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1.
Ramos R Balló E Marrugat J Elosua R Sala J Grau M Vila J Bolíbar B García-Gil M Martí R Fina F Hermosilla E Rosell M Muñoz MA Prieto-Alhambra D Quesada M 《Revista espa?ola de cardiología》2012,65(1):29-37
Introduction and objectives
Information in primary care databases can be useful in research, but the validity of these data needs to be evaluated. We sought to analyze the validity of the data used in the EMMA study based on data from the Information System for the Development of Research in Primary Care.Methods
We compared the prevalence of cardiovascular risk factors observed in EMMA–hypertension, diabetes, hypercholesterolemia (and its treatments), obesity, and smoking–with equivalent data from the Registre Gironí del Cor (REGICOR), a population-based study that uses standardized methodology, in 2000. We also compared the incidence rates of vascular diseases and its association with these risk factors in a 5-year follow-up.Results
We analyzed data from 34 823 participants included in EMMA and 2540 REGICOR2000 study participants aged 35 to 74. The prevalence of risk factors did not differ significantly between the 2 studies, except for the prevalence of former smokers in men, which was higher in REGICOR2000 (24.7% [95% confidence interval, 23.9%-25.5%] vs 30.1% [95% confidence interval, 27.1%-33.1%]), and the proportion of patients with lipid-lowering and antihypertensive therapy, which was higher in EMMA (46.9% vs 32.7% and 8.7% vs 6.3%, respectively). There were no differences between the 2 studies when comparing the incidence of vascular diseases (2.1% in both studies in men and 1.18% [95% confidence interval, 0.7%-1.7%] in REGICOR2000 vs 0.75% [95% confidence interval, 0.64%-0.87%] in EMMA in women) and its association with risk factors.Conclusions
The prevalence of cardiovascular risk factors and their association with the incidence of vascular disease observed in the EMMA study are consistent with those observed in an epidemiological population-based study with a standardized methodology.Full English text available from:www.revespcardiol.org 相似文献2.
Minerva Mas-Heredia Eloisa Molés-Moliner Luis González-de Paz Belchin Kostov Jacinto Ortiz-Molina Vanesa Mauri-Vázquez Ignacio Menacho-Pascual Daniel Cararach-Salami Cristina Sierra-Benito Antoni Sisó-Almirall 《Revista espa?ola de cardiología》2014
Introduction and objectives
Blood pressure measurement methods and conditions are determinants of hypertension diagnosis. A recent British guideline recommends systematic 24-h ambulatory blood pressure monitoring. However, these devices are not available at all health centers and they can only be used by 1 patient per day. The aim of this study was to test a new blood pressure recording method to see if it gave the same diagnostic results as 24-h blood pressure monitoring.Methods
One-hour blood pressure monitoring under routine clinical practice conditions was compared with standard method of day time recording by analyzing the coefficient of correlation and Bland-Altman plots. The Kappa index was used to calculate degree of agreement. Method sensitivity and specificity were also analyzed.Results
Of the 102 participants, 89 (87.3%) obtained the same diagnosis regardless of method, with high between-method agreement (κ= 0.81; 95% confidence interval, 0.71-0.91). We observed robust correlations between diastolic (r = 0.85) and systolic blood pressure (r = 0.76) readings. Sensitivity and specificity for the new method for diagnosing white coat hypertension were 85.2% (95% confidence interval 67.5%-94.1%) and 92% (95% confidence interval, 83.6%-96.3%), respectively.Conclusions
One-hour blood pressure monitoring is a valid and reliable method for diagnosing hypertension and for classifying hypertension subpopulations, especially in white coat hypertension and refractory hypertension. This also leads to a more productive use of monitoring instruments.Full English text available from:www.revespcardiol.org/en 相似文献3.
