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obstructive » obstructiva (Expander búsqueda), constructive (Expander búsqueda), obstruction (Expander búsqueda)
1
artículo
Publicado 2021
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Acute myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) represents a diagnostic challenge in clinical practice. Documentation of an ischemic substrate is necessary for its diagnostic approach, with a treatment that must be specific according to the identified etiology. A group of these patients presents ischemia secondary to an alteration in the oxygen supply/demand ratio. We present the case of a female adult patient, with severe hyperthyroidism and thyrotoxicosis, who develops an acute coronary syndrome, with elevated troponin T and normal coronary arteries on coronariography. Treatment was aimed at treating the triggering cause, initially pharmacologically and later surgically, with a total resolution of the condition, symptomatic improvement in the patient, and a decrease in cardiac biomarkers.
2
artículo
Publicado 2021
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Acute myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) represents a diagnostic challenge in clinical practice. Documentation of an ischemic substrate is necessary for its diagnostic approach, with a treatment that must be specific according to the identified etiology. A group of these patients presents ischemia secondary to an alteration in the oxygen supply/demand ratio. We present the case of a female adult patient, with severe hyperthyroidism and thyrotoxicosis, who develops an acute coronary syndrome, with elevated troponin T and normal coronary arteries on coronariography. Treatment was aimed at treating the triggering cause, initially pharmacologically and later surgically, with a total resolution of the condition, symptomatic improvement in the patient, and a decrease in cardiac biomarkers.
3
artículo
Publicado 2017
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Introduction and objectives. Fetal obstructive uropathy can be treated early in pregnancy by intrauterine vesicoamnioticshunting, immediately after being diagnosed by ultrasound, in specific cases with a favorable prognosis in renal function usingfetal urinary beta-2 microglobuline. The main objective of the study was to determine the changes of beta-2 microglobulinein consecutive samples of fetal urine in 48 – 72 hour-intervals in fetuses with obstructive uropathy at 16 weeks of gestation.Methods. We performed a descriptive and longitudinal study, including 15 pregnant women whose fetuses were diagnosedwith obstructive uropathy and without chromosomal abnormalities, performing vesicocentesis for urinary biometry.
4
artículo
Publicado 2017
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Introduction and objectives. Fetal obstructive uropathy can be treated early in pregnancy by intrauterine vesicoamnioticshunting, immediately after being diagnosed by ultrasound, in specific cases with a favorable prognosis in renal function usingfetal urinary beta-2 microglobuline. The main objective of the study was to determine the changes of beta-2 microglobulinein consecutive samples of fetal urine in 48 – 72 hour-intervals in fetuses with obstructive uropathy at 16 weeks of gestation.Methods. We performed a descriptive and longitudinal study, including 15 pregnant women whose fetuses were diagnosedwith obstructive uropathy and without chromosomal abnormalities, performing vesicocentesis for urinary biometry.
5
tesis de grado
Publicado 2025
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La isquemia con arterias coronarias no obstructivas (INOCA) es una entidad cada vez más reconocida en pacientes con dolor torácico y pruebas de isquemia positivas. Aunque se ha relacionado con disfunción microvascular y vasoespasmo, su diagnóstico definitivo requiere pruebas especializadas no disponibles en nuestro medio, por lo que en esta investigación se definió operativamente como angina y/o prueba de isquemia positiva asociada a ausencia de lesiones coronarias obstructivas (<50%) en la angiografía. El objetivo fue evaluar la asociación entre el sexo y la ocurrencia de eventos cardiovasculares adversos mayores (MACE) en pacientes con INOCA atendidos en el Instituto Nacional Cardiovascular. Se realizó un estudio observacional analítico de corte ambispectivo, que incluyó pacientes mayores de 18 años sometidos a cateterismo cardíaco electivo por sospecha de enfermedad coron...
6
artículo
Publicado 2023
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Objective. To evaluate the association between chronic exposure to high altitude and the presence of coronary ectasia (CE) in patients with ST-segment elevation myocardial infarction (STEMI) treated in a highly specialized cardiovascular reference hospital in Peru. Materials and methods. Retrospective matched case-control study. The cases were patients with CE and controls without CE. The relationship between CE and chronic exposure to high altitude was evaluated considering intervening variables such as arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and hematocrit values. Patients with chronic inflammatory pathologies, chronic obstructive pulmonary disease, and previous revascularization were excluded. Multivariate logistic regression was applied to obtain the OR value and their respective confidence intervals. Results. Eighteen cases and 18 controls were studied, most...
