Spontaneous splenic rupture due to Plasmodium Falciparum-nonoperative management

Universitatea de Medicină și Farmacie “Carol Davila”, București, Clinica Chirurgie, Spitalul de Urgență, București, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Introducere. Ruptura spontană a splinei malarice (Plasmodium Falciparum) este o complicație rară fiind frecvent asociată cu malaria cauzată de Plasmodium Vivax. Material și metode. Lucrarea prezintă cazul unui pacient de 30 de ani internat de urgență prin transfer de la Spitalul Clinic de Boli Infecțioase cu diagnosticul ruptura spontană de splină patologică (malarică), hemoperitoneu mare tratat nonoperator (angioembolizare splenică proximală).Rezultate. Evoluție favorabilaă cu recuperare compleăa.Concluzii. Ruptura splinei malarice poate fi tratată nonoperator cu succes iar prezervarea acesteia trebuie sa fie obiectivul tratamentului. Pentru stabilirea precoce a diagnosticului este necesar un indice ridicat de suspiciune pentru evitarea unor consecințe catastrofale.Introduction Spontaneous rupture of malarial spleen due to Plasmodium Falciparum is uncommon. It is most frequently associated with Plasmodium Vivax malaria. Material and methodsWe report the case of a 30-years old male transferred to our hospital from Clinical Hospital of Infectious and Tropical Diseases. He was admitted with the diagnosis of spontaneous splenic rupture and large haemoperitoneum. Because the hemodynamic stability we decided a nonoperative management and performed a proximal splenic angioembolization.ResultsThe evolution was uneventful and the patient was discharged on day 14th.ConcluziiRupture of the pathologic spleen do heal and attempt at splenic salvage should be the aim in management. A high index of suspicion of splenic rupture is imperative because delay in diagnosis may lead to catastrophic consequences

Fire and herbivory drive fungal and bacterial communities through distinct above- and belowground mechanisms

Fire and herbivory are important natural disturbances in grassy biomes. Both drivers are likely to influence belowgroundmicrobial communities but no studies have unravelled the long-term impact of both fire and herbivory on bacterial and fungal communities. We hypothesized that soil bacterial communities change through disturbance-induced shifts in soil properties (e.g. pH, nutrients) while soil fungal communities change through vegetation modification (biomass and species composition). To test these ideas, we characterised soil physicochemical properties (pH, acidity, C, N, P and exchangeable cations content, texture, bulk density, moisture), plant species richness and biomass,microbial biomass and bacterial and fungal community composition and diversity (using 16S and ITS rRNA amplicon sequencing, respectively) in six long-term (18 to 70 years) ecological research sites in South African savanna and grassland ecosystems.We found that fire and herbivory regimes profoundly modified soil physico-chemical properties, plant species richness and standing biomass. In all sites, an increase in woody biomass (ranging from 12 to 50%) was observed when natural disturbances were excluded. The intensity and direction of changes in soil properties were highly dependent on the topo-pedo-climatic context. Overall, fire and herbivory shaped bacterial and fungal communities through distinct driving forces: edaphic properties (including Mg, pH, Ca) for bacteria, and vegetation (herbaceous biomass and woody cover) for fungi. Fire and herbivory explained on average 7.5 and 9.8% of the fungal community variability, respectively, compared to 6.0 and 5.6% for bacteria. The relatively small changes inmicrobial communities due to natural disturbance is in stark contrast to dramatic vegetation and edaphic changes and suggests that soilmicrobial communities, having evolved with disturbance, are resistant to change. This represents both a buffer to short-term anthropogenicinduced changes and a restoration challenge in the face of long-term changes.The National Research Foundation, South Africa and the Patterson Foundation via Conservation International, South Africa.http://www.elsevier.com/locate/scitotenvam2022BiochemistryGeneticsMicrobiology and Plant Patholog

Fire and herbivory drive fungal and bacterial communities through distinct above- and belowground mechanisms

Fire and herbivory are important natural disturbances in grassy biomes. Both drivers are likely to influence belowground microbial communities but no studies have unravelled the long-term impact of both fire and herbivory on bacterial and fungal communities. We hypothesized that soil bacterial communities change through disturbance-induced shifts in soil properties (e.g. pH, nutrients) while soil fungal communities change through vegetation modification (biomass and species composition). To test these ideas, we characterised soil physico-chemical properties (pH, acidity, C, N, P and exchangeable cations content, texture, bulk density, moisture), plant species richness and biomass, microbial biomass and bacterial and fungal community composition and diversity (using 16S and ITS rRNA amplicon sequencing, respectively) in six long-term (18 to 70 years) ecological research sites in South African savanna and grassland ecosystems. We found that fire and herbivory regimes profoundly modified soil physico-chemical properties, plant species richness and standing biomass. In all sites, an increase in woody biomass (ranging from 12 to 50%) was observed when natural disturbances were excluded. The intensity and direction of changes in soil properties were highly dependent on the topo-pedo-climatic context. Overall, fire and herbivory shaped bacterial and fungal communities through distinct driving forces: edaphic properties (including Mg, pH, Ca) for bacteria, and vegetation (herbaceous biomass and woody cover) for fungi. Fire and herbivory explained on average 7.5 and 9.8% of the fungal community variability, respectively, compared to 6.0 and 5.6% for bacteria. The relatively small changes in microbial communities due to natural disturbance is in stark contrast to dramatic vegetation and edaphic changes and suggests that soil microbial communities, having evolved with disturbance, are resistant to change. This represents both a buffer to short-term anthropogenic-induced changes and a restoration challenge in the face of long-term changes

