Fluid and Electrolyte Requirements in Severe Burns

Evans, Everett Idris; Purnell, Oliver J.; P, Robinett; Batchelor, A.D.R.; Martin, Mary M.

doi:10.1097/00000658-195206000-00006

Cited by 237 publications

(53 citation statements)

References 2 publications

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“…The pertinent clinical data on the subjects included in this study are presented in Table I. Included is an estimate of the degree of skin involvement, as determined by the method of Evans and associates (25), at the time of isotope administration. Three of the patients had greater than 70 per cent and two had less than 50 per cent of their skin involved with psoriasis.…”

Section: Resultsmentioning

confidence: 99%

Uric Acid Metabolism in Psoriasis

Eisen¹,

Seegmiller²

1961

J. Clin. Invest.

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Hyperuricemia has been noted to occur in approximately 30 to 40 per cent of patients with psoriasis (1-5). The cause of the hyperuricemia and its possible relation to the psoriatic process has received very little attention.Uric acid synthesis has been evaluated in man by determining the turnover of injected isotopically labeled uric acid as well as by the incorporation of isotopically labeled glycine into urinary uric acid. Observations made on subjects with primary gout have shown that there is a prompt incorporation of glycine-l-C14 or glycine-N'5 into urinary uric acid (6-13) while in gout secondary to proliferative disorders of the hemopoietic system, isotopic incorporation is delayed presumably because the major pathway of uric acid synthesis involves the incorporation of glycine into tissue purines with their slower rate of turnover (14,15).In psoriasis, the skin lesion is a result of hyperplasia of the epidermis in which the rate of cellular reproduction is accelerated to such an extent that maturation of the epidermal cells and the process of normal keratinization do not occur (16). By analogy with the hyperuricemia seen in myeloproliferative diseases, it is possible that the hyperuricemia of psoriasis may reflect an increased nucleic acid turnover resulting from the marked acceleration of epidermal proliferation that occurs in this disease.The present study was undertaken to determine whether the pattern of glycine-l-C14 incorporation control subjects. The patient with gout and psoriasis (F.M.) had a history of frequent attacks of acute arthritis which responded to colchicine. A synovial biopsy of his left knee revealed characteristic deposition of urate crystals. The control subjects had no family history or stigmata of either psoriasis or gout. Remission of psoriasis occurred in one patient (L.P.) following a severe drug eruption resulting from the oral administration of chloroquin phosphate. Within 2 weeks after the drug had been discontinued, complete healing of the skin had occurred and no lesions of psoriasis were present. The repeat glycine-1-C1' incorporation study was carried out approximately 10 weeks after the last dose of chloroquin had been administered, while the psoriasis was still in complete remission.All subjects were hospitalized throughout the studies and were maintained on a standard 2,600 calorie diet, essentially free of purines and containing 70 g of protein, 350 g of carbohydrate and 100 g of fat. At least 5 days were allowed for equilibration on the diet before the studies were performed. Patients received no medication during the study. The clinical diagnosis of psoriasis in each case was confirmed by skin biopsy. Renal function was assessed by routine urinalysis, blood urea nitrogen and phenolsulfonphthalein excretion.Daily 24-hour urine collections were preserved with toluene and stored at room temperature. Serum and urinary uric acid determinations were performed by means of the enzymatic spectrophotometric assay of Praetorius and Poulsen (17) as modified by Liddle, Seegm...

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Section: Resultsmentioning

confidence: 99%

Uric Acid Metabolism in Psoriasis

Eisen¹,

Seegmiller²

1961

J. Clin. Invest.

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“…shock patient [2,6,10,20] or one who suffers from a hemorrhagic shock [11,26] might not be properly infused if getting this material. It is debatable if hypertonic solutions are of benefit to the burned patient.…”

Section: Resultsmentioning

confidence: 99%

The Constituents of Fresh Frozen Plasma Stored with Citrate Phosphate Dextrose and Their Clinical Implications

et al. 1982

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The authors have investigated the constituents of fresh frozen plasma stored in citrate phosphate dextrose (CPD) at -20 °C. The results indicate abnormal characteristics of several of the constituents, whereas some others remain within normal values. This is attributed to preparation procedures with the addition of a CPD solution. Fresh frozen plasma being hyperosmolal, hypematremic, hyperglycemic, hyperphosphatemic, normokalemic and containing normal values of protein, calcium, magnesium, and water carries a clinical implication for the physician as a guide for the treatment of the critically ill patient when large amounts of plasma are needed.

