Bacteriological and Clinical Observations on the Blood of Cases suffering from Acute Continuous Mania

1903 ◽  
Vol 49 (205) ◽  
pp. 219-231 ◽  
Author(s):  
Lewis C. Bruce
Keyword(s):  
Blood Serum ◽  
Soft Tissues ◽  
Adult Woman ◽  
Necrotic Area ◽  
Acute Mania ◽  
Microscopical Examination ◽  
Nutrient Media ◽  
General Paralysis ◽  
The Third ◽  
Clinical Observations

Two years ago, when the toxic theory of the causation of insanity was attracting attention in this country, I made a series of observations on the blood of acute recent cases of insanity with the object of ascertaining whether organisms were ever present. In no case, with the exception of one of general paralysis, did I ever find an organism in the blood. It occurred to me, however, that if I could make an aseptic necrotic area subcutaneously, the serum and pus in such an area would be a suitable nidus for the growth of organisms circulating in the blood, and that by aspirating the serum and pus and placing it in suitable nutrient media one should be able to grow such organisms, if present. Acting upon this theory, I took a case of acute mania—an adult woman—and, with antiseptic precautions, injected into the soft tissues of the flank 2 c.c. of turpentine.(1) An abscess formed, and on the third day after the injection I aspirated some fluid, consisting of blood-serum and pus. A couple of drops of this fluid were then added to each of four tubes containing 8 c.c. of sterile nutrient broth. These tubes were incubated for forty-eight hours, when they showed slight turbidity, and upon microscopical examination the broth was found to contain a pure growth of a small diplo-bacillus.

Further Clinical Observations in Cases of Acute Mania, particularly Adolescent Mania

1903 ◽  
Vol 49 (206) ◽  
pp. 441-447 ◽  
Author(s):  
Lewis C. Bruce
Keyword(s):  
The Other ◽  
Acute Mania ◽  
Polymorphonuclear Leucocytes ◽  
The Third ◽  
Clinical Observations ◽  
Control Serum ◽  
The Individual

Following up my observations made upon the blood of patients suffering from acute continuous mania read before this Association at the autumn meeting, I have been able to observe three cases of acute continuous mania in adults which relapsed while in the asylum. The results of the first series of observations were that in every case of acute continuous mania there existed a leucocytosis which persisted after recovery indefinitely. I advanced the theory that this leucocytosis was a protective leucocytosis. In the three patients who relapsed the leucocytosis was found to have fallen to below 13,000 per c.mm. of blood, instead of being nearer 20,000 per c.mm. of blood, which is characteristic of the recovered cases of mania. The polymorphonuclear leucocytes averaged 60 per cent, in two of these patients, and 47 per cent, in the third. In one of these patients the attack passed off in two days, and the leucocytosis at once rose to 25,000 per c.mm. of blood. The other two patients passed into a definite second attack, and their leucocytes averaged 15,000 to 16,000 per c.mm. of blood, with a polymorphonuclear percentage of 60 or below 60. The fact that the leucocytosis fell in each patient at the commencement of the attack, and rose at once in the patient who recovered from the relapse, strengthens the hypothesis that acute continuous mania is an infective disorder, and that immunity from maniacal attacks rests upon the resistive power of the individual patient. This hypothesis receives further support from the fact that there exists in the blood of patients suffering from acute mania a specific agglutinin. During the month of November a patient suffering from acute mania was admitted to Murthly. The patient was so ill that I did not think she would live many days. I isolated from the blood a very small coccus, which was a pure growth, but, as the patient was exhausted, I regarded the organism as a terminal infection. The patient improved, however, and three weeks later I tested the agglutinative power of her serum upon this organism in a dilution of 1 in 30. Agglutination was complete in three hours, while the serum of a member of the staff in a dilution of 1 in 20 produced no action in twenty hours. Since then I have made fifty agglutination tests with this organism. Only ten of these cases, however, have been pure cases of continuous mania. Eight gave a decided definite agglutination, one was doubtful, and the tenth—one of the patients above noted, who relapsed—gave no reaction. No “control” serum ever gave a reaction, nor did the serum of these patients suffering from mania agglutinate other organisms. The agglutinin in the blood was therefore a specific agglutinin.

