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1.
Ann Cardiol Angeiol (Paris) ; 73(4): 101781, 2024 Sep.
Artigo em Francês | MEDLINE | ID: mdl-39059043

RESUMO

Coronary artery anomalies (ANOCOR) are congenital anomalies with various anatomical forms. Percutaneous treatment can be offered in certain situations, most often to address associated atherosclerotic disease or, more rarely, to correct a congenital stenosis. Due to the frequent difficulties of catheterization, percutaneous coronary interventions for ANOCOR are recognized as complex procedures. A thorough anatomical understanding facilitates the identification of the connection site and the initial ectopic course of an ANOCOR during coronary angiography. Selecting an appropriate catheter is a crucial step in the procedure. There is a higher prevalence of atherosclerotic disease along retroaortic courses compared to other ectopic courses. When treating atherosclerotic stenosis downstream of an ectopic course, techniques typically used for complex coronary procedures can be helpful. While angioplasty for congenital stenosis is technically feasible, its role in management algorithms remains to be defined. Currently, this type of percutaneous treatment may be offered to right ANOCOR with interarterial course in adults over 35 years old and with ischemic symptoms or myocardial ischemia.


Assuntos
Anomalias dos Vasos Coronários , Humanos , Anomalias dos Vasos Coronários/cirurgia , Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/terapia , Angiografia Coronária , Angioplastia Coronária com Balão/métodos , Adulto
2.
Sci Rep ; 12(1): 18834, 2022 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-36336702

RESUMO

We present a co-axial acoustic-based optical coherence vibrometry probe (CoA-OCV) for vibro-acoustic resonance quantification in biological tissues. Sample vibrations were stimulated via a loudspeaker, and pre-compensation was used to calibrate the acoustic spectrum. Sample vibrations were measured via phase-sensitive swept-source optical coherence tomography (OCT). Resonance frequencies of corneal phantoms were measured at varying intraocular pressures (IOP), and dependencies on Young´s Modulus (E), phantom thickness and IOP were observed. Cycling IOP revealed hysteresis. For E = 0.3 MPa, resonance frequencies increased with IOP at a rate of 3.9, 3.7 and 3.5 Hz/mmHg for varied thicknesses and 1.7, 2.5 and 2.8 Hz/mmHg for E = 0.16 MPa. Resonance frequencies increased with thickness at a rate of 0.25 Hz/µm for E = 0.3 MPa, and 0.40 Hz/µm for E = 0.16 MPa. E showed the most predominant impact in the shift of the resonance frequencies. Full width at half maximum (FWHM) of the resonance modes increased with increasing thickness and decreased with increasing E. Only thickness and E contributed to the variance of FWHM. In rabbit corneas, resonance frequencies of 360-460 Hz were observed. The results of the current study demonstrate the feasibility of CoA-OCV for use in future OCT-V studies.


Assuntos
Pressão Intraocular , Vibração , Animais , Coelhos , Acústica , Tomografia de Coerência Óptica/métodos
3.
Clin Transl Oncol ; 19(3): 373-378, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27770397

RESUMO

PURPOSE: We compared biochemical control and quality of life with intermittent (6 months) versus continuous (36 months) androgen deprivation therapy (ADT) in a non-inferiority randomized phase 3 trial in patients with biochemical failure (BF) after external beam radical radiotherapy (EBRT). MATERIALS AND METHODS: Patients were stratified according to the Gleason score (GS) and were classified as low risk with a GS < 6 and 7 (3 + 4) and high risk with a GS of 7 (4 + 3) and >7. Patients were followed with PSA determinations and quality-of-life assessments (QLQ C-30 and QLQ PR-25) every 6 months for a period of 3 years. BF after radiation was defined as a PSA level of nadir +2 ng/ml. Disease progression (DP) after ADT was defined as PSA ≥4 ng/ml (BF) and/or metastases. RESULTS: Seventy-seven patients were included in this multicenter phase 3 trial from 2005 to 2009. Thirty-eight and 39 patients were included in the intermittent and continuous groups, respectively. The median follow-up for both groups was 48 months (40-68). DP after ADT in the intermittent group was seen in three patients (distant metastases in one patient) versus 0 in the continuous group. The QLQ-C30 and QLQ PR-25 scores did not show any statistically difference between the two ADT groups. CONCLUSIONS: No significant differences were seen in DP and QLQ between intermittent (6 months) and continuous (36 months) ADT in patients with BF after EBRT.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Braquiterapia , Recidiva Local de Neoplasia/diagnóstico , Neoplasias da Próstata/tratamento farmacológico , Qualidade de Vida , Idoso , Terapia Combinada , Seguimentos , Humanos , Masculino , Gradação de Tumores , Recidiva Local de Neoplasia/sangue , Estadiamento de Neoplasias , Prognóstico , Estudos Prospectivos , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Fatores de Tempo
4.
Chest ; 101(4): 1154-5, 1992 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1555439

RESUMO

We report the rare occurrence of fatal cardiac tamponade due to coronary sinus and right atrial thrombosis associated with central venous catheterization. The clinical course was extremely rapid, with death occurring a few minutes after the acute clinical event. Other causes of acute cardiac tamponade were ruled out by the postmortem studies.


