Baja disponibilidad de recursos y apoyo para atender a personas con diabetes e hipertensión arterial en las Unidades de Salud de la Familia de Paraguay

Introducción: Paraguay asumió el reto de lograr cobertura universal mediante redes basadas en Atención Primaria de la Salud con Unidades de Salud de la Familia (USF) en el primer nivel de atención. Un desafío es la atención integral ante enfermedades no transmisibles, principal causa de mortalidad en el país. Objetivo: analizar la capacidad de las USF para la atención de personas con hipertensión arterial y diabetes en el sistema nacional de salud. El diseño fue no experimental, cuantitativo, transversal, descriptivo con componente analítico. Metodología: Incluyó a 761 USF de 12 regiones sanitarias agrupados en 4 ejes territoriales. Se adaptó el método de evaluación SARA de la OMS con 75 variables, aplicando un cuestionario a profesionales de salud entre noviembre y diciembre de 2022. Se calculó índices de disponibilidad y preparación así como un índice que los integra. La medida continua de estos índices se categorizó en 3 grupos: suficiente >0,75 a 1; intermedio 0,5 a 0,75 y bajo <0,5. Resultados: Solo en el 38 % de las USF el índice de disponibilidad fue suficiente, en el 31,5 % para el índice de preparación y en el 31,1 % para el índice integrador SARA DM/HTA. El desempeño se asoció de forma significativa con el eje territorial no así con el área ni con la cobertura a población indígena Discusión: las USF presentaron limitaciones para la atención de personas con diabetes e hipertensión en estas regiones del país.

Introduction: Paraguay assumed the challenge of achieving universal coverage through networks based on Primary Health Care with Family Health Units (USF) at the first level of care. One challenge is comprehensive care for non-communicable diseases, the main cause of mortality in the country. Objective: to analyze the capacity of the USF to care for people with high blood pressure and diabetes in the national health system. The design was non-experimental, quantitative, cross-sectional, descriptive with an analytical component. Methods: It included 761 USF from 12 health regions grouped into 4 territorial axes. The WHO SARA evaluation method was adapted with 75 variables, applying a questionnaire to health professionals between November and December 2022. Availability and preparation indices were calculated as well as an index that integrates them. The continuous measurement of these indices was categorized into 3 groups: sufficient >0.75 to 1; intermediate 0.5 to 0.75 and low <0.5. Results: Only in 38.0% of the USF the availability index was sufficient, in 31.5% for the readiness index and in 31.1% for the SARA DM/HTA integrating index. The performance was significantly associated with the territorial axis, but not with the area or with the coverage of the indigenous population. Discussion: the USF presented limitations for the care of people with diabetes and hypertension in these regions of the country.

Calçada amiga: dialogando com a comunidade sobre a hipertensão arterial e o diabetes mellitus no território / Calçada Amiga: dialogando con la comunidadsobre la hipertensión arterial y la diabetes mellitus en el territorio / Calçada Amiga: dialoguing with the community about hypertension and diabetes mellitus in the territory

Introdução: As Doenças Crônicas não Transmissíveis constituem-se em um grande desafio de saúde pública. Dentro deste grupo, a Hipertensão Arterial e o Diabetes Mellitus merecem destaque, pois seu enfrentamento requer bastante dos serviços de saúde. Na realidade da Atenção Básica, tem-se destaque para as atividades educativas, em especial para a Educação Popular em Saúde, como a "Calçada Amiga". Objetivo: Abordar a experiência da atividade de educação popular em saúde intitulada "Calçada Amiga" como instrumento de proteção, prevenção e promoção da saúde na Hipertensão Arterial e no Diabetes Mellitus em um serviço de Atenção Primária à Saúde. Metodologia: Trata-se de um relato de Experiência de uma atividade de educação popular em saúde desenvolvida no território de uma Unidade Básica de Saúde do Município de Mossoró/Rio Grande do Norte, durante o ano de 2022.Resultados e Discussões: Foram realizadas 13 ações. Sobre a Hipertensão Arterial e o Diabetes Mellitus, notou-se uma certa dificuldade na adesão ao tratamento, com relatos tanto na prática do exercício físico quanto na alimentação adequada, além do uso das medicações. Ainda sobre as dificuldades na adesão, muitos deles afirmavam uma subutilização dos serviços de saúde, em especial a UBS. Foi possível observar a validade da Educação Popular em Saúde por meio de afirmações de avaliação positiva sobre o método adotado para as atividades, com boa aceitação, frequência e retorno da comunidade. Conclusões: A atividade permitiu o fortalecimento do vínculo entre a Unidade Básica de Saúde e a comunidade por meio da imersão no território com momentos de diálogos horizontais e escuta ativa, facilitando a compreensão por parte dos profissionais sobre a realidade dos sujeitos assistidos no serviço. Para a comunidade, permitiu um momento de fala e escuta, expressando seus anseios, medos e dificuldades sobre as condições, tornando-se ativa no processo de saúde/doença (AU).

Introduction: Chronic non-communicable diseases are a major public health challenge. Within this group, Hypertension and Diabetes Mellitus deserve to be highlighted, because coping with it requires a lot of health services. In the reality of Primary Care, there is emphasis on educational activities, especially for Popular Health Education, such as "Calçada Amiga".Objective:To address the experience of popular health education activity entitled "Calçada Amiga" as an instrument of protection, prevention and health promotion in Hypertension and Diabetes Mellitus in a Primary Health Care service.Methodology:This is an experience report of a popular health education activity developed in the territory of a Basic Health Unit of the Municipalityof Mossoró/ Rio Grande do Norte during the year 2022.Results and Discussion:13 actions were performed. Regarding Hypertension and Diabetes Mellitus, there was some difficulty in adherence to treatment, with reports both in the practice of physical exercise and in proper nutrition, in addition to the use of medications. Still on the difficulties in adherence, many of them stated an underutilization of health services, especially the UBS. It was possible to observe the validity of Popular Health Education through affirmations of positive evaluation of the method adopted for the activities, with good acceptance, frequency and community return.Conclusions:The activity allowed the strengthening of the bond between the Basic Health Unit and the community through immersion in the territory with moments of horizontal dialogues and active listening, professionals about the reality of the subjects assisted in the service. For the community, it allowed a moment of speech and listening, expressing their desires,fears and difficulties about the conditions, becoming active in the health/disease process (AU).

