Parathyroid hormone [PTH] and markers of calcium metabolism in children with congestive heart failure

Parathyroid hormone [PTH] regulates the content of calcium and exerts an effect on myocardial function. Abnormal secretion of PTH has been sporadically reported to be associated with depressed mechanical performance of the heart muscle. The aim of this study is to evaluate parathyroid function in patients with CHF due to dilated cardiomyopathy [DCM], measuring some different parameters of calcium metabolism This work was carried on 30 cases [20 males and 10 females] with congestive heart failure [CHF] having a mean age of 6.69 +/- 3.94 years. They were recruited from Cardiomyopathy Clinic at Cairo University Children Hospital [Abou El Riche], All our patients were subjected to full history taking, general examination and echo-cardiographic examinations. Thirty normal healthy children of matched age and sex were included to serve as control. Cases were further classified into[i] Decompensated HF[n=18] [NYHA III, IV] who were admitted to in patient units and[ii] Compensated HF[n=12] [NYHA II]. The following laboratory parameters were measured and compared. Osteocalcin[OC] and Parathyroid hormone[PTH], in addition to total serum calcium, phosphorus, creatinine, urea, alkaline phosphatase, sodium and potassium. The results of our work revealed statistically significant lower serum calcium, higher serum phosphorus levels and lower serum osteocalcin in DCM cases compared to controls [p=0.0001,0.002 and 0.0001 respectively].There was no statistically significant difference between cases and controls regarding serum PTH. l.e. normal PTH, however the calcium is depressed in DCM. Parathyroid hormone level was normal in patients with CHF, however three cases of the decompenstated group showed non-significant elevated levels. Significant hypocalcaemia, hyperphosphatemia and reduction in serum OC levels were noted in our CHF patients. Further studies of these factorscontributing to the associated morbidity of patients with decompensated CHF-should be well traced

adrenergic system in the ischemic heart: evidence for a protective role induced by cardiac gene modulation

Twenty-one rabbits' isolated perfused hearts were used in this study. Animals were divided into three groups. Group 1 [control, non preconditioned group] received no treatment and subjected to ischemia reperfusion protocol designed for all groups. Group 2 [PE group] was preconditioned by alpha-1 adrenoceptor agonist [50 mug/kg phenylephrine [PE]] pretreatment 24 hours before induction of ischemia. Group 3 [PE and Pr group] received alpha-1 adrenergic blocker prazosin [Pr] in a dose of 50 mug/kg 15 minutes prior to administration of PE. 24 hours later, hearts were isolated and perfused in Langendorff mode. All hearts were subjected to 30 minutes of no flow ischemia, followed by 120 minutes reperfusion. The following parameters were measured at base line, during and at the end of 120 minutes reperfusion period: Left ventricular developed pressure [LVDP], heart rate [HR], rate pressure product [RPP], peak rate of maximum left ventricular pressure rise [dP/dTmax] and peak rate of pressure fall [dP/dTmin]. ECG changes were recorded. Expression of iNOS was also detected in left ventricular tissue of all studied groups at the end of reperfusion by reverse transcriptase polymerase chain reaction. Isolated hearts after phenylephrine pretreatment significantly improved post ischemic cardiac performance as indicated by higher: LVDP, HR, RPP, dP/dTmax and dP/dTmin and lower St segment elevation as compared to control group. Increased expression of iNOS mRNA was also demonstrated. Prazocin administration completely abrogated the improved functional recovery observed with PE alone. The phenylephrine induced expression of iNOS mRNA was attenuated when hearts received prazocin

Incidencia de úlcera peptica perforada en el Hospital Dr. Luis E. Aybar durante el período febrero 1990 febrero 1995 / Incidence of perforated peptic ulcer in Dr. Luis E. Aybar Hospital durint the period February 1990-February 1995

Se realizó un estudio retrospectivo con el fin de conocer la incidencia de úlcera péptica perforada en el Hospital Dr. Luis E. Aybar durante el periodo feb 90-feb 95 en el Hospital Dr. Luis E. Aybar en Santo Domingo, República Dominicana. Encontramos un total de 49 casos en este periodo, de los que obtuvimos los siguientes datos: Mayor incidencia entre la segunda y tercera década de la vida, más frecuente en el sexo masculino, el cuadro clínico evolucionó por mas de 24 horas antes de recibir atención médica, los pacientes no tenían antecedentes de úlcera péptica, ni de haber recibido tratamiento alguno para esta enfermedad. El tratamiento quirúrgico efectuado fue el cierre de Graham modificado en casi todos los casos; la mayoría de los pacientes permaneció en el hospital menos de ocho días