A case of ochronosis with far-advanced cardiovascular, skeletal, and prostatic manifestations is reported. An attempt is made to correlate the location of pigment with other pathological changes in this disorder. A brief discussion of the hereditary factors, the metabolic pathways of homogentisic acid, and the pathogenesis of ochronosis is presented.

Journal Article↗

PubMedDate not supplied

Destructive polyarthritis secondary to Mycobacterium kansasii.

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Adult↗

PubMedDate not supplied

Dicoumarol toxicity in cattle associated with ingestion of silage containing sweet vernal grass (Anthoxanthum odoratum).

A diagnosis of dicoumarol toxicity in a herd of Friesian cattle was made following investigation of the deaths of three mature cows and eleven yearling heifers. Affected stock had been fed wrapped, bailed silage containing approximately 90% sweet vernal grass (Anthoxanthum odoratum). Sweet vernal grass contains coumarin, which can be converted to dicoumarol, a vitamin K antagonist, through the action of moulds. Most deaths were preceded by lethargy, severe anaemia and subcutaneous and internal haemorrhage. Dicoumarol toxicosis was suspected based on clinical signs, necropsy findings and prolonged prothrombin and activated partial thromboplastin times. Dicoumarol analysis of blood from affected animals and silage confirmed the diagnosis. Activated partial thromboplastin time Haemoglobin Packed cell volume Prothrombin time Red cell count

Animal Feed↗

PubMedDate not supplied

Drug-induced depression in the aged. What can be done?

Over 10% of medically ill elderly persons have concurrent major depression, and medical illness is the most influential stressor contributing to depression in old age. The contribution of prescribed medications to depression in the medically ill is poorly understood. Most information on drug-induced depression is derived from case reports; 43 classes of medications have been implicated, including reserpine, beta-blockers, levodopa, corticosteroids, and antipsychotics. However, large rigorously performed studies of some drugs, particularly antihypertensives, suggest that drug-induced depression is uncommon and idiosyncratic. There is no evidence that age is an independent risk factor for drug-induced depression. However, elderly persons are the largest consumers of prescribed drugs, and the burden of drug-induced depression is carried by the old. Because of the frequency of atypical presentations of mental disorders in the elderly, drug-induced depression is often misdiagnosed. Nevertheless, basic principles of geriatric medicine offer useful guidance to clinicians in evaluating the complex interrelationships between prescribed medications and depression. We recommend an approach that includes regular inquiry into the common symptoms of mood disorders, vigilance in assessing the contribution of drugs in their development, but scepticism in assessing a depressive episode as caused only by medication.

Aged↗

PubMedDate not supplied

Drug-induced mania in the elderly.

Mania is a rare complication of prescribed drug use in elderly persons. The drugs most likely to produce mania include corticosteroids and dopamine agonists. It is uncertain if antidepressants cause mania or only increase the propensity for latent bipolar mania to be expressed. Drug-induced mania may promote poor judgment, risk-taking behaviours and medical noncompliance. The majority of episodes of drug-induced mania are short-lived and respond to discontinuation of the drug. Antipsychotic agents may hasten resolution of this psychiatric syndrome. Lithium may prevent corticosteroid-induced mania, but the role of lithium in the treatment of other drug-induced manic episodes has not been studied adequately.

Aged↗

PubMedDate not supplied

Liquid nitrogen: how to make it last.

AIM: To compare the rate of heat flow into two vacuum flasks with vacuum envelopes of different materials (glass and stainless steel). DESIGN: Prospective non-randomised comparison (n = 2). SETTING: Home (edge of the Great Sandy Desert), Sunday. OUTCOME MEASURE: Change in liquid nitrogen content over time. RESULTS: Within eight hours, the flask with a stainless steel envelope lost almost all its nitrogen (about 800 g), while the flask with a glass envelope lost only about 100 g. The stainless steel flask therefore had a heat leakage rate about eight times that of the glass flask. CONCLUSION: A glass-lined vacuum flask is better for keeping liquid nitrogen cold (and coffee hot) than a steel-lined flask.

Equipment Design↗

PubMedDate not supplied

Serum ferritin, free erythrocyte protoporphyrin, and urinary iron excretion in patients with iron disorders.

Tests to evaluate body iron stores were compared in patients with iron deficiency and the anemia of chronic disease. The serum ferritin assay separated these disorders in 20 of 22 patients. One discrepancy was explained by the concomitant association of both disorders. From this study and review of literature a low serum ferritin level is a good indication for iron therapy. The serum ferritin assay is a clinically useful test in lieu of bone marrow estimation of body iron stores to detect patients with iron deficiency. Total iron binding capacity levels when high-normal or elevated are sometimes helpful as a screening test in separating iron deficiency from the anemia of chronic disorders. Free erythrocyte protoporphyrin values were elevated in both conditions but were higher in iron deficiency than in the anemia of chronic disorders with considerable overlap of values. Urinary iron excretion with deferoxamine was not helpful in separating these disorders but is a useful test to establish iron overload. An elevated serum ferritin level is usually found with disease of iron overload but serum iron levels, deferoxamine iron excretion tests, and liver biopsy for estimation of iron stores are still beneficial diagnostic aids.

Anemia↗