Muscle-building supplement use and increased risk of testicular germ cell cancer in men from Connecticut and Massachusetts.

BACKGROUND: No analytic epidemiological study has examined the relationship between use of muscle-building supplements (MBSs) and testicular germ cell cancer (TGCC) risk. METHODS: We conducted a population-based case-control study including 356 TGCC cases and 513 controls from Connecticut and Massachusetts. RESULTS: The odds ratio (OR) for ever use of MBSs in relation to risk of TGCC was significantly elevated (OR=1.65, 95% confidence interval (CI): 1.11-2.46). The associations were significantly stronger among early users, men with more types of MBSs used, and longer periods of use. CONCLUSIONS: MBS use is a potentially modifiable risk factor that may be associated with TGCC.

Impact of cigarette smoke exposure on host-bacterial pathogen interactions.

The human respiratory tract of individuals with normal lung function maintains a fine-tuned balance, being asymptomatically colonised by the normal microbiota in the upper airways and sterile in the lower tract. This equilibrium may be disrupted by the exposure to insults such as cigarette smoke. In the respiratory tract, the complex and noxious nature of inhaled cigarette smoke alters host-microorganism interaction dynamics at all anatomical levels, causing infections in many cases. Moreover, continuous exposure to cigarette smoke itself causes deleterious effects on the host that can trigger the development of chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer. COPD is an irreversible airflow obstruction associated with emphysema, fibrosis, mucus hypersecretion and persistent colonisation of the lower airways by opportunistic pathogens. COPD patients keep a stable (without exacerbation) but progressively worsening condition and suffer periodic exacerbations caused, in most cases, by infections. Although smoking and smoking-associated diseases are associated with a high risk of infection, most therapies aim to reduce inflammatory parameters, but do not necessarily take into account the presence of persistent colonisers. The effect of cigarette smoke on host-pathogen interaction dynamics in the respiratory tract, together with current and novel therapies, is discussed.

Lipopolysaccharide-binding protein and CD14 are increased in the bronchoalveolar lavage fluid of smokers.

Lipopolysaccharide-binding protein (LBP) and CD14 contribute to the recognition of pathogens by cells, which triggers the activation of defence responses. Smoking is a risk factor for the development of chronic obstructive pulmonary disease (COPD) and respiratory infections. The current authors theorised that levels of LBP and CD14 in the lungs of smokers would be higher than those in the lungs of never-smokers. These elevated levels could affect host responses upon infection. LBP, soluble CD14 (sCD14) and interleukin (IL)-8 were detected by ELISA. Nuclear factor (NF)-kappaB, p38 and the inhibitor IkappaBalpha were studied by immunoassays. Gene expression was assessed by RT-PCR. Bronchoalveolar lavage levels of LBP and CD14 were significantly higher in smokers and COPD patients than in never-smokers, whereas levels of both proteins were not significantly different between smokers and COPD patients. IL-6, IL-1beta and cigarette smoke condensate induced the expression of LBP and CD14 by airway epithelial cells. LBP and sCD14 inhibited the nontypeable Haemophilus influenzae (NTHi)-dependent secretion of IL-8 and the activation of NF-kappaB and p38 mitogen-activated protein kinase signalling pathways but they increased the internalisation of NTHi by airway epithelial cells. Thus, in the inflamed airways of smokers both proteins could contribute to inhibit bacteria-dependent cellular activation without compromising the internalisation of pathogens by airway cells.

Senckenberg lignite: a lignitized wood with apparently original cellulose and lignin.

A lignitized wood of Miocene derivation has been identified to the genus Taxodium. The cell walls of latewood tracheids are Mäule positive. A structurally intact lignin residue is obtained after incubation of the wood in 72 percent sulfuric acid. Cellulose persists as a structural polysaccharide in the lignitized wood.

Vegetable ingredients of dusts in textile and nontextile cotton industries.

The objective was to determine if garnetting and raw cotton dusts differed in botanical composition. Estimates of dust composition were based on the contents of gross trash in cotton raw materials and the potential of each gross trash component to be converted into less than 10 mum particulate by a laboratory abrasion test. All types of garnetting dusts are predicted to contain a lower percent content of leaflike material than raw cotton dust. Garnetting dusts arising from linter-polyester blends are estimated to contain only 20 to 25 percent of the concentration of leaflike ingredients predicted to be present in raw cotton dusts. The low prevalence of byssinosis reported in the garnetting industry may be explained, in part, by the relatively low percent content of leaflike particulate in this cotton dust.

Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor.

