Saving Lives with Tourniquets: A Review of Penetrating Injury Medical Examiner Cases.

Background: After numerous recent mass casualty events, civilian hemorrhage control has taken a militaristic approach with aggressive and early use of tourniquets. While military literature has demonstrated the utility of tourniquets in preventing battlefield deaths from extremity injuries, there is limited understanding of their role in civilian penetrating trauma deaths. The purpose of this study is to review medical examiner (ME) autopsy records in a defined population to determine the incidence of preventable deaths from extremity wounds amenable to tourniquet placement. Methods: This is a retrospective review of ME cases from one urban county with a descriptive analysis of the demographics, mechanisms of injuries, and causes of death of homicide cases from 2003 to 2017. Mechanism of injury and wound patterns were reviewed to determine the overall occurrence of extremity injuries and amenability of tourniquet placement. Results: A total of 1,804 homicide cases were reviewed with 1,521 (84.3%) resulting from penetrating trauma. Isolated extremity injuries were present in 22 (1.45%) of the penetrating cases, all of which were amenable to tourniquet placement. There were 409 (26.9%) concurrent extremity and central penetrating injuries. The vast majority of extremity wounds were amenable to tourniquet placement (92.1%). Extrapolating nationally to 16,187 annual penetrating injury related homicides in 2016, an estimated 235 (1.45%) isolated extremity injury related deaths could be prevented and an additional estimated 4,354 (26.9%) concurrent extremity and central injury related deaths could potentially receive enhanced care with early tourniquet placement. Conclusion: Among urban ME cases, both isolated extremity cases and concurrent extremity-central injuries exist that may be amenable to life-saving tourniquet use. Extrapolating our findings nationwide suggests that many lives could be saved with early tourniquet use. Considering these findings, tourniquet availability and early placement may have a prominent role in reducing injury deaths from penetrating trauma.

Vipericidins: a novel family of cathelicidin-related peptides from the venom gland of South American pit vipers.

Cathelicidins are phylogenetically ancient, pleiotropic host defense peptides-also called antimicrobial peptides (AMPs)-expressed in numerous life forms for innate immunity. Since even the jawless hagfish expresses cathelicidins, these genetically encoded host defense peptides are at least 400 million years old. More recently, cathelicidins with varying antipathogenic activities and cytotoxicities were discovered in the venoms of poisonous snakes; for these creatures, cathelicidins may also serve as weapons against prey and predators, as well as for innate immunity. We report herein the expression of orthologous cathelicidin genes in the venoms of four different South American pit vipers (Bothrops atrox, Bothrops lutzi, Crotalus durissus terrificus, and Lachesis muta rhombeata)-distant relatives of Asian cobras and kraits, previously shown to express cathelicidins-and an elapid, Pseudonaja textilis. We identified six novel, genetically encoded peptides: four from pit vipers, collectively named vipericidins, and two from the elapid. These new venom-derived cathelicidins exhibited potent killing activity against a number of bacterial strains (S. pyogenes, A. baumannii, E. faecalis, S. aureus, E. coli, K. pneumoniae, and P. aeruginosa), mostly with relatively less potent hemolysis, indicating their possible usefulness as lead structures for the development of new anti-infective agents. It is worth noting that these South American snake venom peptides are comparable in cytotoxicity (e.g., hemolysis) to human cathelicidin LL-37, and much lower than other membrane-active peptides such as mastoparan 7 and melittin from bee venom. Overall, the excellent bactericidal profile of vipericidins suggests they are a promising template for the development of broad-spectrum peptide antibiotics.

Comparative effects of carbapenems on bacterial load and host immune response in a Klebsiella pneumoniae murine pneumonia model.

