Características y causas de muerte de pacientes fallecidos con enfermedad renal crónica. Cuba 2011-2016 / Deceased patients with chronic kidney disease. Characteristics and causes in Cuba during 2011-2016

Introducción: La morbimortalidad por enfermedad renal crónica (ERC) ha presentado en las dos últimas décadas un incremento desconcertante. En Cuba, aunque la mortalidad por esta causa ha tenido un comportamiento estable, la incidencia y la prevalencia se mantienen elevadas. Objetivo: Caracterizar los pacientes fallecidos con ERC según variables demográficas, causas de muerte y otras variables seleccionadas. Material y Métodos: Estudio descriptivo, transversal. El universo de estudio estuvo constituido por todos los fallecidos del país en el período, en cuyos certificados de defunción se incluyó entre una de las causas, la ERC. La información fue obtenida de las bases de datos de mortalidad de la Dirección Nacional de Registros Médicos y Estadísticos de Salud del MINSAP. Procesamiento de forma automatizada (SPSS versión 22.0). Fueron calculadas las frecuencias absolutas y relativas. Resultados: La frecuencia global de pacientes fallecidos se incrementó de forma mantenida y resultó mayor en la provincia La Habana (23,6 por ciento). La media de la edad fue de 70 años. Prevaleció el sexo masculino, el color de piel blanco y el grupo de edad de 80 años y más. Los porcentajes más altos según la causa básica de muerte correspondieron a enfermedad renal hipertensiva y Diabetes Mellitus. Conclusiones: Los fallecidos con ERC son mayormente hombres, de piel blanca, y con edades avanzadas. Las principales causas de muerte son la enfermedad hipertensiva y la Diabetes Mellitus(AU)

Introduction: Chronic kidney disease (CKD) has increased at an alarming rate worldwide over the last two decades. Although mortality due to CKD has registered stable behavior in Cuba, its prevalence and incidence are showing higher rates. Objective: To describe the main demographic features of deceased patients with CKD in Cuba, the causes of death and other variables during the period 2011-2016. Material and Methods: A descriptive cross-sectional study was conducted. The study universe included all deceased patients in Cuba during the period mentioned. CKD was listed on their death certificates as one of the causes of death. The information used was obtained from the mortality database available on the National Directorate of Medical Records and Health Statistics of the Cuban Ministry of Public Health. Data was processed using SPSS version 22.0. Absolute and relative frequencies were calculated. Results: The global frequency of deceased patients showed a steady increase. Havana was the city that presented the highest percentage (23,6 percent). Nonetheless, the rest of the cities showed an increased frequency rate. The median age was 70 years. The male gender prevailed over the female one as well as white ethnicity and the 80 years and over age group. Regarding the cause of death, the highest percentages corresponded to hypertensive kidney disease and Diabetes Mellitus. Conclusions: Most of the deceased patients with CKD are male, white and at advanced ages. The main causes of death are hypertensive disease and Diabetes Mellitus(AU)

Effects of hypertensive disorders of pregnancy on birth weight differences in twins / 中国新生儿科杂志

Objective:To study the effects of hypertensive disorders of pregnancy (HDP) on the birth weight (BW) differences in twins.Method:From January 2011 to January 2020, twins delivered in our hospital were retrospectively analyzed. The twins born to HDP mothers were the HDP group and those born to healthy mothers were the control group. The maternal and neonatal data of the two groups were collected and the effects of HDP on the BW differences were analyzed.Result:The age of the mothers, the proportion of mothers of older ages and more-than-once delivery in HDP group (418 cases) were significantly higher than the control group (499 cases) [(31.4±5.3) years vs. (30.4±3.8) years, 26.6% (111/418) vs. 12.6% (63/499), 20.6% (86/418) vs. (15.0% (75/499)] ( P<0.05). The gestational age (GA) of newborns in the HDP group (836 cases) was significantly lower than the control group (998 cases) [(35.1±2.2) weeks vs. (36.7±1.2)]( P<0.05). The proportion of twins with GA <34 weeks in the HDP groups was significantly higher than the control group [24.2% (101/418) vs. 3.8% (19/499)] ( P<0.05). Cesarean section was the main delivery mode in both groups. The BW differences of the twins in the HDP group were larger than the control group [22.4% (9.1%, 31.9%) vs. 13.1% (5.8%, 19.6%)]. Significantly more twins in the HDP group showed ≥30% BW difference than the control group [28.7% (120/418) vs. 3.8% (19/499)] ( P<0.05). The incidences of BW discordant in twins (BWDT) in the HDP group was significantly higher than the control group [BWDT≥15%:61.5% (257/418) vs. 38.3% (191/499), BWDT≥20%: 51.4% (215/418) vs. 25.3% (126/499)] ( P<0.05).Among twins with GA of 34~37 weeks, the BW of the bigger infants and the smaller infants in the HDP group were all lower than the control group and the percentage of BW difference was significantly higher than the control group ( P<0.05). Conclusion:HDP may influence the intrauterine growth of the twins, aggravate the BW differences and increase the incidences of BWDT. It is necessary to make better prenatal management of HDP and closely monitor the intrauterine growth of the fetuses.

