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Sample records for angina inestable como

  1. Ectasia coronaria, angina inestable e insuficiencia aórtica

    Directory of Open Access Journals (Sweden)

    Róger A Lanzas Rodríguez

    2009-12-01

    Full Text Available Se presenta el caso de una paciente femenina de 79 años, conocida portadora de cardiopatía hipertensiva, insuficiencia aórtica y dislipidemia, que se hospitalizó con un síndrome coronario agudo. Durante su evolución presentó cambios electrocardiográficos de isquemia subepicardica anterior extensa e inferior, por lo que se le realizó una coronariografia selectiva bilateral, detectándose ectasia de la arteria coronaria derecha, con flujo lento y retención del medio de contraste. Se refirió el caso para cirugía de reemplazo valvular.Coronary artery ectasia, unstable angina and aortic insufficiency The case of a 79 year old female patient, who was hospitalized with acute coronary syndrome (ACS, is presented. She had known hypertensive heart disease, aortic insufficiency and dyslipidemia. During the evolution of her ACS, she presented electrocardiographic changes of ischemia. Selective coronary angiography detected ectasia of the right coronary artery with slow flow and retention of contrast medium. The patient was referred for aortic valve replacement surgery.

  2. Variabilidad de la frecuencia cardíaca en pacientes con angina inestable: correlación con otros marcadores pronósticos

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    Oswaldo Gutiérrez Sotelo

    2004-01-01

    Full Text Available Introducción: La importancia del análisis de la variabilidad de la frecuencia cardíaca (VFC está bien establecida como marcador pronóstico en pacientes que han tenido infarto agudo de miocardio y en otras cardiopatías. El objetivo de este estudio es establecer la correlación entre las variables de VFC y los índices pronósticos tradicionales en angina inestable Materiales y Métodos: Se reclutaron prospectivamente pacientes con diagnóstico de angina inestable. Se consignaron indicadores de riesgo cardiovascular clínicos (angor de reposo refractario, hipotensión arterial, insuficiencia cardíaca, presencia de cambios dinámicos en el ST-T, fracción de eyección =40% y los hallazgos angiográficos (2 ó más vasos, conformándose entonces dos grupos, de alto riesgo y de bajo riesgo. A todos los pacientes se les realizó un registro electrocardiográfico de 5 minutos y se analizaron diversas variables de VFC en dominio de tiempo y de frecuencia mediante un programa de computadora. Estas variables se compararon entre ambos grupos. Resultados: Se reclutaron 63 pacientes (44 hombres, 70% con edad promedio de 63 + 10.4 años (35-90; 46 se consideraron de alto riesgo por cambios electrocardiográficos dinámicos y la fracción de eyección disminuida y 17 de bajo riesgo. En el primer grupo, el poder espectral total fue significativamente menor que en el grupo de bajo riesgo (p=0.04. La banda de baja frecuencia mostró diferencia pero sin alcanzar significancia estadística (p=0.07 y otras variables como el SDNN, el NN50 y la banda de baja frecuencia, mostraron sólo tendencia de ser menores en el grupo de alto riesgo. Conclusión: En pacientes con angina inestable de alto riesgo, la presencia de indicadores pronósticos tiene correlación con una menor VFC en dominio de frecuencia.Introduction: The usefullness of heart rate variability (HRV analysis is well known in myocardial infarction as in other cardiac diseases as a prognostic tool. The

  3. Analgesia epidural torácica para el tratamiento de la angina inestable Thoracal epidural analgesia for the management of unstable angina

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    M. Castro

    2005-07-01

    Full Text Available La miocardiopatía isquémica en pacientes con angina inestable refractaria al tratamiento médico constituye un escenario clínico complicado. Una anatomía desfavorable o un riesgo quirúrgico excesivamente alto pueden desaconsejar la realización de una angioplastia o de una cirugía de derivación coronaria. En este artículo se pretende revisar la utilización de la analgesia/anestesia epidural torácica para el tratamiento y estabilización de este tipo de pacientes, a través de una breve descripción de la fisiopatología de la isquemia cardiaca, estudios experimentales en animales y humanos, uso en cirugía cardiaca y efectos secundarios.Ischemic cardiomyopathy in patients with unstable angina refractory to medical therapy is a difficult medical condition. Unfavorable anatomy or excessive surgical risk can advise against the performance of angioplasty or coronary bypass surgery. This study has reviewed the use of thoracal epidural analgesia/anesthesia for the management and stabilization of this type of patients, with a brief description of the physiopathology of cardiac ischemia, experimental studies in animals and human beings, use of cardiac surgery and side effects.

  4. Diferencias en las características clínicas y en la evolución intrahospitalaria entre la angina inestable primaria y secundaria en ancianos

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    Giorgi, Mariano A; Andrés Ahuad Guerrero; Pablo Schygiel; Fernando Sokn; Guillermo Suárez; Jorge E. Trongé

    2007-01-01

    IntroducciónLa angina inestable (AI) se clasifica en primaria (AP) y secundaria (AS) sobre la base de la presencia o no de causas secundarias de isquemia. Estas condiciones son frecuentes en los ancianos y podrían influir en su pronóstico.ObjetivoEl presente trabajo se llevó a cabo con el objetivo de evaluar las características clínicas y la evolución intrahospitalaria de ancianos con AI primaria y secundaria.Material y métodosSe registraron 298 ancianos (edad ≥ 75 años) con diagnóstico final...

  5. Diferencias en las características clínicas y en la evolución intrahospitalaria entre la angina inestable primaria y secundaria en ancianos

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    Mariano A. Giorgi

    2007-01-01

    Full Text Available IntroducciónLa angina inestable (AI se clasifica en primaria (AP y secundaria (AS sobre la base de la presencia o no de causas secundarias de isquemia. Estas condiciones son frecuentes en los ancianos y podrían influir en su pronóstico.ObjetivoEl presente trabajo se llevó a cabo con el objetivo de evaluar las características clínicas y la evolución intrahospitalaria de ancianos con AI primaria y secundaria.Material y métodosSe registraron 298 ancianos (edad ≥ 75 años con diagnóstico final de AI. La muestra se dividió, según la presencia de causas secundarias de isquemia (anemia, taquicardia, hipertensión no controlada, infección, hipertiroidismo, en dos grupos: AS y AP. Secompararon antecedentes, características clínicas al ingreso, tratamientos, procedimientos y la ocurrencia de muerte y muerte o infarto en la fase intrahospitalaria. Se identificaronpredictores univariados de mala evolución.ResultadosCincuenta y dos pacientes (17,45% tenían AS y 246 (82,5% padecían AP. Los pacientes con AS eran más añosos y tenían mayores registros de tensión arterial y de frecuencia cardíaca al ingreso. El tratamiento médico, la cinecoronariografía y la revascularización se utilizaron menos en el grupo AS. La mortalidad (7,7% versus 6,9% [p = 1,00; OR (IC 95 = 1,12 (0,36-3,48] AS y AP, respectivamente y la combinación de muerte o infarto (7,7% versus 9,7%[p = 0,79; OR (CI 95 = 0,77 (0,25-2,32] AS y AP, respectivamente fueron similares. Los predictores univariados de muerte o infarto fueron infradesnivel del ST y desarrollo de insuficiencia cardíaca para ambos grupos y la refractariedad y necesidad de coronariografía y revascularización para el grupo AP. ConclusiónLa AS es una causa común de isquemia en los ancianos y, pese a que requiere un manejo diferente, orientado a su etiología, tiene un pronóstico similar al de la AP.

  6. Comparação de biomarcadores inflamatórios entre pacientes diabéticos e não-diabéticos com angina instável Comparación de biomarcadores inflamatorios entre pacientes diabéticos y no-diabéticos con angina inestable Comparison of inflammatory biomarkers between diabetic and non-diabetic patients with unstable angina

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    Marçal de Oliveira Huoya

    2009-04-01

    concentração de marcadores inflamatórios de fase aguda, independentemente do estado metabólico.FUNDAMENTO: Pocos estudios compararon la actividad inflamatoria entre pacientes diabéticos y no-diabéticos con síndrome coronario agudo, y todavía no se publicó ninguno que investigara solamente a los portadores de angina inestable (AI. OBJETIVO: Este estudio tuvo dos objetivos. En primer lugar, comparar los niveles séricos de proteína C reactiva (PCR y interleuquina-6 (IL-6 en pacientes diabéticos y no-diabéticos con angina inestable (AI para determinar si la diferencia en la actividad inflamatoria justifica el empeoramiento pronóstico en los pacientes diabéticos. En segundo, evaluar la correlación entre los marcadores inflamatorios y el perfil metabólico en pacientes diabéticos y entre la respuesta inflamatoria y los desenlaces hospitalarios, como muerte, infarto agudo de miocardio, insuficiencia cardiaca congestiva y tiempo de hospitalización. MÉTODOS: Estudio de cohorte prospectiva de 90 pacientes consecutivos, ingresados a la Unidad de Dolor Torácico con angina inestable. Se dividieron a los pacientes en dos grupos: diabéticos y no-diabéticos. Los niveles séricos de PCR e IL-6, el perfil metabólico y el conteo de leucocitos se obtuvieron al ingreso al hospital. RESULTADOS: De todos los pacientes analizados, 42 (47% eran diabéticos (edad 62 ± 9 y 48 (53% no eran diabéticos (edad 63 ± 12. No se encontraron diferencias entre la mediana de la PCR (1,78 vs. 2,23 mg/l, p = 0,74 y de la IL-6 (0 vs. 0 pg/ml, p = 0,31 entre los dos grupos. Hubo una correlación positiva entre la PCR y el colesterol total (rs = 0, 21, p = 0, 05, la PCR y el colesterol LDL (rs = 0,22, p = 0,04 y la PCR y el conteo de leucocitos (rs = 0,32, p = 0,02 en los dos grupos. No se encontró ninguna asociación entre los marcadores inflamatorios y los desenlaces hospitalarios. CONCLUSIÓN: No encontramos diferencia en la actividad inflamatoria entre los pacientes diabéticos y no

  7. Ecuador: una democracia inestable

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    Juan J. Paz y Miño Cepeda

    2009-12-01

    Full Text Available En 1979, tras una década de dictaduras militares, se inició la fase constitucional más larga en la historia del Ecuador. Ésta se levantó sobre las herencias del pasado y se caracterizó, de manera fundamental, por el tránsito desde un modelo estatal-desarrollista hacia uno de tipo empresarial, por el aparecimiento de nuevos agentes sociales, el multipartidismo político, la regionalización nacional, la presencia multicultural y la inserción del país en nuevas relaciones internacionales. Pero esos procesos trajeron como consecuencias centrales: la edificación de una economía inequitativa, una sociedad tensionada, la desestructuración institucional, la precarización del trabajo y la debilidad con la que la nación ha enfrentado el nuevo mundo unipolar. Todo ello ha configurado un cuadro de riesgos para la incipiente democracia. El Ecuador contemporáneo tiene, por tanto, una serie de desafíos económicos, sociales y políticos para escapar a la inestabilidad que ha acompañado a la construcción de su modernización democrática.___________________ABSTRACT:In 1979, after one decade of military dictatorships, the longest constitutional phase in the history of Ecuador was initiated. It was built upon the inheritance of the past and can be fundamentally characterized by the transition from a model that focused on the state as developing the economy (State-model to a model that focused on private business (enterprise-model. The appearance of new social agents, a multiparty system, national regionalization, multicultural presence and the country´s new international relationships are processes which show some important consequences: the establishment of an unequal economy, a society under tension, the breakdown of institutional structures, the vulnerability of working conditions and the weakness with which the nation faced the new polarized world. All this might put into danger this incipient democracy. And this is why Ecuador in these

  8. Estudio de eficacia y coste en la electroestimulación medular como tratamiento de la angina refractaria Cost-effectiveness study of medullary electrostimulation for the management of refractory angina

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    M. Mayo

    2004-07-01

    Full Text Available Objetivo: Valorar la evolución de los pacientes, de nuestro hospital, diagnosticados de angina refractaria y tratada con estimulación eléctrica medular (EEM cervical desde 1994-2002, además de valorar los costes asociados a dicho tratamiento y su relación coste/beneficio. Material y métodos: Estudio retrospectivo de 12 pacientes observando su evolución a lo largo de 8 años con controles clínicos periódicos, objetivándose tanto en la historia previa como posterior al implante, las siguientes variables: fracción de eyección del ventrículo izquierdo (FEVI, estadio funcional NYHA, frecuencia de ingresos hospitalarios, frecuencia de episodios anginosos e ingesta de cafinitrinas, sensación subjetiva de mejora del dolor anginoso, exitus, costes hospitalarios previos y posteriores a la colocación del EEM. Resultados: El electrodo de EEM fue implantado a nivel cervical siendo más frecuente la localización C2-C3 (58,3%. No se presentó ninguna complicación intraoperatoria. En el postoperatorio inmediato tuvimos como única complicación un desplazamiento del electrodo. No hubo ninguna complicación a largo plazo. Comprobamos que existió una disminución del número de anginas por semana (14 vs 4 p = 0,005 asociada a una disminución del número de tomas de nitroglicerina de acción rápida (15,7 vs 3,8 p = 0,002 y a una disminución en el número de ingresos hospitalarios/año (2,62 vs 0,84 p = 0,003. La mejoría subjetiva por parte del paciente tras la colocación del neuroestimulador fue del 70%. En cuanto al coste hospitalario quinquenal (conformado sólo por el coste del ingreso sin pruebas complementarias fue de 37.921,85 e en los pacientes con angina refractaria que no portaban EEM, frente a los 15.150,25 € de los pacientes portadores EEM.Objective: To assess the evolution of patients in our hospital with diagnosis of refractory angina treated with cervical medul-lary electrostimulation (MES over the period 1994-2002, and to

  9. Stable angina

    Science.gov (United States)

    ... include: Coronary angiography Blood cholesterol profile ECG Exercise tolerance test (stress test or treadmill test) Nuclear medicine ( ... PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Angina Browse the Encyclopedia ...

  10. Unstable angina

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    ... pressure High LDL cholesterol Low HDL cholesterol Male gender Sedentary lifestyle (not getting enough exercise) Obesity Older ... Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your health ...

  11. Efectos del entrenamiento en superficies inestables sobre el equilibrio y funcionalidad en adultos mayores

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    Juan C. López S

    2015-02-01

    Full Text Available Objetivo: determinar los efectos de un programa de ocho semanas de entrenamiento en superficies inestables con y sin trabajo de fuerza, sobre el equilibrio y la capacidad funcional en adultos mayores de 60 años, pertenecientes al programa “Escuelas populares del deporte” del inder Medellín. Metodología: se llevó a cabo un estudio experimental simple, ciego y enmascarado con asignación al azar de 34 sujetos a dos grupos de intervención con y sin trabajo de fuerza sobre superficies inestables; se midió el equilibrio unipodal, bipodal con ojos abiertos y cerrados, además de pruebas funcionales como Up and Go, arm curl y chair test. Resultados: las intervenciones con y sin trabajo de fuerza mejoraron el equilibrio total en 57,0 y 69,5 segundos respectivamente, sin diferencias estadísticamente significativas en la comparación entre los grupos (p = 0,13. Se mejoró la velocidad de la marcha con ambas intervenciones sin diferencias intragrupos estadísticamente significativas (p = 0,33 pero importantes para la práctica. Conclusión: ambas intervenciones mejoran el equilibrio, sin embargo existen diferencias importantes para la práctica a favor del programa sobre superficies inestables sin trabajo de fuerza, pues la intervención tiene un mejor efecto sobre el equilibrio unipodal y bipodal tanto con ojos abiertos como con cerrados.

  12. Terapia celular associada à revascularização transmiocárdica laser como proposta no tratamento da angina refratária Cell therapy plus transmyocardial laser revascularization: a proposed alternative procedure for refractory angina

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    Luís Alberto Oliveira Dallan

    2008-03-01

    Full Text Available OBJETIVO: É descrita uma proposição cirúrgica para o tratamento de pacientes com doença arterial coronária (DAC terminal, não mais passíveis de revascularização miocárdica convencional. Constitui-se na revascularização transmiocárdica com raios laser (RTML, associada ao emprego de células progenitoras hematopoiéticas autólogas (CPH. MÉTODOS: Nove pacientes (oito homens, 65±5 anos, com as características supracitadas foram submetidos ao procedimento combinado. Além da avaliação clínica, o protocolo incluiu o estudo da perfusão miocárdica através da ressonância cardíaca (RMC sob estresse farmacológico, antes e seis meses após a intervenção cirúrgica. Procedeuse à RMTL através de minitoracotomia esquerda e utilização de laser de CO2, com média de 11±3 tiros por paciente. As CPH foram obtidas por punção medular, seguindo-se sua injeção direta (1,9±0,3x10(8 células/paciente em múltiplas áreas do miocárdio isquêmico. RESULTADOS: Não ocorreram óbitos ou complicações imediatas decorrentes dos procedimentos. Um paciente faleceu no segundo ano de pós-operatório, de causa não cardíaca (choque séptico. O seguimento clínico pós-operatório desses pacientes revelou redução significativa da classe funcional de angina de 3,7±0,2 para 1,3±0,2 (pOBJECTIVE: We tested the hypothesis that TMLR combined with intramyocardial injection of BMC is safe, and may help increase the functional capacity of patient with refractory angina. METHODS: Nine patients (eight men, 65±5 years old, with refractory angina for multivessel disease and previous myocardial revascularization procedures (CABG/PCI, not candidates for another procedure due to the extension of the disease were enrolled. TMLR (11±3 laser drills was performed via a limited thoracotomy using a CO2 Heart Laser System. BMC were obtained immediately prior to surgery, and the lymphomonocytic fraction separated by density gradient centrifugation. During

  13. Bloqueo de Ganglio Estrellado en el tratamiento de angina de pecho refractaria: un posible tratamiento coadyuvante

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    Isaías Salas Herrera

    2002-04-01

    Full Text Available El presente trabajo corresponde una revisión bibliográfica de los estudios clínicos realizados en síndromes anginosos refractarios al tratamiento convencional, utilizando como tratamiento el bloqueo de ganglio estrellado. Se realizó una búsqueda de literatura publicada entre los años 1.900 al 2.000 en las bases de datos MDConsult, Medline y ProQuest. A su vez se revisaron las publicaciones en la Biblioteca del Hospital Rafael Ángel Calderón Guardia y en la Biblioteca del BINASSS (Biblioteca Nacional de Salud del Seguro Social. De acuerdo a los estudios analizados el bloqueo de ganglio estrellado se describe como posibilidad terapéutica para el control de dolor de la angina de pecho refractaria . La descripción clásica de la inervación cardíaca consiste en tres nervios simpáticos mayores originados de los ganglios cervicales superior, medio e inferior. Esta inervación simpática en conjunto con diversos nervios parasimpáticos, se describen como el plexo cardíaco. En contraste Jane et. al. (1986 en un estudio anatómico de 23 cadáveres describe que la inervación cardiopulmonar en el hombre se origina en el ganglio estrellado y las mitades caudales de las cadenas simpáticas cervicales junto con nervios que se originan del nervio recurrente laríngeo o del vago. De estas estructuras derivan los dos plexos cardiopulmonares. De estos plexos derivan tres nervios cardíacos mayores que se proyectan hacia el corazón. Se estima que determinado porcentaje de los pacientes diagnosticados con angina inestable progresará a desarrollar una angina refractaria al tratamiento. El bloqueo de ganglio estrellado podría ser un nuevo método terapéutico para controlar el dolor de dicha condición. Sin embargo se necesitan estudios clínicos randomizados a doble ciego para obtener resultados concluyentes.

  14. Pharmacotherapy of Vasospastic Angina.

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    Harris, Justin R; Hale, Genevieve M; Dasari, Tarun W; Schwier, Nicholas C

    2016-09-01

    Vasospastic angina is a diagnosis of exclusion that manifests with signs and symptoms, which overlap with obstructive coronary artery disease, most often ST-segment elevation myocardial infarction. The pharmacotherapy that is available to treat vasospastic angina can help ameliorate angina symptoms. However, the etiology of vasospastic angina is ill-defined, making targeted pharmacotherapy difficult. Most patients receive pharmacotherapy that includes calcium channel blockers and/or long-acting nitrates. This article reviews the efficacy and safety of the pharmacotherapy used to treat vasospastic angina. High-dose calcium channel blockers possess the most evidence, with respect to decreasing angina incidence, frequency, and duration. However, not all patients respond to calcium channel blockers. Nitrates and/or alpha1-adrenergic receptor antagonists can be used in patients who respond poorly to calcium channel blockers. Albeit, evidence for use of nitrates and alpha1-adrenergic receptor antagonists in vasospastic angina is not as robust as calcium channel blockers and can exacerbate adverse effects when added to calcium channel blocker therapy. Despite having a clear benefit in patients with obstructive coronary artery disease, the benefit of beta-adrenergic receptor antagonists, statins, and aspirin remains unclear. More data are needed to elucidate whether or not these agents are beneficial or harmful to patients being treated for vasospastic angina. Overall, the use of pharmacotherapy for the treatment of vasospastic angina should be guided by patient-specific factors, such as tolerability, adverse effects, drug-drug, and drug-disease interactions. PMID:27081186

  15. Identificación de variables predictivas de riesgo en la evaluación incial de la angina inestable.

    OpenAIRE

    Rueda Soriano, Joaquín

    2005-01-01

    RESUMEN Objetivo: 1. Conocer el perfil clínico y electrocardiográfico de los pacientes ingresados con síndrome coronario agudo sin elevación persistente del segmento ST (SCASEST). 2. Incidencia de eventos adversos isquémicos intrahospitalarios. 3. Identificar las variables que obtenidas en el ingreso, sean predictivas de eventos adversos intrahospitalarios. 4. Analizar la incidencia de eventos adversos a largo plazo 5. Identificar las variables predictivas de eventos adversos isquémicos a ...

  16. Pharmacological approaches of refractory angina.

    Science.gov (United States)

    Giannopoulos, Andreas A; Giannoglou, George D; Chatzizisis, Yiannis S

    2016-07-01

    Refractory angina refers to a group of patients with stable coronary atherosclerotic disease and angina symptoms, unresponsive to traditional medical management, while considered to be suboptimal candidates for revascularization procedures. Up to 15% of angina patients are considered to have refractory angina and, taking into account the aging population and the improvements in the treatment of stable coronary artery disease, the incidence of this entity is expected to increase. This review describes traditional and novel pharmacotherapies for symptoms relief and for long-term management of refractory angina. Mechanisms of action and relevant clinical trials are discussed and current recommendations from major European and US cardiovascular societies are reported.

  17. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

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    Eduardo Contreras Zuniga

    2009-08-01

    Full Text Available Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacientes, é uma manifestação de distúrbio vasoespástico e está associado à migrânea, fenômeno de Raynaud ou asma induzida por aspirina. Apresentamos um caso associado com depressão transitória do segmento ST.Este síndrome es causado por un espasmo focal de una arteria coronaria epicárdica, llevando a isquemia miocárdica grave. Aunque frecuentemente se crea que el espasmo ocurra en arterias sin estenosis, muchos pacientes con angina de Prinzmetal presentan espasmo adyacente a placas ateromatosas. La causa exacta del espasmo no está bien definida, pero puede estar relacionada a la hipercontractilidad del músculo liso vascular debido a mitógenos vasoconstrictores, leucotrienos o serotonina. En algunos pacientes, es una manifestación de disturbio vasoespástico y está asociado a la migraña, fenómeno de Raynaud o asma inducida por aspirina. Presentamos un caso asociado con depresión transitoria del segmento ST.This syndrome is due to focal spasm of an epicardial coronary artery, leading to severe myocardial ischemia. Although it is frequently thought that the spasm occurs in arteries without stenosis, many Prinzmetal patients have spasm adjacent to atheromatous plaques. The exact cause of the spasm has not been well defined, but it may be related to the hypercontractility of the vascular smooth muscle due to vasoconstrictor mitogens, leukotrienes, or serotonin. In some patients, it is a manifestation of a vasospastic disorder and it

  18. Valor del BNP y de la proteína C reactiva en el diagnóstico diferencial entre angina primaria y secundaria por hipertensión arterial

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    Enrique P. Gurfinkel

    2006-01-01

    Full Text Available Introducción A los episodios de inestabilidad anginosa precipitados por causas secundarias que, no infrecuentemente, no pueden discernirse de razones primarias se les concede poca atención. El presente trabajo intenta responder si algunos biomarcadores pueden contribuir a identificar a aquellos individuos con angina IIIb de los conocidos como anginosos IIIa de la clasificación de Braunwald. Material y métodos En total, participaron del ensayo 64 pacientes seleccionados. De éstos, 33 tuvieron diagnóstico final de angina inestable secundaria a hipertensión arterial y 21 de angina primaria, en tanto que 10 enfermos anginosos estables, referidos para la práctica de un estudio angiográfico diagnóstico, sirvieron de control. En todos ellos, en el momento de la admisión se obtuvieron alícuotas de sangre venosa para la determinación del péptido natriurético auricular tipo B (BNP y de proteína C reactiva ultrasensible (hs-CRP, y luego se realizó un estudio angiográfico invasivo a fin de analizar la carga aterosclerótica con puntajes (scores angiográficos. Resultados Los pacientes con angina primaria tuvieron una extensión aterosclerótica mayor en la angiografía (p < 0,025, más vasos comprometidos (p = 0,029 y un porcentaje mayor de estenosis (p < 0,001 que los anginosos secundarios. Los pacientes controles presentaron valores de BNP de 133 pg/mL (41; 224 [mediana (percentiles 25 y 75] y de 1,6 mg/L (0,4; 3,6 de hs-CRP. Los anginosos primarios no difirieron de los controles: 129 (95; 231 y 4,0 (2,0; 5,6 para BNP y hs-CRP, respectivamente. Los anginosos secundarios tuvieron valores de 73 (19; 325 y de 4,5 (2,2; 9,0, respectivamente. No hubo diferencias significativas entre ambos cuadros anginosos: p = 0,458 para BNP y p = 0,552 para hs-CRP. Conclusiones Independientemente de la carga aterosclerótica elevada en los anginosos primarios, el BNP y la hs-CRP no reconocieron con precisión la inestabilidad clínica inducida por un

  19. Riesgo en la zona andina tropical por laderas inestables

    OpenAIRE

    Duque Escobar, Gonzalo

    2000-01-01

    Las presentes notas relacionadas con la definición de riesgo y amenaza, y la aplicación de estos conceptos para eventos como los relacionados con la inestabilidad de las vertientes, pueden tener importancia para las comunidades de la región andina. Este trabajo se ocupa de una de las amenazas más importantes del medio tropical andino: los deslizamientos de tierra vistos desde la óptica de los desastres naturales. Se definen los movimientos de masas. Luego se discuten los parámetros de la ines...

  20. Un sistema internacional inestable con dominio de los Estados Unidos

    Directory of Open Access Journals (Sweden)

    Pierre Gilhodes

    2004-11-01

    Full Text Available Con la imposición de la agenda única de terrorismo y la invasión a Iraq ¿se consolidó Estados Unidos como potencia mundial? o con el ascenso de China y los avances constitucionales europeos podríamos avanzar hacia una nueva división del mundo sobre bases diferentes de las de la Guerra Fría. En este caso ¿dónde se situaría AméricaLatina?

  1. How Can Angina Be Prevented?

    Science.gov (United States)

    ... changes and treating related conditions. Making Lifestyle Changes Healthy lifestyle choices can help prevent or delay angina and heart disease. To adopt a healthy lifestyle, you can: Quit smoking and avoid secondhand ...

  2. Mediastinite descendente necrosante pós-angina de Ludwig Necrotizing descending mediastinitis afetr Ludwig angina

    Directory of Open Access Journals (Sweden)

    MARICÉLIA BROMMELSTROET

    2001-09-01

    Full Text Available A angina de Ludwig é uma infecção do espaço submandibular originada, em geral, da infecção do 2º ou 3º molar inferior. Como conseqüência, pode causar mediastinite descendente necrosante, que representa uma forma grave e rara de infecção mediastinal, a qual exige diagnóstico precoce e tratamento cirúrgico para reduzir a alta mortalidade associada a esta doença. Dois casos de mediastinite descendente necrosante pós-angina de Ludwig foram tratados com excelentes resultados em nosso hospital. A drenagem mediastinal transcervical está justificada em pacientes com doença limitada ao mediastino superior. Porém, sepse com comprometimento extenso do mediastino requer drenagem através de toracotomia sem demora.Ludwig's angina is an infection of the submandibular space generally caused by an infection of the 2nd or 3rd lower molar. As a consequence, descending necrotizing mediastinitis, a rare and severe form of mediastinal infection, may occur. The descending necrotizing mediastinitis represents a rare form of mediastinal infection. It presents a high mortality and to decrease that rate it is necessary prompt diagnosis and surgical treatment. Two cases of descending necrotizing mediastinitis due to Ludwig's angina were treated with excellent results in our hospital. The transcervical mediastinal drainage is justified in patients with disease limited to the upper mediastinum. Even so, when there is extensive involvement of the whole mediastinum it is suitable the accomplishment of a wide thoracotomy.

  3. Medications for Angina (Beyond the Basics)

    Science.gov (United States)

    ... of medications used to treat stable angina: ● Nitrates ● Beta blockers ● Calcium channel blockers ● Ranolazine Nitrates or beta blockers are usually preferred for initial treatment of angina, ...

  4. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... please enable JavaScript. Coronary artery disease - living with Heart Disease and Angina Coronary heart disease (CHD) is a ...

  5. Bradycardiac angina: haemodynamic aspects and treatment.

    Science.gov (United States)

    Fowler, P B; Ikram, H; Maini, R N; Makey, A R; Kirkham, J S

    1969-01-11

    A patient with a sinus bradycardia and angina is described who was unable to increase his heart rate on vigorous exercise by more than a few beats. His severe angina was attributed to the bradycardia. Atrial pacing of his heart abolished his angina and increased his exercise tolerance. Circulatory changes at rest, on exertion, and with atrial pacing are described. The cause of angina in this patient is discussed.

  6. Tórax inestable, evolución sin osteosíntesis: presentación de un caso.

    Directory of Open Access Journals (Sweden)

    Elbert Oberto Reyes Graterol

    2012-09-01

    Full Text Available El trauma torácico cerrado suele ser el resultado de un impacto directo a alta velocidad o caídas siendo responsable de fracturas costales. Se define  tórax inestable como la fractura de tres o cuatro costillas en más de dos segmentos de su longitud, ocasionando un fenómeno paradójico en la caja  torácica durante la respiración, colapsándose en inspiración y expandiéndose en espiración. Los de localización anterior o lateral son los más graves,  dada su repercusión fisiopatológica. El diagnóstico se establece con el examen físico, radiografías y tomografías de tórax, así como también estudios  de fisiología respiratoria. El tratamiento se basa en la estabilización neumática interna mediante ventilación mecánica y osteosíntesis. Se presenta el  caso de paciente femenino de 18 años de edad quien ingresa al Hospital General del Sur por presentar trauma toraco-abdominal cerrado complicado,  con neumotórax derecho, hemoneumotórax izquierdo que ameritó colocación de drenaje torácico e intubación, lesión hepática grado IV de segmentos  II y III y lesión del ángulo esplénico del colon, ingresando a UCI donde permaneció durante doce días bajo ventilación mecánica asistida.  Se destaca la consolidación costal en ausencia de osteosíntesis o fijación con una evolución observable en estudios de imágenes de control periódico.

  7. Myocardial ischemia and angina pectoris

    International Nuclear Information System (INIS)

    Ambulatory monitoring of ST segment changes was performed in 60 patients presenting with angina, positive ECG stress tests and coronary artery disease, 85% of ischemic ECG events were asymptomatic, 37% occurred with no increase in heart rate and 15% of episodes either lasted 20 minutes or more or fluctuated in severity. A controlled pilot study in ten patients showed depression. Radionuclide studies in 50 patients with angina and coronary artery disease have shown that stress (i.e., atrial pacing) produced different patterns of disturbed regional myocardial perfusion related to the patient's exercise capacity and eventually leading to a decrease in regional myocardial perfusion during the ischemic episode. ST segment depression appeared only after the decrease in regional myocardial perfusion. These findings combined with past research suggest that patients with angina and coronary artery disease can suffer frequent asymptomatic disturbances of the regional myocardial perfusion. The frequency of these episodes and the time course for the recovery of the metabolic consequences mean that segments of ventricular myocardium may be constantly abnormal. The relative importance of changes in coronary tone and malfunction of platelets in the diseased coronary tree needs to be examined in clinical research. Pilot studies of antiplatelet agents have shown a significant beneficial effect on episodes of ischemia occurring at night and those occurring without any increase in heart rate. The techniques and observations in these patients with coronary artery disease all suggest that acute transient regional myocardial ischemia is caused by a variety of mechnisms. Further research using objective methods is required to discover the causes of ischemia and to rationalize treatment. (orig./MG)

  8. Angina de Ludwig. Reporte de 2 casos

    Directory of Open Access Journals (Sweden)

    Antonio Fabbio Gagliardi Lugo

    2014-10-01

    Full Text Available La angina de Ludwig (AL es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, origen, vías de diseminación, manejo terapéutico y posibles complicaciones. Se reportan 2 casos que acuden a Emergencias del Hospital General del Oeste «Dr. José Gregorio Hernández» (HGO en Los Magallanes de Catia (Caracas, Venezuela con diagnóstico de AL. Se presenta el manejo clínico y la relevancia del rol que adquiere el cirujano maxilofacial en el diagnóstico en aras de la preservación de la vida del paciente.

  9. Angina

    Science.gov (United States)

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71. Lange RA, Hillis LD. ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 72. Marrow DA, Boden WE. ...

  10. Interpreting angina: symptoms along a gender continuum

    Science.gov (United States)

    Crea-Arsenio, Mary; Shannon, Harry S; Velianou, James L; Giacomini, Mita

    2016-01-01

    Background ‘Typical’ angina is often used to describe symptoms common among men, while ‘atypical’ angina is used to describe symptoms common among women, despite a higher prevalence of angina among women. This discrepancy is a source of controversy in cardiac care among women. Objectives To redefine angina by (1) qualitatively comparing angina symptoms and experiences in women and men and (2) to propose a more meaningful construct of angina that integrates a more gender-centred approach. Methods Patients were recruited between July and December 2010 from a tertiary cardiac care centre and interviewed immediately prior to their first angiogram. Symptoms were explored through in-depth semi-structured interviews, transcribed verbatim and analysed concurrently using a modified grounded theory approach. Angiographically significant disease was assessed at ≥70% stenosis of a major epicardial vessel. Results Among 31 total patients, 13 men and 14 women had angiograpically significant CAD. Patients describe angina symptoms according to 6 symptomatic subthemes that array along a ‘gender continuum’. Gender-specific symptoms are anchored at each end of the continuum. At the centre of the continuum, are a remarkably large number of symptoms commonly expressed by both men and women. Conclusions The ‘gender continuum’ offers new insights into angina experiences of angiography candidates. Notably, there is more overlap of shared experiences between men and women than conventionally thought. The gender continuum can help researchers and clinicians contextualise patient symptom reports, avoiding the conventional ‘typical’ versus ‘atypical’ distinction that can misrepresent gendered angina experiences. PMID:27158523

  11. Therapy for Stable Angina in Women

    OpenAIRE

    Sarbaziha, Raheleh; Sedlak, Tara; Shufelt, Chrisandra; Mehta, Puja K.; Merz, C. Noel Bairey

    2012-01-01

    Mortality rates for cardiovascular disease are higher in women than in men, but studies of women have been conducted less frequently. Current pharmacological and nonpharmacological treatment options for women with stable angina are reviewed.

  12. Angina crónica estable. Consideraciones actuales

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-03-01

    Full Text Available La angina de pecho crónica estable es un síndrome clínico caracterizado por dolor o malestar precordial secundario a isquemia miocárdica y sin características clínicas de inestabilidad. El debate actual sobre esta entidad clínica incluye tres aspectos fundamentales: diagnóstico, prevalencia e impacto socioeconómico, y tratamiento médico frente a revascularización miocárdica. En los últimos cuatro años se han dado a conocer los resultados de varios estudios multicéntricos de gran importancia que compararon tratamiento médico con revascularización miocárdica y cirugía de revascularización frente a intervención coronaria percutánea; además, han mejorado las técnicas de revascularización y existe abundante información sobre la eficacia de nuevos fármacos antiisquémicos. El presente trabajo tiene como objetivo hacer una revisión de los aspectos actuales más importantes relacionados con la angina de pecho estable y su tratamiento, publicados en la literatura especializada.

  13. CLINICAL EFFECT OF TESTOSTERONE IN MEN WITH STABLE ANGINA

    OpenAIRE

    A. Ya. Kravchenko; V. M. Provotorov

    2016-01-01

    Aim. To study efficacy of testosterone undecanoate (TU) therapy in men with stable angina and androgen deficiency.Material and methods. The serum testosterone level was detected in 247 men (aged 51,6±1,8 y.o.) with stable effort angina. 60 patients with androgen deficiency additionally to basic angina therapy received TU (120-160 mg daily). 54 patients with androgen deficiency (control group) received only basic angina therapy. Dynamics of clinical and ECG manifestations of myocardial ischemi...

  14. Coronary angioplasty for early postinfarction unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); A. Soward; M.J.B.M. van den Brand (Marcel); E. Bos (Egbert); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractCoronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had

  15. Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    José Marconi Almeida de Sousa

    2004-05-01

    Full Text Available OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS. MÉTODO:As pressões, assim como os fatores de risco para doença arterial coronariana (DAC foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariografia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001 e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002, enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003. Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave.OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB 2 times greater than the standard value used in the hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI. METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI underwent cinecoronariography

  16. Angina - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Portuguese (português) ... poitrine - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Angina हिन्दी (Hindi) Bilingual PDF ...

  17. A rare cause of Ludwig's angina by Morganella morganii.

    Science.gov (United States)

    Ho, Min-Po; Tsai, Kuang-Chau; Yen, Szu-Lin; Lu, Cheng-Lin; Chen, Chia-Hung

    2006-10-01

    Ludwig's angina is a rapidly spreading and potentially lethal infection involving the floor of the mouth and neck. We present a rare case of Ludwig's angina caused by an unusual microorganism, Morganella morganii, and the group D alpha-hemolytic streptococcus. To our knowledge, this is the first case of Ludwig's angina and deep neck infection caused by Morganella morganii. Adequate airway maintenance, appropriate use of antibiotics and surgical drainage resulted in survival of the patient without complications.

  18. Comparación entre diferentes materiales inestables utilizados dentro del proceso de entrenamiento: Revisión Sistemática

    OpenAIRE

    Bustamante Aranguren, Paula

    2014-01-01

    RESUMEN: Introducción: la popularidad de los entrenamientos realizados en superficies inestables para mejorar el rendimiento deportivo ha ido creciendo en los últimos años. El objetivo de esta revisión fue conocer la efectividad de los ejercicios realizados en inestabilidad durante los entrenamientos deportivos. Métodos: se realizó una búsqueda bibliográfica sobre el tema en bases electrónicas de datos: Medline, PubMed, PEDro, Elsevier, Cochrane Library y Google Académico,mediante las pala...

  19. Preinfarction angina: old story initiates new attention

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo

    2012-01-01

    Since first report by Murry et al1 in 1986,the role of ischemia preconditioning before sustained coronary occlusion in protecting myocardium and reducing infarct size has been identified in animal studies.2-4 The mechanism underlying the endogenous cardioprotective effects of ischemia preconditioning is complex and may involve humoral,neural,or a combination of both,with different signaling pathwaysinvolving adenosine,bradykinin,protein kinases and K(ATP) channels.5,6 In humans,episodes of angina before acute myocardial infarction (AMI) may also confer a preconditioning or protective effect.

  20. Ludwig's angina after severe thrombocytopenic purpura associated with dengue fever

    Directory of Open Access Journals (Sweden)

    Maria Antonia Campos

    2014-01-01

    Full Text Available Here, we report a case of Ludwig's angina, which required surgery because of toothache. The patient had dengue and severe thrombocytopenia as confirmed by clinical and laboratory diagnoses. However, dengue is not included among the predisposing factors for Ludwig's angina.

  1. Anipamil prevents ST depression in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Larsen, C T; Sørum, C; Rasmussen, V;

    1993-01-01

    test with > or = 0.10 mV horizontal or down-sloping ST-segment depression and limited by angina pectoris, and at least 10 attacks of angina pectoris in the initial single-blind placebo period. During the placebo period, a total duration of transient myocardial ischemia > or = 0.10 mV during the 24-hour...

  2. Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study (EARL)

    DEFF Research Database (Denmark)

    Andréll, P; Yu, W; Gersbach, P;

    2010-01-01

    To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation.......To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation....

  3. Diseño y control de un sistema electromecánico inestable de dos grados de libertad: aplicación al caso de un péndulo invertido

    OpenAIRE

    Molis Merino, Eugenio

    2015-01-01

    En este proyecto, se ha realizado el diseño y el control de un sistema electromecánico inestable de dos grados de libertad. Aplicación al caso de un péndulo invertido, un sistema no lineal e inestable controlado mediante un microcontrolador para la etapa de control, un giroscopio para la lectura de datos para su posterior procesamiento y control y un driver para la etapa de potencia. Para el diseño del controlador y la obtención de los diferentes parámetros de ajuste ha sido...

  4. External minifixation in unstable fractures of the metacarpal Minifijación externa en fracturas inestables de los metacarpianos

    Directory of Open Access Journals (Sweden)

    Pablo Oquendo Vázquez

    Full Text Available Background: External fixation is one of the surgical treatment methods more used in traumatology for its versatility and the care it provides to the soft parts. Objectives: To demonstrate that external minifixation allows obtaining a stable fixation that doesn’t limit the hand functionally and facilitates early rehab. Methods: A descriptive study about 42 patients managed at the orthopaedic service in the time period between February 2000 and February 2004, to whom an unstable metacarpal fracture was diagnosed with surgical treatment criteria. All cases were submitted to reduction and stabilizing of the lesion, using an external minifixator RALCA. Hand rehab began in immediate post surgical state. Results: In our series predominated the male sex (83, 3 %, white skinned (92, 8%, with age groups between 31 and 40 years. Lesions in predominant hands were more frequent (80, 9%, and the direct production mechanism (76, 1%, with prevalence of transversal diaphysial pattern (38% and short slanting (35, 1%. Consolidation time was considered inside normal limits in the 88% of the sample. The 52, 3% of the patients incorporated to their social active lives without functional limitations.
    Fundamento: La fijación externa es uno de los métodos de tratamiento quirúrgico más utilizados en traumatología por su versatilidad y el cuidado que provee a las partes blandas. Objetivo: Demostrar que el uso de la minifijación externa permite obtener una fijación estable que no limita funcionalmente la mano y facilita la rehabilitación precoz. Métodos: Estudio descriptivo sobre 42 pacientes atendidos en el Servicio de Ortopedia en el período de tiempo comprendido entre febrero del 2000 y febrero del 2004, a los que se les diagnosticó una fractura inestable de los metacarpianos con criterio de tratamiento quir

  5. Physical Activitiea Associted with Angina Pectoris Before Myocardial Infarction and the Onset of Myocardial Infarction

    OpenAIRE

    Matsuda, Masako

    1984-01-01

    One hundred and ninety-seven patients with a history of myocardeal infarction were interviewed to evaluate the incidence of angina pectoris and the physical activity precipitating angina before myocardial infarction, and the mode of physical activity at the onset of myocardial infarction. Ninety-ewo patients had no angina before infarction, whereas 105 did, In 105 patients, 58 had a chronic stable angina without a change of pattern of angina before infarction, while 22 noticed worsening of th...

  6. Unstable angina of crescendo pattern vs new onset: a clinical, coronary arteriographic and hemodynamic study.

    Science.gov (United States)

    Hussain, K M; Gould, L; Bharathan, T; Abdelsayed, G; Karpov, Y

    1995-06-01

    Unstable angina includes a variety of clinical presentations with a different level of risk for an unfavorable outcome. In this study the authors investigated the prognostic significance of crescendo angina and new-onset angina to discuss management strategies, paying attention to the relevance of baseline clinical characteristics, coronary artery lesions, and left ventricular function, as well as their alterations during atrial pacing. Accordingly coronary arteriographic anatomy and changes in left ventricular volumes and ejection fraction before and during atrial pacing were studied by means of digital subtraction ventriculography in 18 patients with crescendo angina and in 18 patients with new-onset angina. Triple-vessel disease was more frequently observed in crescendo angina (56%; P crescendo angina. The angiographic evidence of intracoronary thrombi was found in 33% (P crescendo angina and in 4% patients with new-onset angina. Compared with the patients with new-onset angina, patients with crescendo angina had higher end-diastolic and end-systolic volumes and lower ejection fraction at rest. At peak pacing, ejection fraction was significantly (P crescendo angina (0.48 +/- 0.06) than in new-onset angina (0.66 +/- 0.04). In crescendo angina, during pacing, the magnitude of velocity of circumferential fiber shortening was significantly decreased as compared with new-onset angina.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Composite reforzado con fibras, utilización como retención en ortodoncia.

    OpenAIRE

    Ornia González, Ana María

    2015-01-01

    Los resultados del tratamiento ortodóncico son potencialmente inestables, por lo que es necesaria una retención permanente o semi-permanente post-tratamiento. Las actuales estrategias de retención incluyen retención removible y fija. Al precisar la primera de la cooperación del paciente, los retenedores fijos son, por norma, los elegidos. Los alambres trenzados de acero están ampliamente aceptados como el material de primera elección para este tipo de retención. Han demostrado tasas de éxito ...

  8. Monitorización de laderas inestables mediante técnicas fotogramétricas a partir de vuelos UAV e históricos

    OpenAIRE

    Fernández, Tomás; Pérez, José Luis; López, Andrés; Gómez, José Miguel; Cardenal, Javier; Delgado, Jorge

    2014-01-01

    Este trabajo presenta una metodología para la monitorización de laderas inestables mediante técnicas fotogramétricas, partiendo de vuelos UAV de muy alta resolución. Para ello se han realizado y analizado cuatro campañas de UAV desde noviembre de 2012 en una zona situada en las inmediaciones de la Guardia (Jaén), y además se ha utilizado un vuelo fotogramétrico previo de la misma zona. Los vuelos UAV se han realizado mediante una plataforma aérea ligera de tipo helicóptero o drone –provisto d...

  9. CLINICAL EFFECT OF TESTOSTERONE IN MEN WITH STABLE ANGINA

    Directory of Open Access Journals (Sweden)

    A. Ya. Kravchenko

    2016-01-01

    Full Text Available Aim. To study efficacy of testosterone undecanoate (TU therapy in men with stable angina and androgen deficiency.Material and methods. The serum testosterone level was detected in 247 men (aged 51,6±1,8 y.o. with stable effort angina. 60 patients with androgen deficiency additionally to basic angina therapy received TU (120-160 mg daily. 54 patients with androgen deficiency (control group received only basic angina therapy. Dynamics of clinical and ECG manifestations of myocardial ischemia and quality of life (QOL parameters was studied.Results. Androgen deficiency is revealed in 114 (46,2% of patients. Therapy with TU during 3 months resulted in reduction of angina attacks and extent of myocardial ischemia (according to Holter ECG monitoring and stress test as well as QOL improvement.Conclusion. Androgen deficiency is observed in 46,2% of men with stable angina. TU increases of antianginal therapy efficacy, improves QOL and is well tolerated. 

  10. Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

    Directory of Open Access Journals (Sweden)

    José Roberto Tavares

    2002-08-01

    Full Text Available OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females with unstable angina and 46 control patients (19 males, paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 µmol/L than in the control group (8.7±4.4 µmol/L (p<0.05. Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 µmol/L versus 11.9±4.2 µmol/L. Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 µmol/L versus 6.4±2.9 µmol/L (p<0.05 in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 µmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.

  11. Functional Role of Dendritic Cells in Patients with Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    LI Dazhu; Sharma Ranjit; ZENG Qiutang

    2005-01-01

    To investigate the function of dendritic cells (DC) in patients with unstable angina, 10 mL of blood was drawn from 30 subjects. 15 patients diagnosed as having unstable angina and 15 healthy subjects were included in an observation and a control groups respectively. The mononuclear cells were separated from the peripheral blood and cultured in RPMI1640 supplemented with recombinant human granulocyte/macrophage-colony stimulating factor (rh GM-CSF) and recombinant human interleukin-4 (rh IL-4) to induce dendritic cells. The shape and ultrastructure of DC was examined with electronic microscope. The phenotype of DC was analyzed with FACS and the alloantigen presenting capacity of DC was evaluated by mixed lymphocyte reaction (MLR). The expression rate of CD86 of DC in patients with unstable angina was (40.7±3.6) %, which was obviously higher than that of normal DC (29.6±2.5 %) (P<0.001). The capacity of the DCs in unstable angina patients to induce allogenic T cells (OD 2.73±1.10), was significantly higher than that of the normal DC (OD:0.9±0.21) (P<0.005). It is suggested that the function of DC in patients with unstable angina is increased, which may play an important role in the initiation of immune reaction in the plaque.

  12. Pharmacological Management of Chronic Stable Angina: Focus on Ranolazine.

    Science.gov (United States)

    Rosano, Giuseppe M C; Vitale, Cristiana; Volterrani, Maurizio

    2016-08-01

    Percutaneous coronary intervention and anti-anginal medications have similar prognostic effectiveness in patients with chronic stable angina. The choice of optimal medical therapy for the management of chronic angina is of pivotal importance in patients with stable ischemic heart disease. The most commonly used anti-anginal agents have demonstrated equivalent efficacy in improving patient reported ischemic symptoms and quantitative exercise parameters. With regards to mortality, beta-blockers are beneficial only in the setting of depressed left ventricular systolic function after a recent myocardial infarction. Recent evidence suggests the lack of any benefit of beta-blockers in patients with preserved systolic function, even in the setting of prior myocardial infarction.Ranolazine is a non-haemodynamic anti-anginal agent. It is effective as adjunctive therapy in patients with chronic stable angina whose symptoms are un-adequately controlled by conventional treatment. The clinical development program of ranolazine has shown that the drug improves exercise performance, decreases angina and use of sublingual nitrates, compared to placebo. Ranolazine is well tolerated with neutral effect on haemodynamics. Besides its role in chronic stable angina, ranolazine has the potential for development in a number of other cardiovascular and non-cardiovascular conditions in the future.

  13. Reduced peripheral vascular reactivity in refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne M; Edvinsson, Marie-Louise; Pettersson, Thomas;

    2011-01-01

    compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian......AIMS: To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. METHODS: Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were...

  14. NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

    Directory of Open Access Journals (Sweden)

    Y. V. Gavrilov

    2015-12-01

    Full Text Available Aim. To evaluate antianginal and antiischemic efficiency of nebivolol in patients with stable angina pectoris.Material and methods. 100 patients with ischemic heart disease showing stable exertional angina pectoris and having no contraindications to beta-blockers were studied. After 5-7 days of control period 50 randomly selected patients began to take nebivolol in initial dose of 5mg once daily and 50 patients started to take metoprolol in initial dose of 50 mg twice daily. Duration of treatment was 8 weeks. Efficiency of treatment was assessed according to the results of control treadmill assessment and control daily ECG monitoring.Results. 56-day therapy with nebivolol at a dose of 7,5 mg per day results in increase in duration of treadmill test before angina or ST depression (p<0.05. Antianginal and antiischemic effect of nebivolol 7.5 mg once daily is rather similar with that of metoprolol in average daily dose of 175 mg. Nebivolol compared to metoprolol significantly (p<0.05 more effectively reduces the number of silent myocardial ischemia.Conclusion. Nebivolol is an efficient antianginal and antiischemic drug for patients with stable exertional angina pectoris.

  15. Management of Stable Angina - Current Guidelines: A Critical Appraisal.

    Science.gov (United States)

    Thadani, Udho

    2016-08-01

    Guidelines provide recommendations to improve patient outcomes, but many of the recommendations made for treating patients with stable angina are opinion based rather than evidence based. Risk stratification to predict patients at an increased risk of myocardial infarction (MI) and sudden ischemic death, and selection of patients for possible revascularization, is based on expert opinion. Randomized trials have compared optimal medical therapy to revascularization, after the coronary anatomy was known, and yet routine coronary angiography to exclude left main disease is not recommended. What exactly is optimal antianginal treatment varies considerably from one country's guideline recommendations to another. None of the antianginal drugs reduce mortality or MI and these drugs are equally effective in treating angina pectoris; and yet beta-blockers and calcium channel blockers are recommended as first line therapy. Double and triple therapy with different classes of antianginal drugs is also expert opinion based rather than evidence based. Recommendations to reduce the incidence of MI and sudden death are appropriate; however the use of a potent, high dose statin, is recommended by AHA/ACC and NICE guidelines for all patients with ischemic heart disease, while the European guidelines recommend a target LDL goal in patients with coronary artery disease (CAD). Management of patients with stable angina pectoris with normal coronary arteries remains ambiguous. This short review critically appraises the recommendations for managing patients with stable angina pectoris. PMID:27638354

  16. Effects of acupuncture in moderate, stable angina pectoris

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Pedersen, F; Pietersen, A;

    1990-01-01

    In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian...

  17. [Microvascular angina in women: a diagnostic and therapeutic challenge

    NARCIS (Netherlands)

    Elias-Smale, S.E.; Boer, M.J. de; Maas, A.H.E.M.

    2014-01-01

    Gender differences play an important role in coronary heart disease (CHD). Not only in the presentation of symptoms, but also in their underlying pathophysiology. Women with persistent angina without obstructive coronary artery disease (CAD) pose a diagnostic and therapeutic challenge. Half of these

  18. Ranolazin--ny behandling af kronisk stabil angina pectoris

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Hansen, Peter Riis

    2009-01-01

    Ranolazine sustained-release tablets were recently approved in the EU for chronic stable angina as add-on therapy when symptoms are not controlled with first-line agents. The mechanism of action is thought to involve inhibition of late sodium influx in the heart, which can reduce abnormalities...

  19. Cardiac catheterization in patients with unstable angina. Recent onset vs crescendo pattern.

    Science.gov (United States)

    Plotnik, G D; Fisher, M L; Carliner, N H; Becker, L C

    1980-08-01

    Among patients with unstable angina pectoris, those with crescendo angina seem to be at high risk for death and myocardial infarction. We reviewed the clinical, arteriographic, and hemodynamic findings in 218 consecutive catheterized patients with unstable angina. Unstable angina was defined as ischemic cardiac pain at rest associated with transient ECG changes but no evidence for acute myocardial infarction. Patients were divided into two groups according to the duration of symptoms: 134 patients with crescendo angina (new, or increasing, rest pain with previous ischemic symptoms present for more than three months) and 84 with recent onset angina (symptoms present for less than three months). Compared with patients with recent onset symptoms, patients with crescendo angina had more extensive coronary disease and lower ejection fractions, which may explain their poor prognosis.

  20. Persistent angina: highly prevalent and associated with long-term anxiety, depression, low physical functioning, and quality of life in stable angina pectoris

    DEFF Research Database (Denmark)

    Jespersen, L.; Abildstrom, S. Z.; Hvelplund, Anders;

    2013-01-01

    To evaluate persistent angina in stable angina pectoris with no obstructive coronary artery disease (CAD) compared to obstructive CAD and its relation to long-term anxiety, depression, quality of life (QOL), and physical functioning. We invited 357 patients (men = 191; women = 166; response rate 83...... %) with no prior cardiovascular disease who had a first-time coronary angiography (CAG) in 2008-2009 due to suspected stable angina to participate in a questionnaire survey in 2011 with the Seattle Angina Questionnaire and the Hospital Anxiety and Depression Scale as key elements. Long-term persistent...... angina (i.e., symptoms at least once a month) was present in 64 % of patients with diffuse non-obstructive CAD (1-49 % stenosis), 49 % of patients with normal coronary arteries (0 % stenosis), and 41 % of patients with obstructive CAD (a parts per thousand yen50 % stenosis) (P = 0.01). Depression and...

  1. High probability of disease in angina pectoris patients

    DEFF Research Database (Denmark)

    Høilund-Carlsen, Poul F.; Johansen, Allan; Vach, Werner;

    2007-01-01

    BACKGROUND: According to most current guidelines, stable angina pectoris patients with a high probability of having coronary artery disease can be reliably identified clinically. OBJECTIVES: To examine the reliability of clinical evaluation with or without an at-rest electrocardiogram (ECG......) in patients with a high probability of coronary artery disease. PATIENTS AND METHODS: A prospective series of 357 patients referred for coronary angiography (CA) for suspected stable angina pectoris were examined by a trained physician who judged their type of pain and Canadian Cardiovascular Society grade...... on CA. Of the patients who had also an abnormal at-rest ECG, 14% to 21% of men and 42% to 57% of women had normal MPS. Sex-related differences were statistically significant. CONCLUSIONS: Clinical prediction appears to be unreliable. Addition of at-rest ECG data results in some improvement, particularly...

  2. Non-Linear Dynamics In Patients With Stable Angina Pectoris

    CERN Document Server

    Krstacic, G; Vargovic, E; Knezevic, A; Krstacic, A

    2001-01-01

    We investigate the clinical and prognostic significance of fractal dimension and detrended fluctuation analysis by comparing the group of patients with stable angina pectoris without previous myocardial infarction with the group of age-matched healthy controls. The fractal dimension of the R-R series was determined using the rescaled range (R/S) analysis technique. To quantify fractal longe-range-correlation properties of heart rate variability, the detrended fluctuation analysis (DFA) technique was used. The heart rate variability was characterized by a scaling exponent $\\alpha$, separately for short-term ($$ 11 beats) time scales. The results of data sets show the existence of crossover phenomena between short-time scales. The short-term fractal scaling exponent was significantly lower in patients with stable angina pectoris.

  3. Management of angina pectoris: the role of spinal cord stimulation.

    Science.gov (United States)

    Eckert, Siegfried; Horstkotte, Dieter

    2009-01-01

    Progress in prevention as well as drug and interventional therapy has improved the prognosis of patients with cardiovascular disorders. Many patients at risk have advanced coronary artery disease (CAD), have had multiple coronary interventions, and present with significant co-morbidity. Despite adequate risk factor modulation and often several revascularization procedures, some of these patients still have refractory angina pectoris. Apart from advanced CAD and insufficient collateralization, the cause is often endothelial dysfunction. For this situation, one treatment option is neuromodulation. Controlled studies suggest that, in patients with chronic refractory angina pectoris, spinal cord stimulation (SCS) provides a relief from symptoms equivalent to that provided by surgical therapy, but with fewer complications and lower rehospitalization rates. SCS may result in significant long-term pain relief with improved quality of life. In patients with refractory angina undergoing SCS, some studies have shown not only a symptomatic improvement, but also a decrease in myocardial ischemia and an increase in coronary blood flow. Discussion is ongoing as to whether this is a direct effect on parasympathetic vascodilation or merely a secondary phenomenon resulting from increased physical activity following an improvement in clinical symptoms. Results from nuclear medical studies have sparked discussion about improved endothelial function and increased collateralization. SCS is a safe treatment option for patients with refractory angina pectoris, and its long-term effects are evident. It is a procedure without significant complications that is easy to tolerate. SCS does not interact with pacemakers, provided that strict bipolar right-ventricular sensing is used. Use in patients with implanted cardioverter defibrillators is under discussion. Individual testing is mandatory in order to assess optimal safety in each patient. PMID:19178129

  4. Epidural spinal electrical stimulation in severe angina pectoris.

    OpenAIRE

    Mannheimer, C; Augustinsson, L E; Carlsson, C A; Manhem, K; Wilhelmsson, C

    1988-01-01

    The short term effects of epidural spinal electrical stimulation were studied in 10 patients with angina pectoris of New York Heart Association functional class III or IV. The antianginal pharmacological treatment given at entry to the study was regarded as optimal and was not changed during the study. The effects of epidural spinal electrical stimulation were measured by repeated bicycle ergometer tests. Treatment with epidural spinal electrical stimulation increased the patients' working ca...

  5. Update on ranolazine in the management of angina

    Directory of Open Access Journals (Sweden)

    Codolosa JN

    2014-06-01

    Full Text Available J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome-TIMI (Thrombolysis In Myocardial Infarction 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. Keywords: ranolazine, chronic stable angina, coronary artery disease

  6. Ivabradine: the evidence of its therapeutic impact in angina

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2008-12-01

    Full Text Available Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed for the treatment of cardiovascular diseases including SAP. It has an exclusive heart rate reducing effect, without any negative effect on left ventricular function or coronary vasodilatation.Aims: The aim of this paper is to review the evidence concerning the use of ivabradine in the treatment of SAP.Evidence review: Ivabradine is an effective antianginal and antiischemic drug, not inferior to the beta blocker atenolol and the calcium channel antagonist (CCA amlodipine. It decreases the frequency of angina attacks and increases the time to anginal symptoms during exercise. Because of its exclusive chronotropic effect, ivabradine is not associated with the typical adverse reactions associated with beta blockers or other antianginal drugs.Clinical value: Clinical evidence shows that ivabradine is a very good antiischemic and antianginal agent, being as effective as beta blockade and CCA therapy in controlling myocardial ischemia and symptoms of stable angina. Ongoing studies will determine the potential of ivabradine to improve morbidity and mortality in coronary artery disease and heart failure.Key words: evidence, If current, ivabradine, outcomes, stable angina pectoris, treatment

  7. A comparative study of dalteparin and unfractionated heparin in patients with unstable angina pectoris

    Directory of Open Access Journals (Sweden)

    Hanmant S Amane

    2011-01-01

    Conclusion : Dalteparin is as effective and safe as unfractionated heparin in the treatment of unstable angina. Dalteparin does not require routine laboratory monitoring as with unfractionated heparin.

