Search

What is the difference in cardio-vascular diseases in the elderly? - In elderly patients with acute coronary syndrome the diagnosis is frequently hampered by non-specific symptoms and these patients often seek medical help later than younger individuals. Elderly and old patients with acute coronary syndrome are still less frequently being referred to percutaneous coronary intervention (PCI) than younger patients, although statistically even octogenarians profit from PCI more than from thrombolysis or purely drug therapy. In stable coronary artery disease the focus is on consistent treatment of risk factors. Therapy of systolic heart failure in the elderly is not fundamentally different from that administered to younger individuals, and therapy is just as effective. In old age diastolic heart failure is frequent. The risk of thrombo-embolic complications in atrial fibrillation increases with age. What makes the difference in cardio-vascular diseases in the elderly? - Physiological organ aging processes and immunosenescence provide possible explanations for the frequently atypical clinical presentation of severe ailments and altered pharmacokinetics in old age. Influenza and pneumococcus vaccinations are effective in preventing cardiovascular events.

The characteristics of the tumor marker CASA (Cancer Associated Serum Antigen) during the menstrual cycle were analysed. We investigated whether hormonal influences in women and the score of this tumor marker ought to be considered. It could be demonstrated in regularly ovulating women that CASA is not influenced by physiological alterations of the hormonal status.

Single measurements of hCG and placental protein 14 were carried out in 32 patients with tubal pregnancies, in 38 patients with spontaneous abortion and 28 women with normal intrauterine pregnancies from the 5th to the 7th week of pregnancy. HCG-measurement could only show significant differences between normal and abnormal early pregnancies. PP 14-measurements showed significant differences between all groups. Low concentrations of serum PP 14 point to an ectopic pregnancy.

In a study it was investigated to what extent the early pregnancy factor, the placental proteins 12 and 14 and tumor necrosis factor alpha are suited to control and select patients with habitual abortions for immunotherapy. Immunotherapy shows good clinical results. Placental protein 12 ist not suited for selecting patients. Placental protein 14 shows typical changes after the application of polyvalent immunoglobulin and could be an important prognostic factor. Tumor necrosis factor alpha seems to be useful for selecting patients for immunotherapy, because in cases of habitual abortions this factor can be a sign for immunological causes. In the late phase of pregnancy, early pregnancy factor is also an indicator for disturbances of pregnancy.

Antibodies against spermatozoa specific antigens may be produced in female as well in male subjects. There is some evidence that they are able to contribute to infertility in susceptible couples. Therefore, we studied these antibodies with regard to the diagnostics of infertility. It is shown that there is no significant enhancement in the serum levels of the antibodies in infertile female patients and their partners. The figures measured are comparable to those found in pregnant or in climacteric women. It is concluded that the determination of these antibodies does not contribute to an improved diagnostic of infertility.

The authors report on a patient of 85 years of age in whom a malignant fibrous histiocytoma of the thoracic wall had formed 51 years after a healed pulmonary tuberculosis that had resulted in the development of a pleural callosity. The malignant fibrous histiocytoma is interpreted as a neoplastic transformation of cells of the primary repair process. Age assumes the role of a predisposing factor.

An increased incidence of neonatal jaundice has been observed in babies born to mothers who were treated with different drugs before or during delivery. In this review literature data on such drugs are collected which are under suspicion to produce increased levels of bilirubin in the newborn infant. Despite numerous attempts to show significant effects of these drugs on neonatal hyperbilirubinaemia most of them give contradictory results. Nevertheless, agents that stimulate uterine motility (oxytocin) as well as drugs that inhibit uterine motility (ritodrine) may have an icterogenic effect. Possible mechanisms of their actions are described. Thus, even if there is some association between drugs given prenatally and jaundice developing postnatally, no practical consequences arise except in such cases where additional risk factors may increase the danger of bilirubin encephalopathies in jaundiced infants.

As biochemical markers for early diagnosis of disturbed pregnancies the placental proteins have been found special interest. It is suggested that measuring the serum concentration of placental proteins may have prognostic value in predicting the course of pregnancy. Furthermore, the activity of decidual tissue as well as the state of the menstrual cycle can be monitored. In this a review is given comprising the characteristics and possible clinical applications of these proteins, especially with respect to placental protein 12 (PP12), placental protein 14 (PP14) and the pregnancy associated plasma protein A (PAPP-A).

In development of endometriosis immunological phenomenons are discussed. In women with endometriosis specific antibodies are demonstrated and it is worth to speculate that there takes place de novo-expression of specific antigens. It is also possible, that changes in humoral immunity in endometriosis are secondary to deficient cellular mechanisms.