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1.
Arch. Soc. Esp. Oftalmol ; 98(4): 233-237, abr. 2023. ilus
Article in Spanish | IBECS | ID: ibc-218547

ABSTRACT

La atrofia coriorretiniana pigmentada paravenosa es una entidad infrecuente, asociada a enfermedades autoinmunes y otras complicaciones oculares, generalmente multifocal, bilateral y simétrica. Se presenta el caso clínico de una paciente con artritis reumatoide que acude por dolor de varios días. Presenta disminución de agudeza visual de ojo izquierdo, escleritis nodular y atrofia coriorretiniana con acumulación de pigmento en espículas óseas en arcada vascular temporal inferior y agujero macular lamelar. El ojo derecho no presenta alteraciones. La autofluorescencia del ojo izquierdo muestra hipoautofluorescencia de bordes definidos en la lesión. La angiografía con fluoresceína evidencia hiperfluorescencia compatible con degeneración del epitelio pigmentario retiniano y bloqueo en las áreas de pigmento. El campo visual revela un defecto altitudinal en hemicampo superior. Este caso describe una atrofia coriorretiniana pigmentada paravenosa atípica unifocal y unilateral. Se debe conocer esta variante para realizar un correcto diagnóstico diferencial, así como proporcionar una información pronóstica adecuada (AU)


Paravenous pigmented chorioretinal atrophy is a generally multifocal, bilateral and symmetric rare entity associated with autoimmune diseases and other ocular complications. We present the clinical case of a patient with rheumatoid arthritis who attended for pain of several days. He presented decreased visual acuity of the left eye, nodular scleritis and chorioretinal atrophy with pigment accumulation in bone spicules in the inferior temporal vascular arcade and lamellar macular hole. The right eye shows no alterations. LE autofluorescence shows a hypoautofluorescence lesion with defined edges. Fluorescein angiography shows hyperfluorescence consistent with retinal pigmentary epithelial degeneration and blockage in pigment areas. The visual field reveals a defect in the superior hemifield. This case describes an atypical unifocal and unilateral paravenous pigmented chorioretinal atrophy. This variant must be known to make a correct differential diagnosis, as well as to provide adequate prognostic information (AU)


Subject(s)
Humans , Female , Middle Aged , Choroid/diagnostic imaging , Choroid/pathology , Retinal Degeneration/etiology , Retinal Vein/pathology , Diagnosis, Differential , Atrophy/pathology
2.
Arch Soc Esp Oftalmol (Engl Ed) ; 98(4): 233-237, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36801254

ABSTRACT

Paravenous pigmented chorioretinal atrophy (PPRCA) is a generally multifocal, bilateral and symmetric rare entity associated with autoimmune diseases and other ocular complications. We present the clinical case of a patient with rheumatoid arthritis who attended for pain of several days. He presented decreased visual acuity of the left eye (LE), nodular scleritis and chorioretinal atrophy with pigment accumulation in bone spicules in the inferior temporal vascular arcade and lamellar macular hole (AML). The right eye shows no alterations. LE autofluorescence (AF) shows a hypoautofluorescence lesion with defined edges. Fluorescein angiography (FAG) shows hyperfluorescence consistent with retinal pigmentary epithelial degeneration and blockage in pigment areas. The visual field (VC) reveals a defect in the superior hemifield. This case describes an atypical unifocal and unilateral PPRCA. This variant must be known to make a correct differential diagnosis, as well as to provide adequate prognostic information.


Subject(s)
Retinal Degeneration , Retinal Vein , Male , Humans , Choroid/diagnostic imaging , Choroid/pathology , Retinal Degeneration/diagnostic imaging , Retinal Degeneration/etiology , Atrophy/pathology
3.
Am J Emerg Med ; 42: 31-37, 2021 04.
Article in English | MEDLINE | ID: mdl-33440328

