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Selected AbstractsThe association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic reviewINTERNATIONAL JOURNAL OF CANCER, Issue 5 2007Article first published online: 27 NOV 200 Abstract Exposure to solar ultraviolet (UV) radiation is a known cause of skin cancer. Sunbed use represents an increasingly frequent source of artificial UV exposure in light-skinned populations. To assess the available evidence of the association between sunbed use and cutaneous malignant melanoma (melanoma) and other skin cancers, a systematic review of the literature till March 2006 on epidemiological and biological studies on sunbed use was performed in Pubmed, ISI Web of Science, Embase, Pascal, Cochrane library, Lilacs and Medcarib. Search for keywords in the title and in the abstract was done systematically and supplemented by manual searches. Only case,control, cohort or cross-sectional studies were selected. Data were abstracted by means of a standardized data-collection protocol. Based on 19 informative studies, ever-use of sunbeds was positively associated with melanoma (summary relative risk, 1.15; 95% CI, 1.00,1.31), although there was no consistent evidence of a dose,response relationship. First exposure to sunbeds before 35 years of age significantly increased the risk of melanoma, based on 7 informative studies (summary relative risk, 1.75; 95% CI, 1.35,2.26). The summary relative risk of 3 studies of squamous cell carcinoma showed an increased risk. For basal cell carcinoma, the studies did not support an association. The evidence does not support a protective effect of the use of sunbeds against damage to the skin from subsequent sun exposure. Young adults should be discouraged from using indoor tanning equipment and restricted access to sunbeds by minors should be strongly considered. © 2006 Wiley-Liss, Inc. [source] Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studiesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2010Bruno R. da Costa PT Abstract Objective This systematic review was designed and conducted in an effort to evaluate the evidence currently available for the many suggested risk factors for work-related musculoskeletal disorders. Methods To identify pertinent literature we searched four electronic databases (Cinahl, Embase, Medline, and The Cochrane Library). The search strategies combined terms for musculoskeletal disorders, work, and risk factors. Only case,control or cohort studies were included. Results A total of 1,761 non-duplicated articles were identified and screened, and 63 studies were reviewed and integrated in this article. The risk factors identified for the development of work-related musculoskeletal disorders were divided and organized according to the affected body part, type of risk factor (biomechanical, psychosocial, or individual) and level of evidence (strong, reasonable, or insufficient evidence). Conclusions Risk factors with at least reasonable evidence of a causal relationship for the development of work-related musculoskeletal disorders include: heavy physical work, smoking, high body mass index, high psychosocial work demands, and the presence of co-morbidities. The most commonly reported biomechanical risk factors with at least reasonable evidence for causing WMSD include excessive repetition, awkward postures, and heavy lifting. Additional high methodological quality studies are needed to further understand and provide stronger evidence of the causal relationship between risk factors and work-related musculoskeletal disorders. The information provided in this article may be useful to healthcare providers, researchers, and ergonomists interested on risk identification and design of interventions to reduce the rates of work-related musculoskeletal disorders. Am. J. Ind. Med. 53:285,323, 2010. © 2009 Wiley-Liss, Inc. [source] Use of morphine and 6-monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin usersADDICTION, Issue 4 2003Anna Fugelstad Abstract Aims, To detect risk factors for sudden death from heroin injection. Design, Evaluation of data from forensic investigations of all fatal cases of suspected heroin death in a metropolitan area. Only cases with detectable morphine and 6-monoacetylmorphine (6-MAM) in blood were included in order to select heroin intoxication cases. Setting, Stockholm, Sweden. Measurements, Autopsy investigation and toxicological analysis of blood and urine; and police reports. Findings, In two-thirds of the 192 cases, death occurred in public places, and mostly without any time delay. Blood concentrations of morphine ranged from 50 to 1200 ng/g, and of 6-MAM from 1 to 80 ng/g. Codeine was detected in 96% of the subjects. In the majority of cases the forensic investigation indicated polydrug use, the most common additional findings being alcohol and benzodiazepines. However, in one-quarter of the cases