Polycyclic aromatic hydrocarbon-degrading bacteria from aviation fuel spill site at Ibeno, Nigeria.

Polycyclic aromatic hydrocarbon (PAH)-degrading bacteria were isolated from aviation fuel contaminated soil at Inua Eyet Ikot in Ibeno, Nigeria. PAH-degrading bacteria in the contaminated soil were isolated by enrichment culture technique. Isolates with high PAH degrading potential characterized by their extensive growth on PAH-supplemented minimal salt medium were screened for their naphthalene, phenanthrene and chrysene degradability. The screening medium which contained selected PAHs as the sole source of carbon and energy showed that Micrococcus varians AFS-2, Pseudomonas putida AFS-3 and Alcaligenes faecalis AFS-5 exhibited a concentration-dependent growth in all the PAH-compounds tested. There were visible changes in the color of growth medium suggesting the production of different metabolites. Their acclimation to different PAH substrates was also evident as A. faecalis AFS-5 isolated from chrysene grew well on other less complex aromatic compounds. The isolate exhibited best growth (0.44 OD(600)) when exposed to 10 ppm of chrysene for 5 days and could utilize up to 90 ppm of chrysene. This isolate and others with strong PAH-degrading potentials are recommended for bioremediation of PAHs in aviation fuel-contaminated sites in the tropics.

Fate of nitrogen-fixing bacteria in crude oil contaminated wetland ultisol.

The effect of crude oil on the growth of legumes (Calopogonium muconoides and Centrosema pubescens) and fate of nitrogen-fixing bacteria in wetland ultisol was investigated using standard cultural techniques. The results revealed observable effects of oil on soil physico-chemistry, plant growth and nodulation as well as on densities of heterotrophic, hydrocarbonoclastic and nitrogen fixing bacteria. The effects however varied with different levels (0.5%, 1%, 5%, 10%, 15% and 20%) of pollution. Ammonium and nitrate levels were high in the unpolluted soil but decreased with increase in pollution levels. Nitrite was not detected in contaminated soil probably due to the reduction in numbers of nitrogen fixers, from 5.26 ± 0.23 × l0(6)cfu/g in unpolluted soil to 9.0 ± 0.12 × 10(5) and 2.2 ± 0.08 × l0(5) cfu/g in soils with 5% and 20% levels of pollution respectively. The contaminated soil also exhibited gross reduction in the nodulation of legumes. A range of 13-57 nodules was observed in legumes from polluted soil against 476 nodules recorded for plants cultured on unpolluted soil. The heterogeneity of the microbial loads between oil-polluted and unpolluted soil were statistically significant (p < 0.05, ANOVA). Positive significant relationships were observed between the levels of hydrocarbons and the densities of heterotrophic bacteria (r = 0.91) and that of hydrocarbon utilizing bacteria (r = 0.86). On the other hand, relationships between the densities of nitrogen fixing bacteria and total hydrocarbons content was negative (r = -0.30) while positive relationships were recorded between the densities of different microbial groups and treatment periods except at 15% and 20% pollution levels. The LSD tests revealed highly significant differences (p < 0.001) in the physiological groups of soil microorganisms at all levels of pollution. The results imply that crude oil seriously affects rhizosphere microbial growth in legumes. Among the bacterial species isolated, Clostridium pasteurianum, Bacillus polymyxa and Pseudomonas aeruginosa exhibited greater ability to degrade hydrocarbons than Azotobacter sp, Klebsiella pneumoniae and Derxia gummusa while Nitrosomonas and Nitrobacter had the least degradability. A continuous monitoring of the environment is advocated to prevent extinction of nitrogen-fixing bacteria and total loss of soil fertility attributable to petroleum hydrocarbon contamination in the Niger Delta ultisol.

Heavy metal burdens in patches of asphyxiated swamp areas within the Qua Iboe estuary mangrove ecosystem.

