Cases reported "Occupational Diseases"

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1/18. decompression illness associated with underwater logging: 6 case reports from Kenyir Lake, malaysia.

    The formation of Kenyir Lake as part of a hydroelectric project in the 1980s caused much forest area to be submerged. From 1991, underwater divers were employed to log these sunken trees at depths of up to 100 meters. At least 6 mishaps involving underwater logging personnel were recorded from March 1994 to August 1996. We retrospectively reviewed 5 cases who were managed in Hospital Kuala Terengganu. The patients presented with marked cardiorespiratory and neurological disturbances. One diver died in the Hospital while another died at the recompression chamber. Three divers were treated with recompression and improved. Average delay before the start of recompression was 14 hours. Underwater logging has definite dangers and steps must be taken to ensure that both the divers and the equipment are appropriate for the task. Availability of a nearby recompression facility would greatly enhance the management of diving accidents, not only for commercial divers but also for recreational divers who frequent the islands nearby.
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2/18. Molecular evolutionary analysis of the complete nucleotide sequence of hepatitis B virus (HBV) in a case of HBV infection acquired through a needlestick accident.

    To elucidate needlestick transmission of hepatitis b virus (HBV), strains isolated from 1 physician who acquired HBV infection through a needlestick accident and 3 patients with chronic hepatitis B (donor patients A, B, and C) were tested using molecular evolutionary analysis based on full-length HBV genomic sequences. Nucleotide sequences of these isolates were aligned with 55 previously reported full-length genomic sequences. Genetic distances were estimated using the 6-parameter method, and phylogenetic trees were constructed using the neighbor-joining method. Strains isolated from patient A and the recipient pair were clustered within a closer range of evolutionary distances than were strains recovered from the recipient pair and patients B and C. Furthermore, strains from patient A and the recipient were also clustered on the S gene sequences of HBV. These results demonstrated that patient A alone was the source of direct transmission to the recipient. This approach can be used to investigate the transmission route of HBV.
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3/18. Cat cuddler's cough.

    pasteurella multocida typically causes cutaneous infections in humans following animal bites or scratches. Primary pulmonary disease, however, can occur in humans after inhalation of airborne particles or by aspiration of colonized or infected nasopharyngeal secretions containing this organism. Symptoms of P. multocida pulmonary infection in humans are variable, ranging from cough with or without hemoptysis to severe prostration. P. multocida infection of the lower respiratory tree has a predilection for elderly patients with underlying lung pathology, especially chronic obstructive pulmonary disease and bronchiectasis. This report reminds the clinician that P. multocida can cause pulmonary infection in patients without underlying lung disease, and stresses the importance of careful history when presented with an indolent infection.
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4/18. anaphylaxis after ingestion of sharon fruit.

    BACKGROUND: The sharon fruit is the edible fruit of the persimmon tree (diospyros kaki) which belongs to the ebenaceae family. There are few references of allergic reaction to this fruit. We introduce a case of a 33-years old man with a anaphylactic reaction immediately after ingestion of sharon fruit. methods: Skin prick test (SPT) were performed by prick by prick with sharon fruit, legumes, vegetables, and fresh fruit. The test was considered positive when the average diameter of the wheal was > 3 mm. serum-specific IgE was identified with use of the EIA, and SDS-PAGE immunoblotting. RESULTS: The skin by prick test with sharon fruit was positive in our case, and negative in five controls patients. Specific IgE in patient serum, assayed by EIA was positive for sharon fruit, but the results of immunoblotting were non-specific. CONCLUSION: We have introduced a cause of anaphylaxis by sharon fruit that suggest an IgE mediated hypersensitivity reaction.
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5/18. urticaria and rhinitis to shrubs of ficus benjamina and breadfruit in a banana-allergic road worker: evidence for a cross-sensitization between Moracea, banana and latex.

    BACKGROUND: We report the case of a road worker with a food allergy to banana, who developed urticaria and rhinitis when cutting shrubs of ficus benjamina and breadfruit. He did not develop an allergy to latex of hevea brasiliensis. RESULTS: Sensitization to latex of F. benjamina, H. brasiliensis, breadfruit and banana was demonstrated using skin tests and specific IgE measurements. RAST inhibitions procedures showed that specific IgE to breadfruit latex cross-reacted more strongly with latex of H. brasiliensis and banana than with latex of F. benjamina with the same extract. CONCLUSION: Given the wide distribution of Moracea trees in tropical regions, sensitization to latex of H. brasiliensis and banana could be a consequence of sensitization to Moracea members; F. benjamina does not seem to be the only Moracea responsible for cross-allergy with latex and fruit. Consequently, it seems interesting to test other members of the Moracea family in patients sensitized to latex of H. brasiliensis and banana. Sensitization to breadfruit could be a risk factor for sensitization to latex of H. brasiliensis.
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6/18. A novel case of mealworm-induced occupational rhinitis in a school teacher.

