RESUMO
The efficacy and safety of intravenous propafenone for conversion of recent-onset and chronic atrial fibrillation was assessed in 46 patients. 40 with atrial fibrillation associated with or without structural heart disease (mean age 63 +/- 14 years) and 6 patients with atrial fibrillation related to the Wolff-Parkinson-White syndrome (mean age 34.8 +/- 13 years). Propafenone treatment was administered at 2 mg/kg over 15 minutes under continuous electrocardiographic monitoring. In 28 of 32 (87.5%) patients with paroxysmal and/or recent-onset atrial fibrillation a stable sinus rhythm was restored within 1 hour after propafenone (mean 17 +/- 11 minutes) and in only 3 of 8 (37.5%) with chronic atrial fibrillation (p < 0.05). Conversion to sinus rhythm was obtained in 5 of 6 (83.3%) patients with atrial fibrillation related ventricular preexcitation, mean time 21 +/- 12 minutes. Propafenone had an additional effect reducing mean heart rate (141 +/- 21 to 102 +/- 15 beat per minute, p < 0.05) and the shortest preexcited R-R intervals was increased, mean 231.6 +/- 27.8 to 355 +/- 37.2 milliseconds (p < 0.001) in cases associated with ventricular preexcitation. Dizziness, hypotension and transient conduction disturbances occurred in only one patient with rheumatic valvular heart disease: EF 40%. Propafenone is an effective and safe antiarrhythmic drug for converting paroxysmal and/or recent-onset atrial fibrillation of various origins with a more limited efficacy in chronic atrial fibrillation.
Assuntos
Antiarrítmicos/administração & dosagem , Fibrilação Atrial/tratamento farmacológico , Propafenona/administração & dosagem , Idoso , Fibrilação Atrial/complicações , Interpretação Estatística de Dados , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Síndrome de Wolff-Parkinson-White/complicaçõesRESUMO
BACKGROUND AND OBJECTIVES: The purpose of the study was to register antibody prevalences of HHV-7 in various locations of the world in comparison to the closely related HHV-6. MATERIALS AND METHODS: Sera of healthy blood donors from nine countries in five continents were titered by indirect immunofluorescent assays using HHV-6 infected HSB2 and HHV-7 infected SupT1 cells. RESULTS: Antibody prevalence for HHV-7 is high (75-98%) in practically all countries except for Northern Japan (44%), with no simple correlation to elevated HHV-6 antibody titers. There were regions of low, intermediate and high mean antibody titers against HHV-7 such as 78.5-91.3 for Belgium, Israel, Japan, USA and Australia, 175.4-182.6 for Mexico and Cologne/Germany, and 389.2 for South Africa for which geographic characteristics may be responsible. CONCLUSION: HHV-7, similar to HHV-6, is a widespread human herpesvirus with elevated antibody titers in the healthy human population essentially everywhere. The data warrant further studies to evaluate its possible pathologic potential, preferentially in persons with defective immune responses.
Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue , Infecções por Herpesviridae/epidemiologia , Herpesvirus Humano 6/imunologia , Herpesvirus Humano 7/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Bélgica/epidemiologia , Feminino , Alemanha/epidemiologia , Infecções por Herpesviridae/virologia , Humanos , Recém-Nascido , Israel/epidemiologia , Japão/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Polônia/epidemiologia , Estudos Soroepidemiológicos , África do Sul/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Esta revisión resume los conocimientos actuales de la copatogénesis inmunopatológica de las principales enfermedades hepáticas, incluyendo la hepatitis viral, hepatitis autoinmune, rechazo de trasplante, reacción del huésped hacia el injerto y otras. El trabajo se refiere principalmente a las implicaciones de los datos para el diagnóstico de la práctica clínica y en menor grado a los datos de las más recientes investigaciones, por lo que está dirigido principalmente al hepatólogo y al patólogo en ejercicio. Los autores desean que la lectura de este trabajo sirva como referencia práctica para el diagnóstico diferencial de las enfermedades hepáticas cada vez más frecuentes
Assuntos
Autoanticorpos , Doenças Autoimunes/imunologia , Doenças Autoimunes/virologia , Colangite Esclerosante/imunologia , Colangite Esclerosante/patologia , Citocinas/imunologia , Hepatite Viral Humana/imunologia , Hepatite Viral Humana/virologia , Imunocompetência/imunologia , Hepatopatias/imunologia , Hepatopatias/patologia , Hepatopatias/virologia , Cirrose Hepática Biliar/imunologia , Testes Imunológicos , Transplante de Fígado/imunologiaRESUMO
Morphologic findings in the kidneys of 138 consecutive acquired immunodeficiency syndrome (AIDS) autopsies performed at the Mexico City General Hospital between 1986 and 1991 were studied. A total of 87 cases (63%) had renal disease, 62 cases presented glomerular alterations, and 80 cases showed tubulointerstitial damage. Glomerular collapse was seen in 30 cases (48%), mesangial expansion in 22 cases (35%), focal and segmental glomerulosclerosis in 20 cases (32%) and glomerular proliferation in only eight cases (11%). Nephrocalcinosis was seen in 25 cases (31%). Thirty-six cases (45%) presented tubulointerstitial infections: Mycobacterium tuberculosis in 19 cases (23%), Cryptococcus in 10 cases (12.5%), Cytomegalovirus CMV in eight cases (10%), Gram-negative bacteria in 3 cases (3.7%), and one case with histoplasmosis. In six cases the pathogens were multiple. Two cases showed infiltration of large-cell non-Hodgkin lymphoma. Based on the results obtained by autopsies, we conclude that in our country there is a high frequency of renal affection in AIDS patients. Clinically, this disease is infrequently diagnosed and not always related to the cause of death.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/patologia , Síndrome da Imunodeficiência Adquirida/complicações , Nefropatias/etiologia , Nefropatias/patologia , Síndrome da Imunodeficiência Adquirida/patologia , Adolescente , Adulto , Autopsia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Proteinúria/etiologia , Proteinúria/patologia , Estudos RetrospectivosRESUMO
Torsade de Pointes (TdP) is an atypical ventricular tachycardia that occurs in the setting of QT interval prolongation which may be an inherited or acquired abnormality. TdP is a recognized complication of bradyarrhythmias, specifically atrioventricular block. However, sinus node dysfunction is a rare cause of syncope associated with TdP. Experimental studies have suggested that the acquired long QTU interval and TdP may be due to bradycardia or pause-dependent early after depolarizations that give rise to triggered activity. This report describes a patient with sinus bradycardia and intermittent AV nodal rhythm induced long QT interval and repetitive syncope related to TdP and successfully treated with temporal and long-term pacing.
