1/19. Rhinoconjunctivitis and asthma provoked by Asticot maggots.Asticot maggots are used as bait by anglers fishing the rivers, reservoirs and coastal waters of spain. We report the case of a male patient, a keen angler, who used this bait on weekends and suffered allergic reactions that affected his conjunctiva and respiratory system for years. Other baits (earthworms, Eisemia foetida) did not elicit this reaction. In order to confirm the allergic reaction, we used maggots in vivo in the Prick Test, obtaining a positive reaction in 15 to 30 minutes. The patient also had an allergic reaction to house dust mites in prick test. To a lesser extent, he also was sensitive to certain grass pollens (Lollium perenne) and seafood (prawns and squid).- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
2/19. An outbreak of respiratory diseases among workers at a water-damaged building--a case report.We describe a military hospital building with severe, repeated and enduring water and mold damage, and the symptoms and diseases found among 14 persons who were employed at the building. The exposure of the employees was evaluated by measuring the serum immunoglobulin g (IgG)-antibodies against eight spieces of mold and yeast common in Finnish water and mold damaged buildings and by sampling airborne viable microbes within the hospital. The most abundant spieces was Sporobolomyces salmonicolor. All but one of the employees reported some building-related symptoms, the most common being a cough which was reported by nine subjects. Four new cases of asthma, confirmed by S. salmonicolor inhalation provocation tests, one of whom was also found to have alveolitis, were found among the hospital personnel. In addition, seven other workers with newly diagnosed rhinitis reacted positively in nasal S. salmonicolor provocation tests. Skin prick tests by Sporobolomyces were negative among all 14 workers. Exposure of the workers to mold and yeast in the indoor air caused an outbreak of occupational diseases, including asthma, rhinitis and alveolitis. The diseases were not immunoglobulin e (IgE)-mediated but might have been borne by some other, as yet unexplained, mechanism.- - - - - - - - - - ranking = 6keywords = water (Clic here for more details about this article) |
3/19. Laryngeal hirudiniasis: an unusual cause of airway obstruction and hemoptysis.Cases of childhood hemoptysis are rare and usually result from foreign body aspiration or congenital heart or lung diseases. However, human hirudiniasis due to the leech still exists, and could involve the upper airways after drinking infested water from quiet streams and pools. We report the case of a 6-year-old child who presented suffocating at the emergency room after having been misdiagnosed and treated for asthma over a 1-month period. His mother reported he had had recurrent hemoptysis, as well. The child inadvertently drank leech-infested water in a rural area of northern syria. Surgical removal of the leech resulted in prompt resolution of the symptoms. Although laryngeal hirudiniasis is rare in the developed world, it remains a possible cause of childhood airway obstruction, hemoptysis, and anemia which needs to be considered in patients with a suggestive history.- - - - - - - - - - ranking = 2keywords = water (Clic here for more details about this article) |
4/19. Occupational asthma caused by chloramines in indoor swimming-pool air.The first series of three workers who developed occupational asthma following exposure to airborne chloramines in indoor chlorinated swimming pools is reported. health problems of swimmers in indoor pools have traditionally been attributed to the chlorine in the water. chlorine reacts with bodily proteins to form chloramines; the most volatile and prevalent in the air above swimming pools is nitrogen trichloride. Two lifeguards and one swimming teacher with symptoms suggestive of occupational asthma kept 2-hourly measurements of peak expiratory flow at home and at work, analysed using the occupational asthma system (OASYS) plotter, and/or had specific bronchial challenge testing to nitrogen trichloride, or a workplace challenge. Air measurement in one of the pools showed the nitrogen trichloride levels to be 0.1-0.57 mg x m(-3), which was similar to other studies. Two workers had peak expiratory flow measurements showing occupational asthma (OASYS-2 scores 2.88 and 3.8), both had a positive specific challenge to nitrogen trichloride at 0.5 mg x m(-3) with negative challenges to chlorine released from sodium hypochlorite. The third worker had a positive workplace challenge. Swimming-pool asthma due to airborne nitrogen trichloride can occur in workers who do not enter the water because of this chloramine. The air above indoor swimming pools therefore needs to be assessed and managed as carefully as the water.- - - - - - - - - - ranking = 3keywords = water (Clic here for more details about this article) |
