Impact of PM 10 and meteorological factors on the incidence of hand, foot, and mouth disease in female children in Ningbo, China: a spatiotemporal and time-series study

Abstract

Hand, foot, and mouth disease (HFMD) is a viral illness that is considered a critical public health challenge worldwide. Previous studies have demonstrated that meteorological parameters are significantly related to the incidence of HFMD in children; however, few studies have focused only on female children. This study quantified the associations of HFMD incidence with meteorological parameters and PM₁₀ (particulate matter with an aerodynamic diameter of 10 μm) among female children. Data were collected on daily HFMD cases, meteorological variables, and PM₁₀ levels in Ningbo, China, from January 2012 to December 2016. Data were assessed using a distributed lag nonlinear model (DLNM) with Poisson distribution. A total of 59,809 female children aged 0−15 years with HFMD were enrolled. The results showed that highest relative risk (RR) of HFMD for temperature was 3 °C and the lag effect was 3 days. The highest RR for PM₁₀ was 80 mg/m³ and the lag effect was 5 days. Spatial analysis showed that female HFMD incidence was mainly concentrated in the suburban of Ningbo city indicating that female children in this area should be more paid attention on avoiding this disease outbreak. Our findings suggest that HFMD prevention strategies should focus more attention on local meteorological parameters.

Modelling local uncertainty in relations between birth weight and air quality within an urban area: combining geographically weighted regression with geostatistical simulation

Abstract

In this study, we combine known methods to present a new approach to assess local distributions of estimated parameters measuring associations between air quality and birth weight in the urban area of Sines (Portugal). To model exposure and capture short-distance variations in air quality, we use a Regression Kriging estimator combining air quality point data with land use auxiliary data. To assess uncertainty of exposure, the Kriging estimator is incorporated in a sequential Gaussian simulation algorithm (sGs) providing a set of simulated exposure maps with similar spatial structural dependence and statistical properties of observed data. Following the completion of the simulation runs, we fit a geographically weighted generalized linear model (GWGLM) for each mother's place of residence, using observed health data and simulated exposure data, and repeat this procedure for each simulated map. Once the fit of GWGLM with all exposure maps is finished, we take the distribution of local estimated parameters measuring associations between exposure and birth weight, thus providing a measure of uncertainty in the local estimates. Results reveal that the distribution of local parameters did not vary substantially. Combining both methods (GWGLM and sGs), however, we are able to incorporate local uncertainty on the estimated associations providing an additional tool for analysis of the impacts of place in health.

Phytoremediation of Mn-contaminated paddy soil by two hyperaccumulators ( Phytolacca americana and Polygonum hydropiper ) aided with citric acid

Abstract

The purpose of this study was to investigate the phytoremediation potential of two hyperaccumulator plants, Phytolacca americana L. and Polygonum hydropiper L., on manganese-contaminated paddy soils. The biomass growth, Mn concentrations in plant tissues, and potential Mn removal efficiency from soils of these two plants were studied with citric acid, and the mechanisms of citric acid on these two plants were analyzed by examining the root activity, the activities of superoxide dismutase (SOD), peroxidase (POD) and catalase (CAT) in leaves, as well as the concentrations of O₂·⁻ and H₂O₂ in leaves. The results showed that the biomass of these two plants were both promoted under low level of citric acid (3 mmol kg⁻¹). The concentration of Mn in the plants and the amount of Mn removed from the soil by the plants through harvesting were enhanced at low and intermediate (10 mmol kg⁻¹) citric acid application levels. The results also showed that root activity was enhanced at the low citric acid level and significantly inhibited under the intermediate and high levels (15 mmol kg⁻¹), which indicates the facilitative function of the low level of citric acid and the inhibitive function of the high level of citric acid application on plant biomass growth. Under the low and intermediate levels of citric acid application, O₂·⁻ in the plant leaves increased sharply, and the SOD, POD, and CAT activities also increased sharply, which made the level of H₂O₂ very similar to that of the control, ensuring the health of the plants. At the high level of citric acid application, however, the O₂·⁻ continued to rise sharply, while the activity of the three antioxidant enzymes declined sharply, causing the concentration of hydrogen peroxide to be much higher than that in the control, thus endangering the plants. The present study shows the potential of P. hydropiper for use in the phytoremediation of soil contaminated with a relatively low level of manganese.

Placa anular pigmentada submentoniana

Publication date: Available online 30 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): F.J. Navarro-Triviño, M.J. Naranjo-Díaz, R. Ruiz-Villaverde

Síndrome de Stewart-Bluefarb: caso clínico y revisión de la literatura

Publication date: Available online 30 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): V.E. García Blanco, E. Dóiz Artázcoz, M.C. Galera Martínez, M. Rodríguez Piñero

Utilidad de la microscopía confocal de reflectancia para el diagnóstico in vivo de los sebomatricomas

Publication date: Available online 30 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): S. Burillo-Martínez, R. Gamo, F. Pinedo, J.L. López-Estebaranz

Medición del impacto psicológico en pacientes con psoriasis en tratamiento sistémico

Publication date: Available online 30 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): M.B. Madrid Álvarez, G. Carretero Hernández, A. González Quesada, J.M. González Martín
Antecedentes y objetivosEl impacto negativo que la psoriasis tiene en la calidad de vida del paciente puede ser tan importante como sus consecuencias físicas. Podríamos suponer que el blanqueamiento de la enfermedad conllevaría también una mejoría de su impacto psicosocial. El presente estudio valora el estado psicológico de los pacientes con psoriasis controlados con tratamiento sistémico en una Unidad de Psoriasis, especialmente en aquellos con una afectación leve o nula de la enfermedad.MétodosEstudio epidemiológico observacional y trasversal, sin intervención, con dos cohortes (casos y controles). Los pacientes autocompletaron datos demográficos y 4 cuestionarios (Cuestionario de autoestima de Rosenberg, Skindex-29, HADS y COPE-28) en una única visita.ResultadosSe reclutaron 111 pacientes diagnosticados de psoriasis y 109 pacientes control. En autoestima, el promedio y la desviación estándar (DE) del grupo de psoriasis fue de 33,5 (4,8) y de 33,3 (6,7) para el grupo control, sin diferencias significativas. En el Skindex-29, la puntuación media del grupo de pacientes con psoriasis fue casi 3 veces mayor que la media del grupo control (30 vs. 11). Se encontraron diferencias significativas en las puntuaciones del HADS de ambos grupos (12,7 vs. 9,0; p<0,001). Las puntuaciones promedio del HADS-A fueron de 8,0 (4,78) en el grupo de psoriasis frente a 5,7 (3,8) en el grupo control (p<0,001), mientras que las del HADS-D fueron de 4,7 (3,9) frente a 3,2 (3,1) (p<0,004), respectivamente.ConclusionesLos resultados obtenidos indican que es necesario medir el estado psicológico de nuestros pacientes con psoriasis, pues incluso con un control casi total de la enfermedad la afectación psicológica permanece.Background and objectivesThe negative impact of psoriasis on patient quality of life can be as important as the physical consequences of the disease. We could assume that clearance of the disease would also lead to an improvement in its psychosocial impact. The present study assesses the psychological state of patients with psoriasis receiving systemic treatment in a psoriasis unit, especially those with mild or no disease involvement.MethodsWe performed a cross-sectional, observational, noninterventional epidemiological study of 2 cohorts (cases and controls). The patients self-completed demographic data and 4 questionnaires (Rosenberg Self-Esteem Scale, Skindex-29, HADS, and COPE-28 questionnaire) at a single visit.ResultsWe recruited 111 patients diagnosed with psoriasis and 109 control patients. In self-esteem, the mean and standard deviation (SD) score was 33.5 (4.8) for the psoriasis group and 33.3 (6.7) for the control group, with no significant differences. In the Skindex-29, the mean score for the psoriasis group was almost 3 times higher than that of the control group (30 vs. 11). Significant differences were found in the HADS scores of both groups (12.7 vs. 9.0, P<.001). The mean HADS-A scores were 8.0 (4.78) for the psoriasis group compared with 5.7 (3.8) for the control group (P<.001). In the case of HADS-D, the scores were 4.7 (3.9) compared with 3.2 (3.1) (P<.004), respectively.ConclusionsOur findings indicate that it is necessary to assess the psychological state of patients with psoriasis, because psychological effects persist even in cases where the disease is almost totally controlled.

Graphical abstract

Tumoración frontal que aumenta de tamaño con maniobra de Valsalva

Publication date: Available online 30 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): A. Catalán Griffiths, F. Alfagueme Roldán, I. Salgüero Fernández, M.G. Ragusa

Lesiones de rascado… sin rascado

Publication date: Available online 30 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): J.L. Ramírez-Bellver, A. Alegre-Sánchez

Silicon improves salt tolerance of Glycyrrhiza uralensis Fisch. by ameliorating osmotic and oxidative stresses and improving phytohormonal balance

Abstract

Si has a beneficial effect on improving plant tolerance to salt stress. Nevertheless, the mechanisms of Si in mediating the stress responses are still poorly understood. Glycyrrhiza uralensis Fisch. (G. uralensis), a well-known medicinal plant, possesses vast therapeutic potentials. In the present study, a pot experiment was conducted to investigate the long-term effects of Si on growth and physiobiochemical characteristics in 2-year-old G. uralensis subjected to different levels of salinity. Si markedly affected G. uralensis growth in a salt concentration-dependent manner and had no effect on G. uralensis growth under 6 g/kg NaCl. However, it partly reversed the reduction effect induced by 9 g/kg NaCl. In addition, Si significantly increased the contents of soluble sugar and protein but deceased proline content and thus increased water relations; Si markedly increased the activities of SOD, peroxidase, and CAT and further resulted in decreased MDA content and membrane permeability. Moreover, Si altered the levels of phytohormones and their balances. With correlation analysis and principal component analysis (PCA), root biomass had a significant negative correlation with MDA and membrane permeability while a positive correlation with indole-3-acetic acid and GA₃. The PCA partitioned the total variance into three PCs contributing maximum (88.234%) to the total diversity among the salt stress with or without Si due to the study of various traits. In conclusion, Si exerts a beneficial property on salt-induced harmful effects in G. uralensis by relieving osmotic stress, improving water relations, and alleviating oxidative stress; thus, altering the levels and balance of phytohormones results in improved growth of salt-stressed G. uralensis.

Ecotoxicological evaluation of electrochemical oxidation for the treatment of sanitary landfill leachates

Abstract

In this study, the efficiency of electrochemical oxidation to treat a sanitary landfill leachate was evaluated by the reduction in physico-chemical parameters and in ecotoxicity. The acute toxicity of the sanitary landfill leachates, before and after treatment, was assessed with the model organism Daphnia magna. Electrochemical oxidation treatment was effective in the removal of organic load and ammonium nitrogen and in the reduction of metal ions concentrations. Furthermore, a reduction of 2.5-fold in the acute toxicity towards D. magna after 36 h of treatment was noticed. Nevertheless, the toxicity of the treated leachate is still very high, and further treatments are necessary in order to obtain a non-toxic effluent to this aquatic organism. Toxicity results were also compared with others described in the literature for different leachate treatments and test organisms.

