Nonadherence to antihypertensive medications and associated factors in general medicine clinics.

OBJECTIVES: Nonadherence to antihypertensive medications has not been assessed in the Saudi population. The aim of this study was to address and evaluate the magnitude of nonadherence among hypertensive patients and the risk factors associated with it. METHODS: A cross-sectional survey was conducted on hypertensive patients who attended the general internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia, using a questionnaire that was modified after reviewing the literature. Hypertensive patients were labeled as nonadherent if they missed their medications for a total of 7 days during the previous month. RESULTS: A total of 302 patients participated in the study, of whom 63% were females with a mean age of 64 years, and 64% were illiterate. The prevalence of nonadherence to medications among hypertensive patients was found to be 12.3%. Poor disease knowledge was reported in 80% of patients, while 66% of the patients had poor monitoring of their disease. Younger age (≤65 years), poor monitoring, and uncontrolled blood pressure (BP ≥140/90 mmHg) were the predictor factors associated with nonadherence (odds ratio [OR] =2.04, P=0.025; OR=2.39, P=0.004; and OR=2.86, P=0.003, respectively). CONCLUSION: Nonadherence to antihypertensive medications is lower than that previously reported in the literature. Younger age, uncontrolled BP, and poor monitoring are the main risk factors associated with nonadherence.

El uso diferencial, según la variable género, de las herramientas terapéuticas en tratamiento residencial / Distinctive use of therapeutic tools in therapeutic community: treatment according to gender

Objetivo. Analizar las diferencias de género en el uso de herramientas educativo-terapéuticas utilizadas en tratamiento residencial de deshabituación a drogas. Material y métodos. Análisis cuantitativo del uso de herramientas entre los/las residentes de la Comunidad Terapéutica. Resultados. Existen diferencias significativas entre hombres y mujeres en el uso de las herramientas educativo-terapéuticas que se analizan. Conclusiones. Las mujeres residentes en la Comunidad Terapéutica Manuene son más observadas y más señaladas por los hombres y por ellas mismas frente a los saltos de norma, pequeñas transgresiones, comportamientos inadecuados y errores. También son las que más ejercicios realizan para cambiar estas actitudes y comportamientos. Son, por tanto, no sólo más exigidas, sino también (o a consecuencia de ello) más activas, implicadas y comprometidas con su propio proceso de cambio

Objective. To analyse gender differences in the use of educative and therapeutic tools that are used in a therapeutics community. Material and method. Cuantitative analysis of the use of educative and therapeutic tools among residents in a therapeutic community and qualitative analysis of diferenciative variables related with relapses according to gender. Results. Significative differences between male and female residents have been found concerning the use of the studied tools. Conclusions. Female residents in Manuene therapeutic community are found to be more observed and pointed out both by men and women when small transgressions, inadecuated behaviour and mistakes occur. It is also female residents who turn out to be more active in trying to correct those actitudes and behaviours. Female residents are thus not only more demanded but also more participative, involved in and compromised with their own changes as well as men´s changes

Prognostic significance of microvascular counts in rectal carcinoma.

Numerous studies of many tumor types have demonstrated that microvessel quantitation as a measure of angiogenesis is a powerful prognostic tool. Vascular enumeration has been claimed to be an independent prognosticator for several human tumors, including breast carcinoma, melanoma or bladder carcinoma; however, the studies of colorectal cancer have rendered variable results. To test the prognostic influence of this factor in our patients, we selected 39 patients with rectal carcinoma Dukes' stages A to C treated only with curative surgery, with no further adjuvant therapy. The minimal follow-up time was 5 years (60 months). After immunostaining with CD34, we performed a manual count of the vessels following Gasparini's criteria. In our series, vascular enumeration has been a prognosticator for OS (overall survival) but not for RFS (relapse-free-survival) at all Dukes' stages in the univariate analysis. This prognostic influence was lost in the multivariate analysis, in which only stage as well as vascular and neural invasion behaved as significant independent prognosticators. The presence of hypervascularization did not show any significant association with histologic grade, tumor staging, and vascular or neural invasion.

Prognostic influence of tumor-associated eosinophilic infiltrate in colorectal carcinoma.

BACKGROUND: In 1983, Pretlow et al. reported one classical study of the prognostic influence of eosinophil infiltration in human colon carcinoma. Since then, very few reports have analyzed this supposed prognostic influence in this type of tumor, although there have been several reports of other types of tumors with different results. Eosinophils seem to play a central role in the immunologic defense against tumors; their activity can be induced through immunotherapy with interleukin in cases that are unresponsive to conventional therapies. METHODS: To analyze the prognostic influence of eosinophils in colorectal carcinoma, the authors selected 126 patients with this type of tumor treated only with curative surgery and followed for a minimal period of 5 years. They divided these patients into 4 categories according to the number of eosinophils per high-power field (400x): 0 (Grade 1), 1-9 (Grade 2), 10-50 (Grade 3), and more than 50 (Grade 4). RESULTS: The results of this series confirm that high eosinophil counts are associated with a significantly better prognosis. In multivariate analysis, this factor was independent from staging, vascularization, p53 expression, and histologic grade. CONCLUSIONS: Eosinophil count served as a significant independent favorable prognosticator in colorectal carcinoma patients.

Vascular enumeration as a prognosticator for colorectal carcinoma.

Vascular enumeration is thought to be an independent prognosticator for several human tumours, including breast, bladder and colorectal carcinomas. There have been 12 reports on the prognostic influence of vascular enumeration in colorectal carcinoma with different results. To test the prognostic influence of this factor in our patients, we have selected 126 patients with colorectal carcinoma Dukes' stages A to C treated only with curative surgery with no further adjuvant therapy. The minimal follow-up time was 5 years (60 months). After immunostaining with CD34, we performed a manual count of the vessels following Gasparini's criteria. In our series vascular enumeration showed significant association with the histological grade (P = 0.03) with a cut-off point at 77 vessels/200x, but not with tumour staging and vascular and neural invasion (P > 0.05). Vascular enumeration was a prognosticator for RFS (relapse-free survival) (P = 0.009) and OS (overall survival) (P = 0.01) in all Dukes' stages in the univariate analysis, but this prognostic influence was lost in the multivariate analysis, in which only stage, histological differentiation, location and vascular and neural invasion behaved as significant independent prognosticators.