    A 47-year-old African American female elementary schoolteacher presented with itchy, watery eyes, rhinorrhea, postnasal drainage, and nasal congestion complicated by recurrent epistaxis for 2 months. She had similar symptoms the previous year from September to May but was symptom free during the summer. Her symptoms began within 1 hour after entering the classroom and improved in the evening at home, on weekends, and vacation. She denied symptoms around dust, freshly cut grass, or pets and had no prior history of underlying allergic rhinitis and asthma. She had a 20-pack-a-year smoking history but quit 1 1/2 years ago. A detailed history of her classroom environment revealed the presence of mealworms that were used to teach the children about life cycles. Physical exam revealed swollen, erythematous nasal turbinates but was otherwise unremarkable. Prick skin testing was positive for oak tree, grasses, feathers, and cockroaches. Mealworm whole body extracts were prepared using standard methodology. Titration intracutaneous skin testing revealed a positive reaction at a 1:1000 concentration associated with a large delayed reaction 8 hours later that persisted for 24 hours. Specific nasal provocation using acoustic rhinometry revealed a dose response change in nasal volume (48% decrease at 1:100; 53% decrease at 1:50) and cross-sectional area (32% decrease at 1:100; 48% decrease at 1:50) in response to mealworm challenge compared with a saline control. Removal of the mealworms from the classroom resulted in complete relief of her symptoms. This is the first reported case of mealworm-induced rhinitis in a schoolteacher. Because mealworm demonstrations are now part of the standard curriculum in public school elementary classrooms in ohio, it is important that school administrators recognize the sensitizing nature of these insects and their potential for causing allergic rhinitis and asthma in the workplace.
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7/18. Cross-reactivity between obeche wood (Triplochiton scleroxylon) and natural rubber latex.

    BACKGROUND: Several studies have shown that allergy to natural rubber latex is associated with cross reactivity to other plants. We have investigated a possible cross reactivity with a tree belonging to the sterculiaceae family, Tryplochiton scleroxylon, in a patient allergic to obeche wood, that began to suffer symptoms of allergy in contact with latex. methods: Determinations of specific IgE by CAP to obeche, natural rubber latex (NRL) and recombinant allergens of latex were done. immunoblotting was performed to study allergens detected by serum of our patient. CAP-inhibition methods were used to study cross-reactive between NRL and obeche wood. RESULTS: In obeche extract, 4 bands were found of an apparent molecular weight of 18, 38, 75 and 199 kDa. In NRL extract the allergens have a molecular weight around 18, 21, 32, 38, 60, 70 and 199 kDa. IgE to latex was almost completely inhibited (96%) by the obeche extract in CAP-inhibition studies. Using obeche extract as inhibitor, IgE binding to native hevein (nHevb 6.02) was reduced by 25%. CONCLUSIONS: The results obtained in CAP-inhibition demonstrate the existence of cross-reactivity between proteins in NRL and obeche wood. In our patient, a band of apparent molecular weight of 38 kDa could be the most important allergen.
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8/18. Occupational wood-dust sensitivity from euonymus europaeus (spindle tree) and investigation of cross reactivity between E.e. wood and artemisia vulgaris pollen (mugwort).

    A 44-year-old goldsmith suffered from rhinitis and conjunctivitis after having worked with wood dust from euonymus europaeus (E.e.) for 15 years. The material was used for drying pieces of jewelry. Very strong reactions could be seen after friction test, scratch test and nasal challenge using wood dust of E.e. RAST-class 3 could be measured with the serum of this patient using E.e. wood and artemisia vulgaris (A.v. pollen) allergen disks. RAST-inhibition, western-blot (WB) and immunoprint (IP) indicated common allergens in extracts of E.e. wood and A.v. pollen of different degree. In addition this study indicated that subjects suffering from A.v. pollen allergy also show sensitization to E.e. wood since in 22 of 37 A.v. pollen allergies A.v. (RAST class 2-4) IgE-antibodies could be seen. The present case probably demonstrates for the first time an IgE-mediated type I allergy to E.e. wood.
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9/18. Human pulmonary infection with corynebacterium equi.

    A 28 year old man with no underlying disease developed a cavity and multiple nodules in the lung from which corynebacterium equi was isolated. He experimented with organic solvents and microorganisms including corynebacterium species for several years. Computed tomography of his pulmonary lesions revealed that these nodules were related to the bronchial tree. Histologically, the lesions were compatible with nonspecific inflammatory changes. The clinician must suspect the pulmonary infections with corynebacterium species even if the patient has no underlying disease.
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10/18. allergens involved in occupational asthma caused by baby's breath (Gypsophila paniculata).

    Although the floral industry deals with many potential allergens, few examples of occupational asthma exist in this industry. A 22-year-old florist experienced symptoms of rhinitis, conjunctivitis, and asthma on exposure to baby's breath. To determine the contribution of baby's breath to the patient's symptoms, an extract of baby's breath was prepared. Prick skin tests with a 1:10(-5) wt/vol concentration of the extract produced an immediate response, whereas nonexposed atopic and normal control subjects did not react. The patient's asthmatic response to baby's breath was confirmed by bronchial challenge that caused an immediate fall in FEV1 of 26.2% from baseline after inhalation of 88 breath units of the extract. With a direct RAST, the patient's serum bound 38 times the amount of IgE bound by the negative control. IgE binding in the RAST was inhibited by the baby's breath extract but not by unrelated inhibitors (ragweed and tree pollens). immunoblotting demonstrated IgE binding to 13 protein bands in the extract with molecular weights ranging from 11.5 to 68 kd. serum from a patient previously reported to have sensitivity to baby's breath recognized five protein bands. Three proteins with molecular weights of 27, 31, and 37 kd were recognized by both patients' sera. We conclude that this patient developed IgE-mediated sensitivity to multiple allergens in baby's breath. This study confirms the importance of this plant as a potential cause of occupational asthma in the floral industry.
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