Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care.

INTRODUCTION Cyanoacrylate glue embolization (CAGE) is a non-surgical procedure that uses a proprietary medical adhesive, delivered endovenously to close truncal, varicose veins. AIM To describe CAGE administered by a New Zealand general practitioner (GP) in primary care. METHODS The procedures were performed by a single GP with a special interest and 19 years' clinical experience in procedural phlebology. The clinical records of 107 consecutive patients who underwent CAGE over a 2-year period were retrospectively reviewed. Some patients had bilateral disease and some had more than one truncal vein per leg treated. Data on 173 truncal veins were included in the audit. Clinical data, procedural details and postprocedural course were recorded and analysed for 71 females and 36 males. RESULTS In total, 173 truncal veins were treated. They included the anterior accessory saphenous vein, the great saphenous vein, the small (lesser) saphenous vein and the thigh extension with a range of clinical severity. The most commonly treated truncal vein was the great saphenous vein with an average truncal diameter of 8.8mm (2.9s.d.). Of the 173 treated truncal veins, two failed to seal with CAGE, but were sealed after adjuvant ultrasound-guided foam sclerotherapy treatment. Post CAGE, 14.5% of treated truncal veins developed a phlebitis. DISCUSSION This audit shows that varicose veins can be treated in general practice with high levels of anatomic efficacy and few adverse effects.

Impact of light rail transit on traffic-related pollution and stroke mortality.

OBJECTIVES: This paper evaluates the changes in vehicle exhaust and stroke mortality for the general public residing in the surrounding area of the light rail transit (LRT) in Houston, Texas, after its opening. METHODS: The number of daily deaths due to stroke for 2002-2005 from the surrounding area of the original LRT line (exposure group) and the control groups was analyzed using an interrupted time-series analysis. Ambient concentrations of acetylene before and after the opening of LRT were also compared. RESULTS: A statistically significant reduction in the average concentration of acetylene was observed for the exposure sites whereas the reduction was negligible at the control site. Poisson regression models applied to the stroke mortality data indicated a significant reduction in daily stroke mortality after the opening of LRT for the exposure group, while there was either an increase or a considerably smaller reduction for the control groups. CONCLUSIONS: The findings support the idea that LRT systems provide health benefits for the general public and that the reduction in motor-vehicle-related air pollution may have contributed to these health benefits.

Burns from acetylene gas: more than skin deep.

Oxyacetylene welding torches are commonly used in industry, yet serious burns are fortunately rare. When dealing with the sequelae of these burn injuries, one must be aware of the high pressure component of these flame burns, which can penetrate and dissect the subcutaneous tissue. Appropriate initial assessment and preoperative planning are, therefore, essential to exclude and identify problems such as, compartment syndrome, subcutaneous emphysema and acute carpal tunnel syndrome. We present a case in which an innocuous palmar burn revealed a penetrating flame injury into the carpal tunnel.

Calcium carbide related ocular burn injuries during mango ripening season of West Bengal, eastern India.

INTRODUCTION: Calcium carbide used in fruit ripening industry as a cheap alternative to natural plant hormone ethylene produces highly inflammable acetylene gas. Inadvertent ignition of this gas can cause severe ocular burn injury with unilateral or bilateral blindness. OBJECTIVE: To determine the characteristics and visual outcome of ocular burn injuries from calcium carbide during mango ripening season of West Bengal, eastern India. MATERIALS AND METHODS: A prospective study of all cases of calcium carbide related ocular burn injury attending a tertiary care hospital during mango ripening season was carried out. The demographic features, characteristics of the injury, management and outcomes were recorded. RESULTS: Fifty five eyes of 33 patients were studied. Males were more commonly affected (20 patients, 60.6%) than females. The injury was bilateral in 22 patients (66.66%). Seventeen patients (51.51%) were below 20 years of age. Ten eyes had open globe injuries and 45 eyes had closed globe injuries. One eye of a patient had to be enucleated (3%). Children below 14 years of age were mainly injured while playing with indigenous fireworks of shooting carbide. Middle aged women were affected particularly during ignition of evening lamps. Carbide lamp was another source of injury. CONCLUSION: Males are more commonly affected by calcium carbide related ocular injuries. Children and young adults are the common victims. Such injuries can involve both the eyes and cause a permanent visual disability.

An autopsy case of suicide by acetylene explosion: a case report.

We report an autopsy case of a male welder in his thirties who was found dead in an exploded truck cabin. The roof, windows and doors of the cabin had been blown up to 50 metres away. An oxygen cylinder and an acetylene cylinder, both unexploded, were found in the back of the truck. The deceased was lying on the driver's seat. His entire body was burnt, carbonised and partially skeletonised. There was a small amount of soot in his oesophagus and stomach and a large volume of bloody fluid in the trachea and bronchi. There was an extensive haemorrhage in the posterior thoracic wall. No drugs were detected in the blood. Hardly any carbon monoxide and combustion-related gases were detected in the blood, therefore he was not considered to have died from the fire. Acetylene was detected in his blood (21.5 microg/ml in the femoral vein blood) and urine (7.49 microg/ml), with marked haemorrhaging in his back. We therefore concluded that the victim died because of an acetylene explosion in the cabin and also that this was a suicide.

