Direct oral anticoagulants for the treatment of cerebral venous thrombosis - a protocol of an international phase IV study.

Introduction: Current guidelines recommend that patients with cerebral venous thrombosis (CVT) should be treated with vitamin K antagonists (VKAs) for 3-12 months. Direct oral anticoagulants (DOACs), however, are increasingly used in clinical practice. An exploratory randomized controlled trial including 120 patients with CVT suggested that the efficacy and safety profile of dabigatran (a DOAC) is similar to VKAs for the treatment of CVT, but large-scale prospective studies from a real-world setting are lacking. Methods: DOAC-CVT is an international, prospective, observational cohort study comparing DOACs to VKAs for the prevention of recurrent venous thrombotic events after acute CVT. Patients are eligible if they are 18 years or older, have a radiologically confirmed CVT, and have started oral anticoagulant treatment (DOAC or VKA) within 30 days of CVT diagnosis. Patients with an absolute contra-indication for DOACs, such as pregnancy or severe renal insufficiency, are excluded from the study. We aim to recruit at least 500 patients within a three-year recruitment period. The primary endpoint is a composite of recurrent venous thrombosis and major bleeding at 6 months of follow-up. We will calculate an adjusted odds ratio for the primary endpoint using propensity score inverse probability treatment weighting. Discussion: DOAC-CVT will provide real-world data on the comparative efficacy and safety of DOACs versus VKAs for the treatment of CVT. Clinical trial registration: ClinicalTrials.gov, NCT04660747.

A Normalized Model of a Microelectromechanical Relay Calibrated by Laser-Doppler Vibrometry.

This work presents a behavioral model for a microelectromechanical (MEM) relay for use in circuit simulation. Models require calibration, and other published relay models require over a dozen parameters for calibration, many of which are difficult to extract or are only available after finite element analysis. This model improves on prior work by taking advantage of model normalization, which often results in models that require fewer parameters than un-normalized models. This model only needs three parameters extracted from experiment and one dimension known from device fabrication to represent its non-contact behavior, and two additional extracted parameters to represent its behavior when in contact. The extracted parameters-quality factor, resonant frequency, and the pull-in voltage-can be found using laser Doppler vibrometry. The device dimension is the actuation gap size, which comes from process data. To demonstrate this extraction process, a series of velocity step responses were excited in MEM relays, the measured velocity responses were used to calibrate the model, and then then simulations of the model (implemented in Verilog-A) were compared against the measured data. The error in the simulated oscillation frequency and peak velocity, two values selected as figures of merit, is less than 10% across many operating voltages.

Climate and demography drive 7000 years of dietary change in the Central Andes.

Explaining the factors that influence past dietary variation is critically important for understanding changes in subsistence, health, and status in past societies; yet systematic studies comparing possible driving factors remain scarce. Here we compile the largest dataset of past diet derived from stable isotope δ13C‰ and δ15N‰ values in the Americas to quantitatively evaluate the impact of 7000 years of climatic and demographic change on dietary variation in the Central Andes. Specifically, we couple paleoclimatic data from a general circulation model with estimates of relative past population inferred from archaeologically derived radiocarbon dates to assess the influence of climate and population on spatiotemporal dietary variation using an ensemble machine learning model capable of accounting for interactions among predictors. Results reveal that climate and population strongly predict diet (80% of δ15N‰ and 66% of Î´13C‰) and that Central Andean diets correlate much more strongly with local climatic conditions than regional population size, indicating that the past 7000 years of dietary change was influenced more by climatic than socio-demographic processes. Visually, the temporal pattern suggests decreasing dietary variation across elevation zones during the Late Horizon, raising the possibility that sociopolitical factors overrode the influence of local climatic conditions on diet during that time. The overall findings and approach establish a general framework for understanding the influence of local climate and demography on dietary change across human history.

Influence of Physical-Chemical Soil Parameters on Microbiota Composition and Diversity in a Deep Hyperarid Core of the Atacama Desert.

