Vancomycin-induced Henoch-Schönlein purpura: a case report

<p>Abstract</p> <p>Introduction</p> <p>Henoch-Schönlein purpura is a small-vessel systemic vasculitis. Although its exact pathophysiology remains unknown, Henoch-Schönlein purpura has been reported in association with various medical conditions including hypersensitivity. We report the case of a patient with vancomycin-induced Henoch-Schönlein purpura.</p> <p>Case presentation</p> <p>A 42-year-old Caucasian man who had previously undergone a heart transplant was diagnosed as having an intra-abdominal abscess after he underwent a Hartmann procedure. At 15 days after initiation of antibiotic therapy including vancomycin, he developed a purpuric rash of the lower limbs, arthralgia, and macroscopic hematuria. At that time, our patient was already on hemodialysis for end-stage renal disease. Henoch-Schönlein purpura was diagnosed. After a second 15-day course of vancomycin, a second flare of Henoch-Schönlein purpura occurred. Skin biopsies showed leucocytoclastic vasculitis with IgA deposits and eosinophils in the peri-capillary inflammatory infiltrate, suggesting an allergic mechanism. After vancomycin was stopped, we did not observe any further flares. Only five cases of isolated cutaneous vasculitis, one case of lupus-like syndrome and one case of Henoch-Schönlein purpura after vancomycin treatment have been described to date in the literature.</p> <p>Conclusions</p> <p>Clinicians should be aware that systemic vasculitis can be induced by some treatments. Vancomycin is a widely prescribed antibiotic. Occurrence of rare but serious Henoch-Schönlein purpura associated with vancomycin requires its prompt discontinuation.</p

Monitoreo de servicios ecosistémicos en un observatorio de cafetales agroforestales. Recomendaciones para el sector cafetalero

Ocho años de estudio de la ecofisiología del café, a través de experimentación y de modelación y el monitoreo de los servicios del ecosistema (SE) en una gran finca cafetalera en Costa Rica, revelaron varias recomendaciones prácticas para los agricultores y los formuladores de políticas. El sistema de cultivo estudiado dentro de nuestro observatorio colaborativo (Coffee-Flux), corresponde a un sistema agroforestal (SAF) a base de café bajo la sombra de grandes árboles de Erythrina poeppigiana (16% de la cubierta del dosel). Una gran cantidad de SE y limitantes dependen de las propiedades locales del suelo (en este caso Andisoles), especialmente de la erosión/infiltración, el agua/carbono y la capacidad de almacenamiento de nutrientes. Por lo tanto, para la evaluación de SE, el tipo de suelo es crucial. Una densidad adecuada de árboles de sombra (bastante baja aquí por la condición de libre crecimiento), redujo la severidad de las enfermedades de las hojas con la posibilidad de reducir el uso de plaguicidas y fungicidas. Un inventario simple del área basal en el collar de las plantas de café permitió estimar la biomasa subterránea y la edad promedio de la plantación, para juzgar su valor de mercado y decidir cuándo reemplazarla. Las fincas de café probablemente estén mucho más cerca de la neutralidad de C que lo indicado en el protocolo actual de C-neutralidad, que solo considera árboles de sombra, no los cafetos ni el suelo. Se proponen evaluaciones más completas, que ncluyen árboles, café, hojarasca, suelo y raíces en el balance C del SAF. Los árboles de sombra ofrecen muchos SE si se gestionan adecuadamente en el contexto local. En comparación con las condiciones a pleno sol, los árboles de sombra pueden (i) reducir la erosión laminar en un factor de 2; (ii) aumentar la fijación de N y el % de N reciclado en el sistema, reduciendo así los requisitos de fertilizantes; (iii) reducir la severidad de enfermedades de las hojas; (iv) aumentar el secuestro de C; (v) mejorar el microclima y (vi) reducir sustancialmente los efectos del cambio climático. En nuestro estudio de caso, no se encontró ningún efecto negativo sobre el rendimiento del café

