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1.
Revista Digital de Postgrado ; 9(1): e189, 2020. tab
Article in Spanish | LILACS (Americas), LIVECS | ID: biblio-1095033

ABSTRACT

Evaluar el impacto educativo en pacientes con Diabetes Mellitus tipo 2 (DMT2) e Hipertensión arterial (HTA), y su efecto en la calidad de vida. Métodos: Se realizó un estudio intervención en comunidad, en pacientes con diagnóstico de DMT2 e HTA, en la consulta de Medicina Interna. Resultados: Participaron 314 pacientes, distribuidos en un grupo estudio (n = 160) y grupo control (n = 154). Sin diferencias en edad (p = 0,491) y sexo (p = 0,747). En la calidad de vida de pacientes DM entre pre y post charla, en cada grupo, sin diferencias entre grupos en pre-charla (p = 0,869), pero sí en post-charla (p = 0,001), siendo calidad de vida más alta en el grupo estudio (98,2%) que en grupo control (76,9%). Al evaluar los cambios entre pre y post charla, se observó que pre charla en el grupo estudio tuvo 86% de alta calidad de vida, posterior aumentó a 98,2%, cambio estadístico (p = 0,008), en grupo control en cambio, la calidad de vida pre charla fue 87% pasó a 76,9% posterior a ésta, aun así, fue un cambio significativo (p = 0,025) La calidad de vida en HTA, sin diferencias en pre y post charla. La comparación entre pre charla y post charla, en el grupo estudio, no tuvo cambios (p = 0,157) como igualmente en el grupo control (p = 0,317). Conclusiones: Se demostró el impacto positivo de un plan educativo en calidad de vida de los pacientes con diabetes, mas no en pacientes hipertensos(AU)


To evaluate the educational impact in patients with Type 2 Diabetes Mellitus (T2DM) and arterial hypertension (AHT), and its effect on quality of life. Methods: A community intervention study was carried out in patients diagnosed with T2DM and HBP in the Internal Medicine department. Results: 314 patients participated, distributed in a study group (n = 160) and control group (n = 154). No differences in age (p = 0.491) and sex (p = 0.747). In the quality of life of DM patients between pre and post talk, in each group, without differences between groups in pre-talk (p = 0.869), but in post-talk (p = 0.001), with higher quality of life in the study group (98.2%) than in the control group (76.9%). When evaluating the changes between pre and post talk, it was observed that pre-talk in the study group had 86% of high quality of life, later it increased to 98.2%, statistical change (p = 0.008), in control group instead, Pre-chat quality of life was 87%, after 76.9%, it was still a significant change (p = 0.025) Quality of life in HTA, without differences in pre and post talk. The comparison between pre-talk and post-talk, in the study group, did not change (p = 0.157) as well as in the control group (p = 0.317). Conclusions: The positive impact of an educational plan on the quality of life of diabetic patients was demonstrated, but not in hypertensive patients(AU)


Subject(s)
Quality of Life , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/prevention & control , Hypertension/complications , Hypertension/diagnosis , Hypertension/prevention & control , Health Programs and Plans , Patient Education as Topic , Control Groups , Surveys and Questionnaires/statistics & numerical data , Disease Progression
2.
Arch. argent. pediatr ; 117(6): S205-S242, dic. 2019. tab, graf
Article in Spanish | LILACS (Americas), BINACIS | ID: biblio-1051592

ABSTRACT

La enfermedad cardiovascular secundaria a aterosclerosis es la principal causa de morbimortalidad en la población adulta a nivel mundial. Aunque las manifestaciones clínicas de aterosclerosis (enfermedad coronaria, accidente cerebrovascular y arteriopatía periférica) son excepcionales en la población pediátrica, la presencia de factores de riesgo para enfermedad cardiovascular, así como la adquisición de hábitos que favorecen su desarrollo, se observan ya desde edades tempranas. En el presente documento, se elaboraron recomendaciones, con dos objetivos principales: prevenir la aparición de factores de riesgo para enfermedad cardiovascular (prevención primordial) y detectar y tratar los que favorecen el desarrollo de aterosclerosis clínica (prevención primaria). Si bien las recomendaciones están dirigidas a la población pediátrica, el objetivo del trabajo conjunto de la Sociedad Argentina de Pediatría y la Sociedad Argentina de Cardiología es asegurar un abordaje integral y consensuado de la prevencion cardiovascular a lo largo de toda la vida, incluso, desde antes de la concepción.


Cardiovascular disease secondary to atherosclerosis is the leading cause of morbimortality in the adult population worldwide. Although clinical manifestations of atherosclerosis (coronary heart disease, stroke and peripheral vascular disease) are extremely rare in the pediatric population, the presence of risk factors for cardiovascular disease and the development of health-behavior patterns that promote them are observed since early childhood.In this document, recommendations were developed addressing two main goals: prevention of the risk factors development for cardiovascular disease (primordial prevention) and early detection and treatment of the risk factors to prevent clinical atherosclerosis (primary prevention). Even though the recommendations are addressed to the pediatric population, the aim of the collaborative work between the Sociedad Argentina de Pediatría and the Sociedad Argentina de Cardiología is to ensure a comprehensive and consensual approach of lifetime cardiovascular prevention beginning even before conception.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Primary Prevention/methods , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Exercise , Tobacco Use Disorder/prevention & control , Risk Factors , Substance-Related Disorders/prevention & control , Alcohol-Related Disorders/prevention & control , Metabolic Syndrome , Diabetes Mellitus, Type 2 , Dyslipidemias/diagnosis , Dyslipidemias/drug therapy , Overweight/prevention & control , Sedentary Behavior , Diet, Food, and Nutrition , Hypertension/diagnosis , Hypertension/prevention & control , Hypertension/therapy , Medical History Taking , Obesity/prevention & control
3.
J. bras. nefrol ; 41(4): 564-569, Out.-Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1056599

