[Analysis of the control of cardiovascular risk factors in patients with peripheral arterial disease]. / Análisis del control de factores de riesgo cardiovascular en pacientes con enfermedad arterial periférica.

INTRODUCTION: The objective was to determine the percentage of patients with peripheral arterial disease (PAD) with good control of their cardiovascular risk factors (CVRF) (LDL cholesterol, blood pressure and smoke cessation). MATERIAL AND METHODS: Cross-sectional multicentre study. The location was Primary Care and other clinics that typically treat patients with peripheral arterial disease (Internal Medicine, Vascular Surgery, Cardiology, Endocrinology and Nephrology). The first 10 patients with peripheral arterial disease were systematically selected by 440 researchers from all regions. RESULTS: The study included 4087 patients. Blood pressure was controlled in 29.5% of the cases. The frequency of patients with optimal control was significantly better in primary care (p<.01). There was an optimal control of LDL-C levels in 30.4% of patients. Factors associated with optimal control of LDL-C was, being diabetic, stage I of La Fontaine, and being seen by a doctor that was not the primary care physician. Control was worse in women and in smokers. CONCLUSIONS: Primary care physicians better manage patients with hypertension. Patients seen in by a specialist as opposed to primary care are more likely to achieve optimal control of CVRF. The situation is far from the ideal, only 6% achieved optimal control of all CVRF.

Análisis del control de factores de riesgo cardiovascular en pacientes con enfermedad arterial periférica / Analysis of the control of cardiovascular risk factors in patients with peripheral arterial disease

Introducción. El objetivo del presente estudio es determinar el porcentaje de pacientes con enfermedad arterial periférica (EAP) con un control óptimo de sus factores de riesgo cardiovascular (FRCV) (colesterol unido a las lipoproteínas de baja densidad [c-LDL], presión arterial [PA] y abandono de tabaco). Material y métodos. Estudio descriptivo transversal multicéntrico, realizado en consultas de atención primaria (AP) y de otras especialidades que habitualmente atienden a pacientes con EAP, medicina interna, cirugía vascular (CV), cardiología, endocrinología y nefrología. Selección sistemática de los 10 primeros pacientes con EAP de las consultas de 440 investigadores pertenecientes a todas las comunidades autónomas. Resultados. Se incluyeron en el estudio a 4.087 pacientes. Tenían controlada la PA el 29,5% de los pacientes. La frecuencia de pacientes con control de la PA fue significativamente mejor en consultas de AP (p<0,01). Se observó un control óptimo de los niveles de c-LDL en un 30,4% de los pacientes. Los factores asociados con un control óptimo de este factor fueron el hecho de ser diabético, el encontrarse en estadio I de La Fontaine y el ser atendido por un médico que no fuese de AP, y se controlaba peor en mujeres y en fumadores activos. Conclusiones. Los médicos de AP manejan mejor al paciente hipertenso. Sin embargo, los pacientes atendidos en especialidad frente a AP tienen mayor probabilidad de conseguir un control óptimo de los FRCV. La situación dista de ser la idónea, ya que solo en un 6% se consiguió el control óptimo de todos los FRCV(AU)

Introduction. The objective was to determine the percentage of patients with peripheral arterial disease (PAD) with good control of their cardiovascular risk factors (CVRF) (LDL cholesterol, blood pressure and smoke cessation). Material and methods. Cross-sectional multicentre study. The location was Primary Care and other clinics that typically treat patients with peripheral arterial disease (Internal Medicine, Vascular Surgery, Cardiology, Endocrinology and Nephrology). The first 10 patients with peripheral arterial disease were systematically selected by 440 researchers from all regions. Results. The study included 4087 patients. Blood pressure was controlled in 29.5% of the cases. The frequency of patients with optimal control was significantly better in primary care (p<.01). There was an optimal control of LDL-C levels in 30.4% of patients. Factors associated with optimal control of LDL-C was, being diabetic, stage I of La Fontaine, and being seen by a doctor that was not the primary care physician. Control was worse in women and in smokers. Conclusions. Primary care physicians better manage patients with hypertension. Patients seen in by a specialist as opposed to primary care are more likely to achieve optimal control of CVRF. The situation is far from the ideal, only 6% achieved optimal control of all CVRF(AU)

Tos crónica: a propósito de un caso / Chronic cough: a case report

Es muy inusual encontrar como origen de tos crónica algún tipo de cáncer de pulmón. Debido a la mayor letalidad que las otras etiologías más frecuentes, el origen neoplásico debe estar presente en el despistaje final. Así mismo, la normalidad en la radiología convencional no descarta la neoplasia pulmonar.Presentamos el caso de un varón de 58 años de edad que presenta tos seca como única manifestación clínica. La radiología de tórax en dos proyecciones, la espirometría, la analítica general y la fibrolaringoscopia fueron normales.La persistencia de la tos como único síntoma a pesar de diversos tratamientos, condujo a la determinación de marcadores tumorales. Siendo la alteración de estos parámetros decisivo para la solicitud de otras pruebas de imagen, y contribuyendo así al diagnóstico definitivo de adenocarcinoma de pulmón (AU)

Finding some kind of lung cancer as a source of chronic cough is very uncommon. However, due to the greater mortality than that of other more frequent etiologies, the neoplastic origin should be present in the final screening. Furthermore, a normal X-ray does not rule out lung cancer.We report the case of a 58-year-old man who presented dry cough as the only clinical manifestation. The chest radiology with two projections, spirometry, general blood analysis and laryngoscopy were normal.Due to the persistent cough as the only symptom in spite of various treatments, a request was made for tumor markers. These abnormal parameters were conclusive for the application of other imaging tests, thus contributing to the definitive diagnosis of adenocarcinoma of the lung (AU)