Agroforesterie et services écosystémiques en zone tropicale

Respectueux de l’environnement et garantissant une sécurité alimentaire soutenue par la diversification des productions et des revenus qu’ils procurent, les systèmes agroforestiers apparaissent comme un modèle prometteur d’agriculture durable dans les pays du Sud les plus vulnérables aux changements globaux. Cependant, ces systèmes agroforestiers ne peuvent être optimisés qu’à condition de mieux comprendre et de mieux maîtriser les facteurs de leurs productions. L’ouvrage présente un ensemble de connaissances récentes sur les mécanismes biophysiques et socio-économiques qui sous-tendent le fonctionnement et la dynamique des systèmes agroforestiers. Il concerne, d’une part les systèmes agroforestiers à base de cultures pérennes, telles que cacaoyers et caféiers, de régions tropicales humides en Amérique du Sud, en Afrique de l’Est et du Centre, d’autre part les parcs arborés et arbustifs à base de cultures vivrières, principalement de céréales, de la région semi-aride subsaharienne d’Afrique de l’Ouest. Il synthétise les dernières avancées acquises grâce à plusieurs projets associant le Cirad, l’IRD et leurs partenaires du Sud qui ont été conduits entre 2012 et 2016 dans ces régions. L’ensemble de ces projets s’articulent autour des dynamiques des systèmes agroforestiers et des compromis entre les services de production et les autres services socio-écosystémiques que ces systèmes fournissent

Faut-il s'echanger des informations sur le flux de capitaux dans un systeme de taxation a la residence?

Nous developpons un modele dans lequel les gouvernement peuvent s'exhanger des informations sur les investissements effectues sur leur territoire par les agents etrangers.INFORMATION ; POLITIQUE FISCALE ; EQUILIBRE ECONOMIQUE

Low-cost drones help measure tree characteristics in the Sahelian savanna

International audienceSavanna is one of the main African ecosystems. The tree community in the savanna is a key element and provides many ecosystem services. Unmanned aerial vehicles (UAVs) combined with photogrammetric analysis are useful tools to produce accurate 3D maps, which, in turn, help describe the structure of the tree populations. The purpose of this study was to evaluate the use of commercial economical UAVs to assess tree characteristics in the savanna. A Dji Spark UAV was used to map 24 1-ha plots in northern Senegal. The images were processed using Pix4D software to produce a high-resolution canopy height model (CHM). A total of 239 trees were selected and their heights and crown areas were manually measured in the field. A strong correlation was found between UAV and field measurements with R2 = 0.84 for height and R2 = 0.93 for crown area. Based on tree canopy colours and tree morphologies measured by UAV, it was possible to predict tree species with an error rate of 20%, using a random forest classification. This study thus confirms the possibility of using low-cost UAVs to assess tree structures in the savanna not only for research on tree communities in savanna, but also by forestry agencies to inform stakeholders

Low-cost drones help measure tree characteristics in the Sahelian savanna

Savanna is one of the main African ecosystems. The tree community in the savanna is a key element and provides many ecosystem services. Unmanned aerial vehicles (UAVs) combined with photogrammetric analysis are useful tools to produce accurate 3D maps, which, in turn, help describe the structure of the tree populations. The purpose of this study was to evaluate the use of commercial economical UAVs to assess tree characteristics in the savanna. A Dji Spark UAV was used to map 24 1-ha plots in northern Senegal. The images were processed using Pix4D software to produce a high-resolution canopy height model (CHM). A total of 239 trees were selected and their heights and crown areas were manually measured in the field. A strong correlation was found between UAV and field measurements with R2 = 0.84 for height and R2 = 0.93 for crown area. Based on tree canopy colours and tree morphologies measured by UAV, it was possible to predict tree species with an error rate of 20%, using a random forest classification. This study thus confirms the possibility of using low-cost UAVs to assess tree structures in the savanna not only for research on tree communities in savanna, but also by forestry agencies to inform stakeholders