WTS database

Title	Pub Year Sort descending	Author	SearchLink
The diagnosis and management of Barrett's esophagus	1999	University of Southern California School of Medicine, Los Angeles, USA.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Advances in Surgery Periodical, Abbrev. Adv.Surg. Pub Date Free Form Volume 33 Issue Start Page 29 Other Pages 68 Notes LR: 20091111; JID: 0045335; RF: 93; ppublish Place of Publication UNITED STATES ISSN/ISBN 0065-3411; 0065-3411 Accession Number PMID: 10572561 Language eng SubFile Journal Article; Review; IM DOI Output Language Unknown(0) PMID 10572561 Abstract Since its description in the 1950s, the definition of Barrett's esophagus has evolved from the macroscopic visualization of gastric-appearing mucosa in the esophagus to the histologic identification of goblet cells confirming the presence of intestinal metaplasia within the esophagus. The length of intestinal metaplasia necessary to be classified as Barrett's, and the relationship between intestinal metaplasia of the esophagus and that limited to the cardia are all areas currently being evaluated. However, any segment of intestinal metaplasia is capable of undergoing dysplastic change and ultimately of becoming a focus of adenocarcinoma. It is logical to expect the degree of risk for developing cancer to be proportional to the amount of intestinal metaplasia present; however, within a population, the low risk to any individual is balanced by the relative frequency of the process. Thus, given the large numbers of people in America with CIM, even a small risk of progression to cancer will result in a large number of patients with adenocarcinoma of the cardia. This is exactly what is occurring today, with the incidence of adenocarcinoma of the cardia and esophagus currently rising faster than any other cancer in the United States. A major risk factor for adenocarcinoma of the esophagus is intestinal metaplasia, which occurs as a consequence of GERD. Patients with Barrett's esophagus usually have more severe reflux disease with significant impairment of LES function and esophageal body motility compared with patients without Barrett's. Furthermore, in patients with Barrett's, the composition of the refluxed juice is different. Patients who reflux both gastric and duodenal juice have a higher prevalence of Barrett's than do those who reflux gastric juice alone. Among patients with Barrett's, a significantly greater esophageal bilirubin exposure has been demonstrated in those with dysplasia. The mechanically defective sphincter and impaired esophageal body function in many patients with Barrett's makes their disease difficult to control medically. In addition, symptoms are unreliable as a guide to successful control of reflux. The hardest symptom to control is regurgitation, and there is concern that this and continued reflux of pharmacologically altered gastric contents, particularly bile acids in their nonpolar form, may contribute to progression of Barrett's. Both medical therapy and failed antireflux surgery are associated with progression of Barrett's to dysplasia and adenocarcinoma. On the other hand, a functioning fundoplication seems to be associated with protection from progression of Barrett's. Intestinal metaplasia of the esophagus is unlikely to regress after antireflux surgery; however, intestinal metaplasia limited to the cardia is perhaps more dynamic and able to regress. Furthermore, low-grade dysplasia frequently regresses after an antireflux procedure. Antireflux surgery is safe, effective, and durable, and often can be performed using minimally invasive techniques. Thus, antireflux surgery should be strongly considered in any patient with intestinal metaplasia of the esophagus or cardia. The possibility of mucosal ablation after an antireflux repair should be considered in patients with low-grade dysplasia. Patients with Barrett's and high-grade dysplasia are at high risk for having a focus of adenocarcinoma present. Even with multiple biopsies, a degree of sampling error exists. Also, adenocarcinoma can develop within the space of several months; and if the cancer is allowed to invade into the submucosa, 50% of these patients will have lymphatic metastases, thereby negating the purpose of surveillance. Although patients with high-grade dysplasia and intramucosal adenocarcinoma on biopsy who do not have an endoscopically visible lesion are unlikely to have lymphatic metastases, 7% do have submucosal invasion. Thus, even in these very early tumors, treatment directed Descriptors Adenocarcinoma/diagnosis/pathology/surgery, Barrett Esophagus/diagnosis/pathology/surgery, Cell Transformation, Neoplastic/pathology, Esophageal Neoplasms/diagnosis/pathology/surgery, Esophagus/pathology/surgery, Humans, Precancerous Conditions/diagnosis/pathology/surgery, Prognosis Links Book Title Database Publisher Data Source Authors DeMeester,S. R., DeMeester,T. R. Original/Translated Title URL Date of Electronic PMCID Editors