This study examined the burden of Zn, Cu, Ni, Pb, Cr and V in patches of asphyxiated mangrove swamp areas within Qua Iboe Estuary mangrove ecosystem by sediments and surface water analysis; in order to establish natural background levels of these metals and to assess anthropogenic influences on them. The analysis shows that the mean concentrations (mg/kg, dw) of Zn, Cu, Ni, Pb, Cr and V in sediments from asphyxiated and healthy mangrove ecosystems of Qua Iboe vary from 36.3-179.4, 29.2-43.2, 3.6-37.4, 39.6-93.8, 0.15-0.53 and 2.9-9.3, with the former exhibiting higher metal accumulating potential. Although heavy metal concentrations in surface water of the asphyxiated swamp were low, their accumulative effect is significant. The concentrations of Cu and Pb in surface water of this ecosystem exceeded the water quality criteria while Ni and Cr were under the maximum concentration for drinking water quality and protection of aquatic life. The values of pollution load index (PLI), which are generally greater than unity, show that the sediments and the surface water from the asphyxiated mangrove ecosystem were polluted with heavy metals, thus suggesting anthropogenic activities as a possible source of these metals. The mean concentrations of Zn, Ni and Pb exceeded the effects range-low (ERL), indicating that there may be some ecotoxicological risk to organisms living in asphyxiated mangrove sediments.

Heat resistance of dermatophyte's conidiospores from athletes kits stored in Nigerian University Sport's Center.

The incidence and heat resistance of conidiospores produced by dermatophytes isolated from athlete's kits (canvasses, stockings and spike shoes) stored in Nigerian University Sport's Centre were investigated. Epidermophyton floccosum, Microsporum oudouinii, Microsporum canis, Trichophyton concentricum, Trichophyton mentagrophytes and Trichophyton rubrum were isolated and their incidence on the athlete's kits varied with the species and type of kits. Among the isolates T. mentagrophytes, T. rubrum and E. floccosum with 25%, 23% and 20% prevalence rates respectively, were the most common isolates, and are often associated with tinea pedis (athletes foot). Canvasses with the highest incidence of dermatophytes (25 out of 34 fungal isolates) were the most contaminated kits and could serve as effective articles for the transmission of tinea pedis among athletes in Nigeria. The common etiological agents screened, produced asexual spores (conidiospores) that exhibited high resistance to heat treatment at 80 degrees C. Of the three isolates, E. floccosum, with a decimal reduction time (D-value) of D80 = 4.4 min was the most resistant followed by T. mentagrophytes with D80 = 4.0 min and then T. rubrum with D80 = 3.2 min. The spores elimination pattern indicates that increasing the heating duration would decrease the decimal reduction time and possibly denature the fungal propagules but may damage the skin during treatment with hot water compresses. The findings have shown that the use of hot water compresses is palliative but heat treatment especially vapour-heat treatment offers adequate preventive measures if applied for periodic treatment of contaminated kits. However, determining the correct condition for effective decontamination will require detailed understanding of the heat resistance of fungal spores. Otherwise treatment of kits with detergent and chaotropic agent such as urea and guanidinium salt is preferred to heat treatment.

Growth, keratinolytic proteinase activity and thermotolerance of dermatophytes associated with alopecia in Uyo, Nigeria.

