Résumé
El objetivo del presente es la caracterización de pacientes en terapia intensiva en el hospital de alta complejidad, y portadores de insuficiencia respiratoria aguda con requerimiento de asistencia ventilatoria mecánica, a su vez, el comportamiento de pacientes con infección por el virus influenza H1N1 que desarrollan síndrome de dificultad respiratorio agudo (SDRA).
Sujets)
Virus de la grippe A , , Insuffisance respiratoire , Sous-type H1N1 du virus de la grippe A , Unités de soins intensifsRésumé
Background: Atrial fibrillation can originate in arrhythmogenic foci coming from the pulmonary veins. Patients with atrial fibrillation, initiated from triggering foci, can be treated with radiofrequency ablation. Aim: To report the results of radiofrequency ablation in patients with focal atrial fibrillation. Patients and methods: Thirteen patients with focal atrial fibrillation (8 male, aged 19 to 60 years old) are reported. Twelve had frequent crises refractory to antiarrhythmic drugs. Two had also flutter and tachycardia. One had a permanent atrial fibrillation lasting five years. Two had ventricular dysfunction and left atrial dilatation. The triggering focus was identified during the electrophysiological study, by the precocity of the potential that initiated the atrial fibrillation. Results: All patients had early atrial extrasystolic beats, isolated or repetitives, that preceded atrial fibrillation. During the electrophysiological study, 18 foci (3 in the right and 15 in the left atrium all in pulmonary veins) were identified. Radiofrequency ablation had immediate success in 11 patients. In 5, a flutter was also ablated. One patient had a sinus dysfunction after the procedure and atrial fibrillation was not eliminated. In this and other patient in whom the procedure failed, a pacemaker was implanted and the atrioventricular node was blocked. In a follow up, ranging from 4 to 31 months, eight patients are asymptomatic and 3 recidivated. No complications have been detected. Conclusions: Patients with focal atrial fibrillation have common clinical and electrocardiographic features. Radiofrequency ablation of the triggering focus is possible and effective in most cases
Sujets)
Humains , Mâle , Femelle , Ablation par cathéter/méthodes , Fibrillation auriculaire/diagnostic , Fibrillation auriculaire/thérapie , Antiarythmiques/usage thérapeutique , ÉlectrocardiographieRésumé
Se presentan 5 pacientes operados por distomatosis de la via biliar principal. Los sintomas semejan los de la litiasis biliar. El diagnostico preoperatorio es dificil. El conocimiento de las imagenes colangiograficas es indispensable para no pasar por alto la presencia de parasitos.El tratamiento quirurgico debe complementarse con la administracion de emetina
Sujets)
Adulte , Adulte d'âge moyen , Humains , Femelle , Lithiase biliaire , Maladies du cholédoque , Fasciola hepatica , CholangiographieRésumé
Es la primera descripcion de un brote de gastroenteritis hemorragica aguda canina en Costa Rica. Se estudiaron doce perros con diarrea y vomitos, se les tomaron muestras de heces y de tejidos, destinadas tanto para microscopia de luz, como para microscopia electronica de barrido y de transmision. Macroscopica y microscopicamente se observaron grandes areas congestivas y hemoragicas en duodeno y yeyuno.Al microscopio de luz se observaron una marcada perdida y descamacion del epitelio de las vellosidades y dilatacion de las criptas. Con microscopia electronica de transmision y de barrido se observo una acentuada perdida de las microvellosidades,capilares con endotelio destruido, alteraciones en el microcaliz y en las mitocondrias. El analisis de las heces por microscopia electronica de transmision con tincion negativa, revelo la presencia de particulas virales semejantes a parvovirus, lo que confirma el diagnostico de gastroenteritis hemorragica aguda canina