Life cycle assessment: Comparing strategic options for the mains infrastructure - Part I	1999	Dennison, F.J., Thames Water Utilities Ltd., Spencer House, Reading, Berkshire RG2 0JN, United Kingdom	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Water Science and Technology Periodical, Abbrev. Water Sci.Technol. Pub Date Free Form 1999/ Volume 39 Issue 11-Oct Start Page 315 Other Pages 319 Notes Place of Publication ISSN/ISBN 0273-1223 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract This paper presents the preliminary results of a Life Cycle Assessment (LCA) study which aims to compare two different potable water pipe materials: ductile iron (DI) and medium density polyethylene (MDPE). Stages where environmental impacts may be reduced in the life cycle of these pipes have been highlighted. A takeback scheme between water companies and pipe suppliers has been identified as an environmental improvement to the current disposal stage of the pipe life cycle. Potential exists for dual-use or reuse of abandoned mains. Descriptors drinking water, iron, polyethylene, conference paper, pipeline, water supply Links Book Title Database Embase Publisher Data Source Embase Authors Dennison,F. J., Azapagic,A., Clift,R., Colbourne,J. S. Original/Translated Title URL Date of Electronic PMCID Editors
Squamous cell carcinoma and keratoacanthoma of the lower lip associated with 'Goza' and 'Shisha' smoking	1999	El-Hakim, I.E., Dept. of Oral/Maxillofacial Surgery, Hadayek Helwan 11433, Cairo, Egypt	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full International journal of dermatology Periodical, Abbrev. Int.J.Dermatol. Pub Date Free Form 1999/ Volume 38 Issue 2 Start Page 108 Other Pages 110 Notes Place of Publication ISSN/ISBN 0011-9059 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract Background: A positive correlation between lip and buccal cancers and pipe smoking has been suggested. Various types of crude and manufactured tobacco products are consumed by smoking, chewing, and snuff dipping habits. 'Shisha' and 'Goza' smoking are widely practiced in the Middle East. The 'hubble-bubble' method and apparatus are used. These smoking habits are hazardous to health, causing obstructive lung disease, and may be important predisposing factors for the development of oral cancers. Case reports: Two cases of squamous cell carcinoma and a case of keratoacanthoma localized to the lower lip are presented in well-known 'Shisha' and 'Goza' smokers. Conclusions: 'Shisha' and 'Goza' smoking have adverse effects on general health and may predispose to oral cancer. An extensive epidemiological study should be performed to determine whether this type of smoking habit is associated with a statistically increased incidence of squamous cell carcinoma and keratoacanthoma of the lips. Descriptors adult, article, case report, excision, human, keratoacanthoma, lip carcinoma, lower lip, male, Middle East, mouth cancer, smoking, squamous cell carcinoma, tobacco Links Book Title Database Embase; MEDLINE Publisher Data Source Embase Authors El-Hakim,I. E., Uthman,M. A. E. Original/Translated Title URL Date of Electronic PMCID Editors
Reflux disease and Barrett's esophagus	1999	Center for Swallowing and Esophageal Disorders, Dept. of Gastroenterology, The Cleveland Clinic Foundation, Ohio 44195, USA. FalkG@cesmtp.ccf.org	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Endoscopy Periodical, Abbrev. Endoscopy Pub Date Free Form Jan Volume 31 Issue 1 Start Page 9 Other Pages 16 Notes LR: 20051116; JID: 0215166; RF: 45; ppublish Place of Publication GERMANY ISSN/ISBN 0013-726X; 0013-726X Accession Number PMID: 10082405 Language eng SubFile Journal Article; Review; IM DOI 10.1055/s-1999-13643 [doi] Output Language Unknown(0) PMID 10082405 Abstract Gastroesophageal reflux disease (GERD) is a common clinical problem. New information suggests that infection with Helicobacter pylori may protect patients from developing GERD and its complications. Endoscopy may be used