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

Clima social escolar y rendimiento académico en comunicación en estudiantes de primaria – Lima, 2014

OpenAIRE

Pacheco Villarreal, Rosa Del Pilar

2014-01-01

La presente investigación titulada: “Clima Social Escolar y Rendimiento Académico en Comunicación de los estudiantes del V ciclo de primaria de la Institución Educativa N° 1157 Julio César Tello Rojas – Cercado de Lima, 2014”, tuvo como objetivo determinar la relación entre el clima social escolar y el rendimiento académico en comunicación de los estudiantes del V ciclo de primaria. Esto como respuesta al problema: ¿Qué relación existe entre clima social escolar y rendimient...

Relación entre los movimientos sacádicos, la lectoescritura y el rendimiento académico en niños de cuarto de Primaria

OpenAIRE

Ramírez-Bohórquez, Viviana

2016-01-01

En el ámbito escolar es frecuente encontrar estudiantes con bajo rendimiento académico, siendo el área de Lengua Castellana una de las asignaturas con mayor pre-valencia de suspensiones caracterizadas por las dificultades a nivel lecto – escrito. El presente estudio se crea con el fin de buscar la relación entre movimientos sacádicos, lecto - escritura y rendimiento académico de niños de grado cuarto de Primaria, perte-necientes a una institución educativa privada de la ciudad de Bogotá. Es u...

Funciones ejecutivas y Rendimiento Escolar en Educación Primaria

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Caro-Franco, Federico

2016-01-01

En el presente Trabajo de Fin de Máster se ha investigado si existe vinculación entre el rendimiento escolar y las funciones ejecutivas en los alumnos que cursan Educación Primaria. Para ello, se evaluaron 32 alumnos de entre 6 y 8 años, 16 de los cuales presentaban un rendimiento académico bajo, y los restantes 16, un rendimiento académico normalizado. Para diagnosticar el grado de rendimiento de las funciones ejecutivas, se evaluó la atención, tanto sostenida como selectiva, la planificació...

Thallium-201 myocardial imaging in unstable angina and variant angina

International Nuclear Information System (INIS)

Wackers, F.J.Th.; Lie, K.I.; Liem, K.L.; Sokole, E.B.; Schoot, J.B. van der

1980-01-01

It is of clinical relevance in the coronary care unit to evaluate the potential role of 201 Tl scintigraphy in patients with unstable angina. In the present chapter the authors discuss 1) the pattern of 201 Tl scintigraphy in patients with unstable angina; and 2) the potential predictive value of 201 Tl scintigraphy in identifying patients with unstable angina who have a poorer prognosis or greater tendency to subsequently develop acute myocardial infarction. All patients with unstable angina pectoris were purposely studied during the pain free period. It seemed conceivable that injecting 201 Tl during an anginal attack would result in a high percentage of scintigraphic defects and probably diminish a potential discriminative value of the method. Moreover in clinical practice the majority of patients arrive at the coronary care unit some time after the last anginal attack. If a diagnostic test performed at this time could distinguish high and low risk patients, important therapeutic decisions might be made at the earliest possible times. (Auth.)

METÁFORAS DE LA TRANSICIÓN: LA RELACIÓN ENTRE LA ESCUELA INFANTIL Y LA ESCUELA PRIMARIA Y LA PERSPECTIVA DE FUTUROS DOCENTES DE EDUCACIÓN INFANTIL

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Javier Argos González

2011-01-01

Full Text Available La transición entre etapas educativas y, en particular la que se realiza entre la Educación Infantil y la Educación Primaria, resulta un elemento clave y un reto para el adecuado desarrollo y aprendizaje de los alumnos. En el presente trabajo realizamos un acercamiento a la perspectiva que tienen estudiantes de Magisterio de Educación Infantil en relación con la continuidad entre las referidas etapas, a partir de la experiencia en su primer año de prácticas en centros educativos. Nuestro análisis se sustenta en las observaciones, reflexiones y argumentaciones efectuadas por los estudiantes en relación con cuestiones que, en torno a la continuidad, les planteamos al iniciar sus prácticas educativas, así como en las metáforas con las que sintetizaban su perspectiva al respecto. Los resultados constatan una cierta disfunción entre la importancia otorgada a la continuidad en los centros y sus prácticas cotidianas. De lo anterior se desprende la necesidad de instaurar en los centros propuestas armonizadas que faciliten una adecuada transición entre etapas.

Relación entre la comprensión lectora, la ortografía y el rendimiento: un estudio en Educación Primaria

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Isabel Pascual-Gómez

2017-01-01

Full Text Available Son numerosos los trabajos realizados para conocer relación entre la comprensión lectora, la ortografía y el rendimiento académico. La codificación y la decodificación son habilidades necesarias para el aprendizaje de la lecto-escritura en las etapas iniciales de su aprendizaje. El objetivo del estudio es comprobar las relaciones existentes entre estas variables al final de la etapa de primaria. Se evaluó la ortografía con un dictado y la comprensión con el test de compresión lectora de Ángel Lázaro. En el estudio participaron 252 alumnos con edades comprendidas entre 11 y 12 años. Para conocer estas relaciones se empleó un diseño correlacional. Se crearon tres grupos en función de los niveles de ejecución en comprensión lectora y ortografía y se realizaron diferentes contrastes. En el total de la muestra se encontraron correlaciones significativas entre el rendimiento académico y la comprensión lectora y débiles y sin significación estadística entre las medidas ortográficas y la comprensión lectora. Con respecto al solapamiento entre ambas, el análisis por grupos confirmó que una buena ejecución en comprensión lectora no asegura un desempeño adecuado en decodificación ortográfica. En la discusión se analizan estas relaciones y sus implicaciones educativas.

Advancements in Pharmacotherapy for Angina

Science.gov (United States)

Jain, Ankur; Elgendy, Islam Y.; Al-Ani, Mohammad; Agarwal, Nayan; Pepine, Carl J.

2017-01-01

Introduction Angina pectoris is the most prevalent symptomatic manifestation of ischemic heart disease, frequently leads to a poor quality of life, and is a major cause of medical resource consumption. Since the early descriptions of nitrite and nitrate in the 19th century, there has been considerable advancement in the pharmacologic management of angina. Areas covered Management of chronic angina is often challenging for clinicians. Despite introduction of several pharmacological agents in last few decades, a significant proportion of patients continue to experience symptoms (i.e., refractory angina) with subsequent disability. For the purpose of this review, we searched PubMed and Cochrane databases from inception to August 2016 for the most clinically relevant publications that guide current practice in angina therapy and its development. In this article, we briefly review the pathophysiology of angina and mechanism-based classification of current therapy. This is followed by evidence-based insight into the traditional and novel pharmacotherapeutic agents, highlighting their clinical usefulness. Expert opinion Considering the wide array of available therapies with different mechanism efficacy and limiting factors, a personalized approach is essential, particularly for patients with refractory angina. Ongoing research with novel pharmacologic modalities is likely to provide new options for management of angina. PMID:28264619

Influencia de la memoria verbal y la memo-ria visual sobre el rendimiento académico en Educación Primaria

OpenAIRE

Blanco-Cerro, Susana

2013-01-01

Objetivo. Estudiar la relación entre la memoria visual a corto y largo plazo, y la memoria verbal respecto al rendimiento académico en distintas áreas educativas en alumnos del ter-cer ciclo de Educación Primaria. Metodología. Para analizar las variables implicadas se ha aplicado el Test de la Figura Compleja de Rey (Meyer, 1995) y el Test de Memoria Auditiva Inmediata (Cordero, 2009) a una muestra de 30 alumnos de entre 10 y 12 años de Educa-ción Primaria. Para realizar los análisis estadíst...

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...

Boletín epidemiológico de la Comunidad de Madrid: encuesta sobre su difusión y percepción entre los médicos de atención primaria en el año 2000

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Fernández Rodríguez Silvia

2002-01-01

Full Text Available Fundamento:. El objetivo es conocer la difusión y percepción del Boletín Epidemiológico de la Comunidad de Madrid (BECAM entre los médicos de atención primaria, con el fin de adaptar la publicación al interés de sus lectores. Método: Encuesta telefónica entre los médicos de primaria de la Comunidad de Madrid, preguntando por la frecuencia de lectura, interés y utilidad de la información contenida El tamaño muestral se estimó en 346 médicos. Se realizó un muestreo bietápico por conglomerados en la primera etapa, con selección aleatoria de 125 centros de salud y 2,7 médicos por centro, siendo el 17% coordinadores de equipo. Se comparan los resultados entre médicos y coordinadores mediante Chi-cuadrado y test exacto de Fisher, con Epi-Info v.6. Resultados: Se realizó un total de 305 entrevistas: 245 médicos y 60 coordinadores. Sabían de la existencia del BECAM el 91,5% (IC 95%: 88,1-94,8, y el 27,2% (IC 95%: 21,9-32,5 conocía más del 50% de los números editados durante el año. El 92,4% (IC 95%: 89,4-95,8 lo consideraba interesante o muy interesante, puntuando con una media de 3,5 sobre 5 su utilidad. De las secciones fijas, la mejor valorada es Brotes Epidémicos, y de los informes, los relacionados con enfermedad meningocócia, tuberculosis y VIH/Sida. Conclusiones: El BECAM es una publicación que, aunque no es conocida ampliamente entre los médicos de primaria de nuestra Comunidad, cuando se lee es bien valorada; siendo así un instrumento útil de retroalimentación en la Red de Vigilancia Epidemiológica.

El lenguaje en la educación: prácticas de lectura y escritura en preescolar básica y primaria 2005

OpenAIRE

Flórez Romero, Rita; Moreno Angarita, Marisol

2005-01-01

El proyecto Hablar, leer y escribir en preescolar y primaria para la participación, el éxito académico y la vida adulta se define, en primera instancia, como una acción cooperativa entre profesores universitarios, profesionales, docentes de preescolar y educación básica primaria, padres de familia y niños. Su intención fundamental es la de contribuir a la transformación de la realidad educativa de los niños y las niñas en edades comprendidas entre los 4 y los 11 años, con el fin d...

ESTUDIO SOBRE CONSUMO DE DROGAS Y ACOSO ESCOLAR ENTRE CURSANTES DE LA ENSEÑANZA PRIMARIA EN COSTA RICA

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Julio Bejarano Orozco

2016-07-01

Full Text Available En este estudio se analiza la problemática del consumo de alcohol, tabaco y otras drogas, así como aspectos relacionados con el uso de tecnologías de la información y comunicación (TIC, intimidación o bullying en población escolarizada del segundo ciclo de educación primaria (4º, 5º y 6º grado de cuatro escuelas urbanas y cuatro de atención prioritaria de las provincias de Alajuela, Cartago, Heredia y San José. Para tal propósito, se realizó una encuesta entre los meses de junio a noviembre del 2013, en una muestra de 537 estudiantes. Los resultados evidencian un inicio temprano en el consumo de alcohol, así como una utilización importante de las TIC y la existencia de situaciones conocidas como cyberbullying, y problemas relacionados con el bullying, lo que evidencia la necesidad de continuar realizando esfuerzos en el nivel interinstitucional en favor de prevenir determinadas conductas de riesgo presentes en la infancia.

Bradycardiac Angina: Haemodynamic Aspects and Treatment*

Science.gov (United States)

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

1969-01-01

A patient with a sinus bradycardia and angina is described who was unable to increase his heart rate on vigorous exercise by more than a few beats. His severe angina was attributed to the bradycardia. Atrial pacing of his heart abolished his angina and increased his exercise tolerance. Circulatory changes at rest, on exertion, and with atrial pacing are described. The cause of angina in this patient is discussed. PMID:5761833

Bradycardiac angina: haemodynamic aspects and treatment.

Science.gov (United States)

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

1969-01-11

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

Detection of angina-related coronary artery in patients with unstable angina pectoris by using 123I-BMIPP myocardial scintigraphy

International Nuclear Information System (INIS)

Oka, Toshiaki; Inoue, Seiji; Asano, Ryuta; Handa, Atsushi; Iguchi, Nobuo; Sumiyoshi, Tetsuya; Hosoda, Saichi; Kobayashi, Hideki; Kusakabe, Kiyoko.

1996-01-01

To evaluate the diagnostic accuracy of detection of angina-related coronary arteries in patients with unstable angina pectoris. Twenty patients with unstable angina pectoris underwent 123 I-BMIPP scintigraphy at rest. A mean duration from last anginal attack to 123 I-BMIPP scintigraphy was 4.8±3.2 days. Seventeen of 20 angina-related coronary territories were detected by reduced 123 -BMIPP uptake. The sensitivity and specificity for detection of angina-related coronary arteries were 85% and 95%, respectively. The decrease in myocardial uptake of 123 I-BMIPP agreed with the decrease in regional wall motion by using ultrasonic echocardiography. 123 I-BMIPP scintigraphy may be useful for detection of angina-related coronary artery in a routine clinical examination in patients with unstable angina pectoris. (author)

Amenorrea primaria

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Alfredo Jácome Roca

1988-08-01

son las gonadotrofinas FSH y LH, el estradiol- y en ocasiones la prolactina-, además del cariotipo, o en su defecto, la cromatina sexual. Entre otras ayudas diagnósticas estarían las imagenológicas (ecografía pélvica, Rayos X de silla turca o tomografía computarizada de alta resolución en la misma región, carpograma y otros exámenes radiológicos, la laparoscopia o la laparotomia. En algunas oportunidades se han de realizar pruebas dinámicas para valorar los ejes de hipotálamo-hipófosis con las glándulas efectoras.

El estudio de estos pacientes lo hacemos en el Hospital San Ignacio de Bogotá, con un equipo multidisciplinario constituido por Endocrinólogos Generales y Ginecológicos, Genetistas, Radiólogos y Patólogos. La mayoría de los casos son referidos a la Consulta de Esterilidad y Endocrinología Ginecológica donde en total se atienden entre 250 y 300 casos al año, de los cuales un 23% corresponde a pacientes con amenorrea y aproximadamente e18% a casos de amenorrea primaria. En ocasiones los pacientes son referidos a la Consulta de Endocrinología General, pero en cualquier eventualidad, el estudio lo hacemos conjuntamente.

En cuanto a la clasificación, algunos prefieren incluir los casos de amenorrea primaria o secundaria en forma conjunta, tomando como base la presencia o ausencia de anormalidades cromosómicas; otros se basan en el fenotipo (seudohermafroditismos masculino y femenino, hipogonadismos con fenotipo femenino, hipogonadismo con virilización, amenorrea con desarrollo puberal normal, etc.. También se encuentran clasificaciones extensas que tratan de incluir todos los casos posibles. En esta presentación preferiremos hacer una división sencilla, por niveles, clasificando las amenorreas primarias en hipotálamo-hipofisiarias, gonadales, anormalidades anatómicas y las asociadas a trastornos suprarrenales o tiroideos. Otras causas podrían ser las enfermedades sistémicas debilitantes tales como diabetes

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

DEFF Research Database (Denmark)

Andréll, P; Yu, W; Gersbach, P

2010-01-01

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

Effectiveness of Ivabradine in Treating Stable Angina Pectoris.

Science.gov (United States)

Ye, Liwen; Ke, Dazhi; Chen, Qingwei; Li, Guiqiong; Deng, Wei; Wu, Zhiqin

2016-04-01

Many studies show that ivabradine is effective for stable angina.This meta-analysis was performed to determine the effect of treatment duration and control group type on ivabradine efficacy in stable angina pectoris.Relevant articles in the English language in the PUBMED and EMBASE databases and related websites were identified by using the search terms "ivabradine," "angina," "randomized controlled trials," and "Iva." The final search date was November 2, 2015.Articles were included if they were published randomized controlled trials that related to ivabradine treatment of stable angina pectoris.Patients with stable angina pectoris were included.The patients were classified according to treatment duration (Angina outcomes were heart rate at rest or peak, exercise duration, and time to angina onset.Seven articles were selected. There were 3747 patients: 2100 and 1647 were in the ivabradine and control groups, respectively. The ivabradine group had significantly longer exercise duration when they had been treated for at least 3 months, but not when treatment time was less than 3 months. Ivabradine significantly improved time to angina onset regardless of treatment duration. Control group type did not influence the effect of exercise duration (significant) or time to angina onset (significant).Compared with beta-blocker and placebo, ivabradine improved exercise duration and time to onset of angina in patients with stable angina. However, its ability to improve exercise duration only became significant after at least 3 months of treatment.

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...... after sumatriptan self-administration was experienced on two occasions by a 61-year old man with a history of minor myocardial infarction--without post-infarction angina--two years previously. The angina after sumatriptan was accompanied on both occasions by significant ST-segment depression on ECG...

Angina

Science.gov (United States)

... situations that cause these emotions. Exercise and relaxation can help relieve stress. Alcohol and drug use play a part in causing stress and don't relieve it. If stress is a problem for you, talk with your ... angina can continue their normal activities. This includes work, hobbies, ...

La informatización de la atención primaria de salud

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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.

Angina - what to ask your doctor

Science.gov (United States)

What to ask your doctor about angina and heart disease; Coronary artery disease - what to ask your doctor ... the signs and symptoms that I am having angina? Will I always have the same symptoms? What ...

Videojuegos, televisión y rendimiento académico en alumnos de primaria

OpenAIRE

M. del Mar Badia Martín; Mercè Clariana Muntada; Concepción Gotzens Busquets; Ramón Cladellas Pros; Teresa Dezcallar Sáez

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 ...

Angina pectoris: current therapy and future treatment options.

Science.gov (United States)

Parikh, Raj; Kadowitz, Philip J

2014-02-01

Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

Thallium-201 scintigraphy in unstable angina pectoris

International Nuclear Information System (INIS)

Wackers, F.J.T.; Lie, K.I.; Liem, K.L.; Sokole, E.B.; Samson, G.; Van Der Schoot, J.B.; Durrer, D.

1978-01-01

Thallium-201 scintigraphy was performed during the pain free period in 98 patients with unstable angina. Scintiscans were positive in 39 patients, questionable in 27 patients and normal in 32 patients. Eighty-one patients responded favorably to treatment (group I). Seventeen patients had complicated courses (group II) and despite maximal treatment with propranolol either developed infarction (six patients) or continued to have angina necessitating coronary surgery (11 patients). In group I during the pain free period 26 of 81 patients had positive thallium-201 scans, whereas 20 patients had an abnormal ECG at that time; during angina 18 patients had transient ECG changes. In group II during the pain free period 13 of 17 patients had positive scans, whereas two patients had abnormal ECG at that time; during angina 12 patients showed transient ECG changes. The sensitivity to recognize group II was 76% for thallium-201 scintigraphy, 11% for ECG during the pain free period; 70% for ECG during angina; 94% for the combination of either positive scans or abnormal ECG. Thus, positive thallium-201 scans occur in patients with unstable angina, positive scans can be obtained during the pain free period, thallium-201 scans are more frequently positive in patients with complicated course

Usefulness of hyperventilation myocardial SPECT for diagnosing vasospastic angina pectoris

International Nuclear Information System (INIS)

Tahara, Yorio; Shimoyama, Katsuya; Nishimura, Tooru; Sasaki, Akira; Taya, Makoto; Mizuno, Haruyoshi; Ono, Akifumi; Tsuya, Tsuneo; Ishikawa, Kyozo

1990-01-01

We evaluated the usefulness of hyperventilation myocardial scintigraphy (HV-SPECT) for diagnosing vasospastic angina pectoris. The subjects consisted of 11 patients with rest angina and 13 with rest and exertional angina in whom coronary spasm was demonstrated by coronary angiography, and 6 with exertional angina in whom a significant stenotic lesion was observed by coronary angiography. Hyperventilation was performed at a rate of 40/min for 5 minutes in all the patients. Ischemia was considered to be present when defect and redistribution were observed by SPECT. HV-SPECT revealed positive findings in 8 patients with rest angina (73%) and 9 with exertional and rest angina (69%) but only in 1 with exertional angina (17%). Ischemic ST changes on monitor ECG were observed in 13 of the 30 patients (43%); ST was enhanced in 4 patients and depressed in 9 patients. In the patients with rest angina, HV-SPECT induced ischemic findings more frequently than exercise SPECT (73% vs 55%). HV-SPECT seems to be useful as a non-invasive method for diagnosing angina pectoris resulting from coronary spasm. (author)

RELACIÓN DE LA LECTOESCRITURA CON LOS PATRONES MOTRICES EN ALUMNOS DE EDUCACIÓN PRIMARIA

OpenAIRE

Del-Pozo-Sánchez, María Josefa

2012-01-01

En el presente trabajo se ha estudiado la posible relación entre los procesos de lectoescritura y motricidad y cómo estos influyen en el rendimiento académico. Para ello se ha tomado una muestra de 33 niños en educación primaria y se les ha evaluado con una batería de pruebas dirigida a valorar su motricidad y habilidades en lectura y escritura. Los resultados obtenidos muestran que si bien existe una relación moderada entre aspectos concretos de la motricidad y la lectura, no se puede ...

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.

Comprensión lectora y resolución de problemas en estudiantes de Educación Primaria Bilingüe en comunidades shipibas

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Dulio Oseda Gago

2014-12-01

Full Text Available Objetivos: Determinar la relación entre la comprensión lectora y la resolución de problemas en estudiantes del sexto grado de educación primaria bilingüe de las comunidades shipibas del distrito de Yarinacocha, Ucayali en el 2014. Métodos: Investigación de enfoque cuantitativo, tipo básica, diseño descriptivo - correlacional. La muestra fue tomada probabilísticamente conformada por 56 estudiantes del sexto grado de Educación Primaria Bilingüe en las comunidades shipibas del distrito de Yarinacocha el cual se determinó con un nivel de significancia del 5 %. Según el diseño, se utilizó los estadígrafos de la estadística descriptiva e inferencial, para contrastar la hipótesis se hizo uso de la prueba r de Pearson y la t de Student, que nos permitió deducir que existe una correlación directa y significativa (r=0,592. Resultados: La significancia obtenida (0,003 resultó inferior al nivel de significación propuesta (α = 0,05 por lo que se decide rechazar la hipótesis nula, afirmando que en términos generales, existe relación directa y significativa entre la comprensión lectora y la resolución de problemas matemáticos en los estudiantes del sexto grado de Educación Primaria Bilingüe evaluados en las comunidades Shipibas del distrito de Yarinacocha. Conclusiones: Se afirma que existe una relación directa entre la comprensión lectora y la resolución de problemas en estudiantes del sexto grado de Educación Primaria Bilingüe en las comunidades shipibas del distrito de Yarinacocha, 2014.

Beneficios y aplicaciones de la educación musical en alumnos con retraso mental en Educación Primaria

OpenAIRE

Catalina Presa, Isabel

2016-01-01

Este trabajo está dirigido a la investigación de los posibles beneficios que pueda ejercer la música sobre los alumnos de Educación Primaria haciendo hincapié en aquellos con la patología de retraso mental. En la primera parte del trabajo se lleva a cabo una investigación y un análisis teórico de los conceptos y contenidos de la educación musical en la enseñanza primaria y el retraso mental junto con la relación entre ambos. En la segunda parte llevo a cabo una propuesta de intervención...

Experiencia de colaboración entre atención primaria y salud mental en el Departamento de Salud La Ribera, 7 años después

Directory of Open Access Journals (Sweden)

Miquel Morera-Llorca

2014-09-01

Full Text Available Pese a la gran frecuencia de problemas de salud mental entre los consultantes de atención primaria, persiste el problema de unos inadecuados diagnóstico y tratamiento. Se necesita una buena capacitación de los médicos de familia para el manejo de estos trastornos, a fin de minimizar su impacto sanitario, económico y social. Entre otros elementos, se considera relevante la cooperación con los servicios de salud mental, para la cual existen diferentes modelos. Nuestro departamento de salud inició en 2006 una colaboración estable según el modelo de enlace. Se han obtenido resultados positivos en términos de reducción de demora para las primeras visitas al especialista y de aumento de la satisfacción de los profesionales, aunque deben interpretarse con cautela. Recientemente se han acumulado evidencias sobre la utilidad del modelo colaborativo, aunque su evaluación y extrapolación son complejas. Nos proponemos ahondar en la evaluación de nuestro modelo, de manera análoga a otras iniciativas de nuestro entorno.

Coronary hemodynamics in vasospastic angina

International Nuclear Information System (INIS)

Matsumura, Kentaro; Kubota, Shinobu; Serizawa, Takashi; Nakase, Emiko; Kawai, Ichiro; Saito, Takayuki

1991-01-01

To evaluate the coronary circulation and myocardial perfusion dynamics, we performed left coronary digital subtraction angiography (DSA) in 35 patients with vasospastic angina. The left coronary circulation time (CCT) measured from the proximal left coronary artery to the coronary sinus was 5.77±0.86 sec, and the left epicardial conducting artery transmission time (CAT) measured from the proximal left coronary artery to the apical area was 2.65±0.82 sec in normal controls. The CCT and CAT were significantly prolonged in patients with vasospastic angina, indicating that the coronary peripheral vascular resistance is probably greater after the cessation of nitrates and Ca ++ -antagonists. After the intracoronary injection of ergonovine malate, the CCT was slightly shortened, but the apical T 1/2 was significantly prolonged in patients with vasospastic angina. This suggested that coronary vasospasm is present not only in the epicardial arteries but also in coronary arteries with peripheral resistance. These phenomena were not observed in normal controls. We performed left coronary DSA after conventional left coronary cineangiography. When the CCT exceeded 6.7 sec, we considered that the coronary circulation was significantly impaired. We concluded that the coronary DSA is very useful for evaluating abnormal coronary circulation in patients with vasospastic angina during myocardial perfusion. (author)

Detección del trastorno depresivo mayor en atención primaria. Una revisión

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José Manuel Calvo Gómez

2015-07-01

Full Text Available Antecedentes: El trastorno depresivo mayor (TDM es una enfermedad frecuente en la población general y una de las principales causas de discapacidad en el mundo. La distinción entre los cambios que normalmente ocurren en el estado del ánimo y aquellos que están presentes en el espectro de los trastornos depresivos no es una tarea fácil, por esta razón se han propuestos varios mecanismos e instrumentos para mejorar la detección de este trastornos en la consulta de atención primaria. Objetivos: Evaluar si la detección sistemática rutinaria con instrumentos de tamizaje, con o sin sistemas de seguimiento y manejo integrado, es más efectiva que la atención usual en identificar pacientes con depresión, facilitar su tratamiento, y mejorar los resultados clínicos, a nivel de la atención primaria. Material y Métodos: Para determinar la utilidad del tamizaje sistemático para depresión a nivel de atención primaria, se llevó a cabo una búsqueda de estudios de casos y controles, cohortes y controlados aleatorizados, revisiones sistemáticas, y meta-análisis, en las bases de datos MEDLINE, Base de datos de revisiones sistemáticas Cochrane, Registro central de estudios controlados Cochrane, PsycINFO, y EMBASE, desde enero de 1976 hasta el 30 de abril de 2013. Resultados: La evidencia existente mostró que muchos casos de depresión no son detectados. Los médicos de atención primaria (MAP logran tasas de detección del trastorno depresivo entre el 30% y 40% (rango 7-70%, sin utilizar herramientas adicionales para el diagnóstico como las escalas de una, dos y tres preguntas. Los pacientes con los cuadros menos severos y más jóvenes son los menos detectados. Conclusiones: La evidencia encontrada muestra que el tamizaje para depresión a nivel de atención primaria con retroalimentación del resultado puede incrementar el reconocimiento del trastorno por parte del MAP. Sin embargo, el efecto de la retroalimentación sobre el tratamiento

The economic burden of angina on households in South Asia

Science.gov (United States)

2014-01-01

Background Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. Methods We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Results Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p angina-affected households relative to matched controls in India (9.60%, p Angina-affected households significantly relied on borrowing or selling assets to finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Conclusions Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD. PMID:24548585

Inteligencia emocional y relaciones interpersonales en estudiantes de 6° grado de primaria de la I.E. N° 6031 “Santa María de Lurín”- distrito de Lurín, 2015

OpenAIRE

Salinas Salinas, Roberto Juan

2016-01-01

Este estudio responde al problema general: ¿Existe relación directa y significativa entre la inteligencia emocional y las relaciones interpersonales en estudiantes de 6° grado de primaria de la I.E N° 6031 “Santa María de Lurín”, 2015? Y tuvo como objetivo determinar la relación entre la inteligencia emocional las relaciones interpersonales en estudiantes de 6° grado de primaria de la I.E N° 6031 “Santa María de Lurín”, 2015. El estudio ha sido de tipo básica sustantiva y de...

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

Acompañamiento pedagógico y desempeño docente en Instituciones Educativas del Nivel Primaria distrito de Barranca, 2014

OpenAIRE

Allca Ilave, Veri Avit

2016-01-01

La presente investigación busca dar respuesta al problema de investigación formulado: ¿Qué relación existe entre el acompañamiento pedagógico y el desempeño docente en una Institución Educativa del nivel primaria en el distrito de Barranca, año 2014?, el objetivo general fue establecer la relación existente entre el acompañamiento pedagógico y el desempeño docente, ya que se busca determinar concretamente la relación entre las variables y la relación de una variable con las dim...

[Treatment aspects of unstable angina. Costs and payments for DRG].

Science.gov (United States)

Brunelli, C; Spallarossa, P; Pasdera, A; Bezante, G P; Zorzet, F; Rossettin, P

1998-01-01

Patients with unstable angina fall into a wide prognostic and therapeutic spectrum but, in general, have great access to specialty care and invasive procedures. In the modern era, in which admissions for unstable angina outnumber those for myocardial infarction, and growing economic pressures are placed on health care systems, cardiologists must re-examine clinical strategies for treating unstable angina in the light of health-cost accounting. The aims of the present study were to examine the current management of patients admitted to our cardiology department and to calculate the medical costs. A patient schedule was drawn up to prospectively register the number and type of cardiac processes carried out during hospitalization for all unstable angina patients in the period between March 1st and May 30th, 1995. Time (minutes) actually spent by both physicians and nurses for each cardiac process were carefully recorded in order to calculate the activity budget. The effective economic budget was built for each cardiac process taking into account salaries, consumable supplies, equipment service contracts, depreciation and indirect medical and non medical costs for CCU and ward. Based to the Diagnosis Related Groups (DRG) system, 53 out of 318 patients (16%) were admitted with documented or suspected unstable angina and allocated to discharge into four DRGs: DRG 140-medically treated unstable angina: 18 patients; DRG 124-unstable angina with angiography: 16 patients; DRG 122-unstable angina evolving in myocardial infarction: 6 patients; DRG 112-unstable angina with angioplasty: 13 patients. The mean cost for hospitalized patient with unstable angina was 5,574,958 Italian Liras (DRG 140 = 2,687,719; DRG 124 = 2,800,347; DRG 122 = 6,086,563; DRG 112 = 12,751,454). The difference in costs was essentially related to the procedures involved in medical care, DRGs with expensive cardiac processes having higher costs. Furthermore, these data show a deep discrepancy between

Baremación de una Prueba Estandarizada de Resúmenes (RESUMeV Para los Niveles de 4º y 6º de Educación Primaria

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José A. León

2015-01-01

Full Text Available El objetivo del estudio fue el de mostrar evidencias de fiabilidad y validez para una prueba de resúmenes (RESUMev que evalúa el grado de comprensión lectora en alumnos de cuarto y sexto de primaria. Participaron un total de 528 estudiantes de primaria, de los cuales 236 fueron estudiantes de 4º de primaria (9 y 10 años y 292 a 6º de primaria (11 a 13 años. Todos estos alumnos procedían de 21 centros escolares. Para evaluar la consistencia interna, se calculó el alfa de Cronbach en los criterios de evaluación de resúmenes (contenido, coherencia y estilo y su índice de homogeneidad (Hj . La validez se evaluó mediante la comparación entre niveles académicos. En cuanto a los resultados, se obtuvieron índices elevados significativos de fiabilidad y de validez. Los resultados proporcionan evidencia empírica para la validez de la prueba.

costarricenses de primaria y secundaria

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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.

Angina in Women Can Be Different Than Men

Science.gov (United States)

... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Angina in Women Can Be Different Than Men Updated: ... stops, so do the symptoms. So why would angina symptoms be different in women and men? Heart ...

Creatividad gráfica y percepción visual en alumnos de 1º de Educación Primaria

OpenAIRE

Diego-Nieto, Vera

2013-01-01

El objetivo de la presente investigación es analizar la relación entre percepción visual y creatividad gráfica, en una muestra de 31 alumnos de 1º de Educación Primaria, con edades comprendidas entre 6 y 7 años. Se utilizó el Test de Desarrollo de la Percepción Visual de Marianne Frostig (1964) y el Test de Pensamiento Creativo Torrance (1966). Los resultados del estudio muestran correlaciones positivas y estadísticamente significativas respecto a los resultados totales de p...

Ranolazin--ny behandling af kronisk stabil angina pectoris

DEFF Research Database (Denmark)

Ahlehoff, Ole; Hansen, Peter Riis

2009-01-01

Ranolazine sustained-release tablets were recently approved in the EU for chronic stable angina as add-on therapy when symptoms are not controlled with first-line agents. The mechanism of action is thought to involve inhibition of late sodium influx in the heart, which can reduce abnormalities...... of contractility and repolarisation associated with ischaemia. Ranolazine increases the exercise capacity, reduces angina, and diminishes the use of nitroglycerine. The drug has an excellent safety profile and may be a valuable addition to the treatment of chronic stable angina....

AGRESIONES SUFRIDAS POR LAS PERSONAS QUE TRABAJAN EN ATENCIÓN PRIMARIA DE LA COMUNIDAD DE MADRID, 2011-2012

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Teresa Rincón-del Toro

2016-01-01

Full Text Available Fundamentos: Las agresiones de usuarios a los profesionales de Atención Primaria se han incrementado en los últimos años. No existen estudios previos en atención primaria que abarquen toda una Comunidad Autónoma y todas las categorías profesionales. El objetivo del estudio fue caracterizar la violencia en atención primaria de la Comunidad de Madrid. Métodos: Estudio descriptivo multicéntrico de las notificaciones de agresiones sufridas por los profesionales de Atención Primaria de la Comunidad de Madrid. Las variables del estudio incluyeron características sociodemográficas de las personas agresoras y de las agredidas, el tipo de agresión, sus causas y consecuencias. Se calcularon la mediana, el rango intercuartílico y las frecuencias. Se realizó un análisis de regresión logística calculando las OR y sus IC95%. Resultados: En el periodo de estudio se notificaron 1.157 agresiones, el 53,07% las notificaron médicos. En el 4,7% de los casos hubo agresión física. El principal motivo fue la disconformidad con la atención recibida (36,1%. El personal no sanitario mostró menos riesgo de ser agredido físicamente que el personal sanitario (OR: 0,38; IC95%: 0,17-0,86. La agresión fue cometida por un hombre en el 56,8% de los casos y del grupo de edad entre 31-40 años en el 26,8%. La persona agredida fue mujer en el 84% de los casos, con una edad comprendida entre 45-60 años. El 10% de los profesionales notificaron las agresiones y el 5,9% la denunció. Conclusiones: El riesgo de sufrir agresión es mayor en el personal sanitario, especialmente médicos. Tanto en el perfil de las personas agresoras como de las agredidas se detectaron diferencias significativas por sexo y edad.

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 ...

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

Therapeutic decisions in patients with angina pectoris are traditionally based on the history reported by the patient, since objective evidence of myocardial ischaemia during daily life is often not available. In this study, ambulatory ST segment monitoring was performed in 60 patients with a his......Therapeutic decisions in patients with angina pectoris are traditionally based on the history reported by the patient, since objective evidence of myocardial ischaemia during daily life is often not available. In this study, ambulatory ST segment monitoring was performed in 60 patients...... 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...

Influencia del rechazo escolar sobre la alta ansiedad ante el castigo escolar en educación primaria

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María Isabel Gómez-Núñez

2017-12-01

Full Text Available El objetivo de este estudio consistió en analizar la capacidad predictiva del rechazo escolar sobre los altos niveles de ansiedad ante el castigo escolar (ACE. Para ello, se reclutó una muestra de 1,003 estudiantes de Educación Primaria con edades comprendidas entre los 8 y los 12 años. Los instrumentos empleados fueron el Inventario de Ansiedad Escolar para Educación Primaria (IAEP y el School Refusal Assessment Scale-Revised for Children (SRAS-R-C. Los resultados del análisis de regresión logística revelaron que el rechazo escolar para evitar estímulos que provocan emociones negativas actuaba como una variable predictora estadísticamente significativa de la ACE en la muestra total, en las muestras por sexo (chicos y chicas y en las muestras por curso académico (3.°, 4.°, 5.° y 6.° de Educación Primaria. Por otro lado, el rechazo escolar para evitar situaciones sociales aversivas y/o de evaluación y el rechazo escolar para llamar la atención influían positivamente sobre la alta ACE en la muestra de chicos y en 4.° de Educación Primaria, respectivamente. Estos resultados muestran la importancia de valorar el rechazo escolar, por la influencia que podría ejercer en la aparición de altos niveles de ansiedad ante el castigo escolar.

The economic burden of angina on households in South Asia.

Science.gov (United States)

Alam, Khurshid; Mahal, Ajay

2014-02-19

Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p < 0.01) and Sri Lanka (7.80%, p = 0.01). However, impoverishment, non-medical consumption expenditure and employment status of the angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD.

INFRAESTRUTURA ESCOLAR: INTERFACE ENTRE A BIBLIOTECA E AS POSSIBILIDADES DE APRENDIZAGEM DOS ALUNOS

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Paulo Sérgio Garcia

2016-10-01

LA INFRAESTRUCTURA ESCOLAR: INTERFAZ ENTRE LA BIBLIOTECA Y LAS POSIBILIDADES DE APRENDIZAJE DE LOS ALUMNOS Resumen: Este estudio tiene como objetivo investigar cómo es la interfaz entre la biblioteca y las oportunidades de aprendizaje del estudiante. Un estudio de caso se utilizó para recopilar datos de las Escuelas Primarias Municipales I de la región del Gran ABC, que los estudiantes presentan un alto rendimiento en las habilidades de lectura y la interpretación de los textos en la Prueba de Brasil (2011. Los resultados mostraron que la escuela organiza y utiliza diferentes proyectos educativos y pedagógicos, organizados por los maestros y la gestión escolar. Han sido identificados y agrupados más de 30 proyectos. Sus objetivos se asociaron con el desarrollo de la lectura y la expansión de tiempo de aprendizaje, entre otros. Comprender el significado de la organización de las actividades y proyectos educativos ayuda a los directores en la organización escolar para mejorar el rendimiento de la lectura en los estudiantes. Palabras clave: Infraestructura. Biblioteca. Proyectos educativos Escuela Primaria I.

[Current Treatment of Stable Angina].

Science.gov (United States)

Toggweiler, Stefan; Jamshidi, Peiman; Cuculi, Florim

2015-06-17

Current therapy for stable angina includes surgical and percutaneous revascularization, which has been improved tremendously over the last decades. Smoking cessation and regular exercise are the cornerstone for prevention of further cerebrovascular events. Medical treatment includes treatment of cardiovascular risk factors and antithrombotic management, which can be a challenge in some patients. Owing to the fact the coronary revascularization is readily accessible these days in many industrialized countries, the importance of antianginal therapy has decreased over the past years. This article presents a contemporary overview of the management of patients with stable angina in the year 2015.

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

La toxicología en la atención primaria de salud

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Jesús Martínez Cabrera

1995-06-01

Full Text Available Se expone la función que debe desempeñar la toxicología en Cuba para contribuir al logro de la meta de Salud para todos en el año 2000, así como los factores que condicionan el surgimiento de la toxicología preventiva. Se expresan los principales elementos que debe conocer el médico de la familia sobre toxicología y la necesidad de ampliar la interacción en el terreno docente, asistencial e investigativo entre la toxicología y el nivel de atención primaria de salud.

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.

Gluconate heart scan in angina pectoris patients

International Nuclear Information System (INIS)

Duska, F.; Novak, J.; Kvasnicka, J.; Vizda, J.; Kubicek, J.; Kafka, P.; Palicka, V.; Hlava, A.

1985-01-01

Scintigraphic examination using 99m Tc-gluconate was carried out of the condition of the myocardium in 6 patients with a clinical diagnosis of angina pectoris of diverse severity. In all six cases the scan was negative. The results confirmed the previous experimental findings. 99m Tc-gluconate is thereby not suitable for the scintigraphic diagnosis of angina pectoris. (author) 13 refs., 1 tab., 1 fig

Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

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José Roberto Tavares

2002-08-01

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

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...

Frequency of Angina Pectoris After Percutaneous Coronary Intervention and the Effect of Metallic Stent Type.

Science.gov (United States)

Gaglia, Michael A; Torguson, Rebecca; Lipinski, Michael J; Gai, Jiaxiang; Koifman, Edward; Kiramijyan, Sarkis; Negi, Smita; Rogers, Toby; Steinvil, Arie; Suddath, William O; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

2016-02-15

Although metallic coronary stents significantly reduce angina pectoris compared with optimal medical therapy, angina after percutaneous coronary intervention (PCI) remains frequent. We, therefore, sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents. Metallic stent type was classified as bare metal stent, Cypher, Taxus Express, Xience V, Promus Element, and Resolute. The primary end point was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year. Overall, 8,804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI. Major adverse cardiovascular events, a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6.8% for patients without angina, 10.0% for patients with class 1 or 2 angina, and 19.7% for patients with class 3 or 4 angina (p angina at 1 year after PCI. Baseline Canadian Cardiovascular Society class 3 or 4 angina, history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina. In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI. Copyright © 2016 Elsevier Inc. All rights reserved.

Ideas previas sobre el reino vegetal en niños entre los 7 y 10 años de tercero de primaria de la Escuela Normal Superior Distrital María Montessori (E.N.S.D.M.M.)

OpenAIRE

Daniela Gomez; Daniela Velasco

2015-01-01

La presente investigación busca reconocer las ideas previas sobre el reino vegetal en niños entre los 7 y 10 años. Se eligió un grupo de 37 estudiantes de tercero de primaria perteneciente a la E.N.S.D.M.M., con los cuales se implementó un instrumento de caracterización tipo cuestionario conformado por 3 preguntas referentes al reino vegetal. A partir de las respuestas dadas por los niños, se clasificaron sus ideas previas generando categorías de estas, posterior a ello, con la referencia de ...

Adolescentes que utilizan servicios de atención primaria: ¿Cómo viven? ¿Por qué buscan ayuda y cómo se expresan?

Directory of Open Access Journals (Sweden)

Lílian dos Santos Palazzo

Full Text Available El objetivo del estudio fue caracterizar a los adolescentes que utilizan los servicios de atención primaria de una comunidad; saber cómo se expresan en la búsqueda de ayuda médica, la atención recibida y aspectos sociofamiliares. De entre un total de 35 unidades de atención primaria urbanas pertenecientes a la red de salud pública del municipio de Pelotas (Brasil, 10 fueron elegidas al azar y entrevistados todos los individuos entre 13 y 19 años que consultaron al médico y no al psiquiatra durante tres meses. (n = 463. La utilización de los servicios tiene un carácter más bien curativo que preventivo. Los varones acuden menos y lo hacen principalmente con quejas somáticas, mientras que las jóvenes suelen manifestar quejas sexuales. Raros son los que expresan sus aflicciones emocionales, aunque algunos relatan problemas familiares, escolares y situaciones estresantes.

Factores relacionados con la práctica de educación sanitaria por los médicos de atención primaria de Galicia

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Gabriel J Díaz Grávalos

2001-01-01

Full Text Available Fundamento: Se ha demostrado que la educación sanitaria por parte de los médicos de atención primaria puede mejorar la salud de la población pero, en general, los facultativos no la utilizan con la intensidad recomendada. La finalidad de este estudio es determinar qué factores influyen en la realización de educación sanitaria por parte de los médicos de atención primaria de Galicia (España, cómo consideran su formación en esta materia, qué obstáculos encuentran para llevarla a cabo y cómo influye la presencia de hábitos no saludables en el médico en la realización de esta actividad. Métodos: Se realizó un estudio transversal. Un cuestionario postal autoadministrado, previamente probado, se envió a una muestra aleatoria, estratificada por provincias, de 420 médicos de atención primaria del Servicio Galego de Saúde. Se realizó un análisis comparativo con los que no respondieron. El análisis principal de los datos se realizó mediante regresión logística. Resultados: Se obtuvo un 73% (307 de contestaciones válidas, sin diferencias entre estratos. El 64% de los médicos consideraba deficiente su formación en educación sanitaria, siendo mejor entre médicos de familia y entre los que habían recibido cursos específicos en esta materia. El principal obstáculo referido fue la falta de tiempo. El 38,4% de los médicos declaraba realizar educación sanitaria, actividad asociada a sexo femenino (Odds Ratio 1,70, mejor formación en esa materia (Odds Ratio 2,20 y mayor capacidad autopercibida para realizarla (Odds Ratio 1,32. No se encontró asociación entre realización de educación sanitaria y presencia de hábitos no saludables. Conclusiones: Ser mujer, sentirse eficaz al realizar educación sanitaria y considerarse bien formado en esta materia se asocian positivamente con la realización de esta actividad por parte de los médicos de atención primaria, de los que sólo una tercera parte afirma realizarla.

El clima organizacional y el desempeño docente en el nivel primaria de la Institución Educativa N° 3063 “Patricia Natividad Sánchez” Independencia – 2015

OpenAIRE

Ramos Amaro, Luis Antonio

2016-01-01

En el presente trabajo de investigación titulado: El Clima Organizacional y el Desempeño Docente en el nivel primaria de la Institución Educativa N° 3063 “Patricia Natividad Sánchez” Independencia – 2015, donde se planteó como problema de investigación: ¿Qué relación existe entre el Clima Organizacional y el desempeño docente en el nivel primaria de la Institución Educativa N° 3063 “Patricia Natividad Sánchez”, Independencia – 2015?. Teniendo como objetivo general: Determinar l...

Abdominal angina

International Nuclear Information System (INIS)

Becker, G.J.; Stewart, J.; Holden, R.W.; Yune, H.Y.; Mail, J.T.; Klatte, E.C.