  8. Angina de pecho con arterias angiográficamente normales: características epidemiológicas y clínicas

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez Sotelo

    2002-12-01

    Full Text Available Introducción: Las lesiones obstructivas por arterioesclerosis coronaria genera diversos síndromes coronarios. Sin embargo, un subgrupo de pacientes con angina de pecho y alteraciones electrocardiográficas no presenta dichas lesiones, en el que se incluyen el vasoespasmo coronario, la angina microvascular, los puentes musculares y otras condiciones. En este estudio se evaluaron las principales características clínicas y electrocardiográficas de este grupo de pacientes. Material y métodos: Se incluyeron pacientes con cualquier síndrome coronario y angiografía coronaria sin lesiones obstructivas. Se consignaron los factores de riesgo cardiovascular, los síntomas de presentación, alteraciones electrocardiográficas y ecocardiográficas y los fármacos utilizados. Resultados: Se reclutaron 26 casos, 13 hombres y 13 mujeres con edad promedio de 56.6 años (rango 16 - 78. Se presentó angina microvascular en 16 casos, vasoespasmo coronario en 8, uno con un puente coronario y uno con flujo lento. Como síntomas se observó disnea en 18 pacientes, angor típico en 19 y angor atípico en 7. El electrocardiograma de reposo fue anormal en 18 pacientes, y el de esfuerzo en 13 casos. De 19 ecocardiogramas, 9 fueron anormales. Los fármacos más utilizados fueron los betabloqueadores, los bloqueadores de los canales del calcio y los nitratos. Conclusiones: Los pacientes con síndromes coronarios y angiografía coronaria sin lesiones obstructivas presentan frecuentemente factores de riesgo coronario, no hay diferencia de género y los exámenes auxiliares son anormales lo que motiva la realización de la angiografía.lntroduction: Coronary arteriosclerosis lesions induce several coronary syndromes. Some patients suffer angina pectoris with abnormal electrocardiograms with no obstructive plaques in the angiogram. This group includes coronary vasospasm, micro vascular angina, muscle bridges and others. This study evaluates the most important clinical

  9. Plasma resistin is increased in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    HU Wen-lan; QIAO Shu-bin; HOU Qing; YUAN Jian-song

    2007-01-01

    Background Resistin, a novel adipokine linked to insulin resistance and obesity in rodents, which is derived mainly from macrophages and identified in atheromas in human, has been shown to play a potential role in atherosclerosis.Resistin levels were reported to increase in coronary artery disease (CAD), while data concerning resistin in different stages of CAD in Chinese people are lacking. The aim of this study was to assess whether plasma concentrations of resistin differed between patients with unstable and stable angina pectoris.Methods Plasma resistin levels were determined by means of enzyme-linked immunosorbent assay (ELISA) in 46 patients with unstable angina (UAP), 37 with stable angina (SAP) and 31 control subjects.Results Plasma concentrations of resistin were significantly increased in UAP group (geometric mean (interquartile range) 12.09 ng/ml (8.40, 18.08)) in comparison with SAP (9.04 ng/ml (7.09, 11.44)) and control groups (8.71 ng/ml (6.58,11.56)). No differences in resistin levels were found between patients with SAP and controls. We also found that plasma resistin positively correlated with leukocyte counts (r=0.21, P=0.027), high sensitive C-reactive protein (hs-CRP) (r=0.25,P=0.008), and endothelin-1 (r=0.21, P=0.025) after adjustment for age, sex and BMI.Conclusion Resistin may be involved in the development of CAD by influencing systemic inflammation and endothelial activation.

  10. Myocardial bridge: The cause of angina in a young man

    International Nuclear Information System (INIS)

    Myocardial bridging is basically the systolic narrowing of epicardial coronary arteries, secondary to their tunneled course in myocardium. Though it is a benign condition it can have the symptoms like acute coronary syndrome, arrhythmias and sudden cardiac death. We report a 32-year-old male, who presented with typical exertional angina, had positive exercise treadmill and thallium-201 test. Coronary angiography revealed myocardial bridge of distal left anterior descending coronary artery. He was put on β-blockers and was doing well at 8 years of follow-up

  11. Ludwig’s Angina in Pregnancy Necessitating Pre Mature Delivery

    OpenAIRE

    Kamath, Abhay Taranath; Bhagania, Manish Kumar; Balakrishna, R.; Sevagur, Ganesh Kamath; Amar, R.

    2012-01-01

    Ludwig’s angina is a potentially life threatening disease that can arise from odontogenic infections if they are not attended well in advance. Its incidence in pregnancy is rare, but has been reported. Pregnancy is associated with complex physiological changes in the body which can make small dental infections assume grave proportions if not treated appropriately. This article presents a case of a 24 year old, 32 week pregnant lady who reported with swelling around the jaws and neck, difficul...

  12. Clinical course of isolated stable angina due to coronary heart disease

    NARCIS (Netherlands)

    Poole-Wilson, Philip A.; Voko, Zoltan; Kirwan, Bridget-Anne; de Brouwer, Sophie; Dunselman, Peter H. J. M.; Lubsen, Jacobus

    2007-01-01

    Aims To describe the clinical course of patients with stable angina due to coronary heart disease without a history of cardiovascular (CV) events or revascutarization (isolated angina). Methods and results Of 7665 patients in a trial comparing long-acting nifedipine with placebo, 2170 (28%) had isol

  13. Angiographic findings in patients with refractory unstable angina according to troponin T status

    NARCIS (Netherlands)

    C. Heeschen (Christopher); C.W. Hamm (Christian); M.L. Simoons (Maarten); M.J.B.M. van den Brand (Marcel)

    1999-01-01

    textabstractBACKGROUND: The CAPTURE (C7E3 fab AntiPlatelet Therapy in Unstable REfactory angina) trial enrolled patients with refractory unstable angina and documented a therapeutic benefit for abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, that was particularly e

  14. Comparison of patients undergoing enhanced external counterpulsation and spinal cord stimulation for refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne; Pettersson, Thomas; Erdling, André;

    2008-01-01

    with refractory angina. METHODS: 153 patients with refractory angina were treated with either EECP, SCS, or were retained on their pharmacological treatment (control). Glyceryl trinitrate usage and Canadian Cardiovascular Society classification were registered at baseline, 6 and 12 months after therapy. RESULTS...

  15. Muscle Fibre Types, Ubiquinone Content and Exercise Capacity in Hypertension and Effort Angina

    DEFF Research Database (Denmark)

    Karlsson, Jan; Diamant, Bertil; Folkers, Karl;

    1991-01-01

    Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone......Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone...

  16. A STUDY OF HIGH SENSITIVITY C-REACTIVE PROTEIN IN UNSTABLE ANGINA

    Directory of Open Access Journals (Sweden)

    Satish

    2014-11-01

    Full Text Available BACKGROUND: Unstable angina has a wide variability in its natural history, changing concepts of Pathophysiology, and newer approaches to its management strategies. So, unstable angina still has importance and prime interest in research work. Various ongoing research works has provided newer insights in pathophysiology of unstable angina syndrome and helps in recognition of clinical variability and unpredictability of it. C - reactive protein being the most sensitive acute phase reactant currently held. A recent previous study has estimated the levels and values of high-sensitivity C - reactive protein in both stable and unstable angina pectoris. Data provided by the study indicated need for further studies in this field. With all these facts, the present study is carried out to estimated Hs CRP levels as a marker of inflammation in patient of unstable angina. AIMS AND OBJECTIVES: The present study was carried out with the following Aims and Objectives. To estimate Hs-CRP levels as a marker of inflammation in patients of unstable angina. To compare Hs-CRP levels in cases of unstable angina, with Hs-CRP levels in patients of stable angina and in healthy age and sex matched controls. MATERIAL AND METHODS: This study was carried out at Basaveshwar Teaching and General Hospital, Gulbarga, MRMC Gulbarga. Approximate duration of study was 1 ½ year from June-2008 to November, 2010. OBSERVATION: Following are the conclusions drawn from the present study.

  17. The impact of guideline compliant medical therapy on clinical outcome in patients with stable angina: findings from the Euro Heart Survey of stable angina

    DEFF Research Database (Denmark)

    Daly, Caroline; Clemens, Felicity; Lopez-Sendon, Jose L.;

    2006-01-01

    interest was death or myocardial infarction (MI). The increasing intensity of guideline compliant medical therapy was quantified by means of a simple treatment score based on the use of guideline advocated therapies: antiplatelets, statins, and beta-blockers. A total of 3779 patients were included in the...... initial survey. Increasing intensity of guideline compliant therapy at initial assessment was associated with a reduction in death and MI during follow-up in patients with angina and confirmed coronary disease (HR 0.68; 95% CI 0.49-0.95 per unit increase in treatment score). All cardiovascular events were...... stable angina. Methods and results The Euro Heart Survey of Stable Angina is a multicentre prospective observational study conducted between 2002 and 2003. Patients with a clinical diagnosis of stable angina by a cardiologist were enrolled and follow-up was conducted at 1 year. The primary outcome of...

  18. Transcutaneous electrical nerve stimulation (TENS) in angina pectoris.

    Science.gov (United States)

    Mannheimer, C; Carlsson, C A; Vedin, A; Wilhelmsson, C

    1986-09-01

    The aim of this study was to determine the efficacy of transcutaneous electrical nerve stimulation (TENS) in the treatment of chronic stable severe angina pectoris. In a short-term study the effect of TENS was studied in 10 male patients with angina pectoris (functional class III and IV). All patients had previously been stabilized on long-term maximal oral treatment. The effects of the treatment were measured by means of repeated bicycle ergometer tests. All patients had an increased working capacity (16-85%), decreased ST segment depression and reduced recovery time during TENS. No adverse effects were observed. A long-term study of TENS on similarly selected patients showed beneficial effects in terms of pain reduction, reduced frequency of anginal attacks, increased physical activity and increased working capacity during bicycle ergometer tests. An invasive study was carried out with respect to systemic and coronary hemodynamics and myocardial metabolism during pacing provoked myocardial ischemia in 13 patients. The results showed that TENS led to an increased tolerance to pacing, improved lactate metabolism, less pronounced ST segment depression. A drop in systolic blood pressure during TENS treatment at identical pacing rates indicated a decreased afterload. An increased coronary flow to ischemic areas in the myocardium was supported by the fact that the rate pressure product during anginal pain increased during TENS.

  19. Angina monocitica con sovrainfezione da Prevotella denticola: caso clinico

    Directory of Open Access Journals (Sweden)

    Maria Teresa Allù

    2005-06-01

    Full Text Available Monocytic angina with superinfection of Prevotella denticola: clinical case Monocytic angina is a clinical sindrome caused by Epstein-Barr virus characterized by fever, pharyngitis, exudative tonsillitis, swollen lymphoglands, splenomegaly and hepatomegaly.The inflamed pharynx and necrotic tonsils of infectious mononucleosis are subject to bacterial superinfection initially or during the course of the illness; the reduced PO2 tension and low oxidation-reduction potential that prevail in a vascular and necrotic tissues favour the growth of anaerobes. In this article we reported the clinical case of a ten years old children, who presented fever and tonsillopharyngitis; he was treated with cefotaxime and piperacillin, he did not improve in health. He was admitted to hospital (Department of Otorhinolaryngology. The patient was treated with aminoglycoside (tobramycin, piperacillin and cortisone; the clinical situation deteriorated. Pus sample was collected from the tonsils and cultured. Isolated strain from culture anaerobic was identified biochemically (Rapid-ID32ANA.The microorganism isolated was: Prevotella denticola (oral anaerobic gram-negative rods; β-lactamase production was tested by using the chromogenic cephalosporin disk test.The susceptibility to antibiotics was performed according to NCCLS recommendations. Prevotella denticola (β-lactamase production was resistant to penicillin, cefoxitin, cefotetan, piperacillin, clindamycin and metronidazole it was susceptible to piperacillin-tazobactam, amoxicillin-clavulanate, ticarcillin-clavulanate, imipenem and chloramphenicol. Children was treated with piperacillin-tazobactam, with rapid symptomatic relief.

  20. A case of relapsing polychondritis mimicking Ludwig’s angina

    Directory of Open Access Journals (Sweden)

    Adnan Agha

    2009-09-01

    Full Text Available Relapsing polychondritis (RP is a severe progressive inflammatory condition involving cartilaginous structures and caused by an autoimmune process, for which there is no confirmatory serological biomarker and which still is diagnosed on a mainly clinical basis. RP has been associated with many diseases like Sweet’s syndrome, Behcet’s disease, rheumatoid arthritis, and other autoimmune disorders. We attempt to describe here a unique case of a 38-year-old female with a high-grade fever, sore throat, difficulty in swallowing, hoarseness of the voice, and found to have signs of tongue swelling and inflammation of the oral cavity that mimicked Ludwig’s angina, necessitating antibiotic use. On careful re-evaluation the patient was diagnosed to have relapsing polychondritis based on auricular and respiratory tract chondritis and response to steroids. The purpose of this report is to emphasize the fact that careful clinical assessment is needed to diagnose RP, which may be misdiagnosed as Ludwig’s angina.

  1. Vasospastic angina with J waves formation in patients with sudden loss of consciousness

    Institute of Scientific and Technical Information of China (English)

    Dan ZHU; Yi-Ming LUO; Ke-Hu A; Ling-Yun ZU; Yan-Hui ZHANG; Li-Jun GUO; Wei GAO; Yuan ZHANG

    2015-01-01

    Vasospastic angina is caused by sudden occlusive vasoconstriction of a segment of an epicardial artery, which can present with a wide spectrum of clinical scenario. We report the cases of two patients diagnosed with vasospastic angina, with one of which presenting with sud-den cardiac arrest, while the other presenting with a relatively benign syncope. But both of them have J waves formation on ECG during active ischemia. The diagnosis and management of vasospastic angina, as well as the proposed clinical significance of J waves during coro-nary spasm are discussed.

  2. Efficacy of anipamil, a phenylalkylamine calcium antagonist, in treatment of angina pectoris

    DEFF Research Database (Denmark)

    Sørum, C; Larsen, C T; Rasmussen, Verner;

    1994-01-01

    with > or = 0.1-mV horizontal or downsloping ST-segment depression limited by angina, and (c) at least 10 attacks of angina pectoris in a single-blind 3-week run-in period. Nineteen patients were randomized to enter the study. In 3-week periods, they received either anipamil 80 mg once daily (o.d.), anipamil...... 160 mg o.d., or placebo. At the end of each period, an exercise test was performed. The number of angina pectoris attacks was significantly reduced during treatment with anipamil 80 mg (p ... reduced during treatment with anipamil 80 mg (p Heart rate (HR) at 0...

  3. An Unusual Case of Suspected Microvascular Angina in a Newborn

    Directory of Open Access Journals (Sweden)

    Stefania Cataldo

    2012-01-01

    Full Text Available Myocardial ischemia in pediatric population is uncommon and usually due to congenital heart disease or extracardiac conditions leading to poor coronary perfusion. A 6-day-old newborn presented with respiratory distress and signs of heart failure. ECG, echocardiography, and laboratory results were consistent with myocardial ischemia. Coronary angiography was performed to exclude anomalous origin of coronary arteries, showing normal coronary artery origin and course. Thrombophilia and extra-cardiac causes were ruled out. Clinical conditions improved with mechanical ventilation and diuretics, enzyme levels lowered, repolarisation and systolic function abnormalities regressed, but ischemic electrocardiographic and echocardiographic signs still presented during intense crying. Becaues of suspicion of microvascular angina, therapy with ASA and beta-blocker was started. At 5 month followup, the baby was in good clinical condition and no more episodes were recorded. We believe it is an interesting case, as no similar cases have been recorded till now.

  4. Invaliderende angina pectoris behandlet med elektrisk rygmarvsstimulation (ERS)

    DEFF Research Database (Denmark)

    Andersen, C; Clemensen, S E; Henneberg, S W;

    1992-01-01

    Thirty patients who had severe incapacitating angina pectoris which had not reacted to the conventional therapeutic measures and which required massive daily opioid consumption were treated with electrical spinal cord stimulation (SCS) by means of a completely implantable stimulation system. The...... therapeutic effect was good in 87% of the patients who experienced considerably reduced frequency of attacks and markedly reduced opioid consumption (p less than 0.00005). Nine of the patients could reduce opioid consumption and 14 out of 27 could cease their otherwise daily opioid consumption. In four...... patients, the therapeutic effect was unsatisfactory. In the first 22 patients in whom a unipolar electrode was introduced, displacement of the electrode and subsequent reoperation was a frequent problem. This problem disappeared after change to multipolar electrodes as slight changes in placing of the...

  5. Predicting prognosis in stable angina - results from the Euro heart survey of stable angina: prospective observational study

    DEFF Research Database (Denmark)

    Daly, Caroline A.; De Stavola, Bianca; Sendon, Jose L. Lopez;

    2006-01-01

    -European survey in 156 outpatient cardiology clinics. Participants 3031 patients were included on the basis of a new clinical diagnosis by a cardiologist of stable angina with follow-up at one year. Main outcome measure Death or non-fatal myocardial infarction. Results The rate of death and non-fatal myocardial...... infarction in the first year was 2.3 per 100 patient years; the rate was 3.9 per 100 patient years in the subgroup (n = 994) with angiographic confirmation of coronary disease. The clinical and investigative factors most predictive of adverse outcome were comorbidity, diabetes, shorter duration of symptoms......, increasing severity of symptoms, abnormal ventricular function, resting electrocardiogaphic changes, or not having any stress test done. Results of non-invasive stress tests did not significantly predict outcome in the population who had tests done. A score was constructed using the parameters predictive of...

  6. Structural and Functional Coronary Artery Abnormalities in Patients With Vasospastic Angina Pectoris

    DEFF Research Database (Denmark)

    Ong, Peter; Aziz, Ahmed; Hansen, Henrik Steen;

    2015-01-01

    Coronary spasm is involved in many clinical scenarios, such as stable angina, acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical...

  7. Gender differences in the management and clinical outcome of stable angina

    DEFF Research Database (Denmark)

    Daly, Caroline; Clemens, Felicity; Sendon, Jose L. Lopez;

    2006-01-01

    Background- We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results- The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable...... angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42% were female. Women were......, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions- Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less...

  8. Evaluating Symptoms to Improve Quality of Life in Patients with Chronic Stable Angina

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Young

    2013-01-01

    Full Text Available Chronic stable angina (CSA is a significant problem in the United States that can negatively impact patient quality of life (QoL. An accurate assessment of the severity of a patient’s angina, the impact on their functional status, and their risk of cardiovascular complications is key to successful treatment of CSA. Active communication between the patient and their healthcare provider is necessary to ensure that patients receive optimal therapy. Healthcare providers should be aware of atypical symptoms of CSA in their patients, as patients may continue to suffer from angina despite the availability of multiple therapies. Patient questionnaires and symptom checklists can help patients communicate proactively with their healthcare providers. This paper discusses the prevalence of CSA, its impact on QoL, and the tools that healthcare providers can use to assess the severity of their patients’ angina and the impact on QoL.

  9. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    International Nuclear Information System (INIS)

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted

  10. Plasma Levels of the Anti-inflammatory Cytokine IL-10 and Inflammatory Cytokine IL-6 in Patients with Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    HONG Mei; WEI Wenning; HU Yu; YANG Rui; YANG Yan

    2005-01-01

    The plasma levels of inflammatory cytokine interleukin-6 (IL-6) and anti-inflammatory cytokine interleukin-10 (IL-10) in the patients with unstable angina or stable angina were determined and compared. In 30 patients with unstable angina and 22 patients with stable angina, plasma levels of IL-10 and IL-6 were detected by ELISA and plasma lipid parameters by lipid research clinical methods respectively. The results showed plasma levels of IL-10 were significantly lower in unstable angina group than in stable angina group (P=0. 005), while those of IL-6 were significantly increased in unstable angina group as compared with those in stable angina group (P = 0. 039).There was a significantly negative correlation between IL-10 and IL-6 in patients with unstable angina (r=-0.41, P=0. 003). In the unstable angina group, IL-6 levels were obviously positively correlated with TC (r=0. 314, P=0. 023), but not with TG and HDL. There were no significant correlations between IL-10 and plasma lipid parameters. It was suggested that the decreased IL-10and increased IL-6 might be associated with the atheromatous plaque stability and progression of coronary heart diseases. IL-10 may play an important role in preventing coronary vascular lesions.

  11. Ventetid og omkostninger ved diagnostik og behandling af stabil angina pectoris

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sanchez, Ricardo

    Introduction: The objective of this pilot study was to examine possible consequences of a logistically non-optimal regimen, for the diagnosis and treatment of stable angina pectoris, on waiting time and costs to inform whether a larger study is warranted. Material and methods: Retrospective cohor...... of stable angina pectoris, which ceteris paribus would be associated with cost savings in the health care sector. However, these potentials should be examined in a larger- scale study....

  12. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study.

    Directory of Open Access Journals (Sweden)

    Birgitta Söder

    Full Text Available Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom.In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis.Of the 1676 subjects, 51 (28 women/23 men had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years, Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16 than the other subjects (p = 0.02. Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01. Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17-4.17 in the association between high calculus index and angina pectoris (p = 0.015.Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study.

  13. Nicorandil in patients with acute coronary syndrome and stable angina undergoing Percutaneous Coronary Intervention: literature review

    OpenAIRE

    Neda Partovi; Homa Falsoleiman

    2014-01-01

    Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary...

  14. Prognostic value of early post-infarction angina in elderly patients

    OpenAIRE

    Erceg Predrag; Davidović Mladen; Vasiljević Zorana; Mitrović Predrag M.; Vukčević Vladan D.; Milošević Dragoslav P.; Stević Radmila; Rajić Miodrag

    2005-01-01

    Although numerous studies have shown that early post-infarction angina was a predictor of poor prognosis in patients with acute myocardial infarction, not a single study has considered this issue in the elderly. The goal of this study, based on a five-year follow-up of elderly patients with acute myocardial infarction, was to determine whether early post-infarction angina in the elderly had any influence on mortality and the incidence of additional coronary events. The study population consis...

  15. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study

    Science.gov (United States)

    2016-01-01

    Objectives Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom. Methods In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis. Results Of the 1676 subjects, 51 (28 women/23 men) had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years), Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16) than the other subjects (p = 0.02). Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01). Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17–4.17) in the association between high calculus index and angina pectoris (p = 0.015). Conclusion Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study. PMID:27336307

  16. [Crescendo angina - an indication for surgery: A short literature survey and a discussion of three cases].

    Science.gov (United States)

    Meyer, J M; Kleynhans, P H; Hugo, J M; Verwoerd, C A; Steyn, J G

    1980-08-01

    A definition of crescendo angina is given, followed by a short discussion of the literature on this disease. A case of a patient treated surgically for crescendo angina is reported, and the angiograms of 2 other patients are reviewed to further illustrate the problem. The favourable postoperative course of the patients who underwent an operation for this life-threatening disease is a strong indication for this mode of treatment.

  17. Five year prognosis in patients with angina identified in primary care: incident cohort study

    OpenAIRE

    Buckley, B. S.; Simpson, C.R.; McLernon, D.J.; Murphy, A W; Hannaford, P.C.

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: ...

  18. TREATMENT OPTIMIZATION IN PATIENTS WITH STABLE ANGINA PECTORIS: FOCUS ON VERAPAMIL SR

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2011-01-01

    Full Text Available Possibilities of angina pectoris pharmacotherapy are analyzed. Achievement of target heart rate (HR 55-60 beats per minute in these patients is possible due to three classes of antianginal medications that slow down HR: beta blockers (BB, If-channel inhibitors, nondihydropyridine calcium channel blockers (CCB. Nondihydropyridine CCB verapamil in slow release (SR formulation is focused. The main results of randomized clinical trials (APSIS, VHAS, CRIS, EVERESTH, VAMPHYRE, INVEST, VESPA, DAVIT-1, DAVIT-2, which have proven efficacy and safety, are presented. Verapamil SR is indicated for the treatment of angina pectoris in patients without history of myocardial infarction (MI; angina patients experienced MI without systolic heart failure and with contraindications to BB; angina with arterial hypertension; left ventricular diastolic dysfunction; peripheral arteries obliterating atherosclerosis; silent myocardial ischemia; vasospastic angina; angina associated with supraventricular cardiac arrhythmias (especially in permanent atrial fibrillation except Wolff-Parkinson-White and Lown-Ganong-Levine syndromes; after coronary angioplasty and the placement of bare metal stents.

  19. Recent advances in the management of chronic stable angina II. Anti-ischemic therapy, options for refractory angina, risk factor reduction, and revascularization

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-08-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas, USAAbstract: The objectives in treating angina are relief of pain and prevention of disease ­progression through risk reduction. Mechanisms, indications, clinical forms, doses, and side effects of the traditional antianginal agents – nitrates, ß-blockers, and calcium channel ­blockers – are reviewed. A number of patients have contraindications or remain unrelieved from anginal discomfort with these drugs. Among newer alternatives, ranolazine, recently approved in the United States, indirectly prevents the intracellular calcium overload involved in cardiac ischemia and is a welcome addition to available treatments. None, however, are disease-modifying agents. Two options for refractory angina, enhanced external counterpulsation and spinal cord stimulation (SCS, are presented in detail. They are both well-studied and are effective means of treating at least some patients with this perplexing form of angina. Traditional modifiable risk factors for coronary artery disease (CAD – smoking, hypertension, dyslipidemia, ­diabetes, and obesity – account for most of the population-attributable risk. Individual therapy of high-risk patients differs from population-wide efforts to prevent risk factors from appearing or reducing their severity, in order to lower the national burden of disease. Current American College of Cardiology/American Heart Association guidelines to lower risk in patients with chronic angina are reviewed. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE trial showed that in patients with stable angina, optimal medical therapy alone and percutaneous coronary intervention (PCI with medical therapy were equal in preventing myocardial infarction and death. The integration of COURAGE results into current practice is discussed. For patients who are unstable, with very high risk, with left main coronary artery lesions, in

  20. Importance of thrombosis and thrombolysis in silent ischaemia: comparison of patients with acute myocardial infarction and unstable angina.

    OpenAIRE

    Gurfinkel, E.; Altman, R.; Scazziota, A.; Rouvier, J.; Mautner, B

    1994-01-01

    OBJECTIVE--To investigate whether plaque rupture and thrombosis have a role in silent ischaemia as well as in unstable angina. DESIGN--Prospective analysis of the results of haemostatic diagnostic tests at the moment of developing silent ischaemia at rest. SETTING--Coronary care unit. PATIENTS--22 patients with acute myocardial infarction, 12 patients with symptomatic angina (unstable angina), and 10 normal volunteers (control group). INTERVENTIONS--Continuous cardiac monitoring detected 15 a...

  1. Effect of anxiety and depression on endothelial function and inflammation degree of coronary heart disease patients with angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Lin Ni; Xiang-Yang Xia; Ka Han; Yong-Xin Wu

    2016-01-01

    Objective:To study the effect of anxiety and depression on endothelial function and inflammation degree of coronary heart disease patients with angina pectoris.Methods: 80 cases of patients diagnosed with angina pectoris of coronary heart disease in our hospital from May 2012 to August 2014 were enrolled for study; anxiety and depression were judged by anxiety subscale (HADS-a) and depression subscale (HADS-d). Endothelial progenitor cell and endothelial microparticle contents in peripheral blood as well as serum ET-1, CGRP, IL-6, IL-6R, IL-18, ADAMTS-1 and NO contents were detected.Results:EPC, NO and CGRP contents of angina pectoris patients with anxiety were lower than those of angina pectoris patients without anxiety, and EMP, ET-1, IL-6, IL-6R, IL-18 and ADAMTS-1 contents were higher than those of angina pectoris patients without anxiety; EPC, NO and CGRP contents of angina pectoris patients with depression were lower than those of angina pectoris patients without depression, and EMP, ET-1, IL-6, IL-6R, IL-18 and ADAMTS-1 contents were higher than those of angina pectoris patients without depression.Conclusions:Angina pectoris of coronary heart disease patients complicated with anxiety and depression have endothelial dysfunction and inflammatory reaction activation; endothelial dysfunction and inflammatory reaction activation are possible pathways that anxiety and depression cause the progression of coronary heart disease.

  2. Renal artery stenosis presenting as crescendo angina pectoris.

    Science.gov (United States)

    Tami, L F; McElderry, M W; al-Adli, N M; Rubin, M; Condos, W R

    1995-07-01

    The coexistence of different clinical syndromes due to atherosclerosis in different organs is not rare and emphasizes the diffuse nature of this vascular process. Although renovascular disease may cause hypertension and/or renal insufficiency, it may also occur in the absence of the usual clinical markers that suggest renovascular hypertension. We report a patient with stable coronary anatomy who presented with crescendo angina pectoris. Diagnosis of renovascular hypertension was made by screening renal angiography at the time of the cardiac catheterization. Renal artery stenting resulted in stabilization of the coronary syndrome and obviated the need for further coronary intervention. To our knowledge, this is the first case of renovascular hypertension precipitating an unstable coronary syndrome in a patient with documented stable coronary anatomy. Review of the literature supports that patients undergoing cardiac catheterization are a high risk population for renovascular disease, particularly in the presence of other predictive factors such as documented coronary artery disease, older age, female gender, congestive heart failure, peripheral vascular disease, renal insufficiency, and smoking. Firm recommendations for routine screening renal angiography in patients undergoing peripheral or coronary angiography will need further studies.

  3. Ranolazine Therapy Reduces Non-ST-Segment-Elevation Myocardial Infarction and Unstable Angina in Coronary Disease Patients with Angina.

    Science.gov (United States)

    Murray, Gary L; Colombo, Joseph

    2016-09-01

    High sympathetic tone and cardiac autonomic neuropathy (CAN) are associated with major adverse cardiac events (MACE). We have shown ranolazine (RAN) improves autonomic function. RAN was introduced to 51 successive anginal CD patients (RANCD). A control group of 54 successive nonanginal CD patients (NORANCD) continued baseline therapy. Mean study duration was 6.1 years, which included semi-annual autonomic function measures (ANX 3.0, ANSAR Medical Technologies, Inc., Philadelphia, PA) and yearly myocardial perfusion SPECT studies (MPI). MACE were experienced by 29% RANCD patients versus 46% NORANCD patients (p = 0.0105). The patients from both groups with abnormal parasympathetic and sympathetic (P&S) measures and MACE totaled 52 of those patients with MACE versus 17% of those patients without MACE (p = 0.0274). Abnormal MPI was demonstrated in 35% of those with abnormal (P&S) measures and MACE versus 12% without MACE. Sympathovagal balance (SB) was lower, indicating higher, relative parasympathetic tone (known to be cardioprotective) in the RANCD group. Acute coronary syndromes occurred 4.5 times as often in NORANCD patients. High SB occur more frequently than abnormal MPI in CD patients experiencing MACE. In addition to increased myocardial blood flow as its proposed mechanism of angina relief, RAN improves P&S measures, a potentially new mechanism whereby RAN improves outcomes.

  4. Relationship between the serologic status of helicobacter pylori with the presence of unstable angina

    International Nuclear Information System (INIS)

    To determine whether unstable angina is co-related to seropositivity to chronic Helicobacter pylori (HP) infection. It is a case control, descriptive study conducted at CCU in Razi Hospital in Ahwaz a city southwest Iran, from 2004 to 2005. We measured serum HP- lgG levels of participants in CCU in a hospital. Blood samples were drawn during study period from 96 patients (mean age 56 years) with Unstable Angina (UA) according to American Heart Association criteria and from 96 participants free of cardiovascular disease (mean age 58 years) and stored at 20 degree C. Serology results were studied in relation to UA. Using chi squared test, odds ratios (OR) and 95% confidence intervals (CI) were calculated, adjusting for age, gender, and established risk factors. Seventy nine (82.3%) of patients with unstable angina and 55(61.1%) in the control group presented a positive anti HP-lgG. Odds ratio was 3 with 95% CI: 1.9 to 4.3. There was significant relation between HP-lgG positivity and unstable angina (P0.05). Our study revealed relationship between seropositivity of HP-lgG and unstable angina. (author)

  5. The initial management of stable angina in Europe, from the Euro Heart Survey: a description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: In order to assess adherence to guidelines and international variability in management, the Euro Heart Survey of Newly Presenting Angina prospectively studied medical therapy, percutaneous coronary intervention (PCI), and surgery in patients with new-onset stable angina in Europe. METHODS AND

  6. A new scoring system to stratify risk in unstable angina

    Directory of Open Access Journals (Sweden)

    Salzberg Simón

    2003-08-01

    Full Text Available Abstract Background We performed this study to develop a new scoring system to stratify different levels of risk in patients admitted to hospital with a diagnosis of unstable angina (UA, which is a complex syndrome that encompasses different outcomes. Many prognostic variables have been described but few efforts have been made to group them in order to enhance their individual predictive power. Methods In a first phase, 473 patients were prospectively analyzed to determine which factors were significantly associated with the in-hospital occurrence of refractory ischemia, acute myocardial infarction (AMI or death. A risk score ranging from 0 to 10 points was developed using a multivariate analysis. In a second phase, such score was validated in a new sample of 242 patients and it was finally applied to the entire population (n = 715. Results ST-segment deviation on the electrocardiogram, age ≥ 70 years, previous bypass surgery and troponin T ≥ 0.1 ng/mL were found as independent prognostic variables. A clear distinction was shown among categories of low, intermediate and high risk, defined according to the risk score. The incidence of the triple end-point was 6 %, 19.2 % and 44.7 % respectively, and the figures for AMI or death were 2 %, 11.4 % and 27.6 % respectively (p Conclusions This new scoring system is simple and easy to achieve. It allows a very good stratification of risk in patients having a clinical diagnosis of UA. They may be divided in three categories, which could be of help in the decision-making process.

  7. Ludwig's angina and ketoacidosis as a first manifestation of diabetes mellitus.

    Science.gov (United States)

    Infante-Cossío, Pedro; Fernández-Hinojosa, Esteban; Mangas-Cruz, Miguel-Angel; González-Pérez, Luis-Miguel

    2010-07-01

    Ludwig's angina is a serious and rapidly progressive infectious process that spreads through the floor of the mouth and neck. In this paper we present an infrequent case of a patient who suffered an odontogenic infection with poor response to the previous treatment, which evolved towards a Ludwig's angina combined with ketoacidosis in the context of a diabetes mellitus not known before. According to the literature reviewed, this case report represents the first contribution of a Ludwig's angina and ketoacidosis as an initial manifestation of a diabetes mellitus. The airway management, the antibiotic prescription and the surgical drainage allowed the healing of the patient without medical complications. Factors of co-morbidity like the diabetes mellitus together with focus tooth of infection may eventually turn into serious medical complications as the diabetic ketoacidosis and develop potentially lethal cervical infections.

  8. Efficacy of a device to narrow the coronary sinus in refractory angina

    DEFF Research Database (Denmark)

    Verheye, Stefan; Jolicœur, E Marc; Behan, Miles W;

    2015-01-01

    BACKGROUND: Many patients with coronary artery disease who are not candidates for revascularization have refractory angina despite standard medical therapy. The balloon-expandable, stainless steel, hourglass-shaped, coronary-sinus reducing device creates a focal narrowing and increases pressure...... ischemia, who were not candidates for revascularization, to implantation of the device (treatment group) or to a sham procedure (control group). The primary end point was the proportion of patients with an improvement of at least two CCS angina classes at 6 months. RESULTS: A total of 35% of the patients...... patient had died and 3 had had a myocardial infarction. CONCLUSIONS: In this small clinical trial, implantation of the coronary-sinus reducing device was associated with significant improvement in symptoms and quality of life in patients with refractory angina who were not candidates for revascularization...

  9. Effects on blood pressure in patients with refractory angina pectoris after enhanced external counterpulsation

    DEFF Research Database (Denmark)

    Bondesson, Susanne; Pettersson, Thomas; Ohlsson, Børje Ola Mattias;

    2010-01-01

    OBJECTIVE: Enhanced external counterpulsation (EECP) is a non-invasive technique that has been shown to reduce the frequency and severity of angina pectoris. Little is known how EECP affects the blood pressure. METHODS: 153 patients with refractory angina were treated with either EECP or retained...... on their pharmacological treatment (reference group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and heart rate were measured pre- and post-treatment and at 12 months follow-up. RESULTS: EECP treatment altered the blood pressure in patients with...... refractory angina pectoris. A decrease in the blood pressure was more common in the EECP group compared with the reference group. In the reference group, an increase in the blood pressure was more common. A correlation between a decrease in blood pressure after EECP treatment and a higher baseline MAP, SBP...

  10. Efficacy of Enhanced External Counterpulsation in Patients With Chronic Refractory Angina on Canadian Cardiovascular Society (CCS) Angina Class: An Updated Meta-Analysis.

    Science.gov (United States)

    Zhang, Chunmei; Liu, Xiangjuan; Wang, Xiaomeng; Wang, Qi; Zhang, Yun; Ge, Zhiming

    2015-11-01

    A growing number of patients with chronic artery disease suffer from angina, despite the optimal medical management (ie, β-blockers, calcium channel blockers, and long-acting nitrates) and revascularization. Currently, enhanced external counterpulsation (EECP) therapy has been verified as a noninvasive, safe therapy for refractory angina. The study was designed to evaluate the efficacy of EECP in patients with chronic refractory angina according to Canadian Cardiovascular Society (CCS) angina class.We identified systematic literature through MEDLINE, EMBASE, the Cochrane Clinical Trials Register Database, and the ClinicalTrials. gov Website from 1990 to 2015. Studies were considered eligible if they were prospective and reported data on CCS class before and after EECP treatment. Meta-analysis was performed to assess the efficacy of EECP therapy by at least 1 CCS angina class improvement, and proportion along with the 95% confidence interval (CI) was calculated. Statistical heterogeneity was calculated by I statistic and the Q statistic. Sensitivity analysis was addressed to test the influence of trials on the overall pooled results. Subgroup analysis was applied to explore potential reasons for heterogeneity.Eighteen studies were enrolled in our meta-analysis. Pooled analysis showed 85% of patients underwent EECP had a reduction by at least one CCS class (95%CI 0.81-0.88, I = 58.5%, P < 0.001). The proportion of patients enrolled at primarily different studies with chronic heart failure (CHF) improved by at least 1 CCS class was about 84% after EECP (95%CI 0.81-0.88, I = 32.7%, P = 0.1668). After 3 large studies were excluded, the pooled proportion was 82% (95%CI 0.79-0.86, I = 18%, P = 0.2528). Funnel plot indicated that some asymmetry while the Begg and Egger bias statistic showed no publication bias (P = 0.1495 and 0.2859, respectively).Our study confirmed that EECP provided an effective treatment for patients who were unresponsive to medical management and

  11. Die Bedeutung der Kaliumkanalöffner für die Therapie der Angina pectoris

    Directory of Open Access Journals (Sweden)

    Auer J

    2003-01-01

    Full Text Available In der Behandlung der koronaren Herzkrankheit ist primär die Senkung der Ereignisrate (Mortalität, Koronarletalität, Myokardinfarkt, rezidivierende Angina, Insult, Herzinsuffizienz, Revaskularisationen anzustreben. Zusätzlich ist die Zielsetzung der antianginösen Therapie vor allem die Verbesserung der Belastungstoleranz sowie die Reduktion von ischämiebedingten Folgeerscheinungen. Für die antianginöse Therapie stehen vier Wirkstoffklassen zur Verfügung, die ein differenziertes Vorgehen erlauben und die wahlweise als Monotherapien oder in Kombination in der Therapie der stabilen Angina pectoris zur Anwendung kommen können: Betablocker, Nitrate, Kalziumantagonisten und Kaliumkanalöffner. Im Rahmen der IONA-Studie (Impact Of Nicorandil in Angina wurde rezent überprüft, ob unter einer Therapie mit Nicorandil bei Patienten mit chronisch stabiler Angina pectoris die Häufigkeit schwerwiegender koronarer Ereignisse verringert werden könnte. Mit dieser Studie konnte nun ein eindeutiger Hinweis für eine Reduktion ischämiebezogener klinischer Ereignisse unter Nicorandil bei Patienten mit Angina pectoris nachgewiesen werden. Während für die antianginöse Therapie bisher lediglich eine symptomlindernde Wirkung zweifelsfrei dokumentiert ist, verbessern Maßnahmen zur Verhinderung von Thrombose- und Atheromentwicklung die Prognose (Aspirin, Cumarine, ACE-Hemmer und Lipidsenker [Statine] sowie Lebensstilmodifikation einschließlich Nikotinkarenz. Grundsätzlich sollte darüber hinaus bei Patienten mit Angina-pectoris-Beschwerden immer die Option einer Koronarangiographie und Koronarintervention (PTCA, Stent, Bypass überlegt werden.

  12. The prognostic significance of angina pectoris experienced during the first month following acute myocardial infarction

    DEFF Research Database (Denmark)

    Jespersen, C M

    1997-01-01

    BACKGROUND: Angina pectoris accompanied by transient ST-segment changes during the in-hospital phase of acute myocardial infarction (AMI) is a well established marker of subsequent cardiac death and reinfarction. HYPOTHESIS: This study was undertaken to record the prognostic significance of angina...... pectoris experienced during the first month following discharge from AMI. METHODS: In all, 803 patients included in the placebo arm of the Danish Verapamil Infarction Trial II were followed up for 18 months in 20 coronary care units in Denmark. The patients were randomized to placebo and were still...

  13. SIMULACIÓN BIDIMENSIONAL DE UN SISTEMA DE COMBUSTIÓN INESTABLE TWO-DIMENSIONAL SIMULATION OF AN UNSTABLE COMBUSTION SYSTEM

    Directory of Open Access Journals (Sweden)

    Javier Achury Varila

    2010-04-01

    Full Text Available La inestabilidad en la combustión es una condición indeseada en algunos sistemas de combustión como en turbinas de gas por ejemplo. Se refiere a la presencia autogenerada de oscilaciones en la presión que pueden afectar a la cámara de combustión y de paso llegar a generar ruido. Una reciente tendencia generalizada en los procesos de combustión apunta al uso de mezclas pobres para la reducción de contaminantes, no obstante que este tipo de mezclas son más susceptibles a la inestabilidad en la combustión. Las complicadas relaciones que gobiernan el fenómeno se pueden resumir como el acoplamiento entre la llama y la acústica del sistema. En el presente trabajo se presenta un planteamiento numérico que permite aproximarse al fenómeno a través de la solución de un modelo de combustión básico implementado computacionalmente. En este modelo se simula una autoexcitación del sistema a través de oscilaciones en la entrada de flujos de reactantes. Finalmente, se comparan los resultados de la simulación numérica con otras simulaciones y datos experimentales.The Combustion instability is an undesirable condition reached in some combustion systems, as during the operation of gas turbines. It refers to self-excited oscillations of pressure that may affect the combustion chamber and generate noise. A recent generalized tendency in combustion processes aims to the use of lean combustion (low fuel/air ratios for pollutants reduction, nevertheless this sort of mixtures are more susceptible to combustion instabilities. The complex relationship that generates the phenomenon can be summarized as the coupling between flame and acoustics. In this paper it is outlined a numerical approach to this phenomenon by solving a basic computational combustion model (by Direct Numerical Simulation. In this model a self-excited system is simulated through imposed oscillations in reactants flows. Finally, results for this numerical simulation are compared

  14. Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients.

    Directory of Open Access Journals (Sweden)

    Jing Wu

    Full Text Available OBJECTIVES: To compare health-related quality of life (HRQoL between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS: A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411 and the general population recruited from 3 Physical Examination Centers (n = 549 was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ. Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS: Compared with the general population (44.2 ± 10 years, 49.9% females, stable angina patients (68.1 ± 12 years, 50.4% females had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05, SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05, and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05. The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6. Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS: Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms

  15. Mechanisms of angina pectoris in syndrome X assessed by myocardial perfusion dynamics and heart rate variability

    NARCIS (Netherlands)

    Meeder, JG; Blanksma, PK; Crijns, HJGM; Anthonio, RL; Pruim, J; Brouwer, J; DeJong, RM; VanderWall, EE; Vaalburg, W; Lie, KI

    1995-01-01

    The fundamental abnormality in syndrome X (angina pectoris, ischaemia-like stress ECG despite angiographically normal coronary arteries) might be patchily distributed increased tone in pre-arteriolar coronary vessels with compensatory release of adenosine. The aim of this study was to confirm this h

  16. Spinal cord stimulation in refractory angina pectoris - Clinical results and mechanisms

    NARCIS (Netherlands)

    Oosterga, M; tenVaarwerk, IAM; DeJongste, MJL; Staal, MJ

    1997-01-01

    Patients with therapeutically refractory angina pectoris do not respond to adequate anti-anginal medication and are not suitable anymore for revascularisation procedures. This group of patients has a poor quality of Life, since their exercise capacity is severely afflicted. A new additional therapy

  17. Percutaneous Revascularization in a Case of Vasospastic Angina Associated with Polymorphic Ventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Roxana Rudzik

    2015-12-01

    Full Text Available Introduction: Coronary vasospasm is a possible cause of ventricular tachyarrhythmias and is frequently associated with atherosclerotic lesions. The revascularization of mild to moderate coronary artery stenosis which causes symptoms only due to associated vasospasm is still a matter of debate, as the standard treatment of Prinzmetal angina is represented by the long term administration of calcium-channel blockers.

  18. Spinal cord stimulation in chronic intractable angina pectoris : A randomized, controlled efficacy study

    NARCIS (Netherlands)

    Hautvast, RWM; DeJongste, MJL; Staal, MJ; van Gilst, WH; Lie, KI

    1998-01-01

    Background Spinel cord stimulation is known to be a successful treatment for chronic intractable angina pectoris. its effect may be anti-ischemic. It is uncertain if the clinical effect is partly caused by a placebo effect of surgery For implantation of a stimulator. In this study, clinical efficacy

  19. Angina pectoris refractory for conventional therapy - Is neurostimulation a possible alternative treatment?

    NARCIS (Netherlands)

    Hautvast, RWM; DeJongste, MJL; TerHorst, GJ; Blanksma, PK; Lie, KI

    1996-01-01

    The treatment of angina pectoris as a symptom of coronary artery disease usually is focused on restoring the balance between oxygen demand and supply of the myocardium by administration of drugs interfering in heart rate, cardiac pre- and afterload, and coronary vascular tone. For nonresponders to d

  20. SAFETY AND EFFICACY OF BETA-BLOCKERS IN THE TREATMENT OF STABLE ANGINA-PECTORIS

    NARCIS (Netherlands)

    DEMUINCK, ED; LIE, KI

    1990-01-01

    In stable exercise-induced angina pectoris, beta-blockers exert their beneficial effects mainly through a reduction in heart rate, blood pressure, and contractility. Additional beneficial effects are an improvement in myocardial oxygen supply through a redistribution of coronary flow, a lengthening

  1. Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department.

    Science.gov (United States)

    Safdar, Basmah; D'Onofrio, Gail

    2016-06-01

    Emergency departments (ED) in the United States see over eight million cases of chest pain annually. While a cardinal symptom of acute coronary syndrome (ACS), multiple emergent and non-emergent causes can attribute to chest pain. This case-based perspective describes the different sex-specific causes of angina seen in ED patients. Once coronary artery disease (CAD) is ruled out with standard protocols, microvascular dysfunction is perhaps the most prevalent but under-diagnosed cause of non-CAD related angina in ED patients. Additional causes include coronary artery spasm, coronary artery dissection, coronary artery endothelial dysfunction and myocardial bridging. Non-CAD related angina is associated with persistent chest pain causing poor function, quality of life, and recidivism. Clinicians should consider additional diagnostics to routinely screen for non-CAD related causes of angina in patients with recurrent chest pain. Future work is needed to better define the epidemiological, clinical, biological, and genetic correlates of microvascular dysfunction in these patients. PMID:27354848

  2. VEGF 165 Gene Therapy for Patients with Refractory Angina: Mobilization of Endothelial Progenitor Cells

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Clarissa G. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Duke University Medical Center, Durham, North Carolina (United States); Plentz, Rodrigo D.M. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Dipp, Thiago [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Salles, Felipe B. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Giusti, Imarilde I.; Sant' Anna, Roberto T.; Eibel, Bruna; Nesralla, Ivo A.; Markoski, Melissa [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Beyer, Nance N. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Kalil, Renato A. K., E-mail: kalil.pesquisa@gmail.com [Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil)

    2013-08-15

    Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9{sup th} and 27{sup th} was comparable to that at baseline. We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on 9{sup th} and 27{sup th}days.

  3. VEGF 165 Gene Therapy for Patients with Refractory Angina: Mobilization of Endothelial Progenitor Cells

    International Nuclear Information System (INIS)

    Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9th and 27th was comparable to that at baseline. We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on 9th and 27thdays

  4. Erhöhter oxidativer Streß bei Patienten mit instabiler Angina pectoris

    Directory of Open Access Journals (Sweden)

    Bodlaj G

    1998-01-01

    Full Text Available Die instabile Angina pectoris führt oft zum akuten Myokardinfarkt. Da die Lipid-Peroxidation im Verdacht steht, chronische und akute Ereignisse der Atherosklerose und der koronaren Herzkrankheit zu fördern, untersuchten wir die Lipid-Peroxidations-Parameter und alpha-Toco-pherol-Spiegel bei 100 KHK-Patienten und verglichen sie mit denen einer entprechenden Kontrollgruppe. 50 konsekutive Patienten mit stabiler Angina pectoris (SAP und 50 konsekutive Patienten mit instabiler Angina pectoris (IAP wurden untersucht und mit 100 klinisch gesunden Personen verglichen. Zusätzlich zur herkömmlichen Lipid- und Lipoprotein-Analyse wurden die Lipid-Peroxidations-Produkte als Hydroperoxide und Thiobarbituric acid reactive substances (TBARS gemessen. Die konjugierten Diene wurden nur bei den Patienten bestimmt. Da alpha-Tocopherol eines der wichtigsten Antioxidantien ist, wurde es ebenfalls quantifiziert. Wie erwartet hatten die Patienten wesentlich höhere Cholesterin-, Triglyzerid-, LDL-C- und Lp(a-Spiegel und niedrigere HDL-C-Spiegel als die Kontrollgruppe. Als die Patienten in Gruppen mit stabiler und instabiler Angina pectoris geteilt wurden, waren Peroxide und TBARS in der letzteren Gruppe wesentlich höher als bei den anderen Patienten und der Kontrollgruppe. Auch konjugierte Diene waren eindeutig höher bei den Patienten mit instabiler Angina pectoris. Der alpha-Tocopherol-Gesamtspiegel war in allen 3 Gruppen vergleichbar, aber der alpha-Tocopherol-Gehalt pro LDL-Partikel war bei den Patienten mit IAP am niedrigsten, gefolgt von denen mit SAP und der Kontrollgruppe. Wir schließen daraus, daß die Lipid-Peroxidations-Parameter bei Patienten mit IAP erhöht sind und SAP-Patienten von IAP-Patienten unterscheiden.

  5. Immediate and long-term clinical outcome after spinal cord stimulation for refractory stable angina pectoris.

    Science.gov (United States)

    Di Pede, Francesco; Lanza, Gaetano Antonio; Zuin, Guerrino; Alfieri, Ottavio; Rapati, Massimo; Romanò, Massimo; Circo, Antonio; Cardano, Paola; Bellocci, Fulvio; Santini, Massimo; Maseri, Attilio

    2003-04-15

    The treatment of patients with angina pectoris refractory to medical therapy and unsuitable for revascularization procedures has yet not been well standardized. Previous retrospective studies and small prospective studies have suggested beneficial effects of spinal cord stimulation (SCS) in these patients. We created a Prospective Italian Registry of SCS to evaluate the short- and long-term clinical outcome of patients who underwent SCS device implantation because of severe refractory angina pectoris. Overall, 104 patients were enrolled in the registry (70 men, aged 68 +/- 17 years), most of whom (83%) had severe coronary artery disease. Average follow-up was 13.2 +/- 8 months. Overall, 17 patients (16%) died, 8 (8%) due to cardiac death. Among clinical variables, only age was found to be significantly associated both with total mortality (p = 0.04) and cardiac mortality (p = 0.02) on Cox regression analysis. A significant improvement of anginal symptoms (> or =50% reduction of weekly anginal episodes, compared with baseline) occurred in 73% of patients, and Canadian Cardiovascular Society angina class improved by > or =1 class in 80% and by > or =2 classes in 42% of patients, with a relevant reduction in the rate of hospital admission and days spent in the hospital because of angina (p <0.0001 for both). No life-threatening or clinically serious complications were observed. The most frequent side effect consisted of superficial infections, either at the site of puncture of electrode insertion or of the abdominal pocket, which occurred in 6 patients. In conclusion, our prospective data point out that SCS can be performed safely and is associated with a sustained improvement of anginal symptoms in a relevant number of patients with refractory stable angina pectoris. PMID:12686334

  6. TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

    Science.gov (United States)

    Mendoza-Ticona, Alberto

    2014-01-01

    Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

  7. Histopathological examination of specimens removed during directional coronary atherectomy in patients presenting with crescendo angina show mural thrombus.

    Science.gov (United States)

    Bellamy, C M; Grech, E D; Ashworth, M T; Ramsdale, D R

    1993-02-01

    Thrombus formation over a fissured coronary atheromatous plaque has been shown by post mortem histological examination to be the pathophysiological mechanism responsible for myocardial ischaemia in those patients who died following a crescendo pattern of angina. Histological examination of plaques responsible for a crescendo pattern of angina in patients who do not die has not been available until recently. We describe two patients who presented with a crescendo pattern of angina. A new technique of coronary revascularization, directional coronary atherectomy, produced symptomatic relief and resolution of myocardial ischaemia. Histological examination of material from the stenosis responsible for their myocardial ischaemia, obtained using this technique, confirmed thrombus formation overlying a fissured atheromatous plaque.

  8. Case management does not decrease mortality of patients with myocardial infarction or unstable angina: Evidence from a systematic review

    Directory of Open Access Journals (Sweden)

    Li-Juan Yi

    2016-06-01

    Conclusion: Case management is not beneficial to all-cause mortality after myocardial infarction or unstable angina compared to routine care. Additional, prospective RCTs of high quality and large scale are warranted to verify these results.

  9. Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    王荣英

    2003-01-01

    Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction@王荣英$河北医科大学第二医院!石家庄050000 0311-70469016011

  10. Use of myocardial perfusion imaging to predict the effectiveness of coronary revascularisation in patients with stable angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Allan [Odense University Hospital, Department of Clinical Physiology and Nuclear Medicine, Odense (Denmark); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming; Moeldrup, Mette [Odense University Hospital, Department of Clinical Physiology and Nuclear Medicine, Odense (Denmark); Christensen, Henrik Wulff [Nordic Institute of Chiropractic and Clinical Biomechanics, Odense (Denmark); Vach, Werner [University of Southern Denmark, Department of Statistics, Odense (Denmark); Haghfelt, Torben [Odense University Hospital, Department of Cardiology, Odense (Denmark)

    2005-12-01

    Coronary revascularisation is the treatment of choice in patients with stable angina who have significant stenoses. From a pathophysiological point of view, however, mitigation of angina is to be expected only in the presence of reversible ischaemia. Therefore it was the aim of this study to examine the effect of revascularisation on stable angina in relation to the myocardial perfusion imaging (MPI) pattern prior to intervention. Three hundred and eighty-four patients (58.0{+-}8.8 years) referred for angiography underwent MPI. Prior to MPI and at 2-year follow-up, patients were classified as having typical angina, atypical angina, non-cardiac chest pain or no pain, and the severity of chest pain was graded according to the Canadian Cardiovascular Society (CCS) criteria. The patients themselves estimated their pain on a visual analogue scale. Management was based on symptoms and angiographic findings, since the results of MPI were not communicated. Among the 240 patients who were not revascularised, 79% had typical or atypical angina at study entrance versus 40% at follow-up. In comparison, 93% of the 144 revascularised patients had typical or atypical angina before intervention versus only 36% at follow-up. This additional advantage of invasive therapy was present only in patients with reversible defects; revascularisation had no additional effect in patients with normal perfusion or irreversible defects. Similarly, additional, significant reductions in CCS class and visual analogue score were observed exclusively in patients with reversible defects. In patients referred for coronary angiography owing to known or suspected stable angina, revascularisation was significantly more effective than medical treatment exclusively in patients with reversible ischaemia. (orig.)

  11. Predictor value of some clinical-biological parameters for the onset of depressive disorder in elderly patients with unstable angina

    OpenAIRE

    Cristina Moşuţan; George Săraci; Caius R. Duncea

    2012-01-01

    Abstract. Objective: To evaluate the potential predictor value of some parameters for the onset of depression after an episode of unstableangina in elderly. Material and Methods: We included 103 elderly patients who suffered an acute unstable angina episode. Clinical, laband imagistic data was recorded in the first week after admittance. Six month after unstable angina episode, patients were evaluated for thepresence of depression. Results: Univariate analysis showed statistically significant...

  12. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    OpenAIRE

    A. I. Kondratiev

    2014-01-01

    Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2).Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina) and acute left ventricular failure(Killip class I–III) during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical...

  13. Xuesaitong Soft Capsule (Chinese Patent Medicine) for the Treatment of Unstable Angina Pectoris: A Meta-Analysis and Systematic Review

    OpenAIRE

    Xiaochen Yang; Xingjiang Xiong; Heran Wang; Guoyan Yang; Jie Wang

    2013-01-01

    Objective. To provide a systematic review to evaluate the effectiveness and safety of Xuesaitong soft capsule (XST) in treating unstable angina (UA). Methods. An extensive search of 6 medical databases was performed up to August 2013. Randomized controlled trials (RCTs) involving XST alone or combined with conventional drugs versus conventional drugs were included. A meta-analysis of reduction of angina symptoms and electrocardiogram (ECG) improvement was performed to evaluate the effects of ...

  14. Association of Low Levels of Vitamin D with Chronic Stable Angina: A Prospective Case-Control Study

    OpenAIRE

    Ab Hameed Raina; Mohammad Sultan Allai; Zafar Amin Shah; Khalid Hamid Changal; Manzoor Ahmad Raina; Fayaz Ahmad Bhat

    2016-01-01

    Background: Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. A low level of vitamin D is associated with chronic stable angina. Aim: This study was aimed at supporting or refuting this hypothesis in our population. M...

  15. Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

    DEFF Research Database (Denmark)

    Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

    2010-01-01

    Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report...... tolerable level of stimulation was carried out to exclude inference with the ICD. The following treatment with SCS has in all cases been successful, with significant pain relief and improved quality of life. There were no incidences of inappropriate defibrillator shocks. Spinal cord stimulation...... successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...

  16. ONE CASE REPORT OF ANGINA TONSILLARIS INDUCED MEDIASTINAL ABSCESS AND THORACIC EMPYEMA

    Institute of Scientific and Technical Information of China (English)

    LI Qing-yun; WANG Xi; WAN Huan-ying; DENG Wei-wu

    2009-01-01

    A 27-year-old female patient with mediastinal abscess and thoracic empyema developed from angina tonsillaris was studied clinically on the manifestations, computed tomography (CT) scan, and the treatment process. The patient was admitted to hospital with a history of fever, sore throat, and chest and neck pain. CT showed air and air-fluid levels within mediastinal dense fatty planes that extended from the thoracic inlet to the sub-carinal region and left pleural empyema. She was cured by mediastinal drainage and extensive debridement of the necrotic tissue under operation and broad spectrum antibiotics treatment. Angina tonsillaris induced acute mediastitis and mediastinal abscess is a relatively rare inflammatory pathology but actually a fatal situation for its high mortality rate. CT scanning is extremely useful for early diagnosis and surgical treatment planning. The main treatment is aggressive and adequate surgical drainage of the abscess and intravenous effective antibiotic treatment.

  17. Improving diagnosis and treatment of women with angina pectoris and microvascular disease: 

    DEFF Research Database (Denmark)

    Prescott, Eva; Abildstrøm, Steen Zabell; Aziz, Ahmed;

    2014-01-01

    , advanced echocardiographic modalities at rest and during stress, and invasive measures of CFR and coronary vascular reactivity. The study will include 2000 women who will be followed for 5 years for cardiovascular outcomes. RESULTS: By May 2013, 1685 women have been screened, 759 eligible patients......BACKGROUND: The iPOWER study aims at determining whether routine assessment of coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease is feasible and identifies women at risk. METHODS: All women with angina referred to invasive angiographic...... assessment in Eastern Denmark are invited to join the study according to in- and exclusion criteria. Assessment includes demographic, clinical and psychosocial data, symptoms, electrocardiogram, blood- and urine samples and transthoracic echocardiography during rest and dipyridamol stress with measurement...

  18. Chest pain and angina pectoris - or the ugly swan and the beautiful duckling

    Science.gov (United States)

    van Tellingen, C.

    2010-01-01

    The original description of Heberden’s angina pectoris is put forward to stress the importance of proper history-taking in identifying patients. In a market-driven approach to improve cost-effectiveness in healthcare, angina pectoris as an entity seems stripped to its bare minimum: chest and pain. The diagnostic yield of exercise testing, however, depends on the pre-test likelihood of disease and therefore knowledge of its clinical utility and pitfalls is essential to refine an initial and subjective diagnosis based on anamnesis. Nowadays chest pain units attempt to improve diagnostic accuracy by submitting all sorts of patients to the (stress) test. In the end protocol-driven policies like these may very well prove to be contraproductive when fundamentals are ignored. (Neth Heart J 2010;18:561–4.) PMID:21113382

  19. Optimal treatment of chronic angina in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kaur H

    2014-07-01

    Full Text Available Harjinder Kaur,1 Kully Sandhu,2 Awais Jabbar,3 Azfar G Zaman3,4 1City Hospitals Sunderland, Sunderland, UK; 2University Hospital of North Staffordshire, Stoke-on-Trent, UK; 3Freeman Hospital, Newcastle-upon-Tyne, UK; 4Institute of Cellular Medicine, Newcastle University, Newcastle, UK Abstract: Type 2 diabetes mellitus (T2DM trebles the risk of developing coronary artery disease (CAD; once CAD has developed, the risk of acute coronary syndromes (ACS and clinical risk associated with a coronary event, both double in diabetic patients. Patients with T2DM have more extensive CAD and present at a younger age; therefore, identification and management of chronic angina in these patients presents an opportunity to limit both cardiovascular symptoms and adverse outcomes. This article reviews the role of screening and treatment for chronic angina in patients with T2DM. There is a strong evidence base for modifying lifestyle as a way of reducing adverse cardiovascular outcomes in the diabetic population and this article reviews evidence of lifestyle modification as an important and necessary adjunct to pharmacologic intervention. Management of chronic stable angina is addressed by looking at treatments that reduce ischemic symptoms and those that reduce adverse cardiovascular outcomes. Trials specific to the diabetic population are limited, with information largely obtained from the diabetic subgroup analysis of large intervention trials. The growing diabetic population with increased propensity to cardiovascular disease mandates trials specifically in this patient population. Revascularization in patients with diabetes is associated with more complications than in the non-diabetic population. Recent trials specific to this population suggest surgical revascularization to be associated with better long-term outcomes and therefore, this article reviews the evidence for the optimal mode of revascularization in this population. Keywords: type 2 diabetes

  20. Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation

    Institute of Scientific and Technical Information of China (English)

    Susanne M Bondesson; Marie-Louise Edvinsson; Thomas Pettersson; Lars Edvinsson

    2011-01-01

    Objective To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina.Methods Twenty patients diagnosed with refractory angina were divided into EECP (n =10) or no EECP (n =10) groups.The data were compared to matched healthy subjects (n =20).The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry.The vascular responsiveness to iontophoretic administration of acetylcholine (ACh),sodium nitroprusside (SNP) and local skin warming were studied.Measurements of Canadian Cardiovascular Society (CCS)-class,blood pressure and plasma samples were registered.Results EECP patients showed reduced CCS-class compared to no EECP (P < 0.05).Both EECP and no EECP (P < 0.05) groups had decreased systolic blood pressure (SBP) as compared to SBP at baseline (P < 0.05).There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up.Responses to heating,the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects (P < 0.05).EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class.Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh,SNP and heat compared to healthy subjects.Although EECP reduced the CCS-class,this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.

