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1.
Arch. argent. pediatr ; 119(4): S198-S211, agosto 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281043

ABSTRACT

La pandemia ocasionada por el nuevo coronavirus (SARS-CoV-2), declarada por la Organización Mundial de la Salud OMS) en marzo de 2020, afecta a un reducido número de pacientes pediátricos, quienes presentan, en su mayoría, compromiso respiratorio leve y evolución favorable. Sin embargo, en niños previamente sanos, comenzó a observarse un aumento de casos definidos como síndrome inflamatorio multisistémico (SIM-C) o similar a Kawasaki (Kawasaki-like) asociado a la enfermedad por el nuevo coronavirus (COVID-19) (KL-C) que evolucionan al shock y requieren internación en la unidad de cuidados intensivos.Los cuadros de SIM-C y los KL-C se caracterizan por fiebre, signos de inflamación, síntomas gastrointestinales y disfunción cardiovascular; las formas graves de presentación tienen mayor incidencia de hipotensión y/o shock. En el laboratorio se observan marcadores de inflamación, hipercoagulabilidad y daño miocárdico. El tratamiento farmacológico de primera línea consiste en la administración de inmunoglobulina por vía intravenosa más ácido acetilsalicílico por vía oral.Se recomienda un abordaje multidisciplinario para un diagnóstico certero y un tratamiento temprano y eficaz para disminuir la morbimortalidad.


The pandemic caused by the SARS-CoV-2 virus declared by the WHO in March 11th 2020, affects a small number of pediatric patients, who mostly present mild respiratory compromise and favorable evolution.However began to be observed in previously healthy children, an increase in cases defined as "Multisystemic Inflammatory Syndrome" (MIS-C) or "Kawasaki-like" post-COVID 19 (KL-C) that evolve to shock and require hospitalization in the Pediatric Intensive Care Unit.MIS-C and KL-C are characterized by fever; signs of inflammation, gastrointestinal symptoms, and cardiovascular dysfunction, associated with sever forms of presentation with higher incidence of hypotension and/or shock. In the laboratory, markers of inflammation, hypercoagulability and myocardial damage are observed. First-line drug treatment consists of intravenous immunoglobulin plus oral acetylsalicylic acid.A multidisciplinary approach is recommended for an accurate diagnosis and an early and effective treatment, in order to reduce morbidity and mortality.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Systemic Inflammatory Response Syndrome/therapy , COVID-19/therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aspirin/therapeutic use , Immunoglobulins, Intravenous/therapeutic use , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/diagnosis , Critical Care , Diagnosis, Differential , COVID-19/complications , COVID-19/diagnosis , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/therapy
2.
Rev. bras. med. esporte ; 27(spe2): 99-103, Apr.-June 2021. graf
Article in English | LILACS | ID: biblio-1280097

ABSTRACT

ABSTRACT Generally speaking, the physiological index of the human body is in a relatively stable state, which refers to the function of various organ systems with the characteristics of high-tide period, low-tide period and critical period. However, for competitive athletes, it is necessary to maintain physiological activation in both training and competition. In view of this, this study will analyze the physiological arousal degree of aspirin and acetaminophen in order to provide a reference for athletes to take analgesic drugs. In this study, the analytic hierarchy process (AHP), principal component analysis and factor analysis, were used to construct a scientific evaluation system of physiological arousal level, and the medication and non-medication status of 90 athletes were evaluated. The results showed that aspirin was better than acetaminophen in blood urea and serum creatine kinase, and the comprehensive score of some athletes was higher than 0.95. Aspirin is better in arousing athletes' physiology. The research results will provide scientific guidance for athletes to take antipyretic and analgesic drugs.


RESUMO Em termos gerais, o índice fisiológico do corpo humano encontra-se num estado relativamente estável, que se refere à função de vários sistemas de órgãos no corpo humano, com as características do período de altas, período de baixas e período crítico. No entanto, para atletas competitivos, é necessário manter a ativação fisiológica em treinamento e competição. Em vista disso, este estudo irá analisar o grau fisiológico de excitação de aspirina e acetaminofeno, a fim de fornecer referência para os atletas a tomar medicamentos analgésicos. Neste estudo, o Analytic Hierarchy Process (AHP), análise de componentes principal e análise de fatores foram usados para construir um sistema de avaliação científica de nível de excitação fisiológica, e o estado de medicação e de não medicação de 90 atletas foram avaliados. Os resultados mostraram que a aspirina foi melhor do que o acetaminofeno na ureia sanguínea e na creatina quinase sérica, e o escore abrangente de alguns atletas foi maior do que 0.95. A aspirina é melhor no despertar da fisiologia dos atletas. Os resultados da pesquisa fornecerão orientação científica para os atletas tomarem medicamentos antipiréticos e analgésicos.


