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Query: UMLS:C0015672 (fatigue)
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Crosslinking of collagenous biomaterials currently employs the use of glutaraldehyde. The putative enhancement of glutaraldehyde crosslinking by lysine was investigated in three model systems: bovine pericardium, collagen membranes, and bovine serum albumin. Repetitive sequential treatment of bovine pericardium with glutaraldehyde and lysine and finally with formaldehyde produced a matrix which, by the two criteria used (shrinkage temperature and urea/SDS soluble collagen), was shown to be more highly crosslinked than pericardium fixed in glutaraldehyde alone. Essentially the same results were obtained when membranes prepared from pepsin-soluble pericardial collagen were subjected to sequential glutaraldehyde and lysine treatments, reaching shrinkage temperatures of more than 90 degrees C. Heart valves prepared from lysine-enhanced glutaraldehyde crosslinked bovine pericardium were tested in vitro in an accelerated fatigue tester and have been shown to behave satisfactorily after 300 million cycles. These additional crosslinks proved to be stable in saline at 37 degrees C. Studies on bovine serum albumin attempted to get an insight into the mechanisms of lysine enhancement of glutaraldehyde crosslinking by treating sequentially albumin with glutaraldehyde and lysine and analysis of the products by gel filtration and SDS-PAGE. These studies suggest that free amino groups exposed by proteins are initially reacted with glutaraldehyde and then bridged by the diamino compound (lysine) producing more extensive intermolecular crosslinking than glutaraldehyde alone.
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PMID:Lysine-enhanced glutaraldehyde crosslinking of collagenous biomaterials. 179 97

An outbreak of complaints consisting primarily of eye and respiratory tract irritation accompanied by headache, dizziness, fatigue, and nausea occurred among the operating room personnel of a large metropolitan hospital. This initially was attributed to infiltration of diesel exhaust emissions into the ventilation system. However, following correction of this problem and subsequent unrevealing air monitoring, symptoms persisted and were noted in personnel in adjacent areas of the hospital as well. An industrial hygiene and medical evaluation was undertaken. Monitoring for carbon monoxide, formaldehyde, and anesthetic gases and review of medical records and patient examinations were unrevealing, and the problem resolved gradually over several weeks. This outbreak represents a case of building-associated illness among health professionals in a hospital setting that was triggered by a single, identifiable noxious exposure but was sustained despite any apparent ongoing noxious exposures.
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PMID:Sick-hospital syndrome. 186 55

Outbreaks of acute illness among office workers have been reported with increasing frequency during the past 10-15 years. In the majority of cases, hazardous levels of airborne contaminants have not been found. Generally, health complaints have involved mucous membrane and respiratory tract irritation and nonspecific symptoms such as headache and fatigue. Except for rare examples of hypersensitivity pneumonitis related to microbiologic antigens, there have been no reports of serious morbidity or permanent sequelae. However, the anxiety, lost work time, decreased productivity and resources spent in investigating complaints has been substantial. NIOSH has reported on 446 Health Hazards Evaluations that were done in response to indoor air complaints. This data base is the source of most of the published accounts of building-related illness. Their results are summarized here with a discussion of common pollutants (tobacco smoke, formaldehyde, other organic volatiles), and the limitations of the available industrial hygiene and epidemiologic data. There has been one large scale epidemiologic survey of symptoms among office workers. The results associate risk of symptoms to building design and characteristics of the heating/air-conditioning systems, consistent with the NIOSH experience. Building construction since the 1970s has utilized energy conservation measures such as improved insulation, reduced air exchange, and construction without opening windows. These buildings are considered "airtight" and are commonly involved in episodes of building-associated illness in which no specific etiologic agent can be identified. After increasing the percentage of air exchange or correcting specific deficiencies found in the heating/air-conditioning systems, the health complaints often resolve, hence, the term "tight building syndrome" or "sick building syndrome."(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sick building syndrome: acute illness among office workers--the role of building ventilation, airborne contaminants and work stress. 219 1

