Oculopharyngeal Muscular Dystrophy: A Case Report From Puerto Rico.

Oculopharyngeal muscular dystrophy (OPMD) is a late-onset inherited skeletal myopathy. The diagnosis is based on a clinical presentation of blepharoptosis, dysphagia, and a positive family history of the disease in patients past 40 years of age. A 57-year-old male patient presented with ptosis without lid crease, adult-onset dysphagia, and bilateral pseudophakia. The patient underwent ptosis repair of upper eyelids via frontalis slings with silicone rods. His mother was subsequently found to have ptosis, dry eyes, and anorexia due to dysphagia, thus suggesting a probable family history. Based on the comprehensive ophthalmic evaluation, and based on his ptosis, dysphagia, and family history, the patient was diagnosed with OPMD.

Muerte súbita cardíaca por fibrilación ventricular asociada a isquemia miocárdica, tratada por desfibrilador automático implantable / Sudden cardiac death due to ventricular fibrillation associated with myocardial ischemia, treated by implantable cardioverter defibrillator

Resumen: Reportamos el caso de un hombre de 67 años, con múltiples factores de riesgo cardiovascular, quien en el año 2015 presentó muerte súbita por fibrilación ventricular sin lesiones coronarias significativas, tras lo cual se implantó un desfibrilador automático. En el año 2019 presentó un nuevo episodio de fibrilación ventricular en relación con síndrome coronario agudo con supradesnivel del ST localizado en pared anterior, registrado y adecuadamente resuelto por el dispositivo. Se demostró una oclusión aterotrombótica en la porción proximal de la arteria descendente anterior. Fue precoz y exitosamente manejado con angioplastía coronaria percutánea e implante de stent fármaco activo, guiado por tomografía por coherencia óptica intracoronaria. A las 48 horas post angioplastía, presentó episodio de taquicardia ventricular polimorfa reconocido y tratado por el cardiodesfibrilador, sin consecuencias. Electivamente se efectuó angioplastía e implante de stent metálico en arteria coronaria derecha distal, con buen resultado angiográfico. La posterior evolución del paciente fue satisfactoria, sin manifestaciones de insuficiencia cardíaca, angina ni arritmias.

Abstract: A 67-year-old man, with multiple cardiovascular risk factors who in 2015 presented sudden death due to ventricular fibrillation without significant coronary lesions, after which an implantable automatic defibrillator (ICD) was implanted. In 2019, he presented a new episode of ventricular fibrillation adequately resolved by the device, in relation to an acute coronary syndrome with ST elevation in the anterior wall of the left ventricle, due to atherothrombotic occlusion in the proximal portion of the anterior descending artery. He was early and successfully managed with percutaneous coronary angioplasty by the insertion of a drug eluting stent, implanted guided by intracoronary optical coherence tomography. Forty eight hours later, he presented an episode polymorphic ventricular tachycardia recognized and treated by the ICD. Angioplasty with a bare metal stent implantation were performed in the distal right coronary artery, with good angiographic results. The subsequent course was satisfactory, with no manifestations of heart failure, angina or arrhythmias.

Síndrome de Brugada asociado a pericarditis aguda / Brugada syndrome associated to acute pericarditis

Resumen Comunicamos el caso de un hombre de 56 años que ingresó por pericarditis aguda febril, probablemente de causa viral, que durante su evolución presentó una fibrilación auricular paroxística y taquicardia ventricular polimorfa recurrente. El análisis de la historia clínica y serie electrocardiográfica permitió el diagnóstico retrospectivo asociado de un síndrome de Brugada. Hubo buena respuesta inicial al tratamiento antiinflamatorio asociado a colchicina y se implantó un desfibrilador automático intracavitario para prevención de muerte súbita. Se discuten aspectos clínicos del síndrome de Brugada, la importancia de la fiebre y de la pericarditis como cuadro clínico asociado.

Abstract A 56-year-old patient was admitted for acute febrile pericarditis, probably viral, who presented with paroxysmal atrial fibrillation and recurrent polymorphic ventricular tachycardia during his clinical course. Analysis of the clinical and electrocardiographic findings allowed the retrospective diagnosis of Brugada syndrome in the context of pericarditis. An initial response to anti-inflammatory treatment associated with colchicine was good. An internal cardioverter defibrillator was implanted to prevent sudden death. Clinical aspects of the Brugada syndrome, the importance of fever and pericarditis as an associated clinical condition are discussed.

Válvula aórtica cuadricúspide: caso clínico y discusión / Ouadricuspid aortic valve

The quadricuspid aortic valve is a rare congenital anomaly, usually presenting as an isolated malformation causing aortic regurgitation in the faith or sixth decades of life. The first reported cases were found at autopsy or became evident by surgical findings. However, the emergence of new imaging modalities currently allows an earlier diagnosis, including in asymptomatic patients. Hereby the case of a 60-year-old woman with quadricuspid aortic valve diagnosed by echocardiography is presented. A brief discussion of the disease is included.

Video-based assessment of pedestrian behavior: development and testing of methods / Estudio de comportamiento peatonal basado en video: desarrollo y prueba de los métodos

ABSTRACT Objective The aim of this paper is to develop a computer algorithm that analyzes pedestrian behavior at an urban site in Bogota, Colombia, considering that the assessment of pedestrian behavior is a road safety priority. Methods Pedestrians were video-taped as they crossed a selected road. An algorithm was developed in order to record, from these videos, pedestrian and vehicle positions and speeds. This information made possible the identification of hazardous behaviors, which were compared through visual assessments. Results 429 pedestrians crossed the selected road at an average distance of 4.5 meters from vehicles that moved at an average speed of 21 km/h. With a maximum difference of 19 % with respect to visual assessments, the algorithm estimated that 58.5 % pedestrians crossed through non-designated locations; 62.2 % crossed near moving vehicles, and that 41.2 % ran while they were crossing the road. Conclusions Video-based analysis can be used to assess pedestrians' behavior. Future research work should focus on improving both the accuracy and the number of safety parameters of the algorithm.(AU)

RESUMEN Objetivo La medición del comportamiento de peatones es una prioridad de la seguridad vial. Por lo anterior, se desarrolló un algoritmo para analizar el comportamiento de los peatones en una zona urbana de Bogotá, Colombia. Métodos Los peatones fueron filmados mientras cruzaban la calle. Mediante el algoritmo se midieron las posiciones y velocidades de peatones y vehículos en los videos. Se identificaron los comportamientos riesgosos y se compararon visualmente. Resultados 429 peatones cruzaron la vía a una distancia promedio de 4.5 metros de los vehículos (velocidad promedio 21 km/h). El algoritmo estimó, con una diferencia máxima de 19 % con respecto a lo observado, que 58.5 % de los peatones cruzaron por zonas incorrectas, 62.2 % cruzaron cerca de vehículos en movimiento y 41.2 % corrieron al cruzar. Conclusiones El análisis basado en video puede utilizarse para medir el comportamiento de los peatones. Los trabajos sobre el tema que se realicen en el futuro deben enfocarse en mejorar la precisión y los parámetros de seguridad del algoritmo.(AU)