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Biomedical subjects

G Maldonado

Publications and source records attributed to G Maldonado.

At least 19 recordsLinked to original sources

An updated study of mortality among North American synthetic rubber industry workers.

AIM: This study evaluated the mortality experience of workers from the styrene-butadiene industry. METHODS: The authors added seven years of follow up to a previous investigation of mortality among 17 924 men employed in the North American synthetic rubber industry. Analyses used the standardised mortality ratios (SMRs) to compare styrene-butadiene rubber workers' cause specific mortality (1943-98) with those of the United States and the Ontario general populations. RESULTS: Overall, the observed/expected numbers of deaths were 6237/7242 for all causes (SMR = 86, 95% CI 84 to 88) and 1608/1741 for all cancers combined (SMR = 92, 95% CI 88 to 97), 71/61 for leukaemia, 53/53 for non-Hodgkin's lymphoma, and 26/27 for multiple myeloma. The 16% leukaemia increase was concentrated in hourly paid subjects with 20-29 years since hire and 10 or more years of employment in the industry (19/7.4, SMR = 258, 95% CI 156 to 403) and in subjects employed in polymerisation (18/8.8, SMR = 204, 95% CI 121 to 322), maintenance labour (15/7.4, SMR = 326, 95% CI 178 to 456), and laboratory operations (14/4.3, SMR = 326, 95% CI 178-546). CONCLUSION: The study found that some subgroups of synthetic rubber workers had an excess of mortality from leukaemia that was not limited to a particular form of leukaemia. Uncertainty remains about the specific agent(s) that might be responsible for the observed excesses and about the role of unidentified confounding factors. The study did not find any clear relation between employment in the industry and other forms of lymphohaematopoietic cancer. Some subgroups of subjects had more than expected deaths from colorectal and prostate cancers. These increases did not appear to be related to occupational exposure in the industry.

Aged↗

Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention.

OBJECTIVE: Analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (PCI) in the first 24 hours of AMI. METHODS: The patients were divided into three different age groups (60/69, 70/79, and > or =80 years) and were treated from 7/95 until 12/99. The primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. Coronary stent implantation and abciximab use were employed at the interventionist discretion. RESULTS: We analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary PCI. Patients with ages above 70 were more often female (p=.015). Those with ages above 80 were treated later with PCI (p=.054), and all of them presented with total occlusion of the infarct-related artery. Coronary stents were implanted in 30% of the patients. Procedural success was lower in > or =80 year old patients (p=.022), and the death rate was higher in > or =70 years olds (p=.019). Reinfarction and coronary bypass surgery were uncommon events. A trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064). CONCLUSION: Elderly patients (> or =70 years) presented with adverse clinical and angiographic profiles and patients > or =80 years of age obtained reduced TIMI 3 flow success rates after primary PTCA, and those > or =70 years had a higher death rate.

Age Distribution↗

An epizootic of patent iridescent virus disease in multiple species of blackflies in Chiapas, Mexico.

Simulium blackfly larvae (Diptera: Simuliidae) were collected from rivers and streams at 500-1500 m a.s.l. in Chiapas State of southern Mexico. Among 45 sites surveyed over an area of 2300 km2 (around 15 degrees 15'N 92 degrees 20'W), some Simulium larvae from three sites were opalescent violet-blue, interpreted as patent infection with invertebrate iridescent virus (IIV). Dissection confirmed the presence of putative Iridovirus particles, 130nm diameter, but no IIV isolates were obtained from homogenates injected into Galleria mellonella (L) larvae (Lepidoptera: Pyralidae). All Simulium with patent IIV infection died before metamorphosis, whereas approximately 60% of asymptomatic Simulium survived to adulthood in the laboratory. During 1997, standard monthly samples from two parallel rivers 42-50 km north-west of Tapachula comprised the following species proportions (and rates of patent IIV infection): 41.8% (47%) Simulium mexicanum Bellardi complex, 31.3% (31.4%) S. rubicundum Knab, 10.1% (13.1%) S. paynei, 6.5% (2.9%) S. callidum (Dyar & Shannon), 6.3% (5.1%) S. ochraceum Walker complex, 3.1% (0.7%) S. downsi Vargas et al., 0.7% S. samboni Jennings and 0.2% S. metallicum Bellardi complex, showing a strong correlation between blackfly abundance and the prevalence of patent infection. An epizootic of IIV in January and February (infection rates 41-100%) was followed by absence of larvae (March-August) until the end of the rainy season, when numbers collected on nylon strings rose to approximately 1/cm with patent IIV infection rates of 0-12.5% during September-December. Further investigations are underway to isolate this IIV and assess its potential usefulness for biological control of Simulium pests and vectors of onchocerciasis.

