[Risk factors for arterial disease]. / Factores de riesgo de enfermedad arterial.

The risk factors of arterial disease (FREA) predict a future damage over the vascular system of the human body. Its detection are considered a key for the diagnostic as well as for the preventive and even curative strategies. For a long time, scientist considered those factors originated as a consecuence of large studies during the middle of the last century, with current validity up to our days. A simple classification spoke of them as traditionals. Further investigations described the so called new or emergents.factors that where joint together accordingly to their actions: coagulation factors, psicosocial, inflamatories and infectious. A recent classification, taking into account the type of impact, divided them into; causatives, predisposals and conditionals. Also, it was described a mechanism, the oxidative power, with consecuences over the endothelium, in the last part of the process. Before, another mechanism was described: the insulin resistance and the hiperinsulinism, bases for the Metabolic Syndrome, that includes a number of traditional risk factors.

[Annex: Prevalence of insulin resistance and its association with type 2 diabetes and other cardiovascular risk factors]. / Anexo. Prevalencia de la insulinoresistencia y su asociación con diabetes tipo 2 y otros factores de riesgo cardiovascular.

We present the results of an epidemiological research undertaken in the province of Córdoba (Argentina) with the aim of studying insulin-resistance (IR) in relation to the increased risk for diabetes and its association with risk factors of arterial disease (RFAD). Overall, there were 1413 subjects between 20 and 70 years of age, from both sexes (Dean Funes 18885 inhabitants; sample 715; Oncativo 13880 inhabitants; sample 696). We studied traditional arterial risk factors (hypertension, diabetes, dyslipidemia, obesity, sedentary life, smoking). To evaluate IR we used the homeostasis model assessment (HOMA-IR). We found a high prevalence of IR clearly related to the traditional (RFAD), thus placing these populations, representatives of national ones, among the western populations at high risk for arterial disease.

[Arterial disease. Prevention]. / Prevención.

Human beings may have or may have not risk factors for arterial disease. Those having these factors may or may not suffer from acute episodes of aterothrombosis. Those who suffer it, may have one or more risk factors for arterial disease. For this long list of situations, there are strategies with some common points. The prevention is of high priority, specially the primary one aim to those without FREA, in particular the children. It has been demonstrated the early beginning of the disease, that is why education is of great value and must be extended to all groups of ages. In some circumstances, also on early ages, it is wise to investigate the clinic and laboratory for FREA, specially in those with hereditary overload. The common measures: healthy diet, no tobacco, reduction of alcohol intake, sporting, should be incorporated in our society as a general practice. In those with FREA, adults in general, it is convenient to establish the global risk in order to be able to consider the deepness of medical intervention and the corresponding patient adherence to medical council and prescription. For those who already suffered an acute episode, the secondary prevention implicate: counselling over the factors that are able to be modified, prescription, such as platelet anti adhesive drugs and those corresponding to each individual factor. The modern tendency is the use of drug to reduce cholesterol and other lipids, anti hypertension and others pharmaceutical interventions. All members of modern society should play a role on the above mentioned preventive actions.

[Body training and insulin resistance in two rural communities of Cordoba - Argentina]. / Actividad fisica e insulinorresistencia en dos comunidades rurales de Cordoba - Argentina.

UNLABELLED: From the AF, the smaller risk is controversial. The influence of the general and environmental components on IR is not know in a satisfactory way. OBJECTIVES: The influence of AF on the prevail IR in two rural communities of Córdoba with different fenotipical configuration and IR risk. MATERIAL AND METHODS: Transverse study (survey, clinical and biochemical checkup) over 1143 people of Oncativo community (ON) and Dean Funes (DF), inclusion: n = 673 (30-60 years old) Normal ECG, no diabetics. Sorts AF according to the spend of calories (Kcal/sem): a) sedentary (< 500), b) low (5001-1000), c) regular (1001-2500), and d) High (> 2500). IR is HOMA > 2.5; where [HOMA = (Glucemia * Insulina)/ 4.5]. RESULTS: AF: 31.4% sedentary, 20.2% low, 26.3% regular and 22.1% high. 16.5% IR in ON opposite 34.8% en DF (P < 0.001), IR in ON 8.2% with AF high opposite 18.8% the rest (P = 0.032), 36.8% and 34.2% like in DF (P = 0.67). With the adjusted results for age and community it was found less IMC (P = 0.002) and waist circumference (P = 0.042) than the most category of AF. The blood pressure had not a meaningful change, lipid profile or HOMA depending of AF. CONCLUSION: if a benefit of AF over IR exists, it will be conditioned for genetics and environmental primaries determiners.

