Combined kidney and pancreas transplantation: a Latin American center experience.
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Biomedical subjects
Publications and source records attributed to V Miranda.
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The aim of this study was to update the thyroid hormone profile in normal pregnant women with adequate iodine nutrition, to analyze the physiological changes that occur during pregnancy and to know the role that TBG and bHCG exert on these changes. One hundred six pregnant women without goiter, former thyroid diseases or positive antimicrosomal antibodies were studied. Fifty three of them were prospectively followed during the gestational period. Thirty age matched non pregnant women were studied as a control group. Serum T3t, T4t, T41, conventional and IRMA TSH, rT3, TBG, bHCG, antimicrosomal antibodies and urinary iodine content were measured. Median urinary iodine content was 18.9 ug/ml in pregnant women, discarding iodine deficiency, the main observed changes occurred between weeks 6 and 14 with significant elevations of T3t, T4t, T41, rT3, TBG and bHCG and TSH decrease. There was a positive correlation between TBG and T3t and T4t indicating a causal relationship. There was a negative correlation between T41 and TSH and between TSH and bHCG and a positive correlation between T41 and bHCG, suggesting a thyroid stimulator effect of bHCG which would raise T41 and thus inhibit TSH secretion.
A national survey of pathology laboratories revealed a great diversity in the use of screening tests, and in the performance and interpretation of oral glucose tolerance tests for the detection of gestational diabetes. This situation is unsatisfactory and highlights the need for rationally established procedures and diagnostic criteria.
The reason to consider the second thoracic cerebrospinal nerve (Th2) as one of the sources of the brachial plexus is the fact of the intersegmentary connection between Th1 and Th2 by means of a neural branch situating on the internal surface of the thorax near the vertebral column (the intrathoracic or paravertebral branch). However, not all cases of the intersegmentary connection Th1-Th2 should be regarded only as participation of Th2 in the formation of the brachial plexus, this is conditioned by certain peculiarities of its structure and by the character of interconnections with the I intercostal nerve. The macro-microscopic method demonstrates that the intersegmentary connection Th1-Th2 includes somatic and vegetative components, that to the same extent participate both in formation of the brachial plexus and in the I intercostal nerve. The intersegmentary connection Th1-Th2 is considered as a vegetative neural structure, containing somatic conductors and is considered as a homologue of superficial connective branches. It is the way, by which sympathetic fibers can reach the brachial plexus from the segment situating below, without passing through the superior thoracic nodes of the sympathetic trunk.
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Jejunogastric intussusception is a rare complication of gastric surgery. We report a case in a 41-year-old woman subjected to gastrojejunostomy with truncal vagotomy 3 years before for pyloric stenosis. The jejunogastric intussusception was diagnosed by upper gastrointestinal series, ultrasonography, and computed tomography. Surgical management consisted of reduction and fixation. Treatment should be as early as possible to prevent gangrene of the invaginated segment.
A new case of nephrotoxic effect of Maneb is related. The patient used this product as fungicide and developed a progressive illness with acute renal failure. The study by light and electron microscopy revealed severe tubular lesions that disappeared some months later with tubular cell regeneration. However, in spite of the renal function returning to normal, a steroid-dependent nephrotic syndrome persisted with glomerular minimal change like lesions.