Thymoma complicated with polymyositis and myasthenia gravis: A case report / 中国胸心血管外科临床杂志

@#Thymoma complicated with polymyositis and myasthenia gravis is a rare case, which can be clearly diagnosed and given symptomatic treatment according to its own diagnostic criteria, imaging and laboratory examinations. This paper reports the clinical data of a thymoma patient with polymyositis and myasthenia gravis admitted to the Seventh Affiliated Hospital of Sun Yat-Sen University, and discusses the possible pathogenesis and treatment methods.

Avaliação da lactatemia e das enzimas musculares de equinos Quarto de Milha submetidos à prova de laço em dupla com diferentes tipos de treinamento / Evaluation of lactatemia and muscle enzymes in Quarter Horses subjected to team ropping with different types of training

O objetivo do trabalho foi avaliar a influência de diferentes tipos de treinamento sobre o condicionamento físico de equinos por meio da determinação do lactato sanguíneo e da atividade sérica de creatina quinase, aspartato aminotransferase e lactato desidrogenase após exercício físico de alta intensidade e curta duração. Amostras de sangue venoso foram obtidas de 16 equinos da raça Quarto de Milha, divididos em dois grupos: grupo de treinamento regular (GTR) e grupo de treinamento esporádico (GTE), em sete diferentes momentos: 30 minutos antes do exercício (M0), imediatamente após (M1), 30 minutos (M2), uma (M3), duas (M4), seis (M5) e 24 (M6) horas após o exercício. Para a análise estatística, os dados foram testados quanto à normalidade e homogeneidade de variâncias. Para comparar os grupos e os momentos em cada grupo foram utilizados testes paramétricos (ANOVA) para a análise das atividades séricas das enzimas musculares e não paramétricos (Mann-Whitney e Friedmann) para a análise do lactato sanguíneo (P<0,05). Não houve diferença significativa entre os grupos para nenhuma variável. No entanto, dentro dos grupos experimentais foi possível observar diferenças significativas entre os momentos avaliados, em relação ao lactato e à LDH. No GTE, foram observadas diferenças significativas quanto ao lactato, entre o M0 e o M1, com valores respectivos de 0,90 mmol/L (mín. 0,8 - máx. 1,6) e 3,65mmo/L (mín. 1,0 - máx. 5,7) e quanto à LDH, onde os valores descritos no M6 diferiram significativamente de M0, M1, M2, M3 e M4. No GTR, diferenças significativas entre os momentos experimentais foram observadas em relação à LDH, sendo que os valores observados no M6 foram os menores e diferiram significativamente daqueles encontrados no M1, M2, M3 e M4. Em conclusão, não houve diferença entre o condicionamento físico dos animais treinados regularmente e aqueles treinados esporadicamente. A baixa magnitude das elevações das concentrações de CK, AST e LDH após o exercício e o rápido retorno aos valores basais, inclusive do lactato, observados em ambos os grupos, sugere que todos os animais avaliados estavam condicionados e aptos a realizar tal atividade física.(AU)

The aim of this study was to evaluate the influence of different types of training on physical fitness through the determination of blood lactate and serum creatinine kinase, aspartate aminotransferase, and lactate dehydrogenase activity after high intensity and short duration physical exercise. Venous blood samples were obtained from 16 Quarter Horses, divided into two groups: the regular training group (GTR) and sporadic training group (GTE), in seven different moments: 30 minutes before exercise (M0), immediately after the exercise (M1), 30 minutes (M2), one hour (M3), two hours (M4), six hours (M5) and 24 hours (M6) after the exercise. For statistical analysis, data was tested for normality and homogeneity of variances. To compare the groups and times in each group, parametric tests (ANOVA) were used for muscular enzymes activity and not parametric tests (Mann-Whitney and Friedmann) were used to analyze blood lactato (P<0.05). There was no significant difference between groups for any variable. However, within the experimental groups it was possible to observe significant differences between the evaluated moments, in relation to lactate and LDH. In the GTE, significant differences were observed for lactate between M0 and M1, with respective values ​​of 0.90 mmol/L (min. 0.8, max. 1.6) and 3.65 mmol/L (min. 1.0, max. 5,7) and for LDH, where the values ​​described in M6 differed significantly from M0, M1, M2, M3 and M4. In the GTR, significant differences between the experimental moments were observed in relation to LDH, and the values ​​observed in M6 were the lowest and differed significantly from those found in M1, M2, M3 and M4. In conclusion, there was no difference between the fitness of animals regularly trained and those trained sporadically. The low magnitude of elevations of serum CK, AST and LDH activity after exercise and the quick return to baseline values, including the blood lactate observed in both groups, suggest that all of evaluated animals were conditioned and able to perform such physical activity.(AU)

