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Fletcher GC, Hay BE, Scott MF. Detoxifying Pacific oysters Crassostrea gigas ; of t he neurotoxic shellfish poisoning NSP ; produced by G. breve. J Shellfish Research 1998; 17 5 ; : 1637-1641. Forrester DJ, Gaskin JM, White FH, Thompson NO, Quick JA, Henderson GE, Woodard JC, Robertson WD. An epizootic of waterfowl associated with a red tide episode in Florida. Journal of Wildlife Diseases, 1977; 13: 160-167. Franz DR, LeClaire RD. Respiratory effects of brevetoxin and saxitoxin in awake guinea pigs. Toxicon 1989; 27: 647-654. Gallagher P, Shinnick-Gallagher P. Effect of G. breve toxin in the rat phrenic nerve diaphragm preparation. British Journal of Pharmacology 1980; 69: 367-372. Garthwaite I, Ross KM, Poli M, Towers NR. Comparison of immunoassay, cellular, and classical mouse bioassay methods for detection of neurotoxic shellfish toxins. In: ACS Symposium Series 621: Immunoassays for Residue Analysis: Food Safety. Beier RC, Stanker LH eds. Washington DC: American Chemical Society, 1996: 404-412. Geraci JR. Clinical investigations of the 1987-88 mass mortality of bottlenose dolphins along the US central and south Atlantic coast. In: Final Report to the National Marine Fisheries Service, US Navy College of Naval Research and Marine Mammal Commission. Guelph, Ontario: Ontario Veterinary College, University of Guelph, 1989: 1-63. Halstead BW. Poisonous and Venomous Marine Animals of the World. Princeton: Darwin Press, 1988. Hannah DJ, Trill DG, Truman P. Phycotoxins - A review of chemical and biological methods of analysis. Proceedings NZMAF Marine Biotoxin Workshop No. 5. Wellington, NZ: New Zealand MAF Regulation Authority, 1996. Hopkins RS, Heber S, Hammond R. Water related disease in Florida: continuing threats require vigilance. J Florida Med Ass 1997; 84: 441-445. Horstman DA, McGibbon S, Pitcher GC, Calder D, Hutchings L, Williams P. Red tides in False Bay 1959-1989 ; with particular reference to recent blooms of Gymnodinium spp. Trans Roy Soc S Afr 1991; 47 4& ; : 611-628. Hua Y, Lu W, Henry MS, Pierce RH, Cole RB. Online high performance liquid chromatographyelectrospray ionization mass spectrometry for the determination of brevetoxins in "red tide" algae. Anal Chem 1995; 67: 1815-1823. Hughes JM, Merson MH. Fish and shellfish poisoning. N Engl J Med 1976; 295: 1117-1120. ICRP, 1994. Human Respiratory Tract Model for Radiological Protection. Publication 66, Annals of ICRP, 24. Music, S.I., Howell, J.T., Brumback, C.L., 1973. Red tide its public health implications. J. Florida Med. Assoc.: 60, 27-39, for example, zestril 10mg. Possible effects on blood pressure As we age there is a loss of arterial elasticity, which is a cause of high blood pressure. Another major cause of hypertension is an enzyme secreted by the kidneys called angiotension-converting enzyme ACE ; . Angiotension-converting enzyme ACE ; has been classically associated with the renin-angiotension system, which regulates peripheral blood pressure. People with high blood pressure are often prescribed drugs such as Zestril, Capoten and Vasotec, referred to as "angiotension-converting enzyme inhibitors" or ACE inhibitors for short. By blocking the effects of ACE, blood pressure can be brought under control in the majority of people with hypertension. Whey peptides, known as Lactokinins, were recently shown to be mild ACE inhibitors in vitro.3 While they do not have the inhibitory potency of the drugs mentioned above used in the treatment of hypertension, the researchers concluded, ".these naturally occurring peptides may represent nutraceutical functional food ingredients for the prevention treatment of high blood pressure." Clearly more research is needed, but if confirmed by future research, this could be yet another use for whey proteins. Effects on hepatitis Considering the importance of glutathione GSH ; for liver function and the resulting oxidative stress that accompanies hepatitis, researchers looked to see what affect high quality whey would have on laboratory indices of viral hepatitis and liver function. In an open clinical study researchers looked at the efficacy of whey protein vs. casein fed to 25 patients suffering from either hepatitis B or C. Twelve grams of either whey or casein as food was given twice a day, in the morning and evening, for 12 weeks. The researchers looked at.
