COVID 19 y Diabetes Mellitus tipo 1 en la infancia. Cuba. Informe preliminar / Covid 19 and Diabetes Mellitus type 1 in childhood. Cuba. Preliminary report

Introducción: en diciembre de 2019 se inició una epidemia por coronavirus SARS-CoV-2, causante de un síndrome de dificultad respiratoria que, posteriormente, se denomina enfermedad COVID-19y que es probable afecta menos a los niños que a los adultos. En Cuba existen aproximadamente 15,246 contagiados menores de 19 años. La diabetes mellitus tipo 1 (DM1) asociada al COVID-19puede representar peligro para la vida del paciente. Objetivo: determinar algunas características de la COVID-19en la población pediátrica estudiada con diabetes mellitus tipo 1 durante el primer año de inicio de la pandemia en Cuba. Método: se seleccionaron al azar los servicios de endocrinología pediátrica de las provincias: Ciego de Ávila, Villa Clara, Pinar del Río y en La Habana (Hospitales Pediátricos Cerro y Centro Habana). Se solicitó cuántos pacientes durante el primer año de la pandemia (marzo 2020-marzo 2021) debutaron con DM1, cuántos en cetosis/cetoacidosis. Estos datos se compararon con el año 2019. Se investigó cuantos niños DM1 ingresaron con Covid 19. Resultados: existió incremento (57.3 %) de los pacientes con debut de DM1 durante el primer año de la pandemia en comparación con 2019. La presencia de cetosis/cetoacidosis aumentó (58.2 %). Se detectó cuatro pacientes con Covid 19 y DM1, (frecuencia baja: 0, 53 %). Conclusiones: el incremento de la DM1 y de cetosis/cetoacidosis pudiera estar relacionado indirectamente con la pandemia por Covid 19, ya sea por stress, confinamiento, alimentación inadecuada o la combinación de estos factores, es prudente tener un seguimiento a mediano y largo plazo de estos pacientes.

Introduction: On December 2019, an epidemic due to the SARS-CoV-2 coronavirus began, causing a respiratory distress syndrome, later it is called the COVID-19disease, it probably affects children less than adults. In Cuba, there are approximately 15,246 infected persons under 19 years of age. Type 1 diabetes mellitus (DM1) associated with COVID-19can be life-threatening. Objective: To determine some characteristics of COVID-19in the pediatric population studied with type 1 diabetes mellitus during the first year of the onset of the pandemic in Cuba. Method: The pediatric endocrinology services of the provinces: Ciego de Ávila, Villa Clara, Pinar del Río and Havana (Hospital Pediátricos Cerro and Centro Habana) were randomly selected. It was requested how many patients during the first year of the pandemic (March 2020-March 2021) debuted with DM1, how many in ketosis / ketoacidosis. These data were compared with 2019. It was investigated how many T1D children were admitted with Covid 19. Results: There was an increase (57.3%) in patients with T1D debut during the first year of the pandemic compared to 2019. The presence of ketosis / ketoacidosis increased (58.2 %). 4 patients with Covid 19 and DM1 were detected (low frequency: 0.53%). Conclusions: The increase in DM1 and ketosis/ketoacidosis could be indirectly related to the Covid 19 pandemic, whether due to stress, confinement, inadequate nutrition or a combination of these factors, it is prudent to have a medium and long-term follow-up of these patients.

Buprenorphine versus dexamethasone as perineural adjuvants in femoral and adductor canal nerve blocks for total knee arthroplasty: a randomized, non-inferiority clinical trial.

BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. METHODS: A randomized, non-inferiority clinical trial (385 patients) evaluated every hour immediate postoperative pain during 24 h, using a verbal rating 11-point scale for patient self-reporting of pain (VRS11). All patients received subarachnoid anesthesia and were randomly allocated in four groups: single shots femoral (FNB) or adductor canal blocks (ACB), both with dexamethasone (dex) and buprenorphine (bup). Patients received intravenous analgesia (metamizole magnesium, dexketoprofen) and rescue analgesia when needed: intravenous (paracetamol and morphine) and/or regional (femoral and sciatic nerve blocks). Demographics and adverse effects were also recorded. RESULTS: A 45.7% of patients had pain: bupACB 56.3%, bupFNB 50.0%, dexACB 40.6% and dexFNB 36.1% (P=0.022). Rescue analgesia was needed in 37.7% of patients (P=0.128). There were statistical differences in percentage of timepoints without pain (95.0±7.9%, P=0.014) and mean VRS11 (0.18±0.3, P=0.012) but no differences in distribution of intensity periods of pain. There were no significant differences in the need of rescue analgesia excepting the use of intravenous morphine (P=0.025). CONCLUSIONS: Buprenorphine is in the present trial inferior to dexamethasone by less than the established non-inferiority limit when used as perineural adjuvant in femoral nerve or adductor canal blocks in total knee arthroplasty analgesia. So, it could be considered an alternative in patients where dexamethasone is contraindicated, such as diabetics.

