Abnormal liver function tests following inadvertent inhalation of volatile hydrocarbons.
The use of aerosols containing volatile hydrocarbons in conditions of poor ventilation can result in accidental overexposure which can cause central nervous system effects and hepatic injury. We present a case in which inadvertent usage of an adhesive spray used to make greeting cards resulted in vague neurological symptoms and abnormal liver function tests both of which fully resolved on discontinuation. (+info
The effects of successful intervention on quality of life in patients with varying degrees of lower-limb ischaemia.
OBJECTIVES: to assess the quality of life after successful intervention among patients with varying degrees of lower-limb ischaemia in comparison with healthy controls and the respondents>> degree of sense of coherence. MATERIALS AND METHODS: one hundred and twelve patients and 102 healthy controls were assessed for quality of life (Nottingham Health Profile) and sense of coherence. MAIN RESULTS: successful angioplasty or surgical intervention led to an improved quality of life at 6 months, in particular with regard to pain, sleep, physical mobility, hobbies and holiday and to a level similar to healthy controls in sleep, social isolation, paid employment and family relationships. It remained at a significantly lower level than that of healthy controls with regard to pain, emotional reactions, physical mobility, energy, housework, hobbies, holidays, sex and social life. Critical ischaemia patients did not reach the same level of quality of life as the claudicants or the healthy controls. CONCLUSION: successful treatment for chronic limb ischaemia improved the quality of life significantly, more so in claudicants than in patients with critical ischaemia. The degree to which the quality of life improved was associated with the patients>> sense of coherence and their ankle pressure. (+info
Are occupational, hobby, or lifestyle exposures associated with Philadelphia chromosome positive chronic myeloid leukaemia?
OBJECTIVES: To investigate a broad range of occupational, hobby, and lifestyle exposures, suggested as risk factors for Philadelphia chromosome positive (Ph+) chronic myeloid leukaemia (CML). METHODS: A case-control study, comprising 255 Ph+CML patients from southern Sweden and matched controls, was conducted. Individual data on work tasks, hobbies, and lifestyle exposures were obtained by telephone interviews. Occupational hygienists assessed occupational and hobby exposures for each subject individually. Also, occupational titles were obtained from national registries, and group level exposure-that is, the exposure proportion for each occupational title-was assessed with a job exposure matrix. The effects of 11 exposures using individual data and two exposures using group data (organic solvents and animal dust) were estimated. RESULTS: For the individual data on organic solvents, an effect was found for moderate or high intensity of exposure (odds ratio (OR) 3.4, 95% confidence interval (95% CI) 1.1 to 11) and for long duration (15-20 years) of exposure (OR 2.1, 95% CI 1.1 to 4.0). By contrast, the group data showed no association (OR 0.69, 95% CI 0.27 to 1.8; moderate or high intensity versus no exposure). For extremely low frequency electromagnetic fields (EMFs), only individual data were available. An association with long occupational exposure to EMFs was found (OR 2.3, 95% CI 1.2 to 4.5). However, no effect of EMF intensity was indicated. No significant effects of benzene, gasoline or diesel, or tobacco smoking were found. OR estimates below unity were suggested for personal use of hair dye and for agricultural exposures. CONCLUSIONS: Associations between exposure to organic solvents and EMFs, and Ph+CML were indicated but were not entirely consistent. (+info
Testing neoclassical competitive market theory in the field.
This study presents results from a pilot field experiment that tests predictions of competitive market theory. A major advantage of this particular field experimental design is that my laboratory is the marketplace: subjects are engaged in buying, selling, and trading activities whether I run an exchange experiment or am a passive observer. In this sense, I am gathering data in a natural environment while still maintaining the necessary control to execute a clean comparison between treatments. The main results of the study fall into two categories. First, the competitive model predicts reasonably well in some market treatments: the expected price and quantity levels are approximated in many market rounds. Second, the data suggest that market composition is important: buyer and seller experience levels impact not only the distribution of rents but also the overall level of rents captured. An unexpected result in this regard is that average market efficiency is lowest in markets that match experienced buyers and experienced sellers and highest when experienced buyers engage in bargaining with inexperienced sellers. Together, these results suggest that both market experience and market composition play an important role in the equilibrium discovery process. (+info
Scleroderma and solvent exposure among women.
