Brominated flame retardants (BFRs) in breast milk and associated health risks to nursing infants in Northern Tanzania.

The main aim of this study was to assess brominated flame retardants (BFRs) in breast milk in the Northern parts of Tanzania. Ninety-five colostrum samples from healthy, primiparous mothers at Mount Meru Regional Referral Hospital (MMRRH), Arusha Tanzania, were analyzed for polybrominated diphenyl ethers (PBDEs), hexabromocyclododecane (HBCD), 1,2-bis(2,4,6-tribromophenoxy) ethane (BTBPE), hexabromobenzene (HBB), (2,3-dibromopropyl) (2,4,6-tribromophenyl) ether (DPTE), pentabromoethylbenzene (PBEB) and 2,3,4,5,6-pentabromotoluene (PBT). The Æ©7PBDE (BDE 28, 47, 99, 100, 153, 154, 183) ranged from below level of detection (

Levels of PCBs in wild bird eggs: considering toxicity through enzyme induction potential and molecular structure.

Polychlorinated biphenyls (PCBs) were analysed in wild bird eggs from industrialised areas in South Africa. The concentration, congener profile, feeding guild, potential associated risk and biology were investigated. PCBs were detected in all eggs with 30 congeners present in more than 80% of the samples. Σ(34)PCB concentrations ranged between 0.9 and 296 ng g(-1) wet weight (ww). The metabolic potential of the PCB metabolic groups showed good agreement with the biodegradability of the individual congeners. Phenobarbital-type (PB-type) inducer PCBs were prevalent, indicating the predominance of less toxic PCB congeners. However, non-ortho PCBs which were not included in the current analyses, could affect the toxic potential of the PCBs in the eggs requiring more investigation. Although the current levels of PCBs measured do not indicate a health risk to the birds assessed, the presence of mono-ortho PCBs at appreciable levels motivates for the assessment of dioxin-like chemicals in wild bird eggs.

Levels and patterns of Persistent Organic Pollutants (POPS) in selected food items from Northwest Russia (1998-2002) and implications for dietary exposure.

Residues of persistent organic pollutants (POPs) were analysed in 70 selected food items from Northwest Russia in 1998-2002. Levels of PCBs ranged from 0.2 to 16ng/g wet weight (ww) in dairy products and fats, 0.2 to 23ng/g ww in meat products, 0.5 to 16ng/g ww in eggs and 0.3 to 30ng/g ww in fish. High levels of DDT (16ng/g ww) were found in locally produced butter from Kola Peninsula, in pork fat from Arkhangels region (10 to 130ng/g ww) and in some fish samples from White Sea and Kargopol region (17 and 30ng/g ww). Findings of low DDE/DDT ratios in many of the studied food items indicated recent contamination to DDTs. Mean levels of sum TEQs(WHO1998) of dioxin-like mono-ortho PCBs: PCBs 105, 118, 156 and 157 (∑mo-PCBs-TEQs(WHO1998)) were highest in dairy products, chicken eggs and fish, with levels of 0.292, 0.245 and 0.254pg/g ww, respectively. The estimated daily intake (EDI) for ∑mo-PCBs-TEQs(WHO1998) was 0.74pg/kgbw/day and in the same range as in Sweden and Denmark. Fish, dairy products, eggs and meat were the main contributors to the EDI of ∑mo-PCBs-TEQs(WHO1998). The EDIs of DDTs, HCHs and HCB were several times higher than in Sweden and Denmark. Consumption of meat and poultry were important sources for intake of DDTs and HCHs, respectively. Contamination of animal feed and agricultural practice were assumed the most important causes for the results in the present study. However, increased control on maximum residue levels in food and feed may have resulted in large changes on levels and patterns of POPs in food in the studied areas.

Levels of chlorinated pesticides and polychlorinated biphenyls in Norwegian breast milk (2002-2006), and factors that may predict the level of contamination.

