Occupational health hazards among nurses exposed to glutaraldeliyde

This study was curried out to describe the occurrence of work-related symptoms, lung function changes among nurses exposed to glutaraldehyde [GA] and DNA damage in human leukocytes incubated with GA [in-vitro study]

Methods: a cross-sectional study was carried out on 65 nurses exposed to GA from operating theaters and endoscopy units in Liver institute and University Hospital of Menufiya, Egypt. Pre and post-ship spirometry to measure forced expiratory flow rate in first second [FEVI] and peak expiratory flow rate [PEER] were performed on 26 nurses who had multiple lower respiratory work related symptoms and comet assay was used for detection of DNA damage in human leukocytec incubated with GA at different concentrations

Results: work-related symptoms reported by nurses were nausea [26.2%], headache [58.5%], skin allergy [86.2%], eye irritation [72.3%], and watering of eyes [35.4%]. Upper respiratory symptoms included nose irritation [84.6%], running nose [18.5%], throat irritation [81.5%]. Lower respiratory symptoms included sneezing [23.1%], cough [30.8%], difficult breathing [30.8%], and chest tightness [23.1%]. Their knowledge and practice turned to be very deficient regarding personal protection. Statistically significant reductions in post-ship PEER and FEVI were revealed, with 8 nurses [30.8%] having reductions >15%. Negative statistically significant correlations were detected between practice scores and post-ship reductions in PEER and FEVI. Human leukocytes incubated with GA at concentrations of 0.05 and 0.1 mg/ml had 13% and 8% DNA damage [DNA migration], respectively, compared to control [4%], p<0.05. Higher concentrations led to less damage

Conclusion: GA is associated with many work-related symptoms and reduction in lung functions among exposed nurses, and might increase DNA damage in in-vitro study. Training of nurses about safe handling and storage of GA, proper use of protective measures, periodical health care and surveillance, with reduction of exposure time, use of automated washing units, and effective ventilation methods are recommended to reduce the hazards of exposure to GA. Further studies involving environment assessment are needed

Ventilatory effects with metabolic and inflammatory responses after laparoscopic and abdominal hysterectomy

This study was carried out to quantify and compare the ventilatory effects with the metabolic and inflammatory responses after laparoscopic and abdominal hysterectomy. Forty patients with no major medical disease requiring abdominal hysterectomy for benign disorders were randomly assigned to have laparoscopic hysterectomy [n = 15] and abdominal hysterectomy [n = 25]. Bed side pulmonary function tests were done preoperanvely and at 2, 4, 6 and 8 hours post operatively using portable vitalograph-compact spirometer. Venous blood samples were collected the day before operation and for each of the first 2 post operative days for estimation of serum interleukin-6, C-reactive protein, plasma glucose and white blood cell count. The results of the study showed no differences in demographic characteristics and operating time in the two groups. No major complications were also encountered. The laparoscopic hysterectomy group had a significantly lower febrile morbidity rate [16% vs 46%, P < 0.05] and shorter hospital stay [Median 4 vs 6 days, P < 0.001]. The study showed also that all measurements of pulmonary function tests that require patient effort like forced expiratory volume in one second [FEVI] and peak expiratory flow rate [PEFR] and which are influenced by the strength of the respiratory muscles are better in case of laparoscopic hysterectomy compared to the abdominal hysterectomy group. The study demonstrated a significant elevations of C-reactive protein and interleukin-6 in both groups and this elevation denotes a less intense stress response in the laparoscopic hysterectomy group compared to the abdominal hysterectomy group as the serum interleukin-6 [median 42.2 vs 83.2 pgi, P < 0.001], C-reactive protein [Median 26.1 mglL vs 45.3 mglL, P < 0.001] and white blood cell count [Median 59.5 vs 69.0 10[9]/L, P = 0.009]. No significant difference was detected in plasma glucose [median 40.5 vs 45.6 mmol /L]. So, we can conclude that laparoscopic hysterectomy is very beneficial in keeping the standard of the pulmonary function post operatively and also, it is associated with a less intense stress response than abdominal hysterectomy for benign diseases

Tumour necrosis factor-alpha in patients with severe preeclampsia with and without HELLP syndrome

Tumor necrosis factor-a [TNF- alpha], acytokine produced mainly by macro-phages, is involved in immunoregulation, the modulation of cell growth and differentiation, as well as in the induction of oxygen radicals. This study was designed to investigate whether tumor necrosis factor- alpha [TNF- alpha] is present in maternal plasma in pregnancies associated with severe preeclampsia with and without HELLP syndrome and its concentrations. Fifty patients with severe preeclampsia composed the study group. This group is further subdivided into severe preeclamptic without HELLP syndrome, [n = 37] and severe preeclampsia with HELLP syndrome [n = 13]. A control group composed of 25 pregnant women, some of them were in early labor [n = 11] and the rest [n - 14] were in late pregnancy. Maternal plasma samples for TNF- alpha were taken for all groups. Also, serum creatinine spartate aminotransferase [AST], alanine aminotransferase [ALT] and platelets count to diagnose the presence of HELLP syndrome. TNF-alpha was detected in 80% of the studied group with severe preeclampsia [n = 50], while it was detected only in 13 patients [21%] only in the control groups. Also, the maternal plasma concentration in the severe preeclamptic group was [61 +/- 17] ng/ml and [146 +/- 37] ng/ml in the severe preeclampsic group with HELLP syndrome [n = 13] respectively which were statistically highly significant when compared to maternal plasma levels in the control group [7 +/- 3] ng/ml. There were no positive or negative correlation between TNF- alpha plasma concentrations in both groups and maternal age, gestational age and parity. Also, in the severe preeclamptic group there were no positive or negative correlation between the diastolic blood pressure, the amount of protein urine, the liver enzymes or platelets count and TNF- alpha maternal serum levels. So, we can concluded that tumor necrosis factor-alpha is increased in the plasma of patients with severe pre-eclampsia especially those developing HELLP syndrome. These data are suggestive of a role for abnormal immune activation in the pathophysiologic mechanisms of severe pre-eclampsia with or without HELLP syndrome