Mastoid obliteration with S53P4 bioactive glass after canal wall down mastoidectomy: Preliminary results.

BACKGROUND: Bioactive glass (S53P4), abbreviated BG, currently seems to be the best material for reconstructing the posterior wall of the auditory canal and obliterating the postoperative cavity. PURPOSE: The aim of the study was to report preliminary results of otosurgery involving obliteration of the mastoid cavity after canal wall down mastoidectomy. METHODS: 11 adult patients who had had a history of chronic otitis media with cholesteatoma in one or both ears and previous canal wall down mastoidectomy. The duration of the follow-up was 6 months, with routine visits after 7 days, then 1, 3, and 6 months after surgery. The patient's medical history, noting other diseases potentially affecting the healing process, was analyzed. Healing, audiometric results, reduction of the volume of the cavity after surgery, and reduction of bacterial flora growth were assessed. RESULTS: There was not worsening in the audiological evaluation. Healing period was uneventful. There was a reduction in volume of the postoperative cavity, no development of pathological flora, and no recurrence of cholesteatoma. CONCLUSION: Obliteration of the mastoid process with S53P4 bioactive glass is a safe and effective method of treatment. Such a procedure should be considered as a treatment for patients after canal wall down surgery (CWD).

The selected goose meat quality traits in relation to various types of heat treatment.

The effect of water bath cooking (WBC), oven convection roasting (OCR), grilling (G), pan frying (PF) on selected physical properties of goose meat was compared in this study. A measurement of cooking loss, texture, color parameters, and sensory evaluation was carried out. The experimental material covered 96 breast muscles cut from carcasses of 17-week-old "Polish oat geese." The kind of goose meat (with and without skin) and the type of heat treatment affected cooking loss, shear force (SF), and rheological parameters (hardness, cohesiveness, gumminess, and chewiness). The water bath-cooked and pan-fried samples for both kinds of meat were characterized by lower cooking loss than other ones. Goose meat with skin and subcutaneous fat showed higher cooking loss and lower SF value, hardness, gumminess, and chewiness than that without skin for all methods. The water bath-cooked samples were characterized by the lowest SF value, hardness, and chewiness for both kinds of meat. They had the highest value of L∗ parameter and were characterized by a lighter color among others, too. Pan-fried meat showed the highest value of a∗ and lowest of ho parameters; the color of these samples was redder. Moreover, the lower C values of oven convection-roasted and grilled samples showed that they were brighter. According to the Comission Internationale de l'Eclairage classification, the ΔE parameter only for G and OCR indicated noticeable color differences (<2), whereas other pairs had visible differences. The method of cooking affected sensory descriptors such as the intensity of flavor and aroma, tenderness, juiciness, springiness, cohesiveness, and overall palatability of goose meat. The goose samples of PF, G, and OCR were characterized as very good and WBC as extremely desirable overall palatability. However, in the next stage of research, there is a need to study changes in the chemical composition, the degree of lipid oxidation, and the nutritional value of this meat that underwent different methods of cooking. Only then it will be possibly to clearly determine which method of the heat treatment of goose meat is optimal.

Anthropogenic- and natural sources of dust in peatland during the Anthropocene.

As human impact have been increasing strongly over the last decades, it is crucial to distinguish human-induced dust sources from natural ones in order to define the boundary of a newly proposed epoch - the Anthropocene. Here, we track anthropogenic signatures and natural geochemical anomalies in the Mukhrino peatland, Western Siberia. Human activity was recorded there from cal AD 1958 (±6). Anthropogenic spheroidal aluminosilicates clearly identify the beginning of industrial development and are proposed as a new indicator of the Anthropocene. In cal AD 1963 (±5), greatly elevated dust deposition and an increase in REE serve to show that the geochemistry of elements in the peat can be evidence of nuclear weapon testing; such constituted an enormous force blowing soil dust into the atmosphere. Among the natural dust sources, minor signals of dryness and of the Tunguska cosmic body (TCB) impact were noted. The TCB impact was indirectly confirmed by an unusual occurrence of mullite in the peat.

