Factores Socioculturales Y Adherencia Al Tratamiento Antirretroviral De Gran Actividad A Pacientes Del Hospital Belén De Trujillo - 2018

El presente trabajo de investigación es de tipo descriptivo, con diseño no experimental de corte trasversal, y se realizó en pacientes del Hospital Belén de Trujillo 2018, en el servicio de Infectologia, para Determinar la Relación de los Factores Socioculturales con la Adherencia al Tratamiento Antirretroviral de Gran Actividad. Teniendo una población de 540 pacientes y una muestra de 118 pacientes, la cual la información se obtuvo a través de un cuestionario de preguntas como instrumento y como técnica la encuesta y para el procesamiento de análisis de la información se diseñó una base de datos como el Excel. En los resultados, vemos que los casos encontrados con nivel alto en adherencia al tratamiento antirretroviral de gran actividad a pacientes del Hospital Belén de Trujillo representa el 54.2%, seguido del nivel medio con un 39%; y se muestra la relación de un nivel alto de Adherencia al TARGA en el caso de las edades en el grupo etario de 46 a 59 años, estado civil, grado de instrucción, creencias religiosas, apoyo familiar, ingreso económico dichos pacientes tienen un TARGA alto. En conclusión, se determino la relación de los factores socioculturales con la adherencia al Tratamiento Antirretroviral de Gran Actividad en pacientes del Hospital Belén de Trujillo, 2018 teniendo un adecuado nivel de adherencia

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Factores Socioculturales Y Adherencia Al Tratamiento Antirretroviral De Gran Actividad A Pacientes Del Hospital Belén De Trujillo - 2018

El presente trabajo de investigación es de tipo descriptivo, con diseño no experimental de corte trasversal, y se realizó en pacientes del Hospital Belén de Trujillo 2018, en el servicio de Infectologia, para Determinar la Relación de los Factores Socioculturales con la Adherencia al Tratamiento Antirretroviral de Gran Actividad. Teniendo una población de 540 pacientes y una muestra de 118 pacientes, la cual la información se obtuvo a través de un cuestionario de preguntas como instrumento y como técnica la encuesta y para el procesamiento de análisis de la información se diseñó una base de datos como el Excel. En los resultados, vemos que los casos encontrados con nivel alto en adherencia al tratamiento antirretroviral de gran actividad a pacientes del Hospital Belén de Trujillo representa el 54.2%, seguido del nivel medio con un 39%; y se muestra la relación de un nivel alto de Adherencia al TARGA en el caso de las edades en el grupo etario de 46 a 59 años, estado civil, grado de instrucción, creencias religiosas, apoyo familiar, ingreso económico dichos pacientes tienen un TARGA alto. En conclusión, se determino la relación de los factores socioculturales con la adherencia al Tratamiento Antirretroviral de Gran Actividad en pacientes del Hospital Belén de Trujillo, 2018 teniendo un adecuado nivel de adherencia

Antiinflammatory therapy with canakinumab for atherosclerotic disease

BACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). CONCLUSIONS: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. Copyright © 2017 Massachusetts Medical Society