Upper vena cava syndrome secondary to giant atrial myxoma.

OBJECTIVE: Cardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. CONCLUSIONS: In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.

Upper vena cava syndrome secondary to giant atrial myxoma

SUMMARY Cardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.

RESUMO O mixoma cardíaco é uma neoplasia benigna, que corresponde ao tumor primário mais comum do coração, responsável por cerca de 50% dos casos. De modo geral, 75 a 80% dos mixomas estão localizados no átrio esquerdo, 18% no átrio direito, e mais raramente, nos ventrículos ou multicêntricos. O mixoma atrial direito, em particular, pode obstruir a válvula tricúspide, causando sintomas de insuficiência cardíaca direita, edema periférico, congestão hepática e síncope. A embolização sistêmica ocorre em 30% dos casos, quer pela fragmentação do tumor ou pelo desprendimento total do mesmo. No presente relato, apresentamos um caso de uma paciente sintomática, que evidenciou grande lesão intra-atrial direita, com consequente síndrome da veia cava superior, sendo, então, submetida a ressecção cirúrgica na internação.

Acute coronary disease, prognosis and prevalence of risk factors in young adults. / Enfermedad coronaria aguda, pronóstico y prevalencia de los factores de riesgo en adultos jóvenes.

Acute coronary disease is a rare entity in young people and is mostly related to atherosclerotic disease. However, other causes such as myocardial bridges, coronary artery dissection and antiphospholipid syndrome may be present. The prognosis of the disease in this group of patients is favorable; although women may have a higher morbidity because diagnosis and treatment can be delayed. The goal of this review is to update the knowledge about risk factors and prognosis of young patients with an acute coronary event compared to the older population.

La enfermedad coronaria aguda es una entidad poco frecuente en personas jóvenes, y en su mayor parte está relacionada con la enfermedad ateroesclerótica. Sin embargo, otras causas como los puentes miocárdicos, la disección de arterias coronarias y el síndrome antifosfolípidos pudieran estar presentes. El pronóstico de la enfermedad en este grupo de pacientes es favorable. Sin embargo, las mujeres pueden tener una mayor morbilidad debido a que el diagnóstico y el tratamiento pueden iniciarse de forma más tardía. Tomando en consideración estos conceptos, se realizó la revisión bibliográfica. Su objetivo es actualizar los conocimientos sobre los factores de riesgo y el pronóstico de los pacientes jóvenes que padecen un evento coronario agudo, en comparación con la población adulta mayor.

Atmospheric pollutants and hospital admissions due to pneumonia in children / Contaminantes atmosfericos e internaciones por neumonia en ninos / Poluentes atmosfericos e internacoes por pneumonia em criancas

OBJECTIVE: To analyze the relationship between exposure to air pollutants and hospitalizations due to pneumonia in children of Sorocaba, São Paulo, Brazil. METHODS: Time series ecological study, from 2007 to 2008. Daily data were obtained from the State Environmental Agency for Pollution Control for particulate matter, nitric oxide, nitrogen dioxide, ozone, besides air temperature and relative humidity. The data concerning pneumonia admissions were collected in the public health system of Sorocaba. Correlations between the variables of interest using Pearson cofficient were calculated. Models with lags from zero to five days after exposure to pollutants were performed to analyze the association between the exposure to environmental pollutants and hospital admissions. The analysis used the generalized linear model of Poisson regression, being significant p<0.05. RESULTS: There were 1,825 admissions for pneumonia, with a daily mean of 2.5±2.1. There was a strong correlation between pollutants and hospital admissions, except for ozone. Regarding the Poisson regression analysis with the multi-pollutant model, only nitrogen dioxide was statistically significant in the same day (relative risk - RR=1.016), as well as particulate matter with a lag of four days (RR=1.009) after exposure to pollutants. CONCLUSIONS: There was an acute effect of exposure to nitrogen dioxide and a later effect of exposure to particulate matter on children hospitalizations for pneumonia in Sorocaba. .

