21-Day dermal exposure to aircraft engine oils: effects on esterase activities in brain and liver tissues, blood, plasma, and clinical chemistry parameters for Sprague Dawley rats

This dermal study tested the potential toxicity of grade 3 (G3) and 4 (G4) organophosphate-containing aircraft engine oils in both new (G3-N, G4-N) and used states (G3-U, G4-U) to alter esterase activities in blood, brain and liver tissues, clinical chemistry parameters, and electrophysiology of hippocampal neurons. A 300 µl volume of undiluted oil was applied in Hill Top Chamber Systems®, then attached to fur-free test sites on backs of male and female Sprague Dawley rats for 6 hr/day, 5 days/week for 21 days. Recovery rats received similar treatments and kept for 14 days post-exposure to screen for reversibility, persistence, or delayed occurrence of toxicity. In brain, both versions of G3 and G4 significantly decreased (32-41%) female acetylcholinesterase (AChE) activity while in males only G3-N and G4-N reduced (33%) AChE activity. Oils did not markedly affect AChE in liver, regardless of gender. In whole blood, G3-U decreased female AChE (29%) which persisted during recovery (32%). G4-N significantly lowered (29%) butyrylcholinesterase (BChE) in male plasma, but this effect was resolved during recovery. For clinical chemistry indices, only globulin levels in female plasma significantly increased following G3-N or G4-N exposure. Preliminary electrophysiology data suggested that effects of both versions of G3 and G4 on hippocampal function may be gender dependent. Aircraft maintenance workers may be at risk if precautions are not taken to minimize long-term aircraft oil exposure.

Cannabinoid Oil Vaping-Associated Lung Injury and its Radiographic Appearance

BACKGROUND

Lung injury associated with cannabinoid oil vaping is rapidly becoming a serious public health concern. We describe the clinical and radiographic presentations of 5 patients with lung injury associated with vaping cannabinoid oils seen at a single institution.

RESULTS

Of the 5 patients with suspected vaping-associated lung injury seen at our institution, 4 required supplemental oxygen, and all these 4 were admitted to the hospital. Three patients required admission to the intensive care unit. None of the patients required mechanical ventilation. All patients demonstrated a consistent radiologic appearance of diffuse bilateral ground-glass lung opacities that spared the extreme periphery. Three patients underwent bronchoalveolar lavage, which revealed lipid-laden macrophages in 2 of them. All patients were successfully discharged from the hospital. Four received only supportive care, while the fifth required intravenous followed by oral corticosteroids.

CONCLUSIONS

We report the clinical and radiographic presentation of 5 patients at our institution with cannabinoid oil vaping-associated lung injury. All patients displayed a consistent chest radiographic pattern of injury. Most responded to supportive care, although one required the addition of corticosteroids. Bronchoalveolar lavage results suggest that this injury may related to a toxic form of lipoid pneumonia.

Thermally Processed Oil Exaggerates Colonic Inflammation and Colitis-Associated Colon Tumorigenesis in Mice

Frying in vegetable oil is a popular cooking and food processing method worldwide; as a result, the oils used for frying are widely consumed by the general public and it is of practical importance to better understand their health impacts. To date, the effects of frying oil consumption on human health are inconclusive, making it difficult to establish dietary recommendations or guidelines. Here we show that dietary administration of frying oil, which was prepared under the conditions of good commercial practice, exaggerated dextran sodium sulfate (DSS)-induced colitis and azoxymethane (AOM)/DSS-induced colon tumorigenesis in mice. In addition, dietary administration of frying oil impaired intestinal barrier function, enhanced translocation of lipopolysaccharide (LPS) and bacteria from the gut into the systemic circulation, and increased tissue inflammation. Finally, to explore the potential compounds involved in the actions of the frying oil, we isolated polar compounds from the frying oil and found that administration of the polar compounds exacerbated DSS-induced colitis in mice. Together, our results showed that dietary administration of frying oil exaggerated development of inflammatory bowel disease (IBD) and IBD-associated colon tumorigenesis in mice, and these effects could be mediated by the polar compounds in the frying oil.

Characterization of PCDD/Fs and dl-PCBs emission from combustion of PCB-containing oil in a fluidized-bed incinerator

Emissions of PCDD/Fs and dl-PCBs from the combustion of PCB-containing oil in a hazardous waste incinerator are characterized. Flue gas samples are simultaneously taken at three points, including the outlet of ultrasonic wet scrubber, the outlet of heat exchanger and stack. In addition, solid matter samples including incinerator bottom ash, wet scrubber sludge, heat exchanger ash and baghouse ash are also collected. The results indicate that TEQ concentration (PCDD/Fs + dl-PCBs) measured in stack from the combustion of PCB-containing oil is 0.51 ng WHO-TEQ/Nm³. For the solid matter, PCDD/F and dl-PCB concentrations of baghouse ash and wet scrubber sludge are significantly higher than those measured in bottom and heat exchanger ashes. The total removal efficiencies of PCDD/Fs + dl-PCBs achieved with bag filtration (BF) + activated carbon injection (ACI) reaches 65.0%. The emission factors of PCDD/Fs and dl-PCBs from incinerating PCB-containing oil are 1.05 and 0.08 ng WHO-TEQ/L, respectively. The overall PCDD/Fs and dl-PCBs destruction efficiencies achieved with fluidized-bed incinerator reach 99.87% and 99.9998%, respectively, which demonstrates that incineration is an effective engineering practice for treating PCB-containing oil. Moreover, this is the first study suggesting the ratios of PCB-114/(PCB-126+ PCB-114) and PCB-157/(PCB-169+ PCB-157) as indicators to distinguish the emission source of dl-PCB from combustion process and technical mixture evaporation in diagnostic ratio analysis.

