OBJECTIVETo compare the effects of dust exposure and smoking on mortality.

METHODSBased on the Guangzhou Occupational Health Surveillance Record System established in 1989-1992, 80 987 factory workers, aged > or = 30, occupationally exposed to dust and non-exposure to dust, were included in a prospective cohort study.

RESULTS(1) The mean age of the cohort was 43.5. Most subjects were workers, with secondary education, and married. Out of them 16.3% having ever exposed to dust, 43.7% ever smoked and 33.5% drank alcohol. (2) The cohort were traced for 8 years on average, but 35 were lost for follow-up. Malignant neoplasm was most commonly seen among 1539 deaths. (3) The adjusted relative risk (RRs) of death of all causes, malignant neoplasm and cerebro-cardiovascular diseases for dust exposed workers were close to those for smokers. However, the adjusted RRs of death of nasopharynx cancer and respiratory system diseases for dust exposed workers were higher than those for smokers. The adjusted RRs of death of lung cancer and stomach cancer for smokers were 2.2 times and 1.5 times of that for dust exposed workers respectively. Dust exposure combined with smoking caused significantly higher death RR. (4) In males, the adjusted RRs of death of all causes, malignant neoplasm and respiratory system diseases for silica dust exposed workers and the adjusted RR of death of cerebro-cardiovascular diseases for wood dust exposed workers were higher those in smokers. (5) The population attributable risk percentage (PARP) of all causes of death for smokers was 2.5 times of that for dust exposed workers. (6) In males, the risks of death for all causes, malignant neoplasm, lung cancer and stomach cancer increased with the amount of smoking per day and the duration of smoking. The risks of death caused by coronary heart disease and respiratory system diseases were increasing with the amount of smoking per day and the duration of smoking respectively.

CONCLUSIONSThe adjusted RRs for dust exposed workers were close to those for smokers with dust exposure and smoking having synergistic effects. Some of the adjusted RRs for smokers were higher than those for dust exposed workers PARP for smokers was higher than that for dust exposed workers. Our findings suggested that there was a significant dose-effect between smoking and risk of deaths.

Adult ; Cause of Death ; China ; epidemiology ; Coal ; Cohort Studies ; Dust ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Prospective Studies ; Risk Factors ; Silicon Dioxide ; Smoking ; adverse effects

It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were performed. We further performed an age- and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region (Hong Kong, China). From January 2002 to December 2012, 3496 patients undergoing TURP were included in our study, with 1764 patients in the LUTS group and 1732 patients in the AROU group. Old age, ischemic heart disease, cerebrovascular accident, and AROU were risk factors of mortality. Patients aged <70 years (adjusted hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.11-2.09, P = 0.010) and 70-80 years (adjusted HR: 1.39, 95% CI: 1.15-1.70, P = 0.001) in the AROU group had worse survival than those in the LUTS group, but such difference was not demonstrated in patients aged >80 years. Compared to the general population, younger patients in the LUTS group appeared to have better survival (<70 years, P = 0.091; 70-80 years, P = 0.011), but younger patients in the AROU group had worse survival (<70 years, P = 0.021; 70-80 years, P = 0.003). For patients aged >80 years, survival was similar with the general population in both the LUTS and AROU groups. In conclusion, AROU at young age was associated with mortality, while early detection and management of LUTS may improve survival.
Age Factors ; Aged ; Aged, 80 and over ; Databases, Factual ; Humans ; Kaplan-Meier Estimate ; Lower Urinary Tract Symptoms ; Male ; Middle Aged ; Prostate/surgery* ; Prostatic Hyperplasia/surgery* ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Transurethral Resection of Prostate/methods* ; Urinary Retention/surgery*

INTRODUCTIONAwake craniotomy allows accurate localisation of the eloquent brain, which is crucial during brain tumour resection in order to minimise risk of neurologic injury. The role of the anaesthesiologist is to provide adequate analgesia and sedation while maintaining ventilation and haemodynamic stability in an awake patient who needs to be cooperative during neurological testing. We reviewed the anaesthetic management of patients undergoing an awake craniotomy procedure.

MATERIALS AND METHODSThe records of all the patients who had an awake craniotomy at our institution from July 2004 till June 2006 were reviewed. The anaesthesia techniques and management were examined. The perioperative complications and the outcome of the patients were noted.

RESULTSThere were 17 procedures carried out during the study period. Local anaesthesia with moderate to deep sedation was the technique used in all the patients. Respiratory complications occurred in 24% of the patients. Hypertension was observed in 24% of the patients. All the complications were transient and easily treated. During cortical stimulation, motor function was assessed in 16 patients (94%). Three patients (16%) had lesions in the temporal-parietal region and speech was assessed intraoperatively. Postoperative motor weakness was seen in 1 patient despite uneventful intraoperative testing. No patient required intensive care unit stay. The median length of stay in the high dependency unit was 1 day and the median length of hospital stay was 9 days. There was no in-hospital mortality.

CONCLUSIONAwake craniotomy for brain tumour excision can be successfully performed under good anaesthetic conditions with careful titration of sedation. Our series showed it to be a well-tolerated procedure with a low rate of complications. The benefits of maximal tumour excision can be achieved, leading to potentially better patient outcome.

Adult ; Aged ; Anesthesia, Local ; methods ; Anesthetics, Local ; administration & dosage ; Brain Neoplasms ; surgery ; Conscious Sedation ; Craniotomy ; Female ; Humans ; Male ; Medical Audit ; Middle Aged ; Outcome Assessment (Health Care) ; Perioperative Care ; Singapore

A biosynthetic gene cluster for the bioactive fungal sesterterpenoids variecolin ( 1) and variecolactone ( 2) was identified in Aspergillus aculeatus ATCC 16872. Heterologous production of 1 and 2 was achieved in Aspergillus oryzae by expressing the sesterterpene synthase VrcA and the cytochrome P450 VrcB. Intriguingly, the replacement of VrcB with homologous P450s from other fungal terpenoid pathways yielded three new variecolin analogues ( 5- 7). Analysis of the compounds' anticancer activity in vitro and in vivo revealed that although 5 and 1 had comparable activities, 5 was associated with significantly reduced toxic side effects in cancer-bearing mice, indicating its potentially broader therapeutic window. Our study describes the first tests of variecolin and its analogues in animals and demonstrates the utility of synthetic biology for creating molecules with improved biological activities.