Exposure Of Man Research Articles

Five years update on relationships between malignant pleural mesothelioma and exposure to asbestos and other elongated mineral particles

ABSTRACTDespite the reduction of global asbestos consumption and production due to the ban or restriction of asbestos uses in more than 50 countries since the 1970s, malignant mesothelioma remains a disease of concern. Asbestos is still used, imported, and exported in several countries, and the number of mesothelioma deaths may be expected to increase in the next decades in these countries. Asbestos exposure is the main risk factor for malignant pleural mesothelioma, but other types of exposures are linked to the occurrence of this type of cancer. Although recent treatments improve the quality of life of patients with mesothelioma, malignant pleural mesothelioma remains an aggressive disease. Recent treatments have not resulted in appreciable improvement in survival, and thus development of more efficient therapies is urgently needed. The development of novel therapeutic strategies is dependent on our level of knowledge of the physiopathological and molecular changes that mesothelial cells acquired during the neoplastic process. During the past 5 years, new findings have been published on the etiology, epidemiology, molecular changes, and innovative treatments of malignant pleural mesothelioma. This review aims to update the findings of recent investigations on etiology, epidemiology, and molecular changes with a focus on (1) attributable risk of asbestos exposure in men and women and (2) coexposure to other minerals and other elongated mineral particles or high aspect ratio nanoparticles. Recent data obtained on genomic and gene alterations, pathways deregulations, and predisposing factors are summarized.

A comparative study of the in vitro permeation of ibuprofen in mammalian skin, the PAMPA model and silicone membrane

Human skin remains the membrane of choice when conducting in vitro studies to determine dermal penetration of active pharmaceutical ingredients or xenobiotics. However there are ethical and safety issues associated with obtaining human tissue. For these reasons synthetic membranes, cell culture models or in silico predictive algorithms have been researched intensively as alternative approaches to predict dermal exposure in man. Porcine skin has also been recommended as an acceptable surrogate for topical or transdermal delivery research. Here we examine the in vitro permeation of a model active, ibuprofen, using human or porcine skin, as well as the Parallel Artificial Membrane Permeation Assay (PAMPA) model and silicone membrane. Finite dose studies were conducted in all models using commercial ibuprofen formulations and simple volatile ibuprofen solutions. The dose applied in the PAMPA model was also varied in order to determine the amount of applied formulation which best simulates typical amounts of topical products applied by patients or consumers. Permeation studies were conducted up to 6h for PAMPA and silicone and up to 48h for human and porcine skin. Cumulative amounts permeated at 6h were comparable for PAMPA and silicone, ranging from 91 to 136μg/cm2 across the range of formulations studied. At 48h, maximum ibuprofen permeation in human skin ranged from 11 to 38μg/cm2 and corresponding values in porcine skin were 59–81μg/cm2. A dose of 1μL was confirmed as appropriate for finite dose studies in the PAMPA model. The formulation which delivered the greatest amount of ibuprofen in human skin was also significantly more efficient than other formulations when evaluated in the PAMPA model. The PAMPA model also discriminated between different formulation types (i.e. gel versus solution) compared with other models. Overall, the results confirm the more permeable nature of the PAMPA, silicone membrane and porcine tissue models to ibuprofen compared with human skin. Further finite dose studies to elucidate the effects of individual excipients on the barrier properties of the PAMPA model are needed to expand the applications of this model. The range of actives that are suitable for study using the model also needs to be delineated.

PERSONAL MEASURES OF POWER-FREQUENCY MAGNETIC FIELD EXPOSURE AMONG MEN FROM AN INFERTILITY CLINIC: DISTRIBUTION, TEMPORAL VARIABILITY AND CORRELATION WITH THEIR FEMALE PARTNERS' EXPOSURE.

Power-frequency magnetic field exposure science as it relates to men and couples have not been explored despite the advantage of this information in the design and interpretation of reproductive health epidemiology studies. This analysis examined the distribution and temporal variability of exposures in men, and the correlation of exposures within couples using data from a longitudinal study of 25 men and their female partners recruited from an infertility clinic. The average and 90th percentile demonstrated fair to good reproducibility, whereas the maximum showed poor reproducibility over repeated sampling days, each separated by a median of 4.6 weeks. Average magnetic field exposures were also strongly correlated within couples, suggesting that one partner's data could be used as a surrogate in the absence of data from the other for this metric. Environment was also an important effect modifier in these explored matters. These issues should be considered in future relevant epidemiology studies.

