In-depth characterization of exhaust particles performed on-board a modern cruise ship applying a scrubber.

To comply with environmental regulations, ship operators may adopt exhaust after-treatment devices such as scrubbers or selective catalytic reduction (SCR). Beyond gaseous emission control, these technologies impact the exhaust particles emitted from marine engines to the atmosphere. This study characterizes comprehensively the chemical composition and physical properties of exhaust aerosol particles upstream and downstream a hybrid scrubber operating in open loop mode on-board a modern cruise ship. The study considers two engines, one equipped with SCR and both with scrubber, during engine load conditions of 75 % and 40 %, and the influence of marine gas oil (MGO) use in addition to heavy fuel oil (HFO). At least 4 different particle types were observed in the exhaust based on transmission electron microscopy (TEM) studies both upstream and downstream scrubber, and both scrubber and SCR affected the particle number size distribution (PSD). The geometric mean diameter (GMD) of the particles increased over scrubber both due to removal of nucleation mode particles and particle growth in the scrubber. The scrubber effectively decreased particle number (PN) and, also, non-volatile particles, but the effect depended on particle size and no significant decrease was observed in number of particles above 50 nm, typically comprising black carbon (BC) and in the case of HFO combustion, also asymmetrical metal containing particles. In addition to PN, concentrations of PAH compounds were reduced in the scrubber. The results may be further utilized when including the exhaust aerosol characteristics from ships applying scrubbers to emission inventories, as well as climate and air quality models.

Household solid waste combustion with wood increases particulate trace metal and lung deposited surface area emissions.

In households, municipal solid waste (MSW) is often burned along with wood to get rid of waste, to help in ignition or simply to reduce fuel costs. The aim of this study was to characterize the influence of household waste combustion, along with wood, on the physical and chemical properties of particulate emissions in a flue gas of a masonry heater. The MSW burning alongside wood increased average particulate matter (PM) mass (65%), lung deposited surface areas (LDSA, 15%), black carbon (BC, 65%) concentrations and the average particle size in the flue gas. The influence of MSW was smaller during ignition and burning phases, but especially during fuel additions, the mass, number, and LDSA concentrations increased significantly and their size distributions moved towards larger particles. For wood burning the trace metal emissions were relatively low, but significant increase (3.3-179 -fold increase over cycle) was seen when MSW was burned along the wood. High ratios were observed especially during fuel addition phases but, depending on compounds, also during ignition and burning end phases. The highest ratios were observed for chloride compounds (HCl, KCl, NaCl). The observed increase in light-absorbing particle, trace metal and BC concentrations in flue gas when adding wood with MSW are likely to have negative impacts on air quality, visibility, human health and climate. Furthermore, metals may also affect the condition and lifetime of the burning device due to corrosion.

Influence of background particulate matter (PM) on urban air quality in the Pacific Northwest.

Elevated particulate matter concentrations due to Asian long-range transport (LRT) are frequently observed in the free troposphere (FT) above the Pacific Northwest, U.S. Transport of this aerosol from the FT to the boundary layer (BL) and its effect to local air quality remain poorly constrained. We used data collected at the Mount Bachelor observatory (MBO, 2.8 km a.s.l) and from ground stations in the Pacific Northwest to study transport of fine particulate matter (PM) from the FT to the BL. During Asian LRT episodes PM concentrations were clearly elevated above the corresponding monthly averages at MBO as well as at low elevation sites across Washington and Oregon. Also, a clear correlation between MBO and low elevation sites was observed, indicating that LRT episodes are seen in both the FT and BL. In addition, drum impactor measurements show that the chemical composition of PM at MBO was similar to that measured at the BL sites. Using a simple regression model, we estimate that during springtime, when the transport from Asia is most effective, the contribution of Asian sources to PM2.5 in clean background areas of the Pacific Northwest was on average 1.7 µg m(-3) (representing approximately 50-80% of PM). The influence of LRT PM was also seen in measurement stations situated in the urban and urban background areas. However, the fraction of LRT PM was less pronounced (36-50% of PM) due to larger local emissions in the urban areas.

