ABSTRACT
The purpose of this study was to quantify the relationship between a drop in end-tidal carbon dioxide (etCO2) and occlusion of pulmonary veins (PVs) to find a delta etCO2 (ΔetCO2) able to predict occlusion during PV isolation (PVI) by cryoballoon. We designed a prospective registry. Paroxysmal atrial fibrillation patients who underwent cryoballoon PVI were included. Capnography was performed. Occlusion was tested by injection. A comparison between ΔetCO2 and occlusion was performed. Eighteen subjects (138 injections) were included. A drop of >3.5 mmHg predicted occlusion of the PV (sensitivity, 80%; specificity, 86.7%). A ΔetCO2 of ≥3.5 mmHg during inflation of the cryoballoon in each PV directly correlates with PV balloon occlusion.
ABSTRACT
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). Consequently, its presentation and optimal treatment are yet to be clearly defined. In the current literature, all case series report less than 50 patients, most of whom are either young peripartum women or women who have used oral contraceptives over long periods. All information in this study was compiled by the database service from two hospitals, the first one between 2003 and 2012 and the second one between 2007 and 2012, to include the clinical characteristics, angiography. and treatment approaches in the study population. The study population consisted in four women (50%) and four men (50%) whose ages ranged between 28 and 57 years. Two women had a history of oral contraceptive use and three women presented during peripartum. None of the patients had traditional cardiovascular risk factors or previous heart disease. In 88% of the cases, the principal diagnoses were non-ST segment elevation myocardial infarction and unstable angina. All patients underwent emergency coronary angiography and percutaneous coronary intervention. Half of them were treated with drug-eluting stents and the other half with bare metal stents. The most frequent type of dissection was NIHBL Type E, and the right coronary artery was the most frequently compromised. SCAD is a rare cause of ACS; however, its identification has improved due to the availability of angiography and new complementary techniques. Regarding treatment, PCI seems effective with adequate long-term results.
Subject(s)
Acute Coronary Syndrome/epidemiology , Aortic Dissection/epidemiology , Acute Coronary Syndrome/diagnostic imaging , Acute Coronary Syndrome/therapy , Adult , Aortic Dissection/diagnostic imaging , Aortic Dissection/therapy , Coronary Angiography , Female , Humans , Male , Middle Aged , Percutaneous Coronary Intervention , Postpartum Period , Risk Factors , Severity of Illness Index , Stents , Turkey/epidemiology , UltrasonographyABSTRACT
El descubrimiento de biomarcadores específicosde una enfermedad brinda la única oportunidad de adelantarseal diagnóstico clínico de la entidad. Esto aporta ventajas enel tratamiento de los pacientes que se verán reflejadas en los desenlaces...
The discovery of specific biomarkers of disease provides the unique opportunity to anticipate the clinical dioagnosis of the disease. This provides advantages in the treatment of patients that will be reflected in the outcomes....
Subject(s)
Humans , Natriuretic Peptide, BrainABSTRACT
La paracoccidioidomicosis es la micosis profunda más frecuente en América Latina. Afecta principalmente a los adultos y produce lesiones crónicas en la piel, las mucosas y los pulmones. El diagnóstico se basa en la demostración de levaduras con gemación múltiple en las muestras clínicas y mediante cultivo para demostrar su dimorfismo. Los casos reportados se han incrementado en parte por enfermedades como el SIDA y por el advenimiento de nuevas terapias inmunosupresoras. En este artículo reportamos el cuadro clínico de un paciente con artritis reumatoide en un estado avanzado y que sin terapia moduladora para su enfermedad de base presenta paracoccidioidomicosis aguda/subaguda.
Subject(s)
Humans , Itraconazole , ParacoccidioidomycosisABSTRACT
El rechazo crónico se ha convertido en la principal causa de disfunción tardía y de pérdida de un aloinjerto. El linfocito B juega un papel amplio en el rechazo crónico de un trasplante y su papel protagónico ha sido enfocado principalmente a la producción de anticuerpos. Sin embargo, es bien conocido que el linfocito B tiene otras funciones importantes que están implicadas en múltiples procesos inmunológicos, pero su rol en el rechazo de los trasplantes no se conoce a profundidad. Estas funciones son: presentación de antígenos y activación de los linfocitos T CD4+; regulación por medio de la producción de citoquinas de las células T, células dendríticas y macrófagos; dirección de la expansión local linfática (linfoangiogénesis) por medio de la producción e factores de crecimiento y quemoquinas. En esta revisión se presenta una visión general de la inmunobiología del trasplante y posteriormente el tema se enfoca en el papel de la célula B en el rechazo crónico de trasplantes, haciendo énfasis en el trasplante renal.
