Objectives: The aim of this review was to compare the efficacy of asparaginase (ASP)-containing vs ASP-absent regimens in the first-line treatment of ENKTL patients.
Methods: The PRISMA protocol was ...used to search PubMed and Embase for both controlled and uncontrolled studies of ASP or alternative chemotherapy (CT) for newly diagnosed ENKTL, published in English by March 2017. The regimens were compared to calculate relative risk (RR) with 95% confidence interval (CI) of the overall response rate (ORR), complete response (CR) or partial response (PR).
Results: Out of 38 studies included, eight were controlled trials, with the pooled RR of ORR in stage I-II 1.54 (95% CI 1.34-1.77); stage I-IV 1.34 (95% CI 1.09-1.64). In stage III-IV CT combined with radiotherapy (RT), RR of ORR was 2.30 (95% CI 1.66-3.18). ASP was also superior in achieving CR. When all single arms combined, RR of ORR after CT with ASP was 1.52 (95% CI 1.38-1.67) in stage I-II (15 studies); 1.44 (95% CI 1.32-1.57) in all stages (29 studies); 1.31 (95% CI 1.24-1.38) and 1.66 (95% CI 1.18-2.34) in stages I-II and III-IV combined with RT, correspondingly.
Conclusions: ASP-based CT significantly improved ORR and CR in patients with newly diagnosed both early-stage and advanced-stage ENKTL.
The sleep-wake cycle plays a fundamental role in maintaining the physiological balance of our body. Its alteration favours the genesis of several organic alterations and diseases including sleep ...disorders and the consumption of several substances of abuse. It has been reported that the work activity, especially that carried out during the night, is able to influence the sleep-wake cycle, promoting the development of insomnia, which, in turn, would subject the worker to a stressful condition such as to encourage adverse behaviour such as the use/abuse of psychotropic substances. Based on the above premises, the aim of our research was to evaluate, in night workers: (i) the pattern of consumption of alcoholic beverages; (ii) the presence of insomnia; and (iii) the possible correlation between alcohol consumption and insomnia disorder. We used the AUDIT-C test (the abbreviated version of the Alcohol Use Disorders Identification Test) and the Insomnia Severity Index to assess alcohol consumption and insomnia disorder, respectively. All questionnaires were completed by workers of both sexes belonging to different types of work activities, exclusively day or night. The results of our research show a higher propensity of night workers to consume alcoholic beverages than those who work during daytime hours, often in binge-drinking mode. In addition, an increase in the amount of alcohol consumed was found to be related to insomnia disorder, especially in night workers. This study provides further awareness of the importance of the negative impact of alcohol consumption on sleep quality in night workers.
We aimed to assess exposure to respirable particulate matter (PM) of beauty salon personnel, identify its determinants and ascertain the associated respiratory effects. We collected 122 full-day ...respirable PM samples from 12 beauty salons (floor area ranging from 24 to 550 m
, staff from 4 to 8) in Almaty, Kazakhstan, taking 10 samples from each place using a portable SidePak AM520 monitor. We also assessed lifestyle (smoking, etc.), respiratory symptoms and health-related quality of life (HRQL) of the personnel using questionnaires. Out of 11,831 5-min data points, daily median respirable PM concentrations were highly variable and ranged from 0.013 to 0.666 mg/m
with 8.5-times difference in the median concentrations between the venue with the highest median (0.29 mg/m
) and the least median (0.034 mg/m
). In a multivariate linear regression modelling, ambient PM
concentration was the strongest predictor of daily median respirable PM concentration (beta 2.12; 95% CI 1.89; 2.39), and R
of the model was 0.63. We also found a positive association of the median respirable PM with respiratory symptoms and seasonal allergy, but not with HRQL. Short-term respirable PM levels in the beauty salons may be very high, but the median concentrations are mainly determined by the ambient air pollution.
