Funkcije bubrega u rudara intermitentno izloženih parama elementarne žive

The authors investigated renal damage in 45 mercury miners under conditions of relatively short and low-level exposure to elemental (metallic) mercury vapour (Hg0). The analysis included urinary mercury, immunoelectrophoresis of urinary proteins, immunofixation and high-resolution electrophoresis, quantitative analysis of urinary albumin, and urinary a1-microglobulin before and after exposure. The activity of urinary N-acetyl-b- D-glucosaminidase (NAG) enzyme was determined after exposure. The average duration of exposure of miners was 37 (6–82) days. Urinary mercury significantly increased during exposure. Immunoelectrophoretic changes in the composition of urinary proteins occurred after exposure in 22 of 45 miners, of whom 15 showed high molecular weight (HMW) pattern of urinary proteins and seven showed low molecular weight (LMW) pattern. Only a slight increase in the urinary a1-microglobulin concentration and NAG activity was found in miners with the LMW pattern of urinary proteins. The results point to a slight glomerular and tubular damage in a significant proportion of exposed miners with increased absorption of mercury vapour.Pri profesionalnoj izloženosti parama elementarne žive (Hg0) mogu se pojaviti oštećenja bubrega. U ovom radu procjenjivana je mogućnost učinaka relativno kraće izloženosti nižim koncentracijama živinih para na glomerularnu i tubularnu funkciju bubrega. U 45 rudara su prije i nakon izloženosti određena živa i proteini u urinu. Nakon izloženosti određena je i aktivnost N-acetil-beta-D glukozaminidaze (NAG) u urinu. Proteini u urinu određeni su primjenom imunoelektroforeze, imunofiksacije i elektroforeze visoke rezolucije (velike sposobnosti razdvajanja), kao i pomoću kvantitativne analize albumina i alfa1-mikroglobulina. Rudari, inače, već duže intermitentno izloženi živinim parama, bili su u vrijeme istraživanja izloženi u prosjeku 37 (6–82) dana pri prosječnim koncentracijama 0,37 (0,05–0,73) mg/m3 zraka. Nakon izloženosti kod svih je rudara ustanovljena pojačana apsorpcija elementarne žive prosječnim koncentracijama žive u urinu 67,8±40,8 µg/g kreatinina. Imunoelektroforezom ustanovljene promjene u sastavu proteina u urinu nakon izloženosti su češće nego prije izloženosti (P<0,01). Kod tih rudara (u 22 od 45) s promjenama u sastavu proteina u urinu prevalencija uzoraka urina s proteinima velike molekularne mase veća je (15 od 45) nego prevalencija uzoraka urina s proteinima male molekularne mase (7 od 45). Nakon izloženosti koncentracije albumina u urinu nisu bile značajno povišene u odnosu na vrijednosti prije izloženosti. U podskupini rudara u čijim su urinima nađeni proteini male molekularne mase ustanovljen je blag porast alfa1- mikroglobulina (P=0,05). Živa u urinu nakon izloženosti u bila je u blagoj pozitivnoj korelaciji sa NAG u urinu (r=0,43; P<0,01). Prema ovim rezultatima moglo bi se zaključiti da je kod dijela promatranih osoba pojačana apsorpcija popraćena blagim – klinički neznačajnim – učincima na glomerularnu ili tubularnu funkciju bubrega. Promjene u sastavu proteina u urinu ustanovljene imunoelektroforetsim analizama, kvantitativne analize alfa1-mikroglobulina i NAG u urinu mogu se upotrijebiti kao biološki pokazatelj u zdravstvenom nadzoru radnika koji su intermitentno izloženi parama elementarne žive u niskim koncentracijama

