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 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or "forme fruste" hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: 1. tachycardia -- every case with more than 80 pulse beats being suspect (not specific); 2. urinary histamine -- every case excreting more than 90 mug/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; 3. urinary thyroxine -- every case excreting more than 20 mug/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and beta-blockers. Propyl thiouracil is rarely required.
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PMID:Intermittent hyperthyreosis -- a heat stress syndrome. 5 84

Data reflecting affect, mood, and personality attributes of 23 normal men were compared after two weeks of placebo administration and two weeks of therapeutic serum lithium levels (mean, 0.91 mEq/liter). The study was a placebo-controlled, split-half crossover, double-blind design. Affect and mood were measured by three self-rating instruments, independent rater observation, and by the subjects' "significant others." Two personality inventories were administered. Substantial affect and mood changes are induced by lithium carbonate. Lethargy, dysphoria, a loss of interest in interacting with others and the environment, and a state of increased mental confusion were reported. No generalized effects were found in the responses to ther personality inventories.
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PMID:The effect of lithium carbonate on affect, mood, and personality of normal subjects. 32 Sep 56

The AA. administered i.v. large doses of gamma-ethylester of glutamic acid to 22 patients affected with severe liver failure associated to mental and neuromuscolar abnormalities as tremors, confusion, restlesness which have been duly recorded for the purpose of this evaluation. The average daily dose was 36.3 gm and the treatment lasted as an average 9.5 days. The peripheral venous blood ammonia was checked, at the beginning and at the end of the treatment, in all the patients and in some, at random, the following parameters were determined: pH, pCO2, pO2, HCO3, TCO2, oxygen saturation on arterial blood. The treatment caused a statistically remarkable decrease of blood ammonia in 21 of 22 patients. The mental and neuromuscolar abnormalities too showed a statistically important downward trend vs. the basal values. The acid-base balance did not record any remarkable variation. The AA. judge as absolutely positive the trial carried out with gamma-ethylester of glutamic acid. The large doses used caused clear-cut and dramatic improvements and were estremely well tolerated.
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PMID:[Glutamic acid gamma-ethyl ester in high doses in the treatment of high blood ammonia levels in severe hepatic failure]. 56 93

In summary, severe hyperchloremic acidosis developed in two patients as a late complication after jejunoileal bypass for morbid obesity. This acidosis was associated with episodes of dizziness, ataxia, headache, weakness, confusion and transient loss of consciousness. Recognition of this symptom complex in the patient with a jejunoileal bypass should suggest metabolic acidosis as a complication of this surgical procedure. Bicarbonate replacement provided prompt, but temporary, improvement in the symptoms and the acidosis. Revision of the intestinal bypass was required for correction. Special studies to rule out renal tubular acidosis were performed and definitely excluded the kidney as a source of the acidosis.
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PMID:Severe hyperchloremic acidosis complicating jejunoileal bypass. 63 46

The classification of functional psychoses has traditionally been dichotomous with schizophrenia and manic-depressive disorder, which are considered separate entities. However, the psychiatric literature is replete with descriptions of psychoses with mixed features. A variety of names has been applied to these psychoses, including the term "schizo-affective." Confusion exists regarding the nature of these psychoses, much of it resulting from a tendency to limit investigation to an acute view of symptom complexes. This article examines the schizo-affective states across a variety of dimensions, including the acute symptomatologic picture, response to lithium carbonate therapy, follow-up studies, family history, and genetics. While the term "schizo-affective," as commonly used, probably describes a heterogeneous group of psychoses, considerable evidence supports the hypothesis that at least a subgroup of these psychoses has a definite relationship to the major affective disorders.
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PMID:Schizo-affective psychosis: fact or fiction? A survey of the literature. 78 71

The factors which affect the standardisation and quality control of serum alkaline phosphatase assays are discussed. A quality control project was designed to test the performance of seven Birmingham laboratories in the assay of sera with alkaline phosphatase activities outside the range normally tested by the National Quality Control and Wellcome schemes. The results showed that the precision of individual laboratories was satisfactory. Differences between the results of the laboratories were considerable and could be accounted for by differences in methodology. Auto-Analyzer methods employing phenyl phosphate as substrate would best be standardised by adopting the optimised reaction conditions of Buch and Buch (1939); but the borate buffer of these authors should be replaced by the carbonate-bicarbonate buffer of Moss et al. (1971). To avoid the confusion which may arise in future if alkaline phosphatases are reported in U/l irrespective of the substrate, it is suggested that some substrate--indicative nomenclature may be advisable.
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PMID:Quality control of serum alkaline phosphatase assays: project report and discussion of some factors affecting the assay. 125 61