Doripenem is a carbapenem with potent broad-spectrum activity against Gram-negative pathogens, including antibiotic-resistant Enterobacteriaceae. As the incidence of extended-spectrum ß-lactamase (ESBL)-producing Gram-negative bacilli is increasing, it was of interest to examine the in vivo comparative efficacy of doripenem, imipenem, and meropenem against a Klebsiella pneumoniae isolate expressing the TEM-26 ESBL enzyme. In a murine lethal lower respiratory infection model, doripenem reduced the Klebsiella lung burden by 2 log(10) CFU/g lung tissue over the first 48 h of the infection. Treatment of mice with meropenem or imipenem yielded reductions of approximately 1.5 log(10) CFU/g during this time period. Seven days postinfection, Klebsiella titers in the lungs of treated mice decreased an additional 2 log(10) CFU/g relative to those in the lungs of untreated control animals. Lipopolysaccharide (LPS) endotoxin release assays indicated that 6 h postinfection, meropenem- and imipenem-treated animals had 10-fold more endotoxin in lung homogenates and sera than doripenem-treated mice. Following doripenem treatment, the maximum endotoxin release postinfection (6 h) was 53,000 endotoxin units (EU)/ml, which was 2.7- and 6-fold lower than imipenem or meropenem-treated animals, respectively. While the levels of several proinflammatory cytokines increased in both the lungs and sera following intranasal K. pneumoniae inoculation, doripenem treatment, but not meropenem or imipenem treatment, resulted in significantly increased interleukin 6 levels in lung homogenates relative to those in lung homogenates of untreated controls, which may contribute to enhanced neutrophil killing of bacteria in the lung. Histological examination of tissue sections indicated less overall inflammation and tissue damage in doripenem-treated mice, consistent with improved antibacterial efficacy, reduced LPS endotoxin release, and the observed cytokine induction profile.

The 3 Minute Step Test is a validated field test to evaluate the functional exercise capacity in children aged 6 to 12.

BACKGROUND: Field tests are useful to assess the functional exercise capacity. The 6minute walking test (6MWT) is the most common field test even if alternatives are needed. The main aim of the study was to verify if the 3minute step test (3MST) is a valid tool to measure the functional exercise capacity and can surrogate the 6MWT in healthy children from 6- to 12-years-old. METHODS: This randomized cross-over trial recruited 30 healthy children from 6 to 12 years. One 6MWT and two 3MST (3MST1 and 3MST2) were performed randomly on 3 consecutive days. The variables were the distance (6MWT), the number of steps (3MST) and the cardiorespiratory parameters. RESULTS: The distance walked during 6MWT was very strongly correlated to the number of steps during the 3MST (3MST1: rho=0.833; P<0.001 and 3MST2: rho=0.868; P<0.001). Heart rate (HR) was lower than the theoretical maximal HR at the end of both tests. The change in HR and perceived fatigue were significantly higher after the 3MST. A learning effect was observed in the 3MST (+8 steps; P<0.001). CONCLUSIONS: The 3MST is validated and can be a surrogate for the 6MWT in healthy children population between 6 and 12 years old. A training test is required in these children.

Bacterial keratitis due to Moraxella nonliquefaciens. / Queratitis bacteriana por Moraxella nonliquefaciens.

Moraxella keratitis can lead to important complications. Moraxella nonliquefaciens(M. nonliquefaciens) has the worst prognosis. Only three cases of corneal infections due to M. nonliquefaciens have been published. The case is presented of a 79-year-old man with bullous keratopathy, recently affected with severe infectious keratitis. Dense, deep, and central stromal infiltrates and hyphaema were detected. After the identification of M. nonliquefaciens in the culture, and given the progression of the condition, the initial empirical treatment was modified to topical ciprofloxacin and ceftazidime in accordance with the antibiogram, combining oral ciprofloxacin and amoxicillin-clavulanate. After 27 days, there was total resolution of the lesion, with central residual leucoma. Keratitis caused by M. nonliquefaciens is rare and must be suspected in elderly patients with local predisposing factors, such as corneal damage or previous eye surgery. Early antibiogram-guided treatment and close monitoring are important to avoid complications and poor compliance.

Delayed-onset bleb-related endophthalmitis caused by Moraxella nonliquefaciens. / Endoftalmitis de inicio tardío asociada a ampolla de filtración por Moraxella nonliquefaciens.

