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This case report describes a 20-year-old woman who developed acute group B streptococcal endocarditis after a saline-induced abortion. She was admitted 2 weeks after an uncomplicated saline-induced abortion for a 16-week pregnancy with a 1-week history of fever, headaches, dizziness, and shortness of breath. The patient showed poor response to antibiotic therapies (initially to nafcillin and gentamicin and then to aqueous penicillin G). 6 to 6 blood cultures after hospital admission showed group B streptococcus which was penicillin sensitive by tetracycline resistant. On Day 3 of admission, a pericardial friction rub was noted and repeat chest x-rays showed marked enlargement of the cardiac shadow. Surgery was performed, and the mitral valve posterior leaflet was necrotic, and a mitral valve prosthesis was placed and an aortic embolectomy was performed. Postoperatively, she was treated with an additional 6-week course of intravenous penicillin, and subsequently, she has remained asymptomatic after 6 months. An addendum to this report, which was only the 2nd such report of endocarditis after saline abortion, describes another case of group B streptococcal endocarditis in a drug abuser after a saline-induced abortion. She required tricuspid valvulectomy and is slowly improving postoperatively.
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PMID:Malignant group B streptococcal endocarditis associated with saline-induced abortion. 38 76

During the winter months 1974/75 we were able to observe a number of unusual respiratory tract infections particularly in children over 6 years of age which appeared as pneumonias. Characteristic clinical findings included a dry, hacky cough, refractive to the usual antitussives, starting 1--2 weeks prior to admission, fever up to 104, malaise, headache, anorexia, shortness of breath and cyanosis. Several Pts were treated prior to admission with a number of antibiotics and failed to respond. Laboratory findings showed a peripheral polymorphonuclear leucocytosis with toxic granulations of neutrophiles. A sedimentation rate above 40 in the first hour occurred in most Pts. X Ray of the lung revealed a characteristic mottled appearance with patchy infiltrations, atelectasis and nodular densities. Frequently a shift of the mediastinum towards the infiltrate was seen. One of the hallmarks on physical examination was the discrepancy between the severity of the clinical illness and the paucity of physical findings. Decreased breath sounds over affected lung areas were often the only findings on auscultation; find rales, rhonchi or dullness on percussion were less often heard. The combination of a typical history, physical examination, laboratory tests and X Ray findings enabled us to make a presumptive clinical diagnosis of Mycoplasma pneumonia before serologic test results were available and to start with the appropriate antibiotic (Erythromycin, Tetracycline) early in the course of the disease. Complement fixation tests with a titer of 1 : 20 and a fourfold rise over the next two weeks or an initial titer of 1 : 80 and above were considered significant for acute disease.
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PMID:[Mycoplasma pneumonias in childhood (author's transl)]. 83 54

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

Five cases of poisoning by cypermethrin, a pyrethroid pesticide, are presented. The chemical was inadvertently introduced to the air-conditioning ducts and the patients inhaled it. Exposed patients experienced shortness of breath, nausea, headaches, and irritability. The exposure was compounded by repeated entry into the contaminated area and slow referral to a physician experienced in pesticide exposures.
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PMID:Five office workers inadvertently exposed to cypermethrin. 157 9

A case report of an urban family who experienced excessive exposure to organophosphate and carbamate pesticides is presented. All three family members developed symptoms that were compatible with cholinesterase inhibition: headache, lightheadedness, wheezing, shortness of breath, nausea, and fatigue. Serial measurement of red blood cell and serum cholinesterases soon after exposure and during subsequent months confirmed the diagnosis of pesticide poisoning. This report demonstrates that the misapplication of pesticides commonly used in residences in urban areas can cause acute pesticide poisoning and demonstrates the usefulness of repeated measurements of cholinesterase during the post-exposure period in establishing the correct diagnosis.
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PMID:Poisoning of an urban family due to misapplication of household organophosphate and carbamate pesticides. 158 78

The delayed health effects from accidental exposure to bromine vapors in a group of six people were evaluated. During the acute exposure, they had only some respiratory symptoms and skin burns of first to second degree involving small areas. All were treated in one hospital and released within 1-4 d. Six to 8 wk later, some still had health complaints such as cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, and memory, sleep, and sexual disturbances, but no objective laboratory or clinical evidence of effects. Mechanisms that might have led to manifestations of such complaints 1-2 mo after the accident are discussed and possible ways to alleviate similar situations are suggested.
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PMID:Delayed health sequelae of accidental exposure to bromine gas. 162 37

