RESUMO
BACKGROUND: Hypertension that develops after 20 gestational weeks and is defined as pregnancy-induced hypertension (PIH). The main cause of PIH is vasoconstriction and the thickening of vascular media, which decreases vascular capacity and increases peripheral resistance. One of the theories postulated to explain this phenomenon is that a transmembrane sodium transport disorder causes an increase in intracellular sodium concentration. In the latest literature, special attention is paid to the role of the increased intracellular sodium concentration in the pathogenesis of essential hypertension (EH). One of the best documented phenotypes for EH is the increased activity of the sodium-proton exchanger (NHE). The aim of this study was to assess if increased NHE activity could be the mechanism responsible for the development of PIH. SUBJECTS AND METHODS: The study included 30 women: 10 pregnant women with PIH after gestational week 30, 10 women with physiological pregnancy after 30 gestational weeks, and 10 healthy non-pregnant women. NHE activity was determined according to Orlov's method as amiloride-sensitive H(+) efflux from acid-loaded cells. RESULTS: The NHE activity in the group of women with PIH was significantly higher than that in women with physiological pregnancy: 10.09 +/- 1.65 vs. 6.81 +/- 2.3 mmol/L RBC/h (p < 0.049) and in the group of non-pregnant women: 10.09 +/- 1.65 vs. 7.56 +/- 1.66 mmol/L RBC/h (p < 0.029). Erythrocyte NHE activity did not differ in the group of women with physiological pregnancy and in the group of non-pregnant women. CONCLUSION: These results seem to suggest that erythrocyte NHE activity is elevated in PIH pregnancies.
Assuntos
Eritrócitos/metabolismo , Hipertensão Induzida pela Gravidez/fisiopatologia , Trocadores de Sódio-Hidrogênio/metabolismo , Sódio/metabolismo , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Gravidez , Terceiro Trimestre da GravidezRESUMO
Angiocentric glioma (AG) is a newly-classified, very rare, WHO grade I central nervous system (CNS) lesion, occurring usually in children and young adults. Only 52 patients with AG have been reported so far, making it one of the rarest neuropathological entities. Hereby we present two new cases of AG in young subjects with detailed neuropathological investigations and a neuroradiological picture along with a brief summary of all already published literature reports of this tumor. Histopathological examination of the resected tissue from both cases revealed similar changes characteristic of AG. The tumors were composed of spindle-like, elongated cells, forming characteristic pseudorosettes around vessels and diffusively infiltrating surrounding tissue, trapping neurons between tumor cells. Noticeably, some neoplastic cells encrusting vessels extended far beyond the main tumor mass. Hypothetically, this may be responsible for the recurrence of the tumor even in the case of apparently total excision. In immunohistochemistry, AG cells were glial fibrillary acidic protein (GFAP) and vimentin positive, also exhibiting a strikingly significant epithelial membrane antigen (EMA) dot-like staining pattern. In one of the cases, electron microscopy revealed ependymal differentiation features such as microvilli and cilia. Taken together, all these data strongly confirm a dual astroglial-ependymal nature of the tumor. Follow up corroborates benign character of this neoplasm. Both AGs reported here were immunonegative for the product of the mutated IDH-1 gene what, according to our best knowledge, has never been reported so far. It may suggest that in their pathogenesis AGs differ from grade II astrocytomas, which in most cases harbor a mutation of IDH-1. Noteworthy, neuroimaging in our cases was relatively characteristic but not conclusive, therefore biopsy (at least) is mandatory. A newly proposed so called "A-B-C" classification of long-term epilepsy-associated tumors (LEATs) places AG in a category named ANET. The authors shortly review the A-B-C classification of LEATs.
