Epidemiology of Acute Lung Injury and Acute Respiratory Distress Syndrome in children in Vietnam

Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) are life- threatening disorders that can result from many severe conditions and diseases. Since the American European Consensus Conference established the internationally accepted definition of ALI and ARDS, the epidemiology of pediatric ALI/ARDS has been described in some developed countries. In the developing world, however, there are very few data available regarding the burden, etiologies, management, outcome, and factors associated with outcomes of ALI/ARDS in children. ^ Therefore, we conducted this observational, clinical study to estimate the prevalence and case mortality rate of ALI/ARDS among a cohort of patients admitted to the pediatric intensive care unit (PICU) of the National Hospital of Pediatrics in Hanoi, the largest children's hospital in Vietnam. Etiologies and predisposing factors, and management strategies for pediatric ALI/ARDS were described. In addition, we determined the prevalence of HIV infection among children with ALI/ARDS in Vietnam. We also identified the causes of mortality and predictors of mortality and prolonged mechanical ventilation of children with ALI/ARDS. ^ A total of 1,051 patients consecutively admitted to the pediatric intensive care unit from January 2011 to January 2012 were screened daily for development of ALI/ARDS using the American-European Consensus Conference Guidelines. All identified patients with ALI/ARDS were followed until hospital discharge or death in the hospital. Patients' demographic and clinical data were collected. Multivariable logistic regression models were developed to identify independent predictors of mortality and other adverse outcome of ALI/ARDS. ^ Prevalence of ALI and ARDS was 9.6% (95% confidence interval, 7.8% to 11.4%) and 8.8% (95% confidence interval, 7.0% to 10.5%) of total PICU admissions, respectively. Infectious pneumonia and sepsis were the most common causes of ALI/ARDS accounting for 60.4% and 26.7% of cases, respectively. Prevalence of HIV infection among children with ALI/ARDS was 3.0%. The case fatality rate of ALI/ARDS was 63.4% (95% confidence interval, 53.8% to 72.9%). Multiple organ failure and refractory hypoxemia were the main causes of death. Independent predictors of mortality and prolonged mechanical ventilation were male gender, duration of intensive care stay prior to ALI/ARDS diagnosis, level of oxygenation defect measured by PaO2/FiO2 ratio at ALI/ARDS diagnosis, presence of non-pulmonary organ dysfunction at day one and day three after ALI/ARDS diagnosis, and presence of hospital acquired infection. ^ The results of this study demonstrated that ALI/ARDS was a common and severe condition in children in Vietnam. The level of both pulmonary and non-pulmonary organ damage influenced survival of patients with ALI/ARDS. Strategies for preventing ALI/ARDS and for clinical management of the disease are necessary to reduce the associated risks.^

Clostridium difficile infection (CDI) in HIV-positive patients

The main aim of this study was to look at the association of Clostridium difficile infection (CDI) and HIV. A secondary goal was to look at the trend of CDI-related deaths in Texas from 1999-2011. To evaluate the coinfection of CDI and HIV, we looked at 2 datasets provided by CHS-TDSHS, for 13 years of study period from 1999-2011: 1) Texas death certificate data and 2) Texas hospital discharge data. An ancillary source of data was national level death data from CDC. We did a secondary data analysis and reported the age-adjusted death rates (mortality) and hospital discharge frequencies (morbidity) for CDI, HIV and for CDI+HIV coinfection.^ Since the turn of the century, CDI has reemerged as an important public health challenge due to the emergence of hypervirulent epidemic strains. From 1999-2011, there has been a significant upward trend in CDI-related death rates; in the state of Texas alone, CDI mortality rate has increased 8.7 fold in this time period at the rate of 0.2 deaths per year per 100,000 individuals. On the contrary, mortality due to HIV has decreased by 46% and has been trending down. The demographic groups in Texas with the highest CDI mortality rates were elderly aged 65+, males, whites and hospital inpatients. The epidemiology of C. difficile has changed in such a way that it is not only staying confined to these traditional high-risk groups, but is also being increasingly reported in low-risk populations such as healthy people in the community (community acquired C. difficile), and most recently immunocompromised patients. Among the latter, HIV can worsen the adverse health outcomes of CDI and vice versa. In patients with CDI and HIV coinfection, higher mortality and morbidity was found in young & middle-aged adults, blacks and males, the same demographic population that is at higher risk for HIV. As with typical CDI, the coinfection was concentrated in the hospital inpatients. Of all the CDI-related deaths in USA from 1999-2010, in the 25-44 year age group, 13% had HIV infection. Of all CDI-related inpatient hospital discharges in Texas from 1999-2011, in patients 44 years and younger, 17% had concomitant HIV infection. Therefore, HIV is a possible novel emerging risk factor for CDI.^

