[Effect of a global intervention in the integral control of multiple risk factors in patients at high or very high cardiovascular risk. CIFARC 2 project]. / Efecto de una intervención global sobre el control integral de múltiples factores de riesgo en pacientes con alto o muy alto riesgo cardiovascular. Estudio CIFARC 2.

OBJECTIVES: To analyze the effect of a global approach on patients with high cardiovascular risk for the integral control of cardiovascular risk factors. PATIENTS AND METHODS: Multicentric prospective study of patients with high vascular risk, followed-up for one year in internal medicine consultations. We measured the grade of control over major cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, tobacco, obesity) before and after the one-year follow-up period. RESULTS: We studied 456 patients (56% males; age: 66.1, standard deviation: 11.5 years); 54.4% were diabetics, 58.0% had target organ damage and 46.2% had cardiovascular disease. Blood pressure control varied from 50.5 to 60.6; LDL-cholesterol control from 44.7 to 58.1%; diabetes control from 56.5 to 56.6%; tobacco control from 63.0 to 87.5% and obesity control from 60.0 to 55.4%. Integral control of all cardiovascular risk factors varied from 10.7 to 23.2% of patients. Factors independently associated to lack of integral control were: diabetes (Odds Ratio [OR]: 4.42; 95% confidence interval [95%CI]: 2.75-7.14), basal systolic blood pressure (OR: 1.03; 95%CI 1.02-1.05) and basal body mass index (OR: 1.08; 95%CI: 1.02-1.14). Lack of integral control was independently associated to the incidence of cardiovascular events (OR: 2.00; 95%CI: 1.09-5.35). CONCLUSIONS: A global approach on the patient with high cardiovascular risk duplicated the integral control of the five main risk factors. Diabetes and obesity were factors which made integral control difficult. Lack of integral control increased two times the risk of cardiovascular events.

[Mesenteric panniculitis in the differential diagnosis of abdominal pain]. / La paniculitis mesentérica en el diagnóstico diferencial del dolor abdominal.

Mesenteric panniculitis is a rare disease affecting adipose tissue of the mesentery that may result in the development of large masses in the abdomen. Diffuse chronic or intermittent abdominal pain is the most frequent symptom. It usually follows a benign course though surgery is sometime needed. We describe a patient with recurrent abdominal pain who was diagnosed of mesenteric panniculitis. An abdominal CT scan oriented to the diagnosis and an open laparotomy and biopsy was needed for a definitive diagnosis. A brief review of the literature is added.

[Cyclosporin A in the treatment of Eaton-Lambert myasthenic syndrome]. / Ciclosporina-A como tratamiento del síndrome miasteniforme de Eaton-Lambert.

The Lambert-Eaton myasthenic syndrome (LEMS) is a disorder of he cholinergic neurotransmition at the presinaptic terminal of the neuromuscular junction. Clinically it is characterized by muscular weakness, hyporeflexia and autonomic dysfunction. In this entity thet presence of antibodies against calcium channels impair acetylcholine release. Whe used cyclosporin-A in a patient with LEMS and this resulted in a complete clinical and neurophysiological recovery after four months of therapy.