[Inhibition of renin-angiotensin-aldosterone system: what evidence?].

The activation of various neuro-humoral systems is involved in the progression of chronic heart failure. The pharmacological blockade of the renin-angiotensin-aldosterone system is possible with agents such as angiotensin converting enzyme inhibitors (ACEI), the angiotensin II receptor antagonists (ARA) and the aldosterone antagonists. The actual scientific evidence supports the use of the ACEI in patient with ventricular dysfunction in all functional NYHA classes, of the ARA in heart failure patients with intolerance to ACEI and of low-dose spironolactone in patients with severe heart failure.

[Rhodococcus equi pneumonia in patients with AIDS].

Rhodococus equi infection is frequent in animals, but rare in humans. It usually appears as an opportunistic infection, occurring in clinical settings where a compromise of cellular immunity exists, such as in leukemia, neoplastic or transplanted patients. It is currently considered, as another opportunistic AIDS infection.

[Influence of smoking on homocysteinemia at baseline and after methionine load].

Introduction And Aims: Homocysteinemia (HC) and smoking are both important risk factors for vascular disease. In the present study, we intend to evaluate the influence of smoking habits on HC values as well as on vitamins B6, B12 and folic acid, co-factors of HC metabolism.

Methods: We measured fasting homocysteinemia (basal) and homocysteinemia 6 hours after an overload with 0.

Sinus tissue pharmacokinetics after oral administration of amoxicillin/clavulanic acid.

Objectives: The in vitro synergy of the amoxicillin/clavulanic acid combination has not always translated in vivo into clinical superiority compared with amoxicillin alone. Specifically, conflicting reports have disputed the superiority of the combination in the treatment of both acute otitis media and acute sinusitis. One possible reason for this may have to do with inadequate target tissue pharmacokinetics.

[Controversies in stress echocardiography: the indications, diagnostic accuracy and stratification of dobutamine stress echocardiography].

In recent years, stress echocardiography has become a valuable tool in the diagnosis, stratification and prognostic evaluation of coronary artery disease. Stress echocardiography has been performed with a variety of methods, including exercise, atrial pacing and pharmacological stress with the use of adenosine, dipyridamol and dobutamine. Either of these modalities of stress echo are a good choice in the evaluation of ischemic disease and the selection of one over another should depend on the patient's characteristics, experience of the stress echo laboratory and clinical needs (in the detection of viability there is greater experience in the use of dobutamine making this the most popular choice when evaluating myocardial hibernation).

The effects of adenoid hypertrophy and subsequent adenoidectomy on pediatric nasal airway resistance.

To investigate how adenoid hypertrophy and subsequent adenoidectomy affect pediatric airway resistance, we developed a prospective controlled study. Fifty children, aged 3 to 12 years, diagnosed with adenoid hypertrophy and selected for adenoidectomy, preoperatively had their nasal airway resistance assessed by active anterior rhinomanometry. Twenty-five of these children were subsequently followed up postoperatively, undergoing nasal resistance evaluations at 1 month, 3 months, 6 months, and 12 months.

Penetration of cefuroxime into chronically inflamed sinus mucosa.

Objectives: Despite its seeming relevance, limited information exists about antibiotic sinus tissue penetration and how it is affected by inflammation. Thus the reason for the present investigation.

Study Design: A randomized, open, multiple-dose, pharmacological study, employing cefuroxime axetil, an approved oral antimicrobial for the treatment of acute bacterial rhinosinusitis, was developed.

[The effect of sex and menopause on basal blood levels of homocysteine and after methionine loading].

Introduction And Objectives: We have already proved that basal and after load homocysteinemia are risk factors for vascular disease and it is also known that premenopausal women are relatively protected against this disease. The objective of this paper was the assess whether there are any differences in the plasma levels of homocystein which might contribute to explain the differences in the incidence of vascular diseases found in both sexes.

Patients And Methods: Two hundred and four patients (153 males) without previous vascular disease were enrolled in the study.

Helicobacter pylori infection and dyspepsia.

Dyspepsia is defined as a persistent or recurrent pain or discomfort, localised in the upper abdomen, which may or may not be related to meals. Its prevalence in the general population is extraordinarily high (20-40%). Several pathological conditions can provoke dyspepsia, although non ulcer dyspepsia is the main cause.

[Aortic peri-valvular abscess, mycotic aneurysm of Valsalva sinus, and fistula to the right ventricle in a context of acute infectious endocarditis].

Infective endocarditis continues to attract the attention of many physicians. The authors present a case report of a 64 year old man with a history of infective endocarditis of a native aortic valve complicated by a perivalvular abscess, mycotic aneurysm of a sinus of valsalva and acquired aorta-right ventricular shunt.

[The solitary pulmonary nodule. A retrospective study of 119 cases].

The authors review 119 cases of solitary pulmonary nodule submitted to surgery, analysing their aetiology and correlating them with their clinical and radiological aspects as well as with the patient's age, sex and smoking habits. An analysis of some pre-surgical diagnostic methods was also made. In half of the nodules (54%) the diagnosis made was of malignancy.

