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PubMed2003

Hydrotherapy for Rett syndrome.

OBJECTIVE: The effects of hydrotherapy on an 11-year-old girl with stage III Rett syndrome were investigated. METHODS: The Halliwick method was used to apply hydrotherapy in a swimming pool twice a week for 8 weeks. The girl's physical abilities were assessed 3 times: before and 5 minutes after a single hydrotherapy session and after 8 weeks of hydrotherapy. The tests included analysis of stereotypical movements, functional hand use, hand skills, gait and balance, hyperactive behaviour, communication and social interaction. RESULTS: Immediately after hydrotherapy, stereotypical movements decreased and this decrease continued during the following 8 weeks. The girl's feeding activities and hand skills increased markedly. After 8 weeks of hydrotherapy, her walking balance was improved, interaction with her environment increased and hyperactive behaviour and anxiety decreased. CONCLUSION: In conclusion, after the application of hydrotherapy, stereotypical hand movements had decreased and purposeful hand functions and feeding skills increased in this case. Whether hydrotherapy has a positive effect on the functional use of the hand in Rett syndrome should be investigated using more subjects.

Adolescent↗

PubMed2006

How well does a national newspaper reporting system profile drowning?

In Finland, the Finnish Association for Swimming Instruction and Life Saving (SUH) and Statistics Finland (SF) both provide nationwide data on unintentional drowning. The SUH database relies on rapid reporting from a newspaper clipping service and additional local police information, whereas the SF database relies on the later release of the death certificate information, which is based on extensive medico-legal investigation. The aim of the study was to explore the main differences between the SUH and SF databases for drowning and to evaluate the capacity of the former to characterize drowning events in Finland from 1998 to 2000. Computerized files of death certificates tabulated by SF were linked with the SUH database by deterministic methods. SF and SUH databases allowed the identification of 704 and 567 unintentional drownings, respectively, giving an unintentional drowning rate of 4.5 and 3.6/100?000 per year. Of the 704 drownings described by SF, 418 (59.4%) were also found in the SUH database. The SUH database markedly underreported drowning fatalities in certain settings, such as bath, ditch and swimming pool drownings; fall- and land-traffic-related drownings; and drownings occurring in South Finland. The narrative text of SUH drownings contributed limited information to characterize the drowning events. It was concluded that the newspaper-based SUH data provide more timely data on individual drownings but are not representative of all drownings. Conversely, the SF vital statistics data are more accurate but may take up to 2 years to become available. Both SUH and SF data provide little detailed information on drowning events. A multidisciplinary national surveillance system for drowning is necessary to provide more accurate and timely drowning data, analyse risk factors and design follow-up studies for developing and monitoring prevention strategies.

Adolescent↗

PubMed2006

Assessment of emotional reactivity produced by exposure to virtual environments in patients with eating disorders.

The aim of this study was to assess the usefulness of virtual environments representing situations that are emotionally significant to subjects with eating disorders (ED). These environments may be applied with both evaluative and therapeutic aims and in simulation procedures to carry out a range of experimental studies. This paper is part of a wider research project analyzing the influence of the situation to which subjects are exposed on their performance on body image estimation tasks. Thirty female patients with eating disorders were exposed to six virtual environments: a living-room (neutral situation), a kitchen with high-calorie food, a kitchen with low-calorie food, a restaurant with high-calorie food, a restaurant with low-calorie food, and a swimming-pool. After exposure to each environment the STAI-S (a measurement of state anxiety) and the CDB (a measurement of depression) were administered to all subjects. The results show that virtual reality instruments are particularly useful for simulating everyday situations that may provoke emotional reactions such as anxiety and depression, in patients with ED. Virtual environments in which subjects are obliged to ingest high-calorie food provoke the highest levels of state anxiety and depression.

Adolescent↗

PubMed2005

Effect of sunscreen and clothing on the number of melanocytic nevi in 1,812 German children attending day care.

The number of melanocytic nevi is the most important risk factor for cutaneous melanoma. This 1998 cross-sectional study of 1,812 children aged 2-7 years from 78 day-care centers in Germany analyzed the protective effect of sunscreen and clothing on the number of melanocytic nevi. Total body nevi were counted, and pigmentary features were assessed. Parents underwent a standardized interview concerning their children's sun exposure and sun-protective behavior. Almost 95% of the children had used sunscreen previously. Children who used sunscreen and wore more clothing spent significantly longer periods on holidays in sunny climates (p < 0.001 and p = 0.006, respectively) and had a higher outdoor activity score at home (p < 0.001 and p = 0.012, respectively). Multivariate analysis adjusted for confounders showed no significant protective effects of applying sunscreen. Examination of the potential protective effect of clothing revealed an inverse dose-response correlation between the number of clothes worn at the beach or outdoor swimming pool and the number of melanocytic nevi (p < 0.001, adjusted for confounding). Randomized controlled trials are needed to confirm these results. Meanwhile, public education should aim to protect children primarily by sun avoidance and protective clothing, while sunscreen should also be used.

