RESUMO
The side effects of intravenous (IV) administration of protirelin (thyrotrophin-releasing hormone [TRH] are usually mild and transient. The loss of consciousness and apical heart tones occurred in two young patients after protirelin injection. The mechanism for the reactions in these patients is not known, but the absence of heart sounds in the presence of no palpable pulse and no obtainable blood pressure should now be included among the adverse effects that may occur after administration of protirelin IV.
Assuntos
Auscultação Cardíaca , Ruídos Cardíacos , Hormônio Liberador de Tireotropina/efeitos adversos , Inconsciência/induzido quimicamente , Adolescente , Feminino , Humanos , Hipotensão/induzido quimicamente , Masculino , PosturaRESUMO
We determined the incidence of bacteremia and associated mortality in diabetic and nondiabetic patients in the four major hospitals of one metropolitan area over the 5-yr period 1977-1981. Mortality rates, based on episodes of bacteremia, were similar in diabetic and nondiabetic patients in most instances. Diabetic patients experienced lower mortality rates from Enterobacteriaceae bacteremia compared with nondiabetic patients; this finding was explained by a greater tendency for diabetic patients to have Escherichia coli bacteremia due to community-acquired urinary tract infection. However, the incidence of bacteremia due to all microorganisms was increased twofold in diabetic patients and the incidence of Enterobacteriaceae bacteremia was increased threefold. Because of their increased incidence of bacteremia, diabetic patients in this population were nearly twice as likely to die as a result of bacteremia compared with nondiabetic patients. Thus, the frequent occurrence of bacteremia among patients with diabetes mellitus represents a significant problem.
Assuntos
Complicações do Diabetes , Sepse/complicações , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Infecções por Enterobacteriaceae/complicações , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/mortalidade , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Sepse/epidemiologia , Sepse/mortalidade , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/mortalidadeRESUMO
Parathyroid cysts are a rare cause of primary hyperparathyroidism. A case is presented of a 25-year-old black man who presented with hyperparathyroidism and at operation was found to have a 2.5 cm parathyroid cyst at the left inferior position. The cyst contained clear fluid, and the wall was thickened and composed of hyperplastic parathyroid tissue. The remaining glands were smaller but also hyperplastic. Subtotal parathyroidectomy was performed. This case presents many of the typical features of parathyroid cysts. The pertinent literature is reviewed. Parathyroid cysts present as two distinct groups, functioning and nonfunctioning. The former are more common in men, and the cyst is more likely to be secondary to degenerative changes in a hyperplastic gland. In contrast, nonfunctioning parathyroid cysts are more common in women and present as neck masses or incidental findings at operation. The different proposed etiologies for parathyroid cysts are discussed. Preoperative diagnosis is rare but important as it may prevent an unnecessary neck exploration or thyroidectomy. The diagnosis should be suspected with any cystic neck mass that yields clear fluid on aspiration, especially if it is in the inferior position. The fluid should be submitted for parathormone evaluation. Aspiration alone has been curative in some cases.