Serological markers of human immunodeficiency virus infection in African patients with AIDS: are they different from markers found in patients from other countries?
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Biomedical subjects
Publications and source records attributed to M Foz.
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Serum total thyroxine, triiodothyronine, and thyrotropin response to thyrotropin-releasing hormone (TRH-TSH test) were measured in 126 consecutive patients admitted with atrial fibrillation: 33 patients with an acute arterial limb embolism (Group I), 31 patients with an acute embolic stroke (Group II), and 62 patients without any arterial occlusion (Group III). A blunted TRH-TSH test, suggestive of thyrotoxicosis, was found in 5 patients in Group I, 8 patients in Group II, and 2 patients in Group III. The diagnosis of hyperthyroidism was confirmed in 8 patients (by repeated TRH-TSH test and scintigraphy): 4 patients in Group I (12.1%) and 4 patients in Group II (12.9%). All of them had a nonvalvular atrial fibrillation. Thyrotoxicosis should not be recognized in 6 of them if TRH-TSH test was not performed, because peripheral hormone levels were normal. Five of these 8 patients with thyrotoxicosis had reversion to sinus rhythm after treatment with carbimazole, either spontaneously or after cardioversion. This outcome prevented prolongation of anticoagulant therapy for an indefinite time.
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Ventilation-perfusion lung scans were done in 70 patients admitted because of an iliofemoral deep vein thrombosis (DVT), and diagnosed by venography. Eighteen items of clinical and laboratory information were measured to predict the presence of lung scan abnormalities consistent with asymptomatic pulmonary embolism. Eighteen patients had perfusion defects in the lung scan that were classified as "high probability of pulmonary embolism", while the lung scan was normal in 32 patients. Patients with an idiopathic DVT were at high risk of pulmonary embolism, but those with a postoperative DVT had a low embolic risk. In patients with a postoperative DVT two factors predicted pulmonary embolism: those patients who developed symptomatic DVT after an operation but had a normal lung scan showed higher platelet counts than their preoperative levels. Conversely, it they developed a pulmonary embolism their platelet count dropped from their preoperative levels.
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Cutaneous vasculitis is an uncommon complication of propylthiouracil therapy. Its pathogenesis has been related to the presence of circulating immune complexes. The lesions may be purpuric or bullous hemorrhagic, possibly evolving into necrotic ulcerations. Usually, lesions develop on the extremities and earlobe. The vasculitis has been related to the duration of the treatment and disappears with the withdrawal of the drug, although a fatal case has been reported. Corticosteroid therapy is often prescribed, but its efficacy has not been demonstrated. We describe a patient in whom treatment with propylthiouracil for a year was associated with vasculitic lesions on the lower extremities and earlobe. Discontinuation of the drug was correlated with disappearance of the lesions.
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