RESUMO
El síndrome de Felty se caracteriza por reunir la tríada compuesta por: artritis reumatoide, neutropenia y esplenomegalia. Es una enfermedad autoinmune poco frecuente, con compromiso sistémico, articular y extra articular. Se desarrolla en personas de mediana edad, con historia de artritis reumatoide crónica deformante. El diagnóstico es eminentemente clínico y el tratamiento está enfocado a disminuir el dolor articular, las altas tasas de infecciones y evitar las deformidades óseas. Presentamos una paciente de 69 años de edad, diagnosticada en nuestro hospital, motivo por el que realizamos revisión bibliográfica de la entidad.
Felty's syndrome has such as main feature the triad composed by: rheumatoid arthritis, neutropenia and splenomegaly. It is unusual autoimmune disease that compromises the nervous system as well as joint affectation and extra joint. This illness develops in middle aged subjects with arthritis rheumatoid chronic deform history. The diagnosis is clinical and the focus treatment is to diminish the articular pain, to reduce the infections high rates and to avoid the bony deformities. We report a clinical case of a patient who is 69 years-old, she was diagnosed in our hospital and we reviewed the bibliographic entity.
RESUMO
El síndrome de Felty se caracteriza por reunir la tríada compuesta por: artritis reumatoide, neutropenia y esplenomegalia. Es una enfermedad autoinmune poco frecuente, con compromiso sistémico, articular y extra articular. Se desarrolla en personas de mediana edad, con historia de artritis reumatoide crónica deformante. El diagnóstico es eminentemente clínico y el tratamiento está enfocado a disminuir el dolor articular, las altas tasas de infecciones y evitar las deformidades óseas. Presentamos una paciente de 69 años de edad, diagnosticada en nuestro hospital, motivo por el que realizamos revisión bibliográfica de la entidad.(AU)
Feltys syndrome has such as main feature the triad composed by: rheumatoid arthritis, neutropenia and splenomegaly. It is unusual autoimmune disease that compromises the nervous system as well as joint affectation and extra joint. This illness develops in middle aged subjects with arthritis rheumatoid chronic deform history. The diagnosis is clinical and the focus treatment is to diminish the articular pain, to reduce the infections high rates and to avoid the bony deformities. We report a clinical case of a patient who is 69 years-old, she was diagnosed in our hospital and we reviewed the bibliographic entity.(AU)
RESUMO
Heart transplantation is an infrequent treatment modality in advanced congenital cardiopathy. We present the case of a 17-years old youngster coursing with a dilated Fallot's tetralogy, in terminal stage, who was subjected to an orthotopic heart transplantation. We present the most relevant data on his management during the 53 months after the surgery and discuss the long-term perspectives, which are comparable to those expected in transplanted patients due to other cardiac disorders.
Assuntos
Transplante de Coração , Tetralogia de Fallot/cirurgia , Adolescente , Progressão da Doença , Transplante de Coração/métodos , Humanos , MasculinoRESUMO
The Intracardiac ectopic thyroid is an extremely rare condition and there is no previous report on this subject in Mexico. This is the case of a 33 years old woman, with normal thyroid function. She was found to have an intracardiac tumor in the interventricular septum. The intraoperative biopsy showed typical thyroid follicules; tumor removal left a septal defect that was closed with a dacron patch suture. Two years follow-up showed normal echocardiographic images, good clinical status an normal thyroid functioning. A brief review of the literature is included.
Assuntos
Coristoma/patologia , Cardiopatias/patologia , Glândula Tireoide , Adulto , Coristoma/cirurgia , Feminino , Cardiopatias/cirurgia , HumanosRESUMO
Definitive pacemakers were placed in 27 children from June 1970 to October 1988. The indication for the pacemakers was congenital auriculoventricular block in 12 patients who were symptomatic; 8 were children with postoperative auriculoventricular block; 4 had developed complete auriculoventricular block from myocardiopathies and 3 from idiopathic sick-sinus syndrome. Two patients died: one 4 months after placement of the pacemaker due to unrelated causes, and the other 14 years later due to fracture of the electrode. There were 23 who were reoperated for different reasons but the most frequent was battery failure in 8 patients and pacemaker malfunction in 4 patients. The electrode was implanted in the epicardium in 21 patients and via subclavian vein into the endocardium in 6 cases. The growth and development physically and mentally were normal during the follow-up of these children. The average follow-up period was 55.6 months.
