatment of stabilized landfill leachate: a comparative study

Abstract

This study explored the efficiencies and mechanisms of refractory organic matters removal in the stabilized landfill leachate by adding different reagents. Calcium-based and aluminum-based materials were added into the leachate as comparing experiments. XRD, FTIR, and EEM were adopted to analyze the solid products and leachate. As a result, the in situ synthesized CaAl-LDHs were more beneficial for refractory organic matters removal, especially for benzodiazepines. When CaAl-LDHs were formed, the removal efficiencies of COD, UV254, and TOC were best and achieved 58.48, 81.22, and 71.30%, respectively. For fluorescent substances, humic acid-like and fulvic acid-like compounds were efficiently removed by CaAl-LDHs. In particular, CaAl-LDHs had selective removal effects on fulvic acid-like compounds, which were characteristic of small molecular weight and major carboxyl groups.

Possible effects of melatonin against rat uterus exposure to bisphenol A during neonatal period

Abstract

The aim of this study was to investigate the possible effects of melatonin on rat uterine tissue against exposure with bisphenol A (BPA) in the neonatal period. Twenty-four female rats were divided into four groups, (n=6) per group. Group I was used as a control (sesame oil + ethanol), group II was injected daily with (100 mg/kg) BPA by subcutaneously (sc) daily postnatal days (PND 0–10), group III was injected daily with (10 mg/kg) melatonin by sc for 10 days (PND 20–30), and group IV was injected daily with (100 mg/kg) BPA (PND 0–10) and (10 mg/kg) melatonin (PND 20–30). All rats were sacrificed in the same day of metestrus cycle, approximately PND 70. Histological analyses, immunostaining of B cell lymphoma 2 (Bcl-2), and cytochrome c and TUNEL assays were performed. According to our results, neonatal exposure to BPA accelerates onset of puberty, causes degenerative and morphometric changes on rat uterus, and increases apoptotic reaction rates. The immunoreactivity of Bcl-2 was decreased after BPA administration. In addition, immunoreactivity of Bcl-2 showed an increase after melatonin treatment. However, cytochrome c immunoreactivity was decreased after melatonin administration. Our results suggest that melatonin may have positive effects against BPA-induced degenerative changes on rat uterus.

Toxic metal tolerance in native plant species grown in a vanadium mining area

Abstract

Vanadium (V) has been extensively mined in China and caused soil pollution in mining area. It has toxic effects on plants, animals and humans, posing potential health risks to communities that farm and graze cattle adjacent to the mining area. To evaluate in situ phytoremediation potentials of native plants, V, chromium, copper and zinc concentrations in roots and shoots were measured and the bioaccumulation (BAF) and translocation (TF) efficiencies were calculated. The results showed that Setaria viridis accumulated greater than 1000 mg kg⁻¹ V in its shoots and exhibited TF > 1 for V, Cr, Zn and BAF > 1 for Cu. The V accumulation amount in the roots of Kochia scoparia also surpassed 1000 mg kg⁻¹ and showed TF > 1 for Zn. Chenopodium album had BAF > 1 for V and Zn and Daucus carota showed TF > 1 for Cu. Eleusine indica presented strong tolerance and high metal accumulations. S. viridis is practical for in situ phytoextractions of V, Cr and Zn and phytostabilisation of Cu in V mining area. Other species had low potential use as phytoremediation plant at multi-metal polluted sites, but showed relatively strong resistance to V, Cr, Cu and Zn toxicity, can be used to vegetate the contaminated soils and stabilise toxic metals in V mining area.

Patient-Centered Breast Reconstruction Based on Health-Related Quality-of-Life Evidence

The article summarizes the available evidence regarding clinical decision making in breast reconstruction from the patient perspective of satisfaction and health-related quality of life. A review of generic and specific patient reported outcome measures is provided. Important components of breast reconstruction care are compared, such as timing of reconstruction, autologous and implant-based reconstruction, and the use of nipple-sparing and skin-sparing mastectomy. This evidence-based summary will be useful to guide clinicians when discussing breast reconstruction with their patients.

Risk-Reducing Mastectomy and Breast Reconstruction

Breast cancer affects nearly every woman either personally or through a family member or friend. Awareness of associated familial and genetic risks has been steadily increasing over the last decade. Bilateral risk-reduction mastectomy seeks to decrease the incidence and mortality of breast cancer in women without abnormality but with elevated risk of developing cancer. Contralateral risk-reduction mastectomy aims to decrease the incidence of contralateral breast cancer in women diagnosed with unilateral breast cancer. As understanding improves and techniques progress, the relative merits of surgical risk reduction will change as well.

