RESUMO
The last therapeutic alternative in severe postsurgical hypoparathyroidism is allotransplantation of microencapsulated parathyroid cells. With this technique, it is possible to implant cells or tissue of parathyroid origin to replace them in such patients, without immusupression. We report an allotransplant of parathyroid tissue in a patient with continous endovenous requirement of calcium to survive. The microencapsulation was carried out with a commercial sodium alginate. We implant 23 microspheres in the nondominant forearm and 40 microspheres in the leg in a second attempt. In this article, we show functionality of the graft for at least 20 months without requirement of endovenous calcium. We report this procedure as a therapeutical alternative in severe hypoparathyroidism.
Assuntos
Hipoparatireoidismo/cirurgia , Glândulas Paratireoides/transplante , Adulto , Criopreservação , Composição de Medicamentos/métodos , Feminino , Bócio/cirurgia , Humanos , Hipocalcemia/etiologia , Complicações Pós-Operatórias/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Transplante HomólogoRESUMO
Se reporta el caso de un paciente con divertículo de Meckel invaginado asociado a intususcepción con clínica de obstrucción intestinal intermitente y simulando un posible tumor de intestino delgado. Se discute su fisiopatología, clínica, estudio imagenológico y tratamiento.
Assuntos
Adulto , Masculino , Humanos , Diverticulite , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico , Divertículo Ileal/terapia , Intestino Delgado/fisiopatologia , Intussuscepção/etiologiaRESUMO
The effects of diltiazem, 240 mg/day, were studied in 12 p atients with chronic exertional angina and angiographically proven coronary artery disease, who received maintenance therapy with propranolol. Mean age was 60,1 years (range 46 to 67). Patients received propranolol, 60 to 240 mg/day, before and during the study. A double blind, placebo contorlled, cross-over design was used to test the effect of added diltiazem, durign 8 weeks. Duration fo execise varied from 398 ñ 30 (mean ñ SEM) to 419 ñ 37 (placebo) or 469 ñ 35 sec (diltiazem) (NS). Time to appearance of angina veried from 283 ñ 32 to 313 ñ 34 and 302 - 27 sec, respectively (NS). Resting and maximal effort heart rate and blood pressure did not differ among basal, placebo and iltiazem conditions. Segmental wall motion analysis by radioisotopic ventriculogram revealed diskynetic zones during placebo rodiltiazem therapy. Basal ejection fraction did not increase during exercise and this was not modified by diltiazem or placebo. Thus, the addition of diltiazem to propanolol in patients with chronic, exertional angina failed to modify angina threshold, exercise duration or left ventricular performance