RESUMEN
Electrical ventricular activation was studied by means of electrocardiogram and vectorcardiogram in 62 patients, 55 women and 7 men, affected by systemic sclerosis of average disease duration of 10.3 years. 45% of the patients showed the "diffused form" of the disease and 55% the "limited form". The vectorcardiogram showed some alterations of the ventricular activation in 55% of the recorded cases. The previous electrocardiogram found only 18%. The alterations, which are more frequent in the diffuse form than in the limited one, are the presence of loss of forces in septal, lateral or inferior or combined areas and intraventricular conduction disorders as complete and incomplete right bundle branch block, left anterior subdivision block, left posterior subdivision block, or combination between incomplete right bundle branch block and left anterior or posterior subdivision block. The vectorcardiogram was more sensitive than the electrocardiogram in showing loss of forces, also in patients with the limited form of systemic sclerosis, when the electrocardiogram was normal. Moreover the vectorcardiogram is helpful to identify left posterior subdivision block. The vectorcardiographic investigation seems to be a useful complement of the electrocardiogram especially for the identification of cases with myocardial involvement that is clinically silent.
Asunto(s)
Electrocardiografía , Esclerodermia Localizada/diagnóstico , Esclerodermia Sistémica/diagnóstico , Vectorcardiografía , Adulto , Anciano , Enfermedad Crónica , Estudios de Evaluación como Asunto , Femenino , Ventrículos Cardíacos/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Esclerodermia Localizada/fisiopatología , Esclerodermia Sistémica/fisiopatologíaRESUMEN
Quatorze pacientes ambulatoriais portadores de bronquite cronica (n=5) ou asma bronquica (n=9) foram admitidos em um ensaio desenhado para avaliar o efeito da inalaçao combinada de fenoterol 200 ug + brometo de ipratropio 80 ug via aerossol pressurizado tres vezes ao dia por um periodo de tratamento de 12 semanas. Com base nos achados clinicos e espirometricos, verificou-se broncodilataçao eficaz com melhora clinica apos a inalaçao da droga ao longode todo o periodo de observaçao. De forma detalhada, o comportamento tanto dos valoresdo VEF nos dias de controle como os dados do peak flow expiratorio (PFE)moniorados diariamente pelo proprio paciente mostraram uma elevaçao constante eestatisticamente significante apos o uso do broncodilatador, com efeito imediato, duradouro e persistente durante o periodo de tres meses; as taxas automonitoradas do PFE foram particularmente compativeis com este resultado. Nao se notou efeitos colaterais em nenhum dos casos, inclusive em cinco pacientes que necessitaram de inalaçoes extras.