Potential risk factors for <Emphasis Type="Italic">Cryptosporidium</Emphasis> infection among HIV/AIDS patients in central areas of Thailand

Background  Cryptosporidiosis is very common in patients with HIV/AIDS and remains a threat to public health. A cross-sectional analytical study to determine the prevalence and identify potential risk factors associated with Cryptosporidium infection among HIV/AIDS patients was conducted. Methods  In the study of 143 HIV/AIDS adult patients with diarrhea, a total of 23 cases with Cryptosporidium infection and 120 cases with Cryptosporidium negative were reported during the study period. Results  Results revealed that the prevalence of cryptosporidiosis was 16.1%. In a stratified analysis controlling for gender, factors associated with Cryptosporidium infection were history of diarrhea >21 days, count ≤50 cells/mm³, and WBC count <4,000 cells/mm³. Conclusion  These findings confirmed that there was a strong association between cryptosporidiosis and count. Such information may provide possible recommended strategies for preventing cryptosporidiosis in HIV/AIDS persons.     

Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised,controlled pilot study

Probiotics are being increasingly studied for their ability to enhance host resistance to, and recovery from, infection. The probiotic strain Lactobacillus casei DN-114001 has previously been shown to reduce the incidence and duration of episodes of diarrhoea in children. Our controlled pilot study aimed to evaluate the effect of supplementation for 3 weeks with milk fermented with yoghurt cultures and L. casei DN-114001 on the incidence and severity of winter infections (gastrointestinal and respiratory) in elderly people. We found no difference in the incidence of winter infections between groups. However, duration of all pathologies was significantly lower in the treatment group (7.0 3.2 days, n=180) than in the control group (8.7 3.7 days; n=180) (p=0.024), as was maximal temperature (38.3 0.5 C treatment group vs. 38.5 0.6 C control; p=0.01). The potential for a 20% reduction in the duration of winter infections that we have found warrants further investigation on a larger scale.     

Dietary effect of folate-rich fermented milk produced by Streptococcus thermophilus strains on hemoglobin level

Objective

Folate, a water-soluble vitamin, functions as a carbon carrier in the formation of heme, the iron-containing non-protein portion of hemoglobin. Therefore, its deficiency leads to anemia. The objective of this study was to determine the dietary effects of folate-rich fermented milk produced by high-folate–producing Streptococcus thermophilus strains (RD 102 and RD 104) on hemoglobin level using a murine model.

Methods

Thirty-two albino mice 30 ± 10 d old were assigned to ingest a basal diet (i.e., a synthetic anemic diet, n = 8, group I, control 1), a basal diet with skim milk (n = 8, group II, control 2), a basal diet with fermented skim milk produced by folate plus RD 102 (n = 8, group III, test 1), and a basal diet with fermented skim milk produced by folate plus RD 104 (n = 8, group IV, test 2) in a 6-wk, double-blind, placebo-controlled study. Hemoglobin concentrations were estimated by the Drabkin–Austin cyanmethemoglobin method during the prefeeding (10 d), feeding (20 d), and postfeeding (10 d) trials, respectively.

Results

The results showed that the test groups (III and IV) receiving folate-rich fermented milks prepared using high-folate producing S. thermophilus strains showed a significant increase in hemoglobin level compared with the control groups (I and II).

Conclusion

Folate-rich fermented milks have the potential to significantly increase the hemoglobin level of blood. Hence, high-folate–producing S. thermophilus strains offer a novel natural approach to fortify dairy products with folate.     