ABSTRACT

ABSTRACT Takayasu arteritis (TA) is a chronic granulomatous inflammatory condition of unknown cause that involves large vessels - particularly the aorta and its branches - such as the carotid, coronary, pulmonary, and renal arteries. The left subclavian artery is the most frequently involved vessel. Stenosis of the renal artery has been reported in 23-31% of the cases and may result in malignant hypertension, ischemic renal disease, decompensated heart failure, and premature death. Involvement of both renal arteries is uncommon. Early onset anuria and acute kidney injury are rare and have been reported only in a few cases in the literature. This report describes the case of a 15-year-old female with constitutional symptoms evolving for a year, combined with headache, nausea, and vomiting, in addition to frequent visits to emergency services and insufficient clinical examination. The patient worsened significantly six months after the onset of symptoms and developed acute pulmonary edema, oliguria, acute kidney injury, and difficult-to-control hypertension, at which point she was admitted for intensive care and hemodialysis. Initial ultrasound examination showed she had normal kidneys and stenosis-free renal arteries. The patient was still anuric after 30 days of hospitalization. A biopsy was performed and revealed her kidneys were normal. Computed tomography angiography scans of the abdominal aorta presented evidence of occlusion of both renal arteries. The patient met the diagnostic criteria for Takayasu arteritis and had a severe complication rarely described in the literature: stenosis of the two renal arteries during the acute stage of ischemic renal disease.


RESUMO A Arterite de Takayasu (AT) é uma doença inflamatória crônica, granulomatosa, de causa desconhecida, que afeta grandes vasos, principalmente a aorta e seus ramos, incluindo artérias carótidas, coronárias, pulmonares e renais, sendo a artéria subclávia esquerda o vaso mais acometido. A estenose da artéria renal é relatada em 23-31% dos casos e pode resultar em hipertensão maligna, insuficiência renal por isquemia, descompensação cardíaca e morte prematura. O acometimento bilateral de artérias renais é incomum, sendo rara a presença de anúria súbita e lesão renal aguda como sintoma inicial da doença, com poucos relatos na literatura. O caso reporta uma adolescente de 15 anos com sintomas constitucionais durante um ano de evolução, associados a problemas como cefaleia, náuseas e vômitos, com idas frequentes a serviços de emergência, sem adequada investigação clínica. Após 6 meses do início dos sintomas, a paciente evoluiu de forma grave, com quadro de edema agudo de pulmão, oligúria, lesão renal aguda e hipertensão arterial de difícil controle, sendo necessário suporte em Unidade de Terapia Intensiva e hemodiálise. A ultrassonografia inicial mostrava rins normais e artérias renais sem sinais de estenose. Após 30 dias de internamento, paciente permanecia anúrica, sendo realizada biópsia renal que se mostrou dentro dos padrões da normalidade. Angiotomografia de aorta abdominal evidenciou oclusão bilateral de artérias renais. A paciente descrita fechou critérios diagnósticos para arterite de Takayasu e manifestou uma complicação grave pouco descrita na literatura: estenose bilateral de artérias renais, ainda na fase aguda da nefropatia isquêmica.


Subject(s)
Humans , Female , Adolescent , Renal Artery Obstruction/complications , Acute Kidney Injury/diagnosis , Oliguria/diagnosis , Oliguria/etiology , Pulmonary Edema/diagnosis , Pulmonary Edema/etiology , Acute Disease , Renal Dialysis/methods , Kidney Transplantation/methods , Treatment Outcome , Takayasu Arteritis/complications , Diagnosis, Differential , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Hypertension/diagnosis , Hypertension/etiology
4.
Nursing (Säo Paulo) ; 22(259): 3405-3411, dez.2019.
Article in Portuguese | BDENF, LILACS (Americas) | ID: biblio-1088022

ABSTRACT

Objetivo: Identificar a melhor evidência científica sobre a correta aferição da pressão arterial. Métodos: revisão sistematizada da literatura com levantamento em ambiente virtual no período de setembro a dezembro de 2016, com textos publicados nas bases virtuais LILACS, PubMed, SciELO e Scopus. O material foi lido e as informações organizadas em quadro. Resultados: foram obtidos 12 artigos, oito abordavam a técnica de aferição em dois tempos, dois discutiram a eficácia de valores obtidos com aparelhos digitais, um debateu a eficácia do rastreômetro, e um comparou a aferição invasiva e não invasiva. Conclusão: o método indireto auscultatório é o mais utilizado para aferição de pressão arterial. Nesse procedimento inclui-se a técnica em dois tempos, considerada padrão ouro na acurácia dos valores e recomendada por normatizações. Recursos como aparelho digital e rastreômetro não apresentam a mesma acurácia, porém são importantes no diagnóstico da hipertensão. São alternativas para garantir a confiabilidade da medida das cifras: estabelecer protocolos para o procedimento, fornecer equipamentos adequados e educação continuada.(AU)


Objective: To identify the best scientific evidence on the correct measurement of arterial pressure. Methods: Systematic review of the literature with a virtual environment survey from September to December 2016, with texts published in the virtual databases LILACS, PubMed, SciELO and Scopus. The material has been read, and the information organized in frame. Results: Twelve articles were obtained, eight were on the technique of measurement in two times, two discussed the effectiveness of values obtained with digital devices, one discussed the effectiveness of the trace meter, and one compared the invasive and noninvasive measurement. Conclusion: the indirect auscultatory method is the most used for blood pressure measurement. This procedure includes the two-stroke technique, considered gold standard in the accuracy of values and recommended by standardization. Features such as digital apparatus and tracker do not present the same accuracy, but are important in the diagnosis of hypertension. They are alternatives to guarantee the reliability of the measurement of the numbers: to establish protocols for the procedure, to provide adequate equipment and continuous education.(AU)


