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2.
Rev Esp Quimioter ; 35(2): 157-164, 2022 Apr.
Article in Spanish | MEDLINE | ID: mdl-35037752

ABSTRACT

OBJECTIVE: Health and non-health workers (HNH-W) in a hospital are more exposed to SARS-CoV-2 infection than the general population. We studied the prevalence of this infection in these workers of Segovia´s Hospital after the first epidemic wave. METHODS: Monocentric, observational, cross-sectional study, carried out between April 29 and May 14, 2020. The infection was diagnosed by capillary immunochromatography test for IgG and / or IgM antibodies, or PCR. Work, health, and exposure variables were studied. RESULTS: A total of 1,335 HNH-W participated in the study out of a total of 1,667 (80.1%), 79.3% women, with a mean age of 47.3 years, and 47.1 for men. The prevalence of infected was 21.95%, 24.7% asymptomatic. Age presented a significant OR of 1.02/year. Exposure outside of work increased the prevalence by 16.8%. The continued use of Personal Protective Equipment (PPE) and the administration of nebulizations presented an OR of 0.54 and 0.46 respectively. The symptoms associated with the highest prevalence were anosmia (OR 9.31), ageusia (OR 3.05), and fever (OR 1.94). Today, about 75% of HNH-W were infected in the first wave. CONCLUSIONS: The prevalence is higher among healthcare workers than the population they serve. Age is associated with a higher prevalence of infection. Almost a quarter of those infected were asymptomatic. The continuous use of PPE was associated with a lower prevalence, for that the administration of nebulisations could be safe. The symptoms with the greatest association were fever, anosmia, and ageusia.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Personnel , Hospitals, General , Humans , Male , Middle Aged , Prevalence , SARS-CoV-2
3.
An Sist Sanit Navar ; 42(2): 77154, 2019 12 27.
Article in Spanish | MEDLINE | ID: mdl-31880297

ABSTRACT

This corrects the authors listed in "Takotsubo syndrome and hyperthyroidism: a case report" published in volume 42(2) pages 215-220, doi: 10.23938/ASSN.0713.

4.
An. sist. sanit. Navar ; 42(2): 215-219, mayo-ago. 2019. ilus
Article in Spanish | IBECS | ID: ibc-188882

ABSTRACT

La miocardiopatía de estrés o síndrome de Takotsubo cursa clínicamente igual que un síndrome coronario agudo, con cambios eléctricos compatibles con isquemia y elevación de troponinas, aunque, en la coronariografía las arterias son normales. Su principal característica es el trastorno de la motilidad apical en el ecocardiograma. Se ha descrito en relación a trastornos tiroideos, aunque la relación causal no está claramente establecida. Se presenta el caso de una mujer que comenzó súbitamente con clínica de dolor torácico agudo, con cambios eléctricos y analíticos. Se objetivó una disfunción ventricular severa y un árbol coronario libre de lesiones, compatible con una miocardiopatía de estrés. Como desencadenante, presentó un hipertiroidismo por enfermedad de Graves. La identificación y manejo de los factores clínicos que podrían predisponer a los pacientes a esta miocardiopatía de estrés es fundamental para su prevención y tratamiento


Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory


Subject(s)
Humans , Female , Middle Aged , Graves Disease/complications , Hyperthyroidism/complications , Takotsubo Cardiomyopathy/diagnosis , Chest Pain/etiology , Echocardiography , Hyperthyroidism/etiology , Takotsubo Cardiomyopathy/etiology
5.
An Sist Sanit Navar ; 42(2): 215-220, 2019 08 23.
Article in Spanish | MEDLINE | ID: mdl-31343641

ABSTRACT

Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory.


Subject(s)
Graves Disease/complications , Hyperthyroidism/complications , Takotsubo Cardiomyopathy/diagnosis , Chest Pain/etiology , Echocardiography , Female , Humans , Hyperthyroidism/etiology , Middle Aged , Takotsubo Cardiomyopathy/etiology
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2016: 5632-5635, 2016 Aug.
Article in English | MEDLINE | ID: mdl-28269532

ABSTRACT

Patients suffering from hypoventilation and pulmonary expansion deficit are at increased risk of developing pulmonary complications such as atelectasis, pneumonia or pleural effusion. These complications can increase the length of stay and spending on health, and generate long-term functional impairment. This study aims to produce a therapeutic alternative to the traditional method of lung re-expansion through incentive spirometry (IS) using the game therapy to build an innovative system. This system makes use of infrared and Bluetooth communication technology to associate the game therapy to EI. At the end of the system implementation, we expect to obtain good adhesion of the patient and the physiotherapists.