5/19. eucalyptus as a specific irritant causing vocal cord dysfunction.BACKGROUND: vocal cord dysfunction (VCD) is a well-recognized clinical entity that frequently mimics asthma and is characterized by inappropriate adduction of the vocal cords during inspiration. The pathogenesis of VCD has not yet been defined. The only previous report suggested that respiratory irritants may trigger paradoxical motion of the vocal cords. OBJECTIVE: To report the case of a 46-year-old woman with VCD precipitated by eucalyptus exposure. methods: A masked flexible fiberoptic nasolaryngoscopy was performed to confirm whether VCD occurred with eucalyptus and not with other known respiratory irritants. The patient underwent inhalation challenges consisting of water, ammonia, pine oil, and a combination of eucalyptus (dried leaves) and ammonia. Two independent observers before patient challenge could not identify eucalyptus. RESULTS: Vocal cord dysfunction occurred within minutes of exposure to eucalyptus. This is the first report to prospectively document that a specific irritant, eucalyptus, can precipitate VCD. Negative skin prick test results, total IgE level, and negative IgE eucalyptus-specific antibodies support a nonimmunologic mechanism. CONCLUSIONS: A new pathogenic mechanism for this clinical entity is supported by our observations. Furthermore, a nonimmunologic mechanism in which respiratory irritants may induce VCD is suspected. Future studies to elucidate this mechanism need to be performed in individuals with irritant-specific VCD.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
6/19. A case of bowen's disease and small-cell lung carcinoma: long-term consequences of chronic arsenic exposure in Chinese traditional medicine.Chronic arsenic toxicity occurs primarily through inadvertent ingestion of contaminated water and food or occupational exposure, but it can also occur through medicinal ingestion. This case features a 53-year-old lifetime nonsmoker with chronic asthma treated for 10 years in childhood with Chinese traditional medicine containing arsenic. The patient was diagnosed with bowen's disease and developed extensive-stage small-cell carcinoma of the lung 10 years and 47 years, respectively, after the onset of arsenic exposure. Although it has a long history as a medicinal agent, arsenic is a carcinogen associated with many malignancies including those of skin and lung. It is more commonly associated with non-small-cell lung cancer, but the temporal association with bowen's disease in the absence of other chemical or occupational exposure strongly points to a causal role for arsenic in this case of small-cell lung cancer. Individuals with documented arsenic-induced bowen's disease should be considered for more aggressive screening for long-term complications, especially the development of subsequent malignancies.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
7/19. Lupine inhalation induced asthma in a child.The ingestion of lupine seed flour has been reported as a cause of allergic reactions. There is some evidence of its allergenic potential after inhalation. An 8-year-old asthmatic child, who was allergic to peanut, was studied in our clinic with the suspicion of an adverse drug reaction due to salbutamol. He suffered an asthma attack while playing with his brother, who had been eating lupine seed as snack; surprisingly, the asthma attack worsened with salbutamol. The skin tests showed a positive result with lupinus albus extract, peanut, garbanzo bean, navy bean, pea, green bean, lentil, soy, olea europea pollen, grass pollen and plantago lanceolata pollen. The prick-by-prick tests both from dried seeds and those preserved in salt and water were strongly positive. serum specific IgE antibodies were positive to Lupine albus (1.43 kU/l), peanut (4.32 kU/l), soy (2.15 kU/l), lentil (3.12 kU/l) and garbanzo (0.7 kU/l). After informed consent salbutamol was well tolerated but the patient had asthma in 5 min of manipulation of the lupine seeds. In our case, reactivity with other legumes was also demonstrated, but only peanut allergy was relevant because boiled legumes were tolerated. It is also notorious that anamnesis is so important to assess the true etiological agents of asthma.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
