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Possible Risks (possible + risk)
Terms modified by Possible Risks Selected AbstractsBioconcentrations of metals (Fe, Cu, Zn, Pb) in earthworms (Eisenia fetida), inoculated in municipal sewage sludge: Do earthworms pose a possible risk of terrestrial food chain contamination?ENVIRONMENTAL TOXICOLOGY, Issue 1 2009Surindra Suthar Abstract Efforts have been made to evaluate the possible risks of metal bioaccumulation in composting earthworms during vermicomposting of hazardous wastes, e.g., sewage sludge. The sewage sludge was diluted by mixing cow dung in different proportions, and vermicomposted sludge as well as inoculated earthworms were analyzed for metal (Fe, Cu, Zn, Pb) contents. The sludge processed by worms showed a significant reduction in concentration of metals, Cu (29.4,51.6%), Fe (13.1,19.9%), Zn (15.2,25.8%), and Pb (4.6,46.9%), at the end. A considerable concentration of metals, total Cu (16.7,27.6 mg kg,1), total Fe (42.9,89.8 mg kg,1), total Zn (5.85,75.0 mg kg,1), and total Pb (1.79,12.4 mg kg,1), in composting earthworms was also recorded. The greater values of bioconcentration factors for metals suggested the possible risk of entering contaminants in higher food chains; since, earthworms are near to the terrestrial food chain, they can potentially mediate metal transfer from soil to a range of predators, including birds. Therefore, feasibility of vermitechnology in hazardous waste recycling needs close attention in respect to possible risk of environmental contamination. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2009. [source] The metabolic syndrome in overweight epileptic patients treated with valproic acidEPILEPSIA, Issue 2 2010Alberto Verrotti Summary Purpose:, To evaluate the presence of metabolic syndrome (MS) in children and adolescents treated with valproate (VPA). Methods:, One hundred fourteen patients (54 male and 60 female) were studied. These patients were followed from the beginning of therapy for at least 24 months; at the end of follow-up, 46 patients (40.4%) had a considerable increase in body weight, whereas the other patients (59.6%) remained with the same weight. The MS was defined as having at least three of the following: abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Results:, Forty-six patients developed obesity; 20 (43.5%) of 46 patients developed MS. Abnormal glucose homeostasis was identified in 45% of patients. High total serum cholesterol concentrations were noted in 10 (50%), high serum triglyceride concentrations in 7 (35%), and low high-density lipoprotein (HDL) in 15 (75%) of the 20 subjects with MS. However, there were no significant differences in the features of MS between boys and girls with MS. Conclusions:, Patients who gain weight during VPA therapy can develop MS with a possible risk of cardiovascular disease. [source] Occurrence of coagulase-positive Staphylococci, microbial indicators and physical,chemical characteristics of traditional semihard cheese produced in BrazilINTERNATIONAL JOURNAL OF DAIRY TECHNOLOGY, Issue 3 2009FABIANA R. VIANA Coagulase-positive Staphylococci and microbial indicators of the ,Requeijão do Norte', a traditional semihard cheese, were surveyed in Brazil. Coagulase-positive Staphylococci were found in quantities of up to 9.4 log cfu/g. The coagulase gene was detected in isolates physiologically classified as coagulase-negative. The SEB and TSST-1 toxins were detected. Salmonella spp. were not detected. High levels of total and fecal coliforms (, 210 MPN/g) and moulds (, 6.48 log cfu/g) were found in most samples. The values of physical,chemical parameters and water activity showed the greatest variations. These results suggest a possible risk that this cheese may pose to consumers. [source] Exposure assessment of fetus and newborn to brominated flame retardants in France: preliminary dataMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 2 2008Jean-Philippe Antignac Abstract Brominated flame retardants (BFR) are chemicals extensively used in many manufactured products to reduce the risk of fire, but also environmental pollutants. In order to assess the potential risk linked to these compounds in human, a French monitoring study was initiated to evaluate the exposure of fetus and newborn. A previously described multi-residue analytical method was used, for measuring the main classes of BFR (hexabromocyclododecane, tetrabromobisphenol-A, and tri- to deca-polybromodiphenylethers) in various biological matrices. These analyzed samples (maternal and umbilical serum, adipose tissue and breast milk) were collected on volunteer women during caesarean deliveries. Preliminary results obtained on 26 individuals (mother/newborn pairs) mainly demonstrated the presence of polybromodiphenylethers (PBDE) and tetrabromobisphenol A both in maternal and fetal matrices, and a possible risk of overexposure of newborns through breastfeeding. Contaminations levels were found globally in the ng/g lipid weight range, consistent with other published European data. Exposure results regarding highly brominated PBDE congeners (octa- to deca-BDE) appeared particularly informative and non-commonly reported, these compounds accounting for around 50% of the total PBDE load. Additional data collection and metabolism investigations are now on-going. A more complete statistical analysis related to this BFR exposition study will be provided in a next future. [source] Garlic (Allium sativum L.): Adverse effects and drug interactions in humansMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 11 2007Francesca Borrelli Abstract Garlic (Alllium sativum L., Fam Liliaceae) is used medicinally mainly for the treatment of hypercholesterolemia and prevention of arteriosclerosis. Clinical trials have consistently shown that "garlic breath" and body odor are the most common (and well-documented) complaints