The spatial distribution of phosphorus and their correlations in surface sediments and pore water in Lake Chaohu, China

Abstract

The study presents the spatial distribution of different forms of phosphorus in the sediments in Lake Chaohu, a large eutrophic Chinese lake, and their correlation with phosphorus content in pore water. The sediment and pore water samples were taken from 19 sampling sites. A sequential extraction was used to determine the contents of different forms of phosphorus in the sediments. The compositions and spatial distribution of different forms of phosphorus in the sediments and their correlation with orthophosphate and total phosphorus content in the pore water were studied. The following results were obtained: (1) the mean content of total phosphorus was 474.7 ± 20.5 mg/kg, with 390.8 ± 82.4 mg/kg for the eastern lake (N = 5), 469.0 ± 53.9 mg/kg for the western lake (N = 5), and 524.5 ± 185.3 mg/kg for rivers (N = 9); (2) the order of the proportions of the different forms of phosphorus was occluded phosphorus (Oc-P, 52.4%) > debris phosphorus (De-P, 14.2%) > auto-calcium-bound phosphorus (ACa-P, 13.5%) > aluminum-bound phosphorus (Al-P, 9.8%) > organic phosphorus (Or-P, 6.8%) > exchangeable phosphorus (Ex-P, 2.1%) > iron-bound phosphorus (Fe-P, 1.3%); (3) Ex-P, Al-P, and Fe-P had significantly positive correlations with orthophosphate and total phosphorus content in pore water, which showed that these forms of phosphorus were released more easily and had an indirect impact on lake eutrophication.

Association between prenatal nickel exposure and preterm low birth weight: possible effect of selenium

Abstract

There is a proposed link between prenatal nickel (Ni) exposure and preterm low birth weight (PLBW); however, this association remains unclear. Selenium (Se) may modify this relationship by protecting against Ni toxicity. Concentrations of Ni and Se were measured in urine samples collected from 408 pregnant women (102 PLBW cases and 306 matched controls) in China. Conditional logistic regression was utilized to explore the association between Ni levels and PLBW, as well as the effect modification by Se on this association. A significant association was observed between higher maternal urinary Ni levels and risk of PLBW [adjusted odds ratio (OR) = 2.80 (95% confidence interval (CI): 1.44, 5.44) for the highest tertile], and this association was more apparent among female infants than that among male infants. Further analyses showed that mothers with high urinary Ni and low urinary Se levels had a significantly increased risk for PLBW [adjusted OR = 2.87 (95% CI: 1.09, 7.56)] compared with the mothers with low urinary Ni and high urinary Se levels. Our study indicates that prenatal exposure to Ni was a risk factor for PLBW. Se might provide protection against the toxicity of Ni.

Impact of waste-derived organic and inorganic amendments on the mobility and bioavailability of arsenic and cadmium in alkaline and acid soils

Abstract

In agriculture, more and more frequently waste-derived amendments are applied to soil to improve physical and chemical properties. Nevertheless, in soils polluted by potentially toxic metal(loid)s, this agricultural practice may significantly affect the mobility and bioavailability of pollutants modifying the risks for biota and human health. This work was aimed to assess the influence of poultry manure, biochar and coal fly ash on the mobility and bioavailability of As and Cd spiked in two Australian soils with different pH and texture: Mount Gambier (MGB)-alkaline sandy clay loam and Kapuda (KPD)-acid loamy sand. After 4 weeks of incubation from spiking and another 4 weeks from amendment addition, the soils were analysed for pH and amounts of As and Cd in pore-water and following 1 M NH₄NO₃ extraction. Bioavailable amounts were assessed by plant uptake, using Zea mays L. as test crop. In the alkaline MGB soil, the availability of Cd was reduced, while that of As increased. An opposite behaviour was observed in the acid KPD soil. All amendments, when added to KPD soil, increased pH and consequently reduced the mobility of Cd and increased the mobility of As. In MGB, the amendment addition had an effect only on As mobility and bioavailability, which increased likely as a result of the increased competition for adsorption with DOC released by organic compounds. These trends were confirmed by the amounts of Cd and As uptaken by maize plants.

Varying concentrations of soil chromium (VI) for the exploration of tolerance thresholds and phytoremediation potential of the oregano ( Origanum vulgare )

Abstract

Varying concentrations of soil Cr(VI) were used in order to explore the tolerance thresholds and phytoremediation potential of Greek oregano (Origanum vulgare), in a pot experiment conducted outdoors. Oregano exhibited a rather exceptional capacity to bioaccumulate Cr in both the aerial part (up to 1200 mg of total Cr kg⁻¹ DM) and the root—reaching 4300 mg kg⁻¹ DM when grown in soil [Cr(VI)] of 150–200 mg kg⁻¹. Plant responses indicated that there was a threshold set at 100 mg Cr(VI) kg⁻¹ in the soil, above which the following results were recorded: (i) a restriction of Cr translocation from below- to above-ground plant part, (ii) a raise of the soil-to-root Cr transfer, and (iii) the Cr(III) evolution from the reduction of Cr(VI) was significantly decelerated in the root and accelerated in the aerial part. Soil [Cr] that surpassed this threshold challenged plant tolerance, resulting in a dose-dependent reduction of growth and antioxidant phenolics pool. Nonetheless, the significant Cr uptake capacity at plant level accounted for the considerably short remediation time (i.e., 29 years at soil [Cr(VI)] of 150 mg kg⁻¹) calculated according to these results. The overall performance of oregano indicated that phytoremediation would be feasible at sites with Cr contamination levels ranging within the above-defined thresholds.

The carotenoid Bixin found to exhibit the highest measured carotenoid oxidation potential to date consistent with its practical protective use in cosmetics, drugs and food

Publication date: Available online 30 June 2018
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Sefadzi Tay-Agbozo, Shane Street, Lowell Kispert
The electrochemical oxidation potentials of cis bixin correspond to the production of the carotenoid radical cation, Car⁺ and dication Car⁺⁺. The oxidation is a two-electron process with oxidation potentials at ~0.94 and ~1.14 V vs SCE (reference to ferrocene at 0.528 V) in THF. These potentials are higher than that of symmetrical canthaxanthin at 0.775 V and 0.972 V and for β-carotene at 0.634 V and 0.605 V respectively. The second oxidation potential for canthaxanthin is higher by 0.20 V than the first. Similar difference is observed for bixin. In contrast, the second oxidation potential for β-carotene is lower by 30 mV than that of the first. Reduction potentials were found to occur at ~−0.69 and ~−1.22 V vs SCE. The lifetime of the radical cation of cis bixin, Car⁺, is short and decays rapidly at ambient temperature. The suggested scavenging ability of cis bixin towards reactive oxidative oxygen species is estimated to be 44. On the other hand, that of β-carotene, symmetrical canthaxanthin and the dicyano substituted carotenoid which exhibit oxidation potentials of 0.634 V, 0.775 V and 0.833 V vs SCE were measured to be 0.64, 1.96 and 23.60 respectively. The non-reversible electrochemical measurements suggest the tendency for bixin to react with trace amounts of reactive oxygen species (OH, O2⁻, OOH).

Graphical abstract

Photobiomodulation improved stereological parameters and sperm analysis factors in streptozotocin-induced type 1 diabetes mellitus

Publication date: Available online 30 June 2018
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Sara Dadras, Mohammad-Amin Abdollahifar, Hamid Nazarian, Seyed Kamran Ghoreishi, Somyeh Fallahnezhad, Parvaneh Naserzadeh, Vahid Jajarmi, Sufan Chien, Mohammad Bayat
The aim of this study was to evaluate the effect of photobiomodulation (PBM) on testicular tissues and fresh sperm analysis factors in streptozotocin (STZ)-induced type one diabetes mellitus (T1DM) mice.T1DM was induced in 15 male Syrian mice by injection of 200 mg/kg STZ. After one month, mice were divided randomly into three groups, harboring 5 mice each: 1, control group; 2, first laser group (890 nm, 80 Hz, 0.03 J/cm²) and 3, second laser group (0.2 J/cm²). Then the mice were euthanized and testicles were dissected for stereological studies, and both epididymis and vas deferens were removed for fresh sperm analysis. Data were analyzed by statistical methods.A significant increase was observed in the Sertoli cell count in both PBM groups, compared to the control group. In addition, the second PBM group shows a significant increase in the Sertoli cell count, compared to the first PBM group. Both PBM groups show significant increase in the Leydig cell count, compared to the control group. There were significant increases of the length in the seminiferous tubules in both PBM groups, compared to the control group. In addition, the second PBM group showed a significant increase of the length in the seminiferous tubules, compared to the first PBM group. The second PBM group showed a significant increase in the sperm count, compared to the control, and first PBM groups. The first PBM group showed a significant increase in sperm count, compared to the control group. The sperm motility and count were significantly increased in the second PBM group, compared to the control and first PBM groups. The sperm motility was significantly increased in the first PBM group, compared to the control group.PBM with 0.2 J/cm² and 0.03 J/cm² energy densities significantly improved the stereological parameters and fresh sperm analysis factors, compared to the control group in STZ-induced T1DM in mice. Moreover, the PBM with 0.02 J/cm² energy density was statistically more effective, compared to the 0.03 J/cm².

Preliminary Analysis of Pulsed Radiofrequency Therapy Combined with Carpal Tunnel Release for Reducing the Pain in Postoperative Period: Early Outcomes

Publication date: Available online 30 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Gokce Yildiran, Osman Akdag, Inci Kara, Mehtap Karamese

The unexpected diversity of microbial communities associated with black corals revealed by high-throughput Illumina sequencing

Abstract

The microbes associated with black corals remain poorly studied. The present study is the first attempt to investigate microbial community structure in the black corals Antipathes ceylonensis and A. dichotoma from the South China Sea by using high-throughput Illumina sequencing. A total of 52 bacterial and 3 archaeal phyla were recovered in this study, suggesting the black corals harboured highly diverse microbial communities. Among the 55 microbial phyla, Proteobacteria, Firmicutes, Bacteroidetes, Chloroflexi, Acidobacteria and Actinobacteria dominated in the two black corals from the South China Sea. Although most of the microbial phyla recovered from the two black corals have been reported in previous studies on coral-associated microbes, eight bacterial phyla including Synergistetes, Thermi, AncK6, GNO2, NKB19, NC10, WWE1 and GAL15, and the archaeal phylum Parvarchaeota are reported for the first time from corals in this study, which expands our knowledge about the diversity of coral-associated microbes. The comparison of microbial communities in the different black coral species indicated that A. ceylonensis harboured few abundant bacterial genera such as Citrobacter and Pseudomonas, whereas a high diversity of rare bacterial genera (<1% abundance), such as Winogradskyella and Rubricoccus, was detected only in A. dichotoma. These results suggested that the microbial community in black corals exhibited species-specific variation.

