Noxious Exposure Research Articles

Rembrandt’s Anatomy Lesson of Dr. Tulp Revisited: Advancements in Teaching Anatomy and Neurobiology in an Integrated Medical Curriculum in the 21st Century.

The recent challenges in anatomy and neurobiology education in medical curricula have imposed a curricular redevelopment in delivery and content, incorporating modules in virtual anatomy and neurobiology, didactic lecture and enhanced cadaveric dissection in a state-of-the-art teaching and learning environment. The combined approach engaged active student participation at each phase of the course, incorporated clinical perspectives, emphasized valuable diagnostic and surgical techniques and procedures, and minimized noxious exposure to formaldehyde by using unembalmed cadavers in a laminar airflow environment. Finally, the objectives of emphasizing the importance of proficiency in anatomy knowledge in clinical medicine were accomplished well within the allocated one semester time frame, in a timely, cost and resource effective manner, and with demonstration of competency to standard during post laboratory examinations.

Vaccination control measures of an epidemic model with long-term memristive effect

COVID-19 is a drastic air-way tract infection that set off a global pandemic recently. Most infected people with mild and moderate symptoms have recovered with naturally acquired immunity. In the interim, the defensive mechanism of vaccines helps to suppress the viral complications of the pathogenic spread. Besides effective vaccination, vaccine breakthrough infections occurred rapidly due to noxious exposure to contagions. This paper proposes a new epidemiological control model in terms of Atangana Baleanu Caputo (ABC) type fractional order differ integrals for the reported cases of COVID-19 outburst. The qualitative theoretical and numerical analysis of the aforesaid mathematical model in terms of three compartments namely susceptible, vaccinated, and infected population are exhibited through non-linear functional analysis. The hysteresis kernel involved in AB integral inherits the long-term memory of the dynamical trajectory of the epidemics. Hyer–Ulam’s stability of the system is studied by the dichotomy operator. The most effective approximate solution is derived by numerical interpolation to our proposed model. An extensive analysis of the vigorous vaccination and the proportion of vaccinated individuals are explored through graphical simulations. The efficacious enforcement of this vaccination control mechanism will mitigate the contagious spread and severity.

Prompt Resolution of Chronic Rhinosinusitis with Nasal Polyposis and Chronic Bronchitis After First Dose of Benralizumab

Several mAB therapies are approved for treatment of moderate to severe eosinophilic asthma. Clinical trials investigating their efficacy in chronic rhinosinusitis and nasal polyps are encouraging and continued trials are underway. We present a patient treated with benralizumab for refractory nasal polyps and non-allergic, non-asthmatic chronic respiratory symptoms. His symptoms began after noxious exposure to mold, and were associated with eosinophilic polyp tissue and elevated peripheral eosinophil count. He is a never-smoker, fit and healthy ex-military officer with no history of allergic rhinitis or asthma. A PubMed review of all articles reporting data on the use of biologic therapies for nasal polyps and chronic rhinosinusitis with or without nasal polyposis was conducted. A 53-year-old man had been aggressively treated with 8 courses of antibiotics, oral and topical steroids, sinus surgery, and ICS/LABA for sudden onset and refractory chronic rhinosinusitis with eventual development of recurrent nasal polyps and fixed airway obstruction over a period of 2.5 years. Following the 1st dose of benralizumab his symptoms, nasal polyps, and airway obstruction improved dramatically. Upper airway rhinitis and PND as well as lower airway wheezing resolved within 17 days. After 3 months of treatment his spirometry was unobstructed with normal FEV1 (+24% from baseline), and minimal polyp tissue was visible on endoscopic exam. After 12 months benralizumab therapy was stopped. Physicians should consider a trial of anti-eosinophil mABs in patients with nasal polyps especially if there is evidence of eosinophilic inflammation of the upper or lower airway.

