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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pharmacotherapy of hypertension in the aged does not differ qualitatively but only quantitatively from that in use for younger patients. Adjusted, usually lower doses of diuretics, beta-blocking agents, ACE-inhibitors and calcium-channel blockers are the basic drugs. Individual aging processes and concomitant diseases determine the choice of drugs in the elderly (individualized therapy). All substances are initially prescribed at very low dose. The increasing infirmity of the aged often associated with tiredness, dyspnea and dizziness even without treatment requires careful instruction of the patient about effects and side effects of the prescribed medication. The old WHO-guidelines (systolic BP greater than or equal to 160, diastolic BP greater than or equal to 95 mm mercury) should be maintained for diagnosis and treatment of hypertension. However antihypertensive therapy in patients over 80 years of age and in those with marginally elevated diastolic or solely elevated systolic pressure is controversial today.
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PMID:[Hypertension and old age]. 268 25

On the basis of neurological, psychological and electroencephalographic investigations the authors present an assessment of the state of the nervous system in 24 males observed in hospital for suspected chronic intoxication with metallic mercury. The most frequent symptoms were: headaches and dizziness (17 cases), recent memory disturbances (16) and irritability (15). Cerebellar signs were found in 13 cases, one eeg record was abnormal, in 4 cases the eeg was borderline normal. Psychological tests revealed in 21 cases evidence of organic brain damage with slowing down of the simple visual and auditory reactions (16), disturbances of recent memory and persistent attention (14), decreased intellectual efficiency (7) and visual perception (5). The authors call attention to the necessity of appropriate prevention of mercury poisoning in view of its selective neurotoxicity and irreversibility of the pathological changes. The importance of psychological testing for psychological testing for the correct assessment of the status of the nervous system in cases of metallic mercury poisoning is stressed.
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PMID:[Chronic toxic encephalopathies caused by metallic mercury]. 358 17

In order to study functional as well as anatomical aspects of various internal organs, SPECT (Single Photon Emission Computerized Tomography) has been used extensively for evaluation of these organs. For SPECT study, intravenous injection of radioactive substances such as technetium-99m (20 millicuries) & thallium-201 chloride (3 millicuries) is commonly used. Although the physical half-life of thallium-201 chloride is 73 hours, its biological half-life is often more than 3.5 times that. Following intravenous injection of thallium-201 chloride it is concentrated in the heart, liver, kidneys, pancreas, thyroid gland, testes or ovaries, and then eventually decays to mercury. Because of its relatively long physical & biological half-lives, thallium-201 chloride may produce mild radiation injury while it remains radioactive. Similar injuries may be induced by technetium-99m (often used for brain SPECT), which radiates Gamma rays (140 KeV), but since its physical half-life is only 6 hours, the side effects are not as significant as those of thallium-201 chloride. Since the main component of thallium-201 chloride radiation is X-ray (68-82 KeV), which consists of photons with a very short wavelength and a high penetrating power, prolonged exposure can induce electromagnetic field-induced injury. As a previous study of the principal author on electromagnetic field exposure indicated, electromagnetic field-induced injury causes the change of L-amino acids to D-amino acids. 2 days after SPECT study of the heart with intravenous injection of thallium-201 chloride, the principal author experienced shortness of breath, loss of appetite, dizziness, fever, and general malaise within the week, and found a progressively significant increase in D-glutamic acid and decrease in L-glutamic acid peaking 2 weeks after the initial injection but lasting for many weeks after in organs such as the heart, liver, kidneys, pancreas, thyroid gland & testes, where radioactive substances had accumulated and radiation was at an average of about 400 counts/min. Even 2 months after the initial injection, the abnormal ratio of D-amino acids and L-amino acids had not returned to normal (in the radiation exposed heart, L-amino acids: 6 mg/dl with D-amino acids: 5 mg/dl; normal tissue, L-amino acids: 10 mg/dl with D-amino acids < 1 mg/dl). The principal author tried to find a safe method of reducing possible radiation injury and accelerating the elimination of the already deposited mercury.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Radiation injury & mercury deposits in internal organs as a result of thallium-201 chloride intravenous injection for SPECT imaging; additional biochemical information obtained in the images of organs from SPECT or PET scans; & potential injury due to radiation exposure during long distance flights. 749 50

