RESUMO
The value of signal-averaged P-wave electrocardiogram and echocardiography for predicting recurrent atrial tachyarrhythmias was prospectively investigated in 60 patients presenting with paroxysmal atrial fibrillation or flutter. All patients were followed up for 1 year after restoration of sinus rhythm. A stepwise discriminant function analysis was used to identify variables predicting recurrent atrial tachyarrhythmias. Analyzed variables included signal-averaged P-wave duration in 3 bipolar orthogonal leads (X,Y,Z) and their vector magnitude, as well as left and right atrial dimensions and volumes. During follow-up, 25 patients had recurrent atrial tachyarrhythmias, while 35 did not. Using discriminant function analysis, the left atrial antero-superior dimension was found to be the only variable predicting the recurrence of atrial tachyarrhythmias (p < 0.0038) and was able to correctly classify 65% of the study patients. It was concluded that, in patients with paroxysmal atrial fibrillation or flutter, the traditionally used determination of left atrial dimension was the variable most closely associated with a high risk for recurrent tachyarrhythmias. The signal-averaged P-wave duration did not improve tachyarrhythmia prediction.
Assuntos
Fibrilação Atrial/epidemiologia , Flutter Atrial/epidemiologia , Ecocardiografia , Eletrocardiografia/métodos , Idoso , Fibrilação Atrial/diagnóstico , Flutter Atrial/diagnóstico , Análise Discriminante , Feminino , Seguimentos , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Recidiva , Medição de Risco , Processamento de Sinais Assistido por Computador , Fatores de TempoRESUMO
Pentamidine isethionate and sulfadoxine plus pyrimethamine are excellent therapeutic agents in experimental and hypoergic, hypoimmune pneumocystosis as well as in focal interstitial plasma cell pneumonia (IPCP) in infants. Their effectiveness is seriously limited in cases in which either a diffuse massive plasma cell exudate has been established or in adults in whom the phagocytic and resorptive facility is depressed. Infantile pneumocystosis leading to IPCP can be completely prevented by proper feeding and care of the patient or prophylactic drug therapy with sulfadoxine-pyrimethamine. Similar measures should be taken for adult patients at risk in hospitals where pneumocystosis is frequent or when pneumocystosis has been recently diagnosed.
Assuntos
Amidinas/uso terapêutico , Pentamidina/uso terapêutico , Pneumonia por Pneumocystis/tratamento farmacológico , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Sulfanilamidas/uso terapêutico , Ácido Aminossalicílico/uso terapêutico , Animais , Testes de Fixação de Complemento , Quimioterapia Combinada , Humanos , Imunoglobulina G/análise , Lactente , Isoniazida/uso terapêutico , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/etiologia , Pneumonia por Pneumocystis/prevenção & controle , Desnutrição Proteico-Calórica/complicações , Coelhos , RatosRESUMO
Two hundred and twelve determinations of IgA, IgG, and IgM were performed in 50 infants during an epidemic of interstitial plasma cell pneumonia. Criteria for diagnosis are discussed. The immunoglobulin levels in pneumocystic, non-pneumocystic, and normal American infants are compared. An analysis of the findings in individual cases reveals a time-related immunoglobulin response, which helps to elucidate the pathogenicity of the disease.
