Effect of serum on the mitochondrial active area on developmental days 1 to 4 in in vitro-produced bovine embryos.

Certain morphological changes at the subcellular level caused by the current techniques for in vitro embryo production seem to affect mitochondria. Many of these, including dysfunctional changes, have been associated with the presence of serum in the culture medium. Thus, the aim of the present work was to assess the mitochondrial dynamics occurring in embryos during the first 4 days of development, in order to analyze the most appropriate time for adding the serum. We used transmission electron microscopy (TEM) micrographs to calculate the embryo area occupied by the different morphological types of mitochondria, and analyzed them with Image Pro Plus analyzer. The results showed hooded mitochondria as the most representative type in 1- to 4-day-old embryos. Swollen, on-fusion, orthodox and vacuolated types were also present. When analyzed in embryos cultured without serum, the dynamics of the different mitochondrial types appeared to be similar, a fact that may provide evidence that the developmental changes control the mitochondrial dynamics, and that swollen mitochondria may not be completely inactive. In contrast, in culture medium supplemented with serum from estrous cows, we observed an increased area of hooded mitochondria by developmental day 4, a fact that may indicate an increased production of energy compared with previous days. According to these results, the bovine serum added to the culture medium seems not to be responsible for the functional changes in mitochondria.

AIDS-related tuberculosis in Rio de Janeiro, Brazil.

BACKGROUND: We studied the incidence of tuberculosis, AIDS, AIDS deaths and AIDS-TB co-infection at the population level in Rio de Janeiro, Brazil where universal and free access to combination antiretroviral therapy has been available since 1997. METHODOLOGY/PRINCIPAL FINDINGS: This was a retrospective surveillance database match of Rio de Janeiro databases from 1995-2004. Proportions of tuberculosis occurring within 30 days and between 30 days and 1 year after AIDS diagnosis were determined. Generalized additive models fitted with cubic splines with appropriate estimating methods were used to describe rates and proportions over time. Overall, 90,806 tuberculosis cases and 16,891 AIDS cases were reported; 3,125 tuberculosis cases within 1 year of AIDS diagnosis were detected. Tuberculosis notification rates decreased after 1997 from a fitted rate (fR per 100,000) of 166.5 to 138.8 in 2004. AIDS incidence rates increased 26% between 1995 and 1998 (30.7 to 38.7) followed by a 33.3% decrease to 25.8 in 2004. AIDS mortality rates decreased dramatically after antiretroviral therapy was introduced between 1995 (27.5) and 1999 (13.4). The fitted proportion (fP) of patients with tuberculosis diagnosed within one year of AIDS decreased from 1995 (24.4%) to 1998 (15.2%), remaining stable since. Seventy-five percent of tuberculosis diagnoses after an AIDS diagnosis occurred within 30 days of AIDS diagnosis. CONCLUSIONS/SIGNIFICANCE: Our results suggest that while combination ART should be considered an essential component of the response to the HIV and HIV/tuberculosis epidemics, it may not be sufficient alone to prevent progression from latent TB to active disease among HIV-infected populations. When tuberculosis is diagnosed prior to or at the same time as AIDS and ART has not yet been initiated, then ART is ineffective as a tuberculosis prevention strategy for these patients. Earlier HIV/AIDS diagnosis and ART initiation may reduce TB incidence in HIV/AIDS patients. More specific interventions will be required if HIV-related tuberculosis incidence is to continue to decline.

Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil.

SETTING: Data from the mortality database, Rio de Janeiro City (RJC) Health Department, Rio de Janeiro, Brazil. OBJECTIVES: To determine the role played by tuberculosis (TB) in Brazil's human immunodeficiency virus (HIV) positive population, we investigated the frequency of TB as the primary cause of death among HIV-positive subjects in RJC. DESIGN: Information about acquired immune-deficiency syndrome (AIDS) deaths from 1996 to 2005 in individuals aged >12 years was obtained from the Mortality Information System (SIM), and the cause of death was classified according to the International Classification of Diseases (ICD-10), through primary causes coded in Chapter I--B20 to B24 (HIV disease). RESULTS: There were 8601 AIDS-related deaths in RJC between 1996 and 2005. TB was the primary cause of death in 9.0% of all AIDS-related deaths, while Pneumocystis carinii pneumonia (PCP) accounted for 4.7%. TB cases erroneously classified under other infectious diseases may have contributed to an underestimation of the number of TB deaths among HIV-positive patients. CONCLUSION: Our study showed that TB is the leading cause of AIDS-related deaths and is responsible for twice as many deaths as PCP, in a scenario of free access to antiretrovirals. The potential benefits of TB preventive treatment and of the availability of highly active antiretroviral treatment could not be established by this analysis.