Subject(s)
Hypoventilation/rehabilitation , Play Therapy/methods , Spirometry/methods , Adult , Humans , Hypoventilation/complications , Physical Therapy Modalities , Pleural Effusion/etiology , Pneumonia/etiology , Pulmonary Atelectasis/etiology
7.
Odontol. pediatr. (Lima) ; 14(2): 164-170, jul.-dic.2015. ilus, tab
Article in Spanish | LILACS, LIPECS | ID: lil-790541

ABSTRACT

La mordida en tijera unilateral es una maloclusión poco frecuente en la dentición primaria. El objetivo de este reporte es describir el caso de un paciente de 4 arios 7 meses de edad que presentaba esta alteración en el sector posterior izquierdo. Esta alteración fue tratada con el uso un arco transpalatino y elásticos cruzados intermaxilares. El tratamiento implico un tiempo de 6 meses y 3 meses adicionales como periodo de contención. Como resultado se logró establecer una adecuada relación intermaxilar...


The unilateral scissors bite is a rare malocclusion in the primary dentition. The purpose of this report is to describe the case of a patient 4 years 7 months old, who presented this alteration in the left posterior sector. This alteration was treated with a transpalatal arch and cross elastics. The treatment involved a period of 6 months and 3 additional months as a retention period. As a result it was possible to establish an adequate intermaxillary relationship...


Subject(s)
Humans , Male , Child, Preschool , Malocclusion , Malocclusion/therapy , Orthodontics, Corrective
8.
Allergy ; 69(7): 898-905, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24773508

ABSTRACT

BACKGROUND: Asthma is characterized by airway inflammation and remodelling in which matrix metalloproteinases (MMPs) play an important role. MMP-9 is the major MMP found in the bronchoalveolar lavage fluids and bronchial biopsies from patients with allergic asthma after allergen challenge, where it correlates with the count of neutrophils and macrophages. However, the cellular sources of MMP-9 in this inflammatory condition have not yet been clearly identified. This work was undertaken to analyse whether neutrophils may be a source of MMP-9 in the allergic asthma condition upon allergen challenge. METHODS: Neutrophils from allergic asthmatic patients were in vitro stimulated, and the levels of MMP-9 release were measured in the cell culture supernatants using enzyme-linked immunosorbent assay (ELISA) and zymography. RESULTS: We show that MMP-9 is released by neutrophils, but not by eosinophils from allergic asthmatic patients in response to allergens to which the patients were sensitized. Neutrophils also released MMP-9 in response to anti-IgE Abs, and agonist Abs against FcεRI, FcεRII/CD23 and galectin-3. Inhibitors of transcription and translation, actinomycin D and cycloheximide, partially cancelled this process, suggesting that MMP-9 is also de novo synthesized in response to stimuli. We also show evidence that the MAPKs, p38 and extracellular signal-regulated kinase, as well as the transcription factor NF-κB, are involved, as specific chemical inhibitors of these cell-signalling pathways abolished the anti-IgE/allergen-dependent MMP-9 release. CONCLUSIONS: These data demonstrate that the exposure of neutrophils to allergens leads to generation of MMP-9, which may then lead to remodelling in asthma.


Subject(s)
Asthma/immunology , Matrix Metalloproteinase 9/metabolism , Neutrophils/immunology , Adult , Allergens/immunology , Asthma/enzymology , Cells, Cultured , Enzyme-Linked Immunosorbent Assay , Female , Humans , Hypersensitivity/immunology , Male , Matrix Metalloproteinase 9/biosynthesis , Neutrophils/enzymology , Neutrophils/metabolism , Real-Time Polymerase Chain Reaction
9.
Infection ; 41(2): 571-4, 2013 Apr.
Article in English | MEDLINE | ID: mdl-22915347

ABSTRACT

The genus Abiotrophia comprises fastidious Gram-positive bacteria previously classified as nutritionally variant streptococci (NVS). The isolation of NVS from the central nervous system (CNS) is very rare. We describe a case of meningitis due to Abiotrophia defectiva in a patient who underwent a total hip arthroplasty 4 days previously. It is possible that the organism could be introduced through the spinal anesthesia. We also review all cases of CNS infections caused by NVS.


