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Resumen: Objetivo: Describir la incidencia de complicaciones en pacientes que iniciaron tratamiento con Acenocumarol, así como analizar los factores asociados, la etiología de las complicaciones y mortalidad de dichos pacientes. Método: Estudio observacional, descriptivo, retrospectivo. Se seleccionó una muestra aleatoria de pacientes de entre aquellos que iniciaron Acenocumarol en 2015. Resultados: 124 pacientes fueron incluidos. El 56,5% eran hombres. No se encontraron diferencias estadísticamente significativas entre la aparición de complicaciones y las comorbilidades estudiadas. Tampoco se encontró relación entre el desajuste de los niveles de INR y la intercurrencia de una complicación. Los pacientes con desajustes de INR presentaron un mayor número de ingresos hospitalarios. Conclusiones: La prevalencia de complicaciones hemorrágicas en el primer año fue del 12%, siendo mayor en los primeros meses tras el comienzo con Acenocumarol Abstract Objective: To describe the incidence of bleeding complications during treatment with Acenocumarol, as well as associated factors, ethiology of this complications and patient´s mortality . Method: Retrospective, observational and descriptive review. A randomly sample of patient was collected from those who started Acenocumarol in 2015. Results: 124 patients were included. 56,5% were men. No statistically significant differences were found between the occurrence of complications and comorbidities. There was also no relation between the mismatch of the INR levels and the intercourse of a complication. There was also no relation between the mismatch of the levels of INR and the presence of complications. Conclusions: Bleeding complications prevalence during first year were 12%, being greater in the first months after starting with Acenocumarol

Resumen Introduccion y objetivo Analizar la frecuencia, las caracteristicas clinicas y la supervivencia de los pacientes con cancer de pulmon nunca fumadores comparandolas con los pacientes fumadores. Pacientes y metodos Estudio retrospectivo de pacientes diagnosticados de cancer de pulmon mediante citohistologia de 1999 al 2011. Se estimo la supervivencia por el metodo de Kaplan-Meier. Para estimar la relacion entre las variables se uso la prueba de χ2. Resultados Se diagnosticaron 2.161 pacientes, 396 (18,3%) nunca fumadores. En este grupo la edad media (± desviacion estandar) fue de 72,85 ± 10,52, el 64,6% mujeres y el 35,4% hombres. Segun la citohistologia, el 55,6% eran adenocarcinoma, el 20,5% epidermoide, el 15% de celula pequena, el 2,7% de celula grande y el 6,2% otros subtipos. El diagnostico se hizo en estadio avanzado ( iv ) en el 61,4% de pacientes, y el 14,4% recibieron tratamiento quirurgico. La supervivencia fue del 12,4%, sin diferencias entre los 2 grupos. En el grupo de nunca fumadores las mujeres tuvieron mejor supervivencia que los hombres. Conclusiones El 18,3% fueron pacientes nunca fumadores. Se diagnosticaron mayoritariamente en mujeres, estadios avanzados y estirpe histologica adenocarcinoma. No hubo diferencias de supervivencia con el grupo de fumadores.

Objective To determine the frequency of obstructive sleep apnoea (OSA) and metabolic syndrome (MS) in normal weight patients and their characteristics, and to compare these with overweight and obese patients. Methods We studied all patients with suspected OSA referred to the sleep laboratory from January to December 2009. OSA was diagnosed when the apnoea-hypopnoea index (AHI) was >5 and symptoms were present. MS was diagnosed according to International Diabetes Federation (IDF) criteria. The patients were distributed into 3 groups according to body mass index (BMI): normal weight ( Results We studied 475 patients: 7.60% normal weight and 56.4% obese. Most patients in the normal weight group were women, snorers, non-smokers, non-drinkers and were significantly younger and with a smaller neck and waist circumference than obese and overweight patients. OSA was diagnosed in 90.10%: 77.70% normal weight. OSA in these patients was mostly mild, and there were differences between the diagnosis of OSA and the BMI classified. MS was diagnosed in 64.40%: 33.33% normal weight. There was a higher probability of MS as the BMI increased. OSA and MS frequency in normal weight patients was 22% and in obese patients was 70.52%. OSA in normal weight patients was related with gender and age. There was no relationship between OSA and MS, or between otorhinolaryngological malformations and OSA in normal weight patients. Eight normal weight patients with OSA were treated with continuous positive airway pressure (CPAP) therapy. Conclusions The frequency of OSA in normal weight patients was lower than in overweight and obese patients. The frequency of concomitant OSA and MS was lower in normal weight patients than in obese subjects. Normal weight patients were mostly women, younger and had no toxic habits. In normal weight patients, age and gender were predictive factors for OSA, but OSA and MS were not related.

