Gender differences in workplace violence against physicians and nurses in Latin America: a survey from the Interamerican Society of Cardiology.

OBJECTIVES: To evaluate gender differences in workplace violence (WPV) against physicians and nurses in Latin America. STUDY DESIGN: Cross-sectional study. METHODS: A cross-sectional electronic survey was conducted between January 11 and February 28, 2022. A prespecified gender analysis was performed. RESULTS: Among the 3056 responses to the electronic survey, 57% were women, 81.6% were physicians, and 18.4% were nurses. At least one act of violence was experienced by 59.2% of respondents, with verbal violence being the most common (97.5%). Women experienced more WPV than men (65.8% vs 50.4%; P < 0.001; odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.63-2.19). Women were more likely to report at least one episode of WPV per week (19.2% vs 11.9%, P < 0.001), to request for psychological help (14.5% vs 9%, P = 0.001) and to experience more psychosomatic symptoms. In addition, women were more likely to report having considered changing their job after an aggression (57.6% vs 51.3%, P = 0.011) and even leaving their job (33% vs 25.7%, P = 0.001). In a multivariate analysis, being a woman (OR: 1.76), working in emergency departments (OR: 1.99), and with COVID-19 patients (OR: 3.3) were independently associated with more aggressive interactions, while older age (OR: 0.95) and working in a private setting (OR: 0.62) implied lower risk. CONCLUSIONS: Women are more likely to experience WPV and to report more psychosomatic symptoms after the event. Preventive measures are urgently needed, with a special focus on high-risk groups such as women.

[Heart failure in Argentina]. / Perspectiva de la insuficiencia cardíaca en la Argentina.

Heart failure is a common and costly clinical entity that implies high morbidity and mortality. The aim of this study was to establish the impact of the heart failure syndrome in our country. We analyzed: 1) the data-base of vital statistics from the National Program of Health Statistics, Ministry of Health, between 1980 and 1997, 2) the registers from two national surveys on heart failure patients performed by the Argentine Society of Cardiology and the Argentine Council of Residents in Cardiology. Cardiovascular syndromes have constituted the first cause of death in our country for the last twenty years. Among these, heart failure represents the most frequent entity. From 1980 to 1997 a progressive reduction of 31% in the rate of cardiovascular mortality was observed. From 1990 to 1997, a decrease in the mortality rate due to heart failure of 22.4% was registered. Age and sex adjusted mortality from heart failure suffered a steady increase in older groups, specially above 65 years of age. Hospital discharge data showed that heart failure and cerebrovascular illness are the highest prevalent entities. National surveys on heart failure demonstrate a high prevalence of hypertension, as an associated risk factor, and non compliance with the medication and diet as causes of decompensation. A trend towards an increase in pharmacological prescriptions was also observed.

Perspectiva de la insuficiencia cardíaca en la Argentina. / [Heart failure in Argentina]

Heart failure is a common and costly clinical entity that implies high morbidity and mortality. The aim of this study was to establish the impact of the heart failure syndrome in our country. We analyzed: 1) the data-base of vital statistics from the National Program of Health Statistics, Ministry of Health, between 1980 and 1997, 2) the registers from two national surveys on heart failure patients performed by the Argentine Society of Cardiology and the Argentine Council of Residents in Cardiology. Cardiovascular syndromes have constituted the first cause of death in our country for the last twenty years. Among these, heart failure represents the most frequent entity. From 1980 to 1997 a progressive reduction of 31

in the rate of cardiovascular mortality was observed. From 1990 to 1997, a decrease in the mortality rate due to heart failure of 22.4

was registered. Age and sex adjusted mortality from heart failure suffered a steady increase in older groups, specially above 65 years of age. Hospital discharge data showed that heart failure and cerebrovascular illness are the highest prevalent entities. National surveys on heart failure demonstrate a high prevalence of hypertension, as an associated risk factor, and non compliance with the medication and diet as causes of decompensation. A trend towards an increase in pharmacological prescriptions was also observed.

[Digital coronary angiography. A new approach in the analysis of the arteriosclerotic plaque]. / Angiografía digital coronaria. Un nuevo enfoque en el análisis de la placa ateroesclerótica.

In order to define the coronary lesions we prospectively performed digital coronary angiographies in 61 patients. The degree of stenosis was measured in 100 lesions by quantitative analysis using densitometric and geometric methods. Two groups of lesions were found by comparing these two methods: Group A, 47 lesions with a poor correspondence in the degree of stenosis between densitometric and geometric analysis (p greater than 0.01; and group B, 53 lesions with a good correspondence. Both groups were correlated with plaque characteristics (unstable or stable), following angiographic criteria. The mean degree of stenosis in all lesions, for densitometric and geometric analysis was 50.04 +/- 21.1% and x 60.66 +/- 22.1% (p less than 0.01), respectively. Unstable plaque was more frequent in group A (80.9%) than in B (17.9%) (p less than 0.0001), and stable plaque was more frequent in B (81.1%) than in A (19.1%) (p less than 0.0001). Less degree of stenosis between A (41.5 +/- 13.2) and B (61.3 +/- 16.05) was found by densitometric analysis (p less than 0.0001) but it was similar by geometric method (60.02 +/- 11.3 in A and 58.6 +/- 14.4 in B) so that the degree of stenosis in unstable plaque was lower by densitometric method. We conclude that densitometric analysis showed poor correlation with geometric analysis in unstable plaques; the difference could be due to the soft component expression of the unstable plaque.

