Biomedical subjects
A G Alcántara
Publications and source records attributed to A G Alcántara.
Does angina the week before protect against first myocardial infarction in elderly patients?
Mortality rates for coronary artery disease are greater in elderly patients. Although prodromal angina occurring shortly before an acute myocardial infarction (MI) has protective effects against ischemia, this effect has not been well documented in older patients. This study investigated whether angina 1 week before a first MI provides protection in this group of patients. A total of 290 consecutive elderly (>64 years old, n = 143) and adult patients (<65 years old, n = 147) with a first MI were examined to assess the effect of preceding angina on the short- and long-term prognosis. Elderly patients with a history of prodromal angina were less likely than those without angina to experience in-hospital death, heart failure, or the combined end point of in-hospital death and heart failure (6% vs 20.4%, p = 0.02; 10% vs 23.7%, p = 0.07; 14% vs 32.3%, p = 0.01, respectively). Left ventricular function was more frequently depressed (ejection fraction <40%) in elderly patients without (44.8%) than with (26%, p = 0.04) preinfarction angina, and the incidence of arrhythmias (complete heart block and ventricular fibrillation) was greater in the former group (16.1% vs 4%, p = 0.03). Multivariate analysis confirmed that the presence of preinfarction angina was an independent predictor of in-hospital death and heart failure in older patients (odds ratio 0.28, p = 0.009). The occurrence of angina 1 week before a first MI may confer protection against in-hospital adverse outcomes, and may preserve left ventricular function in older patients.
[Depression among the elderly. Etiological and clinical aspects].
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[Depression in the elderly. Etiological and clinical aspects].
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Is there a role for the alpha2 antagonism in the exacerbation of hallucinogen-persisting perception disorder with risperidone?
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Mania-like syndrome in a patient with chronic schizophrenia during olanzapine treatment.
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A possible dopaminergic mechanism in the serotonergic antidepressant-induced sexual dysfunctions.
The administration of antidepressant serotoninergic medication is associated with the presentation of sexual dysfunctions. This seems to be mediated by the activation of the 5-HT2 receptors. Segraves (1995) has proposed that the inhibition of noradrenergic transmission by serotonin may be the mechanism which causes the antidepressant-induced sexual dysfunctions. The inhibition which the 5-HT2 receptors carry out on dopaminergic transmission leads us to propose this mechanism as also participating in the antidepressant-induced sexual dysfunctions.
[Combination of risperidone and serotonergic antidepressants in refractory obsessive-compulsive disorder].
We present the use of risperidone as a potentiation strategy of the serotonergic antidepressants in four patients suffering from refractory obsessive-compulsive disorder. There were an important improvement in three patients. Adding risperidone to serotonergic antidepressants causes complex interactions between serotonergic, dopaminergic and noradrenergic systems, that could lay to the clinical improvement. These and other similar cases make necessary controlled studies. Adding risperidone to serotonergic antidepressants in patients suffering from refractory obsessive-compulsive disorder might be an effective strategy with low risk for secondary effects and without the presence of tics or psychotic symptoms.