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Montaner J, Alvarez-Sabín J, Rovira A, Molina C, Grivé E, Codina A, Miquel F. [Vertebrobasilar abnormalities in patients with hemifacial spasm: MR-angiography findings]. Rev Neurol 1999; 29:700-3. [PMID: 10560103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Hemifacial spasm (HFS) is a disorder characterized by a complex of symptoms with hyperactive motor dysfunction of the facial nerve. It is indicated that HFS in the majority of cases can be caused by a blood vessel compressing the nerve adjacent to the brainstem. PATIENTS AND METHODS We studied and treated 44 patients with HFS. Magnetic resonance imaging (MR) and MR-angiography of the brain were performed in patients with HFS to asses the presence of an artery of the vertebrobasilar system compressing the root of the facial nerve. We evaluate the response to treatment with Botulinum toxin in these cases. 14 patients were excluded (6 patients presented HFS due to other lesions and in 8 patients the MR was not performed). The remaining 30 patients with idiopathic HFS underwent MR/MRA (3D-FISP) and it was also performed in 14 patients with synkineses after facial palsy to be used as controls. RESULTS The MRA documented an abnormal position of the arteries surrounding the facial nerve (ipsilaterally to HFS) in 22 patients. The compressing artery was the PICA in 3 patients (10%), the AICA in 3 patients, the vertebral artery in 7 patients and the basilar artery in 8 patients, one patient showed a combined compression by AICA and PICA. The remaining 8 patients had a normal MRI. At the control group only one patient presented an abnormal AICA and the other had a normal MRI-MRA. Patients were followed-up for 22.4 months and after Botulinum toxin treatment patients kept 4.81 months free of symptoms. CONCLUSIONS We recommend to perform MR studies in all HFS patients to rule out a secondary cause of the disease and MRA to evaluate the underlying vertebrobasilar abnormalities if surgery is planned. Botulinum toxin is a useful treatment in these patients and only after its failure, microvascular decompression will be considered.
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Molina C. [Exterior and interior air pollution. Its impact on health]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 1999; 183:323-5. [PMID: 10371779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Montaner J, Mauleón A, Vidal C, Molina C, Alvarez-Sabín J. [Stroke: a stranger among the people]. Rev Neurol 1998; 27:943-7. [PMID: 9951009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Lack of awareness of warning signs of stroke is a factor that contribute to late patient arrival to the emergency department. OBJECTIVE The goal of this pilot study was to determine the baseline knowledge of stroke among the population (terminology, signs-symptoms, risk factors and attitude) prior to educational campaigns. PATIENTS AND METHODS A population-based interview using closed-ended questions was conducted by neurologists among 100 users of the Vall d'Hebron's Primary Health Center, randomly sampled. RESULTS In our population a 9% unknowns totally the disease, of the remainder, 42% has a good knowledge of signs-symptoms and 46% of risk factors. Only 22% of the sample has good global knowledge of the disease. If suffering a stroke this population should seek medical attention through 911 (46.2%) or come directly to the emergency department (50.5%). If symptoms were gone away, transient ischemic attack (TIA), appears a trend to contact primary physicians (59.3%). Respondents aged > 65 years were less likely to recognize symptoms (p = 0.001) and to consider stroke as an emergency. Respondents with an affected relative (50.5%) tend to locate more exactly the disease at the brain (p = 0.05) and to arrive earlier to the emergency department (p = 0.045), than those with non-affected relatives. CONCLUSIONS Less than a quarter of our population have a good knowledge of the disease. Stroke is considered an emergency unlike TIA. The information about stroke is theoretically associated with early presentation to the emergency department. These results permit a redesign of the questionnaire to conduct a second phase of the study and generalize them for the Spanish population.
