Francisco Santolaria Fernández

Benzodiacepinas, alcohol y deterioro neuropsicológico

En Espana, cada ano mas de 50.000 personas presentan una parada cardiaca extrahospitalaria, pero menos de la mitad recibe tratamiento y en menos del 10% se aplican con exito tecnicas de resucitacion que les permiten regresar a sus hogares para llevar una vida productiva. La aplicacion de la evidencia cientifica disponible en resucitacion podria modificar de forma sustancial este resultado tan triste. Sin embargo, la mayoria de los procedimientos que han conseguido reducir la mortalidad por parada cardiaca no se emplean suficientemente en nuestro medio. Junto con el establecimiento de estrategias realmente energicas para la desfibrilacion precoz, otros 4 aspectos de la resucitacion tienen el mayor potencial para mejorar el pronostico: a) prevencion de la parada cardiaca mediante el reconocimiento precoz de los signos de alarma e intervencion oportuna; b) resucitacion orientada hacia el flujo sanguineo, con un papel limitado de la ventilacion; c) aplicacion de la tecnologia para guiar las intervenciones en resucitacion, y d) empleo de hipotermia.

Síndrome metabólico y riesgo cardiovascular en la población diabética de El Hierro, Islas Canarias

Introduction: In the Canary Islands there is a high prevalence of vascular risk factors. Objective: To analyze the clinical characteristics of 300 patients with type 2 diabetes in El Hierro, in the Canary Islands. Methods: Patients were assessed at the Internal Medicine Unit of the hospital from 1982 to 2010, and followed up until December 2014 or until death. The sample is composed of 154 women and 156 men (52%). Results: mean age was 66.40 ± 11.60 years, with an average follow-up time of 11.04 ± 4.93 years, and 80.3% were diagnosed of metabolic syndrome, signifi cantly more frequent among women (86.43% vs74.67%, χ2 = 5.62, p = 0.018). During the follow-up period, 51 patients died and a signifi cant proportion developed new cardiovascular complications, such as heart failure (6.7%), ischemic heart disease (17.3%), atrial fi brillation (14.3%), stroke 7%), or peripheral arterial disease (6.9%). Cox regression analysis showed that, although advanced age was the major factor involved in the development of all these complications and in mortality, low cholesterol levels were related to the development of ischemic heart disease and mortality, results that were not dependent on the consumption of statins (as in other examples of inverse epidemiology). Ethanol consumption was related to the incidence of peripheral arterial disease. Conclusions: Old age was the main factor involved in the development of complications and mortality. In addition, low cholesterol levels were related to the development of ischemic heart disease and mortality.