RESUMO
Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic vascular disease that has been reported in renal and internal carotid arteries and in almost every arterial bed, primarily affecting young to middle-aged people, mainly female individuals. These patients may be asymptomatic or may present with hypertension. A 29 year-old hypertensive woman was referred for a renal color Doppler ultrasound (CDU) scan because of a suspicion of renovascular hypertension and we revealed the presence of three separate stenosis on the right renal artery. Digital selective angiography (DSA) and percutaneous transluminal angioplasty (PTA) were performed but an incomplete dilation of the vessel was obtained. Because of the suboptimal result, it was decided to stent the lesions during two different procedures. Percutaneous transluminal renal angioplasty is the primary treatment of renal FMD, but should not be excluded primary stent implantation as an alternative technique to surgical revascularization.
Assuntos
Displasia Fibromuscular/cirurgia , Obstrução da Artéria Renal/cirurgia , Stents , Adulto , Angiografia Digital/métodos , Angioplastia com Balão/métodos , Feminino , Displasia Fibromuscular/diagnóstico por imagem , Humanos , Obstrução da Artéria Renal/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodosRESUMO
SACT was evaluated in 50 subjects during 24 hours ECG monitoring. All of these subjects presented frequent atrial beats with no evidence of bradyarrhythmias. SACT was measured in accordance with Strauss' formula (SACT = P2P3 - P1P1/2). Twenty-four hours recording were divided in to 4 time intervals, 6 hour each, starting 7 o'clock. The SACT is higher during nighttime than during daytime. The phenomenon is, presumably, attributable to predominance of the para-sympathetic tone during the night.
Assuntos
Ritmo Circadiano , Nó Sinoatrial/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Results of the study of cardiac function carried out on young women during various phases of the menstrual cycle were correlated to those obtained after acute administration of progesterone. In all cases systolic time intervals reveals a reduction of mechanical systole and of preejection. Direct action progesterone on cardiac function by an unknown mechanism was confirmed.
Assuntos
Hormônios Esteroides Gonadais/fisiologia , Coração/fisiologia , Adulto , Eletrocardiografia , Feminino , Hormônios Esteroides Gonadais/sangue , Coração/efeitos dos fármacos , Humanos , Ciclo Menstrual/efeitos dos fármacos , Progesterona/farmacologiaRESUMO
The Authors have studied cardiovascular effects induced by progesterone administration. The results obtained in the present investigation reveal a significant reduction in O-S2 and PEP in the absence of modifications in the values of the other parameters of systolic time intervals. The results confirm the hypothesis that progesterone exerts an adrenergic effect upon cardiac function.
Assuntos
Hemodinâmica/efeitos dos fármacos , Progesterona/farmacologia , Adolescente , Adulto , Eletrocardiografia , Feminino , HumanosRESUMO
The day-time concentrations of TSH, T3, T4, FT3 and FT4 were investigated in clinically healthy volunteers, 20 young individuals, aged from 20 to 27 years, and 12 elderly subjects, aged from 70 to 81 years. Nocturnal sampling was purposely avoided in order to eliminate the interindividual differences in sleep patterns. The day-time series were analysed by means of cosinor analysis to interpolate the best-fitting sinusoidal wave that covers the day-night period. The reconstruction of the circadian sinusoidal wave was validated for TSH, T3, T4, FT3 and FT4 in young subjects, and, with limitation, for T4 in elderly individuals. The findings suggest that the day time patterns of TSH, T3, FT4 and FT3 in elderly subjects are characterized by a dyschronism that is not detectable in young subjects. The investigation of the day-time concentrations is suggested as a cost-effective tool for exploring the circadian cycle of the pituitary-thyroid hormones in aged people.
