O-095 MECHANISMS OF CARCINOGENICITY OF OCCUPATIONAL EXPOSURES: INTEGRATION OF THE MECHANISTIC EVIDENCE IN THE IARC MONOGRAPHS OVERALL EVALUATION IN THE LAST 10 YEARS
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Abstract Introduction Over the years, mechanistic data has become critical to the understanding of human cancer hazards. Their increasing prominence was reflected in the 2019 revision of the IARC Monographs Preamble, which has placed mechanistic evidence, through the application of the key characteristics (KCs) of human carcinogens, alongside evidence for cancer in humans and experimental animals in the integration of evidence. Here, the evolution on the use of this information is described in the evaluation of occupational exposures. Methods Occupational exposures such as, styrene/styrene oxide, night shift work, 1,1,1-Trichloroethane, and recently occupational exposure as a firefighter and 2-bromopropane were examined based on the available studies, strength of the various KCs, and relevance of the associated endpoints across test systems. Results The evidence, as described by the 10 KCs, was supportive or strong and contributed substantially to the description of the mechanisms and the overall evaluation when the evidence from epidemiological studies was sufficient (for firefighting exposure), mainly limited or inadequate (for styrene oxide and 2-bromopropane), and it was sufficient for cancers in animal studies. Discussion Several KCs such as it is genotoxic, induces chronic inflammation and modulates receptor mediated effects or is immunosuppressive, for which the evaluation of mechanistic studies was consistent and coherent contributed to the overall evaluation of the occupational agents as IARC group 1 or Group 2A. Conclusion Mechanistic information is critical to the identification of carcinogenic hazard the KCs are a powerful tool that allow understanding further the mechanisms contributing to the carcinogenicity.Cite
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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ABSTRACT Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre- mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app- lication of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial defor- mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest- hesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies. Key Words: Caudal anaesthesia, children, congenital anomaly OZET Havayolu yonetimi, ciddi konjenital anomalileri olan cocuklarda ozellikle zordur. Bu tur hastalar anestezik ilaclarin solunum depresan etkilerine karsi asiri derecede duyarlidir. Kaudal anestezinin inguinal herni onarimindaki basarili ve guvenli uygulamasi konjenital anomalileri (Joubert sendromu, I-cell hastaligi) olan uc olguda gosterilmistir. Ilgili uc cocuk hastada, ciddi yuz deformitesi, solunum yetmezligi ve kardiyovaskuler bozukluk dahil konjenital bozuk- luklar vardi. Genel anesteziyle iliskili komplikasyonlari onlemek icin inguinal herni cerrahisinde tek doz kaudal epi- dural anestezi uygulandi. Kaudal anestezide %0.25 levobupivakain 1 mL/kg kullanildi. Kaudal epidural anestezinin, ciddi konjenital bozukluklari olan cocuklarda inguinal herni onarimi acisindan genel anesteziye veya endotrakeal entubasyona gerek duyulmadan etkili, uygun ve guvenli bir alternatif anestezi teknigi olabilecegi sonucuna varildi. A na h ta r Sozcukler: Kaudal anestezi, cocuk, konjenital bozukluk
Levobupivacaine
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The nationally-recognized Susquehanna
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