Dermatomiositis en un adulto / Dermatomyositis in an adult

Se presenta el caso clínico de un adulto de 37 años de edad, quien presentó, a finales del 2010, síntomas de debilidad muscular y fiebre, que se agravaron progresivamente al aumentar la fatiga y manifestar dificultad respiratoria. En el 2012 fue ingresado en estado crítico en la Unidad de Cuidados Intensivos del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso", debido a daño multiorgánico. Se estudiaron los antecedentes epidemiológicos para determinar alguna causa infecciosa, y se aplicó el tratamiento con antimicrobianos, esteroides e inmunoglobulinas; posteriormente fue valorado por un equipo multidisciplinario que sugirió la presencia de lupus eritematoso sistémico. A pesar de que el paciente mostró mejoría, se mantuvo con fiebres periódicas; de manera que fue reevaluado y se le diagnosticó una dermatomiositis.

The case report of a 37 year adult is presented who, at the end of 2010 had muscle weakness and fever, which progressively worsened when fatigue increased and respiratory distress emerged. In the 2012 he was admitted in critical condition in the Intensive Care Unit from "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital, due to a multiorgans damage. The epidemiological records were studied to determine some infectious cause, and the treatment with antimicrobials, steroids and immunoglobulines was applied; later on it was evaluated by a multidisciplinary team which suggested the existence of systemic lupus erythematous. Although the patient showed improvement, he had periodic fevers, so that he was reevaluated and a dermatomyositis was diagnosed.

Treatment of patients with hypoparathyroidism accompanied by elevated serum muscle enzymes / 中华内分泌代谢杂志

The clinical data of patients with hypoparathyroidism accompanied by elevated and normal muscle enzymes were analyzed retrospectively.The results showed that there were no differences in age,gender,pathogenesis,etiology,and parathormone level between groups with elevated muscle enzyme and normal muscle enzyme.Serum calcium concentration in the group with normal muscle enzyme was within normal range.Serum calcium concentration in the group with elevated muscle enzyme was significantly lower than that in the group with normal muscle enzyme (P＜0.01).As the serum calcium concentration rose,the elevated enzyme level gradually returned to normal range,suggesting that the decrease of serum calcium concentration resulted in the elevated muscle enzyme levels in patients with hypoparathyroidism.

Intoxicação experimental com extratos de Mascagnia rigida (Malpighiaceae) em camundongos / Experimental intoxication in mice with extracts of Mascagnia rigida (Malpighiaceae)

Foi realizado o fracionamento químico do extrato aquoso da Mascagnia rigida Griseb., uma importante planta tóxica no Brasil, para se obter cinco substratos ricos em diferentes grupos químicos - alcalóides, flavanóides, taninos, saponinas e açúcares, ácidos orgânicos e aminoácidos -, e investigar a toxicidade dessas frações, exceto a última, em 75 camundongos. Os animais, distribuídos aleatoriamente em cinco grupos, receberam: grupo I - alcalóides; grupo II - flavanóides; grupo III - taninos; grupo IV - saponinas e grupo V - placebo, este último funcionando como controle negativo. Todos os grupos, com exceção do grupo-controle, redistribuídos em três subgrupos, A, B e C, com cinco animais cada, receberam, respectivamente, 9g/kg, 18g/kg e 27g/kg de cada substrato. As frações foram fornecidas via oral, diariamente, por sete dias; no sétimo dia, foi coletado sangue para o estudo do perfil sangüíneo e dosagem de enzimas musculares. As frações de alcalóides e taninos foram capazes de causar alteração no perfil enzimático-muscular, com aumento significativo da enzima miocárdica. Observou-se, também, aumento significativo na porcentagem da CK-MB após a administração das frações de saponinas e taninos, comprovando a ação tóxica da M. rigida sobre a fibra muscular cardíaca.

