Traqueobronquite aguda causada por Aspergillus: relato de caso e achados de imagem / Acute tracheobronchitis caused by Aspergillus: case report and imaging findings

Traqueobronquite aguda é uma forma rara da aspergilose invasiva e geralmente ocorre em pacientes com imunodepressão grave. Relatamos o caso de um paciente no pós-transplante de medula óssea com a manifestação desta doença, dando ênfase aos achados tomográficos encontrados.

Acute tracheobronchitis is a rare manifestation of invasive aspergillosis, generally occurring in severely immunocompromised patients. The authors report the case of a patient presenting with this condition after bone-marrow transplantation, with emphasis on tomographic findings.

Acute tracheobronchitis caused by Aspergillus: case report and imaging findings.

Acute tracheobronchitis is a rare manifestation of invasive aspergillosis, generally occurring in severely immunocompromised patients. The authors report the case of a patient presenting with this condition after bone-marrow transplantation, with emphasis on tomographic findings.

Traqueobronquite aguda é uma forma rara da aspergilose invasiva e geralmente ocorre em pacientes com imunodepressão grave. Relatamos o caso de um paciente no pós-transplante de medula óssea com a manifestação desta doença, dando ênfase aos achados tomográficos encontrados.

Immunoexpression of cyclooxygenase-2 in primary gastric carcinomas and lymph node metastases.

AIM: To evaluate immunoexpression of cyclooxygenase-2 (COX-2) in primary gastric carcinomas and respective lymph node metastases. METHODS: Immunohistochemistry to analyze COX-2 expression was performed on tissue microarray slices obtained from 36 specimens of gastrectomy and satellite lymph nodes from patients with gastric carcinoma. RESULTS: Immunostaining was seen in most cases, and COX-2 expression was higher in lymph node metastases than in corresponding primary gastric tumors of intestinal, diffuse and mixed carcinomas, with a statistically significant difference in the diffuse histotype (P = 0.0108). CONCLUSION: COX-2 immunoexpression occurs frequently in primary gastric carcinomas, but higher expression of this enzyme is observed in lymph node metastases of the diffuse histotype.

Adjunct therapy in STEMI intervention.

ST-elevation myocardial infarction (STEMI) interventions have significantly reduced mortality and morbidity from acute myocardial infarction. Compulsive management of thrombus is a fundamental requirement of these interventions. A pragmatic thrombus-guided management strategy is reviewed along with additional novel therapeutic adjuncts for STEMI interventions.

STEMI interventions--a review of relevant clinical trials.

Major advances have been made in primary reperfusion and adjunctive therapies for STEMI. Mechanical reperfusion therapy has become the preferred reperfusion strategy for patients with STEMI. Outcomes have improved with the use of stents, platelet inhibitors, and with increased experience, and there is a promise that outcomes can become even better with new methods to enhance myocardial reperfusion and reduce reperfusion injury and with new anticoagulants and drug-eluting stents. Recent trends from the NRMI have shown that the frequency of use of primary PCI has increased and has surpassed lytic therapy, but primary PCI is used to treat only a minority of patients with STEMI. The major challenge for clinicians in the next decade will be to find new ways to make mechanical reperfusion more available, improve outcomes through the use of optimal adjuvant therapies and improved systems of care to speed primary PCI. The nation-wide effort to reduce door-to-balloon times has been launched by American Heart Association, with goal of making primary PCI more available to patients with STEMI.

Optimizing door-to-balloon times for STEMI interventions - Results from the SINCERE database.

BACKGROUND: Primary angioplasty decreases mortality and improves long-term outcomes for patients with STEMI. To be most effective, it needs to be performed expediently, with door-to-balloon times (D2B) less than 90 min. METHODS: From January 2005 to presently, 420 short D2B STEMI interventions were performed at 5 community hospitals by a single experienced operator creating the SINCERE (Single INdividual Community Experience REgistry) database. RESULTS: Median D2B time was 78 min, median procedure time (local anesthesia to recanalization) was 13 min; 85.2% of procedures had D2B time <90 min; 95% of the procedures were successful - relief of chest pain, >70% ST segment resolution, TIMI 3 flow and Myocardial Perfusion Grade 3. CONCLUSIONS: Primary PCI with high success rates and predictable short D2B times can be performed with standardized techniques in community hospitals.

TNK-tPA (tenecteplase).

Management of acute myocardial infarction (AMI) has undergone seismic changes in the last two decades, primarily with the global availability of thrombolytic agents and with the burgeoning use of Primary PCI. Application of these two modalities has dramatically reduced both the mortality and morbidity from AMI. Advances in thrombolytic therapy have been noteworthy in three areas: firstly, in genetically engineering superior third-generation lytic agents: secondly, in developing protocols of appropriate use, and thirdly, creating unambiguous guidelines for admninistration of thrombolytics, of utilizing Primary PCI, or hybrid strategies. Our submitted review on thrombolytic therapy builds on this scientific progress. It provides a pertinent historical perspective that elucidates discovery of lytic agents and the vast array of biogenetic inventions that lead to the development of the novel agent, tenecteplase. The review manuscript also provides a comprehensive compendium of the numerous clinical trials that have been methodically presented in easy-to-read tables. We have additionally designed these tables to facilitate comparison of different lytic agents and for critical analysis of the individual clinical trials. Finally, to make this review most relevant for the IHJ, a section has been devoted to the use of thrombolytic therapy in India. Unique attributes of tenecteplase have been discussed and the benefits of using it to treat Indian patients have been highlighted.