Mycological research was conducted on the mycelial growth, keratinolytic proteinase activity and thermotolerance ofdermatophytes associated with alopecia patients in Uyo, Nigeria. The results revealed that Microsporum sp. - AP1, Epidermophyton sp. - AP2, Trichophyton rubrum - AP4, Trichophyton mentagrophytes - AP5 and a yeast Candida albicans - AP3 isolated exhibited variable growth and keratinase activity at different temperatures. Microsporum sp. - AP1 and T. mentagrophytes - AP5 survived heat treatment at 90 degrees C but exhibited best mycelial growth at 30 degrees C (with 53.41 mg/50 ml biomass dry weight) and 40 degrees C (with 61.32 mg/50 ml biomass dry weight) respectively, after incubation for 2 weeks. Trichophyton rubrum - AP4 and Epidermophyton sp. - AP2 could not survive heat treatment at 90 degrees C but grew better at 40 degrees C (with 38.52 mg/50 ml biomass dry weight) and 30 degrees C (with 48.32 mg/50 ml biomass dry weight) respectively, over the same incubation period, while C. albicans - AP3 grew better at 30 degrees C with 38.7 mg/50 ml biomass dry weight after 2 weeks, but failed to survive at 70 degrees C. All the isolates except Candida albicans - AP3 survived at 80 degrees C and exhibited great potential to elaborate keratinolytic enzymes, with T. mentagrophytes demonstrating the best potential at 30 degrees C and 40 degrees C. Higher temperatures tended to reduce keratinolytic activities and there were significant (P < 0.05) relationships between biomass weight and enzyme productivities of all the isolates except T. mentagrophytes. This indicates that in some dermatophytes keratinolytic proteinase activity is not a function of cell multiplicity. This plus the high thermostability of the enzymes are important attributes in the consideration of preventive and therapeutic methods against dermatophytes in the tropics.

Chromatium species: an emerging bioindicator of crude oil pollution of tidal mud flats in the Niger Delta mangrove ecosystem, Nigeria.

Establishing microbiological indices for the monitoring of environmental decay by crude oil pollution in the Niger Delta region has been a major concern of our current researches. Chromatium species, a purple, Gram positive pleomorphic, motile, microaerophlic sulfur bacterium offers a good potential for use in the assessment of the short term effects of oil pollution of tidal mud flats in the Niger Delta mangrove ecosystem. Its response to the November 22, 2003 spillage at the Qua Iboe Estuary and the adjoining Cross River Estuary was investigated. Our results have revealed that the sulphur bacterium is easily identified and widely distributed in the epipellic sediment of the mangrove ecosystem but very sensitive to hydrocarbon pollution. The bacterium was readily detected in the tidal mud flats containing as much as 2.0 mg kg(-1) but not detected in sediment with THC level of 3.65 mg kg(-1) and above. It is thus, suggestive that the threshold and lethal limits of effect of hydrocarbons against the sulfur bacterium lies between 2.04 and 3.65 mg kg(-1). These imply that in any case of crude oil pollution that Chromatium is not detected during monitoring the THC levels of the sediment may have been raised to a level close to or above 3.65 mg kg(-1). Statistical analysis of the relationship between THC level and density of Chromatium in sediment revealed a significant (p < 0.05) negative relationship (r = -0.85) in Qua Iboe mangrove ecosystem as against an insignificant (p > 0.05) relationship (r = -0.41) recorded for the Cross River mangrove ecosystem which served as the control. The result indicates that oil pollution affect the homeostatic status of Chromatium in tidal mud flats despite its even distribution (R2 = 71.4%). The finding though not definitive may contribute to the hierarchical process of oil pollution assessment in the Niger Delta region of Nigeria. However, its effective utilization will require not only the development of a selective medium for enumeration and isolation of the bacterium but also the establishment of a defined dose-response relationship under controlled conditions which requires further research.

La cesárea del milenio: técnica de Misgav Ladach modificada / Cesarian of the millennium: the modified Misgav Ladach procedure

