Randomised clinical trial: Polyethylene glycol 3350 with sports drink vs. polyethylene glycol with electrolyte solution as purgatives for colonoscopy--the incidence of hyponatraemia.

BACKGROUND: Polyethylene glycol 3350 plus sports drink (PEG-SD) is a hypo-osmotic purgative commonly used for colonoscopy, though little safety data are available. AIM: To evaluate the effect of PEG-SD on serum sodium (Na) and other electrolytes compared with PEG-electrolyte solution (PEG-ELS). METHODS: We performed a single center, prospective, randomised, investigator-blind comparison of PEG-ELS to PEG-SD in out-patients undergoing colonoscopy. Laboratories were obtained at baseline and immediately before and after colonoscopy. The primary endpoint was development of hyponatraemia (Na <135 mmol/L) the day of colonoscopy. Changes in electrolyte levels were computed as the difference between the lowest value on the day of colonoscopy and baseline. Purgative tolerance and efficacy were assessed. RESULTS: A total of 389 patients were randomised; 364 took purgative and had baseline and day of colonoscopy labs (180 PEG-SD, 184 PEG-ELS). The groups were well matched except for a higher fraction of women and Blacks in PEG-ELS. Seven patients (3.9%) in PEG-SD and four patients (2.2%) in PEG-ELS developed hyponatraemia (OR = 1.82, 95% CI: 0.45-8.62, P = 0.376). Changes in electrolytes from baseline were small but significantly worse with PEG-SD for sodium, potassium and chloride (P = 0.001, 0.012, 0.001, respectively). Preparation completion, adverse events, and overall colon cleansing were similar between the groups, but PEG-ELS had more excellent preparations (52% vs. 30%; P = 0.001). CONCLUSIONS: Greater, but very modest, electrolyte changes occur with PEG-SD. Hyponatraemia is infrequent with both purgatives. A significant increase in hyponatraemia was not identified for PEG-SD vs. PEG-ELS, but the sample size may have been inadequate to identify a small, but clinically important difference. ClinicalTrials.gov identifier NCT01299779.

Evaluation of a 5-year school-based county-wide smoking education programme.

Reports on an evaluation of Smoke Free Leitrim (SFL): a five-year (1996-2001) school-based county-wide smoking education programme that was offered to all fourth class students in all county Leitrim primary schools (n = 450). By programme end 208 (59%) SFL students and 147 (55%) of the control group had tried smoking. Sixty-six (19%) of the SFL group and 63 (24%) of the control group currently smoke. No significant differences were found between the groups for current smoking. Daily smoking of SFL and control males was identical: SFL 19 (10%); control 12 (10%). There was a significant difference between daily smoking of females: 14 (8%) SFL girls and 24 (16%) control group girls smoke everyday. The SFL intervention did not delay or prevent the uptake of smoking, but may have had some gendered effect. It reflected the limited effectiveness of long-term wide-scale smoking education interventions. A more sophisticated approach to young people and tobacco usage is required, that extends beyond the school to focus on tobacco usage in adults, families and the wider community.

A partition assay for the simultaneous determination of insect juvenile hormone esterase and epoxide hydrolase activity.

A partition assay was developed to measure insect juvenile hormone (JH) I and III metabolism in biological samples containing both JH esterase and JH epoxide hydrolase activity. The assay utilizes commercially available radiochain 3H-labeled JH as substrate and the selective JH esterase inhibitor 3-octylthio-1,1,1-trifluoro-2-propanone. JH partitions into an isooctane phase and the metabolites JH acid, JH diol, and JH diol-acid into aqueous methanol after incubation of JH substrate with inhibited and uninhibited sample. The assay provides a time- and cost-efficient alternative to the currently available thin-layer chromatography method for the measurement of JH esterase and epoxide hydrolase activity.

Wage differentials in Jordan: effects on integrated labour market.

PIP: The emigration of Jordanian workers has benefited the country by reducing the scale of unemployment that existed in the 1960s and early 1970s. In addition, workers' remittances have had a favorable effect on the Jordanian balance of payments and contributed to increases in wage rates and demands for labor. Any shortages of labor resulting from the emigration flow appear to have been offset by the importation of workers from neighboring countries. A sample survey encompassing 495 foreign workers in Jordan and 518 Jordanian workers indicates that immigrant workers' wages are below those of Jordanian workers and considerably below the wages that Jordanian workers earn abroad. The average monthly wage for the Jordanians in the sample was JD 193.03 compared to JD 132.93 for the immigrants--a 45% difference. Over half of the immigrants surveyed earned under JD 99/month, while only 26% of the Jordanian workers were in this low income category. In part this wage differential is caused by the high proportions of immigrant workers employed in the clerical and unskilled occupational groups, where they are paid only half the wages earned by Jordanians engaged in the same occupations. A similar differential was observed in the average amount of monthly remittances to home countries: in 1982, Jordanians working abroad remitted an average of JD 77.5/worker compared with JD 59/worker remitted by foreign workers employed in Jordan. On balance, it appears that Jordan is a net gainer from the process of labor import and export.^ieng