Nuevas perspectivas en el estudio y tratamiento de la sepsis

La sepsis es una disfunción orgánica potencialmente mortal debida a una respuesta desregulada del hospedero a la infección. No sólo contribuye con el 20 % de todas las causas de muerte de forma global, sino que los sobrevivientes de esta también pueden experimentar una significativa morbilidad a largo plazo. La sepsis y el shock séptico son emergencias médicas que requieren reconocimiento rápido, administración de antimicrobianos apropiados, soporte hemodinámico cuidadoso y control de la fuente infecciosa. El objetivo de esta revisión fue describir la definición y los criterios diagnósticos, la epidemiología, los factores de riesgo, la patogenia y la conducta inicial ante la sepsis.

Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to infection. It severely impacts global disease burden as it constates 20 % of all causes of death; its survivors may experience long-term morbidity. Sepsis and septic shock are medical emergencies that require rapid identification, administration of appropriate antimicrobials, careful hemodynamic support, and control of the infection source. This review aims to update the definition of sepsis and its diagnostic criteria, epidemiology, risk factors, pathogenesis, and baseline behavior.

Relación entre la composición de la microbiota y la hipertensión arterial esencial. Una revisión narrativa / Relationship between microbiota composition and essential hypertension. A narrative review

La hipertensión arterial esencial es una patología de alta prevalencia a nivel mundial, y uno de los determinantes más significativos para enfermedad cardiovascular. Por otra parte, se ha generado un gran interés por la microbiota del cuerpo, y la forma en que se ve alterada por factores tanto internos como externos, ocasionando disbiosis. En la actualidad se viene estudiando el efecto de la microbiota en diferentes enfermedades, entre ellas, la relación entre la microbiota y la hipertensión. En este artículo se hizo una revisión de la literatura, entre 2010 a 2021, con el objetivo de identificar la evidencia científica que sustenta la relación entre la composición de la microbiota y la hipertensión arterial esencial. Se encontró en muchos estudios que los hipertensos tenían una diversidad menor de la microbiota, en comparación con los grupos de control sanos. En los hipertensos se encontraron principalmente bacterias del género Prevotella y en el grupo control predominaba el género Bacteroidetes. Adicionalmente, se observó una disminución de Faecalibacterium, Roseburia y Bifidobacterium en el grupo de hipertensos. Existen varias técnicas de laboratorio para el reconocimiento de la población bacteriana del intestino, tales como la secuenciación de la subunidad de ARNr 16S, la secuenciación del genoma completo y la metagenómica de la microbiota. A pesar de que los estudios realizados sobre la relación microbiota e hipertensión concluyen que existe una relación significativa entre ambas, es necesario hacer más investigaciones en diferentes grupos poblacionales

Essential arterial hypertension is a highly prevalent pathology worldwide and is one of the most significant determinants of cardiovascular disease. On the other hand, great interest has been generated in the microbiota of the body, and how it is altered by both internal and external factors, causing dysbiosis. Currently, the effect of the microbiota in different diseases is being studied, including the relationship between the microbiota and hypertension. In this article, a review of the literature was made, between 2010 and 2021, with the objective of identifying the scientific evidence that supports the relationship between the composition of the microbiota and essential arterial hypertension. It was found in many studies that individuals with high blood pressure had lower microbiota diversity compared to healthy control groups. In hypertensive patients, bacteria of the genus Prevotella were mainly found, while in the control group the genus Bacteroidetes predominated. Additionally, a decrease in Faecalibacterium, Roseburia and Bifidobacterium was observed in the hypertensive group. There are several laboratory techniques for the analysis of the intestinal bacterial population, such as 16S rRNA subunit sequencing, whole genome sequencing, and microbiota metagenomics. Despite the fact that the studies conclude that there is a significant relationship between microbiota and hypertension, it is necessary to do more research in different population groups