Introducción: Las Enfermedades Crónicas no Transmisibles se constituyen en un gran desafío de salud pública. Dentro de este grupo, la Hipertensión Arterial y el Diabetes Mellitus merecen destaque, pues su enfrentamiento requiere bastante de los servicios de salud. En realidad de la Atención Básica, se ha destacado para las actividades educativas, en especial para la Educación Popular en Salud, como la "Calçada Amiga". Objetivo: Abordar la experiencia de la actividad de educación popular en salud titulada "Calçada Amiga" como instrumento de protección, prevención y promoción de la salud en la Hipertensión Arterial y en la Diabetes Mellitus en un servicio de Atención Primaria de Salud.Metodología: Se trata de un relato de experiencia de una actividad de educación popular en salud desarrollada en el territorio de una Unidad Básica de Salud del Municipio de Mossoró/ Rio Grande do Norte durante el año 2022.Resultados y Discusión: Fueron realizadas 13 acciones. Sobre la Hipertensión Arterial y la Diabetes Mellitus, se notó una cierta dificultad en la adhesión del tratamiento, con relatos tanto en la práctica del ejercicio físico como en la alimentación adecuada, además del uso de las medicaciones. También sobre las dificultades en la adhesión, muchos de ellos afirmaban una infrautilización de los servicios de salud, en especial la UBS. Fue posible observar la validez de la Educación Popular en Salud por medio de afirmaciones de evaluación positiva sobre el método adoptado para las actividades, con buena aceptación, frecuencia y retorno de la comunidad.Conclusiones: La actividad permitió el fortalecimiento del vínculo entre la Unidad Básica de Salud y la comunidad por medio de la inmersión en el territorio con momentos de diálogos horizontales y escucha activa, facilitando la comprensión por parte de los profesionales de la realidad de los sujetos asistidos en el servicio. Para la comunidad, permitió un momento de habla y escucha, expresando sus anhelos, miedos y dificultades sobre las condiciones, haciéndose activa en el proceso de salud/enfermedad (AU).

Consumption of sugar-sweetened and artificially sweetened beverages and prevalence of hypertension in adults: a population- based study

Systemic Arterial Hypertension is a multifactorial clinical condition associated with severe outcomes such as stroke and death. One of the main modifiable risk factor for hypertension is an unhealthy diet, often characterized by the consumption of ultraprocessed foods such as sweetened beverages. We aimed to investigate the relationship between the consumption of sweetened beverages, both sugar-sweetened and artificially sweetened, and the prevalence of hypertension in adults. A cross-sectional, household, population-based study with 1,162 adults from two Brazilian cities were carried out. The consumption of food groups and sweetened beverages was obtained by food frequency questionnaire and other data were self-reported. Weight, height, and waist circumference were measured. The association between sweetened beverages consumption and hypertension was analyzed using Poisson regression models, expressed as Prevalence Ratio. The prevalence of hypertension was 16.7%, with no significant difference between genders. The prevalence of consumption of sweetened beverages was 70.3% in men and 54.6% in women, being significantly higher in men. Women who consumed sugar-sweetened and artificially sweetened beverages 6 to 7 days per week had 92% higher prevalence of hypertension compared to those who did not consume or consumed at a lower frequency. Furthermore, women who consumed artificially sweetened beverages at least 1 time per week had 3.36 times higher prevalence of hypertension. The habitual consumption of sweetened beverages may be an important risk factor for hypertension, especially the consumption of diet beverages, which are often marketed as healthier than sugar-sweetened beverages.

La Hipertensión Arterial Sistémica es una condición clínica multifactorial asociada a resultados graves como el ictus y la muerte. Uno de los principales factores de riesgo modificables de la hipertensión es una dieta poco saludable, a menudo caracterizada por el consumo de alimentos ultraprocesados como las bebidas endulzadas. Nuestro objetivo fue investigar la relación entre el consumo de bebidas endulzadas, tanto azucaradas como edulcoradas artificialmente, y la prevalencia de hipertensión en adultos. Se realizó un estudio transversal, domiciliario y poblacional con 1,162 adultos de dos ciudades brasileñas. El consumo de grupos de alimentos y bebidas endulzadas se obtuvo mediante cuestionario de frecuencia de alimentos y los demás datos fueron autoinformados. Se midieron el peso, la talla y el perímetro de la cintura. La asociación entre el consumo de bebidas endulzadas y la hipertensión se analizó mediante modelos de regresión de Poisson, expresados como Ratio de Prevalencia. La prevalencia de hipertensión fue del 16,7%, sin diferencias significativas entre géneros. La prevalencia de consumo de bebidas endulzadas fue del 70,3% en los hombres y del 54,6% en las mujeres, siendo significativamente mayor en los hombres. Las mujeres que consumían bebidas azucaradas y edulcoradas artificialmente entre 6 y 7 días a la semana tenían 92% mayor prevalencia de hipertensión que las que no consumían o consumían con una frecuencia menor. Además, las mujeres que consumían bebidas edulcoradas al menos 1 vez por semana tenían una prevalencia de hipertensión 3,36 veces mayor. Así pues, el consumo habitual de bebidas endulzadas puede ser un importante factor de riesgo de hipertensión, especialmente el consumo de bebidas dietéticas, que a menudo se comercializan como más saludables que las bebidas azucaradas.

Síndrome de Eisenmenger secundario a comunicación interatrial tipo ostium secundum en mujer adulta / Eisenmenger Syndrome Associated with an ostium secundum Atrial Septal Defect in an Adult Woman

El síndrome de Eisenmenger es la forma más severa de presentación de hipertensión arterial pulmonar secundaria a defectos cardíacos congénitos no reparados, aunque su prevalencia es baja, continúa siendo un reto para los sistemas de salud de los países en vías de desarrollo por su complejidad en el manejo. Presentación del caso. Paciente femenina sin antecedentes médicos conocidos quien consulta por disnea relacionada a los esfuerzos y policitemia. Intervención terapéutica. Se realiza ecocardiograma transesofágico que arroja la presencia de defecto interatrial tipo ostium secundum e hipertensión arterial pulmonar severa, con cortocircuito de derecha a izquierda, se inicia oxigenoterapia y terapia farmacológica. Evolución clínica. Paciente permaneció ingresada presentando notable mejora a la disnea, se le dio de alta con referencia a la clínica de cardiopatías congénitas del adulto en Hospital Nacional Rosales.