The extreme environmental conditions and lack of water on the soil surface in hyperarid deserts hamper microbial life, allowing only highly specialized microbial communities to the establish colonies and survive. Until now, the microbial communities that inhabit or have inhabited soils of hyperarid environments at greater depths have been poorly studied. We analyzed for the first time the variation in microbial communities down to a depth of 3.4 m in one of the driest places of the world, the hyperarid Yungay region in the Atacama Desert, and we related it to changes in soil physico-chemical characteristics. We found that the moisture content changed from 2 to 11% with depth and enabled the differentiation of three depth intervals: (i) surface zone A (0-60 cm), (ii) intermediate zone B (60-220 cm), and (iii) deep zone C (220-340 cm). Each zone showed further specific physicochemical and mineralogical features. Likewise, some bacterial phyla were unique in each zone, i.e., members of the taxa Deinococcota, Halobacterota, and Latescibacterota in zone A; Crenarchaeota, Fusobacteriota, and Deltaproteobacterium Sva0485 in zone B; and Fervidibacteria and Campilobacterota in zone C, which indicates taxon-specific preferences in deep soil habitats. Differences in the microbiota between the zones were rather abrupt, which is concomitant with abrupt changes in the physical-chemical parameters. Overall, moisture content, total carbon (TC), pH, and electric conductivity (EC) were most predictive of microbial richness and diversity, while total sulfur (TS) and total phosphorous (TP) contents were additionally predictive of community composition. We also found statistically significant associations between taxa and soil properties, most of which involved moisture and TC contents. Our findings show that under-explored habitats for microbial survival and existence may prevail at greater soil depths near water or within water-bearing layers, a valuable substantiation also for the ongoing search for biosignatures on other planets, such as Mars.

Deep Learning Classification for Diabetic Foot Thermograms.

According to the World Health Organization (WHO), Diabetes Mellitus (DM) is one of the most prevalent diseases in the world. It is also associated with a high mortality index. Diabetic foot is one of its main complications, and it comprises the development of plantar ulcers that could result in an amputation. Several works report that thermography is useful to detect changes in the plantar temperature, which could give rise to a higher risk of ulceration. However, the plantar temperature distribution does not follow a particular pattern in diabetic patients, thereby making it difficult to measure the changes. Thus, there is an interest in improving the success of the analysis and classification methods that help to detect abnormal changes in the plantar temperature. All this leads to the use of computer-aided systems, such as those involved in artificial intelligence (AI), which operate with highly complex data structures. This paper compares machine learning-based techniques with Deep Learning (DL) structures. We tested common structures in the mode of transfer learning, including AlexNet and GoogleNet. Moreover, we designed a new DL-structure, which is trained from scratch and is able to reach higher values in terms of accuracy and other quality measures. The main goal of this work is to analyze the use of AI and DL for the classification of diabetic foot thermograms, highlighting their advantages and limitations. To the best of our knowledge, this is the first proposal of DL networks applied to the classification of diabetic foot thermograms. The experiments are conducted over thermograms of DM and control groups. After that, a multi-level classification is performed based on a previously reported thermal change index. The high accuracy obtained shows the usefulness of AI and DL as auxiliary tools to aid during the medical diagnosis.

Conocimientos sobre COVID-19 en recién nacidos y lactancia materna en trabajadores de la salud grupo de especialistas de la red COVID-19 y gestación / Knowledge of health care workers about COVID-19 in newborn and maternal breastfeeding

El coronavirus SARS-CoV-2 podría transmitirse verticalmente de la madre al feto y causar infección perinatal. Hay conocimiento muy limitado sobre el impacto clínico de COVID-19 en el escenario materno, fetal y neonatal. Objetivos: determinar el nivel de conocimiento de los trabajadores de la salud sobre diferentes aspectos de COVID-19 en recién nacidos y madres lactantes; también evaluar sus conocimientos sobre la transmisión vertical en este grupo de pacientes.El virus se ha aislado en leche materna, pero se necesitan más estudios al respecto. Métodos: Se realizó un estudio descriptivo, transversal, de tipo exploratorio sobre una enfermedad (COVID-19) por un grupo poblacional (TS), en un intervalo finito de tiempo (15/4/2020 al 22/4/2020). Resultados: Para ello se elaboró una encuesta con diferentes variables relacionadas con COVID-19 y los trabajadores de salud mostraron conocimientos asertivos acerca de la transmisión vertical, atención del recién nacido y lactancia materna en COVID-19(AU)

SARS-CoV-2 could be transmitted vertically from the mother to the fetus and cause perinatal infection. There is very limited knowledge about the clinical impact of COVID-19 in the maternal, fetal, and neonatal settings. Objective: Find out the level of knowledge in HCW about COVID-19 in newborn and Breastfeeding Mothers. Results. In the present study, the 617 health workers who answered the survey showed assertive knowledge about vertical transmission, diagnosis, newborn care and breastfeeding within the COVID-19 scenario(AU)

Earliest occupation of the Central Aegean (Naxos), Greece: Implications for hominin and Homo sapiens' behavior and dispersals.