1988-01-01

Abdominal angina due to occlusive disease of the mesenteric arteries has been the to become clinically manifest only in the presence of severe disease in at least two of the following vessels: celiac, SMA, and IMA. Still, many patients who gradually develop significant two-vessel disease have few or no associated symptoms. Differences in collateral circulation and in cardiac index account for some of the clinical variation. The usual clinical manifestations include severe post-prandial pain, sitophobia (fear of eating because of the anticipated symptoms), and profound weight loss. Uncommonly, diarrhea, nausea, or vomiting may be encountered. Smoking is a common historical feature. Most series document a female predilection. Aside from occasional abdominal bruits and (more commonly) findings of peripheral vascular occlusive disease, the physical exam discloses only cachexia. But the differential diagnosis of profound weight loss is extensive. Therefore, abdominal angina has always created a diagnostic challenge. Multiple imaging modalities are often employed, and a seemingly negative evaluation often culminates in biplane aortography. The latter typically reveals stenoses and/or occlusions in at least two of the three mesenteric arteries. The authors discuss how a variety of surgical treatments, including thromboendarterectomy and bypass grafting, have evolved. Recently reported results have been excellent

Effectiveness of acupuncture for angina pectoris: a systematic review of randomized controlled trials.

Science.gov (United States)

Yu, Changhe; Ji, Kangshou; Cao, Huijuan; Wang, Ying; Jin, Hwang Hye; Zhang, Zhe; Yang, Guanlin

2015-03-28

The purpose of this systematic review is to assess the effectiveness of acupuncture for angina pectoris. Eleven electronic databases were searched until January 2013. The study included randomized controlled trials that the effectiveness of acupuncture alone was compared to anti-angina medicines (in addition to conventional treatment) and the effectiveness of a combination of acupuncture plus anti-angina medicines was compared to anti-angina medicines alone. The trial selection, data extraction, quality assessment and data analytic procedures outlined in the 2011 Cochrane Handbook were involved. The study included 25 randomized controlled trials (involving 2,058 patients) that met our inclusion criteria. The pooled results showed that the number of patients with ineffectiveness of angina relief was less in the combined acupuncture-anti-angina treatment group than in the anti-angina medicines alone group (RR 0.33, 95% CI 0.23-0.47, p angina medicines alone group, fewer patients in the combined treatment group showed no ECG improvement (RR 0.50, 95% CI 0.40-0.62, p angina medicines alone for both outcome measures. Only four trials mentioned adverse effects. One trial found no significant difference between acupuncture and Chinese medicine, and three reported no adverse events. The quality of the trials was found to be low. The findings showed very low evidence to support the use of acupuncture for improving angina symptoms and ECG of angina patients. However, the quality of the trials included in this study was low. Large and rigorously designed trials are needed to confirm the potential benefit and adverse events of acupuncture.

Positron emission tomography in the diagnosis of variant angina

NARCIS (Netherlands)

Jessurun, GAJ; Meeder, JG; Tio, RA

The diagnosis of coronary vasospasm in chronic vasospastic angina is established by the history of typical nocturnal angina pectoris with rapid relief after sublingual nitroglycerin, concomitant ST-segment elevation on the electrocardiogram and a recent normal coronary angiogram, True vasospasm may

Angina pectoris em paciente com hipertireoidismo e coronárias angiograficamente normais Angina pectoris in patient with hyperthyroidism and normal angiography coronary

Directory of Open Access Journals (Sweden)

Alessandra Ferri Casini

2006-11-01

Full Text Available A presença de angina pectoris em mulher pré-menopausa sem outros fatores de risco para doença arterial coronariana, obriga-nos a descartar outras causas de lesão coronariana não aterosclerótica. A relação entre o hipertireoidismo e as alterações no sistema cardiovascular está bem estabelecida, contudo o hipertireoidismo responde por menos de 5% dos casos de dor torácica. Apresenta-se um caso de uma mulher, 47 anos, com sintomas de precordialgia típica e eletrocardiograma (ECG sugestivo de isquemia coronariana, mas sem alteração laboratorial sugestiva de lesão miocárdica. Anamnese, exame físico e resultados laboratoriais permitiram firmar o diagnóstico de hipertireoidismo. Investigação subseqüente com o cateterismo cardíaco não demonstrou lesões obstrutivas. Após tratamento com iodo radioativo e retorno ao eutireoidismo, a paciente manteve-se assintomática e o ECG e a cintilografia miocárdica foram negativos para isquemia. Esses resultados sugerem uma interação entre hiperatividade tireoidiana e isquemia miocárdica, tendo o hipertireoidismo como provável etiologia dos achados clínicos e eletrocardiográficos.In the presence of angina pectoris in a premenopausal woman without significant risk factors for coronary disease, we have to rule out other causes of coronary lesion of non atherosclerotic origin. The relations between hyperthyroidism and the cardiovascular system are well known, but hyperthyroidism is responsable for less than 5% of all causes of chest pain. We present a clinical case of a 47 year old woman with typical chest pain and eletrocardiogram (EKG suggesting coronary ischemia but with normal laboratory data. Anamnesis, clinical and the laboratory data confirmed the diagnosis of hyperthyroidism. Further investigation showed a normal coronary angiography. After treatment with radioiodine and the establishment of euthyroidism, the patient remained asymptomatic and EKG and myocardial scintilography were

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

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.

Residual Angina After Elective Percutaneous Coronary Intervention in Patients With Diabetes Mellitus.

Science.gov (United States)

Grodzinsky, Anna; Kosiborod, Mikhail; Tang, Fengming; Jones, Philip G; McGuire, Darren K; Spertus, John A; Beltrame, John F; Jang, Jae-Sik; Goyal, Abhinav; Butala, Neel M; Yeh, Robert W; Arnold, Suzanne V

2017-09-01

Previous studies suggest that among patients with stable coronary artery disease, patients with diabetes mellitus (DM) have less angina and more silent ischemia when compared with those without DM. However, the burden of angina in diabetic versus nondiabetic patients after elective percutaneous coronary intervention (PCI) has not been recently examined. In a 10-site US PCI registry, we assessed angina before and at 1, 6, and 12 months after elective PCI with the Seattle Angina Questionnaire angina frequency score (range, 0-100, higher=better). We also examined the rates of antianginal medication prescriptions at discharge. A multivariable, repeated-measures Poisson model was used to examine the independent association of DM with angina over the year after treatment. Among 1080 elective PCI patients (mean age, 65 years; 74.7% men), 34.0% had DM. At baseline and at each follow-up, patients with DM had similar angina prevalence and severity as those without DM. Patients with DM were more commonly prescribed calcium channel blockers and long-acting nitrates at discharge (DM versus not: 27.9% versus 20.9% [ P =0.01] and 32.8% versus 25.5% [ P =0.01], respectively), whereas β-blockers and ranolazine were prescribed at similar rates. In the multivariable, repeated-measures model, the risk of angina was similar over the year after PCI in patients with versus without DM (relative risk, 1.04; range, 0.80-1.36). Patients with stable coronary artery disease and DM exhibit a burden of angina that is at least as high as those without DM despite more antianginal prescriptions at discharge. These findings contradict the conventional teachings that patients with DM experience less angina because of silent ischemia. © 2017 American Heart Association, Inc.

Angina pectoris in a child with sickle cell anemia.

Science.gov (United States)

Hamilton, W; Rosenthal, A; Berwick, D; Nadas, A S

1978-06-01

A 7-year-old black boy with sickle cell disease, Wolff-Parkinson-White syndrome, mild left ventricular dysfunction, and normal coronary arteries developed angina pectoris five months after cessation of hypertransfusion therapy. Exercise-induced ECG ST segment depression associated with angina disappeared following transfusion therapy.

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

Directory of Open Access Journals (Sweden)

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

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

Directory of Open Access Journals (Sweden)

I. M. Sokolov

2011-01-01

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

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.

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

African Journals Online (AJOL)

1983-01-15

Jan 15, 1983 ... The treatment of angina pectoris in patients with arterial hyper- ..... An alternative mechanism whereby labetalol may reduce angina pectoris is .... alpha and beta adrenergic receptor blockade on myocardial cell necrosis after.

Autoestima y agresividad en estudiantes de quinto grado de educación primaria de la institución educativa estatal "Pedro Adolfo Labarthe", distrito La Victoria, UGEL 03 San Miguel 2015.

OpenAIRE

Pariona Martínez, Magaly

2015-01-01

Este estudio responde al objeto determinar si existe relación significativa de la autoestima con la agresividad en estudiantes de quinto grado de educación primaria de la Institución Educativa estatal “Pedro Adolfo Labarthe”, distrito la Victoria, UGEL 03 San Miguel, 2015. El interés de la presente investigación es establecer la relación entre los factores emocionales – particularmente la autoestima- y la agresividad en estudiantes de quinto grado de educación primaria, describir cómo ha sido...

Análisis de ideas de docentes de educación primaria sobre diversidad familiar

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Alvaro Capano Bosch

2016-10-01

Full Text Available Este artículo intenta indagar en las ideas de los docentes de educación primaria sobre los modelos familiares que se apartan del tradicional de familia nuclear. Se trabajó con 60 docentes de Montevideo y zona metropolitana respondiendo el Cuestionario de Ideas de los Docentes sobre Diversidad Familiar –CIDF– (Morgado, Jiménez-Lagares & González, 2009. Los datos obtenidos refieren que los docentes no mantienen una visión homogénea de los distintos tipos de hogares. Las familias adoptivas, las de progenitores divorciados y las monoparentales bajo responsabilidad de madres tuvieron mejor aceptación entre los docentes que las homoparentales o las encabezadas en solitario por un padre. Los ítems relativos a familias homoparentales fueron respondidos por menos personas. Los docentes con formación de posgrado se mostraron más tolerantes y flexibles ante la diversidad familiar. Se discuten estos resultados a la luz de las necesarias adaptaciones en la educación primaria con respecto a la diversidad de familias que allí asisten.

NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

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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.

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...... coherence tomography have been applied to study the coronary pathology in patients with vasospastic angina. Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis. They share the common pathophysiological phenomenon...... of this article is to review structural and functional coronary artery abnormalities in patients with vasospastic angina....

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...

La enseñanza de la moral en la escuela primaria

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ÉMILE DURKHEIM

2000-01-01

Full Text Available El objetivo en la escuela primaria en Francia hoy es enseñar moral en términos puramente laicos. Esta es una tarea compleja y difícil ; primero porque la enseñanza de la moral requiere prescindir de referencias a cualquier clase de religión revelada y teología racional alguna y segundo porque es necesario expresar los conceptos morales en términos accesibles a los niños. Los conceptos morales se han identificado con los religiosos, pero moral y religión no son sinónimos, aquí se somete a discusión las diferencias entre ambas. Las dimensiones morales del comportamiento humano se han definido usando conceptos como "deber" "bueno" y "bien moral". En el artículo se reflexiona en torno a las relaciones entre moralidad y organización social. La enseñanza de las ideas morales debe poner en conexión la moral con algo real, por ejemplo, la condición social con la sociedad.

Elecciones primarias en España. 1993-2015

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Sanz Díaz, Benito

2015-01-01

“Elecciones primarias en España. 1993-2015 ” analiza la intro¬ducción y desarrollo de las elecciones primarias de los partidos políti¬cos en España, y como una forma de participación típica de la política de los EE.UU., va consiguiendo arraigar en los partidos españoles. Será el PSOE el primero que implante el sistema de primarias (Con¬ferencia Política del PSPV en 1993); después en las elecciones pri¬marias para elegir candidato a la Presidencia del Gobierno de España (Almunia-Borrell), por ...

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

Science.gov (United States)

Söder, Birgitta; Meurman, Jukka H; Söder, Per-Östen

2016-01-01

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.

Necesidades y actitudes de los facultativos de Atención Primaria frente a la gestión de las enfermedades profesionales

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M.ª Josefa Ruiz-Figueroa

2013-12-01

Full Text Available Objetivos: Desde 2007 la normativa relativa a la gestión por la Seguridad Social de las Enfermedades Profesionales y al sistema de información para su vigilancia epidemiológica, asigna a los médicos en Atención Primaria un papel como comunicadores a partir de su "sospecha diagnóstica". Este trabajo pretende mostrar algunas de sus necesidades expresadas en relación al conocimiento específico y sus actitudes y sensibilización en su práctica cotidiana respecto al origen laboral de estas patologías. Métodos: Para ello, hemos analizado los textos generados en la interacción entre los alumnos y tutores participantes en 2 ediciones de un curso online ("Enfermedades Profesionales para Médicos de Atención Primaria" realizado sobre el campus electrónico de la Escuela Nacional de Medicina del Trabajo del Instituto de Salud Carlos III, promovido y financiado por el Ministerio de Sanidad, entre otros. Resultados: Los participantes expresan su inquietud en relación con: i su falta de conocimientos específicos, ii la carencia de utilidades o instrumentos habilitados en las historias clínicas informatizadas para orientarles en el diagnóstico de procesos "presumiblemente" laborales, y iii los problemas de comunicación entre los actores del sistema. Conclusiones: Destacamos su interés por saber cómo establecer el origen laboral de algunos procesos en un sentido amplio, más allá de la determinación de Enfermedad Profesional, y cómo apuntan soluciones que contemplarían: aumentar sus conocimientos, facilitarles el asesoramiento por expertos, hacer más visible lo laboral en la historia clínica de atención primaria y habilitar canales de comunicación eficaces con el resto de implicados en la gestión de las enfermedades profesionales.

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

To evaluate the efficacy of anipamil, a phenylalkylamine calcium antagonist, in treatment of stable angina pectoris, we performed a randomized, double blind placebo-controlled, cross-over study. Inclusion criteria were (a) stable angina pectoris for at least 2 months, (b) an exercise test...... 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

Entorno psicosocial y estrés en trabajadores sanitarios de la sanidad pública: diferencias entre atención primaria y hospitalaria

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Antonio García-Rodríguez

2015-06-01

Conclusiones: Nuestros hallazgos muestran que el ambiente psicosocial de los trabajadores sanitarios difiere del de la población asalariada española, siendo más desfavorable en el colectivo de facultativos/as de atención primaria.

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

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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

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....... 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....

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

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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.

Economic impact of angina after an acute coronary syndrome: insights from the MERLIN-TIMI 36 trial.

Science.gov (United States)

Arnold, Suzanne V; Morrow, David A; Lei, Yang; Cohen, David J; Mahoney, Elizabeth M; Braunwald, Eugene; Chan, Paul S

2009-07-01

Angina in patients with coronary artery disease is associated with worse quality of life; however, the relationship between angina frequency and resource utilization is unknown. Using data from the MERLIN-TIMI 36 trial, we assessed the association between the extent of angina after an acute coronary syndrome (ACS) and subsequent cardiovascular resource utilization among 5460 stable outpatients who completed the Seattle Angina Questionnaire at 4 months after an ACS and who were then followed for an additional 8 months. Angina frequency was categorized as none (score, 100; 2739 patients), monthly (score, 61 to 99; 1608 patients), weekly (score, 31 to 60; 854 patients), and daily (score, 0 to 30; 259 patients). Multivariable regression models evaluated the association between angina frequency and overall costs attributable to cardiovascular hospitalizations, outpatient visits and procedures, and medications. As compared with no angina, overall costs increased in a graded fashion with higher angina frequency-no angina, $2928 (reference); monthly angina, $3909 (adjusted relative cost ratio, 1.29; 95% CI, 1.21 to 1.39); weekly angina, $4558 (adjusted relative cost ratio, 1.52; 95% CI, 1.48 to 1.67); and daily angina, $6949 (adjusted relative cost ratio, 2.32; 95% CI, 2.01 to 2.69; P for trend 2-fold increase in resource utilization and incremental costs of $4000 after 8 months of follow-up.

Significance of Tc-99m pyrophosphate accumulation in unstable angina

International Nuclear Information System (INIS)

Tange, Shoichi; Kondo, Chisato; Ohta, Yoshiko; Kusakabe, Kiyoko; Shigeta, Akiko; Uchida, Tatsuro; Sumiyoshi, Tetsuya; Kaneko, Noboru; Hosoda, Saichi

1993-01-01

Tc-99m pyrophosphate (PYP) and Tl-201 simultaneous dual energy single photon emission computed tomography (SPECT) were performed in 33 patients with clinically unstable angina. According to the presence or absence of PYP accumulation in the myocardium, the patients were classified as PYP (+) group (n=22) and PYP (-) group (n=11). Clinical features, types of unstable angina, ECG changes, and serial creatine kinase (CK) data were compared in the two groups. The 'new angina at rest' type of unstable angina was more significantly common in the PYP (+) group (16/22) than the PYP (-) group (2/11). The remaining 6 patients in the PYP (+) group and 2 patients in the PYP (-) group had 'angina of effort with changing pattern'. There was a significant difference in the occurrence of ST elevation and ST depression between the group: 59% in the PYP (+) group vs. 18% in the PYP (-) group for ST elevation and 23% in the PYP (+) group vs. 64% in the PYP (-) group for ST depression. The PYP (+) group showed significant improvement in ejection fraction in the stable state (57±12%) as compared with the unstable state (62±11%), although there was no difference between the stable and unstable state in the PYP (-) group. Although wall motion abnormality index (WMI) was poorer in the PYP (+) group than the PYP (-) group, it improved to the same degree as the PYP (-) group one month later. These data suggest that the area showing PYP (+) may reflect stunned myocardium and that Tc-99m PYP accumulation may correlate with clinical features of unstable angina. (N.K.)

Relación entre habilidades de lectura de palabras y comprensión lectora

OpenAIRE

Vieiro, Pilar; Amboage, Isabel

2016-01-01

La lectura es un aprendizaje instrumental que debe ser enseñado con un método específico. En este sentido es importante conocer la interrelación entre los distintos subprocesos implicados. En este contexto el objetivo general de este estudio es analizar si existe una asociación o disociación entre las habilidades de lectura de palabras y los procesos de comprensión en alumnos de 2º ciclo de Educación Primaria y a partir de aquí analizar las implicaciones educativas de los resultad...

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

Itinerarios lectores en el marco de la Didáctica de la Lengua y la Literatura en Educación Primaria

OpenAIRE

Moral Barrigüete, Cristina del; Senís Fernández, Juan

2016-01-01

El punto de partida de este trabajo es la necesidad de coordinación entre las dos principales materias del área de la Didáctica de la Lengua y la Literatura en los grados de Maestro de Educación Primaria, como son Literatura Infantil y Juvenil (2˚) y Didáctica de la Lengua (3˚). Aparentemente, la conexión es clara, pero pocas veces se llega en la práctica a la unión total de ambas asignaturas, normalmente por falta de coordinación entre los docentes. Así, los objetivos que nos propusimos eran...

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

Science.gov (United States)

Zirpoli, Josefina Cláudia; Lacerda, Heloisa Ramos; Albuquerque, Valéria Maria Gonçalves de; Albuquerque, Maria de Fátima Pessoa Militão de; Miranda Filho, Demócrito de Barros; Monteiro, Verônica Soares; de Barros, Isly Lucena; de Arruda Junior, Evanízio Roque; Montarroyos, Ulisses Ramos; Ximenes, Ricardo Arraes de Alencar

2012-01-01

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. 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. 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. 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. This study suggests that angina pectoris is underdiagnosed, even in patients with medical monitoring, revealing lost opportunities in identification and prevention of cardiovascular morbidity.

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

Science.gov (United States)

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

2015-11-01

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

DISPERSIÓN PRIMARIA DIURNA DE SEMILLAS DE DACRYODES CHIMANTENSIS Y PROTIUM PANICULATUM (BURSERACEAE EN UN BOSQUE DE TIERRA FIRME DE LA AMAZONIA COLOMBIANA

Directory of Open Access Journals (Sweden)

ROZO-MORA MARÍA CAROLINA

2004-06-01

Full Text Available Estudiamos la dispersión primaria diurna de las semillas de Dacryodes chimantensisy Protium paniculatum (Burseraceae en un bosque de tierra firme de la Amazoniacolombiana. Desde diciembre de 1999 hasta junio de 2000 registramos las visitas defrugívoros, la remoción de frutos y la dispersión primaria de semillas de cincoindividuos por especie. Encontramos que D. chimantensis presenta en promediouna mayor altura, DAP, área de proyección de la copa y mayores cosechas que P.paniculatum. El porcentaje del valor promedio de frutos maduros de D. chimantensisosciló entre el 3 y el 21% del tamaño de la cosecha durante toda la estación de frutos,mientras que este porcentaje en P. paniculatum varió entre el 1 y 15%. Observamosactividad frugívora diurna en cuatro de los cinco individuos de D. chimantensisestudiados, mientras que en los individuos de P. paniculatum no se presentófrugivoría diurna. Únicamente Amazona festiva y A. amazonica consumieron frutosde D. chimantensis y removieron en promedio 1.8 % de los frutos por árbol, pero noalejaron semillas viables del parental (dispersión primaria. En las trampas ubicadasbajo el área de la proyección de la copa sobre el suelo, encontramos que el númerode frutos probados, intactos y dañados por frugívoros fue similar para las dosespecies. Las cosechas pequeñas, el número reducido de frutos maduros y las bajastasas de reducción de la cosecha, sumado a las pocas visitas diurnas, la baja remocióny dispersión primaria diurna de semillas por parte de los frugívoros, sugieren queestas dos especies tuvieron una dispersión limitada. Discutimos si la dispersión poranimales puede estar modelando la abundancia y los patrones de distribución espacialde estas especies.

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.

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 and resu......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...... and results. A total of 31 patients with stable CAD, moderate to severe angina and no further revascularization options, were included. Bone marrow MSC were isolated and culture expanded for 6-8 weeks. It was feasible and safe to establish in-hospital culture expansion of autologous MSC and perform intra......-myocardial injection of MSC. After six months follow-up myocardial perfusion was unaltered, but the patients increased exercise capacity (p angina attacks (p Angina Questionnaire (SAQ) evaluations (p

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...... echocardiography. RESULTS: Women with angina pectoris had significantly longer QTc intervals (429±20ms) and increased MCS (IQR) (0.73 [0.64-0.80]) compared with the controls (419±20ms) and (0.63 [(0.53-0.73]), respectively (both p... 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....

Usefulness of 123I-BMIPP myocardial imaging in patients with stable effort angina and unstable angina

International Nuclear Information System (INIS)

Inoue, Seiji; Kobayashi, Hideki; Oka, Toshiaki; Kawaguchi, Masao; Momose, Mitsuru; Kasanuki, Hiroshi; Kusakabe, Kiyoko; Hosoda, Saichi

1995-01-01

We evaluated the clinical significance of myocardial imaging using 123 I-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) scintigraphy in patients with stable effort angina pectoris (SAP) and unstable angina pectoris (UAP). Thirty-three patients with SAP were studied using rest BMIPP and stress 201 TlCl (Tl) myocardial scintigraphy, and 13 patients with worsening effort type of UAP were also examined using both rest BMIPP and Tl scintigraphy. We compared those BMIPP findings with myocardial perfusion images obtained with Tl and the regional wall motion determined by left ventriculography. In 45% of 282 segments of myocardial ischemia of SAP, the degree of myocardial uptake of BMIPP was concordant with that of stress Tl and the defect score of Tl was higher than that of BMIPP. On the other hand, in 32% of 62 segments of ischemia of UAP, the degree of myocardial BMIPP and Tl uptake was concordant and BMIPP defect score was higher than Tl score. In SAP, the decrease in regional wall motion agreed better with the decrease in myocardial uptake of BMIPP than that of Tl. These results suggest that myocardial ischemic regions decreased BMIPP uptake show the disturbance of fatty acid metabolism and lead to abnormal wall motions. Such ischemic regions may be clinically severe state in patients with angina pectoris. (author)

Conocimientos tecnológicos, pedagógicos y disciplinares del profesorado de Primaria

Directory of Open Access Journals (Sweden)

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.

Creatividad e Inteligencias Múltiples según el género en alumnado de Educación Primaria

OpenAIRE

María Pilar Garín-Vallverdú; Verónica López-Fernández; Fátima Llamas-Salguero

2016-01-01

Los primeros años de escolarización son fundamentales para potenciar el desarrollo de la creatividad y las inteligencias múltiples. Bajo el sustento de los marcos teóricos de referencia que explican ambas variables, el objetivo del estudio fue analizar las diferencias significativas existentes en la creatividad y las inteligencias múltiples entre niños y niñas de 1º de Educación primaria. La muestra se compuso de 60 estudiantes (chicos=31; chicas=29) de 6 y 7 años escolarizados en un centro p...

Gender differences in the management and clinical outcome of stable angina

DEFF Research Database (Denmark)

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

2006-01-01

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

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

Role of ivabradine in management of stable angina in patients with different clinical profiles

Science.gov (United States)

Kaski, Juan Carlos; Gloekler, Steffen; Ferrari, Roberto; Fox, Kim; Lévy, Bernard I; Komajda, Michel; Vardas, Panos; Camici, Paolo G

2018-01-01

In chronic stable angina, elevated heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Accordingly, heart rate reduction is a well-known strategy for improving both symptoms of myocardial ischaemia and quality of life (QOL). The heart rate-reducing agent ivabradine, a direct and selective inhibitor of the I f current, decreases myocardial oxygen consumption while increasing diastolic time, without affecting myocardial contractility or coronary vasomotor tone. Ivabradine is indicated for treatment of stable angina and chronic heart failure (HF). This review examines available evidence regarding the efficacy and safety of ivabradine in stable angina, when used as monotherapy or in combination with beta-blockers, in particular angina subgroups and in patients with stable angina with left ventricular systolic dysfunction (LVSD) or HF. Trials involving more than 45 000 patients receiving treatment with ivabradine have shown that this agent has antianginal and anti-ischaemic effects, regardless of age, sex, severity of angina, revascularisation status or comorbidities. This heart rate-lowering agent might also improve prognosis, reduce hospitalisation rates and improve QOL in angina patients with chronic HF and LVSD. PMID:29632676

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...

Mapa bibliométrico de la investigación realizada en atención primaria en España durante el periodo 2008-2012

Directory of Open Access Journals (Sweden)

Jesús López-Torres Hidalgo

2014-12-01

Conclusiones: En las publicaciones de atención primaria existe gran diversidad tanto en áreas de investigación como en las revistas donde se publican. La mayoría proceden de centros de salud, tratan aspectos clínicos y se publican en revistas españolas. Se observan diferencias en el volumen de producción científica entre comunidades autónomas.

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.

Elementos de análisis de la educación para la alimentación saludable en la escuela primaria

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Juan Manuel Muñoz Cano

2013-01-01

Full Text Available El objetivo de la investigación fue caracterizar los elementos de estudio de la educación para la alimentación saludable en la escuela primaria. Esto fue para establecer líneas de investigaciones del contexto escolar y desarrollar mejores prácticas educativas integradoras que involucren a educandos, docentes y la comunidad. El estudio de caso fue realizado mediante una observación participante a través de un taller con ejes en educación para la alimentación y la sustentabilidad realizado a lo largo de un semestre en una escuela rural multigrado. Se identificaron elementos que deben considerarse en la educación para la alimentación saludable en la escuela primaria: la vinculación entre la preparación de los desayunos escolares y los procesos educativos, las orientaciones transversales con educación ambiental y sustentabilidad, así como la urgente reconfiguración de los contenidos conceptuales, procedimentales y valorales.

Análisis de la validez de la Escala de Irritación en una muestra de profesores de Educación Primaria: un estudio exploratorio

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Enrique Merino-Tejedor

2013-01-01

Full Text Available El propósito de este artículo es comprobar la validez de constructo de la versión española de la Escala de Irritación (Irritation Scale en una muestra de 106 profesores de Educación Primaria. Para ello, los datos obtenidos mediante la Escala de Irritación se contrastaron con otro instrumento que evalúa estrés, el Cuestionario Breve de Burnout adaptado para profesores, esperando obtener correlaciones positivas entre ambos instrumentos. Además, se utilizaron otros dos instrumentos adicionales, la Escala de Autoeficacia General y la Escala de Autorregulación, con la hipótesis de obtener una correlación negativa con la Escala de Irritación. Los resultados obtenidos confirmaron las hipótesis planteadas en este estudio, dado que se obtuvieron correlaciones positivas y significativas entre los resultados de la Escala de Irritación y el Cuestionario Breve de Burnout. Mientras tanto, las correlaciones de la Escala de Irritación con las otras dos escalas fueron negativas y también significativas. Por tanto, los análisis estadísticos corroboran la validación de la Escala de Irritación y su utilidad para la evaluación del estrés entre el profesorado de Educación Primaria.

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

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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.

Detection of unstable angina by /sup 99m/technetium pyrophosphate myocardial scintigraphy

International Nuclear Information System (INIS)

Abdulla, A.M.; Canedo, M.I.; Cortez, B.C.; McGinnis, K.D.; Wilhelm, S.K.

1976-01-01

/sup 99m/Technetium stannous pyrophosphate has been shown to accumulate in acutely infarcted myocardium. To determine if the isotope is also taken up by severely ischemic, but not necrotic myocardium, we performed myocardial scintigraphic studies in 17 patients with chest pains. Seven of the patients satisfied conventional clinical, electrocardiographic, and laboratory criteria for the diagnosis of unstable angina and showed no electrocardiographic or enzymatic evidence of myocardial necrosis. Five of these seven patients with unstable angina demonstrated abnormal localized patterns, and one showed a borderline picture. Myocardial scintiscans were normal in all of a control group of ten patients with stable angina. Thus, scanning with /sup 99m/technetium stannous pyrophosphate is shown to be of value in the objective demonstration of myocardial abnormality in unstable angina

RELACIÓN ENTRE EL NIVEL DE CONOCIMIENTO SOBRE PREVENCIÓN PRIMARIA Y LA CONDICIÓN DE SALUD BUCAL EN GESTANTES DEL HOSPITAL REGIONAL HIPÓLITO UNANUE. TACNA. 2013

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BEGAZO DE LA CRUZ, MIGUEL ARTURO

2014-01-01

PREVENCIÓN PRIMARIA CONCEPTO NIVELES DE PREVENCIÓN PRIMARIA ÍNDICE DE HIGIENE ORAL SIMPLIFICADO ÍNDICE DE CARIES DENTAL: CPO PROCEDIMIENTO PARA EL EXAMEN CÓDIGOS Y CRITERIOS PARA SU VALORACIÓN CÁLCULO DEL ÍNDICE LIMITACIONES DEL ÍNDICE ÍNDICE PERIODONTAL DE RUSSELL CONCEPTO ENFERMEDAD PERIODONTAL CRITERIOS PARA LA APLICACIÓN DEL ÍNDICE RESEÑA HISTÓRICA DEL IPR CÓDIGOS Y CRITERIOS PARA LA EVALUACIÓN INSTRUMENTAL Y MATERIAL PARA EL EXAMEN PROCEDIMIENTO PARA EL EXAMEN REGISTRO DE CÓDIGOS EN LA F...

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

Myocardial ischemia and angina pectoris

International Nuclear Information System (INIS)

Selwyn, A.P.; Fox, K.M.; Jonathan, A.; Lavender, P.; Watson, I.

1981-01-01

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

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

African Journals Online (AJOL)

Background: Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. Aim: 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. Materials and ...

Condicionantes en la utilización de los servicios de atención primaria: evidencias empíricas e inconsistencias metodológicas

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Sáez M.

2003-01-01

Full Text Available Introducción: En España, el grado y las características de la utilización de los servicios sanitarios de atención primaria está siendo objeto de análisis desde, por lo menos, los años ochenta. Uno de los motivos principales es averiguar hasta qué punto dicha utilización se corresponde con unas necesidades de atención sanitaria. De hecho, se ha establecido como prioridad generalmente aceptada un servicio de salud adecuado para los pacientes que más lo necesitan. Factores condicionantes de la utilización: La evidencia muestra que las características del individuo, sobre todo su estado de salud, son las que se relacionan principalmente con la utilización de servicios de atención primaria. Otras características personales, como el sexo y la edad, podrían actuar como moduladores de la necesidad de atención. Algunas variables familiares y/o culturales, así como las variables relacionadas con el profesional sanitario y otras institucionales, podrían explicar también parte de la variabilidad observada en la utilización de los servicios de atención primaria. Respecto a las variables socioeconómicas, como la renta, se produce una situación paradójica. De forma añadida, existe una evidencia empírica que demuestra que la renta constituye el principal determinante, tanto de la utilización como del gasto sanitario. Cuando se analizan los datos individuales, sin embargo, dicha variable no está relacionada con la utilización de servicios de atención primaria. Inconsistencias metodológicas: La situación es controvertida, con implicaciones no simplemente metodológicas sino, sobre todo, respecto al análisis de la eficiencia en la utilización de los servicios sanitarios de atención primaria. El problema es que, revisando la bibliografía, se pueden apreciar ciertas inconsistencias metodológicas que podrían explicar, al menos en parte, la disparidad de los resultados obtenidos. Entre otras, cabe citar las siguientes

¿Qué hacemos en el barrio? Descripción de las actividades comunitarias de promoción de la salud en atención primaria: Proyecto frAC

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Sebastià March

2014-07-01

Discusión: Se aprecia variabilidad entre comunidades autónomas en los tipos y formas de aplicación de las actividades comunitarias realizadas por atención primaria, así como en el reconocimiento institucional y la implicación comunitaria en el desarrollo y la evaluación de la actividad.

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

Sexual function in patients with chronic angina pectoris.

Science.gov (United States)

Kloner, Robert A; Henderson, Luana

2013-06-01

Drugs for erectile dysfunction (ED) may be contraindicated with nitrates commonly used to treat patients with angina pectoris, and certain antianginal therapies may worsen ED. The American Heart Association and the Princeton Consensus Conference panel of experts recommend that patients with coronary artery disease and ED who experience angina pectoris undergo full medical evaluations to assess the cardiovascular risks associated with resuming sexual activity before being prescribed therapy for ED. Current antianginal therapies include β blockers, calcium channel blockers, short- and long-acting nitrates, and ranolazine, a late sodium current inhibitor. Short- and long-acting nitrates remain a contraindication with phosphodiesterase-5 inhibitors commonly used to treat patients with ED, and the benefits of the other antianginal therapies must be weighed against their effects on cardiovascular health and erectile function. In conclusion, patients with coronary artery disease and ED who wish to initiate phosphodiesterase-5 inhibitor therapy and need to discontinue nitrate therapy need treatment options that manage their angina pectoris effectively, maintain their cardiovascular health, and provide the freedom to maintain their sexual function. Copyright © 2013 Elsevier Inc. All rights reserved.

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

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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

Update on ranolazine in the management of angina

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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

ANGINA PECTORIS AND NORMAL CORONARY ANGIOGRAPHY*

African Journals Online (AJOL)

A 14th patient, a woman aged 28, had angina pectoris with an abnormal cardiogram ... coronary arteries, and there was no cardiac muscle or valve pathology. ... depression of abnormal shape, werebdes~ribed as pn;'bably positive. Selective ...

La comunicación oral en el aula de inglés en Educación Primaria

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Ibarguren Ibeas, Sara

2015-01-01

Este Trabajo Fin de Grado nace a partir del interés y pasión por fomentar la comunicación oral entre los alumnos de Educación Primaria en aulas de lengua extranjera. El propósito de este trabajo es incrementar y mejorar el aprendizaje de una lengua extranjera para estimular en los alumnos un interés y disfrute hacia ello. En él abordaremos desde una perspectiva teórica la comunicación oral en el aula de inglés así como el desarrollo de estrategias de comunicación en el aula. ...

Datos normativos para el Test de los Cinco Dígitos: desarrollo evolutivo de la flexibilidad en Educación Primaria

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Cristina Rodríguez

2012-06-01

Full Text Available El objetivo de este trabajo ha sido evaluar el desarrollo evolutivo de flexibilidad cognitiva y obtener datos normativos de la prueba “Test de los Cinco Dígitos” en escolares de Educación Primaria (EP en la Comunidad Autónoma de Canarias. Con este propósito se seleccionó una muestra de 1.032 alumnos escolarizados entre primero y sexto curso de EP, con edades comprendidas entre los 6 y 12 años. Se analizó el tiempo invertido en la realización de las tareas de lectura, conteo y alternancia y calculándose finalmente el de flexibilidad. Los resultados encontrados ponen de manifiesto una tendencia lineal en el desarrollo de esta función, produciéndose un mayor crecimiento entre los 6 y 9 años y un descenso en la tasa de crecimiento entre los 9 y 13 años. Se calcularon también los baremos por curso de la prueba en la población escolar seleccionada de la Comunidad Autónoma de Canarias

Presence of angina pectoris is related to extensive coronary artery disease in diabetic patients.

Science.gov (United States)

Celik, Atac; Karayakali, Metin; Erkorkmaz, Unal; Altunkas, Fatih; Karaman, Kayihan; Koc, Fatih; Ceyhan, Koksal; Kadi, Hasan; Avsar, Alaettin

2013-08-01

Due to sensorial autonomic neuropathy, the type and severity of angina pectoris in patients with diabetes mellitus (DM) may be rather different from the type and severity of angina pectoris in patients without DM. The aim of the study was to understand if angina pectoris is related to extensive coronary artery disease (CAD) in patients with DM. The study included 530 patients with DM who underwent coronary angiography at our center in 2009 and 2010. Patients were divided into 4 groups according to type of chest pain: group 1, noncardiac chest pain or no pain; group 2, angina equivalent; group 3, atypical angina; and group 4, typical angina. All angiograms were re-evaluated and Gensini scores were calculated. Three-vessel disease was diagnosed in the presence of stenosis >50% in all 3 coronary artery systems. There were no statistically significant differences between the groups with regard to age, sex, systolic or diastolic blood pressures, body mass index, creatinine clearance, or lipid profile. Fasting blood glucose was significantly higher in group 4 than in group 2. Gensini scores were not statistically different between groups 1 and 2 or between groups 3 and 4; however, the scores for groups 3 and 4 were higher than the score for either group 1 or group 2. Prevalence of 3-vessel disease was significantly higher in groups 3 and 4 compared with the other groups. The presence of angina pectoris was related to extensive CAD in patients with DM. The extent of CAD was not correlated with the type of angina (typical or atypical). © 2013 Wiley Periodicals, Inc.

Resiliencia en estudiantes del V ciclo de educación primaria de una institución educativa del Callao

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Silva Silva, Rosanna

2012-01-01

La presente investigación descriptiva simple tuvo el propósito de determinar el nivel de resiliencia de los estudiantes del V ciclo de educación primaria de una institución educativa del Callao. Se trabajó con una muestra de 150 estudiantes, cuyas edades fluctúan entre 9 y 12 años de edad. Para procesar resultados se realizó un análisis descriptivo mediante medidas de frecuencias y gráficos de barras para la variable resiliencia y sus respectivas dimensiones. El instrumento aplicado fue el In...

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 assess...

Developments in electrical neurostimulation for angina

NARCIS (Netherlands)

de Vries, Jessica

2007-01-01

Als de hartspier niet voldoende bloed toegevoerd krijgt, ontstaat een drukkend gevoel of pijn op de borst. Angina pectoris heet deze aandoening, die veelal met medicijnen, dotteren en/of een bypassoperatie bestreden wordt. Elektrische neurostimulatie (ENS) is een effectieve therapievorm voor

Diagnóstico fenotípico de las inmunodeficiencias primarias en Antioquia, Colombia, 1994-2002.

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Carlos Julio Montoya

2002-12-01

Full Text Available La infección recurrente es una causa frecuente de consulta médica y puede deberse a un grupo heterogéneo de trastornos que incrementan la susceptibilidad a los microorganismos patógenos y oportunistas, como las deficiencias inmunológicas subyacentes. Con el fin de definir un tratamiento racional oportuno y orientar el diagnóstico molecular de las inmunodeficiencias primarias, se estableció un programa para el diagnóstico fenotípico de estas enfermedades en el departamento de Antioquia (Colombia, que comprende un análisis clínico y de laboratorio de los individuos que presentan infecciones recurrentes de evolución anormal. Entre el 1 de agosto de 1994 y el 31 de julio de 2002 se hizo el diagnóstico fenotípico de inmunodeficiencia primaria en 98 pacientes. Similar a lo informado en la literatura especializada, en esta región las deficiencias predominantes de anticuerpos fueron las más frecuentes (40,8% seguidas por las deficiencias combinadas (21,4%. Esta caracterización fenotípica ha permitido iniciar rápidamente el tratamiento adecuado y, en algunos casos, comenzar los estudios funcionales y moleculares que conduzcan al diagnóstico molecular definitivo.

Ventetid og omkostninger ved diagnostik og behandling af stabil angina pectoris

DEFF Research Database (Denmark)

Søgaard, Rikke; Sanchez, Ricardo

Introduction: The objective of this pilot study was to examine possible consequences of a logistically non-optimal regimen, for the diagnosis and treatment of stable angina pectoris, on waiting time and costs to inform whether a larger study is warranted. Material and methods: Retrospective cohort...... study among 104 consecutive patients referred on suspected stable angina pectoris. Data on the diagnostic regimen was systematically collected from patient files and data on other resource use was collected using a questionnaire for self- reporting. Non-parametric bootstrapping was applied. Results...... 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....

Evaluation of coronary hemodynamics and exercise 201Tl-myocardial scintigraphy in patients with vasospastic angina

International Nuclear Information System (INIS)

Matsumura, Kentaro; Nakase, Emiko; Haiyama, Tohru; Hasegawa, Akira; Saito, Takayuki

1992-01-01

To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina, we performed exercise 201 Tl-myocardial scintigraphy (planar and SPECT) in 72 patients and left coronary digital subtraction angiography (DSA) in 37 patients without significant organic coronary artery stenosis. Coronary artery spasm was documented by coronary angiography in all patients. Fifty-four patients (75%) developed exercise-induced 201 Tl-myocardial perfusion defect on SPECT. 201 Tl pulmonary uptake (L/H) was significantly increased in patients with vasospastic angina. Especially, L/H was higher in patients with multiple small perfusion defect on 201 Tl-SPECT, so that exercise-induced left ventricular dysfunction existed in patients with vasospastic angina and especially in cases of multiple small perfusion defect on 201 Tl-SPECT. The left coronary circulation time (CCT) was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina, but its abnormal coronary circulation had no relation to location of spasm-induced vessels. We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. (author)

Angina pectoris refractory for conventional therapy--is neurostimulation a possible alternative treatment?

Science.gov (United States)

Hautvast, R W; DeJongste, M J; ter Horst, G J; Blanksma, P K; Lie, K I

1996-07-01

The treatment of angina pectoris as a symptom of coronary artery disease usually is focused on restoring the balance between oxygen demand and supply of the myocardium by administration of drugs interfering in heart rate, cardiac pre- and afterload, and coronary vascular tone. For nonresponders to drug therapy or for those with jeopardized myocardium, revascularization procedures such as coronary bypass surgery and percutaneous transluminal coronary angioplasty are at hand. However, the atherosclerotic process is not stopped by these therapies and, at longer terms, angina may recur. It is not always possible to revascularize all the patients who do not positively react to medical treatment. Those with angina, not responding to adequate medication and who are not suitable anymore for revascularization, are considered to suffer from refractory angina pectoris. This group of patients has a poor quality of life, for their exercise tolerance is severely afflicted. For these patients, neurostimulation has been described repeatedly as an effective and safe therapy. The mechanism of action of neurostimulation is not completely known, but recent studies suggest an anti-ischemic effect, exerted through changes in myocardial blood flow. As soon as its safety is sufficiently established, it may become a useful alternative in the treatment of refractory angina pectoris.

Beneficial effect of nitrates on myocardial glucose utilization in unstable angina pectoris

International Nuclear Information System (INIS)

Araujo, L.I.; Camici, P.; Spinks, T.; Jones, T.; Maseri, A.

1987-01-01

Myocardial uptake of the glucose analog F-18-2-fluoro-2-deoxy-D-glucose (FDG) was assessed by positron emission tomography in 6 normal volunteers, 7 patients with chronic stable angina and 22 patients with unstable angina at rest in fasting conditions. Regional myocardial perfusion was assessed by rubidium-82. The study was repeated a few days later after intravenous infusion of isosorbide dinitrate. FDG uptake was similar in control subjects and patients with stable angina (0.023 +/- 0.032 vs 0.012 +/- 0.008 mol/ml/min, p less than 0.42) but was about 4-fold higher on the average in patients with unstable angina (0.084 +/- 0.047, p less than 0.01). The severity of coronary obstructions in stable and unstable angina patients was similar. The increased uptake involved the whole heart, including areas not distal to critically stenosed vessels; it was not associated with reduced myocardial perfusion and was not related to a recent episode of transient ischemia as assessed by symptoms and by Holter monitoring. After continuous infusion of nitrates, FDG uptake was consistently and significantly reduced toward normal levels both in areas perfused by critically stenosed coronary arteries and by noncritically stenosed vessels

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.

Algunas implicaciones jurídicas del matrimonio entre personas del mismo sexo en la Ciudad de México

OpenAIRE

Rojas Martínez, Alejandro

2011-01-01

El artículo analiza y expone el reconocimiento del matrimonio entre personas del mismo sexo en la Ciudad de México, así como sus implicaciones primarias a partir de su concreción en el sistema jurídico mexicano. El estudio contiene el análisis de la "Sociedad de Convivencia" como un mecanismo de reconocimiento de derechos de carácter civil a personas con relaciones personales de convivencia permanente, entre las que se encuentran las personas con identidad de género distinta de la correspondi...

Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris.

Science.gov (United States)

Xu, Mingzhu; Yang, Xiangjun

2015-01-01

Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated. Copyright © 2015 Elsevier Inc. All rights reserved.

201Tl uptake in variant angina: probable demonstration of myocardial reactive hyperemia in man

International Nuclear Information System (INIS)

Kronenberg, M.W.; Robertson, R.M.; Born, M.L.; Steckley, R.A.; Robertson, D.; Friesinger, G.C.

1982-01-01

Myocardial thallium scintigraphy was performed in four subjects with variant angina and in one subject with isolated, fixed coronary obstruction. Three subjects with variant angina had short episodes of ischemic ST-segment elevation that lasted 20--100 seconds. Thallium scintigrams demonstrated excess uptake in regions judged to be ischemic by angiographic and electrocardiographic criteria. Two subjects, one with variant angina and the other with a fixed coronary lesion, had prolonged episodes of ischemia that lasted 390--900 seconds. Both had reduced thallium uptake in the ischemic regions. We conclude that myocardial reactive hyperemia is the cause of excess thallium uptake in patients with variant angina who have short episodes of myocardial ischemia

La motricidad en el proceso lectoescritor: estudio realizado en un colegio de Educación Primaria de Badajoz

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Moreno-Benítez, Rocío

2012-01-01

El presente estudió se ocupa de la relación existente entre motricidad y proceso lectoes-critor en niños de primer curso de Primaria. Para ello, se consideró: a) la motricidad y desempeño en el área de la escritura; b) la velocidad lectora; y, c) la comprensión lectora. Los resultados mostraron que las pruebas llevadas a cabo de motricidad no guar-daron relación, en la mayoría de los casos, con las de lectoescritura. Por otra parte, se plantea la influencia de la motricidad en la lectoescr...

