Malignant mesothelioma in 91 danish women: The environmental asbestos exposure.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 8560-8560 ◽  
Author(s):  
Vasiliki Panou ◽  
Mogens Vyberg ◽  
Christos Meristoudis ◽  
Øyvind Omland ◽  
Ulla Møller Weinreich ◽  
...  
Keyword(s):  
Risk Factor ◽  
Environmental Exposure ◽  
Malignant Mesothelioma ◽  
Patient Information ◽  
Medical Records ◽  
Asbestos Exposure ◽  
University Hospital ◽  
Populated Area ◽  
Asbestos Worker ◽  
Asbestos Cement

8560 Background: Malignant Mesothelioma (MM) is an asbestos-related malignancy that presents mainly in the pleura (MPM) and peritoneum (MAM). In a densely populated area of Aalborg city in North Jutland, Denmark, a large Eternit asbestos factory that was active for 60 years until 1986 and two shipyards were situated. The Region of North Jutland, Denmark has a high mm incidence in women of 1.0/100,000. Methods: From 1974-2015, 101 histological and cytological samples of women diagnosed with mm in Aalborg University Hospital were identified re-evaluated by modern immunohistochemistry. Patient information regarding asbestos exposure was retrieved from medical records and selected Danish registries. Asbestos exposure was classified as primary for asbestos workers; domestic, for women living with an asbestos worker; environmental, when living or working within 10.000 meters from an asbestos emitting location; unknown, where no source of asbestos exposure could be identified. Results: Clinical and histopathological mm diagnosis was certain for 91 women. Potential asbestos exposure is summarized in Table 1. The employment of the women and their relatives include work at the asbestos cement factory, shipyard, construction, laboratory, pipe factory, electrician and insulator. The women with domestic and combined domestic and environmental (secondary) exposure to asbestos were most prone to develop MPM rather than MAM while women primary exposed to asbestos developed MAM rather than MPM (p=0.016). Conclusions: This study showed that the vast majority (64%) of the women diagnosed with mm had documented non-occupational asbestos exposure and almost 1/5 had a sole environmental exposure, by living in proximity to asbestos industry. Environmental asbestos exposure is a serious risk factor for mm in women. Primary asbestos exposure, inferring more intense exposure through occupation, may predispose to peritoneal mesothelioma in women. [Table: see text]

scholarly journals Asbestos Exposure Level and the Carcinogenic Risk Due to Corrugated Asbestos-Cement Slate Roofs in Korea

2021 ◽  
Vol 18 (13) ◽  
pp. 6925
Author(s):  
Eun-Soo Lee ◽  
Young-Ki Kim
Keyword(s):  
Asbestos Exposure ◽  
Health Impact ◽  
Pooled Analysis ◽  
Carcinogenic Risk ◽  
University Hospital ◽  
Exposure Level ◽  
Lifetime Cancer Risk ◽  
Indoor Exposure ◽  
Asbestos Cement ◽  
Environmental Causes

Asbestos-cement slate roofs are one of the most common environmental causes of asbestos exposure. However, few studies have examined residential asbestos-cement slate-related exposure and its effects on human health. This study was performed to evaluate cumulative asbestos exposure levels and to calculate the Excess Lifetime Cancer Risk (ELCR) of residents of asbestos-cement slate-roofed houses. We reviewed previous Korean literature to estimate the concentration of airborne asbestos from asbestos-cement slate roofed buildings. Finally, eight studies were selected, and a pooled analysis was performed. The results derived from the pooled analysis were combined with the data from a health impact survey conducted from 2009 to 2016 at the Environmental Health Center for Asbestos (EHCA) of the Yangsan Pusan National University Hospital, and a carcinogenic risk assessment was performed. As a result, the representative value of the indoor exposure concentration related to asbestos-cement slate was found to be 0.0032 f/cc on average, and the representative value of the exposure related to occupational asbestos-cement slate dismantling and demolition was found to be 0.0034 f/cc. In addition, the ELCR of asbestos-cement slate related indoor exposure and occupational dismantling and demolition was found to be of medium risk, and the ELCR of residential dismantling and demolition of asbestos-cement slate was less than 10−6, indicating that the risk was low. Since there is no threshold for carcinogenicity related to asbestos, this should not be ignored even if the risk appears low, and it would be reasonable to calculate the carcinogenic risk based on total lifetime exposure. More studies on asbestos exposure scenarios and the scope of similar exposure groups through additional data collection and further analysis of risk are needed.

