Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
World J Urol ; 37(7): 1415-1420, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30341450

RESUMO

PURPOSE: To analyze and compare preoperative patient characteristics and postoperative results in men with stress urinary incontinence (SUI) selected for an adjustable male sling system or an artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. METHODS: 658 male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in this study (n = 176 adjustable male sling; n = 482 AUS). Preoperative patient characteristics and postoperative outcomes were analyzed. For statistical analysis, the independent T test and Mann-Whitney U test were used. RESULTS: Patients undergoing adjustable male sling implantation were less likely to have a neurological disease (4.5% vs. 8.9%, p = 0.021), a history of urethral stricture (21.6% vs. 33.8%, p = 0.024) or a radiation therapy (22.7% vs. 29.9%, p = 0.020) compared to patients that underwent AUS implantation. Mean pad usage per day (6.87 vs. 5.82; p < 0.00) and the ratio of patients with a prior incontinence surgery were higher in patients selected for an AUS implantation (36.7% vs. 22.7%; p < 0.001). At maximum follow-up, patients that underwent an AUS implantation had a significantly lower mean pad usage during daytime (p < 0.001) and nighttime (p = 0.018). Furthermore, the patients' perception of their continence status was better with a subjective complete dry rate of 57.3% vs. 22.0% (p < 0.001). CONCLUSIONS: Patients selected for an AUS implantation showed a more complex prior history and pathogenesis of urinary incontinence as well as a more severe grade of SUI. Postoperative results reflect a better continence status after AUS implantation, favoring the AUS despite the more complicated patient cohort.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Idoso , Estudos de Coortes , Humanos , Masculino , Medidas de Resultados Relatados pelo Paciente , Seleção de Pacientes , Radioterapia/estatística & dados numéricos , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Estreitamento Uretral/epidemiologia
2.
Actas urol. esp ; 42(3): 202-206, abr. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-172872

RESUMO

Introducción: La lesión uretral iatrogénica con posterior erosión del manguito durante la cistoscopia es una complicación poco frecuente. Se presentará la estrategia quirúrgica alternativa con uretroplastia in situ manteniendo el manguito abierto in situ. Materiales y métodos: Los autores describen 3 casos de lesión uretral iatrogénica con erosión del manguito durante la evaluación cistoscópica para excluir la estenosis o la erosión del manguito debido a la reaparición de síntomas obstructivos del tracto urinario inferior. Todos los pacientes tenían antecedentes de implantación de AMS 800 por incontinencia posprostatectomía. Se realizó una cistoscopia rígida, que no reveló alteraciones; sin embargo, se identificó una pequeña lesión uretral iatrogénica durante la extirpación del cistoscopio en la proyección del manguito. Resultados: Se realizó uretroplastia in situ y el manguito se dejó abierto in situ. Además, se colocó una solapa de grasa protectora alrededor de la uretra desde la cara dorsolateral, separando el manguito y la uretra del contacto directo entre sí. Después de 6 semanas el defecto uretral se curó completamente y a través de una incisión perineal primaria el manguito fue readaptado y cerrado. El dispositivo estaba funcionando sin ningún ajuste adicional. Conclusión: Nuestra modificación debe considerarse, en casos seleccionados sin infección, como parte de la estrategia de tratamiento en los casos de lesiones uretrales iatrogénicas con posterior erosión del manguito. De esta manera se puede evitar el manguito original y la preparación posiblemente difícil de la uretra durante la reoperación. Sin embargo, se deben presentar más casos en la literatura mundial para confirmar la utilidad de este principio quirúrgico