Méndez-Vásquez RI Suñén-Pinyol E Cervelló R Camí J 《Revista espa?ola de cardiología》2012,65(7):642-650
Introduction and objectives
The abundance of macro-level studies on scientific production in the field of biomedicine in Spain only serves to highlight the scarcity of micro-level studies reporting on the activity of research groups–the basic units of the science and technology system. This lack of information may well be explained by the ambiguity inherent in the “research group” concept and by the existence of synonymous and homonymous bibliographic signatures that confuse the correspondence between these and the real authors. The aim of this study is to describe bibliographic production in cardio-cerebrovascular research and identify research groups active in the field.Methods
Using Thomson-Reuters’ National Citation Report for Spain database and the National Library of Medicine Medical Subject Headings thesaurus, we defined the field of cardio-cerebrovascular research and identified research groups through coauthorship analysis supported by the opinions of an expert. Groups were described in terms of bibliometric indicators of activity and visibility.Results
Ninety-three groups made up of 772 different authors were identified from an initial subset of 6540 publications on cardio-cerebrovascular research. The groups we identified came mainly from the healthcare sector and the universities and were mostly located in the autonomous regions of Catalonia and the Community of Madrid. The scientific production attributable to the groups presented indicators of visibility above the mean for biomedicine.Conclusions
Collaboration between the healthcare sector and the universities dominated cardio-cerebrovascular research, although international collaboration rates were poor, standing at levels below the mean for biomedicine.Full English text available from:www.revespcardiol.org 相似文献4.
Joan Antoni Gómez-Hospital Paolo Domenico DallaglioJose Carlos Sánchez-Salado Albert ArizaSilvia Homs Victoria LorenteJose Luis Ferreiro Josep Gomez-LaraRafael Romaguera Joel Salazar-MendiguchíaLuis Teruel Ángel Cequier 《Revista espa?ola de cardiología》2012
Introduction and objectives
A standardized protocol of emergent transfer for primary percutaneous coronary intervention for patients with ST elevation myocardial infarction, defined as the Infarction Code, was implemented in June 2009 in the Catalan regional health system. The objective of this study was to evaluate the impact of the new protocol on delay times, number of procedures and clinical characteristics compared with the previous period in the population of patients referred to our hospital.Methods
All consecutive patients undergoing primary percutaneous coronary intervention in our hospital were prospectively registered. The clinical characteristics, delay times and mortality in the follow-up of the protocol implementation period (June 2009-May 2010) were analyzed and compared with the previous year (June 2008-May 2009).Results
During the protocol period, 514 patients were included, compared with 241 in the previous year. Age, cardiovascular risk factors, anterior myocardial infarction and procedure characteristics were similar in the 2 groups. The first medical contact to balloon time was lower in the protocol period (median time 120 min vs 88 min; P<.001). Patients in the protocol period showed a trend toward less severe disease (Killip III, rescue angioplasty). The multivariate regression analysis showed a significant association between 1-year mortality and age, Killip class≥ III at admission, anterior infarction and 3-vessel disease.Conclusions
The introduction of the Infarction Code program increased the number of patients treated by primary percutaneous coronary intervention with a reduction in delay times and better clinical characteristics at presentation.Full English text available from:www.revespcardiol.org 相似文献5.
Factors associated with hospital admission for exacerbation of chronic obstructive pulmonary disease
Alcázar B García-Polo C Herrejón A Ruiz LA de Miguel J Ros JA García-Sidro P Conde GT López-Campos JL Martínez C Costán J Bonnin M Mayoralas S Miravitlles M 《Archivos de bronconeumología》2012,48(3):70-76
Introduction
Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) that require hospital admission have a major impact on the progression of disease and generate high health costs.Method
A multi-center, cross-sectional, observational, study was conducted with the aim to identify factors associated with hospital admission in patients with COPD. We obtained data of socio-demographic and anthropometric characteristics, quality of life, respiratory symptoms, anxiety and depression, physical activity and pulmonary function tests. We analyzed their association with hospital admission with a multivariate analysis using a logistic regression model.Results
We analyzed 127 patients, 50 (39%) of whom had been hospitalized. 93.7% were men, mean age 67 years (SD = 9) and a FEV1 of 41.9% (SD = 15.3). In the first model obtained, the baseline SpO2, the BODE index and emergency room (ER) visits were associated with hospital admission and the area under the ROC curve (AUC) was 0.809. In a second model we included only variables readily available (without the 6 minutes walking test) and only the SpO2 and previous visits to the ER weresignificant with an AUC ROC 0.783.Conclusions
hospital admission for exacerbation of COPD is associated with poor SpO2, higher BODE index score and a greater number of visits to the ER. In case you do not have the 6 minutes walking test, the other two variables offer a similar discriminative ability. 相似文献6.