Assuntos
Ritmo Circadiano , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: A peculiar finding from penis eco color-Doppler, detected in healty subjects with erection dysfunction, is described. METHODS: 385 patients with erection dysfunction were studied, by using duplex scan with color Doppler, 85 of these patients normal Regiscan test were chosen and patients with Induratio penis plastica or hormonal disorder were excluded. RESULTS: A "reverse" flow during the entire diastolic phase was detected in 58 normal patients (68%) with age < of 41 years. CONCLUSIONS: In the evaluation of healthy subjects with erection dysfunction, the presence of a complete "reverse" diastolic flow is indicative of a venous reflux block, that may represent an important pathogenetic mechanism in this specific setting.
Assuntos
Ereção Peniana/fisiologia , Pênis/diagnóstico por imagem , Adolescente , Adulto , Humanos , Masculino , Ultrassonografia Doppler em CoresRESUMO
NAG-urinary activity was assessed in order to study the renal effects of arterial hypertension in pregnant women. The results obtained showed that there were no significant differences between mean levels of enzymuria in control subjects and normotensive pregnant women. On the contrary, significant differences were found between these two groups and hypertensive pregnant women (above all if arterial hypertension predated pregnancy). The paper stresses the usefulness of this method, which is reliable and non-invasive, for an accurate assessment of the extent of renal damage caused by arterial hypertension during the course of pregnancy.
Assuntos
Acetilglucosaminidase/urina , Hipertensão/urina , Pré-Eclâmpsia/urina , Complicações Cardiovasculares na Gravidez/urina , Proteinúria/urina , Adulto , Feminino , Humanos , Hipertensão/complicações , Rim/fisiopatologia , Testes de Função Renal , Pessoa de Meia-Idade , Gravidez , Proteinúria/etiologiaRESUMO
So-called "endocrine" ophthalmopathy may arise even in the absence of thyroid disorders since although these two nosographic and clinical conditions are both linked to closely inter-related organ-specific auto-immune responses, they may also present independently. After a review of the two clinical conditions, the case of an autoimmune ophthalmopathy unaccompanied, at least during a long observation period, by demonstrable functional thyroid alterations is reported. The case was also unusual because only one eye was affected.
Assuntos
Doenças Autoimunes/imunologia , Exoftalmia/imunologia , Adulto , Autoanticorpos/análise , Exoftalmia/tratamento farmacológico , Feminino , Mucosa Gástrica/imunologia , Humanos , Metilprednisolona/uso terapêutico , Tireoglobulina/imunologia , Testes de Função TireóideaRESUMO
Some psychonephrological remarks on the reactions of 36 patients with chronic renal failure with respect to diet in predialysis and dialytic phase are presented.
Assuntos
Falência Renal Crônica/dietoterapia , Adulto , Proteínas Alimentares/administração & dosagem , Feminino , Humanos , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Diálise Renal/psicologiaRESUMO
Some patients undergoing periodic hemodialysis have complained that between one treatment session and the next they suffer form thirst and have serious problems in maintaining their interdialytic weight gain within the limits indicated by the medical team. Weight gain may usually be explained by psychological factors: they may be more or less acute depending on the situation in which the patient finds himself. On the basis of the present study, the Authors affirm that the lack of interdialytic weight control may be easily improved by providing the patient with psychological support capable of optimising his general level of adaptation, and that this can lead to excellent results with regard to specific problems which otherwise detract from the wellbeing of the patient and hamper the work of the medical team.
Assuntos
Diálise Renal/psicologia , Aumento de Peso , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Fatores de TempoRESUMO
A simple empirical method based on linear relation-ships between certain types of enzymuria (NAG, LDH, GRS, Isoenzymes I and V of total dehydrogenase lactate) has been used in a series of 80 patients presenting chronic nephropathy [40 interstitial nephropathy (IN) and 40 glomerulonephritis (GN)]. Diagnosis made on the basis of the results obtained in each case was identical to that based on clinical findings (in the absence of enzymuria determinations). This method, if confirmed on a larger number of statistically significant data, might be useful to obtain a differential diagnosis between I.N. and G.N. only assaying these few enzymurias. Prefixed relationships could be employed on a larger group of patients with other diseases studied for comparative purposes. Furthermore, this method appears to be fast and unexpensive.
