Late Quaternary history of the Vakinankaratra volcanic field (central Madagascar): insights from luminescence dating of phreatomagmatic eruption deposits

The Quaternary Vakinankaratra volcanic field in the central Madagascar highlands consists of scoria cones, lava flows, tuff rings, and maars. These volcanic landforms are the result of processes triggered by intracontinental rifting and overlie Precambrian basement or Neogene volcanic rocks. Infrared-stimulated luminescence (IRSL) dating was applied to 13 samples taken from phreatomagmatic eruption deposits in the Antsirabe–Betafo region with the aim of constraining the chronology of the volcanic activity. Establishing such a chronology is important for evaluating volcanic hazards in this densely populated area. Stratigraphic correlations of eruption deposits and IRSL ages suggest at least five phreatomagmatic eruption events in Late Pleistocene times. In the Lake Andraikiba region, two such eruption layers can be clearly distinguished. The older one yields ages between 109 ± 15 and 90 ± 11 ka and is possibly related to an eruption at the Amboniloha volcanic complex to the north. The younger one gives ages between 58 ± 4 and 47 ± 7 ka and is clearly related to the phreatomagmatic eruption that formed Lake Andraikiba. IRSL ages of a similar eruption deposit directly overlying basement laterite in the vicinity of the Fizinana and Ampasamihaiky volcanic complexes yield coherent ages of 68 ± 7 and 65 ± 8 ka. These ages provide the upper age limit for the subsequently developed Iavoko, Antsifotra, and Fizinana scoria cones and their associated lava flows. Two phreatomagmatic deposits, identified near Lake Tritrivakely, yield the youngest IRSL ages in the region, with respective ages of 32 ± 3 and 19 ± 2 ka. The reported K-feldspar IRSL ages are the first recorded numerical ages of phreatomagmatic eruption deposits in Madagascar, and our results confirm the huge potential of this dating approach for reconstructing the volcanic activity of Late Pleistocene to Holocene volcanic provinces.

Volcanostratigraphic Controls on the Occurrence of Massive Sulfide (VMS) Deposits in the Semail Ophiolite, Oman

The Semail ophiolite in Oman is capped by up to 2 km of basaltic-andesitic lavas that host copper-dominant, Cyprus-type, volcanogenic massive sulfide (VMS) deposits. This study identifies multiple volcanostratigraphic horizons on which the deposits are situated, based on characterization of footwall and hanging-wall lavas from 16 deposits or deposit clusters. Comparison of field and petrographic features, compositions of igneous clinopyroxenes, and whole-rock geochemical signatures permits classification of the lavas within a modified version of the established regional volcanostratigraphy. Four extrusive units host deposits: Geotimes (earliest), Lasail, Alley, and Boninitic Alley (latest). The latter was previously known only at few localities, but this study reveals its regional extent and significance as a host for VMS deposits. The Geotimes and Lasail units represent Late Cretaceous, ocean spreading ridge and related off-axis volcanic environments, respectively. The Alley and Boninitic Alley units represent younger, subduction-related volcanism prior to Coniacian-Santonian obduction of the ophiolite. Our results show that VMS deposits occur on or near the Geotimes/Lasail and Geotimes/Alley contacts as well as entirely within the Geotimes, Lasail, Alley, and Boninitic Alley units. Highest Cu grades tend to occur in deposits lying on or within the Geotimes, whereas highest Au grades occur in deposits within the Boninitic Alley. In contrast to earlier studies, we conclude that essentially every horizon marking a hiatus in lava deposition in the Semail ophiolite, i.e., contacts between the four major eruptive units, and umbers and sedimentary chert layers within the units, has exploration potential for Cu-Au VMS deposits.

Microscale mapping of alteration conditions and potential biosignatures in basaltic-ultramafic rocks on early Earth and beyond

