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Introduction: Remote patient monitoring (RPM) is a telehealth activity to collect and analyze patient health or medical data. Its use has expanded in the past decade and has improved medical outcomes and care management of non-communicable chronic diseases. However, implementation of RPM into routine clinical activities has been limited. The objective of this study was to describe the French funding program for RPM (known as ETAPES) and one of the RPM solution providers (Satelia®) dedicated to chronic heart failure (CHF). Methods: A descriptive assessment of both the ETAPES funding program and Satelia® RPM solution was conducted. Data were collected from official legal documents and information that was publicly available online from the French Ministry of Health. Results and Discussion: ETAPES was formally created in 2016 based on previous legislation pertaining to the national health insurance funding strategy. However, it only started to operate in 2018. Patients with CHF were only eligible if they were at medium or high risk of re-hospitalization with a New York Heart Association (NYHA) score superior or equal to two and a BNP>100â pg/ml or NT pro BNP>1000â pg/ml. Medical monitoring was supported through the therapeutic education of a patient on the RPM model of care with a minimum of three training sessions during the first six months. The use of Satelia® Cardio is noteworthy since it relies only on symptomatic monitoring through which the patient manually reports their information by answering a simple questionnaire on a regular basis and does not rely on any connected devices. Conclusion: Innovative funding programs and solutions for RPM need real-world evaluation in the future.
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OBJECTIVE: The objective of this work is to give epidemiological data, established in a prospective way, on the myocardial infarction in young and its risk factors. METHODS: All patients admitted to the CHG of Pau for myocardial infarction, old, for the men of less than 45 years and for the women of less than 55 years, of November the 1st 2002 to October 31st, 2003, are included. RESULTS: Twenty-seven patients (11.2%) do a myocardial infarction including 44.4% women. The found traditional risk factors are: smoking (92.6%), absence of regular physical activity (81.5%), dyslipidaemia (66.7%), family history of cardiovascular disease (48.2%), hypertension (37.0%), obesity (18.5%), oral contraception (11.1%), diabetes (7.4%), personal thrombotic history (7.4%). The principal emergent risk factors highlighted are: stress (66.7%), inhibitor of the activation of the plasminogene (57.1%), C-reactive protein (50%), lipoprotein a (41.7%), fibrinogen (33.3%), elevated plasma homocysteine (25%), excessive alcohol use (22.2%). None patients does not have an absolute cardiovascular risk > 20%. The clinical characteristics, coronarographic data and the acute treatments were also listed. The prognosis is worse for the women with more risk factors, more complications, and risk of more significant ventricular replanning. CONCLUSION: The principal risk factors of the myocardial infarction in young can be modifiable. The prevention is of primary importance. The therapeutic education of the patients corresponds to the total assumption of responsibility required by this pathology.
Assuntos
Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Adulto , Fatores Etários , Doenças Cardiovasculares/complicações , Dislipidemias/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/prevenção & controle , Prognóstico , Estudos Prospectivos , Fatores de Risco , Fumar/efeitos adversosRESUMO
OBJECTIVES: The QKD interval is measured between the onset of QRS on the ECG and detection of last Korotkoff sound by a microphone placed on the brachial artery while measuring BP. It is the sum of preejection time and pulse transmission time and thus is correlated to pulse wave velocity (PWV). This interval is automatically monitored with BP and HR every 15 minutes during 24 h with an ambulatory blood pressure monitoring device (Diasys integra, Novacor, France). The 96 measurements obtained allow to automatically calculate the QKD(100-60), QKD value for 100 mmHg SBP and 60 bpm HR. This indice of arterial stiffness has been shown to be linked to future cardiovascular (CV) events, independently of 24 h BP. However this interval may be abnormally prolonged in case of left bundle branch blocks (LBBB). METHODS: We tested the effects of simply removing QRS duration from QKD(100-60) value on the prediction of CV events in a population of 412 hypertensives (247 males: age = 53 +/- 14 years; office BP = 158 +/- 19/97 +/- 11 mmHg; 24 h BP = 133 +/- 17/86 +/- 11 mmHg) followed prospectively. RESULTS: Mean follow up was 65 months, 32 pts were lost, 49 CV events occurred including 11 deaths. Cox model showed that baseline QKD(100-60) (m = 202 +/- 19; 142-254 ms) was significantly (p < 0.05) associated to events independently of age, 24h SBP and other traditional risk factors. Removing QRS duration (m = 85 +/- 10: 61-158 ms) improves the relation to events (monovariate khi2 = 38 vs 30). CONCLUSION: Removing QRS duration from QKD(100-60) improves its predictive value of future CV events and allows using this method in patients with LBBB.
