ABSTRACT
TITLE: Reducción de los niveles plasmáticos de CGRP en pacientes con migraña tratados con erenumab o galcanezumab.
Subject(s)
Antibodies, Monoclonal, Humanized , Calcitonin Gene-Related Peptide , Migraine Disorders , Humans , Antibodies, Monoclonal, Humanized/therapeutic use , Migraine Disorders/drug therapy , Migraine Disorders/blood , Female , Male , Calcitonin Gene-Related Peptide Receptor Antagonists/therapeutic use , Adult , Middle Aged , Antibodies, Monoclonal/therapeutic useABSTRACT
AIMS: To compare the performance of the CRUSADE, ACUITY-HORIZONS, and ACTION risk models in the ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS: We studied all consecutive patients with STEMI who underwent PPCI at our institution between 2006 and 2010 (n=1391). The CRUSADE, ACUITY-HORIZONS, and ACTION risk scores were calculated based on the patients' clinical characteristics. The occurrence of in-hospital major bleeding (defined as the composite of intracranial or intraocular bleeding, access site haemorrhage requiring intervention, reduction in haemoglobin ≥4 g/dl without or ≥3g/dl with overt bleeding source, reoperation for bleeding, or blood transfusion) reached 9.8%. Calibration and discrimination of the three risk models were evaluated by the Hosmer-Lemeshow test and the C-statistic, respectively. We compared the predictive accuracy of the risk scores by the DeLong non-parametric test. RESULTS: Calibration of the three risk scores was adequate, given the non-significant results of Hosmer-Lemeshow test for the three risk models. Discrimination of CRUSADE, ACUITY-HORIZONS, and ACTION models was good (C-statistic 0.77, 0.70, and 0.78, respectively). The CRUSADE and ACTION risk scores had a greater predictive accuracy than the ACUITY-HORIZONS risk model (z=3.89, p-value=0.0001 and z=3.51, p-value=0.0004, respectively). There was no significant difference between the CRUSADE and ACTION models (z=0.63, p=0.531). CONCLUSIONS: The CRUSADE, ACUITY-HORIZONS, and ACTION scores are useful tools for the risk stratification of bleeding in STEMI treated by PPCI. Our findings favour the CRUSADE and ACTION risk models over the ACUITY-HORIZONS risk score.
ABSTRACT
Radiation therapy is the usual treatment for nasopharyngeal carcinoma. However, in recent years the use of neoadyuvant chemotherapy in the treatment of local and regionally advanced carcinoma has been investigated. We report the results of a retrospective study of two treatments used in our center. The study included 68 patients: 34 (group A) who received radiotherapy alone and 34 (group B) who received neoadyuvant chemotherapy before radiotherapy. In group A, 70.6% achieved a complete clinical response: 23.5% relapsed: 5 patients presented distant metastases. Survival rates at 5 and 10 years were 53% and 27% respectively; the disease-free survival was 71.4% at 5 years and 54% at 10 years. In group B, the complete clinical response rate to neoadyuvant chemotherapy was 35.3%, which increased to 73.5% when the treatment was complemented with radiotherapy. The relapse rate was 14.7%; the survival rates at 5 and 10 years were 49.5% and 49%, respectively; and the disease-free survival was 77.2% at 5 and 10 years.
Subject(s)
Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Female , Humans , Male , Middle AgedABSTRACT
A patient with a jejunal leiomyoblastoma presented with lower gastrointestinal haemorrhage, a most unusual occurrence according to the literature. The provisional diagnosis was made by arteriography and confirmed pathologically. The characteristics of these tumours are analyzed and the management discussed.
Subject(s)
Gastrointestinal Hemorrhage/etiology , Jejunal Diseases/etiology , Jejunal Neoplasms/complications , Leiomyoma/complications , Female , Humans , Jejunal Neoplasms/pathology , Leiomyoma/pathology , Middle AgedABSTRACT
The authors report a case of gastric lipoma which was discovered because of severe upper gastrointestinal bleeding. The entity is seldom reported in the literature; only 17 cases have been reported in our country. The diagnostic possibilities are analyzed. In most cases they only confirm the diagnosis of a benign tumour and pathological verification is necessary. Surgical treatment is recommended in the light of the frequent complications of this tumor.