ABSTRACT
An increasingly greater fraction of the general population is getting involved in the immunization program. However, conditions of individual subjects are not always properly evaluated prior to immunization. The clinical case reported below demonstrates the difficulty of diagnostic examination of patients with Graves disease (toxic goiter), endocrine ophthalmopathy, and post-immunization reaction.
Subject(s)
Graves Disease/diagnosis , Influenza Vaccines/adverse effects , Vaccination/adverse effects , Adult , Autoimmunity/drug effects , Diagnosis, Differential , Follow-Up Studies , Graves Disease/blood , Graves Disease/chemically induced , Graves Disease/immunology , Humans , Male , Thyroid Hormones/bloodABSTRACT
To study the effectiveness of ACE-inhibitors in diabetic nephropathy (DN) 12 male and 16 female patients aged 13-21 years with DN having normal blood pressure (BP) were given ramipril (tritace) in a dose 2.5-5 mg/day in the course of 12-24 weeks. Efficacy and safety of the treatment were assessed by changes in albuminuria and proteinuria, BP. Reduction of albuminuria occurred in 19(79.1%) out of 24 patients with microalbuminuria, in 13(54.1%) of them urine excretion of albumin returned to normal levels. All the patients with proteinuria and macroalbuminuria benefited from ramipril therapy because their proteinuria diminished or even disappeared (2 cases). The persistence of the antiproteinuria effect on posttreatment week 12 was 66.6%. Ramipril effect on BP was minimal. It is inferred that ramipril is effective in the treatment of DN at the stage of microalbuminuria and proteinuria in patients with normal BP.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Diabetic Nephropathies/drug therapy , Ramipril/therapeutic use , Adolescent , Adult , Blood Pressure , Child , Female , Humans , Male , Time Factors , Treatment OutcomeABSTRACT
The use of various regimens of multiple insulin injections versus the regimen of a single injection resulted in more stable compensation of diabetes mellitus (glycemia stabilization), a decrease in insulin demand, smoothing over circadian glycemic variations, and correction of hypoglycemia. A choice of the number of injections and the time of administration depended on the type of a diabetic course, individual features of the patient's life style and work.