Subseafloor environments preserved in Archean greenstone belts provide an analogue for investigating potential subsurface habitats on Mars. The c. 3.5-3.4 Ga pillow lava metabasalts of the mid-Archean Barberton greenstone belt, South Africa, have been argued to contain the earliest evidence for microbial subseafloor life. This includes candidate trace fossils in the form of titanite microtextures, and sulfur isotopic signatures of pyrite preserved in metabasaltic glass of the c. 3.472 Ga Hooggenoeg Formation. It has been contended that similar microtextures in altered martian basalts may represent potential extraterrestrial biosignatures of microbe-fluid-rock interaction. But despite numerous studies describing these putative early traces of life, a detailed metamorphic characterization of the microtextures and their host alteration conditions in the ancient pillow lava metabasites is lacking. Here, we present a new nondestructive technique with which to study the in situ metamorphic alteration conditions associated with potential biosignatures in mafic-ultramafic rocks of the Hooggenoeg Formation. Our approach combines quantitative microscale compositional mapping by electron microprobe with inverse thermodynamic modeling to derive low-temperature chlorite crystallization conditions. We found that the titanite microtextures formed under subgreenschist to greenschist facies conditions. Two chlorite temperature groups were identified in the maps surrounding the titanite microtextures and record peak metamorphic conditions at 315 ± 40°C (XFe3+(chlorite) = 25-34%) and lower-temperature chlorite veins/microdomains at T = 210 ± 40°C (lower XFe3+(chlorite) = 40-45%). These results provide the first metamorphic constraints in textural context on the Barberton titanite microtextures and thereby improve our understanding of the local preservation conditions of these potential biosignatures. We suggest that this approach may prove to be an important tool in future studies to assess the biogenicity of these earliest candidate traces of life on Earth. Furthermore, we propose that this mapping approach could also be used to investigate altered mafic-ultramafic extraterrestrial samples containing candidate biosignatures.

Risk Behavior and Reciprocity of Organ Donation Attitudes in Young Men

Background Lack of donor organs remains a major obstacle in organ transplantation. Our aim was to evaluate (1) the association between engaging in high-risk recreational activities and attitudes toward organ donation and (2) the degree of reciprocity between organ acceptance and donation willingness in young men. Methods A 17-item, close-ended survey was offered to male conscripts ages 18 to 26 years in all Swiss military conscription centers. Predictors of organ donation attitudes were assessed in bivariate analyses and multiple logistic regression. Reciprocity of the intentions to accept and to donate organs was assessed by means of donor card status. Results In 1559 responses analyzed, neither motorcycling nor practicing extreme sports reached significant association with donor card holder status. Family communication about organ donation, student, or academic profession and living in a Latin linguistic region were predictors of positive organ donation attitudes, whereas residence in a German-speaking region and practicing any religion predicted reluctance. Significantly more respondents were willing to accept than to donate organs, especially among those without family communication concerning organ donation. Conclusions For the first time, it was shown that high-risk recreational activities do not influence organ donation attitudes. Second, a considerable discrepancy in organ donation reciprocity was identified. We propose that increasing this reciprocity could eventually increase organ donation rates.

Findings in uteri and ovaries from Eringer cows, slaughtered due to fertility problems

Eringer cows are often slaughtered due to fertility problems which result from inflammatory and degenerative changes of the uterus or hormonal imbalances. Twenty-one genital tracts from Eringer cows suffering from fertility problems were collected in the abattoir. The purpose of the study was the macroscopic evaluation of the ovaries and the uterus followed by a histological and microbiological analysis of the uterus. Data from inseminations and calvings were provided by the Eringer breeding association and through the internet portal www.agate.ch. Median age of the cows was 6.9 years, number of calves per cow was 2.5 and median period between last calving and slaughter was 1.5 years. In 13 from 21 of the urogenital tracts examined, macroscopic abnormalities of the ovaries and/or histologic or microbiologic findings in the uterus could explain fertility-associated slaughter.

Dentinhaftkraft zweier neuer CAD/CAM-Materialien in Abhängigkeit verschiedener adhäsiver Zementsysteme