RESUMEN En términos generales, el índice fisiológico del cuerpo humano se encuentra en un estado relativamente estable, que se refiere a la función de varios sistemas de órganos en el cuerpo humano, con las características del período de altas, período de bajas y período crítico. Mientras tanto, para atletas competitivos, es necesario mantener la activación fisiológica en entrenamiento y competición. En vista de eso, este estudio analizará el grado fisiológico de excitación de aspirina y acetaminofeno, a fin de proveer referencia para los atletas para tomar medicamentos analgésicos. En este estudio, el Analytic Hierarchy Process (AHP), análisis de componentes principal y análisis de fatores fueron usados para construir un sistema de evaluación científica de nivel de excitación fisiológica, y el estado de medicación y de no medicación de 90 atletas fueron evaluados. Los resultados mostraron que la aspirina fue mejor que el acetaminofeno en la urea sanguínea y en la creatina quinasa sérica, y el escore abarcador de algunos atletas fue mayor de 0.95. La aspirina es mejor en el despertar de la fisiología de los atletas. Los resultados de la investigación proveerán orientación científica para que los atletas tomen medicamentos antipiréticos y analgésicos.


Subject(s)
Humans , Adolescent , Young Adult , Track and Field/physiology , Aspirin/pharmacology , Analgesics, Non-Narcotic/pharmacology , Athletes , Acetaminophen/pharmacology
3.
Rev. colomb. cardiol ; 28(1): 67-73, ene.-feb. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341262

ABSTRACT

Resumen El ácido acetilsalicílico (Aspirina) es un inhibidor irreversible de la acetil ciclooxigenasa (COX) y su actividad no es restaurada hasta la formación de nuevas plaquetas. Sus efectos benéficos terapéuticos cardiovasculares lo han convertido en la piedra angular del tratamiento del paciente con enfermedad arterial coronaria. Existe una población de pacientes con indicación absoluta para su uso; sin embargo, la presencia o antecedente de hipersensibilidad a esta molécula conlleva un alto riesgo de complicaciones no relacionadas con enfermedad cardiovascular. En algunos de estos pacientes es crucial conocer e implementar protocolos de desensibilización para el ácido acetilsalicílico y, de esta manera, continuar con el uso de esta estrategia terapéutica necesaria e idónea en esta población.


Abstract Acetylsalicylic acid (Aspirin) is an irreversible inhibitor of acetyl cyclooxygenase (COX) and its activity is not restored until new platelets are formed. Its beneficial therapeutic cardiovascular effects have made it the cornerstone of the treatment of patients with coronary artery disease. There is a population of patients with absolute indication for its use, however, the presence or history of hypersensitivity to this molecule leads to a high risk of complications unrelated to their cardiovascular disease. It is vital to know and implement in some of these patients, desensitization protocols for acetyl salicylic acid and in this way to continue the use of this therapeutic strategy necessary and appropriate in this population.


Subject(s)
Humans , Male , Female , Aspirin , Guideline , Coronary Disease , Protocols , Intensive Care Units , Myocardial Infarction
4.
Bol. méd. postgrado ; 37(1): 27-33, Ene-Jun 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147875

ABSTRACT

Se realizó una investigación descriptiva transversal retrospectiva con el fin de determinar el perfil clínico y epidemiológico de la enfermedad de Kawasaki (EK) en 95 niños egresados del Hospital Pediátrico Dr. Agustín Zubillaga durante el período 2014-2017. El promedio de edad de los pacientes se ubicó en 3,9 ± 3,3 años, siendo 69,5% del sexo masculino. El tiempo de evolución de la enfermedad fue menor de 10 días en el 68,4% de los casos. Las manifestaciones clínicas predominantes fueron fiebre (100%), edema y/o descamación de palmas y plantas (85,3%), alteración de la mucosa oral (65,3%), inyección conjuntival (59%) y eritema polimorfo (55,8%). El tratamiento recibido consistió en aspirina (100%) e inmunoglobulina (96,8%). La respuesta al tratamiento fue satisfactoria en el 95,8% de los pacientes. Los hallazgos de laboratorio evidenciaron una PCR elevada (51,6%) y trombocitosis (97,9%) con hemoglobina normal en 62,1% de los casos. 41% de los pacientes presentaron ecocardiograma anormal y 97,9% presentaron ultrasonido abdominal normal. El diagnóstico de ingreso de la EK fue incompleto en 53,7% de los pacientes y el diagnóstico de egreso de la EK fue completo en 51,6%. Los resultados de este estudio brindan datos epidemiológicos recientes sobre la enfermedad de Kawasaki en nuestra institución prestadora de salud(AU)