Entre o ver e o ser visto: notas sobre a visibilidade do homem e do animal no cinema e na literatura

http://dx.doi.org/10.5007/1984-784X.2015v15n24p34Este artigo pretende estabelecer interseções entre a produção cinematográfica Ex isto, de Cao Guimarães, e a obra literária que a motiva, Catatau, de Paulo Leminski, tendo como eixo a discussão sobre as posições ocupadas pelo homem e pelo animal. A fim de evidenciar as implicações de uma inversão crítica propiciada pela exposição do homem, que é perscrutado, e torna-se, imagem, e do animal, que se posiciona como o detentor do olhar, recorremos ao pensamento de George Didi-Huberman, Giorgio Agamben e Michel Foucault.

Men's Objectifying Media Consumption, Objectification of Women, and Attitudes Supportive of Violence Against Women.

A recent White House Council Report on Women and Girls called attention to sexual assault on college campuses and encouraged continued research on this important public health problem. Media that sexually objectify women have been identified by feminist scholars as encouraging of sexual assault, but some researchers question why portrayals that do not feature sexual assault should affect men's attitudes supportive of violence against women. Guided by the concepts of specific and abstract sexual scripting in Wright's (Communication Yearbook 35:343-386, 2011) sexual script acquisition, activation, application model of sexual media socialization, this study proposed that the more men are exposed to objectifying depictions, the more they will think of women as entities that exist for men's sexual gratification (specific sexual scripting), and that this dehumanized perspective on women may then be used to inform attitudes regarding sexual violence against women (abstract sexual scripting). Data were gathered from collegiate men sexually attracted to women (N=187). Consistent with expectations, associations between men's exposure to objectifying media and attitudes supportive of violence against women were mediated by their notions of women as sex objects. Specifically, frequency of exposure to men's lifestyle magazines that objectify women, reality TV programs that objectify women, and pornography predicted more objectified cognitions about women, which, in turn, predicted stronger attitudes supportive of violence against women.

Polychlorinated biphenyls (PCBs) in fish from the Sana River (Bosnia and Herzegovina): A preliminary study on the health risk in sport fishermen

Fish is the main single source of polychlorinated biphenyls (PCBs) exposure in men. Anecdotal reports suggest high wild fish consumption rates among sport fishermen in Sanski Most area, Bosnia and Herzegovina (BiH). Presence of PCBs in the environment in BiH was previously documented. The main objective of this work was to estimate the magnitude of PCBs exposure and assess the potential health risk in sport fishermen in Sanski Most. The fishing pattern and magnitude of fish consumption were estimated in the questionnaire survey conducted during April 2012 among members (n = 60) of the local sport fishermen association in Sanski Most. Calculated median and high-end (90th percentile) fish consumption rates were 31 g d−1 and 126 g d−1, respectively. The PCB concentrations (as Aroclor 1254 equivalents), determined by ELISA immunoassay in 28 fish fillets ranged from undetectable to 208 μg kg−1. Two different exposure scenarios were used: (a) median exposure, calculated from the median fish consumption rate and median PCB concentrations, and (b) “worst case” scenario, calculated from the high-end fish consumption rate and mean PCB concentrations. The results suggest negligible lifelong cancer and non-cancer risks in case of low to moderate fish consumption rate, but possibly unacceptable risk levels in high-end consumers.

Exposure to family planning messages and modern contraceptive use among men in urban Kenya, Nigeria, and Senegal: a cross-sectional study.

