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Cureus Dec 2019Postviral gastroparesis can result from a variety of viral infections and may cause severe, persistent gastrointestinal symptoms. We report the case of an 85-year-old...
Postviral gastroparesis can result from a variety of viral infections and may cause severe, persistent gastrointestinal symptoms. We report the case of an 85-year-old man with one year of persistent nausea, epigastric pain, early satiety, and 25-pound weight loss after an episode of viral gastroenteritis contracted on a cruise ship. The patient reported that he had tested positive for norovirus shortly after the onset of symptoms. Esophagogastroduodenoscopy revealed no abnormalities, and his symptoms persisted despite treatment for a positive serum H. pylori IgG antibody. Lab workup, including hemoglobin A1c, was otherwise normal, and computed tomography (CT) angiography was unremarkable. A gastric emptying study performed one year after the onset of illness revealed moderate gastroparesis. While most cases of postviral gastroparesis resolve within a year or less, there are a few reports of gastroparetic symptoms lasting two to three years or longer. The pathophysiology might involve a slowly reversible injury to gut neuromodulator cells. Antiviral treatment has not been shown to be effective; symptomatic treatment with antiemetic and prokinetic drugs may be helpful in some cases.
PubMed: 31911875
DOI: 10.7759/cureus.6283 -
Advances in Physiology Education Sep 2021Exercise is thought to be an effective means to quick weight loss. However, few people have realistic exercise-induced weight loss expectations. Fewer understand how...
Exercise is thought to be an effective means to quick weight loss. However, few people have realistic exercise-induced weight loss expectations. Fewer understand how weight is "lost" and where the lost mass goes. Understanding that fat is "burned" with inhaled oxygen and most of the mass lost must be exhaled as carbon dioxide might help individuals create realistic weight loss expectations. The purpose of this laboratory activity is to ) provide students with a basic understanding of the role of oxygen in fuel metabolism during physical activity and its relationship to energy expenditure and mechanical work, and ) engage students with collection of their own data to determine a realistic timeframe for exercise-induced weight loss. In the prelaboratory, questions such as, "When you lose weight, where does it go?" are asked. A guided discussion helps students understand the basic biochemistry required for weight loss. For the activity, students complete walking or running exercise, recording the time and distance. The relationship of exercise to physics' concepts of mechanical work and energy utilization are discussed with the concept of "calorie burn" and its relationship to oxygen consumption. Students estimate oxygen consumed and calories burned during exercise using established metabolic equations. Finally, the amount of energy (i.e., calories) equivalent to 1 pound of fat is discussed. Students calculate how long he/she would have to exercise to burn 10 pounds (4.5 kg) of fat. A person of average size and fitness, needs 60+ h of exercise to burn 10 pounds of fat. Supplementary activities including a dramatic gummy bear oxidation and the use of a metabolic cart reinforces these concepts and validates the laboratory estimates.
Topics: Energy Metabolism; Female; Humans; Laboratories; Male; Obesity; Oxygen Consumption; Weight Loss
PubMed: 34379483
DOI: 10.1152/advan.00006.2021 -
Survey of Ophthalmology 2023A 23-year-old previously healthy woman presented with headache, generalized seizures, ataxia, encephalopathy, abdominal pain, nausea, and vomiting culminating in a...
A 23-year-old previously healthy woman presented with headache, generalized seizures, ataxia, encephalopathy, abdominal pain, nausea, and vomiting culminating in a 40-pound weight loss. A contrasted magnetic resonance imaging scan of the brain showed T2/FLAIR hyperintensities in the sulci of the occipital and parietal lobes, a punctate focus of restricted diffusion along the inferior aspect of the left caudate head and an empty sella. A lumbar puncture showed an opening pressure of 55 cm H2O, and kidney, ureter, and bladder X ray showed a radiopaque particle in the colon. Serum lead level was 85 mcg/dL (<3.5). Blood smear showed foreign bodies identified as lead particles in the blood with basophilic stippling of RBCs. She was treated with chelation therapy and bowel irrigation and eventually recovered. Further investigation indicated that she was being slowly poisoned by her husband, a chiropractor who had access to lead.
