Foliar Lesions Induced by Pestalotiopsis arengae in Oil Palm (O × G) in the Colombian Southwest Palm Zone.

In Colombia, plantings with the oil palm hybrid between Elaeis oleifera × Elaeis guineensis, known as O × G hybrid, have increased due to its tolerance to bud rot. Despite this, different degrees of foliar necrosis, chlorosis, and leaf blight have been reported in some cultivars; therefore, this work aimed to diagnose this problem. We visited plantation plots with palms exhibiting the mentioned symptoms and collected 21 samples of affected tissues in different disease states. The affected tissues were examined and seeded in a culture medium. Pathogenicity tests were performed and the isolates were characterized by culture and morphological and molecular features. Curvularia, Colletotrichum, Phoma, and 25 Pestalotiopsis-like fungi were isolated from the foliar lesions. In the pathogenicity tests, the symptoms observed in the field were reproduced with MFTU01-1, MFTU12, and MFTU21 isolates, which were identified at the species level through a sequence analysis of three genes (ITS, TUB2, and TEF1-α) as Pestalotiopsis arengae with an identical level of 99% based on the results of BLAST and phylogenetic tree analyses. The remaining 22 Pestalotiopsis-like non-pathogenic isolates were identified as species of Neopestalotiopsis and Pseudopestalotiopsis. The direct association of P. arengae with the disease was confirmed via molecular detection in affected tissues in 15 of 21 samples collected for this evaluation. This is the first report of P. arengae as the causal agent of foliar lesions in O × G hybrid oil palm in Colombia.

Medición de la vaina del nervio óptico mediante tomografía computarizada como predictor de mortalidad en pacientes con traumatismo craneoencefálico grave al ingreso a la Unidad de Cuidados Intensivos / Optic nerve sheath measurement through computerized scan as death predictor in patients with serious cranioencephalic trauma on entry to the Intensive Care Unit / Medição da bainha do nervo óptico por tomografia computadorizada como preditor de mortalidade em pacientes com trauma cranioencefálico grave internados na Unidade de Terapia Intensiva

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Abstract: Introduction: Traumatic brain injury (TBI) is a medical-surgical condition characterized by brain involvement secondary to a traumatic lesion. Patients with severe TBI are at high risk of mortality and this will depend on different factors such as the presence of intracranial hypertension, age, origin of the injury and score on the Glasgow coma scale. Measurement of the optic nerve sheath diameter (ONSD) appears to be a good indirect indicator of intercranial hypertension and therefore, a good predictor of mortality. Objective: To determine the most appropriate cut-off point, as well as the measurement of the ONSD usefulness as a prognostic indicator of mortality in patients with severe TBI in the Intensive Care Unit (ICU). Material and methods: This is an analytical, descriptive, and retrospective study. The universe of study consists of all the case/files with TBI. For the sample selection, all available records of patients with severe TBI sent to the ICU during the period from March 1 to August 31, 2021, will be included. Within the inclusion criteria patients with a Glasgow scale score of < 8 points on entry and with a computerized scan done. The dependent variables to considerer are the outcome understood as death or survival of the patient, the days hospitalized in the ICU, the presence of complications; among the dependent variables is the diameter of the optic nerve sheath measured by computerized tomography. Intervening variables were also considered such as the presence of comorbidities and overweight/obesity, the age and sex of the patient. The project consisted of four phases: 1) request for authorization and access to files, 2) application of selection criteria, 3) performance of ONSD measurements and 4) creation of the database. Finally, once the database is formed, the statistical analysis will proceed; for the descriptive part, prevalence's, means (standard deviation) and medians (percentiles) will be calculated for the variables by sex and by outcome, subsequently the diagnostic capacity of the ONSD will be analyzed through the area under the ROC curve (receiving operating characteristics) for the outcome. Afterwards the performance of this and other cut-off points are compared using the Youden index. Results: Sixty records of TBI patients admitted to the ICU were studied, 51 were men (85%), 45 patients survived (75%) and 15 patients died (25%). The average age was of 50.5 ± 10.6 years, the average Glasgow score on admission was 6.6 ± 1.6 points, the average BMI was 26.42 ± 4.10 kg/m2, and the average number of days spent in the ICU was 9.03 ± 6.4. The diameter of the optic nerve was not a predictor of mortality, but if the Glasgow coma scale was, with an AUC of 0.775 (95% CI: 0.648-0.901, p = 0.002), the best cut-off point was 7 with a sensitivity of 93% and specificity of 54%. The bivariate linear regression model points to low Glasgow coma score and long hospital stay as predictors of mortality. Conclusions: The results of this study infer that, consistent with current scientific evidence, the sociodemographic characteristics of our population are similar to those reported by other authors, with men over 50 years of age being the most affected by this entity. On the other hand, the measurement of the diameter of the optic nerve sheath has been considered a good prognostic indicator of intracranial hypertension, which in turn is associated with increased mortality. However, in the present study there is no association between the diameter of the optic nerve sheath and the prognosis of mortality.

