Anestesia para cirurgia ortopédica em criança com susceptibilidade à hipertermia maligna: relato de caso Anestesia para cirugía ortopédica en niño con susceptibilidad a la hipertermia maligna: relato de caso Anesthesia for orthopedic surgery in a child susceptible to malignant hyperthermia: case report

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Renato Santiago Gomez

2003-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Hipertermia maligna é uma miopatia autossômica dominante desencadeada por anestésicos inalatórios e bloqueadores neuromusculares, como halotano e succinilcolina, causando aumento da temperatura que pode ser fatal sem o tratamento imediato. O objetivo deste relato é descrever a conduta anestésica em uma criança susceptível à hipertermia maligna que foi submetida a procedimento cirúrgico ortopédico. RELATO DO CASO: Paciente do sexo feminino, com 3 anos, portadora de luxação congênita do quadril e susceptibilidade à hipertermia maligna, conforme história de anestesia anterior, foi submetida à correção cirúrgica ortopédica sob anestesia geral, com propofol e fentanil, associada à anestesia peridural lombar. A temperatura da paciente foi monitorizada continuamente durante a cirurgia e no período pós-operatório. A paciente apresentou recuperação pós-operatória sem intercorrências e recebeu alta hospitalar após cinco dias. CONCLUSÕES: A combinação de anestesia regional e venosa para o procedimento cirúrgico proposto em paciente com susceptibilidade à hipertermia maligna permitiu a condução anestésica com segurança.JUSTIFICATIVA Y OBJETIVOS: Hipertermia maligna es una miopatia autosómica dominante desencadenada por anestésicos inhalatorios y bloqueadores neuromusculares, como halotano y succinilcolina, causando aumento de la temperatura que puede ser fatal sin el tratamiento inmediato. El objetivo de este relato es describir la conducta anestésica en un niño susceptible a la hipertermia maligna que fue sometida a procedimiento quirúrgico ortopédico. RELATO DEL CASO: Niño, del sexo femenino, con 3 años, portadora de luxación congénita del cuadril (anca y susceptibilidad a la hipertermia maligna, conforme historia de anestesia anterior, fue sometida a la corrección quirúrgica ortopédica bajo anestesia general, con propofol y fentanil, asociada a anestesia peridural lumbar. La

Neoplasias malignas de glândulas salivares: estudo retrospectivo = Malignant neoplasms of salivary glands: retrospective study

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Barbosa, Renata Pereira de Sousa et al.

2005-01-01

Full Text Available Este trabalho objetivou identificar a ocorrência de neoplasias malignas em glândulas salivares de pacientes dos hospitais de referência no tratamento de Câncer do Estado da Paraíba no período de 1998 a 2003. Foi realizado um estudo retrospectivo pelo método indireto, através da análise de 914 prontuários arquivados do Hospital Dr. Napoleão Laureano, em João Pessoa-PB, e do Centro de Cancerologia Ulisses Pinto, em Campina Grande-PB. Encontrou-se 29 casos de neoplasias malignas de glândulas salivares, dos quais 53,6% acometeram indivíduos do gênero masculino e 46,4% do feminino; a faixa etária com maior número de casos foi de 61-80 anos com 48,3%. A glândula parótida apresentou maior prevalência com 48,3%, sendo o tipo neoplásico com maior representação da amostra o Carcinoma adenóide cístico com 58,6%

Valor diagnóstico del pepsinógeno i/ii como biomarcador de lesiones pre-malignas y malignas gástricas: revisión sistemática

OpenAIRE

Hidalgo Mora, Viviana Marcela; Whang, Joon Kyung

2016-01-01

Antecedentes: El cáncer gástrico se diagnostica tardíamente. Sólo en países como Corea y Japón existen políticas de tamizaje, que se justificarían en cualquier país con alta prevalencia de cáncer gástrico como Colombia o Chile. El análisis del pepsinógeno sérico se ha propuesto para el diagnóstico de lesiones premalignas y malignas gástricas, por lo cual se pretende revisar sistemáticamente en la literatura el valor diagnóstico del cociente pepsinógeno I/II como marcador de lesiones premalign...

Comentario al margen del artículo estenosis malignas del estómago

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Gaitán Yanguas, Mario

2012-01-01

Leyendo la magnífica contribución que con el título anotado publicaron los doctores Jácome, Gutierrez, Parra, Forero y Medina en la página 214 del volumen 22 de la Revista de la Facultad de Medicina, encontré que dicen los autores que "entre los 301 casos de estenosis malignas del estómago observados en el Instituto Nacional de Cancerología no se encuentra ningún caso" de sarcoma gástrico, y que todos corresponden a carcinomas (escamosos ó glandulares). Sin embargo, existen en los archivos...

RASTREAMENTO MAMOGRÁFICO: DETECÇÃO DE LESÕES NEOPLÁSICAS MALIGNAS EM MULHERES DE SANTA CATARINA E DO BRASIL

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Luciana Martins da Rosa

2016-01-01

Full Text Available El objetivo fue analizar las tasas de incidencia de lesión neoplásica maligna según tipo de detección y distribución proporcional de mamografías en mujeres de 40 a 69 años del Estado de Santa Catarina y de Brasil. Se trata de un estudio observacional descriptivo fundamentado en datos del Departamento de Tecnología de la Información del Sistema Único de Salud entre 2009 y 2012 y del Instituto Brasileño de Geografía y Estadística. En Brasil y en Santa Catarina, la mayor cobertura de la mamografía en mujeres de 45 a 49 años fue de 22,2% y 23,1% respectivamente. La mayor distribución proporcional fue de 89,2% en las brasileñas de 40 a 44 años y de 50 a 54 años en Santa Catarina. Las tasas de incidencia de lesión neoplásica maligna de mama diagnosticada por imagen se elevaron en el Brasil y Santa Catarina. En 2012, en Brasil la mayor detección ocurrió por medio de la palpación y en Santa Catarina a través de imagen en 2012. Se concluye que el cribado mamográfico está por debajo del nivel recomendado. Mayores distribuciones proporcionales de mamografías permitieron mayor número de diagnósticos de lesiones neoplásicas malignas y finalmente, la realización de la mamografía a partir de los 40 años contribuyó para el diagnóstico de cáncer de mama entre la fase etaria de 40 a 49 años.

El poder del testimonio, experiencias de mujeres

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Rosana Paula Rodríguez

2013-09-01

experiencia singular. Las palabras de las mujeres que relatan experiencias corporales nombran una dimensión fundamental de nuestra experiencia, la de la diferencia sexual produciendo un dislocamiento en la presunta neutralidad de la lengua. Se trata de una reflexión que abre la posibilidad de poner palabras a lo innombrable.

La experiencia docente en un MOOC

OpenAIRE

Ramírez Montoya, María Soledad

2013-01-01

1. Objetivo de la conferencia; 2. Antecedentes de experiencias de cursos masivos; 3. Experiencia en un curso MOOC-Proyecto SINED-CLARISE para la educación a distancia; 4. Preparación para un curso MOOC en Coursera

324. Asistencia ventricular mecánica. Experiencia del centro del corazón, berlín (berlin heart institute, alemania

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T. Chávez

2012-04-01

Conclusiones: Sistemas de asistencia ventricular ofrecen la posibilidad de auxiliar o reemplazar por completo un corazón dañado. La mortalidad como consecuencia de cardiomiopatías dilatadas agudas o falla cardíaca por infarto agudo de miocardio ha sido considerablemente reducida mediante la aplicación de estos sistemas de asistencia ventricular.

Results of 52 cases with struma maligna treated with radio-iodine

International Nuclear Information System (INIS)

Grebe, S.F.; Huth, K.D.

1982-01-01

Results of 52 cases with struma maligna treated with radio-iodine. Between 1966 and 1977, 52 thyroid carcinoma patients received radio-iodine therapy. Their age ranged from 18 to 82 years. Out of 52 patients, 46 underwent surgery with 26 thyrodectomized subtotally and 20 totally so. No surgery was performed in 6 cases since this was refused in 2 cases and inoperable for clinical reasons in 4 cases. Radio-iodine treatment was performed 6 to 10 weeks after operation or 2 to 4 weeks after diagnosis. In 9 cases, additional irradiation therapy was performed on metastases (predominantly in skeleton) at total doses ranging between 2500-7500 R focal dose for palliative reasons. In terms of summary, the authors draw the conclusion that surgical ablation of thyroid tissue as total as possible combined with subsequent radio-iodine treatments till complete destruction of the iodine-storing tissue imposes as the optimum treatment of follicular and papillary thyroid carcinoma. (orig./MG) [de

Una experiencia del atletismo en Cantabria

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Castillo Saornil, Santos

2017-01-01

Tesina titulada "Una experiencia del atletismo en Cantabria" del autor Santos Castillo Saornil y dirigida por el profesor Jesús Patricio Durán Piqueras. Instituto Nacional de Educación Física, curso 1983-1984. Consta de los siguientes capítulos: enseñanza del atletismo, iniciación al atletismo, la lección de iniciación al atletismo, iniciación a las carreras, experiencias personales, conclusiones y bibliografía.

EXPERIENCIAS EXTRASENSORIALES Y EXPERIENCIAS ALUCINATORIAS: EXAMINANDO LA HIPÓTESIS DEL CONTINUO DE EXPERIENCIAS ESQUIZOTÍPICAS/ EXTRASENSORIAL AND HALLUCINATORY EXPERIENCES: EXAMINING THE CONTINUOUS THEORY ON SCHIZOTYPAL EXPERIENCES

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Alejandro Parra*

2010-05-01

Full Text Available RESUMENUna experiencia extrasensorial es aquella en la que parece que la mente de una persona ha adquirido la informaciónremota, es decir, aparentemente sin la mediación de los sentidos humanos conocidos o procesos de inferencia lógica. Portanto, lo «extrasensorial» en la experiencia extrasensorial corresponde a juzgar por las apariencias y no necesariamente a larealidad, mientras que lo «extrasensorial» en la percepcion extrasensorial se refiere a la naturaleza de una presunta realidadparanormal. Se ponen a prueba dos hipótesis específicas: Una muestra de estudiantes argentinos que reportan haber tenidoexperiencias extrasensoriales tienen mayor capacidad de experimentar (1 alucinaciones visuales y táctiles, y (2 propensióna la esquizotipia en comparación con quienes no tuvieron experiencias extrasensoriales. Los resultados mostraron mayornivel de esquizotipia cognitivo-perceptual y propensión a la alucinación en individuos con experiencias que quienes no lastuvieron. Los resultados sugieren que hay procesos disociativos subyacentes, como absorción y propensión a la fantasía,que parecen estar asociadas a las experiencias extrasensoriales.ABSTRACTAn extrasensory experience is one in which it appears that the experient’s mind has acquired information directly, thatis, seemingly without either the mediation of the recognized human senses or the processes of logical inference. The«extrasensory» in extrasensory experience therefore pertains to appearances and not necessarily to reality, whereas the«extrasensory» in extrasensory perception refers to the nature of a hypothesized paranormal reality. Two specific hypothesesare tested: A sample of Argentinean participants who have reported Extrasensorial experiences have a higher capacity for (1visual and tactile hallucination, and (2 schizotypy proneness than non--experients. The results showed a higher level ofcognitive-perceptual schizotypy and hallucination proneness in

Hipertermia maligna no Brasil: análise da atividade do hotline em 2009

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Helga Cristina Almeida da Silva

2013-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Hipertermia maligna (HM é doença farmacogenética, com reação hipermetabólica anormal a anestésicos halogenados e/ou relaxantes musculares despolarizantes. Desde 1991 há um serviço hotline de atendimento telefônico para HM no Brasil, disponível 24 horas por dia, em São Paulo. Este artigo analisa a atividade do serviço brasileiro de hotline para HM em 2009. MÉTODOS: Análise prospectiva de todas chamadas telefônicas paria maligna (HM é doença farmacogenética, com reação hipermetabólica anormal a anestésicos halogenados e/ou relaxantes musculares despolarizantes. Desde 1991 há um serviço hotline de atendimento telefônico para HM no Brasil, disponível 24 horas por dia, em São Paulo. Este art go analisa a at vidade do serviço brasileiro de hotline para HM em 2009a o serviço brasileiro de hotline para HM, de janeiro a dezembro de 2009. RESULTADOS: Foram recebidas 22 ligações; 21 provenientes do Sul-Sudeste do Brasil e uma do Norte. Quinze eram pedidos de informações gerais sobre HM. Sete foram suspeitas de crises agudas de HM, das quais duas não foram consideradas como HM. Nas cinco crises compatíveis com HM, todos os pacientes receberam anestésicos inalatórios halogenados (2 isoflurano, 3 sevoflurano e um usou também succinilcolina; havia quatro homens e uma mulher, com média de idade de 18 anos (2-27. Problemas descritos nas cinco crises de HM: taquicardia (cinco, aumento do gás carbônico expirado (quatro, hipertermia (três, acidemia (um, rabdomiólise (um e mioglobinúria (um. Um paciente recebeu dantrolene. Todos os cinco pacientes com crises de HM foram seguidos em unidade de terapia intensiva e recuperaram-se sem sequelas. A suscetibilidade à HM foi posteriormente confirmada em dois pacientes por meio do teste de contratura muscular in vitro. CONCLUSÕES: O número de chamadas por ano no serviço brasileiro de hotline para HM ainda é reduzido. As características das crises

Lesiones premalignas y malignas de cérvix en adolescentes y mujeres jóvenes. Clínica Maternidad Rafael Calvo, Cartagena

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Ivette Marina Romero Pérez, MD* Clarena Ceballos Díaz, MD** Álvaro Monterrosa Castro, MD**

2009-04-01

Full Text Available Objetivo: Determinar la frecuencia de lesiones premalignas y malignas de cérvix en adolescentes y mujeres jóvenes. Métodos: Estudio descriptivo transversal de 136 historias clínicas de pacientes entre 14 y 24 años remitidas al Servicio de Patología Cervical de Clínica Maternidad Rafael Calvo. Se evaluaron citología, colposcopia y estudio histopatológico. Resultados: La edad media fue de 21,0 (DE 2,4 años, la de inicio de vida sexual de 16,0 (DE 1,9 y la del primer embarazo 15,0 (DE 6,1 años. El 51,4% informaron dos o más compañeros sexuales. Treinta y seis (26,4% eran adolescentes y 100 (73,6% adultas jóvenes de 20 a 24 años. El 48,5% de toda la población tuvo citología anormal. Se observaron hallazgos colposcópicos de lesiones premalignas en 48 pacientes (35,3%: 12 adolescentes y 36 adultas. Se realizaron 50 biopsias: 39 (78,0% resultaron con lesiones de bajo grado, nueve (18,0% lesiones de alto grado y una (2% con cáncer de cérvix infiltrante. No se observó diferencia estadísticamente significativa entre la frecuencia de LIE de bajo o alto grado entre adolescentes y adultas jóvenes. En las pacientes con lesiones de alto grado y cáncer se observó una mayor frecuencia de inicio de vida sexual antes de 16 años y más de un compañero sexual. Conclusión. Se observó una mayor frecuencia de lesiones premalignas y malignas que las descritas en otros estudios. Nuevas evaluaciones deben inferir las causas que influyen en el incremento en la presencia de LIE a edades tempranas. [Romero IM, Ceballos C, Monterrosa A. Lesiones premalignas y malignas de cérvix en adolescentes y mujeres jóvenes. Clínica Maternidad Rafael Calvo, Cartagena. MedUNAB 2009; 12: 14-18].

Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis.

Science.gov (United States)

Lallas, A; Tschandl, P; Kyrgidis, A; Stolz, W; Rabinovitz, H; Cameron, A; Gourhant, J Y; Giacomel, J; Kittler, H; Muir, J; Argenziano, G; Hofmann-Wellenhof, R; Zalaudek, I

2016-05-01

Dermoscopy is limited in differentiating accurately between pigmented lentigo maligna (LM) and pigmented actinic keratosis (PAK). This might be related to the fact that most studies have focused on pigmented criteria only, without considering additional recognizable features. To investigate the diagnostic accuracy of established dermoscopic criteria for pigmented LM and PAK, but including in the evaluation features previously associated with nonpigmented facial actinic keratosis. Retrospectively enrolled cases of histopathologically diagnosed LM, PAK and solar lentigo/early seborrhoeic keratosis (SL/SK) were dermoscopically evaluated for the presence of predefined criteria. Univariate and multivariate regression analyses were performed and receiver operating characteristic curves were used. The study sample consisted of 70 LMs, 56 PAKs and 18 SL/SKs. In a multivariate analysis, the most potent predictors of LM were grey rhomboids (sixfold increased probability of LM), nonevident follicles (fourfold) and intense pigmentation (twofold). In contrast, white circles, scales and red colour were significantly correlated with PAK, posing a 14-fold, eightfold and fourfold probability for PAK, respectively. The absence of evident follicles also represented a frequent LM criterion, characterizing 71% of LMs. White and evident follicles, scales and red colour represent significant diagnostic clues for PAK. Conversely, intense pigmentation and grey rhomboidal lines appear highly suggestive of LM. © 2015 British Association of Dermatologists.

La experiencia de la maternidad en mujeres feministas

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Natalie Sánchez Benítez

2016-01-01

Full Text Available El siguiente artículo sitúa sus relexiones sobre la maternidad desde el feminismo y describe cuáles son las e xperiencias de la maternidad cuando se es mujer feminista, para el caso especí- ico de la organización Casa de la Mujer. Los ejes de análisis son: i la experiencia ambivalente del deseo; ii las experiencias de exclusión y vulneración; iii pareja y crianza, encuentros y desencuentros; y iv autonomía. Se concluye que en la experiencia hay varios elementos que potencian la reconiguración subjetiva de las mujeres madres y no madres, feministas y no feministas.

Surgical ablation of ventricular tachycardia secondary to congenital ventricular septal aneurysm.

Science.gov (United States)

Graffigna, A; Minzioni, G; Ressia, L; Vigano, M

1994-04-01

Three patients underwent surgical ablation for ventricular tachycardia resulting from an aneurysm of the membranous portion of the ventricular septum. Two patients had a definite history of cardiac murmur during infancy, and one of them was found at the time of operation to have a left-to-right shunt through the apex of the aneurysm. The earliest ventricular activation sites were located around the neck of the aneurysm and were ablated in 1 patient by encircling the endocardial ventriculotomy and by cryoablation in the remaining 2. After focus resection had been completed, aneurysm resection and ventricular septal reconstruction were performed. All patients were alive and free of ventricular tachycardia and did not need medication as of 61, 66, and 88 months postoperatively. Spontaneous closure of a ventricular septal defect may lead to the formation of an aneurysm in the ventricular septum that may sustain ventricular tachycardias. Such arrhythmias can be effectively treated using electrically guided surgical techniques.

Estudio de Caso de la Experiencia Subjetiva del Cuerpo

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Edith Flores Pérez

2007-01-01

Full Text Available Estudio de caso que explora la experiencia subjetiva del cuerpo en la trayectoria con el uso de drogas a través del relato de vida. Se utilizó la entrevista abierta bajo los supuestos metodológicos del relato autobiográfico. Se propuso al participante “Hablar de sí mismo y contar su experiencia con el uso de drogas”. La estrategia analítica se diseñó con base en la propuesta de Barthes (1990 para el análisis estructural de los relatos. Los resultados muestran que en el relato emerge una subjetividad que articula modos de haber sido y ser cuerpo como instancias constitutivas de la existencia. Desde el punto de vista de la corporalidad, la trayectoria con el uso de drogas deviene en una relación de saber-poder con el propio cuerpo, donde la experiencia subjetiva se entreteje en una red de controles y normas sociales. El análisis del cuerpo como experiencia enriquece la comprensión de prácticas como el uso de drogas.

Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

DEFF Research Database (Denmark)

Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

2013-01-01

Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...... [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients....

Left ventricular function in patients with ventricular arrhythmias and aortic valve disease

International Nuclear Information System (INIS)

Santinga, J.T.; Kirsh, M.M.; Brady, T.J.; Thrall, J.; Pitt, B.

1983-01-01

Forty patients having aortic valve replacement were evaluated preoperatively for ventricular arrhythmia and left ventricular ejection fraction. Arrhythmias were classified as complex or simple using the Lown criteria on the 24-hour ambulatory electrocardiogram; ejection fractions were determined by radionuclide gated blood pool analysis and contrast angiography. The ejection fractions determined by radionuclide angiography were 59.1 +/- 13.1% for 26 patients with simple or no ventricular arrhythmias, and 43.9 +/- 20.3% for 14 patients with complex ventricular arrhythmias (p less than 0.01). Ejection fractions determined by angiography, available for 31 patients, were also lower in patients with complex ventricular arrhythmias (61.1 +/- 16.3% versus 51.4 +/- 13.4%; p less than 0.05). Seven of 9 patients showing conduction abnormalities on the electrocardiogram had complex ventricular arrhythmias. Eight of 20 patients with aortic stenosis had complex ventricular arrhythmias, while 2 of 13 patients with aortic insufficiency had such arrhythmias. It is concluded that decreased left ventricular ejection fraction, intraventricular conduction abnormalities, and aortic stenosis are associated with an increased frequency of complex ventricular arrhythmias in patients with aortic valve disease

Rest and exercise ventricular function in adults with congenital ventricular septal defects

International Nuclear Information System (INIS)

Jablonsky, G.; Hilton, J.D.; Liu, P.P.; Morch, J.E.; Druck, M.N.; Bar-Shlomo, B.Z.; McLaughlin, P.R.

1983-01-01

Rest and exercise right and left ventricular function were compared using equilibrium gated radionuclide angiography in 19 normal sedentary control subjects and 34 patients with hemodynamically documented congenital ventricular septal defect (VSD). Gated radionuclide angiography was performed at rest and during each level of graded supine bicycle exercise to fatigue. Heart rate, blood pressure, maximal work load achieved, and right and left ventricular ejection fractions were assessed. The control subjects demonstrated an increase in both the left and right ventricular ejection fractions with exercise. All study groups failed to demonstrate an increase in ejection fraction in either ventricle with exercise. Furthermore, resting left ventricular ejection fraction in Groups 2 and 3 was lower than that in the control subjects and resting right ventricular ejection fraction was lower in Group 3 versus control subjects. Thus left and right ventricular function on exercise were abnormal in patients with residual VSD as compared with control subjects; rest and exercise left ventricular ejection fractions remained abnormal despite surgical closure of VSD in the remote past; resting left and right ventricular function was abnormal in patients with Eisenmenger's complex; lifelong volume overload may be detrimental to myocardial function

La experiencia brasileña

OpenAIRE

Barbosa, Phidias

2011-01-01

16 transparencias.-- Presentado en: Tercer Seminario internacional TECMERIN "Televisión digital terrestre: confrontando las experiencias brasileña y española", celebrado del 18 al 20 de enero de 2011 en la Universidad Carlos III de Madrid

Aprendizaje Servicio. Una experiencia en Gobierno TI

OpenAIRE

García-Peñalvo, F. J.

2017-01-01

La conferencia “Aprendizaje Servicio. Una experiencia en Gobierno TI” fue impartida el día 16 de octubre de 2017 en la II Jornada: Aprendizaje Servicio y otras experiencias de innovación educativa en la UPM, dentro del Ciclo de Jornadas 2017. Tendencias en Innovación Educativa y su implantación en UPM. Presenta cómo se ha aplicado el aprendizaje-servicio en el contexto de la asignatura Gobierno de Tecnologías de la Información, del Máster en Ingeniería Informática de la Universidad ...

Arrhythmogenic Right Ventricular Cardiomyopathy in an Endurance Athlete Presenting with Ventricular Tachycardia and Normal Right Ventricular Function.

Science.gov (United States)

Hedley, Jeffrey S; Al Mheid, Ibhar; Alikhani, Zoubin; Pernetz, Maria A; Kim, Jonathan H

2017-08-01

Arrhythmogenic right ventricular cardiomyopathy, a genetically inherited disease that results in fibrofatty replacement of normal cardiac myocytes, has been associated with sudden cardiac death in athletes. Long-term participation in endurance exercise hastens the development of both the arrhythmic and structural arrhythmogenic right ventricular cardiomyopathy phenotypes. We describe the unusual case of a 34-year-old, symptomatic, female endurance athlete who had arrhythmogenic right ventricular cardiomyopathy in the presence of a structurally normal right ventricle. Clinicians should be aware of this infrequent presentation when evaluating athletic patients who have ventricular arrhythmias and normal findings on cardiac imaging studies.

Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia.

LENUS (Irish Health Repository)

Corrado, Domenico

2010-09-21

The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy\\/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.

La experiencia de las enfermeras ante la muerte

OpenAIRE

Alvarez de Arriba, Daniel

2016-01-01

Trabajo fin de grado en Enfermería Introducción: Las enfermeras han heredado de la sociedad un concepto histórico de la muerte que en la actualidad se ha convertido en tabú. Esto produce sentimientos negativos cuando enfrentan la muerte de sus pacientes en la práctica diaria. Esta experiencia es común a todas las enfermeras y se encuentra influenciada por diversos factores: la experiencia laboral, unidad de trabajo, creencias religiosas, educación previa y edad del fallecido. Objetivo: ...

Stress induced right ventricular dysfunction: An indication of reversible right ventricular ischaemia

International Nuclear Information System (INIS)

Underwood, S.R.; Walton, S.; Emanuel, R.W.; Swanton, R.H.; Campos Costa, D.; Laming, P.J.; Ell, P.J.

1987-01-01

Stress induced changes in left ventricular ejection fraction are widely used in the detection and assessment of coronary artery disease. This study demonstrates that right ventricular dysfunction may also occur, and assesses its significance in terms of coronary artery anatomy. This study involved 14 normal subjects and 26 with coronary artery disease investigated by equilibrium radionuclide ventriculography, at rest and during maximal dynamic exercise. Mean normal resting right ventricular ejection fraction (RVEF) was 0.40 (SD 0.118), and all normal subjects increased RVEF with stress (mean ΔRVEF+0.13 SD 0.099). Mean ΔRVEF in the subjects with coronary artery disease was significantly lower at 0.00 (SD 0.080), but there was overlap between the two groups. The largest falls in RVEF were seen if the right coronary artery was occluded without retrograde filling. In this subgroup with the most severely compromised right ventricular perfusion (nine subjects), RVEF always fell with stress, and mean ΔRVEF was -0.08 (SD 0.050). There was no significant correlation between ΔLVEF and ΔRVEF, implying that the right ventricular dysfunction was due to right ventricular ischaemia, rather than secondary to left ventricular dysfunction. Stress induced right ventricular ischaemia can therefore be detected readily by radionuclide ventriculography. (orig.)

Pensar la experiencia mística desde la epistemología

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Lina Marcela Cadavid Ramírez

2016-06-01

Full Text Available Con la crisis del paradigma newtoniano a principios del siglo XX, vemos surgir un acercamiento entre la ciencia, la religión y el misticismo, alentado por algunos de los físicos cuánticos más destacados, asimismo, la epistemología se vio afectada y a lo largo del siglo XX se entabló una discusión en torno a la objetividad del conocimiento y la construcción socio-lingüística de la realidad. Con este trasfondo, la experiencia mística será objeto de estudio por la epistemología, que desde una perspectiva constructivista afirmará el carácter mediado de este tipo de experiencias. Sin embargo, una revisión de esta postura muestra que es necesario conceder un carácter singular a la experiencia mística, que a su vez permite una comprensión renovada de la experiencia mística.

Systolic ventricular filling.

Science.gov (United States)

Torrent-Guasp, Francisco; Kocica, Mladen J; Corno, Antonio; Komeda, Masashi; Cox, James; Flotats, A; Ballester-Rodes, Manel; Carreras-Costa, Francesc

2004-03-01

The evidence of the ventricular myocardial band (VMB) has revealed unavoidable coherence and mutual coupling of form and function in the ventricular myocardium, making it possible to understand the principles governing electrical, mechanical and energetical events within the human heart. From the earliest Erasistratus' observations, principal mechanisms responsible for the ventricular filling have still remained obscured. Contemporary experimental and clinical investigations unequivocally support the attitude that only powerful suction force, developed by the normal ventricles, would be able to produce an efficient filling of the ventricular cavities. The true origin and the precise time frame for generating such force are still controversial. Elastic recoil and muscular contraction were the most commonly mentioned, but yet, still not clearly explained mechanisms involved in the ventricular suction. Classical concepts about timing of successive mechanical events during the cardiac cycle, also do not offer understandable insight into the mechanism of the ventricular filling. The net result is the current state of insufficient knowledge of systolic and particularly diastolic function of normal and diseased heart. Here we summarize experimental evidence and theoretical backgrounds, which could be useful in understanding the phenomenon of the ventricular filling. Anatomy of the VMB, and recent proofs for its segmental electrical and mechanical activation, undoubtedly indicates that ventricular filling is the consequence of an active muscular contraction. Contraction of the ascendent segment of the VMB, with simultaneous shortening and rectifying of its fibers, produces the paradoxical increase of the ventricular volume and lengthening of its long axis. Specific spatial arrangement of the ascendent segment fibers, their interaction with adjacent descendent segment fibers, elastic elements and intra-cavitary blood volume (hemoskeleton), explain the physical principles

DISCRIMINACION ETNICA EN RELATOS DE LA EXPERIENCIA ESCOLAR MAPUCHE EN PANGUIPULLI (CHILE)

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Poblete S,María Pía

2003-01-01

El propósito de este artículo es indagar en las percepciones y valoraciones de la experiencia escolar en un contexto interétnico. Presentamos información proveniente de 30 relatos sobre la educación y la experiencia escolar de personas mapuches de la precordillera de la Comuna de Panguipulli. Los resultados nos muestran que las experiencias en la escuela estuvieron marcadas por la discriminación étnica en la mayoría de los entrevistados. La discriminación se vivió en la interacción con profes...

Un nuevo contexto para la experiencia de usuario

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Capossio, Ana Paula

2014-01-01

¿Cómo afecta la incorporación de metodologías de diseño centrado en el usuario (DCU) al momento de diseñar una experiencia para una instalación interactiva? Uno de los factores más importantes para una obra de arte interactivo es el usuario, ya que es el que interactúa directamente con la interfaz de la obra. El desafío del artista es conseguir diseñar una interfaz que los usuarios comprendan y entiendan el significado de la obra. Para poder lograr una mejor experiencia de usuario, el arti...

Síndrome neuroléptica maligna: relato de caso com recorrência associada ao uso de olanzapina

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HANEL RICARDO A.

1998-01-01

Full Text Available A síndrome neuroléptica maligna (SNM consiste em reação idiossincrática a neurolépticos, provavelmente relacionada a bloqueio dos receptores dopaminérgicos nos gânglios da base, sendo por isso também conhecida como síndrome da deficiência aguda de dopamina.A SNM é caracterizada por hiperpirexia, alteração do nível de consciência, hipertonia, disfunção autonômica e insuficiência respiratória, podendo ainda ser encontrados rabdomiólise e leucocitose. O haloperidol é a droga mais frequentemente associada à síndrome. Relatamos o caso de um paciente de 30 anos que apresentou SNM em duas ocasiões diferentes, a primeira delas relacionada ao uso de haloperidol e clorpromazina e a segunda relacionada ao uso de olanzapina, fato este sem menção anterior na literatura indexada.

Simulaciones aumentadas: una experiencia contemporánea del territorio

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Santamarina-Macho, Carlos

2017-01-01

Recientemente han comenzado a popularizarse los denominados juegos de realidad aumentada geolocalizada, aplicaciones tecnológicas que ofrecen una experiencia lúdica combinando el mundo real y virtual. El artículo analiza el modo en el que estas herramientas modifican nuestra experiencia territorial. Partiendo de su caracterización teórica, se describen primeramente algunos procesos de creación de “lugar” en el marco de estas realidades mixtas, para continuar con el análisis de su aplicación p...

¿Con qué saboreamos?: tareas y experiencias para un taller de ciencias

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Sánchez Ramos, M.A.

2008-04-01

Full Text Available En un grupo de primero de primaria hicimos una pregunta aparentemente simple: ¿Con qué saboreamos? La respuesta inmediata entre los niños fue “con la lengua” y, aunque ésta no fue totalmente correcta, sirvió para iniciar un proyecto en el que se ofreció a los niños la oportunidad para observar, proponer hipótesis, establecerobjetivos y buscar métodos que les ayudaran a resolver la pregunta. Planteamos 4 experiencias cuya finalidad fue que los niños extendieran sus conocimientos y su comprensión sobre un proceso aparentemente sencillo como es la percepción al sabor. Primero cuestionamos la idea de que fuera la lengua el lugar primordial para la detección del sabor (experiencia 1; después incluimos al sentido del olfato como parte de la percepción del sabor (experiencia 2; tratamos de convencer a los niños de que el olor es el elemento más importante para detectar el sabor (experiencia 3; por último discutimos la posibilidad de que fuera el cerebro el que realmente saborea (experiencia 4.

¿Con qué saboreamos?: tareas y experiencias para un taller de ciencias

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Marco A. Sánchez Ramos

2008-01-01

Full Text Available En un grupo de primero de primaria hicimos una pregunta aparentemente simple: ¿Con qué saboreamos? La respuesta inmediata entre los niños fue "con la lengua" y, aunque ésta no fue totalmente correcta, sirvió para iniciar un proyecto en el que se ofreció a los niños la oportunidad para observar, proponer hipótesis, establecer objetivos y buscar métodos que les ayudaran a resolver la pregunta. Planteamos 4 experiencias cuya finalidad fue que los niños extendieran sus conocimientos y su comprensión sobre un proceso aparentemente sencillo como es la percepción al sabor. Primero cuestionamos la idea de que fuera la lengua el lugar primordial para la detección del sabor (experiencia 1; después incluimos al sentido del olfato como parte de la percepción del sabor (experiencia 2; tratamos de convencer a los niños de que el olor es el elemento más importante para detectar el sabor (experiencia 3; por último discutimos la posibilidad de que fuera el cerebro el que realmente saborea (experiencia 4.

Diagnóstico de febre catarral maligna em bovinos do Uruguai

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Marcela Preliasco

2013-01-01

Full Text Available Foi realizado um estudo retrospectivo de 14 focos de febre catarral maligna (FCM em bovinos, detectados nos anos de 1999-2011, a partir dos arquivos da Seção Anatomia Patológica da Divisão de Laboratórios Veterinários (DILAVE "Miguel C. Rubino" Montevideo. Foram analisados os dados epidemiológicos, apresentação clínica e lesões macroscópicas e histopatológicas. Para a detecção do herpesvírus ovino tipo 2 (OvHV-2 foi utilizada a técnica de PCR sobre as amostras do sistema nervoso central de bovinos de 12 focos. Os surtos ocorreram principalmente nos meses de primavera e verão, na região norte do país. Em 64% (9/14 dos focos ocorreram episódios individuais da enfermidade, enquanto que os casos coletivos foram 5, nos quais a morbidade e mortalidade oscilaram entre 2% e 5%, sendo a letalidade 100% em todos os relatos. Em 50% dos surtos foi confirmado o contato direto entre bovinos e ovinos, enquanto no restante não havia tal informação. Clinicamente predominaram os sinais de opacidade bilateral da córnea, conjuntivite, secreção nasal e ocular mucopurulenta, assim como a síndrome nervosa. Os achados de necropsia mais frequentes foram opacidade bilateral da córnea e lesões inflamatórias nas mucosas. Os achados histopatológicos caracterizaram-se por panvasculite necrótica sistêmica. Foi possível detectar o agente etiológico por PCR em 5 dos 12 casos analisados.

Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

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Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

2014-05-15

Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

International Nuclear Information System (INIS)

Tassi, Eduardo Marinho; Continentino, Marcelo Abramoff; Nascimento, Emília Matos do; Pereira, Basílio de Bragança; Pedrosa, Roberto Coury

2014-01-01

Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups

Experiencias sorprendentes de química con indicadores de pH caseros

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Heredia Avalos, S.

2006-01-01

Full Text Available En este trabajo se describen varias experiencias sencillas relacionadas con las reacciones ácido-base. Todas ellas pueden realizarse con utensilios de cocina y usando sustancias baratas que pueden encontrarse fácilmente en un supermercado, una farmacia o en casa. En concreto, se describe la forma de obtener algunos indicadores de pH a partir de extractos vegetales o de medicamentos. Además, se proponen varias experiencias en las que se hace uso de estos indicadores con el fin de estudiar las reacciones ácido-base. Todas estas experiencias están enfocadas a alumnos de enseñanza secundaria.

Experiencias de haber crecido con un padre/madre con trastorno mental severo (TMS)

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Vivanco B, Gabriela; Grandón F, Pamela

2016-01-01

Introducción. La experiencia de vivir con personas que presentan un Trastorno Mental Severo (TMS) es difícil para las familias, en especial para los hijos quienes han sido poco estudiados. El objetivo de la investigación fue conocer cómo la experiencia de haber vivido con un padre o madre con un trastorno mental severo influyó en la infancia, adolescencia y adultez joven de sus hijos e hijas. Método. Se analizan las experiencias de convivencia con un padre/madre con TMS en 10 hijos (6 hombres...

Museos construidos y reconstruidos. Experiencias educativas para la creatividad

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Romina Elisondo

2015-09-01

Full Text Available Los museos son espacios educativos promisorios para el aprendizaje y la creatividad. En el artículo contamos experiencias vinculadas a la construcción de propuestas educativas en museos, entendidos como construcciones sociales. Específicamente, nos referimos a dos propuestas educativas: un museo construido en el aula y una visita a un museo fuera del aula. Nos interesa describir las propuestas desarrolladas haciendo especial hincapié en las percepciones y valoraciones de los estudiantes respecto de las potencialidades educativas de los museos. Participaron de las experiencias estudiantes de las carreras de Licenciatura en Psicopedagogía y Educación Especial de la Universidad Nacional de Río Cuarto. Los museos, construidos y visitados, generan espacios para aprender y vivenciar experiencias significativas de aprendizaje. También se observan impactos positivos de los museos en la promoción de la creatividad y el desarrollo de innovaciones educativas. Historias personales, grupales y sociales circulan por los museos configurando entornos propicios para construir conocimientos dentro y fuera de las aulas.

Una visión panorámica de las experiencias de Telesalud en Perú

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Ernesto Gozzer Infante

Full Text Available El artículo presenta las principales experiencias de telesalud realizadas en el Perú entre los años 2002 al 2010. Analiza información de literatura publicada y documentos no publicados acerca de experiencias de telesalud públicas y privadas. A partir de esta información se consultó con 26 expertos acerca de las características de las experiencias de telesalud identificadas. Se generó una base de datos de 38 experiencias, que se describen y analizan en esta publicación. Se presenta reflexiones y recomendaciones para ampliar el uso de la telesalud en el Perú

Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia

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Hugo Van Herendael

2010-06-01

Full Text Available Hugo Van Herendael, Paul DorianDivision of Cardiology, St. Michael’s Hospital, University of Toronto, Toronto, CanadaAbstract: Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation. Although the superiority of the transvenous implantable cardioverter defibrillator (ICD over amiodarone has been well established in the preventive treatment of patients at high risk of life-threatening ventricular arrhythmias, amiodarone (if used with a beta-blocker is the most effective antiarrhythmic drug to prevent ICD shocks and treat electrical storm. Both the pharmacokinetics and the electrophysiologic profile of amiodarone are complex, and its optimal and safe use requires careful patient surveillance with respect to potential adverse effects.Keywords: amiodarone, ventricular fibrillation, unstable ventricular tachycardia

The overloaded right heart and ventricular interdependence.

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Naeije, Robert; Badagliacca, Roberto

2017-10-01

The right and the left ventricle are interdependent as both structures are nested within the pericardium, have the septum in common and are encircled with common myocardial fibres. Therefore, right ventricular volume or pressure overloading affects left ventricular function, and this in turn may affect the right ventricle. In normal subjects at rest, right ventricular function has negligible interaction with left ventricular function. However, the right ventricle contributes significantly to the normal cardiac output response to exercise. In patients with right ventricular volume overload without pulmonary hypertension, left ventricular diastolic compliance is decreased and ejection fraction depressed but without intrinsic alteration in contractility. In patients with right ventricular pressure overload, left ventricular compliance is decreased with initial preservation of left ventricular ejection fraction, but with eventual left ventricular atrophic remodelling and altered systolic function. Breathing affects ventricular interdependence, in healthy subjects during exercise and in patients with lung diseases and altered respiratory system mechanics. Inspiration increases right ventricular volumes and decreases left ventricular volumes. Expiration decreases both right and left ventricular volumes. The presence of an intact pericardium enhances ventricular diastolic interdependence but has negligible effect on ventricular systolic interdependence. On the other hand, systolic interdependence is enhanced by a stiff right ventricular free wall, and decreased by a stiff septum. Recent imaging studies have shown that both diastolic and systolic ventricular interactions are negatively affected by right ventricular regional inhomogeneity and prolongation of contraction, which occur along with an increase in pulmonary artery pressure. The clinical relevance of these observations is being explored. Published on behalf of the European Society of Cardiology. All rights

Lectura crítica: tres experiencias venezolanas

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Adolfo Herrera E.

2015-01-01

Full Text Available Las tres experiencias seleccionadas tienen que ver con la difusión de mensajes, lo que las introduce en un mecanismo de amplio espectro informativo, y esto podría llamarse el ingrediente popular.

La Naturaleza de la Experiencia Estética

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George Herbert Mead

2001-04-01

Full Text Available El texto que presentamos en este número de Athenea Digital es "La Naturaleza de la Experiencia Estética" escrito por G.H.Mead en 1926, traducido e introducido por Estaban Laso y Anna Vitores. Como los mismos traductores explican en la introducción que precede al texto de Mead: El artículo ?La Naturaleza de la Experiencia Estética? (1926 que presentamos en este mismo número ?y que como la inmensa mayoría de los escritos de Mead es muy breve? se inscribe dentro de la orientación hacia la crítica cultural de su obra tardía. En tanto que parte de la brecha entre la esfera instrumental y la de los valores que caracteriza a la actividad y al pensamiento humano en la sociedad moderna, ofrece una buena oportunidad para pensar acerca de la tensión meadiana entre creatividad y normatividad. Y quizás también, para ir más allá y reflexionar sobre la tensión entre cambio y reproducción social, y sobre las formas en que podríamos ofrecer un concepto de acción y de experiencia no individualistas que permitieran articular esta tensión.

Surgery for ventricular tachycardia in patients undergoing surgical ventricular restoration: the Karolinska approach.

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Sartipy, Ulrik; Albåge, Anders; Insulander, Per; Lindblom, Dan

2007-09-01

This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided.

[The reasonable use of right ventricular protection strategy in right ventricular outflow tract reconstruction].

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Zhang, Y; Yuan, H Y; Liu, X B; Wen, S S; Xu, G; Cui, H J; Zhuang, J; Chen, J M

2018-06-01

As a result of right ventricular outflow tract reconstruction, which is the important and basic step of complex cardiac surgery, the blood flow of right ventricular outflow tract is unobstructed, while pulmonary valve regurgitation and right heart dysfunction could be happened. These problems are often ignored in early days, more and more cases of right heart dysfunction need clinical intervention, which is quite difficult and less effective. How to protect effectively the right ventricular function is the focus. At present main methods to protect the right ventricular function include trying to avoid or reduce length of right ventricular incision, reserving or rebuilding the function of the pulmonary valve, using growth potential material for surgery. The protection of the right ventricular function is a systemic project, it involves many aspects, single measures is difficult to provide complete protection, only the comprehensive use of various protection strategy, can help to improve the long-term prognosis.

Las experiencias extracorpóreas y las experiencias alucinatorias: relación con variables cognitivas y perceptuales

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Alejandro Parra

2008-12-01

Full Text Available RESUMENLa experiencia fuera del cuerpo (EFC se define como un experiencia mediante la cual el “yo” o centro de conciencia parece ocupar una posición remota respecto a su propio cuerpo. Un total de 648 estudiantes de psicología que incluyó 78% de mujeres y 24% de hombres, completaron un número de escalas para comparar los puntajes de ambos grupos (con EFC N = 132 vs sin EFC N = 516. Los resultados mostraron mayor esquizotipia cognitivo-perceptual, absorción, disociación, propensidad a la fantasía, tendencia a alucinar, imaginería visual en individuos que tienen EFC en comparación con un grupo control. La incidencia de tales experiencias incluye a individuos que han señalado los efectos benéficos de lasEFCs como un modo adaptativo al estrés postraumático.ABSTRACTAbstract. An out-of-body experience or OBE is one in which the “self” or center of awareness seems to the experient to occupy temporarily a position that is spatially remote from his or her body. A total of 648 undergraduate students population included 76% females and 24% males, and who completed a number of scales. Data for experients of OBE were compared with data for those who did not (experients N= 132 vs. non‑experients N= 516. The results showed a higher level of cognitive-perceptual schizotypy, absorption, dissociation, fantasy and hallucination proneness, and visual imagery in OBErs than in non-OBErs. This study suggest that the dissociational model of OBE. Anomalous perceptual experiences and some subjects report beneficial effects from OBEs in an adaptive way.

Límite fino y transliminalidad en relación con experiencias aparicionales y sensación de presencia

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Alejandro Parra

2017-01-01

Full Text Available Objetivo. Comparar la transliminalidad y el límite fi no en personas que tienen experiencias de apariciones y sensación de presencia con un grupo control. Se plantea como hipótesis que las personas que reportan experiencias aparicionales y sensación de presencia tienen: (a mayor propensión a tener experiencias anómalas, (b mayor transliminalidad y (c límites más fi nos en comparación con un grupo control. Método.Se administraron cuatro medidas, la Escala Cardiff de Percepciones Anómalas, la Escala de Transliminalidad (revisada, el Inventario de Experiencias Anómalo/Paranormales y el Cuestionario de Límites, a una muestra compuesta por 203 participantes interesados en experiencias paranormales (151 mujeres y 52 hombres. Resultados. Se confi rmaron las tres hipótesis, esto es, mayor nivel de experiencias anómalas, transliminalidad y límite más fi no en individuos que reportan la experiencia en comparación con quienes no las reportan.Conclusión. Estos resultados indican que, particularmente, el constructo de límite fi no refl eja unos procesos atencionales o hiperestesia particular para la detección del entorno en aquellos involucrados en presuntas experiencias aparicionales.

Right Ventricular Endomyocardial Fibrosis Presenting With Ventricular Tachycardia And Apical Thrombus - An Interesting Presentation

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Amitesh Aggarwal

2009-11-01

Full Text Available Endomyocardial fibrosis is a progressive disease of unknown origin affecting children and young adults. It involves inflow portion of right and/or left ventricle and apex. It may be associated with thrombus. Literature regarding right ventricular endomyocardial fibrosis with thrombus is scarce. Here we report a rare case of right ventricular endomyocardial fibrosis presenting as ventricular tachycardia and echocardiographic evidence of apical thrombus. Interestingly there was no pulmonary involvement or evidence of deep venous thrombosis. This case also underscores the importance of urgent echocardiography in diagnosis of obscure cases of ventricular tachycardia.

Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

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Bortolo Martini

2015-01-01

Full Text Available A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT. ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects

International Nuclear Information System (INIS)

Peter, C.A.; Bowyer, K.; Jones, R.H.

1983-01-01

In patients with ventricular or atrial septal defect, the ventricle which is chronically volume overloaded might not appropriately respond to increased demand for an augmentation in output and thereby might limit total cardiac function. In this study we simultaneously measured right and left ventricular response to exercise in 10 normal individuals, 10 patients with ventricular septal defect (VSD), and 10 patients with atrial septal defect (ASD). The normal subjects increased both right and left ventricular ejection fraction, end-diastolic volume, and stroke volume to achieve a higher cardiac output during exercise. Patients with VSD failed to increase right ventricular ejection fraction, but increased right ventricular end-diastolic volume and stroke volume. Left ventricular end-diastolic volume did not increase in these patients but ejection fraction, stroke volume, and forward left ventricular output achieved during exercise were comparable to the response observed in healthy subjects. In the patients with ASD, no rest-to-exercise change occurred in either right ventricular ejection fraction, end-diastolic volume, or stroke volume. In addition, left ventricular end-diastolic volume failed to increase, and despite an increase in ejection fraction, left ventricular stroke volume remained unchanged from rest to exercise. Therefore, cardiac output was augmented only by the heart rate increase in these patients. Right ventricular function appeared to be the major determinant of total cardiac output during exercise in patients with cardiac septal defects and left-to-right shunt

Right ventricular pressure response to exercise in adults with isolated ventricular septal defect closed in early childhood.

Science.gov (United States)

Moller, Thomas; Lindberg, Harald; Lund, May Brit; Holmstrom, Henrik; Dohlen, Gaute; Thaulow, Erik

2018-06-01

We previously demonstrated an abnormally high right ventricular systolic pressure response to exercise in 50% of adolescents operated on for isolated ventricular septal defect. The present study investigated the prevalence of abnormal right ventricular systolic pressure response in 20 adult (age 30-45 years) patients who underwent surgery for early ventricular septal defect closure and its association with impaired ventricular function, pulmonary function, or exercise capacity. The patients underwent cardiopulmonary tests, including exercise stress echocardiography. Five of 19 patients (26%) presented an abnormal right ventricular systolic pressure response to exercise ⩾ 52 mmHg. Right ventricular systolic function was mixed, with normal tricuspid annular plane systolic excursion and fractional area change, but abnormal tricuspid annular systolic motion velocity (median 6.7 cm/second) and isovolumetric acceleration (median 0.8 m/second2). Left ventricular systolic and diastolic function was normal at rest as measured by the peak systolic velocity of the lateral wall and isovolumic acceleration, early diastolic velocity, and ratio of early diastolic flow to tissue velocity, except for ejection fraction (median 53%). The myocardial performance index was abnormal for both the left and right ventricle. Peak oxygen uptake was normal (mean z score -0.4, 95% CI -2.8-0.3). There was no association between an abnormal right ventricular systolic pressure response during exercise and right or left ventricular function, pulmonary function, or exercise capacity. Abnormal right ventricular pressure response is not more frequent in adult patients compared with adolescents. This does not support the theory of progressive pulmonary vascular disease following closure of left-to-right shunts.

Four cases of right ventricular dysplasia

International Nuclear Information System (INIS)

Takamura, Ichiro; Ando, Joji; Miyamoto, Atsushi; Kobayashi, Takeshi; Sakamoto, Sanya; Yasuda, Hisakazu

1985-01-01

Finding of 81 Kr right ventriculography and 201 Tl myocardial perfusion imaging in 4 patients with right ventricular dysplasia (RVD) were compared with those in 28 patients with dilated cardiomyopathy. Remarkably dilated right ventricle was detected on 201 Tl myocardial perfusion imaging in the RVD group. In a patient with RVD who died suddenly, perfusion defect of the left ventricular myocardium, a decreased right ventricular ejection fraction, and an increased right ventricular end diastolic volume were seen. Perfusion defect of the left ventricular myocardium was seen in 10 of the 28 patients with dilated cardiomyopathy, 4 of whom died suddenly. In these 4 patients, a decreased left ventricular ejection fraction and an increased right ventricular end diastolic volume were seen. These findings obtained by the radionuclide techniques suggested that there are differences in cardiac dysfunction of the both ventricles between the groups with RVD and dilated cardiomyopathy. (Namekawa, K.)

Empoderamiento en mujeres mexicanas: Experiencias de mujeres líderes de México

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Julita Elemí Hernández Sánchez

2015-06-01

Full Text Available En artículo analiza el término de empoderamiento, y las experiencias en la vida de mujeres líderes políticas mexicanas, con el fin de determinar cuáles de estas experiencias influyeron  en el  proceso de empoderamiento. Se analiza como las mujeres mismas vivieron ese proceso y que sucesos fueron comunes a ellas, en especial desde los ejes de análisis de educación, crianza, ambiente familiar, religión, entre otras. De acuerdo a lo esperado, se encontró que las mujeres entrevistadas, a pesar de ser de diversos orígenes comparten experiencias que las ayudaron o bien dificultaron su proceso de empoderamiento.

Otitis maligna del diabético: nuestra experiencia y revisión de la literatura Malignant otitis of the diabetic: our experience and literature review

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Pedro P. Morales Hechevarría

2002-04-01

Full Text Available Se realizó un estudio transversal en 22 diabéticos (18 tipo 2 y 4 tipo 1, mayores de 15 años, afectados de otitis maligna del diabético, para conocer las características clínicas y la evolución de estos pacientes. Se les confeccionó historia clínica completa (endocrinólogo y otológica minuciosa (otorrinolaringólogo. Se precisó la edad, sexo, tipo de tratamiento y tiempo de evolución de la DM, valores promedio de las glucemias, resultado del estudio bacteriológico de la secreción ótica, e imagenológico, así como síntomas y signos dependientes de esa otitis, complicaciones y resultado del tratamiento. Se empleó tratamiento insulínico intensivo y antibioticoterapia específica. La Pseudomona aeruginosa fue el germen causal más frecuente. La otalgia, el granuloma del conducto auditivo externo y el compromiso de los pares craneales (VII, IX y X fueron frecuentes. Se comprobó que más de la mitad de los pacientes egresaron mejorados o curados, no hubo fallecidos. Se observaron secuelas en 4 pacientes. Se presentó mayor frecuencia de OMD en los pacientes con DM tipo 2 con evolución mayor de 10 años. La causa más frecuente de indicación quirúrgica fue el granuloma del CAE. Se observaron las secuelas en 4 pacientes (18,2 %. Se concluyó que el diagnóstico precoz de la OMD, el tratamiento insulínico intensivo y una terapia con antibióticos adecuada puede disminuir significativamente la estadía hospitalaria, las secuelas y la mortalidad en estos pacientes.A cross-sectional study was conducted among 22 diabetics (18 type 2 and 4 type 1 over 15 that were affected by malignant otitis of the diabetic in order to know the clinical characteristics and evolution of these patients. A complete medical history (endocrinologist and a detailed otological history (ear, nose and throat specialist were made. Age, sex, type of treatment and time of evolution of diabetes mellitus, mean values of glycaemia, the result of the bacteriological

Large right ventricular sinusoids in an infant with aorta-left ventricular tunnel and proximal right coronary artery atresia.

Science.gov (United States)

Chen, Peter C; Spinner, Joseph A; Heinle, Jeffrey S

2018-07-01

We report a 1-month-old infant diagnosed with an aorta-left ventricular tunnel, ventricular septal defect, and right coronary atresia with right ventricular sinusoids. The patient's anatomy and physiology did not indicate right-ventricular-dependent coronary circulation, and therefore right ventricular decompression could be performed without compromising coronary perfusion during surgical correction. A detailed understanding of the coronary anatomy is critical in managing this defect when coronary anomalies are present.

Efeitos da estimulação ventricular convencional em pacientes com função ventricular normal Efectos de la estimulación ventricular convencional en pacientes con función ventricular normal Conventional ventricular stimulation effects on patients with normal ventricular function

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Luiz Antonio Batista de Sá

2009-08-01

Full Text Available FUNDAMENTO: A estimulação de ventrículo direito pode ser deletéria em pacientes com disfunção ventricular, entretanto há poucas evidências sobre o impacto dessa estimulação em pacientes com função normal. OBJETIVO: Avaliar a evolução clínica e laboratorial de pacientes com função ventricular normal submetidos a implante de marcapasso cardíaco artificial. MÉTODOS: Foram estudados de forma prospectiva 16 pacientes com os seguintes critérios de inclusão: função ventricular normal definida pelo ecocardiograma e presença de estimulação ventricular superior 90% (avaliação por telemetria do gerador. Parâmetros analisados: classe funcional (CF, teste de caminhada, dosagem de BNP, ecocardiograma (convencional e parâmetros de dessincronia intraventricular e teste de qualidade de vida (SF36. Essas medidas fora feitas com 10 dias(d (t1, 120d(t2 e 240 d(t3. Os dados foram comparados ao longo do tempo segundo método ANOVA. Comparações múltiplas de médias foram efetuadas utilizando-se o método de Tukey. RESULTADOS: Dos dados avaliados os seguintes não apresentaram variação estatística significante (p>0,05: classe funcional, dosagem de BNP, parâmetros ecocardiográficos convencionais, dessincronia intraventricular (Doppler tecidual. Apresentaram piora (pFUNDAMENTO: La estimulación del ventrículo derecho puede ser dañosa a pacientes con disfunción ventricular. Sin embargo, hay pocas evidencias sobre el impacto de esa estimulación en pacientes con función normal. OBJETIVO: Evaluar la evolución clínica y laboratorial de pacientes con función ventricular normal sometidos a implante de marcapaso cardíaco artificial. MÉTODOS: Se estudiaron de forma prospectiva a 16 pacientes con los siguientes criterios de inclusión: función ventricular normal definida por el ecocardiograma y presencia de estimulación ventricular superior a 90% (evaluación por telemetría del generador. Parámetros analizados: clase funcional

Mi experiencia en COMISEDH - Comisión de Derechos Humanos

OpenAIRE

Leal Lillo, María

2017-01-01

Treball final de Màster Universitari en Cooperació al Desenvolupament (Pla de 2015). Codi: SRP531. Curs acadèmic 2016-2017 En este trabajo se presenta la experiencia de prácticas externas del Máster en Cooperación al Desarrollo de la Universidad Jaume I, llevada a cabo en COMISEDH-Comisión de Derechos Humanos, una asociación civil sin ánimo de lucro con 38 años de experiencia en la lucha por los derechos humanos en Perú. A lo largo de los distintos apartados se presenta la entidad y el con...

Role of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy

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Alberto Cipriani

2017-11-01

Full Text Available Arrhythmogenic right ventricular cardiomyopathy (ARVC is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT. These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes.

La experiencia del proyecto EMILIA en Barcelona. El usuario como experto: concepto, modalidades y experiencia desde el Proyecto Emilia.

OpenAIRE

Paz Flores; Carmen Masferrer; Eithne Leahy; Roser Izquierdo; Eduard Palomer

2010-01-01

Se relata la experiencia del proyecto EMILIA y se ofrece una visión global de qué se entiende por “usuario experto” y “implicación de los usuarios” en salud mental. Se discuten sus implicaciones para los profesionales, usuarios y el sistema sanitario.

Experiencias formativas de jóvenes de la Universidad Intercultural de Chiapas

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Diego Rodríguez Calderón de la Barca

2016-04-01

Full Text Available El presente texto expone las principales experiencias formativas deestudiantes y egresados/as de la Universidad Intercultural de Chiapas,San Cristóbal de las Casas (UNICH, México, en las que está implícita laarticulación de tres instituciones fundamentales en la reproducción social:la familia, la escuela (en este caso la universidad y el trabajo. Así, elobjetivo es reflexionar sobre las experiencias formativas que van marcandoa las y los jóvenes antes, durante y después de que ingresany egresan de la universidad. Son experiencias que están relacionadascon su tránsito y estancia en la universidad, pero también a otras externasal campus universitario, y a partir de las cuales también construyensu condición juvenil (social y subjetivamente. El texto está dividido entres partes. En la primera presento sintéticamente características delcontexto y población de estudio. En la segunda, de manera muy brevemenciono la perspectiva teórica y la metodología. Y en la tercera expongolas experiencias más trascendentes de acuerdo al análisis delestudio y con base en los testimonios de los jóvenes entrevistados.

Dynamic Changes of QRS Morphology of Premature Ventricular Contractions During Ablation in the Right Ventricular Outflow Tract: A Case Report.

Science.gov (United States)

Yue-Chun, Li; Jia-Feng, Lin; Jia-Xuan, Lin

2015-10-01

Electrocardiographic characteristics can be useful in differentiating between right ventricular outflow tract (RVOT) and aortic sinus cusp (ASC) ventricular arrhythmias. Ventricular arrhythmias originating from ASC, however, show preferential conduction to RVOT that may render the algorithms of electrocardiographic characteristics less reliable. Even though there are few reports describing ventricular arrhythmias with ASC origins and endocardial breakout sites of RVOT, progressive dynamic changes in QRS morphology of the ventricular arrhythmias during ablation obtained were rare.This case report describes a patient with symptomatic premature ventricular contractions of left ASC origin presenting an electrocardiogram (ECG) characteristic of right ventricular outflow tract before ablation. Pacing at right ventricular outflow tract reproduced an excellent pace map. When radiofrequency catheter ablation was applied to the right ventricular outflow tract, the QRS morphology of premature ventricular contractions progressively changed from ECG characteristics of right ventricular outflow tract origin to ECG characteristics of left ASC origin.Successful radiofrequency catheter ablation was achieved at the site of the earliest ventricular activation in the left ASC. The distance between the successful ablation site of the left ASC and the site with an excellent pace map of the RVOT was 20 mm.The ndings could be strong evidence for a preferential conduction via the myocardial bers from the ASC origin to the breakout site in the right ventricular outflow tract. This case demonstrates that ventricular arrhythmias with a single origin and exit shift may exhibit QRS morphology changes.

Esclerosis múltiple. : nuestra experiencia

OpenAIRE

Houlne, M.; Zalazar, M.; Sagaz, A.; López Laur, José Daniel

2006-01-01

Objetivos: analizar la experiencia obtenida y evaluar los resultados urodinámicos del estudio de 18 pacientes con esclerosis múltiple. Material y Métodos: se estudiaron 18 casos, valorándose la historia clínica, ecografía vesical y renal, analizándolos urodinámicamente con uroflujometría, residuo post miccional (RPM), cistotonometría y electromiografía esfinteriana. Urocultivo y antibiograma de orina. Resultados: del análisis de toda...

