Sudden cardiac death due to pharmacological cardioversion of atrial fibrillation

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia. The global prevalence of AF is 0.51% of the world population (37.5 million people) and has increased 33% in the last 20 years. AF may be associated with increased risk of sudden cardiac death (SCD); as well as ischemic stroke or coagulopathies. Coronary heart disease and heart failure are the two most common substrates of SCD. Therefore, the relationship between AF and SCD is particularly difficult to address. AF may have a shared molecular basis with ventricular fibrillation (VF; the most common arrhythmia underlying SCD), as both involve cellular and ion channel abnormalities, respectively, at the atrial and ventricular levels. Presentation of the case: 83-year-old woman, hypertensive, reports asthenia, adynamia and insomnia (21 days); the resting 12-lead electrocardiogram did not report ischemia or necrosis, AF was diagnosed; 160 beats per minute (BPM) (Figure 1). The transthoracic echocardiogram did not show thrombi or effusion; preserved ejection fraction. Pharmacological cardioversion (PC) of AF was performed with oral acetylsalicylic acid 100 mg every 24 h indefinitely; digoxin 0.25 mg orally every 8 hours for 24 hours (impregnation) and 0.25 mg orally every 24 hours (maintenance). After administration of the second dose of digoxin, HOLTER electrocardiographic monitoring detected sustained supraventricular tachycardia. Conclusions: VF caused SCD; the SCD prevented the administration of the third dose of digoxin. Amioradone was not indicated due to age and lack of ventricular response (VR) in AF; its use could prevent VF and SCD. VF is the rhythm that most causes SCD. 70% of SCD are due to coronary disease and, in 40% of SCD, it may be the initial manifestation of coronary disease. Arrhythmias such as VF, in this case, can cause acute ischemia (AI) and subsequently SCD. In cases of AF with VR, low output, and hypotension, electrical cardioversion (EC) is recommended. The PC of the arrhythmia depends on the severity and response of AF, age, ventricular function; atrial size; previous treatments. Cardioversion (PC/EC) is not recommended in elderly people with a history of multiple AF recurrences. According to the European Society of Cardiology and the American College of Cardiology/ American Heart Association, the AF was persistent, long-lasting, and noncardioreversible. Coronary heart disease was not observed. The VF probably caused the AI and, in turn, the AI caused the SCD without the patient reviving. No cardiomyopathies, Brugada syndrome, or coronary heart disease were observed in this case. Due to lack of resources to carry out a genetic study, the presence of single nucleotide polymorphisms associated with cardiac arrhythmias or AF in genes such as SCN5A (rs1805126) and SCN10A (rs6795970), which encoding a subunit of the voltage-gated sodium channel

Ética, productividad humanista y desarrollo sustentable

1 archivo PDF (16 páginas). magyetnMediante las aportaciones de algunos pensadores con criterio integrador, con una misma preocupación por el incierto porvenir de nuestro planeta y por las dificultades actuales para la preservación y la recuperación de la vida digna en muchas regiones, se ha desarrollado el presente trabajo, cuyo principal propósito es el de colaborar con la reflexión académica del desarrollo sustentable. Se parte de dos concepciones diferentes de lo que se entiende por desarrollo sustentable: una reduccionista, apegada a una visión parcial, mecanicista y proclive a la explotación de los recursos naturales y humanos para generar riqueza como meta por sí misma, y no como medio para lograr la productividad humana, más pragmática pero alienada; la otra holística, acorde con categorías éticas universales, menos aceptada pero rectificadora. La argumentación se complementa con la exposición de experiencias personales de los colaboradores en la elaboración de este documento, quienes están insertos en el centro político, económico y cultural de México. ABSTRACT: Through the contributions of some thinkers with an integrative approach and a common concern about the uncertain future of our planet and the current difficulties in the preservation and restoration of decent life in many regions, the present work has been developed with the main purpose of collaborating with the academic reflection of sustainable development. The article starts with two different conceptions from what is understood for sustainable development: a reductionistic, attached to a view that is partial, mechanical and prone to exploitation of natural and human resources to generate wealth as the main goal rather than as means to human productivity, more pragmatic but alienated; the other holistic, in accordance with universal ethical categories, less accepted but rectifiable. The argument is complemented by the exposure of personal experiences of the collaborators of this document, who are present in the political, economic and cultural development of Mexico. PALABRAS CLAVE: Desarrollo sustentable, ética, ecología, productividad humanista. KEYWORDS: Sustainable development, ethics, ecology, humanistic productivity

Propuesta de diseño de una arquitectura de software para comunicación y ejecución de aplicaciones remotas, basado en tecnologías Microsoft.Net.

