Background: Acute myocardial infarction is a serious and frequent illness, and its treatment with thrombolytic therapy or percutaneous coronary intervention (PCI) is well established. Rescue PCI is an alternative when thrombolysis fails. In the last ten years several clinical studies have tested different features about this procedure. Methods: Eighty four studies about rescue angioplasty published in the major cardiovascular relevance literary sources were analyzed between 1997 to 2007. Results: Rescue PCI was superior to conservative treatment, such as rethrombolysis, when well indicated, and seemed similar to primary PCI, in some features. The concomitant use of GPIIb/IIIa inhibitors seemed to show clinical benefits. The use of drug-eluting stents and the association with mechanic thrombectomy still requires better scientific support. The latest metaanalysis about this topic have shown clear favorable results to rescue angioplasty according to clinical outcomes, heart failure and re-infarction, but not so definite results as to mortality. On the other hand, there was a trend of increased stroke risk, of the same magnitude as benefit. Conclusion: Rescue PCI has better results than conservative treatment or repeat fibrinolysis. However, the indication of the procedure still needs more precise selection criteria as well as better definition of the clinical benefit/safety ratio. These uncertainties persist due to the small number of rescue angioplasty procedures compared to the total number of angioplasties performed. In the CENIC Registry, rescue angioplasty amounts to 4% of all angioplasties performed.
In December 2019, patients with respiratory symptoms attended some medical institutions in Wuhan, China, and were subsequently diagnosed with a new type of coronavirus pneumonia. In February 2020, WHO considered the disease as a Public Health Emergency, a pandemic known as Corona Virus Disease 2019 (CoVid-19). In this sense, this article aims to demonstrate findings in the literature that corroborate the use of chloroquine / hydroxychloroquine in the clinical management of CoVid-19. This is a bibliographic review, in which the following reference databases were used: Virtual Health Library (Bvs), Web of Science; Capes Journal; SciELO; PubMed and LILACS. The critical evaluation of the articles selected for writing the article was performed using the Critical Appraisal Tool (CAT). In turn, it is understood that chloroquine / hydroxychloroquine can inhibit the replication of several viruses, interacting with the viral input mediated by endossoma or with the final stages of viruses replication involved. In addition, the use of Chloroquine concomitant with remdesivir may have promising outcomes until a vaccine can be developed. Therefore, chloroquine / hydroxychloroquine has immunomodular properties that may be of interest in viral infections associated with inflammation and/or immune activation, requiring additional research, always considering its potential for toxicity to the human body.
Em dezembro de 2019, pacientes com sintomas respiratórios compareceram em algumas instituições médicas em Wuhan, na China e foram posteriormente diagnosticados com um novo tipo de pneumonia por coronavírus. A Organização Mundial da Saúde (OMS) em fevereiro de 2020 considerou a doença como uma Emergência em Saúde Pública, tratando-se de uma pandemia, conhecida como Corona Virus Disease 2019 (CoVid-19). Nesse sentido, objetiva-se com o presente artigo demonstrar registros na literatura que corroborem o uso da cloroquina no manejo clínico da CoVid-19. Trata-se de uma revisão bibliográfica, em que se utilizou as seguintes bases de dados referenciais: Biblioteca Virtual de Saúde (Bvs), Web of Science; Periódico da Capes; SciELO; PubMed e LILACS. A avaliação crítica dos artigos selecionados para redação do artigo foi realizada mediante a ferramenta Critical Appraisal Tool (CAT). Por sua vez, compreende-se que a cloroquina pode inibir a replicação de vários vírus, interagindo com a entrada viral mediada por endossoma ou com os estágios finais da replicação de vírus envolvidos. Além disso, o uso de cloroquina concomitante ao remdesivir pode ter desfechos promissores até que uma vacina possa ser desenvolvida. Portanto, a cloroquina apresenta propriedades imunomoduladoras que podem ser de interesse nas infecções virais associadas à inflamação e/ou ativação imune, necessitando de pesquisas adicionais e considerando sempre seu potencial de toxicidade ao organismo humano.
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