ELECTROLYTIC EXCHANGE FEATURES DURING MYOCARDIAL INFARCTION WITH RECURRENT EPISODES OF ISCHEMIA IN MEN UNDER 60 YEARS OLD

2021 ◽  
pp. 120-126
Author(s):  
Golikov A.V. ◽  
Epifanov S.Yu. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Blood Serum ◽  
Absolute Risk ◽  
Risk Groups ◽  
Unfavorable Outcome ◽  
Study Group ◽  
Type I ◽  
Sodium Potassium ◽  
The Third ◽  
Recurrent Myocardial Infarction

Relevance. Recurrent myocardial infarction and early postinfarction angina negatively effects on the prognosis of myocardial infarction. Aim. To evaluate myocardial infarction sodium, potassium, chlorides, calcium metabolism, features in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 110 patients; II - control, without it - 555 patients. A comparative analysis of blood serum electrolyte levels, their dynamics from the first hours to the end of the third week of myocardial infarction in the selected groups were performed. Their impact on the risk of recurrent ischemia and unfavorable outcome was assessed. Results. In the study group, in the first hours of the disease, the levels of chloride were higher (103.7±5.5 and 101.7±4.7 (mmol/l); p=0.002), and total calcium at the end of the third week of myocardial infarction (2.3±0.2 mmol/l) - lower than in the control (2.46±0.16; p=0.001). With an unfavorable outcome in the study group, the sodium level was lower in the first hours of the disease (138.7±4.9 and 142.7±6.6 (mmol/l); p=0.049). Moreover, the risk of its development was associated with sodium levels ≥148.0 mmol/l (absolute risk: 100.0%; relative - 13.8; p<0.0001) and potassium levels ≥5.3 mmol/l (absolute: 71,4%; relative - 12.4; p<0.0001). The risk of developing recurrent episodes of ischemia in the examined increased at chloride levels ≥104.7 mmol/l (absolute: 28.4%; relative: 3.1; p=0.0001) and sodium ≥139.0 mmol/l (absolute: 19.5%; relative: 1.7; p=0.03) in the first hours of myocardial infarction and calcium (<2.4 mmol/l) at the end of the third week of the disease (absolute: 31.0%; relative: 4.9; p=0.003). Conclusions. The listed combinations of levels of basic electrolytes in blood serum are markers of recurrence of ischemia in myocardial infarction and poor outcome. They should be used to identify risk groups with the necessary preventive measures and for predictive modeling.

scholarly journals PREDICTION OF VERTICAL IMPACTION OF LOWER WISDOM TOOTH ACCORDING ORTHOPANTOMOGRAPHY OF LOWER JAW

2021 ◽  
pp. 5-10
Author(s):  
A.M. Hohol ◽  
A.I. Pankevych ◽  
I.A. Kolisnyk ◽  
D.S. Machulenko ◽  
Ya.A. Hohol
Keyword(s):  
Vertical Position ◽  
Wisdom Tooth ◽  
Linear Measurements ◽  
The Third ◽  
Clinical Observations ◽  
Number Of Factors ◽  
Radiological Data ◽  
Tooth Impaction ◽  
Vertical Impaction ◽  
Search Data

Topic relevance. The dental surgeon often is left alone with the dilemma: to save or remove the third lower molars. The justification of indications for tooth extraction must have objective criteria. It should be noted that a patient with this problem does not always have the opportunity to receive comprehensive advice from an orthodontist. In view of this, the solution to this problem requires the search for radiological data, which are the most available today and would help to justify treatment tactics for preservation or removal of the tooth. The conditions of tooth preservation in the dentition are most favorable with a slight medio-distal inclination and a vertical position of the third lower molars. However, this does not exclude the possibility of tooth impaction, which is often accompanied by periodic inflammatory phenomena in the tissues adjacent to the tooth and motivates both the patient and the dental surgeon to solve this problem. The aim of our study was to research of radiographic indicators of orthopantomography of the mandible to predict the vertical retention of the third lower molars. Material and methods of research. The platforms of Google Scholar, Research Gate and PubMed are used for research and analysis of the scientific literature on the application of objective criteria of mandibular orthopantomography data in the prediction of vertical impaction of the third lower molars. Impaction of mandibular molars is the result of a number of factors, including heredity, racial characteristics, muscle function, the nature of the food consumed, insufficient growth of the mandible, the size of the retromolar space. The accurately determination the positions of the molars and the size of the retromolar space of the mandible by available methods of X-ray diagnosis (the most common of which is the method of orthopantomography of the jaws) are necessary to prediction of tooth retention. The accuracy of imaging and measurements on orthopantomograms of the jaws was studied by both domestic and foreign authors. The angle of inclination of lower wisdom tooth, the size of the retromolar space of the mandible and the mesiodistal size of the teeth are determined on OPTG of jaws in the vast majority of publications. The age aspect of patients is also important for prediction of tooth impaction. In particular, most researchers state the fact that up to 20 years of life there is a significant probability of changing the position of the teeth during their eruption and therefore it is quite appropriate to wait. To predict the nature of the impaction of the third lower molars, the authors provide indicators of the angle of the tooth, the structure of their roots, the degree of impact and age of the patient. The publication of Maria Mersedes Gallas-Torreira and co-authors, which compared two methods of linear measurements on OPTG – Olive-Basford’s and Olmos ’methods have greatest interest. Both methods can be used to predict of impaction of lower wisdom tooth. However, if the prognostic estimate is based on orthopantomogram data rather than cone-beam computed tomography, the Olmos` method demonstrates a lower error rate and a more plausible prediction. To substantiate the algorithm for predicting the vertical retention of third lower molar in order to improve treatment tactics for the preservation or removal of the tooth which based on the obtained search data and the results of our own clinical observations and it is planned in the future.