associated to garlic intake. Case reports have highlighted the possibility that garlic use may cause allergic reactions (allergic contact dermatitis, generalized urticaria, angiedema, pemphigus, anaphylaxis and photoallergy), alteration of platelet function and coagulation (with a possible risk of bleeding), and burns (when fresh garlic is applied on the skin, particularly under occlusive dressings). Consumption of garlic by nursing mothers modifies their infant's behavior during breast-feeding. Finally, garlic may enhance the pharmacological effect of anticoagulants (e. g. warfarin, fluindione) and reduce the efficacy of anti-AIDS drugs (i. e. saquinavir). [source] Distribution of 10 periodontal bacterial species in children and adolescents over a 7-year periodORAL DISEASES, Issue 7 2008K Nakano Objective:, There is scant information available regarding the distribution of periodontal bacterial species in children and adolescents over an extended period. The purpose of this study was to compare bacterial profiles in the same individuals over a period of 7 years. Subject and methods:, Twenty-six children and adolescents from whom dental plaque and saliva specimens were obtained during both the first (1999,2000) and second (2006,2007) periods, were analyzed. Bacterial DNA was extracted from each specimen and the presence of 10 periodontal bacterial species was determined using a PCR method, with a focus on the red complex species of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Results:, Subjects with red complex species in saliva specimens obtained during the second collection possessed a significantly higher number of total bacterial species than those without. The detection rate of the red complex species in the second collection period samples was significantly greater in subjects who had two or more species detected in samples taken during the first collection compared with the other subjects. Conclusion:, Subjects possessing red complex species may be at possible risk for infection with a high number of periodontal bacterial species during adolescent and younger adult years. [source] Total body bone measurements: A cross-sectional study in children with acute lymphoblastic leukemia during and following completion of therapyPEDIATRIC BLOOD & CANCER, Issue 1 2009Kara M. Kelly MD Abstract Background Abnormalities in bone mineral density (BMD) occur in children treated for acute lymphoblastic leukemia (ALL). However, BMD estimates have been performed using varied instruments, reference data, and interpretations. This exploratory cross sectional study to evaluate bone mass in children with ALL, uses an algorithm that serially adjusts for variables known to affect pediatric bone measures by dual energy X-ray absorptiometry (DXA), based on models developed in 1,218 healthy children and adolescents. Procedure Anthropometry, DXA scans, and factors with possible influence on bone mass were evaluated in 21 ALL patients receiving chemotherapy and 20 in the follow-up phase. Main outcome was treatment group differences in Z -scores for total body bone mineral content (BMC), bone area (Area), and areal BMD (aBMD). Results Mean Z -scores for the entire study population for BMC, Area, and aBMD were significantly less than zero. Among possible contributing factors, only calcium intake was a significant co-variate. Comparison between treatment groups showed that least-square mean Z -scores for patients on-therapy for at least 12 months were significantly lower than those off therapy for at least 12 months (P: 0.0008,0.044), except for BMC at last step of the algorithm (adjusted for sex, age, ethnicity, height, weight, and bone area). Conclusions Evaluation of total body DXA by this algorithm is consistent with better general bone status in those off-therapy. However, in this small exploratory study, the lack of significant difference between Z -scores for fully adjusted BMC in on- versus off-therapy groups suggests possible risk of low peak bone mass. Additional longitudinal evaluation is warranted. Pediatr Blood Cancer 2009;52:33,38. © 2008 Wiley-Liss, Inc. [source] Fine-Scale Spatial Genetic Structure of the Distylous Primula veris in Fragmented HabitatsPLANT BIOLOGY, Issue 3 2007F. van Rossum Abstract: In Flanders (northern Belgium), the distylous self-incompatible perennial herb Primula veris is common, but mainly occurs in fragmented habitats. Distyly, which favours disassortative mating, is characterized in P. veris by two genetically determined floral morph types (pin or thrum). Using 18 polymorphic loci, we investigated fine-scale spatial genetic structure (SGS) and spatial distribution of the morphs within four populations from two regions that differ in degree of habitat fragmentation. We studied the contributions made by sexual reproduction and clonal propagation and compared the SGS patterns between pin and thrum morph types. Clonal growth was very restricted to a few individuals and to short distances. One population showed a non-random spatial distribution of the morphs. Pin and thrum individuals differed in SGS patterns at a small scale, suggesting intrapin biparental inbreeding, also related to high plant densities. This may be explained by partial self-compatibility of the pin morph combined with restricted seed dispersal and pollinator behaviour. There is an indication of more pronounced SGS when populations occur in highly fragmented habitats. From our findings, we may hypothesize disruption of the gene flow processes if these large populations evolve into patchworks of small remnants, but also a possible risk for long-term population survival if higher intrapin biparental inbreeding leads to inbreeding depression. Our study emphasizes the need for investigating the interactions between the heterostylous breeding system, population demographic and genetic structure for understanding population dynamics in