A follow-up study of respiratory function in workers exposed to acid aerosols in a food-processing industry

A follow-up investigation was performed on 49 female workers studied 2 years earlier in a vegetable-pickling plant. Acute and chronic respiratory symptoms and ventilatory capacity measurements were recorded during the original and the follow-up studies. Maximal expiratory flow-volume (MEFV) curves were recorded during the Monday morning work shift. The forced vital capacity (FVC), 1-s forced expiratory volume (FEV1), and flow rates at 50% and the last 25% of the FVC (FEF50, FEF25) were measured. There were small increases in the prevalence of chronic symptoms between the two studies for both smokers and nonsmokers, but these did not reach statistical significance. Five workers at the time of the initial study had a diagnosis of occupational asthma; only one of these was still working at the time of follow-up. Workers lost to the follow-up had lower lung function than those seen at follow-up. In workers who were followed, larger than expected mean annual declines were noted for all ventilatory capacity parameters in both smokers (FVC 0.070 l, FEV1 0.070 l; FEF50 0.355 l/s, FEF25 0.270 l/s) and nonsmokers (FVC 0.045 l, FEV1 0.045 l, FEF50 0.285 l/s; FEF25 0.130 l/s). The decrease was particularly pronounced for FEF50 and FEF25. The accelerated decline in ventilatory capacity tests noted in the female nonsmokers suggests an independent effect on lung function of work exposure in this environment. Our data confirm that work in the pickling industry, particularly in small, poorly regulated plants, has deleterious effects on respiratory function. Received: 24 September 1996 / Accepted: 19 June 1997     

The impact of lower urinary tract symptoms on general health status and on the use of prostatectomy

Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to the decision to undergo surgery. A cross-sectional population survey using postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing prostatectomy (North West Thames and Oxford regions). The subjects in the first survey were 221 men aged 55 and over with previously reported mild, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy. Main outcome measures were selfreported symptom severity, bothersomeness and general health status (Nottingham Health Profilie, Part 1). The response rate among eligible responders in the population survey was 85.7%. Increasing symptom severity was associated with worsening NHP scores for energy, emotional reactions, sleep and physical mobility (p<0.01). Increasing bother-someness of symptoms was associated with emotional reactions, sleep and pain (p<0.05). Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards emotional reactions, energy and pain. For a given level of symptom severity, the impact of those symptoms on aspects of a man's general health status may be the determinant of seeking and undergoing surgery. Greater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept treatment.     

Foreign body aspiration in children. The diagnostic value of signs,symptoms and pre-operative examination

One hundred and fifteen patients, between 6 months and 12 years of age, had bronchoscopy on suspicion of foreign body aspiration. The histories of these patients were studied to examine the diagnostic value of signs, symptoms and examinations, and to determine the time that passed between aspiration and removal of the foreign body. The sensitivity of the symptoms choking and coughing was fairly high (81 and 78%), but the specificity was poor. The sensitivity of a chest radiograph was 82%, the specificity 44%. The sensitivity of radiographs on inspiration and expiration was 80%, the specificity 55%. The patients had been referred with the initial diagnosis foreign body aspiration (80), pneumonia (34), or subglottic laryngitis (1). In 85 patients a foreign body was identified and extracted. The other 30 patients had respiratory tract infections. The initial diagnosis of foreign body aspiration was correct in 61 out of 85 patients. In these cases, the period between aspiration and extraction of the foreign body was a mean 6 days, compared with 55 days, if the initial diagnosis was pneumonia or sub-glottic laryngitis. We conclude that the diagnosis of foreign body aspiration is too often missed, and that, apart from bronchoscopy, diagnostic tools are of little value.     

晚期肺癌的中医证候研究

目的　探讨晚期肺癌的主要中医证候。方法　采用回顾性与前瞻性相结合的方法进行临床观察。结果　经 χ2 检验 ,不同中医证候的晚期肺癌组之间有显著性差异 (P <0 0 1) ,而血瘀证、气虚证、痰证、阴虚证最为多见 ;晚期非小细胞肺癌与晚期小细胞肺癌的中医证型没有显著性差异。结论　晚期肺癌的中医证候以血瘀证、气虚证、痰证、阴虚证为主 ;晚期非小细胞肺癌与小细胞肺癌的中医证候无明显差异。     

Health-related quality of life under six months' treatment of migraine—an open clinic-based longitudinal study

