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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Glyphosate is used extensively as a non-selective herbicide by both professional applicators and consumers and its use is likely to increase further as it is one of the first herbicides against which crops have been genetically modified to increase their tolerance. Commercial glyphosate-based formulations most commonly range from concentrates containing 41% or more glyphosate to 1% glyphosate formulations marketed for domestic use. They generally consist of an aqueous mixture of the isopropylamine (IPA) salt of glyphosate, a surfactant, and various minor components including anti-foaming and colour agents, biocides and inorganic ions to produce pH adjustment. The mechanisms of toxicity of glyphosate formulations are complicated. Not only is glyphosate used as five different salts but commercial formulations of it contain surfactants, which vary in nature and concentration. As a result, human poisoning with this herbicide is not with the active ingredient alone but with complex and variable mixtures. Therefore, It is difficult to separate the toxicity of glyphosate from that of the formulation as a whole or to determine the contribution of surfactants to overall toxicity. Experimental studies suggest that the toxicity of the surfactant, polyoxyethyleneamine (POEA), is greater than the toxicity of glyphosate alone and commercial formulations alone. There is insufficient evidence to conclude that glyphosate preparations containing POEA are more toxic than those containing alternative surfactants. Although surfactants probably contribute to the acute toxicity of glyphosate formulations, the weight of evidence is against surfactants potentiating the toxicity of glyphosate. Accidental ingestion of glyphosate formulations is generally associated with only mild, transient, gastrointestinal features. Most reported cases have followed the deliberate ingestion of the concentrated formulation of Roundup (The use of trade names is for product identification purposes only and does not imply endorsement.) (41% glyphosate as the IPA salt and 15% POEA). There is a reasonable correlation between the amount ingested and the likelihood of serious systemic sequelae or death. Advancing age is also associated with a less favourable prognosis. Ingestion of >85 mL of the concentrated formulation is likely to cause significant toxicity in adults. Gastrointestinal corrosive effects, with mouth, throat and epigastric pain and dysphagia are common. Renal and hepatic impairment are also frequent and usually reflect reduced organ perfusion. Respiratory distress, impaired consciousness, pulmonary oedema, infiltration on chest x-ray, shock, arrythmias, renal failure requiring haemodialysis, metabolic acidosis and hyperkalaemia may supervene in severe cases. Bradycardia and ventricular arrhythmias are often present pre-terminally. Dermal exposure to ready-to-use glyphosate formulations can cause irritation and photo-contact dermatitis has been reported occasionally; these effects are probably due to the preservative Proxel (benzisothiazolin-3-one). Severe skin burns are very rare. Inhalation is a minor route of exposure but spray mist may cause oral or nasal discomfort, an unpleasant taste in the mouth, tingling and throat irritation. Eye exposure may lead to mild conjunctivitis, and superficial corneal injury is possible if irrigation is delayed or inadequate. Management is symptomatic and supportive, and skin decontamination with soap and water after removal of contaminated clothing should be undertaken in cases of dermal exposure.
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PMID:Glyphosate poisoning. 1586 83

It is widely known that haemodialysis patients do not readily comply with nutrition guidance. At least 6 months after initiating haemodialysis, the patients' dietary knowledge was tested by use of a questionnaire. The relationship between patient dietary compliance and religion and educational level was studied. Seventy patients were included in the study (33 Christians and 37 Muslims), ages ranging from 24 to 87 years. All patients had received haemodialysis for a period of the time ranging from 6 to 216 months. The questionnaire included questions related to salt, potassium and phosphate. Regarding questions, concerning salt, the Christians answered 85.7 +/- 22.8% correctly whilst the Muslims answered 60.1 +/- 34.6% correctly, a difference which was statistically significant (p=0.0001). However, more Christians arrived at the hospital with pulmonary oedema over a two-year period for emergency haemodialysis than Muslims (p=0.017), whilst there was no difference in the number of patients with residual diuresis between the two groups (p=NS). The difference in the incidence of pulmonary oedema could be attributed to the fact that more Christians had heart failure than Muslims (12/33 vs 6/37, p=0.09). Regarding questions concerning potassium, the Christians answered 74.6 +/- 33.9% correctly whilst the Muslims answered 41.1 +/- 38.5% correctly, a difference that was statistically significant (p=0.0001). However despite this difference, no Muslims attended hospital for emergency haemodialysis related to hyperkalaemia over the two-year period. Finally, regarding questions concerning phosphates, the answers from both group of patients were disappointing. Specifically, Christians answered 49.1 +/- 43% correctly, whilst Muslims answered 19.1 +/- 3.3% of the questions correctly, a difference which was statistically significant (p=0.0001). Patients did not acquire the necessary dietary knowledge but despite insufficient knowledge, they had a low incidence of fluid overload, hyperkalaemia and hyperphosphataemia. The Christians, despite superior knowledge, compared to the Muslims had more episodes of fluid overload.
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PMID:A study of dietary knowledge and its religious relationship in patients receiving haemodialysis. 1655 Oct 25

