Hemoglobin life-threatening value (1.9 g/dl) in good general condition: a pediatric case-report

Abstract Background We report a pediatric patient presenting in good general condition despite a hemoglobin value of 1,9 g/dL, which is normally regarded as life-threatening. Case presentation An African 5 years-old girl presented to our Emergency Department (ED) for worsening asthenia, within a clinical picture of good general condition. The hemoglobin value at admission was 1,9 g/dL. The subsequent diagnostic-therapeutic pathway highlighted the presence of two different causes, both well known to be responsible for chronic anemia (with slow reduction of hemoglobin values): iron deficiency anemia (IDA) due to a very low dietary intake of iron-rich foods, and homozygous sickle cell disease (HbSS). She received transfusions of packed red blood cells (overall 15 ml/kg) and subsequently intravenous iron preparations (total amount 200 mg) followed by oral iron supplements. The Hb value at discharge, 10 days after the admission, was 9.8 g/dL. Conclusions When approaching a picture of severe anemia, we suggest pediatricians take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis

Herbaceous Vegetation Dynamic after Cut and Burn Shrub Plants in Southern Brazil

A savanna area at Serra do Sudeste in southern Brazil, was studied during four years to evaluate the influence of cutting and burning shrub plants on dynamic of herbaceous vegetation. The cover of each species in 44 permanent quadrats (0,25 m2) and in each area (cut and burned) was evaluated. The results suggested that grasses and legumes were favored by cutting shrub plants. Burning favored forbs in the first years after disturbance and retarded the development of native forage species desirable for grazing

Investigation on virucidal activity of chlorine dioxide. Experimental data on Feline calicivirus, HAV and Coxsackie B5

Introduction. The aim of this study was to evaluate the efficacy of ClO2 with regard to viruses which show a particular resistance to oxidizing agent such as HAV and Norwalk and Norwalk-like viruses, and which play an important role in the epidemiology of viral foodborne diseases. In the food industry, disinfection of processing systems and equipment is a very important instrument to prevent secondary contamination and to guarantee food safety. Among disinfectants, chlorine dioxide (ClO2) presents a good efficacy at wide range of pH values, its action is rapid and generates few reaction byproducts if compared to hypoclorite. Experimental studies have highlighted that ClO2 shows a good bactericidal activity and it is also active towards viruses. Furthermore, the low concentrations and low contact times required to obtain microbial load reduction are favourable elements for the application of this compound in the industrial sanitizing practices. Methods. As it is impossible to cultivate the Norwalk virus in vitro, we tested the resistance of Feline calicivirus (F9 strain) vs. ClO2, in comparison with HAV (strain HM-175) and CoxsackieB5. Chlorine dioxide was used at concentrations ranging from 0.2 to 0.8 mg/l in water solution, at pH 7 and at +20 °C. Viral suspensions were added to disinfecting solution and, at pre-set times, were sampled to undergo to titration after blocking the disinfectant action with thiosulphate 0.05 M. On the basis of the data obtained, for each virus and in relation to different concentrations, mean reduction times were calculated for 99%, 99.9% and 99.99% using the regression analysis model. Results. As regards Feline calicivirus, at a concentration of 0.8 mg/l of ClO2, we obtained the complete elimination of the viral titre in 2 min while 30 min were required at concentrations of 0.2 mg/l. Coxackie B5 showed a similar behaviour, being completely inactivated in 4 min with 0.4 mg/l of ClO2 and after 30 min at a concentration of 0.2 mg/l. Inactivation was quicker for HAV, which was eliminated after only 30 sec at a concentration of 0.8 mg/l and after 5 min at 0.4 mg/l. Conclusion. Our data show that for complete inactivation of HAV and Feline calicivirus, concentrations ? 0.6 mg/l are required. This observation is true for Coxsackie B5 too, but this virus has shown a good sensitivity at all concentration tested according to regression analysis results. For Feline calicivirus and HAV, at low concentrations of disinfectant, prolonged contact times were needed to obtain a 99.99% reduction of viral titres (about 16 and 20 minutes respectively)

Impact of an asbestos cement factory on mesothelioma incidence: Global assessment of effects of occupational, familial, and environmental exposure

Few studies have examined the incidence of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure (occupational, familial, or environmental). We assessed the impact of asbestos exposure—global and by source—on the incidence of MM in Broni, an Italian town in which an asbestos cement factory once operated (1932–1993). Based on data collected by the Lombardy Mesothelioma Registry, we calculated the number of observed and expected MM cases among workers, their cohabitants, and people living in the area in 2000–2011. We identified 147 MM cases (17.45 expected), 138 pleural and nine peritoneal, attributable to exposure to asbestos from the factory. Thirty-eight cases had past occupational exposure at the factory (2.33 expected), numbering 32 men (26 pleural, six peritoneal) and six women (four pleural, two peritoneal). In the families of the workers, there were 37 MM cases (4.23 expected), numbering five men (all pleural) and 32 women (31 pleural, one peritoneal). Among residents in Broni or in the adjacent/surrounding towns, there were 72 cases of pleural MM (10.89 expected), numbering 23 men and 49 women. The largest MM excess was found in the towns of Broni (48 observed, 3.68 expected) and Stradella (16 observed, 1.85 expected). This study documents the large impact of the asbestos cement factory, with about 130 excess MM cases in a 12-year period. The largest MM burden was among women, from non-occupational exposure. Almost half of the MM cases were attributable to environmental exposure. Keywords: Asbestos, Mesothelioma, Cancer incidence, Occupational exposure, Familial exposure, Environmental exposur