RESUMEN
We describe the chest radiographic and computed tomographic appearances of the temporary total artificial heart in 2 patients.
Asunto(s)
Cardiomiopatía Dilatada/cirugía , Corazón Artificial , Radiografía Torácica/métodos , Tomografía Computarizada por Rayos X/métodos , Cardiomiopatía Dilatada/diagnóstico por imagen , Medios de Contraste , Humanos , Masculino , Persona de Mediana EdadRESUMEN
As the role for diagnostic and therapeutic contrast-enhanced imaging increases, review of the epidemiology, mechanisms, risk factors, and pretreatment for radiocontrast-mediated anaphylactoid reactions becomes more and more pertinent. Ongoing research has failed to elucidate the precise mechanisms of both early and late reactions, though the current data point to a multifactorial pathogenesis. The risk of reactions has decreased over time as contrast media have evolved from ionic, high-osmolality to nonionic, low-osmolality formulations; however, the expense of the low-osmolality agents limit their universal use. Today, 1-12% of patients exhibit adverse responses ranging from mild to severe, with individual risk depending on the type of contrast administered and certain baseline patient characteristics. For those high-risk patients who must receive contrast, effective pretreatment guidelines have been established.
Asunto(s)
Anafilaxia/inducido químicamente , Medios de Contraste/efectos adversos , Anafilaxia/epidemiología , Anafilaxia/prevención & control , Humanos , PremedicaciónRESUMEN
Visceral leishmaniasis is an endemic protozoal disease of humans and dogs in tropical and subtropical regions in Asia, Africa, southern Europe, Central America, and South America, where sand flies (genera Phlebotomus and Lutzomyia) act as vectors. An outbreak in a New York foxhound kennel and subsequent surveillance revealed widespread Leishmania infantum infection of dogs in the United States, outside the known range of the vector sand flies. For this study, we conducted surveillance for sand flies during the summers of 2001 and 2002 at two areas: on the grounds of the New York kennel and at the Institute of Ecosystem Studies (IES) 10 km away. CO2-baited light traps were used for surveillance. Populations of Lutzomyia vexator, not previously known in New York, were widespread and locally abundant (range, 0.26-1.16 flies/trap night) at the IES site. These populations showed a bimodal, midsummer activity peak and were most abundant on steep slopes within mature mixed hardwood forests. Further research will be necessary to determine whether the New York populations of L. vexator in the vicinity of the kennel could be involved in transmission of canine leishmaniasis.