RESUMO
BACKGROUND: Ciguatera fish poisoning is a clinical syndrome associated with the consumption of contaminated fish. The clinical picture is a constellation of gastrointestinal, neurologic and cardiovascular symptoms. AIM: To report 10 cases of ciguatera poisoning in our country. METHOD: We recorded the clinical course during the severe acute symptoms with a follow up of 34 months. RESULTS: The time between the ingestion of contaminated fish and symptoms varied from 20 minutes to 12 hours. All suffered gastrointestinal disturbances as the main manifestation. Watery diarrhea was the earliest complaint. Cold-to-hot temperature reversal dysesthesia occurred in all but there were differences in the occurrence of nausea, vomiting, cramping, abdominal pain, weakness, paresthesia, arthralgia, myalgia, dizziness, dysuria, dyspnea, headache, pruritus, lip numbness, dry mouth, dental pain, chills, tremors, fasciculations, blurred vision, hypersalivation and dysphagia. CONCLUSION: 1. There were some differences in the clinical picture of our cases mainly in the initial symptoms and their severity. 2. Gastrointestinal symptoms were the most common complaint. 3. We did not find associations between the amount of toxic fish ingested with the latency period and the severity and duration of the symptoms.
Assuntos
Ciguatera , Alimentos Marinhos/intoxicação , Adolescente , Adulto , Animais , Pré-Escolar , Feminino , Peixes , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
Forty patients with mild or moderate essential hypertension were studied. They received daily doses of either 240 mg verapamil or 10 mg enalapril, as well as a placebo. Total duration of trial was 24 weeks: a "washout" period of 2 weeks, a treatment period of 6 weeks with one of the two drugs, another "washout" period of 2 weeks, and another treatment period of 6 weeks with the alternate drug. Those patients with persistence of diastolic blood pressure (DBP) above 90 mmHg received simultaneously both drugs for an additional period of 8 weeks. Patients were assigned alternately to one of the groups. When each drug was given during the first treatment period, DBP was reduced below 90 mmHg in 15 of 19 patients receiving verapamil, and in 12 of 20 that received enalapril. When the drugs were given during the second treatment period, DBP became normal in 16 of 19 patients receiving enalapril, and in all the 18 patients treated with verapamil. Three patients achieved normal DBP when received simultaneously both drugs. Two patients withdrew from the trial for personal reasons and one for experimenting cough as reaction to enalapril. There were no other undesirable side effects. Laboratory tests did not show changes. Both products were similarly effective. Synergy was shown by the improvement of patients unresponsive to either drug when given singly, but responding when both were given simultaneously.
Assuntos
Hipertensão/tratamento farmacológico , Adulto , Idoso , Análise de Variância , Pressão Sanguínea/efeitos dos fármacos , Avaliação de Medicamentos , Sinergismo Farmacológico , Quimioterapia Combinada , Enalapril/uso terapêutico , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Verapamil/uso terapêuticoRESUMO
We assessed the efficacy and safety of cilazapril, alone or in combination with hydrochlorothiazide. It was an open trial, that included 14 patients with or more 114 mmHg of diastolic arterial tension. On the first stage of 25 days, the arterial tension was normalized in 5 patients with 10 mg of cilazapril and 7 patients when hydrochlorothiazide was added, 2 patients did not respond. On the second stage of 52 weeks, of the 12 patients whose diastolic arterial tension was normalized, 2 patients remained with normal arterial tension with cilazapril, 5 when hydrochlorothiazide was added and the rest 5 patients did not respond. No undesirable side effects were detected, nor abnormalities in the laboratory tests. The long-term benefit obtained on 50% of patients make evident the usefulness of cilazapril in severe arterial hypertension. Its administration once a day and the absence of side effects increase the interest of its use.
Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Hipertensão/tratamento farmacológico , Piridazinas/uso terapêutico , Adulto , Idoso , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Cilazapril , Quimioterapia Combinada , Feminino , Humanos , Hidroclorotiazida/administração & dosagem , Masculino , Pessoa de Meia-Idade , Piridazinas/administração & dosagemRESUMO
Between August/1987, and February/1988, 60 homosexual-men from Cancun, Q. Roo, Mexico, were studied to determine the prevalence of HIV antibodies (Elisa and Western Blot). Six subjects were seropositive. No relationship was found between HIV antibodies and age, socioeconomic level or sexual intercourse with foreign subjects. The number of sexual partners/month, and the number of sexual intercourse/month were associated with the presence of HIV antibodies. Bisexual practices were found in 43 percent of all the group. Two subjects with HIV antibodies were classified in the phase II of HIV infection, one in phase III, two in phase IV-A and one more in phase IV-c2.