fragmented habitats and for developing sustainable conservation strategies. [source] Occupational risk in health care and research,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2003Daniela Vecchio MS Abstract Background Working in the health care and research sectors has been linked to various hazards. Methods Studies published in the peer-reviewed literature that are pertinent to the exposures or diseases relevant to these fields were reviewed. Results The most important exposures include infectious agents, formaldehyde, anesthetic agents, antineoplastic drugs, and ethylene oxide. The best-documented evidence is that of infectious risk primarily among clinical personnel. Monitoring studies of persons occupationally exposed to anesthetics clearly demonstrate behavioral effects, possible risk of reproductive problems, as well as cytogenetic effects of unknown significance. The latter two impairments are also observed among those exposed to antineoplastic drugs and ethylene oxide. Exposure to formaldehyde appears to be associated with nasopharyngeal tumors. Whereas increased risk of cancer of certain sites, particularly the brain and lymphohematopoietic system, is found among research and health care personnel, no specific exposure has been linked to these neoplasms. Conclusions Although some results are inconsistent, continued environmental and biological monitoring will allow better assessment of exposures and of implemented protection measures. Am. J. Ind. Med. 43:369,397, 2003. © 2003 Wiley-Liss, Inc. [source] Treatment strategy after non-curative endoscopic resection of early gastric cancer,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2008I. Oda Background: Endoscopic resection (ER) is indicated for patients with early gastric cancer who have a negligible risk of lymph node metastasis (LNM). Histological examination of the resected specimen may indicate a possible risk of LNM or a positive resection margin. These patients are considered to have undergone non-curative ER. The aim of this study was to determine the appropriate treatment strategy for such patients. Methods: A total of 298 patients who had non-curative ER were classified into those with a positive lateral margin only (group 1; 72 patients) and those with a possible risk of LNM (group 2; 226 patients). Results: Surgery was performed within 6 months of non-curative ER in 19 patients in group 1 and 144 in group 2. In group 1, nine patients were found to have local residual tumours, all limited to the mucosal layer without LNM. In Group 2, 13 patients had residual disease, including four local tumours without LNM, two local tumours with LNM and seven cases of LNM alone. The rate of LNM after surgery was 6·3 per cent in group 2. Conclusion: Surgery remains the standard treatment after non-curative ER in patients with a possible risk of LNM. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Beta-carotene in multivitamins and the possible risk of lung cancer among smokers versus former smokersCANCER, Issue 1 2008A meta-analysis, evaluation of national brands Abstract BACKGROUND Some studies have suggested that beta-carotene supplementation may increase the risk of lung cancer, particularly among smokers or former smokers. Beta-carotene, a provitamin A, is available in multivitamins. In the current study, the authors investigated the risk of lung cancer associated with beta-carotene in smokers or former smokers and surveyed the beta-carotene content in national brand multivitamins. METHODS The authors systemically reviewed the published literature using a search of the MEDLINE database and performed a meta-analysis of large randomized trials that reported on the effect of beta-carotene supplementation on the incidence of lung cancer among smokers or former smokers. A sample of multivitamins was evaluated for their beta-carotene content and the suggested daily dosage. RESULTS Four studies contributing 109,394 subjects were available for analysis. The average daily beta-carotene dosage in these trials ranged from 20 to 30 mg daily. Among current smokers, beta-carotene supplementation was found to be significantly associated with an increased risk of lung cancer (odds ratio [OR], 1.24; 95% confidence interval [95% CI], 1.10,1.39). Among former smokers, there was no significant increase noted (OR, 1.10; 95% CI, 0.84,1.45). In a sample of 47 common multivitamins, beta-carotene was present in 70% of the identified formulas. The median dosage of beta-carotene was 0.3 mg (range, 0,17.2 mg) daily. The beta-carotene content was found to be significantly higher among multivitamins sold to improve visual health than among other multivitamins, with a median daily dosage of 3 mg (range, 0,24 mg). CONCLUSIONS High-dose beta-carotene supplementation appears to increase the risk of lung cancer among current smokers. Although beta-carotene was prevalent in multivitamins, high-dose beta-carotene was observed among multivitamin formulas sold to promote visual health. Cancer 2008. © 2008 American Cancer Society. [source] Thermal biology of the meadow grasshopper, Chorthippus parallelus, and the implications for resistance to diseaseECOLOGICAL ENTOMOLOGY, Issue 6 2005Simon Springate Abstract., 1.,The thermal biology of the meadow grasshopper, Chorthippus parallelus, a common, habitat generalist acridid species found in the U.K., was characterised and the influence of thermoregulatory behaviour for resistance against a temperate (Beauveria bassiana) and tropical (Metarhizium anisopliae var. acridum) fungal pathogen was determined. 2.,Chorthippus parallelus was found to be an active behavioural thermoregulator, with a preferred temperature range of 32,35 °C. 3.,Both pathogens proved lethal to fifth instar and adult grasshoppers. No evidence of behavioural fever in response to infection by either pathogen was found, but normal thermoregulation was found to reduce virulence and spore production of B. bassiana. Normal thermoregulation did not appear to affect M. anisopliae var. acridum. 