Distribution of bismuth in the rat after oral dosing with ranitidine bismuth citrate and bismuth subcitrate.

Bismuth preparations are used world-wide for the management of peptic ulcer disease, for eradication of Helicobacter pylori, and in the prevention and treatment of diarrhoea. However neurological toxicity of bismuth has always been a major concern and evidence has been found of the absorption of bismuth. Recent studies have suggested that the absorption of bismuth increases when bismuth salts are used with ranitidine hydrochloride.

Psychosocial consequences of nasal aesthetic and functional surgery: a controlled prospective study in an ENT setting.

Much still needs to be known about what motivates and goes through patients' minds when undergoing nasal aesthetic surgery. Little is also known on how the aesthetic change affects the way other people see those patients after surgery, and if the improved appearance significantly benefits the patients' psychosocial functioning. So far, research has largely focused on subjects in Plastic Surgery settings, neglecting to investigate the specificities of rhinoplasty as performed by otolaryngologists.

Rhinomanometry, sinus CT-scan and allergy testing in the diagnostic assessment of chronic nasal obstruction.

In order to assess how effective a combination of diagnostic methods, each addressing specific aetiopathogenic aspects, would be in uncovering the cause of common chronic nasal obstruction, we evaluated 45 consecutive adult subjects. They were submitted to rhinomanometry testing, sinus CT-scans and RASTs to prevalent allergens. Most, but not all, patients ended up showing abnormal results in at least one of the diagnostic procedures.

Sinusitis and asthma: how do they interrelate in sinus surgery?

Sinusitis has been suspected to be etiopathogenically linked to bronchial asthma. Asthma, on the other hand, has been reported to affect negatively the outcome of sinus surgery. The purpose of this study is to elucidate how sinusitis and asthma clinically interrelate, in a group of asthmatic subjects undergoing surgical interventions on the sinuses.

[Amiodarone and the lung].

The pulmonary toxicity induced by amiodarone is one of the major complications that can limit the use of this potent antidysrhythmic agent. The authors perform a bibliographical revision concerning the toxic effects of amiodarone in the lung, pathogenesis, clinical, radiologic and pathologic features, diagnostic problems, risk factors and prognostic data.

Focal lesion of African histoplasmosis presenting as a malignant gastric ulcer.

We describe the case of a localized lesion of African Histoplasmosis, presenting as a gastric ulcer, with radiological and endoscopic features suggesting malignancy, that was submitted to surgery. Histologic examination of the resected specimen revealed typical yeasts of Histoplasma duboisii. There where no clinical, radiological or endoscopic signs of disseminated disease and conventional antifungal therapy was not prescribed.

[The treatment of obstructive hypertrophic myocardiopathy refractory to medical therapy].

Until a few years ago, therapy of refractory Hypertrophic Obstructive cardiomyopathy was mainly surgical--Morrow's myotomy/myectomy or mitral valve replacement. Despite the good results of these techniques, they are not free of mortality and morbidity. In the last years a new and promising therapy has been developed: the Dual Chamber Pacemaker.

[Sudden death in hypertrophic myocardiopathy].

Sudden death is a very important event in the natural history of hypertrophic cardiomyopathy. Although its physiopathology is not still fully understood, there are several potential mechanisms to explain it, such as electrical, ischemic and hemodynamic events. It is thought that these mechanisms vary from patient to patient and that more than one mechanism may coexist in a specific patient.

Bronchial reactivity and work-related symptoms in farmers.

Work-related respiratory symptoms and bronchial reactivity were studied in 76 never-smoking farmers and in a control group not exposed to organic dusts. The farmers were divided into those working with vegetables/grain crops, animals but not swine, and with swine. The extent of symptoms was evaluated using a specific organic dust questionnaire.

[Significance of the persistence of ST segment elevation in anterior infarction].

Objective: Persistent ST segmentary elevation in anterior myocardial infarction was classically attributed to ventricular aneurysm. This association is now considered controversial. We studied the association between this electrocardiographic finding and the left ventricular wall motion abnormalities and global function.

[Pulmonary lymphangioleiomyomatosis].

The authors present a clinical case of Lymphangioleiomyomatosis of the lung. They analyse the clinical, radiological and functional features and comment on the evolution and therapeutic approach of this rare disorder. To the authors, lung involvement as well as therapeutic decision are important features that affect the prognosis.

[Extrapulmonary tuberculosis].

Although the respiratory tract is the major site for tuberculous lesions, all organs can be affected. The authors review the clinical files of 25 patients admitted to our Department with lung and/or pleural tuberculous disease, confirmed by bacteriology or histopathology, who simultaneously suffered from tuberculosis in other organs. We included 20 men and 5 women, aged from 10 to 74 years (mean: 37.

Schistosomiasis and vascular alterations of the colonic mucosa.

The diagnosis of schistosomiasis is made by identification of Schistosoma in stool and urine, or by colonic or hepatic biopsies. The authors demonstrate in this paper, however, that it is also possible to suspect this disease by colonoscopy, i.e.