Resumo: Introdução: O traumatismo cranioencefálico (TCE) é uma condição médico-cirúrgica caracterizada por lesão cerebral secundária a uma lesão traumática. Pacientes com TCE grave apresentam alto risco de mortalidade e isso dependerá de diversos fatores, como presença de hipertensão intracraniana, idade, origem da lesão e pontuação na Escala de Coma de Glasgow. A medida do diâmetro da bainha do nervo óptico (DBNO) parece ser um bom indicador indireto de hipertensão intracraniana e, portanto, um bom preditor de mortalidade. Objetivo: Determinar o ponto de corte mais adequado, bem como a utilidade da medida do DBNO como indicador prognóstico de mortalidade em pacientes com TCE grave na Unidade de Terapia Intensiva. Material e métodos: Trata-se de um estudo analítico, descritivo e retrospectivo. O universo de estudo é composto por todos os prontuários de casos/pacientes com TCE grave. Para a seleção da amostra foram incluídos todos os prontuários disponíveis de pacientes com TCE grave encaminhados à Unidade de Terapia Intensiva no período de 1o de março a 31 de agosto de 2021, dentro dos critérios de inclusão foram considerados pacientes com escala de Glasgow < 8 pontos na admissão e com uma tomografia computadorizada realizada. As variáveis ​​dependentes consideradas são o desfecho entendido como óbito ou sobrevida do paciente, os dias de internação na UTI, a presença de complicações; dentro das variáveis ​​independentes está o diâmetro da bainha do nervo óptico medido por tomografia computadorizada. Também foram consideradas variáveis ​​intervenientes, como presença de comorbidades e sobrepeso/obesidade, idade e sexo do paciente. O projeto consistiu em três fases: a) Pedido de autorização e acesso aos prontuários, b) Aplicação dos critérios de seleção, c) Desenvolvimento da base de dados. Por fim, uma vez formada a base de dados, procedeu-se à análise estatística. Para a parte descritiva, foram calculadas as prevalências, médias (desvio padrão) e medianas (percentis) das variáveis ​​por sexo e por desfecho. Posteriormente, a capacidade diagnóstica do DBNO foi analisada pela área sob a curva ROC (Receiving Operating Characteristics) para o resultado. Posteriormente, o desempenho deste e de outros pontos de corte foi comparado pelo índice de Youden. Resultados: Foram estudados 60 prontuários de pacientes com TCE que deram entrada na UTI, 51 eram homens (85%), 45 pacientes sobreviveram (75%) e 15 pacientes morreram (25%). A média de idade foi de 50.5 ± 10.6 anos, a média de Glasgow na admissão foi de 6.6 ± 1.6 pontos, a média de IMC foi de 26.42 ± 4.10 kg/m2 e a média de dias de internação na UTI foi de 9.03 ± 6.4. O diâmetro do nervo óptico não foi preditor de mortalidade, mas a Escala de Coma de Glasgow sim, com AUC de 0.775 (IC 95%: 0.648-0.901, p = 0.002), o melhor ponto de corte foi 7 com sensibilidade de 93% e especificidade de 54%. O modelo de regressão linear bivariada aponta para baixo escore de coma de Glasgow e longa permanência hospitalar como preditores de mortalidade. Conclusões: Os resultados deste estudo inferem que, de acordo com as evidências científicas atuais, as características sociodemográficas de nossa população são semelhantes às relatadas por outros autores, sendo os homens com aproximadamente 50 anos de idade os mais acometidos por essa entidade. Por outro lado, a medida do diâmetro da bainha do nervo óptico tem sido considerada um bom indicador prognóstico de hipertensão intracraniana, que por sua vez está associada ao aumento da mortalidade. No entanto, no presente estudo não há associação entre o diâmetro da bainha do nervo óptico e o prognóstico de mortalidade.