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Hernández D, Jiménez C, Loinaz C, Pinto IG, Gómez R, Molina C, Palma F, Moreno C, López A, García I, Moreno González E. Risk factors of graft loss in orthotopic liver transplantation. Transplant Proc 1998; 30:3241-2. [PMID: 9838431 DOI: 10.1016/s0041-1345(98)01010-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Paoli M, Bellabarba G, Velazquez E, Mendoza S, Molina C, Wang P, Glueck CJ. Sex steroids, lipids, and lipoprotein cholesterols in women with subclinical and overt hypothyroidism before and after L-thyroxine therapy. Clin Chim Acta 1998; 275:81-91. [PMID: 9706846 DOI: 10.1016/s0009-8981(98)00074-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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106
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Molina C. [Presentation of the Environmental-Health Prize 1997: Lyme borreliosis]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 1998; 182:263-5. [PMID: 9648342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Lyme borreliosis is an infectious disease, with multisystem involvement, due to a spirochete known as Borrelia burgdorferi, transmitted to humans by ticks; its recent emergence is, in part, the consequence of reforestation and the rise in deer and rodents populations. The prevention and the treatment of this disease are well standardized, the main risk being its misdiagnosis.
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Lacorte S, Molina C, Barceló D. Temperature and extraction voltage effect on fragmentation of organophosphorus pesticides in liquid chromatography–atmospheric pressure chemical ionization mass spectrometry. J Chromatogr A 1998. [DOI: 10.1016/s0021-9673(97)00949-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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108
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Molina C, Arenas A, Victoria L, Ibáñez JA. Characterization of a Membrane System. Complex Character of the Permeability from an Electrical Model. J Phys Chem B 1997. [DOI: 10.1021/jp9711104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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109
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Molina C, Alvarez-Sabín J, Abilleira S, Codina A. [Isolated axial lateral pulse as a sign of latero-bulbar ischemia: clinical topographic correlation]. Rev Neurol 1997; 25:1582-4. [PMID: 9462987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Isolated body lateropulsion in absence of vertigo, cerebellar syndrome, sensory loss or motor weakness is an extremely rare. This condition has only been reported four times. CLINICAL CASES AND CONCLUSION We present four patients in whom isolated body lateropulsion was a single manifestation of lateral medullary ischemia.
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Lamas M, Molina C, Foulkes NS, Jansen E, Sassone-Corsi P. Ectopic ICER expression in pituitary corticotroph AtT20 cells: effects on morphology, cell cycle, and hormonal production. Mol Endocrinol 1997; 11:1425-34. [PMID: 9280058 DOI: 10.1210/mend.11.10.9987] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The products of the cAMP response element modulator (CREM) gene play an important role in the transcriptional response to cAMP in endocrine cells. By virtue of an alternative, intronic promoter within the gene, the inducible cAMP early repressor (ICER) isoform is generated. ICER was shown to act as a dominant negative regulator and to be cAMP-inducible in various neuroendocrine cells and tissues. ICER negatively autoregulates its own expression and has been postulated to participate in the molecular events governing oscillatory hormonal regulations. To elucidate ICER function in pituitary physiology, we have generated AtT20 corticotroph cell lines expressing the sense or antisense ICER transcript under the control of the cadmium-inducible human methallothionein IIA promoter. Here we demonstrate that changes in the regulated levels of ICER have drastic consequences on the physiology of the corticotrophs. Ectopic ICER expression induces remarkable modifications in AtT20 morphology. Cells with persistent, nonregulated high levels of ICER are blocked in the G2/M phase of the cell cycle, while the opposite effect is obtained in cells expressing an antisense ICER transcript. We show that the effect of ICER on the AtT20 cell cycle is correlated to a direct down-regulation of the cyclin A gene promoter by ICER. Finally, we show that ACTH hormonal secretion from the corticotrophs is completely blocked by ICER ectopic expression. Interestingly, this effect is not due to a direct regulation of the POMC gene, but is mediated by a transcriptional control of the prohormone convertase 1 gene. These results point to a key regulatory function of CREM in pituitary physiology.
