RESUMO
Objective: This study aims to evaluate long-term complications after tonsil surgery using an exploratory retrospective cohort study design based on data from the Swedish Quality Register for Tonsil Surgery (SQTS). Methods: All patients registered in the SQTS between 1 January 2009 and 31 May 2021 were eligible for the study. In this study, a long-term complication is defined as any complication persisting for a minimum of 6 months after surgery. The definition of a complication was based on individual patient reports, provided in a free text format, of any remaining issues 6 months after tonsil surgery. Complications were categorized as follows: disturbed taste or sense of smell, dysphagia, miscellaneous and general symptoms and signs, miscellaneous throat problems, pain or discomfort in the mouth or throat, problems with jaws or teeth, problems with the ears or hearing, problems with the nose or sinuses, problems with throat secretions or throat clearing, problems with voice or speech, and sensory symptoms. A multivariable logistic regression analysis was used to identify independent predictors of long-term complications. Results: In total, 54,462 patients were included in the study. A total of 3,780 patients (6.9%) reported one or more long-term complications. The most frequent long-term complications, with a plausible connection to the surgery, were found in the following categories: pain or discomfort in the mouth or throat (1.9%), problems with throat secretions or throat clearing (0.8%), dysphagia (0.6%), and problems with voice or speech (0.6%). Tonsillotomy was associated with a lower risk of long-term complications than tonsillectomy. Conclusion: This study suggests that subjective long-term complications after tonsil surgery, in general, are relatively common (6.9%). However, complications with a plausible connection to the surgery were less common (4.0%), and specific complications seemed to be relatively rare, with no single specific problem reaching a prevalence of ≥0.6%.
RESUMO
Obstructive sleep disordered breathing (OSDB) is a spectrum from habitual snoring and labored breathing to obstructive sleep apnea (OSA), which is common and potentially serious in children. The process contains a new question at child care centers, directed at caretakers with children at age 18 months and 3 years, concerning habitual snoring (3 times a week or more). A primary care doctor verifies the suspicion of OSDB in case of a positive answer to one of 7 additional questions or 4 status findings (e.g. tonsil hypertrophy). The process starts with the suspicion of OSDB, from the age of 18 months to 18 years, and ends when symptoms are improved after watchful waiting or upper airway surgery. National equality is a goal, with increased access to nocturnal respiratory recordings of children with comorbidities or doubtful cases. Also, with short waiting time to first visit at ORL department, and to surgery. Children with comorbidities or severe symptoms get postoperative follow-ups with a nurse after 6 months. The new ICD code for OSDB is R06.8A.
Assuntos
Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Tonsilectomia , Criança , Humanos , Lactente , Ronco/cirurgia , Suécia , Apneia Obstrutiva do Sono/terapia , Apneia Obstrutiva do Sono/cirurgia , Síndromes da Apneia do Sono/cirurgiaRESUMO
Very little is known about the dermal uptake of isocyanates, and dermal exposure to isocyanates has been discussed as a factor involved in the induction of respiratory diseases. To investigate the dermal uptake of diphenylmethane-4,4'-diisocyanate (4,4'-MDI). Four volunteers were dermally exposed to 10, 25, 49 and 50 mg 4,4'-MDI, respectively, for eight hours. The exposed areas were tape stripped. Urine and blood were biologically monitored for 48 hours. Tape strips, plasma, and urine were analysed by liquid chromatography-mass spectrometry. In total, 35-70% of the applied dose of 4,4'-MDI was absorbed by the skin. Very low fractions of applied dose were found in the tape strips. The 4,4'-MDA concentration in plasma and urine was low, but peaked in urine at 10-14 hours and plasma at 8-32 hours after exposure. 4,4'-MDI is readily absorbed by human skin. Only small fractions of 4,4'-MDI remain as such in the superficial skin layers. The amounts found in blood and urine were only small fractions of the total applied doses which indicates that very small amounts of 4,4'-MDI penetrate the skin and reach the blood stream. The dermal uptake and distribution of 4,4'-MDI is much slower compared to that associated with airway uptake. Our data strongly indicate that formation of 4,4'-MDA from 4,4'-MDI upon reacting with water in the skin can only occur to a very limited extent.
