Surveillance on meticillin-sensitive Staphylococcus aureus colonization and infection in a neonatal intensive care unit.

BACKGROUND: Meticillin-sensitive Staphylococcus aureus (MSSA) infection is a significant health concern in neonatal intensive care units (NICUs). Bacterial colonization increases the risk of subsequent infection, leading to morbidity and mortality. AIM: To report the findings of a retrospective cohort study on the surveillance of MSSA colonization and infection in NICU patients. METHODS: The weekly microbial surveillance results for MSSA colonization in the throat, nose, anus, and groin, as well as invasive and non-invasive MSSA infections, were analysed from November 2020 to June 2022. The MSSA infection and colonization risk were compared after adjustment for confounders by stepwise logistic regression analysis. FINDINGS: Three hundred and eighty-three neonates were screened; 42.8% (N=164) were MSSA colonized. Significant risk factors for MSSA colonization were length of stay, vaginal delivery and extreme low gestational age <28 weeks (ELGAN) (all P<0.05). The surveillance detected 38 (9.9%) mild MSSA infections and 11 (2.9%) invasive MSSA infections. Neonatal colonization with MSSA is a major risk factor for MSSA infection overall (29.3% in colonized/infected vs 70.7% colonized/not-infected and 0.5% in not-colonized/infected vs 99.5% in not-colonized/not-infected infants) and invasive MSSA infections (6.1% in colonized/infected vs 93.9% in colonized/not-infected and 0.5% in non-colonized/infected vs 99.5% not-colonized/not-infected infants). Also, extreme low birth weight (<1000 g), ELGAN and invasive ventilation were significant risk factors for MSSA infections (all, P<0.05). CONCLUSIONS: The link between postnatal MSSA colonization and subsequent MSSA infection offers possibilities for prevention. Additional research is needed to explore the association between vaginal birth and the pathogenesis of neonatal MSSA colonization.

Compliance with international prevention guidelines for central-line-associated bloodstream infections in neonatal intensive care units in Belgium: a national survey.

BACKGROUND: Central-line-associated bloodstream infections (CLABSIs) are a preventable cause of morbidity among patients in neonatal intensive care units (NICUs). AIMS: To assess compliance with international guidelines for prevention of CLABSIs in Belgian NICUs, and to study unit characteristics contributing to CLABSIs. METHODS: A survey was undertaken to measure the adherence of various NICUs to the CLABSI prevention guidelines related to catheter insertion, catheter maintenance and quality control measurements. A Poisson regression model was used to estimate the CLABSI adjusted relative risk for each prevention guideline item implemented. Multi-variable linear regression was used to estimate associations between guideline compliance rate and facility characteristics and the incidence of CLABSIs for 2015-2016. FINDINGS: In Belgium, the overall CLABSI incidence density was 8.48/1000 central-line-days, and was higher in larger NICUs: 10.87‰ vs 6.69‰ (P<0.05). Adherence was highest for prevention items at catheter insertion (64%), and low for catheter maintenance and quality control items (47% and 50%, respectively). Superior adherence to insertion items (P=0.051) and quality performance items (P=0.004) was associated with decreased risk of CLABSIs, but this was not found for maintenance prevention items (P=0.279). After adjustment for guideline adherence, the size of the NICU was found to be an independent determinant for CLABSIs (P=0.002). CONCLUSIONS: In Belgium, the adherence of NICUs to international CLABSI prevention guidelines is moderate to poor. Compliance of NICUs with the guidelines is significantly associated with decreased CLABSI rates. The reasons for the gap between current practice in Belgian NICUs and international prevention guidelines need further investigation.

Effects of gradual differences in trypsin inhibitor activity on the estimation of digestible amino acids in soybean expellers for broiler chickens.

