Neumopericardio debido a herida por arma blanca

Hombre de 24 años de edad que ingresó en el hospital debido a una herida por arma blanca penetrante en el hemitórax derecho. La herida, de 3 cm a nivel de la piel, se localizaba a nivel del segundo espacio intercostal derecho y la radiografía de tórax demostró un neumotórax del mismo lado y una colección radiotransparente, por debajo del pericardio parietal, desde el origen de los grandes vasos hasta la porción apical del ventrículo izquierdo

Neumopericardio debido a herida por arma blanca

Hombre de 24 años de edad que ingresó en el hospital debido a una herida por arma blanca penetrante en el hemitórax derecho. La herida, de 3 cm a nivel de la piel, se localizaba a nivel del segundo espacio intercostal derecho y la radiografía de tórax demostró un neumotórax del mismo lado y una colección radiotransparente, por debajo del pericardio parietal, desde el origen de los grandes vasos hasta la porción apical del ventrículo izquierdo

Factores asociados a la prehipertensión arterial en jóvenes de 20 a 25 años de edad

Introduction: Hypertension is a major health problem worldwide. Prehypertension is a category that has been little studied in young adults.Objective: To determine the factors associated with prehypertension in young adults between 20-25 years of age.Method: A descriptive cross-sectional study was conducted in a universe consisting of 257 second-year medical students. A total of 134 young adults, between 20-25 years of age, were selected by simple random sampling in the academic year 2009-2010.Results: The prevalence of prehypertension was 27.6 %. Males (51.5 %) and white skin subjects (59.7 %) were the most affected. Home environment, a personal history of low birth weight (OR=2.3; p=0.179) and gestational age less than 37 weeks (OR= 2.5; p=0.187) did not influence the possibility of having prehipertensives figures in the subjects of this sample.Conclusions: The high body mass index (OR=34.1; p<0.001), family history of hypertension (OR=12, p<0.01) and family obesity (χ2=11.19, p=0.001) were the factors most strongly associated with prehypertension in these young people.Introducción: La hipertensión arterial constituye un importante problema de salud a nivel mundial. La prehipertensión es una categoría que se ha estudiado poco en los jóvenes.Objetivo: Determinar los factores asociados a la prehipertensión arterial en jóvenes entre 20 a 25 años de edad.Método: Se realizó un estudio descriptivo y transversal a un universo constituido por 257 estudiantes de segundo año de medicina. Por muestreo aleatorio simple se escogieron 134 jóvenes entre 20 a 25 años de edad, correspondientes al curso académico 2009-2010.Resultados: Se observó una prevalencia de prehipertensión arterial de 27,6 %. Los del sexo masculino (51,5 %) y de color de piel blanca (59,7 %) fueron los más afectados. El ambiente familiar, el antecedente personal de bajo peso al nacer (OR=2,3; p=0.179) y la edad gestacional menor de 37 semanas (OR=2,5; p=0.187) no influyeron en la posibilidad de presentar cifras prehipertensivas en los jóvenes de esta muestra.Conclusiones: El índice de masa corporal elevado (OR=34,1; p<0.001), los antecedentes familiares de hipertensión arterial (OR=12; p<0.01) y la obesidad familiar (χ2=11,19; p=0.001), fueron los factores más fuertemente asociados a la prehipertensión arterial en estos jóvenes

Caracterización de la fibrilación auricular en el Servicio de Medicina Interna del Hospital Nacional San Rafael (El Salvador)

Introduction: Atrial fibrillation is a serious health problem. Central American countries are not exempt from this scourge.Objective: To characterize atrial fibrillation, specify its clinical and epidemiological variables and determine stroke risks by using CHA2DS2-VASc score.Method: A descriptive and prospective study was carried out on 107 patients admitted with diagnosis of atrial fibrillation, in the Department of Internal Medicine at “Hospital Nacional San Rafael” from Santa Tecla city, La Libertad, El Salvador, from January to July 2013. The clinical and epidemiological variables were analyzed, an echocardiogram was performed on all patients and CHA2DS2-VASc risk score was calculated. Methods were used to establish the relationships betweenvariables.Results: More than half of atrial fibrillation patients (57.0%; p=0.015) are women, 51.4% white and the average age is 74.7 ± 13.8 years. 80.4% of patients have non-valvular atrial fibrillation. There was hypertension prevalence (54.2%), ischemic heart disease (28.0%), hypertensive (23.4%) and dilated cardiomyopathies (24.3%), and permanent atrial fibrillation (49.5%). The left atrium average size was 42.67 ± 8.2 mm. The lower ejection fraction (p=0.012) and increased left ventricular diastolic diameter (p=0.004) showed significant relationship with the occurrence of non-valvular atrial fibrillation. 84.9% of patients have a high risk of stroke according to CHA2DS 2-VASc score. Age older than 75 years (p <0.001), between 65 and 74 (p=0.025), female sex (p=0.001) and increased thickness of the interventricular septum (p=0.006) were associated with higher risk.Conclusions: The lower ejection fraction and increased left ventricular diastolic diameter were associated with atrial fibrillation. Most patients have a high risk of stroke; variables associated are older age, female gender and increased thickness of the interventricular septum.Introducción: La fibrilación auricular es un serio problema de salud y los países centroamericanos no escapan de este flagelo.Objetivo: Caracterizar la fibrilación auricular, precisar sus variables clínico-epidemiológicas y determinar el riesgo de accidente cerebrovascular, a partir del uso de la escala CHA2DS2-VASc.Método: Se realizó un estudio descriptivo y prospectivo en 107 pacientes que ingresaron, con diagnóstico de fibrilación auricular, en el servicio de Medicina Interna del Hospital Nacional San Rafael de la ciudad de Santa Tecla, La Libertad, El Salvador; en el período de enero a julio de 2013. Se analizaron las variables clínico-epidemiológicas, se realizó ecocardiograma a todos los pacientes y se calculó la escala de riesgo CHA2DS2-VASc. Se utilizaron métodos para establecer las relaciones entre las variables.Resultados: Más de la mitad de los pacientes con fibrilación auricular (57,0 %; p= 0,015) son mujeres, el 51,4 % tiene color blanco de piel y una edad media de 74,7 ± 13,8 años. El 80,4 % de los pacientes tiene una fibrilación auricular no asociada a valvulopatía. Predominaron la hipertensión arterial (54,2 %), las cardiopatías isquémica (28,0 %) e hipertensiva (23,4 %), la miocardiopatía dilatada (24,3 %) y la fibrilación auricular permanente (49,5 %). La media del tamaño de la aurícula izquierda fue de 42,67 ± 8,2 mm. La menor fracción de eyección (p=0,012) y el mayor diámetro diastólico del ventrículo izquierdo (p=0,004) mostraron relación significativa con la aparición de fibrilación auricular de origen no valvular. El 84,9 % de los pacientes tiene alto riesgo de ACV según el puntaje de CHA2DS2-VASc. La edad mayor de 75 años (p<0,001), de 65-74 (p=0,025), el sexo femenino (p=0,001) y el mayor grosor del septum interventricular (p=0,006), se asociaron al mayor riesgo.Conclusiones: La menor fracción de eyección y el mayor diámetro diastólico del ventrículo izquierdo se relacionaron con la fibrilación auricular. La mayoría de los pacientes presenta un riesgo elevado de accidente cerebrovascular, las variables que se le asocian son: la mayor edad, el sexo femenino y el mayor grosor del septum interventricular

