RESUMO
Folie à deux - Thrombosis and Infections Abstract: Although infections are not represented in the Revised Geneva or Wells score, they increase the risk of venous thromboembolism (VTE) similarly to the known risk factors (immobilization, major surgery, active neoplasia). This increased risk of VTE can persist for six to twelve months after infection; moreover, the more severe the infection, the higher the risk of VTE may be. In addition to VTEs, infections can promote arterial thromboembolism. For example, 20% of pneumonias are accompanied by an acute cardiovascular event (acute coronary syndrome, heart failure, atrial fibrillation). In the case of infection-associated atrial fibrillation, the CHA2DS2 VASc score remains an appropriate guide for the indication of anticoagulation.
Assuntos
Fibrilação Atrial , Transtorno Paranoide Compartilhado , Acidente Vascular Cerebral , Trombose , Tromboembolia Venosa , Humanos , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/complicações , Medição de Risco , Transtorno Paranoide Compartilhado/complicações , Fatores de Risco , Anticoagulantes/efeitos adversos , Acidente Vascular Cerebral/complicaçõesRESUMO
The limited effectiveness of orlistat, an inhibitor of gastrointestinal lipases, in inhibiting fat digestion is not completely understood. Therefore we studied the effect of orally and duodenally administered orlistat on gastric emptying, cholecystokinin (CCK) secretion, and gallbladder contraction. In healthy males, gastric emptying of solids and fat were quantified scintigraphically, gallbladder contraction by ultrasound and CCK release by radioimmunoassay. Three studies were performed: (1) oral and (2) duodenal orlistat with a fat-containing meal, and (3) duodenal orlistat with a fat-free meal. Gastric emptying rates of solids and fat (T50% accelerated by 16 and by 22%, p < 0.05, respectively) were significantly faster after duodenal perfusion of orlistat; gallbladder contraction and CCK release were reduced under these conditions (p < 0.005, respectively). With oral orlistat no significant effect was documented on these parameters. We conclude that fat hydrolysis is essential in the regulation of fat-induced gastric emptying and gallbladder contraction.
Assuntos
Colecistocinina/metabolismo , Inibidores Enzimáticos/administração & dosagem , Ácidos Graxos não Esterificados/metabolismo , Esvaziamento da Vesícula Biliar/efeitos dos fármacos , Esvaziamento Gástrico/efeitos dos fármacos , Lactonas/administração & dosagem , Adulto , Colecistocinina/efeitos dos fármacos , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Emulsões Gordurosas Intravenosas , Ácidos Graxos não Esterificados/sangue , Esvaziamento da Vesícula Biliar/fisiologia , Esvaziamento Gástrico/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Orlistate , Radioimunoensaio , Valores de Referência , Medição de Risco , Sensibilidade e EspecificidadeRESUMO
Life event research examines the effect of life events on the course of psychiatric diseases, but the published literature considers almost only negative events. We describe the cases of two female patients who had to be hospitalized for depression after lottery winnings of over 1M DM. The 4-year follow-up shows a good outcome in both patients. Case analyses suggest that in both patients, winning was a life event relevant to the development of the depressive episode. Desirable life events might influence the course of a psychiatric illness just as negative events do. (Int J Psych Clin Pract 2002; 6: 183-186).