Effect of repeated freeze/thawing of household dust extracts on ß-(1,3)-glucan levels.

ß-(1,3)-glucan exposure from household dust has been shown to be associated with respiratory symptoms and thus is increasingly being measured in epidemiological studies. Various factors are known to influence its measurement; however, no studies have assessed the effects of sample extract freeze-thawing on ß-(1,3)-glucan. The aim of this study was to assess the effects of repeated freeze-thawing of household dust extracts on levels of ß-(1,3)-glucan. Forty random household dust samples were extracted with 0.3 M NaOH and aliquots of extracts stored at -20 °C were subjected to one, two, and three freeze-thaw cycles. They were analyzed for ß-(1,3)-glucan by the Limulus amoebocyte assay (LAL) and results compared to freshly extracted samples (paired Pearson's t-test on logged values). Initial freezing of house dust extracts results in a significant decline in ß-(1,3)-glucan. However, repeated freeze/thawing (up to three times) does not results in any further decline in ß-(1,3)-glucan levels.

Cat, dog and house dust mite allergen levels on children's soft toys.

OBJECTIVE: Children's soft toys are known to harbour house dust mite (HDM) allergens, but little is known whether they harbour cat or dog allergens. The objective of the study was to measure cat (Fel d 1), dog (Can f 1) and HDM allergens on children's soft toys. METHODS: Dust was collected from 40 children's soft toys and their mattresses. Data were collected on pet ownership. Dust samples were analysed for Fel d 1, Can f 1, Der p 1 and Der f 1 by enzyme-linked immunosorbent assay (ELISA) and results are expressed as median levels with inter-quartile ranges. RESULTS: Thirty-five (87.5%) soft toys had detectable Fel d 1 levels (median: 0.73 µg/g; inter-quartile range: 0.26-2.56 µg/g) while 34 (85%) had detectable Can f 1 levels (1.20 µg/g; 0.53-2.68). Correspondingly, 32 (80%) mattresses had detectable Fel d 1 levels (0.18 µg/g, 0.07-1.01) while 34 (85%) had detectable Can f 1 levels (0.50 µg/g; 0.33-1.06). All mattresses and soft toys had detectable HDM allergen (Der p 1 + Der f 1) levels with soft toys containing about three times higher levels than mattresses. In homes with cats (n = 10) Fel d 1 levels were higher on soft toys than homes without cats (2.49 versus 0.48 µg/g; p = 0.0009). In homes with dogs (n = 25) Can f 1 levels were generally higher on soft toys (1.38 versus 0.63 µg/g; p = 0.10). CONCLUSIONS: This study has shown that soft toys can harbour cat and dog allergen as well as HDM allergens, some with very high levels. Cat and dog ownership resulted in higher Fel d 1 and Can f 1 levels on soft toys and mattresses. The levels of Fel d 1, Can f 1 and HDM allergens on soft toys could be of importance to sensitized asthmatic children.

Daily vacuuming of mattresses significantly reduces house dust mite allergens, bacterial endotoxin, and fungal ß-glucan.

BACKGROUND AND AIMS: Atopic patients are advised to cover their mattresses with occlusive coverings; however, these are not cheap. We investigated whether daily vacuum cleaning of mattresses significantly reduces content of house dust mite allergens, bacterial endotoxin, and fungal ß-glucan. METHODS: Twenty volunteers vacuumed their mattress daily for 8 weeks. Dust samples collected at two weekly intervals were analyzed for house dust mite allergens (Der p 1 and Der f 1) by double monoclonal antibody ELISA and for endotoxin and ß-glucan by the Limulus amoebocyte lysate kinetic assay. Results are presented as geometric means with 95% confidence interval (CI). RESULTS: Total house dust mite allergens (Der p 1 + Der f 1) significantly reduced from a geometric mean (95% CI) of 4.07 µg (2.44-6.79) at the start to 0.42 µg (0.21-0.81) at week 8. Total endotoxin and ß-glucan were also significantly reduced from 13.6 EU (8.6-21.4) to 3.4 EU (2.3-5.0) and from 94.4 µg (57.1-156.2) to 19.7 µg (10.2-37.9), respectively (p for trend >.0001). Percentage reductions in total house dust mite allergens, endotoxin, and ß-glucan after 8 weeks of daily vacuum cleaning were 85.1% (80.1-90.1), 71.0% (70.4-81.0), and 75.7% (70.4-81.0), respectively. This was mainly due to a 77.7% (70.8-84.7) reduction in total dust. CONCLUSION: Daily vacuum cleaning of mattresses over time significantly reduces house dust mite allergens, endotoxin, and ß-glucan. This gives atopic patients a practical and cheaper alternative to reduce their exposure to indoor house dust mite allergens and microbial bio-contaminants.

