Interactive impacts of photoaged micro(nano)plastics and co-occurring chemicals in the environment.

In the environment, sunlight or ultraviolet (UV) radiation is considered to be the primary cause of plastic aging, leading to their fragmentation into particles, including micro(nano)plastics (MNPs). Photoaged MNPs possess diverse interactive properties and ecotoxicological implications substantially different from those of pristine plastic particles. This review aims to highlight the mechanisms and implications of UV-induced photoaging of MNPs, with an emphasis on various UV sources and their interactions with co-occurring organic and inorganic chemicals, as well as the associated ecological and health impacts and factors affecting those interactions. Compared to UV-B, UV-A and UV-C were more widely used in laboratory studies for MNP degradation. Photoaged MNPs act as vectors for the transportation of organic pollutants, organic matter, and inorganic chemicals in the environment. Literature showed that photoaged MNPs exhibit a higher sorption capacity for PPCPs, PAHs, PBDEs, pesticides, humic acid, fulvic acid, heavy metals, and metallic nanoparticles than pristine MNPs, potentially causing significant changes in associated ecological and health impacts. Combined exposure to photoaged MNPs and organic and inorganic pollutants significantly altered mortality rate, decreased growth rate, histological alterations, neurological impairments, reproductive toxicity, induced oxidative stress, thyroid disruption, hepatotoxicity, and genotoxicity in vivo, both in aquatic and terrestrial organisms. Limited studies were reported in vitro and found decreased cellular growth and survival, induced oxidative stress, and compromised the permeability and integrity of the cell membrane. In addition, several environmental factors (temperature, organic matter, ionic strength, time, and pH), MNP properties (polymer types, sizes, surface area, shapes, colour, and concentration), and chemical properties (pollutant type, concentration, and physiochemical properties) can influence the photoaging of MNPs and associated impacts. Lastly, the research gaps and prospects of MNP photoaging and associated implications were also summarized. Future research should focus on the photoaging of MNPs under environmentally relevant conditions, exploiting the polydisperse characteristics of environmental plastics, to make this process more realistic for mitigating plastic pollution.

Effects of Trace Elements on the Fatty Acid Composition in Danubian Fish Species.

In this study, the concentrations of metals and trace elements (As, Cd, Co, Cr, Cu, Hg, Ni, Pb and Zn) were determined in the muscle tissue of adult roach and white bream at two different sites in the Belgrade section of the Danube. Twenty-six fatty acids, consisting of nine saturated FA (SFAs), seven monosaturated FA (MUFAs) and ten polysaturated FA (PUFAs), were identified. The analysis of the concentration of metals and trace elements of the roach and white bream showed species-specific differences in their bioaccumulation. Four of all elements analyzed (As, Hg, Ni and Pb) correlated significantly with the changes in FA profiles in fish from both sampling sites, with the exception of Cu, which correlated with the FA profile at the site before, and Zn, whose concentration influenced the FA profile at the site after wastewater discharges. The lower PUFA content in the fish from a site under higher environment pressure could indicate that the fish are stressed. The results suggest that changes in lipid composition may be one of the protective mechanisms of cells to cope with anthropogenic stressors.

An ontology-based study on water quality: probabilistic risk assessment of exposure to fluoride and nitrate in Shiraz drinking water, Iran using fuzzy multi-criteria group decision-making models.

World Health Organization reports that 2.2 million people die yearly from insufficient sanitary drinking water. This ontology-based study focused on investigating the chemical quality of drinking water through a new water quality index designed by fuzzy multi-criteria group decision-making methods, merged with GIS, and, secondly, surveying non-carcinogenic risk assessment of fluoride and nitrate using Monte Carlo simulation and sensitivity analysis in Shiraz's water sources. F-, NO3-, NO2-, EC, TDS, alkalinity, TH, SO42-, Cl-, and Na were applied in the WQI. The NO3- mean concentrations were 23.15 and 27.66 mg/L in the cold and warm seasons, while the mean concentrations of fluoride were 0.50 and 0.46 mg/L during the cold and warm period. The 95th centiles of fluoride's HQs among infants, children, teenagers, and adults were 0.56, 0.7, 0.49, and 0.4, respectively, in the cold season, which was 0.65 and 0.81, respectively, 0.57 and 0.46 for mentioned groups in the warm season. In comparison, the 95th centiles of nitrate's HQs among infants, children, teenagers, and adults were 1.27, 1.59, 1.13, and 0.9, respectively. The HQs were more than 1 for infants, children, and teenagers, so nitrate can have various adverse effects, whereas fluoride does not adversely affect all aging groups in both seasons. Also, nitrate concentration can increase the non-carcinogenic risk, which the IR and ED lead to the HQ increasing. In contrast, BW has a negative effect on risk increasing. Overall, source management of these parameters can significantly reduce the concentration of nitrate and their adverse human health effect.