4.,These results suggest that the effects of temperature on host resistance depend on the thermal sensitivity of the pathogen and, in this case, derive from direct effects of temperature on pathogen growth rather than indirect effects mediated by host immune response. 5.,The implications for possible risks of exotic pathogens and influence of climate change are discussed. [source] Bioconcentrations of metals (Fe, Cu, Zn, Pb) in earthworms (Eisenia fetida), inoculated in municipal sewage sludge: Do earthworms pose a possible risk of terrestrial food chain contamination?ENVIRONMENTAL TOXICOLOGY, Issue 1 2009Surindra Suthar Abstract Efforts have been made to evaluate the possible risks of metal bioaccumulation in composting earthworms during vermicomposting of hazardous wastes, e.g., sewage sludge. The sewage sludge was diluted by mixing cow dung in different proportions, and vermicomposted sludge as well as inoculated earthworms were analyzed for metal (Fe, Cu, Zn, Pb) contents. The sludge processed by worms showed a significant reduction in concentration of metals, Cu (29.4,51.6%), Fe (13.1,19.9%), Zn (15.2,25.8%), and Pb (4.6,46.9%), at the end. A considerable concentration of metals, total Cu (16.7,27.6 mg kg,1), total Fe (42.9,89.8 mg kg,1), total Zn (5.85,75.0 mg kg,1), and total Pb (1.79,12.4 mg kg,1), in composting earthworms was also recorded. The greater values of bioconcentration factors for metals suggested the possible risk of entering contaminants in higher food chains; since, earthworms are near to the terrestrial food chain, they can potentially mediate metal transfer from soil to a range of predators, including birds. Therefore, feasibility of vermitechnology in hazardous waste recycling needs close attention in respect to possible risk of environmental contamination. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2009. [source] N -methyl-1-(1,3-benzodioxol-5-yl)-2-butanamine (MBDB): its properties and possible risksADDICTION BIOLOGY, Issue 3 2000L. A. G. J. M. Van Aerts MBDB (N -methyl-1-(1,3-benzodioxol-5-yl)-2-aminobutane) is the ,-ethyl homologue of MDMA (3,4-methylenedioxy-N-methylamphetamine). MBDB is metabolized and excreted similarly to MDMA: presumably, the majority of oral MBDB is excreted in urine unmetabolized. The main metabolic routes in man are thought to be O-dealkylation and subsequent methylation, sulphation and glucuronidation of the newly formed hydroxy groups. The major acute neuropharmacological effects of MBDB in the rat are an increase in serotonin release in the brain and an inhibition of serotonin and noradrenaline re-uptake. These effects compare well with those of MDMA, although the latter is more potent. MBDB may also slightly increase dopamine release and inhibit dopamine re-uptake, but to a lesser extent than MDMA. This is important, as dopamine release has been implicated in the reinforcing qualities of substances such as cocaine and amphetamine. The neuroendocrine effects of MBDB resemble those of MDMA. Both substances increase plasma ACTH, corticosterone, prolactin and renin. The neurophysiological effects of MBDB are characterized by a decrease in electrical activity throughout the brain, most notably in the alpha 2 and delta frequency bands. In contrast, hallucinogens increase the activity in the alpha 1 band, especially in the corpus striatum. In drug discrimination tests in the rat, MBDB, like MDMA, can be distinguished clearly from both stimulants and hallucinogens. The class of substances to which MBDB belongs may be named entactogens. MBDB dose-dependently increases locomotor activity and decreases exploratory behaviour in the rat and causes distress vocalization and wing extension in the newly hatched chicken. The rewarding properties of MBDB appear to be smaller than those of MDMA, as suggested by a 2.5 times weaker potency in the conditioned place preference test in rats. The main subjective effects of MBDB in man are a pleasant state of introspection, with greatly facilitated interpersonal communication and a pronounced sense of empathy and compassion between subjects. In this respect, MBDB again resembles MDMA. However, there are also differences. MBDB has a slower and more gentle onset of action than MDMA, produces less euphoria and has less stimulant properties. The few toxicological data available suggest that MBDB may cause serotonergic deficits in the brain, although the potency of MBDB to cause this neurotoxic effect is smaller than that of MDMA. Severe acute reactions in man as have been reported for MDMA have not been published for MBDB. The dependence potential of MBDB appears to be small, probably even smaller than that of MDMA. MBDB has been available at least since 1994 but its position on the synthetic drugs market is marginal. Subjective reports indicate that MBDB is less popular among users than MDMA. The reason may be that MBDB produces less euphoria than MDMA. Another possible explanation is that MBDB largely lacks the stimulant properties of MDMA. We calculated a margin of safety with a method similar to one used in the risk assessment of pharmaceuticals. The results suggest that MBDB is three times less likely to cause serotonergic brain deficits than MDMA. However, it should be noted that for both substances the margin of safety is less than one, indicating that the risk of neurotoxicity is not negligible. In animals, serotonergic brain deficits after exposure to MDMA have been linked to the degeneration of serotonergic nerve terminals. [source] Transgenic fish: an evaluation of benefits and risksFISH AND FISHERIES, Issue 2 2000N. Maclean Transgenic fish have many potential applications in aquaculture, but also raise concerns regarding the possible deleterious effects of escaped or released transgenic fish on natural ecosystems. In