Objetivo: conocer cuáles son las recomendaciones de las literaturas actuales para la correcta medición de la presión arterial sistémica. Metodo: revisión sistematizada de la literatura con levantamiento en ambiente virtual en el período de septiembre a diciembre de 2016, con textos publicados en las bases virtuales LILACS, PubMed, Scielo y Scopus. El material fue leído, y la información organizada en cuadro. Resultados: se obtuvieron 12 artículos, ocho abordaban la técnica de medición en dos tiempos, dos discutieron la eficacia de valores obtenidos con aparatos digitales, un debatió la eficacia del rastreo, y uno comparó la aferencia invasiva y no invasiva. Conclusión: el método indirecto auscultatorio es el más utilizado para la medición de la presión arterial. En este procedimiento se incluye la técnica en dos tiempos, considerada patrón oro en la exactitud de los valores y recomendada por normatizaciones. Los recursos como el dispositivo digital y el rastreo no presentan la misma exactitud, pero son importantes en el diagnóstico de la hipertensión. Son alternativas para garantizar la confiabilidad de la medida de las cifras: establecer protocolos para el procedimiento, suministrar equipos adecuados y educación continuada.(AU)


Subject(s)
Humans , Blood Pressure Determination , Blood Pressure Monitors , Arterial Pressure , Hypertension/diagnosis , Hypertension/prevention & control
5.
J. bras. nefrol ; 41(3): 400-411, July-Sept. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1040253

ABSTRACT

Abstract Hypertension (blood pressure > 140/90 mm Hg) is very common in patients undergoing regular dialysis, with a prevalence of 70-80%, and only the minority has adequate blood pressure (BP) control. In contrast to the unclear association of predialytic BP recordings with cardiovascular mortality, prospective studies showed that interdialytic BP, recorded as home BP or by ambulatory blood pressure monitoring in hemodialysis patients, associates more closely with mortality and cardiovascular events. Although BP is measured frequently in the dialysis treatment environment, aspects related to the measurement technique traditionally employed may be unsatisfactory. Several other tools are now available and being used in clinical trials and in clinical practice to evaluate and treat elevated BP in chronic kidney disease (CKD) patients. While we wait for the ongoing review of the CKD Blood Pressure KIDGO guidelines, there is no guideline for the dialysis population addressing this important issue. Thus, the objective of this review is to provide a critical analysis of the information available on the epidemiology, pathogenic mechanisms, and the main pillars involved in the management of blood pressure in stage 5-D CKD, based on current knowledge.


Resumo A hipertensão (pressão arterial > 140/90 mmHg) é muito comum em pacientes submetidos à diálise regular, com uma prevalência de 70-80%, e apenas a minoria tem controle adequado da pressão arterial (PA). Em contraste com a associação incerta entre de PA pré-dialítica com mortalidade cardiovascular, estudos prospectivos mostraram que a PA interdialítica, registrada como PA domiciliar ou pela monitorização ambulatorial da pressão arterial em pacientes em hemodiálise, está mais relacionada à mortalidade e eventos cardiovasculares. Embora a PA seja medida com frequência no ambiente de tratamento de diálise, aspectos relacionados à técnica de medição tradicionalmente empregada podem ser insatisfatórios. Várias outras ferramentas estão agora disponíveis, e estão sendo usadas em ensaios clínicos e na prática clínica para avaliar e tratar a PA elevada em pacientes com doença renal crônica (DRC). Enquanto esperamos pela revisão das diretrizes do KIDGO para a pressão sanguíneana DRC, não há nenhuma diretriz para a população em diálise abordando essa importante questão. Assim, o objetivo desta revisão é fornecer uma análise crítica das informações disponíveis sobre a epidemiologia, os mecanismos patogênicos e os principais pilares sustentadores do manejo da pressão arterial no estágio 5-D da DRC, com base no conhecimento atual.


Subject(s)
Humans , Peritoneal Dialysis , Hypertension/therapy , Hypertension/epidemiology , Prevalence , Risk Factors , Blood Pressure Monitoring, Ambulatory , Diet, Sodium-Restricted , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/therapy , Hypertension/diagnosis , Hypertension/physiopathology , Antihypertensive Agents/therapeutic use
6.
Rev. medica electron ; 41(4): 899-913, jul.-ago. 2019. tab
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1094097

ABSTRACT

RESUMEN Introducción: la diabetes mellitus es un trastorno metabólico caracterizado por hiperglucemia crónica con alteraciones en los carbohidratos, grasas y proteínas. Las tasas de morbimortalidad han aumentado al igual que la obesidad, constituye un problema de salud en el mundo, Cuba y la provincia de Matanzas. Objetivo: realizar una caracterización clínica epidemiológica de la diabetes mellitus tipo 2 en dos áreas de salud, conocer las variables e identificar las barreras para una posterior intervención. Materiales y métodos: se realizó un estudio epidemiológico descriptivo- transversal a 750 diabéticos tipo 2 mayores de 18 años en dos áreas de salud. Se realizaron encuestas, procesándose en el programa Epi-Info, obteniéndose la frecuencia de las variables, y las diferencias estadísticas significativas entre variables de las dos aéreas de salud, utilizándose el valor de p < 0,05 % y el Chi2. Resultados: el promedio de edad fue de 62,2 años, predominio del sexo femenino y color de la piel blanca. La hipertensión arterial y la obesidad fueron las enfermedades más asociadas, y el tabaquismo, la ingestión de bebidas alcohólicas y azucaradas, y la no realización de ejercicios físicos fueron los factores asociados más relevantes. Los medicamentos más utilizados fueron la glibenclamida y la metformina. Conclusiones: la diabetes mellitus es la primera causa de fracaso renal en el mundo occidental, siendo la insuficiencia renal una de las complicaciones crónicas más graves de esta enfermedad. Entre las principales causas de muerte de esta enfermedad son las complicaciones macrovasculares, manifestadas clínicamente como cardiopatía isquémica, insuficiencia cardíaca, la enfermedad vascular cerebral y la insuficiencia arterial periférica.


