RESUMEN
Age-adjusted oesophageal cancer mortality rates for Japanese women declined by 58% between 1960 and 1989, whereas corresponding rates for Japanese men have shown no decline. We speculate that alcohol-related oesophageal cancer mortality rates have been increasing in Japanese men replacing non-alcohol related oesophageal cancer deaths. Specifically, male birth cohorts, which experienced increased alcohol-related cirrhosis mortality rates, would also experience a rise in oesophageal cancer mortality rates. To test this hypothesis, we compared male to female ratios of oesophageal cancer mortality rates by birth cohort with those of liver cirrhosis mortality rates. We calculated the attributable risk of alcohol consumption and smoking to oesophageal cancer in Japanese men using oesophageal cancer mortality rates in Japanese women as a baseline, i.e. non-alcohol and non-smoking related oesophageal cancer deaths. We applied this method to head and neck cancer deaths to test its feasibility. Male birth cohorts born after 1926, which experienced male to female cirrhosis mortality ratios, also experienced increased oesophageal cancer mortality ratios. Overall, drinking and smoking accounted for 86% of all oesophageal cancer deaths and 85% of head and neck cancer deaths among Japanese men.
Asunto(s)
Neoplasias Esofágicas/etiología , Neoplasias Esofágicas/mortalidad , Neoplasias de Cabeza y Cuello/etiología , Neoplasias de Cabeza y Cuello/mortalidad , Cirrosis Hepática Alcohólica/complicaciones , Cirrosis Hepática Alcohólica/mortalidad , Vigilancia de la Población , Fumar/efectos adversos , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Causas de Muerte , Estudios de Cohortes , Neoplasias Esofágicas/epidemiología , Femenino , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Fumar/epidemiologíaRESUMEN
A cross-sectional analysis of the relation between the estimated healthy worker effect (HWE), as measured by a total Standardized Mortality Ratio (SMR) less than 100, and relevant design characteristics in 270 published retrospective occupational cohort studies is presented. The majority of the reviewed studies showed a HWE, varying in SMR from 50 to 99 (mean: 84). The estimated HWE seemed to influence the final outcomes of the studies to a great extent. A tendency for a positive relation between the study size in terms of the number of exposed workers, total number of person-years of follow-up, and the HWE emerged. Studies with a comparatively short follow-up period had an increased chance of resulting in a HWE. Cross-sectional cohorts did not show a stronger HWE than open cohorts. Studies of chemical exposures revealed a fivefold excess of having a HWE compared with other studies.
Asunto(s)
Efecto del Trabajador Sano , Enfermedades Profesionales/mortalidad , Proyectos de Investigación/normas , Estudios de Cohortes , Estudios Transversales , Humanos , Modelos Logísticos , Valores de Referencia , Estudios RetrospectivosRESUMEN
Silver coating of medical devices is believed to prevent device-associated infection. Several in-vitro and in-vivo studies, as well as clinical observations on silver-nylon, silver-intramedullary pins, silver oxide Foley catheters and silver-coated vascular prostheses have been performed during the past 30 years. Nevertheless, randomized clinical studies showing efficacy of such coated medical devices in high-risk patient populations are rare, have dealt with very small numbers of patients or are controversial. Physico-chemical, pharmacological and microbiological data explaining the antimicrobial efficacy of silver in prophylaxis of implants are presented here, as well as the scientific background for the established clinical benefits of silver-preparations in burns.
Asunto(s)
Materiales Biocompatibles Revestidos , Contaminación de Equipos/prevención & control , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/prevención & control , Plata , Prótesis Vascular/efectos adversos , Clavos Ortopédicos/efectos adversos , Catéteres de Permanencia/efectos adversos , Materiales Biocompatibles Revestidos/química , Humanos , Ensayo de Materiales , Plata/química , Cateterismo Urinario/instrumentaciónRESUMEN
Telecommunication relay service (TRS) is a lifeline for deaf, deaf-blind, hard-of-hearing, and speech-disabled persons. Nurses who are technology shy and unfamiliar with TRS fail to integrate this simple telephone process into their pursuit of quality healthcare outcomes for patients with communication disorders. This article aims to increase home care nurses' awareness, comfort, and use of TRS.
