Martin Ruiz - Academia.edu (original) (raw)
Papers by Martin Ruiz
Respiratorio. ¿Qué es el Cáncer? ¿Qué es el Cáncer de Pulmón? Tipos de Cáncer de Pulmón. ... more Respiratorio. ¿Qué es el Cáncer? ¿Qué es el Cáncer de Pulmón? Tipos de Cáncer de Pulmón. Lugares frecuentes de Metástasis. Causas y Factores de Riesgo. Signos y Síntomas. Detección y tratamiento. Capítulo 2: Epidemiologia del Cáncer de Pulmón Mundial Epidemiologia del Cáncer de Pulmón Tasas brutas y especificas según sexo de Mortalidad a nivel Mundial Tasas brutas y especificas según sexo de Prevalencia a nivel Mundial Tasas brutas y especificas según sexo de Incidencia a nivel Mundial Nacional Tasas brutas y especificas según sexo de Mortalidad a nivel Nacional Tasas brutas y especificas según sexo de Prevalencia a nivel Nacional Tasas brutas y especificas según sexo de Incidencia a nivel Nacional Provincial Tasas brutas y específicas de Prevalencia a nivel Provincial Tasas brutas y específicas de Incidencia a nivel Provincial Tasas brutas y específicas de Mortalidad a nivel Provincial Tasa bruta de Letalidad a nivel Provincial Capítulo 1 Anatomía y Fisiología normal de pulmón. Anatomía: El sistema respiratorio está formado por un conjunto de órganos que tiene como principal función llevar el oxígeno atmosférico hacia las células del organismo y eliminar del cuerpo el dióxido de carbono producido por el metabolismo celular. Los órganos que componen el sistema respiratorio son cavidades nasales, la faringe, la laringe, la tráquea, los bronquios, los bronquiolos y los dos pulmones. Los pulmones son los órganos centrales del sistema respiratorio donde se realiza el intercambio gaseoso. El resto de las estructuras, llamadas vías aéreas o respiratorias, actúan como conductos para que pueda circular el aire inspirado y espirado hacia y desde los pulmones, respectivamente. Aunque la cavidad bucal permite la entrada de aire a las vías respiratorias no forma parte el sistema respiratorio. Fisiología: es una rama en la fisiología humana que se enfoca en el proceso de respiración, tanto externa, captación de oxígeno (O 2) y eliminación de dióxido de carbono (CO 2), como interna, utilización e intercambio de gases a nivel tisular. Hombres mujeres Letalidad general de cáncer de pulmón, en Mendoza del 2008 al 2012. Tasas estandarizadas por 100.000 habitantes. Mortalidad especifica de cáncer de pulmón por departamentos, en el año 2013. Tasas estandarizadas por 1.000 habitantes. Mortalidad especifica de cáncer de pulmón por departamentos, en el año 2014. Tasas estandarizadas por 1.000 habitantes. Mortalidad especifica de cáncer de pulmón por departamentos, en el año 2014. Tasas estandarizadas por 1.000 habitantes.
The distinction between the mind and body, their relatedness and respective properties is perhaps... more The distinction between the mind and body, their relatedness and respective properties is perhaps the single most persistent problem that faces philosophical contemplation. Various models have been proposed in order to overcome this gaping duality: idealism, occasionalism, epiphenomenalism, behaviourism, etc.. The model proposed within this thesis corresponds to psychophysical parallelism - a parallelism judged purely phenomenological - wherein mind and body are conceived in terms of two aspects of an unconscious transcendental reality. Historically, philosophy has tended to prioritise one of the aspects over the other: Hegel and Marx serve to illustrate this point. As I will argue throughout this thesis, this transcendental reality - within which we will situate spontaneous creativity - is essentially double and subsists between the two extremes. The consequence of this duplicity is to negate the possibility of any reconciliation into an originary Being, but through which the extre...
Evidencia, actualizacion en la práctica ambulatoria, 2003
International Journal of Cardiology, 2016
Background. Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial f... more Background. Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial fibrillation (AF). Our aim was to study the clinical profile of octogenarians treated with oral anticoagulation and to study the effect of age on the quality of VKAs anticoagulation. Methods. Data are from a prospective national registry in an adult Spanish population of nonvalvular AF. We included 1637 patients who had been receiving VKAs for at least 6 months before enrolment. Results. Mean age was 73.8 ± 9.4 years. Patients aged > 80 years (N = 429) had a high risk profile with higher risk of stroke and bleeding than younger patients; CHA 2 DS 2-VASc (Cardiac failure, Hypertension, Age > 74, Diabetes, Stroke, Vascular disease, Age 65-74 years, and Sex category) 4.5 ± 1.3 vs. 3.5 ± 1.6, p < 0.001, HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 64 years), Drugs/alcohol concomitantly) 2.4 ± 0.9 vs. 1.9 ± 1.1, p < 0.001. Creatinine clearance was lower in octogenarians than in younger patients (54.3 ± 16.1 ml/min vs. 69.5 ± 23.7 ml/min, p < 0.001) and severe renal disease with creatinine clearance < 30 ml/min was more frequent in octogenarians (5.2% vs. 2.2%, p < 0.001). In patients treated with VKAs (N = 1637), the international normalized ratio values of the 6 months previous to enrollment were similar in all age quartiles, as was the time in the therapeutic range. Conclusion. In this large registry octogenarians with nonvalvular AF had high risk of stroke and bleeding and frequent renal disease. VKAs anticoagulation quality was similar in octogenarians and in younger patients.
