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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-eight workers from a factory producing nickel-cadmium and other types of batteries came to us for medical evaluation. They included 21 women and 17 men (seniority 2-20 years, age range 31-63 years), and represented a self-selected subset of 700-900 ever-employed and 200+ recently or currently employed workers in the factory. Thirty-four worked on the nickel-cadmium assembly line. Symptoms and signs included: headache in 34; weakness, fatigue and lassitude in 26; dizziness in 16; pruritus and skin eruptions in 37; gingivitis, teeth loss and caries in 34; nasal congestion, nosebleeds and anosmia in 30; cough, phlegm production, wheezing and shortness of breath in 26; "asthma" in 14; bone pain in 18; urinary frequency, beta 2 microglobulinuria and kidney stones in 17; and sterility or multiple abortions (33) in 8 of 21 women. One additional patient had died from an "amyotrophic lateral sclerosis-like syndrome", while CT scans in six workers revealed brain atrophy. One other worker had leukemia, and two had died from cancer (lung and pancreas). Those who had worked for more than 10 years had more symptoms and signs than shorter-term employees, especially neurological illness, bone pain and urinary tract problems, including beta 2 microglobulinuria. Past blood and urinary cadmium levels were in the range of 1.6-8.7 micrograms/dl and 8-306 micrograms/l, respectively. Our findings indicated that: a) health risks for workers were not confined to the nickel-cadmium assembly line or to older workers, b) hazardous exposures still existed and illness appeared in new workers after a clean-up and intervention program, and c) exposures involved increased risks for renal disease and cancers. Finally, there is a need to control exposures and determine health risks in the full cohort of those ever employed, in the workers' children, and in the surrounding environment (air, ground, water) due to the dumping of waste from the plant.
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PMID:Medical findings in nickel-cadmium battery workers. 142 13

Chronic rhinosinusitis is a multifactorial disease defined as inflammation of the nasal cavity and paranasal sinuses with a history of at least 12 weeks in duration. The major symptoms include facial pressure or pain, nasal obstruction, discharge or purulence, and hyposmia or anosmia. The minor symptoms include fever, halitosis, fatigue, and dental pain. Microorganisms play a significant role in the persistence and origination of the inflammatory process, although the exact role of these organisms in the pathogenesis of chronic rhinosinusitis is unclear. The clinical diagnosis relies heavily on the patient history and physical examination, which may include nasal endoscopy and computed tomography. Diagnostic techniques are here reviewed.
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PMID:Diagnosis of chronic rhinosinusitis. 1517 54

Olfactory loss can occur through accidental exposure, poor industrial hygiene, or exposure to low levels of toxins in the ambient air over long periods. This loss can lead to transient olfactory disorders, irreversible anosmia, temporary olfactory fatigue, or industrial anosmia. Inevitably, a practicing otolaryngologist will encounter a patient with complaints of decreased smell and taste that initially may be difficult to diagnose and treat. Much of the challenge in evaluating a patient with disturbances of olfaction is in obtaining adequate quantitative measurements of sensory dysfunction and identifying a source for the olfactory loss. Although there is no particular test for environmental toxins as a source of olfactory loss, an accurate cause can be determined by obtaining a careful, detailed history. A significant exposure history and lack of more common causes of olfactory loss strengthens an argument for environmental toxins as an etiology. Unfortunately, no available treatments can reverse permanent damage caused by toxic exposure, but removal from the source of toxins may allow for repair of the olfactory system and return of normal function, especially in acute exposures. Despite the increasing number of studies investigating toxic exposure on olfactory function, these effects are understood poorly. With continued study of human exposure to these substances and the use of animal models, the mechanisms by which damage occurs will be understood better and new approaches for diagnosis and treatment will be developed. Furthermore, with increasing regulations of occupational environments and stricter policies on industrial air pollution, olfactory dysfunction secondary to toxicity should become less prevalent.
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PMID:Olfactory loss as a result of toxic exposure. 1556 10

