Valentinosborne2248

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal adverse reaction. It can be difficult to diagnose, even more so among children, because symptoms may mimic other commonly encountered pediatric conditions.

To describe clinical and laboratory features of DRESS syndrome in the pediatric population (age ≤18 years) and establish causative agents and treatment modalities.

This was a multicenter retrospective study of probable and definite DRESS cases (Registry of Sever Cutaneous Adverse Reaction score ≥ 4) in children hospitalized in 15 French university hospitals between 2000 and2020.

We included 49 cases. All children had fever and rash, 69.4% had lymphadenopathy, and 65.3% had facial edema. The most common organ affected was the liver (83.7%). Treatment consisted of topical corticosteroid in only 30.6% and systemic corticosteroid in 55.1%; 12.2% received intravenous immunoglobulin. Among probable and likely culprit drugs, 65% were antibiotics and 27.5% were antiepileptics, median time to DRESS symptom onset after initiation of 15 days (13 days with antibiotics and 21 days with antiepileptics). Twenty-seven children had allergy assessment for causative agents, 65.4% of whom had positive tests.

Culprit drugs are frequently antibiotics and antiepileptic drugs, and onset is often less than 2 weeks after treatment starts, especially with antibiotics. Treatment with topical corticosteroids appears to be sufficient in the least severe cases. Treatment by systemic corticosteroid therapy remains the reference treatment in case of severe organ damage.

