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Sample records for angina inestable primaria

  1. 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.

  2. Angina

    Science.gov (United States)

    ... is usually similar to previous types of chest pain you've had Lasts a short time, perhaps five minutes or less Disappears sooner if you rest or use your angina medication The severity, duration and type of angina can vary. New or different symptoms may signal a more dangerous ...

  3. 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

    Directory of Open Access Journals (Sweden)

    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

  4. Angina (Chest Pain)

    Science.gov (United States)

    ... angina, including microvascular angina, Prinzmetal's angina, stable angina, unstable angina and variant angina. View an animation of angina . ... they differ is important. Stable Angina / Angina Pectoris Unstable Angina Variant (Prinzmetal) Angina Microvascular Angina Understand Your Risk ...

  5. Epileptic Angina

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    Sachin Sureshbabu

    2017-01-01

    Conclusion: Pain is a rare manifestation of epilepsy observed in less than 1% of patients. When present, it is usually accompanied by other focal features. This rare occurrence of epileptic seizures masquerading as angina is a novel observation.

  6. Ludwig's angina.

    Science.gov (United States)

    Saifeldeen, K; Evans, R

    2004-03-01

    The case is described of an occurrence of Ludwig's angina with advanced stage of the disease with progressive and rapid airway compromise and fatal consequence. A review of the literature is undertaken to gain a better understanding of the disease, and gives the opportunity for presenting a summary of the key issues regarding this dreaded disease, particularly the immediate management of it in the emergency department.

  7. Epileptic Angina.

    Science.gov (United States)

    Sureshbabu, Sachin; Nayak, Dinesh; Peter, Sudhir; Sobhana, Chindripu; Mittal, Gaurav

    2017-01-01

    To investigate the probable ictal origin of unexplained episodic chest pain and if possible to lateralize and localize the epileptic focus. A 14 year old boy presented with episodic short lasting localized chest pain. His cardiac and other systemic work-up were normal. MRI brain did not reveal any structural pathology. Video telemetry was done for characterization of the paroxysms. Interictal record showed left fronto-central epileptiform discharges. A left hemispheric, predominantly centroparietal ictal rhythm was identified. The possible localizations of this unusual semiology are somatosensory areas I and II, supplementary sensorimotor area, posterior insula and cingulate cortex. Patient responded remarkably to antiseizure drugs. Pain is a rare manifestation of epilepsy observed in less than 1% of patients. When present, it is usually accompanied by other focal features. This rare occurrence of epileptic seizures masquerading as angina is a novel observation.

  8. Tórax inestable: Fisiopatología, tratamiento

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    Gerardo Llera Domínguez

    1996-12-01

    Full Text Available Se reporta que el traumatismo de tórax tiene una alta mortalidad y el tórax inestable que es una modalidad, mostró en Cuba, en una serie de 1985 a 1988, el 25 %. Se indica que el tratamiento del tórax batiente ha ido cambiando de acuerdo con la fisiopatología que ha sido aceptada en cada momento. Se refiere que cuando se pensó que el problema principal era la inestabilidad torácica, los métodos usados fueron para inmovilizar. Posteriormente se utilizó la estabilización neumática interna, pero a largo plazo producía mortalidad por infección respiratoria y estenosis traqueales. Se destaca que con el concepto actual de que lo principal es la contusión pulmonar subyacente se seleccionan los pacientes y se ventilan sólo los que tienen función respiratoria comprometida, y los otros se tratan con fisioterapia y bloqueos o anestesia peridural para combatir el dolor. Se concluye en que a los pacientes que se ventilan es importante desacoplarlos tempranamente del respirador mecánico, para lo que son útiles los fijadores externos como el de Valls. En los pacientes que tienen que ser sometidos a una toracotomía se puede aprovechar para hacer una osteosíntesisIt is reported that thoracic traumas have a high mortality, and the flail chest, a modality, showed in Cuba, in a series from 1985 to 1988, the 25 %. The management of flail chest has been changing with the physiopathology accepted at each moment. When it was thought that the main problem was the thoracic instability, the methods were used just to immobilize. Later, the internal pneumatic stabilization was used, but at a long term it produced mortality due to respiratory infections and tracheal stenosis. It is highlighted that with today's concept, the main objective is the underlying lung contusion; the patients are selected and ventilation is indicated only for those who have a compromised respiratory function; the others are treated with physical therapy and blockade, or peridural

  9. Tórax inestable: Fisiopatología, tratamiento

    Directory of Open Access Journals (Sweden)

    Gerardo Llera Domínguez

    1996-06-01

    Full Text Available Se reporta que el traumatismo de tórax tiene una alta mortalidad y el tórax inestable que es una modalidad, mostró en Cuba, en una serie de 1985 a 1988, el 25 %. Se indica que el tratamiento del tórax batiente ha ido cambiando de acuerdo con la fisiopatología que ha sido aceptada en cada momento. Se refiere que cuando se pensó que el problema principal era la inestabilidad torácica, los métodos usados fueron para inmovilizar. Posteriormente se utilizó la estabilización neumática interna, pero a largo plazo producía mortalidad por infección respiratoria y estenosis traqueales. Se destaca que con el concepto actual de que lo principal es la contusión pulmonar subyacente se seleccionan los pacientes y se ventilan sólo los que tienen función respiratoria comprometida, y los otros se tratan con fisioterapia y bloqueos o anestesia peridural para combatir el dolor. Se concluye en que a los pacientes que se ventilan es importante desacoplarlos tempranamente del respirador mecánico, para lo que son útiles los fijadores externos como el de Valls. En los pacientes que tienen que ser sometidos a una toracotomía se puede aprovechar para hacer una osteosíntesisIt is reported that thoracic traumas have a high mortality, and the flail chest, a modality, showed in Cuba, in a series from 1985 to 1988, the 25 %. The management of flail chest has been changing with the physiopathology accepted at each moment. When it was thought that the main problem was the thoracic instability, the methods were used just to immobilize. Later, the internal pneumatic stabilization was used, but at a long term it produced mortality due to respiratory infections and tracheal stenosis. It is highlighted that with today's concept, the main objective is the underlying lung contusion; the patients are selected and ventilation is indicated only for those who have a compromised respiratory function; the others are treated with physical therapy and blockade, or peridural

  10. Amenorrea primaria

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    Alfredo Jácome Roca

    1988-08-01

    Full Text Available

    La amenorrea o ausencia de menstruación es una causa común de consulta. La mayoría de los casos están representados por causas fisiológicas tales como embarazo y lactancia, estados prepuberales y menopausia, o por los de amenorrea secundaria en quienes la regla se ha presentado antes, pero que desaparece por un período determinado de tiempo, considerado con criterio estricto por algunos como de seis meses para mujeres con ciclos regulares o de doce para aquellas con ciclos irregulares.

    La amenorrea primaria es una situación menos común y se define como la ausencia de menarquía a los 18 años, aunque este diagnóstico podría entrar a considerarse en pacientes de 16 años o más con menarquía retrasada en quienes otros signos de pubertad que suelen aparecer previamente – tales como pubarquia, telarquia y adrenarquia- no se observan. La división de amenorrea en primaria y secundaria es algo artificial, ya que algunos pacientes con trastornos que usualmente se asocian a amenorrea primaria, logran menstruar espontáneamente algunas veces.

    La historia y el examen físico son muy importantes para un diagnóstico inicial, ya que en algunas ocasiones el mismo problema existe en otras hermanas o se observa un fenotipo característico como en el Síndrome de Turne:- o en el de los testículos feminizantes; la asociación de signos de hiperandrogenismo nos haría pensar en una hiperplasia suprarrenal congénita o en tumores suprarrenales u ováricos con elevada producción de andrógenos; el infantilismo sexual, en causas hipotalámicas o hipofisiarias, si además hay corta estatura sin otras alteraciones fenotípicas; un fenotipo femenino puberal normal sin genitales internos y palpables nos haría pensar en una agenesia uterina, mientras que una queja de dolor abdominal cíclico con distensión pélvica sugiere un himen imperforado que se comprueba al examen pélvico.

    Los exámenes de laboratorio que deben solicitarse

  11. Problemas de adaptación fisiológica en personas con angina

    OpenAIRE

    Nóbrega Fortes, Allyne; Martins da Silva, Viviane; Lopes, Marcos Venícios de Oliveira

    2006-01-01

    En este artículo fueron identificados los problemas comunes de adaptación fisiológica presentados por pacientes con angina inestable teniendo como base el Modelo de la Adaptación de Callista Roy. Estudio descriptivo desarrollado en un hospital de servicio especializado en enfermedades cardíacas. La muestra para el estudio fue de 20 pacientes. Para caracterización y discusión, utilizamos las definiciones presentadas por Roy para cada problema de adaptación fisiológic...

  12. EVOLUCIÓN CLÍNICA DE PACIENTES CON INFARTO AGUDO DE MIOCARDIO TRATADOS CON ANGIOPLASTIA PRIMARIA / Clinical evolution of patients with acute myocardial infarction treated with primary angioplasty

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    Ernesto del Pino Sánchez

    2012-07-01

    Full Text Available ResumenIntroducción y objetivos: La angioplastia primaria restablece de manera rápida y mantenida la permeabilidad de la arteria coronaria responsable del infarto agudo de miocardio, disminuye significativamente la mortalidad, y mejora el pronóstico y la calidad de vida a largo plazo. El objetivo fue describir la evolución clínica de los pacientes con infarto agudo de miocardio tratados con angioplastia primaria. Método: Estudio descriptivo, longitudinal y prospectivo con 69 pacientes, recepcionados de 8:00 am a 4:00 pm, tratados con angioplastia primaria en el Instituto de Cardiología y Cirugía Cardiovascular, desde el 1 de julio de 2007 hasta el 31 de diciembre de 2008. Se realizó seguimiento clínico durante 180 días, donde se evaluó la frecuencia de sucesos clínicos mayores: muerte, reinfarto, angina postinfarto e inestable, necesidad de nueva revascularización y hemorragia mayor. Resultados: El tabaquismo y la hipertensión arterial tuvieron una prevalencia elevada. La localización inferior del infarto y la enfermedad de un vaso fueron las más frecuentes. Prevaleció el resultado inmediato exitoso. Los casos fallidos se relacionaron, con la coronaria derecha, el flujo TIMI 0 - 1 y el tiempo de evolución mayor de seis horas. Los sucesos clínicos mayores en el seguimiento fueron escasos y más frecuentes durante los primeros 30 días de seguimiento. Conclusiones: La angioplastia primaria realizada durante las primeras seis horas después del comienzo de los síntomas, es un procedimiento eficaz para tratar el infarto agudo de miocardio, debido al predominio del resultado exitoso y la escasa frecuencia de sucesos clínicos mayores durante seis meses de seguimiento clínico. / AbstractIntroduction and Objectives: Primary coronary angioplasty reestablishes fast and sustained way the permeability of acute myocardial infarction related artery. It decreases the mortality, improves the prognosis and quality of life to long-term. The

  13. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

    OpenAIRE

    Eduardo Contreras Zuniga; Juan Esteban Gomez Mesa; Sandra Ximena Zuluaga Martinez; Vanesa Ocampo; Cristian Andres Urrea

    2009-01-01

    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 pacie...

  14. Ludwig’s Angina: The Original Angina

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    Karim Kassam

    2013-01-01

    Full Text Available Ludwig’s angina was first detailed by the German surgeon Wilhelm Friedrich von Ludwig in 1836. We present a case which needed awake fibreoptic intubation due to severe trismus and a prolonged period intubated in the Intensive Care Unit after incision and drainage of neck spaces and removal of his lower wisdom teeth. He was finally discharged a week after admission and followed up in the outpatient clinic. The case is presented with clinical photographs and a video of the fibreoptic intubation to illustrate the airway.

  15. 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

  16. 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.

  17. [Anaemia as a cause of haemodynamic angina in a patient with chronic ischaemic heart disease].

    Science.gov (United States)

    Miguéns Blanco, I; Bravo Amaro, M

    2014-01-01

    Ischaemic heart disease is the leading cause of mortality and morbidity and one of the primary causes of morbidity in Spain. The variability in the clinical presentation of this condition at both primary care and emergency services level requires a careful history and a thorough physical examination. In the case presented, the main symptoms of angina and dyspnea reported in the anamnesis, and the obvious pallor in the physical examination, were the key data to identify anaemia as a cause of angina. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  18. Angina - when you have chest pain

    Science.gov (United States)

    ... gov/ency/patientinstructions/000088.htm Angina - when you have chest pain To use the sharing features on ... discusses how to care for yourself when you have angina. Signs and Symptoms of Angina You may ...

  19. Angina de Prinzmetal

    OpenAIRE

    Contreras Zuniga, Eduardo; Gomez Mesa, Juan Esteban; Zuluaga Martinez, Sandra Ximena; Ocampo, Vanesa; Andres Urrea, Cristian

    2009-01-01

    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 pacie...

  20. Ludwig's angina and pneumococcal sepsis.

    Science.gov (United States)

    Gridley, J; Franaszek, J

    1986-01-01

    We present a 75-year-old patient with an unusual bacteriologic cause of Ludwig's angina, Streptococcus pneumoniae. This organism appears more commonly in children. Recognition of Ludwig's angina, its causative organisms, and the necessity for airway management in addition to antibiotic therapy are important to limit its morbidity.

  1. TÓRAX INESTABLE, EVOLUCIÓN SIN OSTEOSINTESIS: PRESENTACIÓN DE UN CASO

    OpenAIRE

    Elbert Oberto Reyes Graterol; Jhonelly Jhoselyn Narváez Rodríguez; Héctor Alonso Moreno Parra; Willington René Zapata Salazar

    2011-01-01

    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 diagnóstic...

  2. Ludwig angina: forewarned is forearmed.

    Science.gov (United States)

    Kremer, Michael J; Blair, Tracy

    2006-12-01

    While the incidence of Ludwig angina is decreasing, this is an important disease process because failure to control the airway can have catastrophic consequences. Accurate diagnosis, airway control, antibiotic therapy, and, occasionally, surgical management are essential for patient safety. Ludwig angina is caused by a rapidly expanding cellulitis of the floor of the mouth and is characterized by hardened induration of the floor and suprahyoid region bilaterally with an elevation of the tongue potentially obstructing the airway. In the preantibiotic era, Ludwig angina was frequently fatal; however, antibiotics and aggressive surgical treatment have significantly lowered mortality.

  3. Linealizacion por realimentacion constructiva de sistemas mecanicos con grado de subactuacion 1 inestables con friccion

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    M. López-Martínez

    2007-10-01

    Full Text Available Resumen: En los últimos años se han desarrollado diversos métodos para controlar sistemas mecánicos subactuados. De hecho, dichos métodos no lineales han conseguido resolver problemas muy interesantes desde el punto de vista de control. Sin embargo, para obtener una solución con estos métodos, normalmente es necesario resolver un sistema de ecuaciones diferenciales en derivadas parciales, lo cual no siempre es posible. En este artículo, se presenta una metodología constructiva para diseñar un controlador para una clase de sistemas mecánicos inestables en bucle abierto y con grado de subactuación uno. Para el diseño se emplean principalmente las técnicas de linealización por realimentación y Lyapunov. La metodología consiste en proponer una salida ficticia que se pueda rediseñar de forma constructiva para resolver el problema planteado, dando lugar a una ley de control explícita, que permite tener en cuenta la fricción incluso en las coordenadas no actuadas.

  4. Ludwig's angina: an update.

    Science.gov (United States)

    Patterson, H C; Kelly, J H; Strome, M

    1982-04-01

    Despite a reduction in preantibiotic mortality rates that exceeded 50%, Ludwig's angina remains a potentially lethal entity primarily because of rapidly progressive airway obstruction. Since the reports of several large series in the 1940's, there have been put sporadic case reports because of widespread use of antibiotics in orodental infection, improved dental care, as well as adherence to strict diagnostic criteria. Since this entity is now uncommon, unnecessary delay in diagnosis and management may occur and may result in serious complications. This presentation will consist of an historical review, discussion of pathogenesis followed by clinical presentation, bacteriology and treatment, as well as a detailed analysis of our most recent 20 cases. There were no complications and no deaths. The infection resolved with medical therapy in 11 patients, while 9 patients required surgical procedures. Penicillin, clindamycin or chloramphenicol were started initially in all cases. Four of these 9 patients developed a localized abscess, while on antibiotics, which required drainage. Tracheotomy or intubation was necessary in 7 patients. Early and aggressive use of appropriate antibiotics and protection of the airway are the mainstays of a successful treatment regimen. Judicious surgical intervention is indicated in those patients who develop localized abscesses while on antibiotics or are unresponsive to medical management.

  5. Las mutaciones inestables, nuevo reto para el consejo genético de enfermedades hereditarias

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    Patricia Cuenca

    2004-09-01

    Full Text Available Las mutaciones inestables constituyen un tipo de alteración genética descubierta en la década de los noventa. En condiciones normales, regiones específicas de los genes están constituidas por repeticiones de una secuencia corta que puede ser de tres, cuatro, cinco o más nucleótidos; por ejemplo CAG, CGG, ATTCT, etc. Este nuevo tipo de mutación consiste en un aumento en la cantidad de éstas repeticiones, lo que causa una alteración en la expresión de dichos genes. Son inestables porque se ha observado que el tamaño de la secuencia repetida varía cuando las células se dividen por mitosis o meiosis, lo cual tiene implicaciones sobre la herencia y por consiguiente sobre el consejo genético que debe brindarse a los afectados. Estas mutaciones se han encontrado en genes importantes para la función neurológica normal del ser humano, donde pueden alterar el transporte de los ARN desde el núcleo al citoplasma, provocar la inactivación del gen o producir una proteína con funciones nuevas. La mayoría de las enfermedades causadas por estas mutaciones afectan el sistema nervioso, son degenerativas y presentan el fenómeno de anticipación genética, es decir que los afectados dentro de una familia se enfermarán más jóvenes y en forma más severa con el paso de las generaciones. La cantidad de repeticiones de la secuencia repetida presenta una correlación negativa con la edad de manifestación, así como una correlación positiva con la severidad de la enfermedad. En este momento existen veinte padecimientos identificados que son causados exclusivamente por este tipo de mutación. Este trabajo es una breve revisión actualizada del tema.Unstable mutations, new challenges for genetic counseling of inherited disorders. Unstable mutations or amplification of DNA tandem repeats sequences constitute a new kind of genetic alteration discovered in the 90´s that cause hereditary diseases. This mutation has been found inside or near important

  6. ANGINA PECTORIS AND NORMAL CORONARY ANGIOGRAPHY*

    African Journals Online (AJOL)

    Thirteen cases of angina pectoris Wilh normal coronary arteriograms are ... Cardiac Clinic. A fourteenth case, a 28-year-old White female, is in- cluded in this report. This patient had typical angina pectoris. She had a story of 6 months' substernal chest ... The diagnosis of angina was made on the history by at least two of us.

  7. Airway management in Ludwig's angina.

    Science.gov (United States)

    Neff, S P; Merry, A F; Anderson, B

    1999-12-01

    A 37-year-old 91 kg man presented with features of Ludwig's angina. Anaesthesia for incision and drainage of his submandibular abscess was undertaken by two specialist anaesthetists with an otorhinolaryngological surgeon prepared for immediate tracheostomy. After preoxygenation, gas induction with sevoflurane in oxygen was followed by a gush of pus into the oral cavity and laryngospam causing acute upper airway obstruction. This resolved with 25 mg of suxamethonium and an endotracheal tube was passed into the trachea with difficulty. Options for management of the difficult airway in Ludwig's angina are discussed.

  8. Angina pectoris efter sumatriptan (Imigran)

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Christiansen, B D

    1992-01-01

    Developed for the treatment of migraine, sumatriptan is an agonist of 5-hydroxytryptamine-1-receptors. Though a pressure sensation is a common complaint, significant ECG changes have not been reported after subcutaneous administration of sumatriptan. A case history is given where angina pectoris ...

  9. La estructura tributaria del Paraguay: presión fiscal baja, inestable y sesgada hacia impruestos indirectos sobre el consumo

    OpenAIRE

    Mendez Orue, Juan Pablo

    2014-01-01

    Metadados do trabalho de conclusão de curso: La estructura tributaria del Paraguay: presión fiscal baja, inestable y sesgada hacia impruestos indirectos sobre el consumo, pela/o discente: Juan Pablo Mendez Orue, sob orientação: Rodrigo Luiz Medeiros da Silva do Centro de Economia e Sociedade, curso de Ciências Econômicas - Economia, Integração e Desenvolvimento da Universidade Federal da Integração Latino-Americana (UNILA), no Repositório Institucional da Unila (RI-UNILA). La estructura t...

  10. Ludwig's angina: a clinical review.

    Science.gov (United States)

    Srirompotong, Somchai; Art-Smart, Thumnu

    2003-08-01

    Ludwig's angina is caused by a rapidly expanding cellulitis of the floor of the mouth and is characterized by a brawny induration of the floor and suprahyoid region (bilaterally), with an elevation of the tongue potentially obstructing the airway. In the pre-antibiotic era, Ludwig's angina was frequently fatal; however, antibiotics and aggressive surgical intervention have significantly reduced mortality. We reviewed nine patients with Ludwig's angina between July 1996 and June 2002, all of whom presented with fever, neck swelling, bilateral submandibular swelling and elevation of the tongue. In eight patients (89%) a dental infection appeared to be the underlying cause. High-dosage intravenous antibiotics directed towards the suspected causative microorganisms were given to all of the patients: two were treated successfully with conservative medical management, while seven underwent surgical drainage (a tracheotomy was necessary in one patient). Routine aerobic cultures were done on samples of drained material and the predominant microorganisms were Streptococcus species in two patients; there were none in the other five. Two patients had post-operative complications, but all recovered.

  11. Angina in Women Can Be Different Than Men

    Science.gov (United States)

    ... Aortic Aneurysm More Angina in Women Can Be Different Than Men Updated:Jun 13,2017 Angina (chest ... the symptoms. So why would angina symptoms be different in women and men? Heart disease in men ...

  12. Ludwig's Angina Following Self Application of an Acidic Chemical ...

    African Journals Online (AJOL)

    Ludwig's angina is a potentially life threatening diffuse cellulitis usually resulting from odontogenic infection. We report a case of Ludwig's angina resulting from self administration of an acidic chemical to treat toothache. Keywords: Toothache, Acid chemical, Ludwig's angina ...

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

    OpenAIRE

    Elbert Oberto Reyes Graterol; Jhonelly Jhoselyn Narváez Rodríguez; Héctor Alonso Moreno Parra; Willington René Zapata Salazar

    2012-01-01

    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 diagnós...

  14. Ludwig's angina: case report and review.

    Science.gov (United States)

    Spitalnic, S J; Sucov, A

    1995-01-01

    Modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. To avoid acute airway obstruction, emergency physicians must be able to rapidly recognize and treat this condition. A typical case of Ludwig's angina is presented, followed by a review of clinical findings and therapeutic modalities. Emphasis is made on airway management, antibiotics, and surgical drainage.

  15. Pregnancy Complicated by Ludwig's Angina Requiring Delivery

    Directory of Open Access Journals (Sweden)

    Kathleen Moorhead

    2010-01-01

    Full Text Available At 33 weeks of gestation, a 24-year-old developed Ludwig's angina that worsened despite aggressive therapy. This is the first reported case of Ludwig's Angina in pregnancy that required an emergent cesarean section for fetal indications. Delivery may have contributed to improvement in the mother's health status.

  16. Suppression of exercise-induced angina by magnesium sulfate in patients with variant angina

    International Nuclear Information System (INIS)

    Kugiyama, K.; Yasue, H.; Okumura, K.

    1988-01-01

    The effects of intravenous magnesium on exercise-induced angina were examined in 15 patients with variant angina and in 13 patients with stable effort angina and were compared with those of placebo. Symptom-limited bicycle exercise and thallium-201 myocardial scintigraphy were performed after intravenous administration of 0.27 mmol/kg body weight of magnesium sulfate and after placebo on different days. In all patients, serum magnesium levels after administration of magnesium sulfate were about twofold higher than levels after placebo. Exercise-induced angina associated with transient ST segment elevation occurred in 11 patients with variant angina receiving placebo and in only 2 of these patients receiving magnesium (p less than 0.005). On the other hand, exercise-induced angina was not suppressed by magnesium in any patient with stable effort angina. In these patients there was no significant difference in exercise duration after administration of placebo versus after administration of magnesium. The size of the perfusion defect as measured by thallium-201 scintigraphy was significantly less in patients with variant angina receiving magnesium than that in those receiving placebo (p less than 0.001), whereas it was not significantly different in patients with stable effort angina receiving placebo versus magnesium. In conclusion, exercise-induced angina is suppressed by intravenous magnesium in patients with variant angina but not in patients with stable effort angina. This beneficial effect of magnesium in patients with variant angina is most likely due to improvement of regional myocardial blood flow by suppression of coronary artery spasm

  17. Angina

    Science.gov (United States)

    ... trials from ClinicalTrials.gov . Visit Children and Clinical Studies to hear experts, parents, and children talk about their experiences with clinical research. More Information Related Health Topics Atherosclerosis Coronary Heart Disease Coronary Heart Disease Risk Factors ...

  18. Ludwig's angina: a case report and review.

    Science.gov (United States)

    Dreyer, A F; de Kock, S E; Rantloane, J L

    1990-09-01

    A case of Ludwig's angina which developed after mandibular fractures in a 14-year-old male patient is reported. We emphasise the serious nature of this condition and the aggressive treatment it requires. It is important to recognise cases of Ludwig's angina at an early stage, as well as cases which are at risk of developing into true Ludwig's angina if treatment is delayed. Management should be aimed at maintaining an open airway by nasotracheal intubation or cricothyroidotomy, together with treatment of the infection by removal of the source, drainage of pus and parenteral antibiotic therapy. In addition, investigation and management of contributing medical conditions and timely specialist consultation are essential.

  19. Who Is at Risk for Angina?

    Science.gov (United States)

    ... emotional stress triggers angina. Learn ways to handle stress that can't be avoided. You also can make lifestyle changes that help lower your risk for coronary heart disease . One of the most important changes is to ...

  20. Emergency coronary angioplasty in refractory unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); M.J.B.M. van den Brand (Marcel); K. Balakumaran (Kulasekaram); A.L. Soward; P.G. Hugenholtz (Paul); A.E.R. Arnold (Alfred); B. Mochtar (Bas)

    1985-01-01

    textabstractWe performed percutaneous transluminal coronary angioplasty as an emergency procedure in 60 patients with unstable angina pectoris that was refractory to treatment with maximally tolerated doses of beta-blockers, calcium antagonists, and intravenous nitroglycerin. The initial success

  1. Intestinal angina. Report on two operated cases.

    Science.gov (United States)

    Solheim, K; Rosseland, A; Lund, B L

    1977-01-01

    In spite of the fact that the concept of intestinal angina is more than 70 years old, it is not generally accepted and only 400 cases of elective revascularization of the celiac/mesenteric arteries are reported in the literature. Two typical cases of intestinal angina treated with elective revascularization are presented and the pertinent literature is reviewed. An aggresive approach to the problem, followed by adequate reconstruction, is recommended.

  2. Surgical management of Ludwig's angina.

    Science.gov (United States)

    Greenberg, Simon L L; Huang, Johnson; Chang, Robert S K; Ananda, Subramaniam N

    2007-07-01

    Ludwig's angina (LA) is a dangerous surgical condition that can cause severe airway compromise and death. There is controversy regarding the best way to manage the airway of patients with LA. Options range from conservative management involving close observation and i.v. antibiotics to airway intervention, including tracheostomy and endotracheal intubation using fibre-optic nasoendoscopy. We present evidence supporting a role for conservative airway management in a select subset of patients. This paper reviews 9 years' experience of treating patients with LA at Liverpool Hospital. Twenty-one out of 29 (72%) of our patients were treated conservatively following initial clinical assessment. One of these patients subsequently deteriorated requiring emergency intubation. Of those treated non-conservatively at initial presentation, seven patients were able to be intubated using fibre-optic nasoendoscopy and one patient required tracheostomy under local anaesthesia. A general discussion of issues related to the management of LA is presented. Based on our experience we conclude that there is a subset of patients with LA who can be managed safely with conservative management.

  3. Podocitopatias primarias: serie de casos

    OpenAIRE

    Moncaleano Bermúdez, Luis Giovanni

    2015-01-01

    Antecedentes: Las podocitopatias primarias son nefropatías en las que directamente están comprometidos los podocitos en su fisiopatología y son de origen idiopático. Estas comprenden la enfermedad de cambios mínimos (ECM), la nefropatía membranosa (NM) y la glomeruloesclerosis focal y segmentaria (GSFS) de tipo primario (1-2). Estas 3 patologías son causa frecuente de síndrome nefrótico en adultos (3-7). De su diagnóstico y manejo, temprano y adecuado depende la sobrevida renal en los siguien...

  4. Peritonitis primaria por Streptococcus pyogenes

    OpenAIRE

    Munrós, Jordina; Alonso Vargas, María Inmaculada; Pino Saladrigues, Marta del; Pahisa Fábregas, Jaume; Almela, M. (Manel); Mensa Pueyo, Josep; Carmona Herrera, Francisco

    2014-01-01

    Sr. Editor: la peritonitis de origen infeccioso habitualmente es secundaria a procesos patológicos del tracto gastrointestinal o genitourinario y suele ser polimicrobiana. Se denomina peritonitis primaria o espontánea aquélla en la que no se objetiva ninguna causa evidente. Generalmente es de etiología monomicrobiana y se observa en pacientes afectos de cirrosis hepática, síndrome nefrótico o inmunosupresión. Su hallazgo en personas sin ninguna comorbilidad es muy poco frecuente. Los microorg...

  5. Prevención primaria

    OpenAIRE

    Henao Gaviria, Luis Fernando

    1989-01-01

    Pretende este trabajo sobre "Prevención primaria" brindar en forma general una seria de conceptos sobre la salud y la enfermedad, las diferentes barreras que se pueden interponer para que esta no se presente o si se presenta sea lo menos virulenta posible, si deja secuelas buscar que el paciente las trate de superar y evitar la muerte, se logra lo anterior aplicando los niveles de prevención de Leavell y Clark, se hará enfasis en el 1° y 2° nivel que corresponden al fomento o promoción de la ...

  6. Enfrentamiento de las vasculitis primarias

    OpenAIRE

    Dr. D. Santiago Rivero

    2012-01-01

    Las Vasculitis Primarias son enfermedades poco frecuentes, potencialmente fatales, sin causa etiológica conocida, que pueden comprometer a vasos sanguíneos de distinto tamaño, produciéndoles un proceso inflamatorio en la pared vascular, que conduce a la estrechez u obstrucción del vaso afectado, con consecuente isquemia o necrosis del tejido que irrigan. Sus manifestaciones clínicas pueden ser muy variadas, y frecuentemente inespecíficas. Sin embargo hay algunas que hacen sospechar el diagnós...

  7. Low education as a risk factor for undiagnosed angina.

    Science.gov (United States)

    McKee, Michael M; Winters, Paul C; Fiscella, Kevin

    2012-01-01

    Early awareness, recognition, and treatment of angina can help prevent or delay an acute myocardial infarction and potentially delay death. A patient's educational level may affect a physician's diagnosis of angina and/or a patient's symptom recognition. The objective of this study was to determine whether low education is a risk factor for undiagnosed angina. This was a cross-sectional observational study based on data from the National Health and Nutrition Examination Survey 2001 to 2008, providing a nationally representative sample of adults ≥40 years of age with angina based on physician diagnosis, presence of angina symptoms based on the Rose Questionnaire, or both. Educational attainment (high school or less vs more than high school) was the independent variable of interest. Undiagnosed angina (angina symptoms in the absence of angina diagnosis) was the dependent variable. We used logistic regression to control for age, sex, race/ethnicity, income, and health care visit during the past year. Low education was associated with undiagnosed angina (odds ratio: 1.43; 95% confidence interval: 1.01-2.03). Other undiagnosed angina predictors included being female, being black, and having no health care visit during the past year. Low education is associated with undiagnosed angina. These results underscore the need for providers to ask about angina symptoms and confirm patients' understanding of their angina diagnosis among those with low education.

  8. Ludwig's angina in the pediatric population.

    Science.gov (United States)

    Lin, Harrison W; O'Neill, Allison; Cunningham, Michael J

    2009-07-01

    As many as 1 in 3 of cases of Ludwig's angina occur in children and adolescents, and pediatricians are therefore ideally situated to detect these individuals at an early stage of their potentially life-threatening disease. The early identification and referral of children afflicted with Ludwig's angina to tertiary care centers allows for the rapid initiation of medical therapy and the consultation of those emergency services critical to providing such patients with optimal diagnostic and therapeutic interventions. This review provides an overview of the anatomical and pathophysiological considerations in Ludwig's angina and describes practical management principles to assist pediatricians in the diagnosis and treatment of this disease. Included in this review is an evidence-based algorithm for airway management.

  9. Angina Treatment: Stents, Drugs, Lifestyle Changes -- What's Best?

    Science.gov (United States)

    ... your body. Unstable angina. Unstable angina is either new chest pain or a change in your usual pattern of chest pain or discomfort — such as chest pain that is getting worse, lasting longer, or not being relieved with rest or use of medications. Unstable angina is dangerous and a warning sign ...

  10. Effect of raised plasma β endorphin concentrations on peripheral pain and angina thresholds in patients with stable angina

    OpenAIRE

    Jarmukli, N; Ahn, J; Iranmanesh, A; Russell, D

    1999-01-01

    OBJECTIVE—To determine whether changes in plasma concentrations of β endorphins alter angina threshold and peripheral pain threshold in patients with stable angina.
DESIGN—Latin square design comparison of angina thresholds by exercise treadmill test and peripheral pain thresholds using a radiant heat source in eight patients with stable angina under control conditions, after stimulation of pituitary β endorphin release by ketoconazole, after suppression of pituitary β endorphin release by de...

  11. 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.

  12. costarricenses de primaria y secundaria

    Directory of Open Access Journals (Sweden)

    Julián Monge Nájera

    2006-01-01

    Full Text Available En Costa Rica, la informática dejó de ser una “nueva tecnología” para ser parte cotidiana de la vida de docentes y estudiantes. Sin embargo, el valor y tipo de uso de las computadoras y otros componentes de la informática en la enseñanza-aprendizaje aún son sujeto de debate entre los teóricos de la educación. La discusión se centra en un aspecto teórico y otro práctico. El teórico: ¿debe enseñarse cómo funciona la computadora o debe enseñarse simplemente a usarla? El práctico: ¿conviene usar la informática durante las lecciones, o sólo como un complemento extra-clase? Tras consultar a 231 mujeres y hombres dedicados a la enseñanza primaria y secundaria en toda Costa Rica, se encontró que la mayoría está a favor de cómo enseñar a usar la computadora (más que cómo funciona, tanto en el aula como fuera de ella. Sin embargo, en la vida real usan la informática más en actividades administrativas que educativas, y no han aprovechado el verdadero potencial de la tecnología de la información y comunicación (TIC en educación, por lo cual no han cosechado los logros que se esperan de su uso. Es urgente entonces un giro radical en la forma en que se apoya al personal docente y en cómo se emplean realmente las computadoras en la educación primaria y secundaria de Costa Rica.

  13. Unstable angina and exposure to carbon monoxide.

    Science.gov (United States)

    Balzan, M V; Cacciottolo, J M; Mifsud, S

    1994-10-01

    Inhalation of small amounts of carbon monoxide diminishes the pain threshold in patients with stable angina pectoris. The aim of this study was to identify and describe patients who had been exposed unknowingly to toxic inhalations of this gas and subsequently presented to hospital with a clinical picture of unstable angina. Blood carboxyhaemoglobin levels of 104 patients referred with unstable angina to a coronary care unit were determined on admission. The likely source of carbon monoxide was identified in all patients. Three patients had definite carbon monoxide intoxication. Another five patients had evidence of minor exposure. When the three cases with carbon monoxide poisoning were excluded, the mean carboxyhaemoglobin level was 2.5% (+/- 1.3) for smokers (n = 30) and 0.6% (+/- 0.5) for non-smokers (n = 71). Use of fossil fuel combustion in an enclosed environment was responsible for the three most serious intoxications and one of the minor cases. We suggest that a number of patients admitted for coronary care with unstable angina may have significant carbon monoxide poisoning. This intoxication is often overlooked by attending physicians with the result that high concentration oxygen therapy is not administered, when it is in fact a necessary part of treatment.

  14. Traditional and Alternative Therapies for Refractory Angina.

    Science.gov (United States)

    Kocyigit, Duygu; Gurses, Kadri Murat; Yalcin, Muhammed Ulvi; Tokgozoglu, Lale

    2017-01-01

    Refractory angina (RFA) is an unfavourable condition that is characterized with persistent angina due to reversible myocardial ischemia in patients with coronary artery disease that remains uncontrollable despite an optimal combination of pharmacological agents and revascularization. Despite significant advances in revascularization techniques and agents used in pharmacological therapy, there is still a significant population suffering from RFA and the global prevalence is even increasing. Anti- anginal treatment and secondary risk-factor modification are the traditional approaches for this group of patients. Furthermore, now there is still a large number of alternative treatment options. In order to review traditional and alternative treatment strategies in patients with RFA, we searched Pubmed for articles in English using the search terms "pharmacological therapy, refractory angina", "alternative therapy, refractory angina" between inception to June 2016. We also went through separately for each alternative treatment modality on Pubmed. To identify further articles, we handsearched related citations in review articles and commentaries. We also included data from the European Society of Cardiology (2013), and the Canadian Society of Cardiology/ Canadian Pain Society (2012) guidelines. Data show that besides traditional pharmacological agents, such as nitrates, beta- blockers or calcium channel blockers, novel antiischemic drugs and if symptoms persist, several non- invasive and/ or invasive alternative strategies may be considered. Impact of some pharmacological agents, such as rho- kinase inhibitors, and novel alternative treatment modalities, such as coronary sinus reducers, stem cell therapy, gene and protein therapy, on outcomes are still under investigation. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Treating angina pectoris by acupuncture therapy.

    Science.gov (United States)

    Xu, Lixian; Xu, Hao; Gao, Wei; Wang, Wei; Zhang, Hui; Lu, Dominic P

    2013-01-01

    Acupuncture therapy on PC 6 (Neiguan) has a therapeutic effect on cardiac and chest ailments including angina pectoris. Additional beneficial acupuncture points are PC 4 (Ximen), HT 7 (Shenmen point), PC 7 (Daling point), PC 5 (Jianshi point), PC 3 (Quze point), CV 17 (Danzhong point), CV 6 (Qihai point), BL 15 (Xinshu point), L 20 (Pishu point), BL 17 (Geshu point), BL23 (Shenshu point), BL18 (Ganshu point), HT 5 (Tongli point), and ST36 (Zusanli point). Acupuncture not only quickly relieve the symptoms of acute angina pectoris, but also improve nitroglycerine's therapeutic effects. Therefore, it is an efficient simple therapeutic method used for emergency and for regular angina treatment. Review of studies on acupuncture therapy has shown effectiveness were between 80% to 96.2% that are almost as effective as conventional drug regimen. When compared with conventional medical treatment, the acupuncture therapy shows the obvious advantage of lacking, adverse side effects commonly associated with the Western anti-anginal drugs such as 1) Nitroglycerine (headache--63% with nitroglycerine patch and 50% with spray; syncope--4%; and dizziness--8% with patch; hypotension--4% with patch; and increased angina 2% with patch). 2) Isosorbide mononitrate (dizziness--3 to 5%; nausea/vomiting--2 to 4% and other reactions including hypotension, and syncope even with small doses). 3) Propranolol (bradycardia, chest pain, hypotension, worsening of AV conduction disturbance, Raynaud's syndrome, mental depression, hyperglycemia, etc.). Many conventional anti-anginal medications cause inter-drug reactions with other medications the patients taking for other diseases. Whereas, acupuncture therapy does not pose such an interference with patient's medications. Nevertheless, surgery is still the treatment of choice when acupuncture or conventional drug therapy fails. Combination of conventional drug therapy and acupuncture would considerably decrease the frequency and the required dosage

  16. Mesenteric angina through superior mesenteric venous thrombosis

    OpenAIRE

    Mohan, Divya; Aijaz, Faisal; Krijgsman, Brandon

    2010-01-01

    We present the case of a 67-year-old male with mesenteric venous thrombosis resulting in mesenteric angina, where early diagnosis made a favourable outcome possible through prompt anticoagulation and bowel rest. Mesenteric venous thrombosis is a relatively rare but important cause of bowel ischaemia, as a delay in diagnosis is associated with high morbidity and mortality. Early diagnosis through computed tomography scanning and subsequent treatment resulted in resolution of the thrombus with ...

  17. Treatment of Angina and Microvascular Coronary Dysfunction

    Science.gov (United States)

    Samim, Arang; Nugent, Lynn; Mehta, Puja K.; Shufelt, Chrisandra; Merz, C. Noel Bairey

    2014-01-01

    Opinion statement Microvascular coronary dysfunction (MCD) is an increasingly recognized cause of cardiac ischemia and angina, more commonly diagnosed in women. Patients with MCD present with the triad of persistent chest pain, ischemic changes on stress testing, and no obstructive coronary artery disease (CAD) on cardiac catheterization. Data from National Heart, Lung and Blood Institute (NHLBI)-sponsored Women’s Ischemia Syndrome Evaluation (WISE) study has shown that the diagnosis of MCD is not benign, with a 2.5% annual risk of adverse cardiac events including myocardial infarction, stroke, congestive heart failure, or death. The gold standard diagnostic test for MCD is an invasive coronary reactivity test (CRT), which uses acetylcholine, adenosine, and nitroglycerin to test the endothelial dependent and independent, microvascular and macrovascular coronary function. The CRT allows for diagnostic and treatment options as well as further risk stratifying patients for future cardiovascular events. Treatment of angina and MCD should be aimed at ischemia disease management to reduce risk of adverse cardiac events, ameliorating symptoms to improve quality of life, and to decrease the morbidity from unnecessary and repeated cardiac catheterization in patients with open coronary arteries. A comprehensive treatment approach aimed at risk factor managment, including lifestyle counseling regarding smoking cessation, nutrition and physical activity should be initiated. Current pharmacotherapy for MCD can include the treatment of microvascular endothelial dysfunction (statins, angiotensin-converting enzyme inhibitor, low dose aspirin), as well as treatment for angina and myocardial ischemia (beta blockers, calcium channel blockers, nitrates, ranolazine). Additional symptom management techniques can include tri-cyclic medication, enhanced external counterpulsation, autogenic training, and spinal cord stimulation. While our current therapies are effective in the treatment

  18. An upper airway obstruction emergency: Ludwig angina.

    Science.gov (United States)

    Chou, Yu-Kung; Lee, Chao-Yi; Chao, Hai-Hsuan

    2007-12-01

    Ludwig angina remains a potentially lethal disease, rapidly spreading bilateral cellulitis of the submental, sublingual, and submandibular spaces, which bears the threat for rapid airway obstruction. Since the introduction of antibiotics in 1940s, the mortality was reduced significantly. This resulted in the rare occurrence of the disease, leaving many physicians with limited experience of Ludwig angina. Although the occurrence of Ludwig angina in adults is rare, its presence in the pediatric edentulous population is even more uncommon. Because the unfamiliarity with this disease is now increasing, unnecessary delaying diagnosis or inadequate management may occur and may result in serious complications. This presentation will consist of a historical review, discussion of pathophysiology, followed by clinical presentation, etiology, bacteriology, and management. With early diagnosis, airway observation and management, aggressive intravenous antibiotic therapy, and judicious surgical intervention, the disease should resolve without complications. In addition, the source of infection should be determined and eliminated if possible. A thoughtful, individualized management strategy seems to be the most reasonable approach to the disease.

  19. Educación Primaria

    Directory of Open Access Journals (Sweden)

    Maite Serna

    2017-01-01

    Full Text Available Este trabajo surge del interés de evaluar la biblioteca escolar como medio lector, como generadora y aleccionadora de hábitos lectores. Pretende responder a la cuestión de si las directrices que rigen las actuaciones en torno a la lectura de las bibliotecas escolares de Bizkaia, en el País Vasco, son convenientes y fructíferas. Con este objetivo, primero se ha realizado un análisis detallado de los hábitos lectores y las percepciones sobre la importancia de la lectura que tienen los escolares y sobre quién los induce. Posteriormente hemos elaborado un estudio diagnóstico de las bibliotecas de centros de Educación Primaria, analizando su trabajo como agente lector y su integración e implicación con la comunidad educativa. Y finalmente se ha establecido la relación de los dos análisis anteriores para ver hasta qué punto la existencia de una biblioteca escolar favorece o no los hábitos lectores, concluyendo, por una parte, que la actitud y el estímulo familiar son elementos básicos para favorecer los hábitos lectores y, por otra, que la mera presencia de una biblioteca escolar en el centro no es suficiente para mejorar hábitos o valoración de la lectura, sino que la clave está en el tipo de biblioteca que trabaja con los escolares.

  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. Variant (Prinzmetal's) Form of Angina Pectoris Manifesting in ...

    African Journals Online (AJOL)

    1974-06-08

    , which has been termed the variant or atypical form of angina pectoris. The distribution of the pain is identical with the classic form of angina pectoris, being substernal with radiation to the jaw and down the ulnar surfaces of ...

  2. Coronary angioplasty early after diagnosis of unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); H. Suryapranata (Harry); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel)

    1987-01-01

    textabstractCoronary angioplasty (PTCA) was performed early after diagnosis of unstable angina in 71 patients who responded favorably with initial pharmacologic treatment and who also had persistent exertional angina. The patients selected for PTCA had predominantly single-vessel disease and a

  3. ORIGINAL ARTICLE Ludwig's Angina: An Analysis of Sixteen Cases ...

    African Journals Online (AJOL)

    Ogunbodede

    ABSTRACT. Objective: To document the prevalence and management of Ludwig's angina in a suburban population. Methods: All consecutive cases of Ludwig's angina seen and managed at the Obafemi. Awolowo University Teaching Hospital, Ile-Ife, Nigeria between 1988 and 2002. Results: There were 16 cases with 10 ...

  4. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P. van den Heuvel; F. Unger (Felix); R. Beyar; W.K. Lindeboom (Wietze); V. de Valk (Vincent); S. Milo; R. Simon (Rudiger); G.F.O. Tyers (Frank); D. Regensburger; P.A. Crean (Peter); I.M. Penn (Ian); E. McGovern; C. van Cauwelaert; P.W.J.C. Serruys (Patrick)

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the

  5. Ludwig's angina and airway considerations: a case report.

    Science.gov (United States)

    Kulkarni, Anand H; Pai, Swarupa D; Bhattarai, Basant; Rao, Sumesh T; Ambareesha, M

    2008-06-20

    Patients with deep neck infections present challenging airways for an anesthesiologist. Patients with Ludwig's angina may die as a result of the inability to effectively manage the airway. Here we discuss the anesthetic management with fiberoptic intubation of a 45-year-old man with Ludwig's angina scheduled for emergency drainage. Awake fiberoptic intubation under topical anesthesia may be the ideal method to secure the airway in advanced cases of Ludwig's angina. When fiberoptic bronchoscopy is not feasible, not available or has failed, an awake tracheostomy may be the preferred option.

  6. Emergency management of Ludwig’s angina: A case report

    Directory of Open Access Journals (Sweden)

    Nur Huda Alimin

    2016-06-01

    Full Text Available Ludwig’s angina is a severe diffuse sellulitis, commonly caused by odontogenic infection, acute on onset, spread rapidly, involving the submandibular, sublingual region bilaterally, and submental region. This case led to the emergency condition because it can cause airway obstruction. The aim of this case report is to describe a case report about diagnosis and management of emergencies Ludwig’s angina. A 40 years old male patient, came to Dr. Hasan Sadikin hospital emergency with pain and swelling at lower jaw, drooling, difficulty to open his mouth and breath. Diagnosed with sepsis accompanied Ludwig’s angina. We managed the patient with close observation, tracheostomy, and source control under local anesthesia. Ludwig’s angina is a rare emergency condition which potentially life-threathening. In this case the patient experienced a significant recovery because immediately management in maintaining airway patency, prevent the spread of infection and further complications.

  7. Severe angina pectoris in asthma attack: a case report.

    Science.gov (United States)

    Nabavizadeh, Seyed Hesamedin; Farahbakhsh, Nazanin; Fazel, Ali; Mosavat, Fereshteh; Anushiravani, Amir

    2016-06-01

    Asthma is a chronic inflammatory disorder of the airways related to the obstruction of reversible airflow. Asthma presents as recurrent attacks of cough and dyspnea. Poor control causes recurrent admissions to the ICU, and mortality is related to poor drug compliance and follow-up. Angina pectoris is a syndrome of recurrent chest discomfort related to myocardial ischemia. The presence of these two disorders rarely has been reported. We reported a 12-year-old boy who was referred with exacerbation of asthma and developed angina pectoris during hospitalization. He had labored breathing and diffuse wheezing. During treatment of the asthma, the patient developed severe chest pain due to shunt formation and coronary hypoxia, caused by the sole administration of ventolin, since oxygen had been disconnected. After receiving appropriate therapy, both his asthma and angina recovered, and, to date, he has not experienced angina pectoris again.

  8. Ludwig's angina: an unusual sequel to endodontic therapy.

    Science.gov (United States)

    Tuffin, J R

    1989-05-01

    Ludwig's angina is an unusual sequel to endodontic treatment: such a case is described. Principles of management are discussed with emphasis placed on the need to secure the airway early. The literature is reviewed.

  9. Prevalência de angina pectoris em Pelotas, RS Prevalence of angina pectoris in Pelotas, south of Brazil

    Directory of Open Access Journals (Sweden)

    Leonardo Alves

    2010-08-01

    Full Text Available FUNDAMENTO: A cardiopatia isquêmica é a doença responsável pelo maior número de mortes no mundo, sendo a angina sua principal manifestação. OBJETIVO: Determinar a prevalência de angina e de possível angina e sua distribuição conforme as principais características sócio-demográficas entre adultos com idade igual ou maior que 40 anos. MÉTODOS: Estudo transversal de base populacional com moradores da área urbana da cidade de Pelotas (RS entre os meses de outubro e dezembro de 2007. Foi adotado o plano de amostragem por conglomerados em dois estágios - setores censitários e domicílios. As prevalências de angina e de possível angina foram definidas de acordo com o questionário de Rose. Essas condições foram avaliadas conforme as características sócio-demográficas: idade, sexo, cor da pele, condição econômica e escolaridade. Para a coleta dos dados, foram aplicados questionários padronizados por meio de entrevista com os indivíduos em seus domicílios. A taxa de não respondentes foi de 6,8%. RESULTADOS: A prevalência de angina entre os 1.680 indivíduos participantes do estudo foi de 8,2 % (IC 95%: 6,7 - 9,6, enquanto a de possível angina, 12,3% (IC 95%: 10,6 - 14,0. As prevalências de angina e de possível angina foram maiores entre os indivíduos do sexo feminino, de cor da pele preta/parda, de pior condição econômica e de menor escolaridade. A prevalência de angina foi maior entre indivíduos mais velhos. Não se observou diferença para possível angina. CONCLUSÃO: A prevalência de angina e de possível angina mostrou-se alta, acometendo cerca de 20% da população de Pelotas.BACKGROUND: Ischemic heart disease is the leading cause of death in the world and angina is its cardinal manifestation. OBJECTIVE: To determine the prevalence of angina and possible angina and its distribution by main demographic and socioeconomic characteristics among adults 40 years of age or older. METHODS: This is a population

  10. 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...... once a day is an effective 24-hour antiischemic drug in the treatment of transient myocardial ischemia....

  11. Modern diagnostic capabilities for vasospastic angina diagnostics (intracoronary provocative testing

    Directory of Open Access Journals (Sweden)

    А. А. Обединский

    2017-04-01

    Full Text Available This review is devoted to a topical problem of modern cardiology – techniques of diagnosing vasospastic angina. The results of retrospective and prospective studies on the efficacy and safety of vasospastic angina diagnostics are reviewed. The literature on the prevalence, progression and treatment of this pathology is discussed.Received 13 January 2017. Accepted 6 February 2017.Financing: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

  12. Modern diagnostic capabilities for vasospastic angina diagnostics (intracoronary provocative testing)

    OpenAIRE

    А. А. Обединский; С. В. Бугуров; О. В. Крестьянинов; И. А. Нарышкин; Д. Д. Зубарев; И. О. Гражданкин; Р. У. Ибрагимов; В. И. Байструков; Р. А. Найденов; Е. И. Кретов

    2017-01-01

    This review is devoted to a topical problem of modern cardiology – techniques of diagnosing vasospastic angina. The results of retrospective and prospective studies on the efficacy and safety of vasospastic angina diagnostics are reviewed. The literature on the prevalence, progression and treatment of this pathology is discussed.Received 13 January 2017. Accepted 6 February 2017.Financing: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

  13. Airway management in Ludwig's angina – a challenge: case report

    OpenAIRE

    Fellini, Roberto Taboada; Volquind, Daniel; Schnor, Otávio Haygert; Angeletti, Marcelo Gustavo; Souza, Olívia Egger de

    2016-01-01

    Abstract Background Ludwig's angina (LA) is an infection of the submandibular space, first described by Wilhelm Frederick von Ludwig in 1836. It represents an entity difficult to manage due to the rapid progression and difficulty in maintaining airway patency, a major challenge in medical practice, resulting in asphyxia and death in 8-10% of patients. Objective Describe a case of a patient with Ludwig's angina undergoing surgery, with emphasis on airway management, in addition to reviewing ...

  14. Ludwig's angina and airway considerations: a case report

    OpenAIRE

    Kulkarni, Anand H; Pai, Swarupa D; Bhattarai, Basant; Rao, Sumesh T; Ambareesha, M

    2008-01-01

    Introduction Patients with deep neck infections present challenging airways for an anesthesiologist. Patients with Ludwig's angina may die as a result of the inability to effectively manage the airway. Case presentation Here we discuss the anesthetic management with fiberoptic intubation of a 45-year-old man with Ludwig's angina scheduled for emergency drainage. Conclusion Awake fiberoptic intubation under topical anesthesia may be the ideal method to secure the airway in advanced cases of Lu...

  15. Emergency management of Ludwig’s angina: A case report

    OpenAIRE

    Nur Huda Alimin; Endang Syamsuddin

    2016-01-01

    Ludwig’s angina is a severe diffuse sellulitis, commonly caused by odontogenic infection, acute on onset, spread rapidly, involving the submandibular, sublingual region bilaterally, and submental region. This case led to the emergency condition because it can cause airway obstruction. The aim of this case report is to describe a case report about diagnosis and management of emergencies Ludwig’s angina. A 40 years old male patient, came to Dr. Hasan Sadikin hospital emergency with pain and swe...

