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The present work intends to analyze the pollution level at the indoor environments of the public transport units of Leon Guanajuato, Mexico during winter season. An identification and quantification of persistent organic pollutants were carried out within three of the principal bus lines of the city in order to determine their possible origin, the differences in the levels of contamination between routes, and the potential risk to the health of the users, these analyses were carried out with different statistical techniques (ANOVA, PCA, and correlation network maps). Fourteen different organic compounds were identified as persistent pollutants. Although toluene and hexane were the compounds that were detected at the highest concentrations (average of 86.52 ± 56.1 μg m−3 and 183.33 ± 10.7 μg m−3, respectively), the correlation analysis showed that xylene, styrene, and ethylbenzene were the compounds that were mostly related to the other compounds identified as persistent. Otherwise, the statistical analysis of the concentration of these pollutants allowed to establish the fuel combustion vapors as the main source of these compounds. In the same way, the potential exposition health risk to the users were calculated in accordance to the Environmental Protection Agency of United States on those commuters grouped as students and workers. This analysis shown that the xylenes are the most representative organic pollutant in this particulate indoor spaces, and is the one with potential to generate a greater risk to the health of the bus-users, this without demising the potential danger of other pollutants.

"En México, el 54 % de las aguas residuales no reciben tratamiento y son desalojadas hacia los cuerpos de agua, suelos y canales de riego lo que genera un fuerte problema de contaminación y un alto riesgo para la salud humana y la biota acuática. En las últimas décadas se han detectado los denominados contaminantes emergentes en aguas superficiales con presencia de aguas residuales crudas y tratadas. Estos compuestos y sus metabolitos reactivos causan severos efectos toxicológicos en los organismos acuáticos o microorganismos del suelo aún en bajas concentraciones. El objetivo del trabajo fue determinar las propiedades físicas y químicas: pH, conductividad eléctrica (CE), sólidos disueltos totales (SDT), Ca2+, Mg2+, Na+, boro (B), fósforo total (P), metales traza (Cu, Zn, Fe, Mn) e identificar y cuantificar los contaminantes emergentes (farmacéuticos y drogas de abuso) en los influentes y efluentes de la Planta de Tratamiento de Aguas Residuales (PTAR) de Morelia, utilizando metodologías estandarizadas, espectrofotometría de infrarrojo (FT-IR) y espectrometría de masas (ESI-MS-TOF). Los valores de pH, CE, SDT, relación de adsorción de sodio (RAS), B, P y metales traza se encontraron dentro de los límites marcados por la norma mexicana NOM-001-ECOL-1996 y directrices internacionales para reúso de aguas residuales en agricultura. Los contaminantes emergentes identificados por ESI-MS-TOF fueron tetraciclina, cefaclor, cefadroxilo, ampicilina, clonazepam, lormetazepam, secobarbital, maprotilina, levotiroxina, cis-androsterona, paracetamol, lidocaína, bromfeniramina, fexofenadina, amfetamina, morfina, benzoilecgonina, 11-nor-Δ9-THC-9-COOH, dimetilamfetamina, fenciclidina, metadona y polietilenglicol. La eficiencia de remoción de estos contaminantes en los efluentes fue de 25.8 %, con extremos de 0 y 74.5 % para el polietilenglicol y metadona, respectivamente"

Patients with Gaucher type 1 (GD1) throughout Argentina were enrolled in the Argentine bone project to evaluate bone disease and its determinants. We focused on presence and predictors of bone lesions (BL) and their relationship to therapeutic goals (TG) with timing and dose of enzyme replacement therapy (ERT). A total of 124 patients on ERT were enrolled in a multi-center study. All six TG were achieved by 82% of patients: 70.1% for bone pain and 91.1% for bone crisis. However, despite the fact that bone TGs were achieved, residual bone disease was present in 108 patients on ERT (87%) at time 0. 16% of patients showed new irreversible BL (bone infarcts and avascular osteonecrosis) despite ERT, suggesting that they appeared during ERT or were not detected at the moment of diagnosis. We observed 5 prognostic factors that predicted a higher probability of being free of bone disease: optimal ERT compliance; early diagnosis; timely initiation of therapy; ERT initiation dose ≥45 UI/kg/EOW; and the absence of history of splenectomy. Skeletal involvement was classified into 4 major phenotypic groups according to BL: group 1 (12.9%) without BL; group 2 (28.2%) with reversible BL; group 3 (41.9%) with reversible BL and irreversible chronic BL; and group 4 (16.9%) with acute irreversible BL. Our study identifies prognostic factors for achieving best therapeutic outcomes, introduces new risk stratification for patients and suggests the need for a redefinition of bone TG. Am. J. Hematol. 91:E448-E453, 2016. © 2016 Wiley Periodicals, Inc.

