LECTURA CRITICA A UNUI STUDIU UNUI STUDIU

LECTURA CRITICA A 

UNUI STUDIU 

Metodologia cercetarii

STUDIILE DE COHORTA 

Forma cea mai riguroasa a studiilor 

epidemiologice neexperimentale. 

Permit evaluarea incidentei unei 

maladii,stabilirea relatiei cauza-efect 

iintre t ffactorul t l dde risc i si i bboala. l 

Incidenta=procentajul de cazuri noi 

id identificate tifi t in i cursul l unei i perioade i d dde 

timp intr-o populatie data.


Selectia pacientilor se face dupa 

prezenta sau absenta factorului de risc 

Intereseaza un esantion foarte larg de 

g 

populatie


..

META META-ANALIZA ANALIZA 

Evaluare cantitativa si calitativa a 

informatiei medicale,sinteza si integrarea 

ei structurata 

“analiza a analizelor” 

Combina date provenind din studii 

independente in scopul obtinerii unei 

estimari ti i globale l b l a efectului f t l i unei i 

proceduri sau a unei variabile asupra 

unui anume eveniment eveniment.


Obtinerea unor estimari mai sigure 

asupra efectului unui tratament 

Contributia la planificarea studiilor clinice 

Contrabalansarea excesului de 

entuziasm care insoteste frecvent 

introducerea unor medicamente noi.

META META-NALIZA NALIZA 

ABORDAREA CALITATIVA 

Acordarea unei importante diferite 

di diverselor l studii t dii iin ffunctie ti dde calitatea lit t llor 

metodologica 

ABORDAREA CANTITATIVA 

Abordarea consta intr-un rezumat cantitativ 

al rezultatelor diverselor studii,astfel , incit 

sa constituie un singur studiu cu putere 

statistica mai mare.


OBIECTIVE 

CAUTAREA LITERATURII 

EXTRAGEREA DATELOR DIN 

FIECARE STUDIU 

EVALUAREA CALITATII FIECARUI 

STUDIU 

REGRUPAREA DATELOR 

ANALIZA SENSIBILITATII 

CONCLUZII

PREZENTARE DE CAZ 

(CASE REPORT) 

TITLUL (alegerea subiectului) 

AUTORII (in ( ordinea importantei p 

contributiei) 

LOCUL DE MUNCA 

DATA PRIMIRII 

DATA ACCEPTARII

EXEMPLU 

Cardiac .. phaeochromocytoma presenting with severe 

hypertension and chest pain 

A. M. Sawka*, W. F. Young Jr*,t and H. V. Schaff* may be highly vascular, 

invasive and difficult to 

* Division of Endocrinology, Metabolism and Nutrition, resect, it can be cured. 

Internal Medicine, tDivision of Hypertension and Internal 

Medicine Medicine, :j:Division of Cardiovascular Surgery Surgery, Mayo 

... ClInic, Mayo FoundatIon, Rochester, MN, USA 

Phaeochromocytomas are catecholamine-producing neoplasms 

(Received 14 March 2000; returned for revision 14 Apri12000; .. 

'" 

-'.

REZUMAT 

.. 

Summary 

Cardiac phaeochromocytoma is a rare cause of 

endocrine hypertension hypertension. We report a case of a 25year-old 

woman, who presented with severe hypertension 

and intermittent chest pain. The patient 

denied typical phaeochromocytoma spells of palpitation, 

headache, and diaphoresis. The 24-hr urinary 

excretion of norepinephrine p p was increased sevenfold 

above the upper limit of normal; however, the 

excretion of total metanephrines, epinephrine, and 

dopamine were normal. Computed tomography (CT) 