Incidence of percutaneous injuries and non-reporting rates among first-aid responders in Taiwan.

We determined the incidence of percutaneous (needlestick and sharps) injuries among emergency medical technicians (EMTs) in one county in Taiwan, compared this with the official reporting rate, and sought reasons for non-reporting. An anonymous questionnaire was distributed to all EMTs in that county, eliciting percutaneous injuries occurrences, reasons why, and reporting data. Data were analyzed by logistic regression. A total of 329 out of 353 EMTs completed the questionnaire, giving a response rate of 93.2%. Thirty-nine EMTs (11.9%) experienced at least one percutaneous injury in the preceding 12 months. Older, less experienced EMTs were at greater risk of percutaneous injuries. None of the EMTs officially reported their percutaneous injuries primarily because they thought reporting was not mandatory and that the reporting process was too complicated. About one in eight EMTs had experienced at least one percutaneous injury in the preceding year. None of these injuries was officially reported to their organization. Ways to make reporting more user friendly are required, along with resources to minimize percutaneous injuries among EMTs in Taiwan.

Cardiac Computed Tomography to exclude left atrial appendage thrombus in atrial arrhythmias prior to electrical cardioversion during the COVID-19 pandemic.

Nil.

Effect of freezing, hot tumble drying and washing with eucalyptus oil on house dust mites in soft toys.

Soft toys are a major source of house dust mites (HDM) and HDM allergens, and sleeping with soft toys is a significant risk factor for HDM sensitization. We studied three techniques to eliminate HDM from soft toys, namely freezing, hot tumble drying and washing with eucalyptus oil. Thirty-six toys (12 in each treatment group) were enumerated for live HDM by the heat escape method before and after freezing overnight, hot tumble drying for 1 h and washing in 0.2% to 0.4% eucalyptus oil. Freezing, hot tumble drying and washing with eucalyptus oil resulted in significant reductions in live HDM, an average reduction of 95.1%, 89.1% and 95.1%, respectively. Additionally, washing with eucalyptus oil resulted in a significant reduction in HDM allergens as well from a geometric mean of 9.12 µg/g to 0.37 µg/g (p = 0.033). These three HDM elimination techniques give parents of infants effective and acceptable methods of limiting HDM exposure.

Imaging the Indian subcontinent beneath the Himalaya.

The rocks of the Indian subcontinent are last seen south of the Ganges before they plunge beneath the Himalaya and the Tibetan plateau. They are next glimpsed in seismic reflection profiles deep beneath southern Tibet, yet the surface seen there has been modified by processes within the Himalaya that have consumed parts of the upper Indian crust and converted them into Himalayan rocks. The geometry of the partly dismantled Indian plate as it passes through the Himalayan process zone has hitherto eluded imaging. Here we report seismic images both of the decollement at the base of the Himalaya and of the Moho (the boundary between crust and mantle) at the base of the Indian crust. A significant finding is that strong seismic anisotropy develops above the decollement in response to shear processes that are taken up as slip in great earthquakes at shallower depths. North of the Himalaya, the lower Indian crust is characterized by a high-velocity region consistent with the formation of eclogite, a high-density material whose presence affects the dynamics of the Tibetan plateau.

Radiopharmaceuticals for Neuroendocrine Tumors.

Neuroendocrine tumors (NETs) are a heterogeneous group of tumors that originate in endocrine tissues throughout the body. Peptide receptor radionuclide therapy (PRRT) has emerged as a promising therapeutic option for patients with locally advanced and/or metastatic disease refractory to standard of care treatment. The landmark international phase III NETTER-1 trial led to the approval of 177Lu-DOTATATE (Lutathera) in the treatment of somatostatin receptor-positive gastroenteropancreatic NETs. Similarly, data from the multicenter, phase II Study IB12B led to the approval of meta-[131I]Iodo-Benzyl-Guanidine (I31I-MIBG) for treatment of iobenguane scan-positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma. With the clinical approval of these novel radiopharmaceuticals for managing select patients with NETs, additional studies are needed to refine patient selection, predict and assess therapy response, and optimize radiopharmaceutical delivery and clinical outcomes.