Animals↗

Safety and efficacy of coronary stent implantation. Acute and six month outcomes of 1,126 consecutive patients treated in 1996 and 1997.

PURPOSE: The authors analyzed the 30-day and 6-month outcomes of 1,126 consecutive patients who underwent coronary stent implantation in 1996 and 1997. METHODS: The 30-day results and 6-month angiographic follow-up were analyzed in patients treated with coronary stents in 1996 and 1997. All patients underwent coronary stenting with high-pressure implantation (> 12 atm) and antiplatelet drug regimen (aspirin plus ticlopidine). RESULTS: During the study period, 1,390 coronary stents were implanted in 1,200 vessels of 1,126 patients; 477 patients were treated in the year 1996 and 649 in 1997. The number of percutaneous procedures performed using stents increased significantly in 1997 compared to 1996 (64% vs 48%, p = 0.0001). The 30-day results were similar in both years: the success and stent thrombosis rates were equal (97% and 0.8%, respectively). The occurrence of new Q wave MI (1.3% vs 1.1%, 1996 vs 1997, p = NS), emergency coronary bypass surgery (1% vs 0.6%, 1996 vs 1997, p = NS) and 30-day death rates (0.2% vs 0.5%, 1996 vs 1997, p = NS) were similar. The 6-month restenosis rate was 25% in 1996 and 27% in 1997 (p = NS); the target vessel revascularization rate was 15% in 1996 and 16% in 1997 (p = NS). CONCLUSIONS: Intracoronary stenting showed a high success rate and a low incidence of 30-day occurrence of new major coronary events in both periods, despite the greater angiographic complexity of the patients treated with in 1997. These adverse variables did not have a negative influence at the 6-month clinical and angiographic follow-up, with similar rates of restenosis and ischemia-driven target lesion revascularization rates.

Aged↗

Inhibition of phagocytic activity by the N-acetyl-D-galactosamine-specific lectin from Amaranthus leucocarpus.

Amaranthus leucocarpus lectin (ALL), specific for N-acetyl-D-galactosamine, induces inhibition of the erythrophagocytic activity of resident murine peritoneal macrophages and of the macrophage-like cell line J-774. This effect was observed only in macrophages that were Mac-2 (CD11c/CD18 or CR4) negative, indicating that macrophage activation induces important modification to the glycosylation (mainly O-glycosylation) of the membrane. Receptors for IgM and C3b remain unaltered after lectin treatment. Ultrastructural analysis revealed (a) that ALL induced the formation of pinocytic vacuoles, and (b) a regular distribution over the macrophage membrane as well as endosomal vesicles of the gold labeled ALL. Our results suggest that macrophage membrane glycoproteins with constitutive N-acetyl-D-galactosamine residues participate in the regulation of pinocytic-phagocytic vacuole formation.

Acetylgalactosamine↗

Interaction of murine macrophage-membrane proteins with components of the pathogenic fungus Histoplasma capsulatum.