The effect of <Emphasis Type="Italic">Lactobacillus helveticus</Emphasis> fermented milk on acute changes in calcium metabolism in postmenopausal women

Summary.Background: Milk fermented with Lactobacillus helveticus (L. helveticus) has been shown to lower blood pressure and to increase bone mineral content in spontaneously hypertensive rats. The effect of L.helveticus may be due to better calcium availability. Aim of the study: In the present study the effect of milk fermented with L. helveticus on acute changes in calcium metabolism and bone resorption in postmenopausal women was studied.Methods: The study was performed as a randomised double-blind crossover study of 20 postmenopausal women (mean age 65, range 50–78). The study was carried out in two parts. Firstly, L. helveticus fermented milk was compared to a control milk. Secondly, juice containing peptides formed with L. helveticus bacteria was compared to a control juice. The acute effect on calcium metabolism was measured during the study day by serum ionised calcium (iCa), parathyroid hormone (PTH), calcium (Ca), phosphate (P), and urinary calcium. A direct marker of bone turnover, carboxyterminal telopeptide of type I collagen (ICTP), was measured from the serum.Results: L. helveticus fermented milk reduced serum PTH (405.3 ± 37 ng/l vs. 454.9 ± 37, p = 0.012) and increased serum calcium (19.1 ± 0.2 mmol/l vs. 18.8 ± 0.2, p = 0.031) compared to the control milk. L. helveticus derived peptides had no significant acute effect on calcium metabolism, in fact, ionised calcium was lower and PTH higher after the juice containing peptides compared to the control juice.Conclusions: Fermentation of milk with Lactobacillus helveticus had a positive acute effect on calcium metabolism. This effect was not explained by the small peptides formed by L. helveticus.     

A structured diet and exercise program promotes favorable changes in weight loss, body composition, and weight maintenance

Background

A number of diet and exercise programs purport to help promote and maintain weight loss. However, few studies have compared the efficacy of different methods.

Objective

To determine whether adherence to a meal-replacement–based diet program (MRP) with encouragement to increase physical activity is as effective as following a more structured meal-plan–based diet and supervised exercise program (SDE) in sedentary obese women.

Design

Randomized comparative effectiveness trial.

Participants/setting

From July 2007 to October 2008, 90 obese and apparently healthy women completed a 10-week university-based weight loss trial while 77 women from this cohort also completed a 24-week weight maintenance phase.

Intervention

Participants were matched and randomized to participate in an MRP or SDE program.

Main outcome measures

Weight loss, health, and fitness-related data were assessed at 0 and 10 weeks on all subjects as well as at 14, 22, and 34 weeks on participants who completed the weight maintenance phase.

Statistical analyses performed

Data were analyzed by multivariate analysis of variance for repeated measures.

Results

During the 10-week weight loss phase, moderate and vigorous physical activity levels were significantly higher in the SDE group with no differences observed between groups in daily energy intake. The SDE group lost more weight (−3.1±3.7 vs −1.6±2.5 kg; P=0.03); fat mass (−2.3±3.5 vs −0.9±1.6 kg; P=0.02); centimeters from the hips (−4.6±7 vs −0.2±6 cm; P=0.002) and waist (−2.9±6 vs −0.6±5 cm; P=0.05); and, experienced a greater increase in peak aerobic capacity than participants in the MRP group. During the 24-week maintenance phase, participants in the SDE group maintained greater moderate and vigorous physical activity levels, weight loss, fat loss, and saw greater improvement in maximal aerobic capacity and strength.

Conclusions

In sedentary and obese women, an SDE-based program appears to be more efficacious in promoting and maintaining weight loss and improvements in markers of health and fitness compared to an MRP type program with encouragement to increase physical activity.     

Influence of chronic low-level exposure to lead on plasma immunoglobulin concentration and cellular immune function in man

Summary The immunological status of individuals occupationally exposed to low levels of inorganic lead has been examined and compared with that of non-exposed, age and sex-matched controls. At the time of testing the exposed population had a mean (± SD) blood lead concentration of 38.4 ±5.6 g · 100 ml^–1 (n = 39) compared witha mean value of 11.8 ±g · 100 ml^–1 (n = 21) for the control group. No differences in the serum concentrations of IgG, IgA and IgM between the populations were observed and there existed no correlation between blood lead concentration and serum immunoglobulin levels. In addition assessment was made of the capacity of peripheral blood mononuclear cells to respond to the mitogen phytohaemagglutinin (PHA), a correlate of T cell function, and to spontaneously lyse cells of the erythroleukaemic cell line K562, a measure of NK cell function. In neither case was there a difference between exposed and control populations and no correlation between reactivity and blood lead concentration. Although previous studies in rodents have indicated that exposure to inorganic lead resulting in similar blood lead concentrations may compromise immune competence our data suggest that no similar effect occurs in man.     