We present evidence of Middle Pleistocene activity in the central Aegean Basin at the chert extraction and reduction complex of Stelida (Naxos, Greece). Luminescence dating places ~9000 artifacts in a stratigraphic sequence from ~13 to 200 thousand years ago (ka ago). These artifacts include Mousterian products, which arguably provide first evidence for Neanderthals in the region. This dated material attests to a much earlier history of regional exploration than previously believed, opening the possibility of alternative routes into Southeast Europe from Anatolia (and Africa) for (i) hominins, potentially during sea level lowstands (e.g., Marine Isotope Stage 8) permitting terrestrial crossings across the Aegean, and (ii) Homo sapiens of the Early Upper Paleolithic (Aurignacian), conceivably by sea.

Validation of the Geriatric Anxiety Inventory in Chilean older people.

OBJECTIVE: Currently in Chile there is a lack of validated tools for measuring anxiety in the elderly population. Considering this, the purpose of this study was to validate the Geriatric Anxiety Inventory (GAI) in the country. METHOD: An analysis of the psychometric properties of the GAI was carried out, using a non-clinical sample of 301 older adults in the Metropolitan and Valparaíso regions of Chile. Older people were asked about anxiety, rumination, depression, well-being and sociodemographic data. RESULTS: An excellent internal reliability was obtained with a Cronbach score of 0.931. An adequate convergent validity was observed with the Depression scales (CES-D) (Rho = 0.549, p < .01), Rumination (RSS) (Rho = 0.618; p < 0.01) and Experiential avoiding (Rho = 0.485; p < 0.01). On the other hand, the discriminant validity of the psychological well-being scale presented a negative correlation of Rho = -0.699 (p < 0.01). Finally, and Exploratory Factor Analysis was made, revealing a one-dimensional model of the instrument. CONCLUSION: The Geriatric Anxiety Inventory has very good psychometric properties measuring anxiety in elderly people, being an adequate instrument for the screening of anxiety on this population.

Intraoperative Anesthesiology Management and Patient Outcomes for Surgical Revascularization for Moyamoya Disease: A Review and Clinical Experience.

BACKGROUND: Moyamoya disease (MMD) is a rare cerebrovascular condition, often presenting as a headache or stroke in adults. Anesthetic management of this illness may challenge providers because it can affect the long-term neurologic outcome and hospital length of stay (LOS) in patients with MMD. MATERIALS AND METHODS: A literature search was conducted to assess etiology and epidemiology, as well as existing reports of intraoperative management of MMD. Due to sparse findings, the search was expanded to include studies of the use of intraoperative anesthetic agents during other neurosurgical procedures. We also retrospectively reviewed all MMD cases from January 1, 2009, to December 31, 2015, at Memorial Hermann Hospital-Texas Medical Center, where intraoperative management involved craniotomy and surgical revascularization. Data were collected primarily on the use of several anesthetic agents. The LOS and any adverse events were also recorded for each case. The data were divided into two equivalent case cohorts: (1) January 1, 2009, to February 18, 2013, and (2) February 19, 2013, to December 31, 2015. RESULTS: Remifentanil use notably increased between the first and second time periods while fentanyl use decreased. Desflurane usage also demonstrated an observed increase when our two cohorts were compared. Additionally, there was a decrease in the mean LOS between the first and second periods of 3.9 and 3.3 days, respectively. CONCLUSION: Increasing use of remifentanil in MMD cases could be attributed to its ability to provide more stable hemodynamics during induction, maintenance, and emergence of anesthesia when compared with fentanyl. Lower systolic pressures, diastolic pressures, and heart rates were reported in patients receiving remifentanil over fentanyl.

Regional paleoclimates and local consequences: Integrating GIS analysis of diachronic settlement patterns and process-based agroecosystem modeling of potential agricultural productivity in Provence (France).