Introduction: Iatrogenic urethral lesion with subsequent cuff erosion during cystoscopy is a rare complication. The alternative surgical strategy with in situ urethroplasty while maintaining the open cuff left in situ will be presented. Materials and methods: The authors report 3 cases of iatrogenic urethral lesion with cuff erosion during cystoscopic evaluation to exclude stricture or cuff erosion due to new onset of obstructive lower urinary tract symptoms. All patients had a history of a AMS 800 implantation due to posprostatectomy incontinence. Rigid cystoscopy was performed, which revelaed no pathologies; however, iatrogenic small urethral lesion was identified during the removal of the cystoscope at the projection of the cuff. Results: In situ urethroplasty was performed, and the cuff was left open in situ. Additionally a protection fat flap was placed around the urethra from the dorsolateral aspect, separating the cuff and urethra from the direct contact with each other. After 6 weeks the urethral defect was completely healed and via a primary perineal incision the cuff was readapted and closed. The device was fully functioning without any additional adjustments. Conclusion: Our modification should be considered in select cases with absence of infection as part of management strategy for cases of iatrogenic urethral lesions with subsequent cuff erosion. Thereby the original cuff can be spared and the possibly difficult preparation of the urethra during reoperation can be avoided. However, additional more cases should be presented in the world-wide literature, to confirm the utility of this surgical principle


Assuntos
Humanos , Masculino , Lesões do Manguito Rotador/diagnóstico , Lesões do Manguito Rotador/etiologia , Uretra/lesões , Doenças Uretrais/diagnóstico , Doenças Urogenitais Masculinas/cirurgia , Incontinência Urinária/complicações , Doença Iatrogênica/epidemiologia , Prostatectomia/métodos , Doenças Uretrais/cirurgia , Incontinência Urinária/diagnóstico , Uretra/cirurgia
3.
Actas Urol Esp ; 42(3): 202-206, 2018 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29100651

RESUMO

INTRODUCTION: Iatrogenic urethral lesion with subsequent cuff erosion during cystoscopy is a rare complication. The alternative surgical strategy with in situ urethroplasty while maintaining the open cuff left in situ will be presented. MATERIALS AND METHODS: The authors report 3cases of iatrogenic urethral lesion with cuff erosion during cystoscopic evaluation to exclude stricture or cuff erosion due to new onset of obstructive lower urinary tract symptoms. All patients had a history of a AMS 800 implantation due to posprostatectomy incontinence. Rigid cystoscopy was performed, which revelaed no pathologies; however, iatrogenic small urethral lesion was identified during the removal of the cystoscope at the projection of the cuff. RESULTS: In situ urethroplasty was performed, and the cuff was left open in situ. Additionally a protection fat flap was placed around the urethra from the dorsolateral aspect, separating the cuff and urethra from the direct contact with each other. After 6 weeks the urethral defect was completely healed and via a primary perineal incision the cuff was readapted and closed. The device was fully functioning without any additional adjustments. CONCLUSION: Our modification should be considered in select cases with absence of infection as part of management strategy for cases of iatrogenic urethral lesions with subsequent cuff erosion. Thereby the original cuff can be spared and the possibly difficult preparation of the urethra during reoperation can be avoided. However, additional more cases should be presented in the world-wide literature, to confirm the utility of this surgical principle.


Assuntos
Cistoscopia , Falha de Prótese/efeitos adversos , Reoperação/métodos , Uretra/lesões , Uretra/cirurgia , Esfíncter Urinário Artificial , Idoso , Humanos , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Urológicos/métodos
4.
J Mater Sci Mater Med ; 29(1): 12, 2017 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-29285633

RESUMO

The release behavior of vancomycin (VAN) from beta-tricalciumphosphate (ßTCP), hydroxyapatite (HA), glass ceramic (GC) and sponge-like collagen ßTCP granule composite (sponge) was studied. Vacuum and drip loading methods were compared. The influence of VAN concentration and pH on release behavior was analyzed with respect to a stable release level of VAN above the minimum inhibitory concentration over 14 days. Initially the morphology of the granule carrier systems was examined with ESEM, stereomicroscopy, µCT-imaging and Camsizer® regarding porosity, interconnecting pores and granule size. Drug release patterns following a vacuum and a drip loading method with VAN at concentrations of 5 and 50 mg/ml were compared. The influence of pH 7.4 compared to pH 5.0 on release behavior was studied. The drug was released in bidistilled water at 37 °C, the concentration determined by photometry at 220 nm. For statistical purposes, the mean and standard deviation were calculated and analyzed by Origin 9.1 Professional SR1 (OriginLab). Due to low interconnectivity and low porosity, the vacuum loading method was unable to attain complete drug loading of the ceramic granules. The sponge showed an inhomogeneous distribution of ßTCP granules. Drug release was high at pH 7.4, at pH 5.0 it practically did not occur. All samples except for the collagen-complex show an initial VAN burst release with a following steady release. Loading with 5 mg/ml concentrated VAN resulted in a higher percentage of available drug being released. However, when loaded with 50 mg/ml, the absolute amount of drug released was higher.


