Pre- and post-fire pollutant loads in an urban fringe watershed in Southern California.

Post-fire runoff has the potential to be a large source of contaminants to downstream areas. However, the magnitude of this effect in urban fringe watersheds adjacent to large sources of airborne contaminants is not well documented. The current study investigates the impacts of wildfire on stormwater contaminant loading from the upper Arroyo Seco watershed, burned in 2009. This watershed is adjacent to the Greater Los Angeles, CA, USA area and has not burned in over 60 years. Consequently, it acts as a sink for regional urban pollutants and presents an opportunity to study the impacts of wildfire. Pre- and post-fire storm samples were collected and analyzed for basic cations, trace metals, and total suspended solids. The loss of vegetation and changes in soil properties from the fire greatly increased the magnitude of storm runoff, resulting in sediment-laden floods carrying high concentrations of particulate-bound constituents. Post-fire concentrations and loads were up to three orders of magnitude greater than pre-fire values for many trace metals, including lead and cadmium. A shift was also observed in the timing of chemical delivery, where maximum suspended sediment, trace metal, and cation concentrations coincided with, rather than preceded, peak discharge in the post-fire runoff, amplifying the fire's impacts on mass loading. The results emphasize the importance of sediment delivery as a primary mechanism for post-fire contaminant transport and suggest that traditional management practices that focus on treating only the early portion of storm runoff may be less effective following wildfire. We also advocate that watersheds impacted by regional urban pollutants have the potential to pose significant risk for downstream communities and ecosystems after fire.

Revisión de las intoxicaciones graves por insecticidas organofosforados atendidas en un período de 11 años (1996-2006) / Review of severe organophosphate poisonings over a period of 11 years (1996-2006)

Objetivo: Revisar las intoxicaciones por organofosforados (OF) en un período de 11años atendidas en nuestro hospital que requirieron ingreso de 7 días o más. Método: Estudio retrospectivo descriptivo de pacientes intoxicados por insecticidas OF atendidos entre 1996 y 2006 con una estancia hospitalaria igual o mayor de 7 días. Se analizan las siguientes variables: la edad, el sexo, el tipo de producto, el destino del ingreso y la duración de las estancias hospitalarias que generaron, el hábitat de residencia(rural o urbano), la causa de la intoxicación, la sintomatología clínica, las medidas terapéuticas aplicadas, la presencia de antecedentes psiquiátricos y las determinaciones seriadas de colinesterasas sérica. Resultados: Se han incluido 8 pacientes, el 50% de los cuales eran hombres, con una edad media de 49 años. El producto un OF puro (50%), un OF más herbicida (25%) y un OF más carbamato (25%). La estancia media hospitalaria fue de 40 días y en los 6pacientes que requirieron unidad de cuidados intensivos (UCI) su estancia en ella fue de 23 días. Cinco casos procedían del medio rural (62,5%) y 3 del urbano (37,5%), yen 5 casos (62,5%) exitió intención suicida. Todos los pacientes presentaron síndrome colinérgico, el 25% síndrome muscarínico leve el 75% sintomatología muscarínica, nicotínicay central. En el 50% de casos se produjo un síndrome intermedio y en el 50%hubo recidiva colinérgica. Hubo hipotermia severa en 2 casos e insuficiencia respiratoria en 6 pacientes, los cuales requirieron intubación orotraqueal. Se realizó descontaminación gástrica en 6 casos, en 2 se administró el carbón sin lavado previo, en 5 la atropina,en 4 la pralidoxima y en 1 el carbón activado y la hemofiltración. La colinesterasasérica fue determinada en 6 casos. Conclusión: Las intoxicaciones graves por OF presentan una gran riqueza sintomática, la cual es mayor cuando las medidas iniciales adoptadas no son enérgicas y/o si se produce una retirada precoz del tratamiento (AU)