In the present study, polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were determined in 423 breast milk samples from women living in Norway. Various predictors for the contaminant levels were also investigated. The samples were collected in six counties, representing South, Central and North Norway in 2002-2006. Initial results showed significantly lower levels of OCPs in breast milk from ethnic Norwegians (N=377) compared to ethnic non-Norwegians (N=46). Median concentrations (range) of PCBs, p,p'-DDE, HCB, beta-HCH and oxychlordane in breast milk of the Norwegian women, all parities included, were 103 (34-450), 41 (5.4-492), 11 (3.6-24), 4.7 (0.9-37) and 2.8 (0.5-16) ng/g lipid weight, respectively. Results indicated that sum of 18 PCBs, p,p'-DDE and beta-HCH are good predictors for monitoring of PCB, DDT and HCH levels in Norwegian breast milk. Multivariable linear regression analyses showed that age was strongly associated with increasing OC levels (P<0.001), whereas parity was associated with decreasing OC levels (P<0.001). Smoking was associated with higher levels of PCBs, p,p'-DDE and beta-HCH. The models explained from 17 to 35% of the variance. Median levels of OCs in the present Norwegian primparaes seemed to be 29-62% lower than corresponding results found in a Norwegian study from 2000-2002.

Levels and temporal trends of chlorinated pesticides, polychlorinated biphenyls and brominated flame retardants in individual human breast milk samples from Northern and Southern Norway.

Human breast milk samples from primipara women from Northern (Tromsø) (N=10) and Southern Norway (Oslo) (N=19) collected in 2000-2001 were analysed with respect to hexachlorobenzene (HCB), hexachlorocyclohexane (HCHs), chlordanes (CHLs), DDTs, mirex, toxaphenes (CHBs), polychlorinated biphenyls (PCBs), polybrominated diphenylethers (PBDEs) and hexabromocyclododecane (HBCD). CHBs, PBDEs and HBCD were only analysed in the Tromsø samples. Sum-PCBs and sum-DDTs were the major organochlorines (OCs) (170 and 110 ng g(-1) lipid weight (lw), respectively). Other OCs were found in levels of approximately 10- to 300-fold lower than sum-PCBs. Overall, the concentrations of OCs followed the decreasing order of PCBs>DDTs>HCB>HCHs approximately CHLs>CHBs>mirex. Concentrations of sum-HCHs were significantly higher in breast milk from Oslo compared to Tromsø (p<0.05). The PCB profile was dominated by PCB-153, -138 and -180. The PBDE pattern was dominated by PBDE-47 and PBDE-153. The median level of sum-PBDEs was 4.1 ng g(-1) lw. PBDE-209 was detected in all analysed samples (median 0.13 ng g(-1) lw). The estimated daily intake (EDI) for the median (range) of sum mono-ortho (mo) PCBs(8) was 3.7 (1-9) pg TEQ kg(-1) body weight per day for breast fed infants in Norway. This exceeded the TDI by a factor of 1.8 (1-4) based only on intake of mono-ortho PCBs. The present study shows that concentrations of OCs in primipara breast milk have decreased 50-60% since 1991, and that this trend is continuing.

Spatial and temporal changes of chlorinated pesticides, PCBs, dioxins (PCDDs/PCDFs) and brominated flame retardants in human breast milk from Northern Russia.

