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1.
An Sist Sanit Navar ; 42(2): 77154, 2019 12 27.
Artigo em Espanhol | MEDLINE | ID: mdl-31880297

RESUMO

This corrects the authors listed in "Takotsubo syndrome and hyperthyroidism: a case report" published in volume 42(2) pages 215-220, doi: 10.23938/ASSN.0713.

2.
An Sist Sanit Navar ; 42(3): 261-268, 2019 Dec 05.
Artigo em Espanhol | MEDLINE | ID: mdl-31859271

RESUMO

BACKGROUND: Given the higher rate of hospital admissions among diabetic patients, discharge should be used to optimize outpatient treatment. We evaluate a follow-up program for diabetic patients after hospital discharge to determine the evolution of glycemic control. METHOD: Retrospective collection of data on 375 diabetic patients enrolled in the follow-up program for optimization treatment: telephonic follow-up where treatment was adjusted if needed; and three months after discharge an in-person consultation was scheduled. Factors potentially associated with a 1% improvement in HbA1c were studied by multivariate logistic regression. RESULTS: Seventy-three percent of enrolled patients completed the follow-up program; each patient received an average of 4.6 phone calls. Globally, basal mean HbA1c was significantly lower three months later regarding the initial value (8.6 vs. 7.2%); the most relevant lowering was found in the group of hyper-glycemia by poor metabolic control (from 9.9 to 7.7%), combined hyperglycemia (from 9.3 to 7.3%) and debut (from 8.3 to 6.4%). Twenty percent of patients reported capillary hypoglycemia, with two severe events. A shorter duration of diabetes, absence of corticotherapy and absence of hypoglycemia during the follow-up period were independent predictors for a 1% reduction in three-months HbA1c. CONCLUSION: In patients whose treatment is changed on hospital discharge, a program allowing frequent treatment adjustment would improve HbA1c levels. These results could help to organize health resources more rationally.


Assuntos
Assistência ao Convalescente/métodos , Glicemia/metabolismo , Diabetes Mellitus/terapia , Hospitalização , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Hemoglobinas Glicadas/metabolismo , Humanos , Hiperglicemia/epidemiologia , Hipoglicemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Retrospectivos
3.
An. sist. sanit. Navar ; 42(2): 215-219, mayo-ago. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-188882

RESUMO

La miocardiopatía de estrés o síndrome de Takotsubo cursa clínicamente igual que un síndrome coronario agudo, con cambios eléctricos compatibles con isquemia y elevación de troponinas, aunque, en la coronariografía las arterias son normales. Su principal característica es el trastorno de la motilidad apical en el ecocardiograma. Se ha descrito en relación a trastornos tiroideos, aunque la relación causal no está claramente establecida. Se presenta el caso de una mujer que comenzó súbitamente con clínica de dolor torácico agudo, con cambios eléctricos y analíticos. Se objetivó una disfunción ventricular severa y un árbol coronario libre de lesiones, compatible con una miocardiopatía de estrés. Como desencadenante, presentó un hipertiroidismo por enfermedad de Graves. La identificación y manejo de los factores clínicos que podrían predisponer a los pacientes a esta miocardiopatía de estrés es fundamental para su prevención y tratamiento


Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença de Graves/complicações , Hipertireoidismo/complicações , Cardiomiopatia de Takotsubo/diagnóstico , Dor no Peito/etiologia , Ecocardiografia , Hipertireoidismo/etiologia , Cardiomiopatia de Takotsubo/etiologia
4.
An Sist Sanit Navar ; 42(2): 215-220, 2019 08 23.
Artigo em Espanhol | MEDLINE | ID: mdl-31343641

RESUMO

Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory.


Assuntos
Doença de Graves/complicações , Hipertireoidismo/complicações , Cardiomiopatia de Takotsubo/diagnóstico , Dor no Peito/etiologia , Ecocardiografia , Feminino , Humanos , Hipertireoidismo/etiologia , Pessoa de Meia-Idade , Cardiomiopatia de Takotsubo/etiologia
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