RESUMEN
A 36-year-old woman developed severe arterial hypertension after taking for five consecutive years increasing dose (up to 10 mg per day) of phenoxazoline HCl in nasal spray. A relationship between the abuse of this sympathomimetic drug and the hypertension was suggested by the unusual appearance of renal arteries on arteriography (stenosis and dilatations resembling aneurisms), the increase in renin activity and the disappearance of hypertension after the drug was discontinued. On control examination, two years later, blood pressure, renin activity and renal arteries were normal. The possibility of sympathomimetic drug overdosage must be borne in mind in cases of suspected iatrogenic arterial hypertension.
Asunto(s)
Hipertensión/inducido químicamente , Simpatomiméticos/efectos adversos , Adulto , Femenino , Humanos , Simpatomiméticos/administración & dosificaciónRESUMEN
The authors present a study of 38 cases of renal malacoplakia, two of which are personal. The clinical roentgenological and pathological data of such a histologically defined disease are reviewed. Nosological and physiopathological recollection is necessary before discussing management.
Asunto(s)
Enfermedades Renales/patología , Riñón/patología , Malacoplasia/patología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/fisiopatología , Malacoplasia/diagnóstico , Malacoplasia/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
Computarized axial tomography has shown the localization of adrenal lesions in four cases of hypertension of adrenal origin: two phaeochromocytomas, one primary hyperaldosteronism, one Cushing's syndrome. This method has the advantage of being neither invasive, nor time-consuming. Unfortunately, it cannot localize tumors smaller than two cm in diameter. It seems to be highly beneficial in phaeochromocytoma, where it can advantageously take the place of arteriography. It is less fruitful in primary hyperaldosteronism and in Cushing's syndrome because lesions are smaller.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Síndrome de Cushing/diagnóstico por imagen , Hiperaldosteronismo/diagnóstico por imagen , Hipertensión/etiología , Feocromocitoma/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Glándulas Suprarrenales/diagnóstico por imagen , Adulto , Angiografía , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Flebografía , CintigrafíaRESUMEN
Sixty-five patients, convalescent from a first myocardial infarction (anterior in 24 cases; inferior in 41 cases), underwent an effort electrocardiogram on a treadmill and coronary arteriography. In the anterior infarcts, coronary arteriography showed single vessel disease (anterior descending artery) in 54% of cases and double or triple vessel disease in the others. The effort test was positive in only 25% of patients with an anterior infarct. The presence of stenotic lesions of the circumflex artery and/or right coronary artery was unsuspected in 63% of patients. In the inferior infarcts, there was a significant stenosis of the anterior descending artery in 51% of the cases. The effort test was positive in 54% of patients and in 77% of those the anterior descending artery showed a significant stenosis. The appearance (or increase) of ST elevation greater than or equal to 1 mm in the leads facing the infarcted zone was an indication of more severe deterioration in left ventricular function as shown by a more marked reduction in ejection fraction and a more extensive akinetic region. The co-existence of ST elevation in the leads facing the infarcted zone and of ST depression greater than or equal to 1 mm in the reciprocal leads always indicated that another major vessel was involved, but this was only found in 25% of cases in this series.