Background Subclinical atherosclerosis (SA) in the carotid, femoral, and coronary territories is a powerful predictor of cardiovascular (CV) events. Whether it is sufficient to assess SA in a single vascular territory in early-stage disease is uncertain. We aimed to determine the prevalence and concordance of SA in these vascular beds in asymptomatic patients without known CV disease. Methods We enrolled patients aged 35 to 75 years who were asymptomatic, without known CV disease, and had undergone carotid and femoral Doppler ultrasonography and calcium scoring. Those receiving statins were excluded. SA was defined as the presence of plaques in the carotid and/or femoral arteries or the presence of calcium in the coronary arteries (Agatston score >0). Results A total of 212 patients were identified with a mean age of 53 ± 7 years, of which 60% (128 patients) were men. The prevalence of SA was 62%. The distribution of SA between the three territories was similar, involving the carotid territory in 38% of cases, the femoral in 31%, and the coronaries in 37%. The concordance between the different vascular territories was weak, with a k index of 0.21 between the coronary and carotid territories, 0.27 between the coronary and femoral territories, and 0.34 between the carotid and femoral territories. Conclusions The prevalence of SA in asymptomatic patients without known CV disease is high. The concordance in the presence of SA between the three vascular territories is weak. Therefore, all three vascular beds need to be investigated.

Una mujer de 40 años de edad procedente de Puerto Limón, Vaupés, consultó al hospital de Mitú por dolor localizado en la fosa ilíaca derecha que se exacerbaba con la maniobra de Valsalva y con el movimiento; se desconoce el tiempo de evolución. La paciente ha tenido 7 gestaciones, 6 partos y 1 cesárea. En el examen físico se encontró una masa móvil dependiente del ovario derecho de 6 cm x 4 cm. En la ecografía pélvica se observó una masa en el anexo derecho, de densidades mixtas, con calcificaciones, de 6 cm x 5 cm que se diagnosticó como un teratoma.En los exámenes de laboratorio se encontró: hemoglobina, 10 g/dl; hematocrito, 30%; leucocitos, 5.150 por µl; neutrófilos, 24%; linfocitos, 35%; eosinófilos, 29%; monolitos, 1%; basófilos, 2%; bandas, 9%.En la laparotomía infraumbilical se encontró un plastrón que comprometía el mesoapéndice y la trompa derecha, razón por la cual se practicó apendicectomía y salpingectomía derecha. El ovario izquierdo era de aspecto normal.Se recibió para estudio histopatológico una masa irregular de tejido fibroadiposo indurado con áreas violáceas, de 6 cm x 3 cm x 3 cm. En los cortes seriados se identificó trompa uterina y apéndice cecal con luz permeable y presencia de múltiples nódulos amarillos que medían 0,3 cm x 0,3 cm en la serosa, el mesosálpinx y el mesenterio.En el examen microscópico, la serosa apendicular y el mesenterio presentaban importante infiltrado inflamatorio crónico granulomatoso, más notorio en el mesenterio, muy rico en eosinófilos, células gigantes multinucleadas, células epitelioides, plasmocitos, y numerosas estructuras ovoides con las siguientes características: cutícula festoneada constituida por una capa interna translúcida y una capa media gruesa de color café; miden en

A total of 200 patients were included. The average daytime ABPM systolic blood pressure (SBP) was 136±16 compared with 136±15 (P=1) with HBPM; the average diurnal diastolic blood pressure (DBP) was 83±12 and 81±9, respectively (P=0.06). The concordance between both methods was very good for SBP [r=0.85; Bland-Altman 0.2 (95% confidence interval 0.9-1.4 mmHg)], and good for the DBP [r=0.77; Bland-Altman 1.8 (95% confidence interval 0.8-2.8 mmHg)]. Both methods were in agreement that HTN was controlled in 68 patients and that it was not controlled in 90 patients, that is, they were concordant in 158 patients (79%, κ=0.6). More patients required changes with ABPM than HBPM (149 vs. 99 patients, P<0.0001) CONCLUSION: There were no significant differences in the measurement of diurnal SBP and DBP between both methods. The concordance to determine proper control of HTN was 79%. There was a significant difference in the decision to modify the treatment in favor of the ABPM.