Eisenmenger syndrome is the most severe form of pulmonary arterial hypertension secondary to an unrepaired congenital heart disease. Despite the low prevalence, it remains a challenge for the public health service of developing countries due to the complexity of the treatment. Case presentation. A female patient without known medical history, who consults with dyspnea on exertion and polycythemia. Treatment. A transesophageal echocardiogram was performed, showing an ostium secundum atrial septal defect and severe pulmonary arterial hypertension with a right-left shunt. Supplemental oxygen was administrated and pharmacological treatment was started. Outcome. The patient presented remarkable clinical improvement to dyspnea, she was discharged with medical reference to the Adult Congenital Heart Disease clinic at Rosales National Hospital.

Clinical application and strategy of total-arterial coronary artery bypass grafting / 中国胸心血管外科临床杂志

@#Since the advent of coronary artery bypass grafting (CABG), the selection of bypass conduits has always been one of the most controversial topics in this field. Arterial conduits have received extensive attention due to their excellent biological features and high patency. In recent years, the application of arterial grafting and total arterial grafting in China keeps increasing in recent years, but there is still a gap compared to the Europe and America. Previous clinical studies have indicated the benefits of the total arterial grafting in terms of patency and long-term outcomes, but the advantage of multiple arterial grafting over other procedures is still in need to be confirmed with high-quality randomized controlled trials. This article reviews the clinical application and strategy of total-arterial CABG, aiming to provide objective reference for future clinical research and application.

Advances in relationship between pyroptosis and pulmonary arterial hypertension and therapeutic drugs / 中国药理学通报

Pyroptosis is the programmed death of cells accompanied by an inflammatory response and is widely involved in the development of a variety of diseases, such as infectious diseases, cardiovascular diseases, and neurodegeneration. It has been shown that cellular scorching is involved in the pathogenesis of pulmonary arterial hypertension ( PAH) in cardiovascular diseases. Patients with PAH have perivascular inflammatory infiltrates in lungs, pulmonary vasculopathy exists in an extremely inflam-matory microenvironment, and pro-inflammatory factors in cellular scorching drive pulmonary vascular remodelling in PAH patients. This article reviews the role of cellular scorch in the pathogenesis of PAH and the related research on drugs for the treatment of PAH, with the aim of providing new ideas for clinical treatment of PAH.

Effect of menthol on hypobaric hypoxia-induced pulmonary arterial hypertension in mice and its mechanism / 中国药理学通报

Aim To study the effect of menthol on hypobaric hypoxia-induced pulmonary arterial hypertension and explore the underlying mechanism in mice. Methods 10 to 12 weeks old wild type (WT) mice and TRPM8 gene knockout (TRPM8

Kidney transplantation from donors with Marfan syndrome: report of 2 cases and literature review / 器官移植

Objective To investigate the feasibility and clinical experience of kidney transplantation from donors with Marfan syndrome (MFS). Methods Clinical data of 2 recipients undergoing kidney transplantation from the same MFS patient were retrospectively analyzed and literature review of 2 cases was conducted. Characteristics and clinical diagnosis and treatment of kidney transplantation from MFS patients were summarized. Results The Remuzzi scores of the left and right donor kidneys of the MFS patient during time-zero biopsy were 1 and 2. No significant difference was observed in the renal arteriole wall compared with other donors of brain death and cardiac death. Two recipients who received kidney transplantation from the MFS patient suffered from postoperative delayed graft function. After short-term hemodialysis, the graft function of the recipients received the left and right kidney began to gradually recover at postoperative 10 d and 20 d. After discharge, serum creatinine level of the recipient received the left kidney was ranged from 80 to 90 μmol/L, whereas that of the recipient received the right kidney kept declining, and the lowest serum creatinine level was 232 μmol/L before the submission date (at postoperative 43 d). Through literature review, two cases successfully undergoing kidney transplantation from the same MFS donor were reported. Both two recipients experienced delayed graft function, and then renal function was restored to normal. Until the publication date, 1 recipient has survived for 6 years, and the other recipient died of de novo cerebrovascular disease at postoperative 2 years. Conclusions MFS patients may serve as an acceptable source of kidney donors. However, the willingness and general conditions of the recipients should be carefully evaluated before kidney transplantation. Intraoperatively, potential risk of tear of renal arterial media should be properly treated. Extensive attention should be paid to the incidence of postoperative complications.

Diagnosis and treatment strategies for vascular complications after kidney transplantation / 器官移植

With persistent progress in donor-recipient evaluation criteria, organ procurement and preservation regimens and surgical techniques, the incidence of vascular complication after kidney transplantation has been declined, whereas it is still one of the most severe surgical complications of kidney transplantation, which may lead to graft loss and recipient death, and seriously affect the efficacy of kidney transplantation. Therefore, the occurrence, clinical manifestations, diagnosis and treatment strategies of common vascular complications after kidney transplantation, including vascular stenosis, arterial dissection, pseudoaneurysm, vascular rupture and thrombosis were reviewed in this article. In combination with the incidence, diagnosis and treatment of vascular complications after kidney transplantation in the First Affiliated Hospital of Xi'an Jiaotong University, diagnosis and treatment strategies for common vascular complications after kidney transplantation were summarized, aiming to provide reference for clinical diagnosis and treatment of vascular complications after kidney transplantation, lower the incidence of vascular complications, and improve clinical efficacy of kidney transplantation and survival rate of recipients.

A Challenging Case Of Pulmonary Arterial Hypertension: Never Judge By Appearances

Abstract We report the case of a patient with symptomatic pulmonary hypertension (PH) associated with diffuse systemic sclerosis (SSc) whose initial assessment suggested a group 3 (clinical classification) PH. The patient had a history of drugs/toxins consumption, which contributed to the development of intrinsic pulmonary vascular disease. This changed the panorama towards the diagnosis of pulmonary arterial hypertension (PAH), with important therapeutic and prognostic implications. In fact, the excellent clinical, laboratory and hemodynamic response to therapy confirmed the hypothesis of a case of drug-associated PAH (DPAH) in a patient with diffuse SSc and lung disease. Considering the presence of DPAH, it was deemed necessary to assess acute vasoreactivity during right heart catheterization (RHC). If criteria were met, the clinical scenario may change towards a favorable and sustained clinical and hemodynamic response with oral calcium channel blockers. However, the response to inhaled nitric oxide was negative in our patient and the therapeutic strategy with dual oral combination therapy with tadalafil and ambrisentan was continued. After six-months of therapy the patient significantly improved, from a high to a low risk of one-year mortality.

