Devenir à long terme d'une scintigraphie myocardique négative de dépistage chez le diabétique de type 2

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ISBN 13 :
Total Pages : 16 pages
Book Rating : 4.:/5 (793 download)

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Book Synopsis Devenir à long terme d'une scintigraphie myocardique négative de dépistage chez le diabétique de type 2 by : Aurélie Martineau

Download or read book Devenir à long terme d'une scintigraphie myocardique négative de dépistage chez le diabétique de type 2 written by Aurélie Martineau and published by . This book was released on 2005 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: Objectif : Les diabétiques de type 2 décèdent d'une complication cardiovasculaire dans 3⁄4 des cas. La présence d'une ischémie myocardique silencieuse est de mauvais pronostic. Elle peut être dépistée par la scintigraphie myocardique (SM) dont l'intérêt principal réside dans son excellente valeur pronostique négative à court terme. Le but de notre étude est d'évaluer à long terme une SM négative et de définir les facteurs susceptibles de modifier sa valeur pronostique. Méthode et résultats : Etude du suivi (7.5±2.5 ans, 97% de suivis complets), après une SM de dépistage, de 382 diabétiques de type 2 de plus de 10 ans d'évolution et au moins un facteur de risque cardiovasculaire. Cent vingt quatre patients avaient un examen positif et 258 négatif dont nous avons comparé le devenir cardiovasculaire. Le critère de suivi était la survenue du premier événement cardiaque majeur (ECM) : décès, infarctus du myocarde non fatal et syndrome coronarien aigu (SCA). Puis nous avons apprécié la prévalence annuelle des ECM après une SM normale et les facteurs pouvant influencer leur survenue. L'étude de survie a été effectuée par la méthode de Kaplan Meier et les facteurs prédictifs estimés par une modélisation type Cox. Les p0.05 ont été jugés comme significatifs. La présence d'une ischémie silencieuse prédispose à plus d'EMC (p=0.0011). Après une SM normale nous avons identifié 65 ECM (26.3%) répartis en : 23 décès (9.3%), 9 infarctus (3.6%) et 33 SCA (13.4%) avec un taux moyen de 3.6% par an, de répartition non homogène puisqu'on a un pic les troisième et quatrième année. Le taux initial de cholestérol total 2.2g/l et de HDL cholestérol

Evaluation de la stratégie de dépistage de l’ischémie myocardique silencieuse chez le diabétique au centre hospitalier du Forez

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (867 download)

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Book Synopsis Evaluation de la stratégie de dépistage de l’ischémie myocardique silencieuse chez le diabétique au centre hospitalier du Forez by : Cyril Mallet