Barium concentration in cast roe deer antlers related to air pollution caused by burning of barium-enriched coals in southern Poland.

Concentrations of Ba, Zn, Pb, Fe, and Mn were determined by atomic absorption spectroscopy in freshly cast antlers from male roe deer of different ages (2 to 4 years old and older than 4 years) collected in Balin near Chrzanów and in the vicinity of Zywiec, S Poland. Barium content ranged from 124 to 196 ppm (mean 165 ppm) in the Balin 12 samples and from 207 to 351 ppm (mean 287 ppm) in 3 antlers from Zywiec. The concentration of Ba was comparable to that of Zn (134-275 ppm, mean 169 ppm). Elevated concentrations of Ba in antlers most probably originated from direct uptake of airborne barite nanocrystals through the respiratory system and/or by digestion of barite-rich dust particles deposited on plants. Burning of Ba-enriched coals is regarded as the principal source of Ba in the investigated areas inhabited by roe deer. Increased concentrations of Ba in antlers from the Zywiec area compared to Balin reflect particularly high air pollution caused by coal-burning mostly for domestic purposes combined with an unfavorable topography that impedes efficient air circulation.

Peatland Microbial Communities as Indicators of the Extreme Atmospheric Dust Deposition.

We investigated a peat profile from the Izery Mountains, located within the so-called Black Triangle, the border area of Poland, Czech Republic, and Germany. This peatland suffered from an extreme atmospheric pollution during the last 50 years, which created an exceptional natural experiment to examine the impact of pollution on peatland microbes. Testate amoebae (TA), Centropyxis aerophila and Phryganella acropodia, were distinguished as a proxy of atmospheric pollution caused by extensive brown coal combustion. We recorded a decline of mixotrophic TA and development of agglutinated taxa as a response for the extreme concentration of Al (30 g kg-1) and Cu (96 mg kg-1) as well as the extreme amount of fly ash particles determined by scanning electron microscopy (SEM) analysis, which were used by TA for shell construction. Titanium (5.9 %), aluminum (4.7 %), and chromium (4.2 %) significantly explained the highest percentage of the variance in TA data. Elements such as Al, Ti, Cr, Ni, and Cu were highly correlated (r > 0.7, p < 0.01) with pseudostome position/body size ratio and pseudostome position. Changes in the community structure, functional diversity, and mechanisms of shell construction were recognized as the indicators of dust pollution. We strengthen the importance of the TA as the bioindicators of the recent atmospheric pollution.

Sources of variation in work disability assessment.

The assessment of work disability due to health problems is a difficult task because there is no straightforward relationship between disease and disability. As a result, there is wide inter-rater variability between physicians in assessing work disability. The aim of this paper is to discuss the sources of the inter-rater variability and to describe possibilities for its reduction. A model is presented in which the process of disability assessment, the instruments used and the role of the assessor is addressed. On the basis of this model, the causes of inter-rater variability and suggestions for improvement are discussed.

Inter-rater reliability in disability assessment based on a semi-structured interview report.

PURPOSE: To investigate whether physicians are able to perform a disability assessment based on a written report and to assess the inter-rater reliability between physicians in the assessment of work limitations. METHOD: In total, 12 insurance physicians used written reports to assess work limitations in 12 patients. The reports involved a semi-structured interview executed by a nurse practitioner. The insurance physicians were asked whether they could make reliable assessments based on these reports. In addition, inter-rater reliability was measured by computing their percentage agreement with respect to the mental and physical items of two Dutch disability lists (the Functional Information System and the Mental Ability List). RESULTS: The quality of the reports was evaluated as reasonable to good. Half the physicians found the assessment based on the reports to be reasonably reliable, 25% found the opposite and 25% was indecisive. The overall agreement between the insurance physicians was reasonable to good, with a mean agreement of 76% (range 64 - 88%). Agreement between the physicians concerning the number of hours a patient could function daily was low. CONCLUSIONS: Half the physicians thought that a reliable assessment based on the written information was possible. The quality of written patient reports made by nurse practitioners trained in conducting a semi-structured interview was considered reasonable to good by insurance physicians. The inter-rater reliability between insurance physicians of physical-disability and mental-disability assessment based on the written reports was reasonable to good. The assessment of the number hours patients could function daily had low inter-rater reliability.