Intrauterine 10 microg and 20 microg levonorgestrel systems in postmenopausal women receiving oral oestrogen replacement therapy: clinical, endometrial and metabolic response.

OBJECTIVE: The clinical and endometrial efficacy and lipid response of two different doses of intrauterine levonorgestrel were assessed in comparison with sequential oral medroxyprogesterone acetate in postmenopausal women receiving continuous oral E2-valerate. DESIGN: One-year prospective multicentre randomised control trial. SETTING: Four outpatient clinics in Oulu, Helsinki and Jyväskylä, Finland. POPULATION: A total of 163 healthy volunteer postmenopausal women with climacteric complaints or already using hormone replacement therapy (HRT). INTERVENTIONS: Subjects were randomly allocated to receive a new intrauterine system releasing 10 microg of levonorgestrel daily or an established intrauterine system (Mirena) releasing 20 microg of levonorgestrel daily or sequential oral medroxyprogesterone acetate (5mg/day, 14/30 days). All three regimens were combined with an oral daily dose of 2mg of E2-valerate. MAIN OUTCOME MEASURES: Bleeding patterns were assessed by diaries kept by the subjects. Endometrial effects were evaluated by histologic biopsies taken at the baseline and after six and 12 months of therapy. Serum concentrations of total, HDL and LDL cholesterol, triglycerides and lipoprotein(a) were determined at the baseline and after six and 12 months of therapy. RESULTS: Insertion of the smaller 10 microg levonorgestrel system was easy in 70% and difficult in 4% and that of Mirena was easy in 46% and difficult in 21% of the subjects. After six months of therapy, 43 (95.6%) of the 47 subjects receiving 10 microg levonorgestrel and 54 (98.2%) of the 55 subjects receiving 20 microg levonorgestrel had no bleeding, while the sequential medroxyprogesterone acetate regimen produced typical cyclic withdrawal bleedings. Endometrial hyperplasia was not observed in any of the treatment groups during the 12-month study. After 12 months of therapy, strong endometrial suppression was found in 46/47 and 55/55 of the subjects receiving 10 microg and 20 microg of levonorgestrel, respectively, while the endometrium was proliferative in 18/47 of the subjects in the medroxyprogesterone acetate group. Serum total cholesterol decreased in all treatment groups. HDL cholesterol increased in women receiving medroxyprogesterone acetate or the smaller intrauterine dose of levonorgestrel. CONCLUSIONS: Both intrauterine doses of levonorgestrel provided good endometrial protection in postmenopausal women on oestrogen replacement therapy. The advantage of the 10 microg system with a smaller size is the easier insertion of the system and a minimal attenuation of the favourable effects of oral oestrogen on the serum lipid profile.

Shorter treatment for vaginal candidosis: comparison between single-dose oral fluconazole and three-day treatment with local miconazole.

Fluconazole is an effective, simple and safe, although slightly expensive, agent for the treatment of vaginal candidosis. Single-dose fluconazole (150 mg) administered orally in capsule form was compared with three-day local treatment with miconazole pessaries in the treatment of vaginal candidosis in a randomized study in Finland. Cure rates were good (> 80%) in randomized patient groups assessed both clinically and by the results of yeast cultures. Oral administration was preferred to local therapy by patients in both the miconazole and fluconazole groups. For the time being, fluconazole is not recommended for use during pregnancy or lactation.

Cardiovascular malformations, work attendance, and occupational exposures during pregnancy in Finland.

To explore for associations between occupational factors and cardiovascular malformations, information on the parents of 160 infants with cardiovascular malformations and 160 control parents was studied. The case infants had been reported consecutively to the Finnish Register of Congenital Malformations. All mothers were interviewed identically after delivery, using both open and pro forma questions about detailed work tasks, exposures, and leisure activities during pregnancy. The interview information was evaluated blindly. Neither parental occupational titles nor maternal working per se gave new clues to the teratogenic risk; nor did shift working, wearing of personal protective equipment, or the mother's own opinion on exposures during pregnancy. Identified occupational exposures, as categorized by an industrial hygienist, showed no remarkable associations to cardiovascular malformations. Few mothers were exposed substantially to specific occupational hazards. Comparing mothers who used medications in the first trimester with those who did not showed an odds ratio of 2.2 (95% confidence interval 1.3-3.9) when adjusted for potential confounding by multivariate logistic methods.

