RESUMO
Introduction and objectives According to the recent European epidemiological studies, the degree of lipid control in patients with very high vascular risk is suboptimal. This study analyzes the epidemiological characteristics, cardiovascular risk factors, lipid profile, recurrence, and degree of achievement of long-term lipid targets, according to the ESC/EAS Guidelines, in a cohort of patients with acute coronary syndrome (ACS) in a real-world clinical practice setting. Methods This work is a retrospective cohort study of patients diagnosed with ACS admitted to the Coronary Unit of a tertiary hospital from January 1, 2012 to December 31, 2015 and followed-up on until March 2022. Results A total of 826 patients were studied. During the follow-up period, greater prescribing of combined lipid-lowering therapy was observed, mainly high- and moderate-intensity statins and ezetimibe. At 24 months after the ACS, 33.6% of living patients had LDL levels <70 mg/dl and 9.3% had LDL levels <55 mg/dl. At the end of the follow-up (101 [88111] months), the corresponding figures were 54.5% and 21.1%. Some 22.1% of patients had a recurrent coronary event and only 24.6% achieved an LDL level <55 mg/dl. Conclusions Achievement of the LDL targets recommended by the ESC/EAS guidelines is suboptimal in patients with ACS, both at two years and in the long-term (710 years), especially in patients with recurrent ACS (AU)
Introducción y objetivos Según los recientes estudios epidemiológicos europeos, el grado de control lipídico de los pacientes de muy alto riesgo vascular es subóptimo. En este estudio se han analizado las características epidemiológicas, los factores de riesgo cardiovascular, el perfil lipídico, la recurrencia y el grado de consecución de los objetivos lipídicos a largo plazo, según las Guías ESC/EAS, en una cohorte de pacientes con síndrome coronario agudo (SCA), en condiciones de práctica clínica real. Métodos Estudio de cohorte retrospectivo de los pacientes con diagnóstico de SCA ingresados en la unidad coronaria de un hospital de tercer nivel, entre el 1 de enero de 2012 y el 31 de diciembre de 2015, y seguidos hasta marzo de 2022. Resultados Se estudiaron 826 pacientes. Durante el periodo de seguimiento se observó una mayor prescripción de terapia hipolipemiante combinada, principalmente estatinas de alta y moderada intensidad y ezetimibe. A los 24 meses del SCA, un 33,6% de los pacientes vivos tenían un LDL < 70 mg/dl y en un 9,3% los niveles eran < 55 mg/dl. Al final del seguimiento (101 [88111] meses), las correspondientes cifras eran del 54,5 y 21,1%. Un 22,1% de los pacientes presentaron un evento coronario recurrente, y solamente un 24,6% de ellos alcanzaron un nivel de LDL < 55 mg/dl. Conclusiones El cumplimiento de los objetivos recomendados por las Guías ESC/EAS en pacientes con SCA, es subóptimo, tanto a los 2 años como a largo plazo (7-10 años) desde el evento, y en especial en los pacientes con SCA recurrente (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Síndrome Coronariana Aguda/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , LDL-Colesterol/sangueRESUMO
INTRODUCTION AND OBJECTIVES: According to the recent European epidemiological studies, the degree of lipid control in patients with very high vascular risk is suboptimal. This study analyzes the epidemiological characteristics, cardiovascular risk factors, lipid profile, recurrence, and degree of achievement of long-term lipid targets, according to the ESC/EAS Guidelines, in a cohort of patients with acute coronary syndrome (ACS) in a real-world clinical practice setting. METHODS: This work is a retrospective cohort study of patients diagnosed with ACS admitted to the Coronary Unit of a tertiary hospital from January 1, 2012 to December 31, 2015 and followed-up on until March 2022. RESULTS: A total of 826 patients were studied. During the follow-up period, greater prescribing of combined lipid-lowering therapy was observed, mainly high- and moderate-intensity statins and ezetimibe. At 24 months after the ACS, 33.6% of living patients had LDL levels <70 mg/dl and 9.3% had LDL levels <55 mg/dl. At the end of the follow-up (101 [88-111] months), the corresponding figures were 54.5% and 21.1%. Some 22.1% of patients had a recurrent coronary event and only 24.6% achieved an LDL level <55 mg/dl. CONCLUSIONS: Achievement of the LDL targets recommended by the ESC/EAS guidelines is suboptimal in patients with ACS, both at two years and in the long-term (7-10 years), especially in patients with recurrent ACS.