Esthesioneuroblastoma (olfactory neuroblastoma) is an uncommon neuroectodermal tumor. Its biological activity ranges from indolent growth to local recurrence and rapid widespread metastasis. Treatment options consist of surgical resection followed by radiation therapy for primary lesions and the addition of chemotherapy for advanced, recurrent, or metastatic lesions. Patients often present with nasal obstruction, rhinorrhea, recurrent epistaxis, hyposmia, or anosmia. However, we report the highly unusual case of a patient with an esthesioneuroblastoma who presented with atypical symptoms of headaches, sinus congestion, and fatigue before acutely losing consciousness. Imaging showed a large frontal skull-based tumor associated with intratumoral hemorrhage. The findings prompted an emergent combined anterior craniofacial resection with gross total resection of the tumor. Except for anosmia, the patient recovered almost completely. Postoperatively, she received adjuvant intensity-modulated radiation therapy and chemotherapy. This is the first reported case of an esthesioneuroblastoma presenting with hemorrhage and rapidly declining mental status, an acute neurological manifestation of which clinicians should be aware.
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PMID:Esthesioneuroblastoma (olfactory neuroblastoma) with hemorrhage: an unusual presentation. 1726 90

Smell (olfactory) and taste (gustatory) are key senses in the regulation of nourishment and individual safety. Olfactory and gustatory dysfunctions have been infrequently reported together in patients following stroke (Landis et al., 2006; Leopold et al., 2006). This case report details two patients who experienced smell and taste dysfunction following minor stroke events. Symptoms reported included hyposmia (diminished sense of smell) and anosmia (complete loss of smell), and dysgeusia (distorted taste). Patients' sense of smell and taste were assessed in an ambulatory care stroke prevention clinic eight months following their strokes. Patient A presented with minor stroke due to a lesion in the anterior circulation, patient B with a lesion in the posterior circulation. Both patients reported intense olfactory and gustatory dysfunction immediately following their strokes. Examination revealed a general inability to detect subtle odours and the ability to identify only 'sweet' tastes for both patients. In addition, both patients reported heavily salting or sweetening their food to mask the distorted and unpleasant taste, which also impacted comorbid conditions such as hypertension and diabetes. Patients and their spouses reported a decrease in their appreciation of family-related activities due to the patients' olfactory and gustatory dysfunction. Patients reported weight loss, lack of energy and strength, likely due to poor nutrition. Olfactory and gustatory dysfunctions are potentially deleterious outcomes following minor stroke and should be assessed by health care professionals prior to patient discharge. Assistance may be required to promote the health and well-being of patients and their carers if smell and taste are impacted by the stroke event.
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PMID:Smell and taste dysfunction following minor stroke: a case report. 1864 78

A solvent can be defined as "a liquid that has the ability to dissolve, suspend or extract other materials, without chemical change to the material or solvent". Numerous chemical or technical processes rely on these specific properties of organic solvents in industry. Occupational exposure to solvents is not rare and some activities may cause substantial exposure to these substances in the workforce. Short-term or acute exposures cause a prenarcotic syndrome, and long lasting exposure conditions have been associated with various neurological and neuropsychiatric disorders, e.g., anosmia, hearing loss, colour vision dysfunctions, peripheral polyneuropathy and depression, but most significantly with the gradual development of an irreversible toxic encephalopathy. For the last 3 decades reports and epidemiological studies have been published reporting sleep disturbances among other complaints, related to long-term exposure to these compounds. In addition, the question has been posed if solvents can be the cause of a sleep apnoea syndrome in exposed workers, or on the contrary, if these workers are misdiagnosed and 'common' sleep apnoea syndromes are the cause of their chronic symptoms of fatigue and memory and attentional disturbances.
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PMID:Sleep disturbances and occupational exposure to solvents. 1920 Dec 27

Nasopharyngeal stenosis as a postoperative complication following pharyngeal surgery (tonsillectomy/adenoidectomy) is rare and may be difficult to treat. All patients with severe nasopharyngeal stenosis treated at UCLA with a bilateral Z-pharyngoplasty procedure from 1999 to 2006 were studied (n = 6). Degree of pharyngeal stenosis preoperatively and following a bilateral Z-pharyngoplasty was graded 0-4 based on (1) symptomatology (snoring, hyponasal speech, difficulty with nasal breathing, difficulty breathing during exercise, obstructive sleep apnea, daytime fatigue, anosmia, rhinorrea, dysphagia, or difficulty in blowing nose) and (2) measurement of stricture at the time of direct nasolaryngoscopy. Nasopharyngeal stenosis after pharyngeal surgery (adenotonsillectomy--67%, uvuloplasty--17%, pharyngoplasty--17%) failed to be alleviated by a mean of 2.3 procedures (kenalog injection or scar excision) and required corrective bilateral Z-pharyngoplasty a mean of 9.2 months after the original surgery. Symptomatic grading of the nasopharyngeal stenosis improved from a mean score of 3.3 (severe stenosis) preoperatively to a score of 0.2 (minimal to no stenosis) in follow-up. Endoscopic stricture measurement improved from 6.1 x 6.3 mm preoperatively to 28.1 x 39.3 mm in follow-up. Bilateral Z-pharyngoplasty was effective in alleviating severe postsurgical nasopharyngeal stenosis.
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PMID:Amelioration of acquired nasopharyngeal stenosis, with bilateral Z-pharyngoplasty. 2048 3