ROMANIAN AWARENESS CAMPAIGNS FOR EARLY DETECTION OF OBSTRUCTIVE LUNG DISEASE

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Obstructive Lungs Diseases are a major health problem and knowing its prevalence is extremely useful in health services planning. On World Asthma and COPD Days, Romanian Society of Pneumology (SRP) organized awareness campaigns consisting of press conference, radio campaign, dedicated website, free testing (spirometry) for general public. The aims of the study were (1) to identify subjects with airflow limitation, (2) to assess the relationships between the presence and severity of respiratory symptoms and spirometry values. METHODS: Spirometry and questionnaire has been performed in 2017. The questionnaire has 17 questions and addresses different issues, like possible suggestive symptoms, risk factors (smoking, noxious exposure, history of allergy), previous lung function tests, known obstructive lung disease, history of exacerbations, existence of any check-up or respiratory therapy. Statistical analysis has been done using Microsoft Office Excel 2007. RESULTS: A total of 650 persons with mean age = 60.4 ± 15.2 years were screened by spirometry, of which 33.3% (217) had lung function impairment with mean FEV1 = 67.6 ± 14%. From symptomatic ones 53.5% (239) had dyspnea, 66.2% (294) cough, 40.5% (181) chest tightness and 41.2% (184) wheezing. Although 31.7% (206) were symptomatic with smoking history, only 17% (35) of them had performed spirometry in the last 6 months. Moreover, 44% (286) were symptomatic with normal lung function and 23.7% (154) previously undiagnosed patients were detected with abnormal spirometry. Even if 20.6% (134) cases had diagnosis of lung disorder (37-asthma, 21-COPD, 5-emphysema, 71-bronchitis) only 52 had treated their disease and 24 had performed spirometry in the last 6 months. CONCLUSIONS: Disease severity: 73.7% (479) had at least an exacerbation/year, 28.2% received antibiotic treatment, 7% presented to the emergency room, 2.7% required hospitalization.Treating obstructive lung disease is still deficitary in Romania, pulmonologists was responsible for managing these disorders in less than 50% of cases. Atopies are more frequent in women, as well as tendency to be treated and seeing by physicians on regularly basis, for assessing asthma control. CLINICAL IMPLICATIONS: Epidemiological data on Obstructive Lung Disease prevalence are limited in Romania. Despite being a major health problem, its expected burden will increase in the coming decades, mostly due to continued exposure to risk factors, missed or delayed diagnosis, social and economical conditions. The campaigns were usefully for detecting new cases, but also for already diagnosed cases, who were not followed up properly, regarding treatment or assessing control. DISCLOSURES: No relevant relationships by Florin Mihaltan, source=Web Response No relevant relationships by RAMONA ELENA NEDELCU, source=Web Response No relevant relationships by Roxana Maria Nemes, source=Web Response No relevant relationships by Ruxandra Ulmeanu, source=Web Response

Noxious Chemical Exposure Trends as Measures of Green Victimization: Public Health, National Health and Nutrition Examination Survey Trends, and Green Criminology

Green criminologists have argued that exposure to environmental pollution constitutes a serious form of green victimization of the general public and public health. This claim has not been widely assessed empirically. The present study employs data from the National Health and Nutrition Examination Survey (NHANES) over time to examine trends in exposure to environmental toxins among the U.S. population. NHANES data allow such an assessment through the collection of biological sampling used to determine exposure to environmental toxins. We examined trends for NHANES exposure estimates for biological indicators of pollutant exposure over time for 64 chemicals that have multiple measures. We divide the exposure trends into declining, stable, increasing, and unclear trajectory patterns and discuss the health consequences associated with exposure to measured chemical exposures. Discussion of the implications of this analysis and the need for future studies is provided.

The relationships between worry, happiness and pain catastrophizing in the experience of acute pain