  16. LUDWIG’S ANGINA AND ANAESTHETIC DIFFICULTIES: A CASE REPORT

    OpenAIRE

    Sarda Devi; Ibemhal

    2015-01-01

    Patients with deep neck infections present challenging airways for an anesthesiologist . Ludwig’s angina is potentially lethal, rapidly spreading cellulitis involving the floor of the mouth and neck. Without aggressive management it often results in life th reatening upper airway obstruction. Securing the airway remains the top priority in treatment of Ludwig’s angina. Although awake fibreoptic intubation remains the ideal method for securing the airway, but it is not ava...

  17. Ludwig's angina: a place for steroid therapy in its management?

    Science.gov (United States)

    Freund, B; Timon, C

    1992-05-01

    Ludwig's angina is an uncommon but potentially fatal condition which presents as a hard swelling of the floor of the mouth. It spreads rapidly as a gangrenous process that may cause death through local airway obstruction. Ludwig's angina carried a 54% mortality rate in the preantibiotic era which has now been reduced to approximately 4%. Diagnosis is based on history and clinical observation. Currently described treatment involves protecting the airway and managing the infection with antibiotics and surgical drainage when indicated.

  18. LUDWIG’S ANGINA - A NIGHT MARE : OUR EXPERIENCE

    OpenAIRE

    Ritu; Valsamma; Vikrant

    2015-01-01

    INTRODUCTION: Patients with ludwig’s angina present challenging airways for anesthesiologist and may die as a result of inability to manage the airway effectively. Successful airway management is critical, but a safe method to control the airway in these patients is yet to be established. METHODS: We retrospectively studied airway management techniques used in 17 patients of Ludwig’s Angina, who required surgical drainage over a period of 12 months from January 2010...

  19. RELANZAMIENTO ATENCIÓN PRIMARIA EN SALUD

    OpenAIRE

    Gustavo Malagón Londoño

    2011-01-01

    Con la memorable sesión, en el auditorio de la Academia Nacional de Medicina, ante autoridades de la salud, miembros del cuerpo docente de las universidades, representantes de las sociedades científicas y académicos, la Directora General de la Organización Panamericana de la Salud, Doctora Mirta Roses Periago, hizo el solemne relanzamiento de la Atención Primaria de Salud en las Américas, como una nueva estrategia renovada, probada a merced de nume...

  20. Danza en Educación Primaria

    OpenAIRE

    Pedrero Muñoz, Concepción

    2013-01-01

    La danza introducida por una breve reseña en educación nos lleva a un estudio de su situación actual en el sistema educativo. La danza en Educación Primaria como aprovechamiento didáctico y recurso educativo, hace posible incorporar el término de Danza histórica (las primeras danzas escritas por los Maestros de danza) en el planteamiento de competencias introducido en el currículo escolar. Expresamos diversos aspectos para la configuración didáctica de la danz...

  1. EVALUACIÓN DEL RIESGO ASOCIADO A VULNERABILIDAD FÍSICA POR TALUDES Y LADERAS INESTABLES EN LA MICROCUENCA CAY, IBAGUÉ, TOLIMA, COLOMBIA

    Directory of Open Access Journals (Sweden)

    Yelena Hernández Atencia

    2016-01-01

    Full Text Available Este artículo de investigación presenta una herramienta de evaluación para detectar la vulnera- bilidad física asociada con taludes inestables, sobre la base de una investigación titulada “Carac - terización y análisis de la amenaza por fenómenos de remoción en masa en la microcuenca de la quebrada Cay (Ibagué, Tolima, Colombia”. Se presenta una ecuación que relaciona los factores clave que influyen en la amenaza y los elementos expuestos asociados con la vulnerabilidad física. Cada factor y elemento expuesto es categorizado. El producto de la amenaza, la vulnerabi- lidad física y la probabilidad de ocurrencia, da como resultado el parámetro RVF (riesgo asociado a vulnerabilidad física, el cual se clasifica de bajo a muy alto, según los efectos del evento amenazante sobre los elementos físicos expuestos. Se obtuvo una valoración del riesgo asociado a la vulnerabilidad física de las zonas de mayor inestabilidad en la microcuenca Cay. Esta puede ser utilizada para diseñar obras de ingeniería civil que permitan prevenir y controlar los daños causados por las inestabilidades sobre la infraestructura física de la microcuenca de la quebrada Cay. La ecuación propuesta es una herramienta valiosa para los tomadores de decisiones para priorizar la inversión de los recursos públicos.

  2. Diagnostic possibilities of radionuclide investigation in patterns with stable and unstable angina pectoris

    International Nuclear Information System (INIS)

    Ponomareva, A.G.; Zudbinov, Yu.I.; Sokolov, O.K.; Kudinov, V.I.

    1986-01-01

    Myocardial radiocardiography and scintigraphy with 99m Tc-pyrophosphate was performed in 58 patients with stable angina and 60 patients with unstable angina. In patients with stable angina, positive scintigrams were mostly recorded after anginal attacks. Their central hemodynamic parameters deteriorated progressively as angina increased in severity. Patients with unstable angina typically showed myocardial accumulation of the label that was unrelated to anginal attacks and recordable by direct-projection scintigraphy. The assessment of myocardial radiocardiographic and scintigraphic data allows one to differentiate between stable and unstable angina

  3. Long-term effects of electrical neurostimulation in patients with unstable angina : Refractory to conventional therapies

    NARCIS (Netherlands)

    de Vries, Jessica; DeJongste, Mike J. L.; Zijlstra, Felix; Staal, Michiel

    2007-01-01

    Background. Patients with unstable angina pectoris may become refractory to conventional therapies. Electrical neurostimulation with transcutaneous electrical stimulation and/or spinal cord stimulation has been shown to be effective for patients with refractory unstable angina pectoris in hospital

  4. Incidence and follow-up of Braunwald subgroups in unstable angina pectoris

    NARCIS (Netherlands)

    A.J.M. van Miltenburg-van Zijl (Addy); M.L. Simoons (Maarten); R.J. Veerhoek (Rinus); P.M.M. Bossuyt (Patrick)

    1995-01-01

    textabstractObjectives. This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. Background. Among many classifications of unstable angina, the Braunwald classification is frequently used. However, the incidence

  5. Bevacizumab-Related Microvascular Angina and Its Management with Nicorandil.

    Science.gov (United States)

    Katoh, Manami; Takeda, Norihiko; Arimoto, Takahide; Abe, Hajime; Oda, Katsutoshi; Osuga, Yutaka; Fujii, Tomoyuki; Komuro, Issei

    2017-10-21

    Bevacizumab, an inhibitor of vascular endothelial growth factor (VEGF)-A, is currently used to treat patients with ovarian or colon cancer. While several cardiovascular toxicities related to bevacizumab-containing regimens have been reported, the effect of bevacizumab on the coronary microcirculation has not been fully elucidated. Here we report a case of 54-year-old female patient who developed microvascular angina after a series of bevacizumab-containing chemotherapeutic regimen. The discontinuation of bevacizumab and nicorandil administration was effective in alleviating her chest discomfort and the ischemic changes on her ECG. This highlights the possibility that coronary microvascular angina can be induced in patients treated with bevacizumab-containing chemotherapy. It should also be noted that nicorandil can be effective in managing microvascular angina.

  6. Ludwig's angina in a 76-year-old man.

    Science.gov (United States)

    Buckley, M F; O'Connor, K

    2009-09-01

    This case is of a 76-year-old man who presented to the emergency department with a 24-h history of a progressive tense, tender midline neck swelling. A computed tomography scan revealed Ludwig's angina and the patient went on to develop respiratory compromise and was admitted to the intensive care unit. The patient's clinical course later became complicated by abscess formation requiring drainage under general anaesthetic. He was eventually discharged home some 9 days after his initial presentation. The emergency medicine management issues surrounding Ludwig's angina are discussed briefly. This case highlights the dynamic airway changes seen in this uncommon condition. Whereas Ludwig's angina has previously been associated in the emergency medicine literature with a younger age group and in patients with a history of dental infection or treatment, this case highlights the fact that it may occur despite these two common associations.

  7. Histological patterns of atherosclerotic plaques in unstable angina patients vary according to clinical presentation

    OpenAIRE

    Mann, J; Kaski, J; Pereira, W; Arie, S; Ramires, J; Pileggi, F

    1998-01-01

    Background—Unstable angina is a heterogeneous clinical syndrome. The diverse clinical presentations of unstable angina may reflect different pathogenic mechanisms within the plaque.
Objective—To investigate the cellular constituents of culprit coronary atheromatous plaques in patients with stable angina pectoris and patients with diverse clinical presentations of unstable angina.
Methods—48 patients who underwent coronary atherectomy for management of ischaemic heart disease: 23 had stable an...

  8. 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...... in male patients, but it makes the high probability groups so small that the addition appears to be of limited clinical relevance....

  9. Ludwig's angina resulting from the infection of an oral malignancy.

    Science.gov (United States)

    Fischmann, G E; Graham, B S

    1985-10-01

    A case of Ludwig's angina is reported in a 60-year-old woman who was discovered to have squamous-cell carcinoma of the tongue and floor of the mouth during intubation for airway management. This report emphasizes the need to consider infection of oral malignancies of the tongue and floor of the mouth in the etiology of Ludwig's angina when an odontogenous origin cannot be demonstrated. It also illustrates the value of bronchoscopy-directed nasotracheal intubation for diagnosis and airway management in such cases.

  10. lenguas en Educación Primaria

    Directory of Open Access Journals (Sweden)

    Charlène Paré

    2017-01-01

    Full Text Available En este artículo se analiza el cómic desde una perspectiva social, artística-literaria y educativa. El estudio se centra en el modelo francés, en el que las historietas ocupan un lugar importante, tanto como medio artístico como documento de lectura. Asimismo, se analizan de forma más concreta los beneficios del cómic en la enseñanza de las lenguas en la etapa de Educación Primaria. Los resultados muestran que el cómic es una elección idónea para esta etapa educativa, ya que permite la realización de actividades de comprensión lectora y expresión creativa, fomentando a la vez la motivación para la lectura en los niños.

  11. Peritonitis primaria en niños.

    OpenAIRE

    CASTRO-RODRIGUEZ, José Antonio; HERNANDEZ DIAZ, Herminio

    2013-01-01

    En un período de 18 años (1969-1986) se admitieron 17 casos de peritonitis primaria (PP) de un total de 22,141 hospitalizaciones en el Departamento de Pediatría del Hospital Cayetano Heredia, Lima, (incidencia 0.76 casos/1000 pacientes); los mismos que representan el 4.75% del total de casos de peritonitis en general atendidas en el mismo período. Los 17 casos de PP (16 pacientes) fueron: 10 mujeres y 6 varones; la edad promedio fue de 6.3 años (rango 10 meses -12.9 años) y el tiempo de enfer...

  12. 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.

  13. NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

    Directory of Open Access Journals (Sweden)

    Y. V. Gavrilov

    2007-01-01

    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.

  14. Ginkgo Biloba extract for angina pectoris: a systematic review.

    Science.gov (United States)

    Sun, Tian; Wang, Xian; Xu, Hao

    2015-07-01

    To evaluate the efficacy and safety of Ginkgo Biloba extract for patients with angina pectoris according to the available evidence. Electronic databases were searched for all of the randomized controlled trials (RCTs) of angina pectoris treatments with Ginkgo Biloba extract, either alone or combined with routine Western medicine (RWM), and controlled by untreated, placebo, Chinese patent medicine, or RWM treatment. The RCTs were retrieved from the following electronic databases: PubMed/MEDLINE, ProQuest Health and Medical Complete, Springer, Elsevier, and ProQuest Dissertations and Theses, Wanfang Data, China National Knowledge Infrastructure (CNKI), VIP database, China Biology Medicine (CBM), Chinese Medical Citation Index (CMCI), from the earliest database records to December 2012. No language restriction was applied. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. RevMan 5.1.0 provided by Cochrane Collaboration The data were analysed by using. A total of 23 RCTs (involving 2,529 patients) were included and the methodological quality was evaluated as generally low. Ginkgo Biloba extract with RWM was more effective in angina relief and electrocardiogram improvement than RWM alone. Reported adverse events included epigastric discomfort, nausea, gastrointestinal reaction, and bitter taste. Ginkgo Biloba extract may have beneficial effects on patients with angina pectoris, although the low quality of existing trials makes it difficult to draw a satisfactory conclusion. More rigorous, high quality clinical trials are needed to provide conclusive evidence.

  15. Ludwig's angina. The anaesthetic management of nine cases.

    Science.gov (United States)

    Loughnan, T E; Allen, D E

    1985-03-01

    We reviewed nine patients with Ludwig's angina who required surgical drainage over a 24-month period. This represents the largest series reported in world literature. All of these patients were managed successfully by a combination of tracheal intubation and early surgical intervention. None required tracheostomy, which is the previously recommended procedure of choice for airway management.

  16. Descriptive terms used by Malay patients for exertional angina pectoris.

    Science.gov (United States)

    Khalid, Y; Malina, O; Rofiah, A; Latinah, M; Thahirahtul, A Z; Zaridah, M S; Tan, M H

    1994-09-01

    Description of the chest pain of angina pectoris by patients is commonly used in the diagnosis, evaluation and monitoring of ischaemic heart disease. Whilst certain descriptive terms have been identified as describing angina and not other causes of chest pain, these terms have not been systematically evaluated among local Malaysian patients. Reliance on a translation of the description used by Western patients may not be totally correct in the local context. Seventy-one Malay patients with documented ischaemic heart disease were asked, by questionnaire and by interview, to identify the descriptive terms they used for their angina pectoris. Common terms used by these patients were sempit (constrictive) [56.3%], mencuck (pricking) [54.9%], berat (heavy) [53.5%], panas (burning) [50.7%], menekan (pressing) [46.4%], and pedih (smarting) [43.7%]. Other less common descriptions used were tajam (sharp), mencengkam (strangulating), hempap (compressive), ngilu, hiris (knife-like), lengoh (aching). Two-thirds of the patients used more than three terms to describe their angina pectoris. Direct translation of the description of angina may not only be inaccurate but could also be misleading. It is suggested that the actual words used by the patients in Bahasa Malaysia be recorded in the patient's notes rather than a translation of these. More studies are required to determine whether the terms used by the patients in this study are related to local dialect (in this case Terengganu) or are actually common in Malaysia. Further, similar studies among Chinese and Indian patients are also required.

  17. Emerging clinical role of ranolazine in the management of angina

    Directory of Open Access Journals (Sweden)

    David S Vadnais

    2010-10-01

    Full Text Available David S Vadnais, Nanette K WengerDivision of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USAAbstract: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for angina consists of beta-blockers, calcium channel blockers, and nitrates. These agents decrease myocardial oxygen demand and ischemia by reducing heart rate, lowering blood pressure, and/or optimizing ventricular loading characteristics. Unique in its mechanism of action, ranolazine is the first new antianginal agent approved for use in the US for chronic angina in over 25 years. By inhibiting the late inward sodium current (INa, ranolazine prevents pathologic intracellular calcium accumulation that leads to ischemia, myocardial dysfunction, and electrical instability. Ranolazine has been proven in multiple clinical trials to reduce the symptoms of angina safely and effectively and to improve exercise tolerance in patients with symptomatic coronary heart disease. These benefits occur without reduction in heart rate and blood pressure or increased mortality. Although ranolazine prolongs the QTc, experimental data indicate that ranolazine may actually be antiarrhythmic. In a large acute coronary syndrome clinical trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation, and bradycardic events. Additional benefits of ranolazine under investigation include reductions in glycosylated hemoglobin levels and improved left ventricular function. Ranolazine is a proven antianginal medication in patients with symptomatic coronary heart disease, and should be considered as an initial antianginal agent for those with hypotension or bradycardia.Keywords: chronic angina, myocardial ischemia, ranolazine, pharmacotherapy, antianginal, sodium current

  18. RELANZAMIENTO ATENCIÓN PRIMARIA EN SALUD

    Directory of Open Access Journals (Sweden)

    Gustavo Malagón Londoño

    2011-04-01

    Full Text Available

    Con la memorable sesión, en el auditorio de la Academia Nacional de Medicina, ante autoridades de la salud, miembros del cuerpo docente de las universidades, representantes de las sociedades científicas y académicos, la Directora General de la Organización Panamericana de la Salud, Doctora Mirta Roses Periago, hizo el solemne relanzamiento de la Atención Primaria de Salud en las Américas, como una nueva estrategia renovada, probada a merced de numerosas experiencias y sometida a los más variados debates durante los 33 años transcurridos desde Alma Ata en 1978, cuando se invocó como la estrategia fundamental para el objetivo de “Salud para todos”.

    Cabe recordar que a raíz de la promulgación en 1978, se tejieron toda clase de versiones alrededor del significado de la estrategia planteada entonces como un paso fundamental, para un objetivo que parecía inalcanzable. En numerosos debates se hablaba de que se presentaba como una atención elemental de salud, en otros se situaba como el primer contacto de la población con la entidad de salud, en el mejor de los casos se le daba el significado de primera atención, en algunos de atención primordial, en otros de atención básica, no pocos la asimilaban a salud familiar, finalmente cuando se habló en Otawa (Canadá 1986 de la promoción y prevención como fuerzas insustituibles y el Director de la Organización Mundial de la Salud (Mahler 1986 habló de la “reacción favorable frente al fracaso de las acciones anteriores”, tomó fuerza el concepto de atención primaria como el motor insustituible para la promoción y prevención.

  19. Experiencias con Ipads en la escuela primaria

    Directory of Open Access Journals (Sweden)

    Martin Ebner

    2014-01-01

    Full Text Available Los ordenadores-tablet están acaparando toda la atención en estos momentos y forman parte de nuestra vida cotidiana. Por ello, no es de extrañar que en el ámbito educativo se hayan arbitrado fórmulas para incorporarlos en las aulas. La presente investigación pretende mostrar las estrategias llevadas a cabo en determinadas experiencias con iPads en escuelas primarias austriacas. Por un lado, se describe el desarrollo de las aplicaciones (apps educativas apropiadas para su empleo en aulas. Y por otro, cada lección apoyada en las tecnologías es analizada y evaluada desde una perspectiva técnica. Las aportaciones más representativas de la investigación evidencian las diversas fórmulas de utilización de este tipo de ordenadores para promover una influencia positiva en la enseñanza, también se apuntan recomendaciones prácticas sobre cómo deberían ser usados en aulas.

  20. Selection of medical treatment in stable angina pectoris

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1995-01-01

    pectoris. BACKGROUND: The characteristics of anginal symptoms and the results of exercise testing are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select......, the patients were randomly allocated to double-blind treatment for 6 weeks with either metoprolol (Controlled Release, 200 mg once daily) or nifedipine (Retard, 20 mg twice daily) according to a parallel group design. At the end of this period, exercise tests were repeated 1 to 4 h after drug intake. RESULTS....... CONCLUSIONS: The results of a baseline exercise test, but not the characteristics of anginal symptoms, may offer useful information for selecting medical treatment in stable angina pectoris....

  1. [Anesthetic management of a patient with Ludwig's angina].

    Science.gov (United States)

    Kakinohana, M; Saitoh, T; Fukuzato, Y; Kawamoto, K; Inamura, T

    1999-07-01

    A 71-year-old woman with cellulitis of the floor of the mouth, referred to as "Ludwig's angina", underwent emergency tracheostomy under general anesthesia, for the control of airway narrowing caused by sublingual and submandibular swelling with tongue elevation. Because difficult airway had been suspected by preoperative assessment, feasible options of intubation in our hospital, including laryngeal mask, fiberoptic intubation and transtracheal jet ventilation, were prepared prior to induction of anesthesia. Anesthetic induction was carried out with propofol and suxamethonium, and subsequently tracheal intubation could be performed with difficulty under condition of partial visualization of vocal cord. Anesthetic maintenance with local anesthesia and continuous infusion of propofol 6 mg.kg-1.hr-1 was carried out during tracheostomy procedure, and this procedure was done uneventfully. Because airway control still remains a top priority in Ludwig's angina, feasible options of airway control should be prepared before induction of anesthesia if tracheostomy was required in a patient with this disease.

  2. Successful conservative management of Ludwig's angina in advanced pregnancy.

    Science.gov (United States)

    Soltero, Roxana; Mercado-Alvarado, Joanna

    2009-01-01

    A 20 year-old female in her 32nd week of gestation presented to the Emergency Department with dysphonia and dysphagia associated to a recent recurrence of a periapical abscess. Her oral examination showed trismus, elevated tongue and neck swelling. A clinical diagnosis of Ludwig's angina was reached, and empirical antibiotic coverage was started. The decompression and drainage placement was performed successfully under local anesthesia without airway compromise. At the moment, no clear guidelines exist for the acute treatment of Ludwig's angina. Establishment of a secure airway has long been considered the gold standard, yet new literature suggests a more conservative management. Ascertaining an early diagnosis at the Emergency Department, and involvement of Anesthesia, Obstetrics, and, Ear, Nose and Throat specialist services is vital for materno-fetal wellbeing. Careful evaluation of the airway status in addition to prompt antimicrobial therapy with surgical decompression may represent a plausible alternative in pregnant patients.

  3. Variant angina associated with bitter orange in a dietary supplement.

    Science.gov (United States)

    Gange, Christopher A; Madias, Christopher; Felix-Getzik, Erika M; Weintraub, Andrew R; Estes, N A Mark

    2006-04-01

    The Food and Drug Administration has banned the sale of ephedrine-based weight-loss products because of their association with many cardiovascular adverse effects. Bitter orange is now being used as a stimulant in "ephedra-free" weight-loss supplements but was recently implicated in adverse cardiovascular sequelae. To our knowledge, this report describes the first case of variant angina associated with bitter orange in a dietary supplement.

  4. 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

  5. Update on ranolazine in the management of angina

    OpenAIRE

    Figueredo, Vincent; Codolosa,Jose; Acharjee,Subroto

    2014-01-01

    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 sym...

  6. Cardiac shockwave therapy in patients with chronic refractory angina pectoris

    OpenAIRE

    Vainer, J.; Habets, J. H. M.; Schalla, S.; Lousberg, A. H. P.; de Pont, C. D. J. M.; V??, S. A.; Brans, B. T.; Hoorntje, J. C. A.; Waltenberger, J.

    2016-01-01

    Background Cardiac shockwave therapy (CSWT) might improve symptoms and decrease ischaemia burden by stimulating collateral growth in chronic ischaemic myocardium. This prospective study was performed to evaluate the feasibility and safety of CSWT. Methods We included 33 patients (mean age 70???7 years, mean left ventricular ejection fraction 55???12?%) with end-stage coronary artery disease, chronic angina pectoris and reversible ischaemia on myocardial scintigraphy. CSWT was applied to the i...

  7. A case of Ludwig's angina following tooth extraction.

    Science.gov (United States)

    Yeo, J F; Loh, H S

    1982-01-01

    Ludwig's angina developed in an adult Chinese male following a mandibular third molar extraction. Brawny and tender swellings of the floor of the mouth and neck, with the elevation of the tongue, were classically present. The management of this case was based on the current emphasis of early broad-spectrum and antibiotic therapy with the maintenance of an adequate airway. The role of dental infection in this condition was highlighted.

  8. Update on ranolazine in the management of angina.

    Science.gov (United States)

    Codolosa, J Nicolás; Acharjee, Subroto; Figueredo, Vincent M

    2014-01-01

    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.

  9. [Airway management in Ludwig's angina - a challenge: case report].

    Science.gov (United States)

    Fellini, Roberto Taboada; Volquind, Daniel; Schnor, Otávio Haygert; Angeletti, Marcelo Gustavo; Souza, Olívia Egger de

    Ludwig's angina (LA) is an infection of the submandibular space, first described by Wilhelm Frederick von Ludwig in 1836. It represents an entity difficult to manage due to the rapid progression and difficulty in maintaining airway patency, a major challenge in medical practice, resulting in asphyxia and death in 8-10% of patients. Describe a case of a patient with Ludwig's angina undergoing surgery, with emphasis on airway management, in addition to reviewing the articles published in the literature on this topic. Male patient, 21 years, drug addict, admitted by the emergency department and diagnosed with LA. Difficult airway was identified during the anesthetic examination. In additional tests, significant deviation from the tracheal axis was seen. Undergoing bilateral thoracoscopic pleural drainage, we opted for airway management through tracheal intubation using fiberoptic bronchoscopy, and balanced general anesthesia was proposed. There were no complications during the surgical-anesthetic act. After the procedure, the patient remained intubated and mechanically ventilated in the intensive care unit. Airway management in patients with Ludwig's angina remains challenging. The choice of the safest technique should be based on clinical signs, technical conditions available, and the urgent need to preserve the patient's life. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  10. Airway management in Ludwig's angina - a challenge: case report

    Directory of Open Access Journals (Sweden)

    Roberto Taboada Fellini

    Full Text Available Abstract Background Ludwig's angina (LA is an infection of the submandibular space, first described by Wilhelm Frederick von Ludwig in 1836. It represents an entity difficult to manage due to the rapid progression and difficulty in maintaining airway patency, a major challenge in medical practice, resulting in asphyxia and death in 8-10% of patients. Objective Describe a case of a patient with Ludwig's angina undergoing surgery, with emphasis on airway management, in addition to reviewing the articles published in the literature on this topic. Case report Male patient, 21 years, drug addict, admitted by the emergency department and diagnosed with LA. Difficult airway was identified during the anesthetic examination. In additional tests, significant deviation from the tracheal axis was seen. Undergoing bilateral thoracoscopic pleural drainage, we opted for airway management through tracheal intubation using fiberoptic bronchoscopy, and balanced general anesthesia was proposed. There were no complications during the surgical-anesthetic act. After the procedure, the patient remained intubated and mechanically ventilated in the intensive care unit. Conclusions Airway management in patients with Ludwig's angina remains challenging. The choice of the safest technique should be based on clinical signs, technical conditions available, and the urgent need to preserve the patient's life.

  11. The sensitivity of the symptom angina pectoris as a marker of transient myocardial ischaemia in chronic stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1987-01-01

    with a history of chronic stable angina pectoris, positive exercise test and/or positive coronary angiography, and a correlation was made between the episodes of chest pain and ST segment change. The patients were grouped according to the results of exercise testing and coronary arteriography, and one group...... was studied with and without antianginal medication. Overall, 195 episodes of angina were noted, only 94 of which (48%) were accompanied by ST segment depression. Pain and ST segment changes were best correlated in patients with a positive exercise test, positive angiography and who were not receiving...... as was previously thought, a finding which supports the use of objective methods in identifying episodes of transient myocardial ischaemia in daily life....

  12. MODERN PHARMACOTHERAPY OF THE STABLE ANGINA: POSSIBILITIES AND PROSPECTS OF NICORANDIL IMPLEMENTATION

    OpenAIRE

    Z. M. Sizova; E. V. Shikh; V. L. Zakharova; E. V. Smirnova

    2010-01-01

    Aim. To evaluate antianginal efficacy and safety of nicorandil for angina attack prevention and relief in patients with ischemic heart disease (IHD) and symptoms of stable angina class 2-3.Material and methods. 30 patients with stable angina class 2-3 (17 men, 13 women; aged 58.6±5.8 y.o.) were included into the study. All patients received amlodipine 10 mg QD within 2 weeks. For angina attack relief patients used nicorandil 10-20 mg and in case of its inefficacy — nitroglycerin. In 2 weeks a...

  13. Trastornos del Desarrollo y Dificultades del Aprendizaje. Primaria. Apuntes (2017)

    OpenAIRE

    Pérez Sánchez, Antonio Miguel

    2017-01-01

    El propósito de este trabajo es ofrecer al futuro Maestro en Educación Primaria, GENERALISTA, los conocimientos necesarios para afrontar los problemas relacionados con los trastornos del desarrollo y las dificultades del aprendizaje que pudieran presentar sus futuros alumnos.

  14. Global variability in angina pectoris and its association with body mass index and poverty.

    Science.gov (United States)

    Liu, Longjian; Ma, Jixiang; Yin, Xiaoyan; Kelepouris, Ellie; Eisen, Howard J

    2011-03-01

    In the absence of a previous global comparison, we examined the variability in the prevalence of angina across 52 countries and its association with body weight and the poverty index using data from the World Health Organization-World Health Survey. The participants with angina were defined as those who had positive results using a Rose angina questionnaire and/or self-report of a physician diagnosis of angina. The body mass index (BMI) was determined as the weight in kilograms divided by the square of the height in meters. The poverty index (a standard score of socioeconomic status for a given country) was extracted from the United Nations' statistics. The associations of angina with the BMI and poverty index were analyzed cross-sectionally using univariate and multivariate analyses. The results showed that the total participants (n = 210,787) had an average age of 40.64 years. The prevalence of angina ranged from 2.44% in Tunisia to 23.89% in Chad. Those participants with a BMI of poverty status was considered. A tendency was seen for underweight status and a poverty index >14.65% to be associated with the risk of having angina, although these associations were not statistically significant in the multilevel models. In conclusion, significant variations were found in the anginal rates across 52 countries worldwide. An increased BMI was significantly associated with the odds of having angina. Published by Elsevier Inc.

  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. Ludwig\\'s Angina in a Puerperant: A Case Report. | Mgbeokere ...

    African Journals Online (AJOL)

    Ludwig's angina is a serious infection of the oral cavity and other soft tissues above the hyoid bone. It is associated with brawny ... Antibiotics therapy, incision and drainage and in many cases creation of artificial airways are the corner stone in the treatment protocol of Ludwig's angina. In this report, we present a case of ...

  17. Incidence and follow-up of Braunwald subgroups in unstable angina pectoris

    NARCIS (Netherlands)

    van Miltenburg-van Zijl, A. J.; Simoons, M. L.; Veerhoek, R. J.; Bossuyt, P. M.

    1995-01-01

    OBJECTIVES. This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. BACKGROUND. Among many classifications of unstable angina, the Braunwald classification is frequently used. However, the incidence and risk for each

  18. Acute and long-term outcome of directional coronary atherectomy for stable and unstable angina

    NARCIS (Netherlands)

    V.A.W.M. Umans (Victor); P.J. de Feyter (Pim); D.C. MacLeod (Donald); M.J.B.M. van den Brand (Marcel); P.P.T. de Jaegere (Peter); P.W.J.C. Serruys (Patrick); J.W. Deckers (Jaap)

    1994-01-01

    textabstractThe clinical efficacy and safety of directional coronary atherectomy for the treatment of stable and unstable angina were assessed in 82 patients with stable and 68 patients with unstable angina. Therefore, clinical and angiographic follow-up was obtained in a prospectively collected

  19. Ludwig's angina: report of a case and review of management issues.

    Science.gov (United States)

    Barakate, M S; Jensen, M J; Hemli, J M; Graham, A R

    2001-05-01

    Ludwig's angina, although uncommon, remains a potentially life-threatening condition because of the risk of impending airway obstruction. Effective treatment is based on early recognition of the clinical process, with the appropriate use of parenteral antibiotics, airway protection techniques, and formal surgical drainage of the infection. We present a case of Ludwig's angina together with a brief review of the relevant literature.

  20. Exercise-based cardiac rehabilitation for adults with stable angina.

    Science.gov (United States)

    Long, Linda; Anderson, Lindsey; Dewhirst, Alice M; He, Jingzhou; Bridges, Charlene; Gandhi, Manish; Taylor, Rod S

    2018-02-02

    A previous Cochrane review has shown that exercise-based cardiac rehabilitation (CR) can benefit myocardial infarction and post-revascularisation patients. However, the impact on stable angina remains unclear and guidance is inconsistent. Whilst recommended in the guidelines of American College of Cardiology/American Heart Association and the European Society of Cardiology, in the UK the National Institute for Health and Care Excellence (NICE) states that there is "no evidence to suggest that CR is clinically or cost-effective for managing stable angina". To assess the effects of exercise-based CR compared to usual care for adults with stable angina. We updated searches from the previous Cochrane review 'Exercise-based cardiac rehabilitation for patients with coronary heart disease' by searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, DARE, CINAHL and Web of Science on 2 October 2017. We searched two trials registers, and performed reference checking and forward-citation searching of all primary studies and review articles, to identify additional studies. We included randomised controlled trials (RCTs) with a follow-up period of at least six months, which compared structured exercise-based CR with usual care for people with stable angina. Two review authors independently assessed the risk of bias and extracted data according to the Cochrane Handbook for Systematic Reviews of Interventions. Two review authors also independently assessed the quality of the evidence using GRADE principles and we presented this information in a 'Summary of findings' table. Seven studies (581 participants) met our inclusion criteria. Trials had an intervention length of 6 weeks to 12 months and follow-up length of 6 to 12 months. The comparison group in all trials was usual care (without any form of structured exercise training or advice) or a no-exercise comparator. The mean age of participants within the trials ranged from 50 to 66 years, the

  1. 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.

  2. El Equilibrio Inestable: El caso de los Chamibida de Cristianía en Antioquia, Colombia Unstable balance: the case of the Chamibida from Cristianía, Antioquia. Colombia

    Directory of Open Access Journals (Sweden)

    María Mercedes Arias V

    2004-11-01

    Full Text Available Este artículo presenta la categoría equilibrio inestable que emergió durante un estudio más amplio de sobrevivencia de minorías étnicas en precarias condiciones de vida. El estudio es etnográfico y da cuenta de las acciones que realizan los Chamibida para lograr su pervivencia. Se realizó en un resguardo de Antioquia, Colombia, durante 150 días de trabajo de campo. Para el análisis de datos se siguieron las reglas del método etnográfico y procedimientos de la teoría fundamentada. La interacción de los indígenas con la sociedad antioqueña muestra superposición de sistemas de cosmovisión con la religión católica y pérdida de sistemas propios de subsistencia para adoptar sistemas ajenos sin ninguna garantía de mejoría de las condiciones de vida y, en ocasiones empeoran las condiciones previas. Las condiciones externas adversas de inseguridad, pobreza, marginalidad y exclusión no permiten que las acciones y prácticas de sobrevivencia tengan eficacia, lo cual da como resultado un equilibrio inestable de pervivencia como sociedad culturalmente diferenciada.This paper presents the category unstable balance that emerged as part of a larger study on survival on ethnic minorities in weak living conditions. The study is ethnographic and uncovers the Chamibida practices to achieve cultural and social survival . It took place in an indigenous reserve in Antioquia during 150 days of field work. To analyse data procedures of the ethnographic method and grounded theory were followed. The interaction of the indigenous shows an overlap of traditional belief system with catholic religion and a loss of their own systems of survival in order to adopt other systems with no guarantee to improve living conditions and sometimes they worsen previous living conditions. The external conditions of insecurity, poverty, marginality and exclusion do not permit effective social and cultural survival actions and practices, this results in an unstable

  3. Atención Primaria de Salud

    Directory of Open Access Journals (Sweden)

    Manuel Bauzá Díaz

    2014-08-01

    Full Text Available Los procesos asistenciales, docentes e investigativos son funciones esenciales de la salud pública; que adquieren su mayor impacto ambiental, social y económico cuando los procesos administrativos tienen orientación científica. Cada una de estas funciones se caracteriza por su alta complejidad, variada composición, el alcance de una dimensión social, elevada dinámica de realización y atributos propios. El efecto de esos procesos depende, esencialmente, de su capacidad para integrarse en un sistema armónico y coherente que requiere de la participación multidisciplinaria del sector salud, la intersectorial social y la participación comunitaria. De lo planteado anteriormente se puede deducir que el estudio, análisis, diseño y ejecución de estos procesos requieren un enfoque en sistema, así como un pensamiento científico (clínico y epidemiológico. Desde la Medicina General Integral (MGI se trabaja sobre acciones de intervención, orientadas a la promoción, la prevención, el diagnóstico, el tratamiento y la rehabilitación; con acciones dirigidas al individuo, la familia, los grupos y/o colectivos, la comunidad y el medio ambiente, como acciones para la mejor solución de los problemas de salud. La MGI es una disciplina sistémica, pues justamente descansa en entender los fenómenos del proceso salud-enfermedad en su integridad, en su diversidad, con particularidades y dinámicas desde el individuo y hasta la comunidad. Como sistema, contiene numerosas singularidades, pero, en conjunto con otros sectores sociales y económicos, participa activamente en pro de la salud de la población. Los decisores en salud deben considerar esta unidad integral y metodológica, lo que se traduce a la utilización del enfoque clínico y epidemiológico. La formación amplia de profesionales desde la Atención Primaria de Salud (APS implica la alineación de médicos plenamente identificados con estas funciones y capaces de contribuir

  4. Actitudes hacia la ciencia en primaria y secundaria.

    OpenAIRE

    Pérez Manzano, Antonio

    2013-01-01

    Se ha tratado de explorar qué actitudes tienen los niños y adolescentes respecto a la ciencia y la tecnología. El tamaño muestral ha sido de 6.827 cuestionarios, de los que 3.895 (57.1%) correspondieron a Educación Primaria y 2.932 (42.9%) a Educación Secundaria Obligatoria, representando una fracción de muestreo del 1.5 por mil. La información recogida nos ha permitido analizar las diferencias en cuanto a género, tipo de centro educativo (público o privado), nivel (Primaria vs Secundar...

  5. Atención Primaria de la Salud en Debate

    Directory of Open Access Journals (Sweden)

    Mario Rovere

    Full Text Available La Atención Primaria de la Salud, un concepto amplio y difundido, es colocado en debate en el presente artículo. Sin embargo, esa es, una tarea nada sencilla, dado el fuerte carácter idealista de sus principios y postulados. A través de diversos mecanismos, como develar sus antecedentes inmediatos y remotos, la detección de modelos en conflicto, de contradicciones conceptuales y el uso extensivo de preguntas, diversas afirmaciones doctrinarias, que parecen de toda obviedad, son puestas en entredicho. Se invita así al lector/a a una 'deconstrucción' del concepto de Atención Primaria de la Salud, de cara a producir nuevas propuestas más estratégicas y eficaces para que los trabajadores de salud, donde quiera que se desempeñen, cuenten con herramientas para enfrentar la creciente mercantilización del sector.

  6. Tratamiento al aprendizaje de convivencia intergeneracional en la escuela primaria

    Directory of Open Access Journals (Sweden)

    Fidel Jesús Cabrera-de la Rosa

    2017-04-01

    Full Text Available La escuela primaria tiene la misión de favorecer los aprendizajes básicos para la vida, donde el aprender a convivir las diferentes generaciones es importante ante los retos intergeneracionales que presenta una sociedad envejecida. El propósito del presente trabajo es realizar una aproximación al tratamiento que se brinda al aprendizaje de convivencia intergeneracional en la escuela primaria teniendo en cuenta los contenidos del currículo y los que se abordan en las escuelas de padres, las actividades extradocentes y extraescolares, y la preparación del maestro para el desempeño de la función orientadora.

  7. Vasospastic angina and microvascular angina are differentially influenced by PON1 A632G polymorphism in the Japanese.

    Science.gov (United States)

    Mashiba, Junko; Koike, George; Kamiunten, Hitoshi; Ikeda, Manami; Sunagawa, Kenji

    2005-12-01

    Ethnicity and smoking are well-known risk factors for the pathogenesis of coronary vasospasm. Oxidative stress induced by smoking plays a crucial role in coronary vasospasm, but is not enough to account for the pathogenesis of coronary vasospasm, indicating that genetic factors are strongly involved. The study group comprised 162 vasospastic angina patients (VSAs), 61 microvascular angina patients (MVAs) and 61 non-responders (NRs) diagnosed by acetylcholine provocation test. Four polymorphisms of the oxidative stress related genes, cytochrome b-245, alpha polypeptide gene (CYBA) C242T and A640G, paraoxonase 1 gene (PON1) A632G, phospholipase A2 group VII gene (PLA2G7) G994T were genotyped. Allele frequency of PON1 632-G was significantly higher in both the VSA with dominant fashion and the MVA with recessive fashion compared with NR. This association was strongly influenced by gender in the MVA only. There were no significant associations between the other polymorphisms and coronary vasospasm. In addition, the allele frequency of PON1 632-G in the Japanese was higher than in Caucasians. There was a significant association between PON1 A632G polymorphism and MVA as well as VSA, but the impact of this on VSA and MVA is different in the Japanese.

  8. Variability in lipid profile among patients presented with acute myocardial infarction, unstable angina and stable angina pectoris.

    Science.gov (United States)

    Yang, N; Feng, J-P; Chen, G; Kou, L; Li, Y; Ren, P; Zhao, L-L; Qin, Q

    2014-01-01

    Despite the amply evidence and guidelines in treating coronary artery disease (CAD) with lipid-lowering therapy, physicians still have concerns in treating acute myocardial infarction (AMI) patients who have the low serum lipid level. We explored the adequacy of lipid-lowering therapy in treating AMI patients. Over 3000 CAD lipid profile data were collected, their data were divided into 3 groups (AMI; stable angina pectoris (SAP) and unstable angina pectoris (UAP) group) based their clinical characteristics. Statistical analyses were performed to compare their baseline lipid levels and clinical feature. The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) level in AMI patients were the lowest, followed by UAP patient group and SAP patient group. There were significant differences in white blood count (WBC) and ejection fraction (EF) between 3 groups. A good correlation was confirmed between EF% and the lipid parameters of TC, LDL-c, HDL-c, non-HDL-c. WBC did not correlate with the lipid except HDL-c. AMI is an acute inflammatory reaction that is accompanied with the change of lipid level. Although the level of TC, LDL-c and HDL-c are lower in AMI, but it is related with acute inflammatory reaction during the rupture of atherosclerotic plaques. Lipid-lowering therapy should not be delayed in treating AMI patients with lower lipid level.

  9. Proyecto de creatividad literaria en el aula de Primaria

    OpenAIRE

    Bellota Miguel, Ibone

    2014-01-01

    Desarrollar en los niños la creatividad literaria a través de los cuentos, de una forma amena y divertida. El cuento usado como instrumento didáctico para aprender y para ayudar al niño a adquirir distintos valores que luego podrán utilizar en aspectos de su vida cotidiana. Fomentar la lectura a través de los cuentos. Grado en Educación Primaria

  10. Meta-analysis of acupuncture therapy for the treatment of stable angina pectoris.

    Science.gov (United States)

    Zhang, Ze; Chen, Min; Zhang, Li; Zhang, Zhe; Wu, Wensheng; Liu, Jun; Yan, Jun; Yang, Guanlin

    2015-01-01

    Angina pectoris is a common symptom imperiling patients' life quality. The aim of this study is to evaluate the efficacy and safety of acupuncture for stable angina pectoris. Clinical randomized-controlled trials (RCTs) comparing the efficacy of acupuncture to conventional drugs in patients with stable angina pectoris were searched using the following database of PubMed, Medline, Wanfang and CNKI. Overall odds ratio (ORs) and weighted mean difference (MD) with their 95% confidence intervals (CI) were calculated by using fixed- or random-effect models depending on the heterogeneity of the included trials. Total 8 RCTs, including 640 angina pectoris cases with 372 patients received acupuncture therapy and 268 patients received conventional drugs, were included. Overall, our result showed that acupuncture significantly increased the clinical curative effects in the relief of angina symptoms (OR=2.89, 95% CI=1.87-4.47, Pacupuncture therapy was superior to conventional drugs. Although there was no significant difference in overall effective rate relating reduction of nitroglycerin between two groups (OR=2.13, 95% CI=0.90-5.07, P=0.09), a significant reduction on nitroglycerin consumption in acupuncture group was found (MD=-0.44, 95% CI=-0.64, -0.24, Pacupuncture therapy than for traditional medicines (MD=2.44, 95% CI=1.64-3.24, Pacupuncture therapy were found. Acupuncture may be an effective therapy for stable angina pectoris. More clinical trials are needed to systematically assess the role of acupuncture in angina pectoris.

  11. Magnetic resonance imaging in patients with unstable angina: comparison with acute myocardial infarction and normals

    International Nuclear Information System (INIS)

    Ahmad, M.; Johnson, R.F. Jr.; Fawcett, H.D.; Schreiber, M.H.

    1988-01-01

    The role of magnetic resonance imaging in characterizing normal, ischemic and infarcted segments of myocardium was examined in 8 patients with unstable angina, 11 patients with acute myocardial infarction, and 7 patients with stable angina. Eleven normal volunteers were imaged for comparison. Myocardial segments in short axis magnetic resonance images were classified as normal or abnormal on the basis of perfusion changes observed in thallium-201 images in 22 patients and according to the electrocariographic localization of infarction in 4 patients. T2 relaxation time was measured in 57 myocardial segments with abnormal perfusion (24 with reversible and 33 with irreversible perfusion changes) and in 25 normally perfused segments. T2 measurements in normally perfused segments of patients with acute myocardial infarction, unstable angina and stable angina were within normal range derived from T2 measurements in 48 myocardial segments of 11 normal volunteers (42 +/- 10 ms). T2 in abnormal myocardial segments of patients with stable angina also was not significantly different from normal. T2 of abnormal segments in patients with unstable angina (64 +/- 14 in reversibly ischemic and 67 +/- 21 in the irreversibly ischemic segments) was prolonged when compared to normal (p less than 0.0001) and was not significantly different from T2 in abnormal segments of patients with acute myocardial infarction (62 +/- 18 for reversibly and 66 +/- 11 for irreversibly ischemic segments). The data indicate that T2 prolongation is not specific for acute myocardial infarction and may be observed in abnormally perfused segments of patients with unstable angina

  12. 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...

  13. 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......, 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...

  14. Ludwig's angina in the pediatric population: report of a case and review of the literature.

    Science.gov (United States)

    Britt, J C; Josephson, G D; Gross, C W

    2000-01-30

    Ludwig's angina is a rapidly progressing cellulitis involving the submandibular neck space. It is characterized by brawny induration of the submental region and floor of mouth, bearing the potential for rapid airway obstruction. Airway management, antibiotics, and judicious surgical intervention are the mainstays of successful therapy. We present a case of Ludwig's angina in a 5-year-old child and offer a meta-analysis of pediatric cases of Ludwig's angina described in the literature over the past 30 years. The presentation, etiology, management, and potential complications of this disorder in the pediatric population are discussed.

  15. PRINZMETAL ANGINA PECTORIS IN CLINICAL PRACTICE: POSSIBILITY OF CHRONO-THERAPEUTIC APPROACH AND LIMITATIONS OF COMORBIDITY

    Directory of Open Access Journals (Sweden)

    M. V. Baeva

    2013-12-01

    Full Text Available Prinzmetal Angina (synonyms: vasospastic angina, variant angina in accordance with the definition of, it is caused by coronary artery spasm which occurs during sleep at night, between midnight and early morning and manifested with ST segment elevation on the ECG. Frequent “attachment” to the attacks of a certain period of the sleep period, gives you the opportunity to use chronomedical approaching the treatment of patients suffering from it, as demonstrated by our observation. On the other hand, for adulthood comorbidity is characteristic, and Prinzmetal is no exception, which we wanted to show, studying the clinical case.

  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...... system. The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption. There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture...... there was a significant increase in exercise tolerance (median 9%) and in delay of onset to pain (median 10%). No significant changes were observed in patients receiving sham acupuncture. Within both groups there was a median reduction of 50% in anginal attack rate and nitroglycerin consumption...

  17. Pulmonary artery dilatation: an overlooked mechanism for angina pectoris.

    Science.gov (United States)

    Ginghina, Carmen; Popescu, Bogdan A; Enache, Roxana; Ungureanu, Catalina; Deleanu, Dan; Platon, Pavel

    2008-07-01

    Dilatation of the pulmonary artery may lead to the compression of adjacent structures. Of those, the extrinsic compression of the left main coronary artery is the most worrisome. We present the case of a 48-year-old woman who was diagnosed with pulmonary artery dilatation due to severe, thromboembolic pulmonary hypertension. She also had angina and coronary angiography revealed a 70% ostial stenosis of the left main coronary artery. The presence of this isolated lesion in a young woman without risk factors for atherosclerosis suggests extrinsic compression of the left main coronary artery by the dilated pulmonary artery as the likely mechanism. The patient underwent direct stenting of the left main coronary stenosis with a good result.

  18. 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.

  19. 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...

  20. Effects of acupuncture in moderate, stable angina pectoris

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Pedersen, F; Pietersen, A

    1990-01-01

    there was a significant increase in exercise tolerance (median 9%) and in delay of onset to pain (median 10%). No significant changes were observed in patients receiving sham acupuncture. Within both groups there was a median reduction of 50% in anginal attack rate and nitroglycerin consumption......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...... system. The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption. There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture...

  1. Salvianolate injection in the treatment of unstable angina pectoris

    Science.gov (United States)

    Zhang, Dan; Wu, Jiarui; Liu, Shi; Zhang, Xiaomeng; Zhang, Bing

    2016-01-01

    Abstract Background: To systematically evaluate the clinical efficacy and safety of Salvianolate injection in the treatment of unstable angina pectoris (UAP). Methods: Using literature databases, we conducted a thorough and systematic retrieval of randomized controlled trials (RCTs) that using Salvianolate injection for treating UAP. The Cochrane Risk of Bias Assessment Tool was used to evaluate the methodological quality of the RCTs, and then the data were extracted and meta-analyzed by RevMan5.2 software. Results: A total of 22 RCTs with 2050 participants were included. The meta-analysis indicated that the combined use of Salvianolate injection and western medicine (WM) in the treatment of UAP can achieve a superior effect in angina pectoris total effective rate (risk ratio [RR] = 1.22, 95% confidence interval [CI] (1.17, 1.27), Z = 10.15, P < 0.00001], and the total effectiveness rate of electrocardiogram [RR = 1.26, 95% CI (1.19,1.34), Z = 7.77, P < 0.00001]. In addition, Salvianolate injection can improve the nitroglycerin withdrawal rate and the serum level of NO, decrease high-sensitivity C-reactive protein. Adverse drug reactions (ADRs) or adverse drug events (ADEs) were reported in 6 RCTs involving 15 cases; however, there were no serious ADRs/ADEs. Conclusion: Based on the systematic review, the combined use of Salvianolate injection and WM in the treatment of UAP can achieve a better effect; however, there was no definitive conclusion about its safety. More the large-sample and multicenter RCTs are needed to support its clinical usage. PMID:28002341

  2. In-flight angina pectoris; an unusual presentation.

    Science.gov (United States)

    Al-Janabi, Firas; Mammen, Regina; Karamasis, Grigoris; Davies, John; Keeble, Thomas

    2018-04-05

    An unusual case of typical angina which occurred on a long haul flight is presented. This case is notable as this was the index presentation, with no previous symptoms prior to this. Physiological changes at altitude can be marked, and include hypoxia, tachycardia and an increase in cardiac output. These changes were enough to expose underlying angina in our patient. A 68 year old man presented with typical cardiac chest pain on a long haul flight. His symptoms first started 10-15 min after take-off and resolved on landing. This was his index presentation, and there were no similar symptoms in the past. Background history included hypercholesterolaemia and benign prostatic hypertrophy only. He led a rather sedentary lifestyle. A CT coronary angiogram showed significant disease in the proximal left anterior descending artery and proximal right coronary artery. He went on to have a coronary angiogram with invasive physiological measurements, which determined both lesions were physiologically significant. Both arteries were treated with drug eluting stents. Since treatment, he once again embarked on a long haul flight, and was completely asymptomatic. The presentation of symptoms in this individual was rather unusual, but clearly caused by significant coronary artery disease. Potentially his sedentary lifestyle was not enough in day-to-day activities to promote anginal symptoms. When his cardiovascular system was physiologically stressed during flight, brought about by hypoxia, raised sympathetic tone and increased cardiac output, symptoms emerged. In turn, when landing, with atmospheric conditions normalised, physiological stress was removed, and symptoms resolved. Clinically therefore, one should not exclude symptoms that occur with differing physiological states, such as stress and altitude, as they are also potential triggers for myocardial ischaemia, despite absence of day-to-day symptoms.

  3. [Characterization of atherosclerotic plaque in patients with unstable angina pectoris and stable angina pectoris by optical coherence tomography].

    Science.gov (United States)

    Chen, Bu-xing; Ma, Feng-yun; Luo, Wei; Ruan, Jian-hong; Zhao, Xi-zhe; Xie, Wen-li; Sun, Shu-hong; Guo, Xu-mei; Wang, Feng; Tian, Ting; Chu, Xiao-wen

    2009-05-01

    To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by > or = 2 quadrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs. 73% (16/22), P = 0.741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5 +/- 34.7) microm vs. (141.1 +/- 68.5) microm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P = 0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22), P = 0.000] and plaque rupture [50% (11/22) vs. 9% (2/22), P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.

  4. Impact of pre-infarction angina on angiographic and echocardiographic outcomes in patients with acute ante

    Directory of Open Access Journals (Sweden)

    Ahmed El Missiri

    2016-09-01

    Conclusions: For patients suffering from a first attack of acute anterior wall STEMI, pre-infarction angina is associated with a better Killip class at presentation, better TIMI flow grade after PPCI, less incidence of TMP 0 flow grade.

  5. Treatment of refractory chest angina with spinal electrical stimulator: literature review

    International Nuclear Information System (INIS)

    Gomezese, Omar F; Paola, Aranda; Echeverria, Luis E; Saibi, Jose F; Calderon, Jaime; Barrera, Juan G

    2008-01-01

    There is a group of patients with chronic refractory chest angina, who are not ideal candidates for surgical or percutaneous revascularization and who although having a good medical handling continues to experience severe episodes of angina. The spinal electrical stimulator is a neuromodulators used as an alternative to treat these patients. The objective is to realize a review of scientific literature regarding the spinal electric stimulation in the treatment of chest angina, its mechanism of action, benefits and its cost effectiveness. Materials and methods: using the Cochrane methodology, a search of articles published from January 1980 to January 2007 in Medline using the terms spinal cord stimulation, was realized. The papers considered most pertinent were selected. Conclusions: the anti-ischemic effect of the electrical spinal stimulator reduces the episodes of chest angina, improves the quality of life and the tolerance to exercise, diminishes the hospital stay and delays the appearance of ischemic signs

  6. Ventricular repolarization alterations in women with angina pectoris and suspected coronary microvascular dysfunction

    DEFF Research Database (Denmark)

    Dose, Nynne; Michelsen, Marie Mide; Mygind, Naja Dam

    2018-01-01

    OBJECTIVES: CMD could be the explanation of angina pectoris with no obstructive CAD and may cause ventricular repolarization changes. We compared T-wave morphology and QTc interval in women with angina pectoris with a control group as well as the associations with CMD. METHODS: Women with angina...... pectoris and no obstructive coronary artery disease (n=138) and age-matched controls were compared in regard to QTc interval and morphology combination score (MCS) based on T-wave asymmetry, flatness and presence of T-wave notch. CMD was assessed as a coronary flow velocity reserve (CFVR) by transthoracic...... was attenuated after multivariable adjustment (p=0.08). CONCLUSION: This study suggests that women with angina pectoris have alterations in T-wave morphology as well as longer QTc interval compared with a reference population. CMD might be an explanation....

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

    International Nuclear Information System (INIS)

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-01-01

    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

  8. 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.