Revista espanola de cardiologia (English ed.), Jan 19, 2016
The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diame... more The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm(2)±0.04 ...
Monthly Notices of the Royal Astronomical Society, 2015
Since 2006, the European Near Earth Asteroids Research (EURONEAR) project has been contributing t... more Since 2006, the European Near Earth Asteroids Research (EURONEAR) project has been contributing to the research of near-Earth asteroids (NEAs) within a European network. One of the main aims is the amelioration of the orbits of NEAs, and starting in 2014 February we focus on the recovery of one-opposition NEAs using the Isaac Newton Telescope (INT) in La Palma in override mode. Part of this NEA recovery project, since 2014 June EURONEAR serendipitously started to discover and secure the first NEAs from La Palma and using the INT, thanks to the teamwork including amateurs and students who promptly reduce the data, report discoveries and secure new objects recovered with the INT and few other telescopes from the EURONEAR network. Five NEAs were discovered with the INT, including 2014 LU14, 2014 NL52 (one very fast rotator), 2014 OL339 (the fourth known Earth quasi-satellite), 2014 SG143 (a quite large NEA), and 2014 VP. Another very fast moving NEA was discovered but was unfortunately lost due to lack of follow-up time. Additionally, another 14 NEA candidates were identified based on two models, all being rapidly followed-up using the INT and another 11 telescopes within the EURONEAR network. They include one object discovered by Pan-STARRS, two Mars crossers, two Hungarias, one Jupiter trojan, and other few inner main belt asteroids (MBAs). Using the INT and Sierra Nevada 1.5 m for photometry, then the Gran Telescopio de Canarias for spectroscopy, we derived the very rapid rotation of 2014 NL52, then its albedo, magnitude, size, and its spectral class. Based on the total sky coverage in dark conditions, we evaluate the actual survey discovery rate using 2-m class telescopes. One NEA is possible to be discovered randomly within minimum 2.8 deg 2 and maximum 5.5 deg 2. These findings update our past statistics, being based on double sky coverage and taking into account the recent increase in discovery.
Revista Española de Cardiología (English Edition), 2015
in 92, and so 46 patients may have experienced a delay in reperfusion, that is, 7.2% of the overa... more in 92, and so 46 patients may have experienced a delay in reperfusion, that is, 7.2% of the overall series. The data presented are only applicable to the network described, as the demographic characteristics, geography, hospital network, and catheterization laboratories vary for each region. 4 The fact that overlap started when the catheterization team was activated instead of when the patient arrived in the room may have increased the percentage of patients reported to have a delay. However, the end time of the procedure is not always predictable and, if the activity had been concentrated in a single center, the transfer times would have been longer for 40% of the patients in the catchment area of the second center. This may have led to overlap with patients other than those indicated, greater ambulance use with a subsequent deterioration in other areas of care, and increased mortality due to delays. 5 There may also have been an increase in the percentage of patients referred for fibrinolysis if the option of a second center were not available, while some of the 6 patients who experienced delay and who did not undergo PPCI may have received unnecessary fibrinolysis. In summary, we believe that the design of regional networks should take potential demand into account and, once in operation, the percentage of patients who have experienced delays in the past year could be used as an indicator analyzed in annual steering committee meetings for the regional network.
![Research paper thumbnail of [Therapeutic community model in short psychiatric hospitalization. Descriptive study on the dynamic psychiatric inpatient unit of the Italian hospital of Buenos Aires]](https://a.academia-assets.com/images/blank-paper.jpg)
](Vertex (Buenos Aires, Argentina)
the aim of this paper is to communicate a project of short term psychiatric hospitalization, base... more the aim of this paper is to communicate a project of short term psychiatric hospitalization, based on a therapeutic community model, considering qualitative and quantitative aspects in the present socio - cultural context. this psychiatric hospitalization model that embraces psychodynamic and pharmacological interventions is focused in the intensity of interactions between members of the therapeutic community and integrated to the administrative structure of a general hospital; this will be the key to consider patient's return to the community and to move forward over the prejudices that inpatients suffer. quantitative, prospective, observational and transversal study on a Dynamic Psychiatric Inpatient Unit. 605 patients were included. mean length of stay was 16.34 days; principal causes of admission were depression (19.4%), suicide ideas (17.7%), suicide attempt (17.6%), substance abuse or dependence (14.3%), psychosis (13.8%), behavioral and psychological symptoms of dementia ...
