ABSTRACT
Iatrogenic pancreatic cancer metastasis after islet infusion is a potential risk of islet autotransplantation performed after pancreatectomy. To model this risk, islets and/or pancreatic exocrine clusters obtained from a genetically engineered mouse model for pancreatic ductal adenocarcinoma (the LSL-KrasG12D/+ ;LSL-Trp53R172H/+ ;Pdx-1-Cre, termed KPC mouse) were transplanted via the portal vein in syngeneic wild type (WT) severely diabetic recipients in the following treatment groups: group A (n = 11) received KPC exocrine clusters in volume equal to 250 islet equivalents (IEQs); group B (n = 12) received 250 WT IEQs mixed with KPC exocrine clusters (1:1 volume ratio); group C (n = 5) received 250 KPC IEQs, and group D (n = 7) received 250 WT IEQs. The incidence of hepatic metastasis was assessed by magnetic resonance imaging and histology over the 13 months of follow-up. Overall survival was not different in the four groups. No mice developed liver metastases during the follow-up. Two mice developed spontaneous tumors: a liver hepatocellular tumor in group A and a malignant lymphoma in group D. Islets and/or exocrine clusters obtained by KPC mouse, a model that develops pancreatic cancer with 100% penetrance, do not retain the same risk of tumor development when transplanted via the portal vein in a syngeneic diabetic recipient.
Subject(s)
Carcinoma, Pancreatic Ductal/etiology , Disease Models, Animal , Iatrogenic Disease , Islets of Langerhans Transplantation/adverse effects , Pancreatic Neoplasms/etiology , Animals , Carcinoma, Pancreatic Ductal/pathology , Humans , Male , Mice , Mice, Inbred C57BL , Pancreatic Neoplasms/pathologySubject(s)
Cardiology/education , Congresses as Topic , Education, Medical, Continuing , Medicine , Specialization , Brazil , Societies, MedicalABSTRACT
PURPOSE: To evaluate the efficacy and tolerability of isradipine, a new dihydropyridine calcium antagonist, in the treatment of mild-to-moderate hypertension. PATIENTS AND METHODS: One hundred and eighty outpatients with different races, who had supine and orthostatic diastolic blood pressure (DBP) > or = 95 mmHg and < or = 115 mmHg, with a mean age of 52.03 +/- 11.47 years, 70 men, 110 women; underwent the study. After a two-week wash-out period patients received isradipine 2.5 mg b.i.d. for 90 days. Follow-up visits were performed at the 30th, 60th and 90th days of treatment. RESULTS: At the end of treatment (90 days), a statistically significant decrease (p < 0.05) in SBP and DBP in supine position was observed. A mean SBP was reduced from 159.28 +/- 16.99 to 142.51 +/- 15.12, and mean DBP declined from 101.49 +/- 6.82 to 86.63 +/- 7.40. Heart rate, weight, electrocardiograms and laboratory tests did not shows significant changes during treatment when compared to baseline evaluation. The most frequent related side effects (headache and dizziness with nausea) were transient, and at the end of the study 96.7% of the patients did not have any complaint. However, two patients were withdrawn from the trial because of important headache. CONCLUSION: Isradipine 2.5 mg by oral route, b.i.d. has shown to be effective and well tolerated in the treatment of mild-to-moderate hypertension in patients of both sexes and several ages and races.
Subject(s)
Dihydropyridines/administration & dosage , Hypertension/drug therapy , Administration, Oral , Adult , Aged , Brazil , Female , Humans , Male , Middle AgedABSTRACT
Estudo multicêntrico, aberto, comparativo entre o Urapidil e a Nifedipina, alocando os pacientes, aleatoriamente, em dois grupos de tratamento, com 95 pacientes (46 pacientes tratados com Urapidil e 49 pacientes tratados com Nifedipina). Houve um período de washout de duas a quatro semanas e, um período de tratamento ativo de 10 semanas, sendo que, após duas semanas, a dose inicial (Urapidil: 60mg/d e Nifedipina: 40mg/d) foi duplicada nos pacientes näo-responsivos. O critério de normalizaçäo foi o de uma pressäo diastólica igual ou inferior a 90 mmHg ou 10% na reduçäo, se a diastólica fosse inferior a 100mmHg. Nos 95 pacientes estudados a porporçäo de pacientes responsivos foi de 78% paa o Urapidil e de 76% para a Nifedipina; a queda de pressäo levou a 139/88mmHg; no grupo do Urapidil e 131/83mmHg no grupo da Nifedipina. A tolerância foi satisfatória com o Urapidil, sendo as principais queixas a vertigem, o mal-estar e a fraqueza que apareceram em 10 doentes; entre os pacientes tratados com Nifedipina 17 apresentaram queixas de cefaléia e 14 pacientes apresentaram vertigem e flushing