BackgroundFamily planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples’ fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming. This study aimed to assess whether men’s exposure to FP demand-generation activities is associated with their reported use of modern contraceptive methods.MethodsWe used evaluation data from the Measurement, Learning & Evaluation project for the Urban Reproductive Health Initiative (URHI) in select cities of three African countries (Kenya, Nigeria, and Senegal) collected in 2012/2013. A two-stage cluster sampling design was used to select a representative sample of men in the study sites. The sample for this study includes men aged 15–59 years who had no missing data on any of the key variables: 696 men in Kenya, 2311 in Nigeria, and 1613 in Senegal. We conducted descriptive analyses and multivariate logistic regression analyses to assess the associations of interest. All analyses were weighted to account for the study design and non-response rates using Stata version 13.ResultsThe proportion of men who reported use of modern contraceptive methods was 58 % in Kenya, 43 % in Nigeria, and 27 % in Senegal. About 80 % were exposed to at least one URHI demand-generation activity in each country. Certain URHI demand-generation activities were significantly associated with men’s reported use of modern contraception. In Kenya, those who participated in URHI-led community events had four times higher odds of reporting use of modern methods (aOR: 3.70; p < 0.05) while in Senegal, exposure to URHI-television programs (aOR: 1.40; p < 0.05) and having heard a religious leader speak favorably about FP (aOR: 1.72; p < 0.05) were associated with modern contraceptive method use. No such associations were observed in Nigeria.ConclusionStudy findings are important for informing future FP program activities that seek to engage men. Program activities should be tailored by geographic context as results from this study indicate city and country-level variations. These types of gender-comprehensive and context-specific programs are likely to be the most successful at reducing unmet need for FP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-015-0056-1) contains supplementary material, which is available to authorized users.

Oestrogen action and male fertility: experimental and clinical findings.

A proper balance between androgen and oestrogen is fundamental for normal male reproductive development and function in both animals and humans. This balance is governed by the cytochrome P450 aromatase, which is expressed also under spatio-temporal control. Oestrogen receptors ERα and/or ERβ, together with the membrane-associated G-protein-coupled functional ER (GPER), mediate the effects of oestrogen in the testis. Oestrogen action in male reproduction is more complex than previously predicted. The androgen/oestrogen balance and its regulation in the masculinisation programming window (MPW) during foetal life is the most critical period for the development of the male reproductive system. If this balance is impaired during the MPW, the male reproductive system may be negatively affected. Recent data from genetically modified mice and human infertile patients have shown that oestrogens may promote the engulfment of live Leydig cells by macrophages leading to male infertility. We also discuss recent data on environmental oestrogen exposure in men and rodents, where a rodent-human distinction is crucial and analyse some aspects of male fertility potentially related to impaired oestrogen/androgen balance.

Gender differences in the structure of risk for alcohol use disorder in adolescence and young adulthood.

Gender differences in the prevalence of alcohol use disorder (AUD) have motivated the separate study of its risk factors and consequences in men and women. However, leveraging gender as a third variable to help account for the association between risk factors and consequences for AUD could elucidate etiological mechanisms and clinical outcomes. Using data from a large, community sample followed longitudinally from 17 to 29 years of age, we tested for gender differences in psychosocial risk factors and consequences in adolescence and adulthood after controlling for gender differences in the base rates of AUD and psychosocial factors. Psychosocial factors included alcohol use, other drug use, externalizing and internalizing symptoms, deviant peer affiliation, family adversity, academic problems, attitudes and use of substances by a romantic partner, and adult socio-economic status. At both ages of 17 and 29 years, mean levels of psychosocial risks and consequences were higher in men and those with AUD. However, the amount of risk exposure in adolescence was more predictive of AUD in women than men. By adulthood, AUD consequences were larger in women than men and internalizing risk had a stronger relationship with AUD in women at both ages. Despite higher mean levels of risk exposure in men overall, AUD appears to be a more severe disorder in women characterized by higher levels of adolescent risk factors and a greater magnitude of the AUD consequences among women than men. Furthermore, internalizing symptoms appear to be a gender-specific risk factor for AUD in women.

Association of Parkinson's Disease and Its Subtypes with Agricultural Pesticide Exposures in Men: A Case-Control Study in France.

