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The indication field of Nortase, a combination of microbial lipolytic and proteolytic enzymes, comprises the replacement therapy of maldigestion and insufficiency of pancreas. Its efficacy and tolerance were tested in 100 patients in an open study under the conditions of general practice. During the 15-day treatment the following symptoms were evaluated: anorexia, flatulence, pressure and pain in the epigastrium, nausea after the meals, belching, pyrosis, the quality of feces and the body weight. 96% of the patients showed relief of the symptoms after treatment, 65% a therapeutic result ranging from very good to good. In 53% an improvement of the quality of feces was observed and 76% reached an increase in weight. 6 patients had some small side effects, in 1 case the treatment had to be interrupted. The altogether good results confirmed the results of former investigations on the acid stability and the high lipolytic activity of lipase from Rhizopus arrhizus.
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PMID:[Experiences with substitution therapy using a new pancreatic enzyme of plant origin]. 70 May 83

In an open controlled multicenter study the effectiveness of various dose levels of (+)-Cyanidanol-3 (Catergen) in patients suffering from chronic liver disease and treated over a period of 6 months is assessed. Subjective symptoms as fatigue, nausea, loss of appetite, vomiting and pruritus are positively influenced at all dose levels. A statistically significant fall of the transaminases SGOT, SGPT and gamma--GT however occurs only at a dosage of 6 tablets per day (3000 mg per day) of (+)-Cyanidanol-3, which cannot be demonstrated at a dose level of 3 X 1 tablet per day. Between the dosage of 2 X 3 or 3 X 2 tablets per day is no significant difference. Side effects due to therapy could not be observed.
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PMID:[A contribution as to the effect of (+)-Cyanidanol-3 in chronic liver disease (author's transl)]. 70 70

Seventeen cases of acute appendicitis complicating pregnancy were analysed. The presenting symptoms were abdominal pain, nausea and anorexia. The usual physical findings were direct abdominal tenderness and rectal tenderness. Correct diagnosis was more difficult when gestation was advanced. This was reflected both by the severity of the disease process found at operation and by the increasing foetal mortality rate. Delay in diagnosis and treatment is the main factor causing high maternal and foetal death rates, especially when pregnancy is advanced.
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PMID:Acute appendicitis complicating pregnancy. 73 85

Biochemical studies of serotonin metabolism and a therapeutic trial of L-5-hydroxytryptophan (L-5-HTP) in combination with carbidopa were carried out in 19 patients with myoclonus. In 6 patients with intention myoclonus, the cerebrospinal fluid concentration of 5-hydroxyindoleacetic acid, a metabolite of serotonin was found to be significantly decreased. L-5-HTP with carbidopa dramatically decreased the frequency and intensity of myoclonus, particularly in those patients with a diagnosis of postanoxic intention myoclonus. The major side effects have been anorexia, nausea, vomiting, diarrhea and mental stimulation. We suggest that a deficiency of brain serotonin is causally related to myoclonic muscle movements and the therapeutic efficacy of L-5-HTP plus carbidopa may be due to the repletion of serotonin in regions of the brain where serotoninergic neurons have degenerated.
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PMID:Serotonin and myoclonus. 79 Jan 70

Magnesium deficiency can occur in congestive heart failure, after diuresis with furoxemide, ethacrynic acid and mercurials, and with digitalis intoxication, diabetic acidosis, acute and chronic alcoholism, delerium tremens, cirrhosis, malabsorption syndromes, protracted postoperative cases, open heart surgery, the diuretic phase of acute tubular necrosis, and with hypoparathyroidism, primary aldosteronism, juxta-glomerular hyperplasia and pancreatitis. Two cases of serious ventricular arrhythmias associated with magnesium depletion are described. Clinical manifestations are vague but center around neurologic symptoms such as weakness, tremors, stupor, coma, nausea, vomiting and anorexia. Serious cardiac arrhythmias also occur with magnesium depletion. Magnesium appears to be very useful in hypomagnesemic or digitalis-toxic tachyarrhythmias. Magnesium may also be valuable in normomagnesemic tachyarrhythmias. Ten to fifteen milliliters of a 20 percent magnesium sulfate solution, given intravenously over 1 minute, followed by a slow 4 to 6 hour infusion of 500 ml of 2 per cent magnesium sulfate in 5 per cent dextrose in water is recommended. Recurrence of arrhythmias is common and a second infusion of magnesium sulfate may be necessary. Hypermagnesemia occurs frequently in renal insufficiency, and magnesium therapy may then be contraindicated. Serum levels above 5.5 meq/liter should be avoided. Loss of deep tendon reflexes and a decrease in respiratory rate can be used as guides to magnesium therapy. A plea is made for frequent analysis of serum magnesium so that more knowledge can be gained regarding this important biologic element in cardiovascular disorders.
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PMID:Magnesium deficiency and cardiac disorders. 80 29

A high rate of side effects (mostly vestibular) was found among 83 people receiving prophylaxis with minocycline because of contact with a patient who had died of meningitis due to Neisseria meningitidis. Three groups of contacts received different lots of minocycline and different dosage regimens. Seventy-eight percent of these people had symptoms temporally related to ingestion of minocycline. These symptoms, which included dizziness, nausea, vomiting, vertigo, anorexia, and headache, generally commenced soon after initiation of chemoprophylaxis; the total dosage of minocycline was low. The high rate of vestibular side effects of minocycline militates against widespread use of minocycline for prophylaxis of meningococcal infection.
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PMID:Minocycline for prophylaxis of infection with Neisseria meningitidis: high rate of side effects in recipients. 81 29

The principal effects of cardiac glycosides probably can be classified as parasympathomimetic or sympathomimetic. Data from animals and from man suggest that polar cardiac glycosides, such as ouabain and digoxin, possess greater parasympathomimetic (vagal) cardiac effect for a given amount of sympathomimetic (positive inotropic) cardiac effect than do less polar cardiac glycosides, such as digitoxin. Polar glycosides therefore offer some advantage in uncomplicated paroxysmal atrial tachycardia and in uncomplicated atrial flutter and atrial fibrillation when the principal desired effect is reduction in the number of atrial impulses reaching the ventricles or conversion to normal sinus rhythm. Non-polar glycosides offer an advantage when positive inotropicity is desired but when there is some degree of atrioventricular block or when inappropriate sinus bradycardia or anorexia, nausea, or vomiting are present. Ecotopic impulse formation when due to cardiac glycosides is a toxic manifestation of excessive sympathomimetic effect, but is aggravated by vagal-induced sinus bradycardia, so that both parasympathomimetic and sympathomimetic capability of cardiac glycosides must be considered when dealing with myocardial electrical instability.
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PMID:Clinical implications of differences in pharmacodynamic action of polar and nonpolar cardiac glycosides. 83 69

As various chemotherapeutic agents are added to treatment routines, the possibility of adverse effects is appreciably increased, particularly in those organs for which the agents have specific toxicity. Symptoms most commonly associated with radiation sickness, such as malaise, anorexia, nausea, vomiting, diarrhea, dysphagia, dermatitis, and depleted hemopoietic elements, are usually seen late in the course of radiation therapy or shortly thereafter. Consequently, they are managed by the physician in charge of radiation or the patient's referring physician. The general physician may be concerned with symptoms arising from delayed organ pathology. These symptoms may arise in many tissues that are still considered somewhat radioresistant, but secondary to sequelae arising because of connective tissue changes from obliterative narrowing of the finer vasculature. Radiation may be only one of several possible causes, and the symptoms of sequelae may appear only after a long latent period, so that the previous radiation may not be considered in the differential diagnosis unless a detailed history is taken. The medical management of these sequelae is, in general, similar to that used for the pathology produced in these organs by other agents.
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PMID:Sequelae of abdominal radiation and their medical management. 83 56

Very fat people die earlier than people of normal weight because hypertension, diabetes and coronary disease are more frequent among the markedly obese. Most obese subjects, however, are only slightly overweight and their mortality is not elevated. Reasons for dieting are more often psychological than somatic. 2. Reducing diets are ineffective because the obese rarely follow them. Total fasting and intestinal bypass may provide better results, but are more dangerous. 3. Atkins' diet eliminates carbohydrates from food without restricting protein and fat intake. Deprived of carbohydrates, the body uses fat for fuel. A small part of metabolized fat is eliminated in the urine as ketone bodies, and this is why such diets are called "ketogenic". They have been known at least since 1863. 4. Caloric loss due to ketonuria does not exceed 100 Cal/day in the non-diabetic. It is maximal during total fasting and cannot be increased by a ketogenic diet. 5. In the short run, such diets produce rapid weight loss due to polyuria. On the other hand, refeeding carbohydrates causes water retention and weight gain. 6. The diet decreases appetite: patients eat less without feeling severe hunger and without measuring their food intake. 7. Orthostatic hypotension, fatigue, and nausea are frequent, despite what Dr. ATKINS claims. 8. The diet increases plasma cholesterol and uric acid. It may be dangerous in diabetes (anorexia, acidosis) and in heart or kidney failure (hypokalemia). 9. The diet, though far from good, is better than the book. ATKINS' theories are at best half-truths, and the results he claims lack credibility. The obese subject's disappointment with traditional reducing diets and the book's hard-sell style account for ATKINS' success.
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PMID:[Dr. Atkins' dietetic revolution: a critique]. 89 45

Preliminary results of this retrospective-prospective analysis of renal hypertension in 110 children indicate that hypertension may be secondary to a wide variety of acute progresive, and chronic renal diseases which may be either congenital or acquired. Affected children may be detected at any time from infancy through adolescence. Symptoms usually associated with acute glomerulonephritis (i.e., headache, swelling, nausea, vomiting, anorexia, fatigue, dizziness, and fever) occur in both acute and chronic renal diseases associated with hypertension. Headache and swelling are the most common symptoms in this series. Peripheral edema, rales, and increased heart size were found in between 10 and 25% of these children. Differential diagnosis may be approached by a consideration of causes of acute and chronic hypertension. The child with chronic renal disease usually presents with a long history of fatigability, poor growth, and pallor, and laboratory tests reveal elevation of the creatinine and BUN along with anemia, hypocalcemia, and hyperphosphatemia. In contrast, the child with acute renal disease and hypertension presents with a history of prior good health followed by the abrupt onset of signs and symptoms of renal disease; laboratory tests usually reveal modest elevations of creatinine and BUN, anemia is unusual, an abnormal urinalysis is common, and serum calcium and phosphorous levels are usually normal. Renovascular and asymmetric renal parenchymal disease represent uncommon but important conditions because surgery may be curative. Treatment may be surgical, medical, or combined. Surgical conditions include renal trauma, hydronephrosis, asymmetric renal disease, and renal arterial disease. Adequate blood pressure control without medication can be expected following surgery in instances of unilateral involvement with a normal contralateral kidney. Meticulous assessment of the contralateral kidney is needed to determine that it is normal. If surgery is unsuccessful or is not indicated, pharmacologic therapy is initiated with a stepwise regimen starting with the mildest agent (e.g., thiazides) and then adding additional antihypertensive drugs when adequate blood pressure control has not yet been achieved. The goal of therapy is the lowest, safest, tolerated blood pressure levels. Long-term, carefully designed studies of antihypertensive agents for children with renal hypertension are not available. The need for collection and critical analysis of data concerning the clinical course of children with renal hypertension is evident from a review of the literature and from the preliminary data presented in this series. The presentation of such information and a critique of outcome variables will provide a basis for program planning for affected children and improvement in patient care where indicated.
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PMID:Renal hypertension in children. 99 44


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