The possible role of endocrine disrupting chemicals in the aetiology of cryptorchidism and hypospadias: a population-based case-control study in rural Sicily.

Abstract This was an open case-control study of the possible association between parental occupational and domestic exposures to potential endocrine disrupting chemicals (EDC) assessed by questionnaire and cryptorchidism and hypospadias in their offspring in the agricultural area of Ragusa. Cases of infants born between 1998 and 2002 with either of these two malformations (n=90), and controls (n=203), were recruited through the paediatric services (for cases) and a random sample of healthy infants attending the same services born in the same period of time (for controls). Data on occupational and environmental exposures of parents prior to and during the index case (or control), were collected through interviews with both parents. Concerning occupational exposures, we did not find a statistically significant increase in risk among parents directly involved in agricultural work. We did find a non-statistically significant increase in risk for cryptorchidism in mothers employed in agriculture [adjusted odds ratios (OR) 2.97; 95% confidence interval (CI) 0.77-11.47] and with probable exposure to pesticides (adjusted OR 2.74; 95% CI 0.72-10.42). Fathers who had indirect contact with agricultural products (transport and retail) had an increased risk (not statistically significant) for cryptorchidism (adjusted OR 2.45; 95% CI 0.63-9.59) and hypospadias and cryptorchidism combined (adjusted OR 2.24; 95% CI 0.67-7.48). Increases in risk of the two malformations pooled were also observed in relation to the mother's age below 25 (adjusted OR 1.99; 95% CI 0.97-4.09), to the presence of genital disease of the father (adjusted OR 2.41; 95%C I0.94-6.17), and the mother (adjusted OR 3.47;95% CI 1.34-8.99), to low birth weight of the infant (adjusted OR 4.49; 95% CI 1.23-16.31). Increased risk was also observed for mothers consuming alcohol during pregnancy (adjusted OR 3.09; 95% CI 0.98-9.66), and for couples who conceived while using condoms (adjusted OR 2.12; 95% CI 1.02-4.41). The study therefore provides only limited support to the hypothesis of a possible association between the risk of cryptorchidism and hypospadias and the occupational exposure to EDC and agricultural work.

Occupational exposures to bloodborne pathogens among healthcare workers in Rio de Janeiro, Brazil.

Healthcare workers (HCWs) frequently face the risk of occupational infection from bloodborne pathogens following exposure to blood and body fluids. This study describes the results of a surveillance system of occupational exposure to bloodborne pathogens among HCWs in Rio de Janeiro, Brazil, during an eight-year period. A total of 15 035 exposures reported from 537 health units were reviewed. Six circumstances comprised nearly 70% of the reported exposures: recapping needles (14%), performing surgical procedures or handling surgical equipment (14%), handling trash (13%), during disposal into sharps containers (13%), performing percutaneous venepuncture (10%) and during blood drawing (5%). Easily preventable exposures, such as incidents related to recapping needles, handling trash, and sharps left in an inappropriate place, represented 30% of the exposures reported. Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) was initiated for 46% of exposed HCWs. Although Brazilian guidelines indicate that PEP is usually not recommended for exposures with insignificant or very low risk of HIV infection, PEP was prescribed to a large proportion of exposed HCWs under these circumstances. The prevention of occupational exposure to bloodborne pathogens among HCWs and their safety must be considered as a public health issue. Although infection-preventative measures such as antiretroviral drugs and rapid tests are available, this study shows that there are still a high number of easily preventable exposures. The implementation of more effective prevention strategies is urgently required in this country.

Cryptorchidism and hypospadias in the Sicilian district of Ragusa and the use of pesticides.

The aim of the study was to explore the role of environmental exposures to pesticides in the birth prevalence of hypospadias and cryptorchidism, in the 12 agricultural municipalities of Ragusa Sicily. Data on the birth prevalence of the two birth defects were obtained from the local pediatric services for the period 1998-2002. Municipalities were ranked according to the degree of "pesticide impact" on the basis of three quantitative criteria of intensity of agricultural activities of the population. We found a significantly higher birth prevalence of hypospadias with increasing "pesticide impact" (trend test, P=0.003). The association with cryptorchidism was not statistically significant, but when the two birth defects were pooled together, the linear trend was significant (trend test, P=0.001).

