Salmonella enteritidis pericarditis with tamponade

Relata-se o caso de paciente feminina, 22 anos, sem história médica prévia relevante, admitida no Serviço de Urgência por cansaço progressivo e dor aguda, referindo queixas abdominais há 72 horas. Avaliação médica revela presença de derrame pericárdio moderado. Internada, evolui em tamponamento cardíaco, requerendo pericardiocentese.É determinada a presença de Salmonella enteritidis no líquido pericárdico, e então iniciado tratamento com antibiótico. O prognóstico foi satisfatório, com recuperação total clínica e ecocardiográfica.Report on a 22 year old female with no relevant prior medical history who was admitted to the Emergency Department complaining of acute chest pain and progressive fatigue, mentioning abdominal complaints 72 hours previously. A medical evaluation showed moderate pericardial effusion. After admission, this developed into pericardial tamponade, requiring pericardiocentesis. Salmonella enteritidis was identified in the pericardial fluid, starting treatment with antibiotics. The prognosis was satisfactory, with complete clinical and echocardiographic recovery.info:eu-repo/semantics/publishedVersio

Dilated Cardiomyopathy Due To H1N1 Virus

Mulher de 58 anos, sem antecedentes médicos relevantes, apresenta infecção respiratória pelo vírus H1N1, requerendo internação na Unidade de Cuidados Intensivos. Após a alta, refere progressiva astenia e dispneia, sendo internada nove meses depois por derrame pleural e infecção respiratória. Avaliação específica pela Cardiologia revela cardiomiopatia dilatada com má função sistólica do ventrículo esquerdo, compatível com miocardite. A ressonância magnética se apresenta compatível com miocardite. Dados os antecedentes e havendo sido descartada doença autoimune e tóxica, associou-se a doença ao vírus H1N1. O prognóstico é muito positivo, com recuperação quase total da função do ventrículo esquerdo.info:eu-repo/semantics/publishedVersio

Plasmatic Klotho and FGF23 levels as biomarkers of CKD-associated cardiac disease in type 2 diabetic patients

Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)/Klotho in Klotho-mediated actions is still under debate. The main objective was to ascertain the potential use of plasmatic Klotho and FGF23 as markers for CKD-associated cardiac disease and mortality.info:eu-repo/semantics/publishedVersio

Independent association of the variant rs1333049 at the 9p21 locus and coronary heart disease

Introdução: Estudos recentes de associação genómica em larga escala (GWAS) identificaram vários polimorfismos de um único nucleótido (SNP), localizados no locus 9p21, associados com doença arterial coronária (DAC). De entre eles o SNP rs1333049 demonstrou uma associação consistente com a DAC tendo sido reproduzida, com sucesso, em várias populações. Objectivo: Investigar se a nova variante rs1333049, no cromossoma 9p21, é um factor de risco independente para DAC, na população Portuguesa. Material e métodos: Estudo caso-controlo, que incluiu 1406 indivíduos, 723 doentes coronários internados consecutivamente (idade média de 53,7±8,9 anos 79,9% do sexo masculino) e 683 controlos sem doença coronária (idade média de 53,3±10,5 anos, 73,9 % do sexo masculino) seleccionados para não serem significativamente diferentes quanto ao sexo e idade. Estudou-se o SNP rs1333049, em todos os indivíduos, com recurso à técnica convencionada de PCR combinada com a técnica TaqMan (Applied Biosystems). Determinou-se a distribuição alélica e genotípica (C/G), odds ratio e respectivo intervalo de confiança para risco de DAC. Foi construído um modelo de regressão logística forward wald ajustado para a idade, sexo, factores de risco convencionais, marcadores bioquímicos e genótipos em estudo, afim de avaliar quais as variáveis associadas de forma significativa e independente com DAC. Resultados: 60% dos doentes coronários e 53% dos controlos apresentaram o alelo C (OR=1,33; p=0,0002), 35,7% dos doentes e 29,3% dos controlos tinham o genótipo homozigoto CC (OR=1,34;p=0,010). O heterozigoto CG estava presente em 48,1% dos doentes e 47% nos controlos, não atingindo significância estatística, para risco vascular (OR=1,05;p=0,670). Após análise multivariada de regressão logística o genótipo CC do cromossoma 9p21 ficou na equação com um OR=1,7, p=0,018 e o genótipo heterozigoto CG com um OR=1,5, p=0,048. Conclusão: Com o presente trabalho replicou-se, numa população portuguesa, o risco coronário ligado à nova variante rs1333049 do cromossoma 9p21. A robustez deste genótipo, tanto em homo como em heterozigotia, tem sido consistente e relevante na estratificação de risco para a DAC, mesmo em contextos populacionais muito diversos. Nestas circunstâncias, a utilização do genótipo CC ou CG poderá vir a revelar-se útil para a previsão do risco de DAC na nossa população.Introduction: Recent genome-wide association studies have identified single-nucleotide polymorphisms (SNPs) at the 9p21 locus as risk factors for coronary artery disease (CAD). Among them, the SNP rs1333049 has demonstrated a consistent association with CAD, which has been successfully replicated in several populations. Aim: To investigate whether the SNP rs1333049 located on the 9p21 chromosome is an independent risk factor for CAD in a Portuguese population. Methods: We performed a case-control study which included 1406 individuals, 723 consecutive coronary patients (mean age 53.7±8.9 years, 79.9% male) and 683 controls without coronary disease (mean age 53.3±10.5 years, 73.9% male). Cases and controls were selected so as not to be significantly different in terms of gender and age. We studied the SNP rs1333049 at the 9p21 locus in all individuals, using standard PCR combined with the TaqMan technique (Applied Biosystems). The allelic and genotype distribution (C/G), odds ratios and corresponding confidence intervals for CAD risk were determined. A forward Wald logistic regression analysis model was constructed, adjusted for age, gender, conventional risk factors, biochemical markers and the genotypes under study, in order to determine which variables were linked significantly and independently with CAD. Results: The C allele was found in 60% of the CAD patients and 53% of the controls, with OR=1.33; p=0.0002. The CC genotype appeared in 35.7% of CAD patients, with OR=1.34, p=0.010. The heterozygous CG genotype was present in 48.1% of the CAD patients and 47% of the controls, and did not present vascular risk (OR=1.05, p=0.670). After logistic regression analysis, the CC genotype remained in the equation with OR=1.7; p=0.018 and CG with OR=1.5, p=0.048. Conclusion: In the present study we replicated the coronary risk linked to the recently discovered variant rs1333049 on the 9p21 chromosome in a Portuguese population. Although the mechanism underlying the risk is still unknown, the robustness of this risk allele in risk stratification for CAD has been consistent, even in very different populations. The presence of the CC or CG genotype may thus prove to be useful for predicting the risk of developing CAD in the Portuguese population.info:eu-repo/semantics/publishedVersio

