Metabolic disorders leading to mental deficiency. I. Screening for excessive urinary excretion of nitrogenous compounds.
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Biochemical Phenomena↗
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[Characteristics of psychoses and deficiency conditions in patients with infectious lesions of the central nervous system associated with mental disorders].
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Central Nervous System Diseases↗
Electrolyte balance in gastrointestinal disease.
Even small losses of gastrointestinal secretions when combined with reduced intake of electrolytes may seriously disturb electrolyte balance. Knowledge of the ionic composition of secretions lost is essential in planning therapy. Loss of gastric contents usually results in excessive loss of chloride; in achlorhydria this is not the case. Loss of sodium and potassium may be large in either case and is often underestimated. Small bowel obstruction results in a more balanced loss of electrolyte which may not affect acidbase balance greatly. In diarrhea loss of base predominates, and may result in a large potassium deficit. Steatorrhea due to nontropical sprue results in large fecal losses of sodium, potassium and chloride, in addition to the large calcium and phosphorus loss. In chronic peptic ulcer excessive ingestion of milk and absorbable alkalies may result in hypercalcemia, azotemia and alkalosis, without hypercalciuria. Since renal function is usually adequate in the milder gastrointestinal disturbances, electrolyte and fluid replacement should be started early, and can be guided by generally available laboratory tests, the carbon dioxide combining power and serum chloride levels, provided the predominate ionic loss is known and potassium deficiency remedied. If this is done, development of serious fluid and electrolyte deficits can usually be prevented.
Alkalosis↗
Chronic renal failure. Its effect on calcium, phosphorus and osseous metabolism unified approach.
The renal osteodystrophies represent the metabolic consequences of (1) vitamin D resistance, (2) secondary hyperplasia of the parathyroids, and (3) the changes in serum PO(4)= and Ca++ secondary to the renal insufficiency per se. The osseous lesion in any given patient with chronic renal failure may be osteitis fibrosa, rickets (osteomalacia), calcium deficiency osteoporosis or any combination of these. The concentration of Ca++ and PO(4)= in the serum is determined by the degree of renal failure and the skeletal response to parathyroid hormone.
Bone and Bones↗