The authors present an outbreak of disease associated with exposure to Stachybotrys chartarum and Aspergillus species. A courthouse and two associated office buildings had generated discomfort among employees for two years since initial occupancy. Multiple interventions had been unsuccessful An initial evaluation of 14 individuals identified three with potential asthma and three with symptoms consistent with interstitial lung disease. A clinical screening protocol to identify individuals who should be removed from work identified three likely and seven possible cases of building-related asthma. Detailed environmental and engineering assessments of the building identified major problems in mechanical system design, building construction, and operational strategies leading to excess moisture and elevated relative humidities. Moisture-damaged interior surfaces in both buildings were contaminated with S. chartarum, A. versicolor, and Penicillium species. Aspergillus species, especially A. versicolor, at concentrations of 10(1) to 10(4)/m3 dominated the indoor air under normal operating conditions. Bulk samples also revealed large quantities of Stachybotrys. A questionnaire survey of the three case and two control buildings documented between three- and 15-fold increases in symptoms. A nested case-control study suggested emphysematous-like disease in individuals meeting questionnaire definitions for cases. Replication of analysis strategies used in similar previous investigations suggested an association between worsening symptoms and decreased diffusing capacity of the lung. Performance on neuropsychological measures was similar for both cases and controls, although workers with symptoms reported increased levels of current but not past psychiatric symptomatology. Chemical analyses demonstrated the presence of satratoxins G and H. Cytotoxic laboratory analyses demonstrated the presence of agents with biological effectiveness in bulk materials. No association was seen between IgE or IgG antibodies and the presence of disease. This outbreak represents a likely human response to inhaled fungal toxins in indoor environments. Moisture indoors represents a public health issue currently inadequately addressed by building, health, or housing codes.

Pulmonary disease associated with cafeteria flooding.

An illness among office workers, consisting of cough, fever, chills, muscle aches, and chest tightness was associated with water leaks from a cafeteria. Mean single breath carbon-monoxide diffusing capacity (DLCO) of cases differed significantly from that of non-cases. There was a significant decrease in the percent of predicted DLCO with increasing number of symptoms. Testing for precipitating antibodies to microbial agents found in the building revealed no differences between cases and non-cases. DLCO is an appropriate cross-sectional instrument for field investigations of building-associated respiratory disease.

Clinical toxicology and management of intoxications with synthetic cathinones ("bath salts").

Synthetic cathinones are synthetic derivatives of the natural cathinone, one of the psychoactive compounds present in Catha edulis (khat). There are at least 12 different types of synthetic cathinones, with mephedrone and 3,4-methylendioxypyrovalerone (MDPV) being the most commonly used by the purchasers. The legal control of these substances is especially difficult because when a specific compound is banned, a new slightly modified chemical variant is introduced into the market. It has been described that patients after taking synthetic cathinones may show signs and symptoms of the sympathicomimetic toxidrome, including agitation, psychosis, tachycardia, hypertension, and seizures. Furthermore, some cases of deaths related to their consumption have also been reported. Nowadays, there is no established treatment protocol for the clinical management of these intoxications. Because of this, we have developed some recommendations that may be useful to determine the treatment of these patients.

[Oxaliplatin-associated neurotoxicity in clinical practice]. / Neurotoxicidad asociada a oxaliplatino en la práctica clínica asistencial.

OBJECTIVES: To evaluate the presence and severity of oxaliplatin-associated neurotoxicity in clinical practice and the clinical management of this adverse side effect. METHOD: Observational retrospective study including patients diagnosed with colorectal cancer that started an oxaliplatin-based chemotherapy regimen during 2008 at a secondary hospital. Data were obtained from an onco-haematological prescription programme at the hospital and from digital clinical histories. We compiled variables related to the clinical characteristics of the patients, antineoplastic treatment, neurotoxicity associated with oxaliplatin, and clinical management of this issue. RESULTS: Our study included a total of 64 patients. Neurotoxicity was recorded in 65.6% of cases, usually in mild or moderate forms. In approximately one third of patients who developed this adverse effect, the oxaliplatin prescription had to be modified. We observed a statistically significant relationship between cumulative oxaliplatin doses and the presence of neurological toxicity (P=.0004). CONCLUSIONS: The presence of oxaliplatin-associated neurotoxicity and its distribution based on its severity was similar to rates published in the literature. The number of patients requiring a change in the oxaliplatin prescription could justify the need for studies that assess the clinical consequences of these modifications. We believe that effective strategies for neurological protection need to be developed in order to guarantee the safety and quality of life in these patients.

Botanically what is raw cotton dust?

The objective of this study was to determine the specific botanical ingredients present in respirable raw cotton dust. Significant differences in content of gross leaflike (bractcontaining) trash were found between several grade divisions of raw cottons. For example, higher grades of raw cotton (strict low middling = SLM) contained less leaflike trash than lower grade cottons (low middling = LM). The potential for production of fine particulate from botanical trash materials plus lint and linters was determined in the laboratory by an abrasive milling test. Bract and wood fragments were the most friable of all plant materials found in raw cottons whereas seed meat, lint, linters and seed coat were the least friable. Respirable (10 less than 10 micrometers) raw cotton dusts associated with the processing of middling, SLM and LM raw cottons were predicted to contain the following % weight composition of specific vegetable ingredients: leaflike = 70--72%, stem = 13--18%, bark = 3--8%, exocarp-mesocarp = 3.6%, endocarp = 1--2% and seed = 0.5--2%. Bract is the most abundant component in respirable raw cotton dust.