Achyrocline alata potentiates repair of skin full thickness excision in mice

Publication date: Available online 29 September 2017
Source:Journal of Tissue Viability
Author(s): Luciana Xavier Pereira, Hygor Kleber Cabral Silva, Tamara Ribeiro Longatti, Patrícia Pereira Silva, Cláudia Di Lorenzo Oliveira, Anna Bárbara de Freitas Carneiro Proietti, Ralph Gruppi Thomé, Maria do Carmo Vieira, Carlos Alexandre Carollo, Daniel Pecoraro Demarque, João Máximo de Siqueira, Hélio Batista dos Santos, Gleydes Gambogi Parreira, Rosy Iara Maciel de Azambuja Ribeiro
Plants of the Asteraceae family have been traditionally used as medicinal plants. The species Achyrocline satureioides and Achyrocline alata present anti-inflammatory properties and great chemical similarity. However, no study has been performed to evaluate the influence of these plants on skin wound healing in vivo. Here, we have assessed the effect of these plants extracts on skin wound healing in mice. Mice were randomly arranged into three groups (n = 10), an injury was performed on the dorsal area of the animals, which received the following topical treatment: group 1, control (ointment base); group 2, A. satureioides extract; group 3, A. alata extract. The solution for treatment was prepared as 10% (w/w) concentration. The wound area was measured on days 1, 4, 9, 15 and 17 after treatment and tissues of local lesion were collected on the ninth day for histological analysis. A. alata was more effective since it induced earlier wound closure associated with decreasing initial inflammatory response, faster reepithelialization and collagen remodeling. A. satureioides improved the collagen renovation, but induced slower closure, which may be due to different concentrations of phenolic compounds among the plants here studied. Both plants did not alter the ultrastructural characteristics of cells in the healing process. In conclusion, our findings suggest the potent wound healing capacity of A. alata extracts, as demonstrated by more efficient and faster induction of wound closure. We believe this plant is a potential wound healing treatment for humans and further studies are necessary to assess its clinical practice.

ROS-mediated cytotoxic activity of ZnO and CeO 2 nanoparticles synthesized using the Rubia cordifolia L. leaf extract on MG-63 human osteosarcoma cell lines

Abstract

In the present scenario, the synthesis and characterization of zinc oxide (ZnO) and cerium oxide (CeO₂) nanoparticles (NPs) through biological routes using green reducing agents are quite interesting to explore various biomedical and pharmaceutical applications, particularly for the treatment of cancer. This study was focused on the phytosynthesis of ZnO and CeO₂ NPs using the leaf extract of Rubia cordifolia L. The active principles present in the plant extract were liable for rapid reduction of Zn and Ce ions to metallic nanocrystals. ZnO and CeO₂ NPs were characterized by UV–visible spectroscopy, X-ray diffraction analysis (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), energy dispersive X-ray spectroscopy (EDAX), and photoluminescence (PL) techniques. ZnO and CeO₂ NPs were partially agglomerated with a net-like structure. Biomedical activities of ZnO and CeO₂ NPs were tested against MG-63 human osteosarcoma cells using MTT and reactive oxygen species (ROS) quantification assays. In treated cells, loss of cell membrane integrity, oxidative stress, and apoptosis was observed and it is well correlated with cellular damage immediately after induction. Overall, this study shed light on the anti-cancer potential of ZnO and CeO₂ NPs on MG-63 human osteosarcoma cells through differential ROS production pathways, describing the potential role of greener synthesis.

Five-year performance monitoring of a high-density polyethylene (HDPE) cover system at a reclaimed mine waste rock pile in the Sydney Coalfield (Nova Scotia, Canada)

Abstract

Cover systems are commonly placed over waste rock piles (WRPs) to limit atmospheric water and oxygen ingress and control the generation and release of acid mine drainage (AMD) to the receiving environment. Although covers containing geomembranes such as high-density polyethylene (HDPE) exhibit the attributes to be highly effective, there are few, if any, published studies monitoring their performance at full-scale WRPs. In 2011, a HDPE cover was installed over the Scotchtown Summit WRP in Nova Scotia, Canada, and extensive field performance monitoring was conducted over the next five years. A range of parameters within the atmosphere, cover, waste rock, groundwater and surface water, were monitored and integrated into a comprehensive hydrogeochemical conceptual model to assess (i) atmospheric ingress to the waste rock, (ii) waste rock acidity and depletion and (iii) evolution of groundwater and surface water quality. Results demonstrate that the cover is effective and meeting site closure objectives. Depletion in oxygen influx resulted in slower sulphide oxidation and AMD generation, while a significant reduction in water influx (i.e. 512 to 50 mm/year) resulted in diminished AMD release. Consistent improvements in groundwater quality (decrease in sulphate and metals; increase in pH) beneath and downgradient of the WRP were observed. Protection and/or significant improvement in surface water quality was evident in all surrounding watercourses due to the improved groundwater plume and elimination of contaminated runoff over previously exposed waste rock. A variably saturated flow and contaminant transport model is currently being developed to predict long-term cover system performance.

MicroRNA-191, acting via the IRS-1/Akt signaling pathway, is involved in the hepatic insulin resistance induced by cigarette smoke extract

Abstract

Cigarette smoke causes insulin resistance, which is associated with type 2 diabetes mellitus (T2DM). However, the mechanism by which this occurs remains poorly understood. Because the involvement of microRNAs (miRNAs) in the development of insulin resistance is largely unknown, we investigated, in hepatocytes, the roles of miR-191 in cigarette smoke extract (CSE)-induced insulin resistance. In L-02 cells, CSE not only decreased glucose uptake and glycogen levels but also reduced levels of insulin receptor substrate-1 (IRS-1) and Akt activation, effects that were blocked by SC79, an activator of Akt. CSE also increased miR-191 levels in L-02 cells. Furthermore, the inhibition of miR-191 blocked the decreases of IRS-1 and p-Akt levels, which antagonized the decreases of glucose uptake and glycogen levels in L-02 cells induced by CSE. These results reveal a mechanism by which miR-191 is involved in CSE-induced hepatic insulin resistance via the IRS-1/Akt signaling pathway, which helps to elucidate the mechanism for cigarette smoke-induced T2DM.