ABSTRACT

INTRODUCTION: Alteplase is an approved treatment for acute ischemic stroke. Tenecteplase is a genetically modified form of alteplase, with lower cost and a more favourable pharmacokinetic profile allowing bolus injection. The aim of this study was to compare both drugs in adult patients with acute ischemic stroke undergoing thrombolysis. MATERIAL AND METHODS: PubMed and CENTRAL were searched for observational and experimental studies comparing both drugs in the population of interest. Additional studies were sought in clinical trial registries and by means of reference check. The efficacy outcomes of interest were functional status at 3 months, recanalization and early neurological improvement (ENI). The safety outcomes of interest were cerebral haemorrhage (ICH), symptomatic ICH and mortality. The effect measure of interest was the absolute risk difference (ARD). Effect measures for each outcome were pooled across studies using random effect models. RESULTS: Eight studies were included, involving 2031 patients. Overall, there were no differences in terms of good or excellent functional outcome (ARR = 0.07 and 0.03 respectively, p > 0.05 for both comparisons) but tenecteplase patients showed higher rates of recanalization (ARD = 0.11, 95% CI [0.01;0.20]) and ENI (ARD = 0.10, 95% CI [0.02;0.17]). There were no differences between groups in terms of ICH (ARD = -0.02, 95% CI [-0.06;0.01]), symptomatic ICH (ARD = 0.00, 95% CI [-0.01;0.02]) or death (ARD = 0.00, 95% CI [-0.03;0.03]). CONCLUSION: Tenecteplase is an alternative to alteplase for stroke thrombolysis, with lower cost and a more favourable pharmacokinetic profile.


Subject(s)
Fibrinolytic Agents/therapeutic use , Tenecteplase/therapeutic use , Thrombolytic Therapy/methods , Thrombotic Stroke/drug therapy , Cerebral Hemorrhage/chemically induced , Fibrinolytic Agents/adverse effects , Fibrinolytic Agents/pharmacokinetics , Humans , Tenecteplase/adverse effects , Tenecteplase/pharmacokinetics , Tissue Plasminogen Activator/pharmacokinetics , Tissue Plasminogen Activator/therapeutic use
4.
Phys Med ; 41: 124-128, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28501270

ABSTRACT

PURPOSE: To design, build and test a stereotactic device that allows PET image-guided biopsies to be performed. METHODS: An initial prototype consisting of four main pieces, one of which contains radioactive markers to make it visible in the PET images, was built using a 3D printer. Once the device is mounted, a spherical coordinate system is built with the entrance needle point in the skin as the origin of coordinates. Two in-house software programs, namely getCoord.ijm, which obtains the spherical coordinates of the tumour tissue to be biopsied, and getNeedle.ijm, which virtualizes the inner needle tip once the puncture has taken place, were written. This prototype was tested on an FDG-doped phantom to characterize both the accuracy of the system and the procedure time. RESULTS: Up to 11 complete biopsy procedures were conducted. The mean total procedure time was less than 20min, which is less than the procedure time of conventional standard CT-guided biopsies. The overall accuracy of the system was found to be 5.0±1.3mm, which outperforms the criterion used in routine clinical practice when targeting tumours with a diameter of 10mm. CONCLUSIONS: A stereotactic frame to conduct real PET image-guided biopsies has been designed and built. A proof-of-concept was performed to characterize the system. The procedure time and accuracy of the system were found to meet the current needs of physicians performing biopsies.


Subject(s)
Biopsy/methods , Positron-Emission Tomography/instrumentation , Humans , Imaging, Three-Dimensional , Needles , Neoplasms/diagnostic imaging , Phantoms, Imaging , Proof of Concept Study , Tomography, X-Ray Computed
6.
J Plast Reconstr Aesthet Surg ; 69(8): e168-73, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27344408

ABSTRACT

BACKGROUND: Although reduction mammoplasty (RM) is an effective and efficient treatment for symptomatic macromastia, overweight and obese patients who request this treatment are frequently rejected because of selection criteria based on the body mass index. Scientific evidence is inconclusive regarding the increased postoperative complications in obese patients undergoing RM, and there is a lack of adequately designed studies examining the impact of RM on the quality of life of this group of patients. PATIENTS AND METHODS: A descriptive cohort study was performed on 37 consecutive obese patients (body mass index > 30 kg/m(2)) undergoing bilateral RM for symptomatic macromastia. Short Form SF-36 quality-of-life questionnaires were completed at interviews a week before surgery and 6 and 18 months after surgery. In addition, 37 women of matching ages, who were companions of patients hospitalized at our short-stay surgery unit, were used as a control group for comparison. Significant differences between repeated measurements on a single sample were assessed using the Wilcoxon signed-rank test. To evaluate these changes, we used effect size by computing Hedges' g corrected. RESULTS: The preoperative SF-36 physical component score was significantly lower than the control group's score (40 vs. 53, p < 0.001). There was no significant difference in the mental component score (45 vs. 49, p = 0.210). Postoperative SF-36 scores were increased with a normalizing effect, as 18 months after surgery only the body pain domain scored lower than the control group scores. CONCLUSIONS: According to our results, obese women with symptomatic macromastia undergoing RM exhibited increased quality of life, and this improvement was maintained over time. THERAPY: Level III Evidence.


