RESUMO
Abstract: Background: Kounis syndrome was described in 1991 as the simultaneous occurrence of acute coronary events and anaphylactic allergic reactions. Reports of clinical cases and series of small cases of angina triggered by allergic reactions have been reported for many years. It encompasses concepts such as allergic angina and allergic infarction. Case report: We report a case of a 47-year-old man with a history of fixed drug eruption for 10 years. The patient attended to the hospital with a moderate-intensity chest pain, electrocardiogram was performed which was compatible with acute coronary syndrome without ST-segment elevation; it progressed favorably with treatment by protocol. The subsequent study showed hypersensitivity to non-steroidal anti-inflammatory drugs and cardiovascular tests was negative, and it was concluded as a case of allergic angina. Conclusions: Kounis syndrome is a difficult to diagnose entity that requires a high index of suspicion in the evaluation of patients with chest pain in the Emergency Department.(AU)
Resumen: Antecedentes: El síndrome de Kounis fue descrito en 1991 como la aparición simultánea de eventos coronarios agudos y reacciones alérgicas anafilácticas. Casos clínicos y pequeñas series de casos de angina generada por reacciones alérgicas han sido reportados en varios años. Engloba conceptos como el de angina alérgica e infarto alérgico. Caso clínico: Presentamos un caso clínico de un hombre de 47 años de edad, con antecedentes de eritema fijo medicamentoso desde hace 10 años. Acude al Departamento de Emergencia por presentar dolor torácico de moderada intensidad, se realiza electrocardiograma el cual es compatible con síndrome coronario agudo sin elevación del segmento ST. Evolucionó favorablemente con tratamiento según protocolo. El estudio posterior demostró hipersensibilidad a antiinflamatorios no esteroideos y las pruebas de estratificación de isquemia cardiovascular fueron negativas, por lo que se concluyó como un caso de angina alérgica. Conclusiones: El síndrome de Kounis es una entidad de difícil diagnóstico que requiere un alto índice de sospecha en la valoración de pacientes con dolor torácico en el Departamento de Emergencia.(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ibuprofeno/efeitos adversos , Isquemia Miocárdica/diagnóstico , Hipersensibilidade a Drogas , Síndrome de Kounis/diagnósticoRESUMO
Introducción: La esclerosis sistémica es una enfermedad crónica multisistémica, caracterizada por alteraciones vasculares, activación inmune y fibrosis de tejidos y órganos. Materiales y métodos: Estudio descriptivo. Pacientes con diagnóstico de Esclerosis Sistémica que cumplieron los criterios de clasificación ACR-EULAR 2013, atendidos en la Unidad de Reumatología del Hospital Carlos Andrade Marín durante el año 2015. Resultados: De 80 pacientes, 18 presentaron esclerosis sistémica en su forma CREST; 32 como CREST incompleto; 14 en la forma difusa; uno con esclerosis sistémica sin esclerosis cutánea; 13 con síndrome de superposición; y, 2 con EMTC. Discusión: Las características clínicas y epidemiológicas de nuestros pacientes coincidieron con las descritas a nivel internacional.
Introduction: Systemic sclerosis is a chronic multisystemic disease characterized by vascular disorders, immune activation, organ and tissue fibrosis. Methods: Descriptive study. Patients diagnosed with systemic sclerosis who met the criteria ACR- EULAR classification 2013, that receive medical care at Carlos Andrade Marín hospital. Results: Prevalence: From 80 patients,18 had systemic sclerosis, full CREST form; 32 had incomplete CREST form; 14 had a diffuse form; one had systemic sclerosis without cutaneous impairment; 13 had overlaping syndrome and two EMTC. Discusion: Clinical and epidemiological characteristics of our patients were consistent with those described in the medical literature.
Assuntos
Humanos , Feminino , Escleroderma Sistêmico , Incidência , Prevalência , Múltiplas Afecções Crônicas , Mulheres , Fibrose , População NegraRESUMO
The association of enumeration and number comparison capacities with arithmetical competence was examined in a large sample of children from 2nd to 9th grades. It was found that efficiency on numerical capacities predicted separately more than 25% of the variance in the individual differences on a timed arithmetical test, and this occurred for both younger and older learners. These capacities were also significant predictors of individual variations in an untimed curriculum-based math achievement test and on the teacher scores of math performance over developmental time. Based on these findings, these numerical capacities were used for estimating the prevalence and gender ratio of basic numerical deficits and developmental dyscalculia (DD) over the grade range defined above (N = 11,652 children). The extent to which DD affects the population with poor ability on calculation was also examined. For this purpose, the prevalence and gender ratio of arithmetical dysfluency (AD) were estimated in the same cohort. The estimated prevalence of DD was 3.4%, and the male:female ratio was 4:1. However, the prevalence of AD was almost 3 times as high (9.35%), and no gender differences were found (male:female ratio = 1.07:1). Basic numerical deficits affect 4.54% of school-age population and affect more boys than girls (2.4:1). The differences between the corresponding estimates were highly significant (α < .01). Based on these contrastive findings, it is concluded that DD, defined as a defective sense of numerosity, could be a distinctive disorder that affects only a portion of children with AD.
Assuntos
Logro , Discalculia/epidemiologia , Discalculia/fisiopatologia , Matemática , Processos Mentais/fisiologia , Adolescente , Fatores Etários , Criança , Estudos de Coortes , Cuba/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Testes Neuropsicológicos , Tempo de Reação/fisiologia , Fatores Sexuais , Estatística como AssuntoRESUMO
In 2006, Utah and New Mexico health departments investigated a multistate cluster of Escherichia coli O157:H7. A case-control study of 22 case-patients found that consuming bagged spinach was significantly associated with illness (p<0.01). The outbreak strain was isolated from 3 bags of 1 brand of spinach. Nationally, 205 persons were ill with the outbreak strain.