Prevención / [Arterial disease. Prevention]

Human beings may have or may have not risk factors for arterial disease. Those having these factors may or may not suffer from acute episodes of aterothrombosis. Those who suffer it, may have one or more risk factors for arterial disease. For this long list of situations, there are strategies with some common points. The prevention is of high priority, specially the primary one aim to those without FREA, in particular the children. It has been demonstrated the early beginning of the disease, that is why education is of great value and must be extended to all groups of ages. In some circumstances, also on early ages, it is wise to investigate the clinic and laboratory for FREA, specially in those with hereditary overload. The common measures: healthy diet, no tobacco, reduction of alcohol intake, sporting, should be incorporated in our society as a general practice. In those with FREA, adults in general, it is convenient to establish the global risk in order to be able to consider the deepness of medical intervention and the corresponding patient adherence to medical council and prescription. For those who already suffered an acute episode, the secondary prevention implicate: counselling over the factors that are able to be modified, prescription, such as platelet anti adhesive drugs and those corresponding to each individual factor. The modern tendency is the use of drug to reduce cholesterol and other lipids, anti hypertension and others pharmaceutical interventions. All members of modern society should play a role on the above mentioned preventive actions.

Anexo. Prevalencia de la insulinoresistencia y su asociación con diabetes tipo 2 y otros factores de riesgo cardiovascular / [Annex: Prevalence of insulin resistance and its association with type 2 diabetes and other cardiovascular risk factors]

We present the results of an epidemiological research undertaken in the province of Córdoba (Argentina) with the aim of studying insulin-resistance (IR) in relation to the increased risk for diabetes and its association with risk factors of arterial disease (RFAD). Overall, there were 1413 subjects between 20 and 70 years of age, from both sexes (Dean Funes 18885 inhabitants; sample 715; Oncativo 13880 inhabitants; sample 696). We studied traditional arterial risk factors (hypertension, diabetes, dyslipidemia, obesity, sedentary life, smoking). To evaluate IR we used the homeostasis model assessment (HOMA-IR). We found a high prevalence of IR clearly related to the traditional (RFAD), thus placing these populations, representatives of national ones, among the western populations at high risk for arterial disease.

Factores de riesgo de enfermedad arterial / [Risk factors for arterial disease]

The risk factors of arterial disease (FREA) predict a future damage over the vascular system of the human body. Its detection are considered a key for the diagnostic as well as for the preventive and even curative strategies. For a long time, scientist considered those factors originated as a consecuence of large studies during the middle of the last century, with current validity up to our days. A simple classification spoke of them as traditionals. Further investigations described the so called new or emergents.factors that where joint together accordingly to their actions: coagulation factors, psicosocial, inflamatories and infectious. A recent classification, taking into account the type of impact, divided them into; causatives, predisposals and conditionals. Also, it was described a mechanism, the oxidative power, with consecuences over the endothelium, in the last part of the process. Before, another mechanism was described: the insulin resistance and the hiperinsulinism, bases for the Metabolic Syndrome, that includes a number of traditional risk factors.

Anexo: prevalencia de la insulinoresistencia y su asociación con diabetes tipo 2 y otros factores de riesgo cardiovascular / Annex: prevalence of insulin resistance and its association with type 2 diabetes and other cardiovascular risk factors

Se presentan los resultados de una investigación epidemiológica en la provincia de Córdoba (RA) con el objetivo de estudiar la insulinoresistencia (IR) en relación a riesgo aumentado para diabetes y su asociación con los FREA. En total fueron 1413 personas entre 20 y 70 años de edad, de ambos sexos (Deán Funes 18885 habitantes; muestra 715; Oncativo 13880 habitantes; muestra 696). Se estudiaron los factores de riesgo arterial tradicionales (HTA, Dia; DPD, Ob, Sed, Tab). Para valorar insulinorresistencia (IR) se utilizó el homeostasis model assesment (HOMA - IR). Se constató alta prevalencia de IR y clara asociación con los FREA tradicionales, colocando a estas poblaciones, representativas de las nacionales, dentro de las poblaciones occidentales de alto riesgo de enfermedad arterial.

