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PubMed2000

Fish mercury concentration in the Alto Pantanal, Brazil: influence of season and water parameters.

The tropical flood plain Pantanal is one of the world's largest wetlands and a wildlife sanctuary. Mercury (Hg) emissions from some upstream gold mining areas and recent findings of high natural Hg levels in tropical oxisols motivated studies on the Hg cycle in the Pantanal. A survey was made on total Hg in the most consumed piscivorous fish species from rivers and floodplain lakes in the north (Cáceres and Barão de Melgaço) and in the south part of Alto Pantanal (around the confluence of the Cuiabá and Paraguai rivers). Samples were collected in both the rainy and dry seasons (March and August 1998) and included piranha (Serrasalmus spp.), and catfish (Pseudoplatystoma coruscans, pintado, and Pseudoplatystoma fasciatum, cachara or surubim). There was only a small spatial variation in Hg concentration of the 185 analyzed fish samples from the 200 x 200 km large investigation area, and 90% contained total Hg concentration below the safety limit for regular fish consumption (500 ng g(-1)). Concentration above this limit was found in both Pseudoplatystoma and Serrasalmus samples from the Baia Siá Mariana, the only acid soft-water lake included in this study, during both the rainy and dry seasons. Concentration above this limit was also found in fish outside Baia Siá Mariana during the dry season, especially in Rio Cuiabá in the region of Barão de Melgaço. The seasonal effect may be connected with decreasing water volumes and changing habitat during the dry season. The results indicate that fertile women should restrict their consumption of piscivorous fishes from the Rio Cuiabá basin during the dry season. Measures should be implanted to avoid a further deterioration of fish Hg levels.

Adult↗
PubMedDate not supplied

The safety experience of New Zealand adventure tourism operators.

BACKGROUND: This survey examined parameters of the New Zealand adventure tourism industry client injury risk. The research also sought to establish priorities for intervention to reduce adventure tourism risk, and identify client injury control measures currently in place (or absent) in the New Zealand adventure tourism industry, with a view to establishing guidelines for the development of effective adventure tourism safety management systems. This 2003 survey builds upon an exploratory study of New Zealand adventure tourism safety conducted by us during 1999. METHOD: A postal questionnaire was used to survey all identifiable New Zealand adventure tourism operators. The questionnaire asked respondents about their recorded client injury experience, perceptions of client injury risk factors, safety management practices, and barriers to safety. RESULTS: Some 27 adventure tourism activities were represented among the responding sample (n=96). The highest client injury risk was reported in the snow sports, bungee jumping and horse riding sectors, although serious underreporting of minor injuries was evident across the industry. Slips, trips and falls (STF) were the major client injury mechanisms, and a range of risk factors for client injuries were identified. Safety management measures were inconsistently applied across the industry. CONCLUSIONS: The industry should consider the implications of poor injury reporting standards and safety management practices generally. Specifically, the industry should consider risk management that focuses on minor (e.g., STF) as well as catastrophic events.

Athletic Injuries↗
PubMed1992

Diagnosis and clinical use of bromperidol in HIV-related psychoses in a sample of seropositive patients with brain damage.

We evaluated in an open trial the safety and effectiveness of a high-potency neuroleptic (bromperidol) for the treatment of AIDS-related organic mental syndromes. Eleven (nine men and two women) seropositive patients with psychotic features were included; six were intravenous drug users (IVDU) and five were not IVDU (NON-IVDU). On the basis of the achievement of a CGI score of 1 or 2 (much improved or very much improved) at the fourth week, nine patients were considered responders, one was a partial responder and one was a non-responder. From a clinical point of view, "positive" psychotic symptoms had a significant remission, while the "negative" ones seemed to be less sensitive or insensitive to bromperidol treatment.

AIDS Dementia Complex↗
PubMed1995

[Programmed autologous transfusion in obstetrics. Blood samples in 100 patients in the last month of pregnancy].