  1. Efficacy evaluation of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression

    Institute of Scientific and Technical Information of China (English)

    Chun-Hua Liao

    2015-01-01

    Objective:To study the efficacy of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression. Methods:120 cases of unstable angina patients with depression were randomly divided into two groups. The anti-depression group received fluoxetine combined with conventional drug therapy; the conventional group received conventional drug therapy. Then contents of monoamine neurotransmitters and their metabolites, antioxidants and inflammatory mediators of both groups were compared. Results:Serum monoamine neurotransmitters NE, 5-HT and HA levels of the anti-depression group were higher than those of the conventional group and metabolites 5-HIAA and HVA contents were lower than those of the conventional group; serum SOD, CAT, GSH and HSP-70 contents of the anti-depression group were higher than those of the conventional group, and hs-CRP, MMP9, MCP1 and HMGB1 contents were lower than those of the conventional group. Conclusion:Fluoxetine combined with conventional drug therapy can increase the contents of monoamine neurotransmitters and antioxidants, and reduce oxidative stress response and inflammatory response; it is an ideal method for treating unstable angina complicated with depression.

  2. Breviscapine Injection Improves the Therapeutic Effect of Western Medicine on Angina Pectoris Patients.

    Directory of Open Access Journals (Sweden)

    Chuan Wang

    Full Text Available To evaluate the beneficial and adverse effects of breviscapine injection in combination with Western medicine on the treatment of patients with angina pectoris. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, the China National Knowledge Infrastructure, the Wanfang Database, the Chongqing VIP Information Database and the China Biomedical Database were searched to identify randomized clinical trials (RCTs that evaluated the effects of Western medicine compared to breviscapine injection plus Western medicine on angina pectoris patients. The included studies were analyzed using RevMan 5.1.0 software. The literature search yielded 460 studies, wherein 16 studies matched the selection criteria. The results showed that combined therapy using Breviscapine plus Western medicine was superior to Western medicine alone for improving angina pectoris symptoms (OR=3.77, 95% Cl: 2.76~5.15 and also resulted in increased electrocardiogram (ECG improvement (OR=2.77, 95% Cl: 2.16~3.53. The current evidence suggests that Breviscapine plus Western medicine achieved a superior therapeutic effect compared to Western medicine alone.

  3. [The quality of life of the patient with unstable angina treated by spinal cord electrical stimulation].

    Science.gov (United States)

    González-Darder, J M; Vázquez, J L; Canela, P; González Martínez, V

    1990-12-01

    Quality of life was evaluated in patients with unstable angina before and after surgical therapy with spinal cord electrical stimulation (SCES). Overall 12 patients were evaluated, with quantification of the mean weekly number of anginal attacks, the degree of effort provoking them and the Nottingham Health Profile (NHP). The criteria of inclusion in the study were: angina grade IV, resistant to drug therapy and without indication of surgery. The mean follow-up period was 9.8 +/- 8.2 months. A significant reduction in the weekly number of anginal attacks (preoperative 30.9 +/- 14.5; postoperative 9.6 +/- 8.2; p less than 0.01); improvement in functional class (p less than 0.001), and significant improvement (p greater than 0.05) in the pain, energy, sleep, social isolation and emotional reactions areas of NHP were observed. It was concluded that SCES is a useful procedure in patients with unstable angina untreatable by other medical or surgical methods, as it reduces the number of anginal attacks and increases quality of life of the patients without additional risk.

  4. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    OpenAIRE

    Gilman Robert H; Loret de Mola Christian; Zaman M Justin S; Smeeth Liam; Miranda J Jaime

    2010-01-01

    Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across dif...

  5. El derecho como hecho o como norma

    Directory of Open Access Journals (Sweden)

    Roberto José Vernengo

    2015-10-01

    Full Text Available Para el historiador, antiguamente, y para el sociólogo, en nuestros días, el derecho es un fenómeno empírico. El derecho de una sociedad es un dato de su realidad: historiador o sociólogo tienen que buscar el derecho en alguna experiencia empírica accesible. Sin embargo, no es fácil toparse con el derecho de una sociedad, como, por caso, con el derecho argentino actual, pues no sabemos muy bien a qué datos de la realidad apuntar. Aquéllos que discernimos aparecen teñidos por alguna concepción previa que tengamos sobre qué haya de entenderse por derecho. (...

  6. Evaluation of the add-on effect of chinese patent medicine for patients with stable or unstable angina: a systematic review and meta-analysis.

    Science.gov (United States)

    Mao, Chen; Chung, Vincent C H; Yuan, Jin-Qiu; Yu, Yuan-Yuan; Yang, Zu-Yao; Wu, Xin-Yin; Tang, Jin-Ling

    2013-01-01

    Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33-0.78), myocardial infarction (RR = 0.32, 95% CI 0.14-0.72), heart failure (RR = 0.37, 95% CI 0.15-0.91), and angina (RR = 0.46, 95% CI 0.30-0.71) than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR = 0.46, 95% CI 0.32-0.66), myocardial infarction (RR = 0.37, 95% CI 0.26-0.54), and angina (RR = 0.36, 95%CI 0.26-0.51). Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR = 0.34, 95% CI 0.17-0.68) and angina (RR = 0.46, 95% CI 0.30-0.70) in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine. PMID:24416066

  7. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  8. Association of the 894G>T polymorphism of the endothelial constitutive nitric oxide synthase gene with unstable angina

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    G.R. Iturry-Yamamoto

    2007-04-01

    Full Text Available The 894G>T polymorphism of the endothelial constitutive nitric oxide synthase gene consists of the substitution of a guanine base by a thymine at the 894th nucleotide of the gene. An association of this polymorphism with acute coronary syndromes has been described, only when in combination with other polymorphisms of this gene. The aim of the present study was to search for an association between this polymorphism and unstable angina in a southern Brazilian population. In a case-control study, 156 patients (group 1 (N = 83: unstable angina, group 2 (N = 73: stable angina were genotyped by PCR and digestion of the product. Univariate analysis demonstrated that the minimal luminal diameter and the degree of stenosis of the culprit lesion differed between groups (P = 0.006 and 0.005, respectively. In addition, the frequencies of the T allele and of the T allele carriers (combined TT and TG genotypes were significantly higher in the group with unstable angina (41.6 vs 28.8%; P = 0.025, Pearson chi-square test, and 73.5 vs 45.2%; P = 0.001, Pearson chi-square test, respectively. Multivariate logistic regression showed that the frequency of the T allele carriers was the only variable with a predictive value for unstable angina, when controlled for the other variables (6.1 (95% CI = 2.55-14.43; P T polymorphism was associated with unstable angina. We suggest that this polymorphism may be a genetic risk factor for unstable angina.

  9. El Blog como consuelo

    OpenAIRE

    Blanco Rodríguez, Fernando del

    2016-01-01

    El Blog Kemixon Reporter 2.0 nació hace ya más de un año como una invitación de la Biblioteca CID a la mezcla y a la curiosidad: la idea era, por una parte, ser útiles para el trabajo de nuestros usuarios, ofreciéndoles instrumentos tanto de investigación como de análisis y, por otra, ser útiles para poner cara, color, discurso, poesía, imagen, desorden… y, en último caso, sentido, a todos los alrededores de las ciencias experimentales que estos usuarios practican.

  10. La imagen como dato

    OpenAIRE

    Rebollo Delgado, Lucrecio

    2009-01-01

    I. INTRODUCCIÓN. II. LA IMAGEN Y EL CONCEPTO DE UNO MISMO. III. EL DERECHO A LA PROPIA IMAGEN EN EL ORDENAMIENTO JURÍDICO ESPAÑOL. IV. LA TEMPORAL EXCLUSIÓN DE LA VIDEOVIGILANCIA. V. LA IMAGEN COMO DATO.

  11. Cetoacidosis Diabética como causa de ingreso en UTIPP

    Directory of Open Access Journals (Sweden)

    Frank Ernesto Medina Alí

    2005-01-01

    Full Text Available Se realizó un estudio descriptivo con el objetivo de describir el comportamiento de los ingresos por cetoacidosis diabética en adolescentes en la unidad de terapia intensiva polivalente pediátrica (utipp de Camagüey, desde enero de 1999 hasta diciembre del 2003, teniendo en cuenta que el adolescente diabético presenta problemas y características en su comportamiento que lo hacen marcadamente diferentes del niño y el adulto diabético y generalmente la diabetes del adolescente se considera ¿inestable¿ dado sus frecuentes episodios de hipoglucemia y cetoacidosis . El universo quedó integrado por 54 pacientes que ingresaron por esta causa, los cuales se obtuvieron del libro de ingresos y egresos y de la revisión de historias clínicas y los datos se procesaron en microstat. Se obtuvo como resultados que el grupo de edades más afectados fue el de 10-14 años con 62.96%, las féminas con 57.40% predominando como el año más afectado, el 1999 con 17 pacientes para un 31.48% con una disminución significativa en los años siguientes sólo ingresando el 12.97% en el 2003, el debut de la diabetes y las transgresiones dietéticas fueron las causas que más se presentan. Se concluye que la cetoacidosis es frecuente en la adolescencia, que la CAD severa constituye la forma más frecuente de debut, y que todo médico debe estar capacitado para reconocer precozmente dicho cuadro con el fin de evitar las complicaciones fatales para la vida de estos pacientes.

  12. Effect of Enhanced External Counterpulsation (EECP on Exercise Time Duration and Functional Capacity in Patients with Refractory Angina Pectoris

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    Ali Bozorgi

    2015-10-01

    Full Text Available Background: Enhanced external counterpulsation (EECP is a noninvasive technique used for patients with refractory angina pectoris. There are controversial data on the effectiveness of EECP in improving patients with refractory stable angina. The aim of the present study was to evaluate the effectiveness and safety of EECP for the treatment of patients with refractory angina pectoris.Methods: Twenty consecutive patients with refractory angina pectoris were treated with EECP, and their symptoms, echocardiographic measures, treadmill exercise test parameters, and Canadian Cardiovascular Society Class were evaluated before and immediately after EECP. The patients were followed up for 6months post treatment.Results: There were significant differences regarding total exercise time before and after treatment (p value < 0.001. The patients showed a significant reduction in angina classes III and IV immediately after EECP (p value < 0.001; for most of the patients, these beneficial effects were sustained for 6 months (p value = 0.010. There was no significant improvement in the echocardiographic parameters.Conclusion: EECP decreased symptoms and increased total exercise time in our study population. These beneficial effectswere sustained for 6 months.

  13. Xuesaitong Soft Capsule (Chinese Patent Medicine for the Treatment of Unstable Angina Pectoris: A Meta-Analysis and Systematic Review

    Directory of Open Access Journals (Sweden)

    Xiaochen Yang

    2013-01-01

    Full Text Available Objective. To provide a systematic review to evaluate the effectiveness and safety of Xuesaitong soft capsule (XST in treating unstable angina (UA. Methods. An extensive search of 6 medical databases was performed up to August 2013. Randomized controlled trials (RCTs involving XST alone or combined with conventional drugs versus conventional drugs were included. A meta-analysis of reduction of angina symptoms and electrocardiogram (ECG improvement was performed to evaluate the effects of XST on UA. Results. After researching, a total of 6 RCTs with 716 participants were included. Our review showed that XST combined with conventional drugs had significant effect on relieving angina symptoms (RR: 1.14 [1.07,1.22]; P=0.0001 and improving ECG (RR: 1.26 [1.12,1.42]; P=0.0001 compared with conventional drugs alone. Conclusions. XST appears to have beneficial effects on improvement of ECG, reduction of angina symptoms, and decreasing the frequency and duration of angina attack in participants with UA. However, the findings should be interpreted with caution due to the poor methodological quality of the included trials.

  14. Xuesaitong soft capsule (chinese patent medicine) for the treatment of unstable angina pectoris: a meta-analysis and systematic review.

    Science.gov (United States)

    Yang, Xiaochen; Xiong, Xingjiang; Wang, Heran; Yang, Guoyan; Wang, Jie

    2013-01-01

    Objective. To provide a systematic review to evaluate the effectiveness and safety of Xuesaitong soft capsule (XST) in treating unstable angina (UA). Methods. An extensive search of 6 medical databases was performed up to August 2013. Randomized controlled trials (RCTs) involving XST alone or combined with conventional drugs versus conventional drugs were included. A meta-analysis of reduction of angina symptoms and electrocardiogram (ECG) improvement was performed to evaluate the effects of XST on UA. Results. After researching, a total of 6 RCTs with 716 participants were included. Our review showed that XST combined with conventional drugs had significant effect on relieving angina symptoms (RR: 1.14 [1.07, 1.22]; P = 0.0001) and improving ECG (RR: 1.26 [1.12, 1.42]; P = 0.0001) compared with conventional drugs alone. Conclusions. XST appears to have beneficial effects on improvement of ECG, reduction of angina symptoms, and decreasing the frequency and duration of angina attack in participants with UA. However, the findings should be interpreted with caution due to the poor methodological quality of the included trials. PMID:24489594

  15. [Prognostic value of high-sensitivity C-reactive protein in assessing intrahospital outcome of unstable angina].

    Science.gov (United States)

    Ben Halima, Afef; Kammoun, Ikram; Sdiri, Wissem; Bachraoui, Kaouther; Chine, Samira; Zoaoui, Walid; Châabène, Olfa; Gargouri, Sami; Keskes, Hend; Lefi, Abdellatif; Ben Ammar, Slim; Boujnah, M Rachid; Kachboura, Salem

    2003-01-01

    Inflammation has been shown to play an important role in the pathogenesis of unstable angina. CRP has been demonstrated to be a reliable marker of prognosis is unstable angina. The aim of this study was to investigate the prognostic value of CRP in assessing short outcome of unstable angina. Our study is a prospective double blinded one. We measured CRP in 33 consecutive patients admitted for unstable angina at the 24th and 48th hour. The mean age is 60 years (30 to 84 years). There were 22 men and 11 women. 8 patients were included in class I of Braunwald classification, 5 were in class II and 20 in class III. 14 patients presented cardiac events. The CRP mean value was significantly higher among these patients (12 mg/l vs 5 mg/l, p or = 3 mg/l have a higher risk of developing complications (66% vs 13%, p = 0.002). Elevation of CRP predicted poor outcome of intrahospital evolution with a sensitivity of 86%, a specificity 68%, a positive and negative predictive values of 66% and 86%. The CRP in our preliminary study is an independent risk factor of early outcome of unstable angina. In association with clinical scores and other cardiac markers will lead to a better identification of high risk patients.

  16. Tratamento de angina mesentérica em pacientes com arterite de Takayasu Treatment of mesenteric angina in patients with Takayasu's arteritis

    Directory of Open Access Journals (Sweden)

    Luana Thayse Barros de Lima

    2011-04-01

    Full Text Available Aarterite de Takayasu (AT é uma doença inflamatória crônica do tecido conectivo, idiopática, que acomete preferencialmente a aorta e seus ramos. A terapêutica utilizada baseia-se sobretudo no uso de corticosteroides e imunossupressores. É relatado o caso de uma paciente, 33 anos, com mal-estar, febre, mialgia, cefaleia intensa, pulsátil, holocraniana, resistente a analgésicos, hipertensão arterial sistêmica de difícil controle, claudicação no membro inferior direito e dor abdominal de forte intensidade, a qual piorava após a alimentação. A angiotomografia revelou aneurisma da aorta ascendente, estenose da artéria ilíaca comum direita, estenose das artérias renais e estenose da artéria mesentérica superior, fato que embasou o diagnóstico de angina mesentérica e a conduta intervencionista através da angioplastia transluminal percutânea múltipla com a colocação de stents.Takayasu's arteritis (TA is an idiopathic chronic inflammatory disease of the connective tissue that affects mainly the aorta and its branches. Treatment is mainly based on corticosteroids and immunosuppressants. We report the case of a 33-year-old female complaining of malaise, fever, myalgia, severe pulsing holocranial headache resistant to analgesics, systemic arterial hypertension hard to control, right lower limb claudication, and severe abdominal pain that worsened after the meals. Angiotomography revealed aneurysm of the ascending aorta, and stenosis of the following vessels: right common iliac artery, renal arteries, and superior mesenteric artery. Those findings supported the diagnosis of mesenteric angina and the interventional approach by use of percutaneous transluminal angioplasty with stent placement.

  17. Facilitação e dominância dos sintomas sôbre a dor da angina de peito e causalgia

    Directory of Open Access Journals (Sweden)

    Nelson Pires

    1962-09-01

    Full Text Available O autor traz à consideração clínica a "facilitação" que Sherrington apreciou nos experimentos de neurofisiologia, e que explica aspectos clínicos importantíssimos em psicologia e em neurologia visceral. Pretende o autor explicar seus casos de dor (um de causalgia no membro superior e três de angina de peito em portadores de esclerose coronária. Ora a anestesia terapêutica no gânglio estrelado, ora na cadeia ganglionar torácica simpática, ora a radioterapia, ora a psicoterapia removeram a dor "facilitada" a tal ponto que se tornara "dominante", isto é, mesmo estímulos inadequados a provocavam. Os doentes eram inválidos e recuperaram-se. A neurofisiologia moderna autoriza a interpretação dessa terapêutica: suprimiu-se - com a anestesia, com a radioterapia e com a psicoterapia - o circuito neural auto-alimentado reverberante, hiperfuncionante em todo ou em parte de seu trajeto, quer aferente ao córtex quer aferente às coronárias. O autor discute o valor clínico dos acessos anginosos apontando fatos que documentam que o acesso "ilegítimo" (psicógeno deve ter como causa a estimulação das aferências vegetativas ao córtex em qualquer ponto (ganglionar, medular ou cortical. Os acessos "legítimos", produzindo lesões transitórias ou definitivas e até morte,, devem ser explicados pela atividade das eferências vagais que executam os efetôres espásticos das coronárias. A dor é apresentada como fenômeno de "gravação neural", aprendido, memorizado e automatizado, ativado em feed-back ora nas aferências vegetativas ao córtex, ora nas eferências, mais perigosas e mortais. Debate-se a superestimada psicogenia da angina de peito.

  18. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2012-01-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  19. [The treatment of chronic stable angina with isradipine. A cooperative Latin American study].

    Science.gov (United States)

    Román, O; Alcocer, L; Espinoza, J; Arcos, R; Gómez, G; Mayorga, E; Buzzi, A; Tavella, N; Romero, C; Kuster, F

    1991-04-01

    In order to study the efficacy and tolerance of isradipine, a new Ca++ antagonist for the treatment of stable chronic angina, a multicentric cooperative study was carried out in eight Latin American countries (Argentine, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay and Venezuela), which included 169 patients (60% men and 40% women), average age 62.6 +/- 9.7. Patients with more than 4 biweekly anginal crisis were accepted, with one or more of the following inclusion criteria: coronariographic evidence of obstruction greater than 60% in one or more vessels, IAM history, positive scintigraphy and positive effort test. The trial was single-blind, with placebo during the admission phase (2 weeks) and active treatment for 12 weeks. isradipine was administered in increasing doses of 2.5, 5, and 7 mg thrice a day, according to the presence or absence of anginal crisis. It was observed that the average frequency of weekly pains decreased from 8.2 +/- 7 under placebo to 6.3 +/- 7.5 under isradipine at low doses, and to 2.0 +/- 2.0 (p less than 0.001) under maximum doses. TNT intake decreased parallel also in a significant way. At the end of the trial, 37% of patients had become asymptomatic, and angina had reduced to less than two crisis a week in 33%. A clear relation doses-effect was observed. There was no alteration in laboratory exams neither in ECG. Seven patients had complications derived from the evolutional course of disease (2 IAM, 5 unstable angina and one sudden death). Adverse events were relatively frequent and the majority derived from vasodilator effect (tibial oedema 37%, flushing 17%, headache 23%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1829846

  20. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-12-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  1. Diagnostic Value of Spiral on Kidney Angina%螺旋CT对肾绞痛的诊断价值

    Institute of Scientific and Technical Information of China (English)

    杨泽年; 张婷

    2003-01-01

    Objective Study the three methods' diacrisis value:X ray sheet of kidney angina cause of urinary calculus,vein renal pelvis contrast and spiral CT. Method Look back on and study 50 clinical kidney angina patients who have taken X ray sheet,or vein renal pelvis contrast, or spiral CT treatment. Compare those three methods and find the calculus positive rate and the areas of calculus frequently happening. Result X ray sheet finds that the calculus positive rate is 58%. Vein renal pelvis contrast finds that the calculus positive rate is 74%. Spiral CT finds that the calculus positive rate is 96% .All the calculus leans to appearing at the hypo - segment of ureter. And the Same - side kidney gets dropsy of different degree.Conclusion Urinary calculus, especially ureter hypo - segment calculus is the main cause of kidney angina. And spiral CT scanning is the best way to find calculus.

  2. Arteriosclerotic coronary arterial aneurysms in a 49-year-old man with crescendo angina: family history, natural course and prevalence.

    Science.gov (United States)

    Schneider, K W; Jesse, R; Deeg, P

    1977-01-01

    In a 49-year-old man with crescendo angina, elevated serum cholesterol level and an old posterior myocardial infarction, selective coronary arteriography showed multiple arteriosclerotic aneurysms of the right coronary artery associated with extensive and severe arteriosclerotic disease of the left coronary artery. The patient's mother and brother have both died of a myocardial infarction. Another brother suffers from angina and has documented arteriosclerotic coronary artery disease. Two sisters suffer from angina as well. The possibility of embolization of distal vessels from a friable clot of the aneurysms as a cause of the patient's infarction is discussed. To the best of our knowledge, this is the tenth patient with nonfistulous arteriosclerotic coronary artery aneurysm diagnosed and documented angiographically ante mortem. Including the present case and reviewing the literature, the prevalence of this condition among nonfistulous coronary aneurysms diagnosed ante mortem is 35 per cent and henceforth cannot be regarded as an incidental autopsy finding in cardiac asymptomatic patients.

  3. Association between thyroid dysfunction and incidence of atrial fibrillation in patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    徐予

    2014-01-01

    Objective To explore the correlation between incidence of atrial fibrillation(AF)and thyroid dysfunction.Methods Patients with stable angina pectoris with thyroid function test results hospitalized at Fuwai Hospital from2011 Jan to 2011 Dec were included in this analysis(n=2 541).General clinical data and related biochemical parameters were analyzed.We divided patients into 5subgroups according to TSH levels:<0.55 mI U/L(n=105),0.55-2.49 mI U/L(n=1 599),2.50-4.77

  4. Comparing systems for costing hospital treatments. The case of stable angina pectoris.

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

  5. Cardiac arrest after sugammadex administration in a patient with variant angina: a case report

    Science.gov (United States)

    Kim, Yong Han; Kang, Eunsu; Lee, Byeong-Cheol; Lee, Sujung

    2016-01-01

    A 76-year-old man with no notable medical history was scheduled for a robot-assisted radical prostatectomy. After the operation, he was given sugammadex. Two minutes later, ventricular premature contraction bigeminy began, followed by cardiac arrest. Cardiac arrest occurred three times and cardiopulmonary resuscitation was done. The patient recovered after the third cardiopulmonary resuscitation and was transferred to the intensive care unit. Coronary angiography was done on postoperative day 1. The patient was diagnosed with variant angina and discharged uneventfully on postoperative day 8.

  6. Chest pain after percutaneous coronary intervention in patients with stable angina

    Directory of Open Access Journals (Sweden)

    Chang CC

    2016-08-01

    Full Text Available Chao-Chien Chang,1–3 Yueh-Chung Chen,4,5 Eng-Thiam Ong,1 Wei-Cheng Chen,1 Chia-Hsiu Chang,1 Kuan-Jen Chen,1 Cheng-Wen Chiang1 1Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan, ROC; 2Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan, ROC; 3Department of Pharmacology, Taipei Medical University, Taipei, Taiwan, ROC; 4Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Ren-Ai branch, Taipai, Taiwan, ROC; 5Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC Background: Percutaneous coronary intervention (PCI has been widely used to treat acute coronary syndrome but is only recommended as an additional treatment to medical therapy and risk modification in patients with refractory or progressing angina. The number of PCI in this patient population is still increasing. Post-PCI chest pain (PPCP is one of the common problems of PCI. Its presentation and causes in patients with stable angina are poorly understood.Patients and methods: This study retrospectively collected clinical information of 167 patients who had stable angina and underwent elective PCI, including 70 patients with PPCP 24 hours after procedure and 97 patients without PPCP. The incidence and predictors of PPCP were analyzed.Results: The incidence of PPCP was 41.9% (70/167. Compared with non-PPCP patients, PPCP patients had more abnormal post-PCI electrocardiogram (ECG changes (new Q-waves, ST-segment shifts, or T-waves inversion and serum cardiac troponin I (cTnI elevation, more PCI vessels, and stent placement (all P<0.05. More PPCP patients required repeat revascularization than non-PPCP patients after PCI (P=0.043. PPCP was correlated with abnormal post-PCI ECG changes (P<0.0001, cTnI elevation (P<0.0001, post-PCI serum level of cTnI (P<0.0001, number of stents placed (P=0.009, and pre-PCI cTnI level (P=0.049. The strongest predictors of

  7. Reduction of recurrent ischemia with abciximab during continuous ECG-ischemia monitoring in patients with unstable angina refractory to standard treatment (CAPTURE)

    NARCIS (Netherlands)

    S. Meij (Simon); R. Melkert (Rein); T. Lenderink (Timo); M.L. Simoons (Maarten); A.P.J. Klootwijk (Peter)

    1998-01-01

    textabstractBACKGROUND: In the CAPTURE (c7E3 Fab Anti Platelet Therapy in Unstable REfractory angina) trial, 1265 patients with refractory unstable angina were treated with abciximab or placebo, in addition to standard treatment from 16 to 24 hours preceding coronary intervention t

  8. O corpo como pulso

    Directory of Open Access Journals (Sweden)

    Flavia Liberman

    2010-06-01

    Full Text Available O corpo é foco de muitos estudos e intervenções. Alguns paradigmas o concebem apenas em seu aspecto sensório-motor, enquanto outros transitam prioritariamente por uma dimensão psicológica. Procurando contribuir para a formulação de outras perspectivas no campo, apresentam-se aspectos da concepção de corpo de Stanley Keleman em ressonância com os estudos de Regina Favre. A partir de cenas clínicas em grupos de seminários, podemos pensar o corpo como pulso, multimídia, multifacetado, que se (des constrói permanentemente nos encontros. Articulando experiências clínicas da autora como terapeuta ocupacional e docente da graduação e em grupos de estudos, essas concepções servem como guia para uma clínica pensada, construída e balizada pelo corpo mediante utilização de abordagens corporais para a promoção de encontros plasmados por afetos e acontecimentos, na tentativa de criar corpos que possam sustentar as intensidades vividas e permitam a observação de si, a aproximação com o outro e a produção de singularidades.

  9. Valor de la tomogammagrafía de perfusión miocárdica en los pacientes con dolor torácico y electrocardiograma no diagnóstico en el área de urgencias

    OpenAIRE

    Oller Martínez, Guillermo

    2004-01-01

    Consultable des del TDX El diagnóstico precoz de los pacientes que consultan por un dolor torácico en Urgencias es muy importante de cara a poder diferenciar los enfermos que presentan un síndrome coronario agudo, como una angina inestable o un infarto agudo de miocardio (IAM), de aquellos que tienen un dolor torácico de otra etiología. Aunque el diagnóstico de IAM no suele ofrecer dificultades cuando el dolor torácico es característico, en el electrocardiograma (ECG) se observa elevación ...

  10. Dual left anterior descending coronary artery from right aortic sinus: report of a case of recurrent unstable angina after CABG.

    Science.gov (United States)

    Formica, Francesco; Corti, Fabrizio; Colombo, Virgilio; Monica, Gionali; Paolini, Giovanni

    2005-01-01

    Anomalies of the left coronary artery are very rare, with an incidence range between .3% and 1.64%. The diagnosis is generally incidental during coronary angiogram, coronary artery bypass operation, or autopsy. However, sometimes this anomaly is not recognized during CABG operation and can be responsible for the recurrence of angina after CABG operation and even compromise the outcome. We presented a case in which the dual left anterior coronary artery from the right aortic sinus occasionally was shown in a coronary angiogram after CABG operation; the angiogram was performed because of the recurrence of angina.

  11. Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease

    DEFF Research Database (Denmark)

    Mygind, Naja Dam; Michelsen, Marie Mide; Pena, Adam;

    2016-01-01

    microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing. METHODS AND RESULTS: After screening 3568 women, 963 women with angina-like chest pain and a diagnostic coronary angiogram without significant coronary......BACKGROUND: The majority of women with angina-like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary.......01), hypertension (P=0.02), current smoking (Pstress testing...

  12. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris

    OpenAIRE

    Vulink, NCC; Jessurun, GAJ; TenVaarwerk, IAM; Kropmans, TJB; van der Schans, CP; Middel, B; Staal, MJ; DeJongste, MJL; Hessurun, G.A.J.

    1999-01-01

    Objective. For patients with refractory angina pectoris, spinal cord stimulation (SCS) is a beneficial and safe adjuvant therapy. However, it has not yet been established whether SCS alters the quality of life (QoL) in these patients. Methods. In this study, 26 consecutive patients (age 61.3 +/- 7.0 years, 13 females, angina duration 12.7 +/- 6.0 years) were recruited. Social, mental, and physical aspects of QoL were determined by Nottingham Health Profile (NHP I), depression scale (CES-D), s...

  13. Management of stable angina: A commentary on the European Society of Cardiology guidelines.

    Science.gov (United States)

    Ambrosio, Giuseppe; Komajda, Michel; Mugelli, Alessandro; Lopez-Sendón, José; Tamargo, Juan; Camm, John

    2016-09-01

    In 2013 the European Society of Cardiology (ESC) released new guidelines on the management of stable coronary artery disease. These guidelines update and replace the previous ESC guidelines on the management of stable angina pectoris, issued in 2006. There are several new aspects in the 2013 ESC guidelines compared with the 2006 version. This opinion paper provides an in-depth interpretation of the ESC guidelines with regard to these issues, to help physicians in making evidence-based therapeutic choices in their routine clinical practice. The first new element is the definition of stable coronary artery disease itself, which has now broadened from a 'simple' symptom, angina pectoris, to a more complex disease that can even be asymptomatic. In the first-line setting, the major changes in the new guidelines are the upgrading of calcium channel blockers, the distinction between dihydropyridines and non-dihydropyridine calcium channel blockers, and the presence of important statements regarding the combination of calcium channel blockers with beta-blockers. In the second-line setting, the 2013 ESC guidelines recommend the addition of long-acting nitrates, ivabradine, nicorandil or ranolazine to first-line agents. Trimetazidine may also be considered. However, no clear distinction is made among different second-line drugs, despite different quality of evidence in favour of these agents. For example, the use of ranolazine is supported by strong and recent evidence, while data supporting the use of the traditional agents appear relatively scanty. PMID:27222385

  14. RE-EVALUATION OF THE MECHANISM AND TREATMENT OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 陈在嘉; 徐义枢; 高润霖; 寇文蓉; 姚康宝; 于全俊; 陶寿琪

    1996-01-01

    30 patients with angina decubittus(AD) were studied during hospitalization. These patients were found to have severe coronary artery obstructive lesions and an increase of myocardial oxygen consumption (MOC) before the onset to AD, indicating that AD belongs to the category of effort angina. 18 patients were investigated by continuous hemodynamic mordtoring. Three patients had significant increase in pulmonary artery diastolic pressure (PADP) before the onset. In the other 15 patients, PADP increased slightly in J2 and remained unchanged in 3 cases before the onset. Left ventriculography showed ejection fraction (EF))45% in 25 of the 27 patients. These results indicate that left ventricular (LV) systolic dysfunction is not a major factor in the pathogenesis of AD. The patients with LVEDP>12 mmHg constituted 60% of 25 patients with EF)45%, suggesting that these patients had obvious LV diastolic dysfunction, which may he the major factor in the pathogenesis of AD. According to the results of our treatment, Beta blockers may be used as the major form of treatment in the patients with AD.

  15. An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

    Directory of Open Access Journals (Sweden)

    Xiaoxia Zhang

    2015-01-01

    Full Text Available Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI for unstable angina (UA. Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

  16. COMO? PALETAS MEXICANAS BRASILEIRAS?

    Directory of Open Access Journals (Sweden)

    Daniela Maria Alves Chaud

    2016-03-01

    Full Text Available As informações sobre alimentação estão mais acessíveis e democráticas. As tendências alimentares são inspiradas por diversos fatores, mas sempre estão associados à moda, mídia e como forma de conjectura de um estilo de vida. Há pouco tempo, as grandes cidades brasileiras foram invadidas por uma nova mania: as paletas mexicanas, que, na verdade, não são “tão mexicanas”. Esses sorvetes apresentam qualidades organolépticas marcantes, em virtude, entre outros fatores, ao alto teor de açúcar e, em alguns casos, de gorduras. A concepção gourmetizada e natural dessa iguaria, seu custo e as propriedades nutricionais são peculiares e, aparentemente, um modismo. Esse trabalho teve como objetivo conhecer a composição desses produtos, a partir das informações nutricionais contidas nos sites das empresas produtoras, bem como as suas peculiaridades e concepções. Apesar da conotação natural e gastronômica, alto valor calórico, gorduras (especialmente na versão recheada sabor brigadeiro e elevadas quantidades de açúcares, foram encontrados, em média, por unidade: 207,2 Kcal; 38,4g de carboidratos; 3,9g de proteínas e 5,3g de gorduras. Uma rica ênfase na cultura mexicana, religiosidade e identidade visual marcante foram identificadas nos sites dos produtos pesquisados.

  17. Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris

    DEFF Research Database (Denmark)

    Ravkilde, J; Nissen, H; Mickley, H;

    1994-01-01

    The incidence of cardiac troponin T (Tn-T) and creatine kinase (CK) isoenzyme MB mass release was studied in 23 patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA). Serial blood samples were drawn for measurement of serum Tn-T,...

  18. Infuences of Previous Angina Pectoris on Coronary Collateral Circulation and Left Ventricular Function in Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    罗初凡; 杜志民; 胡承恒; 梅卫义; 伍贵富; 李怡; 马虹

    2001-01-01

    Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed.Results ① In the 307 patients, there were 192(62.5 % ) with previous angina [PA ( + ) group] and 115 (37.5 % ) without [PA ( - ) group]. ②The peak creatine kinase (CK) and CK- MB were significantly higher in PA (-) group than in PA (+) group ( P < 0.05 for both comparisons) . ③ Collateral circulation to infarct- related artery was more likely to be present in PA (+) group than in PA (-) group ( P < 0.05) . ④ The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA ( + ) group than in PA ( - ) group ( P < 0.01 for both comparisons) .Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular unction.

  19. Creatine kinase and creatine kinase subunit-B in coronary sinus blood in pacing-induced angina pectoris

    DEFF Research Database (Denmark)

    Bagger, J P; Ingerslev, J; Heinsvig, E M

    1982-01-01

    In nine out of 10 patients with angiographic documented coronary artery disease, pacing-induced angina pectoris provoked myocardial production of lactate, whereas no significant release of either creatine kinase or creatine kinase subunit-B to coronary sinus and peripheral venous blood could be...

  20. STIMULATION CHARACTERISTICS, COMPLICATIONS, AND EFFICACY OF SPINAL-CORD STIMULATION SYSTEMS IN PATIENTS WITH REFRACTORY ANGINA - A PROSPECTIVE FEASIBILITY STUDY

    NARCIS (Netherlands)

    DEJONGSTE, MJL; NAGELKERKE, D; HOOYSCHUUR, CM; JOURNEE, HL; MEYLER, PWJ; STAAL, MJ; DEJONGE, P; LIE, KI

    1994-01-01

    Objectives: In a prospective study with a 1-year follow-up we evaluated: (1) the feasibility of a method for the adjustment of spinal cord stimulator (SCS) parameters, (2) complications of SCS, and (3) efficacy of SCS. Methods: In patients receiving an SCS for severe angina unresponsive to standard

  1. Spinal cord stimulation in the treatment of refractory angina : systematic review and meta-analysis of randomised controlled trials

    NARCIS (Netherlands)

    Taylor, Rod S.; De Vries, Jessica; Buchser, Eric; DeJongste, Mike J. L.

    2009-01-01

    Background: The aim of this paper was undertake a systematic review and meta-analysis of the use of spinal cord stimulation ( SCS) in the management of refractory angina. Methods: We searched a number of electronic databases including Medline, Embase and Cochrane Library up to February 2008 to ident

  2. Value of the addition of Amlodipine to atenolol in patients with angina pectoris despite adequate beta blockade

    NARCIS (Netherlands)

    Dunselman, PHJM; Bouwens, LHM; Herweijer, AH; Bernink, PJLM

    1998-01-01

    Anginal patients who remain symptomatic despite optimally dosed beta blockade may also be given dihydropyridine calcium antagonists. This treatment regimen was examined in a double-blind parallel, randomized, controlled study in 147 patients with angina and positive bicycle exercise tests despite op

  3. Electrical neuromodulation improves myocardial perfusion and ameliorates refractory angina pectoris in patients with syndrome X : fad or future?

    NARCIS (Netherlands)

    Jessurun, G; Hautvast, RWM; Tio, RA; DeJongste, M

    2003-01-01

    At present, there is no reliable antianginal drug therapy for patients with cardiac syndrome X. Therefore, the effect of electrical neuromodulation on refractory angina pectoris and myocardial perfusion in cardiac syndrome X was assessed. Eight patients (aged 55 +/- 7 years) with heterogeneous myoca

  4. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris

    NARCIS (Netherlands)

    Vulink, NCC; Jessurun, GAJ; TenVaarwerk, IAM; Kropmans, TJB; van der Schans, CP; Middel, B; Staal, MJ; DeJongste, MJL; Hessurun, G.A.J.

    1999-01-01

    Objective. For patients with refractory angina pectoris, spinal cord stimulation (SCS) is a beneficial and safe adjuvant therapy. However, it has not yet been established whether SCS alters the quality of life (QoL) in these patients. Methods. In this study, 26 consecutive patients (age 61.3 +/- 7.0

  5. Ludwig's angina

    Science.gov (United States)

    ... the emergency room or call your local emergency number (such as 911) right away. Call your health care provider if you have symptoms of this condition, or if symptoms do not get better after treatment. Prevention Visit the dentist for regular checkups. Treat symptoms of mouth or ...

  6. Angina - discharge

    Science.gov (United States)

    ... Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a ... Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ...

  7. Unstable Angina

    Science.gov (United States)

    ... Privacy Policy What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

  8. Microvascular Angina

    Science.gov (United States)

    ... Privacy Policy What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

  9. El inquisidor como profesor

    Directory of Open Access Journals (Sweden)

    Adriano PROSPERI

    2009-12-01

    Full Text Available Giovanni Botero, en una célebre página de su Ragion di stato, se detuvo sobre el tema de la fuerza de la religión en los gobiernos. Esta función de la religión cristiana —para Botero, católica— es garante del orden público y se presenta también como opuesta a la generadora de desorden de Lutero y Calvino, quienes siembran por todo cizañas y revoluciones de estados y ruinas de los reinos. Estamos en los orígenes del esquema historiografía de la periodización de la Edad Moderna que confió precisamente a la Reforma el papel de nodriza de las revoluciones que nacieron en Europa.

  10. O ensaio como narrativa

    Directory of Open Access Journals (Sweden)

    Pedro Duarte

    2016-02-01

    Full Text Available O artigo tenta demonstrar que todos os textos, mesmo aqueles cuja natureza é teórica, têm alguma forma de narrativa. Nem sempre são personagens que os ocupam, podem ser ideias, mas mesmo assim há um enredo conceitual que se passa. Modernamente, a forma dessa narrativa foi sobretudo o sistema, com a pretensão totalizadora presente, por exemplo, na filosofia de Hegel. Contemporaneamente, porém, a forma do ensaio – surgida ainda na era moderna – ganha destaque por sua forma descontínua de narrar. O objetivo do artigo é apontar que, se o ensaio é uma forma, como explicitaram Lukács, Benjamin e Adorno, ele é também uma forma de narrar – ainda que de narrar conceitualmente objetos da cultura.

  11. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chen Mao

    2013-01-01

    Full Text Available Chinese herbal medicine (CHM has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR=0.50, 95% confidence interval (CI 0.33–0.78, myocardial infarction (RR=0.32, 95% CI 0.14–0.72, heart failure (RR=0.37, 95% CI 0.15–0.91, and angina (RR=0.46, 95% CI 0.30–0.71 than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR=0.46, 95% CI 0.32–0.66, myocardial infarction (RR=0.37, 95% CI 0.26–0.54, and angina (RR=0.36, 95%CI 0.26–0.51. Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR=0.34, 95% CI 0.17–0.68 and angina (RR=0.46, 95% CI 0.30–0.70 in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine.

  12. Nitrate-Induced Headache in Patients with Stable Angina Pectoris: Beneficial Effect of Starting on a Low Dosage.

    Science.gov (United States)

    Cleophas, Ton J.M.; Niemeyer, Menco G.; van Der Wall, Ernst E.

    1996-12-01

    BACKGROUND: Nitrates, although important for the management of angina pectoris, cause significant headache in many patients. METHODS: In a randomized, double-blind crossover study, 89 patients with stable angina pectoris were used to compare two different dosage strategies of isosorbide-5-mononitrate (5-ISMN). Patients were randomized to either 60 mg 5-ISMN once daily (o.d.) for 2 weeks or 30 mg 5-ISMN o.d. for 1 week followed by 60 mg 5-ISMN o.d. for 1 week. A 2-week placebo wash-out ensued, after which the alternative treatment was given. We assessed the occurrence of angina pectoris and headache by diary cards while taking into account the numbers of isosorbide dinitrate sublingual puffs and paracetamole tables required. Data were assessed for carryover and time effects. RESULTS: The two dosage regimens were equally efficient for the relief of angina pectoris without development of tolerance. Thirty percent of the patients never experienced headache from the given dosages. The remainder showed a highly significant time-effect: The total numbers of headache attacks in the 1st period of active treatment were 2,380 vs 1,400 attacks is the 2nd period (p < 0.003), yet significantly fewer patients had headaches on low dosages than high ones (45 vs 57, p < 0.02). CONCLUSIONS: Starting on a low dosage was associated with reduced frequency and severity of headache and did not notably influence the beneficial effect of nitrates on angina pectoris. One in three patients never experienced headache from the given dosages. The overall number of headache attacks in the 1st period of active treatment was significantly higher than that of the 2nd period, irrespective of the dosages given. PMID:11862241

  13. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    OpenAIRE

    Chen Mao; Vincent C H Chung; Jin-Qiu Yuan; Yuan-Yuan Yu; Zu-Yao Yang; Xin-Yin Wu; Jin-Ling Tang

    2013-01-01

    Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33–0.78), myocar...

  14. Predictores de riesgo en cirugía coronaria sin circulación extracorpórea: análisis de 1.000 pacientes

    Directory of Open Access Journals (Sweden)

    Juan M. Vrancic

    2006-01-01

    Full Text Available Objetivo Analizar los resultados posoperatorios e identificar predictores de morbimortalidad a los 30 días en la cirugía de revascularización coronaria (CRM sin circulación extracorpórea (CEC. Material y métodos Se incluyeron en el estudio 1.000 pacientes consecutivos operados entre enero de 1997 y agosto de 2005, a quienes se les efectuó CRM sin CEC únicamente. Resultados El 86% eran hombres, con edad promedio de 64,7 ± 15,7 años. El 27% era mayor de 70 años. La mortalidad global fue del 3,3% (CRM electiva, del 1,8%; no electiva, del 6%; p < 0,001. La mortalidad según Euroscore fue la siguiente: riesgo bajo 1,42%, medio 2,5% y alto 8,04% (p < 0,001. En el análisis multivariado resultaron predictores independientes para mortalidad hospitalaria la edad (OR 1,01, p = 0,013, IC 95% 1,00-1,03, la CRM previa (OR 3,87, p = 0,01, IC 95% 1,33-11,28, la angina inestable (OR 4,97, p = 0,01, IC 95% 1,41-17,48, la cirugía no electiva (OR 2,36, p = 0,02, IC 95% 1,09-5,09, la conversión a cirugía con CEC (OR 5,91, p = 0,01, IC 95% 1,43-24,45. Las complicaciones mayores ocurrieron en el 5,4% de los pacientes. Se identificaron como predictores independientes para morbilidad la conversión a CRM con CEC (OR 15,96, p < 0,001, IC 95% 5,24-48,53, la angina inestable (OR 3,01, p = 0,01, IC 95% 1,30-7,03 y la presencia de mayor enfermedad coronaria (OR 1,39, p = 0,04, IC 95% 1-1,9. Conclusiones La CRM sin CEC presentó una incidencia baja de morbimortalidad posoperatoria. La presencia de angina inestable, cirugía no electiva, conversión a cirugía con CEC, CRM previa y la edad se identificaron como predictores de mortalidad. La presencia de mayor enfermedad coronaria, la conversión a cirugía con CEC y la angina inestable resultaron predictores de morbilidad posoperatoria.

  15. La persona como creatura

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    Emmanuel Housset

    2010-01-01

    Full Text Available El artículo de Emmanuel Housset implica un esfuerzo de rehabilitación del concepto «persona» para la filosofía contemporánea y la fenomenología. Para ello el autor busca mostrar cómo poco a poco «persona» tomó otra significación que la de «personaje» o sujeto de derecho. Es en autores como san Agustín y santo Tomás de Aquino que se halla un acceso diferente que pone el énfasis más bien en su carácter relacional y responsivo de la persona, antes que en su dimensión autónoma y autotélica. Tal dimensión aparece, según Housset, junto con la idea de persona como creatura y en oposición a la de individuo racional dueño de sí. La dimensión afectiva, la personalidad despertada por las diversas figuras de la alteridad son algunas de las dimensiones de la persona que examina el autor a partir del examen de la carne, las pasiones, la memoria, la historicidad y el amor alteridad.Emmanuel Housset's paper is an effort to revitalize the concept of 'person' for contemporary philosophy and phenomenology To this end the author looks to show how little by little the understanding of 'person' took on a different meaning to that of 'character' or "right bearing individual". It is in authors such as St. Augustine and St. Thomas Aquinas that a different approach is found, one that puts emphasis on the relational and responsive character of a person, rather than on the autonomous and auto telic dimension. According to Housset, such a dimension appears together with the idea of the person as a creation, and in opposition to the idea of the rational individual, that is his own master. The emotional dimension and the personality that is awoken by the many figures of alterity are some of the dimensions of the person that the author analyzes, based on examining the flesh, passions, memory historicity and love.

  16. Comparing systems for costing hospital treatments. The case of stable angina pectoris.

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed. PMID:15036817

  17. Effects on costs of frontline diagnostic evaluation in patients suspected of angina

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Olsen, Jens; Markenvard, John;

    2012-01-01

    associated with downstream diagnostic utilization (DTU), treatment, ambulatory visits, and hospitalizations were registered. There was no difference between cohorts in demographic characteristics or the pre-test probability of significant CAD. The mean (SD) age was 56 (11) years; 52% were men; and 96% were......AIMS: The aim of this study was to investigate in patients with stable angina the effects on costs of frontline diagnostics by exercise-stress testing (ex-test) vs. coronary computed tomography angiography (CTA). METHODS AND RESULTS: In two coronary units at Lillebaelt Hospital, Denmark, 498...... patients were identified in whom either ex-test (n = 247) or CTA (n = 251) were applied as the frontline diagnostic strategy in symptomatic patients with a low-intermediate pre-test probability of coronary artery disease (CAD). During 12 months of follow-up, death, myocardial infarction and costs...

  18. Psychophysical rehabilitation aspects of patient with coronary heart disease and Angina.

    Directory of Open Access Journals (Sweden)

    Mohammed Ali Khaleel.

    2012-03-01

    Full Text Available It is analyzed scientific and methodological literature, considered the views of scientists on the link of stress and cardiovascular diseases. It is determined causes of stress, with recommendations for combating stress and its prevention. A program of rehabilitation for patients with coronary artery disease after hospital discharge is shown. The experiment involved 88 patients of coronary heart disease and angina, II and III functional class at the age of 40-65 years. Participants were divided into two groups the main and control. The control group performed a program of physical rehabilitation, including breathing and physical exercises, in the program we have added to the main group autogenic exercises. At the end the experiment revealed that the health indicators of main group better than the control group in 23%.

  19. Serum Adenosine deaminase activity and C-reactive protein levels in unstable angina

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    Rani Surekha

    2003-01-01

    Full Text Available In unstable angina (USA patients, immunological responses contributing to inflammation play a vital role in plaque rupture and thrombosis causing stroke. In the present study an attempt is made to estimate the levels of adenosine deaminase activity, an immunoenzyme marker and C-reactive protein, a marker of inflammation in USA patients. 45 patients presenting USA and 50 age and sex matched healthy controls were included in the study. Serum ADA activity was measured spectrophotometrically at 630nm and serum C-reactive protein was detected using Avitex CRP kit, which is a rapid latex agglutination test. The Mean ADA levels were 41.15 ± 11.04 in patients and 20.71±5.63 in controls and 66.6% of patients and none of the controls were positive to CRP. The present study observed the importance of ADA as a serum marker in addition to CRP for assessing the immune response in USA patients.

  20. Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

    DEFF Research Database (Denmark)

    D'Souza, Maria; Sarkisian, Laura; Saaby, Lotte;

    2015-01-01

    BACKGROUND: Since the arrival of the universal definition of myocardial infarction more sensitive troponin assays have been developed. How these occurrences have influenced the proportions and clinical features of the components of acute coronary syndrome have not been studied prospectively...... in unselected hospital patients. METHODS: During 2010 we evaluated all patients in whom cardiac troponin I had been measured at a single university hospital. The diagnosis of acute myocardial infarction (ST-elevation myocardial infarction [STEMI] or non-ST-elevation myocardial infarction [NSTEMI......]) was established in cases of a rise and/or fall of cardiac troponin I together with cardiac ischemic features. Patients with unstable chest discomfort and cardiac troponin I values below the decision limit of myocardial infarction were diagnosed as having unstable angina pectoris. The definition of acute coronary...

  1. SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

    Objective. To determine whether serum vascular endothelial growth factor(VEGF)concentrations are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay(ELISA), serum VEGF concentra tions were determined in antecubital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarction(AMI) before and after thrombolytic therapy, and of 16 age and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(98.60 ± 26.99pg/ml) and UAP (103.61 ± 24.89pg/ml) tended to be higher than those in control subjects(80.44 ± 24.57pg/ml), but the differences did not reach statistical significance (P > 0.05 for each). Before throm bolytic therapy, the concentrations of serum VEGF in patients with AMI (285.92 ± 125.15pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects ( P < 0.01 ,respectively), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents(r=0.866, P < 0.001 and r =0.948,P < 0.001;respectively). Three hours after thrombolysis, the concentrations of VEGF had fallen to 111.57 ± 31.29pg/ml ( P <0.01 vs. before thrombolytic therapy and P< 0.05 vs .control subjects). Conclusion. The present study shows that serum concentrations of VEGF in patients with AMI are markedly ele vated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfusion.

  2. SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

    Objective. To determine whether serum vascular endothelial growth factor (VEGF) concontrafions are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay (ELISA), serum VEGF concemra-tions were determined in anteotbital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarcfion (AMI) before and after thrombolytic therapy, and d 16 age- and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(98.60 ± 26.99pg/ml) and UAP ( 103.61 ± 24.89pg/ml) tended to be higher than those in control subjects(80.44 ± 24.57pg/ml), but the differences did notreach statistical significance ( P > 0.05 for each). Before thrombolyfie therapy, the concentrations of serum VEGF in patients with AM1 (285.92 ± 125.15pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects ( P < 0.01 ,respectively), and correlated with synchronous serum ereafine kinase (CK) and its MB iscenzyme (CK-MB) contents( r = 0.866, P < 0.001 and r = 0.948, P < 0.001 ;respectively). Three hours after thrombolysis,the concentrations of VEGF had fallen to 111.57 ± 31.29pg/ml ( P < 0.01 vs. before thrombelytie therapy and P <0. 05 vs. control subjects). Condusion. The present study shows that serum concentrafiom of VEGF in patients with AMI are markedly ele-vated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfnsion.

  3. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left veraricular diastolic dysfunction on the pathogenesis of angina decubitus (AD).Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease.Results. Left ventricnlography (LVG) showed that left ventricnlar (LV) first 1/3 filling fraction (1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P <0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P < 0.05, P < 0.01). Left ventricular end-diastohc presstrre(LVEDP) was markedly inereased before and after LVGin group Ⅱ and Ⅲ as compared with group Ⅰ (beth P<0.05, beth P<0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD) before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P < 0.01, P < 0.001). Howevere, there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01).Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen-esis of angina decubitus.

  4. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left ventricular diastohc dysfunction on the pathogenesis of angina decubitus (AD). Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease. Results. Left ventriculography (LVG) showed that left ventricular (LV) first 1/3 filling fraction(1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P < 0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P <0.05, P < 0.01). Left ventricular end-diastolic pressure(LVEDP)was markedly increased before and after LVG in group Ⅱ and Ⅲ as compared with group Ⅰ (bothP<0.05, both P< 0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD)before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P <0.01, P < 0.001). Howevere,there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01). Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen esis of angina decubitus.

  5. Significance of silent ischemia in dipyridamole perfusion scintigraphy. Evaluation in patients with angina

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, Hiroaki; Takata, Jun; Yamada, Mitsutoshi; Seo, Hiromi; Doi, Yoshinori [Kochi Medical School, Nankoku (Japan)

    1995-07-01

    The significance of silent myocardial ischemia detected by dipyridamole perfusion scintigraphy was evaluated in 80 patients with stable angina and reversible defects (RD) but no infarction. The patients consisted of 26 patients with silent RD and 54 patients with painful RD. There was no significant difference in the incidence of coronary risk factors between the two groups, except for hyperlipidemia which was less frequently observed in patients with silent RD than in those with painful RD (8% vs 41%), Coronary angiography revealed a higher prevalence of insignificant lesions or single vessel disease in patients with silent RD than in those with painful RD (73% vs 39%). Dipyridamole perfusion scintigraphy revealed a lower degree of RD in patients with silent RD than in those with painful RD (4.4{+-}3.3 vs 9.0{+-}4.1 segments), though there was no significant difference in the localization of RD between these two groups. Treadmill stress testing revealed a lower incidence of chest pain in patients with silent RD than in those with painful RD (26% vs 65%), despite the mean exercise-duration being significantly longer in the former than in the latter (5.5{+-}1.7 vs 3.9{+-}11.7 min). Although initial percutaneous transluminal coronary angioplasty (PTCA) and/or coronary artery bypass grafting (CABG) were less frequently performed in patients with silent RD than in those with painful RD (12% vs 31%), there was no significant difference in the cardiac event rate during the mean follow-up period of 24{+-}14 months between the two groups. Patients with stable angina and silent RD on dipyridamole perfusion scintigraphy may have less extensive coronary lesions and smaller amounts of ischemic myocardium than patients with painful RD. Dipyridamole perfusion scintigraphy is useful for detecting and evaluating silent myocardial ischemia, even in those patients who cannot exercise adequately. (J.P.N.).

  6. INFLUENCE OF MILDRONATE ON EFFICIENCY OF ANTIANGINAL THERAPY IN PATIENTS WITH STABLE BURDEN ANGINA

    Directory of Open Access Journals (Sweden)

    N. P. Kutishenko

    2005-01-01

    Full Text Available Aim. To study influence of mildronate (M on treatment efficiency of patients with ischemic heart disease (IHD, receiving standard antianginal therapy (AATMaterials and methods. Double-blind, randomized, placebo-controlled study was carried out in parallel groups. All patients continued the earlier prescribed AAT without changes. After control period (10-14 days was over, randomization of patients either to the treatment group (M 500mg twice per day, or to the control group (placebo (Pl twice per day was made for 6 weeks therapy. Criterion of treatment efficiency: increase in duration of trial with burden on treadmill (TB, decrease in angina attack frequency (AA and reduction in nitroglycerin taking (NTT. TB was carried out at the beginning (TB-1, at the end of the control period (TB-2, and at the end of the treatment (TB-3.Results. TB-1 and TB-2 had good reproducibility, their duration didn’t differ. At the end of the treatment additionally with M, growth in duration of TB-3 (p=0,002 was registered, while there was no growth of TB duration with the Pl treatment (p=0,07. During the treatment decrease in AA number both with M (p=0,002, and with Pl (p=0,02 was noted. With M treatment decrease in NTT treatment (p=0.02 was observed, while NTT with Pl didn’t change (p=0,7. Number of side effects, registered with M and Pl, didn’t differ.Conclusion. Mildronate provides additional benefits for patients with IHD with stable burden angina, when they do not reach desired effect with the prescribed AAT.

  7. Alterations in left ventricular function during therapy of unstable angina pectoris: relationship to clinical outcome

    International Nuclear Information System (INIS)

    We studied 30 consecutive patients with unstable angina during pain-free intervals with gated blood pool scintigraphy. The initial study was performed within 18 hours of admission to the coronary care unit. A second study was performed near the time of hospital discharge, after stabilization with medical therapy. Three months thereafter patients were categorized according to their worst anginal status following hospital discharge. Fifteen patients were New York Heart Association functional class I or II (group A); 15 patients were in functional class III or IV (group B). Left ventricular ejection fraction was similar at the time of initial study (55.9 +/- 2.18% and 56.0 +/- 3.55% for groups A and B respectively). At the time of hospital discharge the ejection fraction had risen to 60.3 +/- 1.85% (p less than 0.01) in group A and in group B it had fallen to 48.1 +/- 3.4% (p less than 0.005). End-systolic volume index in group B rose from 37 ml/m2 +/- 6.1 to 43 +/- 6.2 ml/m2 (p less than 0.005) at the time of the follow-up study. There were no significant intergroup patients during the two scintigraphic examinations. Eleven group B patients subsequently underwent coronary artery bypass surgery. A significant increase in ejection fraction and a significant decrease in end-systolic volume index were noted when these patients were restudied an average of 3.2 months after surgery. This study suggests that changes in left ventricular function during the course of unstable angina pectoris are common and may be detected by serial gated blood pool scintigraphy

  8. El riesgo como oportunidad

    Directory of Open Access Journals (Sweden)

    Daniela Gargantini

    2003-01-01

    Full Text Available Durante los últimos años el crecimiento mundial de catástrofes naturales ha ido en franco aumento. Sin embargo, desde un enfoque sistémico puede verificarse que la gran mayoría de los desastres se origina en los países en desarrollo (entre ellos los latinoamericanos, siendo las pérdidas en ellos significativamente más altas que en los países industrializados. Bajo esta postura los desastres no son sólo naturales sino socio- naturales, enfatizando la estrecha relación de causalidad entre modelos de desarrollo y urbanización y procesos de generación de riesgos, al incrementar la vulnerabilidad de los sectores más desprotegidos. El desastre pone en evidencia así una situación (la pobreza y segregación urbana ya existente, pero no considerada hasta el momento de la catástrofe. Frente a este panorama el desastre aparece como oportunidad que precipita tres catalizadores de políticas habitacionales: tierra, asistencia técnica y financiamiento, incrementando la celeridad y la creatividad de las respuestas. El interrogante que surge es por qué esperar el desastre para ponerlos en marcha, cuando ninguno de ellos es estrictamente dependiente de la situación de riesgo, sino sujeto de luchas de poder.

  9. El signo como emblema

    Directory of Open Access Journals (Sweden)

    Sáez, Carlos

    2003-06-01

    Full Text Available The aim of this article is to study the signs and symbols that appear in the hispanic medieval documents and manuscripts. These signs and symbols have usually been considered simply as mere elements to validate the charters. However, these alements were useful as a mean of visual communication between the high classes, able to generate charters, and the rest of medieval society—the majority illiterate— who received those charters. Because of their inability of understand an alphabetical code, they needed the graphic help to comprehend the message. Besides this, the article deals with non diplomatic signs and their function.

    Este artículo se centra en los signos o símbolos presentes en los documentos y manuscritos medievales hispanos, que habitualmente han sido tratados como meros elementos de validación de los diplomas. Pero estos elementos servían también de nexos de comunicación visual entre las clases poderosas, capaces de producir escritos, y los demás miembros de la sociedad medieval, receptores y destinatarios de tales escritos, en su mayoría analfabetos. Precisamente por esta razón, su incapacidad de descifrar un código alfabético, necesitan de auxilio gráfico para acercarse a la comprensión del mensaje. Asimismo, tratamos de los signos no diplomáticos y de su función.

  10. Endomarketing: como diferencial competitivo

    Directory of Open Access Journals (Sweden)

    Karin Birck

    2013-05-01

    Full Text Available Atualmente, com a profissionalização das empresas e com a grande concorrência no mercado, observa-se uma demanda cada vez maior de gestores comprometidos com o bem-estar pessoal e profissional de seus colaboradores. E, com esse intuito, de apresentar algumas idéias básicas de gestão voltadas à aplicação nas mais diversas técnicas de Endomarketing. Demonstra assim, a importância da utilização de feedback, tanto por parte dos colaboradores quanto dos gestores, destacando a importância de trabalhos de motivação, do clima organizacional favorável e de uma comunicação interna eficaz e a necessidade ímpar de tratar o colaborador como o diferencial dentro de uma empresa. Desta forma, foi realizada uma pesquisa bibliográfica que auxiliará e dará subsídios que lhe permitam retribuir em ações e atitudes de sucesso e, também, fazer um confronto de idéias, onde os autores apresentam suas mais diversas opiniões. Contudo, valendo-se, muitas vezes, de narrativas de experiências de outros gestores e até mesmo de suas próprias, tirando cada um suas próprias conclusões.