Lignin-Based Polyols with Controlled Microstructure by Cationic Ring Opening Polymerization.

Lignin-based polyols (LBPs) with controlled microstructure were obtained by cationic ring opening polymerization (CROP) of oxiranes in an organosolv lignin (OL) tetrahydrofuran (THF) solution. The control on the microstructure and consequently on the properties of the LBPs such as hydroxyl number, average molecular weight, melting, crystallization and decomposition temperatures, are crucial to determine the performance and application of the derived-products. The influence of key parameters, for example, molar ratio between the oxirane and the hydroxyl groups content in OLO, initial OL concentration in THF, temperature, specific flow rate and oxirane nature has been investigated. LBPs with hydroxyl numbers from 35 to 217 mg KOH/g, apparent average Mw between 5517 and 52,900 g/mol and melting temperatures from -8.4 to 18.4 °C were obtained. The CROP procedure allows obtaining of tailor-made LBPs for specific applications in a very simple way, opening the way to introduce LBPs as a solid alternative to substitute currently used fossil-based polyols.

Isosorbide bis(methyl carbonate) synthesis from isosorbide and dimethyl carbonate: the key role of dual basic-nucleophilic catalysts.

Isosorbide bis(methyl carbonate) (IBMC) is a scarcely studied green chemical with potential applications in the manufacturing of non-isocyanate polyurethanes and bisphenol A-free polycarbonates. Its synthesis by transesterification of isosorbide with dimethyl carbonate (DMC) is very negatively influenced by the presence of small amounts of acidic impurities in isosorbide when heterogeneous inorganic carbonates such as potassium and cesium carbonates are used as catalysts. In this paper it is shown that the problem can be solved by using homogeneous catalysts consisting of nitrogenated bases and superbases having a suitable dual nucleophilic-basic character and able to form a highly reactive acyl intermediate with the electrophilic reactant DMC. Cycloaliphatic secondary and tertiary amines, guanidines and amidines covering a nucleophilicity parameter (N) range between 13.58 and 20.58 in either acetonitrile or dichloromethane, and a pK a range in acetonitrile between 15.68 and 26.02 have been tested in batchwise mode. Highly active catalysts leading to hydroxyl conversions of 84-93% require a minimum N of 16 and a pK a ranging from 18.0 to 26.0. Within this pK a range, N must increase by about 0.5-0.6 units per each unit the pK a falls to keep the catalytic activity, indicating that nucleophilicity has approximately twice as much influence as basicity on the catalytic activity. One guanidine (TBD), one amidine (DBN) and three cycloaliphatic secondary amines (N-methylpyrrolidine, quinuclidine and DABCO) have been found to be excellent catalysts at 5 mol% vs. ISO. The side reaction leading to oligomer formation is not avoided, with oligomers, mainly the dimer, affording 6 wt% of the crude product independently of hydroxyl-conversion and catalyst type.

Postoperative analgesia for elective total knee arthroplasty under subarachnoid anesthesia with opioids: comparison between epidural, femoral block and adductor canal block techniques (with and without perineural adjuvants). A prospective, randomized, clinical trial.

BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 hours) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm). Patients received intravenous analgesia (metamizole magnesium, dexketoprofen) and rescue analgesia when needed, intravenous (paracetamol and morphine) and/or regional (epidural boluses, femoral and sciatic nerve blocks). Demographics, orthopedic knee scores and adverse effects were also recorded. RESULTS: A 45.2% of patients had no immediate postoperative pain (P=0.0001). Rescue analgesia was needed in 48.8% of patients (P=0.0001): control group 72.8% of patients, EA 51.9%, FNB 40.0%, FNB+Dexa 33.3%, BNF+Dexm 41.3%, ACB 51.9%, ACB+Dexa 38.3% and ACB+Dexm 61.5% respectively. There were also differences in the total postoperative time without pain (P=0.0001), with mild (P=0.0001) or moderate pain (P=0.001) but not with severe pain (P=0.119). CONCLUSIONS: Peripheral nerve blocks with perineural dexamethasone improve postoperative analgesia for TKA. The addition of dexamethasone to adductor canal block open new possibilities to improve analgesia for TKA, and should be investigated as an alternative to femoral nerve block.

