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

Thirteen orbital lesions in 12 patients were evaluated with both conventional spin-echo magnetic resonance (MR) imaging and phase-dependent proton spectroscopic imaging. This technique, which makes use of small differences in the resonant frequencies of water and fat protons, provides excellent high-resolution images with simultaneous chemical shift information. In this method, there is 180 degrees opposition of phase between fat protons and water protons at the time of the gradient echo, resulting in signal cancellation in voxels containing equal signals from fat and water. In this preliminary series, advantages of spectroscopic images in orbital lesions included better lesion delineation, with superior anatomic definition of orbital apex involvement; more specific characterization of high-intensity hemorrhage with a single pulse sequence; elimination of potential confusion from chemical shift misregistration artifact; further clarification of possible intravascular flow abnormalities; and improved apparent intralesional contrast.
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PMID:Orbital lesions: proton spectroscopic phase-dependent contrast MR imaging. 360 94

Forty-two patients with proven intra-abdominal sepsis were studied in a prospective clinical trial. The following parameters were evaluated: (1) Nine parameters on admission: age, sex, obesity, malnutrition, history of cardiac, respiratory or renal disease, diabetes mellitus and malignant neoplasia. Four of these parameters had a prognostic value (p less than 0.05): age 65 years, diabetes mellitus and cardiac disease. (2) Thirty parameters representing the functional status of six organic systems during sepsis: respiratory, cardiovascular, nervous, kidneys, blood coagulation, liver. Six of these parameters had a prognostic values: PEEP 0-10 cm H2O to keep PaO2 greater than 60 mmHg (p less than 0.001), serum creatinine greater than 3.6 mg/dl (p less than 0.01), prothrombin time greater than 15'' or platelet count less than 100,000/mm3 (p less than 0.001), need of vasoconstrictive drug to keep arterial pressure greater than 100 mmHg (p less than 0.001), bilirubin greater than 3 mg/dl (p less than 0.01) and mental confusion. The combination of these ten statistically significant prognostic criteria for each patient showed that the mortality was 0 with 0-2 criteria, 36% with 3-5 criteria, 94% with 6-8 criteria and 100% with 8-10 criteria. Patients with more than five of these criteria had a significant higher mortality risk (p less than 0.001).
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PMID:Prognostic criteria in intra-abdominal sepsis. 367 39

The winter athlete has several potential tactics for sustaining body temperature in the face of severe cold. An increase in the intensity of physical activity may be counter-productive because of increased respiratory heat loss, increased air or water movement over the body surface, and a pumping of air or water beneath the clothing. Shivering can generate heat at a rate of 10 to 15 kJ/min, but it impairs skilled performance, while the resultant glycogen usage hastens the onset of fatigue and mental confusion. Non-shivering thermogenesis could arise in either brown adipose tissue or white fat. Brown adipose tissue generates heat by the action of free fatty acids in uncoupling mitochondrial electron transport, and by noradrenaline-induced membrane depolarisation and sodium pumping. The existence of brown adipose tissue in human adults is controversial, and although there are theoretical mechanisms of heat production in white fat, their contribution to the maintenance of body temperature is small. Acclimatisation to cold develops over the course of about 10 days, and in humans the primary change is an insulative, hypothermic type of response; this reflects the intermittent nature of most occupational and athletic exposures to cold. Nevertheless, with more sustained exposure to cold air or water, humans can apparently develop the humoral type of acclimatisation described in small mammals, with an increased output of noradrenaline and/or thyroxine. The associated mobilisation of free fatty acids suggests the possibility of using winter sport as a pleasant method of treating obesity. In men, a combination of moderate exercise and facial cooling induces a substantial fat loss over a 1- to 2-week period, with an associated ketonuria, proteinuria, and increase of body mass. Possible factors contributing to this fat loss include: (a) a small energy deficit; (b) the energy cost of synthesising new lean tissue; (c) energy loss through the storage and excretion of ketone bodies; (d) catecholamine-induced 'futile' metabolic cycles with increased resting metabolism; and (e) a specific reaction to cold dehydration. Current limitations for the clinical application of such treatment include uncertainty regarding optimal environmental conditions, concern over possible pathological reactions to cold, and suggestions of a less satisfactory fat mobilisation in female patients. Possible interactions between physical fitness and metabolic reactions to cold remain controversial.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Adaptation to exercise in the cold. 388 60