Assuntos
Fosfatos de Cálcio/farmacologia , Colágeno/química , Portadores de Fármacos/química , Vancomicina/farmacologia , Antibacterianos/farmacologia , Osso e Ossos , Cerâmica/química , Avaliação Pré-Clínica de Medicamentos , Liberação Controlada de Fármacos , Durapatita/química , Humanos , Concentração de Íons de Hidrogênio , Cinética , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Varredura , Porosidade , Temperatura
5.
J Vestib Res ; 10(2): 75-86, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10939682

RESUMO

The goal of the present study was to determine if adaptive modulation of vestibulo-ocular reflex (VOR) function is associated with commensurate alterations in manual target localization. To measure the effects of adapted VOR on manual responses we developed the Vestibular-Contingent Pointing Test (VCP). In the VCP test, subjects pointed to a remembered target following passive whole body rotation in the dark. In the first experiment, subjects performed VCP before and after wearing 0.5X minifying lenses that adaptively attenuate horizontal VOR gain. Results showed that adaptive reduction in horizontal VOR gain was accompanied by a commensurate change in VCP performance. In the second experiment, bilaterally labyrinthine deficient (LD) subjects were tested to confirm that vestibular cues were central to the spatial coding of both eye and hand movements during VCP. LD subjects performed significantly worse than normal subjects. These results demonstrate that adaptive change in VOR can lead to alterations in manual target localization.


Assuntos
Adaptação Fisiológica , Mãos/fisiologia , Doenças do Labirinto/fisiopatologia , Movimento/fisiologia , Desempenho Psicomotor , Reflexo Vestíbulo-Ocular , Comportamento Espacial/fisiologia , Adulto , Escuridão , Movimentos Oculares , Feminino , Movimentos da Cabeça/fisiologia , Humanos , Masculino , Valores de Referência , Reflexo Anormal , Rotação
6.
Occup Environ Med ; 57(9): 605-14, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10935941

RESUMO

OBJECTIVES: In response to a previous finding of increased mortality from lymphohaematopoietic (LH) malignancies, this study examines incidence of LH malignancy in a petrochemical industry cohort. Emphasis is on chronic lymphocytic leukaemia (CLL) and on comparisons by period of first employment. METHOD: The study cohort consists of 8942 employees who were active in the period 1970-92 and alive on 31 December 1982. Record linkage with the Louisiana tumour registry (LTR) provided information on cancer for cases occurring between 1983 and 1994. Standardised incidence ratios (SIR), with the south Louisiana population as a comparison, were computed for all cancers, all LH malignancies and specific LH subtypes. Analyses were conducted for sex and race categories, and by period of first employment, job type, duration of employment, and latency. RESULTS: 672 Cases of cancer were identified, including 59 LH malignancies. Women (n=1169) had an overall cancer SIR below unity and four LH malignancies versus 2.28 expected. Among the 7773 men, those first employed before 1950 had no overall cancer excess, a significant 1.4-fold increase in overall LH malignancies (43 observed versus 30.78 expected), and four CLL cases versus 3.27 expected. Findings for men first employed after 1950 are based on fewer cases, but there was no indication of excesses of overall cancer or LH malignancy. Numbers were too small in the group first employed after 1950 for meaningful analysis of LH malignancy subtypes such as CLL (one case). CONCLUSION: These findings do not suggest a continuing excess of CLL but do suggest a small increase in incidence of overall LH malignancy for workers first employed before 1950. This may reflect associations with earlier workplace conditions, although work related patterns are mixed. Interpretation is limited by the diverse group of diseases within LH malignancies, and the lack of control for non-work factors other than sex, age, race, and period of diagnosis. This study has a major advantage of more complete and reliable cancer ascertainment compared with the mortality investigation, and shows the feasibility and benefits of using cancer registry incidence data in an occupational cohort study.


