Importancia global y local de la diabetes mellitus tipo 2 / Global and local importance of type 2 diabtes mellitus

The purpose of this paper is to report on the current situation of diabetes mellitus, in order to gauge the current pandemic to which we are confronted. Diabetes, especially type 2, is a disease that has increased in prevalence in recent decades. In 2011 there were more than 366 million people affected by diabetes worldwide (comparative prevalence of 8.5 percent. Of the diabetic patients, 90 percent have type 2. Currently, diabetes is considered a pandemic, being the most developed regions and developing countries the most affected. Although there is an increased prevalence in all age groups, the highest number of people affected by diabetes is in the group between 40 and 59 years; but, if you analyze the relative prevalence by age group, the adult population over 65 years had the highest prevalence, bordering 40 percent. In our country, the overall prevalence of diabetes more than doubled between 2003 and 2009: from 4.2 to 9.4 percent, partly due to the exaggerated increase in obesity, which is directly linked to the development of this pathology. In sum, the exaggerated increase in prevalence of this disease makes it to be considered as a public health problem, which requires public policies to improve its prevention and management.

Fibrilación auricular focal: características clínicas y resultado de la ablación con radiofrecuencia / Results of radiofrequency ablation in focal atrial fibrillation

Background: Atrial fibrillation can originate in arrhythmogenic foci coming from the pulmonary veins. Patients with atrial fibrillation, initiated from triggering foci, can be treated with radiofrequency ablation. Aim: To report the results of radiofrequency ablation in patients with focal atrial fibrillation. Patients and methods: Thirteen patients with focal atrial fibrillation (8 male, aged 19 to 60 years old) are reported. Twelve had frequent crises refractory to antiarrhythmic drugs. Two had also flutter and tachycardia. One had a permanent atrial fibrillation lasting five years. Two had ventricular dysfunction and left atrial dilatation. The triggering focus was identified during the electrophysiological study, by the precocity of the potential that initiated the atrial fibrillation. Results: All patients had early atrial extrasystolic beats, isolated or repetitives, that preceded atrial fibrillation. During the electrophysiological study, 18 foci (3 in the right and 15 in the left atrium all in pulmonary veins) were identified. Radiofrequency ablation had immediate success in 11 patients. In 5, a flutter was also ablated. One patient had a sinus dysfunction after the procedure and atrial fibrillation was not eliminated. In this and other patient in whom the procedure failed, a pacemaker was implanted and the atrioventricular node was blocked. In a follow up, ranging from 4 to 31 months, eight patients are asymptomatic and 3 recidivated. No complications have been detected. Conclusions: Patients with focal atrial fibrillation have common clinical and electrocardiographic features. Radiofrequency ablation of the triggering focus is possible and effective in most cases