OBJECTIVES: Evaluation (usefulness and safety) of programmed autologous transfusion in obstetrics. SITE. Blood Transfusion Centre, Hôpital Louis-Mourier, F 92700 Colombes. PATIENTS: Prospective study of 150 patients for whom blood withdrawal was planned during the last month of pregnancy. Entry criteria were either a risk of haemorrhage or persistent patient request. PROTOCOL: Two withdrawals were planned during the last month of pregnancy at the out-patient clinic at a one-week interval. The autologous units were transfused per-partum in case of haemorrhage and/or post-partum in case of anaemia. RESULTS: One hundred pregnant women entered the protocol (43 had a risk of haemorrhage). Both preplanned withdrawals were made in 60 of these patients. Per-partum transfusions were necessary in only 7 patients including 4/43 with a risk factor (9%) and 3/57 with no risk factor (5%). Post-partum transfusions were made in 22 other patients. Consequently, 117 of the 160 units collected were not used (73%). CONCLUSION: Despite good tolerance (5% incidence) due to the known problems in evaluating the risk of haemorrhage and the small percentage of patients without risk factors who were transfused per-partum, we have decided to reserve this protocol for patients with an authentically identified risk of haemorrhage (placenta praevia, cesarean section, uterine scar tissue).

Adult↗
PubMed2004

Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients.

STUDY DESIGN: Case series of a consecutive sample. Retrospective audit. OBJECTIVE: To analyze the long-term safety and efficacy of intrathecal baclofen (ITB), and technical incidents. SETTING: Neurosurgical and Physical Medicine Departments of two university hospitals in western France. METHODS: The medical records of 40 patients who underwent ITB pump placement for the treatment of severe chronic spasticity were reviewed. Patients were eligible independently of the origin of the spasticity (spinal cord origin 33, brain damage 8). They underwent a final assessment with clinical examination and questionnaire in 2001. Ashworth scale scores were assessed, patient satisfaction was rated on a visual analog scale (VAS), functional independence before and after treatment was classified as bed-ridden, wheelchair dependent or ambulant, and the frequency and nature of complications were noted. RESULTS: The average follow-up period was of 4 years. The average Ashworth score at the final assessment was 1.8+/-0.6. Average patients satisfaction was 7.4/10+/-2.21 on VAS. In all, 85% would have undergone the procedure again if they had to make the decision. In 85% of the cases the ambulation status was unchanged. Technical incidents occurred at least once in 37% of the patients (due to the catheter in 58% and to the pump in 42%). They included catheter disconnections (4), migration (4), kinks (3), obstruction (3), development of fibrosis (3), disconnection of pump reservoir (2), porosity of pump membrane (2), unexplained pump dysfunction (4) leakage, and subcutaneous collection (5). Severe pharmacological side effects requiring transfer to intensive care unit occurred in 12% of cases, 80% of which were directly related to pump refill procedures. CONCLUSION: ITB remained effective in the long term and patients were satisfied. Nevertheless, complications were frequent, involving mainly the catheters, which would require further technical improvements.

Adult↗
PubMed2002

An evaluation of total and inhalable samplers for the collection of wood dust in three wood products industries.

In 1998 the American Conference for Governmental Industrial Hygienists (ACGIH) proposed size selective sampling for wood dust based on the inhalable fraction. Thus the proposed threshold limit values (TLVs) require the use of a sampler whose performance matches the inhalable convention. The Institute of Occupational Medicine (IOM) sampler has shown good agreement with the inhalable convention under controlled conditions, and the Button sampler, developed by the University of Cincinnati, has shown reasonable agreement in at least one laboratory study. The Button sampler has not been previously evaluated under wood working conditions, and the IOM has been shown to sample more mass than expected when compared to the standard closed-face cassette, which may be due to the collection of very large particles in wood working environments. Some projectile particles may be > 100 microm aerodynamic diameter and thus outside the range of the convention. Such particles, if present, can bias the estimates of concentration considerably. This study is part of an on-going research focus into selecting the most appropriate inhalable sampler for use in these industries, and to examine the impact of TLV changes. This study compared gravimetric analyses (National Institute of Occupational Safety and Health Method 0500) of side-by-side personal samples using the Button, IOM, and 37 mm closed-face cassette (CFC) under field-use conditions. A total of 51 good sample pairs were collected from three wood products industries involved in the manufacturing of cabinets, furniture, and shutters. Paired t-tests were run on each sample pair using Statistical Package for the Social Sciences (SPSS) version 10. The IOM and the CFC measured statistically different concentrations (p < 0.0005, n = 16). The IOM and Button measured statistically different concentrations (p = 0.020, n = 12). The Button and CFC did not measure statistically different concentrations of wood dust (p = 0.098, n = 23). Sampler ratios for IOM/CFC pairs ranged from 1.19-19 (median 3.35). Sampler ratios for IOM/Button pairs ranged from 0.49-163 (median 3.15). Sampler ratios for CFC/Button pairs ranged from 0.36-27 (median 1.2). In all cases, higher ratios were associated with higher concentrations. The median relative difference between the IOM's and CFC's is in accord with prior field studies in woodworking environments, and, taken together, the data imply a conversion factor greater than the 2.5 normally applied to CFC results to approximate inhalable values, as measured by the IOM. Raising the limit values by approximately 50% appears warranted for this particular situation of inhalable wood dust measured by the IOM. The IOM/Button and CFC/Button ratios were unexpectedly low, which may be due to the exclusion of very large particles, collected by the IOM and CFC samplers. Further work is required to explain these results.

