ABSTRACT
The incidence of snake bites grows more and more. The effects of the snake poison depend on the snake species. They can be cardio-, neuro-, myo-, tissue-, and/or cytotoxic, as well as hemorrhagically. In most cases a symptomatically therapy together with close controls of the labor parameters and a good monitoring is enough. Antivenom-therapy should be reserved for cases with strong indication.
Subject(s)
Crotalus , Snake Bites/diagnosis , Adult , Animals , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Antivenins/administration & dosage , Blood Coagulation Tests , Crotalid Venoms , Humans , Male , Prednisolone/administration & dosage , Prednisolone/therapeutic use , Snake Bites/blood , Snake Bites/therapy , Time FactorsSubject(s)
Adrenal Gland Neoplasms/diagnosis , Headache/etiology , Hypertension/etiology , Hypokalemia/etiology , Pheochromocytoma/diagnosis , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/surgery , Adrenal Glands/pathology , Adrenalectomy , Adult , Diagnosis, Differential , Female , Humans , Pheochromocytoma/pathology , Pheochromocytoma/surgeryABSTRACT
On the occasion of a treatment of frequent infections of the upper respiratory tract an antibody deficiency syndrome was noticed in a 32-year-old female patient. Further investigations revealed a variable immunodeficiency syndrome, a disease belonging to the primary humoral immune defects and presenting with multiple clinical manifestations. Leading symptoms, however, are recurring respiratory infections that may lead to bronchiectasis. Therapy consists in the prevention of infections by periodical intravenous substitution with 7-S immunoglobulins and opportune prescription of antibiotics.
Subject(s)
Common Variable Immunodeficiency/immunology , Respiratory Tract Infections/immunology , gamma-Globulins/deficiency , Adult , Common Variable Immunodeficiency/diagnosis , Common Variable Immunodeficiency/therapy , Female , Humans , Immunoglobulin G/therapeutic use , RecurrenceABSTRACT
A 25-year-old patient presented with fever over a period of more than three months, night sweats, fatigue and a weight loss of more than 10 kg. A splenomegaly and an enlargement of cervical, thoracic and abdominal lymph nodes were found. The suspected malignant hematologic disorder could not be confirmed. Instead, epithelioid noncaseating granulomas in the bone marrow and a cervical lymph node as well as an elevated serum ACE and a lymphocytic alveolitis were found. These findings led us to the conclusion that the patient was suffering from sarcoidosis. Treatment with corticosteroids resulted in complete regression of all symptoms, including the splenomegaly and the enlargement of the lymph nodes. Sarcoidosis is an important consideration in differential diagnosis of fever of unknown origin, even in the absence of pathological changes on X-ray films of the chest.
Subject(s)
Fever of Unknown Origin/diagnosis , Lymphadenitis/diagnosis , Sarcoidosis/diagnosis , Adult , Diagnosis, Differential , Glucocorticoids/therapeutic use , Hematologic Diseases/diagnosis , Humans , Lymphadenitis/etiology , Lymphadenitis/pathology , Male , Sarcoidosis/drug therapy , Tuberculosis/diagnosisABSTRACT
A 24 year old patient with epigastric pain, polyuria, polydipsia and hypercalcemia was admitted to the hospital. Besides the frequent causes of hypercalcemia such as primary hyperparathyroidism and malignancy-related hypercalcemia we had to consider sarcoidosis because of massive splenomegaly. The interstitial lung disease shown on x-ray films of the chest, the epithelioid granulomas in lung tissue and the increased ACE confirmed the diagnosis of sarcoidosis. Hypercalcemia is found in less than 5% of all cases with sarcoidosis. After treatment with steroids, diphosphonates and diuretics all symptoms and the hypercalcemia improved.
Subject(s)
Drinking , Hypercalcemia/complications , Polyuria/etiology , Sarcoidosis/complications , Adult , Diagnosis, Differential , Humans , Hypercalcemia/physiopathology , Male , Sarcoidosis/diagnosis , Sarcoidosis/physiopathologyABSTRACT
A 65-year-old man had abdominal pain and night sweat for several weeks. He had lost weight and also reported black stools. Anemia of iron deficiency was found in laboratory tests. Further investigation revealed a stenosing process in the small intestine as source of bleeding. High grade non-Hodgkins' lymphoma was diagnosed histologically in the resected bowel segment and the mesenteric lymph nodes. Further staging did not reveal further manifestations of lymphoma. Polychemotherapy and subsequent irradiation were administered.
