Ambient air and its potential effects on conception in vitro

Incidences of chemical air contamination (CAC) are common in assisted reproductive technology, but not reported in peer review format. Justified fear of car and industrial emissions clearly exists among reproductive specialists, but standards for air contents and gaseous emission limits have not been reported. Here, we describe air sampling methods and assay systems which can be applied to any laboratory or laboratory item. It was found that unfiltered outside air may be cleaner than high efficiency particulate air filtration (HEPA) filtered laboratory air or air obtained from incubators, due to accumulation of volatile organic compounds derived from adjacent spaces or specific laboratory products such as compressed CO2, sterile Petri dishes and other materials or devices known to release gaseous emissions. Specific groups of products such as anaesthetic gases, refrigerants, cleaning agents, hydrocarbons and aromatic compounds such as benzene and toluene are described. The latter were shown to accumulate specifically in incubators. Isopropyl alcohol was the most dominant product found, though it was not used by the laboratory staff. Concentrations of this agent were low in incubator air, indicating that it was probably absorbed by the water in the pan or by culture medium. Measures to counter CAC are proposed, including the use of activated carbon filters and oxidizing material placed in the central air handling systems, in separate free-standing units or even inside the incubators.      

Uptake and toxicity of toxaphene in several estuarine organisms

The organochlorine insecticide, toxaphene, was tested in flow-through bioassays to evaluate its toxicity to estuarine organisms. The organisms tested and their respective 96-hr LC5Os (based on measured concentrations) are: pink shrimp (Penaeus duorarum), 1.4g/L; grass shrimp (Palaemonetes pugio), 4.4g/L; sheepshead minnow (Cyprinodon variegatus), 1.1g/L; and pinfish (Lagodon rhomboides), 0.5g/L. Toxaphene concentration estimated to reduce shell deposition in American oysters (Crassostrea virginica) by 50% (EC50) was 16g/L. Concentration factors (concentration of toxaphene in tissues divided by concentration measured in water) for fishes and oysters in 96 hr ranged from 3,100 to 20,600 and for shrimp, from 400 to 1,200.Individuals from various ontogenetic stages of longnose killifish (Fundulus similis) were exposed to toxaphene for 28 days in flow-through bioassays. Toxaphene was toxic to embryos, fry, juveniles, and adult fish, but fertilization of ova in static tests was not affected by the concentrations tested (0.32 to 10g/L). The 28-day measured LC50s for all stages ranged from 0.9 to 1.4g/L. Toxaphene was accumulated in ova and other body tissues of the longnose killifish; concentration factors in ova were 1,000 to 5,500, and in whole-body tissues, 4,200 to 60,000.Contribution No. 269, Gulf Breeze Environmental Research Laboratory.Portions relating toFundulus similis based on a thesis submitted by S.C.S. in partial fulfillment of the degree of Master of Science from the University of West Florida, 1975.     

Post-phototherapy neonatal bilirubin rebound: a potential cause of significant hyperbilirubinaemia.

AIM: To determine the incidence of post-phototherapy neonatal plasma total bilirubin (PTB) rebound. METHODS: A prospective clinical survey was performed on 226 term and near-term neonates treated with phototherapy in the well baby nursery of the Shaare Zedek Medical Center from January 2001 to September 2002. Neonates were tested for PTB 24 hours (between 12 and 36 hours) after discontinuation of phototherapy, with additional testing as clinically indicated. The main outcome measure, significant bilirubin rebound, was defined as a post-phototherapy PTB > or =256 micromol/l. Phototherapy was not reinstituted in all cases of rebound, but rather according to clinical indications. RESULTS: A total of 30 (13.3%) neonates developed significant rebound (mean (SD) PTB 287 (27) micromol/l, upper range 351 micromol/l). Twenty two of these (73%) were retreated with phototherapy at mean PTB 296 (29) micromol/l. Multiple logistic regression analysis showed significant risk for aetiological risk factors including positive direct Coombs test (odds ratio 2.44, 95% CI 1.25 to 4.74) and gestational age <37 weeks (odds ratio 3.21, 95% CI 1.29 to 7.96). A greater number of neonates rebounded among those in whom phototherapy was commenced < or =72 hours (26/152, 17%) compared with >72 hours (4/74, 5.4%) (odds ratio 3.61, 95% CI 1.21 to 10.77). CONCLUSION: Post-phototherapy neonatal bilirubin rebound to clinically significant levels may occur, especially in cases of prematurity, direct Coombs test positivity, and those treated < or =72 hours. These risk factors should be taken into account when planning post-phototherapy follow up.     