Indoor allergens and microbial bio-contaminants in homes of asthmatic children in central Taiwan.

Indoor allergens and microbial bio-contaminants play a significant role in asthma symptoms. The aim of the study was to determine levels of house dust mite allergens, bacterial endotoxin, and fungal beta-glucan in homes of 120 asthmatic children in central Taiwan. Dust samples from 120 mattresses (67 double-sided) were analyzed for house dust mite allergens (Der p 1, Der f 1, and Blo t 5), endotoxin, and beta-glucan. Pillows (n = 118) were analyzed for house dust mite allergens only. Kitchen dust samples were analyzed for the cockroach allergen, Bla g 1. Blo t 5 was detected in 9.3% pillows and 82.2% mattresses, Der p 1 in 95.8% pillows and 93.2% mattresses, and Der f 1 in 82.2% pillows and 83.1% mattresses. Geometric mean levels (95% confidence interval) of endotoxin and beta-glucan in mattresses were 108.4 Eu/mg (81.4-144.2) and 25.2 microg/g (22.7-28.0), respectively. House dust mite allergens and endotoxin levels were significantly lower on the bamboo side of 67 mattresses, compared to the inner sprung mattress side. Geometric mean of kitchen Bla g 1 was 0.61 U/g (95% CI: 0.43-0.85). Given the presence of Der p 1, Der f 1 and Blo t 5 in central Taiwan, it is advised to measure allergens of all three house dust mite species to obtain a true index of allergen exposure. Bamboo sides of mattresses had significantly lower house dust mite allergens and endotoxin levels.

Effect of Betel (Areca) Nut Chewing on Fractional Exhaled Nitric Oxide: A Pilot Study.

Betel (areca) nuts are extensively chewed in many countries. This has been associated with respiratory symptoms. We aimed to determine whether betel nut chewing is associated with acute changes in fractional exhaled nitric oxide, a non-invasive marker of airway inflammation. Betel nut chewing resulted in an immediate significant decline in fractional exhaled nitric oxide levels that persisted for up to 180 minutes. This effect has to be taken into account in epidemiological studies, reference ranges, and patient preparation.

Traumatic cardiac injury following sternal fracture: a case report and literature review.

Myocardial injury used to be thought as one of the major complications associated with sternal fracture even though recent studies on injuries associated with fracture of sternum are contrary to this belief. Many authors now believe the presence of sternal fracture is no longer indicative of occult injuries to the underlying structure such as the heart. However, clinicians should still maintain a high index of suspicion for the presence cardiac tamponade in cases presented as blunt chest trauma as early diagnosis and surgical intervention is vital to the patient's survival. Presented is a case of a 38-year-old female patient transferred to our hospital after being injured in a motor vehicle accident. On arrival her blood pressure (BP) was 90/50 mmHg but it then dropped to 60/30 mmHg two hours later. Although her chest roentgenography and electrocardiography (ECG) did not reveal any significant findings, the two-dimensional echocardiography was performed and revealed a moderate amount of pericardial effusion. The chest computerized tomography (CT) scan later revealed sternal fracture and cardiac tamponade. A diagnosis of cardiac rupture resulting from sternal fracture following blunt chest trauma was made. Under midline sternotomy, her right atrial rupture was repaired. The patient was reported to be doing well during a three months, post-operative follow-up.

Endotoxin and ß-(1,3)-glucan levels in automobiles: a pilot study.

