RESUMEN
A survey of staff opinion using anonymous questionnaires was conducted simultaneously in five French psychiatric hospitals in January and February 1995. The 36 questions concerned collective HIV prevention practices for hospitalised patients, actual participation in various actions, and personal choice and judgement concerning prevention strategies, especially with regard to sexual transmission. The paper gives an initial data analysis of the 1473 questionnaires collected. In general, psychiatric hospital staff feel concern for AIDS issues and seem to be already involved in specific prevention strategies.
Asunto(s)
Actitud del Personal de Salud , Infección Hospitalaria/prevención & control , Infecciones por VIH/prevención & control , Hospitales Psiquiátricos , Control de Infecciones/métodos , Personal de Hospital/psicología , Adulto , Infección Hospitalaria/sangre , Infección Hospitalaria/transmisión , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/transmisión , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
Subacute thrombosis of coronary stents may occur up to the end of the first month after their implantation and remains the major problem associated with the technique. A cohort of 238 patients with placement of one or more stents in 244 arteries was monitored for this period. All patients were given 500 mg/day of ticlopidine (started 3 days before) and a push dose of 10,000 IU of heparin during the procedure, then 1,000-1,500 IU/hr for 20 hr. Following removal of the arterial introducer, they were kept on subcutaneous heparin for 1 week and ticlopidine (500 mg/day) for 3-6 months. Nine patients (3.8%) showed evidence of thrombosis at 7 days. The overall thrombosis rate at 30 days was 4.2% (3.5% for elective stents, as compared with 7.9% associated with occlusive dissections). Emergency treatment by further angioplasty (8 cases) and intracoronary thrombolysis (5 cases) was undertaken. Complications were as follows: 5 deaths (2%), 3 MI (1.2%), 2 non-Q MI (1.7%). Three predictive factors for subacute thrombosis were identified: age < 70 (p = 0.00006), unstable angina (p = 0.006) and arterial diameter less than 3 mm (p = 0.043). The peripheral vascular complication rate was 4.6%. This study suggests that preventive treatment with ticlopidine appears to reduce the incidence of subacute thrombosis of stents in patients > 70 years of age. Furthermore, the combination of ticlopidine and heparin facilitates laboratory monitoring after stenting. Stenting is thought to represent definitive treatment in situations where placement for occlusive dissection is the indication.
Asunto(s)
Angioplastia Coronaria con Balón , Trombosis Coronaria/prevención & control , Heparina/uso terapéutico , Stents , Ticlopidina/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Trombosis Coronaria/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Stents/efectos adversosRESUMEN
Assessment of left ventricular hypertrophy (LVH) in 231 essential hypertensive patients (61 year'old) treated in a department of internal medicine. Incidence of LVH defined by echocardiography: 34%. Better relationship between LVH and ambulatory blood pressure (BP) monitoring than with casual BP. Influence of age and obesity in the occurrence of LVH.
Asunto(s)
Cardiomiopatía Hipertrófica/epidemiología , Hipertensión/complicaciones , Anciano , Atención Ambulatoria , Cardiomiopatía Hipertrófica/etiología , Femenino , Humanos , Hipertensión/terapia , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
In order to assess the efficacy of antihypertensive treatment in the population, a study was undertaken in 5 French cities during the commercial fairs of Grenoble, Marseilles, Nice, Toulouse and Lille. The blood pressure was measured according to the WHO recommendations in volunteers. The study included a total of 7107 subjects of both sexes, with 4064 subjects in the 35-64 year age group. The therapeutic efficacy was evaluated in the 791 hypertensive patients who knew their antihypertensive therapy. Taking < 160/95 mmHg as the criterion of efficacy, 52 to 73% of the hypertensive patients were well controlled. However, if the therapeutic objective of normalisation of the blood pressure (BP < 140/90 mmHg) is taken as the criterion of efficacy, only 23 to 29% of the hypertensive patients were controlled whilst their BP remained significantly higher than that of normotensive controls of the same age. The difference in efficacy of antihypertensive therapy between the cities may be explained by the heterogenicity of the populations whereas the treatment did not differ significantly. After adjustment analysis with respect to sex showed that women were better controlled than men whatever the criterion chosen. The group controlled at BP < 160/95 mmHg only differed from the group < 140/90 with respect to the average BP value which was higher before treatment and decreased less with treatment; though this did not achieve statistical significance. In matters of public health, if the ideal blood pressure is taken as < 140/90 mmHg, this study shows that the objective is only attained in one out of four patients in the population studied.