ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Serum zinc concentrations are decreased in patients with a variety of clinical disorders including cirrhosis, nephrotic syndrome and renal insufficiency. Urinary zinc excretions are increased in the first two disease states. Symptoms of acute zinc deficiency (anorexia, dysfunction of smell and taste and mental and cerebellar disturbances) and chronic zinc deficiency (growth retardation, anemia, testicular atrophy and impaired wound healing) are common in these patients. It remains unresolved whether these low serum zinc concentrations in these disease states are indicative of true symptomatic or asymptomatic zinc deficiency, or merely reflect a decrease in available zinc-binding proteins, as well over 90% of serum zinc is bound to protein in normal subjects. The correlation between serum zinc and albumin concentrations, reportedly the major zinc-binding protein, is unimpressive. Studies of serum and urine binding of added radiozinc65using Sephadex G-200 gel column chromatography and polyacrylamide gel electrophoresis suggest most of the radiozinc is bound to a protein with a molecular weight near albumin (68,000). Polyacrylamide gel electrophoresis suggests this might be a prealbumin. The low serum zinc concentration in the patient with nephrotic syndrome does not appear to be due to loss of zinc bound to urinary protein.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

In 17 normal subjects and 1 26 patients with various endocrine disorders, including 13 patients with Cushing's syndrome, plasma levels of fluorogenic corticosteroids were measured at 9 AM and midnight, and again at 9 AM the following morning, after the patient had received 1 mg of dexamethasone by mouth immediately after the midnight sampling. Basal morning levels of plasma corticosteroids were of little diagnostic value in differentiating between Cushing's syndrome and non-Cushing's states because of the wide overlap of values observed. At midnight the overlap almost completely disappeared. After overnight suppression, only one patient with a mild form of Cushing's disease had normal (false-negative) results in two of four instances. There were virtually no false-positive results, except for two patients with anorexia nervosa showing minor abnormalities of the test. The results were in general agreement with those of the classic Liddle test. However, one patient with Cushing's disease had repeatedly abnormal responses to overnight suppression and normal responses to the Liddle test. When the inhibitory tests gave equivocal results in the differential diagnosis between exogenous obesity and Cushing's disease due to adrenal hyperplasia, the response of plasma corticosteroids to hypoglycemia, normal in obesity and absent in Cushing's disease, proved to be an excellent ancillary test in differentiating between the two conditions.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Classical dehydration and vasopressin tests for estimation of renal concentrating capacity are inconvenient and sometimes hazardous. We attempted to use the new potent long-lasting synthetic vasopressin analogue (DDAVP) which has no side effects for testing renal concentrating capacity in adults. Four groups of persons were investigated: in Groups 1 and 3, 11 and another 11 healthy subjects; in Group 2, seven convalescent older patients; and in Group 4, 11 patients with pituitary diabetes insipidus (DI). Groups 1 and 2 were investigated during 15 hours' dehydration; DDAVP was given at the end of the 12th hour intravenously (4 μg) or intranasally (80 μ). DDAVP failed to influence strikingly the normal increase in renal concentration induced by lengthening the dehydration from 12 hours to 15 hours. On the other hand, in patients with Dl under prolonged treatment as well as in healthy individuals (Group 3), a dose of 20 to 40 μg of DDAVP administered intranasally induced (at least) as high peak urine osmolality duringad libitumfluid intake as was induced in normal subjects (Group 1) by 12 hours' dehydration alone. In patients with Dl the maximal effect of DDAVP obtained duringad libitumfluid intake could be further enhanced by added dehydration. Urine sampling for osmolality three hours after a single intranasal dose of 40 μg DDAVP duringad libitumfluid intake is a new safe, simple and convenient test for rapid estimation of concentrating ability.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Of 29,524 hospitalized medical patients monitored in a drug surveillance program, 649 (2.2%) received the fixed dose combination of trimethoprim-sulfamethoxazole, co-trimoxazole. Adverse effects of this drug occurred in 8% of recipients, the most frequent being skin rashes which occurred in 23 patients (3.5%) and upper gastrointestinal upsets which occurred in 22 (3.4%). Reactions frequently occurred within 72 hours of starting the drug and promptly resolved on stopping it. No patient experienced severe or life-threatening adverse effects. Adverse effects were unrelated to age, weight, duration of hospitalization or presenting blood urea nitrogen concentration, but were significantly commoner in female recipients.