Síndrome de QT largo. El electrocardiograma de interacciones medicamentosas peligrosas

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Mariela Fontana

2008-01-01

Full Text Available La repolarización ventricular no siempre se evalúa correctamente a la hora de adoptar una conducta médica determinada y sus consecuencias pueden ser fatales. Los trastornos electrolíticos del medio interno y la administración de drogas antiarrítmicas de clase III son asociaciones que se presentan con frecuencia en la práctica clínica diaria y constituyen dos factores de gran repercusión en la modificación de la repolarización ventricular y en la generación de arritmias ventriculares malignas.En el caso clínico que se presenta se hace referencia a esta interacción, a su repercusión electrocardiográfica y a sus consecuencias arrítmicas.REV ARGENT CARDIOL 2008;76:491-494

Arrhythmogenic right ventricular dysplasia: MRI findings

International Nuclear Information System (INIS)

Wall, E.E. van der; Bootsma, M.M.; Schalij, M.J.; Kayser, H.W.M.; Roos, A. de

2000-01-01

Arrhythmogenic right ventricular dysplasia (ARVD) is a heart muscle disorder of unknown cause that is characterized pathologically by fibrofatty replacement of the right ventricular myocardium. Clinical manifestations include structural and functional malformations of the right ventricle, electrocardiographic abnormalities, and presentation with ventricular tachycardias with left bundle branch pattern or sudden death. The disease is often familial with an autosomal inheritance. In addition to right ventricular dilatation, right ventricular aneurysms are typical deformities of ARVD and they are distributed in the so-called ''triangle of dysplasia'', i. e., right ventricular outflow tract, apex, and infundibulum. Ventricular aneurysms at these sites can be considered pathognomonic of ARVD. Another typical hallmark of ARVD is fibrofatty infiltration of the right ventricular free wall. These functional and morphologic characteristics are relevant to clinical imaging investigations such as contrast angiography, echocardiography, radionuclide angiography, ultrafast computed tomography, and magnetic resonance imaging (MRI). Among these techniques, MRI allows the clearest visualization of the heart, in particular because the right ventricle is involved, which is usually more difficult to explore with the other imaging modalities. Furthermore, MRI offers the specific advantage of visualizing adipose infiltration as a bright signal of the right ventricular myocardium. MRI provides the most important anatomic, functional, and morphologic criteria for diagnosis of ARVD within one single study. As a result, MRI appears to be the optimal imaging technique for detecting and following patients with clinical suspicion of ARVD. (orig.) [de

Gestión del marketing sensorial sobre la experiencia del consumidor

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Leonardo Ortegón-Cortázar

2016-01-01

Full Text Available El rápido desarrollo de mercados con productos competitivos de difícil diferenciación y consumidores mejor informados que demandan experiencias memorables, justifican estudiar los elementos sensoriales que pueden potenciar e influir positivamente sobre dichas experiencias. El objetivo de este artículo es analizar el estado del arte respecto a la gestión y uso del marketing sensorial sobre la experiencia del consumidor. El diseño de investigación es no experimental documental, con un tipo de estudio descriptivo, empleando fuentes de recolección de información secundarias, mediante un arqueo bibliográfico de revistas de impacto que figuran en bases de datos de libre acceso. Los resultados revelan la dominancia del sentido de la visión sobre la persuasión y las actividades de marketing, mientras que el sentido del olfato demuestra mayor influencia sobre el nivel de recuerdo y evocación de información. Se concluye la utilidad de jerarquizar por nivel de influencia las actividades de estimulación sensorial en marketing a partir del funcionamiento y participación de los sentidos humanos y poder combinar dichas estimulaciones como medio para maximizar la experiencia del consumidor y distinguir la oferta de valor, considerando el grado de diferenciación, la favorabilidad y la fuerza de la actividad sensorial basada en planeación estratégica empresarial.

Experiencias y vivencias del embarazo en adolescentes explicadas desde lo social

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VIRGINIA INÉS SOTO

2008-12-01

Full Text Available Describir y explicar desde lo social las experiencias y vivencias de las adolescentes embarazadas, como el contexto para una provisión de cuidado integral, individualizado y contextualizado, es necesario para la práctica de enfermería, y tratar este fenómeno como hecho social exige asimilar las realidades del mundo social a las del mundo exterior, adoptando el principio de que se ignora por completo lo que son, reconociendo que el hecho social no puede ser modificado por un simple decreto de la voluntad, sino que exige un esfuerzo laborioso, considerando la experiencia desde los ámbitos interno y externo. Presentar un marco conceptual y referencial desde lo social, interpretando la experiencia y la vivencia, permitirá a la enfermera comprender este fenómeno cuando dichas experiencias involucran o ponen en riesgo la salud de la adolescente gestante, máxime que la práctica clínica de enfermería se ha estudiado primariamente desde una perspectiva sociológica, pues comparte una importancia social destacada y un fin social, centrada en facilitar, apoyar y atender a los individuos, familias, comunidades y/o sociedades para realzar, mantener y recuperar la salud, y reducir y aliviar los efectos de la enfermedad, con el resultado explícito de promover la calidad de vida relacionada con la salud dentro de contextos ambientales inmediatos y más amplios.

una experiencia de intervención

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Cecilia Villarreal Montoya

2007-01-01

Full Text Available El artículo resume la experiencia de intervención con una familia de la escuela de Villa Esperanza de Pavas. Se trata de un matrimonio con dificultades para disciplinar a sus tres hijos varones de ocho, seis, y cuatro años. En primer lugar, se exponen los principios teóricos y metodológicos, para luego mostrar la aplicación de ellos en el proceso vivido por la familia. Se aplica el modelo de intervención estructural, que busca que la misma familia logre realizar, paso a paso, los cambios requeridos en la dinámica y estructura familiar. En la situación específica de esta familia, se observa el fortalecimiento de la pareja como tal y como madre y padre en la medida que van logrando asumir la autoridad en forma compartida para disciplinar a los hijos. Al compartir esta experiencia, la autora pretende estimular a profesionales en Orientación a asumir el reto de considerar a las familias de la comunidad estudiantil, de las instituciones educativas donde laboran, como parte importante en el quehacer orientador.

Left ventricular function in right ventricular overload

International Nuclear Information System (INIS)

Iwanaga, Shiro; Handa, Shunnosuke; Abe, Sumihisa; Onishi, Shohei; Nakamura, Yoshiro; Kunieda, Etsuo; Ogawa, Koichi; Kubo, Atsushi

1989-01-01

This study clarified regional and global functions of the distorted left ventricle due to right ventricular overload by gated radionuclide ventriculography (RNV). Cardiac catheterization and RNV were performed in 13 cases of atrial septal defect (ASD), 13 of pure mitral stenosis (MS), 10 of primary pulmonary hypertension (PPH), and 10 of normal subjects (NL). Right ventricular systolic pressure (RVSP) was 32.9±13.9, 45.0±12.2, 88.3±17.1, and 21.2±4.5 mmHg, respectively. The end-systolic LAO view of the left ventricle was halved into septal and free-wall sides. The end-diastolic halves were determined in the same plane. Ejection fractions of the global left ventricle (LVEF), global right ventricle (RVEF), the septal half of the left ventricle (SEPEF), and the free-wall half of the left ventricle (FWEF) were obtained. LVEF was 56.8±9.8% in NL, 52.8±10.5% in ASD, and 49.5±12.9% in PPH. In MS, LVEF (47.0±13.0%) was smaller than those in the other groups. RVEF was 37.0±5.2% in NL, 43.7±15.5% in ASD, and 32.8±11.5% in MS. In PPH, RVEF (25.0±10.6%) was smaller than those in the other groups. SEPEF was smaller in ASD (42.5±13.2%), MS (40.4±13.1%), PPH (40.5±12.5%) than in NL (53.5±8.5%). Systolic function of the septal half of the left ventricle was disturbed by right ventricular overload. RVEF (r=-0.35, p<0.05) and SEPEF (r=-0.51, p<0.01) had negative correlations with RVSP. As RVSP rose, systolic function of the septal half of the left ventricle was more severely disturbed. FWEF was the same among the four groups; NL (57.0±12.6%), ASD (48.6±15.2%), MS (50.5±12.0%), and PPH (51.1±12.3%). There was a good correlation between SEPEF and LVEF in NL (r=0.81), although in PPH this correlation was poor (r=0.64). These data showed that the distorted left ventricular due to right ventricular overload maintains its global function with preserved function of the free-wall side. (J.P.N.)

Measurement of ventricular function using Doppler ultrasound

International Nuclear Information System (INIS)

Teague, S.M.

1986-01-01

Doppler has wide application in the evaluation of valvular heart disease. The need to know ventricular function is a much more common reason for an echocardiographic evaluation. Interestingly, Doppler examinations can assess ventricular function from many perspectives. Description of ventricular function entails measurement of the timing, rate and volume of ventricular filling and ejection. Doppler ultrasound examination reveals all of these aspects of ventricular function noninvasively, simply, and without great expense or radiation exposure, as described in this chapter

Right ventricular function in patients with ischemic heart disease

International Nuclear Information System (INIS)

Araki, Haruo; Hisano, Ryuichi; Nagata, Yoshiyuki; Caglar, N.; Nakamura, Motoomi

1985-01-01

Thirty-five patients with ischemic heart disease (IHD) and 10 normal subjects were studied. Right and left ventricular ejecction fractions (EF) were determined using equilibrium radionuclide ventriculography with technetium-99m. Furthermore, abnormal motion of the right ventricular septal wall was obtained by cardiac cathetelization, and its relation to the right ventricular EF was examined. In IHD patients with anterior myocardial infarction, left ventricular EF decreased, but right ventricular EF was normal. This suggested that left ventricular dysfunction does not always have an effect on right ventricular function. Right ventricular EF was normal even when akinesis or dyskinesis was present in the ventricular septul, suggesting that abnormal motion of the ventricular septal wall has no significantly stimulant effect on right ventricular function. A decreased right ventricular EF was likely to occur only when the right ventricular free wall became ischemic or necrotic simultaneously with occurrence of posterior myocardial infarction. (Namekawa, K.)

El conocimiento profesional adquirido por el entrenador de balonmano: experiencias y formación

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Sebasti\\u00E1n Feu Molina

2012-01-01

Full Text Available El objetivo del estudio fue conocer la procedencia del conocimiento que utilizan los entrenadores de balonmano en su ejercicio profesional. En el estudio participaron 333 entrenadores españoles, 86.8% hombres y 13.2% mujeres. Se diseñó y validó un cuestionario que permitió conocer la influencia del conocimiento profesional en su intervención como entrenador: experiencia como jugador, formación académica o experiencia como entrenador. El análisis estadístico reflejó que los factores de la escala tenían una validez y fiabilidad adecuadas (¿ > .70, acreditando a este cuestionario como una herramienta válida y fiable. Los entrenadores utilizan las tres fuentes de conocimiento (académica, experiencia como jugador y autoformación, existiendo una mayor utilización del conocimiento académico. Los entrenadores con mayor formación utilizan menos las experiencias y conocimientos adquiridos como jugador y utilizan más los conocimientos adquiridos en su vida profesional.

Right ventricular failure after implantation of a continuous-flow left ventricular assist device

DEFF Research Database (Denmark)

Cordtz, Johan Joakim; Nilsson, Jens C; Hansen, Peter B

2014-01-01

Right ventricular failure (RVF) is a significant complication after implantation of a left ventricular assist device. We aimed to identify haemodynamic changes in the early postoperative phase that predicted subsequent development of RVF in a cohort of HeartMate II (HMII) implanted patients....

Ventricular fibrillation in an ambulatory patient supported by a left ventricular assist device: highlighting the ICD controversy.

Science.gov (United States)

Boilson, Barry A; Durham, Lucian A; Park, Soon J

2012-01-01

Left ventricular assist devices (LVADs) provide an effective means of managing advanced pump failure as a means of bridging to cardiac transplantation or as permanent therapy. Although ventricular arrhythmias remain common post-LVAD implantation, such therapy may allow malignant arrhythmias to be tolerated hemodynamically. This report describes the clinical findings in a patient who had likely been in a ventricular tachyarrhythmia for several days and presented in ventricular fibrillation, ambulatory, and mentating normally. This report, with previous similar reports, is additive to the body of evidence that LVADs alter the physiologic impact of ventricular arrhythmias in advanced heart failure and highlights the need for thoughtful programming of implantable cardioverter defibrillator therapies in these patients.

Action potential conduction between a ventricular cell model and an isolated ventricular cell

NARCIS (Netherlands)

Wilders, R.; Kumar, R.; Joyner, R. W.; Jongsma, H. J.; Verheijck, E. E.; Golod, D.; van Ginneken, A. C.; Goolsby, W. N.

1996-01-01

We used the Luo and Rudy (LR) mathematical model of the guinea pig ventricular cell coupled to experimentally recorded guinea pig ventricular cells to investigate the effects of geometrical asymmetry on action potential propagation. The overall correspondence of the LR cell model with the recorded

Algunas experiencias de innovación educativa

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de Haro, J. José

2009-09-01

Full Text Available In this article we show some experiences in educational innovation area performed by teachers with students of ESO and Bachelor at Amor de Dios school in Barcelona (www.amordedios. org. We also discuss the characteristics of blogs, wikis and social networks, as well as their potential usage, all based on the experience carried out with the students. We also present some useful guidelines about selection of the various systems depending on teachers’ needs.Se presentan algunas de las experiencias llevadas a cabo en el ámbito de la innovación educativa con alumnos de ESO y Bachillerato en el centro concertado de educación primaria y secundaria Amor de Dios de Barcelona (www.amordedios.org. Se discuten las características de blogs, wikis y redes sociales, así como sus posibilidades de uso, todo ello en base a las experiencias realizadas con los alumnos. Igualmente se presentan algunas directrices que pueden ayudar para la selección de unos sistemas u otros según las necesidades educativas del profesor.

The helical ventricular myocardial band: global, three-dimensional, functional architecture of the ventricular myocardium.

Science.gov (United States)

Kocica, Mladen J; Corno, Antonio F; Carreras-Costa, Francesc; Ballester-Rodes, Manel; Moghbel, Mark C; Cueva, Clotario N C; Lackovic, Vesna; Kanjuh, Vladimir I; Torrent-Guasp, Francisco

2006-04-01

We are currently witnessing the advent of new diagnostic tools and therapies for heart diseases, but, without serious scientific consensus on fundamental questions about normal and diseased heart structure and function. During the last decade, three successive, international, multidisciplinary symposia were organized in order to setup fundamental research principles, which would allow us to make a significant step forward in understanding heart structure and function. Helical ventricular myocardial band of Torrent-Guasp is the revolutionary new concept in understanding global, three-dimensional, functional architecture of the ventricular myocardium. This concept defines the principal, cumulative vectors, integrating the tissue architecture (i.e. form) and net forces developed (i.e. function) within the ventricular mass. Here we expose the compendium of Torrent-Guasp's half-century long functional anatomical investigations in the light of ongoing efforts to define the integrative approach, which would lead to new understanding of the ventricular form and function by linking across multiple scales of biological organization, as defined in ongoing Physiome project. Helical ventricular myocardial band of Torrent-Guasp may also, hopefully, allow overcoming some difficulties encountered in contemporary efforts to create a comprehensive mathematical model of the heart.

Application of radionuclide ventriculography phase analysis in patients with atrial or ventricular pacing for detecting ventricular abnormal excitation

International Nuclear Information System (INIS)

Shi Rongfang; Wang Zhonggan; Li Shengting

1996-01-01

The aim of the study was to increase the accuracy of detecting ventricular abnormal excitation. During atrial or ventricular pacing, radionuclide ventriculography phase analysis (RNV-PA) was performed in 17 patients with Wolff-Parkinson-White (W-P-W) syndrome and paroxysmal supra ventricular tachycardia (PSVT) and ventricular tachycardia (PVT). During pacing, detection rate of abnormal excitation by RNV-PA was 95.5%, compared with 68.2% during basic conduction. Atrial or ventricular pacing can significantly increase the detection rate of abnormal excitation by RNV-PA in patients with W-P-W syndrome. It may be a valuable method for identifying the abnormal excitation and estimating the therapeutic effect of ablation

Experiencias de vida económica y desarrollo humano de estudiantes universitarios de otras localidades en Barranquilla (Colombia

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Mayilin Moreno Torres

2004-01-01

Full Text Available Esta investigación se propuso indagar si las experiencias económicas vividas en Barranquilla (Colombia por estudiantes universitarios provenientes de otras localidades favorecían su desarrollo humano. Para llevarla a cabo se utilizó un método cualitativo con orientación interpretativa. Los resultados mostraron que las experiencias económicas sí contribuyen notablemente a la construcción de desarrollo humano porque logran tener mucho significado en la vida de estos estudiantes. Es decir, a medida que viven estas experiencias, las decisiones de su vida van teniendo un solo y auténtico sujeto: él mismo. En consecuencia, lo que se impone es su libertad, su autonomía. Estas experiencias económicas, por tanto, no sólo le permiten tomar distancia de sus propios impulsos sino también de la tradición. Ello configura una experiencia de progreso, de ilustración, de modernidad.

Effect of right ventricular electrode location (outflow tract vs. apex) on mechanical Ventricular synchrony in patients that underwent pacemaker implant therapy

International Nuclear Information System (INIS)

Rincon, Oscar S; Saenz, Luis C; Salazar, Gabriel; Hernandez, Edgar

2008-01-01

Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials And Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent trans thoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group). There was no structural cardiopathy, ejection fraction was ? 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler) and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages.Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25%) a pre-implant ventricular asynchrony was found; in seven (70%) ventricular asynchrony post-implant in the right ventricle outflow tract and in 5 (50%) in the apex. Mean interventricular pot-implant delay was 21,6 ms in the right ventricular outflow tract and 11,5 ms in the apex (p = 0,8); mean septal to lateral wall delay was 73 ms in the right ventricular outflow tract and 26 ms in the apex (p = 0,8). QRS post-implant delay was 134 ms in the right ventricular outflow tract and 140 ms in the apex (p = 0,1). No differences between implant parameters and device programming were found. Conclusions: presence of ventricular asynchrony was evidenced in patients with normal QRS and structurally healthy heart. Ventricular stimulation with pacemaker from the apex or the right ventricular outflow tract suggests acute ventricular asynchrony at least in 60% of the cases, without statistically significant difference between both groups.

Relación entre estrés laboral, alucinación y experiencias anómalas entre profesionales de enfermería

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Alejandro Enrique-Parra,

2016-12-01

Full Text Available Objetivo: evaluar el tipo y frecuencia de experiencias perceptuales inusuales en ámbitos hospitalarios, así como su relación con el estrés laboral y la absorción, y comparar tales experiencias en enfermeros (os que las han tenido. Materiales y Métodos: se analizó una muestra de 39 enfermeros (as con tales experiencias y un grupo control de 61 profesionales (sin experiencias. Las enfermeros (as completaron cuatro instrumentos: la Encuesta de Experiencias Anómalo/Paranormales en Enfermeras y Trabajadores de la Salud, el Maslach Burnout Inventory que mide el estrés laboral, el Cuestionario de Experiencias Alucinatorias que evalúa la propensión a la alucinación y la Escala de Absorción de Tellegen que evalúa el grado de involucramiento en la percepción. Resultados: los profesionales que reportaron tales experiencias no tendían a experimentar mayor estrés laboral, en comparación con un grupo control, en contra de la principal hipótesis; sin embargo, mostraron mayor frecuencia experiencias perceptivas anómalas asociadas a la capacidad de absorción psicológica, que resultó el principal predictor entre enfermeras con experiencia y el grupo control [β= 0,33, p= 0,005; R2= 0,12] combinando estrés laboral y propensión a la alucinación. Conclusión: el análisis estadístico confirma que los profesionales de enfermería que reportan experiencias perceptuales inusuales, tienden a mostrar mayor absorción psicológica, de igual forma, mayor propensión a alucinar; sin embargo, ninguna de estas variables se relaciona con el estrés laboral. El turno de noche es el más propenso a estas experiencias.

EXPERIENCIAS DE GUERRA DESDE LA VOZ DE LAS MUJERES

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Elsa Blair

2003-01-01

Full Text Available El articulo recoge algunas reflexiones en tormo al trabajode campo realizado con mujeres excombatientes de diversos grupos armados colombianos en el marco de la investigación Mujeres en tiempos de guerra: una mirada a lo femenino en el contexto de los grupos armados colombianos. A partir de una concepción de la guerra como construcción cultural, las autoras interrogan los efectos de la misma sobre su identidad femenina, esto es, lo que la guerra ha representado para ellas como mujeres y los efectos que ha tenido en términos de su identidad genérica. Tras una reflexión inicia en torno a los desafíos éticos planteados por el trabajo de campo, las autoras abordan la problemática de la identidad de género a través de dos vías: por una parte, los campos o "nudos¿ temáticos que amarran las narraciones de mujeres entrevistadas -la familia, la maternidad y los hijos, las relaciones con los "otros", las experiencias de muerte y el dolor de la guerra-; y por otra, la forma particular en que ellas construyen sus relatos sobre su experiencia como combatientes. Por último, a partir de esa mirada analítica sobre la manera como estas mujeres han vivido y significado su experiencia como guerreras, las autoras plantean, algunas conclusiones preliminares en torno a dicha problemática.

Visión activa y aprendizaje perceptual: Cómo la experiencia cambia nuestro mundo visual

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Carlos M. Hamamé

2011-06-01

Full Text Available Nuestra experiencia es capaz de modificar el modo en que percibimos. Este tipo de aprendizaje perceptual nos indica la importancia del observador en la construcción de la percepción. En este artículo se examinan evidencias neurofisiológicas recientes que demuestran la presencia, no sólo de procesos perceptuales, sino también atencionales y de actualización de contexto, en el modo en que nuestra percepción visual cambia con la experiencia. Considerar la experiencia sensorial, junto con el estado actual del observador, ayudará a completar los modelos actuales, que son insuficientes para explicar la visión en condiciones naturales.

Ventricular Effective Refraction Period and Ventricular Repolarization Analysis in Experimental Tachycardiomyopathy in Swine.

Science.gov (United States)

Noszczyk-Nowak, Agnieszka; Pasławska, Urszula; Gajek, Jacek; Janiszewski, Adrian; Pasławski, Robert; Zyśko, Dorota; Nicpoń, Józef

2016-01-01

Swine are recognized animal models of human cardiovascular diseases. However, little is known on the CHF-associated changes in the electrophysiological ventricular parameters of humans and animals. The aim of this study was to analyze changes in the durations of ventricular effective refraction period (VERP), QT and QTc intervals of pigs with chronic tachycardia-induced tachycardiomyopathy (TIC). The study was comprised of 28 adult pigs (8 females and 20 males) of the Polish Large White breed. A one-chamber pacemaker was implanted in each of the 28 pigs. Electrocardiographic, echocardiographic and electrophysiological studies were carried out prior to the pacemaker implantation and at subsequent 4-week intervals. All electrocardiographic, echocardiographic and short electrophysiological study measurements in all swine were done under general anesthesia (propofol) after premedication with midazolam, medetomidine, and ketamine. No significant changes in the duration of QT interval and corrected QT interval (QTc) were observed during consecutive weeks of the experiment. The duration of the QTc interval of female pigs was shown to be significantly longer than that of the males throughout the whole study period. Beginning from the 12th week of rapid ventricular pacing, a significant increase in duration of VERP was observed in both male and female pigs. Males and females did not differ significantly in terms of VERP duration determined throughout the whole study period. Ventricular pacing, stimulation with 2 and 3 premature impulses at progressively shorter coupling intervals and an imposed rhythm of 130 bpm or 150 bpm induced transient ventricular tachycardia in one female pig and four male pigs. One episode of permanent ventricular tachycardia was observed. The number of induced arrhythmias increased proportionally to the severity of heart failure and duration of the experiment. However, relatively aggressive protocols of stimulation were required in order to induce

Ventricular arrhythmias in Chagas disease

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Marco Paulo Tomaz Barbosa

2015-02-01

Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

Evaluation of Right Ventricular Function with Radionuclide Cardiac Angiography - Right Ventricular Ejection Fraction in Chronic Obstructive Lung Disease

International Nuclear Information System (INIS)

Sohn, In; Shin, Sung Hae; Chung, June Key; Lee, Myung Chul; Cho, Bo Youn; Lee, Young Woo; Han, Yong Cheol; Koh, Chang Soon

1982-01-01

To evaluate the usefulness of radionuclide cardiac angiography in the assessment of the right ventricular function, we measured right ventricular ejection fraction (RVEF) using single pass method. In 12 normal persons, RVEF averaged 52.7±5.9% (mean±S.D.). In 25 patients with chronic obstructive lung disease, RVEF was 37.2±10.6% and significantly lower than that of normal person (p<0.01). All 10 patients with right ventricular failure had abnormal RVEF, which was significantly lower than that of 14 persons without right ventricular failure (27.6±5.7%, 43.9±8.5%, respectively, p<0.01). It concluded that RVEF measured by single pass radionuclide cardiac angiography was a useful, noninvasive method to assess right ventricular function.

Experiencias, Sensaciones y Demandas de (Inseguridad Ciudadana. Configuraciones complejas en la Argentina reciente

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Daniel Pedro Míguez

2013-06-01

Full Text Available En las últimas décadas, el problema de la inseguridad debida al incremento del delito y el posible impacto sobre la estabilidad de las democracias latinoamericanas ha sido objeto de debate recurrente. En este marco, el presente artículo analiza para el caso argentino la relación entre las experiencias y sensaciones de inseguridad, y su vinculación con las demandas de rigor punitivo. El análisis se basa en la combinación de dos aproximaciones metodológicas. Inicialmente, se toman datos estadísticos de encuestas internacionales, como Latinobarómetro. Estos son luego comparados con datos revelados mediante la observación participante en un barrio pobre de una ciudad intermedia de Argentina. La combinación de fuentes alternativas permite ver la complejidad del proceso. Contrario a lo que muchas veces se ha asumido, no existen vínculos lineales que conduzcan de experiencias y sensaciones de seguridad a demandas de rigor punitivo. La manera en que los actores sociales elaboran sus experiencias de inseguridad es fuertemente situacional y, además, poco sistemática. Hemos encontrado que no necesariamente hay procesos consistentes de ‘construcción de sentido’ que articulen las sensaciones y experiencias de inseguridad con demandas políticas.

Experiencia en el aula de secundaria con fractales

OpenAIRE

Gallardo, Sandra; Martínez-Santaolalla, Manuel José; Molina, Marta; Peñas, María; Cañadas, María C.; Crisóstomo, Edson

2006-01-01

Presentamos una experiencia docente en un aula de 2º ESO en la que trabajamos los fractales mediante el uso de material de carácter manipulativo. La metodología seguida se basa en la construcción de casos particulares con el fin de llegar al concepto de fractal.

EXPERIENCIAS PEDAGÓGICAS CON EL PÁRRAFO

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Ligni Molano Barona

2010-01-01

Full Text Available En este documento se compendia la experiencia que tres profesoras de lengua materna han construido a lo largo de su actividad docente, en lo relacionado con el párrafo. Está estructurado en tres puntos. En el primero, ¿Qué es un párrafo?, se abordan elementos de orden teórico, que, a modo de referentes, sustentan la búsqueda de un concepto propio y eficaz a la hora de emprender la escritura con los estudiantes. Con este fin, se realizó un pequeño estado del arte sobre el estudio del párrafo, en el que se escogieron cinco autores, cuya experiencia en la didáctica textual es bastante amplia, y se indagaron a los pares de la Universidad Icesi. En el segundo, ¿Para qué sirve un párrafo?, se reflexiona acerca de la utilidad y la importancia del párrafo en la escritura de cualquier tipo de texto. En el tercero, ¿Cómo se puede enseñar a escribirlo?, se plantea una metodología para el trabajo del párrafo en el aula.

Detection of left ventricular thrombi by computerised tomography

International Nuclear Information System (INIS)

Nair, C.K.; Sketch, M.H.; Mahoney, P.D.; Lynch, J.D.; Mooss, A.N.; Kenney, N.P.

1981-01-01

Sixteen patients suspected of having left ventricular mural thrombi were studied. All had suffered transmural myocardial infarction. Fifteen patients had a ventricular aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four out of eight patients. Computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography, was found to have thrombi on computerised tomography. In another, two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. (author)

Arrhythmogenic right ventricular dysplasia

International Nuclear Information System (INIS)

Vignolo Puglia, W.; Freire Colla, D.; Rivara Urrutia, D.; Lujambio Grene, M.; Arbiza Bruno, T.; Oliveira, G.; Cobas Rodriguez, J.

1997-01-01

The arrhythmogenic right ventricular dysplasia is a condition predominantly well defined with arrhythmic events. We analyze three cases diagnosed by the group. These cases were presented as ventricular tachycardia with a morphology of left bundle branch block, presenting one of them aborted sudden death in evolution. The baseline electrocardiogram and signal averaging were abnormal in two of the three cases, like the echocardiogram. The electrophysiological study was able to induce in the three patients with sustained monomorphic ventricular tachycardia morphology of left bundle branch block. The definitive diagnosis was made by right ventriculography in two cases and magnetic resonance imaging in the other. Treatment included antiarrhythmic drugs in the three cases and the placement of an automatic defibrillator which survived a sudden death (Author)

Isolated left ventricular non-compaction cardiomyopathy associated with polymorphous ventricular tachycardia mimicking torsades de pointes

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Oana Dickinson

2013-02-01

Full Text Available Left ventricular non-compaction (LVNC cardiomyopathy is a rare congenital disorder, classified by the American Heart Association as a primary genetic cardiomyopathy and characterized by multiple trabeculations within the left ventricle. LVNC cardiomyopathy has been associated with 3 major clinical manifestations: heart failure, atrial and ventricular arrhythmias and thromboembolic events, including stroke. In this case report, we describe a female patient with apparently isolated LVNC in whom pause-dependent polymorphic ventricular tachycardia suggesting torsades de pointes occurred in the presence of a normal QT interval.

Two-dimensional echocardiographic features of right ventricular infarction

International Nuclear Information System (INIS)

D'Arcy, B.; Nanda, N.C.

1982-01-01

Real-time, two-dimensional echocardiographic studies were performed in 10 patients with acute myocardial infarction who had clinical features suggestive of right ventricular involvement. All patients showed right ventricular wall motion abnormalities. In the four-chamber view, seven patients showed akinesis of the entire right ventricular diaphragmatic wall and three showed akinesis of segments of the diaphragmatic wall. Segmental dyskinetic areas involving the right ventricular free wall were identified in four patients. One patient showed a large right ventricular apical aneurysm. Other echocardiographic features included enlargement of the right ventricle in eight cases, paradoxical ventricular septal motion in seven cases, tricuspid incompetence in eight cases, dilation of the stomach in four cases and localized pericardial effusion in two cases. Right ventricular infarction was confirmed by radionuclide methods in seven patients, at surgery in one patient and at autopsy in two patients

Unir Gamificación y Experiencia de Usuario para mejorar la experiencia docente

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Emiliano Labrador

2016-06-01

Full Text Available En unos estudios como son las ingenierías TIC se realiza un tipo de asignatura obligatoria y transversal a todos los alumnos. Es una asignatura que trabaja la parte creativa y la parte crítica del alumno, contando que son alumnos con un tipo de perfil de base principalmente tecnológico. Se trata de una asignatura presencial con soporte de una plataforma online que dispone de todos los recursos necesarios para llevarla a cabo. La gamificación forma parte de la asignatura de primer curso de ingeniería, diseño y usabilidad 1. Su aplicación ha sido diseñada y evaluada para iterar constantemente en la metodología y aplicar cambios continuos que mejoren su diseño y, por lo tanto, que mejoren la aplicación con los alumnos. La gamificación se centra principalmente en respetar el contenido de la asignatura: comunicación, diseño gráfico y usabilidad y experiencia de usuario para tenerlo en cuenta en las mecánicas de juego aplicadas. Tras la gamificación del curso 2013-2014, se realizaron encuestas a los alumnos basadas en técnicas de evaluación de experiencia de usuario para poder obtener datos tanto de la aplicación del contenido académico como de los puntos positivos y negativos de las mecánicas aplicadas. Estas encuestas se contrastaron con los resultados académicos de los alumnos tanto de notas parciales como de notas finales. Este artículo muestra los cambios introducidos en el diseño metodológico, su evaluación y sus posteriores resultados. La pregunta que se pretende responder es: ¿las mejoras introducidas han hecho que mejoren los resultados?

La intimidad y la experiencia en lo público

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María Teresa Luna

2007-05-01

Full Text Available Esta investigación, de corte fenomenológico, se posiciona en los postulados de la fenomenología del mundo social desarrollada por Alfred Schütz; en este sentido se discute la categoría intimidad como experiencia subjetiva en la que se vivencia la configuración del yo y el tú, y en la que se producen y decantan significaciones esenciales para la relación con uno mismo o con una misma, y con los otros u otras, lo cual parece producir esquemas de actuación en lo público, entendido como el espacio físico y simbólico compartido con otros mediatos u otras mediatas. La información fue construida mediante entrevistas conversacionales en las que cuatro profesionales (tres mujeres y un hombre, vinculados a Organizaciones No Gubernamentales de la ciudad de Medellín con un fuerte trabajo en lo público, construyeron narrativas autobiográficas. La unidad de lectura de la información fue el relato –entendido como una historia con un principio, un desarrollo y un final–y el criterio de selección de relatos significativos fue el acontecimiento biográfico, entendido como un evento que produce un quiebre en la propia biografía, sea porque rompe algo o inaugura algo. Los acontecimientos seleccionados fueron aquellos que aportaban información pertinente para comprender la progresiva configuración de la experiencia íntima y su encadenamiento con una cierta forma de experienciar la actuación en lo público. Los resultados muestran que la intimidad es experiencia de posicionamiento en asuntos morales que están en la base de la actuación en lo público, así como también que en las relaciones íntimas –básicamente con los contemporáneos inmediatos como los amigos, las amigas y las parejas– se construyen experiencias como la confianza, el cuidado y el respeto, que son determinantes en la manera de transitar por la esfera pública.

La intimidad y la experiencia en lo público

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María Teresa Luna C.

2007-01-01

Full Text Available Esta investigación, de corte fenomenológico, se posiciona en los postulados de la fenomenología del mundo social desarrollada por Alfred Schütz; en este sentido se discute la categoría intimidad como experiencia subjetiva en la que se vivencia la configuración del yo y el tú, y en la que se producen y decantan significaciones esenciales para la relación con uno mismo o con una misma, y con los otros u otras, lo cual parece producir esquemas de actuación en lo público, entendido como el espacio físico y simbólico compartido con otros mediatos u otras mediatas. La información fue construida mediante entrevistas conversacionales en las que cuatro profesionales (tres mujeres y un hombre, vinculados a Organizaciones No Gubernamentales de la ciudad de Medellín con un fuerte trabajo en lo público, construyeron narrativas autobiográficas. La unidad de lectura de la información fue el relato –entendido como una historia con un principio, un desarrollo y un final–y el criterio de selección de relatos significativos fue el acontecimiento biográfico, entendido como un evento que produce un quiebre en la propia biografía, sea porque rompe algo o inaugura algo. Los acontecimientos seleccionados fueron aquellos que aportaban información pertinente para comprender la progresiva configuración de la experiencia íntima y su encadenamiento con una cierta forma de experienciar la actuación en lo público. Los resultados muestran que la intimidad es experiencia de posicionamiento en asuntos morales que están en la base de la actuación en lo público, así como también que en las relaciones íntimas –básicamente con los contemporáneos inmediatos como los amigos, las amigas y las parejas– se construyen experiencias como la confianza, el cuidado y el respeto, que son determinantes en la manera de transitar por la esfera pública.

El climaterio y las inmigrantes ecuatorianas: una experiencia natural en manos de otros

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Juan Manuel Leyva-Moral

Full Text Available Introducción: El modelo biomédico describe la menopausia como un problema de salud. Los científicos sociales sostienen que se trata de un proceso biológico normal individual cuya experiencia viene determinada por factores culturales. Objetivo: Comprender la experiencia de la menopausia entre las inmigrantes ecuatorianas que viven en Barcelona (España. Diseño: Estudio cualitativo fenomenológico hermenéutico. Trece mujeres ecuatorianas menopáusicas fueron entrevistadas en sus hogares durante el período 2008-2009. Las entrevistas fueron transcritas textualmente y analizadas siguiendo el proceso hermenéutico. Resultados: Cuatro dominios interrelacionados fueron identificados: Una experiencia individual natural, ser mujer, mi sexualidad en manos de otros, ser vs. sentirse mayor. Conclusión: la menopausia entre las inmigrantes ecuatorianas aparece como un evento natural repleto de falsos mitos y tabúes en cuya construcción influyen sustancialmente la biomedicina y el contexto social.

Exercise thallium testing in ventricular preexcitation

Energy Technology Data Exchange (ETDEWEB)

Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

1987-05-01

Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation.

Exercise thallium testing in ventricular preexcitation

International Nuclear Information System (INIS)

Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

1987-01-01

Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation

Idiopathic ventricular tachycardia and fibrillation.

Science.gov (United States)

Belhassen, B; Viskin, S

1993-06-01

Important data have recently been added to our understanding of sustained ventricular tachyarrhythmias occurring in the absence of demonstrable heart disease. Idiopathic ventricular tachycardia (VT) is usually of monomorphic configuration and can be classified according to its site of origin as either right monomorphic (70% of all idiopathic VTs) or left monomorphic VT. Several physiopathological types of monomorphic VT can be presently individualized, according to their mode of presentation, their relationship to adrenergic stress, or their response to various drugs. The long-term prognosis is usually good. Idiopathic polymorphic VT is a much rarer type of arrhythmia with a less favorable prognosis. Idiopathic ventricular fibrillation may represent an underestimated cause of sudden cardiac death in ostensibly healty patients. A high incidence of inducibility of sustained polymorphic VT with programmed ventricular stimulation has been found by our group, but not by others. Long-term prognosis on Class IA antiarrhythmic medications that are highly effective at electrophysiologic study appears excellent.

Left Ventricular Function Improves after Pulmonary Valve Replacement in Patients with Previous Right Ventricular Outflow Tract Reconstruction and Biventricular Dysfunction

Science.gov (United States)

Kane, Colin; Kogon, Brian; Pernetz, Maria; McConnell, Michael; Kirshbom, Paul; Rodby, Katherine; Book, Wendy M.

2011-01-01

Congenital heart defects that have a component of right ventricular outflow tract obstruction, such as tetralogy of Fallot, are frequently palliated in childhood by disruption of the pulmonary valve. Although this can provide an initial improvement in quality of life, these patients are often left with severe pulmonary valve insufficiency. Over time, this insufficiency can lead to enlargement of the right ventricle and to the deterioration of right ventricular systolic and diastolic function. Pulmonary valve replacement in these patients decreases right ventricular volume overload and improves right ventricular performance. To date, few studies have examined the effects of pulmonary valve replacement on left ventricular function in patients with biventricular dysfunction. We sought to perform such an evaluation. Records of adult patients who had undergone pulmonary valve replacement from January 2003 through November 2006 were analyzed retrospectively. We reviewed preoperative and postoperative echocardiograms and calculated left ventricular function in 38 patients. In the entire cohort, the mean left ventricular ejection fraction increased by a mean of 0.07 after pulmonary valve replacement, which was a statistically significant change (P < 0.01). In patients with preoperative ejection fractions of less than 0.50, mean ejection fractions increased by 0.10. We conclude that pulmonary valve replacement in patients with biventricular dysfunction arising from severe pulmonary insufficiency and right ventricular enlargement can improve left ventricular function. Prospective studies are needed to verify this finding. PMID:21720459

The right ventricular response to ventricular hypofunction in anteroseptal infarction

International Nuclear Information System (INIS)

Kanayama, Sugako

1992-01-01

Thirty-seven patients with acute anteroseptal infarction but not significant right coronary artery stenosis were examined by using thallium-201 (Tl-201) myocardial perfusion SPECT to determine how the right ventricular (RV) free wall responded to a severely impaired ventricular septum. The patients were divided into the group in which RV free wall was visualized on Tl-201 myocardial SPECT (n=19, RV(+) Group) and the group in which it was not visualized (n=18, RV(-) Group). The relationship between visualization of RV free wall and both RV and left ventricular (LV) function was evaluated. RV(+) Group had larger extent of anteroseptal necrosis and severer impairment of RV free wall, as compared with RV(-) Group. LV ejection fraction (LVEF) was significantly lower in RV(+) Group than RV(-) Group in both acute and chronic phases. Although RV ejection fraction (RVEF) in acute phase was significantly lower in RV(+) Group than RV(-) Group, it did not differ in chronic phase between the two groups. In RV(+) Group, RV stroke work index (RVSWI), pulmonary artery end diastolic pressure (PAEDP), and mean pulmonary artery pressure (MPA) in chronic phase showed a statistically significant increase compared with those in acute phase; these hemodynamic variables in chronic phase were also significantly higher than those in RV(-) Group. RV/LV ratio inversely correlated with LVEF, and both necrotic extent and impairment severity positively correlated with both PAEDP and MPA. RV free wall could be visualized more clearly, corresponding to extremely decreased LV function. These findings suggest that RV free wall may play an important role in maintaining LV and RV function when ventricular septum is severely impaired by anteroseptal infarction. (N.K.)

EXAMEN DE POST-EFECTO PARA EXPERIENCIAS ANÓMALO/ PARANORMALES CON UN ABORDAJE HUMANISTA

OpenAIRE

PARRA, ALEJANDRO; CORBETTA, JUAN MANUEL

2014-01-01

Se presentan los resultados de una investigación que tuvo como objetivos: explorar la utilidad de la terapia grupal para hacer frente a los efectos de las experiencias paranormales y explorar cómo la terapia humanista produce cambios positivos hacia las experiencias anómalo/paranormales. Se les pidió a la muestra (N= 20, rango 22-71 años, M= 45,65, DT= 12,52), 65 % mujeres y 35 % varones, responder un cuestionario autoadministrado de siete preguntas antes y al finalizar su participación en un...

β1-Adrenoceptor blocker aggravated ventricular arrhythmia.

Science.gov (United States)

Wang, Yan; Patel, Dimpi; Wang, Dao Wu; Yan, Jiang Tao; Hsia, Henry H; Liu, Hao; Zhao, Chun Xia; Zuo, Hou Juan; Wang, Dao Wen

2013-11-01

To assess the impact of β1 -adrenoceptor blockers (β1 -blocker) and isoprenaline on the incidence of idiopathic repetitive ventricular arrhythmia that apparently decreases with preprocedural anxiety. From January 2010 to July 2012, six patients were identified who had idiopathic ventricular arrhythmias that apparently decreased (by greater than 90%) with preprocedural anxiety. The number of ectopic ventricular beats per hour (VPH) was calculated from Holter or telemetry monitoring to assess the ectopic burden. The mean VPH of 24 hours from Holter before admission (VPH-m) was used as baseline (100%) for normalization. β1 -Blockers, isoprenaline, and/or aminophylline were administrated successively on the ward and catheter lab to evaluate their effects on the ventricular arrhythmias. Among 97 consecutive patients with idiopathic ventricular arrhythmias, six had reduction in normalized VPHs in the hour before the scheduled procedure time from (104.6 ± 4.6%) to (2.8 ± 1.6%) possibly due to preprocedural anxiety (P < 0.05), then increased to (97.9 ± 9.7%) during β1 -blocker administration (P < 0.05), then quickly reduced to (1.6 ± 1.0%) during subsequent isoprenaline infusion. Repeated β1 -blocker quickly counteracted the inhibitory effect of isoprenaline, and VPHs increased to (120.9 ± 2.4%) from (1.6 ± 1.0%; P < 0.05). Isoprenaline and β1 -blocker showed similar effects on the arrhythmias in catheter lab. In some patients with structurally normal heart and ventricular arrhythmias there is a marked reduction of arrhythmias associated with preprocedural anxiety. These patients exhibit a reproducible sequence of β1 -blocker aggravation and catecholamine inhibition of ventricular arrhythmias, including both repetitive ventricular premature beats and monomorphic ventricular tachycardia. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

Left Ventricular Myocardial Function in Children With Pulmonary Hypertension: Relation to Right Ventricular Performance and Hemodynamics.

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Burkett, Dale A; Slorach, Cameron; Patel, Sonali S; Redington, Andrew N; Ivy, D Dunbar; Mertens, Luc; Younoszai, Adel K; Friedberg, Mark K

2015-08-01

Through ventricular interdependence, pulmonary hypertension (PH) induces left ventricular (LV) dysfunction. We hypothesized that LV strain/strain rate, surrogate measures of myocardial contractility, are reduced in pediatric PH and relate to invasive hemodynamics, right ventricular strain, and functional measures of PH. At 2 institutions, echocardiography was prospectively performed in 54 pediatric PH patients during cardiac catheterization, and in 54 matched controls. Patients with PH had reduced LV global longitudinal strain (LS; -18.8 [-17.3 to -20.4]% versus -20.2 [-19.0 to -20.9]%; P=0.0046) predominantly because of reduced basal (-12.9 [-10.8 to -16.3]% versus -17.9 [-14.5 to -20.7]%; Pright ventricular free-wall LS (r=0.64; PBrain natriuretic peptide levels correlated moderately with septal LS (r=0.48; P=0.0038). PH functional class correlated moderately with LV free-wall LS (r=-0.48; P=0.0051). The septum, shared between ventricles and affected by septal shift, was the most affected LV region in PH. Pediatric PH patients demonstrate reduced LV strain/strain rate, predominantly within the septum, with relationships to invasive hemodynamics, right ventricular strain, and functional PH measures. © 2015 American Heart Association, Inc.

Resolving the True Ventricular Mural Architecture

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Robert S. Stephenson

2018-06-01

Full Text Available The precise nature of packing together of the cardiomyocytes within the ventricular walls has still to be determined. The spiraling nature of the chains of interconnected cardiomyocytes has long been recognized. As long ago as the end of the nineteenth century, Pettigrew had emphasized that the ventricular cone was not arranged on the basis of skeletal muscle. Despite this guidance, subsequent anatomists described entities such as “bulbo-spiral muscles”, with this notion of subunits culminating in the suggestion that the ventricular cone could be unwrapped so as to produce a “ventricular myocardial band”. Others, in contrast, had suggested that the ventricular walls were arranged on the basis of “sheets”, or more recently “sheetlets”, with investigators seeking to establishing the angulation of these entities using techniques such as magnetic resonance imaging. Our own investigations, in contrast, have shown that the cardiomyocytes are aggregated together within the supporting fibrous matrix so as to produce a three-dimensional myocardial mesh. In this review, we summarize the previous accounts, and provide the anatomical evidence we have thus far accumulated to support the model of the myocardial mesh. We show how these anatomic findings underscore the concept of the myocardial mesh functioning in antagonistic fashion. They lend evidence to support the notion that the ventricular myocardium works as a muscular hydrostat.

Right ventricular involvement in cardiac sarcoidosis demonstrated with cardiac magnetic resonance.

Science.gov (United States)

Smedema, Jan-Peter; van Geuns, Robert-Jan; Ainslie, Gillian; Ector, Joris; Heidbuchel, Hein; Crijns, Harry J G M

2017-11-01

Cardiac involvement in sarcoidosis is reported in up to 30% of patients. Left ventricular involvement demonstrated by contrast-enhanced cardiac magnetic resonance has been well validated. We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis. We prospectively evaluated 87 patients diagnosed with pulmonary sarcoidosis with contrast-enhanced cardiac magnetic resonance for right ventricular involvement. Pulmonary artery pressures were non-invasively evaluated with Doppler echocardiography. Patient characteristics were compared between the groups with and without right ventricular involvement, and right ventricular enhancement was correlated with pulmonary hypertension, ventricular mass, volume, and systolic function. Left ventricular late gadolinium enhancement was demonstrated in 30 patients (34%). Fourteen patients (16%) had right ventricular late gadolinium enhancement, with sole right ventricular enhancement in only two patients. The pattern of right ventricular enhancement consisted of right ventricular outflow tract enhancement in 1 patient, free wall enhancement in 8 patients, ventricular insertion point enhancement in 10 patients, and enhancement of the right side of the interventricular septum in 11 patients. Pulmonary arterial hypertension correlated with the presence of right ventricular enhancement (P Right ventricular enhancement correlated with systolic ventricular dysfunction (P Right ventricular enhancement was present in 16% of patients diagnosed with pulmonary sarcoidosis and in 48% of patients with left ventricular enhancement. The presence of right ventricular enhancement correlated with pulmonary arterial hypertension, right ventricular systolic dysfunction, hypertrophy, and dilation. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Impact of the right ventricular lead position on clinical outcome and on the incidence of ventricular tachyarrhythmias in patients with CRT-D

DEFF Research Database (Denmark)

Kutyifa, Valentina; Bloch Thomsen, Poul Erik; Huang, David T.

2013-01-01

Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited.......Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited....

Right ventricular strain in heart failure: Clinical perspective.

Science.gov (United States)

Tadic, Marijana; Pieske-Kraigher, Elisabeth; Cuspidi, Cesare; Morris, Daniel A; Burkhardt, Franziska; Baudisch, Ana; Haßfeld, Sabine; Tschöpe, Carsten; Pieske, Burket

2017-10-01

The number of studies demonstrating the importance of right ventricular remodelling in a wide range of cardiovascular diseases has increased in the past two decades. Speckle-tracking imaging provides new variables that give comprehensive information about right ventricular function and mechanics. In this review, we summarize current knowledge of right ventricular mechanics in heart failure with reduced ejection fraction and preserved ejection fraction. We searched PubMed, MEDLINE, Ovid and Embase databases for studies published from January 2000 to December 2016 in the English language using the following keywords: "right ventricle"; "strain"; "speckle tracking"; "heart failure with reduced ejection fraction"; and "heart failure with preserved ejection fraction". Investigations showed that right ventricular dysfunction is associated with higher cardiovascular and overall mortality in patients with heart failure, irrespective of ejection fraction. The number of studies investigating right ventricular strain in patients with heart failure with reduced ejection fraction is constantly increasing, whereas data on right ventricular mechanics in patients with heart failure with preserved ejection fraction are limited. Given the high feasibility, accuracy and clinical implications of right ventricular strain in the population with heart failure, it is of great importance to try to include the evaluation of right ventricular strain as a regular part of each echocardiographic examination in patients with heart failure. However, further investigations are necessary to establish right ventricular strain as a standard variable for decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Right ventricular function in patients with dilated cardiomyopathy

International Nuclear Information System (INIS)

Kubota, Shuhei; Kubota, Sachio; Iwase, Takashi; Iizuka, Toshio; Imai, Susumu; Murata, Kazuhiko; Inoue, Tomio; Suzuki, Tadashi; Sasaki, Yasuhito.

1993-01-01

The characteristics and pathogenesis of right ventricular dysfunction in 14 patients with dilated cardiomyopathy (DCM) were investigated by equilibrium right ventricular blood pool scintigraphy using ultrashort-lifetime 81m Kr. Thirteen patients with severe left ventricular dysfunction due to old anterior myocardial infarction (OMI) and nine normal subjects were used as controls. The right ventricular end-diastolic pressure and volume index, mean pulmonary arterial pressure, and total pulmonary vascular resistance index were almost the same in the DCM and OMI patients. The right ventricular ejection fraction was 44.2±6.0% (mean±SD) in DCM patients and 47.1±7.9% in OMI patients, both significantly lower than those in the normal subjects (54.5±5.3%), but with no difference between the two case groups. The right ventricular peak filling rate was significantly reduced in both case groups as compared with the normal subjects (2.46±0.81 EDV/sec). The reduction was significantly greater (p 81m Kr blood pool scintigraphy is useful in the study of the right ventricular systolic and diastolic function. The diastolic parameters are more sensitive indicators for evaluation of right ventricular function in DCM than the systolic parameters. (author)

Arrhythmogenic right ventricular cardiomyopathy in a dog : case report

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A.J. Möhr

2000-07-01

Full Text Available An 8-month-old Labrador retriever bitch was evaluated for sudden-onset, progressive abdominal distension. Physical examination revealed an exaggerated inspiratory effort, severe ascites, bilateral jugular vein distension, and hypokinetic femoral arterial pulses. Thoracic auscultation detected tachycardia with muffled heart sounds, without audible cardiac murmurs. Thoracic radiographs identified severe right ventricular enlargement and pleural effusion. The electrocardiogram was consistent with incomplete right bundle branch block or right ventricular enlargement. Echocardiography demonstrated severe right ventricular and atrial dilation, secondary tricuspid regurgitation, and thinning and hypocontractility of the right ventricular myocardium. Left heart chamber sizes were slightly decreased, with normal left ventricular contractility. Adiagnosis of arrhythmogenic right ventricular cardiomyopathy was reached, based on the characteristic clinical, electrocardiographic, radiographic and echocardiographic findings, and the exclusion of other causes of isolated right ventricular failure. Treatment effected good control of clinical signs, until acutely decompensated congestive right heart failure led to euthanasia after 4 months. Arrhythmogenic right ventricular cardiomyopathy is a well-described clinical entity in humans, and has previously been documented in 3 male dogs. The condition is characterised by progressive fibro-adipose replacement of right ventricular myocardium, while the left ventricle usually remains unaffected. It should be considered a differential diagnosis in any young dog presented with isolated right heart failure, syncope, or unexplained ventricular tachyarrhythmias. This article reports the 1st case of arrhythmogenic right ventricular cardiomyopathy in a female dog, and highlights its echocardiographic features.

Antes de los Estudios Culturales. Robert Warshow y la experiencia

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Antonio Lastra

2008-01-01

Full Text Available Este artículo estudia la influencia del concepto de experiencia que desarrolla Robert Warshow. Warshow ha supuesto el contrapunto americano a las teorías desarrolladas por Walter Benjamien en Europa. Si bien ambos insistieron en la pobreza de la experiencia, como resultado de la tecnificación de la sociedad, Warshow supo introducir matizaciones que influyeron en todo el círculo de intelectuales concentrados en Nueva York durante la etapa de consolidación de los Estudios Culturales. This paper studies the influence of the experience concept by Robert Warshow. Warshow is the American counterpoint to theories developed by Walter Benjamin in Europe. Although both insisted in the poverty of experience, as a result of technique, Warshow knew how to introduce nuances that influenced intellectuals in New York as Cultural Studies emerged.

Arquitectura para aguijonear la experiencia de conocer en la escuela

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Diego Emilio Clementin

2017-09-01

Full Text Available El presente artículo es una invitación para que los docentes asumamos el desafío de afirmarnos como media­dores de cultura en el marco de un vínculo pedagógico no autoritario, esto significa asumir la responsabilidad de transmitir conocimientos, aguijonear la experiencia de conocer; ulteriormente, el alumno hará con esos co­nocimientos lo que quiera, pueda o necesite, pero luego de haberlos tenido a disposición. Para desarrollar un tema, en el marco de un vínculo pedagógico no autoritario que pueda aguijonear la experiencia de conocer de los alumnos, se sugiere considerar las fases de construcción, elaboración, ejercitación y aplicación durante las clases, no de manera aislada, sino muy articuladas entre sí. 

The influence of type 2 diabetes and gender on ventricular repolarization dispersion in patients with sub-clinic left ventricular diastolic dysfunction

OpenAIRE

Jani, Ylber; Kamberi, Ahmet; Xhunga, Sotir; Pocesta, Bekim; Ferati, Fatmir; Lala, Dali; Zeqiri, Agim; Rexhepi, Atila

2015-01-01

Objective: To assess the influence of type 2 DM and gender, on the QT dispersion, Tpeak-Tend dispersion of ventricular repolarization, in patients with sub-clinic left ventricular diastolic dysfunction of the heart. Background: QT dispersion, that reflects spatial inhomogeneity in ventricular repolarization, Tpeak-Tend dispersion, this on the other hand reflects transmural inhomogeneity in ventricular repolarization, that is increased in an early stage of cardiomyopathy, and in patients with ...

Música y experiencia: De las "sociedades primitivas" a las redes sociales

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Israel V. Mázquez

2011-05-01

Full Text Available El artículo traza un itinerario circular que parte de la experiencia musical en su sentido tradicional de interacción y actividad grupal, sigue con algunas de las características de la figura moderna del oyente solitario y su relación con el espacio público y privado, y termina con las nuevas tecnologías de la información y las redes sociales de la web 2.0, las cuales hacen posible nuevas formas de interactividad y nuevas maneras de fortalecer los lazos de afiliación y sociabilidad a través de la música, hecho que aquí interpretamos como un retorno a los orígenes grupales y comunitarios de la experiencia musical.

Investigación educativa: la experiencia en el estado de Chihuahua

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Evangelina Cervantes Holguín

2016-04-01

Full Text Available Este ensayo tiene como propósito recuperar las experiencias de investigación de los académicos e instituciones superiores establecidas en la región. Asimismo, permite conocer el estado que guarda esta actividad intelectual y el desarrollo que ha tenido el campo de la educación en el estado de Chihuahua. De manera concreta se establecen cuatro etapas: antecedentes, primeras experiencias de investigación (1984 a 1990; cambios y desafíos (1990 al 2000; crecimiento (2000 al 2009 y apertura y expansión (2009. En esta última fase, se destaca la pertinencia de la Rediech como espacio para generar, desarrollar, fortalecer y difundir la actividad investigativa en esta entidad.

A Left-Sided Prevalence of Lentigo Maligna: A UK Based Observational Study and Review of the Evidence

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Mark Gorman

2015-01-01

Full Text Available Skin cancer has been shown to present asymmetrically, prevalent on the left side of the body, more so in subtypes of cutaneous melanoma such as lentigo maligna. Biases have been linked to cumulative UV light exposure and automobile driving patterns. Though left-right ratios have previously correlated with the side men or women tend to position themselves or countries drive on, more recent trends indicate a consistent left-sided bias. To clarify reasons for changing trends, a review of the evidence base and LM’s laterality in a UK cohort (99 cases 2000–2011 was conducted for the first time. The strong correlation of left-sided excess, found in both genders (ratios 1.381–1.5, P<0.05  X2 0.841, is congruent with more recent findings. Though evidence indicates that driving position is no longer a risk factor for LM, due most likely to improved car window UV protection, it remains the most commonly attributed cause. Understanding phenomena such as UV lights “scatter effect” or that cumulative exposure may not be a significant risk factor helps rationalize older conclusions that would otherwise appear contradictory. The reasons for left-sided excess remain unclear but may be due to factors requiring further research such as the body’s anatomical/embryological asymmetry.

Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?

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Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun

2014-06-01

We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%-40% (for all comparisons, Pfunction capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.

Noninvasive reconstruction of the three-dimensional ventricular activation sequence during pacing and ventricular tachycardia in the rabbit heart.

Science.gov (United States)

Han, Chengzong; Pogwizd, Steven M; Killingsworth, Cheryl R; He, Bin

2011-01-01

Ventricular arrhythmias represent one of leading causes for sudden cardiac death, a significant problem in public health. Noninvasive imaging of cardiac electric activities associated with ventricular arrhythmias plays an important role in better our understanding of the mechanisms and optimizing the treatment options. The present study aims to rigorously validate a novel three-dimensional (3-D) cardiac electrical imaging (3-DCEI) technique with the aid of 3-D intra-cardiac mapping during paced rhythm and ventricular tachycardia (VT) in the rabbit heart. Body surface potentials and intramural bipolar electrical recordings were simultaneously measured in a closed-chest condition in thirteen healthy rabbits. Single-site pacing and dual-site pacing were performed from ventricular walls and septum. VTs and premature ventricular complexes (PVCs) were induced by intravenous norepinephrine (NE). The non-invasively imaged activation sequence correlated well with invasively measured counterparts, with a correlation coefficient of 0.72 and a relative error of 0.30 averaged over all paced beats and NE-induced PVCs and VT beats. The averaged distance from imaged site of initial activation to measured site determined from intra-cardiac mapping was ∼5mm. These promising results suggest that 3-DCEI is feasible to non-invasively localize the origins and image activation sequence of focal ventricular arrhythmias.

LO QUE EL OJO NO VE: ANÁLISIS DE UNA EXPERIENCIA

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J.A. García-García

2010-09-01

Full Text Available Durante diez meses hemos realizado una actividad-exposición en el Parque de las Ciencias de Granada. En el espacio “Ventana a la Ciencia” la exposición “Lo que el ojo no ve” ha pretendido mostrar a la ciudadanía aspectos de la Óptica relacionados conlos límites de la visión humana y los avances científicos que han permitido superar dichos límites. Ha sido una actividad didáctica, divulgativa e interactiva, que ha buscado fomentar la reflexión del visitante.El objetivo fundamental de este trabajo es analizar dicha experiencia, planteándonos si experiencias como ésta contribuyen a fomentar la cultura científica de la ciudadanía. Para realizar la evaluación de la misma se ha aplicado una encuesta a una muestra de los visitantes cuyos resultados muestran que más del 90% consideraque ha aprendido de ella, al tiempo que la valoran como divertida. Así mismo, al pedírseles que la calificaran, lo han hecho con una nota media de 9 sobre 10. Por la experiencia vivida y por los resultados obtenidos, consideramos que actividades como ésta resultan de interés y debieran potenciarse como una vía válida para la divulgación científica.

Delayed recovery of right ventricular systolic function after repair of long-standing tricuspid regurgitation associated with severe right ventricular failure.

Science.gov (United States)

Kim, Jong Hun; Kim, Kyung Hwa; Choi, Jong Bum; Kuh, Ja Hong

2016-03-01

After tricuspid valve surgery for long-standing tricuspid regurgitation associated with right ventricular failure, reverse remodelling of the enlarged right ventricle, including recovery of right ventricular systolic function, is unpredictable. We present the case of a 31-year old man with early reduction of dilated right ventricular dimensions and delayed recovery of impaired right ventricular systolic function after valve repair for traumatic tricuspid regurgitation lasting 16 years. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Diseño de una experiencia de tiro parabólico para Bachillerato

OpenAIRE

Peña Maniega, Víctor

2014-01-01

En este trabajo fin de máster se presenta el diseño de una experiencia de laboratorio de tiro parabólico para alumnos de Bachillerato. El objetivo general es que dicha experiencia sea novedosa, motivante y un ejemplo práctico de la aplicación de las diversas fases del método científico. Para ello, se utiliza un lanzador casero de proyectiles de aire comprimido, y la grabación en video digital como herramienta de trabajo y análisis. También se presentan opciones de cómo realizar...

experiencias en el sistema

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B. Fernández Manjón

2005-01-01

Full Text Available En este trabajo se presenta la experiencia de aplicación e implementación del modelo de objetos educativos en el sistema . Se describe una visión práctica de la aplicación de las tecnologías de marcado tanto en la estructuración de los cursos como en el desarrollo de contenidos que pueden ser adaptados al usuario. En se han seguido las especificaciones de IMS, desarrollándose un soporte completo del empaquetamiento de cursos (content packaging reflejado en un sistema de autoría de cursos y una herramienta de importación. Además se ha particularizado un perfil específico de cursos y de objetos educativos que permiten su adaptación al usuario.

Experiencia Educacional en Paraguay.

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Mari Blanca Pavon.

