ABSTRACT
INTRODUCTION: Identifying ST-elevation myocardial infarction (STEMI) patients who can be referred back to the general practitioner (GP) can improve patient-tailored care. However, the long-term prognosis of patients who are returned to the care of their GP is unknown. Therefore, the aim of this study was to assess the long-term prognosis of patients referred back to the GP after treatment in accordance with a 1-year institutional guideline-based protocol. METHODS: All consecutive patients treated between February 2004 up to May 2013 who completed the 1year institutional MISSION! Myocardial Infarction (MI) follow-up and who were referred to the GP were evaluated. After 1 year of protocolised monitoring, asymptomatic patients with a left ventricular ejection fraction >45% on echocardiography were referred to the GP. Long-term prognosis was assessed with Kaplan-Meier curves and Cox proportional hazards analysis was used to identify independent predictors for 5year all-cause mortality and major adverse cardiovascular events (MACE). RESULTS: In total, 922 STEMI patients were included in this study. Mean age was 61.6⯱ 11.7 years and 74.4% were male. Median follow-up duration after the 1year MISSION! MI follow-up was 4.55 years (interquartile range [IQR] 2.28-5.00). The event-free survival was 93.2%. After multivariable analysis, age, not using an angiotensin-converting enzyme (ACE) inhibitor/angiotensin-II (AT2) antagonist and impaired left ventricular function remained statistically significant predictors for 5year all-cause mortality. Kaplan-Meier curves revealed that 80.3% remained event-free for MACE after 5 years. Multivariable predictors for MACE were current smoking and a mitral regurgitation grade ≥2. CONCLUSION: STEMI patients who are referred back to their GP have an excellent prognosis after being treated according to the 1year institutional MISSION! MI protocol.
ABSTRACT
La prevalencia de caries dental en los primeros años de vida es un problema de Salud Publica muy debatido a nivel mundial, por ende, la presente investigación tuvo como propósito general describir la prevalencia de la enfermedad caries dental en pacientes pertenecientes al grupo etario comprendido entre seis meses y cinco años de edad que asistieron el último trimestre del 2012, a la consulta externa de pediatría de un Hospital de Valencia, Estado Carabobo. La indagación está enmarcada dentro de una modalidad no experimental, descriptiva y de campo debido a que se obtuvieron datos directos a través de la observación y se vaciaron los mismos en una computadora portátil y en una ficha, luego, se analizaron los datos a través de estadística descriptiva. El porcentaje de niños afectados por caries fue del 41%, mientras niños libres de caries arrojo el 59%. En cuanto al sexo el valor del índice del ceod registra un mayor promedio en el sexo masculino. En cuanto a la prevalencia se encontró el valor del índice del ceod mas alto lo registra el grupo de 4 a 5 años de edad (3.63) el índice de ceod y ceos aumenta a medida que incrementa la edad de la población estudiada.
The prevalence of dental caries in the first years of life is a public health problem worldwide hotly debated, therefore, the present research was to generally describe the prevalence of dental caries disease in patients in the age group between six months and five years who attended the last quarter of 2012, the pediatric outpatient in a hospital in Valencia, Carabobo State. The inquiry is framed within a non-experimental method, descriptive field because data were obtained through direct observation and emptied them on a laptop and on a form, then the data were analyzed by descriptive statistics. The percentage of children affected by caries was 41%, while caries-free children threw 59%. As for sex the dmft index value recorded a higher average in males. Regarding the prevalence was found dmft index value as recorded highest group 4-5 years (3.63). dmft index and ceos increases as age increases the population studied.