EL presente proyecto persigue proveer una propuesta de diseño y recomendaciones para un mecanismo de comunicación y ejecución remota de aplicaciones a través de una Red o Internet

The Copper(II)-Thiodiacetate (tda) Chelate as Efficient Receptor of N9-(2-Hydroxyethyl)Adenine (9heade): Synthesis, Molecular and Crystal Structures, Physical Properties and DFT Calculations of [Cu(tda)(9heade)(H2O)]·2H2O

This research was funded by MICIU/AEI of Spain project PID2020-115637GB-I00 FEDER, MICINN of Spain project PGC2018-102047-B-I00, Project B-FQM-478-UGR20 (FEDER-Universidad de Granada, Spain). Funds and instrumental support of research group FQM-283 (Junta de Andalucia, Spain) are also acknowledged.Supplementary Materials: The following supporting information can be downloaded at: https://www. mdpi.com/article/10.3390/molecules28155830/s1Considering that Cu(tda) chelate (tda: dithioacetate) is a receptor for adenine and related 6-aminopurines, this study reports on the synthesis, molecular and crystal structures, thermal stability, spectral properties and DFT calculations related to [Cu(tda)(9heade)(H2O)]& BULL;2H(2)O (1) [9heade: N9-(2-hydroxyethyl)adenine]. Concerning the molecular recognition of (metal chelate)-(adenine synthetic nucleoside), 1 represents an unprecedented metal binding pattern (MBP) for 9heade. However, unprecedentedly, the Cu(tda)-9heade molecular recognition in 1 is essentially featured in the Cu-N1(9heade) bond, without any N6-HMIDLINE HORIZONTAL ELLIPSISO(carboxyl tda) interligand interaction. Nevertheless, N1 being the most basic donor for N9-substituted adenines, this Cu-N1 bond is now assisted by an O2-water-mediated interaction (N6-HMIDLINE HORIZONTAL ELLIPSISO2 and O2MIDLINE HORIZONTAL ELLIPSISCu weak contact). Also, in the crystal packing, the O-H(ol) of 9heade interacts with its own adenine moiety as a result of an O3-water-mediated interaction (O(ol)-HMIDLINE HORIZONTAL ELLIPSISO3 plus O3-H36MIDLINE HORIZONTAL ELLIPSIS & pi;(adenine moiety)). Both water-mediated interactions seem to be responsible for serious alterations in the physical properties of crystalline or grounded samples. Density functional theory calculations were used to evaluate the interactions energetically. Moreover, the quantum theory of atoms-in-molecules (QTAIM), in combination with the noncovalent interaction plot (NCIPlot), was used to analyze the interactions and rationalize the existence and relative importance of hydrogen bonding, chalcogen bonding and & pi;-stacking interactions. The novelty of this work resides in the discovery of a novel binding mode for N9-(2-hydroxyethyl)adenine. Moreover, the investigation of the important role of water in the solid state of 1 is also relevant, along with the chalcogen bonding interactions demonstrated by the density functional theory (DFT) study.MICIU/AEI of Spain project PID2020-115637GB-I00MICINN of Spain project (FEDER-Universidad de Granada, Spain) PGC2018-102047-B-I00, B-FQM-478-UGR20Junta de Andalucí

Enfermedad de Hodgkin variedad esclerosis nodular, hallazgo clínico: Presentación atípica de un caso

Resumen La Enfermedad de Hodgkin (EH) es una entidad neoplásica que se presenta de forma más frecuente en pacientes femeninos, mayores de 16 años, está relacionada a una infección anterior por virus de Epstein-Barr. La presentación de este caso clínico tiene como objetivo describir este padecimiento de la variedad esclerosis nodular en un paciente pediátrico masculino de 12 años de edad, el cual se presentó al servicio de urgencias del Hospital General de Ciudad Juárez con cefalea intensa de un año de evolución. La hospitalización posterior, para el estudio integral del paciente, arrojó la presencia de un ganglio supraclavicular derecho, aumentado de tamaño y asintomático. El diagnóstico arrojado por los estudios clínicos y paraclínicos indica claramente la presencia de EH tipo esclerosis nodular, entidad rara para el tipo de paciente que se presenta. La descripción de este cuadro debe hacernos pensar en la posibilidad de esta patología en pacientes hasta cierto punto atípicos, y poder diagnosticar a estos pacientes en estadio I y II, ya que la EH es asintomática en la mayoría de los casos. Palabras clave: Linfoma de Hodgkin, esclerosis nodular, diagnóstico. Abstract Hodgking’s disease (HD) is a neoplasic entity more often presented in female patients, age 16 and above. It is related to a previous infection by Epstein – Barr virus. The presentation of this clinic case aims to describe this disease of nodular sclerotic variety in a male paediatric patient, age 12, who came to the Ciudad de Juarez General Hospital urgency services with a one-year-evolution intense migraine. The further hospitalization for the patient whole study showed the presence of a right supra-clavicle ganglion, increased in size and asymptomatic. The diagnosis obtained by clinical and paraclinic study clearly indicates the presence of HD type nodular sclerosis, strange entity for the type of patient presented. The description of this picture should make us think in the possibility of this pathology in some atypical patients, and be able to diagnose them in I and II stages, because HD is asymptomatic in most of the cases. Key words: Hodgkin Lymphoma, Nodular sclerosis, diagnosis