Performance of Number-Between g-Type Statistical Control Charts for Monitoring Adverse Events

Alternate Shewhart-type statistical control charts, called g and h charts, have been developed for monitoring the number of cases between hospital-acquired infections and other adverse events, such as heart surgery complications, catheter-related infections, surgical site infections, contaminated needle sticks, medication errors and other care induced concerns. This article investigates the statistical properties of these new charts and illustrates several design considerations that significantly can improve their operating characteristics and sensitivity, including the use of with-in limit rules, a new in-control rule, redefined Bernoulli trials, and probability-based limits. These new charts are based on inverse sampling from geometric and negative binomial distributions, are simple for practitioners to use, and in some cases exhibit significantly greater detection power over conventional binomial-based approaches, particularly for infrequent events and low defect rates.     

Safety of the etonogestrel-releasing implant during the immediate postpartum period: a pilot study

Background

The effects of etonogestrel (ETG)-releasing contraceptive implant during the immediate postpartum period on maternal safety are unknown.

Study design

Forty healthy women exclusively breastfeeding were randomized to receive either ETG-releasing implant 24–48 h after delivery (n=20) or depot medroxyprogesterone acetate (DMPA group; n=20) at the sixth week postpartum. We measured blood pressure, maternal and neonatal weight, body mass index (BMI; kg/m²), waist circumference (WC), complete blood count, C-reactive protein, interleukin-6, tumor necrosis factor (TNF-alpha), lipid profile, fasting serum glucose and maintenance of exclusive lactation up to the 12th week postpartum.

Results

Decreases in mean maternal weight, BMI (kg/m²) and WC were significantly greater in the ETG-releasing implant group than in the DMPA group during the first 6 weeks postpartum (-4.64±2.71 kg vs. -2.6±2.45 kg mean±SD, p=.017; -1.77±1.06 kg/m² vs. -0.97±0.95 kg/m², p=.026; -15.3±6.72 cm vs. -9.05±5.84 cm, p=.003, respectively). In addition, total cholesterol and HDL, were lower in DMPA users, and TNF-alpha and leukocytes were higher in DMPA users compared to in the implant group, between 6 and 12 weeks after delivery. The newborns of implant users showed a trend towards gaining more weight, as compared with the infants of the DMPA mothers during the first 6 weeks of life (implant group: +1460.50±621.34 g vs. DMPA group: +1035.0±562.43 g, p=.05). The remaining variables, including the duration of exclusive breastfeeding, were similar between the groups.

Conclusion

The insertion of ETG-releasing contraceptive implant during the immediate postpartum period was not associated with deleterious maternal clinical effects or with significant maternal metabolic alterations or decreased infant weight gain.     