Topics: Female; Humans; Young Adult; Adult; Lead; Magnetic Resonance Imaging; Brain; Brain Diseases
PubMed: 37211095
DOI: 10.1016/j.survophthal.2023.05.005 -
IUCrData Aug 2023In the title com-pound (systematic name: 2,3-di-hydro-1,4-dithiino[2,3-]furan-5,7-dione), CHOS, the observed geometry agrees well with those of its phthalamide, thieno...
In the title com-pound (systematic name: 2,3-di-hydro-1,4-dithiino[2,3-]furan-5,7-dione), CHOS, the observed geometry agrees well with those of its phthalamide, thieno and hy-droxy analogs, and with a calculated geometry obtained by density functional theory (DFT) calculations. Specific structural features are an S-C-C-S torsion angle of -70.39 (17)° and S-C bonds to -hybridized C atoms approximately 0.1 Å shorter than those to -hybridized C atoms. Unlike the extended structures of the analogs, there are no directed inter-molecular inter-actions and the head-to-tail rows of mol-ecules that are a prominent structural motif of the packing can be rationalized in terms of optimized dipole-dipole inter-actions.
PubMed: 37693786
DOI: 10.1107/S2414314623006478 -
Metabolites Jan 2023This paper contains a revision of the Harris-Benedict equations through the development and validation of new equations for the estimation of resting metabolic rate...
This paper contains a revision of the Harris-Benedict equations through the development and validation of new equations for the estimation of resting metabolic rate (RMR) in normal, overweight, and obese adult subjects, taking into account the same anthropometric parameters. A total of 722 adult Caucasian subjects were enrolled in this analysis. After taking a detailed medical history, the study enrolled non-hospitalized subjects with medically and nutritionally controlled diseases such as diabetes mellitus, cardiovascular disease, and thyroid disease, excluding subjects with active infections and pregnant or lactating women. Measurement of somatometric characteristics and indirect calorimetry were performed. The values obtained from RMR measurement were compared with the values of the new equations and the Harris-Benedict, Mifflin-St Jeor, FAO/WHO/UNU, and Owen equations. New predictive RMR equations were developed using age, body weight, height, and sex parameters. RMR males: (9.65 × weight in kg) + (573 × height in m) - (5.08 × age in years) + 260; RMR females: (7.38 × weight in kg) + (607 × height in m) - (2.31 × age in years) + 43; RMR males: (4.38 × weight in pounds) + (14.55 × height in inches) - (5.08 × age in years) + 260; RMR females: (3.35 × weight in pounds) + (15.42 × height in inches) - (2.31 × age in years) + 43. The accuracy of the new equations was tested in the test group in both groups, in accordance with the resting metabolic rate measurements. The new equations showed more accurate results than the other equations, with the equation for men (R-squared: 0.95) showing better prediction than the equation for women (R-squared: 0.86). The new equations showed good accuracy at both group and individual levels, and better reliability compared to other equations using the same anthropometric variables as predictors of RMR. The new equations were created under modern obesogenic conditions, and do not exclude individuals with regulated (dietary or pharmacological) Westernized diseases (e.g., cardiovascular disease, diabetes, and thyroid disease).
