RESUMO
Este consenso fue ideado por el Director del Programa Nacional de Prevención Cardiovascular del M.S P. y B.S. (Paraguay) a raíz de que se necesitaba un documento actualizado que sirva como guía a los profesionales de la salud de todos los niveles de atención incluyendo a las diferentes especialidades, que tratan la hipertensión arterial y sus complicaciones agudas y crónicas. A través del convenio entre el Programa Nacional de Prevención Cardiovascular y la Sociedad Paraguaya de Cardiología de realizar actualizaciones de las Guías o documentos para difusión de manejo de patologías cardiovasculares y factores de riesgo asociados, se ha decidido elaborar y lanzar este material, que será utilizado como guía oficial en todo el territorio nacional. Con mesas de trabajo de varios días y la colaboración de representantes de sociedades científicas afines y asesores internacionales se ha logrado esta guía. Se presentan recomendaciones para facilitar el manejo de los pacientes con hipertensión arterial y sus complicaciones, con el propósito de disminuir la morbimortalidad cardiovascular. Han sido elaboradas según las evidencias científicas y conocimiento de expertos, con un enfoque práctico y sencillo. Todos los participantes aprobaron las decisiones finales. Los autores reconocen que la publicación y difusión de directrices serán siempre una guía práctica y que permitirá a los médicos ampliar los conocimientos con las recomendaciones propuestas, detectar precozmente el daño de órganos blancos y mejorar la calidad de vida de los pacientes hipertensos.
This consensus was conceived by the Director of the National Program of Cardiovascular Prevention of the M.S P. y B.S. (Ministry of Public Health and Social Welfare, Paraguay) because an updated document was necessary as a guide for health professional of all care levels including different specialties that treat arterial hypertension and its acute and chronic complications. Through this consensus between the National Program of Cardiovascular Prevention and the Paraguayan Cardiology Society of updating Guides or documents for the dissemination of the management of cardiovascular pathologies and associated risk factors it was decided to elaborate and launch this material that will be used as an official guide in the national territory. This guide was achieved after working tables held during several days and the collaboration of representatives of related scientific societies and international advisers. Recommendations for facilitating the management of patients with arterial hypertension and its complications are presented in order to reduce the cardiovascular morbidity and mortality. They have been elaborated according to scientific evidence and knowledge of experts with a practical and simple approach. All the participants approved the final decisions. The authors recognize that the publications and dissemination of guidelines will always be a practical guide that will allow physicians to increase their knowledge with the proposed recommendation in order to early detect the damage of target organs and improve the quality of life of the hypertensive patients.
RESUMO
Investiga la verdadera prevalencia de pacientes que tienen factores de riesgo, factores precipitantes, complicaciones morbi-mortalidad, etiologías y tratamientos realizados en el medio hospitalario, se utilizo como fuente la ficha clínica de 192 pacientes con el diagnóstico de insuficiencia cardíaca moderada a severa, examinados desde enero de 1993 a diciembre de 1997 abarcando 5 años de estudio, en la segunda Cátedra de Clínica Médica del Hospital de Clínicas de Asunción
Assuntos
Fatores de Risco , Insuficiência Cardíaca , ParaguaiRESUMO
Epithelial-mesenchymal interaction in the early development of the anterior pituitary gland was examined by chronological observations on fetal pituitary epithelium grafted in vivo with and without its own mesenchyme. At 8.5 days of gestation, the RATHKE'S pouch began to evaginate toward the diencephalon. The mesenchymal tissue around the pouch was at first very sparsely scattered, but then condensed, on day 10 becoming visible under a dissecting microscope. When RATHKE'S pouch epithelia from 10- and 12-day fetuses were transplanted alone under the kidney capsule, they proliferated slightly to form cysts, the cells of which differentiated into ACTH-producing cells, but not into prolactin-producing cells. Pituitary morphogenesis did not occur. When these epithelia were recombined with homotypic mesenchyme and transplanted, the epithelia proliferated remarkably on one side of the wall of the pouch, resulting in formation of a pars distalis that contained both ACTH-producing cells and prolactin-producing cells. Heterotypic mesenchyme, such as lung, dermis and mammary gland mesenchyme, could induce 12-day epithelium, but not 10-day epithelium to develop into pars distalis. Thus, fetal pituitary epithelium has the capacity of autodifferentiation into ACTH-producing cells, not into prolactin-producing cells, and requires mesenchymal support for development of the pars distalis.