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In two female patients chronic mercurialism following topical application of skin bleachers for the treatment of freckles was diagnosed. Over 20 to 25 years 3 to 10% mercurial ointments were applied twice daily. Recurrent attacks of headache, dyspnoea and abdominal colic-like cramps had lead repeatedly to emergency hospitalisations, multiple medical check-ups and surgical exploratory procedures. The diagnosis of mercurialism was made clinically because of a slate-grayish skin hyperpigmentation in the presence of freckles, and the drug-history. Metallic deposits in facial biopsies were demonstrated by electron microscopy. On admission 15.4 microgram% and 5.0 microgram % total Hg respectively were found in the two patients (normal values up to 2.0 microgram %). Following D-penicillamine treatment the mercury excretion via the urine could be elevated up to 25 microgram %. Neither the slate-gray facial discoloration nor the neurasthenic complaints were affected by this therapeutic trial. In one patient, a maculo-papular drug-induced skin rash to D-penicillamine developed. Persistent unsolved neurological complaints and cramp-like abdominal pains should remind that percutaneous mercury intoxication through intact skin following skin bleachers is still possible today.
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PMID:[Chronic mercury poisoning following topical application of skin bleachers (author's transl)]. 44 53

Workers occupationally exposed to mercury vapours were examined. Concentrations of mercury vapours in the air in a plant producing thermometers did not exceed 0.02 mg/m3 whereas in a plant producing electrical lamps they ranged from 0.02 to 0.05 mg/m3. Most of the workers complained of nervous system disorders, especially of headaches, hypersensibility, dyssomnia, paresthesias. Subjective changes in form of some marks of central and peripheral nervous system impairment were found in more than 40% of working women exposed to mercury vapours, whereas in the control group--only in 4%. The symptoms of the central nervous system impairment were more frequent and diversified in the group of women working in the plant producing electrical lamps. In the EEG tests abnormal electroencephalograms amounted to 44.5%. The most frequent changes were of generalized nature (24.0%). Paroxysmal changes in form of the discharge of dysrhythmical function of theta and sharp waves, were found in 16.6%. In the control group changes in electroencephalograms were less frequent and comprised only 15.3% of those tested. Generalized and paroxysmal changes were also less frequent, 10.7% and 4.0%, respectively.
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PMID:[Evaluation of neurological status and EEG tests in workers exposed to metallic mercury vapors]. 70 94

A multicenter open trial involving 50 hypertension patients enabled evaluation of the efficacy and tolerability of Isoptine L.P. (sustained release verapamil) in mild to moderate essential hypertension. Following a 2-week placebo run-in period, patients were given Isoptine L.P. (240 mg/24 h) as a morning dose for 3 months, with a possible dose increase (360 mg/24 h) in case of diastolic blood pressure of 95 mmHg or more at the 30-day evaluation. Blood pressure was measured by mercury sphygmomanometer and, in 20 patients, by a Dinamap type Automatic device. After 3 months of treatment, blood pressure levels in supine and standing position, measured manually and automatically, showed a highly significant decrease, with a mean fall of 18.4 mmHg for systolic (13.7 percent) and 13.2 mmHg diastolic (-14.6 percent). 67 percent of patients were responders after 1 month of treatment and 79 percent at 3 months, including one-fifth at the dose of 360 mg/24 h. Seventeen patients, i.e. 34 percent, reported one or more adverse reactions. Among these, four patients had to stop treatment, twice because of headache and twice for constipation. Adverse events seen most frequently were constipation, headache, tiredness and vomiting. No cardiac adverse events were reported with the exception of one case of atrial premature contractions. The electrocardiogram revealed significant slowing of heart rate, as well as slight prolongation of PR and QT intervals and slight widening of the QRS complex. Tolerability on the basis of laboratory parameters was good.
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PMID:[Efficacy and tolerability of isoptine LP in mild to moderate hypertension. A multicenter study with 50 patients]. 130 Sep 22

Nowadays mercury poisoning usually results from the oral ingestion of methylmercury or from inhalation of mercury vapor. Mercury intoxication in a gold prospector after inhalation of mercury vapor is described. The patient presented a history of fever, tachypnea and headache. Despite the treatment with dimercaprol, penicillamine and intensive supportive care the patient died with symptoms of acute respiratory distress.
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PMID:[Acute lethal intoxication caused by mercury vapor]. 130 1