Self perceived health and mental health among women flight attendants.

AIMS: The authors investigated associations of work related risk factors with self perceived health as less than "good" and psychological distress among Italian women flight attendants. METHODS: The authors conducted a cross sectional survey on health and mental health among 1955 former and current flight attendants, using a postal questionnaire. RESULTS: More current than former flight attendants reported self perceived health as fair to poor and psychological distress measured as a GHQ-12 score of six or more. Among current flight attendants, reporting health as fair to poor was associated with low job satisfaction (OR 1.89) and recent experiences of sexual harassment by passengers (OR 2.83). Psychological distress was associated with low job satisfaction (OR 2.38) and frequent tension with partner over childcare (OR 1.79). CONCLUSIONS: Perceived health as fair to poor and psychological distress were greater among current flight attendants and were related to job characteristics and family difficulties. Perceived poor health has been shown in the literature to be related to mortality, high job strain, and early retirement, and psychological distress is associated with work absence. The effect of sexual harassment by passengers on perceived health of flight attendants may be relevant to other working women dealing with the public. The health effects of family/work conflicts, low job satisfaction, and sexual harassment should be explored more in depth, using qualitative as well as quantitative methods among working women in various occupations.

Mortality in a cohort of pesticide applicators in an urban setting: sixty years of follow-up.

The study is a further follow-up of a cohort of 168 urban pesticide applicators of the municipality of Rome who were first employed in 1946. An earlier analysis of the mortality of this group concerned the deaths observed up to 1987, and showed a significant excess in mortality from liver cancer. In this report we present an updated follow up of the mortality of the cohort, which comprises the total of 85 deaths for the entire period of observation, corresponding to 5227 person/years. The living status of each member of the cohort was ascertained through the official records up to 2005. For the 85 deceased individuals, the primary cause of death was coded according to the 9th Revision of the ICD. Standardized mortality ratios (SMR) were calculated on the basis of the age, sex, and cause specific mortality rates prevailing during the same calendar years in the province of Rome. The SMR from all causes for the whole cohort was 103.8 (90 %CI 86 124). The SMR for all cancers was 106.0 ( 90 % CI 75-146). An increased risk was observed for the exposed for cancer of the gallbladder (SMR 723.8 90% CI 129-2279), of the liver (SMR 596.3, 90 % CI 204-1365) and for cancer of the nervous system (SMR 529.2, 90 % CI 144-1368). All increases were statistically significant, but no association was found between the increased risk of these cancers and the longer duration of exposure. The increase in risk of the three cancers mentioned above (liver, nervous system and gallbladder), was further increased, when the analysis was restricted to the workers exposed prior to the 1978 ban of DDT and products containing arsenic.

Integrating qualitative methods into occupational health research: a study of women flight attendants.

AIMS: To identify possible work related sources of psychosocial stress in order to develop pertinent questionnaire items for a cross-sectional health survey of 3000 Italian women flight attendants, and to solicit suggestions on improving survey participation. METHODS: Qualitative study in which 26 current and former women flight attendants participated: three focus groups of 6-7 participants each and six in-depth individual interviews. The session themes included positive and negative aspects of the job; relationships with colleagues, superiors, and passengers; perception of occupational risk for serious diseases; compatibility of work and family; and experiences of work related sources of stress and their effect on health. A transcript based analysis of the focus groups and interviews was used to identify emerging themes related to risk factors for mental health problems. RESULTS: The participants indicated that mental health was a major concern. Several work related risk factors possibly related to adverse outcomes, such as depression and anxiety, were highlighted. These included isolation and solitude, fears of being inadequate partners and mothers due to job demands, passenger relationships, and lack of protection by employers with respect to workplace exposures and violent passengers. The information gained was used to develop a mental health module for inclusion in the health survey questionnaire which included questions on history of severe depression or anxiety, suicidal ideation or attempt, substance abuse, workplace sexual harassment, social support, leisure time activities, relationship with a partner, and role as mother. CONCLUSIONS: Employing qualitative methods to identify work related sources of psychosocial stress enabled development of pertinent questionnaire items for a cross-sectional epidemiological study of women flight attendants. Follow up qualitative research may be necessary in order to put the cross-sectional study findings into context and to explore actions or strategies for preventing work related health problems evidenced from the survey.

