MENTAL HEALTH MATTERS EDITORIAL Mental Health: It’s Not All in Your Head PDF LETTERS TO THE EDITORS PDF FEATURE Community Mental Health Services in Cuba Conner Gorry MA PDF / PDF ESPAÑOL Therapeutic Clowns Bring Joy to Cuban Patients Conner Gorry MA PDF INTERVIEW Approaches to Substance Abuse in Cuba: Ricardo A. González MD PhD […]
Margarita Chacón Roger MS PhD Nurse with a master’s degree in health psychology and a doctorate in health sciences. Dr Chacón’s practice and research focus on cancer care, particularly palliative care and quality of life, and on occupational stress in the health professions. A full professor and senior researcher at the National Oncology and Radiobiology […]
Abdominal pain and asthenia as common clinical features in hospitalized children for giardiasis. Almirall P, Núñez FA, Bello J, González OM, Fernández R, Escobedo AA. Acta Trop. 2013 May 18. pii: S0001-706X(13)00131-9. doi: 10.1016/j.actatropica.2013.05.005. [Epub ahead of print] Giardiasis is a disease with worldwide distribution, although its prevalence differs from country to country. In order […]
Norma E. Batista Hernández MD Physician specializing in biostatistics and family medicine. Dr Batista is medical biostatistician in the biomedical research unit of the Medical University of Villa Clara, Cuba, where she focuses on chronic diseases. She is currently completing postgraduate work in biostatistics using spatiotemporal analysis applied to cancer epidemiology. Dr Batista is a […]
CHRONIC DISEASES REVISITED EDITORIAL NCDs: Can Healthy Synergies Replace Fatal Interactions? PDF LETTERS TO THE EDITORS PDF INTERVIEW Sounding the Alarm on Chronic Kidney Disease in Farming Communities: María Isabel Rodríguez MD. Minister of Health, El Salvador Conner Gorry MA PDF ORIGINAL RESEARCH Prognostic Factors in Hemodialysis Patients: Experience of a Havana Hospital Julio Valdivia […]
Enrique Beldarraín Chaple MD PhD Epidemiologist with a doctorate in health sciences. Full professor at the Medical University of Havana and senior researcher and research director, Cuban National Health Care Telecommunications Network and Portal (INFOMED) in Havana. Dr Beldarraín’s research and publications on a range of topics in communicable and non-communicable disease control, as well […]
INTRODUCTION Myocardial reperfusion during the course of an acute myocardial infarction improves patients’ short- and long-term prognosis; coronary blood flow is successfully re-established while preserving a large amount of at-risk muscle. Clinical evolution, however, varies. Presence of residual ischemia or viable myocardial tissue affects a patient’s prognosis. Assessment by noninvasive methods allows better prognostic stratification. Cardiac-gated SPECT provides appropriate parameters to support treatment selection and monitoring of these patients.
OBJECTIVES Assess the prognostic value—ability to predict occurrence of major cardiac events—of perfusion and cardiac function obtained by myocardial perfusion scintigraphy in myocardial infarction patients treated by any myocardial reperfusion method, whether pharmacological or surgical.
MEDTHODS Forty patients were included, mean age 58.8±9 years, diagnosed with myocardial infarction. Participants were divided into two groups: primary percutaneous transluminal coronary angioplasty (15) or thrombolysis (25). All received myocardial perfusion scintigraphy with cardiac-gated SPECT to assess perfusion and left ventricular function, and were followed for six months with telephone interviews and review of clinical records.
RESULTS In the 11 patients who had major cardiac events within six months of followup, a nonsignificant increase in perfusion defect extent was seen post reperfusion. Six (54.5%) of those with major cardiac events had anterior perfusion defects. In functional parameters, a significant increase in end-diastolic and end-systolic volumes and decrease in left ventricular ejection fraction were observed post stress (p = 0.006) and at rest (p = 0.001). Post-stress end-diastolic volume of ≥70 mL had a higher prognostic value for major cardiac events [sensitivity 100%; specificity 89%, area under ROC curve 0.835 (CI 0.702–0.969), p = 0.001].
