Interpreting short and medium exposure etched-track radon measurements to determine whether an action level could be exceeded

Publication date: October 2016
Source:Journal of Environmental Radioactivity, Volumes 162–163
Author(s): A.R. Denman, R.G.M. Crockett, C.J. Groves-Kirkby, P.S. Phillips
Radon gas is naturally occurring, and can concentrate in the built environment. It is radioactive and high concentration levels within buildings, including homes, have been shown to increase the risk of lung cancer in the occupants. As a result, several methods have been developed to measure radon. The long-term average radon level determines the risk to occupants, but there is always pressure to complete measurements more quickly, particularly when buying and selling the home. For many years, the three-month exposure using etched-track detectors has been the de facto standard, but a decade ago, Phillips et al. (2003), in a DEFRA funded project, evaluated the use of 1-week and 1-month measurements. They found that the measurement methods were accurate, but the challenge lay in the wide variation in radon levels - with diurnal, seasonal, and other patterns due to climatic factors and room use. In the report on this work, and in subsequent papers, the group proposed methodologies for 1-week, 1-month and 3-month measurements and their interpretation. Other work, however, has suggested that 2-week exposures were preferable to 1-week ones. In practice, the radon remediation industry uses a range of exposure times, and further guidance is required to help interpret these results. This paper reviews the data from this study and a subsequent 4-year study of 4 houses, re-analysing the results and extending them to other exposures, particularly for 2-week and 2-month exposures, and provides comprehensive guidance for the use of etched-track detectors, the value and use of Seasonal Correction Factors (SCFs), the uncertainties in short and medium term exposures and the interpretation of results.



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Utility of Routine Colonic Biopsies in Pediatric Colonoscopic Polypectomy for Benign Juvenile Hamartomatous Polyps.

Introduction: Benign juvenile hamartomatous polyps are common in pediatric gastrointestinal practice. We hypothesize that in the absence of gross mucosal abnormalities, the likelihood of histologic abnormalities from routine random colonic biopsies is low. Methods: We performed a retrospective chart review identifying patients aged 1 to 18 years who underwent complete colonoscopy and polypectomy for suspected colorectal polyps from January 1, 2004 to July 1, 2014. Indication, age, number of polyps, gross and histologic findings, and any management changes resulting from endoscopy were recorded. Exclusion criteria included history of polyposis syndrome, more than 5 polyps on colonoscopy, inflammatory bowel disease, and incomplete documentation. Practice patterns were assessed by online survey distributed via Pediatric Gastroenterology listserv. Results: 141 patients underwent colonoscopy with anticipated polypectomy. 72 (63% male) were included. Mean age was 6.5 years. Indication was hematochezia in 71. Findings other than polyps were found in 7 (10%). Juvenile hamartomatous polyps were documented by histologic examination in 68 patients (94%). Routine colonic biopsies were performed in 55 patients (76%). In 8 (15%), histologic abnormalities were seen that did not result in management changes. 73 providers responded to the online survey; 56% reported not taking ileo-colonic biopsies in the absence of other mucosal abnormalities; 45% routinely biopsied from the terminal ileum and/or colon. None would biopsy the terminal ileum only. Conclusion: In children with benign juvenile hamartomatous polyps, routine colonic biopsies are not required in the absence of mucosal abnormalities. Overuse of pathology services, increased procedural time, risk, and cost can be avoided. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Percutaneous Transhepatic Cholangioplasty to Treat Multiple Intrahepatic Biliary Strictures After Hepatoportoenterostomy.

In children with biliary atresia (BA), hepatoportoenterostomy (HP) is recommended to improve bile flow. Biliary strictures are known potential complications following HP which can again impair bile flow often leading to biliary cirrhosis and liver transplantation. In patients who are status post HP and have biliary strictures, non-surgical therapeutic options such as endoscopic dilation can pose technical difficulties due to altered anatomy. Percutaneous transhepatic cholangiography with cholangioplasty (PTC-C) is a valuable tool for obstructive cholangiopathies, but to our knowledge this has not been previously demonstrated to be successful in patients with multiple intrahepatic biliary strictures status post HP. Herein, we present three patients status post HP who presented with multiple intrahepatic biliary strictures and underwent successful PTC-C. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Self-referential processing in adolescents: Stability of behavioral and ERP markers