Amiloride-sensitive Na+ channels belong to the epithelial Na+ channel (ENaC)-degenerin superfamily of ion channels. In addition to their key role in sodium handling, they serve diverse functions in many tissues. Improper functioning of ENaC has been implicated in several diseases, including salt-sensitive hypertension (Liddle's syndrome), salt-wasting syndrome (pseudohypoaldosteronism type I), pulmonary edema, and cystic fibrosis. We have utilized planar lipid bilayers, a well-defined system that allows simultaneous control of "internal" and "external" solutions, to study ENaCs.
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PMID:Epithelial sodium channel in planar lipid bilayers. 1692 41

High blood pressure in dialysis patients is related to extracellular volume excess and the related increase of systemic vascular resistances. Scribner has early described the treatment of hypertension with ultrafiltration and low salt diet, without any drugs. The dry weight method relies on the progressive reduction of the postdialysis body weight until blood pressure is normalized. Additional measures are needed such as low salt diet, neutral sodium balance during dialysis treatment, stop of antihypertensive drugs, adequate length of the dialysis session, and patient education. It may exist a lag time between the normalization of the extracellular volume and blood pressure. It is related to the correction of the hemodynamic consequences of the extracellular volume overload. Moreover, the dry weight may potentially vary in patients undergoing catabolic intercurrent events. The complications of these changes (severe hypertension, pulmonary oedema) must be anticipated by the nephrologist and the staff to avoid additional morbidity to the patient.
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PMID:[Non-pharmacologic treatment of arterial hypertension in hemodialysis patients]. 1834 Jun 84

The epithelial Na(+) channel (ENaC) is a major regulator of salt and water reabsorption in a number of epithelial tissues. Abnormalities in ENaC function have been directly linked to several human disease states including Liddle's syndrome, psuedohypoaldosteronism, and cystic fibrosis and may be implicated in states as diverse as salt-sensitive hypertension, nephrosis, and pulmonary edema. ENaC activity in epithelial cells is highly regulated both by open probability and number of channels. Open probability is regulated by a number of factors, including proteolytic processing, while ENaC number is regulated by cellular trafficking. This review discusses current understanding of apical membrane delivery, cell surface stability, endocytosis, retrieval, and recycling of ENaC and the molecular partners that have so far been shown to participate in these processes. We review known sites and mechanisms of hormonal regulation of trafficking by aldosterone, vasopressin, and insulin. While many details of the regulation of ENaC trafficking remain to be elucidated, knowledge of these mechanisms may provide further insights into ENaC activity in normal and disease states.
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PMID:Regulation of the epithelial sodium channel by membrane trafficking. 1850 77

Postinfectious acute glomerulonephritis mostly happens in children aged two to 10 years old. Typically, it follows group A beta-hemolytic streptococcus skin or upper respiratory tract infection. There is a latent period of one to three weeks before nephritic syndrome appears. Microscopic or macroscopic hematuria is always present. Proteinuria and decreased glomerular filtration rate are usually mild. By contrast, salt and water retention can be severe and complicated with hypertension, congestive heart failure or pulmonary edema. Fluid overload must be urgently treated by loop diuretics or renal replacement therapy in the most severe cases.
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PMID:[Postinfectious acute glomerulonephritis]. 1880 69

