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At least 505 records · Page 28Linked to original sources
PubMed1991

Malnutrition in a compulsive runner: a case conference.

A 28-yr-old, female marathon and "fitness" runner presented with leg swelling, fatigue, and loss of endurance. She was running an hour or more daily in addition to regular biking and swimming. She was an instructor in a fitness center. For 2 months prior to her leg swelling, she had increased fatigue and decreased exercise tolerance. She had been seen previously for a slow healing hamstring strain. She had not had a menstrual period for over 2 yr and had refused evaluation. She admitted to very low dietary intake, which she had always denied. She was worried about her body fat. She denied recent blood loss, diuretic or cathartic use, and induced vomiting. She appeared malnourished, pale, and older than her stated age. Her weight was 41.4 kg. Her blood pressure was 90/60, and her pulse was 100 per minute. She had pitting edema of the lower extremities to the knees. The diagnosis of anorexia nervosa was made and will be discussed.

Adult↗
PubMed1978

[Culture and establishment of new Mexican Strains of Entamoeba histolytica].

Mixed and monoxenic cultures of rectal exudates from three patients with amebiasis of colon, and of feces from three asymptomatic carriers of Entamoeba histolytica obtained after administration of a saline cathartic, and from a case of exudate of the perianal cutaneous lesion border produced by this parasite, were done. The culture media used were for: mixed culture, Boeck and Drbohlav modified culture and, for monoxenic culture, Diamond's monophasic TP-S-1 medium without vitamin mixture and using bovine serum. In order to inhibit the bacterial growth in the mixed culture, streptomycin sulphate and pencillin G were used. In order to eliminate the bacterial flora kanamicin sulphate, chloramphenicol, gentamycin and disodic carbenicillin were added. Mixed cultures of seven strains of Entamoeba histolytica were obtained: HM22:IMSS, HM23:IMSS, HM24:IMSS, HM26:IMSS, HM27:IMSS, HM28:IMSS y HM29:IMSS, and monoxenic culture with Bacteroids symbiosus of the strains HM22:IMSS and HM27:IMSS, with a previous adaptation in mixed culture. The adaptation of HM26:IMSS strain in monoxenic culture was obtained by means of direct seeding of the rectal exudate with Fusobacterium symbiosus.

Animals↗
PubMed1990

Emergency treatments for police dogs used for illicit drug detection.

The key to saving police dogs that have been exposed to large quantities of illicit substances is rapid action. Removal from the gastrointestinal tract, adsorption, and catharsis are the first steps. Some of these measures can be instituted on site by the attending officer. In case of accidental drug exposures of a dog during a search, police officers should have on hand apomorphine, syringes for administration of the drug and rinsing of the conjunctival sac, activated charcoal, a saline cathartic such as sodium sulfate (not needed if the activated charcoal product contains sorbitol), a resuscitator bag, and a well-fitting canine face mask. If bags of drugs are ingested intact, immediate surgery by a veterinarian may be required to remove the bag and prevent an obstruction or rapid absorption of a lethal dose. Injectible medications to antagonize the effects of the drugs should be reserved for administration by a readily available veterinarian upon arrival of the dog at the veterinary hospital. Pharmacologic antagonistic agents may have adverse side effects, especially if used in the treatment of a drug exposure against which they are not specifically indicated. Proper dosage and route of administration are additional important factors with such treatment. The veterinarian must instruct the police officers on the proper use, dosages, and methods of administration of the detoxifying agents as well as the proper procedures for using the face mask and resuscitator bag before an emergency arises. The officer should also be aware of the clinical signs likely to be produced following exposure to the agents for which these dogs search.(ABSTRACT TRUNCATED AT 250 WORDS)

Amphetamines↗
PubMed1990

[Somatic and biochemical complications in bulimia].