Revista Española de Cardiología (English Edition), 2004
Introduction. The Ross procedure has become established as an appropriate method for aortic valve... more Introduction. The Ross procedure has become established as an appropriate method for aortic valve replacement in children and young adults. There is controversy regarding the results of this surgical technique depending on whether the aortic valve disorder is congenital or acquired. The objective of this study was to analyze the outcome of this technique in different etiologies. Patients and method. We analyzed 61 patients who underwent the Ross procedure between November 1997 and November 2001. Age range was 6 to 54 years, and 44 patients (72%) were male. The mean duration of follow-up was 15.6 (10.6) months. The aortic valve lesion was stenosis in 17 patients, regurgitation in 22 and both in 22. The patients were divided into two groups: etiology was congenital in group I (40 patients) and acquired in group II (21 patients: 14 rheumatic, 2 degenerative, 2 endocarditis, and 3 other). Results. Pre-intervention data showed significant differences in age, functional class and percentage of patients with previous cardiac surgery. In the last follow-up examination, autograft gradient and homograft gradient were similar in both groups. Diastolic and systolic diameters and left ventricle ejection fraction were normal in both groups and did not differ between groups. Major events during follow-up were: 1 patient died, 1 patient had endocarditis, and 2 patients needed stent implantation in the homograft in group I; 2 patients in group II underwent reoperation because of severe autograft dysfunction. There were no statistically significant differences between groups. Conclusion. Short-term morbidity and mortality associated with the Ross procedure are low in patients with either congenital or acquired aortic valvulopathy.
Revista Española de Cardiologia, 2004
Short-Term Results With the Ross Procedure. Does the Etiology of Aortic Valvulopathy Affect the O... more Short-Term Results With the Ross Procedure. Does the Etiology of Aortic Valvulopathy Affect the Outcome? Introduction. The Ross procedure has become established as an appropriate method for aortic valve replacement in children and young adults. There is controversy regarding the results of this surgical technique depending on whether the aortic valve disorder is congenital or acquired. The objective of this study was to analyze the outcome of this technique in different etiologies. Patients and method. We analyzed 61 patients who underwent the Ross procedure between November 1997 and November 2001. Age range was 6 to 54 years, and 44 patients (72%) were male. The mean duration of follow-up was 15.6 (10.6) months. The aortic valve lesion was stenosis in 17 patients, regurgitation in 22 and both in 22. The patients were divided into two groups: etiology was congenital in group I (40 patients) and acquired in group II (21 patients: 14 rheumatic, 2 degenerative, 2 endocarditis and 3 other). Results. Pre-intervention data showed significant differences in age, functional class and percentage of patients with previous cardiac surgery. In the last follow-up examination, autograft gradient and homograft gradient were similar in both groups. Diastolic and systolic diameters and left ventricle ejection fraction were normal in both groups and did not differ between groups. Major events during follow-up were: 1 patient died, 1 patient had endocarditis, and 2 patients needed stent implantation in the homograft in group I; 2 patients in group II underwent reoperation because of severe autograft dysfunction. There were no statistically significant differences between groups. Conclusion. Short-term morbidity and mortality associated with the Ross procedure are low in patients with either congenital or acquired aortic valvulopathy.
Revista Española de Cardiología (English Edition), 2010
Introduction and objectives. o investigate the relationship between patent foramen ovale and cryp... more Introduction and objectives. o investigate the relationship between patent foramen ovale and cryptogenic stroke in patients aged ≥55 years. Methods. This prospective study determined the presence of patent foramen ovale and atrial septal aneurysm using transesophageal echocardiography in 262 consecutive patients with a diagnosis of probable cryptogenic stroke. Data from 44 patients aged ≥55 years with cryptogenic stroke (Group A) were compared with those from 2 other groups: 194 patients aged <55 years with cryptogenic stroke (Group B) and 24 control patients aged ≥55 years with stroke of known origin, namely grade III-V aortic atheromatosis (Group C). Results. The frequency of patent foramen ovale in Group A was similar to that in Group B (38% vs 36%; P=.85) but significantly higher than that in Group C (38% vs 8%; P=.029). The frequency of patent foramen ovale with concomitant atrial septal aneurysm was significantly higher in the study group (Group A) than in the control Group C (18% vs 0; P=.039) and non-significantly higher than in Group B (18% vs 11%; P=.11). Conclusions. The frequency of patent foramen ovale alone or in association with atrial septal aneurysm in patients with cryptogenic stroke aged ≥55 years was similar to that in those aged <55 years, but higher than that in patients aged ≥55 years with stroke of atherosclerotic origin. These data suggest that paradoxical embolism could be a cause of stroke in both age groups.
Revista Española de Cardiología, 2011
Revista Española de Cardiología, 2008
El cierre percutáneo del foramen oval permeable es una de las opciones terapéuticas propuestas pa... more El cierre percutáneo del foramen oval permeable es una de las opciones terapéuticas propuestas para el ictus criptogénico. El objetivo del presente trabajo es describir la experiencia de nuestro centro. Hasta febrero de 2006, se ha tratado con cierre percutáneo de foramen oval permeable a 52 pacientes que habían presentado uno o más ictus o ataques isquémicos transitorios criptogénicos. El procedimiento se realizó con anestesia y guiado por ecocardiografía transesofágica (ETE). La tasa de éxito primario fue del 100%. Inmediatamente tras el implante del dispositivo, en 27 pacientes no se observó paso derechaizquierda por ETE. Tras un seguimiento clínico medio de 26 meses en 49 pacientes, ninguno ha tenido nuevos episodios isquémicos ni complicaciones atribuibles al dispositivo. El seguimiento ecocardiográfico mostró en todos un sellado completo del foramen oval. Palabras clave: Foramen oval permeable. Isquemia cerebral. Cierre percutáneo.