The effects of a 12-week aerobic exercise training protocol on 32 symptomatic women with mitral valve prolapse were studied. Subjects were randomly assigned to control or exercise groups. Exercise subjects completed a 12-week (3 times per week) exercise training program based on guidelines established by the American Heart Association for phase II cardiac rehabilitation programs; control group subjects maintained normal activities. Before and after training, subjects underwent maximal multistage treadmill testing, and measurements were obtained for plasma catecholamine levels at rest and during peak exercise; they completed the State Trait Anxiety Inventory and General Well-Being Schedule. Weekly symptom frequency of chest pain, arm pain, palpitations, shortness of breath, fatigue, headache, mood swings, dizziness and syncope were monitored for the 12-week period. Data were analyzed using multivariate analysis of variance, multivariate analysis of covariance, and analysis of covariance with repeated measures. Compared with control subjects, the exercise group showed a significant (p less than 0.05) decrease in State Trait Anxiety Inventory scores, an increase in General Well-Being scores, an increase in functional capacity and a decline in the frequency of chest pain, fatigue, dizziness and mood swings. No statistically significant differences were noted in catecholamine levels at rest or during peak exercise. These findings support the use of aerobic exercise in the management of symptomatic women with mitral valve prolapse.
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PMID:Effects of aerobic exercise training on symptomatic women with mitral valve prolapse. 201 86

Approximately 3,000 persons were evacuated from a Texas community after 24,036 kg (53,000 lb) of caustic hydrofluoric acid (HF) were released from a nearby petrochemical plant. Emergency room and hospital records of 939 persons who were seen at two area hospitals were reviewed. Most persons who presented at the emergency rooms were female (56%) or black (60%), and their mean age was 33.9 y. The most frequently reported symptoms were eye irritation (41.5%), burning throat (21%), headache (20.6%), and shortness of breath (19.4%). Physical examination results were normal for 49% of the cases; however, irritation of the eyes, nose, throat, skin, and lungs were noted on other exams. Decreased pulmonary function was demonstrated by pulmonary function tests (forced expiratory volume in the first second, less than 80% of predicted value, 42.3%); hypoxemia (pO2 less than 80 mm Hg, 17.4%) and hypocalcemia (less than 8.5 mg/dl, 16.3%) were also noted. Ninety-four (10%) of the cases were hospitalized, and more than 83% of all cases were discharged with a primary diagnosis of "HF exposure." There are several reports of individuals who are acutely and chronically exposed to HF; however, we are unaware of other published reports that describe exposure of a community to HF. This incident represented a unique opportunity to study the immediate health impact on a community of residents who were exposed to a hazardous materials release. Results of this analysis suggest that (a) initial health problems should be followed up, (b) any long-term health effects of HF exposure must be assessed, and (c) the health impact on the population at risk should be determined.
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PMID:Acute health effects in a community after a release of hydrofluoric acid. 203 70

The knowledge and opinions of health professionals of Botucatu about the frequency and severity of thirteen symptoms and signs of diseases were studied with a view to comparing then with the opinions of Botucatu's urban population. Four hundred and thirty-five active health professionals (physicians, nurses, nurse aides, health workers (orderlies) and others were interviewed. Most of them were women, with ages ranging from 25 to 44. The health workers (orderlies) were the most numerous category. In general, the last five symptoms included in the form: bloody sputum, vaginal bleeding, breast lump, seizures and bloody urine, were considered less frequent and more serious as compared with the first eight symptoms: shortness of breath, fever, weakness, back pain (backache), chest pain, headache, cough and diarrhoea. Among the categories, the physicians differed from the other categories in less frequently attributing high scores to frequency and severity. The clinicians gave more value to these two factors than the surgeons for almost all symptoms. The comparison with the opinions of the laymen interviewed showed similar tendencies although the laymen regarded frequency and severity as more significant.
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PMID:[Analysis of health and life conditions of the urban population of Botucatu, SP (Brazil). III. Knowledge and opinions of health professionals about symptoms of diseases, 1984]. 209 96

Health and environmental assessment of the consequences of accidental contamination of an area in the Negev desert is described and the effects of exposure to bromine vapor in 6 persons evaluated. They were only mildly affected during the acute spillage of the bromine, with some respiratory symptoms and first and second degree skin burns of small exposed areas on the legs. All were treated in hospital and were released within 1-4 days. 6-8 weeks later they demonstrated a complex array of complaints, including cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, memory disturbances, sleep and sexual disturbances. These complaints could not be substantiated by objective clinical or laboratory examination. There was thus obvious magnification of the complaints 1-2 months after the accident.
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PMID:[Late health sequelae of accidental bromine exposure]. 225 10


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