[Is it possible to use sex ratio at birth as indicator of the presence of endocrine disrupters in environmental pollution?]. / E possibile utilizzare il sex ratio alla nascita come indicatore di presenza di endocrine disrupters in contaminazioni ambientali?

The sex ratio at birth (male births/total births) seems to be influenced by both biological and environmental factors. Endocrine Disrupters such as dioxin, DBCP and other pesticides have been studied as possible determinants of the decline in the sex ratio observed in some western countries. High serum concentration of dioxin in about two hundred fathers exposed during the well-known Seveso accident (1976), have been found associated with a significant decline in male births. The present study examines the possible variation of the sex ratio at birth in the offspring of the entire populations residing in the municipalities around the site of the Seveso accident. We observed a reduction of male births in the eight years following the accident (1977-1984) in the two municipalities with the highest level of contamination (Meda and Seveso). This effect was no longer detectable in the subsequent decades. No reduction in the sex ratio was observed when all considered municipalities are grouped in three exposure categories, according to their distance from the centre of the contaminated area. It is concluded that variations of the sex ratio may be detected only in populations with high exposure to dioxin, but this effect is concealed when the analysis of the sex ratio is based on large populations, with lower levels of exposure.

[Occupational exposure and male fertility. Results of an Italian multicenter study in an exposed population]. / Esposizioni occupazionali e fertilità maschile. Risultati di uno studio italiano multicentrico tra popolazioni esposte.

It was believed that occupational exposure to several toxic agents could negatively affect male fertility. This paper reports the results of a study on the fertility of couples in whom the man was occupationally exposed to three different toxics: metals, solvents and pesticides, having effects on reproduction. Fertility was evaluated during the time that elapsed between attempting and achieving the first pregnancy of the couple (time to pregnancy--TTP). Exposure to occupational risks during the period preceding conception was defined on the basis of data collected from 153 workers of a mint (exposed to metal and solvents), 322 agricultural workers licensed to handle pesticides and 127 greenhouse workers. Comparing the groups exposed during the conception period with comparable non-exposed groups, we found a slight delay in conception among couples with male exposure to metals (OR = 1.3; 95% CI 0.5-3.6), to solvents (OR = 1.7; 95% CI 0.6-4.6) and to pesticides among greenhouse workers (OR = 1.6; 95% CI 0.8-3.1 for the moderately exposed and OR = 2.4; 95% CI 1.2-5.1 for the heavily exposed). No increase in the risk of conception delay was observed in agricultural workers with generic exposure to pesticides. The results of this study suggest that the workers exposed to metals and solvents and greenhouse workers exposed to pesticides experienced a delay in conception at the time of their wives' first pregnancy.

Patterns of contraceptive use in 5 European countries. European Study Group on Infertility and Subfecundity.

OBJECTIVES: The use of contraception in Denmark, Germany, Poland, Italy, and Spain is described. METHODS: Data were drawn from a population-based cross-sectional study, the European Study of Infertility and Subfecundity. Interviews were conducted with 6630 women aged 25 to 44 years. Logistic regression was used to estimate the effect of factors associated with contraceptive use. RESULTS: Residents of Northern European countries tended to use more effective methods of contraception than residents of Southern European countries. The use of contraception was generally more common among single women, the more highly educated, those with children, and those with a previous induced abortion. These characteristics were also the main determinants of the use of more effective methods. Periodic abstinence and withdrawal were more common among older women. CONCLUSIONS: The European countries are in different phases of contraceptive practice: in Northern and Western Europe, use of more modern methods has been stable over the past 10 years, whereas these methods are less common in Southern and Eastern Europe. The results suggest the need for information, education, and provision of contraceptive services in Eastern and Southern Europe.

[Incidence of measles in Italy in the 1985-1994 period]. / L'incidenza del morbillo in Italia nel periodo 1985-1994.

Measles notifications in Italy underestimate the actual incidence by a factor of ten, as it is ascertained by seroepidemiological investigation. In the decade 1980-89, 45,000 measles cases were notified, on average, per year. Since 1988 mass vaccination campaigns were implemented in several Italian regions. The strategy aimed to offer the prophylaxis actively to all children aged 13 months to 8-12 year for whom a sure recollection of measles was absent. The study has aimed to evaluate the impact of the strategy that worked in the period 1989-91, on the standardised average annual incidence of measles notification, comparing the periods 1985-89 and 1990-94. A reduction of 45% resulted all over Italy. On the contrary the incidence of chickenpox notifications has increased, indicating that the notification system did not worse.