Holocene climate variability in the Mediterranean Basin is often cited as a potential driver of societal change, but the mechanisms of this putative influence are generally little explored. In this paper we integrate two tools-agro-ecosystem modeling of potential agricultural yields and spatial analysis of archaeological settlement pattern data-in order to examine the human consequences of past climatic changes. Focusing on a case study in Provence (France), we adapt an agro-ecosystem model to the modeling of potential agricultural productivity during the Holocene. Calibrating this model for past crops and agricultural practices and using a downscaling approach to produce high spatiotemporal resolution paleoclimate data from a Mediterranean Holocene climate reconstruction, we estimate realistic potential agricultural yields under past climatic conditions. These serve as the basis for spatial analysis of archaeological settlement patterns, in which we examine the changing relationship over time between agricultural productivity and settlement location. Using potential agricultural productivity (PAgP) as a measure of the human consequences of climate changes, we focus on the relative magnitudes of 1) climate-driven shifts in PAgP and 2) the potential increases in productivity realizable through agricultural intensification. Together these offer a means of assessing the scale and mechanisms of the vulnerability and resilience of Holocene inhabitants of Provence to climate change. Our results suggest that settlement patterns were closely tied to PAgP throughout most of the Holocene, with the notable exception of the period from the Middle Bronze Age through the Early Iron Age. This pattern does not appear to be linked to any climatically-driven changes in PAgP, and conversely the most salient changes in PAgP during the Holocene cannot be clearly linked to any changes in settlement pattern. We argue that this constitutes evidence that vulnerability and resilience to climate change are strongly dependent on societal variables.

Transpalpebral Electrical Stimulation as a Novel Therapeutic Approach to Decrease Intraocular Pressure for Open-Angle Glaucoma: A Pilot Study.

PURPOSE: To determine the effect on intraocular pressure of transpalpebral specific exogenous voltages in a cohort of open-angle glaucoma patients. METHODS: This is a prospective, comparative, and experimental pilot study. The electrical stimuli applied consisted of 10 Hz, biphasic, nonrectangular current pulses (100 µA) delivered from an isolated constant current stimulator. At intake, baseline IOP measurements were obtained from each eye. The measurement was repeated before and after microstimulation until the end of the treatment. RESULTS: Seventy-eight eyes of 46 patients diagnosed with POAG were studied: 58 eyes with maximum tolerated medical treatment and 20 eyes without treatment (naïve). The mean baseline IOP on the treated POAG group was 19.25 mmHg ± 4.71. Baseline IOP on the naïve group was 20.38 mmHg ± 3.28. At the four-month follow-up visit, the mean IOP value on the treatment group was 14.41 mmHg ± 2.06 (P < 0.0001). The obtained mean IOP measurement on the treatment-naïve group was 15.29 mmHg ± 2.28 (P < 0.0001). CONCLUSIONS: The hypotensive response obtained using transpalpebral electrical stimulation on POAG patients, both on treatment-naïve patients and on patients receiving maximum tolerable treatment, was statistically significant when comparing basal IOP measurements to those obtained at the four-month follow-up visit.

Tumor filoide. Estado del arte / Phyllodes tumour. State of the art

El tumor filoide (TF) es una neoplasia fibroepitelial con una baja incidencia a nivel mundial, lo que limita el poder contar con estudios prospectivos acerca de su abordaje diagnóstico y terapéutico. Se hace una revisión actualizada de su presentación, diagnóstico y tratamiento. Con las características histopatológicas disponibles actualmente se puede subdividir el TF en: de histología benigna, limítrofe y maligna. Esta subclasificación permite establecer el abordaje quirúrgico, que es la base del manejo terapéutico, la indicación de terapias adyuvantes, y finalmente establecer el pronóstico de la paciente.

Phyllodes tumour is a fibroepithelial neoplasm of the breast, with a low world incidence, and with few prospective trials on its diagnosis and treatment. A review is presented of the available world medical literature on this topic. Phyllodes tumours can currently be classified as benign, borderline and malign. This classification helps to determine the surgical treatment, which is the cornerstone of the treatment of Phyllodes tumour, as well as the adjuvant treatment, and finally it helps to determine the patient's prognosis.

Vitreous humor thermodynamics during phacoemulsification.

The purpose of this study is to determine baseline vitreous humor temperature during a combined phacoemulsification and pars plana vitrectomy (PPV) procedure; to determine what is the temperature variation during phacoemulsification; and to compare vitreous temperature to sublingual temperature. The methods used are prospective, interventional and comparative study. Patients with a diagnosis of cataract and vitreous hemorrhage, programed for a combined procedure of phacoemulsification and PPV, were included. Patients were excluded if posterior capsular rupture existed during the anterior segment procedure. A thermoprobe was inserted through a PPV trocar. Measurement of the vitreous temperature was obtained at baseline and throughout phacoemulsification, at the end of every surgical step, and every 5 min. Sublingual temperature was measured with the same probe at the end of the surgery. Room temperature was registered. Seventeen eyes of 17 patients were included. Mean sublingual temperature was 36.5 °C (standard deviation [σ] 0.26 °C). Mean total vitreous temperature was 31.47 °C (σ 2.1 °C). Mean baseline vitreous temperature was 33.04 °C (σ 0.99 °C). Comparison of sublingual temperature with baseline vitreous temperature resulted in a significant difference (t test P < 0.000. 95 % confidence interval 2.93-3.98). Temperature measured by surgical step and surgical time presented a significant decrease in temperature from baseline (Kruskal-Wallis P < 0.000, P = 0.003, respectively). Vitreous humor is significantly hypothermic when compared to sublingual temperature. Vitreous temperature decreases significantly during phacoemulsification.