Download or read book Evaluation de la stratégie de dépistage de l’ischémie myocardique silencieuse chez le diabétique au centre hospitalier du Forez written by Cyril Mallet and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction/contexte : La maladie coronaire représente la principale cause de morbi-mortalité chez les diabétiques de type 2, et son diagnostic est compliquée par une prévalence plus élevée de l’ischémie myocardique silencieuse (IMS) dans cette population. Un dépistage précoce des lésions coronariennes chez les patients diabétiques à haut risque cardio-vasculaire pourrait en améliorer leur pronostic. Les stratégies de dépistage ont évolué ces dernières années et les dernières études ainsi que l’évaluation de nouvelles techniques d’examens (échocardiographie de stress) remettent en cause la stratégie du dépistage actuel, basé sur les recommandations françaises de 2004. Patients et méthodes : Il s’agit d’une étude rétrospective de janvier 2010 à décembre 2012 inclus, dont le but était d’observer la stratégie de dépistage de l’IMS chez les patients diabétiques dans un centre hospitalier de taille moyenne (CH de Montbrison) et d’en comparer l’efficacité. Au cours de ces trois dernières années, la stratégie de dépistage a évolué au CH de Montbrison. L’échocardiographie de stress (ES), si elle est possible à réaliser, est devenue notre technique de choix. 54 % des diabétiques dépisté pour une IMS en ont profité en 2012, contre 49% et 8.5% : respectivement 2011 et 2010. Afin de vérifier l’efficience de cette stratégie, nous l’avons comparé à celle recommandée en 2004. 143 patients diabétiques, sans aucun antécédent coronarien et asymptomatique, ont été inclus dans l’étude selon les critères de dépistage actuels, c’est-à-dire évoluant depuis plus de 10 ans associés à au moins deux facteurs de risques cardio-vasculaires. Ils ont été répartis en deux groupes, selon qu’ils aient eu ou non une ES. Le groupe 1, composé de 54 patients, profitait du dépistage par ES. Les patients devaient être échogènes (échocardiographie transthoracique, [ETT], avant l’inclusion). Dans le groupe 2, 89 patients ont été dépistés par une scintigraphie myocardique où une épreuve d’effort (EE). Dans ces deux groupes, si un examen a été litigieux / sont maximal un coroscanner été réalisé. Une coronarographie était faite en cas d’examens de dépistage positif. Nous avons donc comparé 54 patients dépisté par ES (groupe 1) avec 89 autres patients dépistés selon les recommandations actuelles (groupe 2). Résultats : Les deux groupes sont comparables sur la plupart des critères : la durée du diabète, la pression artérielle (PA), l’hémoglobine glycosylée, la dyslipidémie, l’albuminurie, la sédentarité, les antécédents familiaux, le tabagisme, les scores de risques cardio-vasculaires de Framingham-Laurier et UKPDS, à l’exception de l’IMC (en moyenne à 29 dans le groupe 1 et 31.5 dans le groupe 2). Il y a eu 13 coronarographies dans le groupe 1, et 12 dans l’autre. La sensibilité de la scintigraphie myocardique et de l’ES varient entre 66 et 70%. Alors que celle de l’épreuve des efforts est proche de 20%. Cependant la stratégie basée sur l’ES a abouti à une coronarographie positive dans 16.7 % des cas, contre 8% pour la scintigraphie myocardique et 3.3 % pour les droits d’effort (Chi2=5.73, p>0.05). Dans le groupe 1, sur les neuf coronarographies positives, trois patients ont été traitées par angioplastie, trois autres ont eu un triple pontage, enfin trois patients ont été traité de manière médicale pour un contrôle optimal des facteurs de risques cardio-vasculaires. Dans le groupe 2, on note 4 coronarographies positives. Deux patients ont été traités de manière médicale, un patient a bénéficié d’une angioplastie et le dernier d’un triple pontage. Discussion : Malgré le nombre peu élevé de patients et le caractère rétrospectif de l’étude, les deux groupes sont globalement comparables, seuls certains critères les distinguent. On peut noter, bien qu’il y ait autant de coronarographies faites dans les deux groupes : 16.7% de lésions coronaire dépistées dans le groupe 1 contre 4.65% dans le groupe 2. Conclusion : Puisque les deux groupes sont globalement comparables, la prescription de l’ES par rapport aux autres examens a permis d’améliorer le dépistage des IMS chez les patients diabétiques et ainsi de mettre en évidence davantage de lésions coronaires chez ces patients.

Oxford Textbook of Palliative Medicine

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Publisher : Oxford University Press, USA
ISBN 13 : 0199656096
Total Pages : 1281 pages
Book Rating : 4.1/5 (996 download)

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Book Synopsis Oxford Textbook of Palliative Medicine by : Nathan I. Cherny

Download or read book Oxford Textbook of Palliative Medicine written by Nathan I. Cherny and published by Oxford University Press, USA. This book was released on 2015 with total page 1281 pages. Available in PDF, EPUB and Kindle. Book excerpt: Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.

Oxford Textbook of Palliative Care for Children

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Publisher : Oxford University Press
ISBN 13 : 019882131X
Total Pages : 535 pages
Book Rating : 4.1/5 (988 download)

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Book Synopsis Oxford Textbook of Palliative Care for Children by : Richard Hain

Download or read book Oxford Textbook of Palliative Care for Children written by Richard Hain and published by Oxford University Press. This book was released on 2021-03-24 with total page 535 pages. Available in PDF, EPUB and Kindle. Book excerpt: The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.

Manual of Hypertension

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ISBN 13 :
Total Pages : 728 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Manual of Hypertension by : Giuseppe Mancia

Download or read book Manual of Hypertension written by Giuseppe Mancia and published by . This book was released on 2002 with total page 728 pages. Available in PDF, EPUB and Kindle. Book excerpt: The aim is to produce a really practical manual that gives clearly presented guidelines to the ordinary practitioner about what to do in given circumstances. It will be a "bench book" on hypertension, in which its various aspects are dealt with from a clinical perspective, and where the text is constructed, laid out, and illustrated, in such a way as to make the work of maximum utility and readability to the practitioner.