Duplex ultrasound and pedal acceleration time as tools to evaluate foot perfusion: a literature review / Ultrassonografia dúplex e tempo de aceleração plantar como ferramentas para avaliar a perfusão do pé: uma revisão da literatura

Abstract Currently, the standard non-invasive test for diagnosing Peripheral Arterial Disease is the Ankle-Brachial Index. However, this test becomes unfeasible in a certain population. New evidence proposes the pedal acceleration time, an ultrasound index, as an alternative test. An integrative bibliographic review was carried out between June 3, 2022 and January 8, 2023, to investigate this new index as a tool to assess foot perfusion. Papers published in English, Portuguese, or Spanish between 2012 and 2022 were searched on PubMed, Google Scholar, and Scielo, using the keywords "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Research that didn't assess foot perfusion using the methods of interest or did not present human data and also case series or reports were excluded. Seven out of the sixty-six articles identified in the searches were selected for the review, all of which had notable methodological limitations. Pedal acceleration time seems to be able to diagnose and stratify and may reflect prognosis.

Resumo Atualmente, o teste não invasivo padrão para diagnosticar a doença arterial periférica é o índice tornozelo-braquial, porém, em uma determinada população, este torna-se inviável. Novas evidências propõem o tempo de aceleração plantar, que é um índice ultrassonográfico, como alternativa. Para investigá-lo no contexto do estudo da perfusão do pé, uma revisão bibliográfica integrativa foi realizada entre 03/06/2022 e 08/01/2023. Artigos em inglês, português ou espanhol, publicados entre 2012 e 2022 foram pesquisados através das ferramentas PubMed, Google Scholar e SciELO, com as palavras-chave "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Pesquisas que não avaliaram a perfusão do pé pelos métodos de interesse, sem dados em humanos e relatos ou séries de casos, foram excluídos. Dos 66 artigos, 7 foram selecionados; todos com notáveis limitações metodológicas. O tempo de aceleração plantar aparenta ser capaz de diagnosticar, estratificar e prognosticar os doentes.

Mal control y elevado riesgo cardiovascular en hipertensos de una universidad

Introducción: La hipertensión arterial es una enfermedad de alta prevalencia y complicaciones mortales. Debido a ello, se necesitan un adecuado manejo en la atención primaria y estrategias preventivas y de intervención, como la iniciativa HEARTS en las Américas. Se sabe también que entre los trabajadores de la Universidad de Ciencias Médicas de Matanzas existe una elevada prevalencia de hipertensos. Objetivo: Identificar el comportamiento del control de la enfermedad y la estratificación de riesgo cardiovascular global. Materiales y métodos: Estudio descriptivo transversal en el que se incluyeron los primeros 80 pacientes hipertensos valorados en la consulta de la mencionada institución. Los métodos empleados fueron el analítico-sintético, el inductivo-deductivo, el histórico-lógico y los estadísticos. Resultados: De 808 trabajadores, 276 eran hipertensos, para una prevalencia de 34,1 %. Dentro de los inadecuados estilos de vida, predominó el sedentarismo, con 59 pacientes (73,7 %); 40 de los 80 pacientes estudiados tenían un riesgo cardiovascular cuantitativo igual o mayor del 10 %, mientras que el riesgo cardiovascular cualitativo mostró que 68 (85 %) tenían un riesgo medio o alto. Dentro del daño en órganos diana predominaron las enfermedades cardiovasculares, con un 16,2 %. Conclusiones: La hipertensión arterial sigue siendo uno de los factores de riesgo más importantes de enfermedad cardiovascular y cerebrovascular. Su pesquisa, control y estimación del riesgo constituyen una prioridad de la atención médica a nivel primario.

Introduction: Arterial hypertension is a disease of high prevalence and fatal complications. Due to this, an adequate management is needed in the primary care, and also preventive and intervention strategies, as the HEARTS initiative in the Americas. It is also known that there is a high prevalence of hypertensive patients among the working staff of the Matanzas University of Medical Sciences. Objective: To identify the behavior of disease control and global cardiovascular risk stratification. Materials and methods: Cross-sectional descriptive study in which the first 80 hypertensive patients evaluated in the consultation of the aforementioned institution were included. The methods used were analytical-synthetic, inductive-deductive, historical-logical and statistical. Results: Of 808 workers, 276 were hypertensive, for a prevalence of 34.1%. Among the inadequate lifestyles, sedentary lifestyle predominated, with 59 patients (73.7%); 40 of the 80 patients studied had a quantitative cardiovascular risk equal to or greater than 10%, while qualitative cardiovascular risk showed that 68 (85%) had a medium or high risk. Cardiovascular diseases predominated within target organ damage, with 16.2%. Conclusions: Arterial hypertension continuous to be one of the most important risk factors for cardiovascular and cerebrovascular diseases. Its screening, control and risk assessment are a priority of the medical care at the primary level.

Pressão arterial invasiva: o YouTube é uma plataforma que compartilha informações confiáveis para enfermeiros? / Invasive blood pressure: is Youtube a platform for sharing controlled information for nurses? / Presión arterial invasiva: ¿es Youtube una plataforma para compartir información controlada para enfermeras?

Objetivo: identificar a qualidade e confiabilidade das informações sobre a pressão arterial invasiva abordadas em vídeos do YouTube. Método: pesquisa descritiva e exploratória com vídeos do YouTube sobre pressão arterial invasiva, identificados em busca única no dia 23 de fevereiro de 2023. Os vídeos foram organizados em uma lista de reprodução e submetidos à análise utilizando a ferramenta Discern Questionnaire para a qualidade educacional do vídeo e a Journal of American Medical Association Benchmarks para a confiabilidade e qualidade da informação e realizada análise estatística descritiva simples. Resultados: elencou-se 62 vídeos publicados há dois anos, dos quais 93,55% apresentaram qualidade educacional dos vídeos ruim, 6,45% moderada, demonstrando 70,97% baixa confiabilidade das informações e 32,25% citaram informações incompatíveis com a ciência. Conclusão: os vídeos encontrados na plataforma do YouTube apresentaram lacunas relacionados ao conteúdo de pressão arterial invasiva demonstrando não ser uma fonte confiável de respaldo para aprendizado do enfermeiro.

