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At least 685 records · Page 38Linked to original sources
PubMed1999

Sildenafil induced priapism.

A 53 year-old Japanese man was referred to our hospital for persistent priapism, which had been induced by 200 mg (usual dose 25-50 mg) of sildenafil citrate (Viagra) three days earlier. He had a history of erectile dysfunction and had undergone penile injection therapy elsewhere; however, he had not used injection therapy this time. He obtained sildenafil personally without a doctor's prescription. He had not taken any other drugs that affect the metabolism of sildenafil, nor did he have any medical complications that might induce priapism. Since needle aspiration and irrigation were ineffective as first line therapy, surgical treatment was indicated to relieve the condition; a incision of tunica albuginea of both corpora cavernosa was made, and vigorous irrigation of saline washed out the blood clots. This is the first case report of priapism induced by sildenafil. Although this drug can be obtained through private commerce, it should be used under professional guidance as its abuse may lead to severe morbidity.

Humans↗
PubMed2005

Shifting epidemiology of Flaviviridae.

The dengue, West Nile, Japanese encephalitis and yellow fever viruses are important mosquito-borne viruses whose epidemiology is shifting in response to changing societal factors, such as increasing commerce, urbanization of rural areas, and population growth. All four viruses are expanding geographically, as exemplified by the emergence of West Nile virus in the Americas and Japanese encephalitis virus in Australasia. The large, recent global outbreaks of severe neurological disease caused by West Nile virus, the increasing frequency of dengue hemorrhagic fever outbreaks in the Americas, and the emergence of yellow fever virus vaccination-associated viscerotropic disease, are new clinical epidemiologic trends. These worrisome epidemiologic trends will probably continue in coming decades, as a reversal of their societal and biological drivers is not in sight. Nevertheless, the substantial reductions in Japanese encephalitis virus incidence resulting from vaccination programs and economic development in some Asian countries provide some encouragement within this overall guarded outlook.

Animals↗
PubMed1997

Amendments to the Center for Devices and Radiological Health federal performance standard for laser products.

Federal law requires that all laser products that are imported into or introduced into commerce in the United States comply with the performance standard published in the Code of Federal Regulations (CRF), Title 21, Parts 1040.10 and 1040.11, administered by the Center for Devices and Radiological Health (CDRH), US Food and Drug Administration. Although it contains somewhat different requirements for hazard classification, engineering controls and labeling, the ANSI Z136.1 standard defers to the CDRH standard. The CDRH standard became effective in August, 1976 and was amended, in 1978 and also in 1985. In the early 1990s, US experts met to formulate an approach to bring the requirements of the CDRH standard and those of the International Electrotechnical Commission (IEC) standard, IEC 825, into closer agreement in order to lower barriers to international trade and to remove any excessive compliance burdens on manufacturers. In 1993, the CDRH published, formally in the Federal Register and informally, a Notice of Intent to amend the CDRH standard. Responses to those notices have now been analyzed and informal draft amendments were distributed in 1996. This draft is now being prepared for formal issuance as a Notice of Proposed Rulemaking. Meanwhile, the IEC standard was amended in 1993 and republished as IEC 825-1; these amendments created considerable controversy since they resulted in over classification of the hazard of many products, especially light emitting diodes (LEDs) that have a large divergence and increased source dimensions. Additional amendments are now being developed to correct this problem. The CDRH has carefully monitored developments in the IEC and actively participated in its proceedings as a guide in developing its own proposal. This paper describes the major changes that are being proposed for the CDRH standard and presents some rationale for the major changes. The more significant changes include expansion of applicability to include LEDs, reduced emission durations for classification, revised measurement for hazard classification, reduced performance requirements for lower power visible radiation products, and revised requirements for medical products.

Air Pollutants, Radioactive↗
PubMed1999

The hazards of chrysotile asbestos: a critical review.

Chrysotile, or "white", asbestos is the dominant form of asbestos in international commerce today. It accounts for 99% of current world asbestos production of 2 million tonnes. Chrysotile is an extremely hazardous material. Clinical and epidemiologic studies have established incontrovertibly that chrysotile causes cancer of the lung, malignant mesothelioma of the pleura and peritoneum, cancer of the larynx and certain gastrointestinal cancers. Chrysotile also causes asbestosis, a progressive fibrous disease of the lungs. Risk of these diseases increases with cumulative lifetime exposure to chrysotile and rises also with increasing time interval (latency) since first exposure. Comparative analyses have established that chrysotile is 2 to 4 times less potent than crocidolite asbestos in its ability to cause malignant mesothelioma, but of equal potency of causation of lung cancer. The International Agency for Research on Cancer of the World Health Organization has declared chrysotile asbestos a proven human carcinogen. Sales of chrysotile asbestos have virtually ended in Western Europe and North America, because of widespread recognition of its health hazards. However, asbestos sales remain strong in Japan, across Asia and in developing nations worldwide. The claim has been made that chrysotile asbestos can be used "safely" under "certain conditions" in those nations. That claim is not accurate. The Collegium Ramazzini, an international learned society in environmental and occupational medicine, has called for an immediate worldwide ban on all sales and uses of all forms of asbestos, including chrysotile. The rationale for this ban is threefold: (1) that safer substitute materials are readily available, (2) that "controlled" use of asbestos is not possible, and (3) that the health risks of asbestos are not acceptable in either the industrialized or the newly industrializing nations.

