Oedeme pulmonaire chez un jeune homme sportif [Acute pulmonary oedema in a young sportive man]

This article reports the case of a 31 years old man who suffered from an acute pulmonary oedema after laryngospasma following extubation. This pathology, better known by anesthesiologists than internists, results primarly from a rapid rise in negative intrapleural pressure. It is not associated with previous cardio-pulmonary illness and has a begnin course with resolution within 48 hours with oxygen and positive end expiratory pressure support.

Kann man auf die ostseefinnisch-permische Gleichsetzung fi. joukko wotj. l'uk, juk syrj. juk verzichten?

Abstract

Physical and chemical attributes of archaeological soils developed from shell middens in the Região dos Lagos, Rio de Janeiro, Brazil

In prehistoric times, innumerous shell middens, called "sambaquis", consisting mainly of remains of marine organisms, were built along the Brazilian coast. Although the scientific community took interest in these anthropic formations, especially since the nineteenth century, their pedological context is still poorly understood. The purpose of this study was to characterize and identify the physical and chemical changes induced by soil-forming processes, as well as to compare the morphology of shell midden soils with other, already described, anthropogenic soils of Brazil. Four soil profiles developed from shell middens in the Região dos Lagos - RJ were morphologically described and the physical and chemical properties determined. The chemical analysis showed that Ca, Mn, Mg, and particularly P and Zn are indicators of anthropic horizons of midden soils, as in the Amazon Dark Earths (Terras Pretas de Índio). After the deposition of P-rich material, P reaction and leaching can mask or disturb the evidence of in situ man-made strata, but mineralogical and chemical studies of phosphate forms can elucidate the apparent complexity. Lower phosphate-rich strata without direct anthropic inputs indicate P leaching and precipitation in secondary forms. The total and bioavailable contents of Ca, Mg, Zn, Mn, Cu, P, and organic C of midden soils were much higher than of regional soils without influence of ancient human settlements, demonstrating that the high fertility persisted for long periods, at some sites for more than 4000 years. The physical analysis showed that wind-blown sand contributed significantly to increase the sand fraction in the analyzed soils (texture classes sand, sandy loam and sandy clay loam) and that the aeolian sand accumulation occurred simultaneously with the midden formation.

Metabolic effects of a mixed and a high-carbohydrate low-fat diet in man, measured over 24 h in a respiration chamber.

1. The relation between dietary carbohydrate: lipid ratio and the fuel mixture oxidized during 24 h was investigated in eleven healthy volunteers (six females, and five males) in a respiration chamber. Values of the fuel mixture oxidized were estimated by continuous indirect calorimetry and urinary nitrogen measurements. 2. The subjects, were first given a mixed diet for 7 d and spent the last 24 h of the 7 d period in a respiration chamber for continuous gas-exchange measurement. The fuels oxidized during 2.5 h or moderate exercise were also measured in the respiration chamber. After an interval of 2 weeks from the end of the mixed-diet period, the same subjects were given an isoenergetic high-carbohydrate low-fat diet for 7 d, and the same experimental regimen was repeated. 3. Dietary composition markedly influenced the fuel mixture oxidized during 24 h and this effect was still present 12 h after the last meal in the postabsorptive state. However, the diets had no influence on the substrates oxidized above resting levels during exercise. With both diets, the 24 h energy balance was slightly negative and the energy deficit was covered by lipid oxidation. 4. With the high-carbohydrate low-fat diet, the energy expenditure during sleep was found to be higher than that with the mixed diet. 5. It is concluded that: (a) the composition of the diet did not influence the fuel mixture utilized for moderate exercise, (b) the energy deficit calculated for a 24 h period was compensated by lipid oxidation irrespective of the carbohydrate content of the diet, (c) energy expenditure during sleep was found to be higher with the high-carbohydrate low-fat diet than with the mixed diet.

Changes in sleeping and basal energy expenditure and substrate oxidation induced by short term thyroxin administration in man.

The present study was designed to explore the thermogenic effect of thyroid hormone administration and the resulting changes in nitrogen homeostasis. Normal male volunteers (n = 7) received thyroxin during 6 weeks. The first 3-week period served to suppress endogenous thyroid secretion (180 micrograms T4/day). This dose was doubled for the next 3 weeks. Sleeping energy expenditure (respiratory chamber) and BMR (hood) were measured by indirect calorimetry, under standardized conditions. Sleeping heart rate was continuously recorded and urine was collected during this 12-hour period to assess nitrogen excretion. The changes in energy expenditure, heart rate and nitrogen balance were then related to the excess thyroxin administered. After 3 weeks of treatment, serum TSH level fell to 0.15 mU/L, indicating an almost complete inhibition of the pituitary-thyroid axis. During this phase of treatment there was an increase in sleeping EE and sleeping heart rate, which increased further by doubling the T4 dose (delta EE: +8.5 +/- 2.3%, delta heart rate +16.1 +/- 2.2%). The T4 dose, which is currently used as a substitutive dose, lead to a borderline hyperthyroid state, with an increase in EE and heart rate. Exogenous T4 administration provoked a significant increase in urinary nitrogen excretion averaging 40%. It is concluded that T4 provokes an important stimulation of EE, which is mostly mediated by an excess protein oxidation.