7
artículo
Publicado 2023
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Objective. To evaluate the association between chronic exposure to high altitude and the presence of coronary ectasia (CE) in patients with ST-segment elevation myocardial infarction (STEMI) treated in a highly specialized cardiovascular reference hospital in Peru. Materials and methods. Retrospective matched case-control study. The cases were patients with CE and controls without CE. The relationship between CE and chronic exposure to high altitude was evaluated considering intervening variables such as arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and hematocrit values. Patients with chronic inflammatory pathologies, chronic obstructive pulmonary disease, and previous revascularization were excluded. Multivariate logistic regression was applied to obtain the OR value and their respective confidence intervals. Results. Eighteen cases and 18 controls were studied, most...
8
artículo
Publicado 2025
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Objective. The presence of coronary lesions of less than 50% in patients with myocardial ischaemia is a common diagnosis in cardiac catheterisation laboratories. The aim of this study was to determine the clinical course of patients with myocardial ischaemia in the absence of obstructive coronary lesions. Materials and methods. A prospective analytical study was conducted in 110 patients of both sexes with documented myocardial ischaemia and coronary lesions of less than 50% on coronary angiography. The follow-up period was three years. Results. The mean age was 64.5 ± 7.2 years, with a predominance of females (57%). The most prevalent risk factors were hypertension (58.2%) and dyslipidaemia (44.5%). In 8.3% of cases, re-hospitalisation was required, with heart failure reported as the leading cause (6.5%). Cardiovascular event-free survival during follow-up was 80%, and was higher in pa...
9
artículo
Publicado 2024
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Objective. Balloon atrioseptostomy is an emergency procedure in congenital heart diseases requiring an atrial septal defect to increase cardiac output in right-sided obstructive lesions or to improve mixing in patients with transposition of the great arteries. This procedure is currently performed with both fluoroscopy and echocardiography. The main objective is to describe our experience with the use of balloon atrioseptostomy under echocardiographic and fluoroscopic guidance in patients under 3 months. Materials and methods. A descriptive, comparative and retrospective study in patients in whom balloon atrioseptostomy was performed under echocardiographic and fluoroscopic guidance between 2018 and 2023 in a referral hospital in Peru. Results. 36 patients were analyzed, of which 21 were from the fluoroscopy group. and 15 patients from the echocardiography group. More than 2/3 o...
10
artículo
We report four cases of glioblastoma in the pineal region. The patients presented a severe headache and vomiting. Brain imaging showed a heterogeneously enhanced tumor in the pineal region with obstructive hydrocephalus. Case 3 developed a subependymal dissemination. The patient went to ventricular-peritoneal shunt and subtotal or total resection and radiotherapy with/without chemotherapy. Cases 1 and 2 received radiation and died 8 and 11 later months. Cases 3 and 4 completed radiotherapy and chemotherapy, and survived 28 and 31 months after the initial diagnosis. Glioblastoma in the pineal region carry a poor prognosis and require neurooncology teams.
11
artículo
Publicado 2024
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Objectives. To compare the occurrence of death, bleeding, and recurrence according to inpatient or outpatient management of venous thromboembolic disease (VTE). Materials and methods. Retrospective cohort that included a consecutive sampling of VTE consultations between 2016 and 2019 diagnosed in the Emergency Center of a private hospital in Argentina. Results. There were 1202 cases, 908 with isolated deep vein thrombosis (DVT), 205 with isolated pulmonary embolism (PE), and 89 cases of combined DVT - PE. 66% were women, with a median age of 77 years; 72% of cases were managed on an outpatient basis (n= 862). Comorbidities associated with hospitalization were obesity (p=0.03), chronic obstructive pulmonary disease (COPD) (p=0.01), heart failure (CHF) (p=0.01), chronic renal failure (CKD) (p=0.01), and cancer (p=0.01). At 90 days, the cumulative incidence of bleeding was 2.6% in inpatient...
12
artículo
Publicado 2021
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Background: WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and range of developmental delays) is a rare contiguous gene deletion syndrome with a 45% to 60% risk of developing Wilms tumor (WT). Currently, surveillance and treatment recommendations are based on limited evidence. Methods: Clinical characteristics, treatments, and outcomes were analyzed for patients with WAGR and WT/nephroblastomatosis who were identified through International Society of Pediatric Oncology Renal Tumor Study Group (SIOP-RTSG) registries and the SIOP-RTSG network (1989-2019). Events were defined as relapse, metachronous tumors, or death. Results: Forty-three patients were identified. The median age at WT/nephroblastomatosis diagnosis was 22 months (range, 6-44 months). The overall stage was available for 40 patients, including 15 (37.5%) with bilateral disease and none with metastatic disease. ...
