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At least 217 records · Page 12Linked to original sources
PubMed1985

The clinical consequences of an industrial aerosol plant explosion.

The factors relating to the clinical outcome of an industrial aerosol plant explosion are reviewed. Eighteen of 24 workers inside the plant required hospitalization and five died. Proximity to the blast was associated with extensive injuries unless workers were shielded by physical barriers or partitions. Burn severity and mortality were increased in those wearing synthetic garments compared to their counterparts wearing fiber clothing. Facial burns occurred in all unprotected workers. Forearm and hand burns in 11 patients required decompressive escharotomies. Topical treatment with silver sulfadiazine was associated with more significant leukopenia and neutropenia than treatment with silver nitrate. We conclude that industrial design should include safeguards which isolate workers from flammable materials, including isolation of explosive materials from working areas, alarm systems to detect leakage of flammable agents, protective barriers and shields, and the regulation and institution of flame and flash-resistant clothing.

Accidents, Occupational↗
PubMed2003

Genes and gene polymorphisms associated with periodontal disease.

The scientific literature during the last ten years has seen an exponential increase in the number of reports claiming links for genetic polymorphisms with a variety of medical diseases, particularly chronic immune and inflammatory conditions. Recently, periodontal research has contributed to this growth area. This new research has coincided with an increased understanding of the genome which, in turn, has permitted the functional interrelationships of gene products with each other and with environmental agents to be understood. As a result of this knowledge explosion, it is evident that there is a genetic basis for most diseases, including periodontitis. This realization has fostered the idea that if we can understand the genetic basis of diseases, genetic tests to assess disease risk and to develop etiology-based treatments will soon be reality. Consequently, there has been great interest in identifying allelic variants of genes that can be used to assess disease risk for periodontal diseases. Reports of genetic polymorphisms associated with periodontal disease are increasing, but the limitations of such studies are not widely appreciated. While there have been dramatic successes in the identification of mutations responsible for rare genetic conditions, few genetic polymorphisms reported for complex genetic diseases have been demonstrated to be clinically valid, and fewer have been shown to have clinical utility. Although geneticists warn clinicians on the over-enthusiastic use and interpretation of their studies, there continues to be a disparity between the geneticists and the clinicians in the emphasis placed on genes and genetic polymorphism associations. This review critically reviews genetic associations claimed for periodontal disease. It reveals that, despite major advances in the awareness of genetic risk factors for periodontal disease (with the exception of periodontitis associated with certain monogenetic conditions), we are still some way from determining the genetic basis of both aggressive and chronic periodontitis. We have, however, gained considerable insight into the hereditary pattern for aggressive periodontitis. Related to our understanding that it is autosomal-dominant with reduced penetrance comes a major clinically relevant insight into the risk assessment and screening for this disease, in that we appreciate that parents, offspring, and siblings of patients affected with aggressive periodontitis have a 50% risk of this disease also. Nevertheless, we must exercise caution and proper scientific method in the pursuit of clinically valid and useful genetic diagnostic tests for chronic and aggressive periodontitis. We must plan our research using plausible biological arguments and carefully avoid the numerous bias and misinterpretation pitfalls inherent in researching genetic associations with disease.

Aggressive Periodontitis↗
PubMed2006

Wounding patterns for U.S. Marines and sailors during Operation Iraqi Freedom, major combat phase.

This investigation examined the wounds incurred by 279 U.S. Navy-Marine personnel (97% Marines and 3% sailors) identified as wounded in action during Operation Iraqi Freedom, from March 23 through April 30, 2003. The goal was to assess the potential impact of each causative agent by comparing the differences in anatomical locations, types of injuries caused, and medical specialists needed to treat the casualties. The overall average number of diagnoses per patient was 2.2, and the overall average number of anatomical locations was 1.6. The causative agents were classified into six major categories, i.e., small arms, explosive munitions, motor vehicle accidents, falls, weaponry accidents, and other/unknown. Explosive munitions and small arms accounted for approximately three of four combat-related injuries. Upper and lower extremities accounted for approximately 70% of all injuries, a percentage consistent for battlefield injuries since World War II.