Exposure to bacterial endotoxin and fungal ß-(1,3)-glucan in the indoor environment can induce respiratory symptoms. Automobiles are an exposure source of allergens but it is not known if, and how much exposure there is to endotoxin and fungal ß-(1,3)-glucan. The objective of the study was to determine whether automobiles are a potential source of exposure to these microbial products. Dust was sampled from the passenger seats of 40 automobiles. Specific Limulus amoebocyte kinetic assays were used to measure endotoxin and ß-(1,3)-glucan, respectively. Endotoxin and ß-(1,3)-glucan was detected in all samples ranging from 19.9-247.0 EU/mg and 1.6-59.8 µg/g, respectively. There were no significant differences in endotoxin levels between automobiles of smokers and non-smokers, but ß-(1,3)-glucan levels were about two-fold higher in the automobiles of non-smokers. In conclusion, endotoxin and ß-(1,3)-glucan exposure in automobiles at levels found in our study may be of importance for asthmatics.

The attitudes, concerns, gloving practices and knowledge of nurses in a Taiwanese hospital regarding AIDS and HIV.

Many studies have documented nurses' attitudes and concerns regarding AIDS/HIV, but little is known about Taiwanese nurses. We documented attitudes, concerns, gloving practices and practical AIDS/HIV knowledge of 1090 nurses from one metropolitan hospital in Changhua City, Taiwan. The response rate was 80.9%. Both HIV and hepatitis contraction in the workplace was nurses' main concern. Two hundred and ten nurses (19.3%) were seriously considering leaving nursing because of fear of contracting AIDS/HIV. Virtually all nurses considered it their right to be informed of the presence of HIV-positive patients in their direct work area and many believed that HIV testing of patients should be mandatory. Practical AIDS/HIV knowledge was deficient. These Taiwanese nurses have concerns and fears that might be related to deficiencies in practical AIDS/HIV knowledge. Continuous educational programmes are recommended to alleviate these nurses' attitudes and concerns regarding AIDS/HIV.

Effects of major liver resection, with or without recombinant bactericidal/permeability-increasing protein (rBPI21), on the angiogenic profile of patients with metastatic colorectal carcinoma.

BACKGROUND: Surgery induces a process of wound healing, which has immunological and angiogenic aspects. Bactericidal/permeability-increasing protein (BPI) is found in azurophilic granules of human neutrophils, which is bactericidal and neutralizes lipo-polysaccharide (LPS). This may reduce postoperative infectious complications. In addition, BPI has been shown to be an inhibitor of angiogenesis. METHODS: A total of 18 patients with metastasized colorectal carcinoma to the liver were double blind randomized. The levels of the pro-angiogenic factors interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) and the angiogenesis inhibitor endostatin were investigated after liver surgery with perioperative administration of either rBPI(21) or placebo. RESULTS: The highest IL-6 levels were found during the first 24 hr and reached peak levels already at 2 hr postoperatively in both groups. In both groups VEGF levels decreased sharply in the postoperative hours, returning to baseline levels in the days afterwards. In both groups, an immediate decrease in endostatin levels was observed which remained significantly low. RBPI(21) transiently influenced IL-6 and VEGF. CONCLUSIONS: RBPI(21) only marginally affected IL-6 and VEGF levels. Surgery per se induced an immediate immune response (IL-6) and an immediate angiogenic response, reflected in an initial VEGF decrease and a longer lasting decrease of endostatin. These findings demonstrate the dynamics of tissue responses in the first phase of wound healing.

The effects of surgery, with or without rhGM-CSF, on the angiogenic profile of patients treated for colorectal carcinoma.

Wound healing is a process with immunological and angiogenic aspects. rhGM-CSF is known to stimulate the immune system and angiogenesis via multiple pathways. In this study we investigated the combined effects of surgery, with or without rhGM-CSF, on angiogenic parameters in patients with a colorectal carcinoma. In this phase II randomized, placebo-controlled trial, 16 patients were assigned to perioperative rhGM-CSF (2.8 microg/kg body weight) treatment or saline. Patients received subcutaneous injections from three days before surgery until four days after. IL-6, VEGF, endostatin and angiostatin levels were measured perioperatively. rhGM-CSF enhanced the production of IL-6 and VEGF, but had no effect on the antiangiogenic agents endostatin and angiostatin. Surgery induced a transient decrease of endostatin. Two types of angiostatin (kringle 1-3 and kringle 1-4) became visible postoperatively. We conclude that this study demonstrated the immediate initiation of angiogenesis postoperatively, reflected by the increase of VEGF and a transient decrease of endostatin, followed by the appearance of two angiostatin bands, which confirms physiological wound healing in these cancer patients.