Optimisation of critical medium components and culture conditions for enhanced biomass and lipid production in the oleaginous diatom Navicula phyllepta : a statistical approach

Abstract

Diatoms hold great promise as potential sources of biofuel production. In the present study, the biomass and lipid production in the marine diatom Navicula phyllepta, isolated from Cochin estuary, India and identified as a potential biodiesel feedstock, were optimized using Plackett-Burman (PB) statistical experimental design followed by central composite design (CCD) and response surface methodology (RSM). The growth analyses of the isolate in different nitrogen sources, salinities and five different enriched sea water media showed the best growth in the cheapest medium with minimum components using urea as nitrogen source at salinity between 25 and 40 g kg⁻¹. Plackett-Burman experimental analyses for screening urea, sodium metasilicate, sodium dihydrogen phosphate, ferric chloride, salinity, temperature, pH and agitation influencing lipid and biomass production showed that silicate and temperature had a positive coefficient on biomass production, and temperature had a significant positive coefficient, while urea and phosphate showed a negative coefficient on lipid content. A 2⁴ factorial central composite design (FCCD) was used to optimize the concentration of the factors selected. The optimized media resulted in 1.62-fold increase (64%) in biomass (1.2 ± 0.08 g L⁻¹) and 1.2-fold increase (22%) in estimated total lipid production (0.11 ± 0.003 g L⁻¹) compared to original media within 12 days of culturing. A significantly higher biomass and lipid production in the optimized medium demands further development of a two-stage strategy of biomass production followed by induction of high lipid production under nutrient limitation or varying culture conditions for large-scale production of biodiesel from the marine diatom.

Influence of aromatic additives on Bismarck Brown Y dye color removal treatment by Fenton processes

Abstract

The influence of diverse aromatic additives on Fenton processes (Fe²⁺/H₂O₂, Fe³⁺/H₂O₂) has been evaluated by using the Bismarck Brown Y (BBY) di azo dye as target pollutant. Results indicate that all tested Fe³⁺-reducing additives (gallic, 3,4-dihydroxyphenylacetic, 2,3-dihydroxybenzoic, and 2,5-dihydroxybenzoic acids, catechol, and hydroquinone) exhibited pro-oxidant properties during BBY dye color removal, mainly during Fe³⁺/H₂O₂ treatments. For example, in the presence of hydroquinone BBY color removal was increased from 22 to 83% for 60 min through the Fe³⁺/H₂O₂ process. The effect of non-reducing additives was less pronounced, among which salicylic and 2,4-dihydroxybenzoic acids were more efficient at removing dye color than benzoic acid and methylene blue. It was suggested that OH radicals may have converted non-reducing additives into Fe³⁺-reducing intermediates, which had a positive effect on the treatments. On the other hand, antioxidant properties were observed during BBY color removal in the presence of higher concentrations of gallic and salicylic acids. These items of data indicate that a minimum amount of aromatic additive was enough to increase BBY dye color removal by Fenton processes.

Lung injury and expression of p53 and p16 in Wistar rats induced by respirable chrysotile fiber dust from four primary areas of China

Abstract

Chrysotile products were widely used in daily life, and a large amount of respirable dust was produced in the process of production and application. At present, there was seldom research on the safety of chrysotile fiber dust, and whether its long-term inhalation can lead to lung cancer was unknown. In order to determine whether respirable chrysotile fiber dust of China caused lung cancer, four major chrysotile-producing mine areas in China were selected for this study. Chrysotile fibers were prepared into respirable dust. Particle size was measured by laser particle analysis, morphology was observed by scanning electron microscope, chrysotile fiber phase was analyzed by X-ray diffraction, trace chemical elements were identified by X-ray fluorescence, and the structure and the active groups of the dust were determined after grinding by Fourier transform infrared spectroscopy. Male Wistar rats were exposed to non-exposed intratracheal instillation with different concentrations of chrysotile fiber dust. The rats were weighed after 1, 3, and 6 months, then the lung tissues were separated, the lung morphology was observed, and the pulmonary index was calculated. Pathological changes in lung tissues were observed by optical microscope after the HE staining of tissues, and the gene expression of p53 and p16 was determined by reverse transcription polymerase chain reaction. First, the results showed that the particle sizes of the four fibers were less than 10 μm. Four primary areas of chrysotile had similar fibrous structure, arranged in fascicles, or mixed with thin chunks of material. Second, the elementary composition of the four fibers was mainly chrysotile, and the structure and the active groups of the grinding dust were not damaged. Third, the weights of the treated rats were obviously lower, and the lung weights and the pulmonary index increased significantly (P < 0.05). Fourth, the treated Wistar rat lung tissues revealed different degrees of congestion, edema, inflammatory cell infiltration, and mild fibrosis. Fifth, the p53 and p16 genes decreased in the Mangnai group after 1 month of exposure, and the other groups increased. The expression of p53 and p16 in each group decreased significantly after 6 months (P < 0.05). In conclusion, the respirable chrysotile fiber dust from the four primary areas of China had the risk of causing lung injury, and these changes may be related to the physical and chemical characteristics of chrysotile from different production areas.

Presence of active pharmaceutical ingredients in the continuum of surface and ground water used in drinking water production

Abstract

Anthropogenic chemicals in surface water and groundwater cause concern especially when the water is used in drinking water production. Due to their continuous release or spill-over at waste water treatment plants, active pharmaceutical ingredients (APIs) are constantly present in aquatic environment and despite their low concentrations, APIs can still cause effects on the organisms. In the present study, Chemcatcher passive sampling was applied in surface water, surface water intake site, and groundwater observation wells to estimate whether the selected APIs are able to end up in drinking water supply through an artificial groundwater recharge system. The API concentrations measured in conventional wastewater, surface water, and groundwater grab samples were assessed with the results obtained with passive samplers. Out of the 25 APIs studied with passive sampling, four were observed in groundwater and 21 in surface water. This suggests that many anthropogenic APIs released to waste water proceed downstream and can be detectable in groundwater recharge. Chemcatcher passive samplers have previously been used in monitoring several harmful chemicals in surface and wastewaters, but the path of chemicals to groundwater has not been studied. This study provides novel information on the suitability of the Chemcatcher passive samplers for detecting APIs in groundwater wells.

