Influence of bedside blood insulin measurement on acute coronary syndrome pathways.

Background: The aim of the study was to evaluate the influence of blood insulin measurements on acute coronary syndrome (ACS) pathways.

Methods: All patients admitted to the emergency department within 12 months for acute, retrosternal, constrictive chest pain lasting for more than 30 minutes; cardiogenic pulmonary edema; electrocardiogram ST changes; and echographic alterations were included. The study parameters were clinical (age, sex, blood pressure, presence of pulmonary rales and gallop), including classic laboratory tests associated with troponin T, blood insulin levels, and hemoglobin A1C, and echographic values.

Increased angiotensin II in ascites during severe ovarian hyperstimulation syndrome: role of early pregnancy and ovarian gonadotropin stimulation.

Objective: To investigate the implications of the ovarian renin-angiotensin system (RAS) in the pathophysiology of the ovarian hyperstimulation syndrome (OHSS) in relation to gonadotropin stimulation and early pregnancy.

Design: A controlled clinical study comparing blood and simultaneously sampled peritoneal fluid (PF) from patients with severe OHSS and from controls without OHSS.

Setting: University Hospitals.

[Biliary ileus].

A case of gallstone ileus in an elderly woman is described and attention is drawn to the insidious clinical presentation and the significance of the often subtle radiological signs. The data from the literature specifies these aspects and allows a more complete review of this relatively rare pathology in order to remind its importance in differential diagnosis to emergency clinicians and radiologists.

Chronic angiotensin-converting enzyme inhibition and endothelial function of rat aorta.

To determine whether chronic angiotensin-converting enzyme (ACE) inhibition produces functional changes in the aorta normotensive rats, four groups of rats were studied in parallel for 6 weeks. Group 1 orally received ramipril and beta 2-kinin antagonist HOE140 500 micrograms/kg per day s.c.

Angiotensin II immunoreactivity is elevated in ascites during severe ovarian hyperstimulation syndrome: implications for pathophysiology and clinical management.

Objective: To investigate the ovarian renin-angiotensin system (RAS) during severe ovarian hyperstimulation syndrome (OHSS).

Design: Simultaneous sampling of blood and ascitic or peritoneal fluid (PF) during therapeutic paracentesis or laparoscopy.

Setting: University Hospital.

Comparison of the hemodynamic responses to molsidomine and isosorbide dinitrate in congestive heart failure.

To evaluate the mechanisms involved in nitrate tolerance, we randomized 23 patients with congestive heart failure resulting from coronary artery disease to an isosorbide dinitrate or a molsidomine infusion. The drugs were titrated to decrease pulmonary capillary wedge pressure by > or = 30% or > or = 10 mm Hg. Then isosorbide dinitrate, molsidomine, or placebo was infused in a double-blind randomized manner for 24 hours.

Hemodynamic response to molsidomine in patients with ischemic cardiomyopathy tolerant to isosorbide dinitrate.

Unlike nitrates, molsidomine is able to relax vascular smooth muscle without depending on the availability of sulfhydryl groups. To assess the clinical relevance of this property, the hemodynamic effects of a 24-h i.v.

Legionellosis and "torsades de pointes".

Myocarditis, pericarditis and endocarditis are rare manifestations of Legionella pneumophila infection. We describe a case of myocarditis complicated with a potentially fatal arrhythmia: "torsades de pointes".

Interaction between nonsteroidal anti-inflammatory drugs and loop diuretics: modulation by sodium balance.

Nonsteroidal anti-inflammatory drugs have been shown to decrease the natriuretic response to loop diuretics in many but not all studies. Recently, indomethacin was shown not to affect the natriuretic response to the new loop diuretic torasemide in healthy volunteers. Inasmuch as sodium balance has been reported to modify the effect of indomethacin on furosemide-induced natriuresis in dogs, we investigated the effect of indomethacin, under two sodium balances (50 and 150 mEq/day), on the natriuretic response to two doses of torasemide in six healthy volunteers.

Indirect evidence of glomerular/tubular mixed-type postexercise proteinuria in healthy humans.

Hypothetical mechanisms have been postulated to explain the presence of proteins in urine after severe exercise. Recently, it has been shown that several amino acids inhibit tubular protein reabsorption. Seven healthy men, hyperhydrated, were studied during a 2-min bicycle exercise at supramaximal load.

Effect of low doses of angiotensin II perfusion on the hypotensive action of captopril in anaesthetized normotensive and spontaneously hypertensive rats.

The effect of intravenous (i.v.) captopril on mean arterial blood pressure (MABP) of anaesthetized normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats perfused i.

Failure of indomethacin to impair the diuretic and natriuretic effects of the loop diuretic torasemide in healthy volunteers.

The effects of torasemide, a new potent loop diuretic, on renin release, water and sodium excretion were investigated in young healthy volunteers before and after 3 days of treatment with indomethacin. Torasemide 20 mg i.v.

Malignant Mediterranean spotted fever. Report of a case with multiple organ failure, hypocalcemia, and euthyroid sick syndrome.

A patient with Mediterranean spotted fever presented an initial history of enteritis, pyrexia, and rash. He subsequently developed shock, multiple organ failure, thrombocytopenia, hypocalcemia with hypercalcitoninemia, and a euthyroid sick syndrome.

Relationships between blood pressure, heart rate and plasma epinephrine, norepinephrine, angiotensin II concentrations, plasma renin activity during chronic guanfacine therapy in patients with essential arterial hypertension.

The evolution of blood pressure, heart rate, epinephrine, norepinephrine, angiotensin II and plasma renin activity has been studied in 10 patients with essential arterial hypertension before and during a two months period of treatment with guanfacine, a new centrally acting hypotensive drug. Guanfacine was proven effective in lowering both systolic and diastolic supine and standing blood pressure. A decrease in supine and standing norepinephrine plasma concentrations and plasma renin activity was observed.

Cardiac tamponade as first manifestation of colonic cancer.

Metastatic cardiac tamponade was the presenting manifestation of a colonic carcinoma. The patient's condition improved after surgical treatment and shows no sign of recurrence of pericardial effusion after more than eight months of systemic chemotherapy. Metastatic pericardial effusions and their treatment are discussed.