194 research outputs found
The International Study of Insulin and Cancer
No full textThe international study of insulin and cancer.
Grimaldi-Bensouda L, Marty M, Pollak M, Cameron D, Riddle M, Charbonnel B, Barnett AH, Boffetta P, Boivin JF, Evans M, Rossignol M, Benichou J, Abenhaim L; ISICA group
Bilan des études portant sur l\u27oxyde d\u27éthylène
No full textL\u27oxyde d\u27éthylène est un produit inflammable et explosif dont les propriétés Irritantes et toxiques sont connues. Au cours des cinq dernières années plusieurs études ont permis de mieux connaitre les effets nocifs pouvant résulter de l\u27exposition à ce produit.
Le National Institute of Occupational Safety and Health (36) et l\u27American Conference of Governmental Industrial Hyglenists (2) considèrent que ces recherches apportent des arguments scientifiques suffisants pour que l\u27oxyde d\u27éthylène soit maintenant considéré comme un produit potentiellement carcinogène. Ils recommandaient par conséquent que la norme relative à la concentration moyenne admissible fixée à 50 ppm en 1971, soit réévaluée d\u27une part et que le degré d\u27exposition des travailleurs soit réduit au plus bas niveau possible compte tenu de la technologie actuelle. L\u27Occupational Safety and Health Administration procède présentement à cette réévaluation et plusieurs compagnies nord-américaines productrices et utilisatrices d\u27O.E., ont déjà adopté des règlements internes dans le but de réduire l\u27exposition à des concentrations moyennes de 10 ppm ou moins (38). Dans son livret TLV 82 , I\u27ACGIH a fixé la norme à 10 ppm et suggère qu\u27elle solt baissée à 1 ppm.
Au Québec, le règlement relatif à la qualité du milieu de travail indique que la concentration moyenne admissible pour 8 heures d\u27exposition est encore de 50 ppm. Ce règlement prévoit également une concentration maximale de 95 ppm (22), pour 4 périodes d\u27d\u27exposition d\u27une durée de 15 minutes chacune qui doivent être espacées entre elles de 60 minutes au minimum.
Ce document fait la synthèse des connaissances utiles à la prévention des risques liés à l\u27exposıtion professionnelle à l\u27oxyde d\u27éthylène. Après avoir énuméré les milieux de travail où ce produit est utilisé, nous présentons des informations favorisant la compréhension des problèmes de santé et de sécurité identifiés aux cours des recherches. Nous terminons par la description des moyens d\u27intervention disponibles dont le degré d\u27efficacité a été évalué par des organismes reconnus dans le domaine de la santé et de la sécurité du travail. Un résumé des principales recherches citées dans ce document est présenté en annexе
Varicose veins : epidemiology and outcomes
No full textVaricose veins are among the most prevalent medical conditions in western populations, with a prevalence estimated at 25--35% in women and 10--20% in men. Until now, few studies have regarded varicose veins as a distinct clinical entity and have investigated specific risk factors. Their consequences for the patients have not been adequately investigated. The main objective of this thesis was to examine the association between varicose veins and specific risk indicators and outcomes, taking into account the effects of more severe venous disorders often found in combination with varicose veins. This work is based on the VEnous INsufficiency Epidemiological and economical Study (VEINES), a one-year cohort study on venous disorders carried out in Belgium, France, Italy and Quebec. It included 1531 patients sampled among 5688 consecutive patients consulting a physician for a venous disorder. A sub-sample of 150 patients were referred to specialists for clinical examination and duplex investigation of venous incompetence. This study illustrated the problems of the diagnosis and classification of varicose veins, with a specificity of 45% for the diagnosis made by general practitioners. In a case-control analysis, the strongest risk indicators of varicose veins were pregnancy, age and family history. No association was found with other hypothesised determinants (obesity, smoking, history of thrombophlebitis, blood group A). Results of duplex studies support the hypothesis of a distal onset of venous reflux and varicose veins.Using a classification of varicose veins proposed to take account the concomitant presence of other signs of venous disease, varicose veins alone had no impact on a symptom score and on generic (SF-36) and disease-specific quality of life scores. The results suggest that symptoms and presence of varicose veins are independent outcomes, which has implications for clinical practice. A detailed analysis of health service utilisation performed in Belgium also showed that both are independent predictors of resource use
The pharmacoepidemiology of Crohn's disease therapy in Saskatchewan /
No full textCrohn's disease is an inflammatory bowel disease associated with substantial morbidity. Complications arising from this disease affect many organ systems. In particular, hepatitis, pancreatitis, blood dyscrasias, and renal disease are believed to occur more frequently in patients with Crohn's disease. The incidence of these conditions is also believed to be increased by some of the medications used to treat Crohn's disease. Sulfasalazine as well as mesalamine have been associated with hepatitis, pancreatitis, renal disease, and blood dyscrasias. In addition to characterizing the demographics and severity of Crohn's disease in Saskatchewan, the purpose of this study was also to determine if, in patients with Crohn's disease, there is an increased risk of developing these adverse conditions associated with the medications used to treat this condition. In this study 1999 patients with Crohn's disease who met inclusion criteria, were identified in the Saskatchewan Healthcare datafiles. (Abstract shortened by UMI.