  9. Transient Giant R Wave as a Marker for Ischemia in Unstable Angina.

    Science.gov (United States)

    Chugh, Yashasvi; Maraboto, Carola; Christia, Panagiota; Faillace, Robert

    2017-04-28

    Unstable angina is a clinical diagnosis that may present with or without electrocardiographic changes. The "giant R wave" on electrocardiogram has been reported as a manifestation of acute ischemia; however, it is a rare finding in current clinical practice. We describe a case of a patient with unstable angina and a transient "giant R wave" pattern with a culprit lesion in the right coronary artery.

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

    OpenAIRE

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

    2010-01-01

    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 ...

  11. [The prevalence of angina and cardiovascular risk factors in the different autonomous communities of Spain: the PANES Study. Prevalencia de Angina en España].

    Science.gov (United States)

    López-Bescós, L; Cosín, J; Elosua, R; Cabadés, A; de los Reyes, M; Arós, F; Diago, J L; Asín, E; Castro-Beiras, A; Marrugat, J

    1999-12-01

    The study of angina prevalence has received little attention in the analysis of the dimension of coronary heart disease. The aim of this study was to determine the prevalence of angina and cardiovascular risk factors in the 45- to 74-year-old population of the different autonomous regions of Spain. A sample of 10,248 subjects was recruited. Sampling was stratified by gender and age groups (45-54, 55-64 and 65 to 74 years), and proportional to the population distribution of the different autonomous regions. A multistage sampling was performed, firstly 200 villages were randomly selected, secondly three different socio-economic household were chosen. Sample unit was neighbouring households. Rose questionnaire of angina and a structured questionnaire to collect socio-demographic and risk factor variables were administered. Angina prevalence in the 45- to 74-year-old Spanish population was 7.5%. The autonomous regions with the higher and lower prevalence were Baleares (11.4%) and Basque Country (3.1%), respectively. The Pearson correlation coefficient between angina prevalence and ischemic heart disease or cardiovascular disease mortality in men and women was 0.52 and 0.55, and 0.31 and 0.44, respectively. The self reported prevalence of hypertension, dyslipemia, diabetes and smoking was 31.1%, 24.2%, 14.3% and 34.6% respectively. Angina prevalence in Spain is similar to that of developed countries although significant differences were observed among the autonomous regions of Spain. These differences correlate with those observed in ischemic heart disease or cardiovascular mortality among them and are associated with the cardiovascular risk factors prevalence which also varies among communities.

  12. [Analysis of information sources in the journal, Atencion Primaria].

    Science.gov (United States)

    Aleixandre, R; Giménez Sánchez, J V; Terrada Ferrandis, M L; López Piñero, J M

    1996-03-31

    To contribute to improving the understanding of the information bases of Spanish scientific production in the primary care field; to aid international contacts and the diffusion of information among doctors in our country. A bibliometric analysis of the bibliographic references of the studies published in the journal Atención Primaria during 1991. A data base, managed by dBASE IV, was created. The Unit of Documental Analysis and Bibliometry of the Institute of Documental and Historical Studies in Science (University of Valencia-CSIC). 2,615 bibliographic references in 205 studies contained in volume 8 of Atención Primaria. References from journal articles (68%) and books (26%) predominated. There were a large number of references from Spanish publications (45%) as against Northamerican (27%) and British (15%). There were few references from other European countries or Latin America. Information was quickly out of date (4 year semiperiod; Price index 50%). High proportion of self-quotations from the journal. The major role of the journal Atención Primaria in communicating information in the primary care field was underlined. The small amount of information from Latin America and E.U. countries (except Great Britain) highlights the isolation of Spain from these countries, which can be explained by the limits of the primary care field itself. There was also little use of information to which access was more difficult for primary care doctors, such as doctoral theses, congress papers or reports. Moreover this is a field with a high percentage of recent literature and rapidly out-of-date information.

  13. 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

  14. Atención primaria: Una estrategia renovada

    OpenAIRE

    José A. Serna; Jaime Lee; Arnold Brommet

    2011-01-01

    Esta revisión profundiza en los cambios establecidos por diferentes estamentos mundiales con respecto al concepto ymodo de implementación de la estrategia de Atención Primaria en Salud (APS) originada en Alma-Ata en 1978. Bajacobertura, altos costos, inequidad, utilización inadecuada del talento humano y del recurso tecnológico hicieron imperiosasu actualización. En ella se establecen cuatro pilares fundamentales a introducir en sistemas de salud que tengan como su ejela APS, como el logro de...

  15. Competencias del profesor de educación primaria

    OpenAIRE

    Lupiáñez, José Luis

    2014-01-01

    En este documento recojo diferentes acercamientos al establecimiento de las competencias que deberían desarrollar los profesores de matemáticas de Educación Primaria. Para ello, en primer lugar analizo el papel de la noción de competencia en el marco de la formación de profesores. A continuación me centro en las directrices europeas que se han empleado para el diseño de las nuevas titulaciones dirigidas a la formación de maestros, prestando especial atención al caso español. Finalmente, anali...

  16. Reconocimiento a la Atención Primaria de Salud

    Directory of Open Access Journals (Sweden)

    Elso Manuel Cruz Cruz

    2014-08-01

    Full Text Available El presente número de nuestra revista constituye un reconocimiento necesario a la Atención Primaria de Salud (APS, estandarte del sistema de salud cubano, referente a nivel mundial. Son muchos los disímiles trabajos que se realizan desde la APS, imposibles de quedar ejemplificados en el muy limitado espacio que ofrece un número de la revista. Esta edición es sin dudas, especial, para ello se han escogido los resultados investigativos de variados trabajos, realizados desde la perspectiva de diferentes especialidades médicas, en diferentes escenarios, incluida la colaboración médica con países hermanos, pero todos con el denominador común de tributar a la Atención Primaria de Salud. Esperamos que estos artículos aporten relevantes conocimientos a nuestros lectores y se conviertan en referentes de sus trabajos investigativos. El número se confeccionó en los días que ambientaban el desarrollo de la Jornada Científica Provincial de Medicina Familiar, espacio de socialización de resultados científicos obtenidos en la APS. El comité editorial de la revista participó en las sesiones de trabajo del evento, reconociendo la calidad en el desarrollo del mismo y quedando en espera de que muchos de esos trabajos originales se divulguen a la comunidad en forma de artículos científicos

  17. Unstable Angina Treatment in Various Periods of Geomagnetic Activity

    Science.gov (United States)

    Parshina, S. S.; Tokayeva, L. K.; Afanasiyeva, T. N.; Samsonov, S. N.; Petrova, V. D.; Dolgova, E. M.; Manykina, V. I.; Vodolagina, E. S.

    In 145 patients with unstable angina (UA) there was analized an efficiency of a drug therapy at different types of heliogeophysical activity (HA) during the 23th solar cycle. 83 patients were examined at the period of a lower HA (Kp-index 16,19±0,18), and 62 patients - at the period of a higher HA (Kp-index 17,25±0,21, p<0,05). Baseline severity of patients' condition with UA at the moment of hospitalization at the studied periods did not differ, but the effectiveness of the therapy depended on the period of HA. At the period of a higher HA antianginal effect was stronger than at the lower period of HA (2,27±0,16 points and 1,75±0,12 points, p<0,05), and the need in nitroglycerin on the background of a drug therapy disappeared for 5-7 days quicker than at the period of a lower HA. Maximal hypotensive effect at a higher HA was achieved quicker - on the 3rd day of the treatment, and at a lower HA - only up to hospital discharge (p<0,05). Blood viscosity did not normalize in both of the studied periods, but in small vessels there was noted a decrease of a BV (p<0,05). So, at a higher HA the effectiveness of a drug therapy in patients with UA is higher than at the period of a lower HA.

  18. Combination therapy with metoprolol and nifedipine versus monotherapy in patients with stable angina pectoris. Results of the International Multicenter Angina Exercise (IMAGE) Study

    DEFF Research Database (Denmark)

    Savonitto, S; Ardissiono, D; Egstrup, K

    1996-01-01

    (which reduces myocardial oxygen consumption) and a dihydropyridine calcium antagonist (which increases coronary blood flow) is a logical approach to the treatment of stable angina pectoris. However, it is not clear whether, in individual patients, this combined therapy is more effective than monotherapy...

  19. Diagnosis of unstable angina pectoris has declined markedly with the advent of more sensitive troponin assays.

    Science.gov (United States)

    D'Souza, Maria; Sarkisian, Laura; Saaby, Lotte; Poulsen, Tina S; Gerke, Oke; Larsen, Torben B; Diederichsen, Axel C P; Jangaard, Nikolaj; Diederichsen, Søren Z; Hosbond, Susanne; Hove, Jens; Thygesen, Kristian; Mickley, Hans

    2015-08-01

    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. 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 syndrome included unstable angina pectoris, NSTEMI, and STEMI. Mortality data were obtained from the Danish Civil Personal Registration System. Of 3762 consecutive patients, 516 had acute coronary syndrome. Unstable angina pectoris was present in 7%, NSTEMI in 67%, and STEMI in 26%. The NSTEMI patients were older, more frequently women, and had more comorbidities than patients with unstable angina pectoris and STEMI. At median follow-up of 3.2 years 195 patients had died: 14% of unstable angina pectoris, 45% of NSTEMI, and 25% of STEMI patients. Age-adjusted log-rank statistics revealed differences in mortality: NSTEMI vs unstable angina pectoris (P = .0091) and NSTEMI vs STEMI (P = .0045). The application of the universal definition together with the use of a contemporary troponin assay seems to have reduced the proportion of patients with unstable angina pectoris to the benefit of patients with NSTEMI. Despite this, NSTEMI patients have a sustained higher mortality than patients with STEMI. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Angina pectoris in patients with HIV/AIDS: prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Josefina Cláudia Zirpoli

    Full Text Available INTRODUCTION: The incidence of ischemic heart disease is higher in patients with HIV/AIDS. However, the frequency of angina pectoris in these patients is still not known. Literature about this subject is still scarce. OBJECTIVE: To evaluate the prevalence of angina pectoris and risk factors for coronary disease and to examine the association between traditional risk factors and HIV-related risk factors and angina pectoris. METHOD: An epidemiological cross-sectional study, analyzed as case-control study, involving 584 patients with HIV/AIDS. Angina pectoris was identified by Rose questionnaire, classified as definite or possible. Information regarding risk factors was obtained through a questionnaire, biochemical laboratory tests, medical records and anthropometric measures taken during consultations at AIDS treatment clinics in Pernambuco, Brazil, from June 2007 to February 2008. To adjust the effect of each factor in relation to others, multiple logistic regression was used. RESULTS: There was a preponderance of men (63.2%; mean ages were 39.8 years for men, 36.8 years for women. The prevalence of definite and possible angina were 11% and 9.4%, respectively, totaling 20.4%, with independent associations between angina and smoking (OR = 2.88; 95% CI: 1.69-4.90, obesity (OR = 1.62; 95% CI: 0.97-2.70, family history of heart attack (OR = 1.70; 95% CI: 1.00-2.88, low schooling (OR = 2.11; 95% CI: 1.24-3.59, and low monthly income (OR = 2.93; 95% CI: 1.18-7.22, even after adjustment for age. CONCLUSION: This study suggests that angina pectoris is underdiagnosed, even in patients with medical monitoring, revealing lost opportunities in identification and prevention of cardiovascular morbidity.

  1. Critical evaluation of ivabradine for the management of chronic stable angina

    Directory of Open Access Journals (Sweden)

    Khan W

    2011-09-01

    Full Text Available Waqas Khan, Jeffrey S BorerDivision of Cardiovascular Medicine and the Department of Medicine, State University of New York Downstate Medical Center and College of Medicine, Brooklyn and New York, NY, USAAbstract: Angina pectoris is the most common symptom of coronary artery disease (CAD. Angina results from an imbalance between myocardial oxygen supply and demand. Heart rate (HR reduction can beneficially alter both elements of this imbalance by increasing diastolic filling time and reducing myocardial oxygen demand. Therefore, HR reduction is an accepted approach to angina prevention. ß-blockers, calcium-channel blockers, and long-acting nitrates are currently the cornerstones in prevention and management of stable angina. However, use of these treatments may be limited by adverse effects or development of tolerance. Thus, additional approaches to angina prevention may be useful for many patients with CAD. The discovery of the f-channel and the resulting current, If, that modulates the rate of spontaneous diastolic depolarization of sinoatrial nodal (SAN myocytes led to the study of these channels as targets for lowering HR. This resulted in the development of a novel agent, ivabradine, a selective and specific If inhibitor. Ivabradine slows the slope of diastolic depolarization of the action potential in the SAN cells, decreasing HR at rest and during exercise, but has no other cardiovascular effects. In different subpopulations with chronic stable angina, ivabradine markedly improves exercise capacity and significantly decreases the number of ambient angina attacks. In a post-hoc analysis of the BEAUTIFUL trial (morBidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left-ventricULar dysfunction, ivabradine also reduced mortality, myocardial infarctions, and heart failure hospitalizations among patients with angina. To date, the drug has been well tolerated; transient visual disturbances and

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

    International Nuclear Information System (INIS)

    Alavi, S.M.; Adel, S. M. H.; Rajabzadeh, A.

    2008-01-01

    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 (P 0.05). Our study revealed relationship between seropositivity of HP-lgG and unstable angina. (author)

  3. Usefulness of myocardial scintigraphy using cigarette smoking and isosorbide dinitrate in patients with angina pectoris

    International Nuclear Information System (INIS)

    Igarashi, Takeki; Horimoto, Masashi; Funayama, Naoki

    1989-01-01

    Cigarette smoking is not only one of the most important risk factors for coronary artery disease, but also anginal attacks often occur during smoking. Coronary vasoconstriction is considered to be one of the mechanisms which cause anginal episodes. Thirty patients with angina pectoris, 27 men and 3 women, were investigated. Group I comprised 22 patients with rest angina and group II consisted of 8 patients with effort angina. Five minutes after smoking one cigarette, a first study of 20l Tl myocardial SPECT was performed. Consequently, after sublingual administration of isosorbide denitrate, a second SPECT was done. Most cases improved and it was recognized as positive when changes of localized perfusion defects were observed between both SPECTs. In the group I, 19 out of 22 patients (86%) were positive, but in the group II, 2 out of 8 (25%) were positive. The differences were statistically significant (p<0.05). By the examination of coronarty angiography in 20 patients, the result of myocardial scintigraphy using cigarette smoking and isosorbide dinitrate seemed inversely proportional to the severity of narrowing of the coronary artery. In addition, background factors including risk factors were also compared for both groups. Because the result of this myocardial scintigraphy was positive in the rest angina group and in the group with minimal coronary arteriogrpahic abnormalities, it seggests that myocardial scintigraphy using cigarette smoking and isosorbide dinitrate is useful as a non-invasive auxiliary diagnostic method to detect coronary spasm or coronary vasoconstriction-prone angina pectoris including silent myocardial ischemia. (author)

  4. Safflower yellow injection combined with conventional therapy in treating unstable angina pectoris: a meta-analysis.

    Science.gov (United States)

    Kong, Dezhao; Xia, Wei; Zhang, Zhe; Xiao, Lei; Yuan, Dongchao; Liu, Yue; Yang, Guanlin

    2013-10-01

    To evaluate the clinical efficacy of safflower yellow injection combined with conventional therapy in treating unstable angina pectoris. We searched online databases: Chinese journal full-text database, China National Knowledge Infrastructure, Wanfang database, Chinese journal full-text database, Pubmed, ScienceDirect, Embase, and the Cochrane Library with manual-screening of relevant literature. Eligible randomized controlled trials (RCT) on angina pectoris were included. We conducted meta-analysis using the RevMan 5.1 software from The Cochrane Collaboration. We treated the relief rate of angina symptoms and electrocardiograph (ECG) as evaluation. Seven articles, including in 1134 patients, were enrolled after the evaluation. There was no significant heterogeneity among the studies (chi2 = 1.08, df = 6, P = 0.98, I2 = 0%). The safflower yellow injection with conventional therapy has a higher effective rate than the control group in relieving the symptoms of angina pectoris [odds ratio (OR)= 2.95, 95% (CI) (1.81, 4.81)] and improving ischemic ECG [OR = 2.85, 95% CI (1.67, 4.86)]. The difference was statistically significant in the "80 mg dosage" and "100 mg dosage" subgroups (P unstable angina and improving ECG over basic therapy alone. However, the conclusions should be interpreted with care until more high-quality RCTs are reported.

  5. Ludwig's angina: report of two cases and review of the literature from 1945 to January 1979.

    Science.gov (United States)

    Hought, R T; Fitzgerald, B E; Latta, J E; Zallen, R D

    1980-11-01

    Two cases of Ludwig's angina treated successfully led us to review the main English language literature from 1945 to January 1979. The most common cause of Ludwig's angina is dental, and the organism cultured most often is streptococcus. However, other avenues of infection and numerous pathogens have been implicated in this disease. Penicillin remains the preferred primary antibiotic, with combinations of this drug and other antibiotics being used by various authors. In both the pre-antibiotic and antibiotic era, the airway remains the prime concern of the surgeon in the management of this potentially life-threatening disease. Of the 75 cases reviewed, there were seven deaths, but four of these patients had pre-existing fatal systemic problems and Ludwig's angina was not the cause of death. The other three deaths were due to Ludwig's angina, yielding a 4% mortality rate. Thus, aggressive management of Ludwig's angina, with respect to airway, antibiotics, and early surgical intervention, has resulted in a significant drop in the mortality rate of this disease which once led "almost uniformly to a fatal ending."

  6. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

    DEFF Research Database (Denmark)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe

    2015-01-01

    ,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST...

  7. Contrapulsación externa aumentada, un tratamiento no invasivo recomendado para la angina refractaria, valoración de la clase funcional y la calidad de vida

    Directory of Open Access Journals (Sweden)

    Fernán Mendoza

    2017-05-01

    Conclusiones: La terapia de contrapulsación externa aumentada, mejora la calidad de vida y la clase funcional de angina y disnea en pacientes con angina refractaria y se convierte en un procedimiento no invasivo seguro y eficaz.

  8. Asma bronquial. Atención primaria de salud

    Directory of Open Access Journals (Sweden)

    Reinaldo Pino Blanco

    2010-12-01

    Full Text Available El siguiente trabajo define las pautas a seguir en la atención primaria de salud para logran un adecuado seguimiento y control de los pacientes que sufren enfermedades respiratorias crónicas y en particular el asma bronquial. Se realiza una revisión profunda de las principales guías para el manejo de la enfermedad, así como las mejores evidencias publicadas hasta la fecha.This paper sets out the guidelines in the primary health care to achieve an adequate monitoring and control of patients suffering from chronic respiratory diseases including bronchial asthma. A systematic review on the main guidelines to handle this disease and the best evidence published to this day are presented.

  9. Newer Therapies for Management of Stable Ischemic Heart Disease With Focus on Refractory Angina.

    Science.gov (United States)

    Singh, Mukesh; Arora, Rohit

    Ischemic heart disease remains a major public health problem nationally and internationally. Stable ischemic heart disease (SIHD) is one of the clinical manifestations of ischemic heart disease and is generally characterized by episodes of reversible myocardial demand/supply mismatch, related to ischemia or hypoxia, which are usually inducible by exercise, emotion, or other stress and reproducible-but which may also be occurring spontaneously. Improvements in the treatment of acute coronary syndromes along with increasing prevalence of cardiovascular risk factors, including diabetes and obesity, have led to increasing population of patients with SIHD. A significant number of these continue to have severe angina despite medical management and revascularization procedures performed and may progress to refractory angina. This article reviews the newer therapies in the treatment of SIHD with special focus in treating patients with refractory angina.

  10. 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

    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...... patients were older, more frequently women, and had more comorbidities than patients with unstable angina pectoris and STEMI. At median follow-up of 3.2 years 195 patients had died: 14% of unstable angina pectoris, 45% of NSTEMI, and 25% of STEMI patients. Age-adjusted log-rank statistics revealed...

  11. Bilateral submandibular gland infection presenting as Ludwig's angina: first report of a case.

    Science.gov (United States)

    Honrado, C P; Lam, S M; Karen, M

    2001-04-01

    We diagnosed and treated a case of Ludwig's angina in a 45-year-old man who had edema of the floor of mouth and the tongue along with bilateral submandibular sialadenitis and sialolithiasis. We secured the patient's airway via nasal fiberoptic intubation in the surgical intensive care unit and administered intravenous antibiotics. The edema subsided, and the patient was extubated on the third postoperative day and discharged shortly thereafter. To our knowledge, this is the first reported case of a patient with bilateral submandibular sialadenitis and sialolithiasis presenting as Ludwig's angina. Despite the decreasing incidence of this disease, Ludwig's angina remains an important disease process because a failure to control the airway can have disastrous consequences. Proper diagnosis, airway control, antibiotic therapy, and occasionally surgical management are essential to ensure the safety of the patient.

  12. Ludwig's Angina-A Controversial Surgical Emergency: How We Do It.

    Science.gov (United States)

    Hasan, Wael; Leonard, David; Russell, John

    2011-01-01

    Objectives. To review the current protocols used for management of Ludwig's angina and to assess the efficacy of conservative measures in these cases. Methods. A retrospective review of patients who were admitted to our institution for management of Ludwig's angina between 2003 and 2010. Results. Two patients were identified. Both were managed successfully with conservative measures and close airway observation. None needed an emergency intubation or surgical tracheostomy. There were no mortalities, and both had a short hospital stay. Conclusion. Recently, management of Ludwig's angina has evolved from aggressive airway management into a more conservative one. This is based on close airway observation on a specialised airway unit and a serial clinical airway assessment. Improved imaging modalities, antibiotic therapy, surgical skills, and clinical experience are the key factors behind this change in practice.

  13. 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.

  14. Invasive angiography and revascularization in patients with stable angina following prior coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Joshi, Francis R; Biasco, Luigi; Pedersen, Frants

    2017-01-01

    BACKGROUND: There are limited data to guide the optimum approach to patients presenting with angina after coronary artery bypass grafting (CABG). Although often referred for invasive angiography, the effectiveness of this is unknown; angina may also result from diffuse distal or micro......-vascular coronary disease and it is not known how often targets for intervention are identified. METHODS: Retrospective review of 50,460 patients undergoing angiography in East Denmark between January 2010 and December 2014. Clinical and procedural data were prospectively stored in a regional electronic database....... Follow-up data were available for all patients, by means of records linked to each Danish social security number. RESULTS: In patients with prior CABG and stable angina (n = 2,309), diagnostic angiography led to revascularization in 574 (24.9%) cases. Chronic kidney disease (HR 1.93 [1.08-3.44], P = 0...

  15. 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...... in the coronary sinus, thus redistributing blood into ischemic myocardium. METHODS: We randomly assigned 104 patients with Canadian Cardiovascular Society (CCS) class III or IV angina (on a scale from I to IV, with higher classes indicating greater limitations on physical activity owing to angina) and myocardial.......6 points; P=0.03). There were no significant between-group differences in improvement in exercise time or in the mean change in the wall-motion index as assessed by means of dobutamine echocardiography. At 6 months, 1 patient in the treatment group had had a myocardial infarction; in the control group, 1...

  16. Temporary sympathectomy in chronic refractory angina: a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Denby, Christine; Groves, David G; Eleuteri, Antonio; Tsang, Hoo Kee; Leach, Austin; Hammond, Clare; Bridson, John D; Fisher, Michael; Elt, Matthew; Laflin, Robert; Fisher, Anthony C

    2015-08-01

    Temporary sympathectomy by injection of bupivacaine at the site of the left stellate ganglion is used in the management of refractory angina at several UK centres. Although patients frequently report significant reduction in symptoms, efficacy has not been established by double-blind, randomised placebo-controlled trial (RCT). To investigate the efficacy of the procedure for the first time by a double-blind RCT. Consecutive patients referred to the authors' National Health Service (NHS) angina centre who were candidates for temporary sympathectomy were invited to participate in a trial. A total of 65 patients were randomised to receive either bupivacaine or saline injections. Identical syringes were prepared remotely, blinding patients and staff from randomisation. Cardiac autonomic function was measured 3 hours pre- and post-injection using new heart rate variability (HRV) analyses. Angina episodes were recorded contemporaneously by patients in study diaries in the 7-day periods pre- and post-injection. In 51 patients suitable for analysis, no significant differences between the active and placebo groups were found in patient-recorded frequency or intensity of angina episodes pre- and post-injection. However, across both groups combined, a significant difference was found in the frequency of angina episodes pre- and post-injection. The reduction in frequency of angina episodes produced by this procedure may not be due to drug pharmacology. It may be a placebo response or due to the mechanical effects of the injection of fluid. There is a need for further work using a larger patient cohort considering both mechanical and psychological factors.

  17. Diferencias culturales en deberes y derechos entre los docentes de Infantil-Primaria y Secundaria

    OpenAIRE

    Larrosa Mart??nez, Faustino; Garc??a Fern??ndez, Jos?? Manuel

    2012-01-01

    El trabajo analiza las diferencias culturales entre el profesorado de Infantil-Primaria y Secundaria a la luz de sus deberes y derechos. Han participado 394 docentes de toda Espa??a de educaci??n Infantil, Primaria y Secundaria, elegidos al azar, contestando a un cuestionario enviado por correo postal a los centros seleccionados aleatoriamente. Se utiliza como instrumento el cuestionario ???Deberes y derechos del profesorado en la comunidad educativa??? y se confirma la hip??t...

  18. Coronary arteriography and left ventriculography during spontaneous and exercise-induced ST segment elevation in patients with variant angina

    International Nuclear Information System (INIS)

    Matsuda, Y.; Ozaki, M.; Ogawa, H.; Naito, H.; Yoshino, F.; Katayama, K.; Fujii, T.; Matsuzaki, M.; Kusukawa, R.

    1983-01-01

    The present study is an angiographic demonstration of coronary artery spasm during both spontaneous and exercise-induced angina in three patients with variant angina. In each case, clinical, ECG, coronary angiographic, and left ventriculographic observations were made at rest, during spontaneous angina, and during exercise-induced angina. The character of chest pain was similar during spontaneous and exercise-induced episodes. ST segment elevation was present in the anterior ECG leads during both episodes. The left anterior descending coronary artery became partially or totally obstructed during both types of attacks. When coronary spasm was demonstrated during both types of attacks, left ventriculography disclosed akinetic or dyskinetic wall motion in the area supplied by the involved artery. In those patients with reproducible exercise-induced ST segment elevation and chest pain, thallium-201 scintigraphy showed areas of reversible anteroseptal hypoperfusion. Thus in selected patients exercise-induced attacks of angina were similar to spontaneous episodes

  19. MODERN PHARMACOTHERAPY OF THE STABLE ANGINA: POSSIBILITIES AND PROSPECTS OF NICORANDIL IMPLEMENTATION

    Directory of Open Access Journals (Sweden)

    Z. M. Sizova

    2010-01-01

    Full Text Available Aim. To evaluate antianginal efficacy and safety of nicorandil for angina attack prevention and relief in patients with ischemic heart disease (IHD and symptoms of stable angina class 2-3.Material and methods. 30 patients with stable angina class 2-3 (17 men, 13 women; aged 58.6±5.8 y.o. were included into the study. All patients received amlodipine 10 mg QD within 2 weeks. For angina attack relief patients used nicorandil 10-20 mg and in case of its inefficacy — nitroglycerin. In 2 weeks all patients were randomized in 2 groups. Patients of the 1st group (n=15 received nicorandil 20 mg TID, patients of the 2nd group (n=15 — amlodipine 10 mg QD. The study duration was 3 months. The efficiency evaluation was based on the analysis of hemodynamic indicators (heart rate, blood pressure, bioelectric heart activity (electrocardiogram, velocity exercise tolerance test, ambulatory blood pressure monitoring indicators. The pain severity was defined with Borg's scale, and the quality of life — with General Health Questionnaire (GHQ-28. Therapy safety was evaluated in according to laboratory tests results.Results. Frequency of angina attacks reduced by 60% (р<0.05 and 47% (р<0.05 in 12 weeks of nicorandil and amlodipine therapy, respectively. Duration of angina decreased by 38% and 37% (р<0.05 in 12 weeks of nicorandil and amlodipine therapy, respectively. Eexercise duration before angina attack onset increased by 56% (р<0.05 in 1 month of nicorandil therapy. A number of myocardial ischemia episodes reduced by 64% (р<0.05 and 54% (р<0.05 due to nicorandil and amlodipine therapy, respectively. General GHQ-28 score decreased by 54% (р<0.05 and 44% (р<0.05 in patients of the 1st and the 2nd groups, respectively. Tolerability of nicorandil was good in 13 (86.7% and satisfactory in 2 (13.3% patients.Conclusion. Nicorandil can be prescribed both for the prevention and for relief of angina attacks in IHD patients.

  20. Economic burden of chronic conditions among households in Myanmar: the case of angina and asthma.

    Science.gov (United States)

    Htet, Soe; Alam, Khurshid; Mahal, Ajay

    2015-11-01

    Non-communicable diseases (NCDs) are becoming a major source of the national disease burden in Myanmar with potentially serious economic implications. Using data on 5484 households from the World Health Survey (WHS), this study assessed the household-level economic burden of two chronic conditions, angina and asthma, in Myanmar. Propensity score matching (PSM) and coarsened exact matching (CEM) methods were used to compare household out-of-pocket (OOP) spending, catastrophic and impoverishment effects, reliance on borrowing or asset sales to finance OOP healthcare payments and employment among households reporting a member with angina (asthma) to matched households, with and without adjusting for comorbidities. Sensitivity analyses were carried out to assess the impacts of alternative assumptions on common support and potential violations of the assumption of independence of households being angina (asthma) affected and household economic outcomes, conditional on the variables used for matching (conditional independence). Households with angina (asthma) reported greater OOP spending (angina: range I$1.94-I$4.31; asthma: range I$1.53-I$2.01) (I$1 = 125.09 Myanmar Kyats; I$=International Dollar) almost half of which was spending on medicines; higher rates of catastrophic spending based on a 20% threshold ratio of OOP to total household spending (angina: range 6-7%; asthma: range 3-5%); greater reliance on borrowing and sale of assets to finance healthcare (angina: range 12-14%; asthma: range 40-49%); increased medical impoverishment and lower employment rates than matched controls. There were no statistically differences in OOP expenses for inpatient care between angina-affected (asthma-affected) households and matched controls. Our results were generally robust to multiple methods of matching. However, conclusions for medical impoverishment impacts were not robust to potential violations of the conditional independence assumption. Myanmar is expanding public

  1. Transient myocardial ischemia after abrupt withdrawal of antianginal therapy in chronic stable angina

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    In 47 patients with chronic stable angina and proven coronary artery disease, abrupt withdrawal of beta-adrenoceptor blocking agents either as monotherapy or in combination with calcium antagonists (group 1, n = 25) was compared with abrupt withdrawal of calcium antagonist monotherapy (group 2, n...... less than 0.05). These results indicate that a rebound increase in ischemic activity (mainly silent) occurs after abrupt withdrawal of beta-receptor blockade in patients with chronic stable angina. This increase in ischemic activity may be caused by increased myocardial oxygen demand....

  2. Combination therapy with metoprolol and nifedipine versus monotherapy in patients with stable angina pectoris. Results of the International Multicenter Angina Exercise (IMAGE) Study

    DEFF Research Database (Denmark)

    Savonitto, S; Ardissiono, D; Egstrup, K

    1996-01-01

    OBJECTIVES: This study was designed to investigate whether combination therapy with metoprolol and nifedipine provides a greater anti-ischemic effect than does monotherapy in individual patients with stable angina pectoris. BACKGROUND: Combination therapy with a beta-adrenergic blocking agent....... METHODS: Two hundred eighty patients with stable angina pectoris were enrolled in a double-blind trial in 25 European centers. Patients were randomized (week 0) to metoprolol (controlled release, 200 mg once daily) or nifedipine (Retard, 20 mg twice daily) for 6 weeks; placebo or the alternative drug...... was then added for a further 4 weeks. Exercise tests were performed at weeks 0, 6 and 10. RESULTS: At week 6, both metoprolol and nifedipine increased the mean exercise time to 1-mm ST segment depression in comparison with week 0 (both p metoprolol was more effective than nifedipine (p

  3. 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

  4. Lack of indication of myocardial cell damage after myocardial ischaemia in patients with severe stable angina

    DEFF Research Database (Denmark)

    Hansen, Knud Nørregaard; Egstrup, K; Nielsen, J R

    1992-01-01

    To evaluate myocardial cell damage in relation to spontaneous and exercise-induced ischaemia, release of myoglobin, creatine kinase (CK) and its isoenzyme MB (CK-MB) into the serum was estimated in 10 patients with severe stable angina. All patients had a positive exercise test, significant steno...

  5. Coronary angioplasty of the unstable angina related vessel in patients with multivessel disease

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); M.L. Simoons (Maarten); W. Wijns (William); R. Geuskens; A. Soward; M.J.B.M. van den Brand (Marcel); P.G. Hugenholtz (Paul); A.E.R. Arnold (Alfred)

    1986-01-01

    textabstractThis study is a retrospective analysis of the efficacy of percutaneous transluminal coronary angioplasty of the ischaemia-related vessel in patients with unstable angina. Forty-three patients had multivessel disease with dilatation of the ischaemia-related vessel only (group I; partial

  6. Alternating Wolff-Parkinson-White syndrome associated with attack of angina

    International Nuclear Information System (INIS)

    Mangiafico, R.A.; Petralito, A.; Grimaldi, D.R.

    1990-01-01

    In a patient with Wolff-Parkinson-White syndrome and an inferior-posterior bypass tract, transient restoration of normal conduction occurred during an attack of angina. The ECG pattern of inferior posterior ischemia was present when the conduction was normal. Thallium scintigraphy showed a reversible posterolateral perfusion defect. The possible mechanisms for production of intermittent preexcitation are discussed

  7. Efficacy of a Device to Narrow the Coronary Sinus in Refractory Angina

    NARCIS (Netherlands)

    Verheye, Stefan; Jolicoeur, E. Marc; Behan, Miles W.; Pettersson, Thomas; Sainsbury, Paul; Hill, Jonathan; Vrolix, Mathias; Agostoni, Pierfrancesco; Engstrom, Thomas; Labinaz, Marino; de Silva, Ranil; Schwartz, Marc; Meyten, Nathalie; Uren, Neal G.; Doucet, Serge; Tanguay, Jean-Francois; Lindsay, Steven; Henry, Timothy D.; White, Christopher J.; Edelman, Elazer R.; Banai, Shmuel

    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 in

  8. 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

  9. pectorIs of labetalol in with angina Beneficial effect hypertensive ...

    African Journals Online (AJOL)

    1983-01-15

    Jan 15, 1983 ... exercise or on pertormance of the cold pressor test. Labetalol significantly reduced blood pressure levels during isometric exercise but did not reduce the systolic pressure- heart rate product. Labetalol improved the angina without evidence of causing a reduction of cardiac work (and presumably oxygen.

  10. Serum potassium values in relation to the use of diuretics in patients with unstable angina pectoris

    NARCIS (Netherlands)

    van Gilst, W. H.; Tijssen, J. G.; van Es, G. A.; Lubsen, J.

    1988-01-01

    Transient hypokalaemia may occur in acutely ill patients and is associated with an increased incidence of life-threatening arrhythmias. Therefore, we performed a retrospective analysis of the serum potassium values of 538 patients with unstable angina included in the Holland Interuniversity

  11. Behandling af ustabil angina pectoris. En spørgeskemaundersøgelse

    DEFF Research Database (Denmark)

    Nielsen, J D; Stoltenberg, Meredin; Juul, A

    1990-01-01

    Questionnaires about therapy in unstable angina pectoris were sent to 63 Danish medical departments and were answered by 52 departments (82.5%). Nitroglycerin is commonly used but only in half of the departments is Nitroglycerin administered intravenously. Calcium-receptor-blockers are used in more...

  12. Transient myocardial ischemia after abrupt withdrawal of antianginal therapy in chronic stable angina

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    In 47 patients with chronic stable angina and proven coronary artery disease, abrupt withdrawal of beta-adrenoceptor blocking agents either as monotherapy or in combination with calcium antagonists (group 1, n = 25) was compared with abrupt withdrawal of calcium antagonist monotherapy (group 2, n...

  13. Tissue Doppler echocardiography improves the diagnosis of coronary artery stenosis in stable angina pectoris

    DEFF Research Database (Denmark)

    Hoffmann, Soren; Jensen, Jan Skov; Iversen, Allan Zeeberg

    2012-01-01

    Aim To determine if colour tissue Doppler imaging (TDI) performed at rest in patients with suspected stable angina pectoris (SAP) is able to predict the presence of significant coronary artery disease (CAD). METHODS AND RESULTS: This study comprises 296 consecutive patients with clinically...

  14. Clinical validation of a quality of life questionnaire in angina pectoris patients.

    Science.gov (United States)

    Marquis, P; Fayol, C; Joire, J E

    1995-11-01

    Angina pectoris impairs patients' quality of life. In order to assess its impact on quality of life, a questionnaire was developed using a literature review and interviews with patients and clinicians. It consisted of a general profile (SF-36) which measured functional status, well-being, perceived health, and a specific index, the Angina Pectoris Quality of Life Questionnaire, supplemented by new items. The acceptability, internal consistency reliability and clinical validity of this 70-item questionnaire were analysed in a cross-sectional study. Of 197 coronary patients approached, 93% (n = 184) agreed to participate and 86% (n = 170) returned the mailed questionnaire. Mean age of patients was 67 years (+/- 10); 79% were male and 70% were retired. Sixty patients were asymptomatic and 110 reported anginal crises (Canadian Cardiovascular Society Classification: class I: 48; II: 37; III: 13; IV: 0; V: 12). Globally, angina pectoris was found to affect each quality of life concept measured: physical functioning, well-being, and perceived health. Quality of life profiles worsened in accordance with increasing severity of the condition, as stratified by angina pectoris class. Asymptomatic patients reported better general and specific profiles. These results support the feasibility and usefulness of evaluating quality of life using the questionnaire. The validation of the data is very encouraging and enables the questionnaire to be used in clinical trials.

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

    Science.gov (United States)

    Amane, Hanmant S; Burte, N P

    2011-11-01

    To compare the efficacy and safety profile of dalteparin, a low-molecular-weight heparin with a standard unfractionated heparin in patients with unstable angina pectoris. This was a 6-month, prospective, parallel, randomized and open-labeled study. Patients of angina pectoris were randomized to receive either unfractionated heparin or dalteparin for 5 days. They were followed for 21 days during three visits on 1(st), 5(th) and 21(st) days. A series of resting electrocardiogram were undertaken in all patients on each visit. The frequency of the combined clinical outcome of death, myocardial infarction and recurrence of angina was similar during 21 days of follow-up with either dalteparin or intravenous unfractionated heparin. In patients who received dalteparin 2.43% patients developed minor bleeding in the form of epistaxis and 2.5% patients who received unfractionated heparin developed minor bleeding in the form of macroscopic hematuria. 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.

  16. Research of Medical Expenditure among Inpatients with Unstable Angina Pectoris in a Single Center.

    Science.gov (United States)

    Wu, Suo-Wei; Pan, Qi; Chen, Tong; Wei, Liang-Yu; Xuan, Yong; Wang, Qin; Li, Chao; Song, Jing-Chen

    2017-07-05

    With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of diagnosis-related groups (DRGs) among patients with unstable angina pectoris in a Grade A tertiary hospital to conduct the referential standards of medical costs for the diagnosis. Single-factor analysis and multiple linear stepwise regression method were used to investigate 3933 cases between 2014 and 2016 in Beijing Hospital (China) whose main diagnosis was defined as unstable angina pectoris to determine the main factors influencing the inpatient medical expenditure, and decision tree method was adopted to establish the model of DRGs grouping combinations. The major influential factors of inpatient medical expenditure included age, operative method, therapeutic effects as well as comorbidity and complications (CCs) of the disease, and the 3933 cases were divided into ten DRGs by four factors: age, CCs, therapeutic effects, and the type of surgery with corresponding inpatient medical expenditure standards setup. Data of nonparametric test on medical costs among different groups were all significant (P unstable angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.

  17. The significance of {sup 123}I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio [Fukushima Medical Coll. (Japan); Katohno, Eiichi; Ohwada, Kenji

    1998-06-01

    Some patients of ischemic heart disease have low uptake in {sup 123}I-labeled beta methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT in spite of normal uptake in thallium-201 (Tl) SPECT. To investigate their clinical significance, we performed both Tl and BMIPP myocardial SPECT in 26 cases with stable angina (n=16) and unstable angina (n=10), and compared with clinical backgrounds electrocardiogram (ECG) and left ventriculography (LVG). In 11 patients of them, the uptake of BMIPP was moderately reduced. We divided 26 cases into two groups according to uptake of BMIPP (normal/reduced). The two groups had no differences in length of angina attack and duration of disease, but they had a significant difference in the abnormality of either ECG or LVG. Three to six months after PTCA, we examined LVG in 18 cases, 12 of 16 cases with the abnormality of LVG showed the improvement of wall motion. We concluded the reduced uptake of BMIPP with normal uptake of Tl was related to more severe ischemia in cases with unstable angina. (author)

  18. [Effect of clopidogrel and aspigrel on ectopic cardiac activity in patients with unstable angina pectoris].

    Science.gov (United States)

    Zaval's'ka, T V

    2013-01-01

    The coronary circulation dysfunction in patients with unstable angina pectoris causes development of ventricular and supraventricular cardiac rhythm disorders. Findings from the current study suggest that antianginal therapy of patients with acute coronary syndrome which includes antiaggregant and anticoagulant is effective in the treatment of extrasystolic arrhythmias.

  19. Early treatment of unstable angina with nifedipine and metoprolol--the HINT trial

    NARCIS (Netherlands)

    Tijssen, J. G.; Lubsen, J.

    1988-01-01

    A multicenter, double-blind, placebo-controlled, randomized trial of nifedipine, metoprolol, and their combination was conducted in a group of 338 patients with unstable angina not pretreated with a beta-blocker and of nifedipine in 177 patients who were. The main outcome event was recurrent

  20. Randomised, double-blind trial of intravenous diltiazem versus glyceryl trinitrate for unstable angina pectoris

    NARCIS (Netherlands)

    Gobel, EJAM; Hautvast, RWM; vanGilst, WH; Spanjaard, JN; Hillege, HL; DeJongste, MJL; Molhoek, GP; Lie, KI

    1995-01-01

    The effect of dihydropyridines in patients with unstable angina is discouraging. To find out the effect of the non- dihydropyridine-like calcium-channel blocker diltiazem, a randomised, double-blind trial was conducted comparing diltiazem with glyceryl trinitrate. both given intravenously, in 129

  1. [Clinical effect and mechanismn of xuefu zhuyu capsule in treating unstable angina pectoris].

    Science.gov (United States)

    Zheng, Guo-ling; Wang, Sheng-hua

    2009-01-01

    To observe the clinical effect of Xuefu Zhuyu Capsule (XFZYC) in treating unstable angina pectoris (UAP) and to investigate its mechanism of protection on vascular endothelia. Sixty UAP patients were randomly assigned to two groups, the 30 in the treated group were treated by conventional therapy plus XFZYC, and the 30 in the control group treated by conventional therapy alone. The frequency and persistent time of angina pectois, dosage of nitroglycerin used, changes of electrocardiogram (ECG) were observed, and the plasma levels of endothelin (ET), nitric oxide (NO), von Willebrand factor (vWF), soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) were tested before and after the two-month therapeutic course. (1) The clinical symptoms as frequency and persistent time of angina pectoris in the treated group were bettered significantly after treatment and the dosage of nitroglycerin used decreased (all P angina pectoris partially by decreasing the plasma levels of ET, vWF, sVCAM-1 and sICAM-1 and elevating the level of NO.

  2. Unstable Angina Pectoris in a 22-year-old Female Patient.

    Science.gov (United States)

    Yoshimura, Hanae; Oba, Toyoharu; Nagata, Takanobu; Kumagai, Eita; Itaya, Naoki; Yoshikawa, Naohiro; Akagaki, Daiki; Ohshima, Hideki; Nishihara, Michihide; Ueno, Takafumi; Fukumoto, Yoshihiro

    2017-04-13

    Because of the protective effect of estrogen for atherosclerosis, the prevalence of acute coronary syndrome in women before menopause is low. We report a rare case of unstable angina in a young Japanese female who had a history of cigarette smoking and contraceptive use. Her coronary stenosis was successfully treated by percutaneous coronary intervention.

  3. Research of Medical Expenditure among Inpatients with Unstable Angina Pectoris in a Single Center

    Directory of Open Access Journals (Sweden)

    Suo-Wei Wu

    2017-01-01

    Conclusions: The classification of DRGs by adopting the type of surgery as the main branch node to develop cost control standards in inpatient treatment of unstable angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.

  4. Management of Ludwig's angina in pregnancy: a review of 10 cases ...

    African Journals Online (AJOL)

    All the patients presented during the third trimester of their pregnancy and odontogenic infections were responsible for 80% (8/10) of the Ludwig's angina. There were 20% mortality among the patients and this was significant for those with underlying systemic conditions (P = 0.02). The time of presentation was not significant ...

  5. Invasive angiography and revascularization in patients with stable angina following prior coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Joshi, Francis R; Biasco, Luigi; Pedersen, Frants

    2017-01-01

    . Follow-up data were available for all patients, by means of records linked to each Danish social security number. RESULTS: In patients with prior CABG and stable angina (n = 2,309), diagnostic angiography led to revascularization in 574 (24.9%) cases. Chronic kidney disease (HR 1.93 [1.08-3.44], P = 0...

  6. Is surgical airway necessary for airway management in deep neck infections and Ludwig angina?

    Science.gov (United States)

    Wolfe, Mary M; Davis, James W; Parks, Steven N

    2011-02-01

    Deep neck infections are potentially life-threatening conditions because of airway compromise. Management requires early recognition, antibiotics, surgical drainage, and effective airway control. The Surgical Education and Self-Assessment Program 12 states that awake tracheostomy is the treatment of choice for these patients. With advanced airway control techniques such as retrograde intubation, GlideScope, and fiberoptic intubation, surgical airway is not required. A retrospective analysis of all deep neck abscesses treated from December 1999 to July 2006 was performed. All patients who underwent urgent or emergent surgery for Ludwig angina and submental, submandibular, sublingual, and parapharyngeal abscesses (Current Procedural Terminology codes 41015, 41016, 41017, 42320, and 42725) were included in our review. Charts were studied for age, presence of true Ludwig angina, presence of airway compromise, airway management, morbidity/mortality, and the requirement for surgical airway. Of 29 patients, 6 (20%) had symptoms consistent with true Ludwig angina. Nineteen (65.5%) had evidence of airway compromise. Eight (42%) of these 19 patients required advanced airway control techniques. No patient required a surgical airway, and no mortality resulted from airway compromise. Advance airway control techniques were required more often in patients with airway compromise (P Ludwig angina and deep neck abscesses requires good clinical judgment. Patients with deep neck infections and symptoms of airway compromise may be safely managed with advanced airway control techniques. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Management of Ludwig's angina with small neck incisions: 18 years experience.

    Science.gov (United States)

    Bross-Soriano, Daniel; Arrieta-Gómez, José R; Prado-Calleros, Héctor; Schimelmitz-Idi, Jose; Jorba-Basave, Santiago

    2004-06-01

    To review Ludwig's angina medical and surgical approach with small incisions. Retrospective, open, noncomparative, longitudinal. All patients with Ludwig's angina who received medical, metabolic, airway management, and surgical treatment from January 1, 1983 to December 31, 2000. Antibiotic treatment, surgical treatment, hospitalization time, associated diseases, etiologic factors, recuperation time. Age range was 18 to 87 years, with a female-to-male ratio of 1.1:1 (68 females, 53 males). Thirty patients belonged to middle or high socioeconomic status. The primary site of infection was odontogenic in 107 of the patients. All the patients were managed with surgical drainage made within the first 12 hours after hospital admission. The most common antibiotic treatments were the combination of clindamycin with crystalline penicillin G. The hospital stay for more than half of patients was 6 days or less. In 62 patients we found extension into the parapharyngeal space and in 32 cases we found retropharyngeal extension of the Ludwig's angina. Forty-six patients had or were diagnosed as having diabetes mellitus. Tracheotomy was required in 34 patients. The airway of the rest of patients was controlled with nasotracheal intubation. Only 33 patients had major complications, such as mediastinitis, sepsis, or death. Drainage using small incisions is a safe and effective method as part of treatment of Ludwig's angina.

  8. A re-evaluation of the role of tracheostomy in Ludwig's angina.

    Science.gov (United States)

    Allen, D; Loughnan, T E; Ord, R A

    1985-06-01

    Ten cases of Ludwig's angina that required surgical decompression in addition to intravenous antibiotic therapy are reviewed. The vocal cords were visualized in all ten patients following deep inhalational anesthesia to relieve trismus. Only one case required tracheostomy, which has previously been recommended as the treatment of choice for airway management; the other nine were intubated under direct vision.

  9. Patients with unstable angina pectoris show an increased frequency of the Fc gamma RIIa R131 allele.

    Science.gov (United States)

    Raaz-Schrauder, Dorette; Ekici, Arif B; Munoz, Luis E; Klinghammer, Lutz; Voll, Reinhard E; Leusen, Jeanette H W; van de Winkel, Jan G J; Reis, André; Schett, Georg; Garlichs, Christoph D; Herrmann, Martin

    2012-11-01

    Patients with Systemic Lupus Erythematosus (SLE) carry an increased risk for the development of coronary artery disease (CAD). The R131 allele of the Fc gamma receptor IIa (FcγRIIa) is associated with SLE incidence and disease severity but also with CAD. Compared to stable angina pectoris (SAP) the unstable angina (UAP), as a manifestation of destabilizing CAD, is associated with increased risk of persistent instability, myocardial infarction, and death. Identification of clinically relevant determinants for unstable angina promises reduction of UAP-associated mortality in patients with SLE. We conducted a clinical study among 553 consecutive patients with stable angina pectoris (n = 330) and unstable angina pectoris (n = 223). All patients were genotyped for a frequent functional variant at position 131 of the mature FcγRIIa. UAP, but not SAP was significantly associated with the R/R131 genotype (P angina carrying the R/R131 genotype the odds ratio for suffering from UAP was 4.02 (95% confidence interval, 2.52-6.41) compared to those with non-R/R131 genotypes. In a multivariable analysis, the R/R131 genotype independently predicted the risk for development of UAP in a model adjusted for classical atherogenic risk factors. Our data imply that risk stratification of SLE- and other high risk patients with troponin-negative angina could be significantly improved by FcγRIIa genotyping.

  10. Transcoronary sinus administration of autologous bone marrow in patients with chronic refractory stable angina

    International Nuclear Information System (INIS)

    Vicario, J.; Campos, C.; Piva, J.; Faccio, F.; Gerardo, L.; Becker, C.; Ortega, H.H.; Pierini, A.; Lofeudo, C.; Novero, R.; Licheri, A.; Milesi, R.; Perez Balino, N.; Monti, A.; Amin, A.; Pfeiffer, H.; De Giovanni, E.; Fendrich, I.

    2004-01-01

    Purpose: Based on our preclinic studies with autologous unfractionated bone marrow (AUBM) via coronary sinus with transitory occlusion, a clinic study in patients with chronic stable angina was designed. The objectives were to evaluate safety, tolerance and feasibility. Methods and materials: A multicenter prospective study with inclusion and exclusion criteria defined by an Independent Clinical Committee was carried out. Fourteen patients underwent transcoronary sinus administration of freshly aspirated and filtered AUBM (60-120 ml). Safety and tolerance were evaluated. Feasibility was evaluated with Seattle Angina Questionnaire (SAQ), Canadian Cardiovascular Society (CCS) angina classification (baseline-Day 180), myocardial perfusion (baseline-Day 90) with independent core laboratory and coronary angiography (baseline and Day 30). Results: There were no changes in the safety and tolerance parameters. Preliminary clinical efficacy at Day 180 disclosed a significant improvement of 38%, evaluated by the SAQ. The CCS angina classification shows that the mean angina class was 3.0±0.55 at baseline and improved to 2.0±0.00 at Day 180 (P<.001). Semiquantitative radionuclide perfusion imaging (core lab) showed a significant improvement at Day 90 in 13/14 patients, with a mean improvement of 24% at rest (P<.01) and 33% at stress (P<.05). Coronary angiography showed more collateral vessels in 9/14 patients. Conclusions: We can conclude that AUBM via coronary sinus with transitory occlusion is tolerable and safe. Significant improvement in the myocardial perfusion at Day 90 and in the quality of life at Day 180 was observed

  11. 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.

  12. An evidence against the effect of chronic cytomegalovirus infection in unstable angina pectoris.

    Science.gov (United States)

    Alavi, Seyed Mohammad; Adel, Seyed Mohammad Hasan; Rajabzadeh, Ali Reza

    2011-01-01

    Recent reports have suggested that cytomegalovirus (CMV) infection may contribute to risk of cardiovascular disease. However, relationship between CMV infection and unstable angina (UA) is controversial and studies about this subject in Iran and even region are lacking. The aim of this study was to determine whether unstable angina is related to seropositivity to chronic cytomegalovirus infection. We measured serum CMV IgG levels in a case control study participants in CCU in Razi Hospital, Ahvaz, Iran, from 2004 to 2005. Blood samples were drawn during study period from 96 patients (mean age 56 years) with UA according to American Heart Association Criteria and from 96 participants free of cardiovascular disease (mean age 58 years) and stored at -20°C. Blood samples of patients were undertaken for investigating the specific anti CMV-IgG by ELISA method. Data were analyzed in SPSS 11.5 by using chi square test, odds ratios (OR) with 95% confidence intervals (CI). Ninety three percent of patients with unstable angina and 96.7% in the control group presented a positive anti CMV-IgG. Odds ratio was 0.52 with 95% CI: 0.10 to 2.42. There was no significant correlation between CMV-IgG positivity and unstable angina (P>0.05). There was also no differences in CMV-IgG positivity in clinical groups of UA (P>0.05). The relationship between seropositivity of CMV-IgG and unstable angina has been restituted by the results of this study. However, further population based cohort studies for relationship between CMV infection and coronary artery disease must be conducted.

  13. [Unstable angina pectoris--combination of an epicardial stenosis and a Prinzmetal spasm].