Full Text Available La experiencia educacional que presentaré concierne al grupo indígena de los guaraníes del Paraguay que se autodenominan Karaguy  jara, que quiere decir  "dueños del monte". También se denominan Avá chiiripá. Esta etnia vive en la región oriental del Paraguay. en un triángulo que se extiende hacia el Brasil. En este mismo sector viven también los Paitauytera, los Mbya y los llamados Ache o Guayaki o Atchi. Se supone .que existen alrededor de 4.500 Avá Chiripá en la región oriental del Paraguay. Viven en pequeñas comunidades y han perdido su hábitat selvático natural casi en su totalidad.

Right Ventricular Pseudoaneurysm Following Endomyocardial Biopsy.

Science.gov (United States)

Pita; Santos; Manteiga; Rodriguez; Beiras

1996-03-01

Ventricular perforation is an unusual complication after endomyocardial biopsy in heart transplanted patients. We report a case of asymptomatic right ventricular perforation and pseudoaneurysm formation, secondary to endomyocardial biopsy, diagnosed by angiography. The spontaneous obliteration of the pseudoaneurysm was observed.

Evaluation of right ventricular volumes measured by magnetic resonance imaging

DEFF Research Database (Denmark)

Møgelvang, J; Stubgaard, M; Thomsen, C

1988-01-01

stroke volume was calculated as the difference between end-diastolic and end-systolic volume and compared to left ventricular stroke volume and to stroke volume determined simultaneously by a classical indicator dilution technique. There was good agreement between right ventricular stroke volume......Right ventricular volumes were determined in 12 patients with different levels of right and left ventricular function by magnetic resonance imaging (MRI) using an ECG gated multisection technique in planes perpendicular to the diastolic position of the interventricular septum. Right ventricular...... determined by MRI and by the indicator dilution method and between right and left ventricular stroke volume determined by MRI. Thus, MRI gives reliable values not only for left ventricular volumes, but also for right ventricular volumes. By MRI it is possible to obtain volumes from both ventricles...

Genetics Home Reference: arrhythmogenic right ventricular cardiomyopathy

Science.gov (United States)

... cardiomyopathy Merck Manual Consumer Version: Cardiomyopathy Merck Manual Consumer Version: Overview of Abnormal Heart Rhythms Orphanet: Arrhythmogenic right ventricular cardiomyopathy Orphanet: Familial isolated arrhythmogenic right ventricular ...

Left Ventricular Assist Devices

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Khuansiri Narajeenron

2017-04-01

Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

Trombose venosa profunda e neoplasia mamária maligna: relato de caso em idosa

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Eliton Edmilson Couto

2017-08-01

Full Text Available A Trombose Venosa Profunda (TVP é caracterizada pela formação de trombos no interior de veias profundas, mais comum nos mem¬bros inferiores (80 a 95% dos casos. A incidência da doença, no Brasil, mostra-se em torno de 0,6 por 1.000 habitantes/ano. A literatura descreve alguns fatores principais no processo de formação dos trombos: estase sanguínea, lesões do endotélio e estados de hipercoagulabilidade. As neoplasias também são reconhecidas como fatores de risco independentes para TVP. Como complicação grave da TVP, em sua fase aguda, cita-se a embolia pulmonar e, tardiamente, a síndrome pós-trombótica. O objetivo do presente estudo é relatar um caso clínico de uma paciente do sexo feminino, idosa, portadora de hipertensão arterial sistêmica, diabetes mellitus tipo 2 e dislipidemia, em uso irregular das medicações. Concomitantemente, há 3 meses, a paciente foi diagnosticada com neoplasia mamária maligna, ainda sem início do tratamento. Ao exame físico a paciente apresentou-se com dor em membro inferior direito, sem hiperemia, com edema e sinal de Homams positivo. Como tratamento para TVP foi proposto uso de anticoagulante oral, e a paciente segue internada, em repouso, há 6 dias. Diante do caso apresentado, cabe destacar que é de suma importância compreender os fatores de risco para TVP, bem como suas alterações fisiológicas no organismo, o que é de extrema importância para o diagnóstico correto e o sucesso terapêutico de cada caso.

The influence of type 2 diabetes and gender on ventricular repolarization dispersion in patients with sub-clinic left ventricular diastolic dysfunction.

Science.gov (United States)

Jani, Ylber; Kamberi, Ahmet; Xhunga, Sotir; Pocesta, Bekim; Ferati, Fatmir; Lala, Dali; Zeqiri, Agim; Rexhepi, Atila

2015-01-01

To assess the influence of type 2 DM and gender, on the QT dispersion, Tpeak-Tend dispersion of ventricular repolarization, in patients with sub-clinic left ventricular diastolic dysfunction of the heart. QT dispersion, that reflects spatial inhomogeneity in ventricular repolarization, Tpeak-Tend dispersion, this on the other hand reflects transmural inhomogeneity in ventricular repolarization, that is increased in an early stage of cardiomyopathy, and in patients with left ventricular diastolic dysfunction, as well. The left ventricular diastolic dysfunction, a basic characteristic of diabetic heart disease (diabetic cardiomyopathy), that developes earlier than systolic dysfunction, suggests that diastolic markers might be sensitive for early cardiac injury. It is also demonstrated that gender has complex influence on indices of myocardial repolarization abnormalities such as QT interval and QT dispersion. We performed an observational study including 300 diabetic patients with similar epidemiological-demographic characteristics recruited in our institution from May 2009 to July 2014, divided into two groups. Demographic and laboratory echocardiographic data were obtained, twelve lead resting electrocardiography, QT, QTc, Tpeak-Tend-intervals and dispersion, were determined manually, and were compared between various groups. For statistical analysis a t-test, X(2) test, and logistic regression are used according to the type of variables. A p value <0.05 was considered statistically significant for a confidence interval of 95%. QTc max. interval, QTc dispersion and Tpeak-Tend dispersion, were significantly higher in diabetic group with subclinical LV (left ventricular) diastolic dysfunction, than in diabetic group with normal left ventricular diastolic function (445.24±14.7 ms vs. 433.55±14.4 ms, P<0.000; 44.98±18.78 ms vs. 32.05±17.9 ms, P<0.000; 32.60±1.6 ms vs. 17.46±2.0 ms, P<0.02. Prolonged QTc max. interval was found in 33% of patients, indiabetic group

Examen de post-efecto para experiencias anómalo/ paranormales con un abordaje humanista

OpenAIRE

Alejandro Parra; Juan Manuel Corbetta

2014-01-01

Se presentan los resultados de una investigación que tuvo como objetivos: explorar la utilidad de la terapia grupal para hacer frente a los efectos de las experiencias paranormales y explorar cómo la terapia humanista produce cambios positivos hacia las experiencias anómalo/paranormales. Se les pidió a la muestra (N= 20, rango 22-71 años, M= 45,65, DT= 12,52), 65 % mujeres y 35 % varones, responder un cuestionario autoadministrado de siete preguntas antes y al finalizar su participación en un...

Experiencias exitosas de liderazgo en enfermería

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Mery Luz Valderrama Sanabria

2014-11-01

Full Text Available Introducción: El objetivo de la investigación fue describir la experiencia de profesionales de enfermería en cargos administrativos en salud para fomentar el liderazgo en el futuro profesional de enfermería. Materiales y Métodos: Investigación cualitativa tipo descriptivo, con diseño narrativo de tópicos puesto que se enfoca en una temática que hace referencia al liderazgo en enfermería. Resultados: Se obtuvieron tres categorías: Experiencias exitosas, de la cual surgieron dos subcategorías: óptimo uso de los recursos y cuidado desde cargos directivos. Las otras categorías se denominaron; liderazgo en enfermería y   profesional del futuro. Discusión: Los resultados fueron analizados a la luz de la literatura encontrando semejanzas en cuanto a que el mercado laboral solicita del enfermero la aplicación del liderazgo y se debe redimensionar la formación del futuro profesional y nuevos escenarios de práctica para que responda a las necesidades de un país. Conclusiones: Las dificultades se presentan para ejercer liderazgo al inicio de la vida laboral son el temor, desconocimiento de los derechos como empleado y no saber cuánto vale el trabajo de enfermería. Posteriormente se van presentando por malos entendidos, relaciones interpersonales poco adecuadas, ausencia de colegaje y falta de posicionamiento y reconocimiento de la profesión. Ser líder es un proceso casi inherente a enfermería ya sea desde el ámbito clínico, comunitario o a través del ejercicio de cargos administrativos y se debe fomentar y potenciar en el estudiante.Palabras clave: Liderazgo, Enfermeros, Educación Continua, Satisfacción en el Trabajo. (Fuente: DeCS BIREME.Cómo citar este artículo: Valderrama ML. Experiencias exitosas de liderazgo en enfermería. Rev Cuid. 2014; 5(2: 765-73. http://dx.doi.org/10.15649/cuidarte.v5i2.89

Seguimiento a largo plazo de pacientes con disfunción ventricular izquierda intervenidos de sustitución valvular aórtica. Experiencia en nuestra institución

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Gemma Candela-Navarro

2016-07-01

Conclusiones: La sustitución valvular aórtica es una opción segura, eficaz y duradera en pacientes con disfunción ventricular izquierda. Se asocia a una mejoría en la clase funcional y fracción de eyección, con una perspectiva de futuro excelente.

A Prospective Study of Ripple Mapping the Post-Infarct Ventricular Scar to Guide Substrate Ablation for Ventricular Tachycardia.

Science.gov (United States)

Luther, Vishal; Linton, Nick W F; Jamil-Copley, Shahnaz; Koa-Wing, Michael; Lim, Phang Boon; Qureshi, Norman; Ng, Fu Siong; Hayat, Sajad; Whinnett, Zachary; Davies, D Wyn; Peters, Nicholas S; Kanagaratnam, Prapa

2016-06-01

Post-infarct ventricular tachycardia is associated with channels of surviving myocardium within scar characterized by fractionated and low-amplitude signals usually occurring late during sinus rhythm. Conventional automated algorithms for 3-dimensional electro-anatomic mapping cannot differentiate the delayed local signal of conduction within the scar from the initial far-field signal generated by surrounding healthy tissue. Ripple mapping displays every deflection of an electrogram, thereby providing fully informative activation sequences. We prospectively used CARTO-based ripple maps to identify conducting channels as a target for ablation. High-density bipolar left ventricular endocardial electrograms were collected using CARTO3v4 in sinus rhythm or ventricular pacing and reviewed for ripple mapping conducting channel identification. Fifteen consecutive patients (median age 68 years, left ventricular ejection fraction 30%) were studied (6 month preprocedural implantable cardioverter defibrillator therapies: median 19 ATP events [Q1-Q3=4-93] and 1 shock [Q1-Q3=0-3]). Scar (ripple mapping conducting channels were seen within each scar (length 60 mm; initial component 0.44 mV; delayed component 0.20 mV; conduction 55 cm/s). Ablation was performed along all identified ripple mapping conducting channels (median 18 lesions) and any presumed interconnected late-activating sites (median 6 lesions; Q1-Q3=2-12). The diastolic isthmus in ventricular tachycardia was mapped in 3 patients and colocated within the ripple mapping conducting channels identified. Ventricular tachycardia was noninducible in 85% of patients post ablation, and 71% remain free of ventricular tachycardia recurrence at 6-month median follow-up. Ripple mapping can be used to identify conduction channels within scar to guide functional substrate ablation. © 2016 American Heart Association, Inc.

follow-up of patients with arrhythmogenic right ventricular

African Journals Online (AJOL)

was sudden, 1 patient died due to left ventricular failure, and ... Arrhythmogenic right ventricular cardiomyopathy/ dysplasia .... hypertension and from atrial fibrillation that developed 2.4 .... of left ventricular function was global without regional ..... 99mTc he brain si before a acid (G minute his sem next 3 - his sem showed.

La experiencia vivida de la mujer con enfermedad cardiovascular revascularizada: un estudio de caso

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Inna Elida Florez Torres

2016-09-01

Full Text Available Objetivo: Comprender los significados de la experiencia vivida de una mujer revascularizada por enfermedad coronaria. Metodología: Estudio de caso fenomenológico con perspectiva de género, realizado en Cartagena, Colombia, entre febrero y junio de 2015. El análisis temático estuvo guiado por el método de Van Manen.  Resultados: La experiencia del cuerpo vivido significó percibir el anuncio de la enfermedad, prever los estragos sobre la corporeidad y feminidad, y anticiparse al sufrimiento. Las relaciones vividas significaron mantener un diálogo con un ser superior, una conexión de ayuda y dependencia con los cuidadores, Sentirse “al revés”: de cuidadora a cuidada. La experiencia del espacio vivido significó la entrada al quirófano: Atravesar la raya roja; la estancia en la unidad de cuidado intensivo, recibir un cuidado en soledad; salir de ella, la alegría de ganar una lucha. El tiempo vivido significó un punto de quiebre entre el antes y el ahora, un tránsito temporal de la experiencia, y recuperarse para mantener el rol. Las cosas vividas significaron una preocupación anticipada y una  pérdida del dominio del rol. Conclusión: Los significados otorgados a la experiencia permiten comprender su particularidad existencial. Durante la espera para la cirugía, la mujer se anticipa a los efectos sobre el rol social, sus dinámicas e interacciones; al enfrentarse al procedimiento, vive una situación límite. Intervenciones sensibles al género son requeridas para reconocer las necesidades de la mujer en los diferentes contextos de cuidado.

Relaciones diferenciales entre experiencias de alfabetización y habilidades de alfabetización emergente

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Liliana Salazar-Reyes

2013-08-01

Full Text Available El objetivo del estudio fue investigar si las experiencias de alfabetización que los padres brindan se relacionan diferencialmente con la alfabetización de los niños. A partir de una muestra intencional, se seleccionaron treinta y cuatro diadas madre-hijo al inicio de preescolar, procedentes de una escuela particular del Estado de México. Se presenta evidencia que considera en un mismo estudio el análisis de las experiencias explícitas e implícitas observadas en una sesión de interacción madre-hijo, haciendo uso de diferentes materiales, y otro tipo de experiencias de alfabetización reportadas por las madres. Ambos resultados se complementaron para comparar los puntajes obtenidos por los niños en las pruebas de alfabetización emergente. Se constataron diferencias significativas en la alfabetización debidas a la escolaridad del padre t(11 = 2,78, p = 0,019; el acercamiento a los libros t(12 = 3,90, p = 0,001, y la frecuencia de lectura de cuentos t(12 = 4,31, p = 0,002. A partir de los resultados se concluye que algunos niños tienen habilidades de alfabetización desde muy temprana edad como resultado de las experiencias que sus padres les proporcionan.

Relationship of left ventricular systolic function to persistence or development of electrocardiographic left ventricular hypertrophy in hypertensive patients

DEFF Research Database (Denmark)

Okin, Peter M; Wachtell, Kristian; Gerdts, Eva

2014-01-01

left ventricular systolic function in patients with new or persistent ECG LVH. METHODS: Baseline and year-3 ECG LVH and left ventricular midwall shortening (MWS) were examined in 725 hypertensive patients in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic...... 1.03-3.50, P = 0.040) at year 3. CONCLUSION: Persistence or development of new ECG LVH during antihypertensive therapy is associated with an increased risk of left ventricular systolic dysfunction after 3 years' follow-up. These findings provide insight into a possible mechanism by which changes......BACKGROUND: Persistence or development of ECG left ventricular hypertrophy (LVH) by Cornell product criteria is associated with an increased risk of developing heart failure compared with regression or continued absence of LVH. We postulated that this association might be in part mediated via worse...

Fibroblasts and the extracellular matrix in right ventricular disease.

Science.gov (United States)

Frangogiannis, Nikolaos G

2017-10-01

Right ventricular failure predicts adverse outcome in patients with pulmonary hypertension (PH), and in subjects with left ventricular heart failure and is associated with interstitial fibrosis. This review manuscript discusses the cellular effectors and molecular mechanisms implicated in right ventricular fibrosis. The right ventricular interstitium contains vascular cells, fibroblasts, and immune cells, enmeshed in a collagen-based matrix. Right ventricular pressure overload in PH is associated with the expansion of the fibroblast population, myofibroblast activation, and secretion of extracellular matrix proteins. Mechanosensitive transduction of adrenergic signalling and stimulation of the renin-angiotensin-aldosterone cascade trigger the activation of right ventricular fibroblasts. Inflammatory cytokines and chemokines may contribute to expansion and activation of macrophages that may serve as a source of fibrogenic growth factors, such as transforming growth factor (TGF)-β. Endothelin-1, TGF-βs, and matricellular proteins co-operate to activate cardiac myofibroblasts, and promote synthesis of matrix proteins. In comparison with the left ventricle, the RV tolerates well volume overload and ischemia; whether the right ventricular interstitial cells and matrix are implicated in these favourable responses remains unknown. Expansion of fibroblasts and extracellular matrix protein deposition are prominent features of arrhythmogenic right ventricular cardiomyopathies and may be implicated in the pathogenesis of arrhythmic events. Prevailing conceptual paradigms on right ventricular remodelling are based on extrapolation of findings in models of left ventricular injury. Considering the unique embryologic, morphological, and physiologic properties of the RV and the clinical significance of right ventricular failure, there is a need further to dissect RV-specific mechanisms of fibrosis and interstitial remodelling. Published on behalf of the European Society of

Free and conjugated dopamine in human ventricular fluid

International Nuclear Information System (INIS)

Sharpless, N.S.; Thal, L.J.; Wolfson, L.I.; Tabaddor, K.; Tyce, G.M.; Waltz, J.M.

1981-01-01

Free dopamine and an acid hydrolyzable conjugate of dopamine were measured in human ventricular fluid specimens with a radioenzymatic assay and by high performance liquid chromatography (HPLC) with electrochemical detection. Only trace amounts of free norepinephrine and dopamine were detected in ventricular fluid from patients with movement disorders. When the ventricular fluid was hydrolyzed by heating in HClO 4 or by lyophilization in dilute HClO 4 , however, a substantial amount of free dopamine was released. Values for free plus conjugated dopamine in ventricular fluid from patients who had never taken L-DOPA ranged from 139 to 340 pg/ml when determined by HPLC and from 223 to 428 pg/ml when measured radioenzymatically. The correlation coefficient for values obtained by the two methods in the same sample of CSF was 0.94 (P<0.001). Patients who had been treated with L-DOPA had higher levels of conjugated dopamine in their ventricular CSF which correlated inversely with the time between the last dose of L-DOPA and withdrawal of the ventricular fluid. Additionally, one patient with acute cerebral trauma had elevated levels of free norepinephrine and both free and conjugated dopamine in his ventricular fluid. Conjugation may be an important inactivation pathway for released dopamine in man. (Auth.)

Alternative right ventricular pacing sites.

Science.gov (United States)

Łuciuk, Dariusz; Łuciuk, Marek; Gajek, Jacek

2015-01-01

The main adverse effect of chronic stimulation is stimulation-induced heart failure in case of ventricular contraction dyssynchrony. Because of this fact, new techniques of stimulation should be considered to optimize electrotherapy. One of these methods is pacing from alternative right ventricular sites. The purpose of this article is to review currently accumulated data about alternative sites of cardiac pacing. Medline and PubMed bases were used to search English and Polish reports published recently. Recent studies report a deleterious effect of long term apical pacing. It is suggested that permanent apical stimulation, by omitting physiological conduction pattern with His-Purkinie network, may lead to electrical and mechanical dyssynchrony of heart muscle contraction. In the long term this pathological situation can lead to severe heart failure and death. Because of this, scientists began to search for some alternative sites of cardiac pacing to reduce the deleterious effect of stimulation. Based on current accumulated data, it is suggested that the right ventricular outflow tract, right ventricular septum, direct His-bundle or biventricular pacing are better alternatives due to more physiological electrical impulse propagation within the heart and the reduction of the dyssynchrony effect. These methods should preserve a better left ventricular function and prevent the development of heart failure in permanent paced patients. As there is still not enough, long-term, randomized, prospective, cross-over and multicenter studies, further research is required to validate the benefits of using this kind of therapy. The article should pay attention to new sites of cardiac stimulation as a better and safer method of treatment.

Left ventricular apical ballooning syndrome

International Nuclear Information System (INIS)

Rahman, N.; Tai, J.; Soofi, A.

2007-01-01

The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

Parasympathetic neurons in the cranial medial ventricular fat pad on the dog heart selectively decrease ventricular contractility.

Science.gov (United States)

Dickerson, L W; Rodak, D J; Fleming, T J; Gatti, P J; Massari, V J; McKenzie, J C; Gillis, R A

1998-05-28

We hypothesized that selective control of ventricular contractility might be mediated by postganglionic parasympathetic neurons in the cranial medial ventricular (CMV) ganglion plexus located in a fat pad at the base of the aorta. Sinus rate, atrioventricular (AV) conduction (ventricular rate during atrial pacing), and left ventricular contractile force (LV dP/dt during right ventricular pacing) were measured in eight chloralose-anesthetized dogs both before and during bilateral cervical vagus stimulation (20-30 V, 0.5 ms pulses, 15-20 Hz). Seven of these dogs were tested under beta-adrenergic blockade (propranolol, 0.8 mg kg(-1) i.v.). Control responses included sinus node bradycardia or arrest during spontaneous rhythm, high grade AV block or complete heart block, and a 30% decrease in contractility from 2118 +/- 186 to 1526 +/- 187 mm Hg s(-1) (P 0.05) decrease in contractility but still elicited the same degree of sinus bradycardia and AV block (N = 8, P < 0.05). Five dogs were re-tested 3 h after trimethaphan fat pad injection, at which time blockade of vagally-induced negative inotropy was partially reversed, as vagal stimulation decreased LV dP/dt by 19%. The same dose of trimethaphan given either locally into other fat pads (PVFP or IVC-ILA) or systemically (i.v.) had no effect on vagally-induced negative inotropy. Thus, parasympathetic ganglia located in the CMV fat pad mediated a decrease in ventricular contractility during vagal stimulation. Blockade of the CMV fat pad had no effect on vagally-mediated slowing of sinus rate or AV conduction.

La Experiencia Contemporánea como Expresión del Fin de una Ética

OpenAIRE

Perdomo, José Camilo

2004-01-01

Educere:Una Brizna de Aliento en el Tiempo Rivas, Pedro El Paradigma Reinante y su Paideia Alonso, Leonor La Experiencia Contemporánea como Expresión del Fin de una ÉticaAlgunas Ideas desde la Postmodernidad para Releer el Dato Educativo Perdomo, José Camilo La Sociedad del Conocimiento y el Fin de la Escuela Rodríguez Rojas, Pedro Escuela, Alteridad y Experiencia de SíLa Producción Pedagógica del Sujeto Valera Villegas, G...

Los Supuestos Metafísicos del Problema de la Experiencia Consciente en la Filosofía de David Chalmers

OpenAIRE

Fontcuberta Llavata, Alejandro

2016-01-01

El problema difícil de la experiencia consciente se resume en la cuestión de cómo es posible que el cerebro sea la base de la experiencia consciente. El objetivo general de la tesis es llevar a cabo una crítica general de los supuestos metafísicos que subyacen a la formulación del problema difícil de la experiencia consciente, centrándose en el análisis que se lleva a cabo del problema en la obra de David Chalmers. Los argumentos presentados tratan de establecer tres clases de resultados que ...

Equipos docentes : experiencias y resultados (2013-2014)

OpenAIRE

Herrero Martín, Ruth; García Martín, Antonio

2014-01-01

Los equipos docentes son grupos de trabajo constituidos al amparo del Programa de Redes de Investigación en Docencia Universitaria (2009-2010) de la UPCT y dedicados a reflexionar sobre distintos aspectos de la actividad docente, a intercambiar experiencias y a mejorar la praxis docente de sus integrantes. Este libro recoge el trabajo desarrollado por los equipos docentes durante el curso 2013-2014. Una parte significativa de ese trabajo se orienta a la mejora de la calidad docente y, en el c...

Las franjas electorales en la experiencia chilena

OpenAIRE

Juan Ignacio García Rodríguez

2013-01-01

Expone la experiencia chilena sobre el establecimiento y regulación de las franjas electorales, para lo cual analiza la constitucionalidad de la franja, los principios involucrados, las disposiciones regulatorias, el papel del Consejo Nacional de Televisión, la jurisprudencia que sobre el tema ha sido emitida por el Tribunal Calificador de Elecciones y los retos que el sistema de franjas electorales enfrenta a futuro como lo es su aplicación a las elecciones primarias de los pa...

Value of the Electrocardiogram as a Predictor of Right Ventricular Dysfunction in Patients With Chronic Right Ventricular Volume Overload.

Science.gov (United States)

Alonso, Pau; Andrés, Ana; Rueda, Joaquín; Buendía, Francisco; Igual, Begoña; Rodríguez, María; Osa, Ana; Arnau, Miguel A; Salvador, Antonio

2015-05-01

Pulmonary regurgitation is a common complication in patients with repaired tetralogy of Fallot or congenital pulmonary stenosis. Electrocardiographic variables have been correlated with parameters used to evaluate right ventricular function. We aimed to analyze the diagnostic value of the width and fragmentation of the electrocardiogram in the identification of patients with right ventricular dysfunction and/or dilation. We selected 107 consecutive patients diagnosed with severe pulmonary insufficiency after repair of pulmonary stenosis or tetralogy of Fallot. The tests included electrocardiography, echocardiography, and magnetic resonance. Each electrocardiogram was analyzed manually to measure QRS duration. We defined QRS fragmentation as the presence of low-voltage waves in the terminal portion of the QRS complex in at least 2 contiguous leads. We found a significant negative correlation between QRS width and right ventricular function, as well as a positive correlation with right ventricular volume. The receiver operating characteristic curve indicated a cut-off point for QRS width of 140ms, which showed good sensitivity for a diagnosis of right ventricular dilation (> 80%) and dysfunction (> 95%). In logistic regression models, a QRS duration > 140ms was found to be the only independent predictor of right ventricular dilation and dysfunction. Electrocardiography is a rapid, widely available, and reproducible tool. QRS width constitutes an independent predictor of the presence of right ventricular dilation and dysfunction. This study is the first to provide a cutoff value for QRS width to screen for right ventricle involvement. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Lone ventricular cardiomyopathy,

African Journals Online (AJOL)

... (I) cardiac catheterisation, including coronary arteriography and pulmonary ... described existence of lone ventricular idiopathic ... spectrum of classic idiopathic dilated cardiomyopathy. ... endomyocardial fibrosis, and from discussions at an.

Ecuador: La experiencia de Radio Latacunga

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David Silva

2015-01-01

Full Text Available En Latacunga - Ecuador es entrevistada Lucelly Villa, de la comunidad Hijas de San Pablo, "Hermanas Paulinas", ella es directora de la Radio y presidenta de la CORAPE (Coordinadora de Radios Populares y Educativas de Ecuador. En la entrevista comenta la experiencia de las emisoras en las zonas campesinas de la provincia cuya población indígena campesina esta geográficamente dispersa en la provincia de Cotopaxi. Habla de las dificultades y logros en once años de labor, informa de cómo funcionan las cabinas y la programación.

Relação entre Fibrose e Arritmias Ventriculares na Cardiopatia Chagásica sem Disfunção Ventricular

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Eduardo Marinho Tassi

2014-06-01

Full Text Available Fundamento: Pacientes com doença de Chagas com alteração segmentar apresentam pior prognóstico independentemente da fração de ejeção ventricular esquerda. A ressonância magnética cardíaca é atualmente o melhor método para detecção de alteração segmentar e para avaliação de fibrose miocárdica. Objetivo: Quantificar a fibrose, por meio do realce tardio, pela ressonância magnética cardíaca, em pacientes com doença de Chagas com fração de ejeção ventricular esquerda preservada ou minimamente comprometida (> 45% e detectar padrões de dependência entre fibrose, alteração segmentar e fração de ejeção ventricular esquerda na presença de arritmia ventricular. Métodos: Foram realizados eletrocardiograma, teste ergométrico, Holter e ressonância magnética cardíaca em 61 pacientes, separados em três grupos: (1 eletrocardiograma normal e ressonância magnética cardíaca sem alteração segmentar; (2 eletrocardiograma alterado e ressonância magnética cardíaca sem alteração segmentar; e (3 ressonância magnética cardíaca com alteração segmentar independentemente de alteração no eletrocardiograma. Resultados: O número de pacientes com arritmia ventricular em relação ao número total de pacientes em cada grupo, a porcentagem de fibrose e a fração de ejeção ventricular esquerda foram, respectivamente: no primeiro grupo, 4/26, 0,74% e 74,34%; no segundo grupo, 4/16, 3,96% e 68,5%; e no terceiro grupo, 11/19, 14,07% e 55,59%. Arritmia ventricular foi encontrada em 31,1% dos pacientes. Aqueles com e sem arritmia ventricular apresentaram fração de ejeção ventricular esquerda média de 59,87% e 70,18%, respectivamente, e fibrose de 11,03% e 3,01%, respectivamente. Das variáveis alteração segmentar, grupos, idade, fração de ejeção ventricular esquerda e fibrose, a última foi a única significativa para a presença de arritmia ventricular, com ponto de corte de 11,78% para massa fibrosada (p < 0

Experiencias y expectativas en el debate político. Jóvenes de Manizales y elecciones

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Juana Ramírez-Castro

2014-01-01

Full Text Available En este artículo se presentan los resultados de una investigación exploratoria realizada durante la segunda ronda del debate electoral del 2010 en Colombia, y que tenía el objetivo de comprender el proceso deliberativo propio del debate público de lo que fue llamado en este estudio, el «sistema elector joven». Esta investigación, diseñada a la sombra de la Teoría de los Sistemas Sociales de Niklas Luhmann, recurrió a grupos focales y a entrevistas semiestructuradas realizadas con jóvenes votantes de la ciudad de Manizales para observar los “sentidos” que, como «experiencias» y «expectativas», soportaban las operaciones del sistema. Según lo observado, gran parte del debate electoral se realizó desde experiencias directas o de socialización y, contrario a la tendencia sobre el tema, las experiencias de socialización virtual tuvieron poca injerencia en la deliberación.

The effect of heart failure and left ventricular assist device treatment on right ventricular mechanics: a computational study.

Science.gov (United States)

Park, Jun I K; Heikhmakhtiar, Aulia Khamas; Kim, Chang Hyun; Kim, Yoo Seok; Choi, Seong Wook; Song, Kwang Soup; Lim, Ki Moo

2018-05-22

Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model. In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value. Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment. LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.

Echocardiographic left ventricular masses in distance runners and weight lifters

Science.gov (United States)

Longhurst, J. C.; Gonyea, W. J.; Mitchell, J. H.; Kelly, A. R.

1980-01-01

The relationships of different forms of exercise training to left ventricular mass and body mass are investigated by echocardiographic studies of weight lifters, long-distance runners, and comparatively sized untrained control subjects. Left ventricular mass determinations by the Penn convention reveal increased absolute left ventricular masses in long-distance runners and competitive weight lifters with respect to controls matched for age, body weight, and body surface area, and a significant correlation between ventricular mass and lean body mass. When normalized to lean body mass, the ventricular masses of distance runners are found to be significantly higher than those of the other groups, suggesting that dynamic training elevates left ventricular mass compared to static training and no training, while static training increases ventricular mass only to the extent that lean body mass is increased.

THE CLINICAL-SIGNIFICANCE OF CORONARY ANATOMY IN POST-INFARCT PATIENTS WITH LATE SUSTAINED VENTRICULAR-TACHYCARDIA OR VENTRICULAR-FIBRILLATION

NARCIS (Netherlands)

WIESFELD, ACP; CRIJNS, HJGM; HILLEGE, HL; TUININGA, YS; LIE, KI

The role of ischaemia in post-infarct patients with ventricular tachyarrhythmias is not firmly established Using coronary angiography, 82 post-infarct patients with sustained ventricular tachycardia or fibrillation were subclassified into three groups. Fourteen patients (17%) had significant

Las violencias y los jóvenes universitarios, una experiencia para reflexionar

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Noemí Ehrenfeld Lenkiewicz

2016-01-01

Full Text Available Este artículo pone de manifiesto aspectos poco o nada explorados de los estudiantes universitarios en relación con las violencias presentes en su cotidianidad, que afectan el desarrollo de su vida académica. A partir de una investigación sobre la percepción y las experiencias de las violencias en diferentes ámbitos se analiza el contexto que se vive en México y la participación de los jóvenes en las casuísticas. Las respuestas de los entrevistados que abordan experiencias propias brindan elementos que exigen pensar en una transformación educativa y pedagógica basada en la adquisición de habilidades para la vida.

Enseñar a aprender con TIC: una experiencia en el marco de un profesorado universitario

OpenAIRE

Martín, María Victoria; Vestfrid, Pamela

2015-01-01

Se presenta la experiencia llevada adelante en el “Taller Estrategias de trabajo colaborativo para el aula con redes sociales virtuales y otros asistentes online”, optativo para el Profesorado en Comunicación Social de la Facultad de Periodismo y Comunicación Social, UNLP. La misma busca brindar saberes conceptuales pero, fundamentalmente vivenciar experiencias de trabajo colaborativo que impliquen cambios en la esencia de los procesos educativos, modificando las verticales y desiguales relac...

Malignant ventricular tachycardia in acromegaly: a case report

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Zhe An

Full Text Available CONTEXT: In patients with acromegaly, cardiovascular complications are the main cause of death; sudden death has been associated with ventricular tachyarrhythmias. In other patients with life-threatening malignant ventricular tachyarrhythmias, surgical placement of an implantable cardioverter-defibrillator (ICD has proved highly effective in reducing sudden death rates. CASE REPORT: The present article reports the case of a 50-year-old male acromegalic patient who presented symptoms of syncope induced by ventricular tachycardia. An ICD was surgically implanted and a pituitary adenoma, which was responsible for the acromegaly, was completely removed in the same procedure. The surgery was successful and the ventricular arrhythmias were effectively terminated. During six months of follow-up, no documented arrhythmic episodes occurred. CONCLUSION: In patients with acromegaly, malignant ventricular tachyarrhythmia might be effectively controlled by implantation of an ICD and surgical removal of the pituitary adenoma.

Right ventricular function assessed by 2D strain analysis predicts ventricular arrhythmias and sudden cardiac death in patients after acute myocardial infarction

DEFF Research Database (Denmark)

Risum, Niels; Valeur, Nana; Søgaard, Peter

2017-01-01

Aims: Left ventricular function is a well-established predictor of malignant ventricular arrhythmias, but little is known about the importance of right ventricular (RV) function. The aim of this study was to investigate the importance of RV function for prediction of sudden cardiac death (SCD) or...

Papel de la experiencia en la aceptación vs. rechazo del paciente con esquizofrenia

OpenAIRE

Carmen Senra-Rivera; Alessandra de Arriba-Rossetto; Gloria Seoane-Pesqueira

2008-01-01

En esta investigación se analiza la influencia que pueden tener distintos tipos y grados de experiencia con la enfermedad mental en la aceptación vs. rechazo del paciente con esquizofrenia. Participaron en el estudio 236 estudiantes universitarios que cumplimentaron una escala de distancia social relacionada con una viñeta en la que se describe un episodio psicótico de un paciente (hombre o mujer) con esquizofrenia y una escala que evalúa distintos tipos y grados de experiencia co...

Arrhythmogenic right ventricular dysplasia: A case report

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Tessa Negrín Valdés

2015-10-01

Full Text Available Arrhythmogenic right ventricular dysplasia is a heart muscle disease that predominantly affects the right ventricle, bringing about the replacement of normal myocardium with fatty or fibrofatty tissue and causing sudden death in young individuals. Ventricular tachycardia is an important clinical manifestation, although there are reports of right or global heart failure. The diagnosis is confirmed by echocardiography and magnetic resonance imaging. The case of a 65-year-old former smoker, with hypertension and ischemic heart disease, a history of effort syncope symptoms and proven non-sustained ventricular tachycardia, with morphology of left bundle branch block, is reported. Relevant diagnostic studies were performed, and echocardiographic elements which were compatible with arrhythmogenic right ventricular dysplasia were found. Therefore, an implantable cardioverter defibrillator was implanted, after which the patient has had a favorable outcome.

Ventricular repolarization measures for arrhythmic risk stratification

Institute of Scientific and Technical Information of China (English)

Francesco Monitillo; Marta Leone; Caterina Rizzo; Andrea Passantino; Massimo Iacoviello

2016-01-01

Ventricular repolarization is a complex electrical phenomenon which represents a crucial stage in electrical cardiac activity. It is expressed on the surface electrocardiogram by the interval between the start of the QRS complex and the end of the T wave or U wave(QT). Several physiological, pathological and iatrogenic factors can influence ventricular repolarization. It has been demonstrated that small perturbations in this process can be a potential trigger of malignant arrhythmias, therefore the analysis of ventricular repolarization represents an interesting tool to implement risk stratification of arrhythmic events in different clinical settings. The aim of this review is to critically revise the traditional methods of static analysis of ventricular repolarization as well as those for dynamic evaluation, their prognostic significance and the possible application in daily clinical practice.

The influence of type 2 diabetes and gender on ventricular repolarization dispersion in patients with sub-clinic left ventricular diastolic dysfunction

Science.gov (United States)

Jani, Ylber; Kamberi, Ahmet; Xhunga, Sotir; Pocesta, Bekim; Ferati, Fatmir; Lala, Dali; Zeqiri, Agim; Rexhepi, Atila

2015-01-01

Objective: To assess the influence of type 2 DM and gender, on the QT dispersion, Tpeak-Tend dispersion of ventricular repolarization, in patients with sub-clinic left ventricular diastolic dysfunction of the heart. Background: QT dispersion, that reflects spatial inhomogeneity in ventricular repolarization, Tpeak-Tend dispersion, this on the other hand reflects transmural inhomogeneity in ventricular repolarization, that is increased in an early stage of cardiomyopathy, and in patients with left ventricular diastolic dysfunction, as well. The left ventricular diastolic dysfunction, a basic characteristic of diabetic heart disease (diabetic cardiomyopathy), that developes earlier than systolic dysfunction, suggests that diastolic markers might be sensitive for early cardiac injury. It is also demonstrated that gender has complex influence on indices of myocardial repolarization abnormalities such as QT interval and QT dispersion. Material and methods: We performed an observational study including 300 diabetic patients with similar epidemiological-demographic characteristics recruited in our institution from May 2009 to July 2014, divided into two groups. Demographic and laboratory echocardiographic data were obtained, twelve lead resting electrocardiography, QT, QTc, Tpeak-Tend-intervals and dispersion, were determined manually, and were compared between various groups. For statistical analysis a t-test, X2 test, and logistic regression are used according to the type of variables. A p value <0.05 was considered statistically significant for a confidence interval of 95%. Results: QTc max. interval, QTc dispersion and Tpeak-Tend dispersion, were significantly higher in diabetic group with subclinical LV (left ventricular) diastolic dysfunction, than in diabetic group with normal left ventricular diastolic function (445.24±14.7 ms vs. 433.55±14.4 ms, P<0.000; 44.98±18.78 ms vs. 32.05±17.9 ms, P<0.000; 32.60±1.6 ms vs. 17.46±2.0 ms, P<0.02. Prolonged QTc max

La influencia del consumo simbólico en la intensidad de uso de las redes sociales digitales y el valor percibido de las experiencias

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Gonzalo Luna Cortés

2017-03-01

Full Text Available Esta investigación analiza cómo el consumo simbólico (congruencia entre el objeto consumido y la identidad del consumidor se extiende en la actualidad hasta el consumo de experiencias. Como muestran los resultados, cuando un consumidor observa que una experiencia refuerza su identidad, este percibe mayor valor de dicha experiencia, lo que aumenta su satisfacción y su intención de recompra. También se desprende de los resultados que, a la hora de materializar la experiencia de cara al exterior, los consumidores hacen uso de una herramienta fundamental: las redes sociales digitales. Así, los resultados de la investigación muestran que los consumidores utilizan más las redes sociales cuando realizan consumo de experiencias congruentes con su identidad, y ello aumenta aún más el valor de la experiencia. Finalmente, y como parte de las conclusiones, se incluyen unas directrices a nivel gerencial que se basan en los resultados de la investigación.

Left ventricular mass in male adolescent athletes and non-athletes

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Erling David Kaunang

2014-10-01

Full Text Available Background Systematic exercise leads to increased left ventricular mass, which may be misleading in a differential diagnosis of heart disease in athletes (physiologic hypertrophy versus pathologic hypertrophy. T he cause of left ventricular hypertrophy is an important risk factor in the morbidity and mortality of cardiovascular diseases. Objective To compare left ventricular mass and left ventricular hypertrophy in male adolescent athletes and non-athletes. Methods We conducted a cross-sectional, analytic study, from September to December 2012 in male adolescents aged 15-18 years. The case group included athletes from the Bina Taruna Football Club Manado, while the control group included non-athlete adolescents. All subjects underwent history-taking, physical examinations and further supporting examinations. Left ventricular mass was measured by cardiovascular echocardiography (Esaote Mylab 4.0 and calculated based on a formula. Left ventricular hypertrophy was defined as left ventricular mass of > 134 g/m2 body surface area. Results Subjects' mean left ventricular masses were 359.69 (SD 188.4; 95%CI 283.58 to 435.81 grams in the athlete group and 173.04 (SD 50.69; 95%CI 152.56 to 103.51 grams in the non· athlete group, a statistically significant difference (P=0.0001. Ventricular hypertrophy was found 76.9% compared to 11.5% in  the non-athlete group (P= 0.0001. Conclusion Left ventricular mass in athletes is bigger than in non-athletes. In addition, left ventricular hypertrophy is more cornmon in male adolescent athletes than in non-athletes.

Las franjas electorales en la experiencia chilena

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Juan Ignacio García Rodríguez

2013-07-01

Full Text Available Expone la experiencia chilena sobre el establecimiento y regulación de las franjas electorales, para lo cual analiza la constitucionalidad de la franja, los principios involucrados, las disposiciones regulatorias, el papel del Consejo Nacional de Televisión, la jurisprudencia que sobre el tema ha sido emitida por el Tribunal Calificador de Elecciones y los retos que el sistema de franjas electorales enfrenta a futuro como lo es su aplicación a las elecciones primarias de los partidos políticos.

Detection of premature ventricular contractions on a ventricular electrocardiogram for patients with left ventricular assist devices.

Science.gov (United States)

Park, Sung Min; Lee, Jin Hong; Choi, Seong Wook

2014-12-01

The ventricular electrocardiogram (v-ECG) was developed for long-term monitoring of heartbeats in patients with a left ventricular assist device (LVAD) and does not normally have the functionality necessary to detect additional heart irregularities that can progress to critical arrhythmias. Although the v-ECG has the benefits of physiological optimization and counterpulsation control, when abnormal heartbeats occur, the v-ECG does not show the distinct abnormal waveform that enables easy detection of an abnormal heartbeat among normal heartbeats on the conventional ECG. In this study, the v-ECGs of normal and abnormal heartbeats are compared with each other with respect to peak-to-peak voltage, area, and maximal slopes, and a new method to detect abnormal heartbeats is suggested. In a series of animal experiments with three porcine models (Yorkshire pigs weighing 30-40 kg), a v-ECG and conventional ECG were taken simultaneously during LVAD perfusion. Clinical experts found 104 abnormal heartbeats from the saved conventional ECG data and confirmed that the other 3159 heartbeats were normal. Almost all of the abnormal heartbeats were premature ventricular contractions (PVCs), and there was short-term tachycardia for 3 s. A personal computer was used to automatically detect abnormal heartbeats with the v-ECG according to the new method, and its results were compared with the clinicians' results. The new method found abnormal heartbeats with 90% accuracy, and less than 15% of the total PVCs were missed. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Evaluation of left ventricular function by cardiac CT

International Nuclear Information System (INIS)

Naito, Hiroaki; Kozuka, Takahiro

1982-01-01

Left ventricular function was evaluated by CT, which was compared with the data of left ventriculography for various cardiac diseases. The end diastolic volume of the left ventricle can be readily computed from CT, with a satisfactory correlation with that of left ventriculography (r = 0.95). The left ventricular ejection fraction, calculated from the areal ratio of the left ventricular lumen in end-diastolic imaging to that in end-sytolic imaging, also roughly reflects left ventricular contractile function, but shows correlation with left ventriculography by only r = 0.79. Although the cardiac output is not sensitive for functional evaluation, it can be directly calculated by means of dynamic scanning and shows a satisfactory correlation with the ear piece pigment dilution (r = 0.85). Evaluation of left ventricular function by CT shows a high precision in comparison with left ventriculography, but still lacks temporal resolving power. (Chiba, N.)

[Ventricular tachycardia in a patient with rate-responsive cardiac pacemaker].

Science.gov (United States)

Himbert, C; Lascault, G; Tonet, J; Coutte, R; Busquet, P; Frank, R; Grosgogeat, Y

1992-11-01

The authors report a case of syncopal ventricular tachycardia in a patient with a respiratory-dependent rate responsive pacemaker, followed-up for valvular heart disease with severe left ventricular dysfunction and sustained atrial and ventricular arrhythmias. The introduction of low dose betablocker therapy with reinforcement of the treatment of cardiac failure controlled the ventricular arrhythmia, after suppression of the data responsive function had been shown to be ineffective. The authors discuss the role of the rate responsive function in the triggering of the ventricular tachycardias.

Estrategias para enriquecer la experiencia de enseñanza-aprendizaje

OpenAIRE

Talavera Pedrol, Núria

2011-01-01

Este documento tiene como objetivo aportar ideas a considerar en el diseño de programas de formación online o semipresenciales y contribuir a la generación de experiencias de aprendizaje enriquecidas y al uso eficiente de los recursos ofrecidos por la plataforma de e-learning SABENTIS.

Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

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N.D. Oryshchyn

2016-11-01

Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

Experiencias, sensaciones y demandas de (inseguridad ciudadana: configuraciones complejas en la Argentina reciente

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Daniel P. Míguez

2013-06-01

Full Text Available En las últimas décadas, el problema de la inseguridad debida al incremento del delito y elposible impacto sobre la estabilidad de las democracias latinoamericanas ha sido objeto dedebate recurrente. En este marco, el presente artículo analiza para el caso argentino la relaciónentre las experiencias y sensaciones de inseguridad, y su vinculación con las demandas derigor punitivo. El análisis se basa en la combinación de dos aproximaciones metodológicas.Inicialmente, se toman datos estadísticos de encuestas internacionales, como Latinobarómetro.Estos son luego comparados con datos revelados mediante la observación participante en unbarrio pobre de una ciudad intermedia de Argentina. La combinación de fuentes alternativaspermite ver la complejidad del proceso. Contrario a lo que muchas veces se ha asumido,no existen vínculos lineales que conduzcan de experiencias y sensaciones de seguridad ademandas de rigor punitivo. La manera en que los actores sociales elaboran sus experienciasde inseguridad es fuertemente situacional y, además, poco sistemática. Hemos encontradoque no necesariamente hay procesos consistentes de ‘construcción de sentido’ que articulenlas sensaciones y experiencias de inseguridad con demandas políticas.

Bidirectional ventricular tachycardia of unusual etiology

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Praloy Chakraborty

2015-11-01

Full Text Available Bidirectional ventricular tachycardia (BDVT is a rare form of ventricular arrhythmia, characterized by changing QRS axis of 180 degrees. Digitalis toxicity is considered as commonest cause of BDVT; other causes include aconite toxicity, myocarditis, myocardial infarction, metastatic cardiac tumour and cardiac channelopathies. We describe a case of BDVT in a patient with Anderson-Tawil syndrome.

Experiencias y aprendizajes con juegos cooperativos

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Evelyn Cerdas Agüero

2013-03-01

Full Text Available El presente trabajo tiene como objetivo presentar experiencias y aprendizajes que  han logrado algunos grupos de docentes con los que se ha trabajado por medio de talleres de juegos cooperativos para la paz. Los talleres se han facilitado desde la actividad de extensión Aula Activa: juegos cooperativos para la Educación para la Paz que se ha implementado en el  Instituto de Estudios Latinoamericanos (IDELA desde el 2006. En este trabajo  nos enfocamos en el trabajo con docentes del Ministerio de Educación Pública (MEP de Costa Rica, proceso que deja una serie de aprendizajes actitudinales, de valores, habilidades y cognocitivos.

Rentabilidad de hoteles boutique explicada desde la experiencia memorable

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Driselda Patricia Sánchez Aguirre

2017-01-01

Full Text Available Los hoteles boutique representan una tendencia en el sector de alojamiento, son organizaciones de lujo, con pocas habitaciones, que surgen a partir de las preferencias de viajeros irónicos y exigentes, aquellos que buscan un espacio en el que converja el escape de la realidad, pero al mismo tiempo puedan sentirse en casa. Aunque varios hoteles boutique son empresas pequeñas e incluso familiares, los indicadores reportados del segmento en México muestran organizaciones rentables en términos de la industria. El principal objetivo de este artículo es explicar la rentabilidad de estas organizaciones desde una perspectiva teórica, considerando la teoría de economía de la experiencia y su complementariedad con la teoría de recursos y capacidades. La reflexión final hace alusión al servicio superior, la capacidad para sorprender a sus huéspedes y la creatividad de los recursos humanos como los principales factores en la generación de experiencias memorables y que gracias a la reputación que construyen, contribuyen a la rentabilidad de estas organizaciones. |

Experiencias divertidas de electroquímica casera

OpenAIRE

Santiago Heredia-Avalos

2007-01-01

La química, dentro de la cual se incluye la electroquímica, es una materia que los estudiantes suelen ver como complicada, aburrida, carente de interés y que, además requiere de material de laboratorio sofisticado y reactivos químicos inaccesibles. Nada más lejos de la realidad, tal y como se pondrá de manifiesto en este trabajo, donde se proponen varias experiencias sencillas usando sustancias baratas, la mayoría de las cuales pueden encontrarse en un supermercado, y utensilio...

Evaluation of ventricular function in patients with coronary artery disease

International Nuclear Information System (INIS)

Rocco, T.P.; Dilsizian, V.; Fischman, A.J.; Strauss, H.W.

1989-01-01

The recent expansion of interventional cardiovascular technologies has stimulated a concomitant expansion of noninvasive cardiac studies, both to assist in diagnosis and to evaluate treatment outcomes. Radionuclide ventricular function studies provide a reliable, reproducible means to quantify global left ventricular systolic performance, a critical determinant of prognosis in patients with cardiovascular disease. In addition, the ability to evaluate regional left ventricular wall motion and to assess ventricular performance during exercise have secured a fundamental role for such studies in the screening and treatment of patients with coronary artery disease. Radionuclide techniques have been extended to the evaluation of left ventricular relaxation/filling events, left ventricular systolic/diastolic function in the ambulatory setting, and with appropriate technical modifications, to the assessment of right ventricular performance at rest and with exercise. As a complement to radionuclide perfusion studies, cardiac blood-pool imaging allows for thorough noninvasive description of cardiac physiology and function in both normal subjects and in patients with a broad range of cardiovascular diseases. 122 references

Ventricular Septal Dissection Complicating Inferior Wall Myocardial Infarction

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Lindsey Kalvin

2017-01-01

Full Text Available Postmyocardial infarction ventricular septal defect is an increasingly rare mechanical complication of acute myocardial infarction. We present a case of acute myocardial infarction from right coronary artery occlusion that developed hypotension and systolic murmur 12 hours after successful percutaneous coronary intervention. Although preoperative imaging suggested a large ventricular septal defect and a pseudoaneurysm, intraoperative findings concluded a serpiginous dissection of the ventricular septum. The imaging technicalities are discussed.

Effect of chronic right ventricular apical pacing on left ventricular function.

Science.gov (United States)

O'Keefe, James H; Abuissa, Hussam; Jones, Philip G; Thompson, Randall C; Bateman, Timothy M; McGhie, A Iain; Ramza, Brian M; Steinhaus, David M

2005-03-15

The determinants of change in left ventricular (LV) ejection fraction (EF) over time in patients with impaired LV function at baseline have not been clearly established. Using a nuclear database to assess changes in LV function over time, we included patients with a baseline LVEF of 25% to 40% on a gated single-photon emission computed tomographic study at rest and only if second-gated photon emission computed tomography performed approximately 18 months after the initial study showed an improvement in LVEF at rest of > or =10 points or a decrease in LVEF at rest of > or =7 points. In all, 148 patients qualified for the EF increase group and 59 patients for the EF decrease group. LVEF on average increased from 33 +/- 4% to 51 +/- 8% in the EF increase group and decreased from 35 +/- 4% to 25 +/- 5% in the EF decrease group. The strongest multivariable predictor of improvement of LVEF was beta-blocker therapy (odds ratio 3.9, p = 0.002). The strongest independent predictor of LVEF decrease was the presence of a permanent right ventricular apical pacemaker (odds ratio 6.6, p = 0.002). Thus, this study identified beta-blocker therapy as the major independent predictor for improvement in LVEF of > or =10 points, whereas a permanent pacemaker (right ventricular apical pacing) was the strongest predictor of a LVEF decrease of > or =7 points.

Formas de mirar y de hacer ver: la experiencia visual en el trabajo de campo del topógrafo

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Carla Lois

2013-06-01

Full Text Available Hacia mediados del siglo XX estaba instalada la idea de que el objetivo de los topógrafos era capturar la morfología del terreno para transcribirla a un lenguaje gráfico estable y “universal”. Este modo de concebir la cartografía se entroncaba con una convicción más generalizada: que todo mapa era el producto de una abstracción intelectual que resultaba de procesos de mensura realizados con “objetividad”. Sin embargo, el trabajo del topógrafo en el terreno consistía en la puesta en acción de formas de percibir y registrar el espacio basadas en experiencias sensibles de observación visual. Esas experiencias eran volcadas en registros visuales que luego serían los insumos utilizados para elaborar el mapa. En este trabajo proponemos conectar la experiencia sensible del terreno y la inscripción cartográfica con la experiencia que un ojo entrenado tiene al observar el mapa.

The helical ventricular myocardial band of Torrent-Guasp.

Science.gov (United States)

Kocica, Mladen J; Corno, Antonio F; Lackovic, Vesna; Kanjuh, Vladimir I

2007-01-01

We live in an era of substantial progress in understanding myocardial structure and function at genetic, molecular, and microscopic levels. Yet, ventricular myocardium has proven remarkably resistant to macroscopic analyses of functional anatomy. Pronounced and practically indefinite global and local structural anisotropy of its fibers and other ventricular wall constituents produces electrical and mechanical properties that are nonlinear, anisotropic, time varying, and spatially inhomogeneous. The helical ventricular myocardial band of Torrent-Guasp is a revolutionary new concept in understanding global, 3-dimensional, functional architecture of the ventricular myocardium. This concept defines the principal, cumulative vectors, integrating the tissue architecture (ie, form) and net forces developed (ie, function) within the ventricular mass. The primary purpose of this review is to emphasize the importance of this concept, in the light of collaborative efforts to establish an integrative approach, defining ventricular form and function by linking across multiple scales of biological organization, as explained in the ongoing Physiome project. Because one of the most important scientific missions in this century is integration of basic research with clinical medicine, we believe that this knowledge is not of merely academic importance, but is also the essential prerequisite in clinical evaluation and treatment of different heart diseases.

Clinical studies on myocardial perfusion imaging in patients with right ventricular overload

International Nuclear Information System (INIS)

Abo, Kenji; Yamagata, Takashi; Nakajima, Masao; Fujita, Kimiaki; Morita, Nobuo

1979-01-01

Patients with heart disease which had been clinically diagnosed underwent 201 Tl myocardial perfusion imaging. The thickness of right ventricular wall measured from original images was directly proportional to systolic pressure of the right ventricle measured by cardiac catheterization, and 201 Tl activity in the right ventricle was more directly proportional to systolic pressure of the right ventricle. Imaging patterns of various diseases were also described. Images of patients with hypertrophic cardiomyopathy revealed that right ventricular wall was thin and right ventricular cavity was small, but the thickness of septal wall and left ventricular wall were maximal. Images of patients with mitral insufficiency revealed that the thickness of right ventricular wall, septal wall, and left ventricular wall was medium, and the right ventricular cavity was smaller than the left ventricular cavity. Images of patients with congestive cardiomyopathy and congestive cardiac failure showed that enlargement of both ventricular cavities was disproportionate to the thickness of each wall. Images of patients with arterial septal defect revealed that the thickness of each wall was comparatively normal, the right ventricular cavity was maximal, and the left ventricular cavity was minimal. Images of patients with primary pulmonary hypertention, pulmonary stenosis and tetralogy of Fallot in whom pressure overload was recognized revealed severe thickenings of right ventricular wall, moderate enlargement of the right ventricle, small left ventricle, and thin left ventricular wall. (Tsunoda, M.)

El rol del profesor y la actividad demostrativa: una experiencia de aula empleando Geogebra

OpenAIRE

Mejía, Cristina; Molina, Óscar

2013-01-01

En esta experiencia de aula presento un ciclo didáctico que forma parte del trabajo de grado que estoy desarrollando para optar por el título de maestría en docencia de las Matemáticas. Pretendo exponer una experiencia en la que se analiza el rol del profesor, bajo la teoría de la mediación semiótica y fundamentado en la aproximación metodológica para la enseñanza del grupo Æ•G. Tal ciclo planteado en un aula de octavo grado, favorece la construcción de un sistema teórico local y se emplea un...

El trabajo colegiado, un espacio para narrar las experiencias desde la práctica docente

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Maríadel Rosario Landín Miranda

2016-01-01

Full Text Available Gestionar el aprendizaje y reaprendizaje durante el profesorado es todo un reto y todo un campo de estudio, por ello, en este trabajo, presentamos nuestra experiencia en la implementación de un proyecto de intervención que tuvo como propósito principal, generar un espacio colegiado para el aprendizaje de las experiencias docentes. El proyecto se implementó en la Escuela Secundaria Artículo 3° de Poza Rica, Veracruz, México, durante el periodo de agosto de 2014 a julio de 2015. La metodología base usada para el desarrollo del proyecto, fue la metodología APRA (Acceso, Permanencia y Rendimiento Académico, que es una propuesta de intervención que considera los elementos fundamentales que apoyan los procesos sistemáticos de cambio y mejora institucional. La estrategia de trabajo transversal empleada durante la intervención fue la narrativa, apoyada de otras estrategias, como el cuaderno docente, la narración de experiencias docentes, el trabajo colegiado con retroalimentación grupal y la autoevaluación.

Bundle of measures for external cerebral ventricular drainage-associated ventriculitis.

Science.gov (United States)

Chatzi, Maria; Karvouniaris, Marios; Makris, Demosthenes; Tsimitrea, Eleni; Gatos, Charalampos; Tasiou, Anastasia; Mantzarlis, Kostas; Fountas, Kostas N; Zakynthinos, Epaminondas

2014-01-01

To assess the prevalence and outcome of external cerebral ventricular drainage-associated ventriculitis in neurocritical patients before and after the implementation of a bundle of external cerebral ventricular drainage-associated ventriculitis control measures. Clinical prospective case series. University Hospital of Larissa, Greece. Consecutive patients were recruited from the ICU of the hospital. Patient inclusion criteria included presence of external ventricular drainage and ICU stay more than 48 hours. The bundle of external cerebral ventricular drainage-associated ventriculitis control measures included 1) reeducation of ICU personnel on issues of infection control related to external cerebral ventricular drainage, 2) meticulous intraventricular catheter handling, 3) cerebrospinal fluid sampling only when clinically necessary, and 4) routine replacement of the drainage catheter on the seventh drainage day if the catheter was still necessary. The bundle was applied after an initial period (preintervention) where standard policy for external cerebral ventricular drainage-associated ventriculitis was established. External cerebral ventricular drainage-associated ventriculitis prevalence, external cerebral ventricular drainage-associated ventriculitis events per 1,000 drainage days (drain-associated infection rate), length of ICU stay, Glasgow Outcome Scale at 6 months, and risk factors for external cerebral ventricular drainage-associated ventriculitis. Eighty-two patients entered the study in the preintervention period and 57 patients during the intervention period. During the preintervention and intervention period, external cerebral ventricular drainage-associated ventriculitis prevalence was 28% and 10.5% (p = 0.02) and drain-associated infection rate was 18 and 7.1, respectively (p = 0.0001); mean (95% CI) length of ICU stay in patients who presented external cerebral ventricular drainage-associated ventriculitis was 44.4 days (36.4-52.4 d), whereas mean

Does in-hospital ventricular fibrillation affect prognosis after myocardial infarction?

DEFF Research Database (Denmark)

Jensen, G V; Torp-Pedersen, C; Hildebrandt, P

1997-01-01

with ventricular fibrillation in time intervals, indicated that the importance of ventricular fibrillation for risk of death was exhausted during the initial 60 days after infarction. CONCLUSION: Ventricular fibrillation is associated with an independent increased risk of death within 0-60 days after infarction......AIM: The aim of this study was to estimate the prognostic information to be gained from ventricular fibrillation in patients with myocardial infarction. METHODS AND RESULTS: We studied 4259 consecutive patients with myocardial infarction admitted to one centre in 1977-1988. Five hundred and twenty......-eight (12.4%) of the patients had ventricular fibrillation in hospital. The following risk factors were included in multivariate models to estimate their importance for 30-day and long-term (median 7 year) prognosis: age, gender, ventricular fibrillation, congestive heart failure, pulmonary oedema...

Evaluation of left ventricular function using digital subtraction ventriculography

International Nuclear Information System (INIS)

Yiannikas, J.; Detrano, R.

1986-01-01

Digital subtraction ventriculography following injections of contrast via peripheral veins provides excellent images to assess left ventricular function. The images are essentially identical to those following DCV, but allow more uniform mixing of contrast in the left ventricular chamber. Furthermore, few, if any, cardiac arrhythmias occur, hence obviating difficulties that arise from DCV. The spatial resolution of the method is such that regional wall motion assessment of ventricular function is more accurate than that of other noninvasive imaging methods. The use of video-densitometry allows accurate assessment of left ventricular function even when the left ventricular cavity is nonsymmetrically deformed and aneurysmal. In the setting of the cardiac catheterization laboratory, digital ventriculography may provide a safer means of assessing left ventricular function when critical coronary or myocardial disease is present and allows multiple assessments of ventricular function during the same study. Although excellent correlations with standard ventriculography have been noted by all workers, significant discrepancies still exist in individual patients, particularly in the calculations of end diastolic volumes. In the authors experience and in those of most workers, the largest discrepancies existed in patients in whom suboptimal studies are included for analysis. The most frequent reason for the occasional suboptimal study as with all digital subtraction work is the misregistration that results from motion

Arrhythmogenic right ventricular cardiomyopathy: contribution of different electrocardiographic techniques.

