Residues of chlordane in fish in the Gulf of Gdańsk

Concentrations, composition and spatial variations of the residues of the pesticide Chlordane were determined in several species of fish caught in Gulf of Gdańsk. The residues of Chlordane (cis-i trans-chlordane, cis-i trans-nonachlor, oxychlordane, heptachlor, heptachlor epoxide, MC4, MC5, MC6, MC7, U82 and U83) were found in all fish examined, however, the concentrations noted were low, i.e. from 0.40 to 12 ng/g wet weight. Among the Chlordane constituents and metabolites determined trans-naonachlor, cis-chlordane, oxychlordan, heptachlor epoxide, cis-nonachlor, MC5, MC6 and trans-chlordane were dominated, and MC4, MC7, U82 and U83 were minor compounds. No heptachlor residues were found in fish examined. A small concentrations and specific composition of the residues of Chlordane and its metabolites determined in fish from the Gulf of Gdańsk do indicate on a distant sources of pollution with that pesticide--mainly transported and deposited via the atmosphere.     

Anthropogenic changes in properties of the water and spatial structure of the vegetation of the lobelia lake Lake Modre in the Bytów Lakeland

Lake Modre is a lobelia lake. Numerous typical plant species occur here, including Lobelia dortmanna, Littorella uniflora, Isoetes lacustris, and Sphagnum denticulatum. They develop the following associations: Lobelietum dortmannae (Oswald 1923) Tx. ap. Dierss. 1972, Isoetetum lacustris Szańkowski et K?osowski 1996 n.n., and a community with Sphagnum denticulatum Brid. In 1991, the water of the lake was characterised by low concentrations of nutrients and calcium, acid reaction (pH<5), and Secchi depth visibility of 12 m. Following fry stocking in the lake in 1993 fish farming took place until approximately 1996. During this period the water quality in the lake changed radically in physiochemical terms. Water transparency decreased. Thermal and oxygen stratification developed, with oxygen deficits in the near-bottom layer. Concentrations of nutrient elements increased. Drastic long-term changes were observed in the spatial and quantitative features of the lake vegetation. These particularly related to the instability of Lobelia dortmanna, and the diminishment of the phytocoenosis of Lobelietum dortmannae. Consequently, the phytocoenosis occurred only in the shallowest part of the phytolittoral. L. uniflora expanded, increasing its occurrence annually. Significant fluctuations in quantities of S. denticulatum occurred, correlated with changes in physiochemical water parameters, but shifted in time.     

Estimation of the prevalence of epilepsy in the Benin region of Zinvié using the capture-recapture method

BACKGROUND: The prevalence of epilepsy was estimated in two villages of 3134 inhabitants, in Benin, in April and May 1997 using the capture-recapture method. METHODS: Information was obtained from (i) a door-to-door cross-sectional study, (ii) a non-medical source consisting of key informants (traditional practitioners, teachers, village leaders, and religious representatives) and (iii) a medical source through evaluation of medical records in health centres. In all the three situations, the diagnosis of epilepsy was confirmed by a neurologist. RESULTS: The door-to-door survey found 50 epileptics, i.e. a prevalence of 15.9 per 1000. The non-medical source found 26 patients. The medical source found only four patients. In total, 66 epileptics were found by combining the three sources, giving a prevalence of 21.1 per 1000. After application of the capture-recapture method, the estimated number of cases from the door-to-door survey and non-medical source was 105, and 110 cases when the medical source was considered as well. The respective prevalences were 33.5 per 1000, and 35.1 per 1000. CONCLUSIONS: The door-to-door survey has been usefully improved by using key informants. The epilepsy prevalence estimate found by capture-recapture is clearly higher than that found by traditional cross-sectional methods, and could better depict the frequency of epilepsy in Africa.     

Was there a disparity in age appropriate infant immunization uptake in the theatre of war in the North of Sri Lanka at the height of the hostilities?: a cross-sectional study in resettled areas in the Kilinochchi district

Background

It was long speculated that there could be under-immunized pockets in the war affected Northern part of Sri Lanka relative to other areas. With the cessation of hostilities following the military suppression of the rebellion, opportunities have arisen to appraise the immunization status of children in areas of re-settlement in former war ravaged districts.

