RESUMEN
OBJECTIVES: Cardiac implantable electronic device (CIED) infection has been a major clinical problem in addition to being a major financial burden. In spite of antimicrobial prophylaxis, CIED infection rates have been increasing disproportionately. We therefore conducted this meta-analysis to assess the role of TYRX antibiotic envelope for the prevention of CIED infection. METHODS: Using extensive online search, we conducted a meta-analysis of studies reporting CIED infections with versus without the use of TYRX antibiotic envelope. A random-effect model was used, and between studies heterogeneity was estimated with I2. All analyses were performed with RevMan (version 5.0.20). RESULTS: Five cohort studies were included in this meta-analysis. The pooled odds ratio (OR) of included studies was 0.29 [95% confidence interval (CI): 0.09-0.94; p < 0.004]. There was evidence of heterogeneity with I2 of 58%. There was also evidence of publication bias on funnel plot analysis. On sensitivity analysis, no statistically significant difference was noted when stratified by study design or duration of follow-up. CONCLUSION: The results of our study demonstrate a significant beneficial effect of TYRX antibiotic envelope for the prevention of CIED infections.
RESUMEN
Pyrethroids are the major components of various commercially used insect repellants. These are less toxic to humans due to their slow absorption and rapid metabolism. However, cases of suicidal and accidental poisoning with household insecticides are not uncommon. We report a case of a 59-year-old female who presented with syncope after an accidental exposure to bed bug repellant spray at home. She was found to be in complete heart block and was treated conservatively. There was complete resolution of symptoms and atrioventricular conduction abnormality on day 2 of hospitalization. She was discharged in a stable condition with an uneventful follow-up course. Cardiac involvement in pyrethroid toxicity is rare. We describe various clinical manifestations and the pathophysiology of toxicity caused by pyrethroid-containing insecticides.
