Skin disorders in patients transplanted in childhood

Only few data are available on skin disorders in pediatric organ transplant recipients. In order to describe the whole range of dermatological diseases in a population of pediatric organ transplant recipients, we studied a group of 217 consecutive organ transplant recipients (168 kidney, 29 heart, 19 liver, one lung) aged <18 years at transplantation followed at a single center. A total of 193 patients showed at least one skin disorder; 149 had more than one skin disease. The most common skin infections were warts (24.4%), pityriasis versicolor (20.7%), folliculitis (12.9%), intertrigo (6.5%); the most common drug side effects were hypertrichosis (69.6%), steroid acne (39.6%), gingival hyperplasia (29%) and severe xerosis (20.7%). Two patients (0.9%) developed nonmelanoma skin cancer. Our study summarizes the main skin complications in patients transplanted in childhood and underlines the necessity of regular dermatologic surveillance of these patients.     

Long-term intraocular pressure control by trabeculectomy: a ten-year life table

A retrospective study of 179 eyes in 127 patients who underwent trabeculectomy at Sydney Eye Hospital under the supervision of two surgeons between 1977 and 1982 was carried out. Survival analysis by life table method shows cumulative two, five, and 10 year success rates to be 78%, 70%, and 67% respectively, with mean duration of intraocular pressure control (IOP<21 mmHg) being 88 months. Anti-glaucoma medication improved the long-term survival significantly (Hazard Ratio of 0.49 and P = 0.01) so that when the definition for failure is taken as IOP >20 mmHg while using medication, the two, five and 10 year success rates were 89%, 87% and 86% respectively. A rise in average intraocular pressure is seen between two weeks and three months after trabeculectomy. The improvement in long-term success rate with use of topical steroids was suggestive (Hazard Ratio of 0.69) but not conclusive (P = 0.21). No difference was found in survival comparing fornix versus limbal based flap technique.     

Microbiological quality of water in a city with persistent and recurrent waterborne diseases under tropical sub-rural conditions: The case of Kikwit City,Democratic Republic of the Congo

The availability of safe drinking water in sub-Saharan countries remains a major challenge because poor sanitation has been the cause of various outbreaks of waterborne disease due to the poor microbiological quality of water used for domestic purposes. The faecal indicator bacteria (FIB) used in the present study included Escherichia coli (E. coli) and Enterococcus (ENT). FIB and aerobic mesophilic bacteria (AMB) were quantified during July 2015 (dry season) and November 2015 (rainy season) in order to assess the quality of drinking water from wells (n = 3; P1–P3), and two rivers, the River Lukemi (RLK, n = 3) and River Luini (RLN, n = 2) in the city of Kikwit, which is located in the province of Kwilu in the Democratic Republic of the Congo. Kikwit is well known for its outbreaks of persistent and recurrent waterborne diseases including Entamoeba, Shigella, typhoid fever, cholera, and Ebola Viral Hemorrhagic Fever. Consequently, E. coli, ENT, and AMB were quantified in water samples according to the standard international methods for water quality determination using the membrane filtration method. The FIB characterization was performed for human-specific Bacteroides by PCR using specific primers. The results obtained revealed high FIB concentrations in river samples collected during both seasons. For example, E. coli respectively reached 4.3 × 10⁴ and 9.2 × 10⁴ CFU 100 mL^?1 in the dry season and the wet season. ENT reached 5.3 × 10³ CFU 100 mL^?1 during the dry season and 9.8 × 10³ CFU 100 mL^?1 in the wet season. The pollution was significantly worse in the wet season compared to the dry season. Surprisingly, no faecal contamination was observed in well water samples collected in the dry season while E. coli and ENT were detected in all wells in the wet season with values of 6, 7, and 11 CFU mL^?1 for E. coli in wells P1–P3, respectively and 3, 5, 9 CFU mL^?1for ENT in the same wells. Interestingly, the PCR assays for human-specific Bacteroides HF183/HF134 indicated that 97–100% captured in all analyses of isolated FIB were of human origin. The results indicate that contamination of E. coli, ENT, and AMB in the studied water resources increases during the wet season. This study improves understanding of the microbiological pollution of rivers and wells under tropical conditions and will guide future municipal/local government decisions on improving water quality in this region which is characterised by persistent and recurrent waterborne diseases. Although the epidemiology can be geographically localised, the effects of cross border transmission can be global. Therefore, the research results presented in this article form recommendations to municipalities/local authorities and the approach and procedures can be carried out in a similar environment.     