Assuntos
Neoplasias Hematológicas/epidemiologia , Doenças Profissionais/epidemiologia , Petróleo , Adulto , Idoso , Indústria Química , Estudos de Coortes , Feminino , Seguimentos , Neoplasias Hematológicas/induzido quimicamente , Humanos , Incidência , Leucemia Linfocítica Crônica de Células B/induzido quimicamente , Leucemia Linfocítica Crônica de Células B/epidemiologia , Louisiana/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Fatores de Tempo
7.
Fertil Steril ; 73(3): 487-92, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10689000

RESUMO

OBJECTIVE: To determine the role of parental and biological factors on the U.S. male birth fraction from 1964 through 1988. DESIGN: Logistic regression on annual U.S. male births by race group. SETTING: Population-based data. PATIENT(S): Live births in the United States 1964 through 1988. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Annual U.S. male birth fraction by parental and biological factors. RESULT(S): During the study period, the annual U. S. male birth fraction showed changes based on race group, parental age, and low birth weight. The overall influence of parental age on the U.S. male birth fraction is strong and is stronger in nonwhites than in whites. The U.S. male birth fraction is also strongly influenced by the percentage of low birth weight infants in nonwhites, but not in whites. The male birth fraction declines with increasing age of either parent and with an increase in the percentage of low birth weight infants. CONCLUSION(S): The relative magnitude of influences on the U.S. male birth fraction depend on the race group, which may be a reflection of the range of observed data rather than biological differences. The developed models have reasonable predictive power and are an appropriate first step in understanding the factors influencing the male birth fraction. These types of parental and biological variables should be included in models before examining other exogenous and population level variables.


Assuntos
Declaração de Nascimento , Coeficiente de Natalidade , Razão de Masculinidade , Fatores Etários , Coeficiente de Natalidade/etnologia , Grupos de Populações Continentais , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Modelos Logísticos , Masculino , Pais , Valor Preditivo dos Testes , Estados Unidos/epidemiologia
8.
J Occup Environ Med ; 42(2): 163-70, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10693077

RESUMO

Clustering of health events in or around industrial facilities sometimes leads to worker and community concerns that plant management or local health professionals must address. We provide an eight-step process to deal with these concerns systematically. We emphasize the use of good scientific practices with managerial oversight for effective worker and community communication. This process is directed to plant management and the local health professional and emphasizes the practical aspects of the investigation.


Assuntos
Exposição Ambiental/prevenção & controle , Doença Ambiental/prevenção & controle , Guias como Assunto , Nível de Saúde , Medicina do Trabalho/organização & administração , Serviços Contratados/organização & administração , Feminino , Humanos , Indústrias/normas , Masculino , Medicina do Trabalho/normas , Técnicas de Planejamento , Estados Unidos
9.
J Occup Environ Med ; 39(10): 970-82, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9343762

RESUMO

This retrospective study examines the mortality patterns of a relatively young cohort of 81,746 former and current petrochemical company employees. Standardized mortality ratios (SMR) for 1979 through 1992 are generally from about unity to well below unity for major causes and numerous specific causes of death studied by gender/race/job subgroups. Findings of note include a SMR (based on incidence rates) of 1.94 (95% confidence interval [CI], 1.04 to 3.33) for mesothelioma, and a SMR of 1.81 (95% CI, 0.90 to 3.24) for chronic lymphocytic leukemia, both among males hired before 1960. All male semiskilled operatives have a 1.6-fold increase (95% CI, 1.07 to 2.29) in motor vehicle accident deaths, with declining rates since the mid-1980s. The overall SMR for acquired immunodeficiency syndrome (AIDS) is at unity (69 deaths), with excesses in technician and office worker subgroups. Four decedents with lymphoma (code 202.8 in 9th revision ICD) had AIDS as a secondary cause of death, suggesting the need to examine secondary causes when studying lymphopoietic conditions. This routine surveillance activity provides leads regarding the presence or absence of excess mortality risk.