COVID-19 and death of older adults in the Northeast region of Brazil: a survival analysis / COVID-19 y muerte de ancianos en la región Nordeste de Brasil: un análisis de supervivencia / COVID-19 e óbito de pessoas idosas na região Nordeste do Brasil: uma análise da sobrevivência

ABSTRACT Objective: to analyze survival and factors associated with increased risk of death for older adults diagnosed with COVID-19, living in the Northeast region of Brazil. Method: retrospective observational study developed with secondary data provided by the Brazilian Ministry of Health, between June 14 and December 26, 2020. The Kaplan-Meyer method, the time-dependent cox regression model was used, including covariates (age, sex, skin color, comorbidities, admission to the ICU, ventilatory support). Results: out of 9,306 individuals analyzed, 55.9% died and 44.1% survived. The highest risk of death was observed for those aged 80-89 (HR=1.95), brown-skinned (HR=1.99), with immunodeficiency (HR=1.259) or kidney disease (HR=1.147), admitted to the ICU (HR=1,795) and in use of ventilatory support (HR=1606). Conclusion: among older adults residing in the Northeast region of Brazil, there was a higher risk of death from COVID-19 for octogenarians, brown-skinned, with comorbidities, hospitalization in the ICU, followed by the use of ventilatory support. The creation of health prevention strategies that identify older adults with these profiles is suggested to prevent deaths in future pandemic situations.

RESUMENObjetivo: analizar la supervivencia y los factores asociados con un mayor riesgo de muerte en ancianos diagnosticados con COVID-19, residentes en la región Nordeste de Brasil. Método: estudio observacional retrospectivo desarrollado con datos secundarios proporcionados por el Ministerio de Salud de Brasil, entre el 14 de junio y el 26 de diciembre de 2020. Se utilizó el método de Kaplan-Meyer, modelo de regresión de Cox-tempo-dependiente, incluyendo covariables (edad, sexo, color de piel, comorbilidades, ingreso en UCI, soporte ventilatorio). Resultados: 9.306 personas analizadas, el 55,9% falleció y el 44,1% sobrevivió. El mayor riesgo de muerte se observó en las personas de 80 a 89 años (HR=1,95), color de piel morena (HR=1,99), inmunodeficiencia (HR=1,259), enfermedad renal (HR=1,147), con ingreso en UCI (HR=1.795) y uso de soporte ventilatorio (HR=1606). Conclusión: entre los ancianos residentes en la región Nordeste de Brasil, hubo mayor riesgo de muerte por COVID-19 para los octogenarios, color de piel morena, que tenían comorbilidades, hospitalización en la UCI, seguido del uso de soporte ventilatorio. Se sugiere la creación de estrategias de prevención en salud que identifiquen a las personas mayores con estos perfiles para prevenir muertes en futuras situaciones pandémicas.

RESUMOObjetivo: analisar a sobrevida e os fatores associados ao maior risco de morte para idosos com diagnóstico de COVID-19, residentes na região Nordeste do Brasil. Método: estudo observacional retrospectivo desenvolvido com dados secundários fornecidos pelo Ministério da Saúde do Brasil, entre 14 dejunho a 26 de dezembro de 2020. Utilizou-se o método de Kaplan-Meyer, o modelo de regressão de cox tempo-dependente, incluindo covariáveis (idade, sexo, cor da pele, comorbidades, admissão na UTI, suporte ventilatório). Resultados: 9.306 indivíduos foram analisados; 55,9% morreram e 44,1% sobreviveram. O maior risco de ocorrência de óbitos foi observado para aqueles entre 80-89 anos (HR=1,95), cor da pele parda (HR=1,99), imunodeficiência (HR=1,259), doença renal (HR=1,147), com admissão em UTI (HR=1,795) e uso de suporte ventilatório (HR=1.606). Conclusão: entre idosos residentes na região Nordeste do Brasil, constatou-se maior risco de óbitos por COVID-19 para octogenários, cor parda, que apresentaram comorbidades, internação em UTI, seguido do uso de suporte ventilatório. Sugere-se a criação de estratégias de prevenção em saúde que identifiquem idosos com esses perfis para prevenir óbitos em futuras situações de pandemia.

