RESUMO
A 34-year-old male was admitted with presumed acute, severe aortic regurgitation. Multimodal imaging was performed and showed a ruptured right coronary sinus of Valsalva aneurysm into the right atrium. He underwent a percutaneous closure of the ruptured sinus of Valsalva aneurysm. The patient had major clinical improvement.
Assuntos
Aneurisma Aórtico , Ruptura Aórtica , Insuficiência da Valva Aórtica , Seio Aórtico , Adulto , Coração , Humanos , MasculinoRESUMO
BACKGROUND: B-lines have been associated with adverse clinical outcomes in patients with heart failure (HF) when found at hospital discharge or during outpatient visits. Whether lung ultrasound (LUS) assessed B-lines may predict in-hospital mortality in patients with acute HF is still undetermined. AIM: To evaluate the association between B-lines on admission and in-hospital mortality among patients admitted with acute HF. METHODS: Hand-held LUS was used to examine patients with acute HF. LUS was performed in eight chest zones with a pocket ultrasound device and analyzed offline. The association between B-lines and in-hospital mortality was assessed using Cox regression models. RESULTS: We included 62 patients with median age 56 years, 69.4% men, and median left ventricle ejection fraction 25%. The sum of B-lines ranged from 0 to 53 (median 6.5). An optimal receiver operating characteristic-determined cut-off of ≥19 B-lines demonstrated a sensitivity of 57% and a specificity of 86% (area under the curve 0.788) for in-hospital mortality. The incremental prognostic value of LUS when compared with lung crackles or peripheral edema by integrated discrimination improvement was 12.96% (95% CI: 7.0-18.8, P = 0.02). Patients with ≥19 B-lines had a 4-fold higher risk of in-hospital mortality (HR 4.38; 95% CI: 1.37-13.95, P < 0.01). CONCLUSION: In patients admitted with acute HF, point-of-care LUS measurements of pulmonary congestion (B-lines) are associated with in-hospital mortality.
Assuntos
Insuficiência Cardíaca , Sistemas Automatizados de Assistência Junto ao Leito , Feminino , Mortalidade Hospitalar , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prognóstico , UltrassonografiaRESUMO
This study examines the rheological behavior of reconstituted spray-dried mucilage isolated from the cladodes of pitahaya (Hylocereus undatus), the effects of concentration and its relationship with physical properties were analyzed in reconstituted solutions. Drying process optimization was carried out through the surface response method, utilizing a factorial 2(3) design with three central points, in order to evaluate yield and rheological properties. The reconstituted mucilage exhibited non-Newtonian shear-thinning behavior, which adequately fit the Cross model (R(2)>0.95). This dynamic response suggests a random coil configuration. The steady-shear viscosity and dynamic response are suitably correlated through the Cox-Merz rule, confirming the mucilage's stability of flow. Analysis of the physical properties of the mucilage (Tg, DTP, and particle morphology) explains the shear-thinning behavior.