Assuntos
Causas de Morte , Indústria Química , Doenças Profissionais/mortalidade , Petróleo , Acidentes de Trabalho/mortalidade , Síndrome de Imunodeficiência Adquirida/mortalidade , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Leucemia Linfocítica Crônica de Células B/induzido quimicamente , Leucemia Linfocítica Crônica de Células B/mortalidade , Masculino , Mesotelioma/induzido quimicamente , Mesotelioma/mortalidade , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Petróleo/efeitos adversos , Neoplasias Pleurais/induzido quimicamente , Neoplasias Pleurais/mortalidade , Estudos Retrospectivos , Análise de Sobrevida , Estados Unidos/epidemiologia
10.
J Vestib Res ; 7(2-3): 161-77, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9178222

RESUMO

During locomotion, angular head movements act in a compensatory fashion to oppose the vertical trunk translation that occurs during each step in the gait cycle. This coordinated strategy between head and trunk motion serves to aid gaze stabilization and perhaps simplifies the sensory coordinate transformation between the head and trunk, allowing efficient descending motor control during locomotion. Following space flight, astronauts often experience oscillopsia during locomotion in addition to postural and gait instabilities, suggesting a possible breakdown in head-trunk coordination. The goal of the present investigation was to determine if exposure to the microgravity environment of space flight induces alteration in head-trunk coordination during locomotion. Astronaut subjects were asked to walk (6.4 km/h, 20 s trials) on a motorized treadmill while visually fixating on a centrally located earthfixed target positioned either 2 m (FAR) or 30 cm (NEAR) from the eyes. In addition, some trials were also performed during periodic visual occlusion. Head and trunk kinematics during locomotion were determined with the aid of a video-based motion analyzing system. We report data collected preflight (10 days prior to launch) and postflight (2 to 4 hours after landing). The coherence between pitch head and vertical trunk movements during gaze fixation of both FAR and NEAR targets was significantly reduced following space flight indicating decreased coordination between the head and trunk during postflight locomotion. Astronauts flying on their first mission showed greater alterations in the frequency spectra of pitch head movements as compared to their more experienced counterparts. These modifications in the efficacy of head movement control may account for the reported disruption in gaze performance during locomotion and may contribute to postflight postural and gait dysfunction.


Assuntos
Astronautas , Cabeça/fisiologia , Locomoção/fisiologia , Movimento/fisiologia , Voo Espacial , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Neuroreport ; 8(2): 469-73, 1997 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-9080431

RESUMO

This paper examines the contribution of egocentric cues and visual context to manual localization of remembered targets. Subjects pointed in the dark to the remembered position of a target previously viewed without or within a structured visual scene. Without a remembered visual context, subjects pointed to within 2 degrees of the target. The presence of a visual context with cues of straight ahead enhanced pointing performance to the remembered location of central but not off-center targets. Thus, visual context provides strong visual cues of target position and the relationship of body position to target location. Without a visual context, egocentric cues provide sufficient input for accurate pointing to remembered targets.


Assuntos
Memória/fisiologia , Percepção Visual/fisiologia , Adulto , Sinais (Psicologia) , Feminino , Humanos , Masculino
12.
Environ Health Perspect ; 104 Suppl 6: 1375-9, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9118923