Transport and metabolic engineering of the cell factory Corynebacterium glutamicum

Abstract

Corynebacterium glutamicum has a long and successful history in the biotechnological production of the amino acids l-glutamate and l-lysine. In the recent years, C. glutamicum has been engineered for the production of a broad catalog of value-added compounds including organic acids, vitamins, terpenoids and proteins. Moreover, this bacterium has been engineered to realize a flexible carbon source concept enabling product formation from various second generation feedstocks without competing uses in human and animal nutrition. In this review, we highlight transport engineering to improve product export and substrate uptake or to avoid loss of intermediates by excretion as well as the application of new metabolic engineering concepts for C. glutamicum strain development including the use of designed synthetic E. coli-C. glutamicum consortia. As examples, pathway extension of l-lysine and l-glutamate biosynthesis to produce derived value-added chemicals is described. The described examples of C. glutamicum strain engineering reflect strategies to cope with the increasing complexity of biotechnological processes that are required for successful applications in the bioeconomy.

Educating in antimicrobial resistance awareness: adaptation of the Small World Initiative program to service-learning

Abstract

The Small World Initiative (SWI) is a consolidated and successful education program rooted in the USA that tackles the antibiotic crisis by a crowdsourcing strategy. Based on active learning, it challenges young students to discover novel bioactive-producing microorganisms form environmental soil samples. Besides its pedagogical efficiency to impart Microbiology contents in academic curricula, SWI promotes vocations on research and development in Experimental Sciences and, at the same time, disseminates the antibiotic awareness guidelines of the World Health Organization (WHO). We have adapted the SWI program to the Spanish academic environment by a pioneering hierarchic strategy based on service-learning that involves two education levels (higher education and high school) with different degrees of responsibility. Along the academic year, 23 SWI teams each consisting of 3–7 undergraduate students led by one faculty member have coordinated off-campus programs in 22 local high schools, involving 597 secondary/high school students as researchers. Post-survey-based evaluation of the program reveals a satisfactory achievement of goals: acquiring scientific abilities and general or personal competencies by university students, as well as promoting academic decisions to inspire vocations for science- and technology-oriented degrees in younger students, and successfully communicating scientific culture in antimicrobial resistance to a young stratum of society.

Insights into the phylogeny of false-branching heterocytous cyanobacteria with the description of Scytonema pachmarhiense sp. nov. isolated from Pachmarhi Biosphere Reserve, India

Abstract

A false branching cyanobacterium (strain 10A1_PS) was isolated from a freshwater body of the Pachmarhi Biosphere Reserve, India and was characterized using the polyphasic approach. The detailed morphological examination indicated that the strain belonged to the complex genus Scytonema as it exhibited typical false branching character whose frequency increased with age of the culture. As the family Scytonemataceae and the genus Scytonema has been shown to be polyphyletic in many studies, we provide deep insights into the phylogenetic complexities within the family Scytonemataceae based on 16S rRNA gene phylogeny along with complete morphological, molecular and phylogenetic characterization of the strain. The 16S rRNA gene phylogenetic tree inferred by Bayesian Inference, Neighbor-Joining and Maximum Parsimony methods showed that the strain clustered within the Scytonema sensu stricto clade. The phylogenetic distance and the positioning of the strain clearly indicated it to be different from other Scytonema species. Further analysis using rbcL phylogeny, folded secondary structures of the 16S-23S ITS, p-distance and percentage pairwise similarity matrix clearly distinguished the strain 10A1_PS from the other closely related species. In accordance with the International Code of Nomenclature of Algae, Fungi and Plants we propose the name of the new species to be Scytonema pachmarhiense.

The influence of sigma factors and ribosomal recognition elements on heterologous expression of cyanobacterial gene clusters in Escherichia coli

Abstract

Cyanobacterial natural products offer new possibilities for drugs and lead compounds but many factors can inhibit the production of sufficient yields for pharmaceutical processes. While Escherichia coli and Streptomyces sp. have been used as heterologous expression hosts to produce cyanobacterial natural products, they have not met with resounding success largely due to their inability to recognize cyanobacterial promoter regions. Recent work has shown that the filamentous freshwater cyanobacterium Anabaena sp. strain PCC 7120 recognizes various cyanobacterial promoter regions and can produce lyngbyatoxin A from the native promoter. Introduction of Anabaena sigma factors into E. coli might allow the native transcriptional machinery to recognize cyanobacterial promoters. Here, all 12 Anabaena sigma factors were expressed in E. coli and subsets were found to initiate transcription from several cyanobacterial promoters based on transcriptional fusions to the chloramphenicol acetyltransferase (CAT) reporter. Expression of individual Anabaena sigma factors in E. coli did not result in lyngbyatoxin A production from its native cyanobacterial gene cluster, possibly hindered by deficiencies in recognition of cyanobacterial ribosomal binding sites by native E. coli translational machinery. This represents an important step toward engineering E. coli into a general heterologous expression host for cyanobacterial biosynthetic gene cluster expression.

An approach to the heating dynamics of residues from greenhouse-crop plant biomass originated by tomatoes ( Solanum lycopersicum , L.)

Abstract

The most representative of greenhouse-crop plant biomass residues of tomatoes (Solanum lycopersicum L.) were selected for this study by using X-ray fluorescence spectrometry (XRF) and X-ray powder diffraction (XRD). The heating dynamics in air in the 600–1150 °C range of these residues for the production of renewable energy and the resultant ashes have been investigated. A total of 11 elements were determined by XRF in the biomass ashes and some minor elements. The content of alkaline elements and chlorides decreased as increasing heating temperature and disappeared at 1150 °C. Alkaline salts, NaCl and KCl, were volatilized by heating since 800 °C. The total contents of S and P in the biomass ashes were associated to CaSO₄, and a complex phosphate identified by XRD. CaCO₃ present at 600 °C was decomposed to CaO with disappearance at 1000 °C. By heating, new silicates were formed by solid-state reactions in the biomass residue. The minor elements have been found in a relative proportion lower than 0.9 wt.% and they characterized the obtained ashes, with potential use as micronutrients.

Harmonization of Respiratory Data From Nine US Population-Based Cohorts: The NHLBI Pooled Cohorts Study

Abstract

Chronic lower respiratory diseases (CLRD) are the fourth leading cause-of-death in the US. To support investigations into CLRD risk determinants and new approaches to primary prevention, we aimed to harmonize and pool respiratory data from US general population-based cohorts. Data were obtained from prospective cohorts that performed pre-bronchodilator spirometry, which was harmonized following 2005 ATS/ERS standards. In cohorts conducting follow-up for non-cardiovascular events, CLRD events were defined as hospitalizations/deaths adjudicated as CLRD-related or assigned relevant administrative codes. Coding and variable names were applied uniformly. The pooled sample included 65,251 adults in nine cohorts followed-up for CLRD-related mortality over 653,380 person-years from 1983-2016. Average baseline age was 52 years; 56% were female; 49% were never-smokers; and racial/ethnic composition was 44% White, 22% Black, 28% Hispanic/Latino, and 5% American-Indians. Over 96% had complete data on smoking, clinical CLRD diagnoses, and dyspnea. After excluding invalid spirometry exams (13%), there were 105,696 valid exams (median 2 per participant). Of 29,351 participants followed-up for CLRD hospitalizations, median follow-up was 14 years; only 5% were lost-to-follow-up at 10 years. Hence, the NHLBI Pooled Cohorts Study provides a harmonization standard applied to a large, US population-based sample that may be used to advance epidemiologic research on CLRD.

¿Qué tipo de guantes debemos utilizar en la cirugía dermatológica? Recomendaciones sobre los guantes a emplear

Publication date: Available online 29 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): X. Bosch-Amate, D. Morgado-Carrasco, J. Riera-Monroig, J. Ferrando

Removal of bisphenol A by Fe-impregnated activated carbons

Abstract

A commercial wood-based activated carbon and the oxidized counterpart were impregnated with iron. The two Fe-impregnated carbons were prepared and characterized for their iron content, textural characteristics, surface chemistry, and their performance for bisphenol A adsorption. Batch adsorption experiments were conducted to study the effect of pH, ionic strength, kinetics, and thermodynamic equilibrium. Equilibrium adsorption data were described by both Langmuir and Freundlich isotherms. The iron impregnated activated carbon and the oxidized impregnated activated carbon presented maximum adsorption capacities of 785.65 and 469.78 mg/g, respectively, while adsorption followed second-order rate kinetics for both impregnated carbons. According to the thermodynamic parameters (ΔΗο, ΔSo, ΔGo), the adsorption is a spontaneous, exothermic, and physical process. Fenton-driven experiments conducted at different molar ratios of [H₂O₂]/[BPA] showed efficient degradation of BPA in spent Fe-impregnated carbons up to 82–95%, with traces of hydroxylated products.

S olubilization of insoluble zinc compounds by zinc solubilizing bacteria (ZSB) and optimization of their growth conditions

Abstract

In this research, the optimum growth conditions for two zinc solubilizing bacteria (ZSB) have been studied for their potential application as bioinoculants to overcome Zn unavailability in soils. For this purpose, a laboratory-scale experiment was carried out to evaluate the zinc solubilizing ability of 80 plant growth promoting bacteria (PGPB) strains isolated from the rhizosphere of barley and tomato plants. To select effective ZSB, isolates were evaluated on Tris-mineral medium supplemented separately with zinc oxide, zinc carbonate, and zinc phosphate at a concentration of 0.1%. Two strains (Agrobacterium tumefaciens and Rhizobium sp.) were selected, based on a clear halo zone around their colonies in the solid medium supplemented with zinc oxide after 10 days of incubation at 29 °C. Results of solubilization at different pH values showed that these strains had solubilization activity in the range of pH 8–10 while no solubilization was observed at pH 6 and 7. The maximum Zn solubilization values were noted at pH 9: 51.4 mg L⁻¹ (Agrobacterium tumefaciens) and 72.1 mg L⁻¹ (Rhizobium sp). According to findings, bacterial growth was affected by different NaCl concentrations under in vitro condition. The salt concentration required for 50% inhibition of absorbance was 2.11 and 2.27% NaCl for Agrobacterium tumefaciens and Rhizobium sp., respectively. The maximum bacterial growth was observed at about 0.8% NaCl concentration.