Desenlace materno-fetal en pacientes con diagnóstico temprano o tardío de diabetes gestacional / Maternal and fetal outcome in early and late diagnosis of gestational diabetes

Resumen OBJETIVO: Comparar el desenlace materno y fetal en pacientes con diabetes gestacional diagnosticada en la primera y segunda mitad del embarazo. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y analítico que incluyó a todas las pacientes con diabetes gestacional tratadas en el Hospital de la Mujer de la Ciudad de México entre los meses de marzo de 2014 y diciembre de 2017. Las pacientes se dividieron en, grupo 1: diagnosticadas entre las 13 y 20.6 semanas de embarazo y grupo 2: con diagnóstico posterior. Se identificaron y compararon las principales complicaciones maternas y fetales. El análisis incluyó medidas de tendencia central, t de Student y χ2. RESULTADOS: Se incluyeron 459 pacientes; 147 embarazadas en el grupo 1 y 312 en el grupo 2. La enfermedad hipertensiva del embarazo (32.7 vs 17.6% p 0.001) y el hiper e hipotiroidismo (7.5 vs 1.6% p 0.001) fueron más frecuentes en el grupo 1. El peso al nacimiento (3054 ± 718.4 vs. 3156 ± 555.7 g. p 0.04) la talla (48.9 ± 3.49 vs 49.2 ± 2.7 cm p 0.05) y el Capurro (37.9 ± 2.5 vs 38.2 ± 1.4 semanas p 0.01) fueron mayores en los neonatos hijos de madres del grupo 2. CONCLUSIÓN: El desenlace materno y fetal de pacientes con diabetes gestacional se modifica de acuerdo con las semanas de embarazo al momento del diagnóstico; por esto debe insistirse en la detección oportuna de las complicaciones descritas con el propósito de reducir las repercusiones de la diabetes gestacional en la madre y su hijo.

Abstract OBJECTIVE: To compare the fetal maternal outcomes in patients with gestational diabetes detected in the first and second half of pregnancy. MATERIALS AND METHODS: An observational, retrospective and analytical study was carried out including all patients with gestational diabetes treated at the Women's Hospital of Mexico City in the years 2014 to 2017. Were divided into two groups, group 1 inserted those patients diagnosed between 13 and 20.6 weeks of gestation and 2 with subsequent diagnosis, the main maternal and fetal complications were identified and compared. The results analysis included central trend measures, Student's t and square Chi. RESULTS: 495 patients were included; Group 1 was composed of 147 pregnant women and group 2 of 312. Maternal complications such as hypertensive disease of pregnancy (32.7 vs 17.6% p 0.001), hyperthyroidism and hypothyroidism (7.5 vs 1.6% p 0.001) were more frequent at the group 1. The birth weight (3054 ± 718.4 vs. 3156 ± 555.7 g. p 0.04), height (48.9 ± 3.49 vs 49.2 ± 2.7 cm p 0.05) and Capurro rating (37.9 ± 2.5 vs 38.2 ± 1.4 weeks p 0.01) were greater in infants in Group 2. CONCLUSION: The maternal fetal outcome in patients with gestational diabetes are modified by gestational age at the time of diagnosis, so greater emphasis should be placed on the timely detection of these complications in order to reduce the impact of gestational diabetes in the mother's binomial.