[Pilot study on compulsory vaccination coverage]. / Studio pilota sulle coperture vaccinali obbligatorie.

The disappearance of diphtheria and poliomyelitis is the best evidence of the efficacy of the vaccination strategies adopted in Italy. The active offer of the prophylaxis, reinforced by law, has characterised the operational aspects of the strategy. The active surveillance system is the main tool to take under control the effectiveness of health services responsible for vaccination. This system could be more easily implemented if the health services will be given a specific software aiming to handle and evaluate vaccination registers. The present pilot study, performed in the regions Marche and Sardegna, is an example of active surveillance and it is based on the ARVA software produced by the Istituto Superiore di Sanità. The results show a good level of coverage (> 95%) within the second year of life. Unsatisfactory results were obtained on the timing of vaccinations, as recommended by the vaccination schedule, mostly for the third doses.

Ultrasonography evaluation of bone lesions of the jaw.

The ultrasonographic aspects of 72 intraosseous lesions of the jaws were evaluated to identify the usefulness of this type of examination. The principal aim of ultrasonography was to recognize the lesion's content before surgical treatment. Four groups of lesions were classified after the definitive histopathologic examination: lesions with solid, liquid, dense liquid, and mixed contents. The initial ultrasonography examination was in agreement with the histopathologic findings in 24 (92.3%) cases with solid content, 17 (73.9%) cases with liquid content, 7 (7.7%) cases with dense liquid content, and 13 (92.8%) cases with mixed content. On the basis of the results of this study, we propose the use of ultrasonography as a complementary examination for intraosseous lesions of the jaws. If a liquid component is identified in ultrasonography, a surgical procedure should be performed immediately. Otherwise, if a lesion with solid component is identified, it should be biopsied for histopathologic examination and final diagnosis before definitive surgery.

Precancerous pathology evoked by hexachlorobenzene treatment.

The porphyrinogenic and carcinogenic ability of hexachlorobenzene (HCB) was assayed in male and female gold hamsters, and histological examinations of tissue alterations were performed. So it was studied, in liver: a) porphyrin content which was significantly increased at five months of HCB treatment, specially in males, and the pattern of accumulated porphyrins which was altered independent of the sex, b) haem pathway enzymes:delta aminolaevulinic acid synthase, ferrochelatase and porphyrinogen carboxylyase (PCL); among which only PCL appeared to be altered just at ten months of HCB feeding. While thyroid gland and kidney remained unaltered along the treatment time, liver and spleen exhibited a noticeable size variation and morphological alterations. In fact the spleen in treated animals was hypotrophic showing a red pulp less developed with respect to the Malpighian corpuscles and many macrophages with iron deposits. Respect to the liver, enlargement in size of hepatocytes, high content of iron deposits, no PAS positive structures in the cytoplasm, several small lipid droplets, microsteatosis although no cytonecrosis, polymorphic nuclei, and proliferations of nucleoli were observed. Therefore HCB is able to cause precancerous pathology and to induce porphyria in hamsters, but not hyperthyroidism, upon this experimental conditions. By the way, males were found to be a good experimental model, better than females, to study the earliest relations between porphyria and cancer.

Precancerous pathology evoked by hexachlorobenzene treatment

The porphyrinogenic and carcinogenic ability of hexachlorobenzene (HCB) was assayed in male and female gold hamsters, and histological examinations of tissue alteraions were performed. So it was studied, in liver: a) prophyrin content which was significantly increased at five months of HCB treatment, specially in males, and the pattern of accumalated porphyrins which was altered independent of the sex, b) haem pathway enzymes: delta aminolaevulinicacid synthase, ferrochelatase and porphyrinogen carboxylyase (PCL); among which only PCL appeared to be altered just at ten months of HCB feeding. While thyroid gland and kidney remained unaltered along the treatment time, liver and spleen exhibited a noticeable size variation and morphological alterations. In fact the spleen in treated animals was hypotrophic showing a red pulp less developed with respect to the Malpighian corpuscles and many macrophages with iron deposits. Respect to the liver, enlargement in size of hepatocytes, high content of iron deposits, no PAS positive structures in the cytoplasm, several small lipid droplets, microsteatosis although no cytonecrosis, polymorphic nuclei, and proliferations of nucleoli were observed. Therefore HCB is able to cause precancerous pathology and to induce porphyria in hamster, but not hyperthyroidism, upon this experimental conditions. By the way, males were found to be a good experimental model, better than females, to study the earliest relations between porphyria and cancer.