Assessing environmental and occupational risk factors for lung cancer in Mexican–Americans

Background

We investigated environmental and occupational exposures and smoking history (while controlling for demographics) in a population of Mexican–American lung cancer cases and controls from the Houston metropolitan area.

Methods

Data were collected between 1991 and 2005 as part of an on-going multi-racial/ethnic, lung cancer case–control study. Cases included 212 Mexican–American lung cancer cases from UT MD Anderson Cancer Center. Controls (n = 328) were recruited from Houston’s largest multispecialty group practice and frequency matched to the cases by age (±5 years), sex, and ethnicity. Environmental and occupational factors were analyzed and odds ratios and 95% confidence intervals were calculated using logistic regression.

Results

We detected elevated risks of lung cancer associated with pesticide exposure and found conventional and antimicrobial (e.g., sterilizers, disinfectants, antiseptics) pesticides were associated with an increased risk of lung cancer in Mexican–Americans (conventional pesticides and antimicrobial pesticides combined: OR = 1.80, 95% CI 1.13–2.86; conventional pesticides: OR = 2.05, 95% CI 1.23–2.39; antimicrobial pesticides: OR = 2.48, 95% CI 1.46–4.21).

Conclusions

Although we found over a two-fold increased risk of lung cancer among Mexican–Americans for pesticides, we could not identify individual pesticides. Our findings are an important preliminary step in identifying factors that are specifically associated with lung cancer risk among Mexican Americans.     

Design, synthesis and docking studies of quinoline-oxazolidinone hybrid molecules and their antitubercular properties

New series of quinoline-oxazolidinone hybrid molecules were synthesized based on the preliminary docking studies. All the newly synthesized compounds were characterized by spectral analyses. The newly synthesized compounds were screened for their antimycobacterial properties based on the promising preliminary antibacterial screening results. Amongst tested compounds, compounds 8a, 8j and 13a were active at 0.65 μg/mL against Mycobacterium tuberculosis H₃₇Rv strain. The mode of action of these active compounds was carried out by docking of receptor enoyl-ACP reductase with newly synthesized candidate ligands 8a, 8j and 13a. These compounds exhibited well established bonds with one or more amino acids in the receptor active pocket. From the docking studies, compound 8j was considered to be the best inhibitor.     

Design, synthesis and docking studies of new quinoline-3-carbohydrazide derivatives as antitubercular agents

Three new series of 4-hydroxy-8-trifluoromethyl-quinoline derivatives were synthesized through multi step reactions. All the newly synthesized compounds were characterized by spectral and elemental analyses. The structure of 5j was evidenced by X-ray crystallographic study. The newly synthesized title compounds were evaluated for their antimicrobial activities including antimycobacterial activity. Amongst the tested compounds, 5b, 5e, 5h, 5j, 6c and 7c displayed promising antimicrobial activity. The mode of action of these active compounds was carried out by docking of receptor enoyl-ACP reductase with newly synthesized candidate ligands, 5b, 5e, 5h, 5j and 6c.     

Lack of Axial Rotation in Mobile-bearing Knee Designs

It has often been assumed rotational kinematics are improved with mobile-bearing TKA designs as the terms mobile-bearing and rotating platform imply. We tested this assumption by assessing the in vivo axial rotation magnitudes and patterns of 527 knees implanted with 12 different mobile-bearing TKA designs. Implants were grouped and compared by type—posterior stabilized (PS), posterior cruciate retaining (PCR), and posterior cruciate sacrificing (PCS)—and by specific design. We hypothesized all three mobile-bearing types (PS, PCR, and PCS) would achieve greater than 10° average axial rotation and we would find no differences in axial rotation between types. Only 14% of PS knees, 3% of PCS knees, and 17% of PCR knees attained greater than 10° axial rotation when measured from 0° to 90°. The percentage of PCS knees with greater than 10° axial rotation was less compared with the other two groups. Axial rotation averaged 4.3°, 2.5°, and 3.8° for the PS, PCS, and PCR knees, respectively. Incidences of reverse rotation were observed in 17% of PS knees, 32% of PCS knees, and 28% of PCR knees. Compared with the PCS group, the PS group achieved greater average axial rotation and had a lower percentage of knees displaying incidences of reverse rotation. The data refuted the hypotheses. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.     