Malignant Mesothelioma in Rome, Italy 1980-1995. A Retrospective Study of 79 Patients

1996 ◽  
Vol 82 (6) ◽  
pp. 526-532 ◽  
Author(s):  
Valeria Ascoli ◽  
Caterina Carnovale Scalzo ◽  
Francesco Facciolo ◽  
Massimo Martelli ◽  
Liborio Manente ◽  
...  
Keyword(s):  
Construction Industry ◽  
Malignant Mesothelioma ◽  
Asbestos Exposure ◽  
Case Series ◽  
Indoor Exposure ◽  
Railroad Workers ◽  
Asbestos Cement ◽  
Job Titles ◽  
Clinical Records ◽  
Navy Personnel

Aim and background To evaluate the characteristics of a case-series of 79 malignant mesothelioma patients collected from the main teaching hospital of Rome, Italy, and other local clinics of Latium Region and to assess the role of asbestos exposure, since previous studies on the occurrence of the disease in this area were lacking. Methods The study included cytohistologically diagnosed malignant mesothelioma (71 pleural, 7 peritoneal, and 1 testicular tunica vaginalis) detected or referred for consultation during the period 1980-1995. Information regarding occupational and/or nonoccupational exposures was derived from clinical records and interviews, when available. Results Patients were resident in Rome and other towns of Latium; a few were from other parts of central and southern Italy. Exposure to asbestos was assessed for 45.5% of patients, another 45.5% had unknown exposure, and for the remaining 9% such information was lacking. Occupational exposure occurred in 53% of men for whom information was available and nonoccupational exposure occurred in 20% of women. The study identified two clusters of cases from an asbestos-cement plant and a facility where asbestos was ubiquitous. Furthermore, most exposed subjects reported occupations in the construction industry, which is particularly active in the Latium Region; others were railroad workers, naval mechanics and navy personnel, bakers, explosive workers and car mechanics. A few patients reported indoor exposure to asbestos at home and/or in the workplace. Conclusions The study confirmed that mesothelioma risk is present in several job titles of the construction industry, and it is no longer confined to workers employed in the manufacture or application of asbestos products. The occurrence of malignant mesothelioma in patients with unexpected occupational and nonoccupational exposures indicates the need for further investigation on previously underestimated exposures.

scholarly journals Environmental and Occupational Exposure to Asbestos as a Result of Consumption and Use in Poland

2019 ◽  
Vol 16 (14) ◽  
pp. 2611 ◽  
Author(s):  
Małgorzata Krówczyńska ◽  
Ewa Wilk
Keyword(s):  
Public Health ◽  
Correlation Coefficient ◽  
Environmental Exposure ◽  
Asbestos Exposure ◽  
Industrial Area ◽  
Morbidity Rate ◽  
Asbestos Fibre ◽  
Asbestos Cement ◽  
Wide Range ◽  
Exposure Methods

Asbestos is harmful to human health; exposure to asbestos causes a wide range of asbestos-related diseases. Aim: Malignant mesothelioma (MM) is unique to occupational and environmental asbestos exposure. Methods: Environmental asbestos exposure was examined in relation to asbestos use and manufacturing, the quantity of the asbestos-containing products still in use, the concentrations of asbestos fibres in the air and the number of MM cases diagnosed each year per county. Results: The correlation coefficient of the measurements of the asbestos fibre concentrations in the air and the quantity of asbestos-cement products in use is high and amounts to 0.68. Meanwhile, the correlation coefficient of the measurements of asbestos fibre concentrations in air and MM morbidity rate resulting from environmental exposure calculated for particular counties in provinces is low and amounts to 0.37. The highest MM morbidity rate was observed for Małopolskie and Śląskie, a typical industrial area of Poland. Conclusions: There are MM cases which are still attributable to occupational asbestos exposure, although MM cases resulting from environmental exposure to asbestos have an increased MM risk. Poland is among those countries with a low MM incidence rate, which seems to be an underestimation of environmental asbestos exposure. As long as asbestos-cement products are used in the environment, actions should be undertaken to protect public health.

