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

The first case of Legionella micdadei (Pittsburgh Pneumonia Agent) infection in Sweden is presented. A previously healthy 68-yr-old man fell ill with diarrhoea, fever, and mental confusion. Subsequently chest roentgenography revealed pneumonic infiltrates and a seroconversion to L. micdadei was shown. No source or transmission of infection was established. The only notable event was that the patient had been drinking rain-water from a barrel 1 day prior to his illness. An alimentary route of infection was considered.
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PMID:Community-acquired Legionella micdadei (Pittsburgh pneumonia agent) infection in Sweden. 664 75

There exists still a considerable confusion in the literature about the appropriate control solution for ethanol. In many studies either no control or equimolar solutions of urea, mannitol or sodium chloride were used as an osmotic control for ethanol; distilled water being given only in a few cases. The confusion is mainly derived from the opinion that the osmolality of the ethanol solution as measured by freezing point depression (= "theoretical osmotic pressure") is the determinant factor for the action of ethanol on the gastrointestinal tract. This opinion, however, is not correct. Since biological membranes are not perfectly semipermeable (i. e., they are permeable to certain solutes) the "effective osmotic pressure" produced by permeant solutes is always less than the ("theoretical") osmotic pressure as determined by freezing point depression. The ratio of the "effective" to the "theoretical" osmotic pressure of a solute is defined by the Stavermann reflection coefficient for a certain membrane. The Stavermann reflection coefficient may have any value between 1 and 0. For an impermeant solute the reflection coefficient equals 1 and for increasingly permeant solutes it becomes progressively less than 1 and closer to 0. The Stavermann reflection coefficient of ethanol for some gastrointestinal organs tested is about 0.1. The ideal osmotic control for ethanol would be a solute which exerts the same effective osmotic pressure on the gastrointestinal membrane as ethanol, i. e. which has the same Stavermann reflection coefficient as ethanol, and has no specific pharmacologic effect. Distilled water seems to be the most suitable osmotic control for ethanol because it has a Stavermann reflection coefficient of 0 and has no pharmacological actions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[What control solutions should be used in studies on the acute effect of alcohol on the gastrointestinal tract?]. 664 35

Recent disputes about the relevance of membrane expansion to the mechanism of anesthesia indicate that there is confusion about the concept of membrane expansion and stabilization. One theory suggests that the membrane is expanded when its size is increased by the size of the incorporated anesthetic molecules, whereas another theory contends that extra space must be created over the size of the incorporated anesthetic molecules in order for the membrane to be considered as expanded. This article is intended to clarify the discrepancies between these concepts. The volume theories of anesthesia are reviewed critically. The volume change of the membrane, induced by the interaction of anesthetics, is not a simple summation of membrane volume and anesthetic volume. There are a number of factors that affect the volume when anesthetic molecules interact with the membrane in water. The theories that envision membrane expansion as the increase of volume by the size of anesthetic molecules assume that there is no interaction between membrane and anesthetic molecules (if there is interaction, there is excess volume change) and are incompatible with the pressure reversal of anesthesia. The physical meaning of the pressure reversal of anesthesia is described, and the absolute necessity of the presence of excess volume for pressure to antagonize anesthesia is discussed. Excess volume expansion per se may not be the cause of anesthesia, but the mechanism by which the excess volume is created must be the key event that induces anesthesia. The mean excess volume hypothesis postulates that the size of the membrane is irrelevant to anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is membrane expansion relevant to anesthesia? Mean excess volume. 665 Sep 11

The premenstrual symptom complex many women experience in a moderate to severe form can be divided into four subgroups. Because there is more than one syndrome and nervous tension is one of the most common symptoms, the term premenstrual tension syndromes (PMTS) is used. The most common subgroup, PMT-A, consists of premenstrual anxiety, irritability and nervous tension, sometimes expressed in behavior patterns detrimental to self, family and society. Elevated blood estrogen and low progesterone have been observed in this subgroup. Administration of vitamin B6 at doses of 200-800 mg/day reduces blood estrogen, increases progesterone and results in improved symptoms under double-blind conditions. Women in this subgroup consume an excessive amount of dairy products and refined sugar, and progesterone may be of value in them. The second-most-common subgroup, PMT-H, is associated with symptoms of water and salt retention, abdominal bloating, mastalgia and weight gain. The severe form of PMT-H is associated with elevated serum aldosterone. Vitamin B6 at high dosage suppresses aldosterone and results in diuresis and clinical improvement. Vitamin E helps the breast symptoms. Methylxanthines and nicotine should be curtailed and sodium limited to 3 gm/day. PMT-C is characterized by premenstrual craving for sweets, increased appetite and indulgence in eating refined sugar followed by palpitation, fatigue, fainting spells, headache and sometimes the shakes. PMT-C patients have increased carbohydrate tolerance and low red-cell magnesium. Adequate magnesium replacement results in improved glucose tolerance tests and decreased PMT-C symptoms. Deficiency of the prostaglandin PGE1 may also be involved in PMT-C. PMT-D is the least common but most dangerous because suicide is most frequent in this subgroup. The symptoms are depression, withdrawal, insomnia, forgetfulness and confusion. In ten PMT-D patients the mean blood estrogen was lower and the mean blood progesterone higher than normal during the midluteal phase. Elevated adrenal androgens are observed in some hirsute PMT-D patients. Two PMT-D patients with normal blood progesterone and estrogens had high lead levels in hair tissue and chronic lead intoxication. This subgroups needs careful medical attention when the symptoms are severe. Therapy should be individualized according to the results of the evaluation.
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PMID:Nutritional factors in the etiology of the premenstrual tension syndromes. 668 67