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What else would you like to know? Mr. Smith's Medical History: Past medical history: Previous Inferior Wall MI two years ago, Percutaneous Transluminal Coronary Angioplasty PTCA ; to the right coronary artery two years ago, hypertension, congestive heart failure, and Non Insulin Dependent Diabetes Mellitus. Past surgical history: Right total hip replacement four years ago Current medications: Aspirin 325 mg po Daily KCL 20 mEq po Daily Atenolol 25 mg po BID Admission Labs: WBC 6.7 Mg + 1.6 Creat 1.0 Hgb 10.8 Ca + 7.9 Digoxin 0.125mg po Daily Zesril 5 mg po Daily Glucophage 500 mg po BID Lasix 40 mg po Daily Extra Strength Tylenol 1000mg po q4-6 hrs PRN for pain.
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Chemia or hemorrhage, persons with unilateral stroke typically do not present with loss of consciousness because 1 hemisphere is sufficient to retain consciousness. Vertebrobasilar strokes affecting the brainstem may result in unconsciousness but should reveal features of brainstem dysfunction eg, pupil or ocular motor abnormalities, extremity weakness ; on neurologic examination. Head trauma or concussion after a fall did not likely cause our patient's seizure because there was neither a history nor signs of head trauma on initial examination. Appropriate efforts to exclude syncope, seizure, and other causes of transient loss of consciousness should be the primary objective. The patient's confusion normalized over the next half hour in the emergency department, and she had no subsequent seizures. The complete blood cell count, electrolytes, and serum glucose level were within normal limits. Chest radiography and 12-lead electrocardiography were normal. Computed tomography CT ; of the head without contrast enhancement showed normal brain parenchyma and no evidence of mass, hemorrhage, or stroke. The patient was given nasal cannula oxygen and was observed in the emergency department. 2. Which one of the following is the most likely factor contributing to the patient's seizure? a. Metabolic abnormality b. Fever c. Meningitis d. Pseudoseizure e. Medication overdose or withdrawal Seizure can result from hypoglycemia, hyperglycemia especially nonketotic hyperglycemia ; , hyponatremia, hypophosphatemia, hypocalcemia, or the effects of severe renal or hepatic dysfunction. Our patient had no major metabolic or electrolyte abnormalities to account for the seizure. Although fever may precipitate seizure in infants and young children, the concept of a benign fever-induced seizure does not apply to adults. Fever and seizure in any adult suggest an underlying metabolic or infectious etiology, a brain abnormality, or a preexisting seizure disorder. Bacterial meningitis should be considered in any patient with fever. Although our patient had a fever and experienced a seizure, she had no meningeal signs of headache and neck stiffness and improved rapidly in the emergency department, facts that do not support a diagnosis of bacterial meningitis. Headache and low-grade fever may be seen after a generalized seizure but resolve in time. Pseudoseizures also known as nonepileptic psychogenic seizures ; are behavioral manifestations that may resemble epileptic seizures. A psychogenic seizure can involve unusual motor activity such as pelvic thrusting and can con668 Mayo Clin Proc. Welchol: colesevelam hydrochloride tablet. Formerly CholestaGel. Wellen's syndrome: critical stenosis of the left anterior descending coronary artery. Often includes biphasic T-waves in V2 and V3, or deeply inverted symmetrical T-waves in V2 and V3. Wenckebach block: Mobitz type I second-degree AV block. widowmaker: medical slang for stenosis of the proximal LAD. Wiggers diagram: graphic representation of events in the cardiac cycle. Wiseguide guide catheter. Mfr: Boston Scientific. Witner coronary artery stent. WorldHeart rotary ventricular assist device: used in Europe and in clinical trials in the U.S. as of March 2006. wringer wrap: see latissimus dorsi procedure. Wytensin: guanabenz acetate. Xact carotid stent system. Mfr: Abbott Vascular Devices. Xcelerant delivery system for AneuRx AAA stent graft system. Mfr: Medtronic. X-Sizer catheter system: for thrombus removal in native coronary arteries and saphenous vein grafts. Mfr: ev3, Inc. Yentl's syndrome: the fact that women's coronary complaints have been treated less than aggressively by the medical establishment. Yumiko-Lita catheter. Used in angiography of the left internal thoracic artery from a right arm approach. Z2 coronary guide catheter. Zaroxolyn: metolazone tablet, thiazide diuretic. Zebeta: disoprolol fumarate tablet. Zestoretic: hydrochlorothiazide, lisinopril, ACE inhibitor diuretic. Zestril: lisinopril, ACE inhibitor.
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