Subject(s)
Abiotrophia/isolation & purification , Gram-Positive Bacterial Infections/diagnosis , Meningitis, Bacterial/diagnosis , Abiotrophia/drug effects , Ampicillin/therapeutic use , Anesthesia , Anti-Bacterial Agents/therapeutic use , Arthroplasty, Replacement, Hip , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/microbiology , Humans , Male , Meningitis, Bacterial/microbiology , Microbial Sensitivity Tests , Middle Aged , Penicillins/therapeutic use , Vancomycin/therapeutic use
10.
Rev. MVZ Córdoba ; 16(3): 2754-2764, sept.-dic. 2011.
Article in Spanish | LILACS | ID: lil-621968

ABSTRACT

Objetivo. Describir el comportamiento de la subespecie Hydrochoerus hydrochaeris isthmius en un sistema productivo del departamento de Córdoba, en época seca y de lluvias Materiales y métodos. Se realizaron seguimientos a una población entre los meses de septiembre de 2005 y mayo de 2007 dentro de un sistema agropecuario en el municipio de Valencia, departamento de Córdoba, Colombia, donde se realizaron observaciones comportamentales por medio de los muestreos ad libitum y muestreos instantáneo. Resultados. Se encontró que el Hydrochoerus hydrochaeris isthmius presentó tolerancia a los humanos, mostró un comportamiento social complejo donde se apreciaron diversos movimientos, actividades y posturas. Se observó que las actividades relacionadas con la reproducción y territorialidad presentaron las frecuencias mas bajas. Conclusiones. El comportamiento del Hydrochoerus hydrochaeris isthmius se caracterizó por ser un sistema social estratificado, mostró una distribución de las actividades comportamentales en periodos del día (mañana, medio día y tarde) presentando una estructuración de acuerdo con variables medioambientales. Los patrones comportamentales no presentaron diferencias con relación a las épocas seca y de lluvias.


Subject(s)
Animals , Behavior, Animal , Sampling Studies , Colombia
11.
J Intern Med ; 270(2): 166-74, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21198992

ABSTRACT

BACKGROUND AND AIMS: At present, a rapid and widely available diagnostic test for stroke remains elusive. The aim of this study was to examine the predictive value of a panel of blood-borne biochemical markers for stroke diagnosis. DESIGN: Consecutive patients with strokes or stroke-mimicking conditions (mimics) were evaluated within 24 h from symptom onset (915 strokes and 90 mimics). Blood samples were analysed by enzyme-linked immunosorbent assay for C-reactive protein, d-dimer, soluble receptor for advanced glycation end products (sRAGE), metalloproteinase 9 (MMP-9), S100B, brain natriuretic peptide, caspase-3, neurotrophin-3, chimerin and secretagogin. RESULTS: The main independent predictors of stroke versus mimics were caspase-3 >1.96 ng mL(-1) [odds ratio (OR) = 3.32; 95% confidence interval (CI) 1.88-5.88, P < 0.0001], d-dimer >0.27 µg mL(-1) (OR = 2.97; 95% CI 1.72-5.16, P = 0.0001), sRAGE >0.91 ng mL(-1) (OR = 2.19; 95% CI 1.26-3.83, P = 0.006), chimerin <1.11 ng mL(-1) (OR = 0.4; 95% CI 0.19-0.81, P = 0.011), secretagogin <0.24 ng mL(-1) (OR = 0.51; 95% CI 0.27-0.97, P = 0.041) and MMP-9 > 199 ng mL(-1) (OR = 1.66; 95% CI 1.01-2.73, P = 0.046). The model's predictive probability of stroke when the six biomarkers are above/below these cut-off levels was 99.01%. The best combination of biomarkers in the model was caspase-3 and d-dimer. Moreover, a model developed for samples obtained within the first 3 h showed high sensitivity (Se) and specificity (Sp) (threshold at 25th percentile: Se 0.87, Sp 0.55; threshold at 75th percentile: Se 0.28, Sp 0.99). CONCLUSIONS: A combination of biomarkers including caspase-3 and d-dimer appears to be the most promising to achieve a rapid biochemical diagnosis of stroke. If replicated, this approach could be used as a tool for urgent referral of stroke patients to hospitals in which acute treatments are available.


