[Prevalence, knowledge and control of arterial hypertension in vulnerable neighborhoods of Argentina: A Cross-sectional Study]. / Estudio de prevalencia, conocimiento y control de la hipertensión arterial en barrios vulnerables de Argentina.

INTRODUCTION: Hypertension (HTN) represents the primary individual risk factor, contributing significantly to the global burden of cardiovascular diseases (CVD). In our country, epidemiological research has highlighted substantial variations in the prevalence of these risk factors across different populations. However, there is a lack of epidemiological studies assessing exclusive cardiovascular risk factors within vulnerable neighborhoods characterized by extremely limited economic resources, sociocultural challenges, and inadequate healthcare access. METHODS: A multicenter cross-sectional observational study was conducted among individuals residing in economically deprived and marginalized communities, including informal settlements and underprivileged neighborhoods. Simple random sampling of households was employed. Blood pressure measurements, anthropometric assessments, and epidemiological, economic, and sociocultural questionnaires were administered. Results encompass prevalence rates, awareness levels, and blood pressure control across diverse regions. Logistic regression was utilized to identify independent variables influencing primary outcomes. RESULTS: A total of 989 participants were analyzed. The overall prevalence of hypertension was 48.2%. About 82% had a body mass index (BMI) >25. Approximately 45.3% had less than 6 years of formal education. Independent association was established between education levels below 6 years and higher hypertension prevalence. Among hypertensive individuals, 44% were unaware of their condition, with only 17.2% achieving control, correlated with having health insurance and a higher educational background. Merely 24% were receiving combined therapy. CONCLUSION: The prevalence of hypertension within vulnerable neighborhoods is alarmingly high, surpassing rates in other social strata. Knowledge, treatment, and control levels of hypertension are suboptimal, comparable to other populations. Inadequate use of combination therapy was observed. This study underscores the urgent need for targeted interventions addressing cardiovascular risk factors in poor areas to mitigate the burden of CVD.

Modeling of post-traumatic epilepsy and experimental research aimed at its prevention

Research on the prevention of post-traumatic epilepsy (PTE) has seen remarkable advances regarding its physiopathology in recent years. From the search for biomarkers that might be used to indicate individual susceptibility to the development of new animal models and the investigation of new drugs, a great deal of knowledge has been amassed. Various groups have concentrated efforts in generating new animal models of traumatic brain injury (TBI) in an attempt to provide the means to further produce knowledge on the subject. Here we forward the hypothesis that restricting the search of biomarkers and of new drugs to prevent PTE by using only a limited set of TBI models might hamper the understanding of this relevant and yet not preventable medical condition.

Análisis multiciiterio del estado de las pasturs de la hacienda Ganadera garcíía abajo en corinto (cauca, Colombia) / Multi-critera annalysis of grasses of the fam livestock garcia abajo in corrinto (cauca, Colombia)

La evaluación de pasturas utilizando criterios múltiples constituye una herramienta de importancia para la toma de decisiones en el manejo de sistemas ganaderos sostenibles. El objetivo fue construir un índice de estado con base en indicadores productivos y biológicos de los componentes herbáceo y leñoso para tipificar 50 potreros de una explotación ganadera de la Hacienda García Abajo, departamento del Cauca, Colombia. Se levantó información de nueve variables que describen factores incidentes en la producción (área de potreros, edad de la pastura, topografía, árboles y cobertura de dosel), la composición botánica (leguminosas, arvenses, especies de gramíneas) e indicadores de cantidad y calidad de las pasturas (biomasa forrajera y color). Siete de estas variables fueron medidas y calificadas con los uso de una herramienta multicriterio. Mediante estadística multivariada se realizó una tipología de potreros. El conglomerado C1 agrupa los 17 potreros con mayor tiempo de establecimiento, mientras C2 corresponde al de menor cantidad de potreros, los cuales son pasturas jóvenes. C3 agrupa el mayor número de potreros (25), los que a su vez tienen la mayor extensión promedio. C2 fue el conglomerado con mayor producción de biomasa y el que presentó menor porcentaje de vegetación espontánea. En conclusión, el análisis multicriterio para evaluar pasturas permite tomar decisiones y realizar juicios fundamentados sobre diferentes valoraciones, lo cual hace que el diagnóstico sea más acertado y mejor la formulación de soluciones con base en referentes endógenos, a fin de ir mejorando progresivamente el manejo de la finca.