Caracterización de la hipertensión inducida por el embarazo / Characterization of pregnancy-induced hypertension

Introducción: los trastornos hipertensivos en el curso del embarazo tienen una incidencia entre el 10 y el 15 % de las gestantes a término, lo que constituye una causa significativa de morbilidad y mortalidad materna y fetal. Objetivo: caracterizar a las pacientes con enfermedad hipertensiva durante el embarazo en las mujeres del Consultorio 85-02 de Villa 1 perteneciente al Policlínico Docente "Julio Antonio Mella" en el período comprendido del 1ro. de enero de 2008 al 31 de diciembre de 2011. Métodos: se realizó un estudio descriptivo, prospectivo, longitudinal. La muestra estuvo constituida por 73 gestantes. Resultados: desarrollaron preeclampsia el 5,9 % de las adolescentes, el 28,6 % de las pacientes con edad mayor o igual a los 35 años, el 10,3 % de nulíparas y el 14,3 % de gestantes con sobrepeso corporal. Hubo solo el 2,7 % de morbilidad materna y el 9,5 % de los recién nacidos presentó morbilidad, aunque ninguno correspondió a pacientes con preeclampsia. Se presentó la preeclampsia en solo 6 pacientes. Conclusiones: la adolescencia, la nuliparidad, la obesidad y el bajo peso no fueron factores predominantes en el desarrollo de la enfermedad hipertensiva inducida por el embarazo en este estudio.

Introducción: hypertensive disorders during pregnancy have an incidence from 10 to 15 % of pregnant women a term, which is a significant cause of maternal morbidity and fetal mortality. Objective: to characterize patients with hypertensive disease during pregnancy in women at medical practice 85-02 Villa 1 from Julio Antonio Mella Polyclinic from January 1st, 2008 to December 31st, 2011. Methods: a descriptive, prospective, longitudinal study was conducted. The sample consisted of 73 pregnant women. Results: 5.9 % of adolescents developed preeclampsia, 28.6 % of patients aged 35 or older, 10.3 % were nuliparous, and 14.3 % of pregnant women had excess body weight. There were only 2.7 % of maternal morbidity and 9.5 of infnts presented morbidity, although none corresponded to patients with preeclampsia. Only 6 patients had preeclampsia. Conclusions: adolecence, nuliparity, obesity, and underweight were not predominant factors in the development of hypertemnsive pregnant-induced disease in this study.

Caracterización de la enfermedad hipertensiva gestacional en pacientes de la Policlínica Máximo Gómez Báez / Gestational Hypertensive Disease Characterization in Patients of Máximo Gómez Báez Polyclinic

Introducción: los estados hipertensivos del embarazo son una de las complicaciones con mayor repercusión en la salud materna. Objetivo: caracterizar el comportamiento de la enfermedad hipertensiva gestacional en pacientes de la Policlínica Máximo Gómez Báez en Holguín durante el año 2009. Métodos: se realizó un estudio de serie de casos sobre el comportamiento de la enfermedad hipertensiva gestacional. El universo estuvo constituido por 35 gestantes que presentaron la enfermedad en el año objeto de estudio y la muestra por 28 embarazadas que recibieron atención prenatal en el área de salud referida. La información se obtuvo mediante la revisión de los registros estadísticos del Programa Materno Infantil y las historias clínicas obstétricas. Se interrogó además a las pacientes sobre los factores de riesgo asociados con la enfermedad hipertensiva del embarazo. Resultados: predominaron las edades de las gestantes de más de 36 años en un 46,42% y factores maternos asociados como: antecedentes patológicos personales de hipertensión arterial crónica en el 39,28% de los casos y la nuliparidad en el 42,85%. La enfermedad apareció con el 60,71% en el tercer trimestre de la gestación. El nivel de conocimiento de las gestantes estudiadas sobre la enfermedad se evaluó de regular en el 53,57% de las pacientes. Conclusiones: la enfermedad hipertensiva gestacional apareció con mayor frecuencia en el tercer trimestre del embarazo y en mujeres mayores de 36 años, donde la hipertensión arterial crónica y la nuliparidad constituyeron factores asociados con esta enfermedad.

