Medicina clinica
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Review
Carbohydrate antigen 125 in heart failure. New era in the monitoring and control of treatment.
In recent years, we have seen a great interest in the search for new biomarkers in heart failure (HF), fundamentally in the field of diagnosis, prognosis, monitoring and as a therapeutic guide. However, most of them do not meet the required criteria for daily clinical practice. The carbohydrate antigen 125 (CA 125) is the mucin 16 glycoprotein (MUC16) antibody, and its use has been restricted to the therapeutic monitoring of ovarian cancer; however, its elevation is confirmed in other non-tumour processes such as HF. ⋯ From the clinical perspective, CA 125 provides information on the degree of extravascular congestion present in HF. Recent evidence consistently shows that its kinetics after admission due to decompensation offer an excellent predictive capacity for adverse events and to guide treatment, mainly diuretic. These qualities make it an ideal candidate for use in evolutionary monitoring and to guide depletive treatment in HF.
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Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant inherited Rare Disease that causes a systemic anomalous vascular overgrowth. The approach and follow-up of these patients should be from multidisciplinary units. Its diagnosis is carried out according to Curaçao clinical Criteria. ⋯ These types of vascular involvement can be established using computerised tomography. Pulmonary arteriovenous fistula should be screened for all HHT patients by contrast echocardiography. The main objective is to review the management of epistaxis, liver and lung involvement of the adult patient with HHT.
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Contamination of sinks, even due to their underuse, is associated with the transmission of non-fermenting gram-negative bacilli (NFGNB) to patients in Augmented Care Units. After previous monitoring with environmental and patient samples, we now explore the impact of removing sinks from ICU cubicles on incidental isolations related to health care in bronchoaspirate samples of patients with invasive mechanical ventilation (IMV). ⋯ Despite of the limitations of the design, the removal of sinks showed a reduction of the isolations.