RESUMEN
Se presentan 4 casos de síndrome de shock tóxico asociados a infección por Streptococcus beta-hemolítico grupo A (Streptococcus pyogenes). Todos presentaron hipotensión y disfunción orgánica. Un caso se presentó en forma típica con fascitis necrotizante. Otro paciente tuvo una forma eritrodérmica con posterior descamación asociado a faringitis no invasiva. Una sepsis puerperal con neumonía cavitada y empiema; y un niño con faringitis y bacteremia. Se discute clínica, teorías fisiopatológicas, epidemiología y tratamiento (AU)
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Infecciones Estreptocócicas/diagnóstico , Streptococcus pyogenes/efectos de los fármacos , Choque Séptico/etiología , Infecciones Estreptocócicas/fisiopatología , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus pyogenes/patogenicidad , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/etiología , Miositis/etiología , Miositis/tratamiento farmacológico , Antibacterianos/uso terapéutico , Clindamicina/uso terapéuticoRESUMEN
Se presentan 4 casos de síndrome de shock tóxico asociados a infección por Streptococcus beta-hemolítico grupo A (Streptococcus pyogenes). Todos presentaron hipotensión y disfunción orgánica. Un caso se presentó en forma típica con fascitis necrotizante. Otro paciente tuvo una forma eritrodérmica con posterior descamación asociado a faringitis no invasiva. Una sepsis puerperal con neumonía cavitada y empiema; y un niño con faringitis y bacteremia. Se discute clínica, teorías fisiopatológicas, epidemiología y tratamiento
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Adolescente , Adulto , Persona de Mediana Edad , Infecciones Estreptocócicas/diagnóstico , Streptococcus pyogenes/efectos de los fármacos , Clindamicina/uso terapéutico , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/etiología , Infecciones Estreptocócicas/fisiopatología , Infecciones Estreptocócicas/tratamiento farmacológico , Lactamas/uso terapéutico , Miositis/tratamiento farmacológico , Miositis/etiología , Choque Séptico/etiología , Streptococcus pyogenes/patogenicidadRESUMEN
Plasma high density lipoprotein cholesterol (HDL-C) was evaluated in 15 rabbits fed cholesterol supplemented diets to assess its protective effect on the atherogenic process. From a baseline level of 29 +/- 11 mg/dl (mean +/- SD) the maximum attained for HDL-C was twofold in only three rabbits, whereas total cholesterol (TC) increased 20 fold. Plasma TC/HDL-C ratio rose 80 fold from the baseline (2.4 +/- 0.9) and it was the best parameter that correlated with aortic cholesterol accumulation and pathological scores. Aortic TC content increased 10 fold and free cholesterol/cholesterol esters ratio decreased 20 fold. Pathological studies showed that aortic lesion scores rose from 0 to 4. It can be concluded that the high correlations obtained when TC/HDL-C ratio was plotted against both aortic cholesterol deposition and lesion scores, support the theory of the reverse cholesterol transport and the effectiveness of this index to predict the degree of the atherogenic process. On the other hand, the poor response of HDL-C in this model encourages future research using drugs to increase this parameter in order to normalize TC/HDL-C ratio and avoid lesions.
Asunto(s)
Enfermedades de la Aorta/sangre , HDL-Colesterol/sangre , Dieta Aterogénica , Animales , Aorta , Hipercolesterolemia/sangre , Masculino , ConejosRESUMEN
Plasma high density lipoprotein cholesterol (HDL-C) was evaluated in 15 rabbits fed cholesterol supplemented diets to assess its protective effect on the atherogenic process. From a baseline level of 29 +/- 11 mg/dl (mean +/- SD) the maximum attained for HDL-C was twofold in only three rabbits, whereas total cholesterol (TC) increased 20 fold. Plasma TC/HDL-C ratio rose 80 fold from the baseline (2.4 +/- 0.9) and it was the best parameter that correlated with aortic cholesterol accumulation and pathological scores. Aortic TC content increased 10 fold and free cholesterol/cholesterol esters ratio decreased 20 fold. Pathological studies showed that aortic lesion scores rose from 0 to 4. It can be concluded that the high correlations obtained when TC/HDL-C ratio was plotted against both aortic cholesterol deposition and lesion scores, support the theory of the reverse cholesterol transport and the effectiveness of this index to predict the degree of the atherogenic process. On the other hand, the poor response of HDL-C in this model encourages future research using drugs to increase this parameter in order to normalize TC/HDL-C ratio and avoid lesions.