ABSTRACT Introduction: diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with alterations in carbohydrates, fats and proteins. Morbi-mortality rates have increased as have done obesity, being a health problem in the world, Cuba and the province of Matanzas. Objective: to carry out clinical-epidemiological characterization of type 2 diabetes mellitus in two health areas, knowing the variables and identifying the barriers for a subsequent intervention. Materials and methods: a cross-sectional descriptive study was carried out in 750 type-2 diabetic patients over 18 years in two health areas. Surveys were made and processed in Epi-Info program, showing significant statistic differences among variables of both health areas; p < 0,05 % value and Chi2 were used. Results: the average age was 62.2 years, predominating female sex and white skin color. The most commonly associated diseases were arterial hypertension and obesity; smoking and drinking alcoholic and sugar-sweetened beverages and sedentary life were the most relevant associated factors. The most commonly used medications were glibenclamide and metformin. Conclusions: diabetes is the first cause of renal failure in the Western world, being renal insufficiency one of the most serious chronic complications of this disease. The main causes of death of this disease are macro vascular complications clinically manifested as ischemic heart disease, heart failure, cerebra-vascular disease and peripheral arterial insufficiency.


Subject(s)
Humans , Adult , Risk Factors , Glyburide/therapeutic use , Diabetes Mellitus/diagnosis , Diabetes Mellitus/etiology , Diabetes Mellitus/mortality , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Metformin/therapeutic use , Tobacco Use Disorder/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Myocardial Ischemia/mortality , Stroke/mortality , Alcoholism/diagnosis , Renal Insufficiency/complications , Sedentary Behavior , Peripheral Arterial Disease/mortality , Heart Failure/mortality , Hypertension/diagnosis , Obesity/diagnosis
7.
Rev. medica electron ; 41(4): 940-958, jul.-ago. 2019.
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1094100

ABSTRACT

RESUMEN El síndrome de ovario poliquístico se ha convertido en un problema de salud pública, siendo el más común de los desórdenes endocrinos en mujeres en edad reproductiva con estudios que reportan una prevalencia de hasta un 21%. El diagnóstico de esta entidad es importante debido a que representa riesgos metabólicos, cardiovasculares y afecta la capacidad reproductiva de estas pacientes. Se realizó una revisión bibliográfica de los principales artículos relacionados sobre el tema, resumiendo los aspectos fundamentales de este problema de salud.


ABSTRACT Polycystic ovary syndrome has become a public health problem, being the most common of the endocrine disorders in reproductive-age women, with studies reporting prevalence by 21 %. The diagnosis of this entity is important because it represents metabolic and cardiovascular risk, and affects the reproductive capacity of these patients. The authors carried out bibliographic review of the main articles related with the theme, summarizing the basic aspects of this health problem.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Polycystic Ovary Syndrome/diagnostic imaging , Preventive Health Services , Cardiovascular Diseases/diagnosis , Disease Management , Metabolic Syndrome/diagnosis , Endocrine System Diseases/diagnosis , Disease Prevention , Reproductive Health , Healthy Lifestyle , Genitalia/physiopathology , Insulin Resistance , Ultrasonography , Hirsutism/diagnosis , Hypertension/diagnosis , Menstruation Disturbances/diagnosis , Obesity/diagnosis
8.
Rev. cient. Esc. Univ. Cienc. Salud ; 6(1): 21-28, ene.-jun. 2019. graf
Article in Spanish | LILACS (Americas) | ID: biblio-1023727

ABSTRACT

La hipertensión es una causa mayor de discapacidad y muerte a nivel mundial. El conocimiento de los pacientes es un factor importante para modificar conceptos erró-neos y el riesgo que constituye la hiperten-sión como condicionante de daño cardiovas-cular. Objetivo: Describir los conocimientos, actitudes y prácticas de pacientes hiperten-sos de la comunidad de San José de Boque-rón, San Pedro Sula, julio del 2018. Pacien-tes y Métodos: Estudio descriptivo de corte transversal cuantitativo. La muestra fue de 30 pacientes con hipertensión arterial, seleccionados a través de muestreo no probabilístico por conveniencia. La recolec-ción de datos se realizó mediante una encuesta aplicada a pacientes hipertensos que cumplían con criterios de inclusión y contaban con un consentimiento informado. Los datos se tabularon mediante Microsoft Excel 2016. Resultados: 76.7% de los pacientes eran mujeres y 64% tenía más de 60 años. El 50% de los pacientes conocía sobre hipertensión arterial, 56.7% refieren que los tratamientos caseros superan a los medicamentos. Un 10% considera que el consumo de sal era mayor del requerimiento diario. El 36.7% no sigue ninguna dieta y 60% no realiza al menos 30 minutos de ejer-cicio diario. Conclusión: El conocimiento en la población de la comunidad de San José de Boquerón fue adecuado, sin embargo, el conocimiento sobre la hipertensión arterial y los parámetros normales de presión arterial sigue siendo insatisfactorios. Hay una acti-tud positiva de los pacientes sobre asistir a consulta con un médico y mayor confianza en la medicina alternativa que en los farma-cos. El mayor déficit fue encontrado en las prácticas de dieta y ejercicio...(AU)