Assuntos
Neoplasias Encefálicas/patologia , Epilepsia/etiologia , Glioma/patologia , Recidiva Local de Neoplasia/patologia , Adulto , Astrócitos/metabolismo , Astrócitos/patologia , Criança , Feminino , Proteína Glial Fibrilar Ácida/metabolismo , Glioma/complicações , Humanos , Imuno-Histoquímica/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Recidiva Local de Neoplasia/complicações , Recidiva Local de Neoplasia/diagnósticoRESUMO
Prostate cancer (PC) is the most common cancer in men and a leading cause of cancer death. Prostatic gland accumulates reasonably high amount of selenium (Se), the element that prevents the development of PC. It is hypothesized that some selenoproteins inhibit the transformation of normal prostate epithelium into neoplasm. We studied Se levels in whole blood, plasma and prostate of 32 PC and 40 benign prostate hyperplasia (BPH) patients and in the control group composed of 39 healthy subjects. The selenoenzyme glutathione peroxidase (GSH-Px) was also measured in the patients' red cells, plasma and prostate tissue. Se concentration in whole blood and plasma in both groups of patients was lower as compared with controls, while in prostate gland it was significantly higher in PC than in BPH patients and controls. Red cell GSH-Px activity was the same in PC patients and controls but significantly lower in BPH patients. Plasma GSH-Px activity was significantly lower in PC patients than in the control group, and prostate GSH-Px activity was significantly lower in PC patients as compared with BPH patients. Since Se has anticancer properties, it is very likely that its low level in blood may facilitate the development of cancer. A higher level of Se in prostate of PC patients has no influence on GSH-Px activity in the gland.
Assuntos
Glutationa Peroxidase/metabolismo , Hiperplasia Prostática/metabolismo , Neoplasias da Próstata/metabolismo , Selênio/análise , Idoso , Eritrócitos/enzimologia , Eritrócitos/metabolismo , Glutationa Peroxidase/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/sangue , Hiperplasia Prostática/enzimologia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/enzimologia , Selênio/sangueRESUMO
Evolution of psychological disorders following head injury including memory disorders and other cognitive ones are common. The best known are psychiatric disturbances of various kind after lesions of frontal lobes. Cognitive, behavioural and emotional disorders are not usually seen in patients with bilateral temporal lesions. In our Department of Neurotraumatology we observed 4 patients with post-traumatic lesions localized bitemporally. They developed Kluver-Bucy syndrome--rarity in human pathology--with combination of three or more the following syndromes: increased oral activity, hypersexuality, hypermetamorphosis, memory disorders, placidity, loss of people recognition, bulimia. Several symptoms responded dramatically to carbamazepine. We conclude that it may be a useful agent in treatment of this unusual syndrome.
Assuntos
Agnosia/diagnóstico , Dano Encefálico Crônico/diagnóstico , Comportamento Alimentar/fisiologia , Transtornos da Memória/diagnóstico , Comportamento Sexual/fisiologia , Lobo Temporal/lesões , Adulto , Idoso , Animais , Humanos , Aprendizagem/fisiologia , Macaca mulatta , Masculino , Síndrome , Tomografia Computadorizada por Raios XRESUMO
We have raised antibodies and developed one-step enzyme-linked immunosorbent assays (ELISA) for the diuretics ethacrynic acid and bumetanide as part of a panel of pre- and post-race tests for high potency drugs in racing horses. These ELISA tests are rapid (completed within one hour), sensitive, and can be read by eye. The ELISA detects ethacrynic acid at a drug concentration for half-maximal inhibition (I-50) of about 2.5 ng/mL for the parent drug. After dosing horses intravenously with 5 mg ethacrynic acid per horse, the parent drug or its metabolites are detectable in urine for at least 8 hours. The bumetanide ELISA has an I-50 for the parent drug of about 2.0 ng/mL and will detect bumetanide or its metabolites for about 8 hours in urine after intravenous administration of a 1.7-mg dose per horse. Both antibodies are relatively specific for each drug and do not cross-react with other commonly used diuretics or other acidic compounds often found in post-race equine urine samples. Ethacrynic acid and bumetanide are potent diuretics suspected of being illegally substituted for furosemide in certain racing jurisdictions. Development of these rapid, sensitive, and simple tests for these agents will allow more effective pre- and post-race control of the use of these agents in racing horses. Both tests have recently uncovered several "positives" for these medications in a midwestern racing jurisdiction.
