Exposure to PCBs and p,p'-DDE and human sperm chromatin integrity

Persistent organochlorine pollutants (POPs) such as polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (p,p'-DDE), the major metabolite of dichlorodiphenyltrichloroethane (DDT), are stable lipophilic compounds widely found in the environment and in the general population. They can enter the food chain, and their negative impact on male reproduction is currently under active scrutiny. To explore the hypothesis that environmental exposure to these compounds is associated with altered sperm chromatin structure integrity in human sperm, we conducted a study of 176 Swedish fishermen (with low and high consumption of fatty fish, a very important exposure source of POPs). We determined serum levels of 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and p,p'-DDE, and we used the sperm chromatin structure assay (SCSA) to assess sperm DNA/chromatin integrity. When CB-153 serum levels (individual dose range, 39-1,460 ng/g lipid) were categorized into equally sized quintiles, we found an association with the DNA fragmentation index (%DFI). A significantly lower %DFI was found in the lowest CB-153 quintile (< 113 ng/g lipid) compared with the other quintiles; there was a similar tendency, although not statistically significant, between %DFI and p,p'-DDE. These results suggest that POP exposure may have a slight negative impact on human sperm chromatin integrity.     

Organic dust induced inflammation--role of atopy and TLR-4 and CD14 gene polymorphisms

BACKGROUND: Polymorphisms in the genes controlling for CD14 and TLR-4 may influence the outcome of endotoxin-induced effects. MATERIALS AND METHODS: A study was performed on 146 workers in industries with exposure to organic dust containing endotoxin and 53 controls. Endotoxin exposure was measured at representative work sites. Inflammagenic markers, cytokines, and CD14 and TLR-4 polymorphisms were determined in blood. RESULTS: Among workers, serum levels of esinophilic cationic protein (ECP) were lower compared to controls and the proportion of atopics was lower. Atopic persons had lower levels of IL-6 and IL-8, both among controls and exposed. IL-6 and ECP values were lower among those with TLR-4 /+896 AG and GG polymorphisms as compared to AA. Among atopic workers with CD-14(-550) polymorphism CC, IL-8 was lower. COMMENTS: The results suggest that CD14 and TLR-4 polymorphisms influence regulators of the inflammation induced by endotoxin in organic dusts. Atopic persons have a lower secretion of certain inflammatory cytokines.     

Short-term systemic prophylaxis with cefoxitin and doxycycline in colorectal surgery: A prospective,randomized study

The efficacy of cefoxitin or doxycycline as antibiotic prophylaxis in colorectal surgery was compared in 102 elective operations. Both drugs were used perioperatively only. Cefoxitin was used in 55 cases and doxycycline in 47. Ten patients in the cefoxitin group and 4 in the doxycycline group had wound infections. Three intraabdominal abscesses were seen, one after cefoxitin and two after doxycycline prophylaxis. All three were due to anastomotic leakage. Bacteriologic studies revealed no negative ecologic effects of prophylaxis. The short-term prophylaxis used did protect against serious infectious complications. The extended spectrum of cefoxitin provided no added benefit in prophylaxis. Patients with inflammatory bowel disease treated preoperatively with salicylazosulfapyridine run a greater risk of postoperative infection in spite of the prophylaxis.     

Emergency contraceptive pills in Sweden: evaluation of an information campaign

OBJECTIVE: To evaluate a community-based intervention regarding emergency contraceptive pills, including a mass media campaign and information to women visiting family planning clinics. DESIGN: Quasi-experimental. SETTING: Two counties in Sweden. POPULATION: Eight hundred randomly selected women aged 16-30 years, 400 women in the intervention group and 400 in a comparison group. METHODS: Postal questionnaires before (2002) and after (2003) the intervention. MAIN OUTCOME MEASURES: Exposure to the intervention, knowledge, attitudes, practices and intention to use emergency contraceptive pills. RESULTS: Before the intervention, the response rate was 71% (n= 564); after the intervention, the corresponding figure was 83% (n= 467); overall response rate 58%. Two-thirds (64%) of the targeted women had noticed the information campaign. One out of six who had visited a family planning clinic during the intervention year recalled being given information about emergency contraceptive pills. Specific knowledge and attitudes improved over time in both groups, but there was no difference in change between the groups. The proportion of women who had used emergency contraceptive pills increased from 27% to 31% over time. Intention to use emergency contraceptive pills in case of need was reported by 74% of the women and remained stable over time, but logistic regression showed that information during the previous year contributed to willingness to use the method in the intervention group. CONCLUSIONS: Knowledge, attitudes and practices about emergency contraceptive pills increased in both groups. Emergency contraceptive pills is gradually becoming a more widely known, accepted and used contraceptive method in Sweden, a trend that may have limited the impact of the intervention.     

Movement pattern of the Exeter femoral stem; a radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years.

BACKGROUND: The design of the Exeter stem may facilitate distal migration, but radiostereometric analysis (RSA) studies have been limited to 2 years of follow-up. PATIENTS AND METHODS: We followed migration of the Exeter femoral stems in 22 primary hip arthroplasties for 5 years with RSA. RESULTS: All stems migrated distally and the median migration at 2 years was 1.34 mm, while at 5 years it was 1.77 mm. 7 stems migrated above accuracy between 3 and 5 years. (RSA) evaluation of the cement mantle could be performed in 14 cases, and in 5 slight migration was found. Most of the stems rotated towards retroversion and the median rotation at 2 years was 1.2 degrees, while at 5 years it was 1.6 degrees. We found 1 patient with impending clinical failure but no deviation in the RSA migration pattern, and 1 patient with unstable migration pattern but no clinical symptoms. INTERPRETATION: We found a greater distal migration of the Exeter stem for longer periods of time than seen with other types of cemented implants.     

Falls and Fall-Related Injuries Among the Elderly: A Survey of Residential-Care Facilities in a Swedish Municipality

Injurious falls among the elderly are an increasing public-health problem in Sweden. One group particularly vulnerable to falls consists of elderly people living in residential-care facilities. The purpose of this study was to investigate the extent to which falls lead to injury within a defined population of elderly people in institutionalized care. All the elderly persons living in residential-care facilities in an urban Swedish municipality during the year 1997 (n = 469 institutional places). Falls and fall-related injuries were registered over a one-year period. Data were gathered by personnel at the time of the falls, using a form specifically designed for surveillance purposes. Of the 865 falls reported during the study period, 375 were among men, with an average age of 82 years, and 490 among women, with an average age of 85 years. Men were subject to falling to a greater extent than women. The most common location was the individual's own bedroom. Injuries were incurred in approximately one in four falls, and the head was the body part most frequently injured. Only 24 falls (2.8%) resulted in a fracture, of which 18 were hip fractures. Although elderly people living in residential-care facilities fall fairly often, serious injuries, in the form of fractures, are incurred to a relatively limited extent.