scholarly journals Work-Related Asthma in Automobile Spray Painters: Two Case Reports

2008 ◽  
Vol 59 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Jordan Minov ◽  
Jovanka Karadžinska-Bislimovska ◽  
Kristin Vasilevska ◽  
Snežana Risteska-Kuc ◽  
Sašo Stoleski
Keyword(s):  
Occupational Asthma ◽  
Diagnostic Procedure ◽  
Case Reports ◽  
Bronchial Hyperresponsiveness ◽  
Diurnal Variations ◽  
The Other ◽  
Respiratory Impairment ◽  
Work Related ◽  
Increased Risk ◽  
History Of

Work-Related Asthma in Automobile Spray Painters: Two Case ReportsThis report describes two patients who had developed asthma after working as automobile painters with isocyanate-based aerosol paint for two years or over. In both patients asthma was confirmed using the standard diagnostic procedure. One of the subjects was atopic. One was ex-smoker and the other had never smoked. Neither had a family history of asthma. The symptoms occurred after workplace exposure lasting two years in one patient and three in the other. As both reported work-relatedness of the symptoms, they underwent serial peak expiratory flow rate (PEFR) measurement and bronchoprovocation testing. Significant work-related changes in PEFR diurnal variations and in non-specific bronchial hyperresponsiveness (NSBH) were observed in one patient, suggesting allergic occupational asthma (OA), while the other patient was diagnosed work-exacerbated asthma (WEA). Our data confirm that spray painting is an occupation with increased risk of respiratory impairment and asthma.

scholarly journals Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Sara Díaz Angulo ◽  
Joanna Szram ◽  
Jenny Welch ◽  
Julie Cannon ◽  
Paul Cullinan
Keyword(s):  
Systematic Review ◽  
Occupational Asthma ◽  
Case Reports ◽  
Bronchial Hyperresponsiveness ◽  
Specific Ige ◽  
Review Of The Literature ◽  
Cross Sectional ◽  
Immunological Tests ◽  
Asthmatic Reaction ◽  
Provocation Testing

Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5–8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required.

scholarly journals 120 Laryngeal Dystonia and Buccolingual Crisis: Dystonic Reactions in 2 Patients Receiving Prochlorperazine During Suboxone Therapy

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 278-278
Author(s):  
Charles Haverty ◽  
Julie Niedermier ◽  
Hossam Guirgis
Keyword(s):  
Opioid Withdrawal ◽  
Nausea And Vomiting ◽  
Designer Drugs ◽  
European Medicines Agency ◽  
List Type ◽  
Respiratory Impairment ◽  
Acute Dystonia ◽  
Laryngeal Dystonia ◽  
Increased Risk ◽  
History Of

Abstract:We report two cases of acute dystonia in patients after receiving prochlorperazine to address nausea in the context of buprenorphine/naloxone (Suboxone) therapy. Both were admitted for opioid withdrawal and developed nausea and vomiting refractory to ondansetron on the first hospital day.Within six hours of receiving an intramuscular injection of ten milligrams of prochlorperazine, a 24-year-old Caucasian male developed buccolingual crisis (trismus and dysphagia). His symptoms resolved with repeated intramuscular doses of diphenhydramine, benztropine, and lorazepam.A 31-year-old Caucasian female developed laryngeal dystonia (stridor) and buccolingual crisis (dysphagia, grimacing, and tongue protrusion) within thirty minutes of receiving ten milligrams of prochlorperazine intramuscularly. Given respiratory impairment, emergency airway protection was initiated, and the patient responded to repeated intramuscular doses of benztropine and lorazepam.Although one patient was male and both were relatively young, they did not have other known risk factors for drug induced acute dystonic reactions including history of dystonic reactions, recent cocaine use, or low BMI. Neither patient had a history of exposure to antipsychotic medications and both had medical histories that were otherwise noncontributory. While both patients were at risk for or developing dehydration from nausea and vomiting, their electrolytes were within normal limits on admission, less than twelve hours earlier. We postulate potential etiologies that may possibly explain these events:1)The patients’ reactions are consistent with the expected number in the general population to have acute dystonia secondary to prochlorperazine use. A small study in 2000 showed that 3.9% of patients receiving prochlorperazine for nausea in an emergency room setting experienced acute dystonia.2)Could patients receiving intramuscular prochlorperazine during Suboxone therapy have increased risk for severe acute dystonic reactions? According to the European Medicines Agency, hypertonicity is a “common” side effect of Suboxone, occurring in 1% to 10% of patients.3)Could there be potential interactions between Suboxone and prochlorperazine or between prochlorperazine and substances detected (or undetectable, such as designer drugs) via routine toxicology screening?4)Could the acute dystonia be unrelated to medication interaction, but instead result from use of prochlorperazine in patients having rapid electrolyte shifts and exhibiting dehydration during acute opioid withdrawal?Given the known risk of opioids, with or without prochlorperazine, to cause respiratory depression and these case reports of acute dystonia with the potential to cause airway impairment due to prochlorperazine administration, we encourage prescribers to exercise caution when utilizing prochlorperazine for the management of nausea and vomiting in patients receiving Suboxone for acute opioid withdrawal.

