In a subgroup of hospitalized patients with an elevated
d
-dimer level, there was no significant benefit for oral betrixaban over subcutaneous enoxaparin on venous thromboembolic events. However, in ...an exploratory analysis involving all the patients, a benefit was seen with betrixaban.
Patients who are hospitalized for acute medical illnesses such as pneumonia, stroke, and heart failure are at increased risk for venous thromboembolism.
1
Prolonged immobilization and risk factors such as an elevated d-dimer level, an age of 75 years or older, cancer, or a history of venous thromboembolism increase this risk.
2
–
5
Randomized, controlled trials of parenteral anticoagulants versus placebo in such hospitalized medical patients have shown a reduction of more than 50% in the rate of venous thromboembolism, including fatal pulmonary embolism, without an increase in major bleeding.
6
–
10
Guidelines recommend the use of low-dose parenteral anticoagulants among patients at . . .
La hipertensión arterial (HTA), constituye un problema de salud pública por la alta prevalencia, la morbilidad asociada y el costo del tratamiento de la enfermedad y de sus complicaciones.
BackgroundSerelaxin is a recombinant form of human relaxin-2, a vasodilator hormone that contributes to cardiovascular and renal adaptations during pregnancy. Previous studies have suggested that ...treatment with serelaxin may result in relief of symptoms and in better outcomes in patients with acute heart failure. MethodsIn this multicenter, double-blind, placebo-controlled, event-driven trial, we enrolled patients who were hospitalized for acute heart failure and had dyspnea, vascular congestion on chest radiography, increased plasma concentrations of natriuretic peptides, mild-to-moderate renal insufficiency, and a systolic blood pressure of at least 125 mm Hg, and we randomly assigned them within 16 hours after presentation to receive either a 48-hour intravenous infusion of serelaxin (30 mu g per kilogram of body weight per day) or placebo, in addition to standard care. The two primary end points were death from cardiovascular causes at 180 days and worsening heart failure at 5 days.
ResultsA total of 6545 patients were included in the intention-to-treat analysis. At day 180, death from cardiovascular causes had occurred in 285 of the 3274 patients (8.7%) in the serelaxin group and in 290 of the 3271 patients (8.9%) in the placebo group (hazard ratio, 0.98; 95% confidence interval CI, 0.83 to 1.15; P=0.77). At day 5, worsening heart failure had occurred in 227 patients (6.9%) in the serelaxin group and in 252 (7.7%) in the placebo group (hazard ratio, 0.89; 95% CI, 0.75 to 1.07; P=0.19). There were no significant differences between the groups in the incidence of death from any cause at 180 days, the incidence of death from cardiovascular causes or rehospitalization for heart failure or renal failure at 180 days, or the length of the index hospital stay. The incidence of adverse events was similar in the two groups.
ConclusionsIn this trial involving patients who were hospitalized for acute heart failure, an infusion of serelaxin did not result in a lower incidence of death from cardiovascular causes at 180 days or worsening heart failure at 5 days than placebo. (Funded by Novartis Pharma; RELAX-AHF-2 ClinicalTrials.gov number, NCT01870778.) In a randomized trial, 6545 patients with acute heart failure were assigned to either serelaxin or placebo in addition to standard care. There were no significant differences between the two groups in the incidence of death from cardiovascular causes at 180 days or worsening heart failure at 5 days.
Se presenta el caso de una paciente que reside en el distrito de Mazamari, provincia de Satipo (selva central del Perú), con un cuadro clínico de dengue, confirmado por serología, donde las mialgias ...fueron una de las manifestaciones importantes y que desarrolló rabdomiolisis, CPK 6931 μ/L (VN 0-190 μ/L) y miocarditis a juzgar por las elevaciones de CPK-MB y troponina I. El tratamiento sintomαtico y una adecuada hidrataciσn permitieron la recuperación de la paciente sin complicaciones mayores.
ASCITES AS MAIN PRESENTATION IN SYSTEMIC LUPUS ERYTHEMATOSUS Pamo Reyna, Oscar G.; Cáceres Alpaca, Daniel; Tsuchida Fernández, Marisa ...
Revista de gastroenterología del Perú,
2000 Oct-Dec, 20001001, Letnik:
20, Številka:
4
Journal Article
A 40 year-old female patient was admitted to the hospital with ascites and abdominal pain developed in the last five days. The ascitic fluid was an exudate with negative results for common diseases. ...Antinuclear antibodies and anti-DNA were positive and a low activity of serum complement was found. The renal biopsy disclosed a lupus glomerulonephritis grade IV. She received oral prednisone and a pulse of cyclophosphamide with gradual resolution of the ascites.
PDF