this review the potential applications of transgenic fish are considered, the probable benefits reviewed, the possible risks to the environment identified and the measures which might be taken to minimize these risks are evaluated. Growth trials of transgenic fish have already been carried out in outdoor facilities and some of these are discussed in the light of possible risks and benefits. Regarding the hazards associated with release or escape, whilst there is some evidence to suggest that transgenic fish may be less fit compared to their wild counterparts, there is insufficient evidence to say that this will be true in all cases. Using mathematical models, we have attempted to predict the magnitude of the genetic effects in a range of different scenarios. A number of possible containment techniques are considered, amongst which containment by sterility is probably the most promising. This can be engineered either by triploidy or by transgenic methods. The conclusions include a tabulated balance sheet of likely benefits and risks, with appropriate weighting. [source] The prevention of deep venous thrombosis in physically restrained patients with schizophreniaINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2010M. De Hert Summary Background:, Physical restraint and seclusion are associated with several risks. Antipsychotic drug use increases this risk. Objective:, To evaluate whether the risk of thromboembolism in physical restraint and seclusion of patients with psychosis, treated with antipsychotic medication, was considered by taking preventive measures. Method:, Anonymous data on all consecutively admitted patients with schizophrenia, treated with antipsychotic medication, between 2002 and 2009, were analysed. Diagnostic information and data about seclusion procedures and medication were collected. Preventive measures of thromboembolism in patients in physical restraint were assessed by reviewing case notes and the medication prescribed at the time of seclusion. Results:, Seclusion of patients with psychosis is common. Out of 679 identified patients, 170 had been secluded (472 events). Physical restraint use was not a rare event (N seclusions with restraint use 296, 62.7%). Pharmacological preventive measures (use of heparine dugs) were taken frequently to prevent deep vein thrombosis (DVT) by physical restraint or isolation. Sixty-five (38.2%) out of 170 secluded patients, including a majority of patients who had been under physical restraint, had been administered anticoagulants at the time of seclusion. No cases of DVT occurred. Conclusions:, Preventive measures were routinely administered in clinical practice and were effective in the prevention of DVT. For a clinical setting, it is important to establish a clear and detailed management plan on seclusion and fixation taken into account in all possible risks of physical restraint. [source] Managing the wandering behaviour of people living in a residential aged care facilityINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2007Brent Hodgkinson BSc MSc GradCertPubHealth GradCertHealthEcon Abstract Background, Wandering behaviour is frequently seen in older people with cognitive impairment. The prevalence of patients exhibiting wandering behaviour has been estimated to be 11.6% on traditional units and 52.7% on Alzheimer's units. Wandering is one of the core behavioural characteristics that impact on familial carers and is likely to influence the decision to place a family member in an aged care environment. Considering the possible risks associated with wandering behaviour, the successful identification and management of wandering is essential. Wandering is also a problem for caregivers in the institutionalised setting, in terms of containment, usually being addressed by securing the environment. There has been some research conducted to assist in the understanding and management of wandering behaviour; however, the findings have been diverse resulting in a level of confusion about the best approaches to take. Objectives, This review aims to present the best available evidence on the management of wandering in older adults who reside in an aged care facility (both high and low care). Search strategy, An extensive search of keywords contained in the title and abstract, and relevant MeSH headings and descriptor terms was performed on the following databases: MEDLINE, CINAHL, PsychINFO, AGELINE, Cochrane Library, Embase, APAIS Health, Current Contents, Dare, Dissertation Abstracts, Personal Communication, Social Science Index. Selection criteria, Papers were selected if they focused on the treatment of wandering in an institutional setting. Some studies were not specifically examining wanderers over the age of 65 years as per the protocol requirements, but were included as it was felt that their findings could be applied to this age group. Data collection and analysis, Study design and quality were tabulated and relative risks, odds ratios, mean differences and associated 95% confidence intervals were calculated from individual comparative studies containing count data where possible. All other data were presented in a narrative summary. Results, Searches identified one care protocol, two systematic reviews and 24 other studies that satisfied the inclusion criteria. The following recommendations are divided into four categories of interventions (environmental, technology and safety, physical/psychosocial, and caregiving support and education) with only Level 1, 2 or 3 evidence presented. Environmental modifications, Gridlines placed in front of doors or covering exit door doorknobs or panic bars may be effective at reducing exit-seeking behaviour (Level 3b). Technology and safety, Mobile locator devices may be effective at enabling quick location of wandering residents (Level 3c). Physical/psychosocial interventions, Implementation of a walking group