11/887. Outbreak of Hendra-like virus--malaysia and singapore, 1998-1999.During September 29, 1998-April 4, 1999, 229 cases of febrile encephalitis (111 [48%] fatal) were reported to the Malaysian Ministry of health (MOH). During March 13-19, 1999, nine cases of similar encephalitic illnesses (one fatal) and two cases of respiratory illness occurred among abattoir workers in singapore. Tissue culture isolation identified a previously unknown infectious agent from ill patients. This report summarizes the preliminary epidemiologic and laboratory investigations of these cases, which indicate that a previously unrecognized paramyxovirus related to, but distinct from, the Australian hendra virus is associated with this outbreak.- - - - - - - - - - ranking = 1keywords = worker (Clic here for more details about this article) |
12/887. Occupational IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria caused by Easter lily (lilium longiflorum) and tulip.BACKGROUND: We report on IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria to two liliaceae plants, tulip and Easter lily (lilium longiflorum), diagnosed in a floral shop worker. methods: Occupational asthma was diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test. Flower-specific IgE was studied, and RAST inhibition tests were performed. RESULTS: skin prick testing showed positive reactions to tulip, Easter lily, and chrysanthemum. Total IgE was 180 kU/I, and specific IgE to tulip was 2.6 and to Easter lily 6.5 kU/I. In the RAST-inhibition test, no cross-reactivity was found. Occupational asthma was diagnosed by peak flow monitoring at work and at home, as well as specific inhalation challenge with Easter lily, with an immediate 18% reduction in PEF. In addition, contact urticaria and conjunctivitis were diagnosed. After a 9-year follow-up without exposure to lilies, the skin prick tests to L. longiflorum and tulip were still positive, but the specific IgE had disappeared. CONCLUSIONS: A case of IgE-mediated occupational asthma, rhinoconjunctivitis, and contact urticaria caused by L. longiflorum and tulip is presented. RAST inhibition tests indicated concomitant sensitization to the two liliaceae plants.- - - - - - - - - - ranking = 0.000213539769keywords = worker (Clic here for more details about this article) |
13/887. Nylon flock-associated interstitial lung disease.A work-related interstitial lung disease has been diagnosed in workers at five nylon flock facilities in three different states and a Canadian province. The National Institute for Occupational safety and health hosted a workshop at which consulting pulmonary pathologists reviewed lung tissue samples from all the cases for which lung biopsy material was available (15 of 20 cases known in January 1998). After independent review and scoring of these lung tissue specimens, the pathologists reached consensus that the histopathological findings revealed a characteristic lesion-a lymphocytic bronchiolitis and peribronchiolitis with lymphoid hyperplasia represented by lymphoid aggregates. The pathologists noted that the pathological findings were distinctive when compared with known lung conditions. The clinical presentation for the cases generally included cough, dyspnea, restrictive ventilatory defect with reduction in diffusing capacity, and interstitial markings on chest radiographs or high-resolution computed tomography (HRCT) scans. Six of the cases improved after removal from workplace exposure without medical treatment. Six others, who had recovered with medical treatment and removal from the workplace, had relapses in both symptoms and objective findings after attempting to return to nylon flock work. With this and other evidence supporting the existence of chronic interstitial pneumonitis associated with nylon flock processing, workshop participants recommended surveillance for early identification of affected workers and their removal from further workplace exposure.- - - - - - - - - - ranking = 0.000451081943keywords = worker, disease (Clic here for more details about this article) |
14/887. Occupational protein contact dermatitis to cornstarch in a paper adhesive.BACKGROUND: Protein contact dermatitis is better known in food-service and health-care workers than in industrial workers. Cornstarch has seldom been a problem, although it can cause contact urticaria to glove powder. OBJECTIVE: To present the case of a paper-bag maker who developed severe occupational (protein) contact dermatitis within two-three hours after returning to work. She lacked any evidence of urticaria and demonstrated largely negative patch-test results. methods: Following a history of occupational exposure to a cornstarch-based adhesive, the patient was patch-tested to materials with which she had worked, which she contacted, and with which she had attempted treatment. Following patch testing, she was prick-tested to cornstarch, the principal ingredient in the adhesive. RESULTS: Patch testing was negative except for a very mild reaction to the adhesive. Prick testing to cornstarch was more severe than the histamine control. The test site became eczematous and remained so for more than ten weeks. Avoidance of cornstarch and the adhesive was followed by clearing. CONCLUSION: Workup for prominent occupational contact dermatitis without urticaria may sometimes require testing for type 1 allergy.- - - - - - - - - - ranking = 0.000427079538keywords = worker (Clic here for more details about this article) |
