ABSTRACT
Iatrogenous transmission of Trypanosoma cruziby blood transfusion was suggested as a potential risk by Pellegrino (1949). Seropositive blood donors in Mexico were first reported in 1978, however, limited information is available due to small sampling, the use of heterogeneous serologic assays, and geographically limited studies. A wide survey carried out in 18 out of the 32 states of Mexico, showed a national mean of 1.6 percent seropositive among 64,969 donors, ranging from 0.2 to 2.8 percent. In the present study, we have screened 43,048 voluntary blood donors in a period of five years at the Instituto Nacional de Cardiología I. Chávez, a concentration hospital located in Mexico city which serves mainly the metropolitan area and accepts from all over the country. Standardized ELISA and IIF were used to identify seropositive individuals in addition to hemoculture, PCR and standard 12 lead ECG tests that were applied to a group of seropositive patients (29/161). The result showed a seropositivity of 0.37 percent (161/43,048). From the group of seropositive individuals 40 percent (12/29) were potential carriers of T. cruzi at the donation time and 5/29 had subclinical ECG abnormalities. Parasitological tests performed in 70 erythrocyte and platelet fractions from seropositive units (70/161) showed negative results. Our findings strongly support T. cruzi screening in the transfusion medicine practice and identify subclinical heart disease among seropositive blood donors.
Subject(s)
Adult , Animals , Female , Humans , Male , Middle Aged , Antibodies, Protozoan/blood , Blood Donors , Chagas Disease/epidemiology , Trypanosoma cruzi/immunology , Blood Transfusion/adverse effects , Chagas Disease/diagnosis , Chagas Disease/transmission , Electrocardiography , Mass Screening , Mexico/epidemiology , Parasitemia/blood , Risk Factors , Seroepidemiologic Studies , Surveys and QuestionnairesABSTRACT
En años recientes el avance tecnológico en la estimulación cardíaca ha sido impresionante. Existen algunas condiciones en las cuales no es posible emplear la sístole auricular para mejorar el gasto cardíaco en pacientes con bloqueo aurículo-ventricular portadores de marcapasos. El presente informe ejemplifica un caso en el cual se presentó esta situación y en el que se obtuvo mejoría en la capacidad del ejercicio del paciente, empleando un nuevo modelo de marcapaso cardíaco (Activitrax). Este es activado por movimiento muscular y responde a las demandas metabólicas del individuo incrementando la frecuencia de disparo del marcapaso, conforme aumenta el ejercicio realizado por el paciente