RESUMO
BACKGROUND AND PURPOSE: There is limited knowledge regarding the long-term outcome of the methcathinone/manganese-induced movement disorder. Our purpose was to define prognosis in intravenous methcathinone abusers affected by this distinctive disorder attributed to manganese (Mn) toxicity. Also, neuropathology from a globus pallidus region biopsy from a former user is reported. METHODS: Eighteen methcathinone abusers were categorized as active (five), discontinued (four) or former (nine) users. They were reassessed after a median of 32.5 months (range 3.4-59.6) clinically, on rating scales, and with MRI and blood Mn levels. The biopsy was examined ultrastructurally. RESULTS: Overall the group showed a slight tendency to deterioration at follow-up on clinical assessment of motor functioning, especially the active users. No significant change occurred on parkinsonian rating scale reassessment. Significant reduction in Mn levels occurred in former users, and decreased T1-weighted hyperintensity on basal ganglia MRI occurred in 3 of 4 former and 2 of 3 discontinued users, despite lack of clinical improvement. The biopsy consisted of white matter showing decompacted myelin sheaths and frequent abnormalities of mitochondria. CONCLUSIONS: No improvement in this Mn-induced movement disorder occurs after cessation of methcathinone abuse despite improvement of Mn blood levels and/or MRI abnormalities. Ultrastructural abnormalities in a former user confirm structural damage to white matter is associated with the disorder. Methcathinone/Mn toxicity is an important, disabling and permanent medical sequel of intravenous drug abuse in the former Soviet Union.
Assuntos
Discinesia Induzida por Medicamentos/patologia , Globo Pálido/patologia , Intoxicação por Manganês/patologia , Manganês/sangue , Propiofenonas/efeitos adversos , Adulto , Discinesia Induzida por Medicamentos/sangue , Feminino , Humanos , Masculino , Intoxicação por Manganês/sangue , Pessoa de Meia-Idade , Adulto JovemRESUMO
System of training for occupational health and safety experts and occupational physicians has been analyzed in comparison with one of the most reliable occupational health and safety indicators--occupational diseases level and its changes during 1981-2010. Increased number of occupational diseases has been registered since 1996, reaching maximum in 2009 with 138.6 cases of occupational diseases per 100 000 employees.
Assuntos
Educação Médica Continuada , Medicina do Trabalho/educação , Currículo/tendências , Educação Médica Continuada/métodos , Educação Médica Continuada/estatística & dados numéricos , Educação Médica Continuada/tendências , Internato e Residência , Letônia , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Medicina do Trabalho/estatística & dados numéricos , Medicina do Trabalho/tendênciasRESUMO
Study carried out in 4 EC countries revealed significant differences in attitude towards health between two examined groups of workers with various education levels, and between countries. Low-educated workers, when compared to more educated workers, are different in acceptable information sources on health state and in general view of study.