Assuntos
Eletrocardiografia , Hipertensão/patologia , Adulto , Idoso , Artéria Braquial/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos ProspectivosRESUMO
Primary hyperaldosteronism is a diagnosis which should be considered in refractory hypertension even in the absence of any hypokalaemia. Its detection relies above all on the levels of renin and aldosterone. The aldosterone/renin ratio has been proposed as the most sensitive criterium. The reference values used for the diagnosis of primary hyperaldosteronism are very variable in the literature, depending not only on the method used but also on the criteria used for their determination. In this study we evaluated the defined reference values prospectively by studying a population of patients with a Conn's adenoma treated surgically. The study included an initial retrospective period which allowed identification of 29 cases of Conn's adenoma treated surgically, and a 9 month prospective period during which 212 reports were collected. During this prospective period a further 9 cases of Conn's adenoma were detected, which were successfully treated with surgery. Analysis to discriminate the 38 Conn's adenomata from the rest showed that 3 parameters contributed significantly and independently to the diagnosis: supine plasma renin activity (ARPc), supine aldosteronaemia and the erect aldosterone/renin ratio, allowing correct classification in 88% of the cases. The reference ranges of these 3 parameters were calculated in order to give a sensitivity of 100% and the best possible specificity, therefore allowing a combined criterium involving all 3 parameters to be defined: ARPc < 0.45 ng/ml/h, supine aldosteronaemia >417 pmol/l, and erect aldosterone/renin >1180.
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Adenoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Hiperaldosteronismo/diagnóstico , Adenoma/cirurgia , Neoplasias das Glândulas Suprarrenais/cirurgia , Aldosterona , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Estudos Prospectivos , Valores de Referência , Renina/sangue , Estudos RetrospectivosRESUMO
This double-blind trial was initiated to test, in a controlled study, the value of single-day drug treatment of amebic liver abscess. Patients were treated with 2 g either of ornidazole or tinidazole, two newly developed 5-nitroimidazole derivatives, given in two equal doses during the course of 1 day. A success rate of over 94% in the 72 patients from both treatment groups who were followed up for 6 months demonstrates the efficacy of the single-day drug treatment.
Assuntos
Abscesso Hepático Amebiano/tratamento farmacológico , Nitroimidazóis/administração & dosagem , Ornidazol/administração & dosagem , Tinidazol/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , MasculinoRESUMO
In a field study conducted in Burma, 60 semi-immune adults were randomly assigned to 2 treatment groups. The first (mean parasite count, 12717/mm3) received a single dose of a fixed combination of 500 mg mefloquine base, 1000 mg sulfadoxine and 50 mg pyrimethamine (2 tablets of 'Fansimef') plus 1 tablet placebo. The second group (mean parasite count, 11 863/mm3) were given 3 tablets of the same medication. The study was double-blind. Parasite count was checked daily for the first week and weekly for a further 3 weeks. Average times for parasite clearance were 1.47 d in patients receiving 2 tablets, and 1.87 d in those given 3 tablets. Asexual parasites reappeared on day 28 in one patient in each group, although they had been free of parasites during the previous 4 weeks; this could be due to reinfection. The drugs were generally well tolerated, though mild and transient giddiness was seen in 80% of patients in the first group and 96% in the second. Nausea was reported by 33% and 43% of patients respectively. No vomiting occurred in the first group but 8 patients vomited in the second (P less than 0.01). In conclusion it seems possible to treat falciparum malaria in semi-immune adults, weighing less than 60 kg, with a single dose of 500 mg mefloquine base, 1000 mg sulfadoxine and 50 mg pyrimethamine (2 tablets), instead of the higher dose (3 tablets) currently recommended. This reduces treatment cost and improves tolerance of the drugs.