Watershed-Scale Risk to Aquatic Organisms from Complex Chemical Mixtures in the Shenandoah River.

River waters contain complex chemical mixtures derived from natural and anthropogenic sources. Aquatic organisms are exposed to the entire chemical composition of the water, resulting in potential effects at the organismal through ecosystem level. This study applied a holistic approach to assess landscape, hydrological, chemical, and biological variables. On-site mobile laboratory experiments were conducted to evaluate biological effects of exposure to chemical mixtures in the Shenandoah River Watershed. A suite of 534 inorganic and organic constituents were analyzed, of which 273 were detected. A watershed-scale accumulated wastewater model was developed to predict environmental concentrations of chemicals derived from wastewater treatment plants (WWTPs) to assess potential aquatic organism exposure for all stream reaches in the watershed. Measured and modeled concentrations generally were within a factor of 2. Ecotoxicological effects from exposure to individual components of the chemical mixture were evaluated using risk quotients (RQs) based on measured or predicted environmental concentrations and no effect concentrations or chronic toxicity threshold values. Seventy-two percent of the compounds had RQ values <0.1, indicating limited risk from individual chemicals. However, when individual RQs were aggregated into a risk index, most stream reaches receiving WWTP effluent posed potential risk to aquatic organisms from exposure to complex chemical mixtures.

Magnetic motion of superparamagnetic iron oxide nanoparticles- loaded dental adhesives: physicochemical/biological properties, and dentin bonding performance studied through the tooth pulpal pressure model.

The limited durability of dentin bonding harshly shortens the lifespan of resin composites restorations. The controlled, dynamic movement of materials through non-contacting forces provides exciting opportunities in adhesive dentistry. We, herein, describe comprehensive investigations of a new dental adhesive with superparamagnetic iron oxide nanoparticles (SPIONs) sensitive to magnetic fields for bonding optimization. This contribution outlines a roadmap of (1) designing and tuning of an adhesive formulation containing SPIONs to enhance penetrability into etched dentin guided by magnetic-field; (2) employing a clinically relevant model of simulated hydrostatic pulpal pressure on the microtensile bond to dentin; and (3) investigating a potential antibacterial effect of the formulated adhesives, and their biocompatibility. SPION-concentration-dependency chemical and mechanical behavior was shown via the degree of conversion, ultimate tensile strength, and micro shear bond strength to dentin. The effects of SPIONs carried on a dental adhesive on the bonding strength to dentin are studied in depth by combining experiments with in vitro simulated model. The results show that under the guided magnetic field, 0.07 wt.% of SPIONs-doped adhesive increased the bond strength that surpasses the reduction caused by hydrostatic pulpal pressure. Using a magnetic guide workflow during the bonding procedures, SPIONs-doped adhesives improved dentin's adhesion without changing adhesives' physicochemical properties. This outcome addresses the key challenge of poor resin infiltration of dentin's conventional total etching during the bonding procedure. The real-time magnetic motion of dental adhesives may open new paths to enhance resin-based restorations' longevity. STATEMENT OF SIGNIFICANCE: In this study, dental adhesives containing superparamagnetic iron oxide nanoparticles (SPIONs) were developed to enhance penetrability into dentin guided by a magnetic field. The adhesives were screened for physical, chemical, antibacterial properties, and cytotoxicity. For the first time, simulated pulpal pressure was used concurrently with the magnetic field to simulate a clinical setting. This approach showed that it is feasible to overcome pulpal pressure jeopardization on bond strength when SPIONs and a magnetic field are applied. The magnetic-responsive adhesives had great potential to improve bond strength, opening new paths to enhance resin-based restorations' longevity without affecting adhesives' biological properties. The use of magnetic-responsive particles and magnetically assisted motion is a promising strategy to improve the sealing ability of dental adhesives.

Underwater Time-Gated Standoff Raman Sensor for In Situ Chemical Sensing.

We describe the fabrication of an underwater time-gated standoff Raman sensor, consisting of a custom Raman spectrometer, custom scanner, and commercial diode-pumped pulsed 532 nm laser all located inside a pressure housing. The Raman sensor was tested in the laboratory with samples in air, a tank containing tap water and seawater, and in the coastal Hawaiian harbor. We demonstrate our new system by presenting standoff Raman spectra of some of the chemicals used in homemade explosive devices and improvised explosive devices, including sulfur, nitrates, chlorates, and perchlorates up to a distance of ∼6 m in seawater and tap water. Finally, the Raman spectra of these hazardous chemicals sealed inside plastic containers submersed in the Hawaiian Harbor water are also presented.

