Addressing influenza's underestimated burden - Iberian experts call to action.

Having a proper understanding of the impact of influenza is a fundamental step towards improved preventive action. This paper reviews findings from the Burden of Acute Respiratory Infections study on the burden of influenza in Iberia, and its potential underestimation, and proposes specific measures to lessen influenza's impact.

Iatrogenic aortic pseudoaneurysm: a forgotten complication.

Pseudoaneurysms of the ascending aorta are a rare complication of cardiac surgery. However, the poor prognosis associated with this condition if untreated makes early diagnosis and treatment important. We present the case of a 66-year-old woman who had undergone mitral valvuloplasty 12 days previously, who was admitted with a diagnosis of new-onset atrial fibrillation.

[A rare form of acute pulmonary edema: case report].

We report the case of a 21-year-old man who underwent appendectomy under general anesthesia and developed acute pulmonary edema immediately after extubation. We then review the literature, focusing on the pathophysiology and the most important aspects of diagnosis and treatment of post-extubation pulmonary edema.

Effectiveness and safety of levosimendan in clinical practice.

Background: In previous randomized studies levosimendan improved hemodynamics and clinical course, with a still unclear effect on prognosis. There are, however, few data regarding its effects when used in daily practice.

Aims: We evaluated the clinical effectiveness and safety of levosimendan in the treatment of acute systolic heart failure (SHF) in daily practice conditions.

The Manchester Triage System in acute coronary syndromes.

Introduction: A growing number of hospitals have implemented the Manchester Triage System (MTS) in their Emergency Department (ED), so as to better prioritize the evaluation of those attending these departments.

Objectives: To assess whether the MTS was used effectively in patients admitted to the hospital with a diagnosis of acute coronary syndrome (ACS).

Methods: We evaluated 114 consecutive patients admitted to the Cardiology Department with a diagnosis of ACS.

Levosimendan in daily intensive care practice--the experience of 15 centers. Background, methods and organization of the PORTLAND study.

Introduction: The LIDO and RUSSLAN trials showed that levosimendan was well tolerated and had a stronger hemodynamic effect than dobutamine and a positive impact on prognosis. There are, however, few data regarding its effectiveness and safety when used in an everyday clinical setting.

Objective: To test the hypothesis that in day-to-day practice conditions levosimendan is both effective and safe for the treatment of decompensated heart failure (HF).

Brugada syndrome complicated with sudden death.

Brugada syndrome is an electrocardiographic diagnosis that is increasingly recognized as a cause of sudden cardiac death. The authors present a clinical case of a patient with a family history of sudden death, in whom a diagnosis of Brugada syndrome had been established, and who died suddenly. They also present a brief review of the main findings of this entity, particularly the diagnostic criteria and treatment of choice, since it is recognized that its prevalence will rise in the coming years.

[Primary hyperaldosteronism--4 clinical cases].

We describe four cases of primary hyperaldosteronism whose initial presentation was a moderate hypertension. Serum potassium and plasmatic aldosterone values were high although plasmatic renin levels were normal. The captopril test (Lyons version), abdominal CT and iodocholesterol (NP-59) scan proved useful to exclude essential hypertension.

[The efficacy of isosorbide dinitrate administered in an intravenous bolus in acute cardiogenic pulmonary edema].

Study Objective: To evaluate the efficacy, safety and tolerability of intravenous (i.v.) isosorbide dinitrate (ISDN) administered as a bolus in the treatment of cardiogenic acute pulmonary edema (CAPE).

[A case of rupture of the free wall of the left ventricle occurring at a district hospital. The problems of communication with heart surgery centers].

This is a report of an acute myocardial infarction complicated with rupture of the free wall of the left ventricle. Some comments concerning diagnosis and therapy are added, with emphasis in the correct communication of community hospitals with the centers of cardiac surgery.

[Fever in the first 48 hours of an acute myocardial infarct treated with fibrinolytics--an indicator of nonreperfusion of the coronary vessels?].

Unlabelled: Fever in the first days of acute myocardial infarction (AMI) is a very common clinical feature, being its prognostic value unquestionable. As infarction area reduction implies a less important fever reaction in the first days of AMI, we believe that thrombolytic therapy would result in a decline of body temperature of patients so treated. That is why we tried to identify such a correlation, and demonstrate the value of normal body temperature as indicative of reperfusion.

[Effect of intravenous administration of SO4Mg in the acute phase of myocardial infarct].

Fifty four patients (p) with acute myocardial infarction (40M; 14F) were entered into a prospective study where they received either intravenous magnesium sulphate (group A-27 p) or placebo (group B-27 p). The incidence of arrhythmias necessitating treatment was greater in group B (37%) than in group A (15%). Mortality was 18.

[Therapeutic effectiveness of intravenous magnesium sulfate in tachyarrhythmia. Apropos of 4 clinical cases].

This is a report about four patients with tachyarrhythmias successfully treated with intravenous magnesium sulfate. In two cases (supraventricular tachycardia and torsade de pointes) because they were resistant to other antiarrhythmic drugs, and in the remaining two cases (paroxistic atrial fibrillation) because they presented characteristic features of magnesium depletion. The efficacy, the rapid onset of action and the absence of adverse reactions must be emphasized and the authors suggest that larger and randomized trials should be carried out, in order to establish the real place of magnesium sulfate in the antiarrhythmic armamentarium.

Serum and red blood cell Mg levels in acute coronary events.

Serum (s-Mg) and red blood cell (e-Mg) Mg levels were assessed in 29 patients with acute myocardial infarction (AMI) and in 16 patients with unstable angina (UA), from admission until discharge. The following results were found: (1) no significant difference existed between mean s-Mg levels in AMI and UA, despite a tendency for an increase being noted with a favorable course of disease, (2) in AMI, mean s-Mg levels were initially lowered, increased within the first 24 h (p less than 0.05), decreased sharply at day 4 (p less than 0.

Serum magnesium levels in patients after myocardial infarction or unstable angina treated with nitrites and calcium antagonists.

A rise of serum Mg levels was observed in patients at 3 and 6 months after acute myocardial infarction, irrespective of therapeutic regimen. In unstable angina follow-up, serum Mg levels remained stable, but below normal values (normal mean values = 2.1 +/- SD 0.