Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Translaryngeal jet ventilation has been proven an effective emergency airway alternative. However, confusion exists as to the proper cannulae and oxygen sources for this technique. Our study was designed to determine the delivered volumes of gas using cannulae and oxygen sources recommended in previous reports on translaryngeal jet ventilation. From this, we hope to clarify the proper technique of translaryngeal jet ventilation. Using a variety of oxygen sources and cannulae, peak flow rates were measured using a digital flowmeter. Delivered volumes of gases generated with each combination were then calculated. All of the cannulae tested (standard 16-gauge IV cannulae and larger) provided peak flow rates high enough so that predicted tidal volumes would be adequate to maintain adequate ventilation in apneic adults when a 50-psi source was used. Only a 4-mm tracheal cannula provided comparable values when a bag-valve device was used. No cannulae provided sufficient flow rates to ensure adequate ventilation in apneic adults when a demand-valve mechanism of 60 cm H2O driving pressure served as the source. Our observations were consistent with previous clinical studies and suggest that standard translaryngeal jet ventilation cannulae (12 to 16 gauge) must be connected to an oxygen source of 50 psi in apneic adults. Demand-valve devices do not provide sufficient driving pressures for these cannulae. A cannula of 4 mm ID should be placed if only a bag-valve device is available for ventilation.
 ...
PMID:Myths and pitfalls in emergency translaryngeal ventilation: correcting misimpressions. 296 62

The etiology, pathophysiology, clinical features, diagnosis, and medical treatment of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) are reviewed. SIADH is a common cause of hyponatremia in hospitalized patients. Increased concentrations of antidiuretic hormone (ADH) result in retention of free water, increased excretion of sodium, and hyponatremia. Symptoms generally occur only when hyponatremia is severe (less than or equal to 125 meq/L) and may include anorexia, vomiting, and confusion, followed by seizures, coma, and death. SIADH may result from a variety of diseases, as well as from the use of drugs such as chlorpropamide, carbamazepine, diuretics, and some antineoplastic agents. Diagnosis of SIADH is confirmed by demonstration of a high urine osmolality with a low plasma osmolality, in the absence of diuretic use. Immediate treatment of the symptomatic patient with SIADH includes intravenous furosemide and 3% sodium chloride injection to produce a negative free-water balance. If the underlying cause of SIADH cannot be corrected, the treatment of choice for chronic SIADH is fluid restriction. If this is not tolerated by the patient, demeclocycline can be used to induce a negative free-water balance. Urea, lithium, phenytoin, and loop diuretics have been reported to be effective, but there are few data to support their use. Future research into the treatment of SIADH must be directed at developing effective antagonists of ADH. Treatment of SIADH consists of elimination of underlying causes and restriction of fluid intake; if these measures are unsuccessful or poorly tolerated, long-term drug therapy may be indicated.
 ...
PMID:Management of the syndrome of inappropriate secretion of antidiuretic hormone. 312 Dec 40

Radium has been distributed in a wide variety of devices during the early part of this century. Antique objects containing significant amounts of radium turn up at flea markets, antique shows, and antique dealers, in a variety of locations. These objects include radium in devices which were used by legitimate medical practitioners for legitimate medical purposes such as therapy, as well as a wide variety of "quack cures." These devices may contain anywhere from a few nanocuries to as much as several hundred microcuries of radium. In addition to medical sources, a large variety of scientific instruments utilize radium in luminous dials. These instruments include compasses, azimuth indicators, and virtually any object which might require some form of calibration. In addition, the consumer market utilized a large amount of radium in the production of wrist watches, pocket watches, and clocks with luminous dials. Some of these watches contained as much as 4.5 microCi of radium, and between 1913 and 1920 about 70 gm was produced for the manufacture of luminous compounds. In addition to the large amount of radium produced for scientific and consumer utilization, there were a number of materials produced which were claimed to contain radium but in fact did not, further adding to the confusion in this area. The wide availability of radium is a result of the public's great fascination with radioactivity during the early part of this century and a belief in its curative properties. A number of objects were produced in order to trap the emanations of radium in water for persons to drink in order to benefit from their healing effects. Since the late 20s and early 30s the public's attitude towards radiation has shifted 180 degrees and it is now considered an extremely dangerous and harmful material. However, even as late as the 1950s, there were still some items produced containing radioactivity which today would be unthinkable. The "Buck Rogers Mystery Ring" of the 1950s was activated with polonium. With the shift in public attitudes towards radioactivity, and increasing problems in disposal of radioactive materials, the disposal of radium presents a particularly perplexing problem. The radium which was produced in the early part of the century is still around in various forms and is extremely difficult to dispose of. All objects discovered claiming to contain radium should be taken seriously and should be properly surveyed.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Radioactive artifacts: historical sources of modern radium contamination. 327 86