The present study investigated the effect of varying trypsin inhibitor activity (TIA) in differently processed soybean expellers on apparent prececal amino acid (AA) digestibility in male broiler chickens. Two different raw soybean batches were treated using varying processing techniques and intensities. In this way, 45 expeller extracted soybean meal (ESBM) variants were created. The processed soybean variants were then merged into a basal diet (160 g/kg crude protein [CP]) at 2 inclusion levels (15%, 30%) resulting in 90 different diets plus one basal diet (0.4 mg/g-8.5 mg/g TIA). All diets contained 0.5% titanium dioxide. A total of 5,460-day-old male broilers (Ross 308) were allocated on d 14 to 546 pens (10 birds/pen) after a starter phase (CP 215 g/kg, 14 g/kg Lysine, 12.5 MJ ME/kg). The 91 experimental diets were fed ad libitum until d 22. Subsequently, birds were euthanized and digesta of the terminal ileum was collected for determination of AA digestibility. TIA depressed the prececal digestibility of every single AA significantly in a straight linear fashion (P < 0.001). Sulfur-containing AA expressed the strongest suppression by TIA with cystine showing the lowest apparent prececal digestibility measured (10.6% at 23.6 mg/g TIA in raw ESBM). The present data demonstrate that TIA severely depresses digestibility of essential and nonessential AA in a straight linear fashion. On the one hand, this questions the usefulness of defined upper limits of TIA in soy products whereas on the other hand, TIA must be considered when testing raw components for their feed protein value in vivo.

Demand-oriented riboflavin supply of organic broiler using a feed material from fermentation of Ashbya gossypii.

Alternatives to riboflavin (vitamin B2) production by recombinant microorganisms are needed in organic poultry production, but are cost-intensive, so that a demand-oriented riboflavin supply is necessary. Details on the riboflavin requirements of organic poultry are not available. A feed material with high native riboflavin content from fermentation of the filamentous fungus Ashbya gossypii was studied. Two runs with 800 Ranger Gold™ broilers each (40 pens with 20 animals) were conducted. The fattening period was divided into starter (S), grower (G) and finisher (F) stage. In the first run, a basal diet without riboflavin supplementation (NATIVE; 3.27, 3.50 and 3.16 mg riboflavin/kg DM in S, G and F) was compared to diets with supplementation at low (LOW; 5.30, 4.85 and 5.19 mg/kg in S, G and F), medium (MEDIUM; 7.56, 6.88 and 7.56 mg/kg in S, G and F) and high (HIGH; 10.38, 9.14 and 9.93 mg/kg in S, G and F) dosage. In the second run, different combinations of low and medium riboflavin supplementation were used in S, G and F diets: S-LOW (4.50 mg riboflavin/kg DM), G-MEDIUM (6.66 mg/kg), F-MEDIUM (5.71 mg/kg) (Treatment A), S-LOW (4.50 mg riboflavin/kg DM); G-LOW (4.92 mg/kg), F-LOW (4.01 mg/kg) (Treatment B); S-MEDIUM (6.37 mg/kg), G-MEDIUM (7.37 mg/kg), F-MEDIUM (5.07 mg/kg) (Treatment C); S-MEDIUM (6.37 mg/kg), G-LOW (5.28 mg/kg), F-LOW (4.22 mg/kg) (Treatment D). Body weight, feed and water consumption were recorded weekly, health and welfare indicators were scored bi-weekly. Slaughter traits were assessed for five males and females per pen. In the first run, NATIVE animals showed symptoms of riboflavin deficiency and lower live weights in the second week of age. Riboflavin contents of this group were increased to avoid further deficiency and recovery was observed. Feed conversion was better in HIGH (2.07) compared with NATIVE and LOW (2.11). At slaughter, treatments differed neither for foot pad dermatitis nor plumage cleanliness. In the second run, daily weight gains did not differ between treatments in any of the weeks. Feed conversion ranged between 1.99 and 2.04. Riboflavin deficiency was not observed in the second run, while treatment D showed superior economic efficiency. In conclusion, native contents of feed components (3.27 mg/kg DM) were not sufficient to meet the riboflavin demand and a total content of 4.50 mg/kg DM was identified as safe lower threshold. The levels rather according to commercial recommendations were not additionally beneficial to performance and health.

Effects of a riboflavin source suitable for use in organic broiler diets on performance traits and health indicators.

