Residue level and health risk assessment of organophosphorus pesticides in country bean and bitter gourd collected from Cumilla, Bangladesh

Organophosphorus pesticides are one of the most commonly used pesticide classes in agriculture in the management of insect pests due to their high efficacy. The extensive use of organophosphorus pesticides can contaminate both the atmosphere and food, which may lead to health problems. In this study, the residue level of organophosphorus pesticides, and their health risk assessment was evaluated on country bean and bitter gourd. Out of forty analysed samples of the country bean, two samples contained multiple residues, seven samples contained single residue. On the other hand, out of forty samples of bitter gourd, one sample contained multiple residues and three samples contained single residue. Among the organophosphorus pesticides, diazinon was the most frequently detected organophosphorus pesticide in country bean and bitter gourd. The highest short-term risks or acute risk (aHI) was below 1.83%, and the highest long-term risk or chronic risk (HQs) was below 10.46% for the country bean and bitter gourd, respectively. Short- and long-term risk assessment results showed that the intake risks of country bean and bitter gourd were acceptable. The health hazard results showed that country bean and bitter gourd consumption in Cumilla, Bangladesh does not pose an acute or chronic risk to human health. However, a routine monitoring system must be established to control the contamination of vegetables with pesticides.

Dynamic risk for first onset of depressive disorders in adolescence: does change matter?

Background Risk factors for depressive disorders (DD) change substantially over time, but the prognostic value of these changes remains unclear. Two basic types of dynamic effects are possible. The ‘Risk Escalation hypothesis’ posits that worsening of risk levels predicts DD onset above average level of risk factors. Alternatively, the ‘Chronic Risk hypothesis’ posits that the average level rather than change predicts first-onset DD. Methods We utilized data from the ADEPT project, a cohort of 496 girls (baseline age 13.5–15.5 years) from the community followed for 3 years. Participants underwent five waves of assessments for risk factors and diagnostic interviews for DD. For illustration purposes, we selected 16 well-established dynamic risk factors for adolescent depression, such as depressive and anxiety symptoms, personality traits, clinical traits, and social risk factors. We conducted Cox regression analyses with time-varying covariates to predict first DD onset. Results Consistently elevated risk factors (i.e. the mean of multiple waves), but not recent escalation, predicted first-onset DD, consistent with the Chronic Risk hypothesis. This hypothesis was supported across all 16 risk factors. Conclusions Across a range of risk factors, girls who had first-onset DD generally did not experience a sharp increase in risk level shortly before the onset of disorder; rather, for years before onset, they exhibited elevated levels of risk. Our findings suggest that chronicity of risk should be a particular focus in screening high-risk populations to prevent the onset of DDs. In particular, regular monitoring of risk factors in school settings is highly informative.

Tobacco-related risk behaviors among amateur rugby players, coaches and referees: targets for prevention

Background High prevalence of smoking has been documented in France and new patterns of tobacco and nicotine consumption are emerging, especially in some sports. In amateur rugby population, such attitudes could be harmful, but data are scarce as well as their knowledge of the risk. Purpose We analyzed tobacco consumption in French amateur players, coaches and referees. Methods Each amateur players [>12-y/o], coaches and referees licensed in the French Rugby Federation and participating in the Burgundy amateur championship was invited to answer to an electronic anonymous questionnaire during the 2017–2018 sport season. Results 683 [sex ratio M/F = 0.9] answers were obtained and fit for analysis. Among them, 559 (81.8%) were players, 167 (24,5%) were coaches and 74 (10.8%) were referees. 176 subjects (25.8%) were current smokers, 126 (18.4%) daily smokers, 54 (37% of usual smokers) smoked more than 10 cigarettes a day and 97 (14.2%) were ex-smokers. Moreover, 24 referees (32.4%) and 47 coaches (28.2%) were current smokers. Most smoked 2 hours before or after a rugby session (86.4% of smokers), including coaches (89.4%) and referees (89%). Although 109 smokers (61.9%) considered quitting, only 27 (24.8%) considered vaping to aid them. Only 28 subjects (4.1%) usually vaped, of whom 15 daily (1.9%); 21 of them (75%) vaped in the 2 hours before or after a rugby session. Number of cigarettes in the 19 dual users was not different compared with non-vaping smokers. Among the 28 vapers, motivation to vape included lower risk than smoking (13), consider to quit (12), cheaper than smoking (8), festive and socializing (6), avoid to smoke (3), respect the performance (2). Other tobacco or nicotine products were infrequent: waterpipe (7), dry snuff (1) and none used snus. The knowledge about risk was incomplete: 35 (5.1%) subjects do not know that smoking is dangerous for their health and 12 (1.8%) think it is not. 246 (36%) and 195 (28.6%) do not know if smoking is more dangerous in the 2 hours before or after sport; 45 (6.6%) and 18 (2.6%) think it is not. Moreover, 27.5% of coaches were unaware on the risk of smoking before a sport session and 19.2% on the risk after. 244 subjects (35.7%) do not know if vaping is less dangerous than smoking; 272 (39.8%) are not informed of the potential risk of nicotine when vaping. Conclusion Despite information, prevalence of smoking remains high in the French amateur rugby players, coaches and referees. Smokers usually smoke in the 2 hours before or after the sport session. This is dangerous for them and for their peers. The low knowledge about the CV risk is of great concern, especially when considering the coaches and referees considering both their symbolic position and their educational role. Vaping and other patterns of nicotine exposure are infrequent; none of them use snus. Targeted education programs are urgently needed to reduce acute and chronic risk of tobacco consumption in this population. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): CHU Dijon Bourgogne ARS Bourgogne Franche Comté

Environmental Risk of Pesticides for Fish in Small- and Medium-Sized Streams of Switzerland

This study assessed the acute and chronic risk of pesticides, singly and as mixtures, for fish using comprehensive chemical data of four monitoring studies conducted in small- and medium-sized streams of Switzerland between 2012 and 2018. Pesticides were ranked based on single substance risk quotients and relative contribution to mixture risk. Concentrations of the pyrethroid insecticides, λ-cyhalothrin, cypermethrin and deltamethrin, and the fungicides, carbendazim and fenpropimorph, posed acute or chronic single substance risks. Risk quotients of eighteen additional pesticides were equal or greater than 0.1, and thirteen of those contributed ≥30% to mixture risk. Relatively few substances dominated the mixture risk in most water samples, with chronic and acute maximum cumulative ratios never exceeding 5 and 7, respectively. A literature review of toxicity data showed that concentrations of several pesticides detected in Swiss streams were sufficient to cause direct sublethal effects on fish in laboratory studies. Based on the results of our study, we conclude that pesticides detected in Swiss streams, especially pyrethroid insecticides, fungicides and pesticide mixtures, pose a risk to fish health and can cause direct sublethal effects at environmental concentrations. Sensitive life stages of species with highly specialized life history traits may be particularly vulnerable; however, the lack of toxicity data for non-model species currently prevents a conclusive assessment across species.

Cerebral venous thrombosis, neutropenia and iron-deficiency anemia in Huntington disease

Neurologic and nonneurologic manifestations have been shown for Huntington disease (HD) as a genetic neurodegenerative disorder. However, cerebral venous thrombosis (CVT), iron-deficiency anemia and neutropenia have not been reported as its presentations to date. We introduce the first case of a HD patient with CVT, iron-deficiency anemia and neutropenia. All transient and chronic risk factors for development of these manifestations were ruled out. According to the experimental evidences reviewed in this article, we suggest that HD itself could promote formation of CVT, iron-deficiency anemia and neutropenia through vascular and blood cell abnormalities.

Pesticide traces in local crops of Sancti Spíritus, Cuba: risk assessment study

Background Vegetables and rice produced in Cuba may contain residue of pesticides that exceed the maximum residue limits (MRLs). Pesticide residues on crop samples from Sancti Spíritus province were analyzed. Based on these residue data, a risk assessment of consumer exposure was conducted. Methods Samples collected during the 2017, 2018, and 2019 periods were analyzed using UPLC-MS/MS and GC/ECD chromatography techniques. A deterministic risk assessment was performed, using consumption data collected by the authors. Also, a probabilistic risk assessment was worked out with @RISK for the Monte Carlo simulation. Results A broad range of pesticides were detected in the samples. Most of the detected active ingredients were insecticides and fungicides. A considerable part of the detected pesticide residues exceeded the EU and Cuban MRLs. However, the deterministic risk assessment revealed that the consumer risk of pesticide exposure is low. Only in the maximum exposure scenario children and adults were exposed to methamidophos residues in tomatoes higher than the acceptable daily intake. Conclusions When a more realistic consumption (50th percentile) and higher (95th percentile) consumption pattern for tomatoes was assumed, the deterministic risk assessment found no chronic risk for children and adults being exposed to methamidophos present in the tomato samples. Furthermore, the probabilistic risk assessment concerning methamidophos exposure in tomato for children and adult strata showed no risk. To perform in the future a more accurate risk assessment for Cuban consumers it is important to have more detailed consumption data and an expanded dataset of the residues in different crops.

