Objective. To evaluate the diagnostic accuracy of exercise stress echocardiography(EchoCG) on a h... more Objective. To evaluate the diagnostic accuracy of exercise stress echocardiography(EchoCG) on a horizontal bicycle ergometer for the detection of obstructive coronary heart disease(oCAD) in patients with low-risk non-ST-segment elevation acute coronary syndrome(NSTEACS). Material and methods. The study included 95 patients, mean age 53 years, 58% of men hospitalized in the department of the regional vascular center with a diagnosis of NSTE-ACS were at low risk. Patients with known coronary heart disease and impaired left ventricular contractility at rest were not included. They underwent stress echocardiography on a horizontal bicycle ergometer according to standard methods of conduct and interpretation, and invasive or non-invasive coronary angiography(CAG). All values of coronary obstruction ≥70% were verified by invasive coronary angiography. The assessment of myocardial revascularization was observational in nature. Results. The result of stress echocardiography according to the...
Introductionto study the characteristics of the anamnestic history, the clinical course, as well ... more Introductionto study the characteristics of the anamnestic history, the clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and evaluate their impact on the prognosis of the disease.Material and methodsthe study included patients aged 60 years or older, survivors of acute myocardial infarction and registered in the database of the Hospital Universitario de los Andes in Merida, Venezuela (n=410). During the 2013-2018 study, a five-year prospective observation of patients with an assessment of their vital status was conducted. For the statistical processing of the data obtained, the Statistica V10.0 application package (StatSoft Inc.) was used.Resultsthe analysis showed that 90% of the patients had a history of comorbid pathology. The presence of an atypical manifestation of myocardial infarction lengthened the prehospital stage of medical care for patients who were late in seeking medical attention (120 [49; 311.5] minutes...
Ciencia Latina Revista Científica Multidisciplinar
La proteína C (PC) es un precursor de la serina proteasa, proteína C activada (PCA). Su activació... more La proteína C (PC) es un precursor de la serina proteasa, proteína C activada (PCA). Su activación proteolítica por trombina ocurre en la superficie del endotelio células e involucra trombomodulina y receptor de PC endotelial (RPCE). La proteína S (PS) también ejerce un efecto inhibidor directo independiente de PCA sobre el complejo de protrombinasa al unirse a FXa y FVa, y por tanto produce en la activación alterada de la protrombina. Además, la PS estimula el inhibidor de la vía del factor tisular. (IFT) en la inactivación de FXa. Los pacientes con deficiencia hereditaria de PC/PS tienen un alto riesgo de recurrencia de tromboembolismo venoso (TEV). Un estudio retrospectivo en una gran cohorte de familias ha demostrado que la incidencia anual de la primera recurrencia después de un primer episodio de TEV fueron del 6,0% (IC del 95%, 3,9–8,7) en pacientes con deficiencia de PC y del 8,4% (IC del 95%, 5,8–11,7) en pacientes con deficiencia de PS. Presentamos el caso de un paciente m...
Objective. Evaluation of the pathogenic factor of autoimmune hypogonadism in men with a positive ... more Objective. Evaluation of the pathogenic factor of autoimmune hypogonadism in men with a positive MAR IgG test result and type 1 diabetes mellitus (DM1) in a South American cohort. Materials and Methods. The retrospective study included 97 men with a positive MAR IgG test result: 30 patients with T1DM and 67 men without diabetes. The examination included determination of total testosterone and titer of antibodies against steroid-producing cells of reproductive tissue. Differences were considered statistically significant when p<0.05. Results.The incidence of high titers of autoantibodies against steroid-producing cells (Leydig cells) of the testes (CPT) in patients with T1DM and a positive MAR test is statistically significantly higher than in people without diabetes. In both groups, testosterone levels were statistically significantly lower with an increased CPT titer than with a normal titer. The incidence of hypogonadism in men with a high CPT titer was statistically significan...