Riboflavin (vitamin B2) is essential for monogastric animals. It is mainly produced by recombinant microorganisms (Candida famata, Bacillus subtilis and Ashbya gossypii). The availability of genetically modified organism (GMO)-free riboflavin, obligatory in European organic agriculture, is a major issue. Besides, requirements for organic livestock might differ from conventional production because other genotypes and feed formulations are used. The effects of a fermentation suspension with a high native content of riboflavin produced with unmodified A. gossypii by fermentation were investigated at graded dosages as an alternative to conventional (GMO-based) riboflavin in slow-growing broilers on performance traits and health and welfare indicators. In 2 runs with 800 animals each, Ranger Gold™ broilers were fed with 4 dietary treatments. For starter diets (day 1 to 18), treatments included a basal diet (1) without any riboflavin supplementation (negative control, N-C), (2) with conventional riboflavin supplementation (Cuxavit B2 80% riboflavin) at 9.6 mg/kg (positive control, P-C), (3) with riboflavin supplementation from the alternative source at 3.5 mg/kg (A-low) and (4) with riboflavin supplementation from the alternative source at 9.6 mg/kg (A-high). For the finisher diet (day 29 until slaughtering), P-C and A-high were supplemented with 8.0 mg/kg and A-low with 3.5 mg/kg. Diets were formulated according to organic regulations. Animals were kept in floor pens with 20 chickens per pen. Weekly, BW, feed and water consumption were recorded. Every second week, animal-based health and welfare indicators (feather score and footpad dermatitis) were scored. Slaughter traits were assessed for five males and females per pen at 62/63 days of age. Final body weight of A-high differed from N-C and A-low, but not from P-C. From week 2 until six years of age, A-high had a higher daily weight gain when compared to all other groups. With 74.4%, dressing percentage was higher in A-high compared with all other groups (73.3%). Breast percentage of A-low was lower than that of both control groups but did not differ from A-high. The highest frequency of liver scores indicating fatty liver syndrome was found in P-C, followed by N-C and A-low. Feather scores did not respond to treatment; the highest frequency of mild footpad dermatitis was observed in A-high, however at a low prevalence. In conclusion, the tested fermentation suspension with a high native content of riboflavin derived from fermentation of A. gossypii can be used at levels of commercial recommendations as alternative to riboflavin produced from GMO in broiler feeding. Further studies must verify whether riboflavin can be reduced without inducing riboflavin deficiency in slow-growing broilers.

Chickens' growth performance and pancreas development exposed to soy cake varying in trypsin inhibitor activity, heat-degraded lysine concentration, and protein solubility in potassium hydroxide.

This study focused on the effect of varying trypsin inhibitor activity (TIA), heat-degraded lysine concentration and protein solubility in potassium hydroxide on broiler performance and pancreas weight. Two soybean breeds were subject to varying thermal, hydrothermal, pressure, and kilning processing. This resulted in a total of 34 soy cake variants, widely varying in TIA (0.25 to 23.6 mg/g), heat-degraded lysine (1.40 to 8.60 g/kg), and potassium hydroxide (65.5 to 97.6%), respectively. These soy cake variants as well as a commercial soybean meal extract were included into a common grower and finisher diet for broiler chicks at fixed amounts (grower: 35%; finisher: 25%) and tested in a 35 d fattening experiment with 1680 broiler chicks (grower phase: day 11 to 24; finisher phase day 25 to 35). TIA was the dominant factor affecting zootechnical performance and pancreas weight at slaughter (day 35), depressing liveweight at day 24 (P < 0.006), and day 35 (0.026), weight gain (grower: P < 0.006) and feed: gain ratio during grower phase (P < 0.005) and increasing pancreas weight (P < 0.010) at the time of slaughter. Negative effects of TIA were also visible in soy cake variants below recommended thresholds. This highlights the necessity of complete elimination of TIA in broiler diets as far as technically possible.

A new stygobiont species of Halocaridinides Fujino Shokita, 1975 (Crustacea, Decapoda, Caridea, Atyidae) from caves on Socotra Island (Yemen), with notes on the genus.

We describe a new species of stygobiont atyid shrimp of the genus Halocaridinides Fujino Shokita, 1975 from subterranean brackish and freshwater environments on Socotra Island (Yemen). This is the first atyid shrimp discovered in the Socotra Archipelago. This Socotran endemic is the second species of Halocaridinides recorded from an Indian Ocean island and the first to occur in non-anchialine environments. The new species is characterized by the absence of eye pigmentation, a reduced rostrum and the presence of a single spine in the uropodal exopod diaeresis. Morphological variability in the robustness of the first and the second chelipeds, particularly obvious in the chelae, may indicate local speciation or phenotypical plasticity. At both extremes of the variation, animals with most slender (tenuis type) or robust (robustus type) morphologies occur. We discuss the Indo-Pacific distribution of the genus and the potential origin of the new Socotran species. An amended diagnosis for the genus and a key to all species are included.