A descriptive cross-sectional retrospective investigation was carried out to evaluate the clinical and epidemiological profile of Kawasaki disease (KD) in 95 children discharged from the Pediatric Hospital Dr. Agustín Zubillaga during the period 2014-2017. Mean age of children was 3.9 ± 3.3 years and 69.5% were male. Time of symptom onset was less than ten days in 68.4% patients. Predominant clinical manifestations were fever (100%), edema and/or desquamation of palms and soles (85.3%), alteration of the oral mucosa (65.3%), conjunctival injection (59%) and polymorphic erythema (55.8%). Treatment received included aspirin (100%) and immunoglobulin (96.8%). Response to treatment was satisfactory in 95.8% of cases. Laboratory findings showed elevated CRP (51.6%), thrombocytosis (97.9%) and normal hemoglobin in 62.1% patients. 41% had an abnormal echocardiogram and 97.9% showed a normal abdominal ultrasound. The diagnosis of CHD admission was incomplete in 53.7% of cases and the diagnosis of EK was complete in 51.6%. Results of this study show recent epidemiological data about Kawasaki disease in our healthcare institution(AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Immunoglobulins/therapeutic use , Aspirin/therapeutic use , Clinical Laboratory Techniques , Coronary Disease/etiology , Mucocutaneous Lymph Node Syndrome/epidemiology , Signs and Symptoms , Vasculitis , Edema , Fever
5.
Chinese Medical Journal ; (24): 164-172, 2021.
Article in English | WPRIM | ID: wpr-878008

ABSTRACT

BACKGROUND@#Aspirin has demonstrated safety and efficacy for venous thromboembolism (VTE) prophylaxis following total hip arthroplasty (THA); however, inconsistent dose regimens have been reported in the literature. This study aimed to evaluate and compare the safety and efficacy of 100 mg aspirin twice daily with rivaroxaban in VTE prophylaxis following THA.@*METHODS@#Patients undergoing elective unilateral primary THA between January 2019 and January 2020 were prospectively enrolled in the study and randomly allocated to receive 5 weeks of VTE prophylaxis with either oral enteric-coated aspirin (100 mg twice daily) or rivaroxaban (10 mg once daily). Medication safety and efficacy were comprehensively evaluated through symptomatic VTE incidence, deep vein thrombosis (DVT) on Doppler ultrasonography, total blood loss (TBL), laboratory bloodwork, Harris hip score (HHS), post-operative recovery, and the incidence of other complications.@*RESULTS@#We included 70 patients in this study; 34 and 36 were allocated to receive aspirin and rivaroxaban prophylaxis, respectively. No cases of symptomatic VTE occurred in this study. The DVT rate on Doppler ultrasonography in the aspirin group was not significantly different from that in the rivaroxaban group (8.8% vs. 8.3%, χ2 = 0.01, P = 0.91), confirming the non-inferiority of aspirin for DVT prophylaxis (χ2 = 2.29, P = 0.01). The calculated TBL in the aspirin group (944.9 mL [658.5-1137.8 mL]) was similar to that in the rivaroxaban group (978.3 mL [747.4-1740.6mL]) (χ2 = 1.55, P = 0.12). However, there were no significant inter-group differences in HHS at post-operative day (POD) 30 (Aspirin: 81.0 [78.8-83.0], Rivaroxaban: 81.0 [79.3-83.0], χ2 = 0.43, P = 0.67) and POD 90 (Aspirin: 90.0 [89.0-92.0], Rivaroxaban: 91.5 [88.3-92.8], χ2 = 0.77, P = 0.44), the incidence of bleeding events (2.9% vs. 8.3%, χ2 = 0.96, P = 0.33), or gastrointestinal complications (2.9% vs. 5.6%, χ2 = 1.13, P = 0.29).@*CONCLUSION@#In terms of safety and efficacy, the prophylactic use of 100 mg aspirin twice daily was not statistically different from that of rivaroxaban in preventing VTE and reducing the risk of blood loss following elective primary THA. This supports the use of aspirin chemoprophylaxis following THA as a less expensive and more widely available option for future THAs.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR18000202894; http://www.chictr.org.cn/showproj.aspx?proj=33284.


