RESUMEN
Cardiovascular mortality has decreased over the past 25 years, largely because of acute coronary syndrome care and preventive actions. Nevertheless, the rate of coronary heart disease remains high, with an annual risk of 4.7% (cardiac mortality, myocardial infarction, stroke). Cardiovascular risk factor management must be a priority in primary and secondary prevention, to improve the prognosis of this severe disease, in which absence of symptoms does not mean benignity. The current goals of therapeutic patient education are smoking cessation, regular physical activity, a cardioprotective (Mediterranean) diet, management of stress, good treatment adherence (which improves compliance), judicious use of the care system and help with occupational reintegration. Current and future programmes must be in accordance with the Haute Autorité de Santé recommendations published in 2007.
Asunto(s)
Enfermedad Coronaria/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto/normas , Prevención Primaria/educación , Conducta de Reducción del Riesgo , Prevención Secundaria/educación , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/fisiopatología , Dieta Mediterránea , Humanos , Actividad Motora , Programas Nacionales de Salud/normas , Cooperación del Paciente , Medición de Riesgo , Factores de Riesgo , Cese del Hábito de Fumar , Estrés Psicológico/prevención & controlRESUMEN
Oxidative stress, involved in many diseases, is defined as an impaired balance between reactive oxygen species (ROS) production and antioxidant defences. Antioxidant enzymes such as superoxide dismutase (SOD) play a key role in diminishing oxidative stress. Thus, the removal of ROS by exogenous SODs could be an effective preventive strategy against various diseases. The poor bioavailability of exogenous SODs has been criticized. However, improvements in SOD formulation may overcome this limitation and boost interest in its therapeutic properties. Here, we provide a review of animal and human studies about SODs supplementation in order to evaluate their therapeutic value. Protective effects have been observed against irradiation, carcinogenesis, apoptosis and neurodegeneration. SODs administration has also been reported to alleviate inflammatory, infectious, respiratory, metabolic and cardiovascular diseases and genitourinary and fertility disorders, raising the question of its mechanism of action in these diverse situations. Some authors have shown an increase in endogenous antioxidant enzymes after exogenous SODs administration. The induction of endogenous antioxidant defence and, consequently, a decrease in oxidative stress, could explain all the effects observed. Further investigations need to be carried out to test the hypothesis that SODs supplementation acts by inducing an endogenous antioxidant defence.
Asunto(s)
Estrés Oxidativo/efectos de los fármacos , Superóxido Dismutasa/administración & dosificación , Animales , Vías de Administración de Medicamentos , Humanos , Especies Reactivas de Oxígeno/metabolismo , Superóxido Dismutasa/farmacocinética , Superóxido Dismutasa/uso terapéuticoAsunto(s)
Cardiología/normas , Cardiopatías/rehabilitación , Actividades Cotidianas , Adulto , Anciano , Cardiología/economía , Análisis Costo-Beneficio , Prestación Integrada de Atención de Salud/normas , Medicina Basada en la Evidencia/normas , Terapia por Ejercicio/normas , Femenino , Francia , Costos de la Atención en Salud/normas , Conocimientos, Actitudes y Práctica en Salud , Cardiopatías/diagnóstico , Cardiopatías/economía , Cardiopatías/fisiopatología , Cardiopatías/psicología , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Grupo de Atención al Paciente/normas , Educación del Paciente como Asunto/normas , Selección de Paciente , Conducta de Reducción del RiesgoRESUMEN
Sudden death of sportspersons is frequently in the news but is relatively uncommon when the total number of sudden deaths is taken into account (1500 vs 40 000 per year in France for example). Sport-related sudden death is often due to an unrecognized or underestimated cardiovascular disorder. The immediate causes of this dramatic event are age-dependent. Before 35, the most frequent causes are hypertrophic cardiomyopathy and arythmogenic right ventricular cardiomyopathy, while complications of coronary atheroma predominate later. Prevention begins with screening, which remains imperfect. Patients with cardiovascular disorders at risk of sudden death must adapt their sports activities accordingly. Knowledge of life-saving first-aid procedures by those supervising sports activities can improve the prognosis.
Asunto(s)
Atletas , Muerte Súbita/prevención & control , Deportes , Adulto , Factores de Edad , Traumatismos en Atletas/complicaciones , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/mortalidad , Traumatismos en Atletas/prevención & control , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/prevención & control , Muerte Súbita/epidemiología , Muerte Súbita/etiología , Muerte Súbita Cardíaca/epidemiología , Muerte Súbita Cardíaca/etiología , Muerte Súbita Cardíaca/prevención & control , Humanos , Deportes/fisiologíaRESUMEN
INTRODUCTION: Septicaemia on endocardial pacemaker leads is very rare but the presentation is insidious and the prognosis very bad if all the implanted materiel is not completely removed. OBSERVATION: A 55 year-old woman presented three episodes of Staphylococcus epidermidis septicaemia in three years, after incomplete removal of the pacing system. Permanent cure was finally obtained after complete removal of the pacemaker material. COMMENT: Emphasis must be placed on the difficulty in diagnosing and treating such affections, their severity and also the interest of a certain number of prophylactic measures.
Asunto(s)
Bacteriemia/etiología , Infección Hospitalaria/etiología , Remoción de Dispositivos/efectos adversos , Marcapaso Artificial/efectos adversos , Infecciones Estafilocócicas/etiología , Antibacterianos/uso terapéutico , Astenia/microbiología , Bacteriemia/sangre , Bacteriemia/diagnóstico , Bacteriemia/prevención & control , Infección Hospitalaria/sangre , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/prevención & control , Remoción de Dispositivos/instrumentación , Remoción de Dispositivos/métodos , Ecocardiografía Transesofágica , Femenino , Fiebre/microbiología , Humanos , Control de Infecciones/métodos , Persona de Mediana Edad , Pronóstico , Proteína C/metabolismo , Recurrencia , Infecciones Estafilocócicas/sangre , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/prevención & control , Staphylococcus epidermidis , Resultado del TratamientoRESUMEN
Permanent and paroxysmal AF is a risk factor for the occurrence and the recurrence of stroke, which can occur as its first manifestation. However, its automatic identification is still unsatisfactory. In this study, a new mathematical approach was evaluated to automate AF identification. A derivation set of 30 24-hour Holter recordings, 15 with chronic AF (CAF) and 15 with sinus rhythm (SR), allowed the authors to establish specific RR variability characteristics using wavelet and fractal analysis. Then, a validation set of 50 subjects was studied using these criteria, 19 with CAF, 16 with SR, and 15 with paroxysmal AF (PAF); and each QRS was classified as true or false sinus or AF beat. In the SR group, specificity reached 99.9%; in the CAF group, sensitivity reached 99.2%; in the PAF group, sensitivity reached 96.1%, and specificity 92.6%. However, classification on a patient basis provided a sensitivity of 100%. This new approach showed a high sensitivity and a high specificity for automatic AF detection, and could be used in screening for AF in large populations at risk.