Background Adherence to antihypertensive medication is a major challenge in the management of hypertension, and non-adherence is an important barrier to effective management of hypertension. Objectives To determine the adherence rate to hypertensive drug treatment and the factors that influence non-adherence in a cohort of the Argentinean population. Methods A multicenter cross-sectional study was conducted in eight cities of Argentina. Consecutive hypertensive patients seen in general practice offices, receiving pharmacological treatment for at least six months were included. Blood pressure measurements were performed by physicians during the patient visit. The level of adherence was assessed using the Morisky questionnaire, and patients were divided into non-adherent and adherent. Continuous variables were compared using independent t-test. Categorical variables were compared using the χ2 test. To identify the variables independently associated with non-adherence, a forward stepwise binary regression logistic model was performed, and the results expressed as odds ratio (OR) with 95% of confidence interval. All tests were two-tailed, and p-values < 0.05 were considered statistically significant. Results A total of 852 individuals (52% women, 62 ± 13 years) were included. The main reason for lack of adherence was forgetfulness of medication intake and errors in the time of intake (~ 40% in both). Individuals with more cardiovascular risk factors (smoking, diabetes, dyslipidemia and previous cardiovascular events) had lower adherence to antihypertensive treatment, and considerably younger (~ five years younger). Conclusions Adherence rate to antihypertensive drug treatment in our study group was higher than the one reported in previous studies, and the main reason for non-adherence was forgetfulness of medication intake. (Int J Cardiovasc Sci. 2020; 33(3):272-277)

Dyslipidemia

Antihypertensive drug

10.36660/ijcs.20190069

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COVID-19 associated acro-ischemia

Revista Virtual de la Sociedad Paraguaya de Medicina Interna (2020)

Rodrigo Sabio Gabriela Giaccaglia Pascual Valdéz

Paciente de 19 años, sexo femenino, residente en Buenos Aires, Argentina, que el día 25 de marzo de 2020 contacta con su médico internista de cabecera en forma privada mediante el sistema de videoconsulta por haber presentado desde 48 horas atrás, lesiones eritemato violáceas en región distal de los dedos de los pies y además lesiones máculo-eritematosas circulares de pocos milímetros en los pulpejos de los dedos de los pies. Las lesiones eran referidas como dolorosas, principalmente durante la noche y presentaban hiperalgesia al tacto. Presentaba nexo epidemiológico con dos personas afectadas por probable SARS-CoV-2, una semana previa a la aparición de estas lesiones.

10.18004/rvspmi/2312-3893/2020.07.02.105

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RESUMEN DE LAS RECOMENDACIONES SAM SOBRE EL MANEJO DE LA HIPERTENSIÓN ARTERIAL EN ADULTOS

REVISTA ARGENTINA DE MEDICINA (2018)

Rodrigo Sabio Pascual Valdéz Hugo Zelechower José Pizzorno Luis Alberto Cámera

La hipertension arterial es el principal factor de riesgo de orbimortalidad cardiovascular. En los ultimos anos se generaron numerosas recomendaciones con respecto al manejo de la hipertension arterial, con informacion divergente entre ellas y muchas de ellas realizadas en paises de altos ingresos con otras realidades socioeconomicas y pidemiologicas. En general, pocas recomendaciones referidas al manejo de la hipertension arterial surgen de la clinica medica, especialidad que permite la mirada holistica e integrada de los problemas de salud del adulto. Los problemas que se asocian a un control deficitario de la hipertension arterial son: subutilizacion del tratamiento farmacologico, baja tasa de pacientes tratados con estrategia combinada, falta de prescripcion adecuada de los cambios en el estilo de vida, baja adherencia terapeutica e inercia clinica. En la presente publicacion se presentan recomendaciones efectuadas por especialistas en clinica medica/medicina interna para el manejo de la hipertension arterial en adultos.Palabras clave. Hipertension arterial, guias, recomendaciones, morbilidad cardiovascular, mortalidad cardiovascular, farmacos antihipertensivos, adherencia, monoterapia, terapia combinada, inercia clinica, estilos de vida.SUMMARY OF SAM GUIDELINES ON THE MANAGEMENT OF HYPERTENSION IN ADULTSAbstractHypertension is the main risk factor for cardiovascular morbidity and mortality. Over the last years, several guidelines have been published regarding the management of arterial hypertension, with divergent information among them and many of them carried out in high-income countries, with their own socioeconomic and epidemiological realities. In general, few guidelines regarding the management of arterial hypertension arise from the medical clinic, specialty that allows a holistic and integrated view of health issues in the adult. There are problems associated with poor control, such as underutilization of pharmacological treatment, low rate of patients treated with a combined strategy, lack of adequate prescription of changes in lifestyle, low therapeutic adherence and clinical inertia. This article presents guidelines made by medical clinic/internal medicine specialists for the management of hypertension in adults.Key words. Hypertension, guidelines, recommendations, cardiovascular morbidity, cardiovascular mortality, antihypertensive drugs, adherence, monotherapy, combination therapy, clinical inertia, lifestyles.