The "sick building syndrome" involves symptoms such as eye, skin and upper airway irritation, headache, and fatigue. A multifactorial study was performed among personnel in consecutive cases of sick buildings to investigate relationships between such symptoms, exposure to environmental factors, and personal factors. The total indoor hydrocarbon concentration was significantly related to symptoms. Other indoor exposures such as room temperature, air humidity, and formaldehyde or carbon dioxide concentration did not correlate with the symptoms. Personal factors such as reported hyperreactivity and sick leave due to airway diseases were strongly related to the sick building syndrome. Other factors associated with the sick building syndrome were smoking, psychosocial factors, and experience of static electricity at work. Neither atopy, age, sex, nor outdoor exposures correlated significantly with the number of symptoms. It was concluded that the sick building syndrome is of multifactorial origin and related to both indoor hydrocarbon exposure and individual factors.
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PMID:Indoor air quality and personal factors related to the sick building syndrome. 235 95

A total of 19,252 stool specimens from 12,136 patients were examined by direct microscopy and the ethyl acetate-Formalin concentration method during the last 2 years. All liquid specimens and those in which parasite identification was difficult or equivocal were also examined in trichrome-stained preparations. A total of 3,070 intestinal parasites were seen in 2,889 patients. Blastocystis hominis was found in fecal material from 647 patients (17.5%). A total of 132 cases (25.6%) were observed to be in association with other enteric pathogens. B. hominis in large numbers was present as the only parasite or with other commensals in 515 specimens from patients (79.6%). Of these patients, 239 (46.4%) had symptoms, the most common being abdominal pain (87.9%), constipation (32.2%), diarrhea (23.4%), alternating diarrhea and constipation (14.5%), vomiting (12.5%), and fatigue (10.5%). Forty-three (18%) of the patients were treated with metronidazole (0.5 to 1.0 g/day) because of recurrent symptoms and the presence of large numbers of B. hominis cells in repeated stool specimens. After 7 to 10 days of treatment, all patients became asymptomatic with negative stools on follow-up examinations for B. hominis.
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PMID:Clinical significance of Blastocystis hominis. 235 28

The prevalence of certain symptoms (eye, skin and airway symptoms, headache, nausea, and fatigue) were studied among hospital workers with and without exposure to glutaraldehyde during cold sterilization work. The exposure to glutaraldehyde and formaldehyde was quantified by hygienic measurements in the breathing zone of the workers. Aldehydes were measured by a specific method, using sorbent tubes with Amberlite XAD-2 coated with 2,4-dinitrophenylhydrazine (2,4-DNF) and analyzed by liquid chromatography. The exposure measurements revealed that the present exposure to glutaraldehyde was intermittent and well below the Swedish occupational exposure limit. In spite of this low exposure, the exposed group exhibited a significantly increased frequency of skin and airway symptoms, as well as headache, in comparison with the unexposed group. A dose-response relationship between the frequency of exposure and the number of symptoms could also be demonstrated. No case of contact allergy to glutaraldehyde was found.
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PMID:Skin and respiratory symptoms from exposure to alkaline glutaraldehyde in medical services. 297 45

Twenty-one subjects exposed to formaldehyde (at levels between 0.12 and 1.6 parts per million [ppm]) in two mobile trailers and the remaining 18 unexposed workers of the same workforce were examined by questionnaire and spirometry. Symptoms of eye and throat irritation and increased headache and fatigue were significantly more common among the exposed group than the comparison group. Irritation of the nose, chest tightness, and shortness of breath were also more common among the exposed. Spirometry revealed no decrease in ventilatory function among the exposed workers. The significant increase in frequency of individuals with symptoms indicated an adverse health effect from exposure to formaldehyde at levels between 0.12 and 1.6 ppm. This may have implications regarding the adequacy of the US permissible exposure limit value and suggests the need for further examination of the health effects of formaldehyde in the nonoccupational environment.
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PMID:Health effects of low-level exposure to formaldehyde. 665 25

