Unusual image.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to P F Pinto.
Explore the source record for details and available documents.
INTRODUCTION: According to recent data, women have a greater risk of dying from an acute coronary event. The determinants of this ominous prognosis are not completely understood. Preliminary analysis of our data suggested that this poorer prognosis is also observed in the subgroup of patients with acute myocardial infarction submitted to direct coronary angioplasty (PTCA). This finding prompted us to investigate gender differences and their determinants in this particular context. OBJECTIVE: To identify risk factors associated with the greater in-hospital mortality of women with acute infarction who underwent PTCA. METHODS: One hundred and forty-five consecutive patients with acute myocardial infarction who underwent direct PTCA in the same hospital were studied retrospectively. Data were collected from the database of the catheterisation laboratory and from clinical files. The following parameters were analysed: in-hospital mortality, age, prevalence of diabetes mellitus, history of coronary heart disease, time elapsed from beginning of symptoms to coronary intervention, peak values of CK and MB-CK, number of coronary arteries with significant disease at angiography, culprit lesion localisation, and prevalence of shock on admission. For statistical analysis, cross-tabulation (Pearson x2) and comparison of means (Student's t test) were employed when appropriate; an error of 5% was admitted for the rejection of the null hypothesis. RESULTS: Women (n = 39) represented 26.9% of sample. In hospital mortality was 28.2% (n = 11) for women and 11.3% (n = 12) for men (p = 0.014). The prevalence of coronary heart disease before the current acute event, the time elapsed from beginning of symptoms to coronary intervention, and maximum values of CK and MB-CK were similar in both genders. Differences between women and men were found as regards the following variables (women vs men): age (61.7 +/- 10 vs 56.1 +/- 12.6 years), prevalence of left main disease (15.3 vs 1.9%) and prevalence of shock (41 vs 17%) and diabetes (38.7 vs 13.6%). Considering women and men who died, only disease severity as evaluated by the number of vessels involved distinguished both genders (p = 0.05). CONCLUSIONS: In our experience, women admitted with acute myocardial infarction and treated by direct PTCA are, on average, older than men and have a greater prevalence of shock at admission, of left main disease and of diabetes, and more severe coronary artery disease. In the present series and as regard in-hospital mortality, disease severity as evaluated by the number of vessels involved is the only variable that discriminates women from men.
Explore the source record for details and available documents.
The metabolic effects of a widely used betamimetic agent (ritodrine) were studied in two groups of pregnant patients with abnormal glucose tolerance. No significance modification of various metabolic parameters was detected when the drug was orally administered in standard doses for at least 1 week. The possible reasons for this finding are discussed. Following the absence of any diabetogenic effect, a prolonged use of betamimetics to achieve tocolysis seems to be safe even in patients with metabolic disorders.
The effects of ritodrine infusion on the cardiovascular system of six women in threatened or premature labour are reported. In contrast to other betamimetics, ritodrine caused a moderate rise in systolic blood pressure, the corresponding fall in diastolic pressure leading to a widened pulse pressure but no risk of hypotension. Ritodrine caused a rise in cardiac output, and was well tolerated by the patients. Special care should be taken in treating patients with known heart disease.
Explore the source record for details and available documents.
Human immunodeficiency virus (HIV)-related dementia and other memory and attention disorders are described in terms of etiology, incidence, and symptoms. Assessment for cognitive impairment includes basic screening (examples are given), or a thorough neuropsychological evaluation. Implications for treatment within the residential drug treatment environment include: (a) providing accurate information to staff and residents; (b) identifying residents' anticipatory anxiety; (c) supportive counseling of residents; (d) coaching residents in the use of coping strategies; (e) creating environmental support; and (f) frequent reassessment of treatment goals, including the appropriateness of independent living. Helpful concrete suggestions are listed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.