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[Recommendations For The Management Of Spontaneous Intracerebral Hemorrhage During Hospitalization].

PubMed (2022)

Santiago Pigretti Matías Mirofsky D. García Cristian Issac Pascual Valdéz

Stroke is the leading cause of neurological disability in people over 40 years of age and the fourth leading cause of death in Argentina. In the last ten years, the indexed publications related to the treatment of ischemic stroke were more numerous than those of hemorrhagic stroke. The objective of this material is to provide local and updated recommendations for the management of patients with spontaneous intracerebral hemorrhage during hospitalization. For the writing of this manuscript, diferent specialists were convened to form working groups. Ten central topics expressed as epidemiology, initial care, imaging, blood pressure treatment, reversal of antithrombotics, indication for surgery, seizure prophylaxis, prognosis, prevention of complications and resumption of antithrombotics were raised. For each topic, the most frequent questions of daily practice were raised through PICO questions. After a systematic review of the literature, recommendations were generated, evaluated using the GRADE system and agreed between authors and patients.El accidente cerebrovascular (ACV) constituye la principal causa de discapacidad de origen neurológico en los adultos mayores a 40 años y la cuarta causa de muerte en Argentina. En los últimos diez años las publicaciones indexadas relacionadas al tratamiento del ACV isquémico fueron más numerosas que las de ACV hemorrágico. El objetivo de este material es proporcionar recomendaciones locales y actualizadas del abordaje de pacientes con hematoma intraparenquimatoso espontáneo durante la internación. Para la redacción de este manuscrito se convocó a especialistas en esta enfermedad que conformaron grupos de trabajo. Se plantearon 10 tópicos centrales expresados como epidemiologia, atención inicial, imágenes, tratamiento de la presión arterial, reversión de antitrombóticos, indicación de cirugía, profilaxis anticonvulsivante, pronóstico, prevención de complicaciones y reinicio de antitrombóticos. De cada tópico se plantearon mediante preguntas PICO los interrogantes más frecuentes de la práctica diaria. Luego de una revisión sistemática de la literatura, se generaron recomendaciones evaluadas mediante sistema GRADE y consensuadas entre autores y pacientes.

Stroke

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COVID-19 associated acro-ischemia

Revista Virtual de la Sociedad Paraguaya de Medicina Interna (2020)

Rodrigo Sabio

ABSTRACT This was a 19-year-old female patient, residing in Buenos Aires, Argentina, who in March 25, 2020 contacted her general internist doctor privately through the video consultation system for having presented violet erythematous lesions in the distal region of the toes and also circular maculo-erythematous lesions of a few millimeters on the toe tips 48 hours ago The lesions were referred to as painful, mainly at night, and they presented hyperalgesia to the touch She had an epidemiological link with two people affected by probable SARS-CoV-2, one week before the appearance of these injuries

2019-20 coronavirus outbreak

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Cerebral venous thrombosis in Argentina: clinical presentation, predisposing factors, outcomes and literature review

Journal of Stroke and Cerebrovascular Diseases (2020)

Matías Alet Celina Ciardi Alberto Alemán Lucrecia Bandeo Pablo Bonardo

Presentation (obstetrics)

Intracranial Thrombosis

10.1016/j.jstrokecerebrovasdis.2020.105145

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