Subject(s)
Anticoagulants , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee , Aspirin/therapeutic use , Humans , Rivaroxaban/therapeutic use , Venous Thromboembolism/prevention & control
6.
Braz. j. med. biol. res ; 54(9): e9570, 2021. graf
Article in English | LILACS | ID: biblio-1278586

ABSTRACT

High proportions of placental lymphocytes expressing DX5+/CD25+/FOXP3+/CD45+/CD4+ are beneficial to maintain immune tolerance and improve pregnancy outcomes. This study aimed to compare and evaluate the therapeutic effects of aspirin, vitamin D3 (VitD3), and progesterone on the autoimmune recurrent spontaneous abortion (RSA) model. The autoimmune RSA mouse model was constructed, and the embryo loss rate was calculated for each group. Then, primary mouse placental lymphocytes were isolated, and the expression of DX5+/CD25+/FOXP3+/CD45+/CD4+ was detected through flow cytometry. The serum levels of anti-cardiolipin antibody (ACA), β2-GP1, CXCL6, IFN-γ, and IL-6 were measured by ELISA to evaluate the proportion of Th1 and Th2 cells. Autoimmune RSA significantly increased the embryo loss rate, which was improved by aspirin, VitD3, and progesterone treatment, and progesterone treatment had the best effect among the three treatments. The positive expression of DX5+/CD25+/FOXP3+/CD45+/CD4+ in the VitD3 and progesterone groups was significantly higher than that in the autoimmune RSA group, and the expression was highest in the progesterone treatment group. In the plasma of autoimmune RSA mice, the ACA, β2-GP1, CXCL6, and IFN-γ levels were significantly higher and the IL-6 level was lower than the levels in control mice. All these changes could be reversed by aspirin and progesterone treatment. In conclusion, aspirin, VitD3 and progesterone treatment improved pregnancy outcomes in autoimmune RSA mice by regulating the Th1/Th2 balance and cytokines, and progesterone had the best effect of the three treatments.


Subject(s)
Humans , Animals , Female , Pregnancy , Mice , Progesterone , Abortion, Habitual/prevention & control , Abortion, Habitual/drug therapy , Placenta , Pregnancy Outcome , Aspirin , Cholecalciferol/therapeutic use
8.
Rev. bras. cir. cardiovasc ; 35(6): 859-868, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1144000

ABSTRACT

Abstract Introduction: This study aimed to determine the effect of preoperative aspirin administration on early and long-term clinical outcomes in patients suffering from diabetes mellitus (DM) undergoing coronary artery bypass grafting (CABG). Methods: In this observational study, a total of 315 patients were included and grouped according to the time interval between their last aspirin dose and the time of surgery; patients who had been continued aspirin intake with last administered dose ≤ 24-hours before CABG (n=144) and those who had been given the last dose of aspirin between 24 to 48 hours before CABG (n=171). Results: Multivariable analysis showed that the continuation of preoperative aspirin intake ≤ 24 hours before CABG in patients with DM is associated with reduced incidence of 30-day major adverse cardiac and cerebral events (MACCE) (P=0.004) as well as reduced incidence of composite 30-day mortality/MACCE (P=0.012). During mean follow-up of 37±17.5 months, the unadjusted hazard ratio (HR) showed that aspirin ≤ 24 hours prior CABG in patients with DM significantly reduced the incidence of MACCE and composite of mortality/MACCE during follow-up (HR: 0.50; 95% confidence interval [CI]: 0.29-0.87; P=0.014 and HR: 0.61; 95% CI: 0.38-0.97; P=0.039, respectively). However, after propensity score (PS) matching, the PS-adjusted HR showed a non-significant trend towards the reduction of MACCE during follow-up (HR: 0.58; 95% CI: 0.31-1.06; P=0.081). Conclusion: Continuation of preoperative aspirin intake ≤ 24 hours before CABG in patients with DM is associated with reduced incidence of early MACCE, but without significant influence on long-term outcomes.


Subject(s)
Humans , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aspirin/therapeutic use , Coronary Artery Bypass , Diabetes Mellitus/drug therapy , Percutaneous Coronary Intervention , Coronary Artery Disease/surgery , Retrospective Studies , Treatment Outcome , Propensity Score
9.
Arq. bras. cardiol ; 115(5): 830-839, nov. 2020. tab, graf
Article in Portuguese | LILACS, SES-SP | ID: biblio-1142260

