[Case 2. Lung mass and contralateral pleural effusion].
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Biomedical subjects
Publications and source records attributed to R Segoviano Mateo.
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INTRODUCTION: Heart failure shows high incidence and prevalence in our population. Objectives of our study are to describe the profile of patients cared in the Internal Medicine Department of our hospital, in order to analyze the therapeutic characteristics and to know the degree of utilization of different pharmacological groups. PATIENTS AND METHODS: A cross-sectional study with collection of data from clinical records of patients admitted to 2002 with the diagnosis of heart failure in Internal Medicine Department of San Carlos Hospital in Madrid. Total patients with heart failure was 1,338. Calculating the sample size with a precision of 5% and a confidence interval of 95%, the number of randomly selected clinical records was 130. Data were obtained with a questionnaire for analysis of different clinical and therapeutic parameters. RESULTS: The average age was 80.3 (SD: 9.64) years, and most patients were women. Most frequent associated pathology was hypertension, and in 70.2% patients a diagnosis of some disease was established. Diuretics were the drugs most utilized and its prescription increased at discharge (p < 0.0001). Furthermore, the higher the functional class the more diuretics were prescribed. Beta-blockers were prescribed in 7.1% patients, more frequently in patients with an ejection fraction higher than 35% (p = 0.042). DISCUSSION AND CONCLUSIONS: Patients with heart failure in our environment have advanced age, shows important comorbidities, and suffer an advanced functional class heart failure, being the diuretics their essential treatment. We observed that there is no uniformity concerning the treatment with regard to the last recommendations, and that there is a limited utilization of drugs as beta-blockers that have demonstrated increase the survival of patients with heart failure.
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INTRODUCTION: The ingestion of alcohol produces oxydative stress generating free radicals of oxygen and ethanol. These free radicals have a molecular reactive ability and, therefore, they play an important role in the production of the injury which appears in the liver and in other organs and tissues. We have done an "in vitro" study where we analyse the oxydative status at rest and the respiratory explosion produced by ethanol at final concentrations of 50 and 25 mM and by the phagocytosis of a previously opsonized concentrate of bacteria (E.coli) in human leucocytes taken from peripheral blood of six healthy persons. METHOD: We have used 1.2.3. dihydrorhodamine (non-fluorescent) as the oxydative marker because it is transformed in rhodamine (fluorescent), which is quantitatively studied by Flow Cytometry. RESULTS: The peak of oxydative stress is reached with the bacteria in the phagocytes (monocytes 50% and granulocytes 90%) and it has a significant difference with the control group. By adding ethanol at 50 mM we have seen an statistic significant difference in oxydative stress in the cells of all three types (lymphocytes 9.19%, monocytes 32% and granulocytes 36%). With a concentration of 25 mM of ethanol the oxydative stress is increased but without a significant difference (lymphocytes 2.39%, monocytes 9.22% and granulocytes 4.46%). We have also seen toxic cellular effect which reaches the 40.75% of cells with ethanol at 50 mM, the 10.7% with ethanol at 25 mM and the 5.65% with bacteria. CONCLUSION: The oxydative stress caused by the production of oxygen and ethanol free radicals in the leucocytes, and the proved cytotoxic effect of ethanol may play an important role over the qualitative and the quantitative leucocyte disorder on different organs and tissues of the alcoholic patient.