Anisakiasis en España

No disponible

La reestenosis de los stents coronarios / The restenosis of coronary stents

A pesar de los importantes avances técnicos y farmacológicos ocurridos en los últimos años, todavía es elevado el índice de reestenosis tras la implantación de los stents coronarios. En este trabajo se revisan los aspectos más novedosos relacionados con ese problema: Factores predisponentes. Trombosis y antitrombóticos. ¿Es posible predecir la reestenosis del stent examinando los genes? La respuesta tisular a la implantación de stents coronarios. Tejido de granulación por cuerpo extraño en las lesiones de novo en pacientes con stents. Las disecciones en el borde del stent tras su despliegue. Diseño y reestenosis: ¿mejor cuanto más grande? Simetría del stent y reestenosis experimental. Sobreestiramiento focal vascular durante el implante. Remodelado patológico tardío. Luz de láser rojo de baja potencia. Stents recubiertos. Tratamiento con estatinas. Tratamiento de las reestenosis del stent (AU)

Zinc levels after intravenous administration of zinc sulphate in insulin-dependent diabetes mellitus patients.

Diabetic patients commonly have increased urinary excretion of zinc, although blood concentrations may be normal, lowered, or raised. We analyzed zinc levels in plasma and urine after an intravenous overload of zinc sulphate (8 mg) in 22 patients with insulin-dependent diabetes mellitus (IDDM) and 22 healthy individuals. No significant differences were found in basal levels of serum zinc in either group (111 +/- 29 micrograms/dl in IDDM vs 119 +/- 19 micrograms/dl in controls), although urinary excretion of zinc was significantly raised in diabetics (1396 +/- 622 micrograms/24 h) versus controls (611 +/- 235 micrograms/24 h). After zinc overload, both serum and urinary levels of this element varied between the two groups. Serum zinc in IDDM patients initially increased more markedly, and subsequently showed a more significant decline, than in controls. Urinary zinc levels in IDDM patients, in contrast to control values, showed no increase after overload. These alterations in serum and urinary zinc concentrations suggest that our diabetic patients may be zinc-deficient.

ECG diagnostic errors due to improper connection of the right arm and leg cables.

Two patients were erroneously diagnosed as having acute myocardial infarction or accelerated junctional rhythm due to improper connection of the right arm and right leg cables. In both cases the error led to unsuitable modifications in treatment. A key sign for identifying the technical oversight is minimal voltage in DII in all P, QRS and T waves (dwarf complexes).

Terminal notching of the QRS complex in V1 and V2 in seborrheic patients.

Widening of the QRS complex by terminal notching in leads V1 and V2 was observed in 6 seborrheic patients with adequate personal hygiene. This anomaly disappeared when the presternal skin was degreased thoroughly with cationic detergent before placing the conductive paste and electrodes. We attribute these electrocardiographic alterations to variations in the apocrine secretions in the presternal region, which modified the resistance of the skin to electrical potentials.

Endocarditis due to Streptococcus agalactiae: a favorable outcome with conservative treatment.

A case of infective endocarditis due to Streptococcus agalactiae was treated conservatively by means of cefotaxime sodium given intravenously at a dose of 1 g every six hours supplemented with gentamycin sulphate, also given intravenously, with the dose adjusted according to concentrations of the drug in the plasma. The treatment was successful.

[Acute mountain sickness]. / Mal de montaña agudo.

Acute mountain sickness is a pathologic reaction as a result of bad adaptation to high altitudes (greater than 2.500 meters). The main symptoms are headache, nausea, vomits, and insomnia. When severe it can produce oliguria, retinal hemorrhage, ataxia and sometimes coma. Its etiology is not well known. It is considered that the first producer factor of the disease is tissular hypoxia secondary to low partial oxygen pressure existing in areas of high sea level. The treatment consists of descent and the use of dexametasone and acetazolamide.

[False diagnosis of myocardial infarction due to inversion of the electrocardiographic leads in the right limbs (author's transl)]. / Infarto de miocardio: falso diagnóstico por inversión de los electrodos del electrocardiógrafo en las extremidades derechas.

An abnormal ECG suggested the diagnosis of myocardial infarction in a 65-year-old man who had suffered a transient chest pain. When the patient was admitted to the Hospital a new ECG and biochemical enzymes were normal, but and identical pathologic ECG was registered following inversion of the electrocardiographic leads in the right superior and inferior extremities. A prospective study of 160 adult patients has demonstrated that inversion of the leads in the right limbs frequently causes the appearance of pathologic Q waves (37.14 percent) and ischemic T waves (51.22 percent), especially in lead I and aVL. Number of pathologic Q and T waves may vary when they are present in the basal register, but we never observed their disappearance in all the precordial lead series. A constant finding was the marked low voltage of P, QRS and T in lead II due to the "distance" of the electrocardiographic leads right leg-left leg. Technical recognition may be difficult because P waves and QRS complex are frequently negative or isoelectric in aVR.

[Jugular phlebogram after cardiac surgery]. / El flebograma yugular tras la cirugía cardíaca.

We studied several parameters of the jugular flebogram in 70 patients who had undergone cardiac surgery. Fifty six of them were on sinusal rithm and 14 in auricular fibrillation. We found among them 39 who had undergone commissurotomy and 16 who had got valvular prothesis. The results of these studies were analyzed and compared with those of 94 normal subjects, taking in consideration the type of surgical intervention and the time elapsed since the operation was performed--the latter in the more numerous group. It is interesting to observe that the sinus grows deeper after the intervention so making the relation xv/yv lower than the unit in 33% of the patients maintaining sinusal rithm. This alteration remained stationary during some years in some of the cases, the results suggesting a greater frequency during the first months of the post-operatory period. We didn't find any relation of this morphologic alteration with the presence of a pericardial construction, pulmonary hypertension, valvular injuries with repercussion on the right heart or modifications on the nenous pressure which we think due to functional changes following the pericardiotomy. It is interesting to observe these mechanographic signs in relation with the post-operatory period of cardiac surgery, but we must avoid hypervaluation of those cases suspicious of pericardial constriction.

[Heart function and phonomechanocardiography (author's transl)]. / Función cardiaca y fonomecanocardiografía.

The phonomechanocardiographic parameters most closely associated with heart failure are reviewed and a critical judgement is made of the method. The conclusion is drawn that phonomechanocardiographic measurements help to establish approximate limits of functional normality in cases of moderate abnormality. When acute phonomechanocardiographic alterations appear following infection or toxic heart disease or the use of potentially cardiotoxic drugs, the diagnosis of miocarditis can be made on an objective basis. To control the clinical course of heart failure the following parameters are useful: variations in the period of expulsion, "a" and "telediastolic" indices of the apexcardiogram, and the expulsion period/pre-expulsion period and expulsion period/systolic isovolumetric phase coefficients. Although phonomechancardiography lacks exact biological precision, it represents a rational and no invasive method for estimating heart function. It provides a means for recognizing diverse functional anomalies at their onset and for controlling their development. It thus helps in choosing adequate preventive and therapeutic measures to keep an early functional miocardial disease from becoming a serious case of heart failure.