ABSTRACT
The authors report the case of a 30 year-old man, who had recently been to Africa, admitted due to fever and pain in the epigastrium and in the right hypocondrius. The evaluation led to the diagnosis of hepatic amebiasis. The patient was treated accordingly with success. The authors further review hepatic amebiasis, including the epidemiology, diagnostic means and ways of treatment, focusing on medical and surgical approaches and their controversies. The interest of the description of such a clinical case and the review that was made is derived from the current impact of globalization of the economy and its respective consequences due frequent trips to endemic countries. A detailed clinical history, including the epidemiology, is paramount for the suspicion of this diagnosis. Immediate treatment is mandatory, without which the patient may be at risk of serious complications.
Subject(s)
Liver Abscess, Amebic/diagnosis , Adult , Humans , Liver Abscess, Amebic/diagnostic imaging , Liver Abscess, Amebic/etiology , Male , Travel , UltrasonographyABSTRACT
A clinical pharmacology review of thiazide diuretics is presented in this paper, highlighting the mechanism of action, dosage considerations in order to optimize both the monotherapy or combination treatment, most relevant metabolic effects and adverse reactions, and clinically significant drug interactions. Reference is made to several attemps of limiting or reducing the popularity of their use which took place in mid eighties. At present, there are no data to substantiate that diuretics are implicated for the lack of a consistent reduction in coronary heart disease events. As a consequence of the renewed interest in the development of drugs with diuretic antihypertensive action, the physiologic changes associated with the use of indapamide have been briefly characterized. This agent is also perceived as having more favourable neutral metabolic profile at subnatriuretic dosage. After careful consideration of relevant scientific evidence and a critical appraisal of individualized approach to antihypertensive therapy, diuretics should be given serious consideration as valid alternative to modern antihypertensive agents in years to come.