RESUMO
Ultraviolet radiation (UVR) may contribute to multiple sclerosis (MS) outcome by a mechanism involving vitamin D and the vitamin D receptor (VDR). In 512 patients with MS duration of 10 or more years, we studied the association of VDR single nucleotide polymorphisms (A/G(1229), C/G(3444), G/A(3944), CC(20965), CC(30056), F/f(30875), C/T(48200), T/t(65013)) with outcome or disability. ff(30875) frequency was lower in cases with EDSS > or = 6.0 than with scores < 6.0 (odds ratio = 0.38, 95% CI = 0.20-0.70). The association of ff(30875) with outcome was not mediated by cumulative exposure to UVR as assessed by questionnaire; low exposure (odds ratio = 0.42, 95% CI = 0.14-1.34) and high exposure (odds ratio = 0.34, 95% CI = 0.16-0.73).
Assuntos
Avaliação da Deficiência , Esclerose Múltipla/genética , Polimorfismo de Nucleotídeo Único , Receptores de Calcitriol/genética , Raios Ultravioleta , Adulto , Feminino , Predisposição Genética para Doença/epidemiologia , Haplótipos , Humanos , Modelos Logísticos , Masculino , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/fisiopatologia , Fatores de Risco , Adulto JovemRESUMO
A case of ascites with peritonitis is described. Delayed diagnosis might have contributed to the death of our patient. The current tools used in investigating ascites with peritonitis and a review of the existing guidelines for a workup of these patients are discussed. The use of the laparoscopic technique is recommended.
Assuntos
Ascite/microbiologia , Peritonite Tuberculosa/complicações , Peritonite Tuberculosa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Anorexia/microbiologia , Diagnóstico Diferencial , Erros de Diagnóstico , Evolução Fatal , Fadiga/microbiologia , Humanos , Laparoscopia , Masculino , Guias de Prática Clínica como Assunto , Fatores de TempoRESUMO
Manifestation of vasculitis and HIV is now being increasingly being observed. However, clinicians need to be conscious of the possible direct association of this virus with vascular disease. It would appear that the nervous and musculoskeletal systems are most commonly affected. No systematic data exist on the benefit of pharmacological agents currently used and there is an axiomatic need to study these agents in terms of the risk/benefit.
Assuntos
Infecções por HIV/complicações , Infecções por HIV/patologia , Vasculite/etiologia , Vasculite/patologia , Adulto , Feminino , Infecções por HIV/terapia , Humanos , Vasculite/terapiaRESUMO
The effect of a 2-hour intravenous chloroquine infusion (0.015, 0.030 and 1.25 micrograms min-1) on renal fluid and electrolyte handling was investigated in the saline infused, Inactin anaesthetized rat. Blood pressure and glomerular filtration rate were not affected by chloroquine administration, remaining around 128 mmHg and 2.4 ml min-1, respectively throughout the 5-hour post-equilibration period. Chloroquine produced an increase in Na+ and Cl- excretion without affecting the urine flow. By 1 hour after the start of treatment (0.03 micrograms chloroquine min-1) the Na+ excretion rate had increased to 14.5 +/- 2.1 mumol min-1 (n = 6), and was significantly (P < 0.01) greater than in control animals (8.6 +/- 1.0 mumol min-1) at the corresponding time. Parallel but lesser increases in Cl- excretion rates were also observed. The plasma aldosterone and corticosterone levels following either 10, 30 or 120 minutes infusion of chloroquine at 0.03 micrograms min-1 did not differ statistically from each other or from control values. It is concluded that acute chloroquine administration induces an increase in Na+ excretion. The mechanism of this natriuresis cannot be established from the present study, but is likely to involve altered tubular handling of Na+.
