Registro de Hipertensión Arterial en consultas privadas en Venezuela: Estudio RHAVEN / Arterial Hypertension register in private clinics in Venezuela: RHAVEN Study

Introducción: En Venezuela no se ha realizado un estudio grande para conocer el nivel de control de la hipertensión arterial (HTA). Objetivo: El objetivo primario fue conocer la prevalencia de la HTA controlada entre hipertensos tratados farmacológicamente. Materiales y métodos: Es un estudio de corte transversal realizado en pacientes mayores de 18años. Resultados: Se registraron 4.320 pacientes. La prevalencia de HTA controlada fue del 52,6% (IC95%: 51,1-54,1). La falta de control de la HTA se asoció con diabetes (p<0,001), cardiopatía hipertensiva (p<0,001), enfermedad renal crónica (p<0,001) y enfermedad arterial periférica (p=0,02). El incumplimiento del tratamiento también se asoció con HTA no controlada (5,1% [117/2.274] en los controlados versus 43,2% [885/2.046] en los no controlados; p<0,001). Conclusión: La prevalencia detectada de HTA controlada fue del 52,6%

Introduction: In Venezuela, no large studies have been conducted to determine the level of control of hypertension (HT). Objective: The primary objective was to know the prevalence of controlled HT among hypertensive patients treated pharmacologically. Materials and methods: A cross-section study was conducted on patients 18years and older. Results: A total of 4,320 patients were included. The prevalence of controlled hypertension was 52.6% (95%CI: 51.1-54.1%). The lack of control of HT was associated with diabetes (P<.001), hypertensive heart disease (P<.001), chronic kidney disease (P<.001), and peripheral arterial disease (P=.02). Non-compliance of treatment was also associated with uncontrolled HT (5.1% [117/2,274] in the controlled versus 43.2% [885/2,046] in the uncontrolled; (P<.001). Conclusion: The prevalence detected of controlled hypertension was 52.6%

[Arterial Hypertension register in private clinics in Venezuela: RHAVEN Study]. / Registro de Hipertensión Arterial en consultas privadas en Venezuela: Estudio RHAVEN.

INTRODUCTION: In Venezuela, no large studies have been conducted to determine the level of control of hypertension (HT). OBJECTIVE: The primary objective was to know the prevalence of controlled HT among hypertensive patients treated pharmacologically. MATERIALS AND METHODS: A cross-section study was conducted on patients 18years and older. RESULTS: A total of 4,320 patients were included. The prevalence of controlled hypertension was 52.6% (95%CI: 51.1-54.1%). The lack of control of HT was associated with diabetes (P<.001), hypertensive heart disease (P<.001), chronic kidney disease (P<.001), and peripheral arterial disease (P=.02). Non-compliance of treatment was also associated with uncontrolled HT (5.1% [117/2,274] in the controlled versus 43.2% [885/2,046] in the uncontrolled; (P<.001). CONCLUSION: The prevalence detected of controlled hypertension was 52.6%.

Evolución de la adherencia al tratamiento antirretoviral del 2000 al 2008 / Evolution of antiretroviral treatment adherence from 2000 to 2008

Objetivos Evaluar la adherencia al tratamiento antirretroviral en la cohorte de pacientes VIH de nuestro hospital y ver su evolución a lo largo de 9 años; así como conocer el patrón individual de la adherencia con el tiempo. Métodos Estudio descriptivo de la evolución de la adherencia media anual y el porcentaje anual de pacientes con adherencias superiores al 95%, desde el 2000 al 2008. Se analizó el patrón individual de adherencia con el tiempo y se clasificó a los pacientes en adherentes consistentes, no adherentes consistentes y fluctuantes. Resultados En el análisis de 577 pacientes, la adherencia basal fue significativamente mayor en los pacientes naive respecto a los pretratados. La adherencia media anual aumentó ligeramente y se mantuvo en valores cercanos al 95%. Al igual que el porcentaje de pacientes con adherencia superior al 95%, que aumentó desde el 64% en el 2000 al 79% en 2008.En cuanto al patrón individual de adherencia con el tiempo, de los 468 pacientes analizados, la mayoría (59%) fueron adherentes consistentes, un 4% no adherente y el resto (37%) presentaban fluctuaciones en su adherencia. Conclusiones En nuestra cohorte los valores de adherencia global se mantienen con el tiempo e incluso presentan una tendencia positiva; resultado de una monitorización sistemática de la adherencia e implantación de estrategias dirigidas a mantener la adherencia (AU)