Bleb-related endophthalmitis is rare and appears months or years after surgery. The causative agents are usually streptococci or gram-negative bacteria. There are few cases in the literature of endophthalmitis caused by Moraxella nonliquefaciens, and most are delayed-onset associated with blebitis after glaucoma filtration surgery. The case is presented of a 90-year-old patient with endophthalmitis in the right eye due to Moraxella nonliquefaciens associated with blebitis 10 years after glaucoma surgery. After treatment, disappearance of blebitis is observed 2weeks later and resolution of vitritis 29 days later, with recovery of vision to previous values (20/200). Endophthalmitis due to Moraxella nonliquefaciens is rare, and is associated with late onset blebitis after glaucoma filtration surgery. Despite the virulence of the clinical symptoms, the visual prognosis is usually favourable.

Synthesis of polycrystalline chalcopyrite semiconductors by microwave irradiation.

Polycrystalline samples of the chalcopyrites CulnS(2), CulnSe(2), and CulnSSe were Prepared from stoichiometric mixtures of the pure elements by microwave irradiation. The reactions were performed in sealed quartz tubes in as few as 3 minutes. The products were analyzed by x-ray diffraction, scanning electron microscopy, energy dispersive x-ray analysis, and x-ray photoelectron spectroscopy. The surface morphology and shape of the particles produced by this method suggest that the products are formed from liquid melts. This method could be applied to the production of bulk chalcopyrite as sources for thin film growth.

Gallium arsenide transistors: realization through a molecularly designed insulator.

A GaAs-based transistor, analogous to commercial silicon devices, has been fabricated with vapor-deposited cubic GaS as the insulator material. The n-channel, depletion mode, GaAs field-effect transistor shows, in addition to classical transistor characteristics, a channel mobility of 4665.6 square centimeters per volt per second, an interfacial trap density of 10(11) per electron volt per square centimeter, and a transconductance of 7 millisiemens for a 5-micrometer gate length at a gate voltage of 8 volts. Furthermore, the GaAs transistor shows an on-to-off resistance ratio comparable to that of commercial devices.

Acetyl coenzyme A stimulates RNA polymerase II transcription and promoter binding by transcription factor IID in the absence of histones.

Protein acetylation has emerged as a means of controlling levels of mRNA synthesis in eukaryotic cells. Here we report that acetyl coenzyme A (acetyl-CoA) stimulates RNA polymerase II transcription in vitro in the absence of histones. The effect of acetyl-CoA on basal and activated transcription was studied in a human RNA polymerase II transcription system reconstituted from recombinant and highly purified transcription factors. Both basal and activated transcription were stimulated by the addition of acetyl-CoA to transcription reaction mixtures. By varying the concentrations of general transcription factors in the reaction mixtures, we found that acetyl-CoA decreased the concentration of TFIID required to observe transcription. Electrophoretic mobility shift assays and DNase I footprinting revealed that acetyl-CoA increased the affinity of the general transcription factor TFIID for promoter DNA in a TBP-associated factor (TAF)-dependent manner. Interestingly, acetyl-CoA also caused a conformational change in the TFIID-TFIIA-promoter complex as assessed by DNase I footprinting. These results show that acetyl-CoA alters the DNA binding activity of TFIID and indicate that this biologically important cofactor functions at multiple levels to control gene expression.

[Cross-sectional study of heart failure of patients intaked in an Internal Medicine Service in the third level hospital in mixed area. Part III: mortality analysis]. / Análisis transversal de la insuficiencia cardiaca en pacientes de un Servicio de Medicina Interna de un hospital de tercer nivel de área mixta (rural y urbana). Parte III: análisis de mortalidad.

OBJECTIVES: To establish the characteristics of the deceased in intaked patients by heart failure. MATERIAL AND METHODS: A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with cualitative and cuantitative measures, chi-cuadrado and t-student. RESULTS: 248 patients were accepted for the study, with the mortality rate rising 8.6% (21 patients). We did not observed differences between sexes, but the median age in death patients was greater than other patients. The median income was 5 days, letter than study population. The hypertension prevalence (30 vs. 42.6%, p = 0.27) and ischemic cardiopathy (30 vs. 27.7%, p = 0.82) did not showed differences with the population. The hypertension prevalence in women (16.7 vs. 35.7%, p = 0.21) and the ischemic cardiopathy prevalence in men (50 vs. 21.4%, p = 0.20) did not showed differences. It made echocardiography in 21.0% of death patients, p = 0.76. The systolic disfunction prevalence was bigger in death patients (80 vs. 41.3%), this difference was not significant statistically. CONCLUSIONS: The older patients showed letter survival. We did not observe any influence of sex or left ventricular systolic function on mortality in patients with heart failure.

