Psoriasis and Coronary Artery Disease in Hispanics.

Psoriasis is an immune disorder characterized by chronic activation of systemic inflammation. Morbidity and mortality in patients with psoriasis is attributed mainly to cardiovascular disease. There are studies in Caucasians and African- Americans, but little is known about how psoriasis is associated to coronary artery disease (CAD) in Hispanics. We intend to describe the angiographic findings of a group of Puerto Rican patients with psoriasis. Retrospective cohort study of 46 patients with psoriasis were studied. Coronary angiographic reports were reviewed, and collected data was statistically analized. Population median age was 56, and 72% were males. Of the 46 patients, 27 had CAD by angiographic criteria (58.7%). Twelve patients were referred to bypass graft surgery, 8 underwent coronary stent placement, and 7 were treated medically. Whether psoriasis can be considered a risk factor for developing CAD is still on debate. More than 50% of our patients with psoriasis had angiographic evidence of CAD. Adjusting for traditional cardiovascular risk factors, we found no significant association (p>0.05) with CAD. We believe that inflammation plays a contributing role in the increased risk of CAD in these patients. The importance of this study relies on being the first retrospective analysis in a group of Hispanics trying to determine an association between coronary artery disease and psoriasis when in Puerto Rico, coronary artery disease is 30% less than in the United States.

Coronary levels of angiotensin-II and endothelin-I in diabetic patients with and without coronary artery disease.

Two groups of patients were studied to find out the levels of angiotensin-II and endothelin-I in the coronary and peripheral circulation. Group A consisted of eight patients with diabetes mellitus type 2 and coronary artery disease; and Group B with diabetes mellitus without coronary artery disease. Significant differences were found between Group A and B in the levels of both peptides peripherally and intracoronary. This shows the importance of these peptides in the origin of coronary artery disease and progression of the disease in diabetics with coronary artery disease.

Celiac trunk and branches dissection due to energy drink consumption and heavy resistance exercise: case report and review of literature.

Higher doses and consumption of energy drinks leads to cardiovascular effects and potential consequences. Principal components found in energy drinks such as caffeine, guarana and taurine has been related to dilatation, aneurysm formation, dissection and ruptures. There is no evidence showing an integration of these components and its effects in endothelium and aortic walls due to higher levels of pressure during exercises. We report a case of a 44 years male with celiac trunk and branches dissection due to long-term consumption of energy drinks and intense exercise routine. Our proposition relates cell and vessel walls alterations including elasticity in endothelial wall due to higher blood pressure, resistance by intense exercise routine and long-term consumption of energy drinks.

Magnesium: the forgotten electrolyte.

UNLABELLED: Magnesium (Mg++), Potassium (K+) and Calcium (CA++) are important electrolytes in keeping a stable electrical status. The purpose of this study was to measure them in critically ill patients. METHODS: We evaluated the electrolytes in 28 consecutive patients. Eighteen were females and 10 males with mean age of 62 +/- 5 years. RESULTS: The admission diagnosis in 95% of the cases was congestive heart failure. Sixty-four percent of the patients had subnormal values of Mg++, 53% subnormal values of K+, and 28% subnormal values of CA++. Fourteen percent showed lower values of the three electrolytes and 35% only of Mg++ and K+ concomitantly. Twenty-eight percent showed prolonged QTC interval. All patients with prolonged QTC interval had low Mg++ and K+ levels. Twenty five percent of the patients showed atrial fibrillation, 25% ventricular tachycardia, and 3% junctional tachycardia. The ventricular tachycardia group had more electrolyte abnormalities than those with atrial fibrillation. None of the patients received Mg++ replacement during critical management while 50% received K+ replacement. CONCLUSION: This data shows physician overlook the Importance of Mg++ and K+ deficiency in critically ill patients.

Opinión de los trabajadores de Salud de la Sala I varones del Hospital Neuropsiquiátrico de Asunción - Paraguay sobre la rehabilitación de los enfermos mentales

Estudio descriptivo de la situación de rehabilitación de los enfermos mentales, vista desde la perspectiva de los trabajadores de Salud de la Sala I varones del Hospital Neuropsiquiátrico de Asunción. Presenta cuadros de tratamiento de la enfermedad, psicoterapia, medicación, complejidades