A 61-year-old Chinese-American man with a history of congestive heart failure and hypertension was admitted to the San Francisco Veterans Administration Hospital with confusion, cortical blindness, and generalized flaccidity. Serum sodium level on admission was 114 meq/liter. Administration of captopril had been begun for afterload reduction two weeks before admission with a concomitant fall in serum sodium level from 137 meq/liter to 126 meq/liter in one week. A history of marked thirst with consumption of large volumes of water was reported for over one week prior to hospitalization. Despite correction of the hyponatremia within 24 hours at a rate of 0.9 meq/liter per hour, the patient remained semi-comatose and died four days later with a gastrointestinal bleed. It is suggested that the thirst phenomenon and hyponatremia were caused by the introduction of captopril. This lead to irreversible neurologic damage and death, despite the correction of the serum sodium level.
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PMID:Captopril-induced hyponatremia with irreversible neurologic damage. 390 48

Over the past 30 years human magnesium (Mg) deficiency has become an accepted fact in most medical circles. Our index patient had striking neurological manifestations including generalized tremulousness, grimaces and fibrillary twitches of facial muscles, athetoid and choreiform movements of upper extremities, dysphagia, inability to speak, repeated convulsions, and confusion. She had received glucose in water and saline intravenously for several months. A patient with chronic alcoholism was noted to have almost identical symptoms and signs as the index patient. He also responded dramatically to MgSO4 injections. This resulted in a series of studies on patients with chronic alcoholism. The evidence of Mg deficiency in alcoholism includes the following: significant hypomagnesemia, strongly positive Mg balance during recovery, significant decrease in muscle Mg, a deficit of total exchangeable 28Mg quantitatively similar to deficit by balance studies, often a dramatic response of symptoms to therapy with Mg, and diuresis of Mg produced by ingestion of alcohol. Lipolysis with high levels of long-chain free fatty acids (FFA) occurs in withdrawal of alcohol in chronic alcoholism, withdrawal of certain addictive drugs, after trauma, surgery, administration of adrenergic compounds or theophylline, exposure to cold, and an adverse environment as in grass staggers. Concentrations of Mg fall when FFA increase in all of the above circumstances. This phenomenon has wide implications in health and disease. Better awareness of Mg deficiency in a wide variety of clinical conditions will result in life-saving treatment and less morbidity of other patients.
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PMID:Magnesium deficiency in human subjects--a personal historical perspective. 398 38

Two cases are reported in which absorption of surgical irrigant into the vascular system during transurethral resection of the prostate gland (TUR) resulted in life-threatening complications due to hypo-osmolar volume overload (also known as water intoxication or the TUR syndrome). Manifestations common to both cases were haemolysis of red cells, cardiac arrhythmias, a drop in the serum sodium level, and an elevated central venous pressure. In addition, one patient developed acute pulmonary oedema and the other hypokalaemia, confusion and visual disturbances due to cerebral oedema. Water as an irrigant for TUR should be superseded by glycine 1,5%, which is safer.
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PMID:Hypo-osmolar intravascular volume overload during anaesthesia for transurethral prostatectomy. A report of 2 cases. 401 81

There is considerable confusion over whether the antigen-specific T suppressor factors (TsF) described by different authors are indeed equivalent. This paper investigates whether monoclonal TsF3, obtained from hybridomas derived from mice injected subcutaneously with NP derived spleen cells, is functionally equivalent to the conventional T suppressor factor, produced by mice injected intravenously with chemically reactive, water soluble haptene (picrylsulphonic acid and oxazolone thioglycolic acid). Comparison of monoclonal anti-NP TsF3 with conventional anti-picryl and anti-oxazolone T suppressor factor showed that both armed the non-specific T acceptor cell (Tacc) which was sensitive to cyclophosphamide and adult thymectomy. Moreover, non-specific inhibitor (nsINH) of the transfer of contact sensitivity was released when antigen, together with major histocompatibility complex products (MHC), reacted with conventional or monoclonal TsF on the surface of the non-specific T acceptor cell. The interaction of monoclonal TsF3 with antigen, which led to the release of NsINH, required the presence of MHC and was I-J restricted. However, there was no Igh-1 restriction. The equivalence of conventional anti-picryl and anti-oxazolone TsF has been demonstrated by arming the Tacc with a mixture of these two suppressor factors, and then triggering the release of nsINH with the mixed haptene 'picryl-oxazolone-lysine' which crosslinks separate molecules of TsF. A similar equivalence of conventional anti-oxazolone TsF and monoclonal anti-NP TsF3 was demonstrated using the mixed hapten 'NP-oxazolone-lysine' to trigger the release of nsINH. It was concluded that monoclonal TsF3 and conventional TsF were equivalent, and that both had an indirect mode of action through the non-specific T acceptor cell which led to the production of non-specific inhibitor.
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PMID:Equivalence of conventional anti-picryl T suppressor factor in the contact sensitivity system and monoclonal anti-NP TsF3: their final non-specific effect via the T acceptor cell. 633 85