15/887. hypersensitivity pneumonitis among workers cultivating tricholoma conglobatum (shimeji).We report five cases of hypersensitivity pneumonitis among workers cultivating tricholoma conglobatum (shimeji). After having worked for 5 to 20 years, they began to notice symptoms of cough, sputum, and dyspnea. They were diagnosed as having a hypersensitivity pneumonitis based on clinical features, bronchoalveolar lavage and transbronchial lung biopsy. By the double immunodiffusion test, precipitating lines between shimeji spore antigen and sera were observed in all of the patients. By enzyme-linked immunosorbent assay, the antibody activities against shimeji and three species of fungi (cladosporium sphaerospermum, penicillium frequentans, and scopulariopsis species) were significantly higher in the sera of the patients than in those of normal subjects who were cultivating shimeji. Although it is not clear what causes this disease, these findings may be helpful in determining the specific antigen.- - - - - - - - - - ranking = 0.001072499326keywords = worker, disease (Clic here for more details about this article) |
16/887. An operative procedure for advanced Kienbock's disease. Excision of the lunate and subsequent replacement with a tendon-ball implant.Excision of the lunate and subsequent replacement with a tendon implant was performed in 22 patients with Kienbock's disease between 1971 and 1985. This procedure was indicated mainly for those with advanced Kienbock's disease, i.e., stage III or IV according to the Lichtman classification. After the collapsed lunate is removed, a tendon-ball implant, made of the palmaris longus and plantaris tendons is placed in the resultant space in the carpus. A forearm distractor is applied during the operation, and distraction is continued for 4 weeks postoperatively. We report the long-term results in 15 patients, whose average follow-up period was 16 years and 3 months. One patient with infection was excluded from the study because the implanted tendon was removed 2 weeks after the operation, and 6 patients were lost to follow-up. All patients were free of pain after the surgery. The flexion-extension range of the wrist increased by 14.2 degrees, on average, after the surgery. The average grip power of the operated hand was 90.2% of that in the non-operated hand. Calcification and ossification were frequent in the implanted tendons a few months postoperatively. The average carpal height ratio (defined as carpal height/length of the third metacarpal) was 0.53 before the operation and 0.49 at the time of follow-up. According to Dornan's classification of clinical results, 9 of the 15 patients were classified as having excellent results and 6 as good.- - - - - - - - - - ranking = 2.8802886E-5keywords = disease (Clic here for more details about this article) |
17/887. Accelerated silicosis with mixed-dust pneumoconiosis in a hard-metal grinder.We describe a fatal case of accelerated silicosis with a component of mixed-dust pneumoconiosis in a young hard-metal grinder that we believe is the first case of its kind in israel and one of the rare cases reported worldwide. The patient's diagnosis was based on typical features: restrictive lung function, abnormal chest roentgenogram suggesting lung fibrosis, a history of exposure to silica and hard metals, bronchoalveolar lavage (BAL) fluid findings, and mineralogical studies. BAL cells showed an abundance of giant multinucleated macrophages. The CD4/CD8 ratio of T lymphocytes was 1.1, with a high percentage of CD8 and CD8/38 positive cells (37% suppressor/cytotoxic and 12% cytotoxic T lymphocytes, respectively). mRNA transcripts isolated from BAL cells were positive for interleukin-1 (IL-1) and transforming growth factor (TGF) Il-5, IL-2, and IL-10 but not for IL-6, IL-4, and interferon. Polarizing light microscopic studies of BAL and induced sputum cells showed polarizing particles, which are typical for silica. Mineralogical studies of electron microscopy performed on BAL fluid and on dust collected at the patient's workstation revealed silica particles as well as aluminum-titanium and other particles. The latter might have contributed to the patient's lung disease.- - - - - - - - - - ranking = 4.800481E-6keywords = disease (Clic here for more details about this article) |
