Comparison between the efficacy of microneedling combined with 5-fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo

Summary

Background

Several treatment modalities had been used for the treatment of vitiligo, but the optimal treatment has not yet been identified.

Objectives

To study the efficacy of microneedling with 5-flurouracil vs its efficacy with tacrolimus in the treatment of vitiligo.

Patients and methods

Twenty-five patients with vitiligo were subjected to microneedling of 2 patches of vitiligo with dermapen, then application of 5-fluorouracil to 1 patch and tacrolimus on the other patch. This procedure was repeated every 2 weeks for every patient for maximum 6 months (12 sessions). The patients were followed up for 3 months after the last session.

Results

The overall repigmentation was significantly higher in 5-fluorouracil-treated patches compared with tacrolimus. Excellent improvement occurred in 48% of 5- flurouracil-treated patches while only in 16% of tacrolimus-treated patches. In the acral parts, 40% of the patches treated with 5-fluorouracil achieved excellent improvement (repigmentation >75%), while no patch in the acral parts achieved excellent improvement with tacrolimus. However, there was significant difference between the 2 drugs,regarding inflammation, ulceration, and hyperpigmentation which occurred with 5-fluorouracil.

Conclusion

Microneedling combined with 5-fluorouracil or tacrolimus is safe and effective treatment of vitiligo. However, 5-fluorouracil achieved a greater percentage of repigmentation than tacrolimus particularly in the acral parts.

Justifying the principle of indifference

Abstract

This paper presents a new argument for the Principle of Indifference. This argument can be thought of in two ways: as a pragmatic argument, justifying the principle as needing to hold if one is to minimise worst-case expected loss, or as an epistemic argument, justifying the principle as needing to hold in order to minimise worst-case expected inaccuracy. The question arises as to which interpretation is preferable. I show that the epistemic argument contradicts Evidentialism and suggest that the relative plausibility of Evidentialism provides grounds to prefer the pragmatic interpretation. If this is right, it extends to a general preference for pragmatic arguments for the Principle of Indifference, and also to a general preference for pragmatic arguments for other norms of Bayesian epistemology.

Demodex mites modulate sebocyte immune reaction: Possible role in the pathogenesis of rosacea

Abstract

Rosacea is a common facial skin disorder affecting middle-aged adults. Its aetiology is unknown and pathogenesis uncertain. Activation of the host innate immune response has been identified as important. The Demodex mite population in the skin of these patients is significantly higher than in subjects with normal skin suggesting they may be of etiological importance in this disorder. Little is known of the role of these mites in human skin and their potential to interact with the host immune system has not been elucidated.

Live Demodex mites were extracted from normal facial skin of control subjects and used in cell stimulation experiments with the immortalised SZ95 sebocyte line. Time and mite dose dependent experiments were performed. Direct Demodex effects and the effects of medium in which Demodex had been cultured were evaluated on the TLR-signalling pathway on both a gene and protein expression level.

Mites modulated TLR signalling events on both mRNA and protein levels in SZ95 sebocytes. An initial trend towards down modulation of genes in this pathway was observed. A subsequent switch to positive gene up-regulation was recorded after 48 hours of co-culture. Demodex secreted bioactive molecules that affected TLR2 receptor expression by sebocytes. High numbers of Demodex induced pro-inflammatory cytokine secretion whereas lower numbers did not.

Demodex mites have the capacity to modulate the TLR signalling pathway of an immortalised human sebocyte line. Mites have the capacity to secrete bioactive molecules that affect the immune reactivity of sebocytes. Increasing mite numbers influenced IL8 secretion by these cells.

This article is protected by copyright. All rights reserved.

Unilateral Cleft Lip Rhinoplasty

Cleft lip rhinoplasty is a challenging procedure both in terms of obtaining desirable appearance and function, but also in achieving consistency across one's patient population. Classically, formal nasal surgery was delayed until the patient had completed nasal and mid-facial growth, however, this paradigm is changing, and more rhinoplasty is being performed at the time of the lip repair which has revolutionized patient outcomes. The three options for repair in terms of timing are designated as primary, intermediate, and secondary (defined later in this text).

Toxic effect and mechanism of four ionic liquids on seedling taproots of Arabidopsis thaliana

Abstract

Arabidopsis thaliana was selected as model organisms to investigate the toxic effect and mechanism of four kinds of imidazolium and pyridinium ionic liquids (ILs) on plant seedling taproots. After exposure to ILs, the growth of seedling taproots was significantly inhibited in a dose-dependent manner. The toxicity of ILs on seedling taproots was [Bmim][BF₄] > [Bmpy][BF₄] > [Bmim][Br] > [Bmpy][Br]. The reduction of seedling root cell vitality, aggravation of seedling root cell death, and repression of gravitropic growth responses were observed. The amounts of H₂O₂ and ROS in seedlings were enhanced with increasing concentrations of ILs. Moreover, the expression levels of cdc2a and pcna1 genes were decreased after exposure to ILs. Our results suggest that ILs can induce the overproduction of ROS in A. thaliana seedling taproots and thus cause oxidative damage to seedling taproots. Meanwhile, ILs alter the expression patterns of two cell cycle-related genes and hence cause the seedling taproot growth inhibition. This work provides an integrated understanding of the toxic effect and mechanism of ILs on A. thaliana seedlings at the molecular and physiological level and also provides theoretical basis and reference for the environmental safety evaluation of ILs, prior to their widespread use and release.

Graphical abstract

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Bioimpedance measurement as an assessment of margin positivity in Mohs surgical specimens of non-melanoma skin cancer: Management implications

High neutrophil-to-lymphocyte ratio before starting anti-PD1 immunotherapy predicts poor outcome in patients with metastatic melanoma

Increased Topical Generic Prices by Manufacturers: An Isolated Trend or Worrisome Future?

There is limited data regarding generic medication prices. Recent studies have shown price changes at the retail level, but much is not known about the pharmaceutical supply chain or price changes at the manufacturer level.

Clinical, dermoscopic and trichoscopic analysis of frontal fibrosing alopecia associated with acquired dermal macular hyperpigmentation: A cross sectional observational case-control study

Studies on mercury occurrence in inorganic constituents of Polish coking coals

Abstract

During the cokemaking process, a significant amount of mercury occurring in a coal blend is released to the atmosphere. One of the ways of reducing this emission is to reduce mercury content in a coal blend. This could be obtained through the coal washing process. The optimization of this process requires the knowledge of mercury occurrence in coal, especially in its inorganic constituents. A qualitative analysis of mercury occurrence in the inorganic constituents of Polish coking coals was performed using an electron probe microanalyzer (EPMA). For that purpose, selected samples of rejects and middling products derived from the washing process in dense media separators and jig concentrators were examined. The obtained results have confirmed a strong connection between mercury occurrence and the presence of sulfides (pyrite, marcasite, and chalcopyrite) in Polish coking coals. Significant amounts of mercury were also noticed for barite, siderite, and aluminosilicates. The highest value of mercury content, at the level of 0.100%, was obtained for marcasite. For the analyzed coals, the effectiveness of mercury removal in the washing process was determined by the forms of pyrite occurring in coal. The highest values of effectiveness of mercury removal were obtained in the case of coals for which the large framboidal pyrite aggregates with chalcopyrite overgrowths were noticed. It was also found that middling products were characterized by the occurrence of the Hg-rich overgrowths of pyrite on organic matter. To achieve a significant reduction in mercury content in clean coal, it is necessary to develop an effective method of removing this form of pyrite from hard coal.

Characterization of phosphate rock and phosphogypsum from Gabes phosphate fertilizer factories (SE Tunisia): high mining potential and implications for environmental protection

Abstract

Since the establishment of the coastal industrial complex in Gabes city (Gulf of Gabes, SE Tunisia), hundred million tons of untreated phosphogypsum have been discharged in the open sea causing serious environmental problems. To better understand the dynamic and behavior of phosphate/phosphogypsum contaminants from raw ores to marine environment, a chemical, organic, mineralogical, and morphological characterization of phosphate rock and phosphogypsum was conducted using several sophisticated techniques. The chemical analysis showed that phosphate and phosphogypsum contain high loads of trace elements and that the transfer factors of pollutants varied from 5.83% (U) to 140% (Hg). Estimated annual flows of phosphogypsum contaminants into the marine environment ranged between 0.05 (Re) and 87,249.60 (F) tons. The phosphate rock was found to be formed by carbonate fluorapatite, calcite, dolomite, natural gypsum, quartz, calcite-Mg, apatite, pyrite, fluorite, and sphalerite-Cd and phosphogypsum by synthetic gypsum and sphalerite-Cd. The phosphate was found to be richer in organic compounds compared to phosphogypsum. Based on this work, the Tunisian phosphogypsum has a high mining potential and encourages the development of an economically beneficial and environmentally friendly phosphogypsum-treating industry.

Modeling the emissions of a dual fuel engine coupled with a biomass gasifier—supplementing the Wiebe function

Abstract

There is a growing market demand for small-scale biomass gasifiers that is driven by the economic incentives and the legislative framework. Small-scale gasifiers produce a gaseous fuel, commonly referred to as producer gas, with relatively low heating value. Thus, the most common energy conversion systems that are coupled with small-scale gasifiers are internal combustion engines. In order to increase the electrical efficiency, the operators choose dual fuel engines and mix the producer gas with diesel. The Wiebe function has been a valuable tool for assessing the efficiency of dual fuel internal combustion engines. This study introduces a thermodynamic model that works in parallel with the Wiebe function and calculates the emissions of the engines. This "vis-à-vis" approach takes into consideration the actual conditions inside the cylinders—as they are returned by the Wiebe function—and calculates the final thermodynamic equilibrium of the flue gases mixture. This approach aims to enhance the operation of the dual fuel internal combustion engines by identifying the optimal operating conditions and—at the same time—advance pollution control and minimize the environmental impact.

Successfully Managing Impending Skin Necrosis following Hyaluronic Acid Filler Injection, using High-Dose Pulsed Hyaluronidase

Summary: Facial fillers are becoming increasingly popular as aesthetic procedures to temporarily reduce the depth of wrinkles or to contour faces. However, even in the hands of very experienced injectors, there is always a small possibility of vascular complications like intra-arterial injection of filler substance. We present a case report of a patient who developed features of vascular obstruction in right infraorbital artery and tell-tale signs of impending skin necrosis, after hyaluronic acid filler injection by an experienced injector. The diagnosis of a vascular complication was made quickly with the help of clinical features like blanching, livedo reticularis, and poor capillary refill. Patient was treated promptly with "high-dose pulsed hyaluronidase protocol" comprising three 1,000-unit pulses of hyaluronidase, administered hourly. There was no further increase in size of the involved area after the first dose of hyaluronidase. All of the involved area, along with 1 cm overlapping in uninvolved skin area, was injected during each injection pulse, using a combination of cannula and needle. Complete reperfusion and good capillary filling were achieved after completion of 3 pulses, and these were taken as the end-point of high-dose pulsed hyaluronidase treatment. Immediate skin changes after filler injections, as well as after hyaluronidase injections and during the 3-week recovery period, were documented with photographs and clinical notes. Involved skin was found to have been fully recovered from this vascular episode, thus indicating that complete recovery of the ischemic skin changes secondary to possible intra-arterial injection could be achieved using high-dose pulsed hyaluronidase protocol.