    Science.gov (United States)

    Bentz, K; Ong, P; Sechtem, U

    2013-12-01

    A 61-year-old man presented with recurrent angina pectoris at rest for 3 days. The medical history revealed hypertension and an elevated cholesterol level as cardiovascular risk factors. The physical examination revealed no pathological findings. ECG at admission showed no signs of ischemia, while high-sensitive Troponin T was slightly elevated. Echocardiography showed diastolic dysfunction and biatrial dilatation. During another episode of angina at rest, ECG showed T-wave inversion in lead aVL. Therefore, coronary angiography was performed. At the beginning of the examination the patient complained of angina at rest and ECG showed ST-elevation in the inferior leads. Coronary angiography revealed a subtotal stenosis in the middle part of the RCA. After intracoronary nitroglycerin injection there was a high-grade stenosis in this region. An intracoronary acetycholin provocation test was performed which reproduced a focal spasm in the area of the RCA stenosis with simultaneous changes in the ECG and reproduction of the patient's unusual angina. After implantation of a bare metal stent a subsequent ACH-test did not elicit any further coronary spasm. Four weeks after the procedure the patient had no further complaints under medical treatment. This case illustrates a patient with a focal Prinzmetal-type spasm with ST-elevation on top of a high-grade stenosis of the right coronary artery as an explanation for the unstable angina. Coronary spasm of the Prinzmetal-type can occur in vessels with epicardial stenosis as well as in vessels without stenosis. In some cases focal coronary spasm can be prevented by the implantation of a stent. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Thunderclap-like headache triggered by micturition and angina as an initial manifestation of bladder pheochromocytoma. A case report

    Directory of Open Access Journals (Sweden)

    You Jin Han

    Full Text Available CONTEXT: Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis and angina. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed. CASE REPORT: This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by micturition and angina as an initial manifestation. CONCLUSION: This case study suggests that thunderclap headache and angina occurring concurrently with sudden blood pressure elevation during or immediately after micturition are important diagnostic clues for bladder pheochromocytoma.

  15. Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

    OpenAIRE

    Coleman, Craig I; Freemantle, Nick; Kohn, Christine G

    2015-01-01

    Objectives To estimate the cost-effectiveness of ranolazine when added to standard-of-care (SoC) antianginals compared with SoC alone in patients with stable coronary disease experiencing ?3 attacks/week. Setting An economic model utilising a UK health system perspective, a 1-month cycle-length and a 1-year time horizon. Participants Patients with stable coronary disease experiencing ?3 attacks/week starting in 1 of 4 angina frequency health states based on Seattle Angina Questionnaire Angina...

  16. Variabilidad e idoneidad del tratamiento antiasmático en pediatría de atención primaria

    OpenAIRE

    Suárez-Castañón, Cristina; Modroño-Riaño, Gracia; Solís-Sánchez, Gonzalo

    2016-01-01

    Objetivo: Analizar los patrones de consumo y las características de las prescripciones de fármacos antiasmáticos en pediatría de atención primaria. Diseño: Estudio observacional retrospectivo. Emplazamiento: Pediatría de atención primaria, Asturias, España. Participantes: Prescripciones para aparato respiratorio en

  17. 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.

  18. Constellation of arterial hypertension and stable angina pectoris, influence of adipokines and inflammation, the place of amlodipine

    OpenAIRE

    Tashchuk, V.K.

    2018-01-01

    The dynamics of C-reactive protein and leptin indices in patients with arterial hypertension and stable angina pectoris were studied in thus article in comparison with the effects of calcium antagonists.

  19. Epidemiologic study of use of resources in patients with unstable angina: the EARISA registry. On behalf on the EARISA Investigators (Epidemiologia dell'Assorbimento di Risorse nell'Ischemia, Scompenso e Angina).

    Science.gov (United States)

    Maggioni, A P; Schweiger, C; Tavazzi, L; Langiano, T; Lucci, D; Ramponi, C; Repetto, F; De Vita, C

    2000-08-01

    The EARISA Registry was designed to describe diagnostic and therapeutic resources used in Italian cardiology centers for patients with the epidemiologically most relevant cardiac diseases. This article focuses on patients with unstable angina; characteristics associated with invasive procedures were specifically analyzed. Information was collected over a 2-week period on 1420 patients with unstable angina discharged from 308 cardiology centers. The mean length of stay was 9 +/- 6 days; 51% of patients were admitted to a coronary care unit (mean length of stay, 4 +/- 3 days). Noninvasive procedures included echocardiography (64%), Holter monitoring (25%), exercise stress testing (24%), and echocardiographic stress testing or nuclear imaging (7%). Invasive procedures were coronary angiography (39%) and percutaneous transluminal coronary angioplasty or coronary artery bypass grafting (13%). Unstable angina had a greater impact on invasive procedures than acute myocardial infarction. Variables independently associated with a higher rate of coronary angiographic procedures were younger age, higher technologic level of the hospital, and need for intravenous therapy. In Italy, approximately half the patients with unstable angina are admitted to hospitals without catheterization laboratories or cardiac surgery facilities. This fact supports the concept that treatments that can be administered in all types of hospitals are more likely to affect the outcome of patients with unstable angina. Overall, the rates of coronary angiography and revascularization procedures appeared low, and the setting where cardiologists practice, rather than patient characteristics, is the major determinant of the care given to patients with unstable angina.

  20. PRESENTACIÓN DE UN CASO CON SÍNDROME X O ANGINA MICROVASCULAR / Report of a case with cardiac syndrome X or microvascular angina

    Directory of Open Access Journals (Sweden)

    Dayan A. García Cuesta

    2013-04-01

    Full Text Available Resumen: El término síndrome X o angina microvascular se emplea habitualmente para definir a un grupo de pacientes que presentan dolor torácico característico, depresión del segmento ST durante el esfuerzo y arterias coronarias angiográficamente normales. Muchos datos apuntan a un posible origen isquémico de los síntomas. Es más frecuente en mujeres y en casi el 50 % de ellas, el dolor anginoso se atribuye específicamente a cambios en la microvasculatura coronaria. Debido a que el pronóstico no es tan benigno como se creía hace años, en pacientes con angina y coronarias epicárdicas normales, se impone una evaluación clínica (incluyendo un cuidadoso análisis de los factores de riesgo e imagenológica, con el propósito de detectar isquemia funcionalmente significativa. La enfermedad coronaria microvascular es, por tanto, una enfermedad que requiere atención por parte del médico de asistencia. En este artículo se presenta una paciente con este diagnóstico, y se muestran las imágenes electrocardiográficas, ecocardiográfica, ergométricas y angiográficas. / Abstract: The term cardiac syndrome X or microvascular angina is commonly used to describe a group of patients who show a typical chest pain, ST segment depression during exercise and angiographically normal coronary arteries. Many data suggest the symptoms may have an ischemic origin. It is more common in women, and, in almost 50% of them, anginal pain is specifically attributed to changes in the coronary microvasculature. The prognosis is not as benign as it was believed for years; therefore, in patients with angina and a normal epicardial coronary, a clinical and imaging assessment is necessary (including a careful analysis of risk factors in order to detect a functionally significant ischemia. Therefore, coronary microvascular disease is a condition that requires attention by the attending physician. A patient with this diagnosis is reported in this article, and

  1. ESTUDIO DEL BULLYING EN EL CICLO SUPERIOR DE PRIMARIA

    Directory of Open Access Journals (Sweden)

    Rosario Ruiz Arroyo

    2015-01-01

    Full Text Available Nuestra investigación trata el fenómeno del bullying en el ciclo superior de primaria. Para llevarla a cabo, hemos elaborado un cuestionario ad hoc a partir de una revisión bibliográfica de diferentes investigaciones en las que se han utilizado varios instrumentos, pruebas, cuestionarios... Este instrumento nos ha servido para analizar diferentes temas: la percepción que tienen los niños de ciclo superior sobre el bullying, en qué escenarios del centro escolar se producen más estos comportamientos, los diferentes tipos de bullying (físico, verbal y exclusión social y cuáles se producen más a menudo y analizar las respuestas que nos dan los alumnos en función del género y del curso (5.º y 6.º. Los resultados que hemos obtenido muestran, entre otras cosas: que en los niños se da más el bullying físico, mientras que en las niñas predomina el de tipo verbal y exclusión social; que la única diferencia según el curso es que en 6.º curso se da más exclusión social que en 5.º curso; y que donde se producen más conductas de bullying es en el patio, seguido del aula cuando no se encuentra el docente. Finalmente, partiendo de los resultados obtenidos, hemos elaborado unas propuestas de actuación psicopedagógicas para mejorar la convivencia en la escuela y otros espacios educativos.

  2. Balanceo de circuitos de distribución primaria

    Directory of Open Access Journals (Sweden)

    Raúl Carvajal Pérez

    2011-03-01

    Full Text Available Se presentan los resultados de aplicar un método de balance de los circuitos de distribución primaria. El balancese realiza desde el último usuario a la subestación pasando transformadores conectados a la fase más cargadahacia la menos cargada, eligiendo el conjunto que más contribuya con el balance ideal. Primero se pasanramales monofásicos completos y después se estudian los ramales de tres conductores haciendo permutacionesde fase o cambiando el ramal completo desde el tronco de acuerdo con el aporte que hagan en el proceso debalance. Finalmente, si es necesario ,se cambian de fase las cargas monofásicas de los ramales trifásicossiguiendo en todos los casos una evaluación de los cambios que más se aproximen al balance ideal. Sepresenta un ejemplo de un circuito "desbalanceado" utilizando un programa de computación elaborado por elautor para estudio de redes que realiza esta función.  In this report is presented a method to obtain the balance of primary circuits. The balance begin at the last branchof the circuit and conclude in the substation, always the changes will be realized from the more charged phase tothe minus charged phase and the selected branches are those that maximize the balance. First will be evaluatedone-phase branches, later branches with tree conductors and at the end the branches with four conductors. Ispresented a solved example using the computer program elaborated to develop studies of distribution circuits, ithas an option to realize circuits balance.

  3. Persistence of recruitable coronary collaterals in the absence of coronary vasospasm in a patient with variant angina

    International Nuclear Information System (INIS)

    Yamashita, Kazuhito; Takeuchi, Masaaki; Nakashima, Yasuhide

    1998-01-01

    Recruitable coronary collaterals may appear when spasm suddenly occludes the coronary artery. We report a patient with variant angina who had visible collateral vessels on a control coronary angiogram, despite the presence of normally appearing coronary arteries. These collaterals disappeared after intracoronary administration of nitroglycerin. These findings suggest that recruitable collateral vessels can remain patent long after spontaneous attacks of angina have resolved, and become visible when there is a pressure difference between two small coronary arteries.

  4. Positive and negative psychological correlates, gender specific and traditional factors for first onset angina in a sample of pakistani women

    International Nuclear Information System (INIS)

    Rafiq, R.; Anjum, A.

    2015-01-01

    Coronary Heart Disease (CHD) occurs to a greater extent in developed than developing countries like Pakistan. Our understanding of risk factors leading to this disease in women, are largely derived from studies carried out on samples obtained from developed countries. Since prevalence of CHD in Pakistan is growing, it seems pertinent to infer risk and protective factors prevalent within the Pakistani women. This case control study investigated the role of psychological, traditional and gender specific risk and protective factors for Angina in a sample of Pakistani women aged between 35-65 years. Methods: Female patients admitted with first episode of Angina fulfilling the study inclusion/exclusion criteria were recruited within the first three days of stay in the hospital. One control per case matched on age was recruited. Translated versions of standardized tools: Life Orientation Test (LOT), The Hope Scale, Subjective Happiness Scale and Depression, Anxiety and Stress Scale (DASS) were used to measure the psychological variables. Information on medical conditions like diabetes, hypertension, family history of IHD, presence and absence of menopause and use of oral contraceptive pills was obtained from the participants. Body Mass Index for cases and controls was calculated separately with the help of height and weight recorded for the participants. Results: Multivariate logistic regression analyses revealed that depression, anxiety and stress are risk factors, were as optimism and hope are protective predictors of Angina. 64% and 85 % of variance in Angina were attributed to psychological factors. Menopause, diabetes and hypertension are significantly associated with the risk of Angina, explaining 37% and 49 % of variance in Angina. The study provides evidence for implementation of gender specific risk assessment and preventive strategies for Angina. The study gives directions for large scale prospective, epidemiological, longitudinal as well as interventional

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

    OpenAIRE

    Wojciech Szot; Joanna Zając; Magdalena Kostkiewicz; Jakub Owoc; Iwona Bojar

    2015-01-01

    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 intr...

  6. Prognostic significance of myocardial imaging with iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid in patients with angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Hatano, Tsuguhisa; Chikamori, Taishiro; Kamada, Tatsuya; Morishima, Takayuki; Hida, Satoshi; Yanagisawa, Hidefumi; Iino, Hitoshi; Yamashina, Akira [Tokyo Medical Coll. (Japan)

    2001-09-01

    To assess the clinical significance of iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT), the predictive value of BMIPP imaging in patients with angina pectoris was evaluated. One hundred seventy-four patients who underwent BMIPP imaging in our institution were aged 61.8{+-}11 years. One hundred thirty-five patients had stable angina and 39 had unstable angina at the time of examination. Patients with previous myocardial infarction or myocardial disorders were excluded. Early and delayed images were acquired in BMIPP SPECT, and the images were analyzed visually. Cardiac events were classified into hard and soft events: the former consisted of cardiac death and nonfatal myocardial infarction, and the latter included coronary revascularization and heart failure. The findings of BMIPP imaging were normal in 82 patients and abnormal in 92. During follow-up of 15.5{+-}9.5 months, hard events were observed in 4 patients and soft events in 53. In patients with normal BMIPP imaging, soft events were observed in nine patients, but no hard event was encountered. Furthermore, in patients with both normal BMIPP and stress thallium imagings, no cardiac event was observed during 2 years. In contrast, 4 hard events and 44 soft events occurred in patients with abnormal BMIPP imaging. Patients with abnormal BMIPP imaging had a higher incidence of soft events than those with normal BMIPP imaging, regardless of the type of angina (16/62 vs 3/73, p<0.0005 for stable angina; 28/30 vs 6/9, p<0.0001 for unstable angina). The finding of BMIPP imaging correlates well with the mid-term prognosis of patients with angina pectoris. Since BMIPP SPECT is performed without stress to the patient, this imaging modality is important in evaluating patients with stable or unstable angina. (author)

  7. Persistence of Recruitable Coronary Collaterals in the Absence of Coronary Vasospasm in a Patient with Variant Angina

    International Nuclear Information System (INIS)

    Yamashita, Kazuhito; Takeuchi, Masaaki; Nakashima, Yasuhide

    1998-01-01

    Recruitable coronary collaterals may appear when spasm suddenly occludes the coronary artery. We report a patient with variant angina who had visible collateral vessels on a control coronary angiogram, despite the presence of normally appearing coronary arteries. These collaterals disappeared after intracoronary administration of nitroglycerin. These findings suggest that recruitable collateral vessels can remain patent long after spontaneous attacks of angina have resolved, and become visible when there is a pressure difference between two small coronary arteries

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

    International Nuclear Information System (INIS)

    Johansen, Allan; Hoeilund-Carlsen, Poul Flemming; Moeldrup, Mette; Christensen, Henrik Wulff; Vach, Werner; Haghfelt, Torben

    2005-01-01

    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.)

  9. 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.)

  10. Tiempo y espacio en atención primaria de salud

    OpenAIRE

    Uribe Oyarbide, José María

    1994-01-01

    En este artículo se esbozan las líneas de repercusión que la reforma sanitaria provoca en la percepción y significación de las categorías tiempo y espacio. La Atención Primaria de Salud obliga a un aprendizaje tanto para trabajadores sanitarios como para usuarios de los criterios que definen y contextualizan la prestación de los servicios de salud. En ese contexto, los equipos de Atención Primaria introducen variaciones en su interrelación con instituciones como los hospitales y los ambulator...

  11. Programa Literatura Infantil Local para la carrera Licenciatura en Educación Primaria

    Directory of Open Access Journals (Sweden)

    Inalvis Basnueva-Cantillo

    2017-09-01

    Full Text Available En los planes de estudio vigentes para la carrera Licenciatura en Educación Primaria se ha concedido muy poco espacio para el desarrollo en los estudiantes del interés hacia la creación literaria del lugar donde vive, lo cual obstaculiza el rescate y promoción de los valores territoriales. En el trabajo se propone y fundamenta un programa de Literatura Infantil Local para la formación inicial de los estudiantes de la carrera Licenciatura en Educación Primaria, como resultado de la tesis de maestría de la autora principal.

  12. La escuela primaria, un lugar privilegiado para la evaluación kinesiológica.

    OpenAIRE

    Retondo, Marianela

    2010-01-01

    El presente trabajo se emprendió con el propósito de conocer la incidencia de las alteraciones posturales en los niños de 4º a 6º grado de la escuela primaria, el conocimiento de los padres sobre las mismas, y corroborar si los niños que presentaban alteraciones realizaban rehabilitación kinesiológica. La población de estudio estuvo compuesta por los niños de 4º a 6º grado que concurren a la escuela primaria Nº 22 de El Maitén provincia de Chubut. Allí se ...

  13. Tiempo y espacio en atención primaria de salud

    Directory of Open Access Journals (Sweden)

    JOSÉ Mª URIBE OYARBIDE

    1994-01-01

    Full Text Available En este artículo se esbozan las líneas de repercusión que la reforma sanitaria provoca en la percepción y significación de las categorías tiempo y espacio. La atención primaria de salud obliga a un aprendizaje tanto para los trabajadores sanitarios como para los usuarios de los criterios que definen y contextualizan la prestación de los servicios de salud. En este contexto, los equipos de atención primaria introducen variaciones en su interrelación con instituciones como los hospitales y los ambulatorios,

  14. El conocimiento del ciclo del agua en el segundo ciclo de Educación Primaria

    OpenAIRE

    María Guerrero Valle

    2017-01-01

    El agua tiene una gran importancia e influencia en nuestras vidas y en nuestro planeta. En este trabajo se presenta una investigación sobre el conocimiento sobre el ciclo del agua en el segundo ciclo de la Educación Primaria. Para el estudio, se ha realizado en dos centros de Primaria un cuestionario sobre lluvia que recoge los conceptos claves para una comprensión básica del mecanismo de la lluvia como del ciclo del agua, junto con un dibujo sobre la lluvia. La investigación pone de manifies...

  15. DIFERENCIAS CULTURALES EN DEBERES Y DERECHOS ENTRE LOS DOCENTES DE INFANTIL-PRIMARIA Y SECUNDARIA

    Directory of Open Access Journals (Sweden)

    Faustino Larrosa Martínez

    2012-01-01

    Full Text Available El trabajo analiza las diferencias culturales entre el profesorado de Infantil-Primaria y Secundaria a la luz de sus deberes y derechos. Han participado 394 docentes de toda España de educación Infantil, Primaria y Secundaria, elegidos al azar, contestando a un cuestionario enviado por correo postal a los centros seleccionados aleatoriamente. Se utiliza como instrumento el cuestionario "Deberes y derechos del profesorado en la comunidad educativa" y se confirma la hipótesis: existen diferencias culturales docentes significativas que nos permiten establecer distintas subculturas.

  16. Síndrome de Burnout y estrategias de afrontamiento en docentes de primaria y bachillerato

    OpenAIRE

    Carlos Andrés Gantiva Díaz; Steffany Jaimes Tabares; María Clara Villa Orozco

    2010-01-01

    El objetivo de esta investigación fue identificar la relación entre las estrategias de afrontamiento y el síndrome de burnout en docentes de primaria y bachillerato de un colegio distrital de la ciudad de Bogotá (Colombia). Para esto se utilizó un diseño descriptivo correlacional y se trabajó con una muestra de 47 docentes de primaria y bachillerato. Se utilizó el Inventario de Burnout de Maslash y la Escala de Estrategias de Coping Modificada. Los resultados indican niveles medios del síndro...

  17. Inteligencia emocional y responsabilidad social en Educación Primaria

    OpenAIRE

    Sancho Arranz, Verónica

    2014-01-01

    Inteligencia Emocional y Responsabilidad Social en Educación Primaria es un Trabajo de Fin de Máster teórico-experimental. Consiste en estudiar qué grado de relación e influencia tiene la Responsabilidad Social entre el alumnado del tercer ciclo de Educación Primaria para la mejora de la Inteligencia Emocional-Social, con el propósito de promover intervenciones didácticas en esa línea. Para la obtención de datos se aplicaron dos cuestionarios (EARSA-P y EQ-i YV) en alumnado de 5º y 6º curso d...

  18. Randomized double-blind comparison of metoprolol, nifedipine, and their combination in chronic stable angina

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    In a randomized double-blind study, treatment with either metoprolol, nifedipine, or their combination was compared for effects on ischemic variables and heart rate obtained during ambulatory monitoring in 42 patients with chronic stable angina. All patients had severe chronic stable angina...... of at least 6 months' duration despite medical treatment, and exhibited coronary artery stenosis of 75% in one or more coronary arteries. Metoprolol reduced the frequency of total (p less than 0.01) and asymptomatic ischemic episodes (p less than 0.05), the duration of ischemia (p less than 0.......05), and the ischemic burden (p less than 0.05), which contrasted to the lack of any similar significant effect during nifedipine monotherapy. During combination therapy, there was a tendency to further improvement, which did not reach statistical significance compared with metoprolol monotherapy. Heart rate...

  19. Percutaneous Device to Narrow the Coronary Sinus: Shifting Paradigm in the Treatment of Refractory Angina?

    Directory of Open Access Journals (Sweden)

    Daniela Benedetto

    2016-10-01

    Full Text Available Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and / or revascularization (percutaneous or surgical. In addition the presence of myocardial ischemia as a cause of the symptoms must have been documented. The coronary sinus Reducer (CSR is a recently introduced percutaneous device to treat patients with severe anginal symptoms refractory to optimal medical therapy and not amenable to conventional revascularization. The purpose of this review is to describe the current evidence from available studies measuring the clinical effect of the CSR implantation on the health and well-being of patients with refractory angina.

  20. 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

    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......, 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...... identified, 530 contacted, and 299 (56%) agreed to participate. Among the first 50 patients, Doppler CFR was successfully measured in 49 (98%). CONCLUSIONS: Among women with suspected ischemic heart disease and no obstructive coronary artery disease, non-invasive Doppler CFR is feasible as a routine...

  1. Coronary artery bypass grafting in a patient with unstable angina pectoris and bronchiectasis.

    Science.gov (United States)

    Oda, Takeshi; Yasunaga, Hiroshi; Matsuura, Yasuo; Watanabe, Genki; Zaima, Yasuyuki; Takaseya, Tohru; Wada, Yoshihiro

    2014-01-01

    Bronchiectasis is characterized by the abnormal and permanent dilatation of bronchi. Clinical manifestations of bronchiectasis include persistent or recurrent cough, purulent sputum, hemosputum, and hemoptysis. A 75-year-old man with bronchiectasis required coronary bypass grafting for unstable angina pectoris with severe stenosis of the left main trunk. Computed tomography showed fistulae between the dilated bronchial arteries and the left pulmonary artery. Cardiac catheter examination showed significant left-right shunt and left ventricular dilatation. To avoid perioperative massive hemoptysis, embolizations of 2 bronchial arteries and an inferior phrenic artery were performed preceding the coronary artery bypass grafting. Both transcatheter embolization and coronary artery bypass grafting were successfully performed without any complications. Herein, we illustrate a very rare case of bronchiectasis in a patient with unstable angina pectoris who underwent transcatheter embolization for a systemic-pulmonary shunt preceding coronary artery bypass grafting with cardiopulmonary bypass.

  2. Effects of ambient temperature, humidity, and other meteorological variables on hospital admissions for angina pectoris.

    Science.gov (United States)

    Abrignani, Maurizio G; Corrao, Salvatore; Biondo, Giovan B; Lombardo, Renzo M; Di Girolamo, Paola; Braschi, Annabella; Di Girolamo, Alberto; Novo, Salvatore

    2012-06-01

    Seasonal peaks in cardiovascular disease incidence have been widely reported, suggesting weather has a role. The aim of our study was to determine the influence of climatic variables on angina pectoris hospital admissions. We correlated the daily number of angina cases admitted to a western Sicilian hospital over a period of 12 years and local weather conditions (temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure) on a day-to-day basis. A total of 2459 consecutive patients were admitted over the period 1987-1998 (1562 men, 867 women; M/F - 1:8). A seasonal variation was found with a noticeable winter peak. The results of Multivariate Poisson analysis showed a significant association between the daily number of angina hospital admission, temperature, and humidity. Significant incidence relative ratios (95% confidence intervals/measure unit) were, in males, 0.988 (0.980-0.996) (p = 0.004) for minimal temperature, 0.990 (0.984-0.996) (p = 0.001) for maximal humidity, and 1.002 (1.000-1.004) (p = 0.045) for minimal humidity. The corresponding values in females were 0.973 (0.951-0.995) (p < 0.017) for maximal temperature and 1.024 (1.001-1.048) (p = 0.037) for minimal temperature. Environmental temperature and humidity may play an important role in the pathogenesis of angina, although it seems different according to the gender. These data may help to understand the mechanisms that trigger ischemic events and to better organize hospital assistance throughout the year.

  3. SOLAR ACTIVITY AND PECULIARITIES OF THE RHEOLOGICAL PROPERTIES OF THE BLOOD IN PATIENTS WITH ANGINA PECTORIS

    Directory of Open Access Journals (Sweden)

    T.N. Afanasjeva

    2008-03-01

    Full Text Available The peculiarities of the rheological properties of the blood are studied in patients with non-stable angina pectohs in different perbds of solar activity. It has been established, that in high solar activity hemorheological disorders are characterized by increase of blood viscosity and compensatory decrease oferythrocyte aggregation and increase of their deformation. In low solar activity less perceptible hyperviscositywas accompanied by significant increase oferythrocyte aggregation and decrease of their deformity capacity.

  4. The Neuromatrix Theory of Pain and Angina during Exercise Stress Testing: Results from the PIMI Study

    Science.gov (United States)

    2011-05-27

    L. J. (2008). Pain management in fibromyalgia . Current Opinion in Rheumatology, 20(3), 246-250. Croft, P., Lewis, M., & Hannaford, P. (2003). Is...Angina Questionnaire in South Asian and European origin populations: a comparative study in Newcastle, UK. International Journal of Epidemiology , 30(5...J., Walters, E. E., & Wang, P.S. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS

  5. A 10-year prognostic model for patients with suspected angina attending a chest pain clinic.

    Science.gov (United States)

    Sekhri, Neha; Perel, Pablo; Clayton, Tim; Feder, Gene S; Hemingway, Harry; Timmis, Adam

    2016-06-01

    Diagnostic models used in the management of suspected angina provide no explicit information about prognosis. We present a new prognostic model of 10-year coronary mortality in patients presenting for the first time with suspected angina to complement the Diamond-Forrester diagnostic model of disease probability. A multicentre cohort of 8762 patients with suspected angina was followed up for a median of 10 years during which 233 coronary deaths were observed. Developmental (n=4412) and validation (n=4350) prognostic models based on clinical data available at first presentation showed good performance with close agreement and the final model utilised all 8762 patients to maximise power. The prognostic model showed strong associations with coronary mortality for age, sex, chest pain typicality, smoking status, diabetes, pulse rate, and ECG findings. Model discrimination was good (C statistic 0.83), patients in the highest risk quarter accounting for 173 coronary deaths (10-year risk of death: 8.7%) compared with a total of 60 deaths in the three lower risk quarters. When the model was simplified to incorporate only Diamond-Forrester factors (age, sex and character of symptoms) it underestimated coronary mortality risk, particularly in patients with reversible risk factors. For the first time in patients with suspected angina, a prognostic model is presented based on simple clinical factors available at the initial cardiological assessment. The model discriminated powerfully between patients at high risk and lower risk of coronary death during 10-year follow-up. Clinical utility was reflected in the prognostic value it added to the updated Diamond-Forrester diagnostic model of disease probability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. 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

  7. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

    OpenAIRE

    Wen-Ying Jin; Xiu-Juan Zhao; Hong Chen

    2016-01-01

    Background: Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD). Women, more frequently than men, are known to develop atypical angina symptoms. The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men. Methods: We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or pr...

  8. Anaesthetic management of case of Ludwig’s angina: Forewarned is forearmed

    OpenAIRE

    Shaikh, Safiya Imtiaz; B M, Sarala; Bhosale, Raghavendra

    2014-01-01

    Ludwig's angina and deep neck infections are potentially lethal entities because of their tendency to cause oedema, distortion, and obstruction of the airway and may arise as a consequence of airway management mishaps. In the early stages of the disease, patients may be managed with observation and intravenous antibiotics. Advanced infections, however, require the airway to be secured in addition to immediate surgical drainage. This is complicated by pain, trismus, airway oedema, and tongue d...

  9. Ludwig's angina in children anesthesiologist's nightmare: Case series and review of literature

    OpenAIRE

    Maitree Pandey; Manpreet Kaur; Manoj Sanwal; Aruna Jain; Sunil K Sinha

    2017-01-01

    Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered durin...

  10. COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

    Directory of Open Access Journals (Sweden)

    A. A. Anderzhanova

    2016-01-01

    Full Text Available Aim. To compare antihypertensive, antianginal and antiischemic efficacy of β1-selective adrenoblockers (betaxolol and metoprolol tartrate in patients with arterial hypertension (HT of 1-2 degree associated with stable angina class II.Material and methods. 100 patients (aged 23-66 y.o. with HT associated with stable angina or without angina were involved in the study. Patients were randomized into 2 groups (G1 and G2. G1 patients were treated with betaxolol, and G2 patients – with metoprolol tartrate. Ambulatory BP and electrocardiogram monitoring, exercise stress-test, echocardiography, evaluating of respiratory function, blood analysis was performed initially and in 30 and 90 days of treatment.Results. Target BP level was reached in 44 (88% patients treated with betaxolol (average daily dose 10±4 mg. 34 patients of G1 took 10 mg daily. Target BP level was reached in 41 (82% patients treated with metoprolol tartrate (average daily dose 150±27 mg. 30 patients of G2 took 150 mg daily. Exercise tolerance increased and a number of ischemic ST segment depressions reduced significantly in both groups. There were no significant differences in antihypertensive, antianginal, and antiischemic efficacy between groups.Conclusion. Betaxolol advantage is an ability to maintain target BP level more than 24 hours. A possibility to take betaxolol once a day raises patient’s compliance with therapy.

  11. ENDOTHELIAL DYSFUNCTION IN STABLE ANGINA AND MYOCARDIAL INFARCTION COMBINED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    M. A. Popova

    2015-01-01

    Full Text Available The research objective is to determine the state of endothelium-dependent and endothelium-independent vasodilatation in patients with coronary heart disease (CHD associated with chronic obstructive pulmonary disease (COPD.Material and methods. In the cross-sectional study included 122 patients with CHD associated with COPD: 68 people of them are patients with stable angina without acute coronary events in history and 54 patients with acute ST segment elevation myocardial infarction (STEMI. Comparison group comprised 53 patients with stable angina and 51 patients after STEMI without concomitant COPD. Patients were included if they met the following inclusion criteria: male, age <60 years, verified forms of CHD (stable angina, STEMI, documented with COPD without exacerbation and forced expiratory volume in 1 second > 30% in the groups with CHD and COPD. Arterial endothelial function was tested with high-resolution ultrasonography: brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation, and after administration of sublingual nitroglycerin (an endothelium-independent dilator.Results. We found that endothelial dysfunction in patients with acute and chronic forms of CHD in combination with COPD are more pronounced than in isolated CHD.Conclusion. Expressed depression functional vascular reserve in patients with CHD associated with COPD, should be taken into account when conducting individualized therapy of these patients.

  12. Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis

    International Nuclear Information System (INIS)

    Nakazato, Masayasu; Maruoka, Yuji; Sunagawa, Osahiko; Kinjo, Kunihiko; Tomori, Masayuki; Fukiyama, Koshiro

    1990-01-01

    We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or infero-posterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aV F on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients. (author)

  13. Puerarin injection for treatment of unstable angina pectoris: a meta-analysis and systematic review.

    Science.gov (United States)

    Gao, Zhisheng; Wei, Baozhu; Qian, Cheng

    2015-01-01

    Puerarin is an effective ingredient isolated from Radix Puerariae, a leguminous plant. In China, a large number of early studies suggest that puerarin may be used in the treatment of coronary heart disease. In recent years, puerarin injection has been widely used to treat coronary heart disease and angina pectoris. To systematically evaluate the clinical efficacy and safety of puerarin injection in the treatment of unstable angina pectoris (UAP). Data were retrieved from digital databases, including PubMed, Excerpt Medica Database (EMBASE), China Biology Medicine (CBM), the Cochrane Library, and Chinese databases. Compared with patients who were treated with conventional Western medicines alone, the patients who were treated with conventional Western medicines in combination with puerarin injection exhibited significant improvements in the incidence of angina pectoris, electrocardiogram findings, nitroglycerin consumption and plasma endothelin levels. Strong evidence suggests that, the use of puerarin in combination with conventional Western medicines is a better treatment option for treating UAP, compared with the use of conventional Western medicines alone.

  14. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Song, Haiying; Wang, Peili; Liu, Jiangang; Wang, Chenglong

    2017-08-01

    This paper assessed the evidence of Panax notoginseng preparations in patients suffering from UAP using meta-analysis and systematic review methods. Methods were according to the Cochrane Handbook and analysed using Revman 5.3. A search of PubMed, Cochrane Library, Embase, MEDLINE, Chinese national knowledge infrastructure (CNKI), Vip information database, Wanfang data and Chinese Biomedical Literature Database (SinoMed) was conducted to identify randomized controlled trials (RCTs) of P. notoginseng preparations on UAP regardless of blinding, sex and language. The outcomes include all-cause mortality, cardiac mortality, cardiovascular events, UAP symptoms, improvement of electrocardiogram and adverse events. Eighteen RCTs including 1828 patients were identified. The level of reporting is generally poor. Among 18 studies, 16 studies were prescribed P. notoginseng injections, and two studies were oral P. notoginseng preparations. Reduction of cardiovascular events (RR:0.35;95% CI:0.13 to 0.94), alleviation of angina pectoris symptoms (RR:1.23;95% CI 1.18 to 1.29), improvement of ECG (RR:1.22;95% CI 1.15 to 1.28) and reduced frequency of angina pectoris (MD:-1.48; 95% CI -2.49 to -0.48) were observed. Cardiac mortality and duration of angina pectoris were not statistically significant. Panax notoginseng is beneficial to UAP patients; the results of these reviews may have important implications to clinical work. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  15. [Concentration of plasma vascular endothelial growth factor and related factors in patients with unstable angina pectoris].

    Science.gov (United States)

    He, Wenfang; Wang, Zhe; Cai, Jun; Chi, Hongjie; Yang, Xinchun

    2015-12-01

    To observe plasma vascular endothelial growth factor(VEGF) levels and related factors in patients with unstable angina pectoris(UAP). A total of 108 consecutive patients with chest pain hospitalized in our department from October to December 2014 were included. They were divided into UAP (n=78) and non-CHD group (n=30) by the result of coronary angiography(CAG). Coronary artery lesion was assessed according to the Gensini score, serum lipids, homocysteine(Hcy) levels and other biochemical indicators were also determined. The peripheral arterial tonometry was evaluated by reactive hyperemia index(RHI) measured by Endo-PAT2000 Noninvasive Diagnostic System.The level of plasma VEGF was detected in patients with unstable angina pectoris. Multiple linear regression analysis was used to analyze the correlations between VEGF and various related factors. Percent of male gender, triglyceride (TG) and Hcy levels were significantly higher in UAP group than in no-CHD group(all Punstable angina pectoris, and VEGF level is significantly associated with the degree of coronary artery stenosis, Gensini score and RHI. V EGF level might serve as a new biochemical indicator for coronary artery lesion in patients with UAP.

  16. Logistic regression analysis of syndrome essential factors in patients with unstable angina pectoris.

    Science.gov (United States)

    Yao, Kui-Wu; He, Qing-Yong; Teng, Fei; Wang, Jie

    2011-12-01

    To explore the correlation between common syndrome essential factors and the symptoms and signs of unstable angina (UA). Eight hundred and fifteen patients with UA confirmed by coronary angiography were identified from several centers. Common syndrome essential factors were selected on the basis of expert experience. The correlations between common syndrome essential factors and symptoms and signs of UA were analyzed using binary logistic regression analysis. The common syndrome essential factors in unstable angina were blood stasis, qi stagnation, phlegm turbidity, heat stagnancy, qi deficiency, yin deficiency, and yang deficiency. Symptoms such as chest pain, hypochondriac distention, ecchymosis, dark orbits, dark and purplish tongue, and tongue with ecchymosis and petechiae were significant diagnostic features of "blood stasis". Aversion to cold and cool limbs, weakness in the waist and knees, and clear abundant urine were significant diagnostic features of"yang deficiency". These results were in accordance with the understanding of traditional clinical Chinese medical practice. This clinical study analyzed the correlations between common syndrome essential factors and the symptoms and signs of unstable angina. The results provide the basis for establishing diagnostic criteria for syndrome essential factors.

  17. Left atrial area index predicts adverse cardiovascular events in patients with unstable angina pectoris.

    Science.gov (United States)

    Li, Yi-Fan; Li, Wei-Hong; Li, Zhao-Ping; Feng, Xin-Heng; Xu, Wei-Xian; Chen, Shao-Min; Gao, Wei

    2016-08-01

    The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in patients with unstable angina pectoris (UAP). This study was aimed to assess the association between LAAI and outcomes in UAP patients. We enrolled a total of 391 in-hospital patients diagnosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of adverse cardiovascular (CV) events, including hospital readmission for angina pectoris, acute myocardial infarction (AMI), congestive heart failure (CHF), stroke and all-cause mortality. During a mean follow-up time of 26.3 ± 8.6 months, 98 adverse CV events occurred (84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality). In a multivariate Cox model, LAAI [OR: 1.140, 95% CI: 1.016-1.279, P = 0.026], diastolic blood pressure (OR: 0.976, 95% CI: 0.956-0.996, P = 0.020) and pulse pressure (OR: 1.020, 95% CI: 1.007-1.034, P = 0.004) were independent predictors for adverse CV events in UAP patients. LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.

  18. [Meta-analysis of Dengzhanxixin injection treatment for unstable angina pectoris].

    Science.gov (United States)

    Nie, Xiao-Lu; Shen, Hao; Xie, Yan-Ming; Hu, Jing; Zhang, Yue-Lun; Li, Yuan-Yuan

    2012-09-01

    To assess the efficacy and safety of Dengzhanxixin injection for unstable angina pectoris. All clinical studies of Dengzhanxixin injection for unstable angina pectoris (UAP) were searched from Cochrane library, Medline, EM-base, CBM, CNKI, Wanfang and VIP. Quality assessment and information extraction were done by two independent screening . The quality of the included documents was evaluated by the Cochrane Collaboration's tool for assessing risk of bias and allocation concealment. Revman 5.1.4 software was used for data analysis. A total of 17 randomized controlled trials were included (1 644 patients), in which, only 2 studies were true RCT, 1 study used single blind method, while other studies did not mention allocation concealment, blind and loss-up information. Meta-analysis showed that the Dengzhanxixin injection group was better than the conventional treatment group in efficiency (OR = 3.54, 95% CI [2.60-4.82]) and ECG (OR = 2.36, 95% CI[1.88-2.96]). Researches with ADR/AE information of Dengzhanxixin injection showed that the symptoms of ADR/AE were slight. This study may exist publication bias. Dengzhanxixin injection on the basis of conventional treatment can improve the efficacy of the treatment of unstable angina pectoris. However, due to the sample size of included studies were small and of lower quality, conclusions above still need high-qualitied randomized, double-blind, controlled trials be confirmed.

  19. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms.

    Science.gov (United States)

    Jin, Wen-Ying; Zhao, Xiu-Juan; Chen, Hong

    2016-09-20

    Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD). Women, more frequently than men, are known to develop atypical angina symptoms. The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men. We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or proven CAD who successively underwent both MSCT and invasive CAG. CAD was defined as any coronary stenosis of ≥50% on conventional invasive CAG, which was used as the reference standard. The patients were divided into typical and atypical groups based on their symptoms of angina pectoris. The diagnostic accuracy of MSCT, including its sensitivity, specificity, negative predictive value, and positive predictive value (PPV), was calculated to determine the usefulness of MSCT in assessing stenoses. The diagnostic performance of MSCT was also assessed by constructing receiver operating characteristic (ROC) curves. The PPV (91% vs. 97%, χ2 = 5.705, P accuracy (87% vs. 93%, χ2 = 5.093,Pwomen than in men. Atypical presentation was an independent influencing factor on the diagnostic accuracy of MSCT in women (odds ratio = 4.94, 95% confidence intervals: 1.16-20.92, Walds = 4.69, P women with typical angina pectoris had higher PPV (98% vs. 74%, χ2 = 17.283. P accuracy (93% vs. 72%, χ2 = 9.571, P accuracy.

  20. Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Nakazato, Masayasu; Maruoka, Yuji; Sunagawa, Osahiko; Kinjo, Kunihiko; Tomori, Masayuki; Fukiyama, Koshiro (Ryukyu Univ., Nishihara, Okinawa (Japan). School of Medicine)

    1990-01-01

    We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or infero-posterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aV{sub F} on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients. (author).

  1. Enhanced regional washout of technetium-99m-sestamibi in patients with coronary spastic angina

    International Nuclear Information System (INIS)

    Ono, Souichi; Yamaguchi, Hiroyuki; Abe, Shigeru; Tachibana, Hidetada; Sato, Takayuki; Takeishi, Yasuchika; Kubota, Isao

    2003-01-01

    Reverse redistribution and rapid washout of 99m Tc-sestamibi are observed in patients with acute myocardial infarction and may indicate viable myocardium. However, the clinical significance of this phenomenon has not been rigorously examined in other cardiac diseases. Thus, we investigated whether reverse redistribution and washout of 99m Tc-sestamibi could be used in the diagnosis and follow-up of patients with coronary spastic angina. Thirty patients diagnosed as coronary spastic angina were examined. During coronary arteriography, spasm was induced by provocation test with ergonovine, and only total or subtotal occlusion was considered positive. Myocardial perfusion tomography was obtained 45 min (early) and 3 hr (delayed) after 99m Tc-sestamibi injection. Segmental defect score was visually graded from 0 (normal) to 4 (defect), and a total defect score was determined as the sum of defect scores for all segments. Washout rate of 99m Tc-sestamibi from the myocardium was calculated for each segment. After medical treatment with calcium antagonists and nitrates for 3 months, 99m Tc-sestamibi imaging was repeated. Out of 30 patients, on the early images 17 (57%) patients demonstrated decreased 99m Tc-sestamibi uptake in spastic segments; on the other hand, 24 (80%) patients did decreased 99m Tc-sestamibi uptake in spastic segments on delayed images. Total defect scores in delayed images were higher than those in early images (6.9±0.3 vs. 3.6±0.4, p 99m Tc-sestamibi was observed in 17 out of 30 patients (57%) with coronary spastic angina. Washout rate of 99m Tc-sestamibi from spastic segments was higher than that from non-spastic segments (16±2% vs. 11±5%, p 99m Tc-sestamibi was observed in patients with coronary spastic angina and might indicate that the ability of myocyte to retain the tracer was impaired due to repetitive brief ischemia by coronary spasm. The early and delayed 99m Tc-sestamibi imaging provides useful information for the diagnosis and responses

  2. Caso clínico-radiológico: Amenorrea primaria por himen imperforado

    Directory of Open Access Journals (Sweden)

    Moënne B. Karla, Dra.

    2011-01-01

    Full Text Available Se presenta el caso de una adolescente que consulta por amenorrea primaria causada por un himen imperforado. Se discute el cuadro clínico imaginológico del himen imperforado, las causas de amenorrea con desarrollo adecuado de caracteres sexuales secundarios y la utilidad de las imágenes en el estudio de estas pacientes.

  3. Caso clínico-radiológico: Amenorrea primaria por himen imperforado

    OpenAIRE

    Moënne B. Karla, Dra.; Merino O. Paulina M, Dra.; Hernández C. María Isabel, Dra.

    2011-01-01

    Se presenta el caso de una adolescente que consulta por amenorrea primaria causada por un himen imperforado. Se discute el cuadro clínico imaginológico del himen imperforado, las causas de amenorrea con desarrollo adecuado de caracteres sexuales secundarios y la utilidad de las imágenes en el estudio de estas pacientes.

  4. Las computadoras en la educación primaria: Un estudio piloto

    Directory of Open Access Journals (Sweden)

    Jesús Francisco Galaz Fontes

    1989-01-01

    Full Text Available De un grupo de cuarto año de primaria se seleccionó a diez estudiantes para tomar un pequeño curso de Logo con una maestra, también de primaria, que había sido previamente entrenada en dicho lenguaje de computación. Ambos grupos de sujetos resolvieron un pretest y un postest de aritmética. Los datos muestran que el grupo que recibió el entrenamiento Logo tuvo una mejor ejecución en el postest que el grupo control. Además, las opiniones de los estudiantes, padres de familia y maestra fueron, en general, positivas respecto a la experiencia de aprender a programar Logo, así como en relación al uso de las computadoras en la educación primaria. Se discute si el uso educativo de las computadoras en general. y del lenguaje Logo en particular, puede representar un medio para mejorar el desempeño académico a nivel primaria, sobre todo en zonas urbanas de la frontera norte de México, donde la cultura y las condiciones económicas hacen más viable esta alternativa educativa.

  5. 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

  6. Cost-utility of ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Spain.

    Science.gov (United States)

    Hidalgo-Vega, Alvaro; Ramos-Goñi, Juan Manuel; Villoro, Renata

    2014-12-01

    Ranolazine is an antianginal agent that was approved in the EU in 2008 as an add-on therapy for symptomatic chronic angina pectoris treatment in patients who are inadequately controlled by, or are intolerant to, first-line antianginal therapies. These patients' quality of life is significantly affected by more frequent angina events, which increase the risk of revascularization. To assess the cost-utility of ranolazine versus placebo as an add-on therapy for the symptomatic treatment of patients with chronic angina pectoris in Spain. A decision tree model with 1-year time horizon was designed. Transition probabilities and utility values for different angina frequencies were obtained from the literature. Costs were obtained from Spanish official DRGs for patients with chronic angina pectoris. We calculated the incremental cost-utility ratio of using ranolazine compared with a placebo. Sensitivity analyses, by means of Monte Carlo simulations, were performed. Acceptability curves and expected value of perfect information were calculated. The incremental cost-utility ratio was €8,455 per quality-adjusted life-year (QALY) per patient in Spain. Sensitivity analyses showed that if the decision makers' willingness to pay is €15,000 per QALY, the treatment with ranolazine will be cost effective at a 95 % level of confidence. The incremental cost-utility ratio is particularly sensitive to changes in utility values of those non-hospitalized patients with mild or moderate angina frequency. Ranolazine is a highly efficient add-on therapy for the symptomatic treatment of chronic angina pectoris in patients who are inadequately controlled by, or intolerant to, first-line antianginal therapies in Spain.

  7. Relación entre las Inteligencias Múltiples y la creatividad en niños 4º de Primaria

    OpenAIRE

    Pérez-Vidal, Belén

    2015-01-01

    En el último siglo la educación ha cambiado vertiginosamente. Multitud de leyes se han ido instaurando en un sistema educativo que va cambiando según el gobierno que llega al poder. Ello ha provocado un Sistema Educativo Español inestable que se traduce en un alto porcentaje de fracaso escolar en los alumnos de nuestro país. Dentro de esta inestabilidad y fallos, encontramos el método de enseñanza empleado por algunos docentes. Un método de enseñanza al que no todo el profesorado ha sab...

  8. La informatización de la atención primaria de salud

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Stusser Beltranena

    Full Text Available La informatización de la atención primaria de salud se percibe como un problema que se soluciona creando redes computarizadas entre los consultorios y policlínicos. El artículo brinda una visión panorámica del estado en que se encuentra el arte de la informatización de la atención primaria y la medicina general integral, en el mundo y en Cuba. Para ello, se sintetiza el origen prehistórico de ese nivel de atención y de la especialidad, así como el desarrollo contemporáneo de la informática y sus aplicaciones médicas; se define igualmente la atención primaria y su informática; se resumen los sistemas de información, las aplicaciones informáticas y sus desafíos; y se ofrece una visión práctica de la historia clínica-electrónica: corazón de la informática de atención primaria de salud y medicina general integral. Se concluye que Cuba ha trabajado 20 años informatizando la dispensarización y estadísticas para la gerencia de servicios de este nivel de atención, pero que también podría trabajar con el enfoque centrado en la vida del paciente, que contribuiría a crear una clasificación integradora de la salud con la enfermedad, y a computarizar la información y la toma de decisiones clínicas en el consultorio del médico, y en el futuro hasta en el hogar del paciente, elevando directamente la calidad de la atención primaria de salud.

  9. Study of C-reactive protein and C3 complement as acute phase reactants in unstable angina.

    Science.gov (United States)

    Sharma, Barnali; Gupta, B; Sharma, D K; Talib, V H

    2013-06-01

    Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary artery disease in Indians. Acute phase reactants C-reactive protein and C3 in Indian subjects with unstable angina were evaluated and compared them with suitable controls to test the hypothesis that a relationship exists between acute phase reactants and unstable angina. Forty cases of unstable angina and forty suitable controls were enrolled for the study. Cases of unstable angina had significantly increased level of CRP as compared to control group (p = 0.01098). Statistically significant difference was found between case and control groups in TLC (p = 0.0037) and ESR (p = 0.0368), TLC and ESR being more in case group as compared to control group. C-reactive protein was significantly correlated with TLC, ESR and C3 in case group and TLC and ESR in control group. C3 was significantly correlated with all the other three inflammatory markers. C-reactive protein, TLC and ESR in case group while no correlation was observed with any variable in control group. The present study concludes that a relationship exists between acute phase reactants studied and unstable angina.

  10. 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.

  11. Clinical Characteristics and Outcomes of Patients With Coronary Artery Disease and Angina: Analysis of the Irbesartan in Patients With Heart Failure and Preserved Systolic Function Trial.

    Science.gov (United States)

    Badar, Athar A; Perez-Moreno, Ana Cristina; Hawkins, Nathaniel M; Jhund, Pardeep S; Brunton, Alan P T; Anand, Inder S; McKelvie, Robert S; Komajda, Michel; Zile, Michael R; Carson, Peter E; Gardner, Roy S; Petrie, Mark C; McMurray, John J V

    2015-07-01

    The aim of our study was to investigate the relationship between coronary artery disease (CAD), angina, and clinical outcomes in patients with heart failure and preserved ejection fraction enrolled in the irbesartan in patients with heart failure and preserved systolic function (I-Preserve) trial. The mean follow-up period for the 4128 patients enrolled in I-Preserve was 49.5 months. Patients were divided into 4 mutually exclusive groups according to history of CAD and angina: patients with no history of CAD or angina (n=2008), patients with no history of CAD but a history of angina (n=649), patients with a history of CAD but no angina (n=468), and patients with a history of CAD and angina (n=1003); patients with no known CAD or angina were the reference group. After adjustment for other prognostic variables using Cox proportional-hazard models, patients with CAD but no angina were found to be at higher risk of all-cause mortality (hazard ratio [HR], 1.58 [1.22-2.04]; P<0.01) and sudden death (HR, 2.12 [1.33-3.39]; P<0.01), compared with patients with no CAD or angina. Patients with CAD and angina were also at higher risk of all-cause mortality (HR, 1.29 [1.05-1.59]; P=0.02) and sudden death (HR, 1.83 [1.24-2.69]; P<0.01) compared with the same reference group and had the highest risk of unstable angina or myocardial infarction (HR, 5.84 [3.43-9.95]; P<0.01). Patients with heart failure and preserved ejection fraction and CAD are at higher risk of all-cause mortality and sudden death when compared with those without CAD. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00095238. © 2015 American Heart Association, Inc.

  12. 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.

  13. Mid term results after bone marrow laser revascularization for treating refractory angina

    Directory of Open Access Journals (Sweden)

    Caballero Paloma

    2010-09-01

    Full Text Available Abstract Background To evaluate the midterm results of patients with angina and diffuse coronary artery disease treated with transmyocardial revascularization in combination with autologous stem cell therapy. Methods Nineteen patients with diffuse coronary artery disease and medically refractory class III/IV angina were evaluated between June 2007 and December 2009 for sole therapy TMR combined with intramyocardial injection of concentrated stem cells. At the time of surgery, autologous bone marrow (120cc was aspirated from the iliac crest. A cardiac MRI and an isotopic test were performed before and after the procedure. Follow-up was performed by personal interview. Results There were no perioperative adverse events including no arrhythmias. Mean number of laser channels was 20 and the mean total number of intramyocardially injected cells per milliliter were: total mononuclear cells(83.6 × 106, CD34+ cells(0.6 × 106, and CD133+ cells(0.34 × 106. At 12 months mean follow-up average angina class was significantly improved (3.4 ± 0.5 vs 1.4 ± 0.6; p = 0.004. In addition, monthly cardiovascular medication usage was significantly decreased (348 ± 118 vs. 201 ± 92; p = 0.001. At six months follow up there was a reduction in the number of cardiac hospital readmissions (2.9 ± 2.3 vs. 0.5 ± 0.8; p Conclusions The stem cell isolator efficiently concentrated autologous bone marrow derived stem cells while the TMR/stem cell combination delivery device worked uneventfully. An improvement in clinical status was noticed in the midterm follow-up. Images test showed no morphological alterations in the left ventricle after the procedure.

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

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    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.

  15. Effect of Yiqi Yangyin Decoction on the quality of life of patients with unstable angina pectoris.

    Science.gov (United States)

    He, Qing-yong; Wang, Jie; Zhang, Yun-ling; Tang, Yan-li; Chu, Fu-yong; Xiong, Xing-jiang

    2010-02-01

    To observe the effect of Yiqi Yangyin Decoction (, YQYYD) on the quality of life (QOL) of patients with unstable angina pectoris (UAP). A total of 108 patients with UAP of qi-yin deficiency syndrome confirmed by coronary angiography were enrolled and assigned to the treated group (treated with YQYYD and conventional therapy of Western medicine) and the control group (treated with conventional therapy of Western medicine), by the use of the PROC PLAN of the SAS 6.12 software, in a prospective, randomized, controlled design. The clinical total effective rate, symptom score, QOL scale [Seattle Angina Questionnaire (SAQ)] and incidence of important clinical events were defined as the observation indices to evaluate the interventional effect of YQYYD on the QOL of patients with UAP of the qi-yin deficiency syndrome. During the study, three cases dropped out in the treated group, one case dropped out in the control group, and 104 cases, including 51 cases in the treatment group and 53 cases in the control group, finished the trial. After four weeks of treatment, the total clinical effective rates in the treated group and the control group were 80.4% and 75.5% respectively, and there was no obvious difference between them (P>0.05). However, the symptom score of the treated group (9.31 + or - 2.02) was significantly lesser than that of the control group (11.62 + or - 3.04, Pangina stability, angina frequency, and treatment satisfaction were significantly ameliorated when compared with the control group after treatment (P0.05). YQYYD could improve the clinical symptoms of patients with UAP of qi-yin deficiency syndrome and greatly improve their QOL.

  16. [Personality self-actualization: an independent additional risk factor of myocardial infarction and unstable angina].

