Usefulness of autocidal gravid ovitraps for the surveillance and control of Aedes (Stegomyia) aegypti (Diptera: Culicidae) in eastern Colombia.

In the past decade, new strategies have been developed to control the Aedes aegypti (Diptera: Culicidae) mosquito vector, as well as a broad range of arboviral agents. Vector control surveillance programmes in Puerto Rico and Australia have implemented the Centers for Disease Control and Prevention autocidal gravid ovitrap (AGO), which has had an impact on vector density and, consequently, the epidemiology of arboviral infections. Colombia intends to establish the AGO as a new tool for the surveillance and control of the A. aegypti vector. AGOs were evaluated in a hyperendemic area for dengue virus during an 8-week period in Villavicencio city, eastern Colombia. The results indicated that the AGOs detect a high density of A. aegypti, with positive results for these traps of over 80% and an average catch of six individuals per trap per week. Acceptance of AGOs in the community exceeded 95%, and adherence was around 89%. This study's results demonstrate, for the first time in Colombia, that traps are a useful tool for the surveillance of A. aegypti. Future studies must consider the implementation of AGOs in the region.

Milk production responses, rumen fermentation, and blood metabolites of dairy cows fed increasing concentrations of forage rape (Brassica napus ssp. Biennis).

The aim of this study was to determine animal performance, rumen fermentation, and health-related blood metabolites of dairy cows in mid lactation fed with increasing levels (30 and 45%) of forage rape (FR) in the diet. Twelve pregnant multiparous lactating Holstein-Friesian dairy cows were randomly allocated to 1 of 3 dietary treatments in a replicated 3 × 3 Latin square design. The experiment was divided into three 21-d periods. For the control diet, 13.0 kg (dry matter, DM) of grass silage, 3.0 kg DM of commercial concentrate, 2.7 kg of DM cold-pressed extracted canola meal, and 0.45 kg DM of solvent-extracted soybean meal were offered daily. For the other two treatments, 30 and 45% of the DM from silage, canola meal, and commercial concentrate were replaced in equal proportions with FR. Data were analyzed individually using linear and quadratic orthogonal polynomials. Ingestive behavior was altered by the inclusion of FR. We observed a linear increase in eating time at the expense of rumination time. Nevertheless, total DM intake was not affected by dietary treatments, averaging 19.5 ± 0.24 kg of DM/d. Milk yield increased linearly with increasing concentration of FR in the diet. Thus, feed efficiency of cows (kg of milk/kg of DM intake) increased linearly with the percentage of FR in the diet. Inclusion of FR in the diet had no effect on milk composition or milk sensory characteristics. Mean rumen pH of cows decreased linearly from the control to the 45% FR diet; however, dietary treatments had no effect on the daily amount of time that rumen pH was below 5.8 (252 ± 71.4), indicating no risk of subacute ruminal acidosis. Concentrations of total volatile fatty acids in the rumen and molar proportions of acetate and butyrate were increased with FR inclusion, whereas the proportion of propionate was linearly reduced. Excretion of uric acid and total purine derivatives tended to be greater for cows fed FR, which resulted in a trend toward a linear increase in estimated microbial N flow. However, N use efficiency was not affected by FR inclusion. Although differences for some hematological measures (increased white blood cell and neutrophils counts) and a quadratic response for glutamate dehydrogenase for cows fed FR in the diet (decreased with inclusion of 30% and increased with 45% in the diet) were observed, all values were within appropriate ranges for dairy cows. These results indicated that including FR to dairy cow diets, up to 45% of diet DM, improved milk production due to changes in volatile fatty acids and predicted microbial N flow and had no negative effects on dairy cow health or sensory characteristics of milk.

HLA-E and NKG2A Mediate Resistance to M. bovis BCG Immunotherapy in Non-Muscle-Invasive Bladder Cancer.

Mycobacterium bovis Bacillus Calmette-Guerin (BCG) is the primary treatment for non-muscle-invasive bladder cancer (NMIBC), known to stimulate inflammatory cytokines, notably interferon (IFN)-γ. We observed that prolonged IFN-γ exposure fosters adaptive resistance in recurrent tumors, aiding immune evasion and tumor proliferation. We identify HLA-E and NKG2A, part of a novel NK and T cell checkpoint pathway, as key mediators of resistance in BCG-unresponsive NMIBC. IFN-γ enhances HLA-E and PD-L1 expression in recurrent tumors, with an enrichment of intra-tumoral NKG2A-expressing NK and CD8 T cells. CXCL9+ macrophages and dendritic cells and CXCL12-expressing stromal cells likely recruit CXCR3/CXCR4-expressing NK and T cells and CXCR7+ HLA-EHIGH tumor cells. NK and CD8 T cells remain functional within BCG-unresponsive tumors but are inhibited by HLA-E and PD-L1, providing a framework for combined NKG2A and PD-L1 blockade strategy for bladder-sparing treatment of BCG-unresponsive NMIBC.