Assuntos
Enzimas/urina , Glomerulonefrite/enzimologia , Nefrite Intersticial/enzimologia , Acetilglucosaminidase/urina , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Glomerulonefrite/diagnóstico , Glomerulonefrite/urina , Glucuronidase/urina , Humanos , Isoenzimas , L-Lactato Desidrogenase/urina , Masculino , Métodos , Pessoa de Meia-Idade , Nefrite Intersticial/diagnóstico , Nefrite Intersticial/urinaRESUMO
The behaviour of catalase activity was studied in patients with respiratory insufficiency and the results assessed in the light of a theory that attributes a completely new teleological function to this substance.
Assuntos
Catalase/sangue , Eritrócitos/enzimologia , Insuficiência Respiratória/enzimologia , Adulto , Idoso , Contagem de Eritrócitos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Respiratória/sangueRESUMO
The urinary activity of 4 enzymes (NAG, GLU, GAL, GRS) was investigated in 105 healthy subjects in order to evaluate the variability of standard levels and establish the degree of such variations in relation to sex, age, weight and height. The results obtained demonstrate that these enzymurias do vary in relation to the parameters examined. Age and sex produced the most pronounced variations though height and body weight also appeared to have some influence. The study of variations in standard levels is of value in the interpretation of pathological enzymurias.
Assuntos
Acetilglucosaminidase/urina , Galactosidases/urina , Glucosidases/urina , Glucuronidase/urina , Hexosaminidases/urina , alfa-Glucosidases/urina , beta-Galactosidase/urina , Adulto , Fatores Etários , Estatura , Peso Corporal , Feminino , Humanos , Masculino , Valores de Referência , Fatores SexuaisRESUMO
The biological effects of cosmic rays and ionising radiations on man are described. Particular attention is paid to the consequences of the environmental pollution caused by the Chernobyl accident and the relationship between I131 radiation and thyroid tumours is analysed.
Assuntos
Contaminação Radioativa do Ar , Radioisótopos do Iodo/efeitos adversos , Neoplasias Induzidas por Radiação/etiologia , Neoplasias da Glândula Tireoide/etiologia , Acidentes , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Reatores Nucleares , Doses de Radiação , Fatores Sexuais , UcrâniaRESUMO
The behaviour of urinary NAG was monitored in diabetic patients some of whom presented more or less severe vascular alterations. The results showed a relationship between urinary NAG levels and the severity of the vascular condition (in fact the greatest NAG activity was found in patients with overt kidney damage). NAG may therefore reveal the existence of a vascular nephropathy that is still too slight to be identified by the standard non-invasive clinical examinations.
Assuntos
Acetilglucosaminidase/urina , Angiopatias Diabéticas/urina , Hexosaminidases/urina , Adulto , Idoso , Humanos , Nefropatias/urina , Pessoa de Meia-IdadeRESUMO
The urinary activity of four enzymes (NAG, GLU, GRS and GAL) was studied in two groups of patients suffering respectively from interstitial nephritis and chronic glomerulonephritis with the aim of further investigating enzyme variability through the theory of partial and multiple correlation. This study permitted the effects of two enzymes on the known correlations between the remaining two enzyme types to be studied. It was established that very stable relationships exist between each enzyme and the group composed of the remaining three. In particular, in patients with interstizial nephritis, correlations with GAL were all highly significant even if the effect of the other two enzymes was ignored. Similarly, correlations with GRS were strongly significant in patients with chronic glomerulonephritis. In the two groups studied, each enzyme appears to have a highly stable relationship with the other three. Accurate estimates may probably be achieved for GAL and GRS in both groups and for NAG in the glomerulonephritis sufferers. This is further evidence that the enzyme procedure may be used to differentiate between interstitial and glomerular nephritis.