Most frequently encountered causes of intractable pain and intractable medical problems, including headache, post-herpetic neuralgia, tinnitus with hearing difficulty, brachial essential hypertension, cephalic hypertension and hypotension, arrhythmia, stroke, osteo-arthritis, Minamata disease, Alzheimer's disease and neuromuscular problems, such as Amyotrophic Lateral Sclerosis, and cancer are often found to be due to co-existence of 1) viral or bacterial infection, 2) localized microcirculatory disturbances, 3) localized deposits of heavy metals, such as lead or mercury, in affected areas of the body, 4) with or without additional harmful environmental electro-magnetic or electric fields from household electrical devices in close vicinity, which create microcirculatory disturbances and reduced acetylcholine. The main reason why medications known to be effective prove ineffective with intractable medical problems, the authors found, is that even effective medications often cannot reach these affected areas in sufficient therapeutic doses, even though the medications can reach the normal parts of the body and result in side effects when doses are excessive. These conditions are often difficult to treat or may be considered incurable in both Western and Oriental medicine. As solutions to these problems, the authors found some of the following methods can improve circulation and selectively enhance drug uptake: 1) Acupuncture, 2) Low pulse repetition rate electrical stimulation (1-2 pulses/second), 3) (+) Qi Gong energy, 4) Soft lasers using Ga-As diode laser or He-Ne gas laser, 5) Certain electro-magnetic fields or rapidly changing or moving electric or magnetic fields, 6) Heat or moxibustion, 7) Individually selected Calcium Channel Blockers, 8) Individually selected Oriental herb medicines known to reduce or eliminate circulatory disturbances. Each method has advantages and limitations and therefore the individually optimal method has to be selected. Applications of (+) Qi Gong energy stored paper or cloth every 4 hours, along with effective medications, were often found to be effective, as Qigongnized materials can often be used repeatedly, as long as they are not exposed to rapidly changing electric, magnetic or electro-magnetic fields. Application of (+) Qi Gong energy-stored paper or cloth, soft laser or changing electric field for 30-60 seconds on the area above the medulla oblongata, vertebral arteries or endocrine representation area at the tail of pancreas reduced or eliminated microcirculatory disturbances and enhanced drug uptake.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Common factors contributing to intractable pain and medical problems with insufficient drug uptake in areas to be treated, and their pathogenesis and treatment: Part I. Combined use of medication with acupuncture, (+) Qi gong energy-stored material, soft laser or electrical stimulation. 135 50

Three siblings with inhaled elemental mercury toxicity are described, and the signs and symptoms of mercury toxicity, interpretation of mercury concentrations, and management of elemental mercury exposure are reviewed. A 4-year-old girl was admitted to the hospital with a history of fever and increasing irritability, fatigue, malaise, insomnia, headache, anorexia, and ataxia. She was discharged two days later with a diagnosis of acute cerebellar ataxia. During the following 18 days, the child's condition worsened, and she was rehospitalized. Meanwhile her 11-year-old sister was hospitalized for evaluation of fatigue, weakness, lower back pain, and ataxia. The older girl's blood mercury concentration, at 5.5 micrograms/dL, was in the toxic range. Twenty-four-hour urine mercury screening confirmed mercury intoxication in both children. Questioning revealed that the girls' brother had recently spilled 0.5-1 oz of elemental mercury in the house. All family members underwent blood and urine mercury testing. The brother underwent a dimercaprol challenge to determine his tissue mercury burden, which was found to be greater than 2.4 micrograms/dL. The sisters underwent two courses of chelation therapy with dimercaprol. Symptoms persisted in all three children, and they underwent five 10-day cycles of N-acetyl-D,L-penicillamine (NAP) therapy; the youngest underwent a third dimercaprol regimen. All siblings continued NAP chelation therapy because of extensive tissue mercury burden until the results of repeated urine mercury concentration determinations were normal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Elemental mercury poisoning. 174 59

