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At least 811 records · Page 45Linked to original sources
PubMed1986

Pitfalls in intranasal laser surgery and how to avoid them.

My experience with 250 intranasal laser surgical procedures performed with the carbon dioxide laser and the surgical microscope are described. Procedures include excision and vaporization of polyps, turbinates, tumors, telangiectasias, synechiae, nasal stenoses, intranasal cysts, papillomas, and septal spurs. Avoidance of technical problems is emphasized in this article since intranasal laser surgery is, in some respects, difficult to perform. Included are practical suggestions about patient positioning, use of protective devices, and patient selection.

Granuloma↗
PubMed1998

Deoxyadenosine metabolism in a human colon-carcinoma cell line (LoVo) in relation to its cytotoxic effect in combination with deoxycoformycin.

We have assessed the intracellular metabolism of 2'-deoxyadenosine in a human colon-carcinoma cell line (LoVo), both in the absence and in the presence of deoxycoformycin, the powerful inhibitor of adenosine deaminase. The combination of 2'-deoxyadenosine and deoxycoformycin has been reported to inhibit the growth of LoVo cells in culture. In this paper we demonstrate that the observed toxic effect is strictly dependent on cell density. In the absence of deoxycoformycin, 2'-deoxyadenosine is primarily deaminated to 2'-deoxyinosine and then converted into hypoxanthine. In the presence of the inhibitor, the deoxynucleoside, in addition to a phosphorylation process, undergoes phosphorolytic cleavage giving rise to adenine. The conversion of 2'-deoxyadenosine to adenine might represent a protective device, emerging when the activity of adenosine deaminase is reduced or inhibited. There is much evidence to indicate that the enzyme catalyzing this process may be distinct from methylthioadenosine phosphorylase and S-adenosyl homocysteine hydrolase, which are the enzymes reported to be responsible for the formation of adenine from 2'-deoxyadenosine in mammals.

Adenine Nucleotides↗
PubMed1996

Prevalence of self-reported respiratory disease symptoms among veterinarians in the Southern Netherlands.

In June 1991, 831 veterinarians registered in the Southern Netherlands were mailed a questionnaire to obtain details of work practice and health problems. One hundred fifty-two veterinarians were not eligible (retired or not working regularly), 497 practitioners returned a complete questionnaire (73% response rate). The purpose was to assess the prevalence of respiratory disease symptoms (RDS) and to compare the prevalence of RDS between occupational specialties and with a group of swine farmers. The professional specialty of each veterinarian was grouped as: small-animal practice (17%), large-animal practice (51%), mixed-animal practice (14%), and other practice (i.e., government, industry) (18%). Adjusted for age, gender, smoking, history of atopy, and use of respiratory protective devices, large-animal practitioners had a two times higher odds of chronic cough (OR = 1.8, 95% CI 1.1-2.8) or chronic phlegm production (OR = 2.1, 95% CI 1.1-3.7) and a three times higher odds of chest wheezing (OR = 2.8, 95% CI 1.3-6.3) than veterinarians with another specialty. Modelling the occurrence of RDS in veterinarians with exposure variables indicated that working more than 20 hr per week in swine confinement buildings increased the odds of occurrence of chronic cough and chronic phlegm production approximately three times, in addition to a significant effect of smoking. Besides a significant effect of smoking and history of atopy, no exposure variables other than occupation were associated with occurrence of asthmatic attacks in swine farmers and large-animal practitioners. Large-animal practitioners had a two times higher odds of asthmatic attacks (OR = 1.8, 95% CI 1.1-2.9) than swine farmers. Large-animal practitioners have a considerably higher proportion of symptoms like cough, phlegm production, a stuffed up nose, sneezing, and tearing eyes than small-animal practitioners during, and 4-8 hr after, working with animals.

Adult↗
PubMed1996

Pulmonary fibrosis in a carpenter with long-lasting exposure to fiberglass.

A 56-year-old male carpenter had a history of glass fiber inhalation for 41 years without any protective device. His chest radiograph showed small nodular opacities in lower lung fields and multiple cystic lesions and low attenuation areas in upper lung fields. Light and polarizing microscopic examinations of his transbronchial lung biopsy specimen revealed mild interstitial fibrosis and mononuclear cell infiltration in alveolar walls without birefringent substances. However, widespread depositions of small glass fibers (< 2.5 microns in length and 0.3 micron in diameter) were detected by analytical electron microscopy, which suggested their possible contribution to the development of his pulmonary fibrosis.

Glass↗
PubMed1997

Toxicity in vitro of some silicon carbides and silicon nitrides: whiskers and powders.