Clinical and lipid metabolic effects of unopposed oestrogen and two oestrogen-progestogen regimens in post-menopausal women.

No differences in the clinical effects on climacteric complaints of an unopposed oestrogen and two oestrogen-progestogen regimens were observed in a double-blind cross-over study. Only 4 out of 18 women with an intact uterus had withdrawal bleeding during oestradiol valerate (2 mg/day) treatment alone, but 14 out of 18 had regular bleeding during the two oestrogen-progestogen regimens (oestradiol/medroxyprogesterone acetate and oestradiol/levonorgestrel (LNG], each of which prevented the development of endometrial hyperplasia. High-density-lipoprotein cholesterol (HDL-CH) concentration remained 6% above the initial level and the atherogenic index (low-density-lipoprotein (LDL) cholesterol to HDL-CH ratio) improved significantly during the oestradiol/medroxyprogesterone acetate regimen, while the HDL-CH concentration fell by 20% in relation to the initial level and there was a deterioration in the atherogenic index during the oestradiol/LNG regimen. The data suggest that both of these oestradiol/progestogen combinations are clinically as effective and well-tolerated as oestradiol alone, but that combined oestradiol/medroxyprogesterone acetate causes fewer adverse lipid metabolic effects than the oestradiol/LNG combination.

IUD perforation leading to obstructive nephropathy necessitating nephrectomy: a rare complication.

A rare case of uterine perforation leading to ureter obstruction and ultimately to nephrectomy is presented to emphasize the importance of a careful IUD insertion technique and follow-up of IUD patients. Complications of this kind can be avoided by prompt localization of 'missing' IUDs by ultrasonography of X-ray.

Iron deficiency in women using modern copper intrauterine devices.

To evaluate the risk of iron deficiency and anemia connected with the use of modern copper intrauterine devices, serum ferritin, transferrin, iron, hemoglobin and hematocrit levels, red cell counts, and morphology, as well as red cell indexes were determined in 40 women and in 19 controls. Follow-up was for one year. Mean hemoglobin, hematocrit, serum iron, and serum ferritin levels decreased and serum transferrin levels increased significantly in the study population. About 20% of intrauterine device users but none of the controls showed signs of iron deficiency, and 10% had clinical anemia at 12 months of use. No differences were found between the three different copper intrauterine devices tested (Nova T, Multiload and Fincoid). Because the risk of anemia did not correlate with subjective evaluation of the amount of bleeding, it is recommended that hemoglobin levels should be determined for all intrauterine device users before its insertion and at six and 12 months of use. In those with decreased hemoglobin levels, serum ferritin should be measured and iron replacement instituted or the device removed.

Hangover headache and prostaglandins: prophylactic treatment with tolfenamic acid.

Tolfenamic acid (TA), a potent inhibitor of prostaglandin (PG) biosynthesis and action, was tested prophylactically against hangover symptoms in 30 healthy volunteers in a double-blind cross-over study. One capsule of TA (200 mg) or placebo was taken before starting to drink alcohol and another before going to bed. The hangover symptoms were evaluated in the morning. TA was found significantly better than placebo in the subjective evaluation of drug efficacy (p less than 0.001) and in reducing the reported hangover symptoms in general (p less than 0.01). In the TA group, significantly lower symptom scores were obtained for headache (p less than 0.01), and for nausea, vomiting, irritation, tremor, thirst and dryness of mouth (all p less than 0.05). In a separate study with eight participants, plasma levels of PGs were followed during ingestion of alcohol with or without TA. The plasma concentrations of PGE2 and TXB2 (a metabolite of thromboxane A2) were lower in the TA group during alcohol ingestion, while PGF2 alpha and 6-keto-PGF1 alpha (a metabolite of prostacyclin) were unaffected. TXB2 correlated with blood alcohol levels in a U-shaped manner.