The lung possesses specific transport systems that intra- and extracellularly maintain salt and fluid balance necessary for its function. At birth, the lungs rapidly transform into a fluid (Na(+))-absorbing organ to enable efficient gas exchange. Alveolar fluid clearance, which mainly depends on sodium transport in alveolar epithelial cells, is an important mechanism by which excess water in the alveoli is reabsorbed during the resolution of pulmonary edema. In this review, we will focus and summarize on the role of ENaC in alveolar lung liquid clearance and discuss recent data from mouse models with altered activity of epithelial sodium channel function in the lung, and more specifically in alveolar fluid clearance. Recent data studying mice with hyperactivity of ENaC or mice with reduced ENaC activity clearly illustrate the impaired lung fluid clearance in these adult mice. Further understanding of the physiological role of ENaC and its regulatory proteins implicated in salt and water balance in the alveolar cells may therefore help to develop new therapeutic strategies to improve gas exchange in pulmonary edema.
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PMID:Importance of ENaC-mediated sodium transport in alveolar fluid clearance using genetically-engineered mice. 2005 45

In the last 50 years, the morbidity and mortality of patients on maintenance dialysis treatment has remained unacceptably high. This is because insufficient attention is paid to the main task of the kidneys: body fluid volume regulation. While nobody denies these basic physiologic principles, several developments have contributed to their neglect. First, a tendency towards short dialysis sessions and even more unfortunately the emphasis of opinion leaders on removal of urea, the least toxic of the metabolites. The necessity of severe dietary salt restriction is insufficiently stressed. Thus most patients remain slightly volume expanded, causing not only hypertension, but also dilatation of the heart. This leads to cardiovascular damage and even pulmonary oedema ('heart failure'), an entirely preventable complication. While several authors have shown better results by applying these principles, the focus on randomised controlled trials, which are practically unfeasible in this setting, still precludes their general acceptance.
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PMID:[Dialysis treatment: an unfulfilled promise]. 2061 22

Glyphosate-surfactant (GlySH) is a commonly used herbicide that has been used in attempted suicide. Most reports of GlySH toxicity in patients have followed ingestion of the commercial product "Round-up" (Monsanto Ltd; Melbourne, Victoria, Australia), which consists of a mixture of glyphosate (as a isopropylanine salt) and a surfactant (polyoxyethyleneamine). Ingestion of Round-up is reported to cause significant toxicity including nausea, vomiting, oral and abdominal pain. Renal and hepatic impairment and pulmonary oedema may also occur. Impaired consciousness and encephalopathy have been reported as sequelae but there are limited data on the central nervous system (CNS) effects of Round-up toxicity. We report a 71-year-old male who attempted suicide with GlySH and developed a prolonged but reversible encephalopathy suggestive of acute CNS toxicity.
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PMID:Glyphosate-surfactant herbicide-induced reversible encephalopathy. 2065 31

Heart failure (HF) is characterized as a limitation to cardiac output that prevents the heart from supplying tissues with adequate oxygen and predisposes individuals to pulmonary edema. Impaired cardiac function is secondary to either decreased contractility reducing ejection (systolic failure), diminished ventricular compliance preventing filling (diastolic failure), or both. To study HF etiology, many different techniques have been developed to elicit this condition in experimental animals, with varying degrees of success. Among rats, surgically induced HF models are the most prevalent, but they bear several shortcomings, including high mortality rates and limited recapitulation of the pathophysiology, etiology, and progression of human HF. Alternatively, a number of non-invasive HF induction methods avoid many of these pitfalls, and their merits in technical simplicity, reliability, survivability, and comparability to the pathophysiologic and pathogenic characteristics of HF are reviewed herein. In particular, this review focuses on the primary pathogenic mechanisms common to genetic strains (spontaneously hypertensive and spontaneously hypertensive heart failure), pharmacological models of toxic cardiomyopathy (doxorubicin and isoproterenol), and dietary salt models, all of which have been shown to induce left ventricular HF in the rat. Additional non-invasive techniques that may potentially enable the development of new HF models are also discussed.
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PMID:Merits of non-invasive rat models of left ventricular heart failure. 2127 39


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