Personal history,training, and worksite as predictors of back pain of nurses

Back pain among nurses is a common problem. Prior studies of this problem have been based on cross-sectional or retrospective data. This 18-month prospective study involving nurses newly graduated from nursing school investigated personal, worksite, and training factors associated with future risk of back pain. Each nurse underwent a preliminary interview and periodic follow-ups to identify those with back injuries. Contingency tables and logistic regression analyses demonstrated that prior significant back pain episodes (evidenced by previous job changes because of back pain, frequent medication use, etc.) were associated with increased future risk. Training at nursing school or on the job did not have a protective effect. This pilot study therefore suggests factors useful in placement and counseling of new nurses and indicates the need for further implementation of mechanical lift assist device use. © 1994 Wiley-Liss, Inc.     

Bed Bugs (Cimex lectularius) as Vectors of Trypanosoma cruzi

Populations of the common bed bug, Cimex lectularius, have recently undergone explosive growth. Bed bugs share many important traits with triatomine insects, but it remains unclear whether these similarities include the ability to transmit Trypanosoma cruzi, the etiologic agent of Chagas disease. Here, we show efficient and bidirectional transmission of T. cruzi between hosts and bed bugs in a laboratory environment. Most bed bugs that fed on experimentally infected mice acquired the parasite. A majority of previously uninfected mice became infected after a period of cohabitation with exposed bed bugs. T. cruzi was also transmitted to mice after the feces of infected bed bugs were applied directly to broken host skin. Quantitative bed bug defecation measures were similar to those of important triatomine vectors. Our findings suggest that the common bed bug may be a competent vector of T. cruzi and could pose a risk for vector-borne transmission of Chagas disease.     

Pancreatic Ectopia: a Case Report

Pancreas ectopia/Ectopic pancreas (EP) is a rare congenital disease, most typically diagnosed in asymptomatic patients by incidental detection during surgery or at autopsy. It is defined by the presence of pancreatic tissue localized in various places drifting from the foregut or mesentery.

It is subject to the same various inflammatory or neoplastic disorders that may affect the orthotopic pancreas, e.g. pancreatitis or pancreatic tumours. Upper GI endosonography is a key examination (tool) in detecting and defining gastroduodenal ectopic pancreas. However its diagnosis remains difficult. The final diagnosis relies on histopathologic analysis of the resected tumor required to confirm the diagnosis.

Its treatment is based on patients’ condition and symptoms as well as the kind of surgery depending on the location of the ectopic pancreatic tissue.     

Ecdysteroid titers during the molt cycle of Orchestia cavimana (Crustacea, Amphipoda)

Ecdysteroids were analyzed during a molt cycle in adult males of the crustacean Orchestia cavimana; levels were determined in the hemolymph and in whole bodies, using radioimmunoassay. Results show a single and sharp peak at the end of D1 stage, reaching 810 pg eq/microliter in the hemolymph (a 230-fold increase compared to the middle of intermolt). From B stage to the beginning of D1, levels are very low but increase regularly and significantly. The amplitude and the temporal position of the peak are discussed in detail, in relation to the precision of the staging (17 different stages can be easily made in Orchestia) and to the cuticle cycle (the hormonal peak occurs ca. 10 hr before the beginning of cuticle synthesis at D2). Preliminary experiments, using monoclonal antibodies during the period of low ecdysteroid titers or high-performance liquid chromatography followed by polyclonal RIA during the peak period, suggest that the immunoreactive hormone in O. cavimana behaves like 20-hydroxyecdysone. However, other minor compounds have been detected (some unknown, others migrating like ecdysone and ponasterone A in HPLC).     

Combined operation: cataract and glaucoma with implantation. Results of a series of 28 cases

28 eyes underwent a combined procedure: trabeculectomy, extra-capsular cataract extraction and implantation of a posterior chamber intraocular lens. With a minimum of 9 months follow-up, 23 eyes had intraocular pressure controlled of all antiglaucoma medications, and 4 additional eyes achieved control with only the use of timolol maleate drops. (1 eye was lost to follow-up.) Preoperative near visual acuity was less than Parinaud 5 (Jaeger 7) in all eyes. Post-operative near visual acuity was Parinaud 2 (Jaeger 1) in 17 eyes. Senile macular degeneration was responsible for less than Parinaud 2 visual acuity in 4 additional eyes. An extracapsular extraction has advantages over the intracapsular method, both in terms of less post-operative vitreoretinal complications for the cataract extraction itself, and for the creation of a functional trabeculectomy by keeping the vitreous away from the filtration site. Use of a posterior chamber intraocular lens implant as part of the combined procedure appears to be highly acceptable. Complications and limits of the combined procedure are discussed.     