The interaction of macrophage-membrane proteins and histoplasmin, a crude antigen of the pathogenic fungus Histoplasma capsulatum, was studied using murine peritoneal macrophages. Membrane proteins were purified via membrane attachment to polycationic beads and solubilized in Tris-HCl/SDS/DTT/glycerol for protein extraction; afterwards they were adsorbed or not with H. capsulatum yeast or lectin binding-enriched by affinity chromatography. Membrane proteins and histoplasmin interactions were detected by ELISA and immunoblotting assays using anti-H. capsulatum human or mouse serum and biotinylated goat anti-human or anti-mouse IgG/streptavidin-peroxidase system to reveal the interaction. Results indicate that macrophage-membrane proteins and histoplasmin components interact in a dose-dependent reaction, and adsorption of macrophage-membrane proteins by yeast cells induces a critical decrease in the interaction. Macrophage-membrane glycoproteins with terminal D-galactosyl residues, purified by chromatography with Abrus precatorius lectin, bound to histoplasmin; and two bands of 68kD and 180kD of transferred membrane protein samples interacted with histoplasmin components, as revealed by immunoblot assays. Specificity for beta-galactoside residues on the macrophage-membrane was confirmed by galactose inhibition of the interaction between macrophage-membrane proteins and histoplasmin components, in competitive ELISA using sugars, as well as by enzymatic cleavage of the galactoside residues.

Animals↗

Direct action of serotonin on prolactin, growth hormone, corticotropin and luteinizing hormone release in cocultures of anterior and posterior pituitary lobes: autocrine and/or paracrine action of vasoactive intestinal peptide.

There is extensive evidence that serotonin (5-HT) is implicated in the neuroendocrine control regulating the secretion of several anterior pituitary hormones. It has also been reported that the posterior pituitary is necessary for prolactin (PRL) response to 5-HT as well as to suckling, in which 5-HT implication has been demonstrated. As we have previously shown that vasoactive intestinal peptide (VIP) mediates through an autocrine or paracrine action the PRL release induced by insulin-like growth factor I, thyrotropin-releasing hormone (TRH) and dopamine withdrawal, the aim of the present work was to determine whether 5-HT has a direct action on pituitary secretion and to study the possible role of pituitary VIP in this situation. Cells from the anterior pituitary lobe (AP) were cultured either alone or together with cells from the posterior pituitary lobe (PP). As melanotropes from PP express glucocorticoid receptors in vitro, both AP cultures and cocultures of AP/PP cells were incubated in the presence or absence of corticosterone (0.1 microg/ml), thus designing four experimental conditions. Then both AP and mixed cultures were incubated with 5-HT (100 nM) for 20, 45 and 180. The release of PRL, growth hormone (GH), corticotropin (ACTH) and luteinizing hormone (LH) was stimulated by 5-HT, but only in cocultures of AP/PP cells preincubated with corticosterone, whereas follicle-stimulating hormone and thyroid-stimulating hormone release was not modified. As AP cultures did not show any response to 5-HT, both in the presence or absence of corticosterone, and as melanotropes are the main cellular type present in the PP cultures, we studied the response of alpha-melanocyte-stimulating hormone (alphaMSH) to 5-HT in PP cells cultured with or without corticosterone. Serotonin did not modify alphaMSH release either in the absence or the presence of corticosterone. VIP release was also stimulated by 5-HT in the cocultures, and the time response profile was only similar to that of PRL. In order to study whether pituitary VIP is implicated in 5-HT action, cocultures preincubated with corticosterone were incubated in the presence of 5-HT, a VIP-receptor antagonist (VIP-At) or simultaneously with 5-HT plus VIP-At. PRL response to 5-HT was abolished by the simultaneous presence of VIP-At, whereas GH, ACTH and LH response remained unchanged. These data demostrate that: (1) 5-HT stimulates the secretion of PRL, GH, ACTH, LH and VIP acting directly at pituitary level on PP, probably by releasing an unidentified mediator from melanotropes; (2) glucocorticoids make the response of AP cells to 5-HT possible due to the presence of PP cells in the coculture; (3) PRL response to 5-HT is mediated through an autocrine and/or paracrine action of VIP.

Adrenocorticotropic Hormone↗

Do vouchers improve breast cancer screening rates? Results from a randomized trial.