Assuntos
Isocianatos/farmacocinética , Absorção Cutânea , Administração Cutânea , Adulto , Braço , Feminino , Humanos , Isocianatos/administração & dosagem , Isocianatos/sangue , Isocianatos/urina , Masculino , Pessoa de Meia-Idade , Fita Cirúrgica , Adulto JovemRESUMO
The crossreactivity of molecularly imprinted polymers (MIPs) and its practical implications are discussed. Screening of MIP libraries is presented as a fasttrack route to discovery of resins selective towards new targets, exploiting the fact that MIPs imprinted with one type of template molecule also show recognition to related and sometimes also to apparently unrelated molecules. Several examples from our own and others' studies are presented that illustrate this crossreactivity and the pattern of recognition is discussed for selected examples.
Assuntos
Impressão Molecular/métodos , Polímeros/química , Polímeros/síntese químicaRESUMO
BACKGROUND: To investigate the dermal uptake of 4,4'-diphenylmethane diisocyanate (4,4'-MDI), a study was performed in which 2 female volunteers were exposed to 10 and 25 mg, respectively, of 4,4'-MDI by applying 2.0% 4,4'-MDI in petrolatum over areas where the surface concentration corresponded to 800 µg/cm(2) . Ten days later, they developed eczematous dermatitis at the area of application. OBJECTIVES: To investigate whether the dermal application caused active sensitization to 4,4'-MDI. METHODS: Chemical analysis of the 4,4'-MDI preparation used in the application and the amount of 4,4'-MDI not absorbed by the skin was performed with liquid chromatography-mass spectrometry. The volunteers were tested with serial dilutions of 4,4'-MDI and the potentially cross-reacting substances 4,4'-diaminodiphenylmethane (4,4'-MDA), p-phenylenediamine (PPD), and dicyclohexylmethane-4,4'-diisocyanate (DMDI). RESULTS: Patch test results suggested that the volunteers were actively sensitized to 4,4'-MDI following the dermal uptake study, as they reacted positively to 4,4'-MDA, a marker for 4,4'-MDI allergy. No positive reactions were seen to PPD or DMDI. Chemical investigation confirmed that the correct concentration had been used for the dermal uptake study, and showed that about 70% of the applied 4,4'-MDI was not absorbed. CONCLUSIONS: A dermal uptake study with 4,4'-MDI in 2.0% pet. with an occlusion time of 8 hr induced active sensitization to 4,4'-MDI and subsequently to 4,4'-MDA.
Assuntos
Compostos de Anilina/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Eczema/induzido quimicamente , Isocianatos/efeitos adversos , Vaselina/química , Absorção Cutânea , Administração Cutânea , Adulto , Compostos de Anilina/química , Dermatite Alérgica de Contato/diagnóstico , Eczema/diagnóstico , Feminino , Humanos , Isocianatos/química , Testes do Emplastro , Fatores de Tempo , Adulto JovemRESUMO
Resin acids are constituents of natural and technical products of widespread use. Exposure is known to cause health effects in the airways and on the skin. Liquid chromatography/positive ion electrospray-mass spectrometry (HPLC/pos ESI-MS) was investigated for determination of 7-oxodehydroabietic (7-OXO), dehydroabietic (DHAA) and abietic acid (AA) in wood dust-containing air samples as a derivatisation-free alternative to the GC/FID HSE method 83/2, developed by the Health and Safety Executive UK. The resin acid 7-OXO was measured as a marker for oxidised resin acids, which are known to be the main contact allergens in colophonium. The found detection limits were 0.42 ng m(-3) for 7-OXO, 5.2 ng m(-3) for DHAA and 9.4 ng m(-3) for AA, respectively, which are considerably lower than with the GC/FID method (24, 115 and 89 ng m(-3)). The two methods correlated well, although consistently and significantly lower concentrations of 7-OXO were detected with LC/MS. The higher concentration of this compound with MDHS 83/2 is suggested to be an artefact from the derivatisation step in the presence of soluble wood dust remains.