Subject(s)
Breast/abnormalities , Hypertrophy/psychology , Hypertrophy/surgery , Mammaplasty , Obesity/complications , Quality of Life , Adult , Body Mass Index , Breast/surgery , Cohort Studies , Female , Humans , Hypertrophy/etiology , Middle Aged , Obesity/pathology , Obesity/psychology , Treatment Outcome
7.
Rev Esp Med Nucl Imagen Mol ; 35(6): 379-384, 2016.
Article in English, Spanish | MEDLINE | ID: mdl-27174866

ABSTRACT

OBJECTIVE: To identify those textural features that are insensitive to both technical and biological factors in order to standardise heterogeneity studies on 18F-FDG PET imaging. MATERIALS AND METHODS: Two different studies were performed. First, nineteen series from a cylindrical phantom filled with different 18F-FDG activity concentration were acquired and reconstructed using three different protocols. Seventy-two texture features were calculated inside a circular region of interest. The variability of each feature was obtained. Second, the data for 15 patients showing non-pathological liver were acquired. Anatomical and physiological features such as patient's weight, height, body mass index, metabolic active volume, blood glucose level, SUV and SUV standard deviation were also recorded. A liver covering region of interest was delineated and low variability textural features calculated in each patient. Finally, a multivariate Spearman's correlation analysis between biological factors and texture features was performed. RESULTS: Only eight texture features analysed show small variability (<5%) with activity concentration and reconstruction protocol making them suitable for heterogeneity quantification. On the other hand, there is a high statistically significant correlation between MAV and entropy (P<0.05). Entropy feature is, indeed, correlated (P<0.05) with all patient parameters, except body mass index. CONCLUSIONS: The textural features that are correlated with neither technical nor biological factors are run percentage, short-zone emphasis and intensity, making them suitable for quantifying functional changes or classifying patients. Other textural features are correlated with technical and biological factors and are, therefore, a source of errors if used for this purpose.


Subject(s)
Fluorodeoxyglucose F18 , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Phantoms, Imaging , Retrospective Studies
8.
J Fr Ophtalmol ; 35(5): 333-7, 2012 May.
Article in French | MEDLINE | ID: mdl-22245055

ABSTRACT

PURPOSE: To determine the capacity for measurement of central corneal thickness by ultrasound pachymetry and by Pentacam (pachymetry at the pupillary axis and minimum corneal pachymetry) to discriminate between healthy controls and patients with primary open-angle glaucoma. METHODS: Measurements of the left eyes of 123 control subjects and 128 glaucomatous patients were taken. Differences between the two data sets for each variable were identified using a t-test for independent samples. Three univariate binary logistic regression models (to discriminate between glaucoma and controls) were constructed, in which the predictive variables were the determinations of corneal thickness. RESULTS: All variables showed a normal distribution. Controls and patients failed to differ significantly in terms of ultrasound pachymetry but did differ in terms of pupillary axis thickness (mean difference 22.01µm in favour of controls; 95% CI: 5.61-34.15) and minimum corneal thickness (mean difference 21.65µm in favour of controls; 95% CI: 3.05-32.25). The logistic regression model for ultrasound pachymetry was not significant (P=0.051) but significant discriminatory capacity was shown for pupillary axis thickness (expB=0.987; 95% CI: 0.99-0.993; sensitivity: 58.5%; specificity: 64.8%) and minimum corneal thickness (expB=0.987; 95% CI: 0.981-0.994; sensitivity: 61.9%; specificity: 63.1%). CONCLUSIONS: Central corneal thickness measurement by Pentacam, while not an ad hoc diagnostic test for glaucoma, showed a similar yet not inappreciable capacity to discriminate between glaucoma patients and controls.


