RESUMO
We report 3 patients who developed emphysematous pyelonephritis. All were diabetic females over 50 years of age with unilateral necrotizing pyelonephritis. Intra and perirenal gas was demonstrated and all patients had infection by E coli. X ray and ultrasound studies allowed the diagnosis. Antibiotic therapy was unsuccessful and all patients had to be operated on.
Assuntos
Nefropatias Diabéticas/etiologia , Enfisema/etiologia , Infecções por Escherichia coli/complicações , Pielonefrite/etiologia , Idoso , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Nefrectomia , Pielonefrite/diagnóstico , Pielonefrite/cirurgiaRESUMO
The hypotensive effect of enalapril, a converting enzyme inhibitor, given as a single agent once daily, was evaluated prospectively over a 16 week period in 20 subjects. One patient abandoned therapy and 2 were withdrawn (increased creatinine levels in one and the need for associated therapy in the other). Side effects developed in 3 patients: creatinine elevation, skin rush and a "salty taste", respectively. A significant decrease in blood pressure (p less than 0.01) attaining normal levels in 6 out of 17 patients was observed. Normal blood pressure levels were not reached in severe hypertension; the association of hydrochlorothyazide was effective in 5 of 11 such subjects. Thus, enalapril may be safely used as a first stage single therapy in mild or moderate hypertension.
Assuntos
Enalapril/uso terapêutico , Hipertensão/tratamento farmacológico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Quimioterapia Combinada , Enalapril/efeitos adversos , Feminino , Humanos , Hidroclorotiazida/efeitos adversos , Hidroclorotiazida/uso terapêutico , Masculino , Pessoa de Meia-IdadeRESUMO
Se tratan seis enfermos hipertensos severos que no respondieron a la terapia asociada de un bloqueador, vasodilatador y diuretico. Se obtuvieron resultados favorables en cinco enfermos esenciales y no se obtuvo descensos tensionales en un caso portador de estenosis de ambas arterias renales. Efecto secundario caracterizado por gusto metalico, se presento en un caso y no impidio continuar la terapia