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Does Coronary Microvascular Spasm Exist?Objective Evidence from Intracoronary Doppler Flow Measurements During Acetylcholine Testing

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Cardiovascular Innovations and Applications 2020年第1期4卷 205-209页

作者： Fabian Guenther Andreas Seitz valeria martinez pereyra Raffi Bekeredjian Udo Sechtem Peter Ong Department of Cardiology Robert-Bosch-KrankenhausAuerbachstr.11070376 StuttgartGermany

A 43-year-old woman with recurrent atypical angina underwent invasive coronary angiography including intracoronary Doppler blood flow assessment and coronary spasm provocation *** obstructive epicardial disease could be ruled-out angiographically,the patient experienced reproduction of her angina symptoms after intracoronary administration of acetylcholine(100μg)during spasm provocation ***,the ECG showed new-onset ST-segment depression in the absence of epicardial *** addition,coronary fl ow velocity was signifi cantly reduced after acetylcholine compared to the baseline *** intracoronary administration of nitroglycerine(200μg),the patient’s symptoms as well as the ECG changes and coronary flow reduction were *** the ongoing challenges in appropriate evaluation of the pathophysiological mechanisms of coronary microvascular dysfunction,simultaneous intracoronary Doppler flow measurement during spasm testing–as shown in this case–may provide objective evidence for microvascular spasm in addition to the standardized diagnostic criteria,especially if they are ambiguous.

关键词： acetylcholine coronary microcirculation coronary flow reserve coronary spasm

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Assessing the progress of desertification of the southern edge of Chihuahuan Desert: A case study of San Luis Potosi Plateau

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Journal of Geographical Sciences 2017年第4期27卷 420-438页

作者： NOYOLA-MEDRANO Cristina martinez-SiAS valeria Abigail facultad de ingeniería/area civil/geoinformática/universidad autónoma de san luis potosí Manuel Nava#8Zona Universitaria Poniente78290San Luis PotosfSLPMexico colegio de posgraduados/campus san luis potosí Iturbide 73Salinas de HidalgoSLPMexico

The aim of this study is to establish if the San Luis Potosi Plateau(SLPP), which is part of the southern edge of the Chihuahuan Desert, is generating desertification processes, indicating a progression of the desert toward the central part of Mexico. Therefore, we analyzed the temporal evolution of four environmental indicators of desertification: Normalized Difference Vegetation Index(NDVI), Normalized Difference Water Index(NDWI), Iron Oxides Index(IO) and Surface Temperature(ST). Landsat TM images are used to cover a period from 1990 to 2011. A new equation of total balance is proposed to generate an image of the overall evolution of each factor which is applied to get a probability map of desertification. The evolution of NDVI, NDWI and IO shows a behavior almost stable over the time. In contrast, the ST shows a slight increase. The outcomes of this study confirm periods of vegetation re-greening and 8.80% of the SLPP has the highest probability to develop desertification. The most affected area is the portion west of the region, and the east and south are the least affected areas. The results suggest a slight advance of the desert, although most of the area doesn't have the necessary conditions to develop desertification.

关键词： Landsat NDVI-NDWI ST-IO desertification re-greening vegetation

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Levamisole-Adultered Cocaine: Vasoconstrictive and Vasculitis Effects Occurring Simultaneously

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Case Reports in Clinical Medicine 2022年第5期11卷 167-174页

作者： María A. Rodríguez-Santiago Hillarie Ríos-Torres Giulianni Oliveras-Maldonado valeria martinez-Lebrón Suheiry Márquez-Márquez Adianez Santiago-Santiago Salvador Vilá-Pérez Marcel Mesa-Pabón Department of Internal Medicine School of Medicine University of Puerto Rico San Juan Puerto Rico

This case presents a rarely seen combination of two Cocaine-induced syndromes occurring simultaneously. Levamisole-adultered cocaine leads to Levamisole-induced Vasculitis (LIV), while cocaine’s vasoconstrictive effect causes destruction of the osteo-cartilaginous structures of nose called Cocaine-induced midline destructive lesions (CIMDL). This case raises awareness of a new pattern of recognition in order to avoid misdiagnosis. We present a case of a 51-year-old male cocaine user who developed severe left-sided ear pain and yellowish secretions with circular necrotic lesions in the nose, right earlobe, and dorsum of feet bilaterally. An extensive workup to assess purpuric lesions’ etiology, including vasculitis, collagen vasculitides, anti-phospholipid syndrome, hypercoagulable state and infectious process, was performed and found negative. He developed bilateral tympanic membrane perforation and purpuric necrotic skin lesions, at the same time, due to CIMDL and LIV, respectively. These two syndromes rarely present simultaneously in a patient. This case report exhibits a new Cocaine-induced clinical presentation that will help hospitalists recognize the disease and avoid misdiagnosis leading to unnecessary tests, prolonged hospitalization, and higher healthcare costs. Diagnosis is challenging, as it consists of establishing a temporal relationship between cocaine ingestion and symptoms’ onset. This disease usually has a benign progression because symptoms frequently resolve without intervention.

关键词： Levamisole-Induced Vasculitis Cocaine-Induced Midline Destructive Lesions Cocaine’s Side Effect Spectrum

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