Dust↗
PubMed2005

Optimisation of sorbent trapping and thermal desorption-gas chromatography-mass spectrometric conditions for sampling and analysis of hydrogen cyanide in air.

Among the chemicals belonging to the schedules of the Chemical Weapons Convention (CWC), sampling and analysis of highly volatile compounds such as hydrogen cyanide (HCN) require special consideration. The latter is present in numerous old chemical weapons that are stockpiled awaiting destruction in Northeastern France: thus, sampling on stockpile area and subsequent verification of HCN levels is compulsory to ensure safety of workers on these areas. The ability of several commercial sorbents to trap hydrogen cyanide at various concentration levels and in various humidity conditions, was evaluated. Furthermore, thermal desorption of the corresponding samples, followed by analysis by gas chromatography-mass spectrometry was also optimised. Carbosieve S-III, a molecular sieve possessing a very high specific area, proved the most efficient sorbent for HCN sampling in all conditions tested. Conversely, the presented results show that Tenax, albeit generally considered as the reference sorbent for air monitoring and analysis of CWC-related chemicals, is not suitable for HCN trapping.

Air Pollutants, Occupational↗
PubMed1991

Medical Research Council European trial of chorion villus sampling. MRC working party on the evaluation pf chorion villus sampling.

First-trimester chorion villus sampling has the advantage over second-trimester amniocentesis of allowing earlier prenatal diagnosis of various genetic and cytogenetic disorders in the fetus (and therefore earlier termination in affected pregnancies) but the relative safety and diagnostic accuracy remain unclear. Between 1985 and 1989, 3248 women seeking prenatal diagnosis, principally because of their age, were recruited to an international, multicentre, randomised comparison of the safety and diagnostic accuracy of the two techniques--5% of women allocated chorion villus sampling and 8% of those allocated amniocentesis were not tested, usually because of spontaneous miscarriage. 6% and 2% were retested, in most because of sampling failure. The endpoint of a liveborn infant who survived was achieved by 86% of women allocated chorion villus sampling and 91% of those allocated amniocentesis; statistical analysis, after appropriate weighting for a centre's contribution, showed that the typical difference between the groups was 4.6% (95% confidence interval 1.6-7.5%; p less than 0.01). This difference reflected more spontaneous fetal deaths before 28 weeks' gestation (2.9% [0.6-5.3%]); more terminations of pregnancy for chromosomal anomalies (1.0% [0.0-2.1%]); and more neonatal deaths (0.3% [-0.1 to 0.7%]). The difference in neonatal deaths was due to a preponderance of very immature liveborn infants in the chorion villus sampling group, and this factor also explained that group's longer mean stay in hospital. More abnormal diagnoses followed chorion villus than amniotic fluid analyses (5.6% vs 3.9%). This difference was largely due to diagnoses of trisomy 18 and of (usually mosaic) abnormalities known to be confined to the placenta. 3 terminated pregnancies were false positives, 1 tested by chorion villus sampling and 2 by amniocentesis, and 2 other mosaic cases diagnosed by chorion villus sampling may have been false positives. There was 1 false-negative result in the chorion villus sampling group. The possibility of earlier exclusion or diagnosis of some fetal disorders afforded by first-trimester chorion villus sampling must be set against its clinical risks.

Abortion, Induced↗
PubMed1997

A computer program to promote understanding of the monitoring method evaluation guidelines used at NIOSH.