Sialometric and Sialochemical Analysis in Individuals With Pulp Stones.

The aim of this study was to analyze the saliva of patients with pulp stones, with sialometric and sialochemical tests. Eighty individuals, aged between18 and 65 years, of both sexes, were investigated. Patients were included in the pulp stone group when radiographic examination was suggestive of pulp stones in at least one permanent tooth, whereas those without this alteration were considered controls. Saliva was collected by stimulation, followed by salivary flowrate (SFR) and pH analysis tests. The organic components, such as urea (URE), glucose (GLU), total proteins (TPTs), alkaline phosphatase, creatinine (CRE), salivary amylase (SAM), and uric acid (URA), and the inorganic components, such as calcium, iron, and phosphorus, were evaluated by colorimetric techniques in an ultraviolet-visible (UV-vis) spectrophotometer. Differences among pulp stones and control groups were compared using Student's t-test, with a significance level of p < 0.05. In both groups prevailed the female. Statistically significant differences between groups were observed for pH (p = 0.027), SFR (p = 0.002), alkaline phosphatase (p = 0.008), and URA (p = 0.005). None of the inorganic components showed significant difference (p > 0.05). In the analyses stratified by sex, difference between groups was observed for pH (p = 0.007) and URA (p = 0.003) in women. In conclusion, sialometric and sialochemical alterations occurred in patients with pulp stones, with significantly higher levels of pH, SFR, alkaline phosphatase, and URA.

Indoor radon concentrations in residential houses, processing factories, and mines in Neyriz, Iran.

PURPOSE: This study aimed to determine radon concentrations in mines, stone processing factories, residential houses, and public areas, as well as calculating its effective dose in Neyriz, Iran. METHOD: A total of 74 alpha Track detectors (CR-39 detector) were installed at the desired locations based on the US-EPA's protocol. After 3 months the detectors were collected and delivered to a Radon Reference Laboratory for analyzing. RESULTS: Mean ± SD, minimum and maximum radon concentrations in the sampling buildings were 29.93 ± 12.63, 10.33, and 66.76 Bq/m3, respectively. The effective annual dose was calculated to be 0.75 mSv/year, which was lower than the recommended value. Significant positive correlations were found between radon concentrations and some studied variables including smoking cigarettes, number of cigarettes smoked, duration of smoking, building's age, number of floors, having cracks, use of colors in the building, use of ceramic for flooring, use of stone for flooring, and gas consumption. The number of cigarettes smoked by the residents was the most important predictor of radon concentrations. Radon concentrations were lower than standard values in all sampling locations. CONCLUSION: It is necessary to conduct further studies in the field of regional geology and determine the sources that release radon in these areas to prevent further increases in radon concentration due to the proximity and plurality of mines and factories.

Progress in inorganic nanomaterials for photothermal therapy of cancer / 肿瘤

Traditional methods of cancer treatment such as surgical resection, chemotherapy and radiotherapy have certain limitations, and their treatment effects are not always satisfactory. As a new cancer treatment method, photothermal therapy based on nanomaterials has attracted people's attention due to its characteristics of minimally invasive, high efficiency, low side effects and inhibition of cancer metastasis. At present, there are a variety of inorganic or organic nanomaterials used in the field of photothermal cancer treatment, and have shown great application prospects. In this paper, the advantages and disadvantages of a variety of inorganic nanomaterials for photothermal therapy as well as their research progress are reviewed.

Inspección preliminar de algunas características de toxicidad en el agua potable domiciliaria, Bogotá y Soacha, 2012 / Preliminary survey to detect toxic substances in domestic potable water, Bogotá and Soacha, 2012