Subject(s)
Caspase 3/blood , Fibrin Fibrinogen Degradation Products/analysis , Stroke/diagnosis , Acute Disease , Aged , Aged, 80 and over , Biomarkers/blood , C-Reactive Protein/analysis , Chimerin Proteins/blood , Diagnosis, Differential , Female , Humans , Male , Matrix Metalloproteinase 9/blood , Middle Aged , Natriuretic Peptide, Brain/blood , Nerve Growth Factors/blood , Neurotrophin 3/blood , Predictive Value of Tests , Receptor for Advanced Glycation End Products , Receptors, Immunologic/blood , S100 Calcium Binding Protein beta Subunit , S100 Proteins/blood , Stroke/blood
12.
Eur J Neurol ; 18(6): 826-35, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21122033

ABSTRACT

BACKGROUND: The biologic agents causing leukoaraiosis are unknown. Our aim was to study the genetic basis of leukoaraiosis. METHODS: We analyzed 212 single nucleotide polymorphisms (SNPs) in 142 patients with ischaemic stroke, generating a total of 30,104 genotypes. Seventy-nine subjects (55.6%) presented leukoaraiosis measured by the Fazekas scale and 69 (48.6%) by ARWMC scale. We analyzed the presence of synergic associations between SNPs using the hfcc software. Finally, functional studies were performed in 56 subjects. The Ingenuity Pathways software (ipa) was used to examine the role of the identified genes. RESULTS: Six SNPs were associated with leukoaraiosis using both measuring scales. After logistic regression adjusted for leukoaraiosis risk factors, the rs2252070 of MMP13 (OR = 4.9, 95%CI: 1.34-17.9, P = 0.016), rs662 of PON1 (OR = 0.37, 95%CI: 0.15-0.87, P = 0.024) and rs1800779 of NOS3 (OR = 3.9, 95%CI: 1.38-11.38, P = 0.01) were independently associated with leukoaraiosis under a dominant/recessive model and the rs2290608 of IL5RA (OR = 0.46, 95%CI: 0.25-0.85, P = 0.013) and rs669 of A2M (OR = 2.5, 95%CI: 1.36-4.83, P = 0.004) under an additive model. Computational analysis showed a synergic association of rs10497212-AA of ITGB6 and rs2290608-GG of IL5RA with leukoaraiosis using both scales. (i) ARWMC (P = 1.3 × 10(-4) ) and (ii) Fazekas (P = 4.5 × 10(-5) ). Functional studies showed that the rs669 SNP was associated with plasma levels of A2M (P = 0.012) and A2M levels with leukoaraiosis in Fazekas scale (P = 0.02). ipa analysis revealed that the genes associated with leukoaraiosis were involved in blood-brain barrier (BBB) homeostasis. CONCLUSIONS: Amongst patients with ischaemic stroke, several genes associated with BBB homeostasis could be involved with a higher risk of leukoaraiosis.


Subject(s)
Blood-Brain Barrier/physiopathology , Brain Ischemia/genetics , Genetic Predisposition to Disease/genetics , Homeostasis/genetics , Leukoaraiosis/genetics , Stroke/genetics , Adult , Aged , Aged, 80 and over , Brain Ischemia/metabolism , Brain Ischemia/physiopathology , Female , Gene Expression Regulation , Humans , Interleukin-5 Receptor alpha Subunit/biosynthesis , Interleukin-5 Receptor alpha Subunit/genetics , Leukoaraiosis/metabolism , Leukoaraiosis/physiopathology , Male , Middle Aged , Risk Factors , Stroke/metabolism , Stroke/physiopathology
13.
Diabetes Metab ; 37(2): 124-30, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21131223