Cambios y oportunidades: la transición de la escuela primaria a la secundaria en el Perú

OpenAIRE

Patricia Ames; Vanessa Rojas

2011-01-01

Este trabajo expone las expectativas, inquietudes y experiencias de niños peruanos provenientes de cuatro distritos contrastantes, durante su transición de la escuela primaria al colegio secundario. Los niños participantes del estudio tenían entre 11 y 13 años y eran parte del proyecto niños del milenio, un estudio longitudinal sobre pobreza infantil en cuatro países. Se visitó a los niños en dos años consecutivos para capturar diferentes puntos de vista antes, durante y después del proceso d...

Technetium-99m-pyrophosphate myocardial imaging in unstable angina

International Nuclear Information System (INIS)

Willerson, J.T.; Parkey, R.W.; Lewis, S.E.; Buja, L.M.; Bonte, F.J.

1980-01-01

The authors have found that approximately one third of patients with the syndrome of unstable angina pectoris have abnormal 99mTc-pyrophosphate myocardial scintigrams even in the absence of abnormal enzymes and electrocardiographic confirmation of the presence of acute myocardial necrosis. Thus, 99mTc-pyrophosphate myocardial imaging technique appears to represent a sensitive means to detect acute multicellular injury associated with the clinical syndrome of unstable angina pectoris even when cardiac enzymes are normal and the electrocardiogram does not definitively document the presence of acute myocardial necrosis. (Auth.)

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

Estilo comunicativo y Eficacia Docente en las Instituciones Educativas Públicas Primarias de la Red Chimor-Parobamba Provincia de Paucartambo-Cusco 2014

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Ojeda Mamani, Julia

2015-01-01

El trabajo de investigación titulado “Estilo Comunicativo y Eficacia Docente en las Instituciones Educativas Públicas Primarias de la Red Chimor-Parobamba Provincia de Paucartambo-Cusco 2014.”, el mismo que tiene como objetivo medir el nivel de relación que existe entre las dos variables y la que influye en calidad educativa. El método de investigación utilizada para el desarrollo de la investigación es de tipo cuantitativo, con un nivel de investigación no experimental porq...

Narrowing of the Coronary Sinus: A Device-Based Therapy for Persistent Angina Pectoris.

Science.gov (United States)

Konigstein, Maayan; Verheye, Stefan; Jolicœur, E Marc; Banai, Shmuel

2016-01-01

Alongside the remarkable advances in medical and invasive therapies for the treatment of ischemic heart disease, an increasing number of patients with advanced coronary artery disease unsuitable for revascularization continue to suffer from angina pectoris despite optimal medical therapy. Patients with chronic angina have poor quality of life and increased levels of anxiety and depression. A considerable number of innovative therapeutic modalities for the treatment of chronic angina have been investigated over the years; however, none of these therapeutic options has become a standard of care, and none are widely utilized. Current treatment options for refractory angina focus on medical therapy and secondary risk factor modification. Interventions to create increased pressure in the coronary sinus may alleviate myocardial ischemia by forcing redistribution of coronary blood flow from the less ischemic subepicardium to the more ischemic subendocardium, thus relieving symptoms of ischemia. Percutaneous, transvenous implantation of a balloon expandable, hourglass-shaped, stainless steel mesh in the coronary sinus to create a fixed focal narrowing and to increase backwards pressure, may serve as a new device-based therapy destined for the treatment of refractory angina pectoris.

Percepción de las estrategias de crianza y la ansiedad en estudiantes de 5to de primaria a 5to de secundaria en una institución privada de Lima

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Carbajal León, Carlos Alberto

2016-01-01

Investigación, de tipo correlacional, que analiza las posibles relaciones entre la percepción de las estrategias de crianza y la ansiedad en estudiantes de 5to de primaria a 5to de secundaria en una institución privada de Lima. Utiliza una muestra de 422 estudiantes cuyas edades oscilan entre los 10 a 16 años, conformada por 143 hombres (33.9%) y 279 mujeres (66.1%). Los instrumentos empleados son la fichas sociodemográficas, la escala de la calidad de la interacción familiar adaptada por Dom...

Modern diagnostic capabilities for vasospastic angina diagnostics (intracoronary provocative testing

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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.

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...

Race and Sex Differences in Post-Myocardial Infarction Angina Frequency and Risk of 1-Year Unplanned Rehospitalization.

Science.gov (United States)

Hess, Connie N; Kaltenbach, Lisa A; Doll, Jacob A; Cohen, David J; Peterson, Eric D; Wang, Tracy Y

2017-02-07

Race and sex disparities in in-hospital treatment and outcomes of patients with acute myocardial infarction (MI) have been described, but little is known about race and sex differences in post-MI angina and long-term risk of unplanned rehospitalization. We examined race and sex differences in post-MI angina frequency and 1-year unplanned rehospitalization to identify factors associated with unplanned rehospitalization, testing for whether race and sex modify these relationships. Using TRANSLATE-ACS (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) data, we examined 6-week and 1-year angina frequency and 1-year unplanned rehospitalization stratified by race and sex among MI patients treated with percutaneous coronary intervention. We used multivariable logistic regression to assess factors associated with unplanned rehospitalization and tested for interactions among angina frequency, race, and sex. A total of 11 595 MI patients survived to 1 year postdischarge; there were 66.6% white male patients, 24.3% white female patients, 5.3% black male patients, and 3.8% black female patients. Overall, 29.7% had angina at 6 weeks, and 20.6% had angina at 1 year postdischarge. Relative to white patients, black patients were more likely to have angina at 6 weeks (female: 44.2% versus 31.8%; male: 33.5% versus 27.1%; both Prace or sex (adjusted 3-way P interaction =0.41). One-fifth of MI patients treated with percutaneous coronary intervention report 1-year postdischarge angina, with black and female patients more likely to have angina and to be rehospitalized. Better treatment of post-MI angina may improve patient quality of life and quality of care and help to lower rates of rehospitalization overall and particularly among black and female patients, given their high prevalence of post-MI angina. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01088503. © 2017 American

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.

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...... could be detected during nifedipine monotherapy. It is concluded that metoprolol monotherapy, as well as its combination with nifedipine, effectively reduces total ischemic activity compared with placebo and nifedipine monotherapy. Control of ischemic activity in chronic stable angina may have...

Oportunidades de aprendizaje y rendimiento en matemática en una muestra de estudiantes de sexto grado de primaria de Lima.

OpenAIRE

Santiago Cueto; Juan León; Cecilia Ramírez; Oscar Pain

2003-01-01

En los últimos años se ha encontrado de manera consistente que el rendimiento de los estudiantes peruanos en general ha sido bajo. Las razones por las que esto ocurre han sido poco estudiadas, pero entre ellas se podrían citar las oportunidades de aprendizaje (ODA). En el presente estudio se describen las ODA de matemática de una muestra de estudiantes de sexto grado de primaria de escuelas públicas, a partir del análisis de los cuadernos y cuadernos de trabajo. Asimismo, se estudió si existe...

BREVE VISIÓN DE LOS PRINCIPALES PROTAGONISTAS DE LA ESCUELA INGLESA DE ATENCIÓN PRIMARIA DURANTE EL ÚLTIMO MEDIO SIGLO

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Carlota Blanco Rubio

2016-01-01

Full Text Available El objetivo es hacer un breve repaso de las influencias, el núcleo duro de perfil clínico, la enfermería científica y el presente de la Escuela Inglesa de Atención Primaria durante los últimos sesenta años. Entendemos que la influencia intelectual más profunda fue la de Archie Cochrane. Entre los médicos de familia componentes del núcleo duro destacamos a John Fry (1922- 1994, David Metcalfe y Julian Tudor Hart. Por otra parte, Lisbeth Hockey (1918-2004, doctora en enfermería, fue la responsable durante varios años de la Unidad de Investigación en Cuidados de la Universidad de Edimburgo. Las fuentes de investigación historiográfica de la enfermería inglesa en internet son notables. Finalmente, Trisha Greenhalgh, médica de familia, investigadora y docente en la Universidad de Oxford, está lanzando a la vieja Escuela Inglesa de Atención Primaria hacia la mediana del siglo XXI.

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

]) 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. RESULTS: 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...

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

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)

Actitud hacia la violencia de género de los profesionales de Atención Primaria: estudio comparativo entre Cataluña y Costa Rica

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Kattia Rojas Loría

2015-10-01

Conclusiones: El uso de los recursos sociosanitarios y la formación actualizada puede incrementar una actitud favorable para el abordaje de la violencia de género en Atención Primaria. El efecto de las variables es el mismo tanto en Cataluña como en Costa Rica.

[Results of the use of pumpan preparation in the treatment of severe forms of angina pectoris].

Science.gov (United States)

Parshina, S S; Golovacheva, T V; Afanas'eva, T N; Panchenko, O V; Baldina, A A; Starostina, N V; Lial'chenko, I F; Egorova, L P

2000-01-01

To assess validity of adjuvant use of pumpan, a homeopathic compound, in patients with unstable angina pectoris and angina of effort (functional class III-IV) receiving conventional treatment. A direct open controlled trial for 15 months performed initially in hospital, then outpatiently, covered 49 patients with severe angina. Examination of the patients included evaluation of clinical condition and the disease course, lipid metabolism, hemostasis, blood plasma electrolytes, aminotransferases, echo-CG, bicycle exercise, rheoencephalography, ultrasonic dopplerography of head and neck vessels. Pumpan produced a positive effect total nonspecific systemic resistance improved, number of hospitalizations reduced, intracardiac hemodynamics improved in some cases with severe angina. Homeopathic compound pumpan can be recommended in the treatment of severe angina to reinforce antianginal effect, improve the disease clinical course, to obtain a hypocoagulative and hypocholesterolemic effect, to normalize intracardiac hemodynamics, to raise myocardial performance and intracoronary reserve as well as nonspecific resistance of the body.

¿ES EL MÉDICO FAMILIAR EL ESPECIALISTA CON MEJOR PERFIL PARA LA ATENCIÓN PRIMARIA EN SALUD Y EL MÁS IDÓNEO PARA LIDERAR SUS EQUIPOS DE ATENCIÓN?

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Dairo F. Beltrán

2012-04-01

Full Text Available La Atención Primaria en Salud es el componente esencial del Sistema Sanitario. Sus actividades son la educación sanitaria, provisión de alimentos, nutrición adecuada, salubridad del agua, saneamiento básico, cuidado materno infantil, inmunización, prevención y control de enfermedades endémicas, tratamiento básico y abastecimiento de fármacos. La especialidad en Medicina Familiar se encarga del cuidado de la salud total del individuo y su familia, combinando ciencias del comportamiento con ciencias tradicionales clínicas y biológicas, ofreciendo un cuidado integral, humanizado y continuo sin importar edad, sexo ni órgano comprometido. Tanto la Medicina familiar como la Atención primaria en salud poseen elementos conceptuales que las definen individualmente y que además tienen en común: Primer contacto, Accesibilidad, Integralidad, Continuidad, Coordinación, Orientación familiar, Énfasis en promoción y prevención, Atención apropiada y Recursos adecuados y sostenibles. Teniendo en cuenta estos conceptos y la indiscutible congruencia entre la Medicina Familiar y la Atención Primaria en Salud, podemos afirmar que es ésta especialidad, la efectora más idónea para realizar las intervenciones médicas necesarias en el contexto de la Atención Primaria en Salud.

Test de Fluidez Verbal: datos normativos y desarrollo evolutivo en el alumnado de primaria

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Eduardo García

2012-06-01

Full Text Available El objetivo principal de este estudio consistió en la baremación y el análisis del desarrollo evolutivo, en una amplia muestra de población infantil de habla española, de dos pruebas destinada a la evaluación de la fluidez verbal (semántica y fonológica. Analizamos el desarrollo de ambas tareas dentro de un contexto de diseño transversal. Se seleccionó una muestra de 1.032 sujetos con edades comprendidas entre los 6 años y 3 meses y los 12 años y cuatro meses que cursaban entre primero y sexto de educación primaria. La fluidez verbal semántica se evaluó con la tarea de evocación ‘de animales en un minuto’ y la fluidez verbal fonológica se evaluó con las consignas ‘F, A, M’. Los resultados muestran una mejora progresiva en el rendimiento en función de la edad en ambas pruebas. Se presentan tablas de medias, desviación estándar y percentiles para los distintos grupos de edad.

Hemorragia intraventricular primaria

OpenAIRE

Pérez Nellar, Jesús; Roselló Silva, Héctor; Scherle Matamoros, Claudio; Hierro García, Daniel; Cutiño Maas, Yaineli; González González, Justo

2006-01-01

Se presentó el caso de una mujer de 21 años con hemorragia intraventricular primaria, causada por una malformación arterio-venosa. Se realizó estudio angiográfico cerebral y se diagnósticó una malformación vascular. Se embolizó la lesión y la paciente se recuperó sin secuelas neurológicas The case of a woman aged 21 with primary intraventricular haemorrhage caused by an arteriovenous malformation is presented. A cerebral angiographic study was carried out and a vascular malformation was di...

La autoeficacia y la autorregulación como variables moderadoras del estrés laboral en docentes de Educación Primaria

OpenAIRE

MERINO TEJEDOR, ENRIQUE; Universidad de Valladolid; LUCAS MANGAS, SUSANA; Universidad de Valladolid

2016-01-01

El objetivo del presente artículo es profundizar en el posible rol modulador que pueden ejercer variables como la autoeficacia y la autorregulación en la experiencia del estrés laboral. La revisión bibliográfica llevada a cabo sobre este tema resulta un tanto ambigua, por este motivo este estudio puede aportar nuevas evidencias empíricas sobre la relación entre estas variables. La muestra estaba compuesta por 106 profesores de Educación Primaria, un colectivo que está sometido a niveles impor...

Risk stratification by using non-invasive radionuclide imaging in patients with unstable angina spec tories

International Nuclear Information System (INIS)

Saghari, M.

2002-01-01

Unstable angina represents a heterogeneous spectrum of clinical entities between chronic stable angina and acute myocardial infraction. Acute ischemic syndromes (including unstable angina) result from abrupt reduction in coronary flow, frequently after atherosclerotic plaque disruption and with or without associated thrombosis or vasospasm. Nuclear cardiology studies and in particular, myocardial perfusion imaging are powerful noninvasive tools for detecting and assessing the severity of acute ischemic syndromes, including unstable angina pec tories. The information derived from a nuclear cardiology study can answer unresolved clinical question and aid in subsequent patient management, specifically jeopardized myocardium detected during spontaneously occurring acute chest pain or controlled stress testing are important determinant of: 1) The need for admission to an intensive care monitoring unit 2) The need for and urgency of coronary angiography 3) The appropriate use of percutaneous or surgical coronary revascularization procedures. Extensive information suggests the stress nuclear perfusion imaging is the best validated technique for predischarge risk stratification with unstable angina patients who have been medically stabilized. Early information suggests avoidance of unecessary coronary angiography or revascularization is the cost effective strategy

Primarias en la Comunitat Valenciana. 2014-2015. Partidos valencianos y primarias para la elección de candidato a la Presidencia de la Generalitat en la CV. Documentos de los partidos

OpenAIRE

Sanz Díaz, Benito

2015-01-01

A lo largo de 2014 y principios de 2015, casi todos los partidos políticos que se van a presentar a las elecciones de 2015 (locales, autonómicas y generales) van a realizar algún tipo de primarias para la selección de sus candidatos, a excepción del PP. Los partidos que celebran primarias abiertas en la Comunidad Valenciana -CV- son el PSPV - presenciales-, EUPV, Compromís y Podemos, estos tres admiten también voto por Internet y correo. Solo votaban en primarias los afiliados ...

Las computadoras en la educación primaria: Un estudio piloto

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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.

A significance of the washout of 123I-BMIPP in patients with vasospastic angina

International Nuclear Information System (INIS)

Fukumitsu, Nobuyoshi; Kawai Mie; Nagata, Masako; Uchiyama, Mayuki; Mori, Yutaka

1999-01-01

We investigated the washout of 123 I-BMIPP from early and delayed SPECT in 28 patients with vasospastic angina from the standpoint of the intervals from the last angina attack. We divided myocardial wall into 13 segments from the early and delayed SPECT, and visually classified into four grades of defect score ranged from 0 (normal) to 3 (severe defect). Early and delayed severity scores were calculated as a total of defect scores in 3 vessel territories, and washout scores (WS) as (delayed severity score early severity score)/ number of segments. WS of the group within 1 month from last angina attack was compared with the groups more than 1 month. In the territory of the right coronary artery, the group within 1 month showed significantly higher WS than groups more than 1 month (p 123 I-BMIPP may reflect the clinical course of vasospastic angina. (author)

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.

Colaboración atención primaria-salud mental en la asistencia a pacientes con depresión: evaluación de una experiencia piloto

OpenAIRE

Carlos Calderón; Laura Balagué; Álvaro Iruin; Ander Retolaza; Jon Belaunzaran; Javier Basterrechea; Isabel Mosquera

2016-01-01

Objetivo: Implementar y evaluar una experiencia colaborativa entre Atención Primaria (AP) y Salud Mental (SM) para mejorar la asistencia a los pacientes con depresión. Diseño: Proyecto colaborativo piloto con enfoque de investigación acción participativa (IAP) durante 2013. Emplazamiento: : País Vasco. Osakidetza (Servicio Vasco de Salud). Bizkaia y Gipuzkoa. Participantes: Doscientos siete profesionales de medicina de familia, enfermería, psiquiatría, enfermería psiquiátrica, psicol...

La enseñanza en contextos plurilingües: estrategias didácticas para paliar las dificultades de alumnos inmigrantes en educación primaria.

OpenAIRE

Jorge, María del Mar

2012-01-01

Actualmente en educación primaria observamos una diferencia entre los resultados académicos obtenidos por alumnos inmigrantes y nativos; diferencias muy relacionadas con los programas de enseñanza-aprendizaje. Desde nuestro trabajo proponemos diferentes alternativas de apoyo lingüístico a los inmigrantes intentando disminuir esa diferencia en el rendimiento académico. Según veremos, las más eficaces son las basadas en las hipótesis del "umbral de las lenguas" y la "interacci...

Música y ciencia: Un estudio de actitudes en estudiantes de Magisterio de Educación Primaria

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Beatriz Mazas Gil

2016-07-01

Full Text Available En este trabajo se muestran resultados del estudio de actitudes sobre la enseñanza del sonido en Educación Primaria realizado con un grupo de estudiantes de Magisterio antes y después de la puesta en práctica de una secuencia de actividades. Las actividades fueron diseñadas con un enfoque integrador y una perspectiva multidisciplinar orientada a la elaboración de propuestas de enseñanza-aprendizaje globalizadas y consistentes con las distintas áreas disciplinares involucradas en Educación Primaria. Para conocer las actitudes e ideas de los futuros maestros se utiliza un cuestionario formado por 10 preguntas abiertas y 10 ítems de escala Likert de 5 puntos. En este trabajo se analizan los resultados obtenidos en los 10 ítems. Los resultados muestran que todos los grupos presentan mejoras en su actitud hacia la enseñanza del sonido. Además, resulta destacable la reducción de las diferencias existentes inicialmente entre ellos una vez realizada la intervención. Esto nos lleva a considerar que el programa realizado ha cumplido su propósito, que llevando a cabo intervenciones con un enfoque interdisciplinar pueden mejorar significativamente la actitud en los futuros maestros, lo que resulta de interés para su futura práctica docente.

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.

Indicadores de depresión en niños de cuarto a sexto grado de primaria en la ciudad de Huancayo

OpenAIRE

Ávila Benito, Carlos; Espinoza Ventura, Juan Carlos

2016-01-01

Esta investigación tuvo como finalidad identificar en qué medida se presentan los indicadores de la depresión infantil en niños de 4° a 6° grado de primaria y observar las diferencias de la presencia de síntomas depresivos entre grados, sexos, tipos de familias y tipos de colegios en el contexto de la Provincia de Huancayo. La investigación fue de tipo cuantitativo, con un diseño no experimental de tipo transversal descriptivo; se aplicó el Cuestionario de Depresión Infantil (CDI) que mide el...

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

Myocardial rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid scintigraphy compared with dipyridamole stress thallium-201 scintigraphy in unstable angina

International Nuclear Information System (INIS)

Misumi, Ikuo; Kimura, Yoshihiro; Hokamura, Youichi; Yamabe, Hiroshige; Ueno, Kazuhiro

1998-01-01

Twelve patients with stable angina and 12 patients with unstable angina underwent rest iodine-123-β-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)

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

DEFF Research Database (Denmark)

Jespersen, C M

1997-01-01

BACKGROUND: Angina pectoris accompanied by transient ST-segment changes during the in-hospital phase of acute myocardial infarction (AMI) is a well established marker of subsequent cardiac death and reinfarction. HYPOTHESIS: This study was undertaken to record the prognostic significance of angina...... on study treatment 1 month after discharge. Of these patients, 311 (39%) reported chest pain during the first month following discharge. RESULTS: Patients with angina pectoris had a significantly increased risk of reinfarction [hazard 1.71; 95%-confidence limit (CL): 1.09, 2.69] and increased mortality...... risk which, however, only reached borderline statistical significance (hazard 1.52; 95%-CL: 0.96, 2.40). When patients were subdivided according to both angina pectoris and heart failure, those with one or both of these risk markers had significantly increased mortality (p 0.03) and reinfarction (p 0...

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

Equidad entre niñas y niños: situaciones didácticas

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Antonio Paoli

2010-01-01

Full Text Available Este artículo presenta cuatro situaciones didácticas para la educación primaria, de cuarto y quinto grado en especial, y un conjunto de principios educativos; su finalidad es esclarecer y ejemplificar claves del programa educativo Jugar y vivir los valores (jvlv, orientadas a propiciar la equidad y la armonía entre los géneros. En este trabajo se muestran actividades prácticas que buscan explícitamente favorecer en las aulas la equidad de género: cuentos, canciones, preguntas a los niños para propiciar diálogos y conceptualizaciones surgidas de ellos, tareas familiares y reflexiones sobre la didáctica aplicada en la comunidad educativa, comunidad que incluye a maestros, padres de familia, niños y a todo el personal de la escuela. El Programa jvlv se creó en el Departamento de Educación y Comunicación de la uam-x, y hoy se aplica en más de 1000 primarias oficiales del estado de Chiapas. El programa se experimentó como programa piloto primero en diez jardines de niñas y niños en el año escolar 2001-2002, posteriormente en seis primarias oficiales en 2003-2004 y hoy se desarrolla un nuevo programa piloto en 52 primarias en los municipios de Tuxtla Gutiérrez y Suchiapa. La concepción de equidad se tiende a identificar con la de justicia, entendida como dar beneficio a los demás, al medio ambiente y a uno mismo. La equidad de género supone centrar la atención en hacer bien tanto a hombres como a mujeres, sistemáticamente.

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...

La lectura del cuento y su relación con los futuros enseñantes de Primaria: análisis de la práctica cultural en el curriculum formativo

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Amelia Benito del Valle Eskauriaza

2017-06-01

Full Text Available A través de este artículo, se analiza el lugar que ocupa la lectura y más concretamente la lectura del cuento, en el saber académico de los estudiantes de magisterio y futuros profesores de primaria. Para ello se ha llevado a cabo una investigación-acción en la universidad del País Vasco UPV-EHU entre los alumnos de segundo de Magisterio de Primaria durante el primer cuatrimestre del curso académico 2015-2016. Esta investigación-acción concierne a la puesta a punto del lugar que debe ocupar la lectura del cuento como práctica cultural, en el curriculum de la formación inicial de los futuros profesores de esta etapa de la educación.

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...

High probability of disease in angina pectoris patients

DEFF Research Database (Denmark)

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

2007-01-01

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

Role of myocardial ischemia in a infarcted area as a possible mechanism for postinfarction angina pectoris

International Nuclear Information System (INIS)

Saito, Muneyasu; Sumiyoshi, Tetsuya; Ishikawa, Kenji; Haze, Kazuo; Fukami, Ken-ichi; Hiramori, Katsuhiko; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kouhei

1984-01-01

Perfusion defects and 201 Tl redistribution on scintigraphic images were compared with clinical findings in 140 patients with myocardial infarction (consisting of 84 with single vessel disease and 56 with double vessel disease), 28 patients with one vessel disease not accompanied by infarction, and 18 healthy persons who underwent left coronary arteriography and 201 Tl stress myocardial scintigraphy. In 30 patients with single vessel disease accompanied by postinfarction angina pectoris, perfusion defects was smaller and Tl redistribution was larger than those in 54 patients with single vessel desease not accompanied by it. The 30 patients with postinfarction angina pectoris had a slight abnormality of left ventricular contraction and marked stenosis of 90% or more of the vessels. These findings were similar to those in the 28 angina patients who had one vessel disease but not accompanied by infarction. In 56 cases of double vessel disease, Tl redistribution was significantly larger in the group with angina than in the group without it. These results suggested that ischemia in an infarct area plays an important role as a mechanism for postinfarction angina pectoris. (Namekawa, K.)

Exercise thallium-201 scintigraphy and prognosis in typical angina pectoris and negative exercise electrocardiography

International Nuclear Information System (INIS)

Bairey, C.N.; Rozanski, A.; Maddahi, J.; Resser, K.J.; Berman, D.S.

1989-01-01

Patients with a history of typical angina but negative exercise electrocardiography represent a subgroup with an intermediate likelihood of having coronary artery disease and future cardiac events. A retrospective study of the prognostic utility of stress-redistribution thallium-201 scintigraphy was performed in 190 such patients. A second group of 203 patients with typical angina and a positive exercise electrocardiogram were analyzed for comparative scintigraphic purposes. The cardiac event rate for the 144 negative exercise electrocardiogram patients with normal thallium results was 5 vs 15% in the 46 patients with abnormal thallium results (p = 0.01). These patients were further stratified into high (14 to 18%), intermediate (9%) and low (less than 2%) risk groups for future cardiac events based on combining the thallium results with the percentage of maximal predicted heart rate achieved. A multivariate analysis revealed that an abnormal thallium result was the only significant correlate of future cardiac events. Mechanisms responsible for the discordant finding of a negative exercise electrocardiogram in patients with typical angina include (1) false-positive angina symptomatology in low prevalence coronary artery disease groups in whom the thallium test is negative, and (2) electrocardiographically silent ischemia in patients in whom the thallium test is positive. These findings reveal that thallium stress-redistribution scintigraphy can be used to stratify 1-year prognosis in this subgroup of patients with typical angina and negative exercise electrocardiograms

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

Unstable angina pectoris: the results of intracoronary administration of fibrinolytic agents

International Nuclear Information System (INIS)

Gratsianskij, N.A.; Panchenko, E.P.; Agapov, A.A.; Logutov, Yu.A.; Vladimirov, S.S.

1986-01-01

Intracoronary thrombolytic infusions were used in 10 patients with unstable angina and high risk of myocardial infarction (MI). Streptokinase (500.000 units per hour) was used in 9 patients, and urokinase, in one. Vascular recanalization was achieved in 4 cases where angiografhy, showed coronary arterial occlusion by a thrombus. Myocardial infarction developed in 8 patients (large-focal in 6 and small focal in 2) within 1 to 16 days after the thrombolytic infuson. Therefore, short-term local thrombolytic infusion fails to prevent myocardial infarction in patients with unstable angina

Impact of ranolazine on clinical outcomes and healthcare resource utilization in patients with refractory angina pectoris.

Science.gov (United States)

Ling, Hua; Packard, Kathleen A; Burns, Tammy L; Hilleman, Daniel E

2013-12-01

Ranolazine is a novel antianginal medication approved for the treatment of chronic angina. There are only limited data concerning the efficacy of ranolazine in reducing healthcare resource utilization in patients with refractory angina pectoris. The primary objective of this analysis was to evaluate the efficacy and safety of ranolazine in refractory angina pectoris. In addition, the impact of ranolazine on healthcare resource utilization was assessed. Consecutive patients with refractory angina pectoris treated with ranolazine at two cardiology practices in the state of Nebraska were included in this analysis. The Canadian Cardiovascular Society (CCS) angina class and frequency and type of healthcare resource consumption were determined during the 12 months prior to and the 12 months after initiation of ranolazine. A total of 150 pts (64 % men) with a mean age of 66 ± 12 years were included in this analysis. All patients had previously undergone coronary revascularization. Nitrates, β-adrenoceptor antagonists (β-blockers), and calcium antagonists (calcium channel blockers) were being used in 83, 97, and 75 % of patients, respectively. During ranolazine treatment, a significant improvement in CCS angina class was observed, with 23 patients improving by one class and no patient experiencing a deterioration in functional class (p = 0.025). A total of 53 side effects occurred in 28 (19 %) patients receiving ranolazine. Of those patients with side effects, four required dose reduction and seven required drug discontinuation. The frequency of clinic visits and emergency room visits was lower during ranolazine treatment, but the differences in frequency were not significant. The number of patients hospitalized and the number of hospitalizations were significantly lower during ranolazine therapy than in the pre-ranolazine study period (p = 0.002). Ranolazine improved the CCS angina class and reduced hospitalizations over a 12-month follow-up period in a group

'Variant' angina: Evidence for small vessel coronary artery spasm

International Nuclear Information System (INIS)

Pfisterer, M.; Mueller-Brand, J.; Cueni, T.; Luetold, B.; Burkart, F.; Basel Univ.

1980-01-01

A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on 201 TI-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antangonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm. (orig.) [de

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...

Percepción de docentes y estudiantes sobre el ciberacoso. Estrategias de intervención y afrontamiento en Educación Primaria y Secundaria

OpenAIRE

Giménez Gualdo, Ana M.; Arnaiz Sánchez, Pilar; Cerezo Ramírez, Fuensanta; Prodócimo, Elaine

2018-01-01

Actualmente los centros educativos tienen el reto de enfrentarse al fenómeno del ciberacoso, cada vez más presente entre los adolescentes. El presente estudio analiza la percepción del profesorado y del alumnado y las estrategias que ambos colectivos utilizan para afrontarlo. Su conocimiento permitirá avanzar en su prevención e intervención en las aulas. El estudio se realizó con 1.704 estudiantes de educación primaria, secundaria y 238 profesores a los que se aplicaron sendos cue...

Los textos, los alumnos y la enseñanza de la historia en la Escuela Primaria: la comprensión de los vaivenes temporales

OpenAIRE

Aisenberg, Beatriz

2008-01-01

Desde el marco de una investigación que se propone conocer las relaciones entre los procesos de lectura y de aprendizaje de la historia escolar, el artículo desarrolla un análisis sobre la lectura de textos históricos realizada por alumnos de escuela primaria (de 9 a 12 años), en clases de historia y en entrevistas clínico-didácticas de lectura de textos de historia trabajados previamente en el aula. El análisis enfoca problemas afrontados por algunos alumnos para comprender los vaivenes temp...

Ischemic preconditioning effect of prodromal angina is attenuated in acute myocardial infarction patients with hypertensive left ventricular hypertrophy

International Nuclear Information System (INIS)

Takeuchi, Toshiharu; Kikuchi, Kenjiro; Hasebe, Naoyuki; Ishii, Yoshinao

2011-01-01

Several animal experiments on acute myocardial infarction (AMI) have shown that the cardioprotective effects of ischemic preconditioning are more significant in hypertensive subjects. However, because there are no clinical data on the impact of hypertension on ischemic preconditioning in patients with AMI, whether clinical ischemic preconditioning of prodromal angina was beneficial in AMI patients with hypertension was investigated in the present study. 125 patients with a first anterior AMI who had undergone successful reperfusion therapy were divided into 2 groups, with or without hypertension, and into 2 further subgroups based on the presence or absence of prodromal angina. Dual-isotope (thallium-201(TL)/Tc-99m pyrophosphate) single-photon emission computed tomography (SPECT) was performed within 1 week of reperfusion therapy. Left ventricular (LV) function and LV mass index (LVMI) were measured by left ventriculography and echocardiography, respectively. In patients without hypertension, prodromal angina resulted in significantly less myocardial damage on TL-SPECT, better LV ejection fraction and a greater myocardial blush grade compared to patients without prodromal angina. However, these cardioprotective effects of prodromal angina were significantly diminished in hypertensive patients. Importantly, the myocardial salvage effects of prodromal angina showed a significant negative correlation with LVMI, which was significantly greater in hypertensive patients. The cardioprotective effects of prodromal angina were attenuated in patients with hypertension. Hypertensive LV hypertrophy may crucially limit the effects of ischemic preconditioning in AMI. (author)

Prevalence of angina pectoris in the Brazilian population from the Rose questionnaire: analysis of the National Health Survey, 2013.

Science.gov (United States)

Lotufo, Paulo Andrade; Malta, Deborah Carvalho; Szwarcwald, Celia Landmann; Stopa, Sheila Rizzato; Vieira, Maria Lucia; Bensenor, Isabela Martins

2015-12-01

To estimate the prevalence of angina pectoris in the Brazilian adult population with the use of the Rose questionnaire for angina in the National Health Survey (PNS 2013). Population survey representing the Brazilian population aged 18 years and older, with probability carried out sampling in three stages. The interview records of 60,202 individuals were obtained in the country. The respondent was presented with the short Rose questionnaire with three questions, adapted by Lawlor in 2003 and validated in Brazil, to identify angina pectoris grade I (mild) and II (moderate/severe). The prevalence rate was calculated with a 95% confidence interval (95%CI) according to sex, age, education, and race/color. The prevalence of mild angina (grade I) was of 7.6% (95%CI 7.2 - 8.0) for the entire population, more frequently in women - 9.1% (95%CI 8.5 - 9.7) - than in men - 5.9% (95%CI 5.3 - 6.4). The frequency of moderate/severe angina (grade II) was of 4.2 (95%CI 3.9 - 4.5), also more common in women - 5.2% (95%CI 4.7 - 5.6) - than in men - 3.0% (95%CI 2.7 - 3.4). The prevalence of angina by age group increased progressively with age. The prevalence of angina of any sort was inverse to years of formal study. Despite the higher value of the presence of angina in black people, there was no significant difference by race/skin color. The high prevalence rate of angina pectoris in the population aged 18 years and above was consistent with studies in other countries, revealing the importance of coronary heart disease as a public health problem.

Effect of Kuanxiong Aerosol () on Patients with Angina Pectoris: A Non-inferiority Multi-center Randomized Controlled Trial.

Science.gov (United States)

Yang, Qiao-Ning; Bai, Rui-Na; Dong, Guo-Ju; Ge, Chang-Jiang; Zhou, Jing-Min; Huang, Li; He, Yan; Wang, Jun; Ren, Ai-Hua; Huang, Zhan-Quan; Zhu, Guang-Li; Lu, Shu; Xiong, Shang-Quan; Xian, Shao-Xiang; Zhu, Zhi-Jun; Shi, Da-Zhuo; Lu, Shu-Zheng; Li, Li-Zhi; Chen, Ke-Ji

2018-05-01

To evaluate the effect and safety of Kuanxiong Aerosol (, KA) on patients with angina pectoris. Block randomization was performed to randomly allocate 750 patients into KA (376 cases) and control groups (374 cases). During an angina attack, the KA group received 3 consecutive sublingual sprays of KA (0.6 mL per spray). The control group received 1 sublingual nitroglycerin tablet (NT, 0.5 mg/tablet). Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment (1, 2, 3, 4, 5, and >5 min). Logistic regression analysis was performed to observe the factors inflfluencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society (CCS) classes of angina. The 5-min remission rates in the KA and control groups were not signifificantly different (94.41% vs. 90.64%, P>0.05). The angina CCS class signifificantly inflfluenced the rate of remission (95% confidence interval = 0.483-0.740, P0.05), while they were signifificantly better for KA in the CCSI and II subgroups (Pangina. Furthermore, in CCSII and III patients, KA is superior to NT, with a lower incidence of adverse reactions. (Registration No. ChiCTRIPR-15007204).

Liderazgo pedagógico del director y desempeño laboral docente en instituciones educativas nivel primaria, Red N°08 .UGEL 03

OpenAIRE

Contreras Espinola, Juana Marleny

2016-01-01

La presente investigación tuvo como objetivo general el determinar la relación que existe entre el liderazgo pedagógico del director y el desempeño laboral de los docentes de las instituciones educativas del Nivel Primaria de la Red Nº 08. UGEL 03 -2015; la población constituida por 51 docentes, la muestra no probabilística consideró toda la población, en los cuales se ha empleado las variables: Liderazgo Pedagógico y Desempeño Laboral El método empleado en la investigación fue...

Tongxinluo (Tong xin luo or Tong-xin-luo) capsule for unstable angina pectoris.

Science.gov (United States)

Wu, Taixiang; Harrison, R A; Chen, Xiaoyan; Ni, Juan; Zhou, Likun; Qiao, Jieqi; Wang, Qin; Wei, Jiafu; Xin, Duan; Zheng, Jie

2006-10-18

Tongxinluo capsule is a medicine consisting of traditional Chinese herbs and insects used for cardiovascular diseases in China and some other Asian countries. To date the evidence of its effect has not previously been subject to systematic review, making it difficult to derive robust conclusions about its actual benefits, and indeed, possible harms. To assess systematically the effects of tongxinluo capsule in people with unstable angina pectoris. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, Issue 4 2004, MEDLINE, EMBASE, Chinese Biomedical Database, China National Knowledge Infrastructure, Japana Centra Revuo Medicina (all 1995 to 2005). We also handsearched the relevant Chinese journals, checked with manufacturers and registers of ongoing studies. Randomised trials comparing either tongxinluo capsule only or standard treatment plus tongxinluo capsule with standard treatment or other anti-angina pectoris drugs, placebo or no intervention. Two authors identified relevant studies for the review independently and went on to abstract data, and assess trial quality. Authors of included studies were contacted to obtain further information as required. 18 short term follow-up trials involving 1413 people were included. The studies did not provide strong support of a benefit of tongxinluo for reducing the combined outcome of acute myocardial infarction, angioplasty (PTCA) coronary artery bypass graft (CABG) and sudden death or all-cause mortality (RR 0.42, 95% CI 0.07 to 2.59, P=0.35; RR 0.33, 95% CI 0.01to 7.78, P=0.49, respectively). Tongxinluo reduced the frequency of acute angina attacks (WMD -1.20, 95%CI -1.38 to -1.02, P<0.00001 and RR -2.36, 95%CI -2.53 to -2.18, P<0.00001, respectively), improved ECG (RR 1.31, 95% CI 1.08 to 1.57, P=0.005) and angina symptoms (RR 1.21, 95% CI 1.06 to 1.40; P=0.007). Tongxinluo in combination with routine angina therapy appears to reduce the risk of subsequent AMI, PTCA or CABG

The significance of 123I-BMIPP myocardial SPECT on the evaluation of angina pectoris

International Nuclear Information System (INIS)

Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio; Katohno, Eiichi; Ohwada, Kenji

1998-01-01

Some patients of ischemic heart disease have low uptake in 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)

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.

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.)

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.

Nitrates for stable angina: a systematic review and meta-analysis of randomized clinical trials.

Science.gov (United States)

Wei, Jiafu; Wu, Taixiang; Yang, Qing; Chen, Mao; Ni, Juan; Huang, Dejia

2011-01-07

To assess the effect (harms and benefits) of nitrates for stable angina. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Randomized controlled trials with both parallel and crossover design were included. The following outcome measures were evaluated: number of angina attacks weekly and nitroglycerin consumption, quality of life, total exercise duration, time to onset of angina and time to 1 mm ST depression. Fifty-one trials with 3595 patients meeting inclusion criteria were analyzed. Both intermittent and continuous regimens of nitrates lengthened exercise duration significantly by 31 and 53 s respectively. The number of angina attacks was significantly reduced by 2.89 episodes weekly for continuous administration and 1.5 episodes weekly for intermittent administration. With intermittent administration, increased dose provided with 21 s more length of exercise duration. With continuous administration, exercise duration was pronged more in low-dose group. Quality of life was not improved by continuous application of GTN patches and was similar between continuous and intermittent groups. In addition, 51.6% patients receiving nitrates complained with headache. Long-term administration of nitrates was beneficial for angina prophylaxis and improved exercise performance but might be ineffective for improving quality of life. With continuous regimen, low-dose nitrates were more effective than high-dose ones for improving exercise performance. By contrast, with intermittent regimen, high-dose nitrates were more effective. In addition, intermittent administration could bring zero-hour effect. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The Effect of Chinese Herbal Medicine Gualouxiebaibanxia Decoction for the Treatment of Angina Pectoris: A Systematic Review

Science.gov (United States)

2016-01-01

We systematically assess the current clinical evidence of Gualouxiebaibanxia (GLXBBX) decoction for the treatment of angina pectoris (AP). We included RCTs testing GLXBBX against conventional drugs and GLXBBX combined with conventional drugs versus conventional drugs. 19 RCTs involving 1730 patients were finally identified, and the methodological quality was evaluated as generally low. The results of the meta-analysis showed that GLXBBX alone had significant effect on improving angina symptoms (RR: 1.24, 95% CI 1.14 to 1.35; P angina symptoms (RR: 1.17 [1.12,1.22]; P angina symptoms in participants with AP. However, the evidence remains weak due to the poor methodological quality of the included studies. More rigorous trials are needed to confirm the results. PMID:27777598

Aprendizaje informal a través de Facebook entre alumnos eslovenos

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Karmen Erjavec

2013-08-01

Full Text Available Teniendo en cuenta que la investigación ha descuidado el estudio de cómo los alumnos de primaria hacen uso de Facebook para el aprendizaje informal y cómo potencia el capital social, el presente trabajo intenta llenar dicho vacío con sesenta entrevistas en profundidad y el protocolo de pensamientos en voz alta con alumnos de escuelas primarias eslovenas. Para analizar el perfil de Facebook también incluimos un análisis de contenido. Los resultados del estudio demuestran que los alumnos eslovenos con frecuencia utilizan Facebook para el aprendizaje informal. El estudio no solo muestra que los estudiantes son conscientes del uso de Facebook para el aprendizaje y lo utilizan en primer lugar como apoyo social, sino también ofrece muestras de intercambio práctico de información, aprendizaje de tecnología, (autoevaluación, apoyo emocional, organización de grupo de trabajo y comunicación con los profesores. Con el uso de Facebook, los estudiantes adquieren competencias relacionales y vinculación de capital social, pues mantienen una amplia red de lazos débiles, capaz de generar relaciones más profundas con apoyo emocional y fuentes de unión. Las principales diferencias entre los participantes se refieren a la expresión del apoyo emocional. Las participantes femeninas prefieren Facebook para dichos fines y expresan con más habilidad sus emociones. El estudio muestra además que nuestros participantes perciben una conexión entre el uso de Facebook y el conocimiento y destrezas que ellos pensaban que sus profesores valoraban en la escuela.

OPTIMIZACIÓN DE ESTRATEGIAS Y TÉCNICAS DE ESTUDIO DEL ALUMNADO DE 6º DE EDUCACIÓN PRIMARIA CON VISTAS AL CAMBIO DE ETAPA EDUCATIVA

OpenAIRE

Gandía-González, Lucía

2013-01-01

El objetivo de este estudio fue comprobar si la carencia de habilidades y estrategias de aprendizaje repercute directamente en el rendimiento académico del alumnado de 6º de Educación Primaria, frente al cambio de etapa educativa. Para ello se seleccionó una muestra de 60 alumnos, entre los que diferenciamos según sus notas académicas, 30 alumnos con alto rendimiento académico y 30 con bajo rendimiento académico. Se administró la escala Diagnóstico Integral del Estudio, nivel 1...

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...

Tiempo y espacio en atención primaria de salud

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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,

The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials.

Science.gov (United States)

Peng, Song; Zhao, Min; Wan, Jing; Fang, Qi; Fang, Dong; Li, Kaiyong

2014-12-20

This meta-analysis aimed to evaluate the efficacy of trimetazidine in combination with other anti-anginal drugs versus other anti-anginal drugs in the treatment of stable angina pectoris (SAP). Randomized controlled trials (RCTs) published in English and Chinese were retrieved from computerized databases: Embase, PubMed, and CNKI. Primary outcomes consist of clinical parameters (numbers of weekly angina attacks and nitroglycerin use) and ergometric parameters (time to 1mm ST-segment depression, and total work (in Mets) and exercise duration (in seconds) at peak exercise) in stable angina pectoris treated by trimetazidine or not. The quality of studies was evaluated using Jadad score. Data analysis of 13 studies was performed using Stata 12.0 software. Results showed that treatment of trimetazidine and other anti-anginal drugs was associated with a smaller weekly mean number of angina attacks (WMD=-0.95, 95%CI: -1.30 to -0.61, Z=5.39, Pangina pectoris. Sensitivity analysis was performed. Sub-group analysis showed that treatment duration was not a significant moderator and patients treated within 8 weeks and above 12 weeks had no difference in the outcomes addressed in this meta-analysis. No publish bias was detected. This meta-analysis confirms the efficacy of trimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Serial thallium-201 imaging at rest in patients with unstable and stable angina pectoris: relationship of myocardial perfusion at rest to presenting clinical syndrome

International Nuclear Information System (INIS)

Brown, K.A.; Okada, R.D.; Boucher, C.A.; Phillips, H.R.; Strauss, H.W.; Pohost, G.M.