Zielsetzung: Ziel der Studie war die Bestimmung der Dentinhaftkraft von zwei so-genannten Hybridmaterialien für computer-aided design/computer-aided manufacturing (CAD/CAM) Restaurationen unter Anwendung von fünf verschiedenen Zementen vor und nach sechsmonatiger Lagerung. Materialien und Methoden: Aus extrahierten menschlichen Molaren wurden 300 Dentinprobekörper hergestellt (n=15 pro Gruppe; 10 Gruppen (2 Hybridkeramiken, 5 Zemente) je nach 24 h/nach sechsmonatiger Lagerung). Aus Hybridkeramikblöcken von Lava Ultimate (3M ESPE) und VITA ENAMIC (VITA Zahnfabrik) wurden Zylinder hergestellt, welche standardisiert aufgeraut wurden. Anschliessend wurden die Hybrid-keramikzylinder mit einem der folgenden fünf Zemente auf die Dentinprobekörper zementiert: mit den Kompositzementen RelyX Ultimate (3M ESPE), PANAVIA F2.0 (Kuraray), Variolink II (Ivoclar Vivadent), els cem (Saremco Dental AG) oder als Negativkontrollgruppe mit dem kunststoffmodifizierten Glasionomerzement Ketac Cem Plus (3M ESPE). Die Dentinhaftkraft der Hybridkeramikzylinder wurde einerseits nach 24 h und andererseits nach sechsmonatiger Lagerung via Scherkrafttest bestimmt. Nach dem Scherkrafttest wurde das Bruchmuster unter einem Lichtmikroskop bei 40-facher Vergrösserung beurteilt. Die Dentinhaftkraftwerte wurden mittels nichtparametrischer ANOVA gefolgt von exakten Wilcoxon Rangsummen-Tests statistisch analysiert (α=0,05). Die Beurteilung des Bruchmusters wurde deskriptiv ausgewertet. Resultate: Für die Hybridkeramik Lava Ultimate und nach 24 h erzielten die Kompositzemente RelyX Ultimate und Variolink II die höchsten Dentinhaftkraftwerte. Die Dentinhaftkraftwerte von RelyX Ultimate und Variolink II unterschieden sich nicht signifikant. Die Dentinhaftkraftwerte von PANAVIA F2.0 unterschieden sich ebenfalls nicht signifikant von denjenigen von RelyX Ultimate, waren jedoch signifikant tiefer als diejenigen von Variolink II. Unter allen Kompositzementen erzielte els cem die tiefsten Dentinhaftkraftwerte. Nach sechsmonatiger Lagerung waren die Dentinhaftkraftwerte für RelyX Ultimate die höchsten, gefolgt von Variolink II, von els cem und anschliessend von PANAVIA F2.0, welcher nach sechsmonatiger Lagerung die tiefsten Dentinhaftkraftwerte der Kompositzemente zeigte. Der kunststoffmodifizierte Glasionomerzement Ketac Cem Plus zeigte sowohl nach 24 h als auch nach sechsmonatiger Lagerung die tiefsten Dentinhaftkraftwerte. Für VITA ENAMIC war die Reihenfolge der Zemente nach Dentinhaftkraft nach 24 h ähnlich wie diejenige nach sechsmonatiger Lagerung: Die Dentinhaftkraft war für RelyX Ultimate und Variolink II am höchsten, gefolgt von PANAVIA F2.0, von els cem und schlussendlich von Ketac Cem Plus mit den tiefsten Dentinhaftkraftwerten. Nach 24 h und für alle fünf Zemente unterschieden sich die Dentinhaftkraftwerte zwischen Lava Ultimate und VITA ENAMIC nicht signifikant. Nach sechsmonatiger Lagerung unterschieden sich die Dentinhaftkraftwerte zwischen Lava Ultimate und VITA ENAMIC ebenfalls nicht signifikant für RelyX Ultimate und els cem im Gegensatz zu den Dentinhaftkraftwerten von PANAVIA F2.0, Variolink II und Ketac Cem Plus, welche signifikant tiefer waren für Lava Ultimate als für VITA ENAMIC. Das häufigste Bruch-muster war für Lava Ultimate nach 24 h und für VITA ENAMIC sowohl nach 24 h als auch nach sechsmonatiger Lagerung adhäsiv zwischen Dentin und Zement. Nach sechs-monatiger Lagerung war für Lava Ultimate das häufigste Bruchmuster tendenziell gemischte Brüche. Schlussfolgerung: Basierend auf den Resultaten kann gesagt werden, dass für beide Hybridkeramiken sowohl RelyX Ultimate als auch Variolink II empfohlen werden können. PANAVIA F2.0 kann für VITA ENAMIC empfohlen werden, für Lava Ultimate allerdings weniger, da die Dentinhaftkraft nach sechsmonatiger Lagerung abnahm. Von einer konventionellen (allerdings nicht indizierten und in dieser Studie experimentellen) Zemen-tierung der beiden Hybridkeramiken mit dem kunststoffmodifizierten Glasionomerzement Ketac Cem Plus muss abgeraten werden.