ABSTRACT

AIM: This study aimed to determine the effect of atorvastatin therapy on plasma lipoprotein (a) [Lp(a)] and biomarkers of inflammation in hypercholesterolaemic patients free of cardiovascular disease. METHODS: In this three-month randomized double-blind placebo-controlled trial, 63 hypercholesterolaemic patients were randomly treated with either placebo or atorvastatin (10 or 40 mg/day) for 12 weeks. Lp(a) and biomarkers of inflammation (C-reactive protein [CRP], interleukin [IL]-6 and -10, and tumour necrosis factor-alpha receptors [TNF-Rs]) were measured at study entry, and at four and 12 weeks of follow-up. RESULTS: At the end of the study, patients allocated to atorvastatin (10 or 40 mg/day) presented with significantly lower Lp(a) levels than those taking placebo (10 [1-41]mg/dL versus 6 [1-38]mg/dL [P = 0.02] and 21 [1-138]mg/dL versus 15 [1-103]mg/dL [P = 0.04], respectively]. In multivariate analyses, the relative changes in Lp(a) were independently related to baseline Lp(a) levels and CRP changes. No significant changes in CRP, IL-6 and TNF-Rs were observed. In contrast, IL-10 (pg/mL) increased significantly in patients taking atorvastatin (2.14 [0.49-43]pg/mL versus 4.54 [0.51-37.5]pg/mL; P = 0.01), and was even more increased with the 40-mg dose than with 10mg. CONCLUSION: Our results suggest that 12-week atorvastatin is effective in reducing Lp(a) in dyslipidaemic patients free of CVD. Furthermore, this is also the first evidence that the drug increases IL-10 in a dose-dependent manner.


Subject(s)
Anticholesteremic Agents/therapeutic use , Heptanoic Acids/therapeutic use , Hypercholesterolemia/drug therapy , Interleukin-10/blood , Lipoprotein(a)/blood , Pyrroles/therapeutic use , Aged , Atorvastatin , Double-Blind Method , Female , Humans , Male , Middle Aged , Placebos
14.
Eur J Neurol ; 17(11): 1390-2, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20402757

ABSTRACT

BACKGROUND: The angiotensin-converting enzyme 1 (ACE1) gene has been extensively studied in stroke, yet generating conflicting results. The goal of our study was thus to clarify the influence of the ACE1 on the risk of suffering an ischaemic stroke (IS). METHODS: We genotyped the rs4341 (in linkage disequilibrium with the I/D polymorphism) of the ACE1 gene in 531 patients with IS and 549 healthy controls, and the rs1799752 (I/D polymorphism) in a subset of 68 patients with IS and 27 controls. We also performed functional studies by measuring serum ACE protein levels and enzymatic activity in 27 controls, 68 patients with IS at baseline and 35 patients with IS 24 h after onset of stroke symptoms. RESULTS: There was no association of the ACE1 variant with IS, although it affected ACE protein levels (P = 0.001). Indeed, patients with IS showed lower ACE levels than controls in the acute phase (115.9 } 38.9 vs. 174.1 } 56.1 ng/ml, P < 0.001), but not in the chronic phase (168.2 } 51.2, P = 0.673), and ACE protein levels did not differ between IS etiologies. Similar results were found for ACE activity. CONCLUSIONS: The D allele of the ACE1 I/D and ACE protein levels was not associated with a higher risk of IS in Spanish individuals.


Subject(s)
Aspartic Acid/genetics , Isoleucine/genetics , Linkage Disequilibrium/genetics , Peptidyl-Dipeptidase A/genetics , Polymorphism, Genetic , Stroke/genetics , Aged , Aged, 80 and over , Female , Gene Frequency , Genome-Wide Association Study , Genotype , Humans , Male , Middle Aged , Peptidyl-Dipeptidase A/metabolism , Spain/epidemiology
15.
JPEN J Parenter Enteral Nutr ; 33(5): 501-12, 2009.
Article in English | MEDLINE | ID: mdl-19420283

ABSTRACT

BACKGROUND: The metabolic effects of intravenous lipid emulsions (ILEs) used in parenteral nutrition (PN) depend on their fatty acid composition. METHODS: Subjects in this prospective and randomized double-blind study were 28 adult patients post digestive surgery. PN was started after surgery and lasts for 5 days. Randomly, patients receive 1 of 4 different ILEs: medium-chain triglycerides/long-chain triglycerides (soybean oil; MCT/LCT), olive/soybean oil (oleic), long-chain triglycerides (soybean oil; LCT), and structured lipid. On days 0 and 6, serum liver function tests were analyzed for cholesterol, triglycerides, lipoproteins, and serum fatty acids. RESULTS: No differences were found in the 4 groups according to their gender, age, body mass index, diagnosis, baseline white blood cell, C-reactive protein, glucose levels, and other study parameters. Differential significant changes were not observed in any of the hepatic function parameters or plasmatic lipid levels between the groups. A significant decrease was observed in cis monounsaturated fatty acids (MUFAs) and a significant increase in omega-6 polyunsaturated fatty acids (PUFAs) and omega-3 PUFA values in LCT and structured groups compared with MCT/LCT and oleic groups, and a tendency for a decrease in trans fatty acids in the oleic and structured groups was found. CONCLUSIONS: All ILEs administered were safe and well tolerated. The changes in serum fatty acids reflected the pattern of fatty acids administered with different ILEs. The group receiving the olive oil emulsion achieved a fatty acid composition of serum lipids that could offer major therapeutic or biological advantages.


