Wood dust exposure and the association with lung cancer risk

BACKGROUND: Wood dust was designated as a human carcinogen based on increased sinus and nasal cancer rates among exposed workers. However, data on an association with lung cancer have been inconclusive. METHODS: Self-reported wood dust exposure was compared between 1,368 lung cancer patients and 1,192 cancer-free adults, in a lung cancer case-control study. Epidemiological information was collected through a detailed personal interview. RESULTS: Using several definitions of wood dust exposure we consistently observed statistically significant elevated adjusted risk estimates; for example, the adjusted odds ratio (OR) for combined wood dust related occupations and industries was 3.15 (95% confidence intervals (CI) 1.45-6.86) and for an overall summary exposure measure it was 1.60 (95% CI 1.19-2.14). The association was maintained when stratified by histopathological type. Among those exposed to cigarette smoke and wood dust, 21% of the cases were attributable to biologic interaction. CONCLUSIONS: Wood dust exposure is a potential risk factor for lung cancer.     

Intraocular pressure profile of a child on a systemic corticosteroid

PURPOSE: To report the ocular hypertensive response to high-dose systemic corticosteroid in a pediatric patient. DESIGN: Observational case report. METHODS: A 9-year-old patient with leukemia received oral prednisolone at a dosage of 2.3 mg/kg/d for 5 weeks, followed by a 4-month break and then a 4-week course of oral dexamethasone at 10 mg/d. Detailed ocular examination was performed for both eyes before and regularly throughout the two courses of treatment. RESULTS: The intraocular pressure in both eyes rose to almost 40 mm Hg after only 8 days of oral corticosteroid. On stopping systemic corticosteroid, the intraocular pressure rapidly returned to baseline level within 2 days. A similar intraocular pressure profile was recorded for both eyes during the course of oral dexamethasone. The patient remained largely asymptomatic throughout. CONCLUSIONS: Systemic corticosteroid may give rise to significant but asymptomatic ocular hypertension in pediatric patients.     

Impact of lead exposure on health status and scholastic achievement of school pupils in Alexandria

Lead exposure among children is a serious health problem affecting virtually every system in their bodies. Affection of their cognitive function with its implication of poor school performance, is one of the serious outcomes of such exposure. In an attempt to arrive to an adequate knowledge about the impact of lead exposure on the health status and scholastic achievement in school age, a cross sectional study was carried out on 250 primary school pupils aged from 8 to 10 years in Wassat region in Alexandria. The concentration, visual and hearing acuity and the cognitive function. Moreover, laboratory investigation of blood lead level of the pupils was carried out. Their final scholastic achievement at the end of the year were recorded. The results indicated that the mean blood lead level among the studied pupils was 17.36 +/- 10.67 microg/dl, more than one third of the sample (36.00%) were highly exposed to lead with blood level of 20 microg/dl and more. A significant negative correlation was found between blood lead level and the 50th percentile of weight for height (r = -0.4488), haemoglobin concentration (r = -0.6133) and IQ scores (r = -0.8150) of the pupils. While a significant positive correlation was observed with the functional visual and hearing loss (r = 0.1390 and 0.2189 respectively). Moreover, the multiple regression analysis determined that age, blood lead level, crowding index, IQ score and number of missed school days were the significant contributing variables to the final scholastic achievement of the pupils from all the studied factors.     

Variants in folate pathway genes as modulators of genetic instability and lung cancer risk

Genetic instability plays a crucial role in cancer development. The genetic stability of the cell as well as DNA methylation status could be modulated by folate levels. Several studies suggested associations between polymorphisms in folate genes and alterations in protein expression and variations in serum levels of the folate. The objective of this study was to investigate the effect of folate pathway polymorphisms on modulating genetic instability and lung cancer risk. Genotyping of 5 SNPs in folate pathway genes and cytokinesis‐blocked micronucleus cytome assay analysis (to determine the genetic instability at baseline and following NNK treatment) was conducted on 180 lung cancer cases and 180 age‐, gender‐, and smoking‐matched controls. Our results showed that individually, folate pathway SNPs were not associated with cytogenetic damage or lung cancer risk. However, in a polygenic disease such as lung cancer, gene–gene interactions are expected to play an important role in determining the phenotypic variability of the diseases. We observed that interactions between MTHFR677, MTHFR1298, and SHMT polymorphisms may have a significant impact on genetic instability in lung cancer patients. With regard to cytogenetic alterations, our results showed that lymphocytes from lung cancer patients exposed to the tobacco‐specific carcinogen 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanone [NNK] had considerably increased frequency of cytogenetic damage in presence of MTHFR 677, MTHFR 1298, and SHMT allelic variants. These findings support the notion that significant interactions may potentially modulate the lung cancer susceptibility and alter the overall the repair abilities of lung cancer patients when exposed to tobacco carcinogens such as NNK. © 2010 Wiley‐Liss, Inc.     

Rapid method for determination of DNA repair capacity in human peripheral blood lymphocytes amongst smokers

Background  

DNA repair capacity is an important determinant of susceptibility to cancer. The hOGG1 enzyme is crucial for repairing the 8-oxoguanine lesion that occurs either as a byproduct of oxidative metabolism or as a result of exogenous sources such as exposure to cigarette smoke. It has been previously reported that smokers with low hOGG1 activity had significantly higher risk of developing lung cancer as compared to smokers with high hOGG1 activity.     

Therapeutics in pediatric epilepsy,Part 1: The new antiepileptic drugs and the ketogenic diet

Epilepsy is one of the most common and challenging neurologic disorders affecting children. Although various modalities exist to treat pediatric-onset seizures, seizures in 25% of children who are diagnosed as having epilepsy remain refractory to available therapies. Of the 8 new antiepileptic drugs (AEDs) (felbamate, gabapentin, lamotrigine, topiramate, tiagabine, levetiracetam, oxcarbazepine, and zonisamide), all but 2 (zonisamide and levetiracetam) have received Food and Drug Administration approval for adjunctive use in the pediatric population. However, most of the new AEDs used in adults have also been used in children, beyond the AEDs' approved indications. The ultimate goal of patient management is to choose the therapeutic option that provides the best chance of improving the patient's quality of life. Issues that relate to treatment choice include the likelihood of seizure recurrence, type and severity of seizures, available AED efficacies and toxicities, need for hematologic monitoring, ease of dosing, underlying medical conditions, medication interactions, urgency of initiating therapy, and cost. In this review, we discuss these issues for each of the 8 new AEDs; we also discuss the ketogenic diet and briefly review the older AEDs. Knowledge of the available AEDs will enable the practitioner to choose the best drug or drugs for individual patients.     

Caregivers of elderly people with loss of autonomy in Lebanon: what is the context of their health care?

The primary objective of this pan Lebanese study was to describe the health care context of family caregivers cohabiting with an elderly relative with loss of autonomy while the secondary objective consisted in the qualitative documentation of their positive and negative perceptions as to the role of the caregivers. The study uses a theoretical framework of stress. The results indicate that the caregivers (N = 319) take care of relatives (40% with memory troubles) having a moderate level of loss of autonomy and who present more depressive behaviors than "disturbing" behaviors. The caregivers are particularly affected by the behaviors of their relatives. They accomplish several health care tasks and very few receive formal services to support them. Their neighborhood offers them more emotional support than instrumental support. More caregivers perceive positive aspects than negative aspects in their role. Recommendations are formulated to guide the elaboration of a national policy of support to caregivers and the development of innovative community care practices.