PubMed: 36837808
DOI: 10.3390/metabo13020189 -
Mitochondrion Mar 2020This paper is written for non-specialists in mitochondrial biology to provide access to an important area of science that has broad implications for all people. The cell... (Review)
Review
This paper is written for non-specialists in mitochondrial biology to provide access to an important area of science that has broad implications for all people. The cell danger response (CDR) is a universal response to environmental threat or injury. Once triggered, healing cannot be completed until the choreographed stages of the CDR are returned to an updated state of readiness. Although the CDR is a cellular response, it has the power to change human thought and behavior, child development, physical fitness and resilience, fertility, and the susceptibility of entire populations to disease. Mitochondria regulate the CDR by monitoring and responding to the physical, chemical, and microbial conditions within and around the cell. In this way, mitochondria connect cellular health to environmental health. Over 7,000 chemicals are now made or imported to the US for industrial, agricultural, and personal care use in amounts ranging from 25,000 to over 1 million pounds each year, and plastic waste now exceeds 83 billion pounds/year. This chemical load creates a rising tide of manmade pollutants in the oceans, air, water, and food chain. Fewer than 5% of these chemicals have been tested for developmental toxicity. In the 1980s, 5-10% of children lived with a chronic illness. As of 2018, 40% of children, 50% of teens, 60% of adults under age 65, and 90% of adults over 65 live with a chronic illness. Several studies now report the presence of dozens to hundreds of manmade chemicals and pollutants in placenta, umbilical cord blood, and newborn blood spots. New methods in metabolomics and exposomics allow scientists to measure thousands of chemicals in blood, air, water, soil, and the food chain. Systematic measurements of environmental chemicals can now be correlated with annual and regional patterns of childhood illness. These data can be used to prepare a prioritized list of molecules for congressional action, ranked according to their impact on human health.
Topics: Cell Biology; Chronic Disease; Environmental Exposure; Environmental Health; Environmental Pollutants; Humans; Metabolomics; Mitochondria
PubMed: 31877376
DOI: 10.1016/j.mito.2019.12.005 -
Diseases of the Colon and Rectum Dec 2023A 61-year-old man presented with penetrating Crohn's ileocolitis and neoterminal ileal fibrostenotic stricture. He developed an anastomotic leak after a redo ileocolic...
A 61-year-old man presented with penetrating Crohn's ileocolitis and neoterminal ileal fibrostenotic stricture. He developed an anastomotic leak after a redo ileocolic resection and now has a chronic low-output enterocutaneous fistula. He was transferred from an outside institution for further management and is currently without Crohn's disease (CD)-related medical therapy. The fistula output is 25 to 50 mL/day of GI contents. His weight dropped by 25 pounds in 6 months after surgery with a current BMI of 19.1, albumin of 2.0 g/dL, and hemoglobin of 9.7 g/dL. During a 3-month period, he was optimized for surgery with local wound care, initiation of infliximab, and nutritional support with exclusive enteral nutrition (EEN). He gained 9 pounds (BMI 20.4). Albumin improved to 3.4 g/dL and hemoglobin to 12.1 g/dL. He underwent a successful open takedown of the enterocutaneous fistula with ileocolic anastomosis.
Topics: Male; Humans; Middle Aged; Crohn Disease; Intestinal Obstruction; Intestinal Fistula; Albumins; Malnutrition; Hemoglobins
PubMed: 37682807
DOI: 10.1097/DCR.0000000000003070 -
British Journal of Anaesthesia Aug 2023The timely correction of anaemia before major surgery is important for optimising perioperative patient outcomes. However, multiple barriers have precluded the global...
The timely correction of anaemia before major surgery is important for optimising perioperative patient outcomes. However, multiple barriers have precluded the global expansion of preoperative anaemia treatment programmes, including misconceptions about the true cost/benefit ratio for patient care and health system economics. Institutional investment and buy-in from stakeholders could lead to significant cost savings through avoided complications of anaemia and red blood cell transfusions, and through containment of direct and variable costs of blood bank laboratories. In some health systems, billing for iron infusions could generate revenue and promote growth of treatment programmes. The aim of this work is to galvanise integrated health systems worldwide to diagnose and treat anaemia before major surgery.
Topics: Humans; Anemia; Iron; Erythrocyte Transfusion; Costs and Cost Analysis; Preoperative Care
PubMed: 37244835
DOI: 10.1016/j.bja.2023.04.038