RESUMO
Management of severe autonomic dysfunction in patients with Guillain-Barre syndrome (GBS) or its variant Miller-Fisher syndrome (MFS) include placement of permanent pacemaker. We report a case of MFS with severe bradycardia and asystole treated initially with an external permanent (temporary-permanent) pacemaker with a transvenous, active fixation right ventricular lead placement as a "bridge" to permanent pacing.
Assuntos
Doenças do Sistema Nervoso Autônomo/etiologia , Doenças do Sistema Nervoso Autônomo/terapia , Estimulação Cardíaca Artificial/métodos , Síndrome de Miller Fisher/complicações , Adulto , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/terapia , Eletrodos Implantados , Humanos , Masculino , Marca-Passo Artificial , Tempo , Resultado do TratamentoRESUMO
Paracelsus lived during the Renaissance. His sober spirit of scientific observation and critical reason were accompanied by emotional turbulence and a volcanic temperament. He remains both a mystery and an object of nostalgia. Paracelsus is today celebrated as the first modern medical scientist. Paracelsus' early life, achievements and latter years are described.
Assuntos
Alquimia , História do Século XVI , SuíçaAssuntos
Artefatos , Dor no Peito/diagnóstico , Terapia por Estimulação Elétrica/instrumentação , Eletrocardiografia/métodos , Eletrodos Implantados/efeitos adversos , Dor Lombar/terapia , Feminino , Seguimentos , Humanos , Dor Lombar/complicações , Dor Lombar/diagnóstico , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Medição de Risco , Medula EspinalRESUMO
Diagnostic information obtained from the evaluation of the unipolar lead aVR in electrocardiography (ECG) is not fully appreciated, and therefore, the lead aVR is often overlooked in the routine evaluation of the 12-lead ECG. Lead aVR may supplement clinical information, aiding in the management of several cardiovascular conditions. The role of the lead aVR in evaluation of various clinical conditions is reviewed.
Assuntos
Eletrocardiografia , Antidepressivos Tricíclicos/intoxicação , Arritmias Cardíacas/diagnóstico , Eletrocardiografia/métodos , Eletrodos , Humanos , Isquemia Miocárdica/diagnósticoAssuntos
Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Arteriosclerose/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Doenças da Aorta/classificação , Arteriosclerose/classificação , Ecocardiografia Transesofagiana , Humanos , Masculino , Tromboembolia/etiologia , Tromboembolia/prevenção & controleRESUMO
An estimated incidence of drug-induced lupus erythematosus caused by all drugs is 15,000 to 20,000 cases a year, and represents approximately 5 to 10% of the total number of patients with systemic lupus erythematosus. Approximately 22% of the patients treated with isoniazid for a mean of 6 months develop antinuclear antibodies. Isoniazid-induced lupus erythematosus affects either sex equally and the most common presenting feature is arthralgia or arthritis with anemia. Fever and pleuritis occur in approximately half of the cases, and pericarditis in approximately 30% of cases. IgG antibody to the (H2A-H2B)-DNA complex appears specific for the isoniazid-induced lupus erythematosus. The drug-induced lupus presenting with cardiac tamponade is a recognized feature of many drugs such as hydralazine, procainamide, and sulfasalazine. Reported here is a case of isoniazid-induced lupus erythematosus presenting with cardiac tamponade. A 73-year-old man was treated with isoniazid for 8 months at a dose of 300 mg a day. The patient responded to the withdrawal of the isoniazid therapy and placement of a pericardial window. The existing literature on the subject is reviewed.
