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

In July 1979, 1,900 gallons of trichloroethylene (TCE) were released into ground and surface water from a pipe manufacturing plant in Montgomery County, Pennsylvania. To evaluate community and occupational exposure to TCE, we conducted environmental and medical surveys. In well water samples obtained in August 1979 within 1 km of the factory, TCE concentrations ranged to 183,000 parts per billion (ppb); EPA's proposed guideline for TCE in drinking water is 5 ppb. Levels of TCE declined with distance from the plant and decreased in the months following the spill. However, lower level TCE contamination was widespread and persistent, suggesting multiple releases. Within the plant, mean time-weighted occupational exposure to TCE of degreaser operators was 205 mg/m3; the recommended time-weighted exposure limit is 135 mg/m3. Mean short-term exposure was 1,084 mg/m3; the recommended short-term limit is 535 mg/m3. Seven of 9 exposed workers reported drowsiness, dizziness, or mental confusion. In exposed workers, mean urinary excretion of TCE metabolites rose from 298 micrograms/L pre-shift to 480 micrograms/L post-shift. On re-evaluation of the factory following improvements in ventilation and work practices, mean time-weighted occupational exposure to TCE had decreased to 84 mg/m3 and short-term exposure to 400 mg/m3; symptom frequency and concentrations of urinary TCE metabolites also were reduced. This episode demonstrates that community and occupational exposure to chemical toxins may share a common origin.
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PMID:Common-source community and industrial exposure to trichloroethylene. 343 9

Despite the widespread use of non-steroidal anti-inflammatory drugs (NSAIDs), the current number of reported cases of poisoning is small. However, with the introduction of 'over-the-counter' preparations of NSAIDs in some countries (e.g. ibuprofen in the UK and USA) an increased incidence of acute poisoning from this group of drugs can be expected. Conventionally, NSAIDs are divided into the following groups based on their chemical structure: arylpropionic acids, indole and indene acetic acids, heteroarylacetic acids, fenamates, phenylacetic acids, pyrazolones and oxicams. Unless NSAIDs are ingested in substantial overdose, acute poisoning with these agents does not usually result in significant morbidity or mortality. In most cases the clinical features are mild and confined to the gastrointestinal and central nervous systems, though acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse and cardiac arrest may complicate severe poisoning. Arylpropionic acid derivatives were thought initially to have a low order of toxicity in overdose but, in addition to anticipated gastrointestinal symptoms, headache, tinnitus, hyperventilation, sinus tachycardia, hypoprothrombinaemia, haematuria, proteinuria and acute renal failure have been described. In addition, drowsiness, coma, nystagmus, diplopia, hypothermia, hypotension, respiratory depression and cardiac arrest have been reported in severe cases of poisoning. Oxyphenbutazone and phenylbutazone are considerably more toxic in overdose. Complications of severe poisoning include coma, convulsions, hepatic dysfunction, acute renal failure, sodium and water retention, haematuria, cardiovascular collapse, respiratory alkalosis, metabolic acidosis, hypoprothrombinaemia and thrombocytopenia. In contrast, indomethacin appears to be much less toxic. In addition to gastrointestinal symptoms, indomethacin taken in overdose induces headache, tinnitus, dizziness, lethargy, drowsiness, confusion, disorientation and restlessness. Only 1 case of acute sulindac poisoning has been reported in the literature. A 16-year-old boy was admitted with hypokalaemia (2.2 mmol/L), transient granulocytosis and 'scanty' haematemesis after ingesting 12 g sulindac. No case of acute tolmetin poisoning have been reported. The fenamates (flufenamic acid, meclofenamic acid, mefenamic acid, tolfenamic acid) are, with the exception of mefenamic acid, not as widely prescribed as other groups of NSAIDs. In overdose, mefenamic acid may result in nausea, vomiting, diarrhoea, muscle twitching, convulsions and coma.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acute poisoning due to non-steroidal anti-inflammatory drugs. Clinical features and management. 353 13

Furazolidone, a synthietic nitrofuran, is active against a broad spectrum of bacteria and Giardia lamblia. Since 1954, furazolidone has been used almost exclusively for the specific and symptomatic treatment of infectious diarrheal diseases. Diarrheal disease is the leading cause of death of children and a major contributing factor of malnutrition in the developing world. It can be avoided with proper water and waste treatment, personal hygiene, and food preparation. The most critical aspect of treating acute diarrhea is maintaining optimal hydration and electrolyte balance. Fluid and electrolyte replenishment must constitute the 1st line of therapy. Antimicrobial therapy, however, improves the outlook further. Effective antimicrobials reduce the average duration of illness and the likelihood of relapses, complications and death. The ideal antimicrobial for treating acute diarrhea is a single broad-spectrum antimicrobial agent of low toxicity that would be effective for empirical treatment of acute diarrheal disease. During 30 years of clinical use worldwide, the effectiveness of furazolidone has shown to be comparable or superior to that of other drugs used to treat these diseases. Because furazolidone has fairly low toxicity, it is a relatively safe drug. The most common reaction appears to be gastrointestinal distress, though dizziness, drowsiness, headaches, and general malaise have also been reported. A drug that acts specifically on its target is generally preferable to one with less specific activity. Furazolidone inhibits a variety of bacterial enzymes, an activity that minimizes the development of resistant organisms. Furazolidone is a single, broad-spectrum antimicrobial that is effective, relatively safe, specific, and is orally administered in tablet or suspension form.
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PMID:Furazolidone for treatment of diarrhoeal disease. 357 95