Juan Jiménez-Jáimez Miguel Álvarez María Algarra Rosa Macías Ruíz Rocío Peñas Francisca Valverde Gustavo Tortajada Jose Antonio Lorente Rafael Melgares Luis Tercedor 《Revista espa?ola de cardiología》2013
Introduction and objectives
Cardiac channelopathies are genetic alterations that can cause sudden death. Long QT syndrome and Brugada syndrome are 2 such conditions. Both are diagnosed according to previously published criteria. Our objective was to determine the sensitivity of these criteria in a consecutive series of patients carrying the mutations that cause them.Methods
We enrolled 15 families and 31 causal mutation carriers with a high pathogenic probability of having long QT syndrome and Brugada syndrome. We conducted clinical and electrocardiographic studies to analyze the extent to which these patients fulfilled the diagnostic criteria. Statistical analysis was with SPSS 17.0.Results
Some 48.3% of the subjects met the criteria indicating a high probability of long QT syndrome or Brugada syndrome. Among those with the mutation for long QT syndrome, only 10 out of 21 had a Schwartz index score≥4. Both the median Schwartz score and the cQT interval were lower in relatives than in probands. Of those with the mutation for Brugada syndrome, 60% failed to meet current diagnostic criteria, which were more frequently fulfilled in relatives. Pharmacological tests with epinephrine and flecainide helped establish the diagnosis in 2 mutation carriers with negative phenotype.Conclusions
Current diagnostic criteria for long QT syndrome and Brugada syndrome had low sensitivity in our sample of genetic carriers. Genetic tests supported by pharmacological tests can increase diagnostic sensitivity, especially in asymptomatic relatives.Full English text available from:www.revespcardiol.org 相似文献7.
Ferran Poveda Debora Gil Enric Martí Albert Andaluz Manel Ballester Francesc Carreras 《Revista espa?ola de cardiología》2013
Introduction and objectives
Deeper understanding of the myocardial structure linking the morphology and function of the heart would unravel crucial knowledge for medical and surgical clinical procedures and studies. Several conceptual models of myocardial fiber organization have been proposed but the lack of an automatic and objective methodology prevented an agreement. We sought to deepen this knowledge through advanced computer graphical representations of the myocardial fiber architecture by diffusion tensor magnetic resonance imaging.Methods
We performed automatic tractography reconstruction of unsegmented diffusion tensor magnetic resonance imaging datasets of canine heart from the public database of the Johns Hopkins University. Full-scale tractographies have been built with 200 seeds and are composed by streamlines computed on the vector field of primary eigenvectors at the diffusion tensor volumes. We also introduced a novel multiscale visualization technique in order to obtain a simplified tractography. This methodology retains the main geometric features of the fiber tracts, making it easier to decipher the main properties of the architectural organization of the heart.Results
Output analysis of our tractographic representations showed exact correlation with low-level details of myocardial architecture, but also with the more abstract conceptualization of a continuous helical ventricular myocardial fiber array.Conclusions
Objective analysis of myocardial architecture by an automated method, including the entire myocardium and using several 3-dimensional levels of complexity, reveals a continuous helical myocardial fiber arrangement of both right and left ventricles, supporting the anatomical model of the helical ventricular myocardial band described by F. Torrent-Guasp.Full English text available from:www.revespcardiol.org/en 相似文献8.
