Modelling of factors influencing the effect of osmotic solution on reduction of selected microorganisms.

AIMS: The goal of this research is to model the effects of two osmotic solutions factors on the reduction of selected microorganisms, and to assess the application in osmotic dehydration process of animal raw materials from the aspect of microbiological safety. METHODS AND RESULTS: Sugar beet molasses and aquatic osmotic solution were prepared and inoculated with Escherichia coli, Listeria monocytogenes and Salmonella spp. Varied factors of osmotic solutions were: time, temperature and concentration of osmotic solutions. Samples of osmotic solutions were subjected to standard and modified microbiological ISO methods. The result showed that increase in factors had a positive effect on the reduction of microbiological load, while the time of the process was the most influential technological parameter. Number of L. monocytogenes was reduced to <10 CFU per g at the end of the process in the highest concentration of sugar beet molasses at all process temperatures. CONCLUSIONS: Developed mathematical models of reduction ratios for tested microorganisms were statistically significant, allowing good prediction of reduction ratio values based on applied factors. SIGNIFICANCE AND IMPACT OF THE STUDY: Obtained levels of reduction of all tested microorganisms present good base for the production of safe osmotically dehydrated products of animal origin.

Maternal plasma polyunsaturated fatty acid levels during pregnancy and childhood lipid and insulin levels.

BACKGROUND AND AIMS: Maternal polyunsaturated fatty acid (PUFA) levels are associated with cord blood lipid and insulin levels. Not much is known about the influence of maternal PUFAs during pregnancy on long-term offspring lipid and insulin metabolism. We examined the associations of maternal plasma n-3 and n-6 PUFA levels during pregnancy with childhood lipid and insulin levels. METHODS AND RESULTS: In a population-based prospective cohort study, among 3230 mothers and their children, we measured maternal second trimester n-3 and n-6 PUFA plasma levels. At the median age of 6.0 years (95% range, 5.6-7.9), we measured childhood total-cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, triglyceride, insulin and c-peptide levels. Higher maternal total n-3 PUFA levels, and specifically DHA levels, were associated with higher childhood total-cholesterol, HDL-cholesterol and insulin levels (p-values <0.05), but not with LDL-cholesterol and triglycerides. Maternal total n-6 PUFA levels were not associated with childhood outcomes, but higher levels of the individual n-6 PUFAs, EDA and DGLA were associated with a lower childhood HDL-cholesterol, and higher AA levels with higher childhood total-cholesterol and HDL-cholesterol levels (all p-values <0.05). A higher maternal n-6/n-3 PUFA ratio was only associated with lower childhood HDL-cholesterol and insulin levels (p-values <0.05). These associations were not explained by childhood body mass index. CONCLUSIONS: Higher maternal total n-3 PUFAs and specifically DHA levels during pregnancy are associated with higher childhood total-cholesterol, HDL-cholesterol and insulin levels. Only individual maternal n-6 PUFAs, not total maternal n-6 PUFA levels, tended to be associated with childhood lipid and insulin levels.

Work practice and some adverse health effects in nurses handling antineoplastic drugs.

BACKGROUND: Widespread use of antineoplastic drugs has led to higher health risks of personnel who prepare and administer these drugs. The short-term, non-specific health effects in nurses handling antineoplastic drugs (AND) have been documented. OBJECTIVES: To establish work practices and preventive measures for nurses handling antineoplastic drugs and to determine the risk of developing symptoms. METHODS: In eight Belgrade hospitals, 263 nurses were selected (response rate 90.1%) for the study. Among these, 186 were involved in preparation and administration of AND, and 77 were not exposed. Data on exposure, work practice, safety precautions, and symptoms were obtained via a questionnaire. The mean age of exposed nurses was lower than in a control group (35 vs. 39 yrs). RESULTS: Only 38% of all nurses used vertical laminar safety cabinets while mixing AND, 82% used gloves, and 57% masks. Special medical rooms for mixing AND, written instructions and special containers for waste material were available only sporadically. No exposure monitoring had ever been performed in any hospital or department. Periodic medical check-ups were rare (24.7% of all nurses). In exposed nurses ORs adjusted for age, smoking habit and shift work were significantly elevated for almost all symptoms, mostly for the following: hair loss (OR = 7.14), skin rash (OR = 4.70), and light-headedness (OR = 4.33), as well as the disappearance of symptoms during the weekend (OR = 4.78). The mean number of symptoms revealed an exposure-effect relationship, with the highest number of symptoms in daily exposed nurses and lowest in non-exposed nurses (6.3 vs. 3.1) (p < 0.001). CONCLUSIONS: Our results indicate without doubt that exposed nurses reported more symptoms than non-exposed nurses, an effect that was not dependent on age, smoking, or night shift. The use of safety precautions was inadequate and reflected the lack of awareness of potential hazards due to occupational exposure to AND.

