oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Diagnóstico y tratamiento de la enfermedad carotídea aterosclerótica extracraneal asintomática Diagnosis and treatment of asymptomatic extracranial atherosclerotic carotid artery disease
Luciano A. Sposato,Patricia M. Riccio,Francisco R. Klein
Medicina (Buenos Aires) , 2011,
Abstract: La enfermedad aterosclerótica asintomática de la arteria carótida interna extracraneal alcanza una prevalencia de hasta el 12.5%. La angioplastia carotídea todavía no ha demostrado ser lo suficientemente segura y eficaz para prevenir el ACV isquémico en estos pacientes. Estudios aleatorizados demostraron que la endarterectomía carotídea es superior al tratamiento médico en cuanto a reducción del riesgo de ACV isquémico si es realizada por equipos con tasas de complicaciones (ACV o muerte) menores que 3%. Sin embargo, los pacientes evaluados en estos estudios comenzaron a reclutarse hace más de 25 a os, cuando la utilización de antiagregantes plaquetarios era menor que la actual, el tratamiento de la hipertensión arterial era menos efectivo y todavía no se usaban estatinas como componentes fundamentales de los esquemas de prevención vascular. La optimización de la calidad del tratamiento médico en las últimas décadas ha llevado a una significativa reducción del riesgo de ACV en pacientes no intervenidos quirúrgicamente. En base a estas observaciones y con la excepción de casos específicos, el tratamiento médico es la opción terapéutica de elección en pacientes con enfermedad aterosclerótica carotídea extracraneal asintomática. The reported prevalence of asymptomatic atherosclerotic disease of the extracranial internal carotid artery is up to 12.5%. Carotid angioplasty has not yet proven safe and effective enough to prevent ischemic stroke in these patients. Randomized studies showed that carotid endarterectomy is superior to medical therapy in reducing the risk of ischemic stroke when performed by surgical teams with complication rates (stroke or death) of less than 3%. However, recruitment of these patients began more than 25 years ago, when the use of antiplatelet agents was lower than today, the treatment of hypertension was less effective than currently, and statins were not considered as key components of vascular prevention strategies. Optimizing the quality of medical treatment in recent decades has led to a significant reduction in stroke risk in patients not undergoing surgery. Based on these observations and with the exception of specific cases, medical therapy is the treatment of choice for patients with asymptomatic atherosclerotic disease of the extracranial carotid arteries.
Lesión carotídea extracraneal asintomática y su asociación con cardiopatía isquémica silente
Hernández Pino,Yadira; González Escudero,Hilda; Pacheco Granja,Griselda; Rivero Varona,Martha M.;
Revista Cubana de Medicina , 2006,
Abstract: 71 patients of both sexes aged 60-75 who were diagnosed extracranial carotid damage, but were asymptomatic from the neurological and cardiovascualr point of view, were studied. all of them underwent high resolution color carotid echodoppler and were divided into categories, according to the vascular damage: 30 with intima media thickness >1,1 mm and 41 con stenosis, in addition to a control group of 30 subjects with vascular risk factor without carotid injury. ekg and an ergometric test were performed in all the individuals to define the diagnosis of silent ischemic heart disease. this diagnostic tool was modified for the elderly. recommendations of conditioning and preventive measures were included for any complication.the variables were codified in a computerized database, and contingency (doble entry) tables were made. chi square test was used for the qualitative variables to evaluate the association between the variables of interest, whereas the t students' test was applied to the quantitative variables.the results were considered significant when the probability of association of the tests was < 0.05. the time of action of the vascular risk factors showed a close relation to the carotid damage, mainly smoking (38.2 years as an average). the behavior of the action of the risk factors on the coronary arteries was evidenced in this same order of frequency by the ergometric test. the coincident relation between the carotid and the coronary damage was proved. there was a higher percentage of positive ergometric tests among the elderly with carotid stenosis (57.7 %).
