Role of serum cholesterol and statin use in the risk of prostate cancer detection and tumor aggressiveness.

The aim of this study was to analyze the relationship between statin use along with serum cholesterol levels and prostate cancer (PCa) detection and aggressiveness. Statin users of three years or more and serum cholesterol levels (SC) were assessed in 2408 men scheduled for prostate biopsy. SC was classified as normal (NSC: <200 mg/dL) or high (HSC: >200 mg/dL). High-grade PCa (HGPCa) was considered if the Gleason score was greater than 7. Statin users comprised 30.9% of those studied. The PCa detection rate was 31.2% of men on statins and 37% of non-statin users (p<0.006). The PCa detection rate was 26.3% in men with NSC and 40.6% in those with HSC (p<0.001). In the subset of NSC men, the PCa rate was 26.5% for statin users and 26.2% for non-users (p=0.939), while in men with HSC, the PCa rate was 36.4% for statin users and 42.0% for non-statin users (p=0.063). The HGPCa rate was 41.8% for statin users and 32.5% for non-users (p=0.012). NSC men had a 53.8% rate of HGPCa, while the rate was only 27.6% in HSC men (p<0.001). NSC men on statins had an HGPCa rate of 70.2%, while non-statin users had a rate of 41.2% (p<0.001). The HGPCa rate for HSC men on statins was 18.8%, while the rate was 30.0% (p=0.011) for non-users. Logistic regression analysis suggested that serum cholesterol levels could serve as an independent predictor of PCa risk, OR 1.87 (95% CI 1.56-2.24) and HGPCa risk, OR 0.31 (95% CI 0.23-0.44), while statin usage could not. Statin treatment may prevent PCa detection through serum cholesterol-mediated mechanisms. A disturbing increase in the HGPCa rate was observed in statin users who normalized their serum cholesterol.

Ecocardiografía de las endocarditis / Echocardiography of endocarditis

Los ecocardiogramas de modo M de 34 pacientes con el diagnóstico de endocarditis bacteriana fueron estudiados: 26 de ellos presentaron vegetaciones, lo cual representa una sensibilidad del 76%. En las necropsias de 2 de ellos las vegetaciones fueron confirmadas y no encontramos falsos negativos. Los pacientes con el diagnóstico ecocardiográfico de endocarditis evolucionaron mal. Concluímos que la ecocardiografía es un procedimiento útil en la comprensión de las endocarditis y tiene valor pronóstico. Sin embargo, un ecocardiograma normal no excluye el diagnóstico de endocarditis

Previción de enfermedad tromboembólica con heparina a pequeñas dósis en pacientes con insuficiencia cardiaca que guardan reposo en cama / Prevention of thromboembolic disease with low dose heparin in bedridden patients with heart failure

Veinte y seis pacientes con insuficiencia cardíaca internados en nuestro servicio recibieron 5 000 U. I. de heparina sódica cada 12 horas por vía subcutánea, mientras que 26 pacientes bajo las mismas condiciones clínicas sirvieron como control. Dos pacientes que no recibieron heparina desarrollaron tromboembolismo pulmonar agudo, lo cual no representa una diferencia estadísticamente significativa