Science.gov (United States)

Moreira, Davide; Delgado, Anne; Marmelo, Bruno; Correia, Emanuel; Gama, Pedro; Pipa, João; Nunes, Luís; Santos, Oliveira

2014-04-01

Arrhythmogenic right ventricular cardiomyopathy, also known as arrhythmogenic right ventricular dysplasia, is a condition in which myocardium is replaced by fibrous or fibrofatty tissue, predominantly in the right ventricle. It is clinically characterized by potentially lethal ventricular arrhythmias, and is a leading cause of sudden cardiac death. Its prevalence is not known exactly but is estimated at approximately 1:5000 in the adult population. Diagnosis can be on the basis of structural and functional alterations of the right ventricle, electrocardiographic abnormalities (including depolarization and repolarization alterations and ventricular arrhythmias) and family history. Diagnostic criteria facilitate the recognition and interpretation of non-specific clinical features of this disease. The authors present a case in which the diagnosis of arrhythmogenic right ventricular cardiomyopathy was prompted by the suspicion of right ventricular disease on transthoracic echocardiography. This was confirmed by detection of epsilon waves on analysis of the ECG, which generally go unnoticed but in this case were the key to the diagnosis. Their presence was also shown by non-conventional ECG techniques such as modified Fontaine ECG. The course of the disease culminated in the occurrence of ventricular tachycardia, which prompted placement of an implantable cardioverter-defibrillator. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

A case of short-coupled premature ventricular beat-induced ventricular fibrillation with early repolarization in the inferolateral leads

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Hidekazu Kondo, MD

2015-02-01

Full Text Available This case report describes a 19-year-old man with early repolarization (ER in the inferolateral leads and a normal QT interval who survived a cardiac arrest that was likely related to polymorphic ventricular tachycardia (VT. Electrocardiograms (ECGs also showed unifocal premature ventricular beats (PVBs with a relatively narrow QRS duration. A Holter ECG documented occasional short-coupled PVBs following non-sustained VTs. Pharmacological stress testing was also performed to assess the effects of anti-arrhythmic drugs on ER (the J wave and PVBs. We performed successful radiofrequency catheter ablation to prevent the recurrence of ventricular fibrillation after cardioverter-defibrillator implantation.

The management of ventricular dysrhythmia in aconite poisoning.

Science.gov (United States)

Coulson, James M; Caparrotta, Thomas M; Thompson, John P

2017-06-01

Aconite poisoning is relatively rare but is frequently complicated by ventricular dysrhythmias, which may be fatal. Molecular basis of aconite alkaloid ventricular arrhythmogenicity: Aconite exerts its toxic effects due to the presence of an admixture of alkaloids present in all parts of the plant. The major target of these aconite alkaloids is the fast voltage-gates sodium channel, where they cause persistent activation. This blockade of the channel in the activated state promotes automaticity within the ventricular myocardium and the generation of ventricular arrhythmias. Aconitine-induced arrhythmias: Aconite alkaloids are known to cause many different types of disturbance of heart rhythm. However, this focused review specifically looks at ventricular rhythm disturbances, namely ventricular ectopy, ventricular tachycardia, torsades des pointes and ventricular fibrillation. The objective of this review was to identify the outcome of anti-dysrhythmic strategies from animal studies and case reports in humans in order to guide the management of ventricular dysrhythmias in aconite poisoning in humans. A review of the literature in English was conducted in PubMed and Google Scholar from 1966 to July 2016 using the search terms "aconite/aconitine"; "aconite/aconitine + poisoning" and "aconite/aconitine + dysrhythmia". 168 human case-reports and case-series were identified by these searches, of which 103 were rejected if exposure to aconite did not result in ventricular dysrhythmias, if it was uncertain as to whether aconite had been ingested, if other agents were co-ingested, if there was insufficient information to determine the type of treatments administered or if there was insufficient information to determine outcome. Thus, 65 case reports of probable aconite poisoning that resulted in ventricular dysrhythmias were identified. Toxicokinetic data in aconite poisoning: Data were only available in three papers; the presence of ventricular rhythm disturbances

Efecto de la localización del electrodo ventricular derecho (tracto de salida vs. ápex sobre la sincronía ventricular mecánica, en pacientes sometidos a terapia de implante de marcapaso cardiaco Effect of right ventricular electrode location (outflow tract vs. apex on mechanical ventricular synchrony in patients that underwent pacemaker implant therapy

Directory of Open Access Journals (Sweden)

Oscar S Rincón

2008-12-01

Full Text Available Objetivo: evaluar a profundidad el efecto de la estimulación ventricular desde el tracto de salida del ventrículo derecho y el ápex, sobre la sincronía ventricular mecánica. Materiales y métodos: estudio analítico de cohorte, en el que se realizó ecocardiograma transtorácico pre y post implante de marcapaso a 20 pacientes (diez por cada grupo con indicación de marcapaso definitivo, con implante del electrodo en el tracto de salida del ventrículo derecho y el ápex, sin cardiopatía estructural, fracción de eyección > 50%; QRS y conducción aurículo-ventricular normal, con el fin de evaluar la asincronía ventricular mecánica (modo M y Doppler tisular y los parámetros de implante y programación del dispositivo. Análisis estadístico: los resultados se presentan como promedios, desviación estándar o porcentajes. Las variables continuas se compararon utilizando prueba Chi cuadrado y ANOVA. Se consideró como estadísticamente significativa una p Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials and Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent transthoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group. There was no structural cardiopathy, ejection fraction was > 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages. Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25% a pre-implant ventricular asynchrony was found; in seven (70% ventricular asynchrony

Muscular anatomy of the human ventricular folds.

Science.gov (United States)

Moon, Jerald; Alipour, Fariborz

2013-09-01

Our purpose in this study was to better understand the muscular anatomy of the ventricular folds in order to help improve biomechanical modeling of phonation and to better understand the role of these muscles during phonatory and nonphonatory tasks. Four human larynges were decalcified, sectioned coronally from posterior to anterior by a CryoJane tape transfer system, and stained with Masson's trichrome. The total and relative areas of muscles observed in each section were calculated and used for characterizing the muscle distribution within the ventricular folds. The ventricular folds contained anteriorly coursing thyroarytenoid and ventricularis muscle fibers that were in the lower half of the ventricular fold posteriorly, and some ventricularis muscle was evident in the upper and lateral portions of the fold more anteriorly. Very little muscle tissue was observed in the medial half of the fold, and the anterior half of the ventricular fold was largely devoid of any muscle tissue. All 4 larynges contained muscle bundles that coursed superiorly and medially through the upper half of the fold, toward the lateral margin of the epiglottis. Although variability of expression was evident, a well-defined thyroarytenoid muscle was readily apparent lateral to the arytenoid cartilage in all specimens.

Una experiencia lexicográfica

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José Aldemar Álvarez Valencia

2006-01-01

Full Text Available Las dinámicas actuales de las sociedades modernas y postmodernas hacen que haya una constante creación y flujo de unidades léxicas cuyo origen se hace cada vez más difícil de identificar. Este documento se propone reportar una experiencia investigativa en el área de la lexicografía que se llevó a cabo en algunos pueblos de la región de Cundinamarca. A través de grabaciones de audio de conversaciones informales, entrevistas y cuestionarios se buscó elaborar un glosario de naturaleza dialectal. Las conclusiones indican que debido a la movilidad de los habitantes de la ciudad de Bogotá hacia los pueblos de Cundinamarca y viceversa, es difuso determinar un vocabulario específico.

Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

Energy Technology Data Exchange (ETDEWEB)

Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto [University Federico II, Department of Biomorphological and Functional Sciences, Institute of Biostructure and Bioimages of the National Council of Research, Naples (Italy); Duilio, Carlo; Santomauro, Maurizio [University Federico II, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Naples (Italy)

2005-09-01

Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction {>=}50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

International Nuclear Information System (INIS)

Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto; Duilio, Carlo; Santomauro, Maurizio

2005-01-01

Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction ≥50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

Left ventricular mass in borderline hypertension assessed by echo cardiography

International Nuclear Information System (INIS)

Mezzasalma, L.; Ghione, S.; Palonebo, C.

1989-01-01

The relationship between clinical measurement of blood pressure (BP) and left ventricular hypertrophy in arterial hypertension appears to be weak in most studies. On the contrary, stronger correlations with target organ damage in general, and left ventricular hypertrophy in particular, have been reported for blood pressure measurements obtained by ambulatory monitoring; this finding may indicate a possible role for blood pressure response to naturally occurring stresses in determining left ventricular hypertrophy. Aim of this study was to investigate, in 18 patients with borderline arterial hypertension, the relationships between echocardiographically assessed left ventricular mass and, respectively, casual BP and BP responses to some standardized stress tests. Only three patients had a diastolic wall thickness of the interventricular septum and of the posterior wall ≥1.2 cm and none had a pathologically increased left ventricular mass index. The following statistically significant correlations were found: casual diastolic BP vs. left ventricular mass index (r=0.53, p<0.02), systolic BP response to bicycle exercise test vs. left ventricular mass index (r=0.55, p<0.05). Multiple regression analysis showed that almost fifty percent of the variability of left ventricular mass index could be predicted by these two BP measurements. These findings suggest that besides the chronically increased afterload, also the transient hypertensive responses to naturally occuring physical stresses may have a role in determining the extent of cardiac structural changes in borderline hypertensive patients. In addition, they indicate a direct relation between left ventricular mass and blood pressure levels also in borderline hypertension, as previously shown for established hypertension, despite the fact that left ventricular hypertrophy represents only an occasional finding in early stages of hypertension

El principio de confiabilidad en el registro electoral. La experiencia cubana

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Raudiel Peña Barrios

2015-01-01

Full Text Available Este artículo pretende dar una panorámica acerca del contenido del principio de confiabilidad en materia registral, específicamente, en sede del registro de electores. Abordaremos las implicaciones que dicho principio tiene para la información que es manejada por los registros electorales, así como las medidas que pueden desarrollarse con el objetivo de lograr niveles cada vez más altos de confiabilidad. En este sentido, expondremos experiencias que se basan fundamentalmente en la utilización de la biometría y en el fortalecimiento del registro civil, como sustento, este último, de un registro electoral eficiente teniendo en cuenta la relación natural que existe entre ambos. Además, ofreceremos un análisis detallado de los puntos de ruptura del registro de electores cubano con el citado principio, con el objetivo de analizar la experiencia de Cuba. Por último, expondremos algunas ideas generales que pudieran contribuir al perfeccionamiento del registro electoral cubano

La experiencia de usuario como clave del éxito den la formación online

OpenAIRE

GARCIA MARTINEZ, MARIA SOL

2016-01-01

El presente estudio realiza una comparativa de los elementos que incluyen en la experiencia de usuario en el ámbito de la formación online dependiendo del rol de usuario, alumnado o profesionales del e-learning. Para ello se realiza un análisis a través de técnicas cuantitativas que nos permitirá respaldar las opiniones y teorías realizadas por la autora del proyecto tras más de quince años de experiencia como profesional de la formación online para diferentes tipos de entidad. Garcia M...

Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

DEFF Research Database (Denmark)

Pedersen, Henriette Sloth; Elming, Hanne; Seibaek, Marie

2007-01-01

The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish...

Left ventricular systolic and diastolic function in hyperthyroidism

International Nuclear Information System (INIS)

Friedman, M.J.; Okada, R.D.; Ewy, G.A.; Hellman, D.J.

1982-01-01

In order to assess the effect of hyperthyroidism on systolic and diastolic function of the left ventricle, M-mode echocardiograms and systolic time intervals were obtained in 13 patients while they were clinically hyperthyroid and again when they were euthyroid following radioactive iodine therapy. Echocardiographic tracings of the septum and left ventricular posterior wall were digitized and analyzed to provide the maximum velocity of shortening and maximum velocity of lengthening. These velocities were normalized for left ventricular diastolic dimension. The left ventricular minor axis fractional shortening and the normalized maximum velocity of shortening were both increased during the hyperthyroid state. The normalized maximum velocity of lengthening, a measure of diastolic left ventricular function, was also increased during the hyperthyroid state when compared to the euthyroid state. The preejection period index and the preejection period/left ventricular ejection time ratio were lower when the patients were hyperthyroid than when they were euthyroid. These data confirm the increased inotropic state and demonstrated increased diastolic relaxation velocities of the hyperthyroid left ventricle

Intradisciplinariedad e Interdisciplinariedad en la adquisición de competencias: estudio de una experiencia de aprendizaje cooperativo

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Pere Lavega

2013-01-01

Full Text Available Los objetivos planteados en este estudio fueron: analizar el nivel de adquisición de las competencias, estudiar el desarrollo del trabajo en equipo y el proceso de interacción profesor – alumno desde ambas perspectivas, así como desvelar el grado de satisfacción expresado por discentes y docentes en una experiencia pedagógica intradisciplinar e interdisciplinar. Esta experiencia se realizó con 130 estudiantes del grado en ciencias de la actividad física y del deporte (INEFC, Universidad de Lleida, con la implicación de seis profesores de tres asignaturas de primer curso que compartían competencias específicas y transversales. Los alumnos debían resolver un problema mediante el aprendizaje cooperativo. Los resultados muestran que esta experiencia merece una valoración positiva en la adquisición de competencias específicas y transversales.

Acantosis Nigricans Maligna Acanthosis Nigricans Maligna

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C Vallejo

2011-06-01

Full Text Available Es un síndrome paraneoplásico poco común, que se asocia a tumores gastrointestinales, más frecuentemente a adenocarcinoma gástrico (69%. Afecta a ambos sexos y no tiene prevalencia por grupo étnico alguno. Clínicamente son lesiones hiperpigmentadas, hipertróficas y verrucosas en zonas de flexión y en la mayoría de los casos, las mucosas también resultan afectadas con lesiones papilomatosas. Habitualmente desaparecen con la eliminación del tumor o reaparecen con la recurrencia o metástasis.Acanthosis nigricans malignant is an uncommon paraneoplastic syndrome associated with gastrointestinal tumors, frequently gastric adenocarcinoma, affects both sexes and it has not prevalence by race. Clinically, lesions are hyperpigmented, hypertrophic and verrucous in flexion areas and in most cases the mucous membranes are also affected with papillomatous lesions. Tipically disappears with the removal of the tumor and reappears when recurrence or metastasis occur.

Curso híbrido y de aula invertida apoyado en MOOC: experiencia de autoevaluación

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Patricia Salinas Martínez

2015-04-01

Full Text Available Este escrito comparte elementos sobre el diseño e implementación del curso híbrido y aula invertida de “Introducción a las matemáticas universitarias”, apoyado en el curso MOOC “Matemáticas y movimiento” en Coursera. La experiencia se realizó en el segundo semestre de 2013 con ocho grupos escolares en una universidad prestigiosa del norte de México. El trabajo fuera del aula y en línea incluye el estudio de videos en preparación para las actividades presenciales en aula, en las que se profundiza en el aprendizaje que los videos promueven. La experiencia considera el trabajo colegiado entre los profesores durante el cual fueron tomadas decisiones a favor de indagar de manera sistemática las bondades de este tipo de formato innovador para el curso. Un estudio diagnóstico se efectúa para valorar varias dimensiones de la experiencia, entre ellas la evaluación, dimensión a la que se dedica este trabajo. La peculiaridad de haber integrado un proceso de autoevaluación por parte de los estudiantes para conformar su calificación del curso invita a la documentación de esta experiencia. Nuestra intención es incitar la reflexión académica acerca del proceso de evaluación ante los cambios de modalidad que se están gestando en la impartición de cursos universitarios.

La experiencia semestral

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Heidi Cañón

2003-11-01

Full Text Available La Corporación Opción Colombia brinda a los estudiantes universitarios la posibilidad de confrontar la teoría de las aulas con la realidad del país. Quienes aplican al programa reciben talleres de capacitación e información sobre los convenios vigentes y los perfiles requeridos par cada uno de ellos. Superada esta primera etapa y de acuerdo con sus expectativas, el estudiante aplica a algunos de los proyectos y la corporación se encarga de ubicarlo en alguna zona del país. En este artículo, el lector conocerá el caso de una estudiante de la Facultad de Administración de Empresas Turísticas y Hoteleras, quien fue ubicada en los municipios Pijao y La Tebaida (Quindío para desarrollar actividades dentro del programa Computadores para Educar, iniciativa que busca proveer de tecnología a las escuelas públicas. La autora deja entrever sus emociones, su visión antes y después de esta experiencia y los aportes dados y recibidos durante el proceso.

Left Ventricular Geometry In Nigerians With Type II Diabetes Mellitus ...

African Journals Online (AJOL)

Background: Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower ...

Assessment of right ventricular function using gated blood pool single photon emission computed tomography in inferior myocardial infarction with or without hemodynamically significant right ventricular infarction

International Nuclear Information System (INIS)

Takahashi, Masaharu

1992-01-01

Right ventricular function was assessed using gated blood pool single photon emission computed tomography (GSPECT) in 10 normal subjects and 14 patients with inferior myocardial infarction. Three-dimensional backbround subtraction was achieved by applying an optimal cut off level. The patient group consisted of 6 patients with definite hemodynamic abnormalities indicative of right ventricular infarction (RVI) and 8 other patients with significant obstructive lesion at the proximal portion of right coronary artery without obvious hemodynamic signs of RVI. Right ventricular regional wall motion abnormalities were demonstrated on GSPECT functional images and the indices of right ventricular function (i.e the right ventricular ejection fraction (RVEF), the right ventricular peak ejection rate (RVPER) and the right ventricular peak filling rate (RVPFR)) were significantly reduced in the patient group, not only in the patients with definite RVI but also in those without hemodynamic signs of RVI, even in the absence of definite hemodynamic signs, when the proximal portion of right coronary artery is obstructed. It is concluded that GSPECT is reliable for the assessment of right ventricular function and regional wall motion, and is also useful for the diagnosis of RVI. (author)

Aplicación de la experiencia de usuario accesible en entornos web de recursos educativos abiertos

OpenAIRE

Navarrete, Rosa

2017-01-01

Esta tesis propone la aplicación de la experiencia de usuario accesible para el diseño de entornos web de recursos educativos abiertos accesibles. Los principales aportes de son: (i) la recopilación del estado de la cuestión mediante una revisión sistemática de la literatura; (ii) la caracterización de los problemas de accesibilidad, usabilidad y arquitectura de información en los entornos web de REA; (iii) la propuesta del concepto de experiencia de usuario accesible para guiar el desarro...

LEFT VENTRICULAR ROTATION, TWIST AND UNTWIST: PHYSIOLOGICAL ROLE AND CLINICAL RELEVANCE

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E. N. Pavlyukova

2015-09-01

Full Text Available The helical ventricular myocardial band of Torrent-Guasp is a new concept, which provides strong grounds for reconciliation of some important aspects in cardiovascular medicine. Oblique fiber orientation provides left ventricular rotation, which in addition to radial thickening and longitudinal shortening, is predicted as an essential component of the effective left ventricular pumping. Left ventricular rotation can be measured in clinical practice noninvasively using echocardiography and this provides new opportunities for the assessment of different aspects of left ventricular mechanical function.

A case report of arrhythmogenic right ventricular dysplasia

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Henry Anselmo Mayala

2013-01-01

Full Text Available Background Arrhythmogenic right ventricular dysplasia is an autosomal dominant disorder affecting parts of myocardium known as desmosomes, areas on the surface of heart muscle cells which link the cells together. The hallmark feature is fibro-fatty replacement of the right ventricle myocardium characterized by hypokinetic areas with associated arrhythmias originating in the right ventricle. CasePresentation Inthisreporta42yearoldmanwasadmittedatWuhanunion Hospital with the presenting complaints of visual hallucination and difficulty in breathing on exertion, with a family history of sudden death. Clinical and imaging findings are suggestive of Arrhythmogenic right ventricular dysplasia. Conclusion Despitebeingamongtherarecardiacdisease,Arrhythmogenicright ventricular dysplasia is an important cause of ventricular arrhythmias in children and young adults, it is also responsible for sudden cardiac death in the young population, making it necessary for this case report.

El aprendizaje de la traducción a través del uso de portfolios: descripción de una experiencia

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Francisco Javier Fernández Polo

2011-12-01

Full Text Available El aprendizaje de la traducción a través del uso de portfolios: descripción de una experienciaEn este trabajo se describe una experiencia pedagógica consistente en la introducción del portafolio como herramienta de aprendizaje y evaluación en un curso universitario de traducción. La descripción se basa en datos recogidos durante dos años y en los resultados de un cuestionario administrado a los participantes. Tras una breve contextualización de la experiencia y la reflexión sobre los aspectos más relevantes del portafolio para la enseñanza de la traducción, específicamente en la universidad, se ofrece una descripción exhaustiva de los efectos positivos de la utilización del instrumento en el curso. El trabajo termina con una valoración de la experiencia por parte de los participantes. 

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy.

Science.gov (United States)

Lanjewar, Swapnil S; Chhabra, Lovely; Chaubey, Vinod K; Joshi, Saurabh; Kulkarni, Ganesh; Kothagundla, Chandrasekhar; Kaul, Sudesh; Spodick, David H

2013-01-01

The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.

Evaluation of the accuracy of ventricular volume measurement by ultrafast CT

International Nuclear Information System (INIS)

Cui Wei; Dai Ruping; Guo Yuyin

1997-01-01

The authors evaluated the accuracy of ventricular volume measured by ultrafast CT (UFCT); and (2) compared the value of ventricular volume derived from long- and short-axis view. Fourteen human left ventricular casts and 15 right ventricular casts were scanned by Imatron C-150 scanner along both the long- and short-axis. The scan protocol was similar to that used in vivo. Eight 7 mm-thick slices were obtained from each cast for both long- and short-axis views. Ventricular volume was determined by the modified Simpson's rule provided by Inamtron Inc. The actual volumes of the ventricular casts were determined by the amount of water displacement by the cast. The actual volumes for left and right ventricles were 55.57 +- 28.91 ml and 64.23 +- 24.51 ml, respectively, the left and right ventricular volumes determined by UFCT were 66.50 +- 33.04 ml and 76.47 +-28.70 ml from long-axis view, and 60.36 +- 29.90 ml and 75.36 +- 28.73 ml from short-axis view, respectively. The measurements by UFCT were significantly greater than the actual volumes of the casts, both for the left and right ventricles (P 0.990). Both left and right ventricular volumes can be determined by UFCT with identical accuracy for both long- and short-axis views in calculating ventricular volume; however, overestimation of ventricular volume by UFCT should be noted

VIOLENCIA URBANA Y SUBJETIVIDADES VICTIMIZANTES: SENTIDOS Y EXPERIENCIAS ORGANIZATIVAS DE LAS VÍCTIMAS DE LA INSEGURIDAD EN ARGENTINA

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Mercedes Celina Calzado

2014-01-01

Full Text Available La violencia urbana introduce en América Latina modalidades de narrar las experiencias de victimización. En las sociedades de seguridad se reconfiguran las subjetividades y se redefinen discursos y prácticas políticas individuales y colectivas. Este artículo reflexiona acerca de los modos en que se constituyen los discursos de los grupos organizados de víctimas de la inseguridad en Argentina ¿La experiencia individual define la subjetividad? ¿Ser familiar de una víctima fatal (o no de la criminalidad establece los parámetros desde los cuales se explica la experiencia? ¿O se ordena a partir de definiciones previas de verdad, conceptos preexistentes que nominalizan el sufrimiento? Desde un conjunto de entrevistas realizadas a familiares de víctimas de la inseguridad, se reflexiona sobre las experiencias que originan un sujeto colectivo atravesado por la violencia urbana. Esta investigación propone una tipología con cinco clases de vocabularios de intervención de los grupos organizados de víctimas de la inseguridad: colectivos tópicos, colectivos categóricos, colectivos de cercanías, colectivos “manzaneros” y colectivos mínimos.

Influence of left ventricular hypertrophy on infarct size and left ventricular ejection fraction in ST-elevation myocardial infarction

International Nuclear Information System (INIS)

Małek, Łukasz A.; Śpiewak, Mateusz; Kłopotowski, Mariusz; Petryka, Joanna; Mazurkiewicz, Łukasz; Kruk, Mariusz; Kępka, Cezary; Miśko, Jolanta; Rużyłło, Witold; Witkowski, Adam

2012-01-01

Background: Left ventricular hypertrophy (LVH) predisposes to larger infarct size, which may be underestimated by the left ventricular ejection fraction (LVEF) due to supranormal systolic performance often present in patients with LVH. The aim of the study was to compare infarct size and LVEF in patients with ST-segment elevation myocardial infarction (STEMI) and increased left ventricular mass on cardiac magnetic resonance (CMR). Methods: The study included unselected group of 52 patients (61 ± 11 years, 69% male) with first STEMI who had CMR after median 5 days from the onset of the event. Left ventricular hypertrophy (LVH) was defined as left ventricular mass index exceeding 95th percentile of references values for age and gender. Infarct size was assessed with means of late gadolinium enhancement (LGE). Results: LVH was found in 16 patients (31%). In comparison to the rest of the group, patients with LVH had higher absolute and relative infarct mass (p = 0.002 and p = 0.02, respectively). LVH was related to higher prevalence of microvascular obstruction and myocardial haemorrhage and higher number of LV segments with transmural necrosis (p = 0.02, p = 0.01 and p = 0.01, respectively). Despite marked difference in the infarct size between both studied subgroups there was no difference in LVEF and mean number of dysfunctional LV segments. Conclusions: Patients with LVH undergoing STEMI have larger infarct size underestimated by the LV systolic performance in comparison to patients without LVH.

Ventricular kinetic energy may provide a novel noninvasive way to assess ventricular performance in patients with repaired tetralogy of Fallot.

Science.gov (United States)

Jeong, Daniel; Anagnostopoulos, Petros V; Roldan-Alzate, Alejandro; Srinivasan, Shardha; Schiebler, Mark L; Wieben, Oliver; François, Christopher J

2015-05-01

Ventricular kinetic energy measurements may provide a novel imaging biomarker of declining ventricular efficiency in patients with repaired tetralogy of Fallot. Our purpose was to assess differences in ventricular kinetic energy with 4-dimensional flow magnetic resonance imaging between patients with repaired tetralogy of Fallot and healthy volunteers. Cardiac magnetic resonance, including 4-dimensional flow magnetic resonance imaging, was performed at rest in 10 subjects with repaired tetralogy of Fallot and 9 healthy volunteers using clinical 1.5T and 3T magnetic resonance imaging scanners. Right and left ventricular kinetic energy (KERV and KELV), main pulmonary artery flow (QMPA), and aortic flow (QAO) were quantified using 4-dimensional flow magnetic resonance imaging data. Right and left ventricular size and function were measured using standard cardiac magnetic resonance techniques. Differences in peak systolic KERV and KELV in addition to the QMPA/KERV and QAO/KELV ratios between groups were assessed. Kinetic energy indices were compared with conventional cardiac magnetic resonance parameters. Peak systolic KERV and KELV were higher in patients with repaired tetralogy of Fallot (6.06 ± 2.27 mJ and 3.55 ± 2.12 mJ, respectively) than in healthy volunteers (5.47 ± 2.52 mJ and 2.48 ± 0.75 mJ, respectively), but were not statistically significant (P = .65 and P = .47, respectively). The QMPA/KERV and QAO/KELV ratios were lower in patients with repaired tetralogy of Fallot (7.53 ± 5.37 mL/[cycle mJ] and 9.65 ± 6.61 mL/[cycle mJ], respectively) than in healthy volunteers (19.33 ± 18.52 mL/[cycle mJ] and 35.98 ± 7.66 mL/[cycle mJ], respectively; P tetralogy of Fallot. Quantification of ventricular kinetic energy in patients with repaired tetralogy of Fallot is a new observation. Future studies are needed to determine whether changes in ventricular kinetic energy can provide earlier evidence of ventricular dysfunction and guide future medical and

Right ventricular function: methodologic and clinical considerations in noninvasive scintigraphic assessment

International Nuclear Information System (INIS)

Manno, B.V.; Iskandrian, A.S.; Hakki, A.H.

1984-01-01

Right ventricular function plays an important role in many cardiac disorders. Changes in left ventricular function, right ventricular afterload and preload, cardiac medications and ischemia may affect right ventricular function. Radionuclide ventriculography permits quantitative assessment of regional and global function of the right ventricle. This assessment can be made at rest, during exercise or after pharmacologic interventions. The overlap between right ventricle and right atrium is a major limitation for gated scintigraphic techniques. The use of imaging with newer short-lived radionuclides may permit more accurate and reproducible assessment of right ventricular function by means of the first pass method. Further work in areas related to improvement of techniques and the impact of right ventricular function on prognosis is needed

Race differences in ventricular remodeling and function among college football players.

Science.gov (United States)

Haddad, Francois; Peter, Shanon; Hulme, Olivia; Liang, David; Schnittger, Ingela; Puryear, Josephine; Gomari, Fatemeh A; Finocchiaro, Gherardo; Myers, Jonathan; Froelicher, Victor; Garza, Daniel; Ashley, Euan A

2013-07-01

Athletic training is associated with increases in ventricular mass and volume. Recent studies have shown that left ventricular mass increases proportionally in white athletes with a mass/volume ratio approaching unity. The objective of this study was to compare the proportionality in ventricular remodeling and ventricular function in black versus white National Collegiate Athletic Association Division I football players. From 2008 to 2011, football players at Stanford University underwent cardiovascular screening with a 12-point history and physical examination, electrocardiography, and focused echocardiography. Compared with white players, black players had on average higher left ventricular mass indexes (77 ± 11 vs 71 ± 11 g/m(2), p = 0.009), higher mass/volume ratios (1.18 ± 0.16 vs 1.06 ± 0.09 g/ml, p 1.2. Mass/volume ratio was inversely related to early diastolic tissue Doppler velocity e' (r = -0.50, p football players exhibit more concentric ventricular remodeling, lower early diastolic annular velocities, and increased ventricular voltage compared with white players. Ventricular mass increases proportionally to volume in white players but not in black players. Copyright © 2013 Elsevier Inc. All rights reserved.

Annular subvalvular left ventricular aneurysm in Bahia, Brazil.

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Guimarães, A C; Filho, A S; Esteves, J P; Abreu, W N; Vinhaes, L A; de Almeida Souza, J A; Machado, A

1976-10-01

Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.

Smart cities, smart lights. Digital signane y experiencia urbana

OpenAIRE

Flore, Giovanni; Pozzoni, Alfio

2012-01-01

Este artículo aborda la experiencia lumínica en la ciudad inteligente y digital o, dicho de otro modo, el uso, cada vez mayor, de la digital signane visual en el entorno urbano, al aire libre y en lugares públicos. La investigación se centra en las áreas de la ciudad donde esta "contaminación" digital goza de mayor visibilidad y accesibilidad, es decir, las zonas comerciales.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction

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Tae Hoon Kim

2015-12-01

Full Text Available A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction.

Science.gov (United States)

Kim, Tae Hoon; Shin, Yu Rim; Kim, Young Sam; Kim, Do Jung; Kim, Hyohyun; Shin, Hong Ju; Htut, Aung Thein; Park, Han Ki

2015-12-01

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Hemoterapia en el trasplante de médula ósea: Experiencia en el instituto de hematología e inmunología

OpenAIRE

Alfonso Valdés, María E; Bencomo Hernández, Antonio; Dorticós Balea, Elvira; Hernández Díaz, Patricia; Alfonso Valdés, Yalile; González Otero, Alejandro

1999-01-01

Se describe la hemoterapia aplicada a 19 pacientes con enfermedades hematológicas malignas que recibieron trasplante de médula ósea autólogo (n=10) y alogénico (n=9). El consumo promedio de concentrados de eritrocitos y concentrados de plaquetas fue de 6,1 y 57,3, respectivamente. El uso de ambos componentes fue mayor en los enfermos que recibieron una médula ósea alogénica. Los pacientes que recibieron tratamiento con ciclosporina requirieron un número menor de concentrados de eritrocitos y ...

Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy

DEFF Research Database (Denmark)

Kjaergaard, Jesper; Hastrup Svendsen, Jesper; Sogaard, Peter

2007-01-01

BACKGROUND: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a regional disease of the RV myocardium with variable degrees of left ventricular involvement. Three-dimensional echocardiography and Doppler tissue imaging (DTI) are new echocardiographic modalities for the evaluation......, patients with ARVC had a decreased RV ejection fraction (0.47 +/- 0.08 vs 0.53 +/- 0.05, P vs 15.1 +/- 3.7 cm/s, P left ventricle (7.0 +/- 2.6 vs 9.5 +/- 1.9 cm/s, P ... of the longitudinal motility appears to be a sensitive marker of preclinical left ventricular involvement....

Reversibility of ventricular dysfunction: clinical experience in a medical office

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Antonio Carlos Pereira Barretto

2001-12-01

Full Text Available OBJECTIVE - To describe clinical observations of marked improvement in ventricular dysfunction in a medical office environment under circumstances differing from those in study protocols and multicenter studies performed in hospital or with outpatient cohorts. METHODS - Eleven cardiac failure patients with marked ventricular dysfunction receiving treatment at a doctors office between 1994 and 1999 were studied. Their ages ranged from 20 and 66 years (mean 39.42±14.05 years; 7 patients were men, 4 were women. Cardiopathic etiologies were arterial hypertension in 5 patients, peripartum cardiomyopathy in 2, nondefined myocarditis in 2, and alcoholic cardiomyopathy in 4. Initial echocardiograms revealed left ventricular dilatation (average diastolic diameter, 69.45±8.15mm, reduced left ventricular ejection fraction (0.38±0.08 and left atrial dilatation (43.36±5.16mm. The therapeutic approach followed consisted of patient orientation, elimination of etiological or causal factors of cardiac failure, and prescription of digitalis, diuretics, and angiotensinconverting enzyme inhibitors. RESULTS - Following treatment, left ventricular ejection fraction changed to 0.63±0.09; left ventricular diameters changed to 57.18±8.13mm, and left atrium diameters changed to 37.27±8.05mm. Maximum improvement was noted after 16.9±8.63 (6 to 36 months. CONCLUSION - Patients with serious cardiac failure and ventricular dysfunction caused by hypertension, alcoholism, or myocarditis can experience marked improvement in ventricular dysfunction after undergoing appropriate therapy within the venue of the doctor's office.

El aprendizaje en-línea: Una experiencia en el Instituto Tecnológico de Costa Rica

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Rosa Inés Lira Valdivia

2002-01-01

Full Text Available La ponencia pretende compartir una experiencia significativa en el ámbito de los cursos virtuales o de la “Comunicación mediada por computadora”. Se enmarca en el contexto de la experiencia generada en el Instituto Tecnológico de Costa Rica, a través del TEC-Virtual cuyo objetivo es producir y poner a disposición de la comunidad cursos universitarios de alta calidad tecnológica y pedagógica en la modalidad asincrónica

Desarrollo del Cuestionario de Experiencias de Violencia en las Relaciones de Pareja y Familia en Estudiantes Universitarios

OpenAIRE

Villafañe Santiago, Angel A.; Universidad de Puerto Rico; Jimenez Chafey, Maria Isabel; Universidad de Puerto Rico; De Jesus Carrasquillo, Damaris; Universidad de Puerto Rico; Vázquez Ramos, Robinson A.; Universidad de Puerto Rico

2010-01-01

Este estudio presenta el proceso de desarrollo del Cuestionario de Experiencias de Violencia en las Relaciones de Pareja y Familia en Estudiantes Universitarios, así como sus propiedades psicométricas y hallazgos a través de un estudio piloto. El instrumento exploró las experiencias de violencia de una muestra de estudiantes en las relaciones de pareja y de familia en cuatro contextos: de la pareja hacia el/la estudiante; del estudiante hacia la pareja; observada entre padres; y de los padre...

Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function.

Science.gov (United States)

van Huls van Taxis, Carine F B; Piers, Sebastiaan R D; de Riva Silva, Marta; Dekkers, Olaf M; Pijnappels, Daniël A; Schalij, Martin J; Wijnmaalen, Adrianus P; Zeppenfeld, Katja

2015-12-01

High idiopathic premature ventricular contractions (PVC) burden has been associated with PVC-induced cardiomyopathy. Patients may be symptomatic before left ventricular (LV) dysfunction develops. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and circumferential end-systolic wall stress (cESS) on echocardiography are markers for increased ventricular wall stress. This study aimed to evaluate the relation between presenting symptoms, PVC burden, and increased ventricular wall stress in patients with frequent PVCs and preserved LV function. Eighty-three patients (41 men; 49±15 years) with idiopathic PVCs and normal LV function referred for PVC ablation were included. Type of symptoms (palpitations, fatigue, and [near-]syncope), PVC burden on 24-hour Holter, NT-proBNP levels, and cESS on echocardiography were assessed before and 3 months after ablation. Sustained successful ablation was defined as ≥80% PVC burden reduction during follow-up. Patients were symptomatic for 24 months (Q1-Q3, 16-60); 73% reported palpitations, 47% fatigue, and 30% (near-)syncope. Baseline PVC burden was 23±13%, median NT-proBNP 92 pg/mL (Q1-Q3 50-156), and cESS 143±35 kdyne/cm(2). Fatigue was associated with higher baseline NT-proBNP and cESS (PFatigue was independently associated with a significantly larger reduction in NT-proBNP. In patients with nonsuccessful ablation, NT-proBNP and cESS remained unchanged. In patients with frequent PVCs and preserved LV function, fatigue was associated with higher baseline NT-proBNP and cESS, and with a significantly larger reduction in NT-proBNP after sustained successful ablation. These findings support a link between fatigue and PVC-induced increased ventricular wall stress, despite preserved LV function. © 2015 American Heart Association, Inc.

Clinical use of ultrashort-lived radionuclide krypton-81m for noninvasive analysis of right ventricular performance in normal subjects and patients with right ventricular dysfunction

International Nuclear Information System (INIS)

Nienaber, C.A.; Spielmann, R.P.; Wasmus, G.; Mathey, D.G.; Montz, R.; Bleifeld, W.H.

1985-01-01

The ultrashort-lived radionuclide krypton-81m, eluted in 5% dextrose from a bedside rubidium-81m generator, was intravenously infused for rapid imaging of the right-sided heart chambers in the right anterior oblique projection adjusted for optimal right atrioventricular separation. Left-sided heart and lung background was minimized by rapid decay and efficient exhalation of krypton-81m, requiring no algorithm for background correction. A double region of interest method decreased the variability in the assessment of ejection fraction to 5%. In 10 normal subjects, 11 patients with pulmonary hypertension, 4 patients with right ventricular outflow tract obstruction and 4 patients with right ventricular infarction, right ventricular ejection fraction determined by krypton-81m equilibrium blood pool imaging ranged from 14 to 76%. The correlation between these values and those determined by cineangiography according to Simpson's rule was close: r . 0.93 for all data points, r . 0.92 for studies at rest and r . 0.93 for exercise studies. Exercise-related changes in right ventricular function revealed a disturbed functional reserve with pulmonary hypertension and right ventricular infarction, whereas in compensated right ventricular outflow tract obstruction there was a physiologic increase in ejection fraction with exercise. Thus, equilibrium-gated right ventricular imaging using ultrashort-lived krypton-81m is a simple, accurate and reproducible method with potential for serial assessment of right ventricular ejection fraction in a variety of right ventricular anatomic and functional abnormalities, both at rest and during exercise. Advantages of this method include an extremely low radiation dose to patients and clear right atrioventricular separation without the need to correct for background activity

Videodensitometric assessment of right and left ventricular functions by digital subtraction angiography

International Nuclear Information System (INIS)

Ikeda, Hisao; Yoshiga, Osamu; Shibao, Keigo

1987-01-01

Intravenous digital subtraction (DS) ventriculography was performed in a series of 50 patients with heart diseases to determine right and left ventricular volumes and systolic indices. Right ventricular volume and right ventricular ejection fraction obtained by DS ventriculography were well correlated with those by geometric methods. In 43 patients with left ventricular ejection fraction of 55 % or greater, end-diastolic volume, stroke volume, and ejection fraction in the right ventricle did not differ from those in the left ventricle ; however, both the 1/3 ejection fraction and the peak ejection rate of the right ventricle were significantly lower than those of the left ventricle, suggesting the different modes of left and right ventricular contraction. In the other seven patients with chronic left ventricular failure, right ventricular systolic function may be preserved, even when left ventricular function is severely impaired. Digital subtraction ventriculography has proved to be a simple, useful method in the quanlitative and quantitative assessments of the right and left ventricles. (Namekawa, K.)

La creación y promoción de experiencias en un destino turístico. Un análisis de la investigación y necesidades de actuación

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Rita Carballo Fuentes

2015-01-01

Full Text Available El artículo realiza una profunda revisión teórica de un término de creciente interés: la experiencia. Se aborda la comprensión de las dimensiones de la experiencia turística, cómo analizarlas, y cómo desarrollar y comunicar una experiencia turística, presentado especial atención a la marca y los eventos como paradigma promocional de la misma. Como aportaciones principales, este trabajo analiza e identifica la situación de la investigación sobre experiencias turísticas, y finaliza con una propuesta: matriz de diseño de la experiencia, para la implementación práctica de experiencias en un destino.

Electrical Signs predictors of malignant ventricular arrhythmias

International Nuclear Information System (INIS)

Aleman Fernandez, Ailema Amelia; Dorantes Sanchez, Margarita

2012-01-01

Recurrence of malignant ventricular arrhythmia is frequent in cardioverter-defibrillators related patients. The risk stratification is difficult, there are numerous electrocardiographic predictors but his sensibility and specificity are not absolute. The limit between normal and pathological is not defined, besides the complexity of ventricular arrhythmias. We expose different electrocardiographic predictors that can help to better individual risk stratification

Nonischemic Left Ventricular Scar as a Substrate of Life-Threatening Ventricular Arrhythmias and Sudden Cardiac Death in Competitive Athletes.

Science.gov (United States)

Zorzi, Alessandro; Perazzolo Marra, Martina; Rigato, Ilaria; De Lazzari, Manuel; Susana, Angela; Niero, Alice; Pilichou, Kalliopi; Migliore, Federico; Rizzo, Stefania; Giorgi, Benedetta; De Conti, Giorgio; Sarto, Patrizio; Serratosa, Luis; Patrizi, Giampiero; De Maria, Elia; Pelliccia, Antonio; Basso, Cristina; Schiavon, Maurizio; Bauce, Barbara; Iliceto, Sabino; Thiene, Gaetano; Corrado, Domenico

2016-07-01

The clinical profile and arrhythmic outcome of competitive athletes with isolated nonischemic left ventricular (LV) scar as evidenced by contrast-enhanced cardiac magnetic resonance remain to be elucidated. We compared 35 athletes (80% men, age: 14-48 years) with ventricular arrhythmias and isolated LV subepicardial/midmyocardial late gadolinium enhancement (LGE) on contrast-enhanced cardiac magnetic resonance (group A) with 38 athletes with ventricular arrhythmias and no LGE (group B) and 40 healthy control athletes (group C). A stria LGE pattern with subepicardial/midmyocardial distribution, mostly involving the lateral LV wall, was found in 27 (77%) of group A versus 0 controls (group C; P<0.001), whereas a spotty pattern of LGE localized at the junction of the right ventricle to the septum was respectively observed in 11 (31%) versus 10 (25%; P=0.52). All athletes with stria pattern showed ventricular arrhythmias with a predominant right bundle branch block morphology, 13 of 27 (48%) showed ECG repolarization abnormalities, and 5 of 27 (19%) showed echocardiographic hypokinesis of the lateral LV wall. The majority of athletes with no or spotty LGE pattern had ventricular arrhythmias with a predominant left bundle branch block morphology and no ECG or echocardiographic abnormalities. During a follow-up of 38±25 months, 6 of 27 (22%) athletes with stria pattern experienced malignant arrhythmic events such as appropriate implantable cardiac defibrillator shock (n=4), sustained ventricular tachycardia (n=1), or sudden death (n=1), compared with none of athletes with no or LGE spotty pattern and controls. Isolated nonischemic LV LGE with a stria pattern may be associated with life-threatening arrhythmias and sudden death in the athlete. Because of its subepicardial/midmyocardial location, LV scar is often not detected by echocardiography. © 2016 The Authors.

Adjustable, physiological ventricular restraint improves left ventricular mechanics and reduces dilatation in an ovine model of chronic heart failure.

Science.gov (United States)

Ghanta, Ravi K; Rangaraj, Aravind; Umakanthan, Ramanan; Lee, Lawrence; Laurence, Rita G; Fox, John A; Bolman, R Morton; Cohn, Lawrence H; Chen, Frederick Y

2007-03-13

Ventricular restraint is a nontransplantation surgical treatment for heart failure. The effect of varying restraint level on left ventricular (LV) mechanics and remodeling is not known. We hypothesized that restraint level may affect therapy efficacy. We studied the immediate effect of varying restraint levels in an ovine heart failure model. We then studied the long-term effect of restraint applied over a 2-month period. Restraint level was quantified by use of fluid-filled epicardial balloons placed around the ventricles and measurement of balloon luminal pressure at end diastole. At 4 different restraint levels (0, 3, 5, and 8 mm Hg), transmural myocardial pressure (P(tm)) and indices of myocardial oxygen consumption (MVO2) were determined in control (n=5) and ovine heart failure (n=5). Ventricular restraint therapy decreased P(tm) and MVO2, and improved mechanical efficiency. An optimal physiological restraint level of 3 mm Hg was identified to maximize improvement without an adverse affect on systemic hemodynamics. At this optimal level, end-diastolic P(tm) and MVO2 indices decreased by 27% and 20%, respectively. The serial longitudinal effects of optimized ventricular restraint were then evaluated in ovine heart failure with (n=3) and without (n=3) restraint over 2 months. Optimized ventricular restraint prevented and reversed pathological LV dilatation (130+/-22 mL to 91+/-18 mL) and improved LV ejection fraction (27+/-3% to 43+/-5%). Measured restraint level decreased over time as the LV became smaller, and reverse remodeling slowed. Ventricular restraint level affects the degree of decrease in P(tm), the degree of decrease in MVO2, and the rate of LV reverse remodeling. Periodic physiological adjustments of restraint level may be required for optimal restraint therapy efficacy.

Radionuclide evaluation of left ventricular function with nonimaging probes.

Science.gov (United States)

Wexler, J P; Blaufox, M D

1979-10-01

Portable nonimaging probes have been developed that can evaluate left ventricular function using radionuclide techniques. Two modes of data acquisition are possible with these probe systems, first-pass and gated. Precordial radiocardiograms obtained after a bolus injection can be used to determine cardiac output, pulmonary transit time, pulmonary blood volume, left ventricle ejection fraction, and left-to-right shunts. Gated techniques can be used to determine left ventricular ejection fraction and sytolic time intervals. Probe-determined indices of left ventricular function agree excellently with comparable measurements determined by conventional camera-computer methods as well as by invasive techniques. These have begun to be used in a preliminary manner in a variety of clinical problems associated with left ventricular dysfunction. This review discusses the types of probe systems available, the methods used in positioning them, and details the specifics of their data acquisition and processing capacity. The major criticisms of probe methods are that they are nonimaging and that they measure global rather than regional left ventricular function. In spite of these criticisms, probe systems, because of their portability, high sensitivity, and relatively low cost are useful supplements to conventional camera-computer systems for the measurement of parameters of left ventricular performance using radionuclide techniques.

Ventricular Arrhythmic Storm after Initiating Sacubitril/Valsartan.

Science.gov (United States)

Vicent, Lourdes; Juárez, Miriam; Martín, Irene; García, Jorge; González-Saldívar, Hugo; Bruña, Vanesa; Devesa, Carolina; Sousa-Casasnovas, Iago; Fernández-Avilés, Francisco; Martínez-Sellés, Manuel

Sacubitril/valsartan was approved recently for the treatment of patients with heart failure and reduced ejection fraction. We present 6 cases of ventricular arrhythmia, that occurred shortly after sacubitril/valsartan initiation, that required drug withdrawal. Other potential triggering factors of electrical storm were ruled out and, from the arrhythmic perspective, all of the patients were stable in the previous year. Our aim is to describe the possible association of sacubitril/valsartan with arrhythmic storm. This was an observational monocentric study performed in the first 7 months of sacubitril/valsartan commercialization in Spain (October 2016). All patients were included in the SUMA (Sacubitril/Varsartan Usado Ambulatoriamente en Madrid [Sacubitril/Valsartan Used in Outpatients in Madrid]) registry. Patients were consecutively enrolled on the day they started the drug. Ventricular arrhythmic storm was defined as ≥2 episodes of sustained ventricular arrhythmia or defibrillator therapy application in 24 h. From 108 patients who received the drug, 6 presented with ventricular arrhythmic storm (5.6%). Baseline characteristics were similar in the patients with and without ventricular arrhythmic storm. The total number of days that sacubitril/valsartan was administered to each patient was 5, 6, 44 (8 since titration), 84, 93, and 136 (105 since titration), respectively. Our data are not enough to infer a cause-and-effect relationship. Further investigations regarding a potential proarrhythmic effect of sacubitril/valsartan are probably needed. © 2018 S. Karger AG, Basel.

Assessment of inter-atrial, inter-ventricular, and atrio-ventricular interactions in tetralogy of Fallot patients after surgical correction. Insights from two-dimensional speckle tracking and three-dimensional echocardiography.

Science.gov (United States)

Abd El Rahman, Mohamed; Raedle-Hurst, Tanja; Rentzsch, Axel; Schäfers, Hans-Joachim; Abdul-Khaliq, Hashim

2015-10-01

We aimed to assess biatrial size and function, interactions on atrial and ventricular levels, and atrio-ventricular coupling in patients after tetralogy of Fallot repair. A total of 34 patients with a mean age of 20.9±9 years, and 35 healthy controls, underwent two-dimensional speckle tracking echocardiography for ventricular and atrial strain measurements and real-time three-dimensional echocardiography to assess ventricular and atrial volumes. When compared with controls, tetralogy of Fallot patients had significantly reduced right atrial peak atrial longitudinal strain (ptetralogy of Fallot group, left ventricular ejection fraction was negatively related to the right ventricular end-systolic volume normalised to body surface area (r=-0.62, ptetralogy of Fallot patients, biatrial dysfunction exists and can be quantified via two-dimensional speckle tracking echocardiography as well as real-time three-dimensional echocardiography. Different forms of interactions on atrial and ventricular levels are evident among such cohorts.

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

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Lanjewar SS

2013-11-01

Full Text Available Swapnil S Lanjewar,1 Lovely Chhabra,1 Vinod K Chaubey,1 Saurabh Joshi,1 Ganesh Kulkarni,1 Chandrasekhar Kothagundla,1 Sudesh Kaul,1 David H Spodick21Department of Internal Medicine, 2Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USABackground: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.Methods: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1 were computed and compared between the two subgroups.Results: There was no statistically significant difference in qualitative lung function (FEV1 between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.Conclusion: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.Keywords: emphysema, electrocardiogram, left ventricular hypertrophy, chronic

A case report of arrhythmogenic right ventricular dysplasia

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Henry Anselmo Mayala

2013-07-01

Full Text Available Background Arrhythmogenic right ventricular dysplasia is an autosomal dominant disorder affecting parts of myocardium known as desmosomes, areas on the surface of heart muscle cells which link the cells together. The hallmark feature is fibro-fatty replacement of the right ventricle myocardium characterized by hypokinetic areas with associated arrhythmias originating in the right ventricle. Case Presentation In this report a 42 year old man was admitted at Wuhan union Hospital with the presenting complaints of visual hallucination and difficulty in breathing on exertion, with a family history of sudden death. Clinical and imaging findings are suggestive of Arrhythmogenic right ventricular dysplasia. Conclusion Despite being among the rare cardiac disease, Arrhythmogenic right ventricular dysplasia is an important cause of ventricular arrhythmias in children and young adults, it is also responsible for sudden cardiac death in the young population, making it necessary for this case report.

[Idiopathic ventricular arrhythmia in children. Apropos of 24 cases].

Science.gov (United States)

Coeurderoy, A; Almange, C; Laurent, M; Biron, Y; Leborgne, P

1985-12-01

The severity and prognosis of idiopathic ventricular arrhythmias in childhood were studied in 24 patients (12 boys, 12 girls) with an average age of 8 years at the time of diagnosis of the arrhythmia. Investigations included clinical assessment and analysis of basal ECG (morphology of the arrhythmias) and dynamic recordings (Holter and exercise stress testing). The clinical course was followed for an average of 3.8 years. The patients were classified in two groups: monomorphic arrhythmias (Group I) and polymorphic arrhythmias (Group II). Group I was divided into 4 subgroups: isolated ventricular extrasystoles (IA), 11 patients; ventricular extrasystoles with bursts of ventricular tachycardia (IB), 6 patients; sustained ventricular tachycardia without intercritical extrasystoles (IC), 1 patient; accelerated idioventricular rhythm (ID), 2 patients. Subgroups IA, IB and ID were characterised by the absence of symptoms, the disappearance of the arrhythmia on exercise, the decreased efficacy of antiarrhythmic drugs and an excellent prognosis. Therapeutic abstention was the rule in these patients. Patients in Group IC were characterised by the variability of their symptoms, the absence of exercise induced arrhythmias, the need for treatment in most cases and a good long-term prognosis. Group II was divided into 2 subgroups: adrenergic polymorphic ventricular tachycardia (IIA), 2 patients, and non-adrenergic polymorphic ventricular tachycardia (IIB), 2 patients. Patients in Subgroup IIA were characterised by syncope on exercise or emotion, the need for betablocker therapy which considerably improved the patients symptoms but which did not usually prevent sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

Ventricular and myocardial scintiscanning: Methodical fundamentals

International Nuclear Information System (INIS)

Standke, R.; Hoer, G.; Maul, F.D.

1984-01-01

Nuclear cardiology is concerned with non invasive procedures to quantitate global and regional left ventricular function (Radionuclide ventriculography), also the imaging of vitally perfused myocardium (Myocardial scintigraphy) is achieved. A gammacamera and a minicomputer are necessary. Radionuclide ventriculography enables the analysis of global and regional time dependent left ventricular volume curves and hence the evaluation of contraction and contractility of the heart muscle. The basis is a sequence of scans covering an average heartcycle. This sequence may be produced either by first pass or equilibrium technique. Myocardial scintigraphy at rest images vital myocardium, scans immediately after exercise represent the interference of myocardial perfusion and muscle mass. The regional difference (Redistribution) between normalized exercise- and rest scans provide quantitative parameters to detect impairment of exercise-induced myocardial perfusion anomalies. The procedures of sectorial analysis of left ventricular function and myocardial perfusion are presented. (orig.) [de

Left ventricular dysfunction after closure of large patent ductus arteriosus.

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Galal, M Omar; Amin, Mohamed; Hussein, Arif; Kouatli, Amjad; Al-Ata, Jameel; Jamjoom, Ahmed

2005-03-01

Changes in left ventricular dimensions and performance were studied in 43 patients after transcatheter occlusion or surgical ligation of patent ductus arteriosus. The patients were assigned to 2 groups based on their ductal diameter: >/= 3.1 mm to group A (n = 27) and ventricular end-diastolic diameter than group B, while all patients had normal shortening fraction and ejection fraction. Within 1 month after intervention, left ventricular end-diastolic diameter showed a trend towards regression while shortening fraction and ejection fraction decreased significantly in group A. There were no significant changes in these parameters in group B. Between 1 and 6 months after intervention, left ventricular performance improved in most of the group A patients who were followed up. We conclude that closure of large ductus arteriosus in children leads to significant immediate deterioration of left ventricular performance, which appears to recover within a few months. Echocardiographic study before hospital discharge is recommended in these patients. Serious deterioration of ventricular performance after closure may warrant the use of angiotensin converting enzyme inhibitors.

A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

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Oudit, Gavin Y; Cameron, Doug; Harris, Louise

2008-01-01

The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T wave oversensing, leading to ventricular oversensing with resultant detection in the ventricular fibrillation rate zone. This was followed by shock therapy, even though the ventricular tachycardia rate was below the programmed detection rate of the ICD. The subsequent emergency treatment of the hyperkalemia normalized the electrogram, corrected the ventricular oversensing and arrhythmia, and restored rate-adaptive single-chamber ventricular pacing. PMID:18340383

Differential diagnosis of the 4th ventricular tumors

International Nuclear Information System (INIS)

Lee, Sang Woo; Lee, Jong Min; Kang, Moo Song; Kim, Chul Min; Kim, Chang Soo

1997-01-01

To determine by analysis of MR and CT findings the points of differentiation among 4th ventricular tumors, especially the change of shape of the 4th ventricle caused by the site at which 4th ventricular tumors originate. The authors retrospectively analyzed and compared the CT(n=5) and MRI(n=12) findings of 13 pathologically proven 4th ventricular tumors comprising six medulloblastomas three ependymomas(4 cases) and three choroids plexus papillomas. On axial MRI medulloblastomas showed anterior and anterolateral CSF-clefts between the tumor mass and the 4th ventricular wall in one and five cases, respectively; on sagittal MRI, anterior beaking of the upper 4th ventricle was seen. Two ependymomas showed posterolateral CSF-cleft on axial MRI and posterior beaking of the upper 4th ventricle on sagittal MRI. Two ependymomas and all choroids plexus papillomas showed anterior, posterior and lateral CSF-clefts on axial MRI, and anterior and posterior beakings of the upper 4th ventricle on sagittal MRI. On Gd-DTPA enhanced T1WI, all medulloblastomas and ependymomas showed inhomogeneous enhancement, and all choroids plexus papillomas showed homogeneous enhancement. On CT, tow choroids plexus papillomas showed dense calcifications. The differential diagnosis of 4th ventricular tumors can be preoperatively suggested by analysis of findings such as a CSF-cleft between the tumor mass and the 4th ventricular wall on axial MR and CT images, the shape of the upper 4th ventricle on sagittal MRI, contrast enhancement pattern, necrosis and cyst, and CSF seeding

Usefulness of ventricular endocardial electric reconstruction from body surface potential maps to noninvasively localize ventricular ectopic activity in patients

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Lai, Dakun; Sun, Jian; Li, Yigang; He, Bin

2013-06-01

As radio frequency (RF) catheter ablation becomes increasingly prevalent in the management of ventricular arrhythmia in patients, an accurate and rapid determination of the arrhythmogenic site is of important clinical interest. The aim of this study was to test the hypothesis that the inversely reconstructed ventricular endocardial current density distribution from body surface potential maps (BSPMs) can localize the regions critical for maintenance of a ventricular ectopic activity. Patients with isolated and monomorphic premature ventricular contractions (PVCs) were investigated by noninvasive BSPMs and subsequent invasive catheter mapping and ablation. Equivalent current density (CD) reconstruction (CDR) during symptomatic PVCs was obtained on the endocardial ventricular surface in six patients (four men, two women, years 23-77), and the origin of the spontaneous ectopic activity was localized at the location of the maximum CD value. Compared with the last (successful) ablation site (LAS), the mean and standard deviation of localization error of the CDR approach were 13.8 and 1.3 mm, respectively. In comparison, the distance between the LASs and the estimated locations of an equivalent single moving dipole in the heart was 25.5 ± 5.5 mm. The obtained CD distribution of activated sources extending from the catheter ablation site also showed a high consistency with the invasively recorded electroanatomical maps. The noninvasively reconstructed endocardial CD distribution is suitable to predict a region of interest containing or close to arrhythmia source, which may have the potential to guide RF catheter ablation.

Experiencias para observar el fenómeno de fluorescencia con luz ultravioleta

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Heredia Avalos, S.

2008-09-01

Full Text Available La fluorescencia tiene lugar cuando una sustancia emite luz visible al absorber radiación de una longitud de onda menor, como por ejemplo luz ultravioleta. La diferencia entre la energía absorbida (del fotón ultravioleta y la emitida (del fotón visible se disipa en forma de calor. Se dice que la sustancia posee fluorescenciacuando este proceso es muy rápido; si es más lento se dice que la sustancia posee fosforescencia. A continuación se describen varias experiencias sencillas para poner de manifiesto el fenómeno de fluorescencia. Todas ellas requieren de reactivos y materiales fácilmente accesibles y asequibles y se pueden realizar con alumnos de secundaria o de bachillerato para poner de manifiesto este fenómeno. Además, también se propone una experiencia en la que se observa la reversibilidad de las reacciones químicas ácido-base a través de la fluorescencia.

Violencia urbana y subjetividades victimizantes: sentidos y experiencias organizativas de las víctimas de la inseguridad en Argentina

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Mercedes Celina Calzado

2014-09-01

Full Text Available La violencia urbana introduce en América Latina modalidades de narrar las experiencias de victimización. En las sociedades de seguridad se reconfiguran las subjetividades y se redefinen discursos y prácticas políticas individuales y colectivas. Este artículo reflexiona acerca de los modos en que se constituyen los discursos de los grupos organizados de víctimas de la inseguridad en Argentina ¿La experiencia individual define la subjetividad? ¿Ser familiar de una víctima fatal (o no de la criminalidad establece los parámetros desde los cuales se explica la experiencia? ¿O se ordena a partir de definiciones previas de verdad, conceptos preexistentes que nominalizan el sufrimiento? Desde un conjunto de entrevistas realizadas a familiares de víctimas de la inseguridad, se reflexiona sobre las experiencias que originan un sujeto colectivo atravesado por la violencia urbana. Esta investigación propone una tipología con cinco clases de vocabularios de intervención de los grupos organizados de víctimas de la inseguridad: colectivos tópicos, colectivos categóricos, colectivos de cercanías, colectivos “manzaneros” y colectivos mínimos.

chronic sleep deprevation and ventricular arrhythmias: effect of symphatic nervous system

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Samira Choopani

2016-04-01

Full Text Available Introduction: We assessed the effect of chronic sleep deprivation on incidence of ischemia/reperfusion-induced ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation and the role of the sympathetic nervous system in this respect. Material and methods: Rats were randomly divided into four groups; 1 ischemia/reperfusion group (IR: 30 minutes ischemia followed by 60 minutes reperfusion was induced, 2 control group (CON: rats has been placed in large multiple platforms for 72h prior to ischemia and reperfusion, 3 Chronic sleep deprivation group( SD: 72h sleep deprivation was induced by using small  multiple platform prior to ischemia and reperfusion, 4 Sympathectomy group (SYM: chemical sympathectomy was done 24h before to chronic sleep deprivation and then underwent ischemia and reperfusion. The heart isolated and perfused by langendorff apparatus. After thoracotomy and aorta cannulation, the hearts perfused in the langendorff apparatus using krebs-Henseleit buffer. Hearts were allowed to recovery for 15 min. After recovery period, 15 minutes was considered as baseline prior to 30 minutes ischemia followed by 60 minutes reperfusion.Tow thin stainless stell electrodes fixed on the ventricular apex and right atrium for recording the lead II of electrocardiogram (ECG.Results: There were no significant differences between heart rates between groups, and ventricular tachycardia significantly increased in chronic sleep deprivation group As compared with IR group in ischemia period. Sympathectomy significantly reduced ventricular tachycardia incidence when compared with SD. There is no difference in incidence of ventricular tachycardia between control group and IR group. The incidence of ventricular fibrillation during early reperfusion was significantly augmented (P<0.05 in sleep deprivation group as compared with IR group and Sympathectomy significantly could reverse ventricular fibrillation incidence to IR group level as

Patterns of left ventricular remodeling among patients with essential and secondary hypertension.

