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91.
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John A. Tomenson Graham A. Matthews 《International archives of occupational and environmental health》2009,82(8):935-949
Purpose The present investigation looks in detail at the causes and types of health incidents reported by 6,300 mainly smallholder
agrochemical users in 24 countries during 2005 and 2006.
Methods The investigation is based on a questionnaire survey of knowledge, attitude and practice that concentrated on the sequence
of events from purchasing the pesticide to disposal. Information was also collected about health problems experienced while
using agrochemicals. The survey targeted mainly smallholder knapsack spray operators who were expected to be at a highest
risk of exposure.
Results In the 12 months prior to interview, 1.2% of users reported an agrochemical-related incident that required hospital treatment,
5.8% reported an incident requiring at least trained medical treatment but not hospitalisation and 19.8% reported only a minor
sign or symptom. Users who had experienced an incident involving agricultural equipment were 3.38 (95% CI 2.29–4.99) times
more likely to experience an agrochemical-related health incident, but confident users who felt that their use of personal
protective equipment while spraying was best practice were 0.60 (95% CI 0.44–0.84) times less likely to experience such an
incident. Over 80% of product-related incidents were caused by insecticides and the incidence rate per spraying time for incidents
linked to insecticides was significantly higher than that for fungicides or herbicides. Headache/dizziness and nausea/vomiting,
often smell related, were the most common symptoms reported by users who listed agrochemical products that had caused them
health problems (52 and 38% of product mentions, respectively).
Conclusions In most countries, the incidence of serious health effects was low; however, there was a high incidence of minor signs and
symptoms in a few countries, especially in Africa. A disproportionate number of incidents occurred during insecticide use
relative to the time that they were sprayed. Failure to exercise caution as indicated by whether users had incidents involving
agricultural equipment or livestock, and lack of confidence in their practices were the most important predictors of agrochemical-related
incidents. 相似文献
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Phase II clinical trials are performed to investigate whether a novel treatment shows sufficient promise of efficacy to justify its evaluation in a subsequent definitive phase III trial, and they are often also used to select the dose to take forward. In this paper we discuss different design proposals for a phase II trial in which three active treatment doses and a placebo control are to be compared in terms of a single‐ordered categorical endpoint. The sample size requirements for one‐stage and two‐stage designs are derived, based on an approach similar to that of Dunnett. Detailed computations are prepared for an illustrative example concerning a study in stroke. Allowance for early stopping for futility is made. Simulations are used to verify that the specified type I error and power requirements are valid, despite certain approximations used in the derivation of sample size. The advantages and disadvantages of the different designs are discussed, and the scope for extending the approach to different forms of endpoint is considered. Copyright © 2008 John Wiley & Sons, Ltd. 相似文献
96.
BackgroundThe incidence of strictures developing after gastrojejunostomy has been reported to range from 3% to 31%. We found an unacceptably high stricture rate (13%) using a 21-mm circular stapler. Attempts to use the 25-mm circular stapler were frustrated by disparities between the size of the instrument and the patient's anatomy. We, therefore, modified the technique to accomplish the anastomosis with the linear stapler and hand sewing (LSA) at community hospitals in Southern California.MethodsA total of 124 anastomoses were accomplished with the circular stapler (CSA) followed by 100 anastomoses using the LSA technique. Drains were used routinely with the CSA technique but were used only selectively with the LSA technique. Stricture was defined as that requiring endoscopic dilation for symptoms. Leaks were confirmed radiologically or surgically, and bleeding was defined as the need for transfusion. Our analysis used the Student t test and Fisher's exact test, with P <.05 considered statistically significant.ResultsNo patient died. The LSA technique was faster and resulted in significantly fewer postoperative strictures and complications compared with the CSA technique.ConclusionThe results of our study have shown that the LSA technique, as described, is preferable to the CSA technique. 相似文献
97.
Histopathological characterisation of effects of the mouse Pax6 missense mutation on eye development
Thaya Ramaesh Steven E. Williams Catriona Paul Kanna Ramaesh John D. West 《Experimental eye research》2009,89(2):263-273
Mutations in PAX6/Pax6 lead to a variety of ocular anomalies in humans and mice. The aim of the study was to characterise the ocular abnormalities caused by the missense Pax6Leca4 mutation and compare them to published observations on Pax6 alleles that are functionally equivalent to Pax6− null alleles (such as Pax6Sey and Pax6Sey-Neu) and human inherited eye diseases. Ocular features of homozygous Pax6Leca4/Leca4 and heterozygous Pax6Leca4/+ embryos at E12.5-E18.5, heterozygous Pax6Leca4/+ young mice at P18 and heterozygous Pax6Leca4/+ adults at 12 weeks were analysed histologically with their wild-type Pax6+/+ littermates. Homozygous Pax6Leca4/Leca4 fetuses died perinatally with no eyes although an optic cup rudiment with pigmented cells developed. Pax6Leca4/+ mice were microphthalmic and a range of other severe ocular phenotypes affected both the anterior and the posterior segments. In contrast to Pax6+/−, the Pax6Leca4/+ eyes had no goblet cells in the corneal epithelium, the iris was not hypoplastic and there was no lens-corneal epithelial plug. However, microphthalmia was more severe, corneal vascularisation occurred earlier (during fetal stages), pigmented cells were present in the vitreous and corneal stroma and the ciliary body was malformed or abnormal. These results show that, although Pax6Leca4/+ lacked some eye abnormalities commonly seen in Pax6Sey/+ and Pax6Sey-Neu/+ eyes, in most respects their eyes were more severely affected. These differences probably reflect both differences between the Pax6Leca4 and the Pax6Sey-Neu mutations and differences in modifier gene expression in different genetic backgrounds. The presence of pigmented cells in the cornea is a novel observation. Some Pax6Leca4/+ ocular abnormalities were similar to those present in human Peters' anomaly and persistent hyperplastic primary vitreous (PHPV) so Pax6Leca4/+ mice provide a useful model for some inherited eye diseases. 相似文献
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Eser Tüfek?i Thomas E Merrill Maria R Pintado John P Beyer William A Brantley 《American journal of orthodontics and dentofacial orthopedics》2004,125(6):733-739
Teeth with white spot lesions (WSL) might be more prone to enamel loss during bracket debonding. This in vitro study compared enamel loss from teeth with (n = 14) and without (n = 14) WSL after polishing with low-speed finishing burs or disks (Sof-Lex, 3M ESPE, St Paul, Minn). Debonded surfaces were analyzed with a contact stylus profilometer, and digitized data were compared with baseline readings by using AnSur NT software (Regents, University of Minnesota, Minneapolis, Minn). Specimen surfaces were also examined with a scanning electron microscope. Two-way analysis of variance was performed to analyze the data. In teeth without WSL, the volume losses were 0.16 mm(3) for the bur group and 0.10 mm(3) for the disk group; the mean maximum depths were 47.7 microm for the bur group and 54.3 microm for the disk group. In teeth with WSL, the volume losses were 0.06 and 0.17 mm(3), and the mean maximum depths were 35.1 and 48.7 microm for the bur and disk groups, respectively. There were no significant differences in enamel loss between the 2 groups of teeth without WSL (P =.12). However, in teeth with WSL, the burs removed less enamel than the disks (P = 0.006). Scanning electron microscope examination showed that any damage on the enamel surface was usually located in the cervical third of the teeth. On most specimens, even though tooth surfaces appeared resin-free to the naked eye, there were remnants of it. The differences between groups were so small that they might be clinically insignificant. 相似文献