PubMed Health⌕ Search

Biomedical subjects

L Zell

Publications and source records attributed to L Zell.

16 recordsLinked to original sources
PubMed2001

[Nitrate headache in blasting work].

CASE REPORT: A 34-year-old white male was executing blasting works in an operation of a quarry several times a month during a period of 1 year. Each time he worked with explosives, he complained of headache, vertigo and concentration failure which started shortly after beginning and continued several hours after. The results of the physical examination on a day without blasting works were normal. Because of the exact working parallel appearance of the symptoms we did further explorations at the workplace which showed the usage of nitroglycerin blasting agents without observance of the safety regulations. The symptoms only at blasting workdays with normal clinical findings at break led considering the relation with the occupational conditions to the diagnosis "headache due to exposure to nitroglycerin explosives". It was reported to the employer's liability insurance association as an occupational disease with the aim of improving occupational conditions. CONCLUSION: Occupational toxic agents as a potential trigger of unclear headache support the requirement of an exact anamnesis of working conditions and environment.

Diagnosis, Differential↗
PubMed2001

[Paget-von Schroetter syndrome as an occupational accident].

HISTORY AND CLINICAL FINDINGS: Two men and one woman developed typical symptoms of a thrombosis in the arms after unusual physical effort at their work place (a coal miner after a bad fall, a radiographer after having to catch a patient, a painter after jerkily moving a heavy piece of furniture). INVESTIGATIONS AND DIAGNOSIS: In all three patients a thrombosis of the subclavian vein was demonstrated by duplex scans or phlebography. In two patients tests for hypercoagulability were unremarkable. None of the patients had a thoracic outlet syndrome. TREATMENT AND COURSE: After initial local thrombolytic or heparin therapy alone, phenprocoumon treatment over several months was given in two cases, and in one case low-molecular-weight heparin was administered over several months. All three patients complained of strain-related residual symptoms in the affected arm (pain, swelling, easy fatigability). In all three cases, the accident insurer recognized the incident to be a work-related accident. CONCLUSION: Patients with a Paget-Schroetter syndrome resulting from a sudden and unusual physical effort at work, which is covered by statutory accident insurance, must be reported to the accident insurer as a work-related accident in order to safeguard individual medical claims of the patient and for general medical and epidemiological reasons.

Accidents, Occupational↗
PubMed2001

Paget-Schroetter syndrome in sports activities--case study and literature review.

The authors report 7 patients with thromboses in the upper extremity resembling Paget-Schroetter syndrome. According to their case histories, all patients had a temporal and causal relationship between partially unusual sports activities and the genesis of the thrombosis. The cause of this condition is a strain on the subclavian and axillary veins by retroversion or hyperabduction of the arm. This can entail microtraumatizations of the venous intima, consequently leading to a consecutive local activation of coagulation and to a possible thrombosis of the vessel. A mechanical compression of the vein by adjoining bone, ligament, and muscle structures can intensify the effects. Further primary diseases and risk factors as secondary causes for thromboses where taken into consideration when examining the patients. The Paget-Schroetter syndrome should be considered as a possible cause for unspecified trouble in the upper extremity reported by athletes. If such prolapses occur, they can be categorized as accidents by private and statutory insurance companies that cover accidents.

Axillary Vein↗
PubMed2001

The Paget-Schroetter syndrome: work accident and occupational disease.

INTRODUCTION: Primary thrombosis of the upper extremity (Paget-Schroetter syndrome, effort thrombosis) is usually not accepted either as a work-related accident or an occupational disease by the industrial injuries insurance authorities. This study aims to look at the circumstances under which this kind of thrombosis may be recognised as an occupational hazard. MATERIALS AND METHODS: After thoroughly studying the clinical records of 82 patients with thrombosis of the upper extremity in the outpatient department for angiology during a 10-year period, we found that in 51 cases the thrombosis was caused by secondary reasons (i.e., central venous catheterisation, malignoma, hypercoagulability, postoperative). In the remaining 31 patients, we painstakingly conducted a general and occupational history and further clinical, laboratory or technical investigations to differentiate the aetiology. RESULTS: Twenty-eight of 31 patients with suspected primary thrombosis of the axillary or subclavian vein (Paget-Schroetter syndrome) showed unusual private or occupational physical exercise as the underlying cause. Sixteen patients reported only short physical exercise up to several hours or acute trauma. Longer physical exercise periods (several days, months or even more) were found in 12 patients. Ten of the 28 patients who acquired the thrombosis doing occupational tasks covered by the industrial insurance, may be eligible for compensation. In 4 of these 10 insured cases, we found strong hints for work accidents, 6 patients of this group apparently revealed criteria of occupational diseases. Four of the 28 patients had a combination of physical effort and additional thrombogenic risk factors (cardiac pacemaker, hypercoagulability). CONCLUSION: Primary thrombosis of the upper extremity (Paget-Schroetter syndrome) should be announced to and compensated by the industrial injuries insurance either as work-related accident or occupational disease if the patient's occupational history shows close relationship between thrombosis manifestation and extraordinary physical efforts or exercises during occupational strains. For this reason, we recommend the recognition of the Paget-Schroetter syndrome in the national list of occupational diseases.