Introducción: Muchas operaciones ginecológicas se han reemplazado hoy por alternativas médicas y quirúrgicas; sin embargo, la cesárea no tiene alternativa y es por eso que tenemos la responsabilidad de hacer el proceder más simple, más eficaz y menos costoso. Método: Se realizó un estudio prospectivo de casos y controles sobre los resultados del método de Misgav Ladach modificado en la operación cesárea en un período de 5 años en el Hospital Docente Gineco-Obstétrico Provincial de Camagüey (Cuba). Se incluyeron 284 pacientes, que se dividieron en 2 grupos. Se determinó la odds ratio y la probabilidad con un 95% de fiabilidad. Resultados: En las indicaciones del proceder, el riesgo quirúrgico, el tiempo de extracción del recién nacido y las condiciones de éste al nacer, no presentaron diferencia significativa entre ambos grupos; sí fue significativa la diferencia en el tiempo quirúrgico, con una media inferior de 9 min en el grupo estudio (p < 0,05). Las complicaciones como abscesos, hematomas de pared e íleo paralítico resaltaron en el grupo control, lo que redujo la posibilidad de complicaciones en el grupo estudio al 0,08%, la estancia hospitalaria fue significativamente menor en el grupo estudio, con una reducción importante de los costes. Conclusión: Se considera que es factible la aplicación de rutina del proceder con beneficios significativos (AU)

Introduction: Many gynecological interventions have been replaced by medical and surgical alternatives. Nevertheless, Cesarean section has no alternative and consequently efforts should be made to make the procedure simpler, more effective and less costly. Method: We performed a prospective case-control study of the results of the modified Misgav-Ladach technique in Cesarean sections performed over a 5-year period at the provincial maternity teaching hospital of Camagüey (Cuba). A total of 284 patients were divided into two groups. Odds ratios (OR) and 95% confidence intervals were determined. Results: The indications for surgery, surgical risk, newborn extraction time, and newborn status at birth showed no significant differences between the 2 groups. However, the mean surgical time was 9 minutes lower in the study group (p < 0.05). Complications such as abscesses, abdominal wall hematomas and paralytic ileus were more frequent in the control group and were reduced in the study group to 0.08%. Hospitalization was significantly reduced in the study group with a marked decline in costs. Conclusion: Routine application of the Misgav Ladach procedure is feasible and has significant benefits (AU)

La histerectomía del milenio: técnica de Misgav Ladach modificada / La histerectomía del milenio: técnica de Misgav Ladach modificada

Se realizó un estudio prospectivo de casos y controles de los resultados de la histerectomía abdominal por la técnica de Misgav Ladach modificada en el Hospital Docente Gineco-Obstétrico Provincial de Camagüey en un período de 4 años. Se formaron 2 grupos de 176 pacientes cada uno; la información se procesó electrónicamente según el programa EPINFO versión V y se determinaron la odds ratio (OR) y la probabilidad con una fiabilidad del 95%. La indicación más frecuente fue el fibroma uterino; entre los riesgos quirúrgicos predominó la hipertensión arterial, aunque sin diferencia significativa entre los 2 grupos. Se redujo el tiempo quirúrgico promedio en 17 min; el absceso de cúpula (OR = 0,00; p < 0,05) y la infección de la herida fueron las complicaciones que predominaron significativamente en el grupo control; la estadía hospitalaria más frecuente en el grupo estudio fue de 3 a 4 días y en el grupo control de 5 a 6 días, manifestándose una reducción importante de los costes en el grupo anterior. Consideramos esta técnica un instrumento para lograr un mejor postoperatorio, una recuperación rápida y una reducción significativa de costes (AU)

We performed a prospective case-control study of the results of abdominal hysterectomy using a modified Misgav-Ladach procedure at the Provincial Teaching Hospital of Camagüey (Cuba) over a 4-year period. There were two groups of 176 patients each. Information was processed electronically with EPINFO version V. Odds ratios (OR) and probability with 95% confidence intervals were determined. The most frequent indication was uterine leiomyoma. The main surgical risk was hypertension, although no significant difference was found between the two groups. Surgical time was reduced by an average of 17 minutes. Vaginal cuff abscess (OR: 0.00; P < .05) and surgical site infection were significantly more frequent in the control group. Length of hospital stay was 3 to 4 days in the study group and 5 to 6 days in the control group, with substantial cost reduction in the former group. We believe this technique is useful in improving the postoperative period and in achieving faster recovery and significant cost (AU)

