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Biomedical subjects

S Blum

Publications and source records attributed to S Blum.

At least 109 records · Page 6Linked to original sources
PubMed1988

Lung cancer case-control study in a rubber manufacturing plant.

This report presents the findings of a case-control study of lung cancer among workers at a rubber manufacturing plant. Detailed work histories of 40 lung cancer deaths, which occurred during 1977 and 1978, were compared with those of 146 controls who were individually matched to cases on age, sex, and race; 66 of the controls were also matched on year of first hire. Elevated odds ratios were noted for different durations of employment in four work areas: Reclaim Operation, Chemicals, Special Products Manufacture, and Curing Preparation. A clear trend of increasing odds ratios with increasing durations of exposure was observed for the first three of these work areas. Several chemicals used in these processes are known respiratory system hazards. The results of this study suggest an association between lung cancer mortality risk and employment in Reclaim Operation, Chemicals, and Special Products Manufacture. A moderate excess risk was observed in these areas among both smokers and nonsmokers, although the risk was greater among the smokers.

Adult↗
PubMed1987

An analysis of the validity of self reported occupational histories using a cohort of workers exposed to PCBs.

An investigation was conducted to examine the validity of self reported work histories obtained from a sample of 326 capacitor manufacturing workers who had participated in an epidemiological study relating health abnormalities to exposure to polychlorinated biphenyls. Based on objective personnel records obtained for 288 members of the sample group, validity scores ranged from 20% to 100% with most falling between 70% and 75%. This validity range corresponded to misclassification proportions ranging from 13% to 29%. Exposure misclassification tended to be random for men but non-random for women (overestimation of exposure). By means of multiple regression analysis, the diversity of the job categorical pattern was found to be a significant independent predictor of validity. The factors sex, duration, and time lapse were also significant validity predictors but only interactively with job diversity. There were also indications that interviewer skill could be an important factor. Knowledge of the magnitude of these factor effects could be critical in planning retrospective epidemiological studies.

Data Collection↗
PubMed1986

Real-time ultrasound evaluation of renal transplant failure during the early postoperative period.

In a prospective clinical trial 385 ultrasound (US) examinations were performed on 50 renal allograft patients. Baseline sonograms were obtained within 24 hrs of transplantation, and serial US examinations were performed in two to three days intervals during hospital recovery. 24 out of 28 cases of acute rejections (85.7%) were detected by US with an 8% false positive rate. Using statistical analysis, enlarged and sonolucent pyramids, areas of decreased parenchymal echogenicity and an increase in anterior-posterior diameter of the organ, proved to be the best US-rejection criteria. Fine needle aspiration cytology revealed a high rate of false positive rejection diagnosis (23.8%). The results demonstrate that US is a valuable diagnostic aid in the evaluation of postoperative renal transplant failure.

Adult↗
PubMed1985

[Ultrasonically targetted fine-needle aspiration cytology in the immediate postoperative follow-up of transplanted kidneys].

From March 1982 to September 1983 62 ultrasound-guided fine needle aspiration cytologies in 22 patients with cadaveric kidney transplants had been performed during the postoperative hospitalisation period. In any case it was possible to guide the needle tip into the cortico-medullary boundary or in sonolucent parenchymal areas occurring during acute cellular rejection episodes. Thus technical failures could be reduced to 6% (4 out of 22). In 79% the clinically suspected diagnosis could be confirmed by FNAC. Aspirates from circumscript sonolucent parenchymal areas allowed rejection diagnosis in 95%. In 17% cellular signs of rejection were seen cytologically despite a regular transplant function.

Adult↗
PubMed1981

Thrombocytopenia with decreased megakaryocytes. Evaluation and prognosis.