ABSTRACT

Resumo Fundamentos: Poucos estudos discutiram causas para o subtratamento medicamentoso na SCA. Objetivos: Avaliar a não-administração e suspensão de medicamentos durante o tratamento intra-hospitalar da SCA na Estratégia de Registro de Síndrome Coronariana Aguda (estudo ERICO). Métodos: Analisamos prontuários de 563 participantes ERICO para avaliar a frequência e motivos da não administração e/ou suspensão de medicamentos. Construímos modelos de regressão logística para avaliar se sexo, idade ≥65 anos, nível educacional ou subtipo de SCA estavam associados com (a) não administração de ≥1 medicamentos; e (b) não administração ou suspensão de ≥1 medicamentos. O nível de significância foi 5%. Resultados: A amostra é composta por 58,1% de homens e com idade mediana de 62 anos. Em 183 (32,5%) participantes ≥1 medicamentos não foram administrados e 288 (51,2%) apresentaram ≥1 medicamentos não administrados ou suspensos. As causas mais frequentes foram risco de sangramento (aspirina, clopidogrel e heparina), insuficiência cardíaca (betabloqueadores) e hipotensão (inibidores da enzima conversora da angiotensina e bloqueadores dos receptores da angiotensina). Indivíduos com idade ≥65 anos (razão de chances [RC]:1,51; intervalo de confiança de 95% [IC95%]:1,05-2,19) e com angina instável (RC:1,72; IC95%:1,07-2,75) tiveram maior chance de não-administração. Considerando apenas pacientes com infarto do miocárdio, idade ≥65 anos foi associada tanto à não administração quanto à não administração ou suspensão. Conclusões: A não administração ou suspensão de ≥1 medicamento não foi rara no estudo ERICO. Indivíduos com idade ≥65 anos ou com angina instável tiveram maior chance de não administração e podem ser subtratados nesse cenário.


Abstract Background: Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS). Objectives: To determine the frequency and reasons for the non-administration and suspension of medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods: The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age ≥65 years of age, educational level, or ACS subtype were associated with (a) the non-administration of ≥1 medications; and (b) the non-administration or suspension of ≥1 medications. The significance level was set at 5%. Results: This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, ≥1 medications were not administered, while in 288 (51.2%), ≥1 medications were not administered or were suspended. The most common reasons were the risk of bleeding (aspirin, clopidogrel, and heparin), heart failure (beta blockers), and hypotension (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers). Individuals aged ≥65 (odds ratio [OR]:1.51; 95% confidence interval [95% CI]:1.05-2.19) and those with unstable angina (OR:1.72; 95% CI:1.07-2.75) showed a higher probability for the non-administration of ≥1 medication. Considering only patients with myocardial infarction, being ≥65 years of age was associated with both the non-administration and the non-administration or suspension of ≥1 medication. Conclusions: Non-administration or suspension of ≥1 medication proved to be common in this ERICO study. Individuals of ≥65 years of age or with unstable angina showed a higher probability of the non-administration of ≥1 medication and may be undertreated in this scenario. (Arq Bras Cardiol. 2020; 115(5):830-839)


Subject(s)
Humans , Male , Female , Middle Aged , Pharmaceutical Preparations , Acute Coronary Syndrome/drug therapy , Angiotensin-Converting Enzyme Inhibitors , Platelet Aggregation Inhibitors , Aspirin , Clopidogrel
11.
An. Fac. Cienc. Méd. (Asunción) ; 53(2): 53-58, 20200800.
Article in Spanish | LILACS | ID: biblio-1119417

ABSTRACT

Introducción: El uso adecuado de la aspirina para la prevención primaria de eventos de enfermedades cardiovasculares requiere de la evaluación de los beneficios y riesgos para el paciente. Objetivos: Determinar el riesgo cardiovascular global y el uso adecuado de aspirina como prevención primaria de enfermedades cardiovasculares en pacientes ambulatorios de Clínica Médica del Hospital de Clínicas. Materiales y métodos: Estudio observacional, descriptivo, transversal, prospectivo en pacientes ambulatorios de Clínica Médica del Hospital de Clínicas entre setiembre de 2017 y setiembre de 2018. Se incluyó a pacientes de ambos sexos, entre 40 y 79 años de edad, que presentan uno o más de los siguientes factores de riesgo cardiovascular: HTA, dislipidemias, DM2, tabaquismo. Se midieron las variables sociodemográficas, presión arterial sistólica y diastólica, colesterol total, c-HDL, c-LDL, historia de HTA, DM2, tabaquismo, uso de estatinas y ácido acetilsalicílico. Para medir las variables se elaboró un cuestionario. Se calculó el puntaje de riesgo cardiovascular global según ACC/AHA, utilizando la calculadora ASCVD Risk. Resultados: Se analizaron 100 cuestionarios, edad promedio de 61±5,3 años, 67% mujeres y el 100% son de raza blanca. El 88% fueron hipertensos, 73% dislipidemicos, 43% diabéticos y 24% tabaquista. El 50% presentaron riesgo cardiovascular global alto, el promedio de riesgo cardiovascular es de 15±3,6 %. El 60% con adecuada indicación de aspirina para la prevención primaria de eventos cardiovasculares. Conclusión: La mitad de los pacientes presentaron riesgo cardiovascular alto y en el 60% el uso de aspirina fue adecuado para la prevención primaria de eventos cardiovasculares.


