ABSTRACT
BACKGROUND: Ciguatera fish poisoning is a clinical syndrome associated with the consumption of contaminated fish. The clinical picture is a constellation of gastrointestinal, neurologic and cardiovascular symptoms. AIM: To report 10 cases of ciguatera poisoning in our country. METHOD: We recorded the clinical course during the severe acute symptoms with a follow up of 34 months. RESULTS: The time between the ingestion of contaminated fish and symptoms varied from 20 minutes to 12 hours. All suffered gastrointestinal disturbances as the main manifestation. Watery diarrhea was the earliest complaint. Cold-to-hot temperature reversal dysesthesia occurred in all but there were differences in the occurrence of nausea, vomiting, cramping, abdominal pain, weakness, paresthesia, arthralgia, myalgia, dizziness, dysuria, dyspnea, headache, pruritus, lip numbness, dry mouth, dental pain, chills, tremors, fasciculations, blurred vision, hypersalivation and dysphagia. CONCLUSION: 1. There were some differences in the clinical picture of our cases mainly in the initial symptoms and their severity. 2. Gastrointestinal symptoms were the most common complaint. 3. We did not find associations between the amount of toxic fish ingested with the latency period and the severity and duration of the symptoms.
Subject(s)
Ciguatera Poisoning , Seafood/poisoning , Adolescent , Adult , Animals , Child, Preschool , Female , Fishes , Foodborne Diseases/physiopathology , Humans , Male , Mexico , Middle AgedABSTRACT
Forty patients with mild or moderate essential hypertension were studied. They received daily doses of either 240 mg verapamil or 10 mg enalapril, as well as a placebo. Total duration of trial was 24 weeks: a "washout" period of 2 weeks, a treatment period of 6 weeks with one of the two drugs, another "washout" period of 2 weeks, and another treatment period of 6 weeks with the alternate drug. Those patients with persistence of diastolic blood pressure (DBP) above 90 mmHg received simultaneously both drugs for an additional period of 8 weeks. Patients were assigned alternately to one of the groups. When each drug was given during the first treatment period, DBP was reduced below 90 mmHg in 15 of 19 patients receiving verapamil, and in 12 of 20 that received enalapril. When the drugs were given during the second treatment period, DBP became normal in 16 of 19 patients receiving enalapril, and in all the 18 patients treated with verapamil. Three patients achieved normal DBP when received simultaneously both drugs. Two patients withdrew from the trial for personal reasons and one for experimenting cough as reaction to enalapril. There were no other undesirable side effects. Laboratory tests did not show changes. Both products were similarly effective. Synergy was shown by the improvement of patients unresponsive to either drug when given singly, but responding when both were given simultaneously.
Subject(s)
Hypertension/drug therapy , Adult , Aged , Analysis of Variance , Blood Pressure/drug effects , Drug Evaluation , Drug Synergism , Drug Therapy, Combination , Enalapril/therapeutic use , Female , Humans , Hypertension/epidemiology , Hypertension/physiopathology , Male , Middle Aged , Verapamil/therapeutic useABSTRACT
We assessed the efficacy and safety of cilazapril, alone or in combination with hydrochlorothiazide. It was an open trial, that included 14 patients with or more 114 mmHg of diastolic arterial tension. On the first stage of 25 days, the arterial tension was normalized in 5 patients with 10 mg of cilazapril and 7 patients when hydrochlorothiazide was added, 2 patients did not respond. On the second stage of 52 weeks, of the 12 patients whose diastolic arterial tension was normalized, 2 patients remained with normal arterial tension with cilazapril, 5 when hydrochlorothiazide was added and the rest 5 patients did not respond. No undesirable side effects were detected, nor abnormalities in the laboratory tests. The long-term benefit obtained on 50% of patients make evident the usefulness of cilazapril in severe arterial hypertension. Its administration once a day and the absence of side effects increase the interest of its use.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Hypertension/drug therapy , Pyridazines/therapeutic use , Adult , Aged , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Cilazapril , Drug Therapy, Combination , Female , Humans , Hydrochlorothiazide/administration & dosage , Male , Middle Aged , Pyridazines/administration & dosageABSTRACT
This paper was designed to investigate the correlation between the renal clearance and the plasma concentration of creatinine. Of the curve obtained, three segments were studied: 1 - When the glomerular filtration rate (GFR) was greater than 60 ml per min. the plasma concentration fluctuated between 0.44 and 1.59 mg/dl. 2 - When GFR was between 30 and 60 ml per min. the plasma concentration reached 2.4 mg/dl, and 3 - When GFR was less than 30 ml per min. the plasma level increased to values as high as 28 ml/min. The urinary concentration of creatinine can be divided into two broad groups depending on the GFR. The boundary of this division is around 60 ml per min. This suggests that when GFR is depressed there would exist a limitation of the tubular secretion of creatinine or urinary dilution problems. It is demonstrated that there is a poor correlation between creatinine clearance and its plasma concentration, and hence the repeated measurement of creatinine clearance becomes imperative in the follow-up of patients.
