Catalogue of scientific papers, 1800-1863 [to 1884-1900]. Compiled by the Royal Society of London.

v. 2

Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

Background: Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods: We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results: Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. Conclusions: We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

Catalogue of scientific papers, 1800-1863 [to 1884-1900]. Compiled by the Royal Society of London.

v. 16

Catalogue of scientific papers, 1800-1863 [to 1884-1900]. Compiled by the Royal Society of London.

v. 17

Catalogue of scientific papers, 1800-1863 [to 1884-1900]. Compiled by the Royal Society of London.

v. 1

When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?

Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.

Proceedings of the Cotteswold Naturalists' Field Club.

v.2 (1854-1860)

Proceedings of the Cotteswold Naturalists' Field Club.

v.1 (1847-1853)

Bulletins de l'Académie royale des sciences, des lettres et des beaux-arts de Belgique.

t.1 (1836)

Mémoires couronnés et mémoires des savants étrangers / publiés par l'Académie royale des sciences, des lettres et des beaux-arts de Belgique.

t.17 (1843-1844)

Comptes rendus hebdomadaires des séances de l'Académie des sciences.

t.9 (1839)

Comptes rendus hebdomadaires des séances de l'Académie des sciences.

t.17 (1843)

Comptes rendus hebdomadaires des séances de l'Académie des sciences.

t.16 (1843)

Comptes rendus hebdomadaires des séances de l'Académie des sciences.

t.3 (1836)

Comptes rendus hebdomadaires des séances de l'Académie des sciences.

t.2 (1836)