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1.
Herz ; 45(6): 586-593, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30276479

RESUMO

BACKGROUND: The aim of our study was to assess the outcomes of surgical treatment for severe tricuspid regurgitation according to whether cardiac surgery had been performed before the tricuspid valve intervention. METHODS: Between 1996 and 2013, 201 consecutive patients with severe tricuspid regurgitation underwent tricuspid surgery at our center. Patients were classified according to whether or not they had undergone previous cardiac surgery, which 33% of the sample had. Perioperative as well as long-term morbidity and mortality were analyzed. RESULTS: Mean patient age was 62.3 years. 32.8% underwent suture annuloplasty, 41.3% underwent ring annuloplasty, 15.4% received a bioprosthesis, and 10.4% received a mechanical prosthesis. There were no significant differences in perioperative mortality between the group that had not undergone previous cardiac surgery and the group that had (12.7% vs. 17.9%, respectively; p = 0.32). The long-term mortality rate (median follow-up time: 53 months) was 43.3%. Long-term survival curves showed no significant differences between the two groups (p = 0.884), and previous cardiac surgery was not a predictive factor for long-term mortality (hazard ratio = 1.211; p = 0.521). CONCLUSION: In a series of patients who underwent tricuspid valve surgery, no significant differences were observed in perioperative mortality or in long-term survival according to whether or not subjects had undergone previous cardiac surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Anuloplastia da Valva Cardíaca , Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Tricúspide , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/cirurgia
2.
Rev Neurol ; 77(12): 293-298, 2023 Dec 16.
Artigo em Espanhol | MEDLINE | ID: mdl-38095053

RESUMO

INTRODUCTION: Chronic non-recreational use of methamphetamine (shabu) is increasing among the Filipino population in Barcelona. The Asian population presents a different stroke pattern, with a higher incidence of haemorrhage, and different vascular risk factors and health behaviours. The objective of this study is to describe the stroke profile and incidence of methamphetamine use in patients of Filipino origin admitted to our centre. PATIENTS AND METHODS: Demographic data, vascular risk factors, clinical data and prognosis were recorded. Methamphetamine exposure was analysed in plasma samples collected on admission, which were then analysed by liquid chromatography-mass spectrometry. RESULTS: Of a total of 6,418 stroke patients, 73 (1.1%) were identified as being of Filipino origin. The mean age was 54.4 ± 12.1 years, 54% were male and the stroke was ischaemic in 64.4% of cases. Arterial hypertension was the main risk factor. Ten (13.7%) patients tested positive for methamphetamine and amphetamine. These results confirm recent substance use prior to the stroke, mostly in men (80%). In patients who were consumers, 60% had a haemorrhagic stroke, with a poor functional prognosis at three months in 55.6% of patients. CONCLUSIONS: In our setting, patients of Filipino ethnicity admitted for stroke related to the consumption of shabu belonged a younger age bracket, with a lower prevalence of vascular risk factors and a predominance of the haemorrhagic subtype. Methamphetamine testing in Filipino stroke patients is recommended due to the high prevalence of methamphetamine use in our country.