other drug combinations were found. Previous abstinence from heroin and use of alcohol were identified as risk factors. For 6-MAM there was also a correlation with the presence of THC and benzodiazepines. Despite a high frequency of heart abnormalities (e.g. myocarditis and focal myocardial fibrosis), these conditions did not correlate with morphine or 6-MAM blood concentrations. Conclusions, We confirm that alcohol intake and loss of tolerance are risk factors for death from heroin use, whereas no connection to heart pathology was observed. Further, prospective, studies should focus on other possible risk factors. [source] Implications of system expansion for the assessment of well-to-wheel CO2 emissions from biomass-based transportationINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 13 2010Elisabeth Wetterlund Abstract In this paper we show the effects of expanding the system when evaluating well-to-wheel (WTW) CO2 emissions for biomass-based transportation, to include the systems surrounding the biomass conversion system. Four different cases are considered: DME via black liquor gasification (BLG), methanol via gasification of solid biomass, lignocellulosic ethanol and electricity from a biomass integrated gasification combined cycle (BIGCC) used in a battery-powered electric vehicle (BPEV). All four cases are considered with as well as without carbon capture and storage (CCS). System expansion is used consistently for all flows. The results are compared with results from a conventional WTW study that only uses system expansion for certain co-product flows. It is shown that when expanding the system, biomass-based transportation does not necessarily contribute to decreased CO2 emissions and the results from this study in general indicate considerably lower CO2 mitigation potential than do the results from the conventional study used for comparison. It is shown that of particular importance are assumptions regarding future biomass use, as by expanding the system, future competition for biomass feedstock can be taken into account by assuming an alternative biomass usage. Assumptions regarding other surrounding systems, such as the transportation and the electricity systems are also shown to be of significance. Of the four studied cases without CCS, BIGCC with the electricity used in a BPEV is the only case that consistently shows a potential for CO2 reduction when alternative use of biomass is considered. Inclusion of CCS is not a guarantee for achieving CO2 reduction, and in general the system effects are equivalent or larger than the effects of CCS. DME from BLG generally shows the highest CO2 emission reduction potential for the biofuel cases. However, neither of these options for biomass-based transportation can alone meet the needs of the transport sector. Therefore, a broader palette of solutions, including different production routes, different fuels and possibly also CCS, will be needed. Copyright © 2009 John Wiley & Sons, Ltd. [source] A probable case of metastatic carcinoma from the late prehistoric eastern Tennessee River ValleyINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 4 2002Maria Ostendorf Smith Abstract There are few described cases of metastatic carcinoma from the prehistoric eastern United States and none primarily differentially diagnosed from the southeast. A mature adult female exhibiting several large lytic cranial lesions suggestive of neoplastic disease was identified in a late prehistoric Mississippian Period (AD 1200,1600) context. Burial 371 is from Ledford Island, a Mouse Creek phase (AD 1400,1500) site from the Chickamauga Reservoir of southeastern Tennessee. It is the only case in this reservoir (total adult n = 843). The radiographs of the otherwise asymptomatic postcranium yielded radiolucencies in both proximal femora, both medial clavicles, the sternum, the surviving humeral metaphysis and fragmentary innominate. The locations are all consistent with metastasized carcinoma. The identity of the possible primary lesion is argumentative. Age, sex and the mixed nature of the osseous response are consistent with carcinoma of the breast but not to the exclusion of bronchogenic, thyroid, or kidney cancers. Copyright © 2002 John Wiley & Sons, Ltd. [source] Bilateral Systematized Porokeratotic Eccrine Ostial and Dermal Duct Nevus with Unilateral Breast HypoplasiaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005A. Jayaraman Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare hamartomatous malformation of the eccrine duct which typically presents at birth or early in life. Multiple punctate pits and verrucous papules and plaques with nonfollicular hyperkeratotic spines are seen over the palms and soles and may extend to the distal extremities. A linear distribution may be present. A wide range of involvement has been reported in the literature, including bilateral systematized