Estornell-Erill J Igual-Muñoz B Monmeneu-Menadas JV Soriano-Navarro C Valle-Muñoz A Vilar-Herrero JV Perez-Bosca L Paya-Serrano R Martinez-Alzamora N Ridocci-Soriano F 《Revista espa?ola de cardiología》2012,65(6):517-524
Introduction and objectives
To evaluate the capability of multidetector computed tomography to diagnose the coronary etiology of left ventricular dysfunction compared with using invasive coronary angiography and magnetic resonance.Methods
Forty consecutive patients with left ventricular dysfunction of uncertain etiology underwent invasive coronary angiography and contrast magnetic resonance. All patients were evaluated with multidetector computed tomography including coronary calcium presence and score, noninvasive coronary angiography, and myocardial tissue assessment.Results
The sensitivity and specificity of the presence of coronary calcium to identify left ventricular dysfunction was 100% and 31%, respectively. If an Agatston calcium score of >100 is taken, specificity increases to 58% with sensitivity still 100%. Sensitivity and specificity for coronary angiography by multidetector computed tomography was 100% and 96%, respectively; for identifying necrosis in contrast acquisition it was 57% and 100%, respectively; and in late acquisition, 84% and 96%, respectively. To identify coronary ventricular dysfunction with necrosis, the sensitivity and specificity was 92% and 100%, respectively.Conclusions
Of all the diagnostic tools available in multidetector computed tomography, coronary angiography is the most accurate in determining the coronary origin of left ventricular dysfunction. A combination of coronary angiography and myocardial tissue study after contrast allows a single test to obtain similar information compared with the combination of invasive coronary angiography and contrast magnetic resonance.Full English text available from:www.revespcardiol.org 相似文献9.
A. Corvol F. Balard G. Moutel D. Somme 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2014
Purpose
Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals’ attitudes and ethical challenges.Methods
Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers.Results
Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits.Conclusion
To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. 相似文献10.
Rodríguez De Miguel C Serradesanferm A Del Manzano S Cárdenas A Fernández-Esparrach G Ginés A Ricart E Sendino O González-Suárez B López-Cerón M Llach J Grau J Castells A Pellisé M 《Gastroenterologia y hepatologia》2012,35(4):236-242
Introduction
The quality and tolerability of antegrade gut lavage bowel preparation are key elements in the success of population-based colorectal cancer screening.Objectives
To evaluate cleansing quality and tolerability according to the timing of polyethylene glycol administration in persons undergoing colorectal cancer screening.Method
Participants in colorectal cancer screening were randomized to two groups: a) control group (colonoscopy scheduled at 9-12 h); preparation with polyethylene glycol on the previous afternoon; b) study group (colonoscopy scheduled at 12-15 h): preparation with polyethylene glycol on the morning of the colonoscopy, with the option of a split dose. The quality of cleansing was evaluated with the Boston scale and tolerability through a questionnaire.Results
A total of 282 participants were included: preparation was carried out the day before the procedure in 134 and on the same day in 148, of which 26 received a split dose. Cleansing was adequate in 95% (n = 268) of the participants. The quality of cleansing was higher in the study group (P = .045). The interval between the end of administration and the beginning of the procedure was inversely correlated with the Boston scale score (P = .036; r = −0.125). Tolerability was unrelated to the time of administration (P > .2). Acceptance of the timing of administration was lower in the study group than in the control group (26% vs 10%, respectively; P = .001).Conclusions
Preparation as close as possible to the colonoscopy improves the quality of cleansing with no detrimental effects on tolerability, although this option is less comfortable. 相似文献11.
Isabel Blanco Claudio Villaquirán José Luis ValeraMaría Molina-Molina Antoni XaubetRobert Rodríguez-Roisin Joan A. BarberàJosep Roca 《Archivos de bronconeumología》2010
Introduction
The six-minute walk test (6MWT) is widely used in evaluating diffuse interstitial lung disease (ILD) and pulmonary hypertension (PH). However, their physiological determining factors have not been well defined.Objective
To evaluate the physiological changes that occur in ILD and PH during the 6MWT, and compare them with the cardiopulmonary exercise test (CPET).Material and methods
Thirteen patients with ILD and 14 with PH were studied using the 6MWT and CPET on an ergometer cycle. The respiratory variables were recorded by means of telemetry during the 6MWT.Results
Oxygen consumption (VO2), respiratory and heart rate reached a plateau from minute 3 of the 6MWT in both diseases. The VO2 did not differ from the peak value in the CPET (14±2 and 15±2 ml/kg/min, respectively, in ILD; 16±6 and 16±6 ml/kg/min, in PH). The arterial oxygen saturation decreased in both diseases, although it was more marked in ILD (−12±5%, p<0,01). The ventilatory equivalent for CO2 (VE/VCO2) in PH during the 6MWT was strongly associated with functional class (FC) (85±14 in FC III-IV, 44±6 in FC I-II; p<0,001).Conclusions
The 6MWT in ILD and PH behaves like a maximal effort test, with similar VO2 to the CPET, demonstrating a limit in oxygen transport capacity. Monitoring using telemetry during the 6MWT may be useful for the clinical evaluation of patients with ILD or PH. 相似文献12.