Dynamic nucleotide mutation gradients and control region usage in squamate reptile mitochondrial genomes.

Gradients of nucleotide bias and substitution rates occur in vertebrate mitochondrial genomes due to the asymmetric nature of the replication process. The evolution of these gradients has previously been studied in detail in primates, but not in other vertebrate groups. From the primate study, the strengths of these gradients are known to evolve in ways that can substantially alter the substitution process, but it is unclear how rapidly they evolve over evolutionary time or how different they may be in different lineages or groups of vertebrates. Given the importance of mitochondrial genomes in phylogenetics and molecular evolutionary research, a better understanding of how asymmetric mitochondrial substitution gradients evolve would contribute key insights into how this gradient evolution may mislead evolutionary inferences, and how it may also be incorporated into new evolutionary models. Most snake mitochondrial genomes have an additional interesting feature, 2 nearly identical control regions, which vary among different species in the extent that they are used as origins of replication. Given the expanded sampling of complete snake genomes currently available, together with 2 additional snakes sequenced in this study, we reexamined gradient strength and CR usage in alethinophidian snakes as well as several lizards that possess dual CRs. Our results suggest that nucleotide substitution gradients (and corresponding nucleotide bias) and CR usage is highly labile over the approximately 200 m.y. of squamate evolution, and demonstrates greater overall variability than previously shown in primates. The evidence for the existence of such gradients, and their ability to evolve rapidly and converge among unrelated species suggests that gradient dynamics could easily mislead phylogenetic and molecular evolutionary inferences, and argues strongly that these dynamics should be incorporated into phylogenetic models.

Gender Differences in Dose of Erythropoietin to Maintain Hemoglobin Target in Hemodialysis Patients.

Dialysis patients receiving erythropoietin (EPO) for anemia management are a challenge due to the significant interindividual variability in erythropoietic response. Our objective was to determine if there is a gender-dependent difference in the EPO doses required to maintain the hemoglobin (Hb) targets in adult patients undergoing hemodialysis. We conducted a historic cohort study with a 12-month follow-up. We include patients with the Hb target, normal serum albumin, and normal transferrin saturation index. Monthly data were gathered for the following: Hb level, EPO doses, and intravenous iron doses. In the 11 hemodialysis facilities included, 1844 patients were on hemodialysis. We considered 389 patients for follow-up, 190 of which were excluded mainly for failing to keep the Hb level in the established range. The final cohort for analysis included 141 men (70.9%) and 58 women (29.1%). At baseline, men weighed more than women (P < 0.001). At the end of the follow-up period, the EPO required to maintain Hb level between 10 and 13 g/dl was significantly higher in women in the monthly dose, weekly dose, and weekly EPO dose/patient weight, with no difference in the monthly iron dose. There was a significant association between female gender and the use of high EPO doses (odds ratio, 4.1; 95% confidence interval, 1.4-12.2; P = 0.01). Our study demonstrates that women require higher doses of EPO to achieve Hb targets.

Cloning, expression and characterization of mugwort pollen allergen Art v 2, a pathogenesis-related protein from family group 1.

Mugwort (Artemisia vulgaris) belongs to the Compositae family, and is one of the main causes of allergy in late summer and autumn. The aim of the study was to characterize the allergen Art v 2 from mugwort pollen. Skin prick tests, performed in 19 patients allergic to mugwort and 10 control patients, showed an Art v 2 sensitization prevalence of 58%, whereas none false-positives were detected among control patients. Art v 2 was purified by standard chromatography and binding to Concanavalin A column and had an apparent molecular mass of 33 and 20 kDa, calculated by gel permeation and SDS-PAGE under denaturing conditions, respectively, showing that the allergen is composed of two identical subunits. Art v 2-encoding cDNA was amplified by PCR using degenerate primers based on reported partial amino acid sequences. Cloned cDNA encoding Art v 2 contains 140 bp that codify for a polypeptide of 15.8 kDa, with a predicted pI value of 5.2, and one potential N-glycosylation site. Protein homology search demonstrated that Art v 2 share 55-42% identical residues with pathogenesis-related protein PR-1 of tomato, potato, rape, wheat and rice. Homology was also found to Ves v 5 (41% identical residues). Bacterial-expressed recombinant Art v 2 was recognized only by 21% of mugwort-allergic patients. In conclusion, Art v 2 from mugwort is the first weed pollen allergen that belongs to the pathogenesis-related protein PR-1 and its recombinant form could help molecular diagnosis of mugwort associated allergy.

