RESUMO
C-Peptide response to oral glucose was measured in 45 elderly diabetics, in whom final treatment was established on clinical grounds during a 16-18 months follow-up. The diabetic patients comprised 19 ultimately classified as insulin-dependent (IDD) (group 1) and 26 regarded as non-insulin-dependent (NIDD) (group 2). Fifteen matched controls (group 3) and 15 young controls (group 4) were similarly studied. Fasting C-peptide values were lower in groups 1 and 2 (1.48 +/- 0.39 and 2.14 +/- 0.22 ng/ml; mean +/- SEM, respectively) compared with groups 3 and 4 (2.51 +/- 0.16 and 2.71 +/- 0.20 ng/ml, respectively) (p less than 0.001). Peak C-peptide levels were reached at 30 min in healthy young and at 60 min in healthy elderly. All non-diabetic control subjects showed a peak of at least 6.5 ng/ml and an increment of at least 4 ng/ml. The ratio of C-peptide increment/blood glucose increment (100 delta CP/delta BG) at 60 min derived to assess beta-cell function was at least 90 in all healthy subjects. The ratio was less than 10 in 68% of IDD but in only 27% of NIDD patients (p less than 0.01). The 100 delta CP/delta BG was inversely related to the prevailing fasting blood glucose (FBG) (p less than 0.001). These findings suggest that C-peptide response to oral glucose may be a useful test in certain elderly diabetic patients whose insulin dependence is in question.
Assuntos
Peptídeo C/sangue , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/sangue , Teste de Tolerância a Glucose , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Ilhotas Pancreáticas/fisiopatologia , MasculinoRESUMO
Endralazine and hydralazine were compared in a randomized double-blind, parallel group study lasting 1 year in 30 patients with essential hypertension inadequately controlled by a beta-blocker and a diuretic. Dosage ranged from 10 mg to 30 mg endralazine per day and from 75 mg to 200 mg hydralazine per day according to patient response. The results showed that endralazine was at least as effective as hydralazine in reducing blood pressure. Patients' tolerance, assessed by drop-out rate, was significantly better (p less than 0.05) in the endralazine group. No cases were found of drug-induced lupus-like syndrome on endralazine as opposed to 2 cases with hydralazine. The dose of endralazine required much less adjustment than that of hydralazine.
Assuntos
Hidralazina/uso terapêutico , Hipertensão/tratamento farmacológico , Piridazinas/uso terapêutico , Antagonistas Adrenérgicos beta/uso terapêutico , Adulto , Idoso , Anticorpos Antinucleares/análise , Diuréticos/uso terapêutico , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Hidralazina/efeitos adversos , Hidralazina/imunologia , Masculino , Pessoa de Meia-Idade , Piridazinas/efeitos adversos , Piridazinas/imunologia , Distribuição AleatóriaAssuntos
Clopamida/uso terapêutico , Complicações do Diabetes , Hipertensão/tratamento farmacológico , Obesidade , Pindolol/uso terapêutico , Adulto , Idoso , Ensaios Clínicos como Assunto , Combinação de Medicamentos , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-IdadeRESUMO
A 33-year old man developed acute epiglottitis of sudden onset which resulted in severe respiratory distress. A small endotracheal tube was passed as an emergency procedure. Respiratory arrest developed after he pulled it out 12 hr later. Subsequent progress was satisfactory following endotracheal intubation and treatment with ampicillin and hydrocortisone. Blood cultures grew Haemophilus influenzae.