Assuntos
Abietanos/análise , Poluentes Atmosféricos/análise , Monitoramento Ambiental/instrumentação , Madeira/química , Abietanos/química , Poluentes Atmosféricos/química , Cromatografia Gasosa , Cromatografia Líquida de Alta Pressão , Poeira/análise , Espectrometria de Massas por Ionização por ElectrosprayRESUMO
OBJECTIVES: To study the correlation between Sunnybrook and House-Brackmann facial grading systems at different time points during the course of peripheral facial palsy. STUDY DESIGN: Prospective multicenter trial. SETTING: Seventeen otorhinolaryngological centers. SUBJECTS AND METHODS: Data are part of the Scandinavian Bell's palsy study. The facial function of 1920 patients with peripheral facial palsy was assessed 5397 times with both Sunnybrook and House-Brackmann (H-B) facial grading systems. Grading was done at initial visit, at days 11 to 17 of palsy onset, and at 1 month, 2 months, 3 months, 6 months, and 12 months. Statistical evaluation was by Spearman correlation coefficient and box plot analysis. RESULTS: Spearman correlation coefficient varied from -0.81 to -0.96, with the weakest correlation found at initial visit. Box plot analysis for all assessments revealed that Sunnybrook scores were widely spread over different H-B grades. With 50% of the results closest to the median, Sunnybrook composite scores varied in H-B grades as follows: H-B I, 100; H-B II, 71 to 90; H-B III, 43 to 62; H-B IV, 26 to 43; H-B V, 13 to 25; and H-B VI, 5 to 14. CONCLUSION: Gradings correlated better in follow-up assessments than at initial visit. As shown by the wide overlap of the grading results, subjective grading systems are only approximate. However, a conversion table for Sunnybrook and H-B gradings was obtained and is included in the article. It can be used for further development of facial grading systems.
Assuntos
Paralisia de Bell/classificação , Paralisia Facial/classificação , Aciclovir/análogos & derivados , Aciclovir/uso terapêutico , Adolescente , Adulto , Idoso , Antivirais/uso terapêutico , Paralisia de Bell/tratamento farmacológico , Paralisia de Bell/fisiopatologia , Assimetria Facial/diagnóstico , Músculos Faciais/fisiopatologia , Paralisia Facial/tratamento farmacológico , Paralisia Facial/fisiopatologia , Glucocorticoides/uso terapêutico , Humanos , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Valaciclovir , Valina/análogos & derivados , Valina/uso terapêutico , Adulto JovemRESUMO
OBJECTIVE: To evaluate if treatment start and age are related to the outcome in Bell's palsy patients treated with prednisolone. STUDY DESIGN: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING: Sixteen otorhinolaryngologic centers in Sweden and 1 in Finland. PATIENTS: Data were collected from the Scandinavian Bell's palsy study. A total of 829 patients were treated within 72 hours of onset of palsy. Follow-up was 12 months. INTERVENTION: Patients were randomly assigned to treatment with placebo plus placebo (n = 206), prednisolone plus placebo (n = 210), valacyclovir plus placebo (n = 207), or prednisolone plus valacyclovir (n = 206). MAIN OUTCOME MEASURES: Facial function was assessed with the Sunnybrook grading system, and complete recovery was defined as Sunnybrook = 100. Time from onset of palsy to treatment start was registered. RESULTS: Patients treated with prednisolone within 24 hours and 25 to 48 hours had significantly higher complete recovery rates, 66% (103/156) and 76% (128/168), than patients given no prednisolone, 51% (77/152) and 58% (102/177) (p = 0.008 and p = 0.0003, respectively). For patients treated within 49 to 72 hours of palsy onset, there were no significant differences. Patients aged 40 years or older had significantly higher complete recovery rates if treated with prednisolone, whereas patients aged younger than 40 years did not differ with respect to prednisolone treatment. However, synkinesis was significantly less in patients younger than 40 years given prednisolone (p = 0.002). CONCLUSION: Treatment with prednisolone within 48 hours of onset of palsy resulted in significantly higher complete recovery rates and less synkinesis compared with no prednisolone.