Introduction: the pregnancy hypertensive states are complications of more repercussion in the maternal health. Objective: to characterize the behavior of gestational hypertensive disease in patients of Maximo Gomez Baez Polyclinic in Holguin. Methods: a case series study on the gestational hypertensive disease behavior it carried out. The universe comprised 35 pregnant women with the disease and the sample 28 of them, who received prenatal care in their health area. The statistical registrations of the Maternal Program and the obstetric clinical histories proportioned the necessary information. The patients were interviewed on the risk factors associated with gestational hypertensive disease. Results: pregnant women over 36 years prevailed (46. 42%) and associated maternal factors such as medical history of chronic hypertension in 39.28% of cases and nulliparity in 42.85 % of them. The illness appeared in the third trimester of the gestation in 60.71% of women. The women´s level of knowledge on the disease was medium in 53.57% of them. Conclusions: gestational hypertensive disease frequently appeared in the third trimester of pregnancy and in women over 36 years, where chronic hypertension and nulliparity.constituted factors associated with this disease.

Enfermedad hipertensiva del embarazo y el calcio / Pregnancy hypertensive disease related to calcium

Actualmente se pueden esperar cifras mundiales de preeclampsia de 143 667 casos y 431 000 de gestosis grave, muertes maternas mundiales de 20 000 pacientes y hasta 86 000 muertes perinatales. Esta afección es responsable de complicar entre el 2 y el 8 por ciento de los embarazos. En países desarrollados, la eclampsia es rara y afecta alrededor de 1 por cada 2 000 partos, mientras que en los países en vías de desarrollo esta cifra varía desde 1 en 100 hasta 1 en 1700. La hipertensión inducida por el embarazo es un factor mayor en la morbilidad y mortalidad materna y perinatal. Aunque esta enfermedad es relativamente común, su etiopatogenia es desconocida. Nuevas evidencias epidemiológicas, experimentales y clínicas en personas no embarazadas y en embarazadas, indican que el calcio puede desempeñar un rol importante en la regulación de la presión arterial. Son muchos los autores que señalan la importancia de suministrar el calcio durante el embarazo como elemento preventivo de la hipertensión arterial

Nowadays, it is possible to expect world figures of pre-eclampsia of 143 667 cases and 431 000 severe gestosis, global mother deaths of 20 000 patients and up to 86 000 perinatal deaths. This affection accounts for the complication between the 2 and the 8 percent of pregnancies. In developed countries, the pre-eclampsia is a rare entity and involves about 1 per each 2 000 labors, whereas in the developing ones, this figure fluctuates from 1 in 100 up to 1 in 1700. The high blood pressure induced by pregnancy is a major factor in the mother and perinatal morbidity and mortality. Although this disease is relatively common, its pathogenesis is unknown. New epidemiologic, experimental and clinical evidences in pregnant and non pregnant persons, suggest that calcium may play a significant role in the regulation of the blood pressure. Many authors emphasize on the significance of to supply calcium during the pregnancy as a preventive element of the high blood pressure

Algunos factores biosociales y obstétricos de la enfermedad hipertensiva gravídica en el Hospital de Chitungwiza, Zimbabwe / Some biosocial and obstetric factors of gestational hypertensive disease in Chitungwiza Hospital, Zimbabwe

Se efectuó un estudio descriptivo y transversal de 181 gestantes con enfermedad hipertensiva, atendidas por los médicos cubanos en el Hospital de Chitungwiza en Zimbabwe, desde enero hasta diciembre del 2007, a fin de caracterizarles según algunos factores biosociales y obstétricos. Predominaron las embarazadas con edades entre 20-24 años y la preeclampsia, eclampsia e hipertensión crónica como formas de la hipertensión arterial, así como las captaciones tardías, la nuliparidad y el bajo peso al nacer. Se recomendó realizar estudios en otros hospitales de ese país para profundizar en las manifestaciones de este indicador y poder establecer estrategias de intervención comunitaria que disminuyan la morbilidad y mortalidad

hA descriptive and cross-sectional study was carried out in 181 pregnant women with hypertensive disease, attended by Cuban doctors at the Hospital of Chitungwiza in Zimbabwe, from January to December 2007, in order to characterize them according to some biosocial and obstetric factors. Pregnant woman between 20-24 years and preeclampsia, eclampsia and chronic hypertension as forms of arterial hypertension predominated as well as late recruitment of women, nuliparity and low birth weight. It was recommended to carry out studies in other hospitals of that country to increase knowledge of manifestations of this condition and to draw up strategies of community intervention that reduce morbidity and mortality