    Science.gov (United States)

    Sharobaro, V I; Zhenchevskaia, Iu V; Ivanova, T M

    2011-01-01

    It is shown for the first time that changes of self-actualization (SA) in patients with CHD are the main risk factor of myocardial infarction (MI) and unstable angina (UA). The clinical course and prognosis of MI correlate with SA prior to the development of an acute coronary event. Isolated correlations exist between CHD risk factors and results of SA questionnaire studies. SA personality peculiarities in patients with MI and UA account for more than 50% dispersion of the results of linear factor analysis.

  17. Ludwig's angina in children anesthesiologist's nightmare: Case series and review of literature

    Directory of Open Access Journals (Sweden)

    Maitree Pandey

    2017-01-01

    Full Text Available Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered during the anesthetic management of six children who required emergency surgical drainage under general anesthesia.

  18. A Giant Verrucous Carcinoma of the Penis Presenting with Urinary Sepsis and Angina

    Directory of Open Access Journals (Sweden)

    Michael Nomikos

    2014-01-01

    Full Text Available Penile verrucous carcinoma also known as Buschke-Löwenstein tumor in the genital region is an uncommon variant of penile carcinoma exhibiting slow, expansive growth. We present a case of a 63-year-old male who presented with a giant purulent penile mass causing urinary sepsis and angina. Regional lymph nodes were clinically negative and staging with CT scans of thorax and abdomen did not show any signs of lymph node or distant metastases. After resuscitation, radical penectomy was performed and a perineal urethrostomy was created. Histological examination revealed a Buschke-Löwenstein tumor of the penis with no invasion of corpus cavernosum and urethra.

  19. Economic evaluation of trimetazidine in the management of chronic stable angina in Greece

    OpenAIRE

    Kourlaba, Georgia; Gourzoulidis, George; Andrikopoulos, George; Tsioufis, Konstantinos; Beletsi, Alexandra; Maniadakis, Nikos

    2016-01-01

    Background To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. Methods A Markov model with 3-month cycles and 1-year time horizon was developed to assess the comparators. The analysis was conducted from a third-party payer perspective. The clinical inputs and utili...

  20. A Whole-Food Plant-Based Diet Reversed Angina without Medications or Procedures

    Directory of Open Access Journals (Sweden)

    Daniele Massera

    2015-01-01

    Full Text Available A 60-year-old man presented with typical angina and had a positive stress test. He declined both drug therapy and invasive testing. Instead, he chose to adopt a whole-food plant-based diet, which consisted primarily of vegetables, fruits, whole grains, potatoes, beans, legumes, and nuts. His symptoms improved rapidly, as well as his weight, blood pressure, and cholesterol levels. Plant-based diets have been associated with improved plasma lipids, diabetes control, coronary artery disease and with a reduction in mortality. Adoption of this form of lifestyle therapy should be among the first recommendations for patients with atherosclerosis.

  1. 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...... of vascular smooth muscle hyperreactivity leading to spasm caused by various factors that may also overlap. Focal coronary spasm is related to epicardial atherosclerosis and in the presence of obstructive coronary artery disease it may be useful to treat the lesion to prevent further spasm. The aim...

  2. Ludwig's angina in children anesthesiologist's nightmare: Case series and review of literature.

    Science.gov (United States)

    Pandey, Maitree; Kaur, Manpreet; Sanwal, Manoj; Jain, Aruna; Sinha, Sunil K

    2017-01-01

    Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered during the anesthetic management of six children who required emergency surgical drainage under general anesthesia.

  3. Management of Ludwig's Angina in Pregnancy: A Review of 10 Cases.

    Science.gov (United States)

    Osunde, Od; Bassey, Go; Ver-Or, N

    2014-05-01

    Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. The present paper reviews the management of Ludwig's angina in the third trimester of pregnancy. The inherent dangers to the mother and her unborn child are highlighted. The case files of pregnant patients who had emergent incision and drainage for life-threatening facial cellulitis at the maxillofacial unit of the Murtala Mohammed Specialist Hospital in Kano, Nigeria, over a 2 year period were retrieved and demographic and clinical characteristics were retrospectively obtained and analyzed descriptively using the statistical package for social sciences (SPSS version 13.0, for Windows, September 2004, Chicago, Illinois). Comparative statistics were determined using Pearson's Chi-square, Fisher's exact tests and independent t tests as appropriate. A P value of less than 0.05 was considered significant. A total of 10 patients were seen within the study period, age ranges from 23 to 40 years, mean 29.5 (5.3) years. Majority of the women were in their third decade [60% (6/10)] while the remaining 40% (4/10) were in their fourth decade of life. Two of the patients presented within the period of less than 1 week of onset of symptoms while those who presented within the periods of 1-2 weeks and periods of over 2 weeks accounted for 50% (5/10) and 30% (3/10) respectively. All the patients presented during the third trimester of their pregnancy and odontogenic infections were responsible for 80% (8/10) of the Ludwig's angina. There were 20% mortality among the patients and this was significant for those with underlying systemic conditions (P = 0.02). The time of presentation was not significant for the survival rate of the gravid patient (P = 0.36) but was significant for survival of the fetus (P = 0.01). During a life-threatening infectious situation such as Ludwig's angina, risks of maternal and fetal morbidity include both septicemia and asphyxia. Attending

  4. Mesenchymal stromal cell derived endothelial progenitor treatment in patients with refractory angina

    DEFF Research Database (Denmark)

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

    2011-01-01

    Abstract Aims. We evaluated the feasibility, safety and efficacy of intra-myocardial injection of autologous mesenchymal stromal cells derived endothelial progenitor cell (MSC) in patients with stable coronary artery disease (CAD) and refractory angina in this first in man trial. Methods......-myocardial injection of MSC. After six months follow-up myocardial perfusion was unaltered, but the patients increased exercise capacity (p ... patients with stable CAD with autologous culture expanded MSC. Moreover, MSC treated patients had significant improvement in left ventricular function and exercise capacity, in addition to an improvement in clinical symptoms and SAQ evaluations....

  5. Manejo de la angina refractaria con estimulación eléctrica espinal: revisión de la literatura Treatment of refractory chest angina with spinal electrical stimulator: literature review

    Directory of Open Access Journals (Sweden)

    Omar F Gomezese

    2008-06-01

    Full Text Available Justificación: existe un grupo de pacientes con angina de pecho crónica refractaria, que no son candidatos a revascularización quirúrgica o percutánea y que a pesar de recibir un manejo médico óptimo, aún experimentan severos episodios de angina. El estimulador eléctrico espinal es un neuromodulador que se emplea como alternativa de manejo en estos pacientes. Objetivos: se realizó una revisión sobre estimulación eléctrica espinal en el manejo de la angina, su mecanismo de acción, sus beneficios y su costo-efectividad. Materiales y métodos: se llevó a cabo una búsqueda en MedLine, según la metodología Cochrane, de artículos publicados desde enero de 1980 a enero de 2007, mediante los términos «spinal cord stimulation» de ésta se seleccionaron los manuscritos que los autores consideraron relevantes. Conclusiones: el efecto anti-isquémico del estimulador espinal eléctrico reduce los episodios de angina de pecho, mejora la calidad de vida y la tolerancia al ejercicio, disminuye la estancia hospitalaria y retarda la aparición de signos de isquemia.Justification: there is a group of patients with chronic refractory chest angina, who are not ideal candidates for surgical or percutaneous revascularization and who although having a good medical handling continue to experience severe episodes of angina. The spinal electrical stimulator is a neuromodulator used as an alternative to treat these patients. Objectives: to realize a review of scientific literature regarding the spinal electric stimulation in the treatment of chest angina, its mechanism of action, benefits and its cost effectiveness. Materials and methods: using the Cochrane methodology, a search of articles published from January 1980 to January 2007 in Medline using the terms «spinal cord stimulation», was realized. The papers considered most pertinent were selected. Conclusions: the anti-ischemic effect of the electrical spinal stimulator reduces the episodes of

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Aims Patients 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 o...... with 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.......Aims Patients 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...... (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

  7. Accelerated collagen turnover in women with angina pectoris without obstructive coronary artery disease: An iPOWER substudy

    DEFF Research Database (Denmark)

    Nielsen, Signe H; Mygind, Naja D; Michelsen, Marie M

    2018-01-01

    , but without significant obstructive coronary artery disease, showed an imbalanced collagen turnover compared to asymptomatic controls. The examined biomarkers are tools to monitor active collagen remodelling in patients with angina pectoris, in risk of developing myocardial fibrosis........ Cardiac magnetic resonance T1 mapping was performed to determine extracellular volume fraction and thus diffuse myocardial fibrosis. A significant association was identified between C5M and extracellular volume fraction by cardiac magnetic resonance (p = 0.01). Conclusion: Women with angina pectoris...... patients with diffuse myocardial fibrosis from asymptomatic controls. Methods and results: Seventy-one women with angina pectoris without significant coronary artery disease assessed by invasive coronary angiogram were included. Competitive enzyme-linked immunosorbent assays (ELISAs) measuring circulating...

  8. Detection of culprit lesion in patients with unstable angina pectoris by using ATP thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Tokuo; Mori, Yutaka [Jikei Univ., Tokyo (Japan). School of Medicine; Yamashina, Akira; Kubo, Toru; Usui, Yasuhiro

    1999-10-01

    The purpose of this study is to determine the diagnostic accuracy for detection of culprit lesions in patients with unstable angina. Both ATP {sup 201}Tl SPECT and coronary angiography were performed in 51 patients with unstable angina pectoris within a week since the last attack. SPECT images were divided into 17 segments and the regional uptakes were scored semiquantitatively (0=normal to 3=no activity) and compared with the coronary angiographic findings. ATP {sup 201}Tl SPECT revealed decreased uptakes in 54 of 56 culprit lesions. The sensitivity, specificity and accuracy for detection of culprit lesions were 96.4%, 89.5% and 92.4%, respectively. Although adverse effects during ATP administration were complicated in 28 (54.9%) patients, all the complications were mild and resolved within two minutes. ATP {sup 201}Tl SPECT is sensitive and reliable method for detecting culprit lesions and can be performed safely even at acute phase in patients with unstable angina pectoris. (author)

  9. A Series of Unfortunate Events: Prinzmetal Angina Culminating in Transmural Infarction in the Setting of Acute Gastrointestinal Hemorrhage

    Science.gov (United States)

    Ruisi, Phillip; Rosero, Hugo; Schweitzer, Paul

    2013-01-01

    Prinzmetal angina or vasospastic angina is a clinical phenomenon that is often transient and self-resolving. Clinically it is associated with ST elevations on the electrocardiogram, and initially it may be difficult to differentiate from an acute myocardial infarction. The vasospasm induced in this setting occurs in normal or mildly to moderately diseased vessels and can be triggered by a number of etiologies including smoking, changes in autonomic activity, or drug ingestion. While the ischemia induced is usually transient, myocardial infarction and life-threatening arrhythmias can occur in 25% of cases. We present the case of a 65-year-old female where repetitive intermittent coronary vasospasm culminated in transmural infarction in the setting of gastrointestinal bleeding. This case highlights the mortality associated with prinzmetal angina and the importance of recognizing the underlying etiology. PMID:24826293

  10. Correction of aggregative thrombocytes activity in patients with unstable angina by THz irradiation of nitrogen oxide occurrence at in vitro conditions

    Directory of Open Access Journals (Sweden)

    Vyacheslav F. Kirichuk

    2013-11-01

    Full Text Available There had been shown a normalizing effect of THz radiation of MEAS (molecular emission and absorption spectrum of 400 GHz nitrogen oxide occurrence on aggregation parameters of thrombocytes in patients with unstable angina at in vitro conditions. 180 patients with an unstable angina had been involved in to the research.

  11. Angina Bullosa Hemorrhagica with a Possible Relation to Dental Treatment, Diabetes Mellitus, Steroid Inhaler and Local Trauma: Report of 3 Cases

    Directory of Open Access Journals (Sweden)

    S M Ravi Prakash

    2010-01-01

    Full Text Available Angina bullosa hemorrhagica is a rare condition characterized by one or more blood filled blisters or bullae predominantly in the soft palate region caused either by local mucosal trauma, dental treatment, underlying systemic conditions or use of steroid inhalers. We report three cases of angina bullosa hemorrhagica with different etiological factors.

  12. Study protocol: a randomised controlled trial investigating the effect of exercise training on peripheral blood gene expression in patients with stable angina

    Directory of Open Access Journals (Sweden)

    Crossman David C

    2010-10-01

    Full Text Available Abstract Background Exercise training has been shown to reduce angina and promote collateral vessel development in patients with coronary artery disease. However, the mechanism whereby exercise exerts these beneficial effects is unclear. There has been increasing interest in the use of whole genome peripheral blood gene expression in a wide range of conditions to attempt to identify both novel mechanisms of disease and transcriptional biomarkers. This protocol describes a study in which we will assess the effect of a structured exercise programme on peripheral blood gene expression in patients with stable angina, and correlate this with changes in angina level, anxiety, depression, and exercise capacity. Methods/Design Sixty patients with stable angina will be recruited and randomised 1:1 to exercise training or conventional care. Patients randomised to exercise training will attend an exercise physiology laboratory up to three times weekly for supervised aerobic interval training sessions of one hour in total duration. Patients will undergo assessments of angina, anxiety, depression, and peripheral blood gene expression at baseline, after six and twelve weeks of training, and twelve weeks after formal exercise training ceases. Discussion This study will provide comprehensive data on the effect of exercise training on peripheral blood gene expression in patients with angina. By correlating this with improvement in angina status we will identify candidate peripheral blood transcriptional markers predictive of improvements in angina level in response to exercise training. Trial Registration Clinicaltrials.gov identifier: NCT01147952

  13. Fracturas intertrocantéricas inestables tratadas con clavos endomedulares cortos. Intertrocantéricos/Subtrocantéricos. Valoración de la calidad de vida y de la recuperación funcional. [Unstable intertrochanteric fractures treated with ITST short intramedullary nails. Quality of life assessment and functional recovery.

    Directory of Open Access Journals (Sweden)

    Federico José Burgo

    2015-04-01

    Full Text Available Introducción El objetivo del presente estudio consistió en evaluar una serie de pacientes con fracturas intertrocantéricas inestables tratados con clavos cortos Intertrocantéricos/Subtrocantéricos ITST(NR con especial atención en la calidad de vida y la recuperación funcional. Material y métodos Se incluyeron 171 pacientes con fracturas AO 3.1 A2 y A3, con un seguimiento mínimo de 14 meses, y una edad promedio de 79 años. Se evaluó: calidad de vida, utilizando la escala de WOMAC reducida convertida a una escala del 1 al 100, recuperación funcional en función del tiempo en que se logró la bipedestación, necesidad de ortesis al final del seguimiento, y el regreso a las tareas de la vida diaria utilizando la sub-escala de función de la Sociedad Americana de Tumores Musculoesqueléticos. Resultados A los 14 meses el promedio de WOMAC total fue 77. El 73 % de la población caminó dentro de las 36 hs de la cirugía. El 48% retornó a las actividades diarias con una restricción mínima, el resto tuvo restricciones recreacionales y parciales. El 71% del grupo que no utilizaba ortesis conservó tal condición al finalizar el seguimiento. La incidencia de complicaciones intraoperatorias y postoperatoria fue 6,5% y 23%. La fractura distal al clavo y el “cut-out” se produjeron solo en el 1%. Discusión La baja incidencia de “cut-out” y fractura distal al clavo con la posibilidad de inserción temprana a las actividades, conservando una buena calidad de vida y función, convierten al ITST en un alternativa de elección para el tratamiento de las fracturas intertrocantéricas inestables de cadera.

  14. A randomized double-blind placebo-controlled crossover trial of sodium nitrate in patients with stable angina INAS.

    Science.gov (United States)

    Schwarz, Konstantin; Singh, Satnam; Parasuraman, Satish Kumar; Bruce, Maggie; Shepstone, Lee; Feelisch, Martin; Minnion, Magdalena; Ahmad, Shakil; Horowitz, John; Dawson, Dana K; Frenneaux, Michael P

    2016-11-01

    In an aging western population, a significant number of patients continue to suffer from angina once all revascularization and optimal medical treatment options are exhausted. Under experimental conditions, oral supplementation with inorganic nitrate was shown to exhibit a blood pressure-lowering effect, and has also been shown to promote angiogenesis, improve endothelial dysfunction and mitochondrial efficiency in skeletal muscle. It is unknown whether similar changes occur in cardiac muscle. In the current study, we investigate whether oral sodium nitrate treatment will improve myocardial ischemia in patients with stable angina.

  15. El conocimiento del ciclo del agua en el segundo ciclo de Educación Primaria

    Directory of Open Access Journals (Sweden)

    María Guerrero Valle

    2017-07-01

    Full Text Available El agua tiene una gran importancia e influencia en nuestras vidas y en nuestro planeta. En este trabajo se presenta una investigación sobre el conocimiento sobre el ciclo del agua en el segundo ciclo de la Educación Primaria. Para el estudio, se ha realizado en dos centros de Primaria un cuestionario sobre lluvia que recoge los conceptos claves para una comprensión básica del mecanismo de la lluvia como del ciclo del agua, junto con un dibujo sobre la lluvia. La investigación pone de manifiesto que el grado de conocimiento sobre el ciclo del agua de los estudiantes es alto, pero se trata de un conocimiento incompleto y, en algunas ocasiones, erróneo. Después de reflexionar sobre los resultados obtenidos, se propone la implicación educativa necesaria para mejorar dichos resultados.

  16. Diseño de materiales educativos digitales para Educación Primaria

    OpenAIRE

    Sola-Munilla, Beatriz

    2015-01-01

    Este TFG ha consistido en la producción, puesta en práctica y evaluación de una serie de recursos didácticos digitales para integrar las TIC en las aulas de Educación Primaria. Una vez expuesta la relación entre TIC y educación, se procedió al diseño de materiales educativos digitales, tomando como referencia el marco legislativo de la LOMCE y el Real Decreto 126/2014, de 28 de febrero, por el que se establece el currículo básico de la Educación Primaria. Los recursos digitales propuestos ...

  17. Salud mental en atención primaria en Chile: aprendizajes para Latinoamérica

    OpenAIRE

    Minoletti, Alberto; Rojas, Graciela; Horvitz-Lennon, Marcela

    2012-01-01

    El presente artículo describió la experiencia chilena de los últimos 20 años con la integración de salud mental en atención primaria de salud y analizó los resultados de algunas evaluaciones, con el fin de contribuir a los procesos de aprendizaje de cómo disminuir brechas de atención. El retorno a la democracia después de la Dictadura Militar y la Declaración de Caracas fueron factores contribuyentes, así como el alto desarrollo de la atención primaria de salud en Chile y la formulación espec...

  18. Diagnóstico Molecular y Genético de Inmunodeficiencias Primarias ligadas al X

    OpenAIRE

    Martínez Martínez, Laura

    2011-01-01

    Las Inmunodeficiencias Primarias (IDPs) son enfermedades congénitas del sistema inmune que tienen en común una susceptibilidad incrementada a las infecciones. Se han descrito más de 200 entidades englobadas bajo esta definición. Algunas de ellas tienen una herencia ligada al X, lo que les confiere ciertas peculiaridades. En esta Tesis presentamos los resultados concernientes a 28 pacientes, casi todos varones, con sospecha de IDP en base a una elevada frecuencia y severidad de ...

  19. Ciberbullying en colegios privados y estatales de primaria en dos distritos de Lima Metropolitana

    Directory of Open Access Journals (Sweden)

    Isabel Amemiya

    2013-04-01

    Full Text Available Objetivos: Determinar las características del ciberbullying en escolares de 5° y 6° de primaria de colegios estatales y particulares, de Jesús María y Pueblo Libre. Diseño: Descriptivo transversal. Institución: Colegios estatales y particulares, de Jesús María y Pueblo Libre. Participantes: Alumnos de 5° y 6° de primaria. Intervenciones: En 826 alumnos de 5° y 6° de primaria, se aplicó una encuesta anónima de Rosario Ortega. Principales medidas de resultado: Análisis descriptivo y pruebas estadísticas de asociación. Resultados: Se comunicó ciberbullying en 24,7% de los alumnos; fue mayor en 6° grado y en colegios privados. La agresión por celular e internet ocurrió en 1,9% y hubo víctimas por celular en 6,3% y por internet 12%. La situación de victimas por internet se asoció a computadora en cuarto (p=0,019 y al uso de internet fuera de casa (p=0,000; fue mayor en colegios privados (p=0,002 y con el empleo de internet fuera de casa aumentó a 23,1% (p=0,032. Los varones agredieron más que las mujeres (p=0,000. Conclusiones: El ciberbullying fue más frecuente en alumnos de 6° de primaria de colegios privados. Las víctimas por internet fueron más frecuentes que por celular, y se asociaron a tener computadora en su cuarto o usarla fuera de casa. Predominó la agresión en los varones.

  20. Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Hori, Masatsugu; Nishimura, Tsunehiko

    1996-01-01

    Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise 201 Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients' impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on 201 Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated 'improved' or better. In the improvement rating on the exercise 201 Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as 'improved' or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as 'no problem', while in 4 patients it was evaluated as 'useful' or more. (author)

  1. [Angina morbidity in an organized collective with a periodic turnover of its personnel].

    Science.gov (United States)

    Sobolev, V I; Beliakov, V D; Briko, N I

    1993-02-01

    The article studies the average angina morbidity in the military unit during 9 years which resulted in 48.4% (scarlet fever--0.34%). Laboratory diagnostics is needed to make the estimation of streptococcal infection which has an acute respiratory infectious character during its clinical course. Among the whole number of patients 89.2% have come through this illness for one time, 9% twice, and 4.8%--three times. The dynamics of the angina morbidity had a periodical cycle of 2-3 years which was independent from the morbidity cycle of local civilian population. The authors show a statistic dependency between average morbidity index and the quantity of servicemen in one dormitory, its square and volume per one man. Application of "time before illness" index for 24 months made it possible to disclose the phase character in the development of streptococcal infection among personnel of the same call-up period. The general tendency towards reduction of the morbidity index was accompanied with regular upgrades of the infection after each spring or autumn renovation of personnel.

  2. Psychometric properties of a specific quality of life questionnaire in angina pectoris patients.

    Science.gov (United States)

    Marquis, P; Fayol, C; Joire, J E; Leplège, A

    1995-12-01

    This paper describes the psychometric properties of the French version of the APQLQ (Angina Pectoris Quality of Life Questionnaire), that is to say, scaling assumptions, reliability and validity. This disease-specific Swedish questionnaire provides a global score as well as four subscores measuring physical activities, somatic symptoms, emotional distress, and life satisfaction. The French version was produced according to the forward-backward translation methodology. In a cross-sectional study, 183 coronary patients filled out the APQLQ and the MOS (Medical Outcomes Study) SF-36; 170 sent it back; the rate of missing data was low (1.3%). The factorial structure and the high level of inter-scale correlations (> 0.60) suggested that the APQLQ measured one global concept rather than separate domains. The multitrait analysis identified one problematic item correlated strongly with all domains. The internal consistency was good (alpha Cronbach > 0.70). The correlations with the SF-36 scales were consistent with what was expected. The distribution of the scores of the APQLQ according to the clinical severity of Angina Pectoris (AP) was as hypothesized: the more severe the AP, the more impaired the Quality of Life. The score significantly discriminated between symptomatic (n = 110) and asymptomatic patients (n = 60) except for the emotional distress scale (p = 0.14). We recommend to analyze the French APQLQ as an index rather than as a profile. Its reliability, concurrent and clinical validity allowed its use in clinical trials.

  3. Effect of oral aminophylline in patients with angina and normal coronary arteriograms (cardiac syndrome X).

    Science.gov (United States)

    Elliott, P. M.; Krzyzowska-Dickinson, K.; Calvino, R.; Hann, C.; Kaski, J. C.

    1997-01-01

    BACKGROUND: Patients with syndrome X (exertional angina, positive exercise test, normal coronary arteriogram) have an altered perception of cardiac pain. This symptom may arise from increased sensitivity to adenosine. Previous studies suggest that intravenous aminophylline (an adenosine receptor blocker) improves exercise tolerance in patients with this disorder. OBJECTIVE: To examine the efficacy of oral aminophylline in syndrome X. METHODS: 13 patients (11 women and two men, mean (SD) 54 (6) years) with syndrome X were studied. Patients were randomised in a double blind crossover study to receive either oral aminophylline or placebo for three weeks. All patients underwent symptom limited exercise testing and ambulatory electrocardiography at the end of each three week period. RESULTS: 10 patients completed the study. The time to angina during exercise testing in patients who were given aminophylline was longer than for the placebo group (mean (SD) 632 (202) seconds v 522 (264) seconds, P = 0.004). Peak exercise ST depression did not differ significantly between patients who received aminophylline and those administered placebo (mean (SD) -1.9 (0.7) mm v -1.5 (0.8) mm). Six patients taking aminophylline reported a reduction in the total number of episodes of chest pain during the three weeks, but the frequency and duration of ST segment depression during Holter monitoring was unchanged. CONCLUSION: Oral aminophylline has a favourable effect on exercise induced chest pain threshold in patients with syndrome X. The disparate effects on symptoms and ST segment changes are intriguing and further study is warranted. PMID:9227295

  4. Lipoprotein(a Is the Best Single Marker in Assessing Unstable Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Vidosava B. Djordjević

    2011-01-01

    Full Text Available This study evaluated whether statin therapy changed a diagnostic validity of lipid and inflammatory markers in ischemic heart disease (IHD patients. Levels of lipids, lipoproteins, apolipoproteins, inflammatory markers, and atherogenic indexes were determined in 49 apparently healthy men and women, 82 patients having stable angina pectoris (SAP, 80 patients with unstable angina (USAP, and 106 patients with acute ST-elevation myocardial infarction (STEMI treated or not treated with statins. Diagnostic accuracy of markers was determined by ROC curve analysis. Significantly lower apoA-I in all statin-treated groups and significantly higher apoB in statin-treated STEMI group compared to non-statin-treated groups were observed. CRP showed the best ROC characteristics in the assessment of STEMI patients. Lp(a is better in the evaluation of SAP and USAP patients, considering that Lp(a showed the highest area under the curve (AUC. Regarding atherogenic indexes, the highest AUC in SAP group was obtained for TG/apoB and in USAP and STEMI patients for TG/HDL-c. Statins lowered total cholesterol, LDL-c, and TG but fail to normalize apoA-I in patients with IHD.

  5. Calidad de vida en pacientes con osteoporosis en atención primaria

    Directory of Open Access Journals (Sweden)

    Mercedes Sánchez Barba

    2011-01-01

    Full Text Available El objetivo de esta investigación fue evaluar la calidad de vida en pacientes clasificados como osteoporóticos en el Ámbito de la Atención primaria. Se llevó a cabo un diseño observacional transversal, los pacientes fueron reclutados de forma consecutiva en un Centro de Salud de Atención primaria de Salamanca (España. Se utilizó un cuestionario sociodemográfico, el EuroQol-5D, para evaluar calidad de vida relacionada con la salud y el QUALEFFO para evaluar calidad de vida en pacientes clasificados como osteoporóticos y que no ha sido aplicado en Atención primaria. En los resultados para las mujeres, se observaron diferencias significativas entre pacientes clasificados como osteoporóticos y no osteoporóticos en todas las dimensiones de ambos cuestionarios. Para los hombres esas diferencias fueron significativas solo para ciertas dimensiones. Los resultados reflejan que la calidad de vida de los pacientes clasificados como osteoporóticos es más baja que para los no osteoporóticos, en todas las dimensiones de la calidad de vida evaluadas.

  6. Addition of felodipine to metoprolol vs replacement of metoprolol by felodipine in patients with angina pectoris despite adequate beta-blockade - Results of the felodipine ER and metoprolol CR in angina (FEMINA) study

    NARCIS (Netherlands)

    Dunselman, P; Liem, AH; Verdel, G; Kragten, H; Bosma, A; Bernink, P

    1997-01-01

    Aims The study aimed to compare the addition of felodipine to metoprolol, and of the replacement of metoprolol by felodipine, with continuation of metoprolol, in patients with angina pectoris despite optimal beta-blockade. Methods and results The study was double-blind, parallel, randomized and

  7. Stable angina

    Science.gov (United States)

    ... Most occur between 6 a.m. and noon. Exams and Tests Your health care provider will examine you and check your blood pressure. Tests that may be done include: Coronary angiography Blood cholesterol profile ECG Exercise tolerance test (stress test or treadmill test) Nuclear medicine (thallium) stress ...

  8. Unstable angina

    Science.gov (United States)

    ... pain that you may also feel in the shoulder, arm, jaw, neck, back, or other area Discomfort that feels like tightness, squeezing, crushing, burning, choking, or aching Discomfort that occurs at rest and does not easily go away when you ...

  9. Epileptic Angina ?

    OpenAIRE

    Sureshbabu, Sachin; Nayak, Dinesh; Peter, Sudhir; Sobhana, Chindripu; Mittal, Gaurav

    2017-01-01

    Purpose: To investigate the probable ictal origin of unexplained episodic chest pain and if possible to lateralize and localize the epileptic focus. Methods: A 14 year old boy presented with episodic short lasting localized chest pain. His cardiac and other systemic work-up were normal. MRI brain did not reveal any structural pathology. Video telemetry was done for characterization of the paroxysms. Results: Interictal record showed left fronto-central epileptiform discharges. A left he...

  10. Percutaneous Device to Narrow the Coronary Sinus : Shifting Paradigm in the Treatment of Refractory Angina? A Review of the Literature

    NARCIS (Netherlands)

    Benedetto, Daniela; Abawi, Masieh; Stella, Pieter R; Nijhoff, Freek; Lakemeier, Maxime D M; Kortlandt, Friso; Doevendans, Pieter A; Agostoni, Pierfrancesco

    2016-01-01

    Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and/or revascularization

  11. 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...

  12. 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...

  13. Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography Improves Diagnostics of Coronary Artery Stenosis in Stable Angina Pectoris

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Hoffmann, Soren; Mogelvang, Rasmus

    2014-01-01

    BACKGROUND: Two-dimensional strain echocardiography detects early signs of left ventricular dysfunction; however, it is unknown whether myocardial strain analysis at rest in patients with suspected stable angina pectoris predicts the presence of coronary artery disease (CAD). METHODS AND RESULTS:...

  14. Chemical and pharmacological evaluation of the effectiveness of enalapril maleate in exertional angina pectoris in elderly and senile patients

    Directory of Open Access Journals (Sweden)

    I. M. Belay

    2013-06-01

    Full Text Available The long-term administration of enalapril maleate in complex therapy of exertional angina pectoris in elderly persons showed antiischemic, antiarrhythmic effects of angiotensin converting enzyme inhibitors. Using chemical-pharmacological analysis the administration of enalapril against the background of basic therapy in patients with ischemic heart disease was grounded.

  15. 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

  16. EFFICACY OF SPINAL-CORD STIMULATION AS ADJUVANT THERAPY FOR INTRACTABLE ANGINA-PECTORIS - A PROSPECTIVE, RANDOMIZED CLINICAL-STUDY

    NARCIS (Netherlands)

    DEJONGSTE, MJL; HAUTVAST, RWM; HILLEGE, HL; LIE, KI

    Objectives. In a prospective, randomized study with an 8-week follow-up period, we evaluated the efficacy of spinal cord stimulation an exercise capacity and quality of life in patients with intractable angina. Background. Despite important achievements in therapy for ischemic heart disease, there

  17. Effects of Ranolazine on Angina and Quality of Life After Percutaneous Coronary Intervention With Incomplete Revascularization: Results From the Ranolazine for Incomplete Vessel Revascularization (RIVER-PCI) Trial.

    Science.gov (United States)

    Alexander, Karen P; Weisz, Giora; Prather, Kristi; James, Stefan; Mark, Daniel B; Anstrom, Kevin J; Davidson-Ray, Linda; Witkowski, Adam; Mulkay, Angel J; Osmukhina, Anna; Farzaneh-Far, Ramin; Ben-Yehuda, Ori; Stone, Gregg W; Ohman, E Magnus

    2016-01-05

    Angina often persists or returns in populations following percutaneous coronary intervention (PCI). We hypothesized that ranolazine would be effective in reducing angina and improving quality of life (QOL) in incomplete revascularization (ICR) post-PCI patients. In RIVER-PCI, 2604 patients with a history of chronic angina who had ICR post-PCI were randomized 1:1 to oral ranolazine versus placebo; QOL analyses included 2389 randomized subjects. Angina and QOL questionnaires were collected at baseline and months 1, 6, and 12. Ranolazine patients were more likely than placebo to discontinue study drug by month 6 (20.4% versus 14.1%, Pdiabetics (mean difference 3.3; 95% CI 0.6, 6.1; P=0.02) and those with more angina (baseline SAQ angina frequency ≤60; mean difference 3.4; 95% CI 0.6, 6.2; P=0.02), but was not maintained at month 12. Despite ICR following PCI, there was no incremental benefit in angina or QOL measures by adding ranolazine in this angiographically-identified population. These measures markedly improved within 1 month of PCI and persisted up to 1 year in both treatment arms. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01442038. © 2015 American Heart Association, Inc.

  18. Myocardial rest iodine-123-{beta}-methyl-iodophenyl-pentadecanoic acid scintigraphy compared with dipyridamole stress thallium-201 scintigraphy in unstable angina

    Energy Technology Data Exchange (ETDEWEB)

    Misumi, Ikuo; Kimura, Yoshihiro; Hokamura, Youichi; Yamabe, Hiroshige; Ueno, Kazuhiro [Kumamoto City Hospital (Japan)

    1998-01-01

    Twelve patients with stable angina and 12 patients with unstable angina underwent rest iodine-123-{beta}-methyl-iodophenyl-pentadecanoic acid (BMIPP), dipyridamole stress thallium scintigraphy and delayed thallium scintigraphy. In stable angina, sensitivity for detecting ischemic segments was higher in dipyridamole thallium (74%) than rest BMIPP (48%) images (p<0.05), but there was no significant difference between the 2 images in unstable angina. In unstable angina, the incidence of segments with higher defect scores on BMIPP images than on delayed thallium images and the opposite pattern was 27 and 5 (p<0.01). In stable angina, there was no difference. The mean defect score on BMIPP (6.3{+-}5.6) was higher than that on delayed thallium scintigraphy (2.9{+-}2.7) and it was almost the same as on the initial dipyridamole stress test (6.5{+-}5.2). In conclusion, BMIPP scintigraphy is safer and may be as useful in detecting myocardial ischemia in patients with unstable angina as thallium scintigraphy. (author)

  19. Comparison of percutaneous coronary intervention versus conservative treatment in unstable angina pectoris

    International Nuclear Information System (INIS)

    Hu Chunyan; Lv Bei; Shen Weifeng; Lu Guoping

    2002-01-01

    Objective: To evaluate the efficacies of percutaneous coronary intervention (PCI) and drug treatment in patients with unstable angina (UAP). Methods: 248 patients with UAP were divided into two groups: conservative group of 123 patients who received antiplatelet, anticoagulant and antianginal therapies only and invasive group of 125 patients who underwent additional PCI 4.4 days after admission. The occurrence of death, AMI, recurrent angina, readmission were assessed during the first hospitalization year. Results: There was no difference in the incidence of composite endpoint of death or AMI between the two groups during the hospitalization (0.8 % vs 1.6 %, P > 0.05 ), but hospitalization duration was shorter in the invasive group than in the conservative group (10.3 ± 5.6 days vs 14.6 ± 10.7 days, P < 0.01 ). In duration of one year, the incidence of AMI (2.4% vs 8.9%, P<0.03), death (1.6% vs 6.5%, P<0.05), composite endpoint of death or AMI (4.0 % vs 13.0 % P < 0.02), recurrent angina pectoris (26.4 % vs 48.7, P <0.001), CABG (1.6% vs 10.5%, P<0.01) and readmission (24.8% vs 45.5%, P<0.01) were also lower in the invasive group than in the conservative group. Survival rate free of composite death or AMI for 1 year was higher in the invasive group than in the conservative group(96.0 % vs 86.9 %, P < 0.02). There was a definite benefit of the invasive treatment in reducing the risk of composite endpoint of death or AMI in patients with chest pain at rest, troponin T positive and three vessel diseases. Old age, three vessel diseases, LAD disease, lower LVEF, ST-segment depression, diabetes and hypertension were the independent factors associated with composite of death or AMI. Conclusions: In patients with UAP, PCI associated with routine antiplatelet, anticoagulant and antiischemic treatment significantly decreases the incidence of adverse cardiac events and improves the survival rate in one year. Such beneficial effects can be more obvious for high-risk patients

  20. Granulocyte colony stimulating factor in chronic angina to stimulate neovascularisation: a placebo controlled crossover trial.

    Science.gov (United States)

    Chih, Sharon; Macdonald, Peter S; McCrohon, Jane A; Ma, David; Moore, John; Feneley, Michael P; Law, Matthew; Kovacic, Jason C; Graham, Robert M

    2012-02-01

    Experimental studies demonstrate that granulocyte colony stimulating factor (G-CSF) promotes neovascularisation and confers cardioprotection. To assess the efficacy of repeated low dose G-CSF plus exercise on myocardial ischaemia in patients with severe chronic ischaemic heart disease. 18 patients with Canadian Cardiovascular Society class III-IV angina completed a randomised, double blind, crossover study of dose adjusted G-CSF versus placebo. Exercise was commenced 6 weeks prior and continued for the duration of the study. G-CSF or placebo was administered daily for 5 consecutive days at fortnightly intervals for three cycles, followed by crossover after 6 weeks. Primary outcome was myocardial perfusion by cardiac magnetic resonance imaging (MRI). Secondary outcomes were: Seattle Angina and Utility Based Quality of Life Heart Questionnaire (SAQ/UBQ-H), Exercise Stress Test (EST) and quantification of endothelial progenitor cells (EPC) by flow cytometry and angiogenic cytokines by immunoassay. Compared with placebo, G-CSF had no effect on myocardial ischaemia by cardiac MRI, EST or SAQ/UBQ-H, despite effective EPC mobilisation (peak fold increase: CD34+ =19, CD34+ CD133+ = 37, CD34+ vascular endothelial growth factor receptor 2 (VEGFR-2)+ = 5, CD34+ CD133+ VEGFR-2+ = 3; all p<0.05 vs. placebo). Plasma levels of stromal cell derived factor 1, angiopoietin 1, interleukin 8 and tumour necrosis factor α decreased after a symptom limited EST while vascular endothelial growth factor and platelet derived growth factor remained unchanged. All cytokines were unchanged following G-CSF. Seven troponin I positive events occurred with G-CSF compared with three with placebo (p=0.289). High sensitivity C reactive protein and N terminal prohormone brain natriuretic peptide increased with G-CSF (both p<0.01 vs. placebo). In patients with chronic ischaemic heart disease, G-CSF mobilises EPCs but does not improve myocardial perfusion or angina. G-CSF increases plasma levels of

  1. Impact of Intracoronary Adenosine on Myonecrosis in Patients with Unstable Angina Pectoris Undergoing Percutaneous Coronary Intervention.

    Science.gov (United States)

    Kizilirmak, Filiz; Gunes, Haci Murat; Demir, Gultekin Gunhan; Gokdeniz, Tayyar; Guler, Ekrem; Cakal, Beytullah; Omaygenç, Mehmet Onur; Yılmaz, Fatih; Savur, Umeyir; Barutcu, Irfan

    2015-12-01

    In this study, we aimed to investigate the impact of prophylactic intracoronary adenosine administered during percutaneous coronary intervention (PCI) due to unstable angina pectoris on myonecrosis by measuring post-procedural levels of cardiac troponin I (cTnI) and creatine kinase-myocardial band (CK-MB). A total of 122 patients with unstable angina undergoing PCI were included in this single-center, double-blind, randomized study. The patients were randomly allocated to adenosine and placebo groups. In the adenosine group, a single-dose of intracoronary adenosine (100 μg for the right coronary artery and 150 μg for the left coronary artery) was administered. Primary endpoint was post-PCI myonecrosis, which was defined as abnormal levels of periprocedural cTnI. Secondary endpoints were defined as elevated cTnI levels [5 × upper limit of normal (ULN)], abnormal CK-MB levels, angiographic coronary flow measured by Thrombolysis In Myocardial Infarction (TIMI) frame count (TFC), the cumulative incidence of in-hospital death and in-hospital urgent target vessel revascularization (TVR). Clinical and angiographic characteristics of both adenosine (61 patients, 61 ± 9 years) and placebo (61 patients, 59 ± 10 years) groups were similar (p > 0.05 for all). Post-procedural abnormal cTnI levels in the adenosine group were significantly lower than the placebo group (32 % vs. 55 %, p: 0.011). cTnI >5 × ULN (21 % vs. 31 %, p: 0.217) and abnormal CK-MB levels (11 % vs. 19 %, p: 0.263) were similar in both groups. Post-procedural TFCs in the adenosine group were significantly lower than the placebo group (24 ± 4 vs. 27 ± 5, p: 0.004). In-hospital events including death and urgent TVR were not observed in either group. Intracoronary administration of single-dose adenosine in patients with unstable angina undergoing PCI is associated with decreased periprocedural myonecrosis and improved coronary blood flow.

  2. Coronary lumen volume to myocardial mass ratio in primary microvascular angina.

    Science.gov (United States)

    Grover, Rominder; Leipsic, Jonathon A; Mooney, John; Kueh, Shaw-Hua; Ohana, Mickael; Nørgaard, Bjarne L; Eftekhari, Ashkan; Bax, Jeroen J; Murphy, Darra T; Hague, Cameron J; Seidman, Michael A; Blanke, Philipp; Sedlak, Tara; Sellers, Stephanie L

    2017-11-01

    Microvascular angina (MVA) is an incompletely understood clinical entity. Computational analysis of coronary Computed Tomography Angiography (CTA) has shown an association between low coronary lumen volume to myocardial mass (V/M) ratio and lower Fractional Flow Reserve values, independent of plaque measures. We hypothesized that low V/M ratio may be present in patients with MVA. A retrospective case-control analysis was performed using patients fulfilling guideline criteria for MVA with controls matched for age, gender, coronary risk factors and atherosclerotic plaque burden. V/M was extracted off site (Heartflow Inc; Redwood City, CA) employing allometric scaling laws that allow the definition of the coronary circulation beyond the epicardium. FFR CT values were calculated in the major epicardial coronary arteries for each group. A total of 30 patients with MVA and 32 matched controls were included in the study. Mean total coronary lumen volume (2302 mm 3  ± 109 vs 2978 mm 3  ± 134, p < 0.001) and mean myocardial mass (90.4 g ± 13.7 vs 100.4 g ± 20.1, p = 0.029) were lower in MVA patients compared to controls. Mean V/M ratio was significantly lower in MVA compared to controls (25.6 mm 3 /g ± 5.9 vs 30.0 mm 3 /g ± 6.5, p = 0.007; c-statistic 0.69). V/M ratio did not differ significantly between subclasses of angina severity (p = 0.747). No difference in mean nadir FFR CT values was found between MVA and control groups in the LAD (0.86 ± 0.07 vs 0.83 ± 0.07, p = 0.154), LCX (0.90 ± 0.05 vs 0.90 ± 0.06, p = 0.240) and RCA (0.90 ± 0.04 vs 0.90 ± 0.03, p = 0.773) vessels. Patients with microvascular angina demonstrate a significantly lower coronary CTA-derived coronary volume/myocardial mass ratio than asymptomatic controls. Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  3. [Six-month xenical (orlistat) therapy of patients with stable angina pectoris concomitant with obesity and hyperlipidemia].

    Science.gov (United States)

    Naumov, V G; Lupanov, V P; Dotsenko, Iu V; Tvorogova, M G

    2002-01-01

    To evaluate the efficiency of 6-month therapy with xenical (gastrointestinal lipase inhibitor) in combination with diet in patients with stable angina pectoris associated with obesity and hyperlipemia. An open comparative randomized study of the efficiency of xenical in combination with diet was carried out in patients with stable angina pectoris concomitant with obesity and hyperlipemia. Thirty coronary patients aged 45-65 years with stable angina of effort (functional class I-II) with body weight index 28.1-45.6 kg/m2 (mean 33.5 kg/m2) were examined. All patients presented with dyslipemia (low density lipoprotein (LDL) cholesterol more than 4.14 mmol/liter, triglycerides (TG) more than 2.2 mmol/liter). Controls (n = 15) were treated with diets alone for 6 months. In the main group diets were supplemented by xenical in a dose of 360 mg/day. Body weight index decreased in both groups (by 9.9% in the main group and by 4.2% in the control). Body weight stabilization during 6 months of treatment and the fact that it was slow and gradual were essential. In patients treated with xenical total cholesterol level decreased by 10.9% and of LDL cholesterol by 12.2% after 6 months (p < 0.05). Changes in the levels of high density lipoprotein cholesterol and TG were insignificant. The drug did not affect the incidence of angina attacks and improved exercise tolerance after 6-month therapy. Blood biochemistry (transaminases, alkaline phosphatase, glucose, and creatinine) changed negligibly. No side effects were observed; all patients received a complete 6-month course. The results confirm that xenical (orlistat) can be used for long therapy of patients with stable angina of effort concomitant with obesity and hyperlipemia.

  4. Paradoxical effect of smoking in the Spanish population with acute myocardial infarction or unstable angina: results of the ARIAM Register.

    Science.gov (United States)

    Ruiz-Bailén, Manuel; de Hoyos, Eduardo Aguayo; Reina-Toral, Antonio; Torres-Ruiz, Juan Miguel; Alvarez-Bueno, Miguel; Gómez Jiménez, Francisco Javier

    2004-03-01

    The paradoxical effect of smoking after acute myocardial infarction (AMI) is a phenomenon consisting of a reduction in the mortality of smokers compared to nonsmokers. However, it is not known whether the benefit of this reduction in mortality is due to smoking itself or to other covariables. Despite acceptance of the paradoxical effect of smoking in AMI, it is not known whether a similar phenomenon occurs in unstable angina. The objective of this study was to investigate the paradoxical effect of smoking in AMI and unstable angina, and to study specifically whether smoking is an independent prognostic variable. The study population was selected from the multicentric ARIAM (Análisis del Retraso en el Infarto Agudo de Miocardio [analysis of delay in AMI]) Register, a register of 29,532 patients with a diagnosis of unstable angina or AMI. Tobacco smokers were younger, presented fewer cardiovascular risk factors such as diabetes or hypertension, fewer previous infarcts, a lower Killip and Kimball class, and a lower crude and adjusted mortality in AMI (odds ratio, 0.774; 95% confidence interval, 0.660 to 0.909; p = 0.002). Smokers with unstable angina were younger, with less hypertension or diabetes. In the multivariate analysis, no statistically significant difference in mortality was found. The reduced mortality observed in smokers with AMI during their stay in the ICU cannot be explained solely by clinical covariables such as age, sex, other cardiovascular factors, Killip and Kimball class, or treatment received. Therefore, smoking may have a direct beneficial effect on reduced mortality in the AMI population. The lower mortality rates found in smokers with unstable angina are not supported by the multivariate analysis. In this case, the difference in mortality can be explained by the other covariables.

  5. Ludwig’s Angina: The Importance of Oral Cavity Examination in Patients with a Neck Mass

    Directory of Open Access Journals (Sweden)

    Mohamad I

    2012-12-01

    Full Text Available neck mass is a common condition in primary care. the most common affected area is the cervical lymph node. the neck region is also prone infection as structurally the nodes and spaces are in close contact with the upper respiratory tract and the alimentary tract. oral cavity is one of the most common route for harbouring infection. Poor oral hygeine and periapical dental problems are the main causes. thus, it is important to perform a complete oral cavity examination even when trismus is present. Besides dental caries, floor of the mouth should be inspected for oedema that may impose threat to the upper airway. We report a case of Ludwig’s angina originating from a periapical lesion of the lower molar stressing the importance of oral examination in patient with neck mass.

  6. Insulin-resistant glucose metabolism in patients with microvascular angina--syndrome X

    DEFF Research Database (Denmark)

    Vestergaard, H; Skøtt, P; Steffensen, R

    1995-01-01

    insulin-stimulated glucose disposal to peripheral tissues was lower in patients with MA (13.4 +/- 1.0 v 18.2 +/- 1.4 mg.kg fat-free mass [FFM]-1.min-1, P metabolism (8.4 +/- 0.9 v 12.5 +/- 1.3 mg.kg FFM-1.min-1, P ...Studies in patients with microvascular angina (MA) or the cardiologic syndrome X have shown a hyperinsulinemic response to an oral glucose challenge, suggesting insulin resistance and a role for increased serum insulin in coronary microvascular dysfunction. The aim of the present study...... was to examine whether patients with MA are insulin-resistant. Nine patients with MA and seven control subjects were studied. All were sedentary and glucose-tolerant. Coronary arteriography was normal in all participants, and exercise-induced coronary ischemia was demonstrated in all MA patients. A euglycemic...

  7. 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%.

  8. Utility of the Japan arteriosclerosis longitudinal study score for identifying a high risk for vasospastic angina.

    Science.gov (United States)

    Funayama, Akira; Watanabe, Tetsu; Otaki, Yoichiro; Nishiyama, Satoshi; Arimoto, Takanori; Takahashi, Hiroki; Shishido, Tetsuro; Miyamoto, Takuya; Kubota, Isao

    2015-01-01

    The aim of this study was to investigate whether the Japan Arteriosclerosis Longitudinal Study (JALS) score, which is calculated from the traditional atherosclerotic coronary risk, is associated with the incidence of coronary vasospasms. We performed vasospasm provocation tests with acetylcholine in 109 patients referred to our hospital due to suspected vasospastic angina and subsequently calculated the atherosclerotic risk score according to the JALS score. Consequently, coronary vasospasms were evoked in 51 patients. The patients were divided into three groups according to the tertile of the JALS score: 1st, 42, n=37. The third tertile exhibited the greatest risk for vasospasms. A multivariate logistic regression analysis revealed that the JALS score (odds ratio: 1.686, pJALS score can serve as a useful tool for evaluating patients with suspected coronary vasospasms.

  9. [Relations of regulatory polypeptide and syndrome differentiation of traditional Chinese medicine of angina pectoris patients].

    Science.gov (United States)

    Huang, H Y; Zhu, W F; Li, B X

    1996-08-01

    Ninety cases of angina pectoris patients with the Deficiency of Heart Qi Syndrome (DHQS), Deficiency of Heart-Yin Syndrome (DHYS) and blood stasis in Heart vessels Syndrome (BSHVS) were studied. The number of patients were 30 for each group. Their regulatory polypeptides:atrial natri-uretic polypeptide (ANP), beta-Endorphine (beta-EP), Endothelin (ET), Angiotensin (A-II) were tested. Results showed that in comparing with normal level, P BSHVS > normal group > DHYS. ET and A-II of them: DHYS > BSHVS > normal group > DHQS. And the comparison between groups revealed that P < 0.05 or < 0.01. So ANP, beta-EP, ET and A-II were the principal material basis, and they could be the specific objective parameters of the Syndrome Differentiation.

  10. Biomarkers of unstable angina pectoris and yangxin decoction intervention: An exploratory metabonomics study of blood plasma.

    Science.gov (United States)

    Yu, Xiao-Hong; Sun, Jing; Wang, Yan; Zhou, Ya-Bin

    2017-05-01

    This study aimed to explore the related metabolic biomarkers and to observe the effects of Yangxin Decoction (YXD) on plasma metabolism of patients with unstable angina (UA). In total, 10 patients with UA (intervention group) and 10 healthy participants (control group) were recruited for this study from January 2009 to December 2010. Plasma samples from both groups were analyzed using liquid chromatography mass spectrometry (LC-MS). Principle component analysis (PCA) and partial least squares (PLS) were used to explore the correlations between metabolic markers in patients with UA. The LC-MS results indicated that the serum levels of 5 potential metabolic markers, namely, ceramide, glycocholic acid, allocholic acid, lithocholic acid, and leukotriene (LT) B4, were significantly higher in the intervention group than those in the control group. The results of this study demonstrated potential metabolic markers that can be used to distinguish and diagnose patients with UA.

  11. Endothelial Dysfunction and Blood Viscosity Inpatients with Unstable Angina in Different Periods of a Solar Activity

    Science.gov (United States)

    Parshina, S. S.; Tokaeva, L. K.; Dolgova, E. M.; Afanas'yeva, T. N.; Strelnikova, O. A.

    The origin of hemorheologic and endothelial defects in patients with unstable angina (comparing with healthy persons) is determined by a solar activity period: the blood viscosity increases in a period of high solar activity in the vessels of small, medium and macro diameters, a local decompensate dysfunction of small vessels endothelium had been fixed (microcirculation area). In the period of a low solar activity there is an increase of a blood viscosity in vessels of all diameters, generalized subcompensated endothelial dysfunction is developed (on the background of the III phase blood clotting activating). In the period of a high solar activity a higher blood viscosity had been fixed, comparing with the period of a low solar activity.

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

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sanchez, Ricardo

    : Separate angiography (AG) and percutaneous coronary intervention (PCI) rather than combined procedures was associated with a significantly prolonged time to treatment, of on average 14 days, and increased costs of DKK 11,338 (95% KI 9,160;13,515). Similarly, re- referral rather than procedures being...... conducted at the centre to which the first referral was addressed was associated with significantly longer time to treatment, of on average 22 days, and increased costs of DKK 9,379 (95% KI 6,477;12,281). Conclusion: There seems to be a potential for optimizing the regimen for diagnosis and treatment...... 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....

  13. Association between ABO blood group and severity of coronary artery disease in unstable angina.

    Science.gov (United States)

    Omidi, Negar; Rafie Khorgami, Mohammad; Effatpanah, Mohammad; Khatami, Farnaz; Mashhadizadeh, Mehrpouya; Jalali, Arash; Hekmat, Hamidreza

    2017-07-01

    ABO blood groups are genetically transmitted through chromosome 9 at locus 9q34. It is supposed that there is a locus on 9p21, which has a role in developing coronary artery disease. Our study population consisted of 309 patients with unstable angina admitted to the Ziaeian Hospital, Tehran, Iran, who underwent coronary angiography. The association between types of blood group (O and non-O) with the severity of coronary artery disease was investigated. Compared to the non-O groups, the O group had more severe coronary artery involvement (P = 0.004). Our study supports recent suggestions on the association between blood group and coronary artery disease. Further studies are needed to evaluate the effect of blood group on atherosclerosis.