by clinicians to tailor GERD therapy, but an empirical trial of a proton-pump inhibitor may be an alternative diagnostic approach. Studies continue to show that laparoscopic antireflux surgery is a cost-effective treatment option for patients requiring maintenance therapy with proton-pump inhibitors. However, the minimally invasive nature of the operation should not alter the indications for antireflux surgery, especially for patients with atypical symptoms. It remains unclear why some patients with GERD develop Barrett's esophagus, whereas others do not. Recent guidelines suggest that patients with long-standing GERD symptoms, especially white men over 50 years of age, should undergo endoscopy at least once to screen for Barrett's esophagus. Debate concerning short-segment Barrett's esophagus continues. Intestinal metaplasia at a normal-appearing gastroesophageal junction may be associated with intestinal metaplasia of the stomach and infection with H. pylori, whereas short tongues of intestinal metaplasia in the esophagus are associated with GERD. Cancer surveillance is indicated in short-segment Barrett's esophagus, as dysplasia may develop in these patients. Barrett's esophagus is the only known risk factor for the development of esophageal adenocarcinoma, but the incidence of adenocarcinoma may be lower than previously reported. New clinical guidelines for endoscopic surveillance suggest that the surveillance interval should be lengthened to every two years in patients without dysplasia. Newer treatment options, such as thermal ablation and photodynamic therapy, continue to show promise, but are not yet ready for routine clinical use. Descriptors Barrett Esophagus/diagnosis/etiology/therapy, Follow-Up Studies, Gastroesophageal Reflux/complications/diagnosis/therapy, Humans Links Book Title Database Publisher Data Source Authors Falk,G. W. Original/Translated Title URL Date of Electronic PMCID Editors
Bone mineral density of the spine and femur in healthy Saudi females: relation to vitamin D status, pregnancy, and lactation	1999	Department of Medicine (MBC-46), King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Calcified tissue international Periodical, Abbrev. Calcif.Tissue Int. Pub Date Free Form Jul Volume 65 Issue 1 Start Page 23 Other Pages 28 Notes LR: 20131121; JID: 7905481; 0 (Parathyroid Hormone); 1406-16-2 (Vitamin D); SY7Q814VUP (Calcium); OID: PIP: 144813; OID: POP: 00289772; OTO: PIP; GN: PIP: TJ: CALCIFIED TISSUE INTERNATIONAL.; ppublish Place of Publication UNITED STATES ISSN/ISBN 0171-967X; 0171-967X Accession Number PMID: 10369729 Language eng SubFile Comparative Study; Journal Article; IM; J DOI CT152-98 [pii] Output Language Unknown(0) PMID 10369729 Abstract Bone mineral density (BMD) measurements of the anterio-posterior lumbar spine and the proximal femur using dual-energy x-ray absorptiometry, as well as relevant clinical and biochemical parameters, were determined in 321 healthy Saudi females in order to establish reference values and to study the effects of physical and lifestyle factors on BMD. Mean +/- SD of age, body mass index (BMI), number of pregnancies, and total duration of lactation were 35.4 +/- 11.3 years, 26.5 +/- 5.2 kg/m2, 3.1 +/- 3.1, and 23.7 +/- 42.4 months, respectively. Mean +/- SD of serum calcium, 25-hydroxyvitamin D (25OHD), and PTH levels were 2.37 +/- 0.09 mmol/liter, 24.5 +/- 17.2 nmol/liter, and 52.0 +/- 30.8 pg/ml, respectively. Peak BMD values were observed around age 35 years at the spine and earlier at the femur. Compared with USA females, Saudi females had lower weight-matched Z scores at the spine (-0.126 +/- 1. 078, P = 0.04), femoral neck (-0.234 +/- 0.846, P /=31 years old were 18-41% and 0-7%, respectively, depending on the site examined. Severe hypovitaminosis D (25OHD level </=20 nmol/liter) was present in 52% of the subjects. However, there was no correlation between 25OHD level and BMD at any site. Parathyroid hormone (PTH) levels correlated significantly with 25OHD levels (r = -0.28, P < 0.0001) and with weight-matched BMD Z scores at the spine (r = -0.17, P = 0.005), femoral neck (r = -0.16, P = 0.007), and Ward's triangle (r = -0.2, P = 0.0008), suggesting that the distribution of 25OHD levels in the cohort is below the threshold needed for maintaining normal BMD. On the other hand, number of pregnancies and total duration of lactation correlated with weight-matched BMD Z scores at the spine (r = -0.17, P = 0.003; r = -0.1, P = 0.08, respectively). We