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PubMed2004

Seasonal variation of sudden infant death syndrome in Hawaii.

OBJECTIVE: To test whether the sudden infant death syndrome (SIDS) rate displays the universal winter maximum and summer minimum in Hawaii where there is no appreciable seasonal variation of temperature. DESIGN: The null hypothesis is tested that there is no seasonal variation of necropsied SIDS in Hawaii. The numbers of live births and SIDS cases by month for the years 1979 to 2002 were collected and the monthly SIDS distribution is predicted based on the age at death distribution. SETTING: The state of Hawaii, located in the midst of the Pacific Ocean, has a semi-tropical climate with temperatures fluctuating diurnally as 25 +/- 5 degrees C throughout the year. Therefore homes are unheated and infants are not excessively swaddled. The Hawaii State Department of Health maintains vital statistics of all infant births and deaths. MAIN RESULTS: The results reject the null hypothesis of no seasonal variation of SIDS (p = 0.026). An explanation for the seasonal effect of the winter maximum and summer minimum for Hawaiian SIDS is that it arises from the cycle of the school session and summer vacation periods that represent variable intensity of a possible viral infection vector. SIDS rates in both Hawaii and the United States increase with parity, also indicating a possible role of school age siblings as carriers. CONCLUSIONS: The winter peak of the SIDS in Hawaii is support for the hypothesis that a low grade viral infection, insufficient by itself to be a visible cause of death at necropsy, may be implicated as contributing to SIDS in vulnerable infants.

Age Distribution↗
PubMed1990

Semen quality in welders before and after three weeks of non-exposure.

In a cross sectional field study concerning the male reproductive system in metalworkers, the major findings were a moderate deterioration of semen quality in mild steel welders and less reliable changes in semen quality in low exposed stainless steel welders. In the present study, a longitudinal design was adopted to deal with methodological drawbacks inherent in the cross sectional approach. The study relies on the assumption that the effect of welding is causal and reversible. The semen quality of 19 mild steel welders, 18 stainless steel welders and 16 non-welding metal-workers, was examined before and three, five, and eight weeks after a three week break in exposure (summer vacation). No consistent improvement in any semen parameter in the follow up period relative to the prevacation period was found in either mild steel or stainless steel welders. The results indicate either a non-causal nature of reported associations between welding exposure and poor semen quality, or that the effect of welding is non-reversible within the rather short non-exposure period.

Adult↗
PubMed1991

Blood and urine concentrations of aluminium among workers exposed to aluminium flake powders.

In a group of workers exposed to aluminium flake powders, blood and urine concentrations of aluminium were assessed before and after vacation. Another group was investigated after retirement. Workers currently exposed to aluminium flake powders had urinary concentrations of the metal 80-90 times higher than those in occupationally non-exposed referents. The calculated half life for concentrations of aluminium in urine was five to six weeks based on four to five weeks of non-exposure. Among the retired workers the half lives varied from less than one up to eight years and were related to the number of years since retirement. These results indicate that aluminium is retained and stored in several compartments of the body and eliminated from these compartments at different rates.

Adult↗
PubMed1993

Increase in neuropsychiatric symptoms after occupational exposure to low levels of styrene.

The results of this study suggest that exposure to styrene below the current Swedish permissible exposure limit of 20 ppm induces neurotoxic effects expressed as an increased number of neuropsychiatric symptoms. Twenty men exposed to styrene at a plastics factory participated. The reference group included 20 non-exposed men matched for age, working schedule, and physical work load. Exposure to styrene during one workday was assessed by personal air monitoring and biological monitoring. To evaluate the physical work load the pulse(heart) rate was measured. One week before the study each man completed a neuropsychiatric symptom questionnaire containing 16 items. Also 17 questions regarding acute symptoms of local irritation and symptoms of the central nervous system were presented after the psychometric tests were performed. The tests were simple reaction time, colour word vigilance, and symbol digit. A follow up with regard to the symptoms among the exposed men was done after their summer vacation, about two to five weeks after their last exposure. The mean eight hour time weighted average (TWA) concentration of styrene in air, measured by passive dosimetry was 8.6 ppm (range 0.04-50.4 ppm). The exposed men had significantly more symptoms than the referents although there were no significant differences for the psychometric tests. At the follow up the exposed men reported fewer symptoms. This study indicates that symptoms are earlier indicators of adverse effects than complex tests and underlines the importance of regular follow up of people exposed to styrene (and probably organic solvents in general).

