The dilemma of diagnosing fever of unknown origin: large arteries vasculitis revealed by 18F-FDG PET/CT imaging. A case report.

Fever of unknown origin (FUO) is an uncommon disease, and its underlying etiology may include a number causes, i.e., infections, malignancies, autoimmune conditions. Diagnosis is often a difficult task, and usually physician spend time and money in order to define the etiology of FUO. We report a case of patient who presented with FUO and headache, and positron emission tomography (PET) with 2-deoxy-2-[fluorine-18] fluoro-D-glucose (18F-FDG) allowed to reveal the presence of a large vessel vasculitis. 18F-FDG PET may represent an useful tool in patients with FUO, since it can early depict an hypermetabolic activity due to inflammation and so help to achieve a final diagnosis in some cases of FUO.

Epidemiological study of urinary tract stones in a northern Italian city.

An epidemiological study of stone disease in a Northern Italian city was carried out by means of a postal questionnaire mailed to 6000 individuals (2.5% of the entire population). It was found that the incidence of stone disease was comparable to that of industrialised Western Europe. There was a relationship between stone disease and gout and stone disease and a positive family history. The frequency of uric acid stones was high (26.5%). Stone-formers showed no alimentary differences from non-stone formers apart from the use of spices and herbs. Stone-formers used less water from public aqueducts and more uncarbonated mineral water, but only 19% of these drank at least 2 litres a day.

Acute effect of indapamide on urine calcium excretion in nephrolithiasis and human essential hypertension.

The effects of indapamide (2.5 mg once a day) on urinary composition are reported in 20 patients (10 with recurrent calcium nephrolithiasis and 10 with essential hypertension) compared with 20 controls. Indapamide was well absorbed in every patient (mean plasma level at the steady state was 111 +/- 41 ng/ml) and its antihypertensive action was more pronounced in hypertensive than in normotensive patients. It lowered calcium excretion in 18/20 patients (mean fall on the 7th day of treatment: 53%) and raised the Mg/Ca ratio in 20/20 patients (mean increase on the 7th day: 167%). The effect on Ca2+ and Mg2+ excretion was not associated with a strong diuretic effect. During intravenous calcium loading (0.375 mmol/kg body weight) 6 normal subjects after a single oral dose of indapamide excreted less calcium, suggesting a direct renal hypocalciuric action by the drug. Indapamide could represent an alternative drug to thiazide diuretics in diseases with dangerous renal calcium losses, but long-term studies are needed.

Skeletal muscle water and electrolytes in treated and untreated essential hypertension.

The question whether body electrolyte composition in patients with primary hypertension differs from that of normotensive subjects is still controversial. The aim of the present work was to investigate on water, electrolyte, and nitrogen muscle cell composition in essential human hypertension. Also the effects of antihypertensive drugs on muscle electrolyte contents were analyzed. The results indicate that muscle Na was higher and muscle K was lower in essential hypertensives in comparison with controls. Muscle water, Mg, and nitrogen were not different in treated patients (with or without diuretics) in comparison with untreated hypertensive patients. But in hypertensive patients treated with diuretics, Nam was higher and Km was lower than in untreated patients. Several mechanisms may explain the changes on muscle electrolyte composition in primary hypertension, but the cellular mechanism involving abnormalities in ion pump and electrolyte transmembrane fluxes are the most probable. The therapy with antihypertensive drugs especially diuretics, seems to enhance different muscle electrolyte patterns in essential hypertension.