Effect of pH on hexavalent and total chromium removal from aqueous solutions by avocado shell using batch and continuous systems

Abstract

Solution pH appears to be the most important regulator of the biosorptive removal of chromium ions from aqueous solutions. This work presents a kinetic study of the effects of solution pH on Cr(VI) and total chromium removal from aqueous solution by Hass avocado shell (HAS) in batch and continuous packed bed column systems. Different Cr(VI) and total chromium removal performances of HAS were obtained in pH-shift batch, pH-controlled batch, and continuous systems. These results emphasize the great importance of determining the most appropriate pH for Cr(VI) and total chromium removal, considering the operational mode of the proposed large-scale treatment system. Total chromium biosorption batch kinetics was well described by the Elovich model, whereas in the continuous system, the fitness of the kinetic models to the experimental data was pH dependent. X-ray photoelectron spectroscopy and kinetic studies clearly indicated that the reaction mechanism of Cr(VI) with HAS was the reductive biotransformation of Cr(VI) to Cr(III), which was partially released to the aqueous solution and partially biosorbed onto HAS.

Assessment of stream water chemistry and impact of geothermal fluid in the up-Buyuk Menderes Basin, Turkey

Abstract

The discharge of geothermal fluid into the natural water environment may lead to serious damages. In this study, the impact of geothermal waste water on surface water has been investigated in the up-Buyuk Menderes River, Turkey. Thermal return water from district heating and from thermal bath in the Sandıklı region were the most important source of major solutes and trace elements to the up-Buyuk Menderes River and tributaries. The thermal contribution causes a drastic increase in Na, SO₄ ions, EC, and temperature of surface waters. The concentrations of As, Al, B, Fe, Cr, Li, S, P, Pb, U, Mn, and Zn are increasing dramatically downstream of thermal water inputs in the Kufi Creek tributary. In addition to natural thermal water inputs, water quality was impacted by anthropogenic trace and major element inputs from surface waters. The increased of some trace elements (Al, As, B, Cu, Cd, Fe, Mn, P, U) in surface water are related to anthropogenic activities such as agricultural activities, sewage effluents, and stockyards in the study area. Additionally, surface water quality of the up-Buyuk Menderes River and tributaries was evaluated according to standards given by the Environmental Protection Agency of both Turkey and USA. Our study demonstrates the influence of thermal water inputs on water quality of surface waters.

Life cycle assessment of a printed circuit board manufacturing plant in Turkey

Abstract

The objective of this study is to investigate the environmental impacts of a printed circuit board (PCB) manufacturing plant through streamlined life cycle assessment approach. As a result, the most effective recommendations on minimizing the environmental impacts for the mentioned sector are revealed and first steps towards establishing a country specific database are taken. The whole PCB production consists of two consecutive stages: namely board fabrication followed by the manufacturing of PCB. Manufacturing of PCB contributes the highest shares to freshwater aquatic ecotoxicity potential (FAETP) and ozone layer depletion potential (ODP). Eighty-nine percent of FAETP is found to be generated from the manufacturing of PCB. Almost all of this contribution can be attributed to the disposal of copper containing wastewater treatment sludge from etching operations to incineration. On the other hand, PCB manufacturing has 73% share in total ODP. Within the manufacturing of PCB, as etching operations are found to be of importance for all the impact categories except eutrophication potential (EP), it is recommended to focus further studies on in-plant control of etching.

Wide band gap Ga 2 O 3 as efficient UV-C photocatalyst for gas-phase degradation applications

Abstract

α, β, γ, and δ polymorphs of 4.6–4.8 eV wide band gap Ga₂O₃ photocatalysts were prepared via a soft chemistry route. Their photocatalytic activity under 254 nm UV-C light in the degradation of gaseous toluene was strongly depending on the polymorph phase. α- and β-Ga₂O₃ photocatalysts enabled achieving high and stable conversions of toluene with selectivities to CO₂ within the 50–90% range, by contrast to conventional TiO₂ photocatalysts that fully deactivate very rapidly on stream in similar operating conditions with rather no CO₂ production, no matter whether UV-A or UV-C light was used. The highest performances were achieved on the high specific surface area β-Ga₂O₃ photocatalyst synthesized by adding polyethylene glycol (PEG) as porogen before precipitation, with stable toluene conversion and mineralization rate into CO₂ strongly overcoming those obtained on commercial β-Ga₂O₃. They were attributed to favorable physicochemical properties in terms of high specific surface area, small mean crystallite size, good crystallinity, high pore volume with large size mesopore distribution and appropriate surface acidity, and to the possible existence of a double local internal field within Ga³⁺ units. In the degradation of hydrogen sulfide, PEG-derived β-Ga₂O₃ takes advantage from its high specific surface area for storing sulfate, and thus for increasing its resistance to deactivation and the duration at total sulfur removal when compared to other β-Ga₂O₃ photocatalysts. So, we illustrated the interest of using high surface area β-Ga₂O₃ in environmental photocatalysis for gas-phase depollution applications.

Results of the 2016 International Skin Imaging Collaboration International Symposium on Biomedical Imaging challenge: Comparison of the accuracy of computer algorithms to dermatologists for the diagnosis of melanoma from dermoscopic images

Computer vision may aid in melanoma detection.