Inflnence of Benazepril combined with jinshuibao capsules on the furction of patients with lyperlensive renal disease / 中国基层医药

Objective To observe influence of Benazepril combined with Jinshuibao capsules on urine protein and Ccr in patients hypertensive renal disease. Methods 47 hypertensive renal disease patients were randomly divided into control group and combine group. Patients in control group were treated with Benazepril, while patients in combined group were treated Jinshuibao plus Benazepril. Clinic index change after treatment for 9 weeks was observed, and calculation endogenous creatinine clearance rate was calculated. Results After treatment for 9 weeks urine protein in 24 hours of two groups were both lower than before( t1 = 1. 9997 ,t2 = 3.3088 ,P ＜ 0. 05 or P ＜ 0. 01 ),while the endogenous creatinine clearance rate were both higher than before ( t1 = 1. 3990, t2 = 1. 4442, P ＞ 0. 05 ), and the press were all in improvment ( t1 = 2.0047, t2 = 2.4557, t3 = 2.0426, t4 = 2.4026, P ＜ 0. 05 ); urine protein in 24 hours of combine group was lower than control group( t = 2.0015,P ＜ 0. 05) Conclusion Benazepril plus Jinshuibao capsules could obviously abate urine protein on patients with hypertensive disease and hypertensive renal disease

Clinical Epidemiological Investigation and Research of Main Symptoms and Pulses of Excessive Rising of Liver Yang in Hypertensive Disease / 中国中医药信息杂志

Objective To approach the main symptoms and pulses of excessive rising of live yang in hypertensive disease. Method The symptoms and pulses of excessive rising of liver yang in hypertensive disease were collected through clinical epidemiology. The frequency of single symptom and pulse or their combinating group was statistical analyzed by multiple factor cluster analysis and principal component analysis. Result Such symptoms and pulses as lightheadedness,headache,distention of head,tantrum,insomnia,dizzy,bitter taste of mouth,red tongue,yellow tongue fur and string pulse not only can reflect the main pathogenesis,but also are the most frequently occurring reflection. Conclusion Symptoms and pulses above are the differentiation of symptoms and signs standard for excessive rising of liver yang in hypertensive disease.

Studying the Related Factors of Left Ventricular Hypertrophy for Hypertensive Disease / 中国医师杂志

Objective Studying the related factors of left ventricular hypertrophy for hypertensive disease, to provide the basis for clinical treatment. HZ Methods 500 hypertensive disease patients were performed dynamic monitoring of blood pressure and UCG. Then 130 patients with left ventricular hypertrophy were compared the dynamic blood pressure, age, sex and diseases course with 130 patients who had not left ventricular hypertrophy. Results (1) Systolic pressure, the load and the night descent rate of systolic pressure were significantly related to left ventricular hypertrophy, there was obviously difference in two groups. To the patients with systolic pressure and diastolic pressure were all increased, the incidence rate of left ventricular hypertrophy was reduced. (2) The age of left ventricular hypertrophy group was higher than no left ventricular hypertrophy group. (3) The female's incidence rate of hypertensive disease in left ventricular hypertrophy group was higher than no left ventricular hypertrophy group. (4) The course of diseases in left ventricular hypertrophy group was extended than no left ventricular hypertrophy group. The incidence rate of left ventricular hypertrophy was obviously higher in the patients whose blood pressure was increased in the daytime. Conclusion (1) The pulse pressure is a important forecast factor in numerous risk factor. (2) The advanced age is a risk factor to hypertensive disease. (3) The female hypertensive disease patients take place left ventricular hypertrophy is easier than the male. (4) Left ventricular hypertrophy is significantly related to hypertensive disease course, and isn't significantly related to blood pressure's durative. The clinic must think highly of observing and evaluating the pulse pressure, the long disease course of old female patients. There is important clinical significance to reinforce monitoring the risk factor of left ventricular hypertrophy, and to perform pertinent treatment and prevention for the high risk patients.

A SMR study of Korean public servants / 예방의학회지

In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U.N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for workmen(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade of workmen was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for 'cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.