The presenting clinical pictures and courses of seven patients with thrombocytopenia, decreased megakaryocytes in the marrow, and minimal changes in other hematopoietic cell lines are described. Little information exists in the literature on such patients. Initial bone marrow aspiration and biopsy in all patients showed decreased megakaryocytes with an otherwise normal marrow. Erythrocyte mean corpuscular volume was elevated in five of seven patients. Bone marrow karyotypes of six of the seven patients were normal. Chromium-51 platelet survival studies with platelet sizing, done in five of the seven patients, showed normal results. In two patients the course progressed to aplastic anemia. One of these died 9 months after presentation, and one responded dramatically to lithium. One patient developed preleukemia and died. The other four patients have remained thrombocytopenic but clinically stable. No useful therapy was identified. The differential diagnosis of such patients should include idiopathic thrombocytopenic purpura with misinterpretation of morphologic findings, hereditary and acquired aplastic anemia, preleukemia, and systemic lupus erythematosus.

Adult↗
PubMed1978

Mortality of female workers in rubber manufacturing plant.

The ten-year mortality experience of a cohort of white female production workers in a large rubber manufacturing plant is presented. An analysis of the observed and expected numbers of death from numerous causes revealed a slightly elevated overall standarized mortality ratio with an excess of deaths from both lung cancer and myocardial infarction, and a deficit of deaths from breast cancer. About two-thirds of all women in this cohort had worked, for the longest period of employment, in the manufacture of industrial products, while the remainder were engaged mostly in the manufacture of tires. Some preliminary associations between type of job and mortality experience are discussed, but a more detailed analytic investigation is required before nonoccupational risk factors can be ruled out.

Adult↗
PubMedDate not supplied

Tryptophan metabolism in alcoholism. Tryptophan but not excitatory amino acid availability to the brain is increased before the appearance of the alcohol-withdrawal syndrome in men.

Tryptophan (Trp) metabolism and disposition and excitatory and other amino acid concentrations were determined in alcohol-dependent subjects in relation to the alcohol-withdrawal syndrome (AWS). Parameters were examined in 12 alcohol-dependent male subjects, undergoing elective upper digestive tract tumour resection, and 12 age-, gender-, and medication-matched controls on three occasions: pre-operatively, post-operatively, and immediately before (i.e. within 24 h of) the appearance of the AWS. No significant differences were observed between controls and alcoholic subjects on the first or second of these occasions. On the third occasion, within 24 h of the appearance of the AWS, alcoholics showed a dramatic elevation (117%) in free serum Trp concentration and a consequent increase (111%) in the ratio of [free Trp]/[competing amino acids], which is an accurate predictor of Trp entry into the brain. Increases were also observed on this third occasion in concentrations of total Trp (49%), cortisol (123%), and norharman (137%). Concentrations of glutamate, glycine, aspartate, serine, and taurine did not differ significantly within or between the control and alcohol-dependent groups of subjects on any of the three occasions. The possible significance of the Trp and related metabolic changes in relation to the behavioural features of the AWS is discussed.

Alcoholism↗
PubMedDate not supplied

Elevated carbohydrate-deficient transferrin predicts prolonged intensive care unit stay in traumatized men.

Carbohydrate-deficient transferrin (CDT) is reported to have a higher specificity in alcoholism than conventional markers. As the morbidity and mortality rates amongst chronic alcoholics are raised following trauma, the objective was to investigate if CDT could be used to predict prolonged intensive care unit (ICU) stay and an increased morbidity in patients with multiple injuries admitted to the ICU. In this prospective double-blind study, 66 traumatized male patients were transferred to the ICU following admission via the emergency room and operative management. Blood samples for CDT determination were taken upon admission to the emergency room, the ICU and on days 2 and 4 following admission. The patients were allocated a priori to two groups: high CDT group (CDT >20 U/l on admission to the emergency room) and low CDT group (CDT < or = 20 U/l). CDT values were determined by microanion-exchange chromatography and radioimmunoassay. Thirty-six patients had an elevated CDT value on admission to the emergency room. The high CDT group had a significantly prolonged ICU stay (median high CDT group: 13 davs; median low CDT group: 5 days). Major intercurrent complications, such as alcohol-withdrawal syndrome, tracheobronchitis, pneumonia, pancreatitis, sepsis, and congestive heart failure, were significantly increased in the high CDT group. The increased risk of pneumonia in the high CDT group may be related to the significantly increased period of mechanical ventilation. As high CDT values were associated with an increased risk of intercurrent complications and a prolonged ICU stay, it seems reasonable to use CDT as a marker in intensifying research work into preventing alcoholism-associated complications.