Bulimia is an eating disorder characterized by binge eating followed by purging, i.e. self-induced vomiting, abuse of cathartic or diuretic drugs, increased activity or periods of restrictive dieting. Studies show that persons with bulimia are prone to a number of medical complications as a result of binge-eating, vomiting and drug abuse. Vomiting is the most harmful in terms of medical risk, and also the most common source of complications. Both vomiting and purging lead to loss of body fluids and electrolytes, often resulting in hypokalemia. Vomiting also leads to sore throats and dental problems such as destruction of enamel. Gastric dilatation is the only complication directly associated with binge-eating. Harmless symptoms, such as abdominal pain, diarrhoea, constipation and neuromuscular symptoms are common. This article discusses the pathophysiology behind the complications and their treatment.

Bulimia↗
PubMed1990

Encopresis: developmental, behavioral and physiological considerations for treatment.

Encopresis (soiling in the clothing) is a complex condition presenting a treatment challenge for health care providers. It is a disruptive event, placing both the child and family at risk for crisis. The definition, incidence, etiology and relevant medical, behavioral and developmental theory are discussed. A multi-dimensional encopretic evaluation and management model is presented that addresses encopresis at developmental, behavioral and physiological levels. This system includes a detailed historical, demographic, behavioral and school-performance profile of the child; appropriate physical and laboratory examinations; and a treatment approach that incorporates bowel evacuation, a high-fiber diet, techniques of behavior modification, and maintenance on either contingent rectal cathartics or oral laxatives. If there are significant behavioral concerns and/or the family is dysfunctional, collaborative psychiatric management can be arranged.

Child↗
PubMed1989

Toxicology of oil field wastes. Hazards to livestock associated with the petroleum industry.

In oil-producing states, the proximity of livestock to drilling operations and production sites often results in poisoning of animals from ingestion of crude oil, condensate, salt water, heavy metals, and caustic chemicals. The heavy metals encountered most frequently are lead from pipe joint compound and arsenicals and chromates used as corrosion inhibitors. Numerous toxic and caustic chemicals are used in drilling muds and fluids. Crude oil and salt water spills are common occurrences around production sites. Pipeline breaks may result in exposure of livestock to crude oil or refined petroleum hydrocarbons. Ingestion of petroleum hydrocarbons may result in sudden death from peracute bloat. The most common cause of illness or death following exposure to petroleum hydrocarbons is aspiration pneumonia, which may cause a chronic progressive deterioration of health, with death after several days or weeks. Cases in which livestock are exposed to oil, salt water, or caustic chemicals, but do not die acutely or from aspiration pneumonia are more frustrating to diagnose. In these cases, parasitism, poor nutrition, and other debilitating diseases must be considered. Anorexia, weight loss, and decreased rumen motility may be caused by a disruption of normal rumen function. Petroleum hydrocarbons, salt water, and caustic chemicals have the potential of altering rumen flora and enzymatic processes as well as damaging the ruminal and gastrointestinal epithelium. The toxicity of petroleum hydrocarbons appears to be related more closely to the volatility and viscosity of the product than to other factors. The more volatile straight chain and aromatic petroleum hydrocarbons have a greater potential for aspiration pneumonia and may produce an anesthetic-like action if absorbed systemically. The more volatile petroleum hydrocarbons also are more irritating to skin and mucous membranes and appear to be more damaging to rumen flora. Treatment of petroleum hydrocarbon ingestion is aimed at preventing aspiration pneumonia and the animal's absorption of highly volatile components. Activated charcoal slurries and, in some instances, vegetable oil may be used to absorb the ingested petroleum or alter its viscosity to minimize absorption and aspiration. These procedures should be followed by the administration of rumenatories or saline cathartics to hasten the evacuation of the gastrointestinal tract. Chronic poor performance animals with anorexia and rumen dysfunction may respond to fresh rumen inoculant, intravenous glucose, and B-complex vitamins. Prognosis primarily hinges on whether or not aspiration pneumonia has occurred. Treatment of aspiration pneumonia rarely is effe

Animals↗
PubMed1989

Acute appendicitis: a clinical pattern in Port Harcourt Nigeria.