  14. The short-term prognostic value of thrombus precursor protein in patients with unstable angina

    International Nuclear Information System (INIS)

    Shen Yanbo; Yu Yan; Tang Jianzhong; Yuan Dingshan; Cai Danlei

    2005-01-01

    Objective: To investigate the short-term prognostic value of thrombus precursor protein (TpP) in patients with unstable angina (UA). Methods: One hundred and ten cases of UA were selected. The TpP was measured by enzyme linked immunosorbent assay (ELISA). The cardiovascular events were observed in 6 months. Results: In the 100 cases of UA, the cardiovascular events were observed in 17 cases. There was an significant difference in three levels of TpP (P<0.05). The risk level was increasing as the increasing of the plasma level of TpP. Conclusion: The level of TpP has certain reference value and plays a role in forecasting of the short-term prognosis of the patients with UA. When the plasma level of TpP increases there is also an increase in OR. (authors)

  15. Ludwig's angina: need for including airways and larynx in ultrasound evaluation.

    Science.gov (United States)

    Narendra, P L; Vishal, N S; Jenkins, Brian

    2014-11-09

    Ludwig's angina is a deep neck space infection. Unlike other abscesses elsewhere in the body, rapid progression of the disease results in serious complications such as airway oedema, distortion, total obstruction with loss of airway and death. Thus, early diagnosis and skilful airway management is necessary. For safe airway management, fibreoptic intubation or tracheostomy under local anaesthesia is recommended.1 We describe a case report where an initial attempt at fibreoptic intubation failed and subsequently bleeding ensued causing difficulty in viewing the larynx by fibreoptic bronchoscopy. Radiological investigations such as ultrasound and computer tomography (CT) are commonly ordered by surgeons and emergency physicians to know the extension of disease, but airways and larynx are seldom included. We discuss the role of ultrasound in airway assessment in such critical cases to ensure safe and uncomplicated airway access.

  16. Transient myocardial ischaemia during ambulatory monitoring out of hospital in patients with chronic stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    Transient myocardial ischaemia during daily life, detected by ambulatory electrocardiographic monitoring, was investigated in 42 patients with chronic stable angina and documented coronary artery disease. Ambulatory monitoring was initiated for 36 hours after all prophylactic antianginal medication...... monitoring was significantly lower than heart rate at the onset of ST-segment change during exercise testing (100.2 +/- 14.6 vs. 115.8 +/- 19.6 beats/min, p less than 0.01), which may indicate different pathophysiological mechanisms. Transient impairment in coronary oxygen supply seems to be of importance...... with and without symptoms was observed, the highest frequency being in the morning hours. Transient myocardial ischaemia was more frequent in patients with double or triple vessel disease, compared with single vessel disease, but with a great variation. Heart rate at the onset of ischaemia during ambulatory...

  17. 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.

  18. Danshen injection as adjuvant treatment for unstable angina pectoris: A systematic review and meta-analysis.

    Science.gov (United States)

    Wu, Jia-Rui; Liu, Shi; Zhang, Xiao-Meng; Zhang, Bing

    2017-04-01

    To systematically evaluate the clinical effectiveness and safety of Danshen Injection (, DS) as one adjuvant treatment for conventional therapy with Western medicine (WM) for unstable angina pectoris (UAP). Using literature databases, a thorough and systematic retrieval of randomized controlled trials (RCTs) comparing DS plus WM with WM was conducted from inception to April 2015. The extracted data from included studies was analyzed by Review Manager 5.2 software. The Cochrane risk of bias tool was used to assess the quality of included studies, and Begg's and Egger's tests conducted by Stata 12.0 were used to evaluate the potential presence of publication bias. A total of 17 RCTs, which involving 1,433 participants, were identified and reviewed. The meta-analysis indicated that the combined use of DS and WM was significantly superior to WM alone for UAP in terms of the total effectiveness rate of angina pectoris [risk ratio (RR) =1.23, 95% confidence interval (CI): 1.17, 1.29, P<0.01] and the total effectiveness rate of electrocardiogram (ECG) [RR=1.18, 95%CI: 1.06, 1.30, P=0.001]. Additionally, DS could also further reduce the content of fibrinogen, adjust blood lipid level, correct T wave inversion, and so on. Fifteen adverse drug reactions were reported in two studies, Four of which appeared in the experimental group. Based on the systematic review, the combined use of DS and WM was more effective than WM alone, it can be further widely used in clinic, however, there was no exact conclusion for its safety.

  19. Salvianolate injection in the treatment of unstable angina pectoris: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Dan; Wu, Jiarui; Liu, Shi; Zhang, Xiaomeng; Zhang, Bing

    2016-12-01

    To systematically evaluate the clinical efficacy and safety of Salvianolate injection in the treatment of unstable angina pectoris (UAP). Using literature databases, we conducted a thorough and systematic retrieval of randomized controlled trials (RCTs) that using Salvianolate injection for treating UAP. The Cochrane Risk of Bias Assessment Tool was used to evaluate the methodological quality of the RCTs, and then the data were extracted and meta-analyzed by RevMan5.2 software. A total of 22 RCTs with 2050 participants were included. The meta-analysis indicated that the combined use of Salvianolate injection and western medicine (WM) in the treatment of UAP can achieve a superior effect in angina pectoris total effective rate (risk ratio [RR] = 1.22, 95% confidence interval [CI] (1.17, 1.27), Z = 10.15, P < 0.00001], and the total effectiveness rate of electrocardiogram [RR = 1.26, 95% CI (1.19,1.34), Z = 7.77, P < 0.00001]. In addition, Salvianolate injection can improve the nitroglycerin withdrawal rate and the serum level of NO, decrease high-sensitivity C-reactive protein. Adverse drug reactions (ADRs) or adverse drug events (ADEs) were reported in 6 RCTs involving 15 cases; however, there were no serious ADRs/ADEs. Based on the systematic review, the combined use of Salvianolate injection and WM in the treatment of UAP can achieve a better effect; however, there was no definitive conclusion about its safety. More the large-sample and multicenter RCTs are needed to support its clinical usage.

  20. Vaspin plasma concentrations and mRNA expressions in patients with stable and unstable angina pectoris.

    Science.gov (United States)

    Li, Hai Ling; Peng, Wen Hui; Cui, Shi Tao; Lei, Hou; Wei, Yi Dong; Li, Wei Ming; Xu, Ya Wei

    2011-09-01

    Vaspin was a recently identified adipokine, playing a protective role in many metabolic diseases. The present study aimed to investigate the association between vaspin plasma level and stable angina pectoris (SAP) and unstable angina pectoris (UAP). A total of 88 patients with angiographically-proved coronary artery disease (CAD) (SAP 47, UAP 41) and 103 control subjects without cardiovascular diseases were enrolled in this study. Circulating vaspin, mRNA expression of vaspin in peripheral blood mononuclear cells (PBMC), clinical parameters, lipid profile and high-sensitivity C-reactive protein (hsCRP) were assayed. The severity of CAD was also assessed according to the number of vessels diseased. There are significant differences in circulating vaspin levels and mRNA levels of PBMC between SAP and UAP groups (SAP 0.91±0.95 ng/mL and UAP 0.43±0.38 ng/mL, p<0.01 in circulating vaspin level; SAP 1.19±0.85 and UAP 0.82±0.56, p<0.05 in mRNA level of PBMC). An inverse correlation between the number of diseased vessels and plasma vaspin concentration was observed (r=-0.350, p<0.01) in the CAD group. Construction of receiver operating characteristic curves confirmed that vaspin plasma concentrations significantly differentiated CAD patients (area under the curve=0.684, p<0.001), as well as UAP (area under the curve=0.640, p<0.05). Decreased vaspin plasma levels and mRNA levels in PBMC were observed in patients with UAP. Low vaspin concentrations correlate with CAD severity. The findings suggested that vaspin could serve as a novel biomarker of CAD as well as UAP.

  1. Economic evaluation of trimetazidine in the management of chronic stable angina in Greece.

    Science.gov (United States)

    Kourlaba, Georgia; Gourzoulidis, George; Andrikopoulos, George; Tsioufis, Konstantinos; Beletsi, Alexandra; Maniadakis, Nikos

    2016-09-27

    To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. A Markov model with 3-month cycles and 1-year time horizon was developed to assess the comparators. The analysis was conducted from a third-party payer perspective. The clinical inputs and utility values were extracted from the published literature. Resource consumption data were obtained from local experts, using a questionnaire developed for the purpose of the study and were combined with unit cost data (in €2016) obtained from official sources. Cost effectiveness was assessed by calculating the incremental cost effectiveness ratio (ICER). Probabilistic sensitivity analysis (PSA) was performed to account for uncertainty and variation in the input parameters of the model. The analysis showed that the cost of TMZ plus SoC was €1755.57 versus €1751.76 of SoC alone. In terms of health outcomes, TMZ plus SoC was associated with 0.6650 QALYs versus 0.6562 QALYs for SoC alone. The incremental analysis resulted in an ICER of €430.67 per QALY gained. PSA revealed that the probability of TMZ plus SoC being cost-effective over SoC was 89 %, at a threshold of €34,000 per QALY gained. The results indicate that TMZ as add -on treatment may be a highly cost-effective option for the symptomatic treatment of patients with chronic stable angina in Greece relative to SoC alone.

  2. Cost of illness for chronic stable angina patients enrolled in a self-management education trial

    Science.gov (United States)

    McGillion, Michael; Croxford, Ruth; Watt-Watson, Judy; LeFort, Sandra; Stevens, Bonnie; Coyte, Peter

    2008-01-01

    BACKGROUND: Chronic stable angina (CSA) is a major debilitating health problem in Canada. A paucity of relevant cardiovascular data sets has precluded a detailed examination of the impact of interventions on CSA-related costs and its broader economic burden. OBJECTIVES: As part of a larger clinical trial, the authors sought to determine the short-term impact of a standardized self-management training program on CSA-related costs. A secondary objective was to estimate the total annualized cost of CSA per patient from a societal perspective. METHODS: Pre- and three-month post-test cost data were collected on 117 participants using the Ambulatory Home Care Record. Mean annualized direct, indirect and system-related CSA costs (2003 to 2005) were estimated; total per-patient CSA costs from a societal perspective were calculated as the sum of these costs. RESULTS: The mean (± SD) age of participants was 68±11 years; 80% were male. The program did not impact costs in the short-term. Direct annual out-of-pocket costs, including money paid for health care, travel to appointments, medication, equipment and home support totaled $3,267. Indirect costs, reflecting the value of all unpaid time spent by those engaged in angina-related care, were $12,963. System costs, including costs paid by public and private insurers, were $2,979. Total estimated annual CSA costs from a societal perspective were $19,209 per patient. CONCLUSIONS: These data suggest that CSA imposes a major economic burden, comparable with other prevalent conditions such as chronic noncancer pain. Advancements in self-management training research are needed to help reduce the economic burden of CSA in Canada. PMID:18841254

  3. Manejo de la angina de pecho en el consultorio del Médico de Familia

    Directory of Open Access Journals (Sweden)

    Héctor Conde Cerdeira

    2000-12-01

    Full Text Available Se realiza una revisión sobre los aspectos clínicos de la angina de pecho haciendo énfasis en el dolor típico que se presenta con los esfuerzos y estrés, con características de ser opresivo, retroesternal, difuso, con irradiación al cuello, mandíbula, hombros y brazo izquierdo, y que se alivia con el reposo y/o la nitroglicerina. Se enuncian los resultados más relevantes del electrocardiograma, el ecocardiograma, la prueba ergométrica y se menciona la utilidad de la angiografía coronaria en estos casos. Por último se brinda la conducta a seguir desde el consultorio del Médico de Familia, referente al tratamiento general y farmacológico, empleando los nitratos, bloqueadores beta, los anticálcicos y los nuevos medicamentos utilizadosA review is made on the clinical aspect of angina pectoris, making emphasis on the typical pain that occurs on effort and stress. This pain is oppressive, retrosternal, diffuse and radiates into the neck, jaw, shoulders and left arm. It relieves by rest and/or nitroglycerine. The most significant results of the electrocardiogram, the echocardiogram and the ergometric test are shown. The usefulness of coronary angiography in these cases is also mentioned. Finally, it is explained the conduct to be followed from the family physician's office in relation to the general and pharmacological treatment by using nitrates, beta blockers, calcium antagonists and new drugs

  4. Estratificando o risco na angina instável com a ecocardiografia sob estresse com dobutamina Stratifying the risk in unstable angina with dobutamine stress echocardiography

    Directory of Open Access Journals (Sweden)

    Brivaldo Markman Filho

    2006-09-01

    Full Text Available OBJETIVO: Avaliar a importância da ecocardiografia sob estresse pela dobutamina (EED na estratificação de risco de pacientes com angina instável (AI de baixo a moderado risco, quanto à capacidade de predizer os eventos clínicos combinados (morte de causa cardiovascular, infarto agudo do miocárdio (IAM, AI recorrente, necessidade de revascularização miocárdica no seguimento de 6 meses. MÉTODOS: Estudo prospectivo, multicêntrico. Os pacientes incluídos estavam internados, assintomáticos havia 24 horas e a medicação em uso não era suspensa para a realização do exame. O EED era realizado preferencialmente até 72 horas da chegada ao hospital. RESULTADOS: Foram avaliados 95 pacientes consecutivos. O EED foi positivo para isquemia em 40 pacientes (42,1% e em 55 (57,9%, foi negativo. Eventos ocorreram em 28 pacientes, 26 dos quais tinham o EED positivo para isquemia miocárdica. Os outros 67 pacientes não tiveram eventos; desses, 53 tinham o EED negativo. A sensibilidade, especificidade, acurácia, valor preditivo positivo e negativo do teste frente aos desfechos foram: 92,9%, 79,1%, 83,2%, 65% e 96,4%, respectivamente. Sobrevida livre de eventos após 6 meses para os pacientes com EED negativo foi de 96%, comparada com 35% nos que tiveram o EED positivo (pOBJECTIVE: To evaluate the role of dobutamine stress echocardiography (DSE in the risk stratification of low to moderate risk unstable angina (UA patients, to predict the combined clinical outcome of cardiovascular death, myocardial infarction (MI, recurrent UA and the need of revascularization procedures in a 6 month period. METHODS: Multicenter prospective study. Patients should be admitted to the hospital and asymptomatic in the last 24 hours. The exam was performed up to 72 hours from the hospital admission and no medication was stopped prior to the test. RESULTS: Ninety-five consecutive patients were evaluated by DSE. Forty patients (42,1% had a positive ischemic test and

  5. A new method to quantify coronary calcification by intravascular ultrasound - the different patterns of calcification of acute myocardial infarction, unstable angina pectoris and stable angina pectoris.

    Science.gov (United States)

    Wang, Xiaofei; Lu, Chengzhi; Chen, Xin; Zhao, Xiangdong; Xia, Dasheng

    2008-11-01

    Intravascular ultrasound (IVUS) enables the identification of calcification with more details and quantification of calcification, but there is not a proper method to quantify the calcification with IVUS. Previous IVUS studies used arc or length of calcium, respectively, to quantify calcification, but calcium is determined by a combination of arc and length. We devised a new method to quantify calcium as arc area (AA) in the present study, and AA is two-dimensional and irrelevant to vessel size. We selected 201 patients with stable angina pectoris (SAP), unstable angina pectoris (UAP), or acute myocardial infarction (AMI) who underwent IVUS imaging of a de novo native atherosclerotic lesion considered to be the culprit lesion before percutaneous coronary intervention between December 2001 and December 2007. The culprit lesion site for analysis was the 10 mm-long segment including the smallest lumen cross-sectional area. The arc of each calcium deposit in each image was measured with a protractor centered on the lumen and the length of each calcium deposit was calculated with the number of images containing the calcium deposit minus 1, then multiplying 0.5 mm (the images were 0.5 mm apart). Finally, the AA was calculated by arc (degree) multiplying length (mm). The average number of calcium deposits in the culprit lesions of patients with acute myocardial infarction (AMI) was significantly larger than patients with SAP or UAP, and the number of calcium deposits of patients with SAP or UAP was almost the same (mean +/- SD, AMI 2.21 +/- 1.98, SAP 1.15 +/- 1.01, UAP 1.20 +/- 1.15, AMI versus SAP or UAP; p < 0.0005). The average AA per calcium deposit was significantly different in culprit lesions of patients with SAP and UAP or AMI, the calcium deposits were bigger in SAP than in UAP or AMI, and there were no differences between UAP and AMI (mean +/- SD, SAP 788.6 +/- 767.0 degree x mm, UAP 136.6 +/- 189.3 degree x mm, AMI 148.4 +/- 217.1 degree x mm, SAP versus UAP or

  6. LAS PERCEPCIONES DE LOS NIÑOS DE PRIMARIA ACERCA DE LAS ESPECIES CARISMATICAS Y NO CARISMATICAS

    Directory of Open Access Journals (Sweden)

    Ángela Becerra Niño

    2014-05-01

    Full Text Available Este trabajo hace parte de un proyecto más amplio llamado denominado: “Evaluación  de la popularidad de especies carismáticas y no carismáticas en niños de primaria. Contribuciones a la Educación ambiental para la biodiversidad”;  tiene  como objetivo principal contrastar el grado de popularidad de los niños de cuarto y quinto grado de primaria de instituciones rurales y urbanas, hacia grupos de animales carismáticos y no carismáticos; por ello,  en este escrito se presenta  los resultados de la prueba piloto realizada con los estudiantes de cuarto grado de primaria del colegio INEM Carlos Arturo Torres  de la ciudad de Tunja; en relación con la visión que tienen los estudiantes hacia estas especies.

  7. Las TIC y la enseñanza del inglés en el aula de Primaria

    OpenAIRE

    Santa Cruz Molinero, Patricia

    2014-01-01

    Este trabajo tiene como objetivo evaluar el uso de las Tecnologías de la Información y de la Comunicación en Educación Primaria y en concreto, en la enseñanza de una Lengua Extranjera, en un área no lingüística como es Science. De esta manera se hará una aproximación teórica sobre las teorías de la enseñanza de una lengua extranjera y del uso de las TIC en el aula de Primaria y seguidamente se hará un estudio de caso llevando a cabo una intervención en el aula. Grado en Educación Primaria...

  8. Niveles de vitamina D en mujeres posmenopáusicas con osteoporosis primaria

    Directory of Open Access Journals (Sweden)

    Wendy Sotelo

    2011-01-01

    Full Text Available La osteoporosis es un problema de salud pública a nivel mundial, particularmente en mujeres posmenopáusicas, jugando la deficiencia de vitamina D un importante rol en su génesis. Objetivo: Determinar los niveles de Vitamina D en mujeres posmenopáusicas con osteoporosis primaria. Material y métodos: Estudio descriptivo tipo serie de casos. Se incluyeron 40 mujeres posmenopáusicas con diagnóstico de osteoporosis primaria; se excluyeron las que habían recibido suplemento de calcio o vitamina D, terapia para osteoporosis o tenían alguna causa de osteoporosis secundaria. A todas las mujeres incluidas se les determinó el nivel sérico de 25 OH vitamina D. Resultados: La edad promedio fue 65,9 ± 10,22 años, y el promedio del Score T L1-L4 fue -2,82 ± 0,71, Score T en Cadera Total -1,59 ±1,05 y el Score T en radio 33% -3,10 ± 0,97 en la densitometría ósea. El nivel de vitamina D sérico fue 13,98 ± 5,95 ng/ml; 87,5% (35 pacientes tuvieron niveles de vitamina D deficientes, 7,5% (3 pacientes tenían niveles insuficientes y sólo 2 pacientes tuvieron niveles normales de vitamina D. Conclusión: La mayoría de mujeres posmenopáusicas con osteoporosis primaria tuvieron niveles de vitamina D en rangos de deficiencia e insuficiencia. Podría ser necesario dar suplementos de calcio y vitamina D a todas las pacientes posmenopáusicas con osteoporosis.(Rev Med Hered 2011; 22;10-14.

  9. Actitudes de docentes mujeres de nivel primaria con respecto a rasgos femeninos en alumnos varones

    OpenAIRE

    Jorge Armando Revilla Fajardo

    2008-01-01

    La presente investigación tuvo como propósito detectar la actitud de las docentes mujeres de escuela primaria acerca de la presencia de rasgos femeninos en alumnos varones. Se llevaron a cabo entrevistas con tres docentes mujeres de escuelas públicas de nivel primario. En el análisis de los resultados se ponen de relieve dos conclusiones básicas: las prácticas sociales como constituyentes de las expectativas individuales de cada docente y la presencia constante de procesos de evaluación soci...

  10. Juegos y materiales para construir las matemáticas en Educación Primaria

    OpenAIRE

    Alonso Muñoz, Paloma

    2013-01-01

    En este trabajo mostramos la importancia de trabajar con materiales didácticos en Educación Primaria, para facilitar el proceso de enseñanza- aprendizaje. En particular, destacamos el uso del juego como herramienta didáctica, imprescindible para llevar a cabo una metodología con tendencia constructivista con la idea de que sean los alumnos los que “hagan matemáticas”. Se presentan una batería de juegos, organizados de forma estructurada, dando una breve descripción del material...

  11. Stop-motion para la alfabetización digital en Educación Primaria

    Directory of Open Access Journals (Sweden)

    2017-04-01

    Full Text Available A pesar de que la alfabetización digital en medios se reconoce como una de las competencias esenciales necesarias para vivir en una nueva era de los medios de comunicación, solo acaba de empezar a ganar atención en la educación primaria de Taiwán. Una de las razones es la educación orientada a los exámenes, y como consecuencia, el que se desvíe muy pocos recursos para este aprendizaje informal. La otra razón es que los educadores tienden a pensar en la educación en medios digitales como una serie de operaciones puramente técnicas, lo que podría llevar a los estudiantes de medios digitales a aprender a trabajar sin sentido. Por lo tanto, este estudio diseñó una exhibición de contenidos basada en el modelo de aprendizaje experiencial de Kolb con el fin de enseñar a los estudiantes conceptos de videos stop-motion y técnicas de producción cinematográfica. El experimento diseñado involucró a 247 estudiantes de tercer grado de primaria que fueron agrupados para visitar la exposición experiencial. Los hallazgos sugieren una mejora en los estudiantes de su conocimiento de videos stop-motion. El análisis de los vídeos producidos también muestra que han mejorado su capacidad mediática para representar sus ideas y comunicarse con los demás. A través del análisis de la influencia de la demografía en la prueba de conocimiento, los hallazgos revelan que la exposición experiencial es más efectiva para los estudiantes de primaria femeninos, y que las experiencias anteriores relevantes de los estudiantes no deberían afectar a los conocimientos adquiridos. Teniendo en cuenta estos resultados y observaciones, creemos que la exposición experimental propuesta es una forma prometedora de llevar a cabo la educación en alfabetización digital en las escuelas primarias.

  12. El acoso escolar en Educación Primaria en la provincia de Huelva

    OpenAIRE

    Ávila Fernández, José Antonio

    2013-01-01

    El resumen que a continuación se presenta, es el reflejo del trabajo de tesis doctoral realizado bajo el título «El Acoso Escolar en Educación Primaria en la Provincia de Huelva». En los últimos años ha existido una preocupación social en relación al tema de la violencia escolar, reconociéndose como un problema común. Los medios de comunicación se han ocupado de difundir situaciones límites relacionadas con e! comportamiento de escolares; a nivel internacional se ha afrontado la investigac...

  13. Escalas de evaluación de riesgo suicida en atención primaria

    Directory of Open Access Journals (Sweden)

    Claudia Ximena Rangel Garzón

    2015-10-01

    Conclusiones. Estas escalas se pueden usar como instrumento de ayuda para definir una conducta en un paciente con riesgo suicida, pero no reemplazan la entrevista psiquiátrica. Se postulan las escalas Modified Scale for Suicide Ideation y Plutchik Suicide Risk Scale por cumplir con las características psicométricas, por tener un tiempo de aplicación adecuado en el servicio de urgencias y por sus preguntas sencillas para ser utilizadas en atención primaria.

  14. Promoviendo la dieta mediterránea en Educación Primaria

    OpenAIRE

    Benavente Florido, Estefanía

    2015-01-01

    Este trabajo fin de grado trata de ofrecer una propuesta didáctica que permita acercar al alumnado de Educación Primaria al conocimiento de la dieta mediterránea y los beneficios de ésta. Es crucial que el alumnado reflexione sobre su propia alimentación y los beneficios que supone adoptar la dieta mediterránea. Su propia concienciación y aprendizaje en torno a la dieta mediterránea, le permitirá explicar a alumnado de otros cursos de Ed...

  15. Diagnóstico molecular y genético de inmunodeficiencias primarias ligadas al X

    OpenAIRE

    Martínez Martínez, Laura

    2012-01-01

    Descripció del recurs: el 01 setembre 2012 Las Inmunodeficiencias Primarias (IDPs) son enfermedades congénitas del sistema inmune que tienen en común una susceptibilidad incrementada a las infecciones. Se han descrito más de 200 entidades englobadas bajo esta definición. Algunas de ellas tienen una herencia ligada al X, lo que les confiere ciertas peculiaridades. En esta Tesis presentamos los resultados concernientes a 28 pacientes, casi todos varones, con sospecha de IDP en base a una ele...

  16. Factores influyentes en las preferencias musicales de los alumnos de Educación Primaria

    OpenAIRE

    Benhamu Henche, Tamar

    2017-01-01

    En el presente trabajo se van a abordar los factores principales que influyen en las preferencias musicales de los jóvenes, con el fin de lograr establecer un nexo entre las experiencias musicales de su contexto sociocultural y el repertorio sonoro que se imparte en la asignatura de música en los colegios. Para ello se realizó un estudio de tipo descriptivo en Sevilla capital administrando un cuestionario a alumnos de cinco colegios pertenecientes al último ciclo de Educación Primaria. Se pla...

  17. La formación matemática del profesorado de primaria

    OpenAIRE

    Blanco, Lorenzo

    2001-01-01

    En los últimos años se han producido importantes cambios en el sistema educativo español que han llevado parejo modificaciones en la formación inicial de los profesores de primaria. Este trabajo analiza algunos dilemas tradicionales en la formación del profesorado, así como la influencia que los sucesivos planes de estudio han tenido en las asignaturas relacionadas con la educación matemática, donde se constata una reiterada pérdida de horas lectivas. Al compás de este análisis se realizan al...

  18. TRANSFERENCIA DE INTELIGENCIAS MÚLTIPLES EN ALUMNOS CON AUTISMO DE EDUCACIÓN PRIMARIA

    OpenAIRE

    Plágaro-Martos, Miriam

    2015-01-01

    El presente estudio de investigación está basado en la Teoría de la Inteligencias Múltiples, descrita por Howard Gardner en 1983. Así como en el concepto de inteligencia emocional, acuñado por Daniel Goleman en 1995. Estudiamos el nivel de desarrollo en cada inteligencia múltiple, en alumnos diagnosticados con Trastorno de Espectro Autista, autismo. Componiéndose la muestra de estudio por 30 alumnos con dicho diagnóstico, escolarizados en la etapa educativa de educación primaria. Para el desa...

  19. Desigualdades en las escuelas primarias de la ciudad de Rosario: presencia de inmigrantes

    OpenAIRE

    Segura, María Laura; Pozzo, María Isabel

    2015-01-01

    El presente trabajo forma parte de mi Tesis de Licenciatura en Ciencias de la Educación por la U.N.R. titulada “Inclusión cultural de niños migrantes y descendientes en escuelas primarias de la ciudad de Rosario”, dirigida por la Dra. María Isabel Pozzo. La investigación fue llevada a cabo durante el período de los años 2009- 2012. Al iniciar la investigación, surgieron los siguientes interrogantes: ¿cómo resulta la inserción de los alumnos migrantes en las instituciones educativas?; ¿existen...

  20. Las plantas en los libros de Conocimiento del Medio de 2o ciclo de primaria

    OpenAIRE

    Carmen Urones; Beatriz Escobar; José Manuel Vacas

    2013-01-01

    Se describen y analizan los resultados de un estudio sobre las plantas en los libros de texto de Conocimiento del Medio de tercer y cuarto curso de educación primaria (escolares de 8-10 años). Concretamente: ¿qué deben conocer los niños sobre las plantas?; ¿qué características generales siguen los libros en el planteamiento del tema?; ¿cómo es el tratamiento de los contenidos de conceptos, procedimientos y actitudes sobre plantas?; y ¿cuáles son los objetivos de las actividades de aprendizaje...

  1. Las plantas en los libros de Conocimiento del Medio de 2º ciclo de primaria

    OpenAIRE

    Urones, Carmen; Escobar, Beatriz; Vacas, José Manuel

    2013-01-01

    Se describen y analizan los resultados de un estudio sobre las plantas en los libros de texto de Conocimiento del Medio de tercer y cuarto curso de educación primaria (escolares de 8-10 años). Concretamente: ¿qué deben conocer los niños sobre las plantas?; ¿qué características generales siguen los libros en el planteamiento del tema?; ¿cómo es el tratamiento de los contenidos de conceptos, procedimientos y actitudes sobre plantas?; y ¿cuáles son los objetivos de las actividades de...

  2. La teoría del desarrollo cognitivo de Piaget aplicada en la clase de Primaria

    OpenAIRE

    Castilla Pérez, María Francisca

    2014-01-01

    El presente trabajo Fin de Grado se encuentra destinado a realizar un estudio de la Teoría del desarrollo cognitivo de Jean Piaget, cuyo entendimiento es fundamental tanto para comprender al niño de hoy como para educar al adulto del mañana. Esta teoría se pondrá en práctica a través de la propuesta de un proyecto de trabajo en el aula, donde se recomendarán actividades fundamentadas en el constructivismo de Piaget para trabajar con un grupo de alumnos de segundo de educación primaria. Basánd...

  3. TRASTORNOS DE LA CONDUCTA ALIMENTARIA EN MUJERES EMBARAZADAS CONTROLADAS EN ATENCIÓN PRIMARIA

    OpenAIRE

    Behar A,Rosa; González A,Javier; Ariza P,Mario; Aguirre S,Andrea

    2008-01-01

    Antecedentes: En relación al impacto de los trastornos de la conducta alimentaria (TCA) sobre el embarazo, la mayoría de la evidencia advierte sobre consecuencias negativas prenatales y postnatales para la madre y el feto. Objetivo: Determinar la presencia de comportamientos alimentarios anormales en gestantes controladas en atención primaria, y analizar descriptiva y comparativamente las pacientes con estas actitudes en relación con variables maternas, del embarazo, rasgos psicológicos y con...

  4. La educación emocional en tercer ciclo de Educación Primaria

    OpenAIRE

    Navarrete-Urgell, Mónica

    2015-01-01

    Este trabajo pretende diseñar una propuesta de intervención para mejorar las competencias emocionales de los alumnos de Tercer Ciclo de Educación Primaria. Su objetivo es dar una visión de los beneficios de la educación emocional en el desarrollo de la personalidad integral de los alumnos. Se realiza una explicación teórica de los conceptos para trabajar la educación emocional, tales como conciencia emocional, regulación emocional, autonomía emocional, competencia social y competencia para...

  5. Alumnos con Bajo Rendimiento Escolar, los blogs y el tutor de Primaria

    OpenAIRE

    Rico-Sánchez, Jesús David

    2013-01-01

    Teniendo en cuenta el problema que tiene el sistema educativo español con un índice muy elevado de fracaso escolar, se pretendió investigar concretamente sobre los alumnos del sexto curso de Primaria que presentan Bajo Rendimiento Escolar aprovechando los avances tecnológicos existentes en la actualidad y que han penetrado con gran fuerza en la sociedad. Por ello, el problema planteado en este trabajo es estudiar si el potencial motivador, comunicativo y utilitario del Edublog puede ayudar a ...

  6. Programa de entrenamiento en habilidades sociales con alumnos de educación primaria

    OpenAIRE

    Mohamed, L.; Mohamed, N.; Seijo, D.

    2005-01-01

    En esta comunicación nos centramos en el entrenamiento de las habilidades sociales, así como su enseñanza y aprendizaje. En este trabajo se presentan las diferentes sesiones diseñadas para entrenar este tipo de habilidades llevadas a la práctica con niños de educación primaria de dos centros educativos de la Ciudad Autónoma de Melilla. Gracias a las características de la población intercultural de esta ciudad, nos interesa conocer los efectos de este entrenamiento en función del origen cultur...

  7. La competencia comunicativa en segundo curso de Educación Primaria

    OpenAIRE

    Seco Alberdi, Beatriz

    2017-01-01

    El presente Trabajo de Fin de Grado tiene como propósito mejorar la competencia comunicativa, oral y escrita, en las aulas. Para ello, he planificado y diseñado actividades que sirven de recurso para 2.º curso de Educación Primaria, de acuerdo con los «cuentos» de Geronimo Stilton y los contenidos establecidos en la LOMCE. La base teórica en la que se apoyan las actividades es la competencia comunicativa, oral y escrita, en sus competencias específicas básicas: lingüística, sociolingüística, ...

  8. Equidad en la educación preescolar, primaria, secundaria y media en el Distrito Capital

    Directory of Open Access Journals (Sweden)

    Torres Núñez Viviana Luz

    2008-12-01

    Full Text Available El presente trabajo identifica la población que asiste a la educación pública en los niveles de preescolar, primaria, secundaria y media en Bogotá desde dos perspectivas: la geográfica, que contrasta los porcentajes de pobreza por localidad frente a la asistencia a la educación pública y privada; y la perspectiva individual, que estima los criterios de equidad horizontal y vertical sobre la población entre 5 y 17 años con ingreso per cápita estimado.

  9. EQUIDAD EN LA EDUCACIÓN PREESCOLAR, PRIMARIA, SECUNDARIA Y MEDIA EN EL DITRITO CAPITAL

    Directory of Open Access Journals (Sweden)

    Viviana Luz Torres Núñez

    2008-12-01

    Full Text Available El presente trabajo identifica la población que asiste a la educación pública en los niveles de preescolar, primaria, secundaria y media en Bogotá desde dos perspectivas: la geográfica, que contrasta los porcentajes de pobreza por localidad frente a la asistencia a la educación pública y privada; y la perspectiva individual, que estima los criterios de equidad horizontal y vertical sobre la población entre 5 y 17 años con ingreso per cápita estimado.

  10. Lenguajes del Poder- Lenguajes de los maestros Innovadores de Básica Primaria

    OpenAIRE

    Zúñiga Osorio, Claudia Patricia

    2013-01-01

    Este articulo pretende hacer una reflexión en torno a los lenguajes del poder de los maestros innovadores de básica primaria, específicamente de algunas sedes de la Institución Educativa Normal Superior Farallones de Cali el cual parte de la necesidad de explorar por aquellos lenguajes empleados por los maestros que no se rinden y que dejan todo en el aula de clase para brindar a sus estudiantes una educación de calidad pero más humana, sin desconocer que deben ir a la par con todos los avanc...

  11. Escribir ciencia: un desafío que comienza en la escuela primaria

    OpenAIRE

    Carina Rudolph; Carla Inés Maturano; María Amalia Soliveres; Cinthia Perinez

    2016-01-01

    Este estudio considera que el docente de ciencias debería ser mediador en la adquisición de habilidades de lectura y escritura en el área de Ciencias Naturales. Esto implica hacer transitar progresivamente a los estudiantes en los géneros específicos de las disciplinas, comenzando desde la escuela primaria. Este artículo propone el abordaje del género relato de procedimiento con el objeto de favorecer el aprendizaje de contenidos científicos mediante la escritura del procedimiento seguido en ...

  12. Propuestas de mejora de trabajo en casos de absentismo escolar en educaci??n primaria

    OpenAIRE

    Coronel Garrido, Raquel; D??az Garc??a, Melody; Moreno Leal, Patricia

    2013-01-01

    Partiendo del concepto de absentismo escolar, de la normativa existente y de las responsabilidades que ata??en a la familia y a los poderes p??blicos, se describen las caracter??sticas personales y sociales de ni??os absentistas. Adem??s se har?? un abordaje de la tipolog??a m??s actual en la que se clasifica el absentismo y sus posibles causas, expuestas por diferentes autores. Derivado de esto, se proponen diferentes actuaciones para combatir el absentismo escolar en primaria, ya que este, ...

  13. Factores asociados a tuberculosis multidrogorresistente primaria en pacientes de Callao, Perú

    Directory of Open Access Journals (Sweden)

    Ana Cecilia Avalos-Rodríguez

    2014-07-01

    Full Text Available Introducción: En el Perú, Lima y Callao constituyen regiones con riesgo alto de transmisión activa de tuberculosis. La tuberculosis multidrogorresistente se presenta en el 5,54% de los casos nuevos de tuberculosis pulmonar (TB MDR primaria en Lima y Callao. Sus factores de riesgo no han sido estudiados en pacientes del Callao. Objetivos: Determinar los factores de riesgo para TB MDR primaria en pacientes atendidos en centros de salud de Callao, durante los años 2009- 2010. Diseño: Estudio caso control. Lugar: Centros de Salud de Callao. Participantes: Participaron 29 pacientes con TB MDR primaria y 37 con tuberculosis sensible, según los registros del Programa de Control de Tuberculosis y las historias clínicas ubicadas en los centros de salud. Intervenciones: Toda la información fue obtenida de fuentes secundarias. En el análisis bivariado se calculó el OR de cada covariable. Para el cálculo de los OR multivariados se utilizó modelos de regresión logística. Principales medidas de resultados: Factores de riesgo para TB MDR. Resultados: En el análisis bivariado, el haber tenido contacto con pacientes TB MDR o XDR fue un factor de riesgo significativo (OR: 5,56; IC95%: 1,05 a 29,27; lo mismo se demostró en el análisis multivariado (OR: 14,56; IC95%: 1,52 a 139,54. Además, en el análisis multivariado, la variable edad ≥ 40 años mostró ser un factor protector significativo (OR: 0,94; IC95%: 0,90 a 0,99. Conclusiones: El tener contacto con pacientes TB MDR/XDR fue factor de riesgo y una edad menor a 40 años un factor protector para contraer TB MDR primaria en los pacientes del Callao estudiados.

  14. Creciendo emocionalmente. Desarrollo de las competencias socioemocionales en el 1r Ciclo de Primaria

    OpenAIRE

    Olmedo-Fernández, Eva

    2013-01-01

    Este trabajo propone una propuesta de intervención para mejorar las competencias socioemocionales de los alumnos de Primer Ciclo de Educación Primaria. Su objetivo es aportar una visión general de los beneficios de la educación emocional en el desarrollo de la personalidad del alumnado. Se inicia con un breve repaso de aspectos teóricos clave en esta materia, definiendo conceptos tales como emoción, inteligencia emocional, educación emocional y habilidades sociales. A continuación, se inci...

  15. MANIFESTACIONES DE LA VIOLENCIA PERVERSA EN ESCUELAS PRIMARIAS DEL NORESTE DE MÉXICO

    OpenAIRE

    Jesús Acevedo Alemán; José González Tovar

    2015-01-01

    El objetivo de este estudio fue identificar la estructura de las prácticas de la llamada “violen-cia perversa” en 54 escuelas primarias del noreste de México, particularmente de la ciudad deSaltillo, Coahuila. La muestra intencional estuvo compuesta por 529 niños con edades de 5 a13 años. El instrumento utilizado fue la Cédula de Percepciones de las Dinámicas Escolares,el cual está integrado por 78 reactivos, de los cuales se generaron inicialmente dos factores:impresiones de un mundo pervers...

  16. El campesinado gallego y su rechazo a la escuela primaria (1868-1874

    Directory of Open Access Journals (Sweden)

    Mercedes SUÁREZ PAZOS

    2010-03-01

    Full Text Available RESUMEN: Con la nueva política de descentralización educativa, nacida al amparo de la «revolución» de septiembre de 1868, los Ayuntamientos y las Juntas locales de Instrucción Primaria fueron responsables directos de numerosas supresiones de escuelas en el ámbito rural gallego y de los graves problemas que se ocasionaban en el pago de las dotaciones escolares: supresiones, reducciones y atrasos, a pesar de que tales modificaciones no se podían llevar a cabo sin la aprobación de la respectiva Diputación provincial.

  17. Capital social y políticas de Atención Primaria de la Salud

    OpenAIRE

    Ernesto Pablo BÁSCOLO; Natalia YAVICH

    2016-01-01

    El objetivo de este trabajo es analizar la influencia de la configuración del capital social de las políticas de atención primaria de la salud (APS) sobre las condiciones de acceso a los servicios de salud. Se llevó a cabo un estudio de casos múltiples (Cochabamba-Bolivia, Rosario y Vicente López-Argentina) retrospectivo (1990-2008). El concepto de capital social fue entendido como el resultado de la relación entre Estado y sociedad. En Rosario se lograron mejoras sustantivas en las condi...

  18. Los efectos del aprendizaje cooperativo en la inclusión en sexto de Primaria

    OpenAIRE

    Ortiz Villanueva, Naiara

    2013-01-01

    En el presente trabajo se busca demostrar la relación entre dos aspectos claves en la educación hoy: la inclusión y los grupos cooperativos. Se parte de una descripción teórica de ambos conceptos, así como de los puntos que los enlazan, para seguir con un estudio empírico llevado a cabo en un centro de Pamplona, San Jorge, en el que se toma como muestra el alumnado de 6º de Educación Primaria, así como el profesorado que lo atiende. Se realiza un estudio comparativo entre alumnos que trabajan...

  19. INTELIGENCIA MUSICAL, RENDIMIENTO ESCOLAR Y DESARROLLO INTEGRAL EN EDUCACIÓN PRIMARIA

    OpenAIRE

    de la Villa-Santotomás, Lorena

    2014-01-01

    Con esta investigación se pretende diseñar un programa de intervención para mejorar la inteligencia musical y la discriminación auditiva, potenciando el rendimiento escolar y el resto de inteligencias. En primer lugar, se utilizó una muestra de 30 alumnos de segundo de Primaria. Se analizó el nivel de desempeño de las distintas inteligencias a través del Cuestionario de Inteligencias Múltiples (Armstrong, 2001). En segundo lugar, se evaluó el nivel de discriminación auditiva co...

  20. ESTADO, COMUNIDADES LOCALES Y ESCUELAS PRIMARIAS EN EL DEPARTAMENTO DE LIMA, PERÚ (1821 - 1905)

    OpenAIRE

    Espinoza,G. Antonio

    2011-01-01

    Este artículo demuestra que desde la Independencia hasta principios del siglo XX, las élites regionales, provinciales y distritales de Lima utilizaron el creciente aparato educativo como un medio para conseguir y mantener la hegemonía política, para lo cual el clientelismo fue un mecanismo clave. Muchas de las deficiencias supuestas o reales de la educación primaria estuvieron directamente vinculadas a la búsqueda de poder político y de recursos materiales.

  1. Prevención primaria del ictus : abordaje desde una perspectiva enfermera

    OpenAIRE

    Méndez González, Beatriz

    2015-01-01

    Introducción En la actualidad, el ictus es una de las prioridades de nuestro sistema sanitario debido al aumento de la incidencia, la prevalencia y la discapacidad en relación con el progresivo envejecimiento de la población española. Para disminuir los casos de ictus, la prevención primaria de esta enfermedad es fundamental con el fin de evitar los casos de muerte prematura y discapacidad así como el incremento en el gasto sanitario como consecuencia del desencadenamiento de este tipo ...

  2. Profilaxis primaria para tromboembolismo venoso en pacientes ambulatorios con cáncer sometidos a quimioterapia

    Directory of Open Access Journals (Sweden)

    2013-07-01

    Conclusiones de los autores: La tromboprofilaxis primaria con HBPM redujo significativamente la incidencia del TEV sintomático en los pacientes ambulatorios con cáncer tratados con quimioterapia. Sin embargo, la ausencia de poder estadístico obstaculiza la posibilidad de establecer conclusiones definitivas sobre los efectos en cuanto a los resultados principales de seguridad, lo cual obliga a la realización de estudios adicionales para determinar el cociente riesgos/beneficios de la HBPM en este contexto.

  3. Tuberculosis primaria de la glándula suprarrenal: comunicación de dos casos

    OpenAIRE

    Coras, Natalia; Somocurcio, José; Aguilar, Cristian

    2013-01-01

    En muchas áreas del mundo, la tuberculosis tiene gran prevalencia y sigue siendo la principal causa de insuficiencia suprarrenal. Clínicamente, esta enfermedad permanece sin sintomatología durante sus primeros estadios, debido a que la pérdida de la función adrenal suele ser progresiva; los síntomas tienen aparición gradual e insidiosa, en su mayoría inespecíficos. Presentamos el caso de dos mujeres con cuadro clínico de insuficiencia adrenal primaria crónica, con afección bilateral de ambas ...

  4. Competencias desde la perspectiva intercultural para el ompetencias grado de educación primaria

    Directory of Open Access Journals (Sweden)

    Fernando GONZÁLEZ ALONSO

    2005-01-01

    matemáticos, el pensamiento científico, el trabajo en equipo, los cambios sociales, la producción creativa y estética, son algunas de las más importantes en las áreas de lengua, matemáticas, ciencias, geografía e historia y educación artística. La idea es capacitar al profesorado para que pueda ayuda a alcanzar a los alumnos los objetivos de cada una de las áreas de Educación Primaria desde la diversidad intercultural.

  5. La realidad aumentada en el aula de educación primaria

    OpenAIRE

    Marín-Díaz, Verónica; Sampedro Requena, Begoña; Muñoz González, Juan Manuel

    2017-01-01

    En el presente trabajo planteamos la valoración, por parte de los futuros docentes, de la realidad aumentada como recurso didáctico dentro de la Educación Primaria. La investigación la abordamos desde una metodología cuantitativa, a través del uso de un cuestionario creado ad hoc y conformado por 32 ítem que hacen referencia a determinados aspectos educativos (inclusividad, necesidades educativas especiales, procesos de e-a…). Se ha trabajado con una muestra de carácter inci...

  6. Introducción de los Chromebooks en la Educación Primaria

    OpenAIRE

    Romero-Aliaga, Javier

    2014-01-01

    Con la realización del presente trabajo se pretende analizar el impacto de la introducción de los Chromebooks en las aulas de 5º y 6º de Primaria, como parte de un proyecto pionero en España. Ante el cambio metodológico en la educación y el asentamiento de las TIC, se investigan los beneficios que los Chromebooks pudieran aportar tanto a los alumnos como a los maestros que los utilizan. Tras varios meses desde su implantación se recopilan datos gracias a la observación, a entrevistas informal...

  7. Angina on the Palm: randomized controlled pilot trial of Palm PDA software for referrals for cardiac testing.

    Science.gov (United States)

    Greiver, Michelle; Drummond, Neil; White, David; Weshler, Jason; Moineddin, Rahim

    2005-03-01

    Personal digital assistants (PDAs) are popular with physicians: in 2003, 33% of Canadian doctors reported using them in their practices. We do not know, however, whether using a PDA changes the behaviour of practising physicians. We studied the effectiveness of a PDA software application to help family physicians diagnose angina among patients with chest pain. Prospective randomized controlled pilot trial using a cluster design. Primary care practices in the Toronto area. Eighteen family physicians belonging to the North Toronto Primary Care Research Network (Nortren) or recruited from a local hospital. We randomized physicians to receive a Palm PDA (which included the angina diagnosis software) or to continue conventional care. Physicians prospectively recorded the process of care for patients aged 30 to 75 presenting with suspected angina, over 7 months. Did the process of care for patients with suspected angina improve when their physicians had PDAs and software? The primary outcomes we looked at were frequency of cardiac stress test orders for suspected angina, and the appropriateness of referral for cardiac stress testing at presentation and for nuclear cardiology testing after cardiac stress testing. Secondary outcome was referrals to cardiologists. The software led to more overall use of cardiac stress testing (81% vs 50%). The absolute increase was 31% (P = .007, 95% confidence interval [CI] 8% to 58%). There was a trend toward more appropriate use of stress testing (48.6% with the PDA vs 28.6% control), an increase of 20% (P = .284, 95% CI -11.54% to 51.4%). There was also a trend toward more appropriate use of nuclear cardiology following cardiac stress testing (63.0% vs 45.5%), an absolute increase of 17.5% (P =.400, 95% CI -13.9% to 48.9%). Referrals to cardiologists did not increase (38.2% with the PDA vs 40.9%, P =.869). A PDA-based software application can lead to improved care for patients with suspected angina seen in family practices; this finding

  8. Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective.

    Science.gov (United States)

    Coleman, Craig I; Freemantle, Nick; Kohn, Christine G

    2015-11-06

    To estimate the cost-effectiveness of ranolazine when added to standard-of-care (SoC) antianginals compared with SoC alone in patients with stable coronary disease experiencing ≥3 attacks/week. An economic model utilising a UK health system perspective, a 1-month cycle-length and a 1-year time horizon. Patients with stable coronary disease experiencing ≥3 attacks/week starting in 1 of 4 angina frequency health states based on Seattle Angina Questionnaire Angina Frequency (SAQAF) scores (100=no; 61-99=monthly; 31-60=weekly; 0-30=daily angina). Ranolazine added to SoC or SoC alone. Patients were allowed to transition between SAQAF states (first cycle only) or death (any cycle) based on probabilities derived from the randomised, controlled Efficacy of Ranolazine in Chronic Angina trial and other studies. Patients not responding to ranolazine in month 1 (not improving ≥1 SAQAF health state) discontinued ranolazine and were assumed to behave like SoC patients. Costs (£2014) and quality-adjusted life-years (QALYs) for patients receiving and not receiving ranolazine. Ranolazine patients lived a mean of 0.701 QALYs at a cost of £5208. Those not receiving ranolazine lived 0.662 QALYs at a cost of £5318. The addition of ranolazine to SoC was therefore a dominant economic strategy. The incremental cost-effectiveness ratio was sensitive to ranolazine cost; exceeding £20,000/QALY when ranolazine's cost was >£203/month. Ranolazine remained a dominant strategy when indirect costs were included and mortality rates were assumed to increase with worsening severity of SAQAF health states. Monte Carlo simulation found ranolazine to be a dominant strategy in ∼71% of 10,000 iterations. Although UK-specific data on ranolazine's efficacy and safety are lacking, our analysis suggest ranolazine added to SoC in patients with weekly or daily angina is likely cost-effective from a UK health system perspective. Published by the BMJ Publishing Group Limited. For permission to use

  9. El juego como recurso de enseñanza de la Educación Músical en la Escuela Primaria

    OpenAIRE

    Warncke Monsalve, Natalia

    2017-01-01

    A través de la Educación Musical en la etapa de Educación Primaria el alumnado desarrolla todos los ámbitos del ser humano: físico, social, cognitivo y emocional. Como maestros de música, podemos usar diversos métodos y numerosos recursos, como los juegos, no solo para conseguir el aprendizaje de los contenidos recogidos en el currículum sino para lograr su educación integral. En este trabajo, realizamos una propuesta, destinada para 4º de Educación Primaria, que recoge la e...

  10. Mujeres participando y construyendo: participación social en salud en atención primaria

    OpenAIRE

    Carrillo Franco, Janeth

    2013-01-01

    OBJETIVO: Describir las dinámicas culturales de la participación social en salud, identificadas en un grupo de mujeres de un territorio de Atención Primaria en Salud en Bogotá. METODOLOGÍA :La investigación cualitativa con historia oral fue desarrollada con un grupo de seis mujeres líderes comunitarias del territorio de Atención Primaria de San Luis, Bogotá, entre septiembre de 2010 y diciembre de 2011. Fueron analizadas de forma inductiva e interpretativa. Emergió un tema cultural y dos...

  11. La relevancia de la autoestima en Educaci??n F??sica y la Educaci??n Primaria

    OpenAIRE

    Morilla Portela, Ignacio

    2015-01-01

    El siguiente trabajo es una revisi??n bibliogr??fica de la autoestima centrada en una de las etapas m??s influyentes para la configuraci??n de la misma, la Educaci??n Primaria. El objetivo del documento no es otro que el de indagar acerca de la relevancia de la autoestima en la Educaci??n Primaria as?? como en el ??rea de Educaci??n F??sica. Con tal prop??sito, se analizan tanto el concepto actual de la autoestima como los curr??culums oficiales, a raz??n de dilucidar la trascendencia que le ...

  12. Conocimientos, actitudes y prácticas sobre el dengue en las escuelas primarias de Tapachula, Chiapas, México

    OpenAIRE

    José Luis Torres; José Genaro Ordóñez; M. Guadalupe Vázquez-Martínez

    2014-01-01

    OBJETIVO: Identificar los conocimientos, actitudes y prácticas sobre el dengue en alumnos de escuelas primarias de Tapachula, Chiapas, México, antes y después de una intervención educativa. MÉTODOS: El estudio se desarrolló en 19 escuelas primarias públicas seleccionadas al azar. Se aplicaron encuestas de conocimientos, actitudes y prácticas antes y después de una estrategia educativa a alumnos de 5º y 6º grado de nivel primario. La estrategia educativa se denominó "Escuelas sin mosquitos" e ...

  13. Uso de las TIC en estudiantes de quinto y sexto grado de educación primaria

    OpenAIRE

    Marisol Villegas Pérez; Sonia Verónica Mortis Losoya; Ramona Imelda García López; Elizabeth del Hierro Parra

    2017-01-01

    El propósito de este estudio es identificar la percepción de los alumnos de quinto y sexto de educación primaria, en escuelas públicas, sobre sus competencias en el uso de las tecnologías de la información y la comunicación (TIC) e indagar si existen diferencias en cuanto al sexo y a tener computadora y acceso a internet en casa. La metodología fue cuantitativa no experimental transeccional y la muestra se conformó de 201 estudiantes de escuelas primarias públicas: 51.6% corresponde a alumnos...

  14. Estudio de las dificultades de comprensión lectora en alumnado de educación primaria

    OpenAIRE

    Martínez Oliveira, Zaida

    2014-01-01

    Traballo de Fin de Grao en Mestre ou Mestra de Educación Primaria. Curso 2013-2014 [ES]El trabajo de investigación presentado analiza, en profundidad, las dificultades de comprensión lectora en el alumnado de Educación Primaria. Se trata de un trabajo de investigación documental en el que se presenta la definición del término, los tipos de comprensión lectora, su etiología, es decir, sus causas o factores que influyen en las dificultades de comprensión lectora, los instrumentos o recursos ...

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

    OpenAIRE

    Niazi, Gamal Eldine M.; Elia, Remon Z.

    2015-01-01

    Objective: To evaluate the different patterns of coronary artery disease among patients with unstable angina by the role of multislice CT coronary angiography. Patients and methods: From September 2013 to May 2014, 40 patients complaining from unstable angina showing initial negative ECG and troponin enzyme underwent a multi-slice CT coronary angiography. Each patient underwent a non-contrast scan to determine the calcium score, then a contrast enhanced ECG gated scan, then the obtained ax...

  16. Validation and comparison of EuroQoL-5 dimension (EQ-5D) and Short Form-6 dimension (SF-6D) among stable angina patients

    OpenAIRE

    Wu, Jing; Han, Yuerong; Zhao, Fei-Li; Zhou, Jin; Chen, Zhijun; Sun, He

    2014-01-01

    Objectives Several preference-based health-related quality of life (HRQoL) instruments have been published and widely used in different populations. However no consensus has emerged regarding the most appropriate instrument in therapeutic area of stable angina. This study compared and validated the psychometric properties of two generic preference-based instruments, the EQ-5D and SF-6D, among Chinese stable angina patients. Methods Convergent validity of the EQ-5D and SF-6D was examined with ...

  17. Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease: The iPOWER Study.