Lesão renal aguda após cirurgias não cardíacas: incidência e impacto das disfunções orgânicas extra-renais nos desfechos / Acute kidney injury during the perioperative: incidence and impact of extrarenal organ dys-function in the outcomes

Introdução: A permanência de pacientes em Unidades de Terapia Intensiva (UTI) é frequentemente complicada por Lesão Renal Aguda (LRA), principalmente em casos de sepse, baixo débito cardíaco e pós-operatório de grandes cirurgias. Objetivo: Avaliar a incidência, características, desenvolvimento de outras disfunções orgânicas, e desfechos de pacientes com LRA adquirida na UTI após cirurgias não cardíacas. Métodos: Estudo de coorte, prospectivo. Todos os pacientes internados consecutivamente nas UTIs após cirurgias não cardíacas nos meses de abril e maio de 2017 foram analisados quanto ao desenvolvimento ou não de LRA, de outras disfunções orgânicas e ao balanço hídrico. Resultados: A incidência de LRA foi de 16,2%. Os pacientes que desenvolveram LRA no pós-operatório eram mais graves, e diferiram quanto à necessidade de ventilação mecânica (60% vs. 11%, p < 0,001), uso de drogas vasoativas (82% vs. 44%, p = 0,021); presença de infecção (80% vs. 21%, p < 0,001), sepse ou choque séptico (50% vs. 9%, p < 0,001) e a outras complicações pós-operatórias (91% vs. 58%, p = 0,023). Outras disfunções de órgãos e sistemas foram mais fre-quentes nos pacientes com IRA (2 [2-3] vs. 1 [0-1], p < 0,001), particularmente disfunção gas-trointestinal (73% vs. 19%, p < 0,001) e cardiovascular (73% vs. 33%, p = 0,015). O número de pacientes com duas ou mais disfunções orgânicas aumentou de 21% para 82% em pacientes com LRA (RR 3,89, IC: 2,18 ­ 6,90, p < 0,001). O tempo de internação (13 ± 9 vs. 5 ± 6 dias, p < 0,001) e a mortalidade hospitalar (54,5% vs. 7%, p = 0,013) foram maiores nos pacientes com LRA. Conclusão: Entre pacientes com cirurgias não cardíacas e necessidade de UTI, a incidência de LRA é elevada e associada a complicações de outros sistemas, incluindo os sistemas neurológico, gastrointestinal, respiratório e cardiovascular; somando-se a isso, balanço hídrico acumulado positivo, sepse e choque, maior tempo de internação e maiores taxas de mortalidade também foram encontrados nesses pacientes.

Introduction: Intensive Care Unit (ICU) stay is frequently complicated by Acute Kidney Injury (AKI), especially in cases of sepsis, low cardiac output syndrome and after major sur-geries. Objective: To evaluate the incidence, characteristics, development of other organ dys-functions and outcomes on patients undergoing non-cardiac major surgery that developed AKI acquired in the ICU. Methods: We carried out a prospective cohort study. All patients consecutively admitted to ICUs after noncardiac surgeries from April to May 2017 was ana-lyzed for the development of AKI or not and other organ dysfunctions. Results: The inci-dence of AKI was 16.2%. Patients who developed AKI in the postoperative period were more severely ill. Their needs as to mechanical ventilation (60% vs. 11%; p < 0.001), use of vasoactive drugs (82% vs. 44%; p = 0.021), the presence of infection (80% vs. 21%; p < 0.001), sepsis or septic shock (50% vs. 9%; p < 0.001). and other postoperative complications (91% vs. 58%; p = 0.023) were different from other patients. Other organs dysfunctions were more fre-quent in patients with AKI (2 [2-3] vs. 1 [0-1]; p < 0.001), such as gastrointestinal (73% vs. 19%; p < 0.001), and cardiovascular dysfunction (73% vs. 33%; p = 0.015). The number of patients with two or more organ dysfunctions increased from 21% to 82% in patients with AKI (RR 3.89; CI: 2,18 ­ 6,90; p < 0.001). The length of hospital stay was 13 ± 9 vs. 5 ± 6 days; p < 0.001, and hospital mortality rates (86% vs. 14%; p < 0.001) were also higher in pa-tients with AKI. Conclusion: Among patients who undergoing noncardiac surgery and re-quired ICU hospitalization, the incidence of AKI is high and associated with complications of other systems, including neurological, gastrointestinal, respiratory and cardiovascular systems. In addition to this, positive cumulative fluid balance, sepsis and shock septic, prolonged length of hospital and ICU stay, as well as higher mortality rates were also found in these pa-tients