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Abilleira S, Romero-Vidal F, Alvarez-Sabín J, Ibarra B, Molina C, Codina A. [Jugular megabulb as a cause of pulsatile tinnitus]. Rev Neurol 1997; 25:1422-4. [PMID: 9377305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Pulsatile tinnitus (AP), possibly of vascular origin, may be a sign of various vascular and non-vascular pathological processes. Arteriovenous fistulas and malformations are, perhaps, the commonest cause of AP. CLINICAL CASE A 64 year-old woman presented with AP of the right ear for the past 14 years. It was continuous all day and could be observed externally by the examiner. The intensity of the tinnitus diminished on right later-cervical compression and on turning her head to the left. There was bilateral transmission deafness. Neurological examination was normal. Complementary explorations (MR, CT of the base of the skull and cerebral arteriography) showed the presence of a jugular megabulb of the right side. CONCLUSIONS The presence of AP may be for many years the only sign of subjacent vascular pathology, such as a megabulb of the jugular vein.
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Molina C. [Introduction: soil pollution, agriculture and public health]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 1997; 181:17-9. [PMID: 9162511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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114
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Terreni M, Benfenati E, Pregnolato M, Bellini A, Giavini D, Bavetta S, Molina C, Barceló D. Synthesis and use of deuterated fenamiphos and its metabolites as internal standards for mass spectrometric analysis in water. J Chromatogr A 1996. [DOI: 10.1016/s0021-9673(96)00442-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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115
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Alvarez-Sabín J, Molina C, Martín R, Matías-Guiu J. [The tolerance of two therapeutic uses of triflusal in patients with ischemic stroke. Letter]. Rev Neurol 1996; 24:1306-7. [PMID: 8983739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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116
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Canton A, Simo R, Mesa J, Molina C, Rovira A, Montalban X. Central diabetes insipidus: a complication of herpes simplex encephalitis. J Neurol Neurosurg Psychiatry 1996; 61:325-6. [PMID: 8795612 PMCID: PMC486564 DOI: 10.1136/jnnp.61.3.325] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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117
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Molina C, Grasso P, Benfenati E, Barceló D. Automated sample preparation with extraction columns followed by liquid chromatography-ionspray mass spectrometry interferences, determination and degradation of polar organophosphorus pesticides in water samples. J Chromatogr A 1996. [DOI: 10.1016/0021-9673(95)01341-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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118
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Molina C, Díaz-Villoslada P, Tintoré M, Serena J, Ortega A. [Dementia, parkinsonism and myoclonic seizures in a 58-year-old woman]. Rev Neurol 1996; 24:574-9. [PMID: 8681179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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119
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Eylar EH, Molina C, Báez I, Kessler M. Slow cluster formation of purified human or rhesus T cells requires protein kinase C and LFA-1. PUERTO RICO HEALTH SCIENCES JOURNAL 1996; 15:13-9. [PMID: 8744862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Homotropic T cell adhesion, as generally studied, consists of a rapid, transient binding process that is measured over a 15-120 min. period. Here we report a slow type of adhesion process occurring with human or rhesus T cells, purified from peripheral blood, that manifests itself by the formation of rounded, multi-layer clusters which may contain hundreds of cells. The maximal number and size of the clusters peak 1-2 days after the addition of phorbol ester, an absolute requirement. The number of clusters formed is proportional to phorbol ester concentration up to 1.25 ng/mL. Phorbol esters such as phorbol myristate acetate (PMA), phorbol dibutyrate (PDB), and 7-octylindolactam (OIL) induced optimal cluster formation at 1-13 ng/mL, levels slightly higher than that required to induce mitogenesis of purified T cells. Phorbol itself and the alpha-form of the ester were inactive. Both cluster formation and mitogenesis (stimulated by Con A or anti-CD3) are completely inhibited by staurosporin at 12.5 ng/mL. Even at 2.5 ng/mL, 74% of cluster formation was inhibited, which strongly implies a crucial role for protein kinase C. In the presence of accessory cells, T cell clusters were suppressed. Monoclonal Ab such as anti-CD3, mouse anti-CD3 followed by anti-mouse IgG, anti-CD4, anti-CD4A, anti-CD2, anti-CD8, and anti-CD45 did not induce cluster formation. None were inhibitory or stimulatory in the presence of PMA, except for anti-CD3 which enhanced cluster formation by 26%. However, anti-LFA-1 beta-chain (mouse monoclonal) completely blocked cluster formation over the range studied (63-1000 ng/mL) for both human and rhesus cells; rat anti-LFA-1 only blocked human cell adhesion. Anti LFA-1 only partially inhibited T cell mitogenesis. These results show that slow cluster formation shares the LFA-1 and phorbol ester requirements of the rapid adhesion of T cells requiring LFA-1 and ICAM-1. However, cluster occurs at a very low phorbol ester concentration, appears more sensitive to staurosporin inhibition, and is not stimulated via the TCR receptor like the rapid adhesion process. We hypothesize that certain neuronal processes, induced by phorbol ester, and which also show a similar protein kinase C activation time course, may share mechanisms in common with cluster formation.