Revista Española de Cardiología, 2011
Clá sicamente la endocarditis infecciosa (EI) afectaba a pacientes con una valvulopatía predispon... more Clá sicamente la endocarditis infecciosa (EI) afectaba a pacientes con una valvulopatía predisponente causada por enfermedad reumá tica, y los estreptococos del tipo viridans eran los pató genos má s frecuentes 1. Esta forma de presentació naú n predomina en los países en vías de desarrollo donde las afecciones reumá ticas son todavía muy prevalentes. En los países desarrollados, el prolapso de la vá lvula mitral se considera hoy la enfermedad predisponente
Pediatría Atención Primaria, 2011
Los autores declaran no presentar conflictos de intereses en relación con la preparación y public... more Los autores declaran no presentar conflictos de intereses en relación con la preparación y publicación de este artículo.
Revista Española de Cardiología (English Edition), 2012
Differences in outcome of heart failure with preserved or depressed systolic function in patients... more Differences in outcome of heart failure with preserved or depressed systolic function in patients older than 70 years who receive beta blockers Diferencias en el pronóstico de la insuficiencia cardiaca con función sistólica conservada o deprimida en pacientes mayores de 70 años que toman bloqueadores beta
Revista Española de Cardiología, 2013
Introducción y objetivos: Diferentes estudios han mostrado mejoría funcional en pacientes con mio... more Introducción y objetivos: Diferentes estudios han mostrado mejoría funcional en pacientes con miocardiopatía dilatada no isqué mica tratada con terapia celular. Sin embargo, los factores que influyen en la respuesta no son bien conocidos. El presente estudio investiga los cambios funcionales y los factores que influyen en la mejora de la fracció n de eyecció n a los 6 meses en 27 pacientes con miocardiopatía dilatada tratados con terapia celular intracoronaria. Me´todos: Los pacientes recibieron una infusió n intracoronaria de cé lulas mononucleares autó logas de la mé dula ó sea (media de cé lulas infundidas, 10,2 AE 2,9 Â 10 8). En todos se efectuó aná lisis funcional y citometría de flujo de las cé lulas infundidas. Resultados: La ganancia en fracció n de eyecció n observada a los 6 meses osciló entre el À9 y el 34% (media, 9%). Estos cambios formaron dos grupos de pacientes: 21 (78%) que mostraron una mejora significativa (ganancia media, 14 AE 7%), frente a 6 (22%) que no mostraron respuesta (ganancia media, À5 AE 3%). Los respondedores eran má s jó venes (50 AE 12 frente a 62 AE 9 añ os; p < 0,04). Se encontró una correlació n inversa (r = À0,41; p < 0,003) entre la ganancia en la fracció n de eyecció n y los valores basales de lipoproteínas de alta densidad. La capacidad migratoria de las cé lulas infundidas a las 24 h estaba significativamente reducida en el grupo de respondedores (factor de crecimiento del endotelio vascular, 5,4 AE 1,7 Â 10 8 frente a 8,1 AE 2,3 Â 10 8 ; p < 0,009; factor 1 derivado de cé lulas estromales, 5,8 AE 1,7 Â 10 8 frente a 8,4 AE 2,9 Â 10 8 ; p < 0,002). Conclusiones: Los pacientes má s jó venes con miocardiopatía dilatada y concentració n plasmá tica de lipoproteínas de alta densidad má s baja parecen tener mayor beneficio funcional tras la terapia celular. La mejoría funcional tambié n parece aumentada en los pacientes con menor capacidad migratoria de las cé lulas infundidas.
Revista Española de Cardiología (English Edition), 2013
Introduction and objectives: Different studies have shown improvement in patients with idiopathic... more Introduction and objectives: Different studies have shown improvement in patients with idiopathic nonischemic dilated cardiomyopathy treated with cell-therapy. However, factors influencing responsiveness are not well known. This trial investigates functional changes and factors influencing the 6-month gain in ejection fraction in 27 patients with dilated cardiomiopathy treated with intracoronary cell-therapy. Methods: Patients received intracoronary infusion of autologous bone-marrow mononuclear cells (mean infused, 10.2 [2.9]Â10 8). Flow cytometry and functional analyses of the cells were also performed. Results: The 6-month angiographic gain in ejection fraction ranged from À9% to 34% (mean, 9%). These changes were distinguished into 2 groups: 21 patients (78%) with a significant improvement at the 6-month evaluation (mean gain, 14 [7]%), and 6 patients who had no response (mean gain, À5 [3]%). The responders were younger as compared to the nonresponders (50 [12] years vs 62 [9] years; P<.04). There was an inverse correlation (r=À0.41; P<.003) between the gain in ejection fraction and the high density lipoprotein level, suggesting higher functional gain with low high density lipoprotein levels. The 24 h migratory capability of the infused cells was significantly reduced in the responders' group (5.4 [1.7]Â10 8 vs 8.1 [2.3]Â10 8 ; P<.009 for vascular endothelial growth factor and 5.8 [1.7]Â10 8 vs 8.4 [2.9]Â10 8 ; P<.002 for stromal cell-derived factor-1). Conclusions: Younger patients with dilated cardiomiopathy and lower plasma high density lipoprotein levels gain greater benefit from intracoronary cell-therapy. Functional improvement also seems to be enhanced by a lower migratory capacity of the infused cells.