BackgroundPesticides have been associated with Parkinson’s disease (PD), but there are few data on important exposure characteristics such as dose–effect relations. It is unknown whether associations depend on clinical PD subtypes.ObjectivesWe examined quantitative aspects of occupational pesticide exposure associated with PD and investigated whether associations were similar across PD subtypes.MethodsAs part of a French population-based case–control study including men enrolled in the health insurance plan for farmers and agricultural workers, cases with clinically confirmed PD were identified through antiparkinsonian drug claims. Two controls were matched to each case. Using a comprehensive occupational questionnaire, we computed indicators for different dimensions of exposure (duration, cumulative exposure, intensity). We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) among exposed male farmers (133 cases, 298 controls). We examined the relation between pesticides and PD subtypes (tremor dominant/non-tremor dominant) using polytomous logistic regression.ResultsThere appeared to be a stronger association with intensity than duration of pesticide exposure based on separate models, as well as a synergistic interaction between duration and intensity (p-interaction = 0.04). High-intensity exposure to insecticides was positively associated with PD among those with low-intensity exposure to fungicides and vice versa, suggesting independent effects. Pesticide exposure in farms that specialized in vineyards was associated with PD (OR = 2.56; 95% CI: 1.31, 4.98). The association with intensity of pesticide use was stronger, although not significantly (p-heterogeneity = 0.60), for tremor-dominant (p-trend < 0.01) than for non-tremor–dominant PD (p-trend = 0.24).ConclusionsThis study helps to better characterize different aspects of pesticide exposure associated with PD, and shows a significant association of pesticides with tremor-dominant PD in men, the most typical PD presentation.CitationMoisan F, Spinosi J, Delabre L, Gourlet V, Mazurie JL, Bénatru I, Goldberg M, Weisskopf MG, Imbernon E, Tzourio C, Elbaz A. 2015. Association of Parkinson’s disease and its subtypes with agricultural pesticide exposures in men: a case–control study in France. Environ Health Perspect 123:1123–1129; http://dx.doi.org/10.1289/ehp.1307970

BioCAST/IFCT-1002: epidemiological and molecular features of lung cancer in never-smokers.

Lung cancer in never-smokers (LCINS) (fewer than 100 cigarettes in lifetime) is considered as a distinct entity and harbours an original molecular profile. However, the epidemiological and molecular features of LCINS in Europe remain poorly understood. All consecutive newly diagnosed LCINS patients were included in this prospective observational study by 75 participating centres during a 14-month period. Each patient completed a detailed questionnaire about risk factor exposure. Biomarker and pathological analyses were also collected. We report the main descriptive overall results with a focus on sex differences. 384 patients were included: 65 men and 319 women. 66% had been exposed to passive smoking (significantly higher among women). Definite exposure to main occupational carcinogens was significantly higher in men (35% versus 8% in women). A targetable molecular alteration was found in 73% of patients (without any significant sex difference): EGFR in 51%, ALK in 8%, KRAS in 6%, HER2 in 3%, BRAF in 3%, PI3KCA in less than 1%, and multiple in 2%. We present the largest and most comprehensive LCINS analysis in a European population. Physicians should track occupational exposure in men (35%), and a somatic molecular alteration in both sexes (73%).

Multiple effects of bracken fern under in vivo and in vitro conditions.

Several toxic substances have been detected in plants which are responsible for animal and human diseases. Bracken fern (Pteridium aquilinum) is one example, widely distributed in many parts of the world. It is known to cause cancer in humans and other animals. In fact, man can be directly or indirectly exposed to the danger by consuming fern, contaminated water, milk, meat, and spore inhalation. Experimental studies have shown an association between bracken exposure and gastric cancer, and research has shown genotoxic and cytotoxic effects in vitro. This paper describes and reviews toxic, carcinogenic, genotoxic/cytotoxic, and immunomodulatory effects of bracken and included possible toxic agents. The chemistry of Ptaquiloside (PT) reactions is emphasized, along with bracken problems in livestock, possible pathways of exposure in man, and control for human health.

Association between occupational exposure and lung function, respiratory symptoms, and high-resolution computed tomography imaging in COPDGene.