Introduction: The adequate use of aspirin for the primary prevention of cardiovascular disease events requires the evaluation of the benefits and risks for the patient. Objectives: To determine the global cardiovascular risk and the adequate use of aspirin as primary prevention of cardiovascular diseases in outpatients of the Clínica Médica del Hospital de Clínicas. Materials and methods: Observational, descriptive, cross-sectional, prospective study in outpatients of the Clínica Médica del Hospital de Clínicas between September 2017 and September 2018. Patients of both sexes, between 40 and 79 years of age, who had one or more of the following cardiovascular risk factors: HT, dyslipidemia, T2DM, smoking. Sociodemographic variables, systolic and diastolic blood pressure, total cholesterol, HDL-c, LDL-c, history of HT, DM2, smoking, use of statins and acetylsalicylic acid were measured. To measure the variables, a questionnaire was prepared. The global cardiovascular risk score was calculated according to ACC / AHA, using the ASCVD Risk calculator. Results: 100 questionnaires were analyzed, average age of 61 ± 5.3 years, 67% women and 100% are white. 88% were hypertensive, 73% dyslipidemic, 43% diabetic and 24% tobacco addicted. 50% presented high global cardiovascular risk, the average cardiovascular risk is 15 ± 3.6%. 60% with adequate indication of aspirin for the primary prevention of cardiovascular events. Conclusion: Half of the patients presented high cardiovascular risk and in 60% the use of aspirin was adequate for the primary prevention of cardiovascular events.


Subject(s)
Cardiovascular Diseases , Aspirin , Primary Prevention
12.
Brasília; s.n; 21 jul. 2020.
Non-conventional in Portuguese | LILACS, BRISA, PIE | ID: biblio-1117680

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referentes ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 9 artigos e 10 protocolos.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Ribavirin/therapeutic use , Technology Assessment, Biomedical , Immunoglobulins/therapeutic use , Chloroquine/therapeutic use , Aspirin/therapeutic use , Interferons/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Azithromycin/therapeutic use , Hydroxychloroquine/therapeutic use , Anti-Bacterial Agents/therapeutic use
13.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 800-805, June 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1136291

ABSTRACT

SUMMARY In patients with atrial fibrillation, standard anticoagulation with a vitamin K antagonist plus dual antiplatelet therapy with a P2Y12 inhibitor and aspirin is the standard of care after percutaneous coronary intervention (PCI). While this therapy reduces the risk of thrombosis and stroke, it increases the risk of bleeding. It is unclear whether the antiplatelet effect of aspirin and clopidogrel may worsen atrial fibrillation (AF). OBJECTIVE Thus we aimed to analyze platelet aspirin resistance (AR) and clopidogrel resistance (CR) in acute coronary (ACS) patients based on sinus rhythm (SR) and AF. METHODS In this prospective trial, we included 543 patients (mean age: 62± 12 years; range: 26 - 89 years) who were on aspirin and clopidogrel therapy after the diagnosis of acute coronary syndrome. AR and CR were analyzed by a Multiplate® MP-0120 device by using the method of whole blood aggregometry. RESULTS AF patients had significantly higher age, mean platelet volume, and High-Sensitivity C-Reactive Protein (p< 0.01 for each parameter). Similarly, Arachidonic-acid induced (ASPI) aggregation was higher in AF patients compared to SR patients (666±218 vs. 187±179, p<0.001). Among the ACS patients, significantly more female patients had AF (p<0.001). The incidence of hypertension in the AF group was higher compared to the SR group (p<0.001). However, adenosine diphosphate levels were not at a significant level in the two groups. CONCLUSION Our findings indicate that the platelet inhibitory effect of Aspirin was worse for patients with AF, suggesting that the effectiveness of aspirin may be less in the prophylaxis of thromboembolism and more a bleeding risk.


