Impact of housing conditions on the health of the people at al-Ama'ri refugee camp in the West Bank of Palestine

Al-Ama'ri camp is situated to the south of Ramallah city in the West Bank of Palestine. It is densely populated, with a total population of 4046, divided into 760 households, on a surface area of 93 dunums (93000 m(2)). In this research, the relationship between the housing conditions at Ama'ri camp and the prevalence and incidence rates of upper respiratory tract diseases has been studied. The diseases and symptoms most encountered in winter, and those include: common cold, cough, pharyngitis, influenza, ear infection, asthma and bronchitis have been studied. It was found that these are diseases directly related to poor housing conditions. Cold housing, presence of dampness and moulds, dust and smoke, burning of biomass fuel, crowding, poor ventilation and inadequate lighting problems are commonly found in the houses of this refugee camp.     

Liposomal amphotericin B versus the combination of fluconazole and itraconazole as prophylaxis for invasive fungal infections during induction chemotherapy for patients with acute myelogenous leukemia and myelodysplastic syndrome

BACKGROUND: Fungal infections are a major cause of morbidity and mortality in patients undergoing induction chemotherapy for acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The authors evaluated the efficacy and toxicity of liposomal amphotericin B (L-AmB) compared with a combination of fluconazole plus itraconazole (F+I) as prophylaxis in this setting. METHODS: Patients with newly diagnosed AML or high-risk MDS who were undergoing initial induction chemotherapy were randomized to receive either F+I (fluconazole 200 mg orally every 12 hours plus itraconazole tablets 200 mg orally every 12 hours) or L-AmB (3 mg/kg intravenously 3 times per week) in this prospective, open-label study. RESULTS: Seventy-two L-AmB-treated patients and 67 F+I-treated patients were enrolled in the study. Of these, 47% of patients completed antifungal prophylaxis without a change in therapy for proven or suspected fungal infection. Three patients in each arm developed a proven fungal infection. Twenty-three percent of the L-AmB-treated patients and 24% of the F+I-treated patients were changed to alternative antifungal therapy because of persistent fever (P value not significant). Nine percent of the L-AmB-treated patients developed pneumonia of unknown etiology compared with 16% of the F+I-treated patients (P value not significant). Increases in serum creatinine levels to > 2 mg/dL (20% for the L-AmB arm vs. 6% for the F+I arm; P = 0.012) and increases in serum bilirubin levels to > 2 mg/dL (43% vs. 22%, respectively; P = 0.021) were more common with L-AmB. Infusion-related reactions were noted in five L-AmB-treated patients. Responses to chemotherapy and induction mortality rates were similar for the two arms. CONCLUSIONS: L-AmB and F+I appear similar in their efficacy as antifungal prophylaxis during induction chemotherapy for patients with AML and MDS. L-AmB was associated with higher rates of increased serum bilirubin and creatinine levels.     

Enecphalocele: 26 retrospective cases at the Maternal and Neonatal Center of La Rabta, Tunis

Encephalocel is leff frequent than spina bifida and anencephalia. Its incidence is 0.25@1000 births. It concern as much female than male. This neural defect is frequency associated to others malformations face (20%) squelette (17%), kidney (13%). In our study the ultra sound is performant in 82% of the cases. Encephalocel is still a lethal and severe abnormality.     

Risk of bioaerosol contamination with Aspergillus species before and after cleaning in rooms filtered with high-efficiency particulate air filters that house patients with hematologic malignancy.