This study presents for the first time temporal changes of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in Russian human breast milk samples. Concentrations of OCPs and PCBs in samples from three locations in the North West of Russia in 2000-2002 (n=42), were compared to corresponding levels measured in 1993-1996 (n=58). In addition brominated flame retardants (BFRs), consisting of polybrominated diphenylethers (PBDEs) (including BDE-209) and hexabromocyclododecane (HBCD) were analysed in samples from 2000-2002 (n=37). The present levels of SigmaDDTs and SigmaHCHs were 5 and 10 times higher than corresponding levels in the neighbouring country Norway. Median concentrations of SigmaHCHs (196 microg/kg lw), SigmaCHBs (19.7 microg/kg lw) and SigmaPCBs(16) (316 microg/kg lw) were highest in Murmansk. The percentage of p,p'-DDT to SigmaDDTs and ratio DDE/DDT suggest possible ongoing use of DDT in Russia. Levels of PBDE were low and dominated by the congeners BDE-47 and BDE-153. The deca brominated BDE-209 was detected in all analysed samples (median concentration 0.19 microg/kg lipid). Levels of SigmaOCPs and SigmaPCBs decreased 56 and 30% in Murmansk and 36 and 43% in Arkhangelsk during the study period. The decline of SigmaOCPs was significant at both locations (p<0.05-p<0.0001). For SigmaPCBs, the decreasing trend was only significant in Arkhangelsk (p<0.0001). In addition, a decline of Sigmatotal TEQs (SigmaTEQs of PCDDs/PCDFs, non-ortho- and mono-ortho PCBs) was observed in Murmansk and Arkhangelsk during the study period. The exposure of infants by PCDDs/PCDFs and dioxin-like PCBs is still exceeding the daily tolerable intake (TDI) in North West Russia. However, the concentrations of PCDDs/PCDFs and dioxin-like PCBs seem to decline very rapidly.

Patient satisfaction and quality of care at four diagnostic imaging procedures: mammography, double-contrast barium enema, abdominal ultrasonography and vaginal ultrasonography.

The objective of this study was to measure patient satisfaction and to investigate the practical implications of monitoring the quality of care at four radiology procedures. A survey was conducted immediately after the examinations in eight radiology departments: 550 patients attending for mammography, 110 for double-contrast barium enema (DCBE), 97 for abdominal ultrasonography and 90 for vaginal ultrasonography. Outcome measures were seven questionnaire scales: pain, emotional distress, information received, staff's punctuality and technical ability, facilities, and general satisfaction. Response rate was 87 %. Multivariate regression analysis showed significant differences between procedures on all scales (p < 0.001). Differences considered to be of practical importance, i. e. >/= 7 scale points, were detected on five of the scales. Mammography and DCBE caused the most pain, and vaginal US and DCBE caused the most distress. The US procedures entailed dissatisfaction with information about the procedures. The DCBE patients recorded dissatisfaction with the staff's lack of punctuality, and these and the mammography patients recorded dissatisfaction with the facilities. The findings indicate a potential for improving patients' experiences. Several aspects of care, i. e. pain management, attention to the patient's emotional concerns, explanation of procedures, punctuality and quality of the facilities, can be improved.

Mammography: influence of departmental practice and women's characteristics on patient satisfaction: comparison of six departments in Norway.

OBJECTIVE: To investigate how departmental practice and women's characteristics are related to low patient satisfaction with mammography. DESIGN: Survey of patients by means of self administered questionnaires before and after mammography. PATIENTS: 488 women (89% of those invited), aged 23-86 years, at six departments. MAIN OUTCOME MEASURES: Low level of satisfaction measured on psychometric scales of physical pain, psychological distress, staff punctuality and technical skills, information provided, and physical surroundings. RESULTS: Satisfaction varied by department on the scales for pain, punctuality, information, and surroundings. After adjustment for women's characteristics an attributable risk of negative outcome by department was identified on the scales for pain, distress, punctuality, information, and surroundings. Adjusted odds ratio (ORs) ranged from 0.3 (95% confidence interval (95% CI) 1.2 to 6.0) on the pain scale, to 6.0 (2.9 to 12.3) on the punctuality scale. After adjustment for confounding variables, higher risk of dissatisfaction was associated with age < 50, nervousness about mammography, expected pain, lack of knowledge about mammography, and distrust in mammography (adjusted OR (95% CI) ranged from 1.6 (1.0 to 2.7) to 3.7 (2.0 to 7.3)). CONCLUSION: Departmental practices differed for breast compression, information, punctuality, and facilities and were associated with a low level of satisfaction irrespective of patient characteristics. Women's lack of knowledge about mammography and distrust in the procedure were confirmed as risk factors for dissatisfaction. All these factors might be helped by training the staff, improving facilities, and informing the women.

Experimental infection of the red-backed vole (Clethrionomys gapperi) with Borrelia burgdorferi.

