[Underrecognized peripheral arterial disease in patients with acute coronary syndrome: prevalence of traditional and emergent cardiovascular risk factors]. / Enfermedad arterial periférica desconocida en pacientes con síndrome coronario agudo: prevalencia y patrón diferencial de los factores de riesgo cardiovascular tradicionales y emergentes.

INTRODUCTION AND OBJECTIVES: Peripheral arterial disease (PAD) frequently coexists with coronary artery disease. Our objective was to determine the prevalence of traditional and emergent cardiovascular risk factors in patients with acute coronary syndrome (ACS), with or without PAD. PATIENTS AND METHOD: A prospective study of 141 consecutive patients (< 70 years old) admitted to our hospital with ACS was performed. PAD was diagnosed when the ankle-brachial index (ABI) was < or = 0.9. Traditional cardiovascular risk factors were evaluated. C-reactive protein, homocysteine, amyloid A, lipoprotein (a), fibrinogen, apolipoprotein A1, and apolipoprotein B100 serum levels, and microalbuminuria were measured. Specific genotypes were also determined. RESULTS: Patients were divided into two groups according to whether PAD was present (37 patients, 26% of total, ACS-PAD group) or absent (104 patients, ACS group). In the ACS-PAD group, patients were older, and diabetes and hypertension were significantly more common. Moreover, levels of C-reactive protein (3.1 mg/L vs 2.18 mg/L; P<.05), homocysteine (11.45 mmol/L vs 9.4 mmol/L; P<.01), amyloid A (5.2 mg/mL vs 3.7 mg/mL; P<.05), and microalbuminuria (4.89 mg/L vs 3.1 mg/L; P<.05) were significantly higher in this group. Logistic regression analysis showed that poorly controlled diabetes (OR = 6.3; 95% CI, 1.1-36.7), time-dependent tobacco exposure (OR = 1.5 per decade; 95% CI, 1.2-2.0), and high pulse pressure (OR = 1.9 per 10 mmHg; 95% CI, 1.3-2.7) were independent predictors of the presence of PAD. CONCLUSIONS: Several traditional and emergent cardiovascular risk factors were more prevalent in patients with acute coronary syndrome and peripheral arterial disease. Moreover, some factors were independent predictors of peripheral arterial disease.

Tendencia de la carga bacilar en sintomáticos respiratorios examinados con frotis positivo entre los años 1995-1999 Hospital Quillabamba. UBASS Santa Ana La Convención / Tendenzi of the load bacilar in symptomatic breathing examined with positive smear among the years 1995-1999 Hospital Quillamba. UBASS Santa Ana The Convention

La tuberculosis pulmonar es una enfermedad endémica en la provincia de La Convención. Existen muchos factores condicionantes tales como el escaso consumo de nutrientes (proteínas, vitaminas y minerales), la pobreza debida a una alta migración sobre todo de las Provincias Altas en busca de mejorar sus ingresos económicos. El PCT tiene como estrategia captar en forma temprana a los sintomáticos Respiratorios, en los grupos de riesgo (PEA). En el presente estudio (1995-1999), de los 1550 casos de TBPFP, existe una tendencia a ir aumentando para los casos de TB BK(+) y TB BK (++); mientras que para los casos de TB BK (+++) la tendencia es a disminuir.