[Preeclampsia-eclampsia: a change in utero-placental microcirculation. Immunologic, histologic, and biochemical features]. / Preeclampsia-eclampsia: una alteración en la microcirculación útero-placentaria. Aspectos inmunológicos, histológicos y bioquímicos.

BACKGROUND: To know the alterations in the microcirculation of the placenta, umbilical cord, as well as the immune and hemorrheologic disorders in preeclampsia-eclampsia. MATERIAL AND METHODS: Two groups were conformed, 30 patients each, all of them with pregnancy of more than 24-week gestation. Group A included patients with preeclampsia-eclampsia and group B (control group) included women with normal pregnancy. In all patients determinations of levels of platelets, fibrinogen, antinuclear antibodies, IgG and IgM anticardiolipin, VDRL were made; clotting times were determined, and histopathologic analyses (placenta, umbilical cord and uterus-placenta membranes) were performed. RESULTS: Platelet levels in the group A were normal in 40% and low in 60%. In group B they were normal in 83.3% and low in 16.7%. with p < 0.05. In group A fibrinogen was normal in 10% and high in 90%; in the group B it was normal in 62.1% and high 37.9%, with p < 0.05. In group A prothrombin time (PT) was normal in 40% and high in 60%; in group B it was normal in 76.7% and low in 23.3%, with p < 0.05. in group TPT was normal in 36.7% and high in 62.1%, with p > 0.05. VDRL was negative in the 100% of the women of group A and positive in the 3.3% of the controls with p > 0.05. The antinuclear antibodies were positive in 6.7% in group A, and in 23.3% in group B, p < 0.05. IgG anticardiolipin antibodies were negatives in the 100% in both groups and IgM antibodies were negative in 96.7% in the group B and 3.3% in group A, p > 0.05. Analysis of histopathologic and immune changes did not show statistic significance when comparing both groups. CONCLUSIONS: Statistical and clinical significance was observed only in the hemorrheologic changes (PT, TPT, fibrinogen and platelets) and in the newborn weight.

Stent coronario: resultados en fase hospitalaria / Coronary stenting: results during in-hospital period

De octubre de 1991 a agosto de 1996 fueron implantados 211 coronarios (s) en 166 pacientes (pst) (1.27 s/pt). Ciento treinta y cinco lesiones tratadas fueron de "novo", 44 por resultado sub-óptimo ost-angioplastía, 14 por restenosis y 17 por disección. Angor estable fue el motivo para implante de stent en 36 pst, angor inestable en 68, angor post-infarto en 37, isquemia asintomática post-infarto en 11 e infarto en evolución en otros 14. El tipo de lesiones tratadas fueron en setenta: tipo A, 112 fueron tipo B y 29 fueron tipo C. El grado de severidad de la estenosis pre-procedimiento fue del 85 ñ 15 por ciento. Los tipos de stents utilizados fueron: AVE en 146, Palmaz-Schatz en 33, Wiktor en 23, Gianturco-Roubin en 8 y Wallstent en uno. Medicación post-implante de stent consistió de aspirina y ticlopidina en 140 pts (84.3 por ciento). Los resultados mostraron un éxito técnico del 98.6 por ciento (208/211 pts) y un éxito primario del 94.6 por ciento (157/166 pts). Las complicaciones mayores fueron: oclusión sub-aguda en 3 pts (1.8 por ciento, muerte en 3 pts. (1.8 por ciento) y cirugía de urgencia en un sólo enfermo (0.5 por ciento). Hematoma mayor se presentó en 5 pts (3 por ciento) y el grado de severidad de la estenosis post-implante de stent coronario en nuesto servicio es un procedimiento seguro con una tasa elevada de éxito clínico y con mínimas complicaciones mayores en una población predominante con angor inestable.