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con Enfermedad Renal Crónica en diálisis / Colombian Expert Consensus on Evidence-Informed Recommendations for the Prevention, Diagnosis, and Management of SARS-CoV-2 / COVID-19 Infection in Patients with Chronic Kidney Disease on Dialysis

Resumen Introducción: Las personas con diálisis de mantenimiento se consideran una población en alto riesgo de infección por SARS-CoV-2, complicaciones y muerte. La periodicidad de la diálisis, la organización y la demanda en las unidades de diálisis y las limitaciones de alfabetización en salud poblacional limitan el cumplimiento del aislamiento y el distanciamiento social. Objetivo: Desarrollar, mediante un consenso de expertos, recomendaciones informadas en evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Materiales y métodos: Se realizó una revisión rápida de literatura en Pubmed, Embase y sociedades científicas. La calidad de evidencia fue evaluada según el tipo de estudio incluido. El acuerdo se definió para cada recomendación con umbral de al menos 70% de aprobación. La fuerza de las recomendaciones fue graduada como fuerte o débil. Resultados: El colectivo fue consultado entre el 17 y 19 de mayo de 2020. Se obtuvo respuesta de 44 expertos clínicos que declararon conflicto de interés previo a la consulta. El acuerdo de las recomendaciones estuvo entre 70,5 y 100%. Se presentan las recomendaciones de un colectivo experto para la prevención, el diagnóstico y el manejo de infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Conclusión: Debido a la reciente aparición de la infección por SARS-CoV-2 y las incertidumbres respecto a la prevención, el diagnóstico y el manejo, las recomendaciones presentadas se conciben como un estándar colombiano que permita garantizar un cuidado centrado en las personas con enfermedad renal crónica y la protección de los profesionales de la salud.

Abstract Introduction: People with chronic dialysis are considered a population at high risk of SARS CoV2 infection and its derived complications and death. The need to go to strict dialysis schedules, the high demand in the kidney facilities and the difficulties derived from the time and space organization in the rooms in the face to the pandemic added to the difficult learning, teaching and adapting new protocols manifest the needed of standard recommendation according to this problem in people who couldn't have an ideal isolation. Objective: Develop through an expert consensus, evidence-informed recommendations for the prevention, diagnosis, and management of SARS-CoV-2/COVID-19 infection in patients with chronic kidney disease on Dialysis. Materials and methods: We carried out a quick literature review, PubMed, Embase and scientific societies were consulted. The quality of the evidence was considered according to the type of study included. The agreement threshold defined for each recommendation was > 70% approval among experts. The strength of the recommendations was rated as strong or weak. Results: Between May 17 and 19, 2020, was conformed a team of 44 clinical experts who declared their interest conflict prior to the consultation. The agreement of the recommendations was between 70.5% and 100%. The recommendations were separated in prevention, early identification, and diagnostic, isolation in hemodialysis facilities and peritoneal dialysis, and team protection. Ethical considerations also were included. Conclusion: Due to the recent appearance of SARS-CoV-2 infection and the uncertainties regarding prevention, diagnosis and management, the recommendations presented are conceived as a Colombian standard that allows guaranteeing focused care for people with chronic kidney disease and the protection of health team.

Considerations on genetic engineering: regarding the birth of twins subjected to gene edition.

In this essay, the bioethical implications of the recent genetic manipulation in human embryos with CRISPR-Cas9 to eliminate the CCR5 gene and the birth of a pair of discordant twin girls are analyzed. The experiment was disseminated via social media. The main bioethical flaws identified include the justification of the model, the informed consent process and the lack of disclosure of evident conflicts of interest. The consequences of the experiment on the life of the twins that were born were not properly evaluated, such as the impact on their autonomy, the alleged benefits to be received and the future risks of harm during their lifetime. Having manipulated the germ cell line, the effects on their future offspring were not considered. This type of actions negatively affects the way society conceives science. Genetic engineering should be reserved to the basic experimental context or as clinical research for the correction of known serious diseases of genetic origin under strict regulatory and bioethical supervision and using a gradualist approach in accordance with the advances of gene editing techniques.

