DD Genotype and Atherosclerosis in Overweight Menopausal Women

Abstract Background Sex-specific pathology of coronary artery disease (CAD) has not been recognized. Women with obstructive or nonobstructive CAD associated with traditional risk factors have similar events; no studies have explored both populations in association with genetic markers. Objective To evaluate the DD genotype in overweight menopausal women and its association with CAD and traditional risk factors. Method This cross-sectional study included 356 menopausal women who underwent coronary angiography as CAD assessment. The patients' DNA was extracted and polymorphisms were detected with a single polymerase chain reaction assay. Two groups were formed based on luminal lesions (normal [n = 134] or pathological [n = 222]) with a cutoff value > 30%, considering overweight and age. The chi-square test, Student's t-test, and multivariate logistic regression were performed as appropriate (p < 0.05) using the following variables: overweight, diabetes, hypertension, dyslipidemia, smoking status, sedentary lifestyle, and a family history of CAD. Results The mean age of the sample was 63 + 8 years, and the mean BMI was 28 + 5 kg/m2. The DD genotype was slightly more prevalent in the pathological group (30.2% vs. 21.6%, p = 0.079), but this significantly changed when BMI > 25 was considered (33% vs. 18%, p = 0.012). In multivariate analysis with two threshold levels (> 50 and > 60 years), diabetes was significantly associated with CAD in both models (p = 0.021 vs. 0.009) but the genotype was only associated with younger age (p = 0.034). Conclusion These data support an association between atherosclerosis and the renin-angiotensin system in overweight menopausal women that is dependent on the age at which the ischemic event occurs.

Tratamiento de la incontinencia urinaria de esfuerzo con cinchas suburetrales: experiencia en el hospital universitario de Caracas / Treatment of urinary incontinence with girths suburethral: experience at the hospital universitario de Caracas

Objetivo: Describir la experiencia en el tratamiento de la incontinencia urinaria de esfuerzo con cinchas en las pacientes de la Unidad de Patología de Piso Pélvico del Hospital Universitario de Caracas. Métodos: Estudio retrospectivo y descriptivo. Se incluyeron pacientes con diagnóstico clínico y urodinámico de incontinencia de esfuerzo, intervenidas con cincha transobturatriz y minicinchas entre enero de 2010 y diciembre de 2011, con seguimiento durante 12 meses (N=81). Resultados: Edad promedio: 54,9 años, índice de masa corporal promedio: 27,6 kg/m2. El 77,7 % presentaba prolapso de órganos pélvicos. La incontinencia de esfuerzo tipo I fue la más observada con 45,7 %. El 76,5 % se trataron con cinchas y el 23,5 % con minicinchas. La complicación más frecuente fue la infección urinaria baja (17,7 %), seguida de la urgencia de novo (16,1 %) y la extrusión (8 %). Se observó 7 % de recidiva. El tiempo quirúrgico fue 10,8 y 7,8 minutos para cinchas y minicinchas respectivamente. La cura objetiva fue de 93 % y la cura subjetiva osciló entre 93,8 % y 100 % al año de seguimiento para las cinchas, mientras que en el caso de las minicinchas la cura subjetiva osciló entre 50 % y 100 % durante el mismo período. Conclusión: El tratamiento de la incontinencia urinaria de esfuerzo mediante cinchas y minicinchas resulta satisfactorio, con baja tasa de recidivas y complicaciones menores.

Objective: To describe the experience of stress urinary incontinence treatment with slings in the Unidad de Patologia de Piso Pelvico of the Hopital Universitario de Caracas. Methods: Retrospective, descriptive study. We included patients with clinical and urodinamic urinary incontinence who were treated with transobturator slings and minislings between January 2010 and December 2011, and had a follow up of 12 months (N = 81). Results: The average age was 54,96 years old, average body mass index was 27.6 kg/m2 and 77.7 % had pelvic organ prolapse. Type I urinary incontinence was the most frequent (45.7 %). Most of the patients were treated with transobturators slings (76.5 %), and 23.5 % with minislings. The most frequent complication was lower urinary tract infection (17.7 %), followed by de novo urgency (16.1 %), and vaginal erosion (8 %). A 7 % of recurrence was observed. The objective cure was 93 % and the subjective cure ranged between 93.8 % and 100 % during 1 year follow up in the slings group. In de minisling’s group the subjective cure ranged between 50 % and 100 %. Conclusion: The treatment of stress urinary incontinence with transobturators slings and minislings resulted satisfactory due to the low risk of complications and few recurrences.