Handbook of ICU EEG Monitoring

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Publisher : Demos Medical Publishing
ISBN 13 : 1936287390
Total Pages : 359 pages
Book Rating : 4.9/5 (362 download)

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Book Synopsis Handbook of ICU EEG Monitoring by : Suzette LaRoche

Download or read book Handbook of ICU EEG Monitoring written by Suzette LaRoche and published by Demos Medical Publishing. This book was released on 2012-12-20 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pearls and take-home points highlighted in every chapter.

Clinical Chronopharmacology

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Publisher : CRC Press
ISBN 13 :
Total Pages : 268 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Clinical Chronopharmacology by : Alain Reinberg

Download or read book Clinical Chronopharmacology written by Alain Reinberg and published by CRC Press. This book was released on 1990-07 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: Periodical and predictable changes in biological susceptibility and response to a large variety of chemical agents, including drugs and food, have been documented since the early 1970s. This book provides a survey of clinically-documented research in chronopharmacology.

Trauma and Pregnancy

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Publisher :
ISBN 13 :
Total Pages : 234 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Trauma and Pregnancy by : Christine E. Haycock

Download or read book Trauma and Pregnancy written by Christine E. Haycock and published by . This book was released on 1985 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:

An Introduction to Differential Manifolds

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Publisher : Springer
ISBN 13 : 3319207350
Total Pages : 408 pages
Book Rating : 4.3/5 (192 download)

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Book Synopsis An Introduction to Differential Manifolds by : Jacques Lafontaine

Download or read book An Introduction to Differential Manifolds written by Jacques Lafontaine and published by Springer. This book was released on 2015-07-29 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is an introduction to differential manifolds. It gives solid preliminaries for more advanced topics: Riemannian manifolds, differential topology, Lie theory. It presupposes little background: the reader is only expected to master basic differential calculus, and a little point-set topology. The book covers the main topics of differential geometry: manifolds, tangent space, vector fields, differential forms, Lie groups, and a few more sophisticated topics such as de Rham cohomology, degree theory and the Gauss-Bonnet theorem for surfaces. Its ambition is to give solid foundations. In particular, the introduction of “abstract” notions such as manifolds or differential forms is motivated via questions and examples from mathematics or theoretical physics. More than 150 exercises, some of them easy and classical, some others more sophisticated, will help the beginner as well as the more expert reader. Solutions are provided for most of them. The book should be of interest to various readers: undergraduate and graduate students for a first contact to differential manifolds, mathematicians from other fields and physicists who wish to acquire some feeling about this beautiful theory. The original French text Introduction aux variétés différentielles has been a best-seller in its category in France for many years. Jacques Lafontaine was successively assistant Professor at Paris Diderot University and Professor at the University of Montpellier, where he is presently emeritus. His main research interests are Riemannian and pseudo-Riemannian geometry, including some aspects of mathematical relativity. Besides his personal research articles, he was involved in several textbooks and research monographs.

Minimum competence in scientific English

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Publisher : L'Editeur : EDP Sciences
ISBN 13 : 9782868835888
Total Pages : 264 pages
Book Rating : 4.8/5 (358 download)

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Book Synopsis Minimum competence in scientific English by : Sue Blattes

Download or read book Minimum competence in scientific English written by Sue Blattes and published by L'Editeur : EDP Sciences. This book was released on 2003 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cet ouvrage, devenu célèbre sous son sigle MCSE, a déjà été utilisé par plus de 50 000 étudiants, chercheurs, professionnels. L'objectif est de lire et écrire des textes en anglais scientifique avec facilité et pertinence. L'ouvrage est conçu pour que l'apprenant devienne un véritable utilisateur de l'anglais. La méthode originale repose sur l'analyse des fonctions et structures nécessaires : measurement, frequency, comparison, modification, link words, time, cause and consequence, hypothesis, modality, purpose and process, impersonal forms, compound nouns and adjectives. Dans chaque unit, des tests d'auto-évaluation permettent de se situer et de construire son parcours de formation, d'abord en définissant ses objectifs à l'aide des key points et du lexis, puis, de façon plus personnalisée, en puisant dans les examples in context, checkpoints (back to basics, word web), web search, FAQs... MCSE est l'outil de base d'une méthode qui comprend aussi d'autres outils dans la même collection (Listening Comprehension for Scientiflc English et Speaking Skills in Scientitic English). L'ouvrage est destiné à tout apprenant de niveau baccalauréat qui désire acquérir une réelle compétence dans l'écriture et la lecture de textes en anglais scientifique.

