Trauma abdominal en menores de 18 años / Abdominal trauma in under 18 years

Se trata de una revisión retrospectiva de los traumatismos en menores de 18 años que ingresaron a la emergencia del Hospital de Emergencia del El Valle "Dr. Leopoldo Manrique Terrero". Con el diagnóstico de traumatismo abdominal puro, en el período comprendido entre enero de 1992 y diciembre de 1996. Durante ese lapso ingresaron 140 pacientes de los cuales 134 (95,72 por ciento) fueron de sexo masculino. El rango de edad más frecuente varió entre los 13 y 18 años con un 87,56 por ciento. El agente causal más frecuente fue herida por arma de fuego con un 74,28 por ciento. De los 140 pacientes a 126(90 por ciento) se le realizó laparotomía, de los cuales se complicaron 33 pacientes (26 por ciento) y tuvimos 10 defunciones que representaron el 7.1 por ciento

Salt sensitivity in human essential hypertension: effect of renin-angiotensin and sympathetic nervous system blockade.

We studied the acute effect of oral captopril (25mg) and clonidine(300 micrograms) on blood pressure (BP) in patients with essential hypertension successively maintained on a low (LSD) and high (HSD) salt diet. Seven patients were salt sensitive (SS) and seven were salt resistant (SR). The maximal decrease in diastolic BP caused by captopril in patients on the LSD was greater in SS than SR individuals. Baseline urinary norepinephrine levels did not change from LSD to HSD (p greater than 0.05) in SS patients and decreased in SR patients (p less than 0.05). The maximal decrease in mean BP during the clonidine test was the same for both diets (p greater than 0.05) in SS patients and was lower (p less than 0.05) for the HSD in SR patients. SS patients on the HSD presented a higher decrease in systolic BP than SR patients (p less than 0.05) during the clonidine test. These data suggest overactivity of the renin-angiotensin system in SS patients on the LSD and of the sympathetic nervous system in SS patients on the HSD and that the clonidine test could be a good indicator for identifying SS and SR patients.

The clonidine test for the diagnosis of pheochromocytoma: the usefulness of urinary metanephrine measurements.

1. The clonidine suppression of urinary metanephrines as a criterion for the diagnosis of pheochromocytoma is described. Twenty-four patients were divided into 3 groups: Group I, 10 patients with pheochromocytoma (confirmed by tomography and surgery); Group II, 9 patients with suspected pheochromocytoma (clinical evidence plus one mildly elevated value of urinary metanephrines, but with negative tomography); Group III, 5 patients with proven essential hypertension. 2. Urinary metanephrine levels were determined in urine collected before (basal) and 3 h after a single oral dose of clonidine (0.4 or 0.8 mg). 3. Mean basal urinary metanephrine levels were above normal for group I (9.2 +/- 2.2 micrograms/mg creatinine) and group II (2.2 +/- 0.3 micrograms/mg creatinine) but were within the normal range for group III (0.6 +/- 0.1 microgram/mg creatinine). After clonidine administration, urinary metanephrine levels remained elevated for all patients with pheochromocytoma but decreased to within the normal range for all but one patient in group II. The urinary metanephrine levels of group III were not significantly altered by clonidine. 4. These data demonstrate that, when monitored by the clonidine suppression test, urinary metanephrine levels are useful for the diagnosis of pheochromocytoma, permitting the differentiation of affected patients from those exhibiting essential hypertension and increased sympathetic drive.

Determinacao simultanea de quatro anticonvulsivantes por cromatografia liquida de alta pressao (HPLC). / Simultaneous determination of four anticonvulsant drugs by high pressure liquid chromatography (HPLC)

Sao revistas as indicacoes de monitorizacao terapeutica dos quatro anticonvulsivantes de maior aplicacao na pratica medica diaria em nosso meio e e descrito um metodo simples,sensivel e preciso de quantificacao destas drogas em soro ou plasma, por cromatografia liquida de alta pressao.O metodo permite a determinacao simultanea de fenobarbital, fenitoina, carbamazepina e primidona, que sao perfeitamente separados dos componentes normais do plasma e de outros medicamentos eventualmente presentes na amostra. A eluicao foi monitorizada em 241 nm e a concentracao de cada uma das drogas foi calculada pela relacao entre as alturas dos picos destas com a dos respectivos padroes. Os resultados foram comparados com os obtidos por enzima-imunoensaio, apresentado os seguintes coeficientes de correlacao: fenobarbital r = 0,990, fenitoina r=0,993, carbamazepina r = 0,994 e primidona r=0,992. Algumas outras drogas foram analisadas no sentido de avaliar eventuais interferencias

Determinacao do zinco no plasma. / Determination of plasma zinc

Sao revistos os aspectos bioquimicos e clinicos que tornam de valia a dosagem de zinco plasmatico, principalmente naqueles pacientes submetidos a alimentacao parenteral total prolongada, a transplante renal e com enteropatias. E descrita a dosagem por espectrofotometria de absorcao e sao definidos valores de referencia