Red-backed voles (Clethrionomys gapperi) were live trapped in northern St. Louis County, Minnesota (USA), in late September and October 1988 and experimentally inoculated with Borrelia burgdorferi. Spirochetes were isolated from most animals 14 and 28 days following inoculation. Thus, red-backed voles exposed to B. burgdorferi were susceptible to infection and could be a reservoir host, along with chipmunks (Tamias striatus) and other small rodents, in areas where white-footed mouse (Peromyscus leucopus) populations are low. No evidence of clinical disease was noted in any infected voles.

Double-contrast barium enema versus colonoscopy in the diagnosis of neoplastic disorders: aspects of decision-making in general practice.

A total of 190 patients, referred by general practitioners for a double-contrast barium enema, were subsequently examined with colonoscopy. With colonoscopy and histology as the reference standard, sensitivity, specificity, positive and negative predictive values, and accuracy for the radiological detection of cancer and polyps were calculated. No cancer was overlooked by the radiological examination, but there were four false positives. The overall sensitivity for polyps was 70%, increasing to 81% for polyps > or = 10 mm. The predictive value was 93-97% for the exclusion of polyps. The caecum was reached in 187 patients by double-contrast barium enema (98%) and in 164 patients (86%) by colonoscopy. Lesions in four of 12 patients who had radiological changes were undetected at the first colonoscopy, but a repeat examination showed polyps > or = 10 mm in size. Although colonoscopy is a more sensitive technique for the detection of small mucosal lesions, the general practitioners may, in the vast majority of patients, rely on a negative result for polyps and cancer obtained by the double-contrast barium enema. The latter is linked with a number of false-positive cases, while colonoscopy is associated with technical difficulties; both techniques may lead to repeated examinations, regardless of which was the first choice.

Age and sex: underestimated selection criteria for referral to x-ray examination of the colon?

An analysis was made of 2416 consecutive patients who underwent a double-contrast barium enema at the Central Roentgen Institute in Oslo. Age, sex, and radiological findings were registered. The age and sex distribution among patients consulting in general practice and in our study was surprisingly similar. This suggests that age as a risk factor for colorectal neoplasms did not play a prominent role among the referring doctors. Colorectal cancer was more frequent in males (4%) than females (2%) (p = 0.03). Odds ratio adjusted for age was 2.1 (1.3-3.8). This may be due to few examinations performed in old age, and different patient behaviour when experiencing colorectal symptoms. The overall polyp frequency was 11%. The frequency increased significantly from the age group 40-49.

Seroprevalence of Lyme disease in gray wolves from Minnesota and Wisconsin.

To determine the seroprevalence of Lyme disease in gray wolves (Canis lupus) from various counties of Minnesota and Wisconsin (USA), 589 serum samples were collected from 528 wolves from 1972 to 1989. An indirect fluorescent antibody (IFA) test was used to detect the presence of antibodies against Borrelia burgdorferi. Titers of greater than or equal to 1:100 were considered positive. Results were confirmed by testing a few selected sera by Western blotting. Of the 589 sera tested, 15 (3%) had IFA titers of greater than or equal to 1:100. Three of the positive samples were collected from Douglas County in Wisconsin and twelve were from Minnesota counties. This study indicates that wolves are exposed to B. burgdorferi and are susceptible to Lyme disease.

110-kilodalton recombinant protein which is immunoreactive with sera from humans, dogs, and horses with Lyme borreliosis.

EcoRI-digested DNA from Borrelia burgdorferi was ligated into the dephosphorylated vector pWR590 and transformed into Escherichia coli DH5 alpha. When the gene library was screened, 20 clones reacted with pooled dog sera with high titers (immunofluorescent antibody titer, greater than or equal to 1,280) to this spirochete. One clone expressed a 110-kDa antigen that reacted strongly with the high-titered pooled sera from dogs with Lyme borreliosis and serum from goats immunized with B. burgdorferi. The 110-kDa protein was serum from goats immunized with B. burgdorferi. The 110-kDa protein was expressed with and without isopropyl-beta-D-thiogalactosidase, indicating the protein is not a fusion protein with beta-galactosidase. Monospecific antisera to the 110-kDa antigen recognized a 75-kDa Borrelia protein. Of the sera that reacted with B. burgdorferi by immunoblotting; 57, 100, and 83% of human, dog, and horse serum samples, respectively, reacted with the 110-kDa protein. Sera from individuals that tested negative with a B. burgdorferi lysate with immunoblotting showed no reaction with the 110-kDa protein. The 110-kDa antigen appears to be useful for the diagnosis of Lyme borreliosis.

