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Biomedical subjects

Vladimir Contreras-Domínguez

Publications and source records attributed to Vladimir Contreras-Domínguez.

5 recordsLinked to original sources

[Persistent left superior vena cava: infrequent localization of central venous catheter].

OBJECTIVE: Our objective was to report a Persistent Left Superior Vena Cava in a critically ill patient. DESIGN: Case report. PLACE: Intensive care unit of a referral center. PATIENT: A 52 years-old male without previous cardiovascular disease was admitted to the intensive care unit due to cranial trauma. A central left subclavian vein catheter was placed at his arrival at the center chest X-ray showed the catheter in the left of the cardiac silhohuete without hemo-pneumothorax. A angiographic evaluation through central venous catheter showed persistent left superior vena cava draining to the coronary sinus and right atrium with normal permeability of right superior vena cava. Other congenital alterations were excluded. Chest computed tomography confirmed the diagnosis. Persistent left superior vena cava is a congenital vascular abnormality. The intensive care unit staff must be aware of this vascular abnormality because it can complicate central venous catheterization.

Angiography↗

[Non-hypothermic J wave in subarachnoid hemorrhage].

Incidence of electrocardiographic abnormalities in subarachnoid hemorrhage secondary to aneurysm rupture is 50-100%. The most frequent electrocardiographic abnormalities described include acuminated, inverted or flat T waves, inverted T waves associated with prolonged QT interval, positive or negative ST segment levels, prominent U waves, PR segment enlargement, acuminated P waves, and pathologic Q waves. J point is the isoelectric union of QRS complex with ST segment. It represents the end of depolarization and the beginning of repolarization. Prominent and positive J point level is named J wave, considered pathognomonic of severe hypothermia, although it has also been described in other clinical entities not associated with hypothermia, such as hypercalcemia, Brugada syndrome, acute brain injury, cardiac arrest, and dysfunction of cervical sympathetic system. Non-hypothermic J wave is an infrequent electrocardiographic manifestation of subarachnoid hemorrhage. We describe a clinical case of non-hypothermic J wave in a patient with subarachnoid hemorrhage.

Aged↗

[Pseudothrombocytopenia induced by ethylenediaminetetraacetic acid in burned patients].

The EDTA-dependent pseudothrombocytopenia is a false decrease in the number of platelets below the normal value when analyzed with automated devices. There is an incidence of 0.09 to 0.21% in hospitalized patients. Pseudothrombocytopenia is secondary to platelet clumping induced by antibodies in the presence of EDTA and has been associated with sepsis, cancer, cardiac surgery and drugs. We report the first case of pseudothrombocytopenia induced by EDTA in a burn patient.

Adult↗

[All-trans retinoic acid syndrome. Case report and a review of the literature].

We described a patient with acute promyelocytic leukemia (APL) who developed all-trans retinoic acid syndrome (ATRAS) and reviewed the literature. ATRAS presents in patients with APL treated with all-trans retinoic acid (ATRA). It has an incidence from 5%-27% with mortality of 29%. It is secondary to ATRA effect on promyelocyte differentiation, which causes systemic inflammatory response syndrome, endothelium damage with increase in capillary permeability, microcirculation obstruction, and tissue infiltration. ATRAS clinical manifestations are fever, hypotension, respiratory, renal and hepatic insufficiency, lung infiltrates, pleural and pericardic effusion, and generalized edema. Treatment is based on ATRA suspension, support measures, and steroids.

Adult↗