When calcium helps: percutaneous coronary intervention without contrast medium in an elderly female patient with renal insufficiency and unstable angina

The use of iodinated contrast media in coronary procedures may lead to contrastinduced nephropathy - particularly in older adults, diabetic individuals and patients with previous renal disease ­ and increase morbidity and mortality. There is no specific treatment for this condition; therefore, use of low contrast volumes and previous hydration remain the best prevention strategies. A case of percutaneous coronary intervention without contrast agent administration, involving an elderly female patient with chronic renal insufficiency and stable angina, is described. Intravascular ultrasound was used for optimal stent deployment. (AU)

Seleção de pacientes para implante transcateter de prótese valva aórtica / Selection of patients for transcatheter implantation of aortic valve prosthesis

Nas últimas décadas, a estenose aórtica tem emergido com grande expressão dentro do espectro das doenças crônico-degenerativas, acompanhando o envelhecimento populacional. Considerando tratar-se de doença de curso insidioso, o apareciemnto dos sintomas ocorre em uma fase avançada, na qual a troca valvar é o único tratamento efetivo. Apesar do reconhecido benefício do tratamento circúrgico em pacientes com estenose aórtica grave, até um terço destes são recusados para cirurgia. O implante transcateter de valva aórtica tem-se mostrado alternativa segura nesses indivíduos, com aumento da sobrevida e melhora da qualidade de vida. Da mesma forma que a curva de aprendizado técnica entre os intervencionistas assegura a qualidade do procedimento, a adequada seleção de pacientes por meio de abordagem multidisciplar é essencial ao sucesso do tratamento...

Seleção de pacientes para o implante transcateter de prótese valvar aórtica / Selection of patients for implantation of transcatheter aortic valve prosthesis

Nas últimas décadas, a EA tem emergido com grande expressão dentro do espectro das doenças crônico-degenerativas, acompanhando o envelhecimento populacional. Considerando se tratar de doença de curso insidiosos, o aparecimento dos sintomas ocorre em uma fase avançada, na qual a troca valvar é o único tratamento efetivo. Apesar do reconhecido benefício do tratamento cirúrgico nos pacientes com EA grave, até um terço destes são recusados para cirurgia. O implante transcateter de valva aórtica (Transcatheter Aortic Valve Implantation - TAVI) vem mostrando ser alternativa segura nesses indivíduos com aumento na sobrevida e melhora na qualidade de vida dos mesmos...

Morphometric analysis of the urethra of castrated female rats treated with tamoxifen.

OBJECTIVES: The aim of this study was to evaluate the effects of tamoxifen on the weight and thickness of the urethral epithelium of castrated female rats. METHODS: Forty castrated adult female Wistar-Hannover rats were randomly divided into two groups: Group I (n=20) in which the animals received only the vehicle (propylene glycol) and Group II (n=20) in which the rats received tamoxifen 250microg/day by gavage. After 30 days of treatment, all animals were sacrificed and the urethra was immediately removed for weighing. Next, the urethra was divided into the proximal and distal segments, which were fixed in 10% formaldehyde and submitted to routine histological techniques for morphometric study. The data were analyzed using the weighted minimum mean-square error method and Student's t-test for two independent samples (p<0.05). RESULTS: There was a significant increase in the mean weight of the urethra in the rats of Group II compared to the control group, 32.0+/-2.0mg and 22.0+/-1.6mg, respectively (p<0.001). The mean thickness of the distal urethral epithelium of the animals treated with tamoxifen was significantly greater than that of the control group, 42.8+/-2.0microm and 36.6+/-1.5microm, respectively (p<0.001). There was no statistically significant difference between the two groups with respect to the epithelial thickness of the proximal urethra (p=0.514). CONCLUSION: Treating castrated adult rats with 250microg/day of tamoxifen for 30 days may increase the weight of the urethra and the thickness of the distal urethral epithelium.