Objective: to identify the quality and reliability of information on invasive blood pressure covered in YouTube videos. Method: descriptive and exploratory research with YouTube videos on invasive blood pressure, identified in a single search on February 23, 2023. The videos were organized into a playlist and subjected to analysis using the Discern Questionnaire tool for the educational quality of the video and the Journal of American Medical Association Benchmarks for reliability and quality of information and performed simple descriptive statistical analysis. Results: 62 videos published two years ago were listed, of which 93.55% presented poor educational quality, 6.45% moderate, 70.97% demonstrated low reliability of information and 32.25% cited information incompatible with science. Conclusion: The videos found on the You Tube platform presented gaps related to the content of invasive blood pressure, demonstrating that it is not a reliable source of support for nurses' learning.

Objetivos:identificar la calidad y confiabilidad de la información sobre presión arterial invasiva cubierta en videos de YouTube. Método: investigación descriptiva y exploratoria con videos de YouTube sobre presión arterial invasiva, identificados en una única búsqueda el 23 de febrero de 2023. Los videos fueron organizados en una lista de reproducción y sometidos a análisis mediante la herramienta Discernir Cuestionario para la calidad educativa del video y la Journal of American Medical Association Se tomaron puntos de referencia para la confiabilidad y calidad de la información y se realizó un análisis estadístico descriptivo simple. Resultados: Se enumeraron 62 videos publicados hace dos años, de los cuales el 93,55% presentó mala calidad educativa, el 6,45% moderada, el 70,97% demostró baja confiabilidad de la información y el 32,25% citó información incompatible con la ciencia. Conclusión: Los videos encontrados en la plataforma You Tube presentaron lagunas relacionadas al contenido de presión arterial invasiva, demostrando que no es una fuente confiable de apoyo para el aprendizaje de los enfermeros.

Prevalência e fatores associados à doença renal crônica em pacientes hipertensos cadastrados na estratégia de saúde da família de Rio Branco, Acre / Prevalence and factors associated with chronic kidney disease in hypertensive patients registered in the family health strategy of Rio Branco, Acre / Prevalencia y factores asociados a la enfermedad renal crónica en pacientes hipertensos registrados en la estrategia de salud familiar de Rio Branco, Acre

Introdução: analisar a prevalência e os fatores associados à doença renal crônica em pessoas com hipertensão arterial (HAS) cadastrados na Estratégia de Saúde da Família em Rio Branco, Acre. Método: Trata-se de um estudo transversal realizado com hipertensos cadastrados nas Estratégias de Saúde da Família (ESF), na zona urbana de Rio Branco, Acre, em 2019. A DRC foi definida por TFG < 60 ml/1,72m², estimada a partir da fórmula Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), ou presença de albuminúria > 29 mg/g. Medidas de associação foram estimadas por regressão logística, com grau de confiança de 95%. Resultados: A prevalência de DRC foi de 27,3% em pessoas com HAS. Observou-se associação estatisticamente significativa nos pacientes hipertensos entre DRC e escolaridade (ensino fundamental ­ OR: 1,56; IC95%:1,09; 2,23; sem escolaridade ­ OR:1,87; IC95%: 1,14; 3,07), não controle da pressão arterial (OR: 2,39; IC95%: 1,45; 3,94), sedentarismo (OR: 1,63; IC95%: 1,02; 2,60). Conclusão: A DRC apresenta alta prevalência nos hipertensos, evidenciando a necessidade de medidas em saúde pública para prevenção de complicações mediante melhor controle da doença e mudanças no estilo de vida.

Introduction: To analyze the prevalence and factors associated with chronic kidney disease in people with hypertension (SAH) registered in the Family Health Strategy in Rio Branco, Acre. Method: This is a cross-sectional study carried out with hypertensive patients registered in the Family Health Strategies (ESF), in the urban area of Rio Branco, Acre, in 2019. CKD was defined by GFR < 60 ml/1.72m², estimated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, or presence of albuminuria > 29 mg/g. Association measures were estimated using logistic regression, with a 95% confidence level. Results: The prevalence of CKD was 27.3% in people with hypertension. A statistically significant association was observed in hypertensive patients between CKD and education (primary education ­ OR: 1.56; 95% CI: 1.09; 2.23; no education ­ OR: 1.87; 95% CI: 1.14; 3.07), lack of blood pressure control (OR: 2.39; 95% CI: 1.45; 3.94), sedentary lifestyle (OR: 1.63; 95% CI: 1.02; 2.60). Conclusion: CKD has a high prevalence in hypertensive patients, highlighting the need for public health measures to prevent complications through better control of the disease and changes in lifestyle.

Introducción: Se analizó la prevalencia y los factores asociados a la enfermedad renal crónica (ERC) en personas con hipertensión arterial (HTA) inscritas en la Estrategia de Salud Familiar en Rio Branco, Acre. Método: Estudio transversal con hipertensos inscritos en las Estrategias de Salud Familiar (ESF) en la zona urbana de Rio Branco, Acre, en 2019. La ERC se definió por un FG <60 ml/1,72m², estimado a partir de la fórmula de Colaboración de Epidemiología de Enfermedades Renales Crónicas (CKD-EPI), o la presencia de albuminuria >29 mg/g. Se estimaron medidas de asociación mediante regresión logística, con un nivel de confianza del 95%. Resultados: La prevalencia de ERC fue del 27,3% en personas con HTA. Se observó una asociación estadísticamente significativa entre la ERC y la escolaridad (educación primaria ­ OR: 1,56; IC95%: 1,09; 2,23; sin escolaridad ­ OR: 1,87; IC95%: 1,14; 3,07), falta de control de la presión arterial (OR: 2,39; IC95%: 1,45; 3,94), y sedentarismo (OR: 1,63; IC95%: 1,02; 2,60) en pacientes hipertensos. Conclusión: La ERC presenta una alta prevalencia en pacientes hipertensos, lo que destaca la necesidad de medidas de salud pública para prevenir complicaciones mediante un mejor control de la enfermedad y cambios en el estilo de vida.

