Administration of total parenteral nutrition solutions via a peripheral vein is an attractive concept. An ideal regimen would meet the requirements of moderately catabolic patients and would contain about 14g of nitrogen and 2200kcals. The feasibility of administering such a regimen was examined in a study at Hammersmith hospital, London. To prolong vein survival and minimise the risk of phlebitis, all patients had a glyceryl trinitrate patch and twice daily hydrocortisone cream applied to the infusion site. Patients were randomised to receive either heparinised or non‐heparinised TPN at a concentration of 1 IU/ml. Sixteen patients were recruited to the study of whom nine received heparin in their TPN. The end point was determined as occurring when the cannula was removed electively or accidentally, or when phlebitis around the cannula site necessitated removal. Infusions ending in phlebitis or tissuing were counted as true failures while cannulae electively withdrawn or pulled out were treated as censored data. The median survival time of infusion sites receiving heparinised TPN was 69 hours while the median survival time of sites receiving TPN only was 31 hours. Life table analysis was carried out on the duration of patency of individual cannulation sites. Comparison of the two groups using the logrank test showed a significant difference (p=0.013). Thus, the addition of heparin at 1 IU/ml to TPN infusate produced a marked extension of the survival of the infusion sites. This technique warrants further investigation with other peripheral regimens.
This study included 114 workers who have been exposed to noise levels of 78 to 91.4 dBA and followed over a six year period. Workers exposed to nose levels up to 85 dBA eight hours daily for six days per week and for twelve years showed a slightly higher (1%) hearing impairment than the corresponding control subjects. Impairment of hearing among workers exposed to higher noise levels was 9.6%.
This study was conducted in a typical Egyptian textile plant located in Alexandria. Male workers from all operations (N = 506) were examined and their dust exposures were assessed. Results showed that airborne dust concentrations were very high and that the plant fraction is mostly concentrated in respirable dust. Byssinosis prevailed in 21% of workers in opening and cleaning sections and in 13% in carding and combing rooms, but was found in none of the workers in drawing, twisting, and spinning operations, in only 1.1% in weaving, and in 3.1% of workers in other "auxiliary" occupations. The rare prevalence of byssinosis among the latter workers' groups was attributed to the workers' continuous exposure without fixed weekend interruption, the personal and family history of exposure to cotton, the low proportion of plant materials in dust evolved in related operations, the fine quality of Egyptian cotton, and/or the population characteristics of Egyptian workers. Reduction in FEV 1.0 at the end of the first work shift after absence from work occured more often than byssinosis, which indicates the importance of this test for the early detection of effects of cotton dust exposure. It is suggested that a nationwide study in the cotton textile industry is indicated.
A previous investigation has shown that family susceptibility and occupational and family histories have a decisive role in the development of byssinosis among workers exposed to flax dust. Results of investigation of silicosis in 814 male workers exposed to silica-bearing dust showed that family susceptibility has an important role in the development of silicosis among examined workers, and workers whose fathers had an occupational history of exposure to silica-bearing dust were more resistant to the development of the disease than those with non-exposed fathers. The degree of consanguinity of parents and individuals' blood groups, also, have a role. Workers with cousin parents were relatively highly susceptible to the development of silicosis as well as workers with blood groups "O" or "AB." It has been concluded that the investigated factors might have a role in the development of other occupational diseases and further investigations are indicated.
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