Chi-Square Distribution↗

PubMed2002

The importance of policy orientation and environment on physical activity participation--a comparative analysis between Eastern Germany, Western Germany and Finland.

Environmental and policy interventions are seen as boosting physical activity because they are designed to influence large groups. However, they have not been much researched and the evidence on their role is still quite limited. The purpose of this study was to investigate differences in and relationships between policy orientation, the objective and perceived physical environment, and physical activity between Finland, Eastern Germany and Western Germany. The data are taken from a public telephone survey carried out as part of the international MAREPS project (Methodology for the Analysis of Rationality and Effectiveness of Prevention and Health Promotion Strategies; Eastern Germany, n = 913; Western Germany, n = 489; Finland, n = 400), statistics of sports facilities and policy documents. Results from the survey showed that Finns are more active than Germans and that they differ in their way of practising physical activity from Germans. Finns were more satisfied with their opportunities for physical activity and were better informed about physical programmes and measures. Finland also has the best opportunities in indoor sports facilities and outdoor sports grounds per number of inhabitants (excluding indoor swimming pools). Analysis of policy orientations showed that Finland had the most extensive 'Sport for All' policy, although West Germany's policy orientation did not differ that much from Finland's. East Germany's policy orientation was characterized by competitive sports. A policy orientation that places emphasis on the physical activity of the whole population seems to be related to better opportunities and a better infrastructure for sports and physical activity. This study suggests that there is a relationship between policy orientation, physical environment and physical activity participation.

Attitude to Health↗

PubMed1985

Duration of whirlpool-spa use as a risk factor for Pseudomonas dermatitis.

Pseudomonas dermatitis occurred among 16 of 49 whirlpool-spa bathers in a Vermont hotel during a weekend in November 1983. Pseudomonas aeruginosa, serotype 0:4, was isolated from a patient and the whirlpool-spa water. Since duration of whirlpool-spa use had been previously postulated as a risk factor for dermatitis, a historical cohort study was designed to test this hypothesis. Each bather was carefully interviewed about the duration in minutes of whirlpool-spa and swimming pool exposure on the weekend. Total duration of whirlpool-spa use was significantly associated with rash illness both on contingency and logistic regression analysis. Females were also found to be at increased risk, after controlling for the study hypothesis. Duration of whirlpool-spa use was an important determinant of risk for Pseudomonas dermatitis in this outbreak.

Dermatitis↗

PubMed2005

Evaluation of induced radioactivity in structural material of Toshiba Training Reactor 'TTR1'.

A decommissioning programme for the Toshiba Training Reactor (TTR1), a swimming pool type reactor used for reactor physics experiments and material irradiation, was started in August 2001. As a part of the programme, induced radioactivity in structural material was evaluated using neutron flux data obtained with the three-dimensional Sn code TORT. Induced activity was calculated with the isotope generation code ORIGEN-79 using activation cross section data created from multi-group library based on JENDL-3. The obtained results for radioactivities such as 60Co, 65Zn, 54Mn and 152Eu were compared with measured ones, and the present calculational method was confirmed to have enough accuracy.

Computer Simulation↗

PubMed2001

Characteristic features of suicidal drownings: a 20-year study.

A retrospective study of cases of drowning suicide was undertaken at the Forensic Science Centre in Adelaide, South Australia for the period April 1980 to March 2000. A total of 123 cases were found, with 76 males (age, 16-88 years; average, 50.5 years; standard deviation [SD], 20.1 years) and 47 females (age, 34-88 years; average, 60.6 years; SD, 13.9 years). There were 66 fresh water drownings and 57 saltwater drownings. Female victims were significantly older than male victims for both fresh water and saltwater drownings (P < .05 and P < .01, respectively). Deaths in young women were rare. No temporal trend in drowning suicides could be shown, with annual numbers varying from 0 to 12 cases (average, 6.15; median, 7). Women preferentially chose the ocean or bath to drown themselves in, whereas males chose rivers, ditches, and lakes. Swimming pools were rarely used for suicide in this population; alcohol use was not usual; and there was often a significant history of mental illness.

