RESUMO
Catheter-induced mechanical trauma to accessory pathways is an infrequent, usually transitory phenomenon related to manipulation of the ablation catheter. We describe a patient with Wolff-Parkinson-White syndrome due to a midseptal accessory pathway with recurrent episodes of paroxysmal tachycardias under antiarrhythmic treatment. During the diagnostic electrophysiological study coinciding with manipulation of the His catheter (5 French), mechanical trauma to the accessory pathways occurred, with preexcitation not being recovered in the midterm follow up (28 months). This is a exceptional case demonstrating the complexity of the decision making (expectant or rescue ablation) following accidental catheter-induced mechanical trauma.
Assuntos
Cateterismo Cardíaco/efeitos adversos , Síndrome de Wolff-Parkinson-White/terapia , Adulto , Eletrodos , Humanos , Masculino , Indução de RemissãoRESUMO
PURPOSE: To test N-acetyl-beta-glucosaminidase (NAG) urinary excretion, early renal damage biochemical marker, in patients with non-insulin-dependent diabetes mellitus grouped according to the degree of retinopathy, establishing its relationships to retinal involvement. METHODS: We make a prospective study of 144 type 2 diabetic patients and 94 healthy subjects. We realized an ocular exploration that included fluorescein angiography and a biochemical study that included the determination of NAG urinary excretion in all of them. The patients were grouped depending on their retinal disease. 76 subjects without retinal abnormalities (40 men and 36 women), 30 with early nonproliferative diabetic retinopathy (13 men and 17 women) and 21 subjects with proliferative diabetic retinopathy (10 men and 11 women). Results were analyzed by using statistical analyses. RESULTS: Our results showed that there exist an increase in the urinary excretion of NAG according to the degree of diabetic retinopathy advance. We also highlight the biggest urinary excretion of NAG in the diabetic patients without retinal involvement regarding healthy subjects. CONCLUSION: There is a parallelism between renal and retinal complications in type 2 diabetes mellitus as other authors had demonstrated previously for the type 1 diabetes mellitus.
Assuntos
Acetilglucosaminidase/urina , Retinopatia Diabética/urina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
The Churg-Strauss's allergic granulomatosis is an entity considered by some authors as a simple clinical problem within the context of vasculitis, but that given its anatomopathological and clinical characteristics (different from other vasculitis), must be studied as a separate syndrome. Its incidence depends on the strictness in the application of the diagnosis criteria and its pathogenic is unknown. Although the most frequent pathology is respiratory, we review the affectation of other organs and systems (circulatory, digestive, urogenital, locomotive, nervous system, skin, etc.), stressing the relevance of its knowledge for a correct diagnosis. The current therapy is based in seeking an useful drug, which added of the patients. of the patients.