Suchergebnisse

"Um den Aufwand der koronaren Bypasschirurgie zu rechtfertigen, wird vor allem postoperative Erwerbstätigkeit als Indikator für deren sozialen als auch ökonomischen Nutzen herangezogen. Die bisherige Forschung zur Erwerbstätigkeit nach koronarer Bypassoperation erbrachte jedoch im wesentlichen widersprüchliche Ergebnisse. Implizit wurde dabei von der Annahme ausgegangen, daß Erwerbstätigkeit bei ausreichender physischer und psychischer Leistungsfähigkeit normentsprechend ist. Eine Berentung ist demnach nur zu rechtfertigen, wenn die institutionalisierte Altersgrenze erreicht ist. Der Erwerbstätigkeit voran geht eine ihr entsprechende Vorbereitungsphase bzw. Ausbildungsphase. Diese institutionalisierte Dreiteilung des Lebenslaufs, die auch als Typus zur lebensweltlichen Strukturierung und biographischen Orientierung dient, hat Kohli (1985) als Normallebenslauf beschrieben. Die Daten und Ergebnisse der DFG-Studie 'Aortakoronarer Venenbypass und Rückkehr zur Arbeit'/RzA) (Gerhardt/Borgetto/Rockenbauch 1993, Borgetto/Gerhardt 1993) stellen die postoperative Erwerbstätigkeit als Erfolgskriterium koronarer Bypassoperationen und die damit implizierte Annahme der uneingeschränkten Geltung der normativen Bedeutung des Normallebenslaufs in Frage. Untersucht wurden 60 Patienten(ehe)paare sowie deren Hausärzte anhand 1- bis 1,5-stündiger themenorientierter Leitfadeninterviews. Die Auswahlkriterien für die Untersuchungseinheiten waren präoperative Erwerbstätigkeit, Alter unter 55 (Ausnahmen bis 57) Jahren, LVEF unter 50 Prozent und angiographisch gesicherte KHK. Diese sollten eine optimale Chance zur postoperativen Rückkehr zur Arbeit sicherstellen. Von besonderer Bedeutung ist die Unterscheidung zwischen Patienten mit arbeitsinhaltlicher und allgemeiner Arbeitsorientierung. Für Patienten mit arbeitsinhaltlicher Orientierung, die teilweise trotz unbefriedigender kardialer Rehabilitation die RA verwirklichen und für die eine Frühberentung (Frb) Scheitern bedeutet, stellt die postoperative Erwerbstätigkeit ein unumgängliches Erfolgskriterium dar. Patienten mit allgemeiner Arbeitsorientierung, die unter spezifischen Bedingungen (Alter, Familie, Arbeitsplatz) trotz Frb, zum Teil bei ausreichender kardialer Rehabilitation ihren Biographieverlauf nach der Operation nicht als gescheitert betrachten, deren Frührentnerkarriere sich sogar als durchaus erfolgreich herausstellen kann, ist Erwerbstätigkeit kein unumgängliches Erfolgskriterium. In dieser Patientengruppe bestätigt sich, daß die normative Bedeutung des Normallebenslaufs nur eingeschränkte Geltung besitzt, sich möglicherweise in Auflösung befindet." (Autorenreferat)

Objective: To characterize patients undergoing cardiac surgery at a referral hospital in northern of Ceara. Method:
This is a quantitative and descriptive study using documentary analysis carried out by 176 medical records in
accordance with the ethical aspects of Resolution 196/96. Results: We identified predominantly men, married, living in
distant cities of the health service and a greater tendency for people over 40 years old. The hospital stay was low,
contributing to reduction of risks related to hospitalization, also reducing the cost of these services, for influencing
turnover and availability of beds. Discussion: This study shows high turnover and effectiveness of the service, allowing
also envision that the primary surgery is coronary artery bypass surgery in men with the duration of hospitalization in
about four days. Conclusion: We found that despite the risks of a cardiovascular surgery in the studied hospital, the
patients recover with a great success