RAS inhibitors decrease apoptosis of acinar cells and increase elimination of pancreatic stellate cells after in the course of experimental chronic pancreatitis induced by dibutyltin dichloride.

Chronic pancreatitis (CP) is a progressive disease, in which the exocrine function of the gland is gradually lost and fibrosis develops due to repeated episodes of acute pancreatitis. The aim of the study was to investigate the effects of RAS inhibitors on the apoptosis of acinar cells and pancreatic stellate cells (PSCs) elimination in experimental CP induced by dibutyltin dichloride (DBTC). CP was induced by administration of DBTC to the femoral vein. Simultaneously captopril, losartan, enalapril and lisinopril were administered intraperitoneally. The rats were decapitated after 60 days and tissue of pancreas was collected. In rats treated by DBTC the features of inflammatory infiltration, ductal lumen dilatation, fibrosis were found. Strong reactivity with caspase2(L) and clusterin-beta antibodies was observed in areas of fibrosis. In animals treated with RAS inhibitors inflammatory changes and fibrosis were less severe. In groups of rats treated with DBTC and RAS inhibitors immunoreactivity of caspase(2L) and clusterin-beta was weak. Positive immunostaining against smooth muscle actine and desmin was observed in the elongated cells (PSC-s). This reaction was weak in groups of rat treated with DBTC and RAS inhibitors. Treatment of CP rats with RAS inhibitors alleviate apoptosis of pancreatic acinar cells and induces PSCs elimination.

Effect of a kestose and nystose preparation on growth performance and gastrointestinal tract function of turkeys.

The aim of the present study was to determine the effects of dietary administration of a fructooligosaccharide preparation rich in kestose and nestose on growth performance and gastrointestinal parameters in young turkeys. The kestose and nestose preparation was obtained through bioconversion of sucrose using fungi fructosyl transferase and contained in DM 39.9% of kestose, 17.6% of nystose, as well as 26.5% of glucose and 14.7% of sucrose. Three dietary levels of the sum of kestose and nystose (0.3, 0.6, and 1.2%) were fed to growing turkeys for 8 wk. When compared with the control treatment, addition of the kestose and nestose preparation had no effect on feed intake, feed conversion, and BW. The kestose and nestose-supplemented diet, especially the medium level of kestose and nystose, influenced microbial metabolism, especially in the ceca. Compared with the control group, the medium level of kestose and nestose decreased relative weight of gizzard (from 18.67 to 16.51 g/kg of BW) and weight of small intestine tissue (from 23.3 to 19.6 g/kg of BW) and increased weight of ceca digesta (from 3.51 to 4.77 g/kg of BW) as well as activities of microbial beta-glucosidase (an increase from 0.22 to 0.38 U/g) and alpha-galactosidase (an increase from 0.90 to 1.61 U/g), pH of digesta (a decrease from 6.13 to 5.79), concentration of NH3 (an increase from 0.60 to 0.98 mg/g), and concentration of total short-chain fatty acids (an increase from 81.1 to 107.7 micromol/g) in the cecal digesta. A high content of kestose and nestose in the diet caused a decrease in ileal and cecal pH (to 5.42 and 5.49, respectively).

Integrated care for MS patients.