Abordaje Transoral para la Extracción de un Diente Supernumerario Intranasal. Presentación de un Caso y Revisión de la Literatura

RESUMEN: El diente supernumerario de ubicación nasal es una patología de baja prevalencia en la población con diferentes formas y sintomatología clínica. Es importante establecer un diagnóstico respecto a sus características clínicas y radiológicas para realizar una planificación de tratamiento quirúrgica adecuada, con nula o escasas complicaciones post intervención. Presentación del caso: En el presente estudio se reporta el caso de un niño de 10 años de edad, sin antecedentes mórbidos, que recurre al servicio por presentar un diente supernumerario en la línea media hallado radiográficamente. El CBCT demuestra un mesiodens en el septum nasal, palatal inclinado e invertido, parcialmente erupcionado cubierto por mucosa nasal, con su corona en sentido a la cavidad nasal en relación a las fosas nasales. El diente fue extraído con anestesia general mediante un abordaje transoral a través de una vestibulotomía. El diente supernumerario nasal es una patología poco prevalente. Es importante conocer sus características clínicas y radiográficas ya que determinarán el tipo de abordaje a realizar. El grado de erupción, la distancia a la espina nasal anterior y su sintomatología asociada son fundamentales para determinar si el abordaje quirúrgico es intraoral o extraoral.

ABSTRACT: The supernumerary tooth of nasal location is a pathology of low prevalence in the population with different forms and clinical symptoms. It is important to establish a diagnosis regarding its clinical and radiological characteristics in order to carry out adequate surgical treatment planning, with few or no post-intervention complications. Case presentation: This study reports the case of a 10-year-old boy, with no morbid history, who presented a supernumerary tooth, found radiographically in the midline. CBCT showed a mesiodens in the nasal septum, tilted and inverted palatal, partially erupted covered by nasal mucosa, with its crown facing the nasal cavity in relation to the nostrils. The tooth was extracted under general anesthesia using a transoral approach through a vestibulotomy. The nasal supernumerary tooth is a rare pathology. It is important to know its clinical and radiographic characteristics since they will determine the type of approach to be used. The degree of eruption, the distance to the anterior nasal spine and its associated symptoms are essential to determine whether the surgical approach is intraoral or extraoral.

Tropical spastic paraparesis on the Caribbean coast of Colombia.

Tropical spastic paraparesis (TSP) is a retroviral disease characterized predominantly by a chronic myelopathy and progressive leg weakness. Four patients from the northern coast of Columbia with chronic spastic paraparesis and serum positivity for antibodies to human T cell lymphotropic virus type 1 by enzyme-linked immunosorbent assay and Western blot are reported. All patients had mixed ethnic origins (white, black, and amerindian). This is the first report of TSP on the Caribbean coast of Colombia. This study extends the geographic boundaries of TSP in the Caribbean basin.

Immunotherapy with a depigmented, polymerized vaccine of Olea europaea pollen allergens. Significantly reduces specific bronchial and skin test reactivity in sensitized patients after one year of treatment.

Clinical manifestations after the inhalation of Olea europaea pollen are very frequent in Spain. Forty-five patients with a clinical history of asthma and sensitivity to O. europaea pollen were included in a randomized trial to evaluate the safety and the clinical efficacy of immunotherapy with a new chemically modified extract (depigmented and glutaraldehyde-polymerized) of Olea europaea. The study was conducted following good clinical practices and appropriate consent forms were signed. Patients were divided into three groups of 15 individuals: Group A received a maximum concentration of 44 micrograms/ml of the depigmented, polymerized allergen extract (equivalent to 100 HEPL of the native unmodified extract). Group B received 10 times less; Group C did not receive any specific immunotherapy. Any adverse event was recorded to assess safety. Efficacy was evaluated by measuring the amount of allergen needed to elicit a positive response in specific bronchial challenges before and after 12 months of immunotherapy. The treatment schedule consisted of an incremental phase of five injections and a maintenance dosage of 0.5 ml per month. Each patient received a total of 14 injections during this period. No moderate or serious adverse events related to immunotherapy were recorded. At the beginning of the study, no significant differences were observed between the three groups in specific bronchial hyperreactivity (p > 0.05). A significant difference (p < 0.05) was obtained after 12 months. Patients in Group A needed four times more native unmodified allergen than Group C to elicit the same degree of bronchoconstriction. The analysis of the individual groups before and after 12 months of treatment showed that patients in Groups B and C did not improve. Patients in Group A showed a significant improvement (p < 0.05) in specific bronchial hyperreactivity, and at the end of the study needed 5.5 times more native unmodified allergen to obtain the same degree of bronchial response as in the beginning. Depigmented and glutaraldehyde-polymerized vaccines of Olea europaea pollen are very safe for treating patients with asthma and clinical sensitivity to allergens of this pollen. The clinical efficacy of this new allergen vaccine seems to be dose-dependent as shown by specific bronchial challenges as well as by symptom and medication scores. These modified extracts induce protection against unmodified native allergens.