TITLE: Perfil clínico y abuso de metanfetamina no recreativa (shabú) entre los pacientes con ictus en la población filipina.Introducción. En la población filipina de Barcelona está aumentando el consumo crónico no recreativo de metanfetaminas (shabú). La población asiática presenta un patrón de ictus diferente, con mayor incidencia de hemorragias, y diferentes factores de riesgo vascular y conductas de salud. El objetivo es describir el perfil de ictus e incidencia de consumo de metanfetaminas en pacientes de origen filipino ingresados en nuestro centro. Pacientes y métodos. Se registraron datos demográficos, factores de riesgo vascular, datos clínicos y pronóstico. Se analizó la exposición a metanfetamina en muestras de plasma recogidas en el ingreso, que se analizaron por cromatografía líquida-espectrometría de masas. Resultados. Del total de 6.418 pacientes con ictus, se identificó a 73 pacientes filipinos (1,1%). La edad media era de 54,4 ± 12,1 años, el 54% eran hombres y el ictus era isquémico en el 64,4%. La hipertensión arterial fue el principal factor de riesgo. Diez (13,7%) pacientes dieron positivo a metanfetamina y anfetamina. Estos resultados confirman un consumo reciente de sustancias previo al ictus, principalmente en hombres (80%). En pacientes consumidores, un 60% presentaba un ictus hemorrágico, con mal pronóstico funcional a tres meses en el 55,6% de los pacientes. Conclusiones. En nuestro medio, los pacientes de etnia filipina ingresados por ictus en relación con consumo de shabú presentaron un perfil de edad más joven, con menor prevalencia de factores de riesgo vascular y predominio del subtipo hemorrágico. Se recomienda la determinación de metanfetamina en los pacientes filipinos con ictus debido a la alta prevalencia del consumo de metanfetamina en nuestro país.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas , Metanfetamina , Acidente Vascular Cerebral , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Filipinas/epidemiologia , Metanfetamina/efeitos adversos , Metanfetamina/análise , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Transtornos Relacionados ao Uso de Anfetaminas/complicações , Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Anfetamina
3.
Clin Transl Oncol ; 9(4): 255-7, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17462979

RESUMO

Kaposi's sarcoma (KS) is characterised by proliferation of vascular endothelial and lymphoreticular cells, frequently with a multicentric expression developed from a single node and evolving to multiple cutaneous lumps or plaque-like appearance. Four types of KS with similar histological patterns have been described in terms of their clinical and epidemiological features: classic KS, endemic (African) KS, iatrogenic KS and epidemic (AIDS-related) KS. The differences in clinical features are quite relevant: classic KS is usually limited to the lower extremities; whereas immunodeficiency-related diseases frequently involve several organs. A case of a 67-year-old woman with metastatic KS and unproven immunodeficiency is presented.


Assuntos
Herpesvirus Humano 8 , Sarcoma de Kaposi , Neoplasias Cutâneas , Idoso , Antibióticos Antineoplásicos , Biópsia , Doxorrubicina/administração & dosagem , Doxorrubicina/uso terapêutico , Feminino , Seguimentos , Humanos , Perna (Membro)/patologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Radiografia Abdominal , Radiografia Torácica , Indução de Remissão , Sarcoma de Kaposi/diagnóstico por imagem , Sarcoma de Kaposi/tratamento farmacológico , Sarcoma de Kaposi/patologia , Pele/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Neoplasias Esplênicas/diagnóstico por imagem , Neoplasias Esplênicas/tratamento farmacológico , Neoplasias Esplênicas/secundário , Fatores de Tempo , Tomografia Computadorizada por Raios X
4.
Clin Transl Oncol ; 9(12): 806-10, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18158986

RESUMO

Angiosarcomas account for 2% of all soft tissue sarcomas and of them, primary renal angiosarcomas represent 1%. Twenty-four cases have been published in the English specialised literature. We report the second case to be described in a middle-aged female, with pulmonary metastases at diagnosis, and fatal outcome despite surgery and chemotherapy.


Assuntos
Hemangiossarcoma/patologia , Neoplasias Renais/patologia , Adulto , Terapia Combinada , Evolução Fatal , Feminino , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/terapia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/terapia , Tomografia Computadorizada por Raios X
6.
Adv Ther ; 28 Suppl 6: 1-18, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21922392

RESUMO

Clinical trials conducted over the last two decades have demonstrated that 5 years of treatment with tamoxifen (TAM) after local treatment in postmenopausal patients with positive hormone receptor early breast cancer improves disease-free survival and overall survival. More recently, aromatase inhibitors (AI) have been tested in several randomized clinical trials in this setting. The studies have tested either AI versus TAM or different sequential approaches combining the two agents. While the most effective strategy remains to be determined, overall, incorporation of AI resulted in better disease-free survival, particularly in the worst-prognosis subgroup of patients. In addition, long-term treatment with AI was, in general, well tolerated. However, mature results are needed in order to be able to assess the effect in overall survival. The authors of this supplement paper include the key points of roundtable presentations and discussions of hormonal therapy in breast cancer by topic.