Subject(s)
Humans , Male , Female , Aged , Health Knowledge, Attitudes, Practice , Patient Education as Topic , Hypertension/diagnosis , Informed Consent
9.
Med. infant ; 26(2): 177-188, Junio 2019. Tab
Article in Spanish | LILACS (Americas) | ID: biblio-1021533

ABSTRACT

El rotular a un niño o adolescente de hipertenso no es una tarea fácil en la actualidad. Sabemos que el pilar para el diagnóstico de Hipertensión Arterial sigue siendo la presión arterial de consultorio; pero tenemos que tener en cuenta que, por su escasa reproducibilidad éste método tiene limitaciones. Hoy existen métodos complementarios reproducibles, validados y confiables como el Monitoreo Ambulatorio de la Presión Arterial (MAPA) y el Monitoreo Domiciliario de la Presión Arterial (MDPA) menos difundido en pediatría, que nos ayudan a llegar a un diagnostico correcto (AU)


Diagnosis of a hypertensive child or adolescent is not an easy task today. We know that the mainstay for diagnosing arterial hypertension remains the measuring of blood pressure at the office; however, it is necessary to bear in mind that, because of its low reproducibility, this method has limitations. Today there are reproducible, validated, and reliable complementary methods, such as ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), that are less widespread in pediatrics, which may be helpful to make an adequate diagnosis.(AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Argentina/epidemiology , Blood Pressure Monitoring, Ambulatory/instrumentation , Hypertension/diagnosis , Hypertension, Pulmonary/drug therapy
10.
Rev. cuba. inform. méd ; 11(1)ene.-jun. 2019. tab, graf
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1093306

ABSTRACT

La prevención de la hipertensión arterial no siempre es trasladada a la edad pediátrica y muchos de los algoritmos de clasificación aplicados a su diagnóstico no ofrecen información relevante. El objetivo del presente trabajo es diagnosticar el riesgo de hipertensión arterial en niños mediante el empleo de sistemas neuroborrosos. Fueron aplicados tres sistemas neuroborrosos al diagnóstico de esta enfermedad y los datos de experimentación fueron obtenidos por el proyecto PROCDEC de escolares en Santa Clara, Cuba. Se analizaron 24 variables en 624 niños de 8 a 11 años, clasificados en normotensos y en riesgo de padecer hipertensión. Tras aplicar los sistemas neuroborrosos de estudio, se evaluó el desempeño de cada uno de ellos y se analizaron las reglas generadas durante el entrenamiento del mejor. Fue determinado que con el algoritmo NSLV se obtienen un conjunto de reglas que facilitan el diagnóstico del riesgo de hipertensión arterial en niños(AU)


The prevention of arterial hypertension is not always transferred to the pediatric age and many of the classification algorithms applied to its diagnosis do not offer relevant information. The aim of this paper is to diagnose the risk of hypertension in children using neurofuzzy systems. Three neurofuzzy systems were applied to the diagnosis of this disease and the experimental data were obtained by the PROCDEC project of schoolchildren in Santa Clara, Cuba. Twenty-four variables were analysed in 624 children from 8 to 11 years old, classified as normotensive and at risk of suffering hypertension. After applying the neurofuzzy systems of study, the performance of each one of them was evaluated and the rules generated during the training of the best were analysed. It was determined that the NSLV algorithm provides a set of rules that facilitate the diagnosis of high blood pressure risk in children(AU)


Subject(s)
Humans , Male , Female , Child , Hypertension/diagnosis , Hypertension/prevention & control , Pediatrics
11.
Rev. medica electron ; 41(3): 628-640, mayo.-jun. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1094072

ABSTRACT

RESUMEN Introducción: la prevalencia del síndrome metabólico, a nivel mundial, es muy elevada y continúa en aumento vertiginosamente en los últimos años. Por lo que se puede considerar una pandemia de la época contemporánea, se estima que el 25 % de la población adulta la padece. Objetivo: determinar la prevalencia del síndrome metabólico e identificar otras formas clínicas de enfermedad vascular ateroesclerótica, en gerontes hospitalizados en Servicios de Geriatría del Hospital Provincial Clínico Quirúrgico Docente "Celia Sánchez Manduley", Manzanillo, Granma; en el período comprendido entre junio 2015 a junio 2016. Materiales y métodos: se realizó estudio observacional, descriptivo, de corte transversal. Se incluyeron los 120 senescentes que ingresaron en los Servicios de Geriatría. Resultados: se estableció el diagnóstico de síndrome metabólico en 105 individuos de 120 sujetos estudiados. El grupo de 70-79 años de edad y el sexo masculino fueron los más afectados por la endocrinopatía. Las otras formas clínicas de enfermedad vascular ateroesclerótica que se identificaron en los senescentes estudiados, fueron: cardiopatía isquémica, enfermedad cerebrovascular y cardiopatía hipertensiva. Conclusiones: existe una alta prevalencia del síndrome metabólico en los adultos mayores estudiados.


ABSTRACT Introduction: the prevalence of the metabolic syndrome is very high around the world and is still vertiginously increasing in the last years. Therefore, it can be considered a pandemic of the current times. It is thought that 25 % of the adult population suffers it. Objective: to determine the prevalence of the metabolic syndrome and to identify other clinical forms of the atherosclerotic vascular disease in elder people who entered the Service of Geriatrics of the Provincial Teaching Clinical Surgical Hospital "Celia Sanchez Manduley", of Manzanillo, Granma, in the period from June 2015 to June 2016. Materials and methods: a cross-sectional, observational, descriptive study was carried out with the inclusion of the 120 elder people who the Service of Geriatrics. Results: 105 individuals of 129 studied were diagnosed with metabolic syndrome. The 79-79 age group and male sex were the most affected by endocrinopathy. Other clinical forms of the arteriosclerotic vascular disease identified in the studied elder people were ischemic heart disease, cerebrovascular disease and hypertensive heart disease. Conclusions: there is a high prevalence of the metabolic syndrome among the studied elder people.