Exposure to solvents has been reported to increase the risk of scleroderma. The authors investigated the relation between exposures to solvents in occupational and hobby settings and the development of scleroderma among women in a case-control study with population-based controls in Michigan (1980-1991) and Ohio (1980-1992). A total of 660 cases and 2,227 frequency-matched controls were interviewed by telephone. Diagnoses of scleroderma were verified by medical records review. Paint thinners and removers were significantly associated with scleroderma both by self-report (odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.4, 2.6) and after expert review (OR = 2.0, 95% CI: 1.5, 2.6). Other petroleum distillates (gasoline and mineral spirits) were not significantly associated with scleroderma after controlling for other correlated exposures in multivariable analyses. Trichloroethylene was associated with scleroderma both by self-report (OR = 2.0, 95% CI: 0.8, 4.8) and after expert review (OR = 1.9, 95% CI: 0.6, 6.6), but not significantly. Analyses by duration of exposure found that risk increased with the duration of use of any of the solvents (OR = 1.01/year of exposure, 95% CI: 1.01, 1.02), but there was no evidence of increasing risk with increasing duration of exposure for any specific solvent studied. In summary, exposures to paint thinners and removers were associated with scleroderma in women but showed no evidence of increasing risk with increasing duration. Exposures to other specific chlorinated and nonchlorinated hydrocarbon solvents were not clearly associated with scleroderma. (+info
Severe soccer injuries in amateurs.
OBJECTIVES: To ascertain the number and type of severe soccer injuries admitted to King Edward Hospital in South Africa over 42 months. METHODS: This was a retrospective study of all patients admitted for treatment or observation to the orthopaedic unit only. Patients treated as outpatients, irrespective of severity, are also presented for comparison. RESULTS: Thirty two patients were admitted with severe injuries. The injuries included 18 fractures of the tibial and femoral shaft. Two tibial shaft fractures were compound. Four tibial plateau fractures and five epiphyseal injuries were identified. One patient had a fracture-dislocation of the hip. One patient with a popliteal artery injury presented 48 hours after the injury had occurred. He had an above knee amputation. In the same period 122 patients were treated as outpatients. The types of injury in this group were similar to soccer injuries reported in other countries. CONCLUSIONS: Very serious injuries are sustained by casual soccer players in South Africa. Urgent measures need to be taken to prevent such injuries. (+info
Wegener's granulomatosis: Possible role of environmental agents in its pathogenesis.
OBJECTIVE: To investigate the possibility that environmental agents contribute to the pathogenesis of Wegener's granulomatosis (WG). METHODS: We undertook an extensive search for possible environmental exposures by developing a comprehensive questionnaire that was administered by telephone interview to 53 patients with WG and 2 control groups: one with osteoarthritis and the other with gout. Questions focused on hobbies and vocations, work, home, and allergies. Exact logistic regression was used to calculate odds ratios and 95% confidence intervals after adjusting for potential confounders. After adjusting for age and sex, data are reported for all exposures with odds ratios >2.0 against either control group or for any allergic propensity. RESULTS: Results suggest that mercury and perhaps lead exposure were positively associated with WG as compared with either control group, although the number of patients exposed was small. A prior history of allergy was also associated with WG as compared with either control group. CONCLUSION: We conclude that heavy metal exposure and a prior history of allergy may play a role in the etiopathogenesis of Wegener's granulomatosis. (+info
Plumbism or lead intoxication mimicking an abdominal tumor.
The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case report, the diagnosis was finally made when bilateral wrist drop developed on top of abdominal cramps and anemia. Before, ascites raised the suspicion of a tumor. Therefore, each element of the triad of unexplained anemia, abdominal cramps, and bilateral wrist (or foot) drop should lead any physician to consider the diagnosis of lead intoxication. This case also illustrates the importance of a careful and meticulous social history in patient management. (+info