RESUMO
We report hypokalaemic quadriparesis presenting in a 43-year-old woman. Evaluation revealed hypokalaemic quadriparesis secondary to underlying distal renal tubular acidosis, also known as type 1 RTA. Four years after the diagnosis of RTA, the patient developed joint pain, and investigation revealed systemic lupus erythematosus with lupus nephritis. RTA is one of the very rare presentations of systemic lupus erythematosus. Thus, tubular dysfunction should be carefully assessed in patients with systemic lupus erythematosus. Similarly, patients with RTA should be evaluated for underlying lupus. Our patient was successfully treated with mycophenolate mofetil and steroids.
Assuntos
Acidose Tubular Renal/complicações , Hipopotassemia/complicações , Lúpus Eritematoso Sistêmico/complicações , Paralisia/complicações , Acidose Tubular Renal/patologia , Doença Aguda , Adulto , Sedimentação Sanguínea , Feminino , Humanos , Hipopotassemia/patologia , Lúpus Eritematoso Sistêmico/patologia , Músculos/patologia , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/farmacologia , Paralisia/patologia , Proteinúria/complicações , Esteroides/farmacologia , Resultado do TratamentoRESUMO
Nineteen women receiving their first cycle of adjuvant chemotherapy for early breast cancer were randomized between two antiemetic drugs: methylprednisolone (MPN) 125mg and metoclopramide (MCP) 20mg, both given by intravenous push as a single dose. The chemotherapy included: cyclophosphamide, methotrexate and 5-fluorouracil (CMF). The total response rates for MPN and MCP were: complete protection 11% versus 0% and partial protection 63% versus 11% of the patients, respectively (P = 0.007). Eighteen patients (95%) preferred MPN over MCP. Common side effects with both drugs were: drowsiness, headache and diarrhea. MPN is recommended as an antiemetic in patients receiving CMF adjuvant chemotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Metilprednisolona/uso terapêutico , Metoclopramida/uso terapêutico , Vômito/prevenção & controle , Adulto , Neoplasias da Mama/tratamento farmacológico , Ciclofosfamida/efeitos adversos , Feminino , Fluoruracila/efeitos adversos , Humanos , Metotrexato/efeitos adversos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Vômito/induzido quimicamenteRESUMO
Seventy-six consecutive patients receiving chemotherapy were evaluated for the antiemetic efficacy and side-effects of the combination of chlorpromazine (CPM) and methylprednisolone (MPN). All patients had previously received the same chemotherapy with metoclopramide in conventional dosage and experienced severe emesis. A significant antiemetic response was achieved in 70% of the patients, and in 28% of them the antiemetic protection was complete. The most common side effects were drowsiness, dry mouth and headache. The combination of CPM and MPN is effective, well tolerated and is recommended for outpatients receiving chemotherapy for cancer.
Assuntos
Clorpromazina/uso terapêutico , Metilprednisolona/uso terapêutico , Náusea/tratamento farmacológico , Vômito/tratamento farmacológico , Adolescente , Adulto , Idoso , Antineoplásicos/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Estudos Prospectivos , Vômito/induzido quimicamenteRESUMO
We studied the glucose dependence of insulin and somatostatin release from rat pancreata, which were perfused in vitro in the presence of 3-isobutyl-1-methylxanthine (IBMX; 0.5 mM). Half-maximal insulin release occurred at approx. 12 mM glucose, and half-maximal somatostatin release at approx. 7 mM glucose.