Although occupational exposure to dust and fumes is considered a risk factor for chronic obstructive pulmonary disease, this determination has been limited by reliance on spirometry alone to assess disease severity in predominantly male populations. To determine the effect of occupational exposure on lung function, respiratory symptoms, and findings of emphysema and airway wall thickness measured using quantitative computed tomography in men and women. COPDGene is a multicenter study of current and former smokers that underwent standardized volumetric chest computed tomography scans to assess airways, % emphysema, and % gas trapping. Spirometry and a respiratory questionnaire including occupational history were also analyzed in 9,614 subjects (4,496 women). Logistic regression and analysis of covariance was used to assess associations with exposure. Occupational exposure to both dust and fumes was reported by 47.9% of men and 20.1% of women. Adjusting for age, race, body mass index, education, and current and lifetime smoking, the odds ratios for persons with dust and fume exposures for chronic cough, chronic phlegm, persistent wheeze, and Global Initiative for Chronic Obstructive Lung Disease stages 2 and higher chronic obstructive pulmonary disease were significantly elevated and similar for men (1.83, 1.84, 2.0, 1.61, respectively) and women (1.65, 1.82, 1.98, 1.90, respectively). The % predicted FEV1 was similarly lower in those with exposure in men (70.7 ± 0.8 vs. 76.0 ± 0.9; P < 0.001) and women (70.5 ± 0.8 vs. 77.2 ± 0.8; P < 0.001). Percent emphysema and gas trapping was greater in those exposed to dust and fumes in men and women. In men, but not in women, persons with exposure had a greater mean square root wall area of 10-mm internal perimeter airways. Occupational exposure to dust and fumes in men and women is similarly associated with airflow obstruction, respiratory symptoms, more emphysema, and gas trapping in men and women.

Higher risk of violence exposure in men and women with physical or sensory disabilities: results from a public health survey.

The World Health Organization has declared that violence is a global public health problem. The prevalence of violence exposure among adults with intellectual and unspecific disabilities has been demonstrated in several studies, whereas only a few articles on people with sensory disabilities have been published. The aim of this study was to investigate the prevalence and risk for exposure to physical violence, psychological offence, or threats of violence in people with physical and/or sensory disabilities, compared with people with no such disabilities, controlling for socioeconomic data. Data from a public health survey were analyzed. A nationally representative sample of women and men aged 16 to 84 years had answered a questionnaire. In the present study, the whole sample, comprised of 25,461 women and 21,545 men, was used. Women with auditory disabilities were generally more often violence exposed than non-disabled women, whereas men with physical disabilities were more often violence exposed than non-impaired men. Some age groups among both women and men with visual disabilities had higher prevalence rates than women and men without disabilities. The adjusted odds ratios (ORs) were significantly higher among the auditory impairment group for exposure to physical (OR = 1.4, confidence interval [CI] = [1.1, 1.9]) and psychological (OR = 1.4, CI = [1.1, 1.8]) violence among women. Men with physical disabilities had raised odds ratios for physical violence (OR = 1.7, CI = [1.2, 2.4]) and psychological violence (OR = 1.4, CI = [1.0, 2.0]) compared with the non-disabled group. Both men and women with a physical or sensory disability showed higher odds of being exposed to violence than men and women without a disability. The results indicated that socioeconomic situation, smoking, and hazardous drinking strengthened the association between impairment and violence.

Liking and wanting pleasant odors: different effects of repetitive exposure in men and women.

Odors can enrich the perception of our environment and are commonly used to attract people in marketing situations. However, the perception of an odor changes over repetitions. This study investigated whether repetitive exposition to olfactory stimuli leads to a change in the perceived pleasantness (“liking”) or in the wish to be further exposed to the same olfactory stimulus (“wanting”), and whether these two mechanisms show gender differences. Three different pleasant odors were each repeatedly presented for 40 times in random order with a mean inter-stimulus interval of 18 s. Eighteen participants rated both “liking” and “wanting” for each of the 120 olfactory stimuli. Wanting ratings decreased significantly over repetitions in women and men, with a steeper decrease for men during the initial trials before plateauing. In contrast, liking ratings decreased significantly over repetitions only in men, with a steeper decrease after the initial ratings, but not in women. Additionally, women scored higher in a questionnaire on reward responsiveness than men. We conclude that positive evaluation (liking) and the wish to experience more of the same (wanting) are different concepts even in the domain of olfaction. The persistence of perceived pleasantness in women may be due to the attribution of a greater subjective value to odors.