Pilar Merlos Maria P. López-Lereu Jose V. Monmeneu Juan Sanchis Julio Núñez Clara Bonanad Ernesto Valero Gema Miñana Fabián Chaustre Cristina Gómez Ricardo Oltra Lorena Palacios Maria J. Bosch Vicente Navarro Angel Llácer Francisco J. Chorro Vicente Bodí 《Revista espa?ola de cardiología》2013
Introduction and objectives
A variety of cardiac magnetic resonance indexes predict mid-term prognosis in ST-segment elevation myocardial infarction patients. The extent of transmural necrosis permits simple and accurate prediction of systolic recovery. However, its long-term prognostic value beyond a comprehensive clinical and cardiac magnetic resonance evaluation is unknown. We hypothesized that a simple semiquantitative assessment of the extent of transmural necrosis is the best resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction.Methods
One week after a first ST-segment elevation myocardial infarction we carried out a comprehensive quantification of several resonance parameters in 206 consecutive patients. A semiquantitative assessment (altered number of segments in the 17-segment model) of edema, baseline and post-dobutamine wall motion abnormalities, first pass perfusion, microvascular obstruction, and the extent of transmural necrosis was also performed.Results
During follow-up (median 51 months), 29 patients suffered a major adverse cardiac event (8 cardiac deaths, 11 nonfatal myocardial infarctions, and 10 readmissions for heart failure). Major cardiac events were associated with more severely altered quantitative and semiquantitative resonance indexes. After a comprehensive multivariate adjustment, the extent of transmural necrosis was the only resonance index independently related to the major cardiac event rate (hazard ratio=1.34 [1.19-1.51] per each additional segment displaying >50% transmural necrosis, P<.001).Conclusions
A simple and non-time consuming semiquantitative analysis of the extent of transmural necrosis is the most powerful cardiac magnetic resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction.Full English text available from: www.revespcardiol.org/en 相似文献13.
Antonio Ríos Ana López-Navas Marco Ayala-García María José Sebastián Anselmo Abdo-Cuza Laura Martínez-Alarcón Ector Jaime Ramírez Gerardo Muñoz Juliette Suárez-López Roberto Castellanos Beatriz González Miguel Ángel Martínez Ernesto Díaz Pablo Ramírez Pascual Parrilla 《Gastroenterologia y hepatologia》2012
Introduction
Hospital professionals are an opinion group that influences the general population.Objective
To analyze attitudes to living donor liver transplantation (LDLT) among non-medical professionals working in Spanish and Latin American hospitals and to determine the variables that influence these attitudes.Material and method
A random sample, stratified by department, was selected from non-medical staff in the “International Donor Collaborative Project”: there were three hospitals in Spain, five in Mexico and two in Cuba. Attitudes were evaluated through a validated, anonymous, self-administered questionnaire.Results
There were 951 non-medical professionals: 277 from Spain, 632 from Mexico and 42 from Cuba. A total of 86% (n = 818) were in favor of related living donation and 31% (n = 299) were in favor of unrelated living donation. This attitude was associated with the following: country (Mexico 88%, Cuba 83%, Spain 81%) (p =0.016), female sex (p =0.026), having experience of donation and transplantation (p =0.001), having a favorable attitude to donation (P <0.001), considering the possibility of needing a transplant (P <0.001), being in favor of living kidney donation (P <0.001), being willing to accept a transplant from a living donor if necessary (P <0.001), discussing donation and transplantation with the family and partner (P <0.001), carrying out pro-social activities (P <0.001), believing that one's religion was in favor of donation and transplantation (P<0.001), and not worrying about bodily mutilation after donation (P <0.001).Conclusions
Attitudes toward related LDLT among non-medical staff in various Spanish, Mexican and Cuban hospitals are favorable. In 86% of those surveyed, this attitude was not influenced by classical psychosocial factors. 相似文献14.
