Assuntos
Testes de Função Renal , Insuficiência Renal Crônica/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Biomarcadores , Creatinina/sangue , Diagnóstico Tardio , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Rim/crescimento & desenvolvimento , Isquemia Miocárdica/complicações , Valor Preditivo dos Testes , Insuficiência Renal Crônica/sangueRESUMO
No disponible
Assuntos
Idoso de 80 Anos ou mais , Idoso , Feminino , Humanos , Masculino , Nefropatias/complicações , Nefropatias/diagnóstico , Nefropatias/terapia , Creatinina , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/terapia , Seguimentos , Taxa de Filtração Glomerular/fisiologia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Isquemia Miocárdica/complicações , Isquemia Miocárdica/diagnósticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Insuficiência Renal Crônica/fisiopatologia , Hematócrito , Ureia/urina , Taxa de Filtração Glomerular , Fatores SexuaisRESUMO
CONTEXT: Several alterations in thyroid function test (TFT) results have been associated with mortality in elderly patients. OBJECTIVE: Our aim was to investigate the relationship between TFT results and all-cause and cardiovascular (CV) mortality in aged hospitalized patients. DESIGN: A 7-year prospective observational study was conducted. TFTs were performed at hospital admission, and mortality was registered in the follow-up period. PATIENTS: Participants were 404 patients aged >65 years admitted to the Department of Geriatrics, Hospital General, Segovia, Spain, for any reason during 2005. MAIN OUTCOME MEASURES: The study evaluated the association between TFT results and mortality from all causes and CV diseases. METHODS: TSH, free T4, and free T3 (FT3) were measured on the first day of admission. In-hospital and total survival times, number of deaths, and all-cause and CV mortality were registered until the census date on January 1, 2012. RESULTS: During the study, 323 patients (80%) died. Kaplan-Meier analysis showed that median survival time for all-cause mortality was significantly lower in patients in the first tertile of serum FT3, in the first tertile of TSH, and in the first tertile of serum free T4 concentrations. Multivariate adjusted Cox regression analysis showed that the history of cancer (hazard ratio, 1.60; 95% confidence interval, 1.12-2.28; P = .009), age (1.03; 1.01-1.06; P = .003), and FT3 levels (0.72; 0.63-0.84; P < .001) were significant factors related to all-cause mortality. The cause of death was known in 202 patients. Of this group, 61 patients (30.2%) died of CV disease. Patients in the first tertile of TSH and FT3 exhibited a significant higher mortality due to CV disease. In the adjusted Cox regression analysis, FT3 was a significant predictor of CV mortality (0.76; 0.63-0.91; P = .004). CONCLUSIONS: Alterations in TFT results during hospitalization are associated with long-term mortality in elderly patients. In particular, low FT3 levels are significantly related to all-cause and CV mortality.
Assuntos
Envelhecimento , Doenças Cardiovasculares/fisiopatologia , Hipertireoidismo/fisiopatologia , Hipotireoidismo/fisiopatologia , Glândula Tireoide/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/mortalidade , Estudos Transversais , Feminino , Seguimentos , Hospitais Gerais , Humanos , Hipertireoidismo/sangue , Hipertireoidismo/complicações , Hipertireoidismo/mortalidade , Hipotireoidismo/sangue , Hipotireoidismo/complicações , Hipotireoidismo/mortalidade , Estimativa de Kaplan-Meier , Masculino , Mortalidade , Espanha/epidemiologia , Testes de Função Tireóidea , Glândula Tireoide/metabolismo , Tireotropina/sangue , Tireotropina/metabolismo , Tiroxina/sangue , Tiroxina/metabolismo , Tri-Iodotironina/sangue , Tri-Iodotironina/metabolismoRESUMO
Hydatid disease is found throughout the world, with a higher prevalence in the Mediterranean area. In Spain, the most endemic regions are Rioja and Aragon, with rates above 10 cases/100,000 inhabitants, followed by Castilla-La Mancha and Castilla y Leon (5-10 cases/100,000 inhabitants). This parasitic disease is caused by the larval stage of Echinococcus granulosus (EG) and the main organs affected are the liver and the lung (85 % cases). We present a case of obstructive jaundice and secondary cholangitis due to a biliary hydatidosis. Abdominal computed tomography scan showed dilatation of the entire biliary tract. The technique used for diagnosis and treatment was endoscopic retrograde cholangiopancreatography.
Assuntos
Doenças dos Ductos Biliares/complicações , Doenças dos Ductos Biliares/parasitologia , Equinococose/complicações , Icterícia Obstrutiva/parasitologia , Idoso de 80 Anos ou mais , Humanos , MasculinoRESUMO
La hidatidosis posee una distribución mundial, con una mayor prevalencia en países mediterráneos. En España, las zonas más endémicas son La Rioja y Aragón, con tasas superiores a 10 casos/100.000 habitantes, seguidas de Castilla-La Mancha y Castilla y León (5-10 casos/100.000 habitantes). Esta parasitosis está causada por la forma larvaria del Echinococcus granulosus y afecta principalmente al hígado y al pulmón (85% de los casos). Presentamos un caso de ictericia obstructiva y colangitis secundaria a una colangiohidatidosis. La tomografía computarizada abdominal evidenció una dilatación de toda la vía biliar y la colangiopancreatografía retrógrada endoscópìca se utilizó como técnica diagnóstica y terapéutica
Hydatid disease is found throughout the world, with a higher prevalence in the Mediterranean area. In Spain, the most endemic regions are Rioja and Aragon, with rates above 10 cases/100,000 inhabitants, followed by Castilla-La Mancha and Castilla y Leon (5-10 cases/100,000 inhabitants). This parasitic disease is caused by the larval stage of Echinococcus granulosus (EG) and the main organs affected are the liver and the lung (85 % cases). We present a case of obstructive jaundice and secondary cholangitis due to a biliary hydatidosis. Abdominal computed tomography scan showed dilatation of the entire biliary tract. The technique used for diagnosis and treatment was endoscopic retrograde cholangiopancreatography