scholarly journals Historical Review: Paroxysmal Nocturnal Hemoglobinuria

Blood ◽  
1951 ◽  
Vol 6 (3) ◽  
pp. 270-284 ◽  
Author(s):  
WILLIAM H. CROSBY
Keyword(s):  
19Th Century ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Case Reports ◽  
Historical Review ◽  
Great Accuracy ◽  
The Other ◽  
Disease Entity ◽  
History Of ◽  
The 19Th Century ◽  
Outstanding Work

Abstract 1. The history of paroxysmal nocturnal hemoglobinuria is reviewed, and attention is called to four case reports published in the 19th century. A bibliography of the disease is appended. 2. The outstanding work of Paul Strübing is reviewed. Strübing identified paroxysmal nocturnal hemoglobinuria as a disease entity in 1882 but failed to give it a distinctive name. He described the disease with great accuracy, calling particular attention to the part played by sleep in precipitating the paroxysms. He cited earlier reports of nocturnal hemoglobinuria and by provocative tests differentiated the disease from the other paroxysmal hemoglobinurias. On the basis of his observations he proposed theories regarding the pathogenesis of the disease which have now been shown to be remarkably accurate.

scholarly journals Methodological evaluation of human research on asthmagenicity and occupational cleaning: a case study of quaternary ammonium compounds (“quats”)

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Judy S. LaKind ◽  
Michael Goodman
Keyword(s):  
Quaternary Ammonium ◽  
Occupational Asthma ◽  
Case Reports ◽  
Challenge Test ◽  
Quaternary Ammonium Compounds ◽  
Work Related ◽  
Lack Of Information ◽  
Potential Link ◽  
State Of The Science ◽  
Ammonium Compounds

AbstractIn this paper, we review methodological approaches used in studies that evaluated the association between occupational exposure to quaternary ammonium compounds (quats) and occupational asthma. This association is of interest because quats are a common active ingredient of disinfectants and have been linked to work-related asthma in some circumstances. However, any evidence-based assessment of an exposure-outcome association needs to consider both strengths and limitations of the literature. We focus on publications cited by various US and international organizations. Eighteen investigations included in the review fall into two broad categories: case reports and challenge studies of individual patients and population studies that examined the association between quats and asthma occurrence in groups of subjects. We evaluated these studies guided by questions that address whether: exposure data on specific quat(s) and other agents that may cause asthma were included, new asthma cases were differentiated from asthma exacerbation, and information on respiratory sensitivity versus irritation was given. We also assessed consistency across studies. Studies of individual patients, particularly those that provided detailed information on challenge test results, document cases of asthma induced by exposure to quats. By contrast, studies of occupational groups with the highest potential for quats exposure (e.g., cleaners and farmers) do not consistently report increased incidence of asthma due specifically to quats. The unresolved methodological issues include: poor understanding of exposure pathways considering that quats are non-volatile, lack of quantitative data allowing for identification of an asthmagenicity threshold, insufficient information on whether quats are sensitizers or act via dose-dependent irritation or some other mechanism, and inability to quantify risk of new-onset asthma attributable to quats. Another important area of uncertainty is the lack of information on the specific quats being used. There is also a lack of data capable of distinguishing the effects of quats from those of other chemical and biological workplace exposures. The current state-of-the-science does not allow a proper assessment of the potential link between quats and occupational asthma.

