RESUMEN
We measured fasting serum total cholesterol (TC), triglycerides (TG), and low- and high-density lipoprotein cholesterol (LDL-C and HDL-C) levels in 5000 individuals. Coronary artery disease (CAD) was present in 31%. Compared with women, men had lower mean TC, LDL-C and HDL-C and higher mean TG. Optimal TC level was observed in only 46% of men and 41% of women, and optimal TG in 42% of men and 50% of women. Only 3% of men and 12% of women had HDL-C > 60 mg/dL. Mean TC was not different in CAD patients and those without CAD, but mean TG was significantly higher and mean HDL-C was lower. In all age groups, low HDL-C was more prevalent among men and women who had CAD.
Asunto(s)
Enfermedad de la Arteria Coronaria/epidemiología , Hiperlipidemias/epidemiología , Adulto , Distribución por Edad , Anciano , Análisis de Varianza , Distribución de Chi-Cuadrado , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Enfermedad de la Arteria Coronaria/etiología , Ayuno , Femenino , Humanos , Hiperlipidemias/sangre , Hiperlipidemias/complicaciones , Hiperlipidemias/diagnóstico , Jordania/epidemiología , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Análisis de Regresión , Factores de Riesgo , Distribución por Sexo , Triglicéridos/sangreRESUMEN
We measured fasting serum total cholesterol [TC], triglycerides [TG], and low- and high-density lipoprotein cholesterol [LDL-C and HDL-C] levels in 5000 individuals. Coronary artery disease [CAD] was present in 31%. Compared with women, men had lower mean TC, LDL-C and HDL-C and higher mean TG. Optimal TC level was observed in only 46% of men and 41% of women, and optimal TG in 42% of men and 50% of women. Only 3% of men and 12% of women had HDL-C > 60 mg/dL. Mean TC was not different in CAD patients and those without CAD, but mean TG was significantly higher and mean HDL-C was lower. In all age groups, low HDL-C was more prevalent among men and women who had CAD
Asunto(s)
Colesterol , HDL-Colesterol , LDL-Colesterol , Triglicéridos , Enfermedad de la Arteria Coronaria , Factores de Riesgo , Distribución por Edad , Distribución por Sexo , LípidosRESUMEN
OBJECTIVES: The aim of this study was to estimate the prevalence of depressive disorders and the influence of sociodemographic characteristics on primary healthcare (PHC) setting in Kuwait. SUBJECTS AND METHODS: A cross-sectional survey was conducted in PHC setting in Kuwait using the Beck Depression Inventory second edition questionnaire (BDI II) as a screening instrument, together with a sociodemographic questionnaire. A representative sample drawn from the target population consisted of 2,320 subjects of Kuwaiti nationality randomly selected from 18 PHC centers covering all Kuwait governorates during the period from April 2003 to January 2004. The target age group was 21-64 years. Participants were asked to complete the BDI II questionnaire consisting of 21 items reflecting the depressive disorder independently. Sociodemographic data such as sex, age, marital status, children, occupation, educational status, chronic diseases and social problems were included in the questionnaire. The optimum cutoff score for BDI II was estimated. RESULTS: A total of 2,320 participants completed the questionnaire, 1,082 (46.8%) male and 1,237 (53.2%) female; 860 (37.1%) screened positive for depressive symptoms, among whom 352 (15.3%) were male and 508 (21.7%) female. Of all participants, 163 (7.0%) were severely depressed, 314 (13.5%) moderately depressed and 383 (16.5%) mildly depressed. Depressive disorder was more prevalent among women than men, young than old, more among highly educated individuals, working participants, married individuals, and parents with 3 or more children. CONCLUSION: Depressive disorder is a highly prevalent condition among Kuwaiti patients attending PHC setting. Chronic diseases and social problems are risk factors for depressive disorder.