Reproductive toxicity of lead, cadmium, and phthalate exposure in men.

Environmental toxicants viz lead or cadmium and phthalate esters (di(2-ethylhexyl) phthalate [DEHP], dibutyl phthalate [DBP], and diethyl phthalate [DEP]) widely found in different environmental strata are linked to deteriorating male reproductive health. The objective was to assess the relationships between the seminal lead, cadmium, and phthalate (DEHP, DBP, DEP) concentrations at environmental level and serum hormone levels and semen quality in non-occupationally exposed men and specify the effect of individual and combined exposure of toxicants on semen quality. A study of 60 male partners of couples attending the Andrology Laboratory of the Reproductive Biology Department, All India Institute of Medical Sciences (AIIMS), New Delhi, India for semen analysis to assess their inability to achieve a pregnancy was selected for the study. The results of univariate and stepwise multiple regression analysis in the unadjusted model showed a significant correlation between lead or cadmium and phthalates DEHP/DBP/DEP and sperm motility, sperm concentration, and DNA damage. After adjusting for potential confounders, an association with lead or DEHP was only observed. The present data shows that lead (Pb) or cadmium (Cd) or phthalates might independently contribute to decline in semen quality and induce DNA damage. Phthalates might influence reproductive hormone testosterone. These findings are significant in light of the fact that men are exposed to a volley of chemicals; however, due to the small sample size, our finding needs to be confirmed in a larger population.

Pharmacodynamic profiling of modithromycin: Assessment in a pneumococcal murine pneumonia model

The pharmacodynamic profile of modithromycin (EDP-420, EP-013420, S-013420), a novel bicyclolide, was evaluated in a neutropenic pneumococcal murine pneumonia model. Streptococcus pneumoniae median minimum inhibitory concentrations (MICs) for five genotypically diverse isolates ranged from 0.016μg/mL to 0.125μg/mL and were unaffected by macrolide or penicillin resistance determinants. The modithromycin dosing regimens (total daily doses of 3.125–1000mg/kg/day) were derived from the pharmacokinetic profile of the compound in infected mice and were selected to produce a wide range of exposures. Dose–response relationships characterised using the Emax model demonstrated high correlations both with the ratio of the area under the concentration–time curve to MIC (AUC/MIC) and the ratio of the maximum drug concentration to MIC (Cmax/MIC). However, dose fractionation studies suggest that the AUC/MIC is the predominant driver of in vivo efficacy. The free drug AUC/MIC (fAUC/MIC) required for stasis and for 80% of maximum activity ranged from 4 to 53 and 25–99, respectively. The fAUC/MIC needed to achieve a 1 log reduction in bacterial density, which is a conventional measure of the required exposure in man to reliably predict efficacy, ranged from 9 to 69. These data demonstrate the in vitro and in vivo potency of modithromycin against S. pneumoniae irrespective of its phenotypic profile to the macrolides or penicillin.

The influence of perinatal and current dioxin and PCB exposure on reproductive parameters (sex-ratio, menstrual cycle characteristics, endometriosis, semen quality, and prematurity): a review

