RESUMO
PURPOSE: To find the association of retinopathy in preeclampsia with fetal birthweight and systolic and diastolic blood pressure (BP) in patients with mild and severe preeclampsia. METHODS: Medical records of patients with preeclampsia who delivered at term between January 2002 and December 2006 were included in the study. Patients with preterm delivery, eclampsia, intrauterine fetal death, congenital defect in the fetus, and other systemic disorders were excluded. Parameters analyzed were retinopathy, systolic and diastolic BP, and fetal birthweight. Multivariable linear regression was used for statistical analysis. p value < or =0.05 was considered significant. RESULTS: The patients were divided into two groups: mild preeclampsia (MP) and severe preeclampsia (SP). The MP had 156 patients and SP had 104 patients. The mean systolic BP in MP and SP was 147.2 mmHg and 164.6 mmHg, while the mean diastolic BP in MP and SP was 98.6 mmHg and 112.7 mmHg. Severity of retinopathy was inversely associated with fetal birthweight (p=0.022) in SP, while it was insignificant in the MP (p=0.082). Low birthweight was due to intrauterine growth retardation of the fetus. Diastolic BP in the SPshowed significant correlation with retinopathy (p=0.041). The systolic (p=0.55) and diastolic BP (p=0.248) in MP and systolic BP (p=0.803) in SP were insignificantly correlated with the retinopathy. CONCLUSIONS: Retinopathy in preeclampsia may indirectly indicate the level of placental insufficiencyand intrauterine growth retardation. The severity of retinopathy is more closely related with diastolic BP rather than systolic BP and the significance of this correlation increases in severe preeclampsia.
Assuntos
Peso ao Nascer , Pressão Sanguínea/fisiologia , Retardo do Crescimento Fetal/fisiopatologia , Pré-Eclâmpsia/fisiopatologia , Doenças Retinianas/fisiopatologia , Adolescente , Adulto , Feminino , Humanos , Insuficiência Placentária/fisiopatologia , Gravidez , Estudos RetrospectivosRESUMO
PURPOSE: To evaluate the safety and efficacy of mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma (POAG). METHODS: A prospective interventional study of mini-trabeculectomy versus conventional trabeculectomy was undertaken on 60 eyes of 54 medically uncontrolled POAG patients requiring glaucoma surgery. They were divided into two groups: Group I underwent mini-trabeculectomy (30 eyes of 26 patients) and Group II underwent conventional trabeculectomy (30 eyes of 28 patients). All patients were followed up for at least 15 months. Statistical analysis was carried using Student's t test and paired t test for quantitative data and Pearson's chi-square test for qualitative data. RESULTS: The mean intraocular pressures (IOP) at the end of 15 months of follow-up in Groups I and II were 15.80+/-4.3 mmHg and 16.13+/-3.3 mmHg versus mean preoperative IOP of 28.63+/-2.74 and 28.60+/-2.44, p<0.0001, respectively. The difference in IOP control was significant only at 6 months of follow up (13.65+/-3.45 versus 15.98+/-4.05, p=0.041). The complications and failure were comparatively less in Group I. CONCLUSIONS: Mini-trabeculectomy is a safe and effective alternative to conventional trabeculectomy in terms of IOP control. A modified tunnel incision employed in mini-trabeculectomy may be responsible for avoiding some of the complications.
Assuntos
Glaucoma de Ângulo Aberto/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Trabeculectomia/métodos , Adulto , Progressão da Doença , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular , Masculino , Estudos Prospectivos , Resultado do Tratamento , Campos VisuaisRESUMO
OBJECTIVE: To determine if those who produce methane (i.e., have presence of methane in breath) have higher serum cholesterol than those who do not produce methane in subjects with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: We measured breath gases and fasting serum total and high-density lipoprotein (HDL) cholesterol and triglyceride (TG) levels in 21 subjects with IGT. RESULTS: The 11 methane-producers were well matched to the 10 non-methane-producers for age, sex, and body mass index. Methane-producers had higher fasting serum total (6.5 +/- 0.3 vs. 5.5 +/- 0.2 mmol/l; P < 0.02) and low-density lipoprotein (4.3 +/- 0.3 vs. 3.4 +/- 0.2 mmol/l; P < 0.05) cholesterol concentrations with no difference in TG or HDL levels. CONCLUSIONS: The results suggest that in subjects with IGT, positive methane-producing status may be associated with increased serum cholesterol levels.
