ABSTRACT
Background: Echocardiography has now a pivotal role as a tool for hemodynamic monitoring, particularly in the critically ill. However, the ideal acoustic window for relevant measurements such as the velocity time integral are not always available. We propose to evaluate if angular correction of this variable is accurate in comparison with standard technique. Patients and methods: Adult patients were evaluated in the echocardiography unit during Juny 2017, having velocity time integral measured with angulation and standard technique, with convenience sampling. Analysis included difference, means and correlation between basal results and maximal angulation, in Stata 12. Results: 25 patients were included, mean velocity time integral was 23,01cm and with a mean angulation of 32,56º the integral was 24,27cm, with 5,5% difference, statistically significant, linear correlation had a 0,932 coefficient with R-square of 0,7897. Bland-Altman analysis revealed mean difference -1,256cm and agreement limits of -5,219 to 2,707. Discussion: In this study the result of the velocity time integral with angular correction had a good correlation and acceptable precision compared with non-angled measurements, which could allow its use when the acoustic window is sub-optimal, however, these findings should be replicated in critically ill patients. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Echocardiography/methods , Echocardiography/trends , Hemodynamic Monitoring/methodsABSTRACT
Cardiovascular mortality has been associated with changes in lifestyle and food habits. The occidental diet has been characterized by high intake of animal fat and meat, and it is associated whit increased risk of type 2 diabetes and high blood pressure, an increase in levels of markers of endothelial dysfunction, and presence of pro-thrombotic risk factors. We search the Pubmed database and other review references. Inclusion criteria were: papers published after 1999, randomized controled clinical studies, case-control studies, systematic reviews and methanalyses. Vegetarians groups show less cardiovascular morbidity and mortality than non-vegetarians. The evidence indicated that a decreasing intake of red meat, saturate fat, trans fat, and mainly processed meat, and an increase in the intake of whole grain cereals, fruits, vegetables and fish, are associated with a better overall cardiovascular health and survival.
El aumento de la mortalidad cardiovascular en el último tiempo está fuertemente asociado a cambios en los hábitos de alimentación. La dieta occidental caracterizada por una alta ingesta de alimentos de origen animal, presenta mayor riesgo de diabetes tipo 2 (DM 2), hipertensión arterial (HTA), aumento de marcadores de disfunción endotelial y factores protrombóticos. La búsqueda se realizó en la biblioteca online Pubmed y en referencias de otras revisiones. Los criterios de inclusión fueron: artículos de 1999 en adelante, ensayos clínicos aleatorizados-controlados, estudios caso-control, revisiones sistemáticas y meta análisis. En grupos con alto consumo de alimentos de origen vegetal se ha evidenciado una menor morbi-mortalidad cardiovascular, comparado con los grupos con alta ingesta de alimentos de origen animal. La evidencia apoya que la disminución en el consumo de carnes rojas, grasas saturadas y grasas trans, así como el aumento en el consumo de cereales integrales, frutas, vegetales y pescado, disminuye la morbi-mortalidad global y cardiovascular.
Subject(s)
Humans , Eating , Cardiovascular Diseases/mortality , Dietary Fats/adverse effects , Feeding Behavior , Plants , /complications , Edible Grain , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Fishes , Fruit , Health Behavior , Hypertension/complications , Meat Products/adverse effects , Risk FactorsABSTRACT
La resistencia antibiótica es un problema frecuente en aislamientos de E. coli asociados a infecciones del tracto urinario (ITU). Para evaluar la magnitud actual de este problema en Santiago se analizaron los perfiles de resistencia antibiótica de 173 muestras de E. coli provenientes de diferentes pacientes afectados por ITU e identificadas en un laboratorio que atiende exclusivamente pacientes ambulatorios. Los resultados indicaron un alto porcentaje de resistencia ante Ampicilina (45,6 por ciento), Trimetroprim-Sulfametoxazol (STX) (33,5 por ciento) y Cefalotina (20,8 por ciento). La resistencia antibiótica fue infrecuente para los ácidos Nalidíxico y Pipemidico (<10 por ciento cada uno) y marginal ante Ciprofloxacina, Cefuroxima, Gentamicina, y Nitrofurantoina (<3 por ciento cada uno). Todos los aislamientos fueron susceptibles ante Cefotaxima y Amikacina. Un 41 por ciento de los aislamientos fue totalmente susceptible, un 18,9 por ciento multiresistente. Las combinaciones prevalentes de resistencia fueron Ampicilina-STX (15,1 por ciento) y Ampicilina-Cefalotina (7,8 por ciento). Todos los aislamientos resistentes a Ciprofloxacina fueron multiresistentes