The objectives of this work were to investigate the toxicity of silicon carbide whiskers and powders and silicon nitride whiskers and powders and to compare their toxicity with the toxicity of crocidolite. The effects studied were inhibition of the cloning efficiency of V79 cells, formation of DNA strand breaks by means of a nick translation assay, formation of oxygen radicals in three different assays, and the ability to stimulate neutrophils to produce hydroxyl radicals. All materials showed concentration-dependent inhibition of the cloning efficiency of V79 cells. The inhibition by the most toxic whiskers was in the same order of magnitude as that of crocidolite. Milled whiskers and powders were less toxic than the whiskers. There was a high DNA breaking potential for crocidolite and four of the silicon carbide whiskers and a rather low one for the other materials. Formation of hydroxyl radicals was found for crocidolite and one of the silicon carbide whiskers. In the neutrophil activation test, there was a great variation in the different materials' abilities to activate neutrophils. There was also a good correlation between chemiluminescence and H2O2 formation. The highest activation was found in neutrophils exposed to two of the silicon carbide whiskers and one milled whisker. The conclusion of the investigation is that some of the ceramic materials studied had damaging biological effects comparable to or greater than those of crocidolite. The results from the investigation clearly imply that caution is needed in the introduction of new ceramic fiber materials, so that the correct precautions and protective devices are used in order to avoid harm to the personnel handling the material.

Air Pollutants, Occupational↗
PubMed2001

Interventions for preventing lower limb soft-tissue injuries in runners.

BACKGROUND: Overuse musculoskeletal injuries occur frequently in runners. Suggestions for prevention have focused on stretching exercises, modifying training schedules and the use of protective devices such as braces and insoles. To date, no systematic analysis of the literature on the effectiveness of these strategies in the prevention of overuse injuries has been published. OBJECTIVES: The objective of the review was to evaluate the evidence from randomised controlled trials on the prevention of lower limb soft-tissue running injuries. SEARCH STRATEGY: An electronic database search included The Cochrane Musculoskeletal Injuries Group specialised register (date of last search October 2000), The Cochrane Controlled Trials Register (The Cochrane Library, Issue 3, 1999), MEDLINE (from 1966), EMBASE (from 1980), SPORT Discus (1975-2000), HERACLES (1975-2000), ATLANTES (1980-1996), BIOSIS, CINAHL, SCISEARCH, Current Contents, Index To Theses and Dissertation Abstracts. Date of last search for these databses: May 2000. SELECTION CRITERIA: Any randomised or quasi-randomised trials evaluating interventions to prevent lower limb soft-tissue running injuries. DATA COLLECTION AND ANALYSIS: All trials fulfilling the selection criteria were assessed by two reviewers independently. Data were also extracted independently by the two reviewers using a pre-derived data extraction form. Exploratory analyses, including pooling of results from groups of trials of similar designs were undertaken, using a fixed effects model. Results were reported as relative risks (RR) with 95 per cent confidence intervals (95% CI). MAIN RESULTS: Twelve trials with 8,806 participants were included. In one trial, a single control group was matched to three different included intervention groups. The effectiveness of stretching exercises (5 trials, 1944 participants in the intervention groups, 3159 controls), and of insoles and footwear modification (5 trials, 903 participants in the intervention groups, 3006 controls) in the prevention of lower extremity soft tissue injuries associated with running is unknown. Reducing the distance, frequency and duration of running may be effective in the prevention of lower extremity soft tissue injuries associated with running (3 trials, 514 participants in intervention groups, 1663 controls). Wearing a knee brace with a patellar support ring may be effective in the prevention of running-associated anterior knee pain (1 trial, 27 participants in the intervention group, 33 controls). REVIEWER'S CONCLUSIONS: This review provides some evidence for the effectiveness of the modification of training schedules, but there is insufficient evidence to determine the effectiveness of stretching exercises for major lower limb muscle groups in reducing lower limb soft-tissue running injuries. More studies are required to confirm that knee braces may prevent knee pain, to clarify the role of stretching, and to quantify optimal training loads. Generalisability of the results may be limited by the intensive nature of military training (the context for most of the studies) and the inclusion of only small numbers of women.

Cumulative Trauma Disorders↗
PubMed1989

Mortality among workers at a municipal waste incinerator.

Mortality was investigated among 176 male workers employed for at least 1 year between 1920 and 1985 at a municipal waste incinerator. Expected numbers of deaths from 1951 to 1985 were calculated from national and local death rates, standardized for age and calendar year. There was an excess of deaths from lung cancer and, after long follow-up, for ischemic heart disease. Analysis of duration of exposure supported that the excess of ischemic heart disease was caused by occupational factors; the lung cancer cases were too few to permit conclusions in this respect. Exposure to combustion products and polycyclic aromatic compounds were common, but other occupational exposures may also have contributed to the risk excesses. Smoking habits were investigated and did not differ from the average for Swedish men in cities and towns. Some work operations are very dusty and should be performed only with appropriate protection devices.

