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Target Concepts:
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Query: UMLS:C0030552 (
paresis
)
5,831
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A now 61-year old man with hypersecretion of vasoactive intestinal polypeptide (VIP) due to carcinoma of the tail of the pancreas was treated and followed for nine years. Combined administration of lomustin (2.5 mg/kg on day 1) and 5-fluorouracil (30 mg/kg on days 2-6) over eight courses at six-week intervals achieved clinical remission for 13 months. No clinical improvement was observed with streptozocin (500 mg/m2 on days 1-5) for two courses four weeks apart. Treatment had to be discontinued after the second course because of the onset of (rarely observed) neurotoxic side-effect of bilateral peroneal
paresis
. High doses of somatostatin (6.9 micrograms/kg hourly intravenously) immediately and markedly reduced stool quantity. But at a lower dose (3.4 micrograms/kg hourly i.v.) there was no noticeable effect. In the further course of the disease, massive attacks of diarrhoea at varying intervals were best controlled in intensity and duration by prednisolone (50-60 mg daily). Other drugs which have been recommended for such cases (indometacin, lithium, trifluoperazine,
nicotinic acid
and clonidine) had no worth-while effect. In future long-acting somatostatin analogues may provide better prospects for long-term treatment.
...
PMID:[Vipoma. 9-year observations using currently available therapy methods]. 286 74
Goldberger discovered human pellagra was a non-infectious disease, affecting mostly the small and the timid in overcrowded institutions. Symptoms were diarrhoea, dermatitis and dementia. The staff and older children escaped the disease. They ate the meat and left the small and timid with the gravy. The 'Goldberger syndrome' is observed during competitive feeding of livestock, in ketotic animals and in the zinc depleted which are lethargic and pick all day at their feed. The pellagra preventative factor was later found to be
nicotinic acid
, derived from the amino acid tryptophan. Deficiencies of copper, magnesium, vitamin B6 (activated by a zinc kinase) inhibit the conversion of tryptophan to
nicotinic acid
. Stresses, including liver diseases, malabsorption, iron overload, porphyria, marasmus, cold stress, pregnancy, lactation, antibiotics and sulfa drugs, all increase dietary needs of
nicotinic acid
. Elevated free fatty acids and ketone bodies in the blood are associated with ketosis, zinc depletion and the pre-diabetic state. There is a diminished uptake of glucose by the tissues, a condition also found in parturient
paresis
of dairy cows when elevated hydrocortisone promotes insulin resistance and hyperglycaemia. This defect in insulin response leads to a diabetic-like state. The major predisposing factor in parturient
paresis
of dairy cows is hypocalcaemia. Gut absorption of dietary calcium may not meet the primary demands of lactation initiation until bone calcium mobilisation is established.
...
PMID:Metabolic disorders of cattle. 839