Acute Disease↗
PubMed2006

Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia.

This article summarises the medical problems of travel to altitudes above 3000 m. These are caused by chronic hypoxia. Acute mountain sickness (AMS), a self limiting common illness is almost part of normal acclimatisation--a transient condition lasting for several days. However, in <2% of people staying above 4000 m, serious illnesses related to hypoxia develop--high altitude pulmonary oedema and cerebral oedema. These are potentially fatal but can be largely avoided by gradual ascent. Short vacations, pressure from travel companies and peer groups often encourage ascent to 4000 m more rapidly than is prudent. Sensible guidelines for ascent are outlined, clinical features, management and treatment of these conditions.

Acute Disease↗
PubMed1984

Exocrine pancreatic insufficiency and idiopathic haemochromatosis.

The case history of a 34-year-old patient with precirrhotic idiopathic haemochromatosis and severe chronic steatorrhoea is presented. The pancreas had a normal appearance on ultrasonography and endoscopic retrograde pancreaticography. However, pancreatic function tests revealed significant abnormalities. The pancreatic output of trypsin, amylase, lipase and bicarbonate was deficient and basal and stimulated serum pancreatic polypeptide levels were subnormal. In contrast, the oral glucose tolerance test was unimpaired. The pancreatic insufficiency had started suddenly during a summer vacation and may have had a viral aetiology. The hypothesis is advanced that in haemochromatosis the iron-laden pancreatic acinar and PP-producing cells are more susceptible to damage by viruses than normal pancreatic cells.

Adult↗
PubMed2003

Burkholderia pseudomallei: another emerging pathogen in cystic fibrosis.

BACKGROUND: Burkholderia pseudomallei is an important cause of acute fulminant pneumonia and septicaemia in tropical regions of northern Australia and south east Asia. Subacute and chronic forms of the disease also occur. There have been three recent reports of adults with cystic fibrosis (CF) who presumably acquired B pseudomallei infection during extended vacations or residence in either Thailand or northern Australia. METHODS: The clinical course, molecular characteristics, serology and response to treatment are described in four adult CF patients infected with B pseudomallei. Polymerase chain reaction (PCR) based methods were used to confirm B pseudomallei and exclude B cepacia complex. Genotyping was performed using randomly amplified polymorphic DNA (RAPD) PCR and pulsed field gel electrophoresis (PFGE). RESULTS: Four patients are described with a mean duration of infection of 32 months. All but one patient lived in tropical Queensland. Two patients (with the longest duration of infection) deteriorated clinically and one subsequently died of respiratory failure. Both responded to intravenous treatment specifically targeting B pseudomallei. Another patient suffered two severe episodes of acute bronchopneumonia following acquisition of B pseudomallei. Eradication of the organism was not possible in any of the cases. PFGE of a sample isolate from each patient revealed the strains to be unique and RAPD analysis showed retention of the same strain within an individual over time. CONCLUSIONS: These findings support a potential pathogenic role for B pseudomallei in CF lung disease, producing both chronic infection and possibly acute bronchopneumonia. Identical isolates are retained over time and are unique, consistent with likely environmental acquisition and not person to person spread. B pseudomallei is emerging as a significant pathogen for patients with CF residing and holidaying in the tropics.

Adolescent↗
PubMed1978

Small animal husbandry: what should be taught?

As far as the small animals are concerned, animal husbandry refers to animal welfare and management. There are five main areas of undergraduate instruction in this subject--normal animal behaviour, nutritional requirements, restraint, housing and management in disease. University education, vacational studies and personal experience all provide important sources of knowledge. Most university instruction in small animal welfare and management is provided in the clinical courses where extensive care material can be utilised in practical teaching. Integration of the animal husbandry and clinical courses is to be encouraged.

Animal Husbandry↗
PubMed2000

The effect of acupuncture on uterine contraction induced by oxytocin.