Overcoming the Bitter Taste of Oils Enriched in Fatty Acids to Obtain Their Effects on the Heart in Health and Disease

Fatty acids come in a variety of structures and, because of this, create a variety of functions for these lipids. Some fatty acids have a role to play in energy metabolism, some help in lipid storage, cell structure, the physical state of the lipid, and even in food stability. Fatty acid metabolism plays a particularly important role in meeting the energy demands of the heart. It is the primary source of myocardial energy in control conditions. Its role changes dramatically in disease states in the heart, but the pathologic role these fatty acids play depends upon the type of cardiovascular disease and the type of fatty acid. However, no matter how good a food is for one's health, its taste will ultimately become a deciding factor in its influence on human health. No food will provide health benefits if it is not ingested. This review discusses the taste characteristics of culinary oils that contain fatty acids and how these fatty acids affect the performance of the heart during healthy and diseased conditions. The contrasting contributions that different fatty acid molecules have in either promoting cardiac pathologies or protecting the heart from cardiovascular disease is also highlighted in this article.

[Injected non-absorbable fillers in large volumes]

AIM

To present treatment strategy for large volumes of injectable non-absorbable 'shell-less' soft tissue fillers (vaseline, synthol, silicone etc.).

MATERIAL AND METHODS

The authors present an experience of surgical treatment of 8 patients who underwent injections of medical vaseline (breast augmentation, n=5) and synthol (muscles enlargement, n=3) and review of the current literature devoted to this problem.

RESULTS

Injection of large amounts (over 50 ml) of non-absorbable fillers into soft tissues is unacceptable and leads to numerous complications. Oil-based 'shell-less' fillers cannot be removed by minimally invasive techniques (puncture, mini-incisions, etc.) due to multiple diffuse lesions in the form of oleogranulomas (cysts of different size) and surrounding widespread inflammation and fibrosis of tissues. Surgery is the only adequate method. However, this approach is followed by scars and often tissue contour deformation. Migration of these fillers to other anatomical areas (from the neck to the lower extremities) significantly complicates the situation, treatment and results. In case of categorical refusal of patients from surgical treatment and no complaints, they should be properly informed about possible consequences and complications and dynamic medical supervision is necessary. Intraoperative ultrasound examination is useful for the control of radical removal of pathological areas. Timely removal of non-absorbable fillers allows to avoid serious complications and to achieve good aesthetic results.

[Paraffin oil injecions due to bigorexia may cause hypercalcaemia]

Paraffin oil injections may cause severe hypercalcaemia, likely due to development of granulomas at injection sites, activating 1,25 dihydroxyvitamin D and increasing calcium uptake from gut, kidney and bone. This is a case report of a 39-year-old male with severe hypercalcaemia and renal failure due to paraffin oil injections. He was treated with prednisolone (25-50 mg daily), but the disease recurred the next two summers probably due to erroneous vitamin D supplement and sun exposure. The disease course and prognosis are unknown. Treatment options are discussed, and paraffin oil injections should be avoided.

Decreasing the use of edible oils in China using WeChat and theories of behavior change: study protocol for a randomized controlled trial

BACKGROUND

The consumption of edible oils in China has increased rapidly in recent years, and the total amount of edible-oil intake in the country has ranked first in the world. The choice and intake of edible oils, as a source of fats, are important factors that affect people's health. Many chronic diseases are closely associated with high-calorie and saturated-fat intake. The influence of traditional concepts that promote the use of edible oils among women, particularly housewives, plays a key role in a household's diet and nutrition because the diet-related knowledge, attitude and behaviour of housewives are dominant factors in planning and preparing their family's meals. WeChat, which was developed by Tencent, is a multipurpose messaging, social media and mobile payment application (app) in China. Described by Forbes as one of the world's most powerful apps, WeChat provides considerable convenience in disseminating knowledge. Accordingly, this study aims to design a pilot intervention to decrease the use of edible oils in Chinese households. The intervention, which is based on theories of behaviour change, will be implemented through WeChat.

DESIGN AND METHODS

The study design is a randomised controlled trial that adopts knowledge, attitude and practice, social cognitive and stages of change theories as theoretical models. A total of 800 housewives between the ages of 25 and 45 years will be recruited on WeChat and from the communities in four areas (including rural and urban) in Chongqing, China. A self-administered questionnaire will be used to collect information regarding age, educational level, occupation, family members, edible-oil intake habits, knowledge of edible oils and WeChat usage habits. A total of 200 participants will be selected and randomly assigned to two equal-sized groups: group A (the intervention group) and group B (the control group). Group A will receive health education regarding edible oils for four consecutive weeks, whereas group B will be treated as the blank control. Each participant will complete a battery of knowledge, attitude and behaviour tests immediately, 3 months and 6 months after the intervention. In addition, weight, moisture rate, fat rate, visceral fat level and body mass index will be calculated using a multifunctional weighing scale, namely, Tanita BC-601 (Japan). The study is currently in the design stage.

