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Trauma cardíaco: una revisión práctica II Parte. Traumatismo Penetrante
Edgar A Méndez J,José Zamora L,Fernando Zeledón S,Fernando Zamora R
Revista Costarricense de Cardiología , 2005,
Abstract:
Trauma Cardíaco: Una revisión práctica. I parte: Traumatismo No Penetrante
Edgar A Méndez J,José F. Zamora L,Fernando Zeledón S,Fernando Zamora R
Revista Costarricense de Cardiología , 2004,
Abstract:
Comparative Coastal Risk Index (CCRI): A multidisciplinary risk index for Latin America and the Caribbean
Ana R. Zamora,Borja G. Reguero,Fernando J. Méndez,I？igo J. Losada,Juliano Calil
- , 2017, DOI: 10.1371/journal.pone.0187011
Abstract:
Cardioprotección mediada por canales de potasio dependientes de ATP
Fernando Zeledón S,Orlando Morales M,Edgar Méndez J,Eduardo Induni L
Revista Costarricense de Cardiología , 2005,
Abstract: La mitocondria juega un rol central en el mantenimiento del metabolismo del cardiomicito durante los fenómenos de isquemia y reperfusión. Esta "cardioprotección" parece estar ligada a la apertura de canales de potasio dependientes de ATP en la membrana mitocondrial, la que evita la apertura del poro transicional de permeabilidad (MPTP), la sobrecarga de calcio y la pérdida del volumen del espacio intermembrana mitocondrial, previniendo la muerte celular por necrosis o apoptosis. Diversos estudios clínicos sustentan el uso prometedor de fármacos que abren estos canales de potasio y que podrían ser una nueva arma terapéutica contra la enfermedad isquémica y sus consecuencias. Mitochondrial ATP-sensitive potassium channels play an important role preventing necrotic cell death and apoptsis during ischaemia/reperfusion fenomena by mean of preventing mitochondrial permeability transition pore (MPTP) opening, intracellular calcium overload and loss of mitochondrial intermembrane space. There is clinical evidence of beneficial effects of a group of drugs called potassium channel openers that colud be a new therapeutic tool against cardiac ischaemic disease and its consequences.
Etiología neurógena en pacientes con disfunción erectil
Valles Antu？a,Consuelo; Fernández Gómez,J. M.; Escaf,S.; Fernández-González,Fernando;
Archivos Espa？oles de Urología (Ed. impresa) , 2008, DOI: 10.4321/S0004-06142008000300007
Abstract: objectives: erectile dysfunction (ed) is a disorder with a high prevalence that increases with age. it is estimated that 18.9% of men？s between 25 and 70 years suffer it in spain. most cases have a multifactorial origin and it is admitted the influence on its pathogenesis of systemic diseases, different kind of drugs, psychogenic factors, cardiovascular, endocrinological and neurological diseases. neurologic cause erectile dysfunction may have its origin in the central or peripheral nervous system. among possible process of neurogenic erectile dysfunction of central origin would be tumors, cerebral vascular accidents, encephalitis, parkinson disease, multiple sclerosis and other demyelinization diseases, dementias, olivopontocerebellar degeneration and epilepsy. myelopathies of any etiology may be, depending on their localization and extension, cause of erectile dysfunction. at the peripheral level, disorders of the sensitive tracts constituting the afferent limb of the erection spinal reflex, and the efferent vegetative or somatic tracts mediating arterial vasodilatation, cavernous smooth muscle relaxation or pelvic floor striated muscle contraction. the aim of this work is to review in detail the most relevant causes of neurogenic erectile dysfunction, their etiopathogenic mechanisms and therapeutic approaches currently considered more adequate for each particular case. conclusions: the correct diagnostic approach to patients with erectile dysfunction passes through identification, if possible, of the etiopathogenic factors implied. regarding this, detection and identification of a possible neurogenic risk factor will contribute to a better understanding of the physiopathologic mechanisms, and more adequate diagnostic, prognostic and therapeutic approaches, mainly in those patients refractory to first line therapy.
Valor predictivo de la historia clínica y el examen físico en el diagnóstico de la neumonía del adulto adquirida en la comunidad: Revisión de la literatura
Saldías P,Fernando; Méndez C,J Ignacio; Ramírez R,David; Díaz P,Orlando;
Revista médica de Chile , 2007, DOI: 10.4067/S0034-98872007000400016
Abstract: distinguishing pneumonia from other causes of respiratory illnesses, such as bronchitis, influenza and upper respiratory tract infections, has important therapeutic and prognostic implications. this decision is usually made by clinical assessment alone or by performing a chest x-ray. the reference standard for diagnosing pneumonia is chest radiography, but many physicians rely on history and physical examination to diagnose or exclude this disease. a review of published studies of patients suspected of having pneumonia reveals that there are no individual clinical findings, or combination of findings, that can predict with certainty the diagnosis of pneumonia. prediction rules have been recommended to guide the order of diagnostic tests, to maximize their clinical utility. thus, some studies have shown that the absence of any vital sign abnormalities or any abnormalities on chest auscultation substantially reduces the likelihood of pneumonia to a point where further diagnostic evaluation may be unnecessary. this article reviews the literature on the appropriate use of the history and physical examination in diagnose community-acquired pneumonia
Choque cardiogénico: Historia, fisiopatología e implicaciones terapeúticas. Parte I
Fernando Zeledón S,Edgar Méndez J,Juan Pucci C,Carlos Escalante G
Revista Costarricense de Cardiología , 2009,
Abstract: El choque cardiogénico es la principal causa de muerte entre los pacientes que presentan un sindrome coronario agudo. Se presenta una revision histórica y conceptos fisiológicos y fisiopatológicos de esta condición clínica que son la base para su abordaje terapéutico, principalmente la revasculrización de emergencia con angioplastia o cirugía. Cardiogenic shock: History, pathophysiology and therapeutic implications. Part I. Cardiogenic shock is the major cause of death among patients with acute coronary syndrome. The history as well as physiologic and pathophysiologic analysis of this clinical condition, based on its therapeutic management, are presented. This management predominantly involves urgent coronary angioplasty/stent placement or coronary artery bypass surgery.
