Acta médica portuguesa
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Allocation of scarce and vital medical resources in intensive care units (ICUs) is one of the most actual and controversial questions within the context of medical ethics. How shall doctors decide which patients shall benefit from scarce resources such as ICU beds, ventilators, incubators, etc.? Which criteria are more acceptable from the ethical viewpoint in these triage situations: The rights of the patients? The expected benefits? The will of the patients or of their relatives? And how can medical responsibility be envisaged within this context? These are some of the questions discussed in this article having in mind the present framework of ethical and legal obligations pending upon doctors practicing in Portugal.
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Acta médica portuguesa · Nov 1989
Review[State of the art in immuno-allergology: histamine-releasing factors (HRF)].
The present concepts on histamina releasing factors are discussed, their cellular origins, their effect on the target cells and its importance in asthma immunopathology. Personal results on the production of HRF by alveolar macrophages stimulated by allergen and its action on non atopic basophils are presented. ⋯ HRF has been tested in a Human Basophil Degranulation Test (HBDT) preparation, a significant degranulation induced by HRF from atopic patient being only observed when atopic basofils are used in HBDT. These results confirm that allergen could induce HRF production from alveolar macrophages and that this HRF could degranulate basophils in atopic and induce mediators release.
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Acta médica portuguesa · Nov 1989
Review[The state of the art in immuno-allergology: histamine releasing factors (HRF)].
The present concepts on histamine releasing factors are discussed, their cellular origins, their effect on the target cells and its importance in asthma immunopathology. Personal results on the production of HRF by alveolar macrophages stimulated by allergen and its action on non atopic basophils are presented. ⋯ HRF has been tested in a Human Basophil Degranulation Test (HBDT) preparation, a significant degranulation induced by HRF from atopic patient being only observed when atopic basophils are used in HBDT. These results confirm that allergen could induce HRF production from alveolar macrophages and that this HRF could degranulate basophils in atopic and induce mediators release.
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With near optimal metabolic control, in diabetes mellitus, hypoglycaemia has become a very important problem. Its main causes are excessive insulin or sulfonylurea dosages, omission of meals, unprogrammed physical exercise or disturbances of the neurohormonal counterregulatory mechanisms.
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Acta médica portuguesa · Jan 1989
Comparative Study[Value of ascitic lipids and sero-ascitic gradient of albumin in the differential diagnosis of ascites].
In order to compare its diagnostic value in the differentiation between malignant and hepatic ascites, we analysed the ascitic fluid concentrations of cholesterol (Ct) and triglycerides (Tg) and the serum-ascites albumin gradient (S-A alb grad) in 58 patients--forty one with chronic liver disease (CLD) and 17 with malignancy. In CLD group the mean values +/- SD for Ct (27.1 +/- 20.1 mg/dl), Tg (34.2 +/- 33.8 mg/dl) and S-A alb grad (1.9 +/- 0.6 g/dl) were significantly different from those obtained in malignant ascites (Ct 103.1 +/- 45.1 mg/dl; Tg 62.1 +/- 43.0 mg/dl; S-A alb grad 0.5 +/- 0.4 g/dl) (p less than 0.001 for all parameters). ⋯ The exclusion of the 4 patients with massive hepatic metastasis from malignant group by ultrasound or computer tomography gave an efficiency of 87.0% for Ct, 88.9% for Tg and 98.1% for S-A alb grad. We conclude that: 1) S-A alb grad is the best analysed parameter in the discrimination between malignant and hepatic ascites, 2) the combination with non-invasive imaging methods increases its diagnostic value.