ABSTRACT
Resumen: Los aneurismas de seno de Valsalva son una malformación rara de observar en la práctica clínica. Se presentan a cualquier edad y pueden ser de origen congénito o adquirido. La importancia de su estudio radica en que potencialmente pueden complicarse con rotura y fistulización a otra estructura cardíaca o extracardíaca, con una alta mortalidad asociada. El diagnóstico muchas veces puede ser complejo, pero existen algunos elementos clínicos inespecíficos que pueden orientarnos en su detección y rápido manejo, lo que puede marcar una diferencia en el pronóstico del paciente. Se presenta el caso de un paciente de 49 años con un aneurisma de seno de Valsalva complicado y a continuación una breve revisión del tema.
Abstract: Aneurysms of the sinus of Valsalva are. They occur at any age, either as a congenital or an acquired malformation. They may rupture and form a fístula to other cardiac structures, with a high mortality rate. The clinical case of a 49 year-old patient with a ruptured sinus of Valsalva an a fístula to the right atrium is presented. A brief review of the subject is included.
Subject(s)
Humans , Male , Middle Aged , Aortic Aneurysm/complications , Aortic Aneurysm/diagnostic imaging , Aortic Rupture/complications , Aortic Rupture/diagnostic imaging , Aortic Aneurysm/surgery , Aortic Rupture/surgery , Sinus of Valsalva/surgery , Sinus of Valsalva/diagnostic imaging , Tomography, X-Ray Computed , Echocardiography, TransesophagealABSTRACT
BACKGROUND: Patients with a cardiovascular (CV) history may be at greater risk of becoming ill and die due to SARS-CoV-2. AIM: To assess the incidence of CV complications in COVID-19 patients, the type of complication, and their association with CV history. MATERIAL AND METHODS: The clinical course of 1,314 patients with COVID-19 admitted consecutively to critical care units of 10 Chilean hospitals was registered between April and August of 2020. RESULTS: The median age of patients was 59 years and 66% were men. One hundred-four (8%) had a CV history, namely heart failure (HF) in 53 (4.1%), coronary heart disease in 50 (3.8 %), and atrial fibrillation in 36 (2.7 %). There were CV complications in 359 patients (27.3%). The most common were venous thrombosis in 10.7% and arrhythmias in 10.5%, HF in 7.2%, type 2 acute myocardial infarction in 4.2%, arterial thrombosis in 2.0% and acute coronary syndrome (ACS) in 1.6%. When adjusted by age, sex and risk factors, only HF (Odds ratio (OR) = 7.16; 95% confidence intervals (CI), 3.96-12.92) and ACS (OR = 5.44; 95% CI, 1.50-19.82) were significantly associated with CV history. There was no association with arrhythmias, type 2 acute myocardial infarction, arterial or venous thrombosis. CONCLUSIONS: Patients with a history of CV disease are at greater risk of suffering HF and ACS when hospitalized due to COVID-19. Arrhythmias, type 2 AMI, and arterial or venous thrombosis occur with the same frequency in patients with or without CV history, suggesting that these complications depend on inflammatory phenomena related to the infection.
Subject(s)
Humans , Male , Female , Middle Aged , Venous Thrombosis/etiology , Venous Thrombosis/epidemiology , Acute Coronary Syndrome , COVID-19/complications , COVID-19/epidemiology , Heart Failure/etiology , Heart Failure/epidemiology , Myocardial Infarction , Chile/epidemiology , SARS-CoV-2 , Hospitals , Intensive Care UnitsABSTRACT
Background: Hydatid disease or cystic echinococcosis, caused by the parasite Echinococcus granulosus, has a worldwide distribution, affecting people of working age and can cause high levels of morbidity and even death. Aim: To estimate the economic impact at the human and animal level caused by the disease in Chile. Material and Methods: We analyzed information about the disease obtained from reports and publications emanated from the Chilean Ministry of Health, United Nations Food and Agriculture Organization, the U.S. National Institute of Statistics and the National Agricultural Service. Animal derived costs were estimated evaluating the expenses for pharmacological treatment of infected dogs and animal production losses derived from confiscations and reductions in meat production. Results: The total number of patients who underwent surgery to remove a hydatid cyst in Chile during 2012, was estimated as 767 individuals. The annual costs derived only from surgical treatment, were estimated in USD 2.46 million. Summing the costs of sick leaves and loss of productivity, the costs at the human level ascended to USD 3.13 million. Considering human and animal costs, the annual economic burden of the disease was estimated in USD 14.35 million. Conclusions: The Analysis of the regional distribution of human and animal hydatidosis, suggests a significant environmental contamination with parasite eggs in high incidence regions such as Aysén, Araucanía, BioBío and Coquimbo. The efficiency of control programs for the disease would be greatly improved if the causes for these regional contaminations are elucidated.
