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Background: Cocaine abuse is associated with an increased risk of cardiac and cerebrovascular events, such as myocardial infarction, sudden cardiac death, and ischemic stroke. The underlying mechanisms leading to these complications are not fully understood although intravascular thrombus formation and accelerated atherosclerosis are prominent findings. We report a 39-year-old male addicted to cocaine, who presented with three consecutive ischemic events characterized by an acute myocardial infarction and two ischemic strokes complicated by cardiac failure and severe neurological sequelae. The pathophysiology of cocaine-induce vascular damage and the management of the ischemic complications are discussed.

The usefulness of positron emission tomography (PET) with fluorine-deoxyglucose (FDG) in sarcomas and non-sarcoma non-epithelial (NSNE) tumors is not clearly defined.To report a Chilean experience with NSNE tumors evaluated using PET with FDG.Retrospective review of the database of a PET laboratory. Demographic data, indications and metabolic findings were compared with conventional imaging in 88 adults and children with diverse bone and soft tissue sarcomas as well as 24 gastrointestinal stromal tumors (GIST), 6 pleural malignant mesotheliomas in adults, and 9 medulloblastomas in children.FDG showed good concordance with conventional imaging in NSNE tumors. It was helpful for staging, restaging, follow-up after treatment and for the detection of new not previously suspected lesions.PET with FDG could have a prognostic role and help in patient management, mainly in musculoskeletal and high grade or less differentiated sarcomas. In GIST, it was a good tool for immunotherapy control.

Cocaine abuse is associated with an increased risk of cardiac and cerebrovascular events, such as myocardial infarction, sudden cardiac death, and ischemic stroke. The underlying mechanisms leading to these complications are not fully understood although intravascular thrombus formation and accelerated atherosclerosis are prominent findings. We report a 39-year-old male addicted to cocaine, who presented with three consecutive ischemic events characterized by an acute myocardial infarction and two ischemic strokes complicated by cardiac failure and severe neurological sequelae. The pathophysiology of cocaine-induce vascular damage and the management of the ischemic complications are discussed.

Tako-Tsubo syndrome resembles an acute myocardial infarction in symptoms, laboratory parameters and electrocardiographic changes. However, angiography does not show evidence of coronary occlusion, and typically an apical ballooning of the ventricle in systole is observed. We report a 78-year-old woman with no coronary risks factors, admitted to the emergency room due to acute chestpain and an electrocardiogram compatible with an acute coronary syndrome with ST elevation. Serum troponin and creatin-kinase (MB fraction) were elevated. An emergency coronary angiography did not show a coronary occlusion. Due to the apical ballooning observed in the left ventriculography, a probable diagnosis of Tako-Tsubo was proposed. The patient had a favorable evolution. A treadmill test, echocardiogram and myocardial perfusión SPECT, performed one month later, disclosed no abnormalities.

Few trials have studied the prevalence of sexual dysfunction (SD) and related risk factors in postmenopausal women using the DSM-IV criteria.To evaluate the prevalence of SD in menopausal women and the impact of risk factors.Five hundred thirty four healthy women, 40 to 64 years of age were interviewed using the Laumann test (DSM-IV).Mean age was 52.4 +/- 5.7 years. Eighty three percent were peri or postmenopausal, 23% used hormonal substitution therapy and 79.2% were sexually active. Among sexually active women, the prevalence of SD increased along with age, from 22.2% at the 40-44 years old range to 66.0% in the 60-64 years old group. Hormone users and healthy women had a low risk for SD (Odds ratio (OR): 0.1 IC: 0.0-0.1 and OR: 0.6 IC: 0.3-0.9, respectively). The risk increased in menopausal women (OR: 3.3 IC: 1.6-6.9), those older than 49 years (OR: 3.4 IC: 1.8-6.4), those subjected to hysterectomy (OR: 3.7 IC: 1.3-10.6) or those with an impotent sexual partner (OR: 3.2 IC: 1.2-8.6).There is a high prevalence of SD among climacteric women. Estrogens, either endogenous or exogenous, have a positive influence on sexuality.

Background: Few trials have studied the prevalence of sexual dysfunction (SD) and related risk factors in postmenopausal women using the DSM-IV criteria. Aim: To evaluate the prevalence of SD in menopausal women and the impact of risk factors. Patients and methods: Five hundred thirty four healthy women, 40 to 64 years of age were interviewed using the Laumann test (DSM-IV). Results: Mean age was 52.4±5.7 years. Eighty three percent were peri or postmenopausal, 23% used hormonal substitution therapy and 79.2% were sexually active. Among sexually active women, the prevalence of SD increased along with age, from 22.2% at the 40-44 years old range to 66.0% in the 60-64 years old group. Hormone users and healthy women had a low risk for SD (Odds ratio (OR): 0.1 IC: 0.0-0.1 and OR: 0.6 IC: 0.3-0.9, respectively). The risk increased in menopausal women (OR: 3.3 IC: 1.6-6.9), those older than 49 years (OR: 3.4 IC: 1.8-6.4), those subjected to hysterectomy (OR: 3.7 IC: 1.3-10.6) or those with an impotent sexual partner (OR: 3.2 IC: 1.2-8.6). Conclusions: There is a high prevalence of SD among climacteric women. Estrogens, either endogenous or exogenous, have a positive influence on sexuality (Rev Méd Chile 2002; 130: 1131-8)