Preterm labor (PTL) is one of the main causes of fetal mortality and morbidity in obstetrical medicine. Current methods of treatment are not very effective and often have significant side effects. For this reason new methods of preventing PTL are currently being sought. In Western medicine the newest development is oxytocin antagonists. In Oriental medicine acupuncture and moxibustion are being utilized for the purpose of stopping PTL. The goals of this study were to determine if acupuncture in pregnant rats can suppress oxytocin induced uterine contractions and to compare these results with those inhibited by an oxytocin antagonist. Uterine contractions were induced by continuous infusion of exogenous oxytocin. The first fetus in one uterine horn near the ovarian end was removed and distilled water-filled catheter was inserted into that vacated amniotic sac to measure uterine contractions as intrauterine pressure changes. Two acupoints of Ho-Ku (LI-4) and San-Yin-Chiao (Sp-6) were selected for acupuncture and Kuan-Yüan (Co-4) was used for moxibustion. The oxytocin-induced uterine contractions were significantly suppressed by acupuncture on the LI-4 (p < 0.05), but not by Sp-6. Stimulation of Co-4 by moxibustion had no significant (p > 0.05) tocolytic effect. The administration of oxytocin antagonist eliminated all the uterine contractions induced by oxytocin. The application of acupuncture to re-stimulate the activity that was suppressed by the oxytocin antagonist did not produce any positive results. However, prostaglandins did cause the uterus to contract. In conclusion, acupuncture on LI-4 was found to suppress uterine contractions induced by oxytocin in the pregnant rat. If acupuncture is similarly effective in counteracting the effects of oxytocin in women, then this may an alternative medical treatment for women in preterm labor.

Acupuncture Therapy↗
PubMed1995

How U.S. radiologists use their professional time: factors that affect work activity and retirement plans.

PURPOSE: To determine what demographic, professional, and practice characteristics are related to the amount of time radiologists work per week, to their allocation of time among professional activities, and to their plans for retirement. MATERIALS AND METHODS: The American College of Radiology surveyed 2,804 radiologists and nuclear medicine specialists. Means and percentiles were calculated for the radiologists' number of hours and days worked per week, number of weeks away, percentage allocation of time, and retirement intentions. Multiple linear and logistic regression analyses were performed. RESULTS: Full-time, post-training radiologists worked a mean of 50 hours per week. Radiologists spent 2 weeks on professional education and 4.4 weeks on vacation each year. On average, 68% of professional time was spent on hospital patient care; 18%, on office patient care; 7%, on teaching and research; and 5% on administration. Forty-one percent of radiologists planned to eventually work part-time; 47% intended to retire fully. CONCLUSION: These data will provide an important baseline for modeling the future size of the radiologist workforce and for assessing changes in the ways radiologists use their time and plan their futures.

Adult↗
PubMed1995

Professional and business characteristics of radiology groups in the United States: 1992.

PURPOSE: In response to requests, to present information on the professional and business characteristics of radiology groups. MATERIALS AND METHODS: The American College of Radiology surveyed a stratified random sample of radiology groups, defining radiology group as any practice with two or more radiologists or radiation oncologists, including academic departments, units in multispecialty groups, and staff of government facilities. The 465 responses (69% response rate) were weighted so the data show what findings would have been if all radiology groups in the country had responded. RESULTS: ACR professional standards are widely used, particularly those for mammography and radiation oncology. Seventy-eight percent of groups required continuing training of their technologists. On average, groups required 2.7 years for new members to become full partners. The average group gave full-time radiologists 11 holidays, 26 vacation days, and 11 days for continuing medical education each year. On average, groups collected 71% of total billings. Net collections (after "allowances" for Blue Shield, Medicare, and other payers are deducted from billings) averaged 86%; half of services were provided by groups with net collection rates of 90% or more. CONCLUSION: In general, changes since 1989 (when the previous Group Practice Survey was conducted) were small.

Data Collection↗
PubMed1997

Hiring by radiology groups in 1996.