DISCUSSION

This study aims to increase knowledge and awareness of the appropriate use of edible oils, thereby encouraging participants to change behaviour by decreasing the intake of unhealthy levels of edible oils. It will be the first intervention to investigate the use of edible oils in China through WeChat. We predict that receiving health education regarding edible oils through WeChat will substantially improve the knowledge and attitude of the respondents. The members of the intervention group will have increased awareness and will be willing to decrease their use of edible oils to remain healthy. Results of this study may provide scientific evidence for the effect of health education through WeChat on edible oil-intake behaviour, thereby offering a comprehensive intervention to decrease the use of edible oils and promote a healthy lifestyle.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (primary registry in the World Health Organisation registry network): ChiCTR-IOR-17013472 . Registered on 21 November 2017.

No pain no gain: tender nodules in a competitive bodybuilder

The subculture of bodybuilding is rife with people willing to do whatever is necessary to achieve the perfect physique. One particularly concerning behavior is the injection of site-enhancing-oils (SEO) into lagging muscle groups to achieve instant size and symmetry. The typical SEO is a combination of lidocaine, alcohol, and oil; it is rarely, if ever, administered by a qualified professional. As a result, there are a variety of potential complications that can manifest in the skin and other organ systems. In our case, a 41-year-old former competitive bodybuilder was referred to our clinic for excision of a subcutaneous nodule. The initial histopathology was concerning for lymphoma, but a more thorough history and review of systems were completely negative. The patient underwent a negative systemic lymphoma workup and it was not until we discussed the prospects of radiation and other forms of treatment that he revealed a history of SEO use, as well as other identical nodules on his body. Subsequent excisions revealed a more classic sclerosing lipogranuloma-type reaction pattern. Owing to the taboo nature of SEOs, most patients are reluctant to provide this vital piece of historical information, highlighting the importance of patient rapport and clinical-pathologic correlation in our specialty.

Non-parathyroid hypercalcemia associated with paraffin oil injection in 12 younger male bodybuilders: a case series

INTRODUCTION

Injection of paraffin oil to augment muscles size is a troubling phenomenon known to cause a foreign body reaction with formation of granulomas. In a few case reports, long-term side effects have been reported in terms of hypercalcemia and renal failure.

METHODS

We identified a case series of 12 male bodybuilders presenting with non-parathyroid hypercalcemia who previously had injected paraffin oil to increase muscles size.

RESULTS

At admission, all patients had moderate-to-severe hypercalcemia with suppressed PTH levels and impaired renal function. Calcitriol levels were within the normal range or slightly elevated. Follow-up measurements showed marked hypercalciuria with nearly normal levels of bone turnover markers. A correlation was found between levels of peptidyl dipeptidase and calcitriol (R = 0.812, P = 0.050). Treatment with antiresorptive agents seemed less effective than glucocorticoids, which resulted in a significantly lowering of ionized calcium levels and improved renal function, although no patients were cured by this treatment. Immunosuppression with azathioprine or mycophenolate may have a glucocorticoid-saving effect. One patient had surgery with removal of affected muscle tissue, without any apparent effect on plasma calcium levels.

CONCLUSION

The hypercalcemia and associated hypercalciuria seems to be due to an intestinal hyperabsorption of calcium. It remains to be elucidated, whether an increased calcitriol synthesis within granulomas is the only (main) mechanism by which intestinal calcium absorption is increased. Glucocorticoids seem most appropriate as the first choice for treatment. Bodybuilders should be warned against use of intramuscular oil injections (and other substances), as this may have severe adverse health consequences.

Final Determination Regarding Partially Hydrogenated Oils. Notification; declaratory order; extension of compliance date

Based on the available scientific evidence and the findings of expert scientific panels, the Food and Drug Administration (FDA or we) made a final determination that there is no longer a consensus among qualified experts that partially hydrogenated oils (PHOs), which are the primary dietary source of industrially produced trans fatty acids (IP–TFA), are generally recognized as safe (GRAS) for any use in human food. In a declaratory order announcing our final determination, we set a compliance date of June 18, 2018. We are now extending the compliance date for certain uses of PHOs.

Hypercalcemia associated with cosmetic injections: a systematic review

INTRODUCTION

Cosmetic injections with silicone and polymethylmethacrylate are not FDA approved for augmentation of body parts such as breast, buttock or legs, but they have been widely used for decades. Cosmetic injections can cause foreign body granulomas and occasionally severe and life-threatening hypercalcemia. We aimed to systematically analyze the published literature on cosmetic injection-associated hypercalcemia.

METHODS

We searched relevant articles on hypercalcemia associated with various cosmetic injections and extracted relevant data on demographics, cosmetic injections used, severity of hypercalcemia, management and outcomes.

RESULTS

We identified 23 eligible patients from 20 articles. Mean age was 49.83 ± 14.70 years with a female preponderance (78.26% including transgender females). Silicone was most commonly used, followed by polymethylmethacrylate and paraffin oil (43.48, 30.43, and 8.70% respectively). The buttock was the most common site followed by the breast (69.57% and 39.13% respectively). Hypercalcemia developed at mean duration of 7.96 ± 7.19 years from the initial procedure. Mean ionized calcium at presentation was 2.19 ± 0.61 mmol/L and mean corrected calcium at presentation was 3.43 ± 0.31 mmol/L. 1,25-Dihydroxyvitamin D (1,25(OH)₂D or calcitriol) was elevated while 25-hydroxyvitamin D (25(OH)D) and PTH were low in majority of cases. Hypercalcemia was managed conservatively with hydration, corticosteroids and bisphosphonates in majority of cases. Surgery was attempted in 2 cases but was unsuccessful. Renal failure was the most common complication (82.35% cases) and 2 patients died.