RESUMO Em pacientes com fibrilação atrial, a anticoagulação padrão com antagonista da vitamina K mais terapia antiplaquetária dupla (DAPT) com inibidor de P2Y12 e aspirina é o padrão de tratamento após intervenção coronária percutânea (ICP). Enquanto essa terapia reduz o risco de trombose e derrame, aumenta o risco de sangramento. Não está claro se o efeito antiplaquetário da aspirina e do clopidogrel pode piorar a fibrilação atrial (FA). OBJETIVO Analisar a resistência à aspirina plaquetária (AR) e ao clopidogrel (CR) em pacientes coronarianos agudos (SCA) com base no ritmo sinusal (SR) e na FA. MÉTODOS Neste estudo prospectivo, foram incluídos 543 pacientes (idade média: 62±12 anos; intervalo: 26-89 anos) em uso de aspirina e clopidogrel após o diagnóstico de síndrome coronariana aguda. AR e CR foram analisados por um dispositivo Multiplate® MP-0120, utilizando o método de agregometria de sangue total. RESULTADOS Os pacientes com FA apresentaram valores significativamente maiores para idade, volume médio de plaquetas e proteína C reativa de alta sensibilidade (p<0,01 para cada parâmetro). Da mesma forma, a agregação induzida por ácido araquidônico (Aspi) foi maior nos pacientes com FA em comparação com os pacientes com SR (666±218 vs. 187±179, p<0,001). Entre os pacientes com SCA, significativamente mais pacientes do sexo feminino apresentaram FA (p<0,001). A incidência de hipertensão no grupo FA foi maior em comparação com o grupo SR (p<0,001). No entanto, os níveis de difosfato de adenosina não foram expressivamente significativos nos dois grupos. CONCLUSÃO Nossos achados indicam que o efeito inibitório plaquetário da aspirina foi pior em pacientes com FA, sugerindo que a eficácia da aspirina pode ser menor na profilaxia do tromboembolismo, com maior risco de sangramento.


Subject(s)
Humans , Female , Adult , Aged , Aged, 80 and over , Atrial Fibrillation , Drug Resistance/physiology , Aspirin/therapeutic use , Acute Coronary Syndrome , Platelet Aggregation Inhibitors , Incidence , Prospective Studies , Drug Therapy, Combination , Percutaneous Coronary Intervention , Middle Aged , Anticoagulants
15.
Rev. Soc. Bras. Med. Trop ; 53: e20200472, 2020. tab, graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136838

ABSTRACT

Abstract INTRODUCTION: In the genesis of coronavirus disease (COVID-19), there is a process of endotheliitis associated with thrombotic changes, no studies have reported the use of acetylsalicylic acid (ASA) as a possible therapeutic approach. Statins could potentiate the ASA therapy. METHODS: This is a series of 14 cases with a laboratory-confirmed diagnosis of COVID-19. All patients underwent the ASA therapy. Those who had risk factors for vascular disease also underwent the high-potency statin therapy. When symptoms were totally or practically resolved, patients were discharged and advised to continue medications for a complementary time, according to the clinical evolution of each patient. RESULTS: The mean age of monitored patients was 48.6 years. A total of 78.6% patients presented with at least one comorbidity, which could have contributed as a risk factor for a poor prognosis in the evolution of COVID-19. Four patients had secondary bacterial infections; three patients needed hospitalization. None of the cases progress to stage III, and all patients had remission of symptoms, with 100% survival. CONCLUSIONS: the process of endothelial dysfunction in COVID-19 involves disseminated thrombosis, initially microvascular and later expansion into larger vessels. ASA could act as a secondary prophylaxis and prevent thrombosis from developing and reaching stage III of the disease. As this was a case series, we cannot provide definitive conclusions; however, this study allows us to formulate hypotheses and support clinical trials to evaluate benefits of the ASA therapy in the treatment of COVID-19.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Thrombosis/drug therapy , Aspirin/therapeutic use , Coronavirus Infections/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Inflammation/drug therapy , Ischemia/drug therapy , Comorbidity , Coronavirus Infections , Endothelium/drug effects , Endothelium/pathology , Pandemics , Betacoronavirus , Middle Aged
16.
Korean Circulation Journal ; : 120-129, 2020.
Article in English | WPRIM | ID: wpr-786227

ABSTRACT

BACKGROUND AND OBJECTIVES: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI).METHODS: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months.RESULTS: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924).CONCLUSIONS: Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.