A retrospective study of 201 patients, 152 with simple and 49 with complicated, appendicitis is presented. Diagnosis of simple acute appendicitis was made on symptoms of abdominal pain, anorexia, nausea and vomiting, together with rebound abdominal tenderness and not on white blood cell count. Normal white blood cell count was found in 80.3% cases of simple acute appendicitis while elevated white cell count was associated with 85.7% of complicated appendicitis. There was no mortality in 152 patients who had appendectomies for uncomplicated acute appendicitis, but the mortality rate in the 49 patients with complications was 12.2%. This was responsible for the overall mortality rate of 3% for all appendectomies in this report. Complicated appendicitis in this review was largely due to pre-admission delays and the ingestion of strong cathartics, both of which could not be influenced by surgeons.

Acute Disease↗
PubMed1989

Stercoraceous perforation of the colon.

Non-traumatic colon perforations are usually caused by malignancy, diverticulum and colitis. They rarely result from stool impaction. A 74-year-old woman with stercoracous perforation of the colon is reported. She had a long history of constipation and hypertension treated irregularly with cathartics, enemas, diuretics and beta-blockers. Resection of the perforated colon with a proximal diverting colostomy and Hartman's procedure was performed. The patient tolerated the operation and subsequent reanastomosis 6 weeks later. In the case of elderly patients with constipation, early management of the constipation is mandatory, although this condition of stercoraceous perforation is rare.

Aged↗
PubMed1989

Emetine identified in urine by HPLC, with fluorescence and ultraviolet/diode array detection, in a patient with cardiomyopathy.

A 15-year-old girl with a four-month history of cardiac failure from undetermined cause was admitted to the hospital with weakness, fatigue, and weight loss. During her hospitalization she was found to have abused diet aids, laxatives, and cathartics. Although an electrocardiogram revealed nonspecific T-wave abnormalities and laboratory studies showed supranormal enzyme test results for creatine kinase and lactate dehydrogenase, no definite explanation of the cardiomyopathy was forthcoming. Ipecac abuse leading to cardiomyopathy was suspected early in the hospitalization. HPLC analysis of a urine sample showed emetine, a principle component of ipecac, the presence of which was later confirmed by more-specific HPLC analysis with photodiode array detection.

Adolescent↗
PubMed1977

Effect of prophylactic systemic administration of cephalothin in colorectal surgery.

The effect of standardized prophylactic treatment with systemically administered cephalothin (Keflin) was studied in a series of 120 consecutive patients in whom elective colorectal surgery was planned. The patients were divided by random selection into one treatment group and one control group. The same mechanical cleansing with cathartics and tap water enemas was performed in both groups. The patients in the treatment group received intravenously 2 g cephalothin 2 hours prior to the operation, 2 g during the operation and then 2 g every 6th hour during 4 days. 14 cases were excluded for various reasons. In 19 cases only minor operations were performed, such as laparotomy with or without simultaneous colostomy. The overall frequency of infections was 17.5% in the treatment group and 53.1% in the control group. In the 87 cases undergoing major operations, infections were registered in 17.4% of the treated patients and 58.5% of the control patients. The difference is highly significant (p less than 0.001) in both cases. Escherichia coli was present in about 70% of the infections, often together with other aerobic or anaerobic organisms.

Adult↗
PubMed1987

Factors influencing the clinical efficacy of activated charcoal.