Subject(s)
Cornea/anatomy & histology , Cornea/diagnostic imaging , Glaucoma, Open-Angle/diagnosis , Case-Control Studies , Cross-Sectional Studies , Diagnostic Techniques, Ophthalmological/instrumentation , Humans , Logistic Models , Sensitivity and Specificity , Ultrasonography
9.
Arch Soc Esp Oftalmol ; 86(9): 287-91, 2011 Sep.
Article in Spanish | MEDLINE | ID: mdl-21893262

ABSTRACT

OBJECTIVES: To compare intraocular pressure (IOP) measurements made by Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT). METHODS: IOPs were measured by GAT and DCT in 63 eyes of 63 healthy subjects. A comparison was made by intraclass correlation coefficient. Passing-Bablok plot was constructed to establish the existence of systematic and/or proportional biases. Multivariate regression analysis was used to examine whether the measurements of both instruments were affected by the power of the steepest and flattest corneal axes, their orientation, age or central corneal thickness (CCT). RESULTS: The intra-class correlations (ICCs) were 0.57 (95% confidence interval (95% CI): 0.29-0.74). Mean differences were 1.68 (DCT minus GAT) (95% CI: 0.92-2.44). Passing-Bablok analysis (X=DCT, Y=GAT) revealed a systematic bias (A=-14.35, 95% CI: -24.51-[-9.14]) and a proportional bias (B=1.74, 95% CI: 1.43-2.26). Multivariate regression analysis revealed that the DCT was independent of the corneal characteristics analysed while GAT was biased by CCT (B=0.042, 95% CI: 0.002-0.082). CONCLUSIONS: While GAT was biased by corneal CCT; DCT readings were independent of corneal morphometry.


Subject(s)
Cornea/anatomy & histology , Ocular Hypertension/diagnosis , Tonometry, Ocular/methods , Age Factors , Aged , Anthropometry , Bias , Confounding Factors, Epidemiologic , Female , Humans , Intraocular Pressure , Male , Middle Aged , Multivariate Analysis , Reproducibility of Results , Tonometry, Ocular/instrumentation
10.
Arch. Soc. Esp. Oftalmol ; 86(9): 287-291, sept. 2011. tab, graf, ilus
Article in Spanish | IBECS | ID: ibc-94287

ABSTRACT

Objetivos: Determinar la concordancia entre la presión intraocular (PIO) medida mediante tonometría de aplanación de Goldmann (TAG) y tonometría de contorno dinámico (TCD).MétodosLa PIO se midió mediante TAG y TCD en 63 ojos de 63 voluntarios sanos. La concordancia se determinó mediante coeficiente de correlación intraclase (CCI). Se empleó el método de Passing-Bablok para establecer la presencia de sesgos proporcionales y/o sistemáticos. El análisis de regresión multvariable se empleó para determinar si las diferencias estaban condicionadas por la potencia de los ejes mayor y menor de la córnea, por su orientación, por el grosor corneal central (GCC) y por la edad.ResultadosEl CCI fue 0,57 (intervalo de confianza [IC] al 95%: 0,29-0,74). La diferencia media entre los dos instrumentos fue 1,68mmHg (TCD menos TAG) (IC 95%: 0,92-2,44). El análisis de Passing-Bablok (X=DCT, Y=GAT) reveló la presencia de un sesgo sistemático (A=-14,35, IC 95%: -24,51-[-9,14]) y otro proporcional (B=1,74, IC 95%: 1,43-2,26). El análisis de regresión multivariable mostró una total independencia del TCD de las características corneales mientras que la TAG estaba afectada por el GCC (B=0,042 CI 95%: 0,002-0,082).ConclusionesLa TCD se mostró independiente de las características morfométricas de la córnea mientras que la TAG se afectó por el GCC (AU)