Resumen La enfermedad de Fabry es el resultado de la deficiencia de alfa-galactosidasa A lisosomal, lo que resulta en deposito progresivo y patologico de glicoesfingolipidos en varias estirpes celulares. El dolor neuropatico suele ser la primera manifestacion en las variantes fenotipicas clasicas. Asociada a la insuficiencia renal y cardiaca, los accidentes cerebrovasculares pueden derivar en la muerte de los pacientes. Se describen los hallazgos de la evaluacion clinica completa y de las neuroimagenes en 9 pacientes pertenecientes a una misma familia. Todos los pacientes presentaron acroparestesias y el 33% de los casos mostro lesiones isquemicas periventriculares silentes, asi como en otro paciente se evidenciaron lesiones compatibles con un proceso inflamatorio. La enfermedad de Fabry debe ser incluida por los neurologos dentro de las posibilidades diagnosticas en pacientes jovenes con dolor neuropatico (neuropatia de fibras finas) y en pacientes con stroke criptogenico debido a la posibilidad de un tratamiento especifico que ha demostrado ser mas eficaz cuanto mas temprano sea indicado.

The purpose of this study was to evaluate the frequency of osteoporosis (OP) in patients with Gaucher disease (GD) in Argentina. GD patients from 28 centers were consecutively included from April 2012 to 2014. Bone mineral density (BMD) was determined by dual X-ray absorptiometry in the lumbar spine and the femoral neck or the total proximal femur for patients ≥20 yr of age, and by whole-body scan in the lumbar spine in patients20 yr of age. In children, mineral density was calculated using the chronological age and Z height. OP diagnosis was determined following adult and pediatric official position of the International Society for Clinical Densitometry. A total of 116 patients were included, of which 62 (53.5%) were women. The median age was 25.8 yr. All patients received enzyme replacement therapy, with a median time of 9.4 yr. Normal BMD was found in 89 patients (76.7%), whereas low bone mass (LBM) or osteopenia was found in 15 patients (13%) and OP in 12 patients (10.3%). The analysis of the pediatric population revealed that 4 patients (9.3%) had LBM and 3 (7%) had OP (Z-score ≤ -2 + fractures height-adjusted by Z), whereas in the adult population (n = 73), 11 patients (15%) had LBM or osteopenia and 9 (12.3%) had OP. Bone marrow infiltration and the presence of fractures were significantly correlated with the presence of OP (p = 0.04 and0.001, respectively). This is the first study in Argentina and in the region describing the frequency of OP or LBM in GD patients treated with imiglucerase using the official position of the International Society for Clinical Densitometry.

Acute pancreatitis is an inflammatory disease of the pancreas, characterized by abdominal pain and high level of pancreatic enzymes. Pancreatitis is the most common disease of pancreas in children and adults. For the diagnosis we need 2 of 3 characteristics: abdominal pain characteristic of acute pancreatitis, amylase and/or lipase 3 times higher than the normal upper limit and characteristic findings in images. The etiologies are multiple: trauma, metabolic disease and infections: mixovirus, HIV, measles, coxsackie, hepatitis B, C, cytomegalovirus, varicella, herpes simplex. Three cases of PA associated with H1N1 Influenza virus were reported, only one in a child with uncomplicated features.

