The Effects of Emotion on Pain
Barry Stimmel in Pain and Its Relief Without Addiction, 1997
The effects of marijuana on organ systems may be related not only to the active ingredients in cannabis but also to the manner in which the drug is taken. The inhalation of marijuana smoke was accompanied by a decreased or an increased tolerance and heightened or unchanged pain. Dronabinol is the synthetically available form of marijuana approved for the treatment of nausea and vomiting associated with chemotherapy. Reports have also appeared associating marijuana use with increased pain or hyperalgesia in patients with neoplastic disease. The hypotension, which at times may be considerable, may be related to a hypovolemia secondary to copious diarrhea or may be the result of central nervous system effect of marijuana on the vasomotor receptor. Although highly effective antiemetic agents are currently available, they are extremely expensive, and synthetic marijuana does not appear to be as effective an agent as in the natural drug.
Hyponatremia in pregnancy
Nadia Barghouthi, Jessica Perini in Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Mild hyponatremia is a common finding in pregnancy. Both serum osmolality and sodium levels drop by a predictable amount due to hormonal, renal, and vascular effects leading to a reset osmostat. Mild, euvolemic hyponatremia is common in pregnancy secondary to a reset osmostat, which is a change in the set point of anti-diuretic hormone (ADH) release and stimulation of thirst. The syndrome of inappropriate ADH can occur in pregnancy, typically associated with nonosmotic stimuli such as hypovolemia, nausea, and pain, promoting the release of ADH. Under nonpregnant conditions, serum osmolality is maintained within a narrow range of 275–295 mOsm/L. Hyponatremia during labor is now thought to be primarily associated with overdrinking. Increased free water intake either due to stress or social encouragement may overcome the kidney’s ability to excrete the water load.
Short Bowel Syndrome
John F. Pohl, Christopher Jolley, Daniel Gelfond in Pediatric Gastroenterology, 2014
Short bowel syndrome (SBS) is a clinical definition used to describe those complications caused by the loss of at least 50% of the small intestine either congenitally or acquired. If severe, SBS can cause intestinal failure which occurs when nutrition/fluid must be supplied using parenteral nutrition (PN). Clinical manifestations of SBS in children are as follows: Diarrhea and steatorrhea; Anemia related to iron and/or vitamin B12 malabsorption; Bleeding diathesis related to vitamin K malabsorption; Hyponatremia, hypokalemia; Hypovolemia; and Macronutrient or micronutrient deficiency states. Complications of SBS are related to the degree of shortened bowel as well as the need for PN and adaptation of the remaining bowel. SBS is a clinical diagnosis dependent on the history and nature of intestinal loss coupled with symptoms suggestive of malabsorption. Fiber supplementation may be helpful in preventing high fluid losses in SBS patients with a remaining colon, as fiber can decrease stool volume and can be useful in infants with perianal skin breakdown.
Hypovolemic Shock and Contrast-Enhanced Computed Tomography of the Pancreas
Published in Scandinavian Journal of Gastroenterology, 1986
P. Nuutinen, L. Kivisaari, A. Lehtola, M. Talja, C. G. Standertskjöld-Nordenstam, M. Lempinen, T. Schröder
The effect of profound hemorrhagic hypovolemia on cardiac output and pancreatic blood flow was studied in pigs with the thermodilution method and microsphere technique. Approximately 30–40% of the circulating blood volume was withdrawn slowly during 5 h. Cardiac output and pancreatic blood flow decreased by 35% and 32%, respectively. The animals underwent contrast-enhanced computed tomography (CT) before hypovolemia and at 5 h after its onset. The changes in systemic and local blood flow were related to the contrast enhancement of the pancreas. In spite of profound hypovolemia and a significant decrease in pancreatic blood flow (p > 0.005), the contrast enhancement remained normal. The results of the present study indicate that pancreatic hypoperfusion caused by hypovolemia does not affect the contrast enhancement of the pancreas in CT.
Peritoneal Blood Flow during Acute Experimental Pancreatitis: The Role of Peritoneal Exudate
Published in Scandinavian Journal of Gastroenterology, 1986
Peritoneal blood flow is closely related to the pathophysiology of peritoneal exudate during acute pancreatitis. Peritoneal blood flow was determined by the radioactive microsphere method before and 5 h after the beginning of the experiment in 39 piglets with acute hemorrhagic pancreatis, acute edemic pancreatitis, or slowly progressing hypovolemia. The effect of hemorrhagic ascitic fluid was also studied. Cardiac output was determined by thermodilution. Acute experimental hemorrhagic pancreatitis and intraperitoneally injected hemorrhagic ascitic fluid per se caused similar and significant increases in peritoneal blood flow, the increase being unaffected by the correction of the secondary hypovolemia in acute hemorrhagic pancreatitis. Laparotomy combined with duodenotomy also caused a similar increase in peritoneal blood flow. Hypovolemia alone caused only insignificant reduction in peritoneal blood flow. Peritoneal exudate accumulating in the peritoneal cavity during early acute experimental hemorrhagic pancreatitis causes a significant increase in peritoneal blood flow which is unaffected by the correction of the secondary hypovolemia during acute pancreatitis. The inflammatory increase in peritoneal blood flow during acute pancreatitis is evidently a major factor in the accumulation of peritoneal exudate during the disease.
Effects of diuretic-induced hypovolemia/isosmotic dehydration on cardiorespiratory responses to hyperthermia and its physical treatment in rabbits
Published in International Journal of Hyperthermia, 2006
Andrea Brozmanova, Jerzy Jochem, Kamil Javorka, Ivan Zila, Krystyna Zwirska-Korczala
Under conditions of heat stress and hyperosmotic dehydration, both animals and humans reduce thermoregulatory evaporation and regulate deep body temperature at elevated levels. Regarding the mechanisms, the main role in producing these thermoregulatory changes during dehydration is attributed to the increased osmolality of body fluids, although the role of the decreased plasma volume without changes in plasma osmolality (hypovolemia/isosmotic dehydration) has not been so far investigated. There are also controversial experimental results regarding the effects of dehydration on heat stress-induced cutaneous vasodilation. Therefore, this paper studied the effects of hypovolemia/isosmotic dehydration on cardiorespiratory responses to hyperthermia and its physical treatment in 17 anaesthetized adult rabbits. The animals were divided into two groups: normovolemic group (NV; n = 10) and hypovolemic group (HV; n = 7). In the HV group, hypovolemia/isosmotic dehydration (decrease in plasma volume by 16.1 ± 1.2%) was induced by furosemide (5 mg kg−1 i.v.) without change in measured plasma Na+ concentration. Hyperthermia (the rise in body temperature (BT) to 42°C by a gradual body surface heating) caused significant increase in minute ventilation (VE) in both groups. However, VE values were significantly higher in the HV rabbits compared to the NV animals despite the lower breathing frequency (p