scholarly journals Pleural mesothelioma in Poland: Spatial analysis of malignant mesothelioma prevalence in the period 1999-2013

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Małgorzata Krówczyńska ◽  
Ewa Wilk ◽  
Piotr Pabjanek ◽  
Gabriela Olędzka
Keyword(s):  
Malignant Mesothelioma ◽  
Spatial Clustering ◽  
Asbestos Exposure ◽  
Incidence Rates ◽  
Autocorrelation Analysis ◽  
Manufacturing Plants ◽  
Southern Poland ◽  
Asbestos Cement ◽  
High Incidence ◽  
Administrative Units

Malignant mesothelioma (MM), a rare and very deadly tumour, can be due to asbestos exposure. To better understand the cause of incidence of MM, spatial autocorrelation analysis with reference to the quantity of asbestos-cement products in use and the localisation of former asbestos manufacturing plants was applied. Geostatistical analysis shows that strong spatial clustering of MM incidence (referring to the general population as well as females and males separately) during the period 1999-2013 in the administrative units of Poland (provinces and counties). Incidence hotspots were found to be concentrated primarily in southern Poland but also seen in the county of Szczecin, which stands out in local autocorrelation analysis in north-western Poland. High incidence rates were discovered, in particular with reference to counties around former plants manufacturing asbestos-containing products, mainly asbestos-cement manufacturers. The highest frequency of MM incidence rate was found in within a 55 km radius of plants in or near the towns Trzebinia, Ogrodzieniec and Szczucin in the South, where asbestos-cement products had been manufactured for close to 40 years. Areas with significantly high incidence rates were also discovered in the provinces of Śląskie, Małopolskie and Świętokrzyskie in southern Poland.

Risk Factor Of Substitution ARV First Line People Living With HIV/AIDS In General Hospital Buleleng Bali

2020 ◽  
Vol 9 (1) ◽  
pp. 190-197
Author(s):  
Luh Putu Desy Puspaningrat ◽  
Gusti Putu Candra ◽  
Putu Dian Prima Kusuma Dewi ◽  
I Made Sundayana ◽  
Indrie Lutfiana
Keyword(s):  
Risk Factor ◽  
General Hospital ◽  
Medical Records ◽  
Secondary Data ◽  
District General Hospital ◽  
People Living With Hiv ◽  
First Line ◽  
The Past ◽  
Factor Substitution ◽  
Living With Hiv

Substitution is still a threat to the failure of ARV therapy so that no matter how small it must be noted and monitored in ARV therapy. The aims  was analysis risk factor substitution ARV first line in therapy ARV. This study was an analytic longitudinal study with retrospective secondary data analysis in a cohort of patients receiving ARV therapy at the District General Hospital of Buleleng District for the period of 2006-2015 and secondary data from medical records of PLHA patients receiving ART.  Result in this study that the percentage of first-line ARV substitution events is 9.88% (119/1204) who received ARV therapy for the past 11 years. Risk factors that increase the risk of substitution in ARV therapy patients are zidovudine (aOR 4.29 CI 1.31 -2.65 p 0.01), nevirapine (aOR1.86 CI 2.15 - 8.59 p 0.01) and functional working status (aOR 1.46 CI 1.13 - 1.98 p 0.01). 

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

scholarly journals A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yasunari Yamashita ◽  
Rina Kitajima ◽  
Kiyoshi Matsubara ◽  
Gaku Inoue ◽  
Hajime Matsubara
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Records ◽  
Low Frequency ◽  
University Hospital ◽  
Diabetes Treatment ◽  
C Statistic ◽  
Risk Engine

Abstract Objective In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values. Results Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.

scholarly journals 53. Incidence of Bloodstream Infections and Outcomes in Patients with Severe COVID-19 Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S156-S157
Author(s):  
Aikaterini Papamanoli ◽  
Jeanwoo Yoo ◽  
Azad Mojahedi ◽  
Robin Jacob ◽  
Prabhjot Grewal ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Blood Cultures ◽  
High Flow ◽  
University Hospital ◽  
Skin Microbiota ◽  
Prolonged Recovery ◽  
The Impact