Adolescent↗
PubMed1990

Technical workshop report: Working Group II: agricultural occupational health and safety services for farmers and ranchers.

This work group felt that there is compelling evidence that effective occupational health services are essential to improve the serious occupational safety and health problems in agriculture. Program initiatives may be stimulated by federal and state governments, but development and implementation must involve the grassroots farm community and local resources. Other countries (Sweden, Finland, Canada) are far ahead of the United States in this area and serve as examples. Developing services should be comprehensive and should include clinical, technical, and educational efforts. Marketing programs to the public must include grassroots involvement. Surveillance and program evaluation are essential in any new program efforts. Funding such programs must be shared by federal, state, local, and private resources. Regulatory options should be a minimal part of such a program, but mandatory rollover protective devices and mandatory reporting seems to be one feasible regulatory option.

Accidents, Occupational↗
PubMed1992

Fiberglass dermatitis from printed circuit boards.

Seven cases of fiberglass dermatitis among production operators in the electronics industry are reported. This was due to the repeated daily handling of printed circuit boards (PRCBs). The predominant complaint of the workers was itch of the lateral aspects of the fingers and finger webs. In six workers, unroofed vesicles, pinhead areas of postinflammatory hyperpigmentation, and excoriation marks were noted at these sites. Skin stripping of the affected sites confirmed the presence of fiberglass spicules in all cases. The glass fibers had diameters of 11-16 microns. Patch testing of six of the workers with the European Standard series of allergens revealed no relevant work-related contact sensitizers. Microscopic examination of the free edges and scrapings from the PRCBs showed glass fibers of similar fiber length and diameter to those found in the workers' skin. Fiberglass can be used as a reinforcement filling material in some types of PRCBs. Free edges of such PRCBs have easily detached fiberglass spicules. Workers in frequent contact with these PRCBs can have a fiberglass-induced irritant dermatitis. Preventive measures could include the use of PRCBs with less free fiberglass at its edges, vacuuming of the newly cut boards, use of dusting powder, protective devices and emollients, and improved personal hygiene of the workers.

Adult↗
PubMed2002

Laser-facilitated thrombectomy: a new therapeutic option for treatment of thrombus-laden coronary lesions.

To overcome the adverse complications of balloon angioplasty in thrombus burden lesions (i.e., distal embolization, platelet activation, no-reflow phenomenon with persistent myocardial hypoxemia), mechanical removal of the thrombus or distal embolization protection devices is required. Pulsed ultraviolet excimer laser light at 308 nm can vaporize thrombus and suppress platelet aggregation. Clinical experience has already shown its efficacy in acute ischemic-thrombotic acute coronary syndromes. Unlike other thrombectomy devices, a 308 nm excimer laser can ablate thrombi as well as the underlying plaque, speed up thrombus clearing, and enhance thrombolytic and GP IIb/IIIa activity. It can also be employed in patients with contraindications for systemic thrombolytic agents or GP IIb/IIIa antagonists. Our report covers clinical data and technical aspects concerning three patients with acute myocardial infarction who presented with a large thrombus burden. After successful laser-transmitted vaporization of the thrombus mass in these patients, the remaining thrombus burden was evacuated, and normal antegrade coronary flow was successfully restored. This approach can be useful for selective patients with acute coronary syndromes.

Aged↗
PubMed2001

Risk assessment of slow or no-reflow phenomenon in aortocoronary vein graft percutaneous intervention.

Slow or no-reflow phenomenon (SNR) complicates 10%-15% of cases of percutaneous intervention (PCI) in aortocoronary saphenous vein grafts (SVG). At present, there are no uniform, effective strategies to predict or prevent this common and potentially serious complication. The purpose of our study was to characterize variables correlated with the risk of SNR in SVG PCI in the era of stenting and glycoprotein IIb/IIIa receptor inhibitors. We identified 2,898 consecutive patients who had PCI, of whom 163 underwent PCI of at least one SVG. The clinical and angiographic characteristics of patients who developed SNR (SNR group) were compared with those who did not (no-SNR group). A total of 23 patients experienced SNR and 140 did not. Using a stepwise multivariate logistic regression analysis, four independent predictors for SNR were detected: probable thrombus (OR 6.9; 95% CI, 2.1-23.9; P = 0.001), acute coronary syndromes (OR 6.4; 95% CI, 2.0-25.3; P = 0.003), degenerated vein graft (OR 5.2; 95% CI, 1.7-16.6; P = 0.003), and ulcer (OR 3.4; 95% CI, 0.99-11.6; P = 0.04). The risk of developing SNR could be estimated according to the number of predictors found: low-grade risk (1%-10%) if < or = one variable was present, moderate risk (20%-40%) if two variables were present, and high risk (60%-90%) if three or more variables were present. We identified and quantified current risk factors for SNR and concluded that the risk of developing SNR during PCI in SVG can be predicted by simple clinical and angiographic variables obtained before PCI. This information may be useful when the risk of PCI has to be balanced against alternative strategies such as medical therapy or redo-bypass surgery or in the selection of those patients that will most benefit from the use of protection devices during PCI.