El adolescente, la familia y su educación sexual / Adolescents, the family and sex education

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Enfermedad inflamatoria pelviana en adolescentes / Pelvic inflammatory disease in adolescents

Objetivo. Se realizó un estudio descriptivo transversal en el Hospital Materno Provincial de Camagüey, durante un período de 12 meses, con el fin de mostrar las consecuencias de la enfermedad inflamatoria pelviana en adolescentes, así como sus factores de riesgo. Material y método. Se escogió a 55 adolescentes que ingresaron en nuestro hospital con el diagnóstico de inflamación pélvica. Los parámetros estudiados incluyeron edad, primera relación sexual, método anticonceptivo, diagnóstico y tratamiento. Resultados. Se observó que el 54,5% tenía menos de 15 años y que en un 69,1% las primeras relaciones sexuales fueron antes de los 15 años; el 76,4% no usaba método anticonceptivo. Hay que señalar que, aunque el 87,3% de los casos se resolvió con tratamiento médico, en 3 pacientes fue necesario el tratamiento quirúrgico radical (AU)

Objective. A cross sectional descriptive study to determine the consequences and risk factors of pelvic inflammatory disease in adolescents was carried out over a 12-month period at the Hospital Materno Provincial in Camagüey (Cuba). Material and method. Fifty-five adolescents who were admitted to our hospital with a diagnosis of pelvic inflammatory disease were selected. The parameters studied included age, first sexual relationship, birth control method used, diagnosis, and treatment. Results. Of the group studied, age was less than 15 years in 54.5%. The first sexual relationship occurred before the age of 15 years in 69.1% and 76.4% used no contraception. Notably, pelvic inflammatory disease was resolved by medical treatment in 87.3%. Radical surgery was required in 3 patients (AU)

Productivity and distribution of epipellic microalgae along salinity gradients in mangrove swamp of the Qua Iboe Estuary (Nigeria).

Based on spatial variation in tidal mud salinity, direct gradient analysis procedures were adopted to relate the productivity and distribution of epipellic microalgae along salinity gradients in mangrove swamp of the Qua Iboe Estuary. Variations in mud salinities were due to distance from the coast, tidal incursions and freshwater input. The dilution effect of fresh water input from rainfall, urban runoff and associated freshwater creeks was most severe during the rainy season month of July, with much lower salinity levels recorded, in comparison to higher salinity values, recorded for same sampling locations during the drier month of December. In the dry season, all the microalgae species but Closterium (a genus of soft, green algae) and Oscillatoria (a cyanobacterium) species encountered in the tidal mud flats showed statistically significant negative correlations with salinity, while most microalgae species excluding Oscillatoria and Closterium species were positively correlated with the same factor during the wet season. Four Ecological Groups of microalgae, were established in the dry season month of December as against two Ecological Groups in the wet season month of July. However no microalgae species was found to occur on the highest values of mud salinity and there were overlapping range of occurrences and ecological optima for most species along the gradients.

Morbimortalidad perinatal de la rotura prematura de membrana en el embarazo pretérmino / Perinatal morbidity and mortality in premature rupture of membranes in preterm pregnancy

Objetivo. Se realizó un estudio descriptivo y retrospectivo en el Hospital Ginecobstétrico Provincial de Camagüey Ana Betancourt de Mora, en el período de un año, para demostrar la morbimortalidad perinatal de la rotura prematura de membranas en embarazos pretérminos. Material y método. Se estudió a 52 gestantes que presentaron este accidente y concibieron en la fecha señalada. Se analizó varios parámetros como la edad de la madre, las enfermedades del embarazo, el lugar de ocurrencia, la duración de la rotura y la morbimortalidad perinatal. Resultados. Se halló que la anemia y la infección vaginal representaron las principales enfermedades asociadas. La neumonía neonatal y el trastorno de adaptación fueron las primeras causas de morbilidad en el neonato, las que guardaron estrecha relación con el período de latencia y el peso del recién nacido, y el 90,9% de los neonatos lograron sobrevivir. Conclusiones. Hay una alta incidencia de morbimortalidad perinatal asociada con la rotura prematura de membranas en el embarazo pretérmino, principalmente de índole infecciosa, siendo éste más probable mientras mayor sea el período de latencia (AU)