Objective. To evaluate the diagnostic accuracy of exercise stress echocardiography(EchoCG) on a h... more Objective. To evaluate the diagnostic accuracy of exercise stress echocardiography(EchoCG) on a horizontal bicycle ergometer for the detection of obstructive coronary heart disease(oCAD) in patients with low-risk non-ST-segment elevation acute coronary syndrome(NSTEACS). Material and methods. The study included 95 patients, mean age 53 years, 58% of men hospitalized in the department of the regional vascular center with a diagnosis of NSTE-ACS were at low risk. Patients with known coronary heart disease and impaired left ventricular contractility at rest were not included. They underwent stress echocardiography on a horizontal bicycle ergometer according to standard methods of conduct and interpretation, and invasive or non-invasive coronary angiography(CAG). All values of coronary obstruction ≥70% were verified by invasive coronary angiography. The assessment of myocardial revascularization was observational in nature. Results. The result of stress echocardiography according to the...
Introductionto study the characteristics of the anamnestic history, the clinical course, as well ... more Introductionto study the characteristics of the anamnestic history, the clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and evaluate their impact on the prognosis of the disease.Material and methodsthe study included patients aged 60 years or older, survivors of acute myocardial infarction and registered in the database of the Hospital Universitario de los Andes in Merida, Venezuela (n=410). During the 2013-2018 study, a five-year prospective observation of patients with an assessment of their vital status was conducted. For the statistical processing of the data obtained, the Statistica V10.0 application package (StatSoft Inc.) was used.Resultsthe analysis showed that 90% of the patients had a history of comorbid pathology. The presence of an atypical manifestation of myocardial infarction lengthened the prehospital stage of medical care for patients who were late in seeking medical attention (120 [49; 311.5] minutes...
Ciencia Latina Revista Científica Multidisciplinar
La proteína C (PC) es un precursor de la serina proteasa, proteína C activada (PCA). Su activació... more La proteína C (PC) es un precursor de la serina proteasa, proteína C activada (PCA). Su activación proteolítica por trombina ocurre en la superficie del endotelio células e involucra trombomodulina y receptor de PC endotelial (RPCE). La proteína S (PS) también ejerce un efecto inhibidor directo independiente de PCA sobre el complejo de protrombinasa al unirse a FXa y FVa, y por tanto produce en la activación alterada de la protrombina. Además, la PS estimula el inhibidor de la vía del factor tisular. (IFT) en la inactivación de FXa. Los pacientes con deficiencia hereditaria de PC/PS tienen un alto riesgo de recurrencia de tromboembolismo venoso (TEV). Un estudio retrospectivo en una gran cohorte de familias ha demostrado que la incidencia anual de la primera recurrencia después de un primer episodio de TEV fueron del 6,0% (IC del 95%, 3,9–8,7) en pacientes con deficiencia de PC y del 8,4% (IC del 95%, 5,8–11,7) en pacientes con deficiencia de PS. Presentamos el caso de un paciente m...
Objective. Evaluation of the pathogenic factor of autoimmune hypogonadism in men with a positive ... more Objective. Evaluation of the pathogenic factor of autoimmune hypogonadism in men with a positive MAR IgG test result and type 1 diabetes mellitus (DM1) in a South American cohort. Materials and Methods. The retrospective study included 97 men with a positive MAR IgG test result: 30 patients with T1DM and 67 men without diabetes. The examination included determination of total testosterone and titer of antibodies against steroid-producing cells of reproductive tissue. Differences were considered statistically significant when p<0.05. Results.The incidence of high titers of autoantibodies against steroid-producing cells (Leydig cells) of the testes (CPT) in patients with T1DM and a positive MAR test is statistically significantly higher than in people without diabetes. In both groups, testosterone levels were statistically significantly lower with an increased CPT titer than with a normal titer. The incidence of hypogonadism in men with a high CPT titer was statistically significan...
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Papers by Luis Dulcey