conclude that BMD in healthy Saudi females is significantly lower than in their USA counterparts. This may be due in part to increased number of pregnancies and longer duration of lactation together with prevalent vitamin D deficiency. http://link.springer-ny.com/link/service/journals/00223/bibs /65n1p23. html; PIP: This paper examines the relationship between bone mineral density (BMD) of the spine and femur and vitamin D status, pregnancy, and lactation among women in Saudi Arabia. The aims of the study are the following: 1) establish normative data for BMD at the anterio-posterior lumbar spine and femur using dual x-ray absorptiometry; 2) compare the BMD of Saudi females and their US counterparts; and 3) examine the relation of BMD to vitamin D status, pregnancy, and lactation. Samples included 321 healthy Saudi females recruited from the city of Riyadh, Saudi Arabia. Results suggest that the mean standard deviation (SD) of age, body mass index, number of pregnancies, and total duration of lactation were, respectively, 35.4 +or- 11.3 years, 26.5 +or- 5.2 kg/sq. m, 3.1 +or- 3.1, and 23.7 +or- 42.4 months. Mean +or- SD of serum calcium, 25-hydroxyvitamin D (25OHD), and PTH levels were 2.37 +or- 0.09 mmol/liter, 24.5 +or- 17.2 nmol/liter, and 52.0 +or- 30.8 pg/ml, respectively. Peak BMD values were observed around age 35 years at the spine and earlier at the femur. Compared with US females, Saudi females had lower weight-matched Z scores at the spine, femoral neck, and Ward's triangle. On the other hand, the number of pregnancies and total duration of lactation correlated with weight-matched BMD Z scores at the spine. This made the BMD in healthy Saudi females significantly lower than their US counterparts. This may due to the increase number of pregnancies and longer duration of lactation together with prevalent vitamin D deficiency. Descriptors Absorptiometry, Photon, Adolescent, Adult, Aged, Bone Density, Calcium/blood, Child, Female, Femur Neck/metabolism/radiography, Humans, Lactation/physiology, Lumbar Vertebrae/metabolism/radiography, Middle Aged, Parathyroid Hormone/blood, Pregnancy/physiology, Reference Values, Saudi Arabia, United States, Vitamin D/blood, Arab Countries, Asia, Biology, Clinical Research, Deficiency Diseases--women, Developing Countries, Diseases, Lactation, Maternal Physiology, Micronutrients, Nutrition Disorders, Osteoporosis--women, Physiology, Pregnancy, Reproduction, Research Methodology, Research Report, Skeletal Effects--women, Vitamins, Western Asia, Women Links Book Title Database Publisher Data Source Authors Ghannam,N. N., Hammami,M. M., Bakheet,S. M., Khan,B. A. Original/Translated Title URL Date of Electronic PMCID Editors
The indigenous Sea Gypsy divers of Thailand's west coast: measurement of carbon monoxide in the breathing air	1999	International Labor Office, Geneva, Switzerland.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Applied Occupational and Environmental Hygiene Periodical, Abbrev. Appl.Occup.Environ.Hyg. Pub Date Free Form Jul Volume 14 Issue 7 Start Page 488 Other Pages 495 Notes LR: 20131121; JID: 9103256; 0 (Air Pollutants, Occupational); 7U1EE4V452 (Carbon Monoxide); ppublish Place of Publication ENGLAND ISSN/ISBN 1047-322X; 1047-322X Accession Number PMID: 10461405 Language eng SubFile Journal Article; IM DOI Output Language Unknown(0) PMID 10461405 Abstract Approximately 400 indigenous divers live and work on Thailand's west coast. They dive with surface supplied air from primitive compressor units mounted on open boats which measure from seven to 11 meters in length. It was suspected that carbon monoxide was present in the breathing air of at least the gasoline-driven compressor units. To determine the presence of carbon monoxide gas in the breathing air, compressed air from the compressor was pumped through the diver air supply hose through a plenum (monitoring) chamber established on the boat. After a compressor warm-up of 15 minutes, the diving air was measured with the boat at eight different bearings to the wind, each 45 degrees apart at intervals of five minutes. Three of the four gasoline-driven compressor units tested showed presence of carbon monoxide in the breathing air. One diesel-driven unit showed a very low concentration of carbon monoxide (3-4 ppm) and six diesel-driven units showed no detectable carbon monoxide. Although not tested, diesel exhaust emissions could also enter the breathing air by the same route. A locally made modification to the compressor air intake was designed and successfully tested on one gasoline-driven compressor unit. An information sheet on the hazards of carbon monoxide as well as on the modification has been developed for distribution among the villages. Descriptors Air/analysis, Air Pollutants, Occupational/analysis, Carbon Monoxide/analysis, Diving, Equipment Safety, Humans, Occupational Exposure/prevention & control, Thailand Links Book Title Database Publisher Data Source Authors Gold,D., Geater,A., Aiyarak,S., Juengpraert,W. Original/Translated Title URL Date of Electronic PMCID Editors
