Prenatal exposure to glycol ethers and cryptorchidism and hypospadias: a nested case–control study

2017 ◽  
Vol 75 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Charline Warembourg ◽  
Jérémie Botton ◽  
Nathalie Lelong ◽  
Florence Rouget ◽  
Babak Khoshnood ◽  
...  

ObjectivesGlycol ethers (GE) are oxygenated solvents frequently found in occupational and consumer products. Some of them are well-known testicular and developmental animal toxicants. This study aims to evaluate the risk of male genital anomalies in association with prenatal exposure to GE using urinary biomarkers of exposure.MethodsWe conducted a case–control study nested in two joint mother–child cohorts (5303 pregnant women). Cases of cryptorchidism and hypospadias were identified at birth and confirmed during a 2-year follow-up period (n=14 cryptorchidism and n=15 hypospadias). Each case was matched to three randomly selected controls within the cohorts for region of inclusion and gestational age at urine sampling. Concentrations of five GE acidic metabolites were measured in spot maternal urine samples collected during pregnancy. ORs were estimated with multivariate conditional logistic regressions including a Firth’s penalisation.ResultsDetection rates of urinary GE metabolites ranged from 8% to 93% and only two were sufficiently detected (>33%) in each cohort to be studied: methoxyacetic acid (MAA) and phenoxyacetic acid (PhAA). A significantly higher risk of hypospadias was associated with the highest tertile of exposure to MAA: OR (95% CI) 4.5(1.4 to 23.4). No association were observed with urinary concentration of PhAA, nor with the risk of cryptorchidism.ConclusionsIn view of the toxicological plausibility of our results, this study, despite its small sample size, raises concern about the potential developmental toxicity of MAA on the male genital system and calls for thorough identification of current sources of exposure to MAA.

2018 ◽  
Vol 1 (21;1) ◽  
pp. E643-E650
Author(s):  
Dong Ah Shin

Background: The non-operative treatment of herniated intervertebral discs has long been a fundamental challenge. A novel technique of laser ablation to ablate the nucleus pulposus under a transforaminal epiduroscope (TELA system, Lutronics, Seoul, Republic of Korea) was recently developed. Objective: The purpose of this study was to evaluate the safety and effectiveness of transforaminal epiduroscopic laser ablation (TELA) for selective ablation of the nucleus pulposus in single-level disc disease. Study Design: Prospective case control study Setting: Multicenter study Methods: This study included a group of 56 patients who underwent transforaminal epiduroscopic laser ablation (TELA) and 56 patients who underwent selective transforaminal epidural block (STEB) for single-level disc disease. Visual analog scale (VAS), Oswestry Disability Index (ODI), and SF-12 were assessed at admission and at 1, 3, 6, and 12 months postoperatively. Results: The mean VAS of back pain was lower for the TELA group than for the STEB group 12 months postoperative (P < 0.05). The mean ODI was lower in the TELA group than in the STEB group at 12 months postoperatively (P < 0.05). There were no major complications related to the TELA and STEB procedures. Limitations: The primary limitation is a small sample size. The control group was created from a database which was prospectively collected in a different time line. Conclusions: The TELA procedure is superior to the STEB procedure in terms of patients reporting less pain and better quality of life over a year. TELA may be a reasonable alternative to conventional interventions or open surgery in single-level disc disease. Key words: Laser-assisted spinal endoscopy, disc decompression, Nd:YAG laser, laser ablation, intervertebral disc disease, lumbar spine


1997 ◽  
Vol 83 (3) ◽  
pp. 130-145
Author(s):  
S J Ryder ◽  
P I Crawford ◽  
R J Pethybridge

AbstractTesticular cancer is the commonest malignancy arising in men actively serving in the Royal Navy. This study, which includes a literature review of the aetiology of the disease, is designed to determine the relative risk of developing testicular cancer in various occupational groups within the Service by means of a Case-Control study. All cases of testicular cancer occurring in serving personnel between 1976 and June 1994, inclusive, were identified. One hundred and ten cases were found. Four randomly selected controls were matched on the basis of date of birth and length of service to each case. Results reveal statistically significant increased Odds Ratios for members of the Fleet Air Arm (OR=1.90 95% Cl : 1.04–.48), Air Engineers (OR=2.32 95% Cl: 1.20–4.48) and the Aircraft Handling sub-speciality (OR=7.31 95% Cl: 1.81–29.53). It is speculated that exposure to glycol ethers in aviation fuel may be the causative mechanism. No associations were found in relation to ionising radiation exposures or length of time served in nuclear submarines.


Author(s):  
Jeremy A Labrecque ◽  
Myriam M G Hunink ◽  
M Arfan Ikram ◽  
M Kamran Ikram

Abstract Case-control studies are an important part of the epidemiologic literature, yet confusion remains about how to interpret estimates from different case-control study designs. We demonstrate that not all case-control study designs estimate odds ratios. On the contrary, case-control studies in the literature often report odds ratios as their main parameter even when using designs that do not estimate odds ratios. Only studies using specific case-control designs should report odds ratios, whereas the case-cohort and incidence-density sampled case-control studies must report risk ratio and incidence rate ratios, respectively. This also applies to case-control studies conducted in open cohorts, which often estimate incidence rate ratios. We also demonstrate the misinterpretation of case-control study estimates in a small sample of highly cited case-control studies in general epidemiologic and medical journals. We therefore suggest that greater care be taken when considering which parameter is to be reported from a case-control study.


2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0029
Author(s):  
Joseph D. Cooper ◽  
Wei Wang ◽  
Heather A. Prentice ◽  
Tadashi Ted Funahashi ◽  
Gregory B. Maletis

Objectives: There is evidence the slope of the tibial plateau may play a role in need for revision following ACL reconstruction (ACLR), however, previous studies are limited by small sample sizes, radiographic measurement, single surgeon experience, lateral tibial posterior slope (LTPS) only, or a lack of confounder adjustment. Further, the role of the medial posterior tibial slope (MTPS) on revision risk has yet to be evaluated. We sought to (1) determine the relationship of revision status following ACLR and LTPS, (2) determine the relationship of revision status and MTPS, and (3) determine the relationship of revision status and the difference between MTPS and LTPS. Methods: We conducted a nested case-control study of 317 matched pairs using an integrated U.S. healthcare system’s ACLR registry (2006- 2014). Cases were defined as patients who underwent a revision following primary unilateral ACLR; controls were defined from the same cohort as non-revised patients during the same time frame. Controls were matched to cases according to age, gender, body mass index, race, graft type, femoral fixation device, and follow-up time. Magnetic resonance imaging (MRI) images were used by a single blinded reviewer to measure tibial slopes. Wilcoxon signed rank test was applied to compare the slopes between revised and non-revised groups continuously and McNemar test to compare slopes of ≥12° between groups. Results: No difference was observed between revised and non-revised patients in LTPS (mean: 6.1 vs. 6.1, p=0.972) or MTPS (mean: 4.6 vs. 4.9, p=0.281) measurement. When comparing revised ACLR to non-revised ACLR, a greater proportion of revised ACLR had a LTPS of ≥12° (7.6% vs. 3.8%, P=0.034), while no difference was found in the proportion of ACLR with a MTPS ≥12° (1.6% vs. 2.5%, P=0.405). No difference was found when evaluating the medial-to-lateral slope difference (-1.5 vs. -1.2, p=0.289). Conclusion: In our nested case-control study of over 300 revised ACLR patients matched to non-revised patients, we did not find an association between the slope of the lateral and medial tibial plateaus and revision. [Figure: see text][Table: see text]


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