Parkinson's disease is a common progressive neurodegenerative disease, of which the main neuropathological hallmark is dopaminergic neuronal loss. Increased attention has been directed towards non-motor symptoms in Parkinson's disease, such as cognitive impairment and behavioural disorders. Clinical and experimental findings support the view that the hippocampus, a temporal lobe structure involved in physiological learning and memory, is also implicated in the cognitive dysfunction seen in some patients with Parkinson's disease. Moreover, emerging data suggest interactions between the dopaminergic systems and the hippocampus in synaptic plasticity, adaptive memory, and motivated behaviour. This structure is also implicated in the pathophysiology of other non-motor symptoms, such as impulse control disorders, anosmia, and fatigue. Evidence from clinical observations and experimental studies suggest a complex hippocampal cross-talk among the dopaminergic and other transmitter systems. Furthermore, neurotrophic factors might interact with the hippocampal dopaminergic system having possible implications on the non-motor symptoms seen in patients with Parkinson's disease.
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PMID:New experimental and clinical links between the hippocampus and the dopaminergic system in Parkinson's disease. 2386 99

Sinusitis is defined as a condition manifested by inflammation of the mucous membrane of the nose & paranasal sinuses, fluid within this cavities and or underlying bone. Chronic rhinosinusitis is diagnosed by the presence of two or more of the following factors facial congestion/fullness, nasal obstruction, nasal discharge or discolored post nasal drainage, hyposmia/anosmia or one major and two of the following minor factors, headache. Halitosis, fatigue, dental pain, cough, ear pressure, fullness. The use of endoscope during surgery of nose & para nasal sinuses improves visualization enable greater preservation of normal structures and reduces the necessity for wide exposure. This cross-sectional study on 50 cases of chronic rhinosinusitis carried out during a period of 6 months. All the cases of both endonasal endoscopic sinus surgery (EESS) group and conventional group assessed clinically endoscopicaly and by imaging both pre and post-operative period. Twenty five cases were EESS group. Twenty five cases of conventional group. Follow-up frequencies are 1st week, 2nd week, 3rd week, 1st month, 3rd months, 6th months. In both type majority of patients in between 21-40 years, most of the cases were male, majority of patients present with headache (80)%, nasal discharge (70%), nasal obstruction (62%), major indication incase of EESS group were ethmoidal polyp 52% & conventional surgery group were chronic sinusitis (56%). Commonest complications were cheek swelling 10(40%) incase of conventional group, crusting 12(84%) in EESS group. Complete recovery incase of EESS were in 21(84%) cases and conventional surgery group 16(64%). Endonasal endoscopic sinus surgery has provided a safe & efficient method for dealing with different sinonasal diseases.
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PMID:Complications of endonasal endoscopic sinus surgery for management of nasal polyp and chronic sinusitis. 2485 47

The rate of Parkinson's Disease (PD) progression in the initial post-diagnosis years can vary significantly. In this work, a methodology for the extraction of the most informative features for predicting rapid progression of the disease is proposed, using public data from the Parkinson's Progression Markers Initiative (PPMI) and machine learning techniques. The aim is to determine if a patient is at risk of expressing rapid progression of PD symptoms from the baseline evaluation and as close to diagnosis as possible. By examining the records of 409 patients from the PPMI dataset, the features with the best predictive value at baseline patient evaluation are found to be sleep problems, daytime sleepiness and fatigue, motor symptoms at legs, cognition impairment, early axial and facial symptoms and in the most rapidly advanced cases speech issues, loss of smell and affected leg muscle reflexes.
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PMID:Predicting rapid progression of Parkinson's Disease at baseline patients evaluation. 2906 Jul 49


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