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Trabulo C, Gramaça J, Fernandes I, Gameiro-dos-Santos R, Pina I, Ravasco P. Body composition and the cancer patient. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gramaça J, Palma Dos Reis A, Gameiro Dos Santos R, Fernandes I, Trabulo C, Baptista A, Da Luz R, Pina I. Development and evaluation of a real-world data-based prognostic score in castration-resistant metastatic prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03151-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Fernandes I, Gramaça J, Gameiro-dos-Santos R, Trabulo C, Pina I. P-275 Evaluation of radical chemoradiation outcomes in stage II/III anal cancer: Real-world data population. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gramaça J, Fernandes I, Gameiro-dos-Santos R, Pina I. P-283 Prognostic factors in the evaluation of stage II/III squamous cell carcinoma of the anus treated with chemoradiation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nogueira-Costa G, Gramaça J, Fernandes I, Trabulo C, Gonçalves J, Pina I. Survival comparison of HER2 breast cancer patients according to HR status: analysis of a single Portuguese centre. Breast 2021. [DOI: 10.1016/s0960-9776(21)00201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gramaça J, Machado D, Ponte T, Pina I. PO-102 Bleeding management challenges in rare cancer-associated thrombosis: a case report of inferior vena cava thrombus in a patient with testicular germ cell tumour. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00172-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Trabulo C, Gramaça J, Pina I, Ravasco P. Cancer specific and chemotherapy-associated anorexia: Megestrol use in weight losing high risk patients. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nogueira-Costa G, Fernandes I, Gameiro R, Gramaça J, Xavier AT, Pina I. Prognostic utility of neutrophil-to-lymphocyte ratio in patients with metastatic colorectal cancer treated using different modalities. Curr Oncol 2020; 27:237-243. [PMID: 33173374 PMCID: PMC7606052 DOI: 10.3747/co.27.6573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction Inflammation is a critical component in carcinogenesis. The neutrophil-to-lymphocyte ratio (nlr) has been retrospectively studied as a biomarker of prognosis in metastatic colorectal cancer (mcrc). Compared with a low nlr, a high nlr is associated with worse prognosis. In the present study, we compared real-world survival for patients with mcrc based on their nlr group, and we assessed the utility of the nlr in determining first-line chemotherapy and metastasectomy benefit. Methods In this retrospective and descriptive analysis of patients with mcrc undergoing first-line chemotherapy in a single centre, the last systemic absolute neutrophil and lymphocyte count before treatment was used for the nlr. A receiver operating characteristic curve was used to estimate the nlr cut-off value, dividing the patients into low and high nlr groups. Median overall survival (mos) was compared using Kaplan-Meier curves and the log-rank test. A multivariate analysis was performed using a Cox regression model. Results The 102 analyzed patients had a median follow-up of 15 months. Regardless of systemic therapy, approximately 20% of patients underwent metastasectomy. The nlr cut-off was established at 2.35, placing 45 patients in the low-risk group (nlr < 2.35) and 57 in the high-risk group (nlr ≥ 2.35). The Kaplan-Meier analysis showed a mos of 39.1 months in the low-risk group and 14.4 months in the high-risk group (p < 0.001). Multivariate Cox regression on the nlr estimated a hazard ratio of 3.08 (p = 0.01). Survival analysis in each risk subgroup, considering the history of metastasectomy, was also performed. In the low-risk group, mos was longer for patients undergoing metastasectomy than for those not undergoing the procedure (95.2 months vs. 22.6 months, p = 0.05). In the high-risk group, mos was not statistically different for patients undergoing or not undergoing metastasectomy (24.3 months vs. 12.7 months, p = 0.08). Conclusions Our real-world data analysis of nlr in patients with mcrc confirmed that this biomarker is useful in predicting survival. It also suggests that nlr is an effective tool to choose first-line treatment and to predict the benefit of metastasectomy.
