Los reconocimientos de la salud de los trabajadores constituyen una oportunidad de detección precoz de factores de riesgo vascular. El presente estudio investiga la prevalencia de factores de riesgo ...vascular en la población laboral española.
Se incluyó a 216.914 trabajadores (edad media, 36,4 años; intervalo, 16-74 años; el 73,1% eran varones) en los que se realizó un reconocimiento en una mutua laboral, que incluyó un cuestionario estructurado, una exploración física y determinaciones bioquímicas.
Tenían diagnóstico previo de enfermedad cardiovascular el 0,7%, de hipertensión arterial el 6,2%, de diabetes el 1,2% y de dislipidemia el 8,9%. Durante el reconocimiento se detectó la presencia de tabaquismo en el 49,3% (el 51,3% varones y el 43,8% mujeres), presión arterial elevada (≥ 140/90 mmHg) en el 22,1% (el 27,0% varones y el 8,8% mujeres), obesidad (índice de masa corporal ≥ 30) en el 15,5% (el 18,3% varones y el 13,3% mujeres), hiperglucemia (> 110 mg/dl) en el 6,2% (el 7,8% varones y el 1,9% mujeres) y alguna forma de dislipidemia (colesterol total ≥ 200 mg/dl, cLDL ≥ 160 mg/dl, triglicéridos ≥ 200 mg/dl o cHDL < 40 mg/dl en varones o < 50 mg/dl en mujeres) en el 64,2%. Con respecto al sector «servicios», y tras ajustar por factores de confusión, los trabajadores del sector industria y sobre todo de la construcción mostraron una mayor prevalencia de elevación de la presión arterial y, especialmente, de tabaquismo.
Hay una alta prevalencia de factores de riesgo en la población laboral española, especialmente en varones y en determinados sectores de actividad.
The routine medical check-up provides a good opportunity for screening workers early for cardiovascular risk factors. The aim of the present study was to investigate the prevalence of cardiovascular risk factors in the Spanish working population.
The study included 216 914 working people (mean age 36.4 years, range 16-74 years, 73.1% male) undergoing routine medical check-up, which involved a structured questionnaire, physical examination, and standard serum biochemical analysis.
Cardiovascular disease had been diagnosed previously in 0.7% of workers, hypertension in 6.2%, diabetes in 1.2%, and dyslipidemia in 8.9%. Routine check-up showed that 49.3% (51.3% of males and 43.8% of females) were smokers, 22.1% (27.0% of males and 8.8% of females) had high blood pressure (≥140/90 mm Hg), 15.5% (18.3% of males and 13.3% of females) were obese (body mass index ≥30), 6.2% (7.8% of males and 1.9% of females) were hyperglycemic (blood glucose >110 mg/dL), and 64.2% had dyslipidemia (total cholesterol ≥200 mg/dL, LDL cholesterol ≥160 mg/dL, triglycerides ≥200 mg/dL, or HDL cholesterol <40 mg/dL in males or <50 mg/dL in females). When compared with workers in the service sector and after adjustment for potential confounders, workers in manufacturing, and particularly those in construction, had higher prevalences of both high blood pressure and smoking.
The prevalence of cardiovascular risk factors in the Spanish working population is high, particularly in males and in certain types of employment.
Cytolytic CD8+ T lymphocytes are the main cell type involved in the fatal lymphoproliferative‐accelerated phase of the Chediak‐Higashi syndrome (CHS). To generate a cellular tool to study the defects ...of this T cell subset in vitro, we have used Herpesvirus saimiri, a lymphotropic virus that transforms human T lymphocytes into extended growth and in addition, endows them with natural killer (NK) features. Transformed CHS CD8+ T cells were generated and characterized in comparison with healthy controls. The results showed that transformed CHS T cells maintained the defects described in primary CHS lymphocytes, such as giant secretory lysosomes and impaired NK and T cell receptor/CD3‐induced, perforin‐mediated cytolytic activity which, however, could be restored after extended culture in the presence of interleukin‐2 (IL‐2). Upon activation with phorbol ester plus calcium ionophore or upon extended culture with IL‐2, transformed CHS T cells showed normal, perforin‐independent plasma membrane CD178/CD95L/FasL‐mediated cytolytic activity but negligible secretion of microvesicle‐bound CD95L. Transformed (and primary) CHS T cells were otherwise normal for cytolysis‐independent activation functions, such as proliferation, surface expression of several activation markers including major histocompatibility complex class II, and cytokine or surface activation‐marker induction. Therefore, the CHS protein CHS1/LYST (for lysosomal traffic regulator) can be dispensable for certain NK and T cell cytolytic activities of activated CHS CD8+ T lymphocytes, but it seems to be required for microvesicle secretion of CD95L. We conclude that transformed CHS T cells may be useful as a tool to study in vitro the relative role of CHS1/LYST in NK and T lymphocyte cytolysis and antigen presentation.
A case is reported of a patient with hypoglycemia episodes secondary to a large sized malignant insulinoma with metastases to the liver. For the control of hypoglycemic episodes, both diet and ...octreotide were initially used but the response obtained was poor. Later, oral diazoxide was used and a good initial response was obtained but treatment was stopped due to severe adverse effects. To obtain a decrease in the tumoral size both adrimaycin and streptozotocin were administered but results were unsuccessful. Finally, embolization of the right hepatic artery was performed and no further hypoglycemic episodes occurred during the following 14 months. We conclude that selective hepatic embolization is a good therapeutic option to control hypoglycemic episodes in malignant insulinoma with metastases to the liver when other therapeutic options have proved unsuccessful.
Objetivo: Analizar factores asociados con amputación en pacientes diabéticos que presentan úlceras en sus pies, con el fin de identificar sujetos con alto riesgo para amputación. Método: Hemos ...estudiado 152 diabéticos que acudieron a la Unidad del pie diabético desde enero de 1996 hasta junio de 1998 con úlceraciones en sus pies. En 14 de ellos fue necesaria la amputación. Se excluyeron sujetos con gangrena. Resultados: Los factores asociados con amputación fueron: antecedentes personales de amputación previa (odds ratio 3,7; 1,01-13,7), retinopatía proliferativa, osteomielitis y, de forma independiente, la presencia de vasculopatía (7,1; 1,88-27,2) e infección grave (14,4; 2,92-71,2). Conclusión: Los pacientes diabéticos con úlceras en pie que presenten antecedentes de amputación, signos clínicos de vasculopatía periférica, infección grave, osteomielitis o retinopatía avanzada son de alto riesgo para la amputación y en ellos se deben instaurar precozmente medidas terapéuticas y preventivas intensas.
PDF
