Double-endpoint Genotoxicity Quantification and PAHs Characterization of Drinking Water Source alongside Polluted Yinghe River with High Tumor Mortality

The etiology for the high tumor mortality in heavy polluted Yinghe river basin is still unclear and polycyclic aromatic hydrocarbons(PAHs)belong to the priority pollutants in water based on the former surveillance data.In order to explore the potential genotoxicants contributing to the double-endpoint genotoxicity of polluted drinking water source,12 groundwater and 3 surface water samples were collected from 3 villages and the nearby rivers alongside Yinghe river basin,respectively and their comprehensive genotoxicity was estimated with a bioassay group of sOS/umu test and micronucleus(MN)test(MNT).Some groundwater samples showed positive genotoxicity and all surface water samples were highly genotoxic.Eight groundwater samples showed DNA genotoxic effct with the average 4-NQO equivalent concentration(TEQ_(4-NQO))of 0.067μg/L and 0.089μg/L in wet and dry season,respectively.The average MN ratios of groundwater samples were 14.19‰ and 17.52‰ in wet and dry season,respectively.Groundwater samples showed different genotoxic effect among 3 villages.The total PAHs concentrations in all water samples ranged from 8.98 to 25.17 ng/L with an average of 14.97±4.85 ng/L.BaA,CHR,BkF,BaP and DBA were the main carcinogenic PAHs contributing to the genotoxicity of water samples.In conclusion,carcinogenic PAHs are possibly related to the high tumor mortality in the target area.Characterization of carcinogenic PAHs to genotoxicity of drinking water source may shed light on the etiology study for high tumor mortality in Yinghe river basin.Key words:genotoxicity test;drinking water source;high tumor mortality;Yinghe river basin;polycyclic aromatic hydrocarbons(PAHs)

Primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome:A case report

BACKGROUND Primary hepatic angiosarcoma(PHA)is a rare malignancy with a poor prognosis.It is difficult to diagnose PHA because of the lack of specific symptoms or tumour markers,and it rapidly progresses and has a high mortality.To our knowledge,PHA has not been reported to mimic hepatic sinusoidal obstruction syndrome.Herein,we present a case of PHA manifesting as hepatic sinusoidal obstruction syndrome,diagnosed using transjugular liver biopsy,that resulted in the death of the patient.CASE SUMMARY A 71-year-old man was admitted with the primary complaint of abdominal distension,decreased appetite,fatigue in the previous month,and loss of 10 kg of weight in the past 2 years.Both the liver and spleen were enlarged,and the liver had a medium-hard texture on percussion.Laboratory examinations were performed,and abdominal plain computed tomography(CT)and contrastenhanced CT showed hepatomegaly and splenomegaly,as well as diffuse lowdensity shadows distributed in the liver and spleen.Contrast-enhanced CT revealed diffuse,hypodense,nodular or flake shadows in the liver and heterogeneous enhancement in the spleen.A transjugular liver biopsy was performed.Based on the pathology results,the patient was diagnosed with hepatic sinusoidal obstruction syndrome secondary to PHA.The patient’s status further deteriorated and he developed serious hepatic failure.The patient was discharged,and died 3 d later.CONCLUSION PHA is rare and has a poor prognosis;however,transjugular liver biopsy can be safely performed to aid in diagnosis.

Patterns of Acute Kidney Injury in a Medical Emergency Department in Sub-Saharan Africa

Background: Acute kidney injury (AKI) is a common in community and a serious outcome in hospital setting. Despite the progress of dialytic and non-dialytic therapeutic means, its mortality remains high. Our objective was to contribute to a better knowledge of how AKI managed in an emergency medical ward in an African country located in the southern part of the Sahara. Patients and Methods: We conducted a retrospective study from January 1 to December 31, 2019, conducted at the emergency department of the University Teaching Hospital of Bouake, on cases of AKI. Results: During the study period, we collected 221 cases of AKI out of a total of 1778 files giving a prevalence of 12.4%. The mean age was 54 ± 19 years. A male predominance with a sex ratio of 1.4 was observed. The main past histories were hypertension in 40.4%, cardiac disease in 16.9%, and diabetes in 14.3%. The patients in were classified in 63.8% of cases as stage I, in 22.1% as stage II and in 14.1% as stage III according to the AKIN criteria. AKI was functional in 93.2% of cases. Hemodialysis was indicated in 15 (6.8%) patients, but only 3 (1.4%) underwent it. The mortality rate was 45.2%. Factors associated with mortality were: creatinine level greater than or equal to 30 mg/l, sepsis and impaired vigilance. Conclusion: Acute renal failure was frequent in subjects under 60 years old. Its mechanism of occurrence is functional and therefore it can be prevented by vascular filling. The majority of patients were seen at AKIN Stage I. The outcome was favorable in more than one third of the cases and the mortality rate remains high.

A Rare Case of Pulmonary Mucormycosis Successfully Treated with Dual Antifungal Agents and Surgery in a Patient with Uncontrolled Diabetes

Pulmonary mucormycosis is an emergent and life-threatening invasive fungal infection underdiagnosed by clinicians due to unspecific clinical picture and lack of awareness. Although the acknowledgment of risk factors, clinical and radiological findings may increase early recognition, the definite diagnosis is challenging to establish and the ideal treatment has never been delineated. The authors describe a rare case of pulmonary mucormycosis that was successfully treated with dual antifungal treatment and surgery in a patient with uncontrolled diabetes. When last evaluated, he was asymptomatic with no evidence of relapse. To our knowledge this is a rare report of a successfully treated diabetic patient with pulmonary mucormycosis with L-AmB, triazole posaconazole and surgery with no evidence of recurrence. We highlight the importance of clinicians’ awareness to early diagnosis, combined antifungal treatment and adjuvant surgery as the greatest chance of cure of a rapidly progressive disease with high mortality and morbidity.