Many psychiatric patients have polydipsia and polyuria without identifiable underlying medical causes. Hyponatremia develops in some polydipsic patients and can progress to water intoxication with such symptoms as confusion, lethargy, psychosis, and seizures or death. This syndrome is sometimes called "compulsive water drinking," "psychogenic polydipsia," and "self-induced water intoxication." Although the underlying pathophysiology of the syndrome is unclear, several factors have been implicated in producing polydipsia and symptomatic hyponatremia. These include a possible hypothalamic defect, the syndrome of inappropriate secretion of ADH (SIADH), and neuroleptic medication. Evaluation of psychiatric patients with polydipsia includes a search for other medical causes of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities currently available include fluid restriction and medications.
 ...
PMID:Polydipsia and hyponatremia in psychiatric patients. 328 1

Two cases of absence status are described, one case following metrizamide myelography and the other from omnipaque myelography. Metrizamide has been well known to cause convulsive seizures even in patients without epilepsy. The exact mechanism is not known but appears to be direct neuronal toxic effects possibly due to competitive inhibition of hexokinase activity. The acute confusional state following myelography from water soluble agents is reviewed. In view of the difficulty in clinical diagnosis and the excellent response to anticonvulsant therapy, the possibility of this clinical entity should be specifically excluded by EEG in any person suffering from prolonged confusion following myelography with water soluble agents.
 ...
PMID:Absence status epilepticus resulting from metrizamide and omnipaque myelography. 339 4

In July 1979, 1,900 gallons of trichloroethylene (TCE) were released into ground and surface water from a pipe manufacturing plant in Montgomery County, Pennsylvania. To evaluate community and occupational exposure to TCE, we conducted environmental and medical surveys. In well water samples obtained in August 1979 within 1 km of the factory, TCE concentrations ranged to 183,000 parts per billion (ppb); EPA's proposed guideline for TCE in drinking water is 5 ppb. Levels of TCE declined with distance from the plant and decreased in the months following the spill. However, lower level TCE contamination was widespread and persistent, suggesting multiple releases. Within the plant, mean time-weighted occupational exposure to TCE of degreaser operators was 205 mg/m3; the recommended time-weighted exposure limit is 135 mg/m3. Mean short-term exposure was 1,084 mg/m3; the recommended short-term limit is 535 mg/m3. Seven of 9 exposed workers reported drowsiness, dizziness, or mental confusion. In exposed workers, mean urinary excretion of TCE metabolites rose from 298 micrograms/L pre-shift to 480 micrograms/L post-shift. On re-evaluation of the factory following improvements in ventilation and work practices, mean time-weighted occupational exposure to TCE had decreased to 84 mg/m3 and short-term exposure to 400 mg/m3; symptom frequency and concentrations of urinary TCE metabolites also were reduced. This episode demonstrates that community and occupational exposure to chemical toxins may share a common origin.
 ...
PMID:Common-source community and industrial exposure to trichloroethylene. 343 9

There has been little information and much confusion regarding the genotoxic effects of fluoride. The purpose of this study was to examine the spermatogenic influence of sodium fluoride (NaF) on the germ cells by means of the mouse sperm morphology test. Male mice of genotype B6C3F1 were obtained at about eight weeks of age and maintained on a low-fluoride diet (less than 0.2 ppm F) and distilled water ad libitum throughout the experiment. At approximately 13 weeks of age, the animals were randomly assigned to eight groups. Group I was intubated with the Maximum Tolerable Dosage (MTD) of NaF (70 mg/kg). Groups II through VI received NaF by stomach intubation at doses of 35, 20, 10, 1, and 0.1 mg/kg, respectively. Group VII served as a negative control and was intubated with distilled water. The positive control, Group VIII, was exposed to a known mutagen, cyclophosphamide (20 mg/kg, i.p.). The animals were treated daily for five days, and killed by cervical dislocation 35 days after the first exposure to chemicals. Slides of sperm from the cauda epididymides were prepared and blindly scored for morphological abnormalities. Weight of the testes was recorded, and the femurs were saved for fluoride (F) analysis. Analysis of bone F demonstrated the effective absorption of fluoride following intubation. The counts of abnormal sperm and the weights of the testes for mice exposed to NaF doses up to the MTD were not significantly different from those of the negative control. The results of this study showed that NaF did not have adverse effects on mouse sperm morphology.
 ...
PMID:Effects of fluoride on the mouse sperm morphology test. 347 24