Assuntos
Tamponamento Cardíaco/etiologia , Cateterismo Venoso Central/efeitos adversos , Trombose Coronária/etiologia , Derrame Pericárdico/etiologia , Idoso , Tamponamento Cardíaco/patologia , Trombose Coronária/patologia , Emergências , Feminino , Humanos , Derrame Pericárdico/patologia , Estado Asmático/complicações , Estado Asmático/terapia , Fatores de Tempo
5.
Acta méd. peru ; 36(2): 110-115, abr.-jun. 2019. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1054738

RESUMO

Objetivo: Determinar la relación entre el riesgo de caídas y deterioro cognitivo en adultos mayores del Centro Médico Naval "Cirujano Mayor Santiago Távara" 2010-2015. Materiales y métodos: Fue un estudio observacional, analítico, retrospectivo, que consistió en el análisis secundario de una base de datos. Se evaluó el riesgo de caídas mediante los resultados de la prueba de alcance funcional (AF), mientras que para determinar el deterioro cognitivo se utilizó el cuestionario de Pfeiffer. Adicionalmente, se estudiaron factores socio-demográficos como la edad, sexo, nivel educativo; y clínicos como la presencia de comorbilidades, polifarmacia o antecedentes de caídas. Resultados: La muestra estuvo conformada por 1786 adultos mayores. El 45,1% tenían entre 71 y 80 años, de sexo masculino (58,9%), con nivel educativo técnico/superior (70,9%), tenían 2 o más comorbilidades (48,9%). Se encontró asociación estadística (p<0,05) entre AF alterado y la edad, el nivel educativo, la presencia de comorbilidades, y el deterioro cognitivo. Al realizar el modelo multivariado, se encontró que el deterioro cognitivo se asoció al riesgo de caídas con un PR ajustado de 3,05 (IC 95%: 2,45-3,79). Conclusión: Se encontró que el deterioro cognitivo estuvo asociado a un riesgo tres veces mayor de caídas en adultos mayores del Centro Médico Naval "Cirujano Mayor Santiago Távara" durante los años 2010-2015.


Objective: To determine the relationship between the risk of falls and cognitive impairment in elderly subjects at Cirujano Mayor Santiago Tavara Peruvian Navy Medical Center for the 2010-2015 period. Materials and Methods: This is a retrospective observational and analytical study, which consisted in a secondary analysis of a database. The risk of falls was assessed using the results of the functional scope test (FS), while cognitive impairment was assessed with the Pfeiffer score. Additionally, socio-demographic factors, such as age, sex, and educational level were studied; also, clinical factors, such as comorbidities, polypharmacy or previous falls were assessed. Results: Nearly eighteen hundred (1786) elderly subjects were included. Nearly half of all subjects (45.1%) were between 71 and 80 years old; most of them were male (58.9%); and the majority had technical/higher education level (70.9%). Nearly half of all subjects (48.9%) had 2 or more comorbidities. A statistical association (p<0.05) was found between an altered FS and age, educational level, presence of comorbidities, and cognitive impairment. The multivariate analysis showed that cognitive impairment was associated with a high risk of falls (adjusted PR: 3.05; 95% CI: 2.45-3.79). Conclusion: It was found that cognitive impairment was associated with a threefold risk of falls in elderly subjects from Cirujano Mayor Santiago Tavara Peruvian Navy Medical Center during 2010-2015.

6.
Osteoarthritis Cartilage ; 15(8): 900-8, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17387026

RESUMO

OBJECTIVE: To evaluate the efficacy and tolerability of aceclofenac, 200 mg/day, and paracetamol, 3000 mg/day, in the treatment of osteoarthritis (OA) of the knee. METHODS: This was a double-blind, parallel-group, multicentre clinical trial involving patients with symptomatic OA of the knee, conducted in Spain. Patients were randomly allocated to aceclofenac 100 mg twice daily (n=82) or paracetamol 1000 mg three times daily (n=86). Patients were assessed at baseline and 6 weeks. Primary efficacy measures were severity of pain (visual analogue scale, VAS), Lequesne OA knee index, and patient's and physician's global assessment of disease activity. Severity of knee pain at rest or walking, stiffness, knee swelling and tenderness, and assessment of health-related quality of life (Health Assessment Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form 36) were included as secondary endpoints. RESULTS: Both treatment groups showed significant improvement compared with their baseline values in the four primary endpoints. Mean between-treatment differences favoured aceclofenac over paracetamol on pain (VAS, 7.64 mm [95% confidence interval (CI), 0.44-14.85 mm]), Lequesne OA index (1.41 [95% CI, 0.45-2.36]), and patient's (0.33 [95% CI, 0.06-0.61]) and physician's (0.23 [95% CI, 0.01-0.47]) global assessments. Adverse events were similar for both drugs (paracetamol, 29% patients vs aceclofenac, 32%; P=0.71). Four patients withdrew in each group due to adverse events. Patients tended to prefer aceclofenac to paracetamol (P=0.001), and more treated with paracetamol withdrew from the study due to lack of efficacy (n=8 vs n=1, P=0.035, for paracetamol and aceclofenac, respectively). CONCLUSION: At 6 weeks, patients with symptomatic OA of the knee showed a greater improvement in pain and functional capacity with aceclofenac than paracetamol with no difference in tolerability.