  11. Factors Associated with the Types of Heparin used in the Treatment of Unstable Angina at a Brazilian Hospital

    Directory of Open Access Journals (Sweden)

    MARIA AUXILIADORA PARREIRAS MARTINS

    2010-06-01

    Full Text Available

    Unfractionated heparin (UFH and low-molecularweight heparins (LMWHs are widely used in curative and preventive treatments of thromboembolic disorders. The aim of the study was to investigate factors associated with the choice of these types of heparin to treat patients with unstable angina under real conditions of hospital use. A cross-sectional study was performed in a private general hospital in Belo Horizonte, Brazil, from January 1st to December 31th, 2001. Data were collected from the hospital electronic database. Inpatients with angina who received enoxaparin or UFH were included in the survey. Data for 555 patients were recorded, including 401 treated with enoxaparin and 154 with UFH. Univariate analysis showed that male and elderly people predominated in both groups, with no statistical difference in the proportions (p>0.05. Multivariate analysis showed 4 factors associated with the use of enoxaparin: cardiac revascularization surgery (OR=0.434, arrhythmias (OR=9.343, risk factors for coronary artery disease (OR=1.333 and private health insurance (OR=0.297. Thus, clinical and organizational factors were associated with the type of heparin used by patients with unstable angina at this hospital. Further drug utilization studies are necessary to expand and improve the data available on the use of heparins in the hospital setting. Keywords: Hospital pharmacy/assessment. Angina pectoris/treatment. Heparin/prescription. Enoxaparin/prescription. RESUMO Fatores associados com os tipos de heparina usados no tratamento da angina instável em um hospital brasileiro A heparina não-fracionada (HNF e heparinas de baixo peso molecular (HBPM são amplamente utilizadas em tratamentos curativos e preventivos de tromboembolismo. O objetivo do estudo foi investigar os fatores associados com a escolha desses tipos de heparinas para tratar pacientes com angina instável sob as condições reais de uso hospitalar. Trata-se de um

  12. LO PINTORESCO COMO CATEGORÍA ESTÉTICA EN EL ARTE DE VIAJEROS: APUNTES PARA LA OBRA DE RUGENDAS

    Directory of Open Access Journals (Sweden)

    Pablo Diener

    2007-12-01

    Full Text Available La categoría estética de lo pintoresco fue incorporada en el repertorio conceptual de artistas y teóricos del arte hacia las últimas décadas del siglo XVIII. Su contenido ha tenido siempre un carácter inestable. De un significado inicial que aludía a una forma de ver y aprehender la naturaleza siguiendo los cánones de composición de artistas clásicos, pasó a ser utilizado con un sentido considerablemente más amplio, como una forma de percepción y registro de la realidad en todos los ámbitos. Tomando como ejemplo la obra de J.M. Rugendas, en este artículo se estudian las connotaciones que lo pintoresco adquirió para los artistas viajeros seguidores de la tradición de Alexander von Humboldt. Se observa que esta categoría estética jugó un papel esencial para vincular el quehacer artístico a los proyectos de reconocimiento científico del continente americano en el curso del siglo XIXThe aesthetic category of "picturesque" was incorporated in the conceptual repertoire of artists and art theorists during the last decades of the eighteenth century. Its content has always had an unstable character. Initially, its meaning alluded to a particular way of seeing and seizing nature, following classic artists' composition canons. Later, it was used in a more comprehensive sense as a form of perception and recording of reality in different fields. This article studies the different connotations that "picturesque" had for travelers that followed the tradition of Alexander von Humboldt. By examining the work of J.M. Rugendas, it is possible to observe that aesthetic categories played an essential role in linking art work and scientific exploration projects in the American continent during the nineteenth century

  13. O direito como imperativo

    Directory of Open Access Journals (Sweden)

    Cloter Miglioriani

    1988-08-01

    Full Text Available We have examined one of the facets which Law presents to society, looking at the theme through a brief history of Law, in which Roman Law stands out, up to modem times, comparing current juridical systems such as the Continental System, Common Law, and Soviet Law. We have looked at Law from the viewpoint of society 's need to have basic mies for living together, with the juridical ruZe being one of the most important. We have highlighted the views of Hart and Kelsen on the foundations of the validity of Law. We have also considered the obligatoriness of Law; giving the point of view of tadbruch who, explaining his ''Theory of the Obligatoriness of Law ", concluded that the obligatoriness of Law can only be withdraw when there is a Clash between morals, law, use and social conventions. We have looked at the notion of the imperativeness of Law the central theme of the work -drawing on the views of Miguel Reale, for whom the juridical nonn cannot be reduced to a "command of a volitional nature", but rather the obligatory character of the juridical nonn arises from the pressure of social values. Del Vecchio, who is also quoted, recognized that imperativeness exists in the juridical norm, whether it is preceptive (a positive command or permissive. Also mentioned is the opinion of Tercio Sampaio Ferraz, for whom the juridical norm has imperativeness to the extent that the imposition of behaviour is unconditionally guaranteed. Foi feita a abordagem de uma das facetas com que o Direito se apresenta à sociedade, enfocando o tema a partir de um brevíssimo histórico do Direito, onde revela a fase romana, até os períodos modernos, com comparações dos sistemas jurídicos hodiernos, como o sistema continental, o da Commum Law e o soviético. Foi enfocado o Direito em face da necessidade sociedade em ter básicas de convivência, despontando a regra jurídica como das mais importantes. Foi dado destaque às posições de Hart e Kelsen, sobre os

  14. Risk stratification in unstable angina and non-Q wave myocardial infarction using soluble cell adhesion molecules

    Science.gov (United States)

    Mulvihill, N; Foley, J; Murphy, R; Curtin, R; Crean, P; Walsh, M

    2001-01-01

    OBJECTIVE—To assess prospectively the prognostic value of soluble cellular adhesion molecules (CAMs) in patients with unstable angina and non-Q wave myocardial infarction and to compare their prognostic accuracy with that of C reactive protein (CRP).
DESIGN AND SETTING—Prospective observational study of patients presenting acutely with unstable angina and non-Q wave myocardial infarction to a single south Dublin hospital.
METHODS—Patients with Braunwald IIIA unstable angina and non-Q wave myocardial infarction had serum samples taken at presentation before initiation of antithrombotic treatment and were followed for six months. The primary end point was the occurrence of major adverse cardiovascular events (recurrent unstable angina, non-fatal myocardial infarction, and cardiovascular death) at six months. Concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble endothelial selectin, and soluble platelet selectin were measured using an enzyme linked immunosorbent assay technique. CRP was measured with an immunophelometric assay.
RESULTS—91 patients (73 men and 18 women, mean (SD) age 61 (11) years) were studied; 27 patients (30%) had major adverse cardiac events during the six months of follow up. Concentration of CRP were significantly raised in patients who had an ischaemic event (mean (SEM) 11.5 (6.4) mg/l v 5.4 (2.5) mg/l, p  3 mg/l and sVCAM-1 > 780 ng/ml for predicting future events was > 90%. There was no difference in concentrations of sICAM-1, soluble endothelin selectin, or soluble platelet selectin between event and non-event groups.
CONCLUSION—Raised concentrations of sVCAM-1 and CRP are predictive of an increased risk of major adverse cardiovascular events six months after presentation with unstable angina and non-Q wave myocardial infarction. These findings suggest that the intensity of the vascular inflammatory process at the time of

  15. Symptoms of angina pectoris increase the probability of disability pension and premature exit from the workforce even in the absence of obstructive coronary artery disease

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrøm, Steen Z; Hvelplund, Anders;

    2013-01-01

    To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals.......To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals....

  16. [Constant-frequency trans-esophageal electric atrial stimulation for evaluation of the severity of illness in patients with stenocardia and the anti-angina effect of erinit].

    Science.gov (United States)

    Gasilin, V S; Sidorenko, B A; Lazarev, I A; Smirnov, M Iu

    1990-12-01

    Constant-frequency transesophageal atrial pacing was used in 87 patients with coronary heart disease concurrent with stable angina pectoris of various functional classes (I-IV). This technique, as a bicycle ergometric test, allows one to assess the functional class of patients with angina and to ascertain the antianginal effect of agents, which was exemplified by erinit given in doses of 80 and 120 mg.

  17. Innovative Strategy in Treating Angina Pectoris with Chinese Patent Medicines by Promoting Blood Circulation and Removing Blood Stasis: Experience from Combination Therapy in Chinese Medicine.

    Science.gov (United States)

    Xiong, Xing-Jiang; Wang, Zhong; Wang, Jie

    2015-01-01

    Coronary heart disease (CHD) is one of the leading causes of death worldwide. Moreover, angina pectoris is one of the most important types of CHD. Therefore, prevention and effective treatment of angina pectoris is of utmost importance in both China and western countries. However, undesirable effects of antianginal therapy do influence treatment adherence to a certain extent. Therefore, it's not surprising that, complementary and alternative medicine (CAM), including Chinese medicine (CM), are widely welcomed among patients with CHD, hoping that it might complement western medicine. In our previous studies, blood stasis syndrome (BSS) (Xueyu Zheng) was the main syndrome (Zheng-hou) of angina pectoris. Currently, China Food and Drug Administration authoritatively recommended more than 200 Chinese patent medicines (CPMs) as complementary or adjunctive therapies for symptom management and enhancing quality of life along with mainstream care on angina pectoris management in mainland China. This paper reviewed 4 kinds of most frequently-used CPMs by promoting blood circulation and removing blood stasis in the treatment of angina pectoris. It aims to evaluate the current evidence of CPMs in combination therapy for angina pectoris. This review indicated that CPMs as adjunctive treatment to routine antianginal therapy play an active role in reducing the incidence of primary endpoint events, decreasing anginal attack rate, and improving electrocardiogram. Additionally, CPMs have been proven relatively safe. Further rigorously designed clinical trials should be conducted to confirm the results. PMID:25360837

  18. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Hvelplund, Anders; Abildstrøm, Steen Z;

    2012-01-01

    (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65%) than men (32%) had no obstructive CAD (P<0.001). In Cox's models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or...... stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.......AimsPatients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no...

  19. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    A. I. Kondratiev

    2014-07-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  20. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    A. I. Kondratiev

    2011-01-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  1. Predictors of coronary intervention-related myocardial infarction in stable angina patients pre-treated with statins

    OpenAIRE

    Veselka, Josef; Hájek, Petr; Malý, Martin; Zemánek, David; Adlová, Radka; Tomašov, Pavol; Martinkovičová, Lucie; Tesař, David; Červinka, Pavel

    2011-01-01

    Introduction Peri-procedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This study was designed to determine the predictors of PMI in patients pre-treated with statins. Material and methods A total of 418 stable angina pectoris patients taking statins and aspirin were included. All the patients underwent PCI. Serum concentrations of creatine kinase (CK-MB mass) and troponin I (TnI) were measured prior to and...

  2. Periodontal disease in relation to selected parameters of the cardiovascular system in a group of patients with stable angina pectoris

    OpenAIRE

    Włosowicz, Monika; Wożakowska-Kapłon, Beata; Górska, Renata

    2014-01-01

    Introduction Periodontal diseases (PD), which are the cause of chronic inflammatory processes, can develop increased susceptibility to vascular diseases through atherosclerosis. Due to the raised inflammatory and thrombotic risk, PD can have a significant influence on the course and results of stable angina pectoris (SAP). Objectives The aim of the study is to evaluate the influence of chosen PD parameters on selected cardiovascular system parameters, and the correlation between chosen parame...

  3. Association of low levels of vitamin D with chronic stable angina: A prospective case-control study

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    Ab Hameed Raina

    2016-01-01

    Full Text Available Background: Coronary artery disease (CAD is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. A low level of vitamin D is associated with chronic stable angina. Aim: This study was aimed at supporting or refuting this hypothesis in our population. Materials and Methods: The study was a prospective case-control study. We studied 100 cases of chronic stable angina and compared them with 100 matched controls. Vitamin D deficiency was defined as <20 ng/mL, vitamin D insufficiency as 20-30 ng/mL and normal vitamin D level as 31-150 ng/mL. Results: The prevalence of vitamin D deficiency among cases and controls was 75% and 10%, respectively. 75% of the cases were vitamin D-deficient (<20 ng/mL; 12% were vitamin D-insufficient (20-30 ng/mL, and 13% had normal vitamin D levels (31-150 ng/mL. None had a toxic level of vitamin D. Among the controls, 10% were vitamin D-deficient, 33% were vitamin D-insufficient, and 57% had normal vitamin D levels. The mean vitamin level among cases and controls was 15.53 ng/mL and 40.95 ng/mL, respectively, with the difference being statistically significant (P ≤ 0.0001. There was no statistically significant relation between the disease severities, i.e., on coronary angiography (CAG with vitamin D level. Among the cases, we found that an increasing age was inversely related to vitamin D levels (P = 0.027. Conclusion: Our study indicates a correlation between vitamin D deficiency and chronic stable angina. Low levels may be an independent, potentially modifiable cardiovascular risk factor.

  4. Richtlinien zur Diagnostik und Therapie der instabilen Angina pectoris und des Non-Q-Wave-Myokardinfarktes: vorgeschlagene Revisionen

    OpenAIRE

    Huber K; Gaul G; Glogar HD; Kaliman J; Mlczoch J

    2000-01-01

    Die letzten Praxis-Empfehlungen der United States Agency for Health Care Policy and Research zum Thema "Diagnose und Behandlung der instabilen Angina Pectoris (IAP)" stammen aus dem Jahre 1994 und wurden trotz der rasanten Fortschritte auf diesem Gebiet in den vergangenen 5 Jahren nicht erneuert. Das International Cardiology Forum (ICF) hat Ende 1998 die existierenden Richtlinien diskutiert und Vorschläge gemacht, in welchen Bereichen die Diagnostik und die Therapie der IAP aufgrund der mittl...

  5. Electrocardiogram Diagnosis of Unstable Angina Pectoris%不稳定型心绞痛心电图诊断

    Institute of Scientific and Technical Information of China (English)

    董红晶

    2014-01-01

    目的:探讨不稳定型心绞痛患者心电图及动态心电图表现。方法选取2012年~2013年收治的不稳定型心绞痛患者心电图诊断资料进行分析。结果心绞痛发作时可出现暂时性心肌缺血引起的ST段压低(≥0.1 mV)。心电图负荷实验及24 h动态心电图可显著提高缺血性心脏病的检出率。结论心电图检查是发现心肌缺血、诊断心绞痛最常用的检查方法。%Objective The electrocardiogram and dynamic electrocardiogram of the patients with the unstable angina pectoris are to be investigated.Methods Electrocardiogram diagnosis data of patients with angina pectoris in this hospital from 2012 to 2013 are selected for analysis.ResultsWhen the angina pectoris happens, ST segment depresion (≥0.1 mV) can be caused by transient myocardial ischemia. Electrocardiogram stres test and 24h dynamic electrocardiogram can significantly improve the detection rate of ischemic heart disease.Conclusion Electrocardiogram examination is the most widely used inspection method to detect the myocardial ischemia and diagnose the angina pectoris.

  6. The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina

    OpenAIRE

    Sadeghi, Masoumeh; Tavasoli, Aliakbar; Roohafza, Hamidreza; Sarrafzadegan, Nizal

    2010-01-01

    BACKGROUND Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina. METHODS This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic informatio...

  7. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris.

    Science.gov (United States)

    Vulink, N C; Overgaauw, D M; Jessurun, G A; Tenvaarwerk, I A; Kropmans, T J; van der Schans, C P; Middel, B; Staal, M J; Dejongste, M J

    1999-01-01

    Objective. For patients with refractory angina pectoris, spinal cord stimulation (SCS) is a beneficial and safe adjuvant therapy. However, it has not yet been established whether SCS alters the quality of life (QoL) in these patients. Methods. In this study, 26 consecutive patients (age 61.3 ± 7.0 years, 13 females, angina duration 12.7 ± 6.0 years) were recruited. Social, mental, and physical aspects of QoL were determined by Nottingham Health Profile (NHP I), depression scale (CES-D), scoring of angina pectoris attacks and short-acting nitroglycerine intake, pain score on the Visual Analog Scale (VAS), perceived health percentage, Satisfaction With Life scale (SWLS), and one-aspect Linear Analog Self Assessment scale (LASA). QoL outcomes at baseline were compared with reference values from healthy subjects. Within-group changes and magnitude of changes (effect size, ES) were assessed after 3 months and 1 year of SCS. Results. Compared to healthy subjects, the patients had significantly worse scores at baseline on NHP, SWLS, and LASA. After 3 months of SCS, NHP I aspect pain (ES = 1.39), AP-score (ES = 0.85), perceived health percentage (ES =- 0.80), NTG-use (ES = 1.08) and VAS-score (ES = 1.13) were all significantly improved (p pain, energy, emotional reactions, social isolation, sleep, and physical mobility (p 0.80). Conclusion. QoL in patients with refractory angina pectoris is poor. Both pain and health aspects of QoL improved significantly after 3 months of SCS. Social, mental, and physical aspects of QoL were found improved after 1 year of SCS. PMID:22151060

  8. Use of Health Care System-Supplied Aspirin by Veterans With Postoperative Heart Attack or Unstable Angina.

    Science.gov (United States)

    Rivera, Cathleen M; Copeland, Laurel A; McNeal, Catherine J; Mortensen, Eric M; Pugh, Mary J; MacCarthy, Daniel J

    2015-10-01

    Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases. VA pharmacy records were used to determine whether a prescription for aspirin was filled after the postoperative MI or unstable angina. Multivariable logistic regression models estimated odd ratios of filling aspirin prescriptions for the predictors of interest. Of the 321,131 men and women veterans who underwent major surgery, 7,700 experienced a postoperative MI or unstable angina. Among those 7,700, 47% filled an aspirin prescription. Only 59% of veterans with no co-pay filled an aspirin prescription. Aspirin fills were more common in younger veterans, Blacks, Hispanics, males, hypertensive veterans, mentally ill patients, those with no co-pay and those prescribed antiplatelets/anticoagulants in addition to aspirin postoperatively. These findings suggest that the impact of dispensing aspirin as a prescription may not be significant in increasing the appropriate use of aspirin for secondary prevention. PMID:26351774

  9. Use of Health Care System-Supplied Aspirin by Veterans With Postoperative Heart Attack or Unstable Angina.

    Science.gov (United States)

    Rivera, Cathleen M; Copeland, Laurel A; McNeal, Catherine J; Mortensen, Eric M; Pugh, Mary J; MacCarthy, Daniel J

    2015-10-01

    Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases. VA pharmacy records were used to determine whether a prescription for aspirin was filled after the postoperative MI or unstable angina. Multivariable logistic regression models estimated odd ratios of filling aspirin prescriptions for the predictors of interest. Of the 321,131 men and women veterans who underwent major surgery, 7,700 experienced a postoperative MI or unstable angina. Among those 7,700, 47% filled an aspirin prescription. Only 59% of veterans with no co-pay filled an aspirin prescription. Aspirin fills were more common in younger veterans, Blacks, Hispanics, males, hypertensive veterans, mentally ill patients, those with no co-pay and those prescribed antiplatelets/anticoagulants in addition to aspirin postoperatively. These findings suggest that the impact of dispensing aspirin as a prescription may not be significant in increasing the appropriate use of aspirin for secondary prevention.

  10. Submandibular cellulitis (Ludwig's angina) associated to a complex odontoma erupted into the oral cavity. Case report and literature review.

    Science.gov (United States)

    Bertolai, R; Acocella, A; Sacco, R; Agostini, T

    2007-01-01

    The clinical presentation of Ludwig's angina consists in a severe expanding cellulitis causing swelling of the floor of the mouth, tongue and submandibular region, thus resulting in a possible obstruction of the airway and in a rapid progress in deep neck soft tissue infection and mediastinitis with potentially fatal consequences. Frequently, submandibular cellulitis develops from an acute infection spreading from the lower molar teeth. Mandibular fractures, traumatic laceration of the floor of the mouth, and peritonsillar abscesses are other concomitant clinical features. A case of Ludwig's angina associated with a large erupted odontoma and with a deeply impacted third molar displaced to the border of the mandible is described. The patient was affected by enlargement of submandibular space, marked face swelling causing an evident face deformity, tenderness and redness of the neck and limited movement of the neck and mouth. In the past, Ludwig's angina was frequently fatal, however aggressive surgical and medical therapy have significantly reduced the mortality rate. The reported case can be considered as important, not only because of the rarity of the odontoma eruption in the oral cavity, but mainly for the extent of the clinical manifestation of a lesion usually described in literature as asymptomatic.

  11. Retinopatia, a imagem como sintoma, o desenho como cicatriz

    OpenAIRE

    Almeida, Paulo Oliveira Freire

    2013-01-01

    Este texto percorre alguma da bibliografia sobre arte, imagem e visão incidindo em curiosidades de relevância variável sob o modo como a representação gráfica revela efeitos sintomáticos, como patologias da retina ou perturbações visuais de origem fisiológica. Essa identidade entre sintoma e imagem, assumida também como metafórica, decorre de um conceito onde a primeira instância do desenho de observação se inscreve na própria superfície da retina como marca de luz no tecido celular. Os exemp...

  12. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    Directory of Open Access Journals (Sweden)

    Gilman Robert H

    2010-10-01

    Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as

  13. La indumentaria como lenguaje performativo

    OpenAIRE

    Mizrahi, Alejandra

    2013-01-01

    Todo lo que existe sobre la faz de la tierra es susceptible de ser visto como un lenguaje, con una sintaxis, una semántica, una pragmática y una gramática. La indumentaria, como lenguaje que es, se conforma como un tipo de lengua que al ser enunciada -vestida- no sólo dice cosas sino que las hace. Si pensamos en este modo de hacer con el vestido, nos estamos remitiendo infaliblemente a la filosofía del lenguaje ordinario de John L. Austin y a la teoría del género performativo de Judith Butler...

  14. Tender Endothelium Syndrome: Combination of Hypotension, Bradycardia, Contrast Induced Chest Pain, and Microvascular Angina.

    Science.gov (United States)

    Goberdhan, Shivesh; Chiew, Soon Kwang; Syed, Jaffer

    2016-01-01

    Hypotension, bradycardia, and contrast induced chest pain are potential complications of cardiac catheterization and coronary angiography. Catheter-induced coronary spasm has been occasionally demonstrated, but its relationship to spontaneous coronary spasm is unclear. We describe a 64-year-old female who underwent coronary artery bypass surgery in 1998 on the basis of an angiographic diagnosis of severe left main disease, who recently presented with increasingly frequent typical angina. Repeat coronary angiography was immediately complicated by severe chest pain, hypotension, and bradycardia but demonstrated only mild disease of the left main artery and entire coronary tree with complete occlusion of her prior grafts. This reaction was almost identical to that observed during her original coronary angiogram. We now believe her original angiogram was complicated by severe catheter-induced left main spasm, with the accompanying contrast reaction attributed to left main disease, and the occlusion of coronary grafts explained by the absence of significant left main disease. The combination of these symptoms has not been documented in the literature. In this instance, these manifestations erroneously led to coronary bypass surgery. It is unknown whether routine, systematic injection of intracoronary nitroglycerin prior to angiography might blunt the severity of such reactions. PMID:26981290

  15. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Murat Yuksel

    2014-01-01

    Full Text Available Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

  16. Nitric Oxide Synthetic Pathway in Patients with Microvascular Angina and Its Relations with Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Benedetta Porro

    2014-01-01

    Full Text Available A decreased nitric oxide (NO bioavailability and an increased oxidative stress play a pivotal role in different cardiovascular pathologies. As red blood cells (RBCs participate in NO formation in the bloodstream, the aim of this study was to outline the metabolic profile of L-arginine (Arg/NO pathway and of oxidative stress status in RBCs and in plasma of patients with microvascular angina (MVA, investigating similarities and differences with respect to coronary artery disease (CAD patients or healthy controls (Ctrl. Analytes involved in Arg/NO pathway and the ratio of oxidized and reduced forms of glutathione were measured by LC-MS/MS. The arginase and the NO synthase (NOS expression were evaluated by immunofluorescence staining. RBCs from MVA patients show increased levels of NO synthesis inhibitors, parallel to that found in plasma, and a reduction of NO synthase expression. When summary scores were computed, both patient groups were associated with a positive oxidative score and a negative NO score, with the CAD group located in a more extreme position with respect to Ctrl. This finding points out to an impairment of the capacity of RBCs to produce NO in a pathological condition characterized mostly by alterations at the microvascular bed with no significant coronary stenosis.

  17. Prevalence of linked angina and gastroesophageal reflux disease in general practice

    Institute of Scientific and Technical Information of China (English)

    Hirohito Kato; Takamasa Ishii; Tatsuo Akimoto; Yoshihisa Urita; Motonobu Sugimoto

    2009-01-01

    AIM: To evaluate the association between gastroesophageal reflux diseases (GERD) and coronary heart diseases. METHODS: One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as Stsegment depression based on the Minnesota code. RESULTS: Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients). CONCLUSION: The present study suggested that ischemic heart disease might be found although apatient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.

  18. Screening and identification of microRNA involved in unstable angina using gene-chip analysis

    Science.gov (United States)

    Li, Si; Sun, Ya-Nan; Zhou, Yun-Tao; Zhang, Chun-Lai; Lu, Feng; Liu, Jia; Shang, Xiao-Ming

    2016-01-01

    Increasing evidence has suggested that microRNA (miRNA) may play a role in the pathogenesis of cardiovascular disease, which has led to a greater understanding of the complex pathophysiological processes underlying unstable angina (UA). The present study aimed to investigate changes in the miRNA expression profiles of patients with UA using gene-chip analysis, in order to further elucidate the pathogenesis of UA. Total RNA was extracted and purified from plasma samples collected from patients with UA and healthy controls. The samples underwent microarray analysis using an Exiqon miRCURY LNA™ microRNA Array. Differentially expressed miRNAs were identified by volcano plot filtering, and were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In addition, functional annotation of the differentially expressed miRNAs involved gene ontology analyses. Among the 212 miRNAs differentially expressed between the two groups, 82 were upregulated and 130 were downregulated. Notably, the results of the RT-qPCR were consistent with the gene-chip results. The miRNAs identified in the present study may be potential novel biomarkers for the prevention and early diagnosis of UA. Furthermore, the results of the present study suggested that UA occurs as a result of complex and dynamic processes regulated by numerous factors, including multiple miRNAs.

  19. Deep Vein Thrombosis, Raynaud's Phenomenon, and Prinzmetal Angina in a Patient with Glanzmann Thrombasthenia

    Directory of Open Access Journals (Sweden)

    Alan Nurden

    2012-01-01

    Full Text Available Patients with Glanzmann thrombasthenia fail to form large platelet thrombi due to mutations that affect the biosynthesis and/or function of the αIIbβ3 integrin. The result is a moderate to severe bleeding syndrome. We now report unusual vascular behaviour in a 55-year-old woman with classic type I disease (with no platelet αIIbβ3 expression and a homozygous ITGA2B missense mutation (E324K affecting the terminal β-propeller domain of αIIb. While exhibiting classic bleeding symptoms as a child, in later life this woman first developed deep vein thrombosis after a long air flight then showed vascular problems characteristic of Raynaud’s phenomenon, and finally this year she presented with chest pains suggestive of coronary heart disease. Yet while coronary angiography first showed a stenosis, this was not seen on a second examination when she was diagnosed with coronary spastic angina and Prinzmetal phenomenon. It is significant that the absence of platelet aggregation with physiologic agonists had not prevented any of the above cardiovascular or vascular diseases.

  20. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

    Directory of Open Access Journals (Sweden)

    N. S. Krylova

    2014-01-01

    Full Text Available Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC developing under the "mask" of the ischemic heart disease not diagnosed for a long period.Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG, echocardiography (EchoCG, Holter ECG monitoring, coronary angiography (CAG, ventriculography.Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6, EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg., CAG (stenotic lesions of coronary arteries were found, ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicatesexpressed apical hypertrophy of the LV myocard. AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

  1. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

    Directory of Open Access Journals (Sweden)

    N. S. Krylova

    2015-01-01

    Full Text Available Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC developing under the "mask" of the ischemic heart disease not diagnosed for a long period.Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG, echocardiography (EchoCG, Holter ECG monitoring, coronary angiography (CAG, ventriculography.Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6, EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg., CAG (stenotic lesions of coronary arteries were found, ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicatesexpressed apical hypertrophy of the LV myocard. AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

  2. Effects of Salvia miltiorrhiza on Hemorheology and vascular endothelial function in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Shi-Lian Chen; Sheng-Bing Huang

    2016-01-01

    Objective:To investigate the effect of Salvia miltiorrhiza (SM) on vascular endothelial function and hemorheology in patients with unstable angina pectoris (UAP).Methods: A total of 60 cases of UAP patients from October 2014 to October 2015 as the research object, randomly divided into treatment group and control group; the two groups were treated with conventional bed rest, ECG monitoring, oxygen inhalation, application of nitroglycerin, beta blockers, aspirin and antiplatelet, statin therapy, the treatment group based on the use of salvianolate 200 mg+5% glucose 250 mL (neutralization amount of 0.9% sodium chloride was used in patients with diabetes or glucose insulin) intravenous drip, 1 times/d, two groups were treated for 2 weeks; the two groups before and after treatment and take venous blood in the morning fasting peripheral blood viscosity, plasma viscosity, measured by automatic blood rheometer (low and middle shear and high shear rate), hematocrit and erythrocyte aggregation index, serum endothelin (ET) and nitric oxide (NO) level was measured by nitrate reductase Set.Results:after the treatment, the treatment group, the plasma viscosity, whole blood viscosity (low shear, cut and high shear rate), red blood cell hematocrit and red blood cell aggregation index decreased than the control group, there is statistical significance; after treatment, in treatment group, the serum NO level, et reduce degree is significantly better than the contrast group, there is statistical significance.Conclusion: Salvia miltiorrhiza can effectively improve blood rheology, improve microcirculation, regulate vascular endothelial function, effectively reduce the risk of cardiovascular events in UAP patients, it is worthy of clinical application.

  3. Unstable angina and non-ST-segment myocardial infarction: an evidence-based approach to management.

    Science.gov (United States)

    Kou, Victoria; Nassisi, Denise

    2006-01-01

    Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) represent two common, closely related acute coronary syndromes with potentially high morbidity and mortality. Integration of information from the history, physical exam, electrocardiogram, and cardiac biomarkers is used to formulate both the diagnosis of UA/NSTEMI and the overall assessment of patient prognosis and risk. Early diagnosis and risk stratification of patients with UA/NSTEMI enable the physician to initiate timely, appropriate treatment. (There is strong clinical evidence supporting the tailoring of specific therapies to the risk profile of the patient.) In recent years, powerful new medical and invasive therapies have been developed. Pharmaceutical agents for UA/NSTEMI may be broadly grouped into one of three categories: anti-ischemic, anti-platelet, and anti-thrombotic agents. Standard therapy for UA/NSTEMI has commonly included oxygen, aspirin, nitrates, morphine, beta-blockers and heparin. Potent new anti-platelet agents, including inhibitors of platelet adenosine diphosphate and glycoprotein IIb/IIIa receptors, play important, expanding roles in the management of these syndromes. Low-molecular-weight heparins have been shown to be an effective alternative to unfractionated heparin in their treatment. Major advances in invasive techniques and devices over the last decade include revascularization with percutaneous coronary intervention and drug-eluting intracoronary stents. Strong interest exists in studying the potential benefits and risks associated with an early invasive therapeutic strategy rather than an aggressive medical regimen for patients with UA/NSTEMI. As new treatments are rapidly added to our growing arsenal of management options, clinicians are constantly challenged with incorporating complex new information and guidelines into their practices in a timely fashion. To assist clinicians with this challenge, this article will review the evidence to support

  4. Correlation between Timi Risk Score and Clinical Outcome in Patients with Unstable Angina Pectoris

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    Savovic Zorica

    2016-06-01

    Full Text Available Given Taking that the TIMI score is a major predictor of MACE, this study aimed to determine the value of the TIMI risk score in predicting poor outcomes (death, myocardial infarction, recurrent pain in patients presenting with unstable angina pectoris in short-term observation. A total of 107 patients with APns were examined at the Clinical Centre Kragujevac and were included in the investigation. The TIMI score was determined on the first day of hospitalization. During hospitalization, the following factors were also observed: troponin, ECG evolution, further therapy (pharmacologic therapy and/or emergency PCI or CABG, age, hypertension and hyperlipidaemia. The low-risk group (TIMI 0 - 2 included 30.8% of patients, whereas 47.6% of patients were in the intermediate-risk group (TIMI 3 - 4, and 21.5% of patients were in the high-risk group (TIMI 5 - 7. Good outcomes (without adverse event and poor outcomes (death, myocardial infarction, and recurring chest pain were dependent on the TIMI risk score. The increase in TIMI risk score per one unit increased the risk of a poor outcome by 54%. Troponin and TIMI risk score were positively correlated. Our results suggest that the TIMI risk score may be a reliable predictor of a poor outcome (MACE during the short-term observation of patients with APns. Moreover, patients identified as high-risk benefit from early invasive PCI, enoxaparin and Gp IIb/IIIa inhibitors. Th us, routine use of the TIMI risk score at admission may reduce the number of patients not recognized as high-risk.

  5. Predictive factors of recurrent angina after acute coronary syndrome: the global registry acute coronary events from China (Sino-GRACE)

    Institute of Scientific and Technical Information of China (English)

    ZHAO Fu-hai; CHEN Yun-dai; SONG Xian-tao; PAN Wei-qi; JIN Ze-ning; YUAN Fei; LI Yong-bin; Ren Fang; L(U) Shu-zheng

    2008-01-01

    Background Many patients with acute coronary syndrome (ACS) develop recurrent angina (RA) during hospitalization. The aim of this non-randomized, prospective study was to investigate the predictive factors of RA in unselected patients with ACS enrolled in the global registry acute coronary events (GRACE) during hospitalization in China. Methods Between March 2001 and October 2004, enrolled were 1433 patients with ACS, including ST segment elevation myocardial infarction (662, 46.2%), non-ST segment elevation myocardial infarction (239, 16.7%) and unstable angina (532, 37.1%). The demographic distribution, medical history and clinical data were collected to investigate the predictive factors of RA by Logistic regression.Results During hospitalization 275 (19.2%) patients were documented with RA including unstable angina (53.2%), non-ST segment elevation myocardial infarction (27.5%), ST segment elevation myocardial infarction (19.3%). A comorbidity of dyslipidemia, prior angina, percutaneous coronary Intervention (PCI) within 6 months was more common in patients with RA, P<0.05. In the patients with RA, a significantly higher proportion of patients with acute pulmonary edema was observed, 23 (8.4%) versus 43 (3.7%), P=0.001. Acute renal failure was present in 8 (2.9%) of patients with RA versus 19 (1.6%) of patients without RA,P=0.165. Hemorrhagic events were present in 6 (2.2%) of patients with RA versus 8 (0.7%) of patients without RA, ventricular tachycardia/ ventricular fibrillation events in 12 patients (4.3%) versus 22 patients (1.9%), congestive heart failure in 69 patients (25.0%) versus 94 patients (8.1%), myocardial re-infarction in 28 patients (10.1%) versus 15 patients (1.3%), P<0.05, respectively. A lower proportion of patients with RA underwent in-hospital PCI, 687 (59.3%) versus 114 (41.5%), P=0.000. A higher proportion of patients with RA received heparin, 260 (94.5%) versus 1035 (89.4%), P=0.006; and beta-blockers 176(64.0%) versus 864 (74

  6. El paisaje como estrategia proyectual

    OpenAIRE

    Mínguez Martínez, Enrique

    2014-01-01

    La presente comunicación tiene por objeto presentar los trabajos realizados por los alumnos de la asignatura de Urbanística III de la titulación Grado en Arquitectura de la Universidad Católica San Antonio de Murcia (UCAM). Mientras que en el Urbanismo funcionalista el objeto del proyecto son los edificios y el paisaje se entiende como un relleno verde, residual, identificado por Colin Rowe en Ciudad Collage (1978) como modelo Acrópolis, en los ejercicios realizados el análisis pormenorizado ...

  7. La Tierra vista como exoplaneta

    OpenAIRE

    Antígona Segura

    2010-01-01

    La Tierra, como único ejemplo de planeta habitable, nos da los primeros elementos para caracterizar el espectro de planetas de tipo terrestre alrededor de otras estrellas que podrían ser detectados en el transcurso de la próxima década gracias a misiones como CoRoT y Kepler y caracterizados por las misiones Terrestrial Planet Finder y Darwin. En este artículo se compendian los estudios que utilizan a la Tierra para determinar las posibles características de mundos habitables alrededor de otra...

  8. Direct intramyocardial mesenchymal stromal cell injections in patients with severe refractory angina - one year follow-up

    DEFF Research Database (Denmark)

    Haack-Sørensen, Mandana; Friis, Tina; Mathiasen, Anders B;

    2013-01-01

    Aims: In patients with stable coronary artery disease (CAD) and refractory angina we performed direct intra-myocardial injections of autologous mesenchymal stromal cells (MSCs) and followed the safety and efficacy of the treatment for 12 months. Methods and Results: A total of 31 patients with st...... follow-up demonstrated, that it was safe to culture expand MSCs and use the cells for clinical treatment. The patients maximal metabolic equivalent (MET) during exercise increased from 4.23 MET at baseline to 4.72 MET at 12 months follow-up (p...

  9. Burden of Hospital Admission and Repeat Angiography in Angina Pectoris Patients with and without Coronary Artery Disease

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrom, Steen Z; Hvelplund, Anders;

    2014-01-01

    AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD) and repeat coronary angiography (CAG) in stable angina pectoris (SAP) with no obstructive coronary artery disease (CAD) versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11......-, and 3-vessel disease, respectively (all Prepeat CAG with multivariable adjusted hazard ratios for patients with angiographically normal coronary arteries being 2.3(1.9-2.9), for angiographically diffuse non-obstructive CAD 5.5(4.4-6.8) and for obstructive CAD...... 6.6-9.4(range)(all Prepeat CAG compared with asymptomatic reference...

  10. Prinzmetal's variant angina evolved in inferior myocardial infarction with involvement of the right ventricle: Sequential radionuclide evaluation

    International Nuclear Information System (INIS)

    A patient with Prinzmetal's variant angina (PVA) who developed an inferolateral myocardial infarction with right-ventricle involvement was studied using sequential radionuclide imaging until 5 months after the acute event. The patient also underwent-contrast ventriculography and coronary-artery angiography. Equilibrium-gated radionuclide angiography (EGRA) revealed the localization of ventricular dysfunction, the results obtained being in agreement with haemodynamic data. We emphasize the usefulness of the parameters obtained using EGRA (regional wall motion, systolic and diastolic parameters) in planing therapy and follow-up. (orig.)

  11. Relevance of 123I-BMIPP delayed scintigraphic imaging for patients with angina pectoris – a pilot study

    OpenAIRE

    Koyama, Kohei; Akashi, Yoshihiro J.; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

    2011-01-01

    Introduction The study was designed to clarify the role of 123I-β-methyl-iodophenylpentadecanoic acid (123I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). Material and methods Ten controls (mean age: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic imag...

  12. GAMMAGRAFÍA DE PERFUSIÓN MIOCÁRDICA EN MUJERES POSMENOPÁUSICAS CON ANGINA Y CORONARIAS EPICÁRDICAS ANGIOGRÁFICAMENTE NORMALES / Myocardial perfusion scintigraphy in postmenopausal women with angina and angiographically normal epicardial coronary

    Directory of Open Access Journals (Sweden)

    Sherien Sixto Fernández

    2011-03-01

    Full Text Available Introduction and Objectives: Microvascular angina is common in postmenopausal women. Myocardial ischemia was induced by stress testing, and reports have been published about the relationship between endothelial dysfunction and myocardial perfusion. The objective of this research was to determine whether myocardial ischemia can be evidenced by abnormalities in perfusion and function, as detected by myocardial scintigraphy in women with typical angina, normal coronary angiography and endothelial dysfunction. Methods: 59 women underwent lipid and endothelial function measurements by brachial artery ultrasound, in addition, a 24-hour ECG study (Holter. During the scintigraphy a stress-rest protocol was applied. Patients were divided into two groups according to presence (group I or absence (group II of myocardial perfusion defects. Results: 21 patients showed perfusion defects. 57 % of group I exhibited greater endothelial dysfunction. Only twelve patients showed reversible perfusion defects, and 75 % of the cases was associated with a reduction of post-stress left ventricular ejection fraction, greater than 5 %, and regional abnormalities of wall motion. Three patients in group I showed evidence of ischemia compared with four in Group II. Conclusions: The stress-induced ischemia was associated with a reduced post-stress ejection fraction and endothelial dysfunction in the studied women, and no ischemic changes in the Holter were found.

  13. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

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    Hui Zhao

    2015-01-01

    Full Text Available Background: As an acute phase protein, α1-antitrypsin (AAT has been extensively studied in acute coronary syndrome, but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP. The purpose of the present study was to investigate the association between AAT plasma levels and SAP. Methods: Overall, 103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study. Plasma levels of AAT, high-sensitivity C-reactive protein (hsCRP, lipid profiles and other clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the Gensini score (GS assessed by coronary angiography. Results: Positively correlated with the GS (r = 0.564, P < 0.001, the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs. 125.50 ± 19.67 mg/dl, P < 0.001. The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] = 1.037, 95% confidence interval [CI]: 1.020-1.054, P < 0.001 and a high GS (OR = 1.087, 95% CI: 1.051-1.124, P < 0.001 in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, plasma AAT level was found to have a larger area under the curve (AUC for predicting a high GS (AUC = 0.858, 95% CI: 0.788-0.929, P < 0.001 than that of hsCRP (AUC = 0.665, 95% CI: 0.557-0.773, P = 0.006; Z = 2.9363, P < 0.001, with an optimal cut-off value of 137.85 mg/dl (sensitivity: 94.3%, specificity: 68.2%. Conclusions: Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  14. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hui Zhao; Hong Liu; Lin Chai; Ping Xu; Lu Hua; Xiao-Yuan Guan; Bing Duan

    2015-01-01

    Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P < 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P < 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95% confidence interval [CO:1.020-1.054,P < 0.001) and a high GS (OR =1.087,95% CI:1.051-1.124,P < 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95% CI:0.788-0.929,P < 0.001) than that of hsCRP (AUC =0.665,95% CI:0.557-0.773,P =0.006; Z =2.9363,P < 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3%,specificity:68.2%).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  15. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Weverton Ferreira, E-mail: wfleite@cardiol.br [Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP (Brazil); Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP (Brazil); Ramires, José Antonio Franchini; Moreira, Luiz Felipe Pinho; Strunz, Célia Maria Cassaro [Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP (Brazil); Mangione, José Armando [Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP (Brazil)

    2015-03-15

    High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable angina (UA). This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Forty patients with CAD (20 with SA and 20 with UA) were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001) and UA (r = 0.976, p < 0.001) and for the entire sample (r = 0.985, p < 0.001). Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA.

  16. Effects of XUEZHIKANG on Oxidized Low Density Lipoprotein,C- Reactive Protein, Fibrinogen in Unstable Angina Pectoris Patients

    Institute of Scientific and Technical Information of China (English)

    姚青海; 崔长琮; 王军奎; 姚晓伟

    2003-01-01

    Objectives To study the effects of XUEZHIKANG on lipid modulating and thelevel of oxidized low density lipoprotein (OX - LDL),C -reactive protein(CRP), fibrinogen(FIB) in serum.Methods XUEZHIKANG was given to patientswith unstable angina pectoris and hyperlipidemia at adose of 0.6 gram bid for 2 months and with half-dose for another 2 months. Vitamin E was given tounstable angina pectoris patients with normal lipid atthe dose of 0.1 gram bid for 4 months respectively.Then compared the level of lipid and OX - LDfL, CRP,FIB in serum at beginning, first -month and second -month. Results XUEZHIKANG can reduce theserum level of total cholesterol, low density lipoproteinin 1 month , and gained better effect in 2 months. Itcan also reduce triglyceride and increase high densitylipoprotein in 2 months. Compared with vitamin EXUEZHIKANG can reduce the level of OX- LDL,CRP, FIB significantly after treatment for 2 months.Conclusions XUEZHIKANG has significant effectin lipid modulating , and it can also inhibit the de-velopment of inflammation in coronary plaque.

  17. A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (CHD-AP) with Xin-blood stagnation syndrome (XBSS).Methods: Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine(TCM) symptoms as well as the safety of the treatment. Results: The significantly effective rate and total effective rate in the tested group were 60.06% (194/323) and 91.02% (294/323) respectively; those in improvement of TCM symptoms were 40.18% (129/321) and 75.23% (243/323) respectively, which were better than those in the control group (P<0.01). Conclusion: SYI Injection is effective and safe in treating CHD-AP-XBSS.

  18. Effect of the platelet membrane GP Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Yonghui Zhao; Changcong Cui; Yanni Wang; Jiaqing Zhu

    2005-01-01

    Objective: To investigate the effect of platelet membrane glycoprotein(GP) Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris (UAP) in Chinese people. Methods: Collagen type Ⅰ -induced platelet aggregation was measured in 33healthy subjects in vitro. Plasma level of α-granule membrane protein (GMP-140) was measured in both the above 33 healthy subjects during fasting and 35 patients with recent onset effort anina during rest onset within 24 h after hospitalization. Furthermore, the platelet membrane GP Ⅰ a gene 807C/T polymorphism was checked in all subjects with polymerase chain reaction-sequence specific primers(PCR-SSP)technique. Results: The lag time before 30% platelet aggregation was significantly longer in healthy subjects with CC genotype than with TC genotype ( P <0.01). However, there was no significant difference in the maximal platelet aggregation between healthy subjects with the above two genotypes. Plasma level of GMP-140 was significantly higher in TC genotypic patients with recent onset effort angina than in CC genotypic patients with the same type of UAP( P < 0.05) and healthy subjects ( P < 0.01), furthermore, there was also significant difference between the latter two groups( P < 0.05). Conclusion: The rapid initiation of collagen-induced platelet aggregation may be associated with platelet membrane GP Ⅰ a T807 allele, which may play an important role in the pathogenesis of UAP.

  19. The effects of lidoflazine on exercise performance and thallium stress scintigraphy in patients with stable angina pectoris

    International Nuclear Information System (INIS)

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a 7-month study, 36 patients with stable angina pectoris were tested during a 3-month single-blind placebo phase. Nineteen were then randomized by double-blind methods to lidoflazine and 17 to placebo therapy. The lidoflazine group had a significant (p < 0.01) reduction in anginal attacks; the placebo group did not. Exercise testing demonstrated that lidoflazine therapy was associated with a 34% increase in total work performance and a 15.6% increase in peak calculated oxygen uptake during double-blind treatment (both p < 0.004 compared with the placebo group). Heart rate was significantly reduced at submaximal levels of exercise during lidoflazine therapy (p < 0.04). Nitroglycerin consumption and electrocardiographic changes at the end of exercise did not change during the double-blind phase. In a second study of six similar patients, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise

  20. El singular como diferencia divina

    Directory of Open Access Journals (Sweden)

    Maria Jose Binetti

    2012-01-01

    Full Text Available Mucho se ha hablado sobre la posición de la diferencia como motor dialéctico de la existencia singular kierkegaardiana. El pecado, el otro o el Otro fisuran la subjetividad humana y la obligan a una identidad que guardará siempre la herida. El sujeto de la escisión es, en este sentido, el existente mismo, y tal debe ser el caso si la perspectiva se concentra en la individualidad. No obstante, y desde el punto de vista especulativo, creemos que los mismos principios utilizados por Kierkegaard para explicar el dinamismo de la existencia singular nos llevan más lejos, a saber, nos conducen al absoluto mismo como sujeto último de toda alteridad, respecto del cual el singular hace la diferencia.

  1. El arte como posible conocimiento

    Directory of Open Access Journals (Sweden)

    Janitzio Alatriste Tobilla

    2010-01-01

    Full Text Available Este artículo es producto de una investigación que intenta construir un modelo metodológico para concebir la producción artística como una forma de conocimiento e incorporar el quehacer imaginario del artista dentro de los esquemas que regulan la investigación académica tanto en México como en el mundo. La construcción de esta propuesta metodológica ha sido creada desde tres posiciones con respecto al conocimiento: la semiótica de Charles S. Peirce, la teoría psicoanalítica de Jacques Lacan y la práctica artística visual.

  2. Angina pré-infarto na evolução intra-hospitalar de pacientes idosos com infarto agudo do miocárdio Preinfarction angina and in-hospital outcome of elderly patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Chiu Wen Shian

    2007-12-01

    Full Text Available FUNDAMENTO: A angina pré-infarto (API pode ser um marcador de pré-condicionamento isquêmico. Foi demonstrada redução da área infartada, do remodelamento ventricular, da incidência de insuficiência cardíaca, choque cardiogênico ou morte, quando a API estava presente. Esses resultados foram mais evidentes em adultos, porém, não em idosos. OBJETIVO: Avaliar a relação entre API e a evolução clínica de pacientes idosos com infarto agudo do miocárdio (IAM. MÉTODOS: Estudo tipo série de casos com grupo de comparação. Foram incluídos 36 pacientes com diagnóstico de IAM com elevação do segmento ST. Os pacientes foram distribuídos em grupo A (21 pacientes com API e grupo B (15 pacientes sem API. RESULTADOS: A idade média da população estudada foi 70,5 anos. A maioria (73% dos pacientes era do sexo masculino. O índice de massa corpórea médio foi 25,3 kg/m2. A amostra era constituída por 77,8% de hipertensos, 27,8% de diabéticos e 32,4% de dislipidêmicos. Dor torácica tipo A foi relatada por 71,4% dos estudados. A maioria (72,2% dos idosos foi classificada em Killip I. Os desfechos clínicos nos grupos A e B foram: angina pós-infarto 9,5% versus 20%, p=0,630; insuficiência cardíaca 23,8% versus 13,3%, p=0,674; revascularização de urgência 4,8% versus 6,7%, p=1; arritmia cardíaca 0% versus 6,7%, p=0,417. Não foi constatado nenhum caso de reinfarto, choque cardiogênico e morte até 30 dias em ambos os grupos. CONCLUSÃO: A presença da angina pré-infarto não se associou com uma melhor evolução clínica em idosos acometidos por IAM nesta série de casos.BACKGROUND: Preinfarction angina (PIA may be a marker of ischemic preconditioning. A decrease in infarct size, ventricular remodeling, congestive heart failure, cardiogenic shock or death was demonstrated in the presence of preinfarction angina. These findings were more evident in adults, but not in the elderly. OBJECTIVE: To assess the relationship between PIA

  3. Predictive value of local and core laboratory echocardiographic assessment of cardiac function in patients with chronic stable angina: The ACTION study

    NARCIS (Netherlands)

    A.M. Dart (Anthony); J.E. Otterstad (Jan Erik); B.A. Kirwan (Bridget Anne); J.D. Parker (John); S. de Brouwer (Sophie); P. Poole-Wilson (Philip); J. Lubsen (Jacobus)

    2007-01-01

    textabstractAims: To evaluate the relationship between echocardiographic cardiac function and outcome in patients with stable symptomatic angina. Methods: Baseline echo left ventricular ejection fraction and volume data measured in a central laboratory was available for 7016 patients (92% of the tot

  4. Sequential comparison of therapy with beta-blockers and calcium channel blockers with celiprolol therapy in patients with angina pectoris, hypertension, or both

    NARCIS (Netherlands)

    Cleophas, TJM; Niemeyer, MG; Bernink, PJLM; Zwinderman, KH; Wijk, AV; Wall, EEVD

    1996-01-01

    Unlike patients with either hypertension (HT) of angina pectoris (AP) alone, patients with both HT and AP usually have a reduced left ventricular compliance and may, therefore, have an impaired capability to cope with acute hemodynamic changes generated by standard beta-blockers or calcium channel b

  5. Incidence and impact on prognosis of peri-procedural myocardial infarction in 2760 elective patients with stable angina pectoris in a historical prospective follow-up study

    DEFF Research Database (Denmark)

    Christensen, Martin Kirk; Huang, Hui; Torp-Pedersen, Christian;

    2016-01-01

    elevated biomarkers after elective PCI in patients with stable angina pectoris using the defined cut-off (>5 x URL) was 15.2 % using cTnT and 4.1 % using CK-MBmass. The independent prognostic value for both cardiac biomarkers of any cut-off showed no statistical significance for all-cause mortality...

  6. Increased expression and plasma levels of myeloperoxidase are closely related to the presence of angiographically-detected complex lesion morphology in unstable angina

    NARCIS (Netherlands)

    T. Naruko; A. Furukawa; K. Yunoki; R. Komatsu; M. Nakagawa; Y. Matsumura; N. Shirai; K. Sugioka; M. Takagi; T. Hozumi; A. Itoh; K. Haze; M. Yoshiyama; A.E. Becker; M. Ueda

    2010-01-01

    Background Myeloperoxidase (MPO) is a leucocyte enzyme that catalyses the formation of a number of reactive oxidant species. Objective The purpose of this study is to evaluate the relationship between angiographic coronary plaque morphology in patients with unstable angina pectoris (UAP) or stable a

  7. [Dengzhan Xixin injection as an adjuvant treatment for angina pectoris: a systematic review and Meta-analysis of randomized controlled trials].

    Science.gov (United States)

    Wang, Feng-jiao; Xie, Yan-ming; Liao, Xing; Jia, Min

    2015-08-01

    The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P < 0.000 010 and electrocardiogram curative effect (OR = 2.21; 95% CI; [1.83, 2.68]; P < 0.000 010. Funnel figure seemed that there was publication bias. The current limited evidence showed that when compared with the control group, treatment group was superior in improving patients with angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.

  8. Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery

    NARCIS (Netherlands)

    Jessurun, GAJ; Tio, RA; De Jongste, MJL; Hautvast, RWM; Den Heijer, P; Crijns, HJGM

    1998-01-01

    To study the effect of transcutaneous electrical nerve stimulation (TENS) on coronary vasomotion, patients with New York Heart Association class III angina pectoris and significant single-vessel left coronary artery disease and who were also scheduled for elective percutaneous transluminal coronary

  9. beta-blocker Therapy is Not Associated with Reductions in Angina or Cardiovascular Events After Coronary Artery Bypass Graft Surgery : Insights from the IMAGINE Trial

    NARCIS (Netherlands)

    Booij, Harmen G.; Damman, Kevin; Warnica, J. Wayne; Rouleau, Jean L.; van Gilst, Wiek H.; Westenbrink, B. Daan

    2015-01-01

    To evaluate whether beta-blockers were associated with a reduction in cardiovascular events or angina after Coronary Artery Bypass Graft (CABG) surgery, in otherwise stable low-risk patients during a mid-term follow-up. We performed a post-hoc analysis of the IMAGINE (Ischemia Management with Accupr

  10. Role of multi-slice CT coronary angiography in evaluating the different patterns of coronary artery disease in patients with unstable angina

    Directory of Open Access Journals (Sweden)

    Gamal Eldine M. Niazi

    2015-09-01

    Conclusion: Non-invasive multi-slice CT coronary angiography is a reliable technique of high ability to detect coronary artery disease and estimate the degree of obstruction, number of affected arteries and the pattern of their affection and can be used in workup in patients with unstable angina.

  11. Are negative aspects of social relations predictive of angina pectoris? A 6-year follow-up study of middle-aged Danish women and men

    DEFF Research Database (Denmark)

    Lund, Rikke; Rod, Naja Hulvej; Christensen, Ulla

    2011-01-01

    OR=2.19 (1.04 to 4.61), other family OR=1.91 (1.24 to 2.96). Except for frequent conflicts with the partner and neighbours, conflicts with the social relations was not a risk factor for angina. The authors found no interaction of negative aspects of social relations with gender, age, social class...... associated with angina pectoris among 4573 middle-aged Danish men and women free of heart disease at baseline in 2000. Results Nine per cent experienced onset of symptoms of angina pectoris. A higher degree of excessive demands or worries from the social relations was associated with increased risk of angina...... after adjustment for age, gender, social class, cohabitation status and depression in a dose-response manner. For example, experiencing excessive demands or worries always/often from different roles in the social relations was associated with an increased risk: partner OR=3.53 (1.68 to 7.43), children...

  12. Espacio y tiempo como conceptos

    OpenAIRE

    Farbiarz L., Benjamín

    1981-01-01

    Corrientemente estamos acostumbrados a utilizar los conceptos de espacio y tiempo bajo la idea de que estas palabras se limitan a designar realidades externas y elementales. Su aparición y uso no es debida la una ni exclusivo el otro a las ciencias físicas ; por el contrario, están presentes en el lenguaje más elemental de nuestra vida "diaria. Sin pretender dar xana definición de ellos, podemos tratar de hacer explícita su significación. El espacio, en términos nnuy generales, funciona como ...

  13. Terroristas como pessoas no direito?

    Directory of Open Access Journals (Sweden)

    Günther Jakobs

    2009-03-01

    Full Text Available A punição de terroristas, em larga medida preliminar, ou os severos interrogatórios, não se adequam a um perfeito Estado de direito. Pertencem ao direito de exceção. Um Estado de direito que tudo abarque não poderia travar esta guerra, pois ele deveria tratar seus inimigos como pessoas e, conseqüentemente, não poderia tratá-las como fonte de perigo. Em Estados de direito que operam na prática de modo ótimo procede-se de outra maneira, e isso lhes dá a chance de não se quebrarem durante o ataque a seus inimigos.The preemptive punishment of terrorists and the use of harsh interrogation techniques are not within the classical standards of the Rule of Law. They belong rather to a state of exception. A State committed to all the usually accepted requirements of the Rule of Law would not be allowed to carry such a war, because it would have the duty to treat its enemies as persons. Therefore, it would not be authorized to treat them as a source of danger. Nevertheless, these classical standards have been challenged in the last two decades by major institutional changes that are now being discussed both in theoretical as in practical levels.

  14. Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.

    Science.gov (United States)

    Stillman, Arthur E; Gatsonis, Constantine; Lima, João A C; Black, William C; Cormack, Jean; Gareen, Ilana; Hoffmann, Udo; Liu, Tao; Mavromatis, Kreton; Schnall, Mitchell D; Udelson, James E; Woodard, Pamela K

    2016-09-01

    RESCUE is a phase III, randomized, controlled, multicenter, comparative efficacy study, designed to compare two diagnostic imaging/treatment paradigms that use coronary computed tomography angiography (CCTA) or single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) for assisting in the diagnosis of ischemic heart disease in patients with stable angina symptoms, and guiding subsequent treatment. The study is based on the hypothesis that CCTA as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with SPECT MPI. The RESCUE trial was funded by the Agency for Healthcare Research and Quality (AHRQ) and the American College of Radiology Imaging Network (ACRIN) Fund for Imaging Innovation, began in 2011, and completed in 2014. PMID:27595676

  15. The pro- and anti-inflammatory markers in patients with acute myocardial infarction and chronic stable angina.

    Science.gov (United States)

    Wojakowski, Wojciech; Maslankiewicz, Katarzyna; Ochala, Andrzej; Wyderka, Rafal; Zuk-Popiolek, Izabela; Flak, Zbigniew; Mroz, Iwona; Tendera, Michal

    2004-08-01

    The aim of this study was to assess the plasma levels of VEGF and interleukin-10 in patients with acute myocardial infarction (AMI) and stable chronic angina (SA) and correlate the values with traditional CHD risk factors, left ventricular ejection fraction (LVEF) and established inflammatory marker hsCRP. Fifty patients with AMI and 30 with SA were enrolled. IL-10 levels in AMI patients were lower than in SA patients (9.81 +/- 5.0 versus 22.63 +/- 8.38 pg/ml, p 40% and Killip class I-II (338.8 +/- 51.59 versus 271.8 +/- 50.51 pg/ml; p 6 h versus inflamatory markers and CHD risk factors and the function of the left ventricle on admission.

  16. [Results of combined therapy of stable 2-3 FC angina of effort with metabolic syndrome including metformin].

    Science.gov (United States)

    Dashdamirov, R L

    2014-01-01

    The aim of the study was to evaluate results of combined therapy of stable 2-3 FC angina of effort with metabolic syndrome including metformin. Group 1 was comprised of 71 patients (38 (53.3%) men and 33 (46.5%) women), group 2 consisted of 57 patients treated with isosorbid-5 mononitrate (40 mg/d + amlodipin (5 mg/d) + eprosartan (600 mg/d) + thrombo ASS (100 mg/d) + carvedilol (25 mg/d) + atorvastatin (20 mg/d). Effects of the treatment were assessed 3, 6, and 12 months after its onset. At the end of the study, fasting blood glucose, total cholesterol, triglyceride, and low density lipoproteide levels decreased by 12.8, 10.9, 12.9 and 13.6% respectively compared with the initial values (p physical load increased by 22.7%. PMID:25980297

  17. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  18. A literature review to evaluate the economic value of ranolazine for the symptomatic treatment of chronic angina pectoris.