Assuntos
Síndrome Coronariana Aguda , Anticolesterolemiantes , Inibidores de Hidroximetilglutaril-CoA Redutases , Humanos , Síndrome Coronariana Aguda/tratamento farmacológico , Resultado do Tratamento , Estudos Retrospectivos , LDL-Colesterol , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêuticoAssuntos
Síndrome de Vazamento Capilar/diagnóstico , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , Idoso , Síndrome de Vazamento Capilar/etiologia , Síndrome de Vazamento Capilar/terapia , Coloides/uso terapêutico , Terapia Combinada , Soluções Cristaloides , Evolução Fatal , Hidratação , Gastroenteropatias/complicações , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Hemodiafiltração , Humanos , Hiperpotassemia/etiologia , Soluções Isotônicas/uso terapêutico , Masculino , Norepinefrina/uso terapêutico , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Derrame Pleural/etiologia , Infecções Respiratórias/complicações , UltrassonografiaRESUMO
A 36-year-old male with acquired immune deficiency syndrome (AIDS) presented with intractable nausea and vomiting of 1 week's duration that was not attributable to his medications. An esophagogastroduodenoscopy showed hemorrhagic and necrotic gastric mucosa but no ulcers were found. Histopathology revealed viral inclusions consistent with cytomegalovirus (CMV) disease of the stomach. The patient received 6 weeks of intravenous ganciclovir with resolution of symptoms and endoscopic findings. Cytomegaloviral involvement of the stomach is rare, even in immunocompromised patients. Characteristic findings on upper endoscopy are punched-out gastric ulcers. This is a rare case of CMV disease of the stomach presenting as hemorrhagic, necrotic gastritis with inflammatory bridging.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/fisiopatologia , Antivirais/uso terapêutico , Infecções por Citomegalovirus/fisiopatologia , Ganciclovir/uso terapêutico , Gastrite/fisiopatologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Infecções por Citomegalovirus/tratamento farmacológico , Gastrite/tratamento farmacológico , Transtornos Hemorrágicos/tratamento farmacológico , Transtornos Hemorrágicos/fisiopatologia , Humanos , Masculino , Náusea/tratamento farmacológico , Náusea/virologia , Vômito/tratamento farmacológico , Vômito/virologiaAssuntos
Preservação de Sangue/métodos , Contagem de Linfócitos/instrumentação , Subpopulações de Linfócitos/citologia , Preservação de Sangue/normas , Progressão da Doença , Citometria de Fluxo/métodos , Citometria de Fluxo/normas , Soropositividade para HIV/sangue , Humanos , Imunofenotipagem/normas , Reprodutibilidade dos Testes , Temperatura , Fatores de TempoAssuntos
Hemorragia Gastrointestinal/etiologia , Neoplasias Primárias Múltiplas/patologia , Tumor de Músculo Liso/patologia , Neoplasias Gástricas/patologia , Adulto , Feminino , Humanos , Leiomioma/complicações , Leiomioma/patologia , Leiomiossarcoma/complicações , Leiomiossarcoma/patologia , Neoplasias Primárias Múltiplas/complicações , Tumor de Músculo Liso/complicações , Neoplasias Gástricas/complicaçõesRESUMO
Pregnancy-associated hypertension is a health problem in Mexico due to its high frequency of morbidity and mortality in mother and fetus as well. Research in this area has been restrained by limitations upon epidemiologic information, unknown etiology and the somewhat easy resolution provided when pregnancy is interrupted. We have reviewed contributions made in our country and up-to-date management concepts.
Assuntos
Eclampsia , Pré-Eclâmpsia , Eclampsia/etiologia , Eclampsia/prevenção & controle , Eclampsia/terapia , Feminino , Humanos , Obstetrícia/métodos , Pré-Eclâmpsia/etiologia , Pré-Eclâmpsia/prevenção & controle , Pré-Eclâmpsia/terapia , GravidezAssuntos
Princípios Morais , Responsabilidade Social , Cuba , História do Século XIX , História do Século XX , Espanha , Estados Unidos , GuerraRESUMO
During the past few years, meaningful progress has been achieved in our understanding of the pathophysiology of preterm premature rupture of membranes. In addition, more evidence has been presented in favor of induction and delivery for rupture between 34 and 37 weeks and expectant management for rupture before 34 weeks. New approaches are being suggested to complement expectant management. The purpose of this article is to review this recent information about the pathophysiology and management of women with preterm premature rupture of membranes.
Assuntos
Ruptura Prematura de Membranas Fetais/fisiopatologia , Ruptura Prematura de Membranas Fetais/terapia , Feminino , Ruptura Prematura de Membranas Fetais/diagnóstico , Humanos , GravidezRESUMO
Pituitary adenoma, familiar type, with apparent affection over the involved somatomammotropin of secretion of growth hormone and prolactin, with dominant autosomic transmission, is described for the first time. It was seen that a couple of members without demonstrable tumour, showed clinical data (phenotype) of acromegaly. On investigation of histocompatibility antigens it was observed that the patients with tumour and other symptomatic ones, but without tumour, shared the same haplotypes, and so is very possible that investigation of HLA antigens in patients with pituitary tumour, contributes to better identify its nature and frequency.