Assuntos
Acetaminofen/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Diclofenaco/análogos & derivados , Osteoartrite do Joelho/tratamento farmacológico , Acetaminofen/efeitos adversos , Adulto , Idoso , Analgésicos não Narcóticos/efeitos adversos , Anti-Inflamatórios não Esteroides/efeitos adversos , Diclofenaco/administração & dosagem , Diclofenaco/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
7.
Aten Primaria ; 36(4): 204-10, 2005 Sep 15.
Artigo em Espanhol | MEDLINE | ID: mdl-16153374

RESUMO

PURPOSE: To investigate the behaviour of primary care (PC) physicians on inadequate hypertension control. DESIGN: Cross-sectional and multicentric study. SETTING: PC clinics in the whole of Spain. PATIENTS: Patients > or =18 years old who followed pharmacological antihypertensive treatment since at least 3 months before, selected by a consecutive sampling. MEASUREMENTS: Blood pressure measured by family doctors. The therapeutic diagram used before and after the visit was registered, and in those cases in which some kind of modification was adopted, the reasons why. RESULTS: 12,754 hypertensive patients were included. The average age was 63.3+/-10.9 years (57.3% women). A 65% lived in urban areas and the 35% in semi-urban o rural areas. The 63.9% (95% confidence interval, 63.1%-64.8%) showed a bad control of hypertension. The majority of the patients followed a therapeutic regimen of monotherapy (56%) being the ACE inhibitors the most prescribed drug (34.8%), followed by the calcium antagonist (21.3%), and angiotensin II antagonists (17.4%). The percentage of patients with inadequate control of the blood pressure, in which the therapeutic behaviour was modified was 18.3% (95% confidence interval, 17.5%-19.1%) (a change of drug in 47%, association in 34.7% and an increase in the dose in 18.3%). The main reasons for which the therapeutic behaviour was modified was because no drug efficacy (63.7%) and the presence of adverse events (5.5%). The price of the therapy originated 1.2% of the modifications. CONCLUSIONS: PC physicians behaviour was conservative in uncontrolled hypertension cases. Amongst the doctors who modified their behaviour, by inadequate blood pressure control, the change of drug was the decision most adopted.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Médicos de Família , Idoso , Anti-Hipertensivos/administração & dosagem , Estudos Transversais , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , População Rural , Espanha , População Urbana
8.
Exp Brain Res ; 57(2): 279-85, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-3972031

RESUMO

Methylazoxymethanol (MAM), a powerful antimitotic, has been extensively used to affect rodent CNS development. Here we show that MAM causes different effects on mouse cerebellum depending on the age of the injected pup. Sublethal doses were determined for each age. A single injection at birth permanently reduces the number of cells. In addition, the cytoarchitecture was greatly perturbed: Purkinje cells retained an immature aspect and were dispersed through the cerebellar cortex. A single dose of MAM injected into 5 day old mice also affected the number of cells but, at the level of light microscopy, the cytoarchitecture of the cerebellar cortex appeared not to be altered. Purkinje cells, however, showed some immaturity and degenerated around the 22nd postnatal day. This modulation of MAM effect appears to provide a good model for studying cerebellar ontogeny and neuronal plasticity.


Assuntos
Compostos Azo/farmacologia , Cerebelo/efeitos dos fármacos , Acetato de Metilazoximetanol/farmacologia , Fatores Etários , Animais , Movimento Celular/efeitos dos fármacos , Cerebelo/análise , Cerebelo/crescimento & desenvolvimento , DNA/análise , Acetato de Metilazoximetanol/análogos & derivados , Camundongos , Microscopia Eletrônica , Modelos Neurológicos , Plasticidade Neuronal
9.
Artigo em Espanhol | MEDLINE | ID: mdl-9381958

RESUMO

In recent years evidence has accumulated to implicate a poor awareness of illness in schizophrenia. This study employed two clinical scales to assess both the psychopathology of 41 schizophrenic patients and the intensity of their awareness of illness. The results show the existence of a close relationship between these two clinical dimensions. Nevertheless, awareness of illness did not appear as a constant and isolated factor. In the authors' opinion, the findings derivated from the study support the idea that a poor awareness of illness could be a nuclear symptom of schizophrenia.


Assuntos
Conscientização , Psicologia do Esquizofrênico , Adulto , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica
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