Introducción. La distribución y el almacenamiento del agua después de su potabilización, pueden originar cambios significativos en su calidad, por lo que es necesario conocer las características finales del agua domiciliaria que consumen los usuarios. Objetivo. Evaluar de forma preliminar las sustancias químicas tóxicas en el agua de tanques y grifos de viviendas abastecidas por el acueducto de Bogotá. Materiales y métodos. Se hizo un estudio descriptivo en 26 viviendas localizadas en Bogotá y Soacha. Se hicieron dos muestreos: uno en época de lluvias y otro en temporada seca, y en ambos se aplicó una encuesta y se recolectaron muestras de agua de los tanques de almacenamiento y los grifos. Las muestras se sometieron a ensayos fisicoquímicos básicos, a una prueba de tamización de sustancias orgánicas e inorgánicas, y a pruebas de determinación de metales pesados y de residuos de plaguicidas organofosforados y carbamatos. Resultados. La conductividad, el color y los nitratos presentaron valores permisibles; el pH y la turbiedad tuvieron una ligera tendencia a presentar niveles altos y, el cloro residual, niveles bajos. Hubo trazas de aluminio en el 94 % de las muestras. En el período seco, 8 % de las muestras presentó compuestos orgánicos y, en el período lluvioso, 66,7 %. Solo hubo un resultado positivo para las sustancias inorgánicas. En el 11,5 % de las viviendas, el nivel de riesgo fue medio, en el 61,5 %, bajo, y en el 27 % no se registró riesgo. Conclusiones. Se evidenció deterioro de la calidad del agua domiciliaria debido a la presencia de sustancias orgánicas en tanques y sobre todo en las redes, presumiblemente a causa de la formación de biopelículas o a la presencia de polímeros orgánicos. Los niveles de aluminio cercanos al máximo aceptable pueden explicarse por los remanentes de los coagulantes utilizados durante el tratamiento.

Introduction: Significant alterations may be found in the water of Bogotá´s water supply system after its purification, specifically during its distribution and storage in home reservoirs, which makes it necessary to study the final quality of the domiciliary water consumed by users. Objective: To conduct a preliminary study of toxic chemical substances in the water supplied by Bogotá´s water supply system in samples obtained from residential reservoirs and faucets. Materials and methods: Descriptive study made in 26 homes located in Bogotá and Soacha. Two samplings were done during different seasons, each including a survey and the collection of water samples from domiciliary storage tanks and faucets. Samples were analyzed for basic physicochemical parameters, a screening test for organic and inorganic substances and the determination of heavy metals and residues of organophosphate pesticides and/or carbamates. Results: Values obtained for conductivity, color and nitrates were acceptable, pH and turbidity were slightly high while residual chlorine levels were low; aluminum traces were found in 94% of the samples; 8% of the samples analyzed during the dry season showed organic compounds, compared to 66.7% during the rainy season, and just one positive result was obtained for inorganic compounds. Consequently, a medium risk level was observed in 11.5% of homes, low risk in 61.5% and no risk in 27.0%. Conclusion: The evidence showed deterioration of the domiciliary water by organic substances present in the reservoirs as well as in the water supply piping, probably caused by the formation of biofilms or organic polymers. Aluminum levels close to the top permissible limit can be explained by the presence of residual coagulants used during water treatment.

Inorganic elemental analysis and identification of residual monomers released from different glass ionomer cements in cell culture medium / Análise elementar inorgânica e identificação de monômeros residuais orgânicos liberados por diferentes cimentos de ionômero de vidro

Introduction: Glass ionomer cements (GICs) release inorganic elements and organic residual monomers with the potential for deleterious effects on pulp cells. Objective: To identify and quantify inorganic elements present in different GICs and released components from these materials in cell culture medium. Material and Method: Samples of two resin-modified GICs for base/liner (Vitrebond and Fuji Lining LC), two resin-modified restorative GICs (Vitremer and Fuji II LC) and two conventional restorative GICs (Ketac Fil Plus and Ketac Molar Easymix) were prepared and analyzed by Energy-Dispersive X-Ray Fluorescence Spectrometry (EDXRF). Extracts of these materials were obtained by immersion of each sample in separate containers of DMEM for 24 h (total surface-liquid ratio = 45.7 mm²/mL). The extracts were analyzed by EDXRF and Gas Chromatography-Mass Spectrometry (GC-MS). Result: Higher percentages of strontium, silicon and aluminum were identified in Vitrebond, Vitremer, Fuji Lining LC, Fuji II LC, and Ketac Fil Plus, while zinc was detected only in Vitrebond. Ketac Molar Easymix presented a greater atomic composition of lanthanum, calcium, aluminum and silicon. Strontium was detected in the extracts from all materials except Ketac Molar Easymix; calcium was present in extracts from Ketac Fil Plus; zinc only in Vitrebond; and silicon in Fuji II LC extract. The analysis by GC-MS detected 2-hydroxyethyl-methacrylate (HEMA) in the extracts from all resin-modified GICs, and iodine benzene was detected only in the Vitrebond extract. Conclusion: Of the GICs sampled, Vitrebond released the highest number of components with cytotoxic potential.