Subject(s)
Gastrointestinal Neoplasms/complications , Lymphoma, Non-Hodgkin/complications , Melena/etiology , Abdominal Pain/etiology , Aged , Diagnosis, Differential , Gastrointestinal Neoplasms/diagnosis , Humans , Lymphoma, Non-Hodgkin/diagnosis , MaleABSTRACT
A young male patient from Somalia presented with a productive cough since a few days, and he complained about vomiting after meals and a rapid loss of weight of 20 kg. Endoscopic, radiological and clinical examinations revealed a broncho-esophageal fistula. Further examinations showed mycobacterium tuberculosis as the underlying cause of the disease; a malignancy was excluded. Antituberculous treatment resulted in the loss of the present symptoms as well as in a clinical and endoscopic closure of the fistula.
Subject(s)
Bronchial Fistula/etiology , Esophageal Fistula/etiology , Tuberculosis, Lymph Node/complications , Adult , Bronchial Fistula/diagnosis , Cough/etiology , Diagnosis, Differential , Esophageal Fistula/diagnosis , Humans , Male , Mediastinal Diseases/complications , Mediastinal Diseases/diagnosis , Tuberculosis, Lymph Node/diagnosis , Vomiting/etiology , Weight LossABSTRACT
Lung perfusion scintigraphy in a patient suffering from superior vena cava obstruction showed distinct MAA uptake in parts of the liver due to a collateral blood flow through abdominal parietal veins and a recanalized umbilical vein. Radiation therapy of mediastinal lymphomas was followed by a rapid decrease of caval portal shunt volume.
Subject(s)
Liver/metabolism , Portacaval Shunt, Surgical , Technetium Tc 99m Aggregated Albumin/pharmacokinetics , Umbilical Veins , Female , Humans , Middle AgedABSTRACT
OBJECTIVE: Evidence suggests that calcium antagonists may suppress vascular smooth muscle cell (VSMC) growth and proliferation, which may be a crucial step in the pathogenesis of hypertension and atherosclerosis. DESIGN: The effects of the dihydropyridine calcium antagonists nifedipine, nitrendipine, nisoldipine, nimodipine and isradipine on cell growth induced by platelet-derived growth factor (PDGF)-AB and angiotensin II (Ang II), and expression of the transcription factors c-fos and early-growth response gene 1 (egr-1) were investigated. METHODS: Proliferation of VSMC in culture was measured by [3H]-thymidine incorporation into cell DNA and by cell count. Expression of c-fos and egr-1 messenger RNA (mRNA) was determined by the Northern blot technique. RESULTS: All of the calcium antagonists blunted the PDGF-induced rise in VSMC DNA synthesis. The inhibitory potency of isradipine on PDGF-stimulated DNA synthesis was approximately 10-fold that of the other calcium antagonists used, isradipine having a half-maximal inhibitory concentration (IC50) of (4.2 +/- 0.16) x 10(-7) mol/l. The calcium antagonists investigated also inhibited Ang II-induced DNA synthesis. Isradipine (10(-6) mol/l) completely abolished the PDGF-induced cell proliferation. Both PDGF (50 ng/ml) and Ang II (10(-7) mol/l) induced c-fos and egr-1 mRNA expression, having maximum effect after 30 min. In the case of c-fos, pre-incubation with 5 x 10(-6) mol/l isradipine led to a decrease in both Ang II- and PDGF-induced expression of this immediate-early gene. The expression of egr-1 was not affected by pre-incubation with 5 x 10(-6) mol/l isradipine. CONCLUSIONS: All calcium antagonists investigated in the present study inhibited cell growth. Isradipine was more potent in blocking growth factor-induced cell growth than the other calcium antagonists studied. The inhibitory effect of the dihydropyridine calcium antagonists appears to be dependent on the expression of c-fos.
