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Biomedical subjects

J Borak

Publications and source records attributed to J Borak.

At least 19 recordsLinked to original sources
PubMed2003

Sources of interference in field studies of diesel exhaust emissions.

This article describes interferences encountered in a variety of occupational settings during industrial hygiene surveys of diesel particulate material (DPM) using the NIOSH 5040 Method. The method yields time-weighted-average measurements of elemental carbon (EC), organic carbon (OC), and total carbon (TC = EC + OC). NIOSH recommends EC as proxy for DPM, but other agencies (e.g., MSHA) regulate exposure as TC. Surveys were conducted in an engine factory and a wood treatment plant where diesel equipment was used, and in a foundry where its use was being considered. Full shift samples were collected using open-faced cassettes and cyclones fitted with 37-mm quartz fiber filters analyzed by the NIOSH 5040 Method. Non-DPM-related interferences were noted for both the OC and EC. In the engine factory and wood treatment facility, OC measurements were very high (range of 10.0-1600 microg/m(3)), while EC levels were mostly below the LOD. These findings almost certainly reflect interferences by cutting oil mists and airborne creosote respectively. In the foundry, EC levels were high and comprised mainly of larger (>4 microm) particles (open face samples: arithmetic mean = 136 microg/m(3), geometric mean = 74.0 microg/m(3); cyclone samples: arithmetic mean = 30.2 microg/m(3), geometric mean = 14.7 microg/m(3)). These findings suggest that OC interferences should be suspected if the EC:TC ratio is <0.35 and, if DPM surveys are performed with open-faced samplers, at least a small number of size-selective samplers should be employed to assure that results do not reflect EC interference by larger (i.e., >1-4 microm) particles. They also support the ACGIH decision to modify its proposed DPM TLV to specifically consider elemental carbon, rather than total carbon.

Air Pollution, Indoor↗
PubMed2002

Observations on the suitability of the aethalometer for vehicular and workplace monitoring.

A field study was undertaken to evaluate the suitability of the aethalometer, an instrument capable of performing near-real-time measurement of low-level (10-1,000 ng/m3) airborne combustion products, for vehicular and workplace monitoring. Several technical limitations were identified: (1) there was no ready means for external calibration of optical measurements; (2) airflow rates were unstable; (3) effective range of concentrations was limited; and (4) the aethalometer demonstrated sensitivity to movement and vibration. Unless addressed, these limitations will restrict future uses of the aethalometer for vehicular and workplace monitoring.

Air Pollutants↗
PubMed2001

Phosgene exposure: mechanisms of injury and treatment strategies.

Phosgene (carbonyl chloride, CAS 75-44-5) is a highly reactive gas of historical interest and current industrial importance. Phosgene has also proved to be a useful model for the study of those biochemical mechanisms that lead to permeability-type pulmonary edema (adult respiratory distress syndrome). In turn, the study of phosgene-induced adult respiratory distress syndrome has provided insights leading to revised treatment strategies for exposure victims. We summarized recent findings on the mechanisms of phosgene-induced pulmonary edema and their implications for victim management. In light of that research, we also provide a comprehensive approach to the management and treatment of phosgene exposure victims.

Adult↗
PubMed2000

Erratum: Does aluminum exposure of pregnant animals lead to accumulation in mothers of their offspring?

Borak J, Wise JP. 1998. Does aluminum exposure of pregnant animals lead to accumulation in mothers of their offspring? Teratology 57:127-139 In response to the article referenced above, Drs. M. Golub and J. Domingo wrote a Letter to the Editor (Teratology 1998;58:225). Included in that letter was the following statement: "We also urge Drs. Borak and Wise to fulfill their ethical obligation to acknowledge sources of support when submitting manuscripts for publication." This comment would not have been necessary if the article by Borak and Wise had included an acknowledgment of their outside support in their article. The authors had disclosed this outside support in the cover letter to the editor when the manuscript was supplied initially and later after revisions. They did not include an Acknowledgment section in the manuscript. The editorial office should have suggested that they do that. We apologize for any confusion this caused.

Journal Article↗
PubMed1999

[Treatment outcome in tobacco dependence after nicotine replacement therapy and group therapy].

The deletorious health effects of smoking are generally known. In spite of that, great numbers of people still smoke tobacco in the whole world. It is primarily due to the addictive properties of nicotine. Cigarette smoking is also dependent on various social and psychologic factors making quitting very difficult. Among various treatment modalities for tobacco dependence we aimed to assess the efficacy of nicotine replacement therapy (NRT) vs group therapy. 325 subjects smoking at least 15 cigarettes/day for more than 3 years were studied. They were allocated to group therapy (neurolinguistic programming) or NRT (gum or patch) at their will. Non-smoking was validated at each of follow-up visits, at 1 and 2 weeks 1, 3, 6, 12 months by measuring CO in expired air. All groups were matched in age, smoking history and nicotine dependence. The best quit rate was observed as a result of group therapy (41% at 1 year, p. < 0.001) as compared to nicotine patch (2%) and nicotine gum (9%).

