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51.
Bogdan Jaremin Ewa Kotulak Maria Starnawska Stanislaw Tomaszunas 《Journal of travel medicine》1996,3(2):91-95
Background: The safety of life and work at sea depends, among other things, on the state of health of the members of the crew. Despite preliminary fitness selection, death at sea is still frequent. In the present paper, causes and circumstances of fatal cases at sea in the years 1985–1994 were analyzed for one Polish shipping company.
Methods: Analysis was based on medical documentation and reports of accidents prepared by health centers, the employer and the marine judiciary. The effects of work conditions, as well as disease, on the resulting death were taken into account. The data obtained were compared to the mortality in nonseafaring men of productive age.
Results: The most frequent causes of deaths were sea catastrophes, circulatory system diseases, injuries, and poisonings (a total of 85%). Next were suicides, "missings," and cerebral apoplexies. Seamen of 50 to 59 years of age died most often, primarily of myocardial infarction. Fatal events occurred in different places (mostly at sea, less frequently in port). Certain onboard occupations were identified as most dangerous for fatal accidents. The shipowner acknowledged 60% of the deaths as accidents at work. The effects of weather conditions, stress, overstrain, and lack of access to qualified medical assistance were analyzed. A relationship between diagnosed disease and death was found only in the case of myocardial infarction and cerebral apoplexy. In scarcely 15% of these cases were preliminary symptoms noticed, while behavioral and personality disturbances were earlier observed in the majority of suicides.
Conclusions: The ship has remained one of the most dangerous workplaces, and fatal cases are to a large extent related to specific labor conditions at sea. 相似文献
Methods: Analysis was based on medical documentation and reports of accidents prepared by health centers, the employer and the marine judiciary. The effects of work conditions, as well as disease, on the resulting death were taken into account. The data obtained were compared to the mortality in nonseafaring men of productive age.
Results: The most frequent causes of deaths were sea catastrophes, circulatory system diseases, injuries, and poisonings (a total of 85%). Next were suicides, "missings," and cerebral apoplexies. Seamen of 50 to 59 years of age died most often, primarily of myocardial infarction. Fatal events occurred in different places (mostly at sea, less frequently in port). Certain onboard occupations were identified as most dangerous for fatal accidents. The shipowner acknowledged 60% of the deaths as accidents at work. The effects of weather conditions, stress, overstrain, and lack of access to qualified medical assistance were analyzed. A relationship between diagnosed disease and death was found only in the case of myocardial infarction and cerebral apoplexy. In scarcely 15% of these cases were preliminary symptoms noticed, while behavioral and personality disturbances were earlier observed in the majority of suicides.
Conclusions: The ship has remained one of the most dangerous workplaces, and fatal cases are to a large extent related to specific labor conditions at sea. 相似文献
52.
53.
Koda M Przystupa W Jarzabek K Wincewicz A Kanczuga-Koda L Tomaszewski J Sulkowska M Wolczynski S Sulkowski S 《Oncology reports》2005,14(1):93-98
Disturbance in expression of estrogen receptors together with changing influence of growth factor receptors and apoptosis associated proteins plays a role in breast cancer development and progression. However, immunohistochemical detection and relationships among these proteins were not often considered in relation to breast cancer and a few evaluations of expression provided mismatching results and conclusions. Consequently, we examined by immunohistochemistry the expression of the insulin-like growth factor-I receptor (IGF-IR), estrogen receptor alpha (ERalpha) and apoptosis-associated proteins, Bcl-2 and Bax, in human primary breast cancer, as well as analyzing the relationships among these proteins. The positive immunostaining for IGF-IR, ERalpha, Bcl-2 and Bax was noted in 56, 63.8, 82.8 and 50% of tumors, respectively. We observed that IGF-IR negatively correlated with ERalpha in the group of all tumors and in axillary node negative cancer (p<0.03, p<0.05, respectively), but not in the subgroup of node positive cancer. Expression of ERalpha correlated positively with Bcl-2 and negatively with Bax proteins (p<0.0001, p<0.05, respectively). We did not note significant relationships between IGF-IR and Bcl-2, or IGF-IR and Bax proteins. We found that increased Bax expression was associated with positive lymph node status, pT2 stage and G3 grade of tumors. Knowledge about alterations in the IGF-IR expression and relations of the receptor to other biological factors could help in our understanding of breast cancer biology and the importance of the IGF-IR in cancer progression as well as in effective management of breast cancer. 相似文献
54.