Assuntos
Colesterol/sangue , Intolerância à Glucose/metabolismo , Metano/metabolismo , Glicemia/análise , Testes Respiratórios , Estudos de Casos e Controles , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Intolerância à Glucose/sangue , Humanos , Insulina/sangue , Masculino , Metano/análise , Pessoa de Meia-Idade , Estudos Prospectivos , Valores de Referência , Triglicerídeos/sangueRESUMO
The effects of the glycemic index (GI) of carbohydrate eaten the previous night on the glycemic response to a standard test meal eaten subsequently in the morning (breakfast) was studied. On separate evenings normal subjects ate low- or high-GI test meals of the same nutrient composition. The dinners consisted of single foods in two experiments and mixed meals containing several foods in the third. The differences between the observed glycemic responses to low- and high-GI dinners were predicted by their GIs. The glycemic responses to breakfast were significantly lower on mornings after low-GI dinners than after high-GI dinners. Eating, at dinner, foods with different fiber contents but the same GI had no effect on postbreakfast glycemia. We conclude that the GI predicts the difference between glycemic responses of mixed dinner meals; breakfast carbohydrate tolerance is improved when low-GI foods are eaten the previous evening.
Assuntos
Glicemia/metabolismo , Carboidratos da Dieta/farmacologia , Adulto , Aminoácidos/análise , Nitrogênio da Ureia Sanguínea , Peptídeo C/análise , Creatinina/análise , Dieta , Gorduras na Dieta/farmacologia , Fibras na Dieta/farmacologia , Proteínas Alimentares/farmacologia , Feminino , Humanos , Masculino , Fatores de TempoRESUMO
Amitriptyline and zimelidine significantly reduce the uptake of 5-HT into the blood platelets of depressive patients. The degree of inhibition is significantly correlated with the plasma drug level of amitriptyline. No significant relationship could be detected between the degree of inhibition of uptake and therapeutic outcome. The accepted mode of action of tricyclic antidepressant drugs and the deficiency hypotheses of affective disorders are discussed.
Assuntos
Amitriptilina/farmacologia , Antidepressivos/farmacologia , Piridinas/farmacologia , Serotonina/metabolismo , Alilamina/análogos & derivados , Alilamina/farmacologia , Alilamina/uso terapêutico , Amitriptilina/sangue , Amitriptilina/uso terapêutico , Antidepressivos/uso terapêutico , Plaquetas/metabolismo , Ensaios Clínicos como Assunto , Depressão/tratamento farmacológico , Feminino , Humanos , Cinética , Masculino , Escalas de Graduação Psiquiátrica , Piridinas/uso terapêutico , Serotonina/sangueRESUMO
Ciclazindol, a new tetracyclic compound, appears to be a potentially important antidepressant of the same order as amitriptyline, but with significantly fewer subjective side effects. Although as a group the patients treated with ciclazindol lost weight, clinical improvement was observed to be significantly correlated with the weight gain in both groups. The peripheral adrenergic interactions were studied. In the dosage used (100 mg/day) ciclazindol was observed to be a peripheral Na-reuptake blocker with no significant effect on the postsynaptic alpha-receptors. Plasma concentrations of the drug were estimated and their relationship to the therapeutic outcome, side effects, and adrenergic interaction were studied. No significant change in resting BP or ECG was observed following 4--6 weeks' treatment with ciclazindol.