PURPOSE: The problem of complex healthcare to MS patients, together with the rising prevalence of MS and escalating costs, has caused healthcare policy makers to consider innovative approaches to controlling costs and improving the quality of care. An integrated care approach may provide a means for better coordination and delivery of care. The aim is to review recent integrated care initiatives and their significance for MS patients. METHOD: A literature search was conducted to trace relevant literature on integrated care for MS patients published between 1995 and 2003. RESULTS: Although integrated care appears to offer potential for eliminating fragmentation and discontinuity in healthcare for MS patients, there are few published studies which have evaluated its implementation with MS patients. CONCLUSIONS: Even though the potential advantages of integrated care are well known, the applicability of this approach for MS patients has still to be demonstrated.

Effect of chicory products with different inulin content on rat caecum physiology.

A 4-week experiment carried out on rats addressed the analysis of physiological properties of model casein diets supplemented with 5% cellulose or different preparations of chicory roots: flour, pulp, high- and low-molecular inulin (IN(HM) and IN(LM) respectively). Of all preparations, only pulp did not induce the hypertrophy of caecum walls or an increase in the bulk of caecal digesta. Chicory preparations lowered caecal pH and ammonia concentration (except IN(LM) preparation), evoked increased hydration of caecal digesta and protein content. The highest concentration of volatile fatty acids (VFA) was observed in rats fed a diet containing chicory pulp and IN(HM), whereas the lowest VFA concentration was reported after the administration of an IN(LM)-containing diet. The VFA pool was the highest in rats receiving a diet supplemented with chicory flour. All preparations examined diminished the coefficient of protein digestibility but not decrease nitrogen retention. The lowest levels of glucose and total cholesterol, at concurrently the highest level of HDL fraction, were recorded in serum of rats fed IN(LM). A distinct increase in intestinal wall and intestinal digesta, as well as the highest production of VFA and the lowest pH of caecal digesta indicate that chicory flour ingested to a semi-synthetic diet had the most profitable effect on the functioning of rat caecum, compared with other chicory products. Compared with the IN(HM), the preparation of IN(LM) increased caecal wall hypertrophy without increasing VFA production, still simultaneously increasing ammonia content and pH of caecal digesta, decreasing the total cholesterol concentration and increasing HDL content in serum.

The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession.

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.

The role of adenosine A2a receptors in experimental acute pancreatitis.

PURPOSE: The role of adenosine and its receptors in acute pancreatitis remains unelucidated. The aim was to evaluate the effects of the adenosine A2a receptor agonist and antagonist in the severe, taurocholate-induced experimental acute pancreatitis (EAP). MATERIAL AND METHODS: The experiments were performed on 80 male Wistar rats, subdivided into 4 groups: C--the control rats, I--the EAP group, IIA--EAP group treated with the A2a adenosine receptor agonist CGS 21680, IIB--EAP group treated with the A2a adenosine receptor antagonist ZM 241385. The blood for alpha-amylase and lipase and tissues samples for the morphological examinations and immunohistochemistry for A2a receptors were collected in 2, 6, 24 hours of the experiment. RESULTS: The serum alpha-amylase tended to decrease in the group IIA as compared to EAP untreated after 6 and 24 h. No significant effect of both treatments on serum lipase was noted. The administration of CGS 21680 resulted in favorable decrease of the inflammatory cell infiltration, hemorrhagic changes, necrosis and vacuolization of acinar cells, without an evident effect on the edema of the interstitial tissue. The administration of ZM 241385 did not affect the scores of necro-hemorrhagic changes and inflammatory infiltration, whereas it decreased the scores of vacuolization and edema. In all groups the expression of A2a receptors was similar. CONCLUSIONS: Our findings suggest, that A2a adenosine receptors are involved in the course of sodium taurocholate EAP. It is probable that the modulation of some subgroups of adenosine receptors could alleviate the course of severe experimental AP.

In vitro angiomodulatory activity of sera from type 2 diabetic patients with background retinopathy.