The study was carried out in 89 men aged 21 to 57 years with a history of exposure to mercury vapour from 2 to 26 years during occupational work involving chlorine production by the method of mercury electrolysis. The workers were divided into three groups depending on the duration of occupational exposure: 1) 32 workers with a short history of exposure 2-10 years, 2) 37 workers with medium-long exposure - 11-20 years, and 3) 20 workers with a history of long exposure - 21-26 years. The urinary concentrations of mercury in these individuals was 73 +/- 60 microliters x 1(-1), and in blood this concentration was not exceeding 50 microliters x 1(-1). The control group comprised 40 men aged 17 to 52 years. They had not had any occupational exposure to chemicals, or harmful physical factors. On the basis of clinical, haematological and biochemical studies 89 workers with occupational exposure to mercury vapour were regarded as clinically healthy. None of them had any symptoms and signs of the complete neurasthenic syndrome or organic brain injury. Increased nervous excitability was the complaint of 24 workers, 9 had headaches, sleep disturbances were reported by 5, and a feeling of tiredness and apathy was mentioned by 5 men. EEG recording demonstrated 81 normal tracings, and moderately pathological records in 8 men. The parameters of immunity and proteins acute phase reaction were determined, measuring the concentration of immunoglobulins, lysozyme, C3c, C4, alpha 1-acid glycoprotein, haptoglobin and ceruloplasmin in serum. A lower level of IgA, IgG and lysozyme was only noted in individuals with occupational exposure exceeding 20 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Parameters of immunity acute phase reaction in men in relation to exposure duration to mercury vapours. 172 75

We assessed the efficacy of long-acting nifedipine as monotherapy in 52 patients with mild to moderate essential hypertension in a randomized, controlled crossover study. Good blood pressure control was achieved in 34 of 40 patients (85%) receiving nifedipine (mean daily dose, 52 mg in 2 divided doses) compared with 23 of 40 patients (58%) receiving metoprolol (mean daily dose, 155 mg in 2 divided doses). After treatment for 4 weeks, the mean blood pressures with nifedipine (149.7 +/- 16.6/88.7 +/- 11.1 mm of mercury) and metoprolol administration (163.9 +/- 23.3/94.2 +/- 10.2 mm of mercury) were significantly lower than with placebo (176.7 +/- 17.3/100.9 +/- 7.1 mm of mercury) (P less than .05). The mean systolic pressure during nifedipine treatment was 14.2 mm of mercury lower (95% confidence interval [CI], 3.9 to 24.5 mm of mercury) and mean diastolic pressure 5.5 mm of mercury (95% CI, 0.3 to 10.7 mm of mercury) lower than with metoprolol therapy. Both drugs were reasonably well tolerated, and intolerance requiring withdrawal was encountered in 3 of 45 (7%) patients receiving nifedipine, compared with 1 of 45 (2%) of those taking metoprolol and placebo, respectively. Adverse effects of nifedipine, most of which were transient, included palpitations, headache, facial flushing, and ankle edema. Long-acting nifedipine is a promising agent when given alone for mild to moderate hypertension and can be safely administered in clinical practice.
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PMID:Long-acting nifedipine versus metoprolol as monotherapy for essential hypertension. A randomized, controlled crossover study. 240 30

Nineteen caisson workers had been exposed to metallic mercury vapours while digging tubes underneath the first district of Vienna (exposure between 470 and 2440 min; mean 1621 min). The blood mercury values on admission were between 29 and 166 micrograms/l (mean 75 +/- 34 micrograms/l). The main findings reported are clinical neurologic symptoms, psychic complaints, neurographic results and autonomic parameters (cardiovascular reflexes): 47% complained of headache and tiredness, 37% showed tremor and suffered from sleep disturbances, 26% showed hypersalivation, 16% changes in handwriting, and 11% slight dysarthria. The cardiovascular reflexes (autonomic parameters) were abnormal in 7 of 12 patients. On neurography the distal latency (median nerve) was pathologic in 47%, the distal latency (peroneal nerve) was pathologic in 26%, the antidromic sensory nerve conduction velocity (median nerve) was abnormal in 10%, the motor nerve conduction velocity, compound amplitude and vibratory threshold were normal.
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PMID:[Neurologic symptoms in inhalation poisoning with metallic mercury]. 340 53

On the basis of neurological, psychological and electroencephalographic investigations the authors present an assessment of the state of the nervous system in 24 males observed in hospital for suspected chronic intoxication with metallic mercury. The most frequent symptoms were: headaches and dizziness (17 cases), recent memory disturbances (16) and irritability (15). Cerebellar signs were found in 13 cases, one eeg record was abnormal, in 4 cases the eeg was borderline normal. Psychological tests revealed in 21 cases evidence of organic brain damage with slowing down of the simple visual and auditory reactions (16), disturbances of recent memory and persistent attention (14), decreased intellectual efficiency (7) and visual perception (5). The authors call attention to the necessity of appropriate prevention of mercury poisoning in view of its selective neurotoxicity and irreversibility of the pathological changes. The importance of psychological testing for psychological testing for the correct assessment of the status of the nervous system in cases of metallic mercury poisoning is stressed.
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PMID:[Chronic toxic encephalopathies caused by metallic mercury]. 358 17


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