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      PREVALENCIA DE LA ENFERMEDAD ARTERIAL PERIFÉRICA EN PACIENTES DIABETICOS TIPO 2, APLICANDO EL INDICE TOBILLO - BRAZO EN EL HOSPITAL “SEGURO SOCIAL UNIVERSITARIO”

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          Abstract

          La enfermedad arterial periférica (EAP) es causa importante de ulceraciones persistentes, dolor y amputaciones en pacientes con diabetes tipo 2. Esta enfermedad es de 2 a 4 veces mayor en pacientes con diabetes que la población general. El índice tobillo/brazo (ITB) ecodoppler portátil, menor de 0,90 tiene una sensibilidad de 90 % y una especificidad de 95 % para el diagnostico de la enfermedad arterial periférica, es simple, barato, rápido y reproducible. Objetivo: Determinar la prevalencia de la enfermedad arterial periférica en pacientes diabéticos tipo 2 calculando el índice tobillo/ brazo con ecodoppler portátil. Material y métodos: Es un estudio prospectivo, trasversal, descriptivo y aplicativo, se aplicó y se midió el índice tobillo/brazo con ecodoppler portátil a 76 pacientes con diabetes mellitus tipo 2, como criterio de inclusión fueron: pacientes con Diabetes Mellitus tipo 2, criterios de exclusión: pacientes con ITB ≥ 1,3. Se utilizó tensiómetro con manguito manual, ecodoppler portátil, gel conductor, bolígrafos Resultados: De los 76 pacientes que se realizaron la medición del índice tobillo/brazo con ecodoppler, 16 (21.05%) pacientes tienen según el índice Tobillo/brazo EAP, 50 (65.78%) pacientes tenían índice dentro la normalidad y 10(13.15%) no valorable. , prevalencia fue de 18.89% (13.52%, 24,25%) Conclusiones: La prevalencia de la enfermedad arterial periférica en pacientes con diabetes mellitus tipo 2 es de prevalencia de 18.89% (13.52%, 24,25%).

          Translated abstract

          Peripheral arterial disease (PAD ) is an important cause of persistent ulcerations , pain and amputations in patients with type 2 diabetes. This disease is 2 to 4 times higher in patients with diabetes than the general population. The ankle/brachial index (ABI) doppler portable, less than 0.90 as a sensitivity of 90 % and a specificity of 95 % for the diagnosis of peripheral arterial disease, is simple, inexpensive , rapid and reproducible. Objective: To determine the prevalence of peripheral arterial disease in type 2 diabetic patients by calculating the ankle/brachial index with portable Doppler ultrasound. Material and methods: A prospective , transversal, descriptive and application study was applied and the ankle/brachial index with portable Doppler ultrasound was measured in 76 patients with diabetes mellitus type 2 , as inclusion criteria were: patients with type 2 diabetes , exclusion criteria : patients with ABI ≥ 1.3. Tensiometer with manual sleeve, portable doppler , conductive gel, pens Results were used: Of the 76 patients that the measurement of the ankle/brachial index were performed with Doppler ultrasound , 16 (21.05 %) patients have under Ankle / brachial index EAP, 50 ( 65.78 %) patients were within normal rate and 10 (13.15 %) were not assessable, Prevalence was 18.89 % (13.52 % , 24.25% ) Conclusions: The prevalence of peripheral arterial disease in patients with type 2 diabetes mellitus prevalence is 18.89 % (13.52% , 24.25%) .

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          The measurement of atherosclerotic peripheral arterial disease in epidemiological surveys.

          In cardiovascular surveys, the WHO questionnaire on intermittent claudication has traditionally been used as a measure of atherosclerotic peripheral arterial disease of the lower limbs. But the questionnaire is of limited value because atherosclerotic disease is frequently asymptomatic. Research on the validity and reliability of the questionnaire and the simpler non-invasive tests of peripheral arterial disease are reviewed. These tests include measurement of the ankle-brachial systolic pressure ratio, a treadmill exercise test, a reactive hyperaemia test, and assessment of toe-pulse reappearance time. The performance of these non-invasive tests is such that they should be used, in conjunction with the intermittent claudication questionnaire, in epidemiological studies of atherosclerotic peripheral arterial disease of the lower limbs.
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            Imaging peripheral arterial disease: a randomized controlled trial comparing contrast-enhanced MR angiography and multi-detector row CT angiography.

            To prospectively evaluate clinical utility, patient outcomes, and costs of contrast material-enhanced magnetic resonance (MR) angiography compared with multi-detector row computed tomographic (CT) angiography for initial imaging in the diagnostic work-up of patients with peripheral arterial disease. Institutional review board approval and informed consent were obtained. Patients referred for diagnostic imaging work-up to evaluate the feasibility of a revascularization procedure were randomly assigned to undergo either MR angiography or CT angiography. Clinical utility was assessed with therapeutic confidence (scale of 0-10) at initial imaging and with the need for additional imaging. Patient outcomes included ankle-brachial index, maximum walking distance, change in clinical status, and health-related quality of life. Actual diagnostic and therapeutic costs were calculated from the hospital perspective. Differences between group means were calculated with unpaired t tests and 95% confidence intervals. A total of 157 consecutive patients with peripheral arterial disease were prospectively randomized to undergo MR angiography (51 men, 27 women; mean age, 63 years) or CT angiography (50 men, 29 women; mean age, 64 years). For one of the 78 patients in the MR group, no data were available. Mean confidence for MR angiography (7.7) was slightly lower than that for CT angiography (8.0, P = .8). During 6 months of follow-up, 13 patients in the MR group compared with 10 patients in the CT group underwent additional vascular imaging (P = .5). Although not statistically significant, there was a consistent trend of less improvement in the MR group across all patient outcomes. The average cost for diagnostic imaging was 359 ($438) higher in the MR group than in the CT group (95% confidence interval: 209, 511 [$255, $623]; P < .001). Therapeutic costs were higher in the MR group, but the difference was not significant. The results suggest that CT angiography has some advantages over MR angiography in the initial evaluation of peripheral arterial disease.
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              Estudio de prevalencia de la enfermedad arterial periférica y diabetes en España

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rmcmlp
                Revista Médica La Paz
                Rev. Méd. La Paz
                Colegio Médico de La Paz (La Paz, , Bolivia )
                1726-8958
                2014
                : 20
                : 1
                : 12-17
                Affiliations
                [03] La Paz orgnamePoliclínico Miraflores
                [01] orgnameHospital General San Juan de Dios Oruro luchito_24@ 123456hotmail.com
                [02] La Paz orgnameHospital Obrero N 1
                Article
                S1726-89582014000100003
                943344f1-5931-49a9-b264-00db54f27f9d

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 19 February 2014
                : 30 April 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 6
                Product

                SciELO Bolivia


                Enfermedad arterial periférica,prevalencia,índice tobillo/brazo,Peripheral arterial disease,prevalence,ankle/brachial index

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