RESUMO
Orthotopic heart transplant recipients need immunosuppressive treatment and are at an increased risk for opportunistic infections such as Malassezia folliculitis. During a 4-month period (July to October 1990), 11 such cases were identified and treated; all were male with mean age of 43+/-9 years and on standard triple immunosuppressive therapy. Skin scrapings in potassium hydroxide (KOH) preparation with microscopy and/or culture identified either Malassezia furfur or Malassezia pachydermatis as the etiologic agent. A treatment with topical preparation (clotrimazole 1% and selenium sulfide lotion) was effective in 6 patients, whereas the rest received systemic fluconazole treatment with satisfactory outcome; all lesions were resolved within 3 weeks. Fluconazole appears to be an effective agent with excellent therapeutic outcome when administered for 3 weeks.
Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Fluconazol/uso terapêutico , Foliculite/tratamento farmacológico , Foliculite/microbiologia , Transplante de Coração , Hospedeiro Imunocomprometido , Malassezia , Adulto , Dermatomicoses/diagnóstico , Dermatomicoses/patologia , Feminino , Transplante de Coração/imunologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The usefulness of fluorimetric techniques in the diagnosis of pheochromocytoma was investigated. In the 63 cases studied during 25 years by measuring simultaneously various aminergic parameters, including plasma catecholamines and urinary adrenaline (A), noradrenaline (N) and vanilmandelic acid (VMA), we were able to establish the diagnosis of pheochromocytoma in all cases. Adrenaline excretion was found to be higher in patients with tumors located on the adrenal region, whereas N excretion was predominantly increased in patients with extra-adrenal tumors. In patients having tumors smaller than 50 g, A + N excretion was higher and VMA was lower than in those whose tumors were heavier; therefore in cases with small tumors the ratio VMA/A + N was lower than in those with larger tumors. It is concluded that simultaneous measurements of PC, A, N and VMA allow the diagnosis to be made in the most patients with this tumor. On the other hand, the predominant increase in A excretion is suggestive of adrenal pheochromocytoma.
Assuntos
Neoplasias das Glândulas Suprarrenais/metabolismo , Catecolaminas/análise , Feocromocitoma/metabolismo , Adolescente , Neoplasias das Glândulas Suprarrenais/diagnóstico , Adulto , Catecolaminas/sangue , Catecolaminas/urina , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Feocromocitoma/diagnósticoRESUMO
Se presenta la utilidad de la cuantificacion fluorometrica de las catecolaminas en el diagnostico de feocromocitoma.En los 63 casos estudiados durante 25 anos, en este Instituto Nacional de Cardiologia Ignacio Chavez, de Mexico, se midieron simultaneamente las catecolaminas plasmaticas y adrenalina (A), noradrenalina (N) y acido vainillilmandelico (AVM) en orina, lo que permitio establecer el diagnostico de la existencia del tumor cromafin en todos los casos. La excrecion de adrenalina fue mas alta en los pacientes con tumor localizado en la suprarrenal mientras que la noradrenalina estuvo mas elevada en los de localizacion extrasuprarrenal. Los pacientes con tumores menores de 50 gms tuvieron excrecion de A + N mas elevada y de AVM mas baja en comparacion con los que tenian tumoracion de mayor peso, y por tanto la relacion AVM/A + N fue mas baja. Se concluye que la determinacion simultanea de CP, A, N y AVM, permiten hacer el diagnostico correcto en la mayoria de los pacientes con feocromocitoma. Por otra parte, el aumento predominante de A en orina sugiere la localizacion suprarrenal de la neoplasia