Asbestos↗
PubMed2001

Man-made respirable-sized organic fibers: what do we know about their toxicological profiles?

Man-made organic fibers (MMOFs) have been manufactured for over 50 years. Until recently, there have been few concerns raised regarding the safety of organic fiber dusts. This is due, in large part, to the perception that the dimensions of most, if not all, of these products were too large to be inhaled into the distal lungs of workers, i.e., were considered to be nonrespirable. A brief review of some of the issues related to organic fiber toxicology is presented herein. Some of the organic fiber-types used in commerce are identified and some fundamental tenets of fiber toxicology are discussed. In addition, the European Union, in their recent consideration for banning chrysotile asbestos fibers, evaluated some organic fiber substitutes and compared them to the hazards of asbestos. A brief review of their conclusions is described below. Finally, the results of some recent studies assessing the mechanisms of biodegradability of para-aramid respirable-sized, fiber-shaped particulates (RFP) are presented. Para-aramid (p-aramid) RFP are the most extensively-studied respirable organic fiber-type and RFP is the new term which describes respirable-sized organic fibers (ECETOC, 1996) (1). The results of these studies provide clues regarding the mechanism(s) of p-aramid RFP shortening in the lungs of exposed animals, and may be relevant for humans.

Administration, Inhalation↗
PubMed1990

The benefits of animal identification for food safety.

The Center for Veterinary Medicine supports the effort to have a practical, workable form of mandatory animal identification. An animal identification system will make tracing of the source of animals with drug or chemical residues quicker and more effective. One of the best means of addressing and solving the problem of residues is through mandatory livestock identification. A successful traceback benefits both the producer and the industry. The U.S. Department of Agriculture (USDA) has proposed a mandatory nationwide system to require that all swine in interstate commerce be identified. Under the proposal several means of identification are listed and could be used. Additional methods or devices could be requested in writing to USDA. Persons required to keep records under the system would maintain the documents at their place of business for 2 yr. Records would be available to authorized USDA employees during ordinary business hours. FDA has had difficulty tracing tissue residue violations, particularly those involving sulfamethazine residues in swine. Investigations involving culled dairy cows and veal calves also have been closed due to lack of producer identification. The ability for FDA to determine the source of residues is vitally important in a coordinated government program to eliminate illegal tissue residues.

Animal Identification Systems↗
PubMed1992

Mycotoxins in foods and feeds in the United States.

Mycotoxins are considered unavoidable contaminants in foods and feeds because agronomic technology has not yet advanced to the stage at which preharvest infection of susceptible crops by fungi can be eliminated. The aflatoxins have received greater attention than any of the other mycotoxins because of their demonstrated carcinogenic effects in susceptible animals and their acute toxic effects in humans. Since 1965, the U.S. Food and Drug Administration (FDA) has enforced regulatory limits on the concentrations of these toxins in foods and feeds involved in interstate commerce. The FDA routinely monitors the food and feed industries through compliance programs to ensure that the levels of exposure to these toxins are kept as low as practical. This report summarizes data generated from compliance programs on aflatoxins for the fiscal years 1989, 1990, and the first half of 1991. Commodities sampled included peanuts and peanut products, tree nuts, corn and corn products, cottonseed, and milk. Higher than usual levels of contamination were found in corn examined from all areas of the United States in 1989 as a result of the severe drought that affected the 1988 corn crop. The drought in parts of the South and Southeast in 1990 resulted in increased contamination in corn and peanuts from those areas. A review of the surveillance data obtained on deoxynivalenol, zearalenone, ochratoxin A, sterigmatocystin, penicillic acid, and patulin over the years along with available toxicological data for these mycotoxins indicated that no regulatory actions were warranted. The lack of sufficient surveillance data on other mycotoxins that occur in the United States can be attributed in part to the unavailability of reliable analytical methodology.

Aflatoxins↗
PubMedDate not supplied

EDI system definition for a European medical device vigilance system.

EDI is expected to be the dominant form of business communication between organizations moving to the Electronic Commerce era of 2000. The healthcare sector is already using EDI in the hospital supply function as well as in the clinical area and the reimbursement process. In this paper, we examine the use of EDI in the healthcare administration sector and more specifically its application to the Medical Device Vigilance System. Firstly, the potential of this approach is examined, followed by the definition of the EDI System Reference Model and the specification of the required system architecture. Each of the architecture's components are then explained in more detail, followed by the most important implementation options relating to them.

