Medicina intensiva
-
Alcohol and other substance abuse that alters behavior make up the principal risk factor to suffer serious traumas. Patients who have had an alcohol or other drug consumption related accident have a high risk of recidivism. ⋯ A brief psychological intervention made during the bedridden period may modify the behavior and decrease the risk of new accidents. Therefore, establishing secondary prevention programs should be considered a priority objective in sites that receive traumatized patients.
-
Case Reports
[Acute inferior myocardial infarction masking the J wave syndrome. Based on four observations].
The J wave syndrome is characterized by a prominent J wave accompanied by ST-segment elevation in the absence of structural heart disease. It includes the benign early repolarization syndrome, the highly arrhythmogenic Brugada syndrome and idiopathic ventricular fibrillation. Although acute coronary syndromes are one of the leading causes of ST-segment deviation, no clinical reports that specifically describe the modulating effects of an ischemic injury current on the ECG manifestations of the J wave syndrome have been found. ⋯ Later, these precordial ECG alterations disappeared and were progressively replaced by prominent J (R') waves and anterior ST-segment elevations, suggesting the presence of a J wave syndrome. In conclusion, the J wave syndrome may be obscured by an acute inferior myocardial infarction with concomitant ST-segment depression in the right precordial leads. In such circumstances, early detection of the J wave (or depressed J point) may be used as ECG marker of the early repolarization syndrome or Brugada syndrome.