RESUMEN
INTRODUCTION: The phenomenon of subclavian steal is a frequent haemodynamic phenomenon which rarely causes symptoms in the vertebrobasilar territory. When this does occur, it is known as the subclavian steal syndrome. CLINICAL CASES: We describe two patients with the syndrome of left subclavian steal diagnosed by doppler. In one of them, symptoms appeared after exercise of the left arm. Various aspects of the syndrome are discussed in relation to diagnosis and indications for treatment. CONCLUSIONS: The subclavian steal syndrome is a condition which can be reliably diagnosed using doppler and the treatment of which should be decided individually in each case.
Asunto(s)
Síndrome del Robo de la Subclavia/diagnóstico por imagen , Anciano , Angioplastia , Estenosis Carotídea/fisiopatología , Estenosis Carotídea/cirugía , Angiografía Cerebral , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ultrasonografía DopplerRESUMEN
AIMS: To assess the level of immunity in a healthy population to the hepatitis A virus (HAV), according to age groups and in an urban health area. DESIGN: Transversal random prospective study of a sample of the population found by letters. SITE. Primary Care Centre covering the population of an urban health area in Valladolid. PATIENTS OR OTHER PARTICIPANTS: Random sample of 726 people with an adjustment as to sex and age according to the area's average, in line with the full census of the above area. The sample was 95% trustworthy, with a 3% margin of error. People with serious illness at the time of the study were excluded. MEASUREMENTS AND MAIN FINDINGS: We carried out a social-health count. We established the anti-HAV titer after its detection by enzyme immunoanalysis (HAVAB EIA Abbott); the titers were inferred from the absorbances relating then to that of a a "pool" of serums with very high titers. 69.9% (standardised rate) gave positive. The highest titers were presented in people between 31 and 50 (29.7 +/- 47.0), with significant differences both for lower (17.0 +/- 15.7) and higher (15.7 +/- 19.8) age groups (p. 0.001 for both). CONCLUSIONS: The highest anti-HAV titers corresponded to people in the middle age-group, with a subsequent dropping-off. This could suggest a greater susceptibility to HAV infection in the older person.