Strenuous exercise and action of antioxidant enzymes.

BACKGROUND: During the course of evolution, the antioxidant system has developed in order to prevent cell damage and to maintain equilibrium between production of free radicals and their neutralization. Because of increased oxygen consumption and energy utilization during physical work, oxidative stress may be expected. A review of current literature revealed no consistent data regarding activity of antioxidant enzymes during strenuous exercise. OBJECTIVES: The aim of this paper was to identify the activity of antioxidant enzymes in erythrocytes during strenuous short-term exercise. METHODS: The activity of superoxide dismutase (SOD), glutathione peroxidase (GPX), and glutathione reductase (GR) were investigated. Also, glucose-6-phosphate dehydrogenase (G-6-PDH) activity was studied in order to assess the level of recovery of reduced glutathione (GSH) by maintaining NADPH. Peripheral blood was drawn before (1) and immediately after (2) the test completed. Modified Astrand's protocol on a bicycle ergometer was used to achieve strenuous exercise in volunteers. RESULTS: The results obtained were: SOD1--897.95 +/- 99.85 U/g Hb and SOD2--828.38 +/- 75.12 U/g Hb; GPX1--30.19 +/- 4.03 U/g Hb and GPX2--26.00 +/- 4.85 U/g Hb; GR1--58.29 +/- 8.23 U/L and GR2--62.67 +/- 7.29 U/L; G-6-PDH1--14.97 +/- 3.79 IU/g Hb and G-6-PDH2--16.5 +/- 2.74 IU/g Hb. The difference was statistically highly significant: p < 0.001 for SOD, GPX, and GR activities, and p = 0.018 for G-6-PDH activity. CONCLUSION: The results reflect the presence of oxidative stress in erythrocytes after strenuous exercise. Further investigations should clarify the role of other antioxidant-relevant compounds during exercise such vitamins, trace elements, and metals and enable estimation of the level of damage caused by generation of free radicals (e.g., malonyl dialdehyde, 8-hydroxydeoxyguanosine etc.). All this information together will undoubtedly give us clear insight into free radical generation during strenuous workloads.

Activity of glutathione peroxidase and superoxide dismutase in workers occupationally exposed to mercury.

According to previous research the lipid peroxidation process has a significant role in mercury toxicity. Since glutathione peroxidase (GPX) and superoxide dismutase (SOD) play a significant role in erythrocyte antioxidative defence, it is very important to determine their activity in occupationally exposed workers. The aim of this study was to assess the activity of antioxidative enzymes in the erythrocytes of workers occupationally exposed to mercury. We compared a group of 42 workers exposed to elemental mercury in a chloralkali plant (Hg group). The control group (C group) consisted of 75 subjects employed in lime production who had never been exposed to mercury or any toxic substance. The GPX activities in erythrocytes were significantly lower in the Hg group than in the control group (Hg group, 9.05 +/- 7.52 IU/gHb; C group 15.54 +/- 4.85 IU/gHb; p < 0.001). Also, SOD activity in the erythrocytes of workers occupationally exposed to mercury was significantly lower than in the control group (Hg group, 1280.7 +/- 132.3 IU/gHb; C group, 1377.9 +/- 207.5 IU/gHb; p < 0.006). The concentrations of mercury in blood were significantly higher in the Hg group compared to the control group (Hg group, 0.179 +/- 0.040 micromol/l; C group, 0.023 +/- 0.011 micromol/l; p < 0.001). Urine mercury concentrations were also significantly higher in the Hg group than in the control group (Hg group, 23.2 +/- 11.3 nmol/mmol creatinine; C group, 2.7 +/- 0.6 nmol/mmol creatinine; p < 0.001). The concentrations of selenium in erythrocytes were almost equal in both groups examined (Hg group, 62.9 +/- 8.72 microg/l; C group, 65.8 +/- 10.57 microg/l). Also, in the Hg group there were increased levels of erythrocyte malondialdehyde (Hg group, 138.58 +/- 33.85 micromol/l; C group 105.21 +/- 49.62 micromol/l; p < 0.001). On the basis of previous results, it can be concluded that occupational exposure to elemental mercury leads to increased lipid peroxidation in erythrocytes. Also, it can be postulated that this exposure leads to decreased activity of GPX and SOD in erythrocytes.