En este ensayo se analizan las implicaciones bioéticas de la reciente manipulación genética en embriones humanos con CRISPR-Cas9 para eliminar el gen CCR5 y el nacimiento de dos gemelas discordantes. El experimento se divulgó en medios sociales. Los principales problemas bioéticos identificados son la justificación del modelo, el proceso de consentimiento informado y la falta de declaración de evidentes conflictos de interés. No se evaluaron apropiadamente las consecuencias del experimento sobre la vida de las gemelas nacidas como la afectación a su autonomía, los supuestos beneficios por recibir y los riesgos futuros de daño durante su vida. Habiendo manipulado la línea celular germinal, no se consideraron los efectos sobre su descendencia futura. Este tipo de acciones tiene un impacto negativo en la forma como la sociedad concibe la ciencia. La ingeniería genética debe reservarse al contexto experimental básico o bien como investigación cínica para la corrección de enfermedades conocidas graves de origen genético, bajo estricta supervisión regulatoria y bioética y de manera gradualista de acuerdo con el progreso de las técnicas de edición genética.

Reflexiones sobre la ingeniería genética: a propósito del nacimiento de gemelas sometidas a edición génica / Considerations on genetic engineering: regarding the birth of twins subjected to gene edition

Resumen En este ensayo se analizan las implicaciones bioéticas de la reciente manipulación genética en embriones humanos con CRISPR-Cas9 para eliminar el gen CCR5 y el nacimiento de dos gemelas discordantes. El experimento se divulgó en medios sociales. Los principales problemas bioéticos identificados son la justificación del modelo, el proceso de consentimiento informado y la falta de declaración de evidentes conflictos de interés. No se evaluaron apropiadamente las consecuencias del experimento sobre la vida de las gemelas nacidas como la afectación a su autonomía, los supuestos beneficios por recibir y los riesgos futuros de daño durante su vida. Habiendo manipulado la línea celular germinal, no se consideraron los efectos sobre su descendencia futura. Este tipo de acciones tiene un impacto negativo en la forma como la sociedad concibe la ciencia. La ingeniería genética debe reservarse al contexto experimental básico o bien como investigación cínica para la corrección de enfermedades conocidas graves de origen genético, bajo estricta supervisión regulatoria y bioética y de manera gradualista de acuerdo con el progreso de las técnicas de edición genética.

Abstract In this essay, the bioethical implications of the recent genetic manipulation in human embryos with CRISPR-Cas9 to eliminate the CCR5 gene and the birth of a pair of discordant twin girls are analyzed. The experiment was disseminated via social media. The main bioethical flaws identified include the justification of the model, the informed consent process and the lack of disclosure of evident conflicts of interest. The consequences of the experiment on the life of the twins that were born were not properly evaluated, such as the impact on their autonomy, the alleged benefits to be received and the future risks of harm during their lifetime. Having manipulated the germ cell line, the effects on their future offspring were not considered. This type of actions negatively affects the way society conceives science. Genetic engineering should be reserved to the basic experimental context or as clinical research for the correction of known serious diseases of genetic origin under strict regulatory and bioethical supervision and using a gradualist approach in accordance with the advances of gene editing techniques.

Development of an antimicrobial resin--a pilot study.

OBJECTIVES: To demonstrate that silver nanoparticles (AgNPs) could be synthesized in situ in acrylic dental resins. METHODS: Light-cure (LC; bisphenol A glycidyl methacrylate, tetraethyleneglycol dimethacrylate, bisphenol A ethoxylate dimethacrylate blend) and chemical-cure systems (CC; orthodontic denture resin) were used to synthesize AgNPs using different concentrations of Ag benzoate (AgBz). RESULTS: Rockwell hardness for LC resins showed that resins could be cured with up to 0.15% AgBz, while the hardness of CC resins were unaffected in the concentrations tested. UV-Vis spectroscopy and transmission electron microscopy confirmed the presence of AgNPs in both LC and CC resins. Generally, CC resins had better distribution of and much smaller AgNPs as compared to LC resins overall. In some samples, especially in LC resins, nanoclusters were visible. An in vitro release study over four-weeks showed that CC resins released the most Ag(+) ions, with release detected in all samples. However, LC resins only released Ag(+) ions when AgBz concentration was greater than 0.1% (w/w). AgNP-loaded CC resins made with 0.2 and 0.5% (w/w) AgBz were tested for antibacterial activity in vitro against Streptococcus mutans, and results showed 52.4% and a 97.5% bacterial inhibition, respectively. Further work is now warranted to test mechanical properties and to optimize the initiator system to produce commercially useful dental and medical resins. SIGNIFICANCE: Success in this work could lead to a series of antimicrobial medical and dental biomaterials that can prevent secondary caries and infection of implants.