Accidents, Occupational↗
PubMed2000

[Paget-Schroetter syndrome caused by wrestling].

Upper extremity thrombosis (Paget-Schroetter syndrome) hints already at physical strains with regard to the synonymous term "effort thrombosis". We report two cases of upper extremity thrombosis caused by wrestling. Wrestling as an example of martial arts activity leads to traumatic venous intima lesions with resulting local activation of coagulation as a main reason in pathogenesis of these thromboses. The possibility of a Paget-Schroetter syndrome should be considered in differential diagnosis if upper extremity complaints of unknown origin occur after wrestling matches. This kind of subclavian vein thrombosis should be reported to the accident insurance.

Adult↗
PubMed1999

[Abscessed pneumonia caused by Pseudomonas aeruginosa as an occupational disease in a metal driller].

We report the case of a 29-year-old man without immunodeficiency who acquired Pseudomonas aeruginosa pneumonia complicated by pulmonary abscess. The source of infection could be identified as aerosolized metalworking fluid at his workplace contaminated with Pseudomonas aeruginosa. A high titer of specific IgG antibodies (type-III-sensitization, Gell & Coombs) against Pseudomonas aeruginosa has been identified in the patients serum as an indicator for longstanding occupational airborne exposure to contaminated metalworking fluid. This community-acquired pneumonia has been reported to the industrial injuries insurance as an occupational disease for discussion of legal consequences and development of effective measures of prevention.

Adult↗
PubMed1998

A phase I study of paclitaxel in combination with etoposide in patients with stage IIIB/IV non-small cell lung cancer (NSCLC).

Paclitaxel is a new antineoplastic agent with activity in lung cancer. This phase I clinical trial was designed to determine the maximum tolerated dose (MTD) of paclitaxel in combination with etoposide in previously untreated patients with non-small cell lung cancer (NSCLC). Doses of paclitaxel were in the range of 150-225 mg/m2 (d1) and of etoposide in the range of 100-120 mg/m2 (d2-4). The drugs were administered by i.v. infusion over 3 h (paclitaxel) and 2 h (etoposide). The patients received four courses at 21-day intervals. Twenty-four patients (six female, 18 male) entered the trial. The characteristics of the patients were as follows: median age 64 (55-73) years; Karnofsky index 80% (70-90%); stage IIIB n = 7, IV n = 17; histology, 14 adenocarcinoma, 10 squamous carcinoma. Hypersensitivity reactions after paclitaxel were not observed. The most relevant toxic effect observed was neutropenia (WHO grade 3-4). Three episodes of febrile neutropenia, two episodes of absolute neutropenia (< 100/microliter for > 3 days), and one case of mucositis (WHO grade > or = 3 for > 7 days) occurred. It can be concluded that the MTD of paclitaxel in combination with etoposide was reached at doses of 200 mg/m2 paclitaxel (d1) and 100 mg/m2 etoposide (d2-4).

Aged↗
PubMed1997

[Effectiveness and hematotoxicity of paclitaxel monotherapy in patients with advanced non-small cell bronchial carcinoma (NSCLC)].

In initial studies the dose-limiting toxicity of paclitaxel monotherapy was leukopenia. In these studies, paclitaxel was administered over 24 hrs. The aim of the present phase II clinical trial was to investigate the efficacy and the hematological toxicity of a 3 hr paclitaxel infusion in previously untreated patients with NSCLC. Patients received 4 cycles of a chemotherapy consisting of paclitaxel 225 mg/m2 every three weeks. 30 patients (7 female, 23 male) were enrolled in the study. The characteristics of the patients are as follows: age 64 (47-75 yrs); histology: 19 x squamous cell carcinoma, 11 x adenocarcinoma: 4 x IIIB, 26 x IV; performance status 80 (70-90). After prior administration of an anti-allergic medication, hypersensitivity reactions after paclitaxel were not observed. After the first course of paclitaxel chemotherapy, hematological toxicity was as follows: leukopenia WHO-grade 1-2: n = 13; grade 3-4: n = 7; neutropenia grade 1-2: n = 9; grade 3-4: n = 12; anemia grade 1-2: n = 8; no significant thrombocytopenia. In all patients symptoms of peripheral neurotoxicity (WHO grade 1-2) were observed. 19 patients completed the intended four cycles of chemotherapy. The response rates were as follows: partial remission n = 8 (42%), no change n = 11 (58%). Among these patients, the 1-year survival rate was 63%. The efficacy of paclitacel monotherapy in patients with advanced NSCLC appears to be acceptable. The hematotoxicity of paclitaxel after 3h-infusion was markedly less compared to a 24h-regimen.

Aged↗