Risky sun tanning behaviours amongst Irish University students: a quantitative analysis.

BACKGROUND: Despite Ireland's temperate maritime climate, it has the third highest rate of malignant melanoma in the European Union, indicating the need to recognise tanning practices as a risky behaviour, especially amongst those most at risk (the younger population). AIM: To explore the factors associated with deliberate sun tanning amongst university students in Cork, Ireland. METHODS: Self-reported sun exposure, attitudes to tanning and sun protection practices were investigated using an online questionnaire in April 2010. RESULTS: There were 833 responses (8.33 %), mean age 22 years, 75 % female. Reporting deliberate tanning in the previous summer (n = 389, 46.7 %) was positively correlated (r = 0.622, p < 0.001) with stating an intention to tan next summer (n = 532, 63.9 %). Women and respondents with darker (vs. fairer) complexion were more likely to engage in deliberate tanning (p < 0.001). Deliberate tanning was associated with reporting enjoying tanning (p < 0.001), with reporting peer pressure into tanning (p = 0.039), and (marginally) with thinking it is worth getting burnt to get a tan (p = 0.068). Younger students were significantly more likely to report these attitudes; being a current smoker was associated with reporting peer pressure and that burning is worth a tan, indicating a level of risk-taking. Respondents reported (average) three sources of information on sun risks. CONCLUSION: Tanning is a form of strongly motivated risk-taking as much in a sun-limited country like Ireland as in hotter sun-rich climates. Risk communication strategies on sun exposure should be developed that target young people and improve their risk awareness.

Delayed diagnosis of pseudoaneurysm formation in a patient with diaphyseal aclasis.

A 15 year old boy, with known diaphyseal aclasis, presented with a swollen left leg. The diagnosis of popliteal pseudoaneurysm, a known and well understood vascular complication, was delayed due to presentation suggestive of a chondrosarcoma. In this age group, sarcomatous change is more common and a potentially sinister complication of diaphyseal aclasis. Following a sarcoma MDT referral, the correct diagnosis was confirmed by ultrasound and CT angiogram. This case identifies one of the largest, non-ruptured popliteal pseudoaneurysms reported and illustrates an unusual complication of a rare orthopaedic genetic condition, which is potentially limb threatening.

Identification of etamiphylline and metabolites in equine plasma and urine by accurate mass and liquid chromatography/tandem mass spectrometry.

Etamiphylline camsylate (Millophylline V) was administered intravenously to two horses at a dose of 2.8 mg/kg. Urine and blood samples were taken up to 32 h post administration. Unhydrolyzed plasma and urine was extracted using solid phase extraction (SPE). The identity of the parent drug and metabolites was confirmed using a linear ion trap mass spectrometer and accurate mass analysis on an orbitrap mass spectrometer. Desethyletamiphylline (molecular weight 251) was the main metabolite observed in the urine and plasma samples and resulted from the N-deethylation of etamiphylline. The second metabolite detected in urine and plasma resulted from the demethylation of etamiphylline (molecular weight 265). The third minor metabolite detected in urine was proposed to have resulted from a simultaneous N-deethylation and demethylation of etamiphylline (molecular weight 238).

An assessment of the implementation of the provincial cervical screening programme in selected Primary Health Care Clinics in the Ilembe Region, KwaZulu-Natal.

Cervical cancer is almost completely preventable, yet it is the second most prevalent cancer amongst women in South Africa. KwaZulu-Natal (KZN) in particular has a high mortality rate of cervical cancer and 1: 40 women die from cancer of the cervix. Therefore, in 1997 a cervical screening policy and programme was implemented in the province. The purpose of the study was to evaluate the implementation of selected aspects of the Provincial cervical screening programme in selected Primary Health Care (PHC) clinics in Ilembe Region, KZN. Results indicated that there was a lack of resources needed for implementing the programme in rural clinics compared to urban clinics. However, all clinics in the study had an adequate supply of the drugs needed for the treatment of abnormal smears. On reviewing the records, the researcher noted that most of the results indicated that smears had adequate cells needed for analysis. However, the results indicated that there was a problem with follow-up of clients with abnormal smears. Feedback to the clinics from the referral hospital regarding the outcome of the visit was inadequate. The results indicated that the mechanisms of record keeping were inadequate. Therefore, the above results indicate that problems exist at the selected PHC clinics that may result in ineffective implementation of the cervical screening programme.

Ontogeny of uteroplacental progestagen production in pregnant mares during the second half of gestation.

