RESUMO
Dehydroepiandrosterone (DHEA) is a weak androgen, but is one of the main precursors of testosterone. Athletes use it for its androgenic and anticatabolic effects and it has been described as a "wonder drug", although there is little evidence to support these claims. There are no published studies of the long-term effects of taking DHEA, particularly in the large doses used by athletes, or of its possible interactions with other agents.
Assuntos
Desidroepiandrosterona , Esportes , Austrália , Desidroepiandrosterona/sangue , Desidroepiandrosterona/metabolismo , Desidroepiandrosterona/uso terapêutico , Humanos , Internet , Testosterona/metabolismoAssuntos
Alumínio/sangue , Doenças Ósseas/diagnóstico , Calcâneo/lesões , Fraturas de Estresse/diagnóstico , Adulto , Idoso , Doenças Ósseas/sangue , Doenças Ósseas/diagnóstico por imagem , Diagnóstico Diferencial , Fraturas de Estresse/sangue , Fraturas de Estresse/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Pancytopenia is an unusual complication of low-dose methotrexate therapy in rheumatoid arthritis. We report a near fatal case that followed an accidental overdose. CLINICAL FEATURES: An 80-year-old Caucasian woman with rheumatoid arthritis presented with pancytopenia and severe mucositis. She had taken her weekly methotrexate dose on four sequential days, due to an error in filling a "Dosette" box. INTERVENTION AND OUTCOME: Following treatment with piperacillin, gentamicin and folinic acid, she recovered completely. CONCLUSIONS: Low-dose methotrexate therapy is uncommonly associated with haematological toxicity. This generally occurs in patients with known risk factors for such reactions. Patient reliability should be considered if methotrexate therapy is contemplated.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Metotrexato/efeitos adversos , Pancitopenia/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Overdose de Drogas , Feminino , Humanos , Erros de Medicação , Metotrexato/administração & dosagem , Metotrexato/uso terapêuticoRESUMO
English and Australian cricket teams on tour used to travel by ship, and many enjoying shipboard life, reached their destination considerably overweight and thus unfit and vulnerable to injury in their sport. Now they travel by air and most national teams employ a fitness coach to supervise sessions of rigorous exercise before and during the season. However the international cricket season is longer than it was and the incidence of overuse injuries is increasing.
Assuntos
Traumatismos em Atletas , Traumatismos em Atletas/etiologia , Extremidades/lesões , Humanos , Doença de Scheuermann/etiologia , Espondilólise/etiologia , Espondilólise/patologiaAssuntos
Corticosteroides/administração & dosagem , Abscesso/induzido quimicamente , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Aracnoidite/induzido quimicamente , Dura-Máter , Fístula/induzido quimicamente , Humanos , Injeções , Deslocamento do Disco Intervertebral/tratamento farmacológico , Vértebras Lombares , Metilprednisolona/administração & dosagem , Metilprednisolona/efeitos adversos , Metilprednisolona/análogos & derivados , Metilprednisolona/uso terapêutico , Acetato de Metilprednisolona , Dor/induzido quimicamente , Ciática/tratamento farmacológico , Medula Espinal , Espaço Subaracnóideo , Triancinolona/administração & dosagem , Triancinolona/efeitos adversos , Triancinolona/análogos & derivados , Triancinolona/uso terapêuticoRESUMO
The effect of enteric coating of aspirin tablets on the gastrointestinal blood loss associated with high dose aspirin therapy was investigated in 12 patients with rheumatoid arthritis. Occult blood loss was measured after labelling the patients' red blood cells with Cr51. Three salicylate preparations were used: enteric coated tablets of aspirin ("Rhusal", G.P. Laboratories, 7 x 650 mg per day), uncoated tablet cores of aspirin from the same batch (7 x 650 mg per day) and enteric coated tablets of sodium salicylate (7 x 600 mg and 1 x 300 mg per day). Daily blood loss during a salicylate-free period was (0.7 +/- 0.15 ml, mean +/- SE). Blood loss was significantly increased during dosage with all three salicylate preparations. Daily blood loss during dosage with the uncoated tablets of aspirin (5.3 +/- 0.3 ml) was significantly greater than during dosage with the enteric coated tablets of aspirin (2.3 +/- 0.3 ml) and enteric coated tablets of sodium salicylate (2.1 +/- 0.4 ml). The bioavailability of the salicylate preparations was studied in seven of the 12 patients. Mean plasma salicylate concentration two hours after the second daily dose during dosage with the enteric coated tablets of aspirin was 118 +/- 15 microgram/ml compared to 131 +/- 16 microgram/ml during dosage with the uncoated tablets. Urinary recoveries of the daily dosage of aspirin in the two formulations were also similar.
Assuntos
Aspirina/administração & dosagem , Hemorragia Gastrointestinal/prevenção & controle , Sangue Oculto , Idoso , Aspirina/metabolismo , Disponibilidade Biológica , Ensaios Clínicos como Assunto , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Salicilatos/administração & dosagem , Salicilatos/metabolismo , Comprimidos com Revestimento EntéricoRESUMO
A severe type of rheumatoid arthritis which is seen in 25% of cases that present with the disease after the age of 60 is a self-limiting illness. It can be well controlled during the acute severe phase and has a good prognosis. This paper describes 29 patients with this pattern of disease who were separated from a larger group of 110 elderly onset cases.