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Occurrence, growth, and suppression of salmonellae in composted sewage sludge.

Composted sewage sludge may be used to improve soil quality, but there remains some doubt concerning the microbiological safety of the product. Sewage sludge composts from 30 municipalities were sampled, and four samples (12%) contained salmonellae (two contained fewer than 0.3/g, and the other two had 21/g and 1.7 X 10(4)/g). All 30 composts were inoculated with salmonellae; the populations decreased at a specific death rate of about 0.15 h-1 over 24 h at 36 degrees C. In irradiation-sterilized composts inoculated with salmonellae, the salmonellae grew at a rate of 0.65 doublings per h for over 24 h. Growth and death rates were found to be moisture and flora associated. The growth or death rates for antibiotic-resistant salmonellae were not different from those of nonresistant strains. It was concluded that the active indigenous flora of compost establishes a homeostatic barrier to colonization by salmonellae, and in the absence of competing flora, reinoculated salmonellae may grow to potentially hazardous densities. The active microflora of moist composts eliminated contaminating salmonellae (10(5)/g) after 6 weeks.

Aerobiosis↗

Severe tardive dyskinesia in affective disorders: treatment with vitamin E and C.

Tardive dyskinesia caused by antipsychotic treatment is a severe problem not only in the management of schizophrenia, but also of affective disorders. Vitamin E monotherapy has been used in schizophrenic patients with tardive dyskinesia. Pharmacologists warn against high dosage of vitamin E because of its pro-oxidative effects on low-density lipoprotein with consecutive cardiac risks. Addition of vitamin C probably reduces this risk because of its interactions with vitamin E, i.e. vitamin C reduces vitamin E radicals formed when vitamin E scavenges the oxygen radicals. We have therefore tested the safety and efficacy of combining vitamin C and E in a sample of patients with affective disorders and tardive dyskinesia who had previously been treated with antipsychotics due to psychotic symptoms. In all 6 patients, a reduction of tardive symptomatology was seen. In our sample, no side effects were observed. Further studies on this combination therapy are suggested.

Adult↗

Risperidone monotherapy in preschool children with pervasive developmental disorders.

The aim of this preliminary study was to examine the short-term efficacy and safety of the atypical antipsychotic risperidone in preschool autistic children. The sample consisted of 10 subjects (7 males and 3 females) aged 3 9/12 to 6 6/12 years (mean age 4.7 years). A 16-week open-label trial with risperidone monotherapy was initiated at a starting dose of 0.25 mg daily and was increased to a maximum dose of 0.50 mg (0.027 mg/kg daily). Outcome measures were the Childhood Autism Rating Scale, the Children's Psychiatric Rating Scale, Clinical Global Impression (improvement score), and the Children's Global Assessment of Functioning. Two subjects did not complete the trial because of side effects (tachycardia and flushes, fever and hyporexia). After the 16-week treatment, data from the eight children who completed the trial indicated a modest improvement in the Childhood Autism Rating Scale total score, Children's Psychiatric Rating Scale total score, and Children's Global Assessment of Functioning. According to the Clinical Global Impression, the global improvement score for four subjects was much improved or very much improved; the score for the other four children was minimally improved. None of the children exhibited behavioral deterioration. The side effects in the eight children were not severe.

Antipsychotic Agents↗

Fate of Staphylococcus aureus in cheese treated by ultrahigh pressure homogenization and high hydrostatic pressure.

