Left atrial myxoma and transient ischemic attack: case report.

Cardiac tumors are rare and myxomas are the most prevalent among them. Although it presents benign histology, they may be the cause of severe consequences due to intracardiac location. Nonspecific manifestations may hinder the diagnosis, which can lead to complications, such as changes in cardiac dynamics, thromboembolic events and death. This paper presents a case report of a patient in the emergency department of a high complexity hospital in Minas Gerais State, Brazil, with a clinical history of angina and 7 previous Transient Ischemic Attack (TIA), besides aphasia, right hemiparesis, dysarthria, and mouth deviation. Submitted to transesophageal echocardiography, she was diagnosed with left atrial myxoma. For the treatment of myxoma, a surgical approach was used to resect the myxoma in the left atrium. The standard surgical approach was through a median sternotomy. Cardiopulmonary bypass (CPB) with aortic and bicaval cannulation and moderate hypothermia was used. Myocardial protection was achieved by cold antegrade blood cardioplegia. The patient had notable characteristics for the diagnosis, especially the previous occurrence of seven episodes of TIA. The importance of correct clinical investigation (anamnesis, general and specific physical examination and imaging tests) is notable and a fundamental tool for the diagnosis and early treatment of neoplasia, providing good clinical outcomes.

Associations between surgical wound infectious and clinical profile in patients undergoing cardiac surgery.

BACKGROUND: Infections are surgical severe adverse events that pose risks to patient safety in health services, in addition to increasing costs and morbidity and mortality. AIM: This study aims to describe the infectious profile of patients undergoing cardiac surgery and associate comorbidities and lifestyle habits with surgical wound infection. DESIGN: Observational and retrospective study. METHODS: The study included 453 patients undergoing cardiac surgery in a public teaching hospital from January 2014 to January 2019. Data were collected from the clinical records through an instrument composed of variables clinical characteristics, comorbidities, life habits, infection rates, infectious agents, clinical management and surgical wound features. Simple frequency, measures of central tendency and variability, Chi-Square test and logistic regression were used for data analysis. RESULTS: There was a predominance of hypertensive patients (367; 81%), smokers (107; 23.6%), alcoholics (76; 16.8%). Surgical wound infection affected 86 (19%) patients. Besides, most patients were under antibiotic therapy (310; 68.4%). Klebsiella pneumoniae; Staphylococcus epidermides and Staphylococcus aureus were the most frequent pathogens. Diabetes Mellitus, nephropathy and age were statistically significant (P<0.05) for higher risk of surgical wound infection. CONCLUSION: Chronic diseases and lifestyle habits were related to postoperative infection. More research is needed, focusing on risk factors for the development of surgical wound infection.

Epidemiological profile, cardiopulmonary fitness and health-related quality of life of patients with heart failure: a longitudinal study.

BACKGROUND: Heart failure (HF) is a severe and self-limiting syndrome. Its signs and symptoms are believed to predict poorer health-related quality of life scores, which are mainly influenced by deterioration in physical capacity. In the present study we try to analyze the influence of clinical and socioeconomic characteristics and physical capacity on the quality of life of people with HF diagnosis. METHODS: A longitudinal study was conducted over 2 years with patients diagnosed with HF. To evaluate the patients the method of face-to-face visit and telephone monitoring was used. In the evaluations were applied: the Clinical and Socioeconomic Characterization Questionnaire, the Minnesota Living With Heart Failure Questionnaire (MLHFQ) for quality of life evaluation and the Veterans Specific Activity Questionnaire (VSAQ) for cardiopulmonary fitness analysis. Measures of central tendency, proportion, normality test, confidence intervals, comparison of data through paired Student t test and Wilcoxon or Mann Whitney test were performed and correlations were verified through Spearman coefficient. RESULTS: The study included 108 patients, most of them female (50.90%) and mean age of 66.62 ± 11.33 years. The median time of HF diagnosis was 5 ± 6 years, being Chagas' disease the main etiologic cause for the disease (57.40%). As for the clinical condition, functional classes II (44.40%) and III (48.10%) of the New York Heart Association (NYHA) were the most frequent. There was a low cardiopulmonary fitness, with loss of capacity to perform daily activities (3 ± 1 to 3 ± 3) over the time of clinical follow-up. There was an increase in the MLHFQ instrument scores, from 50.98 ± 15.52 to 61.76 ± 19.95, over the analysis time. The analysis of correlations demonstrated that variables such as schooling, NYHA class, echocardiographic alterations and the drug profile have a significant relationship with the constructs of quality of life and physical fitness. CONCLUSION: Individuals in HF have significant impairment of cardiorespiratory capacity and tend to present worsening of QL along the evolution of the disease.

Effects of acute and chronic exercise on the osmotic stability of erythrocyte membrane of competitive swimmers.

This study aimed to evaluate the influence of acute and chronic exercise on erythrocyte membrane stability and various blood indices in a population consisting of five national-level male swimmers, over 18 weeks of training. The evaluations were made at the beginning and end of the 1st, 7th, 13th and 18th weeks, when volume and training intensity have changed. The effects manifested at the beginning of those weeks were considered due to chronic adaptations, while the effects observed at the end of the weeks were considered due to acute manifestations of the exercise load of that week. Acute changes resulting from the exercise comprised increases in creatine kinase activity (CK) and leukocyte count (Leu), and decrease in hematocrit (Ht) and mean corpuscular volume (MCV), at the end of the first week; increase in the activities of CK and lactate dehydrogenase (LDH), in the uric acid (UA) concentration and Leu count, at the end of the seventh week; increases in CK and LDH activities and in the mean corpuscular hemoglobin concentration (MCHC), at the end of the 13th week; and decrease in the value of the osmotic stability index 1/H50 and increases in the CK activity and platelets (Plt) count, at the end of the 18th week. Chronic changes due to training comprised increase in the values of 1/H50, CK, LDH, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), serum iron (Fe), MCV and Plt. Although acute training has resulted in decrease in the osmotic stability of erythrocytes, possibly associated with exacerbation of the oxidative processes during intense exercise, chronic training over 18 weeks resulted in increased osmotic stability of erythrocytes, possibly by modulation in the membrane cholesterol content by low and high density lipoproteins.