scholarly journals Hematological Effects and Benchmark Doses of Long-Term Co-Exposure to Benzene, Toluene, and Xylenes (BTX) in BTX-Exposed Petrochemical Workers Cohort (BEPWC)

2022 ◽  
Author(s):  
Zhaorui Zhang ◽  
Xin Liu ◽  
Xinjie Zhang ◽  
Yingying Zhang ◽  
Na Deng ◽  
...  
Keyword(s):  
Positive Association ◽  
Cumulative Exposure ◽  
Mean Corpuscular Hemoglobin ◽  
Combined Effects ◽  
Cell Counts ◽  
Hematological Effects ◽  
Benzene Toluene ◽  
Exposure Levels

Abstract Background Ubiquitous benzene, toluene, and xylenes (BTX) frequently occur together. Exposure to single BTX component and BTX-rich mixtures could induce hematological effects. However, it still needs to clarify the hematological influences of long-term co-exposure to BTX components, and propose reference exposure levels (REL) base on their hematological effects. Objective We sought to evaluate the hematological effects of long-term BTX co-exposure and estimate REL based on these effects. Methods We established BTX-Exposed Petrochemical Workers Cohort (BEPWC), quantified long-term BTX exposure levels by calculating cumulative exposure doses (CED), and detected multiple hematologic parameters in both baseline and follow-up stages. Generalized weighted quantile sum (gWQS) regression models were used to evaluate the combined effects of BTX components and identify their contributions. Benchmark Dose (BMD) Software was used to calculate BMD and the lower confidence limits (BMDL). Results Most hematologic parameters were decreased after four-year follow-up (P<0.05). We found a positive association of benzene with the decline in monocyte counts (β = 0.012), and a negative association of toluene with the decline in mean corpuscular hemoglobin concentrations (β =-0.905) after false discovery rate (FDR) adjustment. The associations of BTX components with the decline in hematologic parameters were mostly significantly stronger in subjects with higher baseline parameters, males, drinkers, and overweighted subjects (FDR-adjusted Pinteraction <0.05). BTX components had positive combined effects on the decline in monocyte counts, red blood cell counts, and hemoglobin concentrations (Ptrend for WQS index <0.05). BMD (and BMDL) for CED levels of benzene, toluene, and xylene were estimated at 2.138 (1.559), 1.449 (1.325), and 2.937 (2.312) mg/m3×year, respectively. Conclusions Our study revealed complex hematological effects of long-term BTX occupational co-exposure, and proposed some REL-TWA around 0.01 ppm for BTX components based on their hematological effects. All these findings are worthy of further investigation.

Partial Splenic Embolization UsingBletilla striataParticles for Hypersplenism in Cirrhosis: A Prospective Study

2011 ◽  
Vol 39 (02) ◽  
pp. 261-269 ◽  
Author(s):  
Rong Liu ◽  
Xiao-Jun Teng ◽  
Jiang-Fu He ◽  
Shao-Shu Xiao ◽  
Zhi-Bing Yuan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Esophageal Varices ◽  
Embolic Material ◽  
Cell Counts ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Bleeding Episodes ◽  
The Mean

The article evaluates the long-term follow-up results of PSE using Bletilla striata (BS) particles for hypersplenism in cirrhosis, as compared to PSE using gelfoam particles. Fifty-nine patients with cirrhosis-induced hypersplenism were treated with PSE. The patients were randomly assigned into two groups: gelfoam group, which includes 32 patients using gelfoam particles as the embolic material, and BS group, which includes 27 patients using BS particles. The peripheral blood cell counts and parameters for complications associated with PSE were measured during the follow-up. The mean values of leukocyte and thrombocyte, but not hemoglobin, were significantly increased after PSE (p < 0.01) in both groups. The values of leukocyte and thrombocyte during the long-term follow-up were significantly improved in BS group than that in gelfoam group (both p < 0.01). The frequency of bleeding episodes from esophageal varices in both groups was significantly reduced after PSE (both p < 0.01), but the post-PSE bleeding episodes showed no remarkable differences between the two groups (p = 0.084). Post-embolization syndrome consisted mainly of fever, nausea and vomiting, and abdominal pain in the two groups. The incidence of grade II to III abdominal pain in BS group (82.8%, 27/33) was significantly higher than in gelfoam group (57.9%, 33/57) (p = 0.020). The mean survival time was 61.5 ± 9.1 (median 60, 1–157) months in gelfoam group and 63.4 ± 9.9 (median 52, 0–161) months in BS group, which showed no significant difference (p = 0.930).In conclusion, BS particles could be used as the embolic material in PSE. Compared to gelfoam used in PSE, BS can achieve even better efficacy in alleviating hypersplenism. It provides a long-term effect on the hematological parameters, bleeding from esophageal varices and good palliation, and improved clinical status contributing to symptomatic control.