Urinary excretion of 1-pyrenol in automotive repair workers

Summary The urinary excretion of a pyrene metabolite was evaluated in 65 automotive repair workers whose skin was exposed to used mineral oils, and in 41 controls. Pyrene contents were determined in oily material taken from cloths used to clean various types of engines (n = 8) and were found to vary (mean ± SD) from 2.8 ± 0.4 ppm for dirty matter obtained from diesel truck engines to 9.3 ± 8.2 ppm for that from petrol car engines. Tobacco smoking and polycyclic aromatic hydrocarbon (PAH)-rich diets were considered as confounding factors. At both the beginning and the end of the working week, the values of urinary 1-pyrenol were slightly higher in exposed subjects (0.178 ± 0.150 and 0.194 ± 0.135 mol/mol creatinine on Monday and Friday, respectively) than in controls (0.124 ± 0.090 mol/mol creatinine) (Mann-Whitney test, z = 2.741, P < 0.01). The urinary 1-pyrenol values were higher in both smoking and non-smoking subjects than in controls. The highest values were found in urinary samples of smokers exposed to used mineral oils (0.259 ±0.201 mol/mol creatinine). In non-smoking workers (n = 40), post-shift 1-pyrenol values were 0.154 ± 0.105 ol/mol creatinine, as against 0.083 ± 0.042 mol/mol creatinine for the 19 non-smoking controls (Mann-Whitney test, z = 2.765, P < 0.01). In automobile repair workers, urinary 1-pyrenol values before the beginning of the weekly workshift did not differ substantially from those measured at the end of the week, not being related to the subjective degree of dirty skin as stated by workers. Multiple regression analysis between urinary metabolite levels and the three independent variables turned out to be statistically significant (r ² = 0.295, 0.246; F-test = 14.2, 11.1; P both < 0.01) for Monday and Friday urinary metabolite values and revealed that tobacco smoking had a greater influence (contribution to r ² = 16.1% and 18.3% on Monday and Friday, respectively) than occupational exposure (3.8% and 6.6%, respectively) on urinary levels of 1-pyrenol; the influence of PAH-rich foods on urinary pyrene metabolite levels was only detectable when subjects returned to work after the weekend (5.5%).Comparison between urinary excretion of 1-pyrenol in this group of workers and that found in professionally exposed subjects indicates that exposure to PAHs through contamination of the skin with used engine oil during automotive repair work is very low.     

Levonorgestrel-releasing intrauterine system compared to low dose combined oral contraceptive pills for idiopathic menorrhagia: a randomized clinical trial

Background

This study compared the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) to low dose combined oral contraceptive pills (COC) in the management of idiopathic menorrhagia.

Study Design

A single-center, open, randomized clinical trial. One hundred twelve women complaining of excessive menstruation who desired contraception were randomized to receive LNG-IUS or COC. Treatment failure was defined as the need for medical or surgical treatment during the follow-up. Other outcomes included: menstrual blood loss (MBL) by alkaline hematin and by pictorial blood assessment chart (PBLAC), hemoglobin levels and assessment of lost days in which physical or mental health prevented participating women from performing usual activities.

Results

At baseline, LNG-IUS (n=56) and COC (n=56) groups were comparable in age (mean±S.D.) (39.3±6.7 vs. 38.7±5.2 years, p=.637), parity (median and range) [3(1-6.4) vs.3(2-6), p=.802] and BMI (mean±S.D.) (29.6±5.9 vs. 31.1±5.7 kg/m², p=.175). Time to treatment failure was longer in LNG compared to COC group with a total of 6 (11%) patients who had treatment failure in the LNG-IUS compared to 18 (32%) in COC group with a hazard ratio of 0.30 (95% CI, 0.15-0.73, p=.007). Using alkaline hematin, the reduction in MBL (mean±S.D.) was significantly more in the LNG-IUS group (87.4±11.3%) compared to the COC group (34.9±76.9%) (p=.013). Utilizing PBLAC scores, the reduction in the LNG-IUS (86.6±17.0%) group was significantly more compared to the COC group (2.5±93.2%) (p<.001). In the LNG-IUS group, increase in the hemoglobin and ferritin levels (mean±S.D.) were noted (from 10.2±1.3 to 11.4±1.0 g/dL; p<.001; with reduction of the number of lost days (from 6.8±2.6 to 1.6±2.4 days, p=.003).

Conclusion

The LNG-IUS is a more effective therapy for idiopathic menorrhagia compared to COC.     