Adolescent↗

PubMed2002

Update on protozoan parasites of the intestine.

The last year has seen new approaches to the diagnosis, treatment, and prevention of protozoal infections of the gastrointestinal tract. Some of the news is not good: new foodborne and swimming pool outbreaks of cyclosporiasis and cryptosporidiosis, respectively, occurred in North America; paromomycin was shown to be ineffective treatment for cryptosporidiosis; and these parasitic diseases continued to have a worldwide impact on human health. On the bright side, there were important advances in the understanding of the pathogenesis of cryptosporidiosis and the diagnosis of amebiasis and giardiasis, and some new leads on the treatment of cryptosporidiosis and refractory giardiasis. Finally, evidence was found of acquired mucosal immunity to amebiasis in Bangladeshi children, offering a guide for the development of an amebiasis vaccine. This review is not intended to be comprehensive, but contains a variety of articles that the authors hope will be of interest to the reader.

Journal Article↗

PubMed2001

Radiological impact on the workers, members of the public, and environment from the partial decommissioning of Pakistan Research Reactor-I and its associated radioactive residues.

The Pakistan Research Reactor-I (PARR-I) is a swimming pool type research reactor originally designed and built for a thermal power of 5 MW using High Enriched Uranium (HEU) fuel. In 1990-1991 the reactor was redesigned, partially decommissioned and recommissioned to operate with Low Enriched Uranium (LEU) fuel at a thermal power of 10 MW. An essential requirement, construction and commissioning of a wet spent fuel storage bay and fabrication of an irradiated fuel transfer cask were completed before actual dismantling of the reactor core. During the partial decommissioning operations, radioactive waste generated included 600 m3 low-level liquid radioactive waste and 14 m3 of solid radioactive waste with an average specific activity of 4.52 Bq ml(-1) and 2.22 kBq g(-1), respectively. External radiation doses of the workers were determined using TLD (NG 6,7) and direct reading dosimeters. The maximum individual external radiation dose received by any worker during this practice was 5 mSv, which was 25% of the annual dose limit of 20 mSv. Detection and measurement of internal contamination was carried out using bioassay techniques. During the whole operation, not a single case of internal contamination was detected. The ambient radiation levels around waste seepage pits are periodically monitored using TLD (G-2 cards) and G. M. radiation survey meters. Underground migration of radioactivity is checked by analyzing seepage water samples taken from boreholes that have been dug at different locations in the vicinity of the radioactive residues. The monitoring around disposal sites containing radioactive residues has been continued during the last 9 y and will be continued in the future. So far, no rise in the environmental gamma radiation dose level and migration of underground radionuclides has been found in the vicinity of these disposal sites. Working personal during the decommissioning of PARR-I have been found to be radiologically safe. Adherence to the ALARA principle, sound decommissioning and proper radioactive waste disposal procedures helped to protect the working personnel, members of the public, and the environment from the harmful effects of the ionizing radiations present due to the partial decommissioning of the research reactor and its radioactive residues. Experience gained during this work, along with the current international procedures, will be helpful for full restoration of the environment from radioactive residues likely to be generated in the future from any other practices in Pakistan.

Body Burden↗

PubMed1991

Treatment of acute hypoxemic respiratory failure caused by chlorine exposure.

Chlorine inhalation may rapidly cause pulmonary edema, leading to acute hypoxemic respiratory failure. We report a 12 year old with acute respiratory failure from inhalation injury after he accidentally dropped chlorine tablets into a swimming pool. Supplemental oxygen alone failed to provide adequate arterial oxygenation. We administered positive end expiratory pressure (PEEP) in the emergency department, resulting in markedly improved oxygenation. Early institution of PEEP should be considered in patients with chlorine poisoning when supplemental oxygen alone is insufficient.

Child↗

PubMed1976

Cryosurgery for benign and malignant skin lesions: treatment with a new instrument.

The Foster "Froster" unit is a new and simplified liquid nitrogen system for use in dermatologic cryosurgery. The details of its operation are described and its use in various benign, premalignant, and malignant lesions is discussed. In malignant lesions, not only type, but frequently location, is important when deciding whether to use cryosurgery as the first, alternate, or adjunctive choice of therapy. Benign and premalignant lesions which respond best are sebaceous hyperplasia, dermatofibromas, actinic keratoses, leukoplakias, lentigines, and certain seborrheic keratoses and verrucae. Initial promising results have been reported in cases of swimming pool granuloma and chromoblastomycosis. Application of the described technics in one's clinical practice must depend primarily on the level of knowledge of skin lesions and on the degree of skill attained in cryosurgical methods.