Subject(s)
Fat Emulsions, Intravenous/administration & dosage , Fatty Acids/blood , Gastrointestinal Tract/surgery , Lipids/blood , Liver/physiology , Parenteral Nutrition , Aged , Body Mass Index , Double-Blind Method , Fat Emulsions, Intravenous/analysis , Fatty Acids/analysis , Female , Humans , Male , Middle Aged , Oleic Acid/administration & dosage , Olive Oil , Plant Oils , Postoperative Care , Prospective Studies , Soybean Oil , Triglycerides/administration & dosage
16.
Puesta día urgenc. emerg. catastr ; 8(2): 79-82, abr.-jun. 2008. ilus, tab
Article in Spanish | IBECS | ID: ibc-77920

ABSTRACT

El síndrome de Wolff-Parkinson-White (WPW) es unaanormalidad cardiaca que consiste en la presencia de unhaz anómalo (haz de Kent) que salva el sistema normal deconducción uniendo directamente aurículas y ventrículos.La fibrilación auricular es la segunda arritmia más frecuenteen el síndrome deWPWy, en presencia de vías accesoriascon periodos refractarios anterógrados muy cortos, puedegenerar frecuencias ventriculares elevadas con el consiguienteriesgo de muerte súbita. Describimos el caso de unpaciente varón de 76 años de edad con síncopes de repeticiónque presenta una fibrilación auricular preexcitada bientolerada, y que sufre un episodio de muerte súbita por fibrilaciónventricular (AU)


The Wolff-Parkinson-White (WPW) syndrome is a cardiacabnormality which consists of the presence of ananomalous bundle (bundle of Kent) that saves the normalconduction system linking directly the atria and the ventricles.The atrial fibrillation is the second most commonarrhythmia in the WPW syndrome and, in the presence ofaccessory pathways with very shorts anterograde refractoryperiods, can generate high ventricular rate with the consequentrisk of sudden death. We describe a 76 years oldpatient man with syncope recurrence that presents a preexcitedatrial fibrillation well tolerated and suffered anepisode of sudden death by ventricular fibrillation (AU)


Subject(s)
Humans , Male , Aged , Wolff-Parkinson-White Syndrome/complications , Death, Sudden, Cardiac/etiology
17.
Eur J Neurol ; 15(1): 82-90, 2008 Jan.
Article in English | MEDLINE | ID: mdl-18070096

ABSTRACT

Although statins are being used for secondary prevention of ischemic stroke, recent experimental data have shown new pleiotropic effects of these drugs responsible for their role in neuroprotection. We conducted a pilot, double-blind, randomized, multicenter clinical trial to study for the first time safety and efficacy of simvastatin in the acute phase of ischemic stroke. Simvastatin/placebo was given at 3-12 h from symptom onset to 60 patients with cortical strokes. Efficacy on the evolution of several inflammation markers [interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, C-reactive protein, sApo/Fas, tumor necrosis factor-alpha, E-selectin, L-selectin and nitrites+nitrates] and neurological outcome was evaluated at baseline, day 1, 3, 5, 7 and 90. No differences were found amongst the biomarkers studied regarding treatment allocation. Although simvastatin patients improved significantly by the third day (46.4% vs. 17.9%, P = 0.022), a non-significant increase in mortality and greater proportion of infections (odds ratio 2.4, confidence interval 1.06-5.4) in the simvastatin group were the main safety concerns. Therefore, a larger clinical trial is needed to confirm the net benefit of this therapeutic approach.