Evaluating the effect of biochar addition on the anaerobic digestion of swine manure: application of Py-GC/MS

Abstract

The anaerobic digestion process of swine manure was studied when char was used as supplement for improving performance. The use of pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) was proposed for assessing the organic matter degradation. The assessment on biogas production was carried out using samples of swine manure (SM) supplemented with char in one case and pre-treated by microwave irradiation in the other. This experimental set-up allows for the comparison of the biological degradation observed under these two different configurations and therefore aids in understanding the effect of char particles on the process. Results showed similar performance for both systems, with an average improvement of 39% being obtained in methane production when compared to the single digestion of SM. The analysis of digestate samples by Fourier transform infrared (FTIR) spectroscopy and Py-GC/MS showed improved degradation of proteins, with the Py-GC/MS technique also capable of identifying an increase in microbial-derived material when char was added, therefore highlighting the relevant role of carbon conductive particles on biological systems. Py-GC/MS along with the use of FTIR spectroscopy has proven to be useful tools when evaluating anaerobic digestion.

A new concept for risk analysis relating to the degradation of water reservoirs

Abstract

This paper presents a proposal for a procedure by which to analyse the risk of reservoirs being degraded. The body of water assessed for its susceptibility to degradation in line with the proposed procedure is Myczkowce Reservoir, SE Poland. This reservoir has a maximum capacity of ten million m³ and helps provide hydropower, by serving as a surge tank located above the main Solina Reservoir. On the basis of an assessment of its morphometric and hydrological parameters, Myczkowce Reservoir was assigned to the low-resilience category where risk of degradation was concerned. The primary factors responsible for that are limited capacity in relation to shoreline length, a lack of thermal stratification, and a high value for the Schindler index. These and other environmental parameters provided for Myczkowce's assignment to the category of susceptible to the impact of matter supplied by its catchment, with this reflecting the instantaneous nature of the basin, high values for the Ohle coefficient, average catchment slope, and the lack of a septic system. The designated risk level supported Myczkowce's assignment to a category characterised by an "unacceptable" risk of degradation. The proposed method taking two parameters (resilience and susceptibility) into account represents the first universal method for assessing reservoirs without reference to risks such as drought, flooding, or lack of water supply for human consumption. The risk depends only on the reservoir and catchment parameters.

Frontalis–Orbicularis Muscle Advancement for Correction of Upper Eyelid Ptosis: A Systematic Literature Review

Purpose: To review the level of standardization of frontalis–orbicularis muscle advancement to correct severe blepharoptosis and the degree of scientific evidence supporting the procedure as a useful modality of blepharoptosis repair. Methods: The authors searched the Medline, Lilacs, and Scopus databases for all articles in English, Spanish, and French that used as keywords the terms "frontalis muscle flap," "orbicularis muscle flap," and "ptosis." Data retrieved included authorship specialty, geographic region where the surgeries were performed, characteristics of the samples reported, type and dimensions of the flaps used, time of follow-up, rate of undercorrection, and complications. Results: Thirty-eight articles were retrieved and analyzed. Most studies originated from Asian countries, especially China, Taiwan, and Korea. Many variations of the procedure were encountered, including location of incisions and frontalis flap design. There were 23 case series with more than 10 patients. None compared the procedure to conventional frontalis suspension surgery. The samples were not homogeneous, including patients with different type of ptosis, variable degrees of levator function, and using distinct methods of evaluating eyelid position. Undercorrection rates ranged from 1.8% to 38% with a median value of 12.2%. The rate of complications (eyelid crease abnormalities, entropion, hematoma, and supraorbital nerve injury) was low. Conclusions: The direct frontalis–orbicularis muscle advancement has been judged positively in all reports analyzed. However, the level of standardization of the surgery is low, and the reported series are not homogeneous. Further studies are needed to better evaluate this operation. Accepted for publication April 4, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Patricia Mitiko S. Akaishi, M. D., Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil. E-mail: patriciamitiko@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Stop eating plastic, molecular signaling of bisphenol A in breast cancer

Abstract

Breast cancer is the second most common fatal cancer in women. Developing a breast cancer is a multi-factorial and hormonal-dependent process, which may be triggered by many risk factors. An endocrine disrupting substance known as bisphenol A (BPA), that is used greatly in the manufacture of plastic products, was suggested as a possible risk factor for developing breast cancer. BPA has a strong binding affinity to non-classical membrane estrogen receptors like estrogen-related and G protein-coupled (GPER) receptors. Based on animal and in vitro studies, results showed a link between BPA exposure and increased incidence of breast cancer. BPA has the ability to alter multiple molecular pathways in cells namely, G protein-coupled receptor (GPER) pathway, estrogen-related receptor gamma (ERRγ) pathway, HOXB9 (homeobox-containing gene) pathway, bone morphogenetic protein 2 (BMP2) and (BMP4), immunoregulatory cytokine disturbance in the mammary gland, EGFR-STAT3 pathway, FOXA1 in ER-breast cancer cells, enhancer of zeste homolog 2 (EZH2), and epigenetic changes. Thus, the aforementioned alterations cause undesired gene stimulation or repression that increase risk of developing breast cancer. So, restricting exposure to BPA should be considered to aid in lowering the risk of developing breast cancer.

Removal of aromatic and hydrophobic fractions of natural organic matter (NOM) using surfactant modified magnetic nanoadsorbents (MNPs)

Abstract

The present study investigated the potential of surfactant modified magnetic nanoadsorbents (MNPs) for the removal of aromatic and hydrophobic fractions of natural organic matter (NOM), leading to the formation of trihalomethanes (THMs) in chlorinated drinking water. Co-precipitation method was used for the synthesis of MNPs. However, MNPs have a tendency to form an agglomeration. Therefore, polyethylene glycol (PEG) was used as a surface modifier to reduce the agglomeration. The PEG-coated MNPs were characterized by field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), energy-dispersive X-ray analysis (EDX), BET surface area, X-ray diffraction (XRD), Fourier transform spectrometer (FTIR), and zeta (ζ) potential. FESEM observation indicates that PEG-coated MNPs were spherical in shape and 25 nm in size. Zeta potential values (− 58.35 to − 74.9 mV) indicated excellent stability of PEG-MNPs. FTIR spectra indicated the presence of a −CH₂ group, responsible for the chemical interaction between aromatic and humic content. Batch experiments were conducted by studying the effect of pH, contact time, and adsorbent dosage on NOM removal. Excellent removal of DOC (94.49%) and UV₂₅₄ (89.32%) was observed at the optimum dose of adsorbent (0.75 g/L) and at pH 7.0. Adsorption kinetics followed pseudo-second-order reaction (R², 0.973) and occurs by multilayer chemisorption which is due to the chemical interaction between aromatic and humic compounds of NOM with MNPs. Thus, MNPs showed great potential as a novel adsorbent for the removal of aromatic and hydrophobic compounds of NOM and can significantly be used to curtail the problem of THMs in drinking water supplies.

Effect of controlled-release fertilizer on N 2 O emissions and tea yield from a tea field in subtropical central China

Abstract

Tea (Camellia sinensis L.), a perennial leaf-harvested crop, favors warm/humid climate and acidic/well-drained soils, and demands high nitrogen (N) fertilizer inputs which lead to significant emissions of N₂O. Potential mitigation options should be adopted to improve N use efficiency (NUE) and reduce environmental pollution in tea field system. A 3-year field experiment was carried out in a tea field in southern China from January 2014 to December 2016 to investigate the effect of controlled-release fertilizer (CRF) application on N₂O emissions in tea field system. Three practices, namely conventional treatment (CON, 105 kg N-oilcake ha⁻¹ year⁻¹ + 345 kg N-urea ha⁻¹ year⁻¹), treatment with a half amount of the N fertilizer (CRF50%, 105 kg N-oilcake ha⁻¹ year⁻¹ + 120 kg N CRF ha⁻¹ year⁻¹) and full amount of N fertilizer (CRF100%, 105 kg N-oilcake ha⁻¹ year⁻¹ + 345 kg N CRF ha⁻¹ year⁻¹) were used. Compared with the CON, our results showed that CRF50% reduced the N₂O emissions by 26.2% (p > 0.05) and increased the tea yield by 31.3% (p > 0.05), while CRF100% significantly increased the N₂O emissions by 96.7% (p < 0.05) and decreased the tea yield by 6.77% (p > 0.05). Overall, yield-scaled N₂O emissions of tea were reduced by 44.5% (p > 0.05) under CRF50% and significantly increased by 100% (p < 0.05) under CRF100%, compared with CON. Based on the gross margin analysis, CRF50% obtained the highest net economic profit. Our findings suggest that reducing N input of CRF (CRF50%) is necessary and feasible for adoption in the current tea plantation system.

Prognostic significance of high serum p53 antibody titers in patients with esophageal squamous cell carcinoma

Abstract

Background

The p53 protein overexpression that usually results from genetic alterations reportedly induces serum antibodies against p53. However, little information is available about the prognostic significance of perioperative serum p53 antibody (s-p53-Abs) titers in patients with esophageal squamous cell carcinoma.

Methods

In this study, we retrospectively evaluated the clinical significance of perioperative s-p53-Abs in 135 patients with esophageal squamous cell carcinoma. Of these, 58 patients received neoadjuvant chemotherapy comprising 5-FU and CDDP. While the cutoff level at 1.3 U/ml indicated seropositive patients, level of 13.4 U/ml was used to identify high-titer patients. We monitored serum titers seropositive patients after surgery and evaluated the prognostic significance by the univariate and multivariate analyses.

Results

In this study, 29 patients (21.5%) were positive for s-p53-Abs before treatment. The frequency of both seropositive patients and high-titer patients (> 13.4 U/ml) was not significantly associated with tumor progression. While seropositive patients did not demonstrate significant poor overall survival, high-titer patients demonstrated significant poor overall survival based on the multivariate analysis (P < 0.001). Moreover, the s-p53-Abs titer did not correlate with the response to neoadjuvant chemotherapy. Among seropositive patients, the negative conversion of s-p53-Abs more likely led to be long-term survival.

Conclusions

This study determined that the high-titer of s-p53-Abs was an independent risk factor to reduce the overall survival of patients with esophageal cancer patients. The negative conversion of s-p53-Abs could be a good indicator of favorable prognosis.

Studies on the UV filtering and radical scavenging capacity of the bitter masking flavanone Eriodictyol

Publication date: Available online 28 June 2018
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Vijisha K. Rajan, T.K. Shameera Ahamed, K. Muraleedharan
A computational analysis of UV filtering and radical scavenging capacity of a flavanone, Eriodictyol has been performed under DFT-B3LYP/6–31+ G (d, p). Eriodictyol is nontoxic and nonirritant bitter masker commonly used in the wine industry. It has been reported that the flavanones were widely acceptable for photoprotection due to its potential UV filtering and radical scavenging capacity. This study provides theoretical evidence that the eriodictyol has an absorbance in the UV-A and UV-B region of the electromagnetic spectrum and therefore can be used as a potential UV filter in sunscreen lotions and other cosmetic products. The major transitions in the UV–Visible spectrum of Eriodictyol are between HOMO and HOMO-1 with LUMO level and are well explained by NBO-NLMO tool in G09 software. In addition to this, Eriodictyol is a potent antioxidant than that of the most commonly studied Quercetin. The most active site in the compound is 3′ position and is confirmed by NPA, NBO and pKa value analysis. The lowest energy conformer of Eriodictyol contains a Hydrogen bond between carbonyl oxygen (O2) and H30. This is confirmed by the highest value of interaction energy between lone pairs of O2 and σ* of O3– H30. Both the two lone pairs of O2 interacts with the σ* of O3-H30. This decreases the bond order of 5 OH and at the same time it restricts the hydrogen transfer from this position to form a radical. Similarly, the lone pair of O5 (3′ position) interacts with H33 resulting in the low bond order value and consequently less favorable for radical formation. These results indicate that the BDE values follow the order 3′ < 4′ < 7 < 5. Thus the title compound can be used for photo protection due to its potential UV filtering and radical scavenging capacity.