Assuntos
Antineoplásicos Hormonais/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/mortalidade , Administração Oral , Adulto , Idoso , Anastrozol , Antineoplásicos Hormonais/efeitos adversos , Inibidores da Aromatase/administração & dosagem , Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Quimioterapia Adjuvante , Intervalo Livre de Doença , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Mastectomia/métodos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nitrilas/administração & dosagem , Nitrilas/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Análise de Sobrevida , Tamoxifeno/administração & dosagem , Tamoxifeno/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Triazóis/administração & dosagem , Triazóis/efeitos adversos
7.
Exp Parasitol ; 103(3-4): 171-3, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12880595

RESUMO

An antigenic characterization of the larval (somatic) and adult (somatic and excretory-secretory) antigens of Uncinaria stenocephala was made, employing immunoblotting and immunoblotting-inhibition with 10 selected sera from dogs naturally infected by this hookworm. The results indicated that each one of the three parasitic extracts has different antigenic components. Sixty percent of the dog sera consistently recognised four antigens of 20, 25, 30, and 38kDa of the larval extract and the immunoblotting inhibition showed that these antigens were only observed at the larval stage. All these results indicated that these antigens can be considered as major antigens and they could be useful for the immunodiagnosis of this parasitic infection.


Assuntos
Ancylostomatoidea/imunologia , Antígenos de Helmintos/imunologia , Doenças do Cão/imunologia , Infecções por Uncinaria/veterinária , Soros Imunes/imunologia , Ancylostomatoidea/crescimento & desenvolvimento , Animais , Doenças do Cão/parasitologia , Cães , Proteínas de Helminto/imunologia , Infecções por Uncinaria/diagnóstico , Infecções por Uncinaria/imunologia , Infecções por Uncinaria/parasitologia , Immunoblotting , Larva/imunologia
8.
Actas Esp Psiquiatr ; 31(3): 149-55, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-12772044

RESUMO

INTRODUCTION: Up-date in the treatment of rapid cycling and other resistant bipolar disorders. METHODS: A Medline research of the literature was performed in several databases as Pub-Med, Cochrane and Embasse, from 1998 to December 2001. We have also reviewed bibliography supplied by different laboratories and several monographies. RESULTS: 30 articles were selected: 11 reviews, 17 openlabeled studies and 2 articles on general recommendations. From the 17 open-labaled studies, 10 were on topiramate (25 to 400 mg/day) as a coadjuvant of another stabilizer. Improvement ranged from 40 to 70%; 4 adding gabapentin to the previous treatment, at the dosage of 60 to 5,600 mg/day, 27 and 92% showed improvement; 1 with mexiletine (200 to 1,200 mg/day) in which 46% were full responders, 15% partial responders and 38 % had no response, 100% response in manic or mixed and 38 % in depressed patients; and 2 with lamotrigine (50 to 500 mg/day) in which 52 to 80 % showed improvement. With risperidone at the dosage of 2-3 mg/day as coadjuvant, improvement was seen in 62 %. Olanzapine had direct short-term antimanic effects, with 49 % improvement in single drug therapy and 57 % as coadjuvant. CONCLUSIONS: More double-blind studies are necessary to assess efficacy in monotherapy or as coadjuvants, in short-term or even in monotherapy, and to compare the different treatments with each other as well as with the conventional treatment. The authors agree in pointing out the efficacy of gabapentin and topiramate associated to another stabilizer, and also of lamotrigine in depressed phases.


Assuntos
Antipsicóticos/classificação , Antipsicóticos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Humanos , Resultado do Tratamento
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