Síndrome del seno silente Silent sinus syndrome  [cached]
Ricardo Trueba,Alfredo Pallante,Alfredo E Buzzi
Revista Argentina de Radiología , 2008,
Abstract: Presentamos un caso de síndrome del seno silente. Se trata de una entidad infrecuente caracterizada por enoftalmos provocada por atelectasia homolateral del seno maxilar sin síntomas nasales ni paranasales. Si bien el diagnostico es clínico, la confirmación se logra mediante las imágenes. We present a case of silent sinus syndrome. It is an uncommon entity characterized by enoftalmos caused by homolateral atelectasia of the maxillary sinus without nasal nor paranasal symptoms. Although the diagnoses is clinical, the confirmation is achieved by images.
Lipoma intrapericárdico gigante silente Silent giant intracardiac lipoma
álex Valencia,Miguel Lombo,Juan Correa
Revista Colombiana de Cirugía , 2011,
Abstract: Los tumores benignos cardiacos son una entidad con diferentes características según su localización y compromiso. En este artículo se describe el caso de una paciente con un lipoma gigante con síntomas insidiosos y silentes, que hacen de ésta una enfermedad de larga data y de difícil diagnóstico. Cardiac tumors are benign entities with different with characteristics depending on their location and degree of involvement. We report a patient with a giant lipoma, with insidious and silent symptoms that make this a longstanding disease of difficult diagnosis.
Isquemia miocárdica silente en diabéticos tipo 2 Silent myocardial ischemia in type 2 diabetes patients
Yordanka Pi?a Rivera,Liz Odelmis Cruz Hernández,Judith Parlá Sardi?as,María Magdalena Fernández Marrero
Revista Cubana de Endocrinología , 2012,
Abstract: Objetivos: determinar la frecuencia de isquemia miocárdica silente en diabéticos tipo 2 y su relación con el control metabólico. Métodos: se realizó un estudio descriptivo transversal en 79 pacientes asintomáticos con diabetes mellitus tipo 2 sin antecedentes de cardiopatía isquémica, hipertensión arterial o de ser fumador, que acudieron a la Consulta de Endocrinología del Hospital Militar Central "Dr. Carlos J. Finlay", entre febrero de 2009 y febrero de 2011. Se les realizó ecocardiografía con doppler tisular y se determinaron los niveles de glucemia en ayunas, posprandial, hemoglobina glucosilada, colesterol y triglicéridos. Las variables clínicas analizadas en relación con la isquemia miocárdica silente fueron: edad, sexo, tiempo de evolución de la diabetes e índice de masa corporal. Para las variables cualitativas se utilizaron distribuciones de frecuencia con el cálculo del porcentaje y para establecer relación entre variables la prueba de chi cuadrado. Resultados: la edad media del total de pacientes fue de 54 a os, de ellos el 69,1 % correspondió al sexo masculino y el 31,9 % al femenino. En el 20,2 % de los pacientes se observaron signos de isquemia miocárdica por doppler tisular, y de ellos, un 75 % tuvo niveles patológicos de colesterol total, con relación estadísticamente significativa (p= 0,01), sujetos que tuvieron 4,4 veces más riesgo relativo de presentar isquemia miocárdica, que los pacientes con colesterol normal. Las cifras de glucemia en ayunas, posprandial y hemoglobina glucosilada fueron significativamente mayor en el grupo con isquemia. Los pacientes con niveles elevados de glucemia en ayunas tuvieron 10,5 veces más riesgo de isquemia miocárdica que los que tenían cifras adecuadas. Igualmente, los casos con cifras elevadas de glucemia posprandial presentaron 12 veces más riesgo de enfermar. Conclusiones: la isquemia miocárdica silente es frecuente en los diabéticos tipo 2 y se relaciona con los niveles patológicos de colesterol y el mal control glucémico. Objectives: to determine the frequency of silent myocardial infarction in type 2 diabetes patients and its relation with the metabolic control. Methods: a cross-sectional descriptive study of 79 asymptomatic patients suffering type 2 diabetes mellitus and without a history of ischemic cardiopathy, blood hypertension or smoking. These patients were seen at the endocrinology service of "Dr Carlos J. Finlay" from February 2009 to February 2011. They underwent Doppler tissue imaging echocardiography and their levels of glycemia on fasting, pospandrial glycemia, glycated haemoglobin, c
