[Apixaban in the treatment of venous thrombosis associated with permanent pacemaker implantation]. / Apixaban en el tratamiento de trombosis venosa asociada a implante de marcapasos definitivo.

Venous thromboembolism is the third vascular disease in morbidity and mortality. The new oral anticoagulants are presented as an effective and safe alternative to conventional antithrombotic therapy. Apixaban has been recently approved to use for the treatment of deep vein thrombosis. A case of an elderly patient, with high risk of bleeding, a history of cancer, and recent pacemaker implant, who consulted for superficial venous thrombosis of the ipsilateral arm to the implant, which was successfully treated with apixaban is here presented.

Weld acoustic emission inspection of structural elements embedded in concrete.

After a catastrophic failure of the weld of the anchoring element of one cable in a stayed bridge, a non-destructive inspection was required to evaluate the weld condition of the 111 remaining anchoring elements to prevent future and similar failures. This examination was quite complicated since the anchoring elements are partially embedded in the reinforced concrete tower, and the weld is fully integrated into the concrete. Considering that direct access to the weld was not possible, acoustic emissions (AE) were a feasible alternative for these inspections. This study describes the inspection method, from laboratory tests simulating actual conditions for calibration to field tests for the method's tuning and evaluation. The AE inspection results are presented, and welds' condition is classified according to the acoustic energy, measured through a severity index and graded from a zonal intensity plot. Two structural elements were selected for concrete demolition to expose the weld for penetrant and ultrasonic inspections to correlate measurements of the actual condition of the welds and their defect size. Because of the analysis, welds are identified for immediate repair and the rest for AE monitoring to evaluate defect evolution through the increase of the severity index.

Arrhythmias in a patient with sarcoidosis.

Arrhythmias in a Patient With Sarcoidosis. Sarcoidosis is a multisystemic granulomatous disease of unknown etiology; up to 27% of cases entail cardiac involvement. Conduction abnormalities and ventricular tachycardia are the most common arrhythmias and can cause sudden death. We describe a patient who developed cardiac sarcoidosis 9 years after undergoing surgery for neurosarcoidosis. He presented with 2:1 second-degree atrioventricular block. Ventricular tachycardia with 3 morphologies was induced by exercise stress test. A DDD pacer/implantable cardioverter defibrillator (ICD) was implanted, which prevented exercise-induced ventricular tachycardia in a follow-up stress test. Treatment with steroids was initiated. The AVB disappeared, and no further arrhythmias were documented at the 1-year follow-up.