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World Journal of Cardiology 2012年第1期4卷 15-19页

作者： Lorenzo Fácila Pedro Morillas Juan Quiles Federico Soria Alberto Cordero Pilar Mazón Manuel Anguita Cándido martín-Luengo Jose Ramón Gonzalez-Juanatey Vicente Bertomeu Department of Cardiology Consorcio Hospitalario General de Valencia Department of Cardiology Hospital Universitario de San Juan Department of Cardiology Hospital Virgen de la Arrixaca Department of Cardiology Hospital Clínico Universitario Santiago de Compostela Department of Cardiology Hospital Reina Sofía Department of Cardiology Hospital Universitario de Salamanca

AIM: To investigate the prognostic significance of resting heart rate in patients with acute coronary syndrome (ACS), independent of other known factors. METHODS: Patients 40 years of age or older who had been admitted with acute coronary syndrome (ACS) to one of the 94 hospitals participating in the Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary Syndrome (PAMISCA) study were included. Patients were divided into two groups based on their resting heart rate (HR ≥ or ns were recording during a follow-up period of 1 year. RESULTS: There were 1054 ACS patients analyzed (43.5% with ST segment elevation and 56.5% without elevation). Mean age was 66.6 ± 11.7 years, 70.6% were male and 29.4% of subjects were female. During follow-up, more patients in the HR ≥ 70 bpm group were hospitalized for heart failure and they also had a higher mortality rate. In the multivariate analysis, a heart rate of ≥ 70 bpm was independently related to overall mortality during the follow-up period (hazard ratio 2.5; 95% confidence interval, 1.26-4.97, P = 0.009). COnCLUSIOn: A resting heart rate ≥ 70 bpm in patients who survive an ACS is an indicator of a high risk of suffering cardiovascular events during follow-up.

关键词： Heart rate Myocardial infarction Prognosis

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Hepatitis C virus infection in Argentina: Burden of chronic disease

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World Journal of Hepatology 2016年第15期8卷 649-658页

作者： Ezequiel Ridruejo Fernando Bessone Jorge R Daruich Chris Estes Adrián C Gadano Homie Razavi Federico G Villamil Marcelo O Silva Hepatology Section Department of Medicine Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno Hepatology and Liver Transplant Unit Hospital Universitario Austral Hepatology Section Escuela de Medicina Universidad de Rosario Hepatology Section Hospital de Clínicas San Martín Universidad de Buenos Aires Center for Disease Analysis Louisville Hepatology and Liver Transplant Unit Hospital Italiano de Buenos Aires Liver Transplantat Unit Hospital Británico

AIM: To estimate the progression of the hepatitis C virus(HCV) epidemic and measure the burden of HCVrelated morbidity and mortality. METHODS: Age- and gender-defined cohorts were used to follow the viremic population in Argentina and estimate HCV incidence, prevalence, hepatic complications, and mortality. The relative impact of two scenarios on HCV-related outcomes was assessed:(1) increased sustained virologic response(SVR); and(2) increased SVR and ***: Under scenario 1, SVR raised to 85%-95% in 2016. Compared to the base case scenario, there was a 0.3% reduction in prevalent cases and liverrelated deaths by 2030. Given low treatment rates, cases of hepatocellular carcinoma and decompensated cirrhosis decreased n contrast to the base case in 2030. Under scenario 2, the same increases in SVR were modeled, with gradual increases in the annual diagnosed and treated populations. This scenario decreased prevalent infections 45%, liver-related deaths 55%, liver cancer cases 60%, and decompensated cirrhosis 55%, as compared to the base case by 2030. COnCLUSIOn: In Argentina, cases of end stage liver disease and liver-related deaths due to HCV are still growing, while its prevalence is decreasing. Increasing in SVR rates is not enough, and increasing in the number of patients diagnosed and candidates for treatment is needed to reduce the HCV disease burden. Based on this scenario, strategies to increase diagnosis and treatment uptake must be developed to reduce HCV burden in Argentina.

