The management of diabetic ketoacidosis in children

The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%–70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1–2 hours; an initial bolus of 10–20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%–10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort

TRIFLURALIN: ACUTE TOXICITY TO THE MIDGE, CHIRONOMUS TENTANS, UNDER FLOW-THROUGH CONDITIONS

The test substance trifluralin, a,a,a-trifluro-2,6-dinitro-N,N-dipropyl-p­ toluidine, is a yellow-orange crystal that is used commercially as a herbicide. Its solubility in water is less than 1 mg/L (Farm Chemicals Handbook, 1987). Commonly used trade names are DigerminR, TR-lOR, TreflanR or TriflurexR. The objectives of this study were to determine the toxicity of trifluralin to the midge, Chironomus tentans, from a single exposure approaching the solubility limit of trifluralin in water, under flow-through test conditions

TRIFLURALIN: ACUTE TOXICITY TOE THE MAYFLY, HEXAGENIA LIMBATA, UNDER FLOW-THROUGH CONDITIONS

The test substance trifluralin, a,a,a-trifluro-2,6-dinitro-N,N-dipropyl-p­-toluidine is a yellow-orange crystal that is used commercially as an herbicide. It is used as a selective preemergence herbicide. Its solubility in water is less than 1 mg/L (Farm Chemicals Handbook, 1987). Commonly used trade names are DigerminR, TR-lOR, TreflanR or TriflurexR. The objectives of this study were to determine the toxicity of trifluralin to the mayfly, Hexagenia limbata, from a single exposure approaching the solubility limit of trifluralin in water, under flow-through test conditions

Genetics of type 5 M protein of Streptococcus pyogenes

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Copper homeostasis at the host vibrio interface: lessons from intracellular vibrio transcriptomics

International audienceRecent studies revealed that several vibrio species have evolved the capacity to survive inside host cells. However, it is still often ignored if intracellular stages are required for pathogenicity. Virulence of Vibrio tasmaniensis LGP32, a strain pathogenic for Crassostrea gigas oysters, depends on entry into hemocytes, the oyster immune cells. We investigated here the mechanisms of LGP32 intracellular survival and their consequences on the host-pathogen interaction. Entry and survival inside hemocytes were required for LGP32-driven cytolysis of hemocytes, both in vivo and in vitro. LGP32 intracellular stages showed a profound boost in metabolic activity and a major transcription of antioxidant and copper detoxification genes, as revealed by RNA sequencing. LGP32 isogenic mutants showed that resistance to oxidative stress and copper efflux are two main functions required for vibrio intracellular stages and cytotoxicity to hemocytes. Copper efflux was also essential for host colonization and virulence in vivo. Altogether our results identify copper resistance as a major mechanism to resist killing by phagocytes, induce cytolysis of immune cells and colonize oysters. Selection of such resistance traits could arise from vibrio interactions with copper-rich environmental niches including marine invertebrates, which favor the emergence of pathogenic vibrios resistant to intraphagosomal killing across animal species