EFFECTS OF FRESH PLASMA OR WHOLE BLOOD TRANSFUSIONS ON PATIENTS WITH VARIOUS TYPES OF MUCOPOLYSACCHARIDOSIS

PEDIATRICS ◽  
1972 ◽  
Vol 50 (5) ◽  
pp. 688-692
Author(s):  
Anatole S. Dekaban ◽  
Kenton R. Holden ◽  
George Constantopoulos
Keyword(s):  
Molecular Weight ◽  
Weight Distribution ◽  
Whole Blood ◽  
Blood Transfusions ◽  
Molecular Weights ◽  
The Third ◽  
Clinical Observations ◽  
Before And After ◽  
Fresh Plasma

Repeated fresh plasma or whole blood transfusions were given to five patients with either Hurler, Hunter, or Sanfilippo types of mucopolysaccharidosis. Clinical observations and total 24-hour urinary AMPS and their composition and molecular weight distribution were determined before, during, and after transfusions. The two patients who received plasma transfusions showed no noticeable change in the amount of AMPS excreted; of the three patients who received whole blood transfusions, two had slightly less excretion of AMPS while the third showed no difference. The AMPS in the CSF were measured in one patient before and after blood transfusions and found to be unchanged; likewise, the determination of molecular weights in the isolated AMPS was virtually identical. In the patients studied, the transfusions caused no demonstrable difference in the patients' clinical condition.

Aphasia and Chorea in General Paralysis

1875 ◽  
Vol 21 (95) ◽  
pp. 421-424 ◽  
Author(s):  
T. S. Clouston
Keyword(s):  
Progressive Disease ◽  
General Paralysis ◽  
The Third ◽  
One Stage ◽  
Short Period

The general progressive disease in the structure of the nervous centres, and the steady deterioration of their functions, that constitute by far the chief part of general paralysis, are attended in their course in some cases by various nervous symptoms that closely imitate many of the neuroses of sensibility and motion; such as neuralgia, amaurosis, locomotor ataxy, glosso-pharyngeal paralysis, hemiplegia, apoplexy and epilepsy. Indeed, it is not uncommon for cases of the disease to be diagnosed as epilepsy and glosso-pharyngeal paralysis. I have lately had three cases of the disease under my care, in two of which the ordinary symptoms of aphasia were present for a short period in one stage of the disease, and in the third the symptoms of unilateral chorea were well marked.

On the use of Hyoscyamine

1881 ◽  
Vol 27 (118) ◽  
pp. 203-212
Author(s):  
G. M. B.
Keyword(s):  
Small Dose ◽  
Toxic Effects ◽  
Acute Mania ◽  
Curative Effect ◽  
General Paralysis ◽  
The Face ◽  
Positive Results

I venture to offer my experience of the use of the above drug for the purpose of comparison with that of other observers. I am anxious not to appear as an advocate of this or any other medicine, having a rather limited faith in the efficacy of drugs in the treatment of disease. It is so difficult to be sure that the results observed are fairly due to the ascribed cause that it is but seldom that any drug can be credited with a direct curative effect. The effects of most medicines are so uncertain and indefinite that it is well-nigh impossible to attribute any positive results to their administration in the face of so many disturbing causes. In dealing with potent drugs the case is different. When the toxic effects of an agent are produced it only remains to ascertain whether these are beneficial or not. For this reason it is easier to pass a judgment on the value of such a drug as hyoscyamine than of morphia or chloral, &amp;c., because its affect is obvious and ascertainable. I will not now discuss whether it is good to give a sedative or not, but only relate my experiences. The preparation I have used has always been “Merck's extractive alkaloid,” dissolved in spirit, for convenience, of the strength of one grain to a drachm of spirit. I have never given more than 1¼ grain, and I usually give either one or two-thirds of a grain as a dose. If one-third does not bring sleep, I double the dose. The usual effect is to send the patient into a heavy sleep in half-an-hour, or even less time, and this may last for six hours, or even more. I have very seldom found it produce sickness, and not, as a rule, interfere with the appetite. I fancy, from what one or two patients have said, that it produces a sensation of fulness and throbbing and headache, and I have seen the face congested and the prolabium purplish. The pupils are widely dilated. I have used this preparation for two years past, and have found it very useful in many cases. I have given it in cases of acute mania, of general paralysis, of chronic excitement, and may safely say it has been of greater use than any other narcotic I have employed. In acute cases, where it is difficult to get medicine down at all, it is a point to be able to give one small dose of fluid and be sure of quieting a patient for several hours. This cannot be ensured by chloral or opium, as the consequences of a dose of Batley, &amp;c., &amp;c., can never be reckoned on, and sickness leaves the prescriber in ignorance of how much has been absorbed by the system.

