Early detection and management of the high-risk patient with elevated blood pressure

Severe or important blood pressure elevations are associated with the risk of cardiovascular disease. However, a significant proportion of myocardial infarctions and strokes occur in subjects with only slight elevations or even with normal blood pressure. Both the coexistence of other cardiovascular risk factors, such as diabetes or dyslipidemia, or those recently recognized, such as elevations of C-reactive protein or abdominal obesity and metabolic syndrome, or the presence of target organ damage, such as microalbuminuria, left ventricular hypertrophy, mild renal dysfunction or increased intima-media thickness, all indicate the existence of a high cardiovascular risk in mild hypertensives or in subjects with normal or high-normal blood pressure. Unfortunately, these high-risk patients are often not recognized and thus under-treated

Notes on Guatemalan Plusiotis (Coleoptera: Scarabaeidae; Rutelinae)

Dos especies nuevas de escarabajos del genero Plusiotis se describen de un bosque nuboso, 1560-1900 m en el departamento de San Marcos, Guatemala. Tambien se describen las hembras de P. turhheimi Ohaus, P. auropunctata Ohaus y P. quiche Moron. Ademas, se registra pOI' primera vez a P. turhheimi para Guatemala.Two new species of Plusiotis are described from a cloud forest between 1560-1900 m in the Department of San Marcos, Guatemala. Females of P. turhheimi Ohaus, P. auropunctata Ohaus and P. quiche Moron are described. Plusiotis turhheimi is reported from Guatemala for the first time

Diseño de un programa psicoeducativo mediante una intervención enfermera para el aumento del afrontamiento y la autoestima

Treball final de Màster Universitari en Rehabilitació Psicosocial en Salut Mental Comunitària. Codi: SAX013. Curs acadèmic 2016-2017Las personas que presentan trastornos mentales graves se encuentran con problemas a lo largo de su vida relacionados con el estigma, siendo más permanentes, constantes y difíciles de intervenir que los propios problemas derivados de la enfermedad o trastorno, susceptibles de poder ser intervenidos con gran efectividad. Revisando la literatura sobre las intervenciones eficaces puestas en marcha para disminuir o corregir los efectos del estigma existe un número importante de recomendaciones basadas en los modelos teóricos de carácter cognitivo-conductual. Es por ello que se ha seleccionado el Diagnostico de enfermería Baja autoestima crónica y el de Afrontamiento ineficaz que abarcan las dificultades que presentan los pacientes con trastorno mental grave en su vida cotidiana para intentar paliar o corregir estos efectos y trabajarlo en este proyecto mediante un grupo psicoeducativo desarrollando las intervenciones enfermeras de estos diagnósticos. Se trata de un estudio con metodología cuantitativa de intervención, cuasi experimental de antes y después, prospectivo y longitudinal. Para participar en el estudio se deberán cumplir los criterios de inclusión y exclusión determinados. Los resultados se obtendrán con la aplicación de los instrumentos descritos al efecto, para determinar cómo ha influido la intervención enfermera. Se utilizarán como instrumentos de medida la escala de indicadores de resultados de la Taxonomía NOC, la escala de autoestigma de la enfermedad (ISMI) y la escala de autoestima de Rosemberg

Derecho procesal laboral colombiano : una mirada desde su historia y evolución

Con este trabajo de investigación se pretende un estudio sobre la historia del derecho procesal laboral, con el objetivo principal de reconstruir los pasos que ha dado el legislador a lo largo de los años hasta llegar al Código Procesal Laboral que actualmente rige en Colombia.81 p.Contenido parcial: Reglas o máximas procesales -- Los sistemas procesales -- Reseña histórica -- Antecedentes del derecho procesal en Colombia