Resumen Objetivo Conocer la frecuencia del sindrome de apnea-hipopnea del sueno (SAHS)y del sindrome metabolico (SM) en normopeso y sus caracteristicas. Determinar si existen diferencias epidemiologicas con aquellos con sobrepeso u obesidad. Metodos Se estudiaron todos los pacientes con sospecha de SAHS remitidos al laboratorio del sueno desde enero a diciembre 2009. Se diagnostico de SAHS cuando el indice de apnea-hipopnea (IAH) era > 5 y existia clinica. Se diagnostico el SM segun los criterios de la International Diabetes Federation (IDF). Los pacientes se distribuyeron en 3 grupos segun el indice de masa corporal (IMC): normopeso ( 2 ), sobrepeso (25-29,9 kg/m 2 ) y obesidad (≥ 30 kg/m 2 ). Resultados Se estudiaron 475 pacientes: 7,60% normopeso y 56,40% obesos. De los normopeso, la mayoria eran mujeres, roncadores, no fumadores, no consumian alcohol y eran significativamente mas jovenes y con menor perimetro de cuello y abdomen. Se diagnostico de SAHS al 90,10%: normopeso 77,70%. En pacientes con SAHS y normopeso la mayoria eran SAHS leve, existiendo diferencias entre diagnostico de SAHS e IMC categorizado. Se diagnostico de SM al 64,40%: 33,33% normopeso, encontrando mayor probabilidad de SM al aumentar el IMC. La prevalencia de SAHS y SM simultaneamente en normopeso fue del 22% y en obesos del 70,52%. El SAHS en normopeso se relaciono con el sexo y la edad. No se encontro relacion entre SM y SAHS, y tampoco entre malformacion otorrinolaringologica y SAHS. Se trato con CPAP a 8 pacientes normopeso con SAHS. Conclusiones La frecuencia de SAHS en normopeso era menor que en los sobrepeso y obesos. La frecuencia de SAHS y SM simultaneamente en normopeso frente a obesos fue menor. Los pacientes normopeso eran con mas frecuencia mujeres, mas jovenes y sin habitos toxicos. Los factores predictores de SAHS en normopeso eran sexo y edad, sin que existiera relacion entre SM y SAHS.

AIM: To ascertain the role of cardiovascular risk factors, cardiovascular diseases, standard treatments and other diseases in the development of ischemic colitis (IC). METHODS: A retrospective, case-control study was designed, using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003. IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible histology. Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy, excluding those with diagnosis of colitis. Cases were matched with controls (ratio 1:2), by age and sex. A conditional logistic regression was performed. RESULTS: A total of 483 patients (161 cases, 322 controls) were included; mean age 75.67 ± 10.03 years, 55.9% women. The principal indications for colonoscopy in the control group were lower gastrointestinal hemorrhage (35.4%), anemia (33.9%), abdominal pain (19.9%) and diarrhea (9.6%). The endoscopic findings in this group were hemorrhoids (25.5%), diverticular disease (30.4%), polyps (19.9%) and colorectal cancer (10.2%). The following variables were associated with IC in the univariate analysis: arterial hypertension (P = 0.033); dyslipidemia (P < 0.001); diabetes mellitus (P = 0.025); peripheral arterial disease (P = 0.004); heart failure (P = 0.026); treatment with hypotensive drugs (P = 0.023); angiotensin-converting enzyme inhibitors; (P = 0.018); calcium channel antagonists (P = 0.028); and acetylsalicylic acid (ASA) (P < 0.001). Finally, the following variables were independently associated with the development of IC: diabetes mellitus [odds ratio (OR) 1.76, 95% confidence interval (CI): 1.001-3.077, P = 0.046]; dyslipidemia (OR 2.12, 95% CI: 1.26-3.57, P = 0.004); heart failure (OR 3.17, 95% CI: 1.31-7.68, P = 0.01); peripheral arterial disease (OR 4.1, 95% CI: 1.32-12.72, P = 0.015); treatment with digoxin (digitalis) (OR 0.27, 95% CI: 0.084-0.857, P = 0.026); and ASA (OR 1.97, 95% CI: 1.16-3.36, P = 0.012). CONCLUSION: The development of an episode of IC was independently associated with diabetes, dyslipidemia, presence of heart failure, peripheral arterial disease and treatment with digoxin or ASA.