RESUMO
Three patients with isolated disease of the left anterior descending coronary received a minimally invasive direct coronary artery bypass operation. All were discharged from the hospital in 2 days and are doing well. This is an exciting new procedure which combines the long-term benefits of bypass using the mammary artery with a shortened hospital stay and a rapid postoperative recovery.
Assuntos
Ponte de Artéria Coronária/métodos , Doença das Coronárias/cirurgia , Doença das Coronárias/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologiaRESUMO
Chagas' Disease is common in Central and South America. As the number of immigrants increase in the United States and North America the incidence of Chagas' Disease is increasing. This is a report of chronic Chagas' Disease diagnosed on the Gulf Coast. A review of the recent literature suggests seropositivity in the United States to be approximately 350,000 people with approximately 100,000 cases of chronic Chagas' Disease. The triad of cardiomegaly, megaesophagus, and mental disease are common symptoms. A case report, literature review, epidemiology, and diagnostic studies are presented.
Assuntos
Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Doença de Chagas/terapia , Doença Crônica , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Mississippi/epidemiologiaRESUMO
Five male patients with chronic stable ventricular arrhythmias underwent a placebo controlled ascending dose study with oral cibenzoline, a new type 1 antiarrhythmic drug. Ambulatory ECG (Holter) recordings and electrophysiologic studies were done while on placebo and on the maximum dose of cibenzoline. Drug toxicity, manifested by vomiting and QRS widening, accompanied by very high serum cibenzoline concentrations, was seen in two patients. A major reduction (greater than 85% in ventricular premature beats occurred in three patients including two in whom only relatively low serum concentrations had been achieved. Cibenzoline caused significant increases in AH (97 +/- 26 vs. 110 +/- 23 msec, p less than 0.01) and HV (59 +/- 7 vs. 78 +/- 7 msec, p less than 0.02), a major but statistically not significant increase in QRS (99 +/- 12 vs. 128 +/- 27 msec, NS) but QT (38 +/- 2 vs. 38 +/- msec) and QTc (42 +/- 1 vs. 44 +/- 3 msec) were essentially unchanged, even in toxic patients. Cibenzoline had no consistant effect on sinus cycle length, sinus node recovery time, or the relative, functional or effective refractory periods of the atrium and AV node. We conclude that cibenzoline has potent type 1 effects in prolonging HV but may be unique in not affecting QT or QTc, even at toxic levels. Its effects upon AH were unexpected and warrant further study.