Asunto(s)
Equipos de Comunicación para Personas con Discapacidad , Trastornos de la Comunicación/enfermería , Enfermería en Salud Comunitaria/métodos , Servicios de Atención de Salud a Domicilio , Telecomunicaciones , Teléfono , Trastornos de la Comunicación/psicología , Humanos , Relaciones Enfermero-PacienteRESUMEN
The Mediterranean diet is associated with a lower incidence of chronic degenerative diseases and higher life expectancy. These health benefits have been partially attributed to the dietary consumption of extra virgin olive oil (EVOO) by Mediterranean populations, and more specifically the phenolic compounds naturally present in EVOO. Studies involving humans and animals (in vivo and in vitro) have demonstrated that olive oil phenolic compounds have potentially beneficial biological effects resulting from their antimicrobial, antioxidant and anti-inflammatory activities. This paper summarizes current knowledge on the biological activities of specific olive oil phenolic compounds together with information on their concentration in EVOO, bioavailability and stability over time.
Asunto(s)
Dieta Mediterránea , Fenoles/análisis , Aceites de Plantas/química , Animales , Antiinfecciosos/administración & dosificación , Antiinfecciosos/análisis , Antiinfecciosos/farmacocinética , Antiinflamatorios/administración & dosificación , Antiinflamatorios/análisis , Antiinflamatorios/farmacocinética , Antioxidantes/administración & dosificación , Antioxidantes/análisis , Antioxidantes/farmacocinética , Humanos , Enfermedades Neurodegenerativas/prevención & control , Aceite de Oliva , Fenoles/administración & dosificación , Fenoles/farmacocinéticaRESUMEN
As part of ongoing medical surveillance, the morbidity prevalence for obese individuals (20% to 40% and greater than 40% overweight) was compared with non-obese corporate employees utilizing group health insurance claims data for 1985. The advantages of claims data as a potential source of morbidity data for disease surveillance and research are discussed herein. The expected finding of a positive association between hypertension (P less than .05) and obesity noted for both male and female employees reiterates the important role of work site weight control programs in reducing hypertension. The positive association between prevalence of mental health disorders and obesity demonstrates the need to address the adverse psychologic risks of obesity in addition to the adverse physical risks. This finding suggests that employee assistance programs emphasize counseling services for obese individuals.
Asunto(s)
Morbilidad , Obesidad/complicaciones , Adulto , Femenino , Sistemas Prepagos de Salud/estadística & datos numéricos , Promoción de la Salud , Humanos , Hipertensión/etiología , Masculino , Persona de Mediana Edad , Servicios de Salud del Trabajador , Factores de RiesgoRESUMEN
A major problem in medicine is the large number of infections associated with implanted and indwelling devices. Silver coating of medical devices is believed to preserve infection resistance. Several in vitro and animal studies as well as clinical observations on silver-nylon, silver-intramedullary pins, silver-oxide-Foley catheters and silver-coated vascular protheses have been interpreted as successful for the prophylaxis of foreign-body infections. Nevertheless, these products have not been established in clinical use. In this study we have been able to present physico-chemical and pharmacological data as well as simple microbiological experiments explaining the reduced anti-microbial activity of silver-ions in some biological fluids.