Assuntos
Antidepressivos , Indóis/farmacologia , Adulto , Idoso , Apetite/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Interações Medicamentosas , Eletrocardiografia , Feminino , Humanos , Indóis/sangue , Masculino , Pessoa de Meia-Idade , Norepinefrina/farmacologia , Fenilefrina/farmacologia , Pirimidinas/sangue , Pirimidinas/farmacologia , Tiramina/farmacologiaRESUMO
Zimelidine, a bicyclic compound with a strong effect on the neuronal reuptake of 5-hydroxy-tryptamine and with weak anticholinergic actions, was evaluated for its antidepressant efficacy in a double-blind comparative trial with amitriptyline. In doses of 200 mg a day it was found to be as effective as 150 mg amitriptyline, but with significantly less subjective side-effects. The plasma concentration of zimelidine and its metabolite, norzimelidine, showed no significant correlation with therapeutic outcome.
Assuntos
Antidepressivos/uso terapêutico , Depressão/tratamento farmacológico , Piridinas/uso terapêutico , Alilamina/efeitos adversos , Alilamina/análogos & derivados , Alilamina/metabolismo , Alilamina/uso terapêutico , Amitriptilina/efeitos adversos , Amitriptilina/uso terapêutico , Antidepressivos/efeitos adversos , Antidepressivos/metabolismo , Peso Corporal , Compostos Bicíclicos com Pontes/efeitos adversos , Método Duplo-Cego , Estudos de Avaliação como Assunto , Feminino , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Piridinas/efeitos adversos , Piridinas/metabolismoRESUMO
In a double-blind study the therapeutic efficacy of sulpiride was compared to that of haloperidol--an established neuroleptic agent. A total of 30 female patients with a diagnosis of chronic schizophrenia were initially stabilised on the dosage of haloperidol which produced optimum therapeutic response when given once or twice daily. The patients were then randomly allocated to receive either sulpiride or haloperidol over a period of 12 weeks. Plasma drug concentrations and prolactin levels were determined. Clinical effects were evaluated by Brief Psychiatric Rating Scale (BPRS), Wing Rating Scale, and Extrapyramidal Symptoms Rating Scale (EPS). A standardised side-effects checklist was used. Treatment with sulpiride was associated with a significant rise in plasma prolactin level, but paradoxically these patients had significantly reduced extrapyramidal symptoms. No significant correlation was found between plasma sulpiride concentration and prolactin level or any of the clinical variables. The study confirms the antipsychotic activity of sulpiride.
Assuntos
Esquizofrenia/tratamento farmacológico , Sulpirida/uso terapêutico , Doença Crônica , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Haloperidol/efeitos adversos , Haloperidol/uso terapêutico , Humanos , Pessoa de Meia-Idade , Prolactina/sangue , Escalas de Graduação Psiquiátrica , Sulpirida/efeitos adversosRESUMO
The urinary excretion of 4-hydroxy-3-methoxyphenylglycol was compared in a group of 23 depressive patients and 27 control subjects of similar age. There was no difference between patients and controls although female controls excreted less than males. After 6 weeks' treatment with 150 mg daily of amitriptyline there was no correlation between therapeutic response and pretreatment urinary excretion value.
Assuntos
Amitriptilina/uso terapêutico , Depressão/tratamento farmacológico , Glicóis/urina , Metoxi-Hidroxifenilglicol/urina , Depressão/urina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
Acinetobacter spp. is emerging as a common cause of nosocomial infections. Community acquired ocular infections due to Acinetobacter are rare. Only one case of perforation of cornea has been reported previously, where old nomenclature was used to describe the causal agent. We report a case of corneal perforation due to Acinetobacter junii for which a therapeutic penetrating keratoplasty was conducted and the patient eventually recovered.
Assuntos
Infecções por Acinetobacter/diagnóstico , Acinetobacter/isolamento & purificação , Úlcera da Córnea/diagnóstico , Ferimentos Oculares Penetrantes/complicações , Infecções por Acinetobacter/microbiologia , Infecções por Acinetobacter/cirurgia , Adulto , Úlcera da Córnea/microbiologia , Úlcera da Córnea/cirurgia , Ferimentos Oculares Penetrantes/microbiologia , Feminino , Humanos , Ceratoplastia PenetranteRESUMO
A rare case of diverticulum of the lacrimal sac associated with rhinosporidiosis is reported. The clinical presentation and possible pathogenesis are discussed.