Characterization of atrial fibrillation in the Department of Internal Medicine at “Hospital Nacional San Rafael” (El Salvador)

Introduction: Atrial fibrillation is a serious health problem. Central American countries are not exempt from this scourge. Objective: To characterize atrial fibrillation, specify its clinical and epidemiological variables and determine stroke risks by using CHA2DS2-VASc score. Method: A descriptive and prospective study was carried out on 107 patients admitted with diagnosis of atrial fibrillation, in the Department of Internal Medicine at “Hospital Nacional San Rafael” from Santa Tecla city, La Libertad, El Salvador, from January to July 2013. The clinical and epidemiological variables were analyzed, an echocardiogram was performed on all patients and CHA2DS2-VASc risk score was calculated. Methods were used to establish the relationships between variables. Results: More than half of atrial fibrillation patients (57.0%; p=0.015) are women, 51.4% white and the average age is 74.7 ± 13.8 years. 80.4% of patients have non-valvular atrial fibrillation. There was hypertension prevalence (54.2%), ischemic heart disease (28.0%), hypertensive (23.4%) and dilated cardiomyopathies (24.3%), and permanent atrial fibrillation (49.5%). The left atrium average size was 42.67 ± 8.2 mm. The lower ejection fraction (p=0.012) and increased left ventricular diastolic diameter (p=0.004) showed significant relationship with the occurrence of non-valvular atrial fibrillation. 84.9% of patients have a high risk of stroke according to CHA2DS 2-VASc score. Age older than 75 years (p <0.001), between 65 and 74 (p=0.025), female sex (p=0.001) and increased thickness of the interventricular septum (p=0.006) were associated with higher risk. Conclusions: The lower ejection fraction and increased left ventricular diastolic diameter were associated with atrial fibrillation. Most patients have a high risk of stroke; variables associated are older age, female gender and increased thickness of the interventricular septum

Measurements of the Total and Differential Higgs Boson Production Cross Sections Combining the H??????? and H???ZZ*???4??? Decay Channels at s\sqrt{s}=8??????TeV with the ATLAS Detector

Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3~fb$^{-1}$ of $pp$ collisions produced by the Large Hadron Collider at a center-of-mass energy of $\sqrt{s} = 8$ TeV and recorded by the ATLAS detector. Cross sections are obtained from measured $H \rightarrow \gamma \gamma$ and $H \rightarrow ZZ ^{*}\rightarrow 4\ell$ event yields, which are combined accounting for detector efficiencies, fiducial acceptances and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be $\sigma_{pp \to H} = 33.0 \pm 5.3 \, ({\rm stat}) \pm 1.6 \, ({\rm sys}) \mathrm{pb}$. The measurements are compared to state-of-the-art predictions.Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3  fb-1 of pp collisions produced by the Large Hadron Collider at a center-of-mass energy of s=8  TeV and recorded by the ATLAS detector. Cross sections are obtained from measured H→γγ and H→ZZ*→4ℓ event yields, which are combined accounting for detector efficiencies, fiducial acceptances, and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be σpp→H=33.0±5.3 (stat)±1.6 (syst)  pb. The measurements are compared to state-of-the-art predictions.Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3 fb$^{-1}$ of $pp$ collisions produced by the Large Hadron Collider at a center-of-mass energy of $\sqrt{s} = 8$ TeV and recorded by the ATLAS detector. Cross sections are obtained from measured $H \rightarrow \gamma \gamma$ and $H \rightarrow ZZ ^{*}\rightarrow 4\ell$ event yields, which are combined accounting for detector efficiencies, fiducial acceptances and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be $\sigma_{pp \to H} = 33.0 \pm 5.3 \, ({\rm stat}) \pm 1.6 \, ({\rm sys}) \mathrm{pb}$. The measurements are compared to state-of-the-art predictions