Objectives: To compare intraocular pressure (IOP) measurements made by Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT).MethodsIOPs were measured by GAT and DCT in 63 eyes of 63 healthy subjects. A comparison was made by intraclass correlation coefficient. Passing-Bablok plot was constructed to establish the existence of systematic and/or proportional biases. Multivariate regression analysis was used to examine whether the measurements of both instruments were affected by the power of the steepest and flattest corneal axes, their orientation, age or central corneal thickness (CCT).ResultsThe intra-class correlations (ICCs) were 0.57 (95% confidence interval (95% CI): 0.29-0.74). Mean differences were 1.68 (DCT minus GAT) (95% CI: 0.92-2.44). Passing-Bablok analysis (X=DCT, Y=GAT) revealed a systematic bias (A=-14.35, 95% CI: -24.51-[-9.14]) and a proportional bias (B=1.74, 95% CI: 1.43-2.26). Multivariate regression analysis revealed that the DCT was independent of the corneal characteristics analysed while GAT was biased by CCT (B=0.042, 95% CI: 0.002-0.082).ConclusionsWhile GAT was biased by corneal CCT; DCT readings were independent of corneal morphometry (AU)


Subject(s)
Humans , Male , Female , Tonometry, Ocular/instrumentation , Tonometry, Ocular/methods , Corneal Diseases/therapy , Corneal Diseases , Gonioscopy/methods , Tonometry, Ocular/statistics & numerical data , Tonometry, Ocular/trends , Tonometry, Ocular , Bias , Multivariate Analysis , Confidence Intervals , Logistic Models
11.
J Pediatr Endocrinol Metab ; 24(3-4): 227-8, 2011.
Article in English | MEDLINE | ID: mdl-21648299

ABSTRACT

Virilization in an adolescent patient can occur for multiple reasons (ovarian, suprarenal or exogenous reasons). We describe a 14-year-old patient with 1-year secondary amenorrhea, who had an ovarian mature teratoma as a cause of her clinical history.


Subject(s)
Ovarian Neoplasms/complications , Teratoma/complications , Virilism/etiology , Adolescent , Amenorrhea/etiology , Amenorrhea/pathology , Amenorrhea/surgery , Female , Humans , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Teratoma/pathology , Teratoma/surgery , Treatment Outcome , Virilism/pathology , Virilism/surgery
12.
Curr Eye Res ; 35(4): 302-7, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20373897

ABSTRACT

PURPOSE: To evaluate the specificity of the Threshold Noiseless Trend program (TNT), designed to measure progression in visual fields, using four procedures. MATERIALS AND METHODS: A. In 63 eyes with ocular hypertension, whose last examination showed no perimetric or morphological defects, we performed a mean of 7.70 +/- 1.71 follow-up examinations during 2.2 +/- 0.6 years. B. In 81 glaucomatous eyes examined twice with a bracketing strategy (Octopus 1-2-3 perimeter), we calculated mean threshold value and long-term fluctuation. We simulated 12 different visual fields, adding a random component to simulate an equivalent fluctuation of amplitude. C. Seventy-two glaucomatous eyes, with and without progression, were examined 7.76 +/- 1.25 times during 4.88 +/- 1.39 years using the Humphrey-Sita Standard strategy. Visual field tests were randomly disordered and analyzed using TNT. D. 1221 eyes were examined 7.19 +/- 3.5 times during 3.50 +/- 1.45 years (10,407 visual fields) using TOP-G1 program. We detected progression in 204 eyes using TNT. They were re-evaluated after random disordering of visual field tests. RESULTS: The four procedures indicated specificity > or = 95% as from the seventh examination; this reduced to 90% in experiment C with six examinations, and in experiments A and C with five examinations. CONCLUSIONS: The specificity of TNT may be considered to be over 95% with a large number of examinations, and 90-100% with fewer examinations. At least five examinations are required for a basic interpretation of progression, and preferably more than six to guarantee the specificity of the result.