1983-01-01

In order to determine whether there are differences in myocardial perfusion at rest among patients with various unstable and stable angina syndromes, serial thallium-201 imaging was performed at rest in 19 patients presenting with rapidly worsening exertional angina (unstable angina, group A), 12 patients with rest angina alone without exertional symptoms (unstable angina, group B), and 34 patients with chronic stable angina. No patient had an episode of angina within 4 hours of study. Nineteen of 19 (100%) patients in group A demonstrated transient defects compared to only 3 of 12 (25%) patients in group B (p less than 0.0001) and 4 of 34 (12%) stable angina patients (p less than 0.0001). The majority of zones demonstrating transient defects in group A were associated with hypokinesis of the corresponding left ventriculogram segment without associated ECG evidence of previous infarction. There were no significant differences in the frequency of persistent thallium defects, severity of angiographic coronary artery disease, or frequency of regional wall motion abnormalities of myocardial segments supplied by stenotic coronary arteries among the three groups of patients. Transient defects have been shown to reflect reduction in regional coronary blood flow to viable myocardium. Therefore, we conclude that regional resting hypoperfusion of viable myocardium is far more common in patients with exertional unstable angina symptoms than in patients with rest angina alone or chronic stable angina

PREVALENCIA DEL DÉFICIT DE ATENCIÓN E HIPERACTIVIDAD EN PERSONAS ADULTAS SEGÚN EL REGISTRO DE LAS HISTORIAS CLÍNICAS INFORMATIZADAS DE ATENCIÓN PRIMARIA

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Enric Aragonès

2010-01-01

Full Text Available Fundamento:El TDAH en adultos no es infrecuente y, según datos epidemiológicos recientes, tiene una prevalencia poblacional del 3-4%. Sin embargo, existe un gran desconocimiento sobre este trastorno entre los médicos, particularmente en atención primaria. El objetivo de este trabajo es determinar la prevalencia del diagnóstico registrado de TDAH en adultos y la proporción de pacientes con prescripción farmacológica para este trastorno en atención primaria. Métodos:Se trata de un estudio transversal sobre las bases de datos de las historias clínicas electrónicas de atención primaria. La población diana son los adultos (18-44 años adscritos a centros de salud del Instituto Catalán de la Salud (n=2.452.107. Hemos obtenido la proporción de pacientes con diagnóstico de TDAH (código F90/CIE-10 en la lista de problemas activos, y la proporción de pacientes con prescripción activa de un fármaco específico para el TDAH en adultos: metilfenidato, metilfenidato de liberación prolongada o atomoxetina. Resultados:La prevalencia de TDAH registrado es del 0,04% (0,07% en hombres; 0,02% en mujeres. Los pacientes con prescripción para TDAH son el 0,07% (0,08% en hombres; 0,05% en mujeres. El 32,05% de los TDAH tenían prescripción específica. Conclusión:El diagnóstico en adultos de TDAH y el tratamiento específico son extremadamente bajos en atención primaria. Estos resultados contrastan con los datos poblacionales: el TDAH registrado es 1/85 de la prevalencia poblacional.

La escritura creativa: Fomento de la lectura en el alumnado de Primaria. (La animación a la lectura y a la escritura en una clase de Primaria)

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Villanueva Roa, Juan de Dios

2017-01-01

LA ESCRITURA CREATIVA: FOMENTO DE LA LECTURA EN EL ALUMNADO DE PRIMARIA. (La animación a la lectura y a la escritura en una clase de Primaria) Conferencia dictada por Juan de Dios Villanueva Roa Profesor Departamento de Didáctica de la Lengua y la Literatura Universidad de Granada RESUMEN En esta conferencia trataremos las inquietudes que pueden existir en la sociedad actual con respecto a la lectura y a la escritura, fundamentalmente en el alum...

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 angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.

Perfis de consumo alcoolico entre pacientes da atencao primaria a saude e seu reconhecimento pelos profissionais de saude

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Maira Lemos de Castro Taufick

2014-02-01

Full Text Available Neste estudo transversal verificaram-se os perfis de consumo alcoólico entre pacientes das Equipes de Saúde da Família (ESF em uma cidade do sudeste brasileiro, e o reconhecimento deste consumo pelos profissionais das ESF. Avaliaram-se 932 pacientes adultos entre novembro de 2010 e novembro de 2011. Entre todos, 17,5% faziam consumo de risco (AUDIT ≥ 8, que foi mais frequente em homens, entre as pessoas mais jovens e aqueles sem doenças crônicas. O questionário CAGE foi positivo em 98 (10,5% pacientes, sendo mais frequente em homens. Homens, pessoas com idades ≥ 55 anos, com doenças crônicas ou com consumo alcoólico mais grave foram mais frequentemente questionadas sobre o uso do álcool (438/932; 47,8%. Homens, pessoas de 35 a 54 anos ou com consumo alcoólico mais grave foram mais frequentemente reconhecidos como alcoolistas (22/175; 12,6%. Conclui-se que o consumo do álcool é frequente entre os pacientes atendidos pelas ESF, é pouco reconhecido pelos profissionais e a minoria dos alcoolistas é orientada quanto aos seus riscos.

ESTUDIO DE LOS EFECTOS DEL FORMATO HIPERTEXTUAL EN LA COMPRENSIÓN LECTORA Y LA MEMORIA TEXTUAL EN NIÑOS DE EDUCACIÓN PRIMARIA

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Anna Soria Andurell

2015-01-01

Full Text Available El formato hipertextual aporta una nueva dimensión a la comprensión lectora añadiendo a la propia escritura una estructura en forma de red semántica que aumenta las posibilidades de relacionar conceptos e ideas a medida que se navega por ella. Este trabajo se plantea estudiar los efectos del formato hipertextual sobre la comprensión lectora y la memoria textual en el ámbito de la educación primaria, partiendo de las actuales teorías del procesamiento de la información y los procesos de comprensión y memoria en el campo de la Psicología y la Pedagogía. Esta investigación busca analizar las diferencias entre la comprensión y el recuerdo de un texto presentado de forma lineal e hipertextual a dos grupos de alumnos de quinto curso de primaria, y determinar si estas son significativas y en qué sentido apuntan para profundizar y aportar datos más precisos sobre las herramientas educativas digitales en el contexto del programa de digitalización de las aulas de primaria de la Generalitat de Catalunya. En este sentido, el estudio parte de la hipótesis de que el formato hipertextual de la información mejora su consolidación y almacenamiento a corto y a largo plazo debido a la estructura de sus nodos (fragmentos de información en forma de red, que la asimilan a la forma de organización neuronal del cerebro humano, así como a su funcionamiento por asociación de ideas y conceptos. Dado que la información se organiza en la mente humana a través de una extensa red neuronal, la información procesada y consolidada siguiendo las mismas pautas de asociación y conectividad entre nodos, es relacionada más rápidamente con aquellos conocimientos ya consolidados en el cerebro y, por lo tanto, se asimila más rápidamente, permitiendo un almacenamiento más profundo y duradero en el tiempo.

Prevalencia de consumo de tabaco entre las medicas y enfermeras de la comunidad de Madrid

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Fernández Ruiz Mª Luisa

1999-01-01

Full Text Available FUNDAMENTOS: El tabaquismo es responsable de una elevada mortalidad y morbilidad en nuestro pais. El tabaquismo de los profesionales de la salud tiene influencia sobre los hábitos de la población. En España, el tabaquismo esta incrementándose entre las mujeres. El objetivo de nuestro estudio es estudiar la prevalencia de consumo de tabaco entre las médicas y enfermeras de la Comunidad de Madrid, así como sus actitudes y conocimientos respecto al tabaquismo. MÉTODOS: Se ha realizado un estudio descriptivo transversal entre las mujeres profesionales de la salud (médicas y enfermeras de la Comunidad de Madrid, mediante una encuesta sobre hábito tabáquico, en un muestreo polietápico por conglomerados. RESULTADOS: Se han estudiado 1.235 profesionales ( 435 médicas y 800 enfermeras. El 43,07% del total son fumadoras, siendo el tabaquismo mayor en las enfermeras (47,62% que en las médicas (34,71%, y entre quienes trabajan en atención especializada (46,68% que entre las que lo hacen en atención primaria (35,29%. El tabaquismo fue diferente en ambas profesiones.según la edad En las médicas era menor tabaquismo en las edades entre 20 y 30 años (22,88%, y en las enfermeras este grupo de edad era el que tenia un mayor porcentaje de fumadoras (52,38%. Eran exfumadoras el 18,3% del total de las encuestadas, y el 64,65% de las que fumaban señalaron que habían intentado dejarlo. Un 2,93% fumaban delante de los/as pacientes, y un 14,94% pensaban que debía permitirse fumar en las salas de espera. El 27,46% creían que estaba permitido fumar en su area de trabajo, y el 90,64% señaló que se fumaba habitualmente en las salas de uso común del personal sanitario, y un 30,37% respondió que existía un lugar especifico para fumar en el centro de trabajo. CONCLUSIONES: La prevalencia de tabaquismo entre las profesionales de la salud, médicas y enfermeras, de la Comunidad de Madrid, es elevada, superior a la de la población general de igual edad

Quantitative exercise thallium-201 scintigraphy for predicting angina recurrence after percutaneous transluminal coronary angioplasty

International Nuclear Information System (INIS)

Stuckey, T.D.; Burwell, L.R.; Nygaard, T.W.; Gibson, R.S.; Watson, D.D.; Beller, G.A.

1989-01-01

The aim of this prospective study was to determine the value of quantitative exercise thallium-201 scintigraphy for predicting short-term outcome in patients after percutaneous transluminal coronary angioplasty (PTCA). Quantitative exercise thallium-201 scintigraphy was performed 2.2 +/- 1.2 weeks after successful PTCA in 68 asymptomatic patients, 64 (94%) of whom had class III or IV angina before the procedure. Clinical follow-up was obtained in all patients at a mean of 10 +/- 2 months and all were followed for at least 6 months; 45 patients (66%) remained asymptomatic during follow-up and 23 (34%) developed recurrent class III or IV angina at a mean of 2.6 +/- 1.2 months. Multivariate analysis of 22 clinical, angiographic and exercise test variables revealed that thallium-201 redistribution, any thallium scan abnormality, presence of a distal stenosis and treadmill time were the only significant predictors of recurrent angina after PTCA. Using a stepwise discriminant function model, thallium-201 redistribution was the only significant independent predictor. Despite its prognostic value relative to other variables as a predictor, thallium redistribution at 2 weeks after PTCA was only detected in 9 of the 23 patients (39%) who subsequently developed recurrent angina, although only 2 of the 45 patients (9%) who remained asymptomatic during follow-up demonstrated thallium-201 redistribution at the time of early testing. After repeat angiography was performed in 17 of the 23 patients with recurrent angina, 14 (82%) demonstrated restenosis and 3 (18%) had worse narrowing distal to or remote from the site of dilatation

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

Condiciones de trabajo de los pediatras de Atención Primaria

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Hernández Guillén, R.; Domínguez Aurrecoechea, B.; Sánchez Cordero, N.

2014-01-01

Introducción: en el sistema público de salud, la población debería ser el centro del sistema y el profesional sanitario su principal activo; garantizar que el encuentro asistencial se realice bajo unas condiciones de calidad es fundamental en la organización y diseño de los sistemas sanitarios. Conocer la realidad de los Equipos de Atención Primaria (EAP) y las condiciones de trabajo de los pediatras de Atención Primaria (PAP) resulta imprescindible para poder ofrecer una mejor asistencia a n...

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

Recent angina pectoris: plasma lipoprotein atherogenic parameters and coronary angiographic data

International Nuclear Information System (INIS)

Kuznetsova, G.V.; Shcherbakova, I.A.; Gratsianskij, N.A.; Perova, N.V.; Nikitina, N.A.; Nechaev, A.S.; Ozerova, I.N.; Zholus, N.N.

1986-01-01

Coronary angiography and the assessment of blood lipoproteins were carried out in 43 patients with recent (not more than three months old) angina. A rise in cholesterol above 270 mg/dl and/or triglycerids bove 200 mg/dl was demonstrated in 19. The level of α-cholesterol was below 35 mg/dl in 11 of 24 normolipidemic patients. The apoprotein B/apoprotein AI ratio was above 1.0 in 7 of 13 patients with normal cholesterol levels. Plasma phospholipid composition was disturbed in 4 of 6 patients with normal apoprotein B/apoprotein AI rations. Therefore atherogenic changes in plasma lipoprotein composition were found in 95% of patients with recent angina

Incidencia del acoso escolar en alumnos de 4º y 6º de Educación Primaria en colegios de la ciudad de Vigo

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Muñoz Prieto, María del Mar

2010-01-01

[ES]La finalidad última de esta investigación es analizar las situaciones de maltrato entre iguales en los niveles de segundo y tercer ciclo de educación primaria, de los centros educativos de Vigo (Pontevedra). En este sentido el objetivo general es analizar la incidencia, características y consecuencias del maltrato en la población indicada. Una cuestión a la que últimamente se le está dando una gran importancia es si los niños y niñas que son víctimas de acoso escolar pueden llegar a ...

1998. Primarias en España. Se inicia la era posfelipista. Almunia versus Borrell. 24 de abril de 1998

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Sanz Díaz, Benito

2015-01-01

Primarias en España. Se inicia la era posfelipista. Almunia versus borrell. 24 de abril de 1998. Felipe González: “…no seré candidato a la Secretaría General”. Las elecciones primarias socialistas en el País Vasco. Nicolás Redondo Terreros/Rosa Díez. 14 de marzo de 1998. Almunia opta por las primarias. Almunia versus Borrell. 24 de abril 1998. Borrell se lanza a la piscina. El proceso. Cómo se organizaron las primeras elecciones primarias. La campaña electoral Almunia/Borrell. Sondeos sobre i...

Angina crónica estable. Consideraciones actuales

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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.

Creatividad e Inteligencias Múltiples según el género en alumnado de Educación Primaria

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María Pilar Garín-Vallverdú

2016-02-01

Full Text Available Los primeros años de escolarización son fundamentales para potenciar el desarrollo de la creatividad y las inteligencias múltiples. Bajo el sustento de los marcos teóricos de referencia que explican ambas variables, el objetivo del estudio fue analizar las diferencias significativas existentes en la creatividad y las inteligencias múltiples entre niños y niñas de 1º de Educación primaria. La muestra se compuso de 60 estudiantes (chicos=31; chicas=29 de 6 y 7 años escolarizados en un centro público de Zaragoza. Los instrumentos utilizados fueron el Cuestionario del profesorado para diagnosticar Inteligencias Múltiples en Primaria y el Test de Pensamiento Creativo de Torrance. Los resultados mostraron diferencias significativas en la creatividad, siendo las chicas quienes obtuvieron mayores puntuaciones. Respecto a las inteligencias múltiples, la inteligencia interpersonal fue la que mayores puntuaciones obtuvo en ambos géneros. Paralelamente, la inteligencia musical fue la de menor puntuación en ambos géneros, siendo la única que mostró diferencias significativas. Estos hallazgos se discuten argumentando la necesidad de realizar un programa de intervención que potencie la creatividad y la inteligencia musical en ambos géneros a través del resto de inteligencias, significando un aprendizaje transversal que optimice la formación del alumnado de manera íntegra.

High-risk angina patient: identification by clinical features, hospital course, electrocardiography, and technetium-99m stannous pyrophosphate scintigraphy

International Nuclear Information System (INIS)

Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

1981-01-01

We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p < 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p < 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup, with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients

High-risk angina patient. Identification by clinical features, hospital course, electrocardiography and technetium-99m stannous pyrophosphate scintigraphy

International Nuclear Information System (INIS)

Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

1981-01-01

We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +/- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p less than 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p less than 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients

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

International Nuclear Information System (INIS)

Hatano, Tsuguhisa; Chikamori, Taishiro; Kamada, Tatsuya; Morishima, Takayuki; Hida, Satoshi; Yanagisawa, Hidefumi; Iino, Hitoshi; Yamashina, Akira

2001-01-01

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)

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 ...

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.

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

International Nuclear Information System (INIS)

Rodrigues, Clarissa G.; Plentz, Rodrigo D.M.; Dipp, Thiago; Salles, Felipe B.; Giusti, Imarilde I.; Sant'Anna, Roberto T.; Eibel, Bruna; Nesralla, Ivo A.; Markoski, Melissa; Beyer, Nance N.; Kalil, Renato A. K.

2013-01-01

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

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

DEFF Research Database (Denmark)

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

2010-01-01

Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report...... successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...... for refractory angina pectoris can be performed in patients implanted with cardioverter defibrillators without interference. However, individual testing during implantation or re-programming the devices is mandatory in order to assess optimal safety in each patient....

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.

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....

La convivencia entre los estudiantes universitarios: su atención desde el proyecto educativo de la carrera

OpenAIRE

Mederos Piñeiro, Milagros

2014-01-01

El artículo es el resultado de una experiencia de la carrera de Licenciatura en Educación Primaria. Se aplicó una estrategia pedagógica con el objetivo de potenciar las relaciones de convivencia entre los estudiantes desde el proyecto educativo de grupo, año y carrera, donde se pone de manifiesto el aprendizaje de actitudes pro-sociales y de convivencia afectuosa, con la inclusión de todos. Las acciones articulan el sistema de influencias educativas con actividades curriculares y extracurricu...

Relación entre la lateralidad y los aprendizajes escolares

Directory of Open Access Journals (Sweden)

M.ª Carmen Mayolas Pi

2010-09-01

Full Text Available Muchos son los autores que relacionan los problemas de aprendizaje de un niño con su lateralidad, achacando a la lateralidad contrariada, cruzada o no definida los problemas en la adquisición, entre otras, de habilidades lecto-escritoras. En el presente trabajo hemos pasado un test de lateralidad a 170 niños de entre 6 y 7 años (primero y segundo de primaria con pruebas de miembro superior, miembro inferior y ojo, así como de discriminación de derecha-izquierda y de orientación espacial. A su vez, los profesores tutores han valorado varios ítems del aprendizaje escolar de los niños, con cuestiones sobre su comprensión lectora, su razonamiento matemático y su atención en clase, entre otras. Según nuestros resultados, los niños con lateralidad homogénea diestra son los que obtienen mejores valoraciones en todos los ítems de aprendizaje con respecto a los homogéneos zurdos, los cruzados y los no confirmados, siendo los pocos casos que tenemos de homogéneos zurdos (un 3% de la muestra los que tienen peores valoraciones. Además, los niños que discriminan entre derecha e izquierda también tienen mejor sus aprendizajes con respecto a los que no lo hacen, así como los que se orientan bien en el espacio con respecto a los que se orientan mal.

Opiniones de los gestores de la atención primaria sobre las fuentes de influencia en la práctica médica: Diferencias con la opinión de los médicos asistenciales

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López L.A.

2002-01-01

Full Text Available Objetivos: Los objetivos del estudio son: conocer la opinión de los gestores de atención primaria acerca de la importancia y legitimidad de distintas fuentes de influencia en la práctica médica, y comparar estos resultados con la opinión de los médicos asistenciales de los equipos de atención primaria. Material y métodos: Diseño de estudio transversal. Población: gestores de atención primaria pertenecientes a la Red del INSALUD (gerentes de área, directores médicos y de enfermería y al Servicio Andaluz de Salud (directores de distrito, coordinadores de enfermería y coordinadores de epidemiología y programas. La muestra se corresponde con la población total y fue de 302. Como variables dependientes se consideró un conjunto de preguntas que recogían las opiniones de los entrevistados sobre distintas estrategias, instituciones y/o colectivos que ejercen algún tipo de influencia en la práctica médica. El grado de «importancia» de cada una de ellas se sintetizó en un conjunto de 9 ítems que se pedía que se puntuaran desde 1 (el más importante hasta 9 (el menos importante. Para valorar la «legitimidad» de las mismas se presentaron 16 ítems medidos mediante una escala tipo Likert de 7 puntos (1: nada legítimo; 7: muy legítimo. Se utilizó un cuestionario autoadministrado enviado por correo. Para el análisis estadístico de los datos se emplearon test no paramétricos (Friedman y Kruskall-Wallis. Resultados: La tasa de respuesta fue del 79,8%. El análisis de los rangos medios de cada ítem, mediante el test de Friedman para una escala ordinal de 9 puntos, puso de manifiesto que entre las fuentes de influencia más importantes para los gestores sanitarios de atención primaria estudiados destacan: la elaboración de protocolos de actuación por los propios médicos; la discusión con los colegas; recibir retroalimentación de los pacientes atendidos, y la asistencia a cursos de formación, lectura de artículos e

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)

Inherited chromosomally integrated human herpesvirus 6 as a predisposing risk factor for the development of angina pectoris.

Science.gov (United States)

Gravel, Annie; Dubuc, Isabelle; Morissette, Guillaume; Sedlak, Ruth H; Jerome, Keith R; Flamand, Louis

2015-06-30

Inherited chromosomally integrated human herpesvirus-6 (iciHHV-6) results in the germ-line transmission of the HHV-6 genome. Every somatic cell of iciHHV-6+ individuals contains the HHV-6 genome integrated in the telomere of chromosomes. Whether having iciHHV-6 predisposes humans to diseases remains undefined. DNA from 19,597 participants between 40 and 69 years of age were analyzed by quantitative PCR (qPCR) for the presence of iciHHV-6. Telomere lengths were determined by qPCR. Medical records, hematological, biochemical, and anthropometric measurements and telomere lengths were compared between iciHHV-6+ and iciHHV-6- subjects. The prevalence of iciHHV-6 was 0.58%. Two-way ANOVA with a Holm-Bonferroni correction was used to determine the effects of iciHHV6, sex, and their interaction on continuous outcomes. Two-way logistic regression with a Holm-Bonferroni correction was used to determine the effects of iciHHV6, sex, and their interaction on disease prevalence. Of 50 diseases monitored, a single one, angina pectoris, is significantly elevated (3.3×) in iciHHV-6+ individuals relative to iciHHV-6- subjects (P = 0.017; 95% CI, 1.73-6.35). When adjusted for potential confounding factors (age, body mass index, percent body fat, and systolic blood pressure), the prevalence of angina remained three times greater in iciHHV-6+ subjects (P = 0.015; 95%CI, 1.23-7.15). Analyses of telomere lengths between iciHHV-6- without angina, iciHHV-6- with angina, and iciHHV-6+ with angina indicate that iciHHV-6+ with angina have shorter telomeres than age-matched iciHHV-6- subjects (P = 0.006). Our study represents, to our knowledge, the first large-scale analysis of disease association with iciHHV-6. Our results are consistent with iciHHV-6 representing a risk factor for the development of angina.

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

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

2013-08-15

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

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

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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.

Traditional Chinese medicine injection for angina pectoris: an overview of systematic reviews.

Science.gov (United States)

Luo, Jing; Shang, Qinghua; Han, Mei; Chen, Keji; Xu, Hao

2014-01-01

Traditional Chinese medicine (TCM) injection is widely used to treat angina pectoris in China. This overview aims to systematically summarize the general characteristics of systematic reviews (SRs) on TCM injection in treating angina, and assess the methodological and reporting quality of these reviews. We searched PubMed, Embase, the Cochrane Library and four Chinese databases from inception until March 2013. Data were extracted according to a preset form. The AMSTAR and PRISMA checklists were used to explore the methodological quality and reporting characteristics of included reviews, respectively. All data analyses were descriptive. 46 SRs involving over 57,463 participants with angina reviewing 23 kinds of TCM injections were included. The main outcomes evaluated in the reviews were symptoms (43/46, 93.5%), surrogate outcomes (42/46, 91.3%) and adverse events (41/46, 87.0%). Few reviews evaluated endpoints (7/46, 15.2%) and quality of life (1/46, 2.2%). One third of the reviews (16/46, 34.8%) drew definitely positive conclusions while the others (30/46, 65.2%) suggested potential benefits mainly in symptoms, electrocardiogram and adverse events. With many serious flaws such as lack of a protocol and inappropriate data synthesis, the overall methodological and reporting quality of the reviews was limited. While many SRs of TCM injection on the treatment of angina suggested potential benefits or definitely positive effects, stakeholders should not accept the findings of these reviews uncritically due to the limited methodological and reporting quality. Future SRs should be appropriately conducted and reported according to international standards such as AMSTAR and PRISMA, rather than published in large numbers.

Productividad primaria y sustancias húmicas en la ciénaga El Eneal, San Onofre Sucre-Colombia

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Elkin Libardo Ríos

2009-01-01

Full Text Available Entre mayo de 2003 y abril de 2004, se determinó la productividad primaria y el contenido de sustancias húmicas en la ciénaga El Eneal. En la zona pelágica se dispusieron los ensayos de medición de la productividad y se tomaron muestras de agua para el análisis de las sustancias húmicas. El sistema cenagoso del Eneal, presentó un estado oligotrófico, con una reducida producción en la época de lluvia. En contraste en época seca, cuando disminuye el nivel de agua, la producción aumentó y los niveles de oxígeno se incrementaron, debido a la presencia de la macrófita sumergida Najas guadalupensis. Esto, se asoció a la baja presencia de plancton y de nutrientes biodisponibles.

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

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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

Intravascular stenting in the superior mesenteric artery for chronic abdominal angina.

Science.gov (United States)

Busquet, J

1997-11-01

Abdominal angina is an early clinical expression of occlusive mesenteric arterial insufficiency, a condition that requires aggressive treatment to prevent intestinal infarction. We report a case of chronic mesenteric ischemia in a young polyvascular man who had symptoms of abdominal angina. An aortic angiogram revealed a significant ostial stenosis of the superior mesenteric artery (SMA) associated with an occlusion of the inferior mesenteric artery. After predilation of the ostial portion of the SMA, significant residual stenosis remained. A balloon-expandable Palmaz P154 stent was deployed, restoring adequate luminal dimensions and blood flow. The patient was discharged after 2 days and remains asymptomatic at 5 months. Intraluminal stenting for treatment of mesenteric ischemia represents a viable alternative to surgical revascularization in selected cases.

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

Science.gov (United States)

Wang, Chuan; Li, Yafeng; Gao, Shoucui; Cheng, Daxin; Zhao, Sihai; Liu, Enqi

2015-01-01

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

La prevención primaria con aspirina de enfermedades cardiovasculares en personas diabéticas. Revisión de las pruebas disponibles

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Carmen Maciá Bobes

2006-01-01

Full Text Available El beneficio del tratamiento con aspirina en la reducción del riesgo de infarto de miocardio, accidente vascular cerebral y muerte de origen vascular, está bien documentado en personas con enfermedad cardiovascular previa, incluido el subgrupo portador de una diabetes mellitus. Sin embargo el papel de la aspirina en prevención primaria es menos claro y objeto de discusión: los resultados de los ensayos clínicos disponibles no son consistentes, aunque los meta-análisis son favorables en algunos aspectos. Parece existir una disparidad entre el tipo de beneficio (cuando se observa y el sexo. Y en particular los resultados son contradictorios en personas diabéticas, las cuales representan un pequeño porcentaje de la muestra de población incluida en los estudios. A pesar de esto, la American Diabetes Association desde 1997, y otras sociedades científicas (incluidas varias españolas desde tiempos más recientes, recomiendan el uso de aspirina a dosis bajas en prevención primaria en todo paciente diabético mayor de 40 años, tipo 1 o tipo 2; y en todos los menores de 40 y mayores de 21 años que presenten otro factor de riesgo cardiovascular, además de la diabetes (antecedentes familiares de enfermedad vascular, hipertensión arterial, tabaquismo, dislipidemia o albuminuria. En este trabajo se revisan los resultados de los ensayos clínicos randomizados y controlados sobre la prevención cardiovascular primaria con aspirina, en los que se podrían apoyar las directrices oficiales de la American Diabetes Association, y se llega a la conclusión de que no existen actualmente pruebas científicas suficientes para sostenerlas.

Effect of spinal cord stimulation on myocardial perfusion reserve in patients with refractory angina pectoris.

Science.gov (United States)

Saraste, Antti; Ukkonen, Heikki; Varis, Antti; Vasankari, Tuija; Tunturi, Satu; Taittonen, Markku; Rautakorpi, Pirkka; Luotolahti, Matti; Airaksinen, K E Juhani; Knuuti, Juhani

2015-04-01

Epidural spinal cord stimulation (SCS) provides symptom relief in refractory angina pectoris, but its mechanism of action remains incompletely understood. We studied effects of short-term SCS therapy on myocardial ischaemia tolerance, myocardial perfusion reserve (MPR), and endothelium-mediated vasodilatation induced by cold pressor test (CPT) in patients with refractory angina pectoris. We prospectively recruited 18 patients with refractory angina pectoris and studied them after implantation of SCS device at baseline before starting the therapy and after 3 weeks of continuous SCS therapy. Myocardial ischaemia was evaluated by dobutamine stress echocardiography. Global and regional myocardial blood flow (MBF) were measured using positron emission tomography and (15)O-water at rest, during adenosine stress, and in response to CPT. Systemic haemodynamics were comparable before and after 3 weeks of SCS at rest, during adenosine stress and during CPT. Appearance of angina pectoris induced by dobutamine stress was delayed after SCS therapy. Global MPR increased (P = 0.02) from 1.7 ± 0.6 at baseline to 2.0 ± 0.6 after 3-week SCS therapy. This was associated with a significant reduction in global MBF at rest and increase in MBF induced by adenosine in the ischaemic regions. Global MBF response to CPT was improved after SCS (0.27 ± 0.20 vs. 0.40 ± 0.15, P = 0.03). Short-term SCS therapy improved myocardial ischaemia tolerance, absolute MPR, and endothelium-mediated vasomotor function in refractory angina pectoris, indicating that this therapy can alleviate myocardial perfusion abnormalities in advanced CAD. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Grado de conocimiento y control sobre la dislepimia entre los médicos de la Región de Murcia: (2004-2005

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María Lucía García Mancebo

2008-01-01

Full Text Available Fundamento: Debido a que los consensos para el tratamiento y control de las dislipemias no siempre se siguen (incluyendo el cálculo del riesgo cardiovascular global, se realizó el presente estudio con el objetivo de analizar el nivel informativo y las pautas de actuación en la detección, evaluación y control de la dislipemia entre los médicos de atención primaria y especializada hospitalaria de la Región de Murcia. Métodos: Estudio observacional transversal que se realizó con 217 médicos de atención primaria (MAP y 133 médicos de atención hospitalaria (MH, mediante un cuestionario formado por 14 ítems. Resultados: El 80,9% de los médicos decían seguir los consensos internacionales para el control de la dislipemia. El cálculo del riesgo cardiovascular se utilizó de forma ocasional por el 58%. El parámetro objetivo más utilizado para tratar las dislipemias fue el colesterol de LDL (89,7%, colesterol total (57,7, colesterol de HDL (55,7% y triglicéridos (53,1%. El objetivo óptimo de colesterol de LDL en prevención primaria fue <130 mg/dl para el 66,6% de los médicos y en prevención secundaria fue <100 mg/dl para el 81,7%. Ante un paciente dislipémico bien controlado, el 76,6% de los profesionales mantendría el tratamiento y el 22,3% lo reduciría. Ante un paciente mal controlado, el 62,3% reforzarían el tratamiento higiénicodietético y el 66,9% el farmacológico. La estatina mejor valorada fue la atorvastatina. El 69,1% de los médicos valora la tolerancia a las estatinas mediante GOT, GPT y CPK. El 60,6% manifestó que el paciente cumplía bien su tratamiento. Conclusiones: No se observaron diferencias importantes en el conocimiento y actuación entre los médicos de atención primaria y especializada, siendo en ambos casos actual y adecuado

Nivel de conocimiento de la gestión administrativa para la toma de decisiones de Instituciones Educativas Primarias Rurales de la provincia de Urubamba, región Cusco 2012

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Santiestaban, Matto Marleny

2014-01-01

La presente investigación titulada "Nivel de conocimiento de la gestión administrativa para la toma de decisiones de las instituciones educativas primarias rurales de la provincia de Urubamba, Región Cusco 2012" es un estudio que consiste en determinar la relación que existe entre las variables de gestión administrativa y toma de decisiones, relación que se ha determinado como resultado de todas las actividades metodológicas y procedimentales que se han desplegado para su realización. Esta in...

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......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...

Resting 123I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

International Nuclear Information System (INIS)

Yamabe, Hiroshi; Abe, Hiroaki; Yokoyama, Mitsuhiro; Shiotani, Hideyuki; Kajiya, Sadashi; Mori, Takao; Hashimoto, Yasunori

1998-01-01

This study was undertaken to assess the diagnostic value of resting 123 I-BMIPP scintigraphy in patients with effort angina pectoris. One hundred and four patients underwent scintigraphic and angiographic examinations. The subsets of the patients were stable effort angina pectoris (stable type) in 27 cases, new onset of effort angina pectoris (new onset type) in 21 cases, and worsening effort angina pectoris (worsening type) in 35 cases. The remaining 21 cases were subjects without evidences of coronary artery disease (non-CAD). 123 I-BMIPP was injected under resting and pain free condition, then data for single photon emission tomography (SPECT) were acquired. The positive regional 123 I-BMIPP defects in three coronary territories were visually judged on the tomographic images. The overall sensitivity to diagnose the patients was 62.6% (52/83) and the overall specificity to exclude non-CAD subjects was 95.2% (20/21). The detection rate in each subset of the disease was 48.1% (13/27) in stable type, 47.6% (10/21) in new onset type and 77.1% (27/35) in worsening type (p 123 I-BMIPP scintigraphy was therefore valuable in diagnosing patients with effort angina pectoris and involved coronary arteries especially in the subset of patients with worsening type. (author)

Diagnostic value of myocardial tomographic imaging with 123I labelled BMIPP for exercise-induced angina pectoris

International Nuclear Information System (INIS)

Wang Lijuan; Kaname Akioka; Hiroyuki Yamagishi

1999-01-01

Objective: To evaluate the diagnostic value of resting myocardial tomographic imaging with 123 I labelled BMIPP ( 123 I-BMIPP SPECT) for exercise-induced angina pectoris by comparison with stress myocardial tomographic imaging with 201 Tl( 201 Tl SPECT). Methods: 123 I-BMIPP SPECT and 201 Tl SPECT were performed in 32 patients with exercise-induced angina pectoris and 12 normal controls. Left ventricle was divided into nine segments and uptake of 201 TL and 123 I-BMIPP was evaluated by four classes score method (defect score, DS). Results: In the patients with angina pectoris, segments of 201 Tl distribution abnormality were more than that of 123 I-BMIPP. Concordant rate between DS of the 20 '1Tl SPECT for detecting coronary artery stenosis were 62%, 92% and 70%, respectively, and 201 Tl SPECT were 84%, 83% and 84%, respectively. Sensitivity of 123 I-BMIPP SPECT was significantly lower than that of 201 Tl SPECT (P 123 I-BMIPP SPECT will be. Conclusions: The results indicated that to a certain extent, resting 123 I-BMIPP SPECT may has practical clinical value for detection of coronary artery stenosis, and determination of stenotic degree in the patients with exercise-induced angina pectoris

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

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

DEFF Research Database (Denmark)

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

2011-01-01

associated with angina pectoris among 4573 middle-aged Danish men and women free of heart disease at baseline in 2000. Results Nine per cent experienced onset of symptoms of angina pectoris. A higher degree of excessive demands or worries from the social relations was associated with increased risk of angina...... after adjustment for age, gender, social class, cohabitation status and depression in a dose-response manner. For example, experiencing excessive demands or worries always/often from different roles in the social relations was associated with an increased risk: partner OR=3.53 (1.68 to 7.43), children......, cohabitation status or depression in terms of angina. Conclusion Excessive demands and serious worries from significant others seem to be important risk factors for development of angina pectoris....

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

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....... 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....

La salud oral en la dentición primaria: (II) Estudio sobre la maloclusión y otras anomalías orales en una muestra de 441 niños de Vigo Oral health in temporary dentition: (II) Research about malocclusion and other oral anomalies in 441 child sample from Vigo

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IM Iglesias Parada

2003-01-01

La intención de este estudio, que se dividió en tres partes, es valorar la salud oral en los niños de Vigo con dentición primaria. En esta segunda parte se estudian la prevalencia de la maloclusión y otras anomalías orales. MUESTRA: 441 niños entre los 14 y 92 meses de edad (edad media S9,6 meses), todos ellos con dentición primaria al inicio del estudio. RESULTADOS: (precisión de ±4,6% para una seguridad del 9S%) el 90,92% de la muestra es ortognática, el 8,17% es retrognática y el 0,91 es p...

Responsabilidad social corporativa, gobierno corporativo y performance financiero: un estudio interdisciplinar entre las finanzas y la psicología

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Alonso Mollar, Eduardo

2013-01-01

En la presente investigación se plantea la relación entre la psicología y las finanzas. El comportamiento humano es decisivo en la evolución de los mercados, son los aspectos cognitivos y emocionales las causas primarias de las decisiones empresariales y por lo tanto, el efecto de una causa derivada. Las finanzas conductuales conforman una disciplina científica que puede arrojar mucha luz en futuras investigaciones y paliar y contribuir a corregir sesgos y perversiones actuales de los modelos...

A protocol of histone modification-based mechanistic study of acupuncture in patients with stable angina pectoris.

Science.gov (United States)

Wang, Ning; Lu, Sheng-Feng; Chen, Hui; Wang, Jian-Fei; Fu, Shu-Ping; Hu, Chen-Jun; Yang, Yi; Liang, Fan-Rong; Zhu, Bing-Mei

2015-04-30

Angina pectoris (Angina) is a medical condition related to myocardial ischemia. Although acupuncture has been widely accepted as a clinical approach for angina, there is no sufficient evidence of its effectiveness against this syndrome, and its mechanisms have not yet been well elucidated. We develop this protocol to confirm the clinical efficacy of electro-acupuncture on stable angina pectoris by needling on acupoint Neiguan (PC6). Furthermore, we employ high-throughput sequencing technology to investigate the gene expression profiling and determine involvement of histone modifications in the regulation of genes after electro-acupuncture treatment. A randomized, controlled, double-blinded (assessor and patients) trial will be carried out. Sixty participants will be randomly assigned to two acupuncture treatment groups and one control group in a 1:1:1 ratio. Participants in acupuncture groups will receive 12 sessions of electro-acupuncture treatment across 4 weeks, followed by a 12-week randomization period. The acupuncture groups are divided into Neiguan (PC6) on Pericardium Meridian of Hand-jueyin or a non-acupoint. The primary clinical measure of effect is the frequency of angina attacks between these groups for four weeks after randomization. RNAs are extracted from peripheral neutrophils collected from all participants on day 0, day 30, and week 16, and are processed to RNA-Seq. We then investigate profiles of histone modifications by ChIP-Seq, for H3 Lysine 4 (H3K4me) and acetylation of H3 Lysine 27 (H3K27ac), in the presence or absence of acupuncture treatment. This study determines the efficacy and mechanisms of electro-acupuncture on stable angina pectoris. We focus on effectiveness of acupuncture on alleviating symptoms of myocardial ischemia and the gene regulation and the chromatin remodeling marks, including H3K4me1, H3K4me2, and H3K27ac, which could be key factors for regulating gene expressions caused by electro-acupuncture treatment at Neiguan. This

Las estrategias didácticas en la formación de docentes de educación primaria

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Wilfredo Gonzaga Martínez

2005-01-01

Full Text Available El artículo tiene como propósito dar a conocer los resultados de un estudio sobre el proceso didáctico y la incorporación de estrategias innovadoras en los procesos de enseñanza y aprendizaje que se llevan a cabo en el desarrollo de los cursos que conforman el área pedagógica del plan de estudio, para la formación de docentes de Educación Primaria, en la Sede de Occidente de la Universidad de Costa Rica. Los cursos que se consideraron fueron: Introducción a la pedagogía, Didáctica General, Principios de Curriculum, Investigación Educativa, Psicología Educativa, Ciencias en la Educación Primaria, Práctica Docente y Evaluación de los Aprendizajes. La investigación se orientó con el siguiente problema general: ¿Cuáles son las estrategias didácticas en la enseñanza del área pedagógica, aplicadas en la formación inicial de docentes para la Educación Primaria en la Sede de Occidente de la Universidad de Costa Rica? En el estudio se analizaron y se confrontaron los programas de los cursos mencionados, considerando las estrategias didácticas que se aplican para su desarrollo, según el criterio de docentes y alumnos. En este análisis se describe la coherencia entre estos dos aspectos, las tendencias pedagógicas que subyacen en las estrategias didácticas y las innovaciones que se desarrollan como parte de los procesos de enseñanza y aprendizaje. El proceso investigativo demuestra que el plan de estudio considera como referencia pedagógica un enfoque humanista; mientras que los programas de los cursos y la práctica docente no logran desligarse de la didáctica tradicional, con tendencia a incorporar aspectos del Constructivismo y de la Pedagogía Crítica. En el estudio no se logró apreciar la incorporación de estrategias didácticas innovadoras de manera significativa.

Atención Primaria de la Salud en Debate

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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.

POSITIVE AND NEGATIVE PSYCHOLOGICAL CORRELATES, GENDER SPECIFIC AND TRADITIONAL FACTORS FOR FIRST ONSET ANGINA IN A SAMPLE OF PAKISTANI WOMEN.

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Rafique, Rafia; Anjum, Afifa

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. 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. 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 studies, to be tailored

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

Capital social y políticas de Atención Primaria de la Salud

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Ernesto Pablo BÁSCOLO

2016-05-01

Full Text Available 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 condiciones de acceso a partir de la creación de nuevas estructuras en donde profesionales de APS establecieron vínculos de cooperación con actores del Estado municipal, movimientos sociales y gestores y médicos especialistas de hospitales. En Vicente López, las mejoras en las condiciones de acceso a los servicios de salud fueron más limitadas debido a que los cambios en la relación Estado y sociedad solo involucraron a profesionales del primer nivel de atención sin mecanismos de cooperación estables con actores claves de los hospitales, el nivel municipal y los movimientos sociales. Por último, en Cochabamba, las mejoras en las condiciones de acceso fueron marginales debido a que los profesionales del sistema de servicios de salud se opusieron a la alianza establecida entre los movimientos sociales y los actores del Estado municipal para generar cambios en el sistema de salud. Este estudio permite reconocer la influencia de la configuración entre Estado y sociedad para modelar las relaciones de poder que subyacen al proceso de implementación de las reformas del sector salud y sus resultados.

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

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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

Estudio de la inteligencia emocional y función ejecutiva en educación primaria

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Rebollo Goñi, Edurne

2017-01-01

Full Text Available La Inteligencia Emocional y la Función Ejecutiva son clave en la educación por la influencia en el proceso de enseñanza-aprendizaje. El objetivo de este trabajo es analizar la relación entre la Inteligencia Emocional (intrapersonal e interpersonal y la Función Ejecutiva. Método: Los participantes (N=87, M=7.50, SD=1.03 eran escolares de Educación Primaria, a los que se les administró la prueba de Evaluación Neuropsicológica de Funciones Ejecutivas en niños (Portellano, Martínez y Zumárraga, 2009 para valorar las funciones ejecutivas, concretamente planificación, fluidez verbal e interferencia cognitiva y el Cuestionario de Inteligencias Múltiples de Armstrong (2001 con las escalas de inteligencia interpersonal e inteligencia intrapersonal para valorar Inteligencia Emocional. Se emplea un diseño ex postfacto, descriptivo y correlacional. Resultados: El análisis evidencia que existen relaciones significativas entre Inteligencia Emocional y Funciones Ejecutivas. Conclusiones: Resalta la relevancia de incluir en el currículo educativo programas de intervención neuropsicológica que trabajen habilidades emocionales y competencias ejecutivas para optimizar el rendimiento académico y personal del alumnado de Educación Primaria. Abstract: Emotional Intelligence and Executive Function are key in education due to their influence in the teaching-learning process. The aim of this research study is to analyze the relationship between emotional intelligence (intra and interpersonal and some of the components of executive functions. Method: The participants (N=87, M=7.50, SD=1.03 are students in Primary Education who were administered the Neuropsychological Assessment of Executive Functions in Children (Portellano, Martínez y Zumárraga, 2009 to assess executive functions, specifically planning, verbal fluency and cognitive interference as well as Armstrong’s questionnaire on Multiples Intelligences (2001 with scales of interpersonal

de primaria

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Purificación Toledo Morales

2014-01-01

Full Text Available Las pizarras digitales interactivas (PDI son una innovación que en los últimos años ha ganado considerable presencia en las aulas de nuestro país. El objetivo principal de este estudio es investigar las percepciones que estudiantes y docentes de educación primaria tienen del uso de la PDI en el aula, así como los problemas a los que se enfrentan. Los hallazgos confirman que estudiantes y docentes aprueban el uso de esta nueva tecnología en la educación, siendo su uso mayor en la enseñanza de matemáticas, lengua y conocimiento del medio. El estudio muestra que los estudiantes creen que la PDI es efectiva en la mejora de diversos aspectos de su aprendizaje. La actitud positiva del docente hacia el uso de las nuevas tecnologías en la enseñanza juega un papel importante en la ejecución y el éxito del uso de la PDI. Por último, inferimos que las PDI no se emplean en todo su potencial.

Programa Leemos en Pareja Propuesta de Intervención en el aula para la potenciación de la comprensión lectora en Educación Primaria!

OpenAIRE

del Palacio-Totorikaguena, Iratxe

2015-01-01

En este trabajo se elabora una propuesta de intervención en el aula que tiene como objetivo la mejora de la comprensión lectora en alumnos de 2º de primaria. El trabajo se fundamenta en una revisión teórica del concepto de comprensión lectora y los factores que toman parte en el proceso. Después se describe detalladamente la intervención basada en el proyecto “Leemos en Pareja”: una tutorización entre pares como metodología de aula con la participación familiar desde casa. Los estudios rea...

Género y diversidad en la educación. La interacción de mujeres con capacidades diferenciadas (mujeres no estándar en un Centro Público de Educación Infantil y Primaria

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Anastasia Téllez Infantes

2014-06-01

Full Text Available En este artículo exponemos desde la perspectiva de género una experiencia coeducativa de aprendizaje-servicio e innovación docente entre un centro ocupacional de personas con diversidad funcional y un colegio de educación infantil y primaria. Se trata de un proyecto educativo puesto en práctica de simbiosis entre dos centros que han pasado de no relacionarse a pesar de estar ubicados muy próximos, a compartir actividades, talleres, espacios y, sobre todo, a convivir y a aprovechar la potencialidad de sus dos comunidades para el crecimiento mutuo de su profesorado, alumnado y familiares. Así, mostramos un ejemplo práctico de transversalidad de género en el ámbito de la diversidad.

Creencias sobre alfabetización mediática en profesores y estudiantes de Educación Primaria

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Emine Sur

2014-01-01

Full Text Available El objetivo de este trabajo es definir la situación y necesidades actuales de alfabetización mediática en el aula, a través de una serie de entrevistas. Los resultados demuestran que los docentes necesitan formación en esta área, que la enseñanza en alfabetización mediática es adecuada en términos de contenido pero inadecuada como actividad. Los estudiantes muestran cambios significativos en sus propias percepciones sobre los medios tras recibir clases de alfabetización mediática. Para evaluar el nivel y la actitud de los estudiantes se aplicaron una escala de alfabetización mediática y una escala de actitud. La información se obtuvo a través de un formulario de información privado desarrollado por los investigadores. En las conclusiones se halló una relación significativa, positiva y de bajo nivel entre los grados de actitud hacia los contenidos de la alfabetización mediática. La principal conclusión obtenida es que no existe una diferencia significativa entre los estudiantes que asisten a clases de alfabetización mediática en segundo grado de educación primaria y sus actitudes en el aula y su nivel de alfabetización. Asimismo, tampoco se aprecia una diferencia significativa entre el nivel educativo de los padres y sus actitudes. Sin embargo, sí se aprecian diferencias notables cuando existe hábito de lectura diaria de la prensa y la radio.

