RESUMO
Hemorrhage secondary to rupture of a brain arteriovenous malformations (AVM) is one of the initial manifestations, and the main cause of, morbidity and mortality in patients with this condition. Current treatment strategies include endovascular embolization with the goal of AVM obliteration and neurological preservation. In the transvenous endovascular embolization procedure, adenosine is the preferred agent to induce temporary hypotension and allow adequate AVM embolization. We describe the intraoperative management of an adenosine-resistant 38 year-old male who underwent a successful intracranial AVM embolization after concomitant administration of gradually increasing doses of nitroglycerin. This report suggests that nitroglycerin infusion can be combined with adenosine boluses to create a pronounced and dose-dependent hypotension in patients partially unresponsive to adenosine alone.
RESUMO
The relationship between pregnancy and breast cancer risk is not fully understood. Most of the literature has described this interaction in terms of the age at first pregnancy and the number of full-term pregnancies. During the prospective accrual of the "Joven & Fuerte: Program for young women with breast cancer in Mexico" cohort, a series of cases with pregnancy-associated breast cancer and a history of a short inter-pregnancy interval was identified. To date, there is a very limited number of descriptions about the interaction between a short inter-pregnancy interval and breast cancer, but none specifically regarding the association of a short inter-pregnancy interval and pregnancy-associated breast cancer. Based on findings from a prospective cohort of young Mexican breast cancer patients, we hypothesize that a short inter-pregnancy interval may increase the incidence of pregnancy-associated breast cancer, possibly by amplifying the effects of the pregnancy-associated factors involved in the development of breast cancer.
Assuntos
Neoplasias da Mama , Intervalo entre Nascimentos , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Incidência , Gravidez , Estudos Prospectivos , Fatores de RiscoRESUMO
Co-infections with HIV and HCV/HBV are frequently found due to the similar routes of transmission (sexual, parenteral and vertical). Since the introduction of highly active antiretroviral therapy (HAART) there has been a notably decrease in patients morbidity and mortality, nevertheless with the prolonged survival, many of these patients are at risk of developing chronic complication, secondary to the infection of hepatotropic viruses. End stage liver disease is one of the main causes of morbid-mortality among HIV patients in developed countries. Nowadays there are new available therapies, diagnostic and follow up techniques for HBV and HCV, what provides a better control of both co-infections.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , HIV-1/efeitos dos fármacos , Hepatite B Crônica/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/complicações , Adulto , Idoso , Argentina/epidemiologia , Feminino , Genótipo , Infecções por HIV/complicações , Infecções por HIV/transmissão , Hepacivirus/efeitos dos fármacos , Hepacivirus/genética , Hepacivirus/crescimento & desenvolvimento , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/genética , Vírus da Hepatite B/crescimento & desenvolvimento , Hepatite B Crônica/complicações , Hepatite C Crônica/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Estudos SoroepidemiológicosRESUMO
Las coinfecciones con virus de la hepatitis C (HCV) y/o virus de la hepatitis B (HBV) en pacientes infectados por el virus de la inmunodeficiencia humana (HIV) son un hallazgo frecuente en virtud de las similares vías de transmisión que estos agentes presentan (sexual, parenteral y vertical). Desde el advenimiento del tratamiento antirretroviral de alta eficiencia (TARV) se evidenció una marcada disminución en la morbi-mortalidad de los pacientes; sin embargo, ante la prolongación de su sobrevida, las complicaciones crónicas debidas a las coinfecciones con estos virus hepatotropos han cobrado importancia, convirtiéndose la enfermedad hepática en una de las primeras causas de morbi-mortalidad de los pacientes HIV positivos en los países desarrollados. Se disponen en la actualidad de nuevas terapias y métodos de diagnóstico y seguimiento para HBV y HCV, lo cual permite un mejor control de ambas coinfecciones.
Co-infections with HIV and HCV/HBV are frequently found due to the similar routes of transmission (sexual, parenteral and vertical). Since the introduction of highly active antiretroviral therapy (HAART) there has been a notably decrease in patients morbidity and mortality, nevertheless with the prolonged survival, many of these patients are at risk of developing chronic complication, secondary to the infection of hepatotropic viruses. End stage liver disease is one of the main causes of morbid-mortality among HIV patients in developed countries. Nowadays there are new available therapies, diagnostic and follow up techniques for HBV and HCV, what provides a better control of both co-infections.