ABSTRACT
Apresentamos o caso debutante na América Latina de reparos transcateteres edge- to-edge nas valvas mitral e tricúspide em um único procedimento em paciente de alto risco para cirurgia. A paciente evoluía com insuficiência cardíaca e limitações em suas atividades diárias quando foi submetida ao procedimento, no qual foram realizados os reparos transcateteres das valvas mitral e tricúspide. Aos 6 meses de evolução, estava assintomática e realizando suas atividades diárias. Debatemos as recomendações mais atualizadas sobre a terapia transcateter para coexistência dessas doenças valvares, assim como expomos as lacunas no conhecimento.
We present the first case in Latin America of transcatheter edge-to-edge mitral and tricuspid valve repair in a single procedure, in a patient at high risk for surgery. The patient progressed to heart failure and limitation in her daily living activities when she was submitted to transcatheter mitral and tricuspid valve repair. Six months later, she was asymptomatic and performing her daily living activities. We discuss the most updated recommendations for transcatheter repair when both valvar conditions coexist, and show the knowledge gaps.
ABSTRACT
Antimony compounds are the cornerstone treatments for tegumentary leishmaniasis. The reactivation of herpes virus is a side effect described in few reports. We conducted an observational study to describe the incidence of herpes zoster reactivation during treatment with antimony compounds. The global incidence of herpes zoster is approximately 2.5 cases per 1,000 persons per month (or 30 cases per 1,000 persons per year). The estimated incidence of herpes zoster in patients undergoing antimony therapy is higher than previously reported.
Subject(s)
Antimony/adverse effects , Antiprotozoal Agents/adverse effects , Herpes Zoster/etiology , Herpesvirus 3, Human/physiology , Adult , Aged , Aged, 80 and over , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Female , Herpes Zoster/virology , Humans , Leishmaniasis, Cutaneous/drug therapy , Male , Middle Aged , Virus ActivationABSTRACT
Antimony compounds are the cornerstone treatments for tegumentary leishmaniasis. The reactivation of herpes virus is a side effect described in few reports. We conducted an observational study to describe the incidence of herpes zoster reactivation during treatment with antimony compounds. The global incidence of herpes zoster is approximately 2.5 cases per 1,000 persons per month (or 30 cases per 1,000 persons per year). The estimated incidence of herpes zoster in patients undergoing antimony therapy is higher than previously reported.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antimony/adverse effects , Antiprotozoal Agents/adverse effects , Herpes Zoster/etiology , /physiology , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Herpes Zoster/virology , Leishmaniasis, Cutaneous/drug therapy , Virus ActivationABSTRACT
Objetivo: Demosntrar a experiência na execução da técnica de punção braquial para a realização de coronariopatia. Método: Foram avaliados 106 pacientes ambulatóriais com suspeita de doença coronária submetidos a coronariografia pela técnica transbraquial. Foi pré-selecionado cateter MP2 introduzido através de bainha 5F, e o cateterismo esquerdo e angiográfico realizado da maneira usual. Ao término do exame foi retirada a bainha e a hemostasia realizada por compressão manual. Resultado: A maioria dos exames (76,4 por cento) foi completada com a utilização de um único cateter (MP2). A mediana do tempo de fluoroscopia foi 4,5 min. Em apenas 4 casos a técnica teve que ser substituída, todas ocorreram com um mesmo operador durante a curva de aprendizagem. Observamos a presença de hematoma de pequeno volume em 3 pacientes, logo após o procedimento, áreas discretas de esquimose em 4 e equimoses mais extensas em 6 doentes, não tendo ocorrido complicações graves. Conclusões: A técnica transbraquial mosntrou-se efetiva e segura , facilitando a realização de cateterismo ambulatorial com baixa frequência de complicações.
Objectives: To report the experience using the transbrachial approach for coronary angiography. Methods: 106 patients were studied with possible diagnosis of coronary artery disease using transbrachial catheterization. A preselected catheter (MP2) was introduced through a 5 F sheath and left heart catheterization and angiography performed in the usual manner. At the end of the procedure, the sheath was removed and hemostasis accomplished by manual compression. Results: Most procedures (76.4%) were performed with a single catheter (MP2). The median fluoroscopy time was 4.5 min. In only 4 cases, during the learning curve of one operator, a different technique had to be performed. Three patients suffered small hematomas, 4 patients presented with small and 6 with moderate ecchymosis; there were no severe complications. Conclusions: The transbrachial technique is effective and safe; it has facilitated outpatient catheterization with a low rate of complications.
Subject(s)
Humans , Male , Female , Middle Aged , Coronary Angiography/methods , Coronary Angiography , Brachial Artery/surgery , Brachial Artery/injuries , Cardiac Catheterization/methods , Cardiac CatheterizationABSTRACT
Avaliou-se, retrospectivamente, a situaçäo epidemiológica e operacional do controle da hanseníase, em quatro municípios da fronteira matogrossense Brasil-Bolívia. As informaçöes foram coletadas do sistema de registro/prontuário de cada paciente inscrito no Programa de Controle da Hanseníase, no período que decorreu do início da operacionalizaçäo dos programas até 1990. Foram estabelecidos os indicadores epidemiológicos e operacionais, definidos pela Organizaçäo Mundial de Saúde. Foi observado registro inadequado das informaçöes dos pacientes em mais da metade dos prontuários. O coeficiente da prevalência oscilou entre 15 e 48/10.000, no período estudado. O coeficiente de detecçäo anual de casos novos para o ano de 1990 foi de 112/100.000 habitantes. Os resultados encontrados apontam alta prevalência da hanseníase, ineficiência na detecçäo de casos, tendência à expansäo da endemia e uma baixa qualidade nos programas
Subject(s)
Humans , Male , Female , Program Evaluation , Leprosy/prevention & control , National Health Strategies , Regional Health Strategies , Leprosy/epidemiology , Health Programs and Plans , National Health Programs , Medical Records , Local Health Systems/organization & administrationABSTRACT
Acute or chronic disseminated paracoccidioidomycosis can be associated with changes in blood and bone marrow cell counts, mainly in the severe forms of this disease. However, there are few reports about the microbiological confirmation of the mycosis in bone marrow tissue. The present report describes a case of an adult patient with severe chronic multifocal paracoccidioidomycosis, whose etiological diagnosis has been done by the microscopical exam and culture fo the bone marrow aspirate. The authors emphasize the importance of these exams as an alternative way for the diagnosis of suspected cases of severe paracoccidioidomycosis.