Insulin infusion pump therapy: a review.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to B Chernow.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A radioisotope scintiscanning technique that can document pulmonary aspiration of gastric contents in patients with gastroesophageal reflux is described. Six patients with suspected nocturnal aspiration from reflux were studied. Three of the six had positive lung scans 8 hr after intragastric placement of 10 mCi of technetium 99m sulfur colloid. Overnight intraesophageal pH monitoring revealed prolonged episodes of GE reflux in those with positive scans. These preliminary observations suggest that this scintigraphic technique may be an effective method for documenting pulmonary symptoms as a consequence of gastroesophageal reflux.
Explore the source record for details and available documents.
Six patients with chronic obstructive pulmonary disease (COPD) (forced expiratory volume in one second, 1.01 +/- 0.08 L [mean +/- SEM] ) were given either 1 mL of 100% alcohol per kilogram of body weight in an aqueous solution or a similar volume of water in a crossover design on consecutive days. All subjects became intoxicated and the peak alcohol concentration was 137 +/- 11 mg/dL, 40 minutes after ingestion. No significant difference was found in either PaO2 or PaCO2 between the alcohol and control period. A significant decrease in arterial pH occurred following alcohol (P less than .05), and represented a mild metabolic acidosis. Alcohol ingestion resulted in an increase in oxygen consumption (P less than .05) and carbon dioxide production (P less than .05) but no change in respiratory rate. It appears that small to moderate amounts of alcohol will not cause marked changes in oxygen tension or alveolar hypoventilation in patients with severe COPD who do not have marked hypercapnia. Nevertheless, other effects of alcohol on the cardiopulmonary system and the concomitant use of sedatives have to be considered before condoning the use of alcohol.
Metastasis to bone marrow, though frequently occult, is an important clinical finding. Variables which correlate with carcinoma metastatic to bone marrow were studied retrospectively in 103 patients with malignancy whose bone marrow biopsies demonstrated metastatic disease. Sixty-six patients with metastatic cancer whose bone marrow biopsies were negative, served as controls. Since no single finding was diagnostic of marrow cancer, multiple variables were analyzed by stepwise discriminate analysis program. The four parameters which strongly correlated with marrow involvement were the leukoerythroblastic blood pattern, a serum lactic dehydrogenase over 500 IU/liter, a platelet count under 100,000/microliter and bone pain. Four parameters correlated less well and included a positive bone scan, hematocrit under 30%, uric acid over 10 mg/dl and blood urea nitrogen over 25 mg/dl. These data should help the clinician select those cancer patients with a high probability of marrow involvement.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We compared venous plasma norepinephrine (NE) concentrations in 191 resting, supine patients with essential hypertension and 129 normotensive controls. Among normotensives, plasma NE increased significantly with age, but among hypertensives, no age-related increase occurred, due to relatively high NE values among young hypertensives. When patients and controls less than 40 years old were considered, hypertensives showed significantly higher plasma NE than the controls (317 vs 245 pg/ml, t = 3.15, p less than 0.01); but above the age of 40 years, no significant hypertensive-normotensive difference was obtained. These results, predicted by recent literature reviews, help to resolve the persistent controversy about sympathetic neural activity in essential hypertension, since such activity appears to be abnormal mainly in young patients. The data are consistent with increased sympathetic nervous system activity in the early stages of essential hypertension.
A 19-yr-old woman developed ketoacidosis 7 wk after the delivery of her first child. Despite breast feeding, she had been on a weight reduction diet resulting in a loss of 12 kg/body wt. With the development of a urinary tract infection, the patient became dehydrated and was found to be in ketoacidosis (arterial pH was 7.25 and PaCO2 was 17 mm Hg). The patient did not use alcohol and was nondiabetic. Therapy with adequate calories, intravenous fluids, and an appropriate antimicrobial agent resulted in prompt normalization of the laboratory abnormalities and resolution of the patient's symptoms. The hypothesis is advanced that the postpartum status of the patient put her at particular risk for development of ketoacidosis and that this may represent the first reported episode of "bovine ketosis" in a human.
Explore the source record for details and available documents.
Explore the source record for details and available documents.