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Olmos M, Molina C, Piskorz E, Tawil J, Magnanini F, Casiró A, Cahn P, Concetti H, Janeiro M, Guelfand L, Kaufman S. [Diarrhea and AIDS: more complex diagnostic techniques; better therapeutic results]. ACTA GASTROENTEROLOGICA LATINOAMERICANA 1996; 26:91-100. [PMID: 9137663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
During 17 months, 73 HIV-positive patients with diarrhea lasting at least for 14 days, were studied prospectively. The patients had stool specimen examinations negative for enteric pathogens, or positive for one of them, but with no response to specific treatment. All patients were subcomitted to digestive endoscopy and biopsies were taken for microbiological and histological studies. The etiology of the diarrhea could be established in 48 patients (66%). In 45, the cause was an enteric infection. There was association of 2 pathogens in 11 patients, and of 3 in 1 patient. The agents found were: Cryptosporidium (24%), MAI (16%), Giardia lambila (12%), isospora belli (5%), Shigella (5%), Salmonella (5%); Entamoeba histolytica (3%), HSV (3%), tuberculosis (2%), adherent bacteria (2%) and spirochetes (2%). In 3 patients the etiology was not infection, their diagnoses were coeliac disease, lymphoma and idiophatic colonic ulcers, respectively. In 51% of the cases only the examination of endoscopic biopsy specimens could identify the cause of the diarrhea. These results justify the use of these methods to improve diagnosis and therapeutic attempts in these patients.
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Molina C, Alvarez Sabín J, Bosch J, Codina Puiggrós A. [Somatosensory focal seizures as an onset form in adult Moyamoya syndrome]. Rev Neurol 1995; 23:1242-5. [PMID: 8556629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Moya-Moya disease is a chronic infrequent vasculopathy. Occasionally such abnormalities are found in association with one of many conditions, in these cases the angiographic abnormality should be termed Moya-Moya syndrome rather than Moya-Moya disease. Although in children the usual manifestations are ischemic events and seizures. This clinical presentation is infrequent in adults. We present a 42-years-old man with a 1-month history of recurrent right sided partial somatosensorial seizures, later he presented a left parietal infarction, the angiographic findings were compatible with moyamoya syndrome.
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Molina C, Durand G, Barceló D. Trace determination of herbicides in estuarine waters by liquid chromatography-high-flow pneumatically assisted electrospray mass spectrometry. J Chromatogr A 1995; 712:113-22. [PMID: 8556145 DOI: 10.1016/0021-9673(95)00192-p] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
High-flow pneumatically assisted electrospray (ESP) was applied to the characterization of triazine (atrazine, simazine, ametryne, cyanazine, deethylatrazine and deisopropylatrazine), phenylurea (chlortoluron++, isoproturon, diuron, linuron and diflubenzuron) and other priority herbicides (alachlor, metolachlor). In LC-ESP-MS the [M+Na]+ ion was used as the base peak in most cases, with the exception of chlorotriazines, which showed [M+H]+ as the base peak. When LC-TSP-MS was used, [M+H]+ was the base peak for many of the pesticides, with the exception of linuron and diflubenzuron, which showed [M+NH4]+ as the base peak. The ESP results were compared with those obtained with thermospray (TSP). LC-TSP-MS offered greater sensitivity for triazines than phenylurea herbicides, whereas the use of LC-ESP-MS offered an enhancement in sensitivity for phenylurea herbicides. As regards the fragmentation obtained using both techniques, ESP offered a considerable amount of structural information for the different chlorotriazines studied when the extraction voltage was increased from 20 to 40 V. Liquid-liquid extraction with dichloromethane was used for the trace enrichment of the different herbicides in estaurine water samples from the Elorn river (France). The presence of the different triazine metabolites, atrazine, simazine, metolachlor, isoproturon and diuron was confirmed by both LC-MS techniques.