Assuntos
Enzimas/urina , Glomerulonefrite/enzimologia , Nefrite Intersticial/enzimologia , Doença Crônica , Humanos , MatemáticaRESUMO
Three groups of subjects (I with infections of the lower urinary ways; II with chronic pyelonephritis; III healthy controls) were treated with pipemidic acid for 10 consecutive days and the behaviour of their urinary NAG and AAP was studied. It was discovered that the healthy group and the patients with infections of the lower urinary ways showed no significant variations in the urinary activity of the two enzymes following the administration of pipemidic acid. However there was a distinct reduction in both enzymes in patients with chronic pyelonephritis who presented demonstrable bacterial sensitivity to the drug. Apart from the fact that it produces no nephrotoxic effects at least in the doses used and for the treatment period adopted, the drug is therefore considered to reduce renal inflammation that is beneficial to individuals with chronic interstitial nephropathy.
Assuntos
Pielonefrite/enzimologia , Infecções Urinárias/enzimologia , Acetilglucosaminidase/urina , Adulto , Idoso , Aminopeptidases/urina , Antígenos CD13 , Doença Crônica , Diagnóstico Diferencial , Feminino , Glomerulonefrite/enzimologia , Glomerulonefrite/urina , Humanos , Masculino , Pessoa de Meia-Idade , Nefrite Intersticial/enzimologia , Nefrite Intersticial/urina , Pielonefrite/urina , Infecções Urinárias/urinaRESUMO
Various substances can interfere with the urinary activity of N-acetyl-beta-D-glycosaminidase (NAG), particularly certain bacteria that exert inhibitory or enhancing effects on the enzyme. Clearly, all this constitutes a limitation on the use of the technique. For these reasons, in patients suffering from interstitial and glomerular nephropathies and essential arterial hypertension a comparative study was carried out between the activity of urinary and serum NAG to establish if the latter produces more reliable results than the former. The results of urinary NAG activity confirm that there is no significant difference between healthy subjects and those with essential arterial hypertension; on the other hand, nephropathic patients present significantly higher urinary enzyme activity than healthy controls. On the other hand, evaluation of serum NAG does not seem to provide any practical aid as it does not highlight any difference between measurements carried out in healthy subjects and those carried out in hypertensive patients or those suffering from interstitial or glomerular nephropathy.
Assuntos
Acetilglucosaminidase/sangue , Acetilglucosaminidase/urina , Ensaios Enzimáticos Clínicos , Glomerulonefrite/diagnóstico , Hexosaminidases/sangue , Hexosaminidases/urina , Hipertensão/diagnóstico , Nefrite Intersticial/diagnóstico , Adulto , Doença Crônica , Creatinina/sangue , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The behaviour of urinary NAG activity was studied in patients during menopause, some of whom were given estrogen therapy due to severe vasomotor symptoms (hot flushes etc.). One group of these patients revealed slightly higher than normal blood pressure. A second group had slight arterial hypertension and pancreatic diabetes. The third group consisted of apparently healthy menopausal women. The significant increase in enzymuria in the first two groups suggests that blood pressure should be carefully checked before starting estrogen therapy. Furthermore this treatment should be given very cautiously and under constant surveillance in the presence of slight hypertension. In patients with diabetes or more severe hypertension, estrogens should never be given.
Assuntos
Acetilglucosaminidase/urina , Climatério/urina , Estrogênios/uso terapêutico , Hexosaminidases/urina , Climatério/efeitos dos fármacos , Diabetes Mellitus/urina , Feminino , Humanos , Hipertensão/urina , Pessoa de Meia-IdadeRESUMO
Traditional therapy for heart failure (diuretics, digitalic compound, vasodilators, inodilatory ACE-inhibitors) cannot arrest the progressive overloading of the circulatory system so that it is inevitable that a refractory stage to all forms of treatment will be reached when more specialised techniques, such as heart transplant and ultrafiltration will be needed. The paper reports the results obtained in 13 patients in ultrafiltration treatment for refractory heart failure: in the majority of these, a marked improvement in general conditions (edema, dyspnea) was recorded together with a regression from class 5 to class 3 NYHA in 5 patients, and to class 2 for others. The ultrafiltration method in spite of not altering the prognosis which remains negative in these patients, allow those waiting for heart transplant to survive and may improve their chances of surviving heart surgery.