Smoking habits of primary health care physicians in Bahrain	1999	Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full The journal of the Royal Society for the Promotion of Health Periodical, Abbrev. J.R.Soc.Promot.Health. Pub Date Free Form Mar Volume 119 Issue 1 Start Page 36 Other Pages 39 Notes LR: 20151119; JID: 101499616; ppublish Place of Publication ENGLAND ISSN/ISBN 1466-4240; 1466-4240 Accession Number PMID: 10327813 Language eng SubFile Comparative Study; Journal Article; IM DOI Output Language Unknown(0) PMID 10327813 Abstract A survey of the smoking habits of all primary health care physicians in Bahrain was carried out to determine their smoking habits and attitudes towards smoking. Sixty-four male doctors and fifty-eight female doctors returned a voluntary self-completed questionnaire resulting in an 80.8% response rate. Male physicians were older than their female counterparts and had a higher proportion of ever-smokers (45.3%), smokers (26.6%), ex-smokers (18.8%) and daily smokers (18.8%). Cigarette smoking was the predominant type of smoking. The ratio of daily smoking prevalence (doctors/general population) among Bahraini citizens was 0.83 for males, 0.45 for females and 0.65 for both sexes combined. Of the smokers, 80% have considered quitting and 83.3% of them had made a serious attempt to quit. All the never-smokers perceived themselves as non-smokers in the coming five years compared to 83.3% of the ever-smokers. Among the perceived reasons for not smoking, primary health care physicians gave the highest importance to protecting their own health and setting a good example to children. Never-smokers gave more importance than ever-smokers to all the reasons for not smoking except for the occurrence of certain symptoms. Descriptors Adult, Age Factors, Attitude of Health Personnel, Attitude to Health, Bahrain, Ethnic Groups, Female, Health Behavior, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Physician's Role, Physicians, Family, Prevalence, Sex Factors, Smoking/prevention & control, Smoking Cessation, Surveys and Questionnaires Links Book Title Database Publisher Data Source Authors Hamadeh,R. R. Original/Translated Title URL Date of Electronic PMCID Editors
Self-etching primer vs phosphoric acid: an alternative concept for composite-to-enamel bonding	1999	University of Kiel, Clinic of Operative Dentistry and Periodontology, Germany.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Operative dentistry Periodical, Abbrev. Oper.Dent. Pub Date Free Form May-Jun Volume 24 Issue 3 Start Page 172 Other Pages 180 Notes LR: 20131121; JID: 7605679; 0 (Clearfil Liner Bond 2); 0 (Composite Resins); 0 (Dental Cements); 0 (Dentin-Bonding Agents); 0 (Diphosphates); 0 (Etch&Prime); 0 (Methacrylates); 0 (Monobond S); 0 (Phosphoric Acids); 0 (Polymers); 3K9958V90M (Ethanol); Place of Publication UNITED STATES ISSN/ISBN 0361-7734; 0361-7734 Accession Number PMID: 10530279 Language eng SubFile Comparative Study; Journal Article; D DOI Output Language Unknown(0) PMID 10530279 Abstract The purpose of this in vitro study was (1) to investigate the composite-to-enamel bond strength and (2) to analyze the marginal adaptation of resin composite restorations in class 2 cavities using three self-etching priming agents in comparison to conventional phosphoric acid etching and bonding application. In the first part of the study 24 extracted bovine incisors were embedded in acrylic resin and ground flat with 800-grit paper. The following three self-etching priming agents/composite resins were applied to the enamel surfaces of six teeth each: Clearfil Liner Bond 2/Clearfil AP-X (Group I), Etch & Prime 3.0/Degufill mineral (Group II), Resulcin AquaPrime + MonoBond/Ecusit (Group III). In Group IV Ecusit-Mono/Ecusit was used after enamel etching with phosphoric acid (37%). Shear bond strength values measured on a T22 K testing machine at a crosshead speed of 