The current study aimed to (a) evaluate the effects of an experimental manipulation of worry and happiness on pain perception and measures of worry about pain and pain catastrophizing and (b) determine if changes in situation-specific worry about pain and pain catastrophizing would be related to changes in acute pain. The study included 120 healthy, pain-free volunteers. Participants were exposed to four levels of noxious stimulation and asked to report on the pain intensity, worry about pain and pain catastrophizing they experienced during the stimulation procedures. They were then randomly assigned to either a Happy or a Worry condition, where they were exposed to emotion induction procedures. The noxious exposure procedures and measures of pain, pain-related worry and pain catastrophizing were then repeated. Participants in the Worry condition reported significant increases in pain intensity, and those in the Happy condition reported significant decreases in pain intensity. Further, the Worry condition participants reported significant increases in both pain-related worry and pain catastrophizing, while the Happy condition showed the opposite effects. Finally, changes in worry about pain and pain catastrophizing were found to mediate the impact of the affect induction procedure on pain intensity. The findings demonstrate that pain intensity, worry about pain and pain catastrophizing are all sensitive to changes in mood. The results have potential clinical implications. The current study shows that manipulation-induced changes in pain-related worry, pain catastrophizing, and affect have direct effects on the experience of acute pain. More broadly, the overlap of these three variables provides with anxiety and mood disorders offers the promise of new vistas for research and treatment of pain conditions by assessing and targeting the cognitions and behaviors that are common to worry and catastrophizing.

Ultrathin microwave absorber based on metamaterial

We suggest that ultrathin broadband metamaterial is a perfect absorber in the microwave regime by utilizing the properties of a resistive sheet and metamaterial. Meta-atoms are composed of four-leaf clover-shape metallic patterns and a metal plane separated by three intermediate resistive sheet layers between four dielectric layers. We interpret the absorption mechanism of the broadband by using the distribution of surface currents at specific frequencies. The simulated absorption was over 99% in 1.8–4.2 GHz. The corresponding experimental absorption was also over 99% in 2.62–4.2 GHz; however, the absorption was slightly lower than 99% in 1.8–2.62 GHz because of the sheet resistance and the changed values for the dielectric constant. Furthermore, it is independent of incident angle. The results of this research indicate the possibility of applications, due to the suppression of noxious exposure, in cell phones, computers and microwave equipments.

Work-associated irritable larynx syndrome.

The purpose of this study is to review the relevant literature concerning work-associated irritable larynx syndrome (WILS), a hyperkinetic laryngeal disorder associated with occupational irritant exposure. Clinical symptoms are variable and include dysphonia, cough, dyspnoea and globus pharyngeus. WILS is a clinical diagnosis and can be difficult to differentiate from asthma. Treatment options for WILS include medical and behavioural therapy. Laryngeal-centred upper airway symptoms secondary to airborne irritants have been documented in the literature under a variety of diagnostic labels, including WILS, vocal cord dysfunction (VCD), laryngeal hypersensitivity and laryngeal neuropathy and many others. The underlying pathophysiology is as yet poorly understood; however, the clinical scenario suggests a multifactorial nature to the disorder. More recent literature indicates that central neuronal plasticity, inflammatory processes and psychological factors are all likely contributors. Possible mechanisms for WILS include central neuronal network plasticity after noxious exposure and/or viral infection, inflammation (i.e. reflux disease) and intrinsic patient factors such a psychological state. Treatment is individualized and frequently includes one or more of the following: environmental changes in the workplace, GERD therapy, behavioural/speech therapy, psychotherapy counselling and neural modifiers.

Work stress related lipid disorders and arterial hypertension in professional drivers: A cross-sectional study