Simulation of Ultra-High Energy Photon Propagation in the Geomagnetic Field

The identification of primary photons or specifying stringent limits on the photon flux is of major importance for understanding the origin of ultra-high energy (UHE) cosmic rays. We present a new Monte Carlo program allowing detailed studies of conversion and cascading of UHE photons in the geomagnetic field. The program named PRESHOWER can be used both as an independent tool or together with a shower simulation code. With the stand-alone version of the code it is possible to investigate various properties of the particle cascade induced by UHE photons interacting in the Earth's magnetic field before entering the Earth's atmosphere. Combining this program with an extensive air shower simulation code such as CORSIKA offers the possibility of investigating signatures of photon-initiated showers. In particular, features can be studied that help to discern such showers from the ones induced by hadrons. As an illustration, calculations for the conditions of the southern part of the Pierre Auger Observatory are presented.Comment: 41 pages, 9 figures, added references in introduction, corrected energy in row 1 of Table 3, extended caption of Table

Mjerenje radona u vodi radi predviđanja potresa u Sloveniji

Radon (222Rn) concentration in water of several thermal springs was measured with the aim of obtaining a correlation with the seismic activity of the region. Though a qualitative correlation was found for a spring with deep water circulation, we are far from being able to predict either the time or the place of an earthquake. An additional study with more relevant sampling sites and more frequent water analyses would be necessary to achieve this.Mjerili smo količinu radona (222Rn) u vodi iz više izvora radi utvrđivanja moguće korelacije sa seizmičkom aktivnosti u Sloveniji. Iako smo našli kvalitativnu korelaciju za jedan izvor s dubokim kruženjem vode, nismo još u mogućnosti predvidjeti mjesto ili vrijeme potresa. Za to su potrebna proširena mjerenja na više mjesta i sa češćim uzorkovanjem vode

Personality Traits in Miners with Past Occupational Elemental Mercury Exposure

In this study, we evaluated the impact of long-term occupational exposure to elemental mercury vapor (Hg(0)) on the personality traits of ex-mercury miners. Study groups included 53 ex-miners previously exposed to Hg(0) and 53 age-matched controls. Miners and controls completed the self-reporting Eysenck Personality Questionnaire and the Emotional States Questionnaire. The relationship between the indices of past occupational exposure and the observed personality traits was evaluated using Pearson’s correlation coefficient and on a subgroup level by machine learning methods (regression trees). The ex-mercury miners were intermittently exposed to Hg(0) for a period of 7–31 years. The means of exposure-cycle urine mercury (U-Hg) concentrations ranged from 20 to 120 μg/L. The results obtained indicate that ex-miners tend to be more introverted and sincere, more depressive, more rigid in expressing their emotions and are likely to have more negative self-concepts than controls, but no correlations were found with the indices of past occupational exposure. Despite certain limitations, results obtained by the regression tree suggest that higher alcohol consumption per se and long-term intermittent, moderate exposure to Hg(0) (exposure cycle mean U-Hg concentrations > 38.7 < 53.5 μg/L) in interaction with alcohol remain a plausible explanation for the depression associated with negative self-concept found in subgroups of ex-mercury miners. This could be one of the reason for the higher risk of suicide among miners of the Idrija Mercury Mine in the last 45 years

Primary debulking surgery versus primary neoadjuvant chemotherapy for high grade advanced stage ovarian cancer: Comparison of survivals