Subject(s)
Aspirin , Drug-Eluting Stents , Hemorrhage , Humans , Incidence , Korea , Myocardial Infarction , Percutaneous Coronary Intervention , Platelet Aggregation Inhibitors , Stents , Stroke , Thrombosis
19.
Article in Chinese | WPRIM | ID: wpr-828443

ABSTRACT

In this study, the clinical characteristics and drug combination rules of Danshen Chuanxiongqin Injection in the treatment of patients with cerebral infarction were analyzed. The inpatient information of 2 857 patients of cerebral infarction treated with Danshen Chuanxiongqin Injection in HIS database of 20 grade Ⅲ class A hospitals in China was collected, and a model was established by description analysis and Apriori algorithm, in order to explore the clinical characteristics and drug combination rules of Danshen Chuan-xiongqin Injection in the treatment of cerebral infarction. The results showed that among patients of cerebral infarction treated with Danshen Chuanxiongqin Injection, 1 727 patients were older than 65 years old, accounting for 69.61%, and 1 610 were males, accounting for 63.59%. Commonly used drugs included lipid-lowering agents, anticoagulant thrombolytic agents, antiplatelet agents, stimulants of brain metabolism, vasodilators and other Western drugs, as well as traditional Chinese medicines, such as blood-activating agents, heat-clearing agents and expectorant agents. The Western medicine with the highest use frequency in combination with Danshen Chuan-xiongqin Injection was aspirin enteric-coated tablets(1 528 cases, 53.48%). The traditional Chinese medicine with the highest use frequency in combination with Danshen Chuanxiongqin Injection was Xingnaojing Injection, with a total of 378 cases, accounting for 13.23%. Among them, the most commonly used Western drugs combined with Danshen Chuanxiongqin Injection were anticoagulant thrombolytic and antiplatelet drugs, with a usage rate as high as 83.48%. In order to further explore the drug combination rules of Danshen Chuanxiongqin Injection, the association analysis of drug combination in patients of cerebral infarction treated with Danshen Chuanxiongqin Injection was carried out. In clinical combination of two Western drugs, Atorvastatin Calcium Capsules+Cerebral Proteolytic Injection were the most common combination, with a support of 27.10%. In clinical combination with 3 Western drugs, Clopidogrel Bisulfate Tablets+Atorvastatin Calcium Capsules+Cerebral Proteolytic Injection were most commonly used, with a support of 15.90%. The results showed that the patients of cerebral infarction treated with Danshen Chuanxiongqin Injection were mainly elderly males, and often complicated with hypertension, coronary heart disease, diabetes and other basic diseases. The clinical application of Danshen Chuanxiongqin Injection was principally in line with the guidelines. In the treatment of cerebral infarction, it was often combined with Western medicine anticoagulant thrombolysis, antiplatelet drugs, traditional Chinese medicine blood-activating and stasis-dissolving prescription and other drugs with similar pharmacological effects, with an auxiliary therapeutic effect on patients of cerebral infarction complicated with other diseases, and can provide guidance for clinical medication.


Subject(s)
Aged , Aspirin , Cerebral Infarction , China , Drugs, Chinese Herbal , Humans , Male , Medicine, Chinese Traditional , Salvia miltiorrhiza
20.
Article in Chinese | WPRIM | ID: wpr-828419

ABSTRACT

To explore the real world clinical application characteristics and the drug combination regularity of Ciwujia Injection, 12 554 cases of patients with Ciwujia Injection were extracted from the information systems of 24 class Ⅲ grade A hospitals in China, and a standardized analysis was carried out. Most of the patients were middle-aged and old-aged, and the main departments were cardiovascular department(22.50%) and neurology department(17.92%). Before 2008, 93.77% of the patients were single overdose users, which reduced to only 2.07% after 2011. The course of treatment was mostly between 8-14 days(32.98%). The top three di-seases diagnosed by Western medicine were hypertension(11.78%), cerebral infarction(9.47%), and coronary heart disease(8.15%), and the most common traditional Chinese medicine syndrome was the deficiency of liver and kidney(18.59%). The most commonly used Western medicine was Acetylsalicylic Acid(51.07%), and the most commonly used traditional Chinese medicine was Danshen Injection(9.67%). The most commonly used Western medicine in combined application was calcium channel blocker(46.88%), and the most commonly used traditional Chinese medicine in combined application was stasis removing agent(93.21%). And the drug combination with the highest support was Isosorbide Mononitrate + Acetylsalicylic Acide, with a high recovery rate after discharge(96.81%). The results showed that Ciwujia Injection had certain regularity. It considered underlying concurrent diseases, anticoagulation and blood circulation, with a wide range of effects in strengthening the body and regulating the mind. The results could expand the understanding of Ciwujia Injection and provide a more detailed real world basis and reference for optimizing therapeutic regimen in clinic.


Subject(s)
Aged , Aspirin , China , Drug Combinations , Drugs, Chinese Herbal , Eleutherococcus , Humans , Medicine, Chinese Traditional , Middle Aged
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