In pregnant mares during late gestation, little, if any, progesterone (P4) is found in the maternal circulation. Hence, quiescence of the equine uterus is believed to be maintained by metabolites of pregnenolone and P4 known as progestagens, which are produced by the uteroplacental tissues. However, little is known about the ontogeny, distribution, or actual rates of uteroplacental progestagen production in pregnant mares and their fetuses during the second half of pregnancy. Therefore, the present study measured the rates of uteroplacental uptake and output of eight specific progestagens in chronically catheterized, pregnant pony mares from 180 days to term. No significant uteroplacental uptake of any of the eight individual progestagens was observed from the uterine circulation. In contrast, significant uteroplacental uptake was observed for five of the eight individual progestagens from the umbilical circulation, and the uptakes increased toward term. The major uteroplacental progestagen outputs were 5 alpha-pregnane-3,20-dione (5 alphaDHP) and 20 alpha-hydroxy-5 alpha-pregnan-3-one (20 alpha 5P). These were released into both the umbilical and uterine circulations at rates that increased toward term. The majority of the total uteroplacental 20 alpha 5P output was distributed into the uterine circulation at all gestational ages studied. In contrast, distribution of the total uteroplacental 5 alphaDHP output switched from preferential delivery into the uterine circulation before 220 days of gestation to release predominantly into the umbilical circulation after 260 days. These findings demonstrate that uteroplacental progestagen production changes during the second half of gestation, which may have important implications for the maintenance of pregnancy and the onset of labor in the mare.

Biotransformation of cyclizine in greyhounds. 1: Identification and analysis of cyclizine and some basic metabolites in canine urine by gas chromatography-mass spectrometry.

1. The partial in vivo biotransformation of Marezine [(cyclizine.HCl); 1-diphenylmethyl-4-methylpiperazine hydrochloride] in the racing greyhound and the excretion of the unconjugated and conjugated (Phase II) basic metabolites of cyclizine in canine urine are reported. 2. Using copolymeric bonded mixed-mode solid-phase extraction cartridges, the basic isolates from both unhydrolysed and enzyme hydrolysed urine samples were isolated, derivatized as trimethylsilyl ethers and analysed by positive-ion electron ionization gas chromatography-mass spectrometry (EI(+)-GC-MS). Selected samples were analysed by positive-ion methane chemical ionization (CI(+))-GC-MS to aid structure elucidation of the putative metabolites. 3. Cyclizine was the major component excreted in post-administration urine. Five substrate-related basic compounds (M1--> M5) were tentatively identified by EI(+)- and CI(+)-GC-MS. The major Phase I metabolite was identified as norcyclizine [1-diphenylmethylpiperazine] (M1), the other metabolites (M2 --> M5) were tentatively identified as monohydroxylated products based on MS data. 4. Cyclizine and the N(4)-desmethyl metabolite (M1) are excreted unconjugated; the other four hydroxylated metabolites are excreted as Phase II conjugates (glucuronides and/or sulphates). Structures of the putative basic metabolites are presented. At least four other basic metabolites were also detected in post-administration urine, but could not be characterized from GC-MS data. 5. All unhydrolysed post-administration urine samples were analysed by selected ion monitoring EI(+)-GC-MS to quantify cyclizine and norcyclizine (M1) using authentic cyclizine as the analyte and chlorcyclizine as the internal standard. The level of M1 is expressed as 'cyclizine equivalents'. The duration of urinary elimination of cyclizine and M1 was obtained from their excretion profiles. 6. From these studies, cyclizine and norcyclizine (M1) would be the target compounds of choice in the development of screening and confirmatory methods for the detection of cyclizine administration to racing greyhounds. Information on any of the other metabolites may also be of some value for confirmatory analysis.

Effects of maternally administered depot ACTH(1-24) on fetal maturation and the timing of parturition in the mare.

The aims of this study were to ascertain 1) whether fetal maturation could be induced precociously by maternal administration with adrenocorticotrophic hormone (ACTH) and 2) whether maturation could be achieved without significant risk to mare or fetus. Twenty-two mares received either 1 mg (low dose, LD, n = 6) or 4 or 5 mg (higher dose, HD, n = 16) synthetic Depot ACTH(1-24) at 300, 301 and 302 days gestation. Because, during the course of the study, ACTH appeared to have a greater influence on mares mated during the later part of the breeding season, the HD group were divided retrospectively into those mated before (HDE, n = 6), or after (HDL, n = 10), 1st July. All LD mares were mated before 1st July. Control injections were not performed but gestational data were compared retrospectively with 64 untreated, spontaneously foaling pony mares mated between May and October. Plasma progestagen and cortisol concentrations increased significantly (P<0.05) following ACTH administration in all groups, but progestagens were higher and cortisol elevated for longer in HD mares. ACTH stimulated mammary development and milk electrolyte changes in HD mares. Mean +/- s.e. gestation period (days) was significantly (P<0.01) shorter in HDL mares (318 +/- 1.8) compared with LD (335 +/- 3.7), HDE (340 +/- 4.3) and untreated mares mated after 1st July (327 +/- 1.3). All foals were mature except 2 HDL foals which were stillborn. HDL foals had a higher MCV and lower mean bodyweight, indicating they were delivered before full term. In conclusion, maternal ACTH administration appears to accelerate fetal maturation and delivery in pony mares given high doses and mated late in the breeding season. Further work is required to establish the optimal gestational age and dosage for maternal ACTH administration before clinical recommendations can be given for this therapy.

