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The British/Belgian Gall Stone Study Group (BBGSG) post-dissolution trial was a prospective, multicentre, randomised, double blind trial of: (i) low dose ursodeoxycholic acid, (ii) placebo, and (iii) a high fibre, low refined carbohydrate diet in the prevention of gall stone recurrence in patients with complete gall stone dissolution. Further aims included establishing the timing and frequency of recurrence and its association with biliary symptoms, a comparison of the sensitivity of ultrasonography v oral cholecystectography in detecting recurrent stones, and a search for risk factors predicting recurrence. Ninety three patients entered the study, and 82 were followed up for up to five years (mean (SEM) 28 (1.5) months) with six monthly ultrasonography and yearly oral cholecystectography. There were 21 recurrences (26 by oral cholecystectography or ultrasonography, or both), only two of which were symptomatic, which were detected between 12 and 42 months after trial entry. This corresponded to an actuarial recurrence rate of 33.9 (7.0%) by lifetable analysis at 42 months and subsequently. There were four recurrences in the ursodeoxycholic acid, six in the placebo, and 11 in the diet groups, corresponding to 21.9 (9.9)%, 27.4 (10.1)%, and 45.8 (12.4)% respectively at 42 months by lifetable analysis (NS). Variables including age, obesity, menopausal state, pregnancy, and oestrogen containing drugs were not shown to affect recurrence rate. Men had more frequent recurrence than women (NS). Patients who had had multiple stones experienced more recurrences than did those with single stones (NS). Recurrence did not occur in patients who took non-steroidal anti-inflammatory drugs (NSAIDs) (p < 0.02). The stone free interval between stone dissolution and trial entry proved to be important--those stone free > nine months had a recurrence rate of only 12.7 (6.0)% at 42 months compared with 55.4 (12.5)% in those stone free < nine months (p < 0.01). There was imbalance between the ursodeoxycholic acid and placebo groups for this factor, and after applying a statistical correction, the adjusted recurrence rate in the ursodeoxycholic acid group was 15% compared with 30% in both placebo and diet groups (NS). These data suggest that after medical dissolution, the risk of gall stone recurrence is not reduced by a high fibre, low refined carbohydrate diet: it may be lowered, but not abolished, by low dose ursodeoxycholic acid.
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PMID:Gall stone recurrence and its prevention: the British/Belgian Gall Stone Study Group's post-dissolution trial. 840 69

Cosmetics are a frequent cause of contact dermatitis, not only in females but also in males. Men use cosmetics in the form of deodorant, hair dye and aftershave lotions. U.S.A men spent more than 6,000,000,000 million dollars in cosmetic products. Responsible substances of contact dermatitis are unidentified in many occasions, what impedes the estimation of morbidity data. It is calculated that 2-4% of dermatological consultations are due to contact dermatitis caused by cosmetics. The Spanish industry manufactures each year articles valued in several thousands of million pesetas, 14% of which are exported. Annual manufacturing is raising between 10 and 11%. The French journal Cosmetology (IMS) pointed as an example the fact that in the third trimester of 1978, the number of sold products was as follows: 87,880 units of cleansing milk; 128,020 creams; 237,200 tonics; 10,228 lip protectors. The Committee of European Unions for Perfumery and Cosmetology (COLIPA) reported in 1978 a yearly sale in Europe of 225,000,000 units of hair dyes, exclusively. Adverse reactions to cosmetics affect not only the skin in the form of irritant or contact dermatitis, but cases of conjunctivitis, asthma, urticaria, rhinitis, angioedema, pneumonitis and anaphylaxis-like reactions due to cosmetic products, mainly hair bleaching agents, perm liquids and hair spray, have been also reported. The present work studied the prevalence of sensitizations to cosmetic products on the professional staff of a beauty salon in our city of Las Palmas (SEM). Twenty people came to our Unit of Allergology to fill a questionnaire and undergo a skin test.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevalence of cosmetic sensitivity among beauticians]. 855 88

