RESUMO
Myxedema is the cause of ascites in less than 1% of new-onset ascites cases, where as only 4% of patients with hypothyroidism present ascites. When ascites is the first manifestation of thyroid insufficiency, there is usually a delay in diagnosis. We report here a case of myxedema ascites occurring in a patient with alcoholic cirrhosis, that was first thought to be the cause of the ascites, and review the features of 48 cases previously reported. Some clinic and analytical findings that have been commonly reported, are the long duration of the ascites before diagnosis, the prompt response (with resolution of ascites) to thyroid replacement treatment, a high total protein concentration in ascites fluid, white moderate white blood cell counts and a lymphocyte predominance. Serum-ascites albumin gradient has been postulated to be high in myxedema ascites, but we believe this has been studied in too few cases thus far, to be conclusive.
Assuntos
Ascite/etiologia , Cirrose Hepática Alcoólica/complicações , Mixedema/complicações , Ascite/tratamento farmacológico , Terapia de Reposição Hormonal/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Mixedema/diagnóstico , Mixedema/tratamento farmacológico , Tiroxina/uso terapêuticoRESUMO
Myxedema is the cause of ascites in less than 1 per cent of new-onset ascites cases, where as only 4 per cent of patients with hypothyroidism present ascites. When ascites is the first manifestation of thyroid insufficiency, there is usually a delay in diagnosis. We report here a case of myxedema ascites occuring in a patient with alcoholic cirrhosis, that was first thought to be the cause of the ascites, and review the features of 48 cases previously reported. Some clinic and analytical findings that have been commonly reported, are the prompt response (with resolution of ascites) to thyroid replacement treatment, a high total protein concentration in ascitec fluid, white moderate white blood cell counts and a lymphocyte predominance. Serum-ascites albumin gradient has been postulated to be high in myxedema ascites, but we believe this has been studied in too few cases thus far, to be conclusive. (Au)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ascite/etiologia , Mixedema/complicações , Cirrose Hepática Alcoólica/complicações , Ascite/tratamento farmacológico , Mixedema/tratamento farmacológico , Mixedema/diagnóstico , Terapia de Reposição Hormonal/métodos , Tiroxina/uso terapêuticoRESUMO
Myxedema is the cause of ascites in less than 1
of new-onset ascites cases, where as only 4
of patients with hypothyroidism present ascites. When ascites is the first manifestation of thyroid insufficiency, there is usually a delay in diagnosis. We report here a case of myxedema ascites occurring in a patient with alcoholic cirrhosis, that was first thought to be the cause of the ascites, and review the features of 48 cases previously reported. Some clinic and analytical findings that have been commonly reported, are the long duration of the ascites before diagnosis, the prompt response (with resolution of ascites) to thyroid replacement treatment, a high total protein concentration in ascites fluid, white moderate white blood cell counts and a lymphocyte predominance. Serum-ascites albumin gradient has been postulated to be high in myxedema ascites, but we believe this has been studied in too few cases thus far, to be conclusive.
RESUMO
Myxedema is the cause of ascites in less than 1 per cent of new-onset ascites cases, where as only 4 per cent of patients with hypothyroidism present ascites. When ascites is the first manifestation of thyroid insufficiency, there is usually a delay in diagnosis. We report here a case of myxedema ascites occuring in a patient with alcoholic cirrhosis, that was first thought to be the cause of the ascites, and review the features of 48 cases previously reported. Some clinic and analytical findings that have been commonly reported, are the prompt response (with resolution of ascites) to thyroid replacement treatment, a high total protein concentration in ascitec fluid, white moderate white blood cell counts and a lymphocyte predominance. Serum-ascites albumin gradient has been postulated to be high in myxedema ascites, but we believe this has been studied in too few cases thus far, to be conclusive.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ascite/etiologia , Cirrose Hepática Alcoólica/complicações , Mixedema/complicações , Ascite/tratamento farmacológico , Terapia de Reposição Hormonal/métodos , Mixedema/diagnóstico , Mixedema/tratamento farmacológico , Tiroxina/uso terapêuticoRESUMO
From January 1983 to July 1985, 64 patients underwent left ventricular aneurysmectomy in our surgical unit. In 11 (17%) of these cases, the lesion was a variant of the true aneurysm that included an extremely thin (1- to 2-mm), well-defined area of myocardium. In 9 of the cases, the aneurysm was confirmed preoperatively by means of high-quality ventriculography (high resolution and many hues of gray). Surgical and pathologic criteria established the lesion's clinical significance. To the best of our knowledge, these aneurysms constitute a heretofore undescribed variant of the classic true left ventricular aneurysm, exhibiting certain gross characteristics of the false left ventricular aneurysm and sharing with false aneurysms their greater risk of rupture. While it is impossible to tell whether these aneurysms are progressing toward rupture, we believe that all such lesions should undergo urgent repair in the presence of cardiac symptoms. Following aneurysmectomy, ventriculoplasty or septoplasty using an elliptical woven Dacron patch helps to preserve the internal contour and surface anatomy of the ventricle. In our series, this procedure resulted in early and late postoperative mortality figures comparable to those associated with the surgical treatment of classic true left ventricular aneurysms.
RESUMO
This report summarizes results of the first 453 consecutive patients who had 491 low profile bioprostheses implanted at the Italian Hospital in Buenos Aires over a 5-year period. During this time, with the goal of long-term durability, the valve mounting technique was slightly modified, whereas the materials and design of the annulus underwent more extensive changes.