Embolismo pulmonar como primera manifestación de extensión intracardiaca de un sarcoma del estroma endometrial / Pulmonary Embolism as a First Manifestation of Intracardiac Extension of an Endometrial Stromal Sarcoma

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Hidroneumomediastino secundario a perforación de vólvulo gástrico en paciente con hernia de hiato gigante / Hydropneumomediastinum Secondary to Gastric Volvulus Perforation in a Patient With Giant Hiatal Hernia

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Alteraciones del metabolismo glucidico en el estudio de control de factores de riesgo de Extremadura (estudio COFRE) / Glucose metabolism disorders in the risk factor control in Extremadura Study (COFRE Study)

Objetivo Evaluar la frecuencia y el grado de control de las alteraciones de la glucemia en la población extremeña con riesgo cardiovascular. Se han estudiado, además, las diferencias entre la población con estos trastornos y los pacientes normoglucémicos dentro del estudio de control de los factores de riesgo cardiovascular en Extremadura (COFRE). Diseño y métodos Se ha recogido la presencia y control de factores de riesgo cardiovascular en una muestra de 1.022 pacientes con al menos un factor de riesgo cardiovascular, vistos consecutivamente en consulta. Novecientos cincuenta y un pacientes fueron aceptados para el análisis. En todos (..) (AU)

Aims To assess the prevalence and control of glucose metabolism disorders in a population of Extremadura (Spain) with at least one cardiovascular risk factor and to compare the characteristics of these patients with those who were normoglycemic in the risk factor control in Extremadura (COFRE study).

[Glucose metabolism disorders in the risk factor control in Extremadura Study (COFRE Study)]. / Alteraciones del metabolismo glucídico en el estudio de control de factores de riesgo de Extremadura (estudio COFRE).

AIMS: To assess the prevalence and control of glucose metabolism disorders in a population of Extremadura (Spain) with at least one cardiovascular risk factor and to compare the characteristics of these patients with those who were normoglycemic in the risk factor control in Extremadura (COFRE study). PATIENTS AND METHODS: The prevalence and control of cardiovascular risk factors were recorded in a sample of 1,022 patients with at least one cardiovascular risk factor consecutively visiting a primary care office. Of these, 951 patients were included in the analysis. In all patients, fasting glycemia was recorded. Glycated hemoglobin was recorded in diabetic patients. RESULTS: A total of 320 patients (33.6%) were previously known to be diabetic (DM) and 84 (8.8%) had glycemia > or = 126 mg/dl without a previous diagnosis of diabetes (12 with glycemia above 200mg/dl). Impaired fasting glycemia (IFG) was found in 211 (22.2%) and normoglycemia (NG) in 336 (35.3%). Within the DM group, glycemia <126 mg/dl was found in only 31.4% but glycated hemoglobin lower than 7% was found in 46.8%. Triglyceride concentrations were higher in the IFG group than in the NG group (137 + or - 65 mg/dL vs 124 + or - 65 mg/dL, p=0,041). Pulse pressure was also higher, but no differences were found in diastolic blood pressure (DBP) or heart rate. Differences in systolic blood pressure (SBP) were at the limit of significance (DM 139.5 + or - 17 vs NG 136.5 + or - 16 mmHg; p=0.056). No significant differences were found in any of these parameters between the DM and IFG groups. CONCLUSIONS: The prevalence of glucose metabolism disorders was very high in the recruited sample. Patients with IFG showed higher pulse pressure and triglyceride concentrations than those with NG but there were no differences in comparison with DM patients. Diabetic control was poor when assessed by fasting glycemia but glycated hemoglobin showed better control.

[Lipid control in diabetic patients in Extremadura (Spain)]. / Control de la dislipemia en pacientes diabéticos en Extremadura.