Phytoplankton parameters in the Large Aral Sea in June 2008

Species composition, abundance, and biomass of phytoplankton in the surface water layer were determined at 10 stations in the central part of the Western Basin (WB) and at one station in the Eastern Basin (EB) of the Large Aral Sea. 42 algal species were found. Diatoms had the highest number of species. Similarity of phytoplankton composition in the WB was high, whereas phytoplankton composition in the WB and EB differed significantly. In WB abundance and biomass of phytoplankton varied from 826x10**3 to 6312x10**3 cells/l (aver. 1877x10**3 cells/l) and from 53 to 241 ?g C/l (aver. 95 ?g C/l). In EB the phytoplankton abundance was 915x10**3 cells/l and 93 ?g C/l. Vertical distribution of phytoplankton in upper 35 m was investigated at one station in WB. Maximum values of phytoplankton abundance and biomass were recorded under the thermocline at 20 m depth. Integrated biomass of phytoplankton was 14 g C/m**2.

Concentration of organic compounds in slush, under-ice water, and the snow-ice fast-ice cover of the southeast sector of the Antarctic in April 2008

Data are presented on concentration of hydrocarbons (HC) relative to concentrations of suspended matter, lipids, organic carbon, and chlorophyll a in surface waters and snow-ice cover of the East Antarctic coastal areas. It was shown that growth of concentrations of aliphatic HC (AHC) to 30 µg/l in surface waters takes place in frontal zones and under young ice formation. AHC concentration in snow increases with growth of aerosol concentration in the atmosphere. In the lower part of ice, at the boundary with seawater, despite low temperatures, autochthonous processes may provide high AHC concentrations (up to 289 µg/l). Within the snow-ice cover on fast ice, concentration co-variations of all the compounds considered take place.

Rocks of the Western Kamchatka-Koryak continental margin volcanogenic belt: age, chemical and mineral compositions

An isotope-geochemical study of Eocene-Oligocene magmatic rocks from the Western Kamchatka-Koryak volcanogenic belt revealed lateral heterogeneity of mantle magma sources in its segments: Western Kamchatka, Central Koryak, and Northern Koryak ones. In the Western Kamchatka segment magmatic melts were generated from isotopically heterogeneous (depleted and/or insignificantly enriched) mantle sources significantly contaminated by quartz-feldspathic sialic sediments; higher 87Sr/86Sr (0.70429-0.70564) and lower 143Nd/144Nd [eNd(T) = 0.06-2.9] ratios in volcanic rocks from the Central Koryak segment presumably reflect contribution of an enriched mantle source; high positive eNd(T) and low 87Sr/86Sr ratios in magmatic rocks from the Northern Koryak segment area indicate their derivation from an isotopically depleted mantle source without significant contamination by sialic or mantle material enriched in radiogenic Sr and Nd. Significantly different contamination histories of Eocene-Oligocene mantle magmas in Kamchatka and Koryakia are related to their different thermal regimes: higher heat flow beneath Kamchatka led to crustal melting and contamination of mantle suprasubduction magmas by crustal melts. Cessation of suprasubduction volcanism in the Western Kamchatka segment of the continental margin belt was possibly related to accretion of the Achaivayam-Valagin terrane 40 Ma ago, whereas suprasubduction activity in the Koryak segment stopped due to closure of the Ukelayat basin in Oligocene.