Objective: To review all the organophosphate poisonings (OP) over a 11-year period which required at least seven days of admission at our hospital. Methods: Descriptive retrospective study of patients with OP attended at the hospital from 1996 to 2006. The variables age, sex, type of poisonous compound, destination at admission, length of stay, environment (rural or urban), cause of poisoning, clinical symptoms, therapeutic measures, acetyl cholinesterase measurement, and history of psychiatric disorders were assessed. Results: Eight patients were included, mean age 49 years (range: 26-65), 50% female. Poisonous compound were pure OP (50%), OP plus herbicide (25%) and OP plus carbamate (25%). Mean hospital stay was 40,5 days. Mean stay in the ICU in 6 patients who required intensive care was 23 days. Five (63.5%) patients were from rural origin and 3 (27.5%) were urban cases. Five cases (62.5%) were suicide attempts, 2 (25%) were accidents and the reason was not clear in one case. 100% presented with cholinergic syndrome, 2 cases (25%) mild muscarinic syndrome and 6 cases (75%) muscarinic, nicotinic and central symptoms. Four cases (50%) presented intermediate syndrome and 4 cases relapse of cholinergic symptoms. Severe hypothermia was present in 2 cases. Respiratory insufficiency was seen in 6 patients, which required orotracheal intubation. Gastrointestinal decontamination was performed in 6 cases. Two patients received activated charcoal without lavage. Atropine was usedin 5 cases (62.5%) and pralidoxime in 4. Hemoperfusion with activated carbon and hemofiltration was used inone case. Serum cholinesterase activity was measured in 6 cases. Conclusion: Severe organophosphate poisonings has multiple symptoms. If general measures adopted are not enough and/or treatment is withdrawn early they can increase significantly (AU)

Unusual complication of ligation of rudimentary ulnar digit.

We report a case of rudimentary ulnar polydactyly of the hand of a 7-year-old female child. Histological examination revealed a central traumatic neuroma which branched into five digit-like projections covered with hyperkeratotic epidermis. We think this was a result of suture ligation during the postnatal period.

Acalasia y cancer de esofago / Achalasia and esophageal cancer

En el período comprendido entre enero de 1970 y diciembre de 1990, fueron estudiados 242 pacientes portadores de acalasia esofágica. De ellos 8 (3.3%) desarrollaron durante la evolución de la enfermedad una neoplasia esofágica. Los 8 casos correspondieron al tipo histológico de carcinoma epidermoide: 3 diferenciados, 3 semidiferenciados y 2 anaplásicos. La terapéutica recibida con anterioridad para la enfermedad de base fue: 1 paciente operado efectuándose miotomía extramucosa de Heller, 4 pacientes recibieron dilatación con bujías prógradas en numerosas oportunidades y los 2 restantes no recibieron tratamiento alguno para su acalasia. Dos pacientes presentaron fístulas traqueobronquiales como complicación de la neoplasia. El tratamiento recibido fue: 3 pacientes, radioterapia (4000 rad); 1 paciente, quimioterapia (bleomicina más cisplatino): 1 paciente quimio más radioterapia; 1 paciente cirugía de resección; 2 pacientes gastrostomía de alimentación. Los 8 pacientes fallecieron dentro del ano de demostrado su cáncer esofágico

Acalasia y cancer de esofago / Achalasia and esophageal cancer

En el período comprendido entre enero de 1970 y diciembre de 1990, fueron estudiados 242 pacientes portadores de acalasia esofágica. De ellos 8 (3.3%) desarrollaron durante la evolución de la enfermedad una neoplasia esofágica. Los 8 casos correspondieron al tipo histológico de carcinoma epidermoide: 3 diferenciados, 3 semidiferenciados y 2 anaplásicos. La terapéutica recibida con anterioridad para la enfermedad de base fue: 1 paciente operado efectuándose miotomía extramucosa de Heller, 4 pacientes recibieron dilatación con bujías prógradas en numerosas oportunidades y los 2 restantes no recibieron tratamiento alguno para su acalasia. Dos pacientes presentaron fístulas traqueobronquiales como complicación de la neoplasia. El tratamiento recibido fue: 3 pacientes, radioterapia (4000 rad); 1 paciente, quimioterapia (bleomicina más cisplatino): 1 paciente quimio más radioterapia; 1 paciente cirugía de resección; 2 pacientes gastrostomía de alimentación. Los 8 pacientes fallecieron dentro del ano de demostrado su cáncer esofágico (AU)

[Achalasia and esophageal cancer]. / Acalasia y cáncer de esófago.