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Utilizing a Doppler ultrasonic flowmeter catheter, phasic instantaneous aortocoronary saphenous vein bypass blood velocity was recorded during various atrial arrhythmias in 17 patients. Atrial premature beats, supraventricular tachycardia and atrial fibrillation reduced peak bypass graft blood velocity in relation to the heart rate and diastolic cycle length. Such changes were more evident during the systolic fraction of bypass blood flow. In a single subject, systolic blood velocity alternans was observed during the course of atrial tachycardia. It is concluded that such study provides insight into the dynamics of bypass graft blood flow velocity during atrial arrhythmias.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Minimal change nephrotic syndrome or lipoid nephrosis is predominantly a disease of childhood. It has a benign course and responds to prednisone and/or cyclophosphamide. Although it is known to occur in young adults also, only an occasional patient over 60 years of age has been reported to have this disorder. In this report six patients 60 years of age and older with minimal change nephrotic syndrome diagnosed by renal biopsy are discussed. All six patients were men and had features of nephrotic syndrome. The daily urinary protein excretion ranged from 4 gm to 19 gm. Four patients had other abnormalities: hypertension controlled with diuretics, arteriosclerotic heart disease requiring digoxin, benign prostatic hypertrophy with obstruction or previous carcinoma of the prostate well controlled with estrogens. While one patient had a spontaneous remission four months after diagnosis, four patients responded satisfactorily to oral prednisone. Remission was induced in two to six weeks after the start of prednisone. One died of heart disease four weeks after diagnosis before any therapy could be given. Of the four patients treated with prednisone, one had a relapse in nephrotic syndrome when therapy was discontinued after two months. A second course of prednisone given over one year has been successful in inducing and maintaining a remission. The renal histopathology besides the minimal glomerular changes was characterized by global sclerosis of varying number of glomeruli. Nephrotic syndrome in the elderly patient warrants investigation and treatments as in children and young adults.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The prevalence of urinary antibody-coated bacteria (ACB), suggesting renal bacteriuria, was studied in three groups of patients: inpatients whose physicians suspected urinary tract infections, asymptomatic outpatients with neurogenic bladders but without urethral catheters, and asymptomatic inpatients with indwelling urethral catheters. The prevalence of ACB was 67% of inpatients with positive cultures without catheters, 94% of patients with neurogenic bladders, and 36% of patients with urethral catheters. These results suggest a high prevalence of upper urinary tract involvement in patients with positive urine cultures, even if asymptomatic.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Sudden death after subcutaneous injection of silicone has been described. However, there are no cases in the literature of clinically diagnosed noncardiogenic pulmonary edema. In the patient reported here, progressive hypoxemia and diffuse pulmonary infiltrates occurred following intramammary injection of a material presumed to be silicone. The presence of birefringent particles in the alveolar macrophages implies entrance of this material into the vascular compartment, its embolization to the lung and migration across the damaged alveolar-capillary membrane. Large volume subcutaneous injections of silicone should be added to the differential diagnosis of the etiology of the adult respiratory distress syndrome.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A 69-year-old man was hospitalized with fatal bacteremicHemophilus influenzaetype F pneumonia. Three cases of type F pneumonia have been reported previously. When compared with 22 reported cases of bacteremic type B pneumonia, patients with type F infection were more likely to be elderly males who succumbed to their infection (p < 0.05). Statistically significant differences in the incidence of underlying conditions or in the extent of pneumonia were not present.

ISSN:0002-9629    

出版商:OVID    

年代:1978

数据来源: OVID