RESUMO

This study was conducted to evaluate the relationship between leukemia occurrence and long-term, low-level benzene exposures in petroleum distribution workers. Fourteen cases were identified among a previously studied cohort [Schnatter et al., Environ Health Perspect 101 (Suppl 6):85-89 (1993)]. Four controls per case were selected from the same cohort, controlling for birth year and time at risk. Industrial hygienists estimated workplace exposures for benzene, without knowledge of case-control status. Average benzene concentrations ranged from 0.01 to 6.2 ppm. Company medical records were used to abstract information on other potential confounders such as cigarette smoking. Odds ratios were calculated for several exposure metrics. Conditional logistic regression modeling was used to control for potential confounders. The risk of leukemia was not associated with increasing cumulative exposure to benzene for these exposure levels. Duration of benzene exposure was more closely associated with leukemia risk than other exposure metrics, although results were not statistically significant. A family history of cancer and cigarette smoking were the two strongest risk factors for leukemia, with cumulative benzene exposure showing no additional risk when considered in the same models. This study is consistent with other data in that it was unable to demonstrate a relationship between leukemia and long-term, low-level benzene exposures. The power of the study was limited. Thus, further study on benzene exposures in this concentration range are warranted.


Assuntos
Benzeno/toxicidade , Leucemia/induzido quimicamente , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional , Petróleo/toxicidade , Adulto , Idoso , Benzeno/administração & dosagem , Carcinógenos/administração & dosagem , Carcinógenos/toxicidade , Estudos de Casos e Controles , Estudos de Coortes , Humanos , Leucemia/epidemiologia , Modelos Logísticos , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Razão de Chances , Fatores de Risco
13.
Occup Environ Med ; 53(11): 773-81, 1996 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9038803

RESUMO

OBJECTIVE: To evaluate the relation between mortality from lymphohaematopoietic cancer and long term, low level exposures to benzene among male petroleum distribution workers. METHODS: This nested case control study identified all fatal cases of lymphohaematopoietic cancer among a previously studied cohort. Of the 29 cases, 14 had leukaemia, seven multiple myeloma, and eight non-Hodgkin's lymphoma. A four to one matching ratio was used to select a stratified sample of controls from the same cohort, controlling for year of birth and time at risk. Industrial hygienists estimated workplace exposures for benzene and total hydrocarbons, without knowledge of case or control status, for combinations of job, location, and era represented in all work histories. Average daily benzene concentrations ranged from 0.01 to 6.2 parts per million (ppm) for all jobs. Company medical records were used to abstract information on other potential confounders such as cigarette smoking, although the data were incomplete. Odds ratios (ORs) were calculated with conditional logistic regression techniques for several exposure variables. RESULTS: Risks of leukaemia, non-Hodgkin's lymphoma, and multiple myeloma were not associated with increasing cumulative exposure to benzene or total hydrocarbons. For leukaemia, the logistic regression model predicted an OR of 1.002 (P < 0.77) for each ppm-y of exposure to benzene. Duration of exposure to benzene was more closely associated with risk of leukaemia than other exposure variables. It was not possible to completely control for other risk factors, although there was suggestive evidence that smoking and a family history of cancer may have played a part in the risk of leukaemia. CONCLUSION: This study did not show a relation between lymphohaematopoietic cancer and long term, low level exposures to benzene. The power of the study to detect low-such as twofold-risks was limited. Thus, further study on exposures to benzene in this concentration range are warranted.


Assuntos
Transtornos Histiocíticos Malignos/induzido quimicamente , Hidrocarbonetos/efeitos adversos , Exposição Ocupacional/efeitos adversos , Transportes , Idoso , Benzeno/efeitos adversos , Canadá/epidemiologia , Estudos de Casos e Controles , Causas de Morte , Transtornos Histiocíticos Malignos/epidemiologia , Humanos , Leucemia/induzido quimicamente , Leucemia/epidemiologia , Linfoma não Hodgkin/induzido quimicamente , Linfoma não Hodgkin/epidemiologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/induzido quimicamente , Mieloma Múltiplo/epidemiologia , Razão de Chances , Petróleo/efeitos adversos , Fatores de Risco
14.
Am J Health Promot ; 11(2): 99-106, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-10163602