Analysis and treatment of dental and medical factors that can cause burning mouth were performed in 25 consecutive patients according to a treatment protocol. The effect of the dental and medical treatment on the burning mouth was evaluated. The sick leave profile was presented. Apart from burning mouth symptoms, the patients reported several oral and general symptoms, such as gustatory changes, xerostomia, back and joint muscle pain, headache, and dizziness. The most common dental diagnoses were temporomandibular joint, masticatory, and tongue muscle dysfunction and lesions in the oral mucosa. The most common medical diagnoses were low serum iron and hypersensitive reaction to mercury. None of the patients tested exceeded the limit of 100 nmol Hg/l urine. Replacement of amalgam fillings was the most common dental therapy, followed by treatment of dysfunction in the masticatory system. Iron replacement was the most frequent medical treatment. The patients had over 50% more days per year sick leave than an age- and sex-matched normal population. A follow-up found that the burning mouth had disappeared in 32% of the patients. This study confirms the opinion that burning mouth is multicausal. Hypersensitive reaction to mercury was more frequent than expected, but replacement of amalgam fillings relieved burning mouth in only two of five such patients, and one of these two patients had hypersensitive reactions to both mercury and gold. One reason that so many patients continued to have burning mouth might have been neglect of dental, medical, or both diagnoses. Another reason might be that assessment of the psychologic status of the patients and psychologic treatment when indicated were not done.
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PMID:Clinical study of patients with burning mouth. 781 55

A total of 217 patients with essential hypertension were enrolled by 25 Canadian centers in this double-blind, parallel study to compare the efficacy and safety of enalapril administered alone or in combination with hydrochlorothiazide. After a 4-week placebo period, patients were given 10 mg of enalapril for 2 weeks. At the end of the 2 weeks of therapy, patients were maintained on the same dose of enalapril, titrated to a higher dose of enalapril, or received combination therapy with hydrochlorothiazide if their diastolic blood pressure remained > 90 mmHg. Patients in group 1 received enalapril 10 mg or 20 mg and those in group 2 received enalapril 10 mg alone or combined with hydrochlorothiazide 25 mg. The maintenance phase lasted 8 weeks. A standard mercury sphygmomanometer was used to measure blood pressure at each visit. The mean decrease in supine diastolic blood pressure (SDBP) was 16 mmHg in groups 1 and 2; the mean decrease in supine systolic blood pressure (SSBP) was 19 mmHg in group 1 and 20 mmHg in group 2. Eighty percent of the patients in group 1 and 81% of those in group 2 had an SDBP < or = 90 mmHg at the final visit. To achieve this control, 67% of the patients received enalapril 10 mg and 33% received enalapril 20 mg in group 1. In group 2, 70% of the patients received enalapril 10 mg and 30% received enalapril 10 mg plus hydrochlorothiazide 25 mg. Eighteen patients in group 1 and 17 patients in group 2 experienced one or more minor adverse events. The most frequently reported adverse events were headache, asthenia, abdominal pain, nausea, and dizziness. No major adverse events were observed. We conclude that enalapril used alone reduces blood pressure in the majority of patients with mild to moderate essential hypertension. When blood pressure is not controlled by enalapril alone, hydrochlorothiazide can safely be added to the regimen.
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PMID:Enalapril and enalapril-hydrochlorothiazide in the treatment of essential hypertension. The Enalapril-Hydrochlorothiazide in Essential Hypertension Canadian Working Group. 851 44

At the Institute of Occupational Medicine and Environmental Health, during 12 years, chronic mercury intoxication was diagnosed in 34 persons. There were male workers tending technological processes in which Hg was used as a catalyst (synthesis of acetic aldehyde and obtaining chlorine). The length of professional exposure was 13-34 years (mean 20.6). The patients were removed from the contact with Hg after Hg intoxication case was confirmed. During the following 11 years, 24 of them were reexamined in the clinical department 2-4 times. The clinical picture of the poisoning consisted mainly of neurasthenic, cerebellar (30 persons), psychoorganic symptoms (20 persons) and behavioural changes (irritability, aggressive states). Headaches, sleep and recent memory disturbances, progressive behavioral changes, dizziness, were the most frequent complaints. The authors stressed the irreversibility of central nervous disorders despite cessession of the exposure to Hg. The degree of cerebellar intensity changes did not handicap examined patients. This is especially important to show the difference between the above described clinical picture of Hg intoxication and multiple sclerosis.
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PMID:[Changes in the nervous system due to occupational metallic mercury poisoning]. 951 54

During 1993-95 a total of 169 patients (112 women, 57 men) with a wide range of complaints associated with earlier or present amalgam fillings were seen by the "Dental Biomaterials Adverse Reaction Unit" in Norway. Most patients had amalgam fillings; 19 had removed all amalgam, and 14 were in the process of replacing the amalgam fillings with other materials. Predominant symptoms were of a subjective and general nature (96% of the patients). Muscle and joint pain, headache, dizziness and feeling exhausted comprised the most common symptoms. Intra-oral pathology was observed in 48%. There was a correlation between the amount of amalgam ("amalgam score") and urinary mercury. Those without amalgam fillings and significantly lower values (median = 1.6 micrograms mercury/g creatinine) than those with amalgam fillings (medians: with amalgam = 3.5 micrograms/g; with partial removal of amalgam = 2.7 micrograms/g). Overall, in the present group of patients, no statistically significant correlation seemed to exist between the type and number of subjective symptoms or objective findings and the urinary mercury. This would indicate therefore that there is no straightforward association between urinary mercury and symptoms in the present group of patients.
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PMID:[Mercury and dental amalgam fillings]. 962 58

