Association between exposure to crystalline silica and risk of sarcoidosis.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOBJECTIVES: The possibility of an association between exposure to silica and autoimmune diseases has recently come under discussion. In the following case-referent study, a cohort exposed to diatomaceous earth and cristobalite provided an opportunity to evaluate such an exposure with reference to sarcoidosis. METHODS: The inhabitants of a district served by a single healthcare centre and a hospital formed the study base. A diatomaceous earth plant is located in this community and the medical institutions are responsible for primary and secondary health care of the population. Cases of sarcoidosis were identified from the hospital records according to certain clinical, radiological, and histological criteria. Referents were selected randomly from the population of the district. Information on exposure to crystalline silica, cristobalite, was obtained by record linkage of the cases and referents with a file which included all present and past workers at the diatomaceous earth plant and those who had worked at loading vessels with the product from the plant. RESULTS: Eight cases of sarcoidosis were found, six of which were in the exposed group. Of the 70 referents, 13 were exposed. The odds ratio (95% confidence interval) was 13.2 (2.0 to 140.9). CONCLUSION: The odds ratios were high and there were some indications of a dose-response relation which will hopefully encourage further studies. To our knowledge this is the first study to indicate a relation between sarcoidosis and exposure to the crystalline silica, cristobalite

Predicting mortality of residents at admission to nursing home: A longitudinal cohort study

<p>Abstract</p> <p>Background</p> <p>An increasing numbers of deaths occur in nursing homes. Knowledge of the course of development over the years in death rates and predictors of mortality is important for officials responsible for organizing care to be able to ensure that staff is knowledgeable in the areas of care needed. The aim of this study was to investigate the time from residents' admission to Icelandic nursing homes to death and the predictive power of demographic variables, health status (health stability, pain, depression and cognitive performance) and functional profile (ADL and social engagement) for 3-year mortality in yearly cohorts from 1996-2006.</p> <p>Methods</p> <p>The samples consisted of residents (N = 2206) admitted to nursing homes in Iceland in 1996-2006, who were assessed once at baseline with a Minimum Data Set (MDS) within 90 days of their admittance to the nursing home. The follow-up time for survival of each cohort was 36 months from admission. Based on Kaplan-Meier analysis (log rank test) and non-parametric correlation analyses (Spearman's rho), variables associated with survival time with a p-value < 0.05 were entered into a multivariate Cox regression model.</p> <p>Results</p> <p>The median survival time was 31 months, and no significant difference was detected in the mortality rate between cohorts. Age, gender (HR 1.52), place admitted from (HR 1.27), ADL functioning (HR 1.33-1.80), health stability (HR 1.61-16.12) and ability to engage in social activities (HR 1.51-1.65) were significant predictors of mortality. A total of 28.8% of residents died within a year, 43.4% within two years and 53.1% of the residents died within 3 years.</p> <p>Conclusion</p> <p>It is noteworthy that despite financial constraints, the mortality rate did not change over the study period. Health stability was a strong predictor of mortality, in addition to ADL performance. Considering these variables is thus valuable when deciding on the type of service an elderly person needs. The mortality rate showed that more than 50% died within 3 years, and almost a third of the residents may have needed palliative care within a year of admission. Considering the short survival time from admission, it seems relevant that staff is trained in providing palliative care as much as restorative care.</p

A Review of the Occurrence of Bats (Chiroptera) on Islands in the North East Atlantic and on North Sea Installations

The bats recorded from Iceland, the Faroe Islands, the Shetland Islands, the Orkney Islands, and North Sea installations are reviewed to the end of 2012. In total 12 species have been positively identified, while a considerable proportion of all records are sightings of unidentified bats. Eight of the species are European in origin and four originate from the New World. The largest number of species (8) has been recorded in Iceland, but the greatest number of individuals (180) has been found in Orkney. The bat invasion on the Faroe Islands in 2010 is without precedence, when 70 observations of a minimum of 45 individuals were noted. Most bat observations in the study area occurred in the autumn, with fewer in the spring. Most observations were of single animals, but there were also sightings of up to 12 individuals. There has been a marked increase in bat records in the past three decades. We discuss whether this is a real increase, or due to improved communications, increased public awareness, increased shipping, changes in weather patterns and/or the effects of climate change. All factors appear to be involved.© Museum and Institute of Zoology PAS. The attached document is the author(’s’) final accepted/submitted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it

The TULIP-tool: a Delphi consensus project on standardized evaluation of flexible ureterorenoscopes

OBJECTIVE: To develop a standardized tool to evaluate flexible ureterorenoscopes (fURS). MATERIAL & METHODS: A three-stage consensus building approach based on the modified Delphi technique was performed under guidance of a steering group. First, scope-related and user-related parameters used to evaluate fURS were identified through a systematic scoping review. Then, the main categories and subcategories were defined, and the expert panel was selected. Finally, a two-step modified Delphi consensus project was conducted to firstly obtain consensus on the relevance and exact definition of each (sub)category necessary to evaluate fURS, and secondly on the evaluation method (setting, used tools and unit of outcome) of those (sub)categories. Consensus was reached at a predefined threshold of 80% high agreement. RESULTS: The panel consisted of thirty experts in the field of endourology. The first step of the modified Delphi consensus project consisted of two questionnaires with a response rate of 97% (n=29) for both. Consensus was reached for the relevance and definition of six main categories and 12 subcategories. The second step consisted of three questionnaires (response rate of 90%, 97% and 100%, respectively). Consensus was reached on the method of measurement for all (sub)categories. CONCLUSION: This modified Delphi consensus project reached consensus on a standardized grading tool for the evaluation of fURS, the TULIP-tool. This is a first step in creating uniformity in this field of research to facilitate future comparison of outcomes of the functionality and handling of flexible ureterorenoscopes