ABSTRACT
Background: Implementation of health programs to reduce cardiovascular risk, are needed for secondary prevention of cardiovascular diseases. Aim: To evalúate achievements of secondary prevention goals, pharmacologic prescription and major cardiovascular events in patients with coronary artery disease. Material and Methods: Patients who had a first event of acute coronary syndrome, angioplasty or revascularization surgery, between January 2008 and June 2010, were contacted for a clinical and laboratory evaluation between June and October 2011. Results: Seven hundred and two medical records were reviewed and 245 eligible patients were identified. Ofthese, we assessed 202 patients aged 64 ± 10 years (70% males). Sixty seven percent had two ormore cardiovascular riskfactors. A goal ofHDL cholesterol level over 40 mg/dL was achieved in 91 % of patients, smoking cessation in 84% and a total cholesterol < 200 mg/dL in 66%. A blood pressure below 130/85 mm Hgwas achieved in 30% of patients, a normal BMI in 19% and LDL cholesterol levels below 70 mg/dL in 18%. At the moment of assessment, 87%> were using aspirin, 78%> statins, 74% angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists and 66%o were using β - blockers. Twenty two percent of patients had a major cardiovascular event during the follow up, which lasted 28 ± 8 months. Conclusions: A low percentage of cardiovascular goals achievement was observed in this sample of patients, with a high prevalence of overweight and obesity. A high percentage quit smoking after their first cardiovascular event. Despite the high percentage of drug prescription, hypertension and dyslipidemia were not fully controlled.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cardiovascular Diseases/prevention & control , Drug Prescriptions/statistics & numerical data , Cardiovascular Diseases/drug therapy , Coronary Disease/drug therapy , Cross-Sectional Studies , Goals , Risk Factors , Socioeconomic FactorsABSTRACT
La psoriasis es un trastorno crónico común de la piel, se caracteriza por pápulas eritematosas y escamas blancas, aunque el diagnóstico diferencial de la psoriasis es amplio, en la gran mayoría de los casos sólo se necesita la anamnesis y el examen físico. En el tratamiento, la luz ultravioleta (UV) ha sido reconocida como beneficiosa a través de sus efectos antiproliferativos y anti- inflamatorios. El propósito nuestro trabajo es describir las características clínicas y epidemiológicas de esta patología en pacientes sometidos a fototerapia en el Hospital Hernán Henríquez Aravena de Temuco entre septiembre de 2007 y diciembre 2009.Se realizó un estudio retrospectivo en el que se revisaron fichas clínicas y informes de fototerapia de 60 pacientes portadores de psoriasis. El tipo clínico más común fue la psoriasis en placa con un 90 por ciento de los casos, seguida de psoriasis eritrodérmica con un 5 por ciento, el tipo de piel más común fue el Tipo 2 con un 87,7 por ciento de los casos. En cuanto a la severidad, la psoriasis moderada fue el 46,8 por ciento de los casos, con un índice de severidad y área de psoriasis (PASI) promedio del grupo estudiado de 11,61 siendo el tipo de psoriasis con mayor gravedad el tipo eritrodérmica (p=0,008). La asociación entre severidad y tipo de piel fue significativa siendo los tipos de piel 1 el que presentó mayor severidad (p=0,012). Nuestro estudio demostró algunas asociaciones significativas entre severidad y tipo de psoriasis, y con tipo de piel. Además de una frecuencia similar en ambos sexos coincidiendo con lo reportado en la literatura.
Psoriasis is a common chronic disorder of the skin which is generally characterized by red papules and white scales. Differential diagnosis of Psoriasis is wide, but it is possible to reach a proper diagnosis with the clinical history and physical examination. For the treatment Ultraviolet light (UV) has been recognized as beneficial, through both antoproliferative and antiinflamatory effects. The purpose of our work is to describe the clinical and epidemiologic features of this pathology in patients with diagnosis of psoriasis submitted for phototherapy in Hospital Hernan Henríquez Aravena of Temuco, between September 2007 and December 2009. A retrospective study was conducted in which there were review medical records and phototherapy protocols of 60 patients with diagnosis of psoriasis. The most common clinical type was the Plaque Psoriasis with 90 percent of the cases, followed by Erythrodermic Psoriasis with 5 percent. The most common skin type was type 2 with 87.7 percent of the cases. Regarding severity, moderate psoriasis presented in 46.8 percent of the cases, with an average Psoriasis area ans severity index (PASI) score of the studied group of 11.61, the type of mayor severity was the Erythrodermic psoriasis (p=0,008). The association between severity and type of skin was significant, being the patients with skin type 1 the ones that presented an increased disease severity (p = 0.012). Our study showed some significant associations between severity and type of psoriasis, and type of skin. Besides the similarity of frequence between genders coincides with previous literature reports.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Child , Middle Aged , Psoriasis/epidemiology , Psoriasis/radiotherapy , Ultraviolet Therapy/statistics & numerical data , Chile , Cross-Sectional Studies , Psoriasis/pathology , Psoriasis/drug therapy , Severity of Illness Index , PUVA Therapy/statistics & numerical dataABSTRACT
Background: The incidence of malignant melanoma is increasing steadily. Aim: To study pathological prognostic factors in malignant melanomas. Material and Methods: Review of pathological records of cutaneous malignant melanomas diagnosed between 1995 and 2008. Medical records of patients were re-viewed and those with distant metastases at the moment of surgery were excluded. Follow up was performed contacting patients and reviewing death records at the Chilean National Identification Registry. The cause of death was classified as related to the melanoma or unrelated. Results: One hundred sixty two records, corresponding to patients aged from 13 to 93 years (51 percent women), were included in the study. Twenty nine percent of patients died during the follow up period that ranged from 1 to 127 months. Five and ten year's survival was 71 and 60 percent respectively. A multivariable Cox analysis demonstrated that only the TNM classification of the primary tumor, which is categorized using the Breslow maximal depth, had prognostic significance. Compared to women, men had a 1.97 higher relative risk of dying due to the melanoma. Conclusions: TNM classification of melanomas is the most important prognostic factor for survival.
Introducción: El Melanoma Maligno (MM) de la piel ha aumentado su incidencia en 5 por ciento anual, se estima que 1 de cada 55 hombres y 1 de cada 77 mujeres desarrollará la enfermedad durante su vida. Método y Diseño: Estudio de cohorte retrospectivo de seguimiento de casos de melanoma maligno primario de la piel diagnosticados en la Unidad de Anatomía Patológica del Hospital Dr. Hernán Henríquez Aravena de Temuco. Se incluyeron 162 casos de MM primario de piel. El período de seguimiento fue de 1 a 164 meses. El análisis estadístico se realizó según método de Kaplan-Meier para la descripción de sobrevida según las variables de interés, utilizando la prueba no paramétrica Log-rank, modelo univariado y multivariado de Cox. Resultados: Se incluyeron 162 casos en la cohorte de estudio. El 28,7 por ciento de los pacientes falleció producto del melanoma durante el tiempo de observación (rango 1 a 127 meses, mediana 23 meses). La sobrevida general de la cohorte a 5 y 10 años fue de 71 por ciento y 60 por ciento respectivamente. El análisis multivariado de Cox demostró que sólo la clasificación del tumor primario según TNM es significativa. Los hombres tienen un riesgo relativo de 1,97 para morir por MM. La edad y distribución topográfica no resultaron ser variables pronosticas. Conclusión: En nuestro estudio se confirman los indicadores histológicos de pronóstico de sobrevida en población de la región de La Araucanía, los factores de mayor importancia son el espesor máximo según Breslow, presencia de úlcera, tipo histológico y nivel de infiltración de Clark.