Treatment for depression and its relationship to improvement in quality of life and psychological well-being in multiple sclerosis patients

Depression, a common problem in multiple sclerosis (MS), is generally associated with poorer quality of life (QOL). However, it is unclear whether treating depression also extends to better perceived QOL. Understanding QOL in MS has been limited by narrow definitions and exclusive focus on symptomology, with little emphasis on positive aspects of QOL. This study examined the impact of treating depression on QOL in 60 patients with a relapsing form of MS and moderate to severe depression, who were randomly assigned to one of three validated 16-week treatments for depression: individual cognitive-behavioral therapy, group psychotherapy, or sertraline. QOL was measured by the MSQOL-54, a version of the SF-36 adapted for MS, and Ryffs scales of psychological well-being, which measure positive attitudes and functioning. Depression and QOL were measured at baseline and immediately following treatment completion. Controlling for baseline neurological impairment and baseline QOL scores, regression analyses showed treating depression was significantly associated with improvements in the MSQOL-54 scales (R²s = 0.19–0.55, p < 0.001) and in four of the six scales of psychological well-being: environmental mastery (R² = 0.13, p < 0.001), positive relations (R² = 0.08, p < 0.001), purpose in life (R² = 0.16, p < 0.001), and self-acceptance (R² = 0.26, p < 0.001). Findings suggest treating depression influences both the negative and positive aspects of QOL and underscore the importance of examining QOL with two complementary approaches.     

Clinical outcome and emotional-behavioural status after isolated coronary surgery

In order to evaluate clinical and psychosocial results of isolated coronary artery by-pass graft (CABG) we studied 626 consecutive patients, mean age 61±8 years (86% men), in a follow-up (median: 58 months) with a complete questionnaire about cardiosurgical problems (post-operative vital status, angine relapse, infarction, heart failure, PTCA, redo, PM) and psychosocial variables (mood, irritableness, job satisfaction, hobby satisfaction, family relations, sexual activity, general well-being and work status). Global evaluation improvement of psychosocial variables was found in 71% of patients without cardiac events (group A) and 11% of patients with cardiac events (group B); worsening was found in 2% of group A and 1% of group B; no referred variations in 13% and 2% respectively (p0.05. Interests (in work, hobbies and sexual activities) demonstrate an improvement in 20% (group A) and 2% (group B); worsening in 12% (group A) and 4% (group B); no variations in 51% (group A) and 11% (group B) (p0.005). Patients reported a well-being evaluation improvement about 66% in the group returning to work without restriction, 13% in those with limitation, 6% no further working; worse or unchanged well-being evaluation was found in 9% of patients returning to work without restriction, 3% with limitation, 3% no further working (p0.001). In the last 2 years we have collected pre-operative and post-operative data in a sample of 58 patients by using standardized self-evaluated rating scales about state and trait anxiety (STAI X1, STAI X2), depression (ZUNG) and quality of life, examining social relationships, interests and affective disturbances. Trait anxiety had no change (T0=38.69±9.20 vs. T1=38.75±9.90; n.s.); state anxiety improved (T0=41.20±9.30 vs. T1=38.34±9.68;p0.018); depression had significantly worsened (T0=37.90±7.59 vs. T1=46.65±4.75;p0.0005). No statistical differences emerged between pre-operative and post-operative self-evaluation of the quality of life. Cardiac events were reported in 7 out of 58 patients (group B: 12%); these patients were characterized by significantly higher levels of state anxiety than group A patients at the pre-operative evaluation (group A: 39.9±8.2; group B: 49.6±11.8;t=0.933; df=56;p0.005) and at the post-operative evaluations (group A: 36.7±8.4; group B: 48.7±11.4;t=–3.6; df=56;p0.001). The trait anxiety was significantly lower at the postoperative control in the group A patients than in the group B (group A: 37.5±9.3; group B: 46.9±10.5;t=–2.602; df=56;p0.012). The pre-operative depression of group B was higher than group A (group A: 37.1±7.6; group B: 43.1±5.5;t=–2.155; df=56;p0.035). The discordance between the improvement of subjective global evaluation versus the worsening of depression (ZUNG Scale) can be related to the importance of physical improvement as much as to some psychosocial variables. Further hypotheses can be represented by the influence of a short pre-operative period in our institution (maximum 30 days) on anxiety and depression levels, the difference between pre-surgical and post-surgical expectations, the removal of pre-operative psychological state; the stress related to psychosocial reintegration etc. In our opinion, taking into consideration the results of the sample of 58 patients, a high level of pre-operative state anxiety and depression and a post-operative higher status of anxiety could be considered as a possible predictor of functional cardiac complications.     