Relación del apoyo social percibido y el logro de las metas de compensación de los pacientes con hipertensión arterial y diabetes mellitus / Relationship of perceived social support and the compensation goals of patients with arterial hypertension and diabetes mellitus

INTRODUCCIÓN: Las enfermedades crónicas son un problema actual que presentan altos porcentajes de descompensación en pacientes hipertensos y diabéticos, que hace interesante evaluar los determinantes sociales que influyen en la situación, como el apoyo social. OBJETIVO DEL ESTUDIO: fue relacionar el apoyo social percibido, adherencia a medicamentos, literacidad y variables sociodemográficas con el logro de compensación en pacientes con hipertensión arterial y diabetes mellitus. METODOLOGÍA: De tipo descriptivo correlacional de corte transversal. RESULTADOS: Se estudió a 600 personas, con un promedio de edad de 62,9 años, 63,5% mujeres. Un 64,66% son diabéticos y 89,5% hipertensos (46,9% y 43,33% descompensados respectivamente). El apoyo social percibido fue alto y presentan una inadecuada adherencia al tratamiento farmacológico y una adecuada literacidad en salud (57,6%). Se realiza un análisis de relaciones que demuestran relación significativa entre una menor percepción de apoyo instrumental y ser mujer; la percepción del apoyo de interacción social disminuye con el aumento de la edad y en relación con el apoyo afectivo, disminuye la percepción a mayores años de estudios. Al realizar una regresión logística, entre la percepción de apoyo social baja y los niveles de compensación de los parámetros de compensación no se evidencia una relación estadísticamente significativa. Se evidencia una asociación entre las personas con menos de 8 años de estudio y presentar presiones arteriales elevadas. DISCUSIÓN: Existe dificultad en la medición del concepto de apoyo social, dado que el sentido y significancia es personal. Las patologías crónicas como estresores debe ser un elemento que continúe estudiándose con estudios longitudinales y experimentales. Las estrategias clínicas para la compensación de la hipertensión y la diabetes deben ir más allá del apoyo social, considerando las crecientes complicaciones y proyecciones de mortalidad. CONCLUSIÓN: Se destaca la importancia de abordar el apoyo social considerando su naturaleza subjetiva y contextual, aunque no se estableció una correlación directa con el logro terapéutico. Se señala la inadecuada adherencia al tratamiento farmacológico, la asociación entre baja escolaridad y presiones arteriales elevadas.

INTRODUCTION: Chronic diseases are a current problem since there are high percentages of decompensation in hypertensive and diabetic patients, which makes it interesting to evaluate the social determinants that influence and social support as a multidimensional concept. OBJECTIVE: To relate the perceived social support, medication adherence, literacy and sociodemographic variables with the achievement of compensation in patients with arterial hypertension and / or diabetes mellitus. METHODOLOGY: Descriptive correlational descriptive study is performed methodologically. RESULTS: 600 people were studied, with an average age of 62.9 years, 63.5% women. 64.66% are diabetic and 89.5% hypertensive (46.9% and 43.33% decompensated respectively). The perceived social support was high and showed inadequate adherence to drug treatment and adequate literacy (57.6%). An analysis of relationships that are significantly related between a lower perception of instrumental support and being a woman is performed; the perception of social interaction support with increasing age and in relation to affective support, the perception of older years of studies. When performing a logistic regression, there is no statistically significant relationship between the perception of low social support and the compensation levels of the compensation parameters. There is evidence of an association between children under 8 years of study and presentation of high arterial references. DISCUSSION: There is difficulty in measuring the concept of social support, since the meaning and meaning is personal. Chronic pathologies as stressors should be an element that continues to study with longitudinal and experimental studies. Clinical strategies for the compensation of hypertension and diabetes must go beyond social support, considering the increasing complications and mortality projections. CONCLUSION: Emphasizes the importance of addressing social support considering its subjective and contextual nature, though no direct correlation with therapeutic achievement was established. Highlights inadequate adherence to pharmacological treatment, the association between low education and elevated blood pressure.

Health and lifestyle parameters in peripheral artery disease at two periods of the COVID-19 pandemic: comparison between men and women

ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease.

Relação entre o índice de resistência vascular e o sucesso hemodinâmico de revascularizações distais dos membros inferiores / Vascular resistance index and the immediate hemodynamic success of lower limb distal artery revascularization

Resumo Contexto A cirurgia de revascularização é proposta para restaurar o fluxo sanguíneo para o pé nos casos de isquemia crítica (IC) devido a doença arterial obstrutiva periférica dos membros inferiores (MMII). O uso de ultrassonografia com Doppler (USD) vem despontando nos últimos anos como um método de grande valor para o planejamento cirúrgico dessa intervenção. Objetivos Avaliar a relação entre o índice de resistência (IR), mensurado por meio de USD, e o sucesso hemodinâmico imediato da cirurgia de revascularização dos MMII em pacientes com IC. Métodos O tipo de estudo empregado foi a coorte prospectiva, na qual foram avaliados 46 pacientes portadores de IC dos MMII submetidos à operação de revascularização infrainguinal por angioplastia ou em ponte de agosto de 2019 a fevereiro de 2022. Todos os pacientes foram submetidos à avaliação clínica vascular, à USD com medida do IR das artérias distais dos MMII, à arteriografia dos MMII e à aferição do índice tornozelo-braquial (ITB) no período pré-operatório. No pós-operatório imediato, todos os pacientes foram submetidos à nova aferição do ITB. Resultados Entre os 46 pacientes avaliados, 25 (54,3%) eram do sexo masculino. A idade variou de 32 a 89 anos (média de 67,83). Quanto ao sucesso hemodinâmico, avaliado pela comparação do ITB pré e pós-operatório, constatou-se que 31 (67,4%) pacientes apresentaram sucesso hemodinâmico após cirurgia de revascularização (aumento do ITB em 0,15 ou mais). Foi observada correlação positiva (p ≤ 0,05) entre o IR da artéria distal revascularizada do MMII e o sucesso hemodinâmico imediato avaliado pela aferição do ITB (IR menor e sucesso hemodinâmico). Conclusões Na presente pesquisa foi observada uma correlação positiva entre o índice de resistência arterial distal e o sucesso hemodinâmico nas revascularizações dos membros inferiores, avaliada através do índice tornozelobraquial, de forma que, quanto menor foi o IR, maior o sucesso hemodinâmico obtido.