Blast Injuries↗
PubMed1985

Renal alpha 2-adrenoceptors, their locations and effects on sodium excretion.

Research on alpha 2-adrenoceptors has been explosive since the first functional or pharmacologic classification of these agents in 1977. While several properties of renal alpha 2-adrenoceptors have been characterized, their possible role in the pathophysiology of hypertension remains elusive. Under normal circumstances, alpha 1-adrenoceptors appear to be located postjunctionally and alpha 2-adrenoceptors are extrajunctional. However, following chronic alpha 1-adrenoceptor blockade with prazosin, the renal alpha 2-adrenoceptor density increases and they may assume the otherwise exclusive alpha 1-adrenoceptor postjunctional domain. This assumed role of alpha 2-adrenoceptors may explain the absence of natriuresis with the clinical use of prazosin and, if a similar change occurs in vascular tissue, the temporary nature of the first-dose phenomenon (orthostatic hypotension) that occurs with the use of this drug. Finally, our description of the "postsynaptic" location of the ubiquitous plasma membrane alpha 2-adrenoceptors in the original functional or pharmacologic basis of classification of alpha-adrenoceptors should now be updated. Under normal conditions, the predominant alpha 2-adrenoceptors on effector organ plasma membranes appear to be extrajunctional and do not ordinarily mediate the effects of sympathetic neuronally released norepinephrine. Postjunctional alpha 1-adrenoceptors remain postjunctional and ordinarily mediate effects of nerve-stimulated norepinephrine release.

Animals↗
PubMed1992

Hazards with disinfecting agents in renal units!

As already described in the April 1991 issue of EDTNA/ERCA Journal (Volume XVII, No. 2), the specific characteristics of various disinfecting agents delineate their respective application areas. Obviously, in a renal unit one needs a large range of disinfecting agents as they are being used for cleaning and disinfection of: water treatment devices; water tanks and distribution systems; single patient units; patient vascular access sites; dialysis connection procedure; dialyser reuse; instruments; floors, etc.... We have been taught never to mix different disinfecting agents as this might reduce their efficiency. However, it had never been hitherto reported that this might be dangerous or even cause an explosion! In this paper, we describe in detail how we were confronted with such an explosion. We further report that similar hazards occurred in other units and present an overview of possible hazards with the most common disinfecting agents. Finally, we emphasize some preventive guidelines to be put forth in renal units.

Disinfectants↗
PubMed1979

Epidemic viral gastroenteritis.

Epidemic viral gastroenteritis is a significant world wide problem. In developed countries, gastroenteritis accounts for significant morbidity and loss of time from work; in the Third World it is the leading cause of mortality among infants and children. Recent technologic advances have been associated with an explosion of research activity. Two virus groups, the Norwalk-like agents and the rotaviruses, are currently accepted as causative agents of viral gastroenteritis in man. The problem of viral gastroenteritis is reviewed both from a current and a historic perspective.

Adult↗
PubMed1981

Norwalk-related viral gastroenteritis due to contaminated drinking water.

An explosive outbreak of gastrointestinal illness clinically compatible with infection by an agent serologically related to Norwalk virus agent occurred in an elementary school in May 1978. Seroconversion by radioimmunoassay to the Norwalk antigen was noted in two of three ill persons, but no viral particles were identified in stool. Illness developed in 72% of students and teachers at the school, and 32% of household contacts of these ill persons. Of household contacts of persons exposed at school but not clinically ill, 11% developed illness. This value, however, was not statistically different from the level of illness observed concurrently in household contacts of students at an unaffected school nearby. Epidemiologic investigation implicated water as the mode of transmission. Average consumption of one or more glasses per day was strongly associated with illness (p less than 0.00000001). Among soccer team members with limited school contact, water consumption at the school was associated with a 14-fold greater risk of illness (p less than 0.000001). Drinking water was most likely contaminated by back-siphonage through a cross-connection between the school's well and septic tank. This contamination occurred approximately 24 to 36 hours before the outbreak developed.

Adolescent↗
PubMed2001

The design of competitive, small-molecule inhibitors of coagulation factor Xa.

