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3.
Bol. Asoc. Méd. P. R ; 89(1/3): 33-34, Jan.-Mar. 1997.
Article in Spanish | LILACS | ID: lil-411474

ABSTRACT

The case of a 64 years old female patient with chest pain, dizziness and abnormal chest x-ray is presented. The different diagnostic possibilities are discussed. The final assessment in the case was a double radiographic exposure of the chest film confusing the clinical picture


Subject(s)
Humans , Female , Middle Aged , Cartilage Diseases , Chest Pain , Osteitis , Diagnosis, Differential , Cartilage Diseases/complications , Cartilage Diseases/diagnosis , Chest Pain/etiology , Osteitis/complications , Osteitis/diagnosis , Ribs
4.
Bol. Asoc. Méd. P. R ; 89(1/3): 15-20, Jan.-Mar. 1997.
Article in English | LILACS | ID: lil-411478

ABSTRACT

The study was designed to evaluate the compliance of general management guidelines, determine the effectiveness of Thrombolytic therapy (TTX), determine the complications, statistics and the [quot ]Door to Needle[quot ] time (DTN) in the management of Myocardial Infarction (MI) in the Bayamón public health care sector. METHODS: Retrospective record review and SPSS statistical calculations were performed. RESULTS: 66 cases (49m, 17f) discharged with MI from January 1993 to June 1995 were included. 27 received TTX. 80 were between 30-69 y/o, while 20 from 70-87 y/o. Past hx and habits; smoker 62, ETOH 45. Labs in adm; hypoMG 15, hypoK 11. The Q MI = 63, Non Q = 38. The sinoatrial and ventricular arrhythmias were seldom seen (7.5 SVT, AIVR 3). Intra and atrioventricular block (3). The most frequent cardiac complication was CHF 10 and the non cardiac; BKP 16.5. The mortality was (6.1). The mean stay was 9.34 days. Therapy used; IV NTG 97, ASA 84, beta B 39, TTX 42.2, ACE inhibitors 32. Absence of TTX was usually due to absence of EKG criteria (63). TTX complications; hypotension 10.5. The mean DTN was 1hr 58m,. 91 were discharged home, 23.3 cath, deaths 6. The ER MD assessment of MI was correct in only 29. CONCLUSIONS: The complications of patients with MI in the TTX era are below the ones before TTX. Mortality and morbidity have improved with the use of TTX. The medical therapy guidelines of MI are generally followed in HURRA. Improvement in the DTN is needed. The prolonged DTN and the inconsistency of the admission assessment by the ER personnel establishes the need to develop a training program which would regulate this abnormality


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Fibrinolytic Agents/therapeutic use , Myocardial Infarction/drug therapy , Thrombolytic Therapy/statistics & numerical data , Drug Therapy, Combination , Fibrinolytic Agents/administration & dosage , Fibrinolytic Agents/adverse effects , Myocardial Infarction/complications , Myocardial Infarction/diagnosis , Myocardial Infarction/mortality , Puerto Rico/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Thrombolytic Therapy/adverse effects , Urban Population
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