Subject(s)
Brain Ischemia/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Simvastatin/administration & dosage , Stroke/drug therapy , Acute Disease , Aged , Aged, 80 and over , Biomarkers/analysis , Biomarkers/metabolism , Double-Blind Method , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Infections/etiology , Inflammation Mediators/analysis , Inflammation Mediators/metabolism , Male , Middle Aged , Pilot Projects , Simvastatin/adverse effects , Treatment Outcome
18.
Acta Neurol Scand ; 115(1): 60-6, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17156267

ABSTRACT

BACKGROUND AND PURPOSE: Although patients with transient ischemic attack (TIA) experience cardiovascular events frequently, strong clinical predictors of recurrence are lacking. High-sensitivity C-reactive protein (hs-CRP) has been shown to be a powerful predictor of future first-ever and recurrent coronary and cerebral ischemic events. We aimed to investigate the relationship between hs-CRP and the risk of further ischemic events in TIA patients. METHODS: High-sensitivity C-reactive protein level was determined <24 h after symptom onset among 135 consecutive TIA patients and stroke recurrence or any new vascular event was recorded during 1 year follow-up period. RESULTS: A total of 38 (28.1%) patients experienced an end point event: 28 (20.7%) cerebral ischemic events, six (4.4%) heart ischemic events, four (3%) peripheral arterial disease, and nine (6.7%) vascular deaths. Cox proportional hazards multivariate analyses identified age [hazard ratio (HR) 1.07, 95% confidence interval (CI) 1.01-1.12, P = 0.01], large-artery occlusive disease (HR 2.73, 95% CI 1.16 to 6.41, P = 0.02) and hs-CRP> 4.1 mg/l (HR 2.81, 95% CI 1.12-7.10, P = 0.03) as independent predictors of stroke. Moreover, age (HR 1.05, 95% CI 1.01-1.10, P = 0.02), large-artery occlusive disease (HR 3.12, 95% CI 1.48-6.58, P < 0.01), coronary disease (HR 2.39, 95% CI 1.11-5.16, P = 0.03), and hs-CRP> 4.1 mg/l (HR 2.71, 95% CI 1.16-6.30, P = 0.02) were also independent predictors of any vascular event. CONCLUSIONS: High-sensitivity C-reactive protein serum level predicts further ischemic events following TIA. Routine CRP measurement might be a useful tool for identifying high-risk TIA patients in order to plan aggressive diagnostic protocols and prevention therapies.


Subject(s)
C-Reactive Protein/metabolism , Ischemic Attack, Transient/blood , Stroke/blood , Age Factors , Aged , Aged, 80 and over , Biomarkers/blood , Follow-Up Studies , Humans , Middle Aged , Prospective Studies , Recurrence , Risk Assessment
19.
20.
Ann Bot ; 98(3): 591-600, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16820409

ABSTRACT

BACKGROUND AND AIMS: Broad surveys have detected inverse relationships between seed and adult longevity and between seed size and adult longevity. However, low and unpredictable precipitation is also associated with seed bank (SB) expression in semi-arid and arid areas. The relationship between adult longevity, SB formation, seed mass and aridity is examined in annual and perennial herbs of Chaetanthera (Asteraceae) from the Chilean Mediterranean-type climate and winter-rainfall desert areas over a precipitation range of one order of magnitude. METHODS: Seeds of 18 species and subtaxa (32 populations) were buried in field locations, and exhumed after two successive germination periods. Seeds not germinating in the field were tested in a growth chamber, and remnant intact seed tested for viability. Seed banks were classed as transient or persistent. The effect of life form, species, population and burial time on persistent SB size was assessed with factorial ANOVA. Persistent seed bank size was compared with the Martonne aridity index (shown to be a surrogate for inter-annual variation in precipitation) and seed size using linear regression. ANCOVA assessed the effect of life-form on SB size with aridity as covariate. KEY RESULTS: Three species had a transient SB and 15 a persistent SB. ANOVA revealed a significant effect of life-form on SB size with annuals having larger SB size and greater capacity to form a persistent SB than perennials. Significant inter-population variation in SB size was found in 64% of cases. Seed mass was negatively correlated with persistent SB size. Persistent seed bank size was significantly correlated with the Martonne aridity index in the perennial and annual species, with species from more arid areas having larger persistent SBs. However, when aridity was considered as a covariate, ANCOVA revealed no significant differences between the annual and perennial herbs. CONCLUSIONS: Persistent seed bank size in Chaetanthera appears to reflect environmental selection rather than any trade-off with adult longevity.


Subject(s)
Asteraceae/growth & development , Asteraceae/physiology , Seeds/growth & development , Chile , Ecosystem , Geography , Phylogeny , Rain
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