CONCLUSION

Hypercalcemia from cosmetic injections can be severe and life threatening and can present years after the initial procedure. Cosmetic injection-associated granuloma should be considered a cause of hypercalcemia, especially in middle-aged females presenting with non-PTH-mediated, non-malignant hypercalcemia, which is often associated with elevated calcitriol; however, it should be noted that calcitriol level may be normal as well.

The INTEROCC case-control study: risk of meningioma and occupational exposure to selected combustion products, dusts and other chemical agents

BACKGROUND

Little is known about occupational risk factors for meningioma.

OBJECTIVES

To study whether risk of meningioma is associated with several occupational exposures, including selected combustion products, dusts and other chemical agents.

METHODS

The INTEROCC study was an international case-control study of brain cancer conducted in seven countries. Data collection by interview included lifetime occupational histories. A job exposure matrix was used to derive estimates of exposure for the 12 agents. ORs for ever versus never exposed and for exposure-response using duration of exposure and cumulative exposure were derived using conditional logistic regression stratified by sex, age group, country/region, adjusted for education.

RESULTS

These analyses included 1906 cases and 5565 controls. For 11 of the 12 agents, no excess risk was found for ever exposed. For ever exposure to oil mists, an elevated OR of 1.57 (95% CI 1.10 to 2.22, 51 exposed cases) was found. Statistically significant exposure-response relationships were observed with cumulative exposure (p=0.01) and duration of exposure (p=0.04). Among women, there were also significant trends for cumulative and duration of exposure to asbestos and excesses in the highest exposure categories for formaldehyde.

CONCLUSIONS

Most agents examined did not provoke excess risks of meningioma. The main finding from this study is that it is the first study to identify a statistical association between exposure to oil mists and meningioma. This may be a chance finding or could be due to confounding with iron exposure and further research is required to understand whether the relationship is causal.

A Review of Indigo Naturalis as an Alternative Treatment for Nail Psoriasis

INTRODUCTION

Nail psoriasis is challenging to treat. The few currently available therapies are limited in efficacy, and often produce unfavorable side effects. A plant extract widely used in Traditional Chinese Medicine, indigo naturalis (Qing Dai), is presented in this review as an alternative topical treatment for skin and nail psoriasis. The purpose of this article is to present information on a viable alternative treatment with a favorable side effect profile for a difficult disease to treat.

METHODS

A PubMed search for the term "indigo naturalis" was performed, and literature from 2006 to the present relevant to indigo naturalis and treatment of psoriasis and nail psoriasis was reviewed.

RESULTS

Indigo naturalis shares several therapeutic mechanisms with current psoriasis treatments, such as regulation of keratinocyte proliferation and differentiation, restoration of epidermal barrier function, and reduction of inflammatory processes. Clinically, it is well tolerated.

CONCLUSION

Recent research of indigo naturalis suggests that it is a safe, inexpensive, and effective alternative topical treatment for skin and nail psoriasis.

Interaction between Polymorphisms in Pre-MiRNA Genes and Cooking Oil Fume Exposure on the Risk of Lung Cancer in Chinese Non-Smoking Female Population

Background

Both genetic polymorphisms and environmental risk factors play important roles in the development of human chronic diseases including lung cancer. This is the first case-control study of interaction between polymorphisms in pre-miRNA genes and cooking oil fume exposure on the risk of lung cancer.

Methods

A hospital-based case-control study of 258 cases and 310 controls was conducted. Six polymorphisms in miRNAs were determined by Taqman allelic discrimination method. The gene-environment interactions were assessed on both additive and multiplicative scale. The statistical analyses were performed mostly with SPSS.

Results

The combination of the risk genotypes of five miRNA SNPs (miR-146a rs2910164, miR-196a2 rs11614913, miR-608 rs4919510, miR-27a rs895819 and miR-423 rs6505162) with risk factor (cooking oil fume exposure) contributed to a significantly higher risk of lung cancer, and the corresponding ORs (95% confidence intervals) were 1.91(1.04-3.52), 1.94 (1.16-3.25), 2.06 (1.22-3.49), 1.76 (1.03-2.98) and 2.13 (1.29-3.51). The individuals with both risk genotypes of miRNA SNPs and exposure to risk factor (cooking oil fumes) were in a higher risk of lung cancer than persons with only one of the two risk factors (ORs were 1.91, 1.05 and 1.41 for miR-146a rs2910164, ORs were 1.94, 1.23 and 1.34 for miR-196a2 rs11614913, ORs were 2.06, 1.41 and 1.68 for miR-608 rs4919510, ORs were 1.76, 0.82 and 1.07 for miR-27a rs895819, and ORs were 2.13, 1.15 and 1.02 for miR-423 rs6505162, respectively). All the measures of biological interaction indicate that there were not indeed biological interactions between the six SNPs of miRNAs and exposure to cooking oil fumes on an additive scale. Logistic models suggested that the gene-environment interactions were not statistically significant on a multiplicative scale.

Conclusions

The interactions between miRNA SNPs and cooking oil fume exposure suggested by ORs of different combination were not statistically significant.

[Injection of synthol in a bodybuilder can cause chronic wounds and ulceration]

In this case report we present a 45-year-old male bodybuilder, who had injected synthol and paraffin oil in both upper arms for augmentation purposes. This led to a circumference of 66 cm of his upper arms. His arms were rock solid and clearly deformed. Few years after the injections the patient suffered from spontaneous ulcerations on both arms. Conservative wound treatment with antibiotics and compression therapy had good effect on the ulcers of the right arm. The left arm needed surgical revision and negative pressure wound therapy preparing the tissue for a split skin graft.