A computer-based training program has been devised to promote better understanding of the recently revised National Institute for Occupational Safety and Health (NIOSH) test guidelines applicable to methods requiring on-site sample collection and laboratory sample analysis of airborne toxic substances. A statistics section explains the basis of the NIOSH accuracy criterion (NAC); an experiments section provides details on the evaluation experiments; and a calculations section calculates method statistics based on data entered by the user. The statistics section graphically explains concepts such as the NAC and limit of detection, allowing the user to experiment with some parameters to see how the results are affected. This section also provides background material to show how some of the performance criteria evolved. The experiments section provides a summary of the experiments used to generate the data for method evaluation. The calculations section has several screens that work like customized spreadsheets for the entry of data collected during the laboratory evaluation of a method. A separate screen then calculates the precision (relative standard deviation) of analytical results at each of four concentrations, tests to see if the precision values are statistically homogeneous, and combines the homogeneous data for calculation of the relative standard deviation. It does the same for bias, and combines the precision with method bias to arrive at an estimate of method accuracy. Other screens in the calculations section facilitate the determination of method limit of detection and sample storage stability.

Computer-Assisted Instruction↗
PubMed2006

Neighborhood safety and overweight status in children.

OBJECTIVE: To determine if there is a relationship between parental perception of neighborhood safety and overweight at the age of 7 years. DESIGN: Cross-sectional analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING: Ten urban and rural US sites. PARTICIPANTS: A total of 768 children selected via conditional random sampling with complete data at follow-up. MAIN OUTCOME MEASURES: Parents reported demographics and perception of neighborhood safety by standardized questionnaire. Child overweight status was defined as a body mass index greater than or equal to the 95th percentile for age and sex from measured anthropometrics at the age of 7 years. The base model included relationship of the safety reporter to the child, sex, and baseline body mass index z score at the age of 4.5 years. Covariates tested included maternal marital status, education, and depressive symptoms; child race/ethnicity; participation in structured after-school activities; Home Observation for Measurement of the Environment total score; and neighborhood social cohesiveness. RESULTS: The sample was 85% white, and 10% of the children were overweight. Neighborhood safety ratings in the lowest quartile were independently associated with a higher risk of overweight at the age of 7 years compared with safety ratings in the highest quartile (adjusted odds ratio, 4.43; 95% confidence interval, 2.03-9.65). None of the candidate covariates altered the relationship between perception of neighborhood safety and child overweight status. CONCLUSIONS: Perception of the neighborhood as less safe was independently associated with an increased risk of overweight at the age of 7 years. Public health efforts may benefit from policies directed toward improving both actual and perceived neighborhood safety.

Body Mass Index↗
PubMed2006

Peginterferon alfa-2a (40KD) (PEGASYS) plus ribavirin (COPEGUS) in retreatment of chronic hepatitis C patients, nonresponders and relapsers to previous conventional interferon plus ribavirin therapy.

Peginterferon alfa plus ribavirin is currently the treatment of choice for chronic hepatitis C. Peginterferon alfa-2a (40KD) plus ribavirin has given an overall sustained virological response of 18% in F3/F4 previous nonresponder US patients. We evaluated the effectiveness of peginterferon alfa-2a (40KD) plus ribavirin in Brazilian patients who were relapsers or nonresponders to previous interferon-based therapy. One-hundred-thirty-four patients with biopsy-proven chronic hepatitis C, HCV RNA positive, elevated ALT and who were either relapsers (n=37) or nonresponders (n=97) to at least 24 weeks of conventional interferon/ribavirin therapy were retreated with peginterferon alfa-2a (40KD) 180mg/qw and ribavirin 800 mg bid for 48 weeks. Efficacy was assessed as virological response (defined as undetectable HCV RNA) at the end of treatment (EoT) and at the end of follow-up (SVR - Sustained Virological Response). Safety assessments consisted of clinical and laboratory evaluations. In the patient sample, 72% were genotype 1 and 34% were cirrhotic. In an intention-to-treat analysis, relapser patients showed 78% EoT response and 51% SVR. Nonresponders showed 57% EoT response and 26% SVR. Positive predictive factors of SVR were non-1 genotype and relapser state. Six percent of the patients interrupted treatment because of adverse events and 45% had dose reduction (mainly associated with leucopenia and anemia). Brazilian patient relapsers and nonresponders to conventional interferon and ribavirin treatment can achieve a sustained virological response when retreated with peginterferon alfa-2a (40KD) and ribavirin. The safety profile is similar to that of naive patients.

