Cancer and heart attack survivors’ expectations of employment status: results from the English Longitudinal Study of Ageing

Background: Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future employment status in cancer survivors was explored. To assess the degree to which these factors specifically concern cancer survivors, a comparison with heart attack survivors was made. Methods: Data from the English Longitudinal Study of Ageing were used. Cancer and heart attack survivors of working age in the UK were included and followed up for 2 years. Baseline characteristics of both cancer and heart attack survivors were compared regarding employment status. Univariate and multivariate regression analyses were performed in survivors at work, and the interaction between independent variables and diagnose group was assessed. Results: In cancer survivors at work (N = 159), alcohol consumption, participating in moderate or vigorous sport activities, general health and participation were univariate associated with employment status at two-year followup. Only fair general health (compared to very good general health) remained statistically significant in the multivariate model (OR 0.31; 95% CI 0.13–0.76; p = 0.010). In heart attack survivors at work (N = 78), gender, general health and expectation of being at work were univariate associated with employment status at follow-up. Female gender (OR 0.03; 95% CI 0.00–0.57; p = 0.018) and high expectation of being at work (OR 10.68; 95% CI 1.23–93.92; p = 0.033) remained significant in the multivariate model. The influence of gender (p = 0.066) and general health (p = 0.020) regarding employment status was found to differ significantly between cancer and heart attack survivors. Conclusions: When predicting future employment status in cancer survivors in the UK, general health is the most relevant factor to consider. While expectation of being at work did not show any significant influence in cancer survivors, in heart attack survivors, it should not be disregarded though, when developing interventions to affect their employment status. Future research should focus on more specific measures for expectation, and additional behavioural factors, such as self-efficacy, and their effect on employment status

Neutrophils in cancer: neutral no more

Neutrophils are indispensable antagonists of microbial infection and facilitators of wound healing. In the cancer setting, a newfound appreciation for neutrophils has come into view. The traditionally held belief that neutrophils are inert bystanders is being challenged by the recent literature. Emerging evidence indicates that tumours manipulate neutrophils, sometimes early in their differentiation process, to create diverse phenotypic and functional polarization states able to alter tumour behaviour. In this Review, we discuss the involvement of neutrophils in cancer initiation and progression, and their potential as clinical biomarkers and therapeutic targets

Verlammende schaaldier vergiftiging; Een overzicht

Paralytic shellfish poisoning (PSP) is caused by ingestion of shellfish containing PSP toxins. The PSP toxins are a group of 18 closely related tetrahydropurines. The first PSP toxin chemically characterised was saxitoxin. The various PSP toxins significantly differ in toxicity, with saxitoxin being the most toxic. The presence of PSP toxins in shellfish can be demonstrated with the mouse bioassay, a non-selective testing procedure, with animal death as toxicity criterion. The test is currently used in many countries for checking the toxicity of shellfish but international pressure a.o. of animal welfare groups has led to stimulation of research to replace the mouse bioassay by chemical methods of analysis. It is expected, however, that several more years of intensive investigations will be needed, before a selective, sensitive and validated method of analysis becomes available and accepted. Although promising developments have been made, limited supplies of purified toxin standards are still delaying rapid progress. The PSP toxins are produced mainly by dinoflagellates belonging to the genus Alexandrium, which may occur both in the tropical and moderate climate zones. Shellfish grazing on these algae can accumulate the toxins , but most of them are rather resistent to the harmful effects of these toxins. The highest concentrations in shellfish are found during or directly after an algal bloom. People consuming the contaminated shellfish can become intoxicated. The primary mode of action of PSP toxins in mammals is their binding to sodium channels in nerve cell membranes, readily at nanomolar concentration. This leads to inhibition of impulses along the nerves, resulting in paralysis, respiratory depression and circulatory failure. Symptoms of human PSP intoxication vary from a slight tingling or numbness to complete respiratory paralysis. In fatal cases, respiratory paralysis occurs within 2-12 hours of consumption of the PSP containing food. During the last 20 years there seems to be an increase in intoxications, caused by PSP. Currently, some 25 countries have regulations for PSP. Most regulations are set for paralytic shellfish poisoning as a group, but some countries indicate specific regulations for one of the PSP toxins, mostly saxitoxin.Paralytic shellfish poisoning (PSP) wordt veroorzaakt door consumptie van schelpdieren die PSP toxinen bevatten. Er zijn 18 verschillende PSP toxinen, waarvan saxitoxine de meest bekende en de meest toxische is. PSP toxinen kunnen worden aangetoond met de muis bioassay, waarbij de dood van het dier als toxiciteitscriterium geldt. Deze methode wordt op dit moment nog veel toegepast, maar de internationale druk die wordt uitgeoefend door o.a. de dierenbeschermingsorganisaties stimuleert het onderzoek naar chemische analysemethoden om de muis bioassay te vervangen. Hoewel er verschillende methoden voorhanden zijn, heeft elke methode wel zwakke punten. Het grootste probleem is dat er weinig analytische standaarden en gecertificeerde referentiematerialen voorhanden zijn, alhoewel er wel veelbelovende ontwikkelingen op dit gebied zijn. De PSP toxinen worden voornamelijk geproduceerd door zogeheten dinoflagellaten van het geslacht Alexandrium. Deze soort komt zowel in tropische gebieden als in de gematigde zones voor en wanneer schelpdieren zich voeden met deze algen, kunnen de toxinen accumuleren in de schelpdieren. De hoogste concentraties toxinen komen voor tijdens, of vlak na een algenbloei, maar zelf ondervinden de schelpdieren bijna geen effect van de toxinen. Wanneer mensen de verontreinigde schelpdieren opeten kunnen ze vergiftigd raken met de PSP toxinen. De effecten zijn aanvankelijk het waarnemen van tintelingen en gevoelloosheid maar uiteindelijk kan verlamming optreden en in ernstige gaveling an dit tot tot de dood leiden doordat ook de ademhalingsspieren verlamd raken. De laatste jaren lijkt het alsof er een toename in het aantal intoxicaties, veroorzaakt door PSP, plaatsvindt.Op dit moment zijn er 25 landen met wetgeving op het gebied van PSP. De meeste landen hebben wetgeving voor PSP in het algemeen, maar sommige landen hebben ook specifieke wetgevingen voor een of meer PSP toxinen

