Premature atrial and ventricular complexes in outpatients referred from a primary care facility.

BACKGROUND: Premature complexes are common electrocardiographic findings in daily clinical practice that require further evaluation. Investigation may sometimes be complex and expensive. The aim of our study was to analyze variables associated with premature beats identified in outpatients referred from a primary care facility. MATERIALS AND METHODS: We performed a cross-sectional study of 407 outpatients (aged 55.8±11years; 56% women) who were followed by general practitioners and were referred for resting 12-lead electrocardiograms for a routine clinical follow-up. After signing informed consent, patients answered a questionnaire and underwent physical examinations, laboratory diagnostics, transthoracic echocardiograms and 24-hour Holter monitoring to evaluate for the presence of premature complexes. After the univariate analyses, logistic regression analyses were performed with adjustment for age, sex, and cardiovascular diseases. RESULTS: Premature complexes distribution revealed that they were frequent but with low density. Premature atrial complexes (≥ 4/hours) were associated with age (Odds Ratio (OD) = 1.030, Confidence Interval (CI) 95% = 1.002 ─ 1.059, p = 0.029), brain natriuretic peptide (BNP) levels > 20mg/dL (OR = 4.489, 95%CI = 1.918 ─ 10.507, p = 0.0005), intraventricular blocks (OR = 4.184, 95%CI = 1.816 ─ 9.406, p = 0.0005) and left atrial diameter (OR = 1.065, 95%CI = 1.001 ─ 1.134, p = 0.046). Premature ventricular complexes (≥ 5/hour) were related to age (OR = 1.032, 95%CI = 1.010 ─ 1.054, p = 0.004), the use of calcium channel blockers (OR = 2.248, 95%CI = 1.019 ─ 4.954, p = 0.045), HDL-cholesterol levels (OR = 0.971, 95%CI = 0.951 ─ 0.992, p = 0.007), BNP levels > 20mg/dL (OR = 2.079, 95%CI = 0.991 ─ 0.998, p = 0.033), heart rate (OR = 1.019, 95%CI = 1.001 ─ 1.038, p = 0.041), left ventricular hypertrophy (OR = 2.292, 95%CI = 1.402 ─ 3.746, p = 0.001) and left ventricular ejection fraction (OR = 0.938, 95%CI = 0.900 ─ 0.978, p = 0.002). CONCLUSIONS: Premature complexes had low density and were associated with BNP levels > 20mg/dL, lower levels of HDL-cholesterol, left atrial enlargement and ventricular hypertrophy. The identification of premature complexes on 24-hour Holter monitor recordings of outpatients in a primary public healthcare setting was associated with uncontrolled cardiovascular risk factors that may be addressed with medical advice and therapy in a primary care setting.

Budd-Chiari syndrome in association with Behçet's disease: review of the literature.

The risk that patients with Behçet's disease may develop various thrombotic complications has been previously described. Although vascular complications from Budd-Chiari syndrome associated with Behçet's disease have been described, the pathogenic mechanisms are still unknown. Severe vascular complications present in Budd-Chiari syndrome associated with Behçet's disease are very common among young male adults. The objective of this study was to review the literature and present the association of Budd-Chiari syndrome with Behçet's disease.

Budd-Chiari syndrome in association with Behçet's disease: review of the literature / Síndrome de Budd-Chiari em associação com a doença de Behçet: revisão de literatura

The risk that patients with Behçet's disease may develop various thrombotic complications has been previously described. Although vascular complications from Budd-Chiari syndrome associated with Behçet's disease have been described, the pathogenic mechanisms are still unknown. Severe vascular complications present in Budd-Chiari syndrome associated with Behçet's disease are very common among young male adults. The objective of this study was to review the literature and present the association of Budd-Chiari syndrome with Behçet's disease.

O risco de pacientes com doença de Behçet desenvolverem várias complicações trombóticas já foi descrito. Apesar de complicações vasculares na síndrome de Budd-Chiari associada à doença de Behçet terem sido descritas, os mecanismos patogenéticos ainda são desconhecidos. Complicações vasculares graves presentes na síndrome de Budd-Chiari associada à doença de Behçet são muito mais comuns no adulto jovem do sexo masculino. O objetivo deste trabalho é o de revisar a literatura e apresentar a associação da síndrome de Budd-Chiari com a doença de Behçet.

Histoplasmosis in the nasal septum without pulmonary involvement in a patient with acquired immunodeficiency syndrome: case report and literature review.

CONTEXT: Histoplasmosis is a fungal disease caused by inhaling spores of the fungus Histoplasma capsulatum. The spores can be found in soil contaminated with bird, bat or chicken feces. Histoplasmosis occurs worldwide and is one of the most common pulmonary and systemic mycoses. CASE REPORT: We report here the case of a 37-year-old man with acquired immune deficiency syndrome and histoplasmosis in the nasal septum, without pulmonary involvement, that evolved rapidly to disseminated infection, multiple organ failure and death.

Histoplasmosis in the nasal septum without pulmonary involvement in a patient with acquired immunodeficiency syndrome: case report and literature review / Histoplasmose no septo nasal sem envolvimento pulmonar em um paciente com síndrome da imunodeficiência adquirida: relato de caso clínico e revisão de literatura

CONTEXT: Histoplasmosis is a fungal disease caused by inhaling spores of the fungus Histoplasma capsulatum. The spores can be found in soil contaminated with bird, bat or chicken feces. Histoplasmosis occurs worldwide and is one of the most common pulmonary and systemic mycoses. CASE REPORT: We report here the case of a 37-year-old man with acquired immune deficiency syndrome and histoplasmosis in the nasal septum, without pulmonary involvement, that evolved rapidly to disseminated infection, multiple organ failure and death.

CONTEXTO: Histoplasmose é uma doença fúngica causada pela inalação de esporos do fungo Histoplasma capsulatum. Os esporos podem ser encontrados no solo contaminado com fezes de aves, morcegos ou galinhas. Histoplasmose ocorre em todo o mundo e é uma das mais comuns micoses pulmonares e sistêmicas. RELATO DE CASO: Relatamos aqui o caso de um homem de 37 anos com síndrome da imunodeficiência adquirida e histoplasmose no septo nasal sem envolvimento pulmonar que evoluiu rapidamente para infecção disseminada, falência de múltiplos órgãos e morte.