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RISS 인기검색어
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- 저자 : ( Carmen Ricart Olmo ) (검색결과 2 건)
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( Juan Jose Tamarit Garcia ),( Belen Roig Espert ),( Carmen Ricart Olmo ),( Pedro Rollan Garcia ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: To determine the prognostic value of procalcitonin (PCT) and C Reactive Protein (CRP) in monitoring patients with sepsis admitted into the Internal Medicine Service of two hospitals. Methods: Prospective, observational study in which 82 patients with sepsis were included from April 2013 to April 2014. Were excluded patients under 18 years, hematologic malignancy, HIV positive, patients on immunosuppressive and those with a fatal disease in the next 24 hours. It was considered as a favorable survival at 28 days. Were evaluated as controls 23 patients admitted with systemic infi ammatory response syndrome of non-infectious origin that underwent the baseline determination of PCT and CRP. Results: - Male 72%. - Blood culture positive 71%. - Mortality 32%. - Infections: pulmonary (41%), gastrointestinal (26%), genitourinary (19%), skin and appendages (7%), other (7%) - PCT had a sensitivity and specifi city of 78% and 80% respectively with a PPV of 90% and a NPV of 62% for the diagnosis of sepsis compared with the control group (SIRS without sepsis). - The persistence of the marker or its increase at 48 hours, allowed to predict mortality with a sensitivity and specifi city of 80% and 87% respectively, with a PPV of 94% and a NPV of 60%. - PCT allows predicting mortality (p=0.00001), sensitivity 80%, specifi city 87%. - PCR was shown to be a useful evolutionary marker (p>0.05, sensitivity 50%, specifi city 33.3%). Conclusions: The semiquantitative determination of the PCT is a fast, simple, reliable method that can be used as a prognostic marker in sepsis. The persistence of high levels of this protein at 48 hours predicts poor prognosis. Conversely when its value decreases or becomes negative correlates with good performance. Instead elevated CRP lasts for several days without differences exist between patients with good or poor outcome.
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( Belen Roig Espert ),( Juan Jose Tamarit Garcia ),( Carmen Ricart Olmo ),( Pedro Rollan Garcia ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Determine the prevalence and morbidity of sleep apnea-hypopnea syndrome (SAHS) in hypertensive patients with riser pattern. Methods: Were selected the fi rst 100 consecutive patients valued, from January 1 2013, into the hypertension doctor`s offi ce of two hospitals. Inclusion criteria: Being hypertensive with a riser pattern at the ambulatory blood pressure monitoring. The diagnosis of SAHS was performed by polysomnography in patients with riser pattern. As an comorbidity we considered: obesity, hypercholesterolemia, smoking, heart failure, ischemic heart disease, ischemic cerebrovascular disease, peripheral artery disease and renal disease. Results: We reviewed 897 hypertensive patients until arrived to the fi rst 100 patients with a riser pattern. Of them: - SAHS: 83 - Mean age: 71 ± 16.7 - Men: 75 - Years of evolution of hypertension: 8.4 - Body mass index: 29.04 (CI 27.62-31.02) - Total cholesterol: 236 (95% CI 213-254) - Smokers: 32% - Comorbidity 72%: dyslipidemia 60%, type 2 diabetes mellitus 32%, benign prostatic hyperplasia 24%, left ventricular hypertrophy 16%, microalbuminuria 13%, ischemic heart disease 12%, transient ischemic attack 9% - Risk by SCORE: normal 8%, light20%, moderate 16%, high 48%, very high 8% - Erectile dysfunction: 36% Conclusions: We detected a prevalence of SAHS fi ve times higher among hypertensive patients than in the general population and especially in patients with riser pattern. Those patients have been associated higher incidence of cardiovascular effects. We can say that maintaining a high suspicion of SAHS, will lead to an early diagnosis and therefore better treatment of hypertension. The existence of SAHS entails greater comorbidity, SAHS is considered as an independent vascular factor risk for angina and peripheral artery disease. Therefore maintaining a high suspicion of this disease would lead to early treatment to prevent the onset of these cardiovascular events.
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