Choque cardiogénico: Historia, fisiopatología e implicaciones terapeúticas. Parte II
Fernando Zeledón S,Edgar Méndez J,Juan Pucci C,Carlos Escalante G
Revista Costarricense de Cardiología , 2010,
Abstract: El choque cardiogénico es la principal causa de muerte entre los pacientes que presentan un síndrome coronario agudo. Después de la revisión histórica y de los conceptos fisiológicos y fisiopatológicos de esta condición clínica expuesta en la primera parte, se revisa su abordaje terapéutico, principalmente la revascularización de emergencia con angioplastía o cirugía. Cardiogenic shock: History, pathophysiology and therapeutical implications. Part II. Cardiogenic shock is the first cause of death among patients with acute coronary syndromes. After a previous discussion of the history and the physiologic and pathophysiologic aspects of this clinical condition in part 1, we review the therapeutic management which predominantly involves urgent angioplasty with stenting or coronary artery bypass graft surgery.
Células Madre en la reparación de tejido miocárdico: Biología y Clínica.
Fernando Zeledón S,Orlando Morales,Edgar Méndez J,Abigail Porras
Revista Costarricense de Cardiología , 2005,
Abstract: En los últimos a os se ha visto como las células madre han pasado de ser un concepto de interés científico,a ocupar tantas páginas en las revistas científicas como esperanzados comentarios en la prensa.Los conocimientos que en este campo de la medicina se vienen produciendo de forma casi diaria han disparado las expectativas de los enfermos y de los médicos de que las células madre vayan a contribuir a la curación de múltiples enfermedades humanas como la diabetes,la enfermedad de Parkinson,el infarto de miocardio u otras muchas.En el centro del debate científico,político y ético se ha situado la utilización e investigación con células madre embrionarias.No obstante,ante el descubrimiento de células madre adultas,ya sean del propio enfermo o de un donador, pareciera que existen menos obstáculos en el campo ético,más grados de libertad para el investigador y ciertamente mayores esperanzas para los enfermos.Es por esta razón,que vamos a comentar algunos de los aspectos básicos sobre este tema,en especial,en el interés que ha provocado la terapia con células madre en la reparación de corazones lesionados. In spite of the controversies involving stem cells,their future utilization has raised enormous expectations.Be as a therapeutic maneuver for degenerative disorders up until now of incurable nature,such as Parkinson ’s disease,muscular dystrophies,diabetes and cardiac diseases,or as a vehicle of genetic therapy,the truth is that we have only started to imagine their therapeutic possibilities. Unfortunately this wide field,has opened more questions than answers.Which is the ideal source for stem cells?Would the different stem cell types cause a beneficial effect in different situations.How many cells should be transplanted?Which is the most advisable access?Is it better to perform cell therapy during the acute phase of a myocardial infarction, or during the chronic phase?What type of stem cells should be transplanted?What mechanisms govern stem cells to survive and to differentiate?What is the average life of the new myocites?How safe is the procedure?Is there a role for pharmaceuticals in conjunction with stem cell therapy?And so on. We have to keep in mind that to make stem cell therapy a reality,is absolutely necessary to continue rigorous basic research,since the ultimate use of this approach in the management of myocardial infarction in the acute or chronic phase of an MI should be based in solid scientific principles and randomized studies that can assure more benefits than side effects.
Valor predictivo de la historia clínica y el examen físico en el diagnóstico de la neumonía del adulto adquirida en la comunidad: Revisión de la literatura Predictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults: A literature review
Fernando Saldías P,J Ignacio Méndez C,David Ramírez R,Orlando Díaz P
Revista médica de Chile , 2007,
Abstract: Distinguishing pneumonia from other causes of respiratory illnesses, such as bronchitis, influenza and upper respiratory tract infections, has important therapeutic and prognostic implications. This decision is usually made by clinical assessment alone or by performing a chest x-ray. The reference standard for diagnosing pneumonia is chest radiography, but many physicians rely on history and physical examination to diagnose or exclude this disease. A review of published studies of patients suspected of having pneumonia reveals that there are no individual clinical findings, or combination of findings, that can predict with certainty the diagnosis of pneumonia. Prediction rules have been recommended to guide the order of diagnostic tests, to maximize their clinical utility. Thus, some studies have shown that the absence of any vital sign abnormalities or any abnormalities on chest auscultation substantially reduces the likelihood of pneumonia to a point where further diagnostic evaluation may be unnecessary. This article reviews the literature on the appropriate use of the history and physical examination in diagnose community-acquired pneumonia
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