    Science.gov (United States)

    Vellopoulou, Katerina; Kourlaba, Georgia; Maniadakis, Nikos; Vardas, Panagiotis

    2016-05-15

    To conduct a systematic review of the evidence regarding the economic value of ranolazine relative to standard-of-care (SOC) for the treatment of symptomatic chronic stable angina (CSA). Electronic databases were searched using relevant keywords. The identified studies were independently reviewed by two investigators against pre-determined inclusion and exclusion criteria. Their data were extracted using a relevant form and consequently were synthesized. Studies were also evaluated using the Quality of Health Economic Studies scale. The main outcomes considered were the cost and effectiveness for each comparator and the incremental cost per quality-adjusted-life year (QALY) gained. Six studies were included in the review. Five of these assessed the cost-utility of ranolazine added to SOC, compared to SOC alone, using decision trees or Markov models whereas one was a retrospective cost evaluation study. The analysis was conducted from a payer perspective in five studies and from a societal perspective in one study with the time horizon varying between six months and a year. The incremental cost-effectiveness ratio (ICER), ranged from €4000 to €15,000 per QALY gained. Ranolazine appears to be dominant or cost-effective, mainly due to its ability to decrease angina-related hospitalizations and also due to a marginal improvement in quality of life. The acquisition cost of ranolazine was the variable with the greatest impact upon the ICER. The existing evidence, although limited, indicates that ranolazine may be a dominant or cost-effective therapy option, for the treatment of patients with symptomatic CSA. Further research is required to evaluate the cost-effectiveness of ranolazine. PMID:26994453

  19. Evaluation of pharmacokinetics and pharmacodynamics relationships for Salvianolic Acid B micro-porous osmotic pump pellets in angina pectoris rabbit

    Directory of Open Access Journals (Sweden)

    Shu-Ling Kan

    2014-06-01

    Full Text Available The work aims to investigate the in vitro release, pharmacokinetics (PK, pharmacodynamics (PD and PK–PD relationships of Salvianolic Acid B micro-porous osmotic pump pellets (SalB-MPOPs in angina pectoris New Zealand White (NZW rabbits, compared with those of SalB immediate-release pellets (SalB-IRPs. The SalB plasma concentrations and Superoxide dismutase levels (PD index were recorded continuously at predetermined time interval after administration, and the related parameters were calculated by using WinNonlin software. The release profile of MPOPs was more sustained than that of IRPs. PK results indicated that the mean Cmax was significantly lower, the SalB plasma concentrations were steadier, both area under concentration-time curve from 0 to 24 h (AUC0–24 h and from 0 to infinity (AUC0–∞ were presented larger, and both the peak concentration time (Tmax and mean residence time (MRT were prolonged for MPOPs, as compared with those of IRPs. PD results suggested that peak drug effect (Emax was lower and the equilibration rate constant (ke0 between the central compartment and the effect compartment was higher of MPOPs vs. those of IRPs. PK–PD relationships demonstrated that the effect-concentration-time (ECT course of MPOPs was clockwise hysteresis loop, and that of IRPs was counter-clockwise hysteresis loop. Collectively, those results demonstrated that MPOPs were potential formulations in treating angina pectoris induced by atherosclerosis.

  20. Vivencias afectivas como discurso virtual

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    Mijaíl Málishev

    2011-01-01

    Full Text Available El discurso virtual expresa nuestras vivencias afectivas tanto en el futuro -esperanza- como en el pasado -culpa y venganza-. La esperanza es un estímulo que nos alienta a alcanzar nuestras metas. A diferencia del futuro, el pasado es irreversible y, sin embargo, el pluscuamperfecto es un "mago" que "transforma" lo irreparable en lo virtual. Nuestra conciencia nos hace sentir culpables, haciéndonos creer que lo indebido que hemos cometido, hubiéramos podido hacerlo de otra manera. El pluscuamperfecto expresa la venganza que nos hace "lavar la ofensa" causada por nuestro adversario, pero el discurso virtual en el pluscuamperfecto nos ayuda a sublimar nuestros rencores sin causar algún daño a nuestro adversario y a nuestra propia reputación.

  1. Como Lo Hago Yo: Myelomeningocele

    Science.gov (United States)

    Lazareff, Jorge

    2014-01-01

    Fortificación con ádico fólico es efectiva, pero aún falta conciencia en los jóvenes. La legalidad del aborto aumenta la importancia de la consulta prenatal. Realizo la cirugía bajo microcoscopio por razones didácticas. Irrigación continua para reducir la temperatura del tejido. Trato a la plaqueta como tejido viable. No suturo la plaqueta. No cierro músculo. ATB por una semana después de cirugía. Hidrocefalia: Válvula en todos los casos de ventriculomegalia. Médula anclada: Desanclar una sola vez. Chiari II: Revisar la válvula. Incluir en el seguimiento rendimiento escolar, puede indicar obstrucción de la válvula o médula anclada. PMID:24791217

  2. Confiabilidade de sintomas sugestivos de angina em pacientes com doença pulmonar obstrutiva crônica Confiabilidad de síntomas sugestivos de angina en pacientes con enfermedad pulmonar obstructiva crónica Reliability of symptoms suggestive of angina in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yilmaz Gunes

    2009-05-01

    baseline clinical characteristics who had undergone diagnostic coronary angiography for the first time were reviewed retrospectively. RESULTS: The frequency of significant CAD was significantly lower in COPD patients than in the control group (52.8% vs. 80.2%, p<0.001. Frequencies of CAD risk factors (older age, hypertension, diabetes, smoking history were significantly more frequent among COPD patients having significant CAD. Among patients reporting stable angina pectoris, significant CAD was detected in 32.7% of COPD patients and 71.0% of non-COPD patients (p<0.001. However, among the patients with a diagnosis of unstable angina pectoris, significant CAD was detected in 87.5% of COPD patients and 90.2% of non-COPD patients (p=0.755. CONCLUSION: Diagnosis of CAD in COPD patients by symptomatology may be difficult. However, clinical diagnosis of CAD in the setting of unstable angina is accurate in most of the COPD patients. Therefore, further noninvasive diagnostic methods or careful follow up may be more appropriate for COPD patients reporting stable angina pectoris.

  3. El investigador como educador musical y como divulgador

    Directory of Open Access Journals (Sweden)

    Suárez-Pajares, Javier

    2000-05-01

    Full Text Available La presente ponencia trataba de plantear en la Mesa redonda "Investigación aplicada a la educación musical" una serie de problemas que surgen no tanto a quienes se dedican profesionalmente a la educación musical, sino a quienes, dedicados a la investigación y al estudio de temas relacionados con la historia de la música desde perspectivas diversas, tienen finalmente que transmitirlos a una audiencia determinada, ya sea otros colegas, alumnos de universidad, u otros públicos en los que se centra el concepto "divulgación" aludido en el título.Se incide particularmente en los problemas de la educación musical universitaria para no especialistas y en la divulgación científica aplicada a la música, un campo casi yermo sobre el que hay mucho que reflexionar: desde las nuevas posibilidades para la explicación de la música que ofrecen soportes nuevos como el CD-Rom, hasta las tradicionales formas de relación con un público melómano a través de notas a programas y críticas de conciertos.

  4. Recent advances in the management of chronic stable angina I: Approach to the patient, diagnosis, pathophysiology, risk stratification, and gender disparities

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-07-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas 77054 USAAbstract: The potential importance of both prevention and personal responsibility in ­controlling heart disease, the leading cause of death in the USA and elsewhere, has attracted renewed ­attention. Coronary artery disease is preventable, using relatively simple and inexpensive lifestyle changes. The inexorable rise in the prevalence of obesity, diabetes, dyslipidemia, and ­hypertension, often in the risk cluster known as the metabolic syndrome, drives the ­ever-increasing incidence of heart disease. Population-wide improvements in personal health habits appear to be a fundamental, evidence based public health measure, yet numerous barriers prevent implementation. A common symptom in patients with coronary artery disease, classical angina refers to the typical chest pressure or discomfort that results when myocardial oxygen demand rises and coronary blood flow is reduced by fixed, atherosclerotic, obstructive lesions. Different forms of angina and diagnosis, with a short description of the significance of pain and silent ischemia, are discussed in this review. The well accepted concept of myocardial oxygen imbalance in the genesis of angina is presented with new data about clinical pathology of stable angina and acute coronary syndromes. The roles of stress electrocardiography and stress myocardial perfusion scintigraphic imaging are reviewed, along with the information these tests provide about risk and prognosis. Finally, the current status of gender disparities in heart disease is summarized. Enhanced risk stratification and identification of patients in whom procedures will meaningfully change management is an ongoing quest. Current guidelines emphasize efficient triage of patients with suspected coronary artery disease. Many experts believe the predictive value of current decision protocols for coronary artery disease still needs improvement in order to

  5. 催眠针法治疗心绞痛的疗效及血浆ET、NO改变的研究%A Study on Hypnotic Acupuncture Therapy for Angina Pectoris and Its Effects on Plasma ET and NO

    Institute of Scientific and Technical Information of China (English)

    李献; 郑强荪; 宋胜云; 高军军; 尼珍; 袁秀兰; 张录兴

    2002-01-01

    Objective: To evaluate the treatment effects of hypnotic acupuncture therapy on angina pectoris. Methods: 40 cases of angina pectoris treated by hypnotic acupuncture therapy were compared with 31 cases of angina pectoris treated by pure acupuncture. Results: Symptom relief rate and change of ECG were found to be more desirable in the Hypnotic acupuncture therapy group than in the pure acupuncture group (P<0.01,P<0.05). Pre-post treatment comparisons on levels of anxiety, depression, ET and NO also showed that hypnotic acupuncture therapy was superior to the pure acupuncture group (P<0.05).Conclusion:The present study provides strong support for hypnotic acupuncture therapy for angina pectoris, in terms of its treatment effects on both mental and physical improvement.

  6. Short‐term and long‐term outcomes in 133 429 emergency patients admitted with angina or myocardial infarction in Scotland, 1990–2000: population‐based cohort study

    OpenAIRE

    Capewell, S; Murphy, N F; MacIntyre, K.; Frame, S; Stewart, S.; Chalmers, J.W.T.; Boyd, J.; Finlayson, A; Redpath, A.; McMurray, J J V

    2006-01-01

    Objective: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. Methods: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years...

  7. La Justicia como valor Constitucional

    Directory of Open Access Journals (Sweden)

    Lavilla Alsina, Landelino

    2003-07-01

    Full Text Available La Constitución Española, sin menoscabo de su carácter prescriptivo, atiende a la necesidad de poner un vigoroso acento —y mejor si lo hace en términos jurídicos— sobre las notas identificadoras del aliento político que más y mejor expresan el fundamento y orientación de la voluntad constituyente. Pero, con independencia de tal aseveración, es definitiva la interpretación del precepto, según criterios y métodos jurídicos, en cuanto enuncia unos «valores» que el Estado constituido «propugna», que se califican como «superiores» y que se predican, precisamente, del «ordenamiento jurídico». La justicia es, desde luego y en sí misma, un valor, al que conviene la nota de clásico en la determinación de los que han de regir una convivencia política estable. Uno u otro sentido de la justicia ha latido con fuerza en la conciencia humana y en toda pretensión racional de ordenación de la convivencia.

  8. El plomo como contaminante alimentario

    Directory of Open Access Journals (Sweden)

    C. Rubio

    2004-01-01

    Full Text Available El plomo es un metal pesado caracterizado por ocasionar efectos tóxicos sobre el tracto gastrointestinal, sobre el sistema renal y sobre el SNC y periférico, así como interferencias con sistemas enzimáticos implicados en la síntesis del grupo hemo. A pesar de que en los últimos diez años, los contenidos de plomo de los productos alimenticios se han reducido sensiblemente gracias a los esfuerzos realizados para reducir la emisión de plomo en su origen y por los progresos en la garantía de calidad de los análisis químicos, la dieta sigue siendo una fuente importante de exposición de plomo. Es por ello que, el objetivo a largo plazo de las autoridades sanitarias es el de continuar reduciendo los contenidos medios de plomo en los productos alimenticios con el fin de que las ingestas medias dietéticas de Pb de las poblaciones cumplan con la PTWI (Provisional Tolerable Weekly Intake de 25 µg Pb/Kg/semana establecida por el Comité Mixto FAO/OMS

  9. Serum high-sensitivity C-reaction protein and heart fatty acid binding protein level and cardiac accidents in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    朱红秋

    2006-01-01

    Objective To investigate the relationship between serum high-sensitivity C-reaction protein (hs-CRP) and heart fatty acid binding protein (h-FABP) on cardiac accidents in patients with unstable angina pectoris (UAP). Methods Serum levels of hs-CRP, h-FABP, cardiac troponin-Ⅰ(cTn-Ⅰ) and creatine kinase MB isoenzyme (CK-MB) were measured and cardiac accidents within 2 weeks after the test were observed in 74 patients (male

  10. [Relations of the duration of pre-existing angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction].

    Science.gov (United States)

    Juillière, Y; Danchin, N; Grentzinger, A; Suty-Selton, C; Perrin, O; Guenoun, P; Pernot, C; Cherrier, F

    1990-10-01

    The aim of this retrospective study was to determine the relationship between the duration of preceding angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction. Coronary angiography of 138 consecutive patients showed isolated and complete occlusions of the left anterior descending (58 patients) or right coronary artery (80 patients). One hundred and four patients had myocardial infarction with (Group A, n = 21) or without (Group B, n = 83) preceding angina pectoris and 34 had angina without myocardial infarction (Group C). The left ventricular ejection fraction was measured by ventriculography in the 30 degrees right anterior oblique projection. The collateral circulation was assessed by coronary angiography and evaluated as follows: no flow or flow limited to collateral branches (subgroup 1) and partial or complete filling of the epicardial arterial segment (subgroup 2). In the global population the left ventricular ejection fraction was higher and the duration of preceding angina pectoris was longer in the subgroups with a well developed collateral circulation. There was no difference in ejection fraction between Groups A and B (presence of myocardial infarction), on the other hand, within each of the groups, a good collateral circulation (subgroup 2) was associated with a significantly higher ejection fraction. Group C (without infarction) patients had better ejection fractions than Groups A or B, especially when the collateral circulation was poorly developed. Within Group C, the quality of the collateral circulation did not seem to affect the ejection fraction. The left ventricular ejection fraction is lower in patients with isolated coronary occlusion and myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Treatment with verapamil and trandolapril in patients with congestive heart failure and angina pectoris or myocardial infarction. The DAVIT Study Group. Danish Verapamil Infarction Trial

    DEFF Research Database (Denmark)

    Hansen, J F; Hagerup, L; Sigurd, B;

    1997-01-01

    In a double-blind, randomized trial in a consecutive group of postinfarct patients in treatment with diuretic agents for congestive heart failure, the 3 month rate of cardiac events (i.e., death, repeat infarction, unstable angina pectoris, or repeat admission because of heart failure) was 14....... These findings indicate that combined treatment with verapamil and trandolapril may be beneficial in patients with congestive heart failure....

  12. An effective tool to detect lesions causing unstable angina with multivessel disease. Iodine-123-betamethyl-p-iodophenyl-pentadecanoic acid single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fukuzawa, Shigeru; Inagaki, Masayuki; Morooka, Shigeru; Inoue, Toshihisa; Sugioka, Juji; Ozawa, Shun [Funabashi Municipal Medical Center, Chiba (Japan)

    1996-10-01

    Radiolabeled fatty acids such as iodine-123-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) have unique metabolic properties suggesting potential use as myocardial perfusion tracers. The uptakes of BMIPP and thallium 201 were compared using single photon emission computed tomography (SPECT) in 24 patients displaying unstable angina with multivessel disease at a mean of 3.4 days after admission. Coronary angiography was performed within a week. Uptake was considered normal if the activity was greater than 80% of the normal area, mildly reduced if 50% to 79%, and severely reduced if less than 50%. The regional activities in four quadrants in short-axis slices were measured from basal, mid and apical sets. We attempted to identify the causative lesion on dual SPECT imaging. We planned the following management of each patient based on the results of the dual SPECT study. BMIPP activity imaging found 4 segments (1.4%) with severe decrease, 70 (24.3%) with mild decrease, and 214 (74.3%) with normal uptake. In contrast, Tl activity imaging showed normal uptake in 68 of 74 abnormal BMIPP activity segments. Furthermore, all segments with abnormal BMIPP uptake were matched with locations of coronary artery stenosis by coronary angiography. Accordingly, coronary revascularization (percutaneous transluminal coronary angioplasty, coronary artery bypass grafting) was performed based on BMIPP SPECT. Reductions in BMIPP activity were common in patients with unstable angina with multivessel disease. BMIPP SPECT is an excellent tool for detecting the causative lesion in unstable angina. The subsequent intervention could be performed with less risk based on the strategy of dilating the only causative lesion which was detected by the BMIPP SPECT in patients with multivessel disease displaying unstable angina. (author)

  13. Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation

    Directory of Open Access Journals (Sweden)

    Ivanović Miloš

    2013-01-01

    Full Text Available Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS. Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability. Objective. Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound - Virtual Histology in patients with stable angina and subjects in acute phase of ACS without ST segment elevation. Methods. The study comprised of 40 patients who underwent preintervention IVUS examination. Tissue maps were reconstructed from radio frequency data using IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions, while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions. In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs. 0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05 respectively. Conclusion. IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.

  14. Comparative study between patients with infarction and angina about the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility

    Directory of Open Access Journals (Sweden)

    Bakella P.

    2010-10-01

    Full Text Available Background: To examine the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility between patients with infarction and angina. Method: Subjects were 104 patients with infarction or angina, who completed the Hostility and Direction of Hostility Questionnaire, the Symptom Checklist-90-R, Cardiac Anxiety Questionnaire, the Pain Anxiety Symptoms Scale-20 and the Fear of Pain Questionnaire – III. Results: For all patients higher levels of fear and anxiety of pain, heart-focused anxiety psychopathology, and a tendency to develop a hostile attitude were observed. For angina group higher levels of fearfull thinking and total PASS-20, avoidance CAQ, somatization and anxiety (SCL-90. In addition, all patients were found to be significantly correlated (P< .005 with sex, fearfull PASS-20, physiological responses PASS-20, total PASS-20, avoidance CAQ, somatization SCL-90, anxiety SCL-90 Conclusion: There is a variety of general factors that may promote the development of cardiophobia. These processes are likely nonspecific in the sense that they increase the chance of negative emotional responding and poor affect regulatory strategies. For persons exposed to cardiac-related illnesses or persons who model the potential dangers of cardiac-related sensations, there may be an enhanced specificity to that general vulnerability.

  15. Pharmaceutical care for patients with unstable angina%不稳定性心绞痛患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    牟燕; 王清; 张勇; 李宏建

    2011-01-01

    Unstable angina (UA) is a common coronary heart disease with the clinical symptom situated between stable angina and acute myocardial infarction. For the complexity of its drug treatment, the clinical pharmaceutical care for patients with UA is very important. In this article, to further optimize the therapeutic project and ensure the safety of drug use, the contents of pharmaceutical care were discussed from the following four aspects respectively: undergoing anti-ischemia therapy, antiplatelet and anticoagulant therapy, lipid adjusting and plaque stabilizing therapy, and simultaneous therapy for some other disease.%不稳定性心绞痛(unstable angina,UA)是介于稳定性心绞痛与急性心肌梗死之间的一组临床综合征,其治疗药物十分复杂,临床药学监护尤为重要.本文结合实例,对抗心肌缺血治疗、抗血小板与抗凝治疗、调脂稳定斑块治疗、合并其他疾病用药时等情况下的药学监护内容进行逐一讨论,以期为该疾病的临床药学工作提供思路,优化临床治疗方案设计,保障患者的用药安全.

  16. Effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Liang Wen; Yi Xie; Xian-Jun Wu; Rui-Feng Wang; Jian Cao

    2016-01-01

    Objective:To analyze the effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris. Methods:A total of 98 cases of coronary heart disease patients with stable angina pectoris who received treatment in our hospital from March 2014 to August 2015 were selected as research subjects and randomly divided into observation group 49 cases and control group 49 cases. Control group received conventional clinical treatment, observation group received folic acid adjuvant therapy, and then differences in levels of Hcy, lipid metabolism, endothelial injury and adhesion molecules were compared between two groups after treatment. Results:Hcy, TC, LDL-C and ApoB values of observation group were lower than those of control group while HDL-C and ApoA1/ApoB values were higher than those of control group;Flow-vel and FMD values of observation group after treatment were higher than those of control group;serum E-selectin, ICAM-1, VCAM-1 and sICAM-1 values of observation group after treatment were lower than those of control group. Conclusion:Folic acid adjuvant therapy for coronary heart disease patients with stable angina pectoris can reduce plasma Hcy level and optimize lipid metabolism, further protects vascular endothelium, and has positive clinical significance.

  17. El Derecho como argumentación

    OpenAIRE

    Atienza, Manuel

    1999-01-01

    Not available

    Frente a las concepciones del Derecho como norma, como hecho o como valor (que caracterizan, respectivamente, al norrnativismo, al realismo jurídico y al iusnaturalismo), se propone aquí un cuarto enfoque que consiste en ver el Derecho como argumentación (y que cohra especial relevancia en las sociedades democráticas). Sin embargo, no hay una única forma de entender la argumentación jurídica. Aunque conectadas entre sí, en el trabajo se distinguen tres concepc...

  18. Sensitivity and related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy to detect stable effort angina pectoris

    International Nuclear Information System (INIS)

    This study evaluated the sensitivity and the related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy to detect stable angina. The subjects were 198 patients with stable angina who underwent BMIPP before percutaneous coronary intervention or coronary bypass graft surgery. Patients with unstable angina, myocardial infarction, congestive heart failure, cardiomyopathy and vasospastic angina were excluded. After investigation of the sensitivity of BMIPP, the patients with single-vessel disease without collateral flow were classified into the normal 123I-BMIPP uptake group (normal group) or decreased 123I-BMIPP uptake group (decreased group), and various factors were compared between the two groups. Sensitivity was 61% overall, 58% in single-vessel disease, 69% in double-vessel disease, 53% in triple-vessel disease, 43% in only left main vessel disease, and 89% in left main and other vessel disease (NS). In single-vessel disease, the sensitivity was 40% in 75% coronary artery stenosis, 58% in 90% stenosis, 89% in 99% stenosis, and 69% in total occlusion (p=0.003). Comparing the decreased and normal groups, diabetes mellitus was more frequent in the normal group (14.6% vs 39.5%), minimal lumen diameter was smaller (0.75±0.37 vs 0.98±0.49 mm) and lesion length was longer in the decreased group (15.4±4.9 vs 11.6±5.5 mm). Logistic multivariate analysis showed that the independent factors were diabetes mellitus [odds ratio 0.20, 95% confidence interval (CI) 0.04-0.87, p=0.03], minimal lumen diameter (odds ratio 0.10, 95% CI 0.02-0.48, p=0.003) and lesion length (odds ratio 1.12, 95% CI 1.00-1.25, p=0.03). BMIPP is useful in stable angina patients because of the acceptable sensitivity. Diabetes mellitus, minimal lumen diameter and lesion length were independent factors associated with decreased BMIPP uptake. (author)

  19. Changes of dendritic cells and fractalkine in type 2 diabetic patients with unstable angina pectoris: a preliminary report

    Directory of Open Access Journals (Sweden)

    Qian Juying

    2011-06-01

    Full Text Available Abstract Background It has been shown that dendritic cells (DCs and fractalkine play a role in accelerating progression of the inflamed atherosclerotic lesions and plaque rupture. We evaluated the numbers and functional changes of DCs and its subsets in human type 2 diabetes with or without unstable angina pectoris (UAP. Methods The study population consisted of 39 diabetic patients (DM:18 without CAD; DM + UAP: 21 with UAP, 18 non-diabetic UAP patients (UAP, and 15 healthy control (Normal. Peripheral blood DCs and its subsets were measured by three color flow cytometry. Serum levels of fractalkine, IL-12, and IFN-α were also measured. The functional status of the monocyte-derived DCs was analyzed by flow cytometry and allogeneic mixed T lymphocytes reaction. Results The percent and absolute numbers of DCs and mDC within the total leukocyte population was similar for Normal and DM, while significantly lower in DM + UAP. pDC numbers were not significantly altered. Serum fractalkine in DM + UAP was highest among the four groups (p = 0.04 vs. UAP, p = 0.0003 vs. DM, p p = 0.01 level. Compared with DM and UAP, the costimulatory molecules CD86 and proliferation of T cells stimulated by DCs were significantly increased in DM + UAP group. Conclusions Our study suggested that increases in the fractalkine level and the number and functional changes of blood DCs might contribute to diabetic coronary atherosclerosis and plaque destabilization.

  20. Richtlinien zur Diagnostik und Therapie der instabilen Angina pectoris und des Non-Q-Wave-Myokardinfarktes: vorgeschlagene Revisionen

    Directory of Open Access Journals (Sweden)

    Huber K

    2000-01-01

    Full Text Available Die letzten Praxis-Empfehlungen der United States Agency for Health Care Policy and Research zum Thema "Diagnose und Behandlung der instabilen Angina Pectoris (IAP" stammen aus dem Jahre 1994 und wurden trotz der rasanten Fortschritte auf diesem Gebiet in den vergangenen 5 Jahren nicht erneuert. Das International Cardiology Forum (ICF hat Ende 1998 die existierenden Richtlinien diskutiert und Vorschläge gemacht, in welchen Bereichen die Diagnostik und die Therapie der IAP aufgrund der mittlerweile vorliegenden Daten modifiziert werden sollten. Es wurde übereinstimmend beschlossen, daß folgende Änderungen empfohlen werden: 1. Troponin T und Troponin I sollten die Palette der Myokardmarker im Serum für diagnostische und prognostische Zwecke erweitern; 2. niedermolekulere Heparine sollten Standard-Heparin als Antikoagulantium ersetzen; 3. neue thrombozyten-inhibierende Substanzen sollten zusätzlich zu Aspirin zur Anwendung kommen; 4. die Verwendung von cholesterinsenkenden Medikamenten in der Langzeitbehandlung dieser Patienten ist sinnvoll. In der vorliegenden Arbeit wurden die Hintergründe für die vorgerschlagenen Revisionen diskutiert, und es wird auf rezente wissenschaftliche Publikationen Bezug genommen.

  1. Identifying Metabolite and Protein Biomarkers in Unstable Angina In-patients by Feature Selection Based Data Mining Method

    Institute of Scientific and Technical Information of China (English)

    SHI Cheng-he; YANG Yi; WANG Wei; ZHAO Hui-hui; HOU Na; CHEN Jian-xin; SHI Qi; XU Xue-gong; WANG Juan; ZHENG Cheng-long; ZHAO Ling-yan

    2011-01-01

    Unstable angina(UA) is the most dangerous type of Coronary Heart Disease(CHD) to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metaboiomics is a better avenue to understand the inner mechanism of it. Feature selection based data mining method is better suited to identify biomarkers of UA. In this study, we carried out clinical epidemiology to collect plasmas of UA in-patients and controls. Proteomics and metabolomics data were obtained via two-dimensional difference gel electrophoresis and gas chromatography techniques. We presented a novel computational strategy to select biomarkers as few as possible for UA in the two groups of data. Firstly, decision tree was used to select biomarkers for UA and 3-fold cross validation was used to evaluate computational performances for the three methods. Alternatively, we combined independent t test and classification based data mining method as well as backward elimination technique to select, as few as possible, protein and metabolite biomarkers with best classification performances. By the method, we selected 6 proteins and 5 metabolites for UA. The novel method presented here provides a better insight into the pathology of a disease.

  2. Pensando al agua como parte del paisaje

    OpenAIRE

    Lorena Salvatelli

    2009-01-01

    El objetivo de este trabajo es discutir la importancia de los estudios de arqueología terrestre y subacuática como parte de un mismo proceso de interpretación del pasado. Se entiende que el registro arqueológico puede hallarse actualmente en una variedad de ambientes tanto terrestres como subacuáticos a causa de varias razones, como por ejemplo las oscilaciones de los niveles de agua ocurridas entre el Pleistoceno Final y el Holoceno Medio. Por lo tanto, se propone que para su ...

  3. Los ritmos como terapia para la impulsividad

    Directory of Open Access Journals (Sweden)

    Mónica Triviño

    2012-10-01

    Full Text Available Investigaciones recientes muestran que el uso de patrones rítmicos facilita la respuesta óptima en el tiempo, por lo que el entrenamiento mediante ritmos podría proponerse como terapia novedosa ante problemas como la impulsividad. Esto podría beneficiar a pacientes con daño prefrontal o personas con trastorno por déficit de atención e hiperactividad (TDAH, que suelen mostrar conductas impulsivas, así como dificultad para estimar el paso del tiempo.

  4. Uso de derivados de sulfamidas como neuroprotectores

    OpenAIRE

    Rodríguez de Fonseca, Fernando; Suárez Pérez, Juan; Romero, Miguel; Fernández Espejo, Emilio; Goya, Pilar; Páez, Juan A.

    2011-01-01

    La presente invención se refiere al uso de un grupo de derivados de sulfamidas con capacidad neuroprotectora que son útiles en el tratamiento y/o prevención de enfermedades que tienen asociada muerte celular, tales como enfermedad de Alzheimer, enfermedad de Parkinson (formas esporádicas y formas hereditarias), isquemia cerebral, esclerosis lateral amiotrófica, parkinsonismo post-encefálítico, así como otras enfermedades raras que cursan con neurodegeneración como la enfermedad de Huntington ...

  5. La tipografía como marca

    OpenAIRE

    Rodríguez Valero, Daniel

    2015-01-01

    Según Interbrand una marca es una combinación de atributos, tangibles e intangibles, simbolizados por una marca registrada que, si se gestiona adecuadamente, genera valor e influencia. La tipografía y la letra en general, como vehículo natural de expresión de la parte verbal de la marca, posee una capacidad de marcación especial que muchas veces no aprovechamos como merece. El objetivo de este estudio es tratar las tipografías como si fueran marcas y no productos para conseguir incrementar su...

  6. Symptoms of Anxiety and Depression Are Correlates of Angina Pectoris by Recent History and an Ischemia-Positive Treadmill Test in Patients with Documented Coronary Artery Disease in the Pimi Study

    Directory of Open Access Journals (Sweden)

    Mark W. Ketterer

    2011-01-01

    Full Text Available Objective. We tested the association of specific psychological characteristics in patients having stable coronary disease with the reporting of anginal symptoms during daily activities, and positive exercise testing. Methods. One hundred and ninety-six patients with documented CAD enrolled in the Psychophysiological Investigations of Myocardial Ischemia (PIMI Study completed an anginal history questionnaire and a battery of psychometric tests. They also underwent standardized exercise treadmill tests. Results. Patients with a recent history of angina were more likely to be female, and had higher Beck Depression (P=.002, State Anxiety (P=.001, Trait Anxiety (P=.03, Harm Avoidance (P=.04 and Muscle Tension (P=.004 scores than patients who had no recent history of angina. Along with several treadmill variables indicating more severe disease state and reduced exercise tolerance, patients who developed angina on a positive treadmill test also displayed higher scores on the Beck Depression Inventory (P=.003 and State Anxiety (P=.004 scales. Conclusions. Several psychological characteristics, and most notably anxiety and depression, are strong correlates of recent angina and angina in the presence of ischemia provoked by treadmill testing.

  7. El videojuego como material educativo: La Odisea

    Directory of Open Access Journals (Sweden)

    Belén Mainer Blanco

    2012-04-01

    Full Text Available La investigación se basa en la función educativa que pueden cumplir los videojuegos, un campo que consideramos inexplorado por tres motivos principalmente: su reciente incorporación, su impopularidad educativa (el rechazo el videojuego como herramienta de aprendizaje y considerado, por el contrario, como una distracción, y la incompleta incorporación de las nuevas tecnologías de información y comunicación (TIC en el ámbito familiar y educativo. En una segunda parte, se ha realizado una aplicación práctica tomando como referencia la gran obra universal “La Odisea”, cuya intención es mostrar la utilidad del videojuego como complemento educativo.

  8. El Derecho como argumentación

    Directory of Open Access Journals (Sweden)

    Atienza, Manuel

    1999-11-01

    Full Text Available Not available

    Frente a las concepciones del Derecho como norma, como hecho o como valor (que caracterizan, respectivamente, al norrnativismo, al realismo jurídico y al iusnaturalismo, se propone aquí un cuarto enfoque que consiste en ver el Derecho como argumentación (y que cohra especial relevancia en las sociedades democráticas. Sin embargo, no hay una única forma de entender la argumentación jurídica. Aunque conectadas entre sí, en el trabajo se distinguen tres concepciones: la formal, la material y la pragmática o dialéctica; muchas cuestiones que se plantean en el ámbito de la teoría de la argumentación jurídica pueden resolverse -o aclararse- teniendo en cuenta esa triple perspectiva.

  9. LA WEBQUEST COMO INNOVACIÓN

    OpenAIRE

    Sábat-Molina, Gloria

    2013-01-01

    La evolución de la sociedad trae consigo una serie de cambios e innovaciones que repercuten en los planteamientos y el desarrollo de todas las actividades, también las educativas, en este trabajo analizaremos el impacto de esta evolución en la educación, tomando como base el estudio de la WebQuest como fruto de los avances en las tecnologías de la información y la comunicación, así como la innovación que representa su utilización en las aulas. La WebQuest se presenta como una actividad inn...

  10. Relationship Between Serum Creatine Kinase Isoenzyme MM Subbands and the Gradation of Coronary Stenosis in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Wu Ziqiang; Zhu shanju; Meng Suron; Sun Yueh

    2000-01-01

    Objective To observe the relationship between serum creatine kinase isoenzyme MM sub-bands (CKMM3/MM1 ratio) and the gradation of coronary stenosis and provide a simple, reliable, and economical method for identifying high-risk unstable angina pectoris (UAP). Mehtods Blood samples were drawn at different time after onset of chest pain in 21 patients with UAP and only once in 20 each volunteers for control. CKMM3/MM1 ratio was detected by nonserial buffer agarose gel electrophoresis. CKMB and CK were observed by velocity method. An emergent coronary arteriography was performed as soon as patients were admitted into hospital. Results Patients with UAP were divided into two subgroups:patients with elevated serum enzyme [P( + )] and patients with normal serum enzyme [P( - ) ] according to CKMM3/MM1 ratio < 0.5. Patients with UAP(+)had higher serum CKMM3/MM1 ratios from 0.5 to 12hrs and serum CKMB from 2 to 12 hrs than those with UAP( - ) and control ( P < 0.05) . Serum enzyme concentrations of patients with UAP whose coronary lumen had 90% or more than 90% stenosis were significantly higher than those whose coronary lumen had less than 90% stenosis (P<0.01) . AnyCKMM3/MM1 ratio was less than 1.0 and CK within the normal range in patients with UAP( + ) group. Conclusions CKMM3/MM1 ratios in patients with UAP can reflect severity of myocardial ischemia. Serum CKMM3/MM1 ratio provides a simple, reliable, and economical method for identifying high-risk UAP.

  11. Comparison of nifedipine gastrointestinal therapeutic system and atenolol on antianginal efficacies and exercise hemodynamic responses in stable angina pectoris.

    Science.gov (United States)

    Wallace, W A; Wellington, K L; Chess, M A; Liang, C S

    1994-01-01

    A gastrointestinal therapeutic system (GITS) of nifedipine has been developed to provide a once-daily dosing, and predictable, relatively constant plasma concentrations. This study compared the antianginal efficacy of nifedipine GITS with a once-a-day beta-receptor blocker, atenolol. Seventeen patients with documented coronary artery disease and stable stress-induced angina pectoris were studied during a 2-week, single-blind, placebo baseline phase and a 12-week randomized, double-blind, active drug crossover efficacy phase, using the bicycle exercise test and ambulatory electrocardiographic recordings. Patients exercised significantly longer with nifedipine GITS (883 +/- 47 seconds) and atenolol (908 +/- 44 seconds) than with placebo (794 +/- 41 seconds). Nifedipine GITS reduced systolic blood pressure at all stages of exercise compared with placebo but, because heart rate tended to increase more during nifedipine therapy, there was no difference in rate-pressure products between the placebo and nifedipine GITS periods. In contrast, atenolol reduced heart rate, systolic blood pressure and rate-pressure product during exercise compared with placebo. Whereas left ventricular ejection fractions (by radionuclide angiocardiography) increased with exercise, the maximal increase was smaller with atenolol than with placebo and nifedipine. The net increase in left ventricular ejection fraction at the end of exercise was greater with nifedipine than with placebo or atenolol. Ambulatory electrocardiograms showed only a small number of ischemic events. Neither nifedipine GITS nor atenolol reduced the number of ischemic events or total duration of ST-segment deviations significantly. It is concluded that nifedipine GITS is as effective an antianginal agent as atenolol, but the hemodynamic effects of the 2 agents differ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8279372

  12. Pre-infarction angina and outcomes in non-ST-segment elevation myocardial infarction: data from the RICO survey.

    Directory of Open Access Journals (Sweden)

    Luc Lorgis

    Full Text Available BACKGROUND: The presence of pre-infarction angina (PIA has been shown to confer cardioprotection after ST-segment elevation myocardial infarction (STEMI. However, the clinical impact of PIA in non-ST-segment elevation myocardial infarction (NSTEMI remains to be determined. METHODS AND RESULTS: From the obseRvatoire des Infarctus de Côte d'Or (RICO survey, 1541 consecutive patients admitted in intensive care unit with a first NSTEMI were included. Patients who experienced chest pain <7 days before the episode leading to admission were defined as having PIA and were compared with patients without PIA. Incidence of in-hospital ventricular arrhythmias (VAs, heart failure and 30-day mortality were collected. Among the 1541 patients included in the study, 693 (45% patients presented PIA. PIA was associated with a lower creatine kinase peak, as a reflection of infarct size (231(109-520 vs. 322(148-844 IU/L, p<0.001 when compared with the group without PIA. Patients with PIA developed fewer VAs, by 3 fold (1.6% vs. 4.0%, p = 0.008 and heart failure (18.0% vs. 22.4%, p = 0.040 during the hospital stay. Overall, there was a decrease in early CV events by 26% in patients with PIA (19.2% vs. 25.9%, p = 0.002. By multivariate analysis, PIA remained independently associated with less VAs. CONCLUSION: From this large contemporary prospective study, our work showed that PIA is very frequent in patients admitted for a first NSTEMI, and is associated with a better prognosis, including reduced infarct size and in hospital VAs. Accordingly, protecting the myocardium by ischemic or pharmacological conditioning not only in STEMI, but in all type of MI merits further attention.

  13. Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

    Energy Technology Data Exchange (ETDEWEB)

    Schlett, Christopher L. [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg (Germany); Nance, John W. Jr. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); O’Brien, Terrence X. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC (United States); Ebersberger, Ullrich [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Centre Munich-Bogenhausen, Munich (Germany); Headden, Gary F. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bamberg, Fabian [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Radiology, University of Munich, Grosshadern Campus, and Munich Heart Alliance, Munich (Germany); Department of Radiology, University of Tuebingen (Germany)

    2014-07-15

    Highlights: • Patients developing UAP had overall more atherosclerosis as patients without any events. • Patients developing MACE had only more mixed plaque as those developing UAP. • Different atherosclerotic plaque components by CTA carry different prognostic value. - Abstract: Objective: CT angiography (CTA) has prognostic value in patients. But it is unknown whether differences in atherosclerosis by CTA predict the development of unstable angina pectoris (UAP) vs. major adverse cardiac events (MACE). Methods: We followed patients undergoing CTA as part of their acute chest pain work-up. Primary outcome was the development of UAP or MACE (cardiac death, myocardial infarction, revascularization) during a minimum follow-up of 12-months. CTAs were assessed for extent and composition of coronary plaque and stenosis. Ordinal regression with a 3-level outcome (no events, UAP, MACE) was applied. Results: Among 315 patients, 22 developed UAP and 31 MACE. While UAP patients had higher atherosclerosis burden with respect to all assessed features compared to patients with no events (p ≤ 0.02), only mixed plaque extent was significantly different between UAP and MACE patients (p = 0.02). The odds ratio was 4.55 for being in a higher disease-level comparing patients with low extent to those with no mixed plaque, and 3.02 comparing patients with high to those with low. These findings remained after adjustments for potential confounders. Conclusion: The extent of mixed coronary plaque is different between patients who develop UAP vs. MACE, supporting the hypothesis that it is a more culprit morphology.

  14. Identical TCR beta-chain rearrangements in streptococcal angina and skin lesions of patients with psoriasis vulgaris.

    Science.gov (United States)

    Diluvio, Laura; Vollmer, Sigrid; Besgen, Petra; Ellwart, Joachim W; Chimenti, Sergio; Prinz, Joerg C

    2006-06-01

    Tonsillar infection with Streptococcus pyogenes may induce several nonsuppurative autoimmune sequelae. The precise pathogenetic mechanisms behind this clinically well-established association are still unresolved. Using TCR analysis, we sought to identify a link between streptococcal tonsillitis and the T cell-mediated autoimmune response in psoriasis. Three patients with streptococcal-induced psoriasis underwent tonsillectomy. Using size spectratyping and sequencing of TCR beta-chain variable region gene (TCRBV) rearrangements, we compared the TCR usage of psoriatic skin lesions, blood, tonsils, and tonsillar T cells fractionated according to the expression of the skin address in "cutaneous lymphocyte-associated Ag" (CLA). TCRBV-size spectratype analysis of the blood lymphocytes, tonsils, and the CLA-negative tonsillar T cells revealed largely unselected T cell populations. Instead, TCRBV gene families of the psoriatic lesions and skin-homing CLA-positive tonsillar T cells displayed highly restricted spectratypes. Sequencing of TCRBV cDNA identified various clonal TCRBV rearrangements within the psoriatic lesions that indicated Ag-driven T cell expansion. Several of these clonotypes were also detected within the tonsils and, in one of the patients, within the small subset of CLA-positive tonsillar T cells, suggesting that T cells from the same T cell clones were simultaneously present within skin and tonsillar tissue. Because after tonsillectomy psoriasis cleared in all three patients our observations indicate that T cells may connect psoriatic inflammation to streptococcal angina. They suggest that the chronic streptococcal immune stimulus within the tonsils could act as a source for pathogenic T cells in poststreptococcal disorders, and they may help to explain why eliminating this source with tonsillectomy may improve streptococcal-induced sequelae.

  15. El humor como herramienta para lograr aprendizajes

    Directory of Open Access Journals (Sweden)

    Hilda Torres de Sánchez

    2003-09-01

    Full Text Available Una tendencia mundial se ha originado: el uso del humor como herramienta para lograr aprendizajes y mejorar el ambiente donde la persona se encuentre. En el área educativa hay pruebas que demuestran su utilidad y que efectivamente origina cambios positivos, medidos en las evaluaciones, tanto en los estudiantes como en participantes de sesiones de facilitación. El objetivo del experimento realizado fue: Determinar el comportamiento a través de la calificaciones en la primera prueba, del efecto del uso del humor en el dictado de clases utilizando diferentes herramientas como: chistes, anécdotas, analogías en los contenidos. A través de un estudio experimental con un grupo de control realizado en dos aulas de clases con 35 alumnos cada uno, al grupo experimental se le aplicó diferentes recursos humorísticos como herramientas de aprendizaje. Se analizaron las calificaciones en la primera prueba a través de porcentajes de aprobados y aplazados, observándose que el grupo experimental arrojó los mayores porcentajes de aprobados. Tales resultados confirman que el humor como herramienta, si induce a un desempeño excelente en alumnos, lo que lleva a implementar acciones de adiestramiento para los facilitadores, así como el surgimiento de investigaciones más profundas sobre el uso del humor en la educación.

  16. Unstable angina pectoris prognosis clinical analysis%不稳定性心绞痛预后临床分析

    Institute of Scientific and Technical Information of China (English)

    闵晓梅; 宁渝

    2008-01-01

    目的 探讨不稳定性心绞痛患者远期预后的影响因素.方法 采用回顾性分析总结我院2001-2007年间92例不稳定性心绞痛患者的临床资料,依据患者静息心电图,连续24 h动态心电图,超声心动图及冠状动脉造影检查结果及患者的年龄、性别、吸烟、饮酒与否、室性心律失常的发生、危险度分层对远期预后的影响关系进行分析.结果 左室射血分数(LVEF)低于45%的患者较高于45%的患者病死率高(P0.05),入院时心率大于90次/min的患者较心率小于90次/min的患者病死率高(P<0.05),发生复杂型室性期前收缩患者病死率较无复杂型室性期前收缩患者病死率有明显意义(P<0.01),高危组患者死亡率较低危组患者死亡率明显增加(P<0.05).结论 左心室功能,冠状动脉病变部位和范围、年龄、性别、吸烟、复杂型心律失常、危险度分层均是影响不稳定性心绞痛的远期预后因素.%Objective Discussion influence unstable angina pectoris patients forward prognosis factor.Methods Uses the review analysis to summarize my courtyard during for 2001-2007 year 92 example unstable angina pectoris patients' clinical material,ceases activity the electrocardiogram based on the patients,the con-tinual 24 hours dynamic electrocardiograms,the eehoeardiogram and the coronary artery radiography inspection result and patients' age, the sex, smoking, drink wine or not, the room arrythmia occurrence, the risk factor lami-nation carry on the analysis to the forward prognosis influence relations. Results The left room shoots the men-struation number(LVEF) , Being lower than 45% the patient to compare higher than 45% The patient case fatali-ty rate is high(P<0.01) ,the left coronary artery branch pathological change patient case fatality rate far is big-ger than the patient who left front falls a pathological change (P<0.01) , the age 60 year old of above patient compares 60 year old of following patient case

  17. Effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after PCI

    Institute of Scientific and Technical Information of China (English)

    Jing Peng; Li Chen

    2016-01-01

    Objective:To study the effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after percutaneous coronary intervention (PCI).Methods:A total of 130 angina pectoris patients who received PCI treatment in our hospital from May 2012 to October 2015 were selected for study, patients' medical records were retrospectively analyzed, they were divided into the experimental group and the control group based on the different medication schemes after PCI, experimental group received routine treatment combined with salvianolate and meglumine adenosine cyclphosphate treatment after operation, and control group received conventional medical treatment after operation. The changes of perioperative blood viscosity, inflammatory factor and NT-proBNP content were compared between two groups.Results:After PCI, the blood viscosity indexes as well as inflammatory factor and NT-proBNP levels of experimental group were significantly lower than those before PCI (P0.05), inflammatory factor and NT-proBNP levels were significantly lower than those before PCI (P<0.05); 7 days after PCI, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity and aggregation index as well as TNF-α, sICAM-1, sVCAM-1, LP-PLA2, NT-proBNP, D-dimer and PTEN levels of experimental group were significantly lower than those of control group (P<0.05).Conclusions: Salvianolate combined with meglumine adenosine cyclphosphate can reduce the blood viscosity of patients with angina pectoris after PCI, and can also reduce inflammation and improve heart pump function.

  18. Significance of retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Fumitaka; Hashimoto, Toshio; Uemura, Shiro; Kawamoto, Atsuhiko; Dohi, Kazuhiro [Nara Medical Univ., Kashihara (Japan); Matsushima, Akihiko

    2001-07-01

    This study investigated retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy in patients with vasospastic angina. Twenty-three patients with vasospastic angina showed abnormal uptake of BMIPP before medical treatment and had coronary vasospasm induced by acetylcholine. The patients were divided into two groups according to uptake of BMIPP after medical treatment: retardation of abnormal uptake of BMIPP (Group R, n=4) and normal uptake of BMIPP (Group N, n=19). Frequency of chest pain, medical treatment and autonomic nervous activity were compared between the two groups. Furthermore, the frequency of chest pain and uptake of BMIPP in group R were obtained after intensive medical treatment. Autonomic nervous activity was evaluated by heart rate variability on Holter electrocardiography. Heart rate variability contained high-frequency elements (HF; 0.15-0.4 Hz) and low-frequency elements (LF; 0.04-0.15 Hz). LF/HF was estimated for sympathetic nervous activity and HF was estimated for parasympathetic nervous activity. Daytime and nighttime autonomic nervous activity were compared between the two groups. The frequency of chest pain was higher in Group R than in Group N (p<0.05). Medical treatment was not different between the two groups. Circadian variation of sympathetic and parasympathetic nervous activity were absent in Group R. During the nighttime, Group R showed higher sympathetic nervous activity (p<0.05) and lower parasympathetic nervous activity (p<0.01) than Group N. The frequency of chest pain was significantly lower after intensive medical treatment (p<0.05), and uptake of BMIPP returned to normal in Group R. We suspected that the disorder in autonomic nervous activity was more severe in Group R, and thus induced coronary vasospasm. Retardation of abnormal uptake of BMIPP in patients with vasospastic angina indicates poor control of coronary vasospasm. Uptake of BMIPP is useful in the evaluation of

  19. Changes of Lipid Profile and C-Reactive Protein after Withdrawal of Xuezhikang, an Extract of Cholestin, in Patients With Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hu Chenglin; Xiang Jizhou; Li Yanbo; Zou Yongguang; Liu Jun; Tang Qizhu; Huang Congxin

    2006-01-01

    Objectives In addition to its lipid-lowering properties, statin decreases the level of C-reactive protein (CRP) resulting in reduction of cardiovascular events. However, information about discontinuation of statin therapy in stable cardiac patients is limited. This was a prospective cohort study to explore whether withdrawal of statin treatment could result in rebound of inflammation in patients with stable angina pectoris in a short-term course.Methods and Results 75 patients with stable angina pectoris were randomly divided into three groups: ① Pretreatment with Xuezhikang (XZK, an extract of cholestin) for 6 weeks and then replaced by placebo; ②Treatment with XZK throughout the study; ③ Placebo. Lipid levels, highly sensitive CRP (hs-CRP) and serum cardiac troponin T (cTnT) were assessed before receiving the XZK therapy, 1 day before discontinuation of XZK, and on day 1, 2, 3,7 and 14 after discontinuation of XZK, respectively.At day 14 after discontinuation of XZK therapy,total cholesterol, LDL-C and triglyceride significantly increased, whereas HDL-C level significantly decreased. The median level of hs-CRP increased significantly from the second day after withdrawal of XZK therapy. There was a prominent rebound of hs-CRP concentration 3 days after discontinuation of XZK therapy. 7 to 14 days after discontinuation of XZK therapy, the hs-CRP concentration declined to a similar level as in the placebo group. Elevated cTnT level did not occur throughout the study course in either group. Conclusions Short-term discontinuation of statin therapy could induce a rapid rebound phenomenon of inflammatory response independently of changes of lipid parameters. However, it was not enough to induce myocardial injury in this cohort of patients with stable angina pectoris.

  20. Comparison of antianginal efficacy of nifedipine and isosorbide dinitrate in chronic stable angina: a long-term, randomized, double-blind, crossover study

    International Nuclear Information System (INIS)

    Using a double-blind, crossover design, the comparative efficacy and safety of nifedipine and isosorbide dinitrate in the treatment of stable angina were studied in 34 patients. The study included a 2-week placebo washout period and two 6-week periods during which patients were randomized to either nifedipine or isosorbide dinitrate. The doses were titrated for each patient, and mean doses of the 2 drugs were comparable. A time-limited thallium treadmill test was performed at the end of each phase. Ischemic zone count rates were normalized to those of the nonischemic zone, and the change in this ratio with redistribution was calculated as reversible thallium defect. Two patients were discontinued from the study within 1 week after initiation of isosorbide dinitrate because of severe, intolerable headache. Two patients were withdrawn while receiving nifedipine: one had new congestive heart failure and the other had increasing angina. Of the remaining 30 patients who tolerated both drugs for at least 1 week, 4 patients from the isosorbide dinitrate group were either prematurely crossed over or discontinued from the study because of headache. One patient suffered headache from both drugs and was discontinued from the study. In the 30 patients, only nifedipine significantly reduced resting arterial pressure compared with baseline. Further, only nifedipine therapy resulted in significant decreases in the rate-pressure product and systolic pressure at a given workload. However, significant decreases in angina frequency, nitroglycerin consumption and exercise-induced maximum ST-segment depression and reversible thallium perfusion defect were produced by both nifedipine and isosorbide dinitrate

  1. Trends in time to invasive examination and treatment from 2001 to 2009 in patients admitted first time with non-ST elevation myocardial infarction or unstable angina in Denmark

    DEFF Research Database (Denmark)

    Mårtensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2014-01-01

    examination and treatment probability (CAG, PCI and CABG at 3, 7, 10, 30 and 60 days) for the years 2001-2009, taking the competing risk of death into account using Aalen-Johansen estimators and a Fine-Gray model. SETTING: Nationwide Danish cohort. RESULTS: The proportion of patients receiving a CAG and PCI...... increased substantially over time while the proportion receiving a CABG decreased for both NSTEMI and unstable angina. For both NSTEMI and unstable angina, a significant increase in invasive examination and treatment probability at 3 days for CAG and PCI were seen especially from 2007 through to 2009....... For NSTEMI, the CAG examination probability at 3 days leaped from 20% in 2007 to 32% in 2008 and 39% in 2009, and for PCI the same was true with a leap in treatment probability from 19% to 28% from 2008 to 2009. CONCLUSIONS: In Denmark the use of CAG and PCI in treatment of NSTEMI and unstable angina has...

  2. Analysis of thrombelastography in type 2 diabetes patients complicated with angina pectoris of coronary heart disease and its correlation with disease severity

    Institute of Scientific and Technical Information of China (English)

    Hong-Hong Liu; Zhao-Chuan Liu; Hong-Tao Liu; Yu-Ji Zhang; Qing-Ling Fu; Jun-Ling Wang

    2016-01-01

    Objective:To analyze the thrombelastography parameters in type 2 diabetes patients complicated with angina pectoris of coronary heart disease and their correlation with disease severity.Methods:30 cases of healthy volunteers, 30 cases of patients with simple angina pectoris of coronary heart disease (CHD) and 30 cases of type 2 diabetes patients complicated with angina pectoris of coronary heart disease were selected for study. Thrombelastography parameters R value, K value, αangle and MA value as well as inflammation-associated molecules YKL-40 and NK-kB expression were detected.Results:R values and K values of simple CHD group and diabetes complicated with CHD group were lower than those of control group, and αangle and MA values were higher than those of control group; R values and K values of diabetes complicated with CHD group were lower than those of simple CHD group, and αangle and MA values were higher than those of simple CHD group; R values and K values of 2 branch lesions group and 3 branch lesions group were lower than those of 1 branch lesion group, and αangle and MA values as well as YKL-40 and NK-kB contents were higher than those of 1 branch lesion group; R values and K values of 3 branch lesions group were lower than those of 2 branch lesions group, and αangle and MA values as well as YKL-40 and NK-kB contents were higher than those of 2 branch lesions group; R value and K value were negatively correlated with YKL-40 and NK-kB contents, and αangle and MA value were positively correlated with YKL-40 and NK-kB contents.Conclusions: Thrombelastography parameters in type 2 diabetes patients complicated with angina pectoris of coronary heart disease are significantly abnormal, and R value, K value, αangle and MA value can reflect disease severity and inflammation degree.

  3. Study on Effect of Zhixinkang Capsule(脂欣康胶囊)in Treating Unstable Effort Angina and Hyperlipidemia and Lts Function in Vascular Endothelium Protection

    Institute of Scientific and Technical Information of China (English)

    ZHANGWen-gao; MENG-Xian-zhongtffu

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endotelium of Zhixin-kang Capsule(ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia.Methods:Sixty-five patients with unstable effort angina were randomly divided into ZXKC group(34 ca-ses)and control group(31 cases).Conventional western medical therapy was given to both groups,with ZXKC group receiving additional ZXKC treatment.Data of 20 healthy persons were taken as normal group.Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 ca-ses) and control group treated with Yixintong(17 cases).The changes of clinical symptoms and laborato-ry indexes in all the patients were observed before and after treatment.Results:In patients with unstable effort angina,the efficacy of treatment of ZXKC,the withdrawal rate of nitroglycerin,the relieving of symptoms,the improvement of the electrocardiogram,the counts of circulating endothelial cells,the con-tent of platelet P-selectin,the content of plasma endothelin(ET),the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde(MDA) were all better than those in the control group.In patients with hyperlipidemia,there was no significant difference in lipids reduction between ZXKC group and the control group.In both groups,the total cholesterol(TC),triglyceride(TG),low density lipo-protein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],ET, oxidized low density lipoprotein,MDA,arte-riosclerotic index(AI)all lowered obviously,while the SOD,HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly.In the ZXKC group,the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly.The total effective rate in symptom relieving,the markedly effective rate,the reduction of TC,ET and ET/CGRP,and the elevation of SOD in ZXKC group were all superior to those in the control group.Conclusion:ZXKC could effectively resist myocardial ische

  4. Study on Effect of Zhixinkang Capsule (脂欣康胶囊)in Treating Unstable Effort Angina and Hyperlipidemia and Its Function in Vascular Endothelium Protection

    Institute of Scientific and Technical Information of China (English)

    张文高; 颜亭祥; 高福军; 孟宪忠; 刘建平; 尹格平; 刘丽莉; 罗南萍; 史炳娥; 马学盛

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endothelium of Zhixinkang Capsule (ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia.Methods: Sixty-five patients with unstable effort angina were randomly divided into ZXKC group (34 cases)and control group (31 cases). Conventional western medical therapy was given to both groups, with ZXKC group receiving additional ZXKC treatment. Data of 20 healthy persons were taken as normal group. Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 cases) and control group treated with Yixintong (17 cases). The changes of clinical symptoms and laboratory indexes in all the patients were observed before and after treatment. Results: In patients with unstable effort angina, the efficacy of treatment of ZXKC, the withdrawal rate of nitroglycerin, the relieving of symptoms, the improvement of the electrocardiogram, the counts of circulating endothelial cells, the content of platelet P-selectin, the content of plasma endothelin (ET), the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde (MDA) were all better than those in the control group. In patients with hyperlipidemia, there was no significant difference in lipids reduction between ZXKC group and the control group. In both groups, the total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), lipoprotein(a) [Lp(a)], ET, oxidized low density lipoprotein, MDA, arteriosclerotic index (AI) all lowered obviously, while the SOD, HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly. In the ZXKC group, the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly. The total effective rate in symptom relieving, the markedly effective rate, the reduction of TC, ET and ET/CGRP, and the elevation of SOD in ZXKC group were all superior to those in the control group. Conclusion: ZXKC could

  5. Universal health care no guarantee of equity: Comparison of socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction and angina

    Directory of Open Access Journals (Sweden)

    Kelman Chris W

    2009-12-01

    Full Text Available Abstract Background In Australia there is a socioeconomic gradient in morbidity and mortality favouring socioeconomically advantaged people, much of which is accounted for by ischaemic heart disease. This study examines if Australia's universal health care system, with its mixed public/private funding and delivery model, may actually perpetuate this inequity. We do this by quantifying and comparing socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction (AMI and patients with angina. Methods Using linked hospital and mortality data, we followed patients admitted to Western Australian hospitals with a first admission for AMI (n = 5539 or angina (n = 7401 in 2001-2003. An outcome event was the receipt, within a year, of a coronary procedure—angiography, angioplasty and/or coronary artery bypass surgery (CABG. Socioeconomic status was assigned to each individual using an area-based measure, the SEIFA Index of Disadvantage. Multivariable proportional hazards regression was used to model the association between socioeconomic status and procedure rates, allowing for censoring and adjustment of multiple covariates. Mediating models examined the effect of private health insurance. Results In the AMI patient cohort, socioeconomic gradients were not evident except that disadvantaged women were more likely than advantaged women to undergo CABG. In contrast, in the angina patient group there were clear socioeconomic gradients for all procedures, favouring more advantaged patients. Compared with patients in the most disadvantaged quintile of socioeconomic status, patients in the least disadvantaged quintile were 11% (1-21% more likely to receive angiography, 52% (29-80% more likely to undergo angioplasty and 30% (3-55% more likely to undergo CABG. Private health insurance explained some of the socioeconomic variation in rates. Conclusions Australia's universal health care system does not guarantee

  6. Efficacy of controlled-release isosorbide-5-mononitrate as adjunctive treatment to beta-blocking agents in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Aldershvile, J; Abildgaard, U;

    1989-01-01

    beta blocker. In bicycle ergometer exercise tests performed 4 h after study drug intake, total exercise time and time until 1-mm ST-depression increased significantly during both regimens as compared with placebo (p less than 0.05). However, only the 60-mg once-daily regimen was significantly better...... than placebo with regard to time until angina pectoris. The results indicate that ISMN-CR 60 mg once daily is effective as adjunctive to beta-blocker treatment, and nitrate tolerance appeared to develop during the twice-daily regimen. In 10 of the patients, the effect of additional sublingual...

  7. Study of relationship between the levels of serum bilirubin ,uric acid and unstable angina pectoris%不稳定型心绞痛患者血清胆红素及尿酸水平的分析

    Institute of Scientific and Technical Information of China (English)

    梁启权; 曾胜宏

    2009-01-01

    目的 探讨冠心病不稳定型心绞痛与胆红素及尿酸的关系.方法 将入选202例冠心病不稳定型心绞痛患者,采集空腹静脉血测定总胆红素、直接胆红素、间接胆红素及尿酸,比较其心绞痛发作时、3个月、6个月及1年内未再发作时胆红素及尿酸的变化情况.结果 心绞痛发作时胆红素降低,尿酸偏高.结论 胆红素和尿酸水平可间接反映不稳定型心绞痛机体氧化、抗氧化情况,胆红素对评估病情有一定帮助.%Objective To investigate the relationship between the levels of serum bilirubin,uric acid(UA) and coronary heart disease unstable angina pectoris.Methods The leves of total bilirubin (TBIL),direct bilirubin (DBIL),indirect bilirubin(IBIL) and UA in venous blood by limosis were determind in 202 patients with unstable angina pectoris.We determine the different levels of TBIL,DBIL,IBIL and UA when they were suffering from angina pectoris.Then we respectively determine the levels of TBIL,DBIL,IBIL and UA in 3 months,6 months and 12 months after they had been suffered from angina pectoris.Results The levels of serum bilirubin were lower and UA were higher,when the patients were suffering from angina pectoris.Conclusion We can indirectly assess the oxidative and antioxidative activities by testing bilirubin and UA in unstable angina pectoris.

  8. Research Progress of Unstable Angina Syndromes Objectification——Metabonomics Article%不稳定型心绞痛中医证候客观化研究进展——代谢组学篇

    Institute of Scientific and Technical Information of China (English)

    周亚滨; 于晓红

    2011-01-01

    代谢组学的不断发展为不稳定型心绞痛的研究带来了新的思路和技术手段,对近年来从代谢组学角度研究不稳定心绞痛中医证候的文献进行了总结.%Metabolomics development for unstable angina study brings new ideas and technology, this paper in recent years from the Angle of metabonomics studies unstable angina syndromes of literature was summarized.

  9. La realidad como materia novelable: Alejo Carpentier

    OpenAIRE

    Raquel Arias Careaga

    2007-01-01

    Desde que en 1897 Benito Pérez Galdós defendiera como materia prima legítima de la literatura «la vida misma, de donde el artista saca las ficciones que nos instruyen y embelesan» (Pérez Galdós, 1990: 159), el realismo como instrumento de indagación y análisis de la sociedad no ha dejado de crecer y expandirse. Realismo crítico, como este de Galdós, que implica una ampliación del concepto chato de «realidad», incluyendo en ella «recuerdos, sueños, imaginación, locura, símbolos» para contribui...