Diabetes and Cardiovascular Disease: prognosis five years after percutaneous revascularization

Fundamentos: O diabetes mellitus (DM) é reconhecidamente fator de risco cardiovascular. Sabendose que a intervenção coronariana percutânea (ICP) melhora o prognóstico da doença coronariana (DC), pretendemos verificar se esse efeito é similar em doentes diabéticos (D) e não diabéticos (ND). Objetivo: Analisar o prognóstico em longo prazo do DM em pacientes submetidos a ICP. Métodos: Estudo de coorte, unicêntrico, retrospectivo, envolvendo pacientes consecutivos submetidos à ICP, eletiva ou de urgência, entre janeiro 2002 e dezembro 2003. Definiram-se dois grupos: pacientes com DM (D) e sem DM (ND). Compararam-se as variáveis clínicas e angiográficas da ICP com o resultado clínico ao final de cinco anos. Definiram-se como eventos maiores cardiovasculares (EMC): morte, nova síndrome coronariana aguda, acidente vascular encefálico (AVE) e nova revascularização cirúrgica ou ICP. Foram ainda avaliadas as taxas de trombose de stent, revascularização do vaso-alvo (RVA) e revascularização da lesão-alvo (RLA). Resultados: O seguimento em cinco anos foi 94%. Foram realizadas 446 ICP em 406 pacientes, média de idade =63,0±11 anos, 70,4% masculino. Destes, 128 (31,5%) eram do grupo D. Em cinco anos o valor de EMC foi 50,7% para D e 36,7% para N. Encontrou-se mortalidade global de 28,1% vs. 14,4% (p=0,0016) e mortalidade cardiovascular de 15,6% vs. 8,3% (p=0,039), respectivamente, para D vs. ND. Os restantes parâmetros não foram estatisticamente significativos. Não houve diferenças em termos de trombose de stent e tipos de stent utilizados nos dois grupos.Background: Diabetes Mellitus (DM) is a recognized cardiovascular risk factor, and knowing that percutaneous coronary intervention (PCI) improves prognoses of coronary artery disease (CAD), we intend to ascertain whether this effect is similar in diabetic (D) and nondiabetic (ND) patients. Objective: To analyze the long term impact of DM in patients undergoing PCI. Methods: Retrospective unicentric cohort study of consecutive patients undergoing elective or urgent PCI between January 2002 and December 2003, divided into two groups: diabetic (D) and non-diabetic (ND). Clinical, angiographic and coronary intervention PCI profiles were compared to clinical outcome at 5 years. Major cardiovascular events (MACE) were defined as death, new acute coronary syndrome (ACS), stroke (S), and new surgical (CABG) or percutaneous (PCI) revascularization. The stent thrombosis, target vessel revascularization (TVR) and target lesion revascularization (TLR) rates were also evaluated. Results: The five year follow-up rate was 94%. During the study, 446 PCIs were performed on 406 patients; 63.0±11 years old, 70.4% male. Among them, 128 (31.5%) were D. At the five-year follow-up, the MACE rate was 50.7% for D and 36.7% for ND (p=0.01). The global mortality rates were 28.1% vs 14.4% (p=0.0016) and the cardiovascular mortality rates were 15.6% vs. 8.3% (p=0.039) for D and ND respectively. The remaining parameters were not statistically significant. No differences were noted between stent thrombosis and the stent types used in both groups.info:eu-repo/semantics/publishedVersio

Surgical Mask Use in Physical Ecercise in Young Healthy Subjects Sume Trial

In the context of the COVID-19 pandemic, the use of surgical masks has become the new normal. The use of these devices in exercise and medical situations has been advocated with the purpose of reducing contagions, but some concerns exist regarding its impact of physical fitness and safety of use. If the use of mask while exercising can cause decreased functional capacity or dangerous hypoxemia is still something we know little of. Therefore, we performed maximal treadmill stress tests in 12 healthy young subjects, with and without surgical mask use, and measured exercise capacity, oxygen saturation (rest, peak exercise and post-exercise) and electrocardiographic changes on a standard treadmill test. Exercise capacity and oxygen saturation levels decreased in peak exercise vs rest in a statistically significant manner when mask was used. ECG changes, although not significant, were present in 3 subjects when mask was used and disappeared when the test was made unmasked. We concluded that masked exercise has the potential to cause decreased exercise load and oxygen saturation and potentially cause diagnostic errors in medical exams