A comparison of PBDE serum concentrations in Mexican and Mexican-American children living in California.

BackgroundPolybrominated diphenyl ethers (PBDE), which are used as flame retardants, have been found to be higher in residents of California than of other parts of the United States.ObjectivesWe aimed to investigate the role of immigration to California on PBDE levels in Latino children.MethodsWe compared serum PBDE concentrations in a population of first-generation Mexican-American 7-year-old children (n = 264), who were born and raised in California [Center for Health Analysis of Mothers and Children of Salinas (CHAMACOS) study], with 5-year-old Mexican children (n = 283), who were raised in the states in Mexico where most CHAMACOS mothers had originated (Proyecto Mariposa).ResultsOn average, PBDE serum concentrations in the California Mexican-American children were three times higher than their mothers' levels during pregnancy and seven times higher than concentrations in the children living in Mexico. The PBDE serum concentrations were higher in the Mexican-American children regardless of length of time their mother had resided in California or the duration of the child's breast-feeding. These data suggest that PBDE serum concentrations in these children resulted primarily from postnatal exposure.ConclusionsLatino children living in California have much higher PBDE serum levels than their Mexican counterparts. Given the growing evidence documenting potential health effects of PBDE exposure, the levels in young children noted in this study potentially present a major public health challenge, especially in California. In addition, as PBDEs are being phased out and replaced by other flame retardants, the health consequences of these chemical replacements should be investigated and weighed against their purported fire safety benefits

GREENMARKET NOVA-IORQUINO: ONDE O RURAL SE ENCONTRA COM A MEGALÓPOLE AMERICANA

O Greenmarket Farmers, como são chamados os mercados hortícolas em Nova Iorque, Estados Unidos da América, tem como uma de suas particularidades a de ser organizado por produtores rurais apoiados pelo Council of Environment of the New York City e cuja venda de produtos deve ser feita diretamente aos consumidores, sem intermediários. Exerce uma importante função, tanto para os agricultores quanto para o público consumidor. No presente estudo foi realizado levantamento contínuo no período de um ano (agosto de 2008 a junho de 2009) seguindo-se de visitas pontuais nos anos de 2010, 2011 e 2012 ao levantamento sistemático, um refinamento dos dados sobre as plantas hortícolas comercializadas e seus produtores no Greenmarket Farmers, que possuem 46 pontos de venda em Manhattan, Brooklyn, Queens, Bronx e Staten Island. Neste período foram observados aspectos de entrelaçamento entre produtores rurais e consumidores urbanos, além da diversidade vegetal. Foram levantadas 120 espécies de plantas comercializadas por 60 produtores, nos diversos pontos do Green Market. Foram listadas 38 famílias botânicas, inseridas em 84 gêneros. A família mais recorrente é Brassicaceae (18), seguida de Asteraceae (13), Lamiaceae (12) e Rosaceae (12). Aspecto que se revela nestas feiras é a face agrícola do estado de Nova Iorque, em geral representado por atividades de turismo e do centro financeiro do mais poderoso país do mundo, e uma das maiores concentrações populacionais do planeta. O apelo ecológico, o estímulo ao consumo de produtos locais e a concessão de cupons de beneficio cedidos às pessoas em dificuldade[1], em uma comunidade cosmopolita e multi-étnica, canalizam recursos públicos e apoiam este tipo de mercado, permitindo uma reflexão sobre as relações e interatividade entre rural e urbano, diluídas pelas características próprias aos países desenvolvidos, em especial em grandes cidades. Portanto, percebe-se com este trabalho que os “greenmarkets” são pontos não só de venda de grande diversidade de vegetais, mas também local para relacionamentos, trocas de experiências e ideologias.[1] Os cupons podem ser usados em qualquer supermercado ou nos Greenmarkets

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A comparison of PBDE serum concentrations in Mexican and Mexican-American children living in California.

BackgroundPolybrominated diphenyl ethers (PBDE), which are used as flame retardants, have been found to be higher in residents of California than of other parts of the United States.ObjectivesWe aimed to investigate the role of immigration to California on PBDE levels in Latino children.MethodsWe compared serum PBDE concentrations in a population of first-generation Mexican-American 7-year-old children (n = 264), who were born and raised in California [Center for Health Analysis of Mothers and Children of Salinas (CHAMACOS) study], with 5-year-old Mexican children (n = 283), who were raised in the states in Mexico where most CHAMACOS mothers had originated (Proyecto Mariposa).ResultsOn average, PBDE serum concentrations in the California Mexican-American children were three times higher than their mothers' levels during pregnancy and seven times higher than concentrations in the children living in Mexico. The PBDE serum concentrations were higher in the Mexican-American children regardless of length of time their mother had resided in California or the duration of the child's breast-feeding. These data suggest that PBDE serum concentrations in these children resulted primarily from postnatal exposure.ConclusionsLatino children living in California have much higher PBDE serum levels than their Mexican counterparts. Given the growing evidence documenting potential health effects of PBDE exposure, the levels in young children noted in this study potentially present a major public health challenge, especially in California. In addition, as PBDEs are being phased out and replaced by other flame retardants, the health consequences of these chemical replacements should be investigated and weighed against their purported fire safety benefits

Frequencies of encapsulated brain cysts with putative REBI from untreated and PZQ-treated pigs.

<p>* compared to UT.</p><p>** compared to PZQ48.</p><p>NS: non significant.</p

Characterization of REBI in muscle cysts.

<p>(<b>A</b>) A representative hematoxylin-eosin (H&E) stained section through a REBI (black arrow) on a non encapsulated muscle cyst; the solid rectangle represents the area shown in “B”; isolated, non encapsulated, muscle cysts demonstrating REBI (inset). (<b>B</b>) A high and even higher magnification view (inset) of the eosinophil-rich cellular infiltrate of the REBI shown in “A” (solid rectangle). (<b>C</b>) Uninvolved cyst wall showing identifiable structures in a region close to the REBI (inset) in two magnified views of the dashed line rectangle in panel “A”. (<b>D</b>) Bright field microscopy of an unstained deparaffinized section of the REBI of the muscle cyst in “A”, demonstrating uptake of EB by eosinophils. (<b>E</b>) Fluorescent microscopy with a rhodamine filter of the same section. (<b>F</b>) H&E staining of the same section. (<b>G</b>) Immunolocalization of eosinophils and EB in a REBI with eosinophil peroxidase (EPX)-specific antibodies (brown interior staining). (<b>H</b>) Fluorescence micrograph of the same section as shown in “G”. (<b>I</b>) Merged image of “G” and “H”. Bar: 1 µm (A inset); 400 µm (A); 200 µm (B, C); 20 µm (D — I and insets in B and C). Key: cw = cyst wall; t = tegument; st = subtegument; ir = internal region.</p