Verlammende schaaldier vergiftiging; Een overzicht

Paralytic shellfish poisoning (PSP) wordt veroorzaakt door consumptie van schelpdieren die PSP toxinen bevatten. Er zijn 18 verschillende PSP toxinen, waarvan saxitoxine de meest bekende en de meest toxische is. PSP toxinen kunnen worden aangetoond met de muis bioassay, waarbij de dood van het dier als toxiciteitscriterium geldt. Deze methode wordt op dit moment nog veel toegepast, maar de internationale druk die wordt uitgeoefend door o.a. de dierenbeschermingsorganisaties stimuleert het onderzoek naar chemische analysemethoden om de muis bioassay te vervangen. Hoewel er verschillende methoden voorhanden zijn, heeft elke methode wel zwakke punten. Het grootste probleem is dat er weinig analytische standaarden en gecertificeerde referentiematerialen voorhanden zijn, alhoewel er wel veelbelovende ontwikkelingen op dit gebied zijn. De PSP toxinen worden voornamelijk geproduceerd door zogeheten dinoflagellaten van het geslacht Alexandrium. Deze soort komt zowel in tropische gebieden als in de gematigde zones voor en wanneer schelpdieren zich voeden met deze algen, kunnen de toxinen accumuleren in de schelpdieren. De hoogste concentraties toxinen komen voor tijdens, of vlak na een algenbloei, maar zelf ondervinden de schelpdieren bijna geen effect van de toxinen. Wanneer mensen de verontreinigde schelpdieren opeten kunnen ze vergiftigd raken met de PSP toxinen. De effecten zijn aanvankelijk het waarnemen van tintelingen en gevoelloosheid maar uiteindelijk kan verlamming optreden en in ernstige gaveling an dit tot tot de dood leiden doordat ook de ademhalingsspieren verlamd raken. De laatste jaren lijkt het alsof er een toename in het aantal intoxicaties, veroorzaakt door PSP, plaatsvindt.Op dit moment zijn er 25 landen met wetgeving op het gebied van PSP. De meeste landen hebben wetgeving voor PSP in het algemeen, maar sommige landen hebben ook specifieke wetgevingen voor een of meer PSP toxinen.Paralytic shellfish poisoning (PSP) is caused by ingestion of shellfish containing PSP toxins. The PSP toxins are a group of 18 closely related tetrahydropurines. The first PSP toxin chemically characterised was saxitoxin. The various PSP toxins significantly differ in toxicity, with saxitoxin being the most toxic. The presence of PSP toxins in shellfish can be demonstrated with the mouse bioassay, a non-selective testing procedure, with animal death as toxicity criterion. The test is currently used in many countries for checking the toxicity of shellfish but international pressure a.o. of animal welfare groups has led to stimulation of research to replace the mouse bioassay by chemical methods of analysis. It is expected, however, that several more years of intensive investigations will be needed, before a selective, sensitive and validated method of analysis becomes available and accepted. Although promising developments have been made, limited supplies of purified toxin standards are still delaying rapid progress. The PSP toxins are produced mainly by dinoflagellates belonging to the genus Alexandrium, which may occur both in the tropical and moderate climate zones. Shellfish grazing on these algae can accumulate the toxins , but most of them are rather resistent to the harmful effects of these toxins. The highest concentrations in shellfish are found during or directly after an algal bloom. People consuming the contaminated shellfish can become intoxicated. The primary mode of action of PSP toxins in mammals is their binding to sodium channels in nerve cell membranes, readily at nanomolar concentration. This leads to inhibition of impulses along the nerves, resulting in paralysis, respiratory depression and circulatory failure. Symptoms of human PSP intoxication vary from a slight tingling or numbness to complete respiratory paralysis. In fatal cases, respiratory paralysis occurs within 2-12 hours of consumption of the PSP containing food. During the last 20 years there seems to be an increase in intoxications, caused by PSP. Currently, some 25 countries have regulations for PSP. Most regulations are set for paralytic shellfish poisoning as a group, but some countries indicate specific regulations for one of the PSP toxins, mostly saxitoxin.Hoofdinspectie Gezondheidsbescherming (HIGB/VWS