Objective. A retrospective and descriptive study was undertaken to determine the association between perinatal morbidity and mortality and premature rupture of membranes over a period of 1 year at the Ana Betancourt de Mora Gynecology and Obstetrics Provincial Hospital in Camagüey. Material and method. The study included 52 women who presented with premature rupture of membranes and delivered during this period. The parameters analyzed included the patient's age, pregnancy- related diseases, place of occurrence, duration of the rupture, and perinatal morbidity and mortality. Results. The main associated abnormalities were anemia and vaginal infection. The principal causes of morbidity in neonates were neonatal pneumonia and adaptation distress, which were closely associated with the latency period of membrane rupture and birth weight. A total of 90.9% of the neonates survived. Conclusions. There is a high incidence of perinatal morbidity and mortality associated with premature rupture of membranes en preterm pregnancies. This occurs mainly as a results of infections, which are more likely the longer (..) (AU)

Studies on mould growth and biomass production using waste banana peel.

Hyphomycetous (Aspergillus fumigatus) and Phycomycetous (Mucor hiemalis) moulds were cultivated in vitro at room temperature (28 + 20 degrees C) to examined their growth and biomass production on waste banana peel agar (BPA) and broth (BPB) using commercial malt extract agar (MEA) and broth (MEB) as control. The moulds grew comparatively well on banana peel substrates. No significant difference (p > 0.05) in radial growth rates was observed between moulds cultivated on PBA and MEA, although growth rates on MEA were slightly better. Slight variations in sizes of asexual spores and reproductive hyphae were also observed between moulds grown on MEA and BPA. Smaller conidia and sporangiospores, and shorter aerial hyphae (conidiophores and sporangiophores) were noticed in moulds grown on BPA than on MEA. The biomass weight of the test moulds obtained after one month of incubation with BPB were only about 1.8 mg and 1.4 mg less than values recorded for A. fumigatus and M. hiemalis respectively, grown on MEB. The impressive performance of the moulds on banana peel substrate may be attributed to the rich nutrient (particularly the crude protein 7.8% and crude fat 11.6% contents) composition of banana peels. The value of this agricultural waste can therefore be increased by its use not only in the manufacture of mycological medium but also in the production of valuable microfungal biomass which is rich in protein and fatty acids.

Condiloma gigante de la vulva. Presentación de un caso / Giant condyloma of the vulva. A case report

EEl propósito de este artículo es comentar el caso de una paciente de 16 años y nulípara que acudió a la consulta de ginecología del Kabwe General Hospital, en Zambia, con antecedentes de buena salud, por notar en los últimos 6 a 12 meses el crecimiento rápido de sus genitales externos, lo que le dificulta la marcha. En el examen físico se observó una gran tumoración en la vulva que la ocluía casi completamente, formada por estrías como si fueran crestas de gallo, lo que la hacía de superficie muy irregular con olor característico sugestivo de condiloma acuminado. El examen vaginal con espéculo fue imposible, y entre los exámenes complementarios destacó la serología reactiva y la positividad para el VIH. Después de los tratamientos antibiótico y antiviral local, sin resultado alguno, se llevó a cabo vulvectomía simple en dos Fig. 1. Condiloma gigante de la vulva (AU)

Absceso piógeno hepático. Presentación de tres casos / Pyogenic hepatic abscess. A report of 3 cases