Effect of preoperative angina pectoris on cardiac outcomes in patients with previous myocardial infarction undergoing major noncardiac surgery (data from ACS-NSQIP).

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Pandey, Ambarish; Sood, Akshay; Sammon, Jesse D; Abdollah, Firas; Gupta, Ena; Golwala, Harsh; Bardia, Amit; Kibel, Adam S; Menon, Mani; Trinh, Quoc-Dien

2015-04-15

The impact of preoperative stable angina pectoris on postoperative cardiovascular outcomes in patients with previous myocardial infarction (MI) who underwent major noncardiac surgery is not well studied. We studied patients with previous MI who underwent elective major noncardiac surgeries within the American College of Surgeons-National Surgical Quality Improvement Program (2005 to 2011). Primary outcome was occurrence of an adverse cardiac event (MI and/or cardiac arrest). Multivariable logistic regression models evaluated the impact of stable angina on outcomes. Of 1,568 patients (median age 70 years; 35% women) with previous MI who underwent major noncardiac surgery, 5.5% had postoperative MI and/or cardiac arrest. Patients with history of preoperative angina had significantly greater incidence of primary outcome compared to those without anginal symptoms (8.4% vs 5%, p = 0.035). In secondary outcomes, reintervention rates (22.5% vs 11%, p angina. In multivariable analyses, preoperative angina was a significant predictor for postoperative MI (odds ratio 2.49 [1.20 to 5.58]) and reintervention (odds ratio 2.40 [1.44 to 3.82]). In conclusion, our study indicates that preoperative angina is an independent predictor for adverse outcomes in patients with previous MI who underwent major noncardiac surgery, and cautions against overreliance on predictive tools, for example, the Revised Cardiac Risk Index, in these patients, which does not treat stable angina and previous MI as independent risk factors during risk prognostication. Copyright © 2015 Elsevier Inc. All rights reserved.

Inteligencia emocional y rendimiento académico en estudiantes del cuarto grado de educación primaria de la institución educativa 7077 “Los Reyes Rojos” de Chorrillos, 2015

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Salazar Rivera, María

2017-01-01

La presente investigación tuvo como objetivo determinar la relación que hay entre la inteligencia emocional y el rendimiento académico en los estudiantes de cuarto grado de educación primaria de la institución educativa No. 7077 Los Reyes Rojos de Chorrillos, 2015. La teoría que fundamentó la variable inteligencia emocional, fue de Daniel Goleman, quién considera como dimensiones el autoconocimiento, el autocontrol, automotivación, empatía, habilidad social. El método emp...

Prevalence of angina in women versus men: a systematic review and meta-analysis of international variations across 31 countries.

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Hemingway, Harry; Langenberg, Claudia; Damant, Jacqueline; Frost, Chris; Pyörälä, Kalevi; Barrett-Connor, Elizabeth

2008-03-25

In the absence of previous international comparisons, we sought to systematically evaluate, across time and participant age, the sex ratio in angina prevalence in countries that differ widely in the rate of mortality due to myocardial infarction. We searched MEDLINE and EMBASE until February 2006 for healthy population studies published in any language that reported the prevalence of angina (Rose questionnaire) in women and men. We obtained myocardial infarction mortality rates from the World Health Organization. A total of 74 reports of 13,331 angina cases in women and 11,511 cases in men from 31 countries were included. Angina prevalence varied widely across populations, from 0.73% to 14.4% (population weighted mean 6.7%) in women and from 0.76% to 15.1% (population weighted mean 5.7%) in men, and was strongly correlated within populations between the sexes (r=0.80, Pethnic groups than among whites. This sex ratio did not differ significantly by participant's age, the year the survey began, or the sex ratio for mortality due to myocardial infarction. Over time and at different ages, independent of diagnostic and treatment practices, women have a similar or slightly higher prevalence of angina than men across countries with widely differing myocardial infarction mortality rates.

Conceptos básicos y rendimiento escolar en niñas de primer grado de primaria de clase socioeconómica baja

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María Isabel La Rosa Cormack

2013-09-01

Full Text Available La finalidad de este trabajo fue resolver la interrogante acerca de la relación entre el conocimiento de conceptos básicos de espacio, tiempo, cantidad y número, y el rendimiento escolar, a partir de un diseño de tipo correlacional. Para ello se tomó una muestra compuesta por treinta niñas de seis años de edad que cursaban el primer grado de primaria, pertenecientes a la clase socioeconómica baja. Como instrumentos se utilizaron el Test Boehm de Conceptos Básicos y una Prueba de Pedagógica que evaluaría el desempeño tanto en lenguaje como en matemáticas. Los resultados mostraron una correlación significativa entre las variables del estudio siendo mayor, la correlación entre conceptos y lenguaje, que entre conceptos y matemáticas. The finality of this work was to solve the question about the relationship between knowledge of basic concepts such as: space, time quantity and number, and school performance. The sample was conformed by 30 low school first grade students aged 6 years belonging to low SES. The Boehm Test of Basic Concepts and a Pedagogical Test were administred to asses performance in language and mathematics. Significant correlation was founded between the study variables being higher the relation about concepts and language than concepts and mathematics.  

Perfil de los adultos mayores usuarios de atención primaria

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Fabianne de Jesus Dias de Sousa

2017-05-01

Full Text Available Introducción: Las proyecciones indican que Brasil será el sexto país del mundo con el mayor número de adultos mayores. El objetivo de este estudio fue caracterizar las condiciones de perfil y de vida socio-demográficos y de salud de los usuarios adultos mayores de la atención primaria de un municipio en la región amazónica del Brasil. Es oportuno porque el envejecimiento de la población está creciendo rápidamente, especialmente en países en desarrollo como el Brasil. Materiales y Métodos: Estudio transversal con una muestra de 441 individuos con edad inferior a 60 años de la población de usuarios de la atención básica en el municipio de Benevides, en la Amazonia brasileña. Os datos fueron obtenidos a través del Elder notebook, un protocolo clínico del Ministerio de la Salud. La prueba del chi-cuadrado con un nivel de significancia de 5% para explorar fue utilizada las asociaciones entre las variables de las condiciones de salud y de vida, y las variables socio-demográficas. Resultados: Se presentaron un perfil predominantemente joven adultos mayores (46.0%, que no practican actividad física (p<0.02, con condiciones crónicas y uso de drogas para inducir el sueño (p<0.05. Discusión y Conclusiones: El perfil de vida desfavorable y de salud encontrados en adultos mayores exige la adopción de medidas reforzadas, sobre la salud y los presupuestos de atención integral como un desafío para efectuar la colocación de sus necesidades, principalmente por la enfermería, en la Atención Básica de Salud en áreas más necesitadas de la región amazónica. Cómo citar este artículo: Sousa FJD, Andrade FS. Perfil de los adultos mayores usuarios de atención primaria. Rev Cuid. 2017; 8(2: 1573-81. http://dx.doi.org/10.15649/cuidarte.v8i2.376

CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival

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Victor Dayan

Full Text Available Abstract Objective: In contrast to unstable angina, optimal therapy in patients with stable angina is debated. Our aim was to evaluate the outcomes of patients with stable angina scheduled for isolated coronary artery bypass grafts and the effect of preoperative use of beta-blockers. Overall and cardiovascular survivals were our primary outcome. Operative mortality and postoperative complications along with subgroup analysis of diabetic patients were our secondary outcomes. Methods: Retrospective evaluation of patients with stable angina scheduled for isolated coronary artery bypass grafts was included. Pre- and postoperative variables were extracted from the institution database. Survival was obtained from the National Registry. Results: We included 282 patients with stable angina, with a mean age of 65.6±9.5 years. 26.6% were female and 38.7% had diabetes. Three-vessel disease was present in 76.6% of patients. Previous beta-blocker treatment was evident in 69.9% of patients. 10-year overall survival in the whole population was 60.5% (95% confidence interval [CI]: 50.3-70.7%. Operative mortality during the study period was 3.5%. Patients with preoperative use of beta-blocker therapy had better overall survival (9.0 years, 95%CI: 8.6-9.5 than those without treatment (7.9 years, 95%CI: 7.1-8.8 years; P=0.048. Predictors for overall survival were: hypertension, diabetes, and age. Predictors for cardiovascular survival in diabetic patients were: beta-blocker use, gender, and age. Conclusion: Coronary artery bypass grafts surgery in patients with stable angina carries low operative mortality, postoperative complications, and excellent long-term cardiovascular survival. The preoperative use of beta-blockers in diabetic patients is associated with better cardiovascular survival after coronary artery bypass grafts.

Regional myocardial perfusion in patients with atherosclerotic coronary artery disease, at rest and during angina pectoris induced by tachycardia

International Nuclear Information System (INIS)

Maseri, A.; L'Abbate, A.; Pesola, A.; Michelassi, C.; Marzilli, M.; De Nes, M.

1977-01-01

We studied regional myocardial perfusion by scintigraphic computer-assisted analysis of initial distribution, washout rates, and residual activity of 133 Xe injected into the left coronary artery of four patients with normal arteriograms and 14 patients with coronary stenosis. At rest, residual activity in poststenotic regions was always greater than in control regions, but initial washout rates were not slower. During angina, following xenon injections, the amount of indicator distributed to the poststenotic regions was markedly reduced; the increase of the initial washout rates was smaller than in control regions relative to rest, and residual activity was higher. Initial washout rates did not differ as much as from those of normal myocardium because in severe ischemia too little indicator is deposited initially in these regions to produce a change of any magnitude. Indeed, when angina was induced immediately after the xenon injection, poststenotic washout rates became much slower during angina than at rest, a finding that implicates functional factors in impairing poststenotic myocardial perfusion during angina

Asociaciones entre rendimiento en comprensión de textos y estrategias pedagógicas utilizadas por docentes

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Lorena Canet Juric

Full Text Available El objetivo de este trabajo ha sido explorar las asociaciones entre el rendimiento en comprensión lectora y distintas estrategias docentes utilizadas con alumnos de segundo y tercer grado de Educación Primaria Básica (EPB de la Ciudad de Mar del Plata (Argentina. El supuesto de este estudio afirma que existe una asociación entre el rendimiento en comprensión lectora y las estrategias pedagógicas docentes. Se aplicó una adaptación del PROLEC para evaluar el rendimiento en lectura y un cuestionario construido para explorar las estrategias docentes. Los instrumentos fueron administrados a una muestra aleatoria de alumnos de 2º y 3º año de 10 escuelas municipales (n=258 y a sus respectivos docentes (n=64. Los resultados permitieron aportar evidencia empírica sobre la ausencia de asociaciones estadísticamente significativas entre ambas variables, lo que permite suponer que la lectoescritura es un fenómeno complejo que depende de numerosos factores como las diferencias cognitivas individuales, el contexto alfabetizador, etc.

Propuesta de intervención para consolidar hábitos lectores en alumnos de 6º de primaria

OpenAIRE

Carcaño-Sobré, Eva

2015-01-01

El Trabajo de Fin de Grado se plantea las características principales de los hábitos lectores de un grupo de edad de 11-12 años y como la lectura forma parte del currículum de Educación Primaria. Para ello se realiza un cuestionario a alumnos de sexto de Primaria para comprobar la importancia de la lectura en este grupo y posteriormente se realiza otro cuestionario dirigido a alumnos de Educación Segundaria Obligatoria para constatar si esos hábitos siguen siendo los mismos que en Primaria...

RELANZAMIENTO ATENCIÓN PRIMARIA EN SALUD

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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...

La informatización de la atención primaria de salud The informatization in primary health care

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Rodolfo J. Stusser Beltranena

2006-12-01

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.The informatization in primary health care is perceived as problem that is solved by creating computer networks between the family physicians' offices and the polyclinics. This article gives a panoramic view of the state in which the art of informatization of primary health care and comprehensive general medicine is in the world and in Cuba. To this end, the prehistoric origin of this care level and of the specialty is synthezised, as well as the contemporary development of informatics and its medical applications. Primary care and its informatics is also defined, and the information

Myocardial ischemia and angina pectoris. The clinical problem in patients

Energy Technology Data Exchange (ETDEWEB)

Selwyn, A.P.; Fox, K.M.; Jonathan, A.; Lavender, P.; Watson, I.

1981-02-01

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

Estilos de aprendizaje y su relación con los resultados académicos de fin de carrera en la especialidad de educación primaria en la Facultad de Ciencias de la Educación de la Universidad Nacional de San Agustín, Arequipa 2012

OpenAIRE

Cisneros Chávez, Betsy Carol

2013-01-01

La investigación titulada “Estilos de aprendizaje y su relación con los resultados académicos de fin de carrera en la especialidad de Educación Primaria en la Facultad de Ciencias de la Educación de la Universidad Nacional de San Agustín”, tuvo como objetivo Determinar la relación entre los Estilos de Aprendizaje y los resultados académicos de fin de carrera. La hipótesis indica que es posible que exista una relación estadísticamente significativa entre los estilos de aprendizaje predomina...

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

Spinal Cord Stimulation for Refractory Angina Pectoris: A Systematic Review and Meta-analysis.

Science.gov (United States)

Pan, Xiaoxiao; Bao, Hongguang; Si, Yanna; Xu, Chenjie; Chen, Hao; Gao, Xianzhong; Xie, Xinyi; Xu, Yajie; Sun, Fan; Zeng, Lingqing

2017-06-01

Paresthesia-free stimulation such as high frequency and burst have been demonstrated as effective therapies for neuropathic pain. The aim of this meta-analysis was to evaluate the efficacy and safety of conventional spinal cord stimulation (SCS) in the treatment of refractory angina pectoris (RAP). Relevant randomized controlled trials that investigated SCS for patients with RAP were comprehensively searched in Medline, Pubmed, Embase, and Cochrane Library. Five meta-analyses were performed examining the changes in Canadian Cardiovascular Society classes, exercise time, Visual Analog Scale (VAS) scores of pain, Seattle Angina Questionnaire, and nitroglycerin use in RAP patients after SCS therapy. We analyzed standardized mean differences (MD) and 95% confidence intervals (CIs) for each outcome by Review Manager 5.0 and STATA 12.0. A total of 12 randomized controlled trials involving 476 RAP patients were identified. A trend of reduction in the angina frequency (MD=-9.03, 95% CI, -15.70 to -2.36) and nitroglycerin consumption (MD=-0.64, 95% CI, -0.84 to -0.45) could be observed in the SCS group. Compared with the control group, SCS showed benefit on increasing exercise time (MD=0.49, 95% CI, 0.13-0.85) and treatment satisfaction (MD=6.87, 95% CI, 2.07-11.66) with decreased VAS scores of pain (MD=-0.50, 95% CI, -0.81 to -0.20) and disease perception (MD=-8.34, 95% CI, -14.45 to -2.23). However, the result did not reach the significance level in terms of physical limitation (95% CI, -8.75 to 3.38; P=0.39) or angina stability (95% CI, -7.55 to 3.67; P=0.50). The current meta-analysis suggested that SCS was a potential alternative in the treatment of PAP patients. Further investigation for finding the appropriate intensity of stimulation is required before this treatment should be widely recommended and applied.

Emerging treatment options for refractory angina pectoris: ranolazine, shock wave treatment, and cell-based therapies.

Science.gov (United States)

Gennari, Marco; Gambini, Elisa; Bassetti, Beatrice; Capogrossi, Maurizio; Pompilio, Giulio

2014-01-01

A challenge of modern cardiovascular medicine is to find new, effective treatments for patients with refractory angina pectoris, a clinical condition characterized by severe angina despite optimal medical therapy. These patients are not candidates for surgical or percutaneous revascularization. Herein we review the most up-to-date information regarding the modern approach to the patient with refractory angina pectoris, from conventional medical management to new medications and shock wave therapy, focusing on the use of endothelial precursor cells (EPCs) in the treatment of this condition. Clinical limitations of the efficiency of conventional approaches justify the search for new therapeutic options. Regenerative medicine is considered the next step in the evolution of organ replacement therapy. It is driven largely by the same health needs as transplantation and replacement therapies, but it aims further than traditional approaches, such as cell-based therapy. Increasing knowledge of the role of circulating cells derived from bone marrow (EPCs) on cardiovascular homeostasis in physiologic and pathologic conditions has prompted the clinical use of these cells to relieve ischemia. The current state of therapeutic angiogenesis still leaves many questions unanswered. It is of paramount importance that the treatment is delivered safely. Direct intramyocardial and intracoronary administration has demonstrated acceptable safety profiles in early trials, and may represent a major advance over surgical thoracotomy. The combined efforts of bench and clinical researchers will ultimately answer the question of whether cell therapy is a suitable strategy for treatment of patients with refractory angina.

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...

INVESTIGACIÓN CUALITATIVA SOBRE LA CONCEPTUALIZACIÓN DE LA HIPERFRECUENTACIÓN POR PARTE DEL PERSONAL MÉDICO DE ATENCIÓN PRIMARIA

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Almudena Alameda Cuesta

2009-01-01

Full Text Available Fundamentos: La hiperfrecuentación es un fenómeno preocupante para los sistemas sanitarios occidentales, por la gran carga de trabajo que genera y sus altos costes materiales y humanos. El objetivo de este trabajo es estudiar los significados, categorías y prácticas que las médicas y médicos de Atención Primaria vivencian en torno a la hiperfrecuentación. Métodos: Estudio cualitativo basado en una aproximación sociosubjetiva, a través de entrevistas en profundidad (ocho entrevistas a médicos/as de Atención Primaria de la Comunidad de Madrid. El material discursivo se analizó desde una perspectiva pragmatista. Resultados: La figura del médico de Atención Primaria se encuentra en la intersección de lógicas profesionales-institucionales contradictorias, lo que genera niveles altos de malestar profesional. Los aspectos sociales y psicológicos aparecen de forma confusa en relación con la consideración de todo aquello que no tiene que ver con lo físico como ajeno al ámbito de actuación de la medicina. La hiperfrecuentación resulta problemática porque se sitúa en el centro de la dicotomía signo-síntoma, su manejo requiere mucho tiempo, precisa de un abordaje integral, e imposibilita el cumplimiento del rol médico como profesional que diagnostica e instaura un tratamiento etiológico. Estas dificultades terminan por traducirse en conflictos en la relación profesional-paciente. Conclusiones: Los significados relativos a la hiperfrecuentación van a variar notablemente en función de las posiciones sociosubjetivas, por lo que abordajes como el que aquí se propone ayudan a comprender la complejidad de una problemática que se construye en el seno de las relaciones entre sujetos particulares, atravesados por dinámicas institucionales, conflictos laborales, trayectorias profesionales e ideologías diversas.

Phase changes caused by hyperventilation stress in spastic angina pectoris analyzed by first-pass radionuclide ventriculography

International Nuclear Information System (INIS)

Wu, Jin; Takeda, Tohoru; Ajisaka, Ryuichi; Masuoka, Takeshi; Watanabe, Sigeyuki; Sato, Motohiro; Itai, Yuji; Toyama, Hinako; Ishikawa, Nobuyoshi

1999-01-01

To understand the effect of hyperventilation (HV) stress in patients with spastic angina, left ventricular (LV) contraction was analyzed by quantitative phase analysis. The study was performed on 36 patients with spastic angina pectoris, including vasospastic angina pectoris (VspAP: 16 patients) and variant angina pectoris (VAP: 20 patients). First-pass radionuclide ventriculography (first-pass RNV) was performed at rest and after HV stress, and standard deviation of the LV phase distribution (SD) was analyzed. The SD was lower in patients with VspAP than in VAP(12.8±1.4 degrees vs. 14.6±2.2 degrees, p<0.005) at rest. After HV stress, the SD (HVSD) tended to increase in VspAP patients (62.5%), whereas the SD decreased in VAP patients (70%). Due to HV stress, the percentage change in SD (%SD) in VspAP patients was 8.9±23.7% whereas that in VAP patients was -9.1±17.3% (p<0.01). Moreover, phase histograms were divided into HVSD increase and HVSD decrease groups. The HVSD increase group had a decrease of HVEF, but the HVSD decrease group tended to have more decreased HVEF than the HVSD increase group. These results indicate that spastic angina pectoris patients show various responses to HV stress. The HVSD increase group might have additional myocardial ischemia due to regional coronary spasm. In contrast, in the HVSD decrease group severe LV dysfunction or diffuse wall motion abnormality might have been generated, and this caused a reduction in the SD value. Phase analysis would therefore add new information regarding electrocardiographically silent myocardial ischemia due to coronary spasm, and HV stress might increase sensitivity for the detection of abnormalities in quantitative phase analysis, especially in VspAP patients. (author)

Phase changes caused by hyperventilation stress in spastic angina pectoris analyzed by first-pass radionuclide ventriculography

Energy Technology Data Exchange (ETDEWEB)

Wu, Jin; Takeda, Tohoru; Ajisaka, Ryuichi; Masuoka, Takeshi; Watanabe, Sigeyuki; Sato, Motohiro; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Toyama, Hinako; Ishikawa, Nobuyoshi

1999-02-01

To understand the effect of hyperventilation (HV) stress in patients with spastic angina, left ventricular (LV) contraction was analyzed by quantitative phase analysis. The study was performed on 36 patients with spastic angina pectoris, including vasospastic angina pectoris (VspAP: 16 patients) and variant angina pectoris (VAP: 20 patients). First-pass radionuclide ventriculography (first-pass RNV) was performed at rest and after HV stress, and standard deviation of the LV phase distribution (SD) was analyzed. The SD was lower in patients with VspAP than in VAP(12.8{+-}1.4 degrees vs. 14.6{+-}2.2 degrees, p<0.005) at rest. After HV stress, the SD (HVSD) tended to increase in VspAP patients (62.5%), whereas the SD decreased in VAP patients (70%). Due to HV stress, the percentage change in SD (%SD) in VspAP patients was 8.9{+-}23.7% whereas that in VAP patients was -9.1{+-}17.3% (p<0.01). Moreover, phase histograms were divided into HVSD increase and HVSD decrease groups. The HVSD increase group had a decrease of HVEF, but the HVSD decrease group tended to have more decreased HVEF than the HVSD increase group. These results indicate that spastic angina pectoris patients show various responses to HV stress. The HVSD increase group might have additional myocardial ischemia due to regional coronary spasm. In contrast, in the HVSD decrease group severe LV dysfunction or diffuse wall motion abnormality might have been generated, and this caused a reduction in the SD value. Phase analysis would therefore add new information regarding electrocardiographically silent myocardial ischemia due to coronary spasm, and HV stress might increase sensitivity for the detection of abnormalities in quantitative phase analysis, especially in VspAP patients. (author)

Programa Literatura Infantil Local para la carrera Licenciatura en Educación Primaria

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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.

Flipped Classroom en un aula de música de Primaria: implementación y análisis de una experiencia de innovación docente.

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Francisco Jesús Parra Giménez

2017-05-01

Full Text Available Con el avance tecnológico y su integración en los procesos de enseñanza - aprendizaje en los centros educativos, aparecen nuevas metodologías apoyadas en las tecnologías de la información y comunicación (TIC de aquí en adelante, entre la que se encuentra Flipped Classroom o Aula Invertida. Nuevos escenarios de enseñanza y aprendizaje, que con el apoyo de las TIC,  permiten una educación centrada en el alumnado y  una educación acorde con la sociedad actual. La metodología de trabajo Flipped Classroom permite  enseñar a los alumnos con las herramientas telemáticas que forman parte de su realidad más próxima y entre las que están creciendo. Por ello, con este artículo se pretende dar a conocer los resultados de una experiencia de innovación docente basada en la metodología Flipped Classroom en el área de Educación Musical, con el alumnado de 4º curso de Educación Primaria. Tras el diseño y puesta en práctica de la Unidad Didáctica “Célebres Compositores”, se han obtenido una serie de resultados a través de diversas técnicas e instrumentos de recogida de información, como son los cuestionarios y la ficha de observación, que han permitido una evaluación positiva de dicha experiencia, así como comprobar que la metodología Flipped Classroom resulta interesante para futuras investigaciones y estudios en Educación Primaria. A continuación, se exponen los datos más relevantes y los resultados obtenidos de dicha experiencia.

Electrical neuromodulation for disabling angina pectoris related to isolated stenoses of small epicardial coronary arteries.

Science.gov (United States)

Jessurun, G A; Hautvast, R W; DeJongste, M J; Meyler, W J; van Boven AJ; Crijns, H J

1999-07-01

Patients with symptomatic small vessel coronary artery disease may be inadequate candidates for revascularization procedures. They may suffer from refractory angina, which does not respond to maximal anti-anginal drug therapy. In addition to patients with end stage coronary artery disease and syndrome X, this newly defined group of subjects with an isolated stenosis of a small coronary artery may benefit from electrical neurostimulation. We describe two patients with intractable angina caused by a significant narrowing of a diagonal branch. This treatment modality should be considered as an alternative method for unsatisfactory revascularization procedures.

Neurostimulation as an adjuvant therapy for patients with intractable angina pectoris.

NARCIS (Netherlands)

Jongste, Michel Johannes Leendert de

2009-01-01

In spite of tremendous improvement in treatment of patients with angina pectoris due to significant coronary artery disease, there remains a group of patients who cannot adequately be treated. These patients are considered as having ‘intractale angina’. Patients, suffering from intractable ischemic

Caracterización de pacientes con neoplasias primarias del segmento hepatobiliopancreático

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Danilo Romaguera Barroso

2015-02-01

Full Text Available Se realizó un estudio observacional, descriptivo y longitudinal de 60 pacientes con cáncer primario del segmento hepatobiliopancreático, operados y egresados vivos del Servicio de Cirugía General del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde el 2005 hasta el 2011, con vistas a caracterizarles según variables seleccionadas. Entre las localizaciones más frecuentes figuraron: páncreas, hígado, vesícula y vías biliares extrahepáticas, en pacientes de la sexta década de la vida del sexo masculino; aunque el tumor de vesícula biliar prevaleció en las féminas. La estadificación clínica de la mayoría correspondió a las etapas más avanzadas, limitada al tratamiento quirúrgico paliativo. Los pacientes con factores de riesgo deben ser dispensarizados en las áreas de atención primaria de salud para que acudan al nivel secundario en etapas iniciales de la enfermedad, y puedan recibir el tratamiento quirúrgico con intención curativa, lo cual mejora su pronóstico y calidad de vida

Transient myocardial ischemia during daily life in rest and exertional angina pectoris and comparison of effectiveness of metoprolol versus nifedipine

DEFF Research Database (Denmark)

Ardissino, D; Savonitto, S; Egstrup, K

1991-01-01

life (p less than 0.05) irrespective of the patients' clinical characteristics. Nifedipine was ineffective, particularly in patients with angina predominantly on effort and with a moderate to severe reduction in exercise tolerance. It is concluded that in patients with mixed angina, ischemic episodes...

Comparison between unstable angina pectoris and stable effort angina pectoris by using 123I-BMIPP and 201Tl myocardial SPECT

International Nuclear Information System (INIS)

Hisatake, Shinji; Yamashina, Shohei; Yamazaki, Junichi

2004-01-01

We performed BMIPP myocardial SPECT and Tl myocardial SPECT in patients with unstable angina (UAP) and stable effort angina (SAP), and compared the results for the two groups. Our subjects were 30 patients with the UAP and 25 patients with the SAP. The early and delayed images of the BMIPP were obtained with patients at rest. The early image of the Tl alone was obtained with patients at rest. We calculated severity score (SS) using the polar map based on SPECT short-axis image on the both myocardial SPECT. And, we calculated % uptake of the responsible coronary lesion and regional washout rate (WR) on myocardial SPECT with BMIPP. On coronary angiogram, no difference in % diameter stenosis was seen between the two groups. On myocardial SPECT with Tl, no difference in the SS was seen between the two groups. However, on myocardial SPECT with BMIPP, the SS was significantly higher score in the UAP group than in the SAP group. And, on myocardial SPECT with BMIPP, the % uptake and the WR were significant lower values in the UAP group than in the SAP group. Even if the two groups have almost the same level of myocardial perfusion disorder, the UAP group may have severer myocardial fatty-acid metabolic disorder than the SAP group, because the defects in BMIPP were significantly severer in the UAP group. (author)

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

DEFF Research Database (Denmark)

Vestergaard, H; Skøtt, P; Steffensen, R

1995-01-01

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 exa......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...... metabolism (8.4 +/- 0.9 v 12.5 +/- 1.3 mg.kg FFM-1.min-1, P

Long-term use of short- and long-acting nitrates in stable angina pectoris.

Science.gov (United States)

Kosmicki, Marek Antoni

2009-05-01

Long-acting nitrates are effective antianginal drugs during initial treatment. However, their therapeutic value is compromised by the rapid development of tolerance during sustained therapy, which means that their clinical efficacy is decreased during long-term use. Sublingual nitroglycerin (NTG), a short-acting nitrate, is suitable for the immediate relief of angina. In patients with stable angina treated with oral long-acting nitrates, NTG maintains its full anti-ischemic effect both after initial oral ingestion and after intermittent long-term oral administration. However, NTG attenuates this effect during continuous treatment, when tolerance to oral nitrates occurs, and this is called cross-tolerance. In stable angina long-acting nitrates are considered third-line therapy because a nitrate-free interval is required to avoid the development of tolerance. Nitrates vary in their potential to induce the development of tolerance. During long-lasting nitrate therapy, except pentaerythritol tetranitrate (PETN), one can observe the development of reactive oxygen species (ROS) inside the muscular cell of a vessel wall, and these bind with nitric oxide (NO). This leads to decreased NO activity, thus, nitrate tolerance. PETN has no tendency to form ROS, and therefore during long-term PETN therapy, there is probably no tolerance or cross-tolerance, as during treatment with other nitrates.

Is refractory angina pectoris a form of chronic pain? A comparison of two patient groups receiving spinal cord stimulation therapy.

Science.gov (United States)

Pak, Nick; Devcich, Daniel A; Johnson, Malcolm H; Merry, Alan F

2014-03-28

To compare psychological and pain-related characteristics of patients with chronic pain and patients with refractory angina pectoris who had been treated with spinal cord stimulation (SCS) therapy. Twenty-four patients receiving SCS therapy were interviewed. Four psychological variables were assessed using standardised questionnaires for pain catastrophising, health locus of control, anxiety sensitivity, and self-efficacy. Patients also completed the revised version of the Short-Form McGill Pain Questionnaire, the Short-Form Health Survey, and self-reported measures of global perceived effect, pain, functionality, and satisfaction with SCS therapy. Most patients reported improvements in pain, functionality, and improvement overall. Some health locus of control dimensions were significantly higher for the angina group than the chronic pain group, and chronic angina patients reported significantly lower levels of intermittent pain. Virtually all patients reported being satisfied with SCS therapy. Most self-rated psychological and pain-related characteristics were no different between the two groups, which gives some support to the view that refractory angina is a form of chronic pain. The results also add to evidence supporting the use of SCS therapy for refractory angina pectoris; however, differences observed on a few variables may indicate points of focus for the assessment and treatment of such patients.

Safety and efficacy of extracorporeal shock wave myocardial revascularization therapy for refractory angina pectoris.

Science.gov (United States)

Cassar, Andrew; Prasad, Megha; Rodriguez-Porcel, Martin; Reeder, Guy S; Karia, Darshak; DeMaria, Anthony N; Lerman, Amir

2014-03-01

To assess the safety and efficacy of extracorporeal shockwave myocardial revascularization (ESMR) therapy in treating patients with refractory angina pectoris. A single-arm multicenter prospective trial to assess safety and efficacy of the ESMR therapy in patients with refractory angina (class III/IV angina) was performed. Screening exercise treadmill tests and pharmacological single-photon emission computed tomography (SPECT) were performed for all patients to assess exercise capacity and ischemic burden. Patients were treated with 9 sessions of ESMR to ischemic areas over 9 weeks. Efficacy end points were exercise capacity by using treadmill test as well as ischemic burden on pharmacological SPECT at 4 months after the last ESMR treatment. Safety measures included electrocardiography, echocardiography, troponin, creatine kinase, and brain natriuretic peptide testing, and pain questionnaires. Fifteen patients with medically refractory angina and no revascularization options were enrolled. There was a statistically significant mean increase of 122.3±156.9 seconds (38% increase compared with baseline; P=.01) in exercise treadmill time from baseline (319.8±157.2 seconds) to last follow-up after the ESMR treatment (422.1±183.3 seconds). There was no improvement in the summed stress perfusion scores after pharmacologically induced stress SPECT at 4 months after the last ESMR treatment in comparison to that at screening; however, SPECT summed stress score revealed that untreated areas had greater progression in ischemic burden vs treated areas (3.69±6.2 vs 0.31±4.5; P=.03). There was no significant change in the mean summed echo score from baseline to posttreatment (0.4±5.1; P=.70). The ESMR therapy was performed safely without any adverse events in electrocardiography, echocardiography, troponins, creatine kinase, or brain natriuretic peptide. Pain during the ESMR treatment was minimal (a score of 0.5±1.2 to 1.1±1.2 out of 10). In this multicenter feasibility

Indicadores de accesibilidad geográfica a los centros de atención primaria para la gestión de inequidades

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Diana De Pietri

2013-12-01

Full Text Available OBJETIVOS: Caracterizar los indicadores geográficos conforme a su utilidad para medir inequidades en el territorio; identificar y describir las áreas según sus grados de accesibilidad geográfica a los centros de atención primaria de salud (CAPS, y detectar poblaciones en riesgo desde la perspectiva del acceso a la atención primaria. MÉTODO: El análisis de accesibilidad espacial mediante sistemas de información geográfica (SIG requirió de tres aspectos: la población sin cobertura médica, la distribución de los CAPS y la red de transporte público que los conecta. RESULTADOS: La construcción de indicadores de demanda (real, potencial y diferencial y el análisis de los factores territoriales que intervienen en la movilidad de la población permitieron caracterizar los CAPS en relación a su entorno, contribuyendo al análisis, tanto en una perspectiva local como regional, y a la detección de diferentes zonas según niveles de conectividad a escala regional. CONCLUSIONES: Los indicadores construidos en el entorno SIG fueron de gran utilidad para el análisis de accesibilidad a los CAPS por la población vulnerable. La zonificación del territorio contribuyó a identificar inequidades al diferenciar áreas de demanda no satisfecha y la fragmentación de la conectividad espacial entre CAPS y transporte público.

Oral Chinese proprietary medicine for angina pectoris: an overview of systematic reviews/meta-analyses.

Science.gov (United States)

Luo, Jing; Xu, Hao; Yang, Guoyan; Qiu, Yu; Liu, Jianping; Chen, Keji

2014-08-01

Oral Chinese proprietary medicine (CPM) is commonly used to treat angina pectoris, and many relevant systematic reviews/meta-analyses are available. However, these reviews have not been systematically summarized and evaluated. We conducted an overview of these reviews, and explored their methodological and reporting quality to inform both practice and further research. We included systematic reviews/meta-analyses on oral CPM in treating angina until March 2013 by searching PubMed, Embase, the Cochrane Library and four Chinese databases. We extracted data according to a pre-designed form, and assessed the methodological and reporting characteristics of the reviews in terms of AMSTAR and PRISMA respectively. Most of the data analyses were descriptive. 36 systematic reviews/meta-analyses involving over 82,105 participants with angina reviewing 13 kinds of oral CPM were included. The main outcomes assessed in the reviews were surrogate outcomes (34/36, 94.4%), adverse events (31/36, 86.1%), and symptoms (30/36, 83.3%). Six reviews (6/36, 16.7%) drew definitely positive conclusions, while the others suggested potential benefits in the symptoms, electrocardiogram, and adverse events. The overall methodological and reporting quality of the reviews was limited, with many serious flaws such as the lack of review protocol and incomprehensive literature searches. Though many systematic reviews/meta-analyses on oral CPM for angina suggested potential benefits or definitely positive effects, stakeholders should interpret the findings of these reviews with caution, considering the overall limited methodological and reporting quality. We recommend further studies should be appropriately conducted and systematic reviews reported according to PRISMA standard. Copyright © 2014 Elsevier Ltd. All rights reserved.

Differential loss of natural killer cell activity in patients with acute myocardial infarction and stable angina pectoris.

Science.gov (United States)

Yan, Wenwen; Zhou, Lin; Wen, Siwan; Duan, Qianglin; Huang, Feifei; Tang, Yu; Liu, Xiaohong; Chai, Yongyan; Wang, Lemin

2015-01-01

To evaluate the activity of natural killer cells through their inhibitory and activating receptors and quantity in peripheral blood mononuclear cells extracted from patients with acute myocardial infarction, stable angina pectoris and the controls. 100 patients with myocardial infarction, 100 with stable angina, and 20 healthy volunteers were recruited into the study. 20 randomly chosen people per group were examined for the whole human genome microarray analysis to detect the gene expressions of all 40 inhibitory and activating natural killer cell receptors. Flow cytometry analysis was applied to all 200 patients to measure the quantity of natural killer cells. In myocardial infarction group, the mRNA expressions of six inhibitory receptors KIR2DL2, KIR3DL3, CD94, NKG2A, KLRB1, KLRG1, and eight activating receptors KIR2DS3, KIR2DS5, NKp30, NTB-A, CRACC, CD2, CD7 and CD96 were significantly down-regulated (Pangina patients and the controls. There was no statistical difference in receptor expressions between angina patients and control group. The quantity of natural killer cells was significantly decreased in both infarction and angina patients compared with normal range (Pangina patients showed a quantitative loss and dysfunction of natural killer cells in myocardial infarction patients.

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

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 (

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...

En acción: mejorando el acceso a la atención óptima para todos los pacientes con inmunodeficiencias primarias Semana mundial de las Inmunodeficiencias Primarias

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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.

Caracterización de Atención Primaria de salud en tres municipios de Minas Gerais, Brasil: Un analisis de los casos

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Luciano José ARANTES

2011-12-01

Full Text Available Este trabajo tuvo como objetivo estudiar la forma en que la atención primaria de salud se caracteriza en tres municipios de Minas Gerais, Brasil. Hemos tratado de comprender el contexto local, la estructura y la gestión de la atención primaria en los municipios pesquisados. Las técnicas utilizadas para la colecta de datos fueron la investigación documental y la entrevista con los gestores locales. Los datos obtenidos fueron analizados de acuerdo con la legislación brasileña para el desarrollo de la atención primaria. Se identificó que los municipios asumen la atención primaria de salud de manera distinta. La característica de la política y del gobierno local fue considerada un punto que parece permear tanto en el contexto del desarrollo de la atención primaria como su forma de estructuración y gestión.

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.

Refractory angina pectoris in end-stage coronary artery disease : Evolving therapeutic concepts

NARCIS (Netherlands)

Schoebel, FC; Frazier, OH; Jessurun, GAJ; DeJongste, MJL; Kadipasaoglu, KA; Jax, TW; Heintzen, MP; Cooley, DA; Strauer, BE; Leschke, M

1997-01-01

Refractory angina pectoris in coronary artery disease is defined as the persistence of severe anginal symptoms despite maximal conventional antianginal combination therapy. Further, the option to use an invasive revascularization procedure such as percutaneous coronary balloon angioplasty or

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

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

Energy Technology Data Exchange (ETDEWEB)

Mangiafico, R.A.; Petralito, A.; Grimaldi, D.R. (Univ. of Catania (Italy))

1990-07-01

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.

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.

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

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

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.

Revascularization with percutaneous coronary intervention does not affect androgen status in males with chronic stable angina pectoris.

Science.gov (United States)

Gosai, J N; Charalampidis, P; Nikolaidou, T; Parviz, Y; Morris, P D; Channer, K S; Jones, T H; Grech, E D

2016-05-01

There is a clear association between low serum testosterone and coronary artery disease (CAD) in men. Hypotestosteronaemia is associated with accelerated atherosclerosis and a quarter of men with CAD are biochemically hypogonadal. Amongst those with CAD, hypotestosteronaemia is associated with increased mortality. Testosterone vasodilates coronary arteries, and exogenous testosterone reduces ischaemia. Whether hypotestosteronaemia is a cause or a consequence of CAD remains unanswered. The aim of this prospective observational study was to investigate whether coronary revascularization affected androgen status in men with stable angina pectoris. Twenty five men (mean age 62.7, SD 9.18) with angiographically significant CAD and symptomatic angina underwent full coronary revascularization by percutaneous coronary intervention. Androgen status and symptoms of angina, stress, depression and sexual function were assessed before, and at one and 6 months after the coronary revascularization. All patients underwent complete revascularization which was associated with a significant reduction in angina symptoms and ischaemia. No significant difference was seen in total testosterone (11.33 nmol/L baseline; 12.56, 1 month post; 13.04 at 6 months; p = 0.08). A significant and sustained rise in sex hormone-binding globulin was seen (33.99 nm/L baseline; 36.11 nm/L 1 month post PCI; 37.94 nm/L at 6 months; p = 0.03) Overall, there was no significant alteration in any other marker of androgen status including free testosterone or bioavailable testosterone. There was no change in symptoms of anxiety, depression or sexual function. Coronary revascularization has no sustained effect on androgen status. This supports the hypothesis that hypotestosteronaemia is not a consequence of angina pectoris or myocardial ischaemia. © 2016 American Society of Andrology and European Academy of Andrology.

El profesorado ante los conflictos en la educación física. El caso de los juegos de oposición en Primaria

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Unai Sáez de Ocáriz

2013-01-01

Full Text Available Aprender a convivir es uno de los temas prioritarios de la educación actual. Los conflictos en educación física muestran la existencia de desequilibrios en la interacción entre iguales. Este trabajo investigó los conflictos motores en una unidad didáctica de juegos de oposición en alumnos de un centro de educación primaria. Se identificó el índice de conflictividad de esas relaciones, las conductas que originaron esos conflictos y también las reacciones. Los resultados aportaron informaciones precisas del perfil conflictivo del grupo en situaciones de juego y sirvieron para reorientar las siguientes intervenciones del profesor orientadas hacia una transformación pedagógica de los conflictos.

¿Son aplicables las funciones SCORE y NCEP para el cálculo del riesgo cardiovascular en prevención primaria en la población argentina?

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Silvia F. Benozzi

2010-01-01

Full Text Available RESUMENIntroducciónLa estimación del riesgo cardiovascular en prevención primaria mediante ecuaciones elaboradaspara tal fin permite optimizar la utilización de recursos disponibles en salud pública.ObjetivosEvaluar el riesgo cardiovascular mediante la aplicación de las funciones SCORE y NCEP yanalizar la concordancia entre ambas tablas en una población argentina.Material y métodosSe obtuvieron datos clínicos y bioquímicos de 234 personas adultas, de ambos sexos, queconcurrieron al Servicio de Medicina Preventiva del Hospital Municipal de Bahía Blanca. Sedefinió el síndrome metabólico según criterios de la AHA y se determinó riesgo cardiovascularbajo según NCEP III < 20% y según SCORE < 5%.ResultadosLas funciones SCORE y NCEP clasificaron con una precisión del 93,16% a los individuoscon riesgo cardiovascular bajo y la concordancia fue moderada (kappa: 0,452.ConclusiónLa aplicación de las tablas SCORE y NCEP en prevención primaria puede ser una herramientaútil y costo-eficiente en la práctica clínica diaria.REV ARGENT CARDIOL 2010;78:346-349.

Alimentación y nutrición en atención primaria en Brasil

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Tatiane Nunes Pereira

2018-05-01

Full Text Available Resumen: Objetivo: Describir las acciones sobre alimentación y nutrición que han sido publicadas en la literatura científica en el ámbito de la atención primaria en salud en Brasil. Método: Revisión exploratoria de los estudios publicados entre los años 2007 y 2016. Se consultaron las bases de datos Lilacs, PubMed, Scopus y Web of Science. Resultados: Se incluyeron 103 artículos, la mayoría publicados entre los años 2012 y 2016, predominantemente en la región sudeste de Brasil. Los temas más frecuentes fueron hábito o consumo alimenticio, estado nutricional y enfermedades crónicas no transmisibles. La mayoría de las acciones fueron propuestas por universidades, principalmente con fines diagnósticos. Fueron encontradas pocas acciones de promoción de la salud, alimentación saludable, asistencia y tratamiento, cuidado integral y prevención de enfermedades relacionadas con la alimentación y la nutrición. Conclusiones: Hubo crecimiento en el interés nacional sobre el tema. Sin embargo, la producción académica todavía se encuentra distante de las necesidades reales de generación de evidencia que impacten positivamente sobre la situación de salud. Se identificó la necesidad de realizar más investigaciones para describir, proponer y evaluar las acciones y los programas ya desarrollados. Resulta fundamental una mayor aproximación entre las universidades, la gestión y los servicios para definir intereses comunes y generar investigaciones que respondan a las necesidades del área, y de esta manera contribuir en la planificación y el perfeccionamiento de las acciones y de los programas ya existentes. Abstract: Objective: To describe food and nutrition actions in primary health care in Brazil. Methods: Exploratory review of articles published between 2007 and 2016. Lilacs, PubMed, Scopus and Web of Science databases were consulted. Results: 103 articles were included, mostly published between 2012 and 2016 and developed

Educación sexual y género en primarias mexicanas ¿qué dicen los libros de texto y el profesorado?

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Adriana Leona Rosales-Mendoza

2017-04-01

Full Text Available El objetivo de esta investigación fue revisar y analizar, desde la perspectiva de género, los contenidos de sexualidad y género incluidos en los libros de texto de Ciencias Naturales y Formación Cívica y Ética de cuarto, quinto y sexto grados de primaria del ciclo escolar 2015-2016 (ediciones 2014, para señalar los aciertos y deficiencias en cuanto a su abordaje. Además, indagamos sobre la formación profesional docente en sexualidad y género, para lo cual nos basamos en testimonios de cuatro entrevistas efectuadas al profesorado de primaria de los Estados del sureste mexicano de Quintana Roo y Yucatán: dos de quinto grado y dos de sexto. Los resultados muestran que los contenidos de los libros de texto reducen la sexualidad a la reproducción, y no incorporan el erotismo, el cual es considerado relevante en el enfoque de educación integral de la sexualidad. Asimismo, transmiten ideas heteronormativas sobre las vinculaciones afectivas, y no incorporan la perspectiva de género a cabalidad, ya que fracasan en denunciar la desigualdad entre hombres y mujeres. La formación de docentes es deficiente y hace evidente la operación del currículo oculto, pues se transmiten estereotipos y prejuicios de género y sexualidad.

