Papers by A. Frati-munari
International Angiology, 2017
BACKGROUND: Sulodexide is a glycosaminoglycan approved for the treatment of chronic venous diseas... more BACKGROUND: Sulodexide is a glycosaminoglycan approved for the treatment of chronic venous disease (CVD). It has been available in Mexico since 2012. The aim of the study was to understand the clinical experience of primary care physicians in the treatment of CVD with sulodexide. METHODS: Clinical data collection forms were distributed among general practitioners. Data was collected for up to four follow-up consultations. All signs and symptoms were rated with the Likert Scale at each examination: 0 to 5 (where 0 means none, and 5 very severe). Both the patient's and the physician's opinions of the effects of the treatment were recorded. RESULTS: Data were collected from 1599 patients at different clinical stages of CVD, 52% of which were at advanced stages (C4-C6). A total of 434 cases were followed up with four examinations (median of thirty days between each examination). In these cases, the overall sign and symptom score decreased significantly at each examination (P<0.01). At the fourth examination, 98.9% of the patients felt better or much better than at the first examination, and 99.7% were better or much better in the physician's opinion (P<0.01). The only adverse effect was nausea, reported in two cases. CONCLUSIONS: Sulodexide was effective and well tolerated in the treatment of CVD.
Rev Med Imss, Apr 1, 1986
Revista Medica Del Instituto Mexicano Del Seguro Social, 1983
Description d'un cas chez une femme de 54 ans atteinte d'une neuropathie autonome, d'... more Description d'un cas chez une femme de 54 ans atteinte d'une neuropathie autonome, d'une retinopathie diabetique et d'une courbe de tolerance a la glucose anormale. L'amelioration a ete obtenue grâce au traitement avec du propanolol
Gaceta médica de México, 1983
JAMA: The Journal of the American Medical Association, 1981
AMONG the causes of acute gastrointestinal (GI) tract bleeding, hookworm infestation is not usual... more AMONG the causes of acute gastrointestinal (GI) tract bleeding, hookworm infestation is not usually considered. Chronic occult bleeding is well known, but acute hemorrhage is rarely recorded.1-5 We describe a patient who had a massive intestinal hemorrhage. Report of a Case A 19-year-old man was admitted because of more than 20 episodes of melena and hematochezia in the preceding 12 hours. Physical examination disclosed pallor, cold skin, blood pressure of 80/50 mm Hg, and pulse rate of 110 per minute. A blood test showed the following values: hemoglobin, 5.2 g/dL; hematocrit, 19%; reticulocytes, 10%; leukocytes, 33,000/cu mm; neutrophils, 58%; eosinophils, 33%; basophils, 1%; and lymphocytes, 8%. Upper GI tract endoscopy, sigmoidoscopy, and small-bowel and barium enema x-ray films were normal. Mesenteric angiography showed a possible bleeding zone in the
Annals of Emergency Medicine, 1987
Intravenous access can be very difficult to obtain in small hypotensive infants. We studied the a... more Intravenous access can be very difficult to obtain in small hypotensive infants. We studied the ability of the intraosseous route to accept a large volume of resuscitation fluid administered to hypovolemic rabbits. Hypotension induced by withdrawing one-third of the blood volume of rabbits was treated by infusion of saline, IV or intraosseously, A control group was bled, but received no saline. All three groups experienced a drop in mean arterial blood pressure (MAP) to at least 50% of the prebleed baseline value. Also, all groups' heart rates dropped to between 90 and 95% of prebleed baseline values. A ten-minute infusion-of a saline volume equal to three times the volume of blood removed reversed hypotension equally by the intraosseous and IV routes. After one-half of the fluid was administered, the MAP was 107 +_ 4% and 104 + 11% of baseline in the intraosseous and IV groups, respectively. In contrast, the control group had a MAP of 70 +-8% of baseline at the same time. At the end of the fluid bolus the intraosseous group had a MAP of 97 + 3% of baseline and the IV group a MAP of 99 +-8%. The control group continued to have a low MAP of 72 +-6% of baseline. Heart rates rose during fluid administration in both the intraosseous and IV groups, reaching 103 + 2% and 99 + 3%, respectively, at the end of fluid administration. The control group was 88 +_ 2% of baseline at the same time. The ch'fferences between the treatment groups and the control group were significant at the .05 level. The intraosseous route will allow sufficient flow of fluid to rapidly reverse hypotension secondary to hemorrhage in a small mammal (ie, the rabbit).