Reliability of a two‐colour chewing gum test to assess masticatory performance in complete denture wearers

The aim of this study was to test the reliability of a method to measure the masticatory performance of complete denture wearers employing a colour‐mixing ability test and assessment by visual and electronic colourimetric analysis. A sample of 75 subjects was selected from patients who received new conventional complete dentures. Masticatory tests were performed using a two‐colour chewing gum that was masticated for 5, 10, 20, 30 and 50 chewing cycles, performed in a random order. The mixing level of the two colours of the chewed gum was assessed visually by two independent raters based on a 5‐point ordinal scale. The specimens were flattened into a 1‐mm‐width wafer, scanned and saved as a two‐sided digital image. Each pair of images was submitted to an electronic colourimetric analysis to assess the level of colour mixture, measured by the circular variance of hue (VOH ). Overall inter‐ and intra‐rater agreements in visual analysis were 64% and 68%, respectively (almost 99% of scores ranged within ±1 point), whilst overall weighted kappa was >0.80. A proportional increase in the level of mixture occurred with increased number of chewing cycles (P  < .001). Similarly, VOH and the visual analysis were highly correlated (r = ?.89; P  < .001). Bland‐Altman plots revealed excellent agreement and extremely low systematic error between duplicated VOH measures. It was concluded that the two‐colour chewing gum test is a reliable method to assess the masticatory performance in complete denture wearers using both visual and electronic colourimetric analyses.     

Implants for elderly patients

In the developed world, the large birth cohorts of the so‐called baby boomer generation have arrived in medical and dental practices. Often, elderly patients are ‘young‐old’ baby boomers in whom partial edentulism is the predominant indication for implant therapy. However, the generation 85+ years of age represents a new challenge for the dental profession, as their lives are frequently dominated by dependency, multimorbidity and frailty. In geriatric implant dentistry, treatment planning is highly individualized, as interindividual differences become more pronounced with age. Nevertheless, there are four typical indications for implant therapy: (i) avoidance of removable partial prostheses; (ii) preservation of existing removable partial prostheses; (iii) stabilization of Kennedy Class I removable partial prostheses; and (iv) stabilization of complete prostheses. From a surgical point of view, two very important aspects must be considered when planning implant surgery in elderly patients: first, the consistent strive to minimize morbidity; and, second, the fact that coexisting medical risk factors are significantly more common in elderly patients. Modern three‐dimensional cone beam computed tomography imaging is often indicated in order to plan minimally invasive implant surgery. Computer‐assisted implant surgery might allow flapless implant surgery, which offers a low level of postoperative morbidity and a minimal risk of postsurgical bleeding. Short and reduced‐diameter implants are now utilized much more often than a decade ago. Two‐stage surgical procedures should be avoided in elderly patients. Implant restorations for elderly patients should be designed so that they can be modified to become low‐maintenance prostheses, or even be removed, as a strategy to facilitate oral hygiene and comfort in the final stage of life.     

Prospective evaluation of chronic organ damage in adult sickle cell patients: A seven‐year follow‐up study

Organ damage in sickle cell disease (SCD) is a crucial determinant for disease severity and prognosis. In a previous study, we analyzed the prevalence of SCD‐related organ damage and complications in adult sickle cell patients. We now describe a seven‐year follow‐up of this cohort.All patients from the primary analysis in 2006 (n = 104), were included for follow‐up. Patients were screened for SCD‐related organ damage and complications (microalbuminuria, renal failure, elevated tricuspid regurgitation flow velocity (TRV) (≥2.5 m/seconds), retinopathy, iron overload, cholelithiasis, avascular osteonecrosis, leg ulcers, acute chest syndrome (ACS), stroke, priapism and admissions for vaso‐occlusive crises (VOC) biannually. Upon 7 years of follow‐up, progression in the prevalence of avascular osteonecrosis (from 12.5% to 20.4%), renal failure (from 6.7% to 23.4%), retinopathy (from 39.7% to 53.8%) was observed in the whole group. In HbSS/HbSβ⁰‐thal patients also progression in microalbuminuria (from 34% to 45%) and elevated TRV (from 40% to 48%) was observed while hardly any progression in the prevalence of cholelithiasis, priapism, stroke or chronic ulcers was seen. The proportion of patients with at least one episode of ACS increased in the group of HbSS/HbSβ⁰‐thal patients from 32% to 49.1%. In conclusion, 62% of the sickle cell patients in this prospective cohort study developed a new SCD‐related complication in a comprehensive care setting within 7 years of follow‐up. Although the hospital admission rate for VOC remained stable, multiple forms of organ damage increased substantially. These observations underline the need for continued screening for organ damage in all adult patients with SCD.     

Anger and Its Control in Graeco-Roman and Modern Psychology

Abstract

Drawing upon literatures in several disciplines, Norris and colleagues (in press) concluded that the resilience of communities, and consequently the wellness of communities, rests upon a network of adaptive capacities, particularly Economic Development, Social Capital, Information and Communication, and Community Competence. There are numerous ways in which efforts to build community resilience might also achieve the five essential elements of mass trauma intervention explicated by Hobfoll and colleagues. Thus, it is argued here that efforts to reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, cultivate trusted and responsible information resources, and enhance decision–making skills will augment more specific intervention efforts to promote safety, calming, efficacy, hope, and connectedness in the aftermath of mass trauma. Many of these outcomes require systems and social changes that can be the target of intervention efforts before as well as after disasters.