Practical aspects of sampling for organic dusts and microorganisms.

Air sampling for organic dusts and microorganisms was carried out in silos when moldy silage was discarded through the discharge chute. Concentrations of respirable dust and airborne viable microorganisms exceeded 20 mg/m3 and 1 x 10(9)/m3, respectively, when dry silage was removed from silos. Much lower concentrations of dust and microorganisms were present when wet silage was discarded. Impinger and filter cassette samplers were equally effective in collecting the hardy spores present in silage dusts.

Airborne endotoxin in industries processing vegetable fibers.

Airborne lipopolysaccharide (LPS) levels were determined at various working sites in industries processing vegetable fibers. On several occasions the amounts assessed with the Limulus assay exceeded those presumed to cause human reactions i.e. about 0.5 microgram/m3. Low values were often found in areas for weaving. High levels of LPS were found in flax carding rooms but levels in jute mills did not exceed those considered to produce reactions in humans. Low values were also found in nontextile industries processing cotton fibers. By and large the variations in airborne LPS corresponded to previous experience on the extent of byssinosis seen in the different types of industries.

Past maternal experience of asthma, childhood morbidity, and the psychosocial impact of the disorder.

Both previous experience of asthma, either in person or in a close family contact, by the mother of an asthmatic child and the child's current morbidity may influence the psychosocial impact of the disorder. A questionnaire concerning prior asthma experience, current psychosocial impact, and morbidity was returned by the mothers of 124 young asthmatic children. Family communication was significantly worse in the past maternal contact group. There were significant trends between morbidity and family communication, emotional distress, and manipulation. No beneficial effect of previous experience of asthma on measures of psychosocial disturbance experienced by the mothers of asthmatic children was detected. Increased psychosocial disturbance was associated with higher morbidity from asthma in the child.

Role of ventilation in the causation of building-associated illnesses.

The objective of this article is to provide the reader with a basic knowledge of the operation of heating, ventilation, and air-conditioning (HVAC) systems and to explain why many systems do not perform correctly. The flow of air through a typical HVAC system is described, and the correlation between system components and their potential to affect indoor air quality is addressed.

Allergic respiratory disease and fungal remediation in a building in a subtropical climate.

An outbreak of allergic respiratory disease occurred in a new building that was characterized from initial occupancy by the presence of extensive visible mold (especially Aspergillus versicolor) on interior surfaces. Epidemiological study of the occupants of both the affected building and a comparison neighboring structure indicated high rates of respiratory and other symptoms among persons working in the affected building. Subsequent clinical evaluations of some persons occupying the building for up to five years identified several cases of building-related allergic respiratory disease, including asthma and hypersensitivity pneumonitis. Based on these findings, the building was evacuated before remediation began. The mycological goal of the three-year building restoration project was to reduce concentration of non-phylloplane fungi such as A. versicolor to the lowest feasible level. All visibly colonized materials in the building were discarded and all fine dust on interior surfaces was removed by vacuuming and/or damp wiping. A medical surveillance program utilizing serial self-reported questionnaires and readily available clinical evaluations was designed to monitor the health of building occupants after re-entry. Symptom rates just prior to building reentry were substantially lower than those found before evacuation and have remained unchanged after re-occupancy was completed. No new or recrudescent cases of illness are known to have occurred after building re-entry.

A comparison of cotton dust sampling techniques.

The standard high volume sampler, multistage cascade impactor, and modified vertical elutriators were evaluated for total cotton dust sampling. The effects of changes in performance parameters is reported. Mass median dust diameter found in four textile operations for several cotton grades are reported.

Plant trash in linters and willowed picker: materials used in the cotton garnetting industry.

First cut linters and willowed picker, used in cotton garnetting, were examined for content of cotton bract an other plant trash. Bract was found to be a minimal contaminant of the trash of first cut linters. A significant amount of bract (about 9% of the trash) was present in willowed picker. Cotton seed hulls, a valuable oil mill by product, contained an insignificant amount of bract trash.

Occupational dust exposures in West Texas cotton gins.

Total and elutriated dust concentrations were measured by four methods for typical ginning situations. Total and elutriated levels were 0.73 and 0.47 and 0.59 and 0.26 mg/m3 per bale/hr by the gin stands and bale press, respectively. Limited data show the corresponding mass media diameters are 9.2-14.8 and 9.6-18.5 micrometer.