Anexo: prevalencia de la insulinoresistencia y su asociación con diabetes tipo 2 y otros factores de riesgo cardiovascular / Annex: prevalence of insulin resistance and its association with type 2 diabetes and other cardiovascular risk factors

Se presentan los resultados de una investigación epidemiológica en la provincia de Córdoba (RA) con el objetivo de estudiar la insulinoresistencia (IR) en relación a riesgo aumentado para diabetes y su asociación con los FREA. En total fueron 1413 personas entre 20 y 70 años de edad, de ambos sexos (Deán Funes 18885 habitantes; muestra 715; Oncativo 13880 habitantes; muestra 696). Se estudiaron los factores de riesgo arterial tradicionales (HTA, Dia; DPD, Ob, Sed, Tab). Para valorar insulinorresistencia (IR) se utilizó el homeostasis model assesment (HOMA - IR). Se constató alta prevalencia de IR y clara asociación con los FREA tradicionales, colocando a estas poblaciones, representativas de las nacionales, dentro de las poblaciones occidentales de alto riesgo de enfermedad arterial.(AU)

Factores de riesgo de enfermedad arterial. / [Risk factors for arterial disease]

The risk factors of arterial disease (FREA) predict a future damage over the vascular system of the human body. Its detection are considered a key for the diagnostic as well as for the preventive and even curative strategies. For a long time, scientist considered those factors originated as a consecuence of large studies during the middle of the last century, with current validity up to our days. A simple classification spoke of them as traditionals. Further investigations described the so called new or emergents.factors that where joint together accordingly to their actions: coagulation factors, psicosocial, inflamatories and infectious. A recent classification, taking into account the type of impact, divided them into; causatives, predisposals and conditionals. Also, it was described a mechanism, the oxidative power, with consecuences over the endothelium, in the last part of the process. Before, another mechanism was described: the insulin resistance and the hiperinsulinism, bases for the Metabolic Syndrome, that includes a number of traditional risk factors.

Anexo. Prevalencia de la insulinoresistencia y su asociación con diabetes tipo 2 y otros factores de riesgo cardiovascular. / [Annex: Prevalence of insulin resistance and its association with type 2 diabetes and other cardiovascular risk factors]

We present the results of an epidemiological research undertaken in the province of Córdoba (Argentina) with the aim of studying insulin-resistance (IR) in relation to the increased risk for diabetes and its association with risk factors of arterial disease (RFAD). Overall, there were 1413 subjects between 20 and 70 years of age, from both sexes (Dean Funes 18885 inhabitants; sample 715; Oncativo 13880 inhabitants; sample 696). We studied traditional arterial risk factors (hypertension, diabetes, dyslipidemia, obesity, sedentary life, smoking). To evaluate IR we used the homeostasis model assessment (HOMA-IR). We found a high prevalence of IR clearly related to the traditional (RFAD), thus placing these populations, representatives of national ones, among the western populations at high risk for arterial disease.

Prevención. / [Arterial disease. Prevention]

Human beings may have or may have not risk factors for arterial disease. Those having these factors may or may not suffer from acute episodes of aterothrombosis. Those who suffer it, may have one or more risk factors for arterial disease. For this long list of situations, there are strategies with some common points. The prevention is of high priority, specially the primary one aim to those without FREA, in particular the children. It has been demonstrated the early beginning of the disease, that is why education is of great value and must be extended to all groups of ages. In some circumstances, also on early ages, it is wise to investigate the clinic and laboratory for FREA, specially in those with hereditary overload. The common measures: healthy diet, no tobacco, reduction of alcohol intake, sporting, should be incorporated in our society as a general practice. In those with FREA, adults in general, it is convenient to establish the global risk in order to be able to consider the deepness of medical intervention and the corresponding patient adherence to medical council and prescription. For those who already suffered an acute episode, the secondary prevention implicate: counselling over the factors that are able to be modified, prescription, such as platelet anti adhesive drugs and those corresponding to each individual factor. The modern tendency is the use of drug to reduce cholesterol and other lipids, anti hypertension and others pharmaceutical interventions. All members of modern society should play a role on the above mentioned preventive actions.