Occupational stress is a term used to define ongoing stress that is related to the workplace. The study was conducted to determine association of occupational stress index (OSI) and its aspects with arterial hypertension and lipid disorders using data from a cross-sectional survey of male professional drivers. The cross-sectional study was performed in 439 professional drivers divided into groups (city- and intercity bus drivers, truck and taxi drivers). The OSI and OSI aspects (high demands, strictness, underload, extrinsic time pressure, noxious exposure, avoidance and conflict) were calculated using the standardized questionnaire. Determination of serum lipids, blood pressure (BP) and cardiovascular risk factors were done. A significant difference in prevalence of diagnosed hypertension and dyslipidemia was found along with a difference in total OSI and OSI aspects among examined subgroups of drivers. A total OSI was highest in city, high in intercity bus drivers, and the lowest one in truck and taxi drivers (82.79 +/- 3.5, 81.28 +/- 3.7, 73.75 +/- 3.5, 71.61 +/- 4.4, respectively; p < 0.01). Similar pattern showed triglycerides (TG), total cholesterol (TC) and LDL cholesterol and BP, while HDL-cholesterol showed reverse order (p < 0.01). Logistic regression analyses with multiple OSI aspects adjusted for age and years of exposure showed associations of total OSI with arterial hypertension [OR 5.5; 95% CI (2.24-7.95)] and dyslipidemia [OR 1.43 95% CI (1.09-2.80)]. Underload was the most important OSI aspect associated with the arterial hypertension [OR 1.18; 95% CI (1.04-2.58)] and elevated LDL cholesterol [1.26; 95 CI (1.19-2.1)]. A total OSI had a significant association with elevated LDL cholesterol [2.64; 95% CI (1.19-7.7)], triglycerides [OR 3.27; 95% CI (1.20-5.1)] and low HDL cholesterol [OR 3.29; 95% CI (1.8-5.8)] (p < 0.01). The study provides the evidence for the significant association of total OSI and underload with lipid disorders and elevated blood pressure in professional drivers, which could be a possible link between job stress and coronary heart disease. Regular periodical examinations and workplace interventions aimed to decrease total OSI and underload are important aspects in primary prevention and additional reduction of cardiovascular risk.

Associations between the Occupational Stress Index and Hypertension, Type 2 Diabetes Mellitus, and Lipid Disorders in Middle-Aged Men and Women

Retrospective and prospective studies show that stress at work is linked to an increased risk of hypertension, diabetes mellitus, and coronary heart disease. However, the nature of the contributory job stressors and biological mechanisms need further elucidation. The study is aimed to determine the associations between aspects of the occupational stress index (OSI) and arterial hypertension, diabetes mellitus (DM) type 2, and lipid disorders in working middle-aged men and women. The cross-sectional study involved 989 middle-aged men and women in different occupations. The OSI was calculated by using standardized questionnaires. The total participation rate was 93%. Occupational stressors were divided into seven groups: High Demands, Strictness, Underload, Extrinsic Time Pressure, Noxious Exposure, Avoidance, and Conflict/Uncertainty. Serum lipid levels, glucoregulation, blood pressure, and cardiovascular risk factors were measured. For both women and men, the total OSI score associated significantly with DM (women: odds ratio [OR] 2.4, 95% confidence intervals [CI] 1.67-3.45; men: 1.21, 1.15-1.45), any type of dyslipidemia (women: 1.54, 1.17-2.03; men: 1.31, 1.24-1.39), and arterial hypertension (women: 1.15, 1.10-1.21; men: 1.58, 1.49-1.68). The group as a whole showed associations between total OSI and low high-density lipoprotein (HDL) cholesterol, high total cholesterol, and high triglyceride levels. Of the OSI aspects, Underload associated significantly in both men and women with arterial hypertension (women: 3.48, 1.91-6.31; men: 2.71, 1.96-3.75) and dyslipidemia (women: 3.26, 2.13-4.99; men: 2.11, 1.76-2.52). Underload was also associated with several lipid abnormalities in the group as a whole. It associated with DM in women only (4.7, 2.84-7.81). All remaining OSI aspects also associated significantly and positively with DM in women only. Conversely, in male workers, but not female workers, High Demand, Conflict/Uncertainty, and Extrinsic Time Pressure associated significantly with arterial hypertension. Strictness and Conflict/Uncertainty associated positively with dyslipidemia in women only. Noxious Exposures associated positively with DM and arterial hypertension in women only. The study provides evidence for the association of work stress with metabolic disorders and hypertension. Total OSI associated significantly with DM type 2, arterial hypertension, and dyslipidemia in both genders. Different OSI aspects associated with these health issues in gender- and occupational-specific patterns. Underload, which represents lack of social communication, simple task preparation, and underestimation of working results, associated most strongly of all OSI aspects with disease in both the sexes.

Noise levels during nCPAP are flow-dependent but not device-dependent

Objective:Nasal continuous positive airway pressure (nCPAP) has been shown to improve the outcome of infants with respiratory distress syndrome. However, noise generation could be of concern. Therefore, our study was...