Uso de las TICs en la enseñanza de la Biología en Educación Primaria

OpenAIRE

Puente Ciria, Esther

2014-01-01

El presente Trabajo de Fin de Grado se centra en la elaboración de diversos recursos educativos basados en las Tecnologías de la Información y la Comunicación (TICs) para la enseñanza de los contenidos de Biología a alumnos del segundo ciclo de Educación Primaria. En primer lugar, se llevará a cabo un análisis sobre la importancia de la Biología en Educación Primaria y los contenidos recogidos en la normativa vigente. Posteriormente, se analizará el uso de las TICs en Educación Primaria...

Estilos de Liderazgo y su Relación con el Desempeño Gerencial de los Directores de Educación Primaria del Distrito de Macusani de la Ugel Carabaya en el Año 2015

OpenAIRE

Ramos Barrios, Pedro Augusto

2015-01-01

El presente trabajo de investigación tiene por objetivo, determinar la relación que existe entre los estilos de liderazgo con el desempeño gerencial de los directores de educación primaria del distrito de Macusani de la UGEL de Carabaya el año 2015. La investigación se realizó guiada por el paradigma cuantitativo, diseño correlacional simple, el muestreo a partir de este universo se seleccionará una muestra representativa. Para ello se utilizará el muestreo aleatorio estratificado. “Consiste ...

Matriz de relación primaria en casos de niños y niñas con problemas de aprendizaje

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Marta Isabel López

2010-10-01

Full Text Available La relación entre las dificultades de aprendizaje (DA y el contexto relacional primario de niño o niña que las presenta, es un aspecto importante reportado en la literatura y en la práctica clínica, y constituye un factor esencial en la comprensión del fenómeno de las DA. Nuestro objetivo en el estudio fue comprender la historia del desarrollo relacional de nueve niños y niñas con DA en la ciudad de Medellín, Colombia, para encontrar relaciones de sentido entre dicha historia y sus DA. La metodología utilizada fue cualitativa desde el enfoque hermenéutico-fenomenológico. Encontramos una dinámica de relación primaria caracterizada por ansiedad y apoyo constante al niño o niña por parte de la madre, y por un padre por fuera de la relación madre - niño o niña. Esa dinámica se reproduce en las relaciones con otras personas y situaciones, favoreciendo la emergencia de un niño o niña en un lugar de discapacidad.

Matriz de relación primaria en casos de niños y niñas con problemas de aprendizaje

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Marta Isabel López

2010-01-01

Full Text Available La relación entre las dificultades de aprendizaje (DA y el contexto relacional primario del niño o niña que las presenta, es un aspecto importante reportado en la literatura y en la práctica clínica, y constituye un factor esencial en la comprensión del fenómeno de las DA. Nuestro objetivo en el estudio fue comprender la historia del desarrollo relacional de nueve niños y niñas con DA en la ciudad de Medellín, Colombia, para encontrar relaciones de sentido entre dicha historia y sus DA. La metodología utilizada fue cualitativa desde el enfoque hermenéutico-fenomenológico. Encontramos una dinámica de relación primaria caracterizada por ansiedad y apoyo constante al niño o niña por parte de la madre, y por un padre por fuera de la relación madre - niño o niña. Esa dinámica se reproduce en las relaciones con otras personas y situaciones, favoreciendo la emergencia de un niño o niña en un lugar de discapacidad.

La función tutorial en Educación Infantil y Primaria: desempeño profesional del profesorado

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Sonia Rodríguez Fernández

2015-01-01

Full Text Available La acción tutorial constituye un proceso, enmarcado dentro de la orientación educativa, que complementa a la acción docente. No tiene sentido entenderla como una serie de actuaciones independientes y puntales entre sí, sino como un conjunto de intenciones y actividades colectivas y coordinadas, que involucra a todos los miembros de la comunidad educativa: profesorado, alumnado y familias. Por este motivo, tan importante es conocer los posibles recursos para ponerla en marcha como la manera de programar y planificar su desarrollo. El propósito del estudio es conocer el grado de desarrollo de la acción tutorial del profesorado de Educación Infantil y Primaria. La muestra estuvo compuesta por 50 docentes tutores de diferentes centros de la provincia de Granada y se utilizó un cuestionario diseñado ad hoc. Una de las conclusiones que podemos extraer es que el profesorado‐tutor participante ofrece más importancia a las tareas académicas que tienen lugar dentro del aula de entre aquellas que tienen relación con la acción tutorial. Las dificultades que normalmente encuentran los tutores y tutoras en la realización de su labor son la falta de tiempo para completar todas las actuaciones de carácter tutorial que se le exige.

Extracorporeal shockwave myocardial therapy is efficacious in improving symptoms in patients with refractory angina pectoris--a multicenter study.

Science.gov (United States)

Prasad, Megha; Wan Ahmad, Wan Azman; Sukmawan, Renan; Magsombol, Edward-Bengie L; Cassar, Andrew; Vinshtok, Yuri; Ismail, Muhammad Dzafir; Mahmood Zuhdi, Ahmad Syadi; Locnen, Sue Ann; Jimenez, Rodney; Callleja, Homobono; Lerman, Amir

2015-05-01

Medically refractory angina remains a significant health concern despite major advances in revascularization techniques and emerging medical therapies. We aimed to determine the safety and efficacy of extracorporeal shockwave myocardial therapy (ESMT) in managing angina pectoris. A single-arm multicenter prospective study was designed aiming to determine the safety and efficacy of ESMT. Patients of functional Canadian Cardiovascular Society class II-IV, despite stable and optimal medical management, with documented myocardial segments with reversible ischemia and/or hibernation on the basis of echocardiography/single-photon emission computerized tomography (SPECT) were enrolled from 2010 to 2012. A total of 111 patients were enrolled, 33 from Indonesia, 21 from Malaysia, and 57 from Philippines. Patients underwent nine cycles of ESMT over 9 weeks. Patients were followed up for 3-6 months after ESMT treatment. During follow-up, patients were subjected to clinical evaluation, the Seattle Angina Questionnaire, assessment of nitrate intake, the 6-min walk test, echocardiography, and SPECT. The mean age of the population was 62.9±10.9 years. The summed difference score on pharmacologically induced stress SPECT improved from 9.53±17.87 at baseline to 7.77±11.83 at follow-up (P=0.0086). Improvement in the total Seattle Angina Questionnaire score was seen in 83% of patients (Pangina.

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

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Michael Ruisi

2013-01-01

Full Text Available 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.

Causas de fracaso de cirugía primaria del ligamento cruzado anterior en futbolistas catalanes

OpenAIRE

García, Santiago Gómez

2013-01-01

El gran incremento de las demandas deportivas y de actividad física de la población ha aumentado el número de cirugías primarias del ligamento cruzado anterior. El estudio identificó las causas potenciales de recidiva¹ de inestabilidad en un grupo de futbolistas federados sometidos a cirugía de revisión. Fueron estudiados retrospectivamente 17 casos de cirugías de revisión del ligamento cruzado anterior, de un total de 629 operaciones de estabilización primaria de rodilla, en el periodo compr...

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 ...

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...

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

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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.

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

Institute of Scientific and Technical Information of China (English)

Chun-Hua Liao

2015-01-01

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

Effect of Shenzhu Guanxin Recipe () on patients with angina pectoris after percutaneous coronary intervention: A prospective, randomized controlled trial.

Science.gov (United States)

Xu, Dan-Ping; Wu, Huan-Lin; Lan, Tao-Hua; Wang, Xia; Sheng, Xiao-Gang; Lin, Yu; Li, Song; Zheng, Chao-Yang

2015-06-01

To evaluate the efficacy and safety of a combination therapy using Chinese medicine (CM) Shenzhu Guanxin Recipe (, SGR) and standard Western medicine treatment (SWMT) in patients with angina pectoris after percutaneous coronary intervention (PCI). Double-blind randomized controlled trial was used in this experimental procedure. One hundred and eighty-seven patients with coronary heart disease receiving SWMT after PCI were randomly assigned to the treatment (SGR) and control (placebo) groups. Outcome measures including angina pectoris score (APS), CM symptom score, and Seattle Angina Questionnaire (SAQ) score were evaluated in 1, 2, 3 and 12 months, and the death rate, restenosis and other emergency treatments were observed. The mixed-effects models were employed for the data analysis. In the treatment group, a larger within-treatment effect size (d=1.74) was found, with a 76.7% reduction in APS from pretreatment to 12-month follow-up assessment compared with the control group (d=0.83, 53.8% symptom reduction); betweentreatment (BT) effect size was d=0.66. CM symptom scores included an 18.3% reduction in the treatment group (d=0.46), and a 16.1% decrease in the control group (d=0.31); d=0.62 for BT effect size. In regard to scores of SAQ, the BT effect size of cognition level of disease was larger in the treatment group (d=0.63), followed by the level of body limitation of activity (d=0.62), condition of angina pectoris attacks (d=0.55), satisfaction level of treatments (d=0.31), and steady state of angina pectoris (d=0.30). Two cardiovascular related deaths and one incidental death were recorded in the control and treatment groups, respectively. No significant difference in any cardiovascular event (including death toll, frequency of cardiovascular hospitalization or emergency room visits) was found between the two groups. The combination therapy of SGR and SWMT is effective and safe in patients with angina pectoris after PCI when compared with SWMT alone.

El entrenamiento en habilidades sociales y su impacto en la convivencia escolar dentro de un grupo de primaria

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Alejandro García Esparza

2017-01-01

Full Text Available El término de convivencia escolar se entiende como la relación establecida entre los diferentes miembros de la comunidad educativa teniendo incidencia signiicativa en el desarrollo integral de los alumnos (Tuvilla, 2004. Existen múltiples variables que tienen correlación con este elemento de entre los cuales están las competencias sociales (Berra y Dueñas, 2009. En el presente trabajo se describen la aplicación y el diseño de dos estrategias elaboradas bajo la técnica del Entrenamiento en Habilidades Sociales, las cuales tienen como objetivo impactar en la convivencia escolar en un grupo de 12 niños de cuarto año de primaria. Se procedió primeramente con observaciones realizadas dentro del aula, después se elaboraron las actividades y se implementaron a los niños seleccionados, evaluando su eicacia con preguntas relexivas y ensayos conductuales y mediante una entrevista semiestructurada con la maestra titular. En los resultados obtenidos se observó que durante las sesiones los niños no tenían problemas para distinguir entre conductas socialmente positivas y negativas pero hubo diicultad a la hora de los ensayos de conducta. La entrevista con la maestra titular evidenció un cambio en la convivencia escolar dentro del salón de clases, sin embargo las habilidades adquiridas sólo fueron implementadas en situaciones especíicas por lo que se vuelve indispensable la integración de elementos o la modiicación de las actividades para la generalización y formación de competencias sociales.

Análisis y evaluación de la condición física en estudiantes de educación primaria de un medio rural y urbano

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Alejandro Cruz Cumbreras

2014-06-01

Full Text Available El objetivo de este trabajo ha sido analizar y evaluar la condición física de escolares estudiantes de educación primaria para conocer la diferencia que existe entre los alumnos que viven en un medio rural y los que viven en un medio urbano. Para ello se seleccionaron 253 estudiantes de segundo y tercer ciclo de educación primaria. La muestra fue clasificada según el tipo de colegio en dos grupos, urbano y rural. A todos los estudiantes se les realizó una valoración antropométrica (talla, masa, IMC, ratio CC, evaluación del salto vertical (CMJ, flexibilidad (test Sit and Reach, fuerza (dinamometría manual y resistencia (test course na­vette. Los resultados muestran diferencias a nivel antropométrico donde los alumnos del colegio rural han presentado mayores índices de sobrepeso. En cambio, los resultados obtenidos en la evaluación de la condición física muestran como en las pruebas de fuerza, resistencia y flexibilidad los alumnos del colegio rural obtienen mayores resultados que los alumnos del colegio urbano, mientras que en el salto vertical los alumnos rurales presentan mayores valores.

Aneurysm of the A. hepatica propria as cause of Angina abdominalis

International Nuclear Information System (INIS)

Rieser, R.; Hauger, W.

1988-01-01

The aetiology of a. hepatica aneurysm can be manifold. Among all the complications, rupture of the vessel is the most dangerous one. We report on a case which was noticed clinically due to an angina abdominalis. In this paper we outline the symptoms, all diagnostic steps and the therapeutic approach. (orig.) [de

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

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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.

La Red de Telesalud de las Américas y su papel en la atención primaria de la salud

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Guillermo Bill

2014-06-01

Full Text Available La necesidad de garantizar un acceso equitativo a la salud, con independencia de las limitaciones geográficas, económicas y tecnológicas, motivó a los estados miembros de la Organización de Estados Americanos a impulsar la creación de una Red de Telesalud de las Américas (Red TSA dependiente de la Comisión Interamericana de Telecomunicaciones. La Red TSA es un desarrollo centrado en el uso de las nuevas tecnologías de la información y la comunicación aplicadas a la salud, asentado en valores de respeto, equidad y solidaridad y amparado en la filosofía de la atención primaria de la salud e integrado por instituciones gubernamentales y no gubernamentales, foros de universidades, federaciones hospitalarias y empresas de telecomunicaciones, y ha iniciado su difusión en diferentes ámbitos continentales y mundiales relacionados con la telemedicina. Entre sus primeros logros, ha puesto en marcha una novedosa herramienta de aplicación en situaciones de catástrofes y escasa accesibilidad geográfica (estación de telemedicina móvil, consistente en un maletín portátil compuesto por un ordenador, diferentes dispositivos digitales (otoscopio, oftalmoscopio, microscopio y dermatoscopio, cámara digital de alta resolución, negatoscopio y antena de conexión satelital. Este maletín permite dar apoyo especializado a los médicos rurales y locales de atención primaria de la salud alejados de los grandes centros urbanos.

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

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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.

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...

TROMBO GIGANTE DE AURÍCULA DERECHA COMO CAUSA DE ANGINA Y SÍNCOPE / Giant thrombus in right atrium as a cause of angina and syncope

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José L. Aparicio Suárez

2012-07-01

Full Text Available ResumenLas tumoraciones intracardíacas son poco frecuentes, y pueden ser de tipo neoplásicas y no neoplásicas. De estas últimas, los trombos, constituyen las masas más frecuentes. Se presenta un paciente joven, operado en el Cardiocentro "Ernesto Che Guevara" de Villa Clara, Cuba, con antecedentes de trastornos hematológicos desde la infancia, que comienza con episodios de disnea progresiva, angina y síncope; con diagnóstico preoperatorio de tumoración gigante en aurícula derecha que resultó ser un trombo intracardíaco, y se demostró la presencia de un agujero oval permeable. / AbstractIntracardiac tumors are rare, and may be of neoplastic and non-neoplastic types. In the latter, the thrombi are the most frequent masses. This is the case of a young patient operated at the Cardiocentro "Ernesto Che Guevara" of Villa Clara, Cuba, with a history of blood disorders since childhood, starting with episodes of progressive dyspnea, angina and syncope, with pre-operative diagnosis of giant tumor in right atrium which turned out to be an intracardiac thrombus, and the presence of a patent foramen ovale was shown.

Influencia de la publicidad televisiva peruana en el consumo de alimentos no saludables en escolares de 4º a 6º primaria

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Evelin C. Rojas-Huayllani

2013-01-01

Full Text Available Introducción: La exposición a la publicidad televisiva promueve el consumo de alimentos no saludables, constituyendo un riesgo para el aumento del sobrepeso y obesidad. Objetivo: Determinar la influencia de la publicidad televisiva peruana en el consumo de alimentos no saludables en escolares de 4º a 6º de primaria. Diseño: Descriptivo de asociación cruzada. Lugar: Institución Educativa Nº 7072, Villa El Salvador, Lima, Perú. Participantes: Escolares entre 9 y 12 años de edad. Intervenciones: Se aplicó dos encuestas previamente validadas y probadas en prueba piloto, a 120 escolares de ambos sexos que asistieron a clases y que tuvieron consentimiento informado firmado por sus padres. Principales medidas de resultados: Tiempo de ver televisión y consumo de alimentos no saludables. Resultados: Los estudiantes en promedio vieron televisión más de 7 horas diarias (DS 1,17. Los programas más vistos fueron los que estaban dirigidos a público mayor de 14 años. Los alimentos no saludables más publicitados y comprados fueron galletas y bebidas azucaradas. Se encontró asociación significativa entre alimentos no saludables más vistos en TV y consumo de alimentos no saludables. Conclusiones: Existió relación entre la publicidad televisiva y el consumo de alimentos no saludables en escolares del nivel primario.

Actividades económicas primarias predominantes en la Reserva Paisajística Nor Yauyos Cochas, Perú. Caso: distritos de Huancaya, Alis y Vitis

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Wilfredo Bulege Gutiérrez

2011-12-01

Full Text Available Objetivos: Determinar las actividades económicas primarias predominantes en los distritos de Huancaya, Alis y Vitis de la provincia de Yauyos, región Lima, ubicados en la zona de aprovechamiento directo de la Reserva Paisajística Nor Yauyos Cochas. Métodos: Es una investigación de tipo básica, alcance descriptiva, diseño transversal, en el proceso de recolección de datos se aplicó un cuestionario estructurado a una muestra no probabilística de 79 personas con edades mayores a 18 años entre varones y mujeres de los distritos de Huancaya, Alis y Vitis, quienes participaron en un evento académico sobre “Econegocios para el desarrollo” organizado por Grupo de Proyección Social “Eco-negocios” de la Universidad Continental, este mismo instrumento se aplicó a personas ubicadas circunstancialmente en la vía pública de los mencionados distritos hasta completar el tamaño muestral de 79. Resultados: El 42% manifiesta que se dedica principalmente a la agricultura; 37%, a la ganadería; 5%, a la acuicultura; 5%, a la artesanía y un 11% a otras actividades entre las cuales se puede identificar el comercio, servicios turísticos, minería, etc. Las personas cuya actividad principal es la agricultura manifestaron que el 44% de su producción es maíz; 28%, papa; 23%, trigo y 5% otros productos. Las personas dedicadas a la ganadería manifestaron que el 41%, cría camélidos; 28%, vacunos; 14%, ovinos y un 17%, otros. Conclusiones: La población de los distritos de Huancaya, Alis y Vitis dedican como una de sus actividades económicas de mayor predominancia a la agricultura, luego la ganadería, siendo este un indicador importanteque caracteriza a estos distritos como zonas con una economía basada en actividades primarias, es decir extractiva de recursos naturales y aprovechada prioritariamente para autoconsumo y su comercialización.

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.

The post-ischemic ventricular dysfunction in PRINZMETAL's variant angina: Radionuclide evaluation

International Nuclear Information System (INIS)

Picozzi, R.; Palagi, B.; Baroffio, R.

1987-01-01

We studied by equilibrium radionuclide angiography 15 patients admitted to our coronary care unit because of PRINZMETAL's variant angina. Patients were examined mostly in the absence of symptoms. The incidence of ejection fraction abnormalities was low, while regional wall motion was always impaired at the site corresponding to ST-segment elevation at the time of the anginal attack. In 7 patients who underwent coronary angiography, we found an almost complete agreement between the site of atherosclerotic lesions and that of regional wall motion abnormalities. The patients were re-studied during intravenous perfusion of nitroglycerin: A detectable improvement of regional wall motion was found in 8 of them. We concluded that equilibrium radionuclide angiography appears to be a suitable tool for identifying reliably, in patients affected with PRINZMETAL's variant angina, the regional ventricular dysfunction remaining after the remission of symptoms in the presence of normalized ECG or signs of non-transmural ischemia. Equilibrium radionuclide angiography performed during nitroglycerin perfusion allowed us to evaluate in advance the importance of the vasospastic component and hence the efficacy of pharmacologic treatment. (orig.) [de

Alfabetización en salud en pacientes con insuficiencia cardiaca atendidos en atención primaria

OpenAIRE

Rosalia Santesmases-Masana; Luis González-de Paz; Jordi Real; Alicia Borràs-Santos; Antoni Sisó-Almirall; Maria Dolors Navarro-Rubio

2017-01-01

Objetivos: Examinar el nivel de alfabetización en salud y los factores que la condicionan en pacientes con insuficiencia cardiaca visitados en atención primaria. Diseño: Estudio transversal multicéntrico. Emplazamiento: Diez centros de atención primaria del área metropolitana de Barcelona. Participantes: Pacientes con diagnóstico de insuficiencia cardiaca. Criterios de inclusión: visita al centro de salud en el último año, desplazarse al centro de manera autónoma y acceder a particip...

Traditional Chinese medicine for stable angina pectoris via TCM pattern differentiation and TCM mechanism: study protocol of a randomized controlled trial.

Science.gov (United States)

Zhang, Zhe; Zhang, Fan; Wang, Yang; Du, Yi; Zhang, Huiyong; Kong, Dezhao; Liu, Yue; Yang, Guanlin

2014-10-30

Stable angina pectoris is experienced as trans-sternal or retro-sternal pressure or pain that may radiate to the left arm, neck or back. Although available evidence relating to its effectiveness and mechanism are weak, traditional Chinese medicine is used as an alternative therapy for stable angina pectoris. We report a protocol of a randomized controlled trial using traditional Chinese medicine to investigate the effectiveness, mechanism and safety for patients with stable angina pectoris. This is a north-east Chinese, multi-center, multi-blinded, placebo-controlled and superiority randomized trail. A total of 240 patients with stable angina pectoris will be randomly assigned to three groups: two treatment groups and a control group. The treatment groups will receive Chinese herbal medicine consisting of Yi-Qi-Jian-Pi and Qu-Tan-Hua-Zhuo granule and Yi-Qi-Jian-Pi and Qu-Tan-Hua-Yu granule, respectively, and conventional medicine. The control group will receive placebo medicine in addition to conventional medicine. All 3 groups will undergo a 12-week treatment and 2-week follow-up. Four visits in sum will be scheduled for each subject: 1 visit each in week 0, week 4, week 12 and week 14. The primary outcomes include: the frequency of angina pectoris attack; the dosage of nitroglycerin; body limited dimension of Seattle Angina Questionnaire. The secondary outcomes include: except for the body limited dimension of SAQ, traditional Chinese medicine pattern questionnaire and so on. Therapeutic mechanism outcomes, safety outcomes and endpoint outcomes will be also assessed. The primary aim of this trial is to develop a standard protocol to utilize high-quality EBM evidence for assessing the effectiveness and safety of SAP via TCM pattern differentiation as well as exploring the efficacy mechanism and regulation with the molecular biology and systems biology. ChiCTR-TRC-13003608, registered 18 June 2013.

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.

Algunas implicaciones jurídicas del matrimonio entre personas del mismo sexo en la Ciudad de México

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Alejandro Rosas Martínez

2011-07-01

Full Text Available El artículo analiza y expone el reconocimiento del matrimonio entre personas del mismo sexo en la Ciudad de México, así como sus implicaciones primarias a partir de su concreción en el sistema jurídico mexicano. El estudio contiene el análisis de la “Sociedad de Convivencia” como un mecanismo de reconocimiento de derechos de carácter civil a personas con relaciones personales de convivencia permanente, entre las que se encuentran las personas con identidad de género distinta de la correspondiente a su sexo y las personas con preferencia sexual distinta de la heterosexual. También se estudia la reforma por la que el matrimonio entre personas del mismo sexo es posible y el criterio que la Suprema Corte de Justicia de México emitió sobre aquélla con base en una acción de inconstitucionalidad en la que se planteó el alcance del principio de igualdad en el constitucionalismo mexicano a partir de los conceptos de familia, matrimonio, heterosexualidad, homosexualidad, adopción e interés superior del menor.

A risk score for predicting coronary artery disease in women with angina pectoris and abnormal stress test finding.

Science.gov (United States)

Lo, Monica Y; Bonthala, Nirupama; Holper, Elizabeth M; Banks, Kamakki; Murphy, Sabina A; McGuire, Darren K; de Lemos, James A; Khera, Amit

2013-03-15

Women with angina pectoris and abnormal stress test findings commonly have no epicardial coronary artery disease (CAD) at catheterization. The aim of the present study was to develop a risk score to predict obstructive CAD in such patients. Data were analyzed from 337 consecutive women with angina pectoris and abnormal stress test findings who underwent cardiac catheterization at our center from 2003 to 2007. Forward selection multivariate logistic regression analysis was used to identify the independent predictors of CAD, defined by ≥50% diameter stenosis in ≥1 epicardial coronary artery. The independent predictors included age ≥55 years (odds ratio 2.3, 95% confidence interval 1.3 to 4.0), body mass index stress imaging (odds ratio 2.8, 95% confidence interval 1.5 to 5.5), and exercise capacity statistic of 0.745 (95% confidence interval 0.70 to 0.79), and an optimized cutpoint of a score of ≤2 included 62% of the subjects and had a negative predictive value of 80%. In conclusion, a simple clinical risk score of 7 characteristics can help differentiate those more or less likely to have CAD among women with angina pectoris and abnormal stress test findings. This tool, if validated, could help to guide testing strategies in women with angina pectoris. Copyright © 2013 Elsevier Inc. All rights reserved.

[Effect of Xinling Wan in treatment of stable angina pectoris: a randomized, double-blinded, placebo parallel-controlled, multicenter trial].

Science.gov (United States)

Gao, Jian-Wei; Gao, Xue-Min; Zou, Ting; Zhao, Tian-Meng; Wang, Dong-Hua; Wu, Zong-Gui; Ren, Chang-Jie; Wang, Xing; Geng, Nai-Zhi; Zhao, Ming-Jun; Liang, Qiu-Ming; Feng, Xing; Yang, Bai-Song; Shi, Jun-Ling; Hua, Qi

2018-03-01

To evaluate the effectiveness and safety of Xinling Wan on patients with stable angina pectoris, a randomized, double-blinded, placebo parallel-controlled, multicenter clinical trial was conducted. A total of 232 subjects were enrolled and randomly divided into experiment group and placebo group. The experiment group was treated with Xinling Wan (two pills each time, three times daily) for 4 weeks, and the placebo group was treated with placebo. The effectiveness evaluation showed that Xinling Wan could significantly increase the total duration of treadmill exercise among patients with stable angina pectoris. FAS analysis showed that the difference value of the total exercise duration was between experiment group (72.11±139.32) s and placebo group (31.25±108.32) s. Xinling Wan could remarkably increase the total effective rate of angina pectoris symptom score, and the analysis showed that the total effective rate was 78.95% in experiment group and 42.61% in placebo group. The reduction of nitroglycerin dose was (2.45±2.41) tablets in experiment group and (0.50±2.24) tablets in placebo group on the basis of FAS analysis. The decrease of symptom integral was (4.68±3.49) in experiment group and (3.19±3.31) in placebo group based on FAS analysis. Besides, Xinling Wan could decrease the weekly attack time and the duration of angina pectoris. PPS analysis results were similar to those of FAS analysis. In conclusion, Xinling Wan has an obvious therapeutic effect in treating stable angina pectoris, with a good safety and a low incidence of adverse event and adverse reaction in experiment group. Copyright© by the Chinese Pharmaceutical Association.

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

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José Luis Torres

2014-03-01

Full Text Available 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 hizo énfasis en la importancia de la participación de los alumnos en el autocuidado de sus escuelas y hogares para la prevención del dengue mediante el control del vector. RESULTADOS: Se aplicaron 3 124 encuestas de conocimientos, actitudes y prácticas antes y después de la estrategia educativa, a 1 562 alumnos de 5º y 6º grado (772 y 790 alumnos, respectivamente con edades que oscilaron entre los 10 y los 12 años. El nivel de conocimiento aumentó de manera significativa en comparación con el que los alumnos tenían antes de la estrategia educativa. Los alumnos de 6º grado tenían y adquirieron significativamente más conocimiento sobre varios aspectos de la enfermedad y el vector en comparación a los de 5º grado. En todas las escuelas se hallaron recipientes con agua y 68% de las escuelas tuvieron recipientes positivos para larvas de Aedes aegypti. CONCLUSIONES: Se demostró que mediante la implementación de una estrategia educativa, aumentan el conocimiento, actitudes y prácticas de los niños sobre el autocuidado de sus escuelas y que pueden actuar como promotores del cambio de actitud sobre esta enfermedad en sus hogares.

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

Science.gov (United States)

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

2015-08-01

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

Clinically stable angina pectoris is not necessarily associated with histologically stable atherosclerotic plaques

NARCIS (Netherlands)

van der Wal, A. C.; Becker, A. E.; Koch, K. T.; Piek, J. J.; Teeling, P.; van der Loos, C. M.; David, G. K.

1996-01-01

OBJECTIVE: To investigate the extent of plaque inflammation in culprit lesions of patients with chronic stable angina. DESIGN: Retrospective study. SETTING: Amsterdam reference centre. SUBJECTS: 89 consecutive patients who underwent directional coronary atherectomy, 58 of whom met the following

Association between edentulism and angina pectoris in Mexican adults aged 35 years and older: a multivariate analysis of a population-based survey.

Science.gov (United States)

Medina-Solís, Carlo Eduardo; Pontigo-Loyola, América Patricia; Pérez-Campos, Eduardo; Hernández-Cruz, Pedro; Ávila-Burgos, Leticia; Kowolik, Michael J; Maupomé, Gerardo

2014-03-01

The possible association between oral infection and chronic inflammation and cardiovascular disease risk has been studied intensively. The present study is designed to determine the strength of association between edentulism and angina pectoris in Mexican adults aged 35 years and older. Using the tools and sampling strategies of the World Health Survey of the World Health Organization, cross-sectional data were collected in Mexico in the National Performance Assessment Survey (probabilistic, multistage, and cluster sampling). Dental information was available for 20 of the 32 states of Mexico. Angina and edentulism are self-reported in this study. Statistical analysis was performed using binary logistic regression adjusting for complex samples. A total of 13,966 participants, representing a population of 29,853,607 individuals, were included. Of the complete study population, 3,052,263 (10.2%) were completely toothless, and 673,810 (2.3%) were diagnosed with angina pectoris. After adjusting for smoking, alcohol consumption, diabetes, body mass index, and sex, the effect of edentulism on angina was modified by age (interaction), being more marked in the younger age group (odds ratio [OR] = exp(2.5597) =12.93) than in the older individuals surveyed (OR = exp(2.5597 + (-0.0334)) =12.51). Additionally, low physical activity (OR = 1.51; 95% confidence interval [CI] = 1.03 to 2.22) and higher socioeconomic status (OR = 1.37; 95% CI = 1.00 to 1.90) were more likely to be associated with angina pectoris. Overall, the results of this study, conducted in a representative sample of Mexican adults, suggest that an association exists between edentulism and angina pectoris. Additional studies are necessary to elucidate the underlying mechanism for this association.

SRP: nuevas estrategias de enseñanza para implicar al alumnado de educación primaria en el proceso de aprendizaje de la natación

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Eduard Ramírez Banzo

2015-12-01

Full Text Available El interés de la investigación, enmarcada en el contexto de la práctica reflexiva, parte de la voluntad de cambio de la propia práctica y deriva hacia el diseño, aplicación y validación de una propuesta de intervención SRP (apoyo, recuerdo y proyección que la hace posible. El foco de interés pasa por buscar una conexión entre los ámbitos formales y no formales de la educación y se refleja a partir de la implicación del alumnado de educación primaria en el proceso de aprendizaje de la natación en un club deportivo, en horario escolar.

Experiencias de trabajo colaborativo mediante Tecnologías de la Información y la Comunicación entre profesores

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Marcos C. González

2016-01-01

Full Text Available Durante los años 2011-2015, el Grupo de Investigación-Innovación enTecnología Educativa de la Facultad de Educación de la Universidad deSalamanca ha llevado a cabo una investigación, financiada por el Ministeriode Ciencia e Innovación, orientada al conocimiento de las concepciones,metodologías y prácticas profesionales de los docentes de EducaciónPrimaria y Educación Secundaria Obligatoria (ESO sobre el aprendizajecolaborativo por medio de las Tecnologías de la Información y laComunicación, en el contexto español, en la llamada Escuela 2.0. Esteartículo se centra en el análisis de una parte de los resultados: el estudio delas experiencias de trabajo colaborativo mediado por TIC que se desarrollanentre los profesores de Primaria y ESO. Se ha utilizado un enfoquemetodológico mixto (cuantitativo y cualitativo y un método no experimental ydescriptivo. Como principal conclusión destacamos que la cultura de trabajocolaborativo mediado por TIC entre docentes es muy pobre.

Estrategias y técnicas para desarrollar la expresión escrita en lengua inglesa en la etapa de Educación Primaria

OpenAIRE

Pellejero Torres, Gema

2014-01-01

En el presente trabajo se realiza una exposición acerca de la expresión escrita en inglés en Educación Primaria. Para ello analizamos su marco teórico, el currículum de primaria y varias estrategias y técnicas para el desarrollo de esta. Dada la importancia de la expresión escrita en el contexto escolar, hemos incluido una programación para poder fomentarla en la escuela. Grado en Educación Primaria

Angina monocitica con sovrainfezione da Prevotella denticola: caso clinico

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Maria Teresa Allù

2005-06-01

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

Relationship between angina pectoris and outcomes in patients with heart failure and reduced ejection fraction: an analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).

Science.gov (United States)

Badar, Athar A; Perez-Moreno, Ana Cristina; Jhund, Pardeep S; Wong, Chih M; Hawkins, Nathaniel M; Cleland, John G F; van Veldhuisen, Dirk J; Wikstrand, John; Kjekshus, John; Wedel, Hans; Watkins, Stuart; Gardner, Roy S; Petrie, Mark C; McMurray, John J V

2014-12-21

Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA). Four thousand, eight hundred and seventy-eight patients were divided into three categories: no history of angina and no chest pain at baseline (Group A; n = 1240), past history of angina but no chest pain at baseline (Group B; n = 1353) and both a history of angina and chest pain at baseline (Group C; n = 2285). Outcomes were examined using Kaplan-Meier and Cox regression survival analysis. Compared with Group A, Group C had a higher risk of non-fatal myocardial infarction or unstable angina (HR: 2.36, 1.54-3.61; P angina are at an increased risk of acute coronary syndrome and HF hospitalization. Whether these patients would benefit from more aggressive medical therapy or percutaneous revascularization is not known and merits further investigation. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Background Complex angiographic lesions and clinic presentation in unstable angina. A prospective study

International Nuclear Information System (INIS)

LLuberas, R.; Mallo, D.; Pouso, J.; Artucio, C.; Korytnicki; Argon, L.; Besada, E.; Tavella, N.

2002-01-01

Background Complex angiography lesions and intracoronary thrombus have been identified in unstable angina.Braunwalds categorization has been accepted in the last years.Identifying severe clinical classes class III (angina at rest during the last 48 hours), class C (angina postinfarction) and class c (angina with maximum therapeutic). The main objective of this study was to determine independent associations of Braunwalds classes III, C and c: complex lesions, intracoronary thrombus, total occlusion and distal flux TIMI<3 of the responsible vessel. The secondary objectives were to analyze the angiographic features of the lesion and the responsible vessel. Aprospective study of 300 patients with diagnosed unstable angina, clustered according to Braunwalds clinis classification was done. The angiographic evaluation was performed identifying the responsible lesion and the presence of the complex lesion, intracoronary thrombus, total occlusion and distal flux TIMI<3 of the responsible vessel. A univariate analysis and a multivariate model of binary logistic regression were used. In the 300 patient population, 22 patients with normal coronaries(7.3%) were identified. The responsible lesion was identified in 243 out of the remaining 278 patients (87,4%). Class III was significantly associated with the complex lesion (OR=2.74, IC95%=1,27-5,9) and intracoronary thrombus (OR=2,82 IC95=1,2-6,6). Class C was significantly associated with intracoronary thrombus (OR=3.9),IC95%=1.53-10,0).Class III was and independent predictor for the presence of the complex lesion(OR=1.98, IC 95%=1,01-3,87) and intracoronary thrombus (OR=2,47 IC95%=1,14-5,37). Class C was and independent predictor for the complex lesion (OR=5,05,IC95%=2.25-11,3), infracoronary thrombus (OR=8,04, IC 95%=3,49-18,0), total occlusion (OR=6,49, IC95%=2,67-15,7) and distal flux TIMI<3(OR=3,96,IC 95%=1,87-8,4) There was no significant association between classes III, C and c and the responsible vessel, localization of

Percutaneous coronary intervention for poor coronary microcirculation reperfusion of patients with stable angina pectoris.

Science.gov (United States)

Li, J S; Zhao, X J; Ma, B X; Wang, Z

2016-01-01

Percutaneous coronary intervention (PCI) has been extensively applied to repair the forward flow of diseased coronary artery and can achieve significant curative results. However, some patients with acute myocardial infarction (AMI) develop non-perfusion or poor perfusion of cardiac muscle tissue after PCI, which increases the incidence of cardiovascular events and the death rate. PCI can dredge narrowed or infarct-related artery (IRA) and thus induce full reperfusion of ischemic myocardium. It is found in practice that some cases of AMI still have no perfusion or poor perfusion in myocardial tissue even though coronary angiography suggests opened coronary artery after PCI, which increases the incidence of vascular events and mortality. Therefore, to explore the detailed mechanism of PCI in treating coronary microcirculation of patients with stable angina pectoris, we selected 140 patients with stable angina pectoris for PCI, observing the index of microcirculatory resistance (IMR) of descending branch and changes of myocardial injury markers and left ventricular systolic function, and made a subgroup analysis based on the correlation between clinical indexes, IMR and other variables of diabetic and non-diabetic patients, PCI-related and non-PCI-related myocardial infarction patients. The results suggest that IMR of anterior descending branch after PCI was higher compared to that before PCI, and the difference was significant (P less than 0.05); creatine kinase-MB (CK-MB), myohemoglobin and high sensitive troponin T were all increased after PCI, and the difference was also significant (P less than 0.05); brain natriuretic peptide (BNP) level became higher after PCI, with significant difference (P less than 0.05); left ventricular ejection fraction (LVEF) declined after PCI, and the difference before and after PCI was statistically significant (P less than 0.05). Moreover, subgroup analysis results of the three groups all demonstrated statistically significant

[Clinical significance of early percutaneous coronary intervention in patients with Braunwald III-B type unstable angina pectoris].

Science.gov (United States)

Nozaki, Katsuhiro; Nakao, Koichi; Horiuchi, Kenji; Kasanuki, Hiroshi; Honda, Takashi

2003-06-01

To assess the efficacy of early invasive strategy for the treatment of Braunwald III-B type unstable angina pectoris. This study included 573 consecutive patients of whom 267 underwent percutaneous coronary intervention (PCI) (312 lesions). The patients were divided into two groups, 95 treated with the early invasive strategy of coronary angiography within 24 hr of admission (Group PCI-I) and the remaining 172 treated with the early conservative strategy of coronary angiography 24 hr after admission (Group PCI-C). No significant differences were noted in the baseline characteristics of the two groups except for ST segment elevation on electrocardiography at presentation, which occurred significantly less frequently in Group PCI-C (36.8% vs 8.1%, p strategy for unstable angina pectoris were almost equivalent to those of the early conservative strategy, despite more frequent ST segmental elevation at admission in Group PCI-I. These findings suggest that the early invasive strategy for unstable angina pectoris may be acceptable even in the current Japanese clinical setting without the use of GP IIb/IIIa receptor antagonist, low molecular weight heparin or clopidogrel.

La competencia digital de la Generación Z: claves para su introducción curricular en la Educación Primaria

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2016-10-01

Full Text Available La convergencia mediática y el uso masivo de dispositivos conectados a Internet, rasgos distintivos de la sociedad actual, provocan cambios en el modo en el que las nuevas generaciones aprenden y acceden al conocimiento. Además, emergen nuevas competencias, las digitales, que la Generación Z necesita para afrontar los retos de una sociedad digitalizada. El estudio presentado, de corte cuantitativo, con una muestra de 678 alumnos de Educación Primaria, pretende aportar evidencias empíricas sobre el nivel de competencia digital del alumnado perteneciente a dicha generación. Los resultados revelan que no adquieren habilidades digitales de forma inherente sino que precisan de educación al respecto, atisbándose el peligro de una brecha digital, no por uso o acceso a ellas, sino por falta de competencia. La ausencia de diferencia significativa en el nivel general de competencia digital entre el alumnado de diferentes cursos de la etapa de Educación Primaria refleja que, en cierta medida, ese nivel se adquiere más por convivencia con las TIC en contextos informales que por un adecuado desarrollo en el contexto escolar que potencie gradual y progresivamente su adquisición. De los resultados se desprende, por tanto, la necesidad de abordar la competencia digital en la escuela, incidiendo en el desarrollo de las áreas que la componen y potenciándola para superar el nivel de uso en la vida cotidiana y acercarla al nivel académico que facilitará su inclusión al mundo laboral.

Leer rápido no siempre es igual a comprender: Examinando la relación entre velocidad y comprensión

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Gabriela Silva-Maceda

2017-12-01

Full Text Available Un cambio en la forma de evaluar la lectura en México en la educación primaria ha sido la introducción de la medición de la velocidad de lectura (palabras por minuto del alumno como principal indicador de logro para la comprensión lectora. Esto tiene implicaciones directas en la enseñanza de la lectura. El objetivo de este estudio es examinar la relación entre velocidad lectora y comprensión lectora en una muestra de niños mexicanos entre 1° y 4° grados, para: a identificar la forma en que la velocidad de lectura de textos y la velocidad de lectura de palabras inventadas se relacionan con la comprensión lectora y b si estas relaciones difieren entre el ciclo 1 (1.° y 2.° grados y el ciclo 2 (3.° y 4.° grados de educación primaria. Se plantearon tres hipótesis y una pregunta de investigación. Las hipótesis fueron: 1 la relación entre la velocidad lectora en textos regulares tendrá una mayor asociación que la velocidad lectora de pseudopalabras con la comprensión lectora a lo largo de los cuatro grados; 2 la velocidad lectora de pseudopalabras tendrá una asociación mayor con comprensión lectora en el ciclo 1 que en el ciclo 2 y; 3 la velocidad lectora de textos regulares tendrá una asociación mayor con comprensión lectora en el ciclo 1 que en el ciclo 2. La pregunta de investigación exploratoria indagó si la velocidad sigue siendo predictiva de la comprensión lectora después de considerar la precisión. Los resultados aportan evidencia que apoyan las tres hipótesis y el análisis realizado para la pregunta de investigación mostró que la velocidad de lectura de textos sólo explicaba una varianza adicional del 6% después de controlar la precisión de lectura de pseudopalabras. Los resultados son interpretados en el contexto de la literatura existente.

Sex-Related Differences in Vasomotor Function in Patients With Angina and Unobstructed Coronary Arteries

DEFF Research Database (Denmark)

Aziz, Ahmed; Hansen, Henrik Steen; Sechtem, Udo

2017-01-01

BACKGROUND Coronary vasomotor dysfunction is an important mechanism for angina in patients with unobstructed coronary arteries. OBJECTIVES The purpose of this study was to determine sex differences in the prevalence and clinical presentation of vasomotor dysfunction in a European population...... and to examine sex differences in the dose of acetylcholine leading to a positive acetylcholine provocation test (ACH test). METHODS Between 2007 and 2014, we included 1,379 consecutive patients with stable angina, unobstructed coronaries and ACH test performed for epicardial vasospasm or coronary microvascular...... dysfunction (CMD) due to microvascular spasm. The predictive value of sex, risk factors, symptoms, and noninvasive test results was analyzed by means of logistic regression. RESULTS The mean patient age was 62 years, and 42% were male. There were 813 patients (59 with a pathological ACH test, 33% for CMD...

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

Incentivos en atención primaria: de la contención del gasto a la salud de la población

OpenAIRE

Gérvas Camacho, Juan Javier; Ortún Rubio, Vicente; Palomo Cobos, Luis; Ripoll, Miguel Ángel

2007-01-01

Este texto se elaboró a partir del debate en el segundo taller presencial de los Seminarios de Innovación en Atención Primaria, que en 2007 se dedican a la organización de los servicios en atención primaria. Se celebró en Madrid, el 22 de junio de 2007, y fue ponente Vicente Ortún, contrapuntos Luis Palomo y Miguel Ángel Ripoll, y coordinador Juan Gérvas. Los Seminarios de Innovación en Atención Primaria están organizados por la Fundación Ciencias de la Salud y la Fundación para la Formación ...

Changes and significance of plasma neuropeptide Y in patients with unstable angina pectoris

International Nuclear Information System (INIS)

Wang Xiaozhou; Yang Yongqing

2001-01-01

Objective: To observe changes of plasma neuropeptide Y(NPY) in patients with unstable angina pectoris (UaP), select patients with stable angina pectoris (SAP) and normal subjects as the controls, and recognize their significance. Methods: Immunoradiometric assay was used to measure the plasma NPY levels in 15 UAP patients, 20 SAP patients and 20 normal subjects: Results: It was found that the plasma NPY levels in patients with UAP, SAP and normal subjects were 202.12 +- 35.34, 164.45 +- 24.27 and 156.35 +- 21.84 pg/ml. The NPY levels in UAP patients were significantly higher than that in the others, but down to 159.66 +- 18.75 pg/ml after treatment for 2 weeks. There was a significant difference between pretreatment and post-treatment (P < 0.05). Conclusion: The plasma NPY levels of UAP patients increases significantly during fit. NPY takes part in the process of AP

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.

APRENDIZAJE-SERVICIO: CONSTRUYENDO ESPACIOS DE INTERSECCIÓN ENTRE LA ESCUELA-COMUNIDAD-UNIVERSIDAD

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Domingo Mayor Paredes

2015-01-01

Full Text Available En las sociedades complejas del siglo XXI, la escuela, por sí sola, no puede dar respuesta a las nuevas demandas sociales. En este escenario cambiante están emergiendo nuevas prácticas educativas que promueven la colaboración entre los distintos espacios por donde circula la educación: escuela-universidad-comunidad.El artículo presenta los resultados de un estudio de caso en un aula de primaria de un centroescolar, situado en un contexto socialmente desfavorecido, donde se implementa un proyecto de Aprendizaje-Servicio. En el mismo participan: maestra y alumnado de primaria, profesorado y alumnado de la universidad, así como profesionales de distintos recursos públicos y representantes de entidades sociales. El objetivo del estudio es conocer en profundidad las acciones realizadas en los centros educativos y las mejoras alcanzadas en distintos ámbitos, para lo cual se utilizaron instrumentos de recogida de datos (observación participante, entrevistas y análisis de documentos, y la triangulación de técnicas e informantes. El análisis de los datos obtenidos a lo largo de un curso escolar, muestra una cartografía que dibuja la riqueza, diversidad y creatividad de las distintas acciones implementadas en los diferentes contextos educativos y, por otro lado, pone de relieve los impactos positivos producidos en el conjunto de las y los participantes. A partir de las evidencias alcanzadas se abre la discusión para seguir indagando en algunas cuestiones claves de esta práctica pedagógica.

