RESUMO
A 62-year-old woman presented for evaluation of chest pain. She ruled out for myocardial infarction, and subsequent non-invasive studies were diagnostic for ischemia. On coronary angiography, she was found to have a previously undescribed variant of single coronary artery, in which the anomalous right coronary artery probably arose from a left atrial recurrent branch. In this patient, the congenital anomaly was an incidental finding, since her clinical presentation was felt to be due to moderate obstructive disease of the left anterior descending artery, in the setting of poorly controlled systemic hypertension.
Assuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Átrios do Coração/patologia , Angina Pectoris/etiologia , Angiografia Coronária , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Several investigators have documented the successful use of oral sustained-release theophylline in treating symptomatic bradycardia and sick sinus syndrome. This paper reports a case of chronotropic incompetence in which specific exercise indices, including the chronotropic response index, were used to measure the therapeutic efficacy of theophylline.
Assuntos
Bradicardia/tratamento farmacológico , Tolerância ao Exercício/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Síndrome do Nó Sinusal/tratamento farmacológico , Teofilina/uso terapêutico , Vasodilatadores/uso terapêutico , Bradicardia/diagnóstico , Bradicardia/fisiopatologia , Preparações de Ação Retardada , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Nó Sinusal/diagnóstico , Síndrome do Nó Sinusal/fisiopatologiaRESUMO
When the health center encountered a student hunger strike, an initial search for medical information regarding fasting provided very little on which to build management decisions. The result of a more thorough evaluation of starvation literature is presented, along with survey responses from students who fasted. Starvation may produce many adverse events, including death. Yet, according to reports, acaloric fasts that include full water intake seem to be readily tolerated for 2 weeks in young, healthy adults. Our students included juice, sports drinks, and vitamins in their diets and completed their strike without major problems. Supplementation with carbohydrates and vitamins may improve the safety or comfort of a hunger striker, but clear proof of this effect does not exist.
Assuntos
Suplementos Nutricionais , Jejum/efeitos adversos , Promoção da Saúde/métodos , Manobras Políticas , Estudantes , Universidades , Adolescente , Adulto , Ingestão de Energia , Feminino , Humanos , Masculino , Necessidades Nutricionais , Serviços de Saúde para EstudantesRESUMO
Active tuberculosis and the potential for widespread disease exist on college campuses. To maximize the benefit and minimize the potential harm of a screening program, health service clinicians should administer tuberculin skin tests to high-risk students only. Those found to be infected should be considered for prophylactic treatment. The criteria that identify students as being at high risk need to be clearly appreciated, especially the issue of birth outside the United States. Certain countries of origin pose a high risk; others do not. By understanding the fundamentals of the current pandemic and employing a consistent approach, college health professionals can make the correct screening decisions, thereby reducing the risk to their campus communities and assisting in the eradication of this preventable disease.