Gac. méd. …, 2000
Base de dados : LILACS. Pesquisa : 304356 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : LILACS. Pesquisa : 304356 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. Texto completo. experimental, Documentos relacionados. Id: 304356 ...
Arch Med Res, Sep 1, 1998
Rev Gastroenterol Mex, Mar 1, 1987
Rev. méd. …, 1993
Base de dados : LILACS. Pesquisa : 176949 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : LILACS. Pesquisa : 176949 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 176949. ...
Digestive Diseases and Sciences, 1994
Background. Sulodexide is a glycosaminoglycan used in the treatment of venous chronic disease (CV... more Background. Sulodexide is a glycosaminoglycan used in the treatment of venous chronic disease (CVD) which has been recently introduced as a therapeutic tool in México. Objective. To collect Mexican experience using sulodexide in the treatment of CVD. Material and methods. From September 2012 to May 2013, angiologist and internist of 20 Mexican cities were invited to fulfill a structured form with demographic and clinical data of their patients treated for CVD. Those receiving sulodexide were analyzed, as well as the clinical data in the following visits. Results. 104 specialists participated with 1,013 patients, most of them (76%) were classified as C3 to C6, 35% as C6. They were previously treated with surgery, sclerotherapy, flebotonics or pentoxifylline. Combined with venous hygiene measures and compressive therapy, sulodexide was prescribed mostly (81%) by oral route, 19% by intramuscular alone or combined with oral route. 768 patients (75.8%) were followed one to four visits (m...
Background. Sulodexide is a glycosaminoglycan useful in chronic venous disease. It was introduced... more Background. Sulodexide is a glycosaminoglycan useful in chronic venous disease. It was introduced for clinical use in Mexico in 2012. Recently a clinical survey which was conducted in Mexico showed the usefulness of sulodexide in any stage of chronic venous disease. Objective. To evaluate the time of healing of venous leg ulcers in Mexico. Material and methods. A sub-analysis of the previous study included the cases with active venous leg ulcers (C-6) with follow-up and information of the time of healing of the ulcer. Results. 183 cases were analysed, 63% received sulodexide only by oral route, the rest also received intramuscular ampoules. All the ulcers healed. Median time of complete ulcer healing was 60 days. At 60 days 50.8 % of the ulcers healed, at 90 days 66.7% and at 180 days 97.9 %. Conclusion. Sulodexide is effective to achieve the complete healing of venous leg ulcers, combined with local measures and compressive therapy.
Revista mexicana de angiología, Jun 15, 2017
Se ha valorado poco el tratamiento farmacológico de la enfermedad venosa crónica (EVc) en etapas ... more Se ha valorado poco el tratamiento farmacológico de la enfermedad venosa crónica (EVc) en etapas clínicas CEAP C3 y C4. Objetivo. Valorar si el tratamiento con sulodexida es eficaz en la EVc etapas clínicas CEAP C3 y C4. Material y métodos. Se invitó a médicos angiólogos a llenar un formato de recolección de datos clínicos de los pacientes tratados con sulodexida con EVc etapas CEAP C3 y C4. El seguimiento fue a los meses 1, 3 y 6. La intensidad de los síntomas se evaluó en escala tipo Likert de 1 a 5, los signos se calificaron como peor, igual o mejor. Resultados. Se incluyeron 359 pacientes en etapa C3 (n = 119) y C4 (n = 240). Hubo datos clínicos para su análisis de 297, 287 y 138 pacientes a los meses 1, 3 y 6, respectivamente. Hubo mejoría gradual de la intensidad de los síntomas: pesantez, dolor/ardor, calambres, hinchazón, oscurecimiento de la piel (cada uno p < 0.001). Se observó mejoría rápida del edema y de la inflamación (p < 0.001), mejoría lenta y en menor grado de hiperpigmentación, eczema y lipodermatoesclerosis (p < 0.01). En la última visita 99% de los pacientes se sentía mejor o mucho mejor y según los médicos el resultado era bueno o muy bueno en 97% de los casos.
