RESUMO
CASE REPORT: The effect of a somatostatin analogue in a patient with Graves' ophthalmopathy is presented, including data on the dose requirements and the results of therapy. DISCUSSION: There are few effective options for the management of Graves' ophthalmopathy, a cell-mediated immune co-morbidity of thyroid disease. Somatostatin analogues inhibit lymphocyte proliferation and activation, and accumulate in the orbital tissue during the active ophthalmopathy. Because of this, such therapy is able to inactivate the ophthalmopathy without complications occurring.
Assuntos
Oftalmopatia de Graves/tratamento farmacológico , Peptídeos Cíclicos/uso terapêutico , Somatostatina/análogos & derivados , Adulto , Humanos , Masculino , Somatostatina/uso terapêuticoRESUMO
Recent studies suggest an association between Chlamydia pneumoniae infection with atherosclerosis, including cerebrovascular disease. We investigated the prevalence of Chlamydial seropositivity in patients with acute ischaemic stroke syndrome compared with age- and sex-matched control subjects. Specific antibodies (IgA) to C. pneumoniae were measured by microimmunofluorescence in both the clinical group (n=91) and the control group (n=112). Forty patients (43.9%) and 34 controls (30.3%) had positive IgA titres (P < 0.05). The pooled data from this and previous series yielded 45% of seropositivity in cerebrovascular patients vs. 19% in control subjects (P < 0.001). In conclusion, we suggest an association between chronic infection by C. pneumoniae and acute ischaemic stroke.
Assuntos
Isquemia Encefálica/epidemiologia , Isquemia Encefálica/microbiologia , Infecções por Chlamydophila/epidemiologia , Chlamydophila pneumoniae/isolamento & purificação , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/microbiologia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/sangue , Infecções por Chlamydophila/diagnóstico , Infecções por Chlamydophila/imunologia , Chlamydophila pneumoniae/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos SoroepidemiológicosRESUMO
No disponible
Assuntos
Pessoa de Meia-Idade , Adulto , Idoso , Masculino , Feminino , Humanos , Antitireóideos , Recidiva , Prognóstico , Estudos Retrospectivos , Doença de GravesRESUMO
No disponible
No disponible
Assuntos
Adulto , Masculino , Humanos , Tireotropina , Octreotida , Antineoplásicos Hormonais , Adenoma , Neoplasias HipofisáriasRESUMO
In essential hypertensive subjects, acute and chronic administration of losartan was followed by favorable neurohormonal (norepinephrine, endothelin-1) and metabolic changes (microalbuminuria).
Assuntos
Anti-Hipertensivos/uso terapêutico , Endotelina-1/sangue , Hipertensão/sangue , Hipertensão/tratamento farmacológico , Losartan/uso terapêutico , Norepinefrina/sangue , Idoso , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We evaluate the acute hemodynamic and neurohormonal effects of losartan in 15 patients with symptomatic chronic heart failure (CHF), mean age 72+/-8 years, which were classified in two subgroups: (A) Patients with left ventricular ejection fraction (LVEF)< or =0.35 (n = 7); (B) subjects with LVEF>0.35 (n = 8). Sympathetic reactivity (blood pressure, heart rate and plasma norepinephrine) and plasma endothelin-1 (ET-1) were evaluated by a cold pressor test (CPT). Single doses of losartan (50 mg p.o.) lowered delta DBP in both subgroups (A, 8+/-9 to 0+/-5 mm Hg, P<0.05; B, 10+/-6 to 3+/-4 mm Hg, P<0.05) and attenuated the rise of HR in patients with mild (4+/-6 to -1+/-2 bpm, P<0.05) but not with severe (4+/-5 to 2+/-5 bpm, n.s.) impairment of left ventricular function. Losartan blunted the response (delta) of PNE during CPT (A, 142+/-131 to 10+/-74 pg/ml, P<0.05; B, 129+/-72 to 1+/-144 pg/ml, P<0.01). A significant rise in plasma ET-1 was observed during CPT in patients from subgroup B (0.64+/-0.40 to 0.81+/-0.40 fmol/ml, P<0.05) but not in patients with LVEF< or =0.35 (1.79+/-0.44 to 1.51+/-0.66 fmol/ml, n.s.). Losartan attenuated the rise in ET-1 during CPT in patients with LVEF>0.35 (delta ET-1 0.17+/-0.86 to 0.03+/-0.11 fmol/ml, P<0.05), with no significant changes in subgroup A. Acute effects of losartan were characterized by a more favorable hemodynamic and neurohumoral response in patients with chronic heart failure and preserved systolic ventricular function related to subjects with lower ejection fractions.
Assuntos
Angiotensina II/antagonistas & inibidores , Anti-Hipertensivos/farmacologia , Temperatura Baixa , Endotelina-1/sangue , Insuficiência Cardíaca/sangue , Losartan/farmacologia , Norepinefrina/sangue , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/efeitos dos fármacos , Doença Crônica , Teste de Esforço/métodos , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/metabolismo , Sistema Nervoso Simpático/fisiopatologia , Vasoconstrição/efeitos dos fármacosRESUMO
Leukemia is an uncommon complication of exposure to radioiodine (131I), used in treatment of thyroid cancer, because low doses are now used. We report two cases of acute myelogenous leukemia developed after the treatment of a thyroid carcinoma with a small dose of 131I.
Assuntos
Carcinoma Papilar/radioterapia , Radioisótopos do Iodo/efeitos adversos , Leucemia Mieloide Aguda/etiologia , Leucemia Promielocítica Aguda/etiologia , Leucemia Induzida por Radiação/etiologia , Segunda Neoplasia Primária/etiologia , Neoplasias da Glândula Tireoide/radioterapia , Adulto , Feminino , Humanos , Radioisótopos do Iodo/administração & dosagemAssuntos
Anemia Refratária/complicações , Diabetes Insípido/complicações , Idoso , Humanos , MasculinoRESUMO
The surgical treatment of hypophyseal tumors has improved from external approach (transcranial-subtemporal) to the trans-septo-transphenoidal approach. Since the last thirty years this way to access has been increasingly used, because it provides an excellent exposure, little bleeding, is rapidly and easily performed with less morbi-morality and has smoother postoperative period. A retrospective study of 16 patients whose hypophyseal tumors were treated surgically using the trans-septo-sphenoidal transnasal (maxillary-premaxillary) approach is presented. All these patients were seen in the E.N.T. Department of Alicante's General University Hospital, between January 1990 and June 1993. The trans-septo-sphenoidal transnasal via avoids some of the problems of the sublabial trans-sphenoidal procedure; namely longer operating time, oral contamination of the surgical field, subsequence difficulties due to the lack of sensibility and discomfort of the upper jax area and postoperative alterations in the projection of the septal-columelar tip.
Assuntos
Microcirurgia , Septo Nasal/cirurgia , Hipófise/patologia , Hipófise/cirurgia , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Osso Esfenoide/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The steady state concentration of cytochrome c oxidase subunit I mRNA and 12 S rRNA, respectively, measured by a quantitative reverse transcription/polymerase chain reaction method, was 4 and 15 molecules per molecule of mt DNA in rat liver and 2 and 9 molecules in rat muscle, respectively. These results imply that in the mitochondrial compartment, the molar concentration of all thirteen mRNAs by far exceeds the concentration of ribosomes, a situation fundamentally different from the cytosolic compartment. Following thyroid hormone treatment, both mitochondrial transcripts increased, in parallel with the mRNA encoding mitochondrial transcription factor A. We conclude that this transcription factor might be the rate limiting factor for mitochondrial transcription in vivo, at least under these conditions.