Prevalence and risk factors associated with common mental disorders among medical students / Prevalência e fatores de risco associados a transtornos mentais comuns entre os estudantes de medicina / Prevalencia y factores de riesgo asociados a transtornos mentales comunes entre los estudiantes de medicina

Objective: To identify the prevalence of common mental disorders (CMD) in medical students at Vila Velha University (UVV), ES, and its associated factors. Methods: A cross-sectional study was conducted with 360 medical students from February to April 2018. A self-administered, confidential and online questionnaire was used, including sociodemographic, economic data, family support, friends' network, physical activity and academic performance, as well as Self- Reporting Questionnaire (SRQ-20). Statistical analysis was performed using the STATA program, version 13.0. The Ethics Committee on Research with Humans approved the study, under number 2.108.290. Results: The prevalence of CMD among students was 45.6%. Risk factors were mental disorder in the family (RR 1.24, 95% CI 1.01-1.54), poor sleep quality (RR 1.49, 95% CI 1.17-1.90), fear that impaired the academic result (RR 1.33, 95% CI 1.01-1.77), feeling rejected by friends (RR 1.45, 95% CI 1.07-1.96), thinking about giving up the course (RR 1.67, 95% CI 1.29-2.17) and physical discomfort during the test (RR 1.63, 95% CI, 1.21-2.20). Conclusions: The overall prevalence of CMD among students was high, and the risk factors were significant. It is recommended that educational institutions and responsible government agencies be able to formulate and subsidize preventive actions and care for the mental health of medical students.

Objetivo: Identificar a prevalência de transtornos mentais comuns (TMC) nos estudantes de medicina da Universidade Vila Velha (UVV), ES, e seus fatores associados. Métodos: Estudo transversal com 360 estudantes de medicina, de fevereiro a abril de 2018. Utilizou-se um questionário autoaplicável, confidencial e online, incluindo dados sociodemográficos, econômicos, suporte familiar, rede de amigos, atividade física e desempenho acadêmico, assim como o teste Self-Reporting Questionnaire (SRQ-20). A análise estatística foi realizada utilizando-se do programa STATA, versão 13.0. O Comitê de Ética em Pesquisa com Seres Humanos aprovou o estudo, sob o número 2.108.290. Resultados: A prevalência de TMC entre os estudantes foi de 45,6%. Os fatores de risco foram transtorno mental na família (RR 1,24; IC95% 1,01-1,54), qualidade do sono insatisfatória (RR 1,49; IC95% 1,17-1,90), medo que prejudica o rendimento escolar (RR 1,33; IC95% 1,01-1,77), sentir-se rejeitado pelos amigos (RR 1,45; IC95% 1,07-1,96), pensar em desistir do curso (RR 1,67; IC95% 1,29-2,17) e desconforto físico durante a prova (RR 1,63; IC95% 1,21-2,20). Conclusões: A prevalência geral de TMC entre os estudantes foi alta, e os fatores de risco foram expressivos. Recomenda-se que as instituições de ensino e órgãos governamentais responsáveis possam formular e subsidiar ações preventivas e um cuidado à saúde mental dos estudantes de medicina.

