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991.
BACKGROUND: In a previous cohort study of glass fiber manufacturing, we found a significant increase in lung cancer. This study extends the follow-up period. METHODS: We conducted a historical prospective study of 2557 men employed in producing glass wool. We obtained work histories, causes and dates of death, and date and site of cancer diagnoses. We computed standardized mortality and incidence ratios (SMR, SIR). RESULTS: The overall SMR for lung cancer was 163 (95% CI = 118-221). The SMR did not vary consistently by duration of employment and time since first employment. However, plant workers with >20 years' employment and >40 years since first exposure had an SMR for lung cancer of 282 (95% CI = 113-582). The SMR dropped with later date of first exposure, but the trend was non-significant. There was an unexpected overall increase in kidney cancer incidence. DISCUSSION: The increase in lung cancer is greater than in other cohorts of glass fiber workers. Since exposure data are lacking from the early years of the plant, we cannot state if the excess was due to glass fibers, other work exposures or other reasons. 相似文献
992.
Bailey MS Boos CJ Vautier G Green AD Appleton H Gallimore CI Gray JJ Beeching NJ 《Emerging infectious diseases》2005,11(10):1625-1628
Gastroenteritis affected many British military personnel during the war in Iraq. In the first month, 1,340 cases were seen; 73% of patients required hospital admission and 36% were hospital staff. In a survey of 500 hospital staff, 76% reported gastroenteritis, which was more likely in clinical workers. Investigations showed only caliciviruses. 相似文献
993.
Predicting postoperative analgesia outcomes: NNT league tables or procedure-specific evidence? 总被引:1,自引:0,他引:1
Number needed to treat (NNT) values have been recommended andused to assess efficacy of analgesics for acute pain management.However, the data analysed come from a variety of procedures,which may potentially hinder the interpretation of the NNT valuefor specific procedures. We reanalysed available NNT data withacetaminophen in relation to the magnitude of surgical injury.Acetaminophen was less effective for pain relief after orthopaedicprocedures than after dental procedures. The relative risk ratiofor more than 50% pain relief, compared with placebo, was only1.87 compared with 3.77 (P<0.05). Although NNT can give avaluable overview of efficacy, this concept is not necessarilyapplicable to all types of surgery. We suggest that estimatesof NNT should be related to specific surgical procedures.
相似文献
994.
Marriott I Gray DL Rati DM Fowler VG Stryjewski ME Levin LS Hudson MC Bost KL 《BONE》2005,37(4):504-512
Incidences of osteomyelitis caused by Staphylococcus aureus have increased dramatically in recent years, in part, due to the appearance of community-acquired antibiotic-resistant strains. Therefore, understanding the pathogenesis of this organism has become imperative. Recently, we have described the surprising ability of bone-forming osteoblasts to secrete a number of important immune mediators when exposed to S. aureus in vitro. In the present study, we provide the first evidence for the in vivo production of the pivotal inflammatory chemokine, monocyte chemoattractant protein-1 (MCP-1), by osteoblasts during S. aureus-associated bone infection. Quantitative real-time PCR was employed to determine levels of mRNA encoding MCP-1 in vivo using a mouse model that closely resembles the pathology of trauma-induced staphylococcal osteomyelitis. Expression of this inflammatory chemokine and osteoblast-specific markers was investigated by confocal laser scanning microscopy in bone tissue from organ cultures of neonatal mouse calvaria and from the in vivo mouse model. Furthermore, the clinical relevancy of these findings was investigated by performing similar studies on infected human bone tissue from patients with S. aureus-associated osteomyelitis. Here, we confirm that expression of mRNA encoding MCP-1 is elevated in bacterially infected murine bone tissue. Importantly, we show that these increases translate into marked elevations in the expression of MCP-1 protein that co-localizes with osteoblast markers in infected bone tissue. Such increases could not be attributed solely to mechanical damage as a similar response was observed in infected but otherwise undamaged organ cultures. Finally, we have demonstrated the in vivo production of MCP-1 by osteoblasts in bone specimens from patients with S. aureus-associated osteomyelitis. As such, these studies demonstrate that bacterial challenge of osteoblasts during bone diseases such as staphylococcal osteomyelitis induces cells to produce a key inflammatory chemokine that can direct appropriate host responses or may contribute to progressive inflammatory damage. 相似文献
995.