Cladocera of the Lençóis Maranhenses (NE - Brazil): faunal composition and a reappraisal of Sars' Method.

We studied the Cladocera of a group of ephemeral interdunal pools in the Lençóis Maranhenses, Maranhão State (NE - Brazil) and recorded 34 species. The fauna was overwhelmingly neotropical, with no evidence of invasive species. Species composition differed in Lagoa da Colher, an acid system. We provide notes on behaviour, morphology and taxonomy of some lesser-known anomopods, with emphasis on the Chydoridae. We figure male Oxyurella longicaudis, Chydorus eurynotus, Disparalona leptorhyncha, Alonella dadayi and A. clathratula. We provide notes on the "Sars' Method", hatching of freshwater crustaceans from dry mud, a simple technique that complements the information of hit-and-run surveys. About half of the total species number (44%) was revived through this method; 18% of species were additional to field-collected samples. The Sars' method also yielded abundant specimens of rare species, useful for identification and studies on behaviour.

Cladocera of the Lençóis Maranhenses (NE - Brazil): faunal composition and a reappraisal of Sars' Method

We studied the Cladocera of a group of ephemeral interdunal pools in the Lençóis Maranhenses, Maranhão State (NE - Brazil) and recorded 34 species. The fauna was overwhelmingly neotropical, with no evidence of invasive species. Species composition differed in Lagoa da Colher, an acid system. We provide notes on behaviour, morphology and taxonomy of some lesser-known anomopods, with emphasis on the Chydoridae. We figure male Oxyurella longicaudis, Chydorus eurynotus, Disparalona leptorhyncha, Alonella dadayi and A. clathratula. We provide notes on the "Sars' Method", hatching of freshwater crustaceans from dry mud, a simple technique that complements the information of hit-and-run surveys. About half of the total species number (44%) was revived through this method; 18% of species were additional to field-collected samples. The Sars' method also yielded abundant specimens of rare species, useful for identification and studies on behaviour.

Os cladóceros de um grupo de lagoas temporárias dulcícolas interdunares nos Lençóis Maranhenses, Maranhão (NE - Brasil) foram estudados e registraram-se 34 espécies. A fauna foi tipicamente neotropical, sem evidências de espécies invasoras. A composição de espécies foi diferenciada na Lagoa da Colher, que constitui um sistema ácido. Informações sobre comportamento, morfologia e taxonomia de alguns anomópodes menos conhecidos são fornecidas, com ênfase nos membros da família Chydoridae. Os machos das espécies Oxyurella longicaudis, Chydorus eurynotus, Disparalona leptorhyncha, Alonella dadayi e A. clathratula foram registrados com desenhos. Foram dadas informações sobre o "método de Sars", o qual consiste na eclosão de microcrustáceos de água doce a partir de ovos de dormência presentes no sedimento seco, uma técnica simples, que complementa as informações de coletas realizadas em limitados intervalos de tempo e espaço. Aproximadamente metade das espécies encontradas (44%) também estava presente nas culturas; 18% das espécies foram registradas apenas nas culturas e complementaram as amostras obtidas no campo. Com o "método de Sars", também se registraram abundantes espécimes de espécies raras, o que se mostra útil para a identificação e estudos sobre comportamento.

Detection algorithm for single motor unit firing in surface EMG of the trapezius muscle.

