RESUMO
Two patients with inferior infarction complicated by right ventricular infarction are presented. Both manifested electrocardiographic changes involving the anterior chest leads with initial S-T segment elevation followed by loss of R waves and the development of QS complexes mimicking anterior infarction. Cardiac catheterization showed right coronary artery occlusion with normal left coronary system and anterior wall motion in each case. Radionuclide angiocardiography showed dilated poorly contracting right ventricles. The ECG changes of "anterior infarction" in these patients were therefore due solely to right ventricular injury.
Assuntos
Infarto do Miocárdio/diagnóstico , Adulto , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/patologia , Infarto do Miocárdio/fisiopatologiaRESUMO
A case of Plasmodium falciparum malaria resistant to chloroquine occurring in a patient taking Fansidar (a combination of pyrimethamine and sulphadoxine) regularly as prophylaxis is reported. It seems likely that the malaria infection was acquired in Tanzania. It is probable that more such cases will be seen, and complacency regarding the emergence of drug-resistant P. falciparum malaria should be guarded against. It is predicted that chloroquine and Fansidar resistance will be increasingly found in a wider area of Africa, including South Africa. A brief review of drug-resistant P. falciparum malaria is presented and alternative therapy discussed.
Assuntos
Cloroquina/uso terapêutico , Malária/tratamento farmacológico , Quinina/administração & dosagem , Tetraciclina/administração & dosagem , Adulto , Resistência a Medicamentos , Quimioterapia Combinada , Humanos , Masculino , Plasmodium falciparum , Pirimetamina/uso terapêuticoRESUMO
In our study we describe a renal transplant from a living related donor who was found to have a retrocaval ureter. The retrocaval ureter is a rare congenital anomaly resulting from a defect in the embryological development of the ureter and the inferior vena cava (IVC). The compression of the ureter between the IVC and the vertebrae can result in progressive hydronephrosis. The non-dilated segment of the ureter was used for the uretero-neocystostomy. The patient presented with ureteric obstruction in the immediate post-transplant period, and at surgical exploration the ureteroneocystostomy was revised using the dilated portion of the ureter. We recommend that when transplanting a kidney with a retrocaval ureter, caution should be exercised in using the non-dilated portion of the ureter, since either the blood supply may be compromised or the peristalsis may be interrupted.