Biological Rhythm Research

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Publisher :
ISBN 13 :
Total Pages : 472 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Biological Rhythm Research by : A. Sollberger

Download or read book Biological Rhythm Research written by A. Sollberger and published by . This book was released on 1965 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Living Donor Transplantation

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Publisher : CRC Press
ISBN 13 : 1420019651
Total Pages : 490 pages
Book Rating : 4.4/5 (2 download)

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Book Synopsis Living Donor Transplantation by : Henkie P. Tan

Download or read book Living Donor Transplantation written by Henkie P. Tan and published by CRC Press. This book was released on 2007-04-27 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: Edited by leaders at one of the acclaimed transplant institutions in the United States, this reference covers all aspects of living donor solid organ and cellular transplantation in current clinical practice, including the kidney, liver, pancreas, lung, small bowel, islet, and hematopoietic stem cell transplantation. Detailed, engaging, and organ-

Endocrine Rhythms

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ISBN 13 :
Total Pages : 352 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Endocrine Rhythms by : Dorothy T. Krieger

Download or read book Endocrine Rhythms written by Dorothy T. Krieger and published by . This book was released on 1979 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Children's Palliative Care in Africa

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Publisher :
ISBN 13 : 0199567964
Total Pages : 448 pages
Book Rating : 4.1/5 (995 download)

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Book Synopsis Children's Palliative Care in Africa by : Justin Amery

Download or read book Children's Palliative Care in Africa written by Justin Amery and published by . This book was released on 2009 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: Childen's palliative care has developed rapidly as a discipline, as health care professionals recognize that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming, and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 85% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed. Written by a group with wide experience of caring for dying children in Africa, this book provides practical, realistic guidance by improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care--including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end of life care, and tips for the professional on compassion and conservation of energy--but always retains the focus on the particular needs of the health care professional in Africa. While containing some theory, the emphasis is on practical action throughout the book. Children's Palliative Care in Africa provides health care professionals working in Africa, and other resource-poor settings, with the confidence, knowledge, and capacity to improve care for the terminally ill child in constrained and demanding environments.

Prostate Cancer Diagnosis

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Publisher : Springer Science & Business Media
ISBN 13 : 162703188X
Total Pages : 390 pages
Book Rating : 4.6/5 (27 download)

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Book Synopsis Prostate Cancer Diagnosis by : J. Stephen Jones

Download or read book Prostate Cancer Diagnosis written by J. Stephen Jones and published by Springer Science & Business Media. This book was released on 2012-11-14 with total page 390 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on the highly successful first edition of Prostate Biopsy: Indications, Techniques, and Complications, this new volume presents new concepts that have emerged in answer to current questions from its audience. Many new perspectives and technologies are presented, many from the authors’ internationally recognized work on the topic. Substantial developments in techniques and complications are explored in detail. The chapter authors comprise a complete spectrum of specialists in their respective subject areas. All authors are internationally accepted as the premier authorities on their chosen topics. Prostate Cancer Diagnosis: PSA, Biopsy, and Beyond presents new data on the controversial issue of PSA screening and thresholds as indication to perform biopsy. Office based transrectal saturation biopsy is covered in detail. Other topics explored include template guided biopsy and image-guided biopsy as well as a completely new paradigm for prevention of complications. Prostate Cancer Diagnosis: PSA, Biopsy, and Beyond will be of great value and utility to all practicing urologists.

Palliative Care Consultant

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Publisher :
ISBN 13 : 9780757561849
Total Pages : 0 pages
Book Rating : 4.5/5 (618 download)

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Book Synopsis Palliative Care Consultant by : Ohio Hospice and Palliative Care Organization Staff

Download or read book Palliative Care Consultant written by Ohio Hospice and Palliative Care Organization Staff and published by . This book was released on 2010-10-21 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Therapy in Nuclear Medicine

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Publisher : Saunders
ISBN 13 :
Total Pages : 424 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Therapy in Nuclear Medicine by : Richard Paul Spencer

Download or read book Therapy in Nuclear Medicine written by Richard Paul Spencer and published by Saunders. This book was released on 1978 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt: