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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As part of a study of drug treatment of aggressive behavior to be reported separately, we have evaluated the double-blind procedure in a recently completed comparison of the efficacy of lithium carbonate versus placebo in modifying aggressive behavior in nonpsychotic incarcerated delinquents. We conclude that the side effects of lithium carbonate are sufficient to reveal the medication to most subjects receiving it. Thus, while the study staff could not identify lithium-receivers at better than chance levels, and while subjects who received placebo could not identify their medication at better than chance levels, subjects who received lithium could accurately identify it. On a weekly symptom check list there was no difference between lithium and placebo groups on average lithium target symptoms reported during 4-week pre- and postmedication control periods; however, lithium-receivers reported significantly more target symptoms every week medication was administered. Of 16 subjects who quit the study, 14 had received lithium and nearly all of those who gave reasons for quitting specified side effects, most often nausea. The methodological problems of using lithium in a double-blind design might be overcome by employing a "discontinuation" design, or, speculatively, a double-blind, cross-over design utilizing an "active placebo".
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PMID:An evaluation of the double-blind design in a study comparing lithium carbonate with placebo. 78 50

The relation between lithium dose, lithium concentrations, and lithium gradients in plasma and the side effects tremor, nausea, abdominal pains, and loose bowels was studied in 19 subjects. Rapidly dissolving lithium carbonate tablets were used. Tremor was related to higher doses, to higher concentrations, and to higher gradients of lithium in plasma. Nausea was related to higher gradients. Abdominal pain and loose bowels showed no relation to doses, levels or gradients. Concentrations of lithium were dose-dependent, while gradients were relatively independent of dose.
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PMID:Lithium side effects in relation to dose and to levels and gradients of lithium in plasma. 84 39

The utility and side effects of sustained-release lithium carbonate (Priadel) in a once-per-day dose regimen was investigated with 66 male delinquents, ages 17-24 years, in a double-blind study comparing the antiaggressive effect of lithium carbonate with placebo. Serum lithium levels and symptoms were determined weekly for up to eight drug-free and 12 on-medication weeks. Average daily doses of 1500-1700 mg Priadel gave 24-hour serum lithium levels in the range 0.7-0.9 mEq/liter. Principal side effects were polyuria and shakiness, with other important side effects bring hand tremor, dryness of mouth, nausea, and weakness. No lithium toxicity was observed, and diarrhea was reported infrequently. Placebo response data are presented.
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PMID:Sustained-release lithium carbonate in double-blind study: serum lithium levels, side effects, and placebo response. 126 38

Acute barium salt poisoning may cause acute hypokalemia and result in respiratory paralysis and ventricular tachyarrhythmias. The early nonspecific gastrointestinal symptoms of barium poisoning due to food contamination could be confused with other benign food poisonings. Early diagnosis and initiation of intensive supportive care is essential. We report an outbreak of acute barium carbonate poisoning, occurring at a family reunion party, which resulted in 9 hospital admissions. All of the victims initially developed nausea, vomiting, abdominal colic, dizziness and watery diarrhea followed by numbness of the face and distal extremities 1-2 h after ingesting fried flour-coated sweet potatoes. The flour was later confirmed to be contaminated with barium carbonate. One person died in the emergency room with a serum potassium level of 0.8 mEq/L. Two other victims developed ventricular tachycardia and respiratory paralysis but completely recovered with the treatment advice provided by the poison center. The poison center was successful in helping to make the correct diagnosis in a timely manner, immediately distribute the treatment protocol, and coordinate the laboratory confirmation of barium carbonate poisoning.
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PMID:The essential role of a poison center in handling an outbreak of barium carbonate poisoning. 203 49

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

We have observed 27 migraineurs whose headaches occurred in groups separated by headache-free periods. Twenty-one of the patients were women. The headaches occurred on either side in most patients. The headaches were severe lasting for an average of 25.5 hours, often preceded by scintillating scotomas, and often associated with nausea, vomiting, and photophobia. The attacks occurred in cycles that lasted an average of six weeks. The cycles recurred an average of five times per year; during the cycles, severe migraine occurred several times per week. In many patients, the cycles were often accompanied by a constant, low-grade headaches and depression. Twenty-two patients were treated with lithium carbonate. Complete or partial control of the headaches was achieved in 19 patients.
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PMID:Cyclical migraine. 678 69

Fifteen patients with multiple myeloma were treated with sodium fluoride (50 mg twice daily) plus calcium carbonate (1 g four times daily) or with the same fluoride-calcium dosage plus vitamin D (50,000 U twice weekly). All patients had increased bone formation, as shown by microradiography and videodensitometry. Ten patients had osteosclerosis demonstrated by roentgenograms. Compressive strength of the vertebral bodies was greater among those who received fluoride-calcium than among controls. Densitometry studies were not helpful. Side-effects were minimal and consisted of nausea and fibrositic symptoms. Hypocalcemia occurred less frequently in patients who received vitamin D along with fluoride-calcium. Administration of sodium fluoride and calcium carbonate produces an increase in bone mass and is a useful adjunct treatment for patients with multiple myeloma.
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PMID:Effect of sodium fluoride, calcium carbonate, and vitamin D on the skeleton in multiple myeloma. 698 79

Recent human studies suggest that oesophageal HCO3- secretion, in conjunction with salivary HCO3- secretion and secondary oesophageal peristalsis, is important for the protection of oesophageal mucosa from refluxed gastric contents. This study evaluated simultaneously the responsiveness of oesophageal and salivary HCO3- secretion to oesophageal acidification in eight healthy subjects. A 10 cm segment of oesophagus was perfused at a constant rate of 5 ml/min with a specially designed tube assembly. Saline was used initially, and then 10 mM and 100 mM HCl. The perfusates contained 3H-polyethylene glycol (PEG) as a concentration marker to determine volumes. Corrections were applied for a small degree of contamination by swallowed saliva and refluxed gastric alkali. Oesophageal perfusion with 10 mM HCl did not cause symptoms (nausea and heartburn), but tripled the oesophageal HCO3- output from a baseline of 51 mumol/10 cm/10 min (p = 0.021), while doubling the rate of salivary HCO3- secretion from a median basal value of 140 mumol/10 min (p = 0.021). Oesophageal perfusion with 100 mM HCl was associated with symptoms of nausea and heartburn in all subjects. The median oesophageal HCO3- output increased 32 fold to 1659 mumol/10 cm/10 min (interquartile range 569 to 3373; p = 0.036), and salivary HCO3- secretion approximately tripled from basal values (p = 0.036). In conclusion, oesophageal acidification stimulates both salivary and oesophageal HCO3- secretion, responses which may be protective to the oesophageal epithelium.
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PMID:Effect of topical oesophageal acidification on human salivary and oesophageal alkali secretion. 779 11

Twenty-one hemodialysis patients were studied during 25 dialysis sessions with a dialysate sodium of 140 mEq/L and during 25 sessions with a high and variable sodium dialysate (145 mEq/L decreased to 140 mEq/L). Bicarbonate dialysate and ultrafiltration-controlled dialysis equipment were used. Neither the average interdialytic weight gain nor the predialysis and postdialysis blood pressures changed. The need for 5% saline infusions decreased from 168 + 137 ml/patient to 2 + 6 ml/patient for 25 dialyses. Use of 0.9% saline boluses remain unchanged. Fewer dialysis sessions required the use of the Trendelenburg position (p < .02) or a decrease in the transmembrane pressure (p < .05). With the use of high and variable sodium dialysate concentration, patients had less symptomatic hypotension (p < .05) and fewer symptoms of dialysis dysequilibrium, such as cramps or nausea.
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PMID:Clinical benefits of high and variable sodium concentration dialysate in hemodialysis patients. 808 Mar 11

A 41-year-old man died in 1995 during ketoacidotic coma. He suffered from chronic manic depression, used lithium carbonate, and consulted the psychiatrist and the general practitioner (GP) frequently. Diabetes had not been diagnosed. Late in 1994 the situation worsened, the patient complaining of general illness, fatigue, nausea, vomiting, diarrhoea, thirst and excessive drinking of soft drinks. The GP referred the patient to a neurologist who found no neurological disorder but who asked for determination of blood glucose and lithium levels, and of thyroid function. The day afterwards the neurologist went on holiday. The blood glucose level proved to be elevated (16.9 mmol/1) but nobody took any action and the GP was not informed. Six days after returning from his holiday, the neurologist who had an administration backlog, found the laboratory findings only after he had been informed that the patient had just died. The court gave the neurologist a warning. Lessons are that somatic problems should be treated as such, even in a psychiatric patient, and that a good administrative signalling system is a prerequisite for quality in medical practice.
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PMID:[Medical and administrative neglect of high blood glucose levels; comments on a decision by a medical disciplinary tribunal]. 954 47


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