El absceso piógeno hepático es infrecuente en niños, y muestra síntomas y signos inespecíficos. El desarrollo de las técnicas de imagen ha revolucionado su diagnóstico y tratamiento. El presente trabajo describe 3 casos diagnosticados en un período de 6 meses, tratados con antibioterapia y drenaje percutáneo mediante aguja con control ultrasonográfico. Los tres pacientes tenían antecedentes de piodermitis, y S. aureus fue el agente etiológico. Uno de los pacientes falleció por diagnóstico tardío de la enfermedad y el resto evolucionó favorablemente, con resolución del absceso en un período de 3-4 semanas.Se pone énfasis en la necesidad de un diagnóstico y tratamiento precoces por la gravedad de esta enfermedad (AU)

Efecto del clorhidrato de metformina sobre el metabolismo en mujeres con síndrome de ovarios poliquísticos / The effect of metformine chlorhydrate on the metabolism of women with polycystic ovary syndrome

Se realizó un ensayo clínico fase II, controlado, con asignación aleatoria, en dos ramas, donde se evaluó la eficacia del uso del clorhidrato de metformina en el tratamiento de las pacientes portadoras del síndrome de ovarios poliquísticos (SOP), con historia de infertilidad y trastornos menstruales en un período de un año en el Hospital Clínico-Quirúrgico de Camagüey. El estudio estuvo constituido por 169 mujeres que recibieron tratamiento con inductores de la ovulación (clomifeno y/o gonadotrofinas) por un período igual o mayor de un año. Las pacientes se dividieron en dos grupos, un grupo control integrado por 83 mujeres con tratamiento con inductores de la ovulación (grupo I), y otro, de 86 mujeres, al que, además, se administró clorhidrato de metformina (grupo II). Este último grupo se determinó de forma aleatoria con el objetivo de evitar riesgos. Los datos se procesaron mediante el sistema estadístico SPSS para Windows realizándose distribución de frecuencia y tablas de contingencia. El grupo de edad predominante fue el de entre 24 y 30 años en ambos grupos. En la evolución del índice de masa corporal de las pacientes, al inicio del estudio, observamos el predominio de las obesas en ambos grupos. También observamos un progreso significativo del índice cintura/cadera en las que usaron clorhidrato de metformina. Después de utilizar este producto los valores de insulina se normalizaron en casi la totalidad de las pacientes a diferencia del grupo control. Se logró una mejoría considerable de los valores del perfil lipídico en el grupo control. El estado de insulinorresistencia mejoró en mayor medida en las pacientes tratadas con clorhidrato de metformina, hasta el punto de no existir. Al final de la investigación ninguna paciente de este grupo siguió presentando alteración de la glucemia en ayunas, aunque con respecto a la prueba de tolerancia a la glucosa no existieron diferencias significativas entre ambos grupos. Es recomendable el uso del clorhidrato de metformina en asociación con la terapia clásica en las pacientes con SOP, en aras de lograr un adecuado control metabólico (AU)

Bioamendment of petroleum contaminated ultisol: effect on oil content, heavy metals and pH of tropical soil.

The effect of organic amendments on the oil content, heavy metals concentration and pH of petroleum contaminated sandy loam ultisol obtained from Rumuekpe oil field in Emohua Local Government Area of Rivers State, Nigeria was determined. Petroleum contaminated soils were treated with wood ash, compost and sawdust. The addition of organic amendments resulted in a significant (at 95% probability level) decrease in oil content by 92% for composting, 81% for soil treated with sawdust and 58% for soil with ash supplementation, over 6 months. The effect of treatments on the iron(Fe), copper(Cu) and lead(Pb) concentration was significant at P < 0.001. The remediation also affected the pH of soil. This initial pH of 5.6 was depressed by the application of compost and sawdust supplements respectively to a final pH of 5.2 and 5.3. On the other hand, amending the soil with wood ash raised the pH from 5.6 to 6.2. Increased acidity caused a decrease in the heavy metals concentration in the contaminated soil. Soil treatment with compost generally gave the best remediation results, followed by sawdust and then ash. Adjusting the pH of oil contaminated soil to high acidic levels may promote the availability and migration of heavy metals in remediated soils and not necessarily the rate of oil mineralization.