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Antimaláricos/administração & dosagem , Malária/tratamento farmacológico , Adolescente , Adulto , Idoso , Animais , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Mefloquina , Pessoa de Meia-Idade , Plasmodium falciparum , Pirimetamina/administração & dosagem , Quinolinas/administração & dosagem , Distribuição Aleatória , Sulfadoxina/administração & dosagemRESUMO
The rural Health Centre of Mengwi, on the island of Bali, was built and equipped for US $ 15,000 by Project Concern, a non-sectarian, medical relief organization. It has been run so successfully by them since it opened in 1974, that not only has the Centre gained the trust of the local community into which it is now fully integrated, but it is also regarded by the Indonesian Government as a pilot project. Amongst the factors leading to this success, the author underlines the following points: a suitable location for the Centre, easily accessible by the villagers; a local staff recruited from the villages of Mengwi District, well trained and sympathetic to the population; constant retraining of the staff leading to better medical care; the availability of a doctor and nurse around the clock; an adequate supply of drugs. Evaluation of the operation is best done by the acceptance of special programmes such as the Under-Five Clinic, the Family Planning Scheme, Ante-Natal Clinic and vaccinations. The mere success of the general clinic would not mean that the Centre had been integrated into the community and become a factor in rural development. The success of these special clinics, as well as the out-reach programmes, demonstrates that through adequate delivery of medical care, the Health Centre of Mengwi can now fulfil its role of being an important factor in the development of a rural community in the tropics.
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Saúde Pública , Saúde da População Rural , Atenção à Saúde , Serviços de Planejamento Familiar , Feminino , Humanos , Indonésia , Gravidez , Estações do AnoRESUMO
The combination of mefloquine plus tetracycline was compared with quinine plus tetracycline in a randomised therapeutic trial in 102 patients with acute uncomplicated falciparum malaria in Thailand. Quinine plus tetracycline is considered the standard treatment for the highly drug-resistant strains of P. falciparum found in this area. Fifty patients received mefloquine (750 mg given immediately, followed by 500 mg 6 h later) with tetracycline and 52 patients received quinine (600 mg every 8 h for seven days) with tetracycline. Tetracycline was administered to both groups in doses of 250 mg four times daily. All patients were admitted to the hospital for 28 days to exclude re-infection. Ninety-three patients completed the study; nine patients left prior to completion of follow-up for reasons unrelated to their treatment. Cure rates for the two groups were 94% (44/47) for mefloquine plus tetracycline and 98% (45/46) for quinine plus tetracycline. Parasite and fever clearance times were shorter for the group treated with mefloquine but the differences were not statistically significant. Nearly all patients (94%) treated with quinine developed cinchonism compared with only 12% treated with mefloquine; all other symptoms following treatment were similar. Thirteen patients (26%) treated with quinine also developed delayed primary attacks of P. vivax during the follow-up period; none developed in the patients treated with mefloquine. These results support the contention that the combination of mefloquine plus tetracycline is equally effective and less toxic than quinine plus tetracycline for treatment of acute uncomplicated falciparum malaria in areas requiring combination therapy for drug resistance.
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Malária Falciparum/tratamento farmacológico , Mefloquina/administração & dosagem , Quinina/administração & dosagem , Tetraciclina/administração & dosagem , Adolescente , Adulto , Idoso , Animais , Esquema de Medicação , Quimioterapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Plasmodium falciparum/isolamento & purificação , Quinina/efeitos adversosRESUMO
One could expect that malignant hypertension would belong to the history. Unfortunately, this complication has not been eradicated even though many physicians have already forgot it. The hypertension care units are still confronted to it, and even the arrival of the renin-angiotensin system blockers have changed the prognosis of those patients, an adequate management on emergency remains mandatory in order to avoid in particular the evolution to renal failure. By reporting a series of 42 patients included in a period of 7 years, we aimed to remind the presentation of this severe pattern of hypertension and the basics of its management.