scholarly journals Persistent depressive symptoms and cognitive decline in older adults

2018 ◽  
Vol 213 (5) ◽  
pp. 638-644 ◽  
Author(s):  
Fanfan Zheng ◽  
Baoliang Zhong ◽  
Xiaoyu Song ◽  
Wuxiang Xie
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Cumulative Exposure ◽  
Orientation Function ◽  
Longitudinal Association ◽  
Nationally Representative ◽  
English Longitudinal Study ◽  
Cognitive Data

BackgroundLittle is known about the effect of persistent depressive symptoms on the trajectory of cognitive decline.AimsWe aimed to investigate the longitudinal association between the duration of depressive symptoms and subsequent cognitive decline over a 10-year follow-up period.MethodThe English Longitudinal Study of Ageing cohort is a prospective and nationally representative cohort of men and women living in England aged ≥50 years. We examined 7610 participants with two assessments of depressive symptoms at wave 1 (2002–2003) and wave 2 (2004–2005), cognitive data at wave 2 and at least one reassessment of cognitive function (wave 3 to wave 7, 2006–2007 to 2014–2015).ResultsThe mean age of the 7610 participants was 65.2 ± 10.1 years, and 57.0% were women. Of these, 1157 (15.2%) participants had episodic depressive symptoms and 525 participants (6.9%) had persistent depressive symptoms. Compared with participants without depressive symptoms at wave 1 and wave 2, the multivariable-adjusted rates of global cognitive decline associated with episodic depressive symptoms and persistent depressive symptoms were faster by –0.065 points/year (95% CI –0.129 to –0.000) and –0.141 points/year (95% CI –0.236 to –0.046), respectively (P for trend < 0.001). Similarly, memory, executive and orientation function also declined faster with increasing duration of depressive symptoms (all P for trend < 0.05).ConclusionsOur results demonstrated that depressive symptoms were significantly associated with subsequent cognitive decline over a 10-year follow-up period. Cumulative exposure of long-term depressive symptoms in elderly individuals could predict accelerated subsequent cognitive decline in a dose-response pattern.Declaration of interestNone.

scholarly journals Long-Term Follow-Up of HIV-Infected Individuals Who Have Significant Increases in CD4+ Cell Counts during Antiretroviral Therapy

2004 ◽  
Vol 39 (10) ◽  
pp. 1500-1506 ◽  
Author(s):  
S. L. Koletar ◽  
P. L. Williams ◽  
J. Wu ◽  
J. A. McCutchan ◽  
S. E. Cohn ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Long Term Follow Up ◽  
Cd4 Cell

Imatinib plus hydroxyurea in pretreated nonprogressive glioblastoma (GBM): Long-term follow up of a single-center phase II study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e13004-e13004
Author(s):  
Gregor Paul Dresemann
Keyword(s):  
Dose Reduction ◽  
Phase Ii ◽  
Survival Data ◽  
Phase Ii Study ◽  
Progression Free Survival ◽  
Continuous Treatment ◽  
Term Survival ◽  
Cell Counts

