Freshwater Cyanobacterial Blooms and Primary Liver Cancer Epidemiological Studies in Serbia

A large part of Central Serbia experiences continual shortage of sufficient ground water resources. For that reason, more than 20 reservoirs serve as drinking water suppliers. Significant and persistent cyanobacterial “blooms” have been recognized in nine of them. Samples for cyanotoxin analyses were taken during and after “blooms” in ?elije Reservoir and from Kru?evac town-supplied tap water from that reservoir two days later. Concentration of microcystin-LR was 650 μ gL^–1 in the reservoir, while the tap water contained 2.5 μ gL^–1.

In the two investigated periods, the high primary liver cancer (PLC) mortality of 11.6 from 1980–1990 and extremely high PLC incidence of 34.7 from 2000–2002 were observed in the regions affected by heavy cyanobacterial “blooms.” In contrast, PLC mortality and incidence rates were substantially lower in the regions not affected by cyanobacterial blooms: in 1980–1990 the rate of PLC mortality amounted to 2.7 in Kosovo, 7.6 in Vojvodina, and 8.3 in the non-affected regions of Central Serbia; while in 2000–2002 PLC incidence amounted to 4.1 in Kosovo, 5.2 in Vojvodina, and 13.6 in the non- or less-affected regions of Central Serbia. Keeping in mind that the most affected PLC regions in Central Serbia (Topli?ki, Ni?ki, and ?umadijski regions) have the water supply systems based on six reservoirs found regularly in bloom during summer months and that some of the regions are also connected with two boundary “blooming” reservoirs, representing a total of eight of nine blooming reservoirs, it is easy to presume that the PLC incidence could be related to drinking water quality.

The uneven geographic distribution of liver cancer in Serbia is conspicuous and hot spots could be related to drinking water supply. It is very clear that the high-risk regions for PLC occurrence correspond with drinking water reservoirs continually found with cyanobacterial blooms, and the low risk regions correspond with water supplies not affected by cyanobacteria.     

Do Trauma Patients Aged 55 and Older Benefit from Air Medical Transport?

Introduction: A recent analysis of the National Sample Project demonstrated that the mortality benefits of air medical transport do not extend to patients age 55 or older. The purpose of the current investigation was to evaluate mortality benefits of air transport in adult trauma patients ≥ 55 years of age. Methods: A retrospective analysis of all adult patients greater than age 55 years directly transported from a trauma scene to a Level I or II facility was conducted. The primary outcome variable was in-hospital mortality. Using the imputed dataset we then performed multivariable logistic regression with mortality as the dependent variable to determine if mode of transport had a significant impact on mortality for patients older than 55 years of age. Results: There were 7,739 (90.9%) patients transported by ground and 682 (9.1%) transported by air in our dataset. There were 3,556 between the ages of 55 to 69 years and an additional 4865 over the age of 69 years. In the multivariable model of all patients ≥ 55, air transport was associated with lower mortality (adjusted odds ratio [aOR] = 0.60; 95% confidence interval [CI] = 0.39--0.91; p = 0.017) when compared to those transported by ground. Conclusion: Our study was able to demonstrate a survival benefit for the cohort of patients age greater than 55 years of age.     

CENTRAL NEUROGENIC NEUROPROTECTION: PROTECTION OF BRAIN FROM FOCAL ISCHEMIA BY CEREBELLAR STIMULATION

Electrical stimulation of the cerebellar fastigial nucleus (FN) elevates regional cerebral blood flow (rCBF) independently of cerebral metabolism (rCGU) throughout brain. One hour of FN stimulation also reduces, by up to 50%, the volume of the focal ischemic infarction produced by occlusion of the middle cerebral artery in rat. Protected areas correspond to the ischemic penumbra. Neuroprotection, while reversible, persists for weeks after 1h of stimulation. It cannot be attributed to increasing rCBF and/or reducing rCGU to improve matching of flow and metabolism. Conditional stimulation of FN initiates long-lived inhibition of expression of peri-infarction depolarizing waves, possibly by altering potassium-channel function and suppresses induction of inducible nitric oxide synthase (iNOS) and ICAM in cerebral microvessels. The brain contains intrinsic networks which may protect the brain from ischemic injury, possibly by producing widespread and longterm suppression of electrical excitability and/or and expression of proinflammatory molecules.     

Alcoholism: newer methods of management

Chronic alcoholics were selected from hospitals and A.A. Centres and subjected to different methods of treatment namely, psycho therapy, stereotaxic surgery, nonvolitional biofeedback, Yoga and meditation and extremely low frequency Pulsed Magnetic Field. Each group comprised a minimum of 20 subjects. All were males between the ages of 20 and 45 years. Investigations done were clinical, psychological, biochemical, neurochemical and electrophysiological. Improvement was noticed in all the patients, the degree varying with the different methods of treatment. The patients were followed up at least for a period of one year.     

Intravenous placement device and infusion thrombophlebitis

The incidence of thrombophlebitis in the present study was 18.3%. It was of mild grade in all the cases. The incidence of thrombophlebitis was more (24%) when short teflon canula was used as intravenous placement device. Under similar infusion conditions with stainless steel needle, scalp vein needle and long teflon canula, the incidence was 16.6%, 13.3% and 16.6% respectively. Thrombophlebitis bears a direct relationship to the duration of infusion. The incidence was negligible at the end of 8 hours, whereas 14 patients developed thrombophlebitis by the end of 24 hours (63.7%).     

Effect of acute sublethal and chronic administration of DDT (chlorophenotane) on brain lipid metabolism of rhesus monkeys

Either a single oral dose of 1,1,1-trichloro-2,2-bis-(p-chlorophenyl) ethane (DDT), 150 mg/kg body weight or a long-term chronic dose of the pesticide, 10 mg/kg body weight daily for 100 days was administered to rhesus monkeys and the level of various lipid classes was studied in the brain. A significant decrease was observed in total lipid, unesterified cholesterol and phospholipid (PL) level. Individual PL fractions showed a generalized pattern of reduction, so also did the cholesterol (chol)/PL ratio. Sphingomyelin (SM) registered a significant increase, while no significant alteration was observed in the brain galactolipid and ganglioside level. Lipid lowering effect of DDT was more pronounced in the chronic group. Lipids associated with the myelin sheath were found to be more resistant to pesticide injury, while cholesterol and PL metabolism were more affected.