Annals of internal medicine
-
Two patients developed severe vascular collapse after left ventriculography with organic iodides. Hemodynamic monitoring showed marked reduction in systemic pressures. In one patient there was no response to the standard therapeutic measures in anaphylactic reactions, and prompt response to fluid administration was obtained. In the second patient response was prompt to fluids, adrenalin, and hydrocortisone.
-
The relation of pulmonary function to aging and cigarette habits has been examined cross sectionally and longitudinally in the Framingham cohort. On cross-sectional analysis, women were found to have lower forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV-1) values than men even after adjusting for height. Their FEV-1 percent was, on the other hand, higher than those of men. ⋯ Longitudinally, cigarette smokers showed a more rapid decline in FVC in 10 years than nonsmokers. On giving up smoking their FVC became more like that of the nonsmokers. A striking relation of FVC to mortality was noted in both sexes, which is not accounted for by associated cigarette habits.
-
Findings in a case of neonatal tetany in a child whose mother had elevated blood parathyroid hormone levels because of a parathyroid adenoma are given. The child was found to have hypocalcemia, hypomagnesemia, and hyperphosphatemia. ⋯ It has been postulated that the pathophysiologic mechanism of the hypocalcemia in this syndrome is transient hypoparathyroidism. The present case suggests a different mechanism: hypomagnesemia and end-organ refractoriness to parathyroid hormone, a state analogous to pseudohypoparathyroidism.
-
Five smokers had erythrocyte masses sufficiently larger than normal to pose a problem in the differential diagnosis of polycythemia. Evaluation excluded lung disease, shunt physiology, hemoglobin with increased oxygen affinity, erythropoietin-producing tumor, renal disease, or polycythemia rubra vera as the primary cause of erythrocytosis in these patients. ⋯ In two patients the erythrocytosis improved when they stopped smoking. Heavy smoking is a reversible cause of polycythemia and should be considered in the differential diagnosis of this problem.