ABSTRACT
Objetivos. Estudiar si existen diferencias en los tiempos empleados en la atención al paciente, según se utilice la vía oral o intravenosa en la administración de betabloqueantes a pacientes ambulatorios sometidos a coronariografía mediante tomografía computarizada (TC). Material y métodos. Estudio prospectivo, analítico, aleatorizado y controlado. Se distribuye a 40 pacientes con frecuencia mayor de 65 latidos por minuto en 2 grupos. En el grupo 1 se administra el betabloqueante por vía oral y en el grupo 2 por vía intravenosa. Se mide el tiempo global transcurrido desde la entrada del paciente en Radiología hasta su marcha y el tiempo parcial de ocupación de sala desde que entra hasta que sale de la sala de TC. Variables secundarias: frecuencia cardíaca, tensión arterial y número de estudios concluyentes. Resultados. La mediana (rango intercuartílico) del tiempo global fue de 120 minutos (100-150) en los 19 pacientes betabloqueados por vía oral y de 35 minutos (27,5-67,5) en los 21 pacientes con medicación intravenosa (p<0,001). El tiempo parcial de ocupación de sala fue 10 minutos (6-15) en el grupo 1 y 10 minutos (9-20) en el grupo 2 (p=0,57). El descenso de la tensión arterial media es 10 mmHg con los betabloqueantes por vía intravenosa frente a 3,3 mmHg por la vía oral (p=0,01). No se hallaron diferencias significativas en la calidad diagnóstica de las exploraciones. Conclusiones. El tiempo de atención al paciente es significativamente menor con la administración intravenosa de betabloqueantes. No se demostraron diferencias en el tiempo de ocupación de sala ni en la calidad diagnóstica (AU)
Objectives. To determine whether the time employed in the radiological management of outpatients undergoing computed tomography (CT) coronary angiography varies in function of whether oral or intravenous beta-blockers are administered. Material and methods. This was a prospective, analytical, randomized controlled trial. A total of 40 patients with heart rates greater than 65 beats per minute were randomly assigned to one of two groups. Patients in group 1 were administered oral beta-blockers and patients in group 2 were administered intravenous beta-blockers. We measured the overall time from entry to the radiology department to exit from the CT examination room. We also measured heart rate, blood pressure, and the number of conclusive studies. Results. The median (interquartile range) overall time was 120 (100-150) minutes in the 19 patients who received oral beta-blockers compared to 35 (27.5-67.5) minutes in the 21 patients who received intravenous beta-blockers (p<0.001). The median time that patients were in the CT examination room was 10 (6-15) minutes in Group 1 and 10 (9-20) minutes in Group 2 (p=0.57). The decrease in mean arterial pressure was 10 mmHg after the administration of intravenous beta-blockers compared to 3.3 mmHg after the administration of oral beta-blockers (p=0.01). No significant differences were found in the diagnostic quality of the examinations. Conclusions. The time employed in the radiological management of patients undergoing CT coronary angiography is significantly lower when beta-blockers are administered intravenously. There was no difference in the time patients were in the CT examination room or in the diagnostic quality of the examinations (AU)
Subject(s)
Humans , Female , Adrenergic beta-Antagonists/therapeutic use , /methods , Heart Rate , Adrenergic beta-Antagonists/metabolism , Adrenergic beta-Antagonists/pharmacokinetics , /trends , Prospective Studies , Coronary Vessels/pathology , Coronary Vessels , Heart Rate/radiation effects , 28599 , Clinical ProtocolsABSTRACT
OBJECTIVES: To determine whether the time employed in the radiological management of outpatients undergoing computed tomography (CT) coronary angiography varies in function of whether oral or intravenous beta-blockers are administered. MATERIAL AND METHODS: This was a prospective, analytical, randomized controlled trial. A total of 40 patients with heart rates greater than 65 beats per minute were randomly assigned to one of two groups. Patients in group 1 were administered oral beta-blockers and patients in group 2 were administered intravenous beta-blockers. We measured the overall time from entry to the radiology department to exit from the CT examination room. We also measured heart rate, blood pressure, and the number of conclusive studies. RESULTS: The median (interquartile range) overall time was 120 (100-150) minutes in the 19 patients who received oral beta-blockers compared to 35 (27.5-67.5) minutes in the 21 patients who received intravenous beta-blockers (p<0.001). The median time that patients were in the CT examination room was 10 (6-15) minutes in Group 1 and 10 (9-20) minutes in Group 2 (p = 0.57). The decrease in mean arterial pressure was 10 mmHg after the administration of intravenous beta-blockers compared to 3.3 mmHg after the administration of oral beta-blockers (p = 0.01). No significant differences were found in the diagnostic quality of the examinations. CONCLUSIONS: The time employed in the radiological management of patients undergoing CT coronary angiography is significantly lower when beta-blockers are administered intravenously. There was no difference in the time patients were in the CT examination room or in the diagnostic quality of the examinations.
