RESUMO
No disponible
Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Doença Celíaca/complicações , Doença Celíaca/tratamento farmacológico , Olmesartana Medoxomila/uso terapêutico , Angiotensina II/uso terapêutico , Biópsia , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Dor Abdominal/tratamento farmacológico , Dor Abdominal/etiologia , Diarreia/complicaçõesRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Abscesso Hepático/etiologia , Corpos Estranhos/diagnóstico , Antro Pilórico , Tomografia Computadorizada por Raios XRESUMO
The objective of the study was to validate externally and prospectively the PROFUND index to predict survival of polypathological patients after a year. An observational, prospective and multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data concerning age, gender, comorbidity, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs and number of admissions during the previous year were gathered for each patient. The PROFUND index was calculated. The follow-up lasted 1 year. A Cox proportional regression model was calculated, and was used to analyze the association of the variables to mortality and C-statistic. 465 polypathological patients, 333 from internal medicine and 132 from geriatrics, were included. One-year mortality is associated with age [hazard ratio (HR) 1.52 95 % CI 1.04-2.12; p = 0.01], presence of neoplasia [HR 2.68 95 % CI 1.71-4.18; p = 0.0001] and dependence for basic activities of daily living [HR 2.34 95 % CI 1.61-3.40; p = 0.0009]. In predicting mortality, the PROFUND index shows good discrimination in patients from internal medicine (C-statistics 0.725 95 % CI 0.670-0.781), but a poor one in those from geriatrics (0.546 95 % CI 0.448-0.644). The PROFUND index is a reliable tool for predicting mortality in internal medicine PP patients.
Assuntos
Doença Crônica/mortalidade , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Geriatria , Departamentos Hospitalares , Humanos , Medicina Interna , Masculino , Neoplasias/mortalidade , Estudos Prospectivos , Espanha/epidemiologiaRESUMO
Lightning strike is one of the most frequent causes of death due to natural phenomena. In such cases, cardiac injury is the main cause of death, with type of lesion varying by type of impact. We report the case of a 29-year-old woman who was struck indirectly by lightning. Upon hospital admission, she showed both the echocardiographic disturbances characteristic of direct impact and electrocardiographic disturbances. Both types of change resolved spontaneously. After describing the case, we briefly review the literature on echo and electrocardiographic disturbances after lightning strike.
Assuntos
Traumatismos Cardíacos/etiologia , Lesões por Ação do Raio , Adulto , Ecocardiografia , Eletrocardiografia , Feminino , Seguimentos , Traumatismos Cardíacos/diagnóstico , Humanos , Lesões por Ação do Raio/diagnóstico , Lesões por Ação do Raio/mortalidade , MasculinoRESUMO
La fulguración es una de las causas más frecuentes de muerte por fenómenos naturales. La lesión cardíaca constituye la principal causa de mortalidad, dependiendo las lesiones producidas del tipo de impacto. Presentamos el caso de una mujer de 29 años que sufrió fulguración por impacto indirecto. En el momento del ingreso presentaba alteraciones ecocardiográficas, lo cual es característico del impacto directo, y anomalías electrocardiográficas. Ambos cambios se resolvieron de forma espontánea. Tras la exposición del caso, realizamos una breve revisión de las alteraciones ecocardiográficas y electrocardiográficas tras la fulguración (AU)