Diaphragmatic Rupture Due To Closed Thoracobdominal Trauma: A Case Report

Background. Diaphragmatic injuries (DI) represent less than 1% of traumatic injuries; they are a marker of severe trauma due to associated injuries, although they often go undiagnosed as they remain hidden. If undetected, delayed herniation and strangulation of the abdominal organs into the chest cavity will result as the defect in the diaphragm is not repaired. DI occurs from penetrating or blunt trauma. The former occurs in approximately 67% of cases; direct injury to the diaphragm caused by automobile accidents has been reported. The remaining third is due to falls and crush injuries. Blunt trauma causes larger tears, even bilateral. Mortality from DI reaches 25% of cases and is higher in patients with blunt mechanisms of injury in the acute setting due to associated injuries. Mortality due to delayed presentation with hernia of abdominal contents into the chest due to previous penetrating trauma is 20% and increases with intestinal strangulation. Case presentation. Male, two years, and eight months-old, admitted to the emergency department due to thoraco-abdominal trauma due to being crushed by a truck tire. Tachypnea and stable vital signs were observed. Chest X-ray revealed elevated diaphragm and right pleural effusion. The patient continued to have dyspnea. Abdominal ultrasound confirmed elevation of the hemidiaphragm. Computed tomography of the chest showed the hepatic gland within the chest cavity. In the operating room, a right lateral thoracotomy was performed, observing diaphragmatic rupture. To correct and restore the hepatic gland to its normal anatomical site, the ruptured diaphragm was sutured with 2-0 Prolene®, supported with a bovine pericardium band, and subsequently a 12-Fr® chest tube was placed. In the end, it was closed by planes. Conclusions. The patient presented a blunt diaphragmatic injury. Intra-abdominal pressure increased above the tensile strength of diaphragmatic tissue. The patient evolved favorably in the postoperative period. He was kept under observation for ten days and was discharged without complications. After discharge, follow-up was performed without observing a diaphragmatic hernia or other injury

Coffee Agroecosystem in Mexico: Productive Culture between Tradition and Change

Objective: Understand the productive cultural dynamics that underlies coffee agroecosystems in the Sustainable Rural Development District 005 Fortín, Veracruz, Mexico. Methodology: A survey was applied designed with open and closed questions. Data sets were subjected to analysis of variance, Tukey tests and frequency tables. Results: The coffee agroecosystems in Mexico are complex systems that underlie a particular cultural dynamic expressing a way of conceiving the world, that influences not only on their life, but also on the reproduction of certain management practices whose logic goes beyond economics. The coffee activity is carried out largely by tradition (39 %), characterized by shade-grown Coffea arabica agroecosystems (100 %), with yields lower than 5.87 t ha-1. Limitations of the study/Implications: This is a case study in a specific area of the state of Veracruz, and the results express a local reality. Findings: Producers perform up to four extra-farm economic activities to supplement their family income; paradoxically, this has served as the basis to keep carrying out the coffee activity, thus reducing their economic vulnerability and facilitating the continuity of their production methods and livelihood.Objective: Understand the productive cultural dynamics that underlies coffee agroecosystems in the Sustainable Rural Development District 005 Fortín, Veracruz, Mexico. Methodology: A survey was applied designed with open and closed questions. Data sets were subjected to analysis of variance, Tukey tests and frequency tables. Results: The coffee agroecosystems in Mexico are complex systems that underlie a particular cultural dynamic expressing a way of conceiving the world, that influences not only on their life, but also on the reproduction of certain management practices whose logic goes beyond economics. The coffee activity is carried out largely by tradition (39 %), characterized by shade-grown Coffea arabica agroecosystems (100 %), with yields lower than 5.87 t ha-1. Limitations of the study/Implications: This is a case study in a specific area of the state of Veracruz, and the results express a local reality. Findings: Producers perform up to four extra-farm economic activities to supplement their family income; paradoxically, this has served as the basis to keep carrying out the coffee activity, thus reducing their economic vulnerability and facilitating the continuity of their production methods and livelihood

Aplicación de localización para los cuerpos de socorro

Implementar una aplicación que facilite la localización de personas en estado de riesgo, peligro o contingencia por el cuerpo de Bomberos Voluntario en el municipio de San José Pinula del departamento de Guatemala, así determinar los impactos de la aplicación en las personas y Realizar un benchmarking del mercado para tomar puntos de diferenciación para el desarrollo de la aplicación

Presence of necrotic strains of Potato virus Y in Mexican potatoes

Correction to Ramírez-Rodríguez VR, Frías-Treviño G, Aviña-Padilla K, Silva-Rosales L, Martínez-Soria JP: Presence of necrotic strains of Potato virus Y in Mexican potatoes. Virology Journal 2009, 6:4