Subject(s)
Adrenergic beta-Antagonists/administration & dosage , Coronary Angiography/methods , Tomography, X-Ray Computed , Administration, Oral , Female , Humans , Injections, Intravenous , Male , Middle Aged , Prospective StudiesABSTRACT
OBJECTIVES: To evaluate the organoleptic characteristics of two specific nutritional supplements for diabetes (Glucerna SR and Resource Suport) and compare them. SETTING: An evaluation was made of 456 patients with Type 2 diabetes (most of them receiving OADs or insulin) from 34 centers. They were non-smoking elderly patients (mean age 73 to (71-78) admitted to nursing homes or homes for the aged distributed all over the Spanish territory. INTERVENTIONS: Palatability was studied using a modified wine tasting scale assessing 6 parameters (appearance, smell, body, sweetness, aftertaste and taste) that were scored individually, with a total score ranging from 0 (most unfavorable) to 20 (most favorable). Each brand was evaluated in two flavors (vanilla and strawberry) according to a crossover, double-blind design. RESULTS: A total of 906 evaluable observations were made, and highly statistically significant differences favorable to Glucerna RS were found in all parameters considered both absolutely and relatively, exception for sweetness, for which statistical significance was not reached because it was relatively evaluated. No statistical differences were found between the two flavors (vanilla and strawberry). The only significant confusing factor found was age; the older the age, the more the differences were noted between the two brands. CONCLUSIONS: Glucerna SR has a better flavor than Resource Suport for institutionalized elderly diabetic patients.
Subject(s)
Consumer Behavior , Diet, Diabetic , Homes for the Aged , Aged , Double-Blind Method , Female , Humans , Male , Prospective StudiesABSTRACT
We describe the polysomnographic data of a 79-year-old woman with an 11-year history of nocturnal headaches that were clinically consistent with hypnic headache. A polysomnographic study showed arousal at stage 3 slow wave sleep because of a headache episode. Although this finding could be nonspecific, it suggests the possible relationship between stage 3 slow wave sleep and hypnic headache.
Subject(s)
Headache/physiopathology , Polysomnography , Sleep , Aged , Female , Humans , Sleep/physiology , Sleep Stages , SyndromeABSTRACT
INTRODUCTION: Several studies suggested a role of 'oxidative stress' (increased production of prooxidants, antioxidants deficiencies or both) in the pathogenesis of Parkinson's disease. In this study we have measured the serum levels of a number of prooxidant and antioxidant substances to evaluate their possible relation with the risk for Parkinson's disease. PATIENTS AND METHODS: We assessed the serum levels of iron, ferritin, ansferrin, ceruloplasmine, vitamin A, alpha-carotene, beta-carotene, and alpha-tocopherol, in 28 patients with Parkinson's disease and 85 matched controls. All of them were recruited from a population study. RESULTS: None of the values studied differed significantly between the two study groups, and none of them were correlated with age at onset, duration of the disease, scores of the Unified Parkinson Disease Rating Scale or the Hoehn and Yahr staging in the Parkinson's disease group. CONCLUSIONS: These results confirm the previous findings of classic case-control studies, suggesting the absence of relationship of the studied values with the risk for Parkinson's disease.
Subject(s)
Antioxidants/analysis , Oxidants/blood , Parkinson Disease/epidemiology , Age of Onset , Aged , Carotenoids/blood , Ceruloplasmin/analysis , Female , Ferritins/blood , Humans , Iron/blood , Male , Oxidative Stress , Parkinson Disease/blood , Prevalence , Risk , Severity of Illness Index , Spain/epidemiology , Transferrin/analysis , Vitamin A/blood , Vitamin E/blood , beta Carotene/bloodABSTRACT
There are multiple evidences that corroborate the importance of mitochondrial dysfunction in the pathogenesis of cellular destruction that causes the aging, and that oxidative stress is the main inductor of these alterations. Damage of the mitochondrial DNA (deletions, duplications), defects of the respiratory chain function, and varied structural modifications have been described in humans and animals with the age. This mitochondrial damage, caused by the progressive action of oxidative stress, would influence in the mechanisms of maintenance of the cell, causing its death. We revised the most important discoveries regarding mitochondrial alterations with aging.
