RESUMO
A young lady developed left middle cerebral artery embolism after percutaneous transseptal mitral commissurotomy. She was successfully treated with immediate percutaneous transluminal angioplasty. There was complete recovery of neurological deficit.
Assuntos
Embolia Intracraniana/diagnóstico , Artéria Cerebral Média/diagnóstico por imagem , Adulto , Angioplastia com Balão , Diagnóstico Diferencial , Dispneia/etiologia , Feminino , Humanos , Embolia Intracraniana/complicações , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/terapia , Estenose da Valva Mitral/cirurgia , Radiografia , Cardiopatia Reumática/cirurgiaRESUMO
A 32-year-old male patient, a case of critical calcific mitral stenosis (following closed mitral valvotomy in 1989) was admitted for mitral valve replacement in September 2001. In hospital, he developed cardiogenic shock, pulmonary oedema and oliguria precluding surgery. An emergency percutaneous transatrial balloon mitral commissurotomy as a life-saving procedure in a valve with unfavourable morphology and 'balloon impasse' is discussed.
Assuntos
Angioplastia Coronária com Balão , Calcinose/complicações , Calcinose/terapia , Cuidados para Prolongar a Vida , Estenose da Valva Mitral/complicações , Estenose da Valva Mitral/terapia , Choque Cardiogênico/etiologia , Choque Cardiogênico/terapia , Adulto , Calcinose/diagnóstico , Humanos , Masculino , Estenose da Valva Mitral/diagnóstico , Choque Cardiogênico/diagnósticoRESUMO
Data on duration of viral excretion and viraemia during hepatitis E virus (HEV) infection are limited. We tested serial stool and serum samples from 20 patients with acute hepatitis E for HEV RNA. Faecal excretion and viraemia in these patients were found to be short lived. In 19 patients, all samples obtained after biochemical resolution of hepatitis tested negative; in the remaining patient, HEV RNA was detected in the serum samples but not in stool after biochemical resolution. Long-term persistence of HEV in body fluids of infected individuals seems to be an unlikely reservoir for transmission of HEV.
Assuntos
Fezes/virologia , Hepatite E/virologia , Viremia/virologia , Doença Aguda , Adulto , Hepatite E/sangue , Vírus da Hepatite E/genética , Humanos , RNA Viral/sangue , Fatores de TempoRESUMO
One hundred patients of Diabetes Mellitus (70 with and 30 without clinical somatic neuropathy) were studied to correlate clinical severity with the magnitude of nerve conduction abnormalities. Age range was 10-79 years (mean 49) with equal number of males and females. Incidence of neuropathy was more in patients over 40 years of age (60 out of 70 patients) with duration of disease over two years (78.33%). The grades of severity were mild in 22 (31.33%), moderate in 25 (35.71%) and severe in 23 (32.86%) patients. Nerve conduction studies were carried out in 48 (27 with and 21 without clinical neuropathy) patients, using the apparatus Dantec (Cantata TM). The nerves (median, peroneal and sural) were stimulated at two points and the recording of latency; amplitude (micro V) and motor and sensory nerve conduction velocities (m/s) were done under identical environmental conditions. Sensory nerve conduction velocity was more affected than motor velocity. In the 21 patients without clinical neuropathy, 14 showed abnormalities indicating early involvement of peripheral nerves. Reduction of motor nerve conduction velocity was more in patients with moderate and severe grades. The reduction was more in lower than in upper limbs. Nerve conduction abnormality helps in diagnosis in diabetic neuropathy even in preclinical state and correlates with severity, in clinical neuropathy.
