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Inhalation Toxicity of Metal Particles and Vapors
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Long-term inhalation of Cr(III) compounds reveal no adverse health effects, but long-term inhalation exposure to insoluble Cr(VI) compounds is associated with lesions of the mucosa and submucosa of the respiratory tract and other toxic effects. Workers exposed to chromates and chromic acid mist may develop contact dermatitis, skin ulcers, nasal membrane inflammation and ulceration, nasal septum perforation, rhinitis, liver damage, and pulmonary congestion and edema. Chronic rhinitis, laryngitis, and pharyngitis are also common (Stokinger, 1981). Progressive pulmonary fibrosis in a small number of workers was reported in 1962, but no subsequent reports have appeared (Stokinger, 1981). Pneumoconiosis has also been reported. Bronchial asthma is common among chromate workers.
Ear, nose and throat
Published in Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol, Handbook of Aviation and Space Medicine, 2019
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol
Physical examination should include: Ears: auriscope examination of external auditory canals, tympanic membranes, middle ear; assessment of tympanic membrane whilst performing a Valsalva manoeuvre (but not always a good predictor of ability to clear ears in flight).Nasal airways: anterior rhinoscopy; nasal septum (perforation in cases of trauma or cocaine abuse); sinus drip.Oro-pharynx: teeth and gums; tongue; palate; salivary glands; uvula; tonsils; speech.CNS: nystagmus; cranial nerves; balance (gait, walking, standing, Romberg’s test).
Intoxicants
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Cocaine blocks reuptake of dopamine, norepinephrine, and serotonin from the synaptic cleft, therefore prolonging their activity on the postsynaptic membrane. Patients under cocaine intoxication present with euphoria, psychomotor agitation, grandiosity, hallucinations (tactile type is formication), and paranoid ideation (Lukas and Renshaw, 1998). The sympathetic system is overstimulated, and as a result pupils dilate, appetite decreases, and heart rate with blood pressure rises. Systemic vasospasm may have end-organ effect causing myocardial infarction, stroke, or placental infarction. Chronic cocaine users may present with nasal septum perforation (Kiesselbach plexus vasospasm) (Businco et al., 2008). Treatment of cocaine overdose is symptomatic with antipsychotics, benzodiazepines, and antihypertensives. Vitamin C promotes excretion of the drug.
Β-Cyclodextrin-graft-poly(amidoamine) dendrons as the nitric oxide deliver system for the chronic rhinosinusitis therapy
Published in Drug Delivery, 2021
Tao Liu, Guowei Li, Xidong Wu, Shaohua Chen, Siyi Zhang, Hong Han, Hongbin Zhang, Xiaoning Luo, Xiang Cai, Dong Ma
Chronic rhinosinusitis (CRS) is a rather prevalent condition with recent estimates demonstrating that roughly 5–12% worldwide is affected (Yim & Orlandi, 2020). The most recent consensus statements both from US and European authorities posit that current evidence suggests CRS is a chronic inflammatory process mediated by a complex interplay of environmental and genetic factors that are not fully elucidated, so there is a lack of therapeutic options for the mechanisms of CRS. What is certain that the pathogenic microorganism infection is a main factor (DeConde & Soler, 2016). Intranasal glucocorticoid spray is the preferred drug for the treatment of CRS, but there are some side effects when the spray is used for a long time. A minority of patients show local adverse reactions, such as nasal dryness, nasal bleeding and even nasal septal perforation (Schleimer, 2017). With higher dose, systemic effects of glucocorticoids may occur, like the growth retardation in children and adolescents. Meanwhile, the long-term safety of glucocorticoid needs to be further evaluated using. Other therapy strategies including saline irrigations, decongestants, leukotriene inhibitors, interleukin antibody, is slight or the overall evidence for their use in CRS remains insufficient (Orlandi et al., 2016; Patel et al., 2020). Therefore, there is clinically a pressing need to develop the safe, anti-inflammatory and biocompatible biomaterials.
Computational investigation of dust mite allergens in a realistic human nasal cavity
Published in Inhalation Toxicology, 2019
Ya Zhang, Yidan Shang, Kiao Inthavong, Zhenbo Tong, Bin Sun, Kang Zhu, Aibing Yu, Guoxi Zheng
In recent years, with the rapid development of manufacturing, computer technology and medical imaging, nasal cavity casts and computational fluid dynamics (CFD) methods are widely used as powerful tools for performing virtual surgery to achieve optimal outcomes. Experimental and numerical study of the flow dynamics and the particle deposition in the nasal cavity has been the subject of many researches. Work by Zachow et al. (2006), Tian et al. (2007), Inthavong et al. (2013a), Patel et al. (2015), Shang et al. (2017) and Dong et al. (2018) are examples of some recent numerical studies for the airflow in the physiological perspective. The work of Garcia et al. (2007) and Wakayama et al. (2016) are examples of some recent numerical studies for the airflow in the pathological perspective. Rhinologists used this approach to simulate surgeries for nasal septum deviation, turbinectomy, maxillary sinus ventilation and nasal septum perforation repair (Morgan and Monticello 1990; Chen et al. 2011; Xiong et al. 2011; Ge QJ et al. 2012; Zhou et al. 2013; Kumar et al. 2016; Lee et al. 2016). Results indicate that CFD is a promising research method compatible with precision medicine. Research performed by Zamankhan et al. (2006), Xi and Longest (2008), Inthavong et al. (2008), Wang et al. (2009), King Se et al. (2010) and Shang et al. (2015) presented numerical results for the micro/nanoparticle deposition in the nasal cavity.
Long-term follow-up in patients treated with electrochemotherapy for non-melanoma skin cancer in the head and neck area
Published in Acta Oto-Laryngologica, 2019
Stefan Kristiansson, Johan Reizenstein, Mathias von Beckerath, Fredrik Landström
There was one serious adverse event that was not reported in the two-year follow-up [19]. There was a seizure six months after treatment with ECT in the left temporal region. The subsequent investigation did not reveal any evidence of epilepsy and the patient had no further seizure in the 10-year follow-up period. If ECT actually had a role in the seizure is unclear but additional incidences of seizures after ECT should be reported as possible SAEs. There was also one AE, a symptomless nasal septal perforation after ECT of a CSSC in the nasal vestibule. There were no recorded malfunctions of the Medpulser system. There was one recorded malfunction of the Cliniporator system that did not prevent a successful treatment. In conclusion, treatment with ECT was safe in these patients.