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Radulescu, Dan; Stoicescu, Laurentiu; Buzdugan, Elena; Donca, Valer

2013-12-01

High blood pressure causes left ventricular hypertrophy, which is a negative prognostic factor among hypertensive patients. To assess left ventricular geometric remodeling patterns in patients with essential hypertension or with hypertension secondary to parenchymal renal disease. We analyzed data from echocardiograms performed in 250 patients with essential hypertension (150 females) and 100 patients with secondary hypertension (60 females). The interventricular septum and the left ventricular posterior wall thickness were measured in the parasternal long-axis. Left ventricular mass was calculated using the Devereaux formula. The most common remodeling type in females and males with essential hypertension were eccentric and concentric left ventricular hypertrophy (cLVH), respectively. Among patients with secondary arterial hypertension, cLVH was most commonly observed in both genders. The prevalence of left ventricular hypertrophy was higher among patients with secondary hypertension. The left ventricular mass index and the relative left ventricular wall thickness were higher in males and also in the secondary hypertension group. Age, blood pressure values and the duration of hypertension, influenced remodeling patterns. We documented a higher prevalence of LVH among patients with secondary hypertension. The type of ventricular remodeling depends on gender, age, type of hypertension, blood pressure values and the duration of hypertension.

Experiencias caseras que muestran aspectos del funcionamiento de la vista, el gusto y el tacto

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Juan A. Navarro de Tuero

2011-01-01

Full Text Available En el laboratorio de Biología explicamos el funcionamiento de algunos de nuestros órganos de los sentidos (vista, olfato, gusto y tacto a través de una serie de experiencias que a lo largo de los años han evidenciado ser muy didácticas. Muestran parte del proceso físico en sí y, al exigir la participación activa del alumnado, permiten que éste aprenda divirtiéndose. Lo fácil y barato que resulta realizar estas experiencias, junto a su gran capacidad de generar asombro, invitan a su difusión y ejecución a todos los niveles.

Experiencias caseras que muestran aspectos del funcionamiento de la vista, el gusto y el tacto

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Juan A. Navarro de Tuero

2011-04-01

Full Text Available En el laboratorio de Biología explicamos el funcionamiento de algunos de nuestros órganos de los sentidos (vista, olfato, gusto y tacto a través de una serie de experiencias que a lo largo de los años han evidenciado ser muy didácticas. Muestran parte del proceso físico en sí y, al exigir la participación activa del alumnado, permiten que éste aprenda divirtiéndose. Lo fácil y barato que resulta realizar estas experiencias, junto a su gran capacidad degenerar asombro, invitan a su difusión y ejecución a todos los niveles.

Ventricular Septal Defect (VSD)

Science.gov (United States)

... Call your doctor if your baby or child: Tires easily when eating or playing Is not gaining ... heart procedures. Risk factors Ventricular septal defects may run in families and sometimes may occur with other ...

OBSERVACIONES PRÁCTICAS EN BASE A LA EXPERIENCIA AUDIOLÓGICA EN IMPLANTE COCLEAR

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TM. Raquel Levy

2016-11-01

En base a nuestra experiencia como centro de referencia a nivel nacional en ésta área, deseamos entregar algunas orientaciones y describir las características más relevantes de los pacientes implantados de acuerdo a su rango etario.

Experiencia de intercambio docente en dos asignaturas de Inteligencia Artificial en universidades argentinas

OpenAIRE

Mariño, Sonia Itatí; Rambo, Alice

2014-01-01

En ámbitos de Educación Superior se propicia la generación de redes de intercambio y difusión de conocimientos y experiencias. Se describe una iniciativa docente desarrollada en dos asignaturas que abordan temas de Inteligencia Artificial.

Epicardial deployment of right ventricular disk during perventricular device closure in a child with apical muscular ventricular septal defect

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Nageswara Rao Koneti

2013-01-01

Full Text Available We report a successful perventricular closure of an apical muscular ventricular septal defect (mVSD by a modified technique. An eight-month-old infant, weighing 6.5 kilograms, presented with refractory heart failure. The transthoracic echocardiogram showed multiple apical mVSDs with the largest one measuring 10 mm. perventricular device closure using a 12 mm Amplatzer mVSD occluder was planned. The left ventricular disk was positioned approximating the interventricular septum; however, the right ventricular (RV disk was deployed on the free wall of the RV due to an absent apical muscular septum and a small cavity at the apex. The RV disk of the device was covered using an autologous pericardium. His heart failure improved during follow-up.

EL CUERPO INVESTIGADOR, EL CUERPO INVESTIGADO. Una aproximación fenomenológica a la experiencia del puerperio

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ANA SABRINA MORA

2009-01-01

Full Text Available El OBJETIVO DE ESTE ARTÍCULO ES EXPLORAR LA UTILIDAD DE LAS DESCRIPCIONES FENOMENOLÓGIcas, incluyendo las experiencias de quien realiza la investigación, como parte de los análisis socioantropológicos sobre el cuerpo y la sexualidad, en especial, para aproximarse al estudio del puerperio y a algunas experiencias que suelen asociarse a él en la contemporaneidad occidental. Intenta, además, integrar la propuesta metodológica de la fenomenología con los marcos analíticos postestructuralistas. Se parte de la idea de que la observación de acontecimientos vitales intensos como el parto y elpuerperio, es una vía de acceso al conocimiento de todas aquellas experiencias que desde el cuerpo repercuten sobre la subjetividad, y considera al cuerpo y al sujeto como una unidad indisoluble, que sólo puede comprenderse desde su imbricación, tal como lo establece la perspectiva del embodiment.

Experiencias Atípicas Psicóticas y Cuasi-Psicóticas en Adolescentes Puertorriqueños/as Deprimidos/as: Prevalencia y Factores Asociados

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Yaritza M. López-Robledo

2009-01-01

Full Text Available Se examinó la prevalencia de experiencias atípicas psicóticas y cuasi-psicóticas y se identificaron factores asociados a éstas en 162 jóvenes puertorriqueños/as entre 13 y 17.5 años. Se evaluó la sintomatología depresiva, la ideación suicida, así como la presencia o historia de experiencias atípicas, eventos traumáticos y maltrato o abuso. Las experiencias atípicas estuvieron asociadas (p<.05 a ser fémina, a tener enfermedades físicas, a experimentar eventos traumáticos, a haber recibido tratamiento para la depresión, y a una sintomatología depresiva e ideación suicida elevada. Los eventos traumáticos, el tratamiento farmacológico para la depresión y la severidad de la ideación suicida fueron predictores significativos del número de experiencias reportadas. Los resultados confirman que la mayoría de las experiencias no son psicóticas. Se discuten las implicaciones para la evaluación y el tratamiento de jóvenes deprimidos/as.

Right ventricular functional analysis utilizing first pass radionuclide angiography for pre-operative ventricular assist device planning: a multi-modality comparison.

Science.gov (United States)

Avery, Ryan; Day, Kevin; Jokerst, Clinton; Kazui, Toshinobu; Krupinski, Elizabeth; Khalpey, Zain

2017-10-10

Advanced heart failure treated with a left ventricular assist device is associated with a higher risk of right heart failure. Many advanced heart failures patients are treated with an ICD, a relative contraindication to MRI, prior to assist device placement. Given this limitation, left and right ventricular function for patients with an ICD is calculated using radionuclide angiography utilizing planar multigated acquisition (MUGA) and first pass radionuclide angiography (FPRNA), respectively. Given the availability of MRI protocols that can accommodate patients with ICDs, we have correlated the findings of ventricular functional analysis using radionuclide angiography to cardiac MRI, the reference standard for ventricle function calculation, to directly correlate calculated ejection fractions between these modalities, and to also assess agreement between available echocardiographic and hemodynamic parameters of right ventricular function. A retrospective review from January 2012 through May 2014 was performed to identify advanced heart failure patients who underwent both cardiac MRI and radionuclide angiography for ventricular functional analysis. Nine heart failure patients (8 men, 1 woman; mean age of 57.0 years) were identified. The average time between the cardiac MRI and radionuclide angiography exams was 38.9 days (range: 1 - 119 days). All patients undergoing cardiac MRI were scanned using an institutionally approved protocol for ICD with no device-related complications identified. A retrospective chart review of each patient for cardiomyopathy diagnosis, clinical follow-up, and echocardiogram and right heart catheterization performed during evaluation was also performed. The 9 patients demonstrated a mean left ventricular ejection fraction (LVEF) using cardiac MRI of 20.7% (12 - 40%). Mean LVEF using MUGA was 22.6% (12 - 49%). The mean right ventricular ejection fraction (RVEF) utilizing cardiac MRI was 28.3% (16 - 43%), and the mean RVEF calculated by

Estudo da função ventricular na técnica de plicatura da parede livre do ventrículo esquerdo em cães Left ventricular function after plication of the left ventricular free wall in dogs

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James Newton Bizetto Meira de Andrade

2004-06-01

Full Text Available OBJETIVO: Avaliar os efeitos da técnica na função ventricular esquerda em cães hígidos e com cardiomiopatia dilatada induzida pela doxorrubicina. MÉTODO: De 13 cães, oito receberam doxorrubicina até que a fração de encurtamento (FE fosse menor que 20%. Destes, quatro animais e os cinco não induzidos foram submetidos à plicatura da parede livre do ventrículo esquerdo (PPLVE. Os demais cães não foram operados. Foram avaliados débito cardíaco (DC, pressão arterial, exame físico, eletrocardiografia, sistema "Holter" e ecocardiografia, por 180 dias. RESULTADOS: Houve redução do volume ventricular esquerdo. Os cães induzidos melhoraram após a operação e a fração de ejeção (FEj retornou aos valores normais para a espécie. O DC e a FE aumentaram após a operação. Um cão foi a óbito. Nos cães não operados, a FE diminuiu e foram a óbito em torno de 40 dias após a indução; nos cães não induzidos, esta não se alterou. Houve extra-sístoles ventriculares, que se resolveram espontaneamente. CONCLUSÕES: A PPLVE sem circulação extracorpórea reduz o volume ventricular esquerdo e melhora a função cardíaca dos cães com cardiomiopatia dilatada induzida pela doxorrubicina, demonstrando baixa morbidade e mortalidade tardia.OBJECTIVE: We tested a new surgical technique, the plication of the left ventricular free wall, to reduce left ventricular area and volume and improve left ventricular systolic function, without using a cardiopulmonary bypass. METHODS: Dilated cardiomyopathy was induced in eight dogs by the injection of doxorubicin. Plication of the left ventricular free wall was performed in four dogs with induced cardiomyopathy and in five control dogs. Two dogs not submitted to surgery. The other two dogs died during the induction phase. Cardiac output, 2-dimensional and M-mode echocardiography, arterial blood pressure and electrocardiography were recorded over a 180 days period. Ambulatory electrocardiography

Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study.

Science.gov (United States)

Abdalla, Marwah; Caughey, Melissa C; Tanner, Rikki M; Booth, John N; Diaz, Keith M; Anstey, D Edmund; Sims, Mario; Ravenell, Joseph; Muntner, Paul; Viera, Anthony J; Shimbo, Daichi

2017-04-05

Abnormal diurnal blood pressure (BP), including nondipping patterns, assessed using ambulatory BP monitoring, have been associated with increased cardiovascular risk among white and Asian adults. We examined the associations of BP dipping patterns (dipping, nondipping, and reverse dipping) with cardiovascular target organ damage (left ventricular mass index and left ventricular hypertrophy), among participants from the Jackson Heart Study, an exclusively black population-based cohort. Analyses included 1015 participants who completed ambulatory BP monitoring and had echocardiography data from the baseline visit. Participants were categorized based on the nighttime to daytime systolic BP ratio into 3 patterns: dipping pattern (≤0.90), nondipping pattern (>0.90 to ≤1.00), and reverse dipping pattern (>1.00). The prevalence of dipping, nondipping, and reverse dipping patterns was 33.6%, 48.2%, and 18.2%, respectively. In a fully adjusted model, which included antihypertensive medication use and clinic and daytime systolic BP, the mean differences in left ventricular mass index between reverse dipping pattern versus dipping pattern was 8.3±2.1 g/m 2 ( P pattern versus dipping pattern was -1.0±1.6 g/m 2 ( P =0.536). Compared with participants with a dipping pattern, the prevalence ratio for having left ventricular hypertrophy was 1.65 (95% CI, 1.05-2.58) and 0.96 (95% CI, 0.63-1.97) for those with a reverse dipping pattern and nondipping pattern, respectively. In this population-based study of blacks, a reverse dipping pattern was associated with increased left ventricular mass index and a higher prevalence of left ventricular hypertrophy. Identification of a reverse dipping pattern on ambulatory BP monitoring may help identify black at increased risk for cardiovascular target organ damage. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Right Ventricular Ejection Fraction using ECG-Gated First Pass Cardioangiography

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Moon, Young Hee; Lee, Hae Giu; Lee, Sung Yong; Park, Suk Min; Chung, Soo Kyo; Yim, Jeong Ik; Bahk, Yong Whee; Shinn, Kyung Sub; Kim, Young Gyun; Kwon, Soon Seog [Catholic University College of Medicine, Seoul (Korea, Republic of)

1993-03-15

Radionuclide cardioangiography has been widely applied and has played major roles in moninvasive assessment of cardiac function. Three techniques, first-pass gated first and gated equilibrium methods have commonly been used to evaluate right ventricular ejection fraction which usually abnormal in the patients with cardiopulmonary disease. It has been known that the gated first pass method is most accurate method among the three techniques in assessment of fight ventricular ejection fraction. The radionuclide right ventricular ejection fraction values were determined in 13 normal subjects and in 15 patients with chronic obstructive pulmonary disease by the gated first pass method and compared with those of the first pass method because there has been no published data of fight ejection fraction by the gated first pass method were compared with the defects from the pulmonary function test performed in the patients with chronic obstructive pulmomary disease. The results were as follows; 1) The values of fight ventricular ejection fraction by the gated first pass method were 50.1 +- 6.1% in normal subjects and 38.5 +- 8.5 in the patients with chronic obstructive pulmonary disease. There was statistically significant difference between the right ventricular ejection fraction of each of the two groups (p<0.05) 2) The right ventricular ejection fraction by the gated first pass method was not linearly correlated ith FEV{sub 1}, VC. DLCO. and FVC as well as P{sub a}O2 and P{sub a}CO2 of the patients with chronic obstructive pulmonary disease. We concluded that right ventricular ejection fraction by the gated first pass method using radionuclide cardioangiography may be useful in clinical assessment of the right ventricular function.

Quantitative measurement of ventricular dilatation on CT scan

International Nuclear Information System (INIS)

Okita, Naoshi; Mochizuki, Hiroshi; Takase, Sadao

1985-01-01

Cerebral atrophy might be judged from the ventricular dilatation with some indices, calculated from various ventricular width. But, there is no general agreement on what index is the most reliable. In this paper, we attempted to establish the index, easy to measure and most reliable. Our method is as follow. 1) We carried out the CT scan (EMI 1010) on 89 neurologically intact patients. Scans were parallel to orbito-meatal line (OML), and were 10 mm in thickness. On CT scan films, various width, area of anterior horns and area of bodies of lateral ventricles were measured. Measurement about the anterior horns of lateral ventricles were carried out on image the most clearly showed the foramen of Monro. And measurements about the bodies of lateral ventricles were on image, 20 mm above the image of anterior horn. Correlations of various width and areas were calculated. Then we proposed new indices with high correlations (over 0.9) with ventricular area; Anterior horn CVI (Cerebro-Ventricular Index) and Body CVI. 2) Patients with myotonic dystrophy show cerebral atrophy. We carried out the CT scan (GECT/T 8800) on 17 myotonic dystrophy patients and 30 controls. Between the two groups, age and sex were almost matched. In the two groups, we calculated our new indices as well as various indices which have been reported; Huckman number, Bifrontal CVI, Bicaudal CVI, Anterior horn index, Hirajima's index, and Cella-media index. The data were analyzed statistically. The ventricular dilatation of myotonic dystrophy patients is more definite with Anterior horn CVI, Bicaudal CVI and Body CVI (p<0.01). These indices have higher correlations with the ventricular area (about 0.9). (J.P.N.)

Assessment of ventricular function by radionuclide ventriculography in hyperthyroidism

International Nuclear Information System (INIS)

Dong Weiyu; He Pinyu; Zhuang Weite

1996-01-01

Left ventricular(LV) and right ventricular(RV) function were determined using radionuclide ventriculography in 50 patients with hyperthyroidism. LVEF, LVPFR, SV of the hyperthyroidism group were decreased in comparison with the normal group (P<0.01), whereas CO of the hyperthyroidism patients were higher than that of normal (P<0.01). Except LVPER, the LVEF, SV had significant difference between two groups. Compared to normal group, RVEF, RVPER, RVPFR were also decreased (P<0.01). Besides 30 cases of the hyperthyroidism were examined by impedance cardiogram (ICG) and impedance pulmonary rheogram (IPR), all showed closely correlation with the parameters determined by ventriculography. There was the involvement of right ventricular function insufficiency, especially in ejection phase. When compared with pre-therapy, pos-therapy cases showed significant improvement in EF, PER, PFR of left and right ventricular

Noninvasive assessment of right ventricular wall motion by radionuclide cardioangiography

International Nuclear Information System (INIS)

Nishimura, Tsunehiko; Uehara, Toshiisa; Naito, Hiroaki; Hayashida, Kohei; Kozuka, Takahiro

1981-01-01

Radionuclide cardioangiography is a useful method to evaluate the left ventricular wall motion in various heart diseases. It has been also attempted to assess the right ventricular wall motion simultaneously by radionuclide method. In this study, using the combination of first-pass (RAO 30 0 ) and multi-gate (LAO 40 0 ) method, the site of right vetricle was classified in five. (1 inflow, 2 sinus, 3 outflow, 4 septal, 5 lateral) and the degree of wall motion was classified in four stages (dyskinesis, akinesis, hypokinesis, normal) according to the AHA committee report. These methods were applied clinically to forty-eight patients with various heart diseases. In the cases with right ventricular pressure or volume overload such as COLD, pulmonary infarction, the right ventricle was dilated and the wall motion was reduced in all portions. Especially, in the cases with right ventricular infarction, the right ventricular wall motion was reduced in the infarcted area. The findings of radionuclide method were in good agreement with those of contrast right ventriculography or echocardiography. In conclusion, radionuclide cardioangiography is a useful and noninvasive method to assess not only the left but also the right ventricular wall motion. (author)

Interdependence of right ventricular systolic function and left ventricular filling and its association with outcome for patients with pulmonary hypertension.

Science.gov (United States)

Motoji, Yoshiki; Tanaka, Hidekazu; Fukuda, Yuko; Sano, Hiroyuki; Ryo, Keiko; Imanishi, Junichi; Miyoshi, Tatsuya; Sawa, Takuma; Mochizuki, Yasuhide; Matsumoto, Kensuke; Emoto, Noriaki; Hirata, Ken-ichi

2015-04-01

Although impaired right ventricular (RV) performance has been associated with adverse outcomes for pulmonary hypertension (PH) patients, the relationship between bi-ventricular interdependence and outcomes is not yet fully understood. We studied 96 PH patients. RV systolic function was assessed by means of RV free-wall longitudinal speckle-tracking strain (RV-free), and left ventricular (LV) filling as early diastolic transmitral flow velocity (TMF-E). RV-free ≤19 % and TMF-E functional class IV and brain natriuretic peptide >150 pg/dl (χ(2) = 1.2) was improved by the addition of RV-free (χ(2) = 5.5, p = 0.04) as well as of TMF-E (χ(2) = 11.5, p = 0.01). In conclusions, RV systolic function was shown to correlate significantly with LV filling in PH patients. In addition, not only assessment of RV systolic function, but also of a combined bi-ventricular parameter comprising RV systolic function and LV filling may well have clinical implications for more successful management of PH patients.

Ventricular rhythm in atrial fibrillation under anaesthetic infusion with propofol

International Nuclear Information System (INIS)

Cervigón, R; Moreno, J; Pérez-Villacastín, J; Reilly, R B; Castells, F

2009-01-01

Changes in patients' autonomic tone and specific pharmacologic interventions may modify the ventricular response (actual heart rate) during atrial fibrillation (AF). Hypnotic agents such as propofol may modify autonomic balance as they promote a sedative state. It has been shown that propofol slightly slows atrial fibrillatory activity, but the net global effect on the ventricular response remains unknown. We aimed to evaluate in patients in AF the effect of a propofol bolus on the ventricular rate and regularity at ECG. We analysed the possible relation with local atrial fibrillatory activities, as ratios between atrial and ventricular rates (AVRs), analysing atrial activity from intracardiac electrograms at the free wall of the right and left atria and at the interatrial septum. We compared data at the baseline and after complete hypnosis. Propofol was associated with a more homogeneous ventricular response and lower AVR values at the interatrial septum

Experiencias de envejecimiento en el México rural Aging experiences in rural Mexico

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Sandra Treviño-Siller

2006-02-01

Full Text Available OBJETIVO: Explorar la experiencia de envejecimiento de hombres y mujeres mayores de 60 años, que viven en contextos rurales de pobreza en los estados de Guerrero y Morelos, México. MATERIAL Y MÉTODOS: Se diseñó un estudio cualitativo basado en entrevistas semiestructuradas. Se trabajó en comunidades con menos de 2 500 habitantes, pobres y de alta marginación. RESULTADOS: La experiencia de envejecimiento es radicalmente diferente según la condición de género; esta vivencia resulta ser más positiva para las mujeres. La soledad es un factor que configura la experiencia diferencial del envejecimiento, así como las redes sociales y el estado de salud-enfermedad. Los principales temores asociados a la vejez fueron la soledad, la enfermedad, la pobreza y la pérdida de independencia. CONCLUSIONES: La identidad de género desempeña un papel fundamental en la configuración de la experiencia diferencial del proceso de envejecimiento, debido a que las oportunidades de desarrollo y las responsabilidades que se derivan de ella, promueven la desigualdad entre los sexos. Es necesario hacer más eficiente la respuesta institucional, de manera que responda a las necesidades específicas de esta población.OBJECTIVE: To explore the aging experience among men and women older than 60 years, living in rural areas from the states of Guerrero and Morelos, Mexico. Materials and Methods. A qualitative study was conducted in poverty-stricken, underserved communities with less than 2 500 inhabitants. Semi-structured interviews were applied to collect data. RESULTS: The aging experience is different according to gender, being more positive for women. Loneliness, together with social networks and the health-illness process, make the difference in the aging experiences. The main fears associated with aging are loneliness, illness, poverty, and loss of independence. CONCLUSIONS: Gender identity plays a central role in different aging experiences because the

M-Learning - una experiencia colaborativa usando el Software Telegram

OpenAIRE

Salas, Marco Antonio; Salas Subía, Juan Carlos

2018-01-01

La presente experiencia de aprendizaje colaborativo presenta los resultados  obtenidos  mediante el uso dispositivos de telefonía móvil (Smartphone) cuyo uso se ha generalizado especialmente en la juventud y en consecuencia debe ser aprovechado dentro del ámbito educativo; junto a estos dispositivos se ha difundido el uso de herramientas de comunicación como el sistema mensajería  Telegram, del  que se ha tomado características que permiten  el fomento del aprendizaje...

Bidirectional ventricular tachycardia of unknown etiology

International Nuclear Information System (INIS)

Ali, M.; Khan, J.A.; Masood, T.; Shamsi, F.; Dero, M.H.; Khan, S.

2013-01-01

A 45 years old male presented to the emergency department with palpitations, headache and apprehension. His electrocardiogram revealed bidirectional ventricular tachycardia. He remained vitally stable and responded to intravenous beta-blocker. Initially digitalis toxicity was suspected but history was negative for digitalis intake. The cause remained unidentified in patient despite detailed investigations. During a short follow-up (of 6 months) he remained asymptomatic and no cause was further identified during this period. Some other unseen causes of bidirectional ventricular tachycardia need to be explored. (author)

An Incidentally Detected Right Ventricular Pseudoaneurysm

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Vamsi C. Gaddipati

2017-01-01

Full Text Available Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture.

Hipertermia maligna no Brasil: análise da atividade do hotline em 2009 Hipertermia maligna en Brasil: análisis de la actividad del hotline en 2009 Malignant hyperthermia in Brazil: analysis of hotline activity in 2009

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Helga Cristina Almeida da Silva

2013-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Hipertermia maligna (HM é doença farmacogenética, com reação hipermetabólica anormal a anestésicos halogenados e/ou relaxantes musculares despolarizantes. Desde 1991 há um serviço hotline de atendimento telefônico para HM no Brasil, disponível 24 horas por dia, em São Paulo. Este artigo analisa a atividade do serviço brasileiro de hotline para HM em 2009. MÉTODOS: Análise prospectiva de todas chamadas telefônicas paria maligna (HM é doença farmacogenética, com reação hipermetabólica anormal a anestésicos halogenados e/ou relaxantes musculares despolarizantes. Desde 1991 há um serviço hotline de atendimento telefônico para HM no Brasil, disponível 24 horas por dia, em São Paulo. Este art go analisa a at vidade do serviço brasileiro de hotline para HM em 2009a o serviço brasileiro de hotline para HM, de janeiro a dezembro de 2009. RESULTADOS: Foram recebidas 22 ligações; 21 provenientes do Sul-Sudeste do Brasil e uma do Norte. Quinze eram pedidos de informações gerais sobre HM. Sete foram suspeitas de crises agudas de HM, das quais duas não foram consideradas como HM. Nas cinco crises compatíveis com HM, todos os pacientes receberam anestésicos inalatórios halogenados (2 isoflurano, 3 sevoflurano e um usou também succinilcolina; havia quatro homens e uma mulher, com média de idade de 18 anos (2-27. Problemas descritos nas cinco crises de HM: taquicardia (cinco, aumento do gás carbônico expirado (quatro, hipertermia (três, acidemia (um, rabdomiólise (um e mioglobinúria (um. Um paciente recebeu dantrolene. Todos os cinco pacientes com crises de HM foram seguidos em unidade de terapia intensiva e recuperaram-se sem sequelas. A suscetibilidade à HM foi posteriormente confirmada em dois pacientes por meio do teste de contratura muscular in vitro. CONCLUSÕES: O número de chamadas por ano no serviço brasileiro de hotline para HM ainda é reduzido. As características das crises

What is the clinical significance of ventricular mural antagonism?

DEFF Research Database (Denmark)

Lunkenheimer, Paul P; Niederer, Peter; Stephenson, Robert S

2018-01-01

alignment, thus deviating from the prevailing tangential orientation. Upon contraction, they produce, in addition to a tangential force, a radial force component that counteracts ventricular constriction and aids widening of the ventricular cavity. In experimental studies, we have provided evidence...... for the existence of such forces, which are auxotonic in nature. This is in contrast to the tangentially aligned myocytes that produce constrictive forces, which are unloading in nature. The ventricular myocardium is, therefore, able to function in an antagonistic fashion, with the prevailing constrictive forces...

A consideration of a measuring point of ventricular dilatation on CT scanning

International Nuclear Information System (INIS)

Kuno, Koichi; Miyake, Kazuo

1980-01-01

Ventricular dilatation has been judged by pneumo-ventricurography, pneumo-encepharography and carotid angiography (CAG), though all these procedures are very uncomfortable for patients. On the other hand, the CT scan is very easy as a follow-up study of ventricular dilatation for a weak patient. We carried out the CT scan (Hitachi CT-H 250 Scanner, NaI detector) and CAG on 84 cases. The ventricular dilatation was judged by the degree of outstretch of the strio-thalamic vein on an AP view of the phrebogram, classified into 3 types. For all three types classified by the phrebogram, we studied various measuring points of the ventricle on the CT scan. The portions measured on the CT scan were: (1) the frontal cerebro-ventricular index (F-CVI), (2) the bicaudate cerebro-ventricular index (Bicaud-CVI), and (3) the maximum Monro's cerebro-ventricular index (M-CVI), the width of the frontal horn, and the thickness of the ventricular body. The following results were obtained: (1) In measuring the ventricular size on the CT scan, the most interrelated point with the ventricular dilatation is the M-CVI - the ratio of the largest width of the body through the Monro foramen to the width of the brain. In this case, however, the width of the frontal horn and of the body should also be considered. (2) Voltage and electric current changed the EMI-number, but did not alter the measuring value. In this case, the width and the level should be kept constant. (3) The group with the marked ventricular dilatation has a larger value of the CT scan than its value of GAG. (4) The normal value of the M-CVI is 24 +- 3%, moreover, the width of the frontal horn is less than 10 mm, and the thickness of the ventricular body is less than 17 mm. (author)

Effect of Hemodialysis on Left and Right Ventricular Volume and Function

International Nuclear Information System (INIS)

Han, Jin Suk; Koh, Chang Soon

1985-01-01

With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

Effect of Hemodialysis on Left and Right Ventricular Volume and Function

Energy Technology Data Exchange (ETDEWEB)

Han, Jin Suk; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1985-09-15

With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

Left ventricular pressure and volume data acquisition and analysis using LabVIEW.

Science.gov (United States)

Cassidy, S C; Teitel, D F

1997-03-01

To automate analysis of left ventricular pressure-volume data, we used LabVIEW to create applications that digitize and display data recorded from conductance and manometric catheters. Applications separate data into cardiac cycles, calculate parallel conductance, and calculate indices of left ventricular function, including end-systolic elastance, preload-recruitable stroke work, stroke volume, ejection fraction, stroke work, maximum and minimum derivative of ventricular pressure, heart rate, indices of relaxation, peak filling rate, and ventricular chamber stiffness. Pressure-volume loops can be graphically displayed. These analyses are exported to a text-file. These applications have simplified and automated the process of evaluating ventricular function.

Independence of intrapericardial right and left ventricular performance in septic pulmonary hypertension

International Nuclear Information System (INIS)

Boeck, J.C.; Eichstaedt, H.; Barker, B.C.; Lewis, F.R.; Lim, A.D.; Pollycove, M.

1990-01-01

To study the effect of septic pulmonary hypertension on right/left ventricular intrapericardial interactions thirteen trauma patients, seven septic and six nonseptic controls, were compared. Ventricular volumes were derived from firstpass or gated equilibrium radionuclide angiocardiography, and related to body surface area. Systemic and pulmonary pressures were measured invasively. Pulmonary arterial pressure was significantly increased in the sepsis group. Although right ventricular end-diastolic volumes were higher in sepsis, left ventricular end-diastolic volumes were not decreased. In terms of intrapericardial right/left ventricular interactions these results indicate that the right and left ventricles operate independently in septic pulmonary hypertension. (orig.) [de

Ventricular dyssynchrony as a cause of structural disease in the heart of Dorper sheep

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J. Ker

2004-11-01

Full Text Available Ventricular dyssynchrony is a disturbance of the normal, organized electromechanical coupling of the two ventricles. This condition has many causes, such as left bundle branch block, ventricular preexcitation, right ventricular pacing and right ventricular premature ventricular complexes (PVCs. Ventricular dyssynchrony has many adverse haemodynamic effects on the left ventricle and we wanted to know whether these adverse haemodynamic effects might have any structural consequences on the left ventricles of such hearts. Six healthy Dorper wethers were subjected to numerous right ventricular PVCs to induce ventricular dyssynchrony in order to determine whether any structural consequences will occur in the left ventricles of these hearts. Myocarditis in the musculature of the left ventricles of all six these hearts was seen.

Experiencias y vivencias en la Ingeniería Clínica

OpenAIRE

Saldarriaga, O. D. (Óscar Darío)

2008-01-01

Comparto con ustedes las experiencias y vivencias en el desarrollo y evolución en la ingeniería en los hospitales y clínicas, en especial la Ingeniería Clínica (IC). Antes, una breve explicación del desarrollo del Departamento de Ingeniería y Mantenimiento en el Hospital Pablo Tobón Uribe (El Hospital).

Observación Electoral: Experiencia de la MOE Regional Valle del Cauca, Elecciones Nacionales de Colombia 2010

OpenAIRE

Escobar Higuera, Katherine

2013-01-01

En el presente artículo se reseña la experiencia de Observación electoral en el departamento del Valle del Cauca, por parte de la Misión de Observación Electoral MOE regional Valle. Con el propósito de visibilizar el trabajo de una red de organizaciones y personas que han tomado iniciativa en el mejoramiento de un proceso importante para el sistema democrático colombiano, las elecciones. Al reseñar esta experiencia, se espera sea referente de una acción de participación política desde las org...

Experiencias formativas, auto-adscripciones y conflictos ambientales en el sudoeste de Misiones (Argentina

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Ana Padawer

2015-04-01

Full Text Available En este artículo abordaremos cómo se relacionan las experiencias formativas vinculadas al trabajo rural, las identificaciones y los conflictos ambientales en San Ignacio, Misiones (Argentina. Nos interesa problematizar cómo los aprendizajes ligados a las tareas rurales se vinculan con las auto-adscripciones de los sujetos, teniendo como referencia las categorías de actores sociales agrarios regionales y las denominaciones que provienen de agendas estatales de intervención. Estos procesos acontecen en un contexto de creciente concentración de propiedades que se destinan a la explotación forestal, donde observamos, en algunos casos, cierta ambientalización de los históricos conflictos territoriales.Utilizando materiales provenientes de un trabajo de campo etnográfico que iniciamos en 2008, presentaremos a dos familias de pobladores rurales. En ambos casos es posible ver cómo el acceso a la tierra es decisivo para las experiencias formativas en las actividades de reproducción social, y que se liga con identificaciones como “gente de la colonia” y una incipiente referencia a la “agricultura familiar” a partir de las intervenciones del Estado. Estas dos familias permiten mostrar cómo las experiencias e identificaciones se expresan en el contexto de la participación de los sujetos en conflictos sociales, que asumen en un caso la forma histórica de reclamos fundiarios mientras que, en el otro, es posible ver que el ambiente tiene protagonismo incipiente.

Sobre la desnaturalización de la experiencia escolar: aportes decoloniales y feministas

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Ana de Anquín

2015-04-01

Full Text Available La huella formativa de la experiencia escolar es indeleble, aunque la memoria parezca olvidarla se hace cuerpo y atraviesa contextos y situaciones hasta re-encontrarnos comodocentes. En parte forjados como tales, nuestro material de trabajo son los conocimientos,más o menos delimitados en currículos, programas o planes de estudios en cada país. Perotanto el conocimiento como la escuela y el estado nacional se inscriben en estructuras más amplias de relaciones coloniales entre centros y periferias. Los estudios decoloniales investigan la pervivencia de categorías coloniales modernas que subordinan pensamientos yprácticas a la lógica del conquistador: hombre, blanco, heterosexual, burgués. La lógica dicotómica del iluminismo moderno, que propagó la dominación capitalista, opera como violencia simbólica que divide y jerarquiza la experiencia escolar y la vida. Por lo contrario, desde una lógica interseccional se articulan distintas dimensiones como raza, clase, sexualidad y género, en un acto de pensamiento capaz de desnaturalizar clasificaciones homogéneas y extrañas. Así, el constructo ficcional “raza” tiene vigencia en una forma heredada de pensarnos a nosotros mismos, minusvalorados desde el patrón europeo (Quijano,2000. Tratamos de abrir paso a una transversalidad alternativa, considerando que las prácticas educativas son producciones históricas y la pedagogía no es un resultado a alcanzar sino posibilidad de experiencias.

Measurement of the ventricular system with computed tomography of the brain

International Nuclear Information System (INIS)

Takayama, Makoto

1979-01-01

In order to establish the diagnostic criteria of a normal ventricular system from the data provided by CT images, including those showing physiological ventricular delatation with age, we have measured, using the ACTA 0100 scanner, the ventricular systems of 348 cases on CT images which were diagnosed as ''nornal'' by several radiologists. We measured the following four widths of the ventricular system: A) width to tips of the frontal horns of the lateral ventricles. B) width at midpoint of the frontal horns of the lateral ventricles, C) width of the third ventricle, and D) width of the body of the lateral ventricles. Measurements were made directly on Polaroid prints, and then the mean and the standard deviation were calculated in each age group. These measurements suggest the following ranges of normal ventricular parameters: A) 38.3 mm or less, B) 20.2 mm or less, C) 6.6 mm or less, and D) 47.0 mm or less. The measurements of the ventricular system showed a steady increase with age. The ventricular systems of 193 cases diagnosed to have no intracranial mass lesion were also measured in different age and symptom groups. Measurements of various parts of the ventricular system on the 193 cases also indicated and increase with age; however, they showed no significant difference in any symptom groups: the convulsion group, the cerebrovascular attack group, the indefinite complaint group (including headaches), the dementia group, the degenerative disease group, or any other. (author)

Impact of aortic prosthesis-patient mismatch on left ventricular mass regression.

Science.gov (United States)

Alassal, Mohamed A; Ibrahim, Bedir M; Elsadeck, Nabil

2014-06-01

Prostheses used for aortic valve replacement may be small in relation to body size, causing prosthesis-patient mismatch and delaying left ventricular mass regression. This study examined the effect of prosthesis-patient mismatch on regression of left ventricular mass after aortic valve replacement. We prospectively studied 96 patients undergoing aortic valve replacement between 2007 and 2012. Mean and peak gradients and indexed effective orifice area were measured by transthoracic echocardiography at 3 and 6 months postoperatively. Patient-prosthesis mismatch was defined as indexed effective orifice area ≤0.85 cm(2)·m(-2). Moderate prosthesis-patient mismatch was present in 25% of patients. There were no significant differences in demographic and operative data between patients with and without prosthesis-patient mismatch. Left ventricular dimensions, posterior wall thickness, transvalvular gradients, and left ventricular mass decreased significantly after aortic valve replacement in both groups. The interventricular septal diameter and left ventricular mass index regression, and left ventricular ejection fraction were better in patients without prosthesis-patient mismatch. There was a significant positive correlation between the postoperative indexed effective orifice area of each valve prosthesis and the rate of left ventricular mass regression. Prosthesis-patient mismatch leads to higher transprosthetic gradients and impaired left ventricular mass regression. A small-sized valve prosthesis does not necessarily result in prosthesis-patient mismatch, and may be perfectly adequate in patient with small body size. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Ventricular arrhythmias in the absence of structural heart disease.

Science.gov (United States)

Prystowsky, Eric N; Padanilam, Benzy J; Joshi, Sandeep; Fogel, Richard I

2012-05-15

Ventricular arrhythmia (VA) in structurally normal hearts can be broadly considered under non-life-threatening monomorphic and life-threatening polymorphic rhythms. Monomorphic VA is classified on the basis of site of origin in the heart, and the most common areas are the ventricular outflow tracts and left ventricular fascicles. The morphology of the QRS complexes on electrocardiogram is an excellent tool to identify the site of origin of the rhythm. Although these arrhythmias are common and generally carry an excellent prognosis, rare sudden death events have been reported. Very frequent ventricular ectopy may also result in a cardiomyopathy in a minority of patients. Suppression of VA may be achieved using calcium-channel blockers, beta-adrenergic blockers, and class I or III antiarrhythmic drugs. Radiofrequency ablation has emerged as an excellent option to eliminate these arrhythmias, although certain foci including aortic cusps and epicardium may be technically challenging. Polymorphic ventricular tachycardia (VT) is rare and generally occurs in patients with genetic ion channel disorders including long QT syndrome, Brugada syndrome, catecholaminergic polymorphic VT, and short QT syndrome. Unlike monomorphic VT, these arrhythmic syndromes are associated with sudden death. While the cardiac gross morphology is normal, suggesting a structurally normal heart, abnormalities exist at the molecular level and predispose them to arrhythmias. Another fascinating area, idiopathic ventricular fibrillation and early repolarization syndrome, are undergoing research for a genetic basis. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Left cardiac sympathetic denervation for catecholaminergic polymorphic ventricular tachycardia

NARCIS (Netherlands)

Wilde, Arthur A. M.; Bhuiyan, Zahurul A.; Crotti, Lia; Facchini, Mario; de Ferrari, Gaetano M.; Paul, Thomas; Ferrandi, Chiara; Koolbergen, Dave R.; Odero, Attilio; Schwartz, Peter J.

2008-01-01

Catecholaminergic polymorphic ventricular tachycardia is a potentially lethal disease characterized by adrenergically mediated ventricular arrhythmias manifested especially in children and teenagers. Beta-blockers are the cornerstone of therapy, but some patients do not have a complete response to

Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment

International Nuclear Information System (INIS)

Tal, A.; Leiberman, A.; Margulis, G.; Sofer, S.

1988-01-01

Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present

Nuclear medical diagnostic with ventricular aneurysm

International Nuclear Information System (INIS)

Litter, H.

1987-01-01

In the diagnostic of ventricular aneurysms myocardial scintigraphy and above all radionuclide ventriculography (RNV) have special importance. Because of the non-invasive method and the as a result safe and easy use even with stress studies, RNV can provide a very valuable aid with aneurysm patients in early diagnosis, evaluation of the operability and as well as in the prognosis. It must be noted, however, that the differentiation of multivascular diseases and sometimes ventricular aneurysms can be difficult and the inclusion of an angiocardiograph as a radiological invasive examination procedure seems fitting. (orig./MG) [de

Left ventricular function in chronic aortic regurgitation

International Nuclear Information System (INIS)

Iskandrian, A.S.; Hakki, A.H.; Manno, B.; Amenta, A.; Kane, S.A.

1983-01-01

Left ventricular performance was determined in 42 patients with moderate or severe aortic regurgitation during upright exercise by measuring left ventricular ejection fraction and volume with radionuclide ventriculography. Classification of the patients according to exercise tolerance showed that patients with normal exercise tolerance (greater than or equal to 7.0 minutes) had a significantly higher ejection fraction at rest (probability [p] . 0.02) and during exercise (p . 0.0002), higher cardiac index at exercise (p . 0.0008) and lower exercise end-systolic volume (p . 0.01) than did patients with limited exercise tolerance. Similar significant differences were noted in younger patients compared with older patients in ejection fraction at rest and exercise (both p . 0.001) and cardiac index at rest (p . 0.03) and exercise (p . 0.0005). The end-diastolic volume decreased during exercise in 60% of the patients. The patients with a decrease in volume were significantly younger and had better exercise tolerance and a larger end-diastolic volume at rest than did patients who showed an increase in volume. The mean corrected left ventricular end-diastolic radius/wall thickness ratio was significantly greater in patients with abnormal than in those with normal exercise reserve (mean +/- standard deviation 476 +/- 146 versus 377 +/- 92 mm Hg, p less than 0.05). Thus, in patients with chronic aortic regurgitation: 1) left ventricular systolic function during exercise was related to age, exercise tolerance and corrected left ventricular end-diastolic radius/wall thickness ratio, and 2) the end-diastolic volume decreased during exercise, especially in younger patients and patients with normal exercise tolerance or a large volume at rest

MADE-mlearn: un marco para el análisis, diseño y evaluación de experiencias de m-learning en el nivel de postgrado

Directory of Open Access Journals (Sweden)

Herrera, Susana Isabel

2013-06-01

Full Text Available En este artículo se propone un marco que permita analizar, diseñar y evaluar experiencias d m-learning en el postgrado. El mismo se denomina Marco para el Análisis, Diseño y Evaluación de Experiencias de m-learning (MADE-mlearn. A partir de antecedentes propios y de una revisión bibliográfica para indagar sobre la temática, se presenta una propuesta con sustento teórico que permite identificar y caracterizar las experiencias o proyectos de m-learning a partir de la utilización de una serie de características agrupadas en categorías, las cuales responden a ejes de análisis. Metodológicamente, se trata de un marco sustentado por el estudio de trabajos previos en el plano nacional e internacional sobre experiencias y fundamentos vinculados al m-learning. Se presenta un estado de avance de MADE-mlearn, sus principales características y fundamentos que permiten orientar el diseño de nuevas experiencias de m-learning en el postgrado. Finalmente se describe el proceso mediante el cual se validará el marco y los trabajos futuros inmediatos que permitirán la evaluación de experiencias de m-learning y recomendaciones para el diseño de aplicaciones.

Towards Early Detection and Risk Stratification of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

NARCIS (Netherlands)

Riele, A.S.J.M. te

2016-01-01

Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an inherited cardiomyopathy characterized by frequent ventricular arrhythmias and usually slowly progressive ventricular dysfunction. Since its initial description in 1982, sudden cardiac death (SCD) occurring in young and usually

Experiencias ecológicas del Colegio de la Inmaculada-Jesuitas

OpenAIRE

Carbajal Alva, Max Alberto

2012-01-01

This article presents a brief systematization about a pioneer experience of Colegio de la Inmaculada-Jesuitas, a private catholic school located in Lima (Peru) in relation to its environmental projects developed as part of its institutional policy since several decades ago. This experience has deserved public acknowledgement by other Peruvian institutions. El presente artículo plantea una breve sistematización de la experiencia pionera del Colegio de la Inmaculada-Jesuitas, escuela privada...

Experiencias exitosas de e- learning en la universidad gallega

OpenAIRE

Gromaz Campos, Manuel; Rodríguez Malmierca, María José; García Tobío, Javier

2008-01-01

Este artículo resume la información obtenida en el marco de un proyecto de investigación, denominado "Observatorio gallego de e-learning". Dicha investigación fue dirigida por el Centro de Supercomputación de Galicia, con la participación activa de las tres universidades gallegas. Su principal objetivo fue realizar un análisis en profundidad sobre el estado del e-learning tanto en la universidad como en la empresa gallegas. Entre los elementos analizados, se encuentran algunas experiencias qu...

Skin Sodium Concentration Correlates with Left Ventricular Hypertrophy in CKD.

Science.gov (United States)

Schneider, Markus P; Raff, Ulrike; Kopp, Christoph; Scheppach, Johannes B; Toncar, Sebastian; Wanner, Christoph; Schlieper, Georg; Saritas, Turgay; Floege, Jürgen; Schmid, Matthias; Birukov, Anna; Dahlmann, Anke; Linz, Peter; Janka, Rolf; Uder, Michael; Schmieder, Roland E; Titze, Jens M; Eckardt, Kai-Uwe

2017-06-01

The pathogenesis of left ventricular hypertrophy in patients with CKD is incompletely understood. Sodium intake, which is usually assessed by measuring urinary sodium excretion, has been inconsistently linked with left ventricular hypertrophy. However, tissues such as skin and muscle may store sodium. Using 23 sodium-magnetic resonance imaging, a technique recently developed for the assessment of tissue sodium content in humans, we determined skin sodium content at the level of the calf in 99 patients with mild to moderate CKD (42 women; median [range] age, 65 [23-78] years). We also assessed total body overhydration (bioimpedance spectroscopy), 24-hour BP, and left ventricular mass (cardiac magnetic resonance imaging). Skin sodium content, but not total body overhydration, correlated with systolic BP ( r =0.33, P =0.002). Moreover, skin sodium content correlated more strongly than total body overhydration did with left ventricular mass ( r =0.56, P skin sodium content is a strong explanatory variable for left ventricular mass, unaffected by BP and total body overhydration. In conclusion, we found skin sodium content to be closely linked to left ventricular mass in patients with CKD. Interventions that reduce skin sodium content might improve cardiovascular outcomes in these patients. Copyright © 2017 by the American Society of Nephrology.

EXPERIENCIAS PSICOSEXUALES DE PACIENTES HISTERECTOMIZADAS DEL SERVICIO DE GINECOLOGÍA DEL HOSPITAL REGIONAL DOCENTE LAS MERCEDES – CHICLAYO 2013

OpenAIRE

Núñez Manayay, Tania Mercedes; Universidad Señor de Sipán; Vera Ñañez, Huendy Jame; Universidad Señor de Sipán

2014-01-01

 La presente investigación cualitativa titulada Experiencias psicosexuales de pacientes histerectomizadas del servicio de Ginecología del Hospital Regional Docente las Mercedes – Chiclayo 2013 tuvo como objetivo describir las experiencias psicosexuales de pacientes histerectomizadas. Con diseño estudio de caso; la muestra conformada por siete pacientes post histerectomizadas de seis meses a un año; en la recolección de datos se utilizó la observación y la entrevista semiestructurada, las que ...

Left ventricular diastolic dysfunction in chronic renal failure patients on chronic hemodialysis in Dr. Cipto-Mangunkusumo Hospital : the association with left ventricular mass

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Idrus Alwi

2006-06-01

Full Text Available Fourty three patients with chronic renal failure undergoing chronic hemodialysis in Division of Nephrology and Hypertension, Faculty of Medicine, University of Indonesia/Cipto-Mangunkusumo Hospital, Jakarta, since October 2003 until February 2004, were examined for echocardiography (2-D, M-mode, Doppler imaging.Diastolic dysfunction was found in 58.1 % of chronic renal failure patients on hemodialysis. There was no significant difference between left ventricular mass in the group with or without left ventricular diastolic dysfunction. (Med J Indones 2006; 15:105-8Keywords: Left ventricular mass, diastolic function, chronic renal failure, hemodyalisis

310. Experiencia inicial con el uso del sistema zipfix de osteosíntesis esternal

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E. Monguió

2012-04-01

Conclusiones: En esta experiencia inicial, no se detectaron problemas de eficacia o seguridad del cierre esternal mediante el sistema ZipFix. Los resultados fueron comparables al cierre convencional con alambres de acero. Es necesario un subsiguiente estudio comparativo.

Postexertional Supraventricular Tachycardia in Children with Catecholaminergic Polymorphic Ventricular Tachycardia

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Scott D. N. Else

2012-01-01

Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a severe arrhythmia associated with sudden death in the young. It is caused by defective calcium handling in ventricular myocytes. The association of supraventricular tachycardia (SVT with CPVT is described in the literature, occurring in the lead-up to ventricular tachycardia during exercise testing. We describe three cases of SVT that were initiated in the recovery period of exercise testing in children with CPVT.

Late deterioration of left ventricular function after right ventricular pacemaker implantation.

Science.gov (United States)

Bellmann, Barbara; Muntean, Bogdan G; Lin, Tina; Gemein, Christopher; Schmitz, Kathrin; Schauerte, Patrick

2016-09-01

Right ventricular (RV) pacing induces a left bundle branch block pattern on ECG and may promote heart failure. Patients with dual chamber pacemakers (DCPs) who present with progressive reduction in left ventricular ejection fraction (LVEF) secondary to RV pacing are candidates for cardiac resynchronization therapy (CRT). This study analyzes whether upgrading DCP to CRT with the additional implantation of a left ventricular (LV) lead improves LV function in patients with reduced LVEF following DCP implantation. Twenty-two patients (13 males) implanted with DCPs and a high RV pacing percentage (>90%) were evaluated in term of new-onset heart failure symptoms. The patients were enrolled in this retrospective single-center study after obvious causes for a reduced LVEF were excluded with echocardiography and coronary angiography. In all patients, DCPs were then upgraded to biventricular devices. LVEF was analyzed with a two-sided t-test. QRS duration and brain natriuretic peptide (BNP) levels were analyzed with the unpaired t-test. LVEF declined after DCP implantation from 54±10% to 31±7%, and the mean QRS duration was 161±20 ms during RV pacing. NT-pro BNP levels were elevated (3365±11436 pmol/L). After upgrading to a biventricular device, a biventricular pacing percentage of 98.1±2% was achieved. QRS duration decreased to 108±16 ms and 106±20 ms after 1 and 6 months, respectively. There was a significant increase in LVEF to 38±8% and 41±11% and a decrease in NT-pro BNP levels to 3088±2326 pmol/L and 1860±1838 pmol/L at 1 and 6 months, respectively. Upgrading to CRT may be beneficial in patients with DCPs and heart failure induced by a high RV pacing percentage.

Flow-related Right Ventricular - Pulmonary Arterial Pressure Gradients during Exercise.

Science.gov (United States)

Wright, Stephen P; Opotowsky, Alexander R; Buchan, Tayler A; Esfandiari, Sam; Granton, John T; Goodman, Jack M; Mak, Susanna

2018-06-06

The assumption of equivalence between right ventricular and pulmonary arterial systolic pressure is fundamental to several assessments of right ventricular or pulmonary vascular hemodynamic function. Our aims were to 1) determine whether systolic pressure gradients develop across the right ventricular outflow tract in healthy adults during exercise, 2) examine the potential correlates of such gradients, and 3) consider the effect of such gradients on calculated indices of right ventricular function. Healthy untrained and endurance-trained adult volunteers were studied using right-heart catheterization at rest and during submaximal cycle ergometry. Right ventricular and pulmonary artery pressures were simultaneously transduced, and cardiac output was determined by thermodilution. Systolic pressures, peak and mean gradients, and indices of chamber, vascular, and valve function were analyzed offline. Summary data are reported as mean ± standard deviation or median [interquartile range]. No significant right ventricular outflow tract gradients were observed at rest (mean gradient = 4 [3-5] mmHg), and calculated effective orifice area was 3.6±1.0 cm2. Right ventricular systolic pressure increases during exercise were greater than that of pulmonary artery systolic pressure. Accordingly, mean gradients developed during light exercise (8 [7-9] mmHg) and increased during moderate exercise (12 [9-14] mmHg, p < 0.001). The magnitude of the mean gradient was linearly related to cardiac output (r2 = 0.70, p < 0.001). In healthy adults without pulmonic stenosis, systolic pressure gradients develop during exercise, and the magnitude is related to blood flow rate.

Inmigrantes colombianos en España. Experiencia parental e inmigración

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Amparo Micolta León

2007-01-01

Full Text Available La parentalidad es una posición dentro de la estructura social, definida por un conjunto de expectativas y tareas socialmente construidas. Son tareas del padre y de la madre atender a los requerimientos tanto afectivos como biológicos de la crianza, el cuidado y la educación de los hijos e hijas. Cuando el padre o la madre –o ambos– emigran hacia otro país pueden dejar a sus hijos e hijas en el país de origen bajo la atención de otros adultos, o llevarlos al lugar de destino. En el presente artículo se analizan las experiencias de colombianos y colombianas que eligieron la segunda opción. En un proceso migratorio internacional se viven nuevas experiencias que pueden llevar a momentos críticos en el desempeño de los roles parentales; porque emigrar hacia el exterior implica, entre otras significaciones, establecerse en un territorio desconocido, y realizar y anticipar funciones novedosas. Padres y madres construyen sueños y esperanzas asociados a la búsqueda de un futuro mejor para sí mismos, para sus hijos e hijas y para su grupo familiar. En el nuevo lugar de residencia, hombres y mujeres, ante la ausencia de redes de apoyo familiar, generan alternativas para asumir la responsabilidad total de sus niñas y niños. En este escrito se analiza lo narrado por los y las informantes, pretendiendo dar respuesta a los siguientes interrogantes: ¿Cuáles fueron las razones que motivaron a los padres y a las madres a llevar a sus hijos a España? ¿Cuáles son sus experiencias frente al desempeño como padres o como madres? ¿Qué expectativas tienen para el futuro de sus hijos e hijas?

Inmigrantes colombianos en España. Experiencia parental e inmigración

Directory of Open Access Journals (Sweden)

Amparo Micolta León

2007-05-01

Full Text Available La parentalidad es una posición dentro de la estructura social, definida por un conjunto de expectativas y tareas socialmente construidas. Son tareas del padre y de la madre atender a los requerimientos tanto afectivos como biológicos de la crianza, el cuidado y la educación de los hijos e hijas. Cuando el padre o la madre –o ambos– emigran hacia otro país pueden dejar a sus hijos e hijas en el país de origen bajo la atención de otros adultos, o llevarlos al lugar de destino. En el presente artículo se analizan las experiencias de colombianos y colombianas que eligieron la segunda opción.En un proceso migratorio internacional se viven nuevas experiencias que pueden llevar a momentos críticos en el desempeño de los roles parentales; porque emigrar hacia el exterior implica, entre otras significaciones, establecerse en un territorio desconocido, y realizar y anticipar funciones novedosas. Padres y madres construyen sueños y esperanzas asociados a la búsqueda de un futuro mejor para sí mismos, para sus hijos e hijas y para su grupo familiar. En el nuevo lugar de residencia, hombres y mujeres, ante la ausencia de redes de apoyo familiar, generan alternativas para asumir la responsabilidad total de sus niñas y niños. En este escrito se analiza lo narrado por los y las informantes, pretendiendo dar respuesta a los siguientes interrogantes: ¿Cuáles fueron las razones que motivaron a los padres y a las madres a llevar a sus hijos a España? ¿Cuáles son sus experiencias frente al desempeño como padres o como madres? ¿Qué expectativas tienen para el futuro de sus hijos e hijas?

Instrumentos para la evaluación de experiencias Flipped Learning en el aula de primaria

OpenAIRE

Núñez Marín, Anunciación

2015-01-01

Instrumentos de evaluación de experiencia de trabajo en el aula con la metodología Flipped Classroom. Se incluyen tres instrumentos: registro de observación, cuestionario familias, cuestionario alumnos.

La experiencia de alfabetización de personas adultas como proceso de aprendizaje en la formación docente

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Luz Emilia Flores-Davis

2010-10-01

Full Text Available Recibido 01 de febrero de 2010 • Aceptado 17 de marzo de 2010 • Corregido 30 de abril de 2010   El aprendizaje se construye en la significación, por lo que promover experiencias que generen sentido y gozo, constituye un reto en la formación docente. En este artículo se comparten las reflexiones emanadas de una investigación que recaba la experiencia de alfabetización de personas adultas que realizan estudiantes universitarias o universitarios en el marco de su formación, la cual crea un proceso de aprendizaje que propicia el respeto a la diversidad y la valoración de la lectura y escritura como liberación del ser humano. El trabajo evidencia los aprendizajes construidos, las formas de respeto a la diversidad que emergen de la experiencia de alfabetización, y el valor que el estudiantado otorga a la lectura y escritura como expresión liberadora.

Ventricular distension and diastolic coronary blood flow in the anaesthetized dog.

Science.gov (United States)

Gattullo, D; Linden, R J; Losano, G; Pagliaro, P; Westerhof, N

1993-01-01

There appears to be no agreement as to whether or not an increase in diastolic left ventricular pressure and/or volume can cause a decrease in diastolic coronary blood flow. We investigated the problem in the anaesthetized dog using a flaccid freely distensible latex balloon inserted into the left ventricle with the animal on extracorporeal circulation and the coronary perfusion pressure constant at about 45 mm Hg. Maximal vasodilatation and suppression of autoregulation in coronary vasculature was obtained by the intracoronary infusion of dipyridamole (10-40 mg/h). Ventricular volume was changed in steps of 10 ml from 10 to 70 ml and back to 10 ml, whilst recording coronary blood flow and left ventricular pressure in the left circumflex coronary artery. Over a range of ventricular volumes from 20 to 50 ml and a concomitant rise in diastolic ventricular pressure to about 20 mm Hg there was no change in the diastolic coronary flow. Only when the ventricular volume was more than two times the control value (i.e. exceeded 50 ml) and left ventricular pressure was more than 20 mm Hg, was there a decrease in coronary flow. During the return of the volume to the control level there was a fall in diastolic flow and ventricular contractility with respect to the values obtained when the volume was increased; these two effects were transient lasting less than 10 min. It was not considered that any of the three models of the coronary circulation, waterfall, intramyocardial pump or varying elastance model could explain our results.(ABSTRACT TRUNCATED AT 250 WORDS)

Impact of Major Pulmonary Resections on Right Ventricular Function: Early Postoperative Changes.

Science.gov (United States)

Elrakhawy, Hany M; Alassal, Mohamed A; Shaalan, Ayman M; Awad, Ahmed A; Sayed, Sameh; Saffan, Mohammad M

2018-01-15

Right ventricular (RV) dysfunction after pulmonary resection in the early postoperative period is documented by reduced RV ejection fraction and increased RV end-diastolic volume index. Supraventricular arrhythmia, particularly atrial fibrillation, is common after pulmonary resection. RV assessment can be done by non-invasive methods and/or invasive approaches such as right cardiac catheterization. Incorporation of a rapid response thermistor to pulmonary artery catheter permits continuous measurements of cardiac output, right ventricular ejection fraction, and right ventricular end-diastolic volume. It can also be used for right atrial and right ventricular pacing, and for measuring right-sided pressures, including pulmonary capillary wedge pressure. This study included 178 patients who underwent major pulmonary resections, 36 who underwent pneumonectomy assigned as group (I) and 142 who underwent lobectomy assigned as group (II). The study was conducted at the cardiothoracic surgery department of Benha University hospital in Egypt; patients enrolled were operated on from February 2012 to February 2016. A rapid response thermistor pulmonary artery catheter was inserted via the right internal jugular vein. Preoperatively the following was recorded: central venous pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac output, right ventricular ejection fraction and volumes. The same parameters were collected in fixed time intervals after 3 hours, 6 hours, 12 hours, 24 hours, and 48 hours postoperatively. For group (I): There were no statistically significant changes between the preoperative and postoperative records in the central venous pressure and mean arterial pressure; there were no statistically significant changes in the preoperative and 12, 24, and 48 hour postoperative records for cardiac index; 3 and 6 hours postoperative showed significant changes. There were statistically significant changes between the preoperative and

Obesity and exercise-induced ectopic ventricular arrhythmias in apparently healthy middle aged adults.