  10. Pensando al agua como parte del paisaje

    Directory of Open Access Journals (Sweden)

    Lorena Salvatelli

    2009-12-01

    Full Text Available El objetivo de este trabajo es discutir la importancia de los estudios de arqueología terrestre y subacuática como parte de un mismo proceso de interpretación del pasado. Se entiende que el registro arqueológico puede hallarse actualmente en una variedad de ambientes tanto terrestres como subacuáticos a causa de varias razones, como por ejemplo las oscilaciones de los niveles de agua ocurridas entre el Pleistoceno Final y el Holoceno Medio. Por lo tanto, se propone que para su recuperación debe utilizarse una metodología adaptada al medio ambiente en el cual se encuentre. En este sentido, es importante la interpretación integral del paisaje para acceder a la comprensión de la diversidad ambiental en la que se puede emplazar un sitio arqueológico, y en consecuencia poder “bucear” un registro integrado.

  11. La realidad como materia novelable: Alejo Carpentier

    Directory of Open Access Journals (Sweden)

    Raquel Arias Careaga

    2007-12-01

    Full Text Available Desde que en 1897 Benito Pérez Galdós defendiera como materia prima legítima de la literatura «la vida misma, de donde el artista saca las ficciones que nos instruyen y embelesan» (Pérez Galdós, 1990: 159, el realismo como instrumento de indagación y análisis de la sociedad no ha dejado de crecer y expandirse. Realismo crítico, como este de Galdós, que implica una ampliación del concepto chato de «realidad», incluyendo en ella «recuerdos, sueños, imaginación, locura, símbolos» para contribuir a la formación de un «realismo total» (Rodríguez Puértolas, 2000, II: 93, al que se une también la asimilación de enseñanzas esenciales como la que representa la narrativa de Cervantes: La novelística de Galdós hunde sus raíces en el mejor Cervantes, como puede verse en su peculiar sentido del humor y de la ironía, en la concepción perspectivista de la realidad y en tantas otras cosas, algunas de ellas en verdad fundamentales. Así el concepto de la Naturaleza y sus relaciones dialécticas con el ser humano; así el Amor como elemento vital y animador del orden cósmico, muy alejado del idealismo vulgar romántico (Ibid., 93.

  12. Como si fuera posible recoger sentimientos

    OpenAIRE

    Vayreda Puigvert, Marian; Vallès Villanueva, Joan

    2011-01-01

    Se trata de una propuesta como resultado del trabajo conjunto entre la escuela de Arte Pigment y el ESPAI ZERO1 del Museu Comarcal de la Garrotxa, destinado exclusivamente a exposiciones temporales de creación contemporánea y como continuidad de propuestas anteriores de colaboración: REPLICA23 y SONESNAT JUNIOR. Com si fos possible recollir el sofriment es un proyecto de la artista Anna Manel.la, y se consideró una propuesta interesante y un reto para conversar, intercambiar y crear con los a...

  13. Dibujo infantil como medio de diagnostico

    OpenAIRE

    González Hernando, Elisa

    2015-01-01

    Con este documento se pretende demostrar la importancia que tiene el dibujo infantil en el correcto desarrollo integral de las personas. Se estudia la importancia del dibujo y su valor a la hora de utilizarlo como método de diagnóstico ante determinados aspectos que pueden determinar la vida de una persona. En definitiva lo que se desarrolla en este trabajo de Fin de Grado es el papel que juega el dibujo como herramienta para el seguimiento del desarrollo de los individuos centrándonos ...

  14. Como una luna en el agua [Score

    Directory of Open Access Journals (Sweden)

    Francisco del Pino

    2014-12-01

    Full Text Available The title of the solo piano piece Como una luna en el agua, composed between June and July of 2014, refers to the end of the seventh chapter of the novel Rayuela (Hopscotch by the Argentine writer Julio Cortázar, in which an allegorical description of a kiss takes the form of a prose poem.

  15. La biblioteca como editora de contenidos

    Directory of Open Access Journals (Sweden)

    Alonso-Arévalo, Julio

    2015-12-01

    Full Text Available Una de las características más innovadoras de la biblioteca del siglo 21 tiene que ver con la toma de una postura activa frente a la gestión y generación de contenidos. Con la llegada de la Web 2.0 las bibliotecas no sólo siguen salvaguardando y difundiendo información como han venido realizando a lo largo de su historia, también cada vez con más frecuencia crean nueva información con el objetivo de prestar los mejores servicios a sus ciudadanos, a través de recursos y servicios tales como la elaboración guías de investigación, boletines de alerta y novedades, recursos web, información a través de sus blogs, y como administradores de contenidos a través de repositorios y revistas de acceso abierto. Un paso más allá en esta dinámica tienen que ver con la biblioteca como editora y distribuidora de libros, especialmente en el ámbito local, siendo la impulsora, formadora, dinamizador y difusoras de las obras de los autores de su comunidad.

  16. El traductor como investigador. Tiempos turbulentos

    OpenAIRE

    Behiels, Lieve

    2013-01-01

    En esta contribución intento colmar la brecha entre un estudio científico de la traducción que se pretende distante de la actividad traductora y la práctica de la traducción como actividad investigadora.

  17. DENEGRINDO A FILOSOFIA: O PENSAMENTO COMO COREOGRAFIA

    Directory of Open Access Journals (Sweden)

    Renato Noguera

    2011-12-01

    Full Text Available Partindo da ideia de Deleuze que filosofia é criar conceitos, este artigo tem como objetivo apresentar a filosofia afroperspectivista, criando conceitos para articular ensino de filosofia e a educação das relações etnicorraciais. O conceito de denegrir trabalha para problematizar o nascimento da filosofia na busca por uma nova coreografia do pensamento.

  18. La medicina tradicional como medicina ecocultural

    OpenAIRE

    Aparicio Mena, Alfonso Julio

    2005-01-01

    Los sistemas terap??uticos tradicionales responden a las culturas de los pueblos en los que surgen. En ellos, se concibe la naturaleza ??ntimamente ligada a la tradici??n. Salud es, para los miembros de las culturas tradicionales, bienestar como equilibrio entre el ser humano, la naturaleza, las creencias y la sociedad.

  19. Los nematodos como indicadores ambientales en agroecosistemas

    Directory of Open Access Journals (Sweden)

    S. Sánchez-Moreno

    2013-01-01

    Full Text Available El suelo es una unidad básica en el funcionamiento y dinámica de los agroecosistemas, ya que proporciona el sustento físico y biológico para la producción vegetal. Aunque el efecto de las prácticas antropógenas sobre el componente abiótico del suelo está ampliamente documentado, existen pocas herramientas capaces de medir el impacto de estas prácticas en la biodiversidad del ecosistema edáfico. Los nematodos del suelo constituyen un grupo de invertebrados de elevada importancia ecológica que presentan atributos que les convierte en valiosas herramientas como indicadores biológicos. Su extraordinaria diversidad taxonómica y funcional, su abundancia y ubiquidad, y la rápida respuesta de las comunidades de nematodos edáficos a perturbaciones ambientales, como el laboreo o la aplicación de insumos químicos, han convertido la nematofauna en un indicador clave en la evaluación del efecto del manejo agrario sobre los ecosistemas. La participación de los nematodos en múltiples eslabones funcionales dentro de la red trófica edáfica hace que sean también indicadores de numerosos procesos ecológicos y biológicos, como el mantenimiento del ciclo de nutrientes o el control de especies plaga.Este trabajo sintetiza los resultados obtenidos en la utilización de la nematofauna como indicadora de perturbaciones ambientales en los agroecosistemas, y expone una breve reseña del estado de la Nematología como disciplina científica en España.

  20. Síndrome de Kounis: una posibilidad a tener en cuenta como causa de muerte súbita cardiaca Kounis syndrome: a possibility to be considered as a cause of sudden cardiac death

    OpenAIRE

    Molina, P.; C. Presentación; P. Beltrán; Zorio, E.

    2012-01-01

    El llamado síndrome miocárdico alérgico, angina alérgica o síndrome de Kounis, se define como la aparición de un síndrome coronario agudo por vasoespasmo secundario a la activación de mastocitos y células inflamatorias interrelacionadas que se produce en las reacciones de hipersensibilidad, anafilácticas y anafilactoides. Presentamos un caso de muerte súbita en un adulto joven compatible con un síndrome de Kounis, donde el estudio histopatológico demuestra patología asmática y una trombosis e...

  1. Observer variability in the evaluation of dual-isotope Tl-201/Tc-99m sestamibi rest/stress myocardial perfusion SPECT in men and women with known or suspected stable angina pectoris

    DEFF Research Database (Denmark)

    Johansen, Allan; Høilund-Carlsen, Poul Flemming; Christensen, Henrik Wulff;

    2004-01-01

    with known or suspected stable angina who were studied before coronary angiography. A 1-day thallium 201/technetium 99m sestamibi rest/stress MPI protocol was used. MPI was interpreted by 2 independent observers without knowledge of clinical data, using a 20-segment scoring model. By consensus, the overall...

  2. Understanding factors that influence the use of risk scoring instruments in the management of patients with unstable angina or non-ST-elevation myocardial infarction in the Netherlands: a qualitative study of health care practitioners’ perceptions.

    NARCIS (Netherlands)

    Engels, J.; Heeren, M.J.; Wulp, I. van der; Bruijne, M.C. de; Wagner, C.

    2014-01-01

    Background Cardiac risk scores estimate a patient’s risk of future cardiac events or death. They are developed to inform treatment decisions of patients diagnosed with unstable angina or non-ST-elevation myocardial infarction. Despite recommending their use in guidelines and evidenc

  3. Living with Angina

    Science.gov (United States)

    ... usual, call 9–1–1 for emergency care. Emotional Stress Anger, arguing, and worrying are examples of ... normal activities. This includes work, hobbies, and sexual relations. However, if you do very strenuous activities or ...

  4. EL DERECHO COMO COMPLEJIDAD DE SABERES DIVERSOS

    Directory of Open Access Journals (Sweden)

    María Isolina Dabove

    2011-08-01

    Full Text Available El motivo principal de este trabajo consiste en observar la estrecha vinculación que existe entre los distintos grados del saber y la configuración misma del mundo jurídico como objeto cultural. Así pues, desde esta perspectiva, se advierte que el Derecho puede ser considerado un fenómeno complejo, en gran medida, debido a los distintos tipos de conocimiento que intervienen en su construcción. El saber, en este marco, será entendido como aquel conjunto de información referida a hechos o abstracciones, que se expresan en proposiciones lógicas y responden a algún criterio de verdad admitido como válido para el caso. Sin embargo, es preciso señalar también que esta definición genérica del conocimiento debe completarse con los conceptos propios de los distintos grados (o clases de saberes que fueron consolidándose históricamente, tales como la filosofía, la ciencia, la tecnología, el saber empírico o popular y el religioso[1]. Hasta donde entendemos, sobre cada uno de estos términos se ha ido desplegando una rica trama teórica. No obstante, en este artículo sólo expondré una breve caracterización de los mismos, con el propósito de señalar de manera aproximativa, por qué razón el Derecho puede ser comprendido como una complejidad, resultante de la interacción diversa de todos los tipos de conocimiento mencionados y no sólo, como el producto de la ciencia o la filosofía, en particular. Veamos, entonces en primer lugar, cuáles son los rasgos más destacados de los modelos gnoseológicos vigentes; para poder observar, en segundo término, los modos por los cuales todos ellos posibilitan la construcción del Derecho en la actualidad.

  5. Simvastation Treatment of Unstable Angina pector Clinical Analysis%辛伐他汀治疗不稳定性心绞痛的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈哲

    2012-01-01

      目的:探讨辛伐他汀治疗不稳定性心绞痛的临床效果.方法:将我院自2010年1月~2012年1月收治的不稳定型心绞痛患者50例随机分为治疗组和对照组各25例,对照组仅给予常规药物治疗,治疗组在常规药物治疗的基础上给予辛伐他汀治疗,比较2组患者的临床疗效.结果:治疗组的总有效率为100%,对照组的总有效率为76%,治疗组的总有效率显著高于对照组,2组对比发现,差异具有统计学意义(P0.05).结论:辛伐他汀治疗不稳定性心绞痛,能显著控制炎症反应,减少新病灶及全堵塞的形成,改善血糖和血脂,延长运动导致的心绞痛发作时间,疗效确切、安全可靠,值得临床推广应用.%  Objective:Discussion simvastation Unstable angina pector treatment of the clinical effect. Methods: Will our hospital from January 2010 to January 2012 were Unstable angina pector 50 patients were randomly divided into the treatment group and control group every 25 cases and control only give regular drug therapy, the treatment group on the basis of routine therapy to give simvastation treatment, compared with two groups of patients with clinical curative effect. Results: The total effective rate of the treatment group were 100%and the total effective rate is 76%and the total effective rate of the treatment group was significantly higher than the control group, the two groups s found that a statistically significant difference (P 0.05). Conclusions: Simvastation treatment of Unstable angina pector can significantly control inflammation, reduce new lesions and the formation of the jam, improve blood sugar and blood fat, extend the movement of heart attacks in time, definite effect, safe and reliable, and clinical application.

  6. 1例不稳定型心绞痛患者的药学监护%Pharmaceutical care on a patient with instable angina

    Institute of Scientific and Technical Information of China (English)

    赵维娟; 王金萍; 刘静; 许景峰

    2011-01-01

    One 78-year-old woman with instable angina, hypertension and type Ⅱ diabetes was hospitalized for acute coronary syndrome and received the therapy of distending the coronary artery, anti-platelet, lowering hypertension, etc. Three days later, the patient was treated with the therapy of PCI, and then the situation was stable. Considering the oral nitroglycerin having no effect on the patient, and the hypertension didn't control very well, the hypertension related gene (HRG) was detected. The results showed that the gene type of ALDH was WM (GA) (low activity). Therefore, the pharmacist advised that nitroglycerin should be withdrawn in acute angina pectoris situation because of low sensitivity. Suxiaojiuxinwan could be administrated against angina pectoris attacks.Basing on the low activity of β receptor blocker' s metabolic enzyme, ACE inhibitor (ACEI) and AT1 acceptor blockers (ARBs)could be chosen. The blood pressure and blood glucose were stable and the state was improved markedly according to the rational optimization based on the gene test.%1例78岁女性患者,因不稳定型心绞痛入院治疗,入院时合并有高血压病和2型糖尿病.给予扩张冠状动脉、抗血小板、降压等治疗,并于入院第3天行经皮冠状动脉介入治疗,术后患者情况稳定.针对患者心绞痛发病时舌下含服硝酸甘油症状不能缓解,高血压药物控制血压效果不佳,行乙醛脱氢酶(ALDH)和高血压药物相关基因检测,作为选用和调整药物依据.患者ALDH为WM(GA)型(低活性),其含服硝酸甘油效果差,不能作为急性心绞痛的治疗药,必要时含服速效救心丸;高血压药物相关基因检测显示,患者对β受体阻滞剂的代谢酶活性低,对ACE抑制剂(ACEI)和AT1受体阻断药(ARBs)敏感,可根据具体情况加以选择.经合理优化治疗方案,患者血压及血糖控制稳定,病情好转出院.

  7. Different edge effects of paclitaxel-and sirolimus-eluting stents on proximal and distal edges in patients with unstable angina:serial intravascular ultrasound analysis

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; YE Fei; ZHANG Jun-jie; LIU Zhi-zhong; SHAN Shou-jie; SUN Xue-wen; ZHANG Ai-ping; CHEN Jing-guo; XU Ya-wei; YANG Song; CHEN Feng; LUO Weng-ping

    2009-01-01

    Background It is unclear whether edge segments have different responses to paclitaxel eluting stent (PES) and sirolimus eluting stent (SES) implantation in patients with unstable angina. This study aimed to compare the different vascular edge responses in patients with unstable angina and single de novo coronary lesion treated with SES and PES. Methods Two hundred and fifty-five patients with unstable angina and single de novo lesion were randomly assigned to PES and SES groups. Serial volumetric intravascular ultrasound (IVUS) images were taken immediately after stenting and at an eight-month follow-up. Five-mm edge segments proximal and distal to the stents were analyzed. Results Baseline characteristics were comparable between the two groups. At proximal-edge segment, the vessel area decreased and the plaque area increased significantly in the PES group as compared with the SES group. A significant net loss of lumen area was found in the PES group (from (11.10±3.12) mm2 at baseline to (9.92+3.59) mm2 at the follow-up, P <0.001). At the distal-edge segment, the net loss of lumen area in the PES group (from (7.71±2.81) mm2 at baseline to (6.66±2.29) mm2 at the follow-up, P <0.001) was attributed to a significant increase of plaque area. Proximal-edge stenosis was commonly seen in the PES group (20.0%) as compared with the SES group (5.0%, P=0.001). This correlated with the higher incidence of target lesion revascularization in the PES group (P=-0.03). Subsegmentally, the smallest A lumen area was located at 2 mm proximally in both groups, at 0 mm distally in the PES group, and at 1 mm distally in the SES group. Conclusions The two groups demonstrated negative remodeling of edge segments. PES was less effective than SES in inhibiting the growth of plaque within the first 1-mm length proximal to the stent.

  8. Correlation of angina pectoris and perfusion decrease by collateral circulation in single-vessel coronary chronic total occlusion using myocardial perfusion single-photon emssion computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Geon; Park, Ki Seong; Kang, Sae Ryung [Chonnam National University Hospital, Gwangju (Korea, Republic of); and others

    2016-03-15

    To evaluate the perfusion decrease in donor myocardium by collateral circulation and its correlation with angina pectoris in patients with chronic total occlusion (CTO) using myocardial perfusion single-photon emission computed tomography (MPS). Thirty-six patients with single-vessel CTO without any other stenosis were included. All patients underwent MPS and coronary angiography (CAG) within 2 months. Total 72 donor arteries were evaluated for the grades of collaterals to the CTO artery using the Rentrop grading system on CAG. Perfusion defects and perfusion scores in donor and CTO territories were analyzed on MPS. Myocardial perfusion of donor and CTO territories were evaluated according to the presence of angina pectoris and the grades of collateral circulation. When the CTO territory was ischemic, symptomatic patients showed higher summed difference scores in the CTO territory compared to asymptomatic patients (3.5 ± 2.4 vs. 1.5 ± 0.8 for symptomatic and asymptomatic groups respectively; p = 0.034). However, when the CTO territory was nonischemic, symptomatic patients showed higher summed stress scores (SSS, 4.3 ± 2.9 vs. 1.6 ± 1.2; p = 0.032) and summed rest scores (SRS, 4.2 ± 2.5 vs. 1.5 ± 1.1; p = 0.003) in the donor territories. On the per-vessel analysis, perfusion defects in donor territories were more frequent (0 % vs. 53 % vs. 86 % for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p < 0.001) and showed higher SSS (0.0 ± 0.0, 1.3 ± 1.6 and 2.1 ± 1.1 for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p = 0.001) and SRS (0.0 ± 0.0, 1.0 ± 1.4 and 1.7 ± 1.2; p = 0.003) at higher Rentrop grades, but their patterns were variable. Angina pectoris was related to either ischemia of the myocardium beyond CTO or a perfusion decrease in the donor myocardium. The perfusion decrease in donor myocardium positively correlated with the collateral grades.

  9. Modified Erxian Decoction Treatment of Post-menopause Patients with Microvascular Angina%二仙汤加味治疗绝经后微血管性心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    张玉芬; 陈艳秋; 陈钧; 刘镘利; 马静

    2012-01-01

    Objective: To observe the effects of modified Erxian decoction upon post-menopause patients with microvascular angina. Method: 80 post-menopause patients with microvascular angina were divided randomly into conventional treatment group ( control group ) and combined with modified Erxian decoction treatment group ( treatment group ) . After 4 weeks treatment, typical angina frequency and exercise ECG test were detected and compared within two groups. Results: After the combination with the modified Erxian decoction treatment, the angina attack frequency and ECG exercise test results were improved significantly compared with that in the control group. Conclusion: Modified Erxian decoction in combination with conventional drugs is the safe and effective treatment for post-menopause patients with microvascular angina.%目的:观察二仙汤加味治疗绝经后微血管性心绞痛的疗效.方法:将80例绝经后微血管性心绞痛患者随机分为常规治疗组(对照组)50例,伍用二仙汤治疗组(治疗组)30例.治疗4周后,比较两组心绞痛发作频率和心电图运动试验,包括ST段压低幅度的变化.结果:治疗组心绞痛发作频率和心电图运动试验结果显著改善,与对照组比较存在显著差异.结论:常规药物合二仙汤加味对绝经后微血管性心绞痛治疗安全有效.

  10. MEMORIA VISUAL COMO PARTE DEL PROCESO LECTOR

    OpenAIRE

    Gamero-Muñiz, Antonia

    2013-01-01

    Este trabajo tiene como objetivo indagar la relación entre los movimientos sacádicos, velocidad y comprensión lectora y la memoria visual en alumnos de 2ºESO, con el propósito de contribuir a la labor docente en los apoyos del aprendizaje de una correcta lectura y tomando como fundamentación teórica la importancia de la memoria visual en el proceso lector. Se ha seleccionado una muestra de 24 niños y 21 niñas con edades comprendidas entre 13 y 15 años. Se evaluaron los movimientos sacádico...

  11. Como (Não crescer a 7%

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Almeida

    2010-07-01

    Full Text Available Comentários a texto de Samuel Pinheiro Guimarães sobre a necessidade de o Brasil crescer a 7% como forma de superar o subdesenvolvimento e de aproximar a renda per capita dos níveis registrados nos EUA. Críticas tópicas das inconsistências econômicas do artigo, manifestadas nas preferências de políticas setoriais, entre elas a leniência com o fenômeno inflacionário, evidenciando lacunas dos argumentos expostos (mais políticos do que econômicos e indicando, como contraponto, os requisitos do crescimento e as reformas indispensáveis a tal efeito.

  12. El manual como texto Schoolbook as text

    OpenAIRE

    Agustín Escolano Benito

    2012-01-01

    Este trabajo aborda la cuestión de la identidad del libro escolar como un género textual específico en el contexto de la manualística clásica y moderna, contextualizando los análisis en el marco de la cultura de la escuela tradicional y en la era de la revolución digital y bajo una perspectiva historiográfica y teórica. También plantea el nacimiento y primeros desarrollos de la manualística como campo intelectual y académico y sus contribuciones a la definición de la identidad del libro escol...

  13. La fenomenología como atavismo

    Directory of Open Access Journals (Sweden)

    Galán, Iván

    2009-04-01

    Full Text Available This paper deals with phenomenology as a result of phenomenological freedom in its possibility of understanding a phenomenon as wild phenomenon. From this perspective, we are enabled to transcend established symbolic systems and to pose the question on the existence of a sense which is immature, not-saturated and imperfect without exception.El artículo pretende mostrar la vigencia de la fenomenología como expresión de la libertad fenomenológica, como posibilidad siempre abierta de acceder al fenómeno en cuanto fenómeno puro, registro arquitectónico en el que, saltando por sobre los sistemas simbólicos instituidos, nos es permitido plantear en toda su radicalidad la pregunta por la existencia de un sentido siempre prematuro, no saturado y jamás clausurable.

  14. Como usado como marcador del discurso en el lenguaje juvenil de Madrid

    OpenAIRE

    Holmvik, Lise

    2011-01-01

    El objetivo del presente estudio ha sido analizar y describir las varias funciones pragmáticas que muestra como en las conversaciones entre los jóvenes madrileños en el corpus COLAm. Asimismo fue analizada la distribución de como según género y clase social. El uso de como tiene una frecuencia de 0,98 pmp (por mil palabras) en el lenguaje juvenil madrileño, el número de hallazgos de como con función de marcador del discurso siendo 499 de un total de apróximadamente 500.000 palabras en el corp...

  15. El rock como conformador de identidades juveniles

    Directory of Open Access Journals (Sweden)

    Adrián de Garay

    1996-04-01

    Full Text Available El autor analiza la relación entre el rock y las identidades juveniles, a partir del abordaje de cinco “estilos” que se pueden identificar como constitutivos de éstas identidades. Ellos son: la jerga, la estética, las producciones culturales, los no-lugares y el territorio. Finaliza el artículo señalando algunos hitos importantes de la culturarockera en la ciudad de México.

  16. EL CONFLICTO COMO CONSTRUCTOR DE CIUDAD

    Directory of Open Access Journals (Sweden)

    Twiggy Ortegón

    2012-04-01

    Full Text Available El planteamiento central de este articulo, es el de sugerir una análisis en torno a algunas de las condiciones o mecanismo necesarios para que el conflicto opere como un potenciador de la diferencia y creador de alternativas para la convivencia Se realiza una distinción del concepto, un análisis de contenidos interaccionales en dinámicas de conflicto y su relación con el contexto urbano de Bogotá, enfocándose en ámbitos escolares. En ciudades como Bogotá, las discusiones y acciones que diferentes estamentos han emprendido frente a la manera de concebir y gestionar el conflicto, desembocan en la creación de diferentes organismos como los centros de conciliación, la aplicación de fórmulas y técnicas para la solución de conflictos, el desarrollo de propuestas desde entes administrativos a nivel distrital y las nuevas disposiciones que plantea la Ley 115 sobre Gobierno Escolar y manuales de convivencia.

  17. Barrios cerrados como estrategia de desarrollo municipal

    Directory of Open Access Journals (Sweden)

    Nora Libertun de Duren

    2010-07-01

    Full Text Available Los barrios cerrados han sido generalmente estudiados desde la perspectiva de sus residentes, preferencias, estatus económico, y ambiciones sociales. Aun más, estos proyectos han sido asociados con el debilitamiento del estado y un desarrollo urbano gobernado por las necesidades del mercado. Sin embargo, queda por responder cual ha sido el papel de las instituciones públicas en la proliferación de barrios cerrados. Este artículo analiza el caso de Buenos Aires, donde las municipalidades suburbanas más pobres han visto a las urbanizaciones cerradas como una estrategia de desarrollo local. Aprovechando la descentralización de la reglamentación sobre los usos del suelo del nivel provincial al municipal, las municipalidades con un alto porcentaje de hogares pobres han facilitado el desarrollo de urbanizaciones cerradas como estrategia para aumentar el empleo local y la inversión privada en la zona. Como consecuencia de esta política, las urbanizaciones cerradas se han concentrado en las municipalidades más pobres del cono urbano bonaerense. Así, se ha incrementando la polarización social dentro de cada municipalidad, lo cual llama a revisar el efecto de las reformas de descentralización en la formación de una sociedad mas inclusiva y participativa.

  18. Multiple Coronary–Cameral Fistulae in the Left Anterior Descending Coronary Artery Causing Angina Pectoris: A Clinical Case and the State of the Art

    Directory of Open Access Journals (Sweden)

    Musuraca G

    2014-02-01

    Full Text Available CLINICAL CASE A 82-year-old man with hypercholesterolemia, hypertension and glucidic intolerance, presented with angina pectoris upon exertion. The vital signs were normal. Echocardiography showed normal left ventricular (LV ejection fraction, non-critical aortic valvular stenosis and LV diastolic dysfunction. Rest and stress myocardial echocardiography showed a reversible abnormal septal-wall motion. Therefore, an initial diagnosis of possible coronary artery disease was made. Coronary arteriography showed no atherosclerotic lesions in the 3 major coronary arteries; however, in the anterior descending artery a communication with the right ventricle (RV cavity through ve small, di use stulae was detected (Figure 1 and 2, resulting in complete RV contrast opaci cation. The patient was stabilised on medical therapy because he refused any further invasive therapy.

  19. Detection of postischemic regional left ventricular delayed outward wall motion or diastolic stunning after exercise-induced ischemia in patients with stable effort angina by using color kinesis.

    Science.gov (United States)

    Ishii, Katsuhisa; Miwa, Kunihisa; Sakurai, Takahiro; Kataoka, Kazuaki; Imai, Makoto; Kintaka, Aya; Aoyama, Takeshi; Kawanami, Masaki

    2008-04-01

    To determine whether postischemic diastolic stunning could be detected using color kinesis, we evaluated regional left ventricular (LV) diastolic wall motion in 36 patients with stable effort angina and a coronary stenosis (> or = 70% of luminal diameter), and in 30 control subjects. Regional LV filling fraction in the short-axis view during the first 30% of the LV filling time (color kinesis diastolic index) was determined before, 20 minutes, 1 hour, and 24 hours after the treadmill exercise test. In 33 of the 36 patients (92%), new regional LV delayed outward motion during early diastole (color kinesis diastolic index < or = 40%) was detected at 20 minutes after exercise. The regional LV delayed diastolic wall motion showed significant improvement but persisted 1 hour afterward in 20 of 36 patients (56%), and disappeared 24 hours after exercise. Detection of regional stunned myocardium with impaired diastolic function may be a useful tool for the diagnosis of coronary artery disease.

  20. Frontline diagnostic evaluation of patients suspected of angina by coronary computed tomography reduces downstream resource utilization when compared to conventional ischemia testing

    DEFF Research Database (Denmark)

    Nielsen, L. H.; Markenvard, John; Jensen, Jesper Møller;

    2011-01-01

    in patients suspected of angina. The purpose of this study was to investigate the consequences of frontline exercise-stress testing (Ex-test) versus CTA on downstream test utilization in clinical practice. In two collaborating departments using either Ex-test (n = 247) or CTA (n = 251) as the frontline...... was recorded. Mean age was 56 years (51% men), and 96% of the total study cohort were at low-intermediate pretest risk of significant coronary disease. Overall, downstream test utilization was more frequent in the Ex-test group than in the CTA group, 32% versus 21% (P = 0.003). Subsequent myocardial...

  1. Parenterale und orale Glykoprotein IIb/IIIa-Antagonisten bei instabiler Angina pectoris - gibt es noch eine Chance für oral wirksame Substanzen?

    Directory of Open Access Journals (Sweden)

    Darius H

    2001-01-01

    Full Text Available Die intravenösen Glykoprotein IIb/IIIa-Antagonisten Abciximab, Tirofiban und Eptifibatide sind wissenschaftlich ohne Zweifel für die Therapie der instabilen Angina und als Begleitmedikation bei Koronarinterventionen etabliert, auch wenn die Anwendung dieser Substanzen in der klinischen Praxis noch ungenügend ist. Insbesondere für das Abciximab konnte eine Letalitätsreduktion auch 3 Jahre nach der Therapie für ein Hochrisikokollektiv von Patienten überzeugend nachgewiesen werden. Für die Therapie des akuten Myokardinfarktes zusammen mit verschiedenen Fibrinolytika werden alle drei Substanzen zur Zeit in größeren Studien untersucht. Die sehr umfangreichen Untersuchungen bei Patienten mit instabiler Angina und nach Koronarinterventionen, die mit den oralen Glykoprotein IIb/IIIa-Antagonisten durchgeführt wurden, haben allesamt enttäuschende Ergebnisse erbracht. Es konnten nur schwache therapeutische Effekte im Sinne einer Reduktion von ischämischen Rezidivereignissen festgestellt werden, wobei jedoch bei allen Untersuchungen eine Tendenz zu einer leicht erhöhten Letalität in der Therapiegruppe im Vergleich zur jeweiligen Placebogruppe festgestellt werden konnte. In einer Metaanalyse wurde eine ca. 35%ige Erhöhung der Sterblichkeit für die mit den oralen Antagonisten behandelten Patienten errechnet. Die Gründe für diesen therapeutischen Fehlschlag könnten in der geringen Bioverfügbarkeit der verschiedenen Substanzen liegen oder in dem bisher noch ungenügenden Verständnis des Verhaltens des thrombozytären GPIIb/IIIa-Rezeptors beim Versuch einer Langzeitblockade. Weitere Substanzen mit anderen pharmakokinetischen Eigenschaften sind derzeit noch in der klinischen Entwicklung.

  2. Comparison of signs and symptoms of myocardial infarction and unstable angina in male and female hospitalizedpatients in coronary care units of Kerman Medical University hospital, 2004-2005

    Directory of Open Access Journals (Sweden)

    S. Sabzevari

    2007-01-01

    Full Text Available Abstract Background and purpose: Coronary Artery Disease (CAD is one of the most common causes of mortality and disability in the world. The results of some studies show that there are differences in signs and symptoms of CAD between male and female.Materials and Methods: This research was done to compare males and females for these signs and symptoms in 600 hospitalized patients in coronary care units of Kerman Medical University from December 2004 to July 2005. For data collection a questionnaire was used which was designed in five sections: demographic characteristics, disease variables, pictures for determining the points of chest pain, Visual Analog Scale for determining the intensity of pain and measures taken by patients after the beginning the signs and symptoms. This questionnaire was completed by two nurses in different shifts by interviewing the patients. For data analysis T test, χ2, Fisher exact and Man-Whitney U were used.Results: The results showed that the women were older than men (p<0.001. Most women had unstable angina and men had myocardial infarction (P<0.05. There were no significant differences between the chest pain in both genders but neck pain, back pain, fatigue, decrease of appetite, flushing, dizziness, tiredness, visual disturbances, suffocation feeling, palpitation and restlessness were experienced in women more than men (p<0.05. Also dyspenea during the heart attack was seen in most women (44.7% vs 29.4% but there was no significant difference between two genders for intensity of pain.Conclusion: This study showed that atypical signs and symptoms of unstable angina and myocardial infarction were seen in female more than male. Furthermore this may be followed by some problems in diagnosis and then delay in referring the patients to medical centers. On the other hand, health care workers may not pay enough attention to these atypical signs and symptoms, in women with normal ECG so they might not receive nessaceery

  3. Correlation Between TCM Syndrome of Patients with Angina Pectoris and Quality of Life%冠心病心绞痛患者中医证型与生存质量相关性

    Institute of Scientific and Technical Information of China (English)

    吴瑾; 袁东超; 张哲; 杨茗茜; 季康寿; 杨关林

    2013-01-01

    目的:探讨冠心病稳定型心绞痛患者中医不同证型与生存质量的关系.方法:采用横断面调查方法,一次性采集多个分中心符合入选标准的1788例患者,使用西雅图心绞痛量表(SAQ)作为评价生存质量的工具,运用Logistic回归、单因素方差分析,探讨SAQ5个不同维度得分及总分与冠心病稳定型心绞痛患者中医证型的关系.结果:冠心病稳定型心绞痛患者生存质量的5个维度得分不同,其中治疗满意度平均分最高,躯体活动受限程度平均分最低.不同维度下的三组间生命质量的差异均无统计学意义,即P>0.05.痰瘀互结组与心绞痛发作频率维度关系最密切成负相关,气虚血瘀组与心绞痛稳定状态维度关系最密切成正相关.结论:冠心病稳定型心绞痛患者不同证型与生存质量间存在一定相关性,并且结果符合中医理论的内涵.%Objective:To study the correlation between different syndromes of traditional Chinese medicine (TCM) and quality of life (QOL) of the patients with angina pectoris.Methods:With the crosssectional survey method,1788 patients with angina pectoris confirmed by coronary angiography were collected at the same time,and their QOL was assessed by the Seattle Angina Questionnaire (SAQ).The correlation of the scores of five different dimensions,including somatic movement limitation,angina stability and attacks,angina frequency,treatment satisfaction,and disease recognition,and the total scores of SAQ and the TCM syndromes were analyzed by Logistic regression and single factor analysis of variance.Results:Five dimensions' scores of the quality of life in coronary heart disease in patients with stable angina pectoris were different,in which the scores of treatment satisfaction was the highest and the scores of somatic movement limitation were the lowest.Under different dimensions,there was no significant difference of the QOL among three groups statistically,P>0.05.Phlegm and

  4. A Meta analysis for the relation of heart rate and postinfarction angina pectoris in Chinese population%心率影响梗死后心绞痛发生率的国内Meta分析

    Institute of Scientific and Technical Information of China (English)

    李婧; 陈汉想; 李伟

    2014-01-01

    By Meta analysis ,we determined the influence of heart rate on postinfarction angina pectoris incidence in Chinese population with acute myocardial infarction .A comprehensive collection of an epidemiological study pub-lished domestically on the relationship between resting heart rate and postinfarction angina pectoris in AMI patients , was carried out , for making the Meta analysis by using RevMan software with fixed effects model and random effects model.We calculated the relative risk (RR) of postinfarction angina pectoris risk of AMI patients in slow heart rate group relative to quick heart rate group ,and evaluated the influence of heart rate level with AMI on occurrence of postinfarction angina pectoris , and analyzed the publication bias by funnel plot .The 7 articles were included .The total sample size was 1888 cases.There were 1030 cases in the heart rate slow group ,and postinfarction angina pec-toris appeared in 128 cases.The heart rate quick group was 858 cases, 247 cases combined with postinfarction angi-na pectoris;RR=0 .46 ,95%confidence interval was ( 0 .38-0 .55 ) .Funnel plot analysis showed no presence of publication bias .There is a correlation between heart rate level and postinfarction angina pectoris occurrence in AMI patients .Postinfarction angina pectoris is increased in heart rate quick patients .Slowing down the heart rate may re-duce the risk of postinfarction angina pectoris .%采用Meta分析( Meta analysis )的方法确定我国人群心率对急性心肌梗死( Acute myo-cardia infarction ,AMI)患者梗死后心绞痛发生的影响。全面收集国内发表的有关AMI患者静息心率与梗死后心绞痛关系的文献,对符合条件的所有研究结果利用RevMan软件进行固定效应模型的Meta分析。计算AMI患者心率慢组相对心率快组发生梗死后心绞痛的危险( rel-ative risk,RR),评价心率快慢对AMI患者梗死后心绞痛发生的影响,并用漏斗图分析发表性

  5. La publicidad como instrumento de aprendizaje escolar

    OpenAIRE

    Pallarés Piquer, Marc

    2013-01-01

    Tradicionalmente los contenidos educativos han sido un resumen de los saberes que representan las formas de hacer de la cultura, el pensamiento y las creencias de la humanidad. Así, las diferentes disciplinas se reflejaban en unos contenidos educativos organizados en torno a unas materias escolares “encerradas” bajo la llave de los libros de texto. En este artículo se alude a la conveniencia del uso de la publicidad como herramienta escolar. Partiendo del alto índice de consumo de mensajes pu...

  6. CAPITAL SOCIAL COMO FATOR DE DESENVOLVIMENTO LOCAL

    OpenAIRE

    Mendonca, Kamila Vieira; Pinheiro, Jose Cesar

    2008-01-01

    O presente estudo verificou e avaliou o grau de acumulação de capital social como fator de desenvolvimento local, do assentamento Che Guevara, localizado no município de Ocara, no Estado do Ceará. O índice de capital social (ICS) foi calculado com base nas respostas de um questionário elaborado com variáveis mensuráveis e que refletem o estoque de capital social. A comunidade dispõe de um grau mediano de capital social.-------------This study verified and evaluated the degree of accumulation ...

  7. La cultura como verdad: pobreza latinoamericana

    OpenAIRE

    Ana María Rocchietti

    2000-01-01

    El artículo parte de un balance crítico de la obra Antropología de la Pobreza, del antropólogo Oscar Lewis para analizar el concepto de pobreza en América Latina. Se argumenta que la cultura de la pobreza ofrece la posibilidad de incluir a las formaciones simbólicas de las tradiciones vivientes y a las que emergen en la existencia comunitaria de los pobres como un factor de peso en la evolución de las relaciones de fuerza entre las clases subalternas y las clases dominantes; entre los sector...

  8. LA PROACTIVIDAD EMPRESARIAL COMO ELEMENTO DE COMPETITIVIDAD.

    OpenAIRE

    Alejandra López- Salazar

    2010-01-01

    El papel del empresario debe basarse en impulsar el cambio y el desarrollo de las organizaciones debiendo contar con las habilidades y características necesarias para lograrlo. Analizar la visión y proactividad empresarial como variables de la cultura empresarial, es de gran importancia para la sobrevivencia y competitividad de la micro, pequeña y mediana empresa. El objetivo de este estudio es analizar el nivel de proactividad y visión que tienen 418 empresarios de la región de Celaya, y det...

  9. Ambientes virtuales como apoyo al Aprendizaje Colaborativo

    OpenAIRE

    Leguizamón, Guillermo; Chiarani, Marcela Cristina; Lucero, María Margarita; Pianucci, Irma Guadalupe; García, Berta Elena; Ponce, Viviana; Allendes Olave, Paola A.

    2005-01-01

    A partir de las conceptualizaciones sobre Educación a Distancia (EaD); y las Tecnologías disponibles para la EAD; se analizan los Ambientes Virtuales y su relación con el Código Abierto; lo que conlleva a presentar, en forma de grilla, las pautas y alcances de evaluación de plataformas virtuales de OS factibles de ser adaptados hacia la consecución de un Ambiente Virtual como apoyo al Aprendizaje Colaborativo. Con la puesta a punto, aplicación y relevo de esta grilla se estará en condicion...

  10. como proyecto lingüístico

    Directory of Open Access Journals (Sweden)

    Ana María Rivas Rivas

    2005-01-01

    Full Text Available Este artículo tiene como objetivo analizar las estructuras discursivas, cognitivas y de representación de algunos de los sectores más desfavorecidos del mercado laboral español y su relación con los modelos interpretativos de la realidad generados y difundidos por el pensamiento economicista neoliberal. Se trata de estudiar los mecanismos por medio de los cuales estos modelos dominantes de la realidad son incorporados por los propios trabajadores y trabajadoras para definir y comprender su situación y para determinar la propia capacidad y posibilidad de modificarla.

  11. Uso de sesquiterpenos eremofilanos como garrapaticidas

    OpenAIRE

    González-Coloma, Azucena; Reina, Matías; Olmeda García, Ángeles Sonia

    2013-01-01

    Uso de al menos un sesquiterpeno eremofilano de fórmula (I) como garrapaticida, donde R{sup,1} es H o OH; [1] es un enlace simple o doble; X se selecciona del grupo que consiste en ausente, CH{sub,3}, OH, OOH y junto a Z forma un epóxido de estructura (ZIV); y Z se selecciona del grupo que consiste en (Z-I), (Z-II), (Z-III) y junto a X forma (Z-IV), preferiblemente el sesquiterpeno (I) es dehidrofukinona, 1 1- hidroxieremofil-6(7), 9(10)-dien-8-ona, 7-11- epoxieremo...

  12. 冠心病心绞痛患者综合护理要点探究%To Explore the Comprehensive Nursing Key Points of Coronary Heart Disease Angina Pectoris Patients

    Institute of Scientific and Technical Information of China (English)

    赵勇敏

    2015-01-01

    目的:探讨分析冠心病心绞痛患者综合护理要点。方法对2014年1月~2015年1月我院收治的30例冠心病心绞痛患者综合护理的临床资料进行回顾性分析,探讨综合护理要点,观察患者心率、收缩压改善情况、心绞痛发作次数及住院时间。结果患者心率、收缩压情况改善明显,分别为(96.6±14.5)次/min、(21.3±1.8)kPa;心绞痛发作次数较护理前减少;患者住院时间为(16.2±1.4)天。结论对冠心病心绞痛患者实施综合护理,可以有效改善患者的心率、收缩压情况,并且减少心绞痛发作次数,缩短患者住院时间,是一种高效、可靠的护理干预措施。%Objective To study the comprehensive analysis of coronary heart disease angina pectoris patient care point. Methods Selected 30 cases with coronary heart disease angina pectoris comprehensive nursing the clinical data from January 2014 and January 2015 in our hospital were analyzed retrospectively, and discussed the key points of nursing care, the patients' heart rate, systolic blood pressure was observed, attack frequency of angina pectoris and length of hospital stay. Results The patients' heart rate, systolic blood pressure is improved obviously, respectively (96.6±14.5) times/min, (21.3±1.8) kPa attack frequency of angina pectoris was reduce before treatment, patients in hospital time was (16.2±1.4) days. Conclusion Comprehensive nursing in patients with coronary heart disease angina pectoris, can improve the patient's heart rate and systolic blood pressure, and decrease the times of angina pectoris attack and shortening the time of patients in hospital, is a efifcient and reliable nursing intervention measures.

  13. Influence of Nursing Intervention on Incidence of Angina Pectoris of Coronary Heart Disease%护理干预对冠心病心绞痛发生率的影响探讨

    Institute of Scientific and Technical Information of China (English)

    袁琳

    2016-01-01

    目的:探究护理干预对冠心病心绞痛发生率的影响。方法选择2015年1月~2016年1月来我院就诊的冠心病心绞痛患者152例为研究对象,将其分成两组,对照组行常规优质护理,以此为基础观察组患者行个性化护理,治疗后,观察两组患者的治疗期间心绞痛发生次数和住院时长。结果和对照组相比,观察组患者在心绞痛发生次数和住院时长方面结果较好,组间数据差异有统计学意义,P <0.05。结论对于冠心病心绞痛患者,使用个性化护理干预,能够在极大程度上降低患者心绞痛发生次数和住院时长,降低医疗成本。%Objective To explore the influence of nursing intervention on the incidence of coronary heart disease angina pectoris. Methods 152 cases of patients with coronary heart disease angina were chosen as the research object from January 2015 to January 2016 in our hospital, it is divided into two groups, control group routine quality care, observation group of patients based on personalized care, after the treatment, observe two groups during the treatment of patients with angina frequency and duration in hospital. Results Compared with control group, the observation group of patients hospitalized in angina frequency and duration, significantly better, data statistical differences between groups, P<0.05. Conclusion For the coronary heart disease angina pectoris, the use of personalized nursing intervention, to reduce the number of patients with angina pectoris occurred on the great degree and the hospitalization time, reduce the medical cost.

  14. Elementos da fenomenologia como uma das possibilidades de compreender o jogo como um movimento humano significativo

    OpenAIRE

    Kunz, Elenor; Marques, Danieli Alves Pereira; Grunennvaldt, José Tarcísio; Surdi, Aguinaldo Cesar; Cunha, António Camilo

    2014-01-01

    O capitulo tem como objetivo fazer uma reflexão a respeito das possíveis relações entre o jogo e o movimento humano significativo. Jogo aqui entendido como conteúdo da Educação Física, que trata de atividades físicas e esportivas e outras formas de movimentos; movimentos esses que são realizados por pessoas com a intenção de auxiliar na descoberta do mundo de forma crítica e criativa. Procurou-se, através da teoria do se-movimentar, mostrar como o jogo e o movimento humano significativo se ap...

  15. Bloque de tierra comprimida como material constructivo

    Directory of Open Access Journals (Sweden)

    Óscar Javier Gutiérrez Junco

    2011-07-01

    Full Text Available La construcción con tierra es poco usada en la actualidad debido a la falta de difusión e investigación, y a que es relacionada con la pobreza; por ende, se desaprovechan muchas de sus ventajas, como la abundancia demateria prima, la localización, la disponibilidad, el reciclaje, la producción sin consumo de energía (calorífica, el bajo costo y la resistencia –con un adecuado estudio del material tierra, de la estructuración y del suelo de fundación–; otras de sus ventajas son el aislamiento térmico y acústico. Con el paso del tiempo se han mejorado las técnicas constructivas con tierra, realizando estabilizaciones e implementando el uso de maquinaria y herramienta mecánica para elaborar bloques de tierra comprimida, y así facilitar el trabajo y obtener mayor rendimiento. Este artículo presenta la tierra como material constructivo, las técnicas o sistemas constructivos, los bloques de tierra comprimida (BTC y algunos ensayos realizados a estos bloques.

  16. Las comunidades locales como estructuras meso.

    Directory of Open Access Journals (Sweden)

    Ferrand, Alexis

    2002-09-01

    Full Text Available Entre el nivel micro y el nivel macro: meso. Si el nivel macro está definido por la regulación nacional, estatal o del mercado y el nivel micro por la regulación interpersonal, una agencia de regulación intermediaria de mayor importancia ha sido definida como “comunidad local” (Wellman, Fischer. Aparte de las dimensiones organizacionales (organizaciones locales, clubes, tiendas... e institucionales (poder local, partidos... locales, es posible definir algunas propiedades estructurales pertinentes de los sistemas de relaciones interpersonales privadas: uno es el grado de “cerrado” (closure local (Barnes: redes locales vs. transversales, o la “dualidad” de estos sistemas. Apoyándose en la idea de que la eficiencia de los “puentes” reside en el tipo de cliques que conectan (Lin, es posible definir tipos variados de micro-estructuras, cuyas distribuciones en diferentes localidades son indicadores sucedáneos o aproximaciones de las diferentes meso estructuras de sistemas relacionales como combinaciones de redes “locales” y “no locales”.

  17. Bloque de tierra comprimida como material constructivo

    Directory of Open Access Journals (Sweden)

    Karen Tatiana Arteaga Medina

    2012-05-01

    Full Text Available La construcción con tierra es poco usada en la actualidad debido a la falta de difusión e investigación, y a que es relacionada con la pobreza; por ende, se desaprovechan muchas de sus ventajas, como la abundancia demateria prima, la localización, la disponibilidad, el reciclaje, la producción sin consumo de energía (calorífica, el bajo costo y la resistencia –con un adecuado estudio del material tierra, de la estructuración y del suelo de fundación–; otras de sus ventajas son el aislamiento térmico y acústico. Con el paso del tiempo se han mejorado las técnicas constructivas con tierra, realizando estabilizaciones e implementando el uso de maquinaria y herramienta mecánica para elaborar bloques de tierra comprimida, y así facilitar el trabajo y obtener mayor rendimiento. Este artículo presenta la tierra como material constructivo, las técnicas o sistemas constructivos, los bloques de tierra comprimida (BTC y algunos ensayos realizados a estos bloques.

  18. A Liberdade como tema: um debate italiano

    Directory of Open Access Journals (Sweden)

    Rego Walquiria D. Leão

    2002-01-01

    Full Text Available O presente trabalho rememora e analisa os termos e as categorias mobilizadas no debate teórico e político, sobre a questão da liberdade, realizado entre liberais-socialistas e comunistas italianos ocorrido nos anos vinte e trinta do século XX. De certo modo, a polêmica esteve presente na fundação mesma do Partido Comunista Italiano, através das reflexões teóricas e da colaboração estreita existente entre o liberal, Piero Gobetti e o marxista, Antonio Gramsci. O diálogo acompanhou a vida do PCI nos mais diversos momentos de sua história, tanto nos momentos de compartilhamento cívico, como o da luta antifascista e a organização da resistência, como nos tempos de reconstrução da Itália nos anos de 1950. Polemizaram assim, pelo lado liberal socialista, Norberto Bobbio, e pelo comunista, o então secretário geral do P.C.I., Palmiro Togliatti.

  19. Marañón como modelo

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    Gracia, Diego

    2013-02-01

    Full Text Available As a result of his consistent attitude as citizen and doctor and his “liberal spirit”, Marañón has gone down in the history of the twentieth century as an archetype. Marañón was, above all, a moralist in the Kantian sense, an autonomous person not governed by external criteria but by duty; a thinker convinced of the transforming role of the positive sciences, towards a happier and more just society through a deep intellectual reform. Marañón, like Fernando de los Rios, integrated Kraussism, neo-Kantianism and socialism and from this ideological platform sought the necessary moral change in the Spanish people.Marañón ha pasado a la historia del siglo XX como arquetipo, debido a su actitud coherente y a su “talante liberal”. Marañón fue, sobre todo, un moralista en el sentido kantiano. Una persona autónoma que no se rigió por criterios externos, sino por deber; un convencido del papel transformador de las ciencias positivas en pos de una sociedad más feliz y más justa gracias a una profunda reforma intelectual. Marañón, como Fernando de los Ríos, integró krausismo, neokantismo y socialismo y desde esa plataforma ideológica, propugnó el necesario cambio moral del pueblo español.

  20. Guatemala como alternativa de desarrollo local

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    Rosa Elba Hernandez Cruz

    2015-01-01

    Full Text Available El área aledaña a la Reserva de la biósfera del Volcán Tacaná, en Chiapas México destaca por la producción de café, además de una alta diversidad de flora y fauna; sin embargo las comunidades rurales que habitan estos espacios están en constante búsqueda de alternativas productivas para mejorar sus medios de vida y cuidar el ambiente el cual está sufriendo deterioro. Ante esta situación se planteó como objetivo la integración de una red de fincas agroecoturísticas en los municipios de Cacahoatán, Tuxtla Chico, Unión Juárez en Chiapas, México y una comunidad en Guatemala. Para construir la propuesta se utilizó la metodología de modos de vida, se realizaron talleres participativos, recorridos en campo y se identificaron los productos turísticos. Se concluye, a partir del análisis de los modos de vida, que la región presenta características y oportunidades para desarrollar la red de agroecoturismo como una alternativa económica.

  1. El manual como texto Schoolbook as text

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    Agustín Escolano Benito

    2012-12-01

    Full Text Available Este trabajo aborda la cuestión de la identidad del libro escolar como un género textual específico en el contexto de la manualística clásica y moderna, contextualizando los análisis en el marco de la cultura de la escuela tradicional y en la era de la revolución digital y bajo una perspectiva historiográfica y teórica. También plantea el nacimiento y primeros desarrollos de la manualística como campo intelectual y académico y sus contribuciones a la definición de la identidad del libro escolar.This paper discusses the question of identifying a coursebook as a specific text genre in the context of the classical and modern manualistics, situating the analysis within the traditional school culture and the digital revolution era, under a historical and theoretical perspective. It also covers the birth and initial development of manualistics as an intelectual and academic field and its contributions to the definition of the schoolbook identity.

  2. Las enfermedades periodontales como infecciones bacterianas

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    A. Bascones Martínez

    2005-12-01

    Full Text Available Las infecciones periodontales son un conjunto de enfermedades localizadas en las encías y estructuras de soporte del diente. Están producidas por ciertas bacterias provenientes de la placa bacteriana. Estas bacterias son esenciales para el inicio de la enfermedad, pero existen factores predisponentes del hospedador y microbianos que influyen en la patogénesis de la enfermedad. La microbiota bacteriana periodontopatógena es necesaria pero no suficiente para que exista enfermedad, siendo necesaria la presencia de un hospedador susceptible. Estas enfermedades se han clasificado en gingivitis, limitadas a las encías y periodontitis, extendidas a tejidos más profundos. La clasificación de las enfermedades periodontales ha ido variando a lo largo de los años y es en el International Workshop for a Clasification of Periodontal Diseases and Conditions, en 1999, cuando se aprueba la clasificación que se expone en este trabajo. En él, se hace una revisión global de los diferentes cuadros de las enfermedades periodontales. Posteriormente, se propone el empleo de antibioterapia de utilización sistémica como la amoxicilina, amoxicilina-clavulánico y metronidazol como primera opción de tratamiento coadyuvante de estas enfermedades.

  3. O escore de risco de sangramento como preditor de mortalidade em pacientes com síndromes coronarianas agudas

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    José Carlos Nicolau

    2013-12-01

    Full Text Available FUNDAMENTO: A ocorrência de sangramento aumenta a mortalidade intra-hospitalar em pacientes com síndromes coronarianas agudas (SCAs, e há uma boa correlação entre os escores de risco de sangramento e a incidência de eventos hemorrágicos. No entanto, o papel dos escores de risco de sangramento como fatores preditivos de mortalidade é pouco estudado. OBJETIVO: Analisar o papel do escore de risco de sangramento como fator preditivo de mortalidade intra-hospitalar numa coorte de pacientes com SCA tratados num centro terciário de cardiologia. MÉTODOS: Dos 1.655 pacientes com SCA (547 com SCA com supra de ST e 1.118 com SCA sem supra de ST, calculou-se o escore de risco de sangramento ACUITY/HORIZONS prospectivamente em 249 pacientes e retrospectivamente nos demais 1.416. Informações sobre mortalidade e complicações hemorrágicas também foram obtidas. RESULTADOS: A idade média da população estudada foi 64,3 ± 12,6 anos e o escore de risco de sangramento médio foi 18 ± 7,7. A correlação entre sangramento e mortalidade foi altamente significativa (p < 0,001; OR = 5,29, assim como a correlação entre escore de sangramento e hemorragia intra-hospitalar (p < 0,001; OR = 1,058, e entre escore de sangramento e mortalidade intra-hospitalar (OR ajustado = 1,121, p < 0,001, área sob a curva ROC 0,753; p < 0,001. O OR ajustado e a área sob a curva ROC para a população com SCA com supra de ST foram 1,046 (p = 0,046 e 0,686 ± 0,040 (p < 0,001, respectivamente, e para SCA sem supra de ST foram 1,150 (p < 0,001 e 0,769 ± 0,036 (p < 0,001, respectivamente. CONCLUSÃO: O escore de risco de sangramento é um fator preditivo muito útil e altamente confiável para mortalidade intra-hospitalar em uma grande variedade de pacientes com SCAs, especialmente aqueles com angina instável ou infarto agudo do miocárdio sem supra de ST.

  4. La verdad como estrategia de legitimación discursiva

    OpenAIRE

    Fuentes Rodríguez, Catalina

    2012-01-01

    La verdad actúa en el discurso parlamentario como marco cognitivo y elemento de legitimación discursiva. El parlamentario lo utiliza como garante de su propia argumentación o argumento de ataque al contrario. Al mismo tiempo, la verdad deriva hacia el plano interpersonal y la estructuración informativa del texto: focalizando ciertos datos o parte de lo conocido para usarlo como fondo justificativo de sus creencias, que impone como conocimiento admitido

  5. Arquitectura como percepción

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    Mañana Borrazás, Patricia

    2003-12-01

    Full Text Available This text sets out to illustrate types of basic analysis in researching a question as intrinsically human as perception. In the analysis of a construction, the aspects relative to perception allow us to access interesting information as to how a construction functions and what is implied by its different spaces, information which is in direct relation to more human, living aspects of architecture. These analyses complement formal analyses, as while these allow us to describe a construction in time and space, analyses of perception seek to stress the existing relationship between the human being and the construction, understanding architecture as a physical element to be experienced and which has been constructed to create a favourable atmosphere for certain perceptions. The study first shows the most basic elements in perception analysis and how these support a methodology that attempts to understand a construction in all its aspects (formal, social, symbolic, giving as an example a Neolithic Galician burial mound.Este texto trata de ilustrar los tipos de análisis básicos para investigar una cuestión tan intrínsecamente humana como la percepción. En el análisis de una construcción, los aspectos relativos a la percepción nos permiten acceder a una interesante información de cómo una construcción funciona y qué implican sus distintos espacios, información en directa relación con los aspectos más humanos y vivenciales de la arquitectura. Son unos análisis complementarios a los análisis formales, ya que mientras estos nos permiten describir en el espacio y en el tiempo una construcción, los análisis de percepción tratan de incidir en la relación existente entre el ser humano y la construcción, entendiendo a la arquitectura también como elemento físico a experimentar y que ha sido construido para propiciar ciertas percepciones. Se exponen en primer lugar las claves más básicas de los análisis de percepción y cómo estos se

  6. 异舒吉治疗不稳定型心绞痛的临床疗效观察%Observation on Clinical Efficacy of Isoket Treating Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    彭国顺; 林晓红

    2003-01-01

    Objective To compare the efficacy of intravenous Isoket with Nitroglycerine in patients with unstable angina pectoris.Methods 70 patients were enrolled and split into treatment group(Isoket group)and control group (Nitroglycerine group) randomly and double-blindedly.There were 36 cases in treatment group who were treated with intravenous Isoket 20~30mg per day for 10 consecutive days;whereas 34 cases in control group who were treated with intravenous Nitroglycerine 10~20mg per day for 10 days.Results 18 cases were significantly effective and 14 patients were effective with total effective rate 88.9% in treatment group compared with 8 cases,11 cases and 55.7% in control group respectively.The treatment group is significantly better than the control group.Conclusion It is effective and safe to treat the patients with unstable angina pectoris with intravenous Isoket.

  7. El "Clientelismo" politico como material novelable

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    Cesar de Vicente Hernando

    2002-12-01

    Full Text Available Lo que instituye el "realismo" en los aproximadamente cien años que median entre la "revolución" burguesa de 1868 ("la Gloriosa" y la ruptura estética de los años sesenta ya en el siglo XX es precisamente lo que definió (y subyace a su producción novelística Benito Peréz Galdós con el título de "La sociedad presente como materia novelable", discurso leído ante la Real Academia Española, con motivo de su recepción en 1897. Este texto es una justificación teórica de lo que viene a ser la inscripción en la literatura de las lunchas y transformaciones ideológicas que la burguesía establece.

  8. La cultura como verdad: pobreza latinoamericana

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    Ana María Rocchietti

    2000-04-01

    Full Text Available El artículo parte de un balance crítico de la obra Antropología de la Pobreza, del antropólogo Oscar Lewis para analizar el concepto de pobreza en América Latina. Se argumenta que la cultura de la pobreza ofrece la posibilidad de incluir a las formaciones simbólicas de las tradiciones vivientes y a las que emergen en la existencia comunitaria de los pobres como un factor de peso en la evolución de las relaciones de fuerza entre las clases subalternas y las clases dominantes; entre los sectores populares rurales y urbanos y los gobiernos; entre las formaciones sociales nacionales y el imperialismo.

  9. Procalcitonina como marcador de sepsis neonatal

    OpenAIRE

    Pereira, Dulce Maria Monteiro

    2011-01-01

    Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas A procalcitonina é uma proteína, produzida nas células C da tiróide, no fígado, macrófagos, pulmão e pâncreas, sendo que a origem parece estar dependente das substâncias estimularas da sua produção. O facto desta ser uma pró-hormona da calcitonina, em nada influencia a produção de PCT, apresentando estas valores diferentes e não correlacionáveis com a prim...

  10. Como Perseu se defendeu de Medusa?

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    Rose Lumertz de Freitas

    2012-04-01

    Full Text Available Na psicanálise francesa, principalmente com Lacan, o conceito de falta passou a ser de grande importância. Ao que, então, perguntamos: o que é a falta? E quando esta falta? O que acontece? O que acontece quando o não especularizável não está excluído, se fazendo, assim, especular? Quando Perseu vai ao encontro de Medusa, guiando-se por sua imagem refletida em um espelho de bronze polido, segurado por Atena, como pôde este herói defender-se de Medusa? Qual foi a forma encontrada por ele para se defender da presença do objeto que introduz a dimensão do real nu?

  11. O PRODUTO COMO CAUSADOR DE ACIDENTES

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    Widomar Carpes Jr

    2004-06-01

    Full Text Available Neste artigo analisa-se a contribuição dos produtos para a geração de acidentes, apresentando-se estatísticas de acidentes de trabalho, de trânsito e aeronáuticos. Além disso, para melhor ilustrar a relação entre produtos e a ocorrência de acidentes, alguns casos de acidentes ocorridos e divulgados pela mídia são comentados. As estatísticas e os casos comentados demonstram a importância do estudo dos acidentes envolvendo produtos, evidenciando que praticamente todos os acidentes estão relacionados com o uso de produtos industrializados. Então, se analisa histórica e criticamente as principais teorias de acidentes de trabalho, porque são as únicas teorias existentes em relação aos acidentes. Além delas, são analisados os diversos conceitos sobre o erro humano e sua ocorrência, pois estes são apontados como grandes causadores de acidentes. Nesta análise, se observa que os acidentes estão mais relacionados aos perigos ou às características perigosas dos produtos do que às atitudes e ao comportamento do usuário. Faz-se uma revisão dos conceitos associados aos acidentes, tais como perigo, risco, acidente e dano, a partir dos quais apresenta-se um fluxograma contendo os elementos necessários para a manifestação dos acidentes. Ao final, conclui-se que a participação dos produtos na ocorrência de acidentes é evidente e que o comportamento do usuário é dependente das características do produto e da situação na qual ele é utilizado.