We evaluated the influence of ultrahigh pressure homogenization (UHPH) treatment applied to milk containing Staphylococcus aureus CECT 976 before cheese making, and the benefit of applying a further high hydrostatic pressure (HHP) treatment to cheese. The evolution of Staph. aureus counts during 30 d of storage at 8 degrees C and the formation of staphylococcal enterotoxins were also assessed. Milk containing approximately 7.3 log(10) cfu/mL of Staph. aureus was pressurized using a 2-valve UHPH machine, applying 330 and 30 MPa at the primary and the secondary homogenizing valves, respectively. Milk inlet temperatures (T(in)) of 6 and 20 degrees C were assayed. Milk was used to elaborate soft-curd cheeses (UHPH cheese), some of which were additionally submitted to 10-min HHP treatments of 400 MPa at 20 degrees C (UHPH+HHP cheese). Counts of Staph. aureus were measured on d 1 (24 h after manufacture or immediately after HHP treatment) and after 2, 15, and 30 d of ripening at 8 degrees C. Counts of control cheeses not pressure-treated were approximately 8.5 log(10) cfu/g showing no significant decreases during storage. In cheeses made from UHPH treated milk at T(in) of 6 degrees C, counts of Staph. aureus were 5.0 +/- 0.3 log(10) cfu/g at d 1; they decreased significantly to 2.8 +/- 0.2 log(10) cfu/g on d 15, and were below the detection limit (1 log(10) cfu/g) after 30 d of storage. The use of an additional HHP treatment had a synergistic effect, increasing reductions up to 7.0 +/- 0.3 log(10) cfu/g from d 1. However, for both UHPH and UHPH+HHP cheeses in the 6 degrees C T(in) samples, viable Staph. aureus cells were still recovered. For samples of the 20 degrees C T(in) group, complete inactivation of Staph. aureus was reached after 15 d of storage for both UHPH and UHPH+HHP cheese. Staphylococcal enterotoxins were found in controls but not in UHPH or UHPH+HHP treated samples. This study shows a new approach for significantly improving cheese safety by means of using UHPH or its combination with HHP.

Animals↗

Production of ex vivo expanded hematopoietic cells and progenitors in a closed bioreactor, starting with a small volume marrow collection: A feasibility study in patients with poor-risk breast cancer and receiving high-doses of cyclophosphamide.

We report a clinical pilot study conducted in 6 women with poor-prognosis breast cancer. The goal was to evaluate the feasibility and safety of producing hematopoietic progenitors and cells from a small marrow sample, for clinical use after high-dose cyclophosphamide. A small volume marrow collection was obtained, using local anesthesia and conscious sedation, before the first of two chemotherapy cycles. Cells were cryopreserved, and later thawed to inoculate two Aastrom Biosciences Inc Replicell bioreactors, on time to reinfuse ex vivo expanded cells after the second chemotherapy cycle. Patients recovered neutrophils and platelets at similar times after the first and second chemotherapy cycles, and showed comparable clinical events. This pilot study prepares future randomized trials, designed to evaluate clinical benefits associated with the use of ex vivo expanded cells in the setting of multicycle high-dose chemotherapy.

Aged↗

Effects of feed withdrawal and transport on cecal environment and Campylobacter concentrations in a swine surgical model.

The objective of the present study was to evaluate how feed withdrawal and transportation influenced the cecal environment and cecal populations of Campylobacter in swine. Four miniature Yucatan gilts (8.8 kg), naturally infected with Campylobacter jejuni, were surgically implanted with cecal cannulas. The gilts were fasted for 48 h. Samples of cecal contents were collected for 7 days prior to and for 7 days after the fast, and mean values were determined for pH, volatile fatty acids (VFA), and CFU enumeration of C. jejuni. This was replicated three times. In another trial, gilts (full-fed) were transported in a livestock trailer for 4 h and cecal samples were collected before and after transport and analyzed for pH, VFA, and CFU. Following a 48-h fast, cecal pH increased (P < 0.05) by 1 unit; acetic and propionic acids decreased (P < 0.05) by 61% and 71%, respectively; and there was a twofold log10 increase (P < 0.05) in CFU/g cecal content of C. jejuni. Values of pH, VFA, and CFU of C. jejuni did not change in cecal samples from gilts following transportation. These data are important for food safety considerations because feed withdrawal, commonly associated with shipping and slaughter, can increase Campylobacter concentrations in the pig intestinal tract.

Animals↗

Structural characterization of a case-implicated contaminant, "Peak X," in commercial preparations of 5-hydroxytryptophan.