1 mm/min were: 24.2 +/- 3.0 MPa (Group I), 21.9 +/- 1.4 MPa (II), 34.0 +/- 3.6 MPa (III), and 26.3 +/- 1.8 MPa (IV). ANOVA revealed significant (P < 0.05) differences in shear bond strength between groups, except comparison of Group I and II, and Group I and IV. In the second part of the study 24 standardized class 2 cavity preparations with the approximal box extending 1 mm above the CEJ were prepared in extracted human molars. Enamel margins were beveled and the teeth were divided into four groups of six teeth each. Cavities were restored using the self-etching priming agents Clearfil Liner Bond 2 (Group I), Etch & Prime 3.0 (Group II), and Resulcin AquaPrime + MonoBond (Group III). In Group IV composite resin restorations were placed after 37% phosphoric acid etching and bonding application (Ecusit-Mono). Quantitative SEM analysis of the marginal adaptation of the restorations after thermocycling (5-55 degrees C, 2500 cycles) and mechanical loading (100 N, 500,000 cycles) revealed excellent, gap-free margins in 91.2% (Group I), 93.0% (Group II), 92.0% (Group III), and 92.5% (Group IV) of the restorations' approximal area. There were no statistically significant differences between the four groups (P < 0.05). In conclusion, results of the present in vitro study indicate that use of self-etching primers may be an alternative to conventional phosphoric acid pre-treatment in composite-to-enamel bonding restorative techniques. Descriptors Acid Etching, Dental, Animals, Cattle, Composite Resins, Dental Bonding/methods, Dental Cements, Dental Enamel, Dental Marginal Adaptation, Dental Restoration, Permanent/methods, Dentin-Bonding Agents, Diphosphates, Ethanol, Humans, Materials Testing, Methacrylates, Microscopy, Electron, Scanning, Phosphoric Acids, Polymers/chemistry, Tensile Strength Links Book Title Database Publisher Data Source Authors Hannig,M., Reinhardt,K. J., Bott,B. Original/Translated Title URL Date of Electronic PMCID Editors
Quantitation of urinary metabolites of a tobacco-specific lung carcinogen after smoking cessation	1999	University of Minnesota Cancer Center, Minneapolis 55455, USA.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Cancer research Periodical, Abbrev. Cancer Res. Pub Date Free Form 1-Feb Volume 59 Issue 3 Start Page 590 Other Pages 596 Notes LR: 20151119; GR: CA-44377/CA/NCI NIH HHS/United States; JID: 2984705R; 0 (4-((methylnitrosoamino)-1-(3-pyridyl)but-1-yl)beta-omega-glucosiduronic acid); 0 (Carcinogens); 0 (Glucuronates); 0 (Nitrosamines); 59578-66-4 (4-(methylnitrosoamino)-4-(3-pyridyl) Place of Publication UNITED STATES ISSN/ISBN 0008-5472; 0008-5472 Accession Number PMID: 9973205 Language eng SubFile Journal Article; Research Support, U.S. Gov't, P.H.S.; IM DOI Output Language Unknown(0) PMID 9973205 Abstract We quantified urinary levels of two metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in people who had stopped smoking: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its O-glucuronide, 4-[(methylnitrosamino)-1-(3-pyridyl)but-1-yl]-beta-O-D-glucosiduronic acid (NNAL-Gluc). Twenty-seven people completed the study. Thirteen used the nicotine patch starting at the quit date, whereas the others used no patch. Two 24-h urine samples were collected on 2 consecutive days before smoking cessation; blood was also obtained. Beginning at their quit date, subjects provided 24-h urine samples on days 7, 21, 42, 70, 98, and 126, and some subjects also provided samples at later times. The urine was analyzed for NNAL, NNAL-Gluc, nicotine plus nicotine-N-glucuronide, and cotinine plus cotinine-N-glucuronide. Some blood samples were also analyzed for NNAL. The decline of urinary NNAL and NNAL-Gluc after smoking cessation was much slower than expected. This was clearly demonstrated by comparison with cotinine and nicotine levels in urine. One week after smoking cessation, 34.5% of baseline NNAL plus NNAL-Gluc was detected in urine, whereas the corresponding values for cotinine and nicotine were 1.1 and 0.5%, respectively. Even 6 weeks after cessation, 7.6% of the original levels of NNAL plus NNAL-Gluc remained. In some subjects, NNAL plus NNAL-Gluc were detected 281 days after cessation. The distribution half-life for NNAL and NNAL-Gluc was 3-4 days, whereas the elimination half-life was 40-45 days. Total body clearance of NNAL was estimated to be 61.4 +/- 35.4 ml/min, and volume of distribution in the beta-phase was estimated to be 3800 +/- 2100 liters, indicating substantial distribution