8/19. Oncogenic osteomalacia cured by removal of an organized hematoma.OBJECTIVE: To describe a patient with oncogenic osteomalacia whose symptoms were rapidly resolved after surgical removal of an organized hematoma of the hip. methods: A case report is presented, including clinical and laboratory findings. The relevant literature is reviewed, and the current understanding of oncogenic osteomalacia is summarized. RESULTS: In September 1996, a 44-year-old black woman presented with a 2-year history of bone pain, progressive muscle weakness, depression, osteomalacia, and hypophosphatemia. Her condition did not improve with use of calcitriol and phosphate replacement. During the previous year, her serum phosphorus levels were low, ranging from 1.0 to 2.2 mg/dL, and the levels of serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] were very low, ranging from <5 to 19.4 pg/mL (normal, 15 to 60). The serum 25-hydroxyvitamin D levels were low, ranging from 8 to 14 ng/mL (normal, 9 to 52). The higher values were noted after she had received large doses of phosphate, 1,25-(OH)2D, and vitamin d. During the previous year, her serum alkaline phosphatase levels were high, ranging from 253 to 314 U/L; serum calcium and parathyroid hormone levels were normal. The abnormalities on physical examination were obesity and a 10- by 10-cm firm, poorly demarcated mass superior to the left greater trochanter. A computed tomographic scan of this region showed a water-density fluid collection in the left buttock measuring 7.8 by 7.8 cm, consistent with a chronic hematoma. The mass was resected, and histopathologic examination revealed features of an organized hematoma with areas of myxoid changes and cartilaginous metaplasia. Postoperatively, the patient's strength improved, and the levels of serum phosphorus and 1,25-(OH)2D became supranormal. CONCLUSION: The symptoms and laboratory abnormalities of this patient with oncogenic osteomalacia promptly resolved after resection of an organized hematoma of the left hip.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
9/19. Urinary arginine vasopressin in asthma: consideration of fluid therapy.To elucidate the role of antidiuretic hormone (ADH) on water and electrolyte balance in patients with asthmatic attacks, urinary arginine vasopressin (AVP) was assayed in 28 asthmatic patients. In a 3-year-old girl with status asthmaticus who developed a grand mal seizure in association with hyponatremia, urinary AVP levels remained high and fluctuated before convulsion; the cause of the convulsion was considered to be water intoxication due to inappropriate ADH secretion. In 19 of 28 patients with moderately severe asthmatic attacks, increases in urinary AVP levels occurred before treatment (300 /- 80 pg/ml vs. 40 /- 24 pg/ml (normal controls), p less than 0.01); elevated AVP levels tended to fall in response to intravenous fluid therapy (appropriate ADH secretion) in 2 of 6 patients, but did not fall (inappropriate ADH secretion) in the remaining patients. It is concluded that inappropriate ADH secretion may occur in asthmatic attacks, and that in such a condition there seems to be a potential risk of water intoxication during fluid therapy, as demonstrated in the present patient.- - - - - - - - - - ranking = 3keywords = water (Clic here for more details about this article) |
10/19. Effect of terfenadine and ipratropium bromide on ultrasonically nebulized distilled water-induced asthma.inhalation of ultrasonically nebulized distilled water was used to evaluate non-specific bronchial reactivity and to investigate nonimmunologically mediated asthma. Release of histamine and other mediators from mast cells and stimulation of lung irritant receptors are mechanisms that may be involved in nebulized distilled water-induced bronchoconstriction. To investigate the contribution of these mechanisms the effect of terfenadine and ipratropium bromide on the bronchial response to this stimulus was assessed. A total of 30 asthmatics (mean 28.7 years) were submitted on three different days to distilled water challenge with or without prior treatment with oral terfenadine or inhaled aerosolized ipratropium bromide. The decrease in forced expiratory volume in 1 s induced by the same dose of distilled water was significantly (P less than 0.001) reduced from 35.6 /- 15.8% to 19.5 /- 16% with terfenadine and to 23.9 /- 19.7% with ipratropium bromide. The results suggest that histamine release and reflex bronchoconstriction are mechanisms involved in asthma induced by ultrasonically nebulized distilled water.- - - - - - - - - - ranking = 9keywords = water (Clic here for more details about this article) |
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