RESUMO
Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rhesus (Rh) antibodies is a significant cause of hemolytic disease of the newborn (HDN). Here, we report a rare case of severe HDN associated with maternal antibody to Rh e. In addition to severe anemia, the infant developed thrombocytopenia, conjugated hyperbilirubinemia and cholelithiasis. Resolution of the infant's cholelithiasis occurred following treatment with ursodeoxycholic acid.
Assuntos
Teste de Coombs , Eritroblastose Fetal/imunologia , Isoimunização Rh/fisiopatologia , Sistema do Grupo Sanguíneo Rh-Hr/imunologia , Colagogos e Coleréticos/uso terapêutico , Colelitíase/etiologia , Eritroblastose Fetal/tratamento farmacológico , Eritroblastose Fetal/fisiopatologia , Transfusão de Eritrócitos , Feminino , Humanos , Hiperbilirrubinemia Neonatal , Recém-Nascido , Fototerapia , Isoimunização Rh/imunologia , Trombocitopenia/etiologia , Ácido Ursodesoxicólico/uso terapêuticoRESUMO
PURPOSE: A swine model of penetrating ocular trauma was used to determine the delivery of systemically administered cefazolin to the vitreous cavity of traumatized and nontraumatized eyes. METHODS: Thirty-one pigs received a scleral laceration to the right eye under anesthesia and then were given intravenous cefazolin every 8 hours. Seven pigs received nine doses at 17 mg/kg. Seven animals received three doses of 36 mg/kg, and six others received nine doses of this regimen. Six pigs received three doses of 79 mg/kg and five others received three doses of 190 mg/kg. RESULTS: Vitreous levels of cefazolin averaged 15.6 micrograms/mL in traumatized eyes but were less than 1 microgram/mL in control eyes of animals receiving three doses at 190 mg/kg (P < or = 0.025). Mean serum concentration in these animals was 49.3 micrograms/mL. Vitreous levels were less than 1 microgram/mL in traumatized and control eyes in animals given lower doses of cefazolin (range, 17-79 mg/kg) despite multiple treatments over 2 and 3 days. CONCLUSIONS: These data demonstrate that systemically delivered cefazolin achieves levels ten times the minimum inhibitory concentration for Staphylococcus epidermidis in injured eyes. Therapeutic intraocular levels can be obtained through intravenous dosing, provided that therapeutic serum concentrations are achieved.
Assuntos
Cefazolina/administração & dosagem , Traumatismos Oculares/tratamento farmacológico , Ferimentos Penetrantes/tratamento farmacológico , Animais , Cefazolina/sangue , Cefazolina/farmacocinética , Esquema de Medicação , Traumatismos Oculares/sangue , Traumatismos Oculares/metabolismo , Injeções Intravenosas , Concentração Osmolar , Valores de Referência , Suínos , Corpo Vítreo/metabolismo , Ferimentos Penetrantes/sangue , Ferimentos Penetrantes/metabolismoRESUMO
The effects of soy-protein consumption with and without soy fiber on plasma lipids in 26 mildly hypercholesterolemic men were studied. Four, 4-wk dietary treatments included 50 g protein and 20 g dietary fiber from soy flour (SF), isolated soy protein/soy cotyledon fiber (ISP/SCF), ISP/cellulose (ISP/C), or nonfat dry milk/C (NFDM/C) in conjunction with a low-fat, low-cholesterol diet. Plasma total cholesterol (TC) concentrations were lowest for both ISP dietary treatments compared with baseline (P < 0.05) and NFDM/C (P < 0.01). SF also led to lower TC compared with NFDM/C (P < 0.05). LDL-cholesterol values were lowest for both ISP treatments compared with NFDM/C (P < 0.01), but lower compared with baseline only with ISP/SCF (P < 0.05). Apolipoprotein B was lowest when ISP/C was fed, compared with baseline, SF, and NFDM (P < 0.05). HDL-cholesterol and total triglycerides (TG) were not affected. Results indicate that 50 g ISP is effective in lowering TC, LDL-C, and apolipoprotein B while maintaining HDL concentrations in mildly hypercholesterolemic men.
