RESUMO
No disponible
Assuntos
Idoso , Pericardite Constritiva , Pericárdio , Tecido Adiposo , Pericardite Constritiva/diagnóstico , Pericardite Constritiva/etiologia , Pericárdio/diagnóstico por imagemRESUMO
No disponible
Assuntos
Humanos , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/prevenção & controle , Pandemias/prevenção & controle , Ultrassonografia/métodos , Ultrassonografia/tendências , Sociedades Médicas/normas , Gastroenterologia/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controleRESUMO
Recently, Dr. Crespo et al. published in your Journal a paper recommending the use of ultrasonography during the current phase of the COVID-19 pandemic whilst wearing only a facial mask for protection, which we deem inadequate. Prevention is key when performing an ultrasound test, since this virus is highly contagious. During the pandemic, every patient should be considered as potentially infected and the procedure requires a close proximity. Therefore, extreme hygiene and a sonographer equipped with the appropriate personal protection (mask, cap, gown, gloves, shoe covers and goggles, with a facial screen and high-efficacy mask for confirmed or highly suspect cases) are of the utmost importance to prevent viral transmission.
Assuntos
Infecções por Coronavirus , Gastroenterologia , Pandemias , Pneumonia Viral , Betacoronavirus , COVID-19 , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , SARS-CoV-2RESUMO
Anomalous origin of the left coronary artery from the opposite sinus of Valsalva with an intramural aortic course is a rare congenital anomaly with a poor prognosis. We report the case of a 14-year-old soccer player who briefly lost consciousness while sprinting. He had exertional chest pain, syncope, ischemic changes on his electrocardiogram, and elevated cardiac troponin levels. Computed tomographic angiograms showed an anomalous origin of the left coronary artery from the right sinus of Valsalva and a course through the aortic wall toward the left coronary sinus. A surgically created neo-ostium in the left coronary sinus relieved the patient's ischemia, and he resumed playing soccer after cardiac rehabilitation.
Assuntos
Atletas , Vasos Coronários/diagnóstico por imagem , Eletrocardiografia , Seio Aórtico/anormalidades , Adolescente , Procedimentos Cirúrgicos Cardíacos/métodos , Angiografia Coronária , Anomalias dos Vasos Coronários , Vasos Coronários/cirurgia , Humanos , Masculino , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/cirurgia , Tomografia Computadorizada por Raios XRESUMO
No disponible
Assuntos
Humanos , Marca-Passo Artificial , Bloqueio Atrioventricular/complicações , Eletrocardiografia/métodosRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Marca-Passo Artificial/efeitos adversos , Bloqueio Atrioventricular/complicações , Eletrocardiografia/métodosRESUMO
BACKGROUND: The aim of the study was to create a straightforward method to rule out abnormalities in electrocardiograms (ECGs) performed in patients with pacemakers. METHODS: The TBC method screens the ECG for any of the following findings: Tachycardia with pacing spikes, Bradycardia without spikes and Chaos with spikes unrelated to QRS-T complexes. T was considered to advise for patient assessment and B and C to require referral for urgent pacemaker evaluation. The diagnostic accuracy of the algorithm was validated using a cohort of 151 ECGs with normal and dysfunctional pacemakers. The effect of the algorithm was then evaluated for diagnostic skills and management of patients with pacemakers by non-cardiologists, comparing their diagnostic accuracy before and after teaching the algorithm. RESULTS: The TBC algorithm had a sensitivity of 86% and a specificity of 94% in diagnosing a malfunctioning pacemaker. The diagnostic skills and patient referral were significantly improved (74.8% vs. 89.5%, p < 0.001; and 57.4% vs. 83%, p < 0.001). CONCLUSIONS: TBC is an easy to remember and apply method to rule out severe abnormalities in ECGs of patients with pacemakers. TBC algorithm has a very good diagnostic capability and is easily applied by non-expert physicians with good results.
RESUMO
No disponible
Assuntos
Humanos , Marca-Passo Artificial , Átrios do Coração/fisiopatologia , Falha de Equipamento , Eletrocardiografia/métodosRESUMO
No disponible
Assuntos
Humanos , Idoso , Eletrocardiografia , Síncope Vasovagal/etiologia , Marca-Passo ArtificialRESUMO
No disponible
Assuntos
Humanos , Eletrocardiografia , Fibrilação Atrial/diagnóstico , Bloqueio Sinoatrial/diagnóstico , Bloqueio Atrioventricular/diagnóstico , Diagnóstico DiferencialRESUMO
No disponible
Assuntos
Humanos , Idoso , Digoxina/efeitos adversos , Astenia/etiologia , Eletrocardiografia , Fibrilação Atrial/diagnóstico , Bloqueio Atrioventricular/diagnóstico , Próteses Valvulares CardíacasRESUMO
In-hospital infections (IHI) are one of the most common and serious problems after invasive procedures. Transcatheter aortic valve implantation (TAVI) is an increasingly used alternative to surgery in patients with severe symptomatic aortic stenosis. The aim of this study was to determine the incidence, origin, risk factors, and clinical outcomes of IHI after TAVI. A total of 303 consecutive patients with severe aortic stenosis who underwent transfemoral TAVI were included and followed during a median time of 21 months. We examined the occurrence, types, origin, and timing of infections during hospital stay as well as short- and long-term clinical outcomes according to the occurrence of IHI. A total of 51 patients (17%; 62 infectious episodes) experienced IHI after TAVI. Respiratory and urinary tract infections were the most frequent type of infections (44% and 34%, respectively), followed by surgical site infection (8%) and bloodstream infection (5%). Positive cultures were obtained in 74% of the samples, of which 65% were gram-negative bacilli. Modifiable factors such as bleeding (p = 0.005) and length of coronary care unit stay (p <0.001) were independently associated with an increased infection risk. Patients with IHI had a longer hospital stay (14 vs 6 days, p <0.001), an increased mortality (hazard ratio 2.48, 95% CI 1.45 to 4.23) and readmission rate (hazard ratio 2.0, 95% CI 1.27 to 3.14) during the follow-up. In conclusion, IHI is a frequent complication after TAVI with a significant impact on short- and long-term clinical outcomes. The most important risk factors associated with the development of this complication were modifiable periprocedural aspects. These results underline the importance to implement specific preventive strategies to reduce in-hospital-acquired infections after TAVI.