Municipal sewage treatment plant workers are potentially exposed to a multitude of industrial chemicals and pathogenic microorganisms. A questionnaire survey of working habits, lifestyle and symptoms of illness was conducted among 189 municipal sewage treatment plant workers processing between three and ten million gallons of wastewater daily in 16 plants in New York State between March and July of 1984. Water treatment plant workers in the same cities comprised the comparison group. Sewage workers reported a significantly higher frequency of headache, dizziness, sore throat, skin irritation and diarrhea within the month immediately preceding receipt of the questionnaire, after controlling for various possible confounders. Eye and skin irritation were significantly associated with exposure to mutagens. The health significance of these findings and possible sources of error in assessing risk are discussed.
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PMID:Health among municipal sewage and water treatment workers. 368 35

Iohexol, a new water-soluble nonionic contrast medium, was evaluated in clinical trials in Europe and North America for lumbar, thoracic, and cervical myelography using direct C1-2 or lumbar puncture. Iohexol was administered at 180, 240, or 300 mg I/ml to 677 adult patients for visualization of the lumbar subarachnoid space, and to 368 adult patients for evaluation of the cervical area. Compared with metrizamide, use of iohexol resulted in equivalent opacification but significantly reduced patient morbidity (headache, nausea, vomiting, dizziness). No epileptogenic activity was recorded in over 370 patients receiving iohexol. No mental or psycho-organic syndrome manifestations were observed in any of the 1,045 patients receiving iohexol. Adverse reactions occurring after iohexol injection were not related to the concentration or site used or to total dose administered. Iohexol has, thus far, proven superior to metrizamide for myelography.
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PMID:Iohexol: summary of North American and European clinical trials in adult lumbar, thoracic, and cervical myelography with a new nonionic contrast medium. 388 16

Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in many women may be precipitated by simple psychological events such as leaving home, while severely stressful events produce a higher incidence. Unless a physiological factor such as malnutrition is operating, menses usually recur spontaneously within a few months. Amenorrhea is a constant feature of anorexia nervosa and may precede related attitudes toward eating and body weight. This syndrome is best regarded as a chronic and often severe neurotic disorder requiring combined physiological and psychological treatment, although some evidence exists to indicate an endocrine disorder. Extensive basic research is needed on the complex relationship between the neuroendocrine system and emotion.
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PMID:Premenstrual symptoms. 473 36

Thirteen normal subjects were given 2, 3, or 4 g of ceftizoxime intravenously in a prospective single-blinded study. Serum and urine concentrations were measured for 48 h. The beta-phase serum half-life ranged from 1.4 to 1.7 h. Approximately 100% of the agent was recovered unchanged in the urine over 48 h. Six of 13 subjects reported subjective complaints consisting of mild dizziness and moderate headache, all of which were transient. One subject also had a minimally elevated serum glutamic oxalacetic transaminase level 1 day after drug administration. Based on serum pharmacokinetics and serum protein binding determined in this investigation, unbound ceftizoxime appeared to distribute with the total body water.
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PMID:Pharmacokinetics, protein binding, and extravascular distribution of ceftizoxime in normal subjects. 629 70

Within 20 months 145 ascending thoracocervical myelographies and 155 lumbar myelographies with the nonionic water-soluble contrast medium iopamidol were performed. The iodine concentration given was 250 mg I/ml or 200 mg I/ml respectively. The total iodine never exceeded 2.5 g (8-10 ml). Image quality was assessed in terms of diagnostic value having experience of more than 1,000 myelographies using metrizamide. Picture quality was similar to metrizamide of equal iodine concentration. In 35 patients electroencephalography (EEG) was recorded before and after myelography with iopamidol 250. No changes that could be referred to the contrast medium were seen. There were no adverse reactions to lumbar myelography other than those following the lumbar puncture. In thoracocervical myelography mild and transient side effects occurred in 41 (28.3%). The most common were headache (41 cases), nausea (12), radicular pain (10), and dizziness (five). General seizures and psychopathologic symptoms were not observed.
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PMID:Clinical experience with iopamidol for myelography. 641 Jul 31

Eight-five of 816 (10.7%) students attending a primary school in Central Thailand were examined and found infected with Fasciolopsis buski. All of students ate fresh water lily stems and most ate other fresh water plants including caltrop, water cress and morning glory. The 85 students were given praziquantel in randomized single doses of 15, 25 or 40 mg/kg body weight. Side effects were mild and transient and consisted of headache, dizziness, nausea, sleepiness, abdominal discomfort, anorexia, diarrhea, epigastric pain, vomiting and lassitude. Those receiving the highest dosages had more side effects than students in the other 2 groups. Large blisters were observed on the tegument of F. buski passed in feces and this was believed to be caused by the drug. The authors recommend a single dose of praziquantel in a dosage of 15 mg/kg of body weight for the treatment of parasitosis.
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PMID:Field trial on the treatment of fasciolopsiasis with praziquantel. 663 61

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4


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