Assuntos
Divertículo/complicações , Doenças do Aparelho Lacrimal/complicações , Rinosporidiose/complicações , Adulto , Divertículo/patologia , Feminino , Humanos , Doenças do Aparelho Lacrimal/patologia , Rinosporidiose/patologiaRESUMO
Xeroderma pigmentosum (XP) is a rare genetic disease characterised by defective DNA repair leading to clinical and cellular hypersensitivity to ultraviolet radiation. The oculocutaneous features of 10 patients with XP were studied retrospectively. General features included parental consanguinity (40%), familiarity (60%), onset of symptoms in first 2 years (50%), malignant skin neoplasms (60%), and carcinoma of the tongue (20%). Among the ocular features, 50% of patients presented with photophobia. Lid freckles or atrophic skin lesions were seen in all patients. Lower lid tumours were seen in 30%, chronic conjunctival congestion in 40%, corneal opacification in 40%, squamous cell carcinoma of limbus in 20%, bilateral pterygium in 40%, and visual impairment in 50%. The clinical features (ocular and cutaneous) of the cases are discussed.
Assuntos
Neoplasias Oculares/patologia , Neoplasias Cutâneas/patologia , Xeroderma Pigmentoso/patologia , Adolescente , Adulto , Idade de Início , Criança , Pré-Escolar , Túnica Conjuntiva/patologia , Consanguinidade , Córnea/patologia , Neoplasias Oculares/genética , Pálpebras/patologia , Saúde da Família , Feminino , Humanos , Masculino , Pele/patologia , Neoplasias Cutâneas/genética , Xeroderma Pigmentoso/genéticaRESUMO
A rare case of malignant fibrous histiocytoma involving the whole eye is reported in an Oriental 60-year-old man. Six months' follow-up after exenteration did not show any evidence of local recurrence or distant metastases.
Assuntos
Neoplasias Oculares/patologia , Histiocitoma Fibroso Benigno/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The plasma prolactin response to thyrotropin-releasing hormone, which is thought to be mediated by central 5-HT mechanisms, has been studied in patients with affective disorders. There was no difference between depressive patients (taken as a whole), bipolar patients undergoing a manic phase and controls in the prolactin response to thyrotropin-releasing hormone. When the depressive patients were divided on a genetic basis into familial pure and sporadic depressive disease it was found that the sporadic patients had an enhanced response. The results do not provide any strong evidence to suggest that central 5-HT mechanisms as measured by the prolactin response to thyrotropin-releasing hormone are abnormal in depressed patients or bipolar patients undergoing a manic phase. Patients after ECT had an increased prolactin response to thyrotropin-releasing hormone which may indicate increased sensitivity of central 5-HT receptors following this treatment.
Assuntos
Transtorno Bipolar/sangue , Transtorno Depressivo/sangue , Eletroconvulsoterapia , Prolactina/sangue , Hormônio Liberador de Tireotropina/farmacologia , Transtorno Bipolar/terapia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Serotonina/metabolismoRESUMO
The plasma thyroid-stimulating hormone response to thyrotropin-releasing hormone in controls and patients with affective disorders has been studied. The results of the investigation do not suggest any abnormality of this response in monopolar or unipolar depressed patients or bipolar patients undergoing a manic phase of their illness. No significant difference in this response could be detected between 'sporadic depressive disease' patients and 'familial pure depressive disease' patients, and age- and sex-matched controls. The neuroendocrine response was essentially unchanged after treatment by ECT.