The last five years have seen an explosion of research into inhibitors of Factor Xa as potential antithrombotic agents. Aventis Pharma was a participant in this effort and its two founder companies have substantially contributed to the discovery of new inhibitors over the years. This review traces the systematic development of the former Rhone-Poulenc Rorer factor Xa program from conception to the realization of potent, orally bioavailable inhibitors with exquisite selectivity against other serine proteases. The work on beta-aminoesters described in Part 1 culminates in the development of FXV673 (Ki = 0.5 nM), an effective anticoagulant for acute indications. Part 2.2 details the de novo design of the pyrrolidinone series of inhibitors (RPR120844), within which a group of efficacious i.v. agents were identified (e.g. RPR130737, Ki = 2 nM). The first active and bioavailable benzamidine isostere i.e. the 1-aminoisoquinoline (RPR208815, Ki = 22 nM) was discovered on the pyrrolidinone scaffold (Part 2.3). Ultimately a variety of benzamidine mimics were explored and incorporated into the ketopiperazine series; the 6-substituted aminoquinazolines were found to be the most potent (Part 3). The azaindole, as represented by RPR200443 (Ki = 4 nM), stands out as imparting favorable pharmacokinetic properties to the sulfonamido-ketopiperazines.

Animals↗
PubMed2005

Dendrimer biocompatibility and toxicity.

The field of biomedical dendrimers is still in its infancy, but the explosion of interest in dendrimers and dendronised polymers as inherently active therapeutic agents, as vectors for targeted delivery of drugs, peptides and oligonucleotides, and as permeability enhancers able to promote oral and transdermal drug delivery makes it timely to review current knowledge regarding the toxicology of these dendrimer chemistries (currently under development for biomedical applications). Clinical experience with polymeric excipients, plasma expanders, and most recently the development of more 'classical polymer'-derived therapeutics can be used to guide development of "safe" dendritic polymers. Moreover, in future it will only ever be possible to designate a dendrimer as "safe" when related to a specific application. The so far limited clinical experience using dendrimers make it impossible to designate any particular chemistry intrinsically "safe" or "toxic". Although there is widespread concern as to the safety of nano-sized particles, preclinical and clinical experience gained during the development of polymeric excipients, biomedical polymers and polymer therapeutics shows that judicious development of dendrimer chemistry for each specific application will ensure development of safe and important materials for biomedical and pharmaceutical use.

Animals↗
PubMed2003

Prions and the human transmissible spongiform encephalopathies.

The last 5 years have seen the emergence of a new disease in humans (vCJD), mainly in the United Kingdom. This emergence has been accompanied by an explosion of scientific data on a novel group of the responsible infectious agents called prions and has profound implications for infection control and transfusion policies. Also of concern is the finding of prions in neural, gingival, pulpal, and salivary tissue in animal models and significant titers of infectivity from extraneural organs (particularly, in cases of vCJD, in lymphoreticular tissues). There is limited information on the presence of prion proteins in the oral tissues from human studies. Because of the differences in patterns of disease in animal models and in strains of prion protein, it is difficult to extrapolate directly these findings to humans, but it illustrates a potential for transmission by way of the dental route. High levels of infectivity may be present in tissues early in the incubation period and before clinical signs and symptoms. The dental profession must turn its attention to the routine decontamination of dental instruments to ensure that these procedures are performed to the highest regulatory standard. Clinicians and manufacturers must work closely together to develop instruments that are either single use or can be presented in a form that can be more easily decontaminated. Clinicians must pay close attention to manufacturers' decontamination instructions and must not reuse items designated as single use, such as endodontic files. Improvements in compliance with these requirements will not only reduce the risk of transmission of TSEs but also other less tenacious infectious agents.

Animals↗
PubMed2002

[Chemical and electrical burns].

Chemical burns are less frequent in routine practice, but could be very serious owing to the complexity and severity of their actions. Influx of casualty after a civil disaster (industrial explosion) or military (war or terrorism) is possible. The action of these agents could be prolonged and deep. In addition to the skin, respiratory lesions and general intoxication could be observed. The urgent local treatment rely essentially on prolonged washing. Prevention and adequate emergency care could limit the serious consequences of these accidents. Accidents (thermal burns or electrisations) due to high or low voltage electricity are frequent. The severity is linked with the affected skin but especially with internal lesions, muscular, neurological or cardiac lesions. All cases of electrisation need hospital care. Locally, the lesions are often deep with difficult surgical repairs and often require amputation. Aesthetic and functional sequela are therefore frequent. Secondary complications could appear several months after the accident: cataract, dysesthesia and hypotonia.