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Affiliation(s)
| | - I Fernandes
- Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
| | - R Gameiro
- Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
| | - J Gramaça
- Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
| | - A T Xavier
- Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
| | - I Pina
- Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
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Nogueira-Costa G, Fernandes I, Guerra-Pereira N, Gameiro R, Gramaça J, Xavier A, Pina I. Neutrophil/lymphocyte ratio in metastatic colorectal cancer: real-world data for evidence of its prognostic role. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Alvarez Villela M, Chinnadurai T, Salkey K, Furlani A, Yanamandala M, Luke A, Castillo C, Taveras M, Sims D, Saeed O, Shin J, Pina I, Jorde U, Patel S. High-Intensity Interval Training Improves Exercise Performance in Patients with LVAD. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Pinto C, Rato J, Labareda M, Pereira B, Batista A, Amoná E, Igñiguez F, Pina I, Couto N, Xavier A, Espirito Santo J. A single center five year follow up analysis of elderly patients with breast cancer. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Leier CV, Young JB, Levine TB, Pina I, Armstrong PW, Fowler MB, Warner-Stevenson L, Cohn JN, O'Connell JB, Bristow MR, Nicklas JM, Johnstone DE, Howlett J, Ventura HO, Giles TD, Greenberg BH, Chatterjee K, Bourge RC, Yancy CW, Gottleib SS. Nuggets, pearls, and vignettes of master heart failure clinicians. Part 2-the physical examination. Congest Heart Fail 2001; 7:297-308. [PMID: 11828174 DOI: 10.1111/j.1527-5299.2001.01167.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- C V Leier
- Division of Cardiology, Heart-Lung Research Institute, The Ohio State University Medical Center, Columbus, OH 43210, USA
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McMurray J, Cohen-Solal A, Dietz R, Eichhorn E, Erhardt L, Hobbs R, Maggioni A, Pina I, Soler-Soler J, Swedberg K. Practical recommendations for the use of ACE inhibitors, beta-blockers and spironolactone in heart failure: putting guidelines into practice. Eur J Heart Fail 2001; 3:495-502. [PMID: 11511437 DOI: 10.1016/s1388-9842(01)00173-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Surveys of prescribing in both hospitals and primary care have shown delays in translating improved survival data from clinical trials into clinical practice thereby denying patients the benefits of proven treatments, such as the angiotensin converting enzyme inhibitors. This may be due to unfamiliarity with clinical guidelines and concerns about adverse events. Recent trials have shown that substantial improvements in survival are associated with spironolactone and beta-blocker therapy. In order to accelerate the uptake of these treatments, and to ensure that all eligible patients should receive the most appropriate medications, a clear and concise set of clinical recommendations has been prepared by a group of clinicians with practical expertise in the management of heart failure. The objective of these recommendations is to provide practical guidance for non-specialists in order to support the implementation of evidenced-based therapy for heart failure. These practical recommendations are meant to supplement rather than replace existing guidelines.
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Affiliation(s)
- J McMurray
- Clinical Research Initiative in Heart Failure, Glasgow, Scotland G11 6NT, UK.
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Abstract
BACKGROUND Milrinone is a positive inotropic agent with vasodilatory and lusitropic activity. Milrinone dosed as a 50 microg/kg bolus followed by a continuous infusion provides an immediate and sustained hemodynamic response. The comparative pharmacodynamics of a placebo bolus and a milrinone bolus followed by a continuous milrinone infusion in patients with decompensated heart failure are unknown. METHODS Nineteen patients with decompensated heart failure underwent right heart catheterization and were randomized to receive an intravenous infusion of milrinone at a rate of 0.50 microg/kg/min with (n = 9) or without (n = 10) a preceding 50 microg/kg bolus. Pulmonary capillary wedge pressure, cardiac index, and plasma milrinone levels were measured serially over 24 hours. RESULTS In the milrinone bolus group, maximal effects on plasma concentration (352.3 ng/mL), cardiac index (+0.97 L/min/m(2), P =.02), and pulmonary capillary wedge pressure (-11.25 mm Hg, P <.001) were seen after the loading dose. In the placebo loading dose group, significant hemodynamic effects were observed starting at 30 minutes after the start of the continuous infusion. Changes in pulmonary capillary wedge pressure (placebo -8.6 vs milrinone -8.78 mm Hg, P not significant [NS]) were similar in both groups at 2 hours, whereas changes in cardiac index (placebo loading +0.81 vs milrinone loading +0.78 L/min/m(2), P NS) and milrinone levels (placebo loading 168.0 vs milrinone loading 165.6 ng/mL, P NS) were similar at 3 hours. One patient randomized to a milrinone bolus demonstrated a marked decrease in blood pressure and was discontinued from therapy. CONCLUSIONS A milrinone infusion without a bolus appears to be a rapidly effective inotropic strategy that may have an improved safety profile during the initiation of therapy compared with a continuous infusion strategy initiated with a bolus.