Minimally Invasive Face Lifting and Lipofilling

No abstract available

In vivo validation of the multicomponent powder (Vitachelox®) against the deposition of polluting ions

What are we measuring? Refocusing on some fundamentals in the age of desktop bibliometrics

BibliometricsResearch evaluationConstruct validity

Treatment of inflammatory bowel disease via green tea polyphenols: possible application and protective approaches

Abstract

Inflammatory bowel disease (IBD) is a collection of inflammatory conditions of colon and small intestine which affect millions of individuals worldwide and the prevalence amount is on the rise. The organ failure as well as loss of tissue function is because of the inflammatory reaction which is the major contributor of tissue healing leading to lifelong debilitation. To stop the tough consequences of inflammation every patient pursues alternative therapy to relieve symptoms. Green tea polyphenols (GTPs) play significant roles in down regulating signaling pathways because GTPs exert effective antioxidant properties and regulate Toll-like receptor 4 (TLR4) expression via certain receptor, inhibited endotoxin-mediated tumor necrosis factor alpha (TNF-α) production by blocking transcription nuclear factor-kappa B (NF-kB) activation and upstream of mediated I kappa B kinase complex pathway activities, as well as intrusion with the flow of cytokines and synthesis of cyclooxygenase-2 (COX-2). This article highlights the green approach regarding the defensive effects of GTP review-related studies concerning the contrary effects and the key therapeutic targets application of GTPs in biomedical field to treat inflammatory bowel disease (IBD) and its complications.

Graphical abstract

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Predicting methotrexate resistance in rheumatoid arthritis patients

Abstract

Rheumatoid arthritis (RA) is an incurable, systemic autoimmune disease that decreases quality of life and can lead to severe disability. While there are many medications available to treat RA, the first-line of therapy is low-dose methotrexate (MTX), a small molecule disease-modifying anti-rheumatic drug (DMARD). MTX is the recommended therapy due to its affordability and efficacy in reducing symptoms in most RA patients. Unfortunately, there is great person-to-person variability in the physiological response to MTX, with up to 50% of patients showing little response to the medication. Thus, many RA patients initially placed on MTX do not experience an adequate reduction of symptoms, and could have benefited more in both the short and long terms if initially prescribed a different drug that was more effective for them. To combat this problem and better guide treatment decisions, many research groups have attempted to develop predictive tools for MTX response. Currently, there is no reliable, clinical-grade method to predict an individual's response to MTX treatment. In this review, we describe progress made in the area of MTX non-response/resistance in RA patients. We specifically focus on application of the following elements as predictive markers: proteins related to MTX transport and function, intracellular MTX concentration, immune cell frequencies, cytokines, and clinical factors.

Correction to: Anti-inflammatory, anti-rheumatic and analgesic activities of 2-(5-mercapto-1,3,4-oxadiazol-2-yl)- N -propylbenzenesulphonamide (MOPBS) in rodents

Abstract

Unfortunately, Fig. 1 was incorrectly published in the original publication. The corrected Fig. 1 is given as below

The tissue distribution and excretion study of paeoniflorin-6′-O-benzene sulfonate (CP-25) in rats

Abstract

Paeoniflorin-6′-O-benzene sulfonate (code: CP-25) is a novel ester derivative of paeoniflorin (Pae). Compared to Pae, CP-25 has higher lipid solubility, bioavailability and better bioactivity. However, the tissue distribution and excretion of CP-25 still remain unknown. The LC–MS method was applied to investigate the tissue distribution and excretion of CP-25 in rats. As such, 50 mg/kg of CP-25 and Pae were administered to rats in multiple doses via an oral route. CP-25 and Pae were distributed widely and rapidly in all the tested tissues. Compared with Pae, the concentrations of CP-25 were almost increased evidently in most tissues. The highest CP-25 level was found in the liver (1476.33 ± 535.20 ng/g, male; 1970.38 ± 177.21 ng/g, female) at 3 h, and a high concentration of CP-25 was detected in male and female intestine, synovium, muscle, lung, and brain. Following a single oral dose of 50 mg/kg of CP-25 in rats, the total excretion of CP-25 was merely 21.8% (18.40, 3.19 and 0.22% for feces, bile and urine, respectively) in males; and was approximately 21.3% (14.04, 7.16 and 0.14% for feces, bile and urine, respectively) in females. The results indicated that the CP-25 concentration was higher in major tissues than Pae; CP-25 was primarily excreted through the feces; and there were gender-related differences in the tissue distribution and excretion.

Ex vivo immunomodulatory effect of ethanolic extract of propolis during Celiac Disease: involvement of nitric oxide pathway

Abstract

Celiac Disease (CeD) is a chronic immune-mediated enteropathy, in which dietary gluten induces an inflammatory reaction, predominantly in the duodenum. Propolis is a resinous hive product, collected by honeybees from various plant sources. Propolis is well-known for its anti-inflammatory, anti-oxidant and immunomodulatory effects, due to its major compounds, polyphenols and flavonoids. The aim of our study was to assess the ex vivo effect of ethanolic extract of propolis (EEP) upon the activity and expression of iNOS, along with IFN-γ and IL-10 production in Algerian Celiac patients. In this context, PBMCs isolated from peripheral blood of Celiac patients and healthy controls were cultured with different concentrations of EEP. NO production was measured using the Griess method, whereas quantitation of IFN-γ and IL-10 levels was performed by ELISA. Inducible nitric oxide synthase (iNOS) expression, NFκB and pSTAT-3 activity were analyzed by immunofluorescence assay. Our results showed that PBMCs from Celiac patients produced high levels of NO and IFN-γ compared with healthy controls (HC). Interestingly, EEP reduced significantly, NO and IFN-γ levels and significantly increased IL-10 levels at a concentration of 50 µg/mL. Importantly, EEP downmodulated the iNOS expression as well as the activity of NFκB and pSTAT-3 transcription factors. Altogether, our results highlight the immunomodulatory effect of propolis on NO pathway and on pro-inflammatory cytokines. Therefore, we suggest that propolis may constitute a potential candidate to modulate inflammation during Celiac Disease and has a potential therapeutic value.

IL-6 signalling pathways and the development of type 2 diabetes

Abstract

Interleukin 6 (IL-6), a multifunctional cytokine, has been implicated in the pathophysiology of type 2 diabetes (T2D). The elevated circulating level of IL-6 is an independent predictor of T2D and is considered to be involved in the development of inflammation, insulin resistance and β-cell dysfunction. On the other hand, an increasing number of evidence suggests that IL-6 has an anti-inflammatory role and improves glucose metabolism. The complex signal transduction mechanism of IL-6 may help explain the pleiotropic nature of the cytokine. IL-6 acts via two distinct signalling pathways called classic signalling and trans-signalling. While both signalling modes lead to activation of the same receptor subunit, their final biological effects are completely different. The aim of this review is to summarize our current knowledge about the role of IL-6 in the development of T2D. We will also discuss the importance of specific blockade of IL-6 trans-signalling rather than inhibiting both signalling pathways as a therapeutic strategy for the treatment of T2D and its associated macrovascular complications.

Antiviral effects and mechanisms of Yinhuapinggan granule against H1N1 influenza virus infection in RAW264.7 cells

Abstract

Yinhuapinggan granule (YHPG), a modified prescription based on Ma-Huang-Tang (MHT), is used in traditional Chinese medicine (TCM) to treat influenza, cough, and viral pneumonia. In this study, we investigated the antiviral effects of YHPG by means of pre-, post-, and co-treatment, and its underlying mechanisms on regulating the levels of inflammatory-related cytokines, modulating the mRNA expressions of interferon-stimulated genes in influenza virus-infected murine macrophage cells (RAW264.7), and evaluating the protein expressions of key effectors in the Type I IFN and pattern recognition receptor (PRRs) signaling pathways. The results showed that YHPG markedly inhibited influenza virus (IFV) replication in pre-, post- and co-treatment assay, especially in post-treatment assay. Antiviral mechanisms studies revealed that YHPG (500 and 250 μg/mL) significantly up-regulated levels of IFN-β, IFN-stimulated genes (Mx-1, ISG-15 and ISG-56) compared with the IFV control group, while the levels of IL-6 and TNF-α were significantly down-regulated. Furthermore, western blot analysis results revealed that the protein expressions of the phosphorylated forms of TBK1, IRF3, ERK1/2, P38 MAPK and NF-κB p65 were significantly down-regulated in RAW264.7 cells with the YHPG (500 and 250 μg/mL) treatment, while the expression of the phosphorylated form of STAT1 was significantly enhanced. Based on these results, YHPG had antiviral effects in IFV-infected RAW264.7 cells, which might be associated with regulation of the inflammatory cytokines production, evaluation of the levels of IFN-stimulated genes, and modulation of the protein expressions of key effectors in the Type I IFN and PRRs signaling pathways.

Anti-inflammatory, anti-rheumatic and analgesic activities of 2-(5-mercapto-1,3,4-oxadiazol-2-yl)- N -propylbenzenesulphonamide (MOPBS) in rodents

Abstract

Chronic inflammation is pathologically associated with various clinical conditions such as rheumatoid arthritis. Several anti-inflammatory and analgesic drugs currently available in market presents a wide range of problems. Therefore, the current study was aimed to evaluate anti-inflammatory and analgesic activities of newly synthesized compound 2-(5-mercapto-1,3,4-oxadiazol-2-yl)-N-propylbenzenesulphonamide (MOPBS). Carrageenan and CFA-induced models were developed for evaluation of anti-inflammatory and analgesic activity. Quantitative real-time PCR (qRT-PCR) was performed to determine the mRNA expression levels of inflammatory mediators. Pain behaviours were evaluated by performing Von Frey, Randall Selitto, cold acetone and hot plate test respectively. X-ray imaging and haematoxylin and eosin (H&E) staining were performed for examination of soft tissues of treated mice paw. Additionally, Kodzeila's screen test and weight test were performed for determination of any side effects on motor function and muscle strength. Acute pretreatment of animals with MOPBS (1, 10, 50 and 100 mg/kg, i.p.) produced a significant reduction of paw oedema against carrageenan-induced acute inflammation as well as notable inhibition of mechanical hyperalgesia, allodynia and thermal hyperalgesia. Similarly, in chronic inflammation model, administration of MOPBS (50 mg/kg, i.p.) produced a remarkable reduction of paw oedema. Additionally, MOPBS pretreatment showed a significant inhibition of thermal hyperalgesia, mechanical allodynia, and mechanical hyperalgesia in chronic arthritis model. Several pro-inflammatory mediators such as nitric oxide (NO), vascular endothelial growth factor (VEGF), interleukins (IL-1β, IL-6) and tumor necrosis factor-α (TNF-α) were inhibited by MOPBS treatment in blood plasma and paw tissues, respectively. MOPBS also enhanced the mRNA expression levels of nuclear factor (erythroid-derived 2)-like 2 (Nrf2), superoxide dismutase (SOD2) and heme oxygenase (HO-1) and in turn reduced arthritis severity and inflammation. Furthermore, anti-inflammatory data were confirmed by X-rays and histological analysis. MOPBS pretreatment did not produce any apparent toxic effect on gastric, kidney and liver function and on muscle strength and motor function. Hence, the present data suggest that MOPBS might be a candidate for several chronic inflammatory diseases such RA and other auto-immune diseases.