CFH haplotypes and ARMS2, C2, C3, and CFB alleles show association with susceptibility to age-related macular degeneration in Mexicans.

PURPOSE: To evaluate the contribution of genetic variants of complement factor H (CFH), complement component 2 and 3 (C2 and C3), complement factor B (CFB), and age-related maculopathy susceptibility 2 (ARMS2) to age-related macular degeneration (AMD) risk in the Mexican Mestizo population. METHODS: Analysis included 282 unrelated Mexican patients with advanced AMD, 205 healthy controls, and 280 population controls. Stereoscopic fundus images were graded on the Clinical Age-Related Maculopathy System (CARMS). We designed a resequencing strategy using primers with M13 adaptor for the 23 exons of the CFH gene in a subgroup of 96 individuals clinically evaluated: 48 AMD cases and 48 age- and sex-matched healthy controls. Single nucleotide polymorphisms (SNPs) in C3 (Arg80Gly and Pro292Leu), C2 (rs547154), CFB (Leu9His), and ARMS2 (Ala69Ser) were genotyped in all patients, healthy and population controls using TaqMan assay. RESULTS: All evaluated individuals were Mexican Mestizos, and their genetic ancestry was validated using 224 ancestry informative markers and calculating F(st) values. The CFH resequencing revealed 19 SNPs and a common variant in the intron 2 splice acceptor site; three CFH haplotypes inferred from individual genotypes, showed significant differences between cases and controls. The risk alleles in C3 (rs1047286, odds ratio [OR]=2.48, 95% confidence interval [CI]=1.64-3.75, p=1.59E-05; rs2230199, OR=2.15, 95% CI=1.48-3.13, p=6.28E-05) and in ARMS2 (rs10490924, OR=3.09, 95% CI=2.48-3.86, p=5.42E-23) were strongly associated with risk of AMD. The protective effect of alleles in C2 (rs547154) and CFB (rs4151667) showed a trend but was not significantly associated after correction for multiple testing. CONCLUSIONS: Our results show that ARMS2 and C3 are major contributors to advanced AMD in Mexican patients, while the contributions of CFH, C2, and CFB are minor to those of other populations, reveling significant ethnic differences in minor allele frequencies. We provide evidence that two specific common haplotypes in the CFH gene predispose individuals to AMD, while another may confer reduced risk of disease in this admixed population.

Tratamiento percutáneo de la litiasis biliar mediante dilatación papilar: esfinteroplastía anterógrada percutánea / Percutaneous treatment of biliary lithiasis with papillary dilation

Antecedentes: La dilatación papilar con balón (esfinteroplastía) ha sido empleada como método novedoso por vía endoscópica para la extracción de cálculos biliares pequeños. Objetivos: Analizar nuestra experiencia con diversos métodos percutáneos hasta adoptar la esfinteroplastía como método electivo, y evaluar los resultados. Lugar de aplicación: Instituto privado de salud. Diseño: Estudio retrospectivo de comparación de 2 series. Población: 132 procedimientos percutáneos por litiasis residual de la vía biliar. Método: Se evalúan 2 series sucesivas en el tiempo, en las que se emplearon métodos percutáneos distintos. Serie A: 31 pacientes, se efectúa predilatación papilar y pulsión del cálculo atrapado en una canastilla modificada al duodeno. Serie B: 101 pacientes, se emplea la sobredilatación papilar con balón (esfinteroplastía) y expulsión por lavado al duodeno. Resultados: En 5 casos (3,8 por ciento) la patología litiásica no pudo ser resuelta. La litiasis residual fue tratada mediante el pasaje al duodeno en 127 pacientes (96,2 por ciento). Las complicaciones que se presentaron fueron: Serie A: 12,8 por ciento, Serie B: 1,9 por ciento. Estas consistieron en: pancreatitis aguda, coleperitoneo y absceso hepático. La hiperamilasemia fue frecuente. No existió mortalidad en este estudio. Conclusiones: El tratamiento percutáneo de la litiasis residual es altamente efectivo. Hemos adoptado la esfinteroplastía como método electivo por su efectividad, sencillez técnica, bajo costo y baja morbilidad (AU)