Administration, Cutaneous↗
PubMed1998

Does aluminum exposure of pregnant animals lead to accumulation in mothers or their offspring?

There is concern that environmental and dietary aluminum (Al) might cause developmental toxicity. To better understand this concern, we reviewed published studies which administered Al compounds to pregnant animals and measured accumulation of Al in mother, fetus, or born offspring. A total of 7 studies were identified which administered Al during gestation and evaluated fetal accumulation. Another 7 studies administered Al at least until birth and then evaluated accumulation in mothers and/or pups. These 14 studies included 4 different Al compounds (hydroxide, chloride, lactate, and citrate) administered by 4 different routes (gavage, feed, intraperitoneal injection, and subcutaneous injection) with total doses ranging from 13.5 to 8,400 mg/kg. Fetal Al levels were not increased in 6 of 7 studies and pup Al levels were not increased in 4 of 5 studies in which they were measured. Maternal Al levels were increased in some studies, but there was no consistent pattern of organ-specific accumulation and several positive studies were contradicted by subsequent reports from the same laboratory. Placental levels were increased in 6 of 9 studies and were greater than corresponding fetal levels. The weight of evidence in these studies suggests that environmental and dietary Al exposures are unlikely to pose risks of Al accumulation to pregnant animals or their fetuses.

Abnormalities, Drug-Induced↗
PubMed1998

Emotional status does not alter exercise tolerance in patients with chronic obstructive pulmonary disease.

Exercise tolerance in chronic obstructive pulmonary disease (COPD) patients has been shown to be related to airway limitation and dyspnoea, but little is known about the effects of an emotional status on physical performance. We examined 49 COPD patients with a wide spectrum of airway limitation severity and hypoxaemia. Exercise tolerance was evaluated using the Six-minute Walking Distance Test (6MWD), dyspnoea at rest and on exercise was measured using the visual analogue scale, and the emotional status was evaluated using the battery of psychological tests. The average 6MWD (mean+/-SD) was 355+/-112 m. In the majority of patients a fall in arterial blood oxygen saturation (Sa,O2) on exercise of >3% was found. The mean dyspnoea score of 21+/-19 at rest increased to 66+/-19 on exercise. All subjects demonstrated an increased level of anxiety. The majority also demonstrated elevated emotional tension, and half of the study group showed signs of depression. Step-wise multiple regression analysis with results of 6MWD as dependent and other studied variables as independent variables showed that exercise tolerance depended mainly on airway limitation. The forced expiratory volume in one second (FEV1) explained 24% of the variance. The forced vital capacity added a further 10%, and arterial blood carbon dioxide tension contributed 7%. The dyspnoea level on exercise added only 0.9%. All four variables explained 42% of the variance. There was no correlation between 6MWD and any of the variables characterizing the emotional status. We conclude that the emotional status of chronic obstructive pulmonary disease patients is characterized by an increased level of psychological tension, anxiety and depression, but these do not affect exercise tolerance as assessed by the six-minute walking distance test.

Anxiety↗
PubMed1996

Effects of CPAP treatment on psychological status in patients with severe obstructive sleep apnoea.

The aim of this study was to evaluate the effects of nocturnal continuous positive airway pressure (CPAP) breathing on the emotional status and cognitive function in 20 patients with severe obstructive sleep apnoea (OSA) (mean +/- SD apnoea/hypopnoea index = 67 +/- 16, mean overnight arterial oxygen saturation = 83 +/- 10%). Psychological tests were performed before, after three, and after twelve months of CPAP treatment. At initial investigation, amongst cognitive functions, the most disturbed were concentration and recent memory. The majority of subjects demonstrated increased mental stress, depression, and anxiety. Anxiety correlated with AHI (r = 0.68). Mental stress correlated with AHI (r = 0.56) and deficiency of Stage 2 NREM sleep (r = -0.55). CPAP treatment resulted in significant improvement in cognitive function; concentration, recent verbal, visual and spatial memory were already seen at three months. No improvement in IQ and in emotional status after three months and one year of treatment was found. It is concluded that in patients with severe OSA CPAP treatment results in a significant early improvement in cognitive function but not in emotional status.

Affect↗
PubMed1996

Psychological status of COPD patients before and after one year of long-term oxygen therapy.