Science.gov (United States)

Sabbag, Avi; Sidi, Yechezkel; Kivity, Shaye; Beinart, Roy; Glikson, Michael; Segev, Shlomo; Goldenberg, Ilan; Maor, Elad

2016-03-01

Obesity and overweight are strongly associated with cardiovascular morbidity and mortality. However, there are limited data on the association between excess weight and the risk of ectopic ventricular activity. We investigated the association between body mass index (BMI) and the risk for ectopic ventricular activity (defined as multiple ventricular premature beats (≥3), ventricular bigeminy, nonsustained ventricular tachycardia or sustained ventricular tachycardia) during exercise stress testing among 22,516 apparently healthy men and women who attended periodic health screening examinations between the years 2000 and 2014. All subjects had completed maximal exercise stress testing annually according to the Bruce protocol. Subjects were divided at baseline into three groups: normal weight (BMI ≥ 18.5 kg/m(2) andexercise-induced ectopic ventricular activity arrhythmias was highest among obese subjects, intermediate among overweight subjects and lowest among subjects with normal weight (3.4%, 2.7% and 2.2% respectively; p exercise compared with subjects with normal weight (p = 0.005), and that each 1 kg/m(2) increase in BMI was associated with a significant 4% (p = 0.002) increased adjusted risk for exercise-induced ventricular arrhythmias. Obesity is independently associated with increased likelihood of ectopic ventricular arrhythmia during exercise. © The European Society of Cardiology 2015.

Resultados de diferentes experiencias con búsqueda local aplicadas a problemas de rutas

Directory of Open Access Journals (Sweden)

Delgado, C.R.

2000-01-01

Full Text Available En los problemas de optimización combinatoria siempre han tenido gran importancia los Algoritmos de Búsqueda Local (o de Búsqueda Vecinal dentro de las técnicas heurísticas, especialmente a partir de la aparición de muchas de las recientes técnicas Metaheurísticas basadas en buena parte en el uso de estos movimientos vecinales. En este trabajo se analizan algunas experiencias relacionadas con estos, aplicados al VRPTW Mixto (carga y descarga. La primera de ellas es la definición y comparación de diferentes tipos de vecindarios para elegir el más adecuado; la segunda es la determinación de qué solución se elige en cada movimiento; la tercera es el uso de una técnica estrategia Búsqueda Local Rápida que puede servir para reducir considerablemente el tiempo de computación en problemas de gran tamaño. Para estas experiencias se usan instancias simuladas.

Ventricular Tachycardia in the Absence of Structural Heart Disease

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Luis R. P. Scott

2005-04-01

Full Text Available In up to 10% of patients who present with ventricular tachycardia (VT, obvious structural heart disease is not identified. In such patients, causes of ventricular arrhythmia include right ventricular outflow tract (RVOT VT, extrasystoles, idiopathic left ventricular tachycardia (ILVT, idiopathic propranolol-sensitive VT (IPVT, catecholaminergic polymorphic VT (CPVT, Brugada syndrome, and long QT syndrome (LQTS. RVOT VT, ILVT, and IPVT are referred to as idiopathic VT and generally do not have a familial basis. RVOT VT and ILVT are monomorphic, whereas IPVT may be monomorphic or polymorphic. The idiopathic VTs are classified by the ventricle of origin, the response to pharmacologic agents, catecholamine dependence, and the specific morphologic features of the arrhythmia. CPVT, Brugada syndrome, and LQTS are inherited ion channelopathies. CPVT may present as bidirectional VT, polymorphic VT, or catecholaminergic ventricular fibrillation. Syncope and sudden death in Brugada syndrome are usually due to polymorphic VT. The characteristic arrhythmia of LQTS is torsades de pointes. Overall, patients with idiopathic VT have a better prognosis than do patients with ventricular arrhythmias and structural heart disease. Initial treatment approach is pharmacologic and radiofrequency ablation is curative in most patients. However, radiofrequency ablation is not useful in the management of inherited ion channelopathies. Prognosis for patients with VT secondary to ion channelopathies is variable. High-risk patients (recurrent syncope and sudden cardiac death survivors with inherited ion channelopathies benefit from implantable cardioverter-defibrillator placement. This paper reviews the mechanism, clinical presentation, and management of VT in the absence of structural heart disease.

Outcomes of patients with right ventricular failure on milrinone after left ventricular assist device implantation.

Science.gov (United States)

Tsiouris, Athanasios; Paone, Gaetano; Brewer, Robert J; Nemeh, Hassan W; Borgi, Jamil; Morgan, Jeffrey A

2015-01-01

Previous studies have grouped together both patients requiring right ventricular assist devices (RVADs) with patients requiring prolonged milrinone therapy after left ventricular assist device (LVAD) implantation. We retrospectively identified 149 patients receiving LVADs and 18 (12.1%) of which developed right ventricular (RV) failure. We then separated these patients into those requiring RVADs versus prolonged milrinone therapy. This included 10 patients who were treated with prolonged milrinone and eight patients who underwent RVAD placement. Overall, the RV failure group had worse survival compared with the non-RV failure cohort (p = 0.038). However, this was only for the subgroup of patients who required RVADs, who had a 1, 6, 12, and 24 month survival of 62.5%, 37.5%, 37.5%, and 37.5%, respectively, versus 96.8%, 92.1%, 86.7%, and 84.4% for patients without RV failure (p milrinone therapy for RV failure had similar survivals compared with patients without RV failure. In the RV failure group, age, preoperative renal failure, and previous cardiac surgery were predictors of the need for prolonged postoperative milrinone. As LVADs become a more widely used therapy for patients with refractory, end-stage heart failure, it will be important to reduce the incidence of RV failure, as it yields significant morbidity and increases cost.

Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure.

Science.gov (United States)

Maslow, Andrew; Schwartz, Carl; Mahmood, Feroze; Singh, Arun; Heerdt, Paul M

2009-07-01

In this report, a case of right ventricular (RV) failure, hemodynamic instability, and systemic organ failure is described to highlight how paradoxical ventricular systolic septal motion (PVSM), or a rightward systolic displacement of the interventricular septum, may contribute to RV ejection. Multiple inotropic medications and vasopressors were administered to treat right heart failure and systemic hypotension in a patient following combined aortic and mitral valve replacement. In the early postoperative period, echocardiographic evaluation revealed adequate left ventricular systolic function, akinesis of the RV myocardial tissues, and PVSM. In the presence of PVSM, RV fractional area of contraction was > or =35% despite akinesis of the primary RV myocardial walls. The PVSM appeared to contribute toward RV ejection. As a result, the need for multiple inotropes was re-evaluated, in considering that end-organ dysfunction was the result of systemic hypotension and prolonged vasopressor administration. After discontinuation of phosphodiesterase inhibitors, native vascular tone returned and the need for vasopressors declined. This was followed by recovery of systemic organ function. Echocardiographic re-evaluation two years later, revealed persistent akinesis of the RV myocardial tissues and PVSM, the latter appearing to contribute toward RV ejection. This case highlights the importance of left to RV interactions, and how PVSM may mediate these hemodynamic interactions.

Assessment of right ventricular systolic function by tissue Doppler echocardiography

DEFF Research Database (Denmark)

Kjærgaard, Jesper

2012-01-01

This thesis summarizes a series of studies performed in order to assess the clinical usefulness of a novel echocardiographic technology that allows non-invasive assessment of regional right ventricular myocardial velocities and deformation: tissue Doppler echocardiography. While the technology...... is a promising tool for improving our understanding of right ventricular hemodynamics, several aspects of the technology must be evaluated. The accuracy and reproducibility of the technology is evaluated in vitro, and normal values, impact of changes in loading of the right ventricle, response to exercise...... on right ventricular hemodynamics: pulmonary embolism, Arrhythmogenic right ventricular cardiomyopathy and pulmonary regurgitation, the latter in an animal model. The conclusions of the thesis are: Color tissue Doppler echocardiography accurately measures velocities, SR and strain in vitro. No systematic...

Predictors of the left ventricular dysfunction induced by ventricular arrhythmia

Directory of Open Access Journals (Sweden)

А. І. Vytryhovskiy

2016-08-01

Full Text Available The most powerful predictor of life-threatening arrhythmia risk is a combination of low heart rate variability with low ejection fraction (EF of the left ventricle. Aim. To identify predictors of left ventricle dysfunction which is induced by ventricular arrhythmia. Materials and methods. To diagnose structural changes of left ventricular functional capacity and reserves in patients with previous myocardial infarction and patients with high and very high cardiovascular risk by SCORE scale and for establishment the relationship between morphological heart changes and pathological phenomenon of heart turbulence echocardiography and study of heart rate turbulence variability were performed. 603 patients were selected for the research. All patients were divided into groups: group 1 – patients with coronary heart disease, but without associated risk factors, such as smoking, obesity, metabolic syndrome; group 2 – patients who smoke tobacco more than 2 years (very high cardiovascular risk by scale SCORE; group 3 – patients with metabolic syndrome without coronary heart disease or arterial hypertension (very high cardiovascular risk by scale SCORE. The control group consisted of 149 persons. Results. The feature of structural changes in patients with myocardial infarction and in patients with a high cardiovascular risk by SCORE with heart rate turbulence compared with cases without НRT is considerably thickening of the left interventricular septum in systole. Based on this, it can be argued that the emergence of ventricular arrhythmia and accordingly phenomenon of heart rate turbulence in patients with existing cardiovascular diseases and risk factors has both morphological and functional character. Significant difference of echocardioscopy parameters in patients with postinfarction cardiosclerosis and risk factors by the SCORE system was established by index of intraventricular septum thickness in systole, and in persons with high risk – in

Bayesian Classification Models for Premature Ventricular Contraction Detection on ECG Traces.

Science.gov (United States)

Casas, Manuel M; Avitia, Roberto L; Gonzalez-Navarro, Felix F; Cardenas-Haro, Jose A; Reyna, Marco A

2018-01-01

According to the American Heart Association, in its latest commission about Ventricular Arrhythmias and Sudden Death 2006, the epidemiology of the ventricular arrhythmias ranges from a series of risk descriptors and clinical markers that go from ventricular premature complexes and nonsustained ventricular tachycardia to sudden cardiac death due to ventricular tachycardia in patients with or without clinical history. The premature ventricular complexes (PVCs) are known to be associated with malignant ventricular arrhythmias and sudden cardiac death (SCD) cases. Detecting this kind of arrhythmia has been crucial in clinical applications. The electrocardiogram (ECG) is a clinical test used to measure the heart electrical activity for inferences and diagnosis. Analyzing large ECG traces from several thousands of beats has brought the necessity to develop mathematical models that can automatically make assumptions about the heart condition. In this work, 80 different features from 108,653 ECG classified beats of the gold-standard MIT-BIH database were extracted in order to classify the Normal, PVC, and other kind of ECG beats. Three well-known Bayesian classification algorithms were trained and tested using these extracted features. Experimental results show that the F1 scores for each class were above 0.95, giving almost the perfect value for the PVC class. This gave us a promising path in the development of automated mechanisms for the detection of PVC complexes.

Salbutamol Abuse is Associated with Ventricular Fibrillation

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Emin UYSAL

2015-06-01

Full Text Available SUMMARY: Salbutamol-induced cardiac complications are well-established. Herein, we describe a case of a 24-year female who was admitted to the emergency department because of a suicide attempt with salbutamol (76 mg. Salbutamol abuse induced the development of supraventricular tachycardia and ventricular fibrillation. Regular sinus rhythm was restored with defibrillation. The hypokalemic patient who stayed in the intensive care unit was discharged after 48 hours of hospitalization. Key words: Salbutamol, suicide, ventricular fibrillation

Clustering Of Left Ventricular Wall Motion Patterns

Science.gov (United States)

Bjelogrlic, Z.; Jakopin, J.; Gyergyek, L.

1982-11-01

A method for detection of wall regions with similar motion was presented. A model based on local direction information was used to measure the left ventricular wall motion from cineangiographic sequence. Three time functions were used to define segmental motion patterns: distance of a ventricular contour segment from the mean contour, the velocity of a segment and its acceleration. Motion patterns were clustered by the UPGMA algorithm and by an algorithm based on K-nearest neighboor classification rule.

Ventricular tachycardia induced by weight loss pills

DEFF Research Database (Denmark)

Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang

2013-01-01

A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....

Studies of left ventricular volume estimation from single photon emission computed tomography

International Nuclear Information System (INIS)

Hiraki, Yoshio; Shimizu, Mitsuharu; Joja, Ikuo; Aono, Kaname; Yanagi, Hidekiyo; Indo, Haruaki; Seno, Yoshimasa; Teramoto, Shigeru; Nagaya, Isao.

1988-01-01

We studied the comparative accuracy of 99m Tc cardiac blood pool Single Photon Emission Computed Tomography (SPECT) for the measurement of left ventricular volume in 20 patients undergoing SPECT and single plane contrast left ventriculography (LVG). Left ventricular volume was calculated based on the total number of voxels in left ventricle. End-diastolic left ventricular volume (EDV) and end-systolic left ventricular volume (ESV) calculated from SPECT were compared with those from LVG. SPECT volume values showed a high degree of correlation with those by LVG (r = 0.923 for EDV, r = 0.903 for ESV). We appreciated the usefulness and accuracy of SPECT in measuring left ventricular volume because of its three-dimensional information. (author)

Correlation between right ventricular T1 mapping and right ventricular dysfunction in non-ischemic cardiomyopathy.

Science.gov (United States)

Jellis, Christine L; Yingchoncharoen, Teerapat; Gai, Neville; Kusunose, Kenya; Popović, Zoran B; Flamm, Scott; Kwon, Deborah

2018-01-01

Right ventricular (RV) fibrosis is increasingly recognized as the underlying pathological substrate in a variety of clinical conditions. We sought to employ cardiac magnetic resonance (CMR) techniques of strain imaging and longitudinal relaxation time (T 1 ) mapping to better examine the relationship between RV function and structure. Our aim was to initially evaluate the feasibility of these techniques to evaluate the right ventricle. We then sought to explore the relationship between RV function and underlying fibrosis, along with examining the evolution of RV remodeling according to the amount of baseline fibrosis. Echocardiography was performed in 102 subjects with non-ischemic cardiomyopathy. Right ventricular parameters were assessed including: fractional area change (FAC) and longitudinal strain. The same cohort underwent CMR. Post-contrast T 1 mapping was performed as a marker of fibrosis with a Look-Locker technique using inversion recovery imaging. Mid-ventricular post-contrast T 1 values of the RV free wall, RV septum and lateral LV were calculated using prototype analysis software. Biventricular volumetric data including ejection fraction was measured by CMR using a cine short axis stack. CMR strain analysis was also performed to assess 2D RV longitudinal and radial strain. Simultaneous biochemical and anthropometric data were recorded. Subjects were followed over a median time of 29 months (IQR 20-37 months) with echocardiography to evaluate temporal change in RV FAC according to baseline post-contrast T 1 values. Longitudinal data analysis was performed to adjust for patient loss during follow-up. Subjects (62% men, 51 ± 15 years) had mild to moderately impaired global RV systolic function (RVEF = 39 ± 15%; RVEDV = 187 ± 69 ml; RVESV = 119 ± 68 ml) and moderate left ventricular dysfunction at baseline (LVEF 30 ± 17%). Good correlation was observed between mean LV and RV post-contrast T 1 values (r = 0.652, p�

Paradox image: a noninvasive index of regional left-ventricular dyskinesis

International Nuclear Information System (INIS)

Holman, B.L.; Wynne, J.; Idoine, J.; Zielonka, J.; Neill, J.

1979-01-01

The paradox image, a functional image of regional dyskinesis derived from the equilibrium (gated) radionuclide ventriculogram, was constructed by subtracting the background-corrected end-diastolic frame from the background-corrected end-systolic frame. In 11 patients showing dyskinesis by contrast ventriculography, the percentage of left-ventricular picture elements containing paradox ranged from 3.6 to 55.6% (21.44% +- 4.45 s.e.m.). In 11 patients with normokinesis and in eight patients with hypookinesis by contrast ventriculography, the left-ventricular picture elements demonstrating paradox were less than 1.1% in all cases. In nine patients with akinesis, the percentage of left-ventricular picture elements containing paradox was 2.05% +- 0.96 s.e.m. and was less than 2% in seven patients. There was also an excellent agreement between the location of dyskinesis on the paradox image and that by contrast ventriculography. The paradox image is a sensitive indicator of left-ventricular dyskinesis and should be useful in the evaluation of patients with suspected left-ventricular asynergy

Hollow mandrin facilitates external ventricular drainage placement.

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Heese, O; Regelsberger, J; Kehler, U; Westphal, M

2005-07-01

Placement of ventricular catheters is a routine procedure in neurosurgery. Ventricle puncture is done using a flexible ventricular catheter stabilised by a solid steel mandrin in order to improve stability during brain penetration. A correct catheter placement is confirmed after removing the solid steel mandrin by observation of cerebrospinal fluid (CSF) flow out of the flexible catheter. Incorrect placement makes further punctures necessary. The newly developed device allows CSF flow observation during the puncture procedure and in addition precise intracranial pressure (ICP) measurement. The developed mandrin is hollow with a blunt tip. On one side 4-5 small holes with a diameter of 0.8 mm are drilled corresponding exactly with the holes in the ventricular catheter, allowing CSF to pass into the hollow mandrin as soon as the ventricle is reached. By connecting a small translucent tube at the distal portion of the hollow mandrin ICP can be measured without loss of CSF. The system has been used in 15 patients with subarachnoid haemorrhage (SAH) or intraventricular haemeorrhage (IVH) and subsequent hydrocephalus. The new system improved the external ventricular drainage implantation procedure. In all 15 patients catheter placement was correct. ICP measurement was easy to perform immediately at ventricle puncture. In 4 patients at puncture no spontaneous CSF flow was observed, therefore by connecting a syringe and gentle aspiration of CSF correct placement was confirmed in this unexpected low pressure hydrocephalus. Otherwise by using the conventional technique further punctures would have been necessary. Advantages of the new technique are less puncture procedures with a lower risk of damage to neural structures and reduced risk of intracranial haemorrhages. Implantation of the ventricular catheter to far into the brain can be monitored and this complication can be overcome. Using the connected pressure monitoring tube an exact measurement of the opening

Catecholaminergic polymorphic ventricular tachycardia in 2012

Directory of Open Access Journals (Sweden)

Christian van der Werf

2011-12-01

Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a rare, potentially lethal inherited arrhythmia syndrome characterized by stress or emotion-induced ventricular arrhythmias. CPVT was first described in 1960, while the genetic basis underlying this syndrome was discovered in 2001. The past decade has seen substantial advances in understanding the pathophysiology of CPVT. In addition, significant advances have been made in elucidating clinical characteristics of CPVT patients and new treatment options have become available. Here, we review current literature on CPVT to present state-of-the-art knowledge on the subject of the genetic basis, pathophysiology, clinical presentation, diagnosis, treatment and prognosis.

Arterial Ventricular Uncoupling with Age and Disease and Recoupling with Exercise

Science.gov (United States)

Chantler, Paul D

2017-01-01

The deterioration in arterial and cardiac function with aging impairs arterial ventricular coupling, an important determinant of cardiovascular performance. However, exercise training improves arterial ventricular coupling especially during exercise during the age and disease process. This review examines the concept of arterial-ventricular coupling, and how age, and disease uncouples but exercise training recouples the heart and arterial system. PMID:28072585

Evaluation of left ventricular function by nuclear stethoscope

International Nuclear Information System (INIS)

Nishimura, Tsunehiko

1981-01-01

The Nuclear Stethoscope (N.S.) is a unique cardiac probe system that provides a precise, rapid, noninvasive method to directly quantify ventricular functions at the bedside or actual beat-to-beat or composite beat basis. The accuracy and validity of N.S. were studied in 42 patients with cardiac diseases in comparison with camera-computer EF. The N.S. EF was well correlated with camera-computer EF (r = 0.82). In this study, clinical application of N.S. was as follows. 1. Beat-to-beat left ventricular volume response for evaluation of arrythmia (atrial fibrillation, premature ventricular conduction, bigemy et al.) 2. exercise study by handgrip and ergometer. EF is an extremely sensitive indicator to discriminate coronary arteries diseases from normal subjects. (author)

Evaluation of left ventricular function by nuclear stethoscope

Energy Technology Data Exchange (ETDEWEB)

Nishimura, T [National Cardiovascular Center, Suita, Osaka (Japan)

1981-03-01

The Nuclear Stethoscope (N.S.) is a unique cardiac probe system that provides a precise, rapid, noninvasive method to directly quantify ventricular functions at the bedside or actual beat-to-beat or composite beat basis. The accuracy and validity of N.S. were studied in 42 patients with cardiac diseases in comparison with camera-computer EF. The N.S. EF was well correlated with camera-computer EF (r = 0.82). In this study, clinical application of N.S. was as follows. 1. Beat-to-beat left ventricular volume response for evaluation of arrythmia (atrial fibrillation, premature ventricular conduction, bigemy et al.) 2. exercise study by handgrip and ergometer. EF is an extremely sensitive indicator to discriminate coronary arteries diseases from normal subjects.

Assessment of cardiac performance with quantitative radionuclide angiocardiography: sequential left ventricular ejection fraction, normalized left ventricular ejection rate, and regional wall motion

International Nuclear Information System (INIS)

Marshall, R.C.; Berger, H.J.; Costin, J.C.; Freedman, G.S.; Wolberg, J.; Cohen, L.S.; Gotischalk, A.; Zaret, B.L.

1977-01-01

Sequential quantitative first pass radionuclide angiocardiograms (RA) were used to measure left ventricular ejection fraction (LVEF) and left ventricular ejection rate (LVER), and to assess regional wall motion (RWM) in the anterior (ANT) and left anterior oblique (LAO) positions. Studies were obtained with a computerized multicrystal scintillation camera suitable for acquiring high count-rate data. Background was determined in a new fashion by selecting frames temporally from the left ventricular region of interest time-activity curve. A ''representative'' cardiac cycle was formed by summing together counts over three to six cardiac cycles. From this background corrected, high count-rate ''representative''cardiac cycle, LVEF, LVER, and RWM were determined. In 22 patients with normal sinus rhythm in the absence of significant valvular regurgitation, RA LVEF correlated well with that measured by contrast angiography (r = 0.95). LVER correlated well with LVEF measured at contrast angiography (r = 0.90) and allowed complete separation of those with normal (LVER = 3.4 +- 0.17 sec -1 ) and abnormal (LVER = 1.22 +- 0.11 sec -1 ) (P < 0.001) left ventricular performance. This separation was independent of background. Isoproterenol infusion in five normal subjects caused LVER to increase by 81 +- 17% while LVEF increased by 10 +- 2.0%. RWM was correctly defined in 21/22 patients and 89% of left ventricular segments with abnormal wall motion

Right ventricular systolic and diastolic function at rest in patients with coronary artery disease

International Nuclear Information System (INIS)

Caglar, N.M.; Araki, Haruo; Taira, Yuji; Fukuyama, Takaya; Nakamura, Motoomi

1985-01-01

Right ventricular systolic and diastolic function was studied in patients with ischemic heart disease using equilibrium radionuclide ventriculography. In patients with inferior myocardial infarction and proximal right coronary lesions, the right ventricular ejection fraction (0.43+-0.06, n=10, mean+-SD) and peak filling rate (1.7+-0.4 EDV/sec) were lower than normals (0.57+-0.07 and 2.7+-0.4 EDV/sec, n=10, p<0.001, respectively). In these patients, the right ventricular time to peak filling rate was longer than in normals (225+-36 msec vs 136+-45 msec, p<0.001), while the left ventricular ejection fraction remained normal. In patients with inferior myocardial infarction and distal right coronary lesions, the right ventricular ejection fraction, peak filling rate and time to peak filling rate were not different from those in normals. Even in patients with proximal right coronary lesions, the right ventricular ejection fraction was normal unless they had an inferior myocardial infarction. A decreased left ventricular ejection fraction and abnormal motion of the ventricular septum did not affect the right ventricular ejection fraction. The present results suggest that patients with an inferior myocardial infarction and proximal right coronary lesion often develop right ventricular systolic and diastolic dysfunction. (author)

Right ventricular function during acute exacerbation of severe equine asthma.

Science.gov (United States)

Decloedt, A; Borowicz, H; Slowikowska, M; Chiers, K; van Loon, G; Niedzwiedz, A

2017-09-01

Pulmonary hypertension has been described in horses with severe equine asthma, but its effect on the right ventricle has not been fully elucidated. To evaluate right ventricular structure and function after a 1-week period of pulmonary hypertension secondary to acute exacerbation of severe equine asthma. Prospective study. A clinical episode of severe equine asthma was induced experimentally in six susceptible horses. Examinations in remission and on day 7 of the clinical episode included a physical examination with clinical scoring, echocardiography, arterial blood gas measurements, venous blood sampling for cardiac biomarkers, intracardiac pressure measurements, right ventricular and right atrial myocardial biopsies, airway endoscopy and bronchoalveolar lavage. After 1 month of recovery, physical examination, echocardiography and cardiac biomarker analysis were repeated. Echocardiographic and pressure measurements were compared with those in 10 healthy control horses. All horses developed clinical signs of acute pulmonary obstruction. Right heart pressures increased significantly. Altered right ventricular function could be detected by tissue Doppler and speckle tracking echocardiography. Cardiac troponin concentrations did not increase significantly, but were highly elevated in one horse which exercised in the paddock prior to sampling. Focal neutrophil infiltration was present in two myocardial samples. Even in remission, asthmatic horses showed a thicker right ventricular wall, an increased left ventricular end-systolic eccentricity index at chordal level and decreased right ventricular longitudinal strain compared with controls. The induced clinical episode was rather mild and the number of horses was limited because of the invasive nature of the study. Pulmonary obstruction in asthmatic horses induces pulmonary hypertension with right ventricular structural and functional changes. © 2017 EVJ Ltd.

Discrete potentials guided radiofrequency ablation for idiopathic outflow tract ventricular arrhythmias.

Science.gov (United States)

Liu, Enzhao; Xu, Gang; Liu, Tong; Ye, Lan; Zhang, Qitong; Zhao, Yanshu; Li, Guangping

2015-03-01

Discrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias. The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs). Seventeen consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation were included. Intracardiac electrograms during the mapping and ablation were analysed. During sinus rhythm, sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular electrograms in all of the 17 patients, peak amplitude 0.51 ± 0.21 mV. The same potential was recorded prior to the local ventricular potential of the PVCs/VTs. Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram during the arrhythmias was noted. The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping. At the sites with DPs, lower unipolar and bipolar ventricular voltage of sinus beats were noted compared with the adjacent regions without DPs (unipolar: 6.1 ± 1.8 vs. 8.3 ± 2.3 mV, P Discrete potentials were not present in seven controls. Discrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias. Discrete potential- and substrate-guided ablation strategy will help to reduce the recurrence of idiopathic outflow tract arrhythmias. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Longitudinal strain predicts left ventricular mass regression after aortic valve replacement for severe aortic stenosis and preserved left ventricular function.

Science.gov (United States)

Gelsomino, Sandro; Lucà, Fabiana; Parise, Orlando; Lorusso, Roberto; Rao, Carmelo Massimiliano; Vizzardi, Enrico; Gensini, Gian Franco; Maessen, Jos G

2013-11-01

We explored the influence of global longitudinal strain (GLS) measured with two-dimensional speckle-tracking echocardiography on left ventricular mass regression (LVMR) in patients with pure aortic stenosis (AS) and normal left ventricular function undergoing aortic valve replacement (AVR). The study population included 83 patients with severe AS (aortic valve area regression (all P regression in patients with pure AS undergoing AVR. Our findings must be confirmed by further larger studies.

Right ventricular function after acute myocardial infarction: dependence upon infarct related coronary artery

International Nuclear Information System (INIS)

Cho, Ihn Ho; Chun, Kyung A; Won, Kyu Chang; Lee, Hyung Woo; Hong, Geu Ru; Park, Jong Seon; Shin, Dong Gu; Kim, Young Jo; Shim, Bong Sub

2004-01-01

We studied to know the relation between right ventricular function and infarct-related artery after acute myocardial infarction. The right and left ventricular function after a first myocardial infarction was assessed ECG-gated blood pool single photon emission computed tomography (GBPS) algorithms (Cedars-Sinai Medical Center, Los Angels, Calif) (12 after LAD related infarction (group 1) and 15 after RCA related infarction (group 2)). The left ventricular ejection fraction, end-diastolic volume and end-systolic volume did not differ significantly between two groups( group 1 vs 2 :LVEF 50.8% vs 55.1%. LVEDV=73.2 vs 79.7 ml, LVESV=38 vs 44 ml : P>0.05), but right ventricular ejection fraction, end-diastolic volume and end-systolic volume were significantly different after anterior myocardial infarction between two groups( group 1 vs 2 : RVEF=57.3% vs 46.3%. RVEDV=56.4 vs 95.1 ml, RVESV=25.6 vs 54.6ml : P<0.05). There was evidence of right ventricular dilatation in the group with RCA related infarction. Six with inferior infarction had abnormal right ventricular ejection fractions (< 40%). The relation between right and left ventricular ejection fractions was markedly different in the two groups. In the group with RCA related infarction there was a significant linear relation between right and left ventricular ejection fraction(R=0.5). Whereas in the group with LAD related infarction there was not (R=-0.3). Thus right ventricular dysfunction commonly occurs after RCA related infarction. Right ventricular impairment is related after RCA related infarction, but are independent after LAD related infarction. Finally, the different effects of LAD and RCA related infarction on right ventricular function may be explained by site of the myocardial wall involvement after infarction

Right ventricular function in asthmatic children determined with PW-TDI

International Nuclear Information System (INIS)

Wang Shaona; Song Lili; Cong Lin; Li Liping; Huang Yanxia

2007-01-01

Objective: To assess the right ventricular function of asthmatic children in onset period or remission period by using PW-TDI. Method: 36 children with confirmed asthma were enrolled. In tricuspid annular, the ECHO were recorded with PW-PDI pattern to obtain fight ventricular function (Sm, e-peak, Vmax for a-peak, and e/a), ICT, ET, IRT and Tei-Index. These were carried out in acute attack period and stable period. Result: Right ventficular function parameter (Sm, Vmax for e-peak, Vmax for a-peak, e/a and Tei-Index) in acute attack period were significant different compared to those in stable period (P<0.05). Conclusions: The fight ventricular function was impaired in patients with asthma in acute attack period. PW-TDI is helpful for assessing right ventricular function to asthmatic children. (authors)

Eisenmenger ventricular septal defect in a Humboldt penguin (Spheniscus humboldti).

Science.gov (United States)

Laughlin, D S; Ialeggio, D M; Trupkiewicz, J G; Sleeper, M M

2016-09-01

The Eisenmenger ventricular septal defect is an uncommon type of ventricular septal defect characterised in humans by a traditionally perimembranous ventricular septal defect, anterior deviation (cranioventral deviation in small animal patients) of the muscular outlet septum causing malalignment relative to the remainder of the muscular septum, and overriding of the aortic valve. This anomaly is reported infrequently in human patients and was identified in a 45-day-old Humboldt Penguin, Spheniscus humboldti, with signs of poor growth and a cardiac murmur. This case report describes the findings in this penguin and summarises the anatomy and classification of this cardiac anomaly. To the authors' knowledge this is the first report of an Eisenmenger ventricular septal defect in a veterinary patient. Copyright © 2016 Elsevier B.V. All rights reserved.

Intraoperative Transesophageal Echocardiography and Right Ventricular Failure After Left Ventricular Assist Device Implantation.

Science.gov (United States)

Silverton, Natalie A; Patel, Ravi; Zimmerman, Josh; Ma, Jianing; Stoddard, Greg; Selzman, Craig; Morrissey, Candice K

2018-02-15

To determine whether intraoperative measures of right ventricular (RV) function using transesophageal echocardiography are associated with subsequent RV failure after left ventricular assist device (LVAD) implantation. Retrospective, nonrandomized, observational study. Single tertiary-level, university-affiliated hospital. The study comprised 100 patients with systolic heart failure undergoing elective LVAD implantation. Transesophageal echocardiographic images before and after cardiopulmonary bypass were analyzed to quantify RV function using tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (S'), fractional area change (FAC), RV global longitudinal strain, and RV free wall strain. A chart review was performed to determine which patients subsequently developed RV failure (right ventricular assist device placement or prolonged inotrope requirement ≥14 days). Nineteen patients (19%) subsequently developed RV failure. Postbypass FAC was the only measure of RV function that distinguished between the RV failure and non-RV failure groups (21.2% v 26.5%; p = 0.04). The sensitivity, specificity, and area under the curve of an abnormal RV FAC (failure after LVAD implantation were 84%, 20%, and 0.52, respectively. No other intraoperative measure of RV function was associated with subsequent RV failure. RV failure increased ventilator time, intensive care unit and hospital length of stay, and mortality. Intraoperative measures of RV function such as tricuspid annular plane systolic excursion, tricuspid annular systolic velocity, and RV strain were not associated with RV failure after LVAD implantation. Decreased postbypass FAC was significantly associated with RV failure but showed poor discrimination. Copyright © 2018 Elsevier Inc. All rights reserved.

Experiencias e interpretaciones en performances rituales (Iruya y El Cajón, noroeste argentino

Directory of Open Access Journals (Sweden)

Karen Avenburg

2014-07-01

Full Text Available Este artículo se propone reflexionar acerca del modo en que dos performances rituales del noroeste argentino recrean en sus puestas en escena diferentes experiencias. Desde un enfoque etnográfico apoyado en los respectivos trabajos de campo de las autoras, se analizan comparativamente la Fiesta Patronal de la Virgen del Rosario de Iruya (Salta y la Semana Santa de El Cajón (Catamarca. En particular, se discuten algunas de las razones por la cuales en un contexto ritual la puesta en escena implica la recreación de su historia sociocultural y política, mientras que en el otro el eje central transcurre reactualizando eventos cosmológicos. El marco teórico utilizado se basa en el concepto de performance y su relación con la experiencia, siguiendo los aportes realizados por Edward Bruner y Victor Turner.

Fibrilação ventricular durante atividade esportiva tratada com sucesso Fibrilación ventricular durante actividad deportiva tratada con êxito Ventricular fibrillation during sport activity successfully treated

Directory of Open Access Journals (Sweden)

Maria Margarita Gonzalez

2009-08-01

Full Text Available A sobrevida após parada cardio-respiratória extra-hospitalar é estimada em menos de 5%. Apresentamos um caso de fibrilação ventricular, durante atividade esportiva. Ressuscitação cardio-pulmonar foi iniciada precocemente por pessoa leiga, e desfibrilação foi realizada em menos de três minutos, com desfibrilador externo automático, com sucesso. O programa de acesso público à desfibrilação tem aumentado a sobrevida após fibrilação ventricular extra-hospitalar. Devemos estimular o treinamento de pessoas leigas com relação ao uso de desfibriladores externos automáticos e o programa Suporte Básico de Vida, incentivando a implementação deste em locais com grande afluxo de pessoas e locais com risco elevado de ocorrer morte súbita, a exemplo de centros esportivos.La sobrevida tras una parada cardiorrespiratoria extrahospitalaria se estima en menos del 5%. Presentamos un caso de fibrilación ventricular durante actividad deportiva La resucitación cardiopulmonar fue iniciada precozmente por personal no técnico, y la desfibrilación se realizó en menos de tres minutos, con desfibrilador externo automático, con éxito. El programa de acceso público a la desfibrilación aumentó la sobrevida después de la fibrilación ventricular extrahospitalaria. Debemos estimular la capacitación de personas no técnicas con relación al uso de desfibriladores externos automáticos y el programa Soporte Básico de Vida, incentivando la implementación del mismo en locales con gran afluencia de personas y locales con riesgo elevado de ocurrencia de muerte súbita, como es el caso de los centros deportivos.Survival after out-of-hospital cardiopulmonary arrest is estimated at less than 5%. We report a case of ventricular fibrillation during sports activity. Cardiopulmonary resuscitation was initiated early by a layperson, and defibrillation was successfully performed within less than three minutes, with an automated external defibrillator. The

Experiencia en el manejo del paciente con VIH entre médicos de la Secretaría de Salud

OpenAIRE

Magis-Rodríguez Carlos; Esquivel-Pedraza Lilly; López-Martínez Carlos

1999-01-01

OBJETIVO: Conocer la experiencia que los médicos de la Secretaría de Salud (SSA) han obtenido en el manejo del sujeto infectado por el VIH y en el uso de antirretrovirales. MATERIAL Y MÉTODOS: Se realizó un estudio transversal, con el apoyo del Consejo Nacional para la Prevención y el Control del SIDA (CONASIDA), en marzo-mayo de 1998. Se proporcionaron cuestionarios autoaplicables a médicos de la SSA con experiencia en el manejo clínico del paciente con VIH, al inicio de cinco simposios sobr...

Cerebrovascular accidents in patients with a ventricular assist device.

Science.gov (United States)

Tsukui, Hiroyuki; Abla, Adib; Teuteberg, Jeffrey J; McNamara, Dennis M; Mathier, Michael A; Cadaret, Linda M; Kormos, Robert L

2007-07-01

A cerebrovascular accident is a devastating adverse event in a patient with a ventricular assist device. The goal was to clarify the risk factors for cerebrovascular accident. Prospectively collected data, including medical history, ventricular assist device type, white blood cell count, thrombelastogram, and infection, were reviewed retrospectively in 124 patients. Thirty-one patients (25%) had 48 cerebrovascular accidents. The mean ventricular assist device support period was 228 and 89 days in patients with and without cerebrovascular accidents, respectively (P cerebrovascular accidents occurred within 4 months after implantation. Actuarial freedom from cerebrovascular accident at 6 months was 75%, 64%, 63%, and 33% with the HeartMate device (Thoratec Corp, Pleasanton, Calif), Thoratec biventricular ventricular assist device (Thoratec Corp), Thoratec left ventricular assist device (Thoratec), and Novacor device (WorldHeart, Oakland, Calif), respectively. Twenty cerebrovascular accidents (42%) occurred in patients with infections. The mean white blood cell count at the cerebrovascular accident was greater than the normal range in patients with infection (12,900/mm3) and without infection (9500/mm3). The mean maximum amplitude of the thrombelastogram in the presence of infection (63.6 mm) was higher than that in the absence of infection (60.7 mm) (P = .0309). The risk of cerebrovascular accident increases with a longer ventricular assist device support period. Infection may activate platelet function and predispose the patient to a cerebrovascular accident. An elevation of the white blood cell count may also exacerbate the risk of cerebrovascular accident even in patients without infection. Selection of device type, prevention of infection, and meticulous control of anticoagulation are key to preventing cerebrovascular accident.

Left ventricular hypertrophy: virtuous intentions, malign consequences.

Science.gov (United States)

Pokharel, Saraswati; Sharma, Umesh C; Pinto, Yigal M

2003-06-01

Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca(2+) homeostasis, there are structural changes in myofilaments, disorganization of the cytoskeletal framework and increased collagen synthesis. LVH is associated with progressive left ventricular remodeling that culminates to heart failure. The modern treatment of left ventricular hypertrophy is now largely based on the hypothesis that neuroendocrine activation is important in the progression of the disease and inhibition of neurohormones is likely to have long-term benefit with regard to morbidity and mortality. Drugs specifically designed to unload the left ventricle, such as diuretics and vasodilators, appears to be less effective in reducing LV mass and improving prognosis. Thus, the evolution of treatment for LVH itself has provided much enlightenment for our understanding of the fundamental biology of the disorder.

"Rescue" ablation of electrical storm in arrhythmogenic right ventricular cardiomyopathy in pregnancy.

Science.gov (United States)

Stec, Sebastian; Krynski, Tomasz; Baran, Jakub; Kulakowski, Piotr

2013-08-13

Radiofrequency ablation (RFCA) became a treatment of choice in patients with recurrent ventricular tachycardia, ventricular fibrillation, and appropriate interventions of implanted cardioverter-defibrillator (ICD), however, electrical storm (ES) ablation in a pregnant woman has not yet been reported. We describe a case of a successful rescue ablation of recurrent ES in a 26-year-old Caucasian woman during her first pregnancy (23rd week). The arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) was diagnosed 3 years earlier and several drugs as well as 2 ablations failed to control recurrences of ventricular tachycardia. RFCA was performed on the day of the third electric storm. The use of electroanatomic mapping allowed very low X-ray exposure, and after applications in the right ventricular outflow tract, arrhythmia disappeared. Three months after ablation, a healthy girl was delivered without any complications. During twelve-month follow-up there was no recurrence of ventricular tachycardia or ICD interventions. This case documents the first successful RFCA during ES due to recurrent unstable ventricular arrhythmias in a patient with ARVD/C in pregnancy. Current guidelines recommend metoprolol, sotalol and intravenous amiodarone for prevention of recurrent ventricular tachycardia in pregnancy, however, RFCA should be considered as a therapeutic option in selected cases. The use of 3D navigating system and near zero X-ray approach is associated with minimal radiation exposure for mother and fetus as well as low risk of procedural complication.

Examen de post-efecto para experiencias anómalo/ paranormales con un abordaje humanista

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Alejandro Parra

2014-07-01

Full Text Available Se presentan los resultados de una investigación que tuvo como objetivos: explorar la utilidad de la terapia grupal para hacer frente a los efectos de las experiencias paranormales y explorar cómo la terapia humanista produce cambios positivos hacia las experiencias anómalo/paranormales. Se les pidió a la muestra (N= 20, rango 22-71 años, M= 45,65, DT= 12,52, 65 % mujeres y 35 % varones, responder un cuestionario autoadministrado de siete preguntas antes y al finalizar su participación en un grupo. La actividad incluyó tres fases: (1 Exposición, (2 Interpretación y (3 Cierre del grupo. Los participantes indicaron que el grupo ayudó a disminuir su malestar emocional (p = ,001, y lograr una comprensión a sus experiencias (p = ,008. Abstract This article shows the results of an investigation aimed to: explore the usefulness of group therapy to deal with the effects of paranormal experiences and explore how humanistic therapy produces positive changes to the anomalous/paranormal experiences. They were asked to sample (N = 20, range 22-71 years, M = 45.65, SD = 12.52, 65 % female and 35 % male, a self-administered questionnaire to answer seven questions before and after your participation in a group. The activity included three phases: (1 Exposure (2 Interpretation y (3 Close the group. Participants indicated that the group helped reduce their emotional distress (p = .001, and gain an understanding of their experiences (p = .008.

La Narración oral: Alternativa para el desarrollo de una experiencia educativa con perspectivas de género

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Marianela Rosa Peña Lora

2015-01-01

Full Text Available El trabajo que se presenta explica el carácter de la experiencia pedagógica realizada en la Universidad de Ciencias Médicas de Santiago de Cuba, referida a la creación de una Cátedra de Oralidad con enfoque de género, que tiene como objetivo contribuir a la gestión y desarrollo de prácticas y procesos sociales de carácter educativo/comunicacional y a los procesos formativos que de ello se derivan, así como desarrollar una reflexión crítica sobre el papel de la mujer en la experiencia narrativa de la vida cotidiana y en el rescate de la palabra en diferentes contextos educativos y socioculturales. En la implementación de la cátedra, organizada en áreas de desarrollo: "Historia de la Universidad de Ciencias Médicas"; "La narrativa oral y la relación interdisciplinaria"; "La medicina narrativa"; "La narración oral como arte y conducta ex-presivo-comunicativa", la transversali-dad del enfoque de género aparece como una estrategia metodológica que desde un planteamiento sistémico vislumbra todo el proceso educativo que posibilita el desarrollo de las habilidades básicas del pensamiento y comunicación basadas en la narración oral. En las conclusiones se expresa cómo el logro de estos objetivos ha transcurrido por un conjunto de actividades en las esferas de la docencia, investigación y extensión, donde además de abordar los aspectos teóricos, se ha realizado una reflexión compartida como construcción y experiencia sociocultural que permitió un intercambio de saberes, experiencias y participación a través de la narración oral, la cual se ha proyectado como espacio abierto para el aprendizaje, experiencia esencialmente humana y estrategia para la investigación.

Subjetividad y socialidad en los fotologs. Juventud y nuevas formas de experiencias: la escritura hecha imagen

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María Belén Espoz

2011-01-01

Full Text Available El presente trabajo ensaya algunas interpretaciones para comprender prácticas y experiencias de jóvenes en relación al uso y consumo de TIC, desde un cruce de lecturas que incluyen la semiótica de C. Sanders Peirce y la microsociología de Erving Goffman. ¿Qué tipos de experiencias se están produciendo en el marco de estas nuevas técnicas y como afectan (si lo hacen las formas de socialidad y su constitución subjetiva de los jóvenes en la actualidad? La importancia que los soportes/mediaciones tecnológicas adquieren en la vida cotidiana de los jóvenes abre el campo a nuevas indagaciones.

Normal left ventricular function does not protect against propafenone ...

African Journals Online (AJOL)

Normal left ventricular function does not protect against propafenone-induced incessant ventricular tachycardia. R. N. Scott Millar, J. B. Lawrenson, D.A. Milne. Abstract. Propafenone is a class Ic anti-arrhythmic agent with mild B-blocking properties which has recently become available in South Africa. We have used the ...

Flecainide Therapy Reduces Exercise-Induced Ventricular Arrhythmias in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia

NARCIS (Netherlands)

van der Werf, Christian; Kannankeril, Prince J.; Sacher, Frederic; Krahn, Andrew D.; Viskin, Sami; Leenhardt, Antoine; Shimizu, Wataru; Sumitomo, Naokata; Fish, Frank A.; Bhuiyan, Zahurul A.; Willems, Albert R.; van der Veen, Maurits J.; Watanabe, Hiroshi; Laborderie, Julien; Haïssaguerre, Michel; Knollmann, Björn C.; Wilde, Arthur A. M.

2011-01-01

Objectives This study evaluated the efficacy and safety of flecainide in addition to conventional drug therapy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background CPVT is an inherited arrhythmia syndrome caused by gene mutations that destabilize cardiac

Usefulness of tomographic phase image in ventricular conduction abnormalities

International Nuclear Information System (INIS)

Sakurai, Mitsuru; Watanabe, Yoshihiko; Kondo, Takeshi

1985-01-01

In order to evaluate three-dimensional phase changes in ventricular conduction abnormalities, tomographic phase images were constructed in 7 normal subjects, 12 patients with ventricular pacing, 21 patients with bundle branch block and 12 patients with Wolff-Parkinson-White syndrome. Eight to 12 slices of the short-axis ventricular tomographic phase image (TPI) were derived using a 7-pinhole collimator, and compared with planar phase images (PPIs) in left anterior oblique (LAO) and right anterior oblique (RAO) projections. TPIs were excellent for observing biventricular phase changes in the long-axis direction. In 6 cases of complete right bundle branch block with left axis deviation (beyond -30 0 ), the phase delay in the left ventricular anterior wall was recognized in 5 cases by TPI, although it was difficult to be detected by PPIs. The site of the pacing electrode was identified by TPI in 11 out of 12 cases, compared to 8 cases by PPIs in LAO and RAO projections. The site of the accessory pathway in Wolff-Parkinson-White syndrome was detected in the basal slice of TPIs in 10 out of 12 cases, compared to 8 cases by PPI in the LAO projection. Therefore, it is obvious that TPIs offer more valid information than PPIs. In conclusion, TPI is useful for investigation of ventricular conduction abnormalities. (author)

Left ventricular performance during psychological stress

International Nuclear Information System (INIS)

Young, D.Z.; Massachusetts General Hospital, Boston; Dimsdale, J.E.; Moore, R.H.; Barlai-Kovach, M.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Fifer, M.A.; Strauss, H.W.

1989-01-01

Left ventricular ejection fraction, systolic blood pressure and plasma norepinephrine were measured in six normotensive and six mildly hypertensive subjects during rest and psychological stress. Compared with rest, 8 of the 12 subjects developed significant changes in ejection fraction (increase in 6, decrease in 2); 10 of 12 subjects developed significant elevations of plasma norepinephrine; and all developed significant increases in systolic blood pressure. When the stress effects were examined for the total group, as opposed to within subjects, there were significant increases in plasma norepinephrine and systolic blood pressure but, interestingly, mean ejection fraction and stroke volume remained unchanged, implying stress led to increased left ventricular contractility. (orig.)

Intermittent′ restrictive ventricular septal defect in Tetralogy of Fallot

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Sudhir S Shetkar

2015-01-01

Full Text Available Ventricular septal defect (VSD in Tetralogy of Fallot (TOF is usually large and non-restrictive with equalization of right and left ventricular pressures. Restrictive VSD in TOF is rare. We present an unusual case of TOF with restriction to VSD caused by accessory tricuspid valve tissue that varied with respiration.

Relatos metodológicos: difractando experiencias narrativas de investigación

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Nicolás Schöngut Grollmus

2015-04-01

Full Text Available Si bien la investigación narrativa está ampliamente establecida en ciencias sociales, su práctica concreta presenta distintas variaciones en función de perspectivas teóricas y epistemológicas. Como una forma de analizar diversas experiencias en la práctica de la investigación narrativa, este artículo analiza seis narrativas de investigadoras respecto a su aproximación y uso de metodologías y técnicas asociadas a lo narrativo. A partir de un primer análisis narrativo, el artículo da cuenta de los resultados mediante dos textos. El primero se centra en los aspectos teóricos, metodológicos y técnicos de la investigación narrativa, mientras que el segundo se enfoca en los aspectos éticos y políticos de la experiencia de las participantes respecto al uso de narrativas para la investigación. Los textos permiten abordar reflexivamente la implantación de distintas formas de investigación narrativa a partir de considerar los posibles presupuestos teórico-epistemológicos en los que se sitúa su implantación concreta. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1502243

EXERCISE-INDUCED VENTRICULAR-TACHYCARDIA - A RARE MANIFESTATION OF DIGITALIS TOXICITY

NARCIS (Netherlands)

GOSSELINK, ATM; CRIJNS, HJGM; WIESFELD, ACP; LIE, KI

Digitalis intoxication is one of the most common adverse drug reactions. Although some arrhythmias are seen more frequently than others, virtually any rhythm disturbance, including ventricular tachycardia, may occur. However, to our knowledge, exercise-induced ventricular tachycardia as a

Preliminary study of left ventricular cavity-to-myocardial count ratio. A new parameter for left ventricular function

International Nuclear Information System (INIS)

Zhou Ying; Qu Wanying; Zhu Ming; Gao Wenping; Zhao Hongshan

1995-01-01

A new simple quantitative parameter, left ventricular cavity-to-myocardial count ratio (C/M ratio) was suggested and compared with LVEF to assess its reliability and clinical value. Of 220 patients in the study, 102 had both exercise 99m Tc-MIBI myocardial SPECT imaging and resting radionuclide ventriculography, another 118 patients had both rest 99m Tc-MIBI myocardial SPECT imaging and rest radionuclide ventriculography, 740 MBq of 99m Tc-MIBI was injected intravenously. Both the exercise and rest C/M ratio were determined on short-axis tomograms and LVEF were calculated from radionuclide ventriculography. The correlation between LVEF and the C/M (exercise and rest) was analyzed. There was a positive linear correlation between LVEF measured by ventriculography and both C/M exercise ratio (r = 0.6964) and C/M rest ratio (r = 0.6995). The sensitivity of C/M exercise and rest ratio for detecting patients with left ventricular dysfunction is 71.9%, 68.6%; the specificity is 92.9%, 97.0%; the accuracy is 86.3%, 84.7% respectively. C/M ratio can accurately identify patients with CAD who have resting left ventricular dysfunction. It was highly reproducible, reliable and useful in clinical diagnosis

Estudiantes de primera generación en Chile: una aproximación cualitativa a la experiencia universitaria

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Valentina Javiera SOTO HERNÁNDEZ

2016-09-01

Full Text Available El propósito de este artículo es analizar la experiencia universitaria de un grupo de estudiantes de primera generación de tres universidades ubicadas en Concepción, Chile. En un contexto de fuerte masificación de la educación superior, la experiencia de los estudiantes cuyos padres completaron como máximo la educación secundaria, se ha transformado en un ámbito de incipiente interés. En función de los objetivos, la investigación fue abordada desde el paradigma constructivista y diseñada de acuerdo al método biográfico, cuya principal técnica de recolección de datos fueron las entrevistas semi-estructuradas. Los resultados de esta investigación, de carácter exploratorio, revelan que la construcción de un proyecto de estudios universitarios se encuentra notablemente influenciado por los padres, quienes se transforman en una fuente fundamental de apoyo. Asimismo, los estudiantes configuran tres significaciones a su experiencia universitaria: la movilidad social ascendente, la vocación y la retribución a los padres. Finalmente, se discuten los resultados a partir de los cuales se proponen nuevos interrogantes.

Experiencia sobre desarrollo con Genexus siguiendo prácticas ágiles

OpenAIRE

Gimson Saravia, Loraine Elizabeth; Gil, Gustavo Daniel

2016-01-01

Este trabajo busca describir la experiencia realizada con alumnos del último año de la Licenciatura en Análisis de Sistemas de la Universidad Nacional de Salta combinando el desarrollo basado en conocimiento (DBC), utilizando Genexus, con un desarrollo ágil. Se pretendió brindarles una práctica real de aplicar los principios ágiles a los alumnos combinando su aplicación con Genexus a dos proyectos concretos.

Reconstrução fisiológica do ventrículo esquerdo: o conceito de máxima redução ventricular e mínima resposta inflamatória Physiologic left ventricular reconstruction: the concept of maximum ventricular reduction and minimum inflammatory reaction

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Walter J. Gomes

2004-12-01

Full Text Available INTRODUÇÃO: A sobrevida em pacientes com insuficiência cardíaca, assim como após a cirurgia de reconstrução do ventrículo esquerdo (VE, está relacionada ao tamanho da cavidade ventricular esquerda. Também o uso de materiais sintéticos na reconstrução ventricular poderia induzir uma reação inflamatória crônica. Relatamos a modificação da técnica de reconstrução ventricular que elimina a necessidade de retalhos intra-cavitários e de uso de material sintético no fechamento do VE. MÉTODO: Onze pacientes consecutivos com aneurisma de VE, evoluindo em classe funcional (CF III e IV da New York Heart Association foram submetidos à cirurgia de reconstrução ventricular direta sem utilização de retalhos intra-cavitários ou materiais protéticos no fechamento da incisão ventricular. RESULTADOS: Não houve mortalidade cirúrgica ou necessidade de suporte circulatório mecânico. A permanência hospitalar pós-operatória variou de 4 a 7 dias (média de 5,3 ± 1,1 dias. O ecocardiograma de controle, realizado em média 4,6 ± 1,5 meses após a operação, evidenciou redução do diâmetro diastólico de VE de 69,0 ± 7,5 mm, no pré-operatório, para 62,6 ± 5,1 mm, no pós-operatório. A fração de ejeção do VE mostrou aumento de 47,3% ± 6,6% para 56,3% ±10,5%. Com um ano de seguimento, 8 pacientes encontram-se em CF I e 3 em CF II. CONCLUSÃO: Esta técnica, com eliminação de uso de material sintético, pode contribuir para a melhora dos resultados clínicos de pacientes submetidos à reconstrução ventricular esquerda, proporcionando virtual eliminação das áreas acinéticas do VE e potencialmente atenuando, no pós-operatório tardio, a reação inflamatória crônica do miocárdio.BACKGROUND: The outcome of patients with heart failure, as well as after left ventricular reconstruction, is related to the size of the left ventricular cavity. Also the use of synthetic materials in the ventricular reconstruction could

Angiographic differentiation of type of ventricular septal defects

International Nuclear Information System (INIS)

Cheon, Mal Soon; Park, Hee Young; Kim, Yang Sook

1989-01-01

Defects of the ventricular septum are the commonest type of congenital cardiac malformations. A classification with axial angiography of the subtypes of ventricular septal defects is proposed on the study of 126 patients with defects of the ventricular septum. The results were as follows: 1. The incidence of the ventricular septal defects was 39.6% of congenital heart malformation. 2. The sex distribution of cases were 70 males and 56 females, the age ranged from 13 months to 26 years. 3. Angiographic features seen by axial angiography were as follows: a. Perimembranous defects as seen on long axial view of left ventriculogram were in continuity wity aortic valve. The relation of the defect to the tricuspid valve allows distinction of the extension of the preimembranous defect toward inlet, trabecular, or infundibular zones. This relation was determined angiographically, using the course of the contrast medium from the left ventricle through the ventricular septal defect, opacifying the right ventricle. In inlet excavation, the shunted blood opacified the recess between septal leaflet of tricuspid valve and interventricular septum in early phase, in infundibular excavation, opacified the recess between anterior leaflet of tricuspid valve and anterior free wall of right ventricle and in trabecular excavation, the shunted blood traversed anterior portion of tricuspid valve ring, opacified trabecular portion of right ventricle. b. Muscular defects were separated from the semilunar and atrioventricular valves. c, Subarterial defects were related to both semilunar valves, and they were best demonstrated on the elongated right anterior oblique view of the left ventriculogram. d. Total infundibular defects were profiled in right anterior oblique 30 and long axial view, subaortic in location in both views

Mujeres mayas en Yucatán: experiencia participativa en una organización productiva

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Amada Rubio-Herrera

2014-01-01

Full Text Available Presentamos resultados de investigación sobre una experiencia participativa de un grupo de mujeres maya-yucatecas: Múuch’ Meyaj Ko’olelo’ob (mmk, dando cuenta del impacto que las intervenciones de un programa universitario tienen en la vida de ellas. Utilizamos un enfoque y técnicas cualitativas. La agrupación se integró como parte del fomento a empresas sociales de mujeres rurales, emprendido por el Sistema Nacional para el Desarrollo Integral de la Familia (dif en 1997. Desde el inicio, sus integrantes se reunieron para producir y comercializar concentrado de horchata; interactuaron con agentes externos, sobresaliendo el Programa Académico de Desarrollo Sustentable en el Sur de Yucatán (padsur de la Universidad Autónoma de Yucatán (uady. Mostramos cómo este proceso se refleja en transformaciones personales identificadas por las mujeres, quienes valoran esta experiencia por posibilitar cambios en sus relaciones de género, aunque se ha incrementado su carga laboral.

EXPERIENCIAS PEDAGÓGICAS: Educar en las primeras infancias: una experiencia de formación docente en nutrición y alimentación saludable

OpenAIRE

Ravelli, Sandra; Manuale, Marcela

2017-01-01

El presente trabajo analiza una experiencia de formación docente centrada en la Educación Alimentaria Nutricional, que permitió fortalecer vínculos entre la universidad y otros nivelesdel sistema educativo, promoviendo intervenciones en la intersección entre educación, salud y primeras infancias. Desde la propuesta del Programa Nacional de Formación Permanente, del Ministerio de Educación de la Nación, se propuso desde la Facultad de  Bioquímica y Ciencias Biológicas (FBCB) de la Universidad ...

[Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease.

DEFF Research Database (Denmark)

Holst, Anders Gaarsdal; Tfelt-Hansen, 1jacob; Olesen, Morten S

2010-01-01

Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease, which can lead to life-threatening ventricular arrhythmias in patients with a structurally normal heart. The age of onset is usually between two and 12 years and the initial symptom is frequently syncope...

[Tricuspid insufficiency and right traumatic ventricular aneurysm. Apropos of a case].

Science.gov (United States)

Boisselier, P; Lombaert, M; Rey, J L; Quiret, J C; Bernasconi, P

1981-12-01

Tricuspid incompetence associated with a right ventricular aneurysm wa discovered after a non-penetrating thoracic injury. The severity of the tricuspid lesion was confirmed by phonomechanography, catheterisation and angiography. The mechanism was demonstrated by two-dimensional echocardiography: the right ventricular aneurysm was located in the right ventricular outflow tract. As the hemodynamic tolerance was good, surgery was not performed. A review of the literature found 41 other reports of traumatic tricuspid incompetence, and 4 cases of right ventricular aneurysm, only one of which was associated with tricuspid regurgitation. The points of interest of ths case: the rarity of the association, the good hemodynamic tolerance and the value of two-dimensional echocardiography for the diagnosis of ruptured chordae in the absence of surgical observations.

LOS PROCESOS DE ESCRITURA EN INGLÉS COMO LENGUA EXTRANJERA: UNA EXPERIENCIA MEDIADA POR TIC EN EL NIVEL MEDIO

OpenAIRE

Alicia Rita Águeda Collado

2015-01-01

El presente trabajo describe una experiencia pedagógica centrada en los procesos de escritura en la clase de inglés como lengua-cultura extranjera (LCE), mediada por TIC. Esta experiencia, llevada a cabo en 5to año B del nivel secundario del Instituto Santo Tomás de Aquino de la ciudad de San Luis, fue diseñada a partir de la concepción de procesos de escritura desarrollada por Nunan (1999), Harmer (2007) y White y Luppi (2010), y a partir de los lineamientos plasmados en los Núcleos de Apren...

Ethical challenges with the left ventricular assist device as a destination therapy

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Rady Mohamed Y

2008-08-01

Full Text Available Abstract The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1 direct participation of a multidisciplinary care team, including palliative care specialists, (2 a concise plan of care for anticipated device-related complications, (3 careful surveillance and counseling for caregiver burden, (4 advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5 a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e

Right ventricular volume and mass determined by cine magnetic resonance imaging in HIV patients with possible right ventricular dysfunction

DEFF Research Database (Denmark)

Kjaer, Andreas; Lebech, Anne-Mette; Gerstoft, Jan

2006-01-01

Impaired right ventricular (RV) function has been reported to occur in patients with HIV when studied by echocardiography. However, for accurate evaluation of RV function and morphology, first-pass radionuclide ventriculography (RNV) and cine magnetic resonance imaging (cine-MRI) are methods...... ventricular ejection fraction (RVEF). To do so, we screened patients with RNV and performed an additional cine-MRI in those with reduced RVEF determined by RNV. Ninety patients with HIV were included. To evaluate the MRI measures exactly we included 18 age- and gender-matched healthy volunteers to establish...

Disneyzación, parques temáticos y cultura corporativa en el capitalismo terciario: experiencias Xcaret, Riviera Maya (México)

OpenAIRE

Khafash Echevarría, Leila

2016-01-01

Esta tesis se propuso desde la perspectiva de la geografía y la antropología demostrar la disneyzación patrimonial recreada, tomando un modelo de negocio corporativo de parques temáticos en pleno auge turístico de la Riviera Maya en México y su hinterland (Experiencias Xcaret), corporativo de parques temáticos. Se propuso igualmente demostrar la expansión de los parques, y algunos efectos territoriales en el contexto de la economía de las experiencias emocionales. Con este objetivo general se...

Left ventricular function abnormalities as a manifestation of silent myocardial ischemia.