OBJECTIVE: To determine the effect of a voucher for free mammography on compliance with recommended mammography screening guidelines. STUDY DESIGN: Vouchers for free mammography distributed to a random sample of women over the age of 50 in two rural southern Minnesota counties. The vouchers were good for one year. Baseline and follow-up data were collected and rates of compliance with current mammography guidelines were observed for the voucher group and a control group of women living in the same counties. METHODS: Logistic regression models were used to estimate the effect of the voucher on compliance with mammography guidelines and the impact of factors potentially influencing the effectiveness of the voucher. PRINCIPAL FINDINGS: The voucher improved mammography rates primarily through increasing screening among women who were out of compliance at baseline. CONCLUSIONS: Vouchers, even when distributed randomly within a population of rural Midwestern women, can significantly improve compliance rates. Vouchers are no less effective a means of increasing screening among vulnerable women than among other women.

Adult↗

Factoring vs linear modeling in rate estimation: a simulation study of relative accuracy.

A common strategy for modeling dose-response in epidemiology is to transform ordered exposures and covariates into sets of dichotomous indicator variables (that is, to factor the variables). Factoring tends to increase estimation variance, but it also tends to decrease bias and thus may increase or decrease total accuracy. We conducted a simulation study to examine the impact of factoring on the accuracy of rate estimation. Factored and unfactored Poisson regression models were fit to follow-up study datasets that were randomly generated from 37,500 population model forms that ranged from subadditive to supramultiplicative. In the situations we examined, factoring sometimes substantially improved accuracy relative to fitting the corresponding unfactored model, sometimes substantially decreased accuracy, and sometimes made little difference. The difference in accuracy between factored and unfactored models depended in a complicated fashion on the difference between the true and fitted model forms, the strength of exposure and covariate effects in the population, and the study size. It may be difficult in practice to predict when factoring is increasing or decreasing accuracy. We recommend, therefore, that the strategy of factoring variables be supplemented with other strategies for modeling dose-response.

Bias↗

Participation of a sialic acid-specific lectin from freshwater prawn Macrobrachium rosenbergii hemocytes in the recognition of non-self cells.

Phagocytic activity of circulating hemocytes from freshwater prawns is mediated by a small group of granulocytes. Recognition of nonself cells by these cells seems to be mediated by two independent mechanisms: specific, via O-acetylsialic acid, as well as N-acetylated sugars on recognized cells and a nonspecific one. Both mechanisms show differences in their optimal temperature and time differences for activity. Hemocytes with phagocytic activity interact positively with rabbit IgG raised against the serum lectin. Attempts to elucidate the nature of the membrane-lectin on hemocytes performed by electroimmunotransfer blot assays on cell lysates indicates the presence of two major proteins with a molecular weight of 68-72 kDa. Electron microscopy revealed a regular distribution of lectin on hemocyte plasma membranes. Our results suggest the active participation of a membrane lectin in the recognition of nonself.

Animals↗

Alternative approaches to analytical designs in occupational injury epidemiology.

In this paper, we discuss the theoretical framework upon which observational studies of occupational injuries are based. Following a general description of how causal effects are estimated, the challenges faced by researchers working in this area are outlined, with an emphasis on case-control studies. These challenges include defining the at-risk period for workers whose tasks change over time and whose hazard period may be very brief, evaluating the underreporting of both exposures and injuries, and considering the effects of multiple injuries per individual on study design and data analysis. We review both the theoretical and practical considerations in the design and conduct of traditional case-control studies, based on the collection of individual level data, as well as other approaches, such as using information culled from administrative and descriptive databases, and case-control studies in which the plant or work site is the unit of analysis. The case-crossover design is also reviewed and its utility for reducing confounding due to differences between individuals by self-matching is highlighted. While this design has not yet been applied to the work setting, its potential for increasing our understanding of the causes of acute-onset occupational injuries seems promising. Finally, a variety of hybrid designs are discussed, including combinations of case-control, case-crossover, and cohort designs.