Insanity is Decreasing: a Statistical Item Suggesting that

1896 ◽  
Vol 42 (176) ◽  
pp. 80-85
Author(s):  
T. A. Chapman
Keyword(s):  
Geographical Distribution ◽  
The Other ◽  
Annual Production ◽  
Acute Mania ◽  
Natural Order ◽  
General Paralysis ◽  
Definite Form ◽  
Degenerative Disorders ◽  
Urban Character ◽  
The One

It has always appeared to me that the various figures that are supposed to indicate an increase of insanity are not only inconclusive, but do not really show anything of the sort, and that there are even some vague and indefinite indications that there is really a decrease in the annual production of insanity. Some years ago I tried to find some figures amongst the various statistics we possess that would throw some light on this point, but practically without success. It seemed that such increase in the annual admissions to asylums as was beyond that due to increase of population was more than accounted for by slighter (i.e., less demonstrative) cases of acute insanity and various forms of chronic, senile, and degenerative disorders being yearly sent to asylums more freely, but I could get no figures proving this. A somewhat suggestive fact in this direction is the often-made remark that acute mania is less abundant, melancholia more so than formerly; acute mania of an active (i.e., demonstrative) type was always sent to asylums pretty well up to its actual amount. Melancholia used to be very largely left at home or treated in workhouses. But where shall we find such facts embodied in figures. Acute mania of our statistics includes the milder as well as the more demonstrative cases, and so shows an increase just as the total figures do. There are, then, so far as I know, no figures showing the real annual occurrence of insanity that are comparable year by year. There are, indeed, no figures that give the actual annual production of insanity apart from chronic and recurrent cases. There are no figures of any definite form and intensity of acute insanity. True the Commissioners' Reports give us statistics of general paralysis, but this is precisely the one form of acute insanity that is not an insanity; that is, it belongs to a different natural order of diseases from the other diseases we mean by insanity. I have elsewhere stated that this always appears clearly on a comparison of the statistics of general paralysis with those of insanity proper, and the same opinion has been expressed by authorities who have approached the matter from a pathological and therapeutical standpoint. Its remarkable geographical distribution and its specially urban character equally show it to be different from the other insanities, which have no similar features. That this disease is increasing owing to the more and more urban character of our population affords no ground for assuming a similar progress in the true insanities. The annual recoveries must, however, be largely dependent on, and proportional to, the annually occurring cases, but will, of course, so regarded, be vitiated by the increase of population and by the increased admissions of milder forms of insanity and by the recoveries of recurrent cases.

Amikacin (BBK8) in Infections Due to Gram-Negative Organisms in Children over the Age of One Month

1976 ◽  
Vol 4 (1) ◽  
pp. 1-14 ◽  
Author(s):  
J I Ramirez ◽  
H Trujillo ◽  
A Uribe ◽  
Nancy H Agudelo ◽  
Esther Luisa de Vidal
Keyword(s):  
Plasma Levels ◽  
Soft Tissues ◽  
Chronic Otitis Media ◽  
Petri Dish ◽  
Gram Negative ◽  
E Coli ◽  
The Third ◽  
Infected Wounds ◽  
Gram Negative Organisms ◽  
Toxic Reactions

Thirty children over the age of one month were treated with amikacin ( BBK8), a new aminoglycoside derived from kanamycin A, with three intramuscular dosage schedules. Each group consisted of ten patients. The first received 7.5 mg/kg/12 hours, the second 7.5 mg/kg/24 hours and the third, 3.75 mg/kg/12 hours. The infections and the bacteria were similar in all three groups: pyelonephritis, abscesses of soft tissues, infected wounds, septicaemia, superinfected empyema, gastro-enteritis, chronic otitis media; the bacteria were E. coli, Klebsiella, Pseudomonas and Salmonella. A were sensitive by the Kirby-Bauer method, although two were resistant by dilution in Petri dish. Of the thirty patients, twenty four (80%) were cured. The schedule of 3.75 mg/kg/12 hours was as effective as the schedule of7.5 mg/kg/12 hours for infections such as pyelonephritis, superficial abcesses, contaminated wounds, gastro-enteritis and sepsis. The cases with infections localized in rather unaccessible sites required double the dose and strict drainage and cleanliness. Plasma levels with the administration of 3.75 mg/kg fluctuated between 8.3 and 12.6 mcg/ml; with 7.5 mg/kg they fluctuated between 8.6 and 13.1. The minimum inhibitory level ( MIL) for the majority of the bacteria was 1.25 mcg/ml. No toxic reactions were observed.

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