Graphical abstract

Wetlands for wastewater treatment and subsequent recycling of treated effluent: a review

Abstract

Due to water scarcity challenges around the world, it is essential to think about non-conventional water resources to address the increased demand in clean freshwater. Environmental and public health problems may result from insufficient provision of sanitation and wastewater disposal facilities. Because of this, wastewater treatment and recycling methods will be vital to provide sufficient freshwater in the coming decades, since water resources are limited and more than 70% of water are consumed for irrigation purposes. Therefore, the application of treated wastewater for agricultural irrigation has much potential, especially when incorporating the reuse of nutrients like nitrogen and phosphorous, which are essential for plant production. Among the current treatment technologies applied in urban wastewater reuse for irrigation, wetlands were concluded to be the one of the most suitable ones in terms of pollutant removal and have advantages due to both low maintenance costs and required energy. Wetland behavior and efficiency concerning wastewater treatment is mainly linked to macrophyte composition, substrate, hydrology, surface loading rate, influent feeding mode, microorganism availability, and temperature. Constructed wetlands are very effective in removing organics and suspended solids, whereas the removal of nitrogen is relatively low, but could be improved by using a combination of various types of constructed wetlands meeting the irrigation reuse standards. The removal of phosphorus is usually low, unless special media with high sorption capacity are used. Pathogen removal from wetland effluent to meet irrigation reuse standards is a challenge unless supplementary lagoons or hybrid wetland systems are used.

Analysis of the adsorption and retention models for Cd, Cr, Cu, Ni, Pb, and Zn through neural networks: selection of variables and competitive model

Abstract

In this study, the neural networks are used to predict and explain the behavior of different edaphological variables in the adsorption and retention of heavy metals, both isolated and competing. A comparison with the results obtained using multiple regression, stepwise analysis, and regression trees is performed. In the neural network technique, CEC amorphous and crystallized oxides and kaolinite in the clay fraction are the most selected variables for making the optimal models, while mica and, to a lesser extent, plagioclase, are the next variables selected. Additionally, a competitive model has been considered, using simultaneously different metals. In the competitive model, the model predicts a more intense competence between Pb and Ni for the adsorption process and between Cr and Ni for the retention process.

Reply to the Editor: The pedicled internal pudendal artery perforator (PIPAP) flap for ischial pressure sore reconstruction: Technique and long-term outcome of a cohort study

Publication date: Available online 28 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): K.W. Karl Waked, A.Z. Assaf A. Zeltzer

Patients with Abdominal-based Free Flap Breast Reconstruction a Decade after Surgery - A Comprehensive Long-term Follow-up Study

Publication date: Available online 28 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Tianyi Liu, Christoffer Freijs, Holger J Klein, Anna Feinbaum, Andreas Svee, Andres Rodrigues Lorenzo, Anders Liss, Rafael Acosta, Maria Mani
BackgroundAbdominal-based free flap breast reconstruction has increasingly become the gold standard, however long-term evidence of aesthetic outcome and quality of life is lacking. Our study aims to gain an overview of patients with abdominal-based free flap breast reconstructions in a long-term perspective.MethodsSeventy-five patients who received abdominal-based free flap breast reconstructions between 2000-2007 in Uppsala, Sweden were invited back for photographs, 3D imaging and questionnaires. A retrospective chart review was conducted. Patient satisfaction with appearance and quality of life were assessed using the Breast-Q questionnaire. A layman panel and a professional panel rated the aesthetic appearance of the reconstructed breast from photographs and 3D images.ResultsFifty-five patients participated with a mean age of 52±8 years at the time of reconstruction and a mean follow-up time of 11.4±1.8 years completed the study. The majority of the patients had received unilateral (83%), delayed reconstructions (73%) with prior radiation (55%). There were 53 patients with DIEP flaps, one with free TRAM flap and one with SIEA flap. Overall patient satisfaction and quality of life were comparable to normative values of women without breast cancer (p<0.001). There was a high level of agreement for the aesthetic results of the reconstructions between patient, professionals and layman panels (0.89 ICC, 95% CI: 0.83 - 0.93).ConclusionAbdominal-based free flap reconstructions were effective in achieving a lasting positive aesthetic result and a high quality of life in patients a decade after surgery.

Examining the Role of Neighborhood-Level Foreclosure in Smoking and Alcohol Use Among Older Adults in the Multi-Ethnic Study of Atherosclerosis

Abstract

The US Great Recession resulted in an alarming number of home foreclosures that weakened the social and physical environment of thousands of neighborhoods. Few studies have evaluated whether these neighborhood changes were related to changes in individual behaviors. We examined the relationship between changes in neighborhood-level home foreclosure within a quarter-mile (0.4-km) buffer of the residence and changes in cigarette smoking and alcohol use among 3,807 adults enrolled in the Multi-Ethnic Study of Atherosclerosis during 2005–2012, using econometric individual-level fixed-effects models. Increases in neighborhood-level foreclosure were associated with small decreases in the number of cigarettes smoked per day (mean difference = −0.08, 95% confidence interval: −0.11, −0.04) and small increases in the number of alcoholic beverages consumed per week (mean difference = 0.11, 95% confidence interval: 0.05, 0.17). Neighborhood-level foreclosure may not uniformly influence high-risk behaviors. The impact of home foreclosure on adult drinking should be further explored, given its potentially negative implications for health.

Leukocyte Telomere Length and All-Cause Mortality: A Between-Within Twin Study With Time Dependent Effects Using Generalized Survival Models

Abstract

Although previous studies examining leukocyte telomere length (LTL) and all-cause mortality controlled for several confounders, the observed association could be biased due to unmeasured confounders, including familial factors. We aimed to examine the association of LTL with all-cause mortality in a Swedish twin sample adjusting for familial factors and allowing for time dependent effects. Three hundred and sixty-six participants were recruited from the Swedish Twin Registry. LTL was assessed using the Southern blot method. All-cause mortality data were obtained through linkage to the Swedish Population Registry updated through to November 2017. To control for familial factors within twin pairs, we applied a between-within shared frailty model based on generalized survival models. Overall, 115 (31.4%) participants were men and 251 (68.6%) were women. The average age of the study participants when blood was drawn was 79.1 years, and follow-up duration spanned from ten days to 25.7 years (mean = 10.2 years). During the follow-up period, 341 (93.2%) participants died. Shorter LTL was associated with higher mortality rates when controlling for familial factors in the between-within shared frailty model. We found significant time dependent effects of LTL on all-cause mortality, where the mortality rate ratios were attenuated with increasing age.

As Long as the Breath Lasts. In Utero Exposure to Ramadan and the Occurrence of Wheezing in Adulthood

Abstract

While prenatal exposure to Ramadan has been shown to be negatively associated with general physical and mental health, studies on specific organs remain scarce. This study explores whether Ramadan during pregnancy has impacts on the occurrence of wheezing, a main symptom for obstructive airways diseases. Using data from the Indonesian Family Life Survey collected between 1993 and 2008 (waves 1 to 4), we compare wheezing occurrence among adult Muslims who had been in utero during Ramadan with adult Muslims who had not been in utero during Ramadan. Wheezing prevalence is higher among adult Muslims who had been in utero during Ramadan, independent of the pregnancy phase in which the exposure to Ramadan occurred. Moreover, this association tends to increase with age, being strongest in the age groups 45+. This is in line with fetal programming theory suggesting that impacts of in utero exposures often only show after the reproductive age. Particularly strong associations were detected for smokers. The respiratory system of prenatally exposed Muslims thus seems to perform worse in mitigating later ex utero harmful influences such as smoking. This study suggests that exposure to Ramadan during pregnancy may have lasting consequences for adult lung functionality.

Associations of dietary protein intake with fat free mass and grip strength: cross-sectional study in 146,816 UK Biobank participants

Abstract

Adequate dietary protein intake is important for the maintenance of fat-free mass (FFM) and muscle strength: optimal requirements remain unknown. The aim of the current study was to explore the associations of protein intake with FFM and grip strength. We used baseline data from the UK Biobank (146,816 participants aged 40-69 years with data collected 2007-2010 across the UK) to examine the associations of protein intake with FFM and grip strength. Protein intake was positively associated with FFM (men 5.1% [95% CI: 5.0; 5.2] and women 7.7% [95% CI: 7.7; 7.8]) and grip strength (men 0.076 kg/kg [95% CI: 0.074; 0.078] and women 0.074 kg/kg [95% CI: 0.073; 0.076]) per 0.5 grams per kg body mass per day (g/kg/day) increment in protein intake. FFM and grip strength were higher with higher intakes across the full range of intakes, i.e. highest in those reporting consuming > 2.0 g/grams per kg/day independently of socio-demographics, other dietary measures, physical activity and comorbidities. FFM and grip strength were lower with age, but this association did not differ by protein intake categories (P > 0.05). Current recommendation for all adults (40-69 years) for protein intake (0.8 grams per kg body mass per day) may need to be increased to optimise FFM and grip strength.

Adsorptive removal of endocrine-disrupting compounds and a pharmaceutical using activated charcoal from aqueous solution: kinetics, equilibrium, and mechanism studies

Abstract

Bisphenol A (BPA), diethyl phthalate (DEP), and carbamazepine (CBZ) have been widely used in chemical and pharmaceutical fields, and their residues are detected in various environments. Therefore, to find a suitable method for removing the compounds from an aqueous solution, an adsorption method by granular activated charcoal (AC) was studied. To investigate the adsorption properties of AC, its kinetics, equilibrium, pH effects, and regeneration of AC were examined. Moreover, its surface properties (i.e., surface area, pore volume, functional groups, and surface charge) were characterized by N₂ adsorption and desorption isotherm, Fourier transform infrared (FTIR), and zeta potential analyses. Experimental results show that AC has high removal efficiencies for the target compounds at the low initial concentration as well as high estimated adsorption capacities (q_m) for DEP, BPA, and CBZ, whose values were 293.4 ± 18.8, 254.9 ± 16.2, and 153.3 ± 1.61 mg/g, respectively. In comparison with other adsorbents based on previously reported results, AC was shown to have generally higher removability for the three compounds than others. Moreover, it was observed that AC's ability to adsorb DEP and BPA was dependent on pH because of hydrolysis and ionization, respectively. Meanwhile, there is no pH effect for CBZ adsorption by AC. After 3 cycles of adsorption/desorption, AC still maintained 92, 100, and 82% of initial adsorption capacities for DEP, BPA, and CBZ, respectively. Therefore, the AC is an effective adsorbent for the removal of endocrine-disrupting chemicals and pharmaceuticals from aqueous solution.