Accidents, Occupational↗

Injury from dairy cattle activities.

Animals have been implicated as an important source of injury for farm household members. Little is known, however, about the specific activities associated with the animal/livestock operations that place a person at increased or decreased risk for injuries. The primary aim of this case-control study was to identify which dairy cattle operation activities (that is, milking, feeding, cleaning barns, trimming and treating feet, dehorning, assisting with difficult calvings, and doing treatments) were associated with an increased or decreased risk of injury. We found milking to have the greatest increase in risk for injury. The ratios for increasing hours per week spent at milking (0, 1-10, 11-20, 21-30, 31-63) were 1.0, 2.3, 5.5, 10.9, and 20.6, respectively. We also found an increased rate ratio associated with trimming or treating hooves (rate ratio = 4.2).

Adolescent↗

Risk factors for work-related violent victimization.

This case-control study used the National Crime Victimization Survey database (a national sample of housing addresses) to examine sociodemographic risk factors for becoming a victim of work-related robbery and assault. Cases (N = 267) reported having been violently victimized in the previous 6 months. Controls (N = 1,783) were chosen from all nonvictims of violent crime at the end of the 6-month period. Risk factors varied by type of victimization, and differences were evident between men and women. Men less than 45 years of age had an increased risk for assault [odds ratio (OR) = 2.0-2.7], compared with those 55 years of age and older; and those with a family income of less than $40,000 had an increased risk for assault (OR = 1.7-1.9), compared with those having a family income of $50,000 or more. We found a decreased risk for those with a high school education (OR = 0.6), compared with those with some college education. For women, an increased risk was seen for ages 16-18 years (OR = 3.3) and 25-34 years (OR = 2.3), compared with those 55 years of age or older. Women who were divorced or separated (OR = 4.4) and never-married (OR = 2.1) were at higher risk than women who were married. We found a decreased risk for nonwhites (OR = 0.5), compared with whites.

Adolescent↗

Lower respiratory illness, recurrent wheezing, and day care attendance.

We prospectively assessed the relations between various characteristics of day care and lower respiratory illness (LRI) in a cohort of 1,268 Minnesotan children, born between October 1989 and January 1991 and followed to 2 yr of age. Information on LRI was abstracted from medical records and data on day care use, respiratory symptoms, and physician diagnosis of asthma were obtained from questionnaires. We identified a subgroup of 60 children with recurrent wheezing illnesses. The LRI rate ratio for day care attendance was 2.0 (95% confidence interval = 1.7, 2.2). Rate ratios were similar regardless of the day care setting, number of other children present, or the number of hours spent in day care. A parental history of asthma further increased the rate ratio for day care attendance. Day care attendance was associated with a threefold risk of having recurrent wheezing illnesses. We conclude that day care attendance is an important risk factor for LRI in young children, and for recurrent wheezing illnesses.

Child Day Care Centers↗

Worker exposures to inhalable and total aerosol during nickel alloy production.

This paper describes a study that was carried out at a North American nickel alloy production facility to compare the levels of personal exposures to inhalable and total nickel-containing aerosols. It is part of a large body of work aimed at assessing the impact of introducing new personal sampling instrumentation with performance consistent with the latest criteria proposed by the International Standards Organization (ISO), the Comité Européen Normalisation (CEN) and the American Conference of Governmental Industrial Hygienists (ACGIH). Side-by-side sampling using the 37-mm filter holder (for total aerosol) and the so-called IOM inhalable aerosol sampler was conducted for the personal exposures of workers in a range of workplaces throughout the facility. The results showed that inhalable aerosol exposure levels-for both overall aerosol and for total nickel-were consistently and significantly higher than the corresponding total aerosol levels. Weighted least-squares linear regression yielded factors ranging from about 1.3 to 2.4 for overall dust and from about 1.5 to 3.5 for nickel. Inspection of the statistical distribution of the exposures for the whole plant suggested that it was log-normal.

Aerosols↗