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M N Cruz

Publications and source records attributed to M N Cruz.

4 recordsLinked to original sources

[Cardiovascular risk factors in middle-age women with acute coronary syndromes].

BACKGROUND: In Chile, 40% of deaths due to acute myocardial infarction occur in women. AIM: To assess the presence of cardiovascular risk factors in women with acute coronary syndromes. PATIENTS AND METHODS: Thirty four women aged 46 to 55 years old, admitted to the hospital due to an acute coronary syndrome and 102 age matched healthy women were studied. A clinical history was obtained, blood pressure and fasting serum lipids were measured. RESULTS: A history of high blood pressure was present in 65 and 16% of patients and healthy controls respectively. Seventy seven percent of patients and 36% of controls smoked, 76% of patients and 48% of controls were postmenopausal, 21% of patients an 5% of controls were diabetic. In patients and controls respectively serum total cholesterol was 230.1 +/- 36.2 and 211.2 +/- 34.8 mg/dl, serum triacylglycerol was 213.4 +/- 109.4 and 143.2 +/- 76.9 mg/dl and serum HDL cholesterol was 44.1 +/- 10.8 and 49.8 +/- 13.3 mg/dl (p < 0.001 or less). In univariate analysis, the risk of acute coronary syndrome increased with high blood pressure (OR: 9.3, CI: 2.5-18.6), menopause (OR: 8.3, CI: 2.2-31:5), smoking (OR: 6.9, CI: 2.5-18.6), diabetes mellitus (OR: 5.0, CI: 1.4-17.5), a high total cholesterol/HDL cholesterol ratio (OR: 6.6, CI: 1.8-12.5) and hypertriglyceridemia (OR: 3.6, CI: 1.5-8.5). Logistic regression analysis showed that hypertension and menopause had the higher predictive values for acute coronary syndrome. CONCLUSIONS: In this group of women with acute coronary syndromes, the main coronary risk factors were high blood pressure and menopause.

Analysis of Variance↗

Use of dexamethasone in the outpatient management of acute laryngotracheitis.

OBJECTIVE: Recent studies have demonstrated that a single intramuscular injection of dexamethasone (0.6 mg/kg) shortens the duration and severity of illness in hospitalized patients with acute viral laryngotracheitis (croup). Our objective was to determine if dexamethasone has a role in the outpatient management of patients with acute viral croup of moderate severity. METHODS: Patients, 6 months to 5 years of age, who came to the emergency department (ED) with acute viral croup, a croup score of at least 2 (range 0 to 17), and a disposition of discharge were randomized in a double-blind fashion to receive a single intramuscular injection of dexamethasone, 0.6 mg/kg, or an equal volume of normal saline before discharge from the ED. Patients were excluded if they had any structural abnormalities, had received any steroids in the preceding 24 hours, or if they required beta-agonist therapy, more than one racemic epinephrine treatment, or hospitalization. Patients were followed up by telephone 24 hours and 7 to 10 days after discharge to determine whether additional medical attention was sought for perceived lack of improvement or worsening of symptoms. Secondary outcome included the parents' perception of how the child was doing at 24 hours, based on a 4-point ordinal scale: worse (1), same (2), improved (3), symptoms resolved (4), and the number of days it took for complete recovery. RESULTS: Of the 38 patients comprising the study group, 19 received dexamethasone. The median age was 19 months (range 6 to 66 months), and median pretreatment croup score was 3 (range 2 to 5) for both groups. The number of patients requiring racemic epinephrine was similar in both groups. Five patients sought additional medical attention within 48 hours. Four of the five patients had received placebo (21% of the placebo group) and one had received dexamethasone (5% of the steroid group) (not statistically significant). At the 24-hour telephone follow-up, significantly more patients in the dexamethasone group had a score consistent with improvement compared with placebo (84% vs 42%, P = .003). There was no difference in the number of days for symptoms to completely resolve between the two groups. CONCLUSION: The use of dexamethasone in the outpatient management of viral croup was associated with a reduction in severity of illness within 24 hours after treatment. Patients with viral croup of moderate severity should be considered as candidates for the use of dexamethasone before discharge from the ED.

Ambulatory Care↗