Angiografía digital coronaria. Un nuevo enfoque en el análisis de la placa ateroesclerótica. / [Digital coronary angiography. A new approach in the analysis of the arteriosclerotic plaque]

In order to define the coronary lesions we prospectively performed digital coronary angiographies in 61 patients. The degree of stenosis was measured in 100 lesions by quantitative analysis using densitometric and geometric methods. Two groups of lesions were found by comparing these two methods: Group A, 47 lesions with a poor correspondence in the degree of stenosis between densitometric and geometric analysis (p greater than 0.01; and group B, 53 lesions with a good correspondence. Both groups were correlated with plaque characteristics (unstable or stable), following angiographic criteria. The mean degree of stenosis in all lesions, for densitometric and geometric analysis was 50.04 +/- 21.1

and x 60.66 +/- 22.1

(p less than 0.01), respectively. Unstable plaque was more frequent in group A (80.9

) than in B (17.9

) (p less than 0.0001), and stable plaque was more frequent in B (81.1

) than in A (19.1

) (p less than 0.0001). Less degree of stenosis between A (41.5 +/- 13.2) and B (61.3 +/- 16.05) was found by densitometric analysis (p less than 0.0001) but it was similar by geometric method (60.02 +/- 11.3 in A and 58.6 +/- 14.4 in B) so that the degree of stenosis in unstable plaque was lower by densitometric method. We conclude that densitometric analysis showed poor correlation with geometric analysis in unstable plaques; the difference could be due to the soft component expression of the unstable plaque.

Estudio angiográfico precoz post angioplastia exitosa: predictor de reestenosis alejada / Early angiographic study post successful angioplasty: predictor of late restenosis

Con el objeto de buscar predictores angiográficos precoces de reestenosis en ATC, se efectuó coronariografia a las 24 hs del procedimiento en forma prospectiva y consecutiva a 71 pacientes que habían sido dilatados exitosamente. El análisis del grado previa a la dilatación, a los 30 minutos posteriores y a las 24 hs, se hizo en forma culatitativa por cine convencional y cuantitativa por angiografia digital. A las 24 hs los hallazgos angiográficos fueronÑ Grupo AÑ Pacientes con igual lúmen que en el momento inmediato post dilatación (65,9%), Grupo BÑ Pacientes con 20% o más de estenosis que en el momento inmediato post ATC (21,5%). Grupo CÑ Pacientes con oclusión total del vaso (12,6%). Clínicamente las características basales de los 3 grupos fueron similares. basal y las características clínicas fueron similares en los 3 grupos, las arterias dilatadas en A y B fueron similares, y en C hubo mayor incidencia de pacientes con oclusión total previa. El grado de obstrucción residual a los 30 minutos de la ATC, fue menor en el Grupo A que en el B (p < ,01) y en C (p = NS). Estas diferencias sin embargo fueron más significativas a las 24 horas y en el seguimiento alejado (p < ,0001). En el seguimiento alejado (x 6,4 meses) hubo un 32,9% de reestenosis global por lesión, en el grupo A ésta fue del 8,6%, en el B del 68,4% (p < 0001) y en B + C del 80%. Los pacientes con grado de obstrucción mayor del 10% tuvieron mayor reestenosis (43,9%) que cuando la misma fue menor del 10% (23,04%). Los pacientes en el grupo A, con menos del 10% de obstrucción residual post ATC, tuvieron 7,6% de reestenosis y en B y C 100%. Con más del 10% en A, la reestenosis fue del 10,5% y en B+C del 72,7%. El estudio angiográfico a las 24 hs. post-angioplastia exitosa separó lesiones con baja (grupo A) o alta (grupo B) probabilidad de reestenosis alejada. Este valor predictivo fue independiente del grado de estenosis residual post-angioplastia inmediata

Estudio angiográfico precoz post angioplastia exitosa: predictor de reestenosis alejada / Early angiographic study post successful angioplasty: predictor of late restenosis

