[Cineventriculography with radionuclides and intravenous dipyridamole in the prognostic evaluation after acute myocardial infarction]. / Cineventriculografia com radionuclídeos e dipiridamol venoso na avaliação prognóstica após infarto agudo do miocárdio.

PURPOSE: To evaluate safety and usefulness of dipyridamole-radionuclide ventriculography (D-RVG), soon after acute myocardial infarction (MI), in the prediction of future cardiac events. Traditionally performed tests were also compared. PATIENTS AND METHODS: Forty-one patients (4 females) with recent MI underwent rest and dipyridamole (0.58 mg/kg of body weight) radionuclide ventriculography. The criteria for a positive test for ischemia was failure to increase left ventricular ejection fraction in 0.05 from baseline value. All patients had also coronary angiography and 36 patients underwent thallium-201 scintigraphy for comparison. The mean follow-up was 16 +/- 3 months. The following findings were considered future for events: cardiac death, reinfarction, significant angina or heart failure. RESULTS: During the follow-up 18 of the 20 patients who had cardiac events had shown positive dipyridamole-RVG, as opposed to 5 of 21 event-free patients (p less than 0.01). The ventriculographic criteria for a positive test and dipyridamole left ventricular ejection fraction were the strongest predictors of those medical events (p less than 0.01 and p less than 0.001). Among the 36 patients who had thallium-201 imaging, 16 subsequently had cardiac events and the scans were positive in 82% (p less than 0.01). Twelve (29%) patients experienced reactions during dipyridamole infusion although no fatal complications were noted. CONCLUSION: Dipyridamole-RVG is relatively safe and a sensitive predictor of future cardiac events soon after acute MI, although additional experience is required before this new technique should be routinely recommended as an alternative approach.

Doenca de Basedow-Graves: grave comprometimento sistemico cutaneo e ocular. / Basedow-Graves' disease: severe systemic cutaneous and ocular involvement

Os autores apresentam dois casos de oftalmopatia infiltrativa de Graves-Basedow em sua forma mais grave e exuberante associada a dermopatia (mucinosis cutis: tanto na forma localizada - mixedema pre-tibial, como na forma tuberosa intensa) e a acropaquia tireotoxica. Discutem a etiopatogenia de cada uma dessas condicoes e consideram as varias medidas terapeuticas locais e sistemicas preconizadas nesses casos

Contribuicao dos metodos radiomarcados na avaliacao da funcao testicular. / Radioimmunoassay contribution to the evaluation of testicular function

A funcao androgenica no homem depende da sindrome da testosterona nas celulas de Leydig do testiculo, sob a influencia ganodotrofica do LH hipofisario, melhor denominado no homem ICSH (interstitial cell stimulating hormone).Entretanto, existe uma importante contribuicao da cortex supra-renal, atraves de esteroides C-19 oriundos da camada reticular e eliminados na urina - a semelhanca da testosterona - sob a forma de 17-cetosteroides neutros. A oportunidade de estudar maridos de casais estereis, selecionados pela normalidade do espermograma, permitiu-se reunir 50 observacoes de homens adultos, de idade conhecida, com dosagens de 17-cetosteroides urinarios (metodo quimico) e FSH, LH e testosterona plasmaticos (metodo RIA) na faixa de normalidade dos metodos respectivos. Foram avaliadas as principais correlacoes, concluindo-se pela existencia de significancia, em determinados limites, apenas da relacao LH/testosterona, o que seria de se esperar no quadro fisiologico conhecido. A fixacao de padroes de normalidade e logicamente o substrato basico para ulterior aplicacao propedeutica