BACKGROUND: Work-related musculoskeletal disorders (MSD) of the neck and the shoulders are a growing problem in society. An interesting pattern of spontaneous muscle activity, the firing of a single motor unit, in the trapezius muscle is observed during a laboratory study in a rest state or a state with a mental load. OBJECTIVE: In this study, we report on the finding of the single motor unit firing and we present a detection algorithm to localize these single motor unit firings. METHODS: A spike train detection algorithm, using a nonlinear energy operator and correlation, is presented to detect burst of highly correlated, high energetic spike-like segments. RESULTS: This single motor unit was visible in 65% of the test subjects on one or both trapezius muscles although there was no change in posture of the test subjects. All the segments in the data that were determined as single motor unit firings were detected by the algorithm. DISCUSSION: The physiological meaning of this firing pattern is a very low and subconscious contraction of the muscle. A long-term contraction could lead to the exhaustion of the muscle fibers, thus resulting in musculoskeletal disorders. The detection algorithm is able to localize this phenomenon in a sEMG measurement. The ability of detecting these firings is helpful in the research of its origin. CONCLUSION: The detection algorithm can be used to gain insight in the physiological origin of this phenomenon. In addition, the algorithm can also be used in a biofeedback system to warn the user for this undesired contraction to prevent MSD.

Ethical aspects of human placental perfusion: interview of the mothers donating placenta.

Within the EU project "NewGeneris" human placental perfusion has been used for assessing in utero fetal exposure to food carcinogens. Within the work package of ethical aspects of the research, we were interested in the way mothers who donated placentas for perfusion perceived their participation in the study. Thematic interviews were conducted with 25 mothers who had donated the placenta for placental perfusion studies. The main themes covered during the interviews were recruitment for placental perfusion studies, informed consent, risks and benefits, handling and confidentiality of personal information and societal meaning of the placental perfusion studies. Data were analysed qualitatively using thematic content analysis. Mothers, when rightly informed about the purpose of the placental perfusion study were very interested in the study and supported the use of the placenta for such purpose. Overall, this study revealed several points of particular interest in placental perfusion studies. First, the recruiters' involvement with and commitment to the research project and its ethical conduct were of utmost importance for handling the informed consent procedure correctly. Second, the timing of the recruitment was important since it considerably affected the understanding of the given information, women in labour being obviously less receptive to such information. Third, the trust of participants depended on the multidisciplinary collaboration between the researchers and hospital personnel and this trust was enhanced by a thorough, objective and fair informed consent procedure.

Testicular dysfunction is responsible for low sperm quality in Belgian Blue bulls.

In a previous study, we demonstrated that Belgian Blue (BB) bulls have a higher prevalence of small scrota and poorer semen morphology compared to the Holstein Friesian (HF) breed in Belgium. The present study tested the hypothesis that the underlying reason for these BB traits negative to fertility was testicular degeneration, associated with an eventual hypoplastic background. At culling, sperm quality and testicular histology of BB bulls were assessed and compared to that of HF bulls. Besides semen quality being generally poorer in the BB breed, significantly more degenerative changes were encountered in BB compared to HF testicles (degeneration index: 37.7+/-11.9 versus 29.3+/-9.9 for BB and HF bulls, respectively; P=0.053). These results correlated to the percentage of normal spermatozoa (r=-0.44; P=0.024) and primary abnormalities (r=0.38; P=0.053). Moreover, the relative amount of collagen fibers present in the testicular interstitial connective tissue was correlated with % normal sperm (r=-0.47; P=0.017), primary defects (0.48; P=0.014), and the degeneration results (r=0.63; P<0.001). The % testicular interstitial collagen fibers differed significantly between breeds (10.6+/-4.0% for the BB versus 7.6+/-1.9% for the HF bulls; P=0.016). This increased amount of connective tissue in BB testes might hypothetically be responsible for the poorer sperm quality. This condition can be defined as a mild form of testicular hypoplasia, and might, in turn, be responsible for the higher sensitivity to testicular degeneration, which is encountered in the BB breed.

Relation between telomerase activity, hTERT and telomere length for intracranial tumours.