Linear monitoring of patients sensitive to Olea and grass pollens treated with immunotherapy based on glutaraldehyde-modified (allergoid) extracts.

Extracts modified with glutaraldehyde (allergoid) have been offered to allergologists for immunotherapy in the last few years as supposedly clinically effective agents that diminish undesirable side-effects (allergenicity vs. immunogenicity). In order to acquire experience in the use of this therapeutic resource, we monitored a group of patients with pollinosis sensitive to Olea, grass pollens or both, who suffered from seasonal rhinoconjunctivitis (SRC) or rhinoconjunctivitis and seasonal asthma (RCSA) and were administered allergoid treatments standardized in biological units (HEP). The patients were monitored by determination of specific IgE and IgG4, endpoint prick tests and conjunctival provocation tests (CPT) with two types of antigen: Lolium perenne and Olea europaea. Measurements were made at baseline (T1), when the maximal tolerated dose had been given (T2) and 1 year after the treatment was started (T3). According to our results, this type of extract is tolerated quite well and causes no alterations in specific IgG4 or IgE levels. On the other hand, it features significantly decreased allergen-specific skin reactivity and increased response thresholds to the CPT (p < 0.01). A high correlation between skin and conjunctival provocation tests was observed at some stages (r = 0.79, p < 0.01).

Study of sensitivity to the pollen of Fraxinus spp. (Oleaceae) in Cordoba, Spain.

The level of ash pollen grains (Fraxinus spp.) detected in the air in the city of Cordoba rarely surpasses the daily average of 8 g/m3 and is always detectable during the winter and the beginning of the spring. This fact, together with the knowledge of the presence of perennial symptoms in patients monosensitive to Olea in this area, allows us to suspect the possibility of cross-reactivity between both taxa. The skin tests carried out on a total of 1500 pollinotic patients with an extract of Fraxinus pollen offer us a global sensitization frequency of 59%. Furthermore, the Fx+ patients generally have a higher frequency of rural origin or they live in the most southerly district of the province. As for the age and sex of the patient, significant differences were found for the age groups between 5-10 years and over 25 but the frequency for both sexes was equal. As for the clinical features, differences in the family and personal antecedents of atopy were not observed, although rhinoconjunctival clinical antecedents seemed to prevail slightly over asthma antecedents. In relation to the duration of the symptoms, the patients presented a long evolution in their symptomatology. The great majority of the patients were polysensitive; only 8% were found to be monosensitive, with unimportant differences in their evolution after immunotherapeutic treatment. On the other hand, 92% of the Fx+ patients presented reactions to Olea pollen (but only 41% of the Fx- patients did), whereas 62% showed sensitivity to Cupressus, marking a strong contrast with the Fx-patients, who all tested negative for Cupressus pollen.(ABSTRACT TRUNCATED AT 250 WORDS)

Double-blind, placebo-controlled clinical trial of preseasonal treatment with allergenic extracts of Olea europaea pollen administered sublingually.

