Determination of the inflammatory potential of bioaerosols from a duck-fattening unit by using a limulus amebocyte lysate assay and human whole blood cytokine response.

Inhalation of bioaerosols from animal houses can induce acute inflammatory reactions in the respiratory tract. Determination of the concentration of airborne endotoxins is widely used to characterize this risk. In this study, the activity of bioaerosol samples from a duck-fattening unit to induce interleukin-1beta (IL-1beta) in human blood and to react with Limulus Amebocyte Lysate (LAL) was investigated. The activity detected in the whole blood assay correlated well with the endotoxic activity found in the LAL assay (Spearmen's rho = 0.902). However in all samples, the inflammation-inducing potential was overestimated by the LAL assay. It is assumed that this overestimation could be, in part, a result of an overestimation of the inflammatory potential of endotoxins originating from Pseudomonadaceae by the LAL assay. Pseudomonadaceae were regularly isolated from the air of the duck-fattening unit. The results presented here indicate that the whole blood assay can be used besides the LAL assay as an additional method to characterize the inflammation-inducing potential of bioaerosols.

[The quality of life after extirpation of the rectum for carcinoma]. / Lebensqualität nach karzinombedingter Rektumexstirpation.

BASIC PROBLEM AND AIM OF STUDY: The quality of life for patients who have undergone total rectal resection for carcinoma is impaired by the artificial intestinal stoma. Their psychosocial disorders were analysed in relation to the method of looking after the stoma (with or without controlled stool emptying by intestinal irrigation) and compared with patients who had a after continence-preserving operation for rectal carcinoma. PATIENTS AND METHODS: Of the 205 patients (aged 58.6 +/- 8.1 years; 72 women and 133 men) 78 had a continence resection (group 1), 127 had a colostomy (irrigation in 81, group 2a; merely looking after the colostomy bag in 46, group 2b). Their personality characteristics were tested prospectively with the State-Trait Anxiety Inventory (STAI) and quality of life parameters with a standardized questionnaire. RESULTS: While personality traits were similar, significantly fewer patients in group 2a complained about disturbances of self esteem (32.9 vs 60.0%; P < 0.01), and had pessimistic future expectations (20.5 vs 46.5; P < 0.01) than those in group 2b. There was no significant difference in these two parameters between groups 1 and 2a. The irrigation procedure was taught to 60.5% of patients during their hospital stay. Accepting irrigation was more common when rehabilitation was begun early rather than delayed (72.9 vs 42.9%; P < 0.01). Disturbances of erection occurred in 69.9% of men younger than 60 years after the operation. CONCLUSIONS: Compared with conventional bag care, regular irrigation improves the quality of life for patients with a colostomy. Postoperatively disordered erection is an independent risk factor for any abnormal self esteem and depression. They should be stressed more during history taking and therapeutically.

Adaptive housing: remodeling considerations for the disabled.

The disabled are handicapped only to the extent that they are prevented from being normal. The process of normalization is hampered by physical barriers in the home that make life difficult for disabled persons. Staff can be trained to eliminate these architectural barriers in the home, focusing primarily on accessibility, the bathroom, the bedroom, and the kitchen. Completion of the barrier-free design of the home should provide a cost-effective means for improving the quality of life for disabled persons and their families.