Subject(s)
Ocular Hypertension/physiopathology , Vision Disorders/physiopathology , Visual Field Tests , Visual Fields , Aged , Disease Progression , Humans , Middle Aged , Ocular Hypertension/diagnosis , Prospective Studies , Retrospective Studies , Sensitivity and Specificity , Sensory Thresholds , Vision Disorders/diagnosis
13.
Acta Crystallogr Sect E Struct Rep Online ; 66(Pt 3): m249-50, 2010 Feb 03.
Article in English | MEDLINE | ID: mdl-21580205

ABSTRACT

In the title compound, [Fe(C(24)H(16)N(6))(2)][N(CN)(2)](2)·4.5H(2)O, the central iron(II) ion is hexa-coordinated by six N atoms of two tridentate 2,3,5,6-tetra-2-pyridylpyrazine (tppz) ligands. Two dicyanamide anions [dca or N(CN)(2) (-)] act as counter-ions, and 4.5 water mol-ecules act as solvation agents. The structure contains isolated cationic iron(II)-tppz complexes and the final neutrality is obtained with the two dicyanamide anions. One of the dicyanamide anions and a water mol-ecule are disordered with an occupancy ratio of 0.614 (8):0.386 (8). O-H⋯O, O-H⋯N and C-H⋯O hydrogen bonds involving dca, water and tppz mol-ecules are observed.

14.
Acta Crystallogr Sect E Struct Rep Online ; 67(Pt 1): m129-30, 2010 Dec 24.
Article in English | MEDLINE | ID: mdl-21522540

ABSTRACT

In the title compound, [Ni(C(24)H(16)N(6))(2)](NCS)(2)·2H(2)O, the central Ni(II) ion is octahedrally coordinated by six N atoms of two tridentate 2,3,5,6-tetra-2-pyridyl-pyrazine ligands (tppz). Two thio-cyanate anions act as counter-ions and two water mol-ecules act as solvation agents. O-H⋯N hydrogen bonds are observed in the crystral structure.

15.
Rev. esp. cardiol. (Ed. impr.) ; 61(12): 1274-1279, dic. 2008. ilus, tab
Article in Spanish | IBECS | ID: ibc-74597

ABSTRACT

Introducción y objetivos. Conocer en la práctica clínica el uso de antiarrítmicos tras cardioversión eléctrica en pacientes sin cardiopatía y su repercusión en el mantenimiento del ritmo sinusal. Métodos. Se realizó un seguimiento a un año de 528 pacientes con fibrilación auricular persistente sin cardiopatía significativa tras una cardioversión eléctrica efectiva en 96 hospitales españoles, con controles clínicos 1, 3, 6 y 12 meses después. Se analizó el uso y la utilidad de los fármacos antiarrítmicos en la prevención de recurrencias de fibrilación auricular persistente. Resultados. Se trató al alta con fármacos antiarrítmicos al 80% de los pacientes, y el más utilizado fue la amiodarona. Ningún factor clínico se relacionó con un mayor uso de antiarrítmicos. El 37% de los pacientes siguió en ritmo sinusal en todos los controles. En el control a los 12 meses, se mantuvo el tratamiento antiarrítmico al 59% de los pacientes que seguían en ritmo sinusal. En el análisis multivariable de la regresión de Cox, el peso (hazard ratio [HR] por cada kilo = 1,01; p = 0,04) y la ausencia de tratamiento antiarrítmico (HR = 1,59; p = 0,001) fueron factores independientes relacionados con la recurrencia de fibrilación auricular persistente. La amiodarona tendía a ser superior a los otros antiarrítmicos. Conclusiones. En la práctica clínica habitual, tras una cardioversión eléctrica efectiva, la gran mayoría de los pacientes sin cardiopatía estructural recibe fármacos antiarrítmicos, especialmente amiodarona, que es el principal factor relacionado con el mantenimiento del ritmo sinusal 1 año más tarde (AU)


Introduction and objectives. The aim was to investigate the clinical effectiveness of using antiarrhythmic drugs after electrical cardioversion in patients without structural heart disease, including their effect on the maintenance of sinus rhythm. Methods. In total, 528 patients with persistent atrial fibrillation but without significant structural heart disease who underwent successful electrical cardioversion at 96 Spanish hospitals were followed up for 1 year. Patients were assessed at 1, 3, 6 and 12 months. The use and effectiveness of antiarrhythmic drugs for preventing the recurrence of persistent atrial fibrillation was evaluated. Results. Some 80% of patients were receiving antiarrhythmic drugs at discharge, most frequently amiodarone. No specific clinical factor was associated with greater use of antiarrhythmics. Overall, 37% of patients were in sinus rhythm at all follow-up assessments. At the 1-year assessment, 59% of patients who remained in sinus rhythm were still taking antiarrhythmic drugs. Multivariate Cox regression analysis identified weight (hazard ratio [HR]=1.01 per kg; P=.04) and no antiarrhythmic treatment (HR=1.59; P=.001) as being independently associated with the recurrence of persistent atrial fibrillation. Amiodarone tended to be better than other antiarrhythmic drugs. Conclusions. In routine clinical practice, the large majority of patients without structural heart disease received antiarrhythmic drugs, most frequently amiodarone, after successful electrical cardioversion. Drug use was the principal factor associated with the maintenance of sinus rhythm at 1 year (AU)


