Health effects and risks from 222Rn in drinking water

This paper presents an evaluation of the inhalation and ingestion doses from exposure to Rn and Rn progeny; an overview of the human and animal health-effects data; estimations of the cancer risks from Rn and Rn-progeny exposures; and suggested limits for Rn concentrations in drinking water and indoor air. We suggest that a rounded Rn-in-water concentration limit of 10,000 pCi/l can be supported by health-effects considerations alone, based on the conservative "tolerance dose" concept and other conservative assumptions regarding lung dose. A practical concentration limit (or action level) of 20,000 pCi/l has been derived by estimations of exposure distributions in the United States and in relation to current U.S. Environmental Protection Agency (EPA) standards for U-tailings-contaminated buildings. Research needed for resolution of the uncertainties in these estimates is suggested. We conclude that before a maximum contaminant level (MCL) for Rn in water can be firmly established, the broader issue of setting the MCL for Rn in indoor air must be addressed.     

Family planning increase in some African countries

Governments in sub-Saharan Africa, recognizing the economic and health benefits of slower population growth, have begun to adopt explicit policies aimed at reducing growth rates. More countries also are providing support to family planning programs. In 1985, more than 70% of the 402 million people living in sub-Saharan Africa lived in countries which have government-supported family planning programs. Yet, the coverage of many of these programs has been and remains limited. Reflecting low demand as well as problems in supplying contraceptive services, results from national-level surveys conducted in 10 countries between 1977-82 as part of the World Fertility Survey (WFS) program showed that approximately 5% of the currently married women aged 15-49 in these countries were using contraceptive methods. More encouraging are the results of surveys conducted in Botswana, Kenya, and Zimbabwe in 1984 as part of the international Contraceptive Prevalence Survey (CPS) program which demonstrate that family planning programs in Africa can be very successful. The CPS data show that substantial proportions of currently married women aged 15-49 in all 3 countries are currently practicing family planning. The level of current use of contraception reported in the CPSs in Botswana, Kenya, and Zimbabwe lay to rest the myth that women in sub-Saharan Africa are unwilling to use family planning. The majority of current users in all 3 countries use modern contraceptive methods. Most nonusers in the 3 countries know at least 1 family planning method. Male approval of family planning also seems to be common, although men are reported to be somewhat more likely than their wives to disapprove of family planning. Despite the fact that there is relatively widespread adoption of modern contraceptive method in Zimbabwe and Botswana as well as an increasing reliance on family planning methods in Kenya, the CPS results show that women in these 3 countries continue to have and want large families. The mean number of children ever born to women aged 45-49 ranges from 6.8 children in Botswana to 8.2 children in Kenya. Interest in planning their families is widespread among women in the 3 countries despite the high fertility expectations.     

The Potential of Anti-Bullying Efforts to Prevent Academic Failure and Youth Crime. A Case Using the Olweus Bullying Prevention Program (OBPP)

Prevention Science - The effectiveness of bullying prevention programs has led to expectations that these programs could have effects beyond their primary goals. By reducing the number of victims...     

Projected Economic Burden of Periprosthetic Joint Infection of the Hip and Knee in the United States

BackgroundIn addition to the significant morbidity and mortality associated with periprosthetic joint infection (PJI), the cost of treating PJI is substantial. Prior high-quality national estimates of the economic burden of PJI utilize data up to 2009 to project PJI growth in the United States through 2020. Now in the year 2020, it is appropriate to evaluate these past projections and incorporate the latest available data to better understand the current scale and burden of PJI in the United States.MethodsThe Nationwide Inpatient Sample (2002-2017) was used to identify rates and associated inpatient costs for primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) and PJI-related revision TKA and THA. Poisson regression was utilized to model past growth and project future rates and cost of PJI of the hip and knee.ResultsUsing the most recent data, the combined annual hospital costs related to PJI of the hip and knee were estimated to be $1.85 billion by 2030. This includes $753.4 million for THA PJI and $1.1 billion for TKA PJI, in that year. Increases in PJI costs are mainly attributable to increases in volume. Although the growth in incidence of primary THA and TKA has slowed in recent years, the incidence of PJI and the cost per case of PJI remained relatively constant from 2002 to 2017.DiscussionUnderstanding the current and potential future financial burden of PJI for surgeons, patients, and healthcare systems is essential. There is an urgent need for efficacious preventive strategies in reducing rates of PJI after THA and TKA.     

健脾益气活血化瘀法对Ⅱ型糖尿病的治疗作用

作者将Ⅱ型糖尿病伴高粘滞血症患者61例随机分为A、B、C、D四组,分别予以降糖灵(A组)、健脾益气方Ⅰ(B组)、活血化瘀方Ⅱ(C组)和方Ⅰ合方Ⅱ(D组)治疗四周,观察其治疗前后血糖、血胰岛素及血液流变学的改变。结果发现,活血化瘀(方Ⅱ)有增强健脾益气(方Ⅰ)的降糖作用。认为其降糖机理除增进周围组织对葡萄糖的利用外,尚具有促进胰岛β细胞分泌胰岛素的作用,推测至少与组织血液循环的改善有关。     

The surgical anatomy of the superior gluteal nerve and anatomical radiologic bases of the direct lateral approach to the hip

Summary In view of the increasing popularity of the direct lateral approach to the hip joint for hemi- or total hip arthroplasty, the location of the superior gluteal nerve (SGN) was studied. This nerve is in danger when using a transgluteal incision. In 20 embalmed specimens the relation of the SGN to the tip of the greater trochanter (TT) was studied as well as the relation to the iliac crest. For this purpose macroscopy, microscopy and CT were used. In 13 hips a so-called most inferior branch was found at an average of 1 cm distal to the inferior branch, the main trunk of the nerve. There was substantial variation in the course of both the inferior and the most inferior branch of the SGN. In order to prevent nerve damage, proximal extension of the transgluteal incision should be limited to 3 cm cranial to TT. Furthermore the incision has to be confined to the distal one third of the distance TT-iliac crest. In tall people extra care should be taken.

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Anatomie chirurgicale du nerf glutéal supérieur et bases anatomo-radiologiques de l'abord latéral direct de la hanche

Résumé Les recours de plus en plus fréquent à la voie latérale directe de la hanche pour les prothèses totales ou cervico céphaliques nous a conduit à étudier la localisation du nerf glutéal supérieur (SGN) qui est exposé lors de l'incision transglutéale. Les rapports du SGN avec le sommet du grand trochanter (TT) et avec la crête iliaque ont été étudiés sur 20 cadavres embaumés. Nous avons eu recours à l'étude macroscopique, microscopique ainsi qu'au scanner. Dans 13 cas nous avons mis en évidence une branche très inférieure, donc plus distale, située 1 cm en moyenne en dessous de la branche inférieure habituelle de bifurcation du tronc principal. Il existait des variations importantes dans les trajets de ces deux branches inférieures. Afin de prévenir une lésion chirurgicale du nerf, l'incision transglutéale ne doit pas aller au delà de 3 cm du sommet du grand trochanter, de plus l'incision doit être confinée en dessous du tiers distal de la ligne joignant le grand trochanter à la crête iliaque.

     

Big brother

Both purchasers and providers will need to change the way they hold patient records on computer, or they could find themselves in breach of the law. Michael Cross examines a report by the Data Protection Registrar.