Einfluss von Politursystemen auf Oberflächenrauigkeit und mechanische Eigenschaften von CAD/CAM-Materialien

Zielsetzung: Das Ziel dieser Studie war, den Einfluss von drei Politursystemen auf die Oberflächenrauigkeit von verschiedenen Materialien für computer-aided design/computer-aided manufacturing (CAD/CAM) Restaurationen mittels Profilometrie sowie die mikromechanischen Eigenschaften der Materialien mittels Mikrohärtemessgerät zu analysieren. Materialien und Methoden: Von dem CAD/CAM-Kompositmaterial Paradigm MZ100 (3M ESPE), der CAD/CAM-Feldspatkeramik VITABLOCS Mark II (VITA Zahnfabrik) und den CAD/CAM-Hybridmaterialien Lava Ultimate (3M ESPE), VITA ENAMIC (VITA Zahnfabrik) und AMBARINO High-Class (Creamed) wurden je 60 Prüfkörper zugeschnitten, gekennzeichnet und standardisiert aufgerauht. Die standardisierte Aufrauhung wurde mit Baseline-Rauigkeitsmessungen überprüft (Ra und Rz; µm). Die Prüfkörper wurden mit einem von drei Politursystemen poliert (n=20 pro CAD/CAM-Material): 1) Sof-Lex Scheiben (Disc-System, 3 Politurschritte: medium, fein und superfein; 3M ESPE), 2) VITA Polishing Set Clinical (Silikonpolitursystem, 2 Politurschritte: medium und fein; VITA Zahnfabrik) oder 3) KENDA Nobilis (Silikonpolierer, 1 Politurschritt (universal); KENDA Dental). Nach Politur der Prüfkörper wurden Ra und Rz sowie die mikromechanischen Eigenschaften Oberflächenhärte (VHN; Vickers Härte) und Elastizitätsmodul (EM; GPa) gemessen. In den darauf folgenden sechs Monaten wurden die Prüfkörper in Leitungswasser gelagert und insgesamt sechs Mal einem maschinellem Zahnbürsten zugeführt. Anschliessend wurden erneut Ra und Rz sowie VHN und EM gemessen. Ra-, Rz-, VHN- und EM-Werte wurden mittels nichtparametrischer ANOVA global analysiert und die p-Werte mittels Bonferroni-Holm Korrektur für multiples Testen korrigiert. Als post-hoc Tests wurden Kruskal-Wallis-Tests sowie exakte Wilcoxon Rangsummen-Tests verwendet und die p-Werte wurden nicht korrigiert. Das Signifikanzniveau wurde auf α=0,05 festgelegt. Resultate: Für alle drei CAD/CAM-Hybridmaterialien ergaben Sof-Lex Scheiben nach der Politur die tiefste Oberflächenrauigkeit (d. h. die tiefsten Ra- und Rz-Werte), gefolgt von KENDA Nobilis und von dem VITA Polishing Set Clinical. Bei dem CAD/CAM-Kompositmaterial sowie bei der CAD/CAM-Feldspatkeramik ergaben Sof-Lex Scheiben und KENDA Nobilis ähnliche Resultate, gefolgt von dem VITA Polishing Set Clinical. Bei einigen CAD/CAM-Materialien zeigten sich – zum Teil in Abhängigkeit des Politursystems – nach maschinellem Zahnbürsten und Lagerung signifikant höhere Ra- und Rz-Werte. Die CAD/CAM-Materialien zeigten unabhängig des Politursystems und der Lagerung signifikant verschiedene VHN- und EM-Werte. Bei einigen CAD/CAM-Materialien zeigten sich – zum Teil ebenfalls in Abhängigkeit des Politursystems – nach maschinellem Zahn-bürsten und Lagerung signifikant tiefere VHN- und EM-Werte. Schlussfolgerungen: Die Wahl des Politursystems beeinflusste die Oberflächenrauigkeit der CAD/CAM-Materialien markant, wobei Sof-Lex Scheiben insgesamt die besten Politurresultate zeigten, gefolgt von dem Silikonpolierer KENDA Nobilis. Von der Verwendung des Silikonpolitursystems VITA Polishing Set Clinical muss eher abgeraten werden. Das CAD/CAM-Kompositmaterial Paradigm MZ100 und die CAD/CAM-Hybridmaterialien Lava Ultimate und AMBARINO High-Class als weichere und elastischere Materialien liessen sich insgesamt besser polieren, waren aber bezüglich mechanischer Eigenschaften anfälliger auf Lagerung als die härtere CAD/CAM-Feldspatkeramik VITABLOCS Mark II und das CAD/CAM-Hybridmaterial VITA ENAMIC.

Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors.

In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist. The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies. An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function. Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors. Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists. In conclusion, proton-pump inhibitors may cause hypomagnesemia. In these cases, switching to a histamine type-2 receptor antagonist is advised.

Unusual Eruptions Associated with Mycoplasma pneumoniae Respiratory Infections: Review of the Literature.

BACKGROUND Maculopapular or urticarial eruptions and erythema multiforme sometimes occur in patients affected with Mycoplasma pneumoniae respiratory infections. Further eruptions have also been reported. OBJECTIVE To review the literature addressing M. pneumoniae respiratory infection and rather unusual eruptions. METHODS Computer-based search in the U.S. National Library of Medicine database as well as in the search engine Google. RESULTS We found a possible relationship between M. pneumoniae infection and Fuchs' syndrome (n = 37), varicella-like eruptions (n = 8), Henoch-Schönlein syndrome and further leukocytoclastic vasculitides (n = 21) and erythema nodosum (n = 11). A temporal relationship was also observed with 2 cases of Gianotti-Crosti syndrome. Finally, there exists reasonable evidence that pityriasis rosea Gibert and pityriasis lichenoides et varioliformis acuta Mucha-Habermann are not associated with Mycoplasma infections. CONCLUSION This review implies that M. pneumoniae may cause, in addition to erythematous maculopapular (or urticarial) eruptions and erythema multiforme, Fuchs' syndrome and varicella-like eruptions. Furthermore, there is an intriguing link with leukocytoclastic vasculitides or erythema nodosum that deserves further investigation.

The great fluid debate: saline or so-called "balanced" salt solutions?

BACKGROUND Intravenous fluids are commonly prescribed in childhood. 0.9 % saline is the most-used fluid in pediatrics as resuscitation or maintenance solution. Experimental studies and observations in adults suggest that 0.9 % saline is a poor candidate for fluid resuscitation. Although anesthesiologists, intensive care specialists, perioperative physicians and nephrologists have been the most active in this debate, this issue deserves some physiopathological considerations also among pediatricians. RESULTS As compared with so-called "balanced" salt crystalloids such as lactated Ringer, administration of large volumes of 0.9 % saline has been associated with following deleterious effects: tendency to hyperchloremic metabolic acidosis (called dilution acidosis); acute kidney injury with reduced urine output and salt retention; damaged vascular permeability and stiffness, increase in proinflammatory mediators; detrimental effect on coagulation with tendency to blood loss; detrimental gastrointestinal perfusion and function; possible uneasiness at the bedside resulting in unnecessary administration of more fluids. Nevertheless, there is no firm evidence that these adverse effects are clinically relevant. CONCLUSIONS Intravenous fluid therapy is a medicine like insulin, chemotherapy or antibiotics. Prescribing fluids should fit the child's history and condition, consider the right dose at the right rate as well as the electrolyte levels and other laboratory variables. It is unlikely that a single type of fluid will be suitable for all pediatric patients. "Balanced" salt crystalloids, although more expensive, should be preferred for volume resuscitation, maintenance and perioperatively. Lactated Ringer appears unsuitable for patients at risk for brain edema and for those with overt or latent chloride-deficiency. Finally, in pediatrics there is a need for new fluids to be developed on the basis of a better understanding of the physiology and to be tested in well-designed trials.

Italo-Swiss "Chalk and blackboard interactive 2-day workshop"-participants feedback

Ten "chalk and blackboard interactive workshops" have taken place between 2011 and 2015 in Southern Switzerland or Italy. Students, residents and expert pediatricians meet during 2 days and discuss 10-15 cases. Pediatricians promote reasoning, provide supporting information and correct statements. Emphasis is placed on history taking and examination, and on all participants being involved in a stimulating atmosphere. Thirty-seven participants were asked, ≥3 months after workshop-completion, to evaluate the workshop and a recent teaching session. Thirty answered and scored the workshop as excellent (N = 24) or above average (N = 6). The scores assigned to the workshop were higher (P < 0.001) than those assigned to the lecture-based teaching.