Ixodes dammini: occurrence and prevalence of infection with Borrelia spp. in Minnesota.

The distribution of Ixodes dammini in Minnesota was studied by collecting adult ticks from hunting dogs during the grouse seasons in September and October of 1985 and 1986. The tick was most frequently found in the east-central part of the state. Borrelia spp. were observed by immunofluorescence in 10% of the ticks. The locations where ticks were found coincide with the primary endemic areas for Lyme disease in the state.

Purification and characterization of the 1q subcomponent of canine complement and its use in the 125I-C1q binding assay for detection of immune complexes.

The complement subcomponent, C1q, was isolated from serum obtained from clinically normal dogs, using a rapid 2-step process involving affinity chromatography. Yield of C1q ranged from 8 to 10 mg/L of serum. Hemolytically active C1q had 3 protein bands after sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions and formed a single line of identity with rabbit anti-canine C1q. The amino acid composition of canine C1q was similar to that of human C1q and contained a high percentage of glycine. Isolated canine C1q was iodinated, and the fluid-phase binding assay was used to detect circulating immune complexes in dogs with systemic lupus erythematosus and rheumatoid arthritis.

Isolation of the Lyme disease spirochete from mammals in Minnesota.

Lyme disease spirochetes were isolated from the kidneys of two Peromyscus spp. trapped in Minnesota in September and October 1983. No spirochetes were isolated from white-tailed deer (Odocoileus virginianus), red backed voles (Clethrionomys gapperi), or shrews (Sorexy cinereus and Blarina brevicauda). This is the first report of the isolation of the Lyme disease spirochete from the midwestern United States and isolations from these animals, which were free of ticks, suggest that the Lyme disease spirochete may persist in animal organs for months.

Effect of antimicrobial agents and corticosteroids on bovine polymorphonuclear leukocyte chemotaxis.

The effect of certain antimicrobial agents and corticosteroids on bovine polymorphonuclear leukocyte chemotaxis was investigated. Peripheral blood was fractioned by density-gradient centrifugation, using Ficoll-Hypaque. The chemotactic assay was performed in modified Boyden chambers, using Micropore filters, and the chemotactic response was measured by the leading-front technique. Tetracyclines, streptomycin, and penicillin had no effect on chemotaxis at concentrations normally achieved in blood during systemic treatment. However, higher concentrations that were achievable with local therapy, such as intramammary injection or topical application, inhibited the chemotactic response. This inhibition was eliminated by serum. Dexamethasone stimulated polymorphonuclear leukocyte chemotaxis with the effect being manifested after the cells were incubated with the drug for 3 hours. Hydrocortisone caused slight inhibition of chemotaxis, whereas prednisone and prednisolone had no effect.

Enhancement of the chemotactic response of bovine polymorphonuclear leukocytes by levamisole.

The effects of levamisole on random migration, chemotaxis, phagocytosis, and intracellular killing by bovine polymorphonuclear leukocytes (PMN) were investigated. Chemotactic assays were performed, using Micropore filters in modified Boyden chambers. Phagocytosis and intracellular killing of Escherichia coli were analyzed by standard viable bacterial counts. Results indicated that levamisole enhanced the chemotactic response of PMN at concentrations ranging from 10(-4) to 5 x 10(-3)M. Phagocytes collected from cows at 90 minutes after IM injection of levamisole also showed enhanced random migration and chemotaxis. Freshly prepared serum was shown to enhance the levamisole-induced stimulation of chemotaxis. Levamisole had no effect on phagocytosis or intracellular killing of E coli by bovine PMN.