PURPOSE: To determine the hiring activity of radiology groups in 1996. MATERIALS AND METHODS: A survey was mailed to a stratified, random sample of 794 radiology groups in autumn 1996. The response rate was 78%. Responses were weighted to be representative of all of the approximately 3,300 groups in the United States. Findings were compared with those of previous, similar surveys. RESULTS: In the 12 months before the survey, groups sought to hire 1,732 +/- 155 (+/- 1 standard error) diagnostic radiologists and radiation oncologists; 788 +/- 105 of these positions were to fill expansion positions, 562 +/- 86 were replacements for persons who had left the profession, and 382 +/- 78 were replacements for persons who moved to other radiology positions. During the year, an additional 500 +/- 119 positions were vacated that groups did not seek to refill. Groups succeeded in hiring 1,438 +/- 143 radiologists. The percentage of available positions that were filled did not differ across fields. Managed health care reduced the probability a group was expanding but did not otherwise affect hiring activity. CONCLUSION: The 1991-1995 decline in hiring has ceased and perhaps even reversed. There were approximately as many positions available in 1996 as were needed by graduates, although there may have been a small shortfall.

Data Collection↗
PubMed1998

Characteristics of radiology groups and of diagnostic radiologists and radiation oncologists in different types of practices.

PURPOSE: To describe the characteristics of U.S. radiology groups and of radiologists in different types of practices in 1995. MATERIALS AND METHODS: A survey was distributed to 3,024 radiologists; the response rate was 75%. Responses were weighted to represent all U.S. groups or radiologists. RESULTS: There were 3,285 groups; 340 were academic, and 356 were multispecialty. Fifty percent of groups had two to four members; 39% of radiologists were in groups with fewer than eight members, and 8% were solo practitioners. Seventy percent of all radiologists were in practices owned entirely by physicians in the practice, and 80% of these were themselves owners. Eight percent of radiologists were in government-owned practices, and 15% (primarily academic) were in privately-owned practices in which all physicians were employees. Sixty-nine percent of academic diagnostic radiologists worked primarily in one field, but this was true of only 22% of those in nonacademic groups. Solo diagnostic practitioners also typically had a broad practice but excluded high-cost modalities. Radiologists in nonacademic groups averaged more vacation days (30 d/yr) than academic (19 d/yr) or solo (12 d/yr) practitioners. Solo and locum tenens practitioners were relatively old; academic radiologists, relatively young. CONCLUSION: Through 1995, average group size has grown slowly. There are important differences among practice types, especially between academic and nonacademic practices.

Academic Medical Centers↗
PubMed1997

Plasticity of synaptic connections in sensory-motor pathways of the adult locust flight system.

We investigated possible roles of retrograde signals and competitive interactions in the lesion-induced reorganization of synaptic contacts in the locust CNS. Neuronal plasticity is elicited in the adult flight system by removal of afferents from the tegula, a mechanoreceptor organ at the base of the wing. We severed one hindwing organ and studied the resulting rearrangement of synaptic contacts between flight interneurons and afferent neurons from the remaining three tegulae (2 forewing, 1 hindwing). This was done by electric stimulation of afferents and intracellular recording from interneurons (and occasionally motoneurons). Two to three weeks after unilateral tegula lesion, connections between tegula afferents and flight interneurons were altered in the following way. 1) Axons from the forewing tegula on the operated side had established new synaptic contacts with metathoracic elevator interneurons. In addition, the amplitude of compound excitatory postsynaptic potentials elicited by electric stimulation was increased, indicating that a larger number of afferents connected to any given interneuron. 2) On the side contralateral to the lesion, connectivity between axons from the forewing tegula and elevator interneurons was decreased. 3) The efficacy of the (remaining) hindwing afferents appeared to be increased with regard to both synaptic transmission to interneurons and impact on flight motor pattern. 4) Flight motoneurons, which are normally restricted to the ipsilateral hemiganglion, sprouted across the ganglion midline after unilateral tegula removal and apparently established new synaptic contacts with tegula afferents on that side. The changes on the operated side are interpreted as occupation of synaptic space vacated on the interneurons by the severed hindwing afferents. On the contralateral side, the changes in synaptic contact must be elicited by retrograde signals from bilaterally arborizing flight interneurons, because tegula projections remain strictly ipsilateral. The pattern of changes suggests competitive interactions between forewing and hindwing afferents. The present investigation thus presents evidence that the CNS of the mature locust is capable of extensive synaptic rearrangement in response to injury and indicates for the first time the action of retrograde signals from interneurons.