A study was carried out to examine the toxic effects of Mascagnia rigida Griseb. Four classes of compounds were extracted from the plant by phytochemistry study and the individual effect of each one on mice was examined as follows: group I - alkaloids; group II- flavones; group III - tannins; group IV - saponins; and group V - water (control). Each group was further divided in three subgroups, A (9g/kg), B (18g/kg), and C (27g/kg), with five mice orally receiving a particular dose, once per day for one week. On the 7th day, blood was collected and hematological exams and levels of muscle enzymes were analyzed. The results showed that both alkaloids and tannins caused a significant increase in myocardial enzyme. Administration of either saponins or tannins fractions caused an increase of CK-MB enzyme. This study showed that Mascagnia rigida Griseb has the ability to cause damage to myocardial fibers.

Resposta divergente da testosterona e do cortisol séricos em atletas masculinos após uma corrida de maratona / Divergent responses of serum testosterone and cortisol in athlete men after a marathon race / Divergent responses of serum testosterone and cortisol in athlete men after a marathon race

O exercício físico altera a homeostase, pois requer rápida mobilização de fontes metabólicas. Neste estudo, analisamos a resposta dos níveis séricos de testosterona (T) e cortisol (C) e das enzimas de desgaste muscular CK, CKMB e LDH, em 20 atletas masculinos sadios (25 a 40 anos), participantes de uma maratona (42,2 km). Coletas de sangue venoso foram feitas em 3 períodos: (i) pela manhã, 48 h antes da maratona (controle), (ii) logo após o término da corrida (final) e (iii) na manhã seguinte, 20 h após a realização da prova (recuperação). Ao final, T estava significantemente mais baixa (de 673 para 303 ng/dl) e C mais elevado (de 20,3 para 42,5 æg/dl) que no período controle. Na recuperação, ambos praticamente retornaram aos níveis basais. CK, CKMB e LDH estavam significantemente mais elevadas ao final da corrida e mais ainda na recuperação (exceto a CKMB), caracterizando o desgaste muscular. Enquanto CK e LDH apresentaram significante correlação negativa com a T (-0,412 e -0,546, respectivamente), CKMB correlacionou-se positivamente com o C (0,4521). Concluímos que a correlação inversa entre T e C, e o comportamento das enzimas CK, CKMB e LDH, permite comprovar que uma corrida de maratona causa intenso stress físico, provocando desequilíbrio hormonal e lesão celular severa.

Physical exercise alters homeostasis, as it requires prompt mobilization of metabolic sources. In this study, we measured serum testosterone (T) and cortisol (C) levels and the muscle-wastage enzymes CK, CKMB and LDH in 20 healthy male athletes (ages 25 to 40 years) in response to a marathon race (42.2 km). Venous blood samples were drawn in 3 different periods: (i) in the morning, 48 h before the competition (control), (ii) at the end of the race (end), and (iii) in the next morning, 20 h after the race (recovery). At the end, T was significantly lower (from 673 to 303 ng/dl) and C higher (from 20.3 to 42.5 æg/dl) as compared to the control period. At recovery, both were virtually identical to control levels. CK, CKMB and LDH were significantly higher at the end of the competition and even higher in the recovering period (except for CKMB), characterizing muscle wastage. CK and LDH disclosed a significant negative correlation with T (-0.412 and -0.546, respectively), whereas CKMB correlated positively with C (0.4521). We conclude that the inverse correlation observed between T and C levels, and the pattern of CK, CKMB and LDH increase, allow us to confirm that a marathon race may cause a marked physical stress, resulting in a distinct hormonal imbalance and severe cellular damage.