Adult↗
PubMed2005

Hepatitis C prevention with nurses.

A state campaign to educate nurses about hepatitis C and encourage nurses to fight the epidemic provided an opportunity to assess the relationship between information and safety practices. Baseline and follow-up surveys were sent to random, representative samples (n = 6000) of licensed nurses in Massachusetts, USA. Responses received by 42% (n = 2443) at baseline and 37% (n = 2167) at follow-up were compared to explore the relationship between receiving information and propensity to counsel patients or use safety equipment. Only data from nurses in direct patient care were analyzed. Although few changes were observed, the assessment provided further evidence that more than a single intervention is needed to achieve health behavior change. The number of nurses who never used safety equipment did decrease slightly, from 13.3% (191) to 8.2% (132), and nurses who received information were more likely to talk to patients about the virus: 49% (414) compared to 21% (120). Hepatitis information aimed at nurses may help control this emerging epidemic.

Attitude of Health Personnel↗
PubMed2006

Examining characteristics and associated distress related to Internet harassment: findings from the Second Youth Internet Safety Survey.

OBJECTIVE: We sought to identify the characteristics of youth who are targets of Internet harassment and characteristics related to reporting distress as a result of the incident. PARTICIPANTS AND METHODS: The Second Youth Internet Safety Survey is a national telephone survey of a random sample of 1500 Internet users between the ages of 10 and 17 years conducted between March and June 2005. Participants had used the Internet at least once a month for the previous 6 months. RESULTS: Nine percent of the youth who used the Internet were targets of online harassment in the previous year. Thirty-two percent of the targets reported chronic harassment (ie, harassment > or = 3 times in the previous year). In specific incidents, almost half (45%) knew the harasser in person before the incident. Half of the harassers (50%) were reportedly male, and half (51%) were adolescents. One in 4 targets reported an aggressive offline contact (eg, the harasser telephoned, came to the youth's home, or sent gifts); 2 in 3 disclosed the incident to another person. Among otherwise similar youth, the odds of being a target of Internet harassment were higher for those youth who harassed others online, reported borderline/clinically significant social problems, and were victimized in other contexts. Likewise, using the Internet for instant messaging, blogging, and chat room use each elevated the odds of being a target of Internet harassment versus those who did not engage in these online activities. All other demographic, Internet-use, and psychosocial characteristics were not related to reports of online harassment. Thirty-eight percent of the harassed youth reported distress as a result of the incident. Those who were targeted by adults, asked to send a picture of themselves, received an aggressive offline contact (eg, the harasser telephoned or came to the youth's home), and were preadolescents were each significantly more likely to report distress because of the experience. Conversely, the youth who visited chat rooms were significantly less likely to be distressed by the harassment. CONCLUSIONS: Internet harassment can be a serious event for some youth. Because there has been a significant increase in the prevalence of Internet harassment from 2000 to 2005, adolescent health professionals should continue to be vigilant about such experiences in the lives of young people with whom they interact. Social problems and online aggressive behavior are each associated with elevated odds of being the target of harassment. Thus, prevention efforts may be best aimed at improving the interpersonal skills of young people who choose to communicate with others using these online tools. Adolescent health professionals should be especially aware of events that include aggressive offline contacts by adult harassers or asking the child or adolescent to send a picture of themselves, because each of these scenarios increase the odds of reporting distress by more than threefold. Findings further support the call for the inclusion of Internet-harassment prevention in conventional antibullying programs empowering schools to address Internet bullying situations that occur between students. This will not solve all situations, however. We also must encourage Internet service providers to partner with consumers to be proactive in serious harassment episodes that violate criminal laws and service-provider codes of conduct.

Adolescent↗
PubMed1980

Beryllium sampling methods.

