Retinopatía hipertensiva y excreción de glucosaminoglicanos urinarios / Hypertensive retinopathy and glycosaminoglycans in urine

Los glucosaminoglicanos (GAG) son componentes fundamentales de las membranas basales de distintos órganos, entre ellos el riñón y la retina. Objetivos. Relacionar su excreción urinaria, fiel reflejo de la alteración de la función renal, con un dato observable como es la lesión de los vasos retinianos. Material y métodos. Se estudian 96 sujetos sanos tomados como control y 204 pacientes diagnosticados de hipertensión arterial esencial y distribuidos según el grado de retinopatía. Los GAG se determinaron en orina de 24 horas según un método colorimétrico. Resultados. La excreción urinaria de GAG aumenta en relación al grado de retinopatía hipertensiva. Sin embargo la correlación de otros parámetros bioquímicos de lesión renal (ácido úrico sérico, aclaramiento de creatinina, microalbuminuria con la afectación renal en el paciente hipertenso, no es tan manifiesta. Conclusiones. Los GAG eliminados por la orina, utilizados como marcador de nefropatía, se relacionan con las lesiones retinianas en el hipertenso

Glycosaminoglycans (GAGs) are the main components of basement membranes in different organs such as the kidney and the retina. Objective: To link urinary excretion that accurately shows renal function changes with retinal injury. Material and methods. Ninety-six healthy subjects were used as controls and 204 patients with essential arterial hypertension were divided according to the retinopathy stage. GAGs were determined in 24 hour urine samples following a colorimetric method. Results. GAGs in urine increase depending on the stage of hypertensive retinopathy. However, the correlation of other biochemical parameters of renal injuries (such as serum uric acid, creatine clearance, microalbuminuria9 with the renal disease in the hypertensive patient is not so evident

[Wolff-Parkinson-White syndrome cured with diagnostic electrode catheter]. / Curación del síndrome de Wolff-Parkinson-White con electrocatéter diagnóstico.

Catheter-induced mechanical trauma to accessory pathways is an infrequent, usually transitory phenomenon related to manipulation of the ablation catheter. We describe a patient with Wolff-Parkinson-White syndrome due to a midseptal accessory pathway with recurrent episodes of paroxysmal tachycardias under antiarrhythmic treatment. During the diagnostic electrophysiological study coinciding with manipulation of the His catheter (5 French), mechanical trauma to the accessory pathways occurred, with preexcitation not being recovered in the midterm follow up (28 months). This is a exceptional case demonstrating the complexity of the decision making (expectant or rescue ablation) following accidental catheter-induced mechanical trauma.

Valor clínico de la excreción urinaria de N-acetil-betaglucosaminidasa en la retinopatía diabética / Clinical trascendence of urinary excretion of N-acetyl-beta-glucosaminidase in diabetic retinopathy

Objetivo: Estudiar la excreción urinaria del enzima N-acetil-beta-glucosaminidasa (NAG), marcador bioquímico de daño renal precoz, en diabéticos tipo 2 con diferentes grados de retinopatía, estableciendo su relación con el grado de afección retiniana. Método: Realizamos un estudio prospectivo de 144 pacientes diabéticos tipo 2 y 94 controles sanos. Se les realizó una exploración oftalmológica (incluida angiografía fluoresceínica) y un estudio bioquímico que incluía la determinación de NAG en orina. Los pacientes fueron clasificados en varios grupos, dependiendo de su afección retiniana: 76 no presentaban retinopatía diabética (40 hombres y 36 mujeres), 30 tenían retinopatía no proliferativa precoz (13 hombres y 17 mujeres), 22 retinopatía no proliferativa avanzada (5 hombres y 17 mujeres) y 21 pacientes presentaban retinopatía diabética proliferativa (10 hombres y 11 mujeres). Los resultados se sometieron a un análisis estadístico mediante comparación de medias con el test de la t de Student. Resultados: Nuestros resultados mostraron que existe un aumento en la excreción urinaria de NAG conforme avanza el grado de retinopatía diabética. Asimismo, también destacamos la mayor excreción urinaria de NAG en los pacientes diabéticos que no presentaban retinopatía respecto a los controles sanos. Conclusión: Existe un paralelismo entre las lesiones renales y retinianas en la diabetes tipo 2, tal y como otros autores habían demostrado previamente para la diabetes tipo 1 (AU)

[Clinical value of urinary excretion of N-acetyl-beta-glucosaminidase in diabetic retinopathy]. / Valor clínico de la excreción urinaria de N-acetil-betaglucosaminidasa en la retinopatía diabética.

PURPOSE: To test N-acetyl-beta-glucosaminidase (NAG) urinary excretion, early renal damage biochemical marker, in patients with non-insulin-dependent diabetes mellitus grouped according to the degree of retinopathy, establishing its relationships to retinal involvement. METHODS: We make a prospective study of 144 type 2 diabetic patients and 94 healthy subjects. We realized an ocular exploration that included fluorescein angiography and a biochemical study that included the determination of NAG urinary excretion in all of them. The patients were grouped depending on their retinal disease. 76 subjects without retinal abnormalities (40 men and 36 women), 30 with early nonproliferative diabetic retinopathy (13 men and 17 women) and 21 subjects with proliferative diabetic retinopathy (10 men and 11 women). Results were analyzed by using statistical analyses. RESULTS: Our results showed that there exist an increase in the urinary excretion of NAG according to the degree of diabetic retinopathy advance. We also highlight the biggest urinary excretion of NAG in the diabetic patients without retinal involvement regarding healthy subjects. CONCLUSION: There is a parallelism between renal and retinal complications in type 2 diabetes mellitus as other authors had demonstrated previously for the type 1 diabetes mellitus.

[Allergic granulomatosis as a systemic disease]. / Granulomatosis alérgica como enfermedad sistémica.

The Churg-Strauss's allergic granulomatosis is an entity considered by some authors as a simple clinical problem within the context of vasculitis, but that given its anatomopathological and clinical characteristics (different from other vasculitis), must be studied as a separate syndrome. Its incidence depends on the strictness in the application of the diagnosis criteria and its pathogenic is unknown. Although the most frequent pathology is respiratory, we review the affectation of other organs and systems (circulatory, digestive, urogenital, locomotive, nervous system, skin, etc.), stressing the relevance of its knowledge for a correct diagnosis. The current therapy is based in seeking an useful drug, which added of the patients. of the patients.