  12. Taxonomia como elemento estruturante em portais corporativos

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    Luciane Paula Vital

    2012-01-01

    Full Text Available Este trabalho busca discutir os objetivos e requisitos necessários a um portal corporativo e de que forma a construção de uma taxonomia possibilita atingi-los, configurando-se em um modelo de representação da informação e do conhecimento nesse contexto. Apresenta a evolução das intranets em direção aos portais, construindo um ponto de acesso comum as informações organizacionais. Apresenta uma revisão sobre as funcionalidades que um portal corporativo deve apresentar. Conceitua e caracteriza os diferentes tipos de taxonomia e a forma com que organiza e representa a informação. Por fim, apresenta a taxonomia como ferramenta para a determinação de categorias conceituais e de relacionamentos semânticos de uma área, assim como, da estrutura navegacional, permitindo qualificar o processo de recuperação da informação. Palavras-chave Taxonomia. Portais Corporativos. Representação da Informação. Organização da Informação. Abstract This article discusses the objectives and requirements necessary for a corporate portal and how to build a taxonomy allows for to reach them, becoming a model of representation information and knowledge in this context. Shows the evolution of intranets into the portal, building a common access point to information organizational. Presents an overview of the features that an enterprise portal should present. Conceptualizes and describes the different types of taxonomy and the way it organizes and represents information. Finally, the taxonomy as a tool for determining the conceptual categories and semantic relationships of an area, as well as the navigational structure, allowing the process to qualify for retrieval. Keywords Taxonomy. Enterprise Portal. Information Representation. Information Organization.

  13. El desarrollo organizacional como facilitador del cambio

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    Henry Molina

    2000-01-01

    Full Text Available El Desarrollo Organizacional (DO ha surgido de las exigencias de un ambiente cambiante y del conocimiento originado por la evolución de las ciencias sociales aplicadas. Los cambios rápidos dentro del entorno organizacional han exigido procesos y estructuras organizacionales que sean mucho más flexibles y que brinden mayor capacidad de respuesta que las estructuras tradicionales. Se requieren nuevas capacidades individuales y organizacionales que puedan impulsar las iniciativas individuales y la disposición para asumir riesgos. Igualmente, debemos considerar que existen marcadas diferencias entre las características individuales de los gerentes, las características individuales de los profesionales del desarrollo organizacional, sus habilidades y conocimientos y los estilos de las intervenciones del desarrollo organizacional. Tbdas estas diferencias hacen que sea virtualmente imposible predecir con precisión el curso y los resultados de las intervenciones en las organizaciones cliente. En este documento presento un resumen de lecturas acerca del desarrollo organizacional como facilitador del cambio; y expongo un marco de referencia para la comprensión de los factores determinantes de la relación entre las intervenciones del DO y los cambios organizacionales con el fin de mejorar la predictabilidad y la efectividad de los esfuerzos de cambio de sus intervenciones. El propósito central de este documento es dotar a los agentes de cambio de conocimiento y herramientas para que comprendan las características del cambio, los métodos de aprendizaje tanto de las organizaciones como de la gente y de cómo los agentes de cambio deben diseñar sus intervenciones y posteriormente mejorar los resultados de las mismas

  14. Como reescribir funciones aleatorias multivariadas como univariadas para hacer cokrigeage. La teoría

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    Adrian Martínez-Vargas

    2010-03-01

    Full Text Available En el año 2005 Martínez-Vargas formuló un sistema de cokrigeage puro heterotópico para estimar una función aleatoria regionalizada (RF Z*(x definida como la combinación lineal de n RF's univariadas Zi(x, cuyos coeficientes 1i(x son indicatrices de un set disyuntivo de categorías i. Aparentemente este modelo se contradice pues asume que las covarianzas cruzadas existen en un mismo punto, a pesar de su carácter puramente heterotópico. Para evadir dicha contradicción se redefinió el set de RF Zi(x como una única RF Z(x,i, siendo los puntos (x,i y (x,j no coincidentes si i y j no son iguales. La heterotopía fue simplemente considerada como una omisión de la RF Z(x,. en los datos y en los puntos a estimar, no impuesta por el modelo; entonces el resultado es simplemente un caso particular del cokrigeage clásico. Con esta notación se reescribió el sistema de cokrigeage clásico como el sistema de krigeage de la RF univariada Z(x,i, asumiendo que esta posee un drift definido como m(x,i,j, donde los miembros fl(x,i,j de m(x,i,j pueden ser linealmente dependientes o independientes. Bajo esta notación el sistema de krigeage se reduce a un sistema univariado, la existencia de más de una variable o la presencia de heterotropía no impone la necesidad de manipulaciones extras para definir el sistema de ecuaciones de krigeage, incrementándose la eficiencia computacional.

  15. Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?

    DEFF Research Database (Denmark)

    Martensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2016-01-01

    nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved...... by the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark....

  16. Characteristics, treatment and outcome of patients with non-ST-elevation acute coronary syndromes and multivessel coronary artery disease: observations from PURSUIT (Platelet Glycoprotein IIb/IIIa in unstable angina: receptor suppression using integreling therapy)

    OpenAIRE

    Breeman, Arno; Mercado, Nestor; Lenzen, Mattie; Harrington, Robert Alex; Califf, Robert; Topol, Eric; Simoons, Maarten; Brand, Marcel, van den; Boersma, Eric

    2002-01-01

    textabstractBACKGROUND: The 6-month clinical outcome of patients with multivessel disease enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) is described. Patients with complete angiography data were included; multivessel disease was stratified according to the treatment strategy applied early during hospitalization, i.e. medical treatment, percutaneous coronary intervention (PCI) (balloon), PCI (stent), or coronary artery by...

  17. Identificação das Síndromes Coronarianas Agudas (SCA na Medicina Tradicional Chinesa e utilização de acupuntura como terapia coadjuvante à prevenção de agravos

    Directory of Open Access Journals (Sweden)

    Silene Celerino da Fonseca

    2012-06-01

    Full Text Available Introdução: As doenças cardiovasculares constituem a principal causa de morbimortalidade em homens emulheres no Brasil e no mundo. Incluem?se neste grupo de doenças, segundo o Ministério da Saúde: a AnginaEstável, Angina Instável e o Infarto Agudo do Miocárdio denominado de maneira global em SíndromesCoronarianas Agudas. O tratamento das SCA requer cuidado amplo e contínuo na busca da estabilidade clínicae melhora da qualidade de vida do paciente. Com o advento das práticas integrativas, a acupuntura tem?setornado mais evidente e tem estimulado os profissionais da Saúde a aplicá?la em diversas patologias. Estudoscientíficos demonstram que a ação no organismo induz à liberação de neurotransmissores que atuam no tônusvascular e na angina. A acupuntura também atua na redução do estresse, da ansiedade e melhora o bem estarfísico e emocional. Objetivo: O objetivo deste estudo foi identificar as síndromes energéticas envolvidas nosquadros de Síndromes Coronarianas Agudas e verificar a aplicabilidade da acupuntura como métodoterapêutico preventivo. Metodologia: Trata?se de uma revisão teórica realizada em bancos de dados da BVS,LILACS, SCIELO, BIREME e MEDLINE, com dezoito artigos, dezesseis livros, dois manuais, duas teses e umaresolução. Conclusão: A pesquisa permitiu identificar as relações da Síndrome Coronariana Aguda com asSíndromes energéticas descritas na Medicina Tradicional Chinesa. Essa associação é uma possibilidade para aprestação da assistência ao paciente com doença coronariana.

  18. COMPARACIÓN DE ESTRATEGIAS TERAPÉUTICAS PARA EL CONTROL DE LA TENSIÓN ARTERIAL Y LA ANGINA DE PECHO EN PACIENTES CON HIPERTENSIÓN ARTERIAL Y CARDIOPATÍA ISQUÉMICA CRÓNICA EN LA PROVINCIA DE VILLA CLARA. APÉNDICE DEL ESTUDIO INVEST / Comparison of therapeutic strategies for the control of blood pressure and angina in patients with hypertension and chronic ischemic heart disease in the province of Villa Clara. Appendix of INVEST study

    Directory of Open Access Journals (Sweden)

    Omaida J. López Bernal

    2011-06-01

    Full Text Available Background and Objectives: The treatment of hypertension and its complications are a worldwide problem. In our country nearly 25 % of the population over 15 years old is hypertensive, and this figure nearly doubles in those over 60. This research aims to compare two treatment strategies for controlling hypertension in outpatients with chronic coronary ischemic syndrome. Method: A total of 150 patients was included, 73 were randomized to receive calcium antagonist and non-calcium antagonist respectively, as 4 patients were subsequently excluded. Each was asked to sign consent, underwent clinical examination and a 12-lead, conventional electrocardiogram. Blood pressure and episodes of angina were evaluated at 6 months and one year. All variables were entered into a database and statistical analysis was performed using Student's t and Chi square. Results: The mean age was 61,5 years. Women and white skin color were predominant. At 12 months of treatment, blood pressure normalized in more than 80 % of patients without significant differences between the two treatment strategies. Over 75 % of patients in both groups controlled the angina episodes and more than 85 % said the quality of life was good. Conclusions: Control of blood pressure and angina was achieved and there were no significant differences between the two treatment strategies.

  19. Quando um primitivo é como um orbe? Quando um primitivo é como um orbe?

    Directory of Open Access Journals (Sweden)

    J. Hillis Miller

    2008-04-01

    Full Text Available Minhas estratégias de analise textual se tornarão mais ou menos evidentes na leitura que se segue. Sua proveniência deveriam tornar-se & cia. 0 ensaio foi inicialmente pensado come parte do livro The Linguistic Moment (Princeton: Princeton University Press, 1985. Aqui, como no livro, minha preocupação maior e com aqueles momentos em poemas em que a poesia como meio de comunicação constitui problema. Interessa-me particularmente a forma pela qual as fronteiras entre a linguagem conceitual e a figurative se tornam pouco visiveis no poema "A Primitive like an Orb", da última fase da poesia de Wallace Stevens.

  20. La cuestión agraria como enfoque y como problema

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    Carlos Salgado

    2000-04-01

    Full Text Available Este ensayo trata de llamar la atención sobre los problemas del agro hoy, colocando especial énfasis en la disrupción entre las razones tecnológicas –que se asumen como ideológicas–, económicas y políticas que han inspirado el desarrollo del agro, o mejor, sobre las cuales se han basado las políticas de crecimiento agropecuario.

  1. Como obter vantagem competitiva utilizando business intelligence?

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    Avanilde Kemczinski

    2003-03-01

    Full Text Available Este artigo tem por objetivo definir Business Intelligence e identificar as tecnologias de informação e comunicação que dão suporte a este tipo de sistema de informação. Faz-se uma contextualização sobre o conceito e as tipologias de sistemas de informação (SI. Data Warehouse, Data Mart e Data Mining são os recursos tecnológicos denominados de Back-end system, utilizados para armazenar dados relevantes e extrair padrões de comportamento e tendências dos processos organizacionais. Os DSS (Decision Support Systems, EIS (Executive Information Systems e ferramentas de OLAP (On-Line Analytical Processing são caracterizados como Front-end systems para os sistemas de Business Intelligence, requerendo-se ampla funcionalidade, flexibilidade e usabilidade para que o usuário possa fazer a transformação das informações em conhecimento estratégico que apóie a tomada de decisão organizacional, objetivando a vantagem competitiva. Palavras-chave: Sistemas de Informação, Business Intelligence, Data Mining, Data Warehouse, OLAP.

  2. A amizade como paisagem conceitual e o amigo como personagem conceitual, segundo Deleuze e Guattari

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    Hélio Rebello Cardoso Jr.

    2007-01-01

    Full Text Available O presente artigo parte da proposição de uma "pedagogia do conceito" segundo Deleuze e Guattari. Com base na mesma, isola-se e explora-se a idéia de que todo pensamento exige, como sua condição interna, "traços relacionais". Dos traços relacionais definidos pela pedagogia do conceito, enfatiza-se o "amigo" como personagem que caracteriza um dado pensamento. Procura-se, em seguida, definir, panoramicamente, o que seriam o amigo e a paisagem da amizade em filosofias como a de Platão, Nietzsche, Heidegger e Foucault.This paper begins with the proposal of a "pedagogy of concept" according to Deleuze and Guattari. On this basis, I emphasize and explore the assertion that every thought demands relational traces" as their internal condition". Among the relational traces defined by this pedagogy of concept, I selected "friend" as a character who distinguishes a given thought. I try, after that, to define, generally what friend and the scene of friendship in Plato's, Nietzsche's, Heidegger's and Foucault's philosophies are.

  3. The Time Profile of Pentraxin 3 in Patients with Acute ST-Elevation Myocardial Infarction and Stable Angina Pectoris Undergoing Percutaneous Coronary Intervention

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    Ragnhild Helseth

    2014-01-01

    Full Text Available Background. High levels of Pentraxin 3 (PTX3 are reported in acute myocardial infarction (AMI. Aim. To investigate circulating levels and gene expression of PTX3 in patients with AMI and stable angina pectoris (AP undergoing PCI. Methods. Ten patients with AP and 20 patients with AMI were included. Blood samples were drawn before PCI in the AP group and after 3 and 12 hours and days 1, 3, 5, 7, and 14 in both groups. Results. Circulating PTX3 levels were higher in AMI compared to AP at 3 and 12 hours (P<0.001 and P=0.003. Within the AMI group, reduction from 3 hours to all later time points was observed (all P≤0.001. Within the AP group, increase from baseline to 3 hours (P=0.022, followed by reductions thereafter (all P<0.05, was observed. PTX3 mRNA increased in the AMI group from 3 hours to days 7 and 14 in a relative manner of 62% and 73%, while a relative reduction from baseline to 3 and 12 hours of 29% and 37% was seen in the AP group. Conclusion. High circulating PTX3 levels shortly after PCI in AMI indicate that AMI itself influences PTX3 levels. PTX3 mRNA might be in response to fluctuations in circulating levels.

  4. ANALYSIS OF COST STRUCTURE FOR PHARMACOTHERAPY OF PATIENTS WITH STABLE ANGINA (THE CASE OF CARDIOLOGY DEPARTMENT OF TVER REGIONAL CLINICAL HOSPITAL

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    M. A. Demidova

    2015-12-01

    Full Text Available Aim. To analyze the cost structure for pharmacotherapy of patients with stable angina (SA, in particular, to compare the cost of pharmacotherapy with drugs, both included and not included into the official Standard of care (SC. Material and methods. Medical records of patients with SA (n=100 admitted to the cardiology department of Tver Regional Clinical Hospital in January-July 2010 were studied retrospectivelly. Costs of treatment with drugs specified in SC for patients with SA as well as drugs not included in SC were considered. Costs of pharmacotherapy and cost structure were determined. Pharmacoeconomical methods, especially ABC analysis, were partially used.  Results. Totally 65502.39 ruble was spent for pharmacotherapy of 100 patients with SA. Cost structure was the following: 32679.34 ruble was spent for drugs recommended by SC, 23698.18 ruble — for drugs not included in SC, and 9124.87 ruble — for drugs to treat concomitant diseases which are not taken into account by SC for patients with SA. Conclusion. SA pharmacotherapy counts 50% of the total cost for drugs recommended by SC, 36% — for drugs not included in SC but belonged to pharmacological class presented in SC, and 14% — drugs from pharmacological class not included in SC. In the process of new SC elaboration for SA patients it is necessary to take into account treatment costs of concomitant diseases especially diabetes mellitus which can account up to 9.5% of total treatment cost of SA patients.

  5. Clinical Trial Study on Effect of Yangxinshi Tablets in Treatment of Angina Pectoris of Coronary Heart Disease%养心氏片治疗心绞痛及冠心病临床试验资料研究

    Institute of Scientific and Technical Information of China (English)

    崔燕; 张辉; 庄婕

    2013-01-01

    Through searching the clinical trial data of Yangxinshi Tablets, the total of 1281 cases were summed up for the effects of Yangxinshi Tablets on the treatment of angina pectoris, diabetes angina, stable angina, coronary heart disease. The clinical effects of Yangxinshi Tablets were as follows:the curative effect on angina was approximately 72.00%-95.30%, the curative effect on traditional Chinese medicine symptoms was 78.90%-95.00%, the curative effect on electrocardiogram was 42.90%-81.30%, and nitroglycerin stop reduction rate is generally determined to be valid for more than 50%. Compared with the chosen control drugs, clinical efficacy of Yangxinshi Tablets was better than isosorbide dinitrate and isosorbide mononitrate, which were western medicines. Clinical efficacy of the combination of isosorbide dinitrate and Yangxinshi Tablets was superior to Compound Danshen Tablets and Compound Danshen Granales, and equivalent to Musk Heart-saving Drop Pill. Combined application of Yangxinshi Tablets and hypoglycemic agents was effective in the treatment on diabetes angina. Consequently, Yangxinshi Tablets could reduce cardiac stress, increase coronary blood flow, resist myocardial ischemia, prolong antianoxia time, and lower blood pressure and blood lipids to a certain extent. Yangxinshi Tablets had good effects on coronary heart disease and angina, especially on Qi deficiency and blood stasis type angina and myocardial infarction. What is more, Yangxinshi Tablets could be used in a long time without toxic effect.%  检索养心氏片临床试验的文献,总结养心氏片治疗心绞痛、糖尿病性心绞痛、稳定型心绞痛、冠心病,共1281例。养心氏片临床疗效:心绞痛疗效总有效率72.0%~95.30%,中医症状疗效总有效率78.90%~95.00%,心电图疗效42.90%~81.30%;硝酸甘油停减率一般在50%以上判定为有效。与所选择的对照药相比,养心氏片的临床疗效优于所对照的西药硝酸异山梨酯(

  6. El sistema educativo como yacimiento de empleo

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    Antoni J. COLOM CAÑELLAS

    2009-11-01

    Full Text Available RESUMEN: Tras realizar una revisión al concepto de «Nuevo yacimiento de empleo» (origen, desarrollo, definición, funcionalidad, etc., se plantean sus posibilidades en el campo educativo, dando lugar a dos perspectivas: la formación necesaria para desarrollar yacimientos de empleo y, considerar a la educación, al sistema educativo, como un nuevo yacimiento de empleo. Tomando esta segunda acepción, se realiza un estudio empírico de las posibilidades que oferta el sistema educativo de las Islas Baleares como nuevo yacimiento de empleo. En él encontramos posibilidades de empleo en tareas de servicios y en las actividades complementarias escolares, llegando a la conclusión de que el sistema educativo de las Islas Baleares (que sólo afecta a unos 850.000 habitantes, encierra una capacidad económica muy significativa (sobre los 20 millones de euros cuyo capital podría desarrollarse socialmente si se cumplimentasen una serie de exigencias que analizamos en nuestro trabajo.ABSTRACT: After revising the concept «New source for employment» (origin, development, definition functionality, etc., its possibilities in the field of education are suggested, giving way to two perspectives: the training needed to develop sources for employment and, to consider education, the education system itself, as a new source for employment. Taking into consideration the latter proposal, we have carried out an empirical study of the possibilities offered by the system of education in the Balearic Islands, as a new source for employment. In it we can find possibilities for employment in the service sector and in the complementary activities of schools, thereby reaching the conclusion that the educational system of the Balearic Islands (which only affects around 850.000 inhabitants, entails a very significant economy capacity (of about 20 millions euros, which could be developed socially if a series of requirements that we are analysing in our work are met

  7. Como Lo Hago Yo: Mielomeningocele En Bolivia

    Science.gov (United States)

    Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

    2014-01-01

    Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusi

  8. La participacion ciudadana como fuente de democracia

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    Orlando José Cadrazco Salcedo

    2009-01-01

    Full Text Available Resumen:La Participación ciudadana es un órgano de deliberación donde confluyen todos los factores reales de poder paradecidir sobre aspectos como el plan de desarrollo, plan de ordenamiento territorial y presupuesto (atendiendo alente territorial donde se establezca , en sí este modelo es un verdadero desarrollo del concepto de democraciaparticipativa que consagra nuestra Carta Política, es un ejemplo de que la soberanía popular consagrada en elartículo tercero de la Carta va más allá del formalismo legalista y los intrincados vericuetos de la ley 134 de 1994que nunca han permitido que se ponga en marcha un verdadero desarrollo de la democracia participativa, y quepor fin salgamos de ese esquema retrogrado de la representatividad y por supuesto que a través de este modelolleguemos a un verdadero contrato social que provenga de las bases.Palabras claves:Democracia Participativa. Carta Politica, Sociedad, Participaciòn Ciudadana, Modelo Democrático, ConstituciónPolítica.Abstract:Citizen participation is a deliberative body where all the real power to decide on aspects such as the developmentplan, development plan and budget (according to the local authority where it is established, this model is itself atrue development the concept of participatory democracy enshrined in our Constitution, is an example of popularsovereignty enshrined in the third article of the Charter goes beyond the legal formalities and vericuetos the intricaciesof the law 134 of 1994 which have never been allowed to put ongoing development of a true participatorydemocracy, and they finally get out of this backward scheme of representation and of course that through this modelto create a real social contract comes from the grassroots.Keywords:Participatory Democracy. Charter Politics, Society, Politics, democratic, Constitution.

  9. EL NIÑO Y ADOLESCENTE COMO CIUDADANO MEXICANO

    OpenAIRE

    Laura E. CANCHÉ ARTEAGA

    2012-01-01

    En este artículo se aborda el tema de la ciudadanía y los derechos del niño y adolescente en el mismo contexto. Tomamos como base la interpretación de los derechos de participación establecidos en la Convención sobre los Derechos del Niño que lo reconoce como ser humano con capacidad de emitir un juicio. Se analizan como punto de partida conceptos básicos como democracia, ciudadanía y derechos políticos. Asimismo, se abordan las consideraciones, en contra y a favor, sobre el reconocimiento de...

  10. La medicine como ciencia arte, ciencia y humanismo

    OpenAIRE

    López Merino, Vicente

    2011-01-01

    En los primeros escritos griegos se designa la medicina como "téchné iatriké", una téchné especial que pasó al mundo romano a través de la palabra ars (ars medica ó ars clinica) que siempre se ha traducido como "arte", é incluso se atribuye a Dungalo, monje de la escuela palatina de Aquitania, en la alta Edad Media, haber sido el primero que propuso la inclusión de la medicina como la octava entre las Artes liberales y entre ellas se ha encontrado hasta hoy y se ha admitido así como expresión...

  11. O direito como juízo

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    Denise Maria Weiss de Paula Machado

    1988-07-01

    Full Text Available This study presents a synthetic and personal view of the consequences arising from the notion of law as justice. For Kelsen, in this "Theory of pure law", human conduct produce facts, justly or injust1y, that become characterized as legal norms. Human behavior is determined by acts of reason, that are defined by a representative (a judge, and then are used as valid norms of justice. The conception of law is, therefore, represented by an ideal object, rational and only apprehensible through abstract processes, following the views of Kelsenians. Without any intent to criticize the "great master of Vienna", a search of the text demonstrates that a neutral ideology, concerning the comprehension and application of law, does not and can not exists law can not depart from empirical reality when following its purpose of promoting the liberty and development of society.O presente texto tem por finalidade apresentar uma visão sintética e pessoal das conseqüências decorrentes da noção do direito como juízo. Para KELSEN, em sua "Teoria pura do direito", a conduta humana produz fatos jurídicos ou injurídicos, conforme assim os caracterizam as normas jurídicas. A conduta humana é determinada por uma razão de agir, que é definida pela representação juízo que o homem tem da norma jurídica 'vigente. A concepção do direito é, pois, representada por um objeto ideal, racional e somente apreensível através de um processo de abstração, segundo a visão Kelseniana. Sem a mínima pretensão de formular críticas ao grande Mestre de Viena, procura o texto demonstrar que a neutralidade ideológica, para a compreensão e aplicação do direito, não existe e nem pode existir, eis que o direito não pode se afastar da realidade empírica, a fim de que possa alcançar sua finalidade de promover a libertação e a evolução da sociedade.

  12. La familia como campo de saber de las ciencias sociales

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    Yolanda López

    2003-01-01

    Full Text Available Como categoría socio-cultural y como campo de conflictos, la familia constituye un objeto de investigación e intervención de diferentes disciplinas. Si bien cada campo de saber define con respecto a la familia su objeto de estudio, la comprensión de la co

  13. El humanismo como paradigma de la enfermería como ciencia

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    Núñez Gómez Nicolás Arturo

    1999-12-01

    Full Text Available

    Humanism's philosophical conception is presented to development a paradigm of nursing science. The nursing from creation has been guided toward professional practice and category; of Care has been fundamental contribution. In this article our intends is to grow some fine general of reflection so that nurses contribute to development of a science called nursing and whose accent is man in their multiple dimensions.

    A partir del humanismo como concepción filosófica se presenta una propuesta para crear un paradigma de la enfermería como ciencia. Desde su creación, la enfermería se ha orientado hacia su práctica profesional y la categoría de cuidado ha sido su aporte fundamental. Este artículo se propone crear unas líneas generales de reflexión, para que las enfermeras aporten al desarrollo de una ciencia llamada enfermería y cuyo acento es el hombre en sus múltiples dimensiones.

  14. A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of STA-2 (Green Tea Polyphenols) in Patients with Chronic Stable Angina

    Science.gov (United States)

    Lee, Tsung-Ming; Charng, Min-Ji; Tseng, Chuen-Den; Lai, Ling-Ping

    2016-01-01

    Background Green tea intake has been shown to improve endurance capacity in animal studies, but whether it has a similar effect on humans remains unclear. A randomized, double-blinded, parallel-controlled study was conducted to evaluate the short-term effect of STA-2, a pharmaceutical preparation of green tea polyphenols, in patients with effort-induced angina and documented positive exercise tolerance test. Methods A total of 79 patients recruited from three medical centers were randomly assigned to receive 2 STA-2 250 mg capsules, each containing 100 mg green tea polyphenols, three times daily, or placebo for six weeks after two consecutive symptom-limited treadmill exercise tests to ascertain the reproducibility of exercise tolerance. Results There was no difference in total exercise tolerance time from baseline to Week 6 between two groups (p = 0.639). There were also no observed improvements in subgroup analyses stratified by age, gender, and BMI categories. However, a significant reduction in low-density lipoprotein levels was shown in patients in the STA-2 group (-8.99 ± 19.18 mg/dL) versus the placebo group (0.57 ± 19.77 mg/dL), p = 0.037, with greater benefits in patients not taking antihyperlipidemic drugs (STA-2: -9.10 ± 19.96 mg/dL vs. placebo: 4.42 ± 15.08 mg/dL, p = 0.037). Conclusions STA-2 treatment for 6 weeks did not increase exercise time as measured on a treadmill. However, this study also indicated that STA-2 treatment could have potential beneficial effects on LDL-cholesterol concentrations. PMID:27471357

  15. [Exercise-induced ST segment shift in vasospastic angina with special reference to comparisons between treadmill and bicycle ergometer exercise testings].

    Science.gov (United States)

    Kasai, A; Yamakado, T; Masuda, T; Aoki, T; Futagami, Y; Hamada, M; Nakano, T

    1991-01-01

    To assess the difference between cardiovascular responses to treadmill exercise (TM) and those to bicycle ergometer exercise (EM) in provoking coronary spasm, we compared the ST segment shifts (elevation or depression) during TM and EM in 67 patients with vasospastic angina. Coronary artery spasm was demonstrated on angiography. Both TM and EM were performed on the same day during a medication-free period. For both tests, multistage, symptom-limited exercise protocols were used; EM in the morning and TM in the afternoon. The results obtained were as follows: 1. Rate-pressure products at peak exercise during TM and EM were similar. Systolic blood pressure levels at peak exercise were higher during EM than during TM (p < 0.01). The patients' heart rates at peak exercise were higher during TM than during EM (p < 0.01). Diastolic blood pressure levels at peak exercise were higher during EM than during TM (p < 0.05). 2. Exercise-induced ST elevation occurred more frequently with TM than with EM (19% vs 9%, p < 0.05). 3. Exercise-induced ST depression was provided in 27 patients during TM and in 13 during EM (40% vs 19%, p < 0.01). Among 45 patients without significant lesions, ST depression occurred in 19 during TM, but in only 7 during EM (42% vs 16%, p < 0.01). In conclusion, coronary spasm seemed to occur more frequently with TM than with EM. The mechanism causing such difference remains to be elucidated, however, we speculate that the difference between TM and EM as to enhanced autonomous nervous system activity and coronary perfusion exercise may be related to the difference in the incidence of coronary spasm. PMID:1841908

  16. Effects of Ginkgo Leaf Extract on Function of Dendritic Cells and Th1/Th2 Cytokines in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    LI Da-zhu; SHARMA Ranjit; ZENG Qiu-tang

    2005-01-01

    Objective: To investigate the effects of Ginkgo leaf extract (GLE) on function of dendritic cells (DC) and Th1/Th2 cytokines in patients with unstable angina pectoris(UAP). Methods: Fifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor (GMCSF) and interleukin-4 (IL-4) to induce mature DC. The expression of co-stimulating factor CD86 (B7-2) on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction (MLR). The blood levels of cytokines, interferon-γ (IFN-γ), and IL-4, were analyzed by ELISA, and blood C-reactive protein (CRP) level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DC were also tested in vitro. Results: After treatment, CD86 expression on DC, the stimulating capacity of DC as well as levels of IFN-γ and CRP were lowered in both groups ( P<0.05 or P<0.01), but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DC. Conclusion: The inhibition of GLE on DC and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

  17. CHANGES OF CELLULAR ADHESION MOLECULES AND COMPLEMENT COMPONENT IN SERUM OF PATIENTS WITH UNSTABLE ANGINA%不稳定型心绞痛病人sCAMS与sC5b-9的变化

    Institute of Scientific and Technical Information of China (English)

    王立杰; 王红巧

    2011-01-01

    目的 探讨不稳定型心绞痛(UA)病人可溶性细胞黏附分子(sCAMS)与可溶性补体激活产物(sC5b-9)水平的变化及其意义.方法 采用ELISA方法 检测36例健康人和110例UA病人血清sCAMS、sC5b-9浓度的变化.结果 UA病人血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞间黏附分子-1(sVCAM-1)、sC5b-9浓度明显高于对照组,差异有极显著性(t=4.485~37.314,P<0.001);心绞痛发作时sICAM-1、sVCAM-1、sC5b-9的浓度增高较缓解后更明显(t=5.764~30.638,P<0.001);不同类型的心绞痛病人发作时和缓解后sICAM-1、sVCAM-1、sC5b-9浓度差异也有显著性(F=12.074~709.477,q=3.340~52.308,P<0.05~0.001);自发性心绞痛病人sCAMS、sC5b-9浓度增高较其他类型更明显.心绞痛发作时和缓解后,血清sC5b-9与sICAM-1、sVCAM-1浓度呈正相关(r=0.530~0.703,P<0.001).结论 UA的发生发展与CAMS和sC5b-9浓度变化有密切关系.%Objective To discuss the significance of changes of the levels of soluble cellular adhesion molecules (sCAMS) and complement activation component (sC5b-9) in patients with unstable angina (UA). Methods Using enzyme-linked immu-nosorbent assay (ELISA) , changes of serum levels of sCAMS and sC5b-9 were detected in 110 UA patients and 36 healthy people. Results Levels of soluble intercellular adhesion moleeule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1 (sVCAM-1) and sC5b-9 in UA patients were significantly higher than that in healthy controls (t=4. 485 - 37. 314,P<0. 001) ; At angina pecto-ris attacks, the elevation of levels of sICAM-1, sVCAM-1 and sC5b-9 were more significant than after remission (2 = 5. 764 - 30. 638,P<0. 001). The differences of the above parameters in different type of patients at angina pectoris attacks and at remission were also significant (F=12. 074-709. 477;q=3. 340 - 52. 308;P<0. 05 - 0. 001), especially in those with spontaneous angina pectoris. The level of sC5b-9 was positively

  18. Clinical Experience of Beta Blocker Therapy in Unstable Angina%β受体阻滞剂治疗不稳定型心绞痛的临床体会

    Institute of Scientific and Technical Information of China (English)

    许志茹

    2015-01-01

    目的:针对β受体阻滞剂治疗不稳定型心绞痛的临床体会进行分析。方法选择我院在2013年6月~2014年6月期间,收治的80例不稳定型心绞痛患者,分为对照组和观察组。对照组常规心绞痛治疗,观察组常规治疗+β受体阻滞剂治疗。观察两组患者的临床治疗效果、不良反应、心绞痛发作情况。结果观察组与对照组患者的临床治疗总有效率分别为95.00%、65.00%,P<0.05,具有统计学意义。观察组与对照组患者的不良反应发生率分别为2.50%、15.00%,P<0.05,具有统计学意义。观察组与对照组患者的心绞痛发作次数和持续时间均有显著差异,P<0.05,具有统计学意义。结论在不稳定型心绞痛治疗中,β受体阻滞剂发挥重要作用,可以改善患者临床症状,降低不良反应,提高患者生活质量。%Objective To analysis Beta blockers in the treatment of unstable angina clinical experience. Methods Selected 80 patients with unstable angina treated in June 2013~June 2014, divided into control group and observation group. The control group conventional treatment angina pectoris, observation group conventional treatment+beta blockers. Observed the clinical therapeutic effect of two groups of patients, adverse reactions, angina pectoris attack Situation. Results Observation group and control group in patients with the clinical total effective rate respectively were 95.00%, 65.00%, P<0.05, there was statistical significance. Observation group and control group patients the incidence of adverse reactions were 2.50%, 15.00%, P<0.05, there was statistical significance. Observation group and control group in patients with angina frequency and duration were signiifcantly different, P<0.05, there was statistical signiifcance. Conclusion In the treatment of unstable angina, β-blockers play an important role, can improve the clinical symptoms and reduce adverse reactions and improve the

  19. 音乐疗法对类心绞痛患者抑郁焦虑状态的干预%Music therapy on patients with angina pectoris class depression anxiety state intervention

    Institute of Scientific and Technical Information of China (English)

    姚倩; 李莉; 彭顺蓉

    2013-01-01

    Objective To study music therapy on patients with angina pectoris class depression anxiety state intervention effect.Methods From June 2009 to August 2012 will depression self rating scale (SDS) and anxiety self-assessment scale (SAS) score 50 points at the same time > 110 cases of the kind of angina pectoris patients were randomly divided into use music therapy in nursing intervention group and control group,evaluate and compare two groups of SDS and SAS box score index signs.Results Music therapy intervention to 3 ~ 4w,the patients with SDS box SAS scores have significantly reduced (P < 0.05),systolic blood pressure have decreased obviously (P < 0.01).Conclusion Music therapy for classes angina pectoris patients depressive state improvement and signs control have a positive effect.%目的 探讨音乐疗法对类心绞痛患者抑郁焦虑状态的干预效果.方法 于2009年6月~2012年8月将抑郁自评量表(SDS)和焦虑自评量表(SAS)评分同时>50分的110例类心绞痛患者随机分为用音乐疗法进行护理干预组和对照组,评定并比较两组SDS和SAS得分及体征指标.结果 音乐疗法干预到第3~4周时,患者的SDS和SAS评分有明显的降低(P<0.05),收缩压也有明显下降(P<0.01).结论 音乐疗法对于类心绞痛患者抑郁状态的改善和体征的控制有积极的作用.

  20. Simvastatin Combined With Low Molecular Heparin in the Treatment of Coronary Heart Disease Angina Pectoris%辛伐他汀联合低分子肝素钠治疗冠心病心绞痛效果探讨

    Institute of Scientific and Technical Information of China (English)

    李海男

    2015-01-01

    Objective To study the effect of simvastatin combined with low molecular heparin for treatment of coronary heart disease angina pectoris. Methods Using digital random method to divided 156 cases into control group and observation group,78 cases in each group. Control group patients were given anti angina pectoris drugs for regular treatment,observation group patients were given simvastatin combined with low molecular heparin,compared two groups of therapeutic effect. Results In observation group,total effective rate was significantly higher than control group,the difference was statistical y significant(P<0.05). Conclusion Simvastatin combined with low molecular heparin sodium have exact curative effect on coronary heart disease angina pectoris.%目的:研究分析辛伐他汀联合低分子肝素钠治疗冠心病心绞痛的临床效果。方法将156例患者按照数字随机法均分为对照组和观察组,每组各78例。对照组患者给予抗心绞痛药物进行常规治疗,观察组患者在对照组的基础上给予辛伐他汀联合低分子肝素钠进行治疗,比较两组治疗效果。结果观察组治疗总有效率高于对照组的高,差异具有统计学意义(P<0.05)。结论辛伐他汀联合低分子肝素钠治疗冠心病心绞痛疗效更加确切,而且安全性高,有效改善患者的病情,提高生活质量。

  1. Como reescribir funciones aleatorias multivariadas como univariadas para hacer cokrigeage. La teoría

    OpenAIRE

    Adrian Martínez-Vargas

    2010-01-01

    En el año 2005 Martínez-Vargas formuló un sistema de cokrigeage puro heterotópico para estimar una función aleatoria regionalizada (RF) Z*(x) definida como la combinación lineal de n RF's univariadas Zi(x), cuyos coeficientes 1i(x) son indicatrices de un set disyuntivo de categorías i. Aparentemente este modelo se contradice pues asume que las covarianzas cruzadas existen en un mismo punto, a pesar de su carácter puramente heterotópico. Para evadir dicha contradicción se redefinió el set de R...

  2. Clinical Effects Observation of Compound Danseng Dripping Pills in Treating Unsteady Angina Pectoris Patients%复方丹参滴丸治疗不稳定性心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    王昕

    2001-01-01

    Aim To observe the clinical effects of treatment for curing the unsteady angina pectoris(belonging to the blood blocked heart vessels symptoms) by taking advantage of the Chinese medicine called compound Danseng dripping pills.Methods By means of randomization control and on the basis of regular treatments,38 cases of the treated group adopt the dripping pills for treatment,meanwhile,35 cases of the control group adopt the Isosorbide dinitrate.Either of the treatments takes four weeks.Observing the changes of the two groups in symptoms,classified angina pectoris,ECG,the blood-flowing power and so on.Results The effect rate of the treated group is 92.1%.Compared with the control group,it has remarkable differences in classified angina pectoris,improving the heart vessels and the character of blood blowing(P<0.05,P<0.001) without any adverse reaction.Conclusion The compound danseng dripping pills have remarkable effects on the unsteady angina pectoris.%目的观察中成药复方丹参滴丸治疗冠心病不稳定性心绞痛(属心血瘀阻证)的临床疗效。方法采用随机对照法,在常规治疗基础上,治疗组38例使用复方丹参滴丸治疗,对照组35例使用硝酸异山梨醇酯片治疗,疗程均为4周。观察两组症状,治疗前后心绞痛分级,心电图,血流动力学等变化。结果治疗组总有效率为92.1%,对心绞痛分级,改善缺血心电图以及改善血液流变性等,与对照组比较,均有显著性差异(P<0.05,P<0.001),无不良反应。结论复方丹参滴丸对不稳定性心绞痛有较显著疗效。

  3. 逐瘀还五解毒颗粒治疗冠心病心绞痛临床研究%Clinical Research of Zhuyu Huanwu Jiedu Granule in Treating Coronary Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    李凯文; 史佃磊; 王凤红; 唐海莲

    2012-01-01

    Objective:To explore the influence of Zhuyu Huanwu Jiedu granule on coronary angina pectoris on clinical symptoms and e-lectrocardiogram changes and evaluate the clinical effects of zhuyu huanwu jiedu granule in treating coronary angina pectoris. Methods: 94 cases of coronary angina pectoris were randomly divided into two groups. The control group was treated by basic western medicine. The treatment group was orally given Zhuyu Huanwu Jiedu granule (composition:peach kernel 12 g,safflower 9 g, Angelica 9 g,dried rehmannia root 9 g,hemlock parsley 4. 5 g.red peony root 6 g, Achyranthes bidentata 9 g.Platycodon grandiflorum 4. 5 g,Chinese thoro-wax 3 g,fructus 6 g,licorice root 6 g,Astragalus membranaceus 18 g,Earthworm 9 g,honeysuckle 12 g,dandelionl2 g) based on the control group. 2 weeks were one treatment course for both groups. Results: Patients' clinical symptoms and the improvement of electrocardiogram in the treatment group were obviously superior to the control group. Conclusion: Zhuyu Huanwu Jiedu granule has a satisfactory therapeutic effect in treating coronary angina pectoris.%目的:探讨逐瘀还五解毒颗粒对冠心痛心绞痛的症状及心电图变化的影响,评估逐瘀还五解毒颗粒治疗冠心病心绞痛的临床疗效.方法:将94例冠心病心绞痛患者随机分为两组,对照组给予基础西药治疗,治疗组在对照组治疗基础上加用逐瘀还五解毒颗粒(方药组成:桃仁12 g,红花9 g,当归9 g,生地黄9 g,川芎4.5g,赤芍6 g,牛膝9 g,桔梗4.5g,柴胡3 g,枳壳6 g,甘草6 g,黄芪18 g,地龙9 g,金银花12 g,蒲公英12 g)治疗,2周为1个疗程.结果:治疗组患者的症状及心电图的改善明显优于对照组.结论:逐瘀还五解毒颗粒治疗冠心病心绞痛疗效满意.

  4. 益气活血法对不稳定型心绞痛心肌能量代谢的影响%Supplementing Qi and Activating Blood Circulation Method for Unstable Angina Myocardial Energy Metabolism

    Institute of Scientific and Technical Information of China (English)

    杨佳瑞; 刘东方

    2014-01-01

    Objective:To observe supplementing Qi and activating blood circulation method for unstable angina myocardial energy metabolism .Methods:80 patients with unstable angina patients were randomly divided into treatment group and control group .Compare two groups before and after medication weekly frequency of angina attack, nitroglycerin stopped reduction rate , resting electrocardiogram changes and changes in serum free fatty acid (FFA) contents.Results:After treatment in both groups after treatment nitroglycerin stopped reduction rate and weekly frequency of angina attack , resting electrocardiogram changes and changes in serum free fatty acid (FFA) contents had no significant difference (P>0.05).Conclusion:Supplementing Qi and activating blood circulation method may take use of influencing the myocardial energy metabolism to play the role in the protection of ischemic myocardium and to reduce the occurrence of clinical cardiovascular events .%目的:观察益气活血法对不稳定型心绞痛心肌能量代谢的影响。方法:80例符合纳入标准的不稳定型心绞痛患者随机分为治疗组和对照组,在常规治疗的基础上,治疗组给予益气活血中药汤剂,对照组口服万爽力,比较两组用药前后每周心绞痛发作频率、硝酸甘油减停率、静息心电图变化及血清中游离脂肪酸( FFA)含量变化。结果:两组患者治疗后硝酸甘油减停率、每周心绞痛发作频率、静息心电图变化及血清中游离脂肪酸(FFA)含量变化无显著差异(P>0.05)。结论:益气活血法可能通过影响心肌能量代谢达到保护缺血心肌的作用,以减少临床心血管事件的发生。

  5. A Study on Syndrome of Angina Pectoris of Coronary Heart Disease Based on Feature Weighted Cluster Analysis%基于特征加权的冠心病心绞痛证候聚类研究

    Institute of Scientific and Technical Information of China (English)

    邹演梅; 张天奉

    2011-01-01

    目的:探讨冠心病心绞痛中医证候分型及分布规律.方法:根据收集符合纳入标准的冠心病心绞痛患者证候信息,并利用Access软件建立冠心病心绞痛证候信息数据库,然后将录入的证候信息导入SPSS进行聚类分析,归纳符合临床的合理证型.结果:通过聚类分析认为冠心痛心绞痛证候聚成气虚血瘀证、痰浊内阻证、阴虚痰瘀证、气滞痰热证、寒凝血瘀证、气阴两虚证、阴虚痰瘀证7类比较合理.结论:基于特征加权的聚类分析所得的冠心痛心绞痛证候分型与临床有较高的符合度,该方法可以在疾病证候分型研究领域进一步推广.%Objective: To discuss the syndrome-types and syndrome distribution of angina pectoris of coronary heart disease. Method: According to “coronary heart disease syndromes information collection form" to collect the angina pectoris of coronary heart disease syndromes information, and use the Access software to establish coronary syndromes database, then input the information into SPSS to cluster analysis,sum up a reasonable clinical syndromes. Result: It is more reasonable that the syndrome of angina pectoris of coronary heart disease are divided into seven types by cluster analysis, they are Qi-deficiency and blood stasis syndrome, phlegm-dampness syndrome, Yin-deficiency and phlegm-blood stasis syndrome, Qistagnation and phlegm-heat syndrome, Harning blood stasis syndrome, Qi and Yin-deficiency syndrome,Yin-deficiency and phlegm-heat syndrome. Conclusion: The syndrome-types of angina pectoris of coronary heart disease based on feature weighted cluster analysis have a higher accordance with clinical, this method can be further extended to syndrome classification research field of disease.

  6. Treatment Experience in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Nocturnal Angina%阻塞性睡眠呼吸低通气综合征并夜间心绞痛的治疗体会

    Institute of Scientific and Technical Information of China (English)

    朱梅生

    2016-01-01

    目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对夜间心绞痛的影响及有效治疗的方法。方法对39例阻塞性睡眠呼吸暂停低通气综合征合并夜间心绞痛患者给予经鼻持续正压通气治疗,采用多导睡眠监测系统进行整夜睡眠监测,比较治疗前后指标改善及症状改善情况。结果患者治疗后睡眠呼吸暂停低通气指数、心肌缺血发作率、心肌梗死发作率、心电图异常率降低(P<0.05),夜间最低血氧饱和度、血压控制良好率增加(P<0.05),夜间心绞痛发作次数减少(P<0.05),左室射血分数改善差异无统计学意义(P>0.05)。结论阻塞性睡眠呼吸暂停低通气综合征诱发加重夜间心绞痛,经鼻持续正压通气治疗可改善阻塞性睡眠呼吸暂停低通气综合征合并夜间心绞痛患者的症状。%Objective To investigate effect and effective treat methods of patients with obstructive sleep apnea hypopnea syndrome and nocturnal angina.Methods 39 patients with obstructive sleep apnea hypopnea syndrome and nocturnal angina treated by nasal continuous positive airway pressure. Sleep monitoring was carried out by multi-guide sleep monitoring system. Improvement of indicators and disorders were compared before and after treatment.Results Sleep apnea hypopnea index,myocardial ischemic attack rate,myocardial infarction attack rate,ECG abnormal rate decreased significantly after treatment(P0.05). Conclusion Obstructive sleep apnea hypopnea syndrome can induce exacerbation of nocturnal angina. Nasal continuous positive airway pressure therapy can improve the symptoms of patients with obstructive sleep apnea hypopnea syndrome and nocturnal angina.

  7. El Derecho Agrario como derecho para la paz

    Directory of Open Access Journals (Sweden)

    Ricardo Zeledón Zeledón

    2015-01-01

    Full Text Available Contenido: El Derecho agrario surgido de la paz y para la consolidación de la paz, como fuente e instrumento para su cumplimiento. La visión de Carrozza como conjunto de reglas destinadas al fin de la paz, y la equidad. Explicación de un Derecho agrario vinculado a la paz por su origen en los Derechos Humanos Económicos y Sociales. Evolución del Derecho Agrario en los Derechos Humanos de la tercera generación (principalmente ambiente, desarrollo y paz, en las nuevas dimensiones del Derecho agrario del futuro. Derecho agrario como derecho para la paz y el respeto de los derechos humanos. Desarrollo sostenible y agricultura del futuro. La nueva orientación de los institutos del derecho agrario como instrumentos de paz, dirigidos a cumplir los fines de la justicia social, el desarrollo económico y el equilibrio ambiental. Desarrollo como respuesta a los problemas del ambiente, alimentario, de la pobreza, indígena y de la mujer rural. El rol de la justicia agraria y ambiental como derecho para la paz. El derecho agrario, disciplina forjada en una concepción iushumanista, acorde con los derechos humanos y la paz. El derecho agrario como derecho para la paz.

  8. Disponibilidad léxica en español como lengua extranjera: el cotejo de las investigaciones en Eslovenia, Salamanca y Finlandia

    OpenAIRE

    Marjana Šifrar Kalan

    2009-01-01

    La competencia léxica es parte fundamental del conocimiento lingüístico y una herramienta cognitiva que nos permite comunicar en una lengua. El léxico, además de ser una manifestación antropológica, es la parte más inestable e íntima de la lengua que puede variar mucho dependiendo de factores muy variados. Si se trata de una lengua extranjera es necesario saber cuál es el léxico fundamental que nos permite desenvolvernos en las situaciones comunicativas más frecuentes. Algunas investigaciones...

  9. La Seguridad ciudadana como función del Estado

    OpenAIRE

    Ridaura Martínez, María Josefa

    2014-01-01

    Este trabajo se centra en uno de los temas medulares de la organización del Estado como es la garantía de la seguridad, y tiene como objeto reivindicar, al calor la reciente sacudida legislativa en materia, la función de la Seguridad ciudadana como una función pública a desarrollar por las Fuerzas y Cuerpos de Seguridad; en tanto que exigencia constitucional, presupuesto de la salvaguarda de los derechos fundamentales y de las libertades públicas.

  10. Los Grupos Interactivos como respuesta inclusiva: un estudio de caso

    OpenAIRE

    López Marí, María; Peirats Chacón, José

    2014-01-01

    Esta contribución analiza la idoneidad de los Grupos Interactivos como método didáctico en la atención a la diversidad en el marco de la escuela inclusiva. Desde las observaciones y entrevistas realizadas en una investigación, mostraremos como se desarrollan las sesiones de trabajo en dos aulas distintas de Educación Primaria e Infantil, así como las valoraciones que la comunidad educativa posee sobre esta nueva estrategia y sus repercusiones en el contexto escolar.

  11. Imaginarios posibles en la arquitectura: neobarroco como estrategia proyectual

    OpenAIRE

    Elizabeth García García; Marianela Camacho Fuenmayor

    2009-01-01

    En el marco de la investigación CONDES Imaginarios posibles en la Arquitectura se propuso, como ejercicio de diseño arquitectónico, la realización de proyectos a partir de una reflexión teórico-crítica sobre el carácter neobarroco de la contemporaneidad. El objetivo fue explorar una poética semiótica generadora de los instrumentos que nos permitiera concebir lo neobarroco como estrategia proyectual. El objeto arquitectónico a proyectar debía imaginarse como un conjunto de formas, contenidos y...

  12. El discurso como acción social

    OpenAIRE

    Dra. Renée Isabel Mengo

    2004-01-01

    El abordaje del discurso como acción social, se presenta como forma de habilitar nuevos caminos en la reconstrucción de acontecimientos, mostrando tanto las estructuras del lenguaje como la ideología que compromete a los actores sociales de un momento determinado. A partir del libro de Teun A. van Dijk [1] se puede conceptualizar esta alternativa para el análisis del discurso. Para reforzar el enfoque,se considerará otro texto del mismo autor [2] para quién el análisis del discurso puede desc...

  13. El discurso como acción social

    Directory of Open Access Journals (Sweden)

    Dra. Renée Isabel Mengo

    2004-01-01

    Full Text Available El abordaje del discurso como acción social, se presenta como forma de habilitar nuevos caminos en la reconstrucción de acontecimientos, mostrando tanto las estructuras del lenguaje como la ideología que compromete a los actores sociales de un momento determinado. A partir del libro de Teun A. van Dijk [1] se puede conceptualizar esta alternativa para el análisis del discurso. Para reforzar el enfoque,se considerará otro texto del mismo autor [2] para quién el análisis del discurso puede describirse en distintos niveles de estructuras.

  14. Potencial generador de biomasa como fuente renovable a escala local

    OpenAIRE

    PERELLÓ GUARRO, PAULA ISABEL

    2013-01-01

    Gran parte de los residuos agrícolas y forestales pueden ser utilizados como biomasa. El aprovechamiento de estos recursos como fuente de energía renovable puede ser la solución a muchos de los problemas medioambientales y económicos que existen actualmente. El objeto del presente proyecto es realizar un inventario del potencial generador de biomasa como fuente renovable a escala local. El trabajo ha sido estructurado en dos grandes partes. La primera contiene, a modo de preliminares, aquello...

  15. El trabajo de campo como proceso. La "etnografía colaborativa" como perspectiva analítica

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    Leticia Katzer

    2011-10-01

    Full Text Available El presente artículo contiene una serie de reflexiones elaboradas al poner en diálogo experiencias de campo en el marco de investigaciones individuales; una, con indígenas adscriptos como Huarpes, en el noreste de la provincia de Mendoza; la otra, con indígenas adscriptos como Qom. Éstas reflexiones intentan contribuir a desnaturalizar y visibilizar la complejidad de los contextos de interacción, considerando que abarcan distintas dimensiones y aspectos —tales como posición de los interlocutores en la estructura social, expectativas individuales, experiencias y relaciones previas de los sujetos, y recursos materiales y simbólicos en intermediación—, enfatizando así el carácter situacional y dinámico de esas relaciones de interlocución.A la luz de los actuales debates de la crítica cultural y en un intento por contribuir a los estudios de la Etnografía Colaborativa, el objetivo de este artículo es exponer y describir comparativamente lo que entendemos como performances de campo, situando como objeto de análisis la experiencia etnográfica en sí misma. Entendiendo el trabajo etnográfico como proceso y texto, identificamos tres grandes nudos críticos, reunidos en tres escenas etnográficas, que analizamos como una red multisituada de mediaciones e interrelaciones.

  16. El conocimiento de ingeniería como conocimiento escolar

    OpenAIRE

    Cajas, Fernando

    2009-01-01

    El artículo considera a la ingeniería como una práctica tecnológica cuyos productos son artefactos y conocimientos tecnológicos. Se introducen dos prácticas de referencia clave para la ingeniería: el diseño y la ejecución. Estas dos prácticas tecnológicas están ausentes en muchos programas de formación de ingenieros, los cuales a pesar de haber evolucionado de una concepción de ingeniería como artefacto hacia ingeniería como conocimiento, particularmente como ciencia aplicada, aún no se enf...

  17. Quests em World Of Warcraft como estrutura narrativa seriada

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    Jônatas Kerr de Oliveira

    2010-10-01

    Full Text Available Assumindo que as quests em World of Warcraft funcionam como uma estrutura narrativa dentro do jogo, busca-se verificar se esta estrutura apresenta características que possam caracterizá-la como uma narrativa seriada. Para tal, é feita uma análise das principais características da narrativa seriada televisiva, assim como da estrutura de quests, para verificar a viabilidade de tal aproximação. Sendo a estrutura narrativa de quests em MMORPGs uma estrutura narrativa seriada, abre-se um grande leque de possibilidades, tanto para as análises teóricas dos videogames, utilizando o ferramental adaptado, como para os game designers utilizarem este referencial para acrescer detalhes aos mundos ficcionais criados.

  18. LOS ACTORES DEL ESCENARIO PEDAGÓGICO COMO COMPONENTE DEL MODELO PEDAGÓGICO PARA INDISCIPLINAR EL DERECHO COMO CIENCIA

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    Jorge Eduardo Vásquez Santamaría

    2011-01-01

    Full Text Available Resultado del escenario pedagógico como plataforma inicial problematizadora a partir de la cual se identifican y describen fundamentos orientadores tradicionales y no tradicionales que permitan reevaluar el Derecho para acreditarlo como ciencia social, se exponen los resultados obtenidos en el trabajo de campo adelantado con abogados docentes y estudiantes de Derecho como sus actores pedagógicos, quienes representan los elementos “Quién” y “A quién” del modelo pedagógico, en este caso primordialmente tradicionalista, imperante en los currículos de los programas de Derecho deColombia.

  19. LOS ACTORES DEL ESCENARIO PEDAGÓGICO COMO COMPONENTE DEL MODELO PEDAGÓGICO PARA INDISCIPLINAR EL DERECHO COMO CIENCIA

    OpenAIRE

    Jorge Eduardo Vásquez Santamaría

    2011-01-01

    Resultado del escenario pedagógico como plataforma inicial problematizadora a partir de la cual se identifican y describen fundamentos orientadores tradicionales y no tradicionales que permitan reevaluar el Derecho para acreditarlo como ciencia social, se exponen los resultados obtenidos en el trabajo de campo adelantado con abogados docentes y estudiantes de Derecho como sus actores pedagógicos, quienes representan los elementos “Quién” y “A quién” del modelo pedagógico, en este caso primord...

  20. Las revistas culturales como documentos de la historia latinoamericana

    OpenAIRE

    Fernanda Beigel

    2003-01-01

    En este trabajo analizamos las revistas culturales latinoamericanas como documentos de cultura, en términos de Benjamin, porque permiten disecar un determinado estado del campo intelectual. Y en tanto textos colectivos, porque contribuyen a conocer los proyectos político-culturales desarrollados en un período. Por tratarse de formas discursivas relacionadas con el periodismo, ellas son vistas como síntoma de la dependencia entre prensa y literatura...

  1. Las directrices del costo como fuentes de ventajas competitivas.

    OpenAIRE

    José Reinel Bermeo Muñoz; Elver Alfonso Bermeo Muñoz

    2005-01-01

    Este trabajo pretende describir con el mayor detalle y actualización posible el comportamiento de los costos dentro de una actividad de valor con base en los diez factores estructurales que influyen en el costo, denominados por Michael E. Porter (1985), como guías o directrices del costo en su libro La Ventaja Competitiva. Estas directrices actúan como fuentes directas para establecer y sostener el posicionamiento estratégico asumido por la empresa, para deter...

  2. El buen entrenador como experto adaptativo que lidera al grupo

    Directory of Open Access Journals (Sweden)

    Sergio Jim\\u00E9nez S\\u00E1iz

    2010-01-01

    expertos en baloncesto, siguiendo los criterios de la literatura específica. Los resultados reflejan que los entrenadores destacan la capacidad de adaptación al contexto que les rodea, como algo prioritario para alcanzar el éxito como entrenadores. Los entrevistados subrayan que no abandonan su modelo de entrenamiento cuando cambian de contexto, sino que lo adaptan a una situación distinta.

  3. La alteridad como puente para la trascendencia ética

    Directory of Open Access Journals (Sweden)

    Rosalía Solla

    2013-09-01

    Full Text Available El presente ensayo tiene como objetivo auscultar la alteridad como puente para la trascendencia ética. El trabajo se desarrolla como un estudio documental de tipo expositivo, ya que en él se exponen diferentes investigaciones en las cuales se visualiza al otro como pilar importante para el desarrollo del ser humano en el campo educativo, visto éste como un ser que debe hacerse humano en su relación con los otros estudiantes, es decir en la propia interrelación cotidiana. Sirven las investigaciones de Heidegger (1967, Pérez Sánchez y Poveda-Serra (2008, Kusch (2007, Rich Harris (1999, Lévinas (2000, Merleau-Ponty (1962, Valles (2004, Buber (1980, Delors (1996, Salmerón (2010, Savater (1997, Dominique (2008, Hobbes (1967, Wojtyla (1976, Gadamer (1998, Cabenellas y Eslava (2001, Morín (2007 y Nietzsche (1979 como antecedentes teóricos al estudio del otro y su trascendencia ética. Cada parte de este ensayo está identificado con títulos como: Apertura del ser en el horizonte, Encuentro con el otro, Los sentidos del otro en nosotros, El individuo en la competencia social ciudadana del otro en el entorno educativo, La Trascendencia del otro y Trascendencia ética los cuales llevan al lector a comprender a su semejante a través de las relaciones que desarrolla con su par. Finalmente, se presenta como corolario que el convivir en alteridad coadyuva a la trascendencia de las ideas éticas-humanas a pesar del rompimiento causado por el distanciamiento de la partida o muerte.

  4. Derivados de cromenopirazoles como ligandos de receptores de cannabinoides

    OpenAIRE

    Jagerovic, Nadine; Cumella Montánchez, José María; Goya, Pilar; Fernández, Javier; Gómez, María; Rodríguez, Patricia

    2009-01-01

    Derivados de cromenopirazoles como ligandos de receptores de cannabinoides. Compuestos derivados de cromenopirazoles que son ligandos de receptores de cannabinoides, su uso para la fabricación de un medicamento, uso de este medicamento para el tratamiento y/o la prevención de trastornos asociados a los receptores de cannabinoides, uso de dicho compuesto como reactivo en ensayos biológicos relacionados con receptores de cannabinoides y procedimiento de obtención de l...

  5. UNIVERSIDADE CORPORATIVA COMO ALAVANCA DA VANTAGEM COMPETITIVA

    Directory of Open Access Journals (Sweden)

    Maria Elisabeth Pereira Kraemer

    2004-05-01

    -style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

    RESUMO

    A educação formal para o trabalho, em nível superior, começa a enfrentar uma concorrência inusitada: as universidades corporativas, surgidas das experiências de programas de treinamento e desenvolvimento profissionais corporativos e da constatação de que a universidade não prepara adequadamente para o trabalho. O conceito de universidade corporativa surgiu nos EUA, em 1995, quando a General Eletric criou a Cotronville. Mas foi só a partir da década de 80 que se assistiu a um aumento considerável destes novos espaços de formação. Outro componente que contribuiu para o rápido crescimento das universidades corporativas é a necessidade de contínua aprendizagem, como conseqüência das vertiginosas mudanças no mundo do trabalho, em razão dos avanços tecnológicos permanentes e do processo de globalização da economia. As universidades corporativas surgem como solução para o alinhamento das iniciativas de treinamento com a estratégia da organização e de criação de vantagem competitiva, por meio de aprendizado permanente.