AbstractPolychlorinated biphenyls (PCBs) and dioxins (PCDDs/Fs) are well-known endocrine disrupters. This paper strives to elucidate the data on reproductive consequences of perinatal dioxin and PCB exposure in men and women. We focused on the following end-points: sex-ratio, endometriosis, menstrual cycle characteristics, sperm quality, and prematurity. We summarize 46 papers and compare their results including effects seen after exposure to background concentrations. Seven of twelve studies showed a decrease in sex-ratio after parental dioxin or PCB exposure. In three of the seven studies, effects were seen after paternal exposure and in three after maternal exposure. In eight of the nine studies on menstrual cycle characteristics, abnormalities were associated with PCB or dioxin exposure, however the results differed. In three studies PCB and TCDD were associated with longer menstrual cycles, while three studies indicated that an increase in PCB/PCDF exposure was associated with shorter cycles. Five studies showed effects on menstrual bleeding with higher PCB or dioxin exposure. A higher rate of irregular menstrual cycles in exposed women was seen in four studies. The conflicting outcomes probably result from variability in study design, timing of exposure and endocrine disrupting properties of the measured congeners. Nine of sixteen studies detected higher PCB or dioxin exposure in women with endometriosis. However, the manner of diagnosing endometriosis and the character of the studies varied from prospective to retrospective. Five of eight studies focusing on sperm quality showed that men, with higher serum concentrations of PCBs and/or PCB congeners and/or PCDFs, had reduced sperm quality, including increased abnormal morphology and reduced motility. The exposure timeframe seemed important here. There are two studies addressing preterm birth in relation to PCBs, one mentioned a shortening of three days of gestational age, two other studies did not find a relation. Recently one study related a shorter gestational age of half a week with overall dioxin activity measured with the CALUX method in cord blood, particularly in boys. In conclusion, exposure to PCBs and dioxins has a negative effect on the reproductive systems of human populations. Although some speculations have been made, the exact mechanism of these effects and the interactions of these compounds with other endocrine disruptors are not yet known. Age at exposure and congener specific properties are probably crucial in interpreting the observed results.

Rabies: Need for active and passive immunisation

Rabies is an acute highly fatal viral disease of the CNS caused by Lyssavirus Type-I. It has a long and variable incubation period. It is a communicable disease of man that is always fatal. The combined administration of a single dose of anti rabies serum with a course of vaccine, together with local treatment of the wound is the best specific prophylactic treatment after exposure of man to rabies. Here, we report a case of rabies, who developed the disease in spite of having taken three doses of anti rabies vaccine (Post exposure).

Time to pregnancy and exposure to pesticides in farmers in the West Bank, occupied Palestinian territory: a 1-year follow-up of newly married couples

Background Pesticides have been associated with a reduction in reproductive capacity. In the occupied Palestinian territory, agricultural work is a family enterprise rendering all members at risk of occupational or paraoccupational exposure. We investigated the effects of pesticide exposure on couples' fecundability (probability of conception in a menstrual cycle). Methods 331 newly married couples (women aged 16–66 years and men 15–42 years) from two Palestinian villages in the Hebron Governorate, West Bank, who were attempting to conceive for the first time during 2005–07, were identified from the Thalassaemia Centre, Hebron, where all individuals who are planning to marry are obliged to register. Couples were followed up prospectively from marriage until pregnancy or a maximum of 12 months. We assessed male exposure on the basis of current use of pesticides by creating a time-dependent exposure variable covering the month of follow-up and the 2 months before the follow-up. In women, work in farming was used as an indicator of exposure. We estimated the adjusted fecundability density ratio (aFDR) with discrete proportional hazards regression. Covariates for the multivariable model, selected on the basis of a-priori assumptions, were coital frequency reported by the women, and for men and women body-mass index, age and education, and village of residence. SPSS (version 16.0) and Stata (version 10.0) were used for statistical analyses. The study was done in accordance with the current revision of the Helsinki Declaration and was approved by Hebron University. All participants provided written informed consent and were informed that participation was voluntary and that they could withdraw from the study at any time. Findings Follow-up was completed in all but four couples. 288 (87%) of 331 couples became pregnant during follow-up with a mean fecundability of 0·20 (95% CI 0·19–0·22). Fecundability was moderately reduced in association with pesticide exposure in men (aFDR 0·72; 0·52–1·00) and farming in women (0·68; 0·42–1·09). Interpretation Exposure to pesticides was associated with reduced fecundability in couples. Furthermore, in the Palestinian population, the first menstrual cycle at risk could be defined accurately because premarital sex or having children outside of marriage are cultural and religious taboos and because all couples stated that they intended to start attempting to conceive immediately after the wedding. The main limitation was that pesticide exposure was reported as crude data, which could lead to an underestimation of the effect of pesticide exposure. Further research with improved exposure data is warranted. Funding Norwegian Programme for Development, Research and Education.