Effect of inhibition treatment, type of inocula, and incubation temperature on batch H2 production from organic solid waste.

Two types of induction treatments (heat-shock pretreatment, HSP, and acetylene, Ac), inocula (meso and thermophilic) and incubation temperatures (37 and 55 degrees C) were tested according to a full factorial design 2(3) with the aim of assessing their effects on cumulative H(2) production (P(H), mmol H(2)/mini-reactor), initial H(2) production rate (R(i,H), micromol H(2)/(g VS(i) x h)), lag time (T(lag), h), and metabolites distribution when fermenting organic solid waste with an undefined anerobic consortia in batch mini-reactors. Type of inocula did not have a significant effect on P(H), T(lag), and R(i,H) except for organic acids production: mini-reactors seeded with thermophilic inocula had the highest organic acid production. Concerning the induction treatment, it was found that on the average Ac only affected in a positive way the P(H) and T(lag). Thus, P(H) in Ac-inhibited units (6.97) was 20% larger than those in HSP-inhibited units (5.77). Also, Ac favored a shorter T(lag) for P(H) in comparison with HSP (180 vs. 366). Additionally, a positive correlation was found between H(2) and organic acid production. In contrast, solvent concentration in heat-shocked mini-reactors were slightly higher than in reactors spiked with Ac. Regarding the incubation temperature, on the average mesophilic temperature affected in a positive and very significant way P(H) (10.07 vs. 2.67) and R(i,H) (2.43 vs. 0.76) with minimum T(lag) (87 vs. 459). The positive correlation between H(2) and organic acids production was found again. Yet, incubation temperature did not seem to affect solvent production. A strong interaction was observed between induction treatment and incubation temperature. Thus, Ac-inhibited units showed higher values of P(H) and R(i,H) than that HSP-inhibited units only under thermophilic incubation. Contrary to this, HSP-inhibited units showed the highest values of P(H) and R(i,H) only under mesophilic conditions. Therefore, the superiority of an induction treatment seems to strongly depend on the incubation temperature.

[Severe ocular burns by calcium carbide in a speleologist: a case report]. / Brûlures oculaires sévères par le carbure de calcium chez un spéléologue amateur.

A case of severe ocular burns in an amateur speleologist is reported. The explosion of his acetylene lamp caused the projection of calcium carbide particles, which induced burning of the cornea and conjunctiva in both eyes. He slowly recovered in several months. The pathophysiology of the burns, linked to the in situ production of lime, and their management are discussed.

[The evaluation of the specific activity and side effects of the m-cholinergic blocker pentifin compared to other antiparkinson agents]. / Otsenka spetsificheskoi aktivnosti i pobochnykh éffektov m-kholinoblokatora pentifina v sravnenii s drugimi antiparkinsonicheskimi sredstvami.

Experiments on rodents showed that pentifin, a muscarine antagonist belonging to the group of acetylene amines, possesses a pronounced antiparkinsonian activity. Pentifin is superior in the breadth of therapeutic action and tolerance characteristics to the conventional agents used for Parkinson's disease treatment.

[A case of acute eosinophilic pneumonia induced by inhalation of acetylene].

A 17-year-old high school student, while carrying out soldering one morning, inhaled 100% acetylene, and experienced nausea and bilateral lower limb numbness several hours later. In the evening his symptoms worsened, dyspnea followed, and the patient was referred to our hospital the next day. On admission chest radiography and CT scanning revealed peripheral ground-glass opacity, patchy infiltrate and Kerley's B line in the right lung fields, and bilateral pleural effusion. Since the laboratory findings revealed leukocytosis without eosinophilia, increased CRP, and hypoxemia, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBLB) was subsequently performed. Fluid analysis revealed marked increases in the total cell and eosinophil counts, and the biopsy result showed eosinophilic and lymphocytic infiltration of the alveolar septa. As a result, the case was diagnosed as acute eosinophilic pneumonia (AEP). Although inhalation of acetylene is known to induce pulmonary edema, all the typical findings of AEP but pulmonary edema were seen. This case demonstrates that AEP may be induced by inhalation of acetylene.

Thermal removal of pyrene contamination from soil: basic studies and environmental health implications.

