In response to comment on “Autoimmune post‑COVID vaccine syndromes: does the spectrum of autoimmune/inflammatory syndrome expand?” by Jara LJ et al

Clinical Rheumatology -     

Synovial fluid analysis for the enhanced clinical diagnosis of crystal arthropathies in a tertiary care institution

Clinical Rheumatology - Few studies have addressed the detection and clinical impact of different crystals in patients with diverse rheumatologic diagnoses in Latin America. The aim of this study...     

Sudden death in patients with implantable cardioverter defibrillators: the importance of post-shock electromechanical dissociation

OBJECTIVES: The purpose of this study was to determine the mechanisms of sudden death (SD) in patients with ventricular tachyarrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) treated with an implantable cardioverter defibrillator (ICD). BACKGROUND: Despite ICD therapy, some patients with VT/VF still die suddenly. Optimal ICD use requires determination of the mechanisms of these residual SDs. METHODS: We reviewed 320 patient deaths during trials of Medtronic transvenous ICD systems (Medtronic Inc., Minneapolis, Minnesota). Sudden deaths were further categorized according to mechanism. Post-shock electromechanical dissociation (EMD) describes a scenario where VT/VF was appropriately detected and treated by an ICD shock that restored a physiologic rhythm, but death still occurred immediately by EMD. RESULTS: A mode of death could be ascribed for 317 patients-90 (28%) were sudden, 156 (49%) were non-sudden cardiac, and 71 (22%) were noncardiac. A mechanism of SD was proposed for 68 patients-20 (29%) had post-shock EMD, 17 (25%) had VT/VF uncorrected by shocks, 11 (16%) had primary electromechanical dissociation, 9 (13%) had incessant VT/VF, 5 (7%) had VT/VF after their ICD was deactivated or removed, and 6 (9%) had single instances of various other terminal events. Only New York Heart Association functional class independently predicted SD by post-shock EMD. CONCLUSIONS: The most common mechanism of SD in patients with an ICD is VT/VF treated with an appropriate shock followed by EMD. As this mechanism accounted for 29% of the SDs to which a cause could be ascribed, this mechanism of SD warrants further investigation.     

Exotic pets are new allergenic sources: allergy to iguana.

Although furry animals are known sources of respiratory allergy, scaly animals are assumed not to be allergenic. Exotic animals such as iguanas are becoming increasingly common pets. Nevertheless, these animals are not suspected to be allergenic. We present the case of a 42-year-old woman suffering from allergic rhinoconjunctivitis and asthma caused by a pet iguana. Clear IgE-sensitization and respiratory allergy to iguana scales is demonstrated, suggesting that scaly pets should be taken into account as possible allergenic sources.