RESUMEN
HISTORY AND PRESENTING COMPLAINT: A 30-year-old primipara after a normal pregnancy had delivered a 3340 g child. After an uneventful post-partum period she had noticed her abdomen failing to reduce in size. INVESTIGATIONS, DIAGNOSIS AND TREATMENT: The abdominal sonography discovered a large retroperitoneal tumor. CT and MRI showed a giant tumor which originated from the right kidney. Suspecting the diagnosis of renal liposarcoma the kidney and tumor were excised with removal of enlarged precaval and preaortal lymph nodes. Gross inspection revealed a ca. 3,2 kg myxoid tumor, measuring 27 x 19 x 10 cm. The histological examination of the surgical preparation revealed a retroperitoneal angiomyolipoma. CONCLUSION: This is the first case of a giant retroperitoneal angiomyolipoma with lymph node involvement diagnosed post partum.
Asunto(s)
Angiomiolipoma/diagnóstico , Neoplasias Renales/diagnóstico , Metástasis Linfática/diagnóstico , Trastornos Puerperales/diagnóstico , Neoplasias Retroperitoneales/diagnóstico , Adulto , Angiomiolipoma/patología , Angiomiolipoma/cirugía , Diagnóstico Diferencial , Diagnóstico por Imagen , Femenino , Humanos , Riñón/patología , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Metástasis Linfática/patología , Nefrectomía , Trastornos Puerperales/patología , Trastornos Puerperales/cirugía , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/cirugíaRESUMEN
BACKGROUND: The beneficial effects of the beta-blocker bisoprolol on mortality and rate of hospitalisation as well as its safety in patients with chronic heart failure has been proven. However, its efficacy in patients in whom beta-blockers have traditionally been contraindicated or caution has been advised has not been clearly determined. Therefore, analyses in high-risk subgroups of patients taking part in CIBIS II have been performed to investigate the effect of bisoprolol in elderly patients, in patients with type 2 diabetes, with renal failure, NYHA functional class IV or concomitantly treated with digitalis, aldosterone antagonists or amiodarone. METHODS: High-risk subgroups of patients with chronic heart failure taking part in the CIBIS II study were retrospectively analysed with respect to mortality, hospitalisation, combined endpoint of cardiovascular mortality or hospitalisation for cardiovascular reasons and treatment withdrawal as well as cause of death and hospitalisation. Analysis is based on intention-to-treat. RESULTS: It was demonstrated that in spite of the expected increase in the overall risk of death and hospitalisation, patients who are diabetic, have renal impairment, NYHA class IV symptoms, are elderly, are taking either digitalis, amiodarone or aldosterone antagonists as co-medication benefit equally from beta-blockade with bisoprolol as patients without these complications or drugs. Benefit was shown for the primary endpoint all cause mortality, as well as for the secondary endpoints. CONCLUSIONS: Contrary to the hitherto prevailing doctrine of not using beta-blockers in high risk patient groups with chronic heart failure, retrospective analyses of the CIBIS II study justify the use of this drug class in patients regardless of age, NYHA functional class, the presence of diabetes, renal impairment or concomitant treatment with digitalis, amiodarone or aldosterone antagonists.
Asunto(s)
Antagonistas Adrenérgicos beta/administración & dosificación , Bisoprolol/administración & dosificación , Causas de Muerte , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/mortalidad , Distribución por Edad , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Intervalos de Confianza , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Alemania , Insuficiencia Cardíaca/complicaciones , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Probabilidad , Valores de Referencia , Insuficiencia Renal/complicaciones , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
The effects of single oral doses of 10 and 20 mg ebastine were compared with placebo and 2 mg clemastine in a double-blind cross-over study in 16 healthy male volunteers. Clemastine produced the known pattern of changes, namely impairment of psychomotor performance, drowsiness, and a selective effect on cognitive processes. Earlier encoding in a perceptual stage was slowed whereas abstract classification processes were not affected. Electrophysiological measures of vigilance showed a general decrease in vigilance especially 2.5 and 4.5 h after dosing. In contrast at no time was any effect of ebastine different from that of the placebo. Ebastine 10 and 20 mg differed positively from clemastine in its effect on pursuit tracking, subjective rating of drowsiness and general discomfort. Ebastine 10 mg also differed positively from clemastine in the EEG features of vigilance. It is concluded that 10 and 20 mg ebastine were free from sedative adverse effects.