Subject(s)
Humans , Male , Female , Atrial Fibrillation/drug therapy , Anti-Arrhythmia Agents/therapeutic use , Electric Countershock , Amiodarone/therapeutic use , Recurrence/prevention & control , Treatment Outcome
16.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.) ; 32(7): 352-353, ago. 2006. ilus
Article in Es | IBECS | ID: ibc-047989

ABSTRACT

Se presenta el caso clínico de un paciente joven con dolor torácico ocasionado por una hernia discal torácica, con compromiso medular y alto riesgo de incapacidad funcional si no es sometido a proceso quirúrgico pronto. Es esencial hacer un buen diagnóstico diferencial, descartando causas frecuentes e infrecuentes. Si en un paciente persiste la sintomatología es necesario insistir en buscar la etiología, evitando pautar tratamientos sintomáticos simplemente, que pueden desembocar en una complicación grave, como podría haber ocurrido en el caso presentado


The clinical case of a young patient with chest pain caused by thoracic disk herniation, with spinal cord involvement and high risk of functional incapacity if early surgery is not performed is presented. It is essential to make a good differential diagnosis, ruling out frequent and rare causes. If the symptoms persist in a patient, it is necessary to insist on searching for the etiology, avoiding prescribing symptomatic treatment alone, that can cause a serious complication. This could have occurred in this present case


Subject(s)
Male , Adult , Humans , Chest Pain/diagnosis , Chest Pain/etiology , Intervertebral Disc Displacement/complications , Intervertebral Disc Displacement/diagnosis , Intervertebral Disc Displacement/surgery
17.
Aten Primaria ; 33(8): 434-42, 2004 May 15.
Article in Spanish | MEDLINE | ID: mdl-15151790

ABSTRACT

OBJECTIVES: To obtain a first Spanish version of the KINDL questionnaire idiomatic and culturally equivalent to the German original version, and then to evaluate its psychometric properties in a sample of healthy children/adolescents 8-16 years old, and their parents. DESIGN: Cross-sectional study. SETTING: 2 public schools of Asturias of similar sociodemographic conditions. PARTICIPANTS: 243 children 8-16 year-old, and 153 parents were investigated. MAIN MEASUREMENTS: HRQoL evaluated through the generic questionnaire KINDL. An external assessment through the parents was made as well. The psychometric properties of the Spanish version of the questionnaire were investigated and results on HRQoL are presented for different ages and gender in the Spanish sample. RESULTS: 6 items (6/24) needed successive translations and conceptual discussion during the phase of idiomatic adaptation. The factorial analysis confirmed the validity of construction of the instrument for most scales. The internal consistency, measured by alpha Cronbach coefficent, was good for the total of the questionnaire (>0.70) and acceptable in most of the scales (>0.50). Only the school scale for adolescents shows very poor reliability. Females and children with higher age scored lower in most of the investigated dimensions (P<.01). CONCLUSIONS: The first Spanish version of the Kindl showed acceptable reliability and validity. In spite of the punctual inadequacies found in this first step of the investigation, the results constitute an important starting point to work further on the KINDL as an HRQoL instrument--in Spanish language--to measure subjective well-being in children.