OBJECTIVE: To determine the chemical structure of a contaminant, X1, previously found in eosinophilia myalgia syndrome case-implicated 5-hydroxytryptophan (5-OHTrp), and also present in over-the-counter (OTC) commercially available 5-OHTrp. METHODS: Case-implicated 5-OHTrp as well as 6 OTC samples were subjected to accurate mass HPLC-mass spectrometry and HPLC-electrochemical detection, and reacted with reduced glutathione. Peak X1 was subsequently subjected to HPLC-tandem mass spectrometry (MS/MS), as well as the resulting nucleophilic glutathione product. All these data were compared with analysis carried out under identical conditions on authentic 4,5-tryptophan-dione (Trp-4,5D). RESULTS: Based on accurate mass, tandem mass spectrometric analysis, and comparision with authentic standard compound analysis, X1 was determined to be 4,5-tryptophan-dione, a putative neurotoxin. The presence of X1 in OTC samples varied from 0.5 to 10.3% of the amount of Trp-4,5D present in case-implicated 5-OHTrp. CONCLUSION: Peak X1 was identified as the putative neurotoxin Trp-4,5D. It was found in case-implicated 5-OHTrp as well as 6 OTC samples. This gives some cause for concern in terms of the safety of such commercial preparations of 5-OHTrp.

5-Hydroxytryptophan↗

[Evaluation on the safety and immunogenicity of Canada split influenza virus vaccine].

OBJECTIVE: To evaluate the safety and immunogenicity of Canada split influenza virus vaccine. METHODS: Cluster samples were by randomly chosen and divided into split vaccination group and homoimported influenza vaccination group. RESULTS: After injection, fever-reaction and local reaction rates of 'trial' group were found as 3.69% and 1.75% respectively, but no statistical significance was found when compared with 'control' group. However the antibody positive rates of 'trail' and 'control' groupsappeared statistically significant (H1N1: 96.8% vs. 92.3%, H3N2: 95.8% vs. 90.2%, B: 52.3% vs. 62.3%). For geometric mean titer (GMT) of type H1N1, H3H2 and B antibody, 'trial' group and 'control' group increased 22.4, 16.8, 8.2 and 21.2, 12.5 and 7.4 times respectively. The antibody protective rates of type H1N1, H3N2 and B were 99%, 99% and 53.9% for 'trial' group, and 96.2%, 98.4% and 62.3% for 'control' but with no statistically significant difference. CONCLUSION: Influenza split vaccine made in Shire company in Canada was safe and with good immunogenicity.

Adolescent↗

Knowledge of and attitude towards road traffic codes among commercial motorcycle riders in Anambra State.

Road traffic accidents (rtas) represent a major epidemic of non communicable disease in the country and has since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the two urban towns of nnewi and Awka of Anambra state, Nigeria. making use of a pre-tested, semi structured, interviewer administered questionnaire, relevant data on socio demographic and motorcycle characteristics were collected from a sample of commercial motorcyclists selected by systematic sampling technique. their knowledge of and attitude towards road traffic and safety codes were elicited. The result showed that the all-male commercial motorcyclists had a mean age of 30+8.9 years. one hundred and seventy six (32.6%) possessed good knowledge of road traffic codes and safety, while 35 (6.5%) exhibited good attitude towards them. both knowledge of and attitude towards traffic codes and safety improved with increase in educational level (p<0.005, p<0.001 respectively). the younger motorcyclists also possessed statistically significant better knowledge of traffic codes than their older counterparts (p<0.025). attitude to traffic codes and safety had no association with age of the motorcyclists (p>0.25). the study has provided useful information on the knowledge of and attitude towards road traffic and safety codes among commercial motorcyclists in nigeria. pursuit of knowledge through formal and informal education should run pari pasu with efforts to improve the nigerian economy in order to ensure a sustainable positive attitudinal change towards road traffic codes and safety among commercial motorcyclists.

Accident Prevention↗

[Multicenter clinical study of the effects of once daily administration of mepartricin 150.000 U. in benign prostatic hypertrophy].

The effects of partricin methyl ester, administered to 481 BPH patients at the dose of 150.000 U as a single administration at night for 90 days were studied in the course of a multicentre study. The favourable evolution of the objective and subjective symptomatologic parameters taken into consideration confirmed the efficacy of the substance used even by this mode of administration. The size of the patient sample ensured that reliable findings were obtained as regards the excellent safety of this form of dosage.