Objetivo: Identificar la prevalencia de trastornos mentales comunes (TMC) en los estudiantes de medicina de la Universidad Vila Velha (UVV), ES, y sus factores asociados. Métodos: Estudio transversal con 360 estudiantes de medicina, de febrero a abril de 2018. Se utilizó un cuestionario autoaplicable, confidencial y online, incluyendo datos sociodemográficos, económicos, soporte familiar, red de amigos, actividad física y desempeño académico, así como el examen Self-Reporting Questionnaire (SRQ-20). El análisis estadístico se realizó utilizando el programa STATA, versión 13.0. El Comité de Ética en Investigación con Seres Humanos aprobó el estudio, bajo el número 2.108.290. Resultados: La prevalencia de TMC entre los estudiantes fue del 45,6%. Los factores de riesgo fueron trastorno mental en la familia (RR 1,24, IC95% 1,01-1,54), calidad del sueño insatisfactoria (RR 1,49, IC95% 1,17-1,90), miedo que perjudica el rendimiento escolar (RR 1,33, IC95% 1,01-1,77), sentirse rechazado por los amigos (RR 1,45, IC95% 1,07-1,96), pensar en desistir del curso (RR (IC95% 1,29-2,17) y la incomodidad física durante la prueba (RR 1,63, IC95% 1,21-2,20). Conclusiones: La prevalencia general de TMC entre los estudiantes fue alta, y los factores de riesgo fueron expresivos. Se recomienda que las instituciones de enseñanza y órganos gubernamentales responsables puedan formular y subsidiar acciones preventivas y un cuidado a la salud mental de los estudiantes de medicina.

Estudios sobre el virus del papiloma humano y cáncer cervical en el Ecuador / Studies on the human papillomavirus and cervical cancer in Ecuador

El presente artículo recopila un extracto de las distintas ponencias realizadas por investigadores de diferentes lugares del Ecuador en el marco del Simposio sobre Cáncer Cervical y el virus del papiloma humano ocurrido en el 5° Congresosobre enfermedades infecciosas llevado a cabo en octubre del 2018 en la Pontificia Universidad Católica del Ecuador (Quito). Estas presentaciones presentan un diagnóstico acerca de la situación actual del virus de papiloma humano (VPH) y del cáncer cervical en nuestra región. Estas presentaciones complementan la información presentada en un evento similar realizado hace un par de años en las Jornadas Nacionales de Biología Espol 2016, constituyendo estas memorias en conjunto como uno de los pocos documentos disponibles que recopilan los últimos avances realizados en este campo en el Ecuador en años recientes.

Thisarticle compiles an extract of the different presentations made by researchers from different parts of Ecuador in the framework of the Symposium on Cervical Cancer and the human papillomavirus occurred at the 5th Congress on infectious diseases carried out in October 2018 at the Pontificia Catholic University of Ecuador (Quito). These presentations present a diagnosis about the current situation of human papilloma virus (HPV) and Cervical Cancer in our region. These presentations complement the informationpresented in a similar event held a couple of years ago at the National Conference of Biology Espol2016, constituting these memories together as one of the few documents available that assemble the latest advances made in this field in Ecuador in recent years.

Relação de quedas em idosos e os componentes de fragilidade / Relationship of falls among the elderly and frailty components