Most patients with sleep apnoea/hypopnoea syndrome (SAHS) are middle-aged men. As there are conflicting data on the effects of age and gender on upper airway calibre, we tested the hypothesis that increasing age and the male sex predispose to upper airway narrowing in normal subjects. We measured upper airway calibre using acoustic reflection in 60 men and 54 women (median 35, range 16-74 yrs) both seated and supine. All upper airway dimensions, except oropharyngeal junction (OPJ), decreased with increasing age in both men and women (r > -0.24, p < or = 0.05) while supine (r2 > 0.06). Men had greater changes in airway area at OPJ on lying down (mean (SEM) 0.5 (0.1), 0.2 (0.1) cm2; p < 0.02). Men had greater body mass indices (mean (SD) 26 (4), 24 (4) kg.m-2; p = 0.04), and larger neck circumferences (mean (SD) 38 (3), 33 (2) cm; p < 0.0001) than women. For any body mass index, neck circumference was larger in men than women (p < 0.001). This study shows that upper airway size decreases with increasing age in both men and women, and that men have greater upper airway collapsibility on lying down at oropharyngeal junction than women.
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PMID:The effect of age, sex, obesity and posture on upper airway size. 931 8

To study the structural basis of bone fragility in men, we compared bone size and volumetric bone mineral density (vBMD) of the third lumbar vertebra and femoral neck in 95 men with spine fractures, 127 men with hip fractures, and 395 healthy controls using dual-energy X-ray absorptiometry (DXA). The results were expressed in absolute terms and age-specific SD scores (mean +/- SEM). In controls, vertebral body and femoral neck width increased across age, being 0.46 +/- 0.11 SD and 0.91 +/- 0.08 SD higher in elderly men than in young men, respectively (both,p < 0.001). Men with spine fractures had reduced vertebral body width (-0.45 +/- 0.10 SD;p < 0.01) but not femoral neck width (-0.15 +/- 0.10 SD, NS). Men with hip fractures had reduced femoral neck width (-0.45 +/- 0.11 SD; p < 0.01) and vertebral body width (-0.25 +/- 0.10 SD; p < 0.05). The deficits in bone volume (BV) exaggerated the deficits in bone mineral content (BMC) by 40% at the vertebrae in men with spine fractures and by 9% at the femoral neck in men with hip fractures. vBMD deficits were greater at the vertebrae in men with spine fractures than in men with hip fractures (-1.37 +/- 0.08 SD vs.-0.70 +/- 0.10 SD, respectively; p < 0.01) but were similar at the femoral neck (-0.93 +/- 0.10 SD and -0.76 +/- 0.11 SD, respectively, NS), despite the men with spine fracture being 10 years younger. Bone fragility leading to spine or hip fractures in men may be the result of fracture site-specific deficits in bone size and vBMD that have their origins in growth, aging, or both.
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PMID:Fracture site-specific deficits in bone size and volumetric density in men with spine or hip fractures. 1114 75

The purpose of this pilot study was to assess DNA damage in buccal cells from individuals chronically exposed to arsenic via drinking water in Ba Men, Inner Mongolia. Buccal cells were collected from 19 Ba Men residents exposed to arsenic at 527.5 +/- 23.7 micrograms/L (mean +/- SEM) and 13 controls exposed to arsenic at 4.4 +/- 1.0 micrograms/L. DNA fragmentation by the DNA ladder and TUNEL assay were used to detect DNA damage in buccal cells. In the DNA ladder assay, 89% (17/19) of the arsenic-exposed group showed < 100 bp DNA fragments, in contrast to 15% (2/13) of the controls (p < 0.0001). For the TUNEL assay, the mean frequencies of positive cells were higher in the exposed group (15.1%) than in the controls (2.0%) (p < 0.0001). This study showed that high arsenic exposure via drinking water resulted in DNA damage and DNA fragmentation in buccal cells thus may be an appropriate biomarker for assessing chronic effects of arsenic in humans. A study investigating DNA fragmentation from the individuals with low levels of arsenic exposure in this population is in progress.
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PMID:DNA damage in buccal epithelial cells from individuals chronically exposed to arsenic via drinking water in Inner Mongolia, China. 1129 89

