In vitro cytotoxic effects of secondary metabolites of DEHP and its alternative plasticizers DINCH and DINP on a L929 cell line

Background

Phthalic acid esters are widely used to improve the plasticity of PVC in medical devices (MD). The most famous plasticizer is DEHP, whose use in medical devices has been contested by the European authorities since 2008. Several alternative plasticizers are being considered to replace DEHP, such as DEHT, TOTM, DINP or DINCH, but they are also released from the PVC throughout their life cycle and are metabolized in the same way as DEHP.

Epidemiological assessment of predictors of caries increment in 7-10-year-olds: a 2-year cohort study

Objective

The aim of this 2-year cohort study (2003 to 2005) was to investigate how caries experience, at initial lesions (early or non-cavited lesions) and cavited stages, predicts caries increment in permanent teeth in 7-10- year-olds.

Material and Methods

The random sample of 765 children attending public schools in the city of Piracicaba, SP, Brazil, was divided into two groups: 423 children aged 7-8 years and 342 children aged 9-10 years. All subjects were examined by a calibrated examiner, using dental mirror and ball-ended probes, after tooth brushing and air-drying in an outdoor setting, based on the World Health Organization criteria. Active caries with intact surfaces were also recorded as initial lesion (IL). Univariate analysis was used for statistical analysis (Odds Ratios and Chisquare).

Results

The association between the DMFT (decayed, missing and filled teeth) increment and the presence of IL was significant only for 9-10-year-old children. The children with DMFT>0 at baseline were more prone to have DMFT increment, with the highest risk for caries increment occurring in children aged 7-8 years.

Conclusion

The predictors of caries increment were the presence (at baseline) of caries experience in permanent teeth for both age groups (7-8; 9-10-year-olds) and the presence of the IL (at baseline) for 9-10-year-olds.     

Western Osteoporosis Alliance Clinical Practice Series: Evaluating the Balance of Benefits and Risks of Long-Term Osteoporosis Therapies

Osteoporosis is a chronic disease that requires life-long strategies to reduce fracture risk. Few trials have investigated the balance of benefits and risk with long-term use of osteoporosis therapies, and fewer still have investigated the consequences of treatment discontinuation. The best available evidence suggests that up to 10 years of treatment with an oral bisphosphonate maintains the degree of fracture risk reduction observed in the 3-year registration trials. With denosumab, 10 years of therapy appears to provide fracture risk reduction similar to or better than that observed in the 3-year registration trial. Available data suggest an increasing but low risk of fractures with atypical features with increasing duration of bisphosphonate therapy. Published data linking duration of therapy to osteonecrosis of the jaw are lacking for bisphosphonates and denosumab. Other side effects associated with denosumab or bisphosphonates do not appear to be related to therapy duration. The antifracture benefits of long-term therapy with bisphosphonates and denosumab in appropriately selected patients outweigh the low risk of serious side effects.     

Current leakage in hemodialysis machines may be a safety risk for patients

During hemodialysis, the dialysis fluid is conductive and allows current to flow from or to the machine if a difference in electrical potential occurs. This may cause a health risk for the patient. We investigated the presence of such current during various conditions in 17 dialysis machines: the Gambro AK10 (n = 5) and AK100 (n = 3), and the Fresenius 2008C (n = 3), 2008E (n = 2), and 4008E (n = 4). Current leakage measurements were performed without connection of the patient to the system by using a copper tube inserted into the stream of the dialysis fluid at the point where the patient would normally be connected to the dialyzer. The current leakage (measured in microA) at the ground site was significantly higher for the AK10 and the 2008C than for the AK100, 2008E, and 4008E machines. The current leakage, at the site where the dialyzer is located, was highest for the AK10 and less for the AK100, 2008C, 2008E, and 4008E. The 2008C and 2008E dialyzers had the highest maximal current leakage when a malfunctioning external device was attached while the AK100 had less and the AK10 had the least leakage. There was a great variation in leakage current among the dialysis machines. The greatest risk occurred when the patient also was connected to other electric devices with current leakage.     

Zum Risiko von Simultaneingriffen bei Colon- und Rectumoperationen

Zusammenfassung In der Klinik für Abdominal- und Transplantationschirurgie der Medizinischen Hochschule Hannover wurden in einem Zeitraum von 4 Jahren bei 56 Patienten mit Colon- und Rectumoperationen 63 Simultaneingriffe durchgeführt. Durch den Vergleich mit einer Patientengruppe, bei der die entsprechenden Operationen als Einzeleingriffe vorgenommen worden waren, wurde die Risikosteigerung durch Simultaneingriffe untersucht. Simultaneingriffe mit kleinem Operationstrauma zeigten keine Risikosteigerung, während mittlere Eingriffe wie Cholecystectomie oder Prostatectomie eine deutliche Erhöhung des Operationstraumas darstellten, jedoch ohne signifikante Beeinflussung der Komplikationsrate. Entsprechend diesen Ergebnissen werden Empfehlungen zur Durchführung und Indikationstellung von Simultaneingriffen bei Colon- und Rectumoperationen angegeben.

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Risk of combined surgical procedures in operations of colon and rectum

Summary In a period of 4 years in the Clinic of Abdominal- and Transplantationsurgery of the Medical School Hannover 63 combined surgical procedures were performed in 56 patients with operations of colon and rectum. In comparison with a group of patients, who were treated with similar operations as a single procedure, the increase of risk was studied. Small combined procedures like appendectomia, herniotomia, exstirpation of cysts or removal of diverticula indicate no elevation of the operative risk.Cholecystectomy or prostatectomy, though increasing the entire trauma of operation, did not elevate the rate of complications significantly.In accordance with our results outlines regarding the performance and indication of operations in combination with colon- and rectum surgery are discribed.

     

The acceptability of combined oral hormonal contraceptives in Shanghai,People's Republic of China

Although combined oral hormonal contraceptives have been described as the most significant medical advance of the 20th century, the usage rate in the People's Republic of China is considerably lower than in developed countries. This survey aimed to explore the acceptability of combined oral hormonal contraceptives (COC) amongst women aged 18-35 years who attended the family planning clinic in the International Peace Maternity and Child Health Hospital in Shanghai, as well as amongst gynecologists who worked in the same hospital. In total, 500 clients and 89 gynecologists were recruited. Only 12% of the clients had ever used COC. Women with a lower educational level or parous women were more likely to use COC (p < 0.05). COC was the third most popular method recommended by the gynecologists (85.4%). Both groups were concerned about the risks and side effects of COC, especially younger doctors and doctors with fewer years of experience (p < 0.01). The results of the survey suggest that it is necessary to provide improved training about COC to reproductive-aged women and professionals to dispel misunderstandings of the pill.