RESUMEN
Regular physical exercice has undeniable cardiovascular benefits and improves life expectancy. This benefice seems limited to moderate intensity exercises. Intense and chronic physical exercice would lead to heart structural changes. For a long time, knowledge of these cardiac effects seemed limited to the left ventricle. Since more authors have shown that right ventricle is vulnerability to the effects of intense chronic training. We report a Gallavardin-type ventricular stress tachycardia in a young with healthy hearted; in whom a right infundibular arrhythmogenic focus has been found in the absence of structural alteration of the right ventricle. Intense athletic activity may reveal a latent arrhythmogenic focus through sympathetic activation. Ablation was the preferred therapeutic strategy, preferred to drug therapy and derived from an analysis of risk-benefit ratios.
Asunto(s)
Deportes/fisiología , Taquicardia Ventricular/fisiopatología , Adulto , Arritmias Cardíacas/diagnóstico , Electrocardiografía , Prueba de Esfuerzo , Femenino , HumanosRESUMEN
BACKGROUND: Safety profile of the interaction between anticancer drugs and radiation is a recurrent question. However, there are little data regarding the non-anticancer treatment (NACT)/radiation combinations. The aim of the present study was to investigate concomitant NACTs in patients undergoing radiotherapy in a French comprehensive cancer center. METHODS: A prospective cross-sectional study was conducted. All cancer patients undergoing a palliative or curative radiotherapy were consecutively screened for six weeks in 2016. Data on NACTs were collected. RESULTS: Out of 214 included patients, a NACT was concomitantly prescribed to 155 patients (72%), with a median number of 5 NACTs per patient (range: 1-12). The most prescribed drugs were anti-hypertensive drugs (101 patients, 47.2%), psychotropic drugs (nâ¯=â¯74, 34.6%), analgesics (nâ¯=â¯78, 36.4%), hypolipidemic drugs (nâ¯=â¯57, 26.6%), proton pump inhibitors (nâ¯=â¯46, 21.5%) and antiplatelet drugs (nâ¯=â¯38, 17.8%). Although 833 different molecules were reported, only 20 possible modifiers of cancer biological pathways (prescribed to 74 patients (34.5%)) were identified. Eight out of the 833 molecules (0.9%), belonging to six drug families, have been investigated in 28 ongoing or published clinical trials in combo with radiotherapy. They were prescribed to 63 patients (29.4%). CONCLUSION: Drug-radiation interaction remains a subject of major interest, not only for conventional anticancer drugs, but also for NACTs. New trial designs are thus required.
Asunto(s)
Neoplasias/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Analgésicos/efectos adversos , Antihipertensivos/efectos adversos , Estudios Transversales , Interacciones Farmacológicas , Femenino , Humanos , Hipolipemiantes/efectos adversos , Masculino , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/efectos adversos , Estudios Prospectivos , Inhibidores de la Bomba de Protones/efectos adversos , Psicotrópicos/efectos adversosRESUMEN
BACKGROUND AND PURPOSE: The ERMANCIA (Etude Réalisée en Martinique et Centrée sur l'Incidence de Accidents vasculaires cérébraux) study was designed to provide the first comparable epidemiological data on stroke in a black Caribbean population. METHODS: ERMANCIA was a prospective community-based study performed in Martinique (French West Indies) from June 1, 1998, to May 31, 1999. The black at-risk population was approximately 360 000. Multiple sources were used to identify hospitalized and nonhospitalized patients with first-ever stroke. RESULTS: Five hundred eighty patients (285 men and 295 women; mean+/-SD age, 71.2+/-14 years) suffered from a first-ever in a lifetime stroke, yielding a crude annual incidence of 164/100 000 per year (95% CI, 151 to 177). The rates adjusted by age and sex to the French population (1999 census) and to the European population were 202 (95% CI, 185 to 218) and 151 (95% CI, 139 to 164), respectively. Thirty-eight patients (6.5%) were not hospitalized during the acute phase of the stroke; 92.8% had CT scan. Pathological types of strokes were infarction (79.8%, including 23% of lacunar strokes), intracerebral hemorrhage (14.3%), subarachnoid hemorrhage (3.4%), and undetermined (2.4%). The main risk factors for stroke were hypertension (69.1%) and diabetes (29.5%). The 30-day case fatality rate was 19.3% (15.8% for cerebral infarction and 37.3% for intracerebral hemorrhage). CONCLUSIONS: In Martinique, the ERMANCIA population-based study showed a high stroke incidence and a high prevalence of hypertension and diabetes in the stroke population compared with those observed in continental France. Epidemiological data on stroke in African Caribbeans from Martinique are comparable to those reported in blacks from the United States and United Kingdom.