Compensatory sweating after restricting or lowering the level of sympathectomy: a systematic review and meta-analysis

OBJECTIVE: To compare compensatory sweating after lowering or restricting the level of sympathectomy. METHOD: A systematic review and meta-analysis were conducted of all randomized controlled trials published in English that compared compensatory sweating after lowering or restricting the level of sympathectomy. The Cochrane collaboration tool was used to assess the risk of bias, and the Mantel-Haenszel odds ratio method was used for the meta-analysis. RESULTS: A total of 11 randomized controlled trials were included, including a total of 1079 patients. Five of the randomized controlled trials studied restricting the level of sympathectomy, and the remaining six studied lowering the level of sympathectomy. CONCLUSIONS: The compiled randomized controlled trial results published so far in the literature do not support the claims that lowering or restricting the level of sympathetic ablation results in less compensatory sweating. .

A Case-Study of Implementation of Improved Strategies for Prevention of Laboratory-acquired Brucellosis

BACKGROUND: In 2012, the Alaska Section of Epidemiology investigated personnel potentially exposed to a Brucella suis isolate as it transited through three laboratories. METHODS: We summarize the first implementation of the United States Centers for Disease Control and Prevention 2013 revised recommendations for monitoring such exposures: (1) risk classification; (2) antimicrobial postexposure prophylaxis; (3) serologic monitoring; and (4) symptom surveillance. RESULTS: Over 30 people were assessed for exposure and subsequently monitored for development of illness. No cases of laboratory-associated brucellosis occurred. Changes were made to gaps in laboratory biosafety practices that had been identified in the investigation. CONCLUSION: Achieving full compliance for the precise schedule of serologic monitoring was challenging and resource intensive for the laboratory performing testing. More refined exposure assessments could inform decision making for follow-up to maximize likelihood of detecting persons at risk while not overtaxing resources.

Vitamin B12 Content Using Modified Microbioassay in Some Korean Popular Seaweeds, Fish, Shellfish and Its Products

There is a limitation to estimate vitamin B12 intake due to a lack of data on vitamin B12 content in many Korean foods. In this study, vitamin B12 content was determined in some seaweeds, fish, and shellfish and their product that are consumed in Korea using a modified microbioassay with Lactobacillus delbruecki ATCC 7830. Dried laver and dried seasoned and toasted laver contained very high levels of vitamin B12 (66.8 and 55.2-71.3 microg/100 g, respectively. Sea lettuce and seaweed fulvescene also contained high vitamin B12 content of 5.47-9.41 and 6.46-7.20 microg/100 g, respectively, whereas sea mustard and sea tangle contained low levels of vitamin B12; vitamin B12 was not detected in seaweed fusifome. Pacific saury, trout, sea-bass, or squid contained 12.01, 2.00, 0.49 and 2.33 microg vitamin B12/100 g, respectively. Ochellatus octopus, and naked sand lance contained 0.72-1.43 and 3.68 microg vitamin B12/100 g, respectively. Dried Alaska pollack contained 0.19-2.64 microg vitamin B12/100 g. Shellfish such as little neck clam and small ark shellfish contained high levels of vitamin B12 of 30.5-40.5 microg/100 g, and mussel and abalone contained 17.71 and 7.82 microg/100 g, respectively. Of unique Korean traditional fermented seafood products, salt-fermented products of squid (2.91 microg/100 g), clams (34.31 microg/100 g), Alaska pollack roe (9.98-12.02 microg/100 g), hairtail guts (4.58 microg/100 g) or small shrimp (0.58-1.55 microg/100 g), and fish sauce from anchovies (1.52-1.78 microg/100 mL), sand eel (0.22-0.24 microg/100 mL) or small shrimp (0.19-0.78 microg/100 mL) were analyzed. A few commercial brands of flying fish roe (0.73-1.73 microg/100 g), canned tuna (0.40 microg/100 g), and fried fish paste (0.25-0.69 microg /100 g) were also analyzed. In conclusion, vitamin B12 content in these foods, chosen considering the Korean food culture, should contribute to improve the present vitamin B12 food database. It may be helpful to estimate vitamin B12 intake more correctly than before, and provide additional information for dietary education related to vitamin B12 and meal management.

Preventing amputations from diabetes mellitus: the Indian Health Service experience

With the heavy burden of diabetes mellitus among American Indians and Alaskan Natives, lower-extremity amputation (LEA) has become a common complication. Rates of diabetes-related LEA are 2-3 times those observed in other diabetic populations. During the past 12 years, the Indian Health Service (IHS) has made LEA prevention a public health priority. From 1988 to 1992 screening criteria based on simple examinations were developed and validated in primary care Settings. Prevention efforts have focused on targeting high-risk individuals for self-care foot education, provision of protective footwear, and routine podiatry care. Follow-up studies in Alaska and northern Minnesota saw 25-50reductions in LEA rates associated with these interventions. In settings where these efforts were augmented with system changes, such as team coordination, patient-tracking systems, comprehensive footcare practice guidelines, flowsheets, and outreach programmes, LEA incidence was reduced by 50-75. Efforts are currently underway to disseminate system-based approaches for comprehensive diabetic footcare and to expand the availability of foot care resources to tribal communities served by the IHS.

Survey on Waste Rates of Foods for Menu Planning

The waste rates of 98 food items after pre-preparation were surveyed to provide database for good menu planning. The waste rates turned out 0~64.27% in vegetables, 6.38~7.03% in potatoes, 6.25~68.75% in fishes and shellfishes, 16.61% in eggs, and 16.00~56.84% in fruits. Foods with high waste rates were vegetables, fishes and shellfishes. Survey results were compared with other food composition tables. Foods with 30% higher waste rate than other food composition tables were squash leaf, pacific ocean perch, sweet potato stalk, water cress, green peas, alaska pollack, bluefin tuna, beka squid, crown daisy, dodok, amaranth, beef ribs. Food which waste rates turned out to be decreased by about 30% in this study were corb shell, pomfret, sea mussel, warty sea squirt. For the menu planning, reasonaly exact waste rates for each food items are essential. Since survey results show signigicant deviations, there should be more studies for exact waste rates for each food.