Assuntos
Transtorno Bipolar/sangue , Transtorno Depressivo/sangue , Eletroconvulsoterapia , Hormônio Foliculoestimulante/sangue , Hormônio Liberador de Tireotropina/farmacologia , Adulto , Transtorno Bipolar/terapia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The effect of maternal levels of fasting blood glucose on fetal outcome was studied in 500 women with normal and toxemic pregnancies. Forty percent of the mothers with low glucose levels gave birth to low birth weight infants. In cases of severe preeclamptic toxemia, low fasting glucose levels were associated with a higher incidence of low birth weight, prematurity and stillbirths. Thus, in a population subsisting on poor caloric and protein intake, maternal levels of fasting blood glucose may be an important index in predicting high-risk pregnancy.
Assuntos
Peso ao Nascer , Glicemia/análise , Morte Fetal , Trabalho de Parto Prematuro/sangue , Pré-Eclâmpsia/sangue , Feminino , Hemoglobinas/análise , Humanos , Hipertensão/sangue , Recém-Nascido , Trabalho de Parto Prematuro/complicações , Pré-Eclâmpsia/complicações , Gravidez , Complicações Cardiovasculares na Gravidez/sangueRESUMO
Amniotic fluid glucose values were measured in 285 women with normal and abnormal pregnancies. A progressive decrease in glucose values was observed with advancing gestation. Complications in pregnancy did not influence the amniotic fluid glucose value for the given gestational age. In patients with diabetes, very high levels were found, but these progressively decreased with advancing gestation. Since abnormal conditions in pregnancy, other than diabetes, do not affect the amniotic fluid glucose level, it seems to be a reliable tool in assessing fetal maturity. Values above 15 mg/100 ml rule out term pregnancies and those below 5 mg/100 ml, prematurity.
Assuntos
Líquido Amniótico/análise , Glucose/análise , Creatinina/análise , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Complicações na Gravidez/metabolismo , Gravidez em Diabéticas/metabolismoRESUMO
Intravenous glucose tolerance tests were performed in undernourished and well-nourished normal pregnant women and for toxemic women near term. Both blood glucose and free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well-nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well-nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well-nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels did not return to basal value even after 90 min of glucose load. Since human placental lactogen in pregnancy is known to regulate free fatty acid release for energy utilization, its deficiency in toxemia (commonly known to occur) could be implicated in the abnormal free fatty acid response seen in this investigation.
Assuntos
Ácidos Graxos não Esterificados/metabolismo , Glucose/administração & dosagem , Distúrbios Nutricionais/metabolismo , Complicações na Gravidez/metabolismo , Adolescente , Adulto , Glicemia/análise , Ácidos Graxos não Esterificados/sangue , Feminino , Glucose/metabolismo , Teste de Tolerância a Glucose , Humanos , Infusões Parenterais , Pré-Eclâmpsia/metabolismo , Gravidez , Fatores de TempoRESUMO
Of 650 patients who underwent various surgical procedures on the anterior segment in which 2% lidocaine hydrochloride plus 1:100,000 epinephrine was used as a local anesthetic, 5 experienced postoperative complications attributed to the anesthetic: ptosis (in 2 cases), horizontal rectus muscle palsy (in 2) and lagophthalmos (in 1). The cause of the complications may have been inadvertent direct infiltration of the anesthetic into the levator palpebrae superioris, the horizontal rectus muscles and the orbicularis oculi respectively. All the patients recovered spontaneously in 8 to 12 weeks. The clinical course was compatible with myotoxic effects of local anesthetics.
Assuntos
Anestesia Local/efeitos adversos , Epinefrina/efeitos adversos , Doenças Palpebrais/induzido quimicamente , Lidocaína/efeitos adversos , Procedimentos Cirúrgicos Oftalmológicos , Oftalmoplegia/induzido quimicamente , Adolescente , Idoso , Idoso de 80 Anos ou mais , Blefaroptose/induzido quimicamente , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A 24-year-old East Indian woman presented with an inflammatory swelling in the supranasal quadrant of the left orbit and vertical diplopia. The motility disorder was of typical acquired Brown's syndrome. Histopathological examination of the lesion revealed Cysticercus cellulosae, a parasitic cyst known to produce a severe inflammatory reaction. To our knowledge this is the first report of acquired inflammatory Brown's syndrome caused by cysticercosis.