Organic contaminants levels, distribution and risk assessment in Jeddah marine coastal zone sediments

Herein, various organic contaminants were determined in surface sediments collected from the Jeddah coastal zone, Saudi Arabia, to assess their levels, origin and probable toxic effects on marine organisms. High hydrocarbons concentrations, indicative of an enhanced pollutant burden, were recorded in the Jeddah Lagoon (mean value 4100 mg/kg for total aliphatic hydrocarbons (∑AHC) and 5800 μg/kg for total polycyclic aromatic hydrocarbons (∑PAH)), whereas mean values in Mena Jeddah were 258 mg/kg for ∑AHC and 615 μg/kg for ∑PAH. By using molecular diagnostic ratios/indices and applying Positive Matrix Factorization, petroleum related pollution seems to predominate in Jeddah lagoons, whereas carcinogenic contaminants of pyrolytic origin were dominant in Mena Jedda. Additionally, municipal wastewaters were identified as a major source of pollution in Jeddah lagoons. Comparison of the concentrations of individual PAHs and polychlorinated biphenyls with sediment quality guidelines indicates that, despite their high total values, adverse biological effects are unlikely to occur.

Private duty nurses in Greek hospitals: a literature review

AIM

The study aims to provide an overview of the practice of private duty nurses in Greek hospitals.

BACKGROUND

For several decades, it has been a necessity for some hospital patients to hire private duty nurses (PDNs) to counterbalance the inadequacies of hospital infrastructures. In the current economic crisis in Greece, the majority of patients will not be able to afford to pay for private nursing care.

METHODS

Databases such as PubMed, CINAHL, ScienceDirect, Wiley Online Library, Google Scholar and national sources were searched for relevant literature through a range of keywords. Information gathered was evaluated for relevance and grouped on a thematic basis.

FINDINGS

Five articles met the inclusion criteria. Nearly 90% of PDNs have secondary levels of education or below. Approximately 15% of patients use PDNs at night due to nurse shortages and inability of their families to stay with them. Fifty per cent of the relatives reported being very unsatisfied with PDN services, while the cost for the use of a PDN is rather high.

CONCLUSION

The existence of private duty nursing has been largely responsible for protecting healthcare authorities from the need to develop effective care infrastructures. In the current economic climate, nursing and healthcare authorities must staff wards appropriately for safe, free and efficient care for all patients. Effective utilization of the national nursing and healthcare workforce--including PDNs with appropriate qualifications--and matching demand with the necessary skills is essential.

Chromogranin a levels in diagnosis, treatment and follow-up of 42 patients with non-functioning pancreatic endocrine tumours

BACKGROUND/AIMS

Non-functioning pancreatic endocrine tumours (NFPET) constitute the largest component (35-50%) of pancreatic endocrine tumours. They are characterized by the absence of symptoms of hormone hypersecretion and frequently have clinical manifestations similar to the more common exocrine pancreatic adenocarcinoma. The present studyaims toevaluate the clinical features, diagnostic approach and, in particular, the significance of serum chromogranin A levels (CgA) in the management and outcome of 42 patients with NFPET (from a series of 121 patients with pancreatic endocrine tumours).

METHODS

Twenty-five males and 17 females were included, and the mean age at diagnosis was 52.3 years (range: 26-68 years). The diagnosis for each patient was established by histopathological examination and immunohistochemistry. After the histopathological confirmation of diagnosis and during the follow-up period, patients were evaluated clinically and radiologically (including OctreoScan), whilst fasting gut hormones (including CgA) were also estimated. At diagnosis, all patients were checked for the presence of multiple endocrine neoplasia type I syndrome. The follow-up was complete and ranged from 12 to 86 months (mean: 49 months).

RESULTS

Dyspepsia (66.5%) and weight loss (47.6%) were the most common symptoms at diagnosis, while in 21.4% of patients tumour lesions were revealed incidentally. Plasma CgA levels were significantly or moderately elevated in all patients with liver metastases at diagnosis (64.3%). The levels also reflected tumour progression or response to treatment during the follow-up period. OctreoScan showed avid uptake in 77.8% of patients with hepatic metastases. Moreover, in 2 patients OctreoScan revealed unexpected metastatic mesenteric deposits, which had not been found by the other studies. However, it was negative in 6 patients with liver metastases, in whom tumours were proved to be poorly differentiated (high-grade).

CONCLUSIONS

(1) NFPET may present with clinical manifestations similar to those of an exocrine pancreatic tumour; (2) plasma CgA levels reflect tumour load, and also seem to correlate with tumour progression or response to treatment; (3) surgeryin patients with localized disease at presentation can be curative, while it can also reduce tumour burden in patients with metastases; (4) long-acting somatostatin analogues provide good quality of life and temporary disease stabilization in patients with low-grade tumours; (5) systemic chemotherapy or chemoembolization seem to be beneficial in high-grade and progressive tumours.