Myopericytoma arising adjacent to the common carotid artery: Case report and systematic review of deep located neck myopericytomas.

BACKGROUND: Myopericytoma is a perivascular tumor of the skin and subcutaneous tissue of the extremities, it is a rare finding in the head and neck, and even rarer is its deep location. METHODS: A 38-year-old woman presented with a slowly growing mass at the right carotid triangle. Contrast-enhanced CT scan revealed a moderately enhancing mass. At surgery, the tumor was firmly attached to the common carotid artery, making it necessary to excise a small portion of the vessel wall. RESULTS: The histopathologic report was myopericytoma. The postoperative course was uneventful, without tumor recurrence. CONCLUSION: The very few deep located myopericytomas at the head and neck region show a predilection to appear near the great neck vessels with a possibility to require vascular repair, or at the parotid space where they can be multicentric. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2479-E2482, 2016.

Myocutaneous sternocleidomastoid flap for reconstruction after the resection of a parapharyngeal heterotopic glioma in a child with cleft palate, and systematic review of parapharyngeal glial heterotopia.

We describe the surgery and reconstruction employed with a sternocleidomastoid myocutaneous flap for the treatment of a heterotopic glioma in a 2-year-old boy with incomplete palatal fissure who presented with dysphagia and snoring, in whom a lateral pharyngeal wall mass obstructing 60% of the airway was noted. Heterotopic gliomas are uncommonly reported in the parapharyngeal space and should be included in the differential diagnosis at this location in children. Parapharyngeal tumors present difficult diagnostic and management challenges; head and neck surgeons must be prepared not only for the resection but also for the reconstruction of these rare lesions.

Metabolic Correction in Patients Sample with Diabetes: Clinical Outcomes and Costs Reductions.

Diabetes is a leading cause of mortality and morbidity worldwide. Diabetes complications produce profound impact on patient's quality of life and represent very significant economic cost to patients, their family, the government and society as a whole. Metabolic correction has been proposed as an efficient method to improve clinical outcomes and reduce costs in diabetes. Metabolic correction is a concept that supports health maintenance and promotes the healing processes by improving the body's biochemical-physiological mechanisms. This is done by helping activate the metabolic enzymes necessary to facilitate key physiological pathways. A group of 50 patients followed a simple metabolic correction strategy based on hydration, diet, and magnesium supplementation during a 6 months period. Outcomes measures included laboratory testing, anthropometric measures and medication use including its related costs. Patients had an average weight loss of 9.4 lbs (↓5.0%) from baseline at month 3 and 12 lbs (↓6.4%) at month 6. Waist circumference decreased on average 3.7 inches (↓9.0%) from baseline at month 3 and had further decrease to 5.5 inches (↓13.4%) from baseline at month 6. Laboratory testing of average triglycerides decreased from a baseline of 156.9 to 116.7 (↓25.6%) at month 3 and maintained a reduction of ↓24.2% by month 6. Total cholesterol concentration decreased from a baseline of 181.1 mg/dL to 173.9 (↓4.0%) in month 3 and to 171.1 (↓5.5%) at month 6. Average HgA1c decreased from baseline of 7.17 to 6.52 (↓9.1%) at month 3 and maintained 6.52 at months 6. The atherogenic index decreased from 4.18 at baseline to 3.85 at month 3 (↓7.9%) and then 3.47 (17.0%) at month 6. Medication use and cost was quantified in various ways. The average baseline monthly diabetes medication cost per patient of $124.10 was reduced to $ 78.23 (↓36.7% reduction) at month 3 and to $62.80 (↓49.4% reduction) at month 6. A simple and well structured metabolic correction program that includes a significant educational component, dietary modifications and dietary supplement intake was able to maintain or improve vital signs, anthopometric and laboratory measurements that correlate with improved clinical diabetes and cardiovascular health. This outcome was achieved while decreasing the use medications at month 3 and 6 at significant cost savings.

[Metabolic correction: a biochemical option against diseases]. / Corrección metabólica: Una opción bioquímica contra las enfermedades.

