scholarly journals Rehabilitación cardíaca fase 2 post infarto agudo al miocardio.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kirby Gutiérrez Arce ◽  
Jessy Estefanía Funez Estrada ◽  
Cristian Yovany Rojas Aboyte ◽  
Perla Lizeth Hernández Cortés Hernández Cortés ◽  
María Cristina Enríquez Reyna

Objetivo. Se propuso analizar la información disponible sobre protocolos de ejercicio diseñados para ofrecer rehabilitación cardiaca fase II para pacientes post infarto agudo al miocardio fase II con el propósito de identificar las características de los programas de entrenamiento y los resultados relativos a la recuperación del funcionamiento cardiaco (fracción de eyección, capacidad respiratoria) y metabólico (glicemia). Método. Revisión sistemática de literatura del 2016 a septiembre del 2019 con búsqueda realizada en PubMed, Google académico, Redalyc, Science direct y Springer. Las palabras clave en inglés fueron: “cardiac rehabilitation or guide for clinical practice" AND acute myocardial infarction AND “Exercise program or physical training”. Los indicadores considerados para el funcionamiento cardíaco incluyen la fracción de eyección o la capacidad respiratoria (VO2máx). Para el funcionamiento metabólico se consideró el reporte de la glicemia. Los hallazgos se presentan considerando los criterios de PRISMA. El nivel de evidencia de acuerdo con criterios de la National Health and Medical Research Council. Resultados. Cinco ensayos clínicos, siete artículos con otros tipos de diseño y seis protocolos de investigación superaron los criterios de selección y fueron analizados en esquemas de acuerdo con el tipo de resultados considerados. Se describen algunas características del entrenamiento, frecuencia, duración e intensidad. Conclusiones. Existen evidencias de cambios positivos en el funcionamiento cardiaco y metabólico. La información resulta de utilidad para el diseño de programas de entrenamiento. La toma de decisiones debiera considerar al equipo multidisciplinario de salud dada la susceptibilidad de este tipo de pacientes.  

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Anselm K Gitt ◽  
Harm Wienbergen ◽  
Uwe Zeymer ◽  
Frank Towae ◽  
Martin G Gottwik ◽  
...  

Background: Hospital mortality of STEMI in recent randomized trials as ASSENT IV ranges between 3.5 and 6.0%. Although registry data have shown a constant improvement of myocardial infarction outcome over the past years due to better implementation of guidelines for the management of acute myocardial infarction, hospital mortality in clinical practice still was much higher than in the selected patient population of randomized trials. Can ongoing registries in clinical practice as quality assurance programmes further reduce hospital mortality of acute myocardial infarction? Methods: The OPTAMI Register (Optimized Therapy of Acute Myocardial Infarction) enrols consecutive patients with STEMI or NSTEMI in 33 Centres (27 with cathlab facilities) in Germany to document patient characteristics, acute therapy as well as hospital outcome. All centres are provided benchmark reports for internal quality control. Results: Out of 1139 enrolled patients, 629 (55%) presented with STEMI and 510 (45%) with NSTEMI. Patients with NSTEMI were older, more often female and had a significantly higher prevalence of relevant comorbidities. OPTAMI documented an extraordinary high rate of primary PCI in STEMI as well as a high rate of early invasive strategy with PCI <48h in NSTEMI. In both groups, adherence to guidelines for the acute adjunctive medical treatment including antiplatelet therapy, betablockers, ACE-inhibitors and statins was higher than ever documented in any German MI registry. Hospital mortality was 4.0% in consecutive patients with STEMI and 3.9% in consecutive patients with NSTEMI. Conclusion: Preliminary data of the ongoing OPTAMI Registry demonstrate that in selected cnetres (mainly with cath lab facilities) hospital mortality in clinical practice can be reduced to levels of randomised controlled trials by adherence to practice guidelines for the management of acute myocardial infarctions.


Vascular ◽  
2016 ◽  
Vol 25 (4) ◽  
pp. 447-448 ◽  
Author(s):  
Marco Zuin ◽  
Gianluca Rigatelli ◽  
Giuseppe Faggian ◽  
Roberto L’Erario ◽  
Mauro Chinaglia ◽  
...  

Acute myocardial infarction, stroke and pulmonary embolism required a prompt revascularization to restore the normal blood flow as soon as possible. Fibrinolytic treatment has gradually become both dated and underused in the treatment of acute myocardial infarction, after the wide diffusion of cathlab and percutaneous transluminal coronary angioplasty. Conversely, the use of systemic thrombolysis remained a benchmark in the treatment of both ischemic stroke and massive pulmonary embolism. In daily clinical practice, the use of thrombolytic agents is often limited by absolute and/or relative contraindications and possible adverse events after the drug administration, as intracranial and/or extracranial bleeding events. To minimize these problems, during the last years, the introduction of nanotechnology in the field of cardiovascular revascularization medicine has created several fascinating results. In the present article, we describe these recent findings and their possible implications in future clinical practice.


