Assuntos
Anticolesterolemiantes/administração & dosagem , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Rosuvastatina Cálcica/administração & dosagem , Anticolesterolemiantes/efeitos adversos , Relação Dose-Resposta a Droga , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Rosuvastatina Cálcica/efeitos adversosRESUMO
Diabetes mellitus (DM) is one of the major risk factors for COVID-19 complications as it is one of the chronic immune-compromising conditions especially if patients have uncontrolled diabetes, poor HbA1c and/or irregular blood glucose levels. Diabetic patients' mortality rates with COVID-19 are higher than those of cardiovascular or cancer patients. Recently, Bacillus Calmette-Guérin (BCG) vaccine has shown successful results in reversing diabetes in both rats and clinical trials based on different mechanisms from aerobic glycolysis to beta cells regeneration. BCG is a multi-face vaccine that has been used extensively in protection from tuberculosis (TB) and leprosy and has been repositioned for treatment of bladder cancer, diabetes and multiple sclerosis. Recently, COVID-19 epidemiological studies confirmed that universal BCG vaccination reduced morbidity and mortality in certain geographical areas. Countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies that have shown low numbers of reported COVID-19 cases. Some countries have started clinical trials that included a single dose BCG vaccine as prophylaxis from COVID-19 or an attempt to minimize its side effects. This proposed research aims to use BCG vaccine as a double-edged weapon countering both COVID-19 and diabetes, not only as protection but also as therapeutic vaccination. The work includes a case study of regenerated pancreatic beta cells based on improved C-peptide and PCPRI laboratory findings after BCG vaccination for a 9 year old patient. The patient was re-vaccinated based on a negative tuberculin test and no scar at the site of injection of the 1st BCG vaccination at birth. The authors suggest and invite the scientific community to take into consideration the concept of direct BCG re-vaccination (after 4 weeks) because of the reported gene expressions and exaggerated innate immunity consequently. As the diabetic MODY-5 patient (mutation of HNF1B, Val2Leu) was on low dose Riomet® while eliminating insulin gradually, a simple analytical method for metformin assay was recommended to ensure its concentration before use as it is not approved yet by the Egyptian QC labs.
Assuntos
Vacina BCG/administração & dosagem , Infecções por Coronavirus/imunologia , Diabetes Mellitus/imunologia , Células Secretoras de Insulina/citologia , Pneumonia Viral/imunologia , Animais , Vacina BCG/imunologia , COVID-19 , Criança , Infecções por Coronavirus/complicações , Diabetes Mellitus/fisiopatologia , Humanos , Masculino , Pandemias , Pneumonia Viral/complicações , Ratos , Regeneração/imunologia , Fatores de Risco , Vacinação/métodosRESUMO
Dieulafoy's disease is a vascular anomaly characterized by the presence of a dysplastic artery that is related to an epithelial ulcer. The French surgeon Georges Dieulafoy first described it in 1898. Most frequently, it is a gastrointestinal condition, but occurrence in the bronchus has been reported in a few cases. The case of a 52-year-old man with massive hemoptysis, for which he underwent successful embolotherapy 10 years previously, is described. Over the next 10 years, he had several hospital admissions due to hemoptysis, and he underwent successful embolotherapy on each occasion. This case report underlines the importance of bronchial arteriography as the investigation of choice for massive hemoptysis.
Assuntos
Broncopatias/complicações , Embolização Terapêutica/métodos , Úlcera/complicações , Doenças Vasculares/terapia , Adulto , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Masculino , Reoperação , Resultado do Tratamento , Doenças Vasculares/complicaçõesRESUMO
The transfer coefficient (KCO) was significantly lower in diabetic patients with microangiopathy than in a matched group without this complication. This may reflect microangiopathy in the pulmonary circulation.
