Asunto(s)
Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Anciano , Antibacterianos/uso terapéutico , Bacterias/aislamiento & purificación , Bronquitis/tratamiento farmacológico , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Esputo/microbiologíaRESUMEN
Anaphylaxis is a systemic reaction which can be very dangerous in many patients. In addition to the most common antigens (drugs, venoms, foods), physical exercise can provoke anaphylaxis in the sensitized patients. The mechanism of this reaction is still unknown. In this report, we describe a case of exercise-induced anaphylaxis in a 25 year old female who had experienced two syncopal attacks during strong physical activity. On other occasions she had noticed that prolonged work would cause urticaria, pruritus and numbness. During hospitalization, on two occasions a treadmill stress test induced bronchial spasm, urticaria and hypotension. We believe that the association of urticaria and anaphylaxis would suggest the possible presence of a vasoactive substance released from the mast-cells and basophil leucocytes.
Asunto(s)
Anafilaxia/etiología , Esfuerzo Físico , Adulto , Aspirina/efectos adversos , Basófilos/metabolismo , Espasmo Bronquial/etiología , Hipersensibilidad a las Drogas/etiología , Femenino , Humanos , Hipotensión/etiología , Mastocitos/metabolismo , Síncope/etiología , Urticaria/inducido químicamente , Urticaria/etiologíaRESUMEN
OBJECTIVE: To investigate the possible associations between sleep apnea syndrome, hyperinsulinemia/insulin resistance and hyperleptinemia in subjects with different degrees of body mass index. DESIGN: To test for the presence or absence of sleep apnea syndrome in association with hyperinsulinemia/insulin resistance and hyperleptinemia. SUBJECTS: Twenty subjects with different body mass index (mean BMI 30.9+/-4.2). MEASUREMENTS: Insulin action and plasma soluble leptin receptor were measured by euglycemic hyperinsulinemic glucose clamp and by ELISA method, respectively. Occurrence of sleep apnea syndrome was assessed by clinical and nocturnal monitoring using a validated sleep apnea recorder. RESULTS: The apnea/hypopnea index (AHI) was positively correlated with plasma soluble leptin receptor (0.76; P<0.001) and negatively with the degree of insulin-mediated glucose uptake (r=-0.73; P<0.001). In a multivariate analysis AHI was associated with plasma soluble leptin receptor and insulin mediated glucose uptake independently of age, gender, BMI, plasma leptin levels and PaCO(2). CONCLUSION: Sleep apnea syndrome is associated with plasma soluble leptin receptor and insulin resistance independently of BMI.