Human development and its physiology depends on a number of complex biochemical body processes, many of which are interactive and codependent. The speed and the degree in which many physiological reactions are completed depend on enzyme activity, which in turn depends on the bioavailability of co-factors and micronutrients such as vitamins and minerals. To achieve a healthy physiological state, organism need that biochemical reactions occur in a controlled and specific way at a particular speed and level or grade fully completed. To achieve this, is required an optimal metabolic balance. Factors such as, a particular genetic composition, inadequate dietary consumption patterns, traumas, diseases, toxins and environmental stress all of these factors rising demands for nutrients in order to obtain optimal metabolic balance. Metabolic correction is a biochemical and physiological concept that explains how improvements in cellular biochemistry of an organism can help the body achieve metabolic and physiological optimization. We summarize the contribution of several pioneers in understanding the role of micronutrients in health management. The concept of metabolic correction is becoming a significant term due to the presence of genetic variants that affect the speed of reactions of enzymes, causing metabolic alterations that enhance or promote the state/development of multiple diseases. Decline in the nutritional value of the food we eat, the increase in demand for certain nutrients caused by normal development, diseases and medications induce, usually, nutrients consumption. These nutritional deficiencies and insufficiencies are causing massive economic costs due to increased morbidity and mortality in our society. In summary, metabolic correction improves the enzymatic function, which favors the physiological normal functions, thus, contributing to improving health and the welfare of the human being. The purpose of this paper is to describe and introduce the concept of optimal metabolic correction as a functional cost-effective mechanism against disease, in addition, to contribute to diseases prevention and regeneration of the body and health.

Metabolic correction: a functional biochemical mechanism against disease--Part 2: mechanisms and benefits.

A healthy physiology depends on a plethora of complex interdependent biochemical reactions. In order for these reactions to occur suitably, the enzymes and cofactors that regulate their flow must be present in the proper balance. The term metabolic correction is used to describe a biochemical-physiological process that improves cellular biochemistry as a means to an individual's achieving metabolic or physiological optimization. Part 2 discusses how metabolic correction, through the increase of cofactors, can supply unmet enzyme needs and compensate for nutritional deficiencies induced by improper nutritional intake or by the increased demand for nutrients caused by genetics, health conditions, medications, or physical or environmental stressors. Nutrient insufficiencies are causing an increase in morbidity and mortality, at great cost to our society. In summary, metabolic correction improves enzymatic function and satisfies the increasing demand for nutrients. Metabolic correction can have a significant impact on the reduction of morbidity and mortality and their financial cost to our society and contribute to improving health and well-being.

Metabolic correction: a functional biochemical mechanism against disease--Part 1: concept and historical background.

Human physiology depends on countless biochemical reactions, numerous of which are co-dependent and interrelated. The speed and level of completion of reactions usually depend on the availability of precursors and enzymes. The enzymatic activity depends on the bioavailability of micronutrient cofactors such as vitamins and minerals. In order to achieve a healthy physiological state, the organism requires that biochemical reactions occur at a controlled rate. To achieve this state it is required that metabolic reactions reach what can be considered an optimal metabolic equilibrium. A combination of genetic makeup, dietary patterns, trauma, disease, toxins, medications, and environmental stressors can elevate the demand for the nutrients needed to reach this optimal metabolic equilibrium. In this, part 1, the general concept of metabolic correction is presented with an elaboration explaining how this concept is increasing in importance as we become aware of the presence of genetic variants that affect enzymatic reactions causing metabolic disturbances that themselves favor or promote the disease state. In addition, part 1 reviews how prominent scientists have contributed in fundamental ways to our understanding of the importance of micronutrients in health and disease and in the development of the metabolic correction concept.

[Study on the resilience internal factors in a sample of Puerto Rican centenarians]. / Estudio sobre los factores internos de resiliencia en una muestra de centenarios Puertorriquenos.