Journal of The Professional Association for Cactus Development, Jul 25, 1992
Revista médica del Instituto Mexicano del Seguro Social, 1982
Diabetes Care, Apr 1, 1990
LITTERS AND COMMENTS immediately. The meter then retests the sample and gives a significantly low... more LITTERS AND COMMENTS immediately. The meter then retests the sample and gives a significantly lower value. One sample read "HI," indicating a value >450 mg/dl, and on retest was 77 mg/dl. This cheating technique can only be performed on samples higher than-280 mg/dl, otherwise an "Err" message is displayed, indicating a correctable problem. By the end of camp, all the boys in the cabin were aware of this technique to have an acceptable glucose value displayed on the console of the ExacTech meter after a high blood glucose value was initially obtained. This limitation of design may be particularly important for children who perform their glucose testing and then show the value to parents to record in a log.
Los glicosaminoglicanos (GAGs) están formados por largas cadenas de dímeros constituidos por un a... more Los glicosaminoglicanos (GAGs) están formados por largas cadenas de dímeros constituidos por un aminoazúcar y un ácido urónico que están sulfatados y se unen a proteínas, formando proteoglicanos. Los GAGs forman parte de la matriz extracelular de todos los órganos y tienen múltiples funciones. En los vasos constituyen el glicocáliz endotelial y la matriz extracelular del endotelio y subendotelio. El glicocáliz es la primera barrera entre las células endoteliales y el torrente sanguíneo, con sus fuerzas de tensión, moléculas de adhesión, células circulantes y sistema de coagulación. En la matriz extracelular los GAGs (sobre todo heparán sulfato) regulan la acción de quimiocinas, citosinas, factores de crecimiento y la migración celular, así como la filtración de moléculas a través del endotelio. La hipertensión venosa crónica deteriora el glicocáliz y permite la acción de moléculas de adhesión y la inflamación que daña el endotelio y las capas venosas más profundas, lo que deforma las valvas y permite la filtración de líquido, proteínas y células al espacio pericapilar y perivenular que causan inflamación de la piel y finalmente su ulceración. El deterioro del glicocáliz y la disfunción endotelial son los pasos iniciales importantes en la aterosclerosis y también en la microangiopatía diabética. En la patogenia de estos procesos intervienen los GAGs. Los GAGs con acción terapéutica en enfermedades vasculares incluyen la heparina y la sulodexida; la primera para la prevención y tratamiento de trombosis, la segunda es particularmente útil en la enfermedad venosa crónica avanzada con úlceras cutáneas, también se han utilizado exitosamente en arteriopatía obstructiva de los miembros inferiores y en microangiopatía diabética.
Revista médica del Instituto Mexicano del Seguro Social, 1984
Observation chez une femme de 39 ans presentant une insuffisance renale chronique. Aucune nouvell... more Observation chez une femme de 39 ans presentant une insuffisance renale chronique. Aucune nouvelle lesion cutanee n'est observee apres 24 heures de traitement et une guerison complete est observee au bout de 8 jours
Vascular disorder is prominent in COVID-19, mainly characterized by endothelial damage, severe in... more Vascular disorder is prominent in COVID-19, mainly characterized by endothelial damage, severe inflammation and thrombotic trend. We reviewed the data suggesting that sulodexide, a glycosaminoglycan with endothelial protective, vascular anti-inflammatory, and antithromotic activities, could be helpful in this disease. Alberto C Frati Munari1*; Sergio O Flores Cantu2; Nora E Lecuona Huet3; Miguel A Bautista Alfaro4 1Internist, Internal Medicine, Hospital Medica Sur, Mexico. 2Angiologist and vascular surgeon, Angiology Vascular Therapy. Hospital Christus Muguerza Alta Especialidad, Monterrey, Nuevo Leon. Mexico. 3Angiologist and vascular surgeon, ConCIENCIA Vascular. Mexico City. Mexico. 4Alfasigma Laboratory, Mexico.
Uploads
Papers by A. Frati-munari