Organophosphorus poisoning in animals and enzymatic antidotes

Abstract

Organophosphorus compounds (OPs) are neurotoxic molecules developed as pesticides and chemical warfare nerve agents (CWNAs). Most of them are covalent inhibitors of acetylcholinesterase (AChE), a key enzyme in nervous systems, and are therefore responsible for numerous poisonings around the world. Many animal models have been studied over the years in order to decipher the toxicity of OPs and to provide insights for therapeutic and decontamination purposes. Environmental impact on wild animal species has been analyzed to understand the consequences of OP uses in agriculture. In complement, various laboratory models, from invertebrates to aquatic organisms, rodents and primates, have been chosen to study chronic and acute toxicity as well as neurobehavioral impact, immune response, developmental disruption, and other pathological signs. Several decontamination approaches were developed to counteract the poisoning effects of OPs. Among these, enzyme-based strategies are particularly attractive as they allow efficient external decontamination without toxicity or environmental impact and may be of interest for treatment. Approaches using bioscavengers for prophylaxis, treatment, and external decontamination are emphasized and their potential is discussed in the light of toxicological observations from various animal models. The relevance of animal models, regarding their cholinergic system and the abundance of naturally protecting enzymes, is also discussed for better extrapolation of results to human.

Equilibrium adsorption study of the adsorptive removal of Cd 2+ and Cr 6+ using activated carbon

Abstract

The performance of activated carbon (AC) with respect to characterization, adsorption kinetics, thermodynamics, and isotherms was addressed in this study. The effects of initial concentration, pH, contact time, ion strength, and temperature on removal efficiency were also studied. The adsorption isotherms of Cd²⁺ and Cr⁶⁺ on activated carbon can fit the Langmuir model well, and correlation coefficients were above 0.99, all higher than the Freundlich and Temkin models. The maximum adsorption quantities of Cd²⁺ and Cr⁶⁺ were 19.380 and 19.305 mg g⁻¹ at 25 °C, respectively. The adsorption capacities of Cd²⁺ and Cr⁶⁺ are clearly pH dependent. The kinetics of the removal of Cd²⁺ and Cr⁶⁺ was in agreement with a pseudo-second-order model, and the adsorption efficiency of Cd²⁺ is higher than that of Cr⁶⁺. The thermodynamic results showed that increased temperature is favorable to adsorption. The speciation on activated carbon was mainly residual Cd²⁺ and Cr⁶⁺, and the potential ecological risk of Cd²⁺ is higher than that of Cr⁶⁺. The adsorptions of Cd²⁺ and Cr⁶⁺ on activated carbon were dominated by chelation and ion exchange, respectively.

The effects of recombinant human epidermal growth factor containing ointment on wound healing and post inflammatory hyperpigmentation prevention after fractional ablative skin resurfacing: A split‐face randomized controlled study

Journal of Cosmetic Dermatology, EarlyView.

Screening of microalgae for treating Garcinia cambogia wash water with potential lipid production

Abstract

The microalgae-based water treatment is gaining importance in recent years as it serves multiple purposes of which includes water treatment and biofuel production. Garcinia cambogia, a Malabar tamarind is a tropical fruit and the active ingredient hydroxycitric acid is popularly used as a weight-loss supplement. After extraction of the hydroxycitric acid, the wash water of G. cambogia is considered as an effluent. The potential microalgal species that can grow and treat G. cambogia wash water were isolated and identified as Dicloster acuatus BVR1 and Kalenjenia gelanitosa BVR2. Both the microalgal species adapted to G. cambogia wash water and entered exponential phase after sixth day with maximum specific growth rate of 0.310 day⁻¹ for D. acuatus and 0.296 day⁻¹ for K. gelanitosa during tenth day. The biomass productivity of D. acuatus was 0.03 g L⁻¹ day⁻¹ which is 58% higher than K. gelanitosa with 0.019 g L⁻¹ day⁻¹. The microalgal strains besides water treatment were subsequently subjected for lipid extraction and lipid productivity determination. The lipid productivity of D. acuatus was 2.68 mg L⁻¹ day⁻¹ which is lesser compared to 3.38 mg L⁻¹ day⁻¹ for K. gelatinosa. Both the microalgal isolates were promising for G. cambogia wash water treatment and lipid production. Hence, an environment friendly approach of water treatment with simultaneous lipid production for biofuel conversion is conducted.

Simultaneous removal of NO and SO 2 from flue gas using vaporized H 2 O 2 catalyzed by nanoscale zero-valent iron

Abstract

To remove NO and SO₂ from flue gas simultaneously, a heterogeneous catalytic oxidation system was developed with the nanoscale zero-valent iron (nZVI), vaporized H₂O₂, and sodium humate (HA-Na) acting as the catalyst, oxidant, and absorbent, respectively. The experimental results indicated that the desulfurization was mainly influenced by the absorption, and the denitrification was significantly affected by the catalytic oxidation parameters. Under the optimal conditions, the simultaneous removal efficiencies of SO₂ and NO were 100 and 88.4%, respectively. The presence of ^·OH during the removal process was proved by the scavenger tests, and the production of ^·OH with and without nZVI was indirectly evaluated by the electron paramagnetic resonance (EPR) and methylene blue experiments. Moreover, the fresh and aged nZVI were characterized by a series of techniques and the results suggested that the redox pair Fe²⁺/Fe³⁺ released by nZVI could react with H₂O₂ to provide the sustainable ^·OH, which was important for the oxidation from NO and SO₂ to NO₃⁻ and SO₄²⁻. The removal mechanism was proposed preliminarily based on the correlative experiments, characterizations, and references.

Pachyonychia congenita: Affecting three generations!

Rohit Singla, Pihu Sethi, TG Savitha, Amrinder Jit Kanwar

Indian Journal of Paediatric Dermatology 2018 19(3):261-262

Pachyonychia congenita is an autosomal dominantly inherited disease that primarily presents as nail dystrophy and dyskeratosis of skin and mucous membranes. A 32-year-old female presented with thickening of the nails and thickening of both heels. Her father showed pincer nails with periungual thickening of skin and fissures with focal plantar keratoderma. Her two sons had similar nail changes.

Monogenic autoinflammatory syndromes in children: Through the dermatologist's lens

Vishal Gupta, M Ramam

Indian Journal of Paediatric Dermatology 2018 19(3):194-201

Autoinflammatory syndromes are a group of rare disorders of innate immunity characterized by repeated episodes of inflammation without an obvious cause. Many of these disorders have a childhood onset, and present as recurrent fevers, skin lesions, joint pains and other systemic features. Newer autoinflammatory syndromes with previously undescribed clinical phenotypes are being increasingly recognized. Several of these have distinctive cutaneous manifestations, and dermatologists have an important role to play in the diagnosis of these conditions. Recently, molecular basis for many of these diseases has been identified, thus paving the way for novel targeted therapies. Interleukin-1 blockers have been found to be more effective than the conventional immunosuppressants in their treatment. In this article, we focus on the cutaneous features of well-recognized as well as some of the recently described monogenic autoinflammatory syndromes in children.

Severe acute malnutrition with hyperpigmentation: An uncommon association

Ibrahim Aliyu, Zainab F Ibrahim

Indian Journal of Paediatric Dermatology 2018 19(3):285-286

Pediatric cutaneous tuberculosis: Indian scenario

Bhushan Kumar, Sheetanshu Kumar

Indian Journal of Paediatric Dermatology 2018 19(3):202-211

Burden of tuberculosis still persists in developing countries despite major advances in its treatment strategies. Cutaneous tuberculosis which is a form of extra-pulmonary tuberculosis is seen in a small but significant subset of patients visiting dermatology outpatient services. Cutaneous tuberculosis is characterized by a spectrum of multiple distinct clinical and histopathology presentations. A significant proportion of patients with cutaneous tuberculosis are seen in paediatric age group. Clinical features in children remain mostly the same as that in adults with cutaneous tuberculosis. However, systemic and lymph node involvement and incidence of disseminated disease is observed more commonly in paediatric age group . Awareness among clinicians of the clinical manifestations of cutaneous tuberculosis is of paramount importance for early diagnosis and management of cases with paediatric cutaneous tuberculosis. This would significantly prevent morbidity and complications of the disease . This review aims to discuss the epidemiology, clinical and histopathological features, diagnosis, differential diagnosis and treatment options in children with tuberculosis, especially in the Indian context.

Focal actinic porokeratosis: A new variant?

Pihu Sethi, Neeti Kumari, Bhuvan Adhlakha, Amrinder Jit Kanwar

Indian Journal of Paediatric Dermatology 2018 19(3):272-273

Porokeratosis is an autosomal dominantly transmitted disorder of keratinization predominantly affecting trunk and extremities. Many clinical variants have been described having a common histopathological feature of coronoid lamella-porokeratosis of Mibelli, superficial disseminate, disseminated superficial actinic porokeratosis, linear porokeratosis and punctuate palmoplantar porokeratosis. We present a case of 16-year-old female who had focal lesions of porokeratosis aggravated by sun exposure, over alae of nose confirmed by histopathology. The previous reports show quite a number of cases of isolated lesions of the disease on nose and perinasal area. This article highlights the actinic nature of focal facial porokeratosis.

Childhood vitiligo: A clinicoepidemiological study

Mrinal Gupta

Indian Journal of Paediatric Dermatology 2018 19(3):212-214

Background: Vitiligo is a chronic disorder of pigmentation which has serious psychosocial implications. Early onset or childhood vitiligo, although clinically similar to adult-onset vitiligo, has been found to have a distinct epidemiological, clinical, therapeutic, and prognostic profile. Aims and Objectives: This study was carried out to study the clinicoepidemiological characteristics of vitiligo in patients aged <18 years. Materials and Methods: It was a prospective, observational study carried out over a period of 1 year in which fifty children having vitiligo were examined. After taking an informed consent from the attendants/parents of the patients, a complete history including age, sex, duration of the disease, family history, history of Koebner's phenomenon, and history of associated diseases was noted. Results: The study group comprised of 29 females and 21 males (male:female 1:1.38), aged between 6 months and 17 years with a mean age of 8.45 ± 2.34 years and the mean age of onset was 5.6 years. The most common clinical subtypes observed in childhood vitiligo were vitiligo vulgaris in 42% (n = 21) followed by focal in 24% (n = 12), segmental in 12% (n = 6), and acrofacial in 10% patients (n = 5). A family history of vitiligo was seen in 16% patients (n = 8). Leukotrichia was observed in four patients, Koebner phenomenon in 5, and halo nevus in one patient. Conclusions: Childhood vitiligo is a common entity with vitiligo vulgaris being the most common subtype and lower limbs being the most common site of involvement. Children with positive family history had an earlier age of onset, and thyroid abnormalities were more common in nonsegmental variant.