Hypolipidemic drugs affect monocyte IL-1beta gene expression and release in patients with IIa and IIb dyslipidemia 总被引:1,自引:0,他引:1
Okopien B Huzarska M Kulach A Stachura-Kulach A Madej A Belowski D Zielinski M Herman ZS 《Journal of cardiovascular pharmacology》2005,45(2):160-164
Because atherosclerosis has been proven to be an inflammatory disease, it became obvious that the proper treatment of dyslipidemic patients should not only correct lipid parameters but also inhibit the inflammatory state. One of the crucial proinflammatory and procoagulant cytokines participating in the pathogenesis of atherosclerosis is interleukin-1beta (IL-1beta). Therefore, the aim of the study was to asses the effect of statin and fibrate therapy (for dyslipidemia IIa and IIb, respectively) on IL-1beta gene expression and monocyte release evaluated in each patient. Additionally, the effect of hypolipidemic therapy on fibrinolysis was evaluated. The study was carried out in 37 patients: 12 with biochemically confirmed type IIa dyslipidemia (treated with atorvastatin), 12 with type IIb dyslipidemia (treated with fenofibrate), and 13 age- and sex-matched normolipidemic persons (control). IL-1beta concentrations in cultured monocytes and PAI-1 (Plasminogen Activator Inhibitor) plasma levels were measured using the ELISA method. To evaluate the expression of IL-1beta gene in monocytes, a semiquantitive RT-PCR procedure was performed. The results were normalized with the expression of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as a housekeeping gene. Although IL-1beta monocyte release was markedly elevated in patients with atherogenic dyslipidemias, IL-1beta gene expression was only slightly and nonsignificantly higher in the studied groups versus control. We have observed significant reduction of IL-1beta mRNA expression after 30-day treatment with the examined drugs (atorvastatin, 2.10 +/- 0.50 versus 1.05 +/- 0.15; P < 0.001, fenofibrate; 2.27 +/- 0.48 versus 1.23 +/- 0.27; P < 0.01). There was no significant difference between statin and fibrate effect on IL-1beta mRNA expression. Similarly, we have noticed significant reduction of IL-1beta release by cultured monocytes after 30-day statin therapy (133.0 +/- 5.7 pg/mL versus 77.0 +/- 3.6 pg/mL; P < 0.01) and fibrate therapy (143.9 +/- 6.5 pg/mL versus 86.2 +/- 5.9 pg/mL; P < 0.01). Besides this antiinflammatory effect, we have observed a 30% reduction of PAI-1 plasma levels in both treated groups. In conclusion, effective 1-month hypolipidemic therapy with atorvastatin or fenofibrate diminished plasma levels of proinflammatory and procoagulatory state markers. 相似文献
55.
OBJECTIVE: The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality. METHODS: The Pennsylvania Trauma Outcome Study database was used to identify trauma patients with known HIV-positive status (HP) and randomly selected age-matched controls (CL). Demographics, Injury Severity Score, Glasgow Coma Scale score, mechanism of injury, preexisting conditions, complications, mortality, hospital length of stay (HLOS), intensive care unit length of stay (ILOS), and operative interventions were compared. RESULTS: Demographics, vital signs on presentation, and Injury Severity Score were similar between the HP and CL groups. There was no difference in mortality between the two groups (3.6% vs. 3.1%, p = 0.6447). HP patients were more likely to present with penetrating injuries (22.6% vs. 15.8%, p < 0.0031) and had significantly fewer major orthopedic injuries than CL patients (p < 0.01). HP patients were more likely to have a history of a neurologic condition; chronic drug/alcohol use; psychiatric diagnosis; or liver, pulmonary, and/or renal disease (all p < 0.01). HP patients had more pulmonary complications (12.3% vs. 4.1%), renal complications, and infectious/septic complications (all p < 0.01) than controls. Infection/sepsis and pulmonary complications were associated with significant mortality in HP patients. HP patients underwent more thoracostomies (7.5% vs. 4.4%, p = 0.0235) and exploratory laparotomies (7.0% vs. 2.4%, p = 0.0002). HLOS (10.2 +/- 10 vs. 6.8 +/- 8.6 days, p = 0.001) and ILOS (2.3 +/- 7.2 vs. 1.5 +/- 4.9 days, p = 0.0178) were greater for HP patients. HP patients were less likely than controls to be discharged directly to home (67.8% vs. 82.7%, p = 0.0001). CONCLUSION: HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures. 相似文献
56.
In a recent issue of the Journal of Trauma, Kim et al. described their experience with the esophageal Doppler monitor (EDM) in major burn patients. Other authors have reported the historical development of the EDM, reviewed the technical and scientific aspects of this modality, and compared the EDM with the pulmonary arterial catheter (PAC). However, most studies exclude the bedside, practical aspects of EDM placement and use. We retrospectively reviewed our EDM utilization over the past 27 months, with emphasis on the practical aspects of its use, potential indications, and contraindications. The purpose of this paper is to share our EDM experience with the reader. 相似文献
57.