In a double-blind, placebo-controlled, pilot clinical trial we evaluated the clinical efficacy and safety of immunotherapy (IT) with an extract of the pollen of the tree Olea europaea administered sublingually. The parameters tested were symptom score, dose-response bioassay of skin prick test and specific IgE and IgG, and the absolute value at a single serum dilution of each IgG subclass. Fifteen patients allergic to this pollen with symptomatology of rhinitis and/or rhinoconjunctivitis were randomly allocated to the placebo group (6 patients) or to the extract group (9 patients). Immunotherapy was administered in a short preseasonal period of time, practically no side effects being recorded. The group of patients treated with extract presented a slightly lower incidence (0.05 < p < 0.1) of nasal symptoms of sneezing and obstruction, and, more importantly, developed less dyspnea (p < 0.05) than the group treated with placebo, suggesting that IT can act as prophylaxis for the development of bronchial symptoms. No differences were observed in the immunological determinations. Differences in skin tests between the two groups displayed a slight significance (0.05 < p < 0.1) at the end of the trial; hence, a higher concentration of the allergen was needed in the group treated with extract to induce the same wheal as in the placebo group. In both groups the size of the wheal showed a time-dependent variation, which was dependent on the time of the year and independent of the type of treatment received, indicating a significant modification in the in vivo skin response to allergen challenge, demonstrated by a shift in the kinetics of allergen-ligand binding (slope) and in the magnitude of the measured response (intercept).

In vivo evaluation of cellular immunity in different phases of contact dermatitis.

Contact dermatitis is a delayed hypersensitivity reaction involving the skin as shock organ. In a delayed cutaneous hypersensitivity reaction to contact with an antigen, the afferent, central and efferent phases of the immune reaction remain untouched and the individual concerned has a nonspecific inflammatory response capacity. Hence, delayed cutaneous hypersensitivity tests and the dinitrochlorobenzene (DNCB) test are of great use in evaluating this type of reaction. This prompted us to evaluate the in vivo response of patients suffering from contact dermatitis, as studies on this topic have been focused on animal experimentation or in vitro techniques. We chose 30 patients with contact dermatitis and studied them at three different stages, namely, when the patients showed the typical clinical signs (acute phase), when the lesions had subsided (intercrisis phase) and when the signs had recurred (acute outbreak). We subjected them to delayed cutaneous hypersensitivity tests and the DNCB test. Both techniques revealed a decrease in the response in the intercrisis phase with respect to the other two phases and to a control group.

Humoral immunity in different phases of contact dermatitis.

Although cell-mediated hypersensitivity seems to be the main immunological response of man in contact dermatitis, recent studies suggest the potential involvement of antibody-mediated and basophilic cutaneous hypersensitivity in the physiopathology of this affection. The aim of this work was to contribute data intended to clarify the possible involvement of factors traditionally assigned to humoral hypersensitivity in the pathology of contact dermatitis. For this purpose blood levels of the different immunoglobulins were determined in patients with contact dermatitis. Three phases were considered, namely, one in which the patients showed typical clinical signs (acute phase), another in which the lesions had subsided (intercrisis phase) and a third in which the signs had recurred (acute outbreak). All those patients who concomitantly suffered from or had any personal or family antecedents of type I hypersensitivity were excluded from the study. The results found were compared with those obtained for a control gorup consisting of healthy individuals with no atopic antecedents. No significant differences were found between the results obtained in the three phases. However, the IgE levels of the patients were significantly higher than those of the control group, whereas the differences in the IgE, IgA and IgM levels were insignificant.

IgG4 levels in relation to Olea europaea immunotherapy.

We determined olive pollen-specific IgG4 levels in 100 patients, 39 of whom had been subjected to no immunotherapy (IT) for Olea (31 allergic and 8 nonallergic individuals) and 61 of whom had been administered IT as extracts, including Olea pollen (29 extracts in BUs, 24 allergenic extracts polymerized with glutaraldehyde:Allergoid and 8 extracts standardized in PNUs). IgG4 levels were correlated to the clinical picture, type of extract and average cumulative dose (ACD). We found average IgG4 levels of 0.80 +/- 0.74, 8.60 +/- 13.07 (p < 0.01) and 1.42 +/- 2.5 micrograms/ml (n.s.) for the untreated group and those treated with BU and Allergoid, respectively. The difference between the IT-BU-treated and IT-Allergoid-treated patients was significant at p < 0.01. On the other hand, we found no significant differences among the average IgG4 levels of the three groups in relation to age or sex. The group of asthmatic patients treated with BU extracts had average IgG4 levels of 16 +/- 17.34 micrograms/ml, while those of the rhinoconjunctivitic, non-asthmatic group were 5.05 +/- 6.149 micrograms/ml, with p < 0.05 (Student's "t" test). Thus, patients treated with extracts polymerized with glutaraldehyde had IgG4 levels that were similar to those of the patients subjected to no IT. Also, the group treated with IT extracts standardized in BUs had increased IgG4 levels that were correlated with the cumulative dose, particularly in asthmatic patients.