Hemobilia postraumática diagnosticada por ultrasonografía: presentación de un caso / Posttraumatic haemobilia diagnosed by ultrasonography: case presentation

Se presentó un caso de hemobilia postraumática en una niña que ingresó por dolor en hipocondrio derecho y sangrado digestivo alto, con el antecedente de un trauma abdominal de dos días de evolución. La presencia de ictero sugirió la realización de estudios radiológicos no invasivos que permitieron diagnosticar esta complicación poco frecuente, de la cual evolucionó favorablemente con reposo y tratamiento médico selectivo(AU)

A case of posttraumatic haemobilia in a girl who was admitted to hospital with pain in the right hypocondrio and high digestive bleeding is presented. The patient had antecedent of abdominal trauma of two days´ course. Presence of icterus suggested the use of radiologic non invasive studies that permitted to diagnose this infrequent complication, which was solved with bed rest and selective medical treatment(AU)

Aneurismas paraclínicos en el Hospital Dr. Hernán Henríquez Aravena de Temuco: experiencia de 16 años / Paraclinoidal aneurysms in the Dr. Hernán Henríquez Aravena Hospital in Temuco

Desde que se inicia la cirugía de aneurismas intracerebrales en el Hospital Dr. Hernán Henríquez Aravena de Temuco (año 1989) a la fecha, se han intervenido 8 por aneurismas paraclinoideos de la arteria carótida interna. Seis pacientes de sexo femenino y dos de sexo masculino, con un promedio de edad de 46.7 años al momento del ingreso. Siete debutaron con cuadro de hemorragia subaracnoídea, en 6 casos determinada por el aneurisma paraclinoideo y uno de otra localización. El restante paciente es diagnosticado a través de una tomografía parte del estudio de patología neoplásica del tracto digestivo. De la técnica utilizada destaca: Control de la arteria carótida cervical disecada previa al tiempo craneal, uso de drenaje espinal, abordaje pterional intradural, fresado de clinoides, disección del anillo distal y uso de clip quirúrgico según anatomía de la lesión. Los pacientes fueron intervenidos en un promedio de 10.12 días desde el inicio de la sintomatología o desde el hallazgo de la lesión en forma incidental. Buenos resultados quirúrgicos 87.5 por ciento y sobrevida promedio de 8 años a la fecha.

Since the beginning of surgery of intracraneal aneurysms in Temuco's Hospital, (1989) to our days, eightr patients has been operated because of an aneurysm situated at the paraclinoid segment of the internal carotid artery. Six of them were female and two were male, with a mean age of 46,7 years at the event. Seven patients consulted for a history of subarachnoid bleeding, six of them had a carotid - ophthalmic aneurysm. The diagnosis of the other patient was done by a tomographic control of malignant digestive tract pathology. All patients were approached by fronto-pterional side of the skull, previously doing a cervical incision at the same side of the aneurysm, to expose the primitive and internal carotid artery, intradural access and spinal drainage. Anterior clinoid process was extirpated and distal ring was dissected before clipping the aneurysm. The use of surgical clips was according to the anatomy of the lesion. The patient was operated in an average of 10 days since the beginning of the symptoms or since the casual discovery of the aneurysm. Good surgical prognosis in 87.5 percent and survival mean 8 days.

Ectacia coronaria en un paciente con angina inestable: informe de un caso y revisión bibliográfica / Coronary Ectasia In A Patient With Unstable Angina: case Report And Literature Review

Coronary ectasia is a little common angiographic finding. Its prevalence varies between 0,3-5,3 por ciento in different series, although a recent study reports until 6,7 por ciento. Coronary ectasia is suffered mainly by males, and may be produced by different causes; however in most of the patients it seems to be related to coronary atherosclerosis. In fact, some authors consider it like a variant of the atherosclerotic disease of coronary arteries. We report the case of a 54-year-old white male who was admitted on intensive care unit because of ustable angina with electrocardiographic changes. Coronary angiography revealed severe coronary ectasia, mainly of the left main coronary artery and the proximal portion of left anterior descending artery. The greatest ectasia of the left main coronary artery that we have found in reviewed literature had 15,0 millimeters and ours sized 12,9 millimeters. Angiographic images are show(AU)

Dual left anterior descending coronary artery / Desenso dual anterior izquierdo de la arteria coronario

