[Doppler ultrasonography diagnosis of right ventricular outflow tract obstruction caused by mediastinal tumor and its reversibility after treatment]. / Diagnóstico por ecocardiografía-Doppler de obstrucción al tracto de salida del ventrículo derecho por tumor mediastínico y su reversibilidad después del tratamiento.

Doppler-echocardiography has proved useful in the assessment of mediastinal masses. We present the case of a young man with fever and new systolic murmur. Echocardiographic examination revealed a paracardiac mass compressing the right ventricular outflow tract and Doppler flow study detected marked acceleration in luminal narrowing. Complete remission of the tumour was obtained with subtotal resection and chemotherapy. Histological diagnosis was of embryonary carcinoma with areas of endodermic sinus. A new Doppler-echocardiography study showed disappearance of both the mass and the compression and showed normal right ventricular outflow tract flow.

[Calculating coronary risk for patients included in the Preventive Activities and Health Promotion Program]. / Cálculo del riesgo coronario de los pacientes incluidos en el Programa de Actividades Preventivas y de Promoción de la Salud.

OBJECTIVE: To calculate coronary risk (CR), or the probability of suffering a "coronary event" within five years, for patients between 35 and 65 included in the Preventive Activities and Health Promotion Programme (PAHPP). DESIGN: A descriptive crossover study. SETTING: Manises Health Centre, Valencia. PATIENTS: All the patients between 35 and 65 included in the PAHPP, 431 in all, were selected. For the coronary risk calculation the coefficients and constants of the Dundee Coronary Risk-Disk were used, the variables being gender, systolic arterial pressure, the number of cigarettes and overall cholesterol. MEASUREMENTS AND MAIN RESULTS: Average CR was 5.1% (CI = 4.7-5.4) "coronary events" in five years. CR was less (p = 0.01) in patients aged between 55 and 65. The risk factors (tobacco dependency, arterial Hypertension and Hypercholesterolaemia) were presented in association in 37.7% of cases. The highest CR was found when the three risk factors were presented in association (CR = 14%), when tobacco dependency was associated with hypercholesterolaemia (CR = 10.4%) or with arterial hypertension (CR = 6.4%). CONCLUSIONS: CR can be calculated on the basis of data obtained by PAHPP: The risk factors are frequently presented in association and therefore require multifactorial vision for a correct assessment. Tobacco dependency is the factor which, whether by itself or in association, has most impact on the determination of modifiable CR.