Two patients with the Pickwickian syndrome and with life-threatening sleep hypoxemia were treated with continuous positive airway pressure (CPAP) applied through the nares only during sleep periods. Each patient presented with severe daytime somnolence, disturbed sleep, nocturnal confusion, and daytime awake cardiorespiratory failure (PaCO2, 63 and 55 mmHg). Both patients demonstrated grossly abnormal breathing during sleep with severe sleep hypoxemia, the arterial oxyhemoglobin saturation (SaO2%) falling repetitively to levels below 50%. One patient had a hypoxemic convulsion during the initial sleep evaluation. Low levels (3.5 and 8.0 cm H2O) of continuous positive airway pressure, when applied via a comfortable nose mask, prevented occlusive apnea and obstructive hypopnea during sleep in both patients and maintained steady levels of arterial oxyhemoglobin saturation. There was rapid recovery of mental function and loss of cardiorespiratory failure within 3 days of treatment. After short-term treatment with nocturnal CPAP therapy (23 days and 35 days) both patients were able to sleep, unaided, without sleep-induced upper airway occlusion with arterial oxyhemoglobin levels sustained above 80%. We conclude that nasal CPAP therapy during sleep is an effective noninvasive therapy for patients with the Pickwickian syndrome, and may lead to a stable remission of the underlying severe disordered breathing in sleep.
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PMID:Remission of severe obesity-hypoventilation syndrome after short-term treatment during sleep with nasal continuous positive airway pressure. 634 78

Cholescintigraphic diagnosis of acute cholecystitis requires accurate assessment of gallbladder nonvisualization. Confusion may occur when the gallbladder overlies the duodenal sweep or when labeled bile pools in the duodenum. Gallbladder activity could not be differentiated from duodenal activity in 21 patients. The oral ingestion of 225 ml of water permitted successful differentiation of the gallbladder from the duodenum. In 25 control subjects, it was demonstrated that that volume of water did not have a cholecystokinetic effect.
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PMID:The use of water ingestion to distinguish the gallbladder and duodenum on cholescintigrams. 654 Apr 64

In July and August 1980 a child feeding survey was conducted at Kimalewa Health Center, Bokoli Location, Western Province, Kenya to become acquainted with traditional child feeding patterns. Interviews were held at the Center with the help of a male health worker. 150 women were interviewed. The majority of the mothers breastfed their children on demand. 1 of 5 (21.4%) of all children taken off the breast was weaned during the 1st year of life. The main reasons for stopping breastfeeding was either the feeling that the child is old enough or because the mother was pregnant again. Other reasons given were not enough milk, illness of the mother, refusal by the child, bottle is better, and abscess of the breast. Most of the children were gradually weaned off the breast by giving them (more of) other foods. Abrupt ways to stop breastfeeding were painting the nipples with pili pili, sending the children to relatives, and mother sleeping dressed. As to the feeding practices, the most important weaning food was porridge. Uji and cow's milk appeared to be the 1st weaning foods. From 5-6 months onwards cow's milk was replaced by other foods. Fruit juice was given to a few babies only. Fresh fruit was more popular (oranges, lemons, and sweet banana) from 3 months onwards. No solid foods were introduced during the 1st 3 months with the exception of beans. Only after 6 months were children given solid foods like ugali and vegetables. Milk intake increased with age. Fresh cow's milk mixed with some water or cow's milk added to uji were commonly used. 63% of the mothers thought that for 3-6 month old infants breastfeeding was best. 23% of the mothers thought that bottle feeding was better than breastfeeding. 21 women did not know which of the 2 methods was better. There was confusion regarding the time solid foods should be introduced. Most mothers seemed to favor early introduction of solid foods, 14% of the mothers thought that breastfeeding should be stopped before the child's 1st birthday; 55.9% would stop breastfeeding before the child is 18 months old. 50 of 124 children between 6-35 months of age were below 80% weight for age. The conclusion was that solid food was introduced too late. A well-planned longterm nutrition program would help mothers/parents to better understand the importance of good nutrition and to prevent protein energy malnutrition.
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PMID:Childfeeding survey at Kimalewa Health Centre. 655 53


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