    Science.gov (United States)

    Flintholm Raft, Kristoffer; Frestad, Daria; Michelsen, Marie Mide; Suhrs, Hannah Elena; Rask, Anna Bay; Nilsson, Malin; Hermann, Thomas Steffen; Prescott, Eva

    2017-01-01

    We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD). Patients (n = 194) were randomly selected women with angina pectoris and no obstructive CAD (<50% stenosis). A reference population of asymptomatic women without CAD (n = 25) was included. We measured FMD in the brachial artery by high-resolution ultrasound. Coronary flow velocity reserve (CFVR) was assessed by transthoracic Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR <2. FMD and CFVR were measured in 128 patients and 21 controls. Mean (SD) age was 64.5 (8.9) years, mean CFVR was 2.3 (2.0-2.7), and mean FMD was 8.4% (4.8%) in angina patients. Angina patients had a higher risk factor burden compared with the reference population. Measures of peripheral endothelial dysfunction and endothelial plasma biomarkers did not differ according to angina or CFVR. CFVR and FMD did not correlate (Spearman ρ = -0.07, p = 0.45). FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD. © 2017 S. Karger AG, Basel.

  18. Eversion Subclavian Endarterectomy and Transposition for Coronary-Subclavian Steal Syndrome in a Patient with Refractory Angina Pectoris.

    Science.gov (United States)

    Hinojosa, Carlos A; Anaya-Ayala, Javier E; Laparra-Escareno, Hugo; Guerrero-Hernandez, Manuel; Galindo-Uribe, Jaime

    2016-01-01

    Late onset of angina pectoris associated with subclavian artery (SA) atherosclerotic occlusive disease is a rare and recognized cause of myocardial ischemia when the lesion is proximal to a left internal mammary artery (LIMA) to coronary bypass. The symptoms typically exacerbate by increasing the flow demand in the extremity; this phenomenon is known as late coronary-subclavian steal syndrome. We describe the case of a 66-year-old woman who underwent coronary artery bypass grafting from the LIMA to the left anterior descending coronary artery in 2000. Years later, she experienced refractory angina pectoris associated to an occlusive lesion in the proximal left SA. SA endarterectomy with eversion technique and subclavian-carotid transposition restored the antegrade flow with resolution of the symptomatology. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Percutaneous Device to Narrow the Coronary Sinus: Shifting Paradigm in the Treatment of Refractory Angina? A Review of the Literature.

    Science.gov (United States)

    Benedetto, Daniela; Abawi, Masieh; Stella, Pieter R; Nijhoff, Freek; Lakemeier, Maxime D M; Kortlandt, Friso; Doevendans, Pieter A; Agostoni, Pierfrancesco

    2016-01-01

    Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and/or revascularization (percutaneous or surgical). In addition, the presence of myocardial ischemia as a cause of the symptoms must have been documented. The coronary sinus reducer (CSR) is a recently introduced percutaneous device to treat patients with severe anginal symptoms refractory to optimal medical therapy and not amenable to conventional revascularization. The purpose of this review is to describe the current evidence from available studies measuring the clinical effect of the CSR implantation on the health and well-being of patients with refractory angina.

  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. 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.

  2. [Application of ″Fu Yang and activating blood circulation″ in treatment of unstable angina pectoris patients].

    Science.gov (United States)

    Gao, Jia-Liang; Li, Jun; Wang, Jie

    2016-02-01

    Coronary heart disease(CHD) has become a major public health problem in the world, while the unstable angina (UA) is one of an important type. Hypofunction of yang qi in chest and cardiac blood stasis has been considered as the basic pathogenesis of UA.According to the deficiency of yang and blood stasis run through the process of CHD, fu yang and activating blood circulation could be main treatment. Wenxin decoction which has the function of fu yang and activating blood circulation, not only can effectively improve the symptoms of angina pectoris, the ischemic ECG, but also can significantly improve blood rheology, blood lipids and so on. So deepening the theory of ″fu yang and activating blood circulation″ and the application of ″Wenxin decoction″ in the treatment of UA would have an important clinical value for improving the therapeutic efficacy of CHD. Copyright© by the Chinese Pharmaceutical Association.

  3. Monocyte to HDL ratio in prediction of BMS restenosis in subjects with stable and unstable angina pectoris.

    Science.gov (United States)

    Tok, Derya; Turak, Osman; Yayla, Çağrı; Ozcan, Fırat; Tok, Duran; Çağlı, Kumral

    2016-08-01

    This study aims to assess the predictive role of the preprocedural circulating monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) on the occurrence of stent restenosis (SR) in patients with stable and unstable angina pectoris undergoing successful bare-metal stenting (BMS). Between February 2008 and June 2014, a total of 831 patients with stable and unstable angina pectoris who underwent successful BMS were retrospectively analyzed. Demographic and clinical characteristics of the patients were recorded. Left ventricular ejection fraction and laboratory data were also noted. In the receiver operating characteristics curve analysis, MHR >14 had 71% sensitivity and 69% specificity in predicting SR. Our study results show that preprocedural MHR is an independent predictor of SR in this patient population.

  4. Coronary microvascular function and myocardial fibrosis in women with angina pectoris and no obstructive coronary artery disease

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Even in absence of obstructive coronary artery disease women with angina pectoris have a poor prognosis possibly due to coronary microvascular disease. Coronary microvascular disease can be assessed by transthoracic Doppler echocardiography measuring coronary flow velocity reserve (CFVR......) and by positron emission tomography measuring myocardial blood flow reserve (MBFR). Diffuse myocardial fibrosis can be assessed by cardiovascular magnetic resonance (CMR) T1 mapping. We hypothesized that coronary microvascular disease is associated with diffuse myocardial fibrosis. METHODS: Women with angina...... using a modified Look-Locker pulse sequence measuring T1 and extracellular volume fraction (ECV). RESULTS: CFVR and CMR were performed in 64 women, mean (SD) age 62.5 (8.3) years. MBFR was performed in a subgroup of 54 (84 %) of these women. Mean native T1 was 1023 (86) and ECV (%) was 33.7 (3.5); none...

  5. N-acetylcysteine modifies the acute effects of isosorbide-5-mononitrate in angina pectoris patients evaluated by exercise testing

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Klarlund, K; Aldershvile, J

    1989-01-01

    significant coronary artery disease were included. All patients received a baseline therapy with beta blockers. None of the patients had developed nitrate tolerance at inclusion. NAC/5-ISMN treatment significantly prolonged the total exercise time as compared with placebo/5-ISMN (7.7 +/- 2.1 min vs. 6.8 +/- 1......, given together with a single oral dose of the long-acting nitrate, isosorbide-5-mononitrate (5-ISMN, 60 mg), would modify the nitrate effect evaluated by exercise testing before and after additional sublingual doses of nitroglycerin (NTG). Ten patients with angina pectoris and angiographically proven.......7 min, p less than 0.05). This increase was of such magnitude that no further effect was obtained after additional NTG doses. This study demonstrated that increased availability of sulfhydryl groups can increase the exercise capacity in angina pectoris patients treated with 5-ISMN without nitrate...

  6. Las plantas en los libros de Conocimiento del Medio de 2o ciclo de primaria

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    Carmen Urones

    2013-01-01

    Full Text Available Se describen y analizan los resultados de un estudio sobre las plantas en los libros de texto de Conocimiento del Medio de tercer y cuarto curso de educación primaria (escolares de 8-10 años. Concretamente: ¿qué deben conocer los niños sobre las plantas?; ¿qué características generales siguen los libros en el planteamiento del tema?; ¿cómo es el tratamiento de los contenidos de conceptos, procedimientos y actitudes sobre plantas?; y ¿cuáles son los objetivos de las actividades de aprendizaje que presentan? Los resultados mostraron que las plantas son muy importantes en la educación primaria; sin embargo, los libros examinados no enseñan a los escolares a analizar la realidad vegetal, y muy poco a aplicar los conocimientos en su vida cotidiana; y presentan algunos conceptos confusos (por ej., nutrición, alimentación, respiración y reproducción sexual. Este estudio proporciona indicadores que pueden ayudar a los docentes para analizar y discutir la adecuación de los libros de texto al currículum vigente.

  7. materiales educativos de enseñanza primaria: atavismos y horizontes

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    Ileana Schmidt Díaz de León

    2003-01-01

    Full Text Available Los materiales educativos han sido considerados por los investigadores medios de socialización, especialmente los libros de texto de educación primaria. Este trabajo analiza, desde una perspectiva de género, los papeles sociales y la estructura de poder de la sociedad mexicana enseñada a los niños mexicanos a través de materiales educativos. Éstos incluyen manuales para el maestro y libros de texto gratuitos de primero y segundo grados de educación primaria escritos en español y en lengua náhuatl para la Huasteca y la Sierra Norte de Puebla, así como algunos de los libros usados como complementarios para estos grados en las escuelas privadas. De los libros de texto gratuitos en español, se han analizado y comparado los editados antes del Programa para la Modernización Educativa (1989-1994 y los elaborados y publicados a partir de 1992 como producto del mismo programa. Debido a que el contenido básico de los libros de primero y segundo grados son el individuo y la familia, se prefirió analizar fundamentalmente éstos, aunque en algunas ocasiones se incluyen materiales de otros grados para apoyar los argumentos presentados.

  8. TIC y desarrollo profesional del profesorado. El caso de un centro de primaria

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    María Dolores FERNÁNDEZ TILVE

    2007-01-01

    Full Text Available Este trabajo se inscribe dentro un proyecto de investigación más amplio, que tiene como propósito analizar la introducción de las Tecnologías de la Información y la Comunicación (TIC en los centros educativos de primaria y secundaria de Galicia, y su incidencia en el desarrollo profesional de los profesores y los cambios organizativos que ello ocasiona. Específicamente, se centra en uno de los tres estudios de caso realizados en la fase cualitativa de la investigación. Un estudio de caso producto del análisis de observaciones participantes realizadas en un centro de primaria, de entrevistas formales e informales (algunas en profundidad a informantes clave y del análisis de diferentes documentos institucionales, diarios y notas de campo. En este artículo nos centramos fundamentalmente en el análisis de la dimensión profesional.

  9. Aspectos éticos en Pediatría, las inmunodeficiencias primarias

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    Martha Leonor Paradoa Pérez

    2012-12-01

    Full Text Available Las inmunodeficiencias primarias son enfermedades genéticas, caracterizadas por infecciones crónicas devastadoras que conllevan a la muerte, al desarrollo de tumores y a enfermedades autoinmunes, y la mayoría de estas enfermedades cursan en la edad pediátrica. Desde la última década del pasado siglo, el desarrollo de la tecnología, el surgimiento del Proyecto del Genoma Humano y la profundización en los aspectos bioéticos, han dado lugar a especificidades en la atención médica e investigativa del paciente pediátrico y del que desarrolla una enfermedad inmunológica. Este trabajo recoge los aspectos bioéticos más importantes y los dilemas éticos con los que se enfrenta el inmunólogo pediátrico en la atención al paciente con inmunodeficiencia primaria, el cual demanda la atención de, prácticamente, todas las especialidades pediátricas.

  10. [Duration of the editorial process of the Atención Primaria journal].

    Science.gov (United States)

    Jiménez Villa, J

    1999-05-01

    To quantify how long the different steps in the process of editing the manuscripts received by the journal Atención Primaria took. Retrospective, descriptive study. The journal Atención Primaria. Manuscripts submitted for publication in the sections Original articles, Short articles and Letters to the Editor between January 1 and June 30 1997 (6 months). Retrospectively, information was collected on the dates of receipt, of sending out to referees, receipt of their views and comments, sending back to the authors, receipt of their modified text or reply, of final decision on acceptance or rejection, and of publication if accepted. Of the 132 original and short articles received, 22 (16.7%) were awaiting a final decision. Of the remaining 110, 53 (48.2%) had been rejected and 57 (51.8%) accepted. The length of each step in the editorial process was less than 30 days for half the manuscripts. The time elapsed from receipt to editorial decision was less than 45 days in half the cases and 60 days on average. The time from acceptance to publication was 137 days on average. How long each step in the editorial process took can be considered acceptable, although the wide variability in the times taken by authors to modify their manuscripts is striking. Mechanisms must be sought to avoid the excessive delay in the publication of research, by increasing the speed of the referees' reviews and of authors' modifications.

  11. Paquidermoperiostosis (osteoartropatía hipertrófica primaria Pachydermoperiostosis (primary hypertrophic osteoarthropathy

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    Javier A. Cavallasca

    2006-04-01

    Full Text Available La paquidermoperiostosis u osteoartropatía hipertrófica primaria es una rara enfermedad caracterizada por compromiso cutáneo y osteoarticular. Comunicamos dos casos que presentaban hipocratismo digital, uñas en vidrio de reloj, agrandamiento óseo, tumefacción articular y diferentes grados de afectación cutánea, sin otros hallazgos clínicos relevantes. Ambos desconocían antecedentes familiares similares. El estudio radiográfico de las zonas comprometidas mostró periostosis. Con resultados de laboratorio y radiografía de tórax normales, y ausencia de evidencia clínica de otra enfermedad subyacente, se realizó diagnóstico de osteoartropatía hipertrófica primaria.Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare disease characterized by cutaneous and osteo-arthicular involvement. We describe two patients with finger clubbing, watch crystal nails, bones thickenings, arthritis and different grades of skin affection, without other clinical manifestations. Both did not know of having relatives with the same alterations. Radiological studies of the affected areas showed periostosis. Because of normal laboratory results and chest radiography plus the absence of other underlying causes, diagnosis of primary hypertrophic osteoarthropathy was made.

  12. Las representaciones sociales sobre Derechos Humanos en niños de primaria

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    Germán Flores Martínez

    2015-08-01

    Full Text Available La presente investigación tuvo como objetivo principal la exploración y descripción de las representaciones sociales que los niños de educación primaria de quinto grado manifiestan sobre los Derechos Humanos. El estudio, realizado desde un enfoque cualitativo, se llevó a cabo en la Escuela Primaria Rural Emiliano Zapata, de la comunidad de Xochiteotla, Chiutempan, Tlaxcala (México. La población del estudio está conformada por 26 alumnos entre los 11 y 12 años. Los resultados obtenidos demuestran que los niños tienen una visión de los Derechos Humanos construida desde su contexto, y materializada en personas que cumplen con una función social. También los derechos humanos se materializan en objetos y en situaciones de su realidad; tanto en su lenguaje, como en su representación gráfica.

  13. Validación de un modelo pronóstico para pacientes pluripatológicos en atención primaria: Estudio PROFUND en atención primaria

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    Pilar Bohórquez Colombo

    2014-06-01

    Conclusiones: el índice PROFUND mantiene una buena calibración reagrupado a tres estratos de riesgo, así como una buena precisión en el pronóstico a los dos años para poblaciones de pacientes pluripatológicos de atención primaria.

  14. Successful intestinal ischemia treatment by percutaneus transluminal angioplasty of visceral arteries in a patient with abdominal angina

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    Nenezić Dragoslav

    2011-01-01

    Full Text Available Introduction. Abdominal angina, also known as chronic mesenteric ischemia or intestinal angina, is a rare disease caused by intestinal flow reduction due to stenosis or occlusion of mesenteric arteries. A case of successful treatment of a patient with abdominal angina by percutaneous transuliminal angioplasty of high-grade superior mesenteric artery and coeliac trunk stenosis was presented. Case Outline. A 77-year-old male patient was admitted at our Clinic for severe postprandial abdominal pains followed by frequent diarrhoeas. Extensive gastrointestinal investigations were performed and all results were normal. Multislice computerized (MSCT arteriography was indicated which revealed ostial celiac trunk and superior mesenteric artery subocclusion. Percutaneous transluminal angioplasty of the superior mesenteric artery and coeliac trunk was done with two stents implantation. Just a few hours following the intervention, after food ingestion, there were no abdominal pains. Six months later, the patient described a significant feeling of relief after food ingestion and no arduousness at all. Conclusion. High-grade visceral arteries stenoses in patients with intestinal ischemia symptoms can be treated by either surgical procedures or percutaneus transluminal angioplasty. In cases when a low operative risk is anticipated, surgical treatment is recommended due to a better anatomical outcome, while percutaneus angioplasty is advised to elderly patients in whom increased operative risks can be expected.

  15. Blood rheology of angina pectoris patients with myocardial injury after ischemia reperfusion and its effect on thromboxane B2levels.

    Science.gov (United States)

    Wang, Wenlong; Huang, Xiaohui; Sun, Yiyong; Zhang, Jinying

    2018-01-01

    This study investigated the changes in the blood rheology of patients with angina pectoris and ischemia reperfusion injury and their effect on thromboxane B 2 (TXB 2 ) levels to examine their relationship. Forty patients with unstable angina pectoris who underwent elective percutaneous coronary intervention (PCI) were selected for the unstable angina group (UA group) and forty patients deemed free of coronary heart disease by coronary angiography were selected for the control group. Venous blood samples were drawn from all participants; patients in the UA group had blood drawn 1 day before and 1 day after the PCI procedure. Blood samples were used to analyze blood rheology and examine hemodynamic parameters, at the same time radioimmunoassay was applied to measure the concentrations of serum endothelin-1 (ET-1) and TXB 2 , and an automatic biochemical analyzer was used to detect the content of superoxide dismutase (SOD) and malondialdehyde (MDA). Our results showed the patients in the UA group all presented hyperviscosity; however the levels were higher for the patients in the UA group (after surgery) than for those in the UA group (before surgery). Patients in the control group exhibited normal levels, and the differences among groups were significant in pairwise comparisons (Pangina pectoris and ischemia reperfusion injury. The higher than normal TXB 2 levels can be used as a marker of platelet activation and a reference for clinical risk stratification, thus having great significance for the prevention and treatment of ischemia reperfusion injury and assessment of disease progression.

  16. Screening of plasma biomarkers in patients with unstable angina pectoris with proteomics analysis

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    Shui-wang HU

    2017-08-01

    Full Text Available Objective To analyze and compare the differentially expressed plasma proteins between patients with stable angina pectoris (SAP and unstable angina pectoris (UAP, and search for the biomarkers that maybe used for early diagnosis of UAP. Methods Sixty plasma samples were collected respectively from normal controls group (N group, SAP group and UAP group during Jun. 2014 to Apr. 2015 from the Third Affiliated Hospital of Southern Medical University. Ten samples (100μl of each group were selected randomly to pool into 3 groups severally. After removing high-abundance proteins from plasma, two- dimensional difference gel electrophoresis (DIGE was used to isolate the total proteins, and then the protein spots with more than 2-fold changes between UAP and SAP were picked up after the differential software analysis. Afterward, the varied proteins were identified by matrix assisted laser desorption ionization-time of flight/time of flight (MALDI-TOF/TOF mass spectrometry (MS. Finally, 40 plasma samples were collected respectively from N, SAP and UAP group, and the UAP specific differential proteins were selected to be verified by ELISA. Results A total of 10 varied protein spots with more than 2-fold changes in UAP and SAP were found including 9 up-regulated proteins and 1 down-regulated one. MS identification indicated that the up-regulated proteins included fibrinogen gamma chain (FGG, complement C4-B (C4B, immunoglobulin (Ig kappa chain C region (IGKC and hemoglobin subunit alpha (HBA1, whereas the down-regulated one was haptoglobin (HP. After comparing the varied proteins with that in N group, 2 specifically UAP-related proteins, IGKC and HP, were detected totally. IGKC was selected to validate by ELISA, and the corresponding results showed that IGKC was increased specifically in UAP plasma (P<0.05 when compared with N and SAP group, which was consistent with DIGE. Conclusion IGKC and HP have been detected as specifically related proteins to UAP

  17. Evaluation of the systemic micro- and macrovasculature in stable angina: A case-control study.

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    Ulf Neisius

    Full Text Available The diagnosis of stable angina involves the use of probability estimates based on clinical presentation, age, gender and cardiovascular risk factors. In view of the link between the cardiac and systemic vasculature we tested whether non-invasive measures of systemic micro- and macrovascular structure and function differentiate between individuals with flow-limiting coronary artery disease (CAD and those with normal coronary arteries (NCA.We recruited 84 patients undergoing elective coronary angiography for investigation of symptoms of stable angina. Patients were selected for either having significant CAD or NCA (n = 43/41; age, 56±7 vs 57±7 years, P = 0.309. Only microvascular endothelial function, measured using the Endo-PAT2000 device to determine reactive hyperaemia index (CAD vs. NCA; 1.9 [1.5; 2.3] vs. 2.1 [1.8; 2.4], P = 0.03 and sonographic carotid plaque score (CAD vs. NCA; 3.0 [1.5; 4.5] vs. 1.2 [0; 2.55], P<0.001 were significantly different between patients with CAD and NCA. No significant differences were detected in reflection magnitude (CAD vs. NCA; 1.7 [1.5; 1.8] % vs 1.7 [1.5; 1.9] %, P = 0.342, pulse wave velocity (CAD vs. NCA; 7.8±1.4 m/sec vs. 8.3±1.5 m/sec, P = 0.186, carotid intima-media thickness (CAD vs. NCA; 0.73±0.10 mm vs. 0.75±0.10 mm, P = 0.518 or carotid distensibility (CAD vs. NCA; 3.8±1.2 10-3/kPa vs. 3.4±0.9 10-3/kPa, P = 0.092. Also, the c-statistic of the pre-test probability based on history and traditional risk factors (c = 0.665; 95% CI, 0.540-0.789 was improved by the addition of the inverse RHI (c = 0.720; 95% CI, 0.605-0.836, carotid plaque score (c = 0.770, 95% CI, 0.659-0.881, and of both markers in combination (c = 0.801; 95% CI, 0.701-0.900.There are distinct differences in the systemic vasculature between patients with CAD and NCA that may have the potential to guide diagnostic and therapeutic decisions. Carotid artery plaque burden and microvascular function appear to be most promising in

  18. Paciente con deficiencia de adhesión leucocitaria tipo 1 y doble falla primaria de injerto

    OpenAIRE

    Alberto Olaya-Vargas; Lilia Vollbrechausen-Castelán; Celso Tomás Corcuera-Delgado; Selma Scheffler-Mendoza

    2015-01-01

    Niño de 4 años de edad con diagnóstico de deficiencia de adhesión leucocitaria tipo 1, postrasplantado de células progenitoras hematopoyéticas en tres ocasiones, las dos primeras con falla primaria de injerto.

  19. Paciente con deficiencia de adhesión leucocitaria tipo 1 y doble falla primaria de injerto

    Directory of Open Access Journals (Sweden)

    Alberto Olaya-Vargas

    2015-11-01

    Full Text Available Niño de 4 años de edad con diagnóstico de deficiencia de adhesión leucocitaria tipo 1, postrasplantado de células progenitoras hematopoyéticas en tres ocasiones, las dos primeras con falla primaria de injerto.

  20. Estudio del bullying en el ciclo superior de primaria = Study about bullying in the upper cycle of primary education.

    OpenAIRE

    Ruíz, Rosario; Riuró, María; Tesouro, Montse

    2015-01-01

    Nuestra investigación trata el fenómeno del bullying en el ciclo superior de primaria. Para llevarla a cabo, hemos elaborado un cuestionario ad hoc a partir de una revisión bibliográfica de diferentes investigaciones en las que se han utilizado varios

  1. 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

  2. Assessment of economic effectiveness in treatment of neuropathic pain and refractory angina pectoris using spinal cord stimulation.

    Science.gov (United States)

    Harat, Aleksandra; Sokal, Paweł; Zieliński, Piotr; Harat, Marek; Rusicka, Teresa; Herbowski, Leszek

    2012-01-01

    The implementation of new diagnostic and therapeutic technologies is related to expanding financial needs. The escalation of expenses for health protection and simultaneous economic problems has resulted in an interest in the subject of economic assessment. Decision makers in the health sector should have reasonable tools that will allow them to make complex evaluations of the economic suitability of health technologies. Economic analysis should also prove that launching new procedures can save money. Numerous studies indicate that chronic pain and psycho-sociological variables lead to a worse quality of life. Chronic pain issues are a major public health problem, by virtue of the difficulties in efficient therapy and the social costs reflected in incapability of work and disability. Spinal cord stimulation is the most efficacious procedure in the treatment of chronic pain. The aim of the study was to estimate the costs of treatment of 37 patients suffering from refractory angina pectoris and neuropathic pain who underwent SCS surgery between 2002 and 2008 in the Neurosurgery Clinic of the 10th Military Hospital in Bydgoszcz in the period of two years before and two years after spinal cord stimulation. The authors also assessed quality of life, using the SF 36 questionnaire, and degree of pain using VAS. The issue was examined with a cost-benefit analysis. Cost was understood as the expenses made two years before and two years after the SCS procedure. The benefits were health care expenses saved by implementation of the SCS procedure. All the costs included in both alternative treatment techniques in a period of 5 years underwent a discounting procedure. The authors also included the price of the neurostimulator under a sensitivity analysis. To assess the quality of life before and after the SCS procedure, a SF 36 questionnaire was used, and to assess the level of pain before and after the SCS procedure, the VAS scale. The costs of treatment of refractory angina

  3. Estado de salud en el adulto mayor en atención primaria a partir de una valoración geriátrica integral

    OpenAIRE

    Roxana Gisela Cervantes Becerra; Enrique Villarreal Ríos; Liliana Galicia Rodríguez; Emma Rosa Vargas Daza; Lidia Martínez González

    2015-01-01

    Objetivo: Determinar el estado de salud en el adulto mayor con 60 o más años de edad en atención primaria a partir de una valoración geriátrica integral. Diseño: Estudio transversal descriptivo. Emplazamiento: Cinco unidades de atención primaria, Instituto Mexicano del Seguro Social; México. Participantes: Adultos mayores con 60 o más años que acuden a la consulta de atención primaria. Previo consentimiento informado, con criterios de eliminación, pacientes que no completaran la valo...

  4. Recursos de internet y su aplicación en la enseñanza de la Geometría en Primaria

    OpenAIRE

    Lobo de Frutos, Francisco Javier

    2015-01-01

    En este documento se analiza el currículum LOMCE de Matemáticas en lo referente al estudio de la geometría en Primaria. Se aportan los fundamentos psicopedagógicos que aconsejan la utilización de los múltiples recursos que ofrece Internet para la enseñanza de la geometría en Primaria. Se describe la realidad en lo relativo al uso de las TIC en los centros docentes de Primaria en España para la enseñanza de la geometría. Asimismo, se detallan las dificultades que encuentran los docentes par...

  5. Hemodynamic effects of metoprolol and nifedipine in angina pectoris measured by isotope technique

    Energy Technology Data Exchange (ETDEWEB)

    Bostroem, P.A.

    1988-01-01

    In order to evaluate the therapeutic effects of metoprolol, nifedipine, and their combination, 11 patients with secondary angina pectoris and with thallium tomographic findings indicating coronary artery disease were studied before and after these three treatment regimes in a single-blind cross-over study. The therapeutic effect was measured by standardized working test and isotope angiocardiography, which enabled evaluation of left ventricular ejection fraction, stroke volume, and phase analysis of left ventricular contraction. Treatment with metoprolol and combination therapy increased work performance. Ejection fraction did not differentiate the treatment regimes, whereas stroke volume was significantly lower at work and heart rate higher at rest and at work during nifedipine treatment compared to either metoprolol or combination treatment (p less than 0.05). Cardiac output was significantly reduced during nifedipine and metoprolol treatment during work (p less than 0.05). Phase improved after all therapeutic regimes, but reached significance only during the metoprolol treatment period at rest (p less than 0.05).

  6. The relation between angina and myocardial ischemia during exercise stress in coronary artery disease

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa

    1988-01-01

    To examine the mechanism of occurrence of anginal chest pain from the aspect of myocardial ischemia, myocardial Tl-201 SPECT scans were obtained immediately and 3 hr after exercise (Ex) in 35 patients with coronary artery disease (CAD). The extent of ischemia was defined as the percentage of ischemic segments to the entire left ventricle. The minimum washout (WO) rate correlated well with the ratio of Tl uptake in the ischemic area to that in the normal area during Ex in the other 9 patients having single vessel CAD without previous history of myocardial infarction. This suggested that the miminum WO rate reflects the severity of Ex-induced ischemia. According to the development of angina during Ex, patients were classified as having either symptomatic ischemia (n = 16) or silent ischemia (n = 19). In regard to age, sex, a history of myocardial infarction, severity of CAD, and the extent of Ex-induced ischemia, there was no difference between the two groups. The minimum WO rate and the incidence of Ex-induced ST depression were significantly lower and higher, respectively, in the group with symptomatic ischemia than that with silent ischemia. The severity of Ex-induced ischemia has important implications for the development of anginal chest pain. (Namekawa, K.)

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

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    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.

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

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    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.

  9. ST depression and left ventricular haemodynamics during exercise in patients with angina pectoris.

    Science.gov (United States)

    Carlens, P; Holmgren, A; Jonasson, R; Landou, C; Orinius, E

    1983-01-01

    The mechanism of ischaemic ST depression and the cause of its low sensitivity to coronary artery stenosis are not well understood. Of 30 patients with severe stable effort angina, 19 (63%) showed ischaemic ST depressions after exercise (the STAE group) and 11 did not. The highest load during the symptom-limited exercise test and the heart rate on that load did not differ between the two groups. The clinical characteristics and angiographic findings were also similar, but the findings at heart catheterization differed during exercise (in supine). Although the load was similar, the stroke index was significantly lower (38 vs. 53 ml/m2 BSA) and the left ventricular end-diastolic pressure rose to a significantly higher value in the STAE group (40 vs. 32 mmHg). When STAE occurred, they were exclusively or concomitantly present in chest lead 5. These findings suggest that ischaemic STAE may not reflect regional ischaemia but the consequent left ventricular dysfunction. The mechanism may, for example, be that a sufficiently elevated left ventricular diastolic pressure causes a global subendocardial ischaemia.

  10. Optimizing Prescription of Chinese Herbal Medicine for Unstable Angina Based on Partially Observable Markov Decision Process

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    Yan Feng

    2013-01-01

    Full Text Available Objective. Initial optimized prescription of Chinese herb medicine for unstable angina (UA. Methods. Based on partially observable Markov decision process model (POMDP, we choose hospitalized patients of 3 syndrome elements, such as qi deficiency, blood stasis, and turbid phlegm for the data mining, analysis, and objective evaluation of the diagnosis and treatment of UA at a deep level in order to optimize the prescription of Chinese herb medicine for UA. Results. The recommended treatment options of UA for qi deficiency, blood stasis, and phlegm syndrome patients were as follows: Milkvetch Root + Tangshen + Indian Bread + Largehead Atractylodes Rhizome (ADR=0.96630; Danshen Root + Chinese Angelica + Safflower + Red Peony Root + Szechwan Lovage Rhizome Orange Fruit (ADR=0.76; Snakegourd Fruit + Longstamen Onion Bulb + Pinellia Tuber + Dried Tangerine peel + Largehead Atractylodes Rhizome + Platycodon Root (ADR=0.658568. Conclusion. This study initially optimized prescriptions for UA based on POMDP, which can be used as a reference for further development of UA prescription in Chinese herb medicine.

  11. [Optimized treatment program for unstable angina by integrative medicine based on partially observable Markov decision process].

    Science.gov (United States)

    Feng, Yan; Xu, Hao; Liu, Kai; Zhou, Xue-Zhong; Chen, Ke-Ji

    2013-07-01

    To initially optimize comprehensive treatment program for treating and preventing unstable angina (UA) by integrative medicine (IM). Based on partially observable Markov decision process model (POMDP), we chose 3 syndrome elements, i.e., qi deficiency, blood stasis, and phlegm turbidity from UA inpatients. The efficacy of treating UA by IM was objectively assessed by in-depth data mining and analyses. The treatment programs for UA patients of qi deficiency syndrome, blood stasis syndrome, and phlegm turbidity syndrome were recommended as follows: nitrates +statins +clopidogrel +angiotensin II receptor blockers +heparins +Astragalus membranaceus +Condonopsis + poria and large-head atractylodes rhizome (ADR = 0.85077869); nitrates + aspirin + clopidogrel + statins + heparins + Astragalus membranaceus + safflower + peach seed + red peony root (ADR = 0.70773000); nitrates + aspirin + statins + angiotensin-converting inhibitors + snakegourd fruit + onion bulb + ternate pinellia + tangerine peel (ADR = 0.72509600). As a POMDP based optimized treatment programs for UA, it can be used as a reference for further standardization and formulation of UA program by integrative medicine.

  12. Relationship of coronary collateral circulation with eosinophils in patients with unstable angina pectoris.

    Science.gov (United States)

    Wang, Jun; Li, Qun; Li, Shi-jing; Wang, De-zhao; Chen, Bu-xing

    2016-01-01

    Eosinophils (EOS) have been associated with prognosis of patients with coronary artery disease, and those who showed plenitudinous coronary collateral circulation (CCC) often have good clinical consequences. However, the relationship between EOS and CCC was seldom reported. To investigate the relationship between EOS and CCC development in patients with unstable angina pectoris (UAP). The study population consisted of 502 consecutive patients with UAP who underwent coronary angiography and coronary stenosis ≥80%. CCC was graded according to the Rentrop grading system of 0-3. Rentrop grades of 0 and 1 indicated low-grade CCC group, whereas grades 2 and 3 indicated high-grade CCC group. The EOS was significantly higher in the high-grade CCC group compared with the low-grade CCC group. In multiple logistic regression analysis, EOS (odds ratio: 1.969; 95% confidence interval [CI]: 1.210-3.3205; P=0.006) and neutrophil count (odds ratio: 0.757; 95% CI: 0.584-0.981; P=0.035) were predictors of high-grade CCC development. EOS of >0.12×10(9)/L could independently predict high-grade CCC with 72.5% sensitivity and 58.4% specificity (area under the curve: 0.681; 95% CI: 0.632-0.729). EOS were associated with high-grade CCC in patients with UAP with coronary stenosis ≥80%. Increased EOS count may play an important role in the development of CCC in patients with UAP.

  13. Analysis of urinary metabolomic profiling for unstable angina pectoris disease based on nuclear magnetic resonance spectroscopy.

    Science.gov (United States)

    Li, Zhongfeng; Liu, Xinfeng; Wang, Juan; Gao, Jian; Guo, Shuzhen; Gao, Kuo; Man, Hongxue; Wang, Yingfeng; Chen, Jianxin; Wang, Wei

    2015-12-01

    (1)H NMR-based urinary metabolic profiling is used for investigating the unstable angina pectoris (UAP) metabolic signatures, in order to find out candidate biomarkers to facilitate medical diagnosis. In this work, 27 urine samples from UAP patients and 20 healthy controls were used. The metabolic profiles of the samples were analyzed by multivariate statistics analysis, including PCA, PLS-DA and OPLS-DA. The PCA analysis exhibited slight separation with R(2)X of 0.681 and Q2 of 0.251, while the PLS-DA (R(2)X = 0.121, R(2)Y = 0.931, and Q(2) = 0.661) and the OPLS-DA (R(2)X = 0.121, R(2)Y = 0.931, Q(2) = 0.653) demonstrated that the model showed good performance. By OPLS-DA, 20 metabolites were identified. A diagnostic model was further constructed using the receiver-operator characteristic (ROC) curves (AUC = 0.953), which exhibited a satisfying sensitivity of 92.6%, specificity of 90% and accuracy of 89.1%. The results demonstrated that the NMR-based metabolomics approach showed good performance in identifying diagnostic urinary biomarkers, providing new insights into the metabolic process related to UAP.

  14. Sodium tanshinone IIA silate as an add-on therapy in patients with unstable angina pectoris.

    Science.gov (United States)

    Zhang, Haiyan; Long, Mingzhi; Wu, Zhiwen; Han, Xu; Yu, Yichao

    2014-12-01

    To investigate whether sodium tanshinone IIA silate (STS) as an add-on therapy to conventional treatment may provide additional benefits for patients with unstable angina pectoris (UAP) and is associated with changes in profiles of serum inflammatory factors. Eighty patients diagnosed with UAP were randomly divided into two groups for the 2-week treatment. The control group received conventional therapy, while the treatment group was given intravenous STS (0.06 mg in 250 mL, once daily) as an add-on therapy to the conventional medications. The therapeutic efficacy and changes in serum levels of several inflammatory cytokines, including monocyte chemotactic protein 1 (MCP-1), tumor necrosis factor alpha (TNF-α), peroxisome proliferator-activated receptor (PPAR-γ), and high-sensitivity C-reactive protein (hs-CRP) from baseline were determined and compared between the two group. The clinical symptoms of all patients in both groups were improved after treatment. The overall rate of effectiveness was 97.5% in the treatment group vs. 80.0% in the control group. Serum levels of MCP-1, TNF-α, and hs-CRP levels were significantly reduced in both groups (P<0.01), whereas the reduction was greater in patients receiving additional STS (P<0.05). PPAR-γ was significantly elevated in both groups (P<0.01). STS in combination with conventional treatment may be associated with better outcomes in patients with UAP.

  15. Assessment of microRNAs in patients with unstable angina pectoris.

    Science.gov (United States)

    Zeller, Tanja; Keller, Till; Ojeda, Francisco; Reichlin, Tobias; Twerenbold, Raphael; Tzikas, Stergios; Wild, Philipp S; Reiter, Miriam; Czyz, Ewa; Lackner, Karl J; Munzel, Thomas; Mueller, Christian; Blankenberg, Stefan

    2014-08-14

    While cardiac troponin measurements have significantly improved the early diagnosis of myocardial infarction, the timely biomarker-based diagnosis of unstable angina pectoris (UAP) remains a major unmet clinical challenge. The aim of this study was to assess levels of circulating microRNAs (miRNAs) as possible novel biomarkers in patients with UAP. A three-phase approach was conducted, comprising (i) profiling of miRNAs in patients with UAP and controls groups; (ii) replication of significant miRNAs in an independent patient cohort, (iii) validation of a multi-miRNAs panel in a third cohort. Out of 25 miRNAs selected for replication, 8 miRNAs remained significantly associated with UAP. In a validation phase, a miRNA panel including miR-132, miR-150, and miR-186 showed the highest discriminatory power [area under the receiver-operating-characteristic curve (AUC): 0.91; CI: 0.84-0.98]. Using a profiling-replication-validation model, we identified eight miRNAs, which may facilitate the diagnosis of UAP. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  16. Negative-Pressure Wound Therapy for Ludwig’s Angina: A Case Series

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    Nainika Nanda, BA

    2017-11-01

    Full Text Available Summary:. Negative-pressure wound therapy (NPWT is a well-established therapeutic approach for various complex wound classes. There is currently limited information on the use of NPWT for the scope of head and neck wounds. However, NPWT has been used successfully in some cases, including malignancy, infection, and trauma. In West Virginia, the incidence of dental-related infections leading to Ludwig’s Angina is high due to lack of access to dental care. Our case series describes the application of vacuum-based therapy in conjunction with antibiotic therapy for quick, effective closure of deep tissue infections before definitive complex wound repair via graft and flap reconstructions. Over a period of 3 months, 2 patients with submental infections extending to the lateral neck demonstrated clean, efficient wound closure with NPWT for less than 14 days while hospitalized at West Virginia University Medicine. Outpatient follow-up with these patients demonstrated excellent cosmetic outcomes with minimal contracture or hypertrophy of healing tissue. NPWT promotes wound healing through decreased edema, improved perfusion, and increased granulation of tissue based on our findings. Our series encourages the use of NPWT for initial closure of complex wounds secondary to deep neck infections.

  17. Vasospastic angina pectoris complicated by acute myocardial infarction and complete atrioventricular block

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    Pavlović Milan

    2011-01-01

    Full Text Available Background. A prolonged coronary artery spasm with interruption of coronary blood flow can lead to myocardial necrosis and increase of cardiospecific enzymes and can be complicated with cardiac rhythm disturbances, syncopc, or even sudden cardiac death. Case report. A 55-year old male felt a severe retrosternal pain when exposing himself to cold weather. The pain lasted for 20 minutes and was followed by the loss of conscience. Electrocardiogram (ECG showed a complete antrioventricular (AV block with nodal rhythm and marked elevation of ST segment in inferior leads. Electrocardiogram was soon normalized, but serum activities of cardiospecific enzymes were increased. Coronarography showed normal findings for the left coronary artery and a narrowing at the middle part of the right coronary artery, which disappeared after intracoronary application of nitroglycerine. The following therapy was prescribed: Diltiazem, Amlodipin, Isosorbid mononitrate, Molisdomin, Atrovastatin, Aspirin and Nitroglycerine spray. After 7 months medicaments were abandoned and the patient experienced again reccurent chest pain episodes at rest. Transitory ST segment elevation was recorded in inferior leads of ECG, but without increase of cardiospecific enzymes serum activities. After restoration of the medicament therapy anginal episodes ceased. Conclusion. Coronary dilators in maximal doses can prevent attacks of vasospastic angina.

  18. Amenorrea primaria

    OpenAIRE

    Alfredo Jácome Roca; Bernardo Moreno Escallón; Lázaro Jiménez González; Claudia Varón

    1988-01-01

    La amenorrea o ausencia de menstruación es una causa común de consulta. La mayoría de los casos están representados por causas fisiológicas tales como embarazo y lactancia, estados prepuberales y menopausia, o por los de amenorrea secundaria en quienes la regla se ha presentado antes, pero que desaparece por un período determinado de tiempo, considerado con criterio estricto por algunos como de seis meses para mujeres con ciclos regulares o de doce para aquellas con ciclos irregulare...

  19. Urban angina in the mountains: effects of carbon monoxide and mild hypoxia on subjects with chronic stable angina; Angine de poitrine dans les villes de montangne: effets du monoxyde de carbone et d'une hypoxie legere chez des patients atteints d'angor stable

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, M.T.; Leaf, D.A.; Kelly, E.; Caiozzo, V.; Osann, K.; O' Neill, T.

    2001-01-01

    The aim of this study is the effects of a carbon monoxide exposure and the altitude on the coming of pectoris angina during physical exercise and on the cardiopulmonary functions for coronary disease patients. (A.L.B.)

  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. Identidad de género de las maestras de primaria

    OpenAIRE

    Tamayo Garza, Julieta

    2016-01-01

    La identidad de género está implícita en la práctica pedagógica de las maestras y los maestros, con ello, los mecanismos que mantienen el orden social en el cual, las mujeres en general, están en desventaja respecto a los hombres. Esta es una de las conclusiones de la investigación cualitativa sobre la identidad femenina y la práctica pedagógica en la escuela primaria, que se realizó desde la perspectiva de género a partir de la observación de su práctica pedagógica en el aula y el análisis d...

  2. Trabajar la expresión oral en primer ciclo de Educación Primaria

    OpenAIRE

    Nieto González, Melania

    2015-01-01

    En el presente Trabajo de Fin de Grado (TFG), se realiza una propuesta para el trabajo y desarrollo de la expresión oral, con el fin de obtener una mejora de la misma en el alumnado de primer ciclo de Educación Primaria. Primeramente, se justifica el por qué la elección de esta temática. Posteriormente, se realiza un análisis de los períodos de prácticas llevados a cabo a lo largo de todo el Grado. A continuación, se realiza una propuesta de intervención, con su correspondiente marco legal y ...

  3. Motivación deportiva en la transición de Primaria a Secundaria

    OpenAIRE

    Lamoneda-Prieto, Javier; Huertas-Delgado, Francisco Javier

    2017-01-01

    El propósito de este trabajo es comparar la motivación hacia la práctica deportiva de los estudiantes gaditanos de Educación Primaria y Secundaria, con el fin de analizar las diferencias en función del género, del tipo de deporte preferido y de la organización (federada o no) de la práctica deportiva. Participaron 704 estudiantes de entre 9 y 16 años de 6 centros de la provincia de Cádiz, España. Como instrumento se utilizó el cuestionario de “Motivación de Educación Física”. Las diferencias ...

  4. La educación sexual en la escuela primaria: intento frustrado de los eugenistas

    Directory of Open Access Journals (Sweden)

    Carmen Diego Pérez

    2014-06-01

    Full Text Available Presentamos un estudio de carácter histórico-educativo sobre los debates en torno a la reforma sexual planteada en España en las primeras décadas del siglo XX y su repercusión en la educación sexual de la infancia. Recuperamos las opiniones que médicos y maestros hicieron públicas en diarios y revistas, así como el papel de varias sociedades que esimularon la publicación de obras sobre educación sexual destinadas al magisterio y a los escolares. A pesar de estas iniciativas, no se consiguió introducir en el plan de estudios de la Escuela Normal ni en la escuela primaria una asignatura específica sobre esta temática, situación que aún continúa.

  5. La multimorbilidad vista desde la perspectiva de los profesionales de atención primaria

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    Roberto Nuño-Solinís

    2014-06-01

    Conclusiones: El aumento de la multimorbilidad es una realidad que preocupa a los profesionales de atención primaria. Los profesionales manifiestan la necesidad de disponer formación adecuada y de sistemas de ayuda a la decisión y de soporte de la práctica diaria que contemplen las situaciones y combinaciones de multimorbilidad más frecuentes. Un abordaje más efectivo de esta problemática requiere un cambio en el modelo sanitario que privilegie una visión integral del paciente, la transición de un enfoque paternalista a uno más proactivo y el desarrollo de la integración asistencial.

  6. Cardiopatía isquémica. Atención primaria de salud

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    Luís Padrón Velázquez

    2010-12-01

    Full Text Available En el siguiente artículo se realiza una revisión de las evidencias actuales relacionadas con la conducta a seguir ante un paciente aquejado de una enfermedad cardiovascular, y en especial de una cardiopatía isquémica. Se presentan los criterios para el diagnóstico y tratamiento de las principales formas de cardiopatía isquémica en la atención primaria de salud, así como el manejo del infarto agudo de miocardio.This article presents a review on the current evidence related to the procedures to be followed when dealing with patients suffering from cardiovascular disease and particularly ischemic heart disease. We present the criteria for the diagnosis and treatment of major forms of heart disease in primary health care and the management of miocardial infarction.

  7. Videojuegos, televisión y rendimiento académico en alumnos de primaria

    OpenAIRE

    Badía Martín, María del Mar; Clariana Muntada, Mercè; Gotzens Busquets, Concepción; Cladellas Pros, Ramón; Dezcallar Sáez, Teresa

    2015-01-01

    El mal uso de las tecnologías puede repercutir en un menor rendimiento académico. En el presente trabajo se ha analizado la relación entre el tiempo dedicado a la televisión, uso de videojuegos, y las notas de los alumnos, en una muestra de educación primaria de Cataluña y de las Islas Baleares, participando 711 alumnos, entre 6 y 13 años. Los resultados muestran que el número de horas de televisión puede guardar una relación negativa con el rendimiento en matemáticas. Se concluye que el uso ...

  8. Maestría en atención primaria de salud: Experiencia en Cuba

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    Irene Perdomo Victoria

    2003-04-01

    Full Text Available La estrategia de la Atención Primaria de Salud es abarcadora, compleja e integradora. Promueve la reorganización de los servicios de atención a la salud de forma que la atención secundaria y terciaria, actúen como apoyo y derivación del nivel de atención primaria. Se orientan las acciones en relación con los distintos factores determinantes de la salud y la enfermedad, requiere de un enfoque necesariamente intersectorial; y conlleva la implicación de individuos y comunidades, no solo en la toma de decisiones, sino también para el desarrollo de una mayor responsabilidad individual sobre su salud, la incorporación y el buen uso de la tecnología apropiada con atención a la relación entre los costos y la efectividad.The primary health care strategy is comprehensive and complex. It promotes the re-organization of health care services so that the secondary and tertiary care act as a sort of support of and derivation from the primary health care, and give guidance on the actions to be taken with different determining factors for health and disease. The strategy requires an inter-sector approach and entails the involvement of both individuals and community not only in the decision-taking process but also in the development of a higher level of individual responsibility for one´s health, and also the introduction and use of adequate technologies, taking cost-effectiveness relation into account.

  9. IL PROCESSO DI PRODUZIONE SCRITTA: LA COESIONE VERBALE IN TESTI DI SCUOLA PRIMARIA

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    Fabiana Rosi

    2015-02-01

    Full Text Available Una delle principali difficoltà che incontrano i bambini della scuola primaria nella produzione scritta riguarda la coesione verbale, ovvero il mantenimento lungo il testo della dimensione temporale inizialmente selezionata per riportare gli eventi. L’articolo esamina questo specifico tipo di competenza testuale negli alunni di sei classi del secondo ciclo della scuola primaria, tre delle quali hanno partecipato alla sperimentazione educativa sulla produzione di testi scritti “Osservare l’interlingua”. Il confronto fra i dati raccolti all’inizio e alla fine dell’anno scolastico mostra una riduzione dei salti immotivati da un tempo verbale all’altro, definiti shift temporali, nei testi prodotti nelle classi del campione sperimentale in misura maggiore rispetto a quelle di controllo e sottolinea gli effetti positivi, a breve e lungo termine, di una didattica task-based condotta con approccio inclusivo, cooperativo ed attivo.  The process of writing: verb cohesion in primary school textsOne of principal difficulties in producing written texts for primary school pupils concerns verb cohesion, i.e. maintaining the temporal dimension initially chosen for expressing events throughout the text. The paper examines this specific textual competence in pupils from six classes within second cycle of primary school. Three of these classes were involved in the “Observing interlanguage” project focused on written production. The comparison of data collected at the beginning and the end of school year shows a decrease in temporal shifts (transitions from one verb tense to another in the texts produced by the students involved in the project with regard to the control group. These findings highlight the positive effects, both short-term and long-term, of task-based teaching through an inclusive, cooperative and active approach. 

  10. La transición primaria – secundaria en los Institutos – Escuela en Catalunya

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    Màrius Martínez Muñoz

    2015-01-01

    Full Text Available Se presentan los resultados de un estudio sobre los aspectos de orientación de los 17 Institutos – Escuela (I--‐E, centros públicos que acogen en una misma institución, educación infantil, primaria y secundaria puestos en marcha en Catalunya a partir de la Ley de Educación de Catalunya (LEC, 2009 recuperando la innovación impulsada en la República. El estudio revisó los aspectos de orientación y transición entre etapas de dichos centros y contrastó dicho funcionamiento con el que tenían centros de primaria y secundaria, de características similares en el mismo territorio. Se utilizaron cuestionarios electrónicos respondidos por responsables de la orientación de las tres tipologías de centro (primara, secundaria, I–E, integrantes de sus ampas, tutores y miembros de sus equipos directivos. Se identificaron visiones distintas de las prácticas de orientación en función del tipo de centro, de la persona encuestada y de su rol. El estudio permitió identificar también 50 prácticas de referencia realizadas tanto en los I--‐E como en la perspectiva territorial en centros ordinarios. Los I--‐E suponen, a la luz del estudio, una alternativa eficaz, no sólo para la mejor articulación entre etapas sino también para luchar contra las desigualdades y las situaciones de vulnerabilidad.

  11. Medida de innovaciones en escuelas de Educación Infantil y Primaria

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    Isabel Cantón Mayo

    2017-01-01

    Full Text Available La innovación es la clave de los avances en educación. Los centros educativos reali - zan innovaciones muy diversas con niveles de impacto y difusión muy bajos fuera de su comu - nidad. No existen muchos estudios que describan, pongan en valor las innovaciones, las cate - goricen y las analicen. La metodología de estudio fue descriptivo-interpretativa para lo que se elaboró un cuestionario denominado GINCENPRINF completado por 86 docentes de Educación Infantil y Primaria seleccionados por muestreo aleatorio estratificado (público-privado, rural-ur - bano. Se evaluó la fiabilidad y la validez de constructo del cuestionario y se determinó la validez de contenido mediante juicio de expertos. Los resultados revelaron una consistencia buena del cuestionario (Alfa de Cronbach: 0.848. Los resultados del análisis factorial confirman las dimen - siones propuestas en el diseño del cuestionario sobre las categorías de los factores incluidos en la innovación (cohesión social, interacción con la comunidad, Tecnologías, y éxito, las escuelas innovadoras y sus característica, el tema y el tipo de innovación (sobre recursos, dirección, mate - riales y tiempo, así como las resistencias a la innovación. Se realizaron los estadísticos descripti - vos y el análisis factorial por categorías. Se concluye que el cuestionario GINCENPRINF es válido y fiable para medir la gestión de las innovaciones en escuelas de Educación Infantil y Primaria.

  12. Escribir ciencia: un desafío que comienza en la escuela primaria

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    Carina Rudolph

    2016-01-01

    Full Text Available Este estudio considera que el docente de ciencias debería ser mediador en la adquisición de habilidades de lectura y escritura en el área de Ciencias Naturales. Esto implica hacer transitar progresivamente a los estudiantes en los géneros específicos de las disciplinas, comenzando desde la escuela primaria. Este artículo propone el abordaje del género relato de procedimiento con el objeto de favorecer el aprendizaje de contenidos científicos mediante la escritura del procedimiento seguido en actividades experimentales llevadas a cabo en las clases de Ciencias Naturales. El estudio fue realizado en una escuela primaria de San Juan (Argentina con estudiantes de quinto grado en dos encuentros en los que se abordaron contenidos relacionados con el sonido y sus características. En el análisis de las producciones escritas por los alumnos consideramos la estructura del relato elaborado en cada instancia y el contenido científico explicitado en las producciones. Los resultados sugieren que el guion de estructura del género proporcionado a los estudiantes ha favorecido la comunicación escrita del relato acerca de los experimentos realizados. Esto se evidencia en aspectos relacionados con el orden de las ideas, su presentación en forma más completa y los intentos de explicación de los fenómenos en estudio, mejorando el uso del lenguaje de la ciencia y el aprendizaje disciplinar.

  13. Conocimientos tecnológicos, pedagógicos y disciplinares del profesorado de Primaria

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    Rosabel Roig Villa

    2015-07-01

    Full Text Available La emergencia de las tecnologías de información y comunicación (TIC plantea nuevos desafíos educativos al profesorado, a los cuales puede responder desde un modelo de formación coherente. El propósito de este estudio es analizar los conocimientos tecnológicos, pedagógicos y disciplinares del profesorado de Educación Primaria, necesarios para la integración de las TIC en la labor docente. Para ello, se llevó a cabo una investigación con una metodología cuantitativa de carácter no experimental en la que participaron 224 profesores de Educación Infantil y Primaria de la provincia de Alicante. Los resultados mostraron que los docentes poseen mayores conocimientos pedagógicos y disciplinares que tecnológicos, lo que conlleva a escasos conocimientos para la integración de las TIC en la labor docente. Se constataron, además, diferencias significativas entre el género y los años de experiencia docente, y la relación entre el uso lúdico de la tecnología y los conocimientos sobre sus aspectos fundamentales. Según los resultados obtenidos, se corrobora la necesidad de una alfabetización digital del profesorado abordada no solo desde una formación tecnológica, sino también pedagógica y disciplinar de forma global. Ello responde al modelo TPACK (Technological, Pedagogical and Content Knowledge, el cual se contempla como un marco de referencia a tener en cuenta por lo que respecta al desarrollo profesional del profesorado y su vinculación a los procesos de enseñanza-aprendizaje en el aula donde las TIC estén presentes.

