[Nursing management in hypertensive crises]. / Manejo de enfermería en la crisis hipertensiva.

Arterial hypertension is the increase in systemic arterial pressure above the values considered normal according to the age of the subject, referenced either to the systolic or diastolic pressure or to both. A diastolic arterial pressure above 120-130 mmHg is called hypertensive crisis, and is classified for its therapeutic management in: Hypertensive emergency that causes damage to target organs, i.e., brain, heart, and kidney, which require an immediate decrease in arterial pressure through the use of i.v. applied medication, although not necessarily down to normal values, and Hypertensive urgency, in which no acute damage is evidenced and treatment is focused on diminishing pressure values within the first 24 hours using oral or sublingual medication. Both conditions require strict surveillance and nursing care starting with the correct procedure to determine blood pressure.

[The prevalence of non-insulin-dependent diabetes mellitus and the associated risk factors in a population of Mexico, D. F]. / Prevalencia de diabetes mellitus no insulinodependiente y factores de riesgo asociados en una población de México, D.F.

Non-insulin-dependent diabetes mellitus (NIDDM) is a chronic disabling disease, that shortens length of life and implies a high burden for a community. Its prevalence goes from 0 per cent in Papua, New Guinea to 34 per cent in Pima Indians. There are very few prevalence studies in Mexico, and the strength of association of the known risk factors with the occurrence of the disease is not established. A prevalence cross sectional study was carried out with users of a first level medical care unit, with a meter measure of capillary glucose levels. Those with a previous diagnosis of diabetes or whose capillary glucose level were 200 mg or over were considered diabetics. Hyperglycemia was when the levels were recorded between 121 and 199 mg. The crude prevalence of NIDDM was 5.6 per cent (CI 95% 4.5-6.8), With almost no sex difference. Hyperglycemia prevalence was 2.9 per cent (CI 95% 2.0-3.7). Age was the main risk factor for the development of NIDDM. Those between 40 and 59 years showed a high risk (OR 10.8; CI 95% 5.4-22.0; p < 0.0001), and it was greater for the 60 years or elder (OR 20.6; CI 95% 9.8-44.1; p < 0.0001). Weight was also an important risk factor, with a 2.7 fold greater risk for obese persons (CI 95% 1.6-4.6; p < 0.0001). Other, risk factors were familiar history of diabetes (OR 1.5; CI 95% 0.9-2.3; p = 0.096), and overcrowding (OR 1.9; CI 95% 1.0-3.4; p = 0.03). In order to analyze independently each variable, a logistic regression model was applied, and a similar strength of association was observed for the crude model, but for obesity whose effect was modified by age. When only new cases were analyzed in the former model, the association with obesity was maintained. There is a need to develop prevalence studies of NIDDM in Mexico and to measure the strength of association with the known and the not jet well known risk factors of this disease in order to establish health policies according to the Mexican reality.