Cognitive function, psychological status, and attitudes were investigated in 90 patients with chronic obstructive pulmonary disease before the initiation of long-term oxygen therapy and after one year of treatment. Assessment included clinical interview, Wechsler Intelligence Scale I.Q., Bourdon-Wiersma Test, Benton Verbal Retention Test, Rey's Test of Remembering 15 Words, Beck's Depression Scale, Taylor's Manifest Anxiety Scale, and Tylka's Psychological Evaluation Scale of the Effectiveness of Rehabilitation. The mean I.Q. of the patients studied was slightly above average at 107 points. Tests of cognitive function showed reduced performance. These included tests of repeating numbers, pictorial anecdotes and numerical symbols. Rey's Test of Word Memory was also below average but increased following treatment. In the Bourdon Test, there were 58 correct deletions and 7 omissions initially, improving to 67 and 8, respectively, after treatment. Poor visual and spatial memory did not improve after treatment. Before treatment, patients demonstrated depressed mood, low self-esteem with narrow interests, signs of anxiety, mental stress and depression. After a year of long-term oxygen therapy significant improvements in mood and attitudes were demonstrated. We conclude that long-term oxygen therapy may be capable of producing a significant improvement in emotional status. However, the effects of oxygen treatment are difficult to separate from effects of other aspects of care in producing a sense of increased security and well-being.

Adult↗
PubMed1992

Agents of chemical warfare: sulfur mustard.

Sulfur mustard is a chemical warfare agent of historical and current interest. Favored militarily because of its ability to incapacitate rather than its ability to kill, its use results in large numbers of casualties requiring prolonged, intensive care. In light of recent threats of chemical warfare and the possibilities of chemical acts of terrorism, North American physicians should be knowledgeable of its effects and the care of its victims.

Antidotes↗
PubMed1992

Chemical warfare agents: II. Nerve agents.

Nerve agents are highly potent and rapidly acting organophosphorus compounds that irreversibly bind and inactive acetylcholinesterase. Only rarely have they been used in warfare, but their great lethality and the threat that they pose have encouraged production and stockpiling in large quantities. They differ in a number of important ways from common agricultural organophosphate insecticides. In light of recent threats of chemical warfare and the possibilities of chemical acts of terrorism, North American physicians should be knowledgeable of the effects of these agents and the care of exposure victims.

Antidotes↗
PubMed1992

[Dyspnea at rest and after exercise and the mental status of patients with chronic obstructive lung diseases].

Thirty two patients with severe COPD were studied. We evaluated relationships between their psychological status, lung function parameters, exercises tolerance (6 MWD test) and dyspnea at rest and exercise (visual analogue scale). Patients demonstrated increased level of anxiety and psychological tension. In nearly half of the patients depression, low self-esteem and disbelief in the efficiency of therapy were observed. The correlations between the psychological status and the exercise tolerance hasn't been found. The correlation between the high level of depression and impairment of the lung function was found. The high increase in dyspnea score during exercises was connected with low self-esteem, although at rest the dyspnea level in those patients was low.

Adult↗
PubMed1991

Hazmat training.

Federal laws and regulations require hazardous-materials-response training for EMS personnel and other emergency responders. The requirements, however, aren't entirely clear about the amount of time and topics to be covered for EMS training. EMTs and paramedics should either be trained to the highest level at which they are likely to perform, or their performance levels should be restricted to the highest level to which they have been trained.

Certification↗
PubMed1991

Psychological status of COPD patients on long term oxygen therapy.

We evaluated the psychological status of chronic obstructive pulmonary disease patients with chronic respiratory failure, who were qualified for or on long-term oxygen therapy. Forty eight patients were examined. The patients' psychological status was assessed by means of the following methods: detailed clinical interview, the Taylor Manifest Anxiety Scale (MAS), Beck's Depression Inventory, and Tylka's Psychological Evaluation of Rehabilitation Efficiency Scale (SOPER). The study demonstrated that the great majority of patients presented a high degree of anxiety, depression and psychological tension, had low self-esteem and did not believe in the efficiency of therapy.

Anxiety↗
PubMed1989

[Psychological state of patients with chronic obstructive pulmonary disease].

The aim of the study was to evaluate the psychical state of 48 patients with chronic respiratory failure in the course of COPD qualified for home oxygen therapy. The psychical state was analysed using the following tests: thorough clinical history, J. Taylor's evident anxiety scale, H. Gough's adjective scale and psychological rehabilitation effectiveness scale according to J. Tylka. The study showed that the majority of patients demonstrated high levels of fear, depression and anxiety, lowered self evaluation, negative attitude toward work, lack of life aims and disbelief in therapy benefit. Correlation between degree of primary disease and lowered self-being could not be demonstrated. The decisive effect had socio-economic situation and individual traits.

Adult↗