Science.gov (United States)

Lambert, C R; Conti, C R; Pepine, C J

1986-11-01

A large body of evidence exists indicating that left ventricular dysfunction is a common occurrence in patients with severe coronary artery disease and represents silent or asymptomatic myocardial ischemia. Such dysfunction probably occurs early in the time course of every ischemic episode in patients with coronary artery disease whether symptoms are eventually manifested or not. The pathophysiology of silent versus symptomatic left ventricular dysfunction due to ischemia appears to be identical. Silent ischemia-related left ventricular dysfunction can be documented during spontaneous or stress-induced perturbations in the myocardial oxygen supply/demand ratio. It also may be detected by nitroglycerin-induced improvement in ventricular function or by salutary changes in wall motion following revascularization. Silent left ventricular dysfunction is a very early occurrence during ischemia and precedes electrocardiographic abnormalities. In this light, its existence should always be kept in mind when dealing with patients with ischemic heart disease. It can be hypothesized that because silent ischemia appears to be identical to ischemia with symptoms in a pathophysiologic sense, prognosis and treatment in both cases should be the same.

Surgical myocardial revascularization in patients with reduced systolic left ventricular function.

Science.gov (United States)

Bruno, Piergiorgio; Iafrancesco, Mauro; Massetti, Massimo

2018-04-20

Surgical myocardial revascularization in patients with reduced left ventricular function has been a matter of debate for decades. Recently published 10-years extension follow-up of the STICH trial have conclusively demonstrated benefit of surgical myocardial revascularization in patients with significant coronary artery disease and low left ventricular ejection fraction. However, selection of patients for surgery remains challenging as well as decision to perform percutaneous rather than surgical revascularization in this class of patients. New evidence helped to clarify the role of preoperative patients' characteristics as risk factors for surgery and to identify those patients who may benefit the most from surgery. Focus of this review is to review epidemiology, aetiology and pathophysiology of coronary artery disease in patients with reduced left ventricular function, role of viability and results of observational and investigational studies on revascularization in patients with reduced left ventricular function with a particular emphasis on relative indication of coronary artery bypass grafting and percutaneous coronary intervention and the surgical implications of development of ischemic mitral regurgitation or ischemic left ventricular aneurysm.

Estilos de defensa predominantes en relación con experiencias anómalo/paranormales (Predominant Defenses Styles in Relation to Abnormal / Paranormal Experiences

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Alejandro Parra

2015-06-01

Full Text Available RESUMEN: El concepto de mecanismos de defensa tiene sus orígenes en la teoría psicoanalítica, que se centra más en el proceso de las defensas que en el objetivo de las defensas. El presente estudio examinó las diferencias entre individuos que tienen experiencias anómalo/paranormales y tres estilos defensivos (factor maduro, neurótico e inmaduro y quienes no han tenido tales experiencias. Estudiantes universitarios (60 % mujeres y 40 % varones, Edad promedio = 33.87 años recibieron el Cuestionario de Estilos de Defensa (DSQ-40 y diez preguntas que exploran varias experiencias anómalo/paranormales. Las personas reportaron una alta frecuencia de experiencias, tales como déjà-vu, sueños de percepción extrasensorial (PES, telepatía y recuerdos de vidas pasadas. Los resultados también mostraron mayor nivel de experiencias paranormales y defensas maduras, así como defensas neuróticas, en comparación con individuos sin experiencias. Aunque la naturaleza del estudio es francamente exploratoria, el autor sugiere que algunas de estas experiencias atribuidas a causas paranormales parecen servir como un mecanismo de protección a potenciales eventos traumáticos, mejorar el bienestar subjetivo del individuo o – al menos– evitar o disminuir las consecuencias perturbadoras de los eventos negativos de la vida. Por lo tanto, las experiencias paranormales podrían corresponder a rasgos no patológicos que producen cambios en la «homeostasis» psicológica. ABSTRACT: The concept of defense mechanisms has its origins in psychoanalytic theory, which focuses more on the defenses´process than on the objective of defenses. The present study examined the differences between individuals who have abnormal/paranormal experiences – and three defensive styles (mature, neurotic, and immature factor, and those who have not had such experiences. College students (60 % women and 40 % men, mean age = 33.87 years old received the Defense Styles

Evaluation of left ventricular volumes measured by magnetic resonance imaging

DEFF Research Database (Denmark)

Møgelvang, J; Thomsen, C; Mehlsen, J

1986-01-01

Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared...

Association between circulating fibroblast growth factor 23, α-Klotho, and the left ventricular ejection fraction and left ventricular mass in cardiology inpatients.

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Kensaku Shibata

Full Text Available BACKGROUND: Fibroblast growth factor 23 (FGF23, with its co-receptor Klotho, plays a crucial role in phosphate metabolism. Several recent studies suggested that circulating FGF23 and α-Klotho concentrations might be related to cardiovascular abnormalities in patients with advanced renal failure. PURPOSE: Using data from 100 cardiology inpatients who were not undergoing chronic hemodialysis, the association of circulating levels of FGF23, α-Klotho, and other calcium-phosphate metabolism-related parameters with the left ventricular ejection fraction (LVEF and left ventricular mass (LVM was analyzed. METHODS AND RESULTS: LVEF was measured using the modified Simpson method for apical 4-chamber LV images and the LVM index (LVMI was calculated by dividing the LVM by body surface area. Univariate analysis showed that log transformed FGF23, but not that of α-Klotho, was significantly associated with LVEF and LVMI with a standardized beta of -0.35 (P<0.001 and 0.26 (P<0.05, respectively. After adjusting for age, sex, estimated glomerular filtration rate, and serum concentrations of intact parathyroid hormone, and 25-hydroxyvitamin D as covariates into the statistical model, log-transformed FGF23 was found to be a statistically positive predictor for decreased left ventricular function and left ventricular hypertrophy. CONCLUSIONS: In cardiology department inpatients, circulating FGF23 concentrations were found to be associated with the left ventricular mass and LVEF independent of renal function and other calcium-phosphate metabolism-related parameters. Whether modulation of circulating FGF23 levels would improve cardiac outcome in such a high risk population awaits further investigation.

Comprensión de la Experiencia de Ansiedad en una Persona Homosexual que siente Amor en su Relación de Pareja: un Estudio Cualitativo de Caso

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López Campo, Enrique

2008-09-01

Full Text Available La presente investigación es un estudio cualitativo de caso de una mujer homosexual quien en su relación de pareja presenta la experiencia de ansiedad. Este proyecto tuvo como propósito la comprensión de la experiencia de esta mujer teniendo como referencia las siguientes preguntas orientadoras: ¿Cómo vivencia la ansiedad una persona homosexual que siente amor en su relación de pareja?, ¿Cuál es el sentido de experimentar ansiedad para esta persona? y ¿Cómo enfrenta dicha experiencia de ansiedad? Para este fin, se empleó un enfoque fenomenológico-hermenéutico, tanto para la recolección de información a través de entrevistas en profundidad, como para la descripci ón, interpretación y análisis minucioso de la experiencia en estudio

Real-time adjustment of ventricular restraint therapy in heart failure.

Science.gov (United States)

Ghanta, Ravi K; Lee, Lawrence S; Umakanthan, Ramanan; Laurence, Rita G; Fox, John A; Bolman, Ralph Morton; Cohn, Lawrence H; Chen, Frederick Y

2008-12-01

Current ventricular restraint devices do not allow for either the measurement or adjustment of ventricular restraint level. Periodic adjustment of restraint level post-device implantation may improve therapeutic efficacy. We evaluated the feasibility of an adjustable quantitative ventricular restraint (QVR) technique utilizing a fluid-filled polyurethane epicardial balloon to measure and adjust restraint level post-implantation guided by physiologic parameters. QVR balloons were implanted in nine ovine with post-infarction dilated heart failure. Restraint level was defined by the maximum restraint pressure applied by the balloon to the epicardium at end-diastole. An access line connected the balloon lumen to a subcutaneous portacath to allow percutaneous access. Restraint level was adjusted while left ventricular (LV) end-diastolic volume (EDV) and cardiac output was assessed with simultaneous transthoracic echocardiography. All nine ovine successfully underwent QVR balloon implantation. Post-implantation, restraint level could be measured percutaneously in real-time and dynamically adjusted by instillation and withdrawal of fluid from the balloon lumen. Using simultaneous echocardiography, restraint level could be adjusted based on LV EDV and cardiac output. After QVR therapy for 21 days, LV EDV decreased from 133+/-15 ml to 113+/-17 ml (p<0.05). QVR permits real-time measurement and physiologic adjustment of ventricular restraint therapy after device implantation.

A case of delayed cardiac perforation of active ventricular lead

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Hangyuan Guo

2011-12-01

Full Text Available A 65-year-old man was admitted as for one month of repetitive dizziness and one episode of syncope. Electrocardiogram showed sinus bradycardia and his Holter monitoring also showed sinus bradycardia with sinus arrest, sino-atrial block and a longest pause of 4.3 s. Then sick sinus syndrome and Adam-Stokes syndrome were diagnosed. Then a dual chamber pacemaker (Medtronic SDR303 was implanted and the parameters were normal by detection. The patient was discharged 1 week later with suture removed. Then 1.5 month late the patient was presented to hospital once again for sudden onset of chest pain with exacerbation after taking deep breath. Pacemaker programming showed both pacing and sensing abnormality with threshold of?5.0V and resistance of 1200?. Lead perforation was revealed by chest X-ray and confirmed by echocardiogram. Considering the fact that there was high risk to remove ventricular lead, spiral tip of previous ventricular lead was withdrew followed by implantation of a new ventricular active lead to the septum. Previous ventricular lead was maintained. As we know that the complications of lead perforation in the clinic was rare. Here we discuss the clinical management and the possible reasons for cardiac perforation of active ventricular lead.

Prognostic significance of radionuclide-assessed right ventricular function in dilated cardiomyopathy

International Nuclear Information System (INIS)

Ohno, Akira; Nishimura, Tsunehiko; Uehara, Toshiisa; Shimonagata, Tsuyoshi; Kumita, Shinichiro; Ogawa, Youji; Nagata, Seiki; Miyatake, Kunio

1991-01-01

To assess the prognostic significance of right ventricular function in dilated cardiomyopathy (DCM), we studied consecutive 57 DCM patients. There were 41 men and 16 women, whose mean age was 48 years (range 3-68 years). The mean left ventricular ejection fraction (LVEF) in all patients was 29±11%, and the mean interval from the onset of symptom of cardiac failure (CHF history) was 4 years (range 0-33 years). With follow-up of 3.8 years, five patients had died until the first year, and 14 had died until the third year. By using multivariate regression analysis, there were no prognostic significance in clinical parameters such as age, CHF history, sex, atrial fibrillation, except for NYHA class, and medication at the third year. In survival curves according to Kaplan-Meier method, right ventricular ejection fraction (RVEF) and mean pulmonary artery (PA) had predictive value (p<0.05), while LVEF did not. The patients with RVEF<45% had poor survival rate compared to those with RVEF≥45%. The patients with RVEF<45% showed lower LVEF and left ventricular end-systolic volume index. RVEF may offer prognostic predictive value through the effect of not only mean PA but also left ventricular parameter. In conclusion, radionuclide assessment of right ventricular function should be valuable for the prognostic evaluation of DCM patients. (author)

Prognostic significance of radionuclide-assessed right ventricular function in dilated cardiomyopathy

Energy Technology Data Exchange (ETDEWEB)

Ohno, Akira; Nishimura, Tsunehiko; Uehara, Toshiisa; Shimonagata, Tsuyoshi; Kumita, Shinichiro; Ogawa, Youji; Nagata, Seiki; Miyatake, Kunio [National Cardiovascular Center, Suita, Osaka (Japan)

1991-09-01

To assess the prognostic significance of right ventricular function in dilated cardiomyopathy (DCM), we studied consecutive 57 DCM patients. There were 41 men and 16 women, whose mean age was 48 years (range 3-68 years). The mean left ventricular ejection fraction (LVEF) in all patients was 29{+-}11%, and the mean interval from the onset of symptom of cardiac failure (CHF history) was 4 years (range 0-33 years). With follow-up of 3.8 years, five patients had died until the first year, and 14 had died until the third year. By using multivariate regression analysis, there were no prognostic significance in clinical parameters such as age, CHF history, sex, atrial fibrillation, except for NYHA class, and medication at the third year. In survival curves according to Kaplan-Meier method, right ventricular ejection fraction (RVEF) and mean pulmonary artery (PA) had predictive value (p<0.05), while LVEF did not. The patients with RVEF<45% had poor survival rate compared to those with RVEF{>=}45%. The patients with RVEF<45% showed lower LVEF and left ventricular end-systolic volume index. RVEF may offer prognostic predictive value through the effect of not only mean PA but also left ventricular parameter. In conclusion, radionuclide assessment of right ventricular function should be valuable for the prognostic evaluation of DCM patients. (author).

Analysis of Contemporary Methods for Designing Rotary Type Ventricular Assist Devices

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E. P. Banin

2015-01-01

Full Text Available The research object is inlet apparatus of ventricular assist device, namely inlet cannula and straightener.The purpose of the study is to reveal features of blood flow in inlet apparatus of ventricular assist device. The mathematical modeling is carried out by computational fluid dynamics analysis in a stationary setting.The first part of study concerns the analysis of existing approaches to the numerical and experimental studies in designing the ventricular assist devices of rotary type. It reveals the features of each approach for their further application in practice. The article presents an original design of developed hydraulic test bench to verify the results of mathematical modeling. Analysis of foreign authors’ studies showed that there is no enough attention paid to design of the adjacent pump assemblies of ventricular assist device. The second part of study considers direct mathematical modeling of input apparatus of ventricular assist device. The study examined straightener with three or four blades. Mathematical modeling has revealed the presence of potentially dangerous stagnation zones and essential asymmetry of the outlet flow from the input unit. The found features must be taken in consideration in designing the ventricular assist device pumps. In the future we plan to use obtained data to create a parametric model of the rotor and the diffuser considering the abovementioned features.

Significance of left ventricular volume measurement after heart transplantation using radionuclide techniques

International Nuclear Information System (INIS)

Novitzky, D.; Cooper, D.; Boniaszczuk, J.

1985-01-01

Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts

Experiencias formativas en la infancia rural mbyá-guaraní

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Ana Padawer

2009-12-01

Full Text Available En este trabajo se analizan las experiencias formativas de niños mbyá guaraní que acontecen fuera de la escuela, tanto aquellas que se producen mediante su participación periférica en actividades productivas realizadas en el monte y destinadas a la reproducción familiar doméstica, como en aquellas formas de participación en juegos infantiles entre pares. En ambos procesos se identificarán saberes implicados, y se plantearán algunas relaciones entre la participación y las diferenciaciones de género y transiciones etarias. Este análisis pretende mostrar algunas formas de articulación de las diversas experiencias formativas de los niños mbyá guaraní en relación con la producción del conocimiento del mundo, necesario para su autonomía como futuros adultos.In this article we analyze Mbyà Guaraní children's formative experiences. They take place outside school, by their peripheral participation in productive activities in forest, which are oriented to family reproduction; and also by participating in children´s play. At both processes we will identify knowledge involved, and also consider relationships between participation, gender and age transitions. This paper attends to analyze some articulations between Mbyà Guaraní children´s formative experiences, attending to their knowledge of world´s production, necessary for their autonomy as future adults.

Assessment of 123I-β-methyl iodophenyl pentadecanoic acid (BMIPP) myocardial scintigraphy in patients of chronic right ventricular overload. Fatty acid metabolism in right ventricular myocardium

International Nuclear Information System (INIS)

Mutoh, Hiroshi

1997-01-01

An investigation on the right ventricular pressure level and the abnormalities in the fatty acid metabolism of myocardium was made using 123 I-βmethyl-iodophenyl pentadecanoic acid (BMIPP) myocardial SPECT in patients with chronic right ventricular overloading. Twenty patients who presented with right ventricular systolic pressure (RVSP) of 35 mmHg or more were used as the subjects. Dual myocardial SPECT with 201 TlCl (Tl) and BMIPP was carried out for the subjects and RVc/LVc, a ratio of radioactivity count incorporated in the right ventricular free wall to the left one was determined for Tl and BMIPP. And the correlations between RVc/LVc and RVSP, and RVc/LVc and RVSP/LVSP were examined. The subjects were classified into 3 groups based on the RVSP levels and the count ratio, BMIPP/Tl was compared among the three groups. With respect of Tl uptake, there were significant, positive correlations between RVc/LVc and RVSP (correlation coefficient r=0.51, p<0.05) and between RVc/LVc and RVSP/LVSP (correlation coefficient r=0.59, p<0.01). On the other hand, no significant correlation was found between them with respect of the uptake of BMIPP. The BMIPP/Tl ratio in the group with higher than 80 mmHg of RVSP was 0.82±0.06, which was significantly lower than the ratio's for two groups of less than 80 mmHg; 0.91±0.07 and 0.98±0.04 in the group with 35-49 and 50-79 mmHg of RVSP, respectively. These results show that when compared with BMIPP, Tl is superior for the estimation of right ventricular pressure. For the patients with right ventricular overloading, it was suggested that when RVSP reaches 80 mmHg or more, there appear some disorders in the fatty acid metabolism in the right ventricular myocardium. (author)

Calculation of the ALMA Risk of Right Ventricular Failure After Left Ventricular Assist Device Implantation.

Science.gov (United States)

Loforte, Antonio; Montalto, Andrea; Musumeci, Francesco; Amarelli, Cristiano; Mariani, Carlo; Polizzi, Vincenzo; Lilla Della Monica, Paola; Grigioni, Francesco; Di Bartolomeo, Roberto; Marinelli, Giuseppe

2018-05-08

Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88). The final study patients were randomly divided into derivation (79.8%, n = 206) and validation (20.1%, n = 52) cohorts. Fifty-seven preoperative risk factors were compared between patients who were successfully managed with an LVAD and those who required a BVAD. Nineteen variables demonstrated statistical significance on univariable analysis. Multivariable logistic regression analysis identified destination therapy (odds ratio [OR] 2.0 [1.7-3.9], p = 0.003), a pulmonary artery pulsatility index right ventricle/left ventricle end-diastolic diameter ratio >0.75 (OR 2.7 [1.5-5.5], p = 0.001), an right ventricle stroke work index 17 (OR 3.5 [1.9-6.9], p the major predictors of the need for BVAD. Using these data, we propose a simple risk calculator to determine the suitability of patients for isolated LVAD support in the era of continuous-flow mechanical circulatory support devices.

Atrioventricular and ventricular-to-ventricular programming in patients with cardiac resynchronization therapy: results from ALTITUDE.

Science.gov (United States)

Steinberg, Benjamin A; Wehrenberg, Scott; Jackson, Kevin P; Hayes, David L; Varma, Niraj; Powell, Brian D; Day, John D; Frazier-Mills, Camille G; Stein, Kenneth M; Jones, Paul W; Piccini, Jonathan P

2015-12-01

Cardiac resynchronization therapy (CRT) improves outcomes in patients with heart failure, yet response rates are variable. We sought to determine whether physician-specified CRT programming was associated with improved outcomes. Using data from the ALTITUDE remote follow-up cohort, we examined sensed atrioventricular (AV) and ventricular-to-ventricular (VV) programming and their associated outcomes in patients with de novo CRT from 2009-2010. Outcomes included arrhythmia burden, left ventricular (LV) pacing, and all-cause mortality at 4 years. We identified 5709 patients with de novo CRT devices; at the time of implant, 34% (n = 1959) had entirely nominal settings programmed, 40% (n = 2294) had only AV timing adjusted, 11% (n = 604) had only VV timing adjusted, and 15% (n = 852) had both AV and VV adjusted from nominal programming. Suboptimal LV pacing (5% was lowest in the AV-only adjusted group (17.9%) and highest in the nominal (27.7%) and VV-only adjusted (28.3%) groups. Adjusted all-cause mortality was significantly higher among patients with non-nominal AV delay >120 vs. 180 vs. ≤180 ms, p = 0.4). Nominal settings for de novo CRT implants are frequently altered, most commonly the AV delay. There is wide variability in reprogramming. Patients with nominal or AV-only adjustments appear to have favorable pacing and arrhythmia outcomes. Sensed AV delays less than 120 ms are associated with improved survival.

Ventricular septal defect closure in a patient with achondroplasia.

Science.gov (United States)

Nakanishi, Keisuke; Kawasaki, Shiori; Amano, Atsushi

2017-01-01

Achondroplasia with co-morbid CHD is rare, as are reports of surgical treatment for such patients. We present the case of a 13-year-old girl with achondroplasia and ventricular septal defect. Her ventricular septal defect was surgically repaired focussing on the cardiopulmonary bypass flow, healing of the sternum, and her frail neck cartilage. The surgery and recovery were without complications.

Identidad, experiencia, diferencia. Re-significaciones de lo político en Esta puente mi espalda

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Panchiba Francisca Barrientos

2015-03-01

Full Text Available Las posibilidades de utilizar las referencias identitarias y los imaginarios del género para construir una mirada capaz de dar cuenta de la experiencia de los sujetos y de sus contradicciones, constituye en la actualidad un escenario reflexivo que fuerza los márgenes de las cartografías simbólicas que se imprimen sobre los cuerpos, obligándonos a cuestionar los mecanismos a través de los cuales, aquello que queda en sombra y que es marcado como “otro”, desborda las identidades que antes parecían unificadas y coherentes: En la escritura de las mujeres de color, la mujer, la experiencia, la diferencia y la identidad se tornan articulaciones ya no lineales sino desmontables, que requieren ser revisadas desde espacios capaces de movilizar ya no sólo certezas o verdades últimas, sino más bien, preguntas, dudas y contradicciones

Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot.

Science.gov (United States)

Jing, Linyuan; Wehner, Gregory J; Suever, Jonathan D; Charnigo, Richard J; Alhadad, Sudad; Stearns, Evan; Mojsejenko, Dimitri; Haggerty, Christopher M; Hickey, Kelsey; Valente, Anne Marie; Geva, Tal; Powell, Andrew J; Fornwalt, Brandon K

2016-08-22

Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their surgical repair. We hypothesized that measures of ventricular strain and dyssynchrony would predict deterioration of ventricular function in patients with rTOF. A database search identified all patients at a single institution with rTOF who underwent cardiovascular magnetic resonance (CMR) at least twice, >6 months apart, without intervening surgical or catheter procedures. Seven primary predictors were derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, LV and RV peak global circumferential strains, and LV and RV peak global longitudinal strains. Three outcomes were defined, whose changes were assessed over time: RV end-diastolic volume, and RV and LV ejection fraction. Multivariate linear mixed models were fit to investigate relationships of outcomes to predictors and ten potential baseline confounders. One hundred fifty-three patients with rTOF (23 ± 14 years, 50 % male) were included. The mean follow-up duration between the first and last CMR was 2.9 ± 1.3 years. After adjustment for confounders, none of the 7 primary predictors were significantly associated with change over time in the 3 outcome variables. Only 1-17 % of the variability in the change over time in the outcome variables was explained by the baseline predictors and potential confounders. In patients with repaired tetralogy of Fallot, ventricular dyssynchrony and global strain derived from cine CMR were not significantly related to changes in ventricular size and function over time. The ability to predict deterioration in ventricular function in patients with rTOF using current methods is limited.

Wave Intensity Analysis of Right Ventricular Function during Pulsed Operation of Rotary Left Ventricular Assist Devices.

Science.gov (United States)

Bouwmeester, J Christopher; Park, Jiheum; Valdovinos, John; Bonde, Pramod

2018-05-29

Changing the speed of left ventricular assist devices (LVADs) cyclically may be useful to restore aortic pulsatility; however, the effects of this pulsation on right ventricular (RV) function are unknown. This study investigates the effects of direct ventricular interaction by quantifying the amount of wave energy created by RV contraction when axial and centrifugal LVADs are used to assist the left ventricle. In 4 anesthetized pigs, pressure and flow were measured in the main pulmonary artery and wave intensity analysis was used to identify and quantify the energy of waves created by the RV. The axial pump depressed the intensity of waves created by RV contraction compared with the centrifugal pump. In both pump designs, there were only minor and variable differences between the continuous and pulsed operation on RV function. The axial pump causes the RV to contract with less energy compared with a centrifugal design. Diminishing the ability of the RV to produce less energy translates to less pressure and flow produced, which may lead to LVAD-induced RV failure. The effects of pulsed LVAD operation on the RV appear to be minimal during acute observation of healthy hearts. Further study is necessary to uncover the effects of other modes of speed modulation with healthy and unhealthy hearts to determine if pulsed operation will benefit patients by reducing LVAD complications.

Experiencias encarnadas. Representaciones audiovisuales de madre(s) y maternidad(es)

OpenAIRE

Brigidi, Serena

2014-01-01

[ES] El artículo presenta una reflexión encarnada sobre la experiencia de ser madre y las representaciones de la maternidad en la cultura occidental, en anuncios y series televisivas, documentales y películas. Habitualmente, la maternidad es imaginada como el producto (tener un hijo, convertirse en madre) y no como el arduo proceso que representa a lo largo de la vida de una persona. Se opta por presentarla con un carácter universal y se usa como una estrategia cinematográfica cua...

Literatura infantil para no lectores. Una experiencia desde la universidad

OpenAIRE

Ponce Naranjo, Genoveva

2016-01-01

La lectura es un tema de indiscutible importancia, como lo refiere Michèle Petit (1999, p. 19), “la lectura es tanto un medio para elaborar su subjetividad como un medio para acceder al conocimiento”; por eso, la experiencia académica con estudiantes de la Carrera de Ciencias Sociales de la Facultad de Ciencias de la Educación de la Universidad Nacional de Chimborazo,  tuvo como objetivo, resignificar  la lectura como práctica cotidiana, a través de una metodología cualitativa que apoyada en ...

Hipertrofia ventricular izquierda como factor de riesgo cardiovascular en el paciente hipertenso

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Llancaqueo V. Marcelo, Dr.

2012-11-01

Full Text Available La hipertrofia ventricular izquierda es una respuesta maladaptativa a la sobrecarga de presión crónica y un factor de riesgo importante para la fibrilación auricular, insuficiencia cardíaca diastólica, insuficiencia cardíaca sistólica, y la muerte súbita en pacientes con hipertensión. Dado que no todos los pacientes con hipertensión desarrollan hipertrofia ventricular izquierda, hay hallazgos clínicos que se deben tener en cuenta que puede alertar al médico sobre la presencia de hipertrofia ventricular izquierda por lo que una evaluación más definitiva se puede realizar utilizando un electrocardiograma, ecocardiograma o la resonancia magnética cardiovascular. Control de la presión arterial, la restricción de sodio, y la pérdida de peso de forma independiente facilitar la regresión de la hipertrofia ventricular izquierda. Elección de un fármaco antihipertensivo puede ser importante cuando se trata a un paciente con hipertrofia ventricular izquierda hipertensiva. Los inhibidores de la enzima convertidora o bloqueadores del receptor de angiotensina II, seguido por los antagonistas de los canales de calcio, facilitan más rápidamente la regresión de la hipertrofia ventricular izquierda. Con la regresión de la hipertrofia ventricular izquierda, la función diastólica y la reserva de flujo coronario generalmente mejoran, y disminuye el riesgo cardiovascular.

Early Right Ventricular Apical Pacing-Induced Gene Expression Alterations Are Associated with Deterioration of Left Ventricular Systolic Function

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Haiyan Xu

2017-01-01

Full Text Available The chronic high-dose right ventricular apical (RVA pacing may have deleterious effects on left ventricular (LV systolic function. We hypothesized that the expression changes of genes regulating cardiomyocyte energy metabolism and contractility were associated with deterioration of LV function in patients who underwent chronic RVA pacing. Sixty patients with complete atrioventricular block and preserved ejection fraction (EF who underwent pacemaker implantation were randomly assigned to either RVA pacing (n=30 group or right ventricular outflow tract (RVOT pacing (n=30 group. The mRNA levels of OPA1 and SERCA2a were significantly lower in the RVA pacing group at 1 month’s follow-up (both p<0.001. Early changes in the expression of selected genes OPA1 and SERCA2a were associated with deterioration in global longitudinal strain (GLS that became apparent months later (p=0.002 and p=0.026, resp. The altered expressions of genes that regulate cardiomyocyte energy metabolism and contractility measured in the peripheral blood at one month following pacemaker implantation were associated with subsequent deterioration in LV dyssynchrony and function in patients with preserved LVEF, who underwent RVA pacing.

Innovación en la Orientación Universitaria. Una experiencia : red de estudiantes mentores en la Universidad Complutense (REMUC

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Mercedes García García

2013-05-01

Full Text Available En este artículo se presenta una experiencia de mentoría en la universidad que utiliza como herramienta esencial un portal web diseñado ad hoc. Siguiendo la iniciativa surgida en el Departamento de Didáctica y Organización Escolar y Métodos de Investigación y Diagnóstico en Educación de la Facultad de Educación de Sevilla en el curso 2001-2002, un grupo de profesores pertenecientes al Departamento MIDE de la Facultad de Educación de la UCM, adaptó e implantó la experiencia en dicha Universidad. La descripción de la Red de Estudiantes Mentores en la Universidad Complutense (REMUC incluye: cómo surge la idea del proyecto, sus objetivos, las fases que fueron necesarias para hacerlo realidad, la estructura y elementos que lo componen, el modelo de intervención en que se sustenta, y las herramientas que utiliza. Así mismo se incluyen los resultados obtenidos durante el desarrollo, su evaluación y las conclusiones derivadas de la experiencia.

Osteopetrose maligna: transplante de medula óssea Malignant osteopetrosis: bone marrow transplantation

Directory of Open Access Journals (Sweden)

Maria L. Borsato

2008-04-01

Full Text Available A osteopetrose é uma osteopatia hereditária caracterizada pela deficiência na reabsorção óssea que ocorre por disfunção dos osteoclastos. Com o acúmulo de material osteóide que oblitera o canal medular, ocorre hematopoiese extramedular (hepato-esplenomegalia, obliteração dos forames dos nervos cranianos (cegueira, surdez, paralisias faciais, macrocefalia, protusão da fronte, hipertelorismo, exoftalmo, aumento da pressão intracraniana, retardo na erupção dentária, atraso no crescimento, atraso no desenvolvimento neuropsicomotor, e a morte ocorre precocemente nos primeiros anos de vida. A única alternativa terapêutica curativa é o transplante de medula óssea (TMO de doador HLA idêntico, pois restabelece a hematopoiese e a função monócito-macrófago, com melhora das lesões ósseas e anormalidades hematopoiéticas, embora não reverta as alterações sensoriais já instaladas. Os autores relatam casos de duas crianças portadoras de osteopetrose maligna submetidas ao transplante de medula óssea com sucesso. A primeira encontra-se no dia +1260 do TMO, com melhora evidente da radiologia esquelética, sem progressão das deficiências neurológicas que apresentava, e com biópsia óssea sem sinais de osteopetrose. O segundo paciente encontra-se no dia + 700, com sinais de reabsorção óssea e sem progressão dos danos neurológicos. Os autores chamam a atenção para a necessidade de diagnóstico precoce da osteopetrose e o rápido encaminhamento para o transplante de medula óssea antes da instalação de seqüelas neurológicas definitivas.Osteopetrosis is an inherited disorder characterized by the inability to reabsorb and remodel bone due to osteoclast dysfunction. The encroachment by bone and mineralized cartilage of the medullary cavities leads to extramedullary hematopoiesis (hepatosplenomegaly and cranial-nerve foramina leads to blindness, auditory nerve damage, and occulomotor and facial nerve palsies. Defective

Influence of age on left ventricular performance during exercise in normal Japanese subject

International Nuclear Information System (INIS)

Konishi, Tokuji; Koyama, Takao; Aoki, Toshikazu; Makino, Katsutoshi; Yamamuro, Masashi; Nakai, Kyudayu; Nakamura, Masayuki; Nakano, Takeshi.

1990-01-01

To assess the effects of age on left ventricular performance, multistage supine ergometer exercise radionuclide ventriculography (RNV) was performed in 92 normal subjects. The subjects ranged in age from 24 to 86 years and were free of cardiopulmonary disease and diabetes. Age-related changes in exercise duration, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), cardiac output (CO) left ventricular ejection fraction (LVEF), left ventricular dv/dt, systolic and diastolic time indexes of dv/dt, and peak systolic pressure/left ventricular end-systolic volume (PSP/LVESV) were analyzed at rest and during the peak exercise stage. Age-related decrease in LVEDV and peak diastolic dv/dt were significant at rest. The time indexes of ECG R to peak systolic dv/dt and time of end-systole to peak diastolic dv/dt also were prolonged with age. Both maximum heart rate and exercise duration were shown to decline with age. No age-related difference was observed in LVESV, LVEF or PSP/LVESV either at rest or during exercise. However, the change of LVEF and LVESV during exercise was less in subjects aged 60 or more. These results indicate decreased left ventricular function during exercise in elderly subjects. (author)

Diclofenac Prolongs Repolarization in Ventricular Muscle with Impaired Repolarization Reserve

Science.gov (United States)

Kristóf, Attila; Husti, Zoltán; Koncz, István; Kohajda, Zsófia; Szél, Tamás; Juhász, Viktor; Biliczki, Péter; Jost, Norbert; Baczkó, István; Papp, Julius Gy; Varró, András; Virág, László

2012-01-01

Background The aim of the present work was to characterize the electrophysiological effects of the non-steroidal anti-inflammatory drug diclofenac and to study the possible proarrhythmic potency of the drug in ventricular muscle. Methods Ion currents were recorded using voltage clamp technique in canine single ventricular cells and action potentials were obtained from canine ventricular preparations using microelectrodes. The proarrhythmic potency of the drug was investigated in an anaesthetized rabbit proarrhythmia model. Results Action potentials were slightly lengthened in ventricular muscle but were shortened in Purkinje fibers by diclofenac (20 µM). The maximum upstroke velocity was decreased in both preparations. Larger repolarization prolongation was observed when repolarization reserve was impaired by previous BaCl2 application. Diclofenac (3 mg/kg) did not prolong while dofetilide (25 µg/kg) significantly lengthened the QTc interval in anaesthetized rabbits. The addition of diclofenac following reduction of repolarization reserve by dofetilide further prolonged QTc. Diclofenac alone did not induce Torsades de Pointes ventricular tachycardia (TdP) while TdP incidence following dofetilide was 20%. However, the combination of diclofenac and dofetilide significantly increased TdP incidence (62%). In single ventricular cells diclofenac (30 µM) decreased the amplitude of rapid (IKr) and slow (IKs) delayed rectifier currents thereby attenuating repolarization reserve. L-type calcium current (ICa) was slightly diminished, but the transient outward (Ito) and inward rectifier (IK1) potassium currents were not influenced. Conclusions Diclofenac at therapeutic concentrations and even at high dose does not prolong repolarization markedly and does not increase the risk of arrhythmia in normal heart. However, high dose diclofenac treatment may lengthen repolarization and enhance proarrhythmic risk in hearts with reduced repolarization reserve. PMID:23300901

Failure of antiarrhythmic drugs to prevent experimental reperfusion ventricular fibrillation.

Science.gov (United States)

Naito, M; Michelson, E L; Kmetzo, J J; Kaplinsky, E; Dreifus, L S

1981-01-01

Ninety-nine adult mongrel dogs underwent acute ligation of the proximal left anterior descending coronary artery. Thirty minutes later, the occlusion was released to evaluate the effectiveness of five antiarrhythmic protocols in eliminating reperfusion ventricular fibrillation. The five protocols included: protocol 1 --i.v. lidocaine, preligation and prerelease (n = 19); protocol 2 -- i.v. lidocaine, prereperfusion only (n = 22); protocol 3 -- chronic, oral, daily amiodarone for 2 weeks preligation (n = 19); protocol 4 -- i.v. procainamide, preligation and prereperfusion (n = 21); and protocol 5 -- i.v. verapamil, prereperfusion (n = 18). Each regimen was evaluated with respect to the incidence of reperfusion ventricular fibrillation in dogs that survived to reperfusion, and the results were compared to 77 control dogs that underwent identical coronary artery occlusion and release procedures without drug therapy. The incidence of reperfusion ventricular fibrillation was as follows: protocol 1 -- seven of 15 dogs (47%); protocol 2 -- six of 18 (33%); protocol 3 -- 11 of 16 dogs (69%); protocol 4 -- eight of 17 dogs (47%); and protocol 5 -- 10 of 17 dogs (59%), compared with 36 of 60 (60%) in control dogs. Using chi-square analysis, protocol 2 was beneficial (p antecedent coronary artery ligation periods, and predictive risk indexes for the occurrence of reperfusion ventricular fibrillation were developed. the Mantel-Haenszel method of statistical analysis revealed that none of these protocols resulted in a statistically significant reduction in the incidence of reperfusion ventricular fibrillation. Thus, use of these predictive indexes plus appropriate statistical methods has revealed, unexpectedly, limitations in the efficacy of a spectrum of antiarrhythmic agents in preventing reperfusion ventricular fibrillation.

Intraoperative Hemodynamic and Echocardiographic Measurements Associated With Severe Right Ventricular Failure After Left Ventricular Assist Device Implantation.

Science.gov (United States)

Gudejko, Michael D; Gebhardt, Brian R; Zahedi, Farhad; Jain, Ankit; Breeze, Janis L; Lawrence, Matthew R; Shernan, Stanton K; Kapur, Navin K; Kiernan, Michael S; Couper, Greg; Cobey, Frederick C

2018-06-05

Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF. A review of LVAD patients between March 2013 and March 2016 was performed. Severe RVF was defined by the need for a right ventricular mechanical support device, inotropic, and/or inhaled pulmonary vasodilator requirements for >14 days. From a chart review, the right ventricular failure risk score was calculated and right heart hemodynamic data were collected. Pulmonary artery pulsatility index (PAPi) [(pulmonary artery systolic pressure - pulmonary artery diastolic pressure)/central venous pressure (CVP)] was calculated for 2 periods: (1) 30 minutes before cardiopulmonary bypass (CPB) and (2) after chest closure. Echocardiographic data were recorded pre-CPB and post-CPB by a blinded reviewer. Univariate logistic regression models were used to examine the performance of hemodynamic and echocardiographic metrics. A total of 110 LVAD patients were identified. Twenty-five did not meet criteria for RVF. Of the remaining 85 patients, 28 (33%) met criteria for severe RVF. Hemodynamic factors associated with severe RVF included: higher CVP values after chest closure (18 ± 9 vs 13 ± 5 mm Hg; P = .0008) in addition to lower PAPi pre-CPB (1.2 ± 0.6 vs 1.7 ± 1.0; P = .04) and after chest closure (0.9 ± 0.5 vs 1.5 ± 0.8; P = .0008). Post-CPB echocardiographic findings associated with severe RVF included: larger right atrial diameter major axis (5.4 ± 0.9 vs 4.9 ± 1.0 cm; P = .03), larger right ventricle end-systolic area (22.6 ± 8.4 vs 18.5 ± 7.9 cm; P = .03), lower fractional area of change (20.2 ± 10.8 vs 25.9 ± 12.6; P = .04), and lower tricuspid annular plane systolic excursion (0.9 ± 0.2 vs 1.1 ± 0.3 cm; P = .008). Right ventricular failure risk score was not a significant predictor of

Clinical application of a right ventricular pressure-volume loop determined by gated blood-pool imaging and simultaneously measured right ventricular pressure

International Nuclear Information System (INIS)

Yasue, Takao; Watanabe, Sachiro; Sugishita, Nobuyoshi; Tanaka, Tsutomu; Yokoyama, Hideo

1983-01-01

The data obtained by ECG-gated radionuclide angiography were collected simultaneously with right ventricular pressure and thermal cardiac output (CO) obtained by a Swan-Ganz catheter in Scintipac 1200 (Shimazu Co) in order to create a right ventricular pressure-volume (RV P-V) loop. Subjects consisted of 15 patients with old myocardial infarction (MI group), seven with angina pectoris (AP group), six with congestive cardiomyopathy (CCM group) and five with neurocirculatory asthenia (NCA group). Right ventricular end-diastolic volume (RVEDV) was calculated as RVEDV = CO/(EF x HR) (CO = cardiac output; HR = heart rate). Systolic work (W sub(S)), diastolic work (W sub(D)) and net work (W sub(N)) were calculated from a RV P-V loop by Simpson's method. The measurements were performed before and 5 min after sublingual administration of nitroglycerin (NG) (0.3 mg). The results were as follows: 1. RV P-V loops shifted towards the left lower part of the P-V plane after sublingual administration of nitroglycerin, indicating the reduction of pressure and volume of the right ventricle. 2. Right ventricular ejection fraction (RVEF) in the MI, AP and CCM groups showed smaller values than that of the NCA group. 3. Right ventricular end-diastolic volume index (RVEDVI) showed a converse relation with RVEF. 4. Cardiac index in all groups decreased after NG and a statistical significance was seen in the MI, AP and NCA groups (p<0.05). 5. RV W sub(S), RV W sub(D) and RV W sub(N) showed no difference among each groups in the control state, and significantly decreased after NG. We conclude that the present method using RV P-V loop might be useful as a noninvasive bedside monitoring and permits the evaluation of RV function in a clinical setting

Regional ejection fraction: a quantitative radionuclide index of regional left ventricular performance

International Nuclear Information System (INIS)

Maddox, D.E.; Wynne, J.; Uren, R.; Parker, J.A.; Idoine, J.; Siegel, L.C.; Neill, J.M.; Cohn, P.F.; Holman, B.L.

1979-01-01

Left ventricular regional ejection fractions were derived from background-corrected, time-activity curves in 43 patients assessed by both gated equilibrium radionuclide angiocardiography and left ventricular contrast angiography. From a single, modified left anterior oblique projection, the regional change in background corrected counts was determined in each of three anatomic regions. The normal range for regional radionuclide ejection fraction was determined in 10 patients with normal contrast ventriculograms and without obstructive coronary artery disease at coronary arteriography. Regional ejection fraction was compared with percent segmental axis shortening and extent of akinetic segments in corresponding regions of the contrast ventriculogram. Radionuclide and roentgenographic methods were in agreement as to the presence or absence of abnormal wall motion in 83 of 99 left ventricular regions (84%) in 33 patients evaluated prospectively. Comparison of regional ejection fraction demonstrated significant differences between regions with roentgenographically determined normokinesis hypokinesis, and akinesis. We conclude that the left ventricular regional ejection fraction provides a reliable quantitative assessment of regional left ventricular performance

New strict left bundle branch block criteria reflect left ventricular activation differences

DEFF Research Database (Denmark)

Emerek, Kasper Janus Grønn; Risum, Niels; Hjortshøj, Søren Pihlkjær

2015-01-01

AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left ven....... CONCLUSION: Interventricular electrical delay predicts left ventricular remodeling after CRT and new, strict ECG criteria of LBBB are superior in predicting remodeling.......AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left...... ventricular electrical delay (RV-LV-IED) was measured. Response to CRT was defined as ≥15% decrease in left ventricular end-systolic volume. RESULTS: Eighteen of 20 (90%) patients with non-ischemic dilated cardiomyopathy (DCM) and 18 of 29 (62%) with ischemic heart disease (IHD) responded to CRT, p

Management of Arrhythmias in Athletes: Atrial Fibrillation, Premature Ventricular Contractions, and Ventricular Tachycardia.

Science.gov (United States)

Lai, Ernest; Chung, Eugene H

2017-10-09

Management of atrial fibrillation, premature ventricular contractions, and ventricular tachycardia without underlying cardiac disease or arrhythmogenic conditions differs in athletes from the general population. Athletes tend to be younger, healthier individuals with few comorbidities. Therapies that work well in the general population may not be appropriate or preferable for athletes. Management strategies include deconditioning, pharmacologic therapy, such as rate control with β-blockers or non-dihydropyridine calcium channel blockers and rhythm control with class I or class III antiarrhythmic drugs, and catheter ablation. Deconditioning is not preferred by athletes because of lost playing time. Pharmacologic therapy is well tolerated among most individuals, but is not as favorable in athletes. Rate control medications can reduce performance and β-blockers, in particular, are prohibited in many sports. Antiarrhythmic drugs are preferred over rate control with athletes, but many, especially younger athletes, may not like the idea of long-term medical therapy. Catheter ablation has been proven to be safe and efficacious, may eliminate the need for long-term medical therapy, and is supported by the major societies (AHA, ACC, ESC).

Applications of magnetic resonance imaging in the assessment of left ventricular dysfunction

Energy Technology Data Exchange (ETDEWEB)

Beacock, David John

2002-07-01

This thesis has described the use of Magnetic Resonance Imaging (MRI) in the investigation of left ventricular dimensions and systolic function. This has been performed in conditions of left ventricular dysfunction, in congestive cardiac failure and following anterior myocardial infarction. The reproducibility of measurements of left ventricular dimensions using MRI has been presented. Such measurements were shown to be reproducible between different MRI studies of normal volunteers and patients with congestive heart failure. Furthermore, measurements from different MRI studies obtained from two commercially different systems were reproducible for the same subject groups. Ventricular dimensions and systolic function was evaluated in adult normal volunteers of different ages. Although left ventricular volumes and mass remained unchanged, detailed studies of the systolic images revealed significant differences between the two age groups. Differences in left ventricular cavity volumes and mass between patients with congestive heart failure and age-matched normal volunteers were also investigated. Left ventricular volumes and myocardial mass were assessed in a group of patients following anterior myocardial infarction. End-systolic volume was significantly increased compared to age-matched volunteers, but no changes in end-diastolic volume or myocardial mass was observed. Serial re-evaluation of these patients revealed no other changes over the subsequent six months. All these patients were treated with optimal medical therapy (thrombolysis, aspirin, beta-blockade and angiotensin converting enzyme inhibition). Thus, the use of this therapy may attenuate the process of left ventricular remodelling. Regional wall thickness was measured in the post-infarct patients. Wall thickening was significantly reduced both in the infarcted regions and in myocardium remote to the infarction. In contrast to previous echocardiographic studies, no 'hypercontractility' was

Clinical value of regression of electrocardiographic left ventricular hypertrophy after aortic valve replacement.

Science.gov (United States)

Yamabe, Sayuri; Dohi, Yoshihiro; Higashi, Akifumi; Kinoshita, Hiroki; Sada, Yoshiharu; Hidaka, Takayuki; Kurisu, Satoshi; Shiode, Nobuo; Kihara, Yasuki

2016-09-01

Electrocardiographic left ventricular hypertrophy (ECG-LVH) gradually regressed after aortic valve replacement (AVR) in patients with severe aortic stenosis. Sokolow-Lyon voltage (SV1 + RV5/6) is possibly the most widely used criterion for ECG-LVH. The aim of this study was to determine whether decrease in Sokolow-Lyon voltage reflects left ventricular reverse remodeling detected by echocardiography after AVR. Of 129 consecutive patients who underwent AVR for severe aortic stenosis, 38 patients with preoperative ECG-LVH, defined by SV1 + RV5/6 of ≥3.5 mV, were enrolled in this study. Electrocardiography and echocardiography were performed preoperatively and 1 year postoperatively. The patients were divided into ECG-LVH regression group (n = 19) and non-regression group (n = 19) according to the median value of the absolute regression in SV1 + RV5/6. Multivariate logistic regression analysis was performed to assess determinants of ECG-LVH regression among echocardiographic indices. ECG-LVH regression group showed significantly greater decrease in left ventricular mass index and left ventricular dimensions than Non-regression group. ECG-LVH regression was independently determined by decrease in the left ventricular mass index [odds ratio (OR) 1.28, 95 % confidence interval (CI) 1.03-1.69, p = 0.048], left ventricular end-diastolic dimension (OR 1.18, 95 % CI 1.03-1.41, p = 0.014), and left ventricular end-systolic dimension (OR 1.24, 95 % CI 1.06-1.52, p = 0.0047). ECG-LVH regression could be a marker of the effect of AVR on both reducing the left ventricular mass index and left ventricular dimensions. The effect of AVR on reverse remodeling can be estimated, at least in part, by regression of ECG-LVH.

El Papel de la Cualidad del Servicio y de la Imagen de la Tienda em la Experiencia de Consumo de Servicios Automotrices.

Directory of Open Access Journals (Sweden)

Ieda Pedógia Martins Damian

2014-06-01

Full Text Available Los servicios han desempeñado un papel cada vez más relevante, al agregar valor a los consumidores. En ese sentido, la evaluación de la experiencia de consumo en relación a esos servicios es importante para los minoristas que actúan en ambientes competitivos. El objetivo de este trabajo es analizar el papel de la cualidad del servicio y de la imagen de la tienda en la experiencia de consumo de servicios automotrices. El estudio fue dividido en dos momentos. En el primero se realizó una investigación cuantitativa (survey con 1346 consumidores, con el objetivo de obtener de ellos una evaluación de los atributos de imagen y cualidad y su contribución para una evaluación positiva de la experiencia de consumo. En seguida, fue realizada una investigación cualitativa, del tipo grupo enfocado, para discutir los resultados obtenidos en la investigación cuantitativa. La principal contribución del estudio fue dejar evidente la relevancia de los aspectos relacionados a la imagen del prestador del servicio. Se debe destacar que la imagen presentó, en la investigación, un papel tan relevante cuanto el de los elementos directamente relacionados a la cualidad de los servicios para el desarrollo de una experiencia de consumo agradable.

Stunning and Right Ventricular Dysfunction Is Induced by Coronary Balloon Occlusion and Rapid Pacing in Humans: Insights From Right Ventricular Conductance Catheter Studies.

Science.gov (United States)

Axell, Richard G; Giblett, Joel P; White, Paul A; Klein, Andrew; Hampton-Til, James; O'Sullivan, Michael; Braganza, Denise; Davies, William R; West, Nick E J; Densem, Cameron G; Hoole, Stephen P

2017-06-06

We sought to determine whether right ventricular stunning could be detected after supply (during coronary balloon occlusion [BO]) and supply/demand ischemia (induced by rapid pacing [RP] during transcatheter aortic valve replacement) in humans. Ten subjects with single-vessel right coronary artery disease undergoing percutaneous coronary intervention with normal ventricular function were studied in the BO group. Ten subjects undergoing transfemoral transcatheter aortic valve replacement were studied in the RP group. In both, a conductance catheter was placed into the right ventricle, and pressure volume loops were recorded at baseline and for intervals over 15 minutes after a low-pressure BO for 1 minute or a cumulative duration of RP for up to 1 minute. Ischemia-induced diastolic dysfunction was seen 1 minute after RP (end-diastolic pressure [mm Hg]: 8.1±4.2 versus 12.1±4.1, P right coronary artery balloon occlusion both cause ischemic right ventricular dysfunction with stunning observed later during the procedure. This may have intraoperative implications in patients without right ventricular functional reserve. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

SISTEMATIZACIÓN DE EXPERIENCIAS DIDÁCTICAS CON DOCENTES: LAS ARTES PLÁSTICAS Y EL CURRÍCULO ESCOLAR

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Julieta Castro Bonilla

2008-01-01

Full Text Available El artículo que presento se refiere al desarrollo de actividades de integración curricular, realizadas con docentes que laboran en instituciones de educación preescolar, primaria, secundaria, y que además forman parte de un proyecto denominado "Primero Aprendo". Deseo rescatar dos aspectos de la experiencia; en primer lugar, una interesante integración entre las artes plásticas y algunos contenidos de los programas de estudio, y en segundo lugar, se resalta un trabajo de equipo en el que participaron, además de la población docente, personas que laboran en actividades culinarias en las mismas instituciones educativas. Durante el desarrollo de las experiencias se enfatizó un trabajo de cooperación, colaboración y entusiasmo, gracias a la apertura mostrada por las direcciones de las instituciones que participaron, situación que favoreció el logro de los objetivos propuestos. Los talleres fueron ofrecidos por profesoras universitarias e investigadoras con experiencia y formación en diferentes especialidades, a saber, música, psicología, educación preescolar y artes plásticas, situación que favoreció en docentes participantes el desarrollo de procesos de integración curricular y aprendizajes, que posteriormente, debían ser aplicados en sus lugares de trabajo.

Experiencias de desarrollo en tareas de procesamiento y gestión de datos en bioinformática

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Alejandro Hadad

2012-05-01

Full Text Available En el presente documento se describen brevemente algunas experiencias de desarrollo relacionadas a tareas de procesamiento y gestión de datos para el área de bioinformática. En dicha área una de sus características es que los mismos suelen tener alta dimensionalidad, siendo esta una de las características que dificultan cualquier proceso de reconocimiento de patrones. Por otro lado en lo que respecta a tareas de gestión de datos, el profesional que trabaja en ámbitos de bioinformática usualmente necesita disponer de suficientes variantes en cuanto al manejo de diferentes formatos de almacenamiento y métodos de procesamiento, dada la naturaleza investigativa de su profesión que le requiere continuamente realizar ensayos in silico de manera no estandarizada. Este perfil de trabajo requiere herramientas con suficiente flexibilidad a fin de dar soporte a dichas tareas. Teniendo en cuenta estos dos aspectos en este trabajo se muestran en primer lugar una experiencia en relación a estrategias para la reducción dimensional. Por otro lado se muestra una experiencia en el diseño y desarrollo de un sistema flexible basado en pipeless y pipelines.

CT and MRI findings of 4th ventricular tumors

International Nuclear Information System (INIS)

Kim, Taek Geun; Ro, Hee Jeong; Byun, Jae Young; Lee, Han Jin; Chung, Myung Hee; Choi, Kyu Ho; Shinn, Kyung Sub

1994-01-01

The purpose of our study is to evaluate characteristic features of 4th ventricular tumors in CT and MRI. Pathologically proved 9 patients with 4th ventricular tumor were examined by CT and/or MRI. 4th ventricular tumors were ependymoma(4 cases), medulloblastoma(2 case), choroid plexus papilloma(2 cases), and oligodendroglioma(1 cases). Include in our study were only those mass lesions that were located at surgery predominantly within 4th ventricle with or without ventricular expansion. The origin of 4th ventricular tumor was the roof (ependymoma 3 cases, medulloblastoma 2 cases), the floor (ependymoma 1 cases), and the undetermined(remaining 3 case). On MRI, all tumors were hypointense except ependymoma (3 cases) showing isointensity on T1WI. All tumors were hypointense on PDWI and T2WI. On Gd-DTPA enhanced T1WI, strong enhancement was seen in all but ependymoma(1 cases) which showed mild enhancement. On CT, as compared with MR images, various density on precontrast and postcontrast images were seen. Calcification was seen in choroid plexus papilloma(1 caes) and oligodendroglioma(1 cases). Hydrocephalus is seen in all cases except ependymoma(2 cases) and oligodendroglioma(1 case). Hemorrhage within tumor was present only in ependymoma(2 cases). Cystic change or necrosis of tumor was seen in ependymoma(3 cases), choroid plexus papilloma(1 case), and oligodendroglioma(1 case). Peritumoral edema was seen in medulloblastoma(1 case). Extension through the foramen Luschka and the Megendie was seen in ependymoma (2 cases), choroid plexus(2 cases), and medulloblastoma (1 case). Seeing along the CSF pathway was seen only in ependymoma(2 case). The results od our study may suggest that specific diagnosis of 4th ventricular tumor can be suggested preoperatively by analysing the origin in 4th ventricle, difference of CT density or MRI signal intensity, presence of extension or seeding through cerebrospinal fluid of the lesion

Repaired tetralogy of Fallot with coexisting unrepaired partial anomalous pulmonary venous connection is associated with diminished right ventricular ejection fraction and more severe right ventricular dilation

International Nuclear Information System (INIS)

Chan, Sherwin S.; Whitehead, Kevin K.; Kim, Timothy S.; Fu, Gregory L.; Fogel, Mark A.; Harris, Matthew A.; Keller, Marc S.

2015-01-01

There is an established association between tetralogy of Fallot and partial anomalous pulmonary venous connections. This association is important because surgically repaired tetralogy patients have increased risk of right heart failure. We hypothesize that partial anomalous venous connections increase right ventricular volumes and worsen right ventricular failure. We reviewed cardiac MRI exams performed at a tertiary pediatric hospital from January 2005 to January 2014. We identified patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection. We used age- and gender-matched repaired tetralogy patients without partial anomalous pulmonary venous connection as controls. We analyzed the MRI results and surgical course and performed comparative statistics to identify group differences. There were eight patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection and 16 controls. In all cases, the partial anomalous pulmonary venous connection was not detected on preoperative echocardiography. There were no significant differences in surgical course and body surface area between the two groups. Repaired tetralogy patients with unrepaired partial anomalous pulmonary venous connection showed significantly higher indexed right ventricular end diastolic volume (149 ± 33 mL/m 2 vs. 118 ± 30 mL/m 2 ), right ventricle to left ventricle size ratios (3.1 ± 1.3 vs. 1.9 ± 0.5) and a higher incidence of reduced right ventricular ejection fraction compared to controls (3/8 vs. 0/16). Repaired tetralogy of Fallot with unrepaired partial anomalous pulmonary venous connection is associated with reduced right ventricular ejection fraction and more significant right ventricular dilation. (orig.)

Repaired tetralogy of Fallot with coexisting unrepaired partial anomalous pulmonary venous connection is associated with diminished right ventricular ejection fraction and more severe right ventricular dilation

Energy Technology Data Exchange (ETDEWEB)

Chan, Sherwin S. [Children' s Mercy Hospital and Clinics, Department of Radiology, Kansas City, MO (United States); Whitehead, Kevin K.; Kim, Timothy S.; Fu, Gregory L.; Fogel, Mark A.; Harris, Matthew A. [Children' s Hospital of Philadelphia, Department of Cardiology, Philadelphia, PA (United States); Keller, Marc S. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

2015-09-15

There is an established association between tetralogy of Fallot and partial anomalous pulmonary venous connections. This association is important because surgically repaired tetralogy patients have increased risk of right heart failure. We hypothesize that partial anomalous venous connections increase right ventricular volumes and worsen right ventricular failure. We reviewed cardiac MRI exams performed at a tertiary pediatric hospital from January 2005 to January 2014. We identified patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection. We used age- and gender-matched repaired tetralogy patients without partial anomalous pulmonary venous connection as controls. We analyzed the MRI results and surgical course and performed comparative statistics to identify group differences. There were eight patients with repaired tetralogy and unrepaired partial anomalous pulmonary venous connection and 16 controls. In all cases, the partial anomalous pulmonary venous connection was not detected on preoperative echocardiography. There were no significant differences in surgical course and body surface area between the two groups. Repaired tetralogy patients with unrepaired partial anomalous pulmonary venous connection showed significantly higher indexed right ventricular end diastolic volume (149 ± 33 mL/m{sup 2} vs. 118 ± 30 mL/m{sup 2}), right ventricle to left ventricle size ratios (3.1 ± 1.3 vs. 1.9 ± 0.5) and a higher incidence of reduced right ventricular ejection fraction compared to controls (3/8 vs. 0/16). Repaired tetralogy of Fallot with unrepaired partial anomalous pulmonary venous connection is associated with reduced right ventricular ejection fraction and more significant right ventricular dilation. (orig.)

Continuous monitoring of left ventricular function by VEST

International Nuclear Information System (INIS)

Ohtake, Tohru; Watanabe, Toshiaki; Kosaka, Noboru

1988-01-01

Using an ambulatory ventricular function monitor (VEST), left ventricular function (LVF) was examined in one healthy volunteer, 3 with ischemic heart disease, and one with dilated myocardiopathy (DMCP) under various conditions, such as treadmill exercise, standing, and sitting. It was also examined when two DCMP patients with associated left ventricular failure were given a nitrite (ISDM) and cardiotonic agent (E 1020). End-diastolic volume (EDV) decreased in the standing position, and increased in exercise, suggesting the involvement of venous blood pool in the legs. Ejection fraction (EF) decreased in the case of widespread ischemia during exercise. Drug tolerance test revealed decrease in EDV and end-systolic volume (ESV), no change in stroke volume (SV), and slight increase in EF on ISDM; and decrease in EDV and ESV, increase in SV, and marked increase in EF on E 1020. For EF, the VEST data were relatively well correlated with gamma camera data. (Namekawa, K.)

Del marketing tradicional al marketing experiencial: la era de las experiencias

OpenAIRE

Rodríguez Herrero, Alba

2016-01-01

En este trabajo se ha realizado una búsqueda bibliográfica del marketing experiencial, un estilo de marketing conocido por el uso de emociones y experiencias para atraer, conectar y retener al consumidor del siglo XXI de una forma innovadora y eficaz. Durante el mismo, se describe la evolución del marketing tradicional al marketing experiencial y las nuevas tendencias de consumering y neuromarketing sobre las que se sustenta el marketing experiencial. Así mismo se describen las característica...

EXPERIENCIA SUBJETIVA DE ESTUDIANTES Y DOCENTES QUE VIVENCIAN UN CAMBIO CURRICULAR

OpenAIRE

Rivas R, Edith; Bustos M, Luis; Rivas L, Ángélica; Lagos P, Ximena; San Martín G, Silvia

2012-01-01

Objetivo: Conocer la experiencia subjetiva de estudiantes y docentes respecto del cambio curricular. Metodología: Estudio transversal, muestra de 169 estudiantes de cuarto año curricular y 32 docentes. Información recogida en cuestionario “Inquietudes y procedimientos para adoptar Innovaciones Educativas” (IPIE) validado y adaptado al estudio. Análisis descriptivo. Estudio respetó normas éticas y consentimiento informado. Resultados: 26,0% de alumnos correspondió a Tecnología Médica; 22,5% En...

