Percutaneous transluminal coronary angioplasty in hypothyroidism

Article Abstract:

Patients with hypothyroidism, or decreased activity of the thyroid gland, are more likely to develop complications after coronary artery bypass (CAB) surgery, an operation that provides an alternate route for blood flow to the heart by bypassing the diseased coronary artery. Complications include heart failure during surgery; hypotension, or abnormally low blood pressure; bleeding; dissection, or rupture, of the aortic root; impairment of fever response after surgery; and gastrointestinal, neurological, and psychiatric disorders. Percutaneous transluminal coronary angioplasty (PTCA) is another method of renewing blood flow to the heart, which dilates a narrowed coronary artery using a small inflatable balloon. The rate of complications associated with PTCA in hypothyroid patients has not been examined. Thus, the complications and outcome were assessed in 13 hypothyroid patients who had undergone PTCA, 22 PTCA patients with normal thyroid function, and 13 hypothyroid patients who had undergone CAB surgery. PTCA patients with and without hypothyroidism did not differ on the rates of: coronary artery dissection; recurring blockage of the arteries; slow heart rate; heart failure; hypotension; heart attack; impaired gastrointestinal function; neuropsychiatric problems; abnormally low blood sodium levels; low body temperature; fever; and death. However, the incidence of hematoma, which is a swelling or mass of blood, was greater in PTCA patients with hypothyroidism than PTCA patients with normal thyroid function. The rates of heart failure, neuropsychiatric problems, abnormally low blood sodium levels, impaired gastrointestinal function, and fever were lower in PTCA patients with hypothyroidism than CAB patients with hypothyroidism. These findings show that PTCA is associated with fewer complications than CAB surgery in hypothyroid patients, and may be the preferred treatment for renewing blood supply to the heart in these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Usage, Coronary heart disease, Myocardial revascularization, Hypothyroidism, Coronary artery bypass, Transluminal angioplasty, Balloon angioplasty

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Spinal epidural abscess caused by group G streptococci

Article Abstract:

Group G streptococci are a type of bacteria that can normally be found on the skin, and in the gastrointestinal tract, and vagina. Although these bacteria may infect the heart, skin, throat, lungs, genital tissue, joints, and other tissues, Group G streptococci rarely cause infections of the central nervous system (the brain and spinal cord). Previous reports described infections with Group G streptococci that resulted in inflammation of the meninges (the three membranes covering the brain and spinal cord), brain abscesses, and the production of pus beneath the dura mater (the outermost membrane covering the brain and spinal cord). A case is described of a 35-year-old woman who developed an abscess in the epidural space (just above the dura mater) following spinal anesthesia for childbirth. The abscess was caused by infection with group G streptococci, which was transmitted by an epidural catheter used to administer the spinal anesthetic agent. The patient had developed symptoms of back pain 36 to 48 hours after delivery, and began to feel tingling sensations in her thigh and feet. The epidural abscess was discovered by magnetic resonance imaging, a diagnostic method that uses electromagnetic energy to provide images of internal structures. She was treated with penicillin G and recovered completely. Symptoms of epidural abscesses begin with back pain and tenderness, followed by pain originating from the site of the abscess, headache, neck stiffness, and changes in reflexes. Muscle weakness and loss of sensation then develop and the patient's condition deteriorates to paralysis. Hence, early diagnosis and treatment of spinal abscesses caused by infection with group G streptococci are essential to avoid nerve-related damage and eventual death. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Streptococcal infections, Disease transmission, Bacterial infections, Peridural anesthesia, Epidural anesthesia, Spine

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