A broken heart — or anguish in top-sport in antiquity

Cardiovascular disease is a major determinant of sudden death. Nevertheless the impact of autonomic dysregulation is grossly underestimated not to say ignored. The limited life expectancy of retired gladiators is a fine example of the interactive influence of an occupational- and socio-cultural hazard at the time. Possibly the fate of retired athletes in antiquity is sealed by autonomic dysregulation, cardiac adaptation and noxious exposure in fatal interaction. Observations like these could be helpful in the understanding of complex pathofysiological mechanisms, and may have implications in medical practice.

A Case of Nitrogen Dioxide-Induced Pulmonary Edema in Oxygen Torch

Background: Welders tend to be exposed to a variety of hazards including metal fumes, toxic gases, electricity, heat, noise, and radiation such as ultraviolet and infrared light. Noxious gases generated during welding include carbon monoxide, ozone, and nitrogen oxide. Although the effects of metal fumes have been well studied, few reports have investigated the influence of noxious gas exposure in welders. Case report: We encountered a patient who developed non-cardiogenic pulmonary edema within a day after fairing up a steel plate with an oxygen/LPG torch. The patient was a 43-year-old female who complained of dyspnea which became exacerbated the following morning. Her chest X-ray and chest CT scan showed an extensive ground glass opacity which was more prominent in the both upper lungs. Both her symptoms and chest X-ray findings improved. We attributed the patient’s symptoms to non-cardiogenic pulmonary edema caused by nitrogen dioxide exposure, by reasoning that: 1) the patient's clinical course and radiologic findings suggested pulmonary edema 2) the event happened following fairing work with oxygen/LPG torch that usually induces a high concentration of nitrogen dioxide, and 3) the other possible causes of pulmonary edema could be excluded. Conclusion: Nitrogen dioxide-induced pulmonary edema should be considered in oxygen torch contrary to arc welding.

Epidermal lipids and the natural history of hydrofluoric acid (HF) injury

To explain several fortuitous observations, we hypothesized that there is a naturally occurring lipid ‘barrier’ to HF injury in guinea-pig skin and sought to characterize both the barrier and its role in the natural history of such injuries. Under anaesthesia, the dorsal trunk skin of groups of guinea-pigs was gently clipped of hair, washed with chloroform, soap and water, acetone or nothing (controls), and examined histologically for the presence of neutral lipid. Thereafter, in animal groups similarly washed, 1.5 in × 1.5 in (38 mm × 38 mm) areas were exposed to 40 per cent HF for up to 50 min and: (a) mean percentages of exposed areas with gross necrosis 5 days postinjury plotted on dose—response curves; or (b) less than 4 h after exposure to HF, intra-aortic India ink was injected and skin specimens examined to discern depth of ischaemia and necrosis. In contrast to controls, washing reduced neutral lipid in epidermis and significantly (at P < 0.001) increased susceptibility to injury by HF. With very rare (but interesting) exceptions, HF injury was found to be full thickness in depth with ischaemia and coagulative necrosis. In this study, development of guinea-pig skin necrosis due to HF was typically an ‘all-or-nothing’ ‘barrier-penetration’ phenomenon relating as much to the integrity of an epidermal lipid barrier as to the duration and intensity of noxious exposure.

Sick-Hospital Syndrome

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.

Polycythemia and Nuclear 'Exposure'

<h3>To the Editor.—</h3> Despite the origins of the report by Caldwell et al¹on polycythemia vera among nuclear weapons test participants and the amount of public funds that must have been used in its production, I find it an unscientific document. The authors admit that ionizing radiation was the only known unusual risk yet cannot bring themselves to draw the obvious conclusion "because of the small individual whole-body doses of radiation." To accept film badges as indicators of whole-body dose in such an atmospheric exposure is naive "science," albeit good political thinking in view of HR 1961 (Atomic Veterans Relief Act). To suggest that the exposure data<i>may</i>be minimal is self-serving, since the most obvious and noxious exposure was not even measured! This "science" has already been used to negate the consequences of internal emitters, and even as a brief report it can only do harm.