New prospects of mesenchymal stem cells for ameliorating temporal lobe epilepsy

Abstract

Temporal lobe epilepsy (TLE) is present in 30% of epileptic patients and does not respond to conventional treatments. Bone marrow derived mesenchymal stem cells (BMSCs) induce endogenous neural stem cells, inhibit neurodegeneration, and promote brain self-repair mechanisms. The present study addresses the feasibility of BMSCs transplantation against pilocarpine-induced TLE experimentally. BMSCs were injected either intravenously (IV) or in hippocampus bilaterally (IC). Increased cell count of BMSCs was achieved via IC route. BMSCs treatment ameliorated the pilocarpine-induced neurochemical and histological changes, retained amino acid neurotransmitters to the normal level, downregulated the immunoreactivity to insulin growth factor-1 receptor, synaptophysin, and caspase-3 and reduced oxidative insult and inflammatory markers detected in epileptic model. It is worth noting that BMSCs IC-administered showed more pronounced effects than those administered via IV route. BMSCs transplantation presents a promise for TLE treatment that has to be elucidated clinically.

Targeting oxidative stress, acetylcholinesterase, proinflammatory cytokine, dopamine and GABA by eucalyptus oil ( Eucalyptus globulus ) to alleviate ketamine-induced psychosis in rats

Abstract

Essential oil of eucalyptus species is among the most common traded essential oils in the world. There is an increasing interest in the application of eucalyptus oil as a natural additive in food and pharmaceutical industry. The present study was undertaken to identify the phytoconstituents present in the essential oil of Eucalyptus globulus leaves (EO) and ascertain their protective effect against ketamine-induced psychosis in rats. GC–MS technique was used for analysis of phytoconstituents present in EO. Ketamine (50 mg/kg, i.p.) was used to induce psychosis in rats. Photoactometer, forced swim test and pole climb avoidance test were used to evaluate the protective effects of the EO (500, 1000 and 2000 mg/kg, p.o.) on acute and chronic administration. Bar test was used to test the side effect of EO. Biochemical and neurochemical estimations were carried out to explore the possible mechanism of action. GC–MS analysis of EO showed the presence of a number of biologically active compounds. EO at the dose of 500, 1000 and 2000 mg/kg, p.o. on acute and chronic administration, decreased locomotor activity, immobility duration and latency to climb the pole. EO was effective to facilitate the release of GABA, increase GSH levels, inhibit dopamine neurotransmission and decrease TNF-α levels as well as diminish AChE activity in different regions of the brain. EO at the dose of 500, 1000 mg/kg did not produce cataleptic behavior in rats. EO at the dose of 500, 1000 mg/kg produced protective effects against ketamine-induced psychosis and can be further explored clinically against neuropsychiatric disorders.

Orofacial antinociceptive effect of sulphated polysaccharide from the marine algae Hypnea pseudomusciformis in rodents

Abstract

This study aimed to evaluate the antinociceptive effect of sulphated polysaccharide from the marine algae Hypnea pseudomusciformis (PLS) using rodent models of orofacial pain. Acute pain was induced by formalin, capsaicin, cinnamaldehyde, acidified saline or glutamate (cutaneous modes) and hypertonic saline (corneal model). In one experiment, animals were pretreated with ruthenium red, glibenclamide, naloxone, L-NAME, methylene blue or ketamine to investigate the mechanism of antinociception. In another experiment, animals pretreated with PLS or saline were submitted to the temporomandibular joint formalin test. In yet another, animals were submitted to craniofacial pain induced by mustard oil. Motor activity was evaluated with the open-field test. Cytotoxicity and antioxidant activities were also assessed. Pre-treatment with PLS significantly reduced nociceptive behavior associated with acute pain. Antinociception was effectively reduced, but not inhibited, by ruthenium red and ketamine. L-NAME and glibenclamide enhanced the PLS effect. PLS antinociception was resistant to methylene blue, naloxone and heating. PLS presented no cytotoxicity or antioxidant properties. Our results confirm the potential pharmacological relevance of PLS as an inhibitor of orofacial nociception in acute pain probably mediated by glutamatergic, nitrergic, TRPs and K + ATP pathways.

Labisia pumila prevented osteoarthritis cartilage degeneration by attenuating joint inflammation and collagen breakdown in postmenopausal rat model

Abstract

The tropical herb Labisia pumila is traditionally used in facilitating childbirth and post-partum care. The effects of L. pumila leaf extract (LP) in explant cartilage culture and on postmenopausal osteoarthritis (OA) rat model were assessed. The LP (10, 25 and 50 µg/ml) or diclofenac (10 µg/ml) was added to the cartilage explants containing bovine IL-1β (20 ng/ml), to evaluate their direct effects on cartilage degradation. In the preclinical study, rats were grouped (n = 8) into: non-treated OA; OA + diclofenac (5 mg/kg); OA + LP extract (150 and 300 mg/kg); and healthy control. To induce OA, monosodium iodoacetate was injected into the ovariectomised female rats' intra-articular knee joints and evaluated for OA severity after 8 weeks via physical (radiological, macroscopic and histological observations), biochemical, ELISA and mRNA expression analysis (for inflammation and cartilage degradation biomarkers). The LP reduced the nitric oxide and proteoglycan release from the cartilage explants under IL-1β induction. The radiological, macroscopic, microscopic and histological images showed the OA rats treated with LP and diclofenac had significantly reduced osteophytes and cartilage erosions compared to non-treated OA rats. The extract significantly up-regulated the anti-inflammatory interleukin-10, collagen type II and down-regulated pro-inflammatory PTGS2 (prostaglandin-endoperoxide synthase 2) mRNA expressions compared to non-treated control. The LP treatment significantly reduced serum collagenases (MMP-1 and MMP-3) and collagen type II degradation biomarker (CTX-II) levels in OA rats. The LP containing myricetin and gallic acid suppressed inflammation, collagenases and cartilage degradation, and helped cartilage matrix synthesis, to prevent OA at the dose equivalent to 30–60 mg/kg daily for humans.

Short-term treatment with metformin reduces hepatic lipid accumulation but induces liver inflammation in obese mice

Abstract

The study aimed to evaluate the metabolic and inflammatory effects of short-term treatments (10 days) with metformin (MET) on the NAFLD caused by a high-fat diet (HFD) in C57BL/6 mice. After the treatment, histological liver slices were obtained, hepatocytes and macrophages were extracted and cultured with phosphate buffered saline, LPS (2.5 µg/mL) and MET (1 µM) for 24 h. Cytokine levels were determined by ELISA. NAFLD caused by the HFD was partially reduced by MET. The lipid accumulation induced by the HFD was not associated with liver inflammation; however, MET seemed to promote pro-inflammatory effects in liver, since it increased hepatic concentration of IL-1β, TNF-α, IL-6, MCP-1 and IFN-γ. Similarly, MET increased the concentration of IL-1β, IL-6 in hepatocyte cultures. However, in macrophages culture, MET lowered levels of IL-1β, IL-6 and TNF-α stimulated by LPS. Overall, MET reduced liver NAFLD but promoted hepatocyte increase in pro-inflammatory cytokines, thus, leading to liver inflammation.

Prunus cerasoides fruit extract ameliorates inflammatory stress by modulation of iNOS pathway and Th1/Th2 immune homeostasis in activated murine macrophages and lymphocytes

Abstract

The present investigation assessed the potential of Prunus cerasoides fruit extract (PCFE) in alleviation of inflammatory stress in response to lipopolysaccharide (LPS) and interferon-γ (IFN-γ)-stimulated murine peritoneal macrophages as well as in concanavalin A (Con A)-activated splenic lymphocytes. We observed a strong inhibition in production of nitric oxide (NO), reactive oxygen species (ROS), inflammatory cytokines (TNF-α/IL-6/IL-1β), inducible nitric oxide synthase (iNOS), and NF-kB in macrophages treated with PCFE. Splenic lymphocytes treated with PCFE also showed a reduction in Con-A-induced cell proliferation and numbers of CD3⁺CD4⁺ T cells. Furthermore, PCFE treatment to Con A-stimulated lymphocytes decreased the production of inflammatory cytokines (TNF-α/IL-6/IL-1β) with a concomitant increase in IL-10 suggesting its possible role in alleviation of inflammation-driven Th1/Th2 immune imbalance. PCFE appeared to influence innate immune response even at lower concentrations (25 and 50 µg/ml), while such effects were more pronounced in lymphocytes only at higher concentrations (100 and 200 µg/ml). UPLC–ESI–MS of PCFE revealed the presence of major bioactive phenolics including catechin, naringin as well as ascorbic acid which could have contributed in above findings. Overall, it is indicative that P. cerasoides fruit could be a valuable source for the development of anti-inflammatory functional foods and nutraceuticals.

Graphical Abstract

Ginger rhizome enhances the anti-inflammatory and anti-nociceptive effects of paracetamol in an experimental mouse model of fibromyalgia

Abstract

Background

The dried rhizome of ginger has been widely used for more than 2500 years in folk medicine for the treatment of various diseases that involve inflammation or are caused by oxidative stress.

Aims

This study was designed to compare the anti-nociceptive and anti-inflammatory effect of dried powdered ginger rhizome (GR) and paracetamol (APAP) on an experimental mouse model of fibromyalgia syndrome (FMS) induced by intermittent cold stress (ICS).

Methods

Forty-eight female C57BL/6 J mice were used for the experiments. The animals were allocated in six groups (n = 8). Each group received one of the following treatments for 8 weeks: healthy control, ICS group, ICS + APAP (40 mg/Kg/day), ICS + GR (0.5%); ICS + GR (1%), and ICS + GR (0.5%) + APAP (40 mg/Kg/day). After treatment, symptoms of FMS were induced by intermittent cold stress (ICS).

Results and conclusions

GR consumption improved mechanical and thermal allodynia and mechanical hyperalgesia and improved behavioural changes related to cognitive disturbances, anxiety, and depression. In addition, GR also significantly decreased the inflammatory response of proinflammatory mediators such as NO, PGE₂, TXB₂, and IL-1β in LPS-stimulated macrophages. The effects of APAP were significantly enhanced by co-administration with GR. These findings provide evidence that the daily consumption of GR enhances the anti-nociceptive effect of APAP in mice, improves other cognitive disturbances associated with chronic pain, and reduces the inflammatory state generated in an experimental FMS model.

Essential oil from waste leaves of Curcuma longa L. alleviates skin inflammation

Abstract

Background

Curcuma longa L. is an important industrial crop used by medicinal and cosmetic industries in the world. Its leaves are a waste material after harvesting rhizomes. The aim of the study was to evaluate the chemical and pharmacological profile of essential oil from waste leaves of Curcuma longa (EOCl) against skin inflammation.

