Comorbidity

Características Clínicas de Pacientes Hipertensos hospitalizados con y sin Enfermedad Cerebrovascular de 60 a 90 años en Quito, Ecuador: Estudio de Casos y Controles. Clinical Characteristics of hospitalized Hypertensive Patients with and without Stroke aged 60 to 90 years in Quito, Ecuador: A Case-Control Study.

Background: Stroke is the world’s second leading cause of death from disease, and disability-adjusted life years. The investment in management of a hospitalized stroke patient generates a high healthcare cost. In Ecuador it is the third leading cause of death. Hypertension is one of the most important factors in the stroke development. Patients with high blood pressure and stroke have a higher risk of complications, mortality and poor prognosis.

Objective: The present study aimed to identify which variables differ between hypertensive patients with stroke versus hypertensive patients without stroke, hospitalized, during 2017- 2020.

Methods: In a population of 96 cases and 57 controls, a retrospective analytical cohort study between two groups of patients was conducted.

Results: The variable education (primary education) was the most affected among cases (χ²=13.298; p=0.039). Patients with atrial fibrillation were significantly higher in the case group (χ²=7.31 p=0.007). Other variables like: sex, age, provenance, years lived with hypertension, smoking, type 2 diabetes mellitus, heart failure, hypercholesterolemia and anticoagulant therapy, showed no significant difference between the two groups.

Conclusions: Patients with complete primary education and atrial fibrillation had significant presence in hypertensive patients with stroke.

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Palabras clave: comorbilidades, enfermedad cerebrovascular, enfermedades cardiovasculares, Factores de riesgo, Hipertensión arterial, síndrome metabólico,

Keywords: Arterial hypertension, cardiovascular diseases, Comorbidity, metabolic syndrome, Risk factors, stroke,

A strange case of Comorbidity in a 60-year-old Portuguese war veteran: War Post Traumatic Stress Disorder, Early Fronto- Temporal Cerebral Atrophy, and Strong Neuropsychological Symptomatology. A Neuropsychological Review.

The Post-Traumatic Stress Disorder is a psychiatric disorder that derives from traumatic events. Although the literature and clinical reports of PTSD is known along centuries, only in 1980 was recognized by the American Psychiatric Association as a diagnostic category of the Diagnostic and Statistical Manual – III. The present article reports the case study of a man with Post-Traumatic Stress Disorder, initial signs of fronto-temporal dementia and other neuropsychological and neuropsychiatric symptomatology. Decurrent of the neuropsychological evaluation was possible to detect a variety of alterations in the humour and personalistic sphere, as well as deficits in orientation, memory, attention, concentration and also in the functions regulated by pre-frontal cortex. This study suggests not only the importance of a deep neuropsychological evaluation, as the necessity to integrate the deficits showed by the patient with the evidence from literature.