RESUMO
OBJECTIVE: The aim of this prospective study was to observe the prescription of low-molecular weight heparin (LMWH) for the prophylaxis of venous thromboembolic disease in medical patients. METHODS: We included all the patients on LMWH prophylaxis in 5 medical departments of Sainte-Marguerite Hospital in Marseille. The study described the reasons for this prophylaxis, the thrombotic risk, the follow-up quality and the side-effects. RESULTS: During four months, 189 (14.3%) of 1317 medical patients have received a prophylaxis with LMWH; sixty one per cent of them were older than 70 years. Thrombotic risk as measured with Thilly's score was low in 50 patients (26%), moderate in 81 patients (43%), high in 58 patients (31%). Platelet count follow-up was optimal in 88 patients (47%). A decrease of platelet count over 30%, reaching less than 100 G/l, was recorded in 4 patients. A venous thrombosis was diagnosed clinically in one patient. Two patients had an overt severe bleeding. A serious hidden bleeding was suspected in 11 patients. CONCLUSION: LMWH were frequently prescribed for the prophylaxis of venous thromboembolic disease in medical patients. Most of these patients were over 70 years of age. Platelet count follow-up was in accordance with guidelines in less than half of the patients. Bleedings were not rare on this treatment. The present work suggests that a precise thrombotic risk assessment is needed before the onset of this therapy and that the association with aspirin should be careful.
Assuntos
Anticoagulantes/uso terapêutico , Fibrinolíticos/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Tromboembolia/prevenção & controle , Trombose Venosa/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/administração & dosagem , Anticoagulantes/efeitos adversos , Prescrições de Medicamentos , Feminino , Fibrinolíticos/administração & dosagem , Fibrinolíticos/efeitos adversos , Heparina de Baixo Peso Molecular/administração & dosagem , Heparina de Baixo Peso Molecular/efeitos adversos , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Fatores de TempoRESUMO
This study compared the performances of 20 middle-aged and 20 older subjects on a Rebus Riddle task that required they retrieve the names of famous persons. Older subjects solved significantly more riddles and responded to prompts designed to aid riddle-solving efforts with significantly greater success than middle-aged subjects. Older subjects also had nonsignificantly faster riddle-solving times than middle-aged subjects. Similar riddles were difficult or easy for both groups. Superior performance of the older group appeared to be related to the age of the subject at the time the persons in the riddles had become famous.
Assuntos
Envelhecimento/psicologia , Rememoração Mental , Resolução de Problemas , Fatores Etários , Idoso , Análise de Variância , Pessoas Famosas , Jogos Experimentais , Humanos , Pessoa de Meia-IdadeRESUMO
We report the case of a patient affected by a subcortical lesion of the right non-dominant hemisphere, and demonstrate that he had selective constructional disorders by comparing his post-stroke performances with those assessed 18 months before the stroke. A detailed analysis was made of the visuospatial, perceptual, representational and executive competences involved in drawing tasks at one, two and six months post-stroke. Neuropsychological follow-up revealed the progressive recovery of all visuospatial abilities. This study provides some interpretative elements for constructional disorders and, in particular, for the closing-in phenomenon observed only during the subacute phase.