    Palavras-chave: avanços tecnológicos, universidade corporativa, vantagem competitiva

     

    ABSTRACT

    The formal education for the work in superior level

  6. EL APRENDIZAJE ORGANIZACIONAL COMO FACILITADOR DE RELACIONES SOCIALES RESPONSABLES

    Directory of Open Access Journals (Sweden)

    Eliecer Mayorca Capataz

    2014-08-01

    Full Text Available La importancia que tienen las relaciones sociales y el aprendizaje en la vida del ser humano: ser social, ser de relaciones, un ser abierto que se define por las relaciones con los demás, se considera imprescindible, abordar el tema para favorecer el desarrollo integral de la personas. Ello supone que, la vida para su permanente desarrollo implica en la persona, articular un entramado de relaciones, mediante la experiencia de aprendizaje y el reconocimiento de los valores fundamentales como el respeto por la humanidad, en un todo interrelacionado, en el que, de alguna forma, remite el actuar de las personas, a su racionalidad, a su espontaneidad, a la forma como se comunica y trabaja con los otros, a la manera constante de aprender, de buscar la calidad de vida, de amar su oficio como forma de influencia positiva, y establecer relaciones socialmente responsables. Para ello, se estableció como objetivo: realizar un análisis conceptual del aprendizaje organizacional como facilitador de las relaciones sociales responsables en la organización. Metodológicamente, el trabajo es de carácter documental y bibliográfico, soportadas en investigaciones previas; y como reflexión se estableció que el centro para aprender y relacionarse es el hombre.

  7. Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gorgels Anton PM

    2011-03-01

    Full Text Available Abstract Background Few studies investigated the association between smoking, alcohol consumption, or physical activity and the risk of unstable angina pectoris (UAP, while the strength of these associations may differ compared to other coronary diseases such as acute myocardial infarction (AMI. Therefore, we investigated whether the associations of these lifestyle factors with UAP differed from those with AMI. Additionally, we investigated whether these effects differed between subjects with and without a family history of myocardial infarction (MI. Methods The CAREMA study consists of 21,148 persons, aged 20-59 years at baseline and randomly sampled from the Maastricht region in 1987-1997. At baseline, all participants completed a self-administered questionnaire. After follow-up of maximally 16.9 years, 420 AMI and 274 UAP incident cases were registered. Incidence rate ratios (RRs were estimated using Cox proportional hazards models. Results For both diseases, smoking increased the risk while alcohol consumption was associated with a protective effect. Associations with both risk factors were stronger for AMI than UAP, although this difference was only statistically significant for smoking. In men, an inverse association was found with physical activity during leisure time which seemed to be stronger for the risk of UAP than of AMI. On the contrary, physical activity during leisure time was associated with an increased risk of both AMI and UAP in women which seemed to be weaker for UAP than for AMI. Except for occupational physical activity in women, no significant interactions on a multiplicative scale were found between the lifestyle factors and family history of MI. Nevertheless, the highest risks were found in subjects with both a positive family history and the most unfavorable level of the lifestyle factors. Conclusions The strength of the associations with the lifestyle factors did not differ between AMI and UAP, except for smoking

  8. Detection of non-ST-elevation myocardial infarction and unstable angina in the acute setting: meta-analysis of diagnostic performance of multi-detector computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Sarno Giovanna

    2007-12-01

    Full Text Available Abstract Background Multi-detector computed tomography angiography (MDCTA has been increasingly used in the evaluation of the coronary arteries. The purpose of this study was to review the literature on the diagnostic performance of MDCTA in the acute setting, for the detection of non-ST-elevation myocardial infarction (NSTEMI and unstable angina pectoris (UAP. Methods A Pubmed and manual search of the literature published between January 2000 and June 2007 was performed. Studies were included that compared MDCTA with clinical outcome and/or CA in patients with acute chest pain, presenting at the emergency department. More specifically, studies that only included patients with initially negative cardiac enzymes suspected of having NSTEMI or UAP were included. Summary estimates of diagnostic odds ratio (DOR, sensitivity and specificity, negative (NLR and positive likelihood ratio (PLR were calculated on a patient basis. Random-effects models and summary receiver operating curve (SROC analysis were used to assess the diagnostic performance of MDCTA with 4 detectors or more. The proportion of non assessable scans (NAP on MDCTA was also evaluated. In addition, the influence of study characteristics of each study on diagnostic performance and NAP was investigated with multivariable logistic regression. Results Nine studies totalling 566 patients, were included in the meta-analysis: one randomised trial and eight prospective cohort studies. Five studies on 64-detector MDCTA and 4 studies on MDCTA with less than 64 detectors were included (32 detectors n = 1, 16 detectors n = 2, 16 and 4 detectors n = 1. Pooled DOR was 131.81 (95%CI, 50.90–341.31. The pooled sensitivity and specificity were 0.95 (95%CI, 0.90–0.98 and 0.90 (95%CI, 0.87–0.93. The pooled NLR and PLR were 0.12 (95%CI, 0.06–0.21 and 8,60 (95%CI, 5.03–14,69. The results of the logistic regressions showed that none of the investigated variables had influence on the diagnostic

  9. Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial

    Science.gov (United States)

    Rief, Matthias; Martus, Peter; Kendziora, Benjamin; Feger, Sarah; Dreger, Henryk; Priem, Sascha; Knebel, Fabian; Böhm, Marko; Schlattmann, Peter; Hamm, Bernd; Schönenberger, Eva; Laule, Michael; Zimmermann, Elke

    2016-01-01

    Objective To evaluate whether invasive coronary angiography or computed tomography (CT) should be performed in patients clinically referred for coronary angiography with an intermediate probability of coronary artery disease. Design Prospective randomised single centre trial. Setting University hospital in Germany. Participants 340 patients with suspected coronary artery disease and a clinical indication for coronary angiography on the basis of atypical angina or chest pain. Interventions 168 patients were randomised to CT and 172 to coronary angiography. After randomisation one patient declined CT and 10 patients declined coronary angiography, leaving 167 patients (88 women) and 162 patients (78 women) for analysis. Allocation could not be blinded, but blinded independent investigators assessed outcomes. Main outcome measure The primary outcome measure was major procedural complications within 48 hours of the last procedure related to CT or angiography. Results Cardiac CT reduced the need for coronary angiography from 100% to 14% (95% confidence interval 9% to 20%, Pcoronary angiography: 75% (53% to 90%) v 15% (10% to 22%), Pcoronary angiography group: 3.6% (1% to 8%) v 10.5% (6% to 16%), P=0.014. CT shortened the median length of stay in the angiography group from 52.9 hours (interquartile range 49.5-76.4 hours) to 30.0 hours (3.5-77.3 hours, Pcoronary angiography group (adjusted hazard ratio 0.90, 95% confidence interval 0.30 to 2.69, P=0.86). 79% of patients stated that they would prefer CT for subsequent testing. The study was conducted at a University hospital in Germany and thus the performance of CT may be different in routine clinical practice. The prevalence was lower than expected, resulting in an underpowered study for the predefined primary outcome. Conclusions CT increased the diagnostic yield and was a safe gatekeeper for coronary angiography with no increase in long term events. The length of stay was shortened by 22.9 hours with CT, and

  10. Evaluation of coronary plaque and stent deployment by intravascular optical coherence tomography in elderly patients with unstable angina and non-ST-elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Caiyi LU; Jinyue ZHAI; Shiwen WANG; Wei YAN; Xingli WU; Yuxiao ZHANG; Qiao XUE; Muyang YAN; Peng LIU; Rui CHEN

    2007-01-01

    Objective To evaluate the feasibility and efficacy of intravascular optical coherence tomography (OCT) in the assessment of plaque characteristics and drug eluting stent deployment quality in the elderly patients with unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI). Methods OCT was used in elderly patients undergoing percutaneous coronary interventions.Fifteen patients, 9 males and 6 females with mean age of 72.6±5.3 years (range 67-92 years) were enrolled in the study. Images were obtained before initial balloon dilatation and following stent deployment. The plaque characteristics before dilation, vessel dissection,tissue prolapse, stent apposition and strut distribution after stent implantation were evaluated. Results Fifteen lesions were selected from 32 angiographic lesions as study lesions for OCT imaging after diagnostic coronary angiography. There were 7 lesions in the left anterior descending artery, 5 lesions in the right coronary artery and 3 lesions in the left circumflex coronary artery. Among them,12 (80.0%) were lipid-rich plaques, and 10 (66.7%) were vulnerable plaques with fibrous cap thickness 54.2±7.3 μm. Seven ruptured culprit plaques (46.7%) were found; 4 in UA patients and 3 in NSTEMI patients. Tissue prolapse was observed in 11 lesions (73.3%).Irregular stent strut distribution was detected in 8 lesions (53.3%). Vessel dissections were found in 5 lesions (33.3%). Incomplete stent apposition was observed in 3 stents (20%) with mean spacing between the struts and the vessel wall 172±96 mm (range 117-436 mm).Conclusions 1) It is safe and feasible to perform intravascular OCT to differentiate vulnerable coronary plaque and monitor stent deployment in elderly patients with UA and USTEMI. 2) Coronary plaques in elderly patients with UA and USTEMI could be divided into acute ruptured plaque, vulnerable plaque, lipid-rich plaque, and stable plaque. 3) Minor or critical plaque rupture is one of the mechanisms of UA

  11. Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study.

    Directory of Open Access Journals (Sweden)

    Lasse Jespersen

    Full Text Available AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD and repeat coronary angiography (CAG in stable angina pectoris (SAP with no obstructive coronary artery disease (CAD versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11,223 patients with no prior CVD having a first-time CAG in 1998-2009 due to SAP symptoms and 5,695 asymptomatic reference individuals from the Copenhagen City Heart Study through registry linkage for 7.8 years (median. In recurrent event survival analysis, patients with SAP had 3-4-fold higher risk of hospitalization for CVD irrespective of CAG findings and cardiovascular comorbidity. Multivariable adjusted hazard ratios(95%CI for patients with angiographically normal coronary arteries was 3.0(2.5-3.5, for angiographically diffuse non-obstructive CAD 3.9(3.3-4.6 and for 1-3-vessel disease 3.6-4.1(range(all P<0.001. Mean accumulated hospitalization time was 3.5(3.0-4.0(days/10 years follow-up in reference individuals and 4.5(3.8-5.2/7.0(5.4-8.6/6.7(5.2-8.1/6.1(5.2-7.4/8.6(6.6-10.7 in patients with angiographically normal coronary arteries/angiographically diffuse non-obstructive CAD/1-, 2-, and 3-vessel disease, respectively (all P<0.05, age-adjusted. SAP symptoms predicted repeat CAG with multivariable adjusted hazard ratios for patients with angiographically normal coronary arteries being 2.3(1.9-2.9, for angiographically diffuse non-obstructive CAD 5.5(4.4-6.8 and for obstructive CAD 6.6-9.4(range(all P<0.001. CONCLUSIONS: Patients with SAP symptoms and angiographically normal coronary arteries or angiographically diffuse non-obstructive CAD suffer from considerably greater CVD burdens in terms of hospitalization for CVD and repeat CAG compared with asymptomatic reference individuals even after adjustment for cardiac risk factors and exclusion of cardiovascular comorbidity as cause. Contrary to common perception, excluding obstructive CAD by CAG in such

  12. Compuesto aromático homoquiral como agente de solvatación quiral y como auxiliar quiral

    OpenAIRE

    Virgili, Albert

    2001-01-01

    Compuesto aromático homoquiral como agente de solvatación quiral y como auxiliar quiral. Compuesto aromático homoquiral de fórmula general (I) donde A representa un núcleo aromático o hetereoaromático que comprende de 1 a 6 anillos, y X un átomo de D, un halógeno, un grupo electrón atrayente, tal como NO{sub,2}, o un grupo electrón dador, tal como OR'' o NR''R''`; donde R'' y R''` representan indistintamente un grupo alquilo, arilo, acilo, D o H; R{sub,1} un átomo de D o H; R{sub,2} un grupo ...

  13. Systematic Review of Associated Prescriptions of Gualou and Xiebai on Unstable Angina Pectoris%《金匮要略》瓜蒌薤白类方治疗不稳定型心绞痛的系统评价

    Institute of Scientific and Technical Information of China (English)

    庄严

    2014-01-01

    Objective:To systematically assess the efficacy of the associated prescriptions of Gualou and Xiebai on unstable angina pectoris. Methods:Randomized controlled trials of associated prescriptions of Gualou and Xiebai on unstable angina pectoris were retrieved from the Cochrane library,PubMed,CNKI, Wanfang database and CBM. The risk of bias of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of interventions. Such statistical analyses as heterogeneity analysis,meta-analysis,sensitivity analysis and funnel plot analysis were performed using the Review Manager 5.2.6 software. Results:Fourteen qualified trials were included. The risk of bias was generally high and clinical heterogeneity exists among them. Meta-analysis shows that the associated pre scriptions of Gualou and Xiebai can improve angina pectoris(RR=1.24,95%CI[1.18,1.31]) and ECG manifestations(RR=1.29,95%CI[1.19,1.39]),funnel plot is asymmetry. Conclusion:Current evidence indicates that treating un-stable angina pectoris with the associated prescriptions of Gualou and Xiebai can improve the efficacy on unstable angina pectoris. Due to the low quality of included studies ,clinical trials with adequate samples , rational design and strict execution should be carried out to provide more reliable evidence.%目的:系统评价《金匮要略》瓜蒌薤白类方治疗不稳定型心绞痛的临床疗效。方法:检索中国学术文献总库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、The Cochrane Library、PubMed等数据库,搜集瓜蒌薤白类方治疗不稳定型心绞痛的随机对照试验,按照Cochrane协作网推荐的方法评估纳入研究的偏倚风险,运用RevMan 5.2.6软件完成异质性检验、Meta-分析、敏感性分析、倒漏斗图分析等相关统计分析。结果:共纳入14项合格研究,均存在较高的方法学偏倚风险,Meta-分析显示瓜蒌薤白类方在

  14. Effectiveness of Trimetazidine on Stable Angina Evaluated by Treadmill Exercise Test%运动平板试验评估曲美他嗪治疗稳定型心绞痛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    戴红艳; 何涛; 姜陆民; 丁华民

    2012-01-01

    目的 通过运动平板试验(Treadmill Exercise Test,TET)观察曲美他嗪辅助治疗稳定型心绞痛的疗效.方法 选取80例明确诊断为稳定型心绞痛且运动平板试验为阳性患者,在传统药物治疗基础上,分为曲美他嗪治疗组及对照组.记录治疗前后运动平板试验阳性率、运动终止时诱发心绞痛率、运动时间、恢复时间、运动后2min ST段压低≥1.0mm的导联数及其ST段压低总和(∑ST),并进行统计分析.结果 曲美他嗪治疗后运动平板试验阳性率、运动终止时诱发心绞痛率、运动时间、恢复时间、运动后2minST段压低≥1.0mm的导联数及其ST段压低总和(∑ST)较治疗前及对照组均有显著改善,且差异具有统计学意义(P<0.05).结论 在传统药物治疗基础上联用曲美他嗪,可使稳定型心绞痛患者进一步获益.%Objective To evaluate the effectiveness of trimetazidine on stable angina by treadmill exercise test (TET). Methods 80 TET positive patients with stable angina were divided into 2 groups: the trimetazidine group and the control group. Before and after therapy, the positive rate, exercise-induced angina rate at the termination, exercise time, recovery time, the number of leads with ST-segment depression≥1.0mm 2 minutes after exercise and the sum of ST-segment depression)∑ST) were recorded and analyzed. Results After therapy with Trimetazidine, the positive rate, exercise-induced angina rate at the termination, exercise time, recovery time, the number of leads with ST-segment depression ≥1.0mm 2 minutes after exercise and the sum of ST-segment depression(∑ST) were all improved apparently compared with control group(P<0.05). Conclusion Patients with stable angina could benefit from the combined treatment with Trimetazidine on the basis of the traditional drug therapy.

  15. The analysis anxiety/depression score and treatment of patients with angina pectoris%冠心病心绞痛患者焦虑/抑郁情绪测定评分的分析及治疗

    Institute of Scientific and Technical Information of China (English)

    姚涛; 吴达军

    2012-01-01

    Objective To investigate the level of anxiety and depression cores in patients with coronary heart disease and the efficacy of anti-anxiety depression treatment. Methods The Hospital Anxiety and Depression Scale(HADS) were measured in 120 patients with angina pectoris and 20 healthy volunteers between March 2010 and February 2012. Patients with anxiety and/or depression were treated by deanxit.The level of Hospital anxiety and depression scores and Seattle Angina scale (SAQ) were compared between pre- and post-treatment. Results The level of Hospital anxiety and depression scores of patients were higher than of the contral. The level of Hospital anxiety and depression scores and quality of life of patients of patients were improved after treatment. After treatment, the degree of anxiety and depression scores and physical activity limitation, angina stability status, onset of angina, treatment satisfaction, knowledge of the disease severity score was negatively correlated. The statistics were significant differences. (P<0.05). Conclusion The patients with angina pectoris have significant symptoms of anxiety and depression.After jointed anti-anxiety depression treatment, the patients felt the quality of life improved, stress relieved, living healthy and relaxed.%目的:探讨冠心痛心绞痛患者焦虑抑郁评分的高低及抗焦虑抑郁治疗的疗效.方法:2010年3月~2012年2月于本院心内科治疗的冠心痛心绞痛患者120例,对照组为健康志愿者20例,行焦虑抑郁评分.有焦虑抑郁患者行黛力新抗焦虑抑郁治疗,治疗前后行焦虑抑郁评分及采用西雅图心绞痛量表(SAQ)对患者治疗前后生活质量评估.结果:冠心病心绞痛患者焦虑评分及抑郁评分均高于对照组.治疗后患者焦虑抑郁评分较治疗前明显改善.治疗后患者生活质量较前明显好转.治疗后焦虑抑郁评分与躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、

  16. Disponibilidad léxica en español como lengua extranjera: el cotejo de las investigaciones en Eslovenia, Salamanca y Finlandia

    Directory of Open Access Journals (Sweden)

    Marjana Šifrar Kalan

    2009-12-01

    Full Text Available La competencia léxica es parte fundamental del conocimiento lingüístico y una herramienta cognitiva que nos permite comunicar en una lengua. El léxico, además de ser una manifestación antropológica, es la parte más inestable e íntima de la lengua que puede variar mucho dependiendo de factores muy variados. Si se trata de una lengua extranjera es necesario saber cuál es el léxico fundamental que nos permite desenvolvernos en las situaciones comunicativas más frecuentes. Algunas investigaciones sobre el vocabulario ya pusieron de manifiesto que, habitualmente, el hombre corriente no emplea más de dos mil palabras; el hombre culto, por su parte, se sirve de unos cuatro o cinco mil vocablos (ver Carcedo González, 2000: 11; Nation, 1990: 11, 2001: 9. Benítez Pérez (1994a: 10 señala que «según los estudiosos de frecuencias léxicas, las primeras 1000 palabras más usadas en español abarcan cerca del 85% del contenido del léxico de cualquier texto no especializado». Cabría añadir lo que ya han demostrado otras investigaciones realizadas sobre lenguas tan lejanas como el chino, el japonés, el francés, y es el hecho de que exista una constante entre muchas lenguas del mundo cuyo vocabulario fundamental varía de 1500 a 2000 palabras sin pasar nunca de esta cifra. De aquí la importancia de escoger cuidadosamente el vocabulario fundamental que debemos enseñar. Según López Morales (1999: 20 el léxico fundamental de una lengua está formado por el léxico básico y el léxico disponible. El léxico básico abarca las palabras más usuales o frecuentes de una comunidad, que se caracterizan por un alto grado de estabilidad o permanencia. Esto les permite que aparezcan con mucha frecuencia en todo tipo de discursos con independencia del tema tratado. En cambio, el léxico disponible está compuesto por aquellas palabras que sólo aparecen en situaciones precisas, es decir, cuando el tema de conversación las requiere. De este modo

  17. Fronts working inestability in laja stones quarying. Lavalleja department in Uruguay

    International Nuclear Information System (INIS)

    This study is about the western edge deposits belong to Lavalleja group locataed in the proximity of the Sierra Animas formation. The rocks dominants In this zone are phyllite, calcareous phyllite and limestone magnesian, usually grey or black denoting environment reduce

  18. Manejo de fracturas intertrocantéricas inestables con enclavijamiento cefalomedular

    OpenAIRE

    Pereira-Betancourt Carlos; Matson-Caraballo Gustavo; Fonseca -Caro John Freddy

    2011-01-01

    INTRODUCCION: en los Estados Unidos más de 250.000 fracturas de cadera se presentan al servicio de urgencias por año, debido alentendimiento de la personalidad de la fractura más del 90% de las mismas son de tratamiento quirúrgico, debido a la necesidadimperiosa de una rehabilitación con apoyo temprano para evitar complicaciones inherentes al reposo prolongado en la población dela tercera edad que sufre la fractura. Los métodos quirúrgicos son diversos, varían desde la osteosíntesis hasta el ...

  19. Mapping Shallow Landslide Slope Inestability at Large Scales Using Remote Sensing and GIS

    Science.gov (United States)

    Avalon Cullen, C.; Kashuk, S.; Temimi, M.; Suhili, R.; Khanbilvardi, R.

    2015-12-01

    Rainfall induced landslides are one of the most frequent hazards on slanted terrains. They lead to great economic losses and fatalities worldwide. Most factors inducing shallow landslides are local and can only be mapped with high levels of uncertainty at larger scales. This work presents an attempt to determine slope instability at large scales. Buffer and threshold techniques are used to downscale areas and minimize uncertainties. Four static parameters (slope angle, soil type, land cover and elevation) for 261 shallow rainfall-induced landslides in the continental United States are examined. ASTER GDEM is used as bases for topographical characterization of slope and buffer analysis. Slope angle threshold assessment at the 50, 75, 95, 98, and 99 percentiles is tested locally. Further analysis of each threshold in relation to other parameters is investigated in a logistic regression environment for the continental U.S. It is determined that lower than 95-percentile thresholds under-estimate slope angles. Best regression fit can be achieved when utilizing the 99-threshold slope angle. This model predicts the highest number of cases correctly at 87.0% accuracy. A one-unit rise in the 99-threshold range increases landslide likelihood by 11.8%. The logistic regression model is carried over to ArcGIS where all variables are processed based on their corresponding coefficients. A regional slope instability map for the continental United States is created and analyzed against the available landslide records and their spatial distributions. It is expected that future inclusion of dynamic parameters like precipitation and other proxies like soil moisture into the model will further improve accuracy.

  20. The impact of socio-economic factors and incentives on farmers' inestment behaviour

    DEFF Research Database (Denmark)

    Olsen, Jakob Vesterlund; Lund, Mogens

    2011-01-01

    This article investigates how socio-economic factors and incentives affect farmers’ investment behaviour. The motivation is a need for a better quantitative knowledge of investment behaviour in order to support farmers’ investment decisions through extension services and public investment support...... incentives as the most important when making investments are those who yield the best financial results. Off-farm income and partial productivity were also higher on these farms. As hypothesised, young farmers with a large production are more likely to invest in real assets than others. No cross sectional...

  1. Aprendizagem como/na prática

    Directory of Open Access Journals (Sweden)

    Jean Lave

    2015-12-01

    Full Text Available ResumoEste artigo considera como o estudo da cultura e da aprendizagem pode ser de particular relevância para o campo da antropologia sociocultural em geral. O termo mais importante na expressão “cultura & aprendizagem” talvez seja o logograma “&” – ou seja, coloca-se a questão sobre o que conecta cultura e aprendizagem, perguntando-se como esses termos estão relacionados. Como devemos compreender cultura e aprendizagem como instâncias produtoras delas próprias, e uma da outra, na prática? Recalibrando em termos relacionais, podemos dizer que não é possível abordar a “aprendizagem” ou “cultura e aprendizagem” sem o seu emaranhamento na vida político-econômica, nas lutas e disputas históricas, em suas coerências e incoerências, e na produção relacional e histórica da vida cotidiana. Através das lentes da teoria da prática social, os estudos etnográficos sobre aprendizagem na prática oferecem diferentes entendimentos sobre como certa vida e certas disputas e incoerências são produzidas.

  2. La felicidad como ideal de la imaginación

    Directory of Open Access Journals (Sweden)

    Soledad García Ferrer

    2011-01-01

    Full Text Available En este artículo intentamos desarrollar mínimamente los cinco discursos sobre la felicidad que hemos encontrado en la obra de Kant. Los hemos encontrado con dificultad, porque no se trata de discursos ordenados ni continuados a lo largo de sus páginas, sino más bien de sugerencias que van apareciendo de vez en cuando al hilo de otras reflexiones. La felicidad se dibuja como totalidad, como un concepto indeterminado, como el polo opuesto a la cultura, como sentimiento y como bien. Aunque no se trate de discursos bien enlazados, es posible seguirles la pista a lo largo de los textos. No obstante, hay otra sugerencia que Kant nos proporciona y que él mismo no desarrolla en absoluto: según ella la felicidad sería el ideal de la imaginación. Este sexto discurso no pronunciado tal vez pudiera suministrar la clave que nos sirva para encontrar la coherencia de los demás.

  3. O jornalismo hiperlocal como mediador do empoderamento feminino

    OpenAIRE

    Aranha, Angelo Sottovia; Miranda, Giovani Vieira

    2015-01-01

    A convergência e o hiperlocal podem ser analisados como elementos que impulsionam o desenvolvimento jornalístico nos ambientes digitais possibilitando a valorização do local e o reforço de identidades, que passam a configurar como fonte básica de significado social em contraste ao processo habitual dos mass media. A efetivação desse cenário emergente será observada como possível novo espaço para o reforço da representação feminina e a ampliação de espaços para os processos de empoderamento e ...

  4. Los portales educativos como fuente de recursos materiales

    Directory of Open Access Journals (Sweden)

    Felipe Gértrudix Barrio

    2012-04-01

    Full Text Available Los portales educativos por sus características como “distribuidores” de información y “almacenes” de recursos, constituyen para la escuela actual un soporte ideal y eficiente de información relacionado con el mundo educativo. Por otro lado, los portales temáticos educativos, como referente específico de una materia, suponen la plataforma ideal en el que los miembros de un colectivo (profesores, maestros, educadores y familias puedan establecer un punto de encuentro para participar, reflexionar, así como cooperar en la actividad docente incentivando nuevas formas de trabajo en el aula. En este sentido presentamos un ejemplo de portal temático educativo dedicado a la educación musical: MOS.

  5. Clinical value analysis of 12 lead dynamic electrocardiogram in the diagnosis of variant angina pectoris%变异性心绞痛采用12导联动态心电图同步记录诊断的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    吕琼

    2015-01-01

    Objective:To explore the clinical value of 12-lead ambulatory electrocardiogram in the diagnosis of variant angina pectoris.Methods:96 cases of patients with variant angina pectoris treated were diagnosed with conventional electrocardiogram and 12-lead ambulatory electrocardiogram,the duration of angina pectoris attacking and times by the two methods were compared. Results:Variant angina pectoris mainly occurred in wee hours and at night.The detection rate of ST segment elevation,ventricular premature beat,U type inverted,T wave towering,atrioventricular block and abnormal Q wave in patients with variant angina pectoris by 12-lead ambulatory electrocardiogram were higher than that of conventional electrocardiogram(P<0.05 or P<0.01). Conclusion:12-lead ambulatory electrocardiogram in the diagnosis of variant angina pectoris had remarkable effect,which could record the attack process of variant angina pectoris perfectly and had big advantage compared with the conventional electrocardiogram.%目的:探讨变异性心绞痛应用12导联动态心电图同步记录诊断的临床价值。方法:收治变异性心绞痛患者96例,所有患者均采用常规心电图和12导联动态心电图诊断,比较两种方法心绞痛的发作时间和次数。结果:变异性心绞痛主要发生在凌晨和夜间。12导联动态心电图对变异性心绞痛患者ST段抬高、室性早搏、U型倒置、T波高耸、房室传导阻滞和异常Q波的检出率均高于常规心电图(P<0.05或P<0.01)。结论:12导联动态心电图诊断变异性心绞痛效果显著,能完整地记录出变异性心绞痛的发作过程,与常规心电图相比具有较大优势。

  6. Entre burlas y veras: Don Quijote como loco-cuerdo

    OpenAIRE

    Gallardo Saborido, Emilio J.

    2009-01-01

    Este artículo indaga en la configuración plural y ambivalente de la figura de Don Quijote, centrándose específicamente en la caracterización de este personaje como loco-cuerdo. Así pues, se consideran varios mecanismos con los que Cervantes jugó para tal fin: desde el uso de la verosimilitud y la parodia, hasta el recurso a modelos médicos propios de su época, pasando por revisiones de arquetipos prestigiosos, como el del caballero erasmista. Las conclusiones obtenidas inciden en la contrapos...

  7. El conejo europeo ("Oryctolagus cuniculus") como especie ingeniera de ecosistemas

    OpenAIRE

    Gálvez Bravo, Lucía I.

    2008-01-01

    En esta tesis doctoral se aborda el papel de un herbívoro excavador, el conejo europeo, Oryctolagus cuniculus, como especie ingeniera de ecosistemas. El objetivo principal fue explorar sus relaciones no-tróficas, especialmente las derivadas de su actividad excavadora y sus efectos sobre el banco de semillas. Para llevar a cabo esta investigación se seleccionó como zona de estudio una dehesa de 300 ha. en el suroeste de Madrid. La exploración de los efectos del conejo se hizo a varias escalas....

  8. El Karate-Do como agente educativo y herramienta social

    OpenAIRE

    González Becerra, Rafael Andrés

    2013-01-01

    Solo contamos con el hombre/mujer y el arte, en nuestro caso un Arte Marcial, el Karate-Do. En la continua búsqueda de implementar el mismo, vemos con mucha alegría la profundización del mismo implementándolo como agente Educativo, en los procesos de integración en los niños, jóvenes y adultos, también con capacidades distintas. Para comprender esto y fundamentarlo concebiremos a la educación como un medio para desarrollar al ser humano. El Karate-Do permite entre otras cosas el desarrollo...

  9. A Psicologia e o Direito como mecanismos do Estado moderno

    OpenAIRE

    José Luiz Quadros de Magalhães; Hugo Baracho de Magalhães

    2016-01-01

    Pretende-se demonstrar, neste trabalho, que o atual Estado Democrático de Direito, em suas raízes, não foi destinado para todos e que a psicologia se apresenta e é utilizada, também, como um aparato na criação de mecanismos de manutenção do poder, assim como pode atuar, também, de forma sutil, na construção da subjetividade dos indivíduos, fazendo com que estes questionem e policiem a si mesmos, desconstruindo e reconstruindo as crenças e costumes des...

  10. La resiliencia como respuesta a los alumnos con baja autoestima

    OpenAIRE

    del Mazo-Maestu, Mª Beatriz

    2016-01-01

    El trabajo Fin de Máster que aquí se presenta versa sobre una propuesta de intervención psicopedagógica destinada a tres alumnos de primero de educación secundaria obligatoria de un colegio concertado de la capital de Burgos que muestran actitudes y comportamientos como alarma a una baja autoestima. Dicha propuesta se basa en un conjunto de sesiones para desarrollar la inteligencia emocional y la autoestima como parte de un programa de aplicación de resiliencia al aula. S...

  11. LA PERSONALIDAD COMO ORGANIZACIÓN DE LOS ESTILOS INTERACTIVOS

    OpenAIRE

    EMILIO RIBES-IÑESTA

    2009-01-01

    Se examina la pertinencia del término personalidad para identificar fenómenos dentro de la teoría psicológica. Se subraya que el término, en el lenguaje ordinario, hace referencia a la manera idiosincrás ica en que cada persona se comporta.Se propone emplear el concepto de estilo interactivo para analizar las consistencias individuales en el comportamiento, como resultado de la biografía de cada individuo. Se examina la lógica del concepto de estilo como una tendencia o propensión de comporta...

  12. A geografia como oxigênio da alma

    Directory of Open Access Journals (Sweden)

    Tarcísio Vanderlinde

    2013-05-01

    Full Text Available Resenha sobre o livro O homem e a terra: natureza da realidade geográfica de Eric Dardel; tradução Werter Holzer. – São Paulo: Perspectiva, 2011, 173 p. A proposta de Eric Dardel questiona a cientificidade como único meio de construção do conhecimento geográfico. Haveria uma relação concreta que liga o Homem à Terra, uma geograficidade que se apresenta como modo da existência humana que precisaria ser considerada.

  13. As marcas no facebook. A Samsung Portugal como exemplo

    OpenAIRE

    Albino, Tatiana Carla dos Santos Costa

    2012-01-01

    Dissertação submetida como requisito parcial à obtenção do grau de Mestre em Ciências da Comunicação – Comunicação Estratégica O desafio apresentado neste estudo diz respeito à forma como as marcas tiram partido dos novos fenómenos comunicacionais numa sociedade cada vez mais tecnológica e digital. Com o acesso à informação facilitado, torna-se difícil ter controlo sobre o que os potenciais consumidores pensam e sentem em relação ao uma determinada marca. No entanto, com fer...

  14. Resiliência como força interna

    Directory of Open Access Journals (Sweden)

    Sara Ponzini Vieira

    2010-10-01

    Full Text Available Partindo da constatação que o processo de enfraquecimento biológico do envelhecimento não corresponde, necessariamente, à debilidade psicológica, este artigo se propõe a explorar o conceito de resiliência na velhice como expressão de uma força interna. A análise deste conceito, relacionado ao senso de significado e à espiritualidade, é apresentada tanto com dados de pesquisa, como com reflexões de alguns importantes autores da gerontologia e do humanismo.

  15. Intervention effects of relaxation therapy on depressive state of patients with class angina%放松疗法对类心绞痛患者抑郁状态的干预

    Institute of Scientific and Technical Information of China (English)

    姚倩; 彭顺蓉; 夏丽娜

    2013-01-01

    Objective To investigate the intervention effect of relaxation therapy on the depressive state of patients with class angina. Methods 107 patients with class angina with the scores of self-rating depressive scale( SDS ) > 50 points from June 2008 to January 2012 were randomly divided into intervention group and control group. The intervention group received the nursing with relaxation therapy,and the control group received the conventional nursing. Comparison of the changes of SDS scores and physical signs after the treatment were made between the two groups. Results In the third to fourth week after the treatment, the SDS score of the intervention group significantly decreased compared with that of the control group( P < 0. 05 ), and the systolic pressure of the patients in intervention group also significantly decreased( P < 0. 01 ). Conclusion The relaxation therapy is conducive to the improvement of depressive state and the control of physical signs of patients with class angina.%目的 探讨放松疗法对类心绞痛患者抑郁状态的干预效果.方法 将2008年6月~2012年1月抑郁自评量表(SDS)评分>50分的114例类心绞痛患者随机分为干预组和对照组,干预组采用放松疗法进行护理,对照组采用常规护理,比较两组治疗后的SDS评分及体征指标变化.结果 放松疗法干预到第3~4 w时,干预组的SDS评分与对照组相比明显降低(P<0.05),收缩压也明显下降(P<0.01).结论 放松疗法对于类心绞痛患者抑郁状态的改善和体征的控制有积极的作用.

  16. 护理干预在不稳定型心绞痛中的应用研究%Analysis of Nursing Intervention Application in Treatment of Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    尹贞顺

    2015-01-01

    目的:探究不稳型性心绞痛患者采用护理措施的效果。方法选取2013年4月~2014年8月收治的35例不稳定型心绞痛患者进行护理,随机分组,实验组19例患者采用综合护理,对照组16例患者选择常规护理,对比患者的护理效果。结果实验组患者护理有效率为94.74%,对照组患者护理有效率为75.0%,差异具有统计学意义(P<0.05)。结论不稳定型心绞痛患者在治疗中采用综合护理,可提高治疗效果,减轻病痛,保持良好心态,效果显著。%ObjectiveTo explore nursing intervention effect in treatment of unstable angina.Methods Choose 35 patients with unstable angina that were treated in hospital from April 2014 to August 2014 and separated them into two groups at random,19 patients in study group were given comprehensive nursing,while 16 patients in control group were given conventional nursing and then compared nursing effects between two groups.ResultsPatients’ nursing efficacy in study group was 94.74%,while patients’ nursing efficacy in control group was 75.0%,there was a great differential of nursing effects between two groups and such a differential had statistic value(P< 0.05).Conclusion Comprehensive nursing is of efficacy in treatment of unstable angina,it is conducive to increasing treatment efficacy,relieving patients’ pain and assisting patients to be in a mood.

  17. Analysis of Curative Effect of Simvastatin in the Treatment of Unstable Angina Pectoris%辛伐他汀治疗不稳定型心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    王亚新

    2014-01-01

    Objective Simvastatin treatment of unstable angina clinical results were evaluated. Methods 120 patients were randomly divided into a control group and the observation group. Changes in two groups of patients before and after treatment LDL cholesterol, ECG and angina time for comparison. Results Efficacy results after treatment showed that patients in the observation group reached 96% of the total efficiency of the control group patients achieved a total ef iciency of 80%, a significant difference was statistical y significant ( <0.05), after treatment LDL cholesterol was observed between the groups compared with the control group, significant dif erence was statistical y significant ( <0.05).Conclusion In the treatment of unstable angina when using simvastatin with ten male significant effect, worthy of promotion and application in clinical practice.%目的对辛伐他汀治疗不稳定型心绞痛的临床效果进行评价。方法随机的将120例患者分为对照组以及观察组。对两组患者在治疗前后的各项指标进行比较。结果经过治疗后的疗效比较结果显示,观察组患者达到了96%的总有效率,而对照组患者达到了80%的总有效率,差异显著具有统计学意义(<0.05),在治疗之后,观察组与对照组之间的低密度脂蛋白胆固醇相比较,差异显著具有统计学意义(<0.05)。结论在对不稳定型心绞痛进行治疗的时候采用辛伐他汀具有十分显著的疗效。

  18. Effect of short-term high-dose atorvastatin on systemic inflammatory response and myocardial ischemic injury in patients with unstable angina pectoris undergoing percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Sun Fei; Yin Zhao; Shi Quanxing; Zhao Bei; Wang Shouli

    2014-01-01

    Background Percutaneous coronary intervention (PCI) could develop periprocedural myocardial infarction and inflammatory response and statins can modify inflammatory responses property.The aim of this study was to evaluate whether short-term high-dose atorvastatin therapy can reduce inflammatory response and myocardial ischemic injury elicited by PCI.Methods From March 2012 to May 2014,one hundred and sixty-five statin-naive patients with unstable angina referred for PCI at Department of Cardiology of the 306th Hospital,were enrolled and randomized to 7-day pretreatment with atorvastatin 80 mg/d as high dose group (HD group,n=56) or 20 mg/d as normal dose group (ND group,n=57) or an additional single high loading dose (80 mg) followed 6-day atorvastatin 20 mg/d as loading dose group (LD group,n=52).Plasma C-reactive protein (CRP) and interleukin-6 (IL-6) levels were determined before intervention and at 5 minutes,24 hours,48 hours,72 hours,and 7 days after intervention.Creatine kinase-myocardial isoenzyme (CK-MB) and cardiac troponin I (cTnl) were measured at baseline and then 24 hours following PCI.Results Plasma CRP and IL-6 levels increased from baseline after PCI in all groups.CRP reached a maximum at 48 hours and IL-6 level reached a maximum at 24 hours after PCI.Plasma CRP levels at 24 hours after PCI were significantly lower in the HD group ((9.14±3.02) mg/L) than in the LD group ((11.06±3.06) mg/L) and ND group ((12.36±3.08) mg/L,P <0.01); this effect persisted for 72 hours.IL-6 levels at 24 hours and 48 hours showed a statistically significant decrease in the HD group ((16.19±5.39) ng/L and (14.26±4.12) ng/L,respectively)) than in the LD group ((19.26±6.34) ng/L and (16.03±4.08) ng/L,respectively,both P <0.05) and ND group ((22.24±6.98) ng/L and (17.24±4.84) ng/L,respectively).IL-6 levels at 72 hours and 7 days showed no statistically significant difference among the study groups.Although PCI caused a significant increase in CK-MB and cTnl at

  19. La gestión ambiental como herramienta de mejoramiento más que como supervivencia

    OpenAIRE

    Magda Rocío González

    2005-01-01

    Este artículo se refiere a cómo la percepción de la gestión ambiental en las organizaciones ha cobrado gran importancia, y se ha vuelto una herramienta para la competitividad, así como una condición indispensable para entrar en los mercados globales, donde el uso eficiente de los recursos genera beneficios para la organización y el medio ambiente. De esta manera, la gestión ambiental se integra en la organización como parte de la planeación estratégica en todas las dimensiones de ésta....

  20. LLAMEMOS LAS COSAS POR SU NOMBRE DEL TRIBUTO COMO CARGA IMPOSITIVA AL TRIBUTO COMO PRINCIPIO DE SOLIDARIDAD DEL CIUDADANO

    OpenAIRE

    Serna, Ruben Dario

    2014-01-01

    La necesidad de llamar las cosas por su nombre nos ha llevado a indagar sobre el real significado que debe dársele a la expresión “Tributo”; la cual es analizada bajo tres perspectivas: 1. El Tributo comoofrenda a Dios o a los dioses. 2. El Tributo como carga impositiva derivada de la autoridad suprema del Estado. 3. El Tributo como deber de solidaridad en el Estado Social de Derecho.El Tributo en Colombia según la Constitución Política, es la obligación que tiene el ciudadano de contribuir a...

  1. Como uma onda no mar: a fluida personalidade da movimento

    Directory of Open Access Journals (Sweden)

    André Luiz Maranhão de Souza Leão

    2013-01-01

    Full Text Available Este artigo se alinha a uma prática cada vez mais comum às organizações quanto ao estabelecimento de vínculos entre suas marcas e os consumidores. Desta forma, a teoria da personalidade de marca, como evidenciada por Aaker (1997, que evoca a atribuição de características humanas à mesma, se apresenta como fundamental. A partir dessa perspectiva, propomos acessarmos a condição ôntica das marcas. Para isso, pesquisamos a Movimento, marca de moda praia, destaque no cenário nacional. O objetivo foi compreender "quem é" a Movimento, a partir das características que constituem sua personalidade na visão dos consumidores. A investigação se caracteriza como um estudo qualitativo exploratório, com base em entrevistas em profundidade, escrutinadas por meio de análise de discurso funcional. Os resultados apontam para catorze categorias. Analisando suas relações, identificamos dois perfis componentes das características ônticas da marca. Tais achados propõem implicações teóricas sobre a relação entre marcas e consumidores, assim como práticas ao fornecer insights à estratégia de posicionamento.

  2. El etanol como materia prima petroquímica

    OpenAIRE

    Luis M. Carballo; Francisco Sánchez

    2011-01-01

    En este trabajo se presentan los aspectos relevantes de un programa a de investigación, aprobado por el CINDEC y COLCIENCIAS, sobre el desarrollo y estudio cinético de catalizadores para algunas reacciones químicas en las que el etanol está involucrado como reactante.

  3. El etanol como materia prima petroquímica

    Directory of Open Access Journals (Sweden)

    Luis M. Carballo

    2011-10-01

    Full Text Available En este trabajo se presentan los aspectos relevantes de un programa a de investigación, aprobado por el CINDEC y COLCIENCIAS, sobre el desarrollo y estudio cinético de catalizadores para algunas reacciones químicas en las que el etanol está involucrado como reactante.

  4. Harold Varmus investido bajo juramento como 14.º director d

    Science.gov (United States)

    Ganador del Premio Nobel, doctor Harold E. Varmus, prestó juramento hoy como 14.º director del Instituto Nacional del Cáncer (NCI).  "Es muy estimulante que estés de regreso con nosotros", dijo la secretaria del Departamento de Salud y Servicios Humanos K

  5. La dimensión cultural como catalizadora del desarrollo

    OpenAIRE

    Duque Escobar, Gonzalo

    2011-01-01

    Cuando se enuncia el desarrollo sostenible, se expresa en términos de tres pilares: el ecológico, el social y el económico, por lo que la cultura como campo que abarca a la ciencia, donde naturaleza y sociedad son variables culturales con relaciones dialécticas, siempre ha escapado.

  6. Audiovisual y semiótica: el videoclip como texto

    OpenAIRE

    Rodríguez-López, Jennifer

    2016-01-01

    El vídeo musical es interpretado en este artículo como un texto audiovisual susceptible de análisis a partir del estudio de las funciones del lenguaje predominantes y de determinados códigos siguiendo los conceptos aportados por la teoría semiótic

  7. Redes bayesianas y redes neuronales como modelos del aprendizaje casual

    OpenAIRE

    Rodríguez Mañanes, Javier

    2009-01-01

    [ES]Este trabajo trata sobre las redes bayesianas y neuronales como modelos del aprendizaje casual. [EN]This paper deals with bayesian and neural networks as models of casual learning. Trabajo de Fin de Máster del Máster en Neurociencias, curso 2008-2009.

  8. Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

    Directory of Open Access Journals (Sweden)

    Alberto Mendoza-Ticona

    2012-06-01

    Full Text Available Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto.There is enough evidence to declare tuberculosis as an occupational disease among healthcare workers. In Peru, there are regulations granting employment rights regarding tuberculosis as an occupational disease, such as healthcare coverage for temporary or permanent disability. However, these rights have not been sufficiently socialized. This study presents information on the risk of acquiring tuberculosis in the workplace, and a review of the evidence to declare tuberculosis as an occupational disease among health care workers, presenting the current Peruvian law related.

  9. A clínica como poiética

    Directory of Open Access Journals (Sweden)

    Mônica Botelho Alvim

    2012-09-01

    Full Text Available Um dos temas fundamentais na clínica diz respeito à produção de sentido. Quando Merleau-Ponty enfatiza a noção de carne, propõe uma espécie de passividade do eu ao campo, a um ser bruto que comporta eu e outro, cultura, historicidade, temporalidade. Afirma a necessidade de passar da erlebnisse (vivência à stiftung (instituição, colocando acento num tipo de produção de sentido que é gênese espontânea, diferenciação, criação a partir da diferença. Neste trabalho discutimos a clínica da Gestalt-terapia em diálogo com essas propostas e as questões contemporâneas, para propor a clínica como lugar de criação, que visa permitir o nascimento espontâneo do sentido como fala falante e desviante; a gênese do sentido como instituição que nos garante o pertencimento com o outro a um mesmo mundo. É nesse sentido que podemos pensar em uma ética da criação na diferença – uma clínica como poiética.

  10. Intervenção Coronariana Percutânea prévia como fator de risco para Revascularização Miocárdica

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Ferreira Lisboa

    2012-07-01

    Full Text Available FUNDAMENTO: A Intervenção Coronariana Percutânea (ICP vem aumentando na doença arterial coronariana crônica. Consequentemente, cada vez mais pacientes submetidos a Cirurgia de Revascularização Miocárdica (CRM apresentam stent coronariano. OBJETIVO: Avaliar a influência do antecedente de stent coronariano na mortalidade hospitalar após CRM. MÉTODOS: Análise prospectiva com 1.099 pacientes consecutivos submetidos a CRM com circulação extracorpórea, entre maio/2007 e junho/2009. Pacientes sem ICP prévia (n = 938; 85,3% foram comparados com pacientes com ICP prévia (n = 161; 14,6%, utilizando modelos de regressão logística e análise de pareamento de amostras. RESULTADOS: Ambos os grupos apresentavam semelhança em relação aos fatores de risco, exceto pela maior presença de pacientes com angina instável no grupo com ICP prévia (16,1% vs. 9,9%; p = 0,019. A mortalidade hospitalar após CRM foi maior entre os pacientes com ICP prévia (9,3% vs. 5,1%, p = 0,034, e foi semelhante à esperada em relação ao EuroSCORE e ao 2000 Bernstein-Parsonnet score. Na análise com regressão logística multivariada a ICP prévia emergiu como fator de risco independente para mortalidade hospitalar pós-operatória (odds ratio 1,94; IC 95% 1,02-3,68; p = 0,044 tão forte quanto diabetes (odds ratio 1,86; IC 95% 1,07-3,24; p = 0,028. Após o pareamento dos grupos, a mortalidade hospitalar continuou sendo maior entre os pacientes com ICP prévia, com odds ratio 3,46 ; IC 95% 1,10-10,93; p = 0,034. CONCLUSÃO: A ICP prévia em pacientes com doença coronariana multiarterial é fator de risco independente para mortalidade hospitalar após CRM. Tal fato deve ser considerado quando a ICP for indicada como alternativa inicial em pacientes com doença arterial coronariana mais avançada. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0

  11. Practical value of cardiac magnetic resonance imaging in unstable angina diagnosis%心脏核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    唐新宇; 欧阳容

    2012-01-01

    Objective To investigate the value of magnetic resonance imaging of heart in diagnosis of unstable angina pectoris.Methods A total of 24 patients with unstable angina pectoris including 15 male and 9 female confirmed by coronary angiography (CAG) were enrolled.All 24 patients were scanned by cardiac magnetic resonance imaging ( CMR),and then the analyses of the first pass images and the delayed contrast enhancement images were carried out for comparison.The findings of cardiac structure,cardiac function,myocardial ischemia,myocardial necrosis,myocardial edema were taken for answering to the images made by echocardiography (UCG) and coronary angiography (CAG) linked with conventional examinations for the diagnosis of coronary disease.Results Compared with the UCG,CMR provided more detailed information about the right ventricle,and the information about left ventricular structure and function given by UCG was very good consistent with that offered by CMR,and CMR could detect myocardial ischemia,myocardial edema and the myocardial necrosis,which were of good consistency with findings often observed by conventional inspection methods.Conclusions Cardiac magnetic resonance imaging (CMR) is of high value in diagnosis and evaluation of unstable angina pectoris and is far superior over other conventional methods for examinations of unstable angina pectoris.%目的 研究心脏核磁共振在不稳定型心绞痛诊治中的价值.方法 选择确诊不稳定性心绞痛患者24例,其中男性15例,女性9例,均行冠脉造影.对24例患者进行心脏核磁共振(CMR)扫描,对图像进行首过灌注和延迟扫描分析(LEG),记录其在心脏结构、功能、心肌缺血、坏死、水肿等方面的信息,并使之与超声心动图(UCG)、冠脉造影(CAG)等传统检查结果对比.结果 CMR与UCG相比,可以提供更多右心室方面的信息.在左心室结构及功能方面,两者有很好的一致性;CMR能发现并检测心肌缺血、水肿及坏死,

  12. Effect of behavioral therapy on quality of life in patients with coronary heart disease angina pectoris%行为干预对冠心病心绞痛患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    兰洁; 廖光荣; 方向红; 张秀芳; 杨雨竹

    2012-01-01

    目的:探讨行为干预对冠心痛心绞痛患者生活质量的影响.方法:将110例冠心病心绞痛患者随机分为研究组和对照组各55例,对照组按心内科常规护理,研究组在此基础上增加行为干预包括戒烟限酒、低脂低盐饮食、规律睡眠、有氧运动、放松训练、听轻音乐、减少孤独焦虑抑郁等.采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)、体重指数(BMI)及生活质量指数评定量表(QOL),于入院后3个月对两组患者进行评估.结果:研究组健康行为改善优于对照组(P<0.01),焦虑、抑郁程度和体重指数(BMI)低于对照组(P<0.05),生活质量各维度评分均高于对照组(P<0.05).结论:常规护理加针对性行为干预可减轻冠心病心绞痛患者的焦虑、抑郁等负性情绪,改善健康行为,从而提高患者的生活质量.%Objective:To evaluate the effect of behavioral intervention on quality of life in patients with coronary heart disease angina pectoris. Methods: 110 Cases of patients with coronary heart disease angina pectoris were randomly divided into the study group (55) cases and the control group ( 55 ) cases. The control group was treated with routine cardiology nursing care. The study group received behavioral therapy including alcohol restriction and smoking giving up,low fat and salt diet,regular sleep,aerobic exercise,relaxation training,light music enjoyment,less loneliness,anxiety or depression on the basis of routine cardiology nursing. Zung Self-rating Anxiety Scale (SAS) ,Self- rating Depression Scale (SDS) ,Body Mass Index (BMI) and Quality of life Index (QOL) were taken to evaluate the two groups of patients respectively 3 months before and after the admission of patients. Results: Compared with the control group, the health behavior of patients with coronary heart disease angina pectoris in the study group was improved significantly. The SAS, SDS and BMI levels of the study group were relieved. The scoring

  13. Clinical Research about Different Antiplatelet Scheme forTreatment of Unstable Angina Pectoris%不同抗血小板方案治疗不稳定性心绞痛疗效临床研究

    Institute of Scientific and Technical Information of China (English)

    邓应忠; 曹晨; 郑兴萍

    2011-01-01

    Objective:To compare unstable angina pectoris curative effect of single,double, double dual antiplatelet therapy.Methods:325 cases of unstable angina patients were divided into dual antiplatelet group of 120 patients,single-agent antiplatelet group 114 cases,the first two group therapy invalid cases into double dual antiplatelet therapy.Observe clinical treatment effect of unstable angina pectoris.Results:Dual antiplatelet therapy was significantly effective in 71 cases(59.17%),effective in 23 cases(19.17%)and invalid in 26 cases(21.67%).Single-agent antiplatelet therapy was significantly effective in 56 cases (49.12%),effective in 19 cases(16.67%)and invalid in 39 cases (34.12%).P<0.05,the difference was statistically significant.Double dual antiplatelet therapy was significantly effective in 21 cases(65.63%),effective in 5 cases(15.63%)and invalid in 6 cases(28.6%).Conclusions:Dual antiplatelet therapy is more effective than single-agent antiplatelet therapy in treatment of unstable angina,double dual antiplatelet therapy can further enhance the curative effect.%目的:比较单重、双重、加倍双重抗血小板治疗不稳定性心绞痛(UAP)的疗效,探讨UAP更好的治疗方案.方法:234例不稳定型心绞痛患者分为双重抗血小板组120例、单重抗血小板组114例,前两组治疗无效病例进入加倍双重抗血小板治疗组32例.观察UAP临床治疗效果.结果:双重抗血小板治疗组显效71例(59.17%),有效23例(19.17%),无效26例(21.67%).单重抗血小板治疗组:显效56例(49.12%),有效19例(16.67%),无效39例(34.21%);差异有统计学意义(P<0.05).加倍双重抗血小板治疗组:显效21例(65.63%),有效5例(15.63%),无效6例(28.6%).结论:双重抗血小板治疗较单重抗血小板治疗有UAP治疗更好的疗效,加倍双重抗血小板治疗可以进一步提高疗效.

  14. Comparison of Outcomes of Patients ≥80 Years of Age Having Percutaneous Coronary Intervention According to Presentation (Stable vs Unstable Angina Pectoris/Non-ST-Segment Elevation Myocardial Infarction vs ST-Segment Elevation Myocardial Infarction)

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per;

    2011-01-01

    prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3......,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and......Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and...

  15. Clinical analysis of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris%盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的效果

    Institute of Scientific and Technical Information of China (English)

    柳青; 李慧芳; 刘丽凤; 董瓅瑾

    2012-01-01

    Objective To observe the efficacy of injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris. Methods 101 patients with unstable angina pectoris in our hospital were randomly divided into test group (re =51) and control group (re = 50) . The test group was administered with diltiazem hydrochloride in combination with nitroglycerin while the control group was given nitroglycerin alone. After 48 hours, the two groups of patients were observed and compared in terms of anginal attacks, heart rate, Prt, Qrto, 01 interval time, blood pressure, myocardial oxygen consumption index, blood routine, blood biochemical index. JvesultS Ihere was no death, no complications or significant arrhythmias and hemodynamic changes. After treatment, the heart rate and myocardial oxygen consumption index of the test group decreased more significantly ( P < 0. 05 ) than in the control group. PR interval and QT interval of the test group were slightly longer than those of the control group, but without significant difference. Conclusion Injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris patients induces no serious adverse rectons and can effectively relieve angina,significantly reduce myocardial oxygen con- sumption and provide better myocardial protection.%目的 观察注射用盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的临床疗效.方法 选择我院住院的101例不稳定型心绞痛患者,随机分为实验组(n=51) 和对照组( n=50),对照组单用硝酸甘油,实验组应用硝酸甘油和盐酸地尔硫联合治疗.观察并比较两组患者用药48 h对心绞痛发作次数、心率、PR间期、QRS时限、QT间期、血压、心肌耗氧指标、血常规、血生化等指标.结果 两组均无并发症,无死亡,并且血流动力学的改变及心律失常的发生率差别均无统计学意义.实验组治疗后心率

  16. La agrobiodiversidad como elemento de la seguridad alimentaria y ambiental

    Directory of Open Access Journals (Sweden)

    De la Rosa Fernández, Lucía

    2016-06-01

    Full Text Available In this article, the importance and situation of the conservation of plant genetic resources for food and agriculture is reviewed, taking into consideration not only the aspects specifically related to the conservation activity but also their role as components of biodiversity and providers of ecosystem services. Special attention is drawn to ex situ collections as providers of germplasm for direct use and for plant breeding, two elements that make an essential contribution to a greater resilience of agriculture to environmental changes. In particular, the state of conservation at national and global levels of genetic resources of Fabaceae species cultivated for human food and animal feed, is examined.En el artículo se revisa la importancia y la situación de la conservación de recursos fitogenéticos para la alimentación y la agricultura, tanto en los aspectos asociados específicamente a esta actividad como en aquellos otros derivados de su faceta como componente de la biodiversidad y proveedor de servicios ecosistémicos. Se incide en la función de las colecciones ex situ como fuente de materiales tanto para su utilización directa como en programas de mejora genética, ambos elementos imprescindibles para una agricultura resiliente frente al cambio ambiental. De forma específica, se describe el estado de la conservación de germoplasma de las especies de la familia de Fabaceae tanto para utilización en alimentación humana como en alimentación animal, en el ámbito nacional e internacional.

  17. El proyecto Wiki Learning: Wikipedia como entorno de aprendizaje abierto

    Directory of Open Access Journals (Sweden)

    2016-10-01

    Full Text Available Los enfoques predominantes en el sistema educativo tradicional circunscriben las posibilidades de aprendizaje a entornos formales y cerrados. Sin embargo, las tecnologías móviles y plataformas digitales están transformando este paradigma, expandiendo las posibilidades de aprendizaje. A partir de esta condición y en el marco de la producción del conocimiento entre pares, sostenemos que Wikipedia puede ser utilizada como un entorno de aprendizaje abierto que cumple varios propósitos: a permite adquirir competencias básicas; b contribuye a la inteligencia colectiva; c acorta la brecha global de conocimiento; y, d facilita la construcción de redes globales de aprendizaje. Este estudio de caso tiene como objetivo presentar el proceso, estrategias y resultados del proyecto Wiki Learning, como modelo de aprendizaje abierto a través del uso de Wikipedia en una universidad mexicana. El proyecto abarcó desde la producción de artículos hasta talleres para el desarrollo de capacidades de profesores y estudiantes. Se realizaron encuestas a 57 docentes y 115 alumnos para identificar la percepción acerca de Wikipedia, su uso y posibilidades como herramienta educativa. Los resultados demostraron que a pesar de que todos son usuarios de Wikipedia, existe un desconocimiento general sobre su funcionamiento, estructura y comunidades, además de cierta desconfianza. Se presenta un desafío para romper el estigma y recuperar el valor de la gestión compartida del conocimiento, el propósito de la enciclopedia y su lugar como producto de la inteligencia colectiva.

  18. Effectiveness analysis of carthamin yellow for injection treating coronary heart disease and angina pectoris%注射用红花黄色素治疗冠心病心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    于泳; 徐清华; 王冰

    2010-01-01

    目的 观察注射用红花黄色素与川芎嗪注射液治疗冠心病心绞痛的临床疗效比较.方法 180例患者随机分为治疗组和对照组各90例,治疗组静脉滴注红花黄色素,对照组静脉滴注川芎嗪,2周后观察其临床疗效,心电图以及一般体检项目.结果 治疗组心绞痛,心电图的总有效率分别为91%,54%.对照组心绞痛,心电图的总有效率分别为90%,44%.结论 注射用红花黄色素在改善冠心病心绞痛病情上与川芎嗪疗效类似.%Objective To compare the effectiveness of carthamin yellow and Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in treating coronary heart disease and angina pectoris. Methods A total of 180 patients were enrolled in the study, 90 subjects were given carthamin yellow and the other half were given Miltiorrhizae and Ligustrazine Hydrochloride.Observing the effectiveness, cardiograph and test item. Results Effective rate of cardiograph were 91% and 54% in treatment group, 90% and 44% in control group. Conclusions The effectiveness of carthamin yellow for injection treating coronary heart disease and angina pectoris were similar to Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection.

  19. Clinical Non-inferiority Trial on Treatment of Coronary Heart Disease Angina Pectoris of Xin-blood Stasis Syndrome Type with Lyophilized Salvia Salt of Lithospermic Acid Powder for Injection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection (SSLA) in treating coronary heart diseases angina pectoris (CHD-AP) of Xin-blood positive control. Methods: An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ ,Ⅱ and Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results: The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility (P<0.01). Adverse reaction appeared in 8 patients in the test groups and 2 in the control group.Conclusion: SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSl, and no evident toxic-adverse reaction.

  20. Observation of the Therapeutic Effect of Ferulic Acid Sodium Treating Unstable Angina Pectoris in 86 Cases%阿魏酸钠治疗不稳定型心绞痛86例疗效观察

    Institute of Scientific and Technical Information of China (English)

    裘健

    2011-01-01

    目的 观察阿魏酸钠治疗不稳定型心绞痛(UAP)的疗效及安全性.方法 164例UAP患者随机分为两组:阿魏酸钠组(治疗组)和丹参组(对照组),观察两组患者的临床症状疗效、心电图改善情况,治疗前后高敏C反应蛋白(hs-CRP)变化及不良反应发生情况.结果 治疗组临床症状及心电图改善情况均显著优于对照组(P<0.05);两组患者治疗前后hs-CRP均无显著变化(P>0.05);两组患者在治疗过程中均未出现明显不良反应.结论 阿魏酸钠治疗UAP疗效明显,安全性佳,值得临床推广应用.%Objective To observe the clinical effect and safety of ferulic acid sodium for patients with unstable angina pectoris( UAP ). Methods 164 UAP patients were randomly divided into ferulic acid sodi-um group( treatment group )and the salvia miltiorrhiza group( control group ). Clinical symptoms, electrocardi-ogram,high sensitive C-reactive protein( hs-CRP)and adverse effect were observed. Results Clinical symp-toms and electrocardiogram,amelioration in treatment group were better than control group( P 0.05 ); there was no obvious adverse effects during the treatment course in bothgroups. Conclusion Ferulic acid sodium is an efficient and safe therapeutic tool for unstable angina pectoris, worthy of clinical applica-tion.