RESUMEN
Twenty eight patients (18 men and 10 women) with delayed pressure induced urticaria were analyzed. The average age was 35.5 years, and the illness lasted 1-20 years, 4.07 years on average. The spontaneous cessation of illness came in 8 patients after approximately 5.75 years. In 23 patients there was also a classical chronic urticaria. C3, C4, alpha 1 antitrypsin, alpha 2 macroglobulin, immunoglobulin IgG, IgA, IgM and IgE were determined for 15 patients and findings were within normal limits apart from the moderate increase of IgE in 2 patients. Fifteen patients were examined for intestinal parasites and in 3 patients they were found. Also, a pathogenetic mechanism of illness was considered: the role of histamine, proteinase inhibitors, mediators of the delayed allergic urticaria.
Asunto(s)
Presión/efectos adversos , Urticaria/etiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Urticaria/metabolismoRESUMEN
The results of the treatment with vitamin E of seven patients with late skin porphyria are presented Vitamin E was given in the daily dose from 60 to 90 IU. The treatment resulted in the decrease of urine porphyrine and regression of skin changes. Side effects of vitamin E have not been observed and the pathophysiologic mechanism of its effect is reported.
Asunto(s)
Porfiria Cutánea Tardía/tratamiento farmacológico , Vitamina E/uso terapéutico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Hirschsprung's disease is rare in adults and represents a unique problem in the diagnosis and therapy. The permanent symptoms of the disease are persistent chronic constipation and meteorism. The degree of constipation depends on the length and narrowing of the aganglionary segment, diet and compensatory capacities of the bowel. Already known characteristics of agangliosis (absence of ganglions cells in intramuscular and submucous plexus, changes in nerve fibers and increased cholinesterase activity of the parasympathetic nerve fibers) cause impairment in peristalsis of the aganglionary segment and insufficient relaxation of the internal anal sphincter. The result is a functional refractory constipation. The disease can be diagnosed on the basis of the history, RTG examination, electromanometry and histopathology. In the majority of cases RTG examination is very reliable if performed according to generally accepted criteria. It is important to reveal the narrowed aganglionary area by oblique and profile images during irrigoscopy and irrigography. The treatment is surgical. The preferred operations are those with a combined transabdominal-transanal approach. Such operations are the most successful in management of constipation and maintenance of contingency. The authors present three cases. Three patients were old between 21 and 23 years. Their stools ranged from 10 days to two months (a stool per 10 days to two months). The diagnosis was established for all three patients by RTG examinations and histopathological findings. All bore the operation very successfully. Three various operation techniques were used according to surgeon's choice.
Asunto(s)
Enfermedad de Hirschsprung , Adulto , Femenino , Enfermedad de Hirschsprung/diagnóstico , Enfermedad de Hirschsprung/terapia , Humanos , MasculinoRESUMEN
Results in the treatment of 5 patients with porphyria cutanea tarda by plasma exchange are presented. The procedure was applied every second or third day, 2-4 procedures in total. Saline solution, 5% or 12% albumin were used as plasma substitutes. The treatment lead to rapid fall in urine porphyrin level and improved clinical picture. The treatment was continued ambulatorily by 60 mg of vitamin E tbl. daily and Essentiale tbl. 3 X 1, which lead to further progressive fall in porphyrin level and improved clinical picture. In one patient citrate intoxication occurred which was prevented by Calcium Sandosten ampl. The importance of this method in the treatment of porphyria cutanea tarda and indications for this treatment are discussed.