Pulmonary oil micro-embolism (POME) syndrome: a review and summary of a large case series

The use of steroid compounds formulated in oil for depot injection can be associated with acute pulmonary reactions characterized primarily by cough, but sometimes with other associated symptoms. The pathophysiology of these reactions remains unclear, although they are reported in the literature as 'POMEs' or pulmonary oil micro-embolism events. We report on a large case series and propose a case definition for these events. These events can raise significant concern even though they are often self-limited. It is hoped that clinicians will recognize these events more readily and be able to inform patients better, and that future reports and assessments can benefit from our proposed case definition.

Eri silkworm: a source of edible oil with a high content of α-linolenic acid and of significant nutritional value

BACKGROUND

The study was undertaken to provide value addition to spent eri silkworm as an alternative source of edible oil for the food and feed industry by carrying out a short-term nutritional and toxicological evaluation of eri silkworm pupae oil using Wistar NIN rats.

RESULTS

Growth performance of rats fed either sunflower oil (Control) or eri silkworm pupae oil (Experimental) was comparable. Histopathological examination of the various tissues showed no signs of toxicity even after feeding the eri silkworm oil for 18 weeks. Serum cholesterol and triglyceride was significantly reduced (P < 0.05) while high-density lipoprotein cholesterol was significantly increased (P < 0.05) which is attributed to the high α-linolenic acid content of eri silkworm oil.

CONCLUSION

The study showed that eri silkworm pupae oil is safe and nutritionally equivalent to commonly used vegetable oils. Eri silkworm pupae can be harvested to provide a cost effective alternative edible oil that can be used to nutritional advantage in the food and feed industry. Therefore eri silkworm and its host plants offer an excellent example of multiple product crops and of sustainable agricultural practice with excellent opportunity for economic and nutritional benefits.

Exogenous lipoid pneumonia (oil granulomas of the lung)

The authors observed three cases of exogenous lipid pneumonia clinically suspected of lung carcinoma. Histological examination of material after thoracotomy gave the possibility of correct diagnosis. The lesions in lungs were characteristic granulomas around lipid material and with surrounding advanced fibrosis.

Immunomodulatory and physical effects of oil composition in vaccine adjuvant emulsions

Squalene-based oil-in-water emulsions have been used for years in some seasonal and pandemic influenza vaccines. However, concerns have been expressed regarding squalene source and potential biological activities. Little information is available regarding the immunomodulatory activity of squalene in comparison with other metabolizable oils in the context of oil-in-water emulsions formulated with vaccines. The present work describes the manufacture and physical characterization of emulsions composed of different classes of oils, including squalene, long chain triglycerides, a medium chain triglyceride, and a perfluorocarbon, all emulsified with egg phosphatidylcholine. Some differences were apparent among the non-squalene oils in terms of emulsion stability, including higher size polydispersity in the perfluorocarbon emulsion, more rapid visual instability at 60°C for the long-chain triglyceride and perfluorocarbon emulsions, and an increased creaming rate in the medium-chain triglyceride emulsion at 60°C as detected by laser scattering optical profiling. The biological activity of each of these emulsions was compared when formulated with either a recombinant malaria antigen or a split-virus inactivated influenza vaccine. Overall, vaccines containing the squalene emulsion elicited higher antibody titers and more abundant long-lived plasma cells than vaccines containing emulsions based on other oils. Since squalene-based emulsions show higher adjuvant potency compared to the other oils tested, non-squalene oils may be more suitable as carriers of amphiphilic or hydrophobic immunostimulatory molecules (such as TLR agonists) rather than as stand-alone adjuvants.

[Oleoma: A case report with good response to tetracycline]

Oleoma or paraffinoma is defined as a foreign body granuloma that results from the injection of oily substances into the skin or subcutaneous tissue. We present a young patient with ulcerated lesions secondary to infiltration of oily material. He had undergone the injections with the aim of increasing muscle mass and definition. The treatment of these cases is quite complex, often with unsatisfactory results. The use of long-term oral tetracycline proved to be helpful.

[Association of cooking oil fumes exposure and oxidative DNA damage among occupational exposed populations]

BACKGROUND

Previous investigations indicate that cooks are exposed to polycyclic aromatic hydrocarbons (PAH) from cooking oil fumes (COF). However, Emission of PAH and their carcinogenic potencies from cooking oil fumes sources have not been investigated among cooks.

AIMS

To investigate the urinary excretion of a marker for oxidative DNA damage, 8-hydroxydeoxyguanosine (8-OHdG), in different groups of cooks and different exposure groups, and to study the association between 8-OHdG and 1-hydroxypyrene (1-OHP), a biological marker for PAH exposure.

METHODS

Urine samples were collected from different groups of cooks (n = 86) and from unexposed controls (n = 36), all are male with similar age and smoking habits. The health status, occupational history, smoking, and alcohol consumption 24 hours prior to sampling was estimated from questionnaires. The urinary samples were frozen for later analyses of 8-OHdG and 1-OHP by high performance liquid chromatography.