Introdução: Os cimentos de ionômero de vidro (CIVs) liberam elementos inorgânicos e monômeros orgânicos residuais que têm o potencial de causar efeitos deletérios sobre as células pulpares. Objetivo: Identificar e quantificar os elementos inorgânicos presentes em diferentes CIVs, bem como os componentes liberados por estes materiais em meio de cultura celular. Material e Método: Espécimes cilindricos de dois CIVs modificados por resina para base/forramento (Vitrebond e Fuji Lining LC), dois CIVs modificados por resina restauradores (Vitremer e Fuji II LC) e dois CIVs convencionais restauradores (Ketac Fil Plus e Ketac Molar Easymix) foram preparados e analisados por Espectrometria de Fluorescência de Raios X por Energia Dispersiva (EDXRF). Em seguida, extratos de 24h desses materiais foram obtidos e analisados por EDXRF e por Cromatografia Gasosa/Espectrometria de Massa (CG/EM). Resultado: Os elementos inorgânicos identificados em maior porcentagem nos CIVs Vitrebond, Fuji Lining LC, Vitremer, Fuji II LC e Ketac Fil Plus foram estrôncio, silício e alumínio, enquanto o zinco foi detectado apenas no Vitrebond. O Ketac Molar Easymix apresentou maior porcentagem dos elementos lantânio, cálcio, alumínio e silício. Estrôncio foi detectado nos extratos de todos os materiais, exceto no Ketac Molar Easymix; cálcio estava presente no extrato do Ketac Fil Plus; zinco apenas no Vitrebond; e silício no extrato do Fuji II LC . O HEMA foi identificado nos extratos de todos os CIVs modificados por resina, e o iodobenzeno, somente no Vitrebond. Conclusão: Entre os CIVs estudados, o Vitrebond é o que libera mais componentes com potencial citotóxico.

Estudo comparativo in vitro das estruturas orgânicas e inorgânicas da dentina saudável e esclerosada humana e bovina: nanodureza, concentração de Ca e P e análise morfológica / In vitro comparative study of organic and inorganic components analysis of health and sclerotic human and bovine dentin: nanohardness, Ca and P concentration and morphological analysis

A dentina esclerosada é um substrato comumente encontrado em pacientes idosos. No entanto, existem poucos estudos comparativos entre dentina humana e bovina esclerosadas. O objetivo deste estudo foi comparar os componentes inorgânicos e orgânicos da dentina saudável e esclerosada humana e bovina, através de cinco parâmetros: nanodureza, módulo de elasticidade, análise quantitativa da concentração de Cálcio (Ca) e Fósforo (P), densidade tubular e morfologia do colágeno. Trinta dentes humanos e 30 bovinos foram distribuídos em 4 grupos experimentais (n=15 por grupo): dentina humana saudável (DHS), esclerosada humana (DEH), bovina saudável (DBS), e bovina esclerosada (DBE). Os dentes saudáveis foram preparados na mesma altura e inclinação dos dentes esclerosados expondo níveis similares da dentina e obtendo fragmentos com 2mm de espessura. Foram realizadas 3 medições por espécime em 3 áreas pré determinadas de dentina intertubular com a utilização do Nanoindentador (carga de 500N por 5 s). Cinco espécimes de cada grupo foram preparados para Microscopia Eletrônica de Varredura (MEV). Com o auxílio da Energia Dispersiva por Raios-X EDX foram obtidos os valores (em percentagem) das concentrações de Ca e P e calculada a relação Ca:P. A contagem dos túbulos por área foi realizada em todas as eletromicrografias. Após descalcificação e preparo, o restante dos espécimes foi analisado em Microscopia Eletrônica de Transmissão (MET)...

The sclerotic dentin has been commonly found in elderly patients. However, there are scarce reports in the literature comparing on the use of human and bovine sclerotic dentins. The objective of this study was to compare inorganic and organic components of healthy and sclerotic dentins from human and bovine. Five parameters were analyzed: nanohardness, elastic modulus, quantitative analysis of Calcium (Ca) and Phosphorous (P) concentrations, tubular density and ultrastructural morphology. Thirty human teeth plus 30 bovine teeth were distributed in 4 experimental groups (n=15 per group): human healthy dentin (HHD), human sclerotic dentin (HSD), bovine healthy dentin (BHD) and bovine sclerotic dentin (BSD). Healthy teeth were cut in the same level and inclination of the sclerotic superficial dentins. The nanohardness and elastic modulus (GPa) of three pre determined areas of each exposed dentin was measured using a nanoindenter (500N for 5s). Five samples of each group were prepared for scanning electron microscopy (SEM) examination. Energy Dispersive X-ray (EDX) was used for obtaining the Ca/P ratio. The tubular density was obtained by counting the tubules in scanning electron micrographs taken in the same magnification and work distance...

Long-term morbidity and mortality following hypoxaemic lower respiratory tract infection in Gambian children.