Chronic heart failure is an important health problem associated with a high mortality and morbidity. Appropriate treatment reduces mortality and leads to improved exercise tolerance but many patients report poor quality of sleep. Sleep studies of patients with heart failure suggest that sleep disordered breathing is experienced in 50% of patients and is a powerful predictor of poor prognosis. Sleep disordered breathing broadly comprises obstructive sleep apnoea, when upper airway instability causes mechanical obstruction to breathing; and central sleep apnoea, characterised by an absence of ventilatory effort. Sleep disordered breathing occurring in patients with heart failure is in most part attributable to central sleep apnoea and reflects uncompensated instability of the ventilatory feedback mechanism. 相似文献
996.
A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy 总被引:1,自引:0,他引:1
Kehlet H Gray AW Bonnet F Camu F Fischer HB McCloy RF Neugebauer EA Puig MM Rawal N Simanski CJ 《Surgical endoscopy》2005,19(10):1396-1415
Background: Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain. However, a systematic review of
postoperative pain management in this procedure has not been conducted.
Methods: A systematic review was conducted according to the guidelines of the Cochrane Collaboration. Randomized studies examining
the effect of medical or surgical interventions on linear pain scores in patients undergoing laparoscopic cholecystectomy
were included. Qualitative and quantitative analyses were performed. Recommendations for patient care were derived from review
of these data, evidence from other relevant procedures, and clinical practice observations collated by the Delphi method among
the authors.
Results: Sixty-nine randomized trials were included and 77 reports were excluded. Recommendations are provided for preoperative analgesia,
anesthetic and operative techniques, and intraoperative and postoperative analgesia.
Conclusions: A step-up approach to the management of postoperative pain following laparoscopic cholecystectomy is recommended. This approach
has been designed to provide adequate analgesia while minimizing exposure to adverse events.
This material was presented in part as abstracts at the Euroanaesthesia Congress in Glasgow, Scotland, 2003 相似文献
997.
Osteocyte Apoptosis and Osteoclast Presence in Chicken Radii 0–4 Days Following Osteotomy 总被引:2,自引:0,他引:2
Clark WD Smith EL Linn KA Paul-Murphy JR Muir P Cook ME 《Calcified tissue international》2005,77(5):327-336
Osteocyte apoptosis caused by load-induced microdamage is followed by osteoclastic bone remodeling, and a causal link between
apoptosis and repair has been suggested. The objectives of the present study were to use a chick model to examine the incidence
of osteocyte apoptosis and the presence of osteoclasts during the first 96 hours following an osteotomy, prior to extensive
callus mineralization. Osteotomies were performed on the right radii of 24 chicks at 23–24 days of age. The left radii served
as controls. Radii were collected and processed at six time points following surgery (0, 12, 24, 48, 72, and 96 hours). Decalcified
bone tissue sections were stained either for apoptosis using a modified TUNEL procedure or for tartrate-resistant acid phosphatase
to identify osteoclasts in the intracortical and periosteal envelopes. The percentage of apoptotic osteocytes, as well as
osteoclast counts (n/mm or n/mm2) were quantified in four regions (0–1, 1–2, 2–4, and 4–8 mm from the site of the osteotomy; regions 1–4, respectively) in
the osteotomized radii and in the same measured areas in the control radii. Data for osteocyte apoptosis and osteoclasts in
the control limb were subtracted from the osteotomized limb data to identify differences due to surgical influence. The incidence
of osteocyte apoptosis was significantly higher at 12, 24, 48, and 72 hours versus 0 hours following osteotomy, and the response
was highest in region 1; however, there was no interaction between time and region. Intracortical osteoclast counts (n/mm2) were elevated after 48 hours, and the response was similar in all regions. The data demonstrate that osteocyte apoptosis
occurs within 24 hours in response to an osteotomy and temporally precedes an increase in osteoclast presence. Hence, osteocyte
apoptosis may play a role in signaling during the bone healing process. 相似文献
998.