Assuntos
Aciclovir/análogos & derivados , Antivirais/administração & dosagem , Paralisia de Bell/tratamento farmacológico , Glucocorticoides/administração & dosagem , Prednisolona/administração & dosagem , Valina/análogos & derivados , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Adolescente , Adulto , Idoso , Antivirais/uso terapêutico , Método Duplo-Cego , Esquema de Medicação , Quimioterapia Combinada , Feminino , Finlândia , Glucocorticoides/uso terapêutico , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Estudos Prospectivos , Recuperação de Função Fisiológica , Suécia , Fatores de Tempo , Resultado do Tratamento , Valaciclovir , Valina/administração & dosagem , Valina/uso terapêuticoRESUMO
OBJECTIVE: To evaluate the effect of prednisolone and valacyclovir on ipsilateral pain around the ear and in the face or neck in Bell's palsy. The incidence and intensity of pain during the first 2 months of palsy and its prognostic value were also assessed. STUDY DESIGN: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING: Sixteen tertiary referral centers in Sweden and 1 in Finland. PATIENTS: Data are part of the Scandinavian Bell's palsy study; 829 patients aged 18 to 75 years with onset of palsy within 72 hours were included. Follow-up time was 12 months. INTERVENTION: Patients were assigned to 1 of 4 treatment arms in a factorial fashion: placebo plus placebo; prednisolone 60 mg daily for 5 days, then tapering for 5 days, plus placebo; valacyclovir 1,000 mg 3 times daily for 7 days plus placebo; or prednisolone plus valacyclovir. MAIN OUTCOME MEASURES: Pain was registered on a visual analog scale within 72 hours, at Days 11 to 17, 1 month, and 2 months. Facial function was assessed with the Sunnybrook and House-Brackmann systems. RESULTS: Prednisolone and/or valacyclovir did not significantly affect the incidence or intensity of pain during the first 2 months. Pain was registered in 542 (65%) of 829 patients. At 2 months, 53 (8%) of 637 patients still reported pain. Subjects with pain at Days 11 to 17 had lower facial recovery rates at 12 months than those with no pain (p < 0.0001). CONCLUSION: Prednisolone and/or valacyclovir did not affect the incidence or intensity of ipsilateral pain in Bell's palsy. The incidence of pain was similar during the first 2 weeks and then decreased. Presence of pain at Days 11 to 17 indicated a worse prognosis for facial recovery.
Assuntos
Aciclovir/análogos & derivados , Anti-Inflamatórios/uso terapêutico , Antivirais/uso terapêutico , Paralisia de Bell/complicações , Paralisia de Bell/tratamento farmacológico , Dor/tratamento farmacológico , Dor/etiologia , Prednisolona/uso terapêutico , Valina/análogos & derivados , Aciclovir/uso terapêutico , Adulto , Método Duplo-Cego , Dor de Orelha/tratamento farmacológico , Dor de Orelha/etiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Cervicalgia/tratamento farmacológico , Cervicalgia/etiologia , Medição da Dor , Prognóstico , Estudos Prospectivos , Resultado do Tratamento , Valaciclovir , Valina/uso terapêuticoRESUMO
BACKGROUND: Previous trials of corticosteroid or antiviral treatments for Bell's palsy have been underpowered or have had insufficient follow-up. The aim of this study was to compare the short-term and long-term effects of prednisolone and valaciclovir in the recovery of the affected facial nerve in a large number of patients. METHODS: In this randomised, double-blind, placebo-controlled, multicentre trial, patients aged 18 to 75 years who sought care directly or were referred from emergency departments or general practitioners within 72 h of onset of acute, unilateral, peripheral facial palsy, between May, 2001, and September, 2006, were assessed. Patients were randomly assigned in permuted blocks of eight to receive placebo plus placebo; 60 mg prednisolone per day for 5 days then reduced by 10 mg per day (for a total treatment time of 10 days) plus placebo; 1000 mg valaciclovir three times per day for 7 days plus placebo; or prednisolone (10 days) plus valaciclovir (7 days). Follow-up was for 12 months. The primary outcome event was time to complete recovery of facial function, as assessed with a regional Sunnybrook scale score of 100 points. Analysis was by modified intention to treat. This study is registered with ClinicalTrials.gov, number NCT00510263. FINDINGS: Of 839 patients who were randomly assigned, 829 were included in the modified intention-to-treat analysis: 206 received placebo plus placebo, 210 prednisolone plus placebo, 207 valaciclovir plus placebo, and 206 prednisolone plus valaciclovir. Time to recovery was significantly shorter in the 416 patients who received prednisolone compared with the 413 patients who did not (hazard ratio 1.40, 95% CI 1.18 to 1.64; p<0.0001). There was no difference in time to recovery between the 413 patients treated with valaciclovir and the 416 patients who did not receive valaciclovir (1.01, 0.85 to 1.19; p=0.90). The number of patients with adverse events was similar in all treatment arms. INTERPRETATION: Prednisolone shortened the time to complete recovery in patients with Bell's palsy, whereas valaciclovir did not affect facial recovery.