[Cross-sectional study of heart failure of patients intaked in an internal medicine service in the third level hospital in mixed area. Part II: prevalence and hypertension control]. / Análisis transversal de la insuficiencia cardiaca en pacientes de un servicio de medicina interna. Parte II: prevalencia y grado de control de hipertensión arterial.

OBJECTIVES: To know the arterial hypertension prevalencia and hypertension control in the patients income by heart failure. METHODS: A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analysed were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with qualitative and quantitative measures, chi-cuadrado and t-student, and multivariant analyses. RESULTS: 248 patients were accepted for the study, and 100 were hypertensive patients (41.8%). We observed more women than men in hypertensive group (63.0%) and in non hypertensive group (51.1%). The median age was 77 years old in both groups. The median income was 11 days. The number of patients with diabetes mellitus and ischemic cardiopathy was bigger in hypertension group (43.0 vs. 22.3%), p < 0.001; (38 vs. 21.6%), p = 0.005. The most frequent symptom was the dyspnea (66,9%), in both groups, p = 0.62. The 62.6% of the patients were bad control of blood pressures. The prevalence of bad control in hypertensive patients was bigger tha non-hypertensive patients (76.9 vs. 59.4%, p = 0.01). The pharmacologic treatment more prescribed in hypertensive patients ECAI or AAR-II (62.6 vs. 26.8%, p < 0.001). And the diuretics wee more prescribed in non-hypertensive patients (91.1 vs. 81.1%, p = 0.03). CONCLUSIONS: The prevalence of diabetes mellitus is associated with hypertension in the patients. The ECAI prescription was acceptable. The number of echocardiograms practiced to the patients is smaller that the number advised by international associations and smaller to the cardiologist registers. The beta-blockers is smaller too.

[Cross-sectional analysis of heart failure among patients in the Internal Medicine Service at a third-level hospital. Part I: epidemiologic analysis]. / Análisis transversal de la insuficiencia cardiaca en pacientes de un servicio de medicina interna de un hospital de tercer nivel de área mixta (rural y urbana). Parte I: análisis epidemiológico (Primera de tres partes).

OBJECTIVES: To observe the epidemiologic characteristics of the patients intake during five years in a internal medicine department, with heart failure. METHODS: A cross-sectional study of the intake patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intake by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with qualitative and quantitative measures, chi-cuadrado and t-student, and multivariant analyses. RESULTS: 248 patients were accepted for the study. We observed more women than men (55.2%) and bigger median age (79 years old vs. 73 years old in men, p < 0.001). The mean income was 13.61 days and a median of 11 days. The 41,8% of the patients had hypertension, 30.9% diabetes mellitus and 81,9% had someone heart disease. The aetiologies of heart failure most frequent were ischemic cardiopathy (27.2%) and hypertension (24.2%). The most frequent symptom was the dyspnea (68.9%). It made echocardiography in 20.9% of patients and 45.1% showed systolic disfunction. The only factor related with this small percentage of echocardiographies was the incoming time. The most frequent etiology was respiratory infections (39.5%). The 8.6% of patients was deceased. The pharmacologic treatment more prescribed were the diuretics (86.9%) and transcutaneous nitrates (49.5%). It was indicated ECAI or AAR-II in the 86.9% of patients and beta-blockers in 0.9%. CONCLUSIONS: The number of echocardiograms practiced to the patients is smaller that the number advised by international associations and smaller to the cardiologist registers. The beta-blockers and ECAI use is smaller too.

[Analises of the mortality in aged in an Internal Medicine Department]. / Análisis de la mortalidad en ancianos en un servicio de Medicina Interna.