Hipotensión nocturna y enfermedad cerebrovascular silente Nocturnal hypotension and silent cerebrovascular disease  [cached]
Jesús Pérez Nellar,Germinal álvarez Batard,Aisa Pe?a Casanova
Revista Cubana de Medicina , 2005,
Abstract: La introducción de técnicas para el monitoreo ambulatorio de la presión arterial ha permitido obtener información acerca de las variaciones diurnas de la presión arterial. El patrón de dipper acentuado que equivale a hipotensión nocturna pudiera tener una relación causal específica con enfermedad cerebrovascular silente y lesión de la sustancia blanca mediada por hipoperfusión cerebral. Se presentó un caso con lesiones de la sustancia blanca cerebral sin factores de riesgo vascular convencionales, en el que el monitoreo ambulatorio de la presión arterial demostró una hipertensión ligera con un patrón de dipper acentuado, una condición fisiopatológica susceptible de ser modificada. En el futuro, esta técnica, al parecer, tendrá un uso más extendido en la enfermedad cerebrovascular, especialmente en los ictus lacunares y hemodinámicos, así como en las lesiones vasculares crónicas de la sustancia blanca cerebral. The introduction of the techniques for the ambulatory monitoring of arterial pressure has allowed to obtain information about the day variations of arterial pressure. The pattern of accentuated Dipper may have a specific causal relation to silent cerebrovascular disease and lesion of the white matter mediated by brain hypoperfusion. A case with lesions of the cerebral white matter without conventional vascular risk factors, was presented. The ambulatory monitoring of the arterial pressure showed a mild hypertension with an accentuated Dipper pattern, a physiopathological condition susceptible to be modified. In the future, it seems that this technique will have a wider use in the cerebrovascular disease, specially in the lacunar and hemodynamic ictus, as well as in the chronic vascular lesions of the cerebral white matter.
Mortalidad por hipertensión arterial. Tras la huella del “asesino silente” Hypertension-related Mortality. Chasing the “Silent Killer”  [cached]
Alfredo Darío Espinosa Brito
Finlay : Revista de Enfermedades no Transmisibles , 2012,
Abstract: La hipertensión arterial es el marcador de riesgo aislado conocido más importante de morbilidad y mortalidad cardiovascular. Aunque su prevalencia se puede determinar de una manera relativamente fácil, no sucede lo mismo con la mortalidad relacionada con ella. En este trabajo nos proponemos resaltar –o rescatar- el verdadero lugar que ocupa la hipertensión arterial -el asesino silente- en la mortalidad, a través de la recuperación y recopilación de evidencias disponibles en nuestro país y en nuestro territorio, lo que pretendemos sirva para ratificar la necesidad de considerar a esta enfermedad como verdadera condición trazadora de las enfermedades crónicas no transmisibles en los servicios de salud y, por tanto, la gran actualidad e importancia de su prevención y control. Hypertension is the most important known isolated risk marker for cardiovascular morbidity and mortality. Although its prevalence can be relatively easily determined, mortality related to it does not behave the same way. In this paper we intend to highlight - or rescue - the true role that high blood pressure -"the silent killer"- plays in mortality, through recovery and in the collection of available evidence in our country and in our territory. We expect this serves to confirm the need to consider this disease as a true hint of chronic non-communicable diseases in health services and, therefore, the huge prevalence and importance of prevention and control.
