Effect of external classroom noise on schoolchildren's reading and mathematics performance: correlation of noise levels and gender.

The present study investigated the effect of low, medium, and high traffic road noise as well as irrelevant background speech noise on primary school children's reading and mathematical performance. A total of 676 participants (324 boys, 47.9% and 352 girls, 52.1%) of the 4th and 5th elementary classes participated in the project. The participants were enrolled in public primary schools from urban areas and had ages ranging from 9 to 10 years and from. Schools were selected on the basis of increasing levels of exposure to road traffic noise and then classified into three categories (Low noise: 55-66 dB, Medium noise: 67-77 dB, and High noise: 72-80 dB). We measured reading comprehension and mathematical skills in accordance with the national guidelines for elementary education, using a test designed specifically for the purpose of this study. On the one hand, children in low-level noise schools showed statistically significant differences from children in medium- and high-level noise schools in reading performance (p<0.001). On the other hand, children in low-level noise schools differed significantly from children in high-level noise schools but only in mathematics performance (p=0.001). Girls in general did better in reading score than boys, especially in schools with medium- and high-level noise. Finally the levels of noise and gender were found to be two independent factors.

Plasma exchange (PE) treatment in drug-induced toxic epidermal necrolysis (TEN).

Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare fulminating skin disease notorious for its rapidly progressive course and high mortality rate. TEN is characterized by the sudden onset of epithelial necrosis of skin with frequently associated involvement of the gastrointestinal, genitourinary tract and bronchopulmonary linings. We describe the clinical course of five patients with severe drug-induced TEN, treated with PE. The suspected drugs were carbamazepine in one patient, paracetamol in one, a combination of paracetamol and mefenamic acid in one, allopurinol in one and ciprofloxacin in one. Three had a skin involvement affecting almost the entire surface of the body. In addition to the skin lesions, mouth, esophagus and lungs were also involved. Steroids proved ineffective. PE was carried out because of the rapid deterioration of the clinical picture. The mean number of PE sessions was 3.22 (range 1-5). Complete remission of the syndrome was achieved in four patients. One patient died due to septic shock. As so far there is no treatment of proven value for this condition, controlled trials should be set up in order to assess the value of PE in TEN.