The use of activated charcoal as part of the treatment of intoxicated patients has increased dramatically over the last ten years. Activated charcoal is currently suggested as therapy to prevent the absorption of orally ingested compounds, and is gaining popularity as a method of increasing systemic drug clearance. This review presents variables that should be considered when activated charcoal is used in the treatment of intoxicated patients. Variables that may alter the efficacy of charcoal therapy include the preparation and dose of charcoal used, the intoxicants involved, stomach contents, the gastrointestinal pH, concurrently administered materials, and time from toxin ingestion to charcoal administration. As a general guideline, a single, large dose should be administered with a cathartic as soon as possible after oral ingestion to prevent drug absorption. When charcoal is used to enhance systemic drug clearance, the dosage regimen should be individualized, based on the drugs involved and the patient's gastrointestinal tract function, fluid and electrolyte status, and the severity of intoxication.

Charcoal↗
PubMed1978

Phencyclidine intoxication: a literature review.

The history, symptoms, diagnosis and treatment of phencyclidine hydrochloride (PCP) intoxication and the pharmacology of PCP are reviewed. Intoxication with low to moderate doses of PCP (5-20 mg) resembles an acute, confusional state generally lasting four to six hours. High doses (greater than 20 mg) may cause serious neurologic and cardiovascular complications and the patient is often comatose for several days. Treatment involves supportive psychological and medical measures. Evacuation of the stomach with activated charcoal and a saline cathartic may be indicated and succinylcholine chloride may ease intubation. Diazepam and chlorpromazine may be used to control the combative patient and the "PCP psychosis" patient, respectively. Antihypertensive agents are not usually needed, but diazoxide and hydralazine hydrochloride have been used to treat hypertensive crises. Diazepam and phenytoin have been used to treat seizures. Ion-trapping by continuous gastric suctioning and by urine acidification with ammonium chloride may increase clearance of PCP. Forced diuresis with furosemide in conjunction with acidification may further increase PCP clearance. Use of physostigmine is based on conjecture.

Animals↗
PubMed1986

[Clinical experience with the use of Amorosa, a low-mineral water, in athletes].

Nine semi-professional football players have been studied during a pre-championship retreat in a hilly area with their team. The nine athletes drank "Amorosa" oligo mineral water for three weeks and various haematochemical parameters (such as uricaemia, creatinemia, azotemia, sodium content) both before and after the retreat, have been evaluated. Furthermore, LDH and CPK were monitored before and after an exertion test on an exercise bicycle after hydropinic ingestion. The results obtained fully confirm the diuretic and cathartic properties of the water and its property of mobilization of hydroelectrolytic system which are even more useful in subjects needing a rapid elimination of metabolic wastes accumulated during muscle fatigue.

Adolescent↗
PubMed1979

Effect of molecular structure on bile acid-induced alterations in absorptive function, permeability, and morphology in the perfused rabbit colon.

An in vivo intestinal perfusion system was used to study the effects of different bile acids on fluid secretion, mucosal permeability, and mucosal morphology in the rabbit colon. To define the structure-activity relationships of the bile acids, nine unconjugated bile acids were used, varying only in the number (two or three) or position (3, 7, or 12 or various combinations) of hydroxy or keto nuclear substituents. Results showed that bile acids with two hydroxy groups in the alpha configuration at the 3,7 position, 3,12 position, or 7,12 position induced fluid secretion, increased mucosal permeability, and produced mucosal damage as assessed by light and scanning electron microscopy and quantitated by DNA loss during perfusion. Replacement of hydroxy groups by keto groups or a change from alpha to beta configuration for the hydroxylic substituent in the 7 position abolished all three activities. Trisubstituted derivatives, whether hydroxy or keto, did not affect fluid secretion permeability or cause mucosal damage. These studies indicate that of the major primary and secondary bile acids in man, only deoxycholic and chenodeoxycholic acids alter colonic structure and function in the rabbit. They show further that the cathartic effects of bile acids have specific structural requirements; and they show that bile acid-induced secretion was invariably associated with increased mucosal permeability and epitheliolysis.

Animals↗
PubMed1979

Three cases of Zigadenus (death camus) poisoning.