Phytoplankton of the southwest Kara Sea on August 9-12, 2007

A research was carried out along a transect from the Yamal Peninsula coast towards the outer shelf of the southwestern the Kara Sea in September 2007. 130 phytoplankton species were identified, among which 63 were found in the area for the first time. Total phytoplankton abundance varied from of 0.2 x10**9 to 11.3x10**9 cells/m**2, while biomass from 43 to 1057 mgC/m**2. A well pronounced cross-shelf zoning in phytoplankton communities was ascertained. The inner shelf zone about 30 km wide with depths down to 30 meters was characterized by predominance of diatoms (up to 80% of total algal abundance and biomass). The second group by value was dinoflagellates. Seaward in the area of depth increase from 30 to 140 m, the zone of the Yamal Current was located, which was 40 km wide and notable for its active water dynamics. Total abundance in the zone was maximal for the entire investigated area: up to 11.3x10**9 cells/m**2. Autotrophic flagellates were the leading group in phytoplankton, their share in total abundance reached 56-82%. Further than 70 km from the shore, the outer shelf zone was found with the water column rigidly stratified. The highest for the whole area phytoplankton biomass was identified here (up to 1.06 gC/m**2), 80% of which concentrated above the halocline. Diatoms dominated in phytoplankton abundance (up to 92%) and biomass (up to 90%) that resulted from mass development of two species: Chaetoceros diadema and Leptocylindrus danicus.

Benthic fauna associated with mussel beds and shrimp swarms within hydrothermal fields on the Mid-Atlantic Ridge

Macrofaunal assemblages with prevalence of Bresiliidae shrimps and Mytilidae mussels are abundant in at hydrothermal vents along the Mid-Atlantic Ridge. Mussels inhabit zones of diffuse seeps of hydrothermal fluids with temperature abnormalities up to several degrees. Shrimps inhabit an extreme biotope in a mixed interface between seawater and hydrothermal fluids at temperature up to 20-30°C. We studied the mussel and shrimp assemblages in three hydrothermal vent fields: Rainbow, Broken Spur, and Snake Pit. Species richness of the mussel assemblages within at least two fields (Broken Spur and Snake Pit) is higher as compared with shrimps from the same hydrothermal vent fields. Fauna inhibiting shrimp swarms lack almost any taxa specific for particular assemblages: almost all the taxa are also present in the mussel beds. Structure of the shrimp assemblage is less homogeneous as compared with that of the mussel assemblage. Population prevalence of one taxon (Copepoda) in the shrimp assemblage is most likely connected with extreme and unstable conditions of the biotope occupied by the shrimps in a hydrothermal field. Taxonomic similarity between the mussel and shrimp assemblages within one hydrothermal vent field is higher as compared with similarity between the mussel (or shrimp) assemblages from different fields.

Microfossils and chemical elements in bottom sediments of the Ashadze-1 Hydrothermal Field (tropical Mid-Atlantic Ridge)

The first thorough analysis of microfossils from ore-bearing sediments of the Ashadze-1 Hydrothermal Field in the Mid-Atlantic Ridge sampled during Cruise 26 of R/V Professor Logachev in 2005 revealed substantial influence of hydrothermal processes on preservation of planktonic calcareous organisms as well as on preservation and composition of benthic foraminifera. From lateral and vertical distribution patterns and secondary alterations of microfossils it is inferred that the main phase of hydrothermal mineralization occurred in Holocene. Heavy metals (Cu, Co, Cr, and Ag) were accumulated by foraminiferal tests and in their enveloping Fe-Mn crusts. Distribution of authigenic minerals replacing foraminiferal tests demonstrates local zoning related to hydrothermal activity. There are three mineral-geochemical zones defined: sulfide zone, zone with elevated Mg content, and zone of Fe-Mn crusts.