Cytogenetic monitoring of pesticide sprayers.

The induction of chromosome aberrations, micronuclei, and sister-chromatid exchanges (SCEs) was examined in cultured lymphocytes of 27 vineyard growers exposed to pesticides. Cytogenetic examinations were performed during the prespraying period, a month after spraying, and at the end of the spraying season. For comparison purposes, the same cytogenetic monitoring program was applied to two control groups. The first consisted of 15 individuals from a nearby town, and the second consisted of 20 volunteers living 200 km from the vine-growing area (reference control group). A positive, though low statistically significant (P < 0.017) difference in the yield of unstable chromosomal aberrations in exposed sprayers was observed compared with both control groups during the prespraying period. The mean group value of micronuclei in exposed workers averaged 5.41 per 1000 binucleated cells, with individual means ranging from 0 to 15. In both control groups, the yield of micronuclei averaged 5.09 per 1000 binucleated cells, with individual means ranging from 1 to 10. No statistically significant (P < 0.5) differences in yield of micronuclei were found in exposed subjects compared with both control groups. Significant individual variation (F = 14.09, P < 0.000) in SCE frequency was observed in exposed subjects, as well as in both control groups (F = 14.09, P < 0.000). A month after spraying, the average incidence of unstable aberrations in pesticide sprayers was 0.22%, and the yield of micronuclei averaged 17.78 per 1000 binucleated cells, with individual means ranging from 7 to 28. The incidence of micronuclei a month after spraying in exposed subjects was elevated (statistically significant at P < 0.01) in comparison with the prespraying period, while the difference in the yield of chromosomal aberrations in exposed subjects was insignificant (P < 0.5). At the end of the spraying season, the average incidence of unstable aberrations in exposed subjects was 0.79%, and the yield of micronuclei averaged 39.92 micronuclei per 1000 binucleated cells, with individual means ranging from 21 to 62. The appearance of more than one micronucleus per binucleated cell was related to the results on chromosome aberrations. The frequencies of chromosomal aberrations and micronuclei were significantly higher (P < 0.001, P < 0.000) in the exposed group than in their matched control groups. The yield of micronuclei in pesticide sprayers at the end of the season was higher than expected with respect to chromosomal aberration frequency, which provides some evidence that some of the micronuclei are induced by the spindle-inhibiting effects of pesticides. A statistically significant (P < 0.003) difference in micronuclei in the first control group was observed compared with the reference control group at the end of the spraying season. With respect to the incidence of micronuclei in the control group in the vine-growing area, a poor but positive correlation (r = 0.074, P < 0.104) with duration of the spraying season was found, which is probably due to airborne pesticides in the vine-growing area. SCE frequencies of the workers' lymphocytes were not significantly changed due to the exposure. The yield of aberrations as well as that of micronuclei in exposed subjects correlated positively (r = 16, P = 0.016) with duration of exposure.

[Treatment of myasthenia gravis with intravenous immunoglobulin G (IVIG)]. / Lecenje miastenije gravis visokim dozama imnoglobulina "Ge".

In the two past years 25 patients with generalized myasthenia gravis (MG) were treated with high-dose intravenous immunoglobulin G (IVIG) at the Institute of Neurology in Belgrade. The patients were affected with severe forms of MG (IIB, III and IV according to Osserman's classification) refractory to all previous treatment. All patients received IVIG, 250-350 mg/kg during five consecutive days. An immediate positive effect was mild and recorded 12-15 days later in only 37.5% patients. On the contrary, 92% patients showed delayed improvement which was effective for over six months. Distribution and severety of the disease decreased as expressed by reduced Besinger mean clinical score from 12.3 to 5.7 after six months. Immunologic parameters before and after IVIG treatment did not differ significantly. An increase of IgG was observed in 88% of patients. IVIG side effects were infrequent, usually mild, and qualitatively different from those induced by other therapies (azathioprine, corticosteroids). The authors emphasize the beneficial delayed effect of IVIG on the course of MG which resulted in significant reduction of the dose of additional immunosuppressive agents. The absance of immediate therapeutic effect of IVIG does not justify this mode of treatment in acute deterioration and crisis of MG.

