Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reported a 32-year-old man with general paresis. He showed slowly progressive bradykinesia and recent memory loss. Argyll Robertson pupils were not present. Muscle strength and sensations were normal except for slight vibratory disturbance. Tendon reflexes were slightly exaggerated. MMSE, HDS-R and WAIS-R scores showed the intellectual impairment. His laboratory investigations revealed elevated both TPHA and FTA-ABS titers in the serum and the CSF. The CSF contained leukocytosis (25/mm3) and protein 80 mg/dl. Cranial CT and MRI demonstrated diffuse cortical atrophy. SPECT revealed marked reduction of the blood flow in bilateral cerebral hemisphere. Cerebral angiography revealed moderate stenosis of the major vessels. The diagnosis of neurosyphilis (general paresis) was made and the treatment of intravenous benzyl penicillin potassium 24 million units per day was started. After 6 weeks of the treatment, the clinical signs (includes MMSE, HDS-R and WAIS-R scores) and the findings of SPECT and cerebral angiography showed improvement. Although the cell count and protein in the CSF became decreased, the titers of TPHA and FTA-ABS in the serum and the CSF were not decreased. Neurosyphilis should always be considered in a etiologically unknown case with bradykinesia and dementia.
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PMID:[Therapeutic case of general paresis manifested by bradykinesia and recent memory loss]. 1061 61

In a 65 years old male patient 38 cc of a 7.45% potassium chloride-solution was inadvertently infused within 3 hours into an epidural catheter on the first postoperative day. The epidural potassium chloride administration resulted in a paresis and painful paraesthesia of the patient's legs and a level of sensory blockade to TH 11. Furthermore vegetative symptoms like hypertension and tachycardia were observed. For therapy a single bolus of 40 mg dexamethasone was administered intravenously followed by an epidural infusion of sodium chloride 0.9% 99 cc/h for several hours. About 6 hours after the start of infusion all symptoms had disappeared. It is proposed that the use of colour-coded epidural catheter devices and coloured electrolyte solutions as well as infusion-pumps with a larger reservoir that reduce the frequency of syringe changes would be helpful in avoiding such complications.
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PMID:[Inadvertent potassium chloride infusion in an epidural catheter]. 1067 53

Certain blood parameters and clinical symptoms have been connected with milk fever and a hypocalcemic condition in the cow. The present study intended to establish a mutual connection between relevant blood parameters and potentially valuable background information about the cow and its observed clinical symptoms at calving. Two veterinarians were summoned within 12 h of parturition of 201 cows, distributed among 41 Danish commercial herds. Cows were at different parity levels (2 to 10) and breeds and management differed broadly among herds. A blood sample was taken from the vena jugularis or the tail vein and was subsequently analyzed in the laboratory. Furthermore, 13 different clinical symptoms were recorded as categorical data. We investigated associations among the data obtained. We assessed an interpretative model for actual blood calcium level with blood parameters and background knowledge of the animals. We established a path analysis using background knowledge, blood parameters, and results of clinical examinations to uncover causal connections among the variables. Twenty-six percent of the animals were diagnosed as having milk fever and subsequent blood analyses revealed a high frequency of hypocalcemia within the general range from 0.69 to 2.73 mmol of Ca per liter. Rectal temperature, inorganic blood phosphate, and potassium were all directly correlated with blood calcium, while glucose, lactate, and magnesium were inversely associated with calcium. Blood osteocalcin was significantly lower in hypocalcemic animals, indicating that de novo synthesis of bone was arrested during hypocalcemia. A mixed effect linear interpretative model explained 75% of the variation in blood calcium. Clinical symptoms like mood, appetite, muscle shivering, rumen motility, and paresis were individually correlated with blood calcium and were thereby predictive of hypocalcemia. The path analysis showed the central role of calcium in affecting the clinical symptoms. However, several other factors contributed to hypocalcemia.
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PMID:Evaluation of clinical and clinical chemical parameters in periparturient cows. 1146 25

Paralysis following scoliosis correction is a catastrophic situation. We report an unusual metabolic cause of neurological deficit after anterior thoracic release. A 15-year-old female developed proximal leg paralysis 1 day after surgery. Investigations disclosed severe serum hypokalaemia (2.8 mmol/l). After intravenous potassium substitution the neurological status completely normalized within a few hours. We assume that the condition was a manifestation of hypokalaemic paralysis since no further abnormalities could be disclosed. Spinal surgeons should bear in mind hypokalaemia as a benign and easily correctable cause of paresis following surgical scoliosis correction.
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PMID:A surprising cause of paresis following scoliosis correction. 1180 89