Con el objeto de buscar predictores angiográficos precoces de reestenosis en ATC, se efectuó coronariografia a las 24 hs del procedimiento en forma prospectiva y consecutiva a 71 pacientes que habían sido dilatados exitosamente. El análisis del grado previa a la dilatación, a los 30 minutos posteriores y a las 24 hs, se hizo en forma culatitativa por cine convencional y cuantitativa por angiografia digital. A las 24 hs los hallazgos angiográficos fueronÑ Grupo AÑ Pacientes con igual lúmen que en el momento inmediato post dilatación (65,9%), Grupo BÑ Pacientes con 20% o más de estenosis que en el momento inmediato post ATC (21,5%). Grupo CÑ Pacientes con oclusión total del vaso (12,6%). Clínicamente las características basales de los 3 grupos fueron similares. basal y las características clínicas fueron similares en los 3 grupos, las arterias dilatadas en A y B fueron similares, y en C hubo mayor incidencia de pacientes con oclusión total previa. El grado de obstrucción residual a los 30 minutos de la ATC, fue menor en el Grupo A que en el B (p < ,01) y en C (p = NS). Estas diferencias sin embargo fueron más significativas a las 24 horas y en el seguimiento alejado (p < ,0001). En el seguimiento alejado (x 6,4 meses) hubo un 32,9% de reestenosis global por lesión, en el grupo A ésta fue del 8,6%, en el B del 68,4% (p < 0001) y en B + C del 80%. Los pacientes con grado de obstrucción mayor del 10% tuvieron mayor reestenosis (43,9%) que cuando la misma fue menor del 10% (23,04%). Los pacientes en el grupo A, con menos del 10% de obstrucción residual post ATC, tuvieron 7,6% de reestenosis y en B y C 100%. Con más del 10% en A, la reestenosis fue del 10,5% y en B+C del 72,7%. El estudio angiográfico a las 24 hs. post-angioplastia exitosa separó lesiones con baja (grupo A) o alta (grupo B) probabilidad de reestenosis alejada. Este valor predictivo fue independiente del grado de estenosis residual post-angioplastia inmediata (AU)

[Early angiographic study post successful angioplasty. Predictor of late restenosis]. / Estudio angiográfico precoz post angioplastia exitosa. Predictor de reestenosis alejada.

Consecutive prospective coronary angiographies following 24 hours were studied to find early angiographic predictors of post-PTCA restenosis in the follow-up of 71 patients who had been dilated successfully. Conventional cine coronary and quantitative digital angiography was used to analyse the degree of obstruction previous to dilatation following 24 hours and 30 minutes after the procedure. Following 24 hours, angiographic findings showed: Group A: patients having the same lumen as at immediate post-PTCA time (65.9%); Group B: patients with 20% or more immediate post-PTCA time (21.5%). Group C: patients with total obstruction of vessel (12.6%). The basal clinical conditions were similar in the three groups. The degree of basal obstruction and the clinical findings were similar in the three groups; the dilated arteries in Groups A and B were similar and total occlusion before PTCA was more frequent in Group C than in B and A; 30 minutes post PTCA lesions in group A had less residual stenosis than group B (p less than .01) and C (p = NS), this difference increased significantly (p less than .0001) at 24 hours and in the late follow-up. In the follow-up (means 6.4 months) there was total restenosis per lesion in 32.9%. In Group A, there was 8.6%; in Group B, 68.4% (p less than .0001) and in Group B plus C, 80%. Patients with more than 10% obstruction had a greater degree of restenosis (43.9%) than when the initial lesion was less than 10% (23.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Estudio angiográfico precoz post angioplastia exitosa. Predictor de reestenosis alejada. / [Early angiographic study post successful angioplasty. Predictor of late restenosis]

Consecutive prospective coronary angiographies following 24 hours were studied to find early angiographic predictors of post-PTCA restenosis in the follow-up of 71 patients who had been dilated successfully. Conventional cine coronary and quantitative digital angiography was used to analyse the degree of obstruction previous to dilatation following 24 hours and 30 minutes after the procedure. Following 24 hours, angiographic findings showed: Group A: patients having the same lumen as at immediate post-PTCA time (65.9

); Group B: patients with 20

or more immediate post-PTCA time (21.5

). Group C: patients with total obstruction of vessel (12.6

). The basal clinical conditions were similar in the three groups. The degree of basal obstruction and the clinical findings were similar in the three groups; the dilated arteries in Groups A and B were similar and total occlusion before PTCA was more frequent in Group C than in B and A; 30 minutes post PTCA lesions in group A had less residual stenosis than group B (p less than .01) and C (p = NS), this difference increased significantly (p less than .0001) at 24 hours and in the late follow-up. In the follow-up (means 6.4 months) there was total restenosis per lesion in 32.9

. In Group A, there was 8.6

; in Group B, 68.4

(p less than .0001) and in Group B plus C, 80

. Patients with more than 10

obstruction had a greater degree of restenosis (43.9

) than when the initial lesion was less than 10

(23.4

).(ABSTRACT TRUNCATED AT 250 WORDS)