Methods

We conducted a cross-sectional study to describe the coverage and age appropriateness of infant vaccinations in a former conflict district during the phase of re-settlement. The target population comprised all children of re-settled families in the age group of 12 – 23 months in the district. We selected a study sample of 300 children from among the target population using the WHO’s 30 cluster EPI survey method. Trained surveyors collected data using a structured checklist. The infant vaccination status was ascertained by reviewing vaccination records in the Child Health Development Record or any other alternative documentary evidence.

Results

The survey revealed that the proportion of fully vaccinated children in the district was 91%. For individual vaccines, it ranged from 92% (measles) to 100% (BCG, DPT/OPV1). However, the age appropriateness of vaccination was less than 50% for all antigens except for BCG (94%). The maximum number of days of delay of vaccinations ranged from 21 days for BCG to 253 days for measles. Age appropriate vaccination rates significantly differed for DPT/OPV1-3 and measles during the conflict and post-conflict stages while it did not for the BCG. Age appropriate vaccination rates were significantly higher for DPT/OPV1-3 during the conflict while for the measles it was higher in the post conflict stage.

Conclusions

Though the vaccination coverage for infant vaccines in the war affected Kilinochchi district was similar to other districts in the country, it masked a disparity in terms of low age-appropriateness of infant immunizations given in field settings. This finding underscores the need for investigation of underlying reasons and introduction of remedial measures in the stage of restoring Primary Health Care services in the ex-conflict zone.

     

Is the self of the infant preserved in the adult?

Medicine, Health Care and Philosophy - What does a confrontation between philosophy and psychoanalysis look like? My task is a philosophical investigation of a psychoanalytic concept. Thus, I offer...     

Analysis of the cost-effectiveness of the implementation of Indoor Residual Spraying and distribution of Long-Lasting Insecticidal Nets in the municipality of Kouandé and municipality of Copargo in Benin

Background

In Benin, malaria was the leading cause of hospital consultation for children less than 5 years old (47.2%), and for all patients not hospitalized (42.3%). Its incidence among those who attended a health facility was respectively 42.9% and 17%. To address this problem, the National Program for the Fight against Malaria undertook, in 2011, a mass campaign of distribution of Long-Lasting Insecticidal Nets (LLINs). In addition to this strategy, the program decided to implement Indoor Residual Spraying in 7 of the 9 municipalities of Atacora department, which is one of the most malaria endemic areas. The objective of this study was to see if adding the IRS to the LLINs (municipality of Kouandé) strategy is cost-effective, as compared to the LLINs-only strategy (municipality of Copargo), in highly malaria endemic areas.

Method

This study was a cross-sectional study of the implementation of the IRS from June 2011 to July 2011. Regarding the selection of health workers, managers of the malaria program, and partners of implementation of the IRS, a reasoned choice was made. The data collection consisted mainly of a series of interviews with people responsible for resource management and the exploitation of documents provided by them.

Results

After the implementation of LLNs + IRS the annual incidence of malaria in health facilities decreased significantly at Kouandé-Centre and at Guilmaro. In the same period it increased significantly at Copargo- Centre, and decreased at Pabégou.The average cost per malaria case prevented (CE) was respectively 85,572.4 FCFA at Copargo Centre, 38,932.6 FCFA at Kouandé Centre, 15,940.6 FCFA at Pabégou and 174,728.5 FCFA at Guilmaro. According to the results, the CE ratio at Kouandé-Centre is lower than the CE ratio at Copargo- Centre and the CE ratio at Guilmaro is higher than the CE ratio at Pabégou.The LLINs?+?IRS strategy is more cost effective in urban areas than the LLINs-only strategy. The opposite result is observed in rural areas.

Conclusion

The LLINs?+?IRS strategy is cost effective in highly endemic areas both urban and rural, if communities sleep in sprayed structures and use LLINs even when it is hot.