Health-related quality of life (HQL) assessment in the clinical setting have distinguished subjective perceptions (e.g. well-being), signssymptoms of the disease, and functional capacity as three major components. The impact of short-term treatment for migraine attacks on these variables was evaluated in an open prospective 6-month study at the Gothenburg Migraine Clinic. Socio-economic factors, subjective symptoms, and general well-beingquality of life were evaluated by self-administered questionnaires in 99 patients with migraine with or without aura in accordance with the classification of the International Headache Society. Short-term treatment comprising conventional therapy or subcutaneous sumatriptan reduced number of days per month with migraine and absenteeism from work, migraine-associated symptoms, but did not significantly improve general well-being between attacks. Future assessment of the patients' HQL in accordance with this approach would enable us to consider all the advantages and disadvantages of current therapies of particular interest in the field of migraine.     

Effects of occupational exposure and smoking on respiratory symptomatology and PFT in healthy panelists and COPD patients

A panel of 377 healthy adults and 920 COPD patients aged 30–65 years, is annually interviewed (ATS-NHLI health questionnaire) and performs pulmonary function test (PFT), which includes: FVC, FEVI, FEVl/FVC, PEF, FEF50 and FEF75. Baseline data analysis showed a more significant excess in respiratory symptmos (8.8% to 21.4%) and lower PFT (2.4% to 8.0%) among patients occupationally exposed to dust, than among healthy exposed panelists (-0.7% to 7.7% excess symptomatology and -0.3 to 5.8% lower PFT). Among patients a significant correlation between PFT and degree of occupational dust exposure was found. Significantly lower FEVl/FVC and excess in respiratory symptoms (with relative risks of 2.47–16.38) was present in healty smokers vs. non smokers as compared with COPD patients.Corresponding author.     

精神分裂症强迫症状的治疗对照研究

采用随机对照的方法，对氯丙咪嗪、氯丙嗪、氯丙咪嗪并氯丙嗪治疗９１例精神分裂症伴发的强迫症状的治疗剂量、起效时间、疗效、副作用进行了研究。结果：氯丙咪嗪的平均治疗量１６３．６８±１７．７６ｍｇ／ｄ，氯丙嗪的平均治疗量７５６．７５±２６．５７ｍｇ／ｄ。氯丙咪嗪，氯丙咪嗪并氯丙嗪治疗精神分裂症的强迫症状疗效显著优于氯丙嗪（Ｐ＜０．０１）。起效时间为１周。氯丙嗪组和氯丙咪嗪并氯丙嗪组的锥体外系副作用比氯丙咪嗪组显著。     

下体负压晕厥前症状下事件相关电位变化特征

目的探讨下体负压晕厥前症状（ＰＳＳ）下事件相关电位（ＥＲＰｓ）的Ｐ３潜时（Ｐ３Ｌ）变化特征，为飞行员加速度性晕厥的医学鉴定提供实验方法和依据。方法用下体负压方法（ＬＢＮＰ）诱发ＰＳＳ，观察ＥＲＰｓ的Ｐ３Ｌ变化特征。结果出现ＰＳＳ时，ＥＲＰｓ的Ｐ３Ｌ由３４３．３５±１４．７２ｍｓ延长至５０６．８７±３７．４４ｍｓ（Ｆ（６，４８）＝１４．９６，Ｐ＜０．０５，ＯＺ电极），相关任务反应时（ＲＴ）由５０８．６５±１１．１３ｍｓ延长至６３１．２５±２９．１６ｍｓ（ｔ＝２．９７，Ｐ＜０．０５），靶刺激反应错误率由（４．００±１．６７）％增加至（４３．３８±３．５４）％（ｔ＝３．０６，Ｐ＜０．０５）。ＰＳＳ后第５ｍｉｎ，Ｐ３Ｌ仍明显高于基线值（Ｐ＜０．０５）。而ＲＴ、错误率与基线值已无显著差异（Ｐ＞０．０５）。结论ＥＲＰｓ的Ｐ３Ｌ结合ＲＴ、错误率等指标对飞行员加速度性晕厥的研究有潜在应用价值。     

The treatment of diffuse lewy body disease: A pilot study

Single case studies may provide useful information and generate hypotheses for later testing in group studies. The effect of anti-Parkinsonian medication is reported in five individual cases of diffuse Lewy body disease. The problems caused by the variability in congnitive function and psychiatric symptoms in these cases are outlined together with suggested strategies for future research.