Compression stockings as an effective treatment for erythema nodosum: Case series

Erythema nodosum (EN) is a septal panniculitis that is characterized clinically by tender, erythematous, subcutaneous nodules that are predominately localized on the pretibial lower legs. EN affects women more than men and can be idiopathic or secondary to another disease process such as infection or an immune response. Treatment options for erythema nodosum are suboptimal and often involve significant side effects or require a change in lifestyle. We investigated the effects of moderate 20 mmHg to 30 mmHg compression stockings as an alternative treatment method in two female patients with recurrent erythema nodosum.

Subcutaneous mastectomy in female-to-male transsexuals – optimizing perioperative and operative management in 8 years clinical experience

The incidence of complications, especially acute hematoma requiring surgical revision in female-to-male transsexuals (FTMTS), is consistently highly documented in literature with up to 33 %. Since 2008 we perform subcutaneous mastectomies in FTMTS with an annually increasing number of cases. Due to an initially high hematoma revision rate in the previously published cohort (2008-2013), we implemented peri- and postoperative preventive measures and compared the results with recent patient cohort (2014-2016).

Group Living and Male Dispersal Predict the Core Gut Microbiome in Wild Baboons

Abstract

The mammalian gut microbiome plays a profound role in the physiology, metabolism, and overall health of its host. However, biologists have only a nascent understanding of the forces that drive inter-individual heterogeneity in gut microbial composition, especially the role of host social environment. Here we used 178 samples from 78 wild yellow baboons (Papio cynocephalus) living in two social groups to test how host social context, including group living, social interactions within groups, and transfer between social groups (e.g., dispersal) predict inter-individual variation in gut microbial alpha and beta diversity. We also tested whether social effects differed for prevalent "core" gut microbial taxa, which are thought to provide primary functions to hosts, versus rare "non-core" microbes, which may represent relatively transient environmental acquisitions. Confirming prior studies, we found that each social group harbored a distinct gut microbial community. These differences included both non-core and core gut microbial taxa, suggesting that these effects are not solely driven by recent gut microbial exposures. Within social groups, close grooming partners had more similar core microbiomes, but not non-core microbiomes, than individuals who rarely groomed each other, even controlling for kinship and diet similarity between grooming partners. Finally, in support of the idea that the gut microbiome can be altered by current social context, we found that the longer an immigrant male had lived in a given social group, the more closely his gut microbiome resembled the gut microbiomes of the group's long-term residents. Together, these results reveal the importance of a host's social context in shaping the gut microbiome and shed new light onto the microbiome-related consequences of male dispersal.

Neurobiology of Female Mate Choice in Frogs: Auditory Filtering and Valuation

Abstract

Mate choice is a decision making process with profound implication for the reproductive success of both the sender and the chooser. Preferences for conspecific over heterospecific males and for some conspecifics over others are typically mediated by a female's response to signals produced by males. And although one can experimentally describe a female's preference function, there is relatively little understood about the neural mechanisms mediating these preferences. In anurans, mating preferences have often been explained in terms of sensory biases. Indeed, in the túngara frog (Physalaemus pustulosus), the auditory system appears to act as a filter for conspecific calls. However, auditory responses are not good predictors of intraspecific mating preferences in túngara frogs. Rather, neural activity in the preoptic area, which can be gated by estradiol, is a better predictor of mating preferences. A similar pattern holds in spadefoot toads (Spea bombifrons): the preoptic area, but not the auditory midbrain, integrates physiological cues in its response to mating calls in a pattern that predicts preferences. Neuroanatomically, the anuran preoptic area is poised to mediate forebrain influences on auditory response of the midbrain and it has descending projections to the medulla and spinal cord that could directly influence motor responses. Indeed, lesions of the preoptic area abolish phonotaxis. A role for the preoptic area in mating preferences is supported by studies in mammals that show the preoptic area is required for the expression of preferences. Further, activity of the preoptic area correlates with mating preference in fish. This leads to a model for the neurobiological mechanisms of mate choice, in which sensory systems filter relevant signals from irrelevant ones, but the preoptic area assigns value to the range of relevant signals.

What’s New in Autophagy

Date: 

Friday, July 21, 2017 - 12:00

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Cover

A 63-Year-Old Korean Woman With Abnormal Magnetic Resonance Imaging Results

(See page 1420 for the Photo Quiz)

A 63-Year-Old Korean Woman With Abnormal Magnetic Resonance Imaging Results

(See pages 1421–2 for the Answer to the Photo Quiz.)

In the Literature

Erratum

An error appeared in the 15 June 2017 issue of the journal [Marks SM, Mase SR, Morris SB. Systematic Review, Meta-analysis, and Cost-effectiveness of Treatment of Latent Tuberculosis to Reduce Progression to Multidrug-Resistant Tuberculosis. Clin Infect Dis 2017; 64(12):1670–77. doi:10.1093/cid/cix208]. FQ/ETA was not cost-effective, was dominated by other regimens, in all scenarios examined. This results in the following changes:

Erratum

An error appeared in the 1 September 2016 issue of the journal [Kalil AC, Mertersky M, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63(5):e61-e111]. In Table 4, the targeted level of vancomycin should be "15–20 µg/mL trough level" [not "15–20 mg/ml"].

Keeping Up With a World in Motion: Screening Strategies for Migrating Populations

tuberculosistuberculosis screeningmigrationasylum seekersmigrants

Systematic Tuberculosis Screening in Asylum Seekers in Italy

Abstract

The preliminary findings of a tuberculosis (TB) screening of asylum seekers performed in a reception center located in northern Italy reveal a post-entry screening prevalence rate of 535 per 100000 individuals screened. This result shows that systematic use of chest radiography is a useful tool for active TB screening among asylum seekers in Italy.

