The orange people.
THE human race comes in various colors: white, yellow, brown, black, and all graduations in between. The American aborigines are described as Red Men and physicians are accustomed to seeing people gray with shock or blue with cyanosis. Yet to see a human as orange as an orange is so startling as to deserve comment—and to see two such cases merits reporting them, especially since no previous emphasis on such bizarre discoloration of patients can be found in medical literature. The parents of orange are the primary colors yellow and red, a fact as old as the history of pigments. Certain foodstuffs have a high content of the yellow pigment carotene, such as carrots and squash; and certain others have a high content of the red pigment lycopene, notably tomatoes and beets. Yellowish discoloration of the skin and other body tissues with carotene is referred to as carotenemia, a not
Carotenemia associated with papaya ingestion.
to believe that the patient took more than 525 to 600 mg of bismuth ("7 or 8 pills" of 75 mg each) although no other means of verifying her account of the incident is available to us. The manufacturer of Bistrimate* recommends a dose of one or two tablets three times daily for seven to ten days for treatment of "chronic sore throat." Accordingly, the dose taken by the patient over a period of a few hours was about three times the recommended daily adult dose. There was no evidence, either from the history or from the renal function studies performed after recovery, that the patient had any preexisting renal disease. Urizar and Verniers recently were able to collect reports of 30 cases of fatal and non-fatal bismuth nephrotoxicity in children from the literature over the past 25 years. In most cases the bismuth had been given by injection for the treatment of stomatitis or warts. Since there is little evidence that bismuth is of any therapeutic value in these disorders, and since bismuth therapy for other diseases has become obsolete, there seems no good reason why bismuth preparations should continue to be marketed. Certainly physicians and patients may reasonably expect that preparations offered for the symptomatic treatment of sore throat will be free from serious toxicity, even should the recommended dose be substantially exceeded.
Clinical chemical values and variations in Rasa Aragonesa ewes and lambs
Reference values of biochemical parameters in serum of Rasa Aragonesa ewes and their physiological variations were determined. Total proteins were 53.0–80.0 g/l, glucose 2.17–5.13 mmol/l, cholesterol 0.83–2.31 mmol/l, total bilirubin 1.85–6.49 μmol/l, urea 3.15–10.39 mmol/l, GGT 36–93 U/l (37°C), ALAT 11–33 U/l (37°C) and ASAT 71–209 U/l (37°C). Ewes were divided into three groups: A, 1- and 2-year-old ewes; B, ewes 3 and 4 years old; C, older ewes. Age had significant influence (P<0.05) on ASAT only during pregnancy, with higher levels for younger ewes. Blood parameters in lambs were determined at 5–10 d of life (nursing), 25 to 30 d of life receiving their mother's milk and 80–90 g of feed; and 45 to 50 d of life, weaned, receiving only solid feed. Serum urea and ALAT tended to increase with age, whereas total protein, globulins, cholesterol and GGT decreased with age. These values are of practical importance in the diagnosis of diseases and metabolic disorders in Rasa Aragonesa ewes and lambs under field conditions.