Global extent and drivers of mammal population declines in protected areas under illegal hunting pressure

Illegal hunting is a persistent problem in many protected areas, but an overview of the extent of this problem and its impact on wildlife is lacking. We reviewed 40 years (1980–2020) of global research to examine the spatial distribution of research and socio-ecological factors influencing population decline within protected areas under illegal hunting pressure. From 81 papers reporting 988 species/site combinations, 294 mammal species were reported to have been illegally hunted from 155 protected areas across 48 countries. Research in illegal hunting has increased substantially during the review period and showed biases towards strictly protected areas and the African continent. Population declines were most frequent in countries with a low human development index, particularly in strict protected areas and for species with a body mass over 100 kg. Our results provide evidence that illegal hunting is most likely to cause declines of large-bodied species in protected areas of resource-poor countries regardless of protected area conservation status. Given the growing pressures of illegal hunting, increased investments in people’s development and additional conservation efforts such as improving anti-poaching strategies and conservation resources in terms of improving funding and personnel directed at this problem are a growing priority

Size Doesn't Matter: Towards a More Inclusive Philosophy of Biology

notes: As the primary author, O’Malley drafted the paper, and gathered and analysed data (scientific papers and talks). Conceptual analysis was conducted by both authors.publication-status: Publishedtypes: ArticlePhilosophers of biology, along with everyone else, generally perceive life to fall into two broad categories, the microbes and macrobes, and then pay most of their attention to the latter. ‘Macrobe’ is the word we propose for larger life forms, and we use it as part of an argument for microbial equality. We suggest that taking more notice of microbes – the dominant life form on the planet, both now and throughout evolutionary history – will transform some of the philosophy of biology’s standard ideas on ontology, evolution, taxonomy and biodiversity. We set out a number of recent developments in microbiology – including biofilm formation, chemotaxis, quorum sensing and gene transfer – that highlight microbial capacities for cooperation and communication and break down conventional thinking that microbes are solely or primarily single-celled organisms. These insights also bring new perspectives to the levels of selection debate, as well as to discussions of the evolution and nature of multicellularity, and to neo-Darwinian understandings of evolutionary mechanisms. We show how these revisions lead to further complications for microbial classification and the philosophies of systematics and biodiversity. Incorporating microbial insights into the philosophy of biology will challenge many of its assumptions, but also give greater scope and depth to its investigations

Outcomes of Expectant Management in HIV-Infected Pregnancy with Preterm Premature Rupture of Membranes at Less Than 34-Week Gestation: A Case Series

Objective: To present outcomes of expectant management (EM) in HIV-infected pregnancy with preterm premature rupture of membranes (PPROM) at less than 34-week gestation. Case presentation: During January 2008-December 2015, there were 513 HIV-infected pregnant women giving birth at Siriraj Hospital, Thailand. Ten of them presented with PPROM at GA <34 weeks and six women received EM. The deliveries took place at GA 28 2/7 - 33 5/7 weeks. The longest interval of ROM was 15 days and the highest on-admission viral load was 633,000 copies/mL. Three of them had antepartum highly active antiretroviral therapy (HAART) for at least four weeks prior to the delivery. Mode of delivery included 3 vaginal deliveries and 3 caesarean sections. All infants’ HIV molecular tests were negative at birth. The longest follow-up interval was 12 months and HIV vertical transmission remained negative. Conclusion: Expectant management in HIV-infected women with PPROM at GA <34 weeks may be sensible because complications of prematurity outweigh the risk of vertical HIV transmission