La "visión del aura" como experiencia alucinatoria en individuos no-clinicos The aura experience as cognitive perceptual schizotypy in non-clinical population

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Alejandro Parra

2008-12-01

Full Text Available Individuos que dicen ver el aura/energía en forma espontánea también tienden a tener un nivel más elevado de actividad imaginativa/fantaseosa o de propensidad a la fantasía. Hay indicadores que muestran que quienes experimentan alta capacidad de absorción, usualmente experimentan también diversas formas parasomáticas, alucinaciones táctiles, y sensaciones de energías sutiles, asi como también ideación esquizotípica, error perceptual, y mayor sinestesia. El objetivo es correlacionar puntajes de absorción psicológica, disociación, propensidad a la fantasía, intensidad de la imaginería, y tendencia a la esquizotipia en individuos que dicen ver el aura (N=83 en comparación con un grupo sin experiencias (N=503. La muestra incluyó 678 estudiantes de psicología de ambos sexos, 449 (76,5% mujeres y 139 (23,5% varones, cuya rango etario es de 17 y 57 años (Media=25,54; SD=7,22 residentes en la Ciudad de Buenos Aires y alrededores. Ningun estudiante recibió compensación económica. Respecto a la experiencia de ver el aura, se formuló la pregunta de la siguiente manera: "¿Ha tenido alguna experiencia usted es capaz de ver campos de energia o luces alrededor del cuerpo de una persona? (si duda, por favor, responda no". Si la respuesta es afirmativa, la pregunta también mapea tres dimensiones de la experiencia: frecuencia de la experiencia, explicación subjetiva (racional, desconocida y paranormal de la experiencia, y positivo o negativo impacto (emocional en una escala Likert, siendo 1 positivo y 7 negativo. Los resultados muestran mayor nivel de esquizotipia cognitivo perceptual en comparación con quienes no tienen la experiencia. Posiblemente, estas personas tienen mucha más intensa vida imaginativa. Esta experiencia no necesariamente posee un significado psicopatológico para el individuo; quienes ven el aura simplemente podrían ser sensibles a las experiencias perceptuales anómalas.Individuals who claim being able to

Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease

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Perez Amanda Arantes

2003-01-01

Full Text Available OBJECTIVE: To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients with Chagas' disease. METHODS: A cross-sectional study of 166 consecutive patients with Chagas' disease and no other associated diseases. The patients underwent cardiac assessment with chest radiography and Doppler echocardiography. Sensitivity, specificity, and positive and negative predictive values of chest radiography were calculated to detect left ventricular dysfunction and the accuracy of the cardiothoracic ratio in the diagnosis of left ventricular dysfunction with the area below the ROC curve. The cardiothoracic ratio was correlated with the left ventricular ejection fraction and the left ventricular diastolic diameter. RESULTS: The abnormal chest radiogram had a sensitivity of 50%, specificity of 80.5%, and positive and negative predictive values of 51.2% and 79.8%, respectively, in the diagnosis of left ventricular dysfunction. The cardiothoracic ratio showed a weak correlation with left ventricular ejection fraction (r=-0.23 and left ventricular diastolic diameter (r=0.30. The area calculated under the ROC curve was 0.734. CONCLUSION: The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction; its use as a screening method to initially approach the patient with Chagas' disease should be reevaluated.

Signal analysis of ventricular fibrillation

NARCIS (Netherlands)

Herbschleb, J.N.; Heethaar, R.M.; Tweel, L.H. van der; Zimmerman, A.N.E.; Meijler, F.L.

Signal analysis of electro(cardio)grams during ventricular fibrillation (VF) in dogs and human patients indicates more organization and regularity than the official WHO definition suggests. The majority of the signal is characterized by a power spectrum with narrow, equidistant peaks. In a further

184. Unidad de cardiopatías congénitas del adulto: Experiencia quirúrgica inicial

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J.L. Reyes-Juárez

2010-01-01

La complejidad y número de pacientes adultos afectos de CC ha aumentado en los últimos años. La formación de unidades de CC del adulto permiten reunir experiencia, casos y obtener buenos resultados. Los resultados de nuestro centro son similares a los comunicados.

Diabetes Mellitus Associates with Increased Right Ventricular Afterload and Remodeling in Pulmonary Arterial Hypertension.

Science.gov (United States)

Whitaker, Morgan E; Nair, Vineet; Sinari, Shripad; Dherange, Parinita A; Natarajan, Balaji; Trutter, Lindsey; Brittain, Evan L; Hemnes, Anna R; Austin, Eric D; Patel, Kumar; Black, Stephen M; Garcia, Joe G N; Yuan Md PhD, Jason X; Vanderpool, Rebecca R; Rischard, Franz; Makino, Ayako; Bedrick, Edward J; Desai, Ankit A

2018-06-01

Diabetes mellitus is associated with left ventricular hypertrophy and dysfunction. Parallel studies have also reported associations between diabetes mellitus and right ventricular dysfunction and reduced survival in patients with pulmonary arterial hypertension. However, the impact of diabetes mellitus on the pulmonary vasculature has not been well characterized. We hypothesized that diabetes mellitus and hyperglycemia could specifically influence right ventricular afterload and remodeling in patients with Group I pulmonary arterial hypertension, providing a link to their known susceptibility to right ventricular dysfunction. Using an adjusted model for age, sex, pulmonary vascular resistance, and medication use, associations of fasting blood glucose, glycated hemoglobin, and the presence of diabetes mellitus were evaluated with markers of disease severity in 162 patients with pulmonary arterial hypertension. A surrogate measure of increased pulmonary artery stiffness, elevated pulmonary arterial elastance (P = .012), along with reduced log(pulmonary artery capacitance) (P = .006) were significantly associated with the presence of diabetes mellitus in patients with pulmonary arterial hypertension in a fully adjusted model. Similar associations between pulmonary arterial elastance and capacitance were noted with both fasting blood glucose and glycated hemoglobin. Furthermore, right ventricular wall thickness on echocardiography was greater in pulmonary arterial hypertension patients with diabetes, supporting the link between right ventricular remodeling and diabetes. Cumulatively, these data demonstrate that an increase in right ventricular afterload, beyond pulmonary vascular resistance alone, may influence right ventricular remodeling and provide a mechanistic link between the susceptibility to right ventricular dysfunction in patients with both diabetes mellitus and pulmonary arterial hypertension. Copyright © 2018 Elsevier Inc. All rights reserved.

Profesores-artistas y didáctica generativa: Experiencias educativas en la universidad.

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Alejandra Montané-López

2009-01-01

Full Text Available El presente artículo es fruto del estudio de tesis doctoral que versa sobre las experiencias pedagógicas innovadoras del profesorado universitario vinculado con el Arte –específicamente con las artes escénicas- y que desarrolla su actividad profesional en los estudios de educación (Pedagogía, Educación Social y Magisterio. La estructura del mismo está compuesta por una introducción, un marco teórico-contextual, la metodología y unas conclusiones y propuestas. El análisis de los saberes didácticos nacidos de la génesis entre el saber pedagógico y el saber artístico configuran conceptualmente una didáctica generativa en el contexto universitario. Se delimitan las competencias complejas del profesorado universitario vinculado al Arte -a través del análisis de las experiencias pedagógicas en educación superior- partiendo inicialmente del modelo del “artista pedagogo” (Barret, 1995; Laferrièrre,2000 sumergiéndose en las configuraciones didácticas alternativas e innovadoras que actualmente encuentran su adecuación con la declaración del 2009 como el Año Internacional de la Creatividad y la Innovación.

218. Asistencia circulatoria de larga duración. Experiencia inicial

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J. Otero

2012-04-01

Conclusiones: La asistencia ventricular de larga duración es una terapia segura y efectiva en pacientes con cardiopatías terminales, ya sea como puente a trasplante, recuperación o terapia de destino.

A novel implantable electromechanical ventricular assist device - First acute animal testing

NARCIS (Netherlands)

Kaufmann, R; Rakhorst, G; Mihaylov, D; Elstrodt, J; Nix, C; Reul, H; Rau, G

1997-01-01

A novel ventricular assist device (HIA-EMLVAD-AT1, Helmholtz Institute Aachen-electromechanical Left Ventricular Assist Device-Animal Test Version 1), driven by a uniformly and unidirectionally rotating actuator and a patented hypocycloidic pusherplate displacement gear unit, was developed and

Computational model based approach to analysis ventricular arrhythmias: Effects of dysfunction calcium channels

Science.gov (United States)

Gulothungan, G.; Malathi, R.

2018-04-01

Disturbed sodium (Na+) and calcium (Ca2+) handling is known to be a major predisposing factor for life-threatening cardiac arrhythmias. Cardiac contractility in ventricular tissue is prominent by Ca2+ channels like voltage dependent Ca2+ channels, sodium-calcium exchanger (Na+-Ca2+x) and sacroplasmicrecticulum (SR) Ca2+ pump and leakage channels. Experimental and clinical possibilities for studying cardiac arrhythmias in human ventricular myocardium are very limited. Therefore, the use of alternative methods such as computer simulations is of great importance. Our aim of this article is to study the impact on action potential (AP) generation and propagation in single ventricular myocyte and ventricular tissue under different dysfunction Ca2+ channels condition. In enhanced activity of Na+-Ca2+x, single myocyte produces AP duration (APD90) and APD50 is significantly smaller (266 ms and 235 ms). Its Na+-Ca2+x current at depolarization is increases 60% from its normal level and repolarization current goes more negative (nonfailing= -0.28 pA/pF and failing= -0.47 pA/pF). Similarly, same enhanced activity of Na+-Ca2+x in 10 mm region of ventricular sheet, raises the plateau potential abruptly, which ultimately affects the diastolic repolarization. Compare with normal ventricular sheet region of 10 mm, 10% of ventricular sheet resting state is reduces and ventricular sheet at time 250 ms is goes to resting state very early. In hypertrophy condition, single myocyte produces APD90 and APD50 is worthy of attention smaller (232 mS and 198 ms). Its sodium-potassium (Na+-K+) pump current is 75% reduces from its control conditions (0.13 pA/pF). Hypertrophy condition, 50% of ventricular sheet is reduces to minimum plateau potential state, that starts the repolarization process very early and reduces the APD. In a single failing SR Ca2+ channels myocyte, recovery of Ca2+ concentration level in SR reduces upto 15% from its control myocytes. At time 290 ms, 70% of ventricular sheet

Synchronous intra-myocardial ventricular pacing without crossing the tricuspid valve or entering the coronary sinus

Energy Technology Data Exchange (ETDEWEB)

Konecny, Tomas; DeSimone, Christopher V.; Friedman, Paul A.; Bruce, Charles [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Asirvatham, Samuel J., E-mail: asirvatham.samuel@mayo.edu [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Department of Pediatric and Adolescent Medicine, Pediatric Cardiology, Mayo Clinic, Rochester, MN (United States)

2013-05-15

Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the “atrio-ventricular septum” without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which the cathode and anode are both intra-myocardial. We demonstrate safety and efficacy of this novel lead for ventricular pacing at the atrio-ventricular septum in canines, including improved synchronous activation of both ventricles, improved differentiation in ventricular versus atrial sensing, while providing reliable ventricular capture, opening novel and a potentially safer alternative to human cardiac resynchronization therapy.

Experiencias de la Corporación Universitaria Adventista en la doble titulación académica

OpenAIRE

Iglesias, Enoc; Corporación Adventista

2015-01-01

En el presente articulo no derivado de investigaciones, se muestran varios aspectos de las experiencias que ha tenido la Corporación Universitaria Adventista en la doble titulación, tema de gran actualidad.

Left ventricular heart failure and pulmonary hypertension†

Science.gov (United States)

Rosenkranz, Stephan; Gibbs, J. Simon R.; Wachter, Rolf; De Marco, Teresa; Vonk-Noordegraaf, Anton; Vachiéry, Jean-Luc

2016-01-01

Abstract In patients with left ventricular heart failure (HF), the development of pulmonary hypertension (PH) and right ventricular (RV) dysfunction are frequent and have important impact on disease progression, morbidity, and mortality, and therefore warrant clinical attention. Pulmonary hypertension related to left heart disease (LHD) by far represents the most common form of PH, accounting for 65–80% of cases. The proper distinction between pulmonary arterial hypertension and PH-LHD may be challenging, yet it has direct therapeutic consequences. Despite recent advances in the pathophysiological understanding and clinical assessment, and adjustments in the haemodynamic definitions and classification of PH-LHD, the haemodynamic interrelations in combined post- and pre-capillary PH are complex, definitions and prognostic significance of haemodynamic variables characterizing the degree of pre-capillary PH in LHD remain suboptimal, and there are currently no evidence-based recommendations for the management of PH-LHD. Here, we highlight the prevalence and significance of PH and RV dysfunction in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), and provide insights into the complex pathophysiology of cardiopulmonary interaction in LHD, which may lead to the evolution from a ‘left ventricular phenotype’ to a ‘right ventricular phenotype’ across the natural history of HF. Furthermore, we propose to better define the individual phenotype of PH by integrating the clinical context, non-invasive assessment, and invasive haemodynamic variables in a structured diagnostic work-up. Finally, we challenge current definitions and diagnostic short falls, and discuss gaps in evidence, therapeutic options and the necessity for future developments in this context. PMID:26508169

Calculation of cardiac pressures using left ventricular ejection fraction (LVEF) derived from radionuclide angiography

International Nuclear Information System (INIS)

Hommer, E.

1981-01-01

An attempt has been made to develop formulas to determine cardiac pressures in an undisturbed flow in patients without valvular or shunt diseases. These are based entirely on the results of left ventricular ejection fraction rates, permitting pressure analysis of several compartments at the same tine. According to BORER et al. they also enable determination of left ventricular 'Functional Reserve' after bycycle exercise as well as left ventricular 'Relaxation Reserve'. They support the views of NYHA in determining the grades of cardiac insufficiency proving the system- and low-pressure participation. A single formula for pulmonary flow can determine the pulmonary arterial pressure. The left ventricular enddiastolic pressure can also be exclusively calculated by values of left ventricular functions, thus both formulas may be used in disorders of the mitral valves. The possibility to calculate pressures of all the compartments of the heart from left ventricular ejection rate shows, that in undisturbed flow global heart function depends on left ventricular function. Therefore the mutual dependence of these formulas presents an intercompartimental pressure regulation of the heart through pulmonary flow and pulmonary vascular pressure, which leaves an aspect of autonomous cardiac regulation open to discussion. (orig.) [de

Diclofenac prolongs repolarization in ventricular muscle with impaired repolarization reserve.

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Attila Kristóf

Full Text Available BACKGROUND: The aim of the present work was to characterize the electrophysiological effects of the non-steroidal anti-inflammatory drug diclofenac and to study the possible proarrhythmic potency of the drug in ventricular muscle. METHODS: Ion currents were recorded using voltage clamp technique in canine single ventricular cells and action potentials were obtained from canine ventricular preparations using microelectrodes. The proarrhythmic potency of the drug was investigated in an anaesthetized rabbit proarrhythmia model. RESULTS: Action potentials were slightly lengthened in ventricular muscle but were shortened in Purkinje fibers by diclofenac (20 µM. The maximum upstroke velocity was decreased in both preparations. Larger repolarization prolongation was observed when repolarization reserve was impaired by previous BaCl(2 application. Diclofenac (3 mg/kg did not prolong while dofetilide (25 µg/kg significantly lengthened the QT(c interval in anaesthetized rabbits. The addition of diclofenac following reduction of repolarization reserve by dofetilide further prolonged QT(c. Diclofenac alone did not induce Torsades de Pointes ventricular tachycardia (TdP while TdP incidence following dofetilide was 20%. However, the combination of diclofenac and dofetilide significantly increased TdP incidence (62%. In single ventricular cells diclofenac (30 µM decreased the amplitude of rapid (I(Kr and slow (I(Ks delayed rectifier currents thereby attenuating repolarization reserve. L-type calcium current (I(Ca was slightly diminished, but the transient outward (I(to and inward rectifier (I(K1 potassium currents were not influenced. CONCLUSIONS: Diclofenac at therapeutic concentrations and even at high dose does not prolong repolarization markedly and does not increase the risk of arrhythmia in normal heart. However, high dose diclofenac treatment may lengthen repolarization and enhance proarrhythmic risk in hearts with reduced repolarization reserve.

Reversible left ventricular dysfunction - important clinical problem of contemporary cardiology

International Nuclear Information System (INIS)

Witkowski, A.

1994-01-01

An important clinical issue there is determination whether left ventricular damages are reversible or not single photon emission computed tomography and positron computed tomography techniques are shown to provide valuable data in this problem. Article describes basic syndromes connected with left ventricular dysfunction, namely: hibernating myocardium, stunned myocardium and ischemic myocardium preconditioning. (author). 18 refs

Subclinical changes in MRI-determined right ventricular volumes and function in subjects with prediabetes and diabetes.

Science.gov (United States)

Patscheider, Hannah; Lorbeer, Roberto; Auweter, Sigrid; Schafnitzel, Anina; Bayerl, Christian; Curta, Adrian; Rathmann, Wolfgang; Heier, Margit; Meisinger, Christa; Peters, Annette; Bamberg, Fabian; Hetterich, Holger

2018-07-01

The aim of this study was to assess subclinical changes in right ventricular volumes and function in subjects with prediabetes and diabetes and controls without a history of cardiovascular disease. Data from 400 participants in the KORA FF4 study without self-reported cardiovascular disease who underwent 3-T whole-body MRI were obtained. The right ventricle was evaluated using the short axis and a four-chamber view. Diabetes was defined according to WHO criteria. Associations between glucose tolerance and right ventricular parameters were assessed using multivariable adjusted linear regression models. Data from 337 participants were available for analysis. Of these, 43 (13%) had diabetes, 87 (26%) had prediabetes, and 207 (61%) were normoglycaemic controls. There was a stepwise decrease in right ventricular volumes in men with prediabetes and diabetes in comparison with controls, including right ventricular end-diastolic volume (β = -20.4 and β = -25.6, respectively; p ≤ 0.005), right ventricular end-systolic volume (β = -12.3 and β = -12.7, respectively; p ≤ 0.037) and right ventricular stroke volume (β = -8.1 and β = -13.1, respectively, p ≤ 0.016). We did not observe any association between prediabetes or diabetes and right ventricular volumes in women or between prediabetes or diabetes and right ventricular ejection fraction in men and women. This study points towards early subclinical changes in right ventricular volumes in men with diabetes and prediabetes. • MRI was used to detect subclinical changes in right ventricular parameters. • Diabetes mellitus is associated with right ventricular dysfunction. • Impairment of right ventricular volumes seems to occur predominantly in men.

Assessment of right ventricular afterload in mitral valve diseases with radionuclide angiography

International Nuclear Information System (INIS)

Shimizu, Mitsuharu; Nakagawa, Tomio; Kohno, Yoshihiro; Kuroda, Masahiro; Takeda, Yoshihiro; Hiraki, Yoshio; Nagaya, Isao; Senoh, Yoshimasa; Teramoto, Shigeru

1991-01-01

Right ventricular function at rest and during exercise was studied in 33 patients with mitral valve disease by equilibrium gated radionuclide angiography using 99m Tc in vivo labeled red blood cells. Radionuclide measurements of right ventricular ejection fraction (RVEF) were correlated with mean pulmonary arterial pressure (mPAP). RVEF decreased significantly with exercise. There was no significant correlation between RVEF at rest and mPAP. However, mPAP showed significant negative correlation with RVEF during exercise and with the changes of RVEF from rest to exercise. It is concluded that RVEF during exercise in mitral valve disease is affected by right ventricular afterload, and the measurements of RVEF at rest and during exercise by equilibrium gated radionuclide angiography is useful to assess right ventricular afterload. (author)

His-Purkinje system-related incessant ventricular tachycardia arising from the left coronary cusp

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Eiji Sato, MD

2014-08-01

Full Text Available We describe the case of a 23-year-old woman who had His-Purkinje system-related incessant ventricular tachycardia with a narrow QRS configuration. The ventricular tachycardia was ablated successfully in the left coronary cusp where the earliest endocardial activation had been recorded. We hypothesize that a remnant of the subaortic conducting tissue was the source of the ventricular arrhythmias.

Ventricular function during the acute rejection of heterotopic transplanted heart: Gated blood pool studies

International Nuclear Information System (INIS)

Valette, H.; Bourguignon, M.H.; Desruennes, M.; Merlet, P.; Le Guludec, D.; Syrota, A.

1991-01-01

Twenty patients who had undergone a heterotopic heart transplant were studied prospectively to determine the relationship between rejection and ventricular dysfunction assessed from gated blood pool studies. A fully automated method for detecting ventricular edges was implemented; its success rate for the grafted left and right ventricles was 94% and 77%, respectively. The parameters, peak ejection and filling rates, were calculated pixel per pixel using a two-harmonic Fourier algorithm and then averaged over the ventricular region of interest. Peak filling and ejection rates were closely related with the severity of the rejection, while the left ventricular ejection fraction was not. Peak filling rates of both ventricles were the indices closely related to the presence of moderate rejection. Despite the low number of patients, these data suggested that gated blood pool derived indices of ventricular function are associated with ventricular dysfunction resulting from myocarditis rejection. Radionuclide ventriculography provides parametric data which are accurate and reliable for the diagnosis of rejection. (orig.)

EVALUACIÓN ECOCARDIOGRÁFICA DE LA FUNCIÓN VENTRICULAR IZQUIERDA EN CENTENARIOS / Echocardiographic assessment of left ventricular function in centenarians

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Vanessa Peña-Bofill

2013-10-01

Full Text Available Resumen Introducción: El envejecimiento poblacional es un fenómeno mundial y constituye un logro de la humanidad. Objetivo: Caracterizar ecocardiográficamente la función ventricular izquierda de pacientes ambulatorios mayores de 100 años del municipio Plaza de la Revolución, en el período de septiembre del 2009 a septiembre del 2010. Método: Se realizó un estudio descriptivo de corte transversal con 20 longevos, en el Departamento de Ecocardiografía del Hospital Universitario "General Calixto García", a los cuáles se les realizó ecocardiograma para evaluar la función ventricular izquierda. Resultados: La edad media fue de 102 años, predominó el sexo femenino con 15 pacientes (75 % y el 50 % tenía color de piel blanco. El factor de riesgo coronario de mayor prevalencia fue la hipertensión arterial (40 %; la diabetes mellitus tipo 2, el tabaquismo y la dislipidemia le sucedieron en orden. Los centenarios tenían conservada la función sistólica del ventrículo izquierdo (90 % con poca tendencia a la supernormalidad, una paciente presentó trastornos segmentarios de la contractilidad en cara inferior, lo que correspondía a antecedentes de infarto de miocardio. Cuatro centenarios tenían patrón de llenado normal, 11 presentaron alteración de la relajación ventricular y cinco patrones pseudonormales. Conclusiones: En los centenarios estudiados se mantiene una función sistólica del ventrículo izquierdo evaluada por ecocardiografía, dentro de parámetros normales, con signos de disfunción diastólica leve. / Abstract Introduction: Population aging is a global phenomenon and an achievement of mankind. Objective: To characterize left ventricular function by echocardiography in ambulatory patients over 100 years old in Plaza de la Revolution Municipality, between September 2009 and September 2010. Method: A descriptive cross-sectional study was carried out with 20 long-lived people, in the Department of Echocardiography of

10-year follow-up after radiofrequency ablation of idiopathic ventricular arrhythmias from right ventricular outflow tract

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Synne Dragesund Rørvik

2016-05-01

Conclusions: A reduction of symptoms and use of antiarrhythmic medication, as well as an improvement in the general health perception and fitness to work after RFA of idiopathic ventricular arrhythmias can be demonstrated at ten-year follow-up.

Algunas experiencias de aplicación del aprendizaje cooperativo y del aprendizaje basado en proyectos

OpenAIRE

García-Almiñana, Daniel; Amante García, Beatriz

2006-01-01

En esta comunicación se pretenden presentar algunas experiencias de aplicación del AC y ABP en distintas asignaturas impartidas en la Universidad Europea de Madrid y en la Universidad Politécnica de Catalunya, destacando los aspectos de mejora observados con respecto a la docencia convencional.

Normalised radionuclide measures of left ventricular diastolic function

International Nuclear Information System (INIS)

Lee, K.J.; Southee, A.E.; Bautovich, G.J.; Freedman, B.; McLaughlin, A.F.; Rossleigh, M.A.; Hutton, B.F.; Morris, J.G.; Royal Prince Alfred Hospital, Sydney

1989-01-01

Abnormal left ventricular diastolic function is being increasingly recognised in patients with clinical heart failure and normal systolic function. A simple routine radionuclide measure of diastolic function would therefore be useful. To establish, the relationship of peak diastolic filling rate (normalized for either end diastolic volume, stroke volume, or peak systolic emptying rate), and heart rate, age, and left ventricular ejection fraction was studied in 64 subjects with normal cardiovascular systems using routine gated heart pool studies. The peak filling rate when normalized to end diastolic volume correlated significantly with heart rate, age and left ventricular ejection fraction, whereas normalization to stroke volume correlated significantly to heart rate and age but not to left ventricular ejection fraction. Peak filling rate normalized for peak systolic emptying rate correlated with age only. Multiple regression equations were determined for each of the normalized peak filling rates in order to establish normal ranges for each parameter. When using peak filling rate normalized for end diastolic volume or stroke volume, appropriate allowance must be made for heart rate, age and ejection fraction. Peak filling rate normalized to peak ejection rate is a heart rate independent parameter which allows the performance of the patient's ventricle in diastole to be compared with its systolic function. It may be used in patients with normal systolic function to serially follow diastolic function, or if age corrected to screen for diastolic dysfunction. (orig.)

Pneumatic distension of ventricular mural architecture validated histologically

International Nuclear Information System (INIS)

Burg, M.C.; Heindel, W.; Lunkenheimer, P.; Niederer, P.; Brune, C.; Redmann, K.; Smerup, M.; Spiegel, U.; Becker, F.; Maintz, D.; Cologne Univ.; Anderson, R.H.

2016-01-01

There are ongoing arguments as to how cardiomyocytes are aggregated together within the ventricular walls. We used pneumatic distension through the coronary arteries to exaggerate the gaps between the aggregated cardiomyocytes, analyzing the pattern revealed using computed tomography, and validating our findings by histology. We distended 10 porcine hearts, arresting 4 in diastole by infusion of cardioplegic solutions, and 4 in systole by injection of barium chloride. Mural architecture was revealed by computed tomography, measuring also the angulations of the long chains of cardiomyocytes. We prepared the remaining 2 hearts for histology by perfusion with formaldehyde. Increasing pressures of pneumatic distension elongated the ventricular walls, but produced insignificant changes in mural thickness. The distension exaggerated the spaces between the aggregated cardiomyocytes, compartmenting the walls into epicardial, central, and endocardial regions, with a feathered arrangement of transitions between them. Marked variation was noted in the thicknesses of the parts in the different ventricular segments, with no visible anatomical boundaries between them. Measurements of angulations revealed intruding and extruding populations of cardiomyocytes that deviated from a surface-parallel alignment. Scrolling through the stacks of tomographic images revealed marked spiraling of the aggregated cardiomyocytes when traced from base to apex. Our findings call into question the current assumption that cardiomyocytes are uniformly aggregated together in a tangential fashion. There is marked heterogeneity in the architecture of the different ventricular segments, with the aggregated units never extending in a fully transmural fashion.

Pneumatic distension of ventricular mural architecture validated histologically

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Burg, M.C.; Heindel, W. [University Hospital Muenster (Germany). Dept. of Clinical Radiology; Lunkenheimer, P. [University Hospital Muenster (Germany). Dept. of Experimental Thoraco-vascular Surgery; Niederer, P. [ETH and University of Zuerich (Switzerland). Inst. for Biomedical Engineering; Brune, C. [Twente Univ. (Netherlands). Dept. of Applied Mathematics; Redmann, K. [University Hospital Muenster (Germany). Center for Reproductive Medicine and Andrology; Smerup, M. [Aarhus University Hospital (Denmark). Dept. of Cardiothoracic and Vascular Surgery; Spiegel, U.; Becker, F. [University Hospital Muenster (Germany). Dept. Surgical Research; Maintz, D. [University Hospital Muenster (Germany). Dept. of Clinical Radiology; Cologne Univ. (Germany). Dept. of Radiology; Anderson, R.H. [Newcastle Univ., London (United Kingdom). Inst. of Genetic Medicine

2016-11-15

There are ongoing arguments as to how cardiomyocytes are aggregated together within the ventricular walls. We used pneumatic distension through the coronary arteries to exaggerate the gaps between the aggregated cardiomyocytes, analyzing the pattern revealed using computed tomography, and validating our findings by histology. We distended 10 porcine hearts, arresting 4 in diastole by infusion of cardioplegic solutions, and 4 in systole by injection of barium chloride. Mural architecture was revealed by computed tomography, measuring also the angulations of the long chains of cardiomyocytes. We prepared the remaining 2 hearts for histology by perfusion with formaldehyde. Increasing pressures of pneumatic distension elongated the ventricular walls, but produced insignificant changes in mural thickness. The distension exaggerated the spaces between the aggregated cardiomyocytes, compartmenting the walls into epicardial, central, and endocardial regions, with a feathered arrangement of transitions between them. Marked variation was noted in the thicknesses of the parts in the different ventricular segments, with no visible anatomical boundaries between them. Measurements of angulations revealed intruding and extruding populations of cardiomyocytes that deviated from a surface-parallel alignment. Scrolling through the stacks of tomographic images revealed marked spiraling of the aggregated cardiomyocytes when traced from base to apex. Our findings call into question the current assumption that cardiomyocytes are uniformly aggregated together in a tangential fashion. There is marked heterogeneity in the architecture of the different ventricular segments, with the aggregated units never extending in a fully transmural fashion.

Experiencia de las madres durante el contacto piel a piel al nacimiento

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P.K. García May

2017-12-01

Full Text Available Resumen: Introducción y objetivo: Las madres disfrutan la experiencia del contacto piel a piel inmediatamente después del nacimiento y se plantea la posibilidad de que tal contacto pueda ayudar a estas madres a sentirse más seguras con sus bebés. Objetivo: describir la experiencia de las madres durante el contacto piel a piel al nacer por parto y cesárea. Material y métodos: Estudio transversal, descriptivo, observacional, prospectivo, realizado en la Unidad Tocoquirúrgica del Instituto Nacional de Perinatología, en la Ciudad de México, durante el contacto piel a piel madre-hijo al nacimiento, en los recién nacidos a término sanos, durante el período comprendido desde el 1 de septiembre de 2015 al 31 de julio de 2016. Se les pidió a las madres describir su experiencia durante el contacto piel con piel al nacimiento. Los resultados se analizaron utilizando Wizard Pro Versión 1.9.7. Resultados: Se obtuvo entrevista de 779 mamás, a las que se les realizó contacto piel a piel al nacimiento durante 11 meses. Se categorizó por nivel de satisfacción como muy satisfactorio, satisfactorio y poco satisfactorio, encontrando que 570 casos (73.2% se categorizaron como muy satisfactorio, 201 (25.8% como satisfactorio y 8 (3% como poco satisfactorio. En cuanto al nivel de satisfacción y la vía de nacimiento, no hubo diferencias estadísticamente significativas (p = 0.212, por lo que podemos inferir que el grado de satisfacción de la madre es independiente de la vía de nacimiento. Conclusiones: La colocación del recién nacido sobre el pecho de la madre después del nacimiento es una experiencia feliz y muy satisfactoria para la gran mayoría de la madres. Abstract: Introduction and objective: Mothers enjoy the experience of skin-to-skin contact immediately after birth, and this raises the possibility that such contact can help these mothers feel more secure with their babies

Relationship between obesity and left ventricular hypertrophy in children

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Johnny Rompis

2016-10-01

Full Text Available Background Obesity is a chronic metabolic disorder associated with cardiovascular disease (CVD increasing morbidity-mortality rates. It is apparent that a variety of adaptations/alterations in cardiac structure and function occurs as excessive adipose tissue accumulates. This leads to a decrease in diastolic compliance, eventually resulting in an increase in left ventricular filling pressure and left ventricular enlargement. Objective To evaluate left ventricular hypertrophy (LVH among  obese using electrocardiographic (ECG criteria. Methods A cross-sectional study was conducted on 74 children aged 10-15 years from February 2009 to October 2009. The subjects were divided into obese and control groups. Physical examination and standard 12 lead electrocardiography (ECG were done in both groups. Results Of 37 obese children, LVH were featured in 3 subjects, while in control group, only 1 child had LVH (P= 0.304. We found that mean RV6 in obese and control group were 9.8446 (SD 3.5854 and 11.9662 (SD 3.2857, respectively (P=0.005. As an additional findings, we found that birth weight was related to obesity in children. Conclusion There is no relation between obesity and left ventricular using ECG criteria in obese children aged 10-15 years.

Comparison of right ventricular septal pacing and right ventricular apical pacing in patients receiving cardiac resynchronization therapy defibrillators: the SEPTAL CRT Study

Science.gov (United States)

Leclercq, Christophe; Sadoul, Nicolas; Mont, Lluis; Defaye, Pascal; Osca, Joaquim; Mouton, Elisabeth; Isnard, Richard; Habib, Gilbert; Zamorano, Jose; Derumeaux, Genevieve; Fernandez-Lozano, Ignacio; Dupuis, Jean-Marc; Rouleau, Frédéric; Tassin, Aude; Bordachar, Pierre; Clémenty, Jacques; Lafitte, Stephane; Ploux, Sylvan; Reant, Patricia; Ritter, Philippe; Defaye, Pascal; Jacon, Peggy; Mondesert, Blandine; Saunier, Carole; Vautrin, Estelle; Kacet, Salem; Guedon-Moreau, Laurence; Klug, Didier; Kouakam, Claude; Marechaux, Sylvestre; Marquie, Christelle; Polge, Anne Sophie; Richardson, Marjorie; Chevallier, Philippe; De Breyne, Brigitte; Lotek, Marcin M.; Nonin, Emilie; Pineau, Julien; Deharo, Jean-Claude; Bastard, Emilie; Franceschi, Frédéric; Habib, Gilbert; Jego, Christophe; Peyrouse, Eric; Prevot, Sebastien; Saint-Joseph, Hôpital; Bremondy, Michel; Faure, Jacques; Ferracci, Ange; Lefevre, Jean; Pisapia, Andre; Davy, Jean-Marc; Cransac, Frederic; Cung, Tien Tri; Georger, Frederic; Pasquie, Jean-Luc; Raczka, Franck; Sportouch-Dukhan, Catherine; Sadoul, Nicolas; Blangy, Hugues; Bruntz, Jean-François; Freysz, Luc; Groben, Laurent; Huttin, Olivier; Bammert, Antoine; Burban, Marc; Cebron, Jean-Pierre; Gras, Daniel; Frank, Robert; Duthoit, Guillaume; Hidden-Lucet, Françoise; Himbert, Caroline; Isnard, Richard; Lacotte, Jérôme; Pousset, Françoise; Zerah, Thierry; Leclercq, Christophe; Bellouin, Annaïk; Crocq, Christophe; Deplace, Christian; Donal, Erwan; Hamon, Cécile; Mabo, Philippe; Romain, Olivier; Solnon, Aude; Frederic, Anselme; Bauer, Fabrice; Bernard, Mathieu; Godin, Benedicte; Kurtz, Baptiste; Savoure, Arnaud; Copie, Xavier; Lascault, Gilles; Paziaud, Olivier; Piot, Olivier; Touche, Thierry; Delay, Toulouse Marc; Chilon, Talia; Detis, Nicolas; Duparc, Alexandre; Hebrard, Aurélien; Massabuau, Pierre; Maury, Philippe; Mondoly, Pierre; Rumeau, Philippe; Pasteur, Clinique; Boveda, Serge; Adrover, Laurence; Combes, Nicolas; Deplagne, Antoine; Marco-Baertich, Isabelle; Fondard, Olivier; Martínez, Juan Gabriel; Ibañez Criado, José Luis; Ortuño, Diego; Mont, Lluis; Berruezo, Antonio; Eduard, Belu; Martín, Ana; Merschon, Franco M.; Sitges, Marta; Tolosana, José María; Vidal, Bárbara; Hebron, H. Valle; i Mitjans, Angel Moya; Rodriguez, Oscar Alcalde; Rodriguez Palomares, José Fernando; Rivas, Nuria; Teixidó, Gisela; de Hierro, H. Puerta; Lozano, Ignacio Fernández; Ruiz Bautista, Maria Lorena; Castro, Victor; Cavero, Miguel Angel; Gutierrez, Carlos; Ros, Natalia; de la Victoria, H. Virgen; Alzueta Rodriguez, Francisco Javier; Cabrera, Fernando; Cordero, Alberto Barrera; Peña, José Luis; de Valme Sevilla, H.; Gonzáles, Juan Lealdel Ojo; Garcia Medina, Mª Dolores; Jiménez, Ricardo Pavón; Villagomez, David; de la Salud Toledo, H. Virgen; Castellanos Martinez, Eduardo; Alcalá, Juan; Maicas, Carolina; Arias Palomares, Miguel Angel; Puchol, Alberto; Valencia, H. La Fé; OscaAsensi, Joaquim; Carmona, Anastasio Quesada; De Carranza, Mª José Sancho-Tello; De Ros, José Olagüe; Pareja, Enrique Castro; Pérez, Oscar Cano; Saez, Ana Osa; Hortega, H. Rio; Guilarte, Benito Herreros; Muñoz San Jose, Juan Francisco; Pérez Sanz, Teresa Myriam; Logeart, Damien; Gil, Maria Lopez; Leclercq, Christophe; Lozano, Ignacio Fernandez; de Hierro, H. Puerta; Derumeaux, Genevieve

2016-01-01

Abstract Aims Cardiac resynchronization therapy (CRT) is a recommended treatment of heart failure (HF) patients with depressed left ventricular ejection fraction and wide QRS. The optimal right ventricular (RV) lead position being a matter of debate, we sought to examine whether RV septal (RVS) pacing was not inferior to RV apical (RVA) pacing on left ventricular reverse remodelling in patients receiving a CRT-defibrillator. Methods and results Patients (n = 263, age = 63.4 ± 9.5 years) were randomly assigned in a 1:1 ratio to RVS (n = 131) vs. RVA (n = 132) pacing. Left ventricular end-systolic volume (LVESV) reduction between baseline and 6 months was not different between the two groups (−25.3 ± 39.4 mL in RVS group vs. −29.3 ± 44.5 mL in RVA group, P = 0.79). Right ventricular septal pacing was not non-inferior (primary endpoint) to RVA pacing with regard to LVESV reduction (average difference = −4.06 mL; P = 0.006 with a −20 mL non-inferiority margin). The percentage of ‘echo-responders’ defined by LVESV reduction >15% between baseline and 6 months was similar in both groups (50%) with no difference in the time to first HF hospitalization or death (P = 0.532). Procedural or device-related serious adverse events occurred in 68 patients (RVS = 37) with no difference between the two groups (P = 0.401). Conclusion This study demonstrates that septal RV pacing in CRT is non-inferior to apical RV pacing for LV reverse remodelling at 6 months with no difference in the clinical outcome. No recommendation for optimal RV lead position can hence be drawn from this study. ClinicalTrials. gov number NCT 00833352. PMID:26374852

Hypertension and left ventricular hypertrophy in liquidators of consequences of the Chernobyl nuclear accident

International Nuclear Information System (INIS)

Shal'nova, S.A.; Smolenskij, A.V.; Shamarin, V.M.; Ehktova, T.V.; Berzak, N.V.; Zemtsova, N.A.; Timofeeva, S.G.; Zhavoronkova, E.A.; Muromtseva, G.A.; Arkad'eva, M.A.; Deev, A.D.

1998-01-01

Echocardiography was used for the study of prevalence of left ventricular hypertrophy in 839 liquidators of consequences of the Chernobyl accident. Prevalence of left ventricular hypertrophy (left ventricular myocardial mass 134 g/m 2 ) was 10.3, 13.4 and 22.5 % in liquidators with normal blood pressure, borderline hypertension and hypertension, respectively. Liquidators with normal blood pressure had significantly greater left ventricular myocardial mass than normotensive men from general population while liquidators and non liquidators with hypertension had equal values of this parameter [ru

[Ventricular tachyarrhythmias in patients with cardiomyopathy

DEFF Research Database (Denmark)

Henningsen, K.; Christensen, A.H.; Svendsen, Jesper Hastrup

2008-01-01

by disease, gender, age, previous cardiac arrest and treatment with implantable cardioverter-defibrillator (ICD). RESULTS: 993 patients were screened and 128 patients with cardiomyopathy were identified, corresponding to 13% of the screened patients. 58 (45%) of the patients had dilated cardiomyopathy (DCM......), 57 (45%) patients had arrhythmogenic right ventricular cardiomyopathy (ARVC) and 13 (10%) had hypertrophic cardiomyopathy (HCM). The average age was 44 years for HCM, 41 years for ARVC and 58 years for DCM. The majority of the patients were male. ICD treatment was used in 95% of the patients...... with ARVC, 70% of the patients with HCM and 59% of the patients with DCM. Only 5 patients had previous cardiac arrest without reversible cause. CONCLUSION: The study shows that cardiomyopathies are relatively frequent causes of ventricular tachyarrhythmias in patients discharged from a specialised...

Esfuerzos nacionales para la implementación de las sentencias interamericanas: La experiencia mexicana

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Gladys Fabiola Morales Ramírez

2015-08-01

Full Text Available El presente artículo está dedicado al análisis de la experiencia de México en el cumplimiento de sentencias emitidas por la Corte Interamericana de Derechos Humanos, específicamente los esfuerzos de las autoridades nacionales en el diseño de instrumentos especializados para la implementación de estas decisiones.

Effects of AV delay programming on ventricular resynchronisation: role of radionuclide ventriculography

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Siegrist, Patrick T.; Comte, Nathalie; Holzmeister, Johannes; Suetsch, Gabor; Koepfli, Pascal; Namdar, Mehdi; Duru, Firat; Brunckhorst, Corinna; Scharf, Christoph [Universitiy Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [Universitiy Hospital Zurich NUK C 32, Cardiovascular Center, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology, Zurich (Switzerland)

2008-08-15

Optimal atrioventricular delay (AVD) setting for cardiac resynchronisation therapy, i.e. biventricular pacing in patients with heart failure, remains a formidable challenge. Thus, the purpose of this study was to evaluate the effects of different AVD on inter- and intra-ventricular resynchronisation using phase histograms of radionuclide ventriculography (RNV). In 17 consecutive patients (mean age 64 {+-} 6 years), RNV was performed 236 {+-} 350 days after pacemaker implantation for cardiac resynchronisation therapy. Images were acquired during atrial pacing at 80 bpm and during biventricular pacing with AVD ranging from 80 to 160 ms. Inter-ventricular dyssynchrony was measured by the delay between the mean phase angles of the left and right ventricles. Intra-ventricular dyssynchrony was measured by the standard deviation (SD) of left ventricular phase histograms. Left ventricular (LV) ejection fraction (EF) was inversely correlated to LV dyssynchrony (SD of LV phase histogram, R = -0.82, p < 0.0001). However, the increase in LVEF by biventricular pacing (mean +4.4 {+-} 4%) showed only modest correlation to the resulting resynchronisation effect (characterised by a -13 {+-} 8 decrease in LV phase histogram SD, R = -0.38, p < 0.0001). RNV is helpful in optimising pacing parameters for resynchronisation therapy. Varying AVD did not have a major impact on intra- or inter-ventricular resynchronisation. Thus, the benefit of AVD-based LVEF optimisation seems to result from atrioventricular resynchronisation. (orig.)

Simultaneous determination of left ventricular perfusion and function

International Nuclear Information System (INIS)

Gremillet, E.; Champailler, A.; Esquerre, J.P.; Ouhayoun, E.; Coca, F.; Furber, A.; Le Jeune, J.J.

1997-01-01

Myocardial perfusion scintigraphy is a very useful tool for the diagnosis and prognosis of coronary artery disease. The evaluation of left ventricular function during stress testing in also very useful to determine the prognosis of coronary artery disease. This chapter highlights three different imaging methods to assess left ventricular function and myocardial perfusion/ The first one consists of sequential dual isotope myocardial SPECT with ECG-gating. The second concerns magnetic resonance imaging and the third explores first pass exercise ventriculography and myocardial perfusion scintigraphy simultaneously evaluated by means of 99m Tc-sestamibi. (authors)

Heart transplantation in arrhythmogenic right ventricular cardiomyopathy - Experience from the Nordic ARVC Registry

DEFF Research Database (Denmark)

Gilljam, Thomas; Haugaa, Kristina H; Jensen, Henrik K

2018-01-01

OBJECTIVE: There is a paucity of data on heart transplantation (HTx) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), and specific recommendations on indications for listing ARVC patients for HTx are lacking. In order to delineate features pertinent to HTx assessment, we......%) and ventricular arrhythmias in 3 patients (10%). During median follow-up of 4.9years (0.04-28), there was one early death and two late deaths. Survival was 91% at 5years after HTx. Age at first symptoms under 35years independently predicted HTx in our cohort (OR=7.59, 95% CI 2.69-21.39, p... consequences of right ventricular failure in conjunction with ventricular arrhythmia....

[Surgical treatment of congenital obstruction of the left ventricular outflow tract].

Science.gov (United States)

Biocina, B; Sutlić, Z; Husedinović, I; Letica, D; Sokolić, J

1993-01-01

This report presents the classification and all types of left ventricular outflow tract obstructions. The possibilities of operative therapies are surveyed as well. Results of surgical treatment in 34 patients with obstruction to left ventricular outflow are shown. The majority of patients underwent operation under extracorporeal circulation (84.4%), while the rest were operated by means of the inflow occlusion technique (14.7%). The obtained results were compared with those from the literature. The importance of echocardiographic evaluation of location of the left ventricular outflow tract obstruction and the appropriate choice of a surgical technique according to the patient's age are emphasized.

Mechanisms and Clinical Management of Ventricular Arrhythmias following Blunt Chest Trauma

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Daniel H. Wolbrom

2016-01-01

Full Text Available Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can be the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor vehicle accidents or traumatic falls. In this setting, the manifestation of ventricular arrhythmias has been observed both acutely and chronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation can occur immediately after chest wall injury (commotio cordis and requires rapid defibrillation. Monomorphic ventricular tachycardia can develop in the chronic stage due to underlying structural heart disease long after blunt chest injury. The associated arrhythmogenic tissue may be complex and provides the necessary substrate to form a reentrant VT circuit. Ventricular tachycardia in the absence of overt structural heart disease appears to be focal in nature with rapid termination during ablation. Regardless of the VT mechanism, patients with recurrent episodes, despite antiarrhythmic medication in the chronic stage following blunt chest injury, are likely to require ablation to achieve VT control. This review article will describe the mechanisms, pathophysiology, and treatment of ventricular arrhythmias that occur in both the acute and chronic stages following blunt chest trauma.

Hemoglobin A1c and arterial and ventricular stiffness in older adults.

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Susan J Zieman

Full Text Available Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE are implicated in this stiffening pathophysiology. We examined the association between HbA(1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes.Baseline HbA(1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG with like measures.HbA(1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP, carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM. FG levels were positively associated with systolic, diastolic and PP and LVM.In this sample of older adults without diabetes, HbA(1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.

Cardiac structure and function, and ventricular-arterial interaction 11 years following a pregnancy with preeclampsia.

Science.gov (United States)

Al-Nashi, Maha; Eriksson, Maria J; Östlund, Eva; Bremme, Katarina; Kahan, Thomas

2016-04-01

Preeclampsia (PE) is associated with acute left ventricular dysfunction. Whether these changes eventually resolve remains unclear. This study assessed left and right ventricular structure and function, and ventricular-arterial interaction in 15 women 11 years after a pregnancy with PE and 16 matched control subjects with a normal pregnancy. We found normal left and right ventricular dimensions, systolic function, and global left ventricular strain, with no differences between the groups. In addition, indices of diastolic function, left and right atrial size, and amino-terminal pro-brain natriuretic peptide were normal and did not differ between the groups. Women with a previous PE had impaired night/day ratios for systolic and diastolic ambulatory blood pressure. However, indices of aortic stiffness or ventricular-arterial coupling did not differ between the groups. In conclusion, we could not demonstrate remaining alterations in systolic or diastolic left or right ventricular function, or in ventricular-arterial interaction in women 11 years after PE. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Conventional heart rate variability analysis of ambulatory electrocardiographic recordings fails to predict imminent ventricular fibrillation

Science.gov (United States)

Vybiral, T.; Glaeser, D. H.; Goldberger, A. L.; Rigney, D. R.; Hess, K. R.; Mietus, J.; Skinner, J. E.; Francis, M.; Pratt, C. M.

1993-01-01

OBJECTIVES. The purpose of this report was to study heart rate variability in Holter recordings of patients who experienced ventricular fibrillation during the recording. BACKGROUND. Decreased heart rate variability is recognized as a long-term predictor of overall and arrhythmic death after myocardial infarction. It was therefore postulated that heart rate variability would be lowest when measured immediately before ventricular fibrillation. METHODS. Conventional indexes of heart rate variability were calculated from Holter recordings of 24 patients with structural heart disease who had ventricular fibrillation during monitoring. The control group consisted of 19 patients with coronary artery disease, of comparable age and left ventricular ejection fraction, who had nonsustained ventricular tachycardia but no ventricular fibrillation. RESULTS. Heart rate variability did not differ between the two groups, and no consistent trends in heart rate variability were observed before ventricular fibrillation occurred. CONCLUSIONS. Although conventional heart rate variability is an independent long-term predictor of adverse outcome after myocardial infarction, its clinical utility as a short-term predictor of life-threatening arrhythmias remains to be elucidated.

Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder

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Er-Ping Xi

2012-11-01

Full Text Available OBJECTIVE: Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. METHODS: We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen Co., LTD, Guangdong, China utilizing standard techniques. RESULTS: Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. CONCLUSION: Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective.

Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder.

Science.gov (United States)

Xi, Er-Ping; Zhu, Jian; Zhu, Shui-Bo; Yin, Gui-Lin; Liu, Yong; Dong, Yong-Qiang; Zhang, Yu; Xia, Feng

2012-11-01

Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs) of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen) Co., LTD, Guangdong, China) utilizing standard techniques. Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective.

LA ESCRITURA EN LOS PROCESOS DE SISTEMATIZACIÓN DE EXPERIENCIAS EDUCATIVAS WRITING IN THE PROCESSES OF SYSTEMATIZATION OF EDUCATIONAL EXPERIENCES

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Ligia Ochoa Sierra

2011-12-01

Full Text Available Este artículo presenta un análisis del proceso de sistematización y escritura de experiencias significativas en el aula, llevado a cabo por docentes de educación básica y media en el marco de la convocatoria del Ministerio de Educación Nacional en el año 2009, sobre el tema de la pertinencia educativa. Los resultados muestran que solo los profesores que han sido protagonistas principales de las experiencias pueden cifrarlas y socializarlas, y que un buen acompañamiento supone, así mismo, adentrarse en las experiencias de los profesores para poder orientarlos adecuadamente en su proceso de escritura.The article analyzes the process of systematization and writing of significant classroom experiences, carried out by elementary and high school teachers in the context of the National Ministry of Education's forum on educational pertinence in 2009. Results show that only the teachers who have been the protagonists of the experiences are able to assess and socialize them, and that a good advisory process implies delving into the teachers' experiences into order to be able to guide them adequately in their writing process.

Early ventricular tachyarrhythmias after coronary artery bypass grafting surgery: Is it a real burden?

Science.gov (United States)

Mouws, Elisabeth M J P; Yaksh, Ameeta; Knops, Paul; Kik, Charles; Boersma, Eric; Bogers, Ad J J C; de Groot, Natasja M S

2017-09-01

The prevalence of ventricular dysrhythmias (VD) [ventricular premature beats (VPBs), ventricular couplets (Vcouplets), ventricular runs (Vruns)] after coronary artery bypass grafting (CABG) has so far not been examined. The goal of this study is to examine characteristics of VD and whether they precede ventricular tachyarrhythmias (VTA) during a postoperative follow-up period of 5 days using continuous rhythm registrations. In addition, we determined predictive factors of VD/VTA. Incidences and burdens of VD/VTA were calculated in patients (N=105, 83 male, 65±9 years) undergoing primary, on-pump CABG. Independent risk factors were examined using multivariate analysis. VPBs, Vcouplets, and Vruns occurred in respectively 100%, 82.9%, and 48.6% with corresponding burdens of 0.05%, 0%, and 0%. Sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) did not occur in our cohort. Independent risk factors for VD included male gender, mitral valve insufficiency, hyperlipidemia, and age ≥60 years. VD are common in patients with coronary artery disease after CABG. Despite high incidences of these dysrhythmias, corresponding burdens are low and sustained VT or VF did not occur. Incidences were highest on the first postoperative day and diminished over time. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Relationship of central and peripheral blood pressure to left ventricular mass in hypertensive patients.

Science.gov (United States)

Pérez-Lahiguera, Francisco J; Rodilla, Enrique; Costa, Jose A; Gonzalez, Carmen; Martín, Joaquin; Pascual, Jose M

2012-12-01

The purpose of the present study was to assess the relationship of central and peripheral blood pressure to left ventricular mass. Cross-sectional study that included 392 never treated hypertensive individuals. Measurement of office, 24-h ambulatory, and central blood pressure (obtained using applanation tonometry) and determination of left ventricular mass by echocardiography were performed in all patients. In a multiple regression analysis, with adjustment for age, gender and metabolic syndrome, 24-h blood pressure was more closely related to ventricular mass than the respective office and central blood pressures. Systolic blood pressures always exhibited a higher correlation than diastolic blood pressures in all 3 determinations. The correlation between left ventricular mass index and 24-h systolic blood pressure was higher than that of office (P<.002) or central systolic blood pressures (P<.002). Changes in 24-h systolic blood pressure caused the greatest variations in left ventricular mass index (P<.001). In our population of untreated middle-aged hypertensive patients, left ventricular mass index is more closely related to 24-h ambulatory blood pressure than to office or central blood pressure. Central blood pressure does not enable us to better identify patients with left ventricular hypertrophy. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

La experiencia escolar más allá de la escuela: notas sobre un estudio de caso acerca de jóvenes y experiencia escolar

OpenAIRE

Crego, María Laura

2014-01-01

El presente trabajo tiene como objetivo compartir una serie de resultados y reflexiones alcanzados en el desarrollo de la tesina de grado de la carrera de Licenciatura en Sociología. En ella, se abordó la pregunta acerca de cómo construyen su experiencia escolar los y las jóvenes en contextos de pobreza. A este fin se desarrolló un estudio de caso en un barrio periférico de la ciudad de La Plata en el que se optó por estrategias cualitativas. El artículo presenta los principales res...

Arrhythmogenic Right Ventricular Cardiomyopathy: Risk Stratification and Indications for Defibrillator Therapy.

Science.gov (United States)

Zorzi, Alessandro; Rigato, Ilaria; Bauce, Barbara; Pilichou, Kalliopi; Basso, Cristina; Thiene, Gaetano; Iliceto, Sabino; Corrado, Domenico

2016-06-01

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined disease which predisposes to life-threatening ventricular arrhythmias. The main goal of ARVC therapy is prevention of sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) is the most effective therapy for interruption of potentially lethal ventricular tachyarrhythmias. Despite its life-saving potential, ICD implantation is associated with a high rate of complications and significant impact on quality of life. Accurate risk stratification is needed to identify individuals who most benefit from the therapy. While there is general agreement that patients with a history of cardiac arrest or hemodynamically unstable ventricular tachycardia are at high risk of SCD and needs an ICD, indications for primary prevention remain a matter of debate. The article reviews the available scientific evidence and guidelines that may help to stratify the arrhythmic risk of ARVC patients and guide ICD implantation. Other therapeutic strategies, either alternative or additional to ICD, will be also addressed.

EXPERIENCIA INTEGRADORA PARA EDUCACIÓN AMBIENTAL

Directory of Open Access Journals (Sweden)

Jorge F. Coronel

2015-01-01

Full Text Available En este trabajo se relacionó la práctica experimental de laboratorio co n el análisis de problemas ambientales. El objetivo de este trabajo es analizar una propuesta que vinculó el trabajo experimental con la situación del ambiente local para promover el cuidado de la naturaleza y su uso con sostenibilidad . Esta estrategia brindó un enfoque integrador aportando a los alumnos de profesorado una alternativa de aprendizaje con exper iencias sencillas para el estudio cualitativo de l ambiente local y motivar a l análisis de problemas asociad o s. Las experiencias permitieron caracterizar las muestras de suelo, agua y aire del lugar de residencia de los alumnos. La información experimental obtenida potenció la discusión de la situación ambiental actual. E l enfoque de enseñanza basado en problemas socio - científicos posibilit ó la visión interdisciplinar del tema , redimensionando valores y acciones para el cuidado ambiental y el desarrollo sustentable.

Assessment of cardiac blood pool imaging in patients with left ventricular outflow tract stenosis

International Nuclear Information System (INIS)

Nakamura, Yutaka; Ono, Yasuo; Kohata, Tohru; Tsubata, Shinichi; Kamiya, Tetsuroh.

1993-01-01

We performed cardiac blood pool imagings with Tc-99m at rest and during supine ergometer exercise to evaluate left ventricular performance in 14 patients with left ventricular outflow tract stenosis. All catheterized patients were divided into two subgroups: 8 patients with peak systolic left ventricular to descending aortic pressure gradients of less than 50 mmHg (LPG group) and 6 patients with peak systolic gradients of more than 50 mmHg (HPG group). Control group included 10 patients without stenotic coronary lesions after Kawasaki disease. Left ventricular ejection fraction (LVEF) was obtained as systolic index; both filling fraction during the first third of diastole (1/3FF) and mean filling rate during the first third of diastole (1/3FR mean) were obtained as diastolic indices. None of the patients had abnormal findings on 201 Tl imaging. LVEF at rest in HPG group was significantly higher than those in control group, but LVEF in HPG group did not increase after exercise. It increased significantly in control group and LPG group. 1/3 FF in HPG group was significantly lower not only at rest but also during exercise. 1/3 FR mean at rest was not different significantly among the 3 groups. However, 1/3FR mean during exercise in LPG group was significantly lower; and 1/3 FR mean during exercise was significantly lower in HPG group than LPG group. The ratio of left ventricular muscular mass to left ventricular end-diastolic volume (M/V) calculated from left ventricular cineangiograms was different significantly among the 3 groups. The M/V ratio showed a correlation with LVEF and 1/3 FF both at rest and during exercise. These results would indicate that systolic function was impaired on exercise in severe left ventricular outflow tract stenosis and diastolic function was impaired on exercise in mild and severe left ventricular outflow tract stenosis. This may correlate with left ventricular hypertrophy and interaction of systolic function. (author)

Comparison of the accuracy of three angiographic methods for calculating left ventricular volume measurement

International Nuclear Information System (INIS)

Hu Lin; Cui Wei; Shi Hanwen; Tian Yingping; Wang Weigang; Feng Yanguang; Huang Xueyan; Liu Zhisheng

2003-01-01

Objective: To compare the relative accuracy of three methods measuring left ventricular volume by X-ray ventriculography: single plane area-length method, biplane area-length method, and single-plane Simpson's method. Methods: Left ventricular casts were obtained within 24 hours after death from 12 persons who died from non-cardiac causes. The true left ventricular cast volume was measured by water displacement. The calculated volume of the casts was obtained with 3 angiographic methods, i.e., single-plane area-length method, biplane area-length method, and single-plane Simpson's method. Results: The actual average volume of left ventricular casts was (61.17±26.49) ml. The left ventricular volume was averagely (97.50±35.56) ml with single plane area-length method, (90.51±36.33) ml with biplane area-length method, and (65.00± 23.63) ml with single-plane Simpson's method. The left ventricular volumes calculated with single-plane and biplane area-length method were significantly larger than that the actual volumes (P 0.05). The left ventricular volumes calculated with single-plane and biplane area-length method were significantly larger than those calculated with single-plane Simpson's method (P 0.05). The over-estimation of left ventricular volume by single plane area-length method (36.34±17.98) ml and biplane area-length method (29.34±15.59) ml was more obvious than that calculated by single-plane Simpson's method (3.83±8.48) ml. Linear regression analysis showed that there was close correlations between left ventricular volumes calculated with single plane area-length method, biplane area-length method, Simpson's method and the true volume (all r>0.98). Conclusion: Single-plane Simpson's method is more accurate than single plane area-length method and biplane area-length method for left ventricular volume measurement; however, both the single-plane and biplane area-length methods could be used in clinical practice, especially in those imaging modality

Beat-to-beat left ventricular performance in atrial fibrillation: radionuclide assessment with the computerized nuclear probe

International Nuclear Information System (INIS)

Schneider, J.; Berger, H.J.; Sands, M.J.; Lachman, A.B.; Zaret, B.L.

1983-01-01

There is wide beat-to-beat variability in cycle length and left ventricular performance in patients with atrial fibrillation. In this study, left ventricular ejection fraction and relative left ventricular volumes were evaluated on a beat-to-beat basis with the computerized nuclear probe, an instrument with sufficiently high sensitivity to allow continuous evaluation of the radionuclide time-activity curve. Of 18 patients with atrial fibrillation, 5 had mitral stenosis, 6 had mitral regurgitation, and 7 had coronary artery disease. Fifty consecutive beats were analyzed in each patient. The mean left ventricular ejection fraction ranged from 17 to 51%. There was substantial beat-to-beat variation in cycle length and left ventricular ejection fraction in all patients, including those with marked left ventricular dysfunction. In 14 patients who also underwent multiple gated cardiac blood pool imaging, there was an excellent correlation between mean ejection fraction derived from the nuclear probe and gated ejection fraction obtained by gamma camera imaging (r . 0.90). Based on beat-to-beat analysis, left ventricular function was dependent on relative end-diastolic volume and multiple preceding cycle lengths, but not preceding end-systolic volumes. This study demonstrates that a single value for left ventricular ejection fraction does not adequately characterize left ventricular function in patients with atrial fibrillation. Furthermore, both the mean beat-to-beat and the gated ejection fraction may underestimate left ventricular performance at rest in such patients

Experiencias de Discriminación Social de Inmigrantes Nicaragüenses en Costa Rica: Reacciones Afectivas y Atribuciones Causales

Directory of Open Access Journals (Sweden)

Vanessa Smith-Castro

2010-01-01

Full Text Available En dos estudios, 190 inmigrantes nicaragüenses fueron encuestados mediante un cuestionario sobre: (a sus experiencias de discriminación en Costa Rica, (b sus reacciones afectivas ante la discriminación, y (c sus representaciones sobre las causas de los eventos discriminatorios. El Estudio 1 (N = 102, 50% mujeres muestra que las reacciones ante la discriminación forman dos dimensiones básicas, a saber, ira y depresión. Estas dimensiones se encontraron diferencialmente relacionadas con marcadores de salud mental, específicamente autoestima personal y colectiva. El Estudio 2 (N = 88, 51% mujeres replica esta estructura bidimensional y muestra que las atribuciones sobre las causas de la discriminación moderan la relación entre discriminación, depresión e ira. Específicamente, las experiencias de discriminación se encontraron asociadas a la depresión, cuando la atribución causal de la discriminación eran las actitudes de los otros (el prejuicio de los costarricenses, pero cuando la explicación causal de la discriminación recayó en la pertenencia al colectivo discriminado (ser nicaragüense, las experiencias discriminación se encontraron asociadas a la ira.