Spontaneous extracranial carotid atherosclerosis evolution in asymptomatic individuals: a three-year prospective study
Gagliardi, Rubens José;Damiani, Ibsen Thadeu;Menoncello, Rogério;Ribeiro, Manoel Carlos Sampaio de Almeida;
Arquivos de Neuro-Psiquiatria , 2004, DOI: 10.1590/S0004-282X2004000400009
Abstract: objective: to evaluate the spontaneous evolution of extracranial carotid atherosclerosis in asymptomatic patients who did not present the main risk factors associated to the disease. method:a prospective study including patients of both genders, age ranging from 40 to 70 years, not presenting any signs and symptoms of cerebrovascular disease and without the main atherosclerosis risk factors were included. patients who were using or had used medication during the follow-up period that could potentially influence in the spontaneous course of atherosclerosis were excluded. the evaluation of the plaque and degree of stenosis were acquired using mode b, 7.5 mhz doppler ultrasonography (usg). the follow-up was carried out for 36 months, with clinical, neurological, and usg exams repeated in a period of 6 to 8 months. ninety-six individuals (48 women) completed the study with the presence of plaque, and 52 (26 women) with a degree of stenosis. results: as to the degree of stenosis, 25% of the patients had worsening, 69% remained stable and 6% improved. when only the presence or absence of plaque was considered, 20% showed worsening (plaque developed during follow-up), 7% improved (disappearance of plaque), and 73% remained stable. no differences were found between the male and female patients. conclusion: these results confirm the dynamic characteristics of plaque. in asymptomatic individuals without specific treatment, spontaneous improvement may occur, however, rarely. these findings may contribute as an assessment criterion when a decision is to be made in high-risk patients.
Spontaneous extracranial carotid atherosclerosis evolution in asymptomatic individuals: a three-year prospective study  [cached]
Gagliardi Rubens José,Damiani Ibsen Thadeu,Menoncello Rogério,Ribeiro Manoel Carlos Sampaio de Almeida
Arquivos de Neuro-Psiquiatria , 2004,
Abstract: OBJECTIVE: To evaluate the spontaneous evolution of extracranial carotid atherosclerosis in asymptomatic patients who did not present the main risk factors associated to the disease. METHOD:A prospective study including patients of both genders, age ranging from 40 to 70 years, not presenting any signs and symptoms of cerebrovascular disease and without the main atherosclerosis risk factors were included. Patients who were using or had used medication during the follow-up period that could potentially influence in the spontaneous course of atherosclerosis were excluded. The evaluation of the plaque and degree of stenosis were acquired using mode B, 7.5 MHz Doppler ultrasonography (USG). The follow-up was carried out for 36 months, with clinical, neurological, and USG exams repeated in a period of 6 to 8 months. Ninety-six individuals (48 women) completed the study with the presence of plaque, and 52 (26 women) with a degree of stenosis. RESULTS: As to the degree of stenosis, 25% of the patients had worsening, 69% remained stable and 6% improved. When only the presence or absence of plaque was considered, 20% showed worsening (plaque developed during follow-up), 7% improved (disappearance of plaque), and 73% remained stable. No differences were found between the male and female patients. CONCLUSION: These results confirm the dynamic characteristics of plaque. In asymptomatic individuals without specific treatment, spontaneous improvement may occur, however, rarely. These findings may contribute as an assessment criterion when a decision is to be made in high-risk patients.
Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease
Marco Matteo Ciccone, Asabella Artor Niccoli, Pietro Scicchitano, et al
Vascular Health and Risk Management , 2011, DOI: http://dx.doi.org/10.2147/VHRM.S16582
Abstract: rdiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease Original Research (5993) Total Article Views Authors: Marco Matteo Ciccone, Asabella Artor Niccoli, Pietro Scicchitano, et al Published Date March 2011 Volume 2011:7 Pages 129 - 134 DOI: http://dx.doi.org/10.2147/VHRM.S16582 Marco Matteo Ciccone1, Artor Niccoli-Asabella2, Pietro Scicchitano1, Michele Gesualdo1, Antonio Notaristefano2, Domenico Chieppa1, Santa Carbonara1, Gabriella Ricci1, Marco Sassara1, Corinna Altini2, Giovanni Quistelli1, Mario Erminio Lepera1, Stefano Favale1, Giuseppe Rubini2 1Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), 2Nuclear Medicine Unit, Department of Internal Medicine and of Public Medicine, University of Bari, Bari, Italy Introduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis. Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries. Results: A statistically significant relationship (P = 0.023) was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively. Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in patients with asymptomatic carotid plaques, considering eventually plaque morphology (symmetry, composition, eccentricity or concentricity of the plaque, etc) for patient stratification.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.