血管内皮生长因子在口腔颌面骨组织工程中的应用

目的:了解血管内皮生长因子促进骨再生和修复作用的机制及应用方式,探讨其在口腔颌面骨组织工程中的应用前景。资料来源:应用计算机检索PubMed数据库1994-01/2006-02有关血管内皮生长因子促进成骨的文章,检索词“Vascular endothelial growth factor,Bone formation,Maxillofacial bone,Bone defect”,限定文章语言种类为English。同时计算机检索中国期刊全文数据库1994-01/2006-02期间的相关文章,检索词“血管内皮生长因子、成骨、颌骨”,限定文章语言种类为中文。资料选择:对资料进行初审,选取符合要求的有关文章找全文。纳入标准:①血管内皮生长因子及其受体分子结构方面的文章。②血管内皮生长因子促进成骨作用的基础研究和临床研究。③血管内皮生长因子在颌骨组织工程中应用的基础研究和临床研究。排除标准:重复或类似的同一研究、Meta分析、个案报道。资料提炼:共收集到186篇有关血管内皮生长因子促进成骨作用的文章,排除重复或类似的同一研究,30篇符合要求(其中2篇为血管内皮生长因子及其受体分子结构方面的文献,18篇为血管内皮生长因子促进成骨作用的基础研究和临床研究方面的文献,10篇涉及血管内皮生长因子在颌骨组织工程中应用的研究)。资料综合:①国内外有关血管内皮生长因子促进成骨作用的机制为:通过促进内皮细胞增殖、血管生成,调节骨组织血供并参与骨的发育形成;作为旁分泌因子参与骨形成代谢;通过调节成骨细胞和破骨细胞的活性促进骨组织的再生、修复和重建。②血管内皮生长因子在骨组织工程中的应用方式主要有外源性应用和内源性应用,外源性应用就是将外源性血管内皮细胞生长因子加入到支架和细胞的复合体中,使它通过促进血管化、调节参与成骨的多种因子及成骨细胞和破骨细胞的活性,提高成骨效能。内源性应用就是利用基因技术,将人血管内皮细胞生长因子基因转入种子细胞,使种子细胞持续的产生血管内皮细胞生长因子,为骨形成提供足够的血管化和调节骨细胞的活性。③动物实验已证实血管内皮生长因子对颌骨牵张成骨和颌骨缺损修复起着促进作用。结论:应用外源性和内源性血管内皮生长因子构建的组织工程骨可促进骨形成和骨缺损修复,用它来加快颌面骨组织工程的骨形成和缩短疗程在理论上是可行的。     

白三烯拮抗剂ONO-1078对化学物质诱导大鼠皮肤微血管渗漏的抑制作用

大鼠皮内注射组胺、辣椒素和甲醛诱导皮肤微血管渗漏,白三烯拮抗剂ONO-1078剂量依赖性抑制这一反应,ID₅₀分别为1.98,1.78,2.23mg·kg^-1。与扑尔敏相比,对组胺的作用较弱,对辣椒素和甲醛的作用较强,地塞米松的作用强于ONOl078和扑尔敏。ONO-l078还抑制LTD4的作用,对大剂量组胺、缓激肽和P物质无明显作用。ONO-l078的作用可能与抑制感觉神经肽释放有关。     

Life course dental caries determinants and predictors in children aged 12 years: a population-based birth cohort

Abstract – Objective: To investigate the main dental caries life course determinants and predictors of dental caries at age 12. Methods: This study was nested in a population‐based birth cohort started in 1993 in Pelotas, Brazil. A sample of 359 children was followed‐up. Dental examinations and interviews were performed at 6 and at 12 years old. Dental caries (DMFT) at 12 years old was the outcome. Exploratory variables included socioeconomic and demographic variables at birth, children’s nutritional and development characteristics, primary dental caries, oral health related behaviors and dental service use at age 6 and 12. Poisson regression was used in order to provide relative risk ratio estimates. Attributable risk or etiology fraction and population attributable risk for both main early life variables were calculated. Dental caries prediction (DMFT ≥ 1) at 12 years old was tested using logistic regression analyses. Results: Children who presented height‐for‐age deficit at 12 months (RR 1.50 CI: 95% = 1.03–2.18), children who showed a DMFT of 1–3 and 4–19 at 6 years (RR = 2.01; CI: 95% = 1.33–3.03, and RR = 2.66; CI: 95% = 1.81–2.53, respectively) and those children aged 12 in the highest tertile of proportion of teeth experiencing gingival bleeding (RR = 1.58; CI: 95% = 1.11–2.24) presented a higher level of dental caries at age 12. Attributable risk for dental caries at age 12 were 79.1% and 74.2% for deficit in height for age at 12 months and for primary dental caries at age 6 years respectively; population attributable risk for dental caries at age 12 were 3.1% for deficit in height for age at 12 months and 64.9% for primary dental caries at age 6. The level of accuracy in predicting dental caries at age 12 by using life course socioeconomic, behavioral and clinical data was modest. Conclusions: The results of this study support the hypothesis linking social, biological and behavioral exposures and dental caries at 12 years old. In addition, the findings reinforce the lack of accuracy of dental caries predictors therefore limiting the individuals high‐risk approach as a public health strategy.     

Allergic bronchopulmonary aspergillosis complicating cystic fibrosis in childhood

Allergic bronchopulmonary aspergillosis, known to be associated with cystic fibrosis in older patients, occurred in 7 young atopic children with cystic fibrosis. The diagnosis was suggested by the onset of, or the increase in, asthmatic symptoms accompanied by major chest x-ray changes ranging from total collapse of a lung or lobe to extensive but changing areas of consolidation. Each of the children had a blood eosinophilia, positive type I skin tests to Aspergillus fumigatus, and reversible airways obstruction. Most had a positive type III skin test and circulating precipitins to A. fumigatus, with raised IgE levels which contained specific antibodies to the fungus on radioallergosorbent (RAST) test. None had advanced suppurative chest disease of cystic fibrosis. None was given specific antifungal agents; two received systemic treatment with corticosteroids, the other received additional drugs for their asthma. Two developed total collapse of one lung, one child being only 2 years old. Five have had recurrences of pulmonary shadowing typical of allergic aspergillosis but are not showing significant progression of their cystic fibrosis lung disease. Our experience suggests that there should be an increased awareness of this condition, particularly its association with extensive pulmonary collapse or consolidation in children with cystic fibrosis who are atopic.