Cardiorespiratory and thermal effects of wearing gas protective clothing

Summary Six healthy men aged 25 to 37 walked on a treadmill at work levels of 21 and 41% of their for 25 to 30 min wearing gas protective clothing (GPC) consisting of an impermeable suit with a self-contained breathing apparatus (total weight 25 kg) or shorts (control tests, CT) in a temperate environment (t _a 24.3°C ± 1.0°C, rh 30–50%). When the GPC was worn at 21 and 41% , the most prominent increases, compared with the CT, were noted in the heart rate ( ± SE, 120 ± 5 vs 76 ± 3 beats min^–1 and 171 ± 5 vs 103 ± 3 beats min^–1), mean skin temperature (36.1 ± 0.2 vs 31.3° C ± 0.1°C and 36.9 ± 0.3 vs 30.9°C ± 0.4°C) and sweat rate (473 ± 51 vs 70 ± 23 g m^–2 h^–1 and 766 ± 81 vs 135 ± 18 g m^–2 h^–1) indicating a high cardiovascular and thermoregulatory strain, which was not decreased by ventilating the suit with an air flow of 281 min^–1 at 41% . The ventilation, oxygen consumption and production of carbon dioxide increased in relation to the extra weight of the GPC, partly dependent on the dynamic work level. It was concluded that the increase in the physiological load caused by the GPC was so high that the work-rest regimens, workers' level of physical fitness, cardiovascular health and heat tolerance should be considered whenever gas protective clothing is used.     

Evaluation of Wetland and Tertiary Wastewater Treatments for Estrogenicity Using <Emphasis Type="Italic">In Vivo</Emphasis> and <Emphasis Type="Italic">In Vitro</Emphasis> Assays

The effects of wetland wastewater treatment on estrogenic activity and estrogenic activity of water after tertiary treatment were evaluated using in vivo (rainbow trout vitellogenin [VTG] expression) and in vitro (yeast estrogen screening) assays. Juvenile rainbow trout exposed to tertiary-treated wastewater from the Green Acres Treatment Plant in Orange County Water District had increased plasma VTG levels compared with control fish. When trout were exposed to wastewater-dominated water before it entered into Prado Wetland (Riverside County, CA), VTG concentrations were increased above those of controls and were not significantly different from fish exposed to water exiting the wetland. VTG E2-equivalent concentrations (EEQs) of the water samples from the Green Acres Plant were 16.92±16.49 ng/L. Activity of water entering Prado Wetland was 29.80±28.41 ng/L EEQ, and water exiting was 24.34±23.17 ng/L EEQ. In vitro assays estimated that estrogenic activity of water from the Green Acres Plant was <1 ng/L EEQ, whereas water entering and exiting Prado Wetland had yeast estrogen screening EEQs of 2.57 and <1 ng/L, respectively. Our results suggest that environmental estrogens that are not potent estrogen-receptor ligands exist in wastewaters from the Green Acres Plant as well as water entering and exiting Prado Wetland. Wetland treatment did not remove environmental estrogens in the water. Our results also suggest that in vitro assays may underestimate estrogenic activity of sampled water.     

