STUDY OBJECTIVE: To describe seasonal congestive heart failure (CHF) mortality and hospitalisations in Quebec, Canada between 1990-1998 and compare trends in CHF mortality and morbidity with those in France. DESIGN: Population cohort study. SETTING: Province of Quebec, Canada. PATIENTS: Mortality data were obtained from the Quebec Death Certificate Registry and hospitalisation from the Quebec Med-Echo hospital discharge database. Cases with primary ICD-9 code 428 were considered cases of CHF. RESULTS: Monthly CHF mortality was higher in January, declined until September and then rose steadily (p<0.05). Hospital admissions for CHF declined from May until September (moving averages analysis p<0.0001). Seasonal mortality patterns observed in Quebec were similar to those observed in France. CONCLUSION: CHF mortality in Quebec is highest during the winter and declines in the summer, similar to observations in France and Scotland. This suggests that absolute temperatures may not necessarily be that important but increased CHF mortality is observed once environmental temperatures fall below a certain "threshold" temperature. Alternatively better internal heating and warmer clothing required for survival in Quebec may ameliorate mortality patterns despite colder external environments. (+info)
Pseudo alopecia areata caused by skull-caps with metal pin fasteners used by Orthodox Jews in Israel.
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BACKGROUND: Alopecia Areata (AA) is a disease characterized by hair loss that is widely believed to be autoimmune in origin. Thus treatment is generally aimed in this direction using immune inhibitors such as steroids and PUVA. OBJECTIVE: To describe a variant of AA, Pseudo Alopecia Areata, caused by a particular cupola pin holder (tic-tac) and to offer a non-pharmacological treatment option (NPT). METHODS: A prospective open label study in 37 Jewish religious patients (34 males, 3 females, mean 35 +/- 2 years), previously diagnosed and treated for scalp AA were randomly referred to one of the three NPT intervention methods: small cupola held by two pins, large cupola held by one pin and similar cupola held by a different pin. RESULTS: Three of the ten patients (33.3%) from the first group developed secondary AA from the additional pin. No changes were seen in the second group. Ten of the seventeen patients (58.8%) from the third group achieved immediate improvement subsequent to replacing the original pin with a new one on a larger cupola. CONCLUSIONS: Conservative pharmacological treatment failed to repair the lesions. The addition of a second pin caused an additional lesion. In contrast, replacing the cupola with a larger one and the original pin-fastener with a different type, successfully reduced the lesions. (+info)
Mortality among a cohort of garment workers exposed to formaldehyde: an update.
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AIMS: To evaluate the mortality experience of 11 039 workers exposed to formaldehyde for three months or more in three garment plants. The mean time weighted average formaldehyde exposure at the plants in the early 1980s was 0.15 ppm but past exposures may have been substantially higher. METHODS: Vital status was updated through 1998, and life table analyses were conducted. RESULTS: Mortality from all causes (2206 deaths, standardised mortality ratio (SMR) 0.92, 95% CI 0.88 to 0.96) and all cancers (SMR 0.89, 95% CI 0.82 to 0.97) was less than expected based on US mortality rates. A non-significant increase in mortality from myeloid leukaemia (15 deaths, SMR 1.44, 95% CI 0.80 to 2.37) was observed. Mortality from myeloid leukaemia was greatest among workers first exposed in the earliest years when exposures were presumably higher, among workers with 10 or more years of exposure, and among workers with 20 or more years since first exposure. No nasal or nasopharyngeal cancers were observed. Mortality from trachea, bronchus, and lung cancer (147 deaths, SMR 0.98, 95% CI 0.82 to 1.15) was not increased. Multiple cause mortality from leukaemia was increased almost twofold among workers with both 10 or more years of exposure and 20 years or more since first exposure (15 deaths, SMR 1.92, 95% CI 1.08 to 3.17). Multiple cause mortality from myeloid leukaemia among this group of workers was also significantly increased (8 deaths, SMR 2.55, 95% CI 1.10 to 5.03). CONCLUSIONS: Results support a possible relation between formaldehyde exposure and myeloid leukaemia mortality. Previous epidemiological studies supporting a relation between formaldehyde exposure and leukaemia mortality have been primarily of formaldehyde exposed professional groups, not formaldehyde exposed industrial workers. Limitations include limited power to detect an excess for rare cancers such as nasal and nasopharyngeal cancers and lack of individual exposure estimates. (+info)
Dermal exposure to terpenic resin acids in Swedish carpentry workshops and sawmills.
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OBJECTIVES: The aim of this study was to evaluate dermal exposure to the resin acids abietic acid, dehydroabietic acid and 7-oxodehydroabietic acid during collecting in sawmills and during sawing in carpentry workshops, respectively. METHODS: Sampling was performed by fastening patches at 12 different areas on a sampling overall, one patch on the front of a cap, one patch on the chest inside the clothing and one patch on the inner lower right leg. Exposure of the hands was assessed by fastening patches on cotton gloves representing the dorsal sides and the palms of the left and right hands. Sampling was performed on 30 different occasions in the sawmills and in the carpentry workshops with mean sampling times of 120 and 59 min, respectively. The acids were solvent desorbed from the patches. Identification and quantification of the resin acids was performed by gas chromatography-mass spectrometry. RESULTS: The geometric means (GMs) of the potential body exposures to abietic acid, dehydroabietic acid and 7-oxodehydroabietic acid during sawing and collecting of wood from pine and spruce were 3346 and 17 247 micro g/h, respectively. The GM of the potential exposure on the hands was 3020 micro g/h in the carpentry workshops and 4365 micro g/h in the sawmills. Resin acids were detected on the inner chest and inner lower front right leg, respectively. CONCLUSIONS: There is a potential dermal exposure to terpenic resin acids in carpentry workshops as well as in sawmills. The hands have the highest exposure during sawing as well as during collecting. There is a spatial distribution of contaminants, with the outer chest, arms and legs showing the highest exposures. Resin acids also contaminated the inner chest and inner lower leg. It is necessary to take action to reduce dermal exposure to these allergenic substances. (+info)
Evaluation of an instrumented glove for hand-movement acquisition.