Malasanos TH Burlingame JB Youngblade L Patel BD Muir AB 《Journal of telemedicine and telecare》2005,11(Z1):74-76
We have used telemedicine clinics supplemented by online education to provide effective care for children with diabetes. Before the programme began, the mean interval between visits was 149 days; in year 1 of the programme it was 98 days, and in year 2 it was 89 days. Before the programme, there were on average 13 hospitalizations a year (47 days) and this decreased to 3.5 hospitalizations a year (5.5 days). Emergency department visits decreased from 8 to 2.5 per year. On 10 occasions after the programme started, ketosis was managed by telephone intervention alone, relying on family-initiated calls. Over 90% of patients and family members expressed satisfaction with the telemedicine service and wished to continue using it. In all, 95% felt little self-consciousness. Over 90% felt their privacy was respected. The programme saved US dollar 27,860 per year. The present study demonstrated improved access to specialized health care via telemedicine in combination with online education improved health status and reduced costs by reducing hospitalizations and emergency department visits. 相似文献
999.
Hegyi P Ordog B Rakonczai Z Takács T Lonovics J Szabolcs A Sári R Tóth A Papp JG Varró A Kovács MK Gray MA Argent BE Boldogköi Z 《World journal of gastroenterology : WJG》2005,11(38):5997-6002
AIM: To examine the effect of acute infection caused by herpesvirus (pseudorabies virus, PRV) on pancreatic ductal secretion. METHODS: The virulent Ba-DupGreen (BDG) and nonvirulent Ka-RREpolacgfp (KEG) genetically modified strains of PRV were used in this study and both of them contain the gene for green fluorescent protein (GFP). Small intra/ interlobular ducts were infected with BDG virus (107 PFU/mL for 6 h) or with KEG virus (1010 PFU/mL for 6 h), while non-infected ducts were incubated only with the culture media. The ducts were then cultured for a further 18 h. The rate of HCO3- secretion [base efflux -J(B-)] was determined from the buffering capacity of the cells and the initial rate of intracellular acidification (1) after sudden blockage of basolateral base loaders with dihydro-4,4,-diisothiocyanatostilbene-2,2,-disulfonic acid (500 μmol/L) and amiloride (200 μmol/L), and (2) after alkali loading the ducts by exposure to NH4CI. All the experiments were performed in HCO3--buffered Ringer solution at 37℃ (n = 5 ducts for each experimental condition). Viral structural proteins were visualized by immunohistochemistry. Virallyencoded GFP and immunofluorescence signals were recorded by a confocal laser scanning microscope. RESULTS: The BDG virus infected the majority of accessible cells of the duct as judged by the appearance of GFP and viral antigens in the ductal cells. KEG virus caused a similarly high efficiency of infection. After blockage of basolateral base loaders, BDG infection significantly elevated -J(B-) 24 h after the infection, compared to the non-infected group. However, KEG infection did not modify -J(B-). After alkali loading the ducts, -J(B-) was significantly elevated in the BDG group compared to the control group 24 h after the infection. As we found with the inhibitor stop method, no change was observed in the group KEG compared to the non-infected group. CONCLUSION: Incubation with the BDG or KEG strains of PRV results in an effective infection of ductal epithelial cells. The BDG strain of PRV, which is able to initiate a lytic viral cycle, stimulates HCO3- secretion in guinea pig pancreatic duct by about four- to fivefold, 24 h after the infection. However, the KEG strain of PRV, which can infect, but fails to replicate, has no effect on HCO3- secretion. We suggest that this response of pancreatic ducts to virulent PRV infection may represent a defense mechanism against invasive pathogens to avoid pancreatic injury. 相似文献
1000.
Emergency preparedness for the chronically ill 总被引:1,自引:0,他引:1
Flume P Gray S Bowman CM Kerrigan C Lester M Virella-Lowell I 《The American journal of nursing》2005,105(3):68-72