Assuntos
Nó Sinoatrial/fisiopatologia , Síncope/etiologia , Torsades de Pointes/complicações , Idoso , Arritmia Sinusal/complicações , Arritmia Sinusal/fisiopatologia , Eletrocardiografia , Feminino , Humanos , Torsades de Pointes/fisiopatologiaRESUMO
Human herpesvirus 7 (HHV-7) has been recently isolated from CD4-positive peripheral blood lymphocytes of a healthy person. The present study was performed to find the antibody prevalence of this virus in the healthy Mexican population. Two hundred blood samples from candidates for blood donation at the General Hospital of Mexico were studied with the indirect immunofluorescence test (IFA) in HHV-7 infected SupT1 cells. 83.5% were male persons and 16.5% female, the mean age for the male group was 28.8 years and for the female group 31.5. The donors came from 12 different states in Mexico, predominantly from the city (60.8%), and had different occupations. Almost all samples (98.5%) were positive to HHV-7. Other studies done revealed 1% positive to brucella, 1% positive to Hepatitis B, 2% positive to syphilis, hepatitis C and HIV test were negative in the whole group studied. There was a high incidence of HHV-7 in the group studied: more than 50% of the subject had high titers. This results should be further studied determine titers indicative of an active infection and to search for any association with illnesses.
Assuntos
Doadores de Sangue/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Infecções por Herpesviridae/etnologia , Herpesvirus Humano 7/isolamento & purificação , Adulto , Bancos de Sangue , Linfócitos T CD4-Positivos/virologia , Estudos Transversais , Feminino , Imunofluorescência , Infecções por Herpesviridae/transmissão , Humanos , Incidência , Masculino , México/epidemiologia , Valores de Referência , Fatores de RiscoRESUMO
The number of nucleolar organizer regions was assessed in 115 histological samples of uterine cervical carcinoma or precursor epithelial lesions. Normal endocervical or exocervical epithelial tissues were used as controls. Nucleolar organizer regions were stained with colloidal silver in formalin fixed histological samples and quantified in 100 cells, according to Crocker's method. The mean number of nucleolar organizer regions were 13.7 in infiltrative carcinoma, 9.15 in carcinoma in situ, 9.3 in severe dysplasia, 8.4 in moderate dysplasia, 7.5 in mild dysplasia, 6.4 in condylomas and 3.2 and 2.9 in normal exocervical and endocervical epithelia respectively. There were significant differences in the number of nucleolar organizer regions between normal and abnormal tissues and between the different lesions except between moderate and mild dysplasia and between carcinoma in situ and moderate and severe dysplasia. The highest number of nucleolar organizer lesions was always observed in the basal strata of both normal and abnormal tissues. It is concluded that nucleolar organizer regions are a good index of cellular proliferation in uterine epidermoid cervical carcinoma and its precursor lesions, and have a diagnostic value in infiltrative carcinoma.
Assuntos
Carcinoma/ultraestrutura , Região Organizadora do Nucléolo/patologia , Neoplasias do Colo do Útero/ultraestrutura , Análise de Variância , Transformação Celular Neoplásica , Epitélio/ultraestrutura , Feminino , Humanos , Invasividade Neoplásica , Lesões Pré-Cancerosas/patologiaRESUMO
Two cases of endometrial carcinoma with an atypical presentation are analyzed. The first case was formerly submitted to pelvic irradiation because a cervical carcinoma, and the second case to a long-term tamoxifen co-adjuvant therapy on account of a breast carcinoma. The risk for seconds primaries carcinomas and the eventual association of pelvic radiation and tamoxifen therapy with a subsequent endometrial carcinoma are discussed.