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Clinical, biochemical, haematological and erythrokinetic studies were performed on 63 adult males with prolonged lead exposure. Their most common symptoms and findings were abdominal pain (62%), gingival lead lines (48%), headache and/or dizziness (33%), muscle cramps (32%), anaemia (19%), and fatigue (18%). Colicky abdominal pain (27%) and gingival lead lines correlated with urinary lead excretion. Anaemia was mild, but more frequent in the subjects with the greatest urinary lead excretion. Other associated findings were: higher reticulocyte counts and more basophilic stippling of the RBCs, more sideroblasts and greater erythroid hyperplasia of the bone marrow, more reduction in 51Cr-tagged RBC survival time, smaller RBC mass, a more rapid plasma iron clearance, a greater plasma iron turnover and greater utilization of 59Fe in subjects with urinary lead excretion of greater than 100 microng/day in comparison with the remainder and normal controls. These findings suggest that minimal chronic exposure to lead causes an increased haemolysis with resulting increased production of erythrocytes.
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PMID:Chronic industrial exposure to lead in 63 subjects. I. Clinical and erythrokinetic findings. 103 Aug 53

Since the obstetrician has the first opportunity to influence the mother, he should be knowledgeable about breast-feeding. Prenatal preparation, discussion of fears and anxieties, and the provision of literature are outlined as elements of successful nursing. The anatomy and physiology of nursing include a discussion in lay terms of milk production and milk ejection (let down), nipple examination, nursing posture, simulated nursing technique, breast massage and manual expression. Elements of nursing during hospital stay discussed are parturition, the nursing staff, jack-nifing the infant in preparation for feeding, breaking suction, feeding schedule, milk tension, foremilk, ejection reflex and the formation of hindmilk, aids in milk ejection, frequency and length of feedings, the use of both breasts, the draught, demand feeding and rooming in, dehydration, brassiere, uterine cramps, sore nipples, prematurity, cesarean section, and multiple births. Infant requirements, jaundice, postpartum examination, stools, colic, rashes, medication, contraception, bottle-feeding, maternal diet, fatigue and stress, leaking, the working mother, solid foods, breast infection and weaning are discussed as a part of the posthospital period.
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PMID:The obstetrician's approach to the breasts and breastfeeding. 112 77

This study compared the mental health of 12 mothers who had infants with colic to 12 mothers of infants without colic. Colic was defined as infant fussing/crying of at least 2 hours/day for at least 5 out of 7 days, infant cry high-pitched and pain-sounding, and maternal report of infant inconsolability. Mental health was operationalized as scores on the Profile of Mood States and the Symptom Checklist-90R. Mothers of infants with colic had multidimensional psychological distress; they reported more bodily dysfunction, fears, disordered thinking, depression, anxiety, fatigue, hostility, impulsive thoughts and actions; and they had stronger feelings of personal inadequacy or inferiority. Implications for nursing research and practice are discussed in the context of study findings.
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PMID:Infant colic and maternal mental health: nursing research and practice concerns. 130 32

Health effects of occupational exposure to lead were investigated among 92 exposed workers in lead-acid battery factory and 40 nonexposed workers serving as a control group from an oil mill in Khartoum North industrial area. The two groups were closely similar in age, stature, body weight, and socioeconomic conditions. A highly significant increase (P less than .01) was recorded in blood lead, urinary coproporphyrin, and basophilic stippled red blood cells of the exposed group in comparison to the control group. Central nervous system symptoms (insomnia, fatigue, weakness, and drowsiness) were reported by 50% and other symptoms such as abdominal colic and constipation were reported by 41% of the exposed group. Blue line on the gum was detected only on 2% of the exposed group. Strong associations between exposure to lead and the prevalence of central nervous system symptoms, abdominal colic, and constipation were recorded. Exposure to exceedingly high levels of lead in the working environment causes adverse health effects.
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PMID:Effects of exposure to lead among lead-acid battery factory workers in Sudan. 376 35

The prevalence of lead induced subjective symptoms was evaluated by a standardised questionnaire in a group of 96 workers employed between nine and 45 years in a secondary lead smelting works. A control group of 96 non-lead exposed subjects, matched for age and sex, were chosen from the Glostrup population study. Blood lead concentrations were in excess of 60 micrograms/100 ml in about 30% of the lead workers. Zinc protoporphyrin levels were found to be higher than 500 mumol/Hb in nearly 18% of the lead workers. The prevalence of fatigue, headache, sleep disturbance, and digestive symptoms (constipation and colic) were not higher in the lead exposed group. The body weight showed no significant difference in the two groups. Nervousness was four times more frequent in the control group. The results indicate that subjective symptoms are useless as indicators of incipient lead poisoning.
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PMID:Subjective symptoms after long term lead exposure in secondary lead smelting workers. 687 Nov 20