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“…The extent of skin involvement was assessed by the rule of nine's (Evans et al, 1952), in which the surface of the body is divided into 11 areas assumed to be 9 % of the total body area, the genitals being assessed as the remaining 1 %. The arthritis was graded as mild (involvement of less than four joints with no loss of function), moderate (involvement of less than four joints with deformity and/or loss of function, or involvement of many joints with only slight impairment of function), or severe (marked deformity and disability).…”

Section: Methodsmentioning

confidence: 99%

Serum Uric Acid Levels in Psoriatic Arthritis

Taccari¹,

Mc²,

Ml³

et al. 1985

Scandinavian Journal of Rheumatology

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SUMMARY Serum uric acid levels were determined in patients with psoriatic arthritis on and off medication, with rheumatoid arthritis on no medication likely to alter serum values, and in patients with uncomplicated psoriasis. Values in males were higher than those in females. A larger prevalence of values above the normal range were seen in males with psoriatic arthritis on uncontrolled medication (13-5 %) and in males with rheumatoid arthritis (12%) than in the other groups. The means for both these groups were around the midpoints of the normal range. These findings suggest that hyperuricaemia is not a common characteristic of psoriatic arthritis.Hyperuricaemia has been generally accepted as a frequent accompaniment of psoriasis and psoriatic arthritis. This association was first noted by Herrmann et al. (1930), who reported levels of uric acid above the upper limit of normal in 44 of 140 patients with psoriasis, especially in those with arthritis. Other authors reported similar findings (Steinberg et al., 1951;Tickner and Mier, 1960;Baumann and Jillson, 1960;Eisen and Seegmiller, 1961;Beveridge and Lawson, 1967;Pokorny and Resl, 1968;Solanet and Shulman, 1972). The prevalence of hyperuricaemia varied in these series from 21 to 50 %, the increase being more marked in males and in patients with arthritis. Eisen and Seegmiller (1961) found correlation of the serum uric acid level with the extent of skin involvement, and it has been postulated that the hyperuricaemia results from increased purine synthesis from the rapid epidermal cell turnover. However, their work with radioactively labelled glycine showed a pattern of turnover resembling primary rather than secondary gout.Further evidence for the association was reported by Kaplan and Klatskin (1960) who described 3 patients with psoriasis, gout, and sarcoidosis. However, Lea et al. (1958) found no difference between the values of 19 psoriatic patients and controls. Schattenkirchner (1970) found no increase in the frequency of raised serum uric acid levels in psoriatic arthritis compared with seronegative chronic polyarthritis, and Little et al. (1975) found that in patients with severe psoriasis, with or without arthritis, the mean serum uric acid levels were Accepted for publication August 19, 1976 Correspondence to Dr. J. R. Lambert, Rheumatism Research Unit, 36 Clarendon Road, Leeds LS2 9PJ in the middle of their normal range. A careful study was undertaken of our patients to try to resolve these conflicting reports. Materials and methodsThe study consisted of three parts. In the first, plasma uric acid levels were estimated in 115 patients (52 men, 63 women) with psoriatic arthritis fulfilling the criteria of Moll and Wright (1973). No account was taken of medication. Values were compared with the laboratory range of normal.In the second part of the study uric acid levels were measured on a group of 45 patients (13 men, 32 women) with psoriatic arthritis who had received only paracetamol for at least the preceding week. Values were compared with th...

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Fluid and Electrolyte Requirements in Severe Burns

Cited by 237 publications

References 2 publications

Uric Acid Metabolism in Psoriasis

Uric Acid Metabolism in Psoriasis

The Constituents of Fresh Frozen Plasma Stored with Citrate Phosphate Dextrose and Their Clinical Implications

Serum Uric Acid Levels in Psoriatic Arthritis

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