Feasibility studies to control acute diarrhoea in children by feeding fermented milk preparations Actimel and Indian Dahi

The aim of this work was to study feasibility of diarrhoea control in children (6 months to 5 y of age) by feeding fermented milk preparations. The design used was a randomized controlled clinical trial and the study was carried out at the Delhi University College Hospital providing tertiary care, and a nearby community centre Nand Nagri, a resettlement colony in East Delhi. Children suffering from acute diarrhoea (75 patients from the hospital and 75 from the community) were allocated to three groups by double-blind technique. Group 1 was given a fermented milk, Actimel, containing 10(8) of each Lactobacillus casei DN-114001, Lactobacillus bulgaricus and Streptococcus thermophilus per gram. Group 2 was given Indian Dahi (Lf 40) containing 10(8) of each Lactococcus lactis, Lactococcus lactis cremoris and Leuconostac mesenteroides cremoris per gram. Group 3 was given ultra-heat-treated yoghurt preparation (no live bacteria). Actimel was also used as a starter to prepare the curd in order to study the preventive effect of diarrhoea in children in a community. In the hospital study Indian Dahi and Actimel administration reduced mean duration of diarrhoea by 0.3 and 0.6 day (P<0.001), respectively. The corresponding figures in the community study were 0.2 and 0.5 day (P<0.05), respectively. The families using Actimel as a starter showed a reduction in diarrhoeal morbidity episodes by 40% of the children tested in a 3 month follow-up. In conclusion, Actimel, fermented milk containing Lactobacillus casei DN-114001, and Indian Dahi can significantly reduce the duration of diarrhoea in children; the former preparation being superior.     

Copper/Metal Ratios in the Gills of Rainbow Trout (Oncorhynchus mykiss) Provide Evidence of Copper Exposure Under Conditions of Mixed-Metal Exposure

Previous work has suggested that the ratio of copper residues to zinc in the gills of rainbow trout may indicate short-term exposure to increased levels of waterborne copper. However, the effect of exposure to a combination of increased copper and zinc concentrates in the water column was unknown. We exposed rainbow trout to 8 ± 2 g L^–1, 40 ± 2 g L^–1 and 90 ± 9 g L^–1 of waterborne copper and 21 ± 3 g L^–1, 129 ± 40 g L^–1, and 202 ± 40 g L^–1 of waterborne zinc in a 2-factor experiments and gill copper and zinc residues were examined. Other gill parameters analyzed included the concentrations of calcium, magnesium, sodium, and potassium, liver copper and zinc concentrations and plasma copper, calcium, sodium, and potassium are also reported here. Copper residues in the gill filaments were significantly higher in the highest level of copper exposure (high Cu, 4.06 g g^–1; low Cu 2.41 g g^–1; 0 Cu 2.01 g g^–1; P = 0.001), whereas no differences were seen in zinc concentrations at any treatment level. Gill sodium and plasma calcium concentrations were also decreased at the highest waterborne copper concentrations. Although copper–zinc ratios in the gills were significantly different between the highest and lowest copper treatments (P = 0.002, F = 6.59), copper–sodium and copper–magnesium ratios were more sensitive to waterborne copper exposure (P = 0.001, F = 17.91 and P = 0.002, F = 15.45, respectively). These copper–metal ratios may be better indicators of copper loading in the water column.     

Training to Reduce Postural Sway and Increase Functional Reach in the Elderly

Poor balance is one of the most common risk factors for falling, a common cause of work-related injury and death. To evaluate the effects of a 10-week intervention program on balance in older adults, 12 participants aged 61–77 years (age = 70.4 ± 5.4 years; mean ± SD) completed an exercise program (60 min, 2 days · week^–1 for 10 weeks) performed while laying/sitting on large air-filled exercise balls (Thera-Band®). Several postural sway composite scores (determined while standing with feet apart and semitandem, eyes open and closed) improved (p 0.05) including medial–lateral amplitude and speed of sway (reduced by 9%), and instantaneous speed (reduced by 13%). Reductions in XY area approached (p = 0.06) statistical significance and anterior–posterior amplitude and speed of sway did not change. Functional reach also improved (20.3%). These results suggest that challenging the physiological systems involved in balance control while on the nonstable support surface of the exercise balls improves both static and dynamic balance in older adults and may reduce the risk for falling.     

