ABSTRACT
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Subject(s)
Humans , Male , Adolescent , Enterocolitis/diagnosis , Enterocolitis/drug therapy , Crohn Disease/diagnosis , Enterocolitis/pathology , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/pathology , Abdominal Pain/etiology , Endoscopy/methods , Crohn Disease/pathology , Budesonide/administration & dosage , MicroscopySubject(s)
Enterocolitis , Eosinophilia , Adolescent , Anti-Inflammatory Agents/therapeutic use , Budesonide/therapeutic use , Enterocolitis/complications , Enterocolitis/pathology , Enterocolitis/therapy , Eosinophilia/complications , Eosinophilia/pathology , Eosinophilia/therapy , Food Hypersensitivity/diagnosis , Food Hypersensitivity/diet therapy , Humans , MaleABSTRACT
Objetivo: Describir nuestra experiencia con la utilización del registrador implantable de eventos (REI) en un grupo de pacientes mayores con caídas frecuentes, y factores predictores de síncope de causa arrítmica. Material y métodos: Estudio retrospectivo de pacientes mayores con caídas, sospecha de síncope y/o alteraciones en el ECG, a quienes tras una evaluación cardiológica se les implantó un REI, para esclarecer si las caídas estaban provocadas por una arritmia. Resultados: Se han analizado 13 pacientes (7 varones con una edad media de 78 a nos), con una media de 3,3 caídas, a los que se implantó un REI como parte del estudio de las mismas. Han sido seguidos durante un periodo mínimo de 24 meses. Seis pacientes han mostrado una arritmia como causa de las caídas, registrada en el REI. En 5 casos se trataba de una bradiarritmia. El otro era una taquiarritmia. Cuatro pacientes no han presentado alteraciones del ritmo cardíaco durante las caídas. Los restantes 3 pacientes no han sufrido nuevas caídas durante el seguimiento. Conclusión: En este grupo seleccionado de pacientes con caídas, el REI ha detectado una causa arrítmica en un apreciable porcentaje de casos (AU)
Objective: To review our experience on using an implantable loop recorder (ILR) in patients with recurrent falls, when an arrhythmogenic cause is suspected. Material and methods: This is a retrospective, observational study of patients with repetitive unexplained falls, suspected syncope, or electrocardiographic abnormalities. All of them had been evaluated by a cardiologist, who decided to implant a loop recorder (ILR) for an accurate diagnosis. Results: A total of 13 patients received an ILR. The average falls rate for the sample was 3.3. The mean age was 78 years, and 46% were female, with a mean follow-up period of 24 months. During this time, three patients did not suffer from a new fall. An arrhythmogenic diagnosis was obtained in 5 patients: bradycardia was identified in 4 cases, and tachycardia in one of them. The symptoms did not coincide with a documented arrhythmia in the rest of the patients. Conclusion: ILR is a helpful tool to establish an arrhythmogenic cause of unexplained and recurrent falls, in this selected sample of older adults (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Accidental Falls/statistics & numerical data , Electrocardiography, Ambulatory , Syncope/epidemiology , Arrhythmias, Cardiac/epidemiology , Risk FactorsABSTRACT
El uso de sanguijuelas ha sido una terapia que ha venido usándose desde las antiguas civilizaciones hasta principios del siglo XX como tratamiento indispensable para diversas dolencias, cayendo en desuso como consecuencia del gran avance científico y considerándose un tratamiento sin valor, atrasado y decadente. El presente articulo pretende dar a conocer la terapia con sanguijuelas, su auge desde la antigüedad, su decadencia y el nuevo renacer actual en el postoperatorio de la microcirugía plástica reconstructiva para prevenir el éxtasis venoso, así como en traumatología en el tratamiento de las artrosis. Dicha terapia se está aplicando en numerosos países, incluyendo España en donde su uso es una realidad en Hospitales y servicios muy concretos (AU)
The use of leeches is a medical therapy which has been used since ancient civilizations until the first decades of the XXth century. It is an irreplaceable remedy to treat many types of illness, however, it fell into disuse due to the increasing confidence in scientific development and because it became considered old-fashioned, obsolete and valueless. The present paper tries to release the therapy with leeches, its peak in the ancient times, its later disuse and the recent reappearance in the post-operative of plastic microsurgical reconstruction in order to prevent the poisoning ecstasy and also in the degenerative osteoarthritis treatment. This therapy is being applied to numerous countries, Spain included, where it is being used at hospitals in particular medical services (AU)