Acute lower respiratory infections (ALRI) are the main cause of death in young children worldwide. We report here the results of a study to determine the long-term survival of children admitted to hospital with severe pneumonia. The study was conducted on 190 Gambian children admitted to hospital in 1992-94 for ALRI who survived to discharge. Of these, 83 children were hypoxaemic and were treated with oxygen, and 107 were not. On follow-up in 1996-97, 62% were traced. Of the children with hypoxaemia, 8 had died, compared with 4 of those without. The mortality rates were 4.8 and, 2.2 deaths per 100 child-years of follow-up for hypoxaemic and non-hypoxaemic children, respectively (P = 0.2). Mortality was higher for children who had been malnourished (Z-score < -2) when seen in hospital (rate ratio = 3.2; 95% confidence interval (CI) = 1.03-10.29; P = 0.045). Children with younger siblings experienced less frequent subsequent respiratory infections (rate ratio for further hospitalization with respiratory illness = 0.15; 95% CI = 0.04-0.50; P = 0.002). Children in Gambia who survive hospital admission with hypoxaemic pneumonia have a good prognosis. Survival depends more on nutritional status than on having been hypoxaemic. Investment in oxygen therapy appears justified, and efforts should be made to improve nutrition in malnourished children with pneumonia.

PIP: Acute lower respiratory infections (ALRI) are the main cause of death among children under 5 years old worldwide. Findings are reported from a study conducted to assess the long-term survival of 190 Gambian children under age 5 years admitted to the Royal Victoria Hospital, Banjul, in 1992-94, with severe pneumonia who survived to discharge. 83 of the children were hypoxemic and treated with oxygen. 118 (62%) subjects were traced on follow-up in 1996-97. Of the children with hypoxemia, 8 died, compared to 4 who did not have the condition. Mortality rates were 4.8 and 2.2 deaths per 100 child-years of follow-up for hypoxemic and nonhypoxemic children, respectively. The level of mortality was higher among children who had been malnourished when seen in hospital, while children with younger siblings experienced less frequent subsequent respiratory infections. These findings suggest that children in Gambia who survive hospital admission with hypoxemic pneumonia have a good prognosis. Survival depends more upon nutritional status than upon having been hypoxemic. Investment in oxygen therapy seems justified, and efforts should be made to improve nutrition in malnourished children with pneumonia.

Effect of seminal oxidative stress on fertility after vasectomy reversal.

OBJECTIVE: To evaluate seminal oxidative stress in men after vasectomy reversal and to determine whether seminal oxidative stress could predict fertility after vasectomy reversal. DESIGN: Measurement of seminal reactive oxygen species (ROS) and total antioxidant capacity (TAC) in normal donors, men who were fertile after vasectomy reversal, and men who were infertile after vasectomy reversal. SETTING: A male infertility clinic of a tertiary care center. PATIENT(S): Thirty men who underwent vasectomy reversal and 17 normal donors. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Semen characteristics, seminal ROS, and TAC were measured with chemiluminescence assays in samples from donors and reversal patients. RESULT(S): Mean adjusted seminal ROS (log [ROS+1]) was higher in infertile reversal patients (2.38+/-0.25) than in normal donors (1.30+/-0.14). Seminal ROS was also higher in all (fertile and infertile reversal combined) reversal patients than in donors. Total antioxidant capacity did not differ between groups. The ROS-TAC score, a composite index of seminal oxidative stress, was a significant predictor of fertility. A ROS-TAC score of 45 or greater had a positive predictive value of 73% in predicting fertility. CONCLUSION(S): Seminal oxidative stress is associated with vasectomy reversal. The ROS-TAC score is a possible predictor of infertility after vasectomy reversal.

PIP: After undergoing sterilization through vasectomy, a considerable number of men request a reversal of the procedure to restore their fertility. While advances in surgical technique have resulted in patency rates of 71-97%, there exists a 26-72% chance of persistent infertility following a reversal procedure. Knowing that oxidative stress is an important cause of male infertility, the authors explored whether such stress was found after vasectomy reversal and if a measure of oxidative stress could predict infertility after such procedures. 30 fertile and infertile men who underwent vasectomy reversal and 17 normal donors at a male infertility clinic were recruited for the study. Mean adjusted seminal reactive oxygen species (ROS) was higher among infertile reversal patients than in normal donors. Seminal ROS was also higher in all reversal patients than in donors, although total antioxidant capacity (TAC) did not differ between groups. The ROS-TAC score, a composite index of seminal oxidative stress, was a significant predictor of fertility. A ROS-TAC score of 45 or greater had a positive predictive value of 73% in predicting fertility. Seminal oxidative stress is therefore associated with vasectomy reversal and the ROS-TAC score is a possible predictor of infertility after vasectomy reversal.

Clinical predictors of hypoxaemia in Gambian children with acute lower respiratory tract infection: prospective cohort study.

