Embryonal and mature thymic extracts in heart transplant acute rejection treatment.
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Biomedical subjects
Publications and source records attributed to Z Religa.
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Plasma atrial natriuretic peptide (ANP), plasma renin activity (PRA), aldosterone (ALD) and vasopressin (VP) were assessed in six heart transplant patients (HTP) and ten healthy subjects under bed rest conditions and 60 and 120 minutes after head-out water immersion (WI). Bed rest had no significant influence on these parameters. WI raised plasma volume (PV) to the same extent in both groups. This increase of PV was accompanied by significant suppression of PRA, ALD and VP and an increase of plasma ANP. In HTP basal plasma ANP was significantly elevated and the ANP response to central hypervolemia reduced. Significantly elevated VP plasma levels were also found in HTP. These endocrine abnormalities in HTP seem to be caused by latent failure of the transplanted heart. No direct correlation was found between plasma ANP and PRA, ALD and VP under basal conditions and after WI in either HTP or normals.
This work was aimed to assess the secretion of volume related hormones in heart transplant patients (HTP) and their relationship to excretory renal function studied under bed rest and water immersion conditions. Fractional sodium (FENa%) and potassium (FEK%) clearance, plasma renin activity (PRA), plasma aldosterone (Ald), vasopressin (AVP) and atrial natriuretic peptide (ANP) were estimated in six HTP with moderate renal failure (C creat = 69 +/- 6.9 ml/min) and in 10 healthy subjects (N) (C creat = 110 +/- 2.0 ml/min). All HTP were treated with cyclosporine A and azathioprine. In HTP basal AVP (6.18 +/- 0.92 pg/ml) and ANP (138.17 +/- 14.69 pg/ml) levels were significantly higher than in normals (2.07 +/- 0.11 pg/ml and 74.10 +/- 7.10 pg/ml, respectively). HTP were also characterized by increased FENa% and FEK% both under bed rest (DI) and water immersion (WI) conditions. As abnormalities of excretory renal function in HTP were not significantly related to the plasma endocrine profiles factors other than PRA, Ald, AVP and ANP seemed to be also involved in their pathogenesis.
Authors present a case of a female patient with abundant attacks of rapid ventricular tachycardia and ventricular fibrillation, frequently resuscitated, who received an automatic cardioverter--defibrillator (AICD)--Ventak 1520 (CPI). Sooner 5-month pharmacotherapy with attainable drugs was deceptive. Operative and postoperative period was uncomplicated. During late 24-month follow-up 27 times a shock was delivered by the implanted cardioverter. Full patient's recovery was observed.
Autopsy findings point to a high prevalence of perivalvular abscesses in patients with infective endocarditis. Diagnosis of this complication, which may have therapeutical implications, is difficult. The authors present echocardiographic image obtained in a patient with bacterial endocarditis in whom an aortic root abscess was subsequently found at operation.
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