Computer Communication Networks↗
PubMedDate not supplied

The relationship between primary care, income inequality, and mortality in US States, 1980-1995.

OBJECTIVES: This study tests the robustness of the relationships between primary care, income inequality, and population health by (1) assessing the relationship during 4 time periods-1980, 1985, 1990 and 1995; (2) examining the independent effect of components of the primary care physician supply; (3) using 2 different measures of income inequality (Robin Hood index and Gini coefficient); and (4) testing the robustness of the association by using 5-year time-lagged independent variables. DATA SOURCES/STUDY SETTING: Data are derived from the Compressed Mortality Files, the US Department of Commerce and the Census Bureau, the National Center for Health Statistics, the Centers for Disease Control and Prevention, and the American Medical Association Physician Master File. The unit of analysis was the 50 US states over a 15-year period. STUDY DESIGN: Ecological, cross-sectional design for 4 selected years (1980, 1985, 1990, 1995), and incorporating 5-year time-lagged independent variables. The main outcome measure is age-standardized, all-cause mortality per 100,000 population in all 50 US states in all 4 time periods. DATA COLLECTION/EXTRACTION METHODS: The study used secondary data from publicly available data sets. The CDC WONDER/PC software was used to obtain mortality data and directly standardize them for age to the 1980 US population. Data used to calculate the income inequality measure came from the US census population and housing summary tapes for the years 1980 to 1995. Counts of the number of households that fell into each income interval along with the total aggregate income and the median household income were obtained for each state. The Gini coefficient for each state was calculated using software developed for this purpose. RESULTS: In weighted multivariate regressions, both contemporaneous and time-lagged income inequality measures (Gini coefficient, Robin Hood Index) were significantly associated with all-cause mortality (P <.05 for both measures for all time periods). Contemporaneous and time-lagged primary care physician-to-population ratios were significantly associated with lower all-cause mortality (P <.05 for all 4 time periods), whereas specialty care measures were associated with higher mortality (P <.05 for all time periods, except 1990, where P <.1). Among primary care subspecialties, only family medicine was consistently associated with lower mortality (P <.01 for all time periods). CONCLUSIONS: Enhancing primary care, particularly family medicine, even in states with high levels of income inequality, could lead to lower all-cause mortality in those states.

Cross-Sectional Studies↗
PubMed2003

Control and prevention of emerging zoonoses.

Emerging and re-emerging zoonoses are zoonotic diseases caused by either totally new or partially new agents or by microorganisms previously known but now occurring in places or in species where the disease was previously unknown. Zoonotic diseases account for the majority of all emerging infectious diseases. Several factors have led to the emergence of these infections, including human demographics, the industrialization of food production, globalization, international travel and commerce, land use, microbial adaptation, and changes and breakdown in public health measures. Several zoonotic agents are also potential agents that could be used as biological weapons. The recent use of anthrax spores in tainted mall in the US underlines our need for preparedness against bioterrorism. Prevention and control of these emerging zoonotic diseases is based on recognition, investigation, and collaboration, the development of advanced diagnosis and surveillance tools, the use of applied epidemiology and molecular biology methods, as well as education, information, communication, and technology transfer.

Animals↗
PubMed2006

The global veterinarian: the why? The what? The how?

Globalization has created an entirely new landscape for veterinarians. Opportunities abound to meet the formidable challenges presented as animals, people, and microbes travel at a previously unimagined speed, fueled by the engine of commerce, resulting in a plethora of new diseases, issues, and partnerships. Re-tooling our profession to ensure that we can continue to fulfill our veterinary oath in the face of these changes will require both short- and long-term changes. It is essential that a single overarching, non-affiliated organization be formed to tie together all entities, providing the structure to create needed synergy to enhance our currently fragmented professional responses and to solicit funds to effect necessary changes.

Animals↗
PubMedDate not supplied

The economic impact of pandemic influenza in the United States: priorities for intervention.

We estimated the possible effects of the next influenza pandemic in the United States and analyzed the economic impact of vaccine-based interventions. Using death rates, hospitalization data, and outpatient visits, we estimated 89,000 to 207,000 deaths; 314,000 to 734,000 hospitalizations; 18 to 42 million outpatient visits; and 20 to 47 million additional illnesses. Patients at high risk (15% of the population) would account for approximately 84% of all deaths. The estimated economic impact would be US$71.3 to $166.5 billion, excluding disruptions to commerce and society. At $21 per vaccinee, we project a net savings to society if persons in all age groups are vaccinated. At $62 per vaccinee and at gross attack rates of 25%, we project net losses if persons not at high risk for complications are vaccinated. Vaccinating 60% of the population would generate the highest economic returns but may not be possible within the time required for vaccine effectiveness, especially if two doses of vaccine are required.

