Essential symptoms

John Parkinson described the essential symptoms of the disease... 

Medical Programs. Large chemical plants have at least one hill-time physician who is at the plant five days a week and on call at all other times. Smaller plants either have part-time physicians or take injured employees to a nearby hospital or clinic by arrangement with the company compensation-insurance carrier. When part-time physicians or outside medical services are used, there is Httle opportunity for medical personnel to become familiar with plant operations or to assist in improving the health aspects of plant work. Therefore, it is essential that chemical-ha2ards manuals and procedures, which highlight symptoms and methods of treatment, be developed. A hill-time industrial physician should devote a substantial amount of time to becoming familiar with the plant, its processes, and the materials employed. Such education enables the physician to be better prepared to treat injuries and illnesses and to advise on preventive measures. 

The unusual physical complaints and findings in workers overexposed to teUurium include somnolence, anorexia, nausea, perspiration, a metallic taste in the mouth and garlic-like odor on the breath (48). The unpleasant odor, attributed to the formation of dimethyl teUuride, has not been associated with any adverse health symptoms. Tellurium compounds and metaboUc products have been identified in exhaled breath, sweat, urine, and feces. Elimination is relatively slow and continuous exposure may result in some accumulation. No definite pathological effects have been observed beyond the physical complaints outlined. Unlike selenium, teUurium has not been proved to be an essential biological trace element. 

Vitamin E was first described ia 1922 and the name was originally applied to a material found ia vegetable oils. This material was found to be essential for fertility ia tats. It was not until the early 1980s that symptoms of vitamin E deficiency ia humans were recognized. Early work on the natural distribution, isolation, and identification can be attributed to Evans, Butt, and Emerson (University of California) and MattiU and Olcott (University of Iowa). Subsequentiy a group of substances (Eig. 1), which fall iato either the family of tocopherols or tocotrienols, were found to act like vitamin E (1 4). The stmcture of a-tocopherol was determined by degradation studies ia 1938 (5). 

Arsenic compounds must be considered extremely poisonous. Dust or fumes irritate mucous membranes and lead to arsenical poisoning. When swallowed they irritate the stomach and affect the heart, Hver, and kidneys. Nervousness, thirst, vomiting, diarrhea, cyanosis, and coUapse are among the symptoms of arsenical poisoning (3). In spite of the toxicity of arsenic compounds, there is evidence that arsenic is an essential nutrient for several animal species (4). 

Dichloroethylene is toxic by inhalation and ingestion and can be absorbed by the skin. It has a TLV of 200 ppm (10). The odor does not provide adequate warning of dangerously high vapor concentrations. Thorough ventilation is essential whenever the solvent is used for both worker exposure and flammabihty concerns. Symptoms of exposure include narcosis, dizziness, and drowsiness. Currently no data are available on the chronic effects of exposure to low vapor concentrations over extended periods of time. 

Cobalt is one of twenty-seven known elements essential to humans (28) (see Mineral NUTRIENTS). It is an integral part of the cyanocobalamin [68-19-9] molecule, ie, vitamin B 2> only documented biochemically active cobalt component in humans (29,30) (see Vitamins, VITAMIN Vitamin B 2 is not synthesized by animals or higher plants, rather the primary source is bacterial flora in the digestive system of sheep and cattle (8). Except for humans, nonmminants do not appear to requite cobalt. Humans have between 2 and 5 mg of vitamin B22, and deficiency results in the development of pernicious anemia. The wasting disease in sheep and cattle is known as bush sickness in New Zealand, salt sickness in Florida, pine sickness in Scotland, and coast disease in AustraUa. These are essentially the same symptomatically, and are caused by cobalt deficiency. Symptoms include initial lack of appetite followed by scaliness of skin, lack of coordination, loss of flesh, pale mucous membranes, and retarded growth. The total laboratory synthesis of vitamin B 2 was completed in 65—70 steps over a period of eleven years (31). The complex stmcture was reported by Dorothy Crowfoot-Hodgkin in 1961 (32) for which she was awarded a Nobel prize in 1964. 

