RESUMO
El tratamiento fibrinolítico en el síndrome coronario agudo con elevación del segmento ST (SCACEST) ha sido considerado como uno de los mayores avances en su manejo para lograr la reperfusión coronaria. Su efectividad es tiempo dependiente: a mayor precocidad mejores resultados. Con posterioridad, se demostró que la intervención coronaria percutánea (ICP) tiene superior eficacia que la fibrinolisis. Pero esta última técnica no está disponible para un porcentaje elevado de enfermos durante el periodo en laque es verdaderamente efectiva, ya que se realiza en centros especializados. Y ello provoca demoras superiores. Por esto, el tratamiento fibrinolítico prehospitalario sigue siendo una terapia efectiva para muchos enfermos. En este artículo, se revisa la historiade la fibrinolisis en el SCACEST y se presentan las recomendaciones para la estrategiade la reperfusión coronaria, junto a las claves para decidirse por el tratamiento fibrinolíticoo por la ICP (AU)
Fibrinolytic therapy has been called one of the most important advances for achieving coronary reperfusion in the management of acute coronary syndrome with ST-segment elevation. The efficacy of this measure depends on how quickly it is implemented, however. Percutaneous coronary intervention has since been shown to be more efficatiousthan fibrinolysis. Timely provision of this treatment within the therapeutic window is not available to a large proportion of patients, however, given that it is provided only in specialized centers, a situation responsible for long delays. Prehospital fibrinolytic therapy therefore continues to be an efficatious measure for many. We review the history offibrinolysis in acute coronary syndrome with ST-segment elevation and offer recommendations for approaches tocoronary reperfusion, discussing key points to consider in deciding between fibrinolytic therapy or percutaneouscoronary intervention (AU)
Assuntos
Humanos , Terapia Trombolítica , Síndrome Coronariana Aguda/terapia , Infarto do Miocárdio/terapia , Assistência Pré-Hospitalar , Síndrome Coronariana Aguda/epidemiologiaRESUMO
OBJECTIVE: To determine the seroprevalence of hepatitis A, B, C and D virus infection among pregnant women attending a perinatal care hospital. MATERIAL AND METHODS: A prospective study was carried out to determine the seroprevalence of hepatitis A virus IgG antibodies (anti-HAV), hepatitis B virus markers (anti-HBcAg and HBsAg) and hepatitis C virus antibodies (anti-HCV) in pregnant women. In HBsAg positive cases. HBeAg and hepatitis D virus antibodies (anti-HDV) were investigated. All analyses were performed with the ELISA technique. RESULTS: Of the 1500 pregnant women studied. 93.3% were positive for anti-HAV IgG. The HBsAg seroprevalence was 0.26% and anti-HCV seroprevalence was 0.53%. There were no patients with HBeAg or anti-HDV. CONCLUSIONS: A higher seroprevalence of HBsAg was found in this study than in other studies of pregnant Mexican women. We propose that HBsAg screening become a routine prenatal test.