RESUMO: Objetivo: Avaliar se a ocorrência de quedas no ano anterior à entrevista está associada aos componentes de fragilidade após um período de quatro anos. Métodos: Os dados foram obtidos a partir da segunda rodada do Estudo Saúde, bem-estar e envelhecimento (SABE), realizado em 2006, quando 1.413 idosos foram entrevistados. Os indivíduos considerados frágeis, de acordo com o modelo de Fried, foram excluídos, resultando em 1.207 idosos no início do estudo. A variável explicativa foi tomada como sendo as quedas ocorridas no ano anterior à pesquisa de 2006. Em 2010, os sobreviventes foram avaliados para os cinco componentes de fragilidade. O teste estatístico com correção para o projeto de amostra (Rao-Scott) foi aplicado para avaliar a associação entre fragilidade e as quedas no início do estudo. Resultados: Dos 1.413 indivíduos na amostra de 2006, 1.397 registraram quedas no ano anterior à entrevista e avaliação da fragilidade. Os componentes de fragilidade para fatores de risco para ocorrência de quedas foram: (1) redução da força de preensão (sem quedas = 21,8%; quedas = 31,5%; razão de risco - RR = 1,44; e p = 0,003); e (2) exaustão (sem quedas = 7,6%; quedas = 14,7%; RR = 1,93; e p = 0,003). Conclusão: Esse achado sugere a realização de estudos longitudinais a fim de precisar a causalidade das quedas em idosos tendo em vista os aspectos da temporalidade entre a exposição e o evento.

ABSTRACT: Objective: To evaluate whether the occurrence of falls in the year preceding the interview is associated with frailty components after a four-year period. Methods: Data were obtained from the second round of the Health, Well-being and Aging SABE Study, conducted in 2006, when 1,413 elderly people were interviewed. Individuals considered weak according to the Fried model were excluded, resulting in 1,207 elderly at the study entry. The explanatory variable was taken as the falls in the year prior to the 2006 survey. In 2010, the survivors were evaluated for the five frailty components. The statistical test with correction for the sample project ­(Rao-Scott) was applied to assess the association between frailty and falls at the beginning of the study. Results: Of the 1,413 individuals in the 2006 sample, 1,397 registered falls in the year before the interview and evaluation of fragility. The fragility of components for risk factors for the occurrence of falls were: (1)reduced grip strength (no falls: 21.8%; falls: 31.5%; relative risk - RR = 1.44; and p = 0.003); and (2) exhaustion (no falls: 7.6%; falls:14.7%; RR = 1.93; and p = 0.003). Conclusion: This finding suggests longitudinal studies in order to clarify the causality of falls in the elderly, considering the aspects of temporality between exposure and the event.

Epidemiologic Study of Adult Femoral Head Osteonecrosis in Chengdu, China / 中国康复理论与实践

@#Objective To investigate the morbidity and characteristics of adult osteonecrosis of the femoral head (ONFH) in Chengdu, and to further explore its related risk factors.Methods Self-designed questionnaires were used to collect data by the way of household or field survey. From January,2016 to February, 2018, a total of 544 cases (797 hips) diagnosed as ONFH were included in the study. The medical data including general condition, risk factors, diagnosis, disease stages and treatment were collected. Based on the data, the risk factors were analyzed statistically.Results The average age of 544 patients (392 males and 152 females) was 55 years old (range: 19 to 90 years); the bilateral incidence was 46.51% (253 cases). The proportion of Association Research Circulation Osseous stages was accounted respectively 3.64% for stage I, 6.15% for stage II, 8.41% for stage III and 81.81% for stage IV when confirmed ONFH initially. In all the reasons of ONFH, 52.39% were alcohol-associated osteonecrosis, 16.18% for steroid-induced osteonecrosis, 11.58% for traumatic osteonecrosis, 5.88% for dysplastic osteonecrosis, and 13.97% for other reasons.Conclusion The incidence of ONFH was higher in men than in women. Stages III-IV accounted for the highest proportion. The high intake of alcohol or overuse of steroid was the leading causes of adult ONFH, among which alcohol-associated osteonecrosis was the main for the males and steroid-induced osteonecrosis for the females.