Subject(s)
Aging/metabolism , Mitochondrial Myopathies/metabolism , DNA, Mitochondrial/genetics , Electron Transport , Humans , Mitochondrial Myopathies/genetics , Oxidative Stress , Point Mutation/geneticsABSTRACT
There are many data suggesting the possible role of oxidative reactions mediated by free radicals in neurodegenerative disease. Because the mitochondrial respiratory chain exerts a protective role against these reactions, its dysfunction could contribute to 'oxidative stress'. There have been described alterations of the mitochondrial respiratory chain and mitochondrial genome in several neurodegenerative diseases, such as in Parkinson's, Alzheimer's and Huntington's diseases. This article focuses on a review of the current knowledge regarding this issue.
Subject(s)
Mitochondrial Myopathies/complications , Neurodegenerative Diseases/complications , DNA, Mitochondrial/genetics , Humans , Mitochondrial Myopathies/geneticsABSTRACT
We report a case of a 48-year-old woman who had a 4 years history of bilateral blepharospasm. CT-scan showed multiple intracranial calcifications (two of them in the left thalamus) corresponding to neurocysticerosis, and a lacunar infarction in right internal capsule area. To our knowledge this case is the first one reported in the literature of blepharospasm associated with (and perhaps symptomatic of?) neurocysticercosis.
Subject(s)
Blepharospasm/etiology , Brain Diseases/parasitology , Calcinosis/parasitology , Cysticercosis/complications , Brain Diseases/complications , Brain Diseases/diagnosis , Calcinosis/complications , Calcinosis/diagnosis , Cysticercosis/diagnosis , Female , Humans , Middle AgedABSTRACT
We describe a 37-year-old man with spinal segmental myoclonus characterized by symmetric, rhythmic contractions of the abdomen with a frequency ranging between 100 and 150/min. The combination of sodium valproate and L-5-hydroxytryptophan was useful to control the myoclonus. We comment on the possible role of the serotonergic system in this syndrome.
Subject(s)
5-Hydroxytryptophan/therapeutic use , Myoclonus/drug therapy , Spinal Cord Diseases/drug therapy , Valproic Acid/therapeutic use , Adult , Drug Therapy, Combination , Humans , MaleABSTRACT
We report the case of a woman suffering from complex partial seizures who developed Parkinson's disease at the age of 58. Parkinsonian symptoms improved transitorily after complex partial seizures. Although this has been reported after generalized seizures, this case is, to our knowledge, the first description of improvement of parkinsonian symptoms following a complex partial seizure.
Subject(s)
Epilepsies, Partial/complications , Parkinson Disease/complications , Female , Humans , Middle AgedABSTRACT
Central nervous system involvement in systemic brucellosis is not frequent. Neurobrucellosis may involve several areas of the central nervous system and may be the cause of several clinical pictures. We report a case of brucellar meningitis that was clinically indistinguishable from a migrainous syndrome. The diagnosis of brucellar meningitis was confirmed by the isolation of Brucella sp. in the cerebrospinal fluid.
Subject(s)
Brucellosis/diagnosis , Meningitis/diagnosis , Migraine Disorders/diagnosis , Adolescent , Anti-Bacterial Agents/therapeutic use , Brucella/isolation & purification , Brucellosis/cerebrospinal fluid , Brucellosis/drug therapy , Diagnosis, Differential , Female , HumansABSTRACT
A prospective study of 3 years' duration on the etiology of late onset epilepsy was carried out in a rural health area with a population of 135,000. Eighty patients were included. History, neurological physical examination, electroencephalogram, cranial computed tomographic scan (CT) and general laboratory investigations were carried out. The cause of epilepsy was unknown in 51.3% of cases. The most commonly identified causes were cerebrovascular disease (20%), chronic alcohol abuse (10%), tumors of central nervous system (6.3%), neurocysticercosis (6.3%) and post-traumatic epilepsy (2.5%). Our data are compared with those from the previous literature, and the value of cranial CT in the investigation of this clinical condition is discussed.