Abstract
The aim of this study was to ascertain the polymorphic markers profile of
ADIPOQ
,
KCNJ
11
and
TCF
7L2
genes in Kyrgyz population and to analyze the association of polymorphic markers and ...combinations of
ADIPOQ
gene's G276T locus,
KCNJ
11
gene's Glu23Lys locus and
TCF
7L2
gene's
VS
3C>T locus with type two diabetes (T2D) in Kyrgyz population. In this case‐control study, 114 T2D patients 109 non‐diabetic participants were genotyped using polymerase chain reaction‐restriction fragment length polymorphism (
PCR
‐
RFLP
). Two individual polymorphisms (
ADIPOQ
rs1501299,
KCNJ
11
rs5219) were found to be associated with T2D. We found two (Lys23Lys/
CC
and Glu23Lys/
CT
) of the overall nine combinations, which were more prevalent in T2D group compared to controls (χ
2
= 4.21, P = 0.04). Lys23Lys/
CC
combination was associated with a 2.65‐fold increased likelihood of T2D (
OR
= 2.65, 95%
CI
1.12‐6.28), whereas the Glu23Lys/
CT
combination also increased such likelihood (
OR
= 3.88, 95%
CI
1.27‐11.91). This study demonstrated some association of 276T allele and
ADIPOQ
gene G276T heterozygous genotype as well as
KCNJ
11
gene 23Lys allele with T2D in ethnic Kyrgyz, but study results should be interpreted with caution because of the limited statistical power.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Objectives: The aim of this study is to compare the toxicity profiles of SMILE versus less intense L-asparaginase-containing regimens, CCRT or "sandwich" RT+CT regimens.
Methods: PRISMA protocol was ...used to search Pubmed and Embase for studies of treatment regimens for extranodal NK/T-cell lymphoma, nasal type (ENKTL) in English published before March 2018. Pooled data were grouped into five categories: A) CHOP-like regimens; B) Gemcitabine-based regimens; C) SMILE-like regimens; D) Concurrent and "sandwich" RT + CT; and E) Methotrexate-based combinations. We pooled prevalence of selected adverse events from each study to calculate the weighted overall prevalence using meta-proportion in Stata.
Results: Group C was the most toxic with the pooled neutropenia 72% (95 CI 64;80) and thrombocytopenia 48% (95% CI 40;55) prevalence. The use of Group D treatment regimens was associated with the lowest anemia (10% (95% CI 1;19)) prevalence. Group E was the least toxic with regard to thrombocytopenia (6% (95% CI 1;11).
Conclusion: Our analysis confirms that SMILE regimen, which is current standard to treat advanced-stage ENKTL may be associated with more severe hematological toxicity compared to other L-asparaginase combinations, including methotrexate-based (AspaMetDex, MESA and MEDA) or gemcitabine-based (GELOX, PGEMOX, DDGP, GDL, GOLD, GLIDE) or CCRT-based regimens.
The aim of the current study was to assess a year-long impact of chronic intermittent exposure to hypoxia on blood pressure (BP) in healthy working middle-aged adults.
Data from pre-employment and ...annual screening of high-altitude mining company (elevation 4000 meters above sea level) were obtained for 472 workers aged 34.1 ± 7.8 years, working 2-week shifts, followed by 2 weeks of rest at low altitude (cumulative exposure 6 months). Overall systolic, diastolic BP change (ΔBP) were calculated, and tested in multivariate regression models in the entire group, as well as in different strata of BP.
Baseline systolic BP reduced from 123.2 ± 11.3 to 116.3 ± 13.1 mmHg (ΔBP 6.8 mmHg), diastolic BP from 76.7 ± 8.4 to 74.9 ± 8.4 mmHg (ΔBP -1.7 mmHg) (p < 0.001), both measured at low altitude before and after one year of exposure to chronic intermittent hypoxia. The greater the baseline BP, the more pronounced was BP decrease. In the most prevalent combined group of normal and high normal BP, both systolic and diastolic BP reduced after one year of high altitude exposure (p < 0.01). In multivariate adjusted models, none of exposures of interest were associated with ΔBP.
One-year intermittent exposure to hypobaric hypoxia in new hires for high-altitude mining company was not associated with BP increase.
Studies of the potential association between cigarette smoking and acute mountain sickness (AMS) have reached contradictory conclusions. Our aim was to perform a meta-analysis of studies across a ...range of populations to ascertain better the true relationship between cigarette smoking and AMS.
We used the PRISMA protocol to identify and screen eligible studies of smoking and AMS. Databases including Pubmed and Google Scholar were searched, using the terms "smoking" and "acute mountain sickness." We conducted a meta-analysis of the selected studies in order to evaluate causal inference, evaluate potential biases, and investigate possible sources of heterogeneity across studies.