Adult↗

Use of safety belts--Madrid, Spain, 1994.

An estimated 300,000 persons die and 10-15 million persons are injured each year in traffic crashes throughout the world (1). In Spain, during 1993, motor-vehicle crashes accounted for 6378 deaths (16 per 100,000 population) and were the leading cause of death for persons aged 1-44 years and the leading cause of years of potential life lost (2). Safety belts are 40%-70% effective in preventing severe injuries and deaths associated with motor-vehicle crashes (3). In April 1975, the Traffic Safety Administration of Spain implemented a mandatory safety-belt-use law for persons who were front-seat passengers traveling outside city limits (i.e., interurban traffic). On June 15, 1992, the law was expanded to include all front-seat passengers traveling in vehicles in the city limits and passengers in the back seats of vehicles with manufacturer-installed safety belts (4). In September 1994, the Ministry of Health of Spain, in collaboration with the Traffic Safety Administration, conducted surveys to assess the impact of the expanded law. This report summarizes findings of this assessment in Madrid, including the first direct observation survey of safety-belt use by front-seat occupants and a telephone sample survey of knowledge, attitudes, and behaviors related to motor-vehicle use.

Female↗

Estimating the safety performance of urban road transportation networks.

Transportation planning models are typically used to estimate future traffic patterns, peak period traffic, travel time, and various environmental or other related traffic flow characteristics. Unfortunately, traffic safety is seldom, if ever, explicitly considered proactively during the transportation planning process. This omission is attributed to various factors, including the lack of available tools needed to estimate the number of crashes during this process. To help fill this void, the research on which this paper is based aimed, as a primary objective, to develop a tool that would allow the estimation of crashes on digital or coded urban transportation networks during the planning process. The secondary objective of the research was to describe how the predictive models should be applied on these networks and explain the important issues and limitations surrounding their application. To accomplish these objectives, safety performance functions specifically created for this work were applied to two sample digital networks created with the help of EMME/2, a software package widely used in transportation planning. The results showed that it is possible to predict crashes on digital transportation networks, but confirmed the reality that the accuracy of the predictions is directly related to the precision of the traffic flow estimates. The crash predictions are also sensitive to how the digital network is coded, and it is shown how appropriate adjustments can be made.

Accidents, Traffic↗

Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting.

OBJECTIVE: Conventional antiemetics are burdened with the potential of teratogenic effects during the critical embryogenic period of pregnancy. Thus, a safe and effective medication would be a welcome addition to the therapeutic repertoire. This systematic review was aimed at assessing the evidence for or against the efficacy and safety of ginger (Zingiber officinale) therapy for nausea and vomiting during pregnancy. DATA SOURCES: Systematic literature searches were conducted in 3 computerized databases (MEDLINE, EMBASE, and Cochrane Library), and the reference lists of all papers located were checked for further relevant publications. METHODS OF STUDY SELECTION: For the evaluation of efficacy, only double-blind, randomized controlled trials (RCTs) were included. All retrieved clinical data, including uncontrolled trials, case reports, observational studies, and RCTs, were included in the review of safety. TABULATION, INTEGRATION, AND RESULTS: Six double-blind RCTs with a total of 675 participants and a prospective observational cohort study (n = 187) met all inclusion criteria. The methodological quality of 4 of 5 RCTs was high. Four of the 6 RCTs (n = 246) showed superiority of ginger over placebo; the other 2 RCTs (n = 429) indicated that ginger was as effective as the reference drug (vitamin B6) in relieving the severity of nausea and vomiting episodes. The observational study retrieved and RCTs (including follow-up periods) showed the absence of significant side effects or adverse effects on pregnancy outcomes. There were no spontaneous or case reports of adverse events during ginger treatment in pregnancy. CONCLUSION: Ginger may be an effective treatment for nausea and vomiting in pregnancy. However, more observational studies, with a larger sample size, are needed to confirm the encouraging preliminary data on ginger safety. LEVEL OF EVIDENCE: I.