Fincoid--a new copper IUD: a preliminary report.

Fincoid, a new copper IUD, was tested on a single clinic basis in a preliminary series of 956 1st insertions and 10,015 woman-months of use with an individual follow-up of 12 months. 458 (48%) of the women were nulliparous and 498 (52%) were parous. About 1/3 of the women had previously discontinued the use of other types of IUDs (mostly copper) because of side effects. The 1st segment of net cumulative rates for the whole series were: pregnancy 1.1, expulsion 4.7, removal for bleeding and/or pain 7.6 and removal for infection 0.8. The continuation rate was 78.9 and the percentage lost to follow-up was 2.8%. The parous group had a higher continuation rate (81) than the nulliparous group (76). Rates for pregnancy, expulsion, and infection in the nulliparous group were about 2-fold the corresponding rates of the parous group. There was no difference in the removal rate for bleeding and/or pain between the 2 parity groups. The results of the study show that the Fincoid is a valid method of intrauterine contraception.

Cervical bacterial flora in women fitted with a copper-releasing intra-uterine contraceptive device (IUD).

A bacterial culture was taken from the cervix in 85 sexually active women before, and 3 and 6 months after, insertion of either a copper-releasing or an inert intra-uterine contraceptive device (IUD). Sixty had a Copper-T (TCu-200) and 25 a Lippes loop D. Although in more than a quarter of the patients the bacterial flora increased slightly in diversity and abundance after IUD insertion, there was no difference in effect between the TCu-200 and Lippes loop D.

PIP: 85 women were examined for cervical bacterial flora before, and at 3 and 6 months after, insertion of either a Copper T (TCu-200) or Lippes loop D IUD. Bacterial flora increased slightly in diversity and abundance after insertion of an IUD in more than 25% of the subjects. However, there was no difference in effect between the TCu-200 and Lippes loop D devices.

Important factors in the use-effectiveness of the copper-T-200 IUD.

PIP: The influence of the time insertion of an intrauterine device (IUD), changes in the characteristics of the menstrual flow after insertion, coital frequency, and the administration of prophylactic antibiotics at the time of insertion on evaluative parameters of the use-effectiveness of the TCu-200 IUD was evaluated in 2689 patients. The continuation rate was highest when the device was inserted either during or immediately after menses. The time of insertion had no effect on the rate of accidental pregnancy (p less than .05). Pregnancy did not occur in 95 subjects whose menstrual cycle became more regular, compared to a pregnancy rate of 1.6 for the entire group. The removal rate for bleeding and pain was higher in women who complained of changes in their menstrual cycle. Removals for infection were not markedly changed by treatment with antibiotics, though pregnancy rates were somewhat higher. Coital frequency had no significant effect on any of the parameters.^ieng

The effect of the copper-T 200 IUD on the luteal phase plasma progesterone concentration in the normal menstrual cycle.

PIP: Plasma progesterone levels were measured by the competitive protein binding assay during the luteal phase of the menstrual cycle to investigate the possibility that the Copper-T (IUD) had a luteolytic effect. 26 women (ages 23-35) were studied for 17 IUD cycles and 18 control cycles. Cycle length of ovulation cycles was nearly identical between control and IUD cycles (28.8 days control vs 28.5 IUD) but IUD cylces were 59% ovulatory compared with 78% ovulatory cycles in the control group. The mean of the peak plasma progesterone level was the same in both groups for ovulatory cycles (15ng/ml). The peak level occurred 1 to 2 days earlier in the control than in the IUD cycles and the plasma progesterone decreased 1 to 2 days earlier in the control than in the IUD cycles. The plasma progesterone level was significantly higher (p.005) in the IUD cycles (7.4 plus or minus than in the control cycles (2.6'ng/ml). (2.6 plus or minus length of the luteal phase was the same in the IUD as in the control cycle according to progesterone levels. Progesterone secretion by the corpus luteum was not affected by the Copper-T 200 IUD.^ieng