Skin lesions simulating child abuse

Sahana M Srinivas, Celia Moss

Indian Journal of Paediatric Dermatology 2018 19(3):187-193

Child abuse is a broad term which describes various forms of maltreatment and neglect in children and is recognized increasingly. Physical abuse presents to dermatologists as well as pediatricians because the skin is so readily accessible for harm. Doctors unfamiliar with the wide range of skin disorders that simulate child abuse may mistakenly diagnose child abuse or "fabricated or induced illness by carers" (Munchausen by proxy), with traumatic consequences for the family. Mimics of child abuse include various cultural practices, birthmarks, bleeding disorders, bacterial infections, bullous diseases, and hereditary conditions. Dermatitis artefacta and self-harm must also be considered. Observation of the skin lesions and their evolution during hospitalization may provide the correct answer, but knowledge of the morphology and presentation of various skin disorders is crucial to avoid incorrect diagnosis of child abuse. This article describes some of the less well-known mimics of child abuse. It is essential that dermatologists support pediatricians in managing conditions that appear unusual and possibly artifactual.

Cutaneous markers of spinal dysraphism: A cross sectional study

Farhana Tahseen Taj

Indian Journal of Paediatric Dermatology 2018 19(3):215-219

Background: Spinal dysraphism is a rare condition where there are many cutaneous markers which will help a dermatologist to arrive at early diagnosis and prevent complications. Aims and Objectives: The aim and objectives of this are to study the various cutaneous marker of spinal dysraphism in neonatal period and its importance of recognizing early to plan for further management. Materials and Methods: Neonates were examined for cutaneous signs of spinal dysraphism in the first 4 weeks of life. Both occult and open spinal dysraphism clinical features were recorded. Detail history was recorded with respect to age of the mother, parity, consanguinity, and folic acid supplementation. Diagnosis was made clinically. Biopsy is not done as it may introduce infection into spinal canal. Results: A total of 1000 neonates were examined, out of which cutaneous signs of spinal dysraphism were seen in 135 (13.5%) newborns. Sacral dimple was most common seen in 128 (12.8%) neonates, meningomyelocele in 5 (0.5%), dermoid cyst in 1 (0.1%) and acrochordons in 1 (0.1%) neonate. Conclusion: Dermatologist should be aware of the cutaneous marker of spinal dysraphism. Although dermatologist has a less role in the management of spinal dysraphism, their early diagnosis will help in the further management and prevent orthopedic, vertebral, and urological complications.

Systematized inflammatory linear verrucous epidermal nevus moderately responsive to systemic acitretin and topical calcipotriol

Sanjay Singh, Mamta Rai, Neetu Bhari, Savita Yadav

Indian Journal of Paediatric Dermatology 2018 19(3):266-268

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare form of epidermal nevus which usually presents in childhood, mostly on the lower half of the body in a blaschkoid distribution. A wide variety of topical, systemic, and surgical modalities have been tried for its treatment, but it is known to be refractory to treatment. We hereby are reporting a rare case of extensive systematized ILVEN which showed moderate response to treatment with acitretin and topical calcipotriol.

A retrospective study of the pattern of sexually transmitted diseases in teenagers attending sexually transmitted disease clinic during a 7-year period at a tertiary care centre

Jigna P Barot, Avanita D Solanki, Neela M Patel, Khushboo R Modi, Miral B Bodar

Indian Journal of Paediatric Dermatology 2018 19(3):220-223

Background: Adolescent period corresponds to the age group of 10-15 years. While teenage period, which corresponds to 13-19 year of age group, is the stage of psychosocial development. More and more young people are becoming sexually active in their mid-teens making them vulnerable to contracting the STDs. Adolescents especially in urban areas have favorable attitudes toward premarital and extramarital sex. Material and Methods: This is a retrospective study conducted at tertiary care center. Data regarding STD in teenagers (13-19 year) and their sexual behavior from January 2009 to December 2015 was collected from STI clinic. Result: Total number of adolescent attended STI clinic was 381,out of which 200 were male and 181 were female. Most common STD in female was VVC and in male was nodular scabies. out of 381 patients 155 male and 93 female had confessed about indulging in sexual activity.10 patients were tested positive for HIV and 11 patients were tested positive for syphilis. Conclusion: There is increasing incidence & prevalence of STDs in adolescents due to risky sexual behavior. It is essential to include sex education in teaching methods.

Darier's sign

Tarang Goyal, Sakshi Kohli

Indian Journal of Paediatric Dermatology 2018 19(3):277-279

Efficacy and safety of propranolol on the proliferative phase of infantile hemangioma: A hospital-based prospective study

Jignaben Krunal Padhiyar, Nayan H Patel, Trusha P Gajjar, Mansi D Buch, Yogesh B Shah, Rekha Solanki

Indian Journal of Paediatric Dermatology 2018 19(3):224-229

Background: Propranolol may be more effective and safer than previously established therapies, and it may be used as a first-line therapy for infantile hemangioma (IH). Propranolol is thought to inhibit the growth of blood vessels by decreasing vascular endothelial growth factor. Aims and Objectives: The aim of this study is to study the efficacy and safety of propranolol in IH and for standardization of dose in tablet form. Materials and Methods: A total of 23 patients with 30 IH s were recruited in the study prospectively, after ruling out any contraindications for oral propranolol and obtaining consent from parents. Patients with <7 kg weight were given oral propranolol 5 mg twice daily and >7 kg weight were given 5 mg thrice daily. Patients were evaluated according to visual analog scale and ultrasonographically on day 0, day 30, day 60, and day 90. Results: Out of a total of 30, 25 (83.33%) were superficial, 3 (10%) were deep, and 2 (6.66%) were mixed hemangioma. All patients with superficial hemangiomas showed a change in the color of the lesion and arrest of growth within the 1st month of therapy and a gradual decrease in size was noticed in 23 (92%, n = 25) patients during the study period except in 2 (8%). Complete clearance was noticed in 68% of patients of superficial hemangioma at the end of the study period. Out of 25 patients, a total of 5 (20%) patients had ulceration at the time of presentation which started to heal within 15 days of therapy. Five (16.66%, n = 30) patients with deep and mixed variety showed arrest of growth but no decrease in size. No side effects were seen except temporary coldness of extremity in 1 (3.33%) patient. Conclusion: Propranolol is safe and effective for treatment of proliferative phase of superficial hemangiomas with very less side effects compared to oral steroids and other recommended therapies, and unavailability of syrup can be overcome by giving tablet in fixed dosage.

LEOPARD syndrome with late onset lentigines: A rarity

Sunder Nagakeerthana, Sankar Madhavi, Kaliaperumal Karthikeyan

Indian Journal of Paediatric Dermatology 2018 19(3):287-290

The efficacy of a combination of oral low-dose prednisolone with propranolol for the treatment of infantile hemangioma

Pradyumna Pan

Indian Journal of Paediatric Dermatology 2018 19(3):230-235

Background: Infantile hemangiomas (IHs) are very common vascular tumors. Corticosteroid and propranolol are drugs for the treatment of hemangioma. High dose given for longer duration causes higher side effects. Aim and Objective: The aim and objective of this study was to determine the outcome of a combination of low-dose oral prednisolone with oral propranolol for the treatment of IH. Methods: The study comprised 42 consecutive patients with IH managed with low-dose oral prednisolone and oral propranolol between 2013 and 2016. Patients fulfilling the inclusion criteria were registered through the outpatient department. Diagnosis was confirmed clinically and on Color Doppler. All the patients were given oral prednisolone at a dose of 1 mg/kg/day and propranolol at a dose of 1.5 mg/kg/day. Treatment was given for 4 months and then titrated down for 2 months before the cessation of treatment. Results: Distribution was more on head, face, and neck. The median age at the start of treatment was 4.7 months. Out of the total 42 patients, forty patients responded to therapy (95.2%). Results were found to be excellent in 57.14% of infants and good in 30.95%. Treatment failure was seen in 4.7%. Side effects were not serious and resolved when treatment was discontinued. Rebound growth occurred in two infants (4.7%). No patients suffered drug morbidity. Conclusion: The frequency of acceptable outcome of a combination of low-dose oral prednisolone with oral propranolol for the treatment of IH shows high efficacy, low severe complication rate, and rapid clinical improvement.

Solitary mastocytoma arising from a tight infant identification bracelet

Wei-Liang Koh, Yong-Kwang Tay, Chee-Seng Sim

Indian Journal of Paediatric Dermatology 2018 19(3):258-260

Mastocytosis is characterized by a proliferation of mast cells in the skin and extracutaneous organs. Cutaneous mastocytoma is the second most common presentation of mastocytosis in children and has been reported to arise post-trauma. We report herein the second case of solitary mastocytoma resulting from application of an excessively tight infant identification bracelet and the first in the English literature.

Cutaneous manifestations of juvenile onset lupus erythematosus: A clinical study

Vinitha Panicker, Anil Mathew, Gopikrishnan Anjaneyan, Soumya Jagadeesan, S. Lekshmi, Jacob Thomas

Indian Journal of Paediatric Dermatology 2018 19(3):236-240

Introduction: Juvenile-onset systemic lupus erythematosus (SLE) is one of the most common systemic autoimmune connective tissue disorders in children. Studies focusing on the mucocutaneous manifestations of childhood lupus are scanty in literature. Objectives: This study was an attempt to describe the cutaneous changes seen in Pediatric Lupus and to correlate with the histopathological and immunofluoresecence findings. Methods: This was a retrospective study. All children under the age of 18 years who were diagnosed to have SLE according to the ACR criteria and presented to the dermatology outpatient department during a period of 1 year were included in the study. Details including clinical features, investigation findings including immunological tests and skin biopsy findings were noted. The analysis was performed using descriptive statistical tools such as percentage and frequency. Results: A total of 14 cases, average age at presentation was 10.14 years. Among the cutaneous manifestations, the most common presenting feature was urticarial vasculitis. Malar rash was seen in 57% of cases. Other cutaneous features seen were diffuse alopecia, oral ulcers. Antinuclear antibody was positive in all cases. Conclusion: Pediatric lupus tends to have a more aggressive course than adult lupus. Early diagnosis and treatment is necessary to prevent progression and development of complications.