Asunto(s)
Medios de Cultivo , Escherichia coli/efectos de los fármacos , Nitrato de Plata , Staphylococcus aureus/efectos de los fármacos , Staphylococcus epidermidis/efectos de los fármacos , Adhesión Bacteriana , Escherichia coli/metabolismo , Iones , Pruebas de Sensibilidad Microbiana , Staphylococcus aureus/metabolismo , Staphylococcus epidermidis/metabolismoRESUMEN
OBJECTIVE: To update the mortality experience of a cohort of 8508 workers with potential exposure to acrylamide at three plants in the United States from 1984-94. METHODS: Analyses of standardised mortality ratios (SMR) with national and local rates and relative risk (RR) regression modelling were performed to assess site specific cancer risks by demographic and work history factors, and exposure indicators for acrylamide and muriatic acid. RESULTS: For the 1925-94 study period, excess and deficit overall mortality risks were found for cancer sites of interest: brain and other central nervous system (CNS) (SMR 0.65, 95% confidence interval (95% CI) 0.36 to 1.09), thyroid gland (SMR 2.11, 95% CI 0.44 to 6.17), testis and other male genital organs (SMR 0.28, 95% CI 0.01 to 1.59), and cancer of the respiratory system (SMR 1.10, 95% CI 0.99 to 1.22); however, none was significant or associated with exposure to acrylamide. A previously reported excess mortality risk of cancer of the respiratory system at one plant remained increased among workers with potential exposure to muriatic acid (RR 1.50, 95% CI 0.86 to 2.59), but was only slightly increased among workers exposed or unexposed to acrylamide. In an exploratory exposure-response analysis of rectal, oesophageal, pancreatic, and kidney cancer, we found increased SMRs for some categories of exposure to acrylamide, but little evidence of an exposure-response relation. A significant 2.26-fold risk (95% CI 1.03 to 4.29) was found for pancreatic cancer among workers with cumulative exposure to acrylamide > 0.30 mg/m3.years; however, no consistent exposure-response relations were detected with the exposure measures considered when RR regression models were adjusted for time since first exposure to acrylamide. CONCLUSION: The contribution of 1115 additional deaths and nearly 60,000 person-years over the 11 year follow up period corroborate the original cohort study findings of little evidence for a causal relation between exposure to acrylamide and mortality from any cancer sites, including those of initial interest. This is the most definitive study of the human carcinogenic potential of exposure to acrylamide conducted to date.
Asunto(s)
Acrilamida/efectos adversos , Neoplasias/mortalidad , Enfermedades Profesionales/mortalidad , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Estudios de Cohortes , Estudios de Seguimiento , Humanos , Ácido Clorhídrico/efectos adversos , Masculino , Persona de Mediana Edad , Neoplasias/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Neoplasias del Sistema Respiratorio/inducido químicamente , Neoplasias del Sistema Respiratorio/mortalidad , Estados Unidos/epidemiologíaRESUMEN
A cohort of 2671 men, 1774 of whom were exposed to acrylonitrile, was observed from 1951 through 1983 for mortality. No statistically significant excess of all-cause or cause-specific mortality was observed. Analysis of exposure duration to acrylonitrile with respiratory cancer mortality showed no trend. Men exposed to high levels of acrylonitrile had respiratory cancer rates similar to men not exposed in the workplace and to the US general male population. These study results do not support the hypothesis that acrylonitrile is a human carcinogen.
Asunto(s)
Acrilonitrilo/efectos adversos , Nitrilos/efectos adversos , Enfermedades Profesionales/mortalidad , Estudios de Cohortes , Humanos , Masculino , Enfermedades Profesionales/inducido químicamente , Neoplasias del Sistema Respiratorio/inducido químicamente , Neoplasias del Sistema Respiratorio/mortalidadRESUMEN
A cohort of 8854 men, 2293 of whom were exposed to acrylamide, was examined from 1925 to 1983 for mortality. This cohort consisted of four plant populations in two countries: the United States and The Netherlands. No statistically significant excess of all-cause or cause-specific mortality was found among acrylamide workers. Analysis by acrylamide exposure levels showed no trend of increased risk of mortality from several cancer sites. These results do not support the hypothesis that acrylamide is a human carcinogen.