RESUMEN
As a result of improved therapies and technology, including the use of surfactant replacement, the features of bronchopulmonary dysplasia (BPD) have changed, and a "new BPD" is emerging that is substantially different from the classical form of the disease. As the pathogenesis of BPD is evolving, so are other features of the disorder, including radiologic features. We describe varicose bronchiectasis with a bulbous appearance in a 6-year-old child with a complicated course including BPD during the neonatal period.
Asunto(s)
Bronquiectasia/complicaciones , Bronquiectasia/diagnóstico por imagen , Displasia Broncopulmonar/complicaciones , Albuterol/uso terapéutico , Bronquiectasia/terapia , Broncodilatadores/uso terapéutico , Displasia Broncopulmonar/terapia , Oscilación de la Pared Torácica , Niño , Disnea/etiología , Disnea/terapia , Humanos , Recién Nacido , Masculino , Nebulizadores y Vaporizadores , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: The American College of Cardiology, American Heart Association, and European Society of Cardiology Board (ACC/AHA/ESC) 2001 guidelines for management of patients with atrial fibrillation (AF) include a new classification system consisting of 4 categories: first-detected episode; recurrent paroxysmal (self-terminating); recurrent persistent (requiring cardioversion); and permanent. The frequency of hospital discharges within these categories has not been reported. METHODS: The new classification system was applied to 135 consecutive hospital discharges with a principal diagnosis of AF. RESULTS: Classification of AF in these discharged patients included 74 (55%) with first-detected episode; 28 (21%) with recurrent paroxysmal AF; 17 (13%) with recurrent persistent AF; and 16 (12%) with permanent AF. Hypertension (n = 48; 35%) was the most common primary cause of AF, followed by alcohol related (n = 23; 17%), coronary artery disease (n = 20; 15%), and valvular heart disease (n = 17; 12%). For the 102 patients with first-detected and recurrent paroxysmal AF, 71 (69%) converted spontaneously to normal sinus rhythm within 48 hours of admission. Of the 48 patients with a discharge diagnosis of AF, 32 (67%) were receiving anticoagulation therapy. CONCLUSIONS: Most hospital discharges with a principal diagnosis of AF represent the first-detected episode. Diverse causes contribute to AF, and to examine them would help direct therapy. Importantly, in our analysis, 69% of those patients with first-detected or recurrent paroxysmal AF converted spontaneously to normal sinus rhythm within 48 hours of admission.