RESUMO

PURPOSE: To identify demographic characteristics associated with worksite health promotion participation and to determine whether employees with high-risk health-related behaviors, as measured by a health risk appraisal, were participating in programs designed to address these behaviors. DESIGN: Descriptive. SETTING: A petrochemical research and development company where employees were offered a health risk appraisal questionnaire, a series of on-site wellness programs, and an on-site fitness center. SUBJECTS: All employees (n = 2290) working continuously from May 1, 1990, through February 28, 1992. MEASURES: Demographic and behavioral risk characteristics of participants and nonparticipants. RESULTS: Participation was 37% (health risk appraisal), 64% (all wellness programs), and 10% (fitness center), with women participating at higher rates than men in all programs. Most programs attracted 10% to 40% of the employees at risk for the particular behavior addressed by the program, although lower penetration (7% to 9%) was observed for the on-site fitness center and blood pressure education programs. With the exception of wellness programs for weight, smoking, and blood pressure, employees at lower behavioral risk tended to be more likely to participate than employees at high risk. CONCLUSIONS: Efforts to increase participation by all company employees, especially among those with high-risk behaviors, would benefit all health promotion programs, particularly the on-site fitness center.


Assuntos
Promoção da Saúde/organização & administração , Serviços de Saúde do Trabalhador/organização & administração , Cooperação do Paciente/psicologia , Recusa do Paciente ao Tratamento/psicologia , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Local de Trabalho
15.
J Neurosci Methods ; 64(2): 233-6, 1996 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8699885

RESUMO

We present an accurate, yet relatively inexpensive, system for measuring the direction of pointing responses. This system utilizes off-the-shelf business presentation components in a novel way to help detect and quantify the pointing measurements. The system configuration, measurement features, and procedures to enhance measurement accuracy are described.


Assuntos
Terminais de Computador , Lasers , Desempenho Psicomotor , Humanos , Modelos Estatísticos , Reprodutibilidade dos Testes
16.
J Vestib Res ; 5(4): 299-322, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7551214

RESUMO

Neglecting the eccentric position of the eyes in the head can lead to erroneous interpretation of ocular motor data, particularly for near targets. We discuss the geometric effects that eye eccentricity has on the processing of target-directed eye and head movement data, and we highlight two approaches to processing and interpreting such data. The first approach involves determining the true position of the target with respect to the location of the eyes in space for evaluating the efficacy of gaze, and it allows calculation of retinal error directly from measured eye, head, and target data. The second approach effectively eliminates eye eccentricity effects by adjusting measured eye movement data to yield equivalent responses relative to a specified reference location (such as the center of head rotation). This latter technique can be used to standardize measured eye movement signals, enabling waveforms collected under different experimental conditions to be directly compared, both with the measured target signals and with each other. Mathematical relationships describing these approaches are presented for horizontal and vertical rotations, for both tangential and circumferential display screens, and efforts are made to describe the sensitivity of parameter variations on the calculated results.


Assuntos
Movimentos Oculares/fisiologia , Movimento/fisiologia , Postura/fisiologia , Percepção Visual/fisiologia , Fixação Ocular , Cabeça , Humanos , Matemática , Músculos do Pescoço/fisiologia
17.
Br J Urol ; 76(1): 34-40, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7544202

RESUMO

OBJECTIVE: To determine the significance of the minima of prostate-specific antigen (PSA) levels after orchidectomy in patients with advanced carcinoma of the prostate (stage C and D disease), to thereby discriminate patients who have a statistically significant difference in prognosis and thus individualize their adjuvant treatment. PATIENTS AND METHODS: A retrospective analysis of 50 patients (mean age 75.8 years) with extracapsular prostate cancer (58% stage C, 42% stage D disease) was performed. PSA measurement and clinical assessment were continued at 3-monthly intervals until there was evidence of clinical progression. The minimum values of PSA were determined, the patients grouped at intervals of 1 ng/mL and the groups compared statistically on the basis of disease progression. RESULTS: Serum PSA levels decreased in all patients to a minimum after 3-6 months. There was a statistically significant difference in the probability of, and time to, disease progression for PSA minima at 1 ng/mL and 10 ng/mL. Of the 13 patients in group 1 (with PSA minima < 1 ng/mL), 11 stayed in remission during a mean follow-up duration of 45.9 months. Of 25 patients in group 2 (with PSA minima between 1 and 10 ng/mL) 19 developed progression after a mean remission period of 16.7 months, while all 12 patients in group 3 (with PSA minima > 10 ng/mL) progressed after a mean remission period of 12.5 months. CONCLUSION: Post-orchidectomy PSA minima are an excellent prognostic factor with significant predictive value. While patients in group 1 tend to have a favourable prognosis after orchidectomy alone, group 2 and 3 patients need adjuvant treatment as early as possible. Group 3 patients, with their high probability of early progression, also form a uniform cohort for studies concerning new therapeutic modalities. If the PSA minimum was included in further examinations, the results of treatment should improve.