Gallbladder and Pancreas in Henoch-Schönlein Purpura: Review of the Literature

OBJECTIVE Involvement of the pancreato-biliary system has been occasionally noted in Henoch-Schönlein purpura. Furthermore, cases of this vasculitis syndrome sometimes develop in the context of a viral hepatitis or after hepatitis vaccination. METHODS We completed a review of the literature. RESULTS Fifty reports published between 1977 and 2015 were retained for the analysis. A pancreato-biliary involvement was recognized in 34 individually well-described patients (♂:♀ = 19:15) with severe abdominal pain: pancreatitis (N = 20), acalculous cholecystitis (N = 11), both pancreatitis and cholecystitis (N = 3). In all of the pancreatitis patients, full recovery occurred (within ≤3 weeks in three-fourths of the patients). Cholecystectomy was performed in 8 cholecystitis patients. Seventeen Henoch-Schönlein patients (♂:♀ = 9:8) were associated with a viral liver disease and 4 (♂:♀ = 1:3) with a hepatitis vaccination. The vasculitis syndrome rapidly remitted in the 7 patients accompanying hepatitis A or E, in 2 patients of hepatitis B, and in the 4 patients preceded by a vaccination. Henoch-Schönlein purpura seemed to be serious in 5 patients with chronic hepatitis B and in 3 with chronic hepatitis C. CONCLUSIONS This analysis indicates that pancreato-biliary involvement is unusual in Henoch-Schönlein purpura. This complication deserves consideration in patients with especially severe abdominal pain. Finally, viral hepatitides and hepatitis vaccinations seem to be rare triggers of Henoch-Schönlein purpura.

Breastfeeding-Associated Hypernatremia: A Systematic Review of the Literature.

There are increasing reports on hypernatremia, a potentially devastating condition, in exclusively breastfed newborn infants. Our purposes were to describe the clinical features of the condition and identify the risk factors for it. We performed a review of the existing literature in the National Library of Medicine database and in the search engine Google Scholar. A total of 115 reports were included in the final analysis. Breastfeeding-associated neonatal hypernatremia was recognized in infants who were ≤ 21 days of age and had ≥ 10% weight loss of birth weight. Cesarean delivery, primiparity, breast anomalies or breastfeeding problems, excessive prepregnancy maternal weight, delayed first breastfeeding, lack of previous breastfeeding experience, and low maternal education level were significantly associated with breastfeeding-associated hypernatremia. In addition to excessive weight loss (≥ 10%), the following clinical findings were observed: poor feeding, poor hydration state, jaundice, excessive body temperature, irritability or lethargy, decreased urine output, and epileptic seizures. In conclusion, the present survey of the literature identifies the following risk factors for breastfeeding-associated neonatal hypernatremia: cesarean delivery, primiparity, breastfeeding problems, excessive maternal body weight, delayed breastfeeding, lack of previous breastfeeding experience, and low maternal education level.

Acute hemorrhagic edema of young children: a prospective case series.

Acute hemorrhagic edema of young children is a rare leukocytoclastic vasculitis that has been reported exclusively in small retrospective cases series, case reports, or quizzes. Considering that retrospective experience deserves confirmation in at least one observational prospective study, we present our experience with 16 children (12 boys and 4 girls, 5-28 months of age) affected by acute hemorrhagic edema. The patients were in good general conditions and with a low-grade or even absent fever. They presented with non-itching red to purpuric targetoid lesions not changing location within hours, with non-pitting and sometimes tender indurative swelling, and without mucous membrane involvement or scratch marks. Signs for articular, abdominal, or kidney involvement were absent. Antinuclear or antineutrophil cytoplasmic autoantibodies were never detected. The cases were managed symptomatically as outpatients and fully resolved within 4 weeks or less. No recurrence or familiarity was noted. CONCLUSION This is the first prospective evaluation of hemorrhagic edema. Our findings emphasize its distinctive tetrad: a well-appearing child; targetoid lesions that do not change location within hours; non-pitting, sometimes tender edema; complete resolution without recurrence. What is known • Acute hemorrhagic edema of young children is considered a benign vasculitis. • There have been ≈100 cases reported in small retrospective case series. What is new • The first prospective evaluation of this condition emphasizes its features: febrile prodrome; well-appearing child; targetoid lesions not changing location within hours; non-pitting, sometimes tender indurative edema; absent extracutaneous involvement; resolution within 3 weeks. • Antineutrophil cytoplasmic autoantibodies do not play a pathogenic role.