We identified 3907 publications, of which 29 were eligible for inclusion by reporting smoking status and AMS. Of these, eight publications were excluded because they were duplicative or were lacking quantitative data. The 21 studies analyzed included 16 566 subjects. These fell into two groups: occupational/military (n = 8) or volunteers/trekkers/mixed (n = 13). Study heterogeneity was high (X (2) = 55.5, P < .001). Smoking was not statistically associated with increased risk of AMS: pooled OR = 0.88 (95% CI = 0.74-1.05). Stratification yielded similar risk estimates among the occupational/military studies versus all others and studies at relatively higher and lower altitudes.
Overall, smoking was not statistically significantly associated with AMS: there is no consistent effect of cigarette smoking acting as either a protective factor against or a risk factor for AMS.
This is the first quantitative assessment of published studies on smoking and AMS, which shows smoking to be neither a risk, nor protective. Studies specifically focusing on smoking as a risk factor, should guide further research on this issue. Although all smokers should be strongly advised to quit, studies on risk factors for AMS focusing on other exposures could shed light on the full range of risks for AMS.
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BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Over the past years, in the agricultural field, geo-localization has been introduced in order to develop specific farming processes, optimize resources, and reduce environmental pollution. ...Researchers have found alternative driving methods to traditional ones, such as assisted and semi-automatic driving. The aim of this study was to monitor the musculoskeletal efforts necessary to carry out different kinds of driving. The muscular strain was assessed using surface electromyographic devices, the distribution of the pressure exerted by the operator's body on the seat was observed by using two barometric pads applied on the seat back and on the seat, respectively, while the body movements and postures were analyzed through a Microsoft Kinect Camera 3D acquisition system. Results showed a significantly greater muscular activation during manual and assisted driving conditions. The pressure exerted by the operator on the barometric pads was significantly higher in manual and semi-automatic driving modes than in the assisted one. A remarkable increase in the average swinging speed of examined joints was also detected, as well as the distances run by the joints in semi-automatic driving. From our study, assisted driving seems to be the best driving mode both in terms of joint economy and from the efficiency of agricultural processes.
Occupation and Obstructive Sleep Apnea Schwartz, Daniel A.; Vinnikov, Denis; Blanc, Paul D.
Journal of occupational and environmental medicine,
06/2017, Volume:
59, Issue:
6
Journal Article
Peer reviewed
OBJECTIVE:Obstructive sleep apnea (OSA) remains a prevalent condition, but its occupational burden is unclear. We carried out a systematic review to characterize the consistency and magnitude of ...occupational associations with OSA.
METHODS:We studied OSA within three occupational categoriescommercial drivers, organic solvent-exposed workers, other selected occupations. We performed a meta-analysis on the prevalence of OSA among drivers and the risk of OSA associated with solvent exposure.
RESULTS:The pooled OSA prevalence in drivers was 41% (95% confidence interval CI 26% to 56%) for apnea hypopnea-index (AHI) is greater than 5, and 15% (95% CI 12% to 19%) for AHI is greater than 15. Exposure to solvents was associated with increased but non-statistically significant risk of OSAsummary relative risk, 2.38 (95% CI 0.89 to 6.32). Evidence of occupational association was inconsistent for other factors.
CONCLUSIONS:OSA is common among commercial drivers and potentially associated with occupations involving likely solvent exposure.
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Elevated exhaled nitric oxide fraction at a flow rate of 50 mL·s
(
) is an important indicator of T-helper 2-driven airway inflammation and may aid clinicians in the diagnosis and monitoring of ...asthma. This study aimed to derive Global Lung Function Initiative reference equations and the upper limit of normal for
.
Available individual
data were collated and harmonised using consensus-derived variables and definitions. Data collected from individuals who met the harmonised definition of "healthy" were analysed using the generalised additive models of location, scale and shape (GAMLSS) technique.
Data were retrospectively collated from 34 782 individuals from 34 sites in 15 countries, of whom 8022 met the definition of healthy (19 sites, 11 countries). Overall, height, age and sex only explained 12% of the between-subject variability of
(R
=0.12).
device was neccessary as a predictor of
, such that the healthy range of values and the upper limit of normal varied depending on which device was used. The range of
values observed in healthy individuals was also very wide, and the heterogeneity was partially explained by the device used. When analysing a subset of data in which
was measured using the same device and a stricter definition of health (n=1027), between-site heterogeneity remained.
Available
data collected from different sites using different protocols and devices were too variable to develop a single all-age reference equation. Further standardisation of
devices and measurement are required before population reference values might be derived.
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