Inhibition of ovarian steroidogenesis by cyclic GMP in a fly

Previous investigations in the female blowfly Phormia regina have shown that 3-isobutyl-1-methylxanthine (IBMX), a broad spectrum inhibitor of phosphodiesterases (PDEs), fails to mimic the steroidogenic effects of cAMP on ovaries, although it efficiently increases the concentrations of this second messenger. In this study, experiments carried out to clear up this contradiction demonstrated that IBMX, besides its effect on cAMP, also increased cGMP concentrations in blowfly ovary and that these two cyclic nucleotides controlled ovarian steroidogenesis antagonistically. In particular, a selective inhibitor of cGMP-specific PDEs, unlike IBMX, had a very strong negative effect on ovarian steroidogenesis. Moreover, a cGMP analog was able to inhibit steroid biosynthesis in previtellogenic and vitellogenic ovaries, thus affecting basal and acute steroidogenesis respectively. Our observations also demonstrated that cGMP was always present in blowfly ovary, reaching its maximal levels at the end of vitellogenesis, in close correlation with the physiological decrease in ovarian steroidogenesis. Experiments using an inhibitor of protein kinase G clearly indicated that the effects of cGMP were mediated by this enzyme. On the contrary, these effects did not seem to involve cGMP-regulated PDEs or ion channels. Our results also indicated that ovarian cGMP concentrations were not controlled by brain factors, suggesting a probable involvement of paracrine/autocrine factors. Nitric oxide (NO) appeared to be a good candidate for such a control, because an NO donor was able to stimulate ovarian cGMP concentrations and to drastically decrease ovarian ecdysteroid biosynthesis in blowflies. These data thus demonstrate, for the first time in invertebrates, a potent role of cGMP in the negative control of ovarian steroidogenesis and suggest a possible co-regulation with NO.     

A case of hepatic alveolar echinococcosis contracted in Belgium

We report herein the case of a Belgian 76-year-old woman who developed a hepatic tumour suspected to be a breast cancer metastasis. Radiological imaging and guided biopsies were not contributive. The patient underwent an explorative laparoscopy with frozen sections that did not provide further diagnosis, and an open left bisegmentectomy was performed during the same anaesthesia. Histopathological examination of the hepatic mass showed Echinococcus multilocularis metacestodes, demonstrating alveolar echinococcosis. As our patient denied any travel in foreign countries and has undergone regular abdominal ultrasonographies since her mastectomy, it is highly likely that this alveolar echinococcosis had been contracted in Belgium. If some imported cases may be seldom managed in Belgium, to our knowledge, this case is the first occurrence of alveolar echinococcosis contracted in Belgium. This report, added to the demonstration of E. multilocaris infection of 50% of red foxes in Southern Belgium, and the potential infection of domestic cats and dogs, should attract attention of the medical community on the possible outbreak of endemic alveolar echinococcosis in Belgium, and on the related public health concerns.     

ABT-335, the choline salt of fenofibric acid, does not have a clinically significant pharmacokinetic interaction with rosuvastatin in humans

ABT-335 is the choline salt of fenofibric acid under clinical development as a combination therapy with rosuvastatin for the management of dyslipidemia. ABT-335 and rosuvastatin have different mechanisms of actions and exert complementary pharmacodynamic effects on lipids. The current study assessed the pharmacokinetic interaction between the 2 drugs following a multiple-dose, open-label, 3-period, randomized, crossover design. Eighteen healthy men and women received 40 mg rosuvastatin alone, 135 mg ABT-335 alone, and the 2 drugs in combination once daily for 10 days. Blood samples were collected prior to dosing on multiple days and up to 120 hours after day 10 dosing for the measurements of fenofibric acid and rosuvastatin plasma concentrations. Coadministering 40 mg rosuvastatin had no significant effect on the steady-state Cmax, Cmin, or AUC24 of fenofibric acid (P > .05). Coadministering ABT-335 had no significant effect on the steady-state Cmin or AUC24 of rosuvastatin (P > .05) but increased Cmax by 20% (90% confidence interval: 12%-28%). All 3 regimens were generally well tolerated with no clinically significant changes in clinical laboratory values, vital signs, or electrocardiograms during the study. Results from this study demonstrate no clinically significant pharmacokinetic interaction between ABT-335 at the full clinical dose and rosuvastatin at the highest approved dose.