scan of the abdomen was normal. An 1311-labelled 

metaiodobenzylguanidine (MIBG) scan was falsely 

negative while the patient was taking labetalol. The 

cardiac phaeochromocytoma was localized with 

indium-111-pentetreotide scintigraphy and chest 

magnetic resonance imaging scan. Repeat 1231-MIBG 

scintigraphy was positive after discontinuing labeta- 

101 101. The cardiac phaeochromocytoma was located in 

the right atrial groove, adjacent to the tricuspid valve, 

and contained multiple ~eeder arteries from the right 

coronary artery. After treatment with volume expansion, 

(X-methyl-p-tyrosine, and (X- and fl-adrenergic 

blockade, , surgical g resection was performed. p While 

under cardiopulmonary bypass, coronary bypass 

grafting and tricuspid annuloplasty were performed 

to facilitate the complete surgical resection of the 4.5cm 

tumour. The surgical course was uncomplicated, 

with complete cure of hypertension and normaliization 

ti of f catecholamine t h l i excretion. ti PPost-operative t ti 

cardiac function, as measured by echocardiogram, 

was normal. Although cardiac phaeochromocytoma

INTRODUCERE 

.. 

Introduction 

Phaeochromocytomas are catecholamjne-producing neoplasms 

of the sympathetic nervous system which account for less than 

0.1% of cases of hypertension (Jebara et at., 1992). 

Phaeochromocytomas may be intrathoracic in 1-2% of cases, 

usually in the posterior mediastinum, and rarely in the heart 

(Jebara et at., 1992; Fitzgerald et at., 1995; Jeevanandam et at., 

1995; Lin et at., 1999). Cardiac phaeochromocytomas occur 

with approximately equal frequency in both sexes, with a mean 

age at presentation of 36-40 years (Jebara et at., 1992; 

JJeevanandarn d et t at., t 1995). 1995) WWe report t a case of f a 25-year-old 

25 ld 

woman with a cardiac phaeochromocytoma.

RELATAREA PROPRIUZISA

DISCUTII 

.

BIBLIOGRAFIE 

.. 

References 

Anton, A.H., Sherman, B.W., Lina, A.A & Acheson, L.S. (1993) An 

atrial ti lpheochromocytoma-induced h h t id dhhypertensive t i crisis ii resistant it ttto 

nitroprusside. Internati()nal J()urnal ()f Clinical Phannacol()gy, 

Therapy, and Toxicology, 31, 89-92. 

Fitzgerald, P.l., Ports, T.A., Cheitlin, M.D., Magilligan, D.l. & Tyrrell, 

lB. ( 1995) Intracardiac pheochromocytoma with dual coronary 

blood supply. supply case report and review of the literature. literature CGI"{liovas- 

CGI {liovas 

cular Surgery, 3,557-561. 

Goldstein, D.l., Oz, M.C., Rose, E.A., Fisher, P. & Michler, R.E. 

( 1995) Experience with heart transplantation for cardiac tumors. 

Journal of Heart and Lung Transplantation, 14, 382-386. 

Gomi, T., Ikeda, T., Sakurai, l., Toya, Y. & Tani, M. (1994) Cardiac 

pheochromocytoma. a case report and review of the literature. 

Japanese Heart Journal, 35, 117-124. 

lebara, V.A., Sousa Uva, M., Farge, A., Acar, C., Azizi, M., Plouin, 

P.F., Corvol, P., Chachques, l.C., Dervanian, P., Fabiani, l.N, 

DeLoche, A. & Carpentier, A. (1992) Cardiac pheochromocytomas. 

Annals of Thorocic Sul:,!ety, Sul: !ety 53 53, 356 356-361. 361 

leevanandam, V., Oz, M.C., Shapiro, B., Barr, M.I., Marboe, C. &

ARTICOL DE SINTEZA AL 

LITERATURII (METAANALIZA) 

PREMISE 

OBIECTIV 

SURSE DE INFORMATIE 

SELECTAREA SI COLECTAREA 

DATELOR 

SINTEZA DATELOR 

CONCLUZII

SURSE DE INFORMATIE 

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SELECTAREA DATELOR 

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metode t d 

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metoda t d 

Trialuri randomizate,controlate 

placebo,obiectivele evaluate de maniera 

oarba 

Heterogenitatea rezultatelor 

Analiza sensibilitatii 

Analize efectuate cu ajutorul…….

STUDIU DE COHORTA 

PROSPECTIV 

Premise 

Obiectiv 

Metoda 

Rezultate 

concluzii

PREMISE 

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LECTURA CRITICA A UNUI STUDIU UNUI STUDIU

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