Abstract

The self-referential encoding task (SRET)—an implicit measure of self-schema—has been used widely to probe cognitive biases associated with depression, including among adolescents. However, research testing the stability of behavioral and electrocortical effects is sparse. Therefore, the current study sought to evaluate the stability of behavioral markers and ERPs elicited from the SRET over time in healthy, female adolescents (n = 31). At baseline, participants were administered a diagnostic interview and a self-report measure of depression severity. In addition, they completed the SRET while 128-channel ERP data were recorded to examine early (P1) and late (late positive potential [LPP]) ERPs. Three months later, participants were readministered the depression self-report measure and the SRET in conjunction with ERPs. Results revealed that healthy adolescents endorsed, recalled, and recognized more positive and fewer negative words at each assessment, and these effects were stable over time (rs = .44–.83). Similarly, they reported a faster reaction time when endorsing self-relevant positive words, as opposed to negative words, at both the initial and follow-up assessment (r = .82). Second, ERP responses, specifically potentiated P1 and late LPP positivity to positive versus negative words, were consistent over time (rs = .56–.83), and the internal reliability of ERPs were robust at each time point (rs = .52–.80). As a whole, these medium-to-large effects suggest that the SRET is a reliable behavioral and neural probe of self-referential processing.

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Association of adenovirus type 2 with encephalitis: A new case report from Kerala, India.

2016-06-14T23-56-57Z
Source: The Southeast Asian Journal of Case Report and Review
Thounaojam Asia Devi, Balakrishnan Anukumar, Mun Amol Baburao.
Adenovirus is a common respiratory pathogen in children that sometime produces encephalitis symptoms in affected children. Very few reports are available on association of adenovirus type 2 with encephalitis cases. However, none of the cases have been reported from India. We have detected and characterized the adenovirus from the clinical specimens collected from a six year old boy who had the symptoms of encephalitis. The adenovirus was isolated from all the three specimens; CSF, serum and throat swab in HEK-293 cells. The presence of adenovirus was confirmed by PCR. Sequencing and BLAST search analysis confirmed that the isolated adenovirus belonged to adenovirus type 2. As per our knowledge this is the first report of adenovirus type 2 associated with encephalitis case from India.


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Remission in Pediatric Inflammatory Bowel Disease Correlates with Prescription Refill Adherence Rates.

Objectives: To utilize pharmacy benefit management (PBM) prescription claims data to assess refill adherence in pediatric inflammatory bowel disease (IBD) and correlate adherence with clinical outcomes in pediatric IBD. Methods: We identified 362 pediatric IBD patients seen at Washington University from 9/1/2012 to 8/31/2013 and matched them within Express Scripts' member eligibility files for clients allowing use of prescription drug data for research purposes. Maintenance IBD medication possession ratios (MPR) were determined through PBM prescription claims data and chart review. Demographic and prospectively captured physician global assessments (PGA) were retrospectively extracted from the medical record. MPR was analyzed as continuous data and also dichotomized as greater or less than 80%. Results: Among our 362 patients, we matched 228 (63%) within Express Scripts' eligibility data files. Of those, 78 patients were continuously eligible for benefits and had at least one outpatient prescription IBD medication. Their mean MPR was 0.63 +/- 0.31 (SD) and 40% had an MPR >= 80%. Patients in clinical remission had a higher mean MPR than those with an active PGA (0.72 +/- 0.28 vs. 0.51 +/- 0.32, P = 0.002) and patients whose MPR were >= 80% were more likely to have a PGA of remission than those with whose MPR were

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Symptoms and Mucosal Changes Stable During Rapid Increase of Pediatric Celiac Disease in Norway.

Objectives: We aimed to study whether the incidence of pediatric celiac disease (CD) in South-Eastern Norway changed from 2000-2010. We also examined if there was a change in symptoms and histopathological morphology in the duodenal biopsies during the same period. Methods: In three hospitals in South-Eastern Norway, records from pediatric patients (0-14.9 years) diagnosed with CD during two three-year periods (2000-2002 and 2008-2010) were reviewed. Only cases with a duodenal biopsy diagnosis of CD classified, as Marsh grade 2 and 3a-c were included. Frequencies of symptoms, anthropometric data and laboratory results were compared, in addition to re-examinations of histological sections from one of the hospitals. Results: A total number of 400 cases were diagnosed with a female:male ratio of 1.5:1. The incidence rate for 2000-2002 was 15.9 cases per 100 000 person-years (95% CI 12.8-19.4), compared to 45.5 cases per 100 000 person-years during 2008-2010 (95% CI 40.5-50.9), p

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