[Intima-media thickness in obese adolescents and their relation with metabolic syndrome]. / Grosor de la íntima-media de la arteria carótida en adolescentes obesos y su relación con el síndrome metabólico.

INTRODUCTION: Obese adolescents have higher cardiovascular risk (CVR). Intima-media thickness (IMT) detects early arterial vascular compromise. OBJECTIVE: To evaluate whether obese adolescents have higher vascular compromise measured by IMT than nonobese adolescents, and if this is greater in those with metabolic syndrome (MS). METHOD: The study group (SG), obese children (BMI/age > p95), with and without MS and control group (CG), non-obese (BMI/age p10-85) and non nutritional or endocrine disease. We measured serum lipids, oral glucose tolerance test with insulin and carotid artery ultrasound. To evaluate the differences between test groups we used parametric and nonparametric statistics. RESULTS: We evaluated 45 obese adolescents (20 women), 19 with MS, age 13 (9-16) years and 18 controls (14 women), aged 13 (11-16) years. IMT of carotid bulb and internal carotid artery (ICA) were significantly higher in SG than CG (0.54 vs. 0.34, 0.34 vs. 0.25, p < 0.05). There was no difference between obese groups. IMT of ICA and bulb correlated positively with BMIz (r = 0.3 and 0.6, p < 0.05) and with waist circumference (CC) (r = 0.3 and 0.55, p < 0, 05). IMT of ICA was positively correlated with fasting insulin, HOMA and systolic blood pressure. In multivariate analysis only BMI and CC were associated independently to IMT. CONCLUSION: Obesity is an early risk factor for cardiovascular damage measured by IMT and IMT of ICA demonstrated a higher correlation with cardiovascular risk factors.

n-3 Fatty acids and cardiovascular disease: actions and molecular mechanisms.

Cardiovascular disease and atherosclerosis are a leading cause of morbidity and mortality worldwide. Epidemiological studies and randomized control intervention trials have reported that n-3 fatty acids reduce cardiovascular events. A variety of biologic and molecular effects of n-3 fatty acids can modulate the mechanisms of development and progression of atherosclerosis. These include n-3 fatty acid effects on inflammation, cardiac excitability, platelet function, triglyceride blood levels, blood pressure and the stability of atheroma plaques. The molecular mechanisms are still not fully defined; but might involve changes in membrane fluidity, receptor responses and binding to intracellular receptors regulating gene transcription. Understanding and elucidating these mechanisms is important to development of future strategies for prevention and treatment of cardiovascular disease.

[Study of patients admitted to a telemetry unit]. / Estudio de pacientes ingresados en una unidad de telemetría.

The current situation of the telemetry unit of Vigil de Quiñones Hospital was studied. Telemetry indications, results, and problems observed since the unit was inaugurated were studied to determine the usefulness of telemetric heart rate monitoring and centralized surveillance in an intensive care unit (ICU) in detecting severe arrhythmias, controlling antiarrhythmic treatment, and evaluating why and to what extent telemetry is clinically useful. In our center, telemetry is used to monitor patients with well-established needs. In most cases, arrhythmias are monitored, most frequently premature ventricular complexes, sinus bradycardia and supraventricular tachycardia. Telemetry was useful in arrhythmia treatment and the follow-up of patients with temporary or permanent pacemakers. In a significant percentage of patients (8.62%), telemetry was the key to their ICU admission and, possibly, their survival. There were generally few problems with signal transmission.