Publications by authors named "Rafael J Zamora"

5 Publications

  • Page 1 of 1

PULSE-HF: A simple clinical and geriatric score to predict systolic dysfunction in the elderly without heart failure.

Curr Probl Cardiol 2021 Nov 21:101066. Epub 2021 Nov 21.

Department of Internal Medicine, Hospital Alemán, Buenos Aires, Argentina; Geriatric Unit, Hospital Alemán, Buenos Aires, Argentina.

Objective: To develop a clinical score to determine preclinical predictors of systolic dysfunction in an outpatient elderly population without a diagnosis of heart failure (HF).

Patients And Methods: PULSE-HF is a cross-sectional study in elderly at-risk (coronary artery disease, diabetes or hypertension) outpatients without a diagnosis of HF. Clinical and geriatric variables were analyzed; independent predictive factors in the logistic regression analysis were included for the score calculation.

Results: Of the 722 subjects enrolled, 47 (6.5%) had a left ventricular ejection fraction (LVEF) < 50% and 15 (2.1%) a LVEF < 40%. Mean age was 76.5 years (5.18) and 445 (61.6%) were female. Multiple logistic regression analysis identified abnormal Q waves (odds ratio [OR]: 4.36; p=0.003), cardiomegaly (OR: 3.32; p < 0.001), right bundle branch block (OR: 2.84; p=0.011), cognitive dysfunction (OR: 2.14; p=0.027) and NT-proBNP (OR 5.43; p < 0.001) as independent predictors of LVEF < 50%. Two prediction scores were built, without and with NT-proBNP inclusion; the area under ROC curves were 0.70 and 0.76, respectively. As the score increased, the sensitivity decreases but increases specificity and accuracy (97.17% and 91.64% respectively in ≥ 6 points). NT-proBNP was associated with an increment in the performance (accuracy of 93.18% for score ≥ 10).

Conclusion: A simple score using clinical information might be useful to predicting asymptomatic systolic dysfunction in the elderly.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cpcardiol.2021.101066DOI Listing
November 2021

[Giant abdominal abscess].

Medicina (B Aires) 2016;76(6):400

VI Cátedra de Medicina Interna, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Argentina. E-mail:

View Article and Find Full Text PDF

Download full-text PDF

Source
August 2017

[Thoracic outlet syndrome].

Medicina (B Aires) 2016 ;76(3):191

VI Cátedra de Medicina Interna, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina. E-mail:

View Article and Find Full Text PDF

Download full-text PDF

Source
July 2019

[Tumor-induced osteomalacia: rhinosinusal hemangiopericytoma].

Medicina (B Aires) 2013 ;73(1):39-42

VI Cátedra de Medicina Interna. Servicio de Medicina Interna, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires.

Tumor-induced osteomalacia is a rare disease of bone metabolism. The characteristic of this disease is an increase in phosphate excretion followed by hypophosphatemia, due to phosphaturic agents produced by different types of tumors. Tumor resection results in complete resolution of clinical, biochemical and radiological abnormalities. We present the case of a 61 year old man with signs, symptoms and laboratory findings consistent with oncogenic osteomalacia due to a rhino-sinusal mesenchymal tumor. The histological diagnosis showed a vascular neoplasm: hemangiopericytoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2013

[Nutritional status, systemic inflammatory response syndrome and mortality in the elderly hospitalized patient].

Medicina (B Aires) 2010 ;70(3):233-9

VI(ta) Cátedra de Medicina, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Argentina.

In order to evaluate the relationship between systemic inflammatory response and mortality in the older hospitalized patient, we developed a prospective cohort study in which we evaluated a nutritional score (SGA), years of instruction, functional status, organic failure (Marshall), presence of sepsis, comorbidities (Charlson), cognitive state (MMSE), albumin, erythrocyte sedimentation rate and mortality. Fifty two patients were included, 19 men (36.5%) and 33 women (63.5%), mean age was 80 (Interquartile Range 12.5) years. 29 (55.8%) patients were well-nourished and 23 (44.2%) malnourished, 53.8% of patients developed sepsis at admission or during hospitalization. Total nosocomial mortality was 7.7 % (n = 4) and one-year mortality was 31.8% (n = 14). Comparative analyses showed older age (80 vs. 78; p = 0.012), less years of instruction (7 vs. 8; p = 0.027), lower MMST (14 vs. 27; p = 0.017), lower previous functional status (21 vs. 32; p < 0.0001), lower albumin (3 vs. 3.35; p = 0.014) and higher organic failure score at admission (3 vs. 1; p = 0.01) with more number of affected organs (2 vs. 1; p = 0.003) in malnourished patients compared to well nourished ones. Higher incidence of sepsis -at admission or during hospitalization- (73.9% vs. 37.9%; p = 0.01) and more severe stages of sepsis were also observed in malnourished patients. One-year mortality was significantly higher in malnourished (52.2% vs. 9.5%, log rank test = 0.002). In conclusion, malnourished patients presented greater systemic inflammatory response.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2011
-->