  14. Apendagitis epiploica primaria: Clínica y evolución de 73 casos

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    Graciela M Vázquez

    2014-12-01

    Full Text Available La apendagitis epiploica primaria es una enfermedad relativamente infrecuente dentro de los diagnósticos diferenciales del abdomen agudo. Describimos las características clínicas y evolución de una serie de 73 casos de apendagitis epiploica primaria. Se realizó una búsqueda de imágenes ecográficas y tomográficas con diagnóstico de apendagitis en el sistema de información hospitalario electrónico del Hospital Alemán entre abril del 2007 y julio del 2013 y posteriormente se revisaron sus historias clínicas. Se incluyeron 73 casos; la edad promedio fue de 45 años (± 16, 54 (74% eran varones. El motivo de consulta fue dolor abdominal: en fosa ilíaca izquierda en 65 (el 89% de los casos; en fosa ilíaca derecha en seis (8% y en otras localizaciones en dos (3%. Se les realizó ecografía abdominal a 44 (60%, tomografía computarizada a 21 (29%, y ambos estudios a 8 (11%. En el 49% de los casos se solicitó interconsulta con el servicio de cirugía. Recibieron tratamiento con antibióticos 15 (21% pacientes, de los cuales el 73% fue indicado por un médico clínico. Recibieron tratamiento ambulatorio con antiinflamatorios no esteroides 67 (92%; dos requirieron cirugía laparoscópica, dos internación y dos opiáceos. La apendagitis epiploica es infrecuente dentro de los diagnósticos diferenciales de abdomen agudo, pero es una entidad que no debe ser desconocida por los médicos para prevenir intervenciones innecesarias y el uso excesivo de antibióticos.

  15. Calidad de vida de los pacientes con inmunodeficiencias primarias de anticuerpos

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    Rodolfo Muriel-Vizcaíno

    2016-02-01

    análisis de covarianza. Se incluyeron 28 pacientes. La mediana de edad fue 5 años y 5 meses. Resultados: el promedio de edad al diagnóstico fue de 6 años con 3 meses. La mediana de retraso diagnóstico fue de 3 años 3 meses. El promedio de calidad de vida en los pacientes fue de 74.1 (DE ± 13.8 y de 83.3 (DE ± 10.1 para los controles (p = 0.005. La relación entre calidad de vida, retraso diagnóstico y presencia de complicaciones se analizó mediante un modelo lineal que fue marginalmente significativo (p = 0.056. Se encontró correlación negativa entre concentraciones de IgG en el último año y la calidad de vida. Se observó que, en los pacientes que presentaban bronquiectasias, conforme aumentan los años de retraso en el diagnóstico la calidad de vida disminuye de forma significativa (p = 0.007. Conclusiones: consideramos necesario evaluar la calidad de vida para conocer el estado de salud de los pacientes con inmunodeficiencias primarias y para su seguimiento durante el tratamiento con el objeto de incidir no sólo en la reducción del número de infecciones, hospitalizaciones y complicaciones, sino también en la mejoría de su calidad de vida. Deberá diseñarse un instrumento específico para evaluar la calidad de vida de los pacientes con inmunodeficiencias primarias.

  16. Actividades extraescolares y rendimiento académico en alumnos de primaria

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    Ramón Cladellas Pros

    2013-08-01

    Full Text Available El objetivo de este trabajo es valorar la posible incidencia en el rendimiento académico de alumnos de primaria, de la realización -o no- de actividades extraescolares, según su tipología (recreativas, cognitivas o ambas y el número de horas de actividades realizadas. La muestra final estaba formada por un total de 721 alumnos de primaria (366 niños y 355 niñas procedentes de diversos centros escolares de las comarcas catalanas y de las Islas Baleares. Se facilitó a los padres de los alumnos un cuestionario en el que debían indicar las notas obtenidas en diferentes materias (matemáticas, catalán, castellano, idiomas, gimnasia y plástica y responder datos relacionados con la realización de actividades extraescolares. Los resultados muestran cómo la realización de algún tipo de actividad extraescolar, sea del tipo que sea, mejora el rendimiento académico de los niños y niñas de la muestra. La sola realización de algún tipo de actividad (ya sea recreativa o cognitiva, o una combinación de ambas, incide positivamente y significativamente en los resultados obtenidos en todas las materias estudiadas, a excepción de las asignaturas de matemáticas, gimnasia y plástica. Asimismo, un número elevado de horas de actividades extraescolares (más de 10 horas y media a la semana afecta negativamente a los resultados obtenidos en todas las materias menos en gimnasia.

  17. La investigación al alcance de los profesionales de Osakidetza: Programa de Investigación en Atención Primaria de Salud

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    Gonzalo Grandes

    2014-04-01

    Conclusiones: Esta experiencia puede servir para otros interesados en el fomento de la investigación en atención primaria de salud (APS, ya que el programa ha logrado sus objetivos, es útil y productivo.

  18. Detección y prevalencia del trastorno por uso de alcohol en los centros de atención primaria de Cataluña

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    Laia Miquel

    2016-03-01

    Conclusiones: Los MAP reconocen poco el TUA en gente joven, mientras que detectan más la enfermedad en pacientes de mayor edad y con comorbilidades asociadas. La prevalencia de TUA es elevada en atención primaria.

  19. Evaluation of Role of C-Reactive Protein Level on Cardiovascular Events During 14 Days after Admission of Patients with Unstable Angina in the Ekbatan Hospital, Hamadan, 2002

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    B. Naghsh Tabrizi

    2007-01-01

    Full Text Available Introduction & Objective: Unstable angina is in the center of spectrum from chronic stable angina to acute myocardial infarction. Due to high prevalence of unstable angina, it is important to find a factor that predicts prognosis and management modality. We decided to measure CRP level for the items that mentioned above.Materials & Methods: This study was a cross-sectional study that 138 patients who were admitted with unstable angina in the CCU and cardiac ward of Ekbatan Hospital in Hamedan were considered for measuring CRP level. Age, sex, period of disease, and left ventricular ejection fraction percentile were worked out. After quantitative CRP measuring and 14 days follow up, the questionnaire was completed.Results: CRP levels were 116.3 and 124.3 ng/ml in the patients with and without cardiovascular events (whole events respectively during 14 days follow up. Recurrent unstable angina, myocardial infarction and mortality rate were higher in the patients with elevated level of CRP but need to perform coronary angiography was lower.Conclusion: CRP level had no correlation with occurrence of cardiovascular events (whole events during 14 days follow up.

  20. Evolução Atípica de Angina de Plaut-Vincent em Criança: Relato de Caso/Atypical Evolution of Plaut-Vincent’s Angina in Child: A Case Report

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    Ananda Fortes Lima

    2014-09-01

    Full Text Available Introdução: A angina de Plaut-Vincent é uma afecção úlcero-necrótica causada pela simbiose de um bacilo fusiforme (Fusobacterium necrophorum e um espirilo (Borrelia vincenti. Ambos são agentes saprófitas habituais da cavidade oral, porém, quando associados, determinam o caráter patogênico da doença. Casuística: Trata-se do caso de uma paciente do sexo feminino, 4 anos de idade, que deu entrada no pronto socorro com choque séptico descompensado não responsivo a volume com necessidade de drogas vasoativas (DVA, além de má conservação dentária, e amigdalas necrosadas. Em 48h evoluiu com piora hemodinâmica refratária a DVA e introdução de hidrocortisona, com crises convulsivas e hemiplegia à esquerda. Foi solicitada TC crânio a qual evidenciou AVC isquêmico. Discussão: Ocorre geralmente em condições de desnutrição e má higiene oral, tendo sua maior incidência entre os adultos-jovens e adolescentes. Cursa com necrose das amigdalas, halitose intensa e disfagia. Conclusão: Considerando que a Angina de Plaut-Vincent acomete principalmente adultos jovens, torna-se de grande relevância relatar o caso de uma paciente pediátrica, que evoluiu de forma incomum, apresentando lesões isquêmicas cerebrovasculares. Introduction: Plaut–Vincent’s angina is an ulcer-necrotic disease caused by the symbiosis of a fusiform bacillus (Fusobacterium necrophorum and spirillum (Borrelia vincenti. Both are common saprophytic agents of the oral cavity, but when combined determine the pathogenic of the disease. Case report: We describe the case of a female patient, 4 years old, which gave entered the emergency room with decompensated septic shock unresponsive to volume in the need of vasoactive drugs (DVA, moreover poor dental conservation and necrotic tonsils. After 48h evolved with hemodynamic deterioration refractory to VAD and insertion of hydrocortisone, with convulsion and left hemiplegia. A cranial CT was requested and revealed

  1. Utility of coronary CT angiography in outpatients with hypertrophic cardiomyopathy presenting with angina symptoms.

    Science.gov (United States)

    Shariat, Masoud; Thavendiranathan, Paaladinesh; Nguyen, Elsie; Wintersperger, Bernd; Paul, Narinder; Rakowski, Harry; Crean, Andrew M

    2014-01-01

    Angina is a frequent symptom in patients with hypertrophic cardiomyopathy (HCM); however, it is often not because of significant epicardial coronary artery stenosis. Coronary CT angiography (CCTA) is an excellent modality to rule out significant coronary artery stenosis in the low- and intermediate-risk patients; however, its value in patients with HCM has not been explored. We sought to assess the utility of CCTA in the assessment of patients with HCM and stable anginal symptoms and compare the incidence of epicardial coronary artery stenosis to an age- and gender-matched control group. Consecutive outpatients with HCM referred for CCTA over a 3-year period because of stable anginal symptoms (chest pain or shortness of breath) were identified retrospectively. Age- and gender-matched patients without HCM referred for CCTA because of similar symptoms over a 6-month period were used as controls. All patients had CCTA using an Aquilion ONE 320 scanner. The coronary arteries were evaluated independently by 2 blinded observers, and any luminal narrowing was scored quantitatively as follows: >70% = severe; 50% to 70% = moderate; symptoms in patients with HCM. The incidence of moderate-to-severe coronary artery stenosis was significantly lower in our HCM patients in comparison to our age-matched, gender-matched, and risk factor-matched control group. Given the high incidence of false-positive findings on perfusion stress studies, we propose that CCTA may be useful for appropriate triage to coronary angiography in the HCM patient with anginal symptoms. Copyright © 2014 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

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

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    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.

  3. Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris

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    Aliyev Emil

    2004-04-01

    Full Text Available Abstract Aim The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1 in patients with unstable angina pectoris (AP. Methods Thirty-five patients with unstable AP (Group I, ten patients with stable AP (Group II and ten subjects who had angiographycally normal coronary arteries (Group III were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15 received tirofiban and Group IB (n = 20 did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h in all patients and at 72 h in Group I. Results The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. Conclusion The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point.

  4. Geogagnetic Activity and Effectiveness of Millimeter Electromagnetic Radiation in Unstable Angina Treatment

    Science.gov (United States)

    Parshina, S. S.; Samsonov, S. N.; Afanasiyeva, T. N.; Tokayeva, L. K.; Petrova, V. D.; Dolgova, E. M.; Manykina, V. I.; Vodolagina, E. S.

    There had been performed a research of an effectiveness of millimeter electromagnetic radiation (MM EMR) use in patients with an unstable angina (UA) at periods of a lower (daily value of Kp-index 16,19±0,18) and a higher (daily value of Kp-index 17,25±0,21, p<0,05) gemagnetic activity (GA). It was found that involving of the MM EMR (the wave length 7.1 mm) into the treatment of the patients with an UA, enhances an antianginal effect of a drug therapy independently on the period of GA. The MM EMR at the period of a lower geomagnetic activity (LGA) enhances the decrease of diastolic blood pressure (BP), and at the period of a higher geomagnetic activity (HGA) - the decrease of systolic BP. At a HGA there were noted: a quick and more serious antianginal effect, maximal antihypertensive effect was achieved quicker, but (as opposed to the period of a LGA) there was no a pulse slowing effect of a MM EMR. Including the MM EMR into the treatment accelerates stabilization of the patients' condition only at a LGA. Positive effect on blood rheological properties is an independent effect of MM EMR, and it is in blood viscosity reduce in microcirculatory at both of the periods of GA. Normalization of blood viscosity under the MM EMR is only at the period of a LGA. So, the effect of MM EMR on a clinical condition of the patients is more evident at the period of a HGA, blood viscosity - at the period of a LGA.

  5. Hospitalizations Due to Unstable Angina Pectoris in Diastolic and Systolic Heart Failure

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    Ahmed, Ali; Zile, Michael R.; Rich, Michael W.; Fleg, Jerome L.; Adams, Kirkwood F.; Love, Thomas E.; Young, James B.; Aronow, Wilbert S.; Kitzman, Dalane W.; Gheorghiade, Mihai; Dell’Italia, Louis J.

    2008-01-01

    Patients with diastolic heart failure (HF) i.e. clinical HF with normal or near normal left ventricular ejection fraction (LVEF) may experience unstable angina pectoris (UAP) due to epicardial atherosclerotic coronary artery disease (CAD) and/or to subendocardial ischemia, even in the absence of CAD. However, the risk of UAP among ambulatory diastolic HF patients has not been well studied. We examined incident hospitalizations due to UAP among 916 diastolic HF (LVEF >45%) patients without significant valvular heart disease and 6800 systolic HF (LVEF ≤45%) patients in the Digitalis Investigation Group trial. During a 38-month median follow-up, 12% (797/6,800) of systolic HF patients (incidence rate, 435/10,000 person-years) and 15% (138/916) of diastolic HF patients (incidence rate, 536/10,000 person-years) were hospitalized for UAP (adjusted hazard ratio for diastolic HF, 1.22; 95% confidence interval, 1.02–1.47; p=0.032). There was a graded increase in incident hospital admissions for UAP with increasing LVEF. Hospitalizations for UAP occurred in 11% (520/4,808; incidence rate, 407/10,000 person-years), 14% (355/2556; incidence rate, 496/10,000 person-years) and 17% (60/352; incidence rate, 613/10,000 person-years) of HF patients, respectively, with LVEF 55%. Compared with HF patients with LVEF 55% were respectively 1.17 (1.02–1.34; p=0.028) and 1.57 (1.20–2.07; p=0.026). In conclusion, in ambulatory chronic HF patients, higher LVEF was associated with increased risk of hospitalizations due to UAP. As in patients with systolic HF, those with diastolic HF should be routinely evaluated for myocardial ischemia and managed accordingly. PMID:17293184

  6. Danshenchuanxiongqin injection in the treatment of unstable angina pectoris: a systematic review and Meta-analysis.

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    Zhang, Xiaomeng; Wu, Jiarui; Zhang, Bing; Zhou, Wei

    2016-04-01

    To evaluate systematically the efficacy and safety of Danshenchuanxiongqin Injection (DCI) in the treatment of unstable angina pectoris (UAP). Randomized controlled trials (RCTs) regarding DCI used for treating UAP were searched in English and Chinese electronic databases from inception to January 2014. Two reviewers independently retrieved RCTs and extracted relevant information. The Cochrane risk of bias method was used to assess the quality of included studies, and a Meta-analysis was conducted with Review Manager 5.2 software. Eleven RCTs involving 1034 participants were included. The methodological quality was relatively passable. The Meta-analysis indicated that the combined use of DCI and conventional treatment with Western Medicine (WM) was more efficacious in the outcomes of total effective rate [Relative Risk (RR) = 1.27, 95% CI (confidence interval; 1.18, 1.35), P < 0.000 01], the total effective rate of ECG [RR = 1.40, 95% CI (1.18, 1.66), P < 0.000 01], total cholesterol [Mean difference (MD) = -0.58, 95% CI (- 0.83, - 0.33), P < 0.000 01], total triglycerides [MD = - 0.36, 95% CI (- 0.54, - 0.17), P = 0.0001], and the number of ST-segment depression [MD = -0.36, 95% CI (- 0.54, - 0.17), P = 0.0001]. There were two adverse drug reactions reported in one study. Based on the systematic review, DCI combined with WM appeared to be efficacious in the treatment UAP. However, the evidence of DCI for treating UAP requires large-scale and double-blind RCTs to substantiate these findings.

  7. Changes of serum angiogenic factors concentrations in patients with diabetes and unstable angina pectoris.

    Science.gov (United States)

    Gui, Chun; Li, Shi-kang; Nong, Qin-ling; Du, Fang; Zhu, Li-guang; Zeng, Zhi-yu

    2013-02-19

    Diabetic microvascular changes are considered to be influenced by angiogenic factors. As a compensatory mechanism, the expression of some angiogenic factors are elevated in ischemic myocardium. The aim of this study was to investigate the changes of serum angiogenic factors, and the association among these angiogenic factors, the severity of coronary artery stenosis and collateral vessels form in patients with diabetes and unstable angina pectoris (UAP). 42 patients with diabetes (diabetes group), 57 patients with UAP (UAP group), and 36 age-matched healthy people (control group) were selected. Serum concentrations of angiogenic factors were measured using cytokine array technology. The severity of coronary artery stenosis was scored using the angiographic Gensini score. Coronary collateral vessels were scored according to Rentrop's classification. No significant differences in the serum concentrations of vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), angiogenin, angiostatin, basic fibroblast growth factor (bFGF) and platelet-derived growth factor-BB (PDGF-BB) were detected between control group and diabetes group. But in patients with diabetes complicated with UAP and in patients with UAP without diabetes, serum concentrations of VEGF and Ang-2 were elevated (p < 0.01, p < 0.01). Only serum Ang-2 concentrations were significantly correlated with Gensini score (r=0.585, p < 0.001), left ventricular end diastolic diameter (r=0.501, p < 0.001), left ventricular end systolic diameter (r=0.563, p < 0.001) and left ventricular ejection fraction (r=-0.523, p < 0.001). Serum concentrations of VEGF and Ang-2 were increased, and diabetes didn't affect this increases in patients with UAP. Serum Ang-2 concentrations were correlated with the severity of coronary artery stenosis.

  8. Does surgical decompression in Ludwig's angina decrease hospital length of stay?

    Science.gov (United States)

    Rowe, David Phillip; Ollapallil, Jacob

    2011-03-01

    Ludwig's angina (LA) is an uncommon and potentially life-threatening condition of the upper aero-digestive tract that often requires the coordinated efforts of the surgical, anesthetic and intensive care teams to optimize management. The purpose of the present study was to investigate the documented clinical features and the surgical and airway management of LA at Alice Springs Hospital for the purpose of assessing surgical outcomes with particular reference to length of stay (LOS). Retrospective chart review from January 1998 to January 2008 examined patients admitted with LA at Alice Springs Hospital. Documented clinical features, interventions, and operative findings including floor of mouth swelling, Mallampati score, and airway compromise were collected. Outcomes, with particular respect to LOS, for those who received intravenous (IV) or inhalational induction and those that received awake fibre-optic intubations were compared. Of 30 patients with LA, 28 (93%) were managed with operative drainage with a LOS in the intensive care unit (ICU) of 2 days and a hospital LOS of 5 days. Seven received awake fibre-optic intubation and 21 had IV or inhalational anesthesia with none requiring tracheotomy. There was no statistical difference in LOS between those patients whose microbiological culture results showed no growth and those whose cultures had positive growth. Management was generally operative decompression with IV antibiotics. LOS is not affected by the presence or absence of culture positive infection. It is proposed that operative intervention is safe, effective, and is associated with shorter patient stays in the intensive care unit and the hospital overall. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

  9. Retrospective analysis of etiology and comorbid diseases associated with Ludwig's Angina.

    Science.gov (United States)

    Botha, Andrew; Jacobs, Fred; Postma, Corne

    2015-01-01

    Ludwig's angina (LA) still presents regularly at our tertiary academic hospital. Various etiologies and comorbid diseases are documented worldwide, but the South African population has not been studied. To establish whether LA cases presenting to the department are different from international reports regarding etiology and comorbidities. Retrospective analysis of patients presenting with LA to a tertiary hospital. 93 patients were included over a 5-year period. Archived files were analyzed for data including age, gender, comorbid diseases, etiology, airway management, and season on admission. Descriptive statistics with the inclusion of frequency distributions. 93 patients were included; 65 (69.9%) male and 28 (30.1%) female; age - minimum 20 years, maximum 75 years, mean 40.366. 68 (73.1%) odontogenic, 13 (14%) nonodontogenic, and 12 (12.9%) unknown cause. Comorbid diseases: 21 (22.6%) diabetes mellitus (DM), 19 (20.4%) hypertension, and 18 (19.4%) human immunodeficiency virus (HIV). Airway management: 61 (65.6%) tracheostomy and 32 (34.4%) nonsurgical. 11 (11.8%) deaths, 8 (8.60%) descending mediastinitis, and 7 (7.53%) necrotizing fasciitis. Seasonal occurrence: 30 (32.3%) spring, 24 (25.8%) winter, 22 (23.7%) summer, and 17 (18.3%) autumn. A 2.32:1 ratio male: female presentation mirrors previous statistics. DM patients had increased risks of complications, which resulted in multiple deaths. HIV patients showed increased risks for complications with more intense, longer hospital stays, but lower percentages of deaths compared to patients with DM and complications who died. There was no statistically significant finding regarding seasonal tendency.

  10. En acción: mejorando el acceso a la atención óptima para todos los pacientes con inmunodeficiencias primarias Semana mundial de las Inmunodeficiencias Primarias

    Directory of Open Access Journals (Sweden)

    Francisco Espinosa Rosales

    2016-04-01

    Full Text Available Las inmunodeficiencias primarias constituyen un grupo de más de 300 defectos innatos del sistema inmunitario, tanto en sus componentes hematopoyéticos como en los no-hematopoyéticos. Dichos defectos pueden presentarse con un amplio espectro de manifestaciones clínicas, ya sea con infecciones (comunes recurrentes, comunes graves, o raras y graves, autoinflamación, autoinmunidad, malignidad y/o alergia. Anteriormente clasificadas como “enfermedades raras”, las inmunodeficiencias primarias no son tan raras como se pensaba: hoy en día se estima que afectan a más de seis millones de personas alrededor del mundo, sin distinciones geográficas, de género o edad.

  11. Influence of nifedipine on left ventricular perfusion and function in patients with unstable angina: Evaluation with radionuclide techniques

    Energy Technology Data Exchange (ETDEWEB)

    Wall, E.E. van der; Kerkkamp, H.J.; Simoons, M.L.; Rijk, P.P. van; Reiber, J.H.C.; Bom, N.; Lubsen, J.C.; Lie, K.I.

    1986-04-01

    In 1981, a large, double-blind, randomized trial was started in The Netherlands to evaluate the therapeutic effects of nifedipine and/or metoprolol in patients with unstable angina. This study has been called the Holland Interuniversity Nifedipine/metoprolol Trial (HINT) and required several hundred patients to establish potential therapeutic effects. From December 1982 to January 1984 the effects of nifedipine on left ventricular (LV) performance in a subgroup of 52 HINT patients were studied using radionuclide techniques. All patients (23 on nifedipine, 29 controls) underwent thallium-201 scintigraphy or radionuclide angiography just before and 48 h after the start of experimental medication. The radionuclide angiographic studies were also performed at 1 and 4 h after treatment. Nifedipine did not influence the incidence of disapperance of perfusion defects on the 48-h thallium images. No significant differences in overall LV ejections fraction (EF) were seen at any time between nifedipine-treated patients and controls. However, paired observations in 37 patients showed improvement of LVEF after 48 h in 8 patients on nifedipine and in only 1 control patient. Scintigraphic measurements on admission were not related to clinical outcome after 48 h. Concomitant administration of metoprolol did not influence LVEF in either group. It is concluded that nifedipine improves LVEF after 48 h in a subset of patients with unstable angina without affecting myocardial perfusion. This finding indicates that nifedipine has a predominant effect on afterload reduction in patients with unstable angina. Also, early scintigraphic measurements had no significant predictive value for subsequent cardiac events.

  12. Accelerated collagen turnover in women with angina pectoris without obstructive coronary artery disease: An iPOWER substudy.

    Science.gov (United States)

    Nielsen, Signe H; Mygind, Naja D; Michelsen, Marie M; Bechsgaard, Daria F; Suhrs, Hannah E; Genovese, Federica; Nielsen, Henning B; Brix, Susanne; Karsdal, Morten; Prescott, Eva; Kastrup, Jens

    2018-01-01

    Aim Collagens are major cardiac extracellular matrix components, known to be actively remodelled and accumulated during diffuse myocardial fibrosis. We evaluated whether accelerated collagen turnover described by neo-epitope biomarkers reflecting collagen formation and degradation separates patients with diffuse myocardial fibrosis from asymptomatic controls. Methods and results Seventy-one women with angina pectoris without significant coronary artery disease assessed by invasive coronary angiogram were included. Competitive enzyme-linked immunosorbent assays (ELISAs) measuring circulating protein fragments in serum assessed the formation and degradation of collagen type III (Pro-C3, C3M and C3C), IV (P4NP7S and C4M), V (Pro-C5 and C5M) and VI (Pro-C6 and C6M), and degradation of collagen type I (C1M). Serum samples from 32 age-matched asymptomatic women were included as controls. Symptomatic women presented significantly elevated levels of Pro-C6, C3C, C3M, C4M and C8-C ( p < 0.0001-0.0058) and significantly decreased levels of Pro-C3, C5M and C6M ( p < 0.0001-0.041), reflecting accelerated collagen turnover and an imbalanced collagen formation and degradation compared to controls. Cardiac magnetic resonance T1 mapping was performed to determine extracellular volume fraction and thus diffuse myocardial fibrosis. A significant association was identified between C5M and extracellular volume fraction by cardiac magnetic resonance ( p = 0.01). Conclusion Women with angina pectoris, but without significant obstructive coronary artery disease, showed an imbalanced collagen turnover compared to asymptomatic controls. The examined biomarkers are tools to monitor active collagen remodelling in patients with angina pectoris, in risk of developing myocardial fibrosis.

  13. The effects of enhanced external counterpulsation on health-related quality of life in patients with angina pectoris

    Science.gov (United States)

    Ziaeirad, Marzieh; Ziaei, Gholam Reza; Sadeghi, Narges; Motaghi, Minoo; Torkan, Behnaz

    2012-01-01

    Background: The complicated concept of quality of life (QOL) has been considered as an important criterion for health outcomes in chronic diseases, such as heart disease, in recent years. The aim of this study was to evaluate the QOL of patients with angina pectoris after treatment with enhanced external counterpulsation (EECP). Materials and Methods: This quasi-experimental study was conducted on 64 patients with angina pectoris undergoing EECP who came to Shahid Chamran and Sina Hospitals in Isfahan. Sampling was performed by the convenient method. Data were collected using a questionnaire containing socio-demographic and clinical data. A standard questionnaire called 36-item Short-Form Health Survey was also used. Questionnaires were completed through interviews and phone calls in three stages (before, immediately and three months after the treatment). The results were analyzed using descriptive statistics (frequency, mean, and standard deviation) and analytical statistics (paired t-test and repeated measures test) in SPSS11.5. Findings: The obtained results demonstrated that the majority of patients were men (59.4%) and aged 56-71 years. In addition, 57.8% had hypertension and 56.3% had hyperlipidemia. A history of myocardial infarction was found in 70.3% of the subjects and the familial history of coronary artery disease was detected in73.4%. Although QOL evaluations showed improvements in all subscales immediately and three months after the treatment, the changes were not statistically significant in case of general health, role limitations due to physical problems and role limitations due to mental problems Conclusions: Similar to previous research, this study showed QOL to improve in patients who undergo EECP. This improvement will remain stable three months after the treatment in all subscales. Therefore, EECP is an efficient noninvasive method in treating patients with angina pectoris and in developing their QOL. PMID:23493242

  14. Ischemia-modified albumin in differential diagnosis of acute coronary syndrome without ST elevation and unstable angina pectoris.

    Science.gov (United States)

    Wudkowska, Anna; Goch, Jan; Goch, Aleksander

    2010-04-01

    Ischemia modified albumin (IMA) was registered by the United States Food and Drug Administration as a marker of myocardial ischemia. To assess the usefulness of IMA measurement for differentiating patients with acute coronary syndrome (ACS) with no ST elevation and patients with unstable angina pectoris. The study group consisted of 121 patients (mean age 63 +/- 12 years, 84 males), who were admitted to our department with retrosternal chest pain occurring at rest and lasting more than 20 minutes. The patients had laboratory tests performed including aspartate aminotransferase, izoenzyme of creatine kinase activity, troponin T, N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein, IMA concentration and creatinine clearance. Coronary angiography was also performed. All study patients were divided into 2 groups: group I with elevated troponin concentration (58 patients) and group II with troponin concentration below reference value (63 patients). The IMA concentration in the serum did not differ significantly between group I (troponin positive) and group II (troponin negative) (95.2 +/- 12.8 U/mL vs 94.0 +/- 17.9 U/mL, NS). The percentage of patients with elevated IMA values (cut off point of 85 U/mL) did not differ significantly between group I and group II patients (76.6% vs 76.2%, NS). In patients from group I an upward trend was noted, whereas in patients from group II a downward trend was associated with the duration of ischemic chest pain. In group I the correlation between the IMA concentration and the NT-proBNP concentration was positive (R = 0.2957; p unstable angina. 2. The upward trend of IMA concentration was associated with the duration of chest pain in patients with ACS, whereas the opposite trend was found in patients with unstable angina pectoris.

  15. Prognosis in medically stabilized unstable angina: Early Holter ST-segment monitoring compared with predischarge exercise thallium tomography

    International Nuclear Information System (INIS)

    Marmur, J.D.; Freeman, M.R.; Langer, A.; Armstrong, P.W.

    1990-01-01

    The objective of this study was to assess the relative value of invasive and noninvasive predictors of outcome in patients after unstable angina. Fifty-four patients with unstable angina who had 6-month follow-up after stabilization on medical therapy were evaluated. We prospectively compared 24-hour Holter ST-segment monitoring at admission, quantitative exercise thallium tomography, and cardiac catheterization 5 +/- 2 days after admission and analyzed their value for predicting a cardiac event in patients with unstable angina within 6 months. When patients with a favorable outcome (n = 40) were compared with patients with an unfavorable outcome (n = 11) no statistical difference was found in duration of ST shift of 1 mm or more on Holter monitoring (51 +/- 119 min compared with 37 +/- 43 min), exercise duration by the standard Bruce protocol (8.0 +/- 3.6 min compared with 7.9 +/- 3.1 min), exercise-induced ST depression (0.6 +/- 0.9 mm compared with 1.0 +/- 1.0 mm), and contrast left ventricular ejection fraction (70% +/- 10% compared with 69% +/- 15%). Patients with a favorable outcome were distinguished from those with an unfavorable outcome by a higher maximum rate-pressure product (24 x 10(3) +/- 6 x 10(3) compared with 18 x 10(3) +/- 7 x 10(3), P = 0.0025), smaller size of the reversible scintigraphic perfusion defect expressed as a percentage of total myocardium imaged (6% +/- 11% compared with 17% +/- 18%, P = 0.05) and a smaller number of vessels with stenosis of 50% or more (1.1 +/- 1.2 compared with 2.1 +/- 1.0, P = 0.01). On multiple logistic regression analysis, a history of previous myocardial infarction was the most powerful predictor of outcome. In patients without myocardial infarction, reversible exercise thallium perfusion defect size was the only predictor

  16. Los mapas conceptuales como instrumento para analizar las ideas de los estudiantes de Maestro de Educación Primaria sobre qué enseñar de nutrición humana en Educación Primaria

    Directory of Open Access Journals (Sweden)

    Juan Carlos RIVADULLA-LÓPEZ

    2016-09-01

    Full Text Available Los mapas conceptuales son una técnica que se utiliza para obtener una representación visual de las ideas de una persona sobre un concepto o un conjunto de conceptos relacionados. Concretamente, en este trabajo, a través de una metodología cualitativa, analizamos los mapas conceptuales propuestos por 52 grupos de estudiantes de Maestro de Educación Primaria con el fin de averiguar las características de los mapas y el grado de adecuación de los contenidos que incluyen en lo que respecta a la enseñanza de la nutrición humana en el 3º ciclo de Educación Primaria. Los participantes cursaban Maestro de Educación Primaria, y la recogida de datos se realizó a través de una actividad formativa incluida en el tema ¿qué enseñar sobre Ciencias en Educación Primaria? Los resultados muestran que los mapas son una herramienta útil para trabajar en la formación docente pues permiten organizar, sintetizar y comunicar lo que saben los alumnos. Además, a través de este trabajo se observa que los estudiantes poseen destrezas aceptables a la hora de representar conceptos/ideas en un mapa conceptual, aunque el nivel de adecuación de los conceptos/ideas sobre nutrición humana y sus relaciones suele ser medio o bajo. Estos resultados constituyen una llamada de atención para la formación docente, tanto inicial como permanente, pues muestran la incapacidad de ésta para cambiar prioridades en lo que a la selección de contenidos se refiere.

  17. THE ASSESSMENT OF NICORANDIL EFFECT ON THE QUALITY OF LIFE IN PATIENTS WITH STABLE ANGINA IN THE "KVAZAR" STUDY

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    S. Yu. Martsevich

    2016-01-01

    Full Text Available Aim. To assess the effect of nicorandil added to the standard therapy of patients with stable ischemic heart disease (IHD on the quality of life (QoL.Material and methods. Patients with verified IHD (stable angina; n=120 were included into double-blind, placebo-controlled, parallel group study. All patients in the study received metoprolol tartrate (100 mg daily. Nicorandil was added (10 mg BID, and then after 2 weeks 20 mg BID to the treatment of patients of the main group. Placebo was added to treatment of patients in the control group. The study duration was 6 weeks. QoL was assessed by theSeattle questionnaire (SAQ and visual analogue scale (VAS at baseline and at the end of the study.Results. A significant decrease in the number of angina attacks was found in the nicorandil group compared to baseline [from 3.0 (2.0, 5.0 to 1.2 (0.7, 2.0; p<0.01] and compared to the placebo group [2.0 (1.0, 3.0; p=0.02]. The positive dynamics of QoL and functionality of patients with IHD was observed in the nicorandil group at the end of the study. It was demonstrated by significant improvement in all SAQ scales compared to baseline. Positive dynamics in the control group was found only in three scales (limitation of physical activity, frequency of angina attacks and patient attitude to the disease. VAS data revealed a significant increase in the integral index in patients of the main group (from 65.0±14.5 to 69.3±15.1; p=0.07, that was significantly higher than this in control group (64.6±15.1; p=0.02 at the end of the study.Conclusion. Nicorandil addition to the standard therapy of patients with IHD (stable angina demonstrated improvement in the QoL, assessed by SAQ questionnaire and VAS.

  18. Ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Greece: a cost-utility study

    OpenAIRE

    Kourlaba, Georgia; Vlachopoulos, Charalambos; Parissis, John; Kanakakis, John; Gourzoulidis, George; Maniadakis, Nikos

    2015-01-01

    Background To conduct an economic evaluation comparing ranolazine as add-on therapy to standard-of-care (SoC) with SoC alone in patients with stable angina who did not respond adequately to first line therapy, in Greece. Methods A decision tree model was locally adapted in the Greek setting to evaluate the cost-utility of ranolazine during a 6-month period. The analysis was conducted from a third-party payer perspective. The clinical inputs were extracted from the published literature. The co...

  19. "Angina pectoris instável: perfil de clientes de uma instituição privada"

    OpenAIRE

    Silvia Sidnéia da Silva

    2003-01-01

    Trata-se de estudo descritivo com abordagem de análise quantitativa que tem por objetivo identificar o perfil de clientes portadores de angina pectoris instável atendidos numa instituição privada, de um município do interior paulista. O referencial teórico utilizado foi o modelo de “Campo de Saúde” de Lalonde que analisa elementos como a biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde diante da ocorrência de patologias. A amostra constituiu-se de 58 cl...

  20. Effects on costs of frontline diagnostic evaluation in patients suspected of angina: coronary computed tomography angiography vs. conventional ischaemia testing

    DEFF Research Database (Denmark)

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

    2013-01-01

    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......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...

  1. 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...... 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...

  2. Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease: The iPOWER Study

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... 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...... testing. Conclusion-Impaired CFVR was detected in a substantial proportion, which suggests that coronary microvascular dysfunction plays a role in the development of angina pectoris. CFVR was associated with few cardiovascular risk factors, suggesting that CFVR is an independent parameter in the risk...

  3. CONDICIONANTES DEL RENDIMIENTO ACADÉMICO EN LA ESCOLARIDAD PRIMARIA EN BRASIL: UN ANÁLISIS MULTIFACTORIAL

    Directory of Open Access Journals (Sweden)

    Mauro Mediavilla

    2016-03-01

    Full Text Available RESUMEN: Una problemática educativa actual en Brasil es el alto porcentaje de alumnos en la escolaridad primaria que muestran un bajo nivel académico. Esta situación justifica el análisis de los determinantes del rendimiento académico en matemáticas para la totalidad de alumnos y su comparación al colectivo con un rendimiento considerado insuficiente. Para ello, se emplea una aproximación lineal y multivariante a partir de los datos contenidos en la base de datos del Sistema de Avaliação da Educação Básica 2005. En conjunto, los resultados obtenidos permiten afirmar que las dimensiones asociadas a la educabilidad resultan determinantes para comprender los rendimientos observados en la educación primaria.

  4. Las relaciones interdisciplinarias en los cursos por encuentro de la Carrera Licenciatura en Educación Primaria

    Directory of Open Access Journals (Sweden)

    MSc. Juan Carlos Pérez Castillo

    2018-01-01

    Full Text Available Las prácticas educativas con enfoque interdisciplinario constituyen un método de trabajo de los profesionales de la Educación Superior. Sobre esta base se implementaron diferentes formas particulares de relaciones interdisciplinarias en los cursos por encuentros de la carrera Licenciatura en Educación Primaria, entre las que se encuentran la determinación de nodos de articulación interdisciplinarios, las estrategias curriculares y evaluaciones integradoras, tomando como medio de las disciplinas de Formación Pedagógica General y Didáctica de La Escuela Primaria. Los resultados obtenidos se perciben a partir de una mayor sistematización de los contenidos de formación de ambas disciplinas, a partir de la consolidación del trabajo metodológico de colectivos interdisciplinarios

  5. Comprensión y Producción Textual Narrativa en Estudiantes de Educación Primaria

    Directory of Open Access Journals (Sweden)

    LEIDY TATIANA GUZMÁN TORRES

    2015-01-01

    Full Text Available Por medio de un enfoque mixto, se caracterizó la comprensión y producción textual narrativa en estudiantes de educación primaria (primero y segundo grado, así como aspectos psicosociales (valor social de la lectura y hábito lector y contextuales (interacciones cognitivas y afectivas docente-niños en docentes de educación primaria de tres instituciones educativas. Se encontró que los estudiantes tuvieron un desempeño medio alto en producción textual y comprensión literal, y bajo en comprensión inferencial. Además, se observó que la mayoría de las docentes son lectoras ocasionales, emplean interacciones cognitivas unidireccionales, ofrecen un mediano apoyo emocional a sus estudiantes y valoran la lectura como una herramienta instrumental y lúdica.

  6. Validation and comparison of EuroQoL-5 dimension (EQ-5D) and Short Form-6 dimension (SF-6D) among stable angina patients.

    Science.gov (United States)

    Wu, Jing; Han, Yuerong; Zhao, Fei-Li; Zhou, Jin; Chen, Zhijun; Sun, He

    2014-10-25

    Several preference-based health-related quality of life (HRQoL) instruments have been published and widely used in different populations. However no consensus has emerged regarding the most appropriate instrument in therapeutic area of stable angina. This study compared and validated the psychometric properties of two generic preference-based instruments, the EQ-5D and SF-6D, among Chinese stable angina patients. Convergent validity of the EQ-5D and SF-6D was examined with eight a priori hypotheses from stable angina patients in conjunction with Seattle Angina Questionnaire (SAQ). Responsiveness was compared using the effect size (ES), relative efficiency (RE) and receiver operating characteristic (ROC) curves. Agreement between the EQ-5D and SF-6D was tested using intra-class correlation coefficient (ICC) and Bland-Altman plot. Factors affecting utility difference were explored with multiple linear regression analysis. In 411 patients (mean age 68.08 ± 11.35), mean utility scores (SD) were 0.78 (0.15) for the EQ-5D and 0.68 (0.12) for the SF-6D. Validity was demonstrated by the moderate to strong correlation coefficients (Range: 0.368-0.594, Pstable-angina-specific health status than the EQ-5D (ES: 0.426 to 1.126). RE suggested that the SF-6D (RE: 44.8 to 177.8%) was more efficient than the EQ-5D except for physical function. Poor agreement between them was observed with ICC (0.448, Pstable angina patients. The SF-6D may be a more effective tool with lower ceiling effect and greater sensitivity. Further study is needed to compare other properties, such as reliability and longitudinal response.

  7. The effects of implementation of guideline-directed medical therapy on relief of angina in patients with stable coronary artery disease in Serbia

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    Ilić Ivan

    2016-01-01

    Full Text Available Introduction. Adherence to proposed lifestyle changes and prescribed medication in patients with stable coronary artery disease (SCAD is poor. Objective. We sought to investigate the influence of adjusting guideline proposed medications on relief of angina in a large group of patients with SCAD in Serbia. Methods. The study included a total of 3,490 patients from 15 cardiology clinics with symptoms of stable angina and at least one of the following criteria: abnormal electrocardiogram (ECG, history of myocardial infarction (MI, positive stress test, significant coronary artery disease on coronary angiogram or previous revascularization. All the patients underwent comprehensive evaluation at initial visit and after two months. The relief of angina was study end-point defined as any reduction in Canadian Cardiology Society (CCS class, number of angina attacks per week and/or number of tablets of short-acting nitrates per week. Results. Most patients were included based on abnormal ECG (48.4%. At Visit 1, the average number of prescribed classes of medications to a single patient increased from 4.16 ± 1.29 to 4.63 ± 1.57 (p < 0.001. At the follow-up, the patients had significantly lower blood pressure (141 ± 19 / 85 ± 11 vs. 130 ± 12 / 80 ± 8 mmHg; p < 0.001 and most of them reported CCS class I (63.3%. The average weekly number of angina attacks was reduced from 2.82 ± 2.50 at Visit 1 to 1.72 0 ± 1.66 at Visit 2, as well as average weekly use of short-acting nitrates to treat these attacks (2.69 ± 2.53 to 1.74 ± 1.47 tablets; p < 0.001 for all. Conclusion. Adjustment of prescribed medications to guideline recommendations in a large Serbian patient population with prevalent risk factors led to significant relief of angina.

  8. 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.

  9. Taller de recursos manipulativos para el aprendizaje de la geometría en educación primaria

    OpenAIRE

    Climent Rodríguez, Nuria

    2010-01-01

    Esta actividad tiene una doble vertiente: por un lado, los alumnos en pequeños grupos indagan sobre un material manipulativo para el aprendizaje de contenidos geométricos en Ed. Primaria; por otra parte, preparan un taller para que sus compañeros de clase experimenten con dicho material y puedan acercarse a lo que ellos han reflexionado sobre el mismo.

  10. La prevención del pié diabético desde atención primaria

    OpenAIRE

    Cabo Sanz, Alejandro de

    2014-01-01

    Se analizan las principales características de la patología y se trazan las pautas para la consecución de una guía de actuación protocolaria para el personal sanitario en atención primaria. El trabajo se basa en el contacto mantenido con diversos pacientes, el sondeo realizado con el personal sanitario implicado, y diversa bibliografía especializada en la materia

  11. Matemática informal y sentido numérico en escolares de priemr ciclo de E. Primaria

    OpenAIRE

    Adrián, Cristina; Jiménez-Fanjul, Noelia; Maz-Machado, Alexander; Bracho López, Rafael; García, Teresa

    2012-01-01

    Presentamos un avance de los resultados de una investigación sobre el sentido númerico en alumnos y alumnas de primero y segundo de Educación Primaria de la provincia de Córdoba. Se utilizó un test estandarizado y validado internacionalmente TEMA-3. Los niños y niñas manifestaron un alto grado de desarrollo del sentido numérico en la matemática informal.

  12. Seguimiento de las recomendaciones en prevención secundaria cerebrovascular en atención primaria

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    Carmen Tamayo-Ojeda

    2017-06-01

    Conclusiones: El seguimiento de las recomendaciones de las guías clínicas para la prevención de la enfermedad cerebrovascular en atención primaria es mejorable, especialmente en los más jóvenes. Son necesarios cambios organizativos e intervención más activa de los profesionales, así como estrategias para combatir la inercia terapéutica.

  13. Peripheral Endothelial Function and Coronary Flow Velocity Reserve Are Not Associated in Women with Angina and No Obstructive Coronary Artery Disease

    DEFF Research Database (Denmark)

    Flintholm Raft, Kristoffer; Frestad, Daria; Michelsen, Marie Mide

    2017-01-01

    PURPOSE: We investigated whether impaired flow-mediated dilation (FMD) and plasma biomarkers reflecting endothelial dysfunction are associated with coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease (CAD). METHODS: Patients (n = 194) were...... Doppler flow echocardiography (TTDE) of the left anterior descending artery during rest and high-dose dipyridamole infusion. CMD was defined as CFVR ....45). CONCLUSIONS: FMD and biomarkers of endothelial dysfunction did not identify individuals with CMD assessed as impaired CFVR by TTDE in women with angina and no obstructive CAD....

  14. Coronary microvascular dysfunction is not associated with a history of reproductive risk factors in women with angina pectoris-An iPOWER substudy

    DEFF Research Database (Denmark)

    Suhrs, Hannah Elena; Kristensen, Anna Meta; Rask, Anna Bay

    2018-01-01

    BACKGROUND: Reproductive risk factors such as preeclampsia and recurrent miscarriages have been associated with adverse cardiovascular (CV) events. Underlying coronary microvascular dysfunction (CMD) may be a common denominator. PURPOSE: We investigated whether a history of reproductive risk...... factors was associated with CMD in women with angina pectoris and no obstructive coronary artery disease (CAD). METHODS: Participants from the iPOWER study, including women with angina pectoris and no obstructive CAD (... risk factors: recurrent miscarriages, gestational diabetes, preeclampsia, rhesus immunity, polycystic ovary syndrome and menopausal status as well as migraine and Raynaud phenomenon. CMD was assessed by transthoracic Doppler echocardiography with measurement of coronary flow velocity reserve (CFVR...

  15. 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......% in patients treated with verapamil and trandolapril and 35% in patients treated with trandolapril (p = 0.01). In another study of patients with angina pectoris and left ventricular ejection fraction less than 40%, trandolapril plus verapamil improved exercise duration and left ventricular ejection fraction...

  16. Valor preditivo da angina em detectar doença coronariana em pacientes com estenose aórtica grave a partir da quinta década de vida Predictive value of angina to detect coronary artery disease in patients with severe aortic stenosis aged 50 years or older

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    Aline Alves Vargas Gonçalves

    2006-12-01

    Full Text Available OBJETIVO: O objetivo deste estudo é verificar o valor de previsão da angina de peito no diagnóstico da DAC em pacientes portadores de EA, a partir da quinta década de vida. MÉTODOS: A população estudada foi constituída por 186 pacientes consecutivos com EA e idade e" 50 anos, referidos para cirurgia de troca valvar aórtica entre junho de 1989 e setembro de 2004. Cinecoronariografia de rotina foi realizada em todos os pacientes. Cento e um eram homens (54,3% e 85, mulheres (45,7%, com idade de 66±8 anos. Angina estava presente em 124 pacientes (66,7%. O gradiente máximo transvalvar aórtico foi de 89,4±27,6 mmHg e a área valvar aórtica de 0,59±0,17 cm2. Calculamos a sensibilidade, a especificidade, o valor de previsão positivo e negativo e a razão de verossimilhança positiva da angina na predição da presença de DAC. RESULTADOS: DAC estava presente em 93 pacientes (50%. Dos 124 pacientes com angina, 68 (54,8% apresentavam DAC; enquanto dos 62 sem angina, 25 apresentavam DAC (40,3%. Portanto, a sensibilidade da angina para DAC foi de 73,1%, a especificidade de 39,7%, valor preditivo positivo de 54,8%, valor preditivo negativo de 59,6% e razão de verossimilhança positiva de 1,6. CONCLUSÃO: A angina de peito não é bom preditor da presença de DAC em pacientes com EA a partir da quinta década de vida.OBJECTIVE: The objective of this study is to evaluate the value of angina pectoris as a predictor of CAD (coronary artery disease in patients with AS (aortic stenosis during and beyond the 5th decade of life. METHODS: The study population consisted of 186 consecutive patients with AS and e" 50 years of age, referred for surgical aortic valve replacement (AVR between June 1989 and September 2004. Routine coronary angiography was performed for all patients. One hundred and one patients were males (54.3% and 85 were females (45.7%, and the mean age was 66±8 years. One hundred and twenty-four patients (66.7% had angina. The maximum

  17. Informe preliminar sobre sutura primaria en heridas de colon izquierdo Primary suture in left colon wounds:

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    Rafael Pinilla González

    2009-09-01

    Full Text Available INTRODUCCIÓN. Es importante evaluar críticamente el tratamiento de las heridas del colon izquierdo tratadas por laparotomía urgente. El presente artículo buscó presentar un informe preliminar del resultado y la evolución de los pacientes tratados con sutura o resección y anastomosis primaria de heridas de colon izquierdo, atendidos en el Hospital Universitario de Maabar (Yemen. Se ofrece también una somera revisión de la literatura. MÉTODOS. Entre mayo de 2006 y enero de 2008 fueron operados 5 pacientes con herida penetrante de abdomen, producidas por arma de fuego y arma blanca, las cuales afectaron al colon izquierdo (hubo 3 pacientes con más de una lesión. Se realizó un estudio retrospectivo descriptivo de estos 5 pacientes. RESULTADOS. La edad promedio fue de 25 años. Hubo 3 lesionados por arma blanca y 2 por arma de fuego. A todos se les realizó sutura o resección y anastomosis primaria. Se encontraron 8 lesiones asociadas, mayormente en el intestino delgado. Tres pacientes fueron clasificados en el grupo II y 2 en el grupo III de la escala CIS-Flint. En la escala AAST, hubo 3 pacientes en el grado III y 2 en el grado V. Estos últimos recibieron heridas por arma de fuego y presentaron mayor número de lesiones asociadas. CONCLUSIONES. Las heridas del colon izquierdo, independientemente del número de estas y de los factores de riesgo y otras lesiones asociadas, pueden ser tratadas de manera segura con reparación primaria.INTRODUCTION: It is important to critically assess the treatment of left colon wounds treated by urgent laparotomy. In present paper we tried to present a preliminary report of results and course of patients treated with suture o resection and primary anastomosis of left colon wounds, seen in University Hospital of Maabar (Yemen. A brief revision of literature is presented. METHODS: Between May, 2006 and January, 2008 5, patients were operated on from an abdomen penetrating wound caused by firearm and by

  18. Inferior J waves in patients with vasospastic angina might be a risk factor for ventricular fibrillation.

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    Fumimoto, Tomoko; Ueyama, Takeshi; Shimizu, Akihiko; Yoshiga, Yasuhiro; Ono, Makoto; Kato, Takayoshi; Ishiguchi, Hironori; Okamura, Takayuki; Yamada, Jutaro; Yano, Masafumi

    2017-09-01

    There is little information about the relationship between J waves and the occurrence of ventricular fibrillation (VF) in patients with vasospastic angina (VSA). The present study aimed to assess the incidence of J waves and the occurrence of VF in patients with VSA. The subjects consisted of 62 patients with VSA diagnosed by acetylcholine provocation tests in our institution from 2002 to 2014. We investigated the VF events, prevalence of J waves, and relationship between the VF events and J waves. J waves were observed in 16 patients (26%) and VF events were documented in 11 (18%). The incidence of VF in the patients with J waves was significantly higher than that in those without J waves (38% vs 11%, p=0.026). J waves were observed in the inferior leads in 14 patients, lateral leads in 5, and anterior leads in 3. A univariate analysis indicated that the incidence of VF in the inferior leads of J wave positive patients (46%=6/14) was significantly (p=0.01) higher than that in the inferior leads of J wave negative patients (10%=5/48). The J waves in the anterior and/or lateral leads were not related to the incidence of VF. Notched type and slurred type J waves were not associated with VF. A multivariate analysis revealed that J waves in VSA patients were associated with VF [odds ratio (OR) 6.41, 95% confidence interval (CI) 1.37-29.93, p=0.02] and organic stenosis (OR 6.98, 95% CI 1.39-35.08, p=0.02). Further, J waves in the inferior leads were strongly correlated with VF (OR 11.85, 95% CI 2.05-68.42, p=0.006). The results suggest that the existence of J waves, especially in the inferior leads, might be a risk factor for VF in VSA patients. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  19. Diagnostic Potential of Plasmatic MicroRNA Signatures in Stable and Unstable Angina

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    D'Alessandra, Yuri; Carena, Maria Cristina; Spazzafumo, Liana; Martinelli, Federico; Bassetti, Beatrice; Devanna, Paolo; Rubino, Mara; Marenzi, Giancarlo; Colombo, Gualtiero I.; Achilli, Felice; Maggiolini, Stefano; Capogrossi, Maurizio C.; Pompilio, Giulio

    2013-01-01

    Purpose We examined circulating miRNA expression profiles in plasma of patients with coronary artery disease (CAD) vs. matched controls, with the aim of identifying novel discriminating biomarkers of Stable (SA) and Unstable (UA) angina. Methods An exploratory analysis of plasmatic expression profile of 367 miRNAs was conducted in a group of SA and UA patients and control donors, using TaqMan microRNA Arrays. Screening confirmation and expression analysis were performed by qRT-PCR: all miRNAs found dysregulated were examined in the plasma of troponin-negative UA (n=19) and SA (n=34) patients and control subjects (n=20), matched for sex, age, and cardiovascular risk factors. In addition, the expression of 14 known CAD-associated miRNAs was also investigated. Results Out of 178 miRNAs consistently detected in plasma samples, 3 showed positive modulation by CAD when compared to controls: miR-337-5p, miR-433, and miR-485-3p. Further, miR-1, -122, -126, -133a, -133b, and miR-199a were positively modulated in both UA and SA patients, while miR-337-5p and miR-145 showed a positive modulation only in SA or UA patients, respectively. ROC curve analyses showed a good diagnostic potential (AUC ≥ 0.85) for miR-1, -126, and -483-5p in SA and for miR-1, -126, and -133a in UA patients vs. controls, respectively. No discriminating AUC values were observed comparing SA vs. UA patients. Hierarchical cluster analysis showed that the combination of miR-1, -133a, and -126 in UA and of miR-1, -126, and -485-3p in SA correctly classified patients vs. controls with an efficiency ≥ 87%. No combination of miRNAs was able to reliably discriminate patients with UA from patients with SA. Conclusions This work showed that specific plasmatic miRNA signatures have the potential to accurately discriminate patients with angiographically documented CAD from matched controls. We failed to identify a plasmatic miRNA expression pattern capable to differentiate SA from UA patients. PMID:24260372

  20. 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.