Aged↗
PubMed2004

Carotid artery surgery vs. stent: a cardiovascular perspective.

Stroke is a major health catastrophe that is responsible for the third most common cause of death and the leading cause of disability. Carotid artery stenosis is an important cause of brain infarctions and the risk of stroke is directly related to the severity of carotid artery stenosis and to the presence of symptoms. Familiarity with different methods of measuring degrees of carotid artery stenosis is a key in understanding the role of revascularization of this disorder. Carotid endarterectomy (CEA), surgical removal of the carotid atherosclerotic plaque, is intended to prevent stroke in patients with carotid artery stenosis and currently the most commonly performed vascular procedure in the United States. Several randomized clinical trials had demonstrated the benefits of CEA in selected groups of patients with symptomatic and asymptomatic carotid artery stenosis. However, CEA can cause stroke, the very thing it intended to prevent, and is associated with significant perioperative complications such as those related to general anesthesia, cardiac or nerve injury. Moreover, several anatomical and medical conditions may limit candidates for CEA. Carotid artery stenting (CS) is an evolving and less invasive technique for carotid artery revascularization. Recent studies demonstrated that CS with embolic protection devices has become an alternative to CEA for high-surgical-risk patients and the procedure of choice for stenoses inaccessible by surgery. The role of CS in low risk patients awaits the completion of several ongoing studies.

Algorithms↗
PubMed2005

Prevention of distal embolization and no-reflow in patients with acute myocardial infarction and total occlusion in the infarct-related vessel: a subgroup analysis of the cohort of acute revascularization in myocardial infarction with excimer laser-CARMEL multicenter study.

To overcome the adverse complications of percutaneous coronary interventions in thrombus laden lesions (i.e., distal embolization, platelet activation, no-reflow phenomenon), mechanical removal of the thrombus or distal embolization protection devices are frequently required. Pulsed-wave ultraviolet excimer laser light at 308 nm can vaporize thrombus, suppress platelet aggregation, and, unlike other thrombectomy devices, ablate the underlying plaque. The following multicenter registry was instituted to evaluate the safety and efficacy of laser ablation in patients presenting with acute myocardial infarction (AMI) complicated by persistent thrombotic occlusions. Patients with AMI and complete thrombotic occlusion of the infarct-related vessel were included in eight participating centers. Patients with further compromising conditions (i.e., cardiogenic shock, thrombolysis failures) were also included. Primary endpoint was procedural respective laser success; secondary combined endpoints were TIMI flow and % stenosis by quantitative coronary analysis and visual assessment at 1-month follow-up. Eighty-four percent of all patients enrolled (n = 56) had a very large thrombus burden (TIMI thrombus scale > or = 3), and 49% were compromised by complex clinical presentation, i.e., cardiogenic shock (21%), degenerated saphenous vein grafts (26%), or thrombolysis failures (5%). Laser success was achieved in 89%, angiographic success in 93%, and the overall procedural success rate was 86%. The angiographic prelaser total occlusion was reduced angiographically to 58% +/- 25% after laser treatment and to 4% +/- 13% final residual stenosis after adjunctive balloon angioplasty and/or stent placement. TIMI flow increased significantly from grade 0 to 2.7 +/- 0.5 following laser ablation (P < 0.001) and 3.0 +/- 0.2 upon completion of the angioplasty procedure (P > 0.001 vs. baseline). Distal embolizations occurred in 4%, no-reflow was observed in 2%, and perforations in 0.6% of cases. Laser-associated major dissections occurred in 4% of cases, and total MACE was 13%. The safety and efficacy of excimer laser for thrombus dissolution in a cohort of high-risk patients presenting with AMI and total thrombotic occlusion in the infarct-related vessel are encouraging and should lead to further investigation.

Aged↗
PubMed2005

FilterWire Ex membrane tear from plaque burden.

Distal protection devices have reduced complications arising from distal embolization of atherosclerotic plaque. However, even while used as recommended, potential complications could arise. We report two cases in which the atherosclerotic plaque captured in the FilterWire EX tore through its filter membrane during the retrieval process.

Aged↗