Long-term results of pancreas transplantation under tacrolimus immunosuppression

Background. The long-term safety and efficacy of tacrolimus in pancreas transplantation has not yet been demonstrated. The observation of prolonged pancreatic graft function under tacrolimus would indicate that any potential islet toxicity is short-lived and clinically insignificant. We report herein the results of pancreas transplantation in patients receiving primary tacrolimus immunosuppression for a minimum of 2 years. Methods. From July 4, 1994 until April 18, 1996, 60 patients received either simultaneous pancreas- kidney transplant (n=55), pancreas transplant only (n=4), or pancreas after kidney transplantation (n=1). Baseline immunosuppression consisted of tacrolimus and steroids without antilymphocyte induction. Azathioprine was used as a third agent in 51 patients and mycophenolate mofetil in 9. Rejection episodes within the first 6 months occurred in 48 (80%) patients and were treated with high-dose corticosteroids. Antilymphocyte antibody was required in eight (13%) patients with steroid-resistant rejection. Results. With a mean follow-up of 35.1±5.9 months (range: 24.3-45.7 months), 6-month and 1-, 2-, and 33-year graft survival is 88%, 82%, 80%, and 80% pancreas) and 98%, 96%, 93%, and 91% (kidney), respectively. Six-month and 1-, 2-, and 3-year patient survival is 100%, 98%, 98%, and 96.5%. Mean fasting glucose is 91.6±13.8 mg/dl, and mean glycosylated hemoglobin is 5.1±0.7% (normal range: 4.3-6.1%). Mean tacrolimus dose is 6.5±2.6 mg/day and mean prednisone dose 2.0±2.9 mg/day at follow-up. Complete steroid withdrawal was possible in 31 (65%) of the 48 patients with functioning pancreases. Conclusions. These data show for the first time that tacrolimus is a safe and effective long-term primary agent in pancreas transplantation and provides excellent long-term islet function without evidence of toxicity while permitting steroid withdrawal in the majority of patients

Animal-related factors associated with moderate-to-severe diarrhea in children younger than five years in western Kenya: A matched case-control study

Background Diarrheal disease remains among the leading causes of global mortality in children younger than 5 years. Exposure to domestic animals may be a risk factor for diarrheal disease. The objectives of this study were to identify animal-related exposures associated with cases of moderate-to-severe diarrhea (MSD) in children in rural western Kenya, and to identify the major zoonotic enteric pathogens present in domestic animals residing in the homesteads of case and control children. Methodology/Principal findings We characterized animal-related exposures in a subset of case and control children (n = 73 pairs matched on age, sex and location) with reported animal presence at home enrolled in the Global Enteric Multicenter Study in western Kenya, and analysed these for an association with MSD. We identified potentially zoonotic enteric pathogens in pooled fecal specimens collected from domestic animals resident at children’s homesteads. Variables that were associated with decreased risk of MSD were washing hands after animal contact (matched odds ratio [MOR] = 0.2; 95% CI 0.08–0.7), and presence of adult sheep that were not confined in a pen overnight (MOR = 0.1; 0.02–0.5). Variables that were associated with increased risk of MSD were increasing number of sheep owned (MOR = 1.2; 1.0–1.5), frequent observation of fresh rodent excreta (feces/urine) outside the house (MOR = 7.5; 1.5–37.2), and participation of the child in providing water to chickens (MOR = 3.8; 1.2–12.2). Of 691 pooled specimens collected from 2,174 domestic animals, 159 pools (23%) tested positive for one or more potentially zoonotic enteric pathogens (Campylobacter jejuni, C. coli, non-typhoidal Salmonella, diarrheagenic E. coli, Giardia, Cryptosporidium, or rotavirus). We did not find any association between the presence of particular pathogens in household animals, and MSD in children. Conclusions and significance Public health agencies should continue to promote frequent hand washing, including after animal contact, to reduce the risk of MSD. Future studies should address specific causal relations of MSD with sheep and chicken husbandry practices, and with the presence of rodents