scholarly journals Clozapine and speech dysfluency: two case reports

2007 ◽  
Vol 31 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Marc Lyall ◽  
Angela Pryor ◽  
Kevin Murray
Keyword(s):  
Sodium Valproate ◽  
Case Reports ◽  
Management Strategies ◽  
Voice Quality ◽  
Personal History ◽  
Seizure Threshold ◽  
Clinical Implications ◽  
Threshold Potential ◽  
Increased Risk ◽  
History Of

Aims and MethodWe describe two patients, both diagnosed with psychotic illnesses, who developed stuttering while being treated with clozapine.ResultsIn both patients the stuttering was severe and significantly impaired progress towards recovery. Deviant speech dimensions and voice quality were consistent with dysarthria and dystonia.Clinical ImplicationsPatients who develop abnormal electroencephalogram activity and those who have a family or personal history of stuttering might be at increased risk of developing speech problems with clozapine. Speech dysfluency might be a consequence of clozapine's action in lowering the seizure threshold. Potential management strategies include the use of sodium valproate and changing the type of antipsychotic.

Constitutional WT1 mutations in Wilms' tumor patients.

1998 ◽  
Vol 16 (11) ◽  
pp. 3634-3640 ◽  
Author(s):  
L Diller ◽  
M Ghahremani ◽  
J Morgan ◽  
P Grundy ◽  
C Reeves ◽  
...  
Keyword(s):  
Wilms Tumor ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Peripheral Blood Lymphocytes ◽  
Wt1 Gene ◽  
Increased Risk ◽  
History Of ◽  
Genitourinary Anomalies ◽  
Wt1 Mutation

PURPOSE Patients with Wilms' tumors (WT) who carry constitutional mutations in the WT1 gene have been described in case reports and small case series. We sought to determine the frequency of constitutional WT1 mutations in a larger cohort, and to identify clinical manifestations associated with the risk for carrying a WT1 mutation. METHODS We collected clinical data and blood samples from 201 patients with a history of WT. Southern blot analysis, single-strand conformation polymorphism (SSCP) analysis, and direct DNA sequencing were performed on DNA isolated from peripheral-blood lymphocytes from each patient. Odds ratios (ORs) for the carriage of a germline mutation of the WT1 gene were calculated for patients who had specific clinical risk factors compared with those who did not. RESULTS Of 201 patients with WT in the cohort, eight patients were carriers of mutations in the WT1 gene. Six of the eight mutations were protein-truncating nonsense mutations. None of 56 patients with isolated unilateral WT was a carrier. The OR of carrying a WT1 mutation was elevated for patients with genitourinary anomalies (OR19.3; P < .002). Seven of 28 boys with WT with cryptorchidism carried WT1 mutations. No increased risk was observed for patients with nephrogenic rests, bilateral tumors, history of secondary cancers, or family history of WT. CONCLUSION Germline WT1 mutations in patients with WT are associated with genitourinary anomalies, especially cryptorchidism and/or hypospadias. Patients with WT and no genitourinary anomalies are at low risk for carrying a WT1 mutation. Constitutional WT1 mutations that encode truncated WT1 proteins may predispose to the development of cryptorchidism, hypospadias, and WTs.