The normal anatomy of coronary arteries is well known but there is a great variety on its origin and distribution. Congenital coronary anomalies are uncommon and the vast majority is diagnosed incidentally during coronary angiogram or necropsy. Isolated coronary anomalies are uncommon diseases (0.64-1.3 por ciento of all patients who underwent coronary angiography) and the anomalous origin of left anterior descending (LAD) artery from the proximal portion of the right coronary artery or from the right sinus of Valsalva is extremely rare ranging between 1.2-6.1 por ciento of all coronary anomalies. We report the case of a 52-year-old obese woman with smoking habit and non-insulin dependent diabetes mellitus who had been complaining of chest pain for two months. Coronary angiography revealed dual LAD coronary artery type IV but we noticed that it is not a typical type IV of Spindola-Franco classification because the major septal perforators did not originate from the short, but from the long LAD artery. Therefore, we have to ask the following question: Is the LAD that we present a typical type IV of Spindola-Franco classification or just a new variant never described before(AU)

Reversión de fibrilación auricular paroxístoca con amiodarona después de una revascularización miocárdic quirúrgica sin bomba / Paroxysmal atrial fibrillation reversion with amiodarone in a patient who underwent off-pump coronary artery bypass surgery

La fibrilación auricular afecta al 1 por ciento-2 por ciento de la población general y es la arritmia con mayor prevalencia en los servicios de urgencia hospitalarios. Es la arritmia que aparece más frecuentemente en el postoperatorio de revascularización miocárdica quirúrgica, oscila entre el 20 por ciento y el 40 por ciento aunque algunas series han informado hasta un 65 por ciento. En estos pacientes la fibrilación auricular aumenta la mortalidad intrahospitalaria y la aparición de accidentes vasculares cerebrales, prolonga la estadía en el hospital y es un predictor independiente de mortalidad a largo plazo. El tratamiento con amiodarona, betabloqueantes y estimulación eléctrica biatrial programada ha tenido resultados alentadores. En este artículo se presenta el caso de un paciente que, en el segundo día del postoperatorio de una revascularización miocárdica quirúrgica con corazón latiendo, sufrió una fibrilación auricular paroxística y recuperó el ritmo sinusal tras la utilización de amiodarona en bolo. Se muestra el trazo eléctrico(AU)

Dual left anterior descending coronary artery / Arteria coronaria descendente anterior izquierda dual

The normal anatomy of coronary arteries is well known but there is a great variety on its origin and distribution. Congenital coronary anomalies are uncommon and the wast majority is diagnosed incidentally during coronary angiogram or necropsy. Isolated coronary anomalies are uncommon diseases (0,64-1.3 por ciento) of all patients who underwent coronary angiography) and the anomalous origin of left anterior descending (LAD) artery from the proximal portion of the right coronary artery or from the right sinus of Valsalva is extremely rare ranging between 1.2-6.1 por ciento of all coronary anomalies. We report the case of a 52-year-old obese woman with smoking habit and non-insulin dependent diabetes mellitus who had been complaining of chest pain for two months. Coronary angiography reveled dual LAD coronary artery type IV but we noticed that it is not a typical type IV of Spindola-Franco classification because the major septal perforators did not originate from the short, but from the long LAD artery. Therefore, we have to ask the following question: Is the LAD that we present a typical type IV of Spindola-Franco classification or just a new variant never described before(AU)

La primera angioplastia coronaria transluminal percutánea primaria en el infarto agudo de miocardio en Villa Clara. Informe de caso / The first primary coronary persutaneous angioplasty in acute myocardial infartion in Villa Clara. A case report

El infarto agudo de miocardio es una de las principales causas de muerte e invalidez en el mundo. Reperfundir el área miocárdica afectada ha sido el mayor objetivo de la terapéutica. La trombolisis ha mostrado eficacia, pero en un por ciento muy limitado de casos, inferior al 50 por ciento; sin embargo, la angioplastia coronaria transluminal percutánea, además de disolver el trombo rojo, elimina la estenosis residual de la arteria producida por la placa de ateroma. El desarrollo de este procedimiento y la introducción de los stents (prótesis endovasculares) han proporcionado, en beneficio del paciente, la posibilidad de mantener abierto el vaso relacionado con el infarto. En este artículo presentamos el caso del primer paciente que fue sometido a una angioplastia coronaria primaria en el infarto agudo de miocardio, fuera de Ciudad de la Habana. Nunca antes se había realizado este procedimiento en el resto de las provincias del país. Se muestran las imágenes angiográficas (AU)