During the period included between January 1970 and December 1990, we studied 242 patients with manometric and radiological diagnosis of esophageal achalasia. Eight of these patients (3.3%) developed during the evolution of their disease an esophageal carcinoma. Eight cases showed histologic type of epidermoid carcinoma: 3 differentiated, 3 semi-differentiated and 2 anaplastic. Therapy for achalasia was: one patient, Heller myotomy, 4 patients, dilatations with bougies in numerous opportunities, and the other two patients receive no treatment for achalasia. Two patients reported tracheobronchial fistulas as complication of carcinoma. Treatment received for carcinoma included: three patients, radiotherapy (4000 rads); one patient, chemotherapy; one patient, chemotherapy and radiotherapy, one resection surgery and two patients feeding gastrostomy. All of the eight patients died within the year of diagnosis of epidermoid carcinoma.

Acalasia y cáncer de esófago. / [Achalasia and esophageal cancer]

During the period included between January 1970 and December 1990, we studied 242 patients with manometric and radiological diagnosis of esophageal achalasia. Eight of these patients (3.3

) developed during the evolution of their disease an esophageal carcinoma. Eight cases showed histologic type of epidermoid carcinoma: 3 differentiated, 3 semi-differentiated and 2 anaplastic. Therapy for achalasia was: one patient, Heller myotomy, 4 patients, dilatations with bougies in numerous opportunities, and the other two patients receive no treatment for achalasia. Two patients reported tracheobronchial fistulas as complication of carcinoma. Treatment received for carcinoma included: three patients, radiotherapy (4000 rads); one patient, chemotherapy; one patient, chemotherapy and radiotherapy, one resection surgery and two patients feeding gastrostomy. All of the eight patients died within the year of diagnosis of epidermoid carcinoma.

Acalasia y cáncer de esófago. / [Achalasia and esophageal cancer]

During the period included between January 1970 and December 1990, we studied 242 patients with manometric and radiological diagnosis of esophageal achalasia. Eight of these patients (3.3

) developed during the evolution of their disease an esophageal carcinoma. Eight cases showed histologic type of epidermoid carcinoma: 3 differentiated, 3 semi-differentiated and 2 anaplastic. Therapy for achalasia was: one patient, Heller myotomy, 4 patients, dilatations with bougies in numerous opportunities, and the other two patients receive no treatment for achalasia. Two patients reported tracheobronchial fistulas as complication of carcinoma. Treatment received for carcinoma included: three patients, radiotherapy (4000 rads); one patient, chemotherapy; one patient, chemotherapy and radiotherapy, one resection surgery and two patients feeding gastrostomy. All of the eight patients died within the year of diagnosis of epidermoid carcinoma.

[Leiomyoma of the bladder as a cause of unilateral ureteral obstruction associated with uterine leiomyoma and polycystic ovary]. / Leiomioma de vejiga causante de una obstrucción unilateral del uréter asociado a leiomiomas uterinos y ovarios poliquísticos.

A case of a female patient with bladder leiomyoma associated to uterus containing several leiomyomatous nodules and polycystic ovaries is presented. The diagnostic convenience that ecography can provide, showing neoformations and their definition with regard to neighbouring organic structures, is highlighted. The existing relationship between uterine leiomyomas and estrogens is outlined, as well as the action of GnRH agonists on such leiomyomas after long-term therapy.