Assuntos
Marca-Passo Artificial , Fatores Etários , Criança , Seguimentos , Bloqueio Cardíaco/congênito , Bloqueio Cardíaco/epidemiologia , Bloqueio Cardíaco/terapia , Humanos , México/epidemiologia , Marca-Passo Artificial/efeitos adversos , Marca-Passo Artificial/estatística & dados numéricos , Fatores SexuaisRESUMO
This is a report of two family members (mother and her first son) with atrial myxoma detected by echocardiography, computed axial tomography and cardiac catheterization, the former located in the left atrium and the latter in the right ventricle. They were successfully treated with heart surgery. We emphasize the need to detect myxoma in the other members of the family, especially when it is of multicentric localization.
Assuntos
Neoplasias Cardíacas/genética , Mixoma/genética , Adolescente , Adulto , Cateterismo Cardíaco , Ecocardiografia , Feminino , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Mixoma/diagnóstico , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Two well documented cases of permanent atrial standstill are reported. Both fulfilled the diagnostic criteria of absence of electrical and mechanical atrial activity. The importance of response to electrical stimuli and escape rhythm is discussed within the context of a severe, irreversible and evolutive disease.
Assuntos
Terapia por Estimulação Elétrica , Eletrocardiografia , Cardiopatias/fisiopatologia , Paralisia/fisiopatologia , Adulto , Criança , Cardiopatias/terapia , Humanos , Masculino , Paralisia/terapiaRESUMO
A case of right ventricular tumor in a 14 year old male is presented. Congestive heart failure and a systolic pulmonary murmur due to right ventricular obstruction were the main symptoms. The diagnosis was confirmed by echocardiogram (M mode) and right ventricular angiography. The surgical treatment was curative and the histological exam revealed a myxoma.
Assuntos
Ecocardiografia , Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Adolescente , Eletrocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração , Humanos , Masculino , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , RadiografiaRESUMO
Two patients who had sudden unexpected death while being monitored by a Holter electrocardiograph apparatus are reported. The first patient with heart disease of unknown etiology initially developed first degree A-V block, progressive left bundle branch block and finally asystole. The second patient with previous coronary artery disease and recent myocardial infarction revealed multifocal ventricular extrasystoles with frequent bigeminism and trigeminism which ended in ventricular tachycardia and fibrillation. Emphasis is made on the necessity of detecting those high risk patients and establishing preventive post-hospitalization care to modify the evolution and prognosis in this group of patients.
Assuntos
Bloqueio de Ramo/diagnóstico , Morte Súbita/etiologia , Eletrocardiografia , Monitorização Fisiológica , Fibrilação Ventricular/diagnóstico , Idoso , Assistência Ambulatorial , Bradicardia/complicações , Bradicardia/diagnóstico , Bloqueio de Ramo/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Fibrilação Ventricular/complicaçõesRESUMO
The clinical and anatomic findings of 7 patients with aortic atresia were studied. All cases had usual atrial arrangement, atrioventricular and ventriculoarterial concordance. All but one had an intact ventricular septum. All cases presented a hypoplastic left ventricle, and in one, a mitral atresia was found. The clinical diagnosis was made by means of cardiac catheterization and angiocardiography. The presence of a patent ductus arteriosus, the size of the atrial and ventricular septal defects, the diameter of the ascending aorta, pulmonary vascular resistances and right ventricular function are all factors that influence the survival in the patients with aortic atresia.
