Health Risk Assessment Related to Dermal Exposure of Chlorpyrifos: A Case Study of Rice Growing Farmers in Nakhon Nayok Province,Central Thailand

To date, pesticides, especially organophosphate pesticide such as chlorpyrifos, have been frequently applied to paddy fields over time to maintain product quality, protect agricultural crops from various pests, and increase yield. This study evaluates dermal exposure to chlorpyrifos in rice farmers along with providing a health risk assessment. Thirty-five rice farmers participated and completed an in-person interview, and patch technique was used to evaluate dermal exposure to chlorpyrifos. The chlorpyrifos residue was extracted from the gauze patches and quantified by gas chromatography equipped with flame photometric detector (GC-FPD). The results showed that chlorpyrifos concentrations were greater in males (526.34 ± 478.84 mg/kg) than females (500.75 ± 595.15 mg/kg). Average daily dose sampled from seven points on male and female farmers were 31.72 × 10^?4, 193.32 × 10^?4, 5.38 × 10^?4, 190.48 × 10^?4, 170.47 × 10^?4, 465.91 × 10^?4, and 43.04 × 10^?4 mg/kg-day. The hazard quotient (HQ) at the mean and 95th percentile level was found to be greater than acceptable (HQ > 1). Rice-growing farmers in this area may be at risk for adverse health effects due to continuous dermal exposure to chlorpyrifos from their improper use of personal protective equipment (PPE).     

Post-traumatic stress disorder (PTSD) is not a contraindication to gastric bypass in veterans with morbid obesity

Background  

The veteran population is routinely screened for post-traumatic stress disorder (PTSD). The prevalence of obesity in this population continues to increase. We examined whether weight loss outcomes in veterans with PTSD is comparable to results in veterans who do not suffer from PTSD, after gastric bypass. We also examined the effect of bariatric surgery on PTSD symptoms.     

Combining etanercept with traditional agents in the treatment of psoriasis: a review of the clinical evidence

Psoriasis is a chronic, systemic inflammatory disorder manifesting primarily in skin and potentially in joints, frequently necessitating treatment with conventional systemic therapies, phototherapy or biological agents. Patients with moderate to severe disease suffer a diminished quality of life, experience significant comorbidities and have a higher mortality. Although traditional treatments are effective in the short‐term, their use is often limited by concerns over long‐term toxicity, including end‐organ damage and risk of malignancy. Combination therapy is a commonly used approach and is often more effective than any single agent. Lower doses of two treatments in combination can also minimize potential side effects from a single agent at higher doses. Etanercept is a recombinant human tumour necrosis factor (TNF)α receptor (p75) protein fused with the Fc portion of IgG1 that binds to TNFα. This article reviews the evidence on the efficacy and safety of etanercept in combination with methotrexate, acitretin, narrowband UVB and cyclosporin. The largest body of evidence assesses the combination with methotrexate, although evidence is available for the other combinations. Data suggest that although highly effective as monotherapy, etanercept in combination with a conventional systemic agent can enhance efficacy and allow drug sparing. Potentially, the combination may also result in faster treatment responses and permit safe transitioning from one systemic agent to another. Evidence to date suggests that these benefits can be achieved without significant additional toxicity, although long‐term data on the efficacy and safety of the combination in psoriatic populations is limited and further evaluation is warranted.