Revista Española de Cardiología, 2006
Respiratorio. ¿Qué es el Cáncer? ¿Qué es el Cáncer de Pulmón? Tipos de Cáncer de Pulmón. ... more Respiratorio. ¿Qué es el Cáncer? ¿Qué es el Cáncer de Pulmón? Tipos de Cáncer de Pulmón. Lugares frecuentes de Metástasis. Causas y Factores de Riesgo. Signos y Síntomas. Detección y tratamiento. Capítulo 2: Epidemiologia del Cáncer de Pulmón Mundial Epidemiologia del Cáncer de Pulmón Tasas brutas y especificas según sexo de Mortalidad a nivel Mundial Tasas brutas y especificas según sexo de Prevalencia a nivel Mundial Tasas brutas y especificas según sexo de Incidencia a nivel Mundial Nacional Tasas brutas y especificas según sexo de Mortalidad a nivel Nacional Tasas brutas y especificas según sexo de Prevalencia a nivel Nacional Tasas brutas y especificas según sexo de Incidencia a nivel Nacional Provincial Tasas brutas y específicas de Prevalencia a nivel Provincial Tasas brutas y específicas de Incidencia a nivel Provincial Tasas brutas y específicas de Mortalidad a nivel Provincial Tasa bruta de Letalidad a nivel Provincial Capítulo 1 Anatomía y Fisiología normal de pulmón. Anatomía: El sistema respiratorio está formado por un conjunto de órganos que tiene como principal función llevar el oxígeno atmosférico hacia las células del organismo y eliminar del cuerpo el dióxido de carbono producido por el metabolismo celular. Los órganos que componen el sistema respiratorio son cavidades nasales, la faringe, la laringe, la tráquea, los bronquios, los bronquiolos y los dos pulmones. Los pulmones son los órganos centrales del sistema respiratorio donde se realiza el intercambio gaseoso. El resto de las estructuras, llamadas vías aéreas o respiratorias, actúan como conductos para que pueda circular el aire inspirado y espirado hacia y desde los pulmones, respectivamente. Aunque la cavidad bucal permite la entrada de aire a las vías respiratorias no forma parte el sistema respiratorio. Fisiología: es una rama en la fisiología humana que se enfoca en el proceso de respiración, tanto externa, captación de oxígeno (O 2) y eliminación de dióxido de carbono (CO 2), como interna, utilización e intercambio de gases a nivel tisular. Hombres mujeres Letalidad general de cáncer de pulmón, en Mendoza del 2008 al 2012. Tasas estandarizadas por 100.000 habitantes. Mortalidad especifica de cáncer de pulmón por departamentos, en el año 2013. Tasas estandarizadas por 1.000 habitantes. Mortalidad especifica de cáncer de pulmón por departamentos, en el año 2014. Tasas estandarizadas por 1.000 habitantes. Mortalidad especifica de cáncer de pulmón por departamentos, en el año 2014. Tasas estandarizadas por 1.000 habitantes.
The distinction between the mind and body, their relatedness and respective properties is perhaps... more The distinction between the mind and body, their relatedness and respective properties is perhaps the single most persistent problem that faces philosophical contemplation. Various models have been proposed in order to overcome this gaping duality: idealism, occasionalism, epiphenomenalism, behaviourism, etc.. The model proposed within this thesis corresponds to psychophysical parallelism - a parallelism judged purely phenomenological - wherein mind and body are conceived in terms of two aspects of an unconscious transcendental reality. Historically, philosophy has tended to prioritise one of the aspects over the other: Hegel and Marx serve to illustrate this point. As I will argue throughout this thesis, this transcendental reality - within which we will situate spontaneous creativity - is essentially double and subsists between the two extremes. The consequence of this duplicity is to negate the possibility of any reconciliation into an originary Being, but through which the extre...
Evidencia, actualizacion en la práctica ambulatoria, 2003
International Journal of Cardiology, 2016
Background. Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial f... more Background. Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial fibrillation (AF). Our aim was to study the clinical profile of octogenarians treated with oral anticoagulation and to study the effect of age on the quality of VKAs anticoagulation. Methods. Data are from a prospective national registry in an adult Spanish population of nonvalvular AF. We included 1637 patients who had been receiving VKAs for at least 6 months before enrolment. Results. Mean age was 73.8 ± 9.4 years. Patients aged > 80 years (N = 429) had a high risk profile with higher risk of stroke and bleeding than younger patients; CHA 2 DS 2-VASc (Cardiac failure, Hypertension, Age > 74, Diabetes, Stroke, Vascular disease, Age 65-74 years, and Sex category) 4.5 ± 1.3 vs. 3.5 ± 1.6, p < 0.001, HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 64 years), Drugs/alcohol concomitantly) 2.4 ± 0.9 vs. 1.9 ± 1.1, p < 0.001. Creatinine clearance was lower in octogenarians than in younger patients (54.3 ± 16.1 ml/min vs. 69.5 ± 23.7 ml/min, p < 0.001) and severe renal disease with creatinine clearance < 30 ml/min was more frequent in octogenarians (5.2% vs. 2.2%, p < 0.001). In patients treated with VKAs (N = 1637), the international normalized ratio values of the 6 months previous to enrollment were similar in all age quartiles, as was the time in the therapeutic range. Conclusion. In this large registry octogenarians with nonvalvular AF had high risk of stroke and bleeding and frequent renal disease. VKAs anticoagulation quality was similar in octogenarians and in younger patients.