Methods

EOCl was subjected to gas chromatography (GC) analysis for identification of essential oil constituents and its anti-inflammatory evaluation through in vitro and in vivo models.

Results

Chemical fingerprinting using GC and GC–MS analysis of EOCl revealed the presence of 11 compounds, representing 90.29% of the oil, in which terpinolene (52.88%) and α-phellandrene (21.13%) are the major components. In the in vitro testing EOCl inhibited the production of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) in lipopolysaccharide (LPS) and 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced inflammation in the human keratinocyte cell line (HaCaT). Topical application of EOCl produced anti-inflammatory effects by reducing ear thickness, ear weight and ameliorating the level of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) at protein and mRNA levels as well as regulating the overproduction of oxidative markers and restoring the histopathological damage in a TPA-induced mouse model of inflammation.

Conclusion

These findings of topical anti-inflammatory properties of EOCl provide a scientific basis for medicinal use of this plant material against inflammatory disorders.

Graphical Abstract

The peripheral corticotropin-releasing factor (CRF)-induced analgesic effect on somatic pain sensitivity in conscious rats: involving CRF, opioid and glucocorticoid receptors

Abstract

The corticotropin-releasing factor (CRF) is involved in somatic pain regulation and may produce an analgesic effect in humans and animals, although the mechanisms of the CRF-induced analgesia remain unclear. CRF action is mediated by the CRF receptors of subtypes 1 and 2 (CRF-R1 and CRF-R2, respectively). Activation of the hypothalamic –pituitary –adrenocortical axis (HPA) is provided by CRF-R1; but CRF-R2 are also involved in the regulation of the HPA axis, and, respectively, glucocorticoids, the end hormones of the HPA axis, also participate in somatic pain regulation. Additionally, opioids may contribute to the CRF-induced analgesia. This article serves as an overview of the role of CRF-R1 and CRF-R2, as well as glucocorticoid and opioid receptors in peripheral CRF-induced analgesia in conscious rats, while we focused on the data obtained under normal (non-pathological) conditions including results of our studies in rats. The involvement of CRF-R1 and CRF-R2, glucocorticoids and opioid receptors was studied under the same experimental conditions following pretreatment with appropriate antagonists: NBI 27914, astressin₂-B, naltrexone and RU 38486, respectively. Somatic pain sensitivity was measured by the tail flick latencies induced by thermal stimulus (tail flick test). Peripheral administration of the CRF caused both an increase in the tail flick latencies (analgesic effect) and plasma corticosterone levels. Pretreatment with NBI 27914, astressin₂-B, naltrexone or RU 38486 attenuated the peripheral CRF-induced analgesia. The results obtained suggest that the peripheral CRF-induced analgesic effect may be mediated through the involvement of CRF-R1 and CRF-R2 as well as opioid and glucocorticoid receptors, including CRF-R2 and opioid receptors within periaqueductal gray matter of the midbrain.

Anti-inflammatory activity of nanoemulsions of essential oil from Rosmarinus officinalis L.: in vitro and in zebrafish studies

Abstract

The essential oil from Rosmarinus officinalis L. (OERO) has bioactive compounds with anti-inflammatory activity. The objective of this study was to evaluate the anti-inflammatory potency of nanoemulsions containing essential oil of Rosmarinus officinalis L. (NOERO, NECHA, NECULT, and NECOM) in vitro and in vivo. This study was accomplished in a quantitative format through tests with diphenyl picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), cellular antioxidant activity (CCA), determination of nitric oxide production, cellular viability and anti-inflammatory activity in zebrafish. OERO's were submitted to the analysis-coupled gas chromatography–mass spectrometry (GC–MS), which highlighted 1,8-cineol and camphor as major compounds. NOEROs were obtained by a low-energy method and presenting the medium size smaller than 200 nm. The efficiency of encapsulation by spectrometry and gas chromatographic analysis was 67.61 and 75.38%, respectively. In the CCA assay, all of the samples presented percentage values of inhibition similar to the quercetin pattern, indicating antioxidant activity. In the test for determination of NO·, all of the samples inhibited the production of NO· when compared to LPS, and NOEROS were more effective than OEROS to 5 µg/mL. In the cell viability assay, the cells remained viable after contact with the samples, demonstrating an absence of cytotoxicity. This study showed that all nanoemulsions (NECHA, NECULT, and NECOM) showed no toxicity to macrophages, besides demonstrating antioxidant activity and potentiation of the essential oil effect in the proliferation of viable fibroblasts. Nanoemulsions has also shown the ability to potentiate the anti-inflammatory action of essential oils by exerting immunomodulatory activity by inhibiting the production of the pro-inflammatory mediator nitric oxide. The results obtained with NECHA in zebrafish confirm the hypothesis that prominent terpenic compounds, alpha-pinene, 1,8-cineole, and camphor, became more available at the target sites, inhibiting the inflammatory process in this animal species.

Influencia de los distintos tipos de artículo en el factor de impacto de las revistas dermatológicas

Publication date: Available online 26 February 2018
Source:Actas Dermo-Sifiliográficas
Author(s): L. Rodríguez-Lago, A. Molina-Leyva, M. Pereiro-Ferreirós, I. García-Doval
Introducción y objetivosPara las revistas científicas el factor de impacto (FI) se ha convertido en un objetivo en sí mismo. El objetivo de nuestro estudio es describir la influencia de los distintos tipos de artículo en el FI de las revistas dermatológicas.Material y métodosEmpleando la base de datos Scopus hemos reproducido los cálculos del FI de 2015 de Actas Dermo-Sifiliográficas y las principales revistas dermatológicas. Hemos eliminado artículos sin resumen, cartas al editor y actas de congresos. Los artículos incluidos se clasificaron en casos clínicos, artículos originales, revisiones narrativas y «otros». Calculamos el FI medio para cada tipo de artículo. Los datos obtenidos son comparados con los proporcionados por el Institute for Scientific Information.ResultadosLas revistas tienen distribuciones diferentes en cuanto a tipos de artículos predominantes. Los originales son los artículos que más se publican en las revistas analizadas (BJD: 76,8%, Contact: 81,1%, JAAD: 63,4%, JAMA Dermatol: 63,7%), a excepción de Actas, en la que corresponden el 31,7% de los artículos publicados. Los tipos de artículo que se asocian con un FI medio menor al global son los casos clínicos y otros, mientras que revisiones y originales tienen un mayor FI.ConclusionesLos casos clínicos, al ser menos citados, disminuyen el FI medio de la revista. Revisiones y originales aumentan el FI. Las revistas centradas en mejorar el FI podrían publicar menos casos y más revisiones y originales. Los comités editoriales deben mantener un equilibrio entre la necesidad de aumentar su FI y el interés de los lectores clínicos.Introduction and objectivesFor scientific journals, achieving a high impact factor (IF) has become a goal in its own right. Our aim was to describe the influence of article type on the IF of dermatology journals.Material and methodsWe used the Scopus database to calculate an IF for Actas Dermo-Sifiliográficas and the major dermatology journals, excluding articles without abstracts, letters to the editor, and conference proceedings. Included articles were classified into 4 categories: case reports, original articles, narrative reviews, and other. We also calculated the mean IF for each article type. We then compared our results with IFs published by the Institute for Scientific Information.ResultsThe proportion of each type of article differed between journals. Original articles carried the greatest weight in the major journals (BJD, 76.8%; Contact, 81.1%; JAAD: 63.4%; JAMA Dermatol, 63.7%.) but not in Actas Dermo-Sifiliográficas, where only 31.7% were original research articles. A higher IF was associated with the publication of reviews and original articles; a lower IF was associated with the publication of case reports and other article types.ConclusionsPublishing case reports, which have lower citation rates, leads to a lower IF. Publishing reviews and original articles will lead to a higher IF. Journals that seek a higher IF should probably publish more reviews and original articles and fewer case reports. Editorial boards should seek a balance between the interests of their clinician readers and the journal's need for a higher IF.

Graphical abstract

Tumoración de rápido crecimiento en la zona anterior del tórax

Publication date: Available online 1 February 2018
Source:Actas Dermo-Sifiliográficas
Author(s): G. González-López, R.M. Ceballos-Rodríguez, E. García-Fernández

Closed-incision negative pressure therapy to reduce groin wound infections in vascular surgery: a randomised controlled trial

Abstract

Groin wound infections pose a major problem in vascular surgery. Closed-incision negative pressure therapy (ciNPT) was especially designed for the management of incisions at risk of surgical site infections. The aim of this study was to investigate whether ciNPT is able to reduce the incidence of wound infections after vascular surgery.

Data on 132 consecutive patients, scheduled for vascular surgery with a longitudinal femoral cutdown, were collected prospectively. All patients were randomised either to the ciNPT group (n = 64) or the control group (n = 68) with conventional dressing. In the ciNPT group, the foam dressing was applied intraoperatively and removed after 5 days. The control group received an absorbent dressing. All wounds were evaluated after 5 and 42 days. Infections were graded according the Szilagyi classification (I–III°).

There were no significant differences between both groups considering patient characteristics. Indications for surgery were peripheral arterial disease in 95% (125/132) and aneurysm in 5% (7/132). The overall infection rates were 14% (9/64) in the ciNPT group and 28% (19/68) in the control group (P = 0·055). Early infections were observed in 6% (4/64) of the ciNPT group and 15% (10/68) of the control group (P = 0·125). ciNPT did not reduce infection rates associated with different risk factors for infection.

While the experiences with the ciNPT device were encouraging, the study fails to provide evidence of the efficacy of the device to reduce groin wound infections after vascular surgery. It illustrates far more that larger multicentre studies are required and appear promising to provide further evidence for the use of ciNPT.

Prevention of pressure ulcers with a static air support surface: A systematic review

The aims of this study were to identify, assess, and summarise available evidence about the effectiveness of static air mattress overlays to prevent pressure ulcers. The primary outcome was the incidence of pressure ulcers. Secondary outcomes included costs and patient comfort. This study was a systematic review. Six electronic databases were consulted: Cochrane Library, EMBASE, PubMed (Medline), CINAHL (EBSCOhost interface), Science direct, and Web of Science. In addition, a hand search through reviews, conference proceedings, and the reference lists of the included studies was performed to identify additional studies. Potential studies were reviewed and assessed by 2 independent authors based on the title and abstract. Decisions regarding inclusion or exclusion of the studies were based on a consensus between the authors. Studies were included if the following criteria were met: reporting an original study; the outcome was the incidence of pressure ulcer categories I to IV when using a static air mattress overlay and/or in comparison with other pressure-redistribution device(s); and studies published in English, French, and Dutch. No limitation was set on study setting, design, and date of publication. The methodological quality assessment was evaluated using the Critical Appraisal Skills Program Tool. Results were reported in a descriptive way to reflect the exploratory nature of the review. The searches included 13 studies: randomised controlled trials (n = 11) and cohort studies (n = 2). The mean pressure ulcer incidence figures found in the different settings were, respectively, 7.8% pressure ulcers of categories II to IV in nursing homes, 9.06% pressure ulcers of categories I to IV in intensive care settings, and 12% pressure ulcers of categories I to IV in orthopaedic wards. Seven comparative studies reported a lower incidence in the groups of patients on a static air mattress overlay. Three studies reported a statistical (P < .1) lower incidence compared with a standard hospital mattress (10 cm thick, density 35 kg/m³), a foam mattress (15 cm thick), and a viscoelastic foam mattress (15 cm thick). No significant difference in incidence, purchase costs, and patient comfort was found compared with dynamic air mattresses. This review focused on the effectiveness of static air mattress overlays to prevent pressure ulcers. There are indications that these mattress overlays are more effective in preventing pressure ulcers compared with the use of a standard mattress or a pressure-reducing foam mattress in nursing homes and intensive care settings. However, interpretation of the evidence should be performed with caution due to the wide variety of methodological and/or reporting quality levels of the included studies.

