ABSTRACT
BACKGROUND AND OBJECTIVE: The European Societies in their last update introduce substantial changes to calculate the cardiovascular risk without thinking about the practical consequences. The objective was to evaluate the agreement between the charts of cardiovascular risk of second and the third recommendations of the European Societies to classify the patients of high risk and to analyze its differences. PATIENTS AND METHOD: Patients (1,227) belonging to 3 primary care centres. Risk calculated to the 10 years by means of the equation of Framingham and SCORE for countries lowers risk. A risk of Framingham > or = 20% or SCORE > or = 5% defined the high risk. RESULTS: The patients of high risk were 8.4% according to Framingham and 5.5% according to SCORE and the coefficient Kappa 0.718. 41.7% of the patients of high risk disagreed: high risk Framingham and SCORE not (40 patients, 88.9%) and high SCORE and Framingham not (5 patients, 11.1%). The group high risk Framingham and SCORE not 1 is constituted by 95% of males, age 60 years, cholesterol 246.2 mg/dl and 37.5% smokers. CONCLUSIONS: The chart SCORE and Framingham have an acceptable agreement, but classify from high risk different percentage of population and with different characteristics. The use of the chart of the SCORE would exclude an important group of patients with Framingham high risk.
Subject(s)
Cardiovascular Diseases/epidemiology , Aged , Cross-Sectional Studies , Europe , Female , Humans , Male , Middle Aged , Risk Assessment , Risk Factors , Societies, MedicalABSTRACT
Se diseñó este estudio, con objeto de determinar la concentración de beta endorfinas plasmáticas en pacientes sometidos a cirugía de urgencia y electiva. De un grupo de 6 pacientes, tres recibieron anestesia con halotano y tres con enfluorano, empléandose concentraciones equipotentes, con una mezcla de N20-O2 al 50%. La relajación muscular se llevó a cabo con bromuro de pancuronio. No se utilizarón narcóticos en el estudio. Se tomaron muestras de sangre a cada paciente durante los periodos pre, trans y postoperatorios para la determinación de beta endorfinas mediante radioinmunoanálisis. Los pacientes que recibieron anestesia con halotano mostraron elevación en los niveles plasmáticos de betaendorfina, en tanto que el grupo que recibió enfluorano presentó disminución (p < 0.05) en los niveles plasmáticos de beta endorfina. No encontramos correlación significativa entre los niveles de beta endorfina y estabilidad cardiovascular. Estos resultados sugieren que el enfluorano probablemente inhibe el sistema endorfínico, mientras que el halotano parece no impedir la respuesta neuroendócrina betaendorfínica durante el stress quirúrgico
