RESUMEN
Hereditary motor and sensory type 1A neuropathy (known as Charcot-Marie-Tooth disease) is a disease of peripheral nerves characterized by symptoms of progressive polyneuropathy with preferential damage of distal extremity muscles. Damage to the cardiovascular system is extremely rare and heterogenous in this pathology. This disease is not included in the list of indications for interventional antiarrhythmic aid. We could not find in available literature a clinical description of the development of sinus node dysfunction associated with this pathology. The present clinical report presents a case of detection and successful treatment of a damage to the cardiovascular system that manifested itself as sinus node dysfunction/sick sinus syndrome in the tachy-brady variant. A combination treatment approach using radiofrequency catheter ablation, implantation of a permanent pacemaker, and antiarrhythmic therapy associated with drug and non-drug treatment of motor sensory neuropathy resulted in recovery and long-term maintenance of sinus rhythm as well as in beneficial changes in the patient's neurological status.
Asunto(s)
Sistema Cardiovascular , Enfermedad de Charcot-Marie-Tooth , Enfermedad de Charcot-Marie-Tooth/complicaciones , Enfermedad de Charcot-Marie-Tooth/diagnóstico , Enfermedad de Charcot-Marie-Tooth/terapia , Humanos , Síndrome del Seno EnfermoRESUMEN
AIM: To assess the possibilities of modern diagnostic techniques to diagnose precancerous pathology and early central lung cancer. MATERIAL AND METHODS: Analysis of Russian and foreign publications for precancerous pathology and early lung cancer, results and comparison of various diagnostic techniques. RESULTS: Central lung cancer has a stepwise development with transformation of normal bronchial epithelium to hyperplastic followed by focal metaplasia, dysplasia, cancer in situ (CIS) and microinvasive cancer. Fluorography, chest X-ray, computed tomography, magnetic resonance imaging and sputum cytology examination are used to diagnose lung cancer. However, endoscopy plays a leading role in diagnosis of early central lung cancer which rapidly and effectively detects changes of tracheobronchial tree mucosa at the initial stages of carcinogenesis thanks to the use of modern techniques (spectral, autofluorescent and ZOOM - endoscopy).
Asunto(s)
Neoplasias Pulmonares/diagnóstico , Lesiones Precancerosas/diagnóstico , Humanos , Neoplasias Pulmonares/patología , Lesiones Precancerosas/patologíaRESUMEN
Majority of published data describing endocytoscopic examination of upper gastrointestinal tract mucosa, but in recent publications, it is reported, that endocytoscopy is suitable for small bowel, colon, respiratory tract and even peritoneum "optical biopsy". In number of articles possibilities of celiac sprue diagnostics with endocytoscopy is discussed, but small-bowel endocytoscopy is limited, due to absence of endocytoscopes, compatible with enteroscopes. More widely endocytoscopy is used in colon, mostly in lateral-spreading adenomas diagnostics. Prof. S-E. Kudo developed endocytoscopic classification of colonic mucosa changes, used for differential diagnostics and lesion mapping, describing hyperplasia, adenomas with different grades of intraepithelial neoplasia, non-invasive and invasive cancer. Some authors reported about good possibilities of endocytoscopy in inflammatory bowel disease diagnostics. Most of data, related to respiratory tract endocytoscopic examination, focused on precancerous conditions and early pharyngeal and lung cancer, and the preliminary results are promising, but, unfortunately, for now, endocytoscopy in bronchial tree is limited, due to lack of thin endocytoscopes. According to some article data, it is possible to use endocytoscopy not only in gastrointestinal and respiratory tract, but also in optical confirmation of peritoneal tumor dissemination in gastric and ovarian cancer patients, and--in bladder mucosa examination.
Asunto(s)
Enfermedades del Sistema Digestivo , Endoscopía del Sistema Digestivo , Enfermedades Respiratorias , Toracoscopía , Enfermedades del Sistema Digestivo/diagnóstico , Enfermedades del Sistema Digestivo/terapia , Endoscopía del Sistema Digestivo/instrumentación , Endoscopía del Sistema Digestivo/métodos , Humanos , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/terapia , Toracoscopía/instrumentación , Toracoscopía/métodosRESUMEN
Analysis of effectiveness and feasibility of hybrid approach to multivessel coronary artery disease and problems of interaction between cardiac surgeons and interventional cardiologists in deciding on the choice of revascularization method is performed in the article. Hybrid approach to multivessel disease defined as sternal sparing, off-pump, minimally invasive, hand sewn left internal mammary - left anterior descending (LAD) arteries by-pass graft with percutaneous coronary revascularization of non-LAD lesions to achieve functionally complete revascularization is described in detail. Data of multicenter studies and clinical recommendations for myocardial revascularization is discussed.
Asunto(s)
Enfermedad de la Arteria Coronaria , Vasos Coronarios , Revascularización Miocárdica , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/patología , Vasos Coronarios/cirugía , Stents Liberadores de Fármacos , Humanos , Relaciones Interprofesionales , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Estudios Multicéntricos como Asunto , Revascularización Miocárdica/clasificación , Revascularización Miocárdica/métodos , Evaluación de Procesos y Resultados en Atención de Salud , Atención Perioperativa/métodos , Atención Perioperativa/psicología , Guías de Práctica Clínica como Asunto , Índice de Severidad de la EnfermedadAsunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/uso terapéutico , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Lisinopril/uso terapéutico , Obesidad/epidemiología , Adulto , Antropometría , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The program has been developed for biopsy diagnosis in lymph node disease including tumors. The expert knowledge is based on the information about more than 200 morphological symptoms of 37 nosological unities: reactive lymphoid hyperplasia, metastatic tumors, granulomatous disease and others. The decision three consists of three sections: diffuse nontumor processes, inflammatory focal processes and tumor diffuse and focal processes. The system can provide a "second opinion" for pathologists in their professional activity and may useful as a teaching tool for medical students.