ABSTRACT
Background: Exercise EKG is used as the test of choice in the diagnosis of coronary artery disease. Classical parameters are angor and ST depression representing myocardial ischemia. Aim: To correlate exercise EKG parameters with SPECT 201Thallium to know their likelihood ratios for ischemia. Patients and methods: Two hundred seventy four patients (171 men), aged 58 years old as a mean, were studied. Of these, 23 percent had a prior myocardial infarction. The likelihood ratios for the presence of ischemia of ST depression, failure to increase blood systolic pressure, the presence of angor and its duration during stress testing were calculated according to the results of SPECT 201Thallium. Seventy one patients were also subjected to a coronary angiography. Results: Among men, likelihood ratios for the presence of angor, failure to increase systolic pressure, ST alterations and duration of angor were 6.9, 6.15, 1.77 and 1.27 respectively. Among women, the figures were 5.45, 1.77, 0.58 and 1.4 respectively. The diagnostic accuracy of SPECT 201Thallium, when correlated with the results of coronary angiography, was 85 percent. Conclusions: Among men, the best exercise EKG predictors for myocardial ischemia were the failure to increase systolic blood pressure and the presence of angor. Among women the only significant predictor was the presence of angor
Subject(s)
Humans , Male , Female , Tomography, Emission-Computed, Single-Photon , Exercise Test , Electrocardiography/methods , Myocardial Ischemia/diagnosis , Predictive Value of Tests , Risk Factors , Coronary Disease/physiopathology , Thallium RadioisotopesABSTRACT
El objetivo de este trabajo es hacer una propuesta viable para dar solución a la situación de salud bucal de nuestro país. Se realizo un análisis estratégico que permitió esquematizar y jerarquizar la problemática actual.Se detecto un inmenso número de deficiencias en el sector salud. Para clarificar el plan de acción y darle viabilidad y efectividad se presenta un plan inmediato de acción. Se reconoce que hay múltiples problemas para abordar, pero inicialmente es imperativo darle vida a un plan inmediato de acción.Para simplificar las propuestas se identificaron 5 frentes de estudio: el sistema educativo, el sector administrativo, la situación epidemiológica en salud bucal, el marco político y la odontología (A.C.F.O. y F.O.C.).Conociendo de antemano la complejidad del problema se plantean inicialmente estrategias enfocadas hacia el sector educativo y el sector administrativo.Primero se presentara el plan inmediato de salud bucal a ser ejecutado por el grupo comunitario de prevención. Esto para darle realce sobre todos los otros puntos que son de gran complejidad...