Administration, Oral↗

Use of secondary enrichment for isolation of Salmonella from naturally contaminated environmental samples.

Since the implementation of Hazard Analysis Critical Control Point (HACCP), the need for on-farm food safety risk assessment and management has greatly increased. In order to provide accurate risk assessments, attention should be focused on better characterization of the Salmonella isolation and identification techniques. In this work, we compared the isolation ability of 4 Salmonella-specific protocols: immunomagnetic separation (DB), tetrathionate (TT) broth, Rappaport-Vassiliadis R10 (RV) broth, and a secondary enrichment (TR) procedure as well as 2 selective solid media (brilliant green agar, BG; and xylose-lysine tergitol 4, XLT4). All 4 methods were compared in litter and drag swab samples that were collected weekly during the broiler grow out period in 7 houses. There were 65/126 (51.6%) pooled litter samples positive and 115/304 (37.8%) drag swab samples positive for Salmonella by at least one method. Of the 65 positive litter samples, DB, RV, and TT isolated 1 (2.7%), 31 (47.7%), and 23 (35.4%) of the samples as positive when using BG agar, respectively. The TR protocol identified 83.1% (54/65) of the positive samples as positive when using BG agar. In the drag swab samples, DB did not identify any samples as positive, whereas TT and RV found 28 (25.7%) and 26 (23.9%) of the 109 samples to be positive when using BG agar, respectively. Again, the TR protocol identified the highest percentage of positive samples (94.5%). An analysis of agreement, kappa, revealed that TT and RV did not always agree on which samples were positive, although the number of samples identified as positive by both were not different. A comparison between the 2 agar plates used, BG and XLT4, showed that they had high agreement when the secondary enrichment protocol was used, but agreement was only moderate to low when the other 3 methods were used.

Animals↗

All terrain vehicle ownership, use, and self reported safety behaviours in rural children.

OBJECTIVES: To describe all terrain vehicle (ATV) ownership, access, use, and safety behaviours in rural Manitoba children. METHODS: Questionnaire administered to a convenience sample of grade 6 students attending an agricultural fair. RESULTS: 162 grade 6 children participated. The mean age was 11.4 years, and 46% were male. 125 students (77%) reported having access to ATVs, including 69 four wheeled, 24 three wheeled, and four both three and four wheeled ATVs. ATV experience was reported in 95 students, significantly more often in males and among those with a family owned ATV, with no difference between children living on a farm and in a town. Use of helmets and protective clothing was inadequate (10-40%), and dangerous riding habits common, with males and children living on a farm reporting significantly fewer desirable behaviours. CONCLUSIONS: ATVs are commonly used by children in rural Manitoba, with inadequate protective gear and dangerous riding habits. Mandatory rider training, consumer and dealer education, and legislation enforcement could improve ATV safety in this population.

Behavior↗

Assessment of effectiveness of traditional herbal medicine in managing HIV/AIDS patients in South Africa.