BACKGROUND: To establish the characteristics of the deceased and the death causes. METHODOLOGY: Transversal study descriptive, with intake patients elder than 65 years old in an Internal Medicine Department. The variables analized were: age, sex, intake date, discharge date, days of hospital stay, chronic disease previous, admission cause, deceased, diagnoses. The statistical analysis was performed with measures of central tendency and of standard deviation, Chi-cuadrado, Mann-Whitney-Wilcoxon and Kruskal-Wallis. RESULTS: During the revised year, there are 770 patients intaked in Internal Medicine Department and 128 exitus (16.6%). The global average death age was 78.3 +/- 1.3 years: 53.1% (0.44-0.62; p = 0.48) were men and 46.9% were women. The average death intake days was 13.3 +/- 1.7 days (p < 0.001), 3.9% died in less than forty-eight hours after hospitalization. The most frequent admission cause was: dyspnea (46.1%). The most frequent chronic diseases were: ischemic and hypertensive heart disease (18.8%) and chronic obstructive pulmonary disease. The most frequent death cause was respiratory tract infection (43.8%). CONCLUSIONS: The prevalence cardiac and pulmonary disease prevalence is high, these diseases are the of the most frequent causes hospital mortality.

Drosophila divalent metal ion transporter Malvolio is required in dopaminergic neurons for feeding decisions.

Members of the natural resistance-associated macrophage protein (NRAMP) family are evolutionarily conserved metal ion transporters that play an essential role in regulating intracellular divalent cation homeostasis in both prokaryotes and eukaryotes. Malvolio (Mvl), the sole NRAMP family member in insects, plays a role in food choice behaviors in Drosophila and other species. However, the specific physiological and cellular processes that require the action of Mvl for appropriate feeding decisions remain elusive. Here, we show that normal food choice requires Mvl function specifically in the dopaminergic system, and can be rescued by supplementing food with manganese. Collectively, our data indicate that the action of the Mvl transporter affects food choice behavior via the regulation of dopaminergic innervation of the mushroom bodies, a principle brain region associated with decision-making in insects. Our studies suggest that the homeostatic regulation of the intraneuronal levels of divalent cations plays an important role in the development and function of the dopaminergic system and associated behaviors.

[Diagnosis by cranial computer tomography of sphenoidal sinusitis]. / Diagnóstico por tomografía axial computarizada de sinusitis esfenoidal.

Sphenoidal sinusitis is an uncommon pathology potentially dangerous condition, that we can find in young population. Clinically it is very difficult to diagnose because of its nonspecific symptoms, but cranial computer tomography confirms the diagnosis. The most cases were treated with antibiotics and recovered completely. We present a young man with isolated sphenoidal sinusitis who was managed in our medical centre, and a review of the literature.

[Bacteraemia due to Leuconostoc spp. in a patient without immunological disorders]. / Bacteriemia por Leuconostoc spp. en paciente sin factores de riesgo.

Leuconostoc spp are gram-positive coccobacilli, catalase and oxidase negative, vancomycin resistant. Causes of infection have been reported previously but it has not been described confirmed bacteremia due to Leuconostoc spp in patient without other immunological disorders. We describe a case of bacteremia in a 64-years-old man with a prosthetic valve 7 months before to begin fever of unknown origin. We confirmed bacteremia due Leuconostoc spp and the treatment with respective antibiotics permits the cure. Leuconostoc spp should be considered as a potential cause of bacteraemia, but we would be observant to the bacteremias due vancomycin resistant germs, because in most cases the laboratory do not find the sensitivity to this antibiotic.

[Control of hypertension in elderly patients admitted in internal medicine]. / Grado de control de hipertensión arterial en población mayor de 65 años ingresada en un servicio de Medicina Interna.