OBJECTIVE: Our study aimed to assess the prevalence and degree of control of dyslipemia, using the 2004 National Cholesterol Education Program criteria, as well as the use of cholesterol lowering drugs in a sample of diabetic patients followed up in primary care settings in Extremadura. PATIENTS AND METHODS: In this crosssectional, multicenter study the prevalence and control of cardiovascular risk factors was assessed in a sample of 1022 patients having at least one cardiovascular risk factors who were recruited by general practitioners. A total of 988 subjects were avalaible for statistic analysis of dyslipemia; 320 patients had diabetes mellitus (DM); 178 had at least one cardiovascular disease without diabetes and 506 patients without those diseases were used as control. RESULTS: Total cholesterol and low density lipoprotein (LDL) fraction were higher in the group control. High density lipoprotein (HDL)-cholesterol was lower in the group DM as compared to control. Triglycerides were higher in group DM. Women had higher HDL-cholesterol and lower triglycerides levels than men. Only 26.6% of diabetics subjetcs and 28.9% of group ECV were well controlled; 42.5% of the control group had LDL cholesterol < 130 mg/dl. 13.3% of diabetics patients suffering from coronary artery disease had LDL-cholesterol < 70 mg/dl. They were taking statins: DM, 56.6); ECV 61.6%; and control, 39.4%. From patients who did not take cholesterol lowering drugs 51.6% in group DM and 33.8% in group ECV would need to take them. CONCLUSIONS: The study shows a poor control of dyslipemia in diabetics subjects and high risk patients in spite of lower lipid levels when compared to lower risk population and a more frequent use of cholesterol lowering drugs. Nevertheless, statin use is still lower than currently recommended.

Control de la dislipemia y uso de hipolipemiantes en Extremadura: resultados del estudio de Control de Factores de riesgo de Extremadura (Estudio COFRE) / Lipid control and cholesterol lowering drugs use in Extremadura. Results from the Control of Risk Factors in Extremadura Study (COFRE Study)

Objetivo. Evaluar la prevalencia de dislipemia, su grado de control y el uso de hipolipemiantes en atención primaria en Extremadura. Diseño y métodos. Se ha recogido la presencia y el control de los factores de riesgo cardiovascular en una muestra de 1.022 pacientes visitados de forma consecutiva en consulta que presentaban al menos un factor de riesgo cardiovascular; de ellos se aceptaron 988 pacientes para el análisis estadístico. Los pacientes se han dividido según los objetivos de control de las cifras de lipoproteínas de baja densidad (LDL) en función de su riesgo cardiovascular, estimado según los criterios del III Panel de Expertos para Adultos. Resultados. El colesterol total y la fracción de LDL eran más bajos cuanto mayor era el riesgo cardiovascular estimado del individuo (p < 0,001). Por el contrario, las concentraciones de triglicéridos aumentaban significativamente de forma proporcional al riesgo cardiovascular de los pacientes. Para los pacientes de riesgo bajo el 69,2% de los individuos estaban controlados, mientras que en el grupo de riesgo moderado solamente el 42,6% tenía colesterol unido a LDL < 130 mg/dl. En cuanto a los pacientes de riesgo elevado, el 22,9 y el 7,1% de los pacientes de riesgo muy elevado estaban controlados. El 48,4% de la muestra global de pacientes estaba recibiendo tratamiento con estatinas, y su uso era más frecuente cuanto mayor era el riesgo estimado. El fármaco más usado era la atorvastatina (45,6%). A pesar del mal control, las dosis medias utilizadas eran bajas. Conclusiones. El control de la dislipemia sigue siendo bajo, especialmente en los pacientes de riesgo alto y muy alto, a pesar de que sus concentraciones de lípidos son inferiores a la población de riesgo menor. El uso mayor de fármacos hipolipemiantes en grupos de riesgo mayor indica un cuidado mayor de estos pacientes, aunque no se alcancen los objetivos deseados; este hecho parece relacionado con el uso de dosis inferiores a las necesarias (AU)

Objective. our study aimed to assess the prevalence and the control of dyslipemia, as well as the use of cholesterol lowering in primary care settings in Extremadura. Patients and methods. It was recorded the prevalence and control of cardiovascular risk factors in a sample of 1022 patients consecutively seen in primary care office who have at least one cardiovascular risk factor. From them, 988 were available for statistical analysis. the patients were split into the cardiovascular risk categories of AtP-III. Results. total cholesterol and LDL fraction were as lower as higher was the patients¿ estimated cardiovascular risk (p < 0.001). Contrariwise, triglycerides concentrations were higher in higher risk groups. women have higher hDL-cholesterol and lower triglycerides levels than men. 69.2% of low risk patients were controlled meanwhile 42.6% of medium risk patients have LDL cholesterol < 130 mg/dl. high and very high risk groups showed respectively 22.9% and 7.1% of controlled patients. 48.4% of patients were taking statins. the most used drug was atovastatin (45.6%). In spite of low control rates mean dosages of drugs were low. Conclusions. the study shows a poor control of dyslipemia specially in high and very high risk patients in spite of lower lipid levels when compared to lower risk population. the more frequent use of cholesterol lowering drugs in high risk subjects suggest an intensified care although selected targets are not reached; these results seems to be related to low dosage of this kind of drugs (AU)