scholarly journals Nasal response in patients with diisocyanate asthma

2014 ◽  
Vol 52 (4) ◽  
pp. 431-436
Author(s):  
Joaquin Sastre ◽  
Anna Poltronieri ◽  
Ignacio Mahillo-Fernandez ◽  
Erika Aguado ◽  
Manuela Garcia del Potro ◽  
...  
Keyword(s):  
Occupational Asthma ◽  
Clinical History ◽  
Analog Scale ◽  
Cross Sectional ◽  
Oral Breathing ◽  
Work Related ◽  
Nasal Symptoms ◽  
History Of ◽  
Response Testing ◽  
Peak Nasal Inspiratory Flow

Background: To date, no studies have assessed nasal and bronchial response to diisocyanates during specific inhalation challenges (SIC). Objectives: This study was performed to assess nasal response during SIC with diisocyanates (nasal and oral breathing) in patients with suspected occupational asthma due to these agents. Methods: Fourteen patients with suspected clinical history of diisocyanate-induced asthma were challenged with diisocynates in a 7m3 chamber. Nasal response testing during challenges was assessed by acoustic rhinometry, peak nasal inspiratory flow (PNIF), and visual analog scale (VAS), alongside bronchial responses. Results: Eleven patients had a significant asthmatic response to diisocyanates. None reported clear work-related nasal symptoms. In patients with positive bronchial response to diisocyanates, nasal mean minimal cross-sectional area (MCA) decreased by 26.9%, nasal volume at 5 cm decreased by 33.5%, and PNIF decreased by 28.3%, all from baseline. A positive nasal response was elicited in 45%, 54%, and 45% of patients, respectively. A significant increase in VAS was observed in 4 patients. Three patients with negative bronchial response had a negative nasal response. Conclusion: SIC revealed an objective nasal response in around 50% of patients with occupational asthma due to diisocyanates, in spite of the fact that none of them reported work-related nasal symptoms. The clinical significance of this finding is a poor association between nasal symptoms at work and an objective nasal response during positive SIC with diisocyanates.

scholarly journals Bronchial Hyperresponsiveness in Farmers: Severity and Work-Relatedness

2014 ◽  
Vol 2 (3) ◽  
pp. 536-543 ◽  
Author(s):  
Saso Stoleski ◽  
Jordan Minov ◽  
Jovanka Karadzinska-Bislimovska ◽  
Dragan Mijakoski
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Smoking Status ◽  
Bronchial Hyperresponsiveness ◽  
Smoking History ◽  
Full Time ◽  
Respiratory Impairment ◽  
Occupational Risk Factors ◽  
Work Related ◽  
Significant Difference

OBJECTIVE: To evaluate the prevalence of respiratory symptoms, lung function and bronchial hyperresponsiveness in farmers, with emphasize to their severity and work-relatedness due occupational risk factors and farming characteristics.METHODS: A cross-sectional survey was performed including 60 cow breeders aged 21 to 65 years, compared to an equal number of agricultural farmers matched by age, job exposure duration, and smoking status. We have used a questionnaire to record the chronic respiratory symptoms, detailed work history, specific farming activities and tasks performed, and smoking history. Evaluation of examined subjects also included lung function spirometry tests, and bronchial hyperresponsiveness testing.RESULTS: We found higher prevalence of work related respiratory symptoms in the last 12 months in cow breeders with significant difference for phlegm (P = 0.039), and wheezing (P = 0.026). Mean values of all spirometric parameters were lower in cow breeders, reaching significance for MEF50 (P = 0.001) and MEF75 (P = 0.000). Significant difference was found for mild bronchial hyperresponsiveness among cow breeders with job exposure of more than 15 years. The risk of developing work-related respiratory symptoms increased significantly with full-time farming, exposure to gases and vapors, and keeping more than 10 cows.CONCLUSION: Our data suggest that workplace exposure in farmers may cause respiratory impairment which is closely related to its duration, characteristics, and intensity. The results suggest that cow breeders in general have higher rates of work-related respiratory symptoms and bronchial hyperresponsiveness than agricultural farmers, whereas their severity increases with an increase in frequency and duration of animal contact.