Adolescent↗
PubMedDate not supplied

Risk factors for infection with plasmid-mediated high-level tetracycline resistant Neisseria gonorrhoeae.

This study was done to determine whether the increase in high-level tetracycline resistant Neisseria gonorrhoeae (TRNG) was associated with increased tetracycline use. From 547 persons with positive cultures seen consecutively at a sexually transmitted disease (STD) clinic, 51 (9%) isolates were resistant to tetracycline. Of these 51 isolates, 37 (73%) had high-level resistance (TRNG) which was mediated by the tetM determinant located on a 25.2-megadalton plasmid. Women were twice as likely as men to have TRNG. Previous visits to an STD clinic and oral antibiotic use for a sexually transmitted disease within a one to five month period were used as surrogates for prior tetracycline use. Patients who had been to an STD clinic were almost twice as likely to have TRNG (RR = 1.9, 95% CI: 1.01, 3.46), and those who took an oral antibiotic had a relative risk of 1.8. The authors postulate that previous tetracycline use selects for tetM-containing microorganisms in the genitourinary tract that, at the time of gonococcal infection, have the ability to transfer the determinant to N. gonorrhoeae. The above findings might have implications for modifying the current Centers for Disease Control (CDC) recommendation to prescribe tetracycline for suspected Chlamydia infection among patients with gonorrhea.

Adult↗
PubMedDate not supplied

Effects of parenteral lipid emulsions with different fatty acid composition on immune cell functions in vitro.

BACKGROUND: Numerous studies suggest that immune function may be compromised by lipid emulsions rich in polyunsaturated fatty acids (PUFAs). In our study, we compared the effect of a new olive oil-based lipid emulsion (ClinOleic) containing a moderate level of PUFAs, with emulsions based on soybean oil (Intralipid or Ivelip), on immune functions of human cell in vitro. METHODS: Peripheral white blood cells were collected from healthy volunteers. Lymphocyte proliferation was evaluated by [3H]-thymidine incorporation after stimulation with either phytohemagglutinin (PHA) or antibodies against T-cell specific antigens. Lymphocytes subsets and T-cell activation markers (CD25 and HLA-DR) were measured by flow cytometry. The release of cytokines (interleukin [IL]-2, IL-1beta, and tumor necrosis factor-alpha [TNF-alpha]) was measured by enzyme-linked immunosorbent assay (ELISA), after lymphocytes or monocytes/macrophages stimulation with PHA or lipopolysaccharide (LPS). RESULTS: A significant dose-dependent inhibition of thymidine incorporation was observed with Intralipid and Ivelip (incorporation down to 39.9% of control, p < .001) whereas ClinOleic showed no inhibitory effect. Activation antigen expression on both CD4+ and CD8+ T-cells tended to decrease with Intralipid (CD25: -53.4% on CD4+ and -57.4% on CD8+; HLA-DR: -61.5% on CD4+ and -58.5% on CD8+) but not with ClinOleic (from -2.9% for CD25 on CD4+ to 16.7% for HLA-DR on CD4+). Intralipid decreased significantly IL-2 production (-39.0%, p < .05) whereas ClinOleic had little effect (-13.0%, NS). Intralipid and ClinOleic tended to inhibit to a similar extent the release of pro-inflammatory cytokines (TNF-alpha: -21.5% and -34.8%, IL-1beta: -45.1% and -40.3%; respectively). CONCLUSIONS: Our results suggest that an olive oil-based lipid emulsion could modulate immune response selectively, maintaining protective immunity and reducing inflammatory response. Olive oil may offer an immunologically neutral alternative to soybean oil for use in parenteral lipid emulsions.

Adult↗