     

Use of the Spanish Version of the Rapid Geriatric Assessment in Mexican Patients in Long-Term Care

We report our experience with the use of a Spanish version of the rapid geriatric assessment of 30 patients in 2 long-term care institutions in Mexico City by a group of healthcare students without prior experience in geriatric medicine. The Spanish version of the rapid geriatric assessment is a very easy tool to administer that can provide overall good results for identifying frailty, sarcopenia, anorexia, weight loss, and cognitive impairment.     

An investigation of douching practices in the botánicas of the Bronx

Douching is a common practice in women and has been associated with adverse health outcomes. In order to explore douching products and practices we conducted qualitative interviews in ten botánicas (stores that provide healing and spiritual services to immigrant communities) located in New York City. We interviewed 15 people, 14 of whom were botánica owners and employees and ten of whom were women. We found that douching was not easily separated from the more holistic concerns of botánica customers involving health, well-being and spirituality. These issues included abortion, infertility, menopause, the prevention and treatment of infections, sexuality, cleanliness, hygiene and relationship issues. The vagina was seen as a sensitive, even vulnerable part of the body, not clearly distinguished from other female organs. A variety of products were used in the vagina in the form of creams, douches, suppositories, baths and herbal steaming of the urogenital area. Alum, an astringent, was used for the purposes of vaginal tightening to enhance sexual pleasure for the partner, to make the vagina 'younger', or to hide evidence of infidelity. Botánicas are part of a complex healing system with conceptual models different from those of allopathic medicine. These models may not be unique to the botánicas.     

Tularemia in Germany: the tip of the iceberg?

SUMMARYTularemia is a rare, notifiable zoonosis in Germany. Since November 2004, several lines of evidence including outbreaks in humans or animals and confirmed infections in indigenous hare and rodent populations have indicated a re-emergence of tularemia in different German federal states. Unfortunately, reliable basic information on the seroprevalence in different geographical regions, permitting the identification of risk factors, does not exist. Combining a sensitive screening assay with a highly specific confirmative immunoblot test, we performed a serological investigation on 2416 sera from a population-based, cross-sectional health survey of the city population of Leutkirch, Baden-Wuerttemberg. A total of 56 sera gave positive results indicating a seroprevalence of 2.32%. Thus, the seroprevalence is tenfold higher than that previously reported in a nationwide study in 2004. Francisella tularensis can cause a wide variety of clinical syndromes including severe, sometimes fatal disease. Missing epidemiological data on its spatial and temporal distribution in an endemic country complicate an appropriate risk assessment necessary for public health authorities to be prepared for an adequate outbreak management. This is of special concern regarding the extraordinary potential of F. tularensis as an agent of bioterrorism. Our investigation performed in a presumed low-risk area demonstrated that tularemia might be seriously underestimated in Germany and probably in other central European countries as well.     

Circumcision in the control of HIV?

Ken Rankin (AH, Jan '94, p 34) rightly points out that more circumcisions are carried out than are justified on clinical grounds alone. However, the advent of AIDS raises a number of interesting points about the possible role of circumcision as an epidemiological tool for the control of HIV transmission. It has been reported that an absence of circumcision increases susceptibility to acquiring STDs. STDs, especially those that cause genital ulcer disease (such as syphilis, chancroid and genital herpes), are recognized major risk factors for the transmission of HIV. Furthermore, some studies have shown that the distribution of HIV seroprevalence in Africa is closely associated with the geographical pattern of circumcision practices, whilst other workers have shown an association between absence of circumcision and HIV seropositivity. In some societies where circumcision was formerly practiced on religious/cultural grounds, it has now largely been abandoned as a consequence of urbanization and the adoption of Western lifestyles. In such situations, a revival of this ancient custom might supplement other control measures against HIV transmission. The only proviso would be an insistence on sterile procedures. The devastating impact of AIDS, especially in sub-Saharan Africa, necessitates a consideration of all possible interventions.