Related factors with non-compliance to arrange appointments of a group of hypertensive patientsF
u e ron más incumplidores los varones (36,2 v s 18,3%) y los menores de 50 años (66,7% de incump l i d o res). No se observ a ron diferencias en re l a c i ó n con nivel cultural, estado civil ni situación laboral, p e ro sí en relación con la convivencia (45,5% los que vivían solos vs 20,2 y 22,2% sí vivían en familia o con otras personas). Los pacientes con incumplimiento previo también fueron más incumplid o res (34,5 v s 1 6 , 9 % ) .No se evidenciaron diferencias en el cumplimiento en función de la consulta, hora de citación, i n t e rvalo entre las citas o distancia desde la última consulta a demanda.
Conclusiones: no existe un perfil claro del paciente hipertenso incumplidor a controles, pero
A B S T R A C T
Fundaments: non-compliance is a fre c u e n t cause of medical actions´failure, being the absence to periodical controls a very important form of the same.
Objective: to know the non-compliance degre e to arrange appointments of patients with art e r i a l h y p e rtension and the factors involve in it.Design
There are well documented complexities and challenges of pregnancy in the adolescent years. Social workers are usually the front line workers with the adolescent population and are often called to provide bereavement services in a hospital setting. This article describes a pathway for short term intervention in working with adolescents experiencing a perinatal loss and focuses on brief intense anticipatory guidance as the optimal way to provide care under these circumstances. This described approach includes: the developmental level of the adolescent, the receptive posture of the social worker, the adolescent's stage of acceptance of the pregnancy; the meaning of the loss; her emotional strengths; environmental resources and risk factors.
This study aims to estimate the effect of synthetic and biologic disease-modifying antirheumatic drugs (DMARDs) on radiographic progression and quality of life in adult patients with psoriatic arthritis. A comprehensive search was performed using MEDLINE, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CCRCT). Clinical trials comparing DMARDs with placebo for ≥ 12 weeks were included. The meta-analysis was conducted with a random-effects model using mean differences (MD). A total of 16 trials with overall moderate quality of evidence were included. Exposure to a biologic agent reduced radiographic progression at 24 weeks of treatment (MD: − 0.66; [95% CI − 0.97 to − 0.34]; P < .00001; I 2 = 100%). The reduction of the baseline score was more than two times higher for TNF blockers compared with IL-17 and IL-12/IL-23 inhibitors (MD: − 0.94 vs − 0.41). Improvement in health-related quality of life scores was observed in biologic-treated populations (MD: − 0.21; [95% CI − 0.25 to − 0.18]; P < .00001; I 2 = 97%). No sufficient data were available regarding conventional synthetic agents. Our data analyses suggest a better control of radiological damage with bDMARDs, as compared to placebo, after 24 weeks of treatment. However, the accuracy of these results in real life are jeopardized by the exceedingly high level of heterogeneity exhibited within and across included studies, and the true intervention effect cannot be determined with confidence. Further research is required to assess long-term outcomes and to control heterogeneity in the evaluation of treatments for psoriatic arthritis. PROSPERO registration number: CRD42019122223.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
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