Lithium is widely used in the management of patients with manic depressive illnesses. It is a valuable drug with a good safety record but occasionally causes severe disorders. A 71-year-old woman is described who previously had a good response to lithium carbonate treatment of a manic depressive illness. Because the patient appeared depressed and withdrawn, lithium carbonate dosage was increased. The development of confusion and choreiform movements precipitated hospital admission. The symptoms were relieved when lithium was stopped but recurred with the reinstitution of lithium. Spontaneous choreiform movements were again relieved on lithium withdrawal. Associated with the abnormal movements were alterations in the serum calcium concentrations, a rise in the parathyroid hormone concentration and a rise in the serum amylase concentration without features of acute pancreatitis.
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PMID:Acute lithium toxicity--chorea, hypercalcemia and hyperamylasemia. 248 12

It is generally agreed that bicarbonate dialysate is preferable to acetate dialysate, but the major limiting factors of high cost and technical difficulty in maintaining its stability for prolonged periods preclude its widespread use. The procedure developed by the authors stabilizes bicarbonate dialysate for up to 4 days, rendering bicarbonate dialysate feasible for routine out-patient use. HCO3 dialysate is produced in our dialysis unit after an initial investment of $10,000.00, at a cost per 4-h treatment of $1.22 at a dialysate flow of 500 cc/min. One hundred fifty-one chronic dialysis patients participated in an 18-week study to evaluate clinical symptomatology when bicarbonate was substituted for acetate as the dialysis base buffer. Evaluation of each dialysis treatment (total of 8,183 treatments) consisted of both subjective and objective criteria (vomiting, angina, cramps, hypotension, and frequency of use of mannitol, hypertonic saline, and nitroglycerine). The patients were unaware of the change in dialysate solutions. There was a significant reduction (p less than 0.001) in the incidence of vomiting, cramps, hypotension, nausea, flushing, and the use of mannitol and hypertonic saline during bicarbonate dialysate treatment compared with acetate dialysate. Shortness of breath, angina, mental confusion, and paresthesias were not statistically changed. Although the method of HCO3 dialysate production is associated with occasional higher bacterial count than currently recommended by AAMI standards, no adverse reactions were observed in patients treated with standard efficiency dialyzers. It is concluded that the process for incenter HCO3 production is safe, economical, and better tolerated than acetate dialysate.
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PMID:An economical new process for incenter bicarbonate dialysate production: comparison with acetate in a large dialysis population. 280 52

Toxic irreversible encephalopathic syndromes developed in 2 patients treated with lithium carbonate and haloperidol. Symptoms consisted of lethargy, fever, tremulousness, confusion, and extrapyramidal and cerebellar dysfunction, accompanied by leucocytosis and elevated serum enzyme, blood urea nitrogen, creatinine and fasting blood glucose levels. One patient suffered widespread irreversible brain damage; the other was left with persistent dyskinesias. Although causal factors have not been identified, this report and others in the literature suggest that diffuse irreversible encephalopathy may occasionally develop in individuals with abnormal brain sensitivity to the lithium carbonate/haloperidol combination. Evidence for this is based on the fact that in our patients and others mentioned in the literature the dosage and blood levels of lithium were not high.
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PMID:Toxic irreversible encephalopathy induced by lithium carbonate and haloperidol. A report of 2 cases. 641 23

We evaluated the performance of an enzymatic method using dry chemistry for serum total carbon dioxide (tCO2) determination using a Vitros 500 analyser. Imprecision results were acceptable and the linearity was verified for concentrations within a range of 5.5-39.2 mmol/l, i.e. Y(measured) = 0.93 x(calculated) + 1.32, r = 0.99. The Vitros tCO2 method was unaffected by haemoglobin at all concentrations tested. Significant interference was caused by bilirubin at concentrations higher than 30 mumol/l; the addition of bilirubin lowered the apparent values for tCO2 dose-dependently. Serum tCO2 results were practically the same as those for plasma. The reference interval for venous tCO2 concentrations in a healthy population was: 22.4-34.2 mmol/l (mean: 28.3 mmol/l). Comparison of venous serum tCO2 results assayed using the Vitros method with bicarbonate (HCO3-) values calculated by blood gas determination of pCO2 and pH in arterial blood samples gave poor agreement, r = 0.58. The data revealed a mean difference of 5.48 +/- 3.09 mmol/l between the tCO2 measurements and calculated bicarbonate. This was statistically (p = 0.01) and clinically significant. We conclude that the Vitros method provides reliable tCO2 results in venous serum but this method must not be used as an interchangeable alternative to calculated arterial bicarbonate in order to avoid confusion, misinterpretation of results and erroneous therapeutic decisions.
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PMID:Total carbon dioxide measured by the Vitros enzymatic method. 959 85


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