Changes in the human karyotype result in alterations with varying degrees in relation to the morphology or intellectuality of the affected individuals. In most cases, genetic alteration can lead to spontaneous abortion. Among the chromosomal anomalies, mosaicism is often found, consisting of more than one type of cell line, derived from a single zygote, that is, mosaicism is a pos zyzotic phenomenon that can originate germ cells or somatic cells. The purpose of this succinct explanation is to show the cytogenetic diagnosis of the EVS patient (1 year and 9 months old) who presented the following chromosomal mosaicism at 21 chromosomes. The result: 46, XY, del (21) (pter?q11.2::q11.2?qter)[75]/46,XY,+21,der(21;21)(q10;q10)[22]/45,XY,-21[3]. Consequently, proband presents Down's Syndrome, with almond eyes and small ears and low implantation. This patient does not present with cardiopathy or intestinal problems. The karyotype shows that mosaicism is much rarer, since the existence of three different cell lines. 75% proband cells have a partial deletion of the long arm of chromosome 21 in its portion q11.2. A second cell line encompasses 22% of cells analyzed consisting of a robertsonian translocation derivative between the long arms of chromosomes 21 and the remaining 3% there was a complete deletion of a 21 chromosome yielding a karyotype with 45, XY with only 1 chromosome 21. Thus and result found shows the need for follow-up of the patient to observe their development and changes that may better characterize their clinical conditions.

Thrombotic material retrieved from acute ischemic stroke (AIS) patients represents a valuable source of biological information. In this study, we have developed a clinical proteomics workflow to characterize the protein cargo of thrombi derived from AIS patients. To analyze the thrombus proteome in a large-scale format, we developed a workflow that combines the isolation of thrombus by endovascular thrombectomy and peptide chromatographic fractionation coupled to mass-spectrometry. Using this workflow, we have characterized a specific proteomic expression profile derived from four AIS patients included in this study. Around 1600 protein species were unambiguously identified in the analyzed material. Functional bioinformatics analyses were performed, emphasizing a clustering of proteins with immunological functions as well as cardiopathy-related proteins with blood-cell dependent functions and peripheral vascular processes. In addition, we established a reference proteomic fingerprint of 341 proteins commonly detected in all patients. Protein interactome network of this subproteome revealed protein clusters involved in the interaction of fibronectin with 14-3-3 proteins, TGFβ signaling, and TCP complex network. Taken together, our data contributes to the repertoire of the human thrombus proteome, serving as a reference library to increase our knowledge about the molecular basis of thrombus derived from AIS patients, paving the way toward the establishment of a quantitative approach necessary to detect and characterize potential novel biomarkers in the stroke field. ; This work was supported by Navarre Government Funding (Industry and Health department) through ADITECH (PT030) and Department of Economic Development from Government of Navarra (Ref. PC025), and Obra Social la Caixa to ES. KA are supported by PEJ-2014-A-61949 (MINECO). The Proteomics Unit of Navarrabiomed is a member of Proteored, PRB3-ISCIII, and is supported by grant PT17/0019/009 to JF, of the PE I+D+I 2013–2016 funded by ISCIII and FEDER