A Preliminary Study on the Prevalence of Cardiovascular Disease Risk Factors in Selected Rural Communities in Samarahan and Kuching Division, Sarawak, Malaysia

Background: It is important to understand the prevalence of risk factors for cardiovascular disease, especially in a rural setting. Methods: A cross-sectional study was carried out in 238 rural households located in the Kuching and Samarahan divisions of Sarawak among individuals aged 16 years and above. Anthropometric measurements, blood levels of glucose and cholesterol, and blood pressure were collected. Results: Prevalence of blood pressure in the hypertensive range was 43.1%. The highest rates of blood pressure in the hypertensive range were found in individuals aged above 60 years (38.6%) and 50–59 years old (31.8%). Age was one factor found to be significantly associated with blood pressure in the hypertensive range (P < 0.001). Prevalence of obesity was 49.0%. The highest prevalence of obesity was found among those aged 40–49 years (41.9%) and 50–59 years (29.9%). Gender was significantly associated with obesity (P = 0.004). The prevalence of blood cholesterol at risk was 21.6%, and the highest rate was found in the 40–49 years age group (34.0%). Fifty percent of respondents were found to have hyperglycaemia, with the highest prevalence in the 50–59 years age group (37.5%). A significant association was found between obesity, blood pressure in the hypertensive range and blood glucose level. When compared with non-obese individuals, those who were obese were more likely to have blood pressure in the hypertensive range and hyperglycaemia. Conclusion: The risk of developing lifestyle-related diseases is no longer based on geographical or socio-economic factors.

Las periodontopatías como factor de riesgo de la cardiopatía isquémica, 2008 / Periodontopathies as a risk factor for ischemic heart failure, 2008

Se realizó una investigación descriptiva, longitudinal y prospectiva, con una muestra constituida por 120 pacientes, pertenecientes al área de salud Turcios Lima y atendidos en la Clínica Estomatológica "Guamá", del municipio Pinar del Río, durante el año 2008, con el objetivo de determinar la relación entre la enfermedad periodontal y la cardiopatía isquémica. Los pacientes fueron divididos en dos grupos etarios: grupo A(Control) integrado por 60 pacientes escogidos aleatoriamente que asistían a nuestra consulta y sin historia de infarto agudo del miocardio, y el grupo B (pacientes infartados) de 60 pacientes que fueron remitidos desde los consultorios médicos para ser incluidos en esta investigación. Al total se aplicó el índice de necesidad de tratamiento periodontal de la comunidad. Todos los pacientes infartados grupo B sufrieron periodontopatías, mientras que entre los no infartados solo la mitad padecieron de afecciones parodontales. Se utilizaron los métodos de la Estadísticos descriptiva y la comparación de frecuencias de Ji cuadrado al 95 % de certeza. El hábito de fumar, la edad mayor de 50 años, el sexo masculino y la mala higiene bucal se identificaron como factores comunes de riesgo para ambas enfermedades. Los estadios más avanzados de la enfermedad periodontal (bolsas de 6 mm o más), aumentaron su incidencia con la edad y fue más frecuente en los pacientes infartados, con mayor necesidad de cirugía periodontal. Todos los pacientes afectados tenían necesidad de adiestramiento en cepillado dental.

A descriptive, longitudinal and prospective research was conducted with a sample of 120 patients belonging to the primary care health area of "Turcios Lima" Outpatient Clinic attending to "Guama" Dentist's Clinic in Pinar del Rio municipality during 2008, and was aimed at determining the relation between periodontal diseases and ischemic heart failure. The patients were divided into two groups: A (control) comprised of 60 patients randomly chosen from those attended to the dentist office without medical history of acute myocardial infarction, and group B- (patients who suffered from infarction) 60 patients referred from the family medical office. The total of the sample was examined and the rate of need for periodontal treatment of the community was applied. Descriptive statistic methods were used, and Ji squared test for 95 % of certainty was used to compare frequencies. All patients of the group-B suffered from periodontopathies, meanwhile those belonging to group-A only the half of them suffered from parodontal affections. The smoking habit, over 50 years, male sex and poor oral hygiene were identified as common risk factors for both diseases. The most advanced stages for periodontal disease (bursas of 6mm or more) increased with age being more frequent in patients of group-B having a greater need of periodontal surgery. All the patients affected had to be trained in teeth brushing.