Motor neuron disease and monoclonal gammopathy.

In a study to determine the prevalence of monoclonal gammopathy (MG) among patients with motor neuron disease (MND), 6 out of 56 (10.7%) were found to have a monoclonal paraprotein. Of these 6 patients, 4 had an IgG and 2 had an IgA paraprotein. The clinical syndromes consisted of amyotrophic lateral sclerosis in 2 patients, lower motor neuron syndrome with preserved reflexes in at least one limb in 3 patients, and motor neuropathy with multifocal conduction block in 1 patient. The presence of gammopathy appears to correlate with the absence of marked upper motor neuron involvement and with elevated CSF protein concentration. An underlying malignant disorder was ruled out in all 6 patients, and they were considered to have MG of undetermined significance (MGUS). In a control group of 121 age-matched patients with other neuroimmunological disorders, 5 patients (4.13%) had MG. Four of these had gammopathy associated with malignant myeloma, and 1 had MGUS. These results support previous reports of increased prevalence of MGUS in patients with MND and suggest that an autoimmune mechanism may play a role in the disease.

Hemiballism: report of 25 cases.

Twenty three patients with hemiballism and two with biballism were studied. Ischaemic and haemorrhagic strokes were the cause in most patients. Other causes were encephalitis, Sydenham's chorea, systemic lupus erythematosus, basal ganglia calcifications, non-ketotic hyperglycaemia, and tuberous sclerosis. Neuroimaging studies showed a lesion of the subthalamic nucleus in only six patients. In others, different subcortical structures were involved or the results were normal. Only two patients had "pure" hemiballism. The others had other types of dyskinesias, mainly chorea, which was present in 16 patients. The prognosis was usually good.

[Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes: the POEMS syndrome]. / Polineuropatija, organomegalija, endokrinopatija, M-protein, promene na kozi: POEMS-sindrom.

We present a case of an unusual multi-systematic disorder whose cardinal signs were severe progressive sensorimotor polyneuropathy, hepatomegaly, endocrinopathy, plasma cell dyscrasia with osteosclerotic bone lesions and M-protein production as well as skin lesions (termed POEMS Syndrome) whose pathophysiology is still unknown, as well as its relationship with myeloma multiplex. The patient, 67 years old, had a history of progressive weakness and numbness of the lower legs, clinically revealed as sensomotor polyneuropathy, hepatomegaly, IgG lambda monoclonal protein in the serum, endocrine abnormalities and skin lesions. The final and definite diagnosis was established by open, surgical biopsy of the second lumbal vertebra.

[Nerve lesions after acute anterior dislocation of the humero-scapular joint--electrodiagnostic study]. / Nervne lezije posle akutne prednje luksacije humeroskapularnog zgloba--elektrodijagnosticka studija.

We present a pilot seria of 18 patients with acute anterior dislocation of the shoulder joint following simple trauma. All the patients underwent conservative treatment using a standard Kocher technique. In the majority of cases muscular spasm and pain rendered through neurological examination difficult to perform. All patients were, therefore, submitted to extensive electrodiagnostic procedure which revealed a nerve injury on half of them. Such high incidence was, probably, due to the increased age (17 out 18 patients were over 40 years old), and rather traumatic reduction procedure. The axillary nerve was the most frequently affected (38.8%), either alone or in combination with musculocutaneus nerve. Comparing to previous reports in the literature, we found musculocutaneus nerve lesion in a rather high number of patients (22%). Extensive electrodiagnostic study is therefore recommended when further treatment and prognosis of anterior dislocation of the shoulder are taken in consideration.

[Intracerebral hemorrhage in a female patient with pulmonary sarcoidosis]. / Intracerebralna hemoragija kod bolesnice sa sarkoidozom pluca.

Sarcoidosis is a chronic, multisystem disorder of unknown cause which is characterized by the accumulation of lymphocytes and mononuclear phagocytes in non-caseating epitheloid granulomas in affected organs. Sarcoidosis is now thought to be a disease of abnormal immune regulation, probably because of an exaggerated helper T lymphocyte process. The presence of immunoglobulins and complement in sarcoid granulomata suggests that the humoral mechanism may also be important. Signs of neurosarcoidosis are observed in only 5% of patients with equal involvement of the peripheral and central nervous system. A rare case of sarcoidosis with typical pulmonary dysfunction, chronic polyneuropathy of asymmetric type and intracerebral bilateral occipital hemorrhage who recovered dramatically within two months after corticosteroid therapy, is reported. Intracerebral haemorrhage as a complication of sarcoidosis has, to our knowledge, not been previously reported.