Rapid Clearance and Frequent Reinfection With Enteric Pathogens Among Children With Acute Diarrhea in Zanzibar

Abstract

Background

Acute infectious gastroenteritis is an important cause of illness and death among children in low-income countries. In addition to rotavirus vaccination, actions to improve nutrition status, sanitation, and water quality are important to reduce enteric infections, which are frequent also among asymptomatic children. The aim of this study was to investigate if the high prevalence of these infections reflects that they often are not cleared properly by the immune response or rather is due to frequent pathogen exposure.

Methods

Rectal swabs were collected at time of acute diarrhea and 14 days later from 127 children, aged 2–59 months and living in rural Zanzibar, and were analyzed by real-time polymerase chain reaction targeting multiple pathogens.

Results

At baseline, detection rates >20% were found for each of enterotoxigenic Escherichia coli, Shigella, Campylobacter, Cryptosporidium, norovirus GII, and adenovirus. At follow-up, a large proportion of the infections had become cleared (34–100%), or the pathogen load reduced, and this was observed also for agents that were presumably unrelated to diarrhea. Still, the detection frequencies at follow-up were for most agents as high as at baseline, because new infections had been acquired. Neither clearance nor reinfection was associated with moderate malnutrition, which was present in 21% of the children.

Conclusions

Children residing in poor socioeconomic conditions, as in Zanzibar, are heavily exposed to enteric pathogens, but capable of rapidly clearing causative and coinfecting pathogens.

Erratum

A system error occurred in the 15 May 2017 and 1 June 2017 issues of the journal. A test script was triggered by the typesetter at press time, corrupting some parenthetical data within some articles. Single letters, numerals, or symbols were replaced with the issue's volume and number. The affected articles are listed below, in the order they appear within the issues.

News

Reply to Dobler

To the Editor—We thank Dr Dobler for her comments regarding the methods of how we calculated and compared cumulative incidence of tuberculosis (TB) in cancer patients and country-specific TB incidence in our study [1]. We estimated the cumulative incidence (proportion) of developing TB during a specific study period in cancer cohorts divided by the mean annual TB incidence in the general US population over the same study period. We were not able to estimate the incidence of TB per year or by unit of time of follow-up in cancer patients because neither time to TB diagnosis of all cases nor the amount of time cancer cohorts were followed was reported in the included studies. Although we adjusted for the change in TB incidence in the general population over the study period, we assumed that the majority of TB cases would have occurred early after the cancer diagnosis. We did not account for the fact that the denominator estimated the annual TB incidence in the United States (also a proportion) and thus all new cases occurring in the US population per year. On reexamination of the data, 2 of the included studies provide insight into the timing of onset of active TB after a cancer diagnosis and support our assumption [2, 3]. In the study by Kaplan et al, 41% of TB cases occurred concurrently with the cancer diagnosis and 90% of all cases occurred within 18 months of cancer therapy [2]. Similarly, in the study by Libshitz et al, 30% of TB cases were diagnosed concurrently with the cancer and 79% of all cases occurred within 18 months of completion of cancer therapy, which for most cancers is approximately 2 years after cancer diagnosis [3]. Extrapolating from studies in which follow-up time of cancer cohorts was reported (Table 1 of our manuscript), this was usually relatively short (2–5 years) whereas study periods were generally longer (up to 13 years) [1]. Thus, cancer patients in the Kamboj study were likely not followed for the entire 25-year study period and, if the timing of TB after cancer diagnosis followed the same pattern as the Kaplan and Libshitz studies, the majority of TB cases also would have occurred within 2 years of cancer diagnosis [2–4].

Cumulative Incidence and Incidence Rate Ratio for Estimation of Risk of Tuberculosis in Patients With Cancer

To the Editor—In their systematic review and meta-analysis of the risk of active tuberculosis (TB) in patients with cancer, Cheng et al evaluated the cumulative incidence of TB among patients with cancer and used this information together with annual country-specific TB incidence rates from the World Health Organization to estimate the incidence rate ratio of TB in patients with cancer compared to the general population [1]. The analysis raises some methodological concerns that have implications for the interpretation of the results. The authors use the term "cumulative incidence rate," when indeed cumulative incidence is a proportion, not a rate (events expressed per unit time) [2, 3]. For included studies that only contained information on cumulative incidence, but not an actual incidence rate, the authors used cumulative incidence (over the study period) divided by the incidence rate per year in the general population to calculate an incidence rate ratio. This calculation is methodologically incorrect [3] and will result in overestimation of the incidence rate ratio. The included study by Kamboj and Sepkowitz that evaluated the risk of TB among patients with cancer at the Memorial Sloan-Kettering Cancer Center in New York City between 1980 and 2004 illustrates the problem [4]. In this study, there were 103 cases of TB among 186843 patients with cancer during the study period, resulting in a cumulative incidence of 55 cases of TB per 100000 patients (over 25 years). In Table 1 of their article, Cheng et al presented the cumulative incidence of 55 and divided this number by the TB incidence per 100000 persons/year in the general population during the study period (8.6/100000/year), resulting in an incidence rate ratio (calculated by the authors) of 6.3 (55/8.6). The problem is that the cumulative incidence among cancer patients accumulated over 25 years whereas the incidence in the general population represented events occurring within 1 year. Assuming a regular distribution of these TB cases over time, the TB incidence rate would have been 2.2/100000 per year (55 cases of TB per 100000 patients over 25 years), but of course this estimate is not correct either, because it wrongly assumes that every patient survived and was followed up for 25 years. Thus, the available study data do not allow calculation of an incidence rate ratio, and the analysis should have been limited to studies that provided a true incidence rate of TB.