An accurate, simple method for assessing energy expenditure in individuals and in free-living populations continues to be elusive. To compare estimates of energy expenditure (EE) from a combination of two previously validated physical activity questionnaires: Tecumseh Occupational (EE(TEC)) and a 4-wk history version of the Minnesota Leisure Time Physical Activity that included household activities (EE(MNLTPA)) and EE from sleep (EE(SLEEP)), to EE obtained from doubly labeled water (EE(DLW)). We studied free-living males (n = 24) eating a controlled diet designed to maintain body weight and determined EE from doubly labeled water (DLW) during 14 days and EE from physical activity instruments used in epidemiological studies (EE(TEC) and EE(MNLTPA)). There was excellent agreement between EE(DLW) (mean +/- SEM, 13.55 +/- 0.38 MJ/d) and EE(TEC) + EE(MNLTPA) + EE(SLEEP) (EE(TOTAL1)) (13.79 +/- 0.89 MJ/d) with a difference of only 1.0% +/- 5.4%. When the EE from watching TV, reading, and childcare activities was added the total EE (EE(TOTAL2)) (14.87 +/- 0.90 MJ/D) overestimated EE(DLW) by 8.9% +/- 5.4%. Both of these estimates of EE had significant regressions against EE(DLW) (EE(TEC) + EE(MNLTPA) + EE(SLEEP), R(2) = 0.38, P < 0.001; EE(TOTAL2), R(2) = 0.39, P < 0.001). Men whose occupations involved significant intermittent moderate activity had the largest disagreement between EE(DLW) and estimates from the questionnaires. This investigation demonstrates that a combination of previously validated physical activity questionnaires can be used to accurately determine the mean energy expenditure of a population of employed males.
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PMID:Estimating energy expenditure from the Minnesota Leisure Time Physical Activity and Tecumseh Occupational Activity questionnaires - a doubly labeled water validation. 1192 8

To determine whether patients from disadvantaged socioeconomic groups present with more advanced thyroid carcinoma or experience differing management and clinical outcomes, we retrospectively reviewed the charts of 292 patients seen at MD Anderson Cancer Center and Ben Taub General Hospital between 1987 and 1994. At diagnosis, the mean age was 42 +/- 16 years, 78% of patients were female, 76% of patients were low risk (TNM stage I or II), and 22% high risk (stage III or IV). Neighborhood income (+/- standard error of the mean [SEM]) (1990 census data) was lower in the high-risk group compared with the low-risk group (US dollars 26200 +/- 1670 vs. US dollars 30900 +/- 870, p = 0.012). Men were more likely than women to present at an older age (47.5 +/- 16.7 vs. 40.2 +/- 16.0, p = 0.0014) and in the high-risk group (46% vs. 15%, p < 0.0001). No socioeconomic factor (ethnicity, marital status, occupation prestige, neighborhood income, insurance type) influenced initial diagnostic assessment. Similarly, no socioeconomic factor influenced initial disease management or the type of follow-up received over the 12-year period. Married patients had a lower 5-year recurrence rate than those unmarried (18% vs. 32%, p = 0.03); however, this did not affect overall or disease-specific survival. Similarly, ethnicity, marital status, occupation prestige, and insurance type did not influence overall or disease-specific survival. Although 10-year overall survival rates were lower in patients in the lowest income quartile (57% vs. 70% for upper, p = 0.0024) and in men compared with women (39% vs. 76%, p < 0.0001), gender alone influenced 10-year disease-specific survival (80% for men, 89% for women, p = 0.047). In summary, no socioeconomic factor appears to affect initial treatment or follow-up pattern in patients with differentiated thyroid cancer. Income and gender may affect stage at initial disease presentation and may be risk factors affecting eventual clinical outcomes.
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PMID:Socioeconomic factors and the presentation, management, and outcome of patients with differentiated thyroid carcinoma. 1249 79

The aim of the study was to evaluate post-operative pain and analgesic use after pre-operative or post-incisional i.v. fentanyl plus low dose i.v. ketamine vs. a standard treatment receiving i.v. fentanyl but not ketamine. Men undergoing radical prostatectomy under general anesthesia were randomly assigned in a double-blinded manner to one of three groups. Patients received i.v. fentanyl before incision followed by an i.v. bolus dose (0.2 ml kg(-1)) and an i.v. infusion (0.0025 ml kg(-1)min(-1)) of 1 mg ml(-1) ketamine (group 1) or normal saline (groups 2 and 3). Seventy minutes after incision, patients received i.v. fentanyl followed by an i.v. bolus dose (0.2 ml kg(-1)) and an i.v. infusion (0.0025 ml kg(-1)min(-1)) of saline (groups 1 and 3) or ketamine (group 2). Pain, von Frey pain thresholds, and cumulative morphine consumption using patient-controlled analgesia (PCA) were assessed up to 72 h after surgery. 143 patients completed the study (group 1, n = 47, group 2, n = 50, group 3, n = 46). Cumulative PCA morphine (mean+/-SD) did not differ significantly among groups (group 1, 92.3+/-45.9 mg; group 2, 107.2+/-58.4 mg; group 3, 103.6+/-50.4 mg; P = 0.08 for groups 1 vs. 2, and groups 1 vs. 3). On day 3, the hourly rate (mean+/-SEM) of morphine consumption was significantly lower (p < 0.0009) in group 1 (0.61+/-0.013 mg h(-1)) than group 2 (0.86+/-0.011 mg h(-1)) and group 3 (0.89+/-0.008 mg h(-1)). Pain scores and von Frey pain thresholds did not differ significantly among groups. Two-week and 6-month follow-ups did not reveal significant group differences in pain incidence, intensity, disability or mental health. Pre-operative, low-dose administration of i.v. ketamine did not result in a clinically meaningful reduction in pain or morphine consumption when compared with post-incisional administration of ketamine or a saline control condition.
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PMID:Pre-emptive analgesia using intravenous fentanyl plus low-dose ketamine for radical prostatectomy under general anesthesia does not produce short-term or long-term reductions in pain or analgesic use. 1528 12

Bilirubin, the primary end product of heme catabolism, is a key marker of liver and hematological disorders, and important cytoprotective properties have been ascribed to this bile pigment. The Third National Health and Nutrition Examination Survey, a comprehensive assessment of health and nutrition in the United States, was analyzed to determine the demographics and correlates of serum bilirubin levels in the general population. Men and women aged 17 and older were included in the weighted analysis, representing a total of 176,748,462 subjects. The mean serum total bilirubin in the adult population is 0.62 +/- 0.003 mg/dL (SEM), with a 97.5% cut-off of 1.4 mg/dL. Serum bilirubin levels are significantly higher in men (0.72 +/- 0.004) than in women (0.52 +/- 0.003 mg/dL) and are lower in non-Hispanic blacks (0.55 +/- 0.005 mg/dL) compared with non-Hispanic whites (0.63 +/- 0.004 mg/dL) and Mexican Americans (0.61 +/- 0.005 mg/dL). Bilirubin concentrations are unrelated to body weight but are reduced in active smokers. Individuals with a history of nondermatological malignancy exhibit significantly lower serum bilirubin concentrations compared with those who do not have a history of nondermatological cancer. In particular, each 1-mg/dL increase in serum bilirubin is associated with a markedly decreased prevalence of colorectal cancer (OR = 0.257; 95% CI 0.254-0.260). In conclusion, serum bilirubin levels vary significantly with gender, race, and smoking status. The observed inverse correlation between serum bilirubin concentrations and a history of nondermatological malignancy, particularly colorectal cancer, warrants further investigation of a potentially important chemopreventive function of bilirubin.
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PMID:Serum bilirubin levels in the U.S. population: gender effect and inverse correlation with colorectal cancer. 1538 74

Arsenic (As) is found naturally in the geological strata within the Ba Men Region of Inner Mongolia, China. A study was conducted to compare the total As measurements from two analytical techniques: instrumental neutron activation analysis (INAA) and atomic fluorescence spectrometry (AFS), and to verify nails as an exposure biomarker in this population. In 1999, nail and water samples were collected in a pilot study. Fingernails and toenails were pooled from 32 participants and analysed for total As by both INAA and AFS. Mean nail As values were 14.8+/-2.4 and 19.4+/-2.8 microg g-1 (+/-SEM) for INAA and AFS, respectively. Results from these two methods were significantly correlated (r=0.93, p<0.0001). In 2000, a second study was conducted and INAA was used to measure total As in toenails from 314 Ba Men residents. Well water samples were collected from 121 households and analysed by AFS. A significant correlation was observed between toenail and well water As (r=0.84, p<0.0001). Based on the results, INAA was significantly correlated with AFS and proved to be a reliable measure of nail As levels. In this population, toenail samples are a useful internal As exposure biomarker from drinking water sources.
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PMID:Human nails as a biomarker of arsenic exposure from well water in Inner Mongolia: comparing atomic fluorescence spectrometry and neutron activation analysis. 1607 25


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