Objectives To evaluate antiretroviral treatment adherence in the HIV patient cohort of our hospital and observe their evolution over a 9-year period; also to determine the individual pattern of adherence over time. Methods Descriptive study of the evolution of average annual adherence and the annual percentage of adherent patients greater than 95% from 2000 to 2008. We analysed the individual pattern of adherence over time and patients were classified into consistently adherent, consistently non-adherent, and fluctuating. Results In the analysis of 577 patients, baseline adherence was significantly greater in naïve patients with respect to those who were pre-treated. Average annual adherence increased slightly and stayed at values around 95%. As with the percentage of patients with adherence greater than 95%, which increased from 64% in 2000 to 79% in 2008.In terms of the individual pattern of adherence over time, of the 468 patients analysed, the majority (59%) were consistently adherent, 4% non-adherent, and the rest (37%) fluctuated in their adherence. Conclusions In our cohort the overall adherence values maintained themselves over time and even show a positive trend, likely the result of systematic monitoring of adherence and implementation strategies to maintain adherence (AU)

[Evolution of antiretroviral treatment adherence from 2000 to 2008]. / Evolución de la adherencia al tratamiento antirretoviral del 2000 al 2008.

OBJECTIVES: To evaluate antiretroviral treatment adherence in the HIV patient cohort of our hospital and observe their evolution over a 9-year period; also to determine the individual pattern of adherence over time. METHODS: Descriptive study of the evolution of average annual adherence and the annual percentage of adherent patients greater than 95% from 2000 to 2008. We analysed the individual pattern of adherence over time and patients were classified into consistently adherent, consistently non-adherent, and fluctuating. RESULTS: In the analysis of 577 patients, baseline adherence was significantly greater in naïve patients with respect to those who were pre-treated. Average annual adherence increased slightly and stayed at values around 95%. As with the percentage of patients with adherence greater than 95%, which increased from 64% in 2000 to 79% in 2008. In terms of the individual pattern of adherence over time, of the 468 patients analysed, the majority (59%) were consistently adherent, 4% non-adherent, and the rest (37%) fluctuated in their adherence. CONCLUSIONS: In our cohort the overall adherence values maintained themselves over time and even show a positive trend, likely the result of systematic monitoring of adherence and implementation strategies to maintain adherence.

[Vibrio vulnificus septicemia in Spain]. / Septicemia por Vibrio vulnificus en España.

Vibrio vulnificus is a virulent marine organism, able to contaminate sea-food. It usually produces bacteremia associated with secondary skin lesions in patients with underlying conditions, such as hepatic cirrhosis. We report a case of septic shock and characteristic skin lesions, due to Vibrio vulnificus in a patient with cirrhosis, who had eaten raw oysters. The patient survived in spite of the severity of the clinical picture. We conclude that Vibrio vulnificus infection must be considered in the differential diagnosis of sepsis and skin lesions.

An outbreak of Q fever in the Basque country.

The main clinical manifestations of 42 cases of Q fever occurring in an outbreak in Valmaseda, Spain during March, April and May 1982 are described in this paper. The benign character of the acute disease is emphasized. Further epidemiologic studies must be done to determine the incidence of Q fever in the Basque country.

Influencia del sodio en la fisiopatogenia y el tratamiento de la hipertensión arterial esencial / Influence of sodium on physiopathogenesis and treatment of essential hypertension

Se valoran las características de algunos aspectos clínicos y de laboratorio (sobre todo aquéllos relacionados con el comportamiento del sodio) en dos series de individuos sanos normotensos y en 130 hipertensos esenciales con función renal normal (creatinina inferior a 1,3 mg porciento y renograma isotópico normal). A 16 de los pacientes hipertensos escogidos al azar se les vuelve a estudiar, desde el punto de vista clínico y humoral después de indicarles regímenes dietéticos ricos en sodio y sin sodio (todo ello sin tratamiento hipotensor o diurético y con actividad física normal). Se observó similitud en los resultados de los grupos de normo e hipertensos, con cierta tendencia de este último a tener más edad, más peso y mayor natriuresis(AU)