OBJECTIVES: To determine clinical correlates and outcome of hypoxaemia in children admitted to hospital with an acute lower respiratory tract infection. DESIGN: Prospective cohort study. SETTING: Paediatric wards of the Royal Victoria Hospital and the hospital of the Medical Research Council's hospital in Banjul, the Gambia. SUBJECTS: 1072 of 42 848 children, aged 2 to 33 months, who were enrolled in a randomised trial of a Haemophilus influenzae type b vaccine in the western region of the Gambia, and who were admitted with an acute lower respiratory tract infection to two of three hospitals. MAIN OUTCOME MEASURES: Prevalence of hypoxaemia, defined as an arterial oxygen saturation <90% recorded by pulse oximetry, and the relation between hypoxaemia and aetiological agents. RESULTS: 1072 children aged 2-33 months were enrolled. Sixty three (5.9%) had an arterial oxygen saturation <90%. A logistic regression model showed that cyanosis, a rapid respiratory rate, grunting, head nodding, an absence of a history of fever, and no spontaneous movement during examination were the best independent predictors of hypoxaemia. The presence of an inability to cry, head nodding, or a respiratory rate >/= 90 breaths/min formed the best predictors of hypoxaemia (sensitivity 70%, specificity 79%). Hypoxaemic children were five times more likely to die than non-hypoxaemic children. The presence of malaria parasitaemia had no effect on the prevalence of hypoxaemia or on its association with respiratory rate. CONCLUSION: In children with an acute lower respiratory tract infection, simple physical signs that require minimal expertise to recognise can be used to determine oxygen therapy and to aid in screening for referral. The association between hypoxaemia and death highlights the need for early recognition of the condition and the potential benefit of treatment.

PIP: Acute lower respiratory tract (ALRT) infections cause considerable child morbidity and mortality in developing countries. Oxygen therapy can improve the outcome of children with moderate or severe ALRT infections and, in those with hypoxemia, the severity of hypoxia correlates with outcome. However, since oxygen is not always available in resource-poor countries, rational guidelines must be followed for the use of oxygen and the referral of patients to specialist hospitals. Findings are presented from a prospective cohort study conducted to determine which clinical signs predict hypoxemia and the outcome of hypoxemia among children admitted to hospital with ALRT infection. Findings are based upon the study of 1072 of 42,848 children aged 2-33 months who were enrolled in a randomized trial of a Haemophilus influenzae type b vaccine in western Gambia, and who were admitted with an ALRT infection to 2 of 3 hospitals. 63 (5.9%) had an arterial oxygen saturation level of less than 90%. Logistic regression found cyanosis, a rapid respiratory rate, grunting, head nodding, absence of a history of fever, and no spontaneous movement during examination were significantly associated with hypoxemia. When cyanosis may not be correctly assessed, the inability to cry, head nodding, and a respiratory rate of at least 90 breaths/minute can be useful ways of predicting hypoxemia. Hypoxemic children were 5 times more likely to die than were nonhypoxemic children. The presence of malaria parasitemia had no effect upon the prevalence of hypoxemia or upon its association with respiratory rate.

Studies on relationship between serum nitric oxide and plasma cyclic guanosine monophosphate and prolonged bleeding after medical abortion as well as prophylaxis and treatment of bleeding with traditional Chinese medicine.

PIP: The aim was to study the relationship between serum nitric oxide (NO) and plasma cyclic guanosine monophosphate (cGMP) and prolonged bleeding after medical abortion. A total of 120 women who had undergone medical abortion were recruited and divided into two groups: group A (n = 60) took ¿Gong-Fu mixture¿ (uterus-recovering mixture) after the abortion, while group B (n = 60) did not take it. On days 10, 20, and 30 after the abortion, serum NO and plasma cGMP were tested before and after mifepristone administration and 10 days later by Gresis reaction method and radioimmunoassay, respectively. Serum NO and plasma cGMP levels decreased significantly after taking mifepristone (P 0.05). 10 days later, the number of those with bleeding discontinuation in group A was significantly greater than those in group B (P 0.05). Serum NO and plasma cGMP levels in group A decreased more significantly than in group B (P 0.05). The slow decrease of serum NO and plasma cGMP levels is closely related to prolonged bleeding after medical abortion. ¿Gong-Fu mixture¿ is effective in the prevention and treatment of prolonged bleeding.^ieng

Misuse of oxygen in a neonatal unit.