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Quantitative assessment of digit range of motion (ROM) is often needed for monitoring effectiveness of rehabilitative treatments and assessing patients' functional impairment. The objective of this research was to investigate the feasibility of using the Humanware Humanglove, a 20-position sensors glove, to measure fingers' ROM, with particular regard to measurement repeatability. With this aim, we performed a series of tests on six normal subjects. Data analysis was based on statistical parameters and on the intraclass correlation coefficient (ICC). Sources of errors that could affect measurement repeatability were also analyzed. The results demonstrate that, in principle, the glove could be used as goniometric device. The main advantage yielded by its use is reduction in the time needed to perform the whole measurement process, while maintaining process repeatability comparable to that achieved by traditional means of assessment. It also allows for dynamic and simultaneous recording of hand-joint movements. Future work will investigate accuracy of measurements. (+info)
Effects of a circulating-water garment and forced-air warming on body heat content and core temperature.
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BACKGROUND: Forced-air warming is sometimes unable to maintain perioperative normothermia. Therefore, the authors compared heat transfer, regional heat distribution, and core rewarming of forced-air warming with a novel circulating-water garment. METHODS: Nine volunteers were each evaluated on two randomly ordered study days. They were anesthetized and cooled to a core temperature near 34 degrees C. The volunteers were subsequently warmed for 2.5 h with either a circulating-water garment or a forced-air cover. Overall, heat balance was determined from the difference between cutaneous heat loss (thermal flux transducers) and metabolic heat production (oxygen consumption). Average arm and leg (peripheral) tissue temperatures were determined from 18 intramuscular needle thermocouples, 15 skin thermal flux transducers, and "deep" hand and foot thermometers. RESULTS: Heat production (approximately 60 kcal/h) and loss (approximately 45 kcal/h) were similar with each treatment before warming. The increases in heat transfer across anterior portions of the skin surface were similar with each warming system (approximately 65 kcal/h). Forced-air warming had no effect on posterior heat transfer, whereas circulating-water transferred 21+/-9 kcal/h through the posterior skin surface after a half hour of warming. Over 2.5 h, circulating water thus increased body heat content 56% more than forced air. Core temperatures thus increased faster than with circulating water than forced air, especially during the first hour, with the result that core temperature was 1.1 degrees +/- 0.7 degrees C greater after 2.5 h (P < 0.001). Peripheral tissue heat content increased twice as much as core heat content with each device, but the core-to-peripheral tissue temperature gradient remained positive throughout the study. CONCLUSIONS: The circulating-water system transferred more heat than forced air, with the difference resulting largely from posterior heating. Circulating water rewarmed patients 0.4 degrees C/h faster than forced air. A substantial peripheral-to-core tissue temperature gradient with each device indicated that peripheral tissues insulated the core, thus slowing heat transfer. (+info)
Mercury exposure aboard an ore boat.
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Two maritime academy interns (X and Y) were exposed to mercury vapor after spilling a bottle of mercury on the floor in an enclosed storeroom while doing inventory aboard an ore boat. During a 3-day period, intern Y suffered transient clinical intoxication that resolved after he was removed from the environment and he showered and discarded all clothing. His initial serum mercury level dropped from 4 ng/mL to < 0.05 ng/mL. Intern X had an initial level of 11 ng/mL, which continued to rise to a maximum of 188.8 ng/mL. He complained of tremulousness, insomnia, and mild agitation and was hospitalized. He had showered and discarded all clothing except his footwear earlier than intern Y. Intern X's continued exposure due to mercury in the contaminated boots during the 2 weeks before hospitalization was presumed to be the cause. Removing his footwear led to resolution of his toxic symptoms and correlated with subsequent lowered serum mercury levels. Chelation was initiated as recommended, despite its uncertain benefit for neurologic intoxication. Mercury is used in the merchant marine industry in ballast monitors called king gauges. New engineering is recommended for ballast monitoring to eliminate this hazard. (+info)
Lineup identification by children: effects of clothing bias.
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This study examined effects of clothing cues on children's identification accuracy from lineups. Four- to 14-year-olds (n = 228) saw 12 video clips of individuals, each wearing a distinctly colored shirt. After watching each clip children were presented with a target-present or target-absent photo lineup. Three clothing conditions were included. In 2 conditions all lineup members wore the same colored shirt; in the third, biased condition, the shirt color of only one individual matched that seen in the preceding clip (the target in target-present trials and the replacement in target-absent trials). Correct identifications of the target in target-present trials were most frequent in the biased condition, whereas in target-absent trials the biased condition led to more false identifications of the target replacement. Older children were more accurate than younger children, both in choosing the target from target-present lineups and rejecting target-absent lineups. These findings suggest that a simple clothing cue such as shirt color can have a significant impact on children's lineup identification accuracy. (+info)