13
artículo
Publicado 2024
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Objectives. To compare the occurrence of death, bleeding, and recurrence according to inpatient or outpatient management of venous thromboembolic disease (VTE). Materials and methods. Retrospective cohort that included a consecutive sampling of VTE consultations between 2016 and 2019 diagnosed in the Emergency Center of a private hospital in Argentina. Results. There were 1202 cases, 908 with isolated deep vein thrombosis (DVT), 205 with isolated pulmonary embolism (PE), and 89 cases of combined DVT - PE. 66% were women, with a median age of 77 years; 72% of cases were managed on an outpatient basis (n= 862). Comorbidities associated with hospitalization were obesity (p=0.03), chronic obstructive pulmonary disease (COPD) (p=0.01), heart failure (CHF) (p=0.01), chronic renal failure (CKD) (p=0.01), and cancer (p=0.01). At 90 days, the cumulative incidence of bleeding was 2.6% in inpatient...
14
artículo
Publicado 2023
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Objective. To evaluate the association between chronic exposure to high altitude and the presence of coronary ectasia (CE) in patients with ST-segment elevation myocardial infarction (STEMI) treated in a highly specialized cardiovascular reference hospital in Peru. Materials and methods. Retrospective matched case-control study. The cases were patients with CE and controls without CE. The relationship between CE and chronic exposure to high altitude was evaluated considering intervening variables such as arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and hematocrit values. Patients with chronic inflammatory pathologies, chronic obstructive pulmonary disease, and previous revascularization were excluded. Multivariate logistic regression was applied to obtain the OR value and their respective confidence intervals. Results. Eighteen cases and 18 controls were studied, most...
15
artículo
Publicado 2024
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We present the case of a woman in her third decade of life, known to have difficult-to-control mixed headaches and polycystic ovary syndrome under hormonal treatment. Without any other manifestation, the patient debuted with an acute coronary syndrome classified as unstable angina. Electrocardiogram showed anterior and lateral ST segment depression and ST elevation in aVR. Coronary computer tomography and coronary angiography showed evidence of significant obstruction of the left main coronary artery. The patient was diagnosed with systemic lupus erythematosus (SLE), and was classified as vasculitis secondary to SLE as an unusual initial manifestation.
16
artículo
Publicado 2024
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Aortic stenosis is a congenital heart defect that causes a fixed left ventricular outflow obstruction with a progressive course. Symptomatology in neonates and young infants resembles congestive heart failure. In addition, the diagnosis of this condition is made by imaging, through echocardiography. On the other hand, treatment can be surgical or interventional under fluoroscopic guidance, depending on the hospital in which it is performed. We describe the case of a minor infant patient who presented severe aortic valve stenosis; however, the fluoroscopy equipment was not available at the time of the emergency to perform the appropriate procedure, therefore, an aortic valvuloplasty was performed under echocardiographic guidance without complications.
17
artículo
Publicado 2024
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Aortic stenosis is a congenital heart defect that causes a fixed left ventricular outflow obstruction with a progressive course. Symptomatology in neonates and young infants resembles congestive heart failure. In addition, the diagnosis of this condition is made by imaging, through echocardiography. On the other hand, treatment can be surgical or interventional under fluoroscopic guidance, depending on the hospital in which it is performed. We describe the case of a minor infant patient who presented severe aortic valve stenosis; however, the fluoroscopy equipment was not available at the time of the emergency to perform the appropriate procedure, therefore, an aortic valvuloplasty was performed under echocardiographic guidance without complications.
18
artículo
Publicado 2015
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Objectives: To determine correlation of hysterosalpingography and laparoscopy findings in infertile women. Design: Descriptive, retrospective, transversal study. Setting: Instituto Nacional Materno Perinatal, Lima, Peru. Participants: Patients with infertility diagnosis who had both hysterosalpingography and laparoscopy. Interventions: We included 125 infertile patients attended from January 2005 through December 2006. Hysterosalpingographies were ambulatory and findings classified according to Mol et al as without obstruction, obstruction of one tube or bilateral obstruction. Laparoscopy and chromotubation with methylene blue were performed in the follicular phase, under general anesthesia. We considered adhesions, endometriosis, cysts and obstructions as abnormal findings. The laparoscopic intervention most frequently performed was adhesiolysis. We obtained both sensitivity and specifi...
19
artículo
Publicado 2015
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Objectives: To determine correlation of hysterosalpingography and laparoscopy findings in infertile women. Design: Descriptive, retrospective, transversal study. Setting: Instituto Nacional Materno Perinatal, Lima, Peru. Participants: Patients with infertility diagnosis who had both hysterosalpingography and laparoscopy. Interventions: We included 125 infertile patients attended from January 2005 through December 2006. Hysterosalpingographies were ambulatory and findings classified according to Mol et al as without obstruction, obstruction of one tube or bilateral obstruction. Laparoscopy and chromotubation with methylene blue were performed in the follicular phase, under general anesthesia. We considered adhesions, endometriosis, cysts and obstructions as abnormal findings. The laparoscopic intervention most frequently performed was adhesiolysis. We obtained both sensitivity and specifi...