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Carrasco HA, Parada H, Guerrero L, Duque M, Durán D, Molina C. Prognostic implications of clinical, electrocardiographic and hemodynamic findings in chronic Chagas' disease. Int J Cardiol 1994; 43:27-38. [PMID: 8175216 DOI: 10.1016/0167-5273(94)90087-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
To evaluate the prognostic importance of 19 clinical, electrocardiographic and hemodynamic variables, 556 chronic chagasic patients were submitted to an extensive protocol, including left cineventriculogram and Holter monitoring, and followed for up to 15 years. The protagonist role of the magnitude of the myocardial compromise in the evolution of chagasic patients is underscored by our results, which indicated the independent prognostic value of an ejection fraction below 0.30 (P < 0.001), a heart rate higher than 89 beats/min (P < 0.01), grade IV functional capacity (P < 0.05), end systolic stress > 120 g/cm2 (P < 0.05), and end diastolic volume index > 200 ml/m2 (P < 0.05). When only patients with an ejection fraction over 0.29 were considered, variables with independent prognostic value were: the cardio-thoracic ratio (P < 0.01), functional capacity (P < 0.05) and heart rate (P < 0.05). Survival analysis demonstrated that the presence of complex (Lown III, IV) ventricular arrhythmias increased mortality significantly (P < 0.01) only in patients with an ejection fraction over 0.29. Therefore, preservation of myocardial function is the capital measure in the treatment of chronic chagasic patients.
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Molina C, Molina N. [Air quality of premises and public health]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 1994; 178:47-55; discussion 55-6. [PMID: 8038994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Indoor air quality is gaining increasing prominence as a public health problem in developed and developing countries. Its pollution brings about diseases (infectious, allergic, toxic, carcinogenic) or benign symptoms (without clear definition) grouped in the so-called Sick Building Syndrome. On the basis of 2 large surveys in air conditioned buildings the authors describe the main factors of this syndrome which is prominently observed in women and is multifactorial. The improvement of indoor air quality needs interaction among the diverse disciplines: architects, engineers, biologists and clinically oriented physicians.
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Payares A, Carrasco HA, Durán D, Molina C, Ortiz R, Violi D. [The anti-arrhythmia effect of carbamazepine in chagasic patients with advanced myocardial damage]. ARCHIVOS DEL INSTITUTO DE CARDIOLOGIA DE MEXICO 1993; 63:241-6. [PMID: 8347054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Oral administration of 600 mg/day of carbamazepine to 14 arrhythmic chagasic patients with advanced myocardial damage and no signs of congestive heart failure did not alter the frequency of ventricular extrasystoles, but reduced the total number of supraventricular ectopic beats in 7/14 patients and the episodes of complex ventricular arrhythmias in up to 43% of patients. This assessment was made from 24 hour continuous Holter recording during the course of this double-blind, placebo controlled, randomized crossover study. Serum levels of carbamazepine were also determined and found within therapeutic limits. Six patients complained of minor side effects. One patient presented with iatrogenic complete AV block, another case had proarrhythmic effect and one patient had to be withdrawn from the study because of gastric irritation. No instance of contractile depression was observed. Accordingly, carbamazepine is a therapeutic alternative for treatment of symptomatic complex ventricular or supraventricular arrhythmias in chronic chagasic patients without evidence of conduction system involvement or with intolerance to other antiarrhythmic drugs.
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