Assuntos
Monóxido de Carbono/fisiologia , Diabetes Mellitus/fisiopatologia , Angiopatias Diabéticas/fisiopatologia , Pulmão/fisiopatologia , Troca Gasosa Pulmonar , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The use of methyl xanthine derivatives for the treatment of bronchospasm is limited by unwanted side-effects which are frequently dose related. Potentiation of the bronchodilating effects of these derivatives would therefore have obvious clinical advantages. This paper reports the results of a trial designed to elucidate whether potentiation occurs between aminophylline and ketotifen.
Assuntos
Aminofilina/farmacologia , Cetotifeno/farmacologia , Adolescente , Adulto , Aminofilina/metabolismo , Aminofilina/uso terapêutico , Asma/prevenção & controle , Brônquios/efeitos dos fármacos , Ensaios Clínicos como Assunto , Método Duplo-Cego , Sinergismo Farmacológico , Feminino , Humanos , Cetotifeno/uso terapêutico , Masculino , Pessoa de Meia-Idade , Placebos , Teofilina/sangueRESUMO
A 77-yr-old man presented with severe episodes of hypotension, flushing and sweating starting immediately after infarcting his only remaining functioning testis. The attacks were shown to be mediated by the cervical sympathetic chain, the reaction on the face and neck being abolished by a stellate ganglion block. The severity and frequency of sweating was also considerably reduced with naloxone as may be seen in female climacteric flushing. Injection of testosterone significantly reduced the frequency and severity of the attacks, which were unaltered by oestrogen treatment.
Assuntos
Rubor/prevenção & controle , Gânglios Simpáticos , Naloxona/uso terapêutico , Idoso , Bloqueio Nervoso Autônomo , Humanos , Infusões Parenterais , Masculino , Sudorese/efeitos dos fármacos , Testosterona/uso terapêuticoRESUMO
A toolsetter developed occupational asthma due to the oil mist generated by his lathe on which it was used as a coolant. The diagnosis was confirmed by serial measurements of peak expiratory flow at home and work, including a prolonged period away from work. Occupational type bronchial provocation tests were performed using the whole emulsified oil and its components separately. He reacted specifically to the whole emulsified oil and to the reodorant, a pine oil preparation. He also reacted to colophony, a constituent of the emulsifier.
Assuntos
Asma/induzido quimicamente , Óleo Mineral/efeitos adversos , Doenças Profissionais/induzido quimicamente , Testes de Provocação Brônquica , Emulsões , Humanos , Masculino , Pessoa de Meia-Idade , Óleos/efeitos adversos , Pico do Fluxo Expiratório , Resinas Vegetais/efeitos adversos , Terebintina/efeitos adversosRESUMO
Serial arterial blood gases were measured during fibreoptic bronchoscopy in 26 patients with diffuse interstitial lung disease. All those having transbronchial biopsy with or without bronchoalveolar lavage, performed breathing room air, showed significant falls in PaO2, at the time of passage of the bronchoscope through the vocal cords both at the beginning and end of the procedure. Patients having bronchoalveolar lavage and transbronchial biopsy performed with supplementary oxygen at least maintained their basal PaO2 levels. Cessation of the supplementary oxygen 30 minutes after withdrawal of the bronchoscope did not result in rebound hypoxaemia. Bronchoalveolar lavage and transbronchial biopsy can be performed safely in patients with diffuse interstitial lung disease without significant hypoxaemia developing, if oxygen is started before the procedure and continued for 30 minutes after withdrawal of the bronchoscope.
Assuntos
Broncoscopia/efeitos adversos , Dióxido de Carbono/sangue , Pulmão/patologia , Oxigênio/sangue , Fibrose Pulmonar/sangue , Adulto , Idoso , Biópsia por Agulha , Broncoscopia/métodos , Feminino , Humanos , Hipóxia/etiologia , Masculino , Pessoa de Meia-Idade , Oxigênio/uso terapêutico , Pressão Parcial , Fibrose Pulmonar/patologia , Irrigação TerapêuticaRESUMO
We describe an elderly man, with pre-existing renal failure and atheromatous renal artery stenosis, who developed persistent anuria due to renal artery thrombosis after acute hypotension following captopril administration. Caution should be used when captopril is first administered to patients with impaired renal function in whom renal artery stenosis is known or suspected.