Predictors of cardiovascular risk in metabolic syndrome carriers

Introduction: Metabolic syndrome is a predictor of cardiovascular morbidity and mortality; habits and lifestyles are important in its expression, in its etiology, progression and complications. The search for better risk predictors, since cardiovascular disease is the first cause of death in Cuba and the world, is a priority for health services. Objective: Characterize predictors of cardiovascular risk in carriers of metabolic syndrome. Methods: A cross-sectional descriptive observational study was carried out in 60 patients, older than 45 years, with a diagnosis of metabolic syndrome and the presence of 4 diagnostic criteria. The study variables were: levels of triglycerides, cholesterol, ApoA, ApoB and the atherogenic indices ApoB/ApoA, ApoB/total cholesterol. Results: There was an increase in proatherogenic predictors, reflected in TG levels (above 1.7 mmol/L), ApoB 100 (1.42 g/L) and a decrease in antiatherogenic markers with ApoA 1 values (1.0 g/L) and the ApoB 100/ApoA 1(0.5 Decile) ratio somewhat far from the 1 Decile value, established as the reference value and a high risk of cardiovascular disease when the ApoB/total cholesterol ratio is found (0.73 g/L) above normal values. Conclusions: Apolipoproteins and atherogenic indices are better predictors of cardiovascular risk by expressing the balance between plasma pro- and anti-atherogenic particles, as well as the formation of atheromatous plaque precursors

Apolipoproteins as predictive markers of metabolic-vascular risk in pediatrics

Introduction: The search for new predictive markers, in the stratification of metabolic-vascular risks, is of vital importance in the prevention, diagnosis and timely treatment of cardiometabolic diseases, considering that the atherosclerotic process begins in childhood. The documentary review was carried out between March and July 2022, consulting the PubMed/Medline, SciElo, Scopus and Google Scholar databases as a gateway to information on the topic. 33 original articles were reviewed in the period 2012-2021 in English and Spanish, 29 were referenced and the key terms for the search were, metabolic-vascular risk, apolipoproteins A1 and B100, markers predictive of metabolic-vascular risk, childhood adolescence. Objective: To analyze the importance of apolipoproteins as predictive markers of pediatric metabolic-vascular risk. Development: Apolipoproteins have emerged as a very viable alternative, particularly the determination of ApoB 100 and ApoA 1, which express the balance between atherogenic and antiatherogenic activity and are present from the early ages of life. Early diagnosis of these markers will allow for early interventions to promote changes to healthy lifestyles, as well as preventive treatments that prevent complications of cardiometabolic disease. Conclusions: Considering that the atherosclerotic process begins at an early age, apolipoproteins constitute markers in the prediction of metabolic-vascular risk, their determination allows the identification, risk stratification and proposal of preventive strategies from pediatric ages

Fecal impaction by Spiny Monkey-orange seeds

Introduction: Fecal impaction is characterized by the presence of compact feces in the rectum or colon, which cannot be evacuated. Eating the fruit of the Spiny Monkey-orange tree (Strychnos spinosa Lam), which contains numerous seeds, is a dietary habit in some African countries. Objective: To describe the particularities of the diagnosis and treatment of fecal impaction due to the ingestion of Spiny Monkey-orange seeds. Clinical case: 12-year-old male, who ingested a large quantity of Spiny Monkey-orange seeds; he couldn't defecate or pass gas; She had abdominal and anal pain. Physical examination revealed tachycardia, abdominal distension, and increased air-fluid noises. A rectal examination revealed impaction with a stony consistency. When the extraction was not possible, in the emergency room, the fecal mass was fragmented and extracted, through the anus, with anesthetic sedation. Conclusions: The ingestion of Spiny Monkey-orange seeds is a dietary habit in Africa and the bezoars or fecal impaction that this habit can produce are not considered a health problem. For the diagnosis it is necessary the antecedent of the ingestion of the fruit, to carry out an exhaustive physical examination of the abdominal and anorectal regions and finally, the extraction of the fecal mass

Manifestaciones neurológicas y psicológicas en pacientes pediátricos convalecientes de la COVID-19

Introducción: La capacidad de SARS-CoV-2 de producir manifestaciones neurológicas y psicológicas es indudable, aunque no son, a primera vista, diferenciables de las originadas por otras infecciones víricas. No es posible hasta el momento determinar si estas secuelas son temporales o permanentes, lo que sí se sabe es que algunos de estos síntomas pueden persistir en el tiempo, independiente de la gravedad de la enfermedad. Objetivo: Caracterizar las principales manifestaciones neurológicas y psicológicas encontradas en menores de 18 años en el período de convalecencia por la COVID-19. Métodos: Se realizó un estudio observacional descriptivo de corte transversal, en el período comprendido de marzo del 2020 y febrero del año 2021, se entrevistaron por vía telefónica 472 pacientes, en un inicio entre 20 y 35 días después del egreso y luego a los 15 días de la primera entrevista. Se recogió edad, sexo, antecedentes patológicos personales, síntomas al diagnóstico, si esos síntomas habían mejorado o desaparecido en el momento de la entrevista y si habían vuelto a su estado de salud habitual. Resultados: Las manifestaciones fueron más frecuentes en el sexo masculino (65 %), en mayores de 5 años (79,1 %), que presentaban comorbilidades y sintomatología durante la infección. Predominó la cefalea (39,2 %), la fatiga (22,5 %) y las mialgias (12,5 %). Conclusiones: Las manifestaciones neurológicas y psicológicas se presenta con mayor frecuencia en adolescentes y escolares del sexo masculino, con formas sintomáticas de la enfermedad y la existencia de antecedentes patológicos personales