Assuntos
Orquiectomia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/cirurgia , Idoso , Progressão da Doença , Intervalo Livre de Doença , Seguimentos , Humanos , Masculino , Prognóstico , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Estudos Retrospectivos
19.
J Vestib Res ; 4(5): 347-53, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7994480

RESUMO

In studies over the past 30 years, D. A. Robinson and colleagues established that the dynamic characteristics of smooth pursuit eye movements (SP) are different at the onset from those at the cessation of the response. They proposed that cessation of SP was due to a separate fixation system. During head movements, both fixation and SP may contribute to gaze stabilization. We investigated the relative contributions of fixation and SP to the "visually enhanced" vestibulo-ocular reflex (VVOR) using a paradigm requiring a transition from VVOR to combined eye-head tracking (CEHT). We found, in four normal subjects, that ringing typical of SP generally did not occur during VVOR, but that it often appeared after the transition to CEHT. The findings were different in two patients with absent peripheral vestibular function; ringing typical of SP occurred always during VVOR but disappeared during the onset of CEHT. These results can be explained by a model in which an internal representation of target velocity serves as input to parallel SP and fixation systems, and as the determinant of which of the two systems will provide the command signal. Interpretation of our data using this model indicates that either fixation or SP systems may "visually enhance" the VOR, depending on the magnitude of retinal error velocity that remains after vestibular eye movements have been generated.


Assuntos
Fixação Ocular/fisiologia , Acompanhamento Ocular Uniforme/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Adulto , Movimentos Oculares , Humanos , Pessoa de Meia-Idade , Movimento (Física) , Doenças Vestibulares/fisiopatologia
20.
J Neurol Sci ; 116(2): 152-64, 1993 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8336162

RESUMO

We investigated the interaction of smooth ocular pursuit (SP) and the vestibulo-ocular reflex (VOR) during horizontal, combined eye-head tracking (CEHT) in patients with abnormalities of either the VOR or SP movements. Our strategy was to apply transient stimuli that capitalized on the different latencies to onset of SP and the VOR. During CEHT of a target moving at 15 deg/sec, normal subjects and patients with VOR deficits all tracked the target with a gain close to 1.0. When the heads of normal subjects were suddenly and unexpectedly braked to a halt during CEHT, the eye promptly began to move in the orbit to track the target, but eye-in-orbit velocity transiently fell to about 60-70% of target velocity. In patients with deficient labyrinthine function, following the onset of the head brake, eye movements to track the target were absent, and SP movements were not generated until about 100 msec later. In patients with deficient SP, CEHT was superior to SP tracking with the head stationary; after the onset of the head brake, tracking eye movements were initiated promptly, but eye velocity was less than 50% of target velocity and increased only slightly thereafter. These results indicate that at least two mechanisms operate to overcome the VOR and allow gaze to track the target during CEHT: (1) the SP system provides a signal to cancel a normally-operating VOR (this cancellation signal is not needed by labyrinthine-deficient patients who have no VOR to cancel), and (2) a reduction of the gain of the VOR is achieved, an ability that is preserved even in patients with cerebral lesions that impair SP.


Assuntos
Movimentos Oculares/fisiologia , Cabeça/fisiologia , Transtornos da Motilidade Ocular/fisiopatologia , Acompanhamento Ocular Uniforme/fisiologia , Doenças Vestibulares/fisiopatologia , Adulto , Orelha Interna/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Neurológicos , Movimento/fisiologia , Estimulação Luminosa , Reflexo Vestíbulo-Ocular/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA