No abstract available.

No abstract available.
Carcinoembryonic Antigen* ; Cell Line* ; Colorectal Neoplasms* ; Humans*

The risks of mercury use have prompted the establishment of Minamata Convention on Mercury which placed strong emphasis on management of mercury-added products. This convention aims to reduce and phase out the use, manufacturing and trade of mercury-added products including batteries, switches and non-electronic measuring devices. This commitment will cause significant impacts especially in the developing countries in designing the right approach to achieve it. This is also true for medical industry which is well known for the utilization of mercury-added devices and dental amalgam in its services but had embarked on efforts in eliminating mercury for many years. The experiences learned within a medical facility can be useful in efforts to meet this global ambition of mercury phase out. This paper aims to provide conceptual discussion on the challenges faced by developing countries and lessons learned from medical facility that can helps the formulation of appropriate approaches to manage mercury-added products. The paper adopted medical industry as a case study and used document analysis to discuss the issue. The main challenges identified for developing countries include lacks of capacity, funding, data and newer technologies. Based on analysis of previous studies, this study proposed a mercury management framework in medical facility and identified the recommended practices, namely technological application, policy instrument, capacity building and guidelines development. These identified approaches are found to have specific relationships between cost and potential impacts, hence giving flexibility for adoption based on the available resources in promoting better mercury management system

Background: The application of three-dimensional computed tomography (3D CT) to analyse craniofacial morphology in individuals with cleft lip and palate (CLP) enables detailed assessments to be made of asymmetry in the region of the cleft and in regions distant from the cleft. The aim of this study was to compare craniofacial morphology in a sample of Malaysian infants with unoperated CLP with a control sample of unaffected Malaysian infants. Methods: The study sample comprised 29 individuals: 10 with unilateral CLP (UCLP), 5 with bilateral CLP (BCLP), 7 with cleft lip and primary palate (CLPP), and 7 with isolated cleft palate (ICP). The control sample consisted of 12 non-cleft (NC) infants. All subjects were between 0.4 and 12.2 months of age. Nine mid-facial and 4 nasal bone landmarks were located on 3D CT scans and compared to a midline reference plane, which was created using the landmarks basion, sella, and nasion. Unpaired t tests and F tests were used to compare means and variances between sample groups, whereas paired t tests were used for comparisons within the UCLP and NC groups. Results: Differences in variances of some mid-facial breadths and nasal bone dimensions were found in both male and female cleft groups when compared to the NC sample. In the UCLP group, some nasal bone and facial breadth dimensions were larger than in the NC sample and the nasal bone tended to deviate to the contralateral side of the cleft. Conclusion: : CLP affects the size and orientation of the nasal bones and is associated with an altered morphology of some facial bones at positions distant from the region of the cleft.

This study provides a closer look to the possibility of having advanced practice in public health nursing by analyzing the power relations between nursing practice and social structures. Representatives from the public health sector, national authorities, and the private sector were invited in a round table discussion. Transcriptions were coded and later on categorized and analyzed drawing upon the concepts of Foucault. Foucauldian analysis hands an important insight on how social structures and institutions can steer the creation of an advanced practice in public health nursing in the Philippines. Various social institutions view the relevance of a master's prepared nurse according to their societal roles and functions. Requisite competencies of a master's prepared nurse in public health nursing include fulfilling the role of a clinician, leader and manager, supervisor, and a researcher. PRBON, CHED, DOH, and nursing schools need to work together to define the knowledge of an advanced practice in public health nursing, to implement appropriate surveillance mechanisms, and to establish a compliant practice.

BACKGROUND: The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site. METHODS: Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias. RESULTS: Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness (60+/-3.2 microm). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured 1,032+/-435 microm in the anteromedial region compared to 1,220+/-257 microm in the anterolateral region. CONCLUSIONS: Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh.
Basement Membrane ; Cadaver* ; Dermatologic Surgical Procedures ; Dermis ; Humans ; Microscopy ; Observer Variation ; Photomicrography ; Skin* ; Thigh* ; Tissue Donors* ; Transplants*

Endovascular neurointervention is typically performed with iodinated contrast medium (ICM) under fluoroscopy. However, some patients may be contraindicated to such procedures based on their sensitivity to ICM. In this report, we describe a case of successful coil embolization of a direct carotid cavernous fistula using angiography with gadolinium-based contrast agents in a patient with severe allergic reaction to ICM. The clinical decision-making for this patient was further complicated by comorbidities of renal impairment, drug allergies, and previously severe gastrointestinal bleeding.

In view of the dearth of information relating to antibiotic resistance in community- and hospital-acquired bacterial infections in Papua New Guinea (PNG), we carried out a prospective, hospital-based observational study of surgical patients between October 2008 and October 2009. In a sample of 115 patients (median age 30 years; 55% males) suspected of having a bloodstream infection, blood cultures were positive in 11 (10%) and a significant pathogen was isolated in 9 (8%). Staphylococcus aureus was isolated in 4 patients (44%) and 3 were methicillin resistant; all these isolates were considered community acquired because cultures were performed within 48 hours of admission. Of the remaining 5 isolates, 4 were Gram-negative organisms with at least intermediate resistance to chloramphenicol that were grown from blood taken > 48 hours post-admission and thus considered nosocomially acquired. These data suggest two distinct patterns of bacterial infection in PNG surgical inpatients that have implications for national antibiotic prescription guidelines.

Cerebellitis is a rarely encountered complication of isoniazid therapy. Its occurrence is usually associated with concomitant renal disease and haemodialysis. Herein, we report the case of a patient with this complication who presented with isolated bilateral symmetrical dentate nucleus T2 hyperintensities on magnetic resonance imaging. Isoniazid neurotoxicity has never been reported to cause bilateral dentate hyperintensities, for which the differentials are few and include metronidazole toxicity.
Adult ; Antitubercular Agents ; adverse effects ; Cerebellar Diseases ; chemically induced ; Cerebellar Nuclei ; pathology ; Diagnosis, Differential ; Female ; Humans ; Isoniazid ; adverse effects ; Magnetic Resonance Imaging ; Renal Dialysis ; Renal Insufficiency ; therapy ; Tuberculosis ; drug therapy