OBJECTIVE: To examine the impact of cleaning and directional airflow on environmental contamination with Aspergillus species in hospital rooms filtered with high-efficiency particulate air (HEPA) filters that house patients with hematologic malignancy. DESIGN: Detailed environmental assessment. SETTING: A 475-bed tertiary cancer center in the southern United States. METHODS: From April to October 2004, 1,258 surface samples and 627 bioaerosol samples were obtained from 74 HEPA-filtered rooms (in addition, 88 outdoor bioaerosol samples were obtained). Samples were collected from rooms cleaned within 1 hour after patient discharge and from rooms before cleaning. Positive and negative airflows were evaluated using air-current tubes at entrances to patient rooms. RESULTS: Of 1,258 surface samples, 3.3% were positive for Aspergillus species. Univariate analysis showed no relationship between cleaning status and occurrence of Aspergillus species. Of 627 bioaerosol samples, 7.3% were positive for Aspergillus species. Multiple logistic analysis revealed independently significant associations with detection of Aspergillus species. Cleaned rooms positive for Aspergillus species had a higher geometric mean density of colonies than that of rooms sampled before cleaning (18.9 vs 5.5 colony-forming units [cfu] per cubic meter; P=.0047). Rooms with positive airflow had a detection rate for bioaerosol samples equivalent to that of rooms with negative airflow (7.3% vs 7.8%; P=.8). There was no significant difference in the density of Aspergillus species between rooms with negative airflow and rooms with positive airflow (12.5 vs 8.4 cfu/m(3); P=.33). CONCLUSIONS: Concentration of bioaerosol contamination with Aspergillus species was increased in rooms sampled 1 hour after cleaning compared with rooms sampled before cleaning, suggesting a possible correlation between re-entrained bioaerosols (ie, those suspended by activity in the room) after cleaning and the risk of nosocomial invasive aspergillosis.     

Depression impairs learning,whereas the selective serotonin reuptake inhibitor,paroxetine, impairs generalization in patients with major depressive disorder

To better understand how medication status and task demands affect cognition in major depressive disorder (MDD), we evaluated medication-naïve patients with MDD, medicated patients with MDD receiving the selective serotonin reuptake inhibitors (SSRI) paroxetine, and healthy controls. All three groups were administered a computer-based cognitive task with two phases, an initial phase in which a sequence is learned through reward-based feedback (which our prior studies suggest is striatal-dependent), followed by a generalization phase that involves a change in the context where learned rules are to be applied (which our prior studies suggest is hippocampal-region dependent). Medication-naïve MDD patients were slow to learn the initial sequence but were normal on subsequent generalization of that learning. In contrast, medicated patients learned the initial sequence normally, but were impaired at the generalization phase. We argue that these data suggest (i) an MDD-related impairment in striatal-dependent sequence learning which can be remediated by SSRIs and (ii) an SSRI-induced impairment in hippocampal-dependent generalization of past learning to novel contexts, not otherwise seen in the medication-naïve MDD group. Thus, SSRIs might have a beneficial effect on striatal function required for sequence learning, but a detrimental effect on the hippocampus and other medial temporal lobe structures is critical for generalization.     

Durability of Anti-Infective Effect of Long-Term Silicone Sheath Catheters Impregnated with Antimicrobial Agents

This study was performed to test the long-term antimicrobial efficacy of impregnated silicone catheters comprising an antimicrobial layer sandwiched between an external surface sheath and a luminal surface silicone sheath. The design of the catheter permits the introduction of various antimicrobials in addition to anticoagulants or antifibrins in the antimicrobial layer and allows their gradual release over a period of months after insertion. The in vitro data presented show that the catheter can provide antimicrobial activity for 90 days, after being replated for 15 7-day cycles of replating. When the catheters were immersed in human serum and incubated at 37 degrees C, they demonstrated significant antimicrobial activity after more than 325 days of incubation. The significant long-term in vitro antimicrobial activity observed may imply effective in vivo activity for almost 1 year after insertion and could serve as a cost-effective alternative to surgically implantable silicone catheters.     

A biotin-avidin-based enzyme immunoassay to quantify three phytohormones: auxin, abscisic acid and zeatin-riboside

Avidin-biotin complexes have been used in an ELISA assay of three phytohormones: auxin (IAA), abscisic acid (ABA) and zeatin-riboside (ZR). Anti-hormone antibodies were elicited in rabbits immunized with hormone-bovine serum albumin conjugates. Microtitration plates coated with antigen protein were used in the ELISA method. The competition between plate-bound and free (standards or samples) antigen for a limiting amount of specific antibody results in a variable level of antibody adsorbed to the wells after washes. Such antibodies were labelled in two steps: first, incubation with biotinylated goat anti-rabbit IgG and, second, incubation with avidin-alkaline phosphatase conjugate. Bound ezyme activity was measured spectrophotometrically with p-nitrophenylphosphate and standard curves and ZR. The detection limit was 3–5 pg of plant hormone and the working range was between 10–1000 pg. This compares favourably with the best systems of analysis described in the literature. To avoid unwanted cross-reactions, a rapid and efficient HPLC purification step was included prior to measuring IAA, ABA and ZR in the same plant extract. About 100 mg fresh weight of a tomato sample could be analyzed by this technique.