Marta Alvarez Estévez Natalia Chueca-PorcunaVicente Guillot-Suay Alejandro Peña-MonjeFernando García-García Federico García-García 《Enfermedades infecciosas y microbiología clínica》2013
Introduction
To know the prevalence of primary resistance in chronic hepatitis B naïve patients is essential to decide on the need of routine laboratory testing.Patients and methods
The genetic sequence of the HBV polymerase from 105 naïve patients was analysed.Results
rtV173L, a lamivudine compensatory mutation, was detected in two patients (1.9%), rtI233V in one patient, and another one carried the sG145R vaccine escape mutation.Conclusion
Our study shows that studying HBV resistance in naïve patients should not be recommended in the routine laboratory setting, for the time being 相似文献15.
Óscar Fabregat-Andrés Pilar García-González Alfonso Valle-Muñoz Jordi Estornell-Erill Leandro Pérez-Boscá Victor Palanca-Gil Rafael Payá-Serrano Aurelio Quesada-Dorador Salvador Morell Francisco Ridocci-Soriano 《Revista espa?ola de cardiología》2014
Introduction and objectives
Cardiac resynchronization therapy with a defibrillator prolongs survival and improves quality of life in advanced heart failure. Traditionally, patients with ejection fraction > 35% estimated by echocardiography have been excluded. We assessed the prognostic impact of this therapy in a group of patients with severely depressed systolic function as assessed by echocardiography but with an ejection fraction > 35% as assessed by cardiac magnetic resonance.Methods
We analyzed consecutive patients admitted for decompensated heart failure between 2004 and 2011. The patients were in functional class II-IV, with a QRS ≥ 120 ms, ejection fraction ≤ 35% estimated by echocardiography, and a cardiac magnetic resonance study. We included all patients (n = 103) who underwent device implantation for primary prevention. Ventricular arrhythmia, all-cause mortality and readmission for heart failure were considered major cardiac events. The patients were divided into 2 groups according to systolic function assessed by magnetic resonance.Results
The 2 groups showed similar improvements in functional class and ejection fraction at 6 months. We found a nonsignificant trend toward a higher risk of all-cause mortality in patients with systolic function ≤ 35% at long-term follow-up. The presence of a pattern of necrosis identified patients with a worse prognosis for ventricular arrhythmias and mortality in both groups.Conclusions
We conclude that cardiac resynchronization therapy with a defibrillator leads to a similar clinical benefit in patients with an ejection fraction ≤ 35% or > 35% estimated by cardiac magnetic resonance. Analysis of the pattern of late gadolinium enhancement provides additional information on arrhythmic risk and long-term prognosis.Full English text available from:www.revespcardiol.org/en 相似文献16.
Vázquez M Santos E Rodriguez I Pato A Vilar M Arias JC Fernández R Costas I Ghioldi A Sanmartin M Tardáguila F 《Revista espa?ola de cardiología》2012,65(2):139-142
Introduction and objectives
To study electrical cardioversion in patients with atrial fibrillation as a potential cause of acute ischemic brain lesions.Methods
We performed prospective analysis of 62 consecutive patients (62 [10] years, 16 female). All of them were anticoagulated for at least 3 weeks with an international normalized ratio of 2.69 (0.66). In all cases a magnetic resonance imaging of the brain was performed before and 24 h after the cardioversion, including diffusion-weighted sequences. A neurological exploration was also performed before and after the procedure, using the modified Ictus on the National Institute of Health Stroke Scale and the modified Rankin scale. Written informed consent was obtained in all cases.Results
Of the 62 patients, 51 (85%) reverted to sinus rhythm. The neurological examination showed no changes after cardioversion. The pre-procedure magnetic resonance imaging showed microvascular disease in 35 (56%), including 2 patients with known cerebrovascular disease, and did not depict new clinically silent ischemic areas after cardioversion.Conclusions
After electrical cardioversion no acute ischemic lesions in the brain nor alteration in the neurological scales were found. Nevertheless, in 35 patients (56%) with persistent atrial fibrillation, the magnetic resonance imaging showed clinically silent ischemic lesions.Full English text available from:www.revespcardiol.org 相似文献17.