Asunto(s)
Butirofenonas/farmacología , Clemastina/farmacología , Electroencefalografía/efectos de los fármacos , Antagonistas de los Receptores Histamínicos H1/farmacología , Piperidinas/farmacología , Desempeño Psicomotor/efectos de los fármacos , Adulto , Cognición/efectos de los fármacos , Método Doble Ciego , Humanos , Masculino , Valores de Referencia , Sueño/efectos de los fármacos , Encuestas y Cuestionarios , Vigilia/efectos de los fármacosRESUMEN
The pharmacodynamic profile of bisoprolol, a new beta 1-selective adrenoceptor antagonist, was investigated in four independent studies including 36 healthy male volunteers. Using the model of exercise-induced tachycardia (ET) the beta-adrenoceptor blocking properties of bisoprolol (2.5-40 mg) were examined in comparison to metoprolol (50 and 100 mg), propranolol (40 and 80 mg) and atenolol (50 and 100 mg). The maximal reduction of ET was achieved between 1 and 4 h following single oral administration. The dose-response relationship using individual maximal reduction of ET showed, on a molar basis, that bisoprolol is about 5, 7 and 10 times more effective than propranolol, atenolol and metoprolol, respectively. In the model of insulin-induced hypoglycaemia bisoprolol behaved as a beta 1-selective adrenoceptor antagonist. There was a good correlation (r = 0.94) between the log bisoprolol concentration and the reduction in exercise-induced tachycardia. Bisoprolol is a potent new cardioselective beta-adrenoceptor antagonist with a competitive action at beta 1-adrenoceptors.
Asunto(s)
Antagonistas Adrenérgicos beta/farmacología , Propanolaminas/farmacología , Adulto , Atenolol/farmacología , Bisoprolol , Relación Dosis-Respuesta a Droga , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Metoprolol/farmacología , Esfuerzo Físico , Propranolol/farmacología , Factores de TiempoRESUMEN
The purpose of the study was to evaluate the duration of inhibition of acid secretion by single oral doses of cimetidine and ranitidine. Basal and postprandial acid secretion in 6 healthy volunteers were measured for 14h by intermittent aspiration and prolonged intragastric titration. 400 mg cimetidine reduced daytime acid secretion by 22% and 150 mg ranitidine produced 38% inhibition. Although the elimination half lives of the drugs were similar, ranitidine led to more pronounced inhibition of acid secretion during the later part of the day. The longer duration of pronounced acid inhibition by ranitidine appears to be due solely to its greater potency.
Asunto(s)
Cimetidina/farmacología , Ácido Gástrico/metabolismo , Ranitidina/farmacología , Adulto , Cimetidina/efectos adversos , Método Doble Ciego , Ingestión de Alimentos , Gastrinas/sangre , Humanos , Masculino , Ranitidina/efectos adversos , Factores de TiempoRESUMEN
Visual evoked potential (VEP) was analyzed in 24 healthy male volunteers (age: 25-35 years) between 7.00 a.m. and 4.00 p.m. to evaluate possible diurnal variation in hemispheric differences of the response to a diffuse or 1 degree flash and checkerboard pattern-reversal (stimulation: binocular). VEP was recorded over O1-A1 and O2-A2, and 64 exposures were averaged during each session. After diffuse and 1 degree flash stimulation the amplitudes of early components (latencies less than 140 ms) were higher over the right hemisphere (O2-A2) than over the left (O1-A1) in the morning. These differences disappeared during the afternoon. Late components (latencies greater than 250 ms) exhibited higher amplitudes over the left than over the right hemisphere during the whole experiment. With checkerboard pattern-reversal stimulation such a time-dependent change in the amplitudes of VEP between both hemispheres was not measurable.
Asunto(s)
Ritmo Circadiano , Dominancia Cerebral/fisiología , Potenciales Evocados Visuales , Adulto , Humanos , Masculino , Tiempo de Reacción/fisiologíaRESUMEN
Cefazedone (Refosporin) was tested for efficacy and tolerance in 1161 patients. The trial was interrupted or unsuitable for evaluation in 54 cases. Diagnostical characteristics of the remaining 1107 patients tested for tolerance were: therapeutical and prophylactic use in surgery (37,5%) infections of the bronchial tract (30.8%), infections of the urogenital tract (17.9%), infections of the abdominocystic tract (6.2%), other infections (7,6%). Of the 1085 patients tested for efficacy--in 22 cases the trial was interrupted because of undesired side effects (exanthema, nausea, local intolerance)--87% concerned exclusively antibiotic therapy with cefazedone. Cefazedone was administered only twice daily i. v. Combined medication with other antibiotics--mainly amino glycosides--was highly efficient.