Functional characterisation of bioactive peptide derived from terrestrial snail Cryptozona bistrialis and its wound-healing property in normal and diabetic-induced Wistar albino rats

Abstract

A peptide might be an exciting biomaterial or template for the development of novel wound-healing agents. In this report, it was isolated from the terrestrial snail Cryptozona bistrialis by enzymatic digestion and was evaluated for its in vitro wound-healing activity in NIH/3T3 mouse fibroblasts cell line and in vivo wound-healing activity in normal and diabetic-induced Wistar albino rats. The C. bistrialis protein was digested by the papain enzyme, and 21.79 kDa peptide (Cb-peptide) was purified by reversed-phase high-performance liquid chromatography and identified by MALDI (matrix-assisted laser desorption/ionization)-TOF analysis. The isolated Cb-peptide was characterised by various analytical methods. The peptide demonstrated a capacity to prevent the development of pathogenic bacterial and fungal cultures and proved that it promotes significant wound-healing activity in the wound scratch assay method by rapid cell migration and closure of wound. Isolated Cb-peptide was lyophilised and formulated to ointment and analysed for in vivo wound-healing activity in normal and diabetic (alloxan monohydrate)-induced Wistar albino rats. Cb-peptide ointment-treated groups showed a greater degree of wound healing and early and complete period of epithelialisation in normal and diabetic-induced Wistar albino rats. Cb-peptide ointment-treated groups showed significant excision and incision wound-healing activity. A conclusion was reached that the peptide isolated from C. bistrialis showed greater wound-healing activity compared with vehicle control and standard control.

Growth hormone-releasing peptide 6 prevents cutaneous hypertrophic scarring: early mechanistic data from a proteome study

Hypertrophic scars (HTS) and keloids are forms of aberrant cutaneous healing with excessive extracellular matrix (ECM) deposition. Current therapies still fall short and cause undesired effects. We aimed to thoroughly evaluate the ability of growth hormone releasing peptide 6 (GHRP6) to both prevent and reverse cutaneous fibrosis and to acquire the earliest proteome data supporting GHRP6's acute impact on aesthetic wound healing. Two independent sets of experiments addressing prevention and reversion effects were conducted on the classic HTS model in rabbits. In the prevention approach, the wounds were assigned to topically receive GHRP6, triamcinolone acetonide (TA), or vehicle (1% sodium carboxy methylcellulose [CMC]) from day 1 to day 30 post-wounding. The reversion scheme was based on the infiltration of either GHRP6 or sterile saline in mature HTS for 4 consecutive weeks. The incidence and appearance of HTS were systematically monitored. The sub-epidermal fibrotic core area of HTS was ultrasonographically determined, and the scar elevation index was calculated on haematoxylin/eosin-stained, microscopic digitised images. Tissue samples were collected for proteomics after 1 hour of HTS induction and treatment with either GHRP6 or vehicle. GHRP6 prevented the onset of HTS without the untoward reactions induced by the first-line treatment triamcinolone acetonide (TA); however, it failed to significantly reverse mature HTS. The preliminary proteomic study suggests that the anti-fibrotic preventing effect exerted by GHRP6 depends on different pathways involved in lipid metabolism, cytoskeleton arrangements, epidermal cells' differentiation, and ECM dynamics. These results enlighten the potential success of GHRP6 as one of the incoming alternatives for HTS prevention.

Prevalence of skin tears in the extremities in inpatients at a hospital in Denmark

Abstract

The aims of the study were to determine the prevalence of skin tears in the extremities and to explore factors associated with development of skin tears in inpatients at a Danish hospital. The study was designed as a point prevalence survey and included 202 patients in the age range 19–99 (mean: 70·7, SD: 16·5). The patients were assessed for presence of skin tears, numbers, locations and previous skin tears. Data were collected using a data collection sheet developed for a previous study. The survey team consisted of four specialist nurses. Data were collected over a period of 24 hours spread over 3 days. Of the 202 patients, 23 had skin tears, yielding a prevalence of 11·4%. In total, 40 skin tears were observed. Multiple logistic regression analysis showed that previous skin tears (odds ratio (OR): 9·3, 95% confidence interval (CI): 2·6–33·4, P < 0·001), ecchymosis (OR: 5·6, CI: 1·4-23·2, P < 0·017) and risk of falling (OR: 3·8, CI: 1·2-12·0, P < 0·021) were significantly associated with development of skin tears. The prevalence of skin tears in this study (11·4%) matches other international observations. The following risk factors were recognised: previous skin tear, ecchymosis and risk of falling. These factors could be used to identify patients requiring prevention of skin tears.

Systematic review of the use of Statistical Process Control methods to measure the success of pressure ulcer prevention

Successful prevention of pressure ulcers is the end product of a complex series of care processes including, but not limited to, the assessment of vulnerability to pressure damage; skin assessment and care; nutritional support; repositioning; and the use of beds, mattresses, and cushions to manage mechanical loads on the skin and soft tissues. The purpose of this review was to examine where and how Statistical Process Control (SPC) measures have been used to assess the success of quality improvement initiatives intended to improve pressure ulcer prevention. A search of 7 electronic bibliographic databases was performed on May 17th, 2017, for studies that met the inclusion criteria. SPC methods have been reported in 9 publications since 2010 to interpret changes in the incidence of pressure ulcers over time. While these methods offer rapid interpretation of changes in incidence than is gained from a comparison of 2 arbitrarily selected time points pre- and post-implementation of change, more work is required to ensure that the clinical and scientific communities adopt the most appropriate SPC methods.

What is the effect of exercise on wound healing in patients with venous leg ulcers? A systematic review

Standard best practice for the treatment of venous leg ulcers (VLUs) is compression bandaging of the lower leg to reduce hydrostatic pressure. There is considerable variation in reported healing rates when using this gold-standard approach; therefore, a systematic and robust evaluation of other interventions is required. Exercise interventions, in addition to standard compression therapy, could improve wound-healing time and prevent their recurrence. We have conducted a systematic review to examine the effects of exercise on wound characteristics, including time to heal, size and recurrence, pain, quality of life, adverse events, and economic outcomes. This review was registered with PROSPERO 2016:CRD42016046407. A systematic search of Ovid Medline, Ovid EMBASE, Ovid CINAHL, The Cochrane Library, PsycINFO, Web of Science, and PEDro was conducted on January 30, 2017, for randomised control trials to examine the effects of exercise on time to heal, size and recurrence, pain, quality of life, adverse events, and economic outcomes. Six studies met the inclusion criteria, but all had design flaws leading to biases, most commonly performance and selective reporting bias. Three studies compared a progressive resistance exercise programme (PREG) plus compression with compression alone for a period of 12 weeks. Low-quality evidence indicates the following: possibly no difference in the proportion of ulcers healed (risk ratio [RR] 1.14, 95% CI 0.71 to 1.84, I² 36%; 3 trials, 116 participants); probably no difference in quality of life (mean difference [MD] 3 points better on 100 point scale with exercise, 95% CI −1.89 to 7.89, 1 trial, 59 participants); possible increase in the risk of adverse events with exercise (OR 1.32, 95% CI 0.95 to 1.85, 1 RCT, 40 participants); and no difference in ankle range of motion and calf muscle pump. Evidence was downgraded due to susceptibility to bias and imprecision. Recurrence, pain, and economic outcomes were not measured in these trials, and time to healing was measured but not fully reported in 1 trial. We are uncertain of the effects of other interventions (community-based exercise and behaviour modification, ten thousand steps, supervised vs unsupervised exercise) due to the availability of low- or very low-quality evidence only from single trials. The review highlights the need for further research, with larger sample sizes, to properly address the significance of the effect of exercise on VLU wound characteristics.

Slow to heel: a literature review on the management of diabetic calcaneal ulceration

Abstract

The diabetic heel ulcer (DHU) represents a reconstructive challenge to clinicians and the multidisciplinary team alike. It is traditionally viewed as a condition that is inherently difficult to treat due to the intrinsic anatomical vulnerabilities of the heel. In addition to this, several factors are associated with poorer end outcomes – namely, that of major amputation. These include peripheral vascular disease, infection/osteomyelitis and the size of the ulcer itself. In light of the significant morbidity, economic burden and mortality seen in this cohort of patients, this review aims to explore current treatment modalities that have been undertaken. Literature in this field has mostly been confined to a handful of small case studies, some of which reflect novel, multimodal approaches, and promising results. Management with osteotomy, flap reconstruction and acellular dermal matrices, amongst other options, is covered within this review.

The ‘Two Bridges Technique’ for sternal wound closure. The use of vacuum-assisted closure for the treatment of deep sternal wound defects: a centre-specific technique

Abstract

The objective is to describe the 'Two Bridges Technique' (TBT), which has proven to be successful and has been the standard technique at our centre for vacuum-assisted closure (VAC) of post-sternotomy mediastinitis. An extensive literature search was performed in four databases to identify all published articles concerning VAC for post-sternotomy mediastinitis. Several VAC methods have been used; however, no article has described our specific technique. TBT consists of a two-bridges construction using two types of foam with different pore sizes, which ensures an equally divided negative pressure over the wound bed and stabilisation of the chest. This guarantees a continuous treatment of the sternal defect and prevents foam displacement. It maintains an airtight seal that prevents skin maceration and provides enough protection to avoid right ventricular rupture. The main advantage of TBT is the prevention of shifting or tilting of the foam during chest movements such as breathing or couching. Along with targeted antibiotic treatment, this alternative VAC technique can be an asset in the sometimes cumbersome treatment of post-sternotomy mediastinitis.

Hyperbaric oxygen therapy and intermittent ischaemia in the treatment of chronic wounds

Another Year, Another Reflection

Calendar

Issue Information

NEWS AND VIEWS

Physical Activity, Body Mass Index, and Clustered Metabolic Risk in U.S. Adolescents: 2007–2012 Nhanes

Metabolic Syndrome and Related Disorders, Volume 16, Issue 2, Page 97-103, March 2018.

Relationship Between Paraoxonase-1 and Butyrylcholinesterase Activities and Nutritional Status in Mexican Children

Metabolic Syndrome and Related Disorders, Volume 16, Issue 2, Page 90-96, March 2018.

