Rabdomiólisis por hipopotasemia severa en paciente con síndrome de Conn / Rhabdomyolysis and profound hypokalemia in a patient with Conn´s syndrome

El Síndrome de Conn o hiperaldosteronismo primario se caracteriza por hipertensión, hipopotasemia con alcalosis metabólica y una masa adrenal. La rabdomiólisis puede ser secundaria a traumatismos, excesiva actividad muscular, enfermedades musculares hereditarias y otras causas médicas, como la hipopotasemia. Presentamos el caso de un hombre de 46 años con rabdomiólisis secundaria e hipopotasemia severa como expresión de hiperaldosteronismo primario por un adenoma suprarrenal(AU)

Conn's syndrome or primary hyperaldosteronism is characterized by hypertension, hypokalemia with metabolic alkalosis and the presence of an adrenal mass. Rhabdomyolysis can be secon- dary to trauma, excessive muscle activity, hereditary muscle diseases and other medical causas, such as hypokalemia. We present the case of a 46-year-old man with secondary rhabdomyolisis and hypokalemia as an-expresión of primary hyperaldosteronism due to an adrenal adenoma(AU)

Interactive effects of imidacloprid, profenofos and carbosulfan at low concentrations on homeostasis and haematological indices in male albino rats

Toxicity data with single pesticides to test animals are far more abundant than with mixtures [Flipo et al., 1992]. Consequently, these data cannot be used directly to predict the effect of pesticide combinations. Three pesticides; imidacloprid, profenofos and carbosulfan, administered to rats per OS at low level dose equal 1/30 LD50 for each insecticide, which represent 111, 70 and 43 ppm, respectively on homeostasis status and haematological indices [El-Kashory and El-Said, 2001], were selected to explore their combined action of subchronic exposure studies for 90 days in adult male albino rats. Homeostasis-related parameters such as; aldosterone [Ald.], sodium ions [Na+], potassium ions [K+], total chloride ions [T.Cl-] levels, pH value and haematological indices were examined in rats after an administration with different insecticide combinations. Moreover, after withdrawal the pesticide combinations for 30 days, as a recovery period, the above mentioned parameters were evaluated, in comparison with the control group. Results showed that, pesticide combination imidacloprid/profenofos [I + P] induced significant decrease in Na+ and T.Cl- ions levels and significant increase in pH value. While, it did not alter both Ald. and K+ ions levels. Combination imidacloprid/carbosulfan [I + C] increased significantly Ald., T.Cl- ions levels and pH values. On the contrary, it reduced Na+ and K+ ions levels significantly. Combination of profenofos/carbosulfan [P + C] decreased Ald. and Na+ significantly, while, K+ and T.Cl- level and pH value did not alter. In addition, tri-combination imidacloprid/ profenofos/carbosulfan [I + P + C] increased Na+ and T.Cl- ions level and pH value; while, a marked decline in Na+ ions level was occurred, as well as, no appreciable changes in K+ ion levels were observed. The combinations of I + P and I + C caused erythropenia [reduced RBC mass] associated with a significant decrease in PCV in I + C-treated rats. While, di-combinations P + C, I + P and I + P + C tri-combinations increased markedly of PCV and MCV. However, leukocytosis [elevated WBCS count] was observed in I + P + C-treated rats. After the pesticides combination withdrawal, changes in some parameters returned to the normal values, in comparison with the control group; while, the others still altered. Moreover, some parameters did not exhibit any changes unless after the stop of the treatment. In conclusion, this study supports the notion that; an interactions effects of pesticide combinations may be consider as contributor factor enhance their side effects

Avaliaçäo hormonal e de reflexos cardiovasculares em portadora de falência autonômica pura / Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure

We report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. For approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. She underwent clinical assessment and laboratory tests (biochemical tests, chest X-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring). Measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. Finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.

Correlación de valores de péptido natriurético auricular con los de renina, angiotensina y aldosterona en pacientes hipertensos menores y mayores de 50 años / Correlation between atrial natriuretic peptide, renin, angiotensin and aldosterone in hypertensive patients younger or older than 50 years

Se compararon determinaciones por radioinmunoanálisis de péptido natriurético auricular (PHA), con los de renina, angiotensina y aldosterona (RAA) en 6 voluntarios sanos >50 años y en 5 sujetos sanos >50 años, con aquellos efectuados en 44 hipertensos esenciales >50 años, y 41>50 años. Los valores de PNA en voluntarios sanos fueron X = 44 ñ 7 PG/ml en los <50 años, y X = 87.33 ñ 14 PG/ml en los >50 años (p < 0.01). En hipertensos <50 años, 80 por ciento tuvieron valores normales (X = 63.8 ñ 10 PG/ml) y 20 por ciento, elevados (X = 131 ñ 6 PG/ml), P < 0.001. En hipertensos >50 años, 70 por ciento tuvieron PNA elevado (X = 260 ñ 114 PG/ml) y 30 por ciento, normal (X = 75 ñ 5 PG/ml), P < 0.001. Los valores de RAA fueron normales o bajos en 96 por ciento de los casos con PNA elevado, P < 0.001; en el 100 por ciento de los casos con RAA elevados, los valores de PNA fueron bajos (P < 0.0001). Esta correlación fue estadísticamente significativa para los hipertensos >50 años (PNA alto y RAA bajos), P < 0.001, así como para los valores de RAA altos, PNA bajo en pacientes <50 años (P < 0.001). De acuerdo con nuestros resultados, en pacientes hipertensos esenciales <50 años los valores de PNA son normales en la mayoría de los casos y elevados en la mayoría de los casos de hipertensión >50 años (P < 0.001). No obtuvimos una correlación significativa entre los valores de PNA y los signos de hipertrofia ventricular izquierda en ambos grupos. Como en reportes previos, hubo una relación inversamente proporcional entre los valores de RAA y los de PNA independiente de la edad. Se corrobora que el sistema de PNA es un mecanismo más, en la regulación de la presión arterial en los sujetos hipertensos mayores de 50 años

Plasma atrial natriuretic peptide, renin activity, aldosterone sodium and potassium in normal and hypertensive pregnancy

To clarify a possible role for atrial naturiuretic peptide [ANP] in the pathophysiology of pregnancy complicated by hypertension, we studied plasma levels of ANP, Aldosterone, plasma rennin activity [PRA], sodium [Na+] and potassium [K+] in normal non pregnant women [n = 20], pregnant women with preeclampsia [n = 30] and in pregnant women with chronic hypertension [n = 12]. Plasma levels of ANP were found to be significantly increased in preeclamptic and chronic hypertensive women with the highest levels in the severe preeclampsia. On the other hand PRA, serum aldosterone and serum Na+ were found to be significantly reduced in severe preeclamptic and chronic hypertensive, pregnant women. An inverse relationship was found between plasma ANP and either serum aldosterone, PRA or serum Na+ in the severe preeclamptic and chronic hypertensive groups