or an exercise program may reduce the incidence of disruptive wandering behaviour (Level 3b). Use of air mat therapy may reduce wandering behaviour for at least 15 min post therapy (Level 2). Providing music sessions (and reading sessions) may keep residents from wandering during the period of the session (Level 3b). Caregiving support and education, There is no evidence to support any interventions. Conclusions, The majority of the available research for which the guidelines are based upon was derived from observational studies or expert opinion (Level of evidence 3 or 4). More rigorous research is required to demonstrate the efficacy of these recommendations. [source] East meets west: adaptive evolution of an insect introduced for biological controlJOURNAL OF APPLIED ECOLOGY, Issue 3 2008C. B Phillips Summary 1A possible explanation for low success rates when introducing natural enemies to new regions for biological control of insect pests is that they fail to adapt to their new conditions. Therefore it has been widely recommended that biological control practitioners increase the probability of local adaptation by maximizing the genetic variation released. An alternative recommendation is to use climate matching to identify native populations that may already possess traits suited to the new region. However, support for these recommendations is weak through lack of empirical evidence that local adaptation is important to biological control. 2This study examined how genetic drift and selection influenced the population frequencies of two asexually reproducing, genetically differentiated parasitoid biotypes that were introduced to New Zealand from South America for biological control. Other than by mutation, the biotypes were genetically fixed due to the absence of recombination both within and between biotypes. This meant that adaptive evolution could occur only if selection acted on any traits that varied between the biotypes introduced from South America. 3The two parasitoid biotypes were released simultaneously at 14 sites and their frequencies were monitored for up to 10 years. Changes in biotype frequency were consistent with strong directional selection favouring one of the South American biotypes, thus generating established parasitoid populations that were better adapted to New Zealand conditions than those that had originally been released. This local adaptation of the control agent contributed to greater mortality of the pest. 4Synthesis and applications. This study provides the first clear demonstration of the importance of releasing natural enemy genetic variation in new regions to foster adaptive evolution and improve success rates in classical biological control. However, the benefit to biological control of maximizing the genetic variation released needs to be balanced against possible risks to non-target species. The results do not support the concept of choosing sampling sites for putative biological control agents based solely on climatic similarities between the source location and the intended region of introduction. [source] Maxillary Sinus Elevation Surgery: An OverviewJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2003ELIAZ KAUFMAN DDS ABSTRACT Maxillary sinus elevation surgery was developed to increase the height of bone available for implant placement in the posterior maxilla. The efficacy and predictability of this procedure have been determined in numerous studies. The basic approach to the sinus (Caldwell-Luc operation) involves an osteotomy performed on the lateral maxillary wall, elevation of the sinus membrane, and placement of bone graft material. The graft materials can be categorized into four groups: autogenous bone, allografts (harvested from human cadavers), alloplasts (synthetic materials), and xenografts (grafts from a nonhuman species). These graft materials can be used alone or in combination with each other. Implant placement can occur at the same surgical procedure (immediate placement) or following a healing period of 6 to 9 months (delayed placement). A more conservative approach to the sinus, the osteotome technique, has been described as well. CLINICAL SIGNIFICANCE This article provides an overview of the surgical technique, with emphasis on anatomic considerations, preoperative patient evaluation (clinical and radiographic), indications and contraindications to the procedure, and possible risks and complications. [source] Allergy to peanut oil , clinically relevant?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2007J Ring Abstract The increasing prevalence of food allergies (especially allergy to peanuts) has led to a discussion of how safe topical preparations containing peanut oil are with respect to allergy. The major allergens from peanuts are proteins that have been characterized at a molecular level and cloned. Clinical signs of peanut allergy symptoms can be observed on the skin (urticaria), or in the gastrointestinal and/or respiratory tract culminating in cardiovascular symptoms and anaphylactic reactions. In most cases, symptoms are elicited by oral uptake; rarely, a contact urticaria has been described. In vegetable oils, the contents of protein differ depending on the production process: crude oils contain approximately 100 times more proteins than refined oils. This has clear-cut implications for allergic individuals. Quantitative data are available regarding elicitation of symptoms in allergic individuals with a threshold dose of 0.1,1 mg peanut allergen in oral provocation tests. There are anecdotal reports of adverse reactions after topical use of peanut oils. In one epidemiological trial, an association between topical use of skin care products containing peanut oil and the development of peanut allergy was observed; however, the data reflect a retrospective analysis without specifying skin care products containing peanut oil and also without