Assuntos
Bumetanida/urina , Dopagem Esportivo , Ácido Etacrínico/urina , Cavalos/urina , Animais , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Cromatografia Gasosa-Espectrometria de Massas/veterinária , Injeções Intravenosas/veterináriaRESUMO
Stroke is the third leading cause of death and the major reason for disability in American adults (Sullivan, 1992). Stroke can be a recurrent disease, but most strokes are preventable. Patient and family education about stroke is a vital link in eliminating the knowledge deficit that can help lead to stroke. This article describes the process of developing and implementing a stroke education program that involves both patients and their significant others. In 1990, rehabilitation nurses at St. Margaret Mercy Healthcare Centers in Hammond, IN, identified 11 essential areas for education and grouped them into six 1-hour teaching sessions. A program was developed and held weekly for a trial period of 3 months. It was so well received that it continues to be a permanent part of the rehabilitation program. Such structured teaching in a relaxed atmosphere better prepares patients for discharge and eases the transition to the home environment.
Assuntos
Transtornos Cerebrovasculares/reabilitação , Família , Educação de Pacientes como Assunto/métodos , Desenvolvimento de Programas , Humanos , Alta do Paciente , Avaliação de Programas e Projetos de SaúdeRESUMO
Former patients in a rehabilitation unit at a large Midwestern hospital continued to actively seek services provided by the inpatient nursing staff, primarily through telephone contact, long after their discharge. A proactive formal follow-up program managed by an advanced practice nurse in rehabilitation was proposed as a better means of providing continuing care for rehabilitation patients after discharge. To examine the efficacy of the nurse-managed follow-up program, a randomized clinical trial was conducted. One hundred patients were randomly assigned to either the intervention group or the control group. Comparisons were made between the two groups on several outcome measures at 4 months after discharge. Outcomes included Functional Independence Measure (FIM) instrument scores, complication rates, rehospitalizations, and anxiety levels. The organizational outcomes included number and types of calls to staff, as well as time spent by staff nurses and social workers. The results indicated significant differences between the intervention and control groups in terms of anxiety levels, the number of calls made to the unit, and the amount of time spent by staff nurses and social workers.
Assuntos
Assistência ao Convalescente/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Profissionais de Enfermagem/organização & administração , Alta do Paciente , Enfermagem em Reabilitação/organização & administração , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Avaliação de Programas e Projetos de SaúdeRESUMO
In the paper 2 cases of non-traumatic spinal epidural haematomas are presented. The possible aetiological factors--vascular malformation, coagulopathy, anticoagulants and neoplasm are discussed. Neurological state, diagnostic procedure and treatment are described. Taking into account our experience we state that only early diagnosis and operation-surgical decompression of spinal cord, could result in complete recovery.
Assuntos
Hematoma Epidural Craniano/complicações , Hematoma Epidural Craniano/patologia , Medula Espinal/irrigação sanguínea , Medula Espinal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Medula Espinal/cirurgia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgiaRESUMO
Posttraumatic vasospasms occur according to various authors in 5-10% of cases, and in our material they were demonstrated in 6% of the patients, that is about 8 times less frequently than in cases of bleeding from a vascular malformation. Computed tomography of the head showing posttraumatic vasospasm complicating "normal" clinical course is ever less frequent which does not mean that this disturbance is not occurring, but rather it shows that CT is insufficient for its demonstration. It was shown that in every case of unclear aetiology in which the clinical condition is not correlating with CT pattern of the head angiography of brain vessels should be performed or cerebral blood flow should be determined by other making possible early institution of adequate (targeted) treatment.
Assuntos
Hematoma/complicações , Ataque Isquêmico Transitório/etiologia , Encéfalo/fisiopatologia , Angiografia Cerebral , Ventriculografia Cerebral , Hematoma/fisiopatologia , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
In the years 1991-1993, 145 patients suffering from central nervous system diseases were operated on using autotransfusion in the Institute of Neurology in Cracow. In 141 cases patients were given blood taken formerly. There were no side effects following blood treatment. In the authors opinion autotransfusion deserves wider use for medical and economic reasons.