Author(s):  
Gheorghe Jurj

This paper presents the results of conceptual research on the nature and operation of visual signs in homeopathic clinical practice. Aims: to analyze the role of visual signs in homeopathy together with their specific semiotic structure in correlation with the codes leading to possible significations and then to assess the possibility of establishing coherence between the symptoms and signs of patients. Methodology: Sign-complexes are approached through a four-stage model including: 1) delimitation; 2) decomposition; 3) correlation and; 4) reintegration of signs. Data for analysis were collected along 15 years of homeopathic clinical practice and recorded by visual means; theoretical foundations derive from Jakobson’s theory of communication and Peirce’s semiotics. Results: stages of delimitation and decomposition are illustrated by a homeopathic semiology of the tongue; analysis of correlation allowed to identify 9 different possible patterns; reintegration requires a first phase of extension of the connotation and denotation of signs followed by a phase of contraction of meaning leading to decision-making. Conclusion: application of the model proposed results in highly qualified and individual visual signs that bring new elements to reconsider the role of objective signs in homeopathic practice. Keywords: Homeopathy; Semiotics; Semiology; Visual signs  Método de observação em Homeopatia: Fundamentos metodológicos do projeto “Entendendo a Homeopatia através de imagens” ResumoEste artigo apresenta os resultados da pesquisa conceitual sobre a natureza e operação de sinais visuais na prática clínica homeopática. Objetivos: analisar a função de sinais visuais na homeopatia juntamente com a sua estrutura semiótica semiótica, correlacionando-os com os códigos, conduzindo a possíveis significações e, em seguida, para avaliar a possibilidade de estabelecer coeréncia entre os sinais e sintomas dos pacientes. Metodologia: o conjunto de sinais são abordados através de um modelo com quatro fases: 1)  delimitação; 2) decomposição; 3) correlação; 4) reintegração de sinais. Os dados para análise foram coletados ao longo de 15 anos de prática clínica homeopática e registrados por recursos visuais; os fundamentos teóricos derivam da teoria da comunicação de Jakobson e semiótica de Peirce. Resultados: as fases de delimitação e decomposição são ilustradas pela semiologia homeopática da língua; a análise de correlação permitiu identificar 9 diferentes padrões; a reintegração exige uma primeira fase de interpretação da conotação e denotação de sinais, seguida por uma fase de contração do significado, levando à tomada de decisão. Conclusão: a aplicação do modelo proposto resulta em sinais visuais altamente qualificados e individualizados, que trazem novos elementos para repensar o papel dos sinais objetivos na prática homeopática. Palavras-chave: Homeopatia, Semiótica, Semiologia, Sinais visuais  Un método de observación en Homeopatía: Bases metodológicas del proyecto "Entendiendo la homeopatía por imágenes" ResumenEste artículo presenta los resultados de la investigación conceptual sobre la naturaleza y el funcionamiento de las señales visuales en la práctica clínica homeopática. Objetivos: analizar el papel de la homeopatía en los signos visuales, junto con su estructura específica semiótica en correlación con los códigos para posibles significaciones y, a continuación, para evaluar la posibilidad de establecer la coherencia entre los signos y síntomas de los pacientes. Metodología: Registro complejos se abordan a través de un modelo de cuatro etapas que incluyen: 1) delimitación, 2) descomposición; 3) correlación y, 4) reintegración de los signos. Datos para el análisis fueron recogidos a lo largo de 15 años de práctica clínica y homeopáticos registrados por medios visuales; los fundamentos teóricos se derivan de la teoría de la comunicación de Jakobson y la semiótica de Peirce. Resultados: las etapas de la delimitación y la descomposición se ilustra con una semiología homeopática de la lengua; la análisis de correlación permitió identificar 9 posibles patrones diferentes; la reinserción requiere una primera fase de ampliación de la connotación y la denotación de los signos seguidos por una fase de contracción de sentido que conducen a la toma de decisiones. Conclusión: la aplicación del modelo propuesto resulta en resultados altamente calificados y signos visuales que aportan nuevos elementos a reconsiderar el papel de los signos objetivos de la práctica homeopática. Palabras-clave: Homeopatía; Semiótica; Semiología; signos visuales  Correspondence author: Gheorghe Jurj, [email protected] How to cite this article: A Method of Seeing in Homeopathy: Methodological Foundations of Project “Understanding Homeopathy by Images”. Int J High Dilution Res [online]. 2009 [cited YYYY Month dd]; 8 (27): 53-69. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/333/386.  


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hannah Piekarz ◽  
Catherine Langran ◽  
Parastou Donyai

AbstractFollowing an acute myocardial infarction, patients are prescribed a regime of cardio-protective medication to prevent recurrent cardiovascular events and mortality. Adherence to medication is poor in this patient group, and not fully understood. Current interventions have made limited improvements but are based upon presumed principles. To describe the phenomenon of medicine-taking for an individual taking medication for secondary prevention for an AMI, Interpretative Phenomenological Analysis was used to analyse transcripts of semi-structured interviews with participants. Themes were generated for each participant, then summarized across participants. Five key themes were produced; the participants needed to compare themselves to others, showed that knowledge of their medicines was important to them, discussed how the future was an unknown entity for them, had assimilated their medicines into their lives, and expressed how an upset to their routine reduced their ability to take medication. Participants described complex factors and personal adaptations to taking their medication. This suggests that a patient-centred approach is appropriate for adherence work, and these themes could inform clinical practice to better support patients in their medicine adherence.


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