Human linear chromosomes are capped by specialized DNA-protein structures called telomeres. The present study analysed the telomerase activity, hTERT protein and telomere length in meningiomas and gliomas in relation to their WHO grading. Fifty-three freshly dissected tumour biopsies were analysed for telomerase activity, hTERT protein expression and telomere length. Telomerase activity was examined in 41 of the 53 biopsies. Telomerase activity was detected in 3 of 35 (8.6%) screened meningiomas (1 benign, 1 atypical and 1 malignant meningioma). For hTERT expression, 56.4% of meningiomas were positive with a mean labelling index (hTERT LI) of 31.3% (SD=26.5) for the hTERT positive meningiomas. The mean telomere length for meningiomas was 6.983 kb (SD=1.969). For gliomas, no active telomerase was detected in 2 low-grade astrocytomas, whereas three of the four screened glioblastomas were positive for telomerase activity. The only hTERT protein positive astrocytoma had a mean labelling index of 9.0%. On the other hand, the hTERT LI for glioblastomas was 53.6% (SD=28.0). The two low-grade astrocytomas had a telomere length of 14.310 and 9.236 kb. The anaplastic astrocytoma had a telomere length of 4.903 kb and the glioblastomas 5.767 kb (SD=2.042). The normal meningeal and neuronal tissue is negative for telomerase activity and hTERT. The length was +/-10.000 kb. These results indicate that telomere shortening may be a critical step in pathogenesis of atypical and malignant meningiomas and gliomas. Critical telomere shortening in vitro was shown to activate telomerase.

Temporal trends in sexually transmitted infection prevalence and condom use following introduction of the female condom to Madagascar sex workers.

We followed 1000 sex workers in Madagascar for 18 months to assess whether adding female condoms to male condom distribution led to increased protection levels and decreased sexually transmitted infections (STIs). For months 1-6, participants had access to male condoms only; in the final 12 months, they had access to male and female condoms. We interviewed participants about condom use every two months and tested for chlamydia, gonorrhoea and trichomoniasis every six months. Following six months of male condom distribution, participants used protection in 78% of sex acts with clients. Following female condom introduction, protection at months 12 and 18 rose to 83% and 88%, respectively. Aggregate STI prevalence declined from 52% at baseline to 50% at month 6. With the female condom added, STI prevalence dropped to 41% and 40% at months 12 and 18, respectively. We conclude female condom introduction is associated with increased use of protection to levels that reduce STI risk.

[Water supply for Peking ducks--possible alternatives for bathing]. / Wasserversorgung von Pekingenten--Badeersatzmöglichkeiten.

In order to investigate possible advantages of open water drinkers such as troughs and bells in the intensive husbandry of ducks, we evaluated in this study the effect of open water systems on the behavior and health of peking ducks. In this investigation six fattening trials each with 1152 Cherry Valley Peking ducks were analyzed. The average fattening period was 47 to 49 days. The ducks were kept on straw in six standardized compartments each 32 qm with 192 ducks. 25% of the compartment with perforated grid, with one of the tested water systems. In contrast to pens with nipple-drinkers only, the ducks in pens with open water troughs/showers had the opportunity to exhibit their natural drinking behavior and water associated activities in accordance with the animal welfare requirements. In the free-choice pens the open water systems were significantly preferred, and over a 24-hour period the ducks in watering areas with open water troughs showed higher activity. Limiting the access to the open water systems to eight, four or two hours per day led to an increased use per time unit. Ducks with access to nipple drinkers only showed a significantly higher percentage of plugged up nostrils than animals from pens with open water drinkers. Open water drinkers had also a positive impact on the plumage condition.

Acceptability and feasibility of continuous diaphragm use among sex workers in Madagascar.

OBJECTIVES: The diaphragm, a woman controlled, reusable contraceptive device, might prevent some sexually transmitted infections (STIs). We assessed the acceptability and feasibility of use of silicone Wide-Seal Arcing Diaphragms (Milex Products, Chicago, IL, USA) by sex workers in Madagascar. METHODS: Over 8 weeks, we evaluated method acceptability by examining patterns of and problems with women's diaphragm use. We also evaluated several measures of study feasibility, including recruitment and follow up methods. RESULTS: 91 women from three cities (Antananarivo, Tamatave, and Mahajanga) participated, and 87 (96%) completed follow up. At enrolment, participants reported a median of six sex acts with five clients in the previous week. During the follow up period, participants reported a median of three sex acts with three clients during the previous 2 days, and self reported continuous diaphragm use during the previous day increased from 87% to 93%. Seven women became pregnant (incidence 53 pregnancies per 100 woman years). Self reported use of male condoms and diaphragms was fairly constant over the study period: women reported condom use in 61% to 70% of acts and diaphragms in 95% to 97% of acts. The number of participants reporting diaphragm problems decreased from 15 (16%) at the first visit to six (7%) at the final visit. 20 women (22%) needed replacement devices during follow up because their original diaphragms were lost, were the wrong size, or became seriously damaged. CONCLUSIONS: Given the high use and steady decrease in reported problems during the study, we believe diaphragms are acceptable and feasible in this resource poor, low education sex worker population.