Subject(s)
Humans , Aged , Aging , Cerebrovascular Disorders/diagnosis , Risk Factors , Myocardial Ischemia/diagnosis , Metabolic Syndrome/diagnosis , Metabolic Syndrome/etiology , Metabolic Syndrome/prevention & control , Metabolic Syndrome/therapy , Metabolic Syndrome/epidemiology , Diabetes Mellitus, Type 2/diagnosis , Geriatrics , Epidemiology, Descriptive , Cross-Sectional Studies , Hospital Care , Obesity, Abdominal/diagnosis , Early Medical Intervention , Observational Study , Hypertension/diagnosis
12.
Rev. medica electron ; 41(3): 698-707, mayo.-jun. 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1094077

ABSTRACT

RESUMEN El debate alrededor de las cifras de tensión arterial, y sobre todo las cifras a obtener mediante el tratamiento es en la actualidad un grave problema de salud. Se realizó una revisión sistemática en inglés y español de los principales artículos publicados en PubMed, Scielo y MEDLINE durante el periodo comprendido desde el año 2012 hasta 2018, acerca de la definición, evaluación y manejó de la tensión arterial. Todas las guías están de acuerdo en la toma de múltiples medidas de la tensión arterial para el diagnóstico, pero no para definir el control de la tensión, definir el control de la tensión arterial debe incluir una dimensión en el tiempo en un año por lo menos, y una proporción mínima de medidas donde debe pensar en la mitad de todas las medidas por lo menos, con medidas de tensión arterial tomadas por lo menos cada tres meses, por lo que sugerimos que un perfil anual de las cifras de tensión arterial debe ser considerado como un requisito mínimo para evaluar el control de la hipertensión arterial, este trabajo ha perfilado dos de los factores menos reconocidos: la necesidad de la intensificación del tratamiento después de la primera toma de tensión arterial por encima de las cifras deseadas, y el incremento de una nueva droga en vez de incrementar las dosis de las ya indicadas.


ABSTRACT The debate on the maintained arterial tension measure, and on the measure to obtain through the long term treatment, is currently a problem for the medical practitioner, due to the variation of arterial tension during the day at different hours because of the patients circadian cycle, and due to variations in different days according to the proper patient's situations or the environment around it, and the different seasons of the year. They make it difficult to know when arterial tension is within the parameters accepted as "controlled". The authors carried out a systematic review of documents published in PubMed, Scielo and MEDLINE in the period 2012-2018, both in English and Spanish, on the arterial tension definition, evaluation and management. The guidelines agree in taking arterial tension measures in different moments for the diagnosis, but not in defining tension control. Defining tension control should include a time dimension of at least a year, and a minimal proportion of measures within the parameters recognized as non-pathological or optimal on the basis of measures taken at least every three months. Therefore, the authors suggest that an annual profile of the arterial tension parameters should be considered as a minimal requirement to evaluate arterial hypertension control.


Subject(s)
Humans , Treatment Outcome , Practice Guidelines as Topic/standards , Symptom Assessment , Time-to-Treatment/organization & administration , Hypertension/diagnosis , Hypertension/etiology , Hypertension/prevention & control , Hypertension/drug therapy , Hypertension/epidemiology , Primary Health Care , Health Records, Personal
13.
J. bras. nefrol ; 41(2): 266-274, Apr.-June 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1012534

ABSTRACT

Abstract Refractory hypertension (RfH) is an extreme phenotype of resistant hypertension (RH), being considered an uncontrolled blood pressure besides the use of 5 or more antihypertensive medications, including a long-acting thiazide diuretic and a mineralocorticoid antagonist. RH is common, with 10-20% of the general hypertensives, and its associated with renin angiotensin aldosterone system hyperactivity and excess fluid retention. RfH comprises 5-8% of the RH and seems to be influenced by increased sympathetic activity. RH patients are older and more obese than general hypertensives. It is strongly associated with diabetes, obstructive sleep apnea, and hyperaldosteronism status. RfH is more frequent in women, younger patients and Afro-americans compared to RFs. Both are associated with increased albuminuria, left ventricular hypertrophy, chronic kidney diseases, stroke, and cardiovascular diseases. The magnitude of the white-coat effect seems to be higher among RH patients. Intensification of diuretic therapy is indicated in RH, while in RfH, therapy failure imposes new treatment alternatives such as the use of sympatholytic therapies. In conclusion, both RH and RfH constitute challenges in clinical practice and should be addressed as distinct clinical entities by trained professionals who are capable to identify comorbidities and provide specific, diversified, and individualized treatment.


Resumo A Hipertensão Arterial Refratária (HARf) representa um fenótipo extremo da hipertensão arterial resistente (HAR), sendo considerada a falência ao tratamento apesar do uso de 5 ou mais classes de anti-hipertensivos, incluindo um diurético tiazídico de longa ação e um antagonista mineralocorticoide. A HAR é comum (10-20%) entre os hipertensos em geral, sendo decorrente de hiperatividade do Sistema Renina Angiotensina Aldosterona e retenção hidrossalina. Aqueles com HARf correspondem a 5-8% dos resistentes e parecem sofrer maior influência catecolaminérgica. Os resistentes tendem a ter maior idade, ao sobrepeso e à obesidade. Comorbidades incluem diabetes, apneia obstrutiva do sono e status de hiperaldosteronismo. Refratários são afro-americanos em maior proporção, mais jovens e, predominantemente, mulheres. Ambos são fortemente associados à elevada albuminúria, HVE, doenças cardio e cerebrovasculares, além da doença renal crônica. O fenômeno do jaleco branco parece ser mais evidente nos resistentes. Quanto ao tratamento, a intensificação da terapia diurética está indicada nos resistentes, enquanto na HARf, a falência à terapia impôs novas alternativas de tratamento ("simpaticolíticas"). Em conclusão, tanto a HAR quanto a HARf constituem-se desafios na prática clínica e devem ser abordadas como entidades clínicas distintas por profissionais especialistas que identifiquem comorbidades e venham a prover um tratamento específico, diversificado e individualizado.


