RESUMEN
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.
Asunto(s)
Fibrilación Atrial , Trastorno Paranoide Compartido , Accidente Cerebrovascular , Trombosis , Tromboembolia Venosa , Humanos , Fibrilación Atrial/tratamiento farmacológico , Fibrilación Atrial/complicaciones , Medición de Riesgo , Trastorno Paranoide Compartido/complicaciones , Factores de Riesgo , Anticoagulantes/efectos adversos , Accidente Cerebrovascular/complicacionesRESUMEN
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.
Asunto(s)
Colecistoquinina/metabolismo , Inhibidores Enzimáticos/administración & dosificación , Ácidos Grasos no Esterificados/metabolismo , Vaciamiento Vesicular/efectos de los fármacos , Vaciamiento Gástrico/efectos de los fármacos , Lactonas/administración & dosificación , Adulto , Colecistoquinina/efectos de los fármacos , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Esquema de Medicación , Emulsiones Grasas Intravenosas , Ácidos Grasos no Esterificados/sangre , Vaciamiento Vesicular/fisiología , Vaciamiento Gástrico/fisiología , Humanos , Masculino , Persona de Mediana Edad , Orlistat , Radioinmunoensayo , Valores de Referencia , Medición de Riesgo , Sensibilidad y EspecificidadRESUMEN
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).