Salud cardiovascular en pacientes inmigrantes en España / Cardiovascular health in immigrant patients in Spain

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Fractura de odontoides en un paciente anciano con mala evolución final: a propósito de un caso y revisión de la bibliografía existente / Odontoid fractures with a poor final outcome in an elderly patient: Presentation of a case and a review of the current literature

Las fracturas de odontoides son las fracturas más frecuentes de la columna cervical en los pacientes ancianos. En estos pacientes las caídas son el mecanismo más frecuente de fractura. La clínica oscila desde leves molestias cervicales hasta tetraplejía o incluso la muerte. En su tratamiento se barajan terapias quirúrgicas y no quirúrgicas como collares cervicales o halo-chaleco. Presentamos el caso de una paciente de 87 años con historia de caídas de repetición y pérdida de fuerza progresiva en las 4 extremidades, que empeoró después de una revisión odontológica. La TC cervical mostró fractura de odontoides con desplazamiento confirmada en la RM. Se optó por un tratamiento conservador mediante collarín cervical. La paciente evolucionó mal y fue exitus (AU)

Odontoid fractures are the most common cervical spine fracture in elderly patients, with falls being the most common mechanism of fracture in these patients. The clinical symptoms range from mild neck pain to quadriplegia, or even death. Treatment options include surgical and non surgical therapies, such as cervical collar or halo vest. We present the case of an 87 year-old patient with a history of recurrent falls and progressive loss of strength in all 4 extremities that worsened after a dental revision. The CT scan showed a cervical odontoid fracture, with displacement confirmed on MRI. Conservative treatment with a cervical collar was decided. The patient progressed poorly and died (AU)

[Odontoid fractures with a poor final outcome in an elderly patient: presentation of a case and a review of the current literature]. / Fractura de odontoides en un paciente anciano con mala evolución final: a propósito de un caso y revisión de la bibliografía existente.

Odontoid fractures are the most common cervical spine fracture in elderly patients, with falls being the most common mechanism of fracture in these patients. The clinical symptoms range from mild neck pain to quadriplegia, or even death. Treatment options include surgical and non surgical therapies, such as cervical collar or halo vest. We present the case of an 87 year-old patient with a history of recurrent falls and progressive loss of strength in all 4 extremities that worsened after a dental revision. The CT scan showed a cervical odontoid fracture, with displacement confirmed on MRI. Conservative treatment with a cervical collar was decided. The patient progressed poorly and died.

[Effectiveness and tolerance of atorvastatin for antiretroviral therapy-secondary dyslipemia]. / Eficacia y tolerancia de la atorvastatina en el tratamiento de la dislipemia secundaria a tratamiento antirretroviral.

BACKGROUND AND OBJECTIVE: We investigated atorvastatin effectiveness and tolerance in HIV patients with hypercholesterolemia related to antiretroviral treatment. PATIENTS AND METHOD: Prospective study that included HIV+ patients under antiretroviral treatment who displayed secondary dyslipemia and medical treatment criteria (according to NCEP-III). These patients were given 10 mg/day atorvastatin and hygienic-dietetic measures. If the therapeutic objectives were not achieved, the dose of atorvastatin was increased to 20 mg/day. Patients were followed up for 6 months. RESULTS: 32 patients were included. In 5 cases it was necessary to increase the dose from 10 mg atorvastatin to 20 mg. The therapeutic objective was obtained in 62% cases, with a good clinical tolerance. Only one adverse effect was noticed, which forced the removal of the drug. CONCLUSION: In our study atorvastatin was effective for the treatment of dyslipemia in HIV patients, and it was safe and well tolerated.

Eficacia y tolerancia de la atorvastatina en el tratamiento de la dislipemia secundaria a tratamiento antirretroviral / Effectiveness and tolerance of atorvastatin for antiretroviral therapy-secondary dyslipemia

Fundamento y objetivo: Conocer la utilidad clínica del tratamiento hipolipemiante con atorvastatina en pacientes infectados por el virus de la inmunodeficiencia humana (VIH) con hipercolesterolemia asociada al tratamiento antirretroviral, así como su tolerabilidad. Pacientes y método: Estudio observacional, prospectivo y no controlado que incluye a pacientes infectados por el VIH en tratamiento antirretroviral que presentan dislipemia secundaria con criterios de tratamiento médico según el National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). La intervención terapéutica realizada fue atorvastatina a dosis de 10 mg/día y medidas higiénico-dietéticas. Si a los 3 meses de tratamiento no se alcanzaba los objetivos terapéuticos, se aumentaba la dosis de atorvastatina a 20 mg/día. Se realizó un seguimiento clínico y analítico durante 6 meses. Resultados: Se incluyó a 32 pacientes. En 5 casos se precisó aumentar la dosis de 10 a 20 mg de atorvastatina al día. En un 62% de los casos se consiguió el objetivo terapéutico con buena tolerancia clínica. Se observó un efecto adverso que obligó a retirar el fármaco. Conclusión: En este estudio, la atorvastatina ha resultado ser eficaz y bien tolerada para el tratamiento de la dislipemia en la población infectada por el VIH+

Background and objective: We investigated atorvastatin effectiveness and tolerance in HIV patients with hypercholesterolemia related to antiretroviral treatment. Patients and method: Prospective study that included HIV+ patients under antiretroviral treatment who displayed secondary dyslipemia and medical treatment criteria (according to NCEP-III). These patients were given 10 mg/day atorvastatin and hygienic-dietetic measures. If the therapeutic objectives were not achieved, the dose of atorvastatin was increased to 20 mg/day. Patients were followed up for 6 months. Results: 32 patients were included. In 5 cases it was necessary to increase the dose from 10 mg atorvastatin to 20 mg. The therapeutic objective was obtained in 62% cases, with a good clinical tolerance. Only one adverse effect was noticed, which forced the removal of the drug. Conclusion: In our study atorvastatin was effective for the treatment of dyslipemia in HIV patients, and it was safe and well tolerated