Subject(s)
Adolescent Health Services/standards , Child Health Services/standards , Health Status Indicators , Psychometrics/instrumentation , Quality of Life , Adolescent , Child , Cross-Sectional Studies , Female , Humans , Male , Reproducibility of Results , Spain , Surveys and Questionnaires , Translations
18.
Prog. obstet. ginecol. (Ed. impr.) ; 44(4): 149-158, abr. 2001. ilus
Article in Es | IBECS | ID: ibc-4529

ABSTRACT

La homocisteína es un aminoácido no esencial que ha resultado ser un nuevo factor de riesgo cardiovascular independiente y un posible marcador biológico de las complicaciones ocurridas durante la gestación. Su tratamiento es fácil e inocuo, la prevalencia parece ser alta y su determinación mediante nuevas técnicas automatizadas hará posible que se realice en cualquier laboratorio. Esto nos hace pensar en la homocisteína como un posible factor de cribado poblacional, especialmente en aquellos pacientes con un mayor riesgo cardiovascular y en mujeres gestantes con antecedentes de embarazo complicado. Pero, por ahora, es una prueba que sólo se realiza en la investigación clínica. (AU)


Subject(s)
Adult , Female , Middle Aged , Humans , Risk Factors , Homocysteine , Homocysteine/adverse effects , Homocysteine/administration & dosage , Biomarkers/analysis , Mass Screening , Pregnancy Complications, Cardiovascular/diagnosis , Methionine/administration & dosage , Pregnancy Complications/diagnosis , Models, Molecular , Genetic Markers/physiology , Drug Antagonism , Isoniazid/antagonists & inhibitors , Cycloserine/antagonists & inhibitors , Hydralazine/antagonists & inhibitors , Carbamazepine/antagonists & inhibitors , Theophylline/antagonists & inhibitors , Pyridoxine/antagonists & inhibitors , Homocysteine/metabolism , Hypoglycemic Agents/antagonists & inhibitors
19.
Toxicon ; 39(6): 757-61, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11137533

ABSTRACT

The presence of paralytic shellfish poisoning (PSP) toxins in cultures of Aphanizomenon flos-aquae, isolated from the Crestuma-Lever reservoir, was found by reversed phase high performance liquid chromatography employing two isocratic elution systems for the separation of PSP toxins. With the first isocratic elution protocol, the presence of apolar toxins as saxitoxin, decarbamoyl saxitoxin and neosaxitoxin not detected. On the other hand, GTX4, GTX1 and GTX3 as well as Cs toxins were present either in the Aphanizomenon flos-aquae cells collected directly from the bloom or in the other toxic isolates priorly cultivated in laboratory conditions.


Subject(s)
Bacterial Toxins/isolation & purification , Cyanobacteria/chemistry , Chromatography, High Pressure Liquid , Portugal , Shellfish
20.
Antonie Van Leeuwenhoek ; 78(1): 99-106, 2000 Jul.
Article in English | MEDLINE | ID: mdl-11016700

ABSTRACT

The presence of Salmonella and its relationship with indicator organisms of fecal pollution, such as total coliforms, fecal coliforms and fecal streptococci, was studied at two marine zones in Portugal. Seventeen different Salmonella serotypes were isolated and identified, S. virchow was the most frequently isolated (21.6%). In addition, a high percentage (35.1%) was recorded for some Salmonella serotypes of clinical significance, namely S. enteritidis, S. infantis, S. typhimurium and S. virchow. In any of the samples from the two zones Salmonella was not detected in the absence of any of the indicator organisms. However, the incidence of Salmonella as a function of indicator concentration intervals established by the EEC standards was 0, 10 and 19.3% at guide values of total coliforms, fecal coliforms and fecal streptococci, respectively in the Faro samples (south of Portugal). In contrast, Salmonella incidence rates of 37.5, 36.4 and 33.3% were recorded at the corresponding guide values the Caminha samples (north of Portugal). No significant correlations (p>0.005) were obtained between Salmonella and the indicators at the sampling stations; however, total coliforms and fecal streptococci were the indicators most closely related to Salmonella in Caminha and Faro samples, respectively. Survival experiments in Escherichia coli, Enterococcus faecalis and S. typhimurium, using diffusion chambers, were performed to verify whether the lack of correlation between indicators and Salmonella was due to different inactivation rates in seawater. The results indicate that survival percentages of the three microorganisms tested were similar after 48 h of exposure to seawater.


Subject(s)
Bathing Beaches , Salmonella/isolation & purification , Seawater , Water Microbiology , Colony Count, Microbial , Diffusion Chambers, Culture , Feces , Portugal , Reproducibility of Results , Salmonella/classification , Specimen Handling , Water Microbiology/standards
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