A 39-year-old man had fever, nuchal rigidity, vomiting, and mental confusion within 24 hours after myelography with metrizamide, a water-soluble contrast medium. Cloudy cerebrospinal fluid showing pleocytosis, a significantly elevated level of protein, and a low glucose value suggested septic meningitis, but rapid resolution of signs of meningeal irritation and negative spinal fluid cultures made chemical meningitis due to the metrizamide the likely diagnosis.
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PMID:Metrizamide meningitis. 669 28

Confusion exists regarding the criteria to be used in determining whether or not particular behaviors are schedule-induced. Four critical characteristics of schedule-induced behaviors are suggested and a comparison made of the complete range of behaviors exhibited by body weight-reduced rats drinking in response to one of three stimuli. These were (1) a fixed-time food reinforcement schedule, (2) a meal of dry food, and (3) 24 hour water deprivation. Drinking, locomotion, rearing and oral and perioral behaviors occurred in accordance with the defining characteristics of schedule-induced behaviors. Rats in the fixed-time reinforcement condition also deposited significantly greater numbers of fecal boli. Sniffing and food bowl related behaviors occurred as terminal responses for this group. It is concluded that animals which receive reinforcers intermittently maintain high levels of arousal for extended periods, and that the presence of the schedule may mimic conditions experienced by wild rats in non-laboratory settings. In such conditions ambulatory behaviors may be particularly adaptive. In contrast, reinforcing sensory feedback and a stress reducing role may be particularly important in the mediation of oral behaviors (such as drinking) which occur during intermittent reinforcement.
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PMID:A reinterpretation of schedule-induced behaviors based on a systematic analysis of behavior. 683 4

In hemodialysis, an excessive oversimplification leads to confuse the transfer direction of a given solute (patient towards dialysate or dialysate towards patient) and the direction of transmembranar concentration gradient. Applied to sodium, this confusion leads to the usual iso- or hypotonic dialysate use, in order to eliminate the patient's sodium overload. We show here how the use of a high sodium dialysate allows the elimination of the sodium overload and makes the free water clearance (approached by the Na-free water clearance) positive, which is the necessary condition to restore an hydro-electrolytic equilibrium near from the normal. That allows a disappearance of hypovolemic symptoms during hemodialysis, a better general condition and a possible increase of water intake between sessions.
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PMID:[Advantage of a high-sodium hemodialysis solution: theoretical bases]. 684 63

A survey was conducted during August-October 1981, to assess the need for disinfectant policy for the Port Moresby General Hospital. Data collected revealed confusion amongst the nursing staff regarding the correct use of various detergents and disinfectants, an unacceptably high incidence of post-operative infections, evidence of poor general cleaning of the hospital and evidence of contamination of the distilled water supply in the Central Sterilizing Department by Pseudomonas species. There is an urgent need for the formation of a committee to advise and promote a disinfectant policy for the hospital, to ensure that this is followed by nursing and cleaning staff and to establish continuous surveillance of hygiene standards within the hospital.
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PMID:Disinfectant usage and hygiene practises at Port Moresby General Hospital. 696 17

Focal fatty infiltration of the liver is an entity that may be confused with liver metastasis on computed tomography (CT). The imaging results and medical records of 16 patients with CT appearance suggestive of focal fatty liver were reviewed, three of whom had the simultaneous presence of metastatic liver disease. Focal fatty liver often has a distinctive appearance with CT, usually with a nonspherical shape, absence of mass effect, and a density close to water. Liver metastases are usually round or oval, and unless cystic or necrotic, they have CT attenuation values closer to normal liver parenchyma than water. A radionuclide liver scan almost always resolves any confusion about the differential diagnosis of focal fatty liver: a well defined focus of photon deficiency is due to neoplasm rather than focal fatty infiltration. Sonography sometimes helps to confirm the CT impression, but may be misleading if the diagnosis of focal or diffuse fatty infiltration is not suspected before the examination.
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PMID:CT appearance of focal fatty infiltration of the liver. 697 79

The observed reference ranges for sodium and potassium as determined by direct potentiometry vary from instrument to instrument, depending on the composition of the calibration standards. To resolve the existing confusion as to which reference intervals are most appropriately considered "normal," we propose a straightforward convention (based on plasma-water concentration units) in which the difference between direct (undiluted sample) and indirect (diluted sample) methodologies is accounted for by the volume displacement effect of proteins, lipids, and other dissolved substances in a typical plasma sample. Thus, the proposed reference intervals for sodium and potassium are approximately 7% greater by direct potentiometry than by procedures involving dilution. Data consistent with this convention can be obtained with a variety of aqueous-based calibrants, provided care is taken to minimize the errors resulting from activity coefficient and liquid junction potential effects. Additional experimental results are presented to show that these effects also account for the apparent suppression of the sodium ion concentration observed in the presence of bicarbonate ion.
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PMID:Establishing the direct-potentiometric "normal" range for Na/K: residual liquid junction potential and activity coefficient effects. 712 9


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