ESTUDIO DEL BULLYING EN EL CICLO SUPERIOR DE PRIMARIA

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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.

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

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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.

Accidentabilidad laboral con productos biológicos en profesionales sanitarios de Atención Primaria de Guadalajara (1994-2000

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J. Cobos López

2001-11-01

Full Text Available Las infecciones por Virus de la Inmunodeficiencia Humana (VIH,Virus de la Hepatitis B (VHB y Virus de la Hepatitis C (VHC, de graves consecuencias médicas y sociales, se transmiten por contacto con sangre u otros fluídos orgánicos. El personal sanitario puede infectarse mediante el contacto con fluídos corporales y también transmitir dichas infecciones a los pacientes. Los objetivos de este estudio son conocer la magnitud y distribución de la accidentabilidad laboral con productos biológicos en los trabajadores de Atención Primaria de Guadalajara, así como la magnitud de la transmisión de la infección por VIH, VHC y VHB durante un período de siete años como paso previo para intentar reducir las infecciones transmitidas a personal sanitario y para implementar políticas de educación sanitaria que reduzcan este tipo de accidentes.Se realizó un estudio descriptivo de los accidentes laborales notificados por los trabajadores de Atención Primaria de Guadalajara y Comunidad que notificaron un accidente laboral entre 1994 y 2000.Se ha objetivado un aumento en las declaraciones de accidentes laborales con productos biológicos a lo largo del tiempo. El 71.25% de los trabajadores de centros sanitarios están vacunados frente a VHB, proporción que se ve reducida al 52.9% si se considera exclusivamente al personal facultativo. La protección con equipos de protección individual se mantenía en el 45% de los trabajadores en el momento del accidente. No se ha objetivado ninguna infección en el personal sanitario ni en población general estudiada durante el período de seguimiento.

Diseño de un modelo de supervisión para la aplicación de la prueba de Evaluación del Desarrollo Infantil en las unidades de atención primaria en México

OpenAIRE

Villasís-Keever, Miguel Ángel; Rizzoli-Córdoba, Antonio; Delgado-Ginebra, Ismael; Mares-Serratos, Blanca Berenice; Martell-Valdez, Liliana; Sánchez-Velázquez, Olivia; Reyes-Morales, Hortensia; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Antillón-Ocampo, Fátima Adriana; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Baqueiro-Hernández, César Iván; Pizarro-Castellanos, Mariel

2015-01-01

Introducción: La prueba Evaluación del Desarrollo Infantil (EDI), diseñada y validada en México, se ha aplicado en las unidades de atención primaria del país. Los resultados han sido heterogéneos entre los estados en que se aplicaron las pruebas, a pesar de haber utilizado un modelo de capacitación estandarizado con la misma metodología para la aplicación. El objetivo de este trabajo fue evaluar un modelo de supervisión que permita identificar la calidad de la aplicación de la prueba EDI a ni...

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

Science.gov (United States)

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

2015-01-01

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

Desempeño TIC de los docentes y su relación con los niveles de logro de los estudiantes en comprensión lectora y en matemática del segundo grado de primaria del distrito de Chorrillos - UGEL 07.

OpenAIRE

Marengo Murga, Víctor Enrique.

2014-01-01

El presente estudio tuvo como objetivo general determinar la relación entre las variables Desempeño TIC de los Docentes y los niveles de logro de Comprensión Lectora y Matemática de los estudiantes de segundo grado de nivel Primaria de las Instituciones Educativas del Distrito de Chorrillos - UGEL 07, utilizando dos instrumentos de recolección de datos el Instrumento de Desempeño TIC Docente y la Prueba de Matemática y Comprensión Lectora, teniendo una población de 31 Instituciones Educativas...

Inorganic Nitrate in Angina Study: A Randomized Double-Blind Placebo-Controlled Trial.

Science.gov (United States)

Schwarz, Konstantin; Singh, Satnam; Parasuraman, Satish K; Rudd, Amelia; Shepstone, Lee; Feelisch, Martin; Minnion, Magdalena; Ahmad, Shakil; Madhani, Melanie; Horowitz, John; Dawson, Dana K; Frenneaux, Michael P

2017-09-08

In this double-blind randomized placebo-controlled crossover trial, we investigated whether oral sodium nitrate, when added to existing background medication, reduces exertional ischemia in patients with angina. Seventy patients with stable angina, positive electrocardiogram treadmill test, and either angiographic or functional test evidence of significant ischemic heart disease were randomized to receive oral treatment with either placebo or sodium nitrate (600 mg; 7 mmol) for 7 to 10 days, followed by a 2-week washout period before crossing over to the other treatment (n=34 placebo-nitrate, n=36 nitrate-placebo). At baseline and at the end of each treatment, patients underwent modified Bruce electrocardiogram treadmill test, modified Seattle Questionnaire, and subgroups were investigated with dobutamine stress, echocardiogram, and blood tests. The primary outcome was time to 1 mm ST depression on electrocardiogram treadmill test. Compared with placebo, inorganic nitrate treatment tended to increase the primary outcome exercise time to 1 mm ST segment depression (645.6 [603.1, 688.0] seconds versus 661.2 [6183, 704.0] seconds, P =0.10) and significantly increased total exercise time (744.4 [702.4, 786.4] seconds versus 760.9 [719.5, 802.2] seconds, P =0.04; mean [95% confidence interval]). Nitrate treatment robustly increased plasma nitrate (18.3 [15.2, 21.5] versus 297.6 [218.4, 376.8] μmol/L, P nitrate treatment). Other secondary outcomes were not significantly altered by the intervention. Patients on antacid medication appeared to benefit less from nitrate supplementation. Sodium nitrate treatment may confer a modest exercise capacity benefit in patients with chronic angina who are taking other background medication. URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02078921. EudraCT number: 2012-000196-17. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

ATENCION PRIMARIA Y RESPONSABILIDADES DE SALUD PÚBLICA EN SEIS PAÍSES DE EUROPA Y AMÉRICA DEL NORTE: UN ESTUDIO PILOTO

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Barbara Starfield

2004-01-01

Full Text Available Fundamento: Los rápidos cambios en los sistemas sanitarios son una oportunidad para reorientar las relaciones entre sus diferentes componentes. Con el objetivo de conocer dónde se ubica la responsabilidad para la realización de diferentes tipos de actividades preventivas, se realizó una encuesta en ocho áreas geográficas de seis países de Europa y Norteamérica. Métodos: Encuesta entre expertos basada en una matriz que relaciona servicios sanitarios preventivos con la población a la que se dirigen. Se establecieron ocho situaciones clínicas (vacunaciones infantiles y antigripal adultos; y detección precoz: de cáncer mediante mamografía, de tuberculosis, de Hipertensión Arterial, de fenilcetonuria, del virus de la inmunodeficiencia humana, y de osteoporosis, con el fin de conocer en relación a las mismas la población diana, nivel de establecimiento de las políticas, nivel de contacto con los individuos, seguimiento de los individuos con diagnósticos positivos y registro de sus datos clínicos. Resultados: Este estudio piloto mostró muy escasa coincidencia de los resultados tanto entre las ocho áreas encuestadas como en cada una de ellas. No se encontró un patrón regular para las actividades de prevención exploradas entre los diferentes países, ni en función de la tipología de sus sistemas sanitarios, ni por la orientación hacia la atención primaria de los diferentes sistemas. Conclusiones: Existe un escaso consenso en las áreas estudiadas en relación con la mejor forma de realizar las intervenciones de salud pública que conllevan prestación de atención sanitaria personal.

Acceso y uso de los dispositivos portátiles de la población estudiantil de primaria a bachillerato: Estudio de caso en Ensenada, México

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Organista Sandoval, Javier

2015-09-01

Full Text Available El artículo identifica los principales dispositivos portátiles e Internet que disponen los estudiantes de Educación Primaria, Secundaria y Bachillerato en Ensenada, México y se determina la frecuencia y restricción de su uso en los espacios escolares. Se construyó un indicador de nivel socio-tecnológico (NST con base en siete variables asociadas con posesiones tecnológicas y servicios en la vivienda para ubicar a estudiantes adscritos a escuelas con NST alto y bajo. Estas variables se recuperaron de la información demográfica publicada por el Instituto Nacional de Estadística y Geografía (INEGI. Se desarrolló una encuesta para recuperar información general de los estudiantes, de sus posesiones tecnológicas, del contexto de uso, entre otros. La encuesta se aplicó a 1972 estudiantes de las escuelas seleccionadas. La posesión de Internet en el NST alto fue mayor al 90% en todos los niveles, mientras que en el NST bajo de Educación Primaria apenas llega a 57%. Los resultados muestran una cobertura superior al 90% en cuanto a computadora y teléfono celular, el mayor porcentaje de posesión de tabletas (46% corresponde a estudiantes de Educación Primaria. Al comparar las posesiones tecnológicas de los estudiantes en el NST alto y bajo, se encontraron diferencias significativas (p<0.05 en cuanto a la posesión de equipo de cómputo y tabletas. Se destaca que la mayoría de los estudiantes lleva su teléfono a la escuela, sin embargo, se prohíbe su uso. Los hallazgos muestran que 2 de cada 5 estudiantes cuentan con los tres dispositivos. Esta condición anticipa una generación de estudiantes con mayores recursos tecnológicos y con posibilidad de apoyar sus estudios.

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

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A. A. Anderzhanova

2009-01-01

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.

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

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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.

Thallium-201 myocardial scintigraphy and left ventricular function at rest in patients with rest angina pectoris

International Nuclear Information System (INIS)

Hakki, A.H.; Iskandrian, A.S.; Kane, S.A.; Amenta, A.

1984-01-01

The purpose of this study was to examine the rest thallium-201 perfusion pattern during angina-free periods in 40 patients with rest angina pectoris secondary to coronary artery disease (greater than or equal to 70% diameter narrowing). Seventeen patients had previous Q wave myocardial infarction. The perfusion defects were considered fixed or reversible, depending on the absence or presence of redistribution in the 4-hour delayed images. There were 40 perfusion defects (26 fixed and 14 reversible) in 27 patients whereas 13 patients had normal scans. Reversible perfusion defects were present in 10 patients (25%). Of the 26 fixed perfusion defects, 17 did not have corresponding Q waves. Occluded vessels (63%) had more perfusion defects than vessels with subtotal occlusion (30%) (p less than 0.01). The perfusion defect size was larger in patients with lower ejection fraction than in patients with higher ejection fraction. We conclude: (1) perfusion defects are common in patients with rest angina and are reversible in 25% of patients indicating reduced regional coronary blood flow; (2) the degree of stenosis affects the presence of perfusion defect; (3) fixed defects may be present without corresponding Q waves; and (4) global left ventricular function is related to the size of perfusion defects

Aspectos de posesión, permisos y usos educativos de dispositivos portátiles durante el trayecto de primaria a universidad

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Javier Organista Sandoval

2014-10-01

Full Text Available Se presentan los principales resultados de una investigación cuyo propósito es explorar el nivel de posesión de teléfono celular de los estudiantes de primaria, secundaria, preparatoria y universidad de la zona urbana de Ensenada, México. Se analiza el contexto de permisos y prohibiciones del uso del teléfono celular en las escuelas y en qué medida el docente implementa estrategias pedagógicas para su uso. Se desarrolló y aplicó una encuesta a 2 635 estudiantes de los cuatro niveles educativos mencionados. La posesión de teléfono celular presenta una tendencia ascendente según el nivel educativo. Mientras que en primaria el porcentaje de posesión llega a 58%, en universidad alcanza 97%. Por su parte, la tableta encuentra su máximo porcentaje de posesión (46% en el nivel primaria. Llama la atención que la edad en que el estudiante de primaria comienza a usar el teléfono celular es a los 7.8 años. El teléfono celular se ubica en un contexto escolar de prohibición en los niveles primaria y secundaria; sin embargo, en preparatoria y universidad es incipiente su uso con propósito educativo. El potencial pedagógico del teléfono celular es enorme, pero requiere una nueva visión del proceso educativo.

Impacto de una intervención informativa sobre el programa de cribado de cáncer colorrectal en profesionales de atención primaria

OpenAIRE

Benito-Aracil, Llúcia; Binefa, Gemma; Milà, Núria; Lluch Canut, Ma. Teresa; Puig Llobet, Montserrat; García Martínez, Montserrat

2015-01-01

Objetivo: Evaluar el impacto de una intervención informativa a profesionales de atención pri-maria sobre sus conocimientos de cribado de cáncer colorrectal, recomendaciones de vigilanciaposterior y estrategias de derivación. Método diseÑo: Ensayo clínico controlado y aleatorizado por conglomerados. Emplazamiento:centros de atención primaria de L'Hospitalet de Llobregat (Barcelona). Participantes: médi-cos y enfermeras de atención primaria. Intervención: sesión informativa y envío de píldorasi...

La creatividad musical y las emociones. Tdah o trastorno de déficit de atención con hiperactividad en el aula de Primaria

OpenAIRE

Ruiz Hernández, Cristina

2016-01-01

Con este trabajo el problema de un TDAH y posibles problemas psicológicos serán investigados por medio de la creatividad musical y de las emociones utilizando la música en la Educación Primaria. Además con el estudio y la investigación de la enseñanza de la música, se intentará animarlos a expresar emociones y a tener creatividad para evitar problemas de comportamiento psicológicos que se dan en la etapa de Primaria. Grado en Educación Primaria

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

NARCIS (Netherlands)

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

1998-01-01

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

Evolución de la prevalencia de tabaquismo entre las médicas y enfermeras de la Comunidad de Madrid

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Fernández Ruiz M.L.

2003-01-01

Full Text Available Fundamentos: En España la prevalencia de tabaquismo es elevada y se está incrementando entre las mujeres. El objetivo de nuestro estudio es estudiar la evolución de la prevalencia de tabaquismo entre las médicas y enfermeras de la Comunidad de Madrid, sus conocimientos y conductas al respecto, así como la existencia de espacios libres de humo en los centros sanitarios. Métodos: Se han realizado, en 1998 y 2001, estudios descriptivos transversales entre las médicas y enfermeras de la Comunidad de Madrid mediante una encuesta sobre hábito tabáquico, en muestreos polietápicos por conglomerados. Resultados: En 1998 se estudió a 1.235 profesionales (435 médicas y 800 enfermeras y en 2001 a 1.000 (400 médicas y 600 enfermeras. Eran fumadoras el 43,1% en 1998 y el 43% en 2001, y en ambos años el tabaquismo fue más frecuente entre las enfermeras (el 47,6 y el 47%, respectivamente que entre las médicas (el 34,7 y el 37%, y entre quienes trabajan en atención especializada (el 46,6 y el 46,7% respecto a las que lo hacen en atención primaria (el 35,3 y el 37,3%. No se encontraron diferencias significativas en la prevalencia de tabaquismo según la profesión, comparando ambos años. En las dos encuestas las médicas más jóvenes (< 30 años presentaban la menor prevalencia de tabaquismo (el 22,9 y el 23,6%, y una situación similar se encontró en 2001 entre las enfermeras (el 43,8% de prevalencia en el grupo menor de 30 años. El porcentaje de ex fumadoras fue mayor en 2001 (el 18,8 frente al 27,8%. El porcentaje de las que fumaban delante de los pacientes disminuyó (el 2,9 frente al 1% así como el de quienes creían que se debía permitir fumar en las salas de espera (el 14,9 frente al 7,4%. Disminuyó el porcentaje de quienes señalaron que se fumaba habitualmente en las salas de uso común (el 90,6 frente al 87,1% y se incrementó el de quienes señalaron que en su centro de trabajo existía un lugar específico para fumar (el 30

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.

VALIDACIÓN DE UN TEST DE AGILIDAD, ADAPTADO A LAS CARACTERÍSTICAS ANATÓMICO-FISIOLÓGICAS Y POSIBILIDADES MOTRICES DEL NIÑO EN PRIMARIA, APTO PARA LA VALORACIÓN GLOBAL DE LA CAPACIDAD MOTRIZ DEL ALUMNO.

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José Bahamón Bhamonde Nava

2010-10-01

Full Text Available

El presente trabajo investigativo concluye en el diseño y validación de un test motriz para la valoración de la agilidad en Primaria, adaptándose a las características anatómicofisiológicas y posibilidades de movimiento del niño entre los 6 y 12 años. La muestra estaba formada por 1010 alumnos de ocho colegios ubicados en Oviedo capital, siendo su nivel de confianza del 95 % para un error del 2,33. Los criterios de calidad resultantes de esta investigación para el citado test quedaron reflejados en los siguientes índices: “fiabilidad alto” (0,91; “dificultad en la ejecución bajo” (8,3 % y de “duración bajo” (16min.. En base a estos resultados y las correspondientes justificaciones cualitativas de índole anatómicofisiológicas y motrices, el test en cuestión resultó de sólida fiabilidad, objetividad y válido para la valoración de la agilidad en esta etapa educativa.
Palabras clave: Test, Valoración, Agilidad, Niño, Primaria.

Prognostic value of thallium-201 myocardial perfusion imaging in patients with unstable angina who respond to medical treatment

International Nuclear Information System (INIS)

Brown, K.A.

1991-01-01

Although the prognostic value of thallium-201 imaging is well established, its ability to risk stratify patients who present with unstable angina is unclear. Fifty-two consecutive patients admitted with unstable angina who responded to medical treatment and underwent stress thallium-201 imaging within 1 week of discharge were studied. Patients were followed up for 39 +/- 11 months. Cardiac events included cardiac death (n = 3), nonfatal myocardial infarction (n = 4) and admission for unstable angina or revascularization (n = 17). The ability of thallium-201 data (redistribution, fixed defects, normal) to predict cardiac events was compared with clinical data (age, gender, prior myocardial infarction, anginal syndrome, rest and stress electrocardiogram) and cardiac catheterization data using logistic regression. Thallium-201 redistribution was the only significant predictor of cardiac death or nonfatal myocardial infarction (p less than 0.05). The number of myocardial segments with thallium-201 redistribution (p less than 0.0005) and a history of prior myocardial infarction (p less than 0.05) were the only significant predictors of all cardiac events. Cardiac death or nonfatal myocardial infarction occurred more frequently in patients with thallium-201 redistribution (6 [26%] of 23) than in those without redistribution (1 [3%] of 29, p less than 0.05). Similarly, total cardiac events developed more frequently in patients with thallium-201 redistribution (p less than 0.001). Stress thallium-201 imaging has important prognostic value in patients admitted with unstable angina who respond to medical therapy and can identify subgroups at high versus low risk for future cardiac events

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

The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11......,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......-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p clinical...

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

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

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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.

2015. 2. Por qué celebrar primarias

OpenAIRE

Sanz Díaz, Benito

2015-01-01

¿Por qué celebrar primarias? ¿Beneficia o perjudica a las organizaciones y partidos que las promueven?, ¿Mejora la participación?, ¿La elección de los dirigentes evita la oligarquización y la Ley de Hierro de los partidos políticos que enunció Robert Michels? Un sistema de selección de candidatos con origen en la política norteamericana, fue adaptado por el PSOE, y a continuación iría extendiéndose su práctica a los todos los partidos políticos. Ignacio Urquizu señalaba sobre l...

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

DEFF Research Database (Denmark)

Mygind, Naja Dam; Michelsen, Marie Mide; Peña, 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.......01), hypertension (P=0.02), current smoking (Ppain characteristics or results from diagnostic stress testing...

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

La competencia mediática en educación primaria en el contexto español

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Antonia Ramírez García

2016-06-01

Full Text Available Resumen Desde hace casi cuatro años un numeroso grupo de investigadores españoles de más de veinte universidades del país estudian los niveles de competencia mediática de la ciudadanía para promover así programas de alfabetización mediática en las escuelas y entornos no formales. La competencia mediática es un concepto que abarca nuestras habilidades y conocimientos frente a los medios de comunicación y puede ser medida a través de seis dimensiones: lenguaje, tecnología, producción y programación, recepción y audiencias, ideología y valores y finalmente la estética. Concretamente, en el estudio descriptivo que aquí se presenta, se explora el grado de dicha competencia en el caso concreto de escolares de cuarto de Educación Primaria de entre nueve y diez años, en el contexto español. Para ello fue necesario el diseño e implementación de un cuestionario online, adaptado a sus edades tanto en el contenido como en el diseño, para poder conocer si los 581 participantes que componen la muestra son competentes desde el punto de vista mediático. Los resultados muestran que nada es lo que parece. Pese a lo que se pudiera suponer, es necesario una mayor formación en medios entre el alumnado de esta etapa obligatoria y por tanto se precisan programas de alfabetización mediática en las escuelas y también en los entornos familiares.

Unstable Angina with Normal Coronary Angiography in Hyperthyroidism: A Case Report

OpenAIRE

Tsung-Hsien Lin; Ho-Ming Su; Wen-Chol Voon; Wen-Ter Lai; Sheng-Hsiung Sheu

2005-01-01

Hyperthyroidism is associated with an increase in myocardial oxygen consumption that, due to an imbalance of oxygen demand and supply, can cause angina. However, subclinical hyperthyroidism rarely presents as chest pain in the resting state. Herein, we present a case of subclinical hyperthyroidism involving a 58-year-old male who complained of frequent chest tightness and typical electrocardiographic changes while in a resting state. Coronary angiography showed no significant lesion. Laborato...

Stop-motion para la alfabetización digital en Educación Primaria

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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.

Prevalência de angina do peito pelo questionário de Rose na população brasileira: análise da Pesquisa Nacional de Saúde, 2013

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Paulo Andrade Lotufo

2015-12-01

Full Text Available RESUMO: Objetivo: Estimar a prevalência de angina do peito na população adulta brasileira com a aplicação do questionário de Rose para angina na Pesquisa Nacional de Saúde (PNS-2013. Métodos: Inquérito populacional representativo da população brasileira acima de 18 anos de idade, com amostragem probabilística conglomerada em três estágios. Foram obtidos registros de entrevistas de 60.202 indivíduos no território nacional. Apresentou-se ao entrevistado o questionário de Rose curto com três questões, adaptado por Lawlor em 2003 e validado no Brasil, para identificar angina do peito grau I (leve e II (moderada/grave. Calcularam-se os valores de prevalência com intervalo de confiança de 95% (IC95% segundo sexo, faixa etária, escolaridade e raça/cor. Resultados: A prevalência de angina leve (grau I foi de 7,6% (IC95% 7,2 - 8,0 para toda população, com frequência maior em mulheres - 9,1% (IC95% 8,5 - 9,7 - do que em homens - 5,9% (5,3 - 6,4. A frequência de angina moderada/grave (grau II foi 4,2 (IC95% 3,9 - 4,5, também mais frequente em mulheres - 5,2% (IC95% 4,7 - 5,6 - do que em homens - 3,0% (IC95% 2,7 - 3,4. A prevalência de angina por faixa etária aumentou progressivamente com a idade. A prevalência de angina, de qualquer tipo, foi inversa aos anos de estudo formal. Apesar do valor maior da presença de angina em negros, não houve diferença significativa por raça/cor da pele. Conclusão: Os valores de prevalência elevada de angina do peito na população brasileira acima de 18 anos foram compatíveis com estudos em outros países, revelando a importância da doença coronariana como problema de saúde pública.

Deporte, periodismo y lengua. Propuesta didáctica para 1º curso de Educación Primaria.

OpenAIRE

Martínez Medina, Adrián

2017-01-01

El deporte y los medios de comunicación son un atractivo para el alumnado. Este trabajo revisa qué dicen distintos autores sobre estos dos temas para justificar el uso del periódico y las noticias deportivas en el aula de Primaria. Además, se incluye una propuesta de intervención para el área de Lengua Castellana y Literatura diseñada a partir de la realización de un cuestionario realizado al alumnado de 1º curso de Educación Primaria del centro educativo “Fuente del Rey” sobre sus gustos y a...

«El paisaje» en el curriculum de Educación Primaria, dentro del área del conocimiento del medio natural, social y cultural

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María Jesús BAJO BAJO

2009-11-01

Full Text Available RESUMEN: La lectura y análisis del paisaje a lo largo de la enseñanza primaria permite a los alumnos alcanzar progresivamente la comprensión significativa de las relaciones entre los diversos elementos del medio físico y el medio humano. El paisaje muestra a los ojos de los alumnos, de forma directa y concreta, la diversidad de relaciones sincrónicas y diacrónicas entre los elementos naturales y humanos que lo configuran. También puede ayudar a descubrir los problemas que pueden aparecer en la interpretación del medio, para así promover nuevas actitudes de los alumnos hacia el entorno.ABSTRACT: The reading and analysis of the landscape throughout primary education allow the students progressively to reach the significant understanding of the relations between the diverse elements of the means physicist and the means human. The landscape shows the eyes of the students, direct form and specific, the diversity of synchronous and diachronic relations between the natural and human elements that form it. Also it can help to discover the problems that can appear in the interpretation of means, thus to promote new attitudes of the students towards the environment.

[INTERVENTIONAL AND SURGICAL TREATMENT OF THE ANGINA PECTORIS RECURRENCE AFTER CORONARY SHUNTING OPERATION].

Science.gov (United States)

Fanta, S M

2015-12-01

There were examined 134 patients, in whom in the clinic in 2005-2014 yrs a coronary shunting operation was performed. In patients with the angina pectoris recurrence a reoperation is indicated. The data of repeated coronaroventriculography and shuntography were analyzed. Efficacy of the surgical and interventional methods application in the patients was proved.

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

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Xiaoxia Zhang

2015-01-01

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

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

Science.gov (United States)

Zhang, Xiaoxia; Wang, Hui; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

2015-01-01

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

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)

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...

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

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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.

RELANZAMIENTO ATENCIÓN PRIMARIA EN SALUD

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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.

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

Estudio de caso de maestra transexual: la transexualidad como ejemplo de diversidad afectivo-sexual en Educación Primaria

OpenAIRE

Parra Rodríguez, Fátima

2017-01-01

El siguiente trabajo «Estudio de caso de maestra transexual: la transexualidad como ejemplo de diversidad afectivo-sexual en Educación Primaria» pretende ser una evidencia de la diversidad afectivo-sexual presente en la escuela como institución que configura y constituye la sociedad. El objeto de estudio es una de las pocas maestras transexuales ejerciendo actualmente en la Educación Primaria andaluza. El testimonio sobre su experiencia personal en el ámbito privado, activista y educativo se ...

Evaluación de resultados de un programa en salud oral en una población capitada infantil en un centro ambulatorio entre 2009-2012

OpenAIRE

Diaz Vera, Lorena Paola; Martinez Bernal, Sandra Paola; Garcia Bejarano, Natalia

2014-01-01

El propósito de este estudio fue analizar los resultados de una intervención primaria en salud oral de una población infantil entre edades de 7 a 12 años y establecer el comportamiento presentado en la población estudiada con respecto al índice internacional de salud oral COE Y COP, determinando aumento o disminución luego de la intervención. Para ello se utilizó un instrumento de recolección de datos, posterior a la observación de los registros clínicos, logrando conocer las características...

Making secondary care a primary concern: the rural hospital in Ecuador Hacer de la atención secundaria una preocupación primaria: los hospitales rurales en Ecuador

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David Gaus

2008-03-01

Full Text Available En Ecuador, el acceso de la población rural a servicios adecuados de atención secundaria de salud se ha hecho cada vez más difícil. A pesar de que los sectores público y privado han acertado en dedicar esfuerzos a la atención primaria y a la salud pública, la mayoría de las poblaciones rurales no tienen acceso a una adecuada atención secundaria. Por lo general, los modelos tradicionales de atención médica secundaria en zonas rurales no se han adaptado a las nuevas situaciones, como la tendencia general a la descentralización, el énfasis en el desarrollo de capacidades locales, el antagonismo entre el acceso universal y la autonomía financiera, las alternativas financieras innovadoras y los recién llegados médicos de familia. En 2001, la organización no gubernamental con sede en los Estados Unidos de América Andean Health & Development (Saludesa en Ecuador inauguró un hospital rural de 17 camas, construido conjuntamente con el municipio local y el Ministerio de Salud de Ecuador. El hospital atiende a una comunidad rural de 50000 personas que antes no tenían acceso local a servicios secundarios de salud. Los esfuerzos de AHD/Saludesa para desarrollar una red autosostenible pública/privada de atención primaria/secundaria de salud y de alta calidad han generado una considerable experiencia en la administración de un hospital rural. El proyecto piloto de AHD se concentró en un hospital rural y logró su autosostenibilidad total en 2007. Esto se logró mediante una combinación de mecanismos financieros, entre ellos la venta de paquetes prepagados de atención sanitaria, un contrato con el Instituto Ecuatoriano de Seguridad Social, contribuciones municipales y el pago tradicional por los servicios.

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

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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.

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

2018-05-01

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 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.

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.

Concepciones sobre las metodologías didácticas desde los profesores de educación primaria

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Dolores Gutiérrez Rico

2015-10-01

Full Text Available El presente estudio surge de la preocupación acerca de cómo los métodos didácticos (estudio de casos, métodos de proyectos, aprendizaje basado en problemas, entre otros se han convertido en una metodología implicada en los procesos de enseñanza de los docentes en la actual Reforma Integral de Educación Básica en México. Sus objetivos consistieron en: describir las concepciones que tienen los docentes de educación primaria sobre las metodologías didácticas para el desarrollo de competencias, identificar los usos que dan los docentes de educación primaria a las metodologías didácticas, identificar las asignaturas en donde comúnmente los docentes de educación primaria utilizan los métodos didácticos, y conocer las experiencias de los docentes en cuanto a los resultados que obtienen en la aplicación de métodos didácticos. El estudio se realizó bajo un enfoque cualitativo y se utilizó como técnica el cuestionario de pregunta abierta. Se concluyó que existe un gran desconocimiento por parte de los informantes de la aplicación de estos métodos y de cómo realizar una planeación y evaluación; sin embargo, el docente está en constante cambio, posee dudas y malestares, pero también manifiesta deseos de trascender y seguirse formando. AbstractThis study arises from the concern about how teaching methods (case study, methods of projects, learning problems, among others have become a methodology involved in the processes of education of teachers in the current comprehensive reform of basic education in Mexico. Its objectives were as follows: to describe the concepts based on the primary education teachers conceptions about didactic methodologies for competency development, to identify the uses that the primary education teachers have for didactic methodologies, to identify the subjects where primary education teachers use the didactic methods most commonly and to better understand the experiences of

Quality of Life With Ivabradine in Patients With Angina Pectoris: The Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients With Coronary Artery Disease Quality of Life Substudy.

Science.gov (United States)

Tendera, Michal; Chassany, Olivier; Ferrari, Roberto; Ford, Ian; Steg, Philippe Gabriel; Tardif, Jean-Claude; Fox, Kim

2016-01-01

To explore the effect of ivabradine on angina-related quality of life (QoL) in patients participating in the Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) QoL substudy. QoL was evaluated in a prespecified subgroup of SIGNIFY patients with angina (Canadian Cardiovascular Society class score, ≥ 2 at baseline) using the Seattle Angina Questionnaire and a generic visual analogue scale on health status. Data were available for 4187 patients (2084 ivabradine and 2103 placebo). There were improvements in QoL in both treatment groups. The primary outcome of change in physical limitation score at 12 months was 4.56 points for ivabradine versus 3.40 points for placebo (E, 0.96; 95% confidence interval, -0.14 to 2.05; P=0.085). The ivabradine-placebo difference in physical limitation score was significant at 6 months (P=0.048). At 12 months, the visual analogue scale and the other Seattle Angina Questionnaire dimensions were higher among ivabradine-treated patients, notably angina frequency (Pangina frequency (P=0.034). The effect on QoL was maintained over the study duration, and ivabradine patients had better scores on angina frequency at every visit to 36 months. Treatment with ivabradine did not affect the primary outcome of change in physical limitation score at 12 months. It did produce consistent improvements in other self-reported QoL parameters related to angina pectoris, notably in terms of angina frequency and disease perception. URL: http://www.isrctn.com. Unique identifier: ISRCTN61576291. © 2015 American Heart Association, Inc.

A CASE OF LUDWiG ANGiNA ENDING WITH MORTALITY

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Abdullah Onur Goksel

2013-06-01

Full Text Available Ludwig angina is a serious infection which is defines as edema, quickly progressing gangrenous sellulitis of soft tissues in neck and flor of the mouth. Airway obstruction is the most common cause of death. We present a case who applied to our outpatient clinic with a swelling under jaw and neck and was dignosed a a Ludwig Anjina. Broad spectrum antibiotherapy was given and followed without tracheotomy. He died because of cardiac arrest. [J Contemp Med 2013; 3(2.000: 112-115

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

DEFF Research Database (Denmark)

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

2013-01-01

Aims: In patients with stable coronary artery disease (CAD) and refractory angina we performed direct intra-myocardial injections of autologous mesenchymal stromal cells (MSCs) and followed the safety and efficacy of the treatment for 12 months. Methods and Results: A total of 31 patients...... with stable CAD, moderate to severe angina, normal left ventricular ejection fraction and no further revascularization options, were included. Bone marrow MSCs were isolated and culture expanded for 6 - 8 weeks and then stimulated with vascular endothelial growth factor (VEGF) for one week.The 12 months...... 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...

Clima social, prosocialidad y violencia como predictores de inadaptación escolar en primaria

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Cira Carrasco

2010-12-01

Full Text Available En este trabajo se pretende analizar la aportación que hacen la percepción del clima social, el comportamiento prosocial y la violencia escolar cotidiana sufrida y observada, informadas por parte del alumnado para predecir la adaptación socioemocional informada por profesores/as y padres o madres. Los participantes son 88 alumnos/as de 8-10 años de edad, de un colegio de la provincia de Málaga. Los resultados muestran que el alumnado evaluado presenta valores normalmente bajos en variables que indican inadaptación escolar y valores normativos en variables que se asocian a una buena adaptación escolar y social. Las correlaciones entre las variables predictoras y criterio muestran dos patrones diferentes: mientras que los datos de padres se asocian más activamente a las variables clima social y violencia sufrida en el caso de los profesores son prosocialidad y violencia sufrida. Los análisis de regresión demuestran también dos patrones diferentes para padres y para profesores, poniendo de manifiesto la importancia que tiene la violencia cotidiana sufrida en los resultados de adaptación o inadaptación escolar y social en alumnado que está en segundo ciclo de Educación Primaria, y la relevancia del comportamiento prosocial para predecir buenos resultados en el ámbito académico.

¿Cómo podemos aprender el arte en Educación Primaria? ¡Traslademos las obras de arte al aula!

OpenAIRE

Feliu Torruella, María

2011-01-01

Con este artículo pretendemos mostrar una experiencia de investigación en el aula de primaria en seis centros educativos. Dónde se han experimentado dos unidades didácticas con metodologías diferentes para verificar la incidencia de los métodos en los procesos de enseñanza y aprendizaje del arte. Palabras clave: investigación, didáctica del arte, educación primaria, metodología enseñanza.

Myocardial scintigraphy (thallium-201) and electrocardiography at rest and during exercise in angina pectoris

International Nuclear Information System (INIS)

Minning, E.; Scharf-Bornhofen, E.; Brueggeman, Th.; Chen, T.; Barthel, W.; Bluemchen, G.; Sankt-Josef-Hospital, Oberhausen

1980-01-01

Ecg (at rest and during exercise) was compared to Thallium-201 myocardial perfusion imaging (at rest and after exercise) in 65 patients with coronary heart disease (myocardial infarction in 53 patients) and angina pectoris. These results were compared to coronary angiography and left ventricular angiography. (orig./AJ) [de

Modelos de colaboración entre atención primaria y salud mental en la asistencia sanitaria a las personas con depresión: resultados principales y retos metodológicos de una metarevisión sistemática

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Carlos Calderón Gómez

2014-01-01

Full Text Available Fundamentos: Las carencias en la colaboración entre Atención Primaria (AP y Salud Mental (SM constituyen un problema relevante en la atención a los pacientes con depresión. Resulta necesario analizar y evaluar los modelos de colaboración existentes para valorar su aplicabilidad en el sistema de salud español. El objetivo del presente estudio es conocer las principales características de los distintos modelos de colaboración AP-SM en la atención a los pacientes diagnosticados de depresión y la calidad de la evidencia científica acerca de su efectividad. Métodos: Meta-revisión sistemática de los estudios secundarios publicados entre 2001 y 2010 en MEDLINE, PsycINFO, Embase, LILACS, IBECS, IME y la Biblioteca Cochrane. Las revisiones se evaluaron mediante la herramienta AMSTAR. Se realizó una síntesis aproximativa de la calidad de las evidencias encontradas. Resultados: Se evaluaron 69 estudios. La variabilidad según contextos y las carencias metodológicas condicionan que la calidad de las evidencias sea en general baja o dudosa. Las estrategias más efectivas integran intervenciones de responsabilización en el seguimiento de los pacientes, rediseños en la gestión, e información y comunicación compartidas. Las meta-revisiones de estudios secundarios sobre modelos colaborativos favorecen la accesibilidad a las evidencias publicadas, pero conllevan importantes retos metodológicos. Conclusiones: La calidad de la evidencia sobre la efectividad de los modelos de colaboración AP-SM durante la atención sanitaria a las personas con depresión es predominantemente baja o dudosa y su significado y aplicabilidad son menores cuanto más se simplifica el análisis de sus componentes, procesos y circunstancias de implementación.

Mediación parental del uso de Internet en el alumnado de Primaria: creencias, estrategias y dificultades

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2018-01-01

Full Text Available El uso de Internet de los niños y las niñas a edades cada vez más tempranas constituye un reto para las familias, las escuelas y la política educativa y social en la actualidad. Se presenta una investigación cualitativa cuyo objetivo es analizar las creencias, prácticas cotidianas y dificultades que afrontan los padres y las madres cuando tratan de enseñar a sus hijos e hijas los beneficios y riesgos de Internet. Se ha utilizado la técnica de los grupos de discusión con cuatro grupos de madres y padres de alumnado de Educación Primaria de cuatro centros educativos. Los resultados indican que comparten una concepción más pesimista que optimista sobre el uso de Internet a estas edades y que perciben diversas dificultades cuando tratan de promover su uso responsable. Se identifican diversas estrategias de mediación parental de control: establecimiento de normas, organización espaciotemporal de límites y supervisión (presencial directa, consensuada, no consensuada y técnica y de apoyo (modelado parental, entre hermanos y diversas estrategias instructivas, de estimulación y comunicación familiar que, a excepción de la supervisión técnica, habitualmente utilizan para educarles o controlar su comportamiento en otras áreas formando parte de su estilo general de parentalidad. Las conclusiones apuntan la necesidad de desarrollar la competencia parental digital y algunas implicaciones para la intervención educativa como promover la colaboración entre la familiaescuela.

IMPLEMENTACION DE UNA CENTRAL DE COORDINACION COMO MEDIDA DE MEJORA AL SISTEMA DE ATENCION PRIMARIA DE SALUD

OpenAIRE

BAZAN GANTZ, OSCAR ANDRES; BAZAN GANTZ, OSCAR ANDRES

2012-01-01

La salud pública chilena, es uno de los servicios públicos con mayor utilización, y a la vez, obtiene, por parte de los usuarios, los peores resultados en la medición de percepción de la calidad de la atención.(Subjetiva, 2010) La atención primaria de salud (APS) es la puerta de entrada al sistema, contando con una altísima cobertura (880 centros de atención primaria) y por tanto un gran número de pacientes atendidos (más de 32 millones de consultas médicas al año). Es el eslab...

Early and long-term outcomes of coronary artery bypass grafting in patients with acute coronary syndrome versus stable angina pectoris.

Science.gov (United States)

Fukui, Toshihiro; Tabata, Minoru; Morita, Satoshi; Takanashi, Shuichiro

2013-06-01

The aim of the present study was to determine the early and long-term outcomes of coronary artery bypass grafting in patients with acute coronary syndrome and stable angina pectoris. From September 2004 to September 2011, 382 patients with acute coronary syndrome (unstable angina pectoris and non-ST-segment elevation myocardial infarction) and 851 patients with stable angina pectoris underwent first-time isolated coronary artery bypass grafting at our institute. The early and long-term outcomes were compared between the 2 groups. Patients with acute coronary syndrome were older, were more likely to be women, had a smaller body surface area, and were more likely to have left main coronary artery disease. In both groups, bilateral internal thoracic artery grafts were used in approximately 89% of the patients, and off-pump techniques in approximately 97% of the patients. The acute coronary syndrome group had a greater operative death rate (2.6% vs 0.1%) and a greater incidence of low output syndrome (3.1% vs 1.2%) and hemodialysis requirement (2.9% vs 1.1%). Multivariate regression analysis demonstrated that age, acute coronary syndrome, lower ejection fraction, and higher creatinine level before surgery were independent predictors of operative death. However, among the hospital survivors, no differences were seen in freedom from all death (85.4% ± 2.5% vs 87.7% ± 2.0%), cardiac death (97.4% ± 0.9% vs 96.5% ± 0.9%), or major adverse cardiac and cerebrovascular events (78.0% ± 2.9% vs 78.1% ± 2.3%) at 7 years between the patients with acute coronary syndrome and stable angina pectoris. Although acute coronary syndrome is an independent predictor of early mortality in patients undergoing coronary artery bypass grafting, the long-term outcomes after surgery were similar between patients with acute coronary syndrome and stable angina pectoris who survived the early postoperative period. Copyright © 2013 The American Association for Thoracic Surgery. Published by

Influence of pre-infarction angina, collateral flow, and pre-procedural TIMI flow on myocardial salvage index by cardiac magnetic resonance in patients with ST-segment elevation myocardial infarction.

Science.gov (United States)

Lønborg, Jacob; Kelbæk, Henning; Vejlstrup, Niels; Bøtker, Hans Erik; Kim, Won Yong; Holmvang, Lene; Jørgensen, Erik; Helqvist, Steffen; Saunamäki, Kari; Thuesen, Leif; Krusell, Lars Romer; Clemmensen, Peter; Engstrøm, Thomas

2012-05-01

In patients with ST-segment elevation myocardial infarction (STEMI) pre-infarction angina, pre-procedural TIMI flow and collateral flow to the myocardium supplied by the infarct related artery are suggested to be cardioprotective. We evaluated the effect of these factors on myocardial salvage index (MSI) and infarct size adjusting for area at risk in patients with STEMI treated with primary percutaneous coronary intervention. Cardiac magnetic resonance (CMR) was used to measure myocardial area at risk within 1-7 days and final infarct size 90 ± 21 days after the STEMI in 200 patients. MSI was calculated as (area-at-risk infarct size) / area-at-risk. Patients with pre-infarction angina had a median MSI of 0.80 (IQR 0.67 to 0.86) versus 0.72 (0.61 to 0.80) in those without pre-infarction angina, P = 0.004). In a regression analysis of the infarct size plotted against the area-at-risk there was a strong trend that the line for the pre-infarction angina group was below the one for the non-angina group (P = 0.05). Patients with pre-procedural TIMI flow 0/1, 2 and 3 had a median MSI of (0.69 (IQR 0.59 to 0.76), 0.78 (0.68 to 0.86) and 0.85 (0.77 to 0.91), respectively (PCollateral flow did not change MSI (P = 0.45) nor area-at-risk (P = 0.40) and no significant difference in infarct size adjusted for area at risk (P = 0.25) was observed. Pre-infarction angina increases MSI in patients with STEMI supporting the theory that pre-infarction angina leads to ischemic preconditioning. As opposed to the presence of angiographically visible collateral flow to the infarct area pre-procedural TIMI flow is strongly associated with MSI.

THE CHOICE OF NITRATE THERAPY IN PATIENTS WITH STABLE ANGINA: COMPARATIVE STUDY OF ISOSORBIDE DINITRATE (IN USUAL TABLETS WITH ISOSORBIDE-5-MONONITRATE (IN VARIOUS PRESENTATIONS

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V. A. Egoro

2008-01-01

Full Text Available Aim. To study efficacy and tolerability of isosorbide-5-mononitrate (IMN in various presentations in comparison with isosorbide dinitrate (IDN in usual tablets in patients with stable angina.Material and Methods. 22 patients (5 women and 17 men with stable angina of II-III functional class were involved into open randomized comparative crossover study. Patients were split in 3 groups and received each of studied drugs during 4 weeks. IDN (Nitrosorbide, Nizpharm, Russia in usual tablets 10 mg prescribed for 3 times a day administration; IMN (Monocinque,Berlin-Chemie, German in tablets 20 mg prescribed for 2 times a day administration. After 1 week therapy the doses of IDN or IMN doubled if it was clinically necessary. Retarded presentation of IMN (Monocinque Retard, Berlin-Chemie, German in capsules 50 mg prescribed once daily. Drug efficacy was evaluated by changes in clinical symptoms, number of angina attacks, demand in short-acting sublingual nitroglycerin as well as physical activity tolerance.Results. After 4 weeks 18 patients completed study, 2 patients dropped out because of protocol nonobservance and 2 patients dropped out because of side effects (headache. IDN therapy in adjusted dose provided antianginal effect in 15 (83,3% patients: a number of angina attacks decreased in 39,6%, short-acting nitroglycerin demand reduced in 47,7%. Monocinque in adjusted dose provided antianginal effect in 16 (88,9% patients: a number of angina attacks decreased in 60%, short-acting nitroglycerin demand reduced in 63%. Monocinque Retard provided good antianginal effect in 18 (100% patients: a number of angina attacks decreased in 72%, short-acting nitroglycerin demand reduced in 84,8%. There were not significant differences in frequency and severity of headache between studied drugs.Conclusion. IMN therapy with both presentations (administrated 1 or 2 times a day was more convenient and effective than IDN (administrated 3 times a day.