Subject(s)
Humans , Drug Resistance , Hypertension/drug therapy , Hypertension/epidemiology , Phenotype , Sympatholytics/therapeutic use , Blood Pressure/drug effects , Complementary Therapies , Alcohol Drinking/adverse effects , Exercise , Smoking/adverse effects , Prevalence , Blood Pressure Monitoring, Ambulatory , Diet, Sodium-Restricted , Diuretics/pharmacology , Dietary Approaches To Stop Hypertension , Hypertension/diagnosis , Hypertension/physiopathology , Antihypertensive Agents/pharmacology
14.
ABC., imagem cardiovasc ; 32(2): 96-102, abr.-junh. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-994667

ABSTRACT

Fundamento: A pré-hipertensão e a hipertensão estágio I estão associadas ao remodelamento do ventrículo esquerdo (VE). No presente estudo, comparamos os parâmetros ecocardiográficos de lesão de órgãos-alvo pré-clínicos da hiper-tensão arterial em indivíduos com pré hipertensão e hipertensão estágio I selecionados a partir da mesma população. Métodos: Comparou-se as medidas ecocardiográficas basais dos participantes incluídos no estudo PREVER com pré-hi-pertensão (PREVER-prevention; n = 106) ou hipertensão estágio I (PREVER-treatment; n = 128). Investigou-se também as diferenças relacionadas ao sexo, verificadas nos parâmetros ecocardiográficos. Resultados: A pressão arterial sistólica e diastólica média mostrou-se significativamente maior no grupo hipertensão estágio I (141,0/90,4 mmHg) quando comparada com o grupo pré-hipertensão (129,3/81,5 mmHg, P<0,001 para ambos os grupos). A média de idade foi de 55 anos (30 a 70), com um número quase igual de homens e mulheres, dos quais 80% eram brancos e 7% tinham diabetes. A maioria dos parâmetros de massa do VE, dimensão do AE e função diastólica mostrou-se semelhante entre os grupos pré-hipertensão e hipertensão estágio I. Os indivíduos hipertensos apresentavam AE com maior diâmetro e maior espessura da parede posterior, além de menores velocidades laterais e, mesmo após ajuste para idade, sexo e índice de massa corporal. A análise em relação ao sexo mostrou VE com maior massa na hipertensão estágio I em comparação à pré-hipertensão apenas em mulheres (141,1 ± 34,1 gvs. 126,1 ± 29,1 g, P<0,05). Conclusões: Em indivíduos de meia-idade com baixo risco cardiovascular, as diferenças nos parâmetros ecocardiográficos relacionadas à lesão de órgãos-alvo são sutis entre a pré-hipertensão e a hipertensão estágio I, embora mulheres com hipertensão estágio I tenham VE com massa significativamente maior, o que pode indicar resposta adaptativa específica do sexo à pressão arterial em estágios iniciais de hipertensão


Subject(s)
Humans , Male , Female , Middle Aged , Echocardiography/methods , Prehypertension/diagnosis , Hypertension/diagnosis , Prognosis , Stroke Volume , Cardiovascular Diseases , Body Mass Index , Sex Factors , Multivariate Analysis , Risk Factors , Age Factors , Hypertrophy, Left Ventricular , Guidelines as Topic/standards , Arterial Pressure , Heart Atria/diagnostic imaging , Heart Ventricles/diagnostic imaging
15.
Rev. habanera cienc. méd ; 18(1): 45-59, ene.-feb. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1004121

ABSTRACT

Introducción: Como problema de la práctica de la profesión, la comorbilidad implica mayor complejidad en el plano del diagnóstico, el tratamiento, la creación de protocolos de atención y en la investigación. Es necesario identificar la comorbilidad del paciente hipertenso atendido en salas de medicina interna y su ordenamiento en mecanismos etiopatogénicos, fisiopatológicos y terapéuticos. Objetivo: Identificar la magnitud de la comorbilidad en pacientes con diagnóstico de hipertensión arterial ingresados en salas de Medicina interna. Material y Métodos: Se realizó una investigación descriptiva y prospectiva de 144 pacientes hipertensos. Se recogió la información necesaria a partir de la entrevista y examen clínico de los enfermos, las historias clínicas y la discusión con los médicos de asistencia. Los datos obtenidos se registraron en la planilla confeccionada al efecto y luego fueron vertidos en la base de datos del paquete estadístico SPSS versión 11.5. Resultados: Las comorbilidades más frecuentes fueron la diabetes mellitus tipo 2 en el 72,9 por ciento; la cardiopatía isquémica 54,9 por ciento y la enfermedad cerebrovascular 36,1 por ciento-. Conclusiones: La magnitud de la comorbilidad en los hipertensos que ingresan en salas de Medicina interna tiene como asociación etiopatogénica más importante a la diabetes mellitus tipo 2 y a las complicaciones ateroscleróticas derivadas de ambas entidades como las asociaciones fisiopatológicas más relevantes(AU)