Basal Cell Carcinoma↗

PubMed2002

A case-control study of childhood environmental risk factors for the development of inflammatory bowel disease.

OBJECTIVE: To clarify the relationship between childhood environment and the risk of subsequent development of Crohn's disease or ulcerative colitis. DESIGN AND OUTCOME MEASURES: A case-control study, assessing the risk of inflammatory bowel disease in relation to a series of historical and serological markers of childhood circumstance, analysed using the maximum likelihood form of conditional logistic regression. SETTING: District general hospital (secondary care institution). PARTICIPANTS: Subjects with Crohn's disease (n = 139) or ulcerative colitis (n = 137) aged between 16 and 45 years, each matched for sex and age with an outpatient control. RESULTS: Helicobacter seroprevalence was substantially reduced in Crohn's disease (OR 0.18; 95% CI, 0.06-0.52) but not in ulcerative colitis (OR 0.91; 95% CI, 0.38-2.16). In ulcerative colitis, a strong negative association with childhood appendectomy was confirmed (OR 0.05; 95% CI, 0.01-0.51). Crohn's disease was associated with childhood eczema (OR 2.81; 95% CI, 1.23-6.42) and the frequent use of a swimming pool (OR 2.90; 95% CI 1.21-6.91). There was no association between hepatitis A seroprevalence and either disease. CONCLUSION: The findings are consistent with the hypothesis that improved childhood living conditions are associated with increased risk of Crohn's disease. The study confirms that the negative association between appendectomy and ulcerative colitis relates primarily to events in childhood. Overall, the findings strongly support the assertion that childhood environment is an important determinant of the risk of inflammatory bowel disease in later life, with quite distinct risk factors for ulcerative colitis and Crohn's disease.

Adolescent↗

PubMed2003

Persistent inner ear injury after diving.

OBJECTIVE: The purpose of this multiple case report was to discuss the occurrence and cause of sudden sensorineural hearing loss after diving. STUDY DESIGN: The study design was a retrospective case review. SETTING: The study was conducted at an academic tertiary referral center. PATIENTS: In this multiple case report, two teenagers with unilateral sudden sensorineural hearing loss after diving, one from a starting block and one from a 1-m board, while performing school swimsports were included. INTERVENTION: The patients underwent diagnostic tympanotomy with sealing of the round and oval window membranes and a vasoactive rheologic therapy combined with corticosteroid treatment. MAIN OUTCOME MEASURES: The average pure-tone bone-conduction thresholds were calculated. The appearance of nystagmus, vertigo, and tinnitus was analyzed. RESULTS: Both patients experienced unilateral sudden deafness after performing a headfirst pike-type dive into a swimming pool. None of the patients contacted with the bottom of the pool. In one patient, a rupture of the round window was found intraoperatively. In the other patient, no rupture of the round or oval window was seen intraoperatively. In spite of sealing of the round window and application of vasoactive rheologic therapy, hearing did not improve significantly in either of the patients. CONCLUSION: Rupture of the round window may occur after diving even if the dive is performed from a low height into the water and the bottom of the pool is not contacted. Besides direct contusion to the external ear and barotrauma, other causes such as whiplash mechanism have to be considered.

Adolescent↗

PubMed1996

The distribution of Clostridium difficile in the environment of South Wales.

A large study of the distribution of Clostridium difficile in the environment of the Cardiff area of South Wales was performed with a methodology designed to maximise recovery. A total of 2580 samples was taken, with 184 (7.1%) yielding isolates. The highest yield for C. difficile was obtained from river waters, with 14 (87.5%) of 16 samples from four rivers positive, and from sea water samples with 7 (44%) of 15 positive from six beaches on the Bristol Channel. In addition, 7 (46.7%) of 15 samples of lake water were also positive. Twenty-two (21%) of 104 soil samples, taken from random sites in Cardiff, were positive, as were 20% of environmental samples from four Cardiff hospitals. C. difficile was also isolated from 50% of eight swimming pool waters examined and 1 (5.5%) of 18 of mains tap water. Carriage of C. difficile in 524 faecal samples of assorted farm animals was c. 1%, and was 10% in dogs and 2% in cats. In private residences, the organism was present in 12 (2.2%) of 550 samples. While 2.4% of 300 raw vegetable samples were positive, none of 107 assorted fish gut contents was. These findings indicate that C. difficile may be more widely distributed in the general environment, particularly water, than was previously thought.

Animals↗

PubMed2006

Mycobacterium kansasii olecranon bursitis.

