RESUMO
Our paper describes 5 patients with a vascular malformation - angiomatosis. In the first patient, a young man, angiomatosis affected the stomach, intestine, the area of mesenterium and retroperitoneum as well as mediastinum. Angiomatous mass had invaded pelvic bones and vertebrae. Treatment was initiated with interferon alpha in a maximum tolerated dose of 3 million units 3 times a week. Because of low efficacy of interferon alpha, thalidomide was added at a dose of 100 mg per day. Bone pain disappeared following a few applications of zoledronate administered in regular monthly intervals. After 3 years of concomitant administration of interferon alpha and thalidomide, we changed the regimen due to adverse effects and are administering thalidomide and interferon alternatively in 4-monthly intervals. Treatment has resulted in 50% reduction, according to imaging, of angiomatous mass, reduced intensity of disseminated intravascular coagulation and disappearance of clinical signs. The second was a case of multiple angiomatosis affecting the intestine only (multiple intestinal angiodysplasias) where we used thalidomide monotherapy. This treatment reduced blood losses and haemoglobin concentrations rose to normal levels. This male patient had consumed 120 transfusion units per year before the initiation of thalidomide. The third case was a slowly progressing vascular malformation of the face. This vascular malformation troubled its sufferer by spontaneous shortening that could not be resolved surgically because of its fragility. Two years of combined treatment with interferon a 6 million unites 3 times a week and thalidomide 100 mg daily led to a reduction and flattening of the malformation, paling of its colour and ceasing of spontaneous bleeding. This development enabled minor surgery--partial excision of this large vascular malformation. Histology examination confirmed that there was no evidence of new capillary formation. Histological examination thus confirmed efficacy of the treatment. The fourth case involved a patient with large vascular malformations affecting supraclavicular region of the neck and nape in whom radiotherapy was applied (54 Gy) leading to a reduction of the malformation mass by a at least 50%. The fifth is a case of an extensive periorbital lymphangioma that diminished following treatment with interferon alpha. These cases illustrate the benefits of combined treatment including thalidomide and interferon alpha in patients with multiple angiomatosis or large proliferating hemangioma (vascular malformation). If combined treatment with thalidomide and interferon a is not possible, it is beneficial to use thalidomide monotherapy. Radiotherapy is another alternative, although it is necessary to apply doses exceeding 50 Gy which may not be always possible.
Assuntos
Inibidores da Angiogênese/administração & dosagem , Angiomatose/tratamento farmacológico , Hemangioma/tratamento farmacológico , Interferon-alfa/administração & dosagem , Talidomida/administração & dosagem , Adulto , Idoso , Angiomatose/patologia , Feminino , Hemangioma/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A method for quantitative determination of iodide in milk by use of the ion-selective electrode is described. The proposed method is rapid and simple. No sample pretreatment is required exept for sample ionic strength adjustment. It was possible to determine iodide concentrations down to 40 microgram/l with average relative standard deviation of 3,4%. The concentration of iodide in milk samples determined by this method ranged from 61,5 microgram J-/l to 190,8 microgram J-/l.
Assuntos
Iodetos/análise , Leite/análise , Potenciometria/instrumentação , Animais , Bovinos , Eletrodos , Potenciometria/métodosRESUMO
Citalopram i.v. and oral had a reliable antidepressive and anxiolytic effect in 101 hospitalized patients, as apparent from the achievement of complete remission in cca 60% of the patients with major depression after four weeks follow-up. Treatment with citalopram by the intravenous or oral route was most successful in anxious or inhibitory depressions, while atypical forms with hypochondriac or obsedant features responded better to infusions. The global score of HAMD and FKD scales and typical symptoms of depression such as a pathic decreased mood, anhedonia, feelings of guilt, lack of interest, anxiety and suicidal thoughts were positively reduced. The following were not affected: loss of appetite, loss of weight, anosognosia, paranoidity, and hallucinations. The clinical onset of the therapeutic effect was on average apparent on the 10th-12th day of therapy, significantly sooner when the intravenous route was used. The authors did not find significant differences in the therapeutic results in patients under and above 60 years and in those with a mild or severe depression. As regards subjective preference and preference by relatives, infusions were unequivically preferred as they had, no doubt, also a psychological effect. As to the incidence of undesirable effects, the authors did not detect a difference between the two routes of administration of citalopram, which was well tolerated and 50% of the patients did not report any side-effects and the rare ones recorded were not more frequent than in 20% of patients.