Trends in incidence and outcomes of gastroschisis in the United States: analysis of the national inpatient sample 2010–2014

Purpose

Gastroschisis is a severe congenital anomaly associated with a significant morbidity and mortality. There are limited temporal trend data on incidence, mortality, length of stay, and hospital cost of gastroschisis. Our aim was to study these temporal trends using the National Inpatient Sample (NIS).

Methods

We identified all neonatal admissions with a diagnosis of gastroschisis within the NIS from 2010 through 2014. We limited admission age to ≤?28 days and excluded all those transferred to other hospitals. We estimated gastroschisis incidence, mortality, length of hospital stay, and cost of hospitalization. For continuous variables, trends were analyzed using survey regression. Cochrane–Armitage trend test was used to analyze trends for categorical variables. P?<?0.05 was considered as significant.

Results

The incidence of gastroschisis increased from 4.5 to 4.9/10,000 live births from 2010 through 2014 (P?=?0.01). Overall mortality was 3.5%, median length of stay was 35 days (95% CI 26–55 days), and median cost of hospitalization was $75,859 (95% CI $50,231–$122,000). After adjusting for covariates, there was no statistically significant change in mortality (OR?=?1.13; 95% CI 0.87–1.48), LOS (β?=???2.1?±?3.5; 95% CI ??9.0 to 4.8) and hospital cost (β?=???2.137?±?10.813; 95% CI ??23,331 to 19,056) with each calendar year increase on multivariate logistic regression analysis.

Conclusion

The incidence of neonates with gastroschisis increased between 2010 and 2014. Incidence was highest in the West. No difference in mortality and resource utilization was observed.

     

Tolerance of vancomycin for surgical prophylaxis in patients undergoing cardiac surgery and incidence of vancomycin-resistant enterococcus colonization

BACKGROUND: In 2001, vancomycin replaced cefuroxime for antibiotic prophylaxis in patients undergoing cardiac surgery at our institution due to high rates of surgical site infections caused by methicillin-resistant Staphylococcus spp. However, few data supported the use of vancomycin for surgical prophylaxis. OBJECTIVE: To determine the tolerance of vancomycin for antibiotic prophylaxis and incidence of vancomycin-resistant Enterococcus (VRE) in cardiac surgery patients. METHODS: In 2 separate studies, we assessed the adverse effects in patients given perioperative vancomycin (study 1) and the incidence of VRE in patients given perioperative vancomycin (study 2). Study 1 was a prospective cohort study of patients undergoing coronary artery bypass graft (CABG) or valve replacement surgery given vancomycin (1 dose preoperatively/2 doses postoperatively) for antibiotic prophylaxis between October 2003 and December 2004. Patients were assessed for tolerance to the antibiotic regimen. In study 2, cardiac surgery patients receiving perioperative vancomycin were screened for VRE before therapy and at day 7 of hospitalization. VRE was detected using standard microbiologic procedures. RESULTS: In study 1, 1161 patients (CABG = 75%; valve = 19%; both = 6%) were evaluated. All patients but one (99.9%) were prescribed preoperative vancomycin. Therapy was changed for 34 (2.9%) patients, of which 20 changes were due to physician preference for another antibiotic. The only toxicity that required a change in the vancomycin regimen was red man's syndrome, which was experienced by 9 (0.8%) patients. Four patients did not receive a second postoperative dose due to prior renal insufficiency. Patients were most commonly switched to cefuroxime (n = 26), linezolid (n = 2), cefepime (n = 2), gatifloxacin, cefazolin, levofloxacin, or ceftriaxone (n = 1, each). In study 2, 100 patients were screened for the emergence of VRE colonization. No patient was VRE positive at baseline and 4 (4%) were positive at day 7. CONCLUSIONS: Surgical antibiotic prophylaxis with vancomycin was reasonably well tolerated in CABG and valve replacement surgery, with a 4% incidence of VRE colonization.