This study considers false results which may arise due to problems in the preparation or examination of specimens for darkground microscopy of subgingival plaque. Subgingival plaque samples obtained with a sterile curette were placed in 0.1-0.3 ml sterile full or 1/4 strength Ringer's solution: 0.85% saline, 1% gelatin in 0.85% saline, formal saline or pyrogen-free water for injection. Test slides were prepared from the original dispersion, and control slides from the corresponding sterile solution. Optimal dispersion solution, syringe dispersion frequency and the effect on motility of delay in processing samples were tested. Slides were also prepared from dispersions of 11 representative subgingival "periodontopathic" organisms. Problems in sampling included variability in counts between sites with comparable pocket depths, contamination of the sample and reduction of the sample volume after scaling. Problems in dispersion included contamination, uneven distribution of the different morphotypes and destruction of delicate organisms. Problems in slide preparation included slide contamination, limitation in the number of samples that can be assessed by one examiner at a given time without loss of activity of motile cells, and preparation of a cell monolayer. Problems in identification and counting included confusion of Brownian movements with motility, coccoid particles with cocci, spirochetes with campylobacter, flagella with flagella-like structures, size of cocci, counting of fragmented spirochetes and non-motile flagellated organisms and motile cells, and also bias in counting. Problems in morphotype grouping included the observation that many (10 of the 11 representative) periodontitis-related organisms were in the non-motile groups and not all cells of the motile species (Campylobacter, Capnocytophaga) showed motility. The results indicate that each stage of subgingival plaque darkground microscopy, sampling, dispersion, slide preparation, counting, morphotype grouping and interpretation may lead to false results if not representative or reproducible. Procedures are suggested for the minimisation of problems in the preparation and examination of subgingival plaque specimens for darkground microscopy.
 ...
PMID:False results associated with darkground microscopy of subgingival plaque. 353 16

Despite the widespread use of non-steroidal anti-inflammatory drugs (NSAIDs), the current number of reported cases of poisoning is small. However, with the introduction of 'over-the-counter' preparations of NSAIDs in some countries (e.g. ibuprofen in the UK and USA) an increased incidence of acute poisoning from this group of drugs can be expected. Conventionally, NSAIDs are divided into the following groups based on their chemical structure: arylpropionic acids, indole and indene acetic acids, heteroarylacetic acids, fenamates, phenylacetic acids, pyrazolones and oxicams. Unless NSAIDs are ingested in substantial overdose, acute poisoning with these agents does not usually result in significant morbidity or mortality. In most cases the clinical features are mild and confined to the gastrointestinal and central nervous systems, though acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse and cardiac arrest may complicate severe poisoning. Arylpropionic acid derivatives were thought initially to have a low order of toxicity in overdose but, in addition to anticipated gastrointestinal symptoms, headache, tinnitus, hyperventilation, sinus tachycardia, hypoprothrombinaemia, haematuria, proteinuria and acute renal failure have been described. In addition, drowsiness, coma, nystagmus, diplopia, hypothermia, hypotension, respiratory depression and cardiac arrest have been reported in severe cases of poisoning. Oxyphenbutazone and phenylbutazone are considerably more toxic in overdose. Complications of severe poisoning include coma, convulsions, hepatic dysfunction, acute renal failure, sodium and water retention, haematuria, cardiovascular collapse, respiratory alkalosis, metabolic acidosis, hypoprothrombinaemia and thrombocytopenia. In contrast, indomethacin appears to be much less toxic. In addition to gastrointestinal symptoms, indomethacin taken in overdose induces headache, tinnitus, dizziness, lethargy, drowsiness, confusion, disorientation and restlessness. Only 1 case of acute sulindac poisoning has been reported in the literature. A 16-year-old boy was admitted with hypokalaemia (2.2 mmol/L), transient granulocytosis and 'scanty' haematemesis after ingesting 12 g sulindac. No case of acute tolmetin poisoning have been reported. The fenamates (flufenamic acid, meclofenamic acid, mefenamic acid, tolfenamic acid) are, with the exception of mefenamic acid, not as widely prescribed as other groups of NSAIDs. In overdose, mefenamic acid may result in nausea, vomiting, diarrhoea, muscle twitching, convulsions and coma.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Acute poisoning due to non-steroidal anti-inflammatory drugs. Clinical features and management. 353 13

Twenty-four isolates of Penicillium (including a green-spored mutant from a French Brie cheese, Penicillium camemberti) with a proposed relationship to the white cheese mold P. camemberti were investigated by immunological procedures. These penicillia, which are representative of species that have caused considerable taxonomic confusion, had common micromorphology (terverticillate penicilli with rough and smooth stipes and smooth ellipsoidal to subglobose [(3 to 5) X 2 1/2 to 4 1/2 microns] conidia); growth rates; good growth on creatine sucrose agar, cheese, and other products with a high amount of protein and lipid as a primary habitat; production (with the exception of Penicillium solitum) of cyclopiazonic acid; and the ability to grow at low temperatures and water activities. The isolates that were investigated proved to be strictly antigenically related. Absorbed antiserum of the green-spored mutant of P. camemberti showed a specific precipitin band when tested by immunodiffusion either with its homologous reference antigen or with the exoantigens obtained from different isolates. The precipitin band was not present in any P. camemberti starter culture but in many unwanted cheese contaminants. The precipitin band can be used in the purity control of P. camemberti starter culture spore preparations. Analysis of the exoantigens of all the cultures by reversed phase high-performance liquid chromatography allowed us to subdivide these penicillia into nine groups below the species level. The results indicate that P. commune Thom is the wild-type ancestor of P. camemberti.
 ...
PMID:Antigenic characterization of Penicillium camemberti and related common cheese contaminants. 357 86


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>