RESULTS

Excretion in urine of 8-OHdG were similar for controls (mean 1.2 µmol/mol creatinine, n = 36), and for those who had been in the kitchen room with exhaust hood operation (mean 1.5 µmol/mol creatinine, n = 45). COF exposed cooks without exhaust hood operation had increased excretion of 8-OHdG (mean 2.3 µmol/mol creatinine, n = 18). The difference between this group and the unexposed controls was significant. The urinary levels of ln 1-OHP and ln 8-OHdG were still significantly correlated in a multiple regression analysis.

CONCLUSION

Results indicate that exposure to PAH or possibly other compounds in COF may cause oxidative DNA damage.

[Paraffin oil injection in bodybuilders calls for preventive action]

Injection of paraffin oil to change physical configuration is an obsolete procedure from 1899, revived by bodybuilders as an alternative to intramuscular injections of steroids. Paraffin oil has destructive consequences: skin inflammation, hard oedema, sterile abscesses, diffuse lymphangitis and paraffinomas. We report a case of a 24-year-old male bodybuilder who self-injected one litre of paraffin oil in each arm. Hazard notice and advice to bodybuilders with potential risk attitude or "reverse anorexia" are warranted.

Thyroid function after hysterosalpingography using an oil-soluble iodinated contrast medium

BACKGROUND

The objective of the present study was to evaluate the effect of an oil-soluble iodinated contrast medium (lipiodol) for hysterosalpingography (HSG) on thyroid function.

METHODS

In 214 of 528 women with infertility examined by HSG using lipiodol between 1996 and 2006 at our institution, serum free thyroxine (FT4) and thyrotropin-stimulating hormone (TSH) were measured before and several months after HSG.

RESULTS

The average age of the women was 34.5 +/- 4.6 years and their average infertility period was 2.9 +/- 2.5 years (mean+/-standard deviation). The 214 patients were divided into three groups based on the results of thyroid function before HSG: 180 in euthyroid, 28 in subclinical hypothyroidism and 13 in subclinical hyperthyroidism. The number of patients in the subclinical hypothyroidism group who developed hypothyroidism after HSG (ten of 28) was significantly higher than that of the euthyroid group (four of 180). Thyroid hormone replacement was required in three patients from the subclinical hypothyroidism group 1, 2 and 5 months after HSG.

CONCLUSIONS

We conclude that thyroid function should be monitored closely after HSG using lipiodol to detect the development of hypothyroidism, particularly in patients with subclinical hypothyroidism, and TSH and FT4 measurements should be performed before HSG to identify patients at risk for hypothyroidism.

Allergic contact hobby dermatitis from turpentine

INTRODUCTION

Turpentine is an oleoresin obtained from various species of pine. It contains a volatile oil (oil of turpentine) which is responsible for its properties and this is the form generally used. Opportunity for contact with turpentine is widespread. It is universally used as a solvent to dissolve and thin lacquers, varnishes and paints. It is also an ingredient in many liniments and cold remedies. Turpentine is regarded as both a local irritant and a sensitizer. Cases of allergic contact dermatitis in painters, mechanics, shoe repairers and home decorators have been reported.

CASE REPORT

We report a case of a non-professional painter who developed a contact allergic dermatitis due to his exposure to turpentine while doing oil-painting as a hobby.

DISCUSSION

Dermatitis is one of the biggest dangers of working with art materials and occupational contact dermatitis is often detected on the hands of the painters. Solvents are indispensable and turpentine is the most important and the traditional one used in oil-painting. Contact allergy to oil of turpentine was reported to have become rare in Europe but over the last few years, increased rates of turpentine sensitization have been reported.

Skin diseases in workers at a perfume factory

The aim of this study is to find out the causes of skin diseases in one-third of the staff of a perfume factory, in which 10 different perfume sprays were being manufactured. Site inspection, dermatological examination and patch testing of all 26 persons at risk with 4 perfume oils and 30 ingredients of them. The results showed 6 bottlers were found suffering from allergic contact dermatitis, 2 from irritant contact dermatitis, 12 workers showed different strong reactions to various fragrances. The main causes of allergic contact dermatitis were 2 perfume oils (12 cases) and their ingredients geraniol (12 cases), benzaldehyde(9), cinnamic aldehyde (6), linalool, neroli oil, terpenes of lemon oil and orange oil (4 each). Nobody was tested positive to balsam of Peru. Job changes for office workers, packers or printers to other rooms, where they had no longer contact with fragrances, led to a settling. To conclude, automation and replacement of glass bottles by cartridges from non-fragile materials and using gloves may minimize the risk.

Evaluation of Allodynia and Pain Associated With Postherpetic Neuralgia Using Current Perception Threshold Testing

OBJECTIVES

Postherpetic neuralgia has various clinical features, and the implicated pathophysiologic mechanisms are controversial. This study was carried out to clarify the roles of peripheral sensory nerves in the production of allodynia and ongoing pain. Current perception threshold (CPT) testing was used to evaluate the sensory function.

METHODS

The intensities of ongoing pain and dynamic allodynia were assessed using a numeric rating scale (0-10). Assessment of sensory nerve function was performed by a series of 2,000-, 250-, and 5-Hz stimuli using CPT testing. These measurements were made in ipsilateral and contralateral area.

RESULTS

CPTs at all frequencies in the ipsilateral area were significantly higher than those in the contralateral area. There were significant and inverse correlations between the intensity of allodynia and CPTs at all frequencies. No correlation was found between the intensity of ongoing pain and CPTs at any frequency. There was no correlation between the intensity of ongoing pain and the intensity of dynamic allodynia.

