Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A 1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that selfreported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.

this study has evidenced a disparity in performing instrumental diagnosis between COPD and HF groups that persists when both conditions coexist. Moreover, the pharmacological treatment of the two conditions shows a consistent under treatment with bronchodilators in COPD patients and with β-blockers in HF patients.

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RESUMOObjetivo: Analisar o estado nutricional de crianças e adolescentes habitantes de uma região com necessidades básicas inadequadamente atendidas a fim de detectar alterações de nutrição e crescimento que possam se tornar fatores de risco para o desenvolvimento de eventos cardiovasculares na idade adulta.Métodos: Estudo descritivo do tipo transversal, incluindo 136 crianças e adolescentes, entre cinco e 15 anos de idade, pertencentes a duas regiões da Cidade de Santa Fé, Argentina. Foram coletados dados socioeconômicos (escolaridade, causas de absenteísmo escolar e tipo de alimentação), dados clínicos (pressão arterial), dados antropométricos (peso, altura e índice de massa corpórea) e dados laboratoriais (hemograma e perfil lipídico). Os dados foram analisados por meio do teste do quiquadrado e teste exato de Fisher. Utilizou-se a regressão logística para determinar um modelo preditor de hipertensão arterial.Resultados: A idade média do grupo estudado foi de 10±2,6 anos, sendo 49% do sexo feminino. Observou-se 22% da amostra com algum tipo de desnutrição, 11% com sobrepeso ou obesidade, 20% com hipertensão arterial e 49% com alguma alteração no perfil lipídico. Pelo modelo de regressão logística, o sexo feminino (OR=3,64; IC95%=1,13-11,73) e a relação LDL/HDL alterada (OR=2,57; IC95%=1,00-6,62) aumentaram o risco de hipertensão arterial.Conclusões: Alterações nutricionais na infância e adolescência podem aumentar o risco de doenças cardiovasculares já nessas faixas etárias e também na vida adulta, principalmente diante da presença de fatores de risco como alteração no perfil lipídico e obesidade, além do sexo feminino.Palavras-chave: antropometria; desnutrição proteicoenergética; obesidade; hipertensão. ABSTRACT Objective:To analyze the nutritional status of children and adolescents living in a region with inadequate care of basic needs in order to detect nutritional and growth problems that are potential risk factors of cardiovascular events in the adult age.Methods: Cross sectional descriptive study that enrolled 136 children and adolescents between five and 15 years old, living in two regions of Santa Fé City, Argentine. Data collected included: socioeconomic characteristics (schooling, causes of school absenteeism and type of feeding), clinical data (blood pressure), anthropometric data (weight, height and body mass index) and laboratorial data (hemoglobin, hematocrit and blood lipids). Statistical analysis included chi-square test, Fisher exact test, and logistic regression to determine a predictor model of hypertension.Results: The studied population presented a mean age of age of 10±2.6 years, 49% were female, 22% presented some type of malnutrition, 11% overweight or obesity, 20% hypertension and 49% had some altered parameter of the blood lipid profile. According to the logistic regression, female gender (OR=3.64; 95%CI=1.13-11.73) as well as LDL/HDL cholesterol ratio (OR=2.57; 95%CI=1.00-6.62) increased the risk of arterial hypertension.Fonte financiadora: bolsa científica da Universidad Nacional d...

Arch Argent Pediatr 2015;113(6):e333-e335 / e333Presentación de casos clínicos RESUMEN El adenocarcinoma colorrectal es excepcional en niños, por lo que, generalmente, se lo diagnostica en estadios avanzados, con mal pronóstico. Presentamos el caso de una niña de 5 años de edad con proctorragia recurrente de 2 meses de evolución, sin alteraciones en los análisis de laboratorio, en quien se confirmó la existencia de un adenocarcinoma colorrectal por medio de una colonoscopía. La estatificación demostró un compromiso local sin enfermedad o metástasis a distancia. La paciente se trató con resección laparoscópica y quimioterapia adyuvante, y permaneció libre de enfermedad a 21 meses de seguimiento. Palabras clave: adenocarcinoma, neoplasias colorrectales, colonoscopía, hemotoquecia. ABSTRACTColorectal adenocarcinoma is exceptional in children, generally diagnosed in advanced stages, with worse prognosis. We report the case of a 5 year old girl with isolated hematochezia lasting two months without other findings, in whom a colorectal adenocarcinoma was confirmed by colonoscopy. Staging revealed localized disease, extending to perisigmoid fat and a few adjacent ganglia. She was treated by laparoscopic resection and adjuvant chemotherapy, being free of disease at 21 moths of follow-up.