Assuntos
Transfusão de Sangue Autóloga , Encefalopatias/cirurgia , Adolescente , Adulto , Idoso , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A group of 100 patients treated immediately following a cranio-cerebral injury was analyzed. The patients, administered piracetam either in an intravenous infusion (GCS 3-8) or orally (GCS above 9), were divided into groups depending on the dose and clinical status. Piracetam participates in the activity of the majority of neurotransmitters, increases glucose and oxygen consumption in the ischaemic nervous tissue and increases blood flow through cerebral terminal vessels. In cranio-cerebral injuries, piracetam is employed to achieve cytoprotection and improve cerebral blood flow. In patients with neurological deterioration following the administration of 6-10 mg/day, no good results were obtained. A dose of 24-30 mg/day had a significant positive effect on therapeutic results providing certain conditions were met, such as ensuring proper partial oxygen pressure (oxygen therapy) and proper blood glucose levels. The use of piracetam is justified immediately after an injury; after the discharge oral piracetam therapy is recommended.
Assuntos
Lesões Encefálicas/tratamento farmacológico , Fármacos Neuroprotetores/uso terapêutico , Piracetam/uso terapêutico , Relação Dose-Resposta a Droga , Humanos , Injeções Intravenosas , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The level of alpha 1-antitrypsin in blood serum in copper miners was examined. Among 278 subjects not a single case of total insufficiency was found, whereas the partial insufficiency of this inhibitor was found in 4.3% of subjects. The studies of the total correlation indicated high indices of the ratio between alpha 1-antitrypsin level and lungs vital capacity in those with bronchitis, which would suggest that the decreased efficiency of the respiratory tract results form the hereditary insufficiency of this inhibitor.
Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Poluentes Atmosféricos/efeitos adversos , Cobre/efeitos adversos , Mineração , Deficiência de alfa 1-Antitripsina , Adulto , Bronquite/enzimologia , Humanos , Pessoa de Meia-Idade , Doenças Profissionais/enzimologia , alfa 1-Antitripsina/análiseRESUMO
The paper presents the clinical picture, diagnostic and therapeutic management of suprasellar arachnoid cysts that result in isosexual precocious puberty in children. The authors stress the importance of physical examinations involving routine assessment of growth and sexual development as well as neurological evaluation in early diagnosis of suprasellar arachnoid cysts and other central causes of precocious puberty. The role of early diagnosis in preventing irreversible somatic and mental changes is emphasized.
RESUMO
In the years 1987-88 the density of the population of I. ricinus on the territory of Kraków-Czestochowa Highland including the Ojców National Park was studied. The method of collection of ticks from 100 m2 fields was applied. On the spite of similar ecological conditions there was marked variation in the population density of I. ricinus. It decreased from East to West, where territories are under the strong pressure of the Upper Silesia and Olkusz industry.
Assuntos
Carrapatos/isolamento & purificação , Altitude , Animais , Ecologia , Poluição Ambiental , Humanos , Indústrias , Polônia , Densidade Demográfica , Estações do Ano , Carrapatos/fisiologiaRESUMO
Nitrates, nitrites and total protein content in selected vegetables from conventional and ecological farms were estimated. The beetroots, carrots, potatoes available on market or special shops in January, May and March were evaluated. The content of nitrates and nitrites was determined by colorimetric method with Griess reagent after previous reduction of nitrates to nitrites by metallic cadmium. Total protein content was determined by Kjel-Foss Automatic 16210 analyser working on the basis of classical Kjeldahl method. The higher content of nitrates was found in vegetables from conventional farms. Amounts of nitrates in both groups of vegetables did not exceed allowed limits. Levels of nitrites in ecological and conventional vegetables were similar-above 0.5 mg NaNO2/kg (except conventional potatoes from January). Slightly more content of protein was recorded in conventional vegetables.