A 25-year-old Caucasian man is admitted to hospital because of severe hyperthyroidism. Soon after his admission, he develops a lower limbs proximal muscles paresis with tendinous hyporeflexia. He has presented similar episodes in the previous months. Serum potassium level is 2.9 meq/l whereas it was 4.1 meq/l a few hours before. The patient receives intravenous potassium and propranolol. He will not develop a similar episode afterwards. Hypokalemic thyrotoxic periodic paralysis associated with Basedow's disease is diagnosed. Hypokalemic thyrotoxic periodic paralysis is a very rare cause of intermittent muscular weakness in the young Caucasian male. The frequency of this entity is at least ten times higher in Asiatic hyperthyroid people. Its physiopathology involves intracellular potassium shifts in which Na/K ATP-ases of cell membranes, the number and the activity of which increase in hyperthyroid people, seem to play a major role. Treatment consists of correction of hyperthyroidism and administration of potassium during the acute episode Propranolol is efficient in preventing recurrent episodes of paralysis. Points of comparison between hypokalemic thyrotoxic periodic paralysis and hypokalemic familial periodic paralysis are discussed.
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PMID:[Hypokalemic thyrotoxic periodic paralysis: a case report]. 1201 51

Anesthetic management of cardiac patients with complete transposition of the great arteries (TGA) undergoing arterial switch operation (ASO) is challenging. The anesthetic course and perioperative problems were studied. A prospective data collection study of 87 patients was performed between January 1991 and February 2002. The patients were divided into 3 groups: Group 1; 27 neonates with TGA with an intact ventricular septum (IVS), Group 2; 21 with TGA, with IVS who underwent two-stage ASO, and Group 3; 39 with TGA, with a large VSD. The anesthesia consisted of low-dose fentanyl, thiopental, atracurium and isoflurane. Monitoring included ECG, radial or femoral arterial pressure, CVP, LAP, core temperature, SpO2, P(E)CO2, urine output, ABG's, Hct, ACT, serum glucose and potassium. Fortunately the courses of anesthesia were uneventful. Usual vasoactive medication administered following CPB included nitroglycerin, dobutamine and dopamine. Groups I, 2 and 3 contained 18.5 per cent, 14.3 per cent and 33.3 per cent of patients who required adrenaline respectively. And only 7.7 per cent of patients in Group 3 had milrinone as an inotrope. Early tracheal extubation, 2 hours after admission to ICU was performed in 3 patients. Perioperative complications included bleeding, low cardiac output, diaphragmatic paresis, digitalis intoxication, metabolic alkalosis, convulsion, pulmonary hypertensive crisis and death. Two patients who developed a pulmonary hypertensive crisis were successfully managed with inhaled nitric oxide. The overall hospital mortality rate was 19.54 per cent. In conclusion, the anesthetic management for ASO in 87 simple dTGA patients was uneventful at Siriraj Hospital. The major perioperative morbidity and hospital mortality were not directly anesthetic contribution.
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PMID:Anesthesia for arterial switch operation in simple transposition of the great arteries: experience at Siriraj Hospital. 1245 17

The pharmacokinetics of a multidose regimen of potassium bromide (KBr) administration in normal dogs was examined. KBr was administered at 30 mg/kg p.o. q 12 h for a period of 115 days. Serum, urine, and cerebrospinal fluid (CSF) bromide (BR) concentrations were measured at the onset of dosing, during the accumulation phase, at steady-state, and after a subsequent dose adjustment. Median elimination half-life and steady-state serum concentration were 15.2 days and 245 mg/dL, respectively. Apparent total body clearance was 16.4 mL/day/kg and volume of distribution was 0.40 L/kg. The CSF:serum BR ratio at steady-state was 0.77. Dogs showed no neurologic deficits during maintenance dosing but significant latency shifts in waves I and V of the brainstem auditory evoked response were evident. Following a subsequent dose adjustment, serum BR concentrations of approximately 400 mg/dL were associated with caudal paresis in two dogs. Estimated half-life during the accumulation phase was shorter than elimination half-lives reported in other studies and was likely related to dietary chloride content. The range of steady-state concentrations achieved suggests individual differences in clearance and bioavailability between dogs. The described protocol reliably produced serum BR concentrations that are required by many epileptic patients for satisfactory seizure control.
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PMID:Pharmacokinetics and toxicity of bromide following high-dose oral potassium bromide administration in healthy Beagles. 1248 48