A retrospective study of increased plasma progestagen concentrations in compromised neonatal foals.

Plasma progestagen concentrations were measured daily by radioimmunoassay (RIA) in 35 sick foals for the duration of their illness. The foals were divided into three groups on the basis of time to stand after birth. Foals were given intensive care treatment according to the severity of their illness. Plasma and urine concentrations of pregnenolone (P5) and pregnenediol (P5 beta beta) were measured by gas chromatography--mass spectrometry; plasma cortisol concentrations were measured by RIA and the foals' renal and respiratory status were assessed by creatinine clearance ratios and arterial oxygen concentrations respectively. Five patterns of plasma progestagen concentrations were identified; in general, values increased when the foal's clinical condition deteriorated and decreased as the foal improved. Median progestagen concentrations decreased over the first three days post partum in Group 1 foals but remained elevated in foals from Groups 2 and 3. Similar changes were observed in plasma P5 and P5 beta beta concentrations. Plasma cortisol concentrations were highest in foals from Groups 2 and 3 (P < 0.01) compared with foals from Group 1. Regardless of foal group, mean cortisol concentrations were highest (P < 0.001) in those foals treated with adrenocorticotrophic hormone compared with those treated with dexamethasone or with neither drug. There was no relationship (r2 = 0.21) between plasma cortisol and progestagen concentrations. Results from renal clearance, steroid conjugation and respiratory status suggest that these factors did not play a significant role in elevating progestagen concentrations in sick foals. It is hypothesized that there may be a relationship between adrenal stimulation and an enzyme block resulting in overproduction of P5 and P5 beta beta in the sick neonatal foal.

Continuing education in South Africa.

An overview of continuing education in South Africa reveals that despite strong philosophical support a number of factors impede the developmental of an effective system of such education. Existing inadequacies have been exacerbated by the introduction in 1986 of a comprehensive program for entry into the profession, resulting in an overwhelming demand for continuing education for nurses who trained prior to that. Rural nurses in particular are disadvantaged, with nondegree continuing education being largely inaccessible. However, efforts to meet these needs are afoot, and two recent initiatives are described.

Increase in plasma progestagen concentrations in the mare after foetal injection with CRH, ACTH or betamethasone in late gestation.

Maternal plasma progestagen concentrations increase about 20 days before parturition. The major contributors to the increase are reduced metabolites (ie 5 alpha-pregnanes). Precocious increases (ie less than 310 days of gestation) in these metabolites may occur in abnormal pregnancies. The effects of CRH, ACTH or betamethasone administered to the foetus at gestational ages ranging from about 250 to 320 days were examined. Sixteen healthy pony mares were used for foetal injection employing aseptic techniques. Water or normal saline were used as controls. Maternal plasma progestagen concentrations were measured using a commercial radioimmunoassay (RIA) progesterone kit and results were confirmed using gas chromatography-mass spectrometry (GC-MS). Results demonstrated clearly that an increase in maternal plasma progestagen concentrations occurred after injection of ACTH, CRH or betamethasone to the foetus, irrespective of gestational age. A comparable increase was not observed in the control animals. Of the 16 mares in which the foetus was injected, 13 produced viable foals at gestational ages ranging from 307 to 339 days whereas 3 mares delivered non-viable foals at 284 to 306 days gestation. The results support the hypothesis that the pre-parturient rise in progestagens occurring in the mare is the result of foetal adrenocortical activity.

Plasma progestagen concentrations in the normal and dysmature newborn foal.

Radioimmunoassay (RIA) and gas chromatography-mass spectrometry (GC-MS) were used to determine plasma progestagen concentrations in the normal and premature foal. Radioimmunoassay provides a profile of plasma progestagens with respect to time but, due to the non-specific nature of the technique and without prior chromatographic purification, quantitative data based on RIA analysis must be interpreted with caution. In contrast, the greater specificity of GC-MS allows identification of specific plasma progestagens and measuring of multiple analytes in a single analysis. Both techniques demonstrated a marked difference in plasma progestagen concentrations between the normal and abnormal foal. GC-MS studies demonstrated that the plasma steroid profile was dominated by pregnenolone and 5-pregnene-3 beta, 20 beta-diol. Measuring the amounts of these 2 steroids in a single analysis demonstrated persistent high concentrations in premature foals, whereas concentrations decreased rapidly in the first few hours following birth in the normal foal. Preliminary analyses of urinary concentrations in the 2 steroids demonstrated again differences between normal and abnormal foals.