Asunto(s)
Depresión/epidemiología , Atención Primaria de Salud/estadística & datos numéricos , Adulto , Distribución por Edad , Estudios Transversales , Depresión/clasificación , Trastorno Depresivo/epidemiología , Femenino , Humanos , Kuwait/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Factores SocioeconómicosAsunto(s)
Cardiología/métodos , Inhibidores de Agregación Plaquetaria/uso terapéutico , Agregación Plaquetaria/efectos de los fármacos , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/antagonistas & inhibidores , Abciximab , Administración Oral , Adulto , Anciano , Angina Inestable/tratamiento farmacológico , Angina Inestable/terapia , Angioplastia Coronaria con Balón , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales/uso terapéutico , Aspirina/farmacología , Ensayos Clínicos como Asunto , Enfermedad Coronaria/sangre , Enfermedad Coronaria/tratamiento farmacológico , Enfermedad Coronaria/prevención & control , Enfermedad Coronaria/terapia , Método Doble Ciego , Embolia/prevención & control , Eptifibatida , Femenino , Fibrinolíticos/efectos adversos , Fibrinolíticos/uso terapéutico , Estudios de Seguimiento , Predicción , Hemorragia/inducido químicamente , Humanos , Fragmentos Fab de Inmunoglobulinas/efectos adversos , Fragmentos Fab de Inmunoglobulinas/uso terapéutico , Masculino , Metaanálisis como Asunto , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Infarto del Miocardio/tratamiento farmacológico , Infarto del Miocardio/terapia , Péptidos/efectos adversos , Péptidos/uso terapéutico , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/efectos adversos , Inhibidores de Agregación Plaquetaria/farmacología , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/química , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/inmunología , Estudios Prospectivos , Riesgo , Stents , Relación Estructura-Actividad , Tirofibán , Resultado del Tratamiento , Tirosina/efectos adversos , Tirosina/análogos & derivados , Tirosina/uso terapéuticoRESUMEN
BACKGROUND: Although the Thrombolysis in Myocardial Infarction flow grade system is a widely used index of coronary blood flow, it has important limitations. We recently described a new continuous measure of blood flow in native coronary arteries, the Thrombolysis in Myocardial Infarction frame count (TFC), and sought to extend this method to coronary artery bypass grafts. METHODS: We retrospectively analyzed cinefilms of patients' status after coronary artery bypass grafting, excluding patients with recent myocardial infarction and grafts with stenoses in the graft or native vessel. We counted the cineframes required for dye to travel from the ostium of the graft to the graft anastomotic site (TFCg) and to a standardized distal coronary landmark (TFC). RESULTS: For all vein grafts combined, TFCg was 19.2+/-5.7 frames (mean+/-SD, n = 93) and the TFC was 33.9+/-8.0 frames (n = 67). The upper limits for "normal" flow, calculated from the 95% confidence intervals, were 31 frames for TFCg and 50 frames for TFC. CONCLUSIONS: The Thrombolysis in Myocardial Infarction frame counting method has now been extended to normal saphenous vein grafts, and normal reference values are provided.
Asunto(s)
Angiografía Coronaria/métodos , Infarto del Miocardio/diagnóstico por imagen , Infarto del Miocardio/cirugía , Vena Safena/trasplante , Cateterismo Cardíaco , Cineangiografía , Puente de Arteria Coronaria , Circulación Coronaria , Humanos , Valores de ReferenciaRESUMEN
The Thrombolysis In Myocardial Infarction (TIMI) frame count is a relative index of coronary flow that measures time by counting the number of frames required for dye to travel from the ostium to a standardized coronary landmark in a cineangiogram filmed at a known speed (frames/s). We describe a new method to measure distance along arteries so that absolute velocity (length divided by time) and absolute flow (area x velocity) may be calculated in patients undergoing percutaneous transluminal coronary angiography (PTCA). After PTCA, the guidewire tip is placed at the coronary landmark and a Kelly clamp is placed on the guidewire where it exits the Y-adapter. The guidewire tip is then withdrawn to the catheter tip and a second Kelly clamp is placed on the wire where it exits the Y-adapter. The distance between the 2 Kelly clamps outside the body is the distance between the catheter tip and the anatomic landmark inside the body. Velocity (cm/s) may be calculated as this distance (cm) divided by TIMI frame count (frames) x film frame speed (frames/s). Flow (ml/s) may be calculated by multiplying this velocity (cm/s) and the mean cross-sectional lumen area (cm2) along the length of the artery to the TIMI landmark. In 30 patients, velocity increased from 13.9 +/- 8.5 cm/s before to 22.8 +/- 9.3 cm/s after PTCA (p <0.001). Despite TIMI grade 3 flow both before and after PTCA in 18 patients, velocity actually increased 38%, from 17.0 +/- 5.4 to 23.5 +/- 9.0 cm/s (p = 0.01). For all 30 patients, flow doubled from 0.6 +/- 0.4 ml/s before to 1.2 +/- 0.6 ml/s after PTCA (p <0.001). In the 18 patients with TIMI grade 3 flow both before and after PTCA, flow increased 86%, from 0.7 +/- 0.3 to 1.3 +/- 0.6 ml/s (p = 0.001). Distance along coronary arteries (length) can be simply measured using a PTCA guidewire. This length may be combined with the TIMI frame count to calculate measures of absolute velocity and flow that are sensitive to changes in perfusion. TIMI grade 3 flow is composed of a range of velocities and flows.