Polypill use for the prevention of cardiovascular disease: A position paper.

Cardiovascular (CV) guidelines stress the need for global intervention to manage risk factors and reduce the risk of major vascular events. Growing evidence supports the use of polypill as a strategy to prevent cerebral and cardiovascular disease, however it is still underused in clinical practice. This paper presents an expert consensus aimed to summarize the data regarding polypill use. The authors consider the benefits of polypill and the significant claims for clinical applicability. Potential advantages and disadvantages, data regarding several populations in primary and secondary prevention, and pharmacoeconomic data are also addressed.

Hypertension healthcare professional beliefs and behaviour regarding patient medication adherence: a survey conducted among European Society of Hypertension Centres of Excellence.

PURPOSE: Little is known on the beliefs, perceptions and practices of hypertension specialists in addressing non-adherence to therapy. Therefore, a survey was undertaken amongst healthcare professionals (HCPs) managing hypertension in the European Society of Hypertension (ESH) Centres of Excellence. MATERIALS AND METHODS: Cross-sectional data were obtained between December 2020 and April 2021 using an online anonymous structured questionnaire including 26 questions/136 items, that was sent to all ESH Excellence centres. RESULTS: Overall 67 from 187 centres (37.3%) responded and 200 HCPs from 30 countries answered the questionnaire. Participants (60% men) were mainly physicians (91%) and nurses (8%) from University hospitals (77%). Among physicians, 83% had >10 years professional experience. Average time dedicated to discuss medications was 1-5 min in 48% and 6-10 min in 29% of cases. Interviews with patients about adherence were the most frequently used assessment method. Chemical detection of medications in urine was available in 36% of centres. One third of physicians involved their patients regularly in treatment decisions. The most frequent methods to improve adherence included simplification of medication therapy, more frequent visits, and home blood pressure monitoring. CONCLUSIONS: The level of implementation of tools to detect and improve adherence in hypertension management by HCPs in ESH excellence centres is low. Structured educational activities focussing on adherence management and access to the newest objective measures to detect non-adherence might improve these deficits.

The use of single-pill combinations as first-line treatment for hypertension: translating guidelines into clinical practice.

: The 2008 European Society of Cardiology/European Society of Hypertension guidelines recommend the first-line prescription of two antihypertensive drugs in single-pill combinations (SPCs), also known as fixed-dose combinations, for the treatment of most patients with hypertension. This recommendation is based on a large amount of data, which shows that first-line treatment with SPCs supports reaching blood pressure targets rapidly and reducing cardiovascular outcome risk while keeping the therapeutic strategies as simple as possible and fostering adherence and persistence. As this approach constitutes a big shift from the stepped-care approaches that have been dominant for many years, practicing physicians have expressed concerns about using SPCs as first-line agents. In this review, we will discuss the barriers to the uptake of this recommendation. We will also offer suggestions to reduce the impact of these barriers and address specific concerns that have been raised.

Mulheres e mariscagem: invenções de si no (in)mundo mangue / Women and shellfish picking: inventions of themselves in the (un)clean mangrove forest / Mujeres y colecta de mariscos: invenciones de sí mismas en el (in)mundo mangle

O artigo decorre de uma pesquisa articulada ao projeto de extensão Fortalecimento Sociopolítico das Marisqueiras de Sergipe, parte do Programa de Educação Ambiental com Comunidades Costeiras. A pesquisa faz-se processo de habitação coletiva em defesa de territórios de vida tradicionais e da vida das mulheres marisqueiras, que veem seus territórios existenciais cotidianamente ameaçados por empreendimentos do grande capital. Inspiradas na etnografia e na cartografia, miramos nos processos de invenção da vida cotidiana das mulheres no mundo mangue. A perspectiva é pesquisar com marisqueiras, conhecer seus modos de vida e formas de resistência, que se tecem num território híbrido entre cidade, campo e mangue. Acompanhamos a construção do movimento social Mulheres Marisqueiras de Sergipe e, com ele, de redes de cuidado e ajuda mútua, invenções de si e de mundos correlatos, ampliando em ato sentidos para a categoria mulher e para o trabalho artesanal.

The present study is based on a research linked to the extension program project of Sociopolitical Empowerment of Shellfish Picker Women in the state of Sergipe, a stage of the Environmental Education Program for Coastal Communities. The project aims to empower the Movement of Shellfish Picker Women from Sergipe. The research is a process of collective habitation in defense of traditional living territories and the shellfish pickers’s lives, who see, daily, their existential territories threatened by large capital enterprises. Inspired by ethnography and cartography, we focused on the processes of invention of women’s daily life in the mangrove forest. The perspective is to research about shellfish picker women, learn about their lifestyle and ways of resistance, which are woven in a hybrid territory involving city, countryside and mangrove forest. We followed the construction of the social movement and, added to it, networks of care and mutual help, inventions of themselves and related worlds, broadening the meanings of the woman category and the handicraft work.

El trabajo resulta de una investigación articulada al proyecto de extensión "Fortalecimiento sociopolítico de las colectoras de mariscos de Sergipe, parte del Programa de Educación Ambiental con Comunidades Costeras". El objetivo del proyecto es fortalecer el Movimiento de las Colectoras de Mariscos de Sergipe. La investigación se hace proceso de habitación colectiva en defensa de territorios de vida tradicionales y de la vida de las mujeres marisqueras que ven sus territorios existenciales cotidianamente amenazados por emprendimientos del gran capital. Inspiradas en la etnografía y en la cartografía miramos los procesos de invención de la vida cotidiana de las mujeres en el mundo mangle. Acompañamos la construcción del movimiento social y, con él, de redes de cuidado y ayuda mutua, invenciones de sí mismas y de mundos correlatos, ampliando sentidos para la categoría mujer y para el trabajo artesanal.

Iron-induced thrombocytopenia in severe iron-deficiency anemia.

Iron deficiency anemia (IDA) is commonly associated with reactive thrombocytosis, but thrombocytopenia is relatively uncommon and generally associated with more severe IDA. Even more rarely described has been thrombocytopenia following iron replacement therapy to treat IDA, and the underlying mechanism remains unclear. The authors present the case of a patient with severe IDA, who developed thrombocytopenia after the initiation of iron therapy. An analysis is made of all the previous reports of similar cases, to compare and start on the path of understanding this rare entity.