e13004 Background: GBM is malignant brain tumour with a median survival of 15.6 months. Dysregulated signalling of platelet derived growth factor receptors is suggested to play a role in pathogenesis. The combination of imatinib (I) plus hydroxyurea (HU) is known to be well tolerated and to show moderate efficacy in patients (pts) with recurrent GBM. Despite the aggressive course of GBM once starting progression, short periods of disease stabilisation after primary treatment or effective treatment of relapse can be observed. This Phase II study was initiated to analyse the efficacy of I plus HU as maintenance treatment (MT) in GBM pts. Methods: From December 2003 up to June 2005 30 pts were included. No enzyme-inducing anticonvulsive drugs were allowed. I (600 mg/day) and HU (1000 mg/day) were given as a continuous treatment. Blood cell counts were taken weekly and magnetic resonance imaging every 6 weeks. Primary endpoint (PE) was 6 and 12 months progression free survival (PFS), secondary endpoints (SE) were 5 years PFS and overall survival (OS). Results: All pts were eligible for PE and SE. 25 pts were male, 5 pts female, median age was 44 years (32 to 71). All pts had prior irradiation, 21 pts had prior temozolomide (T) containing therapy and 9 pts non-temozolomide containing therapy. 8 pts had none, 17 pts one and 5 pts two prior relapses. 25 pts had measurable disease, 4 of these pts achieved a partial response (PR), there was no complete remission, 5 pts had no evidence of disease. Median follow up is 90 months. Hematotoxicity grade 2 and 3 occurred in 11 out of 30 pts and required dose reduction of HU in 8 pts, dose reduction of I in 1 patient and G-CSF in 8 pts. PFS rate at 6, 12, 24 and 60 months were 60% (18/30), 40% (12/30), 17% (5/30) and 17% (5/30 ) respectively, OS rate at 6, 12, 24 and 60 months were 90% (27/30), 67% (20/30), 37% (11/30) and 17% (5/30). 4 pts are still alive without progression. Conclusions: Although I and HU did not demonstrate relevant efficacy in GBM and never reached admission status the reported study indicates impressive long-term survival data for I and HU as a continuous oral MT. Further studies should analyse more effective drugs like temozolomide as MT (proof of principle). Clinical trial information: STI571DE21.

scholarly journals Long-Term Outcomes of Arteriovenous Fistulas with Unassisted versus Assisted Maturation: A Retrospective National Hemodialysis Cohort Study

2019 ◽  
Vol 30 (11) ◽  
pp. 2209-2218 ◽  
Author(s):  
Timmy Lee ◽  
Joyce Zhang Qian ◽  
Yi Zhang ◽  
Mae Thamer ◽  
Michael Allon
Keyword(s):  
Cohort Study ◽  
Positive Association ◽  
Primary Patency ◽  
Data System ◽  
Long Term Outcomes ◽  
Arteriovenous Fistulas ◽  
Increased Risk ◽  
The Us

BackgroundAbout half of arteriovenous fistulas (AVFs) require one or more interventions before successful dialysis use, a process called assisted maturation. Previous research suggested that AVF abandonment and interventions to maintain patency after maturation may be more frequent with assisted maturation versus unassisted maturation.MethodsUsing the US Renal Data System, we retrospectively compared patients with assisted versus unassisted AVF maturation for postmaturation AVF outcomes, including functional primary patency loss (requiring intervention after achieving AVF maturation), AVF abandonment, and frequency of interventions.ResultsWe included 7301 patients ≥67 years who initiated hemodialysis from July 2010 to June 2012 with a catheter and no prior AVF; all had an AVF created within 6 months of starting hemodialysis and used for dialysis (matured) within 6 months of creation, with 2-year postmaturation follow-up. AVFs matured without prior intervention for 56% of the patients. Assisted AVF maturation with one, two, three, or four or more prematuration interventions occurred in 23%, 12%, 5%, and 4% of patients, respectively. Patients with prematuration interventions had significantly increased risk of functional primary patency loss compared with patients who had unassisted AVF maturation, and the risk increased with the number of interventions. Although the likelihood of AVF abandonment was not higher among patients with up to three prematuration interventions compared with patients with unassisted AVF maturation, it was significantly higher among those with four or more interventions.ConclusionsFor this cohort of patients undergoing assisted AVF maturation, we observed a positive association between the number of prematuration AVF interventions and the likelihood of functional primary patency loss and frequency of postmaturation interventions.

scholarly journals Naïve CD4+ cell counts significantly decay and high HIV RNA levels contribute to immunological progression in long-term non-progressors infected with HIV by blood products: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ling Xu ◽  
Yubin Liu ◽  
Xiaojing Song ◽  
Yanling Li ◽  
Yang Han ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Blood Products ◽  
Hiv Rna ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Rna Levels

