Traditionally a crease in the ear has been considered a visible marker of atherosclerosis. There is strong evidence of its association with coronary heart disease (CHD) revealed in several retrospective and prospective studies. However, the usefulness of the earlobe crease (ELC) as a marker of atherosclerotic diseases of other vascular beds, especially in the intracranial or extracranial carotid vasculature, is not clear. A non-systematic search of studies evaluating the association between ELC and atherosclerosis was performed. Observational studies that explored the association of ELC with atherosclerosis in many vascular beds were reviewed. Most studies presented methodological limitations, selection bias, and relatively small sample sizes. Discrepancies were found between studies, mainly due to the interaction of age in the association pathway. In a population cohort study, age was the main modifier of the effect of ELC with atherosclerosis in different vascular beds. The role of ELC as a marker of atherosclerosis remains unclear, at least for extra-coronary atherosclerosis.
Cerebrovascular diseases
Mortalidad por enfermedades cerebrovasculares en Ecuador 2001- 2015: Estudio de tendencias, aplicación del modelo de regresión joinpoint. Mortality due to cerebrovascular diseases in Ecuador 2001- 2015: a trend study, application of the joinpoint regression model.
Objective. To analyze the mortality trend for cerebrovascular diseases in Ecuador and to identify the presence of changes in the temporal trend using the joinpoint regression model.
Materials and Methods. A mixed ecological study was carried out. Standardized mortality rates for the last 15 years (2001 to 2015) in Ecuador were calculated and stratified by age, sex, and provinces. A joinpoint regression analysis was used for analysis of trends.
Results. From 2001 to 2015, there were 48,621 deaths from cerebrovascular diseases in Ecuador. In the joinpoint regression analysis, age-adjusted rates in men declined from 71.4 to 59.5 deaths per 100,000 population, with an annual decline of 1.51% (p <0.05) in females from 61.2 to 55.5 deaths per 100,000 population, with an annual decrease of 1.11% (p <0.05). In the analysis by provinces, Sucumbíos presented a growing trend of 3.17% per year (p <0.05).
Conclusions. Mortality from cerebrovascular disease has declined in Ecuador in the last 15 years. The downward trend was observed in almost all age demographics.
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Hemorragia Talámica Bilateral. Bilateral Thalamic Hemorrhage.
Thalamic hemorrhages represent a small group of cerebrovascular diseases of which only 0.7-3% is manifested bilaterally, being chronic hypertension the key factor for its development. We report a case of a 45-year-old patient with 10-years history of arterial hypertension who presented with brachiocrural motor deterioration accompanied by dysarthria, dyspnea, vomiting in number of two, with increased basal blood pressure. Neurimaging demostrated a bilateral thalamic hematoma.
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Enfermedad Cerebrovascular en el Ecuador: Análisis de los Últimos 25 Años de Mortalidad, Realidad Actual y Recomendaciones
Background. Cerebrovascular disease is the second cause of death and occupies the third place as a factor causing disability worldwide. At present, despite the recognition of its importance, the available data about Ecuador is scarce and there are not published analysis of its behavior. Methods. Retrospective longitudinal analysis of available public data on cerebrovascular disease in Ecuador, from 1991 to 2015. Results Cerebrovascular disease was the leading cause of mortality by 77 897 (6.70%) deaths and it is the only one with a constant trend pattern in the last 25 years. Conclusions. Cerebrovascular disease is the number one cause of death in Ecuador and its mortality is steadily increasing. Government policies must be implemented to reduce their mortality.