A Rare Case of Double Antibody-Positive Rapidly Progressive Glomerulonephritis: A Therapeutic Challenge

Crescentic glomerulonephritis, also known as rapidly progressive glomerulonephritis, is a syndrome characterized by progressive and rapid deterioration of renal function over the course of weeks to months. Oliguria, hematuria, azotemia, and hypertension are characteristic features of this condition. Crescentic glomerulonephritis is further classified according to the staining pattern on immunofluorescence. In rare instances, a mixed pattern of injury is encountered as in the case of double antibody-positive rapidly progressive glomerulonephritis (RPGN). This case illustrates the challenge in treatment of double antibody-positive RPGN in an elderly female with no previous renal disease. The patient was found to be positive for anti-GBM antibody and MPO-ANCA. Treatment was initially targeted against MPO-ANCA as the biopsy was most consistent with this process; however, the patient failed to respond to treatment and was subsequently transitioned to oral cyclophosphamide directed against anti-GBM disease. In cases of doubly antibody-positive RPGN with anti-GBM disease and ANCA-associated vasculitis, initial treatment should focus on inducing remission of anti-GBM disease as double antibody-positive disease often presents with the aggressive morbidity and mortality seen in anti-GBM disease, and the chronic risk of relapse seen in ANCA-mediated vasculitis.

Combination of biomarker with clinical risk factors for prediction of severe acute kidney injury in critically ill patients

Background: Acute kidney injury (AKI) occurs commonly in the intensive care unit (ICU). Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinase-2 (TIMP-2), known as [TIMP-2] x [IGFBP7] (NephroCheck), have been identified as novel biomarkers for the prediction of AKI risk. However, the effective use of disease biomarkers is indispensable from an appropriate clinical context. We conducted a retrospective cohort study to find risk factors and assess the performance of the combination of NephroCheck with risk factors, so as to provide feasible information for AKI prediction.Methods: All patients who were admitted in the ICU ( from June 2016 to July 2017) participated in the study. The primary outcome was the detection of severe AKI within the first seven days after patients being admitted to the ICU. The predictors were separated into three categories: chronic risk factors, acute risk factors and biochemical indicators. Results: The study included 577 patients. 96 patients developed to severe AKI (16.6%) within seven days. In addition to NephroCheck (+) (OR=2.139, 95% CI (1.260-3.630), P =0.005), age >65 years (OR=1.961, 95% CI (1.153-3.336), P=0.013), CKD (OR=2.573, 95% CI (1.319-5.018), P=0.006) and PCT (+)(OR=3.223, 95% CI (1.643-6.321), P=0.001) were also the independent predictors of severe AKI within seven days. Compared to NephroCheck (+) only (AUC=0.66, 95% CI:0.60-0.72), the combination of NephroCheck (+) and risk factors (age>65years, CKD and PCT positive) (AUC=0.75, 95% CI:0.70-0.81) led to a significant increase in the area under ROC curve for severe AKI prediction within seven days.Conclusions: Although NephroCheck is an effective screening tool for recognizing high-risk patients, we found that combination with biomarker and risk factors (age>65years, CKD, procalcitonin positive) for risk assessment of AKI has the greatest significance to patients with uncertain disease trajectories.

Combination of biomarker with clinical risk factors for prediction of severe acute kidney injury in critically ill patients

Background Acute kidney injury (AKI) occurs commonly in the intensive care unit (ICU). Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinase-2 (TIMP-2), known as [TIMP-2] x [IGFBP7] (NephroCheck), have been identified as novel biomarkers for the prediction of AKI risk. However, the effective use of disease biomarkers is indispensable from an appropriate clinical context. We conducted a retrospective cohort study to find risk factors and assess the performance of the combination of NephroCheck with risk factors, so as to provide feasible information for AKI prediction. Methods All patients who were admitted in the ICU (from June 2016 to July 2017) participated in the study. The primary outcome was the detection of severe AKI within the first 7 days after patients being admitted to the ICU. The predictors were separated into three categories: chronic risk factors, acute risk factors and biochemical indicators. Results The study included 577 patients. 96 patients developed to severe AKI (16.6%) within 7 days. In addition to NephroCheck (+) (OR = 2.139, 95% CI (1.260–3.630), P = 0.005), age > 65 years (OR = 1.961, 95% CI (1.153–3.336), P = 0.013), CKD (OR = 2.573, 95% CI (1.319–5.018), P = 0.006) and PCT (+)(OR = 3.223, 95% CI (1.643–6.321), P = 0.001) were also the independent predictors of severe AKI within 7 days. Compared to NephroCheck (+) only (AUC = 0.66, 95% CI:0.60–0.72), the combination of NephroCheck (+) and risk factors (age > 65 years, CKD and PCT positive) (AUC = 0.75, 95% CI:0.70–0.81) led to a significant increase in the area under ROC curve for severe AKI prediction within 7 days. Conclusions Although NephroCheck is an effective screening tool for recognizing high-risk patients, we found that combination with biomarker and risk factors (age > 65 years, CKD, procalcitonin positive) for risk assessment of AKI has the greatest significance to patients with uncertain disease trajectories.