Public/private partners. Key factors in creating a strategic alliance for community health.

BACKGROUND: The rapidly evolving American health system creates economic and societal incentives for public and private health organizations to collaborate. Despite the apparent benefits of collaboration, there is a paucity of information available to help local agencies develop partnerships. This study, itself a collaboration between a school of public health (SPH) and a Georgia health district, was undertaken to identify critical factors necessary to successfully initiate and sustain a public/private community health collaboration. METHODS: Professional staff at the SPH conducted 26 standardized interviews involving participants from Cobb and Douglas counties Boards of Health; Promina Northwest (now known as Wellstar), a not-for-profit health system; and community stakeholders. Content analysis of each interview question was performed and comparisons were made both within each group and across groups. RESULTS: Trends were identified in the following key areas: vision of health care for Cobb and Douglas counties, forces driving collaboration, strengths of each organization, critical negotiating issues, and potential community gain resulting from the partnership. CONCLUSION: A shared vision between potential collaborators facilitates communication regarding strategies to achieve common goals. A previous history of working together in limited capacities allowed the partners to develop trust and respect for one another prior to entering negotiations. These factors, when taken in conjunction with each organization's strong leadership and knowledge of the community, build a strong foundation for a successful partnership.

Positioning for partnerships. Assessing public health agency readiness.

BACKGROUND: Public health organizations are redefining their roles and aligning their structures with other components of the evolving American health system. Health departments must proactively and strategically plan how to position themselves for the coming years. Prior to implementing changes in functioning, structure, and/or future strategies, an organization should assess its internal readiness to commit to creating these substantial alterations. METHODS: Using a diagnostic tool developed by study investigators, employees of the Cobb and Douglas Counties Boards of Health were surveyed in order to assess their organizational readiness to enter into a strategic partnership with Promina Northwest, a not-for-profit hospital network in the Atlanta, Georgia area. Frequency distributions were conducted for each categorical variable and data were analyzed in aggregate and by job category. RESULTS: The 122 analyzed questionnaires revealed some significant trends. Respondents ranked the six factors having the greatest impact on an organization's ability to change in the following order: leadership, planning, teamwork, mission, information and operations. Interestingly, this rank ordering parallels the perceived strengths and weaknesses of the health departments as determined by the frequency of the most positive responses. CONCLUSION: Cobb and Douglas Counties Boards of Health have taken many key steps to prepare the organizations for significant proactive changes. Survey results emphasized the need for open channels of communication within the organizations and with the external environment so that effective planning can guide the strategic alignment of the health departments with community partners.

Future directions for research in laboratory medicine: the findings of a Delphi survey of stakeholders.

In July 1995, we asked 101 experts to anticipate future areas for research in clinical laboratory medicine using a modified Delphi survey approach. The panel included academicians, clinical laboratory professionals, laboratory managers, practicing physicians public health officials, hospital administrators, and representatives of manufacturing industries, managed care organizations, commercial laboratories, and government health agencies. The participants predicted fewer laboratories, more automation, and fewer skilled staff needed in the future. The consensus was that laboratory quality assurance will focus on patient outcomes and be benchmarked against peer groups. They agreed that quality assurance routinely will be integrated into testing kits. Measures derived from medical informatics, such as outcomes analysis and utilization statistics, will become a standard feature of health care. A major area of concern was the effect that reorganizing health care and striving for cost containment will have on laboratory services. These views were consistent with those expressed by participants at a CDC conference on the frontiers of laboratory medicine research held shortly after the study was completed. These topics by now are familiar to most laboratory professionals, and we urge them to explore the many research issues raised with their colleagues in their clinical laboratories, health-care organizations, and industry.