Acute pancreatitis is an inflammatory disease of the pancreas, characterized by abdominal pain and high level of pancreatic enzymes. Pancreatitis is the most common disease of pancreas in children and adults. For the diagnosis we need 2 of 3 characteristics: abdominal pain characteristic of acute pancreatitis, amylase and/or lipase 3 times higher than the normal upper limit and characteristic findings in images. The etiologies are multiple: trauma, metabolic disease and infections: mixovirus, HIV, measles, coxsackie, hepatitis B, C, cytomegalovirus, varicella, herpes simplex. Three cases of PA associated with H1N1 Influenza virus were reported, only one in a child with uncomplicated features.

Multiple hereditary exostoses (MHE), also known as multiple osteochondromatosis, is an autosomal-dominant O-linked glycosylation disorder recently classified as EXT1/EXT2-CDG in the congenital disorder of glycosylation (CDG) nomenclature1. MHE is characterized by the presence of multiple cartilage-capped tumors, called “osteochondromas,” which usually develop in the juxta-epiphyseal regions of the long bones. The prevalence of MHE is estimated at 1:50,000 in the general population2,3. The Online Mendelian Inheritance in Man (OMIM) database classified it as either 133700 or 133701, according to whether the mutations occurred in the EXT1 or the EXT2 gene. These genes are located at 8q24 and 11p11-11p12, respectively, and they encode the co-polymerases responsible for heparan sulfate biosynthesis. EXT1 and EXT2 are tumor suppressor genes of the EXT gene family. The EXT1 gene contains eleven exons with a coding region of 2238 base pairs (bp), and the EXT2 gene contains sixteen exons with a coding region of 2154 bp4-7. These genes encode two glycosyltransferases involved in heparan sulfate biosynthesis, exostosin-1 (EXT1) (EC2.4.1.224) and exostosin-2 (EXT2) (EC2.4.1.225), whose impairment leads to the formation of exostoses5,8-10. Inactivating mutations (nonsense, frameshift, and splice site mutations) in EXT1 and EXT2 genes represent the majority of mutations that cause MHE. An overview of the reported variants is provided by the online Multiple Osteochondroma Mutation Database11. The most important complication of MHE is the malignant transformation of osteochondroma to chondrosarcoma, which is estimated to occur in 0.5% to 5% of patients7. Chondrosarcomas arise de novo (primary) or as a result of a preexisting cartilage lesion (secondary). The biological aggressiveness of chondrosarcomas can be predicted by means of a histological grading system (grade I to grade III), based on three parameters: cellularity, degree of nuclear atypia, …

The etiology of pneumonia is important to indicate antibiotics. A clinical prediction score (RP) has been designed, although the radiological interpretation is not easy.To design a simple prediction score (PRs) to identify etiology in children with pneumonia, including radiological patterns, clinical and laboratory features.Cross sectional study. We prospectively included children under 5 years hospitalized for pneumonia with microbiological evidence (2007-2008). According to the RP, were allocated 3 points when the temperature value was ≥ 39 º C, 2 when the patient age was ≥ 9 months, 2 when the number of neutrophils was 8000/mm3 and 1 when the immature neutrophils number was ≥ 5%. Radiography was evaluated as one point when consolidation was diagnosed and 0 point when pleural effusion or other infiltrations were present. RPS range was from 0 to 9 points. We determined the best cutoff for predicting bacterial pneumonia (ROC) and was calculated based on the same sensitivity (S), specificity (Sp), positive predictive value (PPV) and negative (NPV) and positive likelihood ratio ( RVP) and negative (NLR).196 patients (viral: 82%, bacteria: 18%), 8.7 ± 10 months. We identified a score ≥ 3 (auROCc = 0.87 95% CI 0.81 to 0.94) as the best point to predict bacterial pneumonia (S: 88.6%, E: 68.9%, PPV: 38.3 %, NPV: 96.5% RVP: 2.85; RPN: 0.17).The PRs showed an acceptable performance, but less sensitive than the original score to predict bacterial pneumonia. Although this tool may be easily applied, it should be validated in future studies.