Fluoroquinolone Resistance Mutation Detection Is Equivalent to Culture-Based Drug Sensitivity Testing for Predicting Multidrug-Resistant Tuberculosis Treatment Outcome: A Retrospective Cohort Study

Abstract

Background

Molecular diagnostics that rapidly and accurately predict fluoroquinolone (FQ) resistance promise to improve treatment outcomes for individuals with multidrug-resistant (MDR) tuberculosis (TB). Mutations in the gyr genes, though, can cause variable levels of in vitro FQ resistance, and some in vitro resistance remains unexplained by gyr mutations alone, but the implications of these discrepancies for treatment outcome are unknown.

Methods

We performed a retrospective cohort study of 172 subjects with MDR/extensively drug-resistant TB subjects and sequenced the full gyrA and gyrB open reading frames in their respective sputum TB isolates. The gyr mutations were classified into 2 categories: a set of mutations that encode high-level FQ resistance and a second set that encodes intermediate resistance levels. We constructed a Cox proportional model to assess the effect of the gyr mutation type on the time to death or treatment failure and compared this with in vitro FQ resistance, controlling for host and treatment factors.

Results

Controlling for other host and treatment factors and compared with patients with isolates without gyr resistance mutations, "high-level" gyr mutations significantly predict poor treatment outcomes with a hazard ratio of 2.6 (1.2–5.6). We observed a hazard of death and treatment failure with "intermediate-level" gyr mutations of 1.3 (0.6–3.1), which did not reach statistical significance. The gyr mutations were not different than culture-based FQ drug susceptibility testing in predicting the hazard of death or treatment failure and may be superior.

Conclusions

FQ molecular-based diagnostic tests may better predict treatment response than traditional drug susceptibility testing and open avenues for personalizing TB therapy.

Characterization of Aerosols Generated During Patient Care Activities

Abstract

Background

Questions remain about the degree to which aerosols are generated during routine patient care activities and whether such aerosols could transmit viable pathogens to healthcare personnel (HCP). The objective of this study was to measure aerosol production during multiple patient care activities and to examine the samples for bacterial pathogens.

Methods

Five aerosol characterization instruments were used to measure aerosols during 7 patient care activities: patient bathing, changing bed linens, pouring and flushing liquid waste, bronchoscopy, noninvasive ventilation, and nebulized medication administration (NMA). Each procedure was sampled 5 times. An SKC BioSampler was used for pathogen recovery. Bacterial cultures were performed on the sampling solution. Patients on contact precautions for drug-resistant organisms were selected for most activity sampling. Any patient undergoing bronchoscopy was eligible.

Results

Of 35 sampling episodes, only 2 procedures showed a significant increase in particle concentrations over baseline: NMA and bronchoscopy with NMA. Bronchoscopy without NMA and noninvasive ventilation did not generate significant aerosols. Of 78 cultures from the impinger samples, 6 of 28 baseline samples (21.4%) and 14 of 50 procedure samples (28.0%) were positive.

Conclusions

In this study, significant aerosol generation was only observed during NMA, both alone and during bronchoscopy. Minimal viable bacteria were recovered, mostly common environmental organisms. Although more research is needed, these data suggest that some of the procedures considered to be aerosol-generating may pose little infection risk to HCP.

A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration

Abstract

Background

Burkholderia cepacia complex (Bcc) are a group of multidrug-resistant gram-negative bacteria rarely reported in patients without cystic fibrosis (CF) or immunocompromising conditions. We investigated Bcc bloodstream infections (BSIs) in a cohort of non-CF patients from the US Veterans Health Administration (VHA).

Methods

Using VHA databases, we identified patients with Bcc BSI at facilities nationwide from 1999 through 2015. We ascertained clinical characteristics, treatments, and outcomes and identified factors associated with 30-day mortality in logistic regression analysis.

Results

We identified 248 patients with Bcc BSI, who were of advanced age (mean, 68 years), chronically ill, and had severe disease. The most common sources were central venous catheters (41%) and pneumonia (20%). Most cases were hospital-acquired (155 [62%]) or healthcare-associated (70 [28%]). Mortality at 14, 30, and 90 days was 16%, 25%, and 36%, respectively. Trimethoprim-sulfamethoxazole (TMP-SMX) and fluoroquinolones were active against 94% and 88% of isolates, respectively. Susceptibility to ceftazidime and meropenem occurred in approximately 70% of the isolates. The most prescribed antibiotics were fluoroquinolones (35%), followed by carbapenems (20%), TMP-SMX (18.5%), and ceftazidime (11%). In regression analysis, age (OR, 1.06 [95% confidence interval {CI}, 1.02–1.10], per added year) and the Pitt bacteremia score (OR, 1.65 [95% CI, 1.44–1.94], per unit increase) were associated with higher 30-day mortality.

Conclusions

In this large cohort of BSIs caused by Bcc, cases were mostly hospital-acquired and we observed high mortality, significant resistance to ceftazidime, and limited use of TMP-SMX. These observations add to our understanding of Bcc infection in non-CF patients and highlight the need for interventions to improve their outcome.

Viral Load and Cytokine Response Profile Does Not Support Antibody-Dependent Enhancement in Dengue-Primed Zika Virus–Infected Patients

Abstract

Background

The pathogenesis of severe dengue disease involves immune components as biomarkers. The mechanism by which some dengue virus (DENV)–infected individuals progress to severe disease is poorly understood. Most studies on the pathogenesis of severe dengue disease focus on the process of antibody-dependent enhancement (ADE) as a primary risk factor. With the circulation of Zika virus (ZIKV) in DENV-endemic areas, many people infected by ZIKV were likely exposed to DENV. The influence of such exposure on Zika disease outcomes remains unknown.