18/887. Occupational asthma induced by cephalosporins.A 20-yr-old pharmaceutical worker who developed attacks of shortness of breath and wheezing 9 months after beginning work on a process in which cefadroxil powder was bottled or encapsulated will be described. skin test with cefaxodril was negative. Baseline spirometry and methacholine inhalation test were normal. A controlled bronchial challenge test was carried out in a closed-circuit system with assessment of respirable dust concentration. Exposure to cefadroxil powder at a mean concentration of 10 mg x m(-3) for 10 min elicited an isolated immediate asthmatic response, but no response was observed to control challenge with lactose. Single-blind oral challenge test with amoxicillin up to 500 mg was well tolerated, whereas the oral challenge with cephalexin (25 mg) elicited an immediate asthmatic response. This patient had developed occupational asthma caused by inhalation of cefadroxil as confirmed by specific inhalation test. Since she tolerated oral amoxicillin, a synthetic penicillin with the side-chain identical to that of cefadroxil, it seems that she may be sensitized to the dihydrothiazine ring of cephalosporins.- - - - - - - - - - ranking = 0.000213539769keywords = worker (Clic here for more details about this article) |
19/887. NMSP binding to dopamine and serotonin receptors in MPTP-induced parkinsonism: relation to dopa therapy.We tested the hypothesis that N-methylspiperone binding to dopamine D2 receptors must be reduced when L-dopa therapy of parkinsonism augments the binding of dopamine to the receptors and improves the clinical state expressed by the Hoehn & Yahr stage. A patient with MPTP-induced parkinsonism underwent two positron emission tomographic studies of the D2-like dopamine receptors with N-[11C]methylspiperone (NMSP). The first study took place 3 days after cessation of the L-dopa medication, the second 5 days after its resumption. Noticeable clinical deterioration occurred during both studies, consistent with significant dopamine receptor blockade by NMSP and elevated NMSP binding in both scans. The dopa treatment did not reduce the NMSP binding. On the contrary, the rate of binding of NMSP (k3) was increased on-dopa, compared to off-dopa. The increase was consistent with the slightly greater dopamine receptor density estimated after resumption of the dopa therapy. The NMSP binding to serotonin receptors suggested lower synaptic serotonin on-dopa than off-dopa. The results are consistent with negative correlation between the Hoehn & Yahr stage and the amount of dopamine bound to dopamine D2 receptors. Low synaptic serotonin may explain the depression seen in some patients on dopa for Parkinson's disease.- - - - - - - - - - ranking = 4.800481E-6keywords = disease (Clic here for more details about this article) |
20/887. Cerebral arterial gas embolism in air force ground maintenance crew--a report of two cases.Two cases of cerebral arterial gas embolism (CAGE) occurred after a decompression incident involving five maintenance crew during a cabin leakage system test of a Hercules C-130 aircraft. During the incident, the cabin pressure increased to 8 in Hg (203.2 mm Hg, 27 kPa) above atmospheric pressure causing intense pain in the ears of all the crew inside. The system was rapidly depressurized to ground level. After the incident, one of the crew reported chest discomfort and fatigue. The next morning, he developed a sensation of numbness in the left hand, with persistence of the earlier symptoms. A second crewmember, who only experienced earache and heaviness in the head after the incident, developed retrosternal chest discomfort, restlessness, fatigue and numbness in his left hand the next morning. Both were subsequently referred to a recompression facility 4 d after the incident. Examination by the diving Medical Officer on duty recorded left-sided hemianesthesia and Grade II middle ear barotrauma as the only abnormalities in both cases. Chest x-rays did not reveal any extra-alveolar gas. Diagnoses of Static Neurological decompression Illness were made and both patients recompressed on a RN 62 table. The first case recovered fully after two treatments, and the second case after one treatment. magnetic resonance imaging (MRI) of the brain and bubble contrast echocardiography performed on the first case 6 mo after the incident were reported to be normal. The second case was lost to follow-up. decompression illness (DCI) generally occurs in occupational groups such as compressed air workers, divers, aviators, and astronauts. This is believed to be the first report of DCI occurring among aircraft's ground maintenance crew.- - - - - - - - - - ranking = 1keywords = worker (Clic here for more details about this article) |
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