关键词： Diagnosis Disease burden Epidemiology Incidence Mortality Prevalence Treatment Argentina Hepatitis C

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Implementation of a Telechemotherapy Module in the Peruvian Jungle with Adequate Quality of Life:Breaking the Access Gaps to Health with Teleoncology

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Journal of Cancer Therapy 2019年第8期10卷 677-691页

作者： Tatiana Vidaurre Jule Vásquez Fernando Valencia Cindy Alcarraz Luis Más nataly Poma Litol Becerra Gino Rodriguez Socorro Saldana Pepe Diaz Silvia neciosup Karina Aliaga Roxana Regalado Miriam Salazar Kavita Sarwal Simon Sutcliffe Julio Abugattas Carlos Castaneda Mónica Calderón Hugo Fuentes Henry Gómez Medical Oncologist Instituto Nacional de Enfermedades Neoplasicas(INEN)LimaPeru Hospital II-E Lamas San MartinPeru Instituto nacional de Enfermedades neoplasicas(InEn) LimaPeru International Cancer Control Congress Association(ICCCA) VancouverCanada

Background: Cancer is a leading cause of death worldwide as well as in Peru. The national cancer plan includes decentralization, but one of the greatest barriers is our complicated geography. san martin is a department located in the Peruvian jungle where there are no public services for cancer care. Our aim was to implement a “distance telemedicine-enabled” outpatient chemotherapy module, monitored by oncologists. Methods: The implementation was conducted in 3 stages: 1) Planning and Organization: working teams were formed, a chemotherapy room was developed and people were trained. 2) Execution: patients from san martín region, aged >18 years with pathological confirmation of cancer, requiring systemic chemotherapy, ECOG nd first course of chemotherapy received at InEn without adverse reaction were selected. 3) Evaluation: adverse events, cost-user evaluation and quality of life (QoL) were assessed. Results: By november 2015, a module with a chemotherapy room with 18 chairs, a pharmacy, a hospitalization room, 1 medical office, a training room, a nutrition area, and a nursing station was implemented. 3 physicians, 3 nurses and 1 pharmacist were trained. Through March 2018, 501 sessions of teleoncology were completed to deliver 232 cycles of chemotherapy for 56 patients aged 19 - 78 years with different solid tumors, with no serious adverse event, without negatively affecting their QoL, and with an average out-of-pocket expense saving of 500 PEn. Conclusions: Using information and communication technology, a telechemotherapy module was successfully implemented in the Peruvian jungle, without adversely affecting the QoL of patients. neither patients nor family members needed to travel to Lima to receive chemotherapy. This first program can be replicated in other rural and remote regions through non-specialized personnel and facilities, providing chemotherapy services equivalent to a tertiary center through trained health care professionals, supported through tel

关键词： Telechemotherapy Module Cancer Treatment Urban Tertiary Center Teleoncology

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Thyroid nodule: Alpha Score 2.0 Classification for FnAB Selection, Multicentric Study in Latin America

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Open Journal of Radiology 2021年第4期11卷 160-174页

作者： Glenn Mena Maria Cristina Chammas Carlos Mario Gonzalez Vasquez Lylian Rocío Villagómez Marco Alfredo Muñoz Pico Patricio Alejandro Montalvo santiago Mena-Bucheli Julio Olmedo Elizabeth Quintero Pedro Henrique de Marqui Moraes Osmar Cassio Saito Hubertino Diaz Denise Romero Gabriela Velalcazar Angel Ramón Sosa Fleitas Yamil Oliver Quevedo Ontaneda Victor Ricardo Chara Alpha Imagen Radiología e Intervencionismo Quito Ecuador Hospital das Clínicas Faculdade de Medicina da Universidade de Sã o Paulo S&#227 o Paulo Brasil Hospital Pablo Tobón Uribe Medellin Colombia Hospital del Instituto Ecuatoriano de Seguridad Social Quito Sur Quito Ecuador Hospital san Francisco de Quito Quito Ecuador Hospital Edgardo Rebagliati martins Lima Perú Hospital Carlos Andrade Marín Quito Ecuador Hospital de Clínicas san José de san martín Buenos Aires Argentina Hospital Universitario de Los Andes Mérida Venezuela Hospital de la Policía Quito Ecuador Hospital Sisol Tacna Perú

Introduction: To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. Materials and Methods: A pro... 详细信息

ng>Introduction:ng> To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. ng>Materials and Methods:ng> A prospective multicentric study in 10 radiological hospitals and institutions of Latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIRADS® and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. ng>Results:ng> Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides Tns into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIRADS of 0.77 and Bethesda of 0.91.ng> Conclusions: ng>Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign Tn in a precise, safe and accurate way, avoiding unnecessary FnABs or determining the necessity of FnAB in cases of moderate to high suspicion of malignancy.

关键词： Thyroid Cancer-Clinical Radiology-Imaging Thyroid nodule Alpha Score TIRADS® Thyroid Ultrasonography

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