Revista espanola de cardiologia (English ed.), Jan 19, 2016
The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diame... more The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm(2)±0.04 ...
Monthly Notices of the Royal Astronomical Society, 2015
Since 2006, the European Near Earth Asteroids Research (EURONEAR) project has been contributing t... more Since 2006, the European Near Earth Asteroids Research (EURONEAR) project has been contributing to the research of near-Earth asteroids (NEAs) within a European network. One of the main aims is the amelioration of the orbits of NEAs, and starting in 2014 February we focus on the recovery of one-opposition NEAs using the Isaac Newton Telescope (INT) in La Palma in override mode. Part of this NEA recovery project, since 2014 June EURONEAR serendipitously started to discover and secure the first NEAs from La Palma and using the INT, thanks to the teamwork including amateurs and students who promptly reduce the data, report discoveries and secure new objects recovered with the INT and few other telescopes from the EURONEAR network. Five NEAs were discovered with the INT, including 2014 LU14, 2014 NL52 (one very fast rotator), 2014 OL339 (the fourth known Earth quasi-satellite), 2014 SG143 (a quite large NEA), and 2014 VP. Another very fast moving NEA was discovered but was unfortunately lost due to lack of follow-up time. Additionally, another 14 NEA candidates were identified based on two models, all being rapidly followed-up using the INT and another 11 telescopes within the EURONEAR network. They include one object discovered by Pan-STARRS, two Mars crossers, two Hungarias, one Jupiter trojan, and other few inner main belt asteroids (MBAs). Using the INT and Sierra Nevada 1.5 m for photometry, then the Gran Telescopio de Canarias for spectroscopy, we derived the very rapid rotation of 2014 NL52, then its albedo, magnitude, size, and its spectral class. Based on the total sky coverage in dark conditions, we evaluate the actual survey discovery rate using 2-m class telescopes. One NEA is possible to be discovered randomly within minimum 2.8 deg 2 and maximum 5.5 deg 2. These findings update our past statistics, being based on double sky coverage and taking into account the recent increase in discovery.
Revista Española de Cardiología (English Edition), 2015
in 92, and so 46 patients may have experienced a delay in reperfusion, that is, 7.2% of the overa... more in 92, and so 46 patients may have experienced a delay in reperfusion, that is, 7.2% of the overall series. The data presented are only applicable to the network described, as the demographic characteristics, geography, hospital network, and catheterization laboratories vary for each region. 4 The fact that overlap started when the catheterization team was activated instead of when the patient arrived in the room may have increased the percentage of patients reported to have a delay. However, the end time of the procedure is not always predictable and, if the activity had been concentrated in a single center, the transfer times would have been longer for 40% of the patients in the catchment area of the second center. This may have led to overlap with patients other than those indicated, greater ambulance use with a subsequent deterioration in other areas of care, and increased mortality due to delays. 5 There may also have been an increase in the percentage of patients referred for fibrinolysis if the option of a second center were not available, while some of the 6 patients who experienced delay and who did not undergo PPCI may have received unnecessary fibrinolysis. In summary, we believe that the design of regional networks should take potential demand into account and, once in operation, the percentage of patients who have experienced delays in the past year could be used as an indicator analyzed in annual steering committee meetings for the regional network.
Vertex (Buenos Aires, Argentina)
the aim of this paper is to communicate a project of short term psychiatric hospitalization, base... more the aim of this paper is to communicate a project of short term psychiatric hospitalization, based on a therapeutic community model, considering qualitative and quantitative aspects in the present socio - cultural context. this psychiatric hospitalization model that embraces psychodynamic and pharmacological interventions is focused in the intensity of interactions between members of the therapeutic community and integrated to the administrative structure of a general hospital; this will be the key to consider patient's return to the community and to move forward over the prejudices that inpatients suffer. quantitative, prospective, observational and transversal study on a Dynamic Psychiatric Inpatient Unit. 605 patients were included. mean length of stay was 16.34 days; principal causes of admission were depression (19.4%), suicide ideas (17.7%), suicide attempt (17.6%), substance abuse or dependence (14.3%), psychosis (13.8%), behavioral and psychological symptoms of dementia ...