UNLABELLED: Old age is a stage that is usually characterized by lost at the physiological, psychological and social level that generates much distress to individuals. However, the centenaries have been identified as an example of successful aging, within other factors, because they have adequate managed skills that help them to deal with healthy normal losses. Resilience could be one of the factors that may help the Centennials to age successfully. It is necessary more studies with Puerto Rico Centennials since we lack such investigations. METHODOLOGY: This study has an expo facto design; in addition we evaluate psychometrically the Symptoms Check List 90-R (SCL-90-R). The scale of Internal Resilience Factors (EFIR), a semi structured interview and the SCL-90-R were used to identify factors associated with successful aging in the centennials. In addition we explore if there exist gender differences in internal factors of resilience within the sample. SAMPLE: 23 Centennials, 15 men and 8 women, of different parts of Puerto Rico (average age = 101. 5 years). RESULTS: Internal resilience factors associated with the aging process were identifying, those were: emotional stability, optimism, behavioral factor and behavioral and emotional skills component. These factors are consistent with the revised literature on positive emotions and adaptive ageing. On the other hand, no statistically significant difference was identified (p <. 05) for the internal factors of resilience on the basis of gender, a finding agreed with the revised literature. The multiple tests administered showed adequate internal consistency (EFIR: (=. 726); SCL-90-R: (=. 941). The Symptoms Check list 90-R (SCL-90-R) was valid with a Cronbach's alpha of. 941. CONCLUSIONS AND LIMITATIONS: We identified internal resilience factors that could be linked with successfully aging: those factors are encouraging the elderly population. In addition used tests showed adequate internal consistency. Limitations in relation to the size of the sample and the distribution of gender were identified, thus we suggest further research with larger samples.

Disability profile in leprosy patients' diagnoses in a rural reference leprosy centre in Ethiopia during 1999-2009.

We assessed the epidemiology of disabilities in leprosy cases treated in a rural hospital over a 10-year period. This is a retrospective data collection using leprosy registers and treatment cards in a rural private mission hospital. Over the 10-year period, 210 patients with leprosy were registered for treatment. One hundred and twenty-eight (61.5%) had disabilities (26.0% grade 1 and 35.6% grade 2): 13.5% ocular disabilities, 44.5% disabilities in hands and 44.7% foot impairment. Patients >19 years had more disabilities (66.7% versus 50.7%) (P = 0.03), especially ocular disabilities (16.7% in >20 versus 6.0% in <20 years) (P = 0.03). This study detected a high prevalence of disabilities.

[Psychosocial characteristics of an initial sample of Puerto Rican centenarians]. / Caracteristicas psico-sociales de una muestra inicial de centenarios puertoriqueños.

This is the first research done in Puerto Rico presenting a basic socio-demographic profile of a sample of Puerto Rican centenary elderly that also includes psychological characteristics. The sample consist of eleven subjects, divided in five women and six men (mean age sample = 102.4 years) evaluated with a battery of psychological instrument that include the Symptom Checklist 90-R (SCL-90-R); the Beck Depressive Inventory (BDI-II); the Beck Suicide Scale (BSS); the Beck Hopelessness Scale (BHS); the Beck Anxiety Inventory (BAI) and the Folstein Mini-Mental. Main findings demonstrate that, with the exception of anxiety and hopelessness symptomatology, this particular sample is with a good psychological health. It is recommended to continue this type of research with a bigger sample and include other psychological and psychiatric screening instruments.

Equivalencia terapéutica entre atorvastatina amorfa (Atovarol) y atorvastatina cristalina tipo I (Lipitor) en el tratamiento de pacientes con hipercolesterolemia / Therapeutic equivalence of amorphous atorvastatin (atovarol) and type I crystalline atorvastatin (lipitor) in the treatment of hypercholesterolemic patients

Determinar la equivalencia terapéutica y la seguridad de la atorvastatina amorfa y la atorvastatina cristalina, utilizadas en la fabricación de Atovarol® y Lipitor ®, a la dosis de 10 mg/día en pacientes con hipercolesterolemia. Estudio clínico multicéntrico, prospectivo, comparativo, simple-ciego, distribuido al azar, de grupos paralelos. A los pacientes que cumplieron los criterios de inclusión les fue administrada atorvastatina amorfa (Atovarol®) o atorvastatina cristalina (Lipitor®) durante un mes. Se realizó una evaluación de laboratorio previa y otra al mes de tratamiento. Se incluyeron 43 pacientes, de los cuales uno fue retirado del estudio por efectos adversos. Los 42 pacientes que completaron el tratamiento con atorvastatina (20 pacientes en el grupo atorvastatina amorfa y 22 pacientes en el grupo atorvastatina cristalina) durante un período de 4 semanas presentaron reducciones estadísticamente significativas en los valores séricos de colesterol total, colesterol LDL y triglicéridos comparados con los valores basales en cada grupo de tratamiento. No se observaron diferencias estadísticamente significativas entre los dos grupos de tratamiento, ni previo ni posterior al tratamiento. Atorvastatina amorfa fue terapéuticamente equivalente a atorvastatina cristalina en la disminución de los valores de colesterol total, colesterol LDL y triglicéridos. El porcentaje de reducción de estos valores está dentro de los rangos reportado por otros estudios clínicos realizados con atorvastatina.