Abstract Background Some long-term non-progressors (LTNPs) have decreasing CD4+ T cell counts and progress to AIDS. Exploring which subsets of CD4+ T cell decreasing and the determinants associated with the decay in these patients will improve disease progression surveillance and provide further understanding of HIV pathogenesis. Methods Twenty-five LTNPs infected with HIV by blood products were classified as decreased (DG) if their CD4+ cell count dropped to < 400 cells/μL during follow-up or as non-decreased (non-DG) if their CD4+ cell count was ≥400 cells/μL. Laboratory and clinical assessments were conducted at 6 consecutive visits to identify DG characteristics. Results The LTNPs were infected with HIV for 12 (IQR: 11.5–14) years, and 23 were classified as the B′ subtype. Six individuals lost LTNP status 14.5 (IQR: 12.5–17.5) years after infection (DG), and the CD4+ T cell count decreased to 237 (IQR: 213–320) cells/μL at the latest visit. The naïve CD4+ T cell count decrease was greater than that of memory CD4+ T cells [− 128 (IQR: − 196, − 107) vs − 64 (IQR: − 182, − 25) cells/μL)]. Nineteen individuals retained LTNP status (non-DG). At enrolment, the viral load (VL) level (p = 0.03) and CD8+CD38+ percentage (p = 0.03) were higher in DG than non-DG individuals. During follow-up, viral load and CD8+CD38+ percentage were significantly increased and negatively associated with CD4+ cell count [(r = − 0.529, p = 0.008), (r = − 0.476, p = 0.019), respectively]. However, the CD8+CD28+ percentage and B cell count dropped in DG and were positively correlated with CD4+ T cell count [(r = 0.448, p = 0.028), (r = 0.785, p < 0.001)]. Conclusion Immunological progression was mainly characterized by the decrease of naïve CD4+ T cell in LTNPs infected with HIV by blood products and it may be associated with high HIV RNA levels.

Blood rheology of captive and free-ranging northern elephant seals and sea otters

1990 ◽  
Vol 68 (2) ◽  
pp. 375-380 ◽  
Author(s):  
L. L. Wickham ◽  
D. P. Costa ◽  
R. Elsner
Keyword(s):  
Blood Cell ◽  
Capillary Viscometer ◽  
Mean Corpuscular Hemoglobin ◽  
Sea Otters ◽  
Elephant Seals ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
Northern Elephant Seals ◽  
Free Ranging

Hematologic and rheologie characteristics of blood from captive and free-ranging sea otters, Enhydra lutris, and northern elephant seals, Mirounga angustirostris, were studied to evaluate short- and long-term responses to captivity. Red blood cell counts, white blood cell counts, hemoglobin concentrations, hematocrits, total plasma proteins, and mean corpuscular volume measurements were made on anticoagulated venous blood samples. Mean corpuscular hemoglobin concentrations were calculated. Viscosity measurements were made at shear rates from 11.5 to 230.4 s−1 on a Wells–Brookfield cone-plate viscometer. A capillary viscometer (radius, 500 μm) provided additional viscometric measurements. Comparisons of hematologic and rheologic data revealed only minor differences between captive and free-ranging seals and sea otters. Although hematologic variables were within the ranges reported in earlier wild vs. captive studies of these species, no evidence of short- (3 weeks) or long-term (> 6 months) acclimatization to captive exposure was found in the hemorheology of these marine mammals.

scholarly journals Long-term follow-up of patients with hairy cell leukemia after treatment with 2'-deoxycoformycin

Blood ◽  
1994 ◽  
Vol 84 (12) ◽  
pp. 4061-4063 ◽  
Author(s):  
EH Kraut ◽  
MR Grever ◽  
BA Bouroncle
Keyword(s):  
Complete Remission ◽  
Hairy Cell Leukemia ◽  
Disease Free Survival ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Cell Counts ◽  
Long Term Follow Up ◽  
The Impact

Twenty-four patients with advanced hairy cell leukemia treated with 2'- deoxycoformycin (dCF) were studied after achieving complete remission to determine the impact of treatment on survival, disease-free survival, long-term complications of treatment, and response to retreatment. At a median follow-up time of 82 months (range, 54 to 104 months), 23 of 24 patients remain alive. One patient has died of recurrent disease refractory to treatment. Of the remaining 23 patients, 11 have relapsed at a median time of 30 months (range, 7 to 80 months) after treatment completion. Of these 11 patients, 7 have been retreated with dCF or 2'-chlorodeoxyadenosine (2-CdA), including one patient that was retreated twice. All seven patients have responded, with five patients achieving second complete remission. Two patients have had normalization of blood cell counts, but repeat bone marrows have not been performed. No serious infections have been seen in dCF-treated patients during follow-up. One case of Hodgkin's disease and three cases of skin malignancies have developed in these 24 patients. From initiation of treatment, survival is 93 months (range, 63 to 116 months). We concluded that dCF significantly prolongs the survival of patients with advanced hairy cell leukemia without resultant long-term complications. It is too early to predict if this therapy will be curative for the patients still in remission.

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