OBJETIVO: Analizar la relación entre la exposición a los contaminantes atmosféricos e internaciones por neumonía en la infancia, en Sorocaba, São Paulo (Brasil). MÉTODOS: Estudio ecológico en series temporales, en el periodo de 2007 a 2008. Los datos diarios de las internaciones por neumonía fueron recogidos en la red pública del municipio. Se obtuvieron además los datos de los siguientes contaminantes, según la Compañía de Tecnología de Saneamiento Ambiental: material particulado, óxido nítrico, dióxido de nitrógeno y ozono, además de la temperatura y humedad relativa del aire. Las correlaciones entre las variables de interés fueron evaluadas por el coeficiente de Pearson. Para analizar la asociación entre la exposición a los contaminantes ambientales y las internaciones hospitalarias, se aplicaron modelos con desfases de cero a cinco días después de la exposición a los contaminantes. El análisis utilizó el modelo lineal generalizado de la regresión de Poisson y el nivel de significancia adoptado fue p<0,05. RESULTADOS: Hubo 1.825 internaciones por neumonía, con un promedio diario de 2,5±2,1. Se observaron fuertes correlaciones entre los contaminantes y las internaciones, excepto por el ozono. Respecto a la regresión de Poisson, en el análisis con el modelo multicontaminante, solamente el dióxido de nitrógeno presentó significancia estadística en el mismo día (riesgo relativo - RR=1,016), así como el material particulado en el desfase de cuatro días (RR=1,009) después de la exposición a los contaminantes. CONCLUSIONES: Se verificó efecto agudo de la exposición al dióxido de nitrógeno y efecto más tardío a la exposición al material particulado sobre las internaciones por neumonía ...

OBJETIVO: Analisar a relação entre exposição aos poluentes atmosféricos e internações por pneumonia na infância, em Sorocaba, São Paulo. MÉTODOS: Estudo ecológico de séries temporais, no período de 2007 a 2008. Os dados diários das internações por pneumonia foram coletados na rede pública do município. Obtiveram-se também os dados dos seguintes poluentes, segundo a Companhia de Tecnologia de Saneamento Ambiental: material particulado, óxido nítrico, dióxido de nitrogênio e ozônio, além da temperatura e da umidade relativa do ar. As correlações entre as variáveis de interesse foram avaliadas pelo coeficiente de Pearson. Para analisar a associação entre a exposição aos poluentes ambientais e as internações hospitalares, aplicaram-se modelos com defasagens de zero a cinco dias após a exposição aos poluentes. A análise utilizou o modelo linear generalizado da regressão de Poisson e o nível de significância adotado foi p<0,05. RESULTADOS: Ocorreram 1.825 internações por pneumonia, com a média diária de 2,5±2,1. Observaram-se correlações fortes entre os poluentes e as internações, com exceção do ozônio. Quanto à regressão de Poisson, na análise com o modelo multipoluente, apenas o dióxido de nitrogênio apresentou significância estatística no mesmo dia (risco relativo - RR=1,016), assim como o material particulado na defasagem de quatro dias (RR=1,009) após a exposição aos poluentes. CONCLUSÕES: Verificou-se efeito agudo da exposição ao dióxido de nitrogênio e efeito mais tardio da exposição ao material particulado sobre as internações por pneumonia em Sorocaba. .

Atmospheric pollutants and hospital admissions due to pneumonia in children.

OBJECTIVE: To analyze the relationship between exposure to air pollutants and hospitalizations due to pneumonia in children of Sorocaba, São Paulo, Brazil. METHODS: Time series ecological study, from 2007 to 2008. Daily data were obtained from the State Environmental Agency for Pollution Control for particulate matter, nitric oxide, nitrogen dioxide, ozone, besides air temperature and relative humidity. The data concerning pneumonia admissions were collected in the public health system of Sorocaba. Correlations between the variables of interest using Pearson cofficient were calculated. Models with lags from zero to five days after exposure to pollutants were performed to analyze the association between the exposure to environmental pollutants and hospital admissions. The analysis used the generalized linear model of Poisson regression, being significant p<0.05. RESULTS: There were 1,825 admissions for pneumonia, with a daily mean of 2.5±2.1. There was a strong correlation between pollutants and hospital admissions, except for ozone. Regarding the Poisson regression analysis with the multi-pollutant model, only nitrogen dioxide was statistically significant in the same day (relative risk - RR=1.016), as well as particulate matter with a lag of four days (RR=1.009) after exposure to pollutants. CONCLUSIONS: There was an acute effect of exposure to nitrogen dioxide and a later effect of exposure to particulate matter on children hospitalizations for pneumonia in Sorocaba.