RESUMEN
The genotypes of hepatitis B (HBV) and delta (HDV) viruses circulating among Venezuelan Amerindian populations, where these viruses are endemic, were determined by sequencing of PCR amplified products from HBsAg positive sera. HDV genotype I (n = 7, 6 from West Amerindians), and III (n = 5, 4 from South Amerindians), were found. Only one HDV genotype I isolate was associated with HBV genotype D, 4 HDV genotype I and 2 HDV genotype III infected individuals were co-infected with HBV genotype F. The failure to detect the South American HDV genotype III in West Amerindians might be related to the outbreak of fulminant hepatitis with high mortality rate occurred between 1979 and 1982, probably affecting more the Amerindians infected with HDV genotype III. These results suggest the circulation of HDV genotype I among Amerindians, probably introduced through European immigrations, and that this HDV genotype is able to replicate in association with HBV genotype F.
Asunto(s)
Biomarcadores/análisis , ADN Viral/análisis , Anticuerpos Antihepatitis/análisis , Virus de la Hepatitis B/genética , Hepatitis D Crónica/complicaciones , Hepatitis D/complicaciones , Hepatitis D/genética , Virus de la Hepatitis Delta/genética , Indígenas Sudamericanos/genética , ARN Viral/análisis , Secuencia de Aminoácidos , Secuencia de Bases , Biomarcadores/sangre , ADN Viral/sangre , Genotipo , Anticuerpos Antihepatitis/sangre , Anticuerpos Antihepatitis/inmunología , Hepatitis B/sangre , Hepatitis B/virología , Antígenos de Superficie de la Hepatitis B/análisis , Antígenos de Superficie de la Hepatitis B/sangre , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis D/sangre , Hepatitis D/epidemiología , Hepatitis D/virología , Hepatitis D Crónica/sangre , Hepatitis D Crónica/epidemiología , Hepatitis D Crónica/virología , Virus de la Hepatitis Delta/aislamiento & purificación , Humanos , Indígenas Sudamericanos/clasificación , Filogenia , Reacción en Cadena de la Polimerasa , ARN Viral/sangre , Alineación de Secuencia , Venezuela/epidemiologíaRESUMEN
We report our experience in radiofrequency catheter ablation between April, 1992 and December, 1998, in which we treated 287 patients less than 18 years of age (mean 14.3 +/- 3.1 years) with supraventricular tachycardia. Accessory, pathways were the arrhythmic substrate in 252 of the patients (87.8%), the patients having a total of 265 accessory pathways. Atrioventricular nodal re-entry was the cause of tachycardia in 26 patients (9.0%), while atrial flutter was detected in the remaining 9 patients (3.1%). We were able successfully to eliminate the accessory pathway in 236 patients (89%), but 25 patients had recurrent arrhythmias. Ablation proved successful in all cases of atrioventricular node re-entry tachycardia, the slow pathway being ablated in 25 patients, and the fast pathway in only one case. Recurrence of the arrhythmia occurred in three patients (11.5%). We performed a second ablation in these children, all then proving successful. The ablation was successful in all cases of atrial flutter, with one recurrence (11.1%). Overall, therefore, ablation was immediately successful in 271 patients (94.4%), with a recurrence of the arrhythmia in 29 cases (10.7%). The incidence of serious complications was 2.09%. There was one late death due to infective endocarditis, 3 patients suffered complete heart block, 1 had mild mitral regurgitation, and 1 patient developed an haematoma in the groin. We conclude that radiofrequency catheter ablation can now be considered a standard option for the management of paroxysmal supraventricular tachycardias in children and young adults.
Asunto(s)
Ablación por Catéter/métodos , Taquicardia Supraventricular/terapia , Adolescente , Distribución por Edad , Aleteo Atrial/etiología , Ablación por Catéter/efectos adversos , Niño , Preescolar , Electrocardiografía , Electrocardiografía Ambulatoria , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Recurrencia , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/etiología , Resultado del Tratamiento , Fibrilación Ventricular/etiología , Síndrome de Wolff-Parkinson-White/etiologíaRESUMEN
INTRODUCTION: We study the effect on Intralipid on pulmonary circulation. METHODS: A 10% infusion of Intralipid was administered at a dose of 0.5/kg in 14 isolated rabbit lungs in which constant blood flow infusion was carried out principally in zone 3. The liquid filtration rate (LFR) and the mean pressure of the pulmonary artery were measured. RESULTS: A constant increase of mean pressure of the pulmonary artery was observed following the infusion (from 12.32 +/- 3.66 cm of H2O to 39.92 +/- 07.68 cmH2O (p < 0.01) which was associated to a significant increase in the rate of liquid filtration (from 0.018 +/- 0.01 g/min to 0.198 +/- 0.04 g/min; p < 0.01). CONCLUSIONS: The administration of Intralipid produces a statistically significant increase of mean pressure of the pulmonary artery and the rate of liquid filtration. This is probably caused by vasoconstriction due to metabolic changes produced by Intralipid on pulmonary circulation.