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A case of epilepsy precipitated by bathing is described and previously reported cases are reviewed. The prognosis for this rare form of reflex epilepsy seems to be good, in that the seizures resolve with age and neurodevelopment remains normal.
Papular umbilicated granuloma annulare is usually localized and is relatively asymptomatic. The generalized condition is rarely reported in children and tends to respond less well to treatment than the localized form. We report the first instance of generalized papular umbilicated granuloma annulare in an 11-year-old boy, which cleared following bath psoralen plus ultraviolet A therapy.
A 57-year-old male was admitted to our hospital because of high fever, productive cough and dyspnea. Six days prior to admission he had an episode of drowning in a public bath. On admission chest X-ray showed wide-spread pneumonia causing severe respiratory distress for which mechanical ventilatory support was started. Despite chemotherapy including erythromycin and rifampicin his condition continued to deteriorate. Chemistry showed marked elevation of CPK and findings of acute renal failure. He eventually passed away with septic shock. During the course Legionellae remained negative with culture of broncho-alveolar lavage fluid. L. pneumophila serogroup 1 (SG1) antigen in the urine was not detected, and no elevation of serum antibody titer was noted. Culture of the material obtained from the lung abscess at autopsy revealed L. pneumophila SG6 and serum antibody titer against SG6 also was found to be extremely high. With this evidence we concluded that this case of pneumonia was caused by L. pneumophila SG6. We believe this is the first reported case of the SG6 pneumonia in Japan. Another remarkable feature of this case was massive rhabdomyolysis pathologically confirmed after autopsy. Although the pathogenesis of this process has not been clarified, there are several case reports of rhabdomyolysis complicated with Legionnair's disease in the past. Therefore, we should bear in mind and pay careful attention while coping with this disease.
Immersion in hot baths is an infrequently recognized cause of reflex epilepsy. Two such cases are described. Increased awareness of unusual forms of reflex epilepsy is necessary as this may have important prognostic and therapeutic implications.
There are inherent weaknesses associated with currently used bacterial fecal pollution indicator systems. Fecal pollution indicator data would be more meaningful if supplemented with information relating to the occurrence of pathogens in recreational water. Through surveys of four bathing beaches on Lake Ontario, it was established that the opportunistically pathogenic yeast Candida albicans occurs in near shore waters. The beaches surveyed could be differentiated on the basis of bacterial fecal pollution indicator levels and numbers of the pathogens C. albicans and Pseudomonas aeruginosa. The occurrence of C. albicans and P. aeruginosa appeared to be related to elevated fecal pollution indicator levels. Maximum numbers of all parameters were observed in July and August in association with peak bather loads at the beaches. In only one instance does the data suggest that a beach was subjected to human fecal contamination.
A series of 14 cases of suicide by drowning in the bath in the Bristol area, England between 1974 and 1996 is presented. There were six males and eight females with a mean age of 66 years. The majority were married and lived with their spouse or another relative. Most drowned at home, face down, fully clothed. Six cases had evidence of concomitant alcohol or substance use. Seven cases had a past psychiatric history and a history of previous deliberate self-harm. Issues concerning prevention are discussed.
The effects of Senkyu (Cnidii Rhizoma and Ligustici chuanxiong Rhizoma) on the drug skin penetration were studied to clarify its effectivity as the baths. Ether and methanol extracts, and some essential oils of Senkyu (i.e. ligustilide, neocnidilide and butylidenephthalide) enhanced remarkably the skin penetration of benzoic acid. Furthermore, an appreciable correlation between the enhancing ratio and the skin/donor partition coefficient of benzoic acid was observed. These facts suggest that the constituents of Senkyu influence the skin penetration by enhancing the partition coefficient.