Gemma Cuberas-Borrós Victor Pineda Santiago Aguadé-Bruix Guillermo Romero-Farina M. Nazarena Pizzi Gustavo de León Joan Castell-Conesa David García-Dorado Jaume Candell-Riera 《Revista espa?ola de cardiología》2013
Introduction and objectives
The aim of this study was to compare magnetic resonance and gated-SPECT myocardial perfusion imaging in patients with chronic myocardial infarction.Methods
Magnetic resonance imaging and gated-SPECT were performed in 104 patients (mean age, 61 [12] years; 87.5% male) with a previous infarction. Left ventricular volumes and ejection fraction and classic late gadolinium enhancement viability criteria (<75% transmurality) were correlated with those of SPECT (uptake >50%) in the 17 segments of the left ventricle. Motion, thickening, and ischemia on gated-SPECT were analyzed in segments showing nonviable tissue or equivocal enhancement features (50%-75% transmurality).Results
A good correlation was observed between the 2 techniques for volumes, ejection fraction (P<.05), and estimated necrotic mass (P<.01). In total, 82 of 264 segments (31%) with >75% enhancement had >50% SPECT uptake. Of the 106 equivocal segments (50%-75% enhancement) on magnetic resonance imaging, 68 (64%) had >50% uptake, 41 (38.7%) had normal motion, 46 (43.4%) had normal thickening, and 17 (16%) had ischemic criteria on SPECT.Conclusions
A third of nonviable segments on magnetic resonance imaging showed >50% uptake on SPECT. Gated-SPECT can be useful in the analysis of motion, thickening, and ischemic criteria in segments with questionable viability on magnetic resonance imaging.Full English text available from:www.revespcardiol.org/en 相似文献18.
Laura García-Jurado Itziar Oyagüez Miguel Ángel Casado Cristina Tural Juan González-García Enrique Ortega Juan Antonio Pineda 《Enfermedades infecciosas y microbiología clínica》2012
Introduction
The assessment of liver fibrosis is crucial for taking therapeutic decisions in patients infected with HIV/AIDS coinfected with HCV, because it allows the prognosis of the disease and the prioritization of hepatitis C treatment in these patients.Methods
A discrete events model simulation (DEMS) and a Markov model have been developed to represent the evolution of liver fibrosis to cirrhosis in patients coinfected with HIV/HVC. The model evaluated two alternatives for the diagnosis and monitoring of these patients, transient elastography performed annually and liver biopsy performed every seven years. The models have been developed under Health Care System perspective and only considered direct medical costs (disease treatment and health state costs). One-way sensitivity analyses were carried out to assess the impact of parameters with higher uncertainty. A discount rate of 3% was applied.Results
Base case analysis shows that the diagnosis and monitoring of patients with transient elastography is a dominant strategy compared with to liver biopsy, resulting in greater life expectancy at lower cost. The sensitivity analysis performed confirmed the robustness of these results.Conclusion
Transient elastography has proved to be a dominant strategy compared to liver biopsy in the diagnosis and monitoring of liver fibrosis in patients coinfected with HIV/HCV in Spain. 相似文献19.
María José Muñoz-Vilches Joaquín Salas Teresa Cabezas David Metz José Vázquez Manuel Jesús Soriano 《Enfermedades infecciosas y microbiología clínica》2012
Introduction
The transmission of Chagas disease is a public health problem in non-endemic countries.Methods
Chagas screening was performed by two serological tests in pregnant women from endemic areas for 4 years.Results
We studied 261 pregnant women from 13 Latin American countries, making a confirmatory diagnosis (two positive tests) in 4 cases. There was no case of vertical transmission.Conclusion
Although Chagas disease has a low prevalence in the province of Almeria, the screening is necessary for the detection and treatment of infants with the disease. 相似文献20.
Mercedes Delgado-Valverde Pedro Fernández-Echauri Nínive Batista-Díaz Álvaro Pascual-Hernández 《Enfermedades infecciosas y microbiología clínica》2014