Effects of temperature (400-1000 degrees C) and rate of heating to 550 degrees C (100, 1000, 5000 degrees C/sec) on reduction of pyrene contamination in a Superfund-related soil and on yields of volatile products (tars, CO, CO2, methane, acetylene, ethylene) have been measured. Fifty (+/- 3)-milligram thin layers (less than or equal to 150 micron) of 63- to 125-micron soil particles, neat (i.e., without exogenous chemicals), or pretreated with 4.75 wt% of pyrene, were heated for about 1 to 6 sec, under 3 psig (pounds per in.(2) gauge) of helium in a 12-liter sealed chamber. Pyrene removal, defined as the difference in weight loss of neat versus contaminated soil, was virtually immune to heating rate but increased strongly with increasing temperature, approaching 100% at about 530 degrees C. However, for pyrenepolluted soil, excess soil weight loss and modified CO yields were observed above about 500 degrees C for a 1000 degrees C/sec heating rate. These observations suggest that soil chemical reactions with pyrene or pyrene decomposition products augment soil volatilization. Consequently at elevated temperatures, the difference in weight loss protocol may overestimate polycyclic aromatic hydrocarbon (PAH) removal from soil. Increasing heating rate caused yields of CO, CO(2), and acetylene from pyrene-polluted soil to pass through maxima. Heating neat or contaminated soil resulted in at least two gaseous products of particular environmental interest:acetylene, a precursor to PAH in thermal synthesis, and CO, a toxin to human hemoglobin.

Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons.

Epidemiologic evidence on the relationship between polycyclic aromatic hydrocarbons (PAH) and cancer is reviewed. High occupational exposure to PAHs occurs in several industries and occupations. Covered here are aluminum production, coal gasification, coke production, iron and steel foundries, tar distillation, shale oil extraction, wood impregnation, roofing, road paving, carbon black production, carbon electrode production, chimney sweeping, and calcium carbide production. In addition, workers exposed to diesel engine exhaust in the transport industry and in related occupations are exposed to PAHs and nitro-PAHs. Heavy exposure to PAHs entails a substantial risk of lung, skin, and bladder cancer, which is not likely to be due to other carcinogenic exposures present in the same industries. The lung seems to be the major target organ of PAH carcinogenicity and increased risk is present in most of the industries and occupations listed above. An increased risk of skin cancer follows high dermal exposure. An increase in bladder cancer risk is found mainly in industries with high exposure to PAHs from coal tars and pitches. Increased risks have been reported for other organs, namely the larynx and the kidney; the available evidence, however, is inconclusive. The results of studies addressing environmental PAH exposure are consistent with these conclusions.

Mortality of workers at acetylene production plants.

To reduce the risk of explosion oxyacetylene cylinders are filled with a spongy mass, acetone is added to saturate the mass, and acetylene is pumped into the cylinder. The first cylinders manufactured before 1936 used a kapok filling topped off with about 16 oz of crocidolite asbestos, with a metal gauze thimble inserted to reduce risk of flash back. Cylinders must be examined annually. The use of crocidolite ceased in 1972 and other fillings have been adopted since 1970; kapok cylinders now constitute less than 5% of the total stock. To assess possible hazards, a mortality study of workers first employed between 1935 and 1975 and followed up to December 1984 was undertaken. Simulation tests showed low concentrations of asbestos in the air even in the earliest period. The population studied consisted of 370 workers at the Bilston plant in the West Midlands, 611 at the 14 other plants in England and Wales, and 120 in Scotland. No deaths occurred from mesothelial tumours but there was an excess of deaths from cancer, particularly lung cancer, cancer of the stomach, and cancer of the pancreas, the latter accounting for eight deaths. Risks appeared to be concentrated at the Bilston plant. The importance of these findings is discussed.

Incidence of cancer among workers producing calcium carbide.

The overall mortality and the incidence of cancer have been studied among male employees at a plant producing calcium carbide. The cohort was defined as all men employed at the plant for at least 18 months in the period 1953 to 1970 and was classified according to 10 occupational categories. The 790 men have been observed from 1953 to 1983 and the incidence of cancer in the cohort has been compared with national incidence rates. A significant excess of colonic cancer (standardised incidence ratio, SIR = 2.09) and of prostatic cancer (SIR = 1.78) was found, and also a slight excess of lung cancer among furnace and maintenance workers (SIR = 1.56). The possible exposure of the workers to polycyclic aromatic hydrocarbons, asbestos, and cadmium is discussed.

Delayed dermal burns caused by dimethyl acetylenedicarboxylate.

A chemical operator handling dimethyl acetylenedicarboxylate (DMAD) developed delayed and pain-free burns on one of his feet 2 days after a supposed spillage of DMAD. The injuries were confirmed to be associated with DMAD by chemical analysis of the operator's safety boot and patch tests. DMAD easily penetrates some protective clothing and dilute solutions can still be hazardous: the toxic effect is compounded by being delayed and painless. The lachrymatory irritant properties of undiluted DMAD are not adequate warning of its presence or spillage in quantities sufficient to cause significant skin damage.