Introduction: Comorbidity, as a problem in the practice of the medical profession, implies greater complexity in terms of diagnosis, treatment, creation of care protocols, and research. It is necessary to identify comorbidity in the hypertensive patient treated in internal medicine wards and establish etiopathogenic, pathophysiological, and therapeutic mechanisms. Objective: To identify the magnitude of comorbidity in patients with arterial hypertension admitted to the Internal Medicine wards. Material and Methods: A descriptive and prospective research was carried out on 144 hypertensive patients. The necessary information was collected from medical interviews, patients´ clinical exams, clinical histories, and case discussions with the doctors that were providing medical care to these patients. The data obtained were recorded in the database of Statistical Package SPSS software version 11.5. Results: The most frequent comorbidities were type 2 diabetes mellitus in a 72.9 percent; ischemic heart disease in a 54.9 percent, and cerebrovascular disease in a 36.1 percent. Conclusions: The magnitude of comorbidity in hypertensive patients admitted to Internal Medicine Wards recognizes Type 2 Diabetes Mellitus and atherosclerotic complications derived from both entities, as the most relevant pathophysiological associations(AU)


Subject(s)
Humans , Male , Female , Comorbidity , Hospitalization , Hypertension/epidemiology , Epidemiology, Descriptive , Prospective Studies , Hypertension/diagnosis
16.
Rev. medica electron ; 41(1): 189-195, ene.-feb. 2019. graf
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-991337

ABSTRACT

RESUMEN El doble píloro es una comunicación anormal entre el antro gástrico y el bulbo duodenal y representa un raro hallazgo endoscópico. Se presentó un paciente de 80 años de edad, con antecedentes de hipertensión arterial, fumador inveterado, tomador de aspirina, que presentó melena aproximadamente 15 días antes del ingreso. La videoendoscopia reveló la existencia de dos orificios similares en el antro, que se comunicaban con el bulbo duodenal de manera independiente que fueron catalogados como píloros. La comunicación se constató con el paso del endoscopio a su través. Se impuso tratamiento médico con inhibidores de la bomba de protones y la evolución fue favorable. Es el cuarto caso reportado en la literatura en nuestro país y el primero en la provincia de Matanzas.


ABSTRACT Double pylorus is an abnormal communication between the gastric antrum and the duodenal bulb and represents a rare endoscopic finding. It is presented the case of a patient aged 80 years, with a background of arterial hypertension, inveterate smoker, taking aspirin, who presented melena about 15 days before the admission. The video-endoscopy revealed the existence of two similar orifices in the antrum that were independently communicating with the duodenal bulb and they went catalogued like pylori. The communication was proved by passing the endoscope through it. He was treated with IBP (the Spanish acronym for proton bomb inhibitors) and the evolution was favorable. It is the fourth case reported in the literature in Cuba and the first one in Matanzas.


Subject(s)
Humans , Male , Aged, 80 and over , Pylorus/abnormalities , Pylorus/physiopathology , Pylorus/diagnostic imaging , Endoscopy, Gastrointestinal/methods , Diverticulum, Colon/diagnostic imaging , Duodenal Ulcer/diagnostic imaging , Proton Pump Inhibitors/therapeutic use , Aspirin/therapeutic use , Melena/diagnosis , Barium Enema/methods , Smokers , Hypertension/diagnosis
19.
Rev. bras. ciênc. saúde ; 23(1): 97-106, 2019. ilus.
Article in Portuguese | LILACS (Americas) | ID: biblio-1009248

ABSTRACT

Introdução: Objetivou comparar e compreender a lógica existente na produção, fluxo e análise dos dados que alimentam o Sistema de Cadastramento e Acompanhamento de Hipertensos e Diabéticos e o formato de Coleta de dados Simplificada do e-SUS Atenção Básica e identificar os desafios encontrados na mudança de um sistema para o outro no que diz respeito ao usuário com hipertensão. Metodologia: Trata-se de um estudo de caso que foi realizado com base na consulta de artigos científicos, documentos e manuais técnicos, relatórios de oficinas de trabalho, opiniões de trabalhadores da APS e vivências durante o processo de concepção e implantação dos dois sistemas. Resultados: Os Sistemas estudados apresentam diferenças entre as informações contidas nos mesmos e que existem divergências na produção, fluxo e análise dos dados entre os dois sistemas, entretanto, o que se percebe é que no HIPERDIA, os dados produzidos na Unidade são referentes aos usuários hipertensos cadastrados e acompanhados mensalmente e que os dados provenientes do e-SUS Atenção Básica formato de Coleta de dados Simplificada são referentes ao curso natural do atendimento. Conclusão: O presente estudo possibilitou a discussão dos dados referentes à hipertensão arterial a partir de duas bases de dados investigadas para Atenção Básica. À escassa literatura cientifica que discuta e reflita sobre a produção, fluxo e análise dos dados do formato de Coleta de dados Simplificada do e-SUS Atenção Básica como um todo, apresenta-se como uma limitação e, portanto, se faz necessário a realização de novas pesquisas sobre a temática. (AU)


Introduction: This study aimed to compare and understand the existing logic in the production, flow and analysis of data that feed the System of Registration and Monitoring of Hypertensive Diabetics and the simplified data collection format e-NHS Primary Care, and identify the challenges encountered in changing from one system to the other with regards to the user with hypertension. Methodology: This is a case study based on scientific articles query, documents and technical manuals, workshops reports, opinions of employees of APS and experiences during the process of design and implementation of the two system. Results: The studied systems differ from the information contained in them and there are differences in the production, flow and analysis of data between the two systems, however, it was noticed that in HIPERDIA, the data produced in the unit refer to hypertensive registered and monitored monthly users and the data from the e-SUS Primary Streamlined data collection format refer to the natural course of care. Conclusion: This study enabled the discussion of data on hypertension from two databases investigated for Primary Care. In the scarce scientific literature to discuss and reflect on the production, flow and analysis of simplified data collection format data from e-NHS Primary Care as a whole, it appears as a limitation and therefore it is necessary to carry out new research on the subject. (AU)


Subject(s)
Hypertension/diagnosis , Public Health
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