Connecting Cerebral White Matter Lesions and Hypertensive Target Organ Damage

Chronic hypertension leads to concomitant remodeling of the cardiac and vascular systems and various organs, especially the brain, kidney, and retina. The brain is an early target of organ damage due to high blood pressure, which is the major modifiable risk factor for stroke and small vessel disease. Stroke is the second leading cause of death and the number one cause of disability worldwide and over 80% of strokes occur in the elderly. Preclinical hypertensive lesions in most target organs are clearly identified: left ventricular hypertrophy for the heart, microalbuminuria for the kidney, fundus abnormalities for the eye, and intima-media thickness and pulse wave velocity for the vessels. However, early hypertensive brain damage is not fully studied due to difficulties in access and the expense of techniques. After age, hypertension is the most-important risk factor for cerebral white matter lesions, which are an important prognostic factor for stroke, cognitive impairment, dementia, and death. Studies have shown an association between white matter lesions and a number of extracranial systems affected by high BP and also suggest that correct antihypertensive treatment could slow white matter lesions progression. There is strong evidence that cerebral white matter lesions in hypertensive patients should be considered a silent early marker of brain damage

Associations between Ambulatory Blood Pressure Parameters and Cerebral White Matter Lesions

Silent cerebral white matter lesions (WMLs) are a common finding on magnetic resonance imaging of the brain in the elderly. However, in patients with hypertension, WMLs tend to occur earlier in life and appear to be more severe. There is a body of evidence that supports the idea that WMLs in asymptomatic hypertensive patients should be considered a silent early marker of brain damage. It is known that ambulatory blood pressure monitoring (ABPM) correlates more closely with hypertension-related organ damage than office blood pressure. This paper focuses on the associations between blood pressure parameters obtained by 24-hour ABMP and cerebral WMLs

Preface: Advances in flood risk assessment and management

Floods are among Earth's most common and most destructive natural hazards, affecting human lives and properties directly and indirectly around the world. The frequency and magnitude of extreme flooding have been increasing in many parts of the world in recent decades (see, e.g. Berghuijs et al., 2017; Blöschl et al., 2019a; Marijnissen et al., 2019), hampering human well-being and economic growth in both developed and developing countries. Flood risk management carries out the flood risk assessment and uses appropriate resources (human, finance, science and technology, and nature) to control the flood risk (Han, 2011), which is an urgent challenge for the scientific and engineering communities to address. In a similar way to "Twenty-Three unsolved problems in hydrology" (Blöschl et al., 2019b), despite decades of research in this field, there are still many unsolved problems in floods as well. This special issue "Flood Risk Assessment and Management" is an outcome of the session "Flood Risk Assessment and Management" in the Naturals Hazards Division at the European Geosciences Union (EGU) General Assembly held in Vienna, Austria. The session series has been organized annually at EGU since 2018. This special issue presents a wide range of in-depth research studies based on flood modelling (including hydrological modelling and hydrodynamic modelling), hazard mapping, flood damage and risk assessment as well as studies that focus on flood relief prioritization, mitigation strategies and flood policies. Extraordinary floods and debris flows are also included due to dam and dike breaks and extreme storms over gullies in mountain areas. The nine articles in this special issue are broadly introduced in the following three categorie

La responsabilidad patrimonial de la Administración en el ámbito penitenciario = The liability of the Administration in the penitentiary environment

La responsabilidad patrimonial de la Administración está regulada, esencialmen-te, en los artículos 121.1 de la Ley de Expropiación Forzosa y 40 de la Ley de Régimen Jurídico de la Administración del Estado; pero además, a nivel constitucional, en el ar-tículo 106. El sistema español de responsabilidad patrimonial administrativa se configura como un sistema principal, directo y objetivo. En el ámbito penitenciario, la responsabi-lidad patrimonial se reconocerá a aquellos particulares que hayan visto lesionado alguno de sus bienes o derechos, como consecuencia de la actuación de la Administración en el ejercicio de sus funciones. El marco real en el que se configura la responsabilidad patrimonial de la Admi-nistración penitenciaria puede, atendiendo al criterio del espacio físico donde puede generarse el daño cuya imputación se atribuye a la Administración, enmarcarse en dos grupos: uno, entorno a los daños que se puedan producir en el interior del Centro peni-tenciario; y otro, entorno al exterior, es decir, los daños que se puedan producir con oca-sión del disfrute de los beneficios otorgados a un recluso. La complejidad de este tema es lo que este trabajo pretende abordar, con una re-ferencia, en primer lugar, a los aspectos doctrinales, para a continuación, analizar la casuística jurisprudencial