The importance of the health education in life quality improvement in patients with psoriasis.

PURPOSE: The aim of the study was to determine the influence of the psoriatic patient knowledge of the disease on the quality of life. MATERIAL AND METHODS: The study was carried out in 149 patients with psoriasis. All patients answered on anonymous questionnaire, in according to Psoriasis Disability Index (PDI). RESULTS: Almost 43% patients could not show any factor which provoked their disease, 31.5% could not tell any recommendations for cure and care of the psoriatic lesions and 32.2% patients could not point out any methods to avoid psoriatic lesions spread. Almost 60% of the group admitted that their quality of life fell because of the disease. At the same time, patients who did not have enough information concerning the disease had lower quality of life index. CONCLUSIONS: The level of the disease knowledge in the patients with psoriasis influences their quality of live. Therefore it is indicated for the patiens and their families to be involved in the proper educational program.

Results of a randomised trial of male condom promotion among Madagascar sex workers.

OBJECTIVES: To test the effect of supplementing peer promotion of male condom use with clinic based counselling, measured in terms of STI prevalence and reported male condom use. METHODS: 1000 female sex workers in Madagascar were randomised to two study arms: peer education supplemented by individual risk reduction counselling by a clinician (peer + clinic) versus condom promotion by peer educators only (peer only). STI testing was conducted at baseline and 6 months. Behavioural interviews were administered at baseline, 2, 4, and 6 months. RESULTS: At baseline, women in the peer only arm had prevalences of 16.0%, 23.6%, and 12.1% for chlamydia, gonorrhoea, and trichomoniasis respectively, with an aggregate prevalence of 38.2%. Baseline STI prevalences for the peer + clinic arm were slightly lower and 34.1% in aggregate. At 6 months, aggregate STI prevalence increased in the peer only arm to 41.4%, whereas the aggregate prevalence diminished slightly to 32.1% in the peer + clinic arm. In logistic regression analyses, the estimated odds ratios (ORs) for chlamydia, gonorrhoea, trichomoniasis, and aggregate STI were 0.7 (95% confidence interval 0.4 to 1.0), 0.7 (0.5 to 1.0), 0.8 (0.6 to 1.2), and 0.7 (0.5 to 0.9) respectively, comparing the peer + clinic arm with the peer only arm. The logistic regression OR for reported condom use with clients in the past 30 days increased from 1.1 at 2 months to 1.8 at 6 months, comparing the peer + clinic arm with the peer only arm, and was 1.4 overall (1.1 to 1.8). Adjustment for baseline factors changed the regression results little. CONCLUSIONS: The impact of male condom promotion on behaviour can be heightened through more concentrated counselling on risk reduction. Persistently high STI prevalence despite increases in reported condom use by sex workers supports the need for multidimensional control programmes.

[Ethical considerations on the planning, assessment and management of biological monitoring data]. / Aspetti etici sull'impostazione, valutazione e gestione dei test di monitoraggio biologico.

If a society aims at preserving its socio-ethical values, practices concerning the planning, assessment and management of biomonitoring tests in occupational health surveillance and research should not conflict with these values. Protecting both health and employment of every candidate or employee must be the aim of the occupational health physician. For assessing ethical acceptability of occupational health surveillance practices, their accuracy, relevance, need or necessity, and consequences must first be analysed. This analysis must constitute the basis for any societal democratic decision making process, which cannot be substituted for simply by individual informed consent. A physician trained in occupational health is the professionalism required for doing the testing and assuring the protection of the confidentiality of medical data, in accordance with strict legal and deontological rules. In biological monitoring studies and, in general, in any occupational health research settings, however, the principle of individual, really informed consent must be used, whenever possible. This may also considerably contribute to the committment of study subjects to the research goals. On the other hand, this committment would also contribute to promoting impartial research which is needed to improve the knowledge in occupational health and to increase health protection and prevention.