Assuntos
Aciclovir/análogos & derivados , Paralisia de Bell/tratamento farmacológico , Prednisolona/administração & dosagem , Valina/análogos & derivados , Aciclovir/administração & dosagem , Aciclovir/efeitos adversos , Adolescente , Adulto , Idoso , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Paralisia de Bell/fisiopatologia , Método Duplo-Cego , Esquema de Medicação , Quimioterapia Combinada , Feminino , Herpes Simples/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Prednisolona/efeitos adversos , Recuperação de Função Fisiológica/efeitos dos fármacos , Recuperação de Função Fisiológica/fisiologia , Fatores de Tempo , Resultado do Tratamento , Valaciclovir , Valina/administração & dosagem , Valina/efeitos adversos , Adulto JovemRESUMO
OBJECTIVES: This study attempted to identify changes in exposure to environmental tobacco smoke, as well as symptoms and attitudes among hospitality workers after the introduction of extended smoke-free workplace legislation. METHODS: A total of 37 volunteers working in bingo halls and casinos (gaming workers) and 54 bars and restaurant employees (other workers) in nine Swedish communities participated in the study. Altogether 71 of 91 persons (14 daily smokers and 57 nonsmokers) participated in both the pre-ban baseline survey and the follow-up 12 months after the ban. Exposure to environmental tobacco smoke, smoking habits, respiratory and sensory symptoms, and attitudes towards the ban were recorded, and spirometry was carried out. RESULTS: The frequency of reported respiratory and sensory symptoms was approximately halved among the nonsmokers in both occupational groups after the introduction of the ban. Initially 87% had exposure to environmental tobacco smoke that was over the nicotine cut-off level chosen to identify possible health risk ( <0.5 microg/m3) while, after the ban, it was only 22%, a relative risk of 0.25 (95% confidence interval 0.15-0.41). The risk decreased in both occupational groups, but gaming workers experienced the highest pre-ban exposure levels. Attitudes towards the legislation were largely positive, particularly after the ban. However, there was no notable change in lung function, and there was no notable reduction in the number of cigarettes consumed by smokers. CONCLUSIONS: The introduction of smoke-free legislation was associated with a substantial reduction in respiratory and sensory symptoms, as well as reduced exposure to environmental tobacco smoke at work, particularly among gaming workers.
Assuntos
Atitude Frente a Saúde , Exposição Ocupacional/prevenção & controle , Política Pública , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Cotinina/urina , Feminino , Jogo de Azar , Humanos , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia , Restaurantes , Espirometria , Suécia/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/análiseRESUMO
A new method, involving SPE and HPLC/UV diode-array detection (DAD), was developed for the quantification of colophonium components in different consumer products, such as cosmetics. Colophonium is a common cause of contact dermatitis since its components can oxidize into allergens on exposure to air. Three different resin acids were used as markers for native and oxidized colophonium, abietic acid (AbA), dehydroabietic acid (DeA), and 7-oxodehydroabietic acid (7-O-DeA). The SPE method, utilizing a mixed-mode hydrophobic and anion exchange retention mechanism, was shown to yield very clean extracts. The use of a urea-embedded C(12) HPLC stationary phase improved the separation of the resin acids compared to common C(18). Concentrations higher than 2 mg/g of both AbA and DeA were detected in wax strips. In this product also 7-O-DeA, a marker for oxidized colophonium, was detected at a level of 28 microg/g. The LODs were in the range of 7-19 microg/g and the LOQs 22-56 microg/g. The method is simple to use and can be applied on many types of technical products, not only cosmetics. For the first time, a method for technical products was developed, which separates AbA from pimaric acid.
Assuntos
Abietanos/análise , Ácido Abscísico/análise , Etanolaminas/análise , Resinas Vegetais/análise , Resinas Vegetais/química , Extração em Fase Sólida/métodos , Abietanos/síntese química , Cromatografia Líquida de Alta Pressão/instrumentação , Cromatografia Líquida de Alta Pressão/métodos , Conformação Molecular , Sensibilidade e Especificidade , Extração em Fase Sólida/instrumentação , Espectrofotometria Ultravioleta/instrumentação , Espectrofotometria Ultravioleta/métodos , EstereoisomerismoRESUMO
The purpose of this study was to develop a sensitive and specific method for quantifying dermal exposure to the resin acids 7-oxodehydroabietic acid (7-OXO), dehydroabietic acid (DHAA), abietic acid (AA), and pimaric acid (PA). In addition the method was evaluated in occupational settings during production of wood pellets. Tape-strips were spiked with the substances to evaluate the recovery of the acids from the tape. The removal efficiency of the tape was assessed by tape-stripping a specified area on a glass plate spiked with resin acids. The recovery of the acids from human skin in vivo was evaluated by applying acids in methanol onto the skin of volunteers. Occupational dermal exposure to the resin acids was assessed by tape-stripping the skin of workers involved in the production of wood pellets. The resin acids were analyzed by liquid chromatography mass spectrometry (LC-MS). The limit of detection was 15 pg (7-OXO), 150 pg (DHAA), 285 pg (AA) and 471 pg (PA) per injection. The recovery from spiked tapes was in general 100%. The removal efficiency of the tape was 48-101%. Recovery tests from human skin in vivo showed a mean recovery of 27%. Quantifiable amounts of resin acids were observed on four different skin areas with an increase in exposure during a work shift. This study shows that occupational dermal exposure to resin acids can be assessed by tape-stripping and quantified by LC-MS.
