Biomedical subjects

F Ayala

Publications and source records attributed to F Ayala.

131 records · Page 8Linked to original sources

PubMedDate not supplied

[The first myocardial infarct in the elderly patient].

UNLABELLED: Acute myocardial infarction (AMI) in patients over 65 years of age represent more than half of the patients with AMI. Among them, between 60 and 80% represent the first AMI. The objective of this study is to evaluate the behavior of AMI in this group of patients. The clinical charts of patients over 65 years of age with ischemic heart disease admitted into the hospital during the past two years, were reviewed. We used the international criteria (clinical, ECG, enzymatic, echocardiographic and scintigraphic studies) for the diagnosis of AMI. Patients with previous AMI were excluded. We included 274 patients (68% males and 32% females). The age varied from 65 to 91 years with an average of 71.7 +/- 5.3 years. Typical symptoms were present in 90.5% and atypical in 9.5% of the cases, being the latest most frequent in those over 75 years of age. RISK FACTORS: cigarette smoking was present in 60% of the patients, hypertension in 52% and diabetes mellitus in 37%. Both of them were associated in 21%. In 144 cases (52.5%) the MI localization was anterior and in 130 (47.5%) inferior; among them 47 patients (36%) had extension to the right ventricle and 7 (2.5%) had a non Q AMI. COMPLICATIONS: Type I-II VPCs of Bernard Lown were present in 18% and type V 10.2%. Compete AV block in 14.2% (all of them with inferior wall MI); bifascicular block in 55 and mitral insufficiency due to papillary muscle dysfunction in 6.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Distribution↗

PubMedDate not supplied

[The echo-dobutamine pharmacological stress test in ischemic cardiopathy].

We report our experience with Echo-Dobutamine stress test. In order to evaluate the sensitivity, specificity and the safety, of the pharmacologic echo-dobutamine stress test, we studied 30 patients with ischemic heart disease based on clinical history, 2D echocardiogram, standard exercise stress test and cardiac catheterization. The test was started under continuous videotape of the segmental left ventricular motility on the conventional views. Dobutamine was administer intravenously 2.5 to 40 micrograms/kg/min every 3 minutes, the mean higher dobutamine dose was 19 +/- 14.3 micrograms/kg/min, having a continuous electrocardiographic monitoring of the heart rate as well as blood pressure. The myocardial motility was recorded with each increment in the dobutamine dose. Among the cases, 22 were males and 8 females with an average age of 55 +/- 9 years. Twenty two patients had history of remote myocardial infarction and were asymptomatic at the moment of the test; 8, who had angina pectoris were on a functional class I-II of the CCS. The mean basal ejection fraction was 62.6 +/- 11.7% by echo vs 64.4 +/- 16.8% obtained by cardiac catheterization (p no significant). There were no arrhythmias in any case. The heart rate increased from 68.7 +/- 10.1 to 85.5 +/- 15.7 beats per minute (p < 0.001). The systolic B/P was increased from a mean of 124 +/- 14.5 to 138.3 +/- 14.4 mmHg (p < 0.0005) while the diastolic pressure varied from 82.3 +/- 8.2 to 90.8 +/- 9.6 mmHg (p < 0.001). There were no severe complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Percutaneous transluminal coronary angioplasty. The experience of the Hospital de Especialidades of the La Raza Medical Center, IMSS].

UNLABELLED: We analyzed the initial results of the PTCA program at the Hospital de Especialidades CMR, IMSS. During the last year we studied 33 patients in whom we performed 35 PTCA procedures with total of 45 lesions. The age of the patients varied from 27 to 75 years of age (average 57 year +/- 10.9). Among them, 84.8% were males and 15.2% females. In 54.5% of the patients, stable angina was present, whereas in 45.5% unstable angina was observed. Multivessel disease was detected in 39.4% of the cases. In 17.8% the coronary lesions were type "A", in 77.8% type "B" and in 4.4% type C. The most frequent lesions were present at the left anterior descending artery in 46.6%, right coronary artery in 40% and circumflex in 13.4%. The global procedural success was 88.5% (32/35 procedure) whereas the procedural success by isolated lesion was 88.8% (40/45 lesions). The average artery stenosis was decreased from 85 +/- 10.4% to 23 +/- 16%. A procedural failure occurred in 4 instances (11.4%), among them, 2 (5.71%) without complications and 2 more, associated to acute myocardial infarction. In the present study there were no emergency operation neither deaths. CONCLUSIONS: Although the number of PTCA performed in our hospital is limited, we consider that the initial results are good, with a success rate of 88.5% with a minimal complications.

Adult↗

PubMedDate not supplied

[Percutaneous mitral commissurotomy using Inoue's balloon during pregnancy].

The authors present three cases of pregnant women with symptomatic severe mitral stenosis with a mean age of 28.6 +/- 2.3 years, and during 27.6 +/- 1.52 weeks of pregnancy. Two patients were in class III and one in class IV of the New York Heart Association (NYHA). All patients had a mitral valvular area equal or less than 1 cm2, with a Wilkins score of 7 to 9 and mitral insufficiency grade I in two cases; two, had severe pulmonary arterial hypertension (mean > 50 mm Hg). After Percutaneous Mitral Valvuloplasty (PMV) the mitral valve measured by 2D echocardiography increased form 0.83 +/- 0.2 cm2 to 1.8 +/- 0.15 cm2; the mean transmitral gradient diminished from 13 +/- 3.4 mm Hg to 3.6 +/- 1.15 mm Hg; the degree of mitral insufficiency was no modified in neither case. Hemodynamic results revealed increasing of the mitral valve from 0.83 +/- 0.18 cm2 to 2.23 +/- 0.3 cm2; the mean mitral gradient decreased from 21.6 +/- 9 to 4.3 +/- 0.5 mm Hg; the mean left atrial pressure from 30 +/- 12 to 12.3 +/- 4 mm Hg; the mean pressure of the pulmonary artery diminished suddenly from 44.3 +/- 16 to 25.6 +/- 11 mm Hg. The average fluoroscopic time was 15.3 +/- 3 minutes. There were no complications. The patients were discharged 48 hours after the procedure and continued their pregnancies in class I NYHA, which resolved in a non complicated vaginal delivery with normal products. We conclude that PMV is a safe and useful therapy in pregnant patient with severe mitral stenosis refractory to medical treatment.

Adult↗

PubMedDate not supplied

[Parenteral nutrition of patients under intensive chemotherapy: comparative study of two lipid emulsions].

Neoplastic patients receiving intensive chemotherapy often need total parenteral nutrition (TPN), with lipid emulsions based on long-chain triglycerides (LCT) or medium-chain triglycerides (MCT). Potential benefits of MCT include easier metabolism and limited storage. Our present investigation was performed to define if there is any real clinical advantage of any of these lipid emulsions in this group of patients. Fifty-one patients receiving the LCT emulsion and sixty of them receiving the MCT-LCT one were evaluated retrospectively. TPN with 40% of non-protein kilocalories as fat was administered during a mean time of 11.5 days. No differences in total cholesterol, albumin, prealbumin, transferrin, bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase and transaminases were found between both groups, neither in nitrogen balances. In conclusion, in a group of neoplastic patients receiving intensive chemotherapy, we did not found any advantage of TPN with LCT or MCT-LCT either in nutritional laboratory parameters or in liver function.

Antineoplastic Combined Chemotherapy Protocols↗