Control de la dislipemia en pacientes diabéticos en Extremadura / Lipid control in diabetic patients in Extremadura (Spain)

Objetivo: Evaluar la prevalencia de dislipemia y su grado de control, según los criterios del National Cholesterol Education Program (NCEP)-2004, y el uso de hipolipemiantes en pacientes que padecen diabetes mellitus (DM) atendidos en consultas de atención primaria en Extremadura. Diseño y métodos: Estudio transversal en el que se ha recogido la presencia de factores de riesgo cardiovascular y su control en una muestra de 1.022 pacientes visitados consecutivamente en consulta que presentaban al menos un factor de riesgo cardiovascular conocido. De ellos, 988 pacientes fueron aceptados para el análisis estadístico de lípidos; 320 tenían DM; 178, alguna enfermedad cardiovascular (ECV) sin DM y el resto, ninguna de esas enfermedades concomitantes (controles). Resultados: El colesterol total y la fracción de las lipoproteínas de alta densidad (cLDL) eran más elevados en el grupo control. El colesterol de las lipoproteínas de alta densidad (cHDL) del grupo con DM era significativamente inferior a los valores del grupo control. Los triglicéridos estaban significativamente aumentados en el grupo con DM respecto a los otros dos grupos. El cHDL era mayor en las mujeres y los triglicéridos estaban más elevados en los varones. El 26,6% del grupo con DM y el 28,9% del grupo con ECV estaban bien controlados, mientras que en el grupo control el 42,5% tenía concentraciones < 130 mg/dl. Solamente el 13,3% de los sujetos con DM y cardiopatía isquémica tenían un cLDL < 70 mg/dl. El 56,6% de los sujetos con DM, el 61,6% del grupo ECV y el 39,4% del grupo control tomaban estatinas. De los pacientes que no tomaban hipolipemiantes del grupo con DM, el 51,6% debería haberlos tomado; del grupo con ECV, el 33,8% Conclusiones: El grado de control de la dislipemia es bajo en los pacientes diabéticos y con alto riesgo a pesar de que sus concentraciones de lípidos son inferiores a las de la población con menor riesgo y que el uso de hipolipemiantes en su tratamiento es más elevado. Aun así, el uso de hipolipemiantes sigue siendo inferior a lo recomendado actualmente AU)

Objective: Our study aimed to assess the prevalence and degree of control of dyslipemia, using the 2004 National Cholesterol Education Program criteria, as well as the use of cholesterol lowering drugs in a sample of diabetic patients followed up in primary care settings in Extremadura. Patients and methods: In this cross-sectional, multicenter study the prevalence and control of cardiovascular risk factors was assessed in a sample of 1022 patients having at least one cardiovascular risk factors who were recruited by general practitioners. A total of 988 subjects were avalaible for statistic analysis of dyslipemia; 320 patients had diabetes mellitus (DM); 178 had at least one cardiovascular disease without diabetes and 506 patients without those diseases were used as control. Results: Total cholesterol and low density lipoprotein (LDL) fraction were higher in the group control. High density lipoprotein (HDL)-cholesterol was lower in the group DM as compared to control. Triglycerides were higher in group DM. Women had higher HDL-cholesterol and lower triglycerides levels than men. Only 26.6% of diabetics subjetcs and 28.9% of group ECV were well controlled; 42.5% of the control group had LDL cholesterol < 130 mg/dl. 13.3% of diabetics patients suffering from coronary artery disease had LDL-cholesterol < 70 mg/dl. They were taking statins: DM, 56.6); ECV 61.6%; and control, 39.4%. From patients who did not take cholesterol lowering drugs 51.6% in group DM and 33.8% in group ECV would need to take them. Conclusions: The study shows a poor control of dyslipemia in diabetics subjects and high risk patients in spite of lower lipid levels when compared to lower risk population and a more frequent use of cholesterol lowering drugs. Nevertheless, statin use is still lower than currently recommended (AU)

Miocardiopatía dilatada en un paciente con acromegalia: evolución ecocardiográfica tras el tratamiento / Dilated cardiomyopathy in a patient with acromegaly: echocardiographic development after treatment

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