Asunto(s)
Enfermedades de las Vías Biliares/tratamiento farmacológico , Cefazolina/análogos & derivados , Cefalosporinas/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Bacteroides/efectos de los fármacos , Evaluación de Medicamentos , Enterobacteriaceae/efectos de los fármacos , Escherichia coli/efectos de los fármacos , Humanos , Proteus vulgaris/efectos de los fármacos , Staphylococcus aureus/efectos de los fármacos , Streptococcus/efectos de los fármacosAsunto(s)
Cefazolina/análogos & derivados , Cefalosporinas/metabolismo , Adulto , Anciano , Líquidos Corporales/metabolismo , Cefalosporinas/sangre , Femenino , Enfermedades de los Genitales Femeninos/cirugía , Humanos , Recién Nacido , Cinética , Lactancia , Persona de Mediana Edad , Leche Humana/análisis , EmbarazoRESUMEN
Data from a heritable translocation test were analysed to estimate the best rule for classification of F1 males in normals or partially sterile translocation carriers according to litter size or numbers of live and dead implants per mating. Six rules were compared for classification with up to three litter sizes per F1 male observed. The results indicate that a translocation rate of 2%, or at best of 1%, can be detected with reasonable cost.
Asunto(s)
Técnicas Genéticas , Infertilidad Masculina/genética , Translocación Genética , Animales , Femenino , Heterocigoto , Tamaño de la Camada , Masculino , Matemática , Ratones , EmbarazoAsunto(s)
Evaluación Preclínica de Medicamentos/métodos , Genes Dominantes/efectos de los fármacos , Genes Letales/efectos de los fármacos , Mutágenos/farmacología , Factores de Edad , Animales , Peso Corporal , Cruzamiento , Femenino , Vivienda para Animales , Masculino , Ratones , Especificidad de la Especie , Estadística como Asunto , Factores de TiempoRESUMEN
On guinea-pig atria part of the inotropic response to histamine is attributable to a concomitant increase of the frequency [7]. Since the chronotropic effect of histamine is mediated by a stimulation of H2-receptors a direct interaction of histamine with H1-receptors a direct interaction of histamine with H1-receptors mediating the inotropic response on heart may be overlooked. For this reason the ability of the H1-antagonist promethazine and the H2-antagonist burimamide to inhibit the positive chronotropic, inotropic and coronary vascular responses to histamine was determined in spontaneously beating and electrically driven perfused guinea-pig hearts. (1) Burimamide produced a competitive blockade of the positive chrono- and inotropic responses to histamine. (2) On the other hand, promethazine in concentrations that had no effect on cardiac function by itself, proved to be ineffective against the positive chrono- and inotropic responses produced by histamine on spontaneously beating and electrically driven heart preparations. (3) The predominant coronary vasodilation observed after infusion with histamine was competitively antagonized by promethazine and burimamide. This blockade was not attributable to an interaction with myocardial H2-receptors mediating increases in heart rate and contractility and was, therefore, direct in nature. (4) Based upon the present study and former investigations [7] the following distribution of different histamine receptors in the guinea-pig heart does exist: H1-receptors are present in the atrial muscle and the coronary vascular bed. H2-receptors are located in the sinus node, the ventricular myocardium and the coronary vessels.
Asunto(s)
Burimamida/farmacología , Circulación Coronaria/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Antagonistas de los Receptores Histamínicos H1 , Antagonistas de los Receptores H2 de la Histamina , Histamina/farmacología , Prometazina/farmacología , Tiourea/análogos & derivados , Animales , Interacciones Farmacológicas , Cobayas , Técnicas In Vitro , Contracción Miocárdica/efectos de los fármacos , Estimulación QuímicaRESUMEN
The time course of 1-butylbiguanide concentration in plasma and the urinary and fecal elimination of the substance were measured in six female elimination of the substance were measured in six female diabetic patients after oral administration of 100 mg of 14C-1-butylibiguanide hydrochloride as Sindiatil. The mean maximum plasma concentration was 37 mug/100 ml and was reached after about 2 1/2 h. At least semi-maximum plasma concentrations (greater than or equal 18 mug/100 ml) were maintained between the 1st and 8th h after administration. Within 24 h 64% of the administered dose were eliminated (36% via the kidneys, 28% with the faeces). After 3 days a total of 80% had been eliminated, one-half each in urine and faeces, respectively. The average time taken for 50% of maximum renal elimination, and thus of the absorbed quantity, to be excreted was 7.2 h.