Risk factors for the development of low back pain in adolescents
No full textA previous history and earlier age of onset of low back pain are associated with chronic low back pain in adults. As such, preventing low back pain in adolescence may have a positive impact in adulthood. The objectives of this study were to determine the incidence of low back pain in a cohort of adolescents and to ascertain whether it was associated with increased growth spurt, decreased muscle flexibility and trunk strength, physical activity, and work. A prospective cohort design with urban high school students was conducted in Montreal, Canada; 502 students were evaluated at three separate times, six months apart. The students completed a questionnaire which addressed health issues of a musculoskeletal nature as well as lifestyle and psychosocial variables. They were also measured for: height, weight, leg and back flexibility, and trunk strength. Questions on low back pain referred to the previous six months and a frequency of occurrence of at least once a week was considered to represent positive reporting. Cumulative incidence of low back pain was then defined as the sum of incident reporting in the two six-month periods, excluding those who reported low back pain at study entry. A multivariate analysis (general estimating equations analysis) was used to model the repeated measures dichotomous outcome as a function of age, gender, smoking status and the repeated measures exposure variables: increased growth, flexibility, strength, activity, work. Of the 377 adolescents who did not complain of low back pain at the initial evaluation, 65 developed substantial back pain over the course of the year (cumulative incidence 17%). Risk factors associated with development of low back pain were: high growth (relative risk 3.00, 95% confidence interval (C.I.) 1.47--6.11), smoking (relative risk 2.47, C.I. 1.31--4.66), working (relative risk 2.19, C.I. 1.12--4.28), and tight quadriceps femoris (relative risk 1.04, C.I. 1.01--1.07). We conclude that low back pain in adol
Public health impact of adverse bone effects of oral corticosteroids
No full textAims: The objective of this study was to estimate the number of fractures attributed to oral corticosteroid use.Methods: Information was obtained from the General Practice Research Database which contains medical records of general practitioners in the UK. The total number of corticosteroid-related fractures during a course of treatment was estimated using the formula for attributable risk among the exposed.Results: A total of 244 235 patients was prescribed an oral corticosteroid. The rate of hip fractures increased exponentially with age in both males and females. The excess number of hip fracture cases among females aged 85 years or older using 7.5 mg prednisolone per day or more was 1.4 cases per 100 patients per year. About 47% of all hip and 72% of all vertebral fractures that occurred can be attributed to oral corticosteroid use. Among 10 000 female users of higher doses, 99.7 nonvertebral, 31.6 hip and 45.8 vertebral fractures can be attributed to use of oral corticosteroids.Conclusions: The targeting of high-risk patients will be important for implementing preventative strategies in a cost-effective manner
The use of a large pharmacoepidemiological database to study exposure to oral corticosteroids and risk of fractures: validation of study population and results
No full textStudy using data from the UK General Practice Research Database on 244,235 oral corticosteroid users and 244,235 controls. Validation of fractures showed that hip fractures were confirmed by GPs on the questionnaire in 90.7% of the cases and by discharge summary in 86.5%. The relative rate of non-vertebral fracture during oral corticosteroid use did not vary substantially between patients with different diseases, age, or gender. The sensitivity analysis, modifying the type of analysis or inclusion of patients, did not materially change the findings. <br/
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