The clinical manifestations, mortality rates, laboratory and imaging findings of SARS-CoV-2 infection are not yet fully elucidated.
To describe the clinical manifestations, imaging and laboratory findings of 164 SARS-CoV-2 (+) patients consulting at an emergency room of a public general hospital in Santiago, Chile.
Review of medical records, imaging and laboratory results of 164 patients aged between 16 and 92 years (57.9% males) consulting at the emergency room between March 12 and April 27, 2020.
The most common presenting symptom was dry cough in 47% of patients, followed by headache in 42% and myalgias in 42%. Forty five percent referred contact with an infected patient or having travelled out of town. Thirty-three (20%) required hospital admission and 5% required admission to an intensive care unit.
These patients were predominantly young, and their most common symptoms were dry cough, headache and myalgias.
These patients were predominantly young, and their most common symptoms were dry cough, headache and myalgias.
Intravenous thrombolysis (IT) in acute ischemic stroke (AIS) is time dependent. The time elapsed from hospital admission to the thrombolytic bolus is named door to needle time (DNT) and is recommend to be of less than 60 min.
To describe the DNT in our center and determine those factors associated with a DNT longer than 60 min.
Prospective analysis of patients treated with IT at a private hospital between June 2016 and June 2019. The percentage of patients with DNT exceeding 60 min, and the causes for this delay were evaluated.
IT was used in 205 patients. DNT was 43.6 ± 23.8 min. Forty patients (19.5% (95% CI, 14.4-25.7), had a DNT longer than 60 min. Uni-varied analysis demonstrated that AIS with infratentorial symptomatology (ITS), was significantly associated with DNTs exceeding 60 min. A history of hypertension, a higher NIH Stroke Scale score, the presence of an hyperdense sign in brain tomography (p = 0.001) and the need for endovascular therapy (p = 0.019), were associated with DNT shorter than 60 min. Multivariate analysis ratified the relationship between ITS and DNT longer than 60 min (Odds ratio 3.19, 95% confidence intervals 1.26-8).
The individual elements that correlated with a DNT longer than 60 min were the failure to detect the AIS during triage and doubts about its diagnosis.
The individual elements that correlated with a DNT longer than 60 min were the failure to detect the AIS during triage and doubts about its diagnosis.
Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is common. Cardiac magnetic resonance (CMR) and intravascular imaging (IVI) may be useful for establishing its etiology.
To describe a population with MINOCA and its multi-image assessment using IVI or CMR.
Review of medical records, imaging and functional studies of patients with MINOCA treated in three different clinical centers between 2015 and 2019.
Twenty-eight patients with MINOCA and IVI were included. Seventy eight percent were women, 46% had hypertension, 32% smoked and 32% had dyslipidemia. At wall motion assessment, 46% presented apical ballooning pattern. https://www.selleckchem.com/products/ca3.html In 36% of patients IVI identified lesions that explained the cause of MINOCA, namely plaque disruption (PD) in 18%, spontaneous coronary dissection in 11% and a thrombus without PD in 7%. Forty-six percent of patients had uncomplicated atherosclerotic plaques, and 36% had no pathological findings. CMR was performed in 50% of patients, identifying in all a diagnostic pattern. In nine cases it was compatible with stress cardiomyopathy, three cases had a myocarditis and two cases had transmural infarctions. PD and transmural late gadolinium enhancement were observed in 23% of patients with apical ballooning. Patients with a pattern of myocarditis did not have acute pathological findings at IVI. After a mean follow-up of 16.4±11.4 months, 3 patients with PD died.
Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.
Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.
Nonmotor symptoms of Parkinson disease significantly hamper the quality of life of patients and have prognostic significance.
To evaluate the presence of nonmotor symptoms in patients with Parkinson disease.
A structured interview was carried out in 32 patients aged 74 ± 9 years (53% men) with Parkinson disease asking specifically for impulse control disorders and dopaminergic dysregulation. The following scales were also applied Hoehn & Yahr scale, Montreal Cognitive Assessment, Geriatric depression scale, Nonmotor symptom scale and REM sleep scale.
A high frequency of nonmotor symptoms was recorded, specially mood, sleep, urinary and gastrointestinal problems and impulse control disorders.
Nonmotor symptoms must be actively sought and managed in patients with Parkinson disease.
Nonmotor symptoms must be actively sought and managed in patients with Parkinson disease.
The prevalence of gestational diabetes (GDM) is increasing along with obesity and gestational age. This prevalence varies in populations and with different guidelines used for the diagnoses.
To estimate the change in prevalence of GDM and obesity in a period 11 years.
Analysis of pregnancies attended at an obstetrics ward of a general hospital between 2001 and 2018. Those women who were diabetic prior to their pregnancy were excluded from the analysis. Annual crude and adjusted prevalence using direct standardization by age were estimated.
We analyzed 33,985 pregnancies. GDM screening was performed in 20,139 (59%), and 1,466 (7%) had GDM. In 2007 the crude and adjusted prevalence of GDM were 4.9 and 5.2%, respectively. The figures in 2018 were 8.8 and 8.5%, respectively, with an annual percentage of change (APC) of 6.9% (p < 0.001). The frequency of obesity also increased with an APC of 4.1% (p < 0.001). In women with GDM the APC of obesity was 4.6% (p < 0.001). There was also an increase in the frequency of screening, with a joinpoint in 2011.
