ABSTRACT
Pesticide poisoning is one of the most inportant health issues associated with rural medicine, and chronic nervous and mental disorders are its importnat sequelae. We investigated suquela cases nationwide, and reviewed chronic nervous and mental disorders from a clinical and epidemiological point of view.<BR>Our nationwide survey found one reported case of delayed neuropathy. The patient ingested organophosphorus insecticides, and showed delayed neuropathy dozens days after.<BR>Cases of delayed neuropathy attributable to Mipafox was reported in1951.This disease is mainly caused by organophosphorus insecticides. Carbamate insecticides are also known as the agents to induce delayed neuropathy. Herbicide Glufosinate (Basta<SUP>TM</SUP>) was put on the market in 1984. The case reports published during the 1990's pointed out that some Glufosinate poisonings cause amnesia and disorientation. Thesecases were reviewed according to the types of pesticides or their groups.<BR>An epidemiological investigation of neurological and psychiatric desorders among such workers exposed to several types of pesticides as plantation workers and sheep dippers was made. These exposed workers were at high risk of mild cognitive dysfunction, tremor, weakness, and so on to a significant extent. Those children who were exposed to organochlorine insecticide and pollutant via placenta or milk were also surveyed whether they had impairments of nervous and mental development. Highly exposed children were significantly slow in development relative to their peers. The results of these investigations were also reviewed.
ABSTRACT
Data concerning clinical cases of pesticide-induced disorders were collected from members of the Japanese Association of Rural Medicine during 1998-2000 FY throughout the nation, and were analyzed statistically.<BR>1) A total of 209 cases of poisoning by agricultural chemicals were reported from 49 hospitals and other medical institutions.<BR>2) By types of clinical manifestations, the majority of the cases were acute or subacute pesticide poisoning (91%), which was followed by acute dermatitis (5%) and chemical burn (3%).<BR>3) Suicide accounted for 67% of the pesticide poisoning cases, which was followed by accidental exposure on the job during spraying (17%), and so forth.<BR>4) Organophosphate insecticides were the most frequent inducers of the clinical cases (34%), which was followed by bipyridylium herbicides (21%) and a carbamate insecticides (9%), and so forth.<BR>5) There were 43 cases of intoxication during spraying, during preparation or settling, and working in sprayed areas By types of clinical manifestations, the majority of the cases were acute or subacute pesticide poisoning (56%), which was followed by acute dermatitis (23%) and chemical burn (16%).<BR>6) Agricultural chemical compounds responsible for the clinical cases varied greatly. They induced organophosphate insecticides (19%), and bipyridylium herbicides (12%).<BR>7) Main factors contributing to the onset of pesticide-related disorders were insufficient protective clothing (32%), carelessness (22%), and inevitable consequences of pesticide use (10%).
ABSTRACT
A questionnaire survey of opinions about postgraduate clinical training was conducted among doctors who had graduated from Kochi Medical School. Completed questionnaires were returned by 121 doctors (46.5%). Many doctors chose hospitals before graduation to secure working positions rather than to receive actual training. About half of the doctors think that training of emergency medicine was poor at their clinical training hospitals. To encourage medical students to participate actively in postgraduate clinical training and to train efficiently, university hospitals and clinical training hospitals designated by the Ministry of Health and Welfare should cooperate with one another and organize training programs for emergency medicine.
ABSTRACT
The Nagoya District Court, on May 1989, ruled that doctors could exercise their discretion about whether or not to inform patients that they were suffering from an incurable or grave illness.<BR>Taking advantage of this opportunity, the authors carried out a questionnaire survey of medical students as to whether or not they knew this and what opinions they had about telling the truth to patients with cancer.<BR>There were 502 respondents among 620 students and these were divided into three groups of almost the same number; those who knew of and understood the judgment correctly, those who knew of it but mistook the meaning, and those who did not know of it.<BR>Two thirds of the respondents said that the number of physicians informing the patients of the truth will increase in the future, and that half of them will do so when they become physicians. Those who responded that they would not inform the patients totaled 16 percent.<BR>In cases where a famiy member had cancer, 53 percent of the respondents would not inform a relative unless the patient was aware of his own disease, but 57 percent would if the relative wanted to know the real diagnosis.<BR>Students in the lower classes gave animated opinions about this problem, and those in the upper classes treatd warily as to whether they would inform the patient of the truth or not.
ABSTRACT
Phosvel is an organophosphorus pesticide known to produce delayed neurotoxicity. In our earlier investigation, the neurotoxicity was greater in hens which fasted for two weeks than in those which were normally or force fed for some weeks. This suggested a relationship between the sensitivity to the neurotoxicity of phosvel and the amount of adipose tissue of animals receiving this compound.<BR>In this study, neurotoxicity levels in five groups of hens, each fasted for different duration (3, 6, 9, 12 and 15 days) before administration of phosvel, were compared with normally fed hens. The results are as follows;<BR>1. A single oral dose of phosvel was administered to each hen at the rate of 250 mg/kg body weight.<BR>2. There were no abnormal hens in the fed group or the ‘3 days fasting’ group.<BR>3. In the ‘6 days fasting’ group, 2 out of 5 hens showed ataxia and one of them developed mild paralysis. But no hens died in this group.<BR>4. However, in both groups of ‘9’ and ‘15 days fasting’, all hens were attacked by delayed neurotoxic effect. Three out of five in each group died after developing severe paralysis.<BR>5. One bird in the ‘12 days fasting’ group died due to the acute poisoning of phosvel on day 3 after administration. This was a very rare case in the series of studies of the compound. Three out of 4 remaining hens developed severe paralysis and one of these affected hens died.<BR>6. In general, the longer the animals fasted the greater was the delayed neurotoxic effect, however, if the adipose tissue of the animals was cosumed more than a certain level by enforced fasting, the neurotoxicity tended to be markedly increased.