into the tissues. Parallel studies in rats treated chronically or acutely with NNK in the drinking water support the conclusion that NNAL has a large volume of distribution. There was no effect of the nicotine patch on levels of NNAL plus NNAL-Gluc, indicating that NNK is not formed endogenously from nicotine. The results of this study demonstrate that NNAL and NNAL-Gluc are slowly cleared from the body after smoking cessation, indicating the presence of a high-affinity compartment where NNK, NNAL, and/or NNAL-Gluc are retained or sequestered and slowly released. Descriptors Adult, Animals, Carcinogens/pharmacokinetics, Cotinine/urine, Female, Glucuronates/pharmacokinetics/urine, Humans, Lung Neoplasms/etiology/urine, Male, Middle Aged, Nicotine/urine, Nitrosamines/metabolism/pharmacokinetics/urine, Rats, Rats, Inbred F344, Smoking Cessation Links Book Title Database Publisher Data Source Authors Hecht,S. S., Carmella,S. G., Chen,M., Dor Koch,J. F., Miller,A. T., Murphy,S. E., Jensen,J. A., Zimmerman,C. L., Hatsukami,D. K. Original/Translated Title URL Date of Electronic PMCID Editors
Cold tap water as a source of fatal nosocomial pneumonia due to Legionella pneumophila in a rehabilitation center	1999	Gemeenschappelijke Gezondheidsdienst Oostelijk Zuid-Limburg, Heerlen. choebe@knmg.nl	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Nederlands tijdschrift voor geneeskunde Periodical, Abbrev. Ned.Tijdschr.Geneeskd. Pub Date Free Form 15-May Volume 143 Issue 20 Start Page 1041 Other Pages 1045 Notes LR: 20081121; JID: 0400770; ppublish Place of Publication NETHERLANDS ISSN/ISBN 0028-2162; 0028-2162 Accession Number PMID: 10368731 Language dut SubFile Case Reports; English Abstract; Journal Article; IM DOI Output Language Unknown(0) PMID 10368731 Abstract OBJECTIVE: Report of the technical, microbiological and epidemiological investigation following 2 cases of fatal Legionella pneumonia. DESIGN: Descriptive. METHOD: Faced with 2 nosocomial cases in a rehabilitation centre in the South of Limburg, the Netherlands, the water supply was investigated. Water temperatures from different taps were measured. Legionella cultures were made from respiratory patients' specimens, water samples and smears from all mixing taps (used in showers), samples from hot and cold water taps from the infected ward and from the five other wards. The strains were typed by serotyping and polymerase chain reaction. RESULTS: The circulating cold water sometimes warmed up to 40 degrees C (within the Legionella growth range). From the sputum of the 2 male patients with rheumatoid arthritis who died of Legionella pneumonia the same Legionella pneumophila (serotype I) was cultured as from the water supply. Of the showers on the contaminated ward 19% (12/63) were positive for Legionella as were 59% (35/59) of the cold water taps. Cultures from the hot water supply were negative just like control cultures from five other wards and swabs from showerheads and hoses. The cold water tubes ran next to the hot water tubes and the central heating system in the same shaft. On the infected ward patients were absent during the weekends. As one of the subsequent measures, the cold water pipes were relocated to another shaft. CONCLUSION: The combination of an elevated cold water temperature caused by heating along a distance by nearby hot water and heating piping and the regular stasis of water during the weekends when the ward was closed, most probably stimulated the multiplication of Legionella in the water supply. In order to minimize contamination of cold water its temperature must be kept below 20 degrees C. Surveillance of intramural water systems is necessary to prevent nosocomial infections. Descriptors Cold Temperature, Cross Infection/microbiology/prevention & control, Disease Reservoirs, Fatal Outcome, Humans, Legionella pneumophila/isolation & purification, Legionnaires' Disease/complications/microbiology/prevention & control, Male, Netherlands, Pneumonia/microbiology/prevention & control, Polymerase Chain Reaction, Rehabilitation Centers, Serotyping, Water Microbiology, Water Supply/analysis Links Book Title Database Publisher Data Source Authors Hoebe,C. J., Cluitmans,J. J., Wagenvoort,J. H., van Leeuwen,W. J., Bilkert-Mooiman,M. A. Original/Translated Title Koud leidingwater als bron van fatale nosocomiale pneumonieen door Legionella pneumophila in een revalidatiekliniek URL Date of Electronic PMCID Editors

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