Three cases are reported where 1/2-2 bulbs of Zigadenus were ingested. This resulted in vomiting, cramping and nausea, starting within 1-2 hours and lasting 4-5 hours. Both the heart rate and blood pressure were affected, generally, but not consistently, decreased. Atropine, when used for the cardiovascular effects, increased the heart rate, but had minimal action on the blood pressure. There was little toxic effect on respiration, central nervous system, or temperature. The one case of increased temperature was though to be due to an unrelated illness. Treatment of such cases should include emesis (or lavage, if emesis is contraindicated), activated charcoal, and saline cathartic. Symptomatic cases need an iv and possible administration of atropine, a sympathometic and/or a ganglionic blocking agent. Since there is considerable variation in what symptoms will be seen with the different species of Zigadenus, each case must be treated symptomatically; first with good supportive care, then possibly with administration of the above agents.

Adolescent↗
PubMed1984

Acute oral poisoning with lindane-solvent mixtures.

Six cases of oral intoxication with lindane-solvent mixtures are reviewed. The ingested doses of lindane (mean dosage 120 mg/kg +/- 86 mg/kg) and benzene (mean dosage 366 mg/kg +/- 93 mg/kg) exceeded the toxic level. Symptoms (vomiting, dizziness and hyperreflexia) occurred within 30 min and all patients had epileptiform seizures. Two patients suffered from pulmonary edema and one of them had a severe rhabdomyolysis. Diazepam was sufficient to control convulsions in five cases. Gastric lavage was performed in five patients and activated charcoal, liquid paraffin with saline cathartic, and cholestyramine were used as adsorbents. Recovery was complete in all patients.

Administration, Oral↗
PubMed1983

Effect of colonic perfusion with sulfated and nonsulfated bile acids on mucosal structure and function in the rat.

A single-pass perfusion system was used in conscious restrained rats to measure changes in water and electrolyte transport and in protein and deoxyribonucleic acid output after perfusing 5-15-mM solutions of sulfated or nonsulfated bile acids through the colon. Perfusion with 5 mM nonsulfated deoxycholic acid or chenodeoxycholic acid changed net water and sodium absorption to net secretion, provoked marked increases in protein and DNA output into the perfusion effluent, and caused microscopic mucosal damage. In contrast, perfusion with 5 and 15 mM sulfated deoxycholic acid or with 5 mM sulfated chenodeoxycholic acid had no effect on water and electrolyte transport and caused only modest changes in protein and DNA output. To see whether or not sulfated bile acid could prevent the effect of its nonsulfated parent compound on colonic structure and function, perfusion with a mixture of 5 mM nonsulfated and 10 mM sulfated deoxycholic acid was performed. This produced net secretion of water and sodium together with less marked increases of protein and deoxyribonucleic acid output and less pronounced microscopic mucosal damage than was seen after 5 mM nonsulfated deoxycholic acid alone. Finally, 5 mM nonsulfated cholic acid had no effect on water or sodium transport, but 5 mM sulfated cholic acid, with one alpha-hydroxyl group masked and two alpha-hydroxyl groups "exposed," reduced water transport. These results suggest that sulfation prevents the cathartic effect of alpha-dihydroxyl bile acids in the colon.

Animals↗
PubMed1978

Fatal paraquat poisoning: tissue concentrations and implications for treatment.

A 27-year-old male died 30 1/2 hours following ingestion of paraquat. Hemodialysis removed 72 mg of paraquat, which represented only 2% of the calculated absorbed dose; paraquat concentrations were determined in post-mortem tissue and were high in the lungs and kidneys. Prominent histologic changes were already present in the lungs, which showed extensive evidence of alveolar injury, and in the adrenal gland, which showed massive selective necrosis of the zonae fasciculata and reticularis. These findings emphasize the inadequacy of treatment regimens that attempt only to remove paraquat from body tissues. Trials of treatments designed to prevent gastrointestinal absorption, including combinations of absorbents, cathartics and gut lavage, are warranted.

Adrenal Glands↗