1/49. Baker's asthma due to the enzyme xylanase -- a new occupational allergen.The asthmatic baker showed IgE-mediated sensitization to xylanase of Aspergillus niger used as a baking additive. Inhalative challenge with approximately 0.5 microg of the enzyme resulted in an immediate-type asthmatic reaction. This case, as well as a preliminary screening of symptomatic bakers, shows that xylanase is a further relevant type I-sensitizer in the baking industry.- - - - - - - - - - ranking = 1keywords = baker (Clic here for more details about this article) |
2/49. Hyperhomocysteinaemia and upper extremity deep venous thrombosis: a case report.A case is presented of a 24 yr old military aircrew applicant who developed a right axillary subclavian deep venous thrombosis following physical exertion. Investigations revealed damage to the right axillary subclavian venous system and limitation to flow. Coagulation studies also showed an elevated plasma homocysteine level. hyperhomocysteinemia has recently been recognized as a risk factor for venous thromboembolic disease. Damage caused by the thrombosis, the hyperhomocysteinemia and environmental factors encountered in flight, may predispose him to recurrent episodes of thrombosis. This complex case involves aspects of hematology and the nature of coagulation which are only just being elucidated and as yet are poorly understood, and highlights some serious aeromedical implications for pilots afflicted with these conditions.- - - - - - - - - - ranking = 4.8314204700486E-5keywords = cyst (Clic here for more details about this article) |
3/49. Baker's asthma due to xylanase and cellulase without sensitization to alpha-amylase and only weak sensitization to flour.BACKGROUND: The baking additives xylanase and cellulase were described as baking additives causing baker's asthma. It is not known whether monosensitization to these enzymes may occur. methods: We present a case report of a baker with work-related asthma evaluated by skin prick test (SPT), enzyme-linked immunosorbent assay (EAST), immunoblot, EAST and immunoblot inhibition, and specific bronchial challenge. Fungal xylanase and alpha-amylase were measured by two-site enzyme immunoassays in products used by the patient at work. RESULTS: Allergy to xylanase and cellulase was demonstrated by SPT, EAST, immunoblot and specific bronchial challenge (for xylanase only). No sensitization to alpha-amylase could be demonstrated, but there was a weak flour allergy as documented by EAST and immunoblot and a positive occupational-type challenge with high concentrations of rye flour. Four baking additives contained measurable amounts of fungal alpha-amylase and xylanase, without a correlation between these enzymes. CONCLUSIONS: We conclude that occupational asthma due to the baking additives xylanase and cellulase may occur without concomitant sensitization to alpha-amylase and only weak sensitization to flour.- - - - - - - - - - ranking = 1keywords = baker (Clic here for more details about this article) |
4/49. A baker's occupational allergy to flour moth (Ephestia kuehniella).BACKGROUND: Allergy to insects is common. However, few reports cover occupational sensitization to flour moth (Ephestia [syn. Anagasta] kuehniella). We describe a baker who suffered from IgE-mediated occupational respiratory allergy to flour moth. methods: The skin prick test (SPT) and serum IgE tests were used to evaluate the patient's sensitivity to flour moth. Allergen cross-reactivity with mites was evaluated in IgE-inhibition studies. Clinical sensitivity was evaluated by nasal challenge test. Pulmonary function tests were repeatedly monitored. RESULTS: SPT with flour moth gave a 6-mm wheal, and an elevated level of flour moth-specific IgE was measured in the patient's serum (1.9 PRU/ml, RAST class 2). immunoblotting with the patient's serum revealed at least seven heavy IgE-binding bands with molecular masses of 22, 35, 43, 53, 65, 77, and >86 kDa in the extract of flour moth. Allergen cross-reactivity with mites was demonstrated in inhibition studies. Immediate-type allergy to flour moth was confirmed by nasal challenge. Increased daily variability of PEF values was observed during workplace exposure. CONCLUSION: A baker's occupational respiratory allergy to flour moth was confirmed.- - - - - - - - - - ranking = 3keywords = baker (Clic here for more details about this article) |
5/49. Malignant pleural mesothelioma in bakers and pastry cooks.BACKGROUND: The occurrence of malignant pleural mesothelioma (MPM) among bakers and pastry cooks has never been documented. case reports: We detected eight cases of MPM in bakers, pastry cooks, and biscuit cooks engaged in making, baking/cooking, and selling pastry/bread in two hospital-based series (rome and Orbassano/Turin, italy; period 1990-1997; 222 cases). Field-investigations revealed asbestos-containing material (ACM) in ovens for baking bread, that were manufactured prior to the 1980s. CONCLUSIONS: It is suggested that there is a possible new association of the risk of having worked as a baker or pastry cook and MPM. Presumptive source of exposure to asbestos was the use of asbestos-insulated ovens.- - - - - - - - - - ranking = 3.5keywords = baker (Clic here for more details about this article) |
6/49. Chronic paronychia in which hair was a foreign body.A patient who worked as a baker and a part-time barber had chronic paronychia. biopsy revealed the presence of hair in the dermis of the nail fold. This is only the second case of chronic paronychia to be reported in which the dermis contained nonmicrobial exogenous material. Based on experimental work it has been previously suggested that the rounding out of the posterior nail fold in most paronychia is due to the body's reaction to the penetration of debris derived from candida albicans. However, patients recalcitrant to therapy or those exposed to chemicals or particulate material deserve detailed histologic study.- - - - - - - - - - ranking = 0.5keywords = baker (Clic here for more details about this article) |