Actividad fisica e insulinorresistencia en dos comunidades rurales de Cordoba - Argentina. / [Body training and insulin resistance in two rural communities of Cordoba - Argentina]

From the AF, the smaller risk is controversial. The influence of the general and environmental components on IR is not know in a satisfactory way. OBJECTIVES: The influence of AF on the prevail IR in two rural communities of Córdoba with different fenotipical configuration and IR risk. MATERIAL AND METHODS: Transverse study (survey, clinical and biochemical checkup) over 1143 people of Oncativo community (ON) and Dean Funes (DF), inclusion: n = 673 (30-60 years old) Normal ECG, no diabetics. Sorts AF according to the spend of calories (Kcal/sem): a) sedentary (< 500), b) low (5001-1000), c) regular (1001-2500), and d) High (> 2500). IR is HOMA > 2.5; where [HOMA = (Glucemia * Insulina)/ 4.5]. RESULTS: AF: 31.4

sedentary, 20.2

low, 26.3

regular and 22.1

high. 16.5

IR in ON opposite 34.8

en DF (P < 0.001), IR in ON 8.2

with AF high opposite 18.8

the rest (P = 0.032), 36.8

and 34.2

like in DF (P = 0.67). With the adjusted results for age and community it was found less IMC (P = 0.002) and waist circumference (P = 0.042) than the most category of AF. The blood pressure had not a meaningful change, lipid profile or HOMA depending of AF. CONCLUSION: if a benefit of AF over IR exists, it will be conditioned for genetics and environmental primaries determiners.

[Serum troponin T in patients with chronic Chagas disease]. / Concentraciones séricas de troponina T en pacientes con enfermdad de Changas crónica.

High serum levels of T troponin (TnT) have been described in patients with nonischemic myocardiopathies as markers of myocardial damage. We aimed to determine whether a highly sensitive TnT assay could identify patients with early stage chronic Chagas disease cardiopathy. We studied 39 outpatients with a serologic diagnosis of Chagas disease by clinical examination, electrocardiogram and echocardiogram. Among all patients, 15 had no cardiac lesions, 15 showed only typical electrocardiographic changes, and nine had echocardiographic alterations. All TnT determinations were negative except in one patient in the latter group (1 out of 9; 11.11%). This patient had the lowest ejection fraction (29%) and had a left ventricular diastolic diameter of 77 mm. Thus, in the present study troponin T levels were not associated with early signs of myocardial damage in Chagas disease.

Concentraciones séricas de troponina T en pacientes con enfermedad de Chagas crónica / Serum troponin T in patients with chronic Chagas disease

Se ha descrito la presencia de concentraciones séricas elevadas de troponina T (TnT) en pacientes con miocardiopatía no isquémica y se ha postulado que estas proteínas puedan ser marcadores de daño miocárdico. El objetivo del presente estudio fue determinar si las concentraciones séricas elevadas de TnT se asocian a una lesión temprana en la miocardiopatía chagásica. Estudiamos a 39 pacientes con serología positiva para enfermedad de Chagas, en los que se llevaron a cabo: evaluación clínica, electrocardiograma, ecocardiograma y medición sérica de TnT (límite de detección, 0,01 ng/ml). Del total, 15 pacientes no presentaban lesión cardíaca, 15 tenían sólo alteraciones electrocardiográficas típicas y en nueve se observó una disminución de la fracción de eyección o dilatación ventricular izquierda. Todas las determinaciones de TnT fueron negativas, excepto en un paciente del último grupo, que presentaba el mayor grado de disfunción ventricular izquierda. En este grupo de pacientes, la TnT no sirvió como marcador de la afección temprana por enfermedad de Chagas crónica (AU)

Trypanosoma cruzi in persons without serologic evidence of disease, Argentina.

Current diagnosis of chronic Chagas disease relies on serologic detection of specific immunoglobulin G against Trypanosoma cruzi. However, the presence of parasites detected by polymerase chain reaction (PCR) in patients without positive conventional serologic testing has been observed. We determined the prevalence and clinical characteristics of persons with seronegative results and T. cruzi DNA detected by PCR in a population at high risk for chronic American trypanosomiasis. We studied a total of 194 persons from two different populations: 110 patients were recruited from an urban cardiology clinic, and 84 persons were citizens from a highly disease-endemic area. Eighty (41%) of persons had negative serologic findings; 12 (15%) had a positive PCR. Three patients with negative serologic findings and positive PCR results had clinical signs and symptoms that suggested Chagas cardiomyopathy. This finding challenges the current recommendations for Chagas disease diagnosis, therapy, and blood transfusion policies.