Adolescent↗
PubMed2005

Dead crow density and West Nile virus monitoring, New York.

New York State used the health commerce system to monitor the number of West Nile virus (WNV) human disease cases and the density of dead crows. In each year from 2001 to 2003 and for the 3 years combined, persons living in New York counties (excluding New York City) with elevated weekly dead crow densities (above a threshold value of 0.1 dead crows per square mile) had higher risk (2.0-8.6 times) for disease caused by WNV within the next 2 weeks than residents of counties reporting fewer dead crows per square mile. This type of index can offer a real-time, relatively inexpensive window into viral activity in time for prevention and control. Changes in reporting, bird populations, and immunity may require that thresholds other than 0.1 be used in later years or in other areas.

Animals↗
PubMed1999

Food-borne disease in the 21st century. What challenges await us?

As the world shrinks and international commerce expands, food-borne illness is likely to become a major public health focus worldwide. Improved surveillance, community education, thorough understanding of the food production chain, use of HACCP strategies, and ionizing radiation are all important for reducing the risks. Primary care physicians play a crucial role in surveillance and early reporting, as well as in educating the public on the importance of basic food safety.

Foodborne Diseases↗
PubMedDate not supplied

Agaricus subrufescens, a cultivated edible and medicinal mushroom, and its synonyms.

Agaricus subrufescens Peck was cultivated first in the late 1800s in eastern North America. The type consists partly of cultivated material and partly of field-collected specimens. Once a popular market mushroom, the species faded from commerce in the early 20th century. More recently, a mushroom species growing wild in Brazil has been introduced into cultivation in Brazil, Japan and elsewhere. This Brazilian mushroom has been referred to by various names, most commonly as A. blazei Murrill (sensu Heinemann) and most recently as A. brasiliensis Wasser et al. The author first cultivated A. subrufescens in 1981 and has grown and studied Brazilian isolates since 1992. The species has an amphithallic pattern of reproduction. Based on DNA sequence analysis of the rDNA ITS region and on mating studies and genetic analysis of hybrid progeny, there is a strong case for conspecificity of the Brazilian mushrooms with A. subrufescens. Based on a study of the type and other data, the recent lectotypification of A. subrufescens is accepted. Data are presented on mushrooms of diverse geographical origins, including A. rufotegulis Nauta from western Europe, another apparent conspecific. A possible role for interpopulational hybridization in current populations of A. subrufescens is proposed. The agronomic history of the species is reviewed.

Agaricus↗
PubMed2006

Nursing in tele-mental health.

This article discusses a cooperative project involving an academic health sciences center, a state university, a women's shelter, and a community mental health center in East Texas, a medically underserved, rural region of Texas. The U.S. Department of Commerce provided grant funding to develop a telehealth network to provide an evaluation, referral, and treatment program for victims of domestic violence. Nurses were involved in all phases of the project, from initial conception through development, implementation, and evaluation. The authors concluded that all of the women involved in the study had significant mental health issues and other health concerns that were not being addressed by the existing health care delivery system. Without the use of telehealth, these women would have had limited access to primary health care and virtually no access to mental health services. The East Texas Tele-Mental Health Network demonstrates the value of the clinical and organizational skills that nurses bring to innovative models of mental health service delivery.

Adult↗
PubMed1995

[Natural resources of Central America: the origin of the botanical expedition to Guatemala].

The scientific commission to Central America originated like a continuation of the three big botanical Spanish expeditions being carried out during the reign of Carlos III through the American territories. The presence of the naturalists José Longinos Martínez and José Mociño, and the painter Vicente de la Cerda at the capital of Guatemala was reason of great interest in the "Capitanía General", and it caused great impact on the Enlightened institutions of the time. Friends' of the Country Economical Society and the Consulado of commerce supported the works of the members of the expedition contributing to the institutionalization of the Natural History in Central America.

Botany↗
PubMed2005

[Globalization of higher education in Europe. The precursor of changes in Chilean medical education].

At the present time, higher education is a central process shaping the society of knowledge. The mutual strength of society and education influence worldwide changes. Globalization, that mainly embraces politics and commerce, is also promoting changes in professional training, modifying programs, structures and the organization of superior education. The European example is attractive and has a great projection. It will cause a profound impact in culture, development and life of Europeans. Universities in Latin America, in an attempt to achieve the same objectives than their European counterparts, are experiencing premonitory changes, that will have the same effects as in Europe. In the medical area, several changes will occur and we will have to provide initiatives to facilitate these changes in a timely manner. The revision of the model in its inception, is convenient to assimilate changes in our culture.

Chile↗