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Biomedical subjects

V Nieto

Publications and source records attributed to V Nieto.

10 recordsLinked to original sources

Gipuzkoa, Basque Country, Spain (1984-2004): a hyperendemic area of Q fever.

Overall 1,261 cases of Q fever were diagnosed between 1984 and 2004 in Gipuzkoa (Basque Country, Spain). Most (75.5%) of the cases ocurred in subjects 15-45 years of age. A total of 79.5% of the cases (n = 1003) ocurred between January and June. The annual incidence for acute Q fever in Gipuzkoa was 7.7, 15.8, 9.6, and 5.7 for the periods 1984-1989, 1990-1994, 1995-1999, and 2000-2004, respectively. In 94% of the cases IgM titer was >/=1/256. The most frequent clinical manifestation was pneumonia (79%). Only two cases of chronic Q fever were detected during the 21 years studied.

Adolescent↗

Epidemiology of Pneumocystis carinii pneumonia in southern Spain.

In order to investigate the impact of Pneumocystis carinii infection in southern Spain following the introduction of highly active anti-retroviral therapy (HAART), all cases of pneumocystosis between 1998 and 1999 were identified from data compiled by the national surveillance system. In total, 498 cases of pneumocystosis were recorded, of which 87% involved HIV-positive patients. The mean age, length of hospital stay and mortality were higher for HIV-negative patients. There was a higher number of cases in winter. Despite HAART implementation, pneumocystosis remains a significant health problem for both HIV-positive and HIV-negative patients.

AIDS-Related Opportunistic Infections↗

Benefit of pacing and beta-blockers in idiopathic repetitive polymorphic ventricular tachycardia.

An 18-year-old woman presented with recurrent exercise-induced syncopal episodes and severe systolic dysfunction. ECG monitoring disclosed repetitive polymorphic ventricular complexes, paroxysms of bidirectional ventricular tachycardia, and nonsustained bursts of slow polymorphic ventricular tachycardia that increased in length and rate during exercise. Ventricular arrhythmias were refractory to medical treatment, which included verapamil and beta-blockers. Addition of permanent atrial pacing to beta-blocker therapy suppressed the arrhythmias and reversed systolic impairment in the following months.

Adolescent↗

Dynamic intraventricular obstruction in acute myocardial infarction.

Transient left ventricular dynamic obstruction (TLVO) is an infrequent complication in acute myocardial infarction (AMI). Its hallmark is a new systolic murmur associated with hemodynamic worsening. An echocardiogram is necessary for diagnosis. We report on two cases, both of which had a good outcome. Serial echocardiograms showed that enhanced contractility of the basal left ventricular segments obstructed cardiac ejection by means of mitral valve systolic anterior movement in the left ventricular outflow tract. In both cases, the intraventricular gradient remained for several days and subsequently disappeared. The understanding of this mechanism is useful for management of this clinical problem.

Diagnosis, Differential↗

Inflammatory extracavitary right atrial mass and pulmonary thromboembolism.

A 40 year old male patient diagnosed as having pulmonary thromboembolism, was found to have a right atrial mass, after being subjected to an echocardiogram, a CT thoracic Scan and magnetic resonance imaging. An intracardiac exploration by cardiopul-monary bypass was performed. The mass was located and excised, but in fact found to be an extracardiac, inflammatory and cavitated mass. The wall of the right atrium was infiltrated due to the inflammatory process. This case illustrates the advantage of echocardiography, followed by surgery, in the clinical diagnosis and also shows how to treat cardiac masses and tumors.

Adult↗