Severe hypertriglyceridemia-induced pancreatitis during pregnancy.

Chylomicronemia syndrome is a rare disorder characterized by the presence of chylomicrons in the fasting state. An acute and potentially life-threatening complication of chyiomicronemia syndrome is severe acute pancreatitis. We report a case of a 24-year-old primigravida with severe hypertriglyceridemia-induced pancreatitis. We reviewed the clinical course and treatment of hypertriglyceridemia-induced pancreatitis. She was admitted in the 37th week of gestation with severe abdominal pain, which was radiating to the back, and having uterine contractions. Cesarean delivery was performed under spinal anesthesia, and a healthy male infant was born. Intraoperative findings included milky peritoneal fluid collection. Elevated pancreatic enzymes with significant hypertriglyceridemia (10,092 mg/dL) suggesting acute pancreatitis were also found on chemical analysis. The diagnosis of acute pancreatitis was confirmed by computed tomography scan. Treatment with continuous intravenous insulin--glucose, cessation of oral intake, and nasogastric decompression--dramatically decreased the triglyceride levels to 608 mg/dL within five days. She was discharged as symptom free with strict dietary intervention after 10 days. Intravenous insulin is a low-cost and effective alternative treatment in hypertriglyceridemia-induced pancreatitis during pregnancy. To our knowledge, such a high triglyceride level has not previously been reported in pregnancy.

Determination of formaldehyde levels in 100 furniture workshops in Ankara.

One of the airborne pollutants in wood products industry is formaldehyde, which may pose some health effects. Therefore this study is conducted to determine formaldehyde levels in 100 furniture-manufacturing workshops in Ankara and also to determine the symptoms, which may be related with formaldehyde exposure among the workers. Indoor formaldehyde levels ranged from 0.02 ppm to 2.22 ppm with a mean of 0.6 +/- 0.3 ppm. Outdoor formaldehyde levels also ranged from 0.0 ppm to 0.08 ppm with a mean of 0.03 +/- 0.03 ppm. Formaldehyde levels were higher in workplaces located at basement than in workplaces located at or above ground level (p < 0.01). An association was found between indoor formaldehyde levels and the types of fuel used (p < 0.05). The levels were higher in workplaces where only sawdust was used for heating, than in workplaces where wood, coal, and sawdust are used (p = 0.02). An association was found between runny nose and indoor formaldehyde levels (p = 0.03). Formaldehyde levels were lower in workplaces where employees had no symptoms than in those where employees had 4 or more symptoms (p = 0.02). Of 229 employees 57 subjects (24.9%) work under the formaldehyde levels of 0.75 ppm and above. Thus, approximately one fourth of the employees in workplaces are working in environments with formaldehyde levels exceeding those permitted by Occupational Safety and Health Administration (OSHA). The employees working in small-scale furniture workshops are at risk of formaldehyde exposure. Measures, such as improved ventilation, have to be taken in these workplaces, in order to decrease the formaldehyde levels.

Necrotizing sialometaplasia of parotid gland: a possible vasculitic cause.

Necrotizing sialometaplasia at the parotid gland location is rare and simulates malignant disease. If it is seen at this location, the causes may be previous dental or parotid gland surgical procedures, which result in blood vessel injuries and thrombosis. We report a parotid gland necrotizing sialometaplasia of a 17-year-old girl, possibly caused by primary vascular damage or vasculitis.