Abstracts
Body Composition (1)
Body Composition (1)
Multiple organ failure is the final common path of numerous medical conditions whereby the various organ systems fail and are supported by pharmacologic or mechanical means. The patient appears septic but often no septic focus can be found. Whole body protein dynamics are similar to severe sepsis with an elevation of both synthesis and breakdown.
Lean body mass is not maintained even in the presence of an apparently adequate energy intake. The more common methods of assessing body composition are all confounded by fluid retention, which also limits parenteral nutrient intake. There are also difficulties with the tolerance of enteral feeding.
In the long term, pharmacologic methods are going to be required if it is deemed that the maintenance of body mass is desirable, but in the interim, a robust noninvasive method is required of monitoring body mass in the presence of severe edema.
Campbell IT: Can body composition in multiple organ failure be favorably influenced by feeding? Nutrition, 1997 Sep, 13:9 Suppl, 79S-83S.
Body Composition (2) Impedance
Body Composition (2) Impedance
To prove that the bias of total body water (TBW) prediction equations based on the impedance index is far greater in fluid overloading than in dehydration.
Due to the hyperbolic shape, functions of the impedance index are critically dependent on the region of the RXc plane where they are calculated and they produce misleading results in patients with fluid overload.
Piccoli A et al., Asymmetry of the total body water prediction bias using the impedance index [see comments]. Nutrition, 1997 May, 13:5, 438-41.
Capsaicin
Capsaicin
We examined the effect of glycyrrhetinic acid (Ia) and its derivatives on ear edema induced by topical application of capsaicin in mice.
The effect of these compounds on capsaicin-induced ear edema is due at least in part to an inhibition of the increase of vascular permeability induced by vasoactive agents released from mast cells.
It seems likely that these compounds (at a high dose) can suppress vasodilatation and plasma extravasation induced by SP involved in capsaicin-induced edema.
Inoue H et al., Inhibitory effect of glycyrrhetinic acid derivatives on capsaicin-induced ear edema in mice. Jpn J Pharmacol, 71:281-9, 1996 Aug.
Childhood (Edema)
Childhood
There are two types of edema: localized edema and generalized edema. The causes of generalized edema in childhood are diverse.
Formation of generalized edema involves retention of sodium and water in the kidney. The treatment of generalized edema depends on the primary etiology. Supportive nutritional and medical therapies are needed to prevent further edema.
Hisano S et al., Edema in childhood. Kidney Int Suppl, 59:S100-4, 1997 Jun.
Cervical Fractures
Cervical Fractures
To determine the sensitivity and specificity of soft tissue measurements in patients with radiographically proven cervical spine fractures. A C2 prevertebral soft tissue measurement of more than 6 mm had a sensitivity of 59% and a specificity of 84% for fractures at C1-C4. A C6 prevertebral soft tissue measurement of more than 22 mm had a sensitivity of 5% and a specificity of 95% for fractures at C4-C7. We conclude that using prevertebral soft tissue measurements as a marker of cervical spine injury fails to identify a large proportion of patients with cervical spine fractures.
Utility of prevertebral soft tissue measurements in identifying patients with cervical spine fractures. DeBehnke, D.J. & Havel, C.J. Ann. Emerg. Med. 1994 Dec;24(6):1119-24.
Disk Edema
Disk Edema
A 55 year old woman presented with an 8 year history of progressive gait dysfunction and a 2-3 week history of horizontal "diplopia". Examination of the patient revealed acute papilledema, intermittent esotropia, and upper and lower motor neuron findings in her lower extremities. A "spinal cord" "tumor" extending from T11 to L3 was visualized by MRI. All symptoms (except for a left foot drop) resolved with aggressive removal of the tumor.
Disk edema and peripheral neuropathy [clinical conference]. Breen, L.A. Surv. Ophthalmol. 1994 Mar-Apr; 38(5):467-74.
Macular Edema [Diabetes] (1)
Macular Edema [Diabetes] (1)
Examined the incidence of and risk factors for clinically significant macular edema in persons with type I diabetes.
Cumulative risk of clinically significant macular edema was 0 until 7 years' duration of diabetes. The cumulative risk of clinically significant macular edema increased linearly for each year of duration between 10 and 20 years, with an average annual increase of approximately 7%.
Significant risk factors for clinically significant macular edema were older age at diagnosis, male sex, and higher Hgb A1c level. Systolic and diastolic blood pressure, proteinuria, body mass index, race, initial presence of retinopathy, and use of antihypertensives did not significantly affect the risk of clinically significant macular edema.
Older age at diagnosis of diabetes, male sex, and higher Hgb A1c levels (poorer control of blood glycemic levels) significantly increase the risk of clinically significant macular edema in persons with type I diabetes.
Data extend the evidence implicating worse glycemic control as a cause of clinically significant macular edema, even within a population with relatively loose control.
Vitale S et al., Clinically significant macular edema in type I diabetes. Incidence and risk factors. Ophthalmology, 102:1170-6, 1995 Aug.
Macular Edema [Diabetes] (2)
Macular Edema [Diabetes] (2)
Evaluate the effect of ten variables on the short-term natural history of macular edema 6 months after diagnosis: age; gender; diabetes duration at diagnosis of macular edema; hemoglobin A1; insulin use; presence of proteinuria; presence of systemic hypertension, cardiac disorders, or both; degree of diabetic retinopathy; history of panretinal photocoagulation; and vitreomacular relationships, as determined by present lens biomicroscopy.
Macular edema spontaneously resolved in 27 (33%) eyes 6 months after diagnosis. Of the 22 eyes with vitreomacular separation at study entry, 12 (55%) had spontaneous resolution of macular edema after 6 months, whereas only 15 of 60 (25%) of the eyes with vitreomacular adhesion at study entry had spontaneous resolution.
Findings suggest that vitreomacular separation may promote the spontaneous resolution of diabetic macular edema and consequently improve visual acuity.
Hikichi T et al., Association between the short-term natural history of diabetic macular
edema and the vitreomacular relationship in type II diabetes mellitus. Ophthalmology, 104:473-8, 1997 Mar.
Marrow Edema
Marrow Edema
Determined if runners have an increased prevalence of marrow edema in the foot and ankle compared with nonrunners at magnetic resonance (MR) imaging.
Reader 1 found edema in 16 of 20 runners and four of 12 nonrunners; runners had a mean score of 4.7 and nonrunners had a mean score of 0.9. The average number of bones with edema was 3.4 for runners and 0.7 for nonrunners.
Reader 2 found edema in 16 of 20 runners and two of 12 nonrunners; runners had a mean score of 4.5 and nonrunners had a mean score of 0.3. The average number of bones with edema was 3.6 for runners and 0.3 for nonrunners.
When the fast short inversion time inversion-recovery sequence is performed, edema seen within the marrow of runners on MR images may be due to exercise alone.
Lazzarini KM et al., Can running cause the appearance of marrow edema on MR images of the foot and ankle? Radiology, 202:540-2, 1997 Feb.
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