Assuntos
Anticorpos Anti-HIV/análise , Soropositividade para HIV/epidemiologia , Homossexualidade , Adolescente , Adulto , Estudos Transversais , Soropositividade para HIV/sangue , Humanos , Masculino , México , Pessoa de Meia-Idade , Fatores de Risco , Comportamento SexualRESUMO
This paper was designed to investigate the correlation between the renal clearance and the plasma concentration of creatinine. Of the curve obtained, three segments were studied: 1 - When the glomerular filtration rate (GFR) was greater than 60 ml per min. the plasma concentration fluctuated between 0.44 and 1.59 mg/dl. 2 - When GFR was between 30 and 60 ml per min. the plasma concentration reached 2.4 mg/dl, and 3 - When GFR was less than 30 ml per min. the plasma level increased to values as high as 28 ml/min. The urinary concentration of creatinine can be divided into two broad groups depending on the GFR. The boundary of this division is around 60 ml per min. This suggests that when GFR is depressed there would exist a limitation of the tubular secretion of creatinine or urinary dilution problems. It is demonstrated that there is a poor correlation between creatinine clearance and its plasma concentration, and hence the repeated measurement of creatinine clearance becomes imperative in the follow-up of patients.
Assuntos
Creatinina/farmacocinética , Rim/fisiologia , Adolescente , Adulto , Idoso , Creatinina/sangue , Creatinina/urina , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Antibacterianos/uso terapêutico , Otite Média/tratamento farmacológico , Infecções Respiratórias/tratamento farmacológico , Sinusite/tratamento farmacológico , Doença Aguda , Fatores Etários , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Pré-Escolar , Humanos , Otite Média/etiologia , Otite Média/microbiologia , Infecções Respiratórias/complicações , Infecções Respiratórias/microbiologia , Sinusite/etiologia , Sinusite/microbiologiaAssuntos
Epoprostenol/deficiência , Pré-Eclâmpsia/fisiopatologia , Angiotensina II/fisiologia , Plaquetas/metabolismo , Vasos Sanguíneos/metabolismo , Coagulação Intravascular Disseminada/fisiopatologia , Feminino , Humanos , Gravidez , Complicações Hematológicas na Gravidez/fisiopatologia , Trombocitopenia/fisiopatologia , Tromboxano A2/fisiologiaAssuntos
Aspirina/farmacologia , Plaquetas/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Adulto , Idoso , Ácidos Araquidônicos/metabolismo , Plaquetas/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Prostaglandina/farmacologia , FumarAssuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Aspirina , Plaquetas , Radioisótopos de Cromo , Diabetes MellitusAssuntos
Pré-Eclâmpsia/etiologia , Doenças Autoimunes/complicações , Coagulação Intravascular Disseminada/complicações , Feminino , Hemodinâmica , Humanos , Isquemia/complicações , Nefropatias/complicações , Paridade , Placenta/irrigação sanguínea , Placenta/imunologia , Pré-Eclâmpsia/imunologia , Pré-Eclâmpsia/fisiopatologia , Gravidez , Sistema Renina-Angiotensina , Útero/irrigação sanguíneaRESUMO
Se revisan los conceptos actuales sobre la etiologia y la fisiopatogenia de la preeclampsia, se relacionan entre si y se describe un modelo fisiopatogenico que resulta muy razonable. Es posible que un trastorno inmunologico de repercusion sistemica, promovido por la placenta en contra de si misma, sea el evento inicial en la genesis de la preeclampsia. Esta respuesta inmunologica del organismo materno ocasiona isquemia placentaria que a su vez determina disminucion de la sintesis de progesterona, la cual es antagonista de la aldosterona, por lo que se produce un desbalance en el sodio corporal que permite la retencion de agua y una mayor respuesta de la angiotensina y de la renina con la consiguiente hipertension arterial. La reaccion inmunologica tambien puede ser causante del dano renal y de la coagulacion intravascular diseminada la cual favorece la isquemia en diferentes organos.Estas alteraciones son capaces de retroalimentarse a si mismas hasta su perpetuacion o hasta la eliminacion del tejido placentario al interrumpirse el embarazo
Assuntos
Humanos , Feminino , EclampsiaAssuntos
Gravidez , Adolescente , Adulto , Humanos , Feminino , Eclampsia , Pré-Eclâmpsia , Coagulação Intravascular DisseminadaRESUMO
The action site of mannitol and furosemide in the nephron level was studied in two groups of dogs which, alternatively, were given both diuretics. The furosemide preferential action site was confirmed in the ascending limb of Henle's loop. It is suggested that mannitol acts on the descending limb of this loop, and that the dilution effects of this diuretic on the ascending limb are due to contamination. Changes in urinary excretion of potassium were not observed during mannitol administration. This fact coincides with the action site suggested for this substance.