Subject(s)
Humans , Biomarkers , Comorbidity , Central America , Caribbean Region , Disease Management , Troponin T , Galectin 3 , Natriuretic Peptides/therapeutic use , Cystatin C , Heart FailureSubject(s)
Humans , Sleep Apnea Syndromes , Cardiovascular Diseases , Comorbidity , Central America , Myocardial Ischemia , Caribbean Region , Disease Management , Diabetes Mellitus , Gout , Heart Diseases , Heart Failure , Hypertension , Anemia , ObesitySubject(s)
Humans , Health Programs and Plans , Cardiovascular Diseases , Central America , Caribbean Region , Disease Management , Heart FailureABSTRACT
Myasthenia Gravis is an infrequent disease. Diagnosis and treatment must be done early to avoid high morbidity that can compromise patients lives. Nine cases were identified during the eight year 1990-1997 at the Santo Tomas Hospital of Panama city but one had to be excluded because he refused treatment. Most of the patients (7/8) had symptoms for more than 3 months. The diagnosis of Myasthenia Gravis requires a high index of suspicion and the clinical impressión must be confirmed by various diagnostic studies that include the edrophonium test, the repetitive stimulation test, the therapeutic test with pyridostigmine, the determination of acetylcholine anti-receptor antibodies and a CT Scan of the thorax. Medical treatment consists mainly of anticholinesterase agents and surgical treatment consists of thymectomy by means of an extended transternal ablation. Operative results were excellent, seven out of eight improved