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Affiliation(s)
- L Baruch
- Bronx Veterans Affairs Medical Center, Bronx, NY, USA
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Cuffe MS, Califf RM, Adams KF, Bourge RC, Colucci W, Massie B, O'Connor CM, Pina I, Quigg R, Silver M, Robinson LA, Leimberger JD, Gheorghiade M. Rationale and design of the OPTIME CHF trial: outcomes of a prospective trial of intravenous milrinone for exacerbations of chronic heart failure. Am Heart J 2000; 139:15-22. [PMID: 10618557 DOI: 10.1016/s0002-8703(00)90303-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The optimal management of an acute exacerbation of chronic heart failure (CHF) is uncertain. There is little randomized evidence available to support the various treatment strategies for patients hospitalized with an exacerbation of CHF. Inotropic agents may produce beneficial hemodynamic effects, and although they are currently used in these patients, their effect on clinical response and impact on clinical outcome is unclear. We present a unique and simple study designed to determine whether a treatment strategy for CHF exacerbations that includes an intravenous agent with inotropic properties can reduce hospital length of stay and lead to improved patient outcome. METHODS The OPTIME CHF (Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure) trial is an ongoing multicenter, randomized, placebo-controlled trial of a treatment strategy for patients with acute exacerbations of CHF. The design of this study provides a novel approach to the evaluation of treatment strategies in the care of this population. The OPTIME CHF design uses early initiation of intravenous milrinone as both an adjunct to the best the medical therapy and to facilitate optimal dosing of standard oral therapy for heart failure. Patients with known systolic heart failure requiring hospital admission for a CHF exacerbation are randomly assigned within 48 hours of admission to receive a 48-hour infusion of either intravenous milrinone or placebo. The primary end point of this design is a reduction in the total hospital days for cardiovascular events within 60 days after therapy. Enrollment of 1000 patients began July 7, 1997, at 80 US centers and is projected to conclude in late 1999.
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Affiliation(s)
- M S Cuffe
- Department of Medicine, Northwestern University, Chicago, USA
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Uretsky BF, Pina I, Quigg RJ, Brill JV, MacInerney EJ, Mintzer R, Armstrong PW. Beyond drug therapy: nonpharmacologic care of the patient with advanced heart failure. Am Heart J 1998; 135:S264-84. [PMID: 9630090 DOI: 10.1016/s0002-8703(98)70255-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- B F Uretsky
- Division of Cardiology, University of Texas Medical Branch at Galveston, USA
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McClurken JB, Todd BA, Mather PJ, Pina I, Bove AA, Addonizio VP, Jeevanandam V. Recipient-donor atrial synchronization benefits acute hemodynamics after orthotopic heart transplantation. J Heart Lung Transplant 1996; 15:368-70. [PMID: 8732595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- J B McClurken
- Department of Surgery, Temple University Health Science Center, Philadelphia, Pa 19140, USA
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Shaw CE, Gorman K, Pina I, Posner J. 178 THE VARIABILITY IN MAXIMAL STRESS TEST RESULTS IN HEALTHY ELDERLY MALES USING THREE MINUTE, ONE MINUTE, AND RAMP STAGE PROTOCOLS. Med Sci Sports Exerc 1990. [DOI: 10.1249/00005768-199004000-00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
We evaluated 36 patients with cerebral ischemia and mitral valve prolapse and compared them with 36 age-matched controls with cerebral ischemia who had similar attributes but who did not have mitral valve prolapse. Stepwise logistic regression analysis revealed an inverse relation between cerebral ischemia in the presence of mitral valve prolapse and hypertension, diabetes mellitus, occlusive cerebrovascular disease, and completed stroke at p less than 0.01. We also found, by correlation analysis, a negative correlation between both hypertension and diabetes mellitus versus mitral valve prolapse at p less than 0.05. Overall, 10 study patients compared with two control patients had no risk factors for cerebrovascular disease detected (chi 2 = 4.9, p less than 0.05). These data indicate that the association of mitral valve prolapse and cerebral ischemia is of special importance in patients who do not have other detected risk factors for cerebrovascular disease.
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Affiliation(s)
- R E Kelley
- Department of Neurology, University of Miami School of Medicine, Florida
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Kessler KM, Pina I, Green B, Burnett B, Laighold M, Bilsker M, Palomo AR, Myerburg RJ. Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects. Am J Cardiol 1986; 58:525-30. [PMID: 3751915 DOI: 10.1016/0002-9149(86)90027-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Seven normal, 7 paraplegic and 7 quadriplegic patients underwent cross-sectional cardiovascular evaluation, including recording of sitting heart rate, blood pressure and echocardiography. Quadriplegic patients had a 26% lower left ventricular (LV) mass index (75 +/- 13 g/m2, p less than 0.01) compared with normal volunteers (102 +/- 16 g/m2) or paraplegic patients (110 +/- 26 g/m2). Six quadriplegic patients and 3 paraplegic patients had an unusual pattern of LV posterior wall asynergy, which was associated with a significant rightward shift of the frontal-plane QRS axis (92 +/- 22 degrees vs 42 +/- 41 degrees, p less than 0.005) and smaller left atrial dimensions (2.4 +/- 0.4 vs 3.0 +/- 0.3 cm, p less than 0.005). The quadriplegic group was characterized by a significantly reduced mean blood pressure (67 +/- 7 vs 88 +/- 8 mm Hg in normal subjects, p less than 0.002), high normal peripheral resistances (22 +/- 5 vs 17 +/- 5 units in normal subjects, difference not significant) and a markedly reduced calculated cardiac output (3.2 +/- 0.6 vs 5.4 +/- 1.4 liters/min in normal subjects, p less than 0.01). Hemodynamic data for the paraplegic patients were similar to those in the normal group. A decrease in LV wall stress, mediated primarily by a decrease in venous return, appeared to result in the "adaptive" cardiac atrophy seen in these quadriplegic patients. LV asynergy was common and also may be related to a decrease in cardiac filling.