Polyneuropathy with osteosclerotic myeloma--POEMS syndrome. A case report.

A rare form of plasma cell dyscrasia characterized by associated polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes has been termed the POEMS syndrome. The pathophysiology is unknown; plasma cell dyscrasia is essential; secondary manifestations are unexplained. We report a 67-year-old man with a 7-month history of progressive weakness and numbness of the legs. Clinical examination revealed sensorimotor polyneuropathy, predominantly affecting the lower extremities, hepatomegaly, and skin haemangiomas. Additional investigations disclosed IgG-lambda monoclonal serum protein, endocrine abnormalities, elevated cerebrospinal fluid protein level and an osteoblastic lesion of the lumbar vertebra. Biopsy of the osteosclerotic vertebra showed a marked lymphoplasmocytic infiltrate. MRI of the liver disclosed two haemangiomas; this association has not been reported previously.

[The effect of penicillamine in copper-processing workers]. / Dejstvo primene penicilamina kod radnika na preradi bakra.

Workers working in copper alloy factories (n = 40) who are professionally exposed to smoke and dust of copper, zinc, lead and cadmium and workers who are not exposed to toxic noxae (n = 15) were perorally administrated penicillamine for three days in order to evaluate deposits of these metals in their organisms. On the basis of the results obtained after penicillamine administration it was concluded that this substance can be useful in the evaluation of the presence of copper in workers. Penicillamine mobilisatory effect on lead and zinc in the organism was also proved. Because of competitive relations between copper and zinc (copper was a dominant noxa) it was not possible to evaluate the internal zinc presence. The mobilisatory effect of penicillamine on cadmium in the organism was not observed.

[The effect of desferrioxamine in aluminum-processing workers]. / Dejstva desferrioxamin-a u radnika na preradi aluminijuma.

The presence of aluminium, iron, copper, zinc and manganum was evaluated in workers who were professionally exposed to aeropollution, especially to metals i.e. aluminium (n = 25) and workers who were not exposed to toxic noxe (= 18). The instantaneous presence of metal concentrations in the blood and urine was not a sufficient sign in the evaluation of the body burden. The intramuscular administration of desferrioxamine had a significant effect on the mobilization of iron- and aluminium-depots. On the basis of increased aluminium elimination, changed values of total transferrin (TIBC) and increased activity of alkaline phosphatase in the serum provoked by desferrioxamine it was possible to evaluate the presence of aluminium in exposed workers. According to the obtained results desferrioxamine had no effect on copper, zinc and manganum in the organism of these workers.

[Immunity in leukemia: reason for onset of leukemia, agent for successful therapy of leukemia]. / Imunitet u leukemijama: povod za nastanak leukemija, cinilac u uspesnom lecenju leukemija.

Authors present the facts which indicate that in human medicine there is immunity against malignant tumors and leukaemia through T lymphocytes immunological control. The appearance of leukaemia in a certain number of persons is due to reduced immunity in the patient or weak antigen immunogenicity of leukaemic cells. Authors also present evidence for the existance of tumor antigens same as in leukaemic leukocytes in human pathology. These antigens belong either to still undiscovered viruses of human leukaemia, as is the case of reverse transcriptase of RNK virus, found in leukocytes of 95 percent of patients with acute leukaemia, or they are new antigens formed by combination of cell genoma and virus genoma, or by depression of the gene which were active only during the foetal life under the influence of oncogenic chemical substances or viruses. The evidence is given too, concerning the existence of immune response in human medicine, in the form of cytotoxic antibodies or sensitized T lymphocytes to tumor antigens which can be demonstrated in vitro by the test of colonial growth inhibition of tumor cells. As the immunity does not operate against tumor or leukaemic cells, the reason for it must be sought in the disorder of the afferent part (weak immunogenicity of tumor antigens, tolerance of tumor antigens, etc.), or of the efferent part of the immune response (the presence of blocking factors in the patient's plasma). At the end, the authors also discuss about the attempts of immunological treatment of acute leukaemia, and the results to this date are encouraging.