Observations on the levels of total mercury (Hg) and selenium (Se) in species common to the artisanal fisheries of Seychelles

Exposure to mercury (Hg) in Seychelles is expected to be high owing to the large amounts of fish regularly consumed. In spite of this consumption, a recent long-term study of child development found no evidence that higher prenatal exposure to Hg increases the risk of neurological disorders. To identify the major sources of mercury in the diets of Seychellois fish consumers, 16 species of fish common to local markets were tested for total Hg. Selenium (Se), which may act as an antidote to Hg toxicity, was also measured. Mercury and selenium were measured using standardised laboratory procedures. The average total Hg concentration across all species was 0.07 mg/kg while the Se concentrations averaged 0.29 mg/kg. Based on the pooled species dataset, there was no correlation between total Hg and Se concentrations, suggesting that joint bioaccumulation of these elements does not occur in the reef fishes tested. Barracuda (Sphyraena jello) had the highest concentration of Hg (0.36 mg/kg), a level that was below European Union guidelines. Although Seychellois traditionally eat a large amount of fish, barracuda would need to be consumed more than 5 times a week for FAO/WHO Total Hg Provisional Tolerable Weekly Intake (PTWI) limits to be exceeded, an unusual rate of consumption. Further investigations are needed to assess the risks posed to the population through the consumption of marine fish and fish products.     

A system for high performance liquid chromatography of 99mTc-compounds with on-line radiometric detection and data processing

A system for HPLC with on-line γ activity (two channels) and u.v.-detection is described, including software for the on-line data processing with a microcomputer.It was developed for the analysis of ^99mTc-diphosphonates. Example of some of its features are given using the separation of ^99mTc and ¹¹³Sn labeled Tc(Sn)EHDP complexes with ion-pair-chromatography.     

Does the inclusion of societal costs change the economic evaluations recommendations? A systematic review for multiple sclerosis disease

Background

Multiple sclerosis imposes a heavy burden on the person who suffers from it and on the relatives, due to the caregiving load involved. The objective was to analyse whether the inclusion of social costs in economic evaluations of multiple sclerosis-related interventions changed results and/or conclusions.

Methods

A systematic review was launched using Medline and the Cost-Effectiveness Analysis Registry of Tufts University (2000–2019). Included studies should: (1) be an original study published in a scientific journal, (2) be an economic evaluation of any multiple sclerosis-related intervention, (3) include productivity losses and/or informal care costs (social costs), (4) be written in English, (5) use quality-adjusted life years as outcome, and (6) separate the results according to the perspective applied.

Results

Twenty-nine articles were selected, resulting in 67 economic evaluation estimations. Social costs were included in 47% of the studies. Productivity losses were assessed in 90% of the estimations (the human capital approach was the most frequently used method), whereas informal care costs were included in nearly two-thirds of the estimations (applying the opportunity and the replacement-cost methods equally). The inclusion of social costs modified the figures for incremental costs in 15 estimations, leading to a change in the conclusions in 10 estimations, 6 of them changing from not recommended from the healthcare perspective to implemented from the societal perspective. The inclusion of social costs also altered the results from cost-effective to dominant in five additional estimations.

Conclusions

The inclusion of social costs affected the results/conclusions in multiple sclerosis-related interventions, helping to identify the most appropriate interventions for reducing its economic burden from a broader perspective.

     

Maternal Serum Interleukin-6 Concentration as a Marker for Impending Preterm Delivery

Objective: To determine whether serum interleukin-6 concentrations predict impending preterm delivery.Methods: Blood samples were collected from 130 gravidas at 22–34 weeks’ gestation. The study group consisted of 89 women evaluated for preterm contractions or premature rupture of membranes, and these women were compared with 41 outpatient controls without evidence of labor or infection, chosen by clinicians at the time of routine prenatal visits. Serum interleukin-6 concentrations were measured using a specific enzyme-linked immunosorbent assay kit. Analyses were by the Mann-Whitney U and the Kruskal-Wallis tests.Results: All 41 control subjects had serum interleukin-6 concentrations less than 8 pg/mL. Sixteen of the 89 study patients had serum interleukin-6 concentrations greater than or equal to 8 pg/mL and 73 had values less than 8 pg/mL. When the serum interleukin-6 concentration was at least 8 pg/mL, the median interval from collection to delivery was significantly shorter than that among study and control subjects with serum interleukin-6 less than 8 pg/mL (5.5 versus 240 and 1801 hours, respectively; P < .001). The median gestational age at delivery was significantly lower when the serum interleukin-6 concentration was at least 8 pg/mL, compared with study and control subjects with serum interleukin-6 concentrations less than 8 pg/mL (29.6 versus 33.4 and 39.0 weeks, respectively; P < .001). In patients with preterm contractions, the interval from collection to delivery was significantly shorter when the serum interleukin-6 concentration was at least 8 pg/mL than when it was less than 8 pg/mL (3 versus 600 hours, P < .001). Similarly, the median gestational age at delivery was significantly lower when serum interleukin-6 was at least 8 pg/mL (29.0 versus 36.1 weeks, P < .001).Conclusion: Maternal serum interleukin-6 concentrations appear to be elevated in women destined to deliver prematurely. Measurement of this cytokine may prove useful in treating patients at high risk for preterm delivery.     

Plaster slipper versus crepe bandage after Wilson’s osteotomy for hallux valgus

Much variability exists in the postoperative mobilization management after modified Wilson’s osteotomy for hallux valgus. This study aimed to elicit the differences, if any, between weightbearing following surgery as managed with a plaster slipper as compared to that of a crepe bandage. Fifty-four operated feet were randomly entered into a prospective trial. All feet underwent identical operations. When a crepe bandage was used there was no significant difference in the rate of complications, or in the patient’s assessment of postoperative pain relief. Patients treated with a crepe bandage were back to full activity as quickly as their plaster slipper counterparts and the patient’s overall assessment of the operation was no different.     

Communicating with children in A & E: what skills does the nurse need?

It is well recognized in the UK that up to 30% of annual attendances to Accident & Emergency (A & E) departments will be from children aged 16 years and under. Whilst much of the available literature relating to the care of children in A & E focuses upon the need for specially trained nurses and environmental improvements, there is little evidence provided as to the skills required by the A & E nurse when caring for this group of patients. This paper investigates some of the communication skills that may be needed by A & E nurses if they are to communicate effectively with pre-school children. The discussion focuses upon how these skills may be developed and the nature of the underpinning knowledge and experience required by the nurse in this context.     

Analysis on the accident casualties influenced by several economic factorsbased on the traffic-related data in China from 2004 to 2016

Purpose: By studying the economic data related to road traffic accidents in recent 10 years, this paper explores the impact of various economic factors on the number of casualties in traffic accidents in China, and puts forward related prevention and management measures. Methods: Based on five economic factors including the number of new health institutions, health investment, transportation investment and disposable income per capita, this paper collects the data of traffic accidents in 31 provinces and municipalities of China from 2004 to 2016 and estimates the parameters using fixed effect model. Results: The number of health institutions, health investment, transportation investment and disposable income per capita are negatively correlated with the number of traffic accident casualties; the number of new health institutions is positively correlated with the number of traffic accident casualties; health investment and transportation investment have a great impact on the number of road traffic accident casualties. Conclusion: Economic development has a positive impact on improving traffic conditions, but the increase in the number of new health institutions does not reduce the number of casualties in accidents. The irrational layout of health institutions and imperfect road traffic management mechanism should be taken into account.