Abstract Background Revascularization surgery is used to attempt to restore blood flow to the foot in patients with critical ischemia (CI) caused by peripheral arterial occlusive disease of the lower limbs (LL). Ultrasonography with Doppler (USD) SAH emerged in recent years as a highly valuable method for planning this surgical intervention. Objectives To evaluate the relationship between the resistance index (RI), measured with USD, and immediate hemodynamic success of LL revascularization surgery in patients with CI. Methods The study design was a prospective cohort assessing 46 patients with LL CLI who underwent operations to perform infrainguinal revascularization by angioplasty or bypass from August 2019 to February 2022. All patients underwent preoperative clinical vascular assessment with USD including measurement of the RI of distal LL arteries, LL arteriography, and measurement of the ankle-brachial index (ABI). All patients had their ABI measured again in the immediate postoperative period. Results Forty-six patients were assessed, 25 (54.3%) of whom were male. Age varied from 32 to 89 years (mean: 67.83). Hemodynamic success was assessed by comparison of preoperative and postoperative ABI, showing that hemodynamic success was achieved in 31 (67.4%) patients after revascularization surgery (ABI increased by 0.15 or more). A positive correlation (p ≤ 0.05) was observed between the RI of the distal revascularized LL artery and immediate hemodynamic success assessed by ABI (lower RI and hemodynamic success). Conclusions This study observed a positive correlation between the resistance index of the distal artery and immediate hemodynamic success of lower limb revascularizations, as assessed by the ankle-brachial index, so that the lower the RI the greater the hemodynamic success achieved.

Correlação entre o índice de resistência vascular e a arteriografia na avaliação do leito arterial distal na isquemia crítica dos membros inferiores / Correlation between the vascular resistance index and arteriography for assessment of the distal arterial bed in chronic limb threatening ischemia

Resumo Contexto Pacientes com isquemia crítica (IC) dos membros inferiores (MMII) precisam de arteriografia para o planejamento da cirurgia de revascularização. A ultrassonografia Doppler (UD) não é invasiva e, através da aferição do índice de resistência (IR), pode fornecer informações sobre as artérias distais. Objetivos Correlacionar a Classificação Angiográfica de Rutherford com o IR na avaliação do leito arterial distal dos MMII. Métodos Estudo transversal, realizado em hospital público terciário, com 120 pacientes portadores de IC dos MMII, entre setembro de 2019 a abril de 2022. Foi comparado o IR das artérias da perna passíveis de serem receptoras de revascularização com a imagem obtida através da arteriografia dessas artérias em acordo com a Classificação Angiográfica de leito distal de Rutherford. Resultados Foram avaliados 120 MMII em 120 pacientes com idade média de 68,6 anos. A amostra foi composta de 50,0% de pacientes do sexo masculino. Na amostra, 90,0% pacientes encontravam-se na classe cinco de Rutherford. Os valores do IR encontrados para as artérias de perna apresentaram uma correlação positiva, estatisticamente significativa, quando comparados com a Classificação de Rutherford (tibial anterior, p< 0,01; tibial posterior, p = 0,012 e fibular, p = 0,034 e artéria dorsal do pé, p < 0,001). Conclusões Neste estudo, os IRs das artérias da perna obtidos através da ultrassonografia Doppler apresentaram uma correlação positiva quando comparados à classificação de Rutherford. Em pacientes com isquemia crítica, esse índice pode ser útil na avaliação do leito arterial distal dos membros inferiores.

Abstract Background Patients with chronic limb threatening ischemia (CLTI) of the lower limbs (LL) undergo arteriography for revascularization surgery planning. Doppler ultrasound (DU) is non-invasive and can provide information about the distal arteries through measurement of the resistance index (RI). Objectives To correlate the Rutherford Angiographic Classification with the RI for assessment of the distal arterial bed of the LL. Methods A cross-sectional study, conducted at a public tertiary hospital with 120 patients with LL CLTI, from September 2019 to April 2022. The RI of arteries that were candidates for revascularization was compared with the images of the same arteries obtained using arteriography, using the Rutherford Angiographic Classification of the distal bed. Results A total of 120 LL were assessed in 120 patients with a mean age of 68.6 years. The sample was 50.0% male and 90.0% of the patients in the sample were classified as Rutherford category five. The RI values found for the arteries of the leg exhibited a statistically significant positive correlation with the Rutherford Classification (anterior tibial, p< 0.01; posterior tibial, p = 0.012 fibular, p = 0.034; and dorsalis pedis, p < 0.001). Conclusions In this study, RIs for the arteries of the leg measured using Doppler ultrasound exhibited a positive correlation with the Rutherford Classification. This index could be useful for assessment of the distal arterial bed of the lower limbs of patients with chronic limb threatening ischemia.

Pilates vs aerobic training effects in hypertensives: randomized trial / Efectos del pilates vs entrenamiento aeróbico en hipertensos: ensayo aleatorizado / Efeitos do pilates vs treinamento aeróbio em hipertensos: ensaio randomizado

ABSTRACT Introduction: The Pilates method (PM) combines slow-deep breathing with strengthening and stretching exercises. However, it has been proposed as a method of physical conditioning for several decades and only recently aroused academic/scientific interest, with few reports of the effects of this intervention in hypertensive patients. Objective: to compare PM to aerobic training (AT) effects on hypertensive subjects' blood pressure (BP), functional capacity and autonomic balance. Methods: Twenty-four hypertensive subjects were randomly allocated into two groups: ATG performed three 40 min sessions/week, moderate intensity (40-70% of reserve HR), and PMG performed two 60 min sessions/week; both during the same eight weeks period. Blood pressure (casual and for 24 hours), 6-minute walking test (6-MWT) and autonomic balance were evaluated before and after intervention. Results: There was a reduction on systolic BP (SBP, p=0.007), diastolic (p=0.032) and mean blood pressure (MBP, p=0.016), measured on 24h, on PMG. There was also a 24h SBP reduction on ATG (p=0.021). The PMG had a greater reduction on 24h SBP (-3.4 mmHg, 95% CI -6.6 to -0.2) and MBP (-3.3 mmHg, 95% CI -6.3 to -0.3) than the ATG. ATG held a longer distance in 6-MWT. Casual BP and autonomic balance had no difference. Conclusion: This PM protocol was superior to AT on BP monitored for 24 hours in hypertensive subjects, but AT was better for functional capacity. The eight weeks of training were not enough to change the autonomic balance. Level of Evidence: I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals.