Skin permeation and its enhancing activity of Coptidis Rhizoma (Coptis japonica Makino) were studied in regard to its application as a bath agent. As a result, methanol extracts and three alkaloids (berberine, coptisine, and palmatine isolated from Coptidis Rhizoma) enhanced effectively the skin permeation of 5-fluorouracil, which is taken as a hydrophilic permeant. Furthermore, it was observed that diffusion coefficient is almost constant on the skin permeation of 5-fluorouracil and was also observed that these three kinds of alkaloids did not penetrate through the skin, but adsorbed into the skin. These results suggest that these three protoberberine type alkaloids increase the concentration of polar drugs in the skin and enhance the skin permeation similarly to surfactants.
The significance of positive ST-T changes during bathing, eating, defecating and urinating was studied in 103 patients with ischemic heart disease using Holter and 12-lead ECG. The incidence of positive ST-T changes was very high in patients with unstable angina (US) and in those with old myocardial infarction (OMI) associated with unstable angina. However, it was relatively low in angina-free OMI and extremely low in stable angina. Positive ST-T changes during defecation and urination were mostly (70% and 73%, respectively) seen from night to early morning. With regard to showering or eating, the incidence of positive ST-T changes was low during spraying hot water on the body without motion or remaining motionless after eating. It was not until light exertion was added that the incidence increased. However, pressure-rate product after such behavior did not always increase as compared with that before them. Consequently, it is suggested that the mechanism of anginal attack during urination may be similar to that of variant angina. With regard to showering or eating, it is considered that the spraying of hot water or food intake may bring about a change in the cardiac autonomic nerve tone, and that the addition of light exertion can easily induce myocardial ischemia which is not due to an increase in the oxygen demand of the myocardium.
Although it has been found that legionellae can exist in a 24-h hot water bath (24HHWB), which has been used recently in Japan, whether longer use of the 24HHWB causes legionellosis is unclear. The present longitudinal study was conducted in 2000 to investigate the 3-yr change in antibody titers in association with the continuous use, non-use, or canceling the use of the 24HHWB, and possible factors relating to the antibody changes. Ninety-two subjects (85 males and 7 females), who had had their anti-Legionella pneumophila (Lp) serum antibody titers measured in our initial study in 1997 and consented to blood sampling 3 yr later, were selected as subjects. There were no clinical cases who had experienced Legionnaires' disease or Pontiac fever during the 3 yr. The continuous users showed no significant changes in antibody titers within 3 yr, whereas the continuous non-users had a significant increase in antibody titers against the Lp serogroup (SG) 5 and 6. Eleven ex-users of the 24HHWB showed a significant decrease in antibody titers against Lp SG 6. The changes in the 24HHWB use, job sector, stress coping strategies, and alcohol-drinking habit were associated with the changes in antibody titers against Lp SG 1, 5 or 6. The anti-Lp antibodies were considered to be IgM dominant. In conclusion, this study indicates that 24HHWB use by healthy subjects does not tend to result in a higher onset risk of legionellosis, even if it is continuously used for 3 yr, although 24HHWB use is likely to induce production of antibodies against legionellae.
Findings are described from the second year of an epidemiological-microbiological study conducted at New York City beaches as part of the U.S. Environmental Protection Agency program to develop health effects-recreational water quality criteria. Symptomatology rates among swimmers (defined as immersion of the head in the water) relative to nonswimming but beach-going controls at a "barely acceptable" (BA) beach and a "relatively unpolluted" (RU) beach were examined. Data were collected by contacting family groups at the beach on weekends, obtaining information on bathing activity, and then questioning them by phone some 8--10 days later. In addition measurements were made for a number of potential water quality indicators. It was observed that the symptom rates, categorized as gastrointestinal (GI), respiratory, "other", and "disabling" (stayed home, stayed in bed, consulted a physician), were higher among swimmers than nonswimmers. As in the pretest conducted the previous year, the rate of GI symptoms was significantly higher among swimmers relative to nonswimmers at the BA but not the RU beach. Children, Hispanic Americans, and the low-middle socioeconomic groups were identified as the most susceptible portions of the population.