PIP: Oxygen is the most liberally and often used medication in any neonatal unit. Appropriate oxygen therapy has resulted in improved neonatal survival and a reduction in oxygen-related morbidity over the past 2 decades. However, the degree of arterial oxygenation needs to be continuously and precisely monitored when managing critically ill neonates in order to prevent the adverse effects of both hypoxia and hyperoxia. The authors measured the extent of hyperoxia in spontaneously breathing neonates receiving supplemental oxygen by hood and the utility of pulse oximeters in detecting hyperoxia in newborn infants. The study was conducted during January-April 1996 among 63 preterm and 60 term babies admitted to the Neonatal Unit of Kalawati Saran Children's Hospital, who required supplemental oxygen by hood. All of the infants were independently evaluated by an observer after initial stabilization of temperature and perfusion. 91% of spontaneously breathing infants receiving supplemental oxygen by hood were hyperoxemic, with no relation to the type of morbidity for which oxygen therapy was indicated.^ieng

Corrosion behavior of copper in a copper bearing intrauterine device in the presence of indomethacin.

As an improvement to the use of the copper bearing intrauterine device, indomethacin has been introduced to reduce the incidence of bleeding after insertion of the device. The effects of indomethacin on copper corrosion were studied in vitro in simulated uterine fluid. Electrochemical polarization resistance measurements indicated that indomethacin powder slightly increased the corrosion rate of copper if pH of the fluid was not under control and it did not change the corrosion rate if pH was adjusted daily to maintain some constancy. The experimental results for medication by indomethacin-releasing Silastic were basically the same as those with powdered indomethacin. X-ray diffraction showed that only cuprous oxide was formed on the copper substrated surface and that indomethacin did not affect the corrosion products. As scanning electron microscopy demonstrated, however, in the presence of indomethacin the oxide particles formed were found to be more coarse and dense than in the absence of indomethacin.

PIP: The effects of indomethacin--a prostaglandin synthesis inhibitor introduced to copper-bearing IUDs to reduce the incidence of postinsertion bleeding--on copper corrosion were investigated in vitro in simulated uterine fluid by Chinese researchers. Indomethacin was introduced to the solution either in various amounts of powdered preparation or in indomethacin-releasing Silastic of different contents. Electrochemical polarization resistance measurements indicated that indomethacin powder slightly increased the copper corrosion rate if the pH of the fluid was not under control, but did not affect corrosion when the pH was adjusted daily to maintain some constancy. Indomethacin-releasing Silastic produced similar effects. X-ray diffraction revealed that, after immersion in the simulated uterine fluid for 7 days, only cuprous oxide was formed on the copper substrate surface, regardless of the presence of indomethacin. Scanning electron microscopy showed that the oxide particles formed were more course and dense in the presence of indomethacin, however. Although these findings suggest that indomethacin does not affect the general corrosion rate of copper, further research is required to verify reduced ion generation.

Depo-Provera and bone density: what should you tell teen users?

PIP: This article discusses the impact of use of Depo-Provera (DMPA) among long-term users on bone density in the US. Depo-Provera suppresses ovarian estradiol production, which maintains bone density by slowing bone resorption. Young women reach peak density of spinal bone about 16 years of age, and the greatest increase in bone density occurs during the first 2 years after menstruation begins. Depro-Provera is particularly attractive to teenagers. The manufacturer, Pharmacia and Upjohn of Kalamazoo, Michigan, conducted a multicenter longitudinal study among long-term users, but did not include adolescents. A retrospective study from New Zealand found a 7% bone density difference between DMPA users 25 and 51 years old and other premenopausal users. Similar findings were found in a Thailand study comparing DMPA users and users of IUDs and Norplant implants. The findings on bone density differences at one point in time are considered unreliable so far, because bone density is known to shift in response to various situations. For example, bone density declines during breast feeding, but returns to normal after weaning. Lactation is not considered a risk for postmenopausal osteoporosis. It is recommended that clinicians recommend calcium supplements for adolescent DMPA users, because adolescents in general are not inclined to be big milk drinkers.^ieng

What's in store for non-latex barrier methods.

PIP: Women who want to use a barrier method of contraception may not be able to do so if they are latex-sensitive. These women have several options. Two type of condoms made from polyurethane are now being manufactured and marketed, the Reality female condom made by Female Health Company in Chicago and the Avanti male condom produced by London International Group. The silicone diaphragm, marketed by Milex Products in Chicago, is yet another non-latex option, as are spermicides alone in the form of vaginal contraceptive film, spermicidal gel, or foaming spermicidal tablets. The Femcap cervical cap is the next silicone device likely to go on the US market. Another barrier method being developed is Lea's Shield, a one-size-fits-all silicone device currently seeking federal regulatory approval after officials requested expanded clinical data. Further down the development road is the SILCS intravaginal barrier contraceptive designed for simplified fitting and ease of use and removal.^ieng