Electrical neuromodulation for disabling angina pectoris related to isolated stenoses of small epicardial coronary arteries

NARCIS (Netherlands)

Jessurun, GAJ; Hautvast, RWM; DeJongste, MJL; Meyler, WJ; van Boven, AJ; Crijns, HJGM

Patients with symptomatic small vessel coronary artery disease may be inadequate candidates for revascularization procedures. They may suffer from refractory angina, which does not respond to maximal anti-anginal drug therapy. In addition to patients with end stage coronary artery disease and

Caracterización de los síntomas de angina en un grupo de mujeres con prueba de esfuerzo positiva Characterization of angina's symptoms in a group of women with positive stress test

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Fanny Rincón O

Full Text Available Introducción: la enfermedad coronaria es una causa importante de morbimortalidad en el mundo. Las características específicas del cuadro clínico de la angina en mujeres se desconoce; éste último influye en atención, tratamiento, mortalidad, calidad de vida y costos sociales. Objetivo: caracterizar los síntomas de angina en relación con el patrón de presentación, la integración de roles y el esfuerzo percibido en un grupo de mujeres cuya prueba de esfuerzo resultó positiva para enfermedad coronaria. Diseño: estudio descriptivo exploratorio con abordaje cualicuantitativo. Incluyó 15 mujeres con dolor o discomfort torácico y prueba de esfuerzo positiva para enfermedad coronaria. Resultados: grupo de 15 mujeres con edad entre 52 y 80 años; se describen los factores de riesgo, la caracterización en relación con la integración de roles, de esfuerzo percibido y patrón de presentación en donde se encontraron categorías como: «opresión», «poca importancia», «sensación punzante», síntomas respiratorios, y simultaneidad de síntomas. La mayoría refiere sentir el síntoma y no consultar ni pedir ayuda. El aumento de la actividad física es el factor determinante en 8 mujeres; la mayoría afronta la situación con reposo y respiración; conviven con el síntoma, toman medicamentos, informan a allegados; 3 consultan con profesionales de salud. Seis interpretan el evento como consecuencia de un trauma físico o estrés psicológico, cinco no sabe y para tres refleja una etapa de la vida. Conclusiones: se observa un patrón de expresión categórico que aporta a la construcción del perfil femenino en el diagnóstico de la enfermedad coronaria.Introduction: coronary disease is an important morbimortality cause worldwide. The specific characteristics of the clinical picture of angina in women are unknown and this fact influences the attention, treatment, mortality, lifestyle and social costs. Objective: to characterize the

Reconocimiento a la Atención Primaria de Salud

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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

CONDICIONANTES DEL RENDIMIENTO ACADÉMICO EN LA ESCOLARIDAD PRIMARIA EN BRASIL: UN ANÁLISIS MULTIFACTORIAL

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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.

CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial.

Science.gov (United States)

2015-06-13

The benefit of CT coronary angiography (CTCA) in patients presenting with stable chest pain has not been systematically studied. We aimed to assess the effect of CTCA on the diagnosis, management, and outcome of patients referred to the cardiology clinic with suspected angina due to coronary heart disease. In this prospective open-label, parallel-group, multicentre trial, we recruited patients aged 18-75 years referred for the assessment of suspected angina due to coronary heart disease from 12 cardiology chest pain clinics across Scotland. We randomly assigned (1:1) participants to standard care plus CTCA or standard care alone. Randomisation was done with a web-based service to ensure allocation concealment. The primary endpoint was certainty of the diagnosis of angina secondary to coronary heart disease at 6 weeks. All analyses were intention to treat, and patients were analysed in the group they were allocated to, irrespective of compliance with scanning. This study is registered with ClinicalTrials.gov, number NCT01149590. Between Nov 18, 2010, and Sept 24, 2014, we randomly assigned 4146 (42%) of 9849 patients who had been referred for assessment of suspected angina due to coronary heart disease. 47% of participants had a baseline clinic diagnosis of coronary heart disease and 36% had angina due to coronary heart disease. At 6 weeks, CTCA reclassified the diagnosis of coronary heart disease in 558 (27%) patients and the diagnosis of angina due to coronary heart disease in 481 (23%) patients (standard care 22 [1%] and 23 [1%]; pheart disease increased (1·09, 1·02-1·17; p=0·0172), the certainty increased (1·79, 1·62-1·96; pheart disease. This changed planned investigations (15% vs 1%; pheart disease, CTCA clarifies the diagnosis, enables targeting of interventions, and might reduce the future risk of myocardial infarction. The Chief Scientist Office of the Scottish Government Health and Social Care Directorates funded the trial with supplementary awards

Alteration in metabolic signature and lipid metabolism in patients with angina pectoris and myocardial infarction.

Science.gov (United States)

Park, Ju Yeon; Lee, Sang-Hak; Shin, Min-Jeong; Hwang, Geum-Sook

2015-01-01

Lipid metabolites are indispensable regulators of physiological and pathological processes, including atherosclerosis and coronary artery disease (CAD). However, the complex changes in lipid metabolites and metabolism that occur in patients with these conditions are incompletely understood. We performed lipid profiling to identify alterations in lipid metabolism in patients with angina and myocardial infarction (MI). Global lipid profiling was applied to serum samples from patients with CAD (angina and MI) and age-, sex-, and body mass index-matched healthy subjects using ultra-performance liquid chromatography/quadruple time-of-flight mass spectrometry and multivariate statistical analysis. A multivariate analysis showed a clear separation between the patients with CAD and normal controls. Lysophosphatidylcholine (lysoPC) and lysophosphatidylethanolamine (lysoPE) species containing unsaturated fatty acids and free fatty acids were associated with an increased risk of CAD, whereas species of lysoPC and lyso-alkyl PC containing saturated fatty acids were associated with a decreased risk. Additionally, PC species containing palmitic acid, diacylglycerol, sphingomyelin, and ceramide were associated with an increased risk of MI, whereas PE-plasmalogen and phosphatidylinositol species were associated with a decreased risk. In MI patients, we found strong positive correlation between lipid metabolites related to the sphingolipid pathway, sphingomyelin, and ceramide and acute inflammatory markers (high-sensitivity C-reactive protein). The results of this study demonstrate altered signatures in lipid metabolism in patients with angina or MI. Lipidomic profiling could provide the information to identity the specific lipid metabolites under the presence of disturbed metabolic pathways in patients with CAD.

[Effects of a smoking cessation education on smoking cessation, endothelial function, and serum carboxyhemoglobin in male patients with variant angina].

Science.gov (United States)

Cho, Sook Hee

2012-04-01

The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group (p<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.

Selected CD133⁺ progenitor cells to promote angiogenesis in patients with refractory angina: final results of the PROGENITOR randomized trial.

Science.gov (United States)

Jimenez-Quevedo, Pilar; Gonzalez-Ferrer, Juan Jose; Sabate, Manel; Garcia-Moll, Xavier; Delgado-Bolton, Roberto; Llorente, Leopoldo; Bernardo, Esther; Ortega-Pozzi, Aranzazu; Hernandez-Antolin, Rosana; Alfonso, Fernando; Gonzalo, Nieves; Escaned, Javier; Bañuelos, Camino; Regueiro, Ander; Marin, Pedro; Fernandez-Ortiz, Antonio; Neves, Barbara Das; Del Trigo, Maria; Fernandez, Cristina; Tejerina, Teresa; Redondo, Santiago; Garcia, Eulogio; Macaya, Carlos

2014-11-07

Refractory angina constitutes a clinical problem. The aim of this study was to assess the safety and the feasibility of transendocardial injection of CD133(+) cells to foster angiogenesis in patients with refractory angina. In this randomized, double-blinded, multicenter controlled trial, eligible patients were treated with granulocyte colony-stimulating factor, underwent an apheresis and electromechanical mapping, and were randomized to receive treatment with CD133(+) cells or no treatment. The primary end point was the safety of transendocardial injection of CD133(+) cells, as measured by the occurrence of major adverse cardiac and cerebrovascular event at 6 months. Secondary end points analyzed the efficacy. Twenty-eight patients were included (n=19 treatment; n=9 control). At 6 months, 1 patient in each group had ventricular fibrillation and 1 patient in each group died. One patient (treatment group) had a cardiac tamponade during mapping. There were no significant differences between groups with respect to efficacy parameters; however, the comparison within groups showed a significant improvement in the number of angina episodes per month (median absolute difference, -8.5 [95% confidence interval, -15.0 to -4.0]) and in angina functional class in the treatment arm but not in the control group. At 6 months, only 1 simple-photon emission computed tomography (SPECT) parameter: summed score improved significantly in the treatment group at rest and at stress (median absolute difference, -1.0 [95% confidence interval, -1.9 to -0.1]) but not in the control arm. Our findings support feasibility and safety of transendocardial injection of CD133(+) cells in patients with refractory angina. The promising clinical results and favorable data observed in SPECT summed score may set up the basis to test the efficacy of cell therapy in a larger randomized trial. © 2014 American Heart Association, Inc.

lenguas en Educación Primaria

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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.

New aspects in the diagnosis of angina abdominalis using digital substraction angiography

International Nuclear Information System (INIS)

Mahmalat, M.O.; Beyer, H.K.

1985-01-01

Selective intra-arterial digital substraction angiography (DSA) is important in the demonstration of the visceral abdominal vessels in angina-abdominalis patients. DSA allows to accurately determine the location of stenoses, vascular occlusions or plaque formations as does conventional angiography; in addition, it provides for simultaneous direct observation which is a major advantage over the conventional technique since suspected lesions can be better focussed in several planes. (orig.) [de

Relaciones entre el bullying y el cyberbullying: prevalencia y co-ocurrencia

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Cristina María García-Fernández

2016-01-01

Full Text Available Objetivo. El estudio del bullying ha sido objeto de investigación durante más de 40 años y ha abierto camino hacia el análisis de nuevas formas de violencia, como es el caso del cyberbullying. Las evidencias revelan un cierto solapamiento entre el alumnado participante de ambos fenómenos. Sin embargo, la continuidad en los roles que conforman estas dinámicas parece no haber encontrado un consenso. Por tal razón, este estudio tuvo como objetivo avanzar en el conocimiento sobre el sistema que modela las relaciones entre aquellos que forman parte de ambos fenómenos. Método. Se empleó el Cuestionario para la Investigación de la Violencia Escolar en Andalucía (CIVEA para entrevistar a 1278 escolares de primaria (cursos 5º y 6º y se identificaron tanto los fenómenos como los roles de participación en cada uno de ellos. Resultados. Las pruebas chicuadrado y los análisis de correspondencias señalan la existencia de un 28.9% de escolares que participan en comportamientos de acoso de ambas vías. Conclusión. Los resultados señalan un alto porcentaje de escolares implicados en bullying y cyberbullying aunque con diferencias en los roles desarrollados en cada fenómeno. Se subraya el valor explicativo de un fenómeno sobre otro.

Thrombopoietin contributes to enhanced platelet activation in patients with unstable angina.

Science.gov (United States)

Lupia, Enrico; Bosco, Ornella; Bergerone, Serena; Dondi, Anna Erna; Goffi, Alberto; Oliaro, Elena; Cordero, Marco; Del Sorbo, Lorenzo; Trevi, Giampaolo; Montrucchio, Giuseppe

2006-12-05

We sought to investigate the potential role of elevated levels of thrombopoietin (TPO) in platelet activation during unstable angina (UA). Thrombopoietin is a humoral growth factor that does not induce platelet aggregation per se, but primes platelet activation in response to several agonists. No data concerning its contribution to platelet function abnormalities described in patients with UA are available. We studied 15 patients with UA and, as controls, 15 patients with stable angina (SA) and 15 healthy subjects. We measured TPO and C-reactive protein (CRP), as well as monocyte-platelet binding and the platelet expression of P-selectin and of the TPO receptor, c-Mpl. The priming activity of patient or control plasma on platelet aggregation and monocyte-platelet binding and the role of TPO in this effect also were studied. Patients with UA showed higher circulating TPO levels, as well as increased monocyte-platelet binding, platelet P-selectin expression, and CRP levels, than those with SA and healthy control subjects. The UA patients also showed reduced platelet expression of the TPO receptor, c-Mpl. In vitro, the plasma from UA patients, but not from SA patients or healthy controls, primed platelet aggregation and monocyte-platelet binding, which were both reduced when an inhibitor of TPO was used. Thrombopoietin may enhance platelet activation in the early phases of UA, potentially participating in the pathogenesis of acute coronary syndromes.

Computed tomography derived fractional flow reserve testing in stable patients with typical angina pectoris

DEFF Research Database (Denmark)

Møller Jensen, Jesper; Erik Bøtker, Hans; Norling Mathiassen, Ole

2017-01-01

Aims: To assess the use of downstream coronary angiography (ICA) and short-term safety of frontline coronary CT angiography (CTA) with selective CT-derived fractional flow reserve (FFRCT) testing in stable patients with typical angina pectoris. Methods and results: Between 1 January 2016 and 30 J...... of safe cancellation of planned ICAs....

Relación entre el perfeccionismo socialmente prescrito y la conducta agresiva durante la infancia tardía

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José Manuel García-Fernández

2017-06-01

Full Text Available El objetivo de este trabajo consistió en examinar la relación entre el perfeccionismo socialmente prescrito (PSP y la agresividad, atendiendo a sus componentes: fisiológico-emocional (ira, motor (agresividad física y verbal y cognitivo (hostilidad. Se empleó una muestra de 776 alumnos de tercero a sexto curso de Educación Primaria (M = 9.72; DE = 1.14, así como la Child and Adolescent Perfectionism Scale y el Aggression Questionnaire para evaluar, respectivamente, el PSP y los componentes de la conducta agresiva: Ira, Hostilidad, Agresividad Física y Agresividad Verbal. Los análisis de diferencia de medias mostraron que los alumnos con altos niveles de PSP puntuaron significativamente más alto en las 4 subescalas del Aggression Questionnaire, en comparación con sus iguales con bajos niveles de PSP, obteniendo tamaños del efecto moderados en todos los casos, excepto para la variable Hostilidad, cuya magnitud de las diferencias encontradas fue pequeña. Los análisis de regresión logística revelaron que las 4 dimensiones del Aggression Questionnaire predijeron significativa y positivamente altas puntuaciones en PSP, con niveles de OR que oscilaron entre 1.07 y 1.12. Los resultados evidencian que existe una estrecha relación entre el PSP y las manifestaciones de la agresividad.

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.

Ethnic difference in the prevalence of angina pectoris in Sami and non-Sami populations: the SAMINOR study

Science.gov (United States)

Eliassen, Bent-Martin; Graff-Iversen, Sidsel; Melhus, Marita; Løchen, Maja-Lisa; Broderstad, Ann Ragnhild

2014-01-01

Objective To assess the population burden of angina pectoris symptoms (APS), self-reported angina and a combination of these, and explore potential ethnic disparity in their patterns. If differences in APS were found between Sami and non-Sami populations, we aimed at evaluating the role of established cardiovascular risk factors as mediating factors. Design Cross-sectional population-based study. Methods A health survey was conducted in 2003–2004 in areas with Sami and non-Sami populations (SAMINOR). The response rate was 60.9%. The total number for the subsequent analysis was 15,206 men and women aged 36–79 years (born 1925–1968). Information concerning lifestyle was collected by 2 self-administrated questionnaires, and clinical examinations provided data on waist circumference, blood pressure and lipid levels. Results This study revealed an excess of APS, self-reported angina and a combination of these in Sami relative to non-Sami women and men. After controlling for age, the odds ratio (OR) for APS was 1.42 (pangina and a combination of these in Sami women and men relative to non-Sami women and men. Established risk factors explained little or none of the ethnic variation in APS. In women, however, less moderate alcohol consumption and leisure-time physical activity in Sami may explain the entire ethnic difference. PMID:24422205

The Efficacy of Guanxinning Injection in Treating Angina Pectoris: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Science.gov (United States)

Jia, Yongliang; Leung, Siu-wai; Lee, Ming-Yuen; Cui, Guozhen; Huang, Xiaohui; Pan, Fongha

2013-01-01

Objective. The randomized controlled trials (RCTs) on Guanxinning injection (GXN) in treating angina pectoris were published only in Chinese and have not been systematically reviewed. This study aims to provide a PRISMA-compliant and internationally accessible systematic review to evaluate the efficacy of GXN in treating angina pectoris. Methods. The RCTs were included according to prespecified eligibility criteria. Meta-analysis was performed to evaluate the symptomatic (SYMPTOMS) and electrocardiographic (ECG) improvements after treatment. Odds ratios (ORs) were used to measure effect sizes. Subgroup analysis, sensitivity analysis, and metaregression were conducted to evaluate the robustness of the results. Results. Sixty-five RCTs published between 2002 and 2012 with 6064 participants were included. Overall ORs comparing GXN with other drugs were 3.32 (95% CI: [2.72, 4.04]) in SYMPTOMS and 2.59 (95% CI: [2.14, 3.15]) in ECG. Subgroup analysis, sensitivity analysis, and metaregression found no statistically significant dependence of overall ORs upon specific study characteristics. Conclusion. This meta-analysis of eligible RCTs provides evidence that GXN is effective in treating angina pectoris. This evidence warrants further RCTs of higher quality, longer follow-up periods, larger sample sizes, and multicentres/multicountries for more extensive subgroup, sensitivity, and metaregression analyses. PMID:23634167

Prolonged angina pectoris and persistent negative T waves in the precordial leads: response to atrial pacing and to methoxamine-induced hypertension

International Nuclear Information System (INIS)

Figueras, J.; Cinca, J.; Gutierrez, L.; Segura, R.; Rius, J.

1983-01-01

In 18 consecutive patients without a history of myocardial infarction (MI), prolonged angina pectoris with persistent negative T waves in the precordial leads was associated with a high frequency of in-hospital spontaneous angina (14 of 18, 78%), usually accompanied by S-T segment elevation, and occasionally in-hospital MI (4 of 18, 22%). Angina and MI always involved the electrocardiographic leads with negative T waves. Coronary arteriography, performed in 16 patients, revealed greater than or equal to 90% proximal diameter reduction of the left anterior descending (LAD) coronary artery in 14 patients. No patient had severe narrowing of all 3 major coronary arteries, but the 3 who had 100% LAD occlusion lacked collateral circulation. The ejection fraction was greater than or equal to 50% in 13 patients. Atrial pacing performed in 11 patients at an average rate of 142 beats/min produced a 1.0 mm S-T segment change in only 5 patients (45%), 3 of whom had an associated lactate production. Arterial systemic hypertension induced by methoxamine in 14 patients caused reversal of negative T waves without significant S-T segment shifts or chest pain and failed to elicit lactate extraction abnormalities in each of the 5 patients in whom it was determined. Thus, prolonged angina with persistent negative T waves in the precordial leads is almost invariably associated with a critical and proximal LAD obstruction, severe narrowing of 1 or 2 coronary arteries, and poor or absent collateral vessels

Análisis de materiales didácticos para enseñar Ciencias Sociales en Educación Primaria: “Un camino de ida y vuelta”

OpenAIRE

Mon Alday, Estefanía

2013-01-01

Con este Trabajo de Fin de Grado se pretende un acercamiento al tema del análisis de materiales didácticos para enseñar Ciencias Sociales en Educación Primaria y más concretamente se pretende analizar los materiales utilizados con el alumnado de 5º de primaria durante el desarrollo del Proyecto “Un Camino de Ida y Vuelta” en el Colegio Público de Educación Infantil y Primaria “Marqués de Santillana” en la localidad de Palencia. En la primera parte de este trabajo se realiza una revisión t...

Elecciones primarias y personalización de la política: El caso de las elecciones locales en Chile 2012

OpenAIRE

CANTILLANA PEÑA, CARLOS; CONTRERAS AGUIRRE, GONZALO; MORALES QUIROGA, MAURICIO

2015-01-01

Aunque las elecciones primarias han sido popularizadas como el mecanismo de selección de candidatos más abierto y participativo, muchas veces generan el efecto contrario, fortaleciendo la personalización de la política y no la institucionalización de los partidos. Estudiamos las elecciones primarias de Chile organizadas por la coalición de centro-izquierda Concertación, para elegir sus candidatos a alcalde en 2012. Sostenemos, en primer lugar, que a mayor fuerza electoral del candidato incumb...

Demoras en la realización de la angioplastia primaria en los pacientes trasladados con infarto agudo de miocardio: un problema médico-asistencial

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Rodrigo Blanco

2009-01-01

Full Text Available IntroducciónEn el infarto agudo de miocardio (IAM está comprobado que cuanto más tempranamente se realice la reperfusión, mejores serán sus resultados a corto y a largo plazos, por lo que el tiempo entre el inicio de los síntomas y la reperfusión coronaria es un elemento de gran importancia en la estrategia de su tratamiento. Este lapso se encuentra conformado por dos períodos: “tiempo paciente” y “tiempo médico-asistencial”. En la angioplastia primaria, el análisis de estos tiempos y sus intervalos es el paso obligado para lograr una reducción de la demora a la reperfusión.ObjetivosAnalizar los tiempos en cada etapa del proceso traslado-realización de una angioplastia, ya sea primaria o de rescate, en pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMEST que debieron ser trasladados desde un hospital derivador a un centro de referencia en el ámbito de la ciudad de Buenos Aires para someterse al procedimiento, como primer paso para un programa de optimización de los tiempos.Material y métodosEstudio prospectivo, observacional, de pacientes derivados al Hospital General de Agudos “Dr. Cosme Argerich” con diagnóstico de IAMEST e indicación de ATC. Se analizaron los tiempos parciales desde el inicio de los síntomas hasta la reperfusión coronaria, para lo cual se consideró “tiempo paciente” desde el inicio de los síntomas hasta la llegada al hospital derivador y “tiempo médico-asistencial” al comprendido entre la llegada al hospital derivador y la insuflación del balón.ResultadosSe incluyeron 313 pacientes, 225 (72% con angioplastia primaria (ATCP y 88 (28% con angioplastia de rescate (ATCR. Las medianas (cuartiles de tiempo en ATCP fueron: tiempo paciente: 90’ (40-240, llegada al hospital derivador-llamada al Equipo de Hemodinamia Cardiovascular de Urgencia (EHCU: 80’ (35-150, llamada EHCU-ingreso hemodinamia: 75’ (55-100, ingreso hemodinamia-balón: 35’ (23-52, tiempo m

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

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

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

International Nuclear Information System (INIS)

Tanaka, Tetsuya; Ohtsuki, Yumi; Takechi, Norikazu; Suzuki, Kenji; Nishibori, Yoshiharu; Matsuo, Akiko; Inoue, Keiji; Fujita, Hiroshi; Inoue, Naoto

2005-01-01

This study evaluated the sensitivity and the related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy to detect stable angina. The subjects were 198 patients with stable angina who underwent BMIPP before percutaneous coronary intervention or coronary bypass graft surgery. Patients with unstable angina, myocardial infarction, congestive heart failure, cardiomyopathy and vasospastic angina were excluded. After investigation of the sensitivity of BMIPP, the patients with single-vessel disease without collateral flow were classified into the normal 12 3 I-BMIPP uptake group (normal group) or decreased 123 I-BMIPP uptake group (decreased group), and various factors were compared between the two groups. Sensitivity was 61% overall, 58% in single-vessel disease, 69% in double-vessel disease, 53% in triple-vessel disease, 43% in only left main vessel disease, and 89% in left main and other vessel disease (NS). In single-vessel disease, the sensitivity was 40% in 75% coronary artery stenosis, 58% in 90% stenosis, 89% in 99% stenosis, and 69% in total occlusion (p=0.003). Comparing the decreased and normal groups, diabetes mellitus was more frequent in the normal group (14.6% vs 39.5%), minimal lumen diameter was smaller (0.75±0.37 vs 0.98±0.49 mm) and lesion length was longer in the decreased group (15.4±4.9 vs 11.6±5.5 mm). Logistic multivariate analysis showed that the independent factors were diabetes mellitus [odds ratio 0.20, 95% confidence interval (CI) 0.04-0.87, p=0.03], minimal lumen diameter (odds ratio 0.10, 95% CI 0.02-0.48, p=0.003) and lesion length (odds ratio 1.12, 95% CI 1.00-1.25, p=0.03). BMIPP is useful in stable angina patients because of the acceptable sensitivity. Diabetes mellitus, minimal lumen diameter and lesion length were independent factors associated with decreased BMIPP uptake. (author)

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

Science.gov (United States)

Kones, Richard

2010-01-01

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

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

Science.gov (United States)

Kones, Richard

2010-08-09

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

Factorización de los síntomas no dolor osos de la dismenorrea primaria y su cambio a lo largo de la edad: estudio en la Comunidad de Madrid

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CRISTINA LARROY

2001-01-01

Full Text Available El presente estudio tiene como doble objetivo: (a determinar si la estructura de los síntomas no dolorosos de la dismenorrea primaria, en la Comunidad Autónoma de Madrid, se corresponde con la utilizada normalmente en los trabajos al uso; y (b determinar si los síntomas de la dismenorrea varían en función de la edad de las mujeres estudiadas. Los resultados indican que los síntomas, en las muestras estudiadas, no se corresponden plenamente con los tradicionalmente asociados a la dismenorrea, aunque presentan cierta similitud con éstos, tienen un carácter netamente psicofisiológico y se mantienen estables a lo largo del tiempo, no mostrando diferencias notables entre los grupos de edad estudiados.

Docentes de inglés de primaria, secundaria y terciaria: Sus creencias pedagógicas sobre sus estudiantes

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Claudio Díaz-Larenas

2015-01-01

Full Text Available Como agente reflexivo de su propia práctica, el profesorado construye creencias pedagógicas sobre el proceso de enseñanza y aprendizaje y, en particular, sobre el rol que sus estudiantes deben asumir en el aprendizaje de un idioma. Este estudio tiene como objetivo identificar las creencias pedagógicas de treinta docentes de inglés de primaria, secundaria y terciaria, en Chile, sobre el rol estudiantil en el proceso didáctico. Un cuestionario, una entrevista semi-estructurada, un diario auto-biográfico y cinco diarios de observación no-participante fueron utilizados para revelar las creencias pedagógicas de sus informantes. Los datos arrojados por los instrumentos fueron analizados con el programa cualitativo ATLASTI, que permitió el levantamiento de tres dimensiones y diez categorías, mediante el uso de la técnica del análisis de contenido semántico. Los resultados muestran que los tres grupos de profesorado declaran que estudiantes que aprenden una lengua extranjera deben tener características personales y académicas relacionadas con la motivación, la participación, la autonomía, entre otras; sin embargo, al interior del aula asumen un rol pasivo y reactivo frente al ambiente de enseñanza altamente estructurado que genera el personal docente. En conclusión, las creencias que cada docente sostiene se alimentan de la teoría y se corroboran o cuestionan en la práctica de aula, a modo de una relación bidireccional entre teoría y práctica, y viceversa.

Estrés laboral y síndrome de burnout en docentes cubanos de enseñanza primaria

OpenAIRE

Oramas Viera, Arlene

2013-01-01

El estrés laboral y el síndrome de burnout en el docente cubano de enseñanza primaria, a pesar del impacto negativo que suelen tener en la salud y el desempeño profesional, han sido poco estudiados. En el presente trabajo, con el objetivo de detectar la presencia del estrés laboral y el síndrome de burnout, en una muestra de 621 docentes de enseñanza primaria en cuatro provincias, se utilizó el Inventario de estrés para maestros, la Escala sintomática de estrés y el Inventario de burnout de M...

Conocimiento de maestros de primaria sobre el trastorno por déficit de atención e hiperactividad

OpenAIRE

Reyes,Marina; Acuña,Laura

2012-01-01

El propósito del estudio fue averiguar la influencia del sexo, edad y clase social de maestros de primaria respecto del Trastorno por Déficit de Atención e Hiperactividad (TDAH), sus causas y como tratarlo. El estudio también averiguó la influencia del grado escolar y del tamaño del grupo que atendían los maestros, así como del tipo de escuela en la que trabajaban. Maestros de primaria (N = 691) señalaron si sabían qué era el TDAH y en caso afirmativo escribieron en qué consiste. También escr...

Metodologías innovadoras para enseñanza de la lengua inglesa en la Educación Primaria

OpenAIRE

Salvador Esteban, Manuel Mariano

2016-01-01

La realización de este trabajo de fin de grado trata de poner de manifiesto la necesidad imperante que existe hoy en día del uso de metodologías innovadoras para la enseñanza de la lengua inglesa en educación primaria. Para ello se ha seguido un camino que comienza con el análisis de la situación de la lengua inglesa dentro del currículo de Educación Primaria que propone la LOMCE. El estudio no ha atendido únicamente a las propias especificaciones de la asignatura, sino que también la ha p...

Análisis de desigualdades en el trato adecuado en las Unidades de Atención Primaria de los Servicios Estatales de Salud de México

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Christian Díaz de León Castañeda

2018-01-01

Full Text Available Objetivo: Analizar desigualdades en el trato adecuado en la atención a pacientes sin seguridad social que utilizan servicios de salud ambulatorios en las Unidades de Atención Primaria (UAP de los servicios estatales de salud de la Secretaría de Salud, en México.Métodos: Se trata de un diseño transversal y ecológico que plantea como unidades de análisis las entidades federativas de México. Se utilizaron datos de tiempo de espera y percepción de calidad en la atención que reportaron los usuarios en la Encuesta Nacional de Salud y Nutrición (ENSANUT 2012. Se plantearon algunos Indicadores de Trato Adecuado (ITA, y se calcularon indicadores de desigualdad sugeridos en la literatura. Asimismo, se recopilaron de la literatura Indicadores Proxy de Determinantes Sociales de la Salud (IPDSS con fines de analizar la posible asociación entre ITA e IPDSS a través de análisis de correlación y regresión (índice de efecto.Resultados: Se identificaron desigualdades en los ITA planteados entre las entidades federativas de México, principalmente en los indicadores de tiempo de espera (disparidad absoluta 52.7 min y disparidad relativa 1.9 para la media estatal en tiempo de espera. Asimismo, se identificaron asociaciones significativas entre ITA e IPDSS. Particularmente, se encontró asociación entre todos los ITA propuestos y la tasa estatal de UAP, aunque con débil índice de efecto.Conclusiones: Persisten desigualdades en el trato adecuado durante la prestación de servicios ambulatorios a población sin seguridad social. Es necesario trabajar más en subsanar desigualdades y promover la equidad en salud.

Cribado para el trastorno bipolar en pacientes de atención primaria que presentan síntomas psicológicos

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Enric Aragonès

2015-03-01

Conclusiones: El cribado del TB en pacientes de atención primaria con otros problemas psicológicos da lugar a una notable proporción de resultados positivos, lo que indica que puede haber una prevalencia relevante de pacientes con TB, la mayor parte de ellos no diagnosticados y no tratados adecuadamente. Es necesario profundizar en la investigación para determinar el eventual papel que puede o debe asumir la atención primaria en la detección, el diagnóstico o el manejo de este trastorno.

La comprensi??n lectora en Educaci??n Primaria: una investigaci??n sobre las inferencias como estrategia b??sica de lectura

OpenAIRE

Rico Tello, Marina

2015-01-01

La comprensi??n lectora es una capacidad b??sica que debe adquirir el alumnado a lo largo su vida escolar y familiar, es por ello por lo que se llevar a cabo una investigaci??n educativa sobre la comprensi??n literal e inferencial en 22 alumnos de 3o de Educaci??n Primaria en el Centro de Educaci??n Infantil y Primaria Alcazaba (Granada). Se examinan las destrezas de las que disponen para comprender el significado literal e inferencial de un texto continuo o discontinuo a trav??s de una in...

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...

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

Effect of PCI on inflammatory factors, cTnI, MMP-9 and NT-pro BNP in patients with unstable angina pectoris

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Ke-Tong Liu

2016-05-01

Full Text Available Objective: To investigate the effect of PCI on inflammatory factors, cTnI, MMP-9and NTpro BNP in patients with unstable angina pectoris. Methods: A total of 80 unstable angina pectoris patients were divided into observation group (40 cases and control group (40 cases. The observation group was given the therapy of PCI, and the control group was given coronary angiography. To observe the of inflammatory factors, cTnI, MMP-9 and NT-pro BNP were tested and compared before and after operation. Results: At 24 h after operation, CRP and IL-18 levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups; At 24 h after operation, cTnI, MMP-9 and NT-pro BNP levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups. Conclusion: PCI therapy can induce inflammation and myocardial injury in patients with unstable angina pectoris.

Adenosine stress and exercise 99Tcm-MIBI myocardial perfusion imaging in the diagnosis and risk stratification of patients with unstable angina

International Nuclear Information System (INIS)

Jia Peng; Guo Wanhua; Xu Shoulin; Feng Xuefeng

2008-01-01

Objective: The aim of this study was to evaluate the clinical value of adenosine stress or exercise 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging in the diagnosis and risk stratification of patients with unstable angina. Methods: Eighty-seven hospitalized patients with unstable angina [54 men and 33 women, aged of (56.5±12.5) years] underwent adenosine stress or exercise myocardial perfusion imaging and coronary angiography. Patients were followed up. Results: Fifty-seven patients had abnormal myocardial perfusion imaging and significant coronary artery stenosis. Ten patients had abnormal myocardial perfusion imaging but normal coronary angiography. Eight patients had normal myocardial perfusion imaging but significant coronary artery stenosis. Twelve patients had normal myocardial perfusion imaging and normal coronary angiography. Patients with abnormal myocardial perfusion imaging had worse prognosis. There was relationship between cardiac events and the extent and severity of myocardial ischemia. Conclusion: Adenosine stress and exercise myocardial perfusion imaging is of important clinical value in the diagnosis and risk stratification of patients with unstable angina. (authors)

Role of platelet parameters and haematological indices in myocardial infarction and unstable angina

International Nuclear Information System (INIS)

Yaghoubi, A.; Golmohamadi, Z.; Alizadehasi, A.; Azarfarin, R.

2013-01-01

Objective: To explore the significance of platelet parameters, including mean platelet volume, platelet count and other haematological indices, in patients of acute coronary syndrome. Methods: In this one-year retrospective cross-sectional study in 2010, a total of 631 patients were enrolled at the Cardiovascular Research Institute, Tabriz University of Medical Sciences, Iran, and classified into three groups: myocardial infarction, unstable angina, and Control. Cardiovascular risk factors such as smoking, diabetes mellitus, hyperlipidaemia and hypertension status were compared. Blood samples were collected for the measurement of platelet count, mean platelet volume and other haematological indices, including prothrombin time, partial thromoplastin time, blood group and Rh, haematocrit, haemoglobin, and erythrocyte sedimentation rate. SPSS 18 was used for statistical analysis. Results: Of the total, there were 210 (33.3%; 163 men, 47 women) with myocardial infarction whose mean age was 62.7+-14.2 years; 211 (33.3%; 110 men, 101 women) had unstable angina with a mean age of 63.5+-13.1 years and 210 (33.3%; 117 men, 90 women) health controls with a mean age of 60.6+-12.8 years. The mean platelet volume values of patients in the first two groups were significantly higher than the control group (10.14 +-1.05 fL, 9.82 +- 0.93 fL and 9.34+-1.14 fL, respectively; p< 0.001). The platelet count was detected to be significantly lower in the patients than the controls (207.92+-58.40*109/L, 220.18+-65.81*109/L, 238+-56.10*109/L, respectively, p<0.001). While blood cell count was significantly higher in those with myocardial infarction compared to the unstable angina patients and control group (P<0.001). Differences in mean values of mean platelet volume between the two patient groups was not significant, but mean values of platelet count was statistically significant between these two groups (p<0.04). Conclusion: Mean platelet volume and platelet count may be considered

Hábitos alimentarios y su relación con el estado nutricional de los estudiantes del V ciclo (5° y 6° grado) del nivel primaria de la Institución Educativa Nº 106 Abraham Valdelomar, Santa Anita - 2014

OpenAIRE

Vicente Huamán, Ibis Julia

2015-01-01

En el presente trabajo de investigación se planteó el problema ¿Cuál es la relación entre los hábitos alimentarios y el estado nutricional de los alumnos del V Ciclo (5º y 6º grado) de primaria de la Institución Educativa. Nº 106 Abraham Valdelomar del distrito de Santa Anita – 2014? Para lo cual se seleccionó una muestra probabilística constituida por 148 estudiantes en quienes se recogió las medidas antropométricas de peso y talla con las cuales se encontró el Índice de Masa Corporal. Los r...

Afectos y algoritmos alternativos en las aulas de primaria

OpenAIRE

Gamazo Alonso, Natalia

2017-01-01

El presente Trabajo Fin de Grado (TFG) recoge una sencilla investigación sobre la evolución del dominio afectivo matemático de una muestra de niños que trabajan las matemáticas con el método ABN (Abierto Basado en Números) y de una muestra de alumnos que las trabajan mediante algoritmos tradicionales. Junto con el análisis de la evolución de la afectividad hacia las matemáticas a lo largo de los cursos académicos que conforman la Educación Primaria, se establece también una comparativa ent...

Clinical usefulness of delayed exercise images on 99mTc-tetrofosmin myocardial SPECT in the diagnosis of vasospastic angina pectoris

International Nuclear Information System (INIS)

Ito, Kazuki; Zen, Kan; Hikosaka, Takatou; Adachi, Yoshihiko; Yoneyama, Satoshi; Katoh, Shuuji; Sugihara, Hiroki; Nakamura, Tomoki; Azuma, Akihiro

2000-01-01

This study was designed to evaluate the clinical usefulness of delayed exercise images in 99m Tc-tetrofosmin (TF) myocardial SPECT in the diagnosis of vasospastic angina pectoris. We studied 30 patients with vasospastic angina, 10 of 30 patients (group A) had both effort and rest angina, 20 of 30 patients (group B) had rest angina. A 370 MBq of TF was intravenously injected at peak exercise, and initial (EX-I) and delayed exercise (EX-D) images were obtained at 30 min and 180 min after the injection. An additional 740 MBq of TF was intravenously reinjected after EX-D image acquisition, and rest images were obtained 30 min after the reinjection. The left ventricular wall was divided into 9 segments. Regional myocardial uptakes of TF were scored by 4-point defect score (0=normal, 1=mildly reduced, 2=moderately reduced, and 3=severely reduced). Total defect score (TDS) was calculated from the sum of defect scores in 9 segments. Reverse redistribution (RR) was defined as increase of more than 2 in TDS on EX-D images. In group A, 4 of 10 cases (40%) showed decreased uptake on EX-I images, 6 of 10 cases (60%) revealed RR on EX-D images, and none of the patients showed decreased uptake on rest images. In group B, no one showed decreased uptake on EX-I and rest images, 11 of 20 cases (55%) revealed RR on EX-D images. The mean±SD of TDS were 2.9±3.4, 5.1±4.5, 0.5±0.5 on EX-I, EX-D, rest images in group A, and serially 0.4±0.5, 3.3±3.6, 0.4±0.5 in group B. Regional wall motion abnormality was reduced in regions with RR. RR on EX-D images may reflect ischemic damaged but viable myocardium in vasospastic angina. The clinical usefulness of exercise-rest TF imaging in detection of organic coronary artery disease has been well established. Therefore, exercise-rest TF imaging with additional delayed exercise image could evaluate not only organic coronary artery disease but also coronary artery vasospasm. (author)

A long-acting calcium antagonist over one year did not improve BMIPP myocardial scintigraphic imagings in patients with pure coronary spastic angina

International Nuclear Information System (INIS)

Sueda, Shozo; Oshita, Akira; Izoe, Yousuke; Kohno, Hiroaki; Fukuda, Hiroshi; Ochi, Takaaki; Uraoka, Tadao

2007-01-01

Calcium antagonists (Ca) have been effective in reducing angina attacks in patients with variant angina. However, there are no reports regarding the effectiveness of Ca on myocardial fatty acid metabolic images in patients with pure coronary spastic angina (CSA). This study sought to examine the correlation between myocardial fatty acid metabolic images and the medical treatment of Ca in patients with pure CSA. This study included 35 consecutive patients (28 men, mean age of 66±10 years) with angiographically confirmed coronary spasm and no fixed stenosis. Long-acting Ca was administered to all 35 patients. Isosorbide dinitrate/nicorandil/another Ca/beta-blocker were administered when chest pain was not controlled. Using an iodinated fatty acid analogue, 15-(p-[iodine-123]iodophenyl)-3-(R,S)methylpentadecanoic acid (BMIPP), myocardial scintigraphies with intravenous adenosine triphosphate infusion were performed before cardiac catheterization and 12 mo after medical therapy. According to the medical control states, these 35 patients were classified into 3 groups; response (disappearance of angina attacks, 12 pts, 60±11 years), partial response (angina attacks <4/mo, 12 pts, 67±10 years), and no response to therapy (angina attacks ≥4/mo, 11 pts, 71±6 years). Reduced BMIPP uptake was observed in 24 (69%) of 35 patients before the treatment. Reduced BMIPP uptake was also found in 18 patients (51%) after 12 mo. Normal BMIPP uptake after 12 mo therapy was observed in about half (response: 42%, partial response: 58%, no response: 45%) of patients among the 3 groups. There was no difference regarding the value of washout rate (WOR) (response; 10±7 (before), 14±8% (12 mo)), partial response; 11±7, 10±5%, no response; 13±9, 14±8%) among the 3 groups. The defect scores of BMIPP in the three groups were not different during at least one year medical therapy. No difference regarding the distribution of other medical therapies (angiotensin converting enzyme

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

Relación entre la capacidad creativa y el asentamiento de la lateralidad en alumnos del Segundo Ciclo de Educación Primaria

OpenAIRE

Lorenzo-Macías, María Isabel

2013-01-01

El objetivo de este estudio es examinar la relación a nivel neuropsicológico entre la lateralidad y los procesos creativos, es decir, explorar la posible relación entre los niveles de capacidad creativa con los distintos tipos de lateralidad (establecida y no establecida). Se aplicaron el test de Pensamiento Creativo de Torrance (expresión figurada) (1974) para valorar creatividad y test de lateralidad de la prueba neuropsicológica (adaptado por Martín Lobo, Gª -Castellón, Rodr...

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...

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...

La investigación y la evolución reciente de la atención primaria Research and the recent evolution of primary health care

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L. Palomo

2002-04-01

Full Text Available La atención primaria en España ha pasado de una etapa de desarrollo florido, en la década de los ochenta, a otra de estancamiento en los noventa, caracterizada por la escasa creatividad, por la rutinización de las tareas y por la puesta en marcha de carteras de servicios y contratos programa. Por otra parte, los recientes cambios en la orientación de la investigación promovida desde la administración sanitaria, a favor de la investigación básica y en detrimento de la investigación en servicios y la epidemiología clínica, contrastan con la importancia de la atención primaria como ámbito natural de abordaje de numerosos agentes causales y prácticas de riesgo para la salud. A pesar de estas limitaciones, la cultura de la investigación ya se ha instalado en un buen número de centros de salud y de farmacias, y la investigación en atención primaria ha ido teniendo una mayor presencia en las revistas científicas. Sin embargo, es necesario gestionar la investigación, también desde las estructuras de atención primaria, de manera específica y diferenciada, favoreciendo la priorización, la evaluación y la responsabilidad mediante fórmulas organizativas flexibles y sistemas de información específicos. Ello debería incluir fórmulas de contratación y de relación laboral flexibles, que permitan la dedicación a la investigación, siquiera a tiempo parcial, así como modelos de carrera profesional que reconozcan las actividades de investigación y docencia. Las asociaciones científicas y profesionales de la atención primaria tienen ante sí el reto de mantener proyectos de investigación activos, incrementar su presencia entre los profesionales, emitir su opinión ante los problemas del sector y reforzar su organización y comunicación.Primary care in Spain has undergone a burgeoning phase in the 80's, followed by a decade of stagnation in the 90's, with little creativity, a routinisation of tasks, and the set up of service

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

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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.

Habilidades del pensamiento creativo asociadas a la escritura de textos multimodales. Instrumento para su evaluación en la Educación Básica Primaria

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Dora Inés Chaverra-Fernández

2016-12-01

Full Text Available El estudio que aquí se reporta tiene un carácter exploratorio y fue desarrollado a partir de una metodología mixta con estudiantes de quinto grado de una institución educativa rural. Tiene como propósito general contribuir al uso pedagógico de las tic en la Educación Básica Primaria mediante la indagación de las habilidades del pensamiento creativo y la escritura de textos multimodales. El artículo se enfoca en la presentación de los resultados relacionados con: a el diseño y la validación del instrumento para evaluar las habilidades del pensamiento creativo vinculadas a la escritura de textos multimodales; b la asociación existente entre estas dos variables; y c la posibilidad de potenciar este tipo de pensamiento en la escuela mediante actividades de escritura digital intencionadas, representativas y transversales al currículo escolar.

Optimization of the clinical course of stable angina pectoris with the use of omega-3 polyunsaturated fatty acids and combined magnetotherapy

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K. O. Zolotarova

2016-12-01

Full Text Available The article presents the results of the study of the comparative efficacy of the protocol for angina pectoris medication and combined therapy with the use of ω-3 PUFA and magnetotherapy on the dynamics of the frequency of anginal attacks of patients with stable angina. It was found that the use of ώ-3 PUFA and MT in therapy allows a significantly higher and further reduction in the frequency of attacks compared with standard therapy, and this effect is largely due to the influence of MT and to a lesser extent - the effect of omega-3 polyunsaturated fatty acids.

Ideas previas sobre el reino vegetal en niños entre los 7 y 10 años de tercero de primaria de la Escuela Normal Superior Distrital María Montessori (E.N.S.D.M.M.

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Daniela Gomez

2015-12-01

Full Text Available La presente investigación busca reconocer las ideas previas sobre el reino vegetal en niños entre los 7 y 10 años. Se eligió un grupo de 37 estudiantes de tercero de primaria perteneciente a la E.N.S.D.M.M., con los cuales se implementó un instrumento de caracterización tipo cuestionario conformado por 3 preguntas referentes al reino vegetal. A partir de las respuestas dadas por los niños, se clasificaron sus ideas previas generando categorías de estas, posterior a ello, con la referencia de las 3 fuentes de origen (sensorial, social y analógica siendo la social en la cual se basa este trabajo; se generaron dos sub-categorias (experiencia cotidiana y  experiencia académica y, en esta última  se tuvieron en cuenta los modelos explicativos de nutrición vegetal para lo cual fue necesario analizar conceptos claves como respiración, morfología, metabolismo e interacciones con el medio. Como resultado de la caracterización se determinó que las construcciones mentales sobre el reino vegetal en estos estudiantes son mediadas por la experiencia cotidiana y son frecuentemente nutridas, modificadas o adecuadas por este a pesar de lo adquirido en la escuela, además se estableció que los modelos de nutrición vegetal más comunes en las representaciones de los niños a esta edad son el edáfico y el de transmutación

The value of myocardial scintigraphy in hypertrophic cardiomyopathy with angina pectoris

International Nuclear Information System (INIS)

Bergen, J.M.; Simons, M.

1981-01-01

Myocardial scintigraphy with thallium-201 is a new, non-invasive diagnostic method by means of which on special indications ischaemic heart diseases may be demonstrated. The case history is described of a man with hypertrophic cardiomyopathy and angina pectoris. The electrocardiogram at rest was affected by the cardiomyopathy to such a degree that the interpretation of the ST-T segment during effort was not reliable. Scintigraphy revealed transient ischaemia. A bypass operation was carried out and post-operatively, the improved myocardial perfusion could be confirmed by myocardial scintigraphy. (Auth.)