Three sampling methods for airborne beryllium are compared to validate observations made in a 1973 National Institute for Occupational Safety and Health (NIOSH) industrywide study of the beryllium industry which indicated that, in general, the three methods yielded different results for samples taken in the same environment. Under NIOSH contract a beryllium production facility was sampled in 1974 by the Atomic Energy Commission (AEC) personal total and personal respirable sampling methods over a period of one year. All samples were analyzed by atomic absorption spectroscopy. Statistical analysis of the resulting data by NIOSH confirms the observations made in the 1973 study that samples collected by the three methods produced different results. No reliable relationship was found to exist which would permit conversion of the result obtained by one method to a result obtained by either of the alternate methods. It appears that, in general, for large numbers of samples taken under the same sampling conditions, the values determined by the personal respirable sampling method will be lower than those obtained by the AEC method and the values determined by the personal total sampling method will be greater.

Air Pollutants↗
PubMedDate not supplied

[Open clinical study of the efficacy and safety of Halazepam in anxiety disorders].

Two open clinical studies were done to evaluate the therapeutic effectiveness and safety of Halazepam. These studies were carried out on an overall sampling of 81 somatic patients suffering from adaptive disorders and symptoms of anxiety, according to DSMIII criteria. The sampling was made up of 40 patients referred for general psychiatric consultation in the Ramón y Cajal Hospital (from any other medical or surgical department) and 41 cardiologic patients (both in- and out-patients). The mean age of the patients referred for general consultation was 40.0, and the mean age of the cardiologic patients was 55.5 years. The posologic standard was 20-120 mg/day, in a single dose or divided into several doses. The following clinical evaluation criteria were applied: Hamilton Anxiety Scale (HS), Physician Evaluation of Improvement (PhEI) and Patient Evaluation of Improvement (PaEI). To determine the safety of the medication, a modified Dotes Secondary Effects Scale was used. At the beginning of the study all the patients had scores of less than or equal to 18 on the Hamilton Depression Scale (HDS) and greater than or equal to 14 on the Hamilton Anxiety Scale. From the first week on till the end of treatment, a statistically significant improvement was observed, based on the scores of the different evaluation scales. Halazepam was found to improve the anxiety condition in 95.0% of the cardiologic patients and 92.5% of the general consultation group. All of the cardiologic patients and 87.5% of the general consultation ones completed the minimum study period (4 weeks) satisfactorily. The only undesirable effects observed were minor and short-lived, and it was not necessary to discontinue treatment in any of the cases. No changes were observed in the clinical significance of the analytic parameters monitored. The results of this study indicate that Halazepam is a fast, safe, effective and easy-to-use drug for treating anxiety.

Adult↗
PubMed2005

Clinical and laboratory safety of one year's use of a combination calcium + vitamin D tablet in ambulatory elderly women with vitamin D insufficiency: results of a multicenter, randomized, double-blind, placebo-controlled study.

OBJECTIVE: This article presents the results of an evaluation of the clinical and laboratory safety of a 1-year course of treatment with a combination calcium and vitamin D tablet in ambulatory women aged >65 years with vitamin D insufficiency. METHODS: In a multicenter, randomized, double-blind, placebo-controlled study conducted in France, women with a 25-hydroxyvitamin D level < or =12 ng/mL were randomized to receive either a combination tablet containing calcium carbonate 500 mg and vitamin D3 400 IU taken twice daily or a matching placebo tablet for 1 year. A complete clinical examination was performed at baseline and at 3, 6, 9, and 12 months of treatment; blood and urine samples were collected for laboratory analyses at the same time points. Safety was monitored based on adverse events recorded during the treatment period and on the results of laboratory tests, including measurement of creatinine and uric acid levels. RESULTS: The study included 192 women (mean [SD] age, 74.6 [6.9] years; mean weight, 64.0 [12.5] kg), 95 in the calcium + vitamin D group and 97 in the placebo group. Fifty women (21/95 [22.1%] calcium + vitamin D, 29/96 [30.2%] placebo) were prematurely withdrawn from the study for various reasons, with no difference in withdrawals between groups. Treatment-related adverse events were reported in 21 (22.1%) and 23 (24.0%) women in the respective treatment groups. These events consisted mainly of metabolic disorders (9 [9.5%] and 10 [10.4%], respectively), particularly hypercalcemia (6 [6.3%] and 8 [8.3%]) and gastrointestinal disorders (9 [9.5%] and 8 [8.3%]). No major complications directly related to calcium and vitamin D supplementation occurred during the course of treatment. Although renal function was not altered, the group who received calcium + vitamin D had significantly elevated concentrations of serum uric acid compared with those who received placebo (52.3% vs 37.2%; P = 0.046) but not urinary uric acid. CONCLUSIONS: In these ambulatory elderly women with vitamin D deficiency, supplementation with calcium + vitamin D appeared to be well tolerated over 1 year of treatment. No significant effects on creatinine clearance were observed. However, the proportion of women with elevated serum uric acid concentrations was significantly greater in those who received calcium + vitamin D compared with those who received placebo.