BACKGROUND: Very few clinical studies have been conducted in South Africa to assess the value and efficacy of traditional herbal medicines that are commonly used by traditional healers for the treatment of HIV-positive patients. OBJECTIVE: To assess efficacy of a South African traditional herbal medicine in reducing viral load and increasing CD4+T cell counts of HIV/AIDS patients. DESIGN: A descriptive, prospective, follow-up study of 33 HIV-positive volunteers over a one year period. Viral load and CD4 counts were taken three times from each participant. SETTING: From November 2001 to October 2002, patients were treated at the Rustenburg Community Based Centre for traditional therapy. Clinical and paraclinical treatments and screening of patients were done at Pretoria Gynaecological Hospital. PARTICIPANTS: Seven men and 26 women aged between 22 and 43 years took part in a 12-month long follow-up study. HIV monitoring was done at the beginning and after 4 and 8 months in symptomatic and asymptomatic patients with CD4 counts below 200 cells/mm3 or viral load counts above 10,000 copies. INTERVENTION AND ASSESSMENT: ab mitio and after 4-months, viral load, CD4+T cell count, FBC, LFT, glycaemia, U/E, cholesterol, pap smear, clinical and subjective assessment, modern drugs plus hospitalisation for opportunistic infections and resuscitation where needed, powder or suspension of herbal medicine followed by meals. MAIN OUTCOME MEASURES: Improvement in overall health condition and immune system, increase in CD4+T cell count and decrease in viral load count. The two sample paired t-test was used to compare initial and final counts at the 5% level of significance and power of 80%. Ninety five per cent confidence intervals were obtained for differences between mean values. RESULTS: After four and/or eight months of therapy, significant health improvement was achieved: better physical appearance (80% of patients), increased appetite (65%), feeling of well-being (60%), disappearance of skin marks (70%) and urogenital lesions (100%), resumption of workplace duties (60%), weight gain (80%), significant reduction in viral loads (85.4%, p = 0.0015) and significant increase in CD4+ T cell counts (226%, p = 0.0000). CONCLUSION: Achievement of health improvement within eight months indicates that herbal medicine can be used as supplementary or alternative treatment for HIV/AIDS patients, and that it is an obvious immune system booster and probable "virus-cidal" factor. The apparent safety and efficacy of herbal medication warrants further research with a larger sample size of study.

Adult↗

A sampling and analytical method for the simultaneous determination of multiple organophosphorus pesticides in air.

A sampling and analytical method for organophosphorus pesticides using a combined filter/XAD-2 sorbent sampler and gas chromatography (GC)-flame photometric detection (FPD) was developed. The method was evaluated for 19 organophosphorus pesticides based on the joint Occupational Safety and Health Administration/National Institute for Occupational Safety and Health Standards Completion Program methods evaluation protocol. The evaluation addressed analyte recovery, sampler capacity, sample stability, and precision and accuracy. Additional experiments addressed long-term sample stability (30-day storage), short-term exposure limits, limits of detection, and concentration levels down to 0.1 times an exposure limit value. Samples were stable for 30 days of storage under either ambient or refrigerated conditions. Based on this research, all 19 compounds studied can be successfully determined simultaneously using one method with an accuracy of +/- 25% of the true value 95 times out of 100.

Air Pollutants↗

Sample size considerations for studies of intervention efficacy in the occupational setting.

OBJECTIVE: Due to a shared environment and similarities among workers within a worksite, the strongest analytical design to evaluate the efficacy of an intervention to reduce occupational health or safety hazards is to randomly assign worksites, not workers, to the intervention and comparison conditions. Statistical methods are well described for estimating the sample size when the unit of assignment is a group but these methods have not been applied in the evaluation of occupational health and safety interventions. We review and apply the statistical methods for group-randomized trials in planning a study to evaluate the effectiveness of technical/behavioral interventions to reduce wood dust levels among small woodworking businesses. METHODS: We conducted a pilot study in five small woodworking businesses to estimate variance components between and within worksites and between and within workers. In each worksite, 8 h time-weighted dust concentrations were obtained for each production employee on between two and five occasions. With these data, we estimated the parameters necessary to calculate the percent change in dust concentrations that we could detect (alpha = 0.05, power = 80%) for a range of worksites per condition, workers per worksite and repeat measurements per worker. RESULTS: The mean wood dust concentration across woodworking businesses was 4.53 mg/m3. The measure of similarity among workers within a woodworking business was large (intraclass correlation = 0.5086). Repeated measurements within a worker were weakly correlated (r = 0.1927) while repeated measurements within a worksite were strongly correlated (r = 0.8925). The dominant factor in the sample size calculation was the number of worksites per condition, with the number of workers per worksite playing a lesser role. We also observed that increasing the number of repeat measurements per person had little benefit given the low within-worker correlation in our data. We found that 30 worksites per condition and 10 workers per worksite would give us 80% power to detect a reduction of approximately 30% in wood dust levels (alpha = 0.05). CONCLUSIONS: Our results demonstrate the application of the group-randomized trials methodology to evaluate interventions to reduce occupational hazards. The methodology is widely applicable and not limited to the context of wood dust reduction.

Dust↗