Revista Española de Cardiología (English Edition), 2004
Introduction. The Ross procedure has become established as an appropriate method for aortic valve... more Introduction. The Ross procedure has become established as an appropriate method for aortic valve replacement in children and young adults. There is controversy regarding the results of this surgical technique depending on whether the aortic valve disorder is congenital or acquired. The objective of this study was to analyze the outcome of this technique in different etiologies. Patients and method. We analyzed 61 patients who underwent the Ross procedure between November 1997 and November 2001. Age range was 6 to 54 years, and 44 patients (72%) were male. The mean duration of follow-up was 15.6 (10.6) months. The aortic valve lesion was stenosis in 17 patients, regurgitation in 22 and both in 22. The patients were divided into two groups: etiology was congenital in group I (40 patients) and acquired in group II (21 patients: 14 rheumatic, 2 degenerative, 2 endocarditis, and 3 other). Results. Pre-intervention data showed significant differences in age, functional class and percentage of patients with previous cardiac surgery. In the last follow-up examination, autograft gradient and homograft gradient were similar in both groups. Diastolic and systolic diameters and left ventricle ejection fraction were normal in both groups and did not differ between groups. Major events during follow-up were: 1 patient died, 1 patient had endocarditis, and 2 patients needed stent implantation in the homograft in group I; 2 patients in group II underwent reoperation because of severe autograft dysfunction. There were no statistically significant differences between groups. Conclusion. Short-term morbidity and mortality associated with the Ross procedure are low in patients with either congenital or acquired aortic valvulopathy.
Revista Española de Cardiologia, 2004
Short-Term Results With the Ross Procedure. Does the Etiology of Aortic Valvulopathy Affect the O... more Short-Term Results With the Ross Procedure. Does the Etiology of Aortic Valvulopathy Affect the Outcome? Introduction. The Ross procedure has become established as an appropriate method for aortic valve replacement in children and young adults. There is controversy regarding the results of this surgical technique depending on whether the aortic valve disorder is congenital or acquired. The objective of this study was to analyze the outcome of this technique in different etiologies. Patients and method. We analyzed 61 patients who underwent the Ross procedure between November 1997 and November 2001. Age range was 6 to 54 years, and 44 patients (72%) were male. The mean duration of follow-up was 15.6 (10.6) months. The aortic valve lesion was stenosis in 17 patients, regurgitation in 22 and both in 22. The patients were divided into two groups: etiology was congenital in group I (40 patients) and acquired in group II (21 patients: 14 rheumatic, 2 degenerative, 2 endocarditis and 3 other). Results. Pre-intervention data showed significant differences in age, functional class and percentage of patients with previous cardiac surgery. In the last follow-up examination, autograft gradient and homograft gradient were similar in both groups. Diastolic and systolic diameters and left ventricle ejection fraction were normal in both groups and did not differ between groups. Major events during follow-up were: 1 patient died, 1 patient had endocarditis, and 2 patients needed stent implantation in the homograft in group I; 2 patients in group II underwent reoperation because of severe autograft dysfunction. There were no statistically significant differences between groups. Conclusion. Short-term morbidity and mortality associated with the Ross procedure are low in patients with either congenital or acquired aortic valvulopathy.
Revista Española de Cardiología (English Edition), 2010
Introduction and objectives. o investigate the relationship between patent foramen ovale and cryp... more Introduction and objectives. o investigate the relationship between patent foramen ovale and cryptogenic stroke in patients aged ≥55 years. Methods. This prospective study determined the presence of patent foramen ovale and atrial septal aneurysm using transesophageal echocardiography in 262 consecutive patients with a diagnosis of probable cryptogenic stroke. Data from 44 patients aged ≥55 years with cryptogenic stroke (Group A) were compared with those from 2 other groups: 194 patients aged <55 years with cryptogenic stroke (Group B) and 24 control patients aged ≥55 years with stroke of known origin, namely grade III-V aortic atheromatosis (Group C). Results. The frequency of patent foramen ovale in Group A was similar to that in Group B (38% vs 36%; P=.85) but significantly higher than that in Group C (38% vs 8%; P=.029). The frequency of patent foramen ovale with concomitant atrial septal aneurysm was significantly higher in the study group (Group A) than in the control Group C (18% vs 0; P=.039) and non-significantly higher than in Group B (18% vs 11%; P=.11). Conclusions. The frequency of patent foramen ovale alone or in association with atrial septal aneurysm in patients with cryptogenic stroke aged ≥55 years was similar to that in those aged <55 years, but higher than that in patients aged ≥55 years with stroke of atherosclerotic origin. These data suggest that paradoxical embolism could be a cause of stroke in both age groups.
Revista Española de Cardiología, 2011
Revista Española de Cardiología, 2008
El cierre percutáneo del foramen oval permeable es una de las opciones terapéuticas propuestas pa... more El cierre percutáneo del foramen oval permeable es una de las opciones terapéuticas propuestas para el ictus criptogénico. El objetivo del presente trabajo es describir la experiencia de nuestro centro. Hasta febrero de 2006, se ha tratado con cierre percutáneo de foramen oval permeable a 52 pacientes que habían presentado uno o más ictus o ataques isquémicos transitorios criptogénicos. El procedimiento se realizó con anestesia y guiado por ecocardiografía transesofágica (ETE). La tasa de éxito primario fue del 100%. Inmediatamente tras el implante del dispositivo, en 27 pacientes no se observó paso derechaizquierda por ETE. Tras un seguimiento clínico medio de 26 meses en 49 pacientes, ninguno ha tenido nuevos episodios isquémicos ni complicaciones atribuibles al dispositivo. El seguimiento ecocardiográfico mostró en todos un sellado completo del foramen oval. Palabras clave: Foramen oval permeable. Isquemia cerebral. Cierre percutáneo.