Bathing in bed (BB) is an essential nursing technique applied to patients with restricted physical abilities. The aim of this technique is to keep the functions of the skin as an external barrier and to prevent the patients from infection and decubitus. However, the effect of BB on the blood circulation of the skin has not yet been identified, and the data observed are controversial. We have evaluated the effects of BB on the blood circulation of the skin by use of thermography. BB was applied on the right side of the back (RB) in 6 healthy female subjects who exposed both sides of their back (RB and LB) at room temperature. Ethanol was applied on the 5 x 5 cm area of RB and LB after BB, and recovery of the skin temperature was observed. After BB, the average temperature of RB was significantly lower than that of LB. This shows that BB decreases temperature of the skin exposed in the air probably due to the supply of water by washcloth. Recovery of the skin temperature after the ethanol-loading was accelerated on RB. This indicates that BB facilitates the response of the blood vessels in the skin.
A survey was undertaken on use of bath seats, and whether diagnosis, age, sex, living conditions and payment for the aid(s) influenced their use. Eighty-two per cent of patients were found to use their aids. Only diagnosis influenced the use significantly (p = 0.008). With correspondence analysis those with joint disease showed closest relationship with permanent use. Those with spinal cord injury showed closest relationship with no use.
Organophosphate (OP) pesticides are widely used as antiparasitic chemicals in finfish aquaculture. However, current antidotes cannot be applied to treat intoxicated fish. We showed in previous studies the importance of glutathione (GSH) metabolism in pesticide resistance of the European eel Anguilla anguilla L. The present work studied the effects of the antioxidant and glutathione pro-drug N-acetyl-L-cysteine (NAC) on the recovery of European eels exposed for 96 h to a sublethal concentration (0.17 mg l(-1); 20% of its 96 h LC50) of the OP pesticide dichlorvos (2,2-dichlorovinyl dimethyl phosphate; DDVP). This insecticide and acaricide decreased muscular GSH content and increased oxidised glutathione (GSSG), lowering the GSH:GSSG ratio, which is indicative of a condition of oxidative stress. Acetylcholinesterase (AChE) and glutathione reductase (GR) activities in the brain, which were biomarkers of neurotoxicity and oxidative stress, respectively, were also highly inhibited. Recovery in a 0.5 mM (81.6 mg l(-1)) NAC concentration ameliorated muscular GSH depletion, GSH:GSSG ratio, and the inhibition of brain AChE and GR activities. Hence, this is the first evidence of improved recovery of organophosphate-poisoned fish by bath treatments.
1. Cognitively impaired elderly patients often become aggressive toward caregivers who are providing assistance with bathing and grooming, but caregivers can learn methods to prevent or reduce some of the aggression. 2. The R.E.S.P.E.C.T. model describes key practices caregivers can use to better meet patient needs and reduce aggression, increasing their understanding and skill. 3. In addition to training, observation of performance and consultation are important steps in enabling caregivers to apply and maintain their skills.
Serum drug levels were measured in channel catfish following bath exposure to kanamycin, gentamicin and chloramphenicol. Kanamycin was absorbed at a rate sufficient to attain therapeutic blood levels in several treatment schedules. Therapeutic blood concentrations could not be attained with gentamicin or chloramphenicol following 24 hrs exposure at 80 and 100 microg/ml water concentrations, respectively.
Effects of Arzni effervescent mineral baths (EMB) on brain tissue metabolism were studied on white rats (normal controls and those with transitory cerebral ischemia). It was found that EMB prevent ischemia-related disorders of phospholipid and adeninnucleotide pools, promote an increase in vasoactive prostaglandins in brain tissue, shifts in catecholamines concentrations in the hemispheres and hypothalamus, inhibit the activity of monoaminoxidase and absorption of 3H-noradrenaline by brains sections. Mechanisms of neuroprotective action of Arzni EMB in cerebral ischemia are considered.
A trial of dry air effervescent baths and low-temperature peloid applications was made in 109 patients with psoriatic arthritis (PA). Marked response was achieved in patients who had received combined therapy with the above two modalities. The effect presented with lower articular index, weaker skin involvement, improvement of blood picture. These positive changes correlated with normalization of immune indices. The benefit persisted for 6-9 months.