CONCLUSIONS

The intensity of dynamic allodynia in postherpetic neuralgia correlates with the preserved functions of Abeta, Adelta, and C fibers. In contrast, the intensity of ongoing pain does not correlate with either the preserved function of C fibers or the intensity of dynamic allodynia. Therefore, it is suggested that postherpetic neuralgia might be a pain syndrome including both peripheral and central mechanisms.

The use of oil adjuvants in therapeutic vaccines

Water in oil emulsions represents one of the new promising generations of adjuvants for immunotherapy. Fifty years ago, incomplete freund adjuvant (IFA) has been used in clinical trials for prophylactic vaccines like poliomyelitis or flu vaccine because of its strong potency. However, even if the quality of the raw materials has been improved in order to avoid secondary reactions, the risk benefit ratio was not favorable to its use for prophylactic vaccines. Moreover, emulsions were highly viscous with a weak stability. The development of new adjuvants concepts like liposomes, oil in water emulsions, bacterial immunostimulating compounds has induced a loss of interest for such formulations. The emergence of immunotherapy treatments for cancer, AIDS or other diseases leads to the re-emergence of these adjuvants, as the risk benefit ratio is more favorable. Then, safety of these adjuvants has been improved by the use of more specific surfactants and refined oils but also by improving their manufacturing process, allowing even sometimes their use in clinical trials for prophylactic vaccines.

Hot oil burns—A study of predisposing factors, clinical course and prevention strategies

A 10-year retrospective study of hot oil scalds was conducted at the Yorkshire Regional Burns Centre from the years 1995-2004. The number of admissions was noted to have increased over this period. Peak occurrence was noted in the 1-5 and the 30-40-year-old age groups. The peak occurrence in adults was significantly older than that previously reported. Ninety-two percent of injuries in the 1-6-year-old age group were due to pulling a handle or cord of a container of hot oil. Older children had similar mechanisms of injury as adults. Injuries due to epilepsy, intoxication or assaults, were seen exclusively in the fourth to seventh decades of life. The total body surface area of adults and children were similar, i.e. 7.15 +/- 5.49% versus 7.23 +/- 6.87%. However, the incidence of full thickness injury in adults was over twice that observed in children, i.e. 67% versus 26%. Prevention of hot oil scalds requires adult supervision of young children. Product modification for fryers is helpful, but is not a substitute for adult supervision. Prevention of injury in adults requires the placement of adequate warning labels on hot oil cooking appliances as well as containers of cooking oil. In addition, adults should refrain from the consumption of alcoholic beverages when using hot oil cooking appliances or deep-frying.

Available friction of ladder shoes and slip potential for climbing on a straight ladder

Straight ladder accidents are a major safety problem. As a leading cause of injuries involving straight ladders, slips at the ladder base occur when the required friction exceeds the available friction at the ladder shoe and floor interface. The objectives of this experiment were to measure the available friction at the base of a portable straight ladder in contact with a floor and to estimate the slip potential of the ladder. The results of friction measurements indicated that the measured friction coefficient on the oily surfaces differed among the six commercially available ladder shoes evaluated. A statistical model was used to compare the available friction results from the current study with the friction requirements under different climbing conditions from a previous study based on their stochastic distributions to estimate the slip potential at the base of the ladder. The results showed that different climbing conditions used in the previous study could be supported by available friction on dry surfaces. However, when the ladder was put onto oily surfaces, resulting in a significant reduction in the available friction due to contamination, slip potential was significantly increased.

Respiratory health status of Australian veterans of the 1991 Gulf War and the effects of exposure to oil fire smoke and dust storms

BACKGROUND

Since the 1991 Gulf War concerns have been raised about the effects on veterans' health of exposures to Kuwaiti oil fire smoke and to dust storms.

METHODS

A cross sectional study compared 1456 Australian Gulf War veterans with a randomly sampled military comparison group (n = 1588). A postal questionnaire asked about respiratory conditions, exposures, medications, tobacco use, demographic characteristics, and military service details. During a medical assessment, spirometric tests and a physical examination were performed and a respiratory questionnaire was administered.

RESULTS

The response rate for the Gulf War veteran group was 80.5% and for the comparison group 56.8%. Australian Gulf War veterans had a higher than expected prevalence of respiratory symptoms and respiratory conditions suggesting asthma (OR 1.4; 95% CI 1.1 to 1.9) and bronchitis first diagnosed since the Gulf War (OR 1.9; 95% CI 1.2 to 3.1) but did not have poorer lung function or more ventilatory abnormalities than the comparison group. Veterans who reported exposure to oil fire smoke had slightly poorer forced vital capacity (difference between means -0.10 l; 95% CI -0.18 to -0.03) and those exposed to dust storms had a slightly better peak expiratory flow rate (difference between means 12.0 l/min; 95% CI 0.6 to 23.4) than veterans who did not report exposure. Veterans who were in the Gulf at or after the start of the oil fires had more respiratory conditions suggesting asthma (OR 1.7; 95% CI 1.0 to 2.9) than those who completed their deployment before this time.

CONCLUSIONS

Increased self-reporting of respiratory symptoms, asthma, and bronchitis by veterans was not reflected in poorer lung function. The findings do not suggest major long term sequelae of exposure to oil fire smoke or dust storms.

Irritation potential of bath and shower oils before and after use: a double-blind randomized study

BACKGROUND

Difficulties in avoiding weak irritants may contribute to chronic contact dermatitis. A large variety of shower and bath oils are claimed to be suitable for use on dry skin because of their mildness and because they deposit a protective oil film on the skin.