7/49. Glucoamylase: another fungal enzyme associated with baker's asthma.BACKGROUND: Aspergillus-derived enzymes are widely used as dough additives in the baking industry. These enzymes may give rise to immunoglobulin (Ig)E-mediated sensitization and occupational asthma. Glucoamylase (or amyloglucosidase) is an important industrial enzyme obtained from aspergillus niger and used to provide fermentable sugars for yeast to improve loaf volume and texture. OBJECTIVE: The aim of our study was to investigate the potential allergenic role of glucoamylase in baker's asthma. methods: We report four subjects with work-related allergic respiratory symptoms who were exposed to glucoamylase and other starch-cleaving enzymes used as baking additives. The causative role of glucoamylase in work-related asthma was investigated by immunologic tests and specific inhalation challenges (SIC). Glucoamylase allergenic components were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. RESULTS: skin prick tests to glucoamylase (10 mg/mL) gave a positive response in all patients. Further, a positive skin prick test to alpha-amylase was obtained in the four patients and to hemicellulase in two of them. SIC to glucoamylase elicited isolated early asthmatic responses in the three patients tested, and SIC to alpha-amylase elicited early asthmatic responses in two patients and a dual asthmatic response in another patient. immunoblotting with glucoamylase showed several IgE-binding bands with molecular masses between 33 and 96 kD. IgE-inhibition assays showed scarce to moderate allergenic cross-reactivity between glucoamylase and alpha-amylase. CONCLUSIONS: These bakers had developed IgE-mediated occupational asthma to glucoamylase and alpha-amylase. Fungal glucoamylase is widely used as a baking additive and this enzyme may give rise to allergic respiratory reactions among exposed workers.- - - - - - - - - - ranking = 3keywords = baker (Clic here for more details about this article) |
8/49. Hard metal interstitial lung disease: high-resolution computed tomography appearance.Hard metal interstitial lung disease (HM-ILD) is a rare form of interstitial lung disease caused by aerosolized particulates containing cobalt inhaled during the manufacture or grinding of hard metal. The high-resolution computed tomography (HRCT) appearance of HM-ILD includes reticulation, traction bronchiectasis, and large peripheral cystic spaces in a mid and upper lung distribution. This appearance, along with a consistent occupational exposure, should specifically suggest the diagnosis of HM-ILD.- - - - - - - - - - ranking = 6.9020292429266E-6keywords = cyst (Clic here for more details about this article) |
9/49. Respiratory allergy to Aspergillus-derived enzymes in bakers' asthma.Baking and food industry workers are exposed to several powdered Aspergillus-derived enzymes with carbohydrate-cleaving activity that are commonly used to enhance baked products. We describe a retrospective study of sensitization to fungal alpha-amylase and cellulase on bakers. Five bakers in whom respiratory allergy symptoms developed when they were exposed to bread "improvers" that contained fungal alpha-amylase and cellulase were investigated by in vivo and in vitro tests. Type I hypersensitivity to these enzymes was demonstrated in the five patients by means of skin testing, histamine release test, positive reverse enzyme-immunoassay for specific IgE antibodies, and bronchial provocation test response to alpha-amylase or cellulase or both. Isolated immediate and dual responses to the bronchial challenge tests with these enzymes were observed. Immunoblot analysis with use of a pooled serum identified IgE-binding components in both enzymes. In the reverse-enzyme immunoassay-inhibition assays cross-reactivity between alpha-amylase and cellulase was not found, but some degree of cross-reactivity between alpha-amylase and A. oryzae, and between cellulase and A. niger was demonstrated. Four of the patients were also sensitized to cereal flour. Aspergillus-derived enzymes used as flour additives can elicit IgE-mediated respiratory allergy, and this fact has to be considered in the diagnosis and clinical management of bakers' asthma.- - - - - - - - - - ranking = 3.5keywords = baker (Clic here for more details about this article) |
10/49. Should computed chest tomography be recommended in the medical certification of professional divers? A report of three cases with pulmonary air cysts.Pulmonary barotrauma (PBT) is a recognised risk of compressed gas diving. Any reason that causes air trapping in the lung during ascent may cause PBT by increasing intrapulmonary pressure. Chest x ray examination is mandatory for medical certification of the professional divers in many countries, but pulmonary air trapping lesions such as an air cyst in the lungs cannot always be detected by plain chest x ray examination. Computed tomography (CT) is a reliable, but expensive measure for detecting pulmonary abnormalities in divers. Three cases with pulmonary air cysts are reported in which air cysts were invisible on the x ray pictures, but well defined by CT. It is impractical and not cost effective to perform CT for medical certification of all divers, but it can be an option to recommend CT once during the initial examination of the candidates for professional diving, especially if there is a history of predisposing factors, such as smoking or pulmonary infections.- - - - - - - - - - ranking = 4.8314204700486E-5keywords = cyst (Clic here for more details about this article) |
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