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1.
BMC Geriatr ; 24(1): 112, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38287253

RESUMO

BACKGROUND: Iron deficiency (ID) is often associated with other comorbidities in older patients and is a factor of morbimortality. However, the prevalence of ID remains poorly documented in this population. METHODS: The CARENFER PA study was a French multicenter cross-sectional study whose objective was to evaluate ID in patients (> 75 years) admitted to a geriatric unit. The primary endpoint was the ID prevalence defined as: serum ferritin < 100 µg/L and/or transferrin saturation coefficient (TSAT) < 20%. The Short Physical Performance Battery (SPPB) test was used to identify older patients at high risk of adverse events (e.g., disability, falls, hospitalization, death). RESULTS: A total of 888 patients (mean age, 85.2 years; women, 63.5%) from 16 French centers were included from October 2022 to December 2022. The prevalence of ID was 57.6% (95% CI, 54.3-60.9) in the cohort of older patients (62.6% in anemic and 53.3% in non-anemic patients; p = 0.0062). ID prevalence increased significantly with the presence of more than three comorbidities (65.6% vs. 55.9%; p = 0.0274), CRP ≥ 12 mg/L (73.0% vs. 49.3%; p < 0.001) and treatment that may influence ID/anemia (60.5% vs. 49.6%; p = 0.0042). In multivariate analysis, only CRP ≥ 12 mg/L was an independent predictive factor of ID (odds ratio, 2.78; 95% CI, 1.92-4.08; p < 0.001). SPPB scores were low (0-6) in 60.5% of patients with ID versus 48.6% of patients without ID (p = 0.0076). CONCLUSION: More than half of older patients had ID, including non-anemic patients. ID was associated with the presence of inflammation and a low SPPB score. TRIAL REGISTRATION: NCT05514951.


Assuntos
Anemia Ferropriva , Deficiências de Ferro , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos Transversais , Hospitalização , Prevalência
2.
Food Chem ; 429: 136893, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37480773

RESUMO

Pesticide residues in tea and herbal tea often exceed EU maximum residue limits. Consideration of the transfer of pesticides from the leaves (called transfer factors) to the brew is essential to assess the associated risk. This study identified infusion parameters influencing the transfer behaviour of 61 pesticides and elaborated a predictive model for pesticides with unknown transfer factors in black, green, herbal and flavoured teas. Tea type and the presence of flavours were the criteria that most influenced the pesticide transfer. Interestingly, infusion parameters that are individual and area dependent such as infusion time, temperature and water hardness, did not play a significant role. Beta regression models developed to characterise pesticide behaviour during infusion showed good predictions for most pesticides and revealed that log (P) was the main physico-chemical parameter to estimate the pesticide transfer. The transfer factors database and validated models are valuable tools for improving risk assessment.


Assuntos
Resíduos de Praguicidas , Praguicidas , Chás de Ervas , Bases de Dados Factuais , Aromatizantes , Chá
3.
Eur J Hybrid Imaging ; 7(1): 11, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-37369917

RESUMO

INTRODUCTION: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) features of the proximal and more elastic half of the thoracic aorta are known to correlate with aorta stiffness in older populations. This prospective study aimed to analyze the changes in these FDG-PET/CT features between young, middle-aged, and older adults, and investigate associations with arterial stiffness and blood pressure (BP). METHODS: Young (< 40 years), middle-aged (40-to-60 years), and older (> 60 years) adults, who underwent an FDG-PET/CT, were prospectively recruited. FDG-PET/CT features of the proximal half of the thoracic aorta were analyzed relative to the age categories, BP and carotid-femoral pulse wave velocity (PWV), a reference indicator of aorta stiffness. RESULTS: We included 79 patients (38 women; 22 young, 19 middle-aged, and 38 older adults). An increase in age category was associated with increases in mean standardized uptake values (SUVs) of blood and aorta and most significantly in aorta SUV heterogeneity, represented by SUV standard deviation (SUV-SD), aorta calcification volume, and the aorta volume indexed to body surface area. However, this indexed aorta volume was the sole variable: (i) exhibiting a stepwise increase from young (median: 25 cm3/m2 [interquartile range: 20-28 cm3/m2]), to middle-aged (41 [30-48] cm3/m2, p < 0.001 vs. Young), and older (62 [44-70] cm3/m2, p < 0.001 vs. middle-age) adults, and (ii) selected in the multivariate predictions of systolic, diastolic, and pulse BP. Indexed aorta volume was also a multivariate predictor of PWV but in association with SUV-SD and hypertension. CONCLUSION: In a population of patients referred to an FDG-PET/CT investigation, the indexed volume of the proximal and more elastic half of the thoracic aorta is the most comprehensive indicator of arterial aging. This imaging parameter exhibits a stepwise increase from young to middle-aged and older adults, is strongly linked to inter-individual changes in both arterial stiffness and BP, and thus, could help assess the early phases of arterial aging. Trial registration ClinicalTrial.gov, NCT03345290. Registered 17 November 2017, https://clinicaltrials.gov/ct2/show/NCT03345290?term=NCT03345290&draw=2&rank=1.