La Insuficiencia Cardiaca (IC) constituyeuno de los principales problemas de salud pública a nivel mundial por su elevada mortalidad y su pronóstico sombrío. OBJETIVOS: Determinar niveles plasmáticos de de péptido natriurético cerebral (NTproBNP), proteína C reactiva ultrasensible (PCRus), diámetros diastólico (DD) y sistólico (DS) final del ventrículo izquierdo (VI), así como su relación con la Clase Funcional (CF) de la New York Heart Association (NYHA) en pacientes con IC. PACIENTESY METODOS: Estudio prospectivo, se analizaron 29 pacientes de la consulta de IC de nuestro departamento con etiología Isquémica y/o Hipertensiva, que cumplieron criterios de inclusión. Se cuantifico niveles plasmáticos de NTproBNP y PCRus mediante analizador Pathfast. Diámetrosy Fracción de eyección del VI por Ecocardiograma transtorácico (ETT), agrupados según la CF de la NYHA. Evaluación estadística: promedios, desviación estándar y análisis de varianza para datos anidados. Considerando significativo p<0,05. RESULTADOS: 29 pacientes evaluados,con edad 57 ± 8 años; 75,86 % del género masculino; 13,7% con cardiopatía hipertensiva, 13,7% con cardiopatíaisquémica y 72,4% con cardiopatía mixta. La CF de la NYHA: 3,44% con CF I; 58,62% con CF II; 37,93% con CF III. Promedio NT-proBNP: 207 ng/ml en CF I; 1189,41 ng/ml en CF II y 2132,27ng/ml en CF III. Promedio PCRus 0,21 mg/dl en CF I; 1,24 mg/dl en CF II y 2,22mg/dl en CF III. Diámetros de cavidades: CF I: DD:57mm y DS: 42mm; CF II: DD:58,29mm y DS: 44,05mm, CF III: DD: 59,72mm y DS: 48,27mm. Análisis de varianza entre las CF de la NYHA y las variables medidas (NTpro BNP, PCRus, DD y DS del VI) se evidencia una relación estadísticamente significativa(p<0,01). CONCLUSION: Los Niveles Plasmáticos NT proBNP y PCRus aumentan de forma proporcional a la disfunción ventricular izquierda y la gravedad de la IC. Estos hallazgos reafirman que en la fisiopatología de este síndrome, existe una relación entre activación neurohormonal,actividad inflamatoria y los diámetros diastólico y sistólico final del Ventrículo Izquierdo. La intervención farmacológica y no farmacológica de la Insuficiencia Cardiaca,actuando sobre la actividad neurohormonal e inflamatoria,permitiría disminuir la injuria que produce la activaciónde estos sistemas en el paciente portadores de este síndrome, y de esta forma contribuiría a la disminución de la morbilidad y mortalidad, así como en el al mejoramientode la calidad de vida en estos pacientes.Cardiac Insufficiency (CI) is one of the main public health problems of at world-wide producing high mortality and shady prognosis. OBJECTIVES: To determinethe plasmatic levels of the cerebral natriuretic peptide (NTproBNP), protein C reactivates ultra sensible (PCRus), diastolic (DD), and systolic (DS) diameters, final of the left ventricle (VI), as well as its relationship with the Class Functional (CF) of New York Heart Association (NYHA) in patients with CI. PATIENTS AND METHODS: A prospective study on 29 patients from the IC department of the Hospital Militar Carlos Arvelo with ischemic etiologyand/or hypertensive, who fulfilled inclusion criteria was performed. It was quantify the plasmatic levels of NTproBNPand PCRus by using the Pathfast analyzer. Diameters and fraction of ejection of VIby transtorácico Echocardiogram(ETT), grouped according to the CF of the NYHA. Statistical evaluation: averages, standard deviation and analysis of variance (p < 0.05). RESULTS: 29 evaluated patients,with 57 ± 8 years old; 75.86% male; 13.7% with hypertensive cardiopathy, 13.7% with ischemic cardiopathyand 72.4% with both cardiopathies. The CF of the NYHA: 3.44% with CF I; 58.62% with CF II; 37.93% with CF III. Average NT-proBNP: 207 ng/ml in CF I; 1189,41 ng/ml in CF II and 2132,27ng/ml in CF III. Average PCRus 0.21 mg/dl in CF I; 1,24 mg/dl in CF II and 2,22mg/dl in CF III. Diameters of cavities: CF I: DD: 57mm and DS: 42mm; CF II: DD: 58,29mm and DS: 44,05mm, CF III: DD: 59,72mm and DS: 48,27mm. Analysis of variance between the CF of the NYHA data and the measured variables (NTpro BNP, PCRus, DD and DS of I SAW) have demonstrates a statisticallysignificant relation (p< 0.01). CONCLUSION: The LevelsPlasmatic NT proBNP and PCRus have a proportional increasing as a function of the left ventricular dysfunction and the gravity of the IC. These findings confirm that in the physiopathology of this syndrome, a relation between neurohormonal physiopathology activation exists, inflammatoryactivity and the diameters diastolic and systolic end of the left ventricle. The pharmacologic and non pharmacologicphysiopathology intervention of the Insufficiency Cardiac, acting on the neurohormonal and inflammatory activity, would allow to diminish the insult that produces the activation of these systems in the patient carrying of this syndrome, and of this form it would contribute to the diminution of the morbidity and mortality, as well as in the a the improvement of the quality of life in these patients.