OBJECTIVES

The aim of the present study was to investigate possible differences in the irritation potential of eight shower or bath oils and to investigate whether surfactant residues may form a reservoir of irritant substance on the skin.

PATIENTS AND METHODS

The study was double-blind and randomized using healthy human volunteers. The inherent capacity of the products to induce irritation was determined using conventional patch test techniques. Detection of potentially irritant residues was done by occlusion of the treated and rinsed skin area, followed by evaluation of the biological response. Instrumental measurements of transepidermal water loss and superficial skin blood flow served as indicators of the injurious effects of the products.

RESULTS AND CONCLUSIONS

The results showed large differences between the products in irritant potential. Some did not irritate skin more than water, whereas others demonstrated considerably damaging effects. Moreover, the study proved the presence of barrier-impairing residues on the skin after rinsing with water. Thus, instead of protecting the skin, some formulations may induce subclinical injuries and delay skin barrier function recovery with prolonged risk for patients with eczema.

Hot Cooking Oil Burns: A 20-Year Experience

Hot cooking oil burns resulted in 316 admissions to the Burns Unit at The Royal Brisbane Hospital between January 1, 1981, and December 31, 2000. Notable demographics of this group were a male:female ratio 1.74:1 and that 24% of all patients were between the ages of 16 and 20. Workplace burns accounted for 6% of admissions only, but these tended to be of a larger total body surface area involvement. The mean duration of admission was 8.5 days, with 40% of patients undergoing surgical débridement and split-skin grafting. Two hundred thirty-nine patients had 5% or less TBSA burned, most commonly involving the hands, legs, feet, and the forearms. No patients in our study died. The proportion of patients undergoing débridement and grafting increased from zero patients at commencement of this study to a peak of 82.5% in 1998. We believe this reflects changing practice with earlier excision and grafting trying to achieve the best functional and cosmetic results. The lack of predisposing factors and the accidental nature of these burns mean appropriate prevention strategies are paramount to decreasing the number of burns of this type. Suggestions discussed include school-based education programs, warning labels included in product information, and mandatory fire blankets within the home.

Occupational asthma in a highly industrialized region of UK: report from a local surveillance scheme

Estimates of the incidence of occupational asthma may be derived from surveillance schemes established in several countries. SHIELD is a voluntary surveillance scheme for occupational asthma in the West Midlands, a highly industrialized region of UK. The aim of this study was to estimate the general and specific incidence of occupational asthma in the West Midlands in 1990-97. The annual incidence was 41.2/million. There was a two fold difference in the incidence by sex (male 59.6/million/yr; female 27.4/million/yr). The highest annual incidence (53.2/million) was observed in the age group 45-64 yr (male) and 45-59 yr (female). Spray painters were the occupation at the highest risk of developing occupational asthma, followed by electroplaters, rubber and plastic workers, bakery workers and moulders. Although the percentage of reported cases was low among healthcare workers, there was a raising trend. Isocyanates still remained the most common causative agents with 190 (17.3%) out of the total 1097 cases reported to the surveillance scheme in seven years. There was a decrease in the reported cases due to colophony (9.5% to 4.6%), flour & wheat (8.9% to 4.9%). There was an increase of reported cases due to latex (0.4% to 4.9%) and glutaraldehyde (1.3% to 5.6%). The serial mesurement of peak expiratory flow at and away from work was the most used method of diagnosis to confirm the occupational cause of asthma. Specific bronchial challenge test with the occupational agents were used when the serial measurement of peak expiratory flow was not able to confirm undoubtdely the diagnostic suspicion or when it was difficult to identify the possible causative agent due to multiple exposures in the workplace. Following diagnosis, 24% of the patients were moved away from exposure within the same workplace in 1997, compared to 15.8% in the previous years. Those remaining exposed to the causative agent in the same workplace decreased from 28.3% to 17.7% between 1990-97. The surveillance of occupational asthma trough this voluntary scheme has allowed to monitor the incidence of the disease in the region and to identify clusters of cases, where control measures are a priority.

Late reactivation of tuberculosis in an oleothorax

The injection of oil into the pleural cavity was a widely used treatment of pulmonary tuberculosis until the advent of effective anti-tuberculous therapy. Long-term complications of oleothorax can occur when the oil is not removed. The authors present an unusual complication of oleothorax, reactivation of tuberculosis, 54 years after oil instillation.

[Exogenous lipoid pneumonia--case report]

A 72-year-old patient with a rare disease-exogenous lipoid pneumonia (ELP) was described. One year ago he underwent laryngectomy because of larynx carcinoma and now he was admitted to hospital because of suspicion of cancer progression in the lungs. Chest HRCT and microscopic picture of BALF suggested diagnosis of lipoid pneumonia. His history supported it because he used oil drops to hist tracheostomy outline.

[Exogenous lipoid pneumonia]

Two cases of exogenous lipoid pneumonia are presented. The 22 years old woman was admitted to hospital because of recurrent dyspnea, cough, fever and chest pain, are changes on chest x-ray. Bronchoscopy, chest CT scan, respiratory functional test and laboratory tests were performed but the diagnosis was not established. Just before thoracoscopy patient revealed frequent intentionally choking with oil. The second patient 39 years old man was admitted because of dyspnea, cough, fever and chest pain, which appeared after accidentally choking with oil. In both cases the diagnosis was confirmed with special staining of bronchial discharge specimen.