Carcinoma hepatocelular y linfoma folicular en paciente cirrótico por virus de la hepatitis C

El virus de la hepatitis C (VHC) tiene demostrado poder oncogénico. Su asociación con Carcinoma Hepatocelular (CHC) en pacientes con cirrosis hepática es bien conocida como también con el Linfoma no Hodgkin indolente. Es poco frecuente que estas tres entidades se presenten simultáneamente. El objetivo de este reporte es describir la presentación clínica, la metodología diagnóstica y la evolución de un paciente que presentó concomitantemente infección crónica por virus C, cirrosis, hepatocarcinoma y linfoma no Hodgkin.Facultad de Ciencias Médica

Carcinoma hepatocelular y linfoma folicular en paciente cirrótico por virus de la hepatitis C

El virus de la hepatitis C (VHC) tiene demostrado poder oncogénico. Su asociación con Carcinoma Hepatocelular (CHC) en pacientes con cirrosis hepática es bien conocida como también con el Linfoma no Hodgkin indolente. Es poco frecuente que estas tres entidades se presenten simultáneamente. El objetivo de este reporte es describir la presentación clínica, la metodología diagnóstica y la evolución de un paciente que presentó concomitantemente infección crónica por virus C, cirrosis, hepatocarcinoma y linfoma no Hodgkin.Facultad de Ciencias Médica

Eosinofilia en sala de clínica médica

La eosinofilia en sangre periférica es un trastorno frecuente en nuestro medio. Las causas son numerosas y dentro de ellas se encuentran las infecciones parasitarias, atopia, reacciones adversas a drogas y neoplasias tanto de órganos sólidos como hematológicas. El objetivo de este estudio es determinar las etiologías más frecuentes de eosinofilia en pacientes que ingresaron o cursaron internación en sala de clínica médica en el último año.Facultad de Ciencias Médica

Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies

Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies

Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries

Proporción y factores que influyen en la conversión de los resúmenes presentados en los congresos argentinos de hipertensión arterial en publicaciones indexadas revisadas por pares

Introduction: Publication rates vary significantly among different scientific meetings, with many abstracts never being published as peer-reviewed articles. This issue has never been investigated in the Hypertension field in Argentina. Our purpose was to determine the proportion of abstracts presented at the Argentinian Congress of Hypertension meetings that were published as full articles in peer-reviewed indexed journals, the time lag to publication and the factors associated with successful publication. Methods: we conducted a PubMed search to identify peer-reviewed publications of abstracts presented at the Argentinian Congress of Hypertension meetings between 2006 and 2015, assessing publication rate along with the time lag to publication. We also extracted information about several abstract characteristics and, for those that got published, we recorded the date of publication and journal name with its impact factor and H index. Predictors of publication were analyzed using a multivariable model. Results: a total of 619 abstracts were presented between 2006 and 2015. The rate of conversion to full-text peer-reviewed articles by June 2017 was 28.1% (95%CI 24.7–31.8%), with a median time to publication of 15.7 months (IQR 8–30.9). On multivariable analysis, the independent predictors of publication were basic science category (OR 5 [95%CI 2.3–10.8], p < 0.001), oral presentation (OR 2.8 [95%CI 1.6–4.9], p < 0.001) and being an award winner for the presentation (OR 3 [95%CI 1.3–6.8], p = 0.01). Conclusion: conversion rate to full peer-reviewed articles of abstracts presented at the Argentinian Congress of Hypertension meetings is far from ideal, with potential areas where efforts should be concentrated to improve dissemination of knowledge.Introducción: El porcentaje de resúmenes que se presentan en reuniones científicas y llegan a publicarse como manuscritos completos en revistas indexadas revisadas por pares es bajo. Este problema no ha sido investigado en el área de la hipertensión en Argentina. Nos propusimos determinar la proporción de resúmenes presentados en los congresos argentinos de hipertensión que llegan a publicarse en revistas indexadas, como artículos completos revisados por pares, el tiempo transcurrido hasta la publicación y los factores asociados a la misma. Métodos: Realizamos una búsqueda en PubMed para identificar las publicaciones en revistas con revisión por pares de los resúmenes presentados en los congresos argentinos de hipertensión entre los anos ˜ 2006 y 2015, determinando el porcentaje de resúmenes que llegaron a publicarse y el tiempo transcurrido hasta la publicación. Registramos fecha de publicación y revista, con su factor de impacto e índice H. Construimos un modelo multivariable de regresión logística para determinar los factores independientemente asociados a la publicación. Resultados: Entre 2006 y 2015 se presentaron 619 resúmenes. La tasa de conversión de resúmenes en artículos revisados por pares a junio de 2017, fue del 28,1% (IC 95%: 24,7-31,8%) con una mediana de tiempo hasta la publicación de 15,7 meses (RIC: 8-30,9). Los factores predictivos independientes de la publicación fueron: categoría ciencia básica (OR: 5 [IC 95%: 2,3-10,8]; p < 0,001), presentación oral (OR: 2,8 [IC 95%: 1,6-4,9]; p < 0,001), y haber obtenido un premio al mejor trabajo (OR: 3 [IC 95%: 1,3-6,8]; p = 0,01). Conclusión: La tasa de conversión de resúmenes en artículos revisados por pares presentados en los congresos argentinos de hipertensión a publicaciones en revistas indexadas dista de ser ideal, habiéndose identificado áreas donde la concentración de esfuerzos podría mejorar la difusión del conocimiento.Fil: Barochiner, J.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Martínez, R.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Choi, Marcelo Roberto. Sociedad Argentina de Hipertensión Arterial; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Espeche, W.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Micali, R.G.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Tomat, A.. Sociedad Argentina de Hipertensión Arterial; Argentin