OBJECTIVES: To investigate hypertension control in elderly patients. To identify the cardiovascular risk factors and cardiovascular diseases associated with poor control of hypertension. To evaluate the pharmacologic treatment needed for the good control of hypertension. To analyse the existence of date in the medical history to evaluate the cardiovascular risk. METHODS: A cross-sectional study of elderly hypertensive patients intaked between 1 to January 2002 to 31 December 2002 in a Internal Medicine Service. Blood pressure was measured in the standard manner. Blood pressure control was regarded as optimum if pressure averaged less than 140/90 mmHg or, in diabetics, less than 130/80 mmHg. RESULTS: The study included 484 hypertensive patients. In the hypertensive patients, both systolic and diastolic blood pressures were well controlled in 53.9% of patients, systolic blood pressure alone in 2,1% and diastolic blood pressure alone in 30.8%. The isolated systolic arterial hypertension prevalence is bigger in the group with poor control, p < 0.001. The 77% of hypertensive patients associated other cardiovascular risk factor, and the 69% associated any cardiovascular disease. The 64% of hypertensive patients needed pharmacologic treatment. CONCLUSIONS: Arterial blood pressure control was optimum in only one out of two hypertensive patients. Diabetes is the most influential variable in poor control. The diuretics are the active ingredients more used in the hypertension therapeutic.

[Epidemiologic analyses of elderly patients in an Internal Medicine department]. / Análisis epidemiológico de los pacientes ingresados en un servicio de medicina interna.

OBJECTIVES: To study the characteristics of the entered patients in an Internal Medicine department. PATIENTS AND METHODS: Descriptive and observational study with admissions elder than 65 years old in an Internal Medicine Department during the year 2002. The variables analyzed were: age, sex, intake date, discharge date, days of hospital stay, chronic disease previous, reason for admission (guide symptom), deceased and diagnosis at discharge. The statistical analysis was performed with measures of central tendency and of standard deviation, Chi-squared Mann-Whitney-Wilcoxon. RESULTS: 770 patients were accepted for the study. The distribution in sex is similar, although the women show greater median age. The most frequent chronic disease was ischemic hypertensive heart disease (25.7%) and the 64.9% of the patients have some cardiovascular risk factor. The men show more cardiovascular risk factor and more chronic disease (p < 0.01). The most frequent was dyspnea (42.7%). The most frequent diagnosis was cardiac failure (20.6%). 16.6% of the patients died in the hospital, and the most frequent diagnosis was respiratory tract infection (49.5%). CONCLUSIONS: The most frequent pathologies are the cardiopulmonary chronic disease of developed countries. The primary and secondary prevention and an improvement of chronic cardiopulmonary disease would be an effective way of cost control in these disease.

[Incidence of hypertension in elderly patients admitted at an internal medicine department]. / Prevalencia de hipertensión arterial en población mayor de 65 años ingresada en un Servicio de Medicina Interna.

OBJECTIVES: To know the arterial hypertension prevalence and isolated systolic hypertension in elderly patients intaked on internal medicine department. MATERIAL AND METHODS: A cross-sectional study of elderly hypertensive patients intaked between 1 to January 2002 to 31 December 2002 in a Internal Medicine Service of the Hospital Clinico Universitario de Santiago de Compostela. The recorded variables were: sex, age, number of days in hospital, hospital exitus, cardiovascular risk factors, number of blood pressure, glucose, cholesterolemia, cardiovascular disease and treatments. It was used descriptive statistic rates of quantitative and qualitative variables, Mann-Withney-Wilcoxon and logistic regression. RESULTS: The study included 770 patients. The arterial hypertension (HTA) prevalence was 37% and the isolated systolic hypertension (ISH) prevalence were 25.9%. The ISH prevalence was greater in the patients with bad control of blood pressures (67.5 vs. 8.9%), p < 0.01. The 78% of patients with hypertension showed one or more risk cardiovascular factor and the 60.9% of these patients showed one or more cardiovascular disease. We found in patients with hypertension bigger prevalence of mellitus diabetes (66.7 vs. 58.8%), hypercholesterolemia (15.8 vs. 5.5%) and cardiac disease (21.7 vs. 13.0%) than in patients with HAS. It was ran farmacologic treatment in the 49.8% of the patients with high blood pressure and in the 61.8% of the patients with isolated systolic hypertension. The loop diuretics (41.2 vs. 30.2%) and ECAI (17.6 vs. 9.5%) were more used in isolated systolic hypertension. CONCLUSIONS: The hypertension and isolated systolic hypertension prevalences are small in the people studied. The prevalence of heart disease is bigger in patients with high blood pressure, and also it is the disease that caused more deaths in hypertensive patients. The pharmacological treatment used in hypertensive patients is not the most guarantied by the actually evidence.