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Hipertensão Maligna/diagnóstico , Hipertensão Maligna/tratamento farmacológico , Antagonistas Adrenérgicos alfa/uso terapêutico , Antagonistas Adrenérgicos beta/uso terapêutico , Adulto , Idoso , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Estudos de Coortes , Diuréticos/uso terapêutico , Feminino , Humanos , Hipopotassemia/etiologia , Masculino , Pessoa de Meia-Idade , Hemorragia Retiniana/etiologiaRESUMO
In the Bordeaux cohort of never treated, uncomplicated hypertensive patients with office BP > 140/90 on at least 2 occasions, we selected those with good quality 24 H ambulatory BP measurement and LVM measured with M mode echo before any antihypertensive treatment. In this group, we studied the relationships between LVM and average 24 h systolic BP in males and females in univariate and multivariate analysis, taking into account age, weight and height. The population studied included 531 patients whose main characteristics are summarized in the table. The slope of the relationship between LVM and 24 h SBP is significantly steeper in males than in females (1.73 vs 0.58, p < 0.01). In multivariate analysis, the variable showing the higher correlation to LVM is 24 h SBP in males, weight in females. For a similar increase in BP, males hypertensive show a higher increase in LVM than females.
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Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/complicações , Função Ventricular , Adulto , Estudos de Coortes , Ecocardiografia , Feminino , Ventrículos do Coração/patologia , Humanos , Hipertrofia Ventricular Esquerda/patologia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores SexuaisRESUMO
Analysis of left ventricular volumes is a prognostic factor in cardiovascular disease. Echocardiography is a means of obtaining these parameters but is limited by poor reproducibility. Recently, a new echocardiographic technique, second harmonic imaging (SHI), developed through contrast agent methods, significantly improved the quality of imaging. The aim of this study was to demonstrate the value of SHI for assessing left ventricular volumes. Thirty patients admitted for cardiovascular evaluation and requiring angiocardiography underwent echocardiography with calculation of end diastolic (EDV) and end systolic volumes (ESV) of the left ventricle in fundamental (FI) and second harmonic (SHI) imaging. These measurements were compared with those of angiocardiography. The reproducibility of SHI was calculated after repetition of the measurements by two independent observers for both echocardiographic modes. There was a significant improvement of the parameters of linear regression in SHI compared with FI both for EDV (r = 0.93 versus 0.76) and for ESV (r = 0.94 versus 0.83), the reproducibility was also significantly improved in SHI (relative error of 5% versus 12% for intra-observer error and 6% versus 13% for inter-observer error). The authors conclude that SHI significantly improves two-dimensional imaging and provides a reliable and reproducible measurement of left ventricular volumes.
Assuntos
Angiografia Coronária , Ecocardiografia/métodos , Função Ventricular Esquerda/fisiologia , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
Twenty eight adult male patients with acute uncomplicated falciparum malaria which showed RI or RII responses to quinine sulfate at the dosage of 600 mg 8 hourly for 7, 10 or 14 days were treated with a single dose of mefloquine (Lariam); 25 patients received 1000 mg, 2 received 750 mg and 1 received 500 mg. The initial response was good; there was no RII or RIII response. Three patients were lost to followup. Of 25 patients who stayed in the Bangkok Hospital for Tropical Diseases where there was no malaria transmission for 28-65 days, only one patient in the 1000 mg group had recrudescence on day 21. The cure rate was 96%. Our prospective study suggests that mefloquine was effective in the treatment of quinine resistant falciparum malaria and the risk of cross-resistance between quinine and mefloquine in P. falciparum in vivo is very low.
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Malária/tratamento farmacológico , Mefloquina/uso terapêutico , Plasmodium falciparum , Administração Oral , Adolescente , Adulto , Animais , Temperatura Corporal/efeitos dos fármacos , Reações Cruzadas , Resistência Microbiana a Medicamentos , Humanos , Malária/sangue , Malária/fisiopatologia , Masculino , Mefloquina/administração & dosagem , Mefloquina/farmacologia , Pessoa de Meia-Idade , Estudos Prospectivos , Quinina/farmacologiaRESUMO
Pharmacokinetic properties of ceftriaxone, such as sustained tissue drug levels over 24 hours after a single injection; good penetration of the antibiotic into cells; significant biliary excretion as active unchanged compound and high potency against S. typhi, should make it possible to significantly shorten the treatment of typhoid fever. To test this hypothesis a pilot, open study was initiated. 17 adult patients suffering from uncomplicated typhoid or paratyphoid fever, documented by blood culture, were treated with 4g ceftriaxone once daily for three days (4 patients) or two days (15 patients). The cure rate of 17 assessable patients was 94.2% (one failure). One possible relapse was observed two months after treatment. It is to be noted that no patient in the study suffered from a severe form of the disease.