CONCLUSIONS Cardiac-gated SPECT is useful to identify variables (including left ventricular systolic dysfunction and dilation of left cavities, particularly left end-systolic volume of >70 mL) predictive of major cardiac events in reperfused patients, independent of treatment modality.
KEYWORDS Scintigraphy, cardiac-gated SPECT, single-photon emission computer-assisted tomography, myocardial infarction, myocardial reperfusion, percutaneous transluminal coronary angioplasty, thrombolysis, prognosis, Cuba
Jorge P. Alfonzo Guerra MD PhD Nephrologist. Founding member, full professor and consulting nephrologist at the national Nephrology Institute in Havana, Dr Alfonzo has published four books and some 250 articles in Cuba and internationally and has received numerous awards for his scientific contributions. He is a pioneer of renal transplantation in Cuba and member […]
CUBA TACKLES DIABETES EDITORIAL Diabetes: The Shark in the Water PDF PEER REVIEWERS Peer Reviewers 2012 LETTERS TO THE EDITORS PDF FEATURE Immunodiagnostics: The Convergence of Biotech and Public Health Aramís Sánchez Gutiérrez MS and Conner Gorry MA PDF / PDF ESPAÑOL SPECIAL ARTICLE Heberprot-P: A Novel Product for Treating Advanced Diabetic Foot Ulcer Jorge […]
Breast cancer suppressor candidate-1 (BCSC-1) is a melanoma tumor suppressor that down regulates MITF. Anghel SI, Correa-Rochal R, Budinska E, Boliganl KF, Abraham S, Colombetti S, et al. Pigment Cell Melanoma Res. 2012 Jul;25(4):482–7. Understanding the molecular aberrations involved in the development and progression of metastatic melanoma (MM) is essential for a better diagnosis and targeted therapy. We identified breast cancer […]
Carlos Aragonés López BEng MS Informatics engineer with a master’s degree in epidemiology. He heads the biostatistics and informatics department at the Pedro Kourí Tropical Medicine Institute, Havana, where he is also an instructor and associate researcher. Mr Aragonés conducts research on a range of issues related to HIV/AIDS, including adherence to therapy, drug resistance, […]
HEALTH SYSTEM MANAGEMENT, EFFICIENCY & QUALITY EDITORIAL Eye on the Prize The Editors PDF POLICY & PRACTICE SIDATRAT: Informatics to Improve HIV/AIDS Care Carlos Aragonés BEng MS, et al. PDF INTERVIEW PAHO’s Presence in Cuban Health: José Luis Di Fabio PhD. PAHO/WHO Representative in Cuba Gail Reed MS PDF SPECIAL ARTICLE Reducing Case Fatality from […]
Access to antiepileptic drug therapy in children in Camagüey Province, Cuba. Bárzaga Z, López A, Mejías Y, González AR, Acosta M, Carbonell D, et al. Int J Pharmacy Practice. 2012 May 21. Epub ahead of print. Objective To describe access to antiepileptic drug therapy and estimate the prevalence of epilepsy in children in Camagüey Province, […]
Anselmo A. Abdo Cuza MD MS PhD Internist and specialist in intensive care and emergency medicine. Full professor, Medical University of Havana, and head of intensive care and transplant coordination, Medical-Surgical Research Center, Havana. Dr Abdo has published extensively in Cuba and internationally on a range of issues in urgent care and has received three […]
GENDER & HEALTH IN CUBA EDITORIAL Gender & Health: Towards a Consensus on Rights, Policy and Public Opinion PDF LETTERS TO THE EDITORS PDF INTERVIEW Revolutionizing Gender: Mariela Castro MS, Director, National Sex Education Center, Cuba Gail Reed MS PDF SPECIAL ARTICLE Speaking from Experience: Today’s Cuban Women and Breast Cancer Marta Núñez MS PhD […]
C. Leticia Artiles Visbal MS PhD Anthropologist with a doctorate in health sciences. Former full professor at the National School of Public Health, now retired, Dr Artiles has researched and published widely on health systems, social determinants of health and gender. She is a member of the Advisory Council to the Latin American Social Medicine […]
