RESUMO
AIM: Mortality from acute myocardial infarction has been falling during the past 30 years. The aim of the study was to evaluate the temporal trends of demographics, mortality rates, and time to treatment in patients admitted for acute ST elevation myocardial infarction (STEMI) in Vendée. PATIENTS AND METHODS: From 2008 to 2016, 1994 patients hospitalised in CHD Vendée for STEMI <48hours were included. Two groups were compared, 838 patients admitted between 2008 and 2011 (group 1), and 1156 admitted between 2013 and 2016 (group 2). RESULTS: Between the 2 periods, mean age was comparable (63.8 vs. 64.4 years), the gender ratio decreased (from 3.15 to 2.79 ; P=0.25). The mean duration of hospital stay was 0.8 day shorter (P=0.008). Treatment at discharge was optimum in 97.5% patients versus 92% (P<0.001). Left ventricular ejection fraction was comparable (50.6% vs. 50.2%). There was a non-significant trend to a decrease in hospital mortality (from 6.3% to 4.4%; p=0.12), and 6-month mortality (from 6.9% to 5.9%; P=0.51). There was a reduction in the use of emergency call-outs (74.9% to 68.9%; P<0.01), but an increase in direct presentations from 44% to 48.7% (P<0.05). The time before calling was comparable (2.5hours vs. 2.3hours; P=04.7). The "door-to-balloon" time decreased (0.71 vs. 0.55hour; P<0.001). The mean time between pain and angioplasty increased (5.7 vs. 6.8hours; P<0.05). CONCLUSIONS: In vendee, from 2011 to 2016, hospital and 6-month mortality of STEMI trend to decrease non-significantly. The door to balloon time decreased, although emergency call-out rates and delays did not. Considerable efforts are still required with respect to patient information and education. Our registry offers an excellent tool to improve practices, the aim being to ensure its integration in the CRAC-France PCI registry.
Assuntos
Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Tempo para o Tratamento , Idoso , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de RegistrosRESUMO
After transplantation, pre-existent vesicoureteral reflux caused a hot paravesical area mimicking urine extravasation.
Assuntos
Transplante de Rim , Refluxo Vesicoureteral/diagnóstico por imagem , Erros de Diagnóstico , Humanos , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Cintilografia , Refluxo Vesicoureteral/complicaçõesRESUMO
Interstitial lymphoscintigraphy is a diagnostic method useful in the staging and follow-up of several tumours as well as in the etiological evaluation of limb edema. It is a simple technique with minimal invasivity which can be performed even in those regions inaccesible to radiographic lymphography. Because of its great sensitivity and low specifity it requires careful interpretation.
Assuntos
Linfografia/métodos , Ascite/etiologia , Axila , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Metástase Linfática , Linfedema/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Pelve , Doses de Radiação , Cintilografia , Neoplasias Urogenitais/diagnóstico por imagemRESUMO
As a consequence of its affinity to leukocytes and tumour cells, 67Gallium-Citrate is a good isotope for detecting infections and tumoral pathology. Its sensitivity is greater for lymphatic system malignancies, primary lung cancer, primary liver carcinoma and melanoma. It is a useful method with more sensitivity than diagnostic specificity.
Assuntos
Radioisótopos de Gálio , Ligação Competitiva , Carcinoma Hepatocelular/diagnóstico por imagem , Fenômenos Químicos , Química , Radioisótopos de Gálio/metabolismo , Humanos , Infecções/diagnóstico por imagem , Ferro/metabolismo , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Cintilografia , Transferrina/metabolismoAssuntos
Carcinoma/radioterapia , Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/radioterapia , Carcinoma/metabolismo , Humanos , Radioisótopos do Iodo/efeitos adversos , Radioisótopos do Iodo/metabolismo , Tireoglobulina/análise , Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/metabolismo , Contagem Corporal TotalRESUMO
A 64-year-old man presented with a massive right-sided hydrothorax associated with cirrhosis of the liver. There was no clinical evidence of ascites nor other underlying disease. The usual complementary tests failed to demonstrate any causative abnormality. Chest and abdominal scintigraphy after intraperitoneal injection of 99mTc-human serum albumin disclosed early filling of the pleural space by the radiopharmaceutical and suggested a diaphragmatic defect as the cause for this rare association.
Assuntos
Diafragma/anormalidades , Hidrotórax/diagnóstico por imagem , Cirrose Hepática/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Agregado de Albumina Marcado com Tecnécio Tc 99mRESUMO
Urinary leakage after renal transplantation is a serious complication that can lead to diagnostic difficulties. A case is reported of urinoma secondary to ureteral fistula characterized in the routine study by a photon-deficient area. Only the image obtained at 6 h allowed a correct diagnosis. The causes for this are discussed and the need to include a delayed study in the follow-up protocol of these patients is emphasized.
Assuntos
Transplante de Rim , Ácido Pentético , Tecnécio , Doenças Ureterais/diagnóstico por imagem , Fístula Urinária/diagnóstico por imagem , Adulto , Humanos , Rim/diagnóstico por imagem , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Cintilografia , Pentetato de Tecnécio Tc 99m , Fatores de TempoRESUMO
Serial myocardial imaging using thallium Tl 201 was performed in the early follow-up of two patients with orthotopic cardiac transplantation. In one patient, non-homogeneous uptake, small defects and an irregular myocardial edge were observed during a moderately acute rejection crisis revealed by endomyocardial biopsy. The abnormal gammagraphic findings and histological changes were coincident and exhibited a parallel reversal. We emphasize the connection between these two events. The mechanisms which could explain these phenomena are discussed.