Cadmium uptake and depuration in different organs ofLymnaea stagnalis L. and the effect of cadmium on the natural zinc level

The uptake of cadmium (0.1 mg/L) into various organs of the pond snailLymnaea stagnalis L., the depuration of accumulated Cd, and the change in the natural Zn level under the influence of Cd treatment were investigated during a 2 month period. The snails were fed with lettuce (Latuca sativa). The concentrations of Cd were measured in the whole soft body, various organs (liver, viscera, foot), the shell and the lettuce; and zinc concentrations were measured in various organs and the lettuce. As its Cd concentration remained at 10 g/g, which was much lower than the initial value for the soft body (69.4±5.71 g/g), the shell, according to our results, is incapable of accumulating Cd. The uptake pattern of the soft body showed a correlation with the initial Cd levels depending on differences in the Cd concentration of the lettuce. At the higher initial value (69.4±5.71 g/g) the linear Cd uptake began later then it did at the lower initial value; afterwards the snail was saturated with Cd. In the case of the lower, 9.02±1.3 g/g initial concentration, a rapid linear Cd uptake occurred till the 7th day, then the intensity of the uptake decreased. Saturation occurred at 200 g/g Cd concentration, regardless of the initial value. At the lower initial tissue level, the foot and the viscera showed a linear uptake pattern, while the liver, which has the greatest accumulation ability, displayed a logarithmic uptake pattern. The initial and the final Cd concentrations in the foot, viscera, and liver of theL. stagnalis were as follows: 10.3±2.15–60.1±7.13, 5.15±1.04–156±27.2, 14.1±3.09–430±23.3 g/g respectively. The bioconcentration factors (CF) were in the 10² (foot) and 10³ (viscera, liver, soft body) orders of magnitude. Forty to 45% of the accumulated Cd was depurated in Cd-free tap water; during the first three days of the uptake period, a negative linear correlation was found between Cd and Zn levels in the snail organs.     

Cadmium and zinc accumulation and elimination by freshwater crayfish

A theoretical compartment model for the uptake of Cd and Zn by the freshwater crayfish,Procambarus acutus acutus (Girard), was constructed, and included a factorially designed experiment to study the relative importance of food and water as uptake vectors for¹⁰⁹Cd and⁶⁵Zn. Food and water were important pathways for Cd accumulation and the two uptake vectors were first order, independent, and additive. The rate of Cd elimination was not significantly different from zero during either the uptake or depuration phases. Rate constants for uptake from 5 and 10 g Cd · L^–1, calculated on a concentration basis, were 0.84 ± 0.031 and 0.83 ± 0.029 day^–1, respectively. Although there was no measurable Cd elimination, crayfish reached a steady state concentration of about 12.5g Cd · g^–1, dry weight. A small amount of Zn was accumulated via food, relative to that accumulated from water; the former had a much longer retention time than the latter, which was lost rapidly. When Zn in food was the only source, steady state was reached rapidly; Zn accumulation from food and water was not additive. Zn accumulated from water, reached no steady state. Zn uptake was proportional to water concentrations within the fed treatment groups and those not fed Zn-contaminated food. Zn elimination was first order to Zn concentration in the crayfish. Rate constants for Zn accumulation from 50 and 100 g Zn · L^–1 when fed Zn-contaminated food were 1.34 ± 0.064 and 1.46 ± 0.073 day^–1 (estimate ± 95% CI based on concentration), respectively, while rate constants for Zn elimination were 0.034 ±0.0021 and 0.05 ± 0.0032, respectively.