Methods

We investigated whether patients previously exposed to DENV exhibited higher viremia when exposed to a subsequent, heterologous dengue or Zika infection than those patients not previously exposed to dengue. We measured viral loads and cytokine profile during patients' acute infections.

Results

Neither dengue nor Zika viremia was higher in patients with prior DENV infection, although the power to detect such a difference was only adequate in the ZIKV analysis. Of the 10 cytokines measured, only 1 significant difference was detected: Levels of interleukin 1β (IL-1β) were lower in dengue-infected patients who had experienced a previous dengue infection than patients infected with dengue for the first time. However, power to detect differences between groups was low. In Zika-infected patients, levels of IL-1β showed a significant, positive correlation with viral load.

Conclusions

No signs of ADE were observed in vivo in patients with acute ZIKV infection who had prior exposure to DENV.

Plasma Indoleamine 2, 3-Dioxygenase, a Biomarker for Tuberculosis in Human Immunodeficiency Virus-Infected Patients

Abstract

Background

There is no biomarker for diagnosing active tuberculosis in patients with human immunodeficiency virus (HIV) infection. Indoleamine 2, 3-dioxygenase (IDO) is an immunoregulatory enzyme that breaks down tryptophan (Trp) to metabolites known as kynurenines (Kyns). We investigated whether IDO activity, as measured by the ratio of Kyn to Trp, could be used to diagnose or predict active tuberculosis disease in HIV-infected adults.

Methods

Kyn and Trp concentrations were measured using ultraperformance liquid chromatography mass spectrometry in plasma samples from 32 HIV-infected patients in whom active tuberculosis developed and who were followed up prospectively. We compared to 70 HIV-infected control subjects from the same cohort in whom tuberculosis did not develop, matched by age, sex, and CD4 cell count, and 37 unmatched HIV-infected patients with a diagnosis of pneumonia. Clinical parameters, including body mass index, CD4 cell count, HIV load, and C-reactive protein levels were analyzed.

Results

At the time of tuberculosis diagnosis, IDO activity was significantly higher in patients with tuberculosis than in controls (P < .001). Six months before tuberculosis diagnosis, IDO activity was significantly higher in all patients who later developed tuberculosis (P < .001) than controls. After 6 months of tuberculosis treatment, IDO activity in patients with tuberculosis declined to levels similar to those in controls. IDO activity was 4-fold higher in patients with tuberculosis than in those with pneumonia, and could be used to distinguish them. With a receiver operating characteristic curve, IDO activity had a sensitivity of 97%, a specificity of 99%, and positive and negative predictive values of 89% and 100% for detecting active tuberculosis disease.

Conclusion

Plasma IDO activity is suitable as a biomarker of active tuberculosis in HIV-positive patients.

Importance of Carbapenemase Production Detection in Carbapenem-Resistant Enterobacteriaceae: Looking Beyond Epidemiological Purposes

To the Editor—We read with great interest the recent article by Tamma et al [1], who reported that patients with carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) have 2.6 and 4.9 higher odds for bacteremia recurrence at 30 days and mortality at 14 days, respectively, compared with patients with non-CP CRE.

Brimonidine for treatment of telangiectasia of dermatomyositis

Corrigendum to “Topical application of neem leaves prevents wrinkles formation in UVB-exposed hairless mice” [J. Photochem. Photobiol. B Biol. 169 (April 2017) 161–170]

Publication date: Available online 29 September 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Hien T.T. Ngo, Eunson Hwang, Seul-A Seo, Bom Park, Zheng-wang Sun, Mengyang Zhang, Yu-Kyong Shin, Tae-Hoo Yi

Consensus guidelines for the identification and treatment of biofilms in chronic non-healing wounds

Abstract

Background: Despite a growing consensus that biofilms contribute to a delay in the healing of chronic wounds, conflicting evidence pertaining to their identification and management can lead to uncertainty regarding treatment. This, in part, has been driven by reliance on in vitro data or animal models, which may not directly correlate to clinical evidence on the importance of biofilms. Limited data presented in human studies have further contributed to the uncertainty. Guidelines for care of chronic wounds with a focus on biofilms are needed to help aid the identification and management of biofilms, providing a clinical focus to support clinicians in improving patient care through evidence-based medicine.

Methods: A Global Wound Biofilm Expert Panel, comprising 10 clinicians and researchers with expertise in laboratory and clinical aspects of biofilms, was identified and convened. A modified Delphi process, based on published scientific data and expert opinion, was used to develop consensus statements that could help identify and treat biofilms as part of the management of chronic non-healing wounds. Using an electronic survey, panel members rated their agreement with statements about biofilm identification and treatment, and the management of chronic non-healing wounds. Final consensus statements were agreed on in a face-to-face meeting.

Results: Participants reached consensus on 61 statements in the following topic areas: understanding biofilms and the problems they cause clinicians; current diagnostic options; clinical indicators of biofilms; future options for diagnostic tests; treatment strategies; mechanical debridement; topical antiseptics; screening anti-biofilm agents; and levels of evidence when choosing anti-biofilm treatments.

Conclusion: This consensus document attempts to clarify misunderstandings about the role of biofilms in clinical practice, and provides a basis for clinicians to recognize biofilms in chronic non-healing wounds and manage patients optimally. A new paradigm for wound care, based on a stepped-down treatment approach, was derived from the consensus statements. This article is protected by copyright. All rights reserved.