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Ceftriaxona/uso terapêutico , Febre Paratifoide/tratamento farmacológico , Febre Tifoide/tratamento farmacológico , Adolescente , Adulto , Idoso , Ceftriaxona/sangue , Feminino , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Salmonella paratyphi A , Salmonella paratyphi BRESUMO
A total of 107 cases of trichomonas vaginitis were treated with different regimens of ornidazole. The overall success rate of the treatment assessed by wet smear and clinical signs after three days in 68 cases was 98.5%. The side effects were mild and of short duration. These were noted in 14.7% of the assessable cases. No significant differences were seen in the success rate between the three drug regimens and the preliminary conclusions of the trial are that ornidazole is safe and effective in the treatment of trichomonas vaginitis in Korean women with an oral dose of 1.0 gm, 1.0 gm plus 0.5 gm intravaginally or 2.0 gm given in a single day.
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Nitroimidazóis/administração & dosagem , Ornidazol/administração & dosagem , Vaginite por Trichomonas/tratamento farmacológico , Adulto , Esquema de Medicação , Feminino , Humanos , Pessoa de Meia-Idade , Vaginite por Trichomonas/microbiologiaRESUMO
Two studies were conduct in Thailand in order to find appropriate falciparum malaria prophylactic drug regimens. The first study was done during June - September 1987 with 363 soldiers who received Fansimef (MSP) 1 tab/week (group 1), 337 soldiers who received MSP 1 tab/2 week (group 2) and 165 soldiers who received chloroquine 300 mg base weekly plus Fansidar 1 tab/week (group 3). At the end of the study there were 9 and 13 falciparum malaria episodes in groups 1 and 2, respectively, with incidence rates of 0.8 and 1.8 cases/100 person-months (P-M). In group 3, the corresponding values were 30 episodes and an incidence of 7.2/100 P-M. For the second study which lasted from October 1987 - January 1988 in the same area, 498 soldiers were given Fansimef 1/2 tab/week (group 4), 499 soldiers were given Lariam 1/2 tab/week (group 5) and 247 soldiers were given chloroquine plus Fansidar (group 6). Thirty malaria episodes were found in group 4, for an incidence of 2.0/100 P-M. In group 5, 23 episodes were found, for an incidence of 1.6/100 P-M. In group 6, 74 episodes occurred, ie an incidence of 12.2/100 P-M. The incidence rates of malaria among Fansimef 1 tab weekly, Fansimef half dose weekly or Lariam half dose weekly were not significantly different but were different from chloroquine plus Fansidar groups. Adverse events in each group were mild.
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Malária Falciparum/prevenção & controle , Mefloquina/análogos & derivados , Mefloquina/uso terapêutico , Militares , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Adulto , Animais , Anticorpos Antiprotozoários/isolamento & purificação , Sangue/parasitologia , Cloroquina/uso terapêutico , Combinação de Medicamentos , Humanos , Masculino , Plasmodium falciparum/imunologia , Plasmodium falciparum/isolamento & purificação , TailândiaRESUMO
Due to mass tourism and the exodus of refugees from Africa and Asia, typhoid fever, common in the tropics, has reappeared in the more temperate climates. The clinical signs of prolonged fever, headache, general malaise, anorexia and abdominal pain are not specific enough to allow diagnosis and only a blood culture will prove the presence of the disease. Unless there is resistance, which is in fact rare in Southeast Asia, chloramphenicol, an effective, well tolerated and cheap antibiotic, remains the treatment of choice for typhoid. In the search for an alternative treatment a cephalosporin, ceftriaxone (Rocephin) seems promising. It has a low MIC of 0.05 micrograms/ml for S. typhi and a high level of biliary excretion which destroys S. typhi in the bile and thus prevents relapse. In Southeast Asia three consecutive studies, of which two were randomised and comparative with chloramphenicol given for 14 days, showed that treatment for two or three days, 3 or 4 g per day of ceftriaxone was as effective as chloramphenicol and was not followed by relapse. In 46 adults there was one failure with ceftriaxone (in an immunocompromised patient) and none in the 30 patients treated with chloramphenicol, three of which, however, relapsed in the 15 days after completion of treatment. Defervescence was a little more rapid with chloramphenicol (six to seven days) than with ceftriaxone (seven to ten days) even though blood, urine and stool cultures were all negative from the third or fourth day of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ceftriaxona/uso terapêutico , Febre Tifoide/tratamento farmacológico , Bile/microbiologia , Ceftriaxona/administração & dosagem , Ceftriaxona/farmacologia , Cloranfenicol/uso terapêutico , Humanos , Recidiva , Salmonella typhi/efeitos dos fármacosAssuntos