Subject(s)
Adult , Aged , Antihypertensive Agents/therapeutic use , Hypertension/diagnosis , Hypertension/drug therapy , Multicenter Studies as Topic , Nifedipine/therapeutic use , Nifedipine/adverse effects , Placebos/therapeutic useSubject(s)
Hypertension/drug therapy , Myocardial Contraction/drug effects , Pindolol/pharmacology , Propranolol/pharmacology , Vascular Resistance/drug effects , Adult , Blood Pressure/drug effects , Echocardiography , Female , Humans , Hypertension/physiopathology , Male , Middle Aged , PhonocardiographySubject(s)
Arrhythmias, Cardiac/diagnosis , Electrocardiography , Mitral Valve Prolapse/complications , Adolescent , Adult , Aged , Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/therapy , Cardiac Pacing, Artificial , Exercise Test , Female , Humans , Male , Middle AgedABSTRACT
A frequencia das arritmias, no prolapso de valva mitral, em 51 pacientes (41 do sexo feminino e 10 do sexo masculino, com idade media de 35 anos), foi avaliada por meio de eletrocardiografia dinamica (sistema Holter) por 12 horas. Disturbios de ritmo foram evidenciado em 30 (58,8%) dos casos: arritmias ventriculares em 70,0%; taquicardia sinusal em 10%; bradicardia sinusal em 6,7%; fibrilacao atrial em 3,3%. Nao se observou correlacao significativa entre os sintomas referidos durante o exame e a presenca de arritmias. Formulam-se comentarios sobre a genese das arritmias na sindrome e sobre a indicacao terapeutica
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Arrhythmias, Cardiac , Mitral Valve Prolapse , ElectrocardiographySubject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Exercise Test , Mitral Valve ProlapseSubject(s)
Mitral Valve Prolapse , Anesthesia , Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/etiology , Death, Sudden/etiology , Female , Humans , Mitral Valve Prolapse/complications , Mitral Valve Prolapse/drug therapy , Pregnancy , Pregnancy Complications, Cardiovascular , Sympatholytics/therapeutic useSubject(s)
Amiloride/therapeutic use , Hydrochlorothiazide/therapeutic use , Hypertension/drug therapy , Pyrazines/therapeutic use , Adult , Aged , Blood Pressure/drug effects , Clinical Trials as Topic , Drug Combinations/therapeutic use , Female , Humans , Male , Middle Aged , Potassium/metabolism , Sodium/bloodSubject(s)
Humans , Female , Pregnancy , Mitral Valve Prolapse , Pregnancy Complications, CardiovascularSubject(s)
Electric Injuries/complications , Myocardial Infarction/etiology , Adult , Coronary Angiography , Electrocardiography , Heart Rate , Humans , MaleSubject(s)
Electrocardiography , Exercise Test , Wolff-Parkinson-White Syndrome/physiopathology , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
E relatado o caso de um paciente de 27 anos, sem fatores de risco e antecedentes de coronariopatia na familia, acometido de infarto do miocardio transmural apos eletrocussao acidental. A cinecoronariografia realizada 30 dias apos, mostrou arterias coronarias normais e acinesia antero-apical. Os autores discutem a etiopatogenia, dando enfase a possibilidade de vasoespasmo coronario ou trombose coronaria com recanalizacao
Subject(s)
Humans , Male , Adult , Electric Injuries , Myocardial InfarctionABSTRACT
Foram submetidos a teste cicloergometrico continuo (protocolo habitual) 30 pacientes (22 do sexo masculino) portadores da sindrome de Wolff-Parkinson_white (WPW). A idade variou de 13 a 70 anos. Nao havia evidencia de outras doencas nem estavam em tratamento com antiarritmicos. Durante o teste, nao foram observados sinais de comprometimento da funcao cardiaca nem arritmias significativas (4 pacientes haviam apresentado previamente taquiarritmias paroxisticas comprovadas). A onda delta permaneceu inalterada em 19 pacientes e nos 3 casos de WPW intermitente, o esforco nao determinou o seu aparecimento. Em 8 pacientes, submetidos a teste maximo, desapareceu a onda delta durante o esforco (mantendo-se o segmento PR curto), com frequencia cardiaca superior a 150 bpm. Neste subgrupo, a onda delta reapareceu apos o esforco (1 a 4 min), ainda com frequencia cardiaca superior a 100 bpm. Foi encontrada em 9 pacientes (30%) resposta isquemica indiscutivel, 1 deles evidenciou desaparecimento da onda delta durante o esforco. Os autores comentam a fisiopatologia das alteracoes eletrocardiograficas encontradas durante o exercicio e o mecanismo determinante de arritmias, concluindo que o teste ergometrico nao parece ser um metodo eficiente para inducao de arritmias e para analise de drogas antiarritmicas em portadores de WPW