Revista Española de Cardiología, 2011
Clá sicamente la endocarditis infecciosa (EI) afectaba a pacientes con una valvulopatía predispon... more Clá sicamente la endocarditis infecciosa (EI) afectaba a pacientes con una valvulopatía predisponente causada por enfermedad reumá tica, y los estreptococos del tipo viridans eran los pató genos má s frecuentes 1. Esta forma de presentació naú n predomina en los países en vías de desarrollo donde las afecciones reumá ticas son todavía muy prevalentes. En los países desarrollados, el prolapso de la vá lvula mitral se considera hoy la enfermedad predisponente
Pediatría Atención Primaria, 2011
Los autores declaran no presentar conflictos de intereses en relación con la preparación y public... more Los autores declaran no presentar conflictos de intereses en relación con la preparación y publicación de este artículo.
Revista Española de Cardiología (English Edition), 2012
Differences in outcome of heart failure with preserved or depressed systolic function in patients... more Differences in outcome of heart failure with preserved or depressed systolic function in patients older than 70 years who receive beta blockers Diferencias en el pronóstico de la insuficiencia cardiaca con función sistólica conservada o deprimida en pacientes mayores de 70 años que toman bloqueadores beta
Revista Española de Cardiología, 2013
Introducción y objetivos: Diferentes estudios han mostrado mejoría funcional en pacientes con mio... more Introducción y objetivos: Diferentes estudios han mostrado mejoría funcional en pacientes con miocardiopatía dilatada no isqué mica tratada con terapia celular. Sin embargo, los factores que influyen en la respuesta no son bien conocidos. El presente estudio investiga los cambios funcionales y los factores que influyen en la mejora de la fracció n de eyecció n a los 6 meses en 27 pacientes con miocardiopatía dilatada tratados con terapia celular intracoronaria. Me´todos: Los pacientes recibieron una infusió n intracoronaria de cé lulas mononucleares autó logas de la mé dula ó sea (media de cé lulas infundidas, 10,2 AE 2,9 Â 10 8). En todos se efectuó aná lisis funcional y citometría de flujo de las cé lulas infundidas. Resultados: La ganancia en fracció n de eyecció n observada a los 6 meses osciló entre el À9 y el 34% (media, 9%). Estos cambios formaron dos grupos de pacientes: 21 (78%) que mostraron una mejora significativa (ganancia media, 14 AE 7%), frente a 6 (22%) que no mostraron respuesta (ganancia media, À5 AE 3%). Los respondedores eran má s jó venes (50 AE 12 frente a 62 AE 9 añ os; p < 0,04). Se encontró una correlació n inversa (r = À0,41; p < 0,003) entre la ganancia en la fracció n de eyecció n y los valores basales de lipoproteínas de alta densidad. La capacidad migratoria de las cé lulas infundidas a las 24 h estaba significativamente reducida en el grupo de respondedores (factor de crecimiento del endotelio vascular, 5,4 AE 1,7 Â 10 8 frente a 8,1 AE 2,3 Â 10 8 ; p < 0,009; factor 1 derivado de cé lulas estromales, 5,8 AE 1,7 Â 10 8 frente a 8,4 AE 2,9 Â 10 8 ; p < 0,002). Conclusiones: Los pacientes má s jó venes con miocardiopatía dilatada y concentració n plasmá tica de lipoproteínas de alta densidad má s baja parecen tener mayor beneficio funcional tras la terapia celular. La mejoría funcional tambié n parece aumentada en los pacientes con menor capacidad migratoria de las cé lulas infundidas.
Revista Española de Cardiología (English Edition), 2013
Introduction and objectives: Different studies have shown improvement in patients with idiopathic... more Introduction and objectives: Different studies have shown improvement in patients with idiopathic nonischemic dilated cardiomyopathy treated with cell-therapy. However, factors influencing responsiveness are not well known. This trial investigates functional changes and factors influencing the 6-month gain in ejection fraction in 27 patients with dilated cardiomiopathy treated with intracoronary cell-therapy. Methods: Patients received intracoronary infusion of autologous bone-marrow mononuclear cells (mean infused, 10.2 [2.9]Â10 8). Flow cytometry and functional analyses of the cells were also performed. Results: The 6-month angiographic gain in ejection fraction ranged from À9% to 34% (mean, 9%). These changes were distinguished into 2 groups: 21 patients (78%) with a significant improvement at the 6-month evaluation (mean gain, 14 [7]%), and 6 patients who had no response (mean gain, À5 [3]%). The responders were younger as compared to the nonresponders (50 [12] years vs 62 [9] years; P<.04). There was an inverse correlation (r=À0.41; P<.003) between the gain in ejection fraction and the high density lipoprotein level, suggesting higher functional gain with low high density lipoprotein levels. The 24 h migratory capability of the infused cells was significantly reduced in the responders' group (5.4 [1.7]Â10 8 vs 8.1 [2.3]Â10 8 ; P<.009 for vascular endothelial growth factor and 5.8 [1.7]Â10 8 vs 8.4 [2.9]Â10 8 ; P<.002 for stromal cell-derived factor-1). Conclusions: Younger patients with dilated cardiomiopathy and lower plasma high density lipoprotein levels gain greater benefit from intracoronary cell-therapy. Functional improvement also seems to be enhanced by a lower migratory capacity of the infused cells.
Revista Española de Cardiología, 2006