Splenic rupture after colonoscopy treated by nonoperative management

Universitatea de Medicină și Farmacie “Carol Davila”, București, Clinica Chirurgie, Spitalul de Urgență, București, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Introducere: Ruptura splenică după colonoscopie reprezintă o complicație rară dar potențial fatală. Primul caz a fost publicat în anul 1974 de către Wherry si Zehner. Incidența acestei complicații este de 0.00005-0.017 % cu o mortalitate de 7.4 %. În mod frecvent (64.4%) tratamentul optim este reprezentat de splenectomie.Metoda: Este relatat un caz de ruptură splenică postcolonoscopie la un barbat de 65 ani, care s-a prezentat la camera de gardă la 4 zile după efectuarea unei colonoscopii de screening, colonoscopie fără incidente. Pacientul a prezentat durere abdominală moderată debutată la 4 ore după colonoscopie; în evoluție durerea a devenit intensă, generalizată. A negat orice fel de traumatism abdominal. CT abdominopelvină cu substanța de contrast iv a evidențiat o ruptură splenică polară inferioară grad II, hematom subcapsular fisurat, hematom perisplenic și hemoperitoneu mic, fără semne de sangerare activă. Stabilitatea hemodinamica și gradul rupturii splenice a mandatat tratamentul nonoperator cu rezultate favorabile. Concluzii: Până în anul 2009 au fost publcate 67 de cazuri de rupturi splenice secundare colonoscopiei; este posibil ca aceasta să fie al 68-lea caz raportat. Diagnosticul este frecvent întarziat. Principalele mecanisme de producere sunt reprezentate de tractiunea excesivă asupra ligamentului spleno-colic sau sindromul aderențial supramezocolic prezent. Diagnosticul de ruptură splenică postcolonoscopie trebuie avut în vedere la orice pacient care, după o procedură de endoscopie digestivă inferioară prezintă dureri abdominale asociate cu scăderea valorilor hemoglobinei în absența hematocheziei. Echipa medicală (medicină de urgența, gastroenterologie, chirurgie) trebuie să aibă în vedere această complicație potențial fatală.Background: Splenic injury is a rare and potentially fatal complication of colonoscopy. It was first reported in 1974 by Wherry and Zehner. The incidence of this complication is around 0.00005-0.017 with a mortality rate about 7.4 %. Frequently, the usual treatment is represented by splenectomy. Method: We report a case of splenic rupture following splenectomy. A 65-years-old Caucasian male was presented to the emergency department 4 days after an uncomplicated screening colonoscopy. He reported poorly abdominal pain that started 4 hours after the procedure; in evolution the pain had become more severe. He denied any abdominal trauma. Clinical abdominal examination revealed diffuse rebound tenderness; a rectal examination was normal. Computed tomography of the abdomen and pelvis with intravenous contrast media revealed a grade 2 splenic rupture (OIS-AAST) lower pole, a ruptured subcapsular hematoma, perisplenic hematoma and small haemoperitoneum without active bleeding. Because of hemodynamic stability and his grade 2 splenic rupture a nonoperative approach was elected with good outcome. Conclusion: Until 2009, 67 cases of splenic rupture following colonoscopy were published; it is possible our case to be the 68th. The diagnosis is frequently delayed. Excessive traction on the splenocolic attachment or on preexisting adhesions represent the essential mechanism of injury. The diagnosis of splenic rupture should be considered in any patient presenting abdominal pain after a colonoscopic procedure and declining hemoglobin levels in the absence of hematochezia. In many cases the surgical treatment is the modality of choice. The medical staff (primary care physicians, gastroenterologists, surgeons) need to be aware of this potentially life threatening complication

Characterisation of ambient Total Gaseous Mercury concentrations over the South African Highveld

Mercury is considered a ubiquitous, toxic, and global pollutant. In this study, ambient Total Gaseous Mercury (TGM) concentrations over the South African Highveld are characterised. Studies on ambient mercury in this region is important because of various anthropogenic emission sources. In this pilot study, concentrations of TGM and criteria pollutants (O3, SO2, NO, NO2, and CO) were measured concurrently with meteorological parameters at Balfour (BF), Middelburg (MB), and Standerton (ST) from January 2009 to December 2009. The spatial variation of TGM concentrations ranged from 0.40 to 28.72 ng/m3 (1.99 0.94 ng/m3), 0.12–9.91 ng/m3 (1.04 0.62 ng/m3), and 0.21–32.10 ng/m3 (1.25 1.38 ng/m3), at BF, MB, and ST, respectively. Generally, concentrations fell within the Northern Hemisphere background range of 1.5–1.7 ng/m3 and Cape Point, South Africa background of 1.2–1.4 ng/m3, with the exception of outliers. The outliers were much higher than the background values and may be the result of pollution events. Seasonal variation varied with descending orders of summer, spring, winter, autumn, at BF; summer, winter, autumn, spring at MB; and winter, spring, summer at ST (no data available for autumn). This study observed no profound diurnal patterns at BF and MB where sparse local and regional sources appear to have been the predominant sources. An interesting phenomena, however, was observed at ST where the diurnal cycle suggests a potential significant influence from local domestic combustion source