Vaspin and Omentin-1 in Obese Children with Metabolic Syndrome: Two New Kids on the Block?

Metabolic Syndrome and Related Disorders, Volume 16, Issue 2, Page 73-75, March 2018.

Dietary Fiber, C-Reactive Protein, and Leisure-Time Physical Activity Among U.S. Adults

Metabolic Syndrome and Related Disorders, Volume 16, Issue 2, Page 104-109, March 2018.

Risk and Age of Cardiovascular Event in Women with Metabolic Syndrome: Menopause Age in Focus

Metabolic Syndrome and Related Disorders, Ahead of Print.

Association Between Carotid Intima Media Thickness, Age, and Cardiovascular Risk Factors in Children and Adolescents

Metabolic Syndrome and Related Disorders, Ahead of Print.

Persistence of TBT and copper in excess on leisure boat hulls around the Baltic Sea

Abstract

A handheld XRF-analyzer specially calibrated for measurements of metals on plastic boat hulls has been used on leisure boats in Denmark (DK), Finland (FI), and Germany (DE). The results on tin and copper are presented as μg metal/cm². Tin is a proxy for the occurrence of organotin compounds on the boat. Two or three sites were visited in each country and between 25 and 90 boats were measured at each site. Every boat was measured at six to eight places, and the results are presented both as mean and median values. Linear regression of mean to median values of the 377 data pairs shows high relationship with R² = 0.9566 for tin and R² of 0.9724 for copper and thus both ways of calculation may be used. However, for regulative use, it is suggested that all individual measurements on each boat should be presented and used for decisions of removal or sealing of boat hulls. The results are compared with published data from different parts of Sweden, i.e., boats in fresh water, brackish water, and salt water. The results show that tin with mean values > 50 μg Sn/cm² is still found on 42, 24, and 23% of the boats in DK, FI, and DE, respectively. The corresponding percentages based on median values are 38, 22, and 18% for DK, FI, and DE, respectively. The variation among boats is high with a maximum mean value of 2000 μg Sn/cm². As comparison, one layer of an old TBT antifouling paint Hempels Hard racing superior, corresponds to 300 μg Sn/cm². The percentage of boats with tin > 400 μg Sn/cm² content based on mean values was 10% in DK, 5% in FI, and 1% in DE. The corresponding median values were 9, 6, and 1% for DK, FI, and DE. Copper, > 100 μg Cu/cm², was detected on all measured boats in DK and in DE and on all but 3% of the FI boats. One layer of Hempels MilleXtra corresponds to ̴ 4000 μg Cu/cm². The recommendation on the can is to apply two layers. The proportion of boats with higher mean copper values than 8000 μg Cu/cm² was 51, 56, and 61 for boats in DK, FI, and DE, respectively. The proportion based on median values > 8000 μg Cu/cm² was 50, 54, and 61% for DK, FI, and DE. The conclusion is that many leisure boats around the Baltic Sea still display or possess antifouling paints containing organotin compounds and that more than half of the boats have more copper than needed for one boat season according to the paint producers. Much of these known toxic compounds will probably be released into the environment and harm the biota. The calibrated XRF-method, intended for area measurements on boat hulls, is an easy and cheap way to detect boats with organotin compounds and high copper content. We recommend environmental authorities to use this method for identification of such boats and to use the results for requesting measures to minimize further leakage to the environment.

Potential harmful elements in coal dust and human health risk assessment near the mining areas in Cherat, Pakistan

Abstract

This study was aimed to investigate the potential harmful element (PHE) concentrations in coal dust and evaluate the human risk assessment and health effects near coal mining areas. For this purpose, dust samples were collected near various coal mines in Cherat, Pakistan, and analyzed for the PHE concentrations. Determined PHE concentrations were evaluated for the health risk assessment. Results revealed that ingestion was the major pathway as compared to others for PHE exposure. Individual chronic daily intake (CDI) of PHEs was higher than their respective permissible exposure limits set for oral exposure routes by the Agency for Toxic Substances and Disease Registry (ATSDR). Chronic risk or health index (HI) values were observed < 1 for all PHEs and in the order of Pb > Cr > Cd > Ni > Cu > Co > Zn. Higher HI values of Pb, Cr, and Cd could attribute to various chronic health problems as observed during the medical examination survey of this study. Cancer risk (CR) values for this study were observed within the US Environmental Protection Agency (EPA) limits. However, if current practices continued, the PHEs will cross these limits in a near future. Therefore, this study strongly recommends the provision of safety measures, rules, and regulation to avoid health hazards in the future.

Effect of dietary phytogenics (herbal mixture) supplementation on growth performance, nutrient utilization, antioxidative properties, and immune response in broilers

Abstract

This experiment was conducted to study that effect of a phytogenics (herbal mixture) supplementation as alternative to antibiotics on the growth performance and immune response in broilers. Three thousand broiler male chicks at 1 day of age were housed in floor pens and divided into five experimental groups with five replicates of 120 birds each. The first group was fed the basal diet without any additive in feed or water; the second group was fed the basal diet, and the drinking water was supplemented with mixture of antibiotics (Doxycycline 1 g/5 L + Colistine sulfate 1 g/5 L) for the first 10 days of life. The other three treatments of chickens were fed the control diet supplemented with herbal mixture at a level of 0.5, 1.0, and 1.5 kg/ton, respectively. Dietary herb mixture supplementation improved growth performance significantly in comparison with control group. In addition, herb mixture supplementation reduced plasma total cholesterol and triglycerides concentrations, whereas, high density lipoprotein HDL-cholesterol and glutathione peroxidase (GPX) were increased significantly. Furthermore, herb mixture supplementation increased plasma levels of total protein and antibodies titers for Newcastle disease virus before and after the infection. It could be concluded that dietary herb mixture supplementation had positive effects on growth performance, antioxidative properties, and humoral immunity in broiler chickens.

Comparison of nickel adsorption on biochars produced from mixed softwood and Miscanthus straw

Abstract

In order to understand the influence of feedstock type on biochar adsorption of heavy metals, the adsorption characteristics of nickel (Ni²⁺), copper (Cu²⁺) and lead (Pb²⁺) onto biochars derived from mixed softwood and Miscanthus straw were compared. The biochars were produced from mixed softwood pellets (SWP) and Miscanthus straw pellets (MSP), at both 550 and 700 °C for each material, using a standardised production procedure recommended by the UK Biochar Research Centre. Kinetics analyses show that the adsorption of Ni²⁺ to all four biochars reached equilibrium within 5 min. The degree of Ni²⁺ removal for all four biochars remained nearly constant within initial pH values of 3–8, because the equilibrium pH values within this range were similar due to the buffering effect of the biochars. A sharp increase of Ni²⁺ removal percentage for all biochars at initial solution pH 8–10 was observed as the equilibrium pH also increased. MSP derived biochars generally had higher maximum adsorption capacities (Q_max) for the three tested metals as compared with those from SWP, which was likely due to their higher degree of carbonisation during production. This study shows that feedstock type is a primary factor affecting the adsorption capacities of the tested biochars for heavy metals.

Effect of composition and microstructure of humic acid on 3,3′,4,4′-tetrachlorobiphenyl sorption

Abstract

The fate and transport of polychlorinated biphenyls (PCBs), a class of persistent organic compounds, in soils was markedly affected by their sorption/desorption on soil organic matters (SOM) due to high hydrophobicity of PCBs. Humic acid (HA), an important fraction of SOM, has no steady composition and microstructure from different origins, resulting in their diverse sorption capacity. Therefore, the effect of composition and microstructure of HA on sorption of 3,3′,4,4′-tetrachlorobiphenyl (PCB77) was investigated in this study. The primary sorption mechanism of PCB77 on HAs was also demonstrated by using Fourier transform infrared (FTIR) and solid-state carbon-13 nuclear magnetic resonance (¹³C-NMR) spectroscopy analysis. Elemental content analysis of three HAs showed that the content of unsaturated C (the total of aromatic, carboxylic, and carbonyl carbon) followed an order of YHA>SHA>AHA. Furthermore, YHA and SHA had remarkably rough and complicated particle surfaces but AHA had relatively smooth surface and the well-proportioned and interspersed particle sizes. The results of the sorption experiment showed that the sorption capacity of PCB77 on HAs followed a similar order of YHA>SHA>AHA, indicating the content of unsaturated C of HAs controlled the sorption of PCB77 on HAs. Sorption of PCB77 on either AHA or SHA did not change with increasing ionic strength of background solution, implying that there was no H-bond or electrostatic interaction between PCB77 and HAs. The result of FTIR and ¹³C-NMR spectra showed the primarily possible mechanism was π-π conjugative interaction and hydrophobic binding between PCB77 and HAs.

The use of probiotics as eco-friendly alternatives for antibiotics in poultry nutrition

Abstract

Antibiotics as growth promoters in poultry have been used for long time for improving feed efficiency and performance. Due to their various side-effects such as antibiotic resistance, destruction of beneficial bacteria in the gut, and dysbiosis, it is required to think about some alternatives. Probiotics are one of the options in this regard for improving poultry production. Probiotics are defined as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." They are available in various forms for use as feed additives. Probiotics as feed additives aid in proper digestion of feed hence make the nutrients available for faster growth. Immunity can also be improved by addition of probiotics to poultry diets. Moreover, probiotics aid in improving meat and egg quality traits. Various infectious diseases of poultry can be countered by use of probiotics in their feed. A proper selection of probiotic strains is required for gaining optimal effects. This review focuses on the mechanisms of action of probiotics and their importance in poultry feed supplementation for enhancing production and safeguarding health of poultry.

Comparative study on the toxic effects of some heavy metals on the Nile Tilapia, Oreochromis niloticus , in the Middle Delta, Egypt

Abstract

Heavy metals are the most dangerous hazards affecting aquatic biota in Egypt specially the Nile Tilapia, Oreochromis niloticus, which is an important species in commercial fisheries. Some areas were not fully studied to screen the hazards that may affect this economic fish. Therefore, the present study aimed to evaluate the potential hazards of heavy metals on O. niloticus in Al-Gharbiya Governorate in the Middle delta of Egypt. Water and fish samples were collected from Al-Qased canal, Kafr El-Zayaat Nile, El-Maash canal in Al-Gharbiya Governorate plus a reference site which is a fish farm at the Faculty of Agriculture, Damietta University, Damitta Governorate, Egypt. The results showed a significant increase (p < 0.05) in the lead, zinc, magnesium, manganese, and copper levels while showed a significant decrease (p < 0.05) in the iron level in the water from all the investigated areas. Cadmium level was significantly high (p < 0.05) in Kafr El-Zayaat Nile and EL-Maash canal only. These metals were also accumulated in the fish livers and gills. Consequently, ALT and AST activities and creatinine level were significantly (p < 0.05) high in all the investigated areas. Histopathological examination revealed cytoplasmic and nuclear degeneration in the hepatocytes in all the investigated areas. Renal glomeruli and Bowman's capsule were not completely intact in Al-Qased and El-Maash canals while conspicuous shrinkage of the glomeruli was determined in Kafr El-Zayaat Nile. Furthermore, slight damage in the secondary lamellae was detected in the gill from Al-Qased canal while in the other areas appeared vacuolated or destructed. Finally, spleen sections of fish from different sites showed the absence of melanin pigments and some vacuoles. In conclusion, the Nile Tilapia, Oreochromis niloticus, is affected by the toxic effects of the heavy metals in Al-Gharbiya Governorate in Egypt and this gives an alarm and should be taken into consideration.