To determine the therapeutic equivalence and the safety of amoãphous and crystalline atorvastatin, used in the manufacture of Atovarol® and Lipitor®, at a dose of 10 mg/day in patients with hypercholesterolemia. Multicenter, prospective, comparative, somple-blind, randomized, parallel group clínical study. Amorphous atorvastatin (Atovarol®) or crystalline atorvastatin (Lipitor®) were administered for one month to patients that met the inclusion criteria. Laboratory evaluations were performed previously and one month after treatment. 43 patients were included, of which one was withdrawn from the study due to adverse effects. The 42 patients that completed atorvastatin treatment for a period of 4 weeks (20 patients in the amorphous atorvastatin and 22 patients in the crystalline atorvastatin group), presented statistically significant reductions in serum values of total cholesterol, cholesterol-LDL and triglycerides, as compared with pretreatment values in each group. Statistically significant differences were not observed between the groups, either before or after treatment. Amorphous atorvastatin is therapeutically equivalent to crystalline atorvastatin in the reduction of total cholesterol, cholesteron-LDL and triglyceride values. The percentage of reduction of these values is withim the range reported by other atorvastatin clinical studies.

Factores de riesgos en la cardiopatía isquémica en los pacientes jóvenes / Risk factors in ischaemic heart disease in young patients

El Infarto Agudo del Miocardio en pacientes jóvenes (menores de 45 años) es una entidad clínica con características específicas que difieren de los pacientes viejos. Realizamos un estudio en pacientes con Infarto Agudo del Miocardio (IMA) menores de 45 años que ingresaron en las Unidades de Cuidados Intensivos de los Hospitales Universitarios "Arnaldo Milián Castro" y "Celestino Hernández Robau", en el período comprendido entre Enero de 1995 y Diciembre del 2003, los que representaron el 4,90 por ciento del total de los pacientes que ingresaron con el diagnóstico de IMA. Existió un franco predominio del sexo masculino y la raza blanca. En la mayoría de los pacientes se identificaron factores de riesgo que se incrementaron con la edad. Predominaron los IMA con supradesnivel del ST en los que fueron más frecuentes los trastornos del ritmo y el fallo de bomba. La localización más frecuente fue la inferior. Se le realizó trombolisis al 60,13 por ciento de los pacientes y se constató que estos tuvieron mayor supervivencia. La estadía promedio fue de4,92 días. El tratamiento farmacológico no trombolítico más utilizado consistión en aspirina, betabloqueadores y nitratos. La localización anterior extensa tuvo una mayor incidencia de shock cardiogénico y por tanto mayor mortalidad(AU)

Estrés e hipertensión arterial. Resultados del proyecto “Hacia un pesquisaje en la adolescencia de hipertensión arterial. (PESESCAD-HTA) / Stress and hypertension. Results of the project "towards hypertension screening in adolescents" (PESESCAD-HTA)

La hipertensión arterial en la adolescencia constituye hoy en día un reconocido problema de salud que ya comienza a afectar a todas las poblaciones del mundo. En este contexto sobresale con una particular importancia una variable de riesgo cardiovascular asociada a niveles elevados de tensión arterial (TA) y que es centro de la atención de numerosos autores hoy en día: el estrés. Sin dudas la cuantificación exacta de este peligroso factor de riesgo cardiovascular es de veras difícil. Las pruebas más empleadas en tal sentido son las de reactividad vascular, demasiado costosas por lo demás y no efectivas para investigaciones a gran escala, como es el caso del presente trabajo que presenta los resultados que en tal sentido ha emitido el Proyecto de Investigación “Hacia un pesquisaje en la adolescencia de HTA (PESESCAD-HTA). Novedoso camino a la excelencia en los servicios de salud”. En los que fue notable la real y significativa asociación de dos variables riesgos relativamente nuevas, al menos en nuestro medio para cuantificar la relación estrés-hipertensión arterial dentro del medio escolar del adolescente, las cuales son la presencia de un ambiente familiar y de un rendimiento académico desfavorables. Las mismas estuvieron estrechamente asociadas a cifras de tensión arterial superiores con respecto a los educandos donde estas situaciones de riesgo no estuvieron presentes. Del mismo modo se precisan asociaciones entre la presencia de hipertensión arterial y la existencia de estos riesgos escolares(AU)