In this study, the influence of simultaneous application of anionic salts (AS) and rumen buffer (RB) on the metabolism of dairy cows was examined. Eleven rumen fistulated, non-pregnant and non-lactating dairy cows received equal amounts of one AS (CaCl2 or CaSO4) and one RB (NaHCO3 or KHCO3) via rumen cannula during feeding time over a period of eight days. Before the first application of AS and RB and on day eight of the treatment period, blood, urine and rumen fluid samples were taken. The following parameters were measured: whole blood: pH, base excess, bicarbonate; serum: sodium, potassium, chloride, calcium; urine: pH, net acid base excretion, sodium, potassium, chloride, calcium; rumen fluid: pH. The changes of each parameter were compared via ANOVA. The changes in acid-base balance on day eight were very small, although significant. But p-values showed that the statistical evidence was low. The most changes occurred when NaHCO3 was fed in combination with one of the AS used. In this case a small acidogenic load was seen in blood (p < 0.05), and calcium concentrations increased slightly (p < 0.05). No alkalotic reaction could be detected when any combination of AS and RB were given to the cows. Simultaneous application of AS and RB results in a loss of effectivity of AS. Neither an adequate acidification of blood nor an activation of calcium metabolism occurred. In feed ration for cows in the last weeks of pregnancy, rumen buffer must not be fed, if anionic salts are given for prevention of parturient paresis.
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PMID:[Impact of a simultaneous application of anionic salts and rumen buffer on acid-base-balance and mineral metabolism in dairy cows]. 1672 72

Hypokalaemic thyrotoxic periodic paralysis is an enigmatic and uncommon condition which occurs exclusively in males of Asian descent. The underlying causes of thyrotoxicosis may be any of the well-recognized etiologies including a toxic multinodular goiter, Graves' disease or iodine excess. Beside thyrotoxicosis, a number of other hormonal factors have been hypothesized to contribute to hypokalaemic thyrotoxic periodic paralysis, particularly postprandial hyperinsulinaemia and testosterone. We hereby present a case of a 48-year-old hepatitis C positive gender-assigned man in whom all of these factors are proposed to interact, lending further support to these hypotheses. The patient presented with interferon-induced thyroiditis causing acute generalized weakness whilst undergoing combination interferon-alpha-2beta and ribavirin therapy. As part of his hepatitis C infection, marked insulin resistance with hyperinsulinaemia was also present, exacerbating the paresis. Initial treatment with beta-blocker failed to normalize his serum potassium concentration, requiring the novel use of spironolactone, despite euthyroidism. This continued to be required until his testosterone supplement dissipated.
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PMID:Hepatitis C infection and thyrotoxic periodic paralysis--a novel use of an old drug. 1909 28

A 5-year-old neutered male Cavalier King Charles Spaniel was evaluated for a 3-week history of progressive paresis. The dog had been receiving potassium citrate capsules to acidify urine for the past 2 years because of an earlier history of urolithiasis. Results of neurologic examination, spinal cord radiography, and magnetic resonance imaging of the skull and spinal cord revealed no lesions that could have accounted for the neurologic signs. The main abnormalities on a clinical chemistry profile were marked hyperchloremia (179 mmol/L, reference interval 108-122 mmol/L) and an anion gap of -50.4 mmol/L (reference interval 16.3-28.6 mmol/L). Because of the severe hyperchloremia, serum bromide concentration was measured (400 mg/dL; toxic concentration >150 mg/dL; some dogs may tolerate up to 300 mg/dL). Analysis of the potassium citrate capsules, which had been compounded at a local pharmacy, yielded a mean bromide concentration of 239 mg/capsule. Administration of the capsules was discontinued and there was rapid resolution of the dog's neurologic signs. This case of extreme bromide toxicity, which apparently resulted from inadvertent use of bromide instead of citrate at the pharmacy, illustrates the importance of knowing common interferents with analyte methodologies and of pursing logical additional diagnostic tests based on clinical and laboratory evidence, even when a patient's history appears to rule out a potential etiology.
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PMID:What is your diagnosis? Marked hyperchloremia in a dog. 1939 64


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