Subject(s)
Animals , Dogs , Humans , Cost of Illness , Echinococcosis/economics , Health Care Costs , Animal Husbandry/economics , Chile/epidemiology , Dog Diseases/drug therapy , Dog Diseases/economics , Dog Diseases/epidemiology , Echinococcosis/epidemiology , Echinococcosis/therapy , Echinococcosis/veterinary , Incidence , Sick Leave/economicsABSTRACT
Background: Transcatheter aortic valve implantation (TAVI) is taking a leading role in the management of patients with severe aortic stenosis. Valve replacement surgery prolongs survival and is the technique of choice considering its historical background and long experience worldwide. Recently however, TAVI has positioned itself as the only standard therapy for symptomatic patients who are not candidates for surgery. Aim: To report the experience with this new technique comparing our results with those reported in the literature. Material and Methods: Between May 2010 and December 2011,17patients aged 81 ± 7.3 years (58.8% men with an Euro SCORE 29 ± 22.4%) underwent a TAVI. Results: The median transvalvular gradient was 54 ± 15.7 mmHg. All patients received a CoreValveTM. Technical success was 100%, with a post implant gradient of 6.29 ± 3.3 mmHg. Residual aortic regurgita-tion was observed in 94%, none greater than grade II. There were no complications at the vascular access site. One patient developed cardiac tamponade during the procedure. Permanent pacemaker implantation was required in 35.2%. Hospital mortality rate was 5.8%, a figure that remained unchanged at 30 days offollow-up. Conclusions: In high-risk patients with aortic stenosis, TAVI has a high success rate and a low rate of complications. Besides an appropriate patient selection, a trained multidisciplinary team and technical conditions to solve possible complications of the procedure are required.
Subject(s)
Aged, 80 and over , Female , Humans , Male , Aortic Valve Stenosis/surgery , Cardiac Catheterization/methods , Heart Valve Prosthesis Implantation/methods , Cardiac Catheterization/standards , Heart Valve Prosthesis Implantation/mortality , Heart Valve Prosthesis Implantation/standards , Hospital Mortality , Treatment OutcomeABSTRACT
En este artículo presentamos resultados respecto de la asociación entre el nivelde integración subjetiva de los jóvenes y las jóvenes estudiantes de enseñanza media de Santiagode Chile, y su percepción de disponer de apoyo por parte de instituciones sociales, empleando losconstructos de anomia y alienación. Determinamos que los niveles de alienación de los jóvenesson intermedios, aunque muy altos en la percepción de desunión social. Percibimos que brindan unmayor soporte las instituciones educativas, de salud y policiales, y lo opuesto ocurre con las políticasy FF. AA. Encontramos una asociación entre la alienación y la percepción de apoyo institucional.Concluimos que el generar condiciones institucionales para la integración subjetiva de los jóveneses una tarea pendiente.
Subject(s)
Adolescent , AnomieSubject(s)
Humans , Female , Aged , Echocardiography, Transesophageal , Pulmonary Embolism , Arthroplasty, Replacement, Hip , Dyspnea , Femoral Vein , Heparin , Leg , Pulmonary EmbolismABSTRACT
Chilean T. cruzi populations from different endemic areas and transmission cycles were characterized at several biochemical levels, to mention: hybridization with kinetoplast DNA probes, molecular karyotype, isoenzyme studies and kinetoplast DNA restriction fragment length polymorphism. Furthermore, an immunological approach with immune sera from Balb/c infected mice with different T. cruzi populations was used to differentiate among parasite types by the in vitro complement-mediated lysis assay. Parasite grouping by the above described methods allows to classify T. cruzi populations on a very defined number, suggesting that they have a clonal structure