A questionnaire study among 70 employees at seven mobile day care centers where urea formaldehyde glued particle board has been used for indoor paneling and among 34 employees at three control institutions selected at random where no particle board has been used as building materials, showed a significantly higher frequency of the following symptoms among the staff at the mobile institutions: mucous membrane irritation, headache, abnormal tiredness, menstrual irregularities and use of analgetics (p less than 0.01). As there was no difference in the age distribution or smoking habits of the two groups working in day care institutions from the same geographical locations, we are, therefore, of the opinion that the differences in the frequency of symptoms discovered must be attributed to the differences in the indoor climate conditions prevalent in the institutions. The median concentration of formaldehyde in the mobile institutions was 0.43 mg/m3 in contrast to a concentration in the control institutions of about 0.08 mg/m3. We assume, therefore, that the higher concentration of formaldehyde in the mobile institutions was a cause of the increased frequency of symptoms among the staff. The National Health Service should be aware of the fact that non-specific symptoms such as headache and abnormal tiredness can be the result of unfavorable indoor climate conditions due to the presence of formaldehyde in building materials.
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PMID:Formaldehyde induced symptoms in day care centers. 709 Sep 90

Diesel exhaust is a common air pollutant and work exposure has been reported to cause discomfort and affect lung function. The aim of this study was to develop an experimental setup which would allow investigation of acute effects on symptoms and lung function in humans exposed to diluted diesel exhaust. Diluted diesel exhaust was fed from an idling lorry through heated tubes into an exposure chamber. During evaluations of the setup we found the size and the shape of the exhaust particles to appear unchanged during the transport from the tail pipe to the exposure chamber. The composition of the diesel exhaust expressed as the ratios CO/NO, total hydrocarbons/NO, particles/NO, NO2/NO, and formaldehyde/NO were almost constant at different dilutions. The concentrations of NO2 and particles in the exposure chamber showed no obvious gradients. New steady state concentrations in the exposure chamber were obtained within 5-7 min. In a separate experiment eight healthy nonsmoking subjects were exposed to diluted exhaust at a median steady state concentration of 1.6 ppm NO2 for the duration of 1 h in the exposure chamber. All subjects experienced unpleasant smell, eye irritation, and nasal irritation. Throat irritation, headache, dizziness, nausea, tiredness, and coughing were experienced by some subjects. Lung function was not found to be affected during the exposure. The experimental setup was found to be appropriate for creating different predetermined steady state concentrations in the exposure chamber of diluted exhaust from a continuously idling vehicle. The acute symptoms reported by the subjects were relatively similar to what patients reported at different workplaces.
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PMID:Evaluation of an exposure setup for studying effects of diesel exhaust in humans. 780

A number of reports over the last several years have linked a previously unidentified acid-fast organism with prolonged diarrhea in humans. Initially thought to be a cyanobacterium, the organism has been identified as a coccidian protozoan of the genus Cyclospora, and the name Cyclospora cayetanensis has been proposed. Organisms that resemble Cyclospora protozoa have been discovered in human stool samples around the world and have been isolated from children, immunocompetent adults, and human immunodeficiency virus (HIV)-seropositive individuals. The apparently waterborne organisms cause disease predominantly in summer months. In wet mounts of fresh stool specimens, the organisms are wrinkled spheres of 8-9 microns in diameter, with well-defined nonrefractile external walls and internal granular material, and resemble large oocysts of Cryptosporidium species. Organisms fluoresce under ultraviolet illumination. Formalin-preserved oocysts are variably acid-fast, and the results of staining with the modified carbolfuchsin technique (which is used to stain Cryptosporidium species) range from no staining to deep-red staining. The clinical syndrome is characterized by watery diarrhea (approximately 6 stools/day), nausea, anorexia, abdominal cramping, fatigue, and weight loss. Diarrhea appears to be self-limiting in the immunocompetent host but may be prolonged in patients with advanced HIV infection. Symptoms have abated in a handful of people treated with trimethoprim-sulfamethoxazole. Many questions remain to be answered about this newly identified pathogen.
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PMID:Cyclospora: a newly identified intestinal pathogen of humans. 803 19


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