Sensitivity to Cupressus: allergenic significance in Córdoba (Spain).

The detection of high levels of Cupressaceae pollen concentration in the air from January to April for several years in our area prompted analysis of the incidence and allergenic significance of sensitivity to this pollen. Furthermore, this is the highest winter-blooming taxa in the city of Córdoba. Skin prick tests were carried out over a one-year period on 1532 patients suffering from respiratory disorders (asthma and/or rhinoconjunctivitis). A total of 42 variables were studied in Cupressus-positive and Cupressus-negative patients; the data obtained were analyzed using a statistical software package. Sensitivity to Cupressus was found in 13% of all outpatients attending the unit, 18% of patients with respiratory disorders and 35% of patients with pollinosis. No significant differences were found between Cupressus-positive (C+) and Cupressus-negative (C-) patients with regard to mean age, sex, patient environment (i.e., rural, semi-rural, urban), personal or family history of atopy, clinical symptoms or evolution after immunotherapy (which did not include this antigen). More C+ patients were found in the higher age brackets (over 25 years old; p < 0.05); C+ patients showed greater duration (p < 0.05) and slower development (p < 0.05) of symptoms, and were also found to be more sensitive to other pollens (p < 0.001). All the Cupressus-sensitive patients also reacted positively to Olea and Fraxinus, compared to 77% and 51% in the two Cupressus-negative groups.

Study of lymphocyte subpopulations at different stages of contact dermatitis.

Contact dermatitis has traditionally been regarded as a T-lymphocyte-mediated delayed hypersensitivity reaction. This has led authors to focus their studies of this affection on establishing the role played by lymphocytes and the different lymphocyte subpopulations in its pathophysiology. However, as most of the research conducted on contact dermatitis has so far been carried out on experimental animals, we believed it of interest to study the potential alterations to the immune system involved in contact dermatitis in humans. For this purpose, we chose 30 patients suffering from contact dermatitis in whom we studied the blood levels of total lymphocytes, as well as those of CD3, CD4 and CD8, and the CD4/CD8 ratio. These parameters were determined at three clinical stages, namely, the clinical stage (acute phase), a period when the symptoms had subsided (intercrisis phase) and another when the lesions recurred (acute outbreak). The aim of this work was to study the changes in these lymphocyte subpopulations in each of the stages. We also studied a control group consisting of 30 healthy subjects in order to contrast the results obtained. We found no significant differences among the results obtained at the three stages. However, they did differ from those obtained for the control group: the patients had lower CD4 and CD8 levels than their healthy counterparts, the differences only being significant in the acute phase.

[Focal auricular fibrillation: catheter ablation with radiofrequency]. / Fibrilación auricular focal: ablación con catéter mediante radiofrecuencia.

Although atrial fibrillation is usually caused by multiple circulating reentrant wavelets, a focal origin has recently been reported. This focal source could be successfully treated by discrete radiofrequency catheter ablation. We report a patient without structural heart disease, but with multiple episodes of palpitations related to atrial premature beats, irregular atrial tachycardia and atrial fibrillation. The electrophysiological study demonstrated that all the atrial arrhythmias were due to the same focus firing irregularly and exhibiting a unique and centrifugal pattern of activation. Successful radiofrequency catheter ablation of the focus was performed, without complications. After three months follow-up the patient is asymptomatic and she has not presented arrhythmia recurrences.

[Aortic dilation and dissection in a patient with Turner syndrome]. / Dilatación y disección aórtica en un paciente con síndrome de Turner.

The ascending aortic dilatation and its dissection is a not very frequent finding in patients with Turner syndrome. The high incidency of structural anomalies in the aortic wall and the severity of its complications, makes it necessary to watch these patients very closely. We present an asymptomatic patient, affected with Turner syndrome, ascending aortic dilatation and aortic wall dissection.

[Ventricular fibrillation secondary to radiofrequency application in ventricular tachycardia ablation]. / Fibrilación ventricular secundaria a la aplicación de radiofrecuencia en la ablación de una taquicardia ventricular.

Radiofrequency catheter ablation has become a first line therapy for several types of tachycardias because of its high efficacy and low complication rate. The development of proarrhythmic complications due to a direct effect of radiofrequency is very unusual. We describe a patient with previous myocardial infarction and well tolerated sustained monomorphic ventricular tachycardia who underwent catheter ablation of the tachycardia substrate. During two of the radiofrequency applications, ventricular fibrillation developed and external defibrillation was required.