scholarly journals Impaired Antioxidant Defence Status Is Associated With Metabolic-Inflammatory Risk Factors in Preterm Children With Extrauterine Growth Restriction: The BIORICA Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
María Dolores Ordóñez-Díaz ◽  
Mercedes Gil-Campos ◽  
Katherine Flores-Rojas ◽  
María Carmen Muñoz-Villanueva ◽  
María Dolores Mesa ◽  
...  
Keyword(s):  
Antioxidant Status ◽  
Growth Restriction ◽  
The Other ◽  
Antioxidant Defence ◽  
Preterm Children ◽  
Increased Risk ◽  
Antioxidant Defence System ◽  
History Of ◽  
Extrauterine Growth Restriction ◽  
Β Carotene

Introduction: An impaired antioxidant status has been described during foetal growth restriction (FGR). Similarly, the antioxidant defence system can be compromised in preterm children with extrauterine growth restriction (EUGR). The aim of this prospective study was to evaluate the antioxidant status in prepubertal children with a history of prematurity without FGR, with and without EUGR, compared to a healthy group.Methods: In total, 211 children were recruited and classified into three groups: 38 with a history of prematurity and EUGR; 50 with a history of prematurity and adequate extrauterine growth (AEUG); and 123 control children born at term. Catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) activities were assessed in lysed erythrocytes with spectrophotometric methods. Plasma levels of the antioxidants α-tocopherol, retinol and β-carotene were determined through solvent extraction and ultra-high-pressure liquid chromatography coupled to mass spectrometry.Results: Children with the antecedent of EUGR and prematurity had lower CAT activity than the other two groups and lower GPx activity than the control children. Lower SOD, GPx and GR activities were observed in the AEUG group compared to the controls. However, higher concentrations of α-tocopherol and β-carotene were found in the EUGR group compared to the other groups; retinol levels were also higher in EUGR than in AEUG children. In EUGR and AEUG children, enzymatic antioxidant activities and plasma antioxidants were associated with metabolic syndrome components and pro-inflammatory biomarkers.Conclusions: This study reveals, for the first time, that the EUGR condition and prematurity appear to be linked to an impairment of the antioxidant defence status, which might condition an increased risk of adverse metabolic outcomes later in life.

Ladies with Leber's Hereditary Optic Neuropathy: An Atypical Disease

2002 ◽  
Vol 12 (6) ◽  
pp. 537-541 ◽  
Author(s):  
S.S. Dandekar ◽  
E.M. Graham ◽  
G.T. Plant
Keyword(s):  
Optic Neuropathy ◽  
Visual Loss ◽  
Dna Analysis ◽  
Past History ◽  
Case Reports ◽  
Leber’S Hereditary Optic Neuropathy ◽  
Leber's Hereditary Optic Neuropathy ◽  
Increased Risk ◽  
History Of ◽  
Hereditary Optic Neuropathy

Purpose Leber's Hereditary Optic Neuropathy (LHON) is considered to be a disease predominantly affecting young males. The risk of women becoming symptomatic if they are carriers of a primary mutation is 1/5 of that in males. The disease however appears to behave differently in women in some instances. We describe three cases of ladies with LHON and discuss the importance of making the diagnosis. Case Reports A 28-year-old female presented with blurring of vision in her left eye with bilateral small hyperemic discs and telangiectatic vessels adjacent to them. DNA analysis confirmed the 11778 mutation and the second eye remains unaffected 10 years later. The second case was 49 years old and presented with bilateral visual loss developing over 3 months. She had no family history of visual loss but had a past history of Wolf Parkinson White syndrome and 3460 mutation was confirmed. The last case was diagnosed with multiple sclerosis at age 24 and went on to develop visual loss with poor recovery. DNA analysis demonstrated the 11778 mutation and confirmed LHON. Conclusions All three cases, although not unique, posed considerable diagnostic difficulties over a long period of time. The authors have highlighted important associations of the disease and stress the importance of making the diagnosis in women. They are at increased risk of having affected children, unlike the affected males, especially if they are affected themselves and may wish to seek further genetic advice.

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