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Diaztagle Fernández JJ, Canal Forero JE, Castañeda González JP. Hipertensión arterial y riesgo cardiovascular. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introducción: la hipertensión arterial es una de las principales enfermedades a nivel mundial y constituye una importante causa de morbilidad y mortalidad para países de bajos y medianos ingresos. Objetivo: determinar la importancia epidemiológica de la hipertensión arterial como factor de riesgo cardiovascular en diferentes estudios realizados a nivel mundial, en Latinoamérica y Colombia. Metodología: se realizó una búsqueda de la literatura científica en las bases de datos de PudMed/Medline, Scielo, LILACS, así como también en revistas médicas y textos publicados por el Ministerio de Salud y Protección Social de Colombia. Discusión y conclusiones: más de 90% de los pacientes hipertensos padecen la forma primaria de la enfermedad, la cual está asociada con un aumento de la resistencia vascular periférica. Las características socioeconómicas de los países y el nivel educativo individual se relacionan con la prevalencia y el manejo adecuado de esta patología. El aumento en la prevalencia de las enfermedades crónicas, sumado a eventos históricos de importancia, fueron determinantes para el desarrollo de estudios epidemiológicos mundiales como el Framingham Heart Study. En América Latina y en Colombia se han realizado diferentes estudios que permiten establecer datos relacionados con la hipertensión arterial, demostrando cifras alarmantes en cuanto al conocimiento, tratamiento y control de esta condición, por lo cual, surge la necesidad de establecer programas para la detección de pacientes hipertensos con el fin de generar estrategias que disminuyan de manera significativa las enfermedades cardiovasculares.
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Elfeky R, Lazareva A, Qasim W, Veys P. Immune reconstitution following hematopoietic stem cell transplantation using different stem cell sources. Expert Rev Clin Immunol 2019; 15:735-751. [PMID: 31070946 DOI: 10.1080/1744666x.2019.1612746] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Adequate immune reconstitution post-HSCT is crucial for the success of transplantation, and can be affected by both patient- and transplant-related factors. Areas covered: A systematic literature search in PubMed, Scopus, and abstracts of international congresses is performed to investigate immune recovery posttransplant. In this review, we discuss the pattern of immune recovery in the post-transplant period focusing on the impact of stem cell source (bone marrow, peripheral blood stem cells, and cord blood) on immune recovery and HSCT outcome. We examine the impact of serotherapy on immune reconstitution and the need to tailor dosing of serotherapy agents when using different stem cell sources. We discuss new techniques being used particularly with cord blood and haploidentical grafts to improve immune recovery in each scenario. Expert opinion: Cord blood T cells provide a unique CD4+ biased immune reconstitution. Initial studies using targeted serotherapy with cord grafts showed improved immune recovery with limited alloreactivity. Two competing haploidentical approaches have developed in recent years including TCRαβ/CD19 depleted grafts and post-cyclophosphamide haplo-HSCT. Both approaches have comparable survival rates with limited alloreactivity. However, delayed immune reconstitution is still an ongoing problem and could be improved by modified donor lymphocyte infusions from the same haploidentical donor.
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Affiliation(s)
- Reem Elfeky
- a Blood and bone marrow transplant unit , Great Ormond Street hospital , London , UK
| | - Arina Lazareva
- a Blood and bone marrow transplant unit , Great Ormond Street hospital , London , UK
| | - Waseem Qasim
- a Blood and bone marrow transplant unit , Great Ormond Street hospital , London , UK
| | - Paul Veys
- a Blood and bone marrow transplant unit , Great Ormond Street hospital , London , UK
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Nadrowski P, Podolecka E, Pajak A, Dorynska A, Drygas W, Bielecki W, Kwasniewska M, Tykarski A, Niklas A, Zdrojewski T, Skrzypek M, Wojakowski W, Kozakiewicz K. How does the risk of cardiovascular death and cardiovascular risk factor profiles differ between socioeconomic classes in Poland: A country in transition. Cardiol J 2018; 26:493-502. [PMID: 29570212 DOI: 10.5603/cj.a2018.0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/25/2018] [Accepted: 11/08/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) is an important factor for cardiovascular diseases (CVD) development. A decline in death rate from CVD among subjects with high SES is observed in developed countries. The aim of this study was to assess differences in cardiovascular risk (CV) between socioeconomic classes in Poland, a country currently in transition. METHODS A sample of 15,200 people was drawn. A three stage selection was performed. Eventually, 6170 patients were examined (2013/2014). Data was collected using a questionnaire in face-to-face interviews, anthropometric data and blood tests were also obtained. Education was categorized as incomplete secondary, secondary and higher than secondary school. Monthly income per person was categorized as low (≤ 1000 PLN), medium (1001-2000 PLN) and high (≥ 2001 PLN). Education and income groups were analyzed by prevalence of CVD risk factors and high CVD risk (SCORE ≥ 5%). RESULTS Higher education was associated with lower prevalence of all analyzed CVD risk factors (p < 0.001), having the highest income with lower prevalence of hypertension, currently smoking, obesity and lower high density lipoprotein cholesterol. Multivariable analysis showed that frequency of high CVD risk decreased with increasing education level (OR 0.61; 95% CI 0.49-0.76; p < 0.01), a similar favorable impact of higher income on high CVD risk was demonstrated in the whole group (OR 0.81; 95% CI 0.67-0.99; p = 0.04). CONCLUSIONS Socioeconomic status is an independent predictor of high CV risk of death. A favorable impact on the prevalence of high CV risk was demonstrated for education and partly for income in the whole group. It may reflect a transition being undergone in Poland, moreover, it predicts how socioeconomic factors may generate health inequalities in other transitioning countries.
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Affiliation(s)
- Pawel Nadrowski
- Division of Cardiology and Structural Heart Diseases, Medical Univer sity of Silesia, Katowice, Poland.
| | - Ewa Podolecka
- Division of Cardiology and Structural Heart Diseases, Medical Univer sity of Silesia, Katowice, Poland
| | - Andrzej Pajak
- Epidemiology and Population Studies Department, Jagiellonian University Medical College, Institute of Public Health, Krakow, Poland
| | - Agnieszka Dorynska
- Epidemiology and Population Studies Department, Jagiellonian University Medical College, Institute of Public Health, Krakow, Poland
| | - Wojciech Drygas
- Department of Epidemiology, Institute of Cardiology, Cardiovascular Disease Prevention and Health Promotion, Warsaw, Poland.,Department of Social and Preventive Medicine, Medical University of Lodz, Poland
| | - Wojciech Bielecki
- Department of Social and Preventive Medicine, Medical University of Lodz, Poland
| | | | - Andrzej Tykarski
- Poznan University of Medical Sciences, Department of Hypertension, Angiology and Internal Medicine, Poznan, Poland
| | - Arkadiusz Niklas
- Poznan University of Medical Sciences, Department of Hypertension, Angiology and Internal Medicine, Poznan, Poland
| | - Tomasz Zdrojewski
- Medical University of Gdansk, Department of Arterial Hypertension and Diabetology, Gdansk, Poland
| | - Michal Skrzypek
- Medical University of Silesia, Department of Biostatistics, School of Public Health, Katowice, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical Univer sity of Silesia, Katowice, Poland
| | - Krystyna Kozakiewicz
- Division of Cardiology and Structural Heart Diseases, Medical Univer sity of Silesia, Katowice, Poland
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Bonaccio M, Donati M, Iacoviello L, de Gaetano G. Socioeconomic Determinants of the Adherence to the Mediterranean Diet at a Time of Economic Crisis: The Experience of the MOLI-SANI Study1. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.aaspro.2016.02.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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