Aged↗
PubMed2000

A comparison of the quality of life of severely mentally ill people in UK & German samples.

The improvement of the quality of life of people with a severe mental illness is a key policy objective and an important outcome for clinical services. Drawing on cases assessed using the Lancashire Quality of Life Profile and its German translation (The Berliner Lebensqualitatprofil), this paper explores the relationship between personal characteristics, objective well being, subjective well being and overall well being. These variables are compared in two large data sets of people with severe mental illness, one from the UK (n = 1279) and the other from Germany (n = 386). The comparison shows that UK cases have significantly lower subjective well-being in almost all life domains (except safety, living situation and employment). UK cases reported slightly but not significantly higher levels of satisfaction with employment but German cases are more often employed than their UK counterparts. The German samples reported substantially better subjective well-being ratings for health, finances, family, leisure and social life. Exploration of the predictors of overall well-being shows that in both countries depression has the effect of reducing subjective well-being scores, except in relation to work (both samples), religion (UK), finance and safety (Germany). Regression analysis confirms that age, depression and objective circumstances make a small contribution to overall well-being but that subjective ratings in individual life domains make the major contribution. The most important individual predictors of overall well-being for the two samples combined include being a victim of crime, depression and satisfaction with leisure, work, health and mental health, family, living situation, finance and social contacts. Factor analysis indicates that the variance in global well-being explained in both samples combined is 36% (31% in the German samples and 38% in the UK sample).

Adult↗
PubMedDate not supplied

Comparison of hair, nails and urine for biological monitoring of low level inorganic mercury exposure in dental workers.

Creatinine-corrected urine mercury measurements in spot urine samples are routinely used in monitoring workers exposed to inorganic mercury. However, mercury measurement in other non-invasive biological material has been used in some epidemiological studies. Dentists and dental nurses remain a group of workers with potential exposure to inorganic mercury through their handling of mercury-containing amalgam, although changes in work practices have reduced the current, likely exposure to mercury. Therefore, dental workers remain an occupational cohort in whom the value of using different biological media to identify exposure to low level inorganic mercury can be investigated. Samples of head hair, pubic hair, fingernails, toenails and urine were analysed for mercury content from a cohort of UK dentists (n=167) and a socioeconomically similar reference population (n=68) in whom any mercury exposure was primarily through diet. The mercury content in all biological material was significantly higher in the dental workers than in the control population (p<0.0001). The geometric mean and 90th percentile mercury concentrations in the urine samples from dentists were 1.7 and 7.3 micromol mol(-1) creatinine, respectively, with only one sample having a value at around the UK's Health and Safety Executive biological monitoring health guidance level of 20 micromol mol(-1) creatinine. Receiver operator characteristic analyses suggested that the ability of the biological material to discriminate between dentists and referents were fingernails>urine approximately equal to toenails>pubic hair approximately equal to head hair. Further investigation is warranted as to why fingernails appear to be such a good discriminator, possibly reflecting some contribution of direct finger contact with amalgam or contaminated surfaces rather than systemic incorporation of mercury into growing nails. Good correlation between head hair and pubic hair mercury levels in all subjects was obtained (r=0.832), which was significantly improved when hair samples weighing <10 mg were excluded (r=0.868). Therefore, under these exposure conditions and using the described pre-analytical washing steps, there is little influence from atmospheric contamination on the level of mercury content of head hair. The choice of non-invasive biological materials for mercury analysis depends on a number of considerations. These include the toxicokinetics of urinary mercury excretion, the growth rates of hair and nail, the nature and time-frame of exposure, and the fact that urine mercury may not reflect the body burden level from dietary methyl mercury. However, the data from this study suggests that urine mercury remains the most practical and sensitive means of monitoring low level occupational exposure to inorganic mercury.

Cohort Studies↗