Assuntos
Valva Aórtica/anormalidades , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/fisiopatologia , Valva Aórtica/patologia , Cardiomegalia/diagnóstico , Cardiomegalia/fisiopatologia , Permeabilidade do Canal Arterial/diagnóstico , Permeabilidade do Canal Arterial/fisiopatologia , Ecocardiografia , Eletrocardiografia , Feminino , Comunicação Interventricular/diagnóstico , Comunicação Interventricular/fisiopatologia , Hemodinâmica , Humanos , Lactente , Recém-Nascido , MasculinoAssuntos
Permeabilidade do Canal Arterial/cirurgia , Doenças do Prematuro/cirurgia , Permeabilidade do Canal Arterial/complicações , Permeabilidade do Canal Arterial/diagnóstico , Feminino , Humanos , Recém-Nascido , Masculino , México , Complicações Pós-Operatórias/mortalidade , Síndrome do Desconforto Respiratório do Recém-Nascido/complicaçõesAssuntos
Permeabilidade do Canal Arterial/tratamento farmacológico , Indometacina/uso terapêutico , Doenças do Prematuro/tratamento farmacológico , Peso ao Nascer , Permeabilidade do Canal Arterial/complicações , Idade Gestacional , Humanos , Indometacina/administração & dosagem , Recém-Nascido , Síndrome do Desconforto Respiratório do Recém-Nascido/complicaçõesAssuntos
Fístula Arteriovenosa/etiologia , Nefrectomia/efeitos adversos , Artéria Renal , Veia Cava Inferior , Aortografia , Fístula Arteriovenosa/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Artéria Renal/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagemRESUMO
Se presenta un caso raro de persistencia del conducto arterioso derecho, con arco aortico a la derecha, sin otras malformaciones.Se reviso la literatura encontrando unicamente cinco casos similares. En estos casos el estudio hemodinamico es fundamental para precisar el diagnostico, descartar anomalias asociadas y realiza el tratamiento quirurgico a traves de toracotomia derecha
Assuntos
Pré-Escolar , Humanos , Feminino , Síndromes do Arco Aórtico , Permeabilidade do Canal ArterialRESUMO
Se presenta un caso de fistula arteriovenosa renal postnefrectomia. Las manifestaciones clinicas fueron de insuficiencia cardiaca, hipertension arterial y la presencia de un soplo continuo grado IV/VI en la region lumbar derecha. El diagnostico se comprobo mediante aortografia lumbar.El tratamiento consistio en ligadura de la arteria renal derecha. Con ello se observo desaparicion de la insuficiencia cardiaca, aunque persitio la hipertension arterial, misma que respondio adecuadamente al tratamiento medico
Assuntos
Fístula Arteriovenosa , Rim , NefrectomiaRESUMO
Se refere la experiencia de los primeros cinco anos de trabajo en la Unidad de Cuidados Intensivos Neonatales del Centro Hospitalario 20 de Noviembro del ISSSTE, en el diagnostico y tratamiento quirurgico del conducto arterioso persistente en neonatos con sindrome de dificultad respiratoria sometidos a ventilacion mecanica. Se senalan los datos clinicos para su diagnostico; la edad gestacional, peso, dia promedio en que se efectuo el diagnostico, dia promedio en que fueron sometidos a la cirugia y se comparan estos datos observando su influencia entre el grupo de supervivientes y el grupo que sufrio una defuncion temprana
Assuntos
Recém-Nascido , Humanos , Masculino , Feminino , Permeabilidade do Canal Arterial , Recém-Nascido Prematuro , Indometacina , Procedimentos Cirúrgicos OperatóriosRESUMO
En una serie de 42 recien nacidos de pretermino con diagnostico de sindrome de dificultad respiratoria y conducto arterioso persistente tratados con indometacina, se analizan los factores que pudieran determinar la respuesta a la indometacina en tres grupos de peso (Grupo I: 1,250g; grupo II: > 1,250g y < 2,000 g y grupo III: 2,001 g < ou igual 2,500 g). Se determino que estadisticamente fue significativa pala hipotesis planteada, la dosis de indometacina empleada y la edad postnatal al momento de iniciar la administracion del farmaco. Estos resultados plantean la alternativa de emplear la via de administracion intravenosa preferentemente sobre la oral, debera considerarse aumentar la dosis del farmaco y finalmente, despues de la primera semana de vida, se recomienda que el farmaco se emplee a dosis repetidas con intervalos cortos
Assuntos
Recém-Nascido , Humanos , Permeabilidade do Canal Arterial , Indometacina , Recém-Nascido PrematuroAssuntos
Veia Cava Inferior/anormalidades , Adolescente , Adulto , Veia Ázigos/anormalidades , Criança , Pré-Escolar , Feminino , Cardiopatias Congênitas/complicações , Humanos , Lactente , Recém-Nascido , Masculino , Radiografia , Situs Inversus/complicações , Baço/anormalidades , Veias/anormalidades , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/embriologiaRESUMO
Forty-two cases of preterm infants with respiratory distress syndrome who developed congestive heart failure secondary to large arteriovenous shunt across permeable ductus arteriosus and who were treated with indomethacin are presented. The cases were divided into three groups according to birth weight: group I less than 1,200 g, group II between 1,250 and 2,000 g and group III from 2,000 to 2,500 g. Satisfactory results were obtained by either ductal closure or by important reduction in the left to right shunt with disappearance of the congestive failure in 37.5% of group 1, 71% in group II and 69% in group III. We concluded that indomethacin is the treatment of choice for patients weighing more than 1,050 g and over 30 weeks gestational age and that surgical ligation is the treatment of choice in patients under this weight and gestational age.