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T E Edes

Publications and source records attributed to T E Edes.

24 records · Page 2Linked to original sources

Leukotriene B4 is measurable in serum of smokers and nonsmokers.

Leukotriene B4 (LTB4), an arachidonic acid metabolite released by neutrophils and macrophages, helps regulate host immune response to antigenic stimulation. LTB4 affects the chemokinesis, aggregation, and enzyme release of neutrophils and stimulates activity of cytotoxic T cells, natural killer cells, and suppressor T cells. LTB4 also has a positive affect on the margination of monocytes and macrophages in the lung in response to inflammatory stimuli. Cigarette smoking represents an inflammatory stimulus in the lung and affects (decreases) the in vitro release of LTB4 by alveolar, macrophages in comparison with that by alveolar macrophages of nonsmokers. By utilizing a sensitive and specific radioimmunoassay we have detected LTB4 concentrations in serum from smokers and nonsmokers. Furthermore, our preliminary data show mean LTB4 concentrations in the serum of smokers to be nearly 60-fold greater than those in nonsmokers, 211 (SEM 35) vs 3.6 (SEM 1.5). Because systemic quantities of LTB4 are now measurable, quantification of this immune system regulatory may be useful in evaluating inflammatory disease states.

Adult↗

Nosocomial diarrhea: beware the medicinal elixir.

An unusual case of osmotic diarrhea that persisted despite fasting led to the discovery of an unexpected source of hospital-acquired diarrhea. Numerous patients were subsequently found to have onset of diarrhea shortly after the initiation of treatment with theophylline elixir. Although theophylline can promote gastrointestinal secretion and motility, this effect should be independent of the route of theophylline administration and the stool should be characteristic of secretory rather than osmotic diarrhea. Patients taking no food orally while taking theophylline elixir continued to have osmotic diarrhea in excess of 1,000 ml/24 hr. Patients whose therapy was switched to intravenous or solid oral theophylline had resolution of diarrhea within 24 hours. The brand of theophylline elixir used was formulated with 30 gm of sorbitol per 240 mg of theophylline; thus a standard regimen of theophylline elixir was delivering four laxative doses of sorbitol daily. A cursory review revealed that many medicinal elixirs are formulated with sorbitol, despite being designated "sugar-free." When patients have osmotic diarrhea in the hospital, beware the medicinal elixir.

Administration, Oral↗

Heparin-induced hyperkalemia.

Heparin sodium is routinely used in the prophylaxis against deep venous thrombosis in medical and surgical patients. While most physicians are aware of heparin-induced thrombocytopenia and skin necrosis, the association of heparin and hyperkalemia is less well recognized. We present four cases in which the use of heparin was associated with hyperkalemia and discuss the pathophysiology. Our findings suggest that hyperkalemia can develop with the use of low-dose heparin, within seven days of initiating heparin therapy, and that patients with diabetes mellitus or chronic renal insufficiency are especially predisposed to this complication.

Aged↗