Soil physicochemical properties of coastal wetland soil cores collected in June 2018 from Barataria Bay, Louisiana

Dataset: Soil physicochemical propertiesNine coastal wetland soil cores (150cm) collected in June 2018 from Barataria Bay, Louisiana were analyzed for biogeochemical properties, organic matter fractionation, and stable isotope signatures For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/840246NSF Division of Ocean Sciences (NSF OCE) OCE-163583

Microbial gene abundance of coastal wetland soil cores collected in June 2018 from Barataria Bay, Louisiana

Dataset: Gene AbundanceNine coastal wetland soil cores (150cm) collected in June 2018 from Barataria Bay, Louisiana were analyzed for microbial gene abundance For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/840278NSF Division of Ocean Sciences (NSF OCE) OCE-163583

Nutrient properties of coastal wetland soil cores collected in June 2018 from Barataria Bay, Louisiana

Dataset: NutrientsNine coastal wetland soil cores (150cm) that were collected in June 2018 from Barataria Bay, Louisiana were analyzed for nutrients For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/840293NSF Division of Ocean Sciences (NSF OCE) OCE-163583

Barataria Bay carbon mineralization and biogeochemical properties from nine soil cores

Dataset: Carbon MineralizationNine soil cores (1 m deep) were collected from three sites within Barataria Bay, LA (USA). Both the biogeochemical properties of the soils with depth were determined, as well as the impacts of the introduction of oxygenated seawater on carbon mineralization rates. For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/775547NSF Division of Ocean Sciences (NSF OCE) OCE-163583

Does edge erosion alter coastal wetland soil properties? A multi-method biogeochemical study

© 2019 Elsevier B.V. Coastal wetlands in Louisiana experience high rates of edge erosion due to combined eustatic sea level rise and coastal subsidence. This study sought to (1) evaluate site-specific spatial and temporal patterns in marsh edge erosion rates within Barataria Bay, LA, (2) develop an understanding of the physical and chemical properties of eroding soils through biogeochemical and spectroscopic characterization, and (3) evaluate interactions between erosion, saltwater incursion, and soil properties through a comparison of sites with different erosion rates and varying distances from the eroding edge. Replicate soil cores were collected at three distances inland (1 m, 3 m, 5 m) at three different sites (west, south, and north) to a depth of 1 m. Erosion rates were measured at each site, and soils were sectioned into 10 cm intervals for a total of 270 soil and porewater samples. Each soil sample was subjected to soil physicochemical analysis (bulk density, moisture content, organic matter content, and total carbon (C), nitrogen (N), and phosphorus (P)) as well as assessments of biogeochemical cycling (production of CO2, mineralization of N and P, and extractable nutrient concentrations). Porewater samples were analyzed to elucidate spectroscopic and fluorometric indicators of carbon quality (aromaticity, humification, lignin proportion, and C source). Erosion rates at the west, north, and south sites were 3.36 ± 0.4, 1.34 ± 0.2, and 0.58 ± 0.03 m yr−1, respectively. Neither erosional magnitude nor saltwater incursion was found to be significant predictors of any measured spectroscopic or biogeochemical parameters, though depth was a significant control on 18 of the measured 20 parameters. The top 30 cm were more biologically active (as indicated by greater mineralization of C, N and P) and were characterized by lower molecular weight porewater DOM with less aromaticity. Degree of humification and aromaticity of porewater DOM increased with both depth and distance inland. Concentrations of bioavailable N and P at 1 m depth were at least 5 times greater than surface concentrations, representing a pool of nutrients that could be exported into the coastal ocean with ongoing erosion. This study is the first to couple spectroscopic and biogeochemical measurements for the purpose of assessing soil and porewater physicochemistry within wetland soils and illustrates an as-yet unaccounted for potential for the export of labile C, N, and P into the coastal ocean