A dual-permeability hydro-biodegradation model for leachate recirculation and settlement in bioreactor landfills

Abstract

A dual-permeability hydro-biodegradation model is developed to describe the leachate flow in municipal solid waste (MSW) and predict the long-term settlement induced by biodegradation in bioreactor landfills. The model is verified against Hydrus-1D and a recirculation experiment conducted in a full-scale landfill. Preferential flow and mass transfer between fissure and matrix can be reasonably modeled by the proposed model. A higher recirculation flow rate can speed up the stabilization process of landfill. However, too much recirculation leachate is not economical and environmental friendly. A stabilization speed index and a leachate utilization index are adopted to evaluate the stabilization speed of bioreactor landfill and utilization rate of leachate, respectively, and the optimal recirculation flow rate is estimated. A flow rate of q = 5 × 10⁻⁵–5 × 10⁻⁴ m/h (equivalent to recirculation intensity of Q = 15–150 L/ton_waste/year) is recommended for recirculation, which has been verified by the field data in numerous bioreactor landfills.

Performance and efficiency of removal of pharmaceutical compounds from hospital wastewater by lab-scale biological treatment system

Abstract

The fate of pharmaceuticals after discharged from hospital into wastewater was clarified experimentally by using a new lab-scale conventional activated sludge (CAS) treatment reactor. The 43 target compounds belong to nine therapeutic classes (antivirals, antibacterials, anticancer drugs, psychotropics, antihypertensives, analgesic–antipyretics, contrast media, herbal medicines, and phytoestrogens) were selected with inclusion of 16 newly estimated compounds. The efficiency of the present reactor was estimated by comparing the reaction rate constant of the solid-water partition coefficients (log K_d) between liquid and solid samples and half-life during 48-h experiment obtained by using hospital effluents with those obtained by using STP wastewater. The results that no significant difference in removal efficiency was observed between both water samples (P > 0.05) indicate high reliability of the present lab-scale reactor. The actual rates of removal when hospital effluent was applied varied widely (mean, 59 ± 40%) independent of type of the pharmaceuticals. More than 90% of 17 compounds were removed after 8 h of treatment. However, the values for psychotropics (mean, 19 ± 26%) and contrast media (mean, 24 ± 17%) were generally low, indicating high stability. The log K_d values ranged from 1.3 to 4.8. Notably, clarithromycin, acridine, and glycitein could be removed in both liquid and solid phases. The dominant removal mechanisms were found to be different for individual pharmaceutical. These results suggest the effectiveness of introduction of the lab-scale biological treatment system for development of a new solution for discharge of pharmaceuticals from hospital.

Effect of compression ratio, nozzle opening pressure, engine load, and butanol addition on nanoparticle emissions from a non-road diesel engine

Abstract

Currently, diesel engines are more preferred over gasoline engines due to their higher torque output and fuel economy. However, diesel engines confront major challenge of meeting the future stringent emission norms (especially soot particle emissions) while maintaining the same fuel economy. In this study, nanosize range soot particle emission characteristics of a stationary (non-road) diesel engine have been experimentally investigated. Experiments are conducted at a constant speed of 1500 rpm for three compression ratios and nozzle opening pressures at different engine loads. In-cylinder pressure history for 2000 consecutive engine cycles is recorded and averaged data is used for analysis of combustion characteristics. An electrical mobility-based fast particle sizer is used for analyzing particle size and mass distributions of engine exhaust particles at different test conditions. Soot particle distribution from 5 to 1000 nm was recorded. Results show that total particle concentration decreases with an increase in engine operating loads. Moreover, the addition of butanol in the diesel fuel leads to the reduction in soot particle concentration. Regression analysis was also conducted to derive a correlation between combustion parameters and particle number emissions for different compression ratios. Regression analysis shows a strong correlation between cylinder pressure-based combustion parameters and particle number emission.

As(V) and Sb(V) co-adsorption onto ferrihydrite: synergistic effect of Sb(V) on As(V) under competitive conditions

Abstract

Competitive adsorption of As(V) and Sb(V) at environmentally relevant concentrations onto ferrihydrite was investigated. Batch experiments and XPS analyses confirmed that in a binary system, the presence of Sb(V) exhibited a slight synergistic effect on As(V) adsorption. XPS analyses showed that As(V) and Sb(V) adsorption led to obvious diminishment of Fe–O–Fe and Fe–O–H bonds respectively. At pH of 9, a more significant decrease of Fe–O–Fe was observed in the binary system than that in a single system, indicating that As(V) displayed an even stronger interaction with lattice oxygen atoms under competitive conditions. Basically, ionic strength demonstrated a negligible or positive influence on As(V) and Sb(V) adsorption in binary system. Study of adsorption sequence also indicated that the presence of Sb(V) showed a promotion effect on As(V) adsorption at neutral pHs. Considering that co-contamination of As and Sb in waters has been of great concern throughout the world, our findings contributed to a better understanding of their distribution, mobility, and fate in environment.

A Note on G-Estimation of Causal Risk Ratios

Abstract

G-estimation is a flexible, semiparametric approach for estimating exposure effects in epidemiologic studies. It has several under-appreciated advantages over other propensity score-based methods popular in epidemiology, which we review in this note. However, it is rarely used in practice, due to a lack of off-the-shelf software. To rectify this, we show a simple trick for obtaining G-estimators of causal risk ratios using existing generalized estimating equations software. We extend the procedure to more complex settings with time-varying confounders.

Applying Multiple Statistical Methods to Derive an Index of Dietary Behaviors Most Related to Obesity

Abstract

To evaluate the success of dietary interventions, we need measures that are more easily assessed and closely aligned with intervention messaging. An index of obesogenic dietary behaviors (e.g., task-eating, servings of fruits and vegetables, fast food, and soft-drinks) may serve this purpose and could be derived via data-driven methods typically used to describe nutrient intake. We used behavioral and physical measurement (i.e., body mass index, waist circumference) data from a subset of two independent cross-sectional samples of employees at baseline (2005–2007) (n = 561) and follow-up (2007–2009) (n = 155) enrolled in Promoting Activity and Changes in Eating. Index derivation methods including principal components regression, partial least squares, and reduced rank regression were compared. The best fitting index for predicting physical measurements included fast food, French fries, and soft-drinks. Each quartile increase in index score was associated with 5% higher BMI (Ratio = 1.053; 95% CI: 1.031, 1.075) and approximate 4% higher WC (1.036; 95% CI: 1.019, 1.054) at baseline adjusted for covariates, using linear mixed models. Results were similar at follow-up before and after baseline adjustment. This index may be useful in evaluating public health or clinic-based dietary interventions to reduce obesity, especially given the ubiquity of these behaviors in the general population.

Silver Oxysalts Promote Cutaneous Wound Healing Independent of Infection

Abstract

Chronic wounds often exist in a heightened state of inflammation whereby excessive inflammatory cells release high levels of proteases and reactive oxygen species (ROS). While low levels of ROS play a fundamental role in the regulation of normal wound healing, their levels need to be tightly regulated to prevent a hostile wound environment resulting from excessive levels of ROS. Infection amplifies the inflammatory response, augmenting levels of ROS which creates additional tissue damage that supports microbial growth. Antimicrobial dressings are used to combat infection; however, the effects of these dressing on the wound environment and healing independent of infection are rarely assessed. Cytotoxic or adverse effects on healing may exacerbate the hostile wound environment and prolong healing. Here we assessed the effect on healing independent of infection of silver oxysalts which produce higher oxidative states of silver (Ag²⁺/Ag³⁺). Silver oxysalts had no adverse effect on fibroblast scratch wound closure whilst significantly promoting closure of keratinocyte scratch wounds (34% increase compared to control). Furthermore, dressings containing silver oxysalts accelerated healing of full-thickness incisional wounds in wild-type mice, reducing wound area, promoting re-epithelialisation and dampening inflammation. We explored the mechanisms by which silver oxysalts promote healing and found that unlike other silver dressings tested, silver oxysalt dressings catalyse the breakdown of hydrogen peroxide to water and oxygen. In addition, we found that silver oxysalts directly released oxygen when exposed to water. Collectively, these data provide the first indication that silver oxysalts promote healing independent of infection and may regulate oxidative stress within a wound through catalysis of hydrogen peroxide. This article is protected by copyright. All rights reserved.

Bacterial community changes in response to oil contamination and perennial crop cultivation

Abstract

We investigated bacterial community dynamics in response to used motor oil contamination and perennial crop cultivation by 16S rRNA gene amplicon sequencing in a 4-year field study. Actinobacteria, Proteobacteria, Chloroflexi, Acidobacteria, and Gemmatimonadetes were the major bacterial phyla, and Rhodococcus was the most abundant genus. Initially, oil contamination decreased the overall bacterial diversity. Actinobacteria, Betaproteobacteria, and Gammaproteobacteria were sensitive to oil contamination, exhibiting clear succession with time. However, bacterial communities changed over time, regardless of oil contamination and crop cultivation. The abundance difference of most OTUs between oil-contaminated and non-contaminated plots remained the same in later sampling years after the initial abundance difference induced by oil spike. The abundances of three oil-favored actinobacteria (Lysinimonas, Microbacteriaceae, and Marmoricola) and one betaproteobacterium (Aquabacterium) changed in different manner over time in oil-contaminated and non-contaminated soil. We propose that these taxa are potential bio-indicators for monitoring recovery from motor oil contamination in boreal soil. The effect of crop cultivation on bacterial communities became significant only after the crops achieved stable growth, likely associated with plant material decomposition by Bacteroidetes, Armatimonadetes and Fibrobacteres.

Control Banding Tools for Engineered Nanoparticles: What the Practitioner Needs to Know

Abstract

Control banding (CB) has been widely recommended for the selection of exposure controls for engineered nanomaterials (ENMs) in the absence of ENM-specific occupational exposure limits (OELs). Several ENM-specific CB strategies have been developed but have not been systematically evaluated. In this article, we identify the data inputs and compare the guidance provided by eight CB tools, evaluated on six ENMs, and assuming a constant handling/use scenario. The ENMs evaluated include nanoscale silica, titanium dioxide, silver, carbon nanotubes, graphene, and cellulose. Several of the tools recommended the highest level of exposure control for each of the ENMs in the evaluation, which was driven largely by the hazard banding. Dustiness was a factor in determining the exposure band in many tools, although most tools did not provide explicit guidance on how to classify the dustiness (high, medium, low), and published data are limited on this topic. The CB tools that recommended more diverse control options based on ENM hazard and dustiness data appear to be better equipped to utilize the available information, although further validation is needed by comparison to exposure measurements and OELs for a variety of ENMs. In all CB tools, local exhaust ventilation was recommended at a minimum to control exposures to ENMs in the workplace. Generally, the same or more stringent control levels were recommended by these tools compared with the OELs proposed for these ENMs, suggesting that these CB tools would generally provide prudent exposure control guidance, including when data are limited.