Evaluation of pasture, based on a multicriteria approach, is an important issue for decision making in the design of sustainable farming systems. The aim was to build a state index, based on production and biological indicators of pasture in 50 paddocks of a farm estate Garcia Abajo, located on department of Cauca, Colombia. Nine variables describing incidents factors in production factors (area of pasture, pasture age, topography, trees and canopy cover), the botanical composition (legumes, weeds, grass species) and indicators of quantity and quality of pastures (forage biomass and color) was measured and ranked with the use of a multi-criteria tool. Using multivariate statistics, a typology of pastures was performed. The C1 cluster groups the 17 paddocks longer listing, while C2 corresponds to fewer paddocks, which are young pastures. C3 contains the largest number of pastures (25), which in turn have the largest area averages. C2 fuel conglomerate highest biomass production, and has the lowest percentage of spontaneous vegetation. In conclusion, the multi-criteria analysis to evaluate pastures allows the decision maker to make judgments based on different ratings, which makes diagnosis and formulating solutions, based on endogenous concerning more successful.

Topiramate for the treatment of juvenile myoclonic epilepsy

OBJECTIVE: The aim of this study was to evaluate the efficacy and tolerability of topiramate (TPM) in juvenile myoclonic epilepsy (JME). METHOD: We assessed seizure control and adverse effects of TPM in 22 patients (18 females) aged 13 to 53 years. Target TPM dosage was up to 200 mg/day. The patients were subdivided into 3 groups: those treated with seizure control plus side effects (n=4); treated with non-controlled seizures (n=15) and with JME newly diagnosed (n=3). RESULTS: Sixteen patients completed the first year of the follow-up. Generalized tonic-clonic seizures were completely controlled in 10 (62.5%); more than 50% of reduction in 4 (25.0%) and less than 50% in 2 (12.5%). Myoclonia were controlled in 11 (68.8%) and persisted in 5 (31.2%) patients. Absence seizures were present in 5 (22.7%) of whom 2 (9.0%) showed more than 50% of seizure reduction while 3 (13.6%) presented worsening. Discontinuations were due to inadequate seizure control and adverse events (N=4), low compliance and loss of follow-up (N=2) and subject choice (N=1). CONCLUSION: TPM showed to be an effective and well-tolerated drug in the treatment of JME. Although frequently observed, TPM side effects were tolerable and the drug could be maintained in the majority of patients.

OBJETIVO: Avaliar a eficácia e tolerabilidade do topiramato (TPM) na epilepsia mioclônica juvenil (EMJ). MÉTODO: Avaliamos a resposta terapêutica e efeitos colaterais do TPM em 22 pacientes (18 mulheres) com idades entre 13 e 53 anos. A dose alvo utilizada foi até 200 mg/dia. Os pacientes foram divididos em 3 grupos no início do tratamento: aqueles com controle das crises mas que apresentavam efeitos colaterais (n=4); com crises não controladas (n=15) e com EMJ recém diagnosticada (n=3). RESULTADOS: Dezesseis pacientes completaram o primeiro ano de acompanhamento. Crises tônico-clonicas generalizadas foram completamente controladas em 10 (62,5%), tiveram redução maior de 50% em 4 (25,0%) e menor de 50% em 2 (12,5%). Mioclonias foram controladas em 11 (68,8%) e persistiram em 5 (31.2%) pacientes. As crises de ausências, presentes em 5 (22,7%) pacientes, tiveram redução maior do que 50% em 2 (9,0%) e agravamento em 3 (13,6%). A retirada do estudo foi devida principalmente ao controle inadequado das crises e efeitos colaterais indesejáveis (n=4), pouca adesão e perda do seguimento (n=2) e escolha do paciente (n=1). CONCLUSÃO: TPM foi considerada droga eficaz e bem tolerada no tratamento da EMJ. Apesar de freqüentemente observados, os efeitos colaterais do TPM foram toleráveis e a medicação pode ser mantida na maioria dos pacientes.