Assuntos
Derme/efeitos dos fármacos , Monitoramento Ambiental/métodos , Exposição Ocupacional , Resinas Vegetais/toxicidade , Absorção Cutânea/efeitos dos fármacos , Abietanos/análise , Abietanos/toxicidade , Derme/metabolismo , Diterpenos/análise , Diterpenos/toxicidade , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Saúde Ocupacional , Fenantrenos/análise , Fenantrenos/toxicidade , Resinas Vegetais/análise , Sensibilidade e Especificidade , Absorção Cutânea/fisiologia , Local de TrabalhoRESUMO
The main aim of this study was to investigate exposure to airborne substances that are potentially harmful to health during the production of wood pellets, including wood dust, monoterpenes, and resin acids, and as an indicator of diesel exhaust nitrogen dioxide. In addition, area measurements were taken to assess background exposure levels of these substances, volatile organic compounds (VOCs), and carbon monoxide. Measurements were taken at four wood pellet production plants from May 2004 to April 2005. Forty-four workers participated in the study, and a total of 68 personal measurements were taken to determine personal exposure to wood dust (inhalable and total dust), resin acids, monoterpenes, and nitrogen dioxide. In addition, 42 measurements of nitrogen dioxide and 71 measurements of total dust, resin acids, monoterpenes, VOCs, and carbon monoxide were taken to quantify their indoor area concentrations. Personal exposure levels to wood dust were high, and a third of the measured levels of inhalable dust exceeded the Swedish occupational exposure limit (OEL) of 2 mg/m3. Parallel measurements of inhalable and total dust indicated that the former were, on average, 3.2 times higher than the latter. The data indicate that workers at the plants are exposed to significant amounts of the resin acid 7-oxodehydroabietic acid in the air, an observation that has not been recorded previously at wood processing and handling plants. The study also found evidence of exposure to dehydroabietic acid, and exposure levels for resin acids approached 74% of the British OEL for colophony, set at 50 microg/m3. Personal exposure levels to monoterpenes and nitrogen dioxide were low. Area sampling measurements indicated that aldehydes and terpenes were the most abundant VOCs, suggesting that measuring personal exposure to aldehydes might be of interest. Carbon monoxide levels were under the detection limit in all area measurements. High wood dust exposure levels are likely to have implications for worker health; therefore, it is important to reduce exposure to wood dust in this industry.
Assuntos
Poluentes Ocupacionais do Ar/análise , Poeira/análise , Exposição Ocupacional/análise , Resinas Vegetais/análise , Madeira/análise , Monitoramento Ambiental/métodos , Humanos , Manufaturas , Suécia , VolatilizaçãoRESUMO
A confirmatory method is described for the determination of the illegal antibiotic chloramphenicol using a specifically developed molecularly imprinted polymer (MIP) as the sample clean-up technique. The newly developed MIP was produced using an analogue to chloramphenicol as the template molecule. Using an analogue of the analyte as the template avoids a major traditional drawback associated with MIPs of residual template leeching or bleeding. The MIP described was used as a solid-phase extraction phase for the extraction of chloramphenicol from various sample matrices including honey, urine, milk and plasma. A full analytical method with quantification by LC-MS/MS is described. The method was fully validated according to the European Union (EU) criteria for the analysis of veterinary drug residues.
