A 46-year-old man presented with severe pain in our emergency department. In addition he had macrohematuria, the further medical history was inconspicuous. The pain showed to be resistant to therapy, therefore we performed a CT scan of the abdomen. The CT scan showed a partial embolism of the right renal artery, a thrombus of the aorta thoracica as well as partial infarction of the spleen and the liver. An immediately initiated therapy with implantation of an aortal stent graft for fixation of the thrombus and an Actilyse® therapy led to full recovery of the patient. Closer questioning of the patient showed that the patient undertook an extended abdominal and thoracic muscle training programme by letting an eight-kilogram bowling ball fall down onto his abdomen from about 80 cm height. The diagnosis embolism of the renal artery cannot be made without extended diagnostics in the emergency room. A good hint for perfusion disorders of the kidney can be obtained with duplex ultrasound. Therapy-resistant pain without hydronephrosis and concomitant arrhythmia of the patient can lead to the diagnosis. The initiation of an adequate diagnosis and therapy is essential as otherwise persisting perfusion disorders of the kidney may occur.
En el curso de estudios electroforéticos seriados en pacientes de LES, se han observado cambios significativos en los niveles séricos de la fración beta-globulina. Se presenta el caso de una paciente que presentó una abeta-globulinemia transitoria, qu desapareció cuando el Lupus fué tratado adecuadamente con esteroides y antimaláricos. La ausencia de la beta-globulina en el papel de filtro teñido para proteínas, con una curva casi normal de fración beta, revelada por el método de las fronteras movibles (Tiselius) y presencia de beta-lipoprmoteína, hace pensar en una carencia selectiva de la porción teñible por el Azul de Bromofenol, de este complejo grupo de proteínas. Se compara este caso con un caso anterior reportado en la literatura y se discute la probable relación del trastorno con el sindrome nefrótico que padecía nuestra enferma.
Apparently unimportant diseases of some prominent figures can have a considerable effect on the course of time at turning points in world history. It is quite conceivable that the Battle of Waterloo on 18 June 1815 had been lost by France because Napoleon was not in full possession of his powers, because he was suffering from acute cystitis. Adverse weather conditions with continuous rain and coldness in advance of the battle, extremely primitive hygienic conditions and more than simple quarters for the night led to the development of cystitis. Based on the records of his biographers, his personal physician and the letters to his brother, we know that Napoleon was not able to give the command to attack in the early morning as intended, but in the early noon, only because of his bad general condition. This delay of several hours led, as we all know, to the intervention of Prussia and the devastating defeat of France. Thus it appears that a relatively unimportant urological disease influenced the course of world history crucially.
Se presentan los resultados de las pruebas LE y de la electroforesis de las seroproteínas practicadas en una serie de pacientes en el curso de un estudio sobre LES y enfermedades relacionadas. Se practicaron 120 investigaciones de células LE, sobre un grupo de 83 pacientes. La prueba fué positiva en 29/30 casos de LES, lo que da un 96.7%. Fué positiva también en 4/9 casos de esclerodemia investigados (44.4%). Todas las demás pruebas fueron negativas. Se hicieron 100 determinaciones electroforéticas. Estudios seriados en 34 enfermos con prueba LE positiva y 20 determinaciones en controles supuestos normales. En los casos de LES se encontró el conocido patrón de disminución de albúmina, aumento de gama-globulina y frecuente elevación de alfa-2-globulina. Se observó correlación entre la evolución del cuadro clínico y la de las proteínas séricas. En algunos casos cambios significativos de los niveles de las fracciones de seroproteínas se produjeron con gran rapidez. Se presenta un caso en que se observó relación entre los resultados de electroforesis y la temperatura de la paciente. No hubo correlación entre las proteínas séricas y el fenómeno LE. Se discuten los hallazgos descritos señalando el valor de ambas pruebas en el estudio clínico de los enfermos.
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