involvement. No systemic involvement has been linked to PEODDN to date. Histologic findings are characteristic and include a dilated eccrine acrosyringium with an overlying parakeratotic column or cornoid lamella. There is slight dyskeratosis and loss of the granular layer under the cornoid lamella. Here, we present a case of bilateral systematized PEODDN in an otherwise healthy, 18 year-old Hispanic female. Physical examination is notable for marked hypoplasia of the left breast with overlying verrucous papules and plaques. Multiple punch biopsies were performed and showed findings diagnostic of PEODDN. To our knowledge, this is the most extensive involvement of PEODDN reported in the literature to date and the only case with associated hypoplasia of the breast. [source] An inclusive fitness analysis of altruism on a cyclical networkJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 6 2007A. GRAFEN Abstract A recent model studies the evolution of cooperation on a network, and concludes with a result connecting the benefits and costs of interactions and the number of neighbours. Here, an inclusive fitness analysis is conducted of the only case solved analytically, of a cycle, and the identical result is obtained. This brings the result within a biologically familiar framework. It is notable that the benefits and costs in the inclusive fitness framework need to be derived, and are not the benefits and costs that are the parameters in the original model. The relatedness is a quadratic function of position in a cycle of size N: an individual is related by 1 to itself, by (N , 5)/(N + 1) to an immediate neighbour, and by very close to ,1/2 to the most distant individuals. The inclusive fitness analysis explains hitherto puzzling features of the results. [source] Thalidomide for the treatment of multiple myelomaCONGENITAL ANOMALIES, Issue 3 2004Yutaka Hattori ABSTRACT Although thalidomide was withdrawn in the 1960s after its teratogenic property was recognized, it was subsequently found that this drug possesses immunomodulatory and anti-inflammatory effects. Recent studies have also demonstrated that thalidomide has antineoplastic activity via an antiangiogenic mechanism. Observations in the late 1990s that the microenvironment in the bone marrow plays a role in tumor progression in multiple myeloma provided an impetus to use thalidomide for the treatment of this disease. It is known that thalidomide monotherapy is effective in one-third of refractory cases, and in combination with glucocorticoids and/or antineoplastic drugs, thalidomide provides a response rate of more than 50%. Thus, thalidomide therapy is considered a standard approach for the treatment of relapsed and refractory myeloma. The exact mechanism of the antimyeloma effect of thalidomide is not yet clearly understood. Anti-angiogenic effects, direct activity in tumor cells such as the induction of apoptosis or G1 arrest of the cell cycle, the inhibition of growth factor production, the regulation of interactions between tumor and stromal cells, and the modulation of tumor immunity have been considered as possible mechanisms. In addition to its teratogenicity, the adverse effects of thalidomide have been general symptoms such as somnolence and headache, peripheral neuropathy, constipation, skin rash, and other symptoms. Although these adverse effects are generally reversible and mild, grade 3 and 4 toxicities such as peripheral neuropathy, deep venous thrombosis, neutropenia, and toxic dermal necrosis have occasionally been reported. The application of thalidomide therapy in patients with multiple myeloma is being broadened to include not only cases of refractory myeloma, but also previously untreated cases, as well as for maintenance therapy after hematopoietic stem cell transplantation and for the treatment of other hematological diseases. The safe use of this drug will depend on the establishment of diagnostic and treatment guidelines. In addition, the establishment of a nation-wide regulation system is urgently needed in Japan. [source] Global change and carnivore body size: data are stasisGLOBAL ECOLOGY, Issue 2 2009Shai Meiri ABSTRACT Aim, Global warming and other anthropogenic changes to the environment affect many aspects of biology and have often been invoked as causing body size changes in vertebrates. Here we examine a diverse set of carnivore populations in search of patterns in body size change that could reflect global warming (in accord with Bergmann's rule). Location, Global. Methods, We used > 4400 specimens representing 22 carnivore species in 52 populations collected over the last few decades to examine whether size changed with collection date when geography and sex are accounted for. We then examined several factors related to global warming, body mass, diet, and the attributes of the different datasets, to see whether they affect the standardized slope (,) of the size versus time regression. Results, Six of 52 populations we examined show a significant effect of year of collection on body size at the 0.05 probability level. The response of size to global warming does not reflect spatial patterns of size variation, nor do diet or body mass affect tendency of populations to change in body size. Size changes are no more pronounced in populations that have been sampled more recently. However, change, where it occurs, is rapid. Main conclusions, There may be a tendency in the literature to report only cases where recent changes are prevalent. Although in our data only a minority of populations show body size changes, we may see changes accelerating in the future in response to more drastic climatic changes and other anthropogenic changes. [source] Costs of managing conditions associated with obesity among Australian teenagersJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2009Michael L Booth Aim: To determine the health-care charges associated with monitoring and managing, over 1 year, the cases of elevated insulin concentration, elevated alanine aminotransferase concentration and dyslipidaemia due to overweight or obesity among 15,19-year-old Australian males and females. Methods: Fasting blood samples (n= 500) were collected in 2004 from a representative population sample of adolescents (n= 496; mean age 15.3 years) attending schools in Sydney, Australia. Full service charges and Medicare expenditures for specialist medical and dietary consultations, pathology tests and radiological investigations, over 1 year, under efficient and inefficient health-care delivery models, including and excluding participants in the healthy body mass index (BMI) category. Results: Under an inefficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A305.1 million per annum (M pa). Exclusion of participants in the healthy BMI category resulted in an annual Medicare expenditure of $A170.0M pa. Under an efficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A295.5M pa. Exclusion of participants in the healthy BMI category reduced annual Medicare expenditure to $A164.8M pa. Medicare expenditure for 15,19-year-olds would increase by 48% if only cases among overweight and obese adolescents were treated and by 85% if all cases were identified and treated. Conclusions: Short-term management of the health consequences of overweight and obesity among adolescents will increase Medicare expenditure on this group by at least 48%. Failure to treat will delay, but compound, health-care expenditure. [source] Extraction and Refinement Strategy for detection of autism in 18-month-olds: a guarantee of higher sensitivity and specificity in the process of mass screeningTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2009Hideo Honda Background:, For early detection of autism, it is difficult to maintain an efficient level of sensitivity and specificity based on observational data from a single screening. The Extraction and Refinement (E&R) Strategy utilizes a public children's health surveillance program to produce maximum efficacy in early detection of autism. In the extraction stage, all cases at risk of childhood problems, including developmental abnormality, are identified; in the refinement stage, cases without problems are excluded, leaving only cases with conclusive diagnoses. Methods:, The city of Yokohama, Japan, conducts a routine child health surveillance program for children at 18 months in which specialized public health nurses administer YACHT-18 (Young Autism and other developmental disorders CHeckup Tool), a screening instrument to identify children at risk for developmental disorders. Children who screen positive undergo further observation, and those without disorders are subsequently excluded. To study the efficacy of early detection procedures for developmental disorders, including autism, 2,814 children born in 1988, examined at 18 months of age, and not already receiving treatment for diseases or disorders were selected. Results:, In the extraction stage, 402 (14.3%) children were identified for follow-up. In the refinement stage, 19 (.7%) of these were referred to the Yokohama Rehabilitation Center and diagnosed with developmental disorders. The extraction stage produced four false negatives, bringing total diagnoses of developmental disorders to 23 (.8%) , including 5 with autistic disorder and 9 with pervasive developmental disorder , not otherwise specified (PDDNOS). Sensitivity was 60% for autistic disorder and 82.6% for developmental disorders. Specificity for developmental disorders rose to 100% with the E&R Strategy. Picture cards used in YACHT-18 provided a finer screen that excluded some false positive cases. Conclusions:, An extraction and refinement methodology utilizing child health surveillance programs achieve high efficacy for early detection of autism. [source] | |||||||||||||