The flight crews of aircraft often report symptoms including dizziness, nausea, disorientation, blurred vision and tingling in legs and arms. Many of these incidents have been traced to contamination of cabin air with lubricating oil, as well as hydraulic fluid, constituents. Considering that these air contaminants are often subjected to temperatures in excess of 500 degrees C, a large number of different exposures can be expected. Although the reported symptoms are most consistent with exposures to volatile organic compounds, carbon monoxide, and the organophosphate constituents in these oils and fluids, the involvement of these agents has not been clearly demonstrated. Possible exposure to toxic elements, such as lead, mercury, thallium and others, have not been ruled out. In order to assess the potential of exposure to toxic elements a multi-elemental analysis was done on two hydraulic fluids and three lubricating oils which have been implicated in a number of air quality incidents. A secondary objective was to establish if the multi-elemental concentrations of the fluids tested are different enough to allow such an analysis to be used as a possible method of identifying the source of exposure that might have been present during aircraft air quality incidents. No significant concentrations of toxic elements were identified in any of the oils or hydraulic fluids. The elemental compositions of the samples were different enough to be used for identification purposes and the measurement of only three elements was able to achieve this. Whether these findings have an application, in aircraft air quality incident investigations, needs to be established with further studies.
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PMID:Multi-elemental analysis of jet engine lubricating oils and hydraulic fluids and their implication in aircraft air quality incidents. 1041 67

We like to think that our homes are a safe haven. However, in recent years we have been discovering that certain products, designs, and even the siting of our homes can create health risks. When families moved into a new development in Waynesville, NC, called "Barber Orchard," they were ecstatic about their new surroundings--the fresh air, mountain views, and clean water. When one of the new residents had his well water tested, their dream homes took on a different character. The water was reflective of the years of pesticide use on the former orchard on which their homes were sited; it contained DDT, DDE, and benzene hydrochlorides (Manual, 2000). The soil was contaminated with lead and arsenic, also the result of pesticide applications. The Environmental Protection Agency (EPA) sent in an emergency response team, removed toposil, and advised residents to install carbon filters on their water systems. Sometimes, we unintentionally bring pollution into our homes. In the homes of middle-income families with small children, vacuum dust was found to have pesticide concentrations 10-100 times greater than those found in the surface soils surrounding their houses (Lewis et al, 1994). In the agricultural area of Washington State, 47 of 48 farm homes had chlorpyrifos (an organophosphate pesticide) measured in the house dust. The human health risks associated with chlorpyrifos are substantial (including headaches, dizziness, muscle twitching, vomiting, and blurred vision); hence, in 2000, the EPA eliminated the widely used pesticide for nearly all-household purposes. The purpose of this independent study module (ISM) is to introduce the reader to basic concepts and issues associated with environmental health risks to children in homes and communities. In this ISM, some of the key hazardous exposures occurring in the home will be discussed. Indoor air quality, drinking water, lead, mercury, pesticides, radon, and UV radiation have been selected as topics of focus. A resource section provides a brief listing of resources; many of them are Web sites, which, in turn will link the reader to additional resources. The EPA's Web site is particularly helpful. The University of Maryland School of Nursing has a new Web site, http://enviRN.umaryland.edu, with links to all of the Web sites noted in this ISM.
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PMID:Environmentally healthy homes and communities. Children's special vulnerabilities. 1178 92

Many herbomineral preparations are currently being used as therapeutic remedies for common ailments. Commonly known cardiotoxic herbs are Aconitum ferox (aconite), Areca catechu (betel nut), Thevetia peruviana (yellow oleander) and Cleistanus collinus (oduvan). Herbs mixed with lead, copper and/or mercury are known to be highly toxic. They produce cardiac arrhythmias, mainly ventricular ectopics, ventricular tachycardia and various degrees of arterioventricular (AV) blocks. We report 12 such successive cases where the patients developed vague feelings of discomfort, dizziness, chest discomfort and ventricular arrhythmias following herbal drug ingestion which warranted the immediate discontinuation of the drug. Three of the patients died. This paper emphasizes the risk of unsupervised use of herbomineral preparations by patients who believe that the remedies are always 'safe' and the urgent necessity for the pharmacognostic identification of the constituent herbs, their toxicological studies, uniform nomenclature, authenticity and standardization of plants and their parts before advocating them for therapeutic use.
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PMID:Cardiotoxicity from 'safe' herbomineral formulations. 2126 56


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