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PALABRAS CLAVEIsquemia miocárdica; Electrocardiografía ambulatoria; Sepsis; Choque séptico Resumen Objetivo: Describir la incidencia de eventos cardiovasculares adversos en pacientes con diagnóstico de sepsis en sus diferentes estadios. Diseño: Estudio observacional, descriptivo, longitudinal. Ámbito: Unidades de cuidados intensivos de tipo mixto de dos hospitales universitarios en la ciudad de Bogotá. Participantes: Se incluyeron una serie de pacientes mayores de edad, que ingresan a UCI con diagnostico de sepsis, sin evidencia de lesión miocárdica isquémica previa. Intervenciones: Registros electrocardiográficos continuos de 12 derivaciones durante 48 horas con monitoría Holter Variables de interés: Isquemia, arritmia cardiaca, variabilidad de la frecuencia cardiaca. Resultados: Se analizaron 100 pacientes, 62% de los cuales se estadificó como choque sép-tico. El 3% presentó evento cardiovascular adverso de tipo isquémico detectado por Holter y desapercibido por monitoreo convencional. El 46% presentaron un evento de tipo arrít-mico por Holter, comparado con solo un 6% detectado por monitoreo convencional. La mortalidad cruda fue de 40%. El 100% presentó pérdida de la variabilidad de la frecuencia cardiaca. Conclusión: La sepsis en esta experiencia mostró una baja incidencia de eventos cardiovasculares isquémicos. Los eventos arrítmicos, sin embargo, mostraron una incidencia alta. El monitoreo convencional falló en detectar la totalidad de los eventos isquémicos y en mayor proporción los eventos arrítmicos. En esta serie, los eventos cardiovasculares generados por descarga adrenérgica no impactan en la mortalidad.

PORCINE stomatitis is uncommon and is usually associated with viral vesicular diseases such as foot-and-mouth disease, vesicular stomatitis, vesicular exanthema of pigs, swine vesicular disease and congenital swine pox (Borst and others 1990, Radostits and others 1994). Other causes of porcine stomatitis include mycotoxins such as T-2 toxin (Sanford and Friendship 1992) and Stachybotrys atra toxins (Forgacs and Carll 1962), bromobenzylnitrile vapour (Oberst and others 1970), and contact with disinfectants or heated food (Liebler and others 1992). Approximately one third of pigs with exudative epidermitis have glossitis or stomatitis (Mebus and others 1968, Andrews 1979, Leibler and others 1992). Porcine stomatitis caused by Fusobacterium necrophorum (oral necrobacillosis) has been described in young pigs (Barker and others 1992); however, references to porcine oral necrobacillosis in adult pigs could not be found in scientific journals from 1930 to 1997. This short communication describes the pathological and microbiological features of necrotising stomatitis (oral necrobacillosis) associated with F necrophorum in three sows. All three animals were submitted from a 200 sow farrow-tofinish farm. Gestating sows were housed in confined stalls on a partially slatted concrete floor. The sows were presented for necropsy during a four month period (August to November). Pig I was a one-year-old crossbred sow with a 10-day history of anorexia, glossitis and pododermatitis. This sow was euthanased due to the severity of the oral lesions and the lack of response to antibiotic treatment. On necropsy, the dorsal surface of the tongue was diffusely ulcerated. Ulcers were covered by a white-grey pseudomembrane and the underlying tissue was hyperaemic. Similar lesions were observed over approximately 50 per cent of the oral mucosa (Fig 1). Numerous teeth were loose. One month after this first case, a five-month-old gilt with a history of facial swelling, anorexia and teeth grinding was presented for necropsy. Euthanasia was carried out after examination of the severe necrotising lesions in the mouth. Necropsy revealed swelling of tissues surrounding the mandible, especially on the right side. The affected area contained friable, dark green and yellow tissue. The mandibular bone was replaced by this necrotic tissue in a 10 cm long segment centred around the lower right canine tooth, and the root of this tooth was absent. Patchy areas of necrosis were also seen in the right side of the maxilla. In addition, abundant green/grey, granular to creamy exudate oozed from the right side of the hard palate.

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