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Fournier A, Goldberg M, Green B, Brucker B, Petrofsky J, Eismont F, Quencer R, Sosenko J, Pina I, Shebert R, Kessler K, MacDonald A, Fiore P, Burnett B. A medical evaluation of the effects of computer assisted muscle stimulation in paraplegic patients. Orthopedics 1984; 7:1129-33. [PMID: 24823184 DOI: 10.3928/0147-7447-19840701-07] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
An examination of the medical and physiological effects of functional electrical stimulation (FES) applied to the quadriceps muscle of five paraplegic male volunteers with complete spinal cord injuries was performed. FES training was provided three days a week over a 12-week period using a progressive resistive exercise protocol. Stimulation was applied through use of a closed-loop microprocessor-based FES system. Prior to the start of and immediately following the 12-week training period, subjects were assessed on several measures, including quadriceps muscle bulk and histochemistry, laboratory studies, echocardiography, and arm ergometry exercise. Results of the study indicated substantial increases in muscle strength and muscle bulk. At the outset of the study one patient suffered a patellar fracture. No significant changes in pretraining and posttraining general examinations, laboratory studies, echocardiography, or arm ergometry exercise testing were noted.
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Heal A, Al-Sheikh W, Pefkaros KC, Pina I, Serafini AN, Hourani M. Diagnosing myocardial infarction with a radioimmunoassay for the B-monomer of the creatine phosphokinase isoenzymes. South Med J 1984; 77:843-7. [PMID: 6740351 DOI: 10.1097/00007611-198407000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A diagnosis of myocardial infarction (MI) is usually established by the evaluation of clinical symptoms, electrocardiographic changes, and serum enzyme levels, specifically creatine phosphokinase, subunit MB (CK-MB), by electrophoresis. A total of 215 patients were evaluated in this study. One hundred two of them were admitted to the coronary care unit and 113 to the emergency room, where they were screened for possible MIs. The radioimmunoassay (RIA) used in this study determines levels of the CK-MB isoenzyme by detecting the B monomer, which also has 100% cross-reactivity with the CK-BB isoenzyme. The intra-assay coefficients of variability (CVs) for 30 samples were 22% (means = 7.0 ng/ml) and 11% (means = 47.3 ng/ml), and the interassay CVs for 30 samples were 17% (means = 7.1 ng/ml) and 9.2% (means = 49.3 ng/ml). Of the 215 patients evaluated, 21 had myocardial infarction by the criteria in the study. The diagnostic sensitivity, specificity, and accuracy were 100.0%, 92.8%, and 93.5% respectively. These values increased to 100.0%, 96.9%, and 97.2% when only coronary care unit patients were considered. The CK-MB RIA was found to be a reliable replacement for electrophoresis, but it was nonspecific in some patients.
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Abstract
A patient with relapsing polychondritis who presented with rapidly progressive glomerulonephritis is described. This is the fourth case in which this association is reported. Crescentic glomerulonephritis was found on renal biopsy. Evidence for immunologic participation in the pathogenesis of this condition is suggested by the demonstration of circulating immune complexes, immunoglobulin and complement deposition by immunofluorescence, and electron dense deposits by electron microscopy of the kidney. Favorable response followed therapy with prednisone and dapsone.
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Radebold H, Bechtler H, Pina I. [Therapy through social workers? The tasks of social therapy in the aged]. Z Gerontol 1981; 14:61-8. [PMID: 7222917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In therapeutic treatment of emotionally ill old persons it is imperative to consider the effect that social environment, diseases, disabilities and increasing dependency have on the individual. It is the purpose of this paper to present a psychoanalytically orientated concept, that integrates both the exploration and analysis of intrapsychic conflicts and supporting interventions by way of social therapy. This is shown for individual as well as for group settings. There is also a discussion of the possibilities to have this treatment carried out by specially trained social workers.
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Abstract
Accidental hypothermia has increased in prevalence among the aged poor, probably because of a marked increase in heating costs. Most cases of accidental hypothermia in the past have been reported from either England or the northern United States. We report our experience with this disorder in the Tampa (Florida) General Hospital over the past five years. Different manifestations, treatment, and complications are reviewed.
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