The clinical manifestations, mortality rates, laboratory and imaging findings of SARS-CoV-2 infection are not yet fully elucidated.
To describe the clinical manifestations, imaging and laboratory findings of 164 SARS-CoV-2 (+) patients consulting at an emergency room of a public general hospital in Santiago, Chile.
Review of medical records, imaging and laboratory results of 164 patients aged between 16 and 92 years (57.9% males) consulting at the emergency room between March 12 and April 27, 2020.
The most common presenting symptom was dry cough in 47% of patients, followed by headache in 42% and myalgias in 42%. Forty five percent referred contact with an infected patient or having travelled out of town. Thirty-three (20%) required hospital admission and 5% required admission to an intensive care unit.
These patients were predominantly young, and their most common symptoms were dry cough, headache and myalgias.
These patients were predominantly young, and their most common symptoms were dry cough, headache and myalgias.
Intravenous thrombolysis (IT) in acute ischemic stroke (AIS) is time dependent. The time elapsed from hospital admission to the thrombolytic bolus is named door to needle time (DNT) and is recommend to be of less than 60 min.
To describe the DNT in our center and determine those factors associated with a DNT longer than 60 min.
Prospective analysis of patients treated with IT at a private hospital between June 2016 and June 2019. The percentage of patients with DNT exceeding 60 min, and the causes for this delay were evaluated.
IT was used in 205 patients. DNT was 43.6 ± 23.8 min. Forty patients (19.5% (95% CI, 14.4-25.7), had a DNT longer than 60 min. Uni-varied analysis demonstrated that AIS with infratentorial symptomatology (ITS), was significantly associated with DNTs exceeding 60 min. A history of hypertension, a higher NIH Stroke Scale score, the presence of an hyperdense sign in brain tomography (p = 0.001) and the need for endovascular therapy (p = 0.019), were associated with DNT shorter than 60 min. Multivariate analysis ratified the relationship between ITS and DNT longer than 60 min (Odds ratio 3.19, 95% confidence intervals 1.26-8).
The individual elements that correlated with a DNT longer than 60 min were the failure to detect the AIS during triage and doubts about its diagnosis.
The individual elements that correlated with a DNT longer than 60 min were the failure to detect the AIS during triage and doubts about its diagnosis.
Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is common. Cardiac magnetic resonance (CMR) and intravascular imaging (IVI) may be useful for establishing its etiology.
To describe a population with MINOCA and its multi-image assessment using IVI or CMR.
Review of medical records, imaging and functional studies of patients with MINOCA treated in three different clinical centers between 2015 and 2019.
Twenty-eight patients with MINOCA and IVI were included. Seventy eight percent were women, 46% had hypertension, 32% smoked and 32% had dyslipidemia. At wall motion assessment, 46% presented apical ballooning pattern. https://www.selleckchem.com/products/ca3.html In 36% of patients IVI identified lesions that explained the cause of MINOCA, namely plaque disruption (PD) in 18%, spontaneous coronary dissection in 11% and a thrombus without PD in 7%. Forty-six percent of patients had uncomplicated atherosclerotic plaques, and 36% had no pathological findings. CMR was performed in 50% of patients, identifying in all a diagnostic pattern. In nine cases it was compatible with stress cardiomyopathy, three cases had a myocarditis and two cases had transmural infarctions. PD and transmural late gadolinium enhancement were observed in 23% of patients with apical ballooning. Patients with a pattern of myocarditis did not have acute pathological findings at IVI. After a mean follow-up of 16.4±11.4 months, 3 patients with PD died.
Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.
Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.
Nonmotor symptoms of Parkinson disease significantly hamper the quality of life of patients and have prognostic significance.
To evaluate the presence of nonmotor symptoms in patients with Parkinson disease.
A structured interview was carried out in 32 patients aged 74 ± 9 years (53% men) with Parkinson disease asking specifically for impulse control disorders and dopaminergic dysregulation. The following scales were also applied Hoehn & Yahr scale, Montreal Cognitive Assessment, Geriatric depression scale, Nonmotor symptom scale and REM sleep scale.
A high frequency of nonmotor symptoms was recorded, specially mood, sleep, urinary and gastrointestinal problems and impulse control disorders.
Nonmotor symptoms must be actively sought and managed in patients with Parkinson disease.
Nonmotor symptoms must be actively sought and managed in patients with Parkinson disease.
The prevalence of gestational diabetes (GDM) is increasing along with obesity and gestational age. This prevalence varies in populations and with different guidelines used for the diagnoses.
To estimate the change in prevalence of GDM and obesity in a period 11 years.
Analysis of pregnancies attended at an obstetrics ward of a general hospital between 2001 and 2018. Those women who were diabetic prior to their pregnancy were excluded from the analysis. Annual crude and adjusted prevalence using direct standardization by age were estimated.
We analyzed 33,985 pregnancies. GDM screening was performed in 20,139 (59%), and 1,466 (7%) had GDM. In 2007 the crude and adjusted prevalence of GDM were 4.9 and 5.2%, respectively. The figures in 2018 were 8.8 and 8.5%, respectively, with an annual percentage of change (APC) of 6.9% (p < 0.001). The frequency of obesity also increased with an APC of 4.1% (p < 0.001). In women with GDM the APC of obesity was 4.6% (p < 0.001). There was also an increase in the frequency of screening, with a joinpoint in 2011.
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