Plant and Animal Nutrient. Copper is one of seven micronutrients that has been identified as essential to the proper growth of plants (87). Cereal crops are by far the most affected by copper deficiency (see Wheat and other cereal grains). Greenhouse studies have shown yield increases from 38% to over 500% for wheat, barley, and oats (88) using copper supplementation. A tenfold increase in the yield of oats was reported in France (89). Symptoms of copper deficiency vary depending on species, but often it is accompanied by withering or chlorosis in the leaves that is not ammenable to iron supplementation. In high concentrations, particularly in low pH sods, copper can be toxic to plants. 

Several clinical trials have been conducted with streptokinase adrninistered either intravenously or by direct infusion into a catheterized coronary artery. The results from 33 randomized trials conducted between 1959 and 1984 have been examined (75), and show a significant decrease in mortaUty rate (15.4%) in enzyme-treated patients vs matched controls (19.2%). These results correlate well with an ItaUan study encompassing 11,806 patients (76), in which the overall reduction in mortaUty was 19% in the streptokinase-treated group, ie, 1.5 million units adrninistered intravenously, compared with placebo-treated controls. The trial also shows that a delay in the initiation of treatment over six hours after the onset of symptoms nullifies any benefit from this type of thrombolytic therapy. Conversely, patients treated within one hour from the onset of symptoms had a remarkable decrease in mortaUty (47%). The benefits of streptokinase therapy, especially in the latter group of patients, was stiU evident in a one-year foUow-up (77). In addition to reducing mortahty rate, there was an improvement in left ventricular function and a reduction in the size of infarction. Thus early treatment with streptokinase is essential. 

Psychological disturbances With nervoms-ncss, disturbances of sleep, and similar symptoms, herbal drugs are often, and often justifiably, used. It is noteworthy that mostly aromatic constituents (essential oil) are present. 

Health Hazards Information - Recommended Personal Protective Equipment Goggles or face shield rubber gloves Symptoms Following Exposure Oil is essentially nontoxic, but can cause mild irritation of eyes on contact General Treatment for Exposure EYES flush with water for at least 15 min. INGESTION do not induce vomiting Toxicity by Inhalation (Threshold Limit Value) Data not available Short-Term Inhalation Limits Data not available Toxicity by Ingestion Data not available Late Toxicity None Vapor (Gas) Irritant Characteristics Data not available Liquid or Solid Irritant Characteristics Data not available Odor Threshold Not pertinent. 

Before a patient starts therapy with an antithyroid drug, die nurse obtains a history of the symptoms of hyperthyroidism. It is important to include vital signs, weight, and a notation regarding the outward symptoms of die hyperthyroidism (see Table 51-1) in the physical assessment. If die patient is prescribed an iodine solution, it is essential that die nurse take a careful allergy history, particularly to iodine or seafood (which contains iodine). 

Allergy mediated by selective IgE to certain types of NSAIDs by which symptoms are caused exclusively by a specific group of NSAIDs and no cross-reactivity exists with the other groups of anti-inflammatories. In a study carried out with 26 methimazole-allergic patients with IgE-mediated reactions [33], 14 of which developed anaphylaxis, BAT showed a sensitivity of 42% with an optimum specificity of 100%. No other validated in vitro test exists to date for the diagnosis of this disorder and so it represents an essential aid to diagnosis. 

DEFICIENCY SYMPTOMS ARE PRODUCED WHEN THE ESSENTIAL FATTY ACIDS (EFA) ARE ABSENT FROM THE DIET... 

The role of essential fatty acids in membrane formation is unrelated to prostaglandin formation. Prostaglandins do not reheve symptoms of essential fatty acid deficiency, and an essential fatty acid deficiency is not caused by inhibition of prostaglandin synthesis. 

Symptoms of Essential Fatty Acid Deficiency in Humans Include Skin Lesions Impairment of Lipid Transport... 

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