Pawel?K.?BurdukEmail author Agnieszka?Garstecka Stanislaw?Betlejewski 《European archives of oto-rhino-laryngology》2005,262(6):517-518
Foreign bodies of the nose in adults are rare, although they are frequently encountered among children and mentally retarded patients. They are often asymptomatic and consequently may remain undetected for many years. We describe a case of an intranasal foreign body mimicking a nasal lesion. 相似文献
58.
Isobolographic analysis was used to characterize the interactions between loreclezole (LCZ) and clonazepam (CZP), ethosuximide (ETS), phenobarbital (PB), and valproate (VPA) in suppressing pentylenetetrazole (PTZ)-induced seizures and in producing acute neurotoxic adverse effects in the chimney test in mice so as to identify optimum combinations. Moreover, protective indices (PIs) and benefit indices (BIs) were calculated so that a ranking in relation to advantageous combination could be established. Any pharmacokinetic contribution was ascertained by measurement of brain antiepileptic drug (AED) concentrations. All AED combinations comprising LCZ and CZP, ETS, PB, and VPA (at the fixed ratios of 1:3, 1:1, and 3:1) were additive in their seizure suppression. However, these interactions were complicated by changes in brain AED concentrations consequent to pharmacokinetic interactions. Thus, LCZ significantly increased total brain ETS concentrations (VPA, CZP, and PB concentrations were unaffected), and ETS decreased, and VPA increased, total brain LCZ concentrations. Only combinations of LCZ with CZP and PB were completely free of any pharmacokinetic interaction. Furthermore, in the chimney test, isobolographic analysis showed that the combination of LCZ and CZP, at the fixed ratio of 1:1, was supra-additive (synergistic, P<0.05), whereas LCZ and ETS at fixed ratios of 1:3 and 1:1 were subadditive (antagonistic, P<0.05). The remaining combinations of LCZ with CZP (1:3 and 3:1), ETS (3:1), PB (all fixed ratios of 1:3, 1:1, and 3:1), and VPA (at the fixed ratios of 1:3, 1:1, and 3:1) barely displayed additivity. In conclusion, BI, which is a measure of the margin of safety and tolerability of drugs in combination and comprises anticonvulsant and neurotoxic measures, was favorable for only one combination (LCZ and ETS at a fixed ratio of 1:3) with a value of 1.39. In contrast, LCZ and CZP constitute an unfavorable combination (BI=0.61-1.01). The combinations of LCZ with PB or VPA do not offer any advantage as assessed by the parameters (BI range: 0.75-0.91) used in this study. However, these conclusions are confounded by the fact that LCZ is associated with significant pharmacokinetic interactions. 相似文献
59.
Hemoglobin, altitude and birth weight: does maternal anemia during pregnancy influence fetal growth?
OBJECTIVE: To investigate the relationship between maternal hemoglobin concentration, altitude and birth weight. STUDY DESIGN: Birth weights in 235 term pregnancies were investigated for their dependence on maternal hemoglobin concentration after other maternal and pregnancy-specific influences on fetal weight were taken into account. The additional predictive value of hemoglobin concentration on birth weight was assessed using multiple regression. Using published data, the relationship of hemoglobin concentration to altitude was determined, as was the effect of increasing altitude on birth weight. The quantitative effect of hemoglobin concentration on birth weight was correlated with the effect of altitude on hemoglobin concentration to assess whether this could account for the known decrease in birth weight with increasing altitude. RESULTS: Birth weights ranged from 2,220 to 4,850 g (mean, 3,505+/-443), and hemoglobin concentrations ranged from 9.3 to 13.5 g/dL (mean, 11.6+/-0.8). Apart from other known predictive variables, the variation in maternal hemoglobin concentrations at constant altitude independently explained 2.6% of the variance in birth weight (r=-.18, P=.003). Term birth weight was reduced by 89 g for each 1.0 g/dL increase in hemoglobin concentration (P<.01). For every 1,000-m increase in altitude, hemoglobin concentration increased by 1.52 g/dL and birth weight decreased by 117 g. CONCLUSION: Birth weight correlates negatively with maternal hemoglobin concentration. This is consistent with the well-known effect of high-altitude exposure during pregnancy, which increases both hematocrit and blood viscosity and lowers birth weight. The quantitative effect on birth weight of increasing maternal hemoglobin concentration at constant altitude is within 13% of the change in birth weight that can be attributed to the change in hemoglobin concentration associated with increases in altitude. 相似文献
60.