analysing the quantity of topicals used. In contrast, oral tolerance was prevented and allergic sensitization was enhanced in a mouse model using high concentrations of peanut protein. So far, no reliable data are available regarding doses required to induce sensitization against peanut allergen via the epidermal route. A possible induction of sensitization against peanut proteins through contact with the skin via skin care products and the respective protein concentrations is a matter of speculation. Patients with atopic diseases, namely eczema, need appropriate skin care because of the disturbed skin barrier function. The benefit of avoiding damage to skin barrier functions of atopic individuals by the use of peanut protein-containing skin care products seems to outweigh possible risks of sensitization and/or allergy induction against substances contained in those products containing refined peanut oil. [source] Consenting to bio-risk: xenotransplantation and the lawLEGAL STUDIES, Issue 3 2005Barrister, Sara Fovargue LLB Research into alternative sources of organs for transplantation, including the use of organs from non-human genetically engineered animals, has occurred since the introduction of allotransplantation in the 1960s. Xenotransplantation is different from other developing genetic technologies because whilst the potential benefit is to the individual, the possible risks are to society as a whole. The risks include the transmission of unknown and currently indeterminable infectious diseases. This article explores whether the current regulator framework is able to address this issue and, in particular, whether,first-party'consent to involvement in a clinical trial is a sufficient to protect third parties from harm. The competence of a xeno-recipient to consent is also considered, and it is suggested that, at the very least, public debate and participation in deciding whether clinical trials should be permitted must occur, because by allowing xenotransplant trials to help an individual, the risks will be borne by all. [source] Guidelines for submitting adverse event reports for publication,,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2007FISPE (Chair), William N. Kelly Pharm D Publication of case reports describing suspected adverse effects of drugs and medical products that include herbal and complementary medicines, vaccines, and other biologicals and devices is important for postmarketing surveillance. Publication lends credence to important signals raised in these adverse event reports. Unfortunately, deficiencies in vital information in published cases can often limit the value of such reports by failing to provide sufficient details for either (i) a differential diagnosis or provisional assessment of cause-effect association, or (ii) a reasonable pharmacological or biological explanation. Properly described, a published report of one or more adverse events can provide a useful signal of possible risks associated with the use of a drug or medical product which might warrant further exploration. A review conducted by the Task Force authors found that many major journals have minimal requirements for publishing adverse event reports, and some have none at all. Based on a literature review and our collective experience in reviewing adverse event case reports in regulatory, academic, and industry settings, we have identified information that we propose should always be considered for inclusion in a report submitted for publication. These guidelines have been endorsed by the International Society for Pharmacoepidemiology (ISPE) and the International Society of Pharmacovigilance (ISoP) and are freely available on the societies' web sites. Their widespread distribution is encouraged. ISPE and ISoP urge biomedical journals to adopt these guidelines and apply them to case reports submitted for publication. They also encourage schools of medicine, pharmacy, and nursing to incorporate them into the relevant curricula that address the detection, evaluation, and reporting of suspected drug or other medical product adverse events. Copyright © 2007 Kelly et al. Reproduced with permission by John Wiley & Sons, Ltd. [source] Occupation and leukemia: A population-based case,control study in Iowa and Minnesota,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2001A. Blair PhD Abstract Background Studies have suggested that risk of leukemia may be associated with occupational or industrial exposures and risk may vary by the histological type of the disease. Methods A population-based case,control study was conducted in Iowa and Minnesota to evaluate the association between various occupations, industries, and occupational exposures and leukemia risk. A total of 513 cases and 1,087 controls was included in the study. A lifetime occupational history and other risk factor information were collected through in-person interviews, and a job-exposure matrix was used to assess possible risks associated with specific exposures. Results A significantly increased risk of leukemia was observed among agricultural service industries and among nursing and healthcare workers. Janitors, cleaners, and light truck drivers also experienced increased risk. Those employed in plumbing, heating and air conditioning industries, and sales of nondurable goods (such as paints and varnishes) had an increased risk. Printers, painters, and workers in the food and metal industries had a nonsignificantly increased risk of leukemia. Analyses by specific exposures and histology of leukemia showed that risk of leukemia associated with occupational or industrial exposures may vary by histological type of the disease. Conclusions An increased risk of leukemia among workers employed in agricultural industries, nursing and healthcare workers, and in a few occupations with possible exposure to solvents is consistent with earlier studies. Associations