Annals of Work Exposures and Health Performance, 2017

I am pleased to offer this report of the publication record of the first volume of Annals of Work Exposures and Health (AWEH) completed in 2017. The change from the Annals of Occupational Hygiene to AWEH was made in recognition of the vast changes occurring in the ways in which work is organized by most enterprises, the risks to health that accompany these changes, and the need for the occupational hygiene community to change with it. In light of these changes in the field, we sought to broaden the types of exposures addressed by the journal, and the methods required to understand the nature of the new threats to health.

Exposure to hexavalent chromium in welders: Results of the WELDOX II field study

Abstract

Objectives

Exposure to hexavalent chromium (Cr(VI)) has been primarily studied in chromate production. Here, we measured personal exposure to respirable Cr(VI) together with airborne and urinary Cr and Ni in welders to explore levels and associations between various measures of exposure.

Methods:

Shift concentrations of Cr(VI), Cr, and Ni were measured in respirable welding fumes in 50 men who used either gas metal arc welding (GMAW) (n = 24) or tungsten inert gas welding (TIG) (n = 19) as their major technique. Cr and Ni were determined in pre- and post-shift urine samples. Concentrations below the limit of quantification (LOQ) were multiply imputed. Spearman correlation coefficients (r_s) were calculated with 95% confidence intervals (CIs) to explore associations between the exposure variables, and regression models were applied to estimate the effect of the parent metal on the urinary concentration.

Results:

Regarding the respirable Cr(VI), 62% of the measurements were below the LOQ, the 75^th percentile was 0.50 µg m⁻³_, and 8 out of 50 (16%) welders exceeded 1 µg m⁻³. The highest shift concentration that occurred as a result of shielded metal arc welding (SMAW) was 180 µg m⁻³. The Cr(VI) content in total Cr ranged from 4 to 82% (median 20%), although the concentration correlated with total Cr (r_s 0.55, 95% CI 0.46; 0.64). The correlation between Cr(VI) and Ni was weaker (r_s 0.42, 95% CI 0.34; 0.51) than that between total Cr and Ni in welding fumes (r_s 0.83, 95% CI 0.74; 0.92). Both Cr(VI) and total Cr influenced the urinary Cr concentrations in post-shift samples (P = 0.0008 and P ≤ 0.0001, respectively). The airborne shift exposure was a weaker determinant than the Cr content in pre-shift urine samples, which strongly correlated with post-shift urinary Cr (r_s 0.78, 95% CI 0.69; 0.87).

Conclusions:

The Cr(VI) content in total Cr varied considerably in welding fumes. The majority of welders using GMAW or TIG presented with shift concentrations of respirable Cr(VI) below 1 µg m⁻³. However, very high Cr(VI) concentrations may occur, for example in SMAW. The urinary concentration of total Cr, cannot be used to precisely determine the shift concentration of respirable Cr(VI) in welders.

Characterization of the Selective Recording of Workplace Exposure Measurements into OSHA’s IMIS Databank

Abstract

Objectives

The Integrated Management Information System (IMIS) is the largest multi-industry source of exposure results available in North America. In 2010, the Occupational Safety and Health Administration (OSHA) released the Chemical Exposure Health Data (CEHD) that contains analytical results of samples collected by OSHA inspectors. However, the two databanks only partially overlap, raising suspicion of bias in IMIS data. We investigated the factors associated with selective recording of CEHD results into the IMIS databank.

Methods

This analysis was based on personal exposure measurements of 24 agents from 1984 to 2009. The association between nine variables (level of exposure coded as detected versus non-detected (ND), whether a sampling result was part of a panel of chemicals, duration of sampling, issuance of a citation, presence of other detected levels during the same inspection, year, OSHA region, amount of penalty, and establishment size) and a CEHD sampling result being reported in IMIS was analyzed using modified Poisson regression.

Results

A total of 461900 CEHD sampling results were examined. The proportion of CEHD sampling results recorded into IMIS was 38% (51% for detected and 28% for ND measurements). In the models, the detected sampling results were associated with a higher probability of recording into IMIS than ND sampling results, and this difference was similar for panel versus non-panel samples. Probability of recording remained constant from 1984 to 2009 for sampling results measured on panels but increased for sampling results of single determinations of an agent. Some OSHA regions had probability of recording two times higher than others. No other variables that we examined were associated with a CEHD sampling result being reported in IMIS.

Conclusions

Our results indicate that the under-reporting of sampling results in IMIS is differential: ND results (especially those determined from the panels) seem less likely to be recorded in IMIS than other results. It is important to consider both IMIS and CEHD data in order to reduce bias in evaluation of exposures in workplaces inspected by OSHA.

Evaluating the Risk of Noise-Induced Hearing Loss Using Different Noise Measurement Criteria

Abstract

Objectives

This article examines whether the Occupational Safety and Health Administration's (OSHA) average noise level (L_AVG) or the National Institute of Occupational Safety and Health's (NIOSH) equivalent continuous average (L_EQ) noise measurement criteria better predict hearing loss.

Methods

A cohort of construction workers was followed for 10 years (2000–2010), during which time their noise exposures and hearing threshold levels (HTLs) were repeatedly assessed. Linear mixed models were constructed with HTLs as the outcome, either the OSHA (L_AVG) or NIOSH (L_EQ) measurement criteria as the measure of exposure, and controlling for age, gender, duration of participation, and baseline HTLs (as both a covariate or an additional repeated measure). Model fit was compared between models for HTLs at 0.5, 1, 2, 3, 4, 6, and 8 kHz using the Akaike information criterion (AIC). The 10th, 50th, and 90th percentiles of hearing outcomes predicted by these models were then compared with the hearing outcomes predicted using the ISO 1999:2013 model.

Results

The mixed models using the L_EQ were found to have smaller AIC values than the corresponding L_AVG models. However, only the 0.5, 3, and 4 kHz models were found to have an AIC difference greater than 2. When comparing the distribution of predicted hearing outcomes between the mixed models and their corresponding ISO outcomes, it was found that L_EQ generally produced the smallest difference in predicted hearing outcomes.

Conclusions

Despite the small difference and high correlation between the L_EQ and L_AVG, the L_EQ was consistently found to better predict hearing levels in this cohort and, based on this finding, is recommended for the assessment of noise exposure in populations with similar exposure characteristics.

The Effect of Workforce Mobility on Intervention Effectiveness Estimates

Abstract

Background

Little is known about how mobile populations of workers may influence the ability to implement, measure, and evaluate health and safety interventions delivered at worksites.

Methods

A simulation study is used to objectively measure both precision and relative bias of six different analytic methods as a function of the amount of mobility observed in the workforce. Those six methods are then used to reanalyze a previously conducted cluster-randomized control trial involving a highly mobile workforce in the construction industry.

Results

As workforce mobility increases, relative bias in treatment effects derived from standard models to analyze cluster-randomized trials also increases. Controlling for amount of time exposed to the intervention can greatly reduce this bias. Analyzing only subsets of workers who exhibit the least amount of mobility can result in decreased precision of treatment effect estimates. We demonstrate a 59% increase in the treatment effect size from the reanalysis of the previously conducted trial.

Conclusions

When evaluating organizational interventions implemented at specific worksites by measuring perceptions and outcomes of workers present at those sites, researchers should consider the effects that the mobility of the workforce may have on the estimated treatment effects. The choice of analytic method can greatly affect both precision and accuracy of estimates.

Effects of Personal Protective Equipment Use and Good Workplace Hygiene on Symptoms of Neurotoxicity in Solvent-Exposed Vehicle Spray Painters

Abstract

Objectives

To assess the association between the use of personal protective equipment (PPE) and good workplace hygiene and symptoms of neurotoxicity in solvent-exposed vehicle spray painters.

Methods

Exposure control measures including PPE-use and workplace hygiene practices and symptoms of neurotoxicity were assessed in 267 vehicle repair spray painters. Symptoms were assessed using an adapted version of the EUROQUEST Questionnaire.

Results

Frequent respirator and glove use was inversely and significantly associated with symptoms of neurotoxicity in a dose-dependent manner (P < 0.05 for trend) with the strongest protective effect found for consistent glove use (odds ratios [OR] 0.1–0.2, P < 0.01, for reporting ≥10 and ≥5 symptoms). A clear dose–response trend was also observed when combining frequency of respirator and glove use (P < 0.05 for reporting ≥5 and ≥10 symptoms), with an overall reduction in risk of 90% (OR, 0.1, P < 0.01) for those who consistently used both types of PPE. Protective effects were most pronounced for the symptom domains of psychosomatic (P < 0.05 for trend, for combined PPE use), mood (P < 0.05), and memory and concentration symptoms combined (P < 0.05), with reductions in risk of >80%. Poor hygiene workplace practices, such as solvent exposure to multiple body parts (OR 3.4, P = 0.11 for reporting ≥10 symptoms), were associated with an increased risk of symptoms. When using a general workplace hygiene score derived from a combination of PPE-use and (good) workplace practice factors an inverse and significant dose–response trend was observed for reporting ≥5 (P < 0.01) and ≥10 symptoms (P < 0.01).

Conclusions

This study has shown that PPE-use and good workplace hygiene are associated with a strongly reduced risk of symptoms of neurotoxicity in solvent-exposed vehicle spray painters.

Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression

Abstract

Objectives

The behavioural experience method has been extensively used in the literature for the measurement of potential bullying behaviours at work. However, this approach presents limitations when used to classify respondents as targets or non-targets of workplace bullying. Therefore, the present study aimed to: (i) identify optimal cut-off points, reflecting a possible subjectively experienced exposure to occasional and frequent workplace bullying, for the 9-item Short Negative Act Questionnaire (S-NAQ), and (ii) examine the criterion validity of these cut-off points in relation to depressive symptoms and diagnosis of depression.

Methods

The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9–45) and a one-item measure applying the self-labelling method with a definition to assess occasional and frequent workplace bullying. We employed receiver operating characteristic (ROC) curve analyses to derive the cut-off points for the S-NAQ. Based on these cut-off points, we created a new S-NAQ variable with three levels of exposure (i.e. 'not exposed', 'first threshold', and 'second threshold') and tested its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844).

Results

The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification accuracy (area under the curve = 0.89 and 0.93) as well as good sensitivity (84.8% and 88.0%) and specificity (77.4% and 94.7%). In the adjusted linear regression analyses, both the first (B = 0.78, 95% confidence interval [CI] = 0.66–0.90) and the second threshold of exposure (B = 1.65, 95% CI = 1.44–1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98–6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93–11.88) were significantly associated with diagnosis of depression.

Conclusions

The two cut-off points for the S-NAQ identified in this study showed a significant association with both depressive symptoms and diagnosis of depression. However, future prospective studies are needed to establish the predictive validity of the proposed cut-off points.