A case is reported of a post-traumatic olecranon bursitis caused by Mycobacterium kansasii following an injury sustained in a public swimming pool. It responded to surgical debridement and combined rifampicin, isoniazid, pyrazinamide and ethambutol antimicrobial therapy. A literature search was performed and a treatment regimen for this uncommon condition is suggested.

Antitubercular Agents↗

PubMed2006

Immobilization of zinc phthalocyanines in silicate matrices and investigation of their photobactericidal effect on E. coli.

The aim of the present investigation was to immobilize zinc phthalocyanines in a silicate matrix and to test the photobactericidal properties of the matrices so prepared toward Esherichia coli in model aqueous media. For the purpose, tetra tertiary butyl zinc phthalocyanine (TBZnPc) and zinc phthalocyanine tetrasulfonic acid (ZnPcTS) were used. The abilities of these two photosensitizers to generate singlet oxygen in solution were compared by following the rate of photobleaching of 1,3-diphenylisobenzofuran (DPBF) at 430 nm in dimethylformamide (DMF). The results of this study show clearly that, under the conditions used here, the TBZnPc is the more effective generator of singlet oxygen; with it the DPBF was virtually completely photobleached in 4 min, while with the ZnPcTS under the same conditions, it took 12 min to reach this point. Glass conjugates with the two phthalocyanines were obtained by the sol-gel technique and were characterized by a well-defined color due to the phthalocyanine incorporated in the silicate matrix. Glasses with an intense, but inhomogeneous, green color were obtained when the tetrasulfonic derivative of the zinc phthalocyanine was used, while blue glasses of evenly distributed coloration were formed from the tetra tertiary butyl derivative. The ZnPcTS conjugate demonstrates more effective singlet oxygen evolution than is the case with the TBZnPc conjugate. These results are the opposite of those obtained for the free phthalocyanines in solution. The structural formulae of the compounds show that TBZnPc has a more pronounced hydrophobic character than the sulfonic derivative. In our view, the relative reactivities of the conjugates can be explained by the tetrasulfonic derivative being situated mainly in the surface parts of the glass matrix where the hydrophilic character is prevailing, while the tertiary butyl derivative is mainly present in the internal parts of the matrix as a result of which it is less accessible and therefore less active. The results obtained on the effect of zinc phthalocyanine conjugates on E. coli show a trend similar to that observed with singlet oxygen evolution shown. Thus, for the ZnPcTS conjugate, the log kill is 1.32 and for the TBZnPc conjugate, it is 0.98, in each case after 120 min. The results obtained show that phthalocyanines can be immobilized successfully in a silicate matrix and used for photodisinfection of microbially polluted waters. The silicate matrix has some advantages in comparison with other organic matrices. It is insoluble in water, resistant towards microorganisms, easy to fabricate, and might be developed successfully for the photodisinfection of water, e.g., in swimming pools and in other open water reservoirs.

Adsorption↗

PubMed2005

Clinical patterns of cutaneous nontuberculous mycobacterial infections.

BACKGROUND: Cutaneous nontuberculous mycobacterial infections result from external inoculation, spread of a deeper infection, or haematogenous spread of a disseminated infection. There are two species-specific infections (fish-tank or swimming-pool granuloma, due to Mycobacterium marinum, and Buruli ulcer, caused by M. ulcerans). Most infections, however, produce a nonspecific clinical picture. OBJECTIVES: To define clinical patterns of cutaneous disease in nontuberculous mycobacterial infections. METHODS: Fifty-one patients with cutaneous nontuberculous mycobacterial infections were reviewed. Clinical and histopathological features of normal hosts and immunosuppressed patients were compared. Two subgroups of immunosuppressed patients were distinguished: patients with cutaneous infection and patients with a disseminated infection and cutaneous involvement. RESULTS: In immunosuppressed patients the number of lesions was significantly higher. Abscesses and ulceration were also more frequently observed. Different species were found in normal hosts and immunosuppressed patients. Several clinical patterns of cutaneous infection were defined: lymphocutaneous or sporotrichoid lesions; nonlymphocutaneous lesions at the site of trauma; folliculitis and furunculosis involving the lower extremities; disseminated lesions on the extremities in immunosuppressed patients. Two patterns were observed in patients with a disseminated infection: localized cutaneous lesions and disseminated cutaneous and mucosal lesions. CONCLUSIONS: Cutaneous manifestations of nontuberculous mycobacterial infections may be classified according to criteria such as cutaneous lesions and immune status.

Abscess↗