Animals↗
PubMed1980

Developmental changes of synaptic endings in the nucleus vestibularis tangentialis of the chicken: degeneration of spoon endings.

The tangential nucleus, a component of the avian lateral vestibular complex, contains a unique class of very large, axosomatic endings, the spoon endings, formed en passant by the largest vestibular afferents, the colossal fibers. In the hatchling, these endings are characterized by numerous gap junctions, attachment plaques, and a few synaptic vesicle complexes on the principal cell. Spoon endings under drastic structural modifications between hatching and 21 months of age in the normal chicken. The spoon endings and their characteristic junctions disappear. However, colossal fibers and principal cells do not degenerate or even atrophy. Synapses are formed by small terminals of unidentified origin on the vacated surfaces of the principal cell bodies. It is concluded that a specific type of synaptic ending may atrophy and degenerate in the normal, young adult brain without the loss of target cells or fibers of origin.

Animals↗
PubMed1986

Microinjection of kainic acid into the hypothalamus of golden hamsters prevents vasopressin-dependent flank-marking behavior.

The purpose of this study was to define the vasopressin-sensitive area in the anterior hypothalamus-medial preoptic area (AH-MPOA) of the golden hamster that is involved in the expression of flank-marking behavior. Male hamsters implanted with guide cannulae stereotaxically aimed at various sites in the AH-MPOA were microinjected initially with 0.1 ng of arginine vasopressin (AVP) in a volume of 10 nl. Hamsters that flank-marked in response to these injections were subsequently microinjected into the same sites with kainic acid (0.2 microgram/20 nl; n = 10) or an equal volume of 1 M NaOH as a vehicle control (n = 10). Four days later hamsters were tested for odor-induced flank marking by placing them into the recently vacated home cage of other hamsters and for flank marking in response to the microinjection of AVP. Animals treated with kainic acid exhibited significantly (p less than 0.01) fewer AVP and odor-induced flank marks as compared to the number of flank marks observed prior to treatment. There was no significant reduction in the number of flank marks in hamsters microinjected with the NaOH vehicle. In another group of hamsters, microinjection of kainic acid (0.2 microgram/20 nl) into the 3rd ventricle (n = 4) and other sites of the hypothalamus (n = 4) did not significantly alter odor-induced flank marking. The locations of the microinjection sites indicate that the neurons sensitive to AVP and involved in the expression of flank-marking behavior are found in the ventromedial area of the AH-MPOA extending from the caudal border of the suprachiasmatic nucleus to the rostral limit of the supraoptic nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Communication↗
PubMed1977

Nickel content of plasma, urine and hair in contact dermatitis.

The nickle (Ni) concentrations of blood plasma, urine and scalp hair do not differ between hypersensitive and non-hypersensitive subjects. Those who are occupationally exposed have about ten times the control content of nickel in the plasma, urine and hair, whether hypersensitive or not. During vacations the Ni contents of their plasmas and urines decrease sharply. Oral administration of only 5 mg Ni (as the sulphate) increases the Ni concentration of plasma and urine to ten times the normal for more than the subsequent 24 h.

Dermatitis, Contact↗
PubMed1999

Nitric oxide and proinflammatory cytokines in nasal lavage fluid associated with symptoms and exposure to moldy building microbes.

Epidemiological data indicate that living or working in a moldy building is associated with increased risk of respiratory symptoms and disease related to inflammatory reactions, but biochemical evidence linking cause and effect is still scarce. The staff working in a mold-contaminated school, and a reference group without such exposure, were studied. Nasal lavage was performed and health data were collected with a questionnaire at the end of the spring term, after a 2.5-mo summer vacation, and at the end of the fall term. Here we show that concentrations of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and nitric oxide (NO) in nasal lavage fluid were significantly higher in the exposed than in the control subjects at the end of the first exposure period. These inflammatory mediators decreased to reference group concentrations during the period when there was no exposure and the production of NO and IL-6 increased again during the reexposure in the fall term. Reports of cough, phlegm, rhinitis, eye irritation, and fatigue paralleled the changes in the measured inflammatory markers. These results point to an association between inflammatory markers in the nasal lavage fluid, the high prevalence of respiratory symptoms among the occupants, and chronic exposure to molds in the indoor environment.

Adult↗