Diabetic retinopathy is the leading cause of adult vision loss and blindness. The most important contributors to the development of diabetic retinopathy are hyperglycemia and hypoxemia that lead to increased vasopermeability, endothelial cell proliferation, and pathological neovascularization. In our previous studies, close relationship between proangiogenic activity of sera from type 2 diabetes mellitus patients (DM2) with background retinopathy, assessed in the in vivo serum-induced mouse cutaneous test (SIA), and VEGF and IL-18 serum concentration were observed. Moreover, it was clearly shown that IGF-1 might play an important role in the negative regulation of neoangiogenesis induced by DM2 patients' sera by diminishing the VEGF stimulatory effect. To confirm the observed phenomenon we evaluated the effect of DM2 patients' sera on the in vitro proliferative activity of human endothelial cells, which is critical for the sprouting and generation of new blood capillaries. Endothelial proliferative activity was significantly higher in the presence of sera from DM2 patients than from healthy controls (P<0.001), as estimated by the MTT test. Moreover, the examined sera from DM2 patients were characterized by increased IL-18 (P<0.05), diminished IGF-1 (P<0.02), and unchanged VEGF levels compared with those in controls. In conclusion, the present study showed a strong stimulatory effect of DM2 patients' sera on the proliferation of endothelial cells, which, along with the findings of our previous studies, proves that the described phenomenon is universal and valid for both animal and human endothelium.

Work-related determinants of return to work of employees on long-term sickness absence.

PURPOSE: The aim of the study is to identify work-related determinants of return to work (RTW) of employees who are on long-term sickness absence. METHOD: The study was based on a sample of 926 employees on sickness absence (maximum duration of 12 weeks). The employees filled out a baseline questionnaire and were subsequently followed until the 10th month after listing sick. Cox proportional hazards regression analyses were used to identify determinants of RTW. RESULTS: Working in one of the vocational sectors public administration, construction, financial and commercial services, transport, or education (P = 0.00) and having low co-worker support (P = 0.01) were related to longer duration to RTW in the multivariate model. Having low supervisor support (P = 0.01) was associated with a higher RTW rate. CONCLUSIONS: Vocational sector is a strong predictor of RTW. Especially employees from the sector education are slow as to RTW. The observed association between low supervisor support and RTW was unexpected. However, the study confirms earlier research on the association between low co-worker support and RTW.

Functional ability, social support, and depression in rheumatoid arthritis.

OBJECTIVE: First, to investigate the patterns of functional ability, depressive feelings, and social support in early stage rheumatoid arthritis (RA) patients. Second, to demonstrate the stress buffering effect of social support. Social support is thought to reduce the impact of chronic stress on psychological well-being; for patients without social support the impact of functional ability on depressive feelings will be stronger. METHODS: In 4 waves with an intervening period of 1 year, longitudinal data was collected of 264 Dutch RA patients, of which 65% was female. At T1, the mean age of these patients was 53 years, while their mean disease duration was 22 months. In an interview at the patients' homes, data was collected on functional ability, social support en psychological well-being. The buffering effect of social support was examined by testing the significance of the (computed) stressor by social support interaction term in a regression analysis on depressive feelings. RESULTS: Although large differences between subjects existed, the mean scores on functional ability, social support, and depressive feelings barely changed from year to year. Patients who deteriorated in functional ability during one year had the best chances to improve next year, and visa versa. Furthermore, the stress by support interaction terms had no significant effect on depressive feelings in a regression analysis. CONCLUSIONS: This study demonstrated clearly the fluctuating pattern of RA in the first years after onset. The patients' level of depressive feelings was linearly related to the level of functional ability. Like many other studies, also this study could not provide evidence for the stress buffering effect of social support.

Physiological effects of lactulose and inulin in the caecum of rats.