A 45-year-old Korean man developed abdominal colic, muscle pain, and fatigue. Following a 3-week hospitalization, acute intermittent porphyria was diagnosed based on the symptoms and a high level of urinary delta-aminolevulinic acid (378 mumol/L [4.95 mg/dL]). However, discovery of an elevated blood lead level (3.7 mumol/L [76 micrograms/dL]) subsequently led to the correct diagnosis. No occupational source of lead exposure was identified. The patient reported ingesting a Chinese herbal preparation for 4 weeks prior to becoming ill. A public health investigation revealed that the source of lead exposure was hai ge fen (clamshell powder), one of the 36 ingredients of the Chinese herbal medicine. We used fluorescence image-based cytometry to determine the frequency distribution of the zinc protoporphyrin content in circulating red blood cells and found that 70% of the patient's cells contained elevated levels of zinc protoporphyrin, consistent with the duration of lead exposure and effect of lead on heme synthesis. Analysis of zinc protoporphyrin content in circulating red blood cell distributions may be useful in the diagnosis, therapy, and kinetic modeling of lead poisoning. Environmental lead poisoning is best addressed through the close collaboration of clinicians, public health specialists, and laboratory scientists.
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PMID:Lead poisoning due to hai ge fen. The porphyrin content of individual erythrocytes. 799 45

The majority of patients with multiple sclerosis (MS) experience genitourinary and bowel dysfunction over the course of their illness. Lower extremity pyramidal signs are excellent predictors of concurrent bladder dysfunction. Constipation is the most common bowel dysfunction, which results from a range of causes including pelvic floor spasticity, decreased gastro-colic reflex, inadequate hydration, medications, immobility, poor physical conditioning, and weak abdominal muscles. Despite the advent of new therapeutic modalities, the physician and patient commonly overlook sexual dysfunction. A detailed history of the patient is crucial to determine the cause of the dysfunction. Fatigue, pain, mood disorders, spasticity, bowel, and bladder dysfunction can all interfere with normal sexual functioning, and these subjects should be explored in detail in order to plan for proper treatment. Integrated treatment plans, often in conjunction with an urologist, can lead to amelioration of symptoms.
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PMID:Bladder, Bowel, and Sexual Dysfunction in Multiple Sclerosis. 1128 36

A total of 82 out-patients were examined for Giardia copro-antigens and 12 neonate stool samples as control. ELISA had a sensitivity of 100% and specificity of 91.67%. ELISA (O.D.) had neither significant correlation to Giardia cyst count, to stool consistency or presence of blood, mucus or fat in stool, nor to age but positive correlation to the severity of diarrhoea, colic, nausea, anorexia, weight loss, distension and fatigue. Giardia cyst count was higher in cases with loose stool, while ELISA (O.D.) correlated positively with symptoms except constipation and vomiting. The different in clinical outcome of giardiasis can be attributed, partially to strain differences and host resistance.
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PMID:Degree of symptoms versus copro-antigen levels in Giardia lamblia infection. 1588 Sep 96

Although knowledge of intestinal parasites predates Hippocrates, the Hippocratic Corpus provides the first scientific observations about the clinical perception and treatment of helminthic diseases. These observations follow the scientific principles of Hippocrates, the father of modern medicine, who relied on knowledge and observation. This article is based on a systematic study of the Hippocratic texts, and presents observations on diseases caused by intestinal parasites with respect to regularity of appearance, patient age, symptoms, and treatment. Three types of helminths are described: "helmins strongyle" (roundworm), "helmins plateia" (flatworm), and "ascaris" (which corresponds to Enterobius vermicularis). Helminthic diseases primarily appear during childhood, well after teething. The described systemic symptoms include weakness, sickness, discomfort, tiredness, anorexia, and emotional instability; gastrointestinal symptoms include change in bowel movements, vomiting, and colic pain in the epigastrium. We identified several accounts of cases of helminthic diseases in the Hippocratic texts. Of particular interest are the descriptions of a helminth emerging from a fistula in the navel region and the surgical treatment of helminthic diseases, reinforced by being described on a dedicatory inscription at the Asclepion in Epidaurus. We finally encountered the use of powerful purgatives as antihelminthics, which have been widely used, even into the 21st century.
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PMID:From the roots of parasitology: Hippocrates' first scientific observations in helminthology. 1791 92

Young-Jo, 83 years old, was the longest lived king of the Chosun Dynasty. Seungjeongwon Ilgi gives more detail about the diseases and prescriptions of Young-Jo. We could close look at what the Annals of the Chosun Dynasty just described that king received medical attention. In inspecting Jung-Jo`s constitution, to examine his medical history is very important. Yong-jo had a weak constitution, but he was always concerned about health care. Youn-jo complained of colic syndrom and heart fire when young; ascris and shoulder pain since middle age; severe fatigue and gait disturbance caused by edema in his latter years. During his last 20 years, he had taken and resorted to Ken-GongTang, the reason was not psychological disposion, but physical disease. Also, Yong-Jo's condition just before death could be assumed in Seungjeongwon Ilgi and Jonhyeongak Ilgi. According to continuous complaints such as edema of the lower limbs, faint(lethargy) and eating disorder caused by abnormal rising of GI (anorexia), we could presume that the cause of death was uremia. In addition, it has significance to correct feasible misconceaption about the cause of death grounded on The Annals of the Chosun Dynasty.
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PMID:[The medical history and the death cause of Young-Jo based on the Seungjeongwon Ilgi : royal secretariat logs)]. 2133 Jul 74


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