RESUMEN Introducción: el método Pilates (MP) combina la respiración lenta-profunda con ejercicios de fortalecimiento y estiramiento. Aunque se ha propuesto como un método de acondicionamiento físico durante varias décadas, solo recientemente despertó interés académico/científico, con pocos reportes de los efectos de esta intervención en pacientes hipertensos. Objetivo: comparar los efectos del MP con el entrenamiento aeróbico (EA) sobre la presión arterial (PA), la capacidad funcional y el equilibrio autónomo en sujetos hipertensos. Métodos: Veinticuatro sujetos hipertensos fueron asignados aleatoriamente en dos grupos: GEA realizó tres sesiones de 40 min/semana, intensidad moderada (40-70% de la FC de reserva), y GMP realizó dos sesiones de 60 min/semana; ambos durante el mismo período de 8 semanas. La presión arterial (casual y durante 24 horas), la prueba de marcha de 6 minutos y el equilibrio autonómico se evaluaron antes y después de la intervención. Resultados: Hubo una reducción de la PA sistólica (PAS, p = 0,007), diastólica (p = 0,032) y presión arterial media (PAM, p = 0,016), medida a las 24 h, en GMP. También hubo una reducción de PAS en 24 h en GEA (p = 0,021). El GMP tuvo una mayor reducción en la PAS de 24 h (-3,4 mmHg, CI del 95%: -6,6 a -0,2) y la PAM (-3,3 mmHg, CI del 95%: -6,3 a -0,3) que la GEA. GEA mantuvo una mayor distancia en la prueba de marcha de 6 minutos. La PA casual y el equilibrio autónomo no tuvieron diferencias. Conclusión: Este protocolo de MP fue superior al EA en la PA monitoreada durante 24 horas en sujetos hipertensos, pero el EA fue mejor para la capacidad funcional. Las ocho semanas de entrenamiento no fueron suficientes para cambiar el equilibrio autonómico. Nivel de Evidencia: I; Estudio clínico aleatorizado de alta calidad con o sin diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.

RESUMO Introdução: O método Pilates (MP) combina respiração lenta e profunda com exercícios de fortalecimento e alongamento. Embora tenha sido proposto como método de condicionamento físico por várias décadas, só recentemente despertou-se o interesse acadêmico/científico, com poucos relatos dos efeitos dessa intervenção em hipertensos. Objetivos: comparar os efeitos do MP com o treinamento aeróbio (TA) sobre a pressão arterial (PA), capacidade funcional e equilíbrio autonômico em hipertensos. Métodos: Vinte e quatro hipertensos foram alocados aleatoriamente em dois grupos: O grupo GTA realizou três sessões de 40 min/semana, intensidade moderada (40-70% da FC de reserva), e o grupo GMP, que realizou duas sessões de 60 min/semana; ambos durante o mesmo período de 8 semanas. A pressão arterial (casual e após 24 horas), o teste de caminhada de 6 minutos (TC6) e o equilíbrio autonômico foram avaliados antes e depois da intervenção. Resultados: Houve redução da PA sistólica (PAS, p = 0,007), diastólica (p = 0,032) e da pressão arterial média (PAM, p = 0,016), medida em 24h, sem GMP. Também houve redução da PAS em 24h no GTA (p = 0,021). O GMP teve uma redução maior em 24h PAS (-3,4 mmHg, IC 95% -6,6 a -0,2) e PAM (-3,3 mmHg, IC 95% -6,3 a -0,3) do que o GTA. O GTA manteve uma maior distância no TC6. A PA casual e o equilíbrio autonômico não apresentaram diferenças estatísticas. Conclusão: Este protocolo de MP foi superior ao TA na PA monitorada por 24 horas em hipertensos, porém o TA foi superior para a capacidade funcional. As oito semanas de treinamento não foram suficientes para alterar o equilíbrio autonômico. Nível de Evidência: 1; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significativa, mas com intervalos de confiança estreitos.

Hemorragia Intracerebral Imprevisible en un Hombre Joven: La Importancia de la Tomografía computarizada craneal post-mortem / Unpredictable Intracerebral Hemorrhage in a Young Male: The Importance of Post-Mortem Cranial Computed Tomography

La muerte súbita es aquella que ocurre dentro de las 24 horas posteriores al inicio de los síntomas y se caracteriza por ser clínicamente inexplicable, inesperada y repentina. Debido a la naturaleza de la muerte súbita, no es posible llegar a un diagnóstico preciso sin una autopsia. En esta comunicación breve, evaluaremos el caso de un empleado de crucero de 33 años, sin historial médico/farmacológico previo, el cual falleció súbitamente mientras reposaba en su camarote. Debido a las sospechas iniciales de una posible muerte causada por una sobredosis de cocaína, se le realizó un panel toxicológico abarcador el cual resultó negativo. Empero, una tomografía computarizada (TC) craneal sin contraste revirtió la hipótesis inicial y la autopsia neuropatológica -sorpresivamente- confirmó que la verdadera causa de muerte fue la ruptura de un aneurisma sacular desconocido en el polígono de Willis.

Sudden death occurs within 24 hours after the onset of symptoms and is characterized by being clinically inexplicable, sudden, and unexpected. Due to the nature of sudden death, it is not possible an accurate diagnosis without performing an autopsy. In this brief communication, we will evaluate the case of a 33-year-old cruise employee, with no prior medical/pharmacological history, who suddenly died while resting in his cabin. Due to initial suspicions of a possible cocaine overdose death, a comprehensive toxicology panel was performed, although yielding a negative result. A cranial computed tomography without contrast reversed the initial hypothesis and the neuropathological autopsy -surprisingly- confirmed that the true cause of death was the rupture of an unknown saccular aneurysm in the Circle of Willis.