A child with multiple café au lait macules: Rare presentation of plexiform neurofibromatosis with facial dysmorphism, alopecia, proptosis, stridor, and limb length discrepancy

Aniruddha Ghosh, Payel Kundu, Sandipan Dhar, Arunaloke Bhattacharya

Indian Journal of Paediatric Dermatology 2018 19(3):263-265

Multiple café au lait macules are one of the cornerstones in diagnosing neurofibromatosis Type 1 (NF 1). NF 1 is often a multisystem neurocutaneous disorder, plexiform NF being one of the most important variants of this phacomatosis. Here, a rare case of a 2.5-year-old male child without positive family history has been described who presented with multiple large café au lait spots, alopecia, dysmorphic facies, proptosis, protrusion and deviation of tongue, biphasic stridor, bilateral neck swelling, and abnormal gait due to foreshortened left leg. Magnetic resonance imaging revealed abnormal soft-tissue infiltration of cavernous sinus through sphenoid bone, retro-orbital, retropharyngeal, parapharyngeal spaces, floor of mouth, and encasement of unilateral neck vessels and compression over trachea. Indirect laryngoscopy revealed unilateral vocal cord palsy most likely due to recurrent laryngeal nerve involvement. Biopsy confirmed the diagnosis of NF. Pediatricians and dermatologists should be aware of syndromic causes and their varied presentations while encountering a child with multiple large café au lait spots.

A novel case of chronic mucocutaneous candidiasis: Overlap between autoimmune polyendocrinopathy, candidiasis, ectodermal dystrophy syndrome and hyper IgE syndrome

Bauyelal Mahto, Payel Kundu, Aniruddha Ghosh, Sandipan Dhar

Indian Journal of Paediatric Dermatology 2018 19(3):241-244

Chronic mucocutaneous candidiasis (CMC) is a clinical entity where extensive fungal infection of skin, hair, nail, and mucosa with Candida sp. is seen. It has got association with several immunological and endocrinal dysfunctions. We report a case of a 14-year-old boy who presented with peculiar facies, gross failure to thrive, fungal granulomatous lesions with scaring alopecia, oropharyngeal candidiasis, ectodermal dystrophy, grade 3 clubbing of all four limbs, interstitial keratitis with leukoma due to recurrent corneal ulcerations, and persistent deciduous teeth. A diagnosis of CMC was made and evaluation of immunological pathways revealed a high titer of immunoglobulin E. CMC with overlapping features of autoimmune polyendocrinopathy candidiasis ectodermal dystrophy syndrome and hyper IgE syndrome is extremely rare in literature. Timely diagnosis of an underlying etiology and proper treatment of a case of CMC may provide a better quality of life of the patient.

Extensive childhood alopecia areata responding to combination of oral cyclosporine and corticosteroid therapy – clinical experience in four patients

Nibedita Patro, Maitreyee Panda, Sibasish Patro, Madhuchhanda Mohapatra

Indian Journal of Paediatric Dermatology 2018 19(3):269-271

Alopecia areata (AA) is a disease of unpredictable treatment outcome. Due to a great psychosocial impact associated with the disease, multitudes of therapy have been tried. We recommend safe consideration of oral cyclosporine in cases of extensive nonresponsive childhood AA.

Homozygous familial hypercholesterolemia: A rare case report

Shashikant Malkud, Sirisha Varala, Geeta Kiran Arakkal, Purnachandra Badabagni

Indian Journal of Paediatric Dermatology 2018 19(3):245-247

A 9-year-old male child presented with asymptomatic skin-colored-to-yellowish nodules over both the buttocks, feet, and over the right Achilles' tendon for 4 years. There was a history of similar complaints in elder sibling and also a history of premature sudden cardiac death in father. Biopsy from the lesions was suggestive of xanthoma. Fasting lipid profile was consistent with the pattern of Type IIa hyperlipoproteinemia. The child was further worked up for systemic involvement which was normal. He was started on rosuvastatin and fenofibrate and is under regular follow-up. The timely diagnosis of familial hypercholesterolemia, especially the homozygous variant, is important for early intervention and prevention of complications.

Prognostic Value of the Metabolic and Volumetric Parameters of 11C-Methionine Positron-Emission Tomography for Gliomas: A Systematic Review and Meta-Analysis [ADULT BRAIN]

BACKGROUND:

Several studies have demonstrated that ¹¹C-methionine positron-emission tomography provides information on prognosis.

PURPOSE:

We performed a systematic review and meta-analysis of the prognostic value of the metabolic and volumetric parameters of ¹¹C-methionine-PET for gliomas.

DATA SOURCES:

A systematic search was performed using the following combination of keywords: "methionine," "PET," "glioma," and "prognosis."

STUDY SELECTION:

The inclusion criteria were the use of ¹¹C-methionine-PET as an imaging tool, studies limited to gliomas, studies including metabolic parameters (tumor-to-normal ratio) and/or volumetric parameters (metabolic tumor volume), and studies reporting survival data. The electronic search first identified 181 records, and 14 studies were selected.

DATA ANALYSIS:

Event-free survival and overall survival were the outcome measures of interest. The effect of the tumor-to-normal ratio and metabolic tumor volume on survival was determined by the effect size of the hazard ratio. Hazard ratios were extracted directly from each study when provided or determined by analyzing the Kaplan-Meier curves.

DATA SYNTHESIS:

The combined hazard ratios of the tumor-to-normal ratio for event-free survival was 1.74 with no significance and that of the tumor-to-normal ratio for overall survival was 2.02 with significance. The combined hazard ratio of the metabolic tumor volume for event-free survival was 2.72 with significance and that of the metabolic tumor volume for overall survival was 3.50 with significance.

LIMITATIONS:

The studies selected were all retrospective, and there were only 4 studies involving the metabolic tumor volume.

CONCLUSIONS:

The present meta-analysis of ¹¹C-methionine-PET suggests that the tumor-to-normal ratio for overall survival and the metabolic tumor volume for event-free survival and overall survival are significant prognostic factors for patients with gliomas.

Assessing Corticospinal Tract Asymmetry in Unilateral Polymicrogyria [PEDIATRICS]

BACKGROUND AND PURPOSE:

Asymmetry of the corticospinal tract in congenital lesions is a good prognostic marker for preserved motor function after hemispherectomy. This study aimed to assess this marker and provide a clinically feasible approach in selected cases of unilateral polymicrogyria.

MATERIALS AND METHODS:

Corticospinal tract asymmetry of 9 patients with unilateral polymicrogyria substantially affecting the central region was retrospectively assessed on axial T1WI and DTI. Volumes of the brain stem and thalamus and DTI parameters of the internal capsule were measured. Two neuroradiologists independently rated the right-left asymmetry at 4 levels along the corticospinal tract. DTI tractography was used to determine the motor cortex within polymicrogyria, with task-based functional MR imaging available in 3/9 cases.

RESULTS:

Visual assessment of the brain stem asymmetry showed excellent correlation with quantitative measures on both T1WI and color-coded DTI maps (P = .007 and P = .023). Interrater reliability regarding structural and DTI-based corticospinal tract asymmetry was best at the midbrain (Cohen = 0.77, P = .018). Three patients underwent functional hemispherectomy with postsurgical stable motor function, all showing marked corticospinal tract asymmetry preoperatively. Following the DTI-based corticospinal tract trajectories allowed identifying the presumed primary motor region within the dysplastic cortex in 9/9 patients, confirmed by functional MR imaging in 3/3 cases.

CONCLUSIONS:

Visual assessment of corticospinal tract asymmetry in unilateral polymicrogyria involving the motor cortex is most reliable with T1WI and color-coded DTI maps at the level of the midbrain. Pronounced asymmetry predicts preserved motor function after hemispherectomy. DTI-based tractography can be used as a guidance tool to the motor cortex within polymicrogyria.

Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers.

MATERIALS AND METHODS:

Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed.

RESULTS:

There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively).

CONCLUSIONS:

The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.

Análisis de supervivencia, eficacia y seguridad en psoriasis moderada–grave tratada con ustekinumab. Estudio observacional de 69 pacientes en la práctica clínica habitual

Publication date: Available online 28 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): I. Salgüero Fernández, M. Hospital Gil, M. Sigüenza Sanz, G. Roustan Gullón

Terapia fotodinámica en el tratamiento de la leishmaniasis cutánea

Publication date: Available online 28 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): L. Sainz-Gaspar, E. Rosón, J. Llovo, H. Vázquez-Veiga

“Dealing with the changeable and blurry edges of living things: a modified version of property-cluster kinds”

Abstract

Despite many attempts to achieve an adequate definition of living systems by means of a set of necessary and sufficient conditions, the opinion that such an enterprise is inexorably destined to fail is increasingly gaining support. However, we believe options do not just come down to either having faith in a future success or endorsing skepticism. In this paper, we aim to redirect the discussion of the problem by shifting the focus of attention from strict definitions (in terms of necessary and sufficient conditions) towards a philosophical framework that allows conceiving of living systems as a natural kind, but whereby natural kinds are not to be defined by fixed necessary and sufficient conditions. We argue for a property-cluster kind approach according to which living systems constitute a natural kind with vague boundaries, capable of changing, and whose members do not need to instantiate every property. We draw from Boyd's homeostatic property-cluster theory and introduce two modifications, one regarding homeostatic mechanisms and another related to the scientific role of kinds. Thus, our view overcomes some difficulties of Boyd's theory and we are able to account for the natural kindhood of living things. We also emphasize the most appealing features of our approach for specific research fields and address three objections to this sort of approach.

Reply: Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction

No abstract available

Nipple-Sparing Mastectomy Incisions for Cancer Extirpation Prospective Cohort Trial: Perfusion, Complications, and Patient Outcomes

Background: Nipple-sparing mastectomy offers several advantages for women seeking postmastectomy breast reconstruction, but compromised skin and nipple perfusion may lead to skin and nipple necrosis. It is unclear whether the incisional approach contributes to these complications; therefore, the purpose of this study was to compare the impact of incision type on outcomes in patients undergoing nipple-sparing mastectomy. Methods: This is a prospective cohort study of patients undergoing nipple-sparing mastectomy with prosthetic breast reconstruction through an inframammary fold versus a lateral radial incision. Skin and nipple perfusion as represented by fluorescence intensity, mammometric parameters, patient-reported outcomes, and clinical outcomes were analyzed and compared for the two cohorts, and multivariable logistic regression models were performed to evaluate the effects of covariates on outcomes. Results: Seventy-nine patients were studied: 55 in the inframammary fold cohort and 24 in the lateral radial cohort. The inframammary fold group had significantly less fluorescence intensity to the inferior (21.9 percent versus 36.9 percent; p = 0.001) and lateral portions of breast skin (23.1 percent versus 40.7 percent; p = 0.003) after reconstruction. Decreased fluorescence intensity was associated with smoking, decreased mean arterial pressure, and greater specimen weight. Postreconstruction breast volumes were increased over preoperative volumes in the inframammary fold group (38.3 percent) versus the lateral radial (31.2 percent) group; however, patients with a lateral radial incision had a greater increase in satisfaction with their breasts and psychosocial well-being. Conclusions: There are significant differences in patient-reported outcomes and final breast volumes based on the incisional approach to nipple-sparing mastectomy. These data can be used to guide providers and counsel patients considering nipple-sparing mastectomy with prosthetic reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.