Tratamiento percutáneo de la litiasis biliar mediante dilatación papilar: esfinteroplastía anterógrada percutánea / Percutaneous treatment of biliary lithiasis with papillary dilation

Antecedentes: La dilatación papilar con balón (esfinteroplastía) ha sido empleada como método novedoso por vía endoscópica para la extracción de cálculos biliares pequeños. Objetivos: Analizar nuestra experiencia con diversos métodos percutáneos hasta adoptar la esfinteroplastía como método electivo, y evaluar los resultados. Lugar de aplicación: Instituto privado de salud. Diseño: Estudio retrospectivo de comparación de 2 series. Población: 132 procedimientos percutáneos por litiasis residual de la vía biliar. Método: Se evalúan 2 series sucesivas en el tiempo, en las que se emplearon métodos percutáneos distintos. Serie A: 31 pacientes, se efectúa predilatación papilar y pulsión del cálculo atrapado en una canastilla modificada al duodeno. Serie B: 101 pacientes, se emplea la sobredilatación papilar con balón (esfinteroplastía) y expulsión por lavado al duodeno. Resultados: En 5 casos (3,8 por ciento) la patología litiásica no pudo ser resuelta. La litiasis residual fue tratada mediante el pasaje al duodeno en 127 pacientes (96,2 por ciento). Las complicaciones que se presentaron fueron: Serie A: 12,8 por ciento, Serie B: 1,9 por ciento. Estas consistieron en: pancreatitis aguda, coleperitoneo y absceso hepático. La hiperamilasemia fue frecuente. No existió mortalidad en este estudio. Conclusiones: El tratamiento percutáneo de la litiasis residual es altamente efectivo. Hemos adoptado la esfinteroplastía como método electivo por su efectividad, sencillez técnica, bajo costo y baja morbilidad

Efecto del tabaquismo en la aterosclerosis coronaria y de la aorta en niños y jóvenes utilizando el sistema aterométrico (1986-96). Investigación multinacional de la Organización Mundial de la Salud / Effects of smoking on atherosclerosis or the aorta and the coronary arteries in children and youth utilizing the Atherometric system

El objetivo del presente trabajo es estudiar el impacto del tabaquismo como factor de riesgo aterogénico en pacientes fallecidos y autopsiados de edades comprendidas entre 5 y 34 años. Esta investigación multinacional de la Organización Mundial de la Salud y la Federación Internacional de Sociedades de Cardiología se desarrolló durante 10 años del 1986-96. Del Centro de Coordinación general de esta investigación de Malmö, se recibieron en el Centro de Investigaciones y Referencias de Aterosclerosis de la Habana (CIRAH) un total de 966 mitad izquierda de la aorta torácica, 947 mitad izquierda de la aorta abdominal y 959 arterias coronaria derecha. Las arterias procedieron de 11 países localizados en cinco regiones de la OMS, America, Africa, Europa, Sudeste Asiatico, y Sudoeste Asiatico. Las arterias se procesaron utilizando la metodología propuesta por la OMS desde 1957 para la aplicación del Sistema Aterométrico (SA), conjunto de métodos y procedimientos considerados idóneos para la carecterización patomorfológica y morfométrica de la lesión aterosclerótica. La población de autopsias se dividió en dos grupos, fumadores y no fumadores. Los datos se procesaron utilizando análisis estadísticos descriptivos, comparativos y multivariado. Entre las conclusiones más importantes se mencionan las siguientes: La distribución de estrías adiposas y placas fibrosas en las tres arterias estudiadas, aorta torácica (AT) aorta abdominal (AA) y coronaria derecha (CD) fue mayor en los fumadores que en los no fumadores. La transformación de estrías adiposas en placas fibrosas comenzó más temprano y con mucho mayor intensidad en los fumadores. El estadístico MANOVA entre fumadores y no fumadores mostró gran significación estadística en las tres arterias. El resultado de estadístico ANOVA mostró significación estadística de las estrías adiposas en la AT y de estas las placas fibrosas en la aorta abdominal y de las placas fibrosas en la coronaria derecha. En esta investigación quedó claramente demostrado que el tabaquismo es un fuerte factor de riesgo de aterosclerosis y por lo tanto de sus consecuencias orgánicas las enfermedades Cardiovasculares en edades tempranas