The aim of the study was to analyze the overall survival (OS) and progression free survival (PFS) of patients with high grade and advanced stage epithelial ovarian cancer (EOC) with at least 60 months of follow-up treated in a single gynecologic oncology institute. We compared primary debulking surgery (PDS) versus neoadjuvant chemotherapy plus interval debulking surgery (NACT + IDS) stratifying data based on residual disease with the intent to identify the rationale for therapeutic option decision and the role of laparoscopic evaluation of resectability for that intention. This is observational retrospective study on consecutive patients with diagnosis of high grade and International Federation of Gynecology and Obstetrics (FIGO) stage III/IV EOC referred to our center between January 2008 and May 2012. We selected only patients with a follow-up of at least 60 months. Primary endpoint was to compare PDS versus NACT + IDS in term of progression free survival (PFS) and overall survival (OS). Secondary endpoints were PFS and OS stratifying data according to residual disease after surgery in patients receiving PDS versus NACT + IDS. Finally, through Cox hazards models, we tested the prognostic value of different variables (patient age at diagnosis, residual disease after debulking, American Society of Anesthesiologists (ASA) stage, number of adjuvant-chemotherapy cycles) for predicting OS. A total number of 157 patients were included in data analysis. Comparing PDS arm (108 patients) and NACT + IDS arm (49 patients) we found no significant differences in term of OS (41.3 versus 34.5 months, respectively) and PFS (17.3 versus 18.3 months, respectively). According to residual disease we found no significant differences in term of OS between NACT + IDS patients with residual disease = 0 and PDS patients with residual disease = 0 or residual disease = 1, as well as no significant differences in PFS were found comparing NACT + IDS patients with residual disease = 0 and PDS patients with residual disease = 0; contrarily, median PFS resulted significantly lower in PDS patients receiving optimal debulking (residual disease = 1) in comparison to NACT + IDS patients receiving complete debulking (residual disease = 0). PDS arm was affected by a significant higher rate of severe post-operative complications (grade 3 and 4). Diagnostic laparoscopy before surgery was significantly associated with complete debulking. We confirm previous findings concerning the non-superiority of NACT + IDS compared to PDS for the treatment of EOC, even if NACT + IDS treatment was associated with significant lower rate of post-operative complications. On the other hand, selecting patients for NACT + IDS, based on laparoscopic evaluation of resectabilty prolongs the PFS and does not worse the OS compared to the patients not completely debulked with PDS

Atmospheric effects on extensive air showers observed with the Surface Detector of the Pierre Auger Observatory

Atmospheric parameters, such as pressure (P), temperature (T) and density, affect the development of extensive air showers initiated by energetic cosmic rays. We have studied the impact of atmospheric variations on extensive air showers by means of the surface detector of the Pierre Auger Observatory. The rate of events shows a ~10% seasonal modulation and ~2% diurnal one. We find that the observed behaviour is explained by a model including the effects associated with the variations of pressure and density. The former affects the longitudinal development of air showers while the latter influences the Moliere radius and hence the lateral distribution of the shower particles. The model is validated with full simulations of extensive air showers using atmospheric profiles measured at the site of the Pierre Auger Observatory.Comment: 24 pages, 9 figures, accepted for publication in Astroparticle Physic

Olfactory and trigeminal interaction of menthol and nicotine in humans

The purpose of the study was to investigate the interactions between two stimuli—menthol and nicotine—both of which activate the olfactory and the trigeminal system. More specifically, we wanted to know whether menthol at different concentrations modulates the perception of burning and stinging pain induced by nicotine stimuli in the human nose. The study followed an eightfold randomized, double-blind, cross-over design including 20 participants. Thirty phasic nicotine stimuli at one of the two concentrations (99 and 134 ng/mL) were applied during the entire experiment every 1.5 min for 1 s; tonic menthol stimulation at one of the three concentrations (0.8, 1.5 and 3.4 μg/mL) or no-menthol (placebo control conditions) was introduced after the 15th nicotine stimulus. The perceived intensities of nicotine’s burning and stinging pain sensations, as well as perceived intensities of menthol’s odor, cooling and pain sensations, were estimated using visual analog scales. Recorded estimates of stinging and burning sensations induced by nicotine initially decreased (first half of the experiment) probably due to adaptation/habituation. Tonic menthol stimulation did not change steady-state nicotine pain intensity estimates, neither for burning nor for stinging pain. Menthol-induced odor and cooling sensations were concentration dependent when combined with low-intensity nicotine stimuli. Surprisingly, this dose dependency was eliminated when combining menthol stimuli with high-intensity nicotine stimuli. There was no such nicotine effect on menthol’s pain sensation. In summary, we detected interactions caused by nicotine on menthol perception for odor and cooling but no effect was elicited by menthol on nicotine pain sensation

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication