Best Way To Stop Drinking
A 61 year old man was admitted to hospital three hours after ingestion of approximately 250 ml of carbon tetrachloride, which he had purchased from a high street pharmacy. The patient had a chronic psychiatric history and had previously taken several drug overdoses. He had been physically fit, did not drink alcohol, and five days previously had stopped his medication (diazepam and lofepramine). On admission he was alert and orientated and although he had not had nausea or vomiting, he had complained of severe diarrhoea for the previous hour. Physical examination was normal with no notable smell of solvent. Urine microscopy showed many granular casts. A plain abdominal radiograph showed radiopaque material consistent with carbon tetrachloride throughout the bowel. Initial biochemical, haematological and coagulation tests were normal except for an increased serum activity of alkaline phosphatase (noted previously and attributed to Paget's disease) and a slightly raised AST.
A 19 year old male who had been drinking alcohol, accidentally ingested an unknown amount of chloroform. He collapsed and was taken to hospital. On admission he was found to be stuporous. He was transferred to an intensive therapy unit (ITU) and was by then unconscious with laboured breathing, cyanosis and reduced deep tendon reflexes. He was intubated and ventilated. Hypoxia could only be corrected with PEEP ventilation. LFTs were elevated but started to decrease after 4-6 days and were normal by eight weeks. The chloroform
Endotoxin comprises proteins in association with lipopolysaccharide (LPS), a major constituent of the outer cell wall of Gram negative bacteria. Such bacteria normally inhabit the intestinal tract in numbers that exceed the number of eukaryotic cells in the human body. When these bacteria divide or are injured, large amounts of LPS are released in the intestinal lumen. Although it was once thought that the gastrointestinal (GI) mucosa was a perfect barrier to LPS, research over the last two decades has indicated that LPS can translocate from the GI lumen into the blood, and thereby the liver and perhaps other organs become exposed. The degree to which this happens in an unstressed GI tract remains a matter of debate some investigators have detected plasma levels of LPS in healthy, unstressed people, whereas others have not.2-4 Nevertheless, it is clear that numerous conditions can lead to an increase in plasma LPS concentration, probably as a result of enhanced GI translocation. These...
Found to be grossly disorientated and lapsing in and out of sleep. He responded appropriately to commands and examination was otherwise normal. His haemoglobin and platelet count were low. A white cell count was also low at 2,600 with 27 mature neutrophils, 1 metamyelocytes, 68 lymphocytes, 1 monocytes and 2 eosinophils. Bone marrow aspiration revealed marrow depression with some signs of recovery. The initial diagnosis was encephalopathy due to alcoholism (he was a moderate to heavy drinker) or industrial toxic exposure. He was managed with vitamins and mineral supplements and made a slow recovery over the following weeks.
A 60 year old man was admitted to hospital confused and pyrexial. Thirty hours prior to admission he had spent approximately one hour painting large surfaces with a polyurethane paint in a small non-ventilated room. Prior to this he had been well, with no history of recent drug or alcohol consumption, nor any other chemical exposure. He drank 30 units of alcohol weekly. Immediately after painting he appeared pale and unwell and complained of malaise and anorexia. He went to bed but spent a very restless night and was noted
Personal behavior and practices also add a further level of complexity to the estimation of individual total exposure for humans. Many publications pointed out harmful effects of high-dose alcohol consumption, smoking, drugs, or the use of mercurials in religious practices, just to name a few. All these chemicals contribute to overall exposures and may affect the toxicity of other chemicals entering the human body (Calabrese 1991). Such personal exposure patterns can also be overlaid on top of more regionally based environmental exposure resulting from diffuse environmental pollution. In this section, first, different pathways of human exposure are considered as well as life-stage-related exposures. Second, the use of monitoring data to assess mixture exposure is discussed.
The effects of chronic ingestion of ethanol are widely known and well documented. Alcohol abuse may reslt in physical dependence, malnutrition, neurological effects including amnesia and dementia, cardiac myopathy, hepatoxicity, pancreatitis, gastrointestinal bleeding and oesophageal varices. Chronic ethanol ingestion is not an occupational route of exposure. For more information see Charness et al. (1989) Regan (1990) Weatherall et al. (1996) and Ashworth and Gerada (1997).
A 23 year old female laboratory technician was employed as an atomic spectrophotometer operator. She was normally fit and well, did not smoke, drink alcohol or use caffeine, although she was taking prenatal vitamins daily including 4000 IU of vitamin A (UK adult recommended daily amount 2500 IU). Working without personal protective equipment, she was exposed daily to NMP and small quantities of methanol and or acetone. Ultrasound examination revealed a healthy fetus at 14 weeks gestation. After raising concerns with an occupational medicine consultant about an NMP material safety data sheet listing reports of fetotoxicity and teratogenicity in rats, she was given a respirator and protective clothing including latex gloves, a lab coat and goggles. The latex gloves dissolved and extensive dermal exposure to the hands occurred at 16 weeks gestation, when she cleaned up a spillage of NMP. Over the following four days she experienced malaise, headache, nausea and vomiting. Staining of the...
A number of psychological and social health effects were mentioned by members of the public, including domestic violence, drug and alcohol abuse, post-traumatic stress disorder, and stress. A few comments also mentioned that fear and mass hysteria could result from mixed messages to the public. One comment noted that stable income is important for maintaining the well-being of families and children. Food insecurity was also mentioned.
Noninfectious or noncommunicable disease The chronic, degenerative, and insidious disease that usually develops over an extended period and whose cause may not be entirely clear. In its broad sense, cancer, alcoholism, mental illnesses, tooth decay, ulcers, and lead poisoning are regarded as noncommunicable or noninfectious diseases. Also included are cardiovascular diseases, pulmonary diseases, diabetes, arthritis, nutritional deficiency diseases, malignant neoplasms, kidney diseases, injuries, and illnesses associated with toxic organic and inorganic chemicals and physical agents in air, water, and food. For the purposes of this text, discussion of noninfec-tious diseases emphasizes the environmental media or factors serving as the vehicle for transmission of the disease. The usual environmental media are air, food, water, and land (soil, flora, fauna) other factors leading to injuries and contact may also be involved.
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