Indústria Farmacêutica , Tratamento Farmacológico , Medicina Tropical , Humanos , Pesquisa , SuíçaRESUMO
The spread of chloroquine resistant strains of P. falciparum requires new approaches to treatment especially in tropical Africa. A single dose of 3 tablets of sulfadoxine-pyrimethamine (Fansidar) is a suitable and relatively inexpensive alternative. But under drug pressure resistance to this compound has developed in some South-East Asian countries and in Brazil, giving rise to multiple resistant strains of P. falciparum. A similar pattern has arisen with quinine to which almost 50% of P. falciparum strains have become resistant in Thailand. However the combination treatment of quinine with tetracycline given for 7 days is still successful in most cases. Unfortunately compliance to this regimen is rather poor in out-patients. Mefloquine (Lariam), recently marketed, and if used as 750 mg dose in semi-immune adult patients weighing less than 60 kg, has made possible a single-dose treatment schedule for falciparum malaria. In controlled studies conducted in South-East Asia the success rate of mefloquine was 97% in 445 patients. Since there is some fear of the appearance of resistance of P. falciparum to mefloquine, a combination of this compound with sulfadoxine and pyrimethamine was developed (MSP or Fansimef). Various controlled studies in South-East Asia have shown a success rate of this compound of 97% in 278 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Antimaláricos/uso terapêutico , Malária/tratamento farmacológico , Animais , Sudeste Asiático , Resistência a Medicamentos , Humanos , Plasmodium falciparumRESUMO
BACKGROUND: The interactions between ultrasound and cardiac muscle can be exploited to characterize abnormalities of myocardial structure in echocardiography. Two different methods permit an objective assessment of myocardial tissue characterization: analysis of the radiofrequency signal and videodensitometry. We conducted a videodensitometric study using a new practical semi-automatic software applied on digital signal to evaluate gray level cyclic variations of myocardial walls. The aim was to determine parameters differentiating healthy and hypertrophic myocardium in hypertensive patients. METHODS AND RESULTS: Echocardiographic examinations were performed on 30 hypertensives vs 30 healthy controls using second harmonic imaging. Dynamic 2D sequences were recorded in digital form and transferred on computer. Region of interest (ROI) was selected on interventricular septum (IVS) and the software automatically analyzed its systolo-diastolic displacements. ROI echo intensity and its cyclic variations were computed. Values were normalized with blood backscatter. The hypertensives had a smaller amplitude of gray level cyclic variation than did the controls (22+/-6 vs 27+/-11; P=0.02), and this parameter was correlated in multivariate analysis with left ventricle fractional shortening (P=0.032) and diastolic pressure(P=0.014). CONCLUSIONS: Magnitude of gray level cyclic variation of IVS can be studied easily with this new semi-automatic software, is altered in hypertensives and correlated with parameters of systolic function.
Assuntos
Ecocardiografia , Hipertensão/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Software , Cardiomegalia/diagnóstico por imagem , Cardiomegalia/etiologia , Densitometria , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-IdadeRESUMO
In a randomized comparative study, adult patients suffering from Gram-negative septicemia or pyemia were treated either with a single daily dose of 1.5g of ceftriaxone in most patients or 6g of cefotaxime divided into four daily doses. K. pneumoniae and E. coli were commonly isolated in both groups. Altogether 17 patients treated with ceftriaxone and 14 with cefotaxime completed the treatment with a success rate of 88.2% and 85.6% respectively. There were two deaths in patients treated with ceftriaxone (12%) and one with cefotaxime (7.2%). Despite the severity of the disease, antibiotic treatment was relatively short: 7 patients (41%) were treated with ceftriaxone for only 7 days, 2 with cefotaxime for 7 days, 5 for 10 days. Others were treated for a longer period with a maximum duration of 22 days. This study confirms in Asian patients the previous reports that a single daily dose of ceftriaxone is as efficacious as four daily doses with cefotaxime in treating patients with severe infections.