Culprit drugs are frequently antibiotics and antiepileptic drugs, and onset is often less than 2 weeks after treatment starts, especially with antibiotics. Treatment with topical corticosteroids appears to be sufficient in the least severe cases. Treatment by systemic corticosteroid therapy remains the reference treatment in case of severe organ damage.Patients with severe chronic rhinosinusitis with nasal polyps represent an unmet clinical need in terms of recurrent disease despite current medical and surgical therapy. Targeting type 2 inflammatory cytokines (IL4/5/13) appears to be a promising therapeutic approach for such patients akin to what has already been seen in severe asthma. An indirect comparison from phase 3 placebo-controlled trials has shown relative improvements in the coprimary end point of nasal polyp score (NPS) ranging from a 15% reduction (-0.8 units) with mepolizumab, 18% with omalizumab (-1.14 units), and 35% (-2.06 units) with dupilumab. This trend was mirrored by relative improvements in health status with the 22-item Sinonasal Outcome Test score showing a 21% reduction (-13.7 units) with mepolizumab, 27% (-16.1 units) with omalizumab, and 43% (-21.1 units) with dupilumab, all exceeding the minimal clinically important difference of 8.9 units. All biologics improved the coprimary end point of nasal airway blockage and also reduced the need for rescue medical and/or surgical polypectomy. We advocate performing real-life studies looking at the response to biologics in patients who are at increased risk for disease recurrence, including initial optimal medical and surgical polyp clearance before commencing biologics.Microplastics represent an emerging environmental issue and have been found almost everywhere including seafood, raising a great concern about the ecological and human health risks they pose. This study addressed the common technical challenges in the assessment of microplastics in seafood by developing an improved protocol based on Raman spectroscopy and using the green-lipped mussel Perna viridis and the Japanese jack mackerel Trachurus japonicus as the test models. Our findings identified a type of stainless-steel filter membranes with minimal Raman interference, and a combination of chemicals that achieved 99-100% digestion efficiency for both organic and inorganic biomass. This combined chemical treatment reached 90-100% recovery rates for seven types of microplastics, on which the surface modification was considered negligible and did not affect the accuracy of polymer identification based on Raman spectra, which showed 94-99% similarity to corresponding untreated microplastics. The developed extraction method for microplastics was further combined with an automated Raman mapping approach, from which our results confirmed the presence of microplastics in P. viridis and T. japonicus collected from Hong Kong waters. Identified microplastics included polypropylene, polyethylene, polystyrene and poly(ethylene terephthalate), mainly in the form of fragments and fibres. Our protocol is applicable to other biological samples, and provides an improved alternative to streamline the workflow of microplastic analysis for routine monitoring purposes.Seed coating ('seed treatment') is the leading delivery method of neonicotinoid insecticides in major crops such as soybean, wheat, cotton and maize. However, this prophylactic use of neonicotinoids is widely discussed from the standpoint of environmental costs. Growing soybean plants from neonicotinoid-coated seeds in field, we demonstrate that soybean aphids (Aphis glycines) survived the treatment, and excreted honeydew containing neonicotinoids. Biochemical analyses demonstrated that honeydew excreted by the soybean aphid contained substantial concentrations of neonicotinoids even one month after sowing of the crop. Consuming this honeydew reduced the longevity of two biological control agents of the soybean aphid, the predatory midge Aphidoletes aphidimyza and the parasitic wasp Aphelinus certus. These results have important environmental and economic implications because honeydew is the main carbohydrate source for many beneficial insects in agricultural landscapes.The risk of pesticide leaching from recreational areas such as golf course turfs is not distinguished in a regulative framework within the EU where the focus is on agricultural soils. But with increasing popularity of golf, and thus, increasing number of golf courses leading to potentially increasing use of pesticides, understanding the processes determining pesticide leaching are critical to ensure optimal quality of both groundwater and golf turf. This study input the measured variation in fate properties of tebuconazole (TBZ) and MCPA as pure active ingredients and commercial products in simulations with realistic hydrological conceptualizations to investigate their implication in leaching assessments. Scenarios with (i) fluctuating and fixed groundwater levels and (ii) preferential flows including fluctuating and fixed groundwater levels were evaluated. The results showed that mobile MCPA leached in higher concentrations by a factor of 1.3 with fluctuating groundwater levels than with fixed groundwater levels. When preferential flow paths were incorporated in the models, the leaching was substantial for MCPA regardless of its formulation as active ingredient or commercial product, while in multiple simulations without preferential pathways there was no leaching of MCPA. Compared to MCPA leaching without preferential flow paths, the leaching concentrations increased up to a factor of 13.9 when preferential flows were included. With preferential flow paths, the increase in leaching concentration from fixed groundwater levels to fluctuating groundwater levels was up to a factor of 2.3 depending on the formulation of MCPA. This study demonstrated that it is imperative to assess fate parameters in the topsoil of golf courses and consider realistic groundwater BC (boundary condition) and the presence of preferential flow paths to obtain representative pesticide leaching risk assessments.There is growing evidence of widespread contamination of freshwater ecosystems with microplastics. However, the effects of chronic microplastic ingestion and its interaction with other pollutants and stress factors on the life-history traits and the host-microbiome of aquatic invertebrates are not well understood. This study investigates the effects of exposure to sediment spiked with 1 μm polystyrene-based latex microplastic spheres, an environmentally realistic concentration of a pyrethroid pesticide (esfenvalerate), and a combination of both treatments on the life-history traits of the benthic-dwelling invertebrate, Chironomus riparius and its microbial community. The chironomid larvae were also exposed to two food conditions abundant or limited food in the sediment, monitored for 28 and 34 days respectively. The microplastics and esfenvalerate had negative effects on adult emergence and survival, and these effects differed between the food level treatments. selleck products The microbiome diversity was negatively affected by the exposure to microplastics, while the relative abundances of the four top phyla were significantly affected only in the high food level treatment. Although the combined exposure to microplastics and esfenvalerate showed some negative effects on survival and emergence, there was little evidence for synergistic effects when compared to the single exposure. The food level affected all life-history traits and the microbiota, and lower food levels intensified the negative effects of the exposure to microplastics, esfenvalerate and their combination. We argue that these pollutants can affect crucial life-history traits such as successful metamorphosis and the host-microbiome. Therefore, it should be taken into consideration for toxicological assessment of pollutant acceptability. Our study highlights the importance of investigating possible additive and synergic activities between stressors to understand the effects of pollutants in the life story traits and host-microbiome.Quantification of source impacts and contributions is a key element for the design of effective air pollution control policies. In this study, O3 source impacts and contributions were comprehensively assessed over the Pearl River Delta (PRD) region of China using brute-force method (BFM), response surface modeling with BFM (RSM-BFM) and differential method (RSM-DM) respectively, high-order decoupled direct method (HDDM), and ozone source apportionment technology (OSAT). The multi-modeling comparison results indicated that under typical nonlinear atmospheric conditions during the O3 formation, BFM, RSM-BFM, and HDDM seemed to be appropriate for assessing the impact of single source emissions; however, the results of HDDM could deviate from those of BFM when the emission reduction ratio was higher than 50 %. Under multi-source control scenarios, the results of source contribution analyses obtained from RSM-DM and OSAT were reasonably well, but the performance of OSAT was limited by its capability in representing the nonlinearity of O3 response to emission reductions of its precursors, particularly NOx. The results of this pilot study in the PRD showed that the RSM-DM appeared to replicate the nonlinearity of O3 chemistry reasonably well (e.g., O3 disbenefits due to local NOx emission reductions in Guangzhou city). Based on the source contribution results, on-road mobile (including both NOx and VOC emissions) and industrial process (mainly VOC emissions) sources were identified as two major contribution sectors by both RSM-DM and OSAT, contributing an average of 31.5 % and 11.4 % (estimated by RSM-DM) and 29.2 % and 13.0 % (estimated by OSAT) respectively to O3 formation in 9 cities of the PRD. Therefore, the reinforced emission reductions on NOx and VOC from on-road mobile and industrial process sources in the central cities (i.e., Guangzhou, Foshan, Dongguan, Shenzhen, and Zhongshan) were suggested to effectively mitigate the ambient O3 levels in the PRD.