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1.
Med. clín (Ed. impr.) ; 151(5): 198-206, sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-173884

RESUMO

Durante medio siglo los antagonistas de la vitamina K han sido la única opción disponible para la terapia anticoagulante oral. En los últimos años se han desarrollado anticoagulantes orales directos: un inhibidor directo de la trombina (dabigatrán etexilato) y 3 inhibidores directos del factor X activado (rivaroxabán, apixabán y edoxabán). Todos ellos han demostrado un beneficio-riesgo favorable, comparables en eficacia y seguridad a los anticoagulantes tradicionales antagonistas de la vitamina K, en la prevención del ictus y la embolia sistémica en pacientes con fibrilación auricular no valvular, la profilaxis y el tratamiento del tromboembolismo venoso y el síndrome coronario agudo. En 2008 la Agencia Europea del Medicamento aprobó el primer anticoagulante oral directo, dabigatrán. Posteriormente, rivaroxabán, apixabán y edoxabán fueron autorizados. En este artículo se revisa la experiencia acumulada con cada uno de estos fármacos


Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome. In 2008, dabigatran was the first direct oral anticoagulant approved by the European Medicine Agency. Subsequently, rivaroxaban, apixaban and edoxaban were also authorised. This article reviews the evidence related to the use of these drugs


Assuntos
Humanos , Dabigatrana/uso terapêutico , Rivaroxabana/uso terapêutico , Inibidores do Fator Xa/uso terapêutico , Tromboembolia Venosa , Anticoagulantes/uso terapêutico , Administração Oral , Vitamina K/antagonistas & inibidores , Doenças Cardiovasculares
2.
Med Clin (Barc) ; 151(5): 198-206, 2018 09 14.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29295790

RESUMO

Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome. In 2008, dabigatran was the first direct oral anticoagulant approved by the European Medicine Agency. Subsequently, rivaroxaban, apixaban and edoxaban were also authorised. This article reviews the evidence related to the use of these drugs.


Assuntos
Antitrombinas/uso terapêutico , Acidente Vascular Cerebral/prevenção & controle , Síndrome Coronariana Aguda/prevenção & controle , Administração Oral , Anticoagulantes/administração & dosagem , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Antitrombinas/administração & dosagem , Antitrombinas/efeitos adversos , Fibrilação Atrial/complicações , Ensaios Clínicos como Assunto , Dabigatrana/administração & dosagem , Dabigatrana/uso terapêutico , Inibidores do Fator Xa/administração & dosagem , Inibidores do Fator Xa/uso terapêutico , Hemorragia/induzido quimicamente , Hemorragia/terapia , Humanos , Complicações Pós-Operatórias/prevenção & controle , Pirazóis/administração & dosagem , Pirazóis/uso terapêutico , Piridinas/administração & dosagem , Piridinas/uso terapêutico , Piridonas/administração & dosagem , Piridonas/uso terapêutico , Rivaroxabana/administração & dosagem , Rivaroxabana/uso terapêutico , Prevenção Secundária , Tiazóis/administração & dosagem , Tiazóis/uso terapêutico , Tromboembolia Venosa/prevenção & controle , Suspensão de Tratamento
3.
World J Oncol ; 6(6): 485-490, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28983351

RESUMO

Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy, with an incidence of approximately 0.72 per million cases per year leading to 0.2% of all cancer deaths in the United States. Metastatic ACC has a dismal prognosis with an overall survival of less than 1 year. We present a case of a 37-year-old man with metastatic ACC with unusual good prognosis and review the therapeutic options in the literature.

6.
Dermatol Online J ; 16(12): 14, 2010 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-21199640

RESUMO

Cutis verticis gyrata is a rare skin condition characterized by ridges and furrows resembling the surface of the brain. It can be considered as a manifestation of a variety of diverse causes such as cerebriform intradermal nevus. We report a 48-year-old man with cerebriform and soft folds on the left parietal and temporal areas. Histology showed solitary or clusters of nevus cells in the dermis. The diagnosis of cerebriform intradermal nevus was confirmed.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Nevo Intradérmico/diagnóstico , Dermatoses do Couro Cabeludo/etiologia , Couro Cabeludo , Neoplasias Cutâneas/diagnóstico , Alopecia em Áreas/etiologia , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Melanose/diagnóstico , Melanose/etiologia , Pessoa de Meia-Idade , Síndromes Neurocutâneas/diagnóstico , Nevo Intradérmico/complicações , Couro Cabeludo/patologia , Neoplasias Cutâneas/complicações
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