Subject(s)
Humans , Animals , Leeching/methods , Leeching/history , Bloodletting/methods , Bloodletting/historyABSTRACT
Se han estudiado varios fármacos coadyuvantes del intervencionismo percutáneo en el infarto agudo de miocardio con el objetivo de mejorar la perfusión tisular y el daño miocárdico isquémico asociado con la reperfusión mecánica. Los fármacos antiplaquetarios, aspirina y clopidogrel, deben ser administrados lo más precozmente posible antes del intervencionismo. Entre los inhibidores de los receptores de la glucoproteína IIb/IIIa, el abciximab es el fármaco más estudiado. Su uso se asocia con un menor número de eventos y una mayor permeabilidad de la arteria antes del intervencionismo. La angioplastia facilitada con trombolíticos, un interesante concepto para generalizar la reperfusión mecánica en el infarto, requiere más estudios antes de su recomendación. Otros fármacos, como las heparinas de bajo peso molecular o la bivalirudina, estudiados en el síndrome coronario agudo sin elevación del segmento ST no lo han sido en el intervencionismo del infarto agudo de miocardio (AU)
Numerous studies of the different adjuvant drugs used with percutaneous coronary intervention for acute myocardial infarction have been carried out with the aim of improving tissue perfusion and decreasing the ischemic myocardial damage associated with mechanical reperfusion. The antiplatelet drugs, aspirin and clopidogrel, must be given as early as possible before coronary intervention. Abciximab is the most studied glycoprotein IIb/IIIa inhibitor. Its use is associated with the occurrence of fewer adverse events and better coronary artery patency before intervention. The use of thrombolytic drugs in combination with angioplasty is a promising way of extending mechanical reperfusion within the infarct but more studies must be carried out before it can be recommended. Other drugs, such as low-molecularweight heparins and bivalirudin, have been studied in non-ST-elevation acute coronary syndrome but not in interventions for acute myocardial infarction (AU)
Subject(s)
Humans , Angioplasty/methods , Percutaneous Coronary Intervention/methods , Myocardial Revascularization/methods , Thrombolytic Therapy/instrumentation , Thrombolytic Therapy/methods , Platelet Aggregation Inhibitors/administration & dosage , Societies, Medical/standards , Platelet Aggregation Inhibitors/metabolism , Odds Ratio , Myocardial Infarction/drug therapy , Myocardial Infarction/prevention & controlABSTRACT
The association of chronic urticaria (CU) to parasitic infestations has been poorly studied. Recently, sensitization to the parasite larva Anisakis simplex has been described as the cause of acute urticaria and anaphylaxis. The aim of this work was to study the relationship between sensitization to A. simplex and CU. One hundred one patients with CU were studied. Data of possible contacts with A. simplex were collected and the usual CU study was performed. Furthermore, total and specific immunoglobulin E (IgE; Pharmacia CAP system IGE fluorescence enzyme immunoassay: CAP) to A. simplex, Ascaris lumbricoides, Echinococcus granulosus, and Toxocara canis were determined as well as skin-prick test with A. simplex and serology to E. granulosus. In accordance with the results of the CAP to A. simplex, the patients were divided into two groups, positive and negative, and, subsequently, subdivided into two other subgroups that were alternatively told to stop eating fish or seafood in their diet or to continue with their normal diet. Checkups were performed at 6, 12, and 18 months. Thirty-five percent of the patients had positive skin tests to A. simplex, and CAP to A. simplex was positive in 55%. The fish-eating habits, acute or chronic gastrointestinal disease, and the background of abdominal surgery were not related to the results of the CAP and/or skin test to A. simplex. A total of 21.8% of all the patients had detectable CAP to A. lumbricoides, 91% of whom had positive CAP to A. simplex. Three patients had specific IgE to T. canis and five patients had specific IgE to E. granulosus, in the absence of positive serology. All had specific IgE to A. simplex. Present infestation could not be proved in any of them. The clinical evolution and variations of CAP to A. simplex and of total IgE were not statistically different among the groups during the 6, 12, and 18 months of the study. The percentage of sensitization to A. simplex in patients with CU is elevated and determines the sensitization to other parasites because of cross-reactivity. We have not found any causal relationship between the presence of specific IgE to A. simplex and CU. The clinical importance of this finding in this disease is still undetermined.