A model experiment was performed on rats to evaluate the effect of partial or total substitution of saccharose (S) and cellulose (C) by preparations of lactulose and inulin on the development and metabolism of the caecum. In the experimental diets given to rats for 4 weeks, the examined preparations were administered either with an equivalent amount of cellulose (each at 4% of the diet) or as sole source of dietary fibre at 8% of the diet. Compared to the saccharose group cellulose had no effect, and low doses of lactulose and inulin in the diet increased to a medium extent the weight of the caecum wall and caecal digesta. The addition of lactulose and inulin at 8% increased significantly the content of caecal digesta (4.62 and 4.11 g/100g BW, respectively) and the weight of the caecal wall (1.10 and 0.86 g/100g BW, respectively), compared to the groups with saccharose and cellulose (0.73, 0.90 and 0.24, 0.28 g/100g BW, respectively). Cellulose and cellulose partially-substituted with lactulose and inulin caused an increase in the dry matter content of caecal digesta (26.5-27.5%), compared to other groups (21.8-22.8%). The administration of lactulose and inulin preparations was accompanied by a significant drop in pH (5.47-5.81), compared to the groups with cellulose or saccharose (6.83-6.91), and a decrease in the ammonia concentration in the caecal digesta, compared to the cellulose control (0.27-0.40 and 0.62 mg/g, respectively). The group with 8% lactulose was characterized by the highest activities of microbiological alpha- and beta-galactosidase and beta-glucosidase in the caecal digesta. Cellulose and both preparations significantly decreased the activity of beta-glucuronidase, compared to the saccharose group (0.39-0.89 and 1.52 U/g, respectively). The highest concentration of VFA in the caecal digesta was observed in the saccharose group (89.2 micromol/g), and the lowest concentration in the group where cellulose was totally substituted by lactulose and inulin (55.1 and 57.5 micromol/g, respectively). The total production of VFA in the caecum was fourfold higher with 8 % lactulose and inulin (254.7 and 236.4 micromol/100g BW, respectively) than in both controls groups (65.1 and 67.8 micromol/100g BW, respectively). The high dose of inulin and lactulose increased the share of propionic acid in the VFA profile (C2:C3:C4) compared to both control groups. When 4% inulin was added to the diet a significant increase of butyrate concentration in the caecum was observed.

People with intellectual disability and their health problems: a review of comparative studies.

BACKGROUND: The transition of people with intellectual disability (ID) from care institutions to the community - according to Western policy - results in a shift of responsibility towards primary health care services. In order to provide optimal care to people with ID living in the community, general practitioners need to be aware of the specific health problems of this patient category. The aim of this paper is to present an overview of recent studies on the specific health problems of people with ID, in particular on health problems of people with ID in the community, compared to those of the general population. METHOD: To reliably compare health problems of individuals with and without ID, this review is limited to comparative research using a control group of individuals without ID. The focus of the review concentrates on international literature, published between 1995 and 2002. RESULTS: Most comparative research among people with ID presents higher prevalence rates for epilepsy, diseases of the skin, sensory loss and (increased risk of) fractures. These health problems are specific for people with ID, both in general and living in the community in particular. CONCLUSIONS: there are only few studies focusing on health problems in people with ID in which a control group of individuals without ID is included. Most comparative studies on health problems in people with ID are based on comparison with reported prevalence rates of general health surveys.

Content of iron, copper and zinc in white sugar samples from Polish and other European sugar factories.

White sugar is a very pure food product, even though it contains very small, significant amounts of soluble and insoluble impurities. The content of these impurities has nutritional significance and determines the usefulness of sugar for various industrial applications. The aim was to evaluate the content of iron, copper and zinc in samples of white sugar from Polish factories compared with commercial white sugar samples from other European countries. The investigations were conducted on 72 campaign-averaged white sugar samples from 37 different Polish sugar factories from 1996 to 2000 and on 16 commercial white sugar samples from nine European countries. The content of iron, copper and zinc in those sugar samples was determined by means of FAAS both in the sediment and in the solution after filtration on 0.45- micro m filters of sugar water solution. The content of iron, copper and zinc was low (averages 0.29, 0.06 and 0.07 mg x kg(-1), respectively) in all the white sugar samples from Polish sugar factories and other European countries. Iron and copper found in all white sugar samples were mainly in insoluble form - 77 and 69%, respectively. The contents of water-insoluble iron and water-soluble zinc in white sugar increase with a lowering of the quality of sugar evaluated according to the standards of the EU sugar market regime.