Assuntos
Técnicas de Química Analítica/métodos , Cloranfenicol/análise , Polímeros/química , Animais , Calibragem , Bovinos , Cloranfenicol/sangue , Cloranfenicol/urina , Mel/análise , Humanos , Reprodutibilidade dos Testes , Extração em Fase SólidaRESUMO
OBJECTIVES: The objectives were to compare the duration of use of polymeric tracheostomy tubes, i.e., silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU), and to determine whether surface changes in the materials could be observed after 30 days of patient use. METHODS: Data were collected from patient and technical records for all tracheostomized patients attending the National Respiratory Center in Sweden. In the surface study, 19 patients with long-term tracheostomy were included: six with Bivona TTS Si tubes, eight with Shiley PVC tubes, and five with Trachoe Twist PU tubes. All tubes were exposed in the trachea for 30 days before being analyzed by scanning electron microscopy (SEM) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). New tubes and tubes exposed in phosphate-buffered saline were used as reference. RESULTS: Si tubes are used for longer periods of time than those made of PVC (P<.0001) and PU (P=.021). In general, all polymeric tubes were used longer than the recommended 30-day period. Eighteen of the 19 tubes exposed in patients demonstrated, in one or more areas of the tube, evident surface changes. The morphologic changes identified by SEM correlate well with the results obtained by ATR-FTIR. CONCLUSIONS: Si tracheostomy tubes are in general used longer than those made of PVC and PU. Most of the tubes exposed in the trachea for 30 days suffered evident surface changes, with degradation of the polymeric chains as a result.
Assuntos
Intubação Intratraqueal/instrumentação , Polímeros , Traqueostomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Feminino , Humanos , Masculino , Teste de Materiais , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Poliuretanos , Cloreto de Polivinila , Sistema de Registros , Elastômeros de Silicone , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície , Fatores de Tempo , Traqueostomia/instrumentaçãoRESUMO
A novel method for detection of reducing ends of sugars is proposed, based on the use of [Formula: see text] as the oxidant in combination with amperometric detection and flow injection analysis (FIA). The method is very sensitive, giving values of <10 muM for the limit of detection for a series of mono- and oligosaccharides. Samples can be analysed every 30 s, and injection can be made fully automated, making it possible to perform on-line analysis of polysaccharide samples subjected to hydrolysis. Three methylcelluloses (MC) of different qualities were hydrolysed with three different glucanases, and the concentrations of reducing ends prior to, during and after hydrolysis were determined. Differences were observed between the results obtained using different combinations of enzymes and MCs, which revealed different selectivities of the various enzymes for the different substrates. One MC was also hydrolysed and analysed in real-time for three hours. The method proposed is superior to many of the standard methods used today, which require manual labour and have a lower sensitivity.
Assuntos
Técnicas de Química Analítica/métodos , Eletroquímica/métodos , Enzimas/análise , Análise de Injeção de Fluxo/métodos , Metilcelulose/análise , Relação Dose-Resposta a Droga , Desenho de Equipamento , Ferricianetos/química , Hidrólise , Metilcelulose/química , Modelos Químicos , Oligossacarídeos/química , Temperatura , Fatores de TempoRESUMO
Idiopathic facial paralysis, or Bell's palsy, shows a nonepidemic pattern that might indicate reactivation of a latent microorganism such as herpes simplex type I as a causative agent. Thirty percent of patients with Bell's palsy given no treatment will not recover completely, and 5% will have severe sequelae. The aim of this study was to find out whether treatment with an antiviral drug in combination with corticosteroids is more effective than no medical treatment at all in patients with Bell's palsy. Fifty-six consecutive adult patients attending the otorhinolaryngology department of the University Hospital of Lund from 1997 to 1999 were treated with 1 g of valacyclovir hydrochloride 3 times per day for 7 days and 50 mg of prednisone daily for 5 days, with the dose being reduced by 10 mg daily for the next 5 days. Fifty-six adult patients with Bell's palsy attending the same department between 1995 and 1996 who were given no medical treatment were studied retrospectively and used as the control group. Forty-nine patients (87.5%) in the treatment group recovered completely, as compared with 38 patients (68%) in the control group (p < .05). One patient (1.8%) in the treatment group displayed severe sequelae, defined as a House-Brackmann score of IV or worse, as compared with 10 of 56 patients (18%) in the control group (p < .01). Among patients over 60 years old, 10 of 10 in the treatment group had complete recovery, as compared with 5 of 12 patients in the control group (p < .01). The present study showed a significantly better outcome in patients with Bell's palsy treated with valacyclovir and prednisone as compared with patients given no medical treatment. This difference in outcome was especially pronounced among elderly patients.