Burn Units↗
PubMed1986

Fertility regulating agents from traditional Chinese medicines.

Chinese scientists have capitalized on the rich flora and the ethnomedical experience in China, in their pursuit of fertility regulating agents from natural products. Discoveries range from anti-implantation agents to abortifacient and pregnancy-terminating compounds, as well as a male contraceptive. Chemistry and bioactivity of these compounds and materials are reviewed in this paper, with the hope that further research and collaboration will take place to help solve the problem of population explosion.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

The basis of current and future therapy for inflammatory bowel disease.

The majority of patients with IBD can be managed with currently available therapy, but the currently available agents do not seem to alter the natural history of the disease. An explosion of information about the immune system and the mediators of inflammation has now generated a host of new strategies that will likely benefit patients with IBD as well as patients with other chronic inflammatory and autoimmune disorders. Molecules of the immune system are being harnessed to treat disorders of the immune system. Some of these new concepts and therapies have been discussed here. Some are already in clinical trials, others have yet to be tried. As more specific immune modulators are tested in patients, it is likely that some will be effective in Crohn's disease but not ulcerative colitis and vice versa, due to, and revealing, the differences in the pathogenesis of these two diseases. The hope is that the application of these new modalities will alter the natural history of these diseases to the benefit of our patients.

Adrenal Cortex Hormones↗
PubMed2005

Divalproex sodium in the treatment of pediatric psychiatric disorders.

Divalproex sodium is an anticonvulsant that is used extensively in adults with indications for epilepsy, acute mania and migraine prophylaxis. It has been used in children and adolescents as a first-line agent for mania in bipolar disorder. Its efficacy as a mood stabilizer has been established, and there have been studies outlining its efficacy as an agent effective in the treatment of conduct disorder, disruptive behavior disorders, aggression and explosive disorder. Longer-acting formulations are now available that cause less gastrointestinal side effects and can also be taken once a day, thus potentially increasing adherence, an important factor in this patient population. Future directions would include developing a more potent valproic acid formulation with fewer side effects, completing randomized controlled trials to establish the efficacy of divalproex sodium in various other pediatric psychiatric disorders, establishing the relative efficacy of the compound in head-to-head comparisons with other mood stabilizers, examining systematically the value of the compound in multimodal pediatric psychiatric treatment packages, and complete effectiveness trials that demonstrate the short- and long-term effectiveness of the compound in the real world of clinicians. In this drug profile, divalproex sodium and its uses in the pediatric population for psychiatric conditions are reviewed.

Adolescent↗
PubMedDate not supplied

Topical mafenide hydrochloride aqueous spray in initial management of massive contaminated wounds with devitalized tissue.

Since at least WWII, some open, contaminated wounds involving massive soft tissue injury and vascular damage have resulted in "irreversible shock," despite prompt rescue, hemorrhage control, and blood and fluid replacement, without signs of clinical infection. In animal studies, survival time was related statistically to the dosage of Clostridium perfringens in multicontaminated explosive wounds. Survival time was lengthened by the application of some topical antibacterial agents, but actual recovery was achieved only with topical mafenide hydrochloride solution aqueous spray, which resulted in negative clostridium. perfringens cultures. Although not related statistically to survival time, the mafenide hydrochloride spray also controlled the Pseudomonas aeruginosa in these wounds. Mafenide hydrochloride had the American trade name of Sulfamylon from about 1942 until 1998, when another pharmaceutical company patented Sulfamylon as the trade name for mafenide acetate, a weaker antibacterial agent. However, mafenide hydrochloride still is available from chemical companies. Mafenide hydrochloride solution spray has been used successfully in treatment of patients with severe by contaminated wounds and deep burns, and its use in initial care should be revisited.

Administration, Topical↗