of risk with occupations not observed previously deserve further assessment. Am. J. Ind. Med. 40:3,14, 2001. Published 2001 Wiley-Liss, Inc. [source] CR11 PATIENT RECALL OF INFORMED CONSENT INFORMATION PRIOR TO COLONOSCOPYANZ JOURNAL OF SURGERY, Issue 2007I. G. Thomson Purpose To determine if patients presenting for colonoscopy can remember information discussed in the informed consent process. Focusing on whether patients know of the possible risks. Methodology A prospective study of patients presenting for elective colonoscopy through the Colorectal Unit. Patients were consented in outpatient clinics prior to the procedure using the colonoscopy consent form supplied by Queensland Health. On the day of the procedure a 2 page questionnaire with 13 questions was completed by the patient prior to their colonoscopy. Indications for colonoscopy date of consent & procedure and seniority of consenting doctor were obtained from medical records. Results 100 patients completed the questionnaire. 94% of patients could correctly identify colonoscopy as the procedure being undertaken. 45% of patients were able to identify that there were any risks involved with the procedure. Only 28% of patients could name perforation as a possible risk. h regard to other investigative options 83% could not identify any from a list of three. Despite this 92% felt they were given enough information and were happy to proceed. Conclusion This study highlights room for improvement in the current informed consent process. The current process falls short in educating patients of the possible serious risks involved. Patients do not recall other therapeutic options given. The consent process does convey basic information allowing the patient to identify the name of the investigation and anatomical area investigated. Despite these shortcomings most patients felt they were given enough information to proceed. [source] Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in relation to the patient's risk profile for progressionBJU INTERNATIONAL, Issue 2005John Trachtenberg SUMMARY Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is a slowly progressing disease, with some patients progressing more rapidly than others. In 80% of patients who progress this is caused by the worsening of symptoms. The physician can predict the risk of progression from the patient's clinical profile; increased symptom severity, a poor maximum urinary flow rate (Qmax), and a high postvoid residual urine volume (PVR), are major risk factors for overall clinical progression of LUTS/BPH. A large baseline prostate volume and a high serum prostate-specific antigen (PSA) level are the predominant risk factors for developing acute urinary retention. After predicting risk, the most appropriate treatment should be established by balancing the benefits of treatment against the possible risks and bother resulting from adverse events. From the Medical Therapy Of Prostatic Symptoms study it can be concluded that monotherapy with an ,1 -adrenoceptor (AR) antagonist is an appropriate treatment for many patients with LUTS/BPH. However, for those at high risk of progression (those with a large prostate volume and high PSA level), it appears more appropriate to add a 5,-reductase inhibitor to the ,1 -AR antagonist to obtain maximum relief of symptoms, and ideally to halt the progression of the disease. This was confirmed by the RAND Appropriateness Method study, in which 12 urologists determined the most appropriate treatment for patients with LUTS/BPH based on their clinical profile, combination of clinical variables and/or risk factors. This study also indicates that patients at very high risk of progression, with severe obstruction (poor Qmax and high PVR), are potential candidates for immediate surgery. [source] e-Assessment and the student learning experience: A survey of student perceptions of e-assessmentBRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY, Issue 2 2009John Dermo This paper describes a piece of research carried out at the University of Bradford into student perceptions of e-assessment. An online questionnaire was delivered to 130 undergraduates who had taken part in online assessment (either formative or summative) during the academic year 2007,2008. The survey looked at six main dimensions: (1) affective factors, (2) validity, (3) practical issues, (4) reliability, (5) security, and (6) learning and teaching. The aim of the survey was to identify possible risks in planning e-assessments, as well as to gauge student opinion. The findings of the survey indicated a range of opinions across the student body, with greatest concern about the fairness of item banking. It was also found that the most positive aspect of e-assessment in the eyes of students concerned the benefits that it can bring to teaching and learning. In addition, the paper concludes that age and gender did not significantly affect student responses in any of the areas studied. [source] Glaucoma induced by periorbital topical steroid use , a rare complicationCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2004D. Sahni Summary Eye complications arising during systemic and ophthalmic steroid use are well known. In contrast, there is little highlighting the similar risks associated with topical steroid use around the eyelids. We now describe a 29-year-old lady who used topical steroids in prolonged fashion throughout most of her life for severe eczema, with the recent application of large quantities of potent steroid continuously for one month, including to the periorbital region. Soon after, she presented to her ophthalmologist with severe bilateral glaucoma and irreversible visual loss attributed to the steroid use. Here we emphasise the possible risks of periorbital topical steroid use, as well as the importance of patient education and ophthalmological follow-up. [source] | ||||||||||||||||||||||||||||