Background:To describe the characteristics of patients ≤40 years of age hospitalized for acute coronary syndrome, analyze the risk factors and identify the variables associated with prognosis.Methods:Case series of patients admitted between 2003 and 2012 inclusive in a tertiary hospital (123 consecutive cases admitted between 2003 and 2012), and case-control study (369 controls selected from the general population matched for sex and age with cases, at a ratio of 3:1). Outcome variables: Mortality, likelihood of survival without readmission for heart-related problems, extent of coronary disease as determined by coronary angiography and cardiovascular risk factors. Results: Mean age was 35.4±4.8 years and 83.7% of the participants were men. Myocardial infarction with abnormal Q wave (48%) and single-vessel involvement (44.7%) predominated. Intrahospital mortality was 1.6%. For the 108 patients eventually included in the follow-up, likelihood of readmission-free survival after 60 months was 69.3±4.8%. In the case group 36% of the patients admitted to using cocaine. Compared to controls, the prevalence in patients was higher for smoking (74.8 vs 33.1%, p<0001), diabetes (14.6% vs 5.1%, p=0.001), low HDL-cholesterol (82.9 vs 34.1%, p<0.001) and obesity (30.0 vs 20.3%, p=0.029). Decreased left ventricular ejection fraction (odds ratio=2.2, p=0.033) and smoking (odds ratio=7.8, p=0.045) were associated with readmission for coronary syndrome.Conclusion: Acute coronary syndrome in people younger than 40 years is associated with diabetes and unhealthy lifestyle: smoking, sedentary behavior (low HDL-cholesterol), cocaine use and obesity. The readmission rate is high, and readmission is associated with smoking and decreased ejection fraction.

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Shed deciduous teeth lead and cadmium content of children from Cartagena (Spain) was assessed. Parents were provided with an interview containing different questions concerning family socioeconomic status, child's health history, zone of residence, or home antiquity. Besides, physiological variables were considered, i.e., sex of donor, presence of caries, type of tooth donated, tooth weight, age of shedding, and position within the mouth. Tooth lead and cadmium data showed a positively skewed distribution and were log-normalized for further analyses. No statistically significant differences could be observed for lead and cadmium values according to the sex of donor. Both heavy metals decreased in content from incisors to molars and with age of shedding. The one-way analysis of variance (ANOVA) displayed both environmental and physiological risk factors contributing to high tooth lead and cadmium values. When a multifactor ANOVA was carried out, the associations between home antiquity, nail biting habit, and jaw with tooth lead levels, as well as those between zone of residence and tooth cadmium levels were found to persist. However, the only common factor for both heavy metals in the multiple analyses was the type of tooth.

A method using differential pulse anodic stripping voltammetry after microwave oven digestion was developed for the simultaneous determination of Cd(II) and Pb(II) in the deciduous teeth of children. Each tooth was weighed; deposited in a 120 mL capped Teflon vessel with 5 mL 65% nitric acid, Suprapur analytical grade; and digested in a 2-step microwave oven for 15 min. The detection limits for Cd(II) and Pb(II) in the final solution were 0.078 and 0.323 μg/L, and the quantitation limits 0.394 and 1.613 μg/L, respectively, with a linearity range of 2 μg/L for Cd(II) and 23.3 μg/L for Pb(II). The sensitivity was 2.51 nA/μg-L and 1.37 nA/μg-L, for Cd(II) and Pb(II). The main advantages of this technique are a complete and satisfactory dissolution of the tooth material with the proposed microwave oven digestion procedure, without sample pretreatments, such as drying, ashing, or powdering. The voltammetric procedure proved to be well designed because of significant goodness of fit to a linear model, and the accuracy of the method was established as compared with standard reference material. The methodology has enabled us to study Cd(II) and Pb(II) in 371 deciduous teeth from school children in Cartagena, Spain.