Abstract Background Coronavirus disease 19 (COVID-19) leading to acute respiratory distress syndrome is associated with need for intensive care (IC), mechanical ventilation (MV), and prolonged recovery. These patients are thus predisposed to blood stream infections which can worsen outcomes. This risk may be aggravated by adjunctive therapies. Methods We reviewed the medical records of all adults admitted to Stony Brook University Hospital, NY, from March 1 to April 15, 2020 with severe COVID-19 pneumonia (requiring high-flow O2). Patients who received MV or died within 24h were excluded. Patients were followed until death or hospital discharge. We reviewed positive blood cultures (PBC) for pathogenic microorganisms, and calculated the incidence of bacteremia, rates of infective endocarditis (IE), and impact on mortality. Microbes isolated only once and belonging to groups defined as commensal skin microbiota were labelled as contaminants. We also examined the impact of adjunctive therapies with immunosuppressive potential (steroids and tocilizumab), on bacteremia. Results A total of 469 patients with severe COVID-19 pneumonia were included (Table 1). Of these, 199 (42.4%) required IC and 172 (36.7%) MV. Median length of stay was 13 days (8–22) and 94 (20.0%) had PBC. Of these, 43 were considered true pathogens (bacteremia), with predominance of E. faecalis and S. epidermidis, and 51 were considered contaminants (Table 2). The incidence of bacteremia (43/469, 9.2%) was 5.1 per 1000 patient-days (95%CI 3.8–6.4). An echocardiogram was performed in 21 patients, 1 had an aortic valve vegetation (IE) by methicillin sensitive S. aureus. Bacteremia rates were nonsignificantly higher with steroids (5.9 vs 3.7 per 1000 patient-days; P=0.057). Use of tocilizumab was not associated with bacteremia (5.8 vs 4.8 per 1000 patient-days; P=0.28). Mortality was nonsignificantly higher in patients with (15/43, 34.9%) vs. without (108/426, 25.4%) bacteremia (P=0.20). Length of stay was the strongest predictor of bacteremia, with risk increasing by 7% (95%CI 6%-9%, P&lt; 0.001) per additional day. Cohort Characteristics of Patients with Severe COVID-19 Pneumonia on High-Flow O2 (N= 469) All Microorganisms Isolated from Blood Cultures Conclusion The incidence of bacteremia was relatively low and IE was uncommon in this study of severe COVID-19 patients. Risk of bacteremia increased with longer hospital stay and with steroids use, but not with tocilizumab. Disclosures All Authors: No reported disclosures

scholarly journals Glutamine and glutathione at ICU admission in relation to outcome

2012 ◽  
Vol 122 (12) ◽  
pp. 591-597 ◽  
Author(s):  
Paul Castillo Rodas ◽  
Olav Rooyackers ◽  
Christina Hebert ◽  
Åke Norberg ◽  
Jan Wernerman
Keyword(s):  
Risk Factor ◽  
Organ Failure ◽  
Independent Predictor ◽  
Apache Ii ◽  
University Hospital ◽  
Glutathione Depletion ◽  
Glutamine Supplementation ◽  
Limiting Factor ◽  
Icu Patients ◽  
Icu Admission

Glutamine depletion is demonstrated to be an independent predictor of hospital mortality in ICU (intensive care unit) patients. Today glutamine supplementation is recommended to ICU patients on parenteral nutrition. In addition to glutamine, glutathione may be a limiting factor in ICU patients with MOF (multiple organ failure). To study the prevalence of glutamine and glutathione depletion an observational study was performed. The results were analysed in relation to mortality and the conventional predictors of mortality outcome, APACHE II (Acute Physiology and Chronic Health Evaluation II) and SOFA (Sequential Organ Failure Assessment). Consecutive patients admitted to the ICU at Karolinska University Hospital Huddinge were studied. Patient admission scoring of APACHE II and SOFA were registered as well as mortality up to 6 months. Plasma glutamine concentration and whole blood glutathione status at admittance were analysed. The admission plasma glutamine concentrations were totally independent of the conventional risk scoring at admittance, and a subnormal concentration was an independent predictor of mortality. In addition, glutathione redox status was also an independent mortality predictor, but here a normal ratio was the risk factor. In both cases the mortality risk was mainly confined to the post-ICU period. A low plasma concentration of glutamine at ICU admission is an independent risk factor for post-ICU mortality. The possible benefit of extending glutamine supplementation post-ICU should be evaluated prospectively.

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