5.
Environ Sci Pollut Res Int ; 30(23): 64499-64516, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37071363

RESUMO

In spite of the fact that bromophenols (BPs) and hexabromocyclododecanes (HBCDs) are widely used as flame retardants, no data was available until now on the levels of these two chemicals in North Africa biota. Seafood products might represent one of the main sources of dietary exposure to persistent organic pollutants such as non-dioxin-like polychlorinated biphenyls (ndl-PCBs), brominated flame retardants (BFRs), and polycyclic aromatic hydrocarbons (PAHs). In this study, the concentrations of the ndl-PCBs, PAH4, and BFRs were determined in seafood products from a North African lagoon (Bizerte lagoon). Almost all the compounds were detected (15 out of 18) in the analyzed marine organisms. The accumulation of the contaminants followed the order BFRs > ndl-PCB > PAH4. Mean contaminants concentrations ranged from 0.35 to 28.7 ng g-1 ww for ∑ndl-PCBs; from below limit of quantification to 476 ng g-1 ww for ∑BFRs and from below limit of quantification to 5.30 ng g-1 ww for ∑PAH4. PCB 138, 153, and 180 were the most frequently detected ndl-PCB congeners due to their high resistance to metabolic degradation. 2,4-dibromophenol (2,4-DBP) was the predominant BFR. Chrysene (Chr) was found to be the main contributor to the total PAH4 concentration. Contaminant profiles varied significantly among seafood which may be due to the difference in lipid content, trophic level, feeding behavior, and metabolism. To assess the human health risks, the average daily dose exposure of ndl-PCBs, the dietary daily intake of PAHs and the estimated dietary intake of 3,3-,5,5-tetrabromobisphenol A (TBBPA) and HBCD from seafood were estimated. Findings indicated no adverse effects for human health from any of the analyzed contaminants, except for ndl-PCBs in eel.


Assuntos
Dioxinas , Retardadores de Chama , Bifenilos Policlorados , Humanos , Bifenilos Policlorados/análise , Tunísia , Retardadores de Chama/análise , Contaminação de Alimentos/análise , Alimentos Marinhos/análise
6.
Food Addit Contam Part B Surveill ; 16(1): 58-68, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36537161

RESUMO

Over the last decade, the consumption of tea and herbal tea has gained more and more popularity across the globe, but the potential presence of chemical contaminants (e.g. pesticides, trace elements, synthetic drugs) may raise health concerns. This study analysed selected teas available in Belgian retail stores and performed a risk assessment for these samples. No chemical adulteration could be detected in dry tea material. More than 38% of the dry leaves samples contained at least one pesticide exceeding the maximal residue level (MRL) set by the EU. However, further risk assessment, based on the values of pesticide residues and the toxic trace elements encountered in the brew, demonstrate that the consumption of these teas will not give rise to health concerns. Nonetheless, attention should be given to the leaching potential of nickel from teas and the presence of arsenic in brews from algae containing teas.


Assuntos
Resíduos de Praguicidas , Praguicidas , Oligoelementos , Praguicidas/análise , Oligoelementos/análise , Chá/química , Bélgica , Contaminação de Alimentos/análise , Resíduos de Praguicidas/análise , Preparações Farmacêuticas/análise
7.
Food Addit Contam Part B Surveill ; 15(4): 292-300, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35975751

RESUMO

A total of 120 spices and herbs bought on the Belgian market have been analysed for occurrence of the four EU regulated polycyclic aromatic hydrocarbons (ΣPAH4). Samples were sorted in three groups according to their use: traditional spices, exotic spices, and herbs. Benzo[a]pyrene has been detected in 56% of samples, while ΣPAH4 were found in 96% of samples. ΣPAH4 were evenly distributed among the three groups with a median content of 7.2 for traditional spices, 5.5 for exotic spices and 6.0 µg kg-1 for herbs. According to the EU legislation, three samples were exceeding maximal limits, with a maximum ΣPAH4 content of 164 µg kg-1. The ΣPAH4 dietary intake has been estimated at 1.4 and 27.8 ng day-1 for average and high consumption, respectively. The risk for the consumer was evaluated by using the margin of exposure (MOE). In all cases, MOE were >20 000, indicating a low concern for the population.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos , Hidrocarbonetos Policíclicos Aromáticos/análise , Especiarias/análise , Contaminação de Alimentos/análise , Bélgica , Benzo(a)pireno/análise
8.
Front Aging Neurosci ; 14: 908063, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35837479

RESUMO

Brain 18F-FDG PET imaging is useful to characterize accelerated brain aging at a pre-symptomatic stage. This study aims to examine the interactions between brain glycolytic metabolism and hemodynamic parameters in different age groups. Methods: A total of 72 patients (from 23 to 88 years of age, 38 women) without any cerebral diseases but with available cardiac, arterial peripheral, and central blood pressure measurements as well as arterial stiffness parameters obtained from brachial pressure and applanation tonometry and a brain 18F-FDG PET scan were prospectively included into this study. Quantitative voxel-to-voxel analyses were carried out to test for negative associations between brain glycolytic metabolism and individual hemodynamic parameters (p-voxel of <0.001 for the whole population and <0.005 for age groups). Results: The heart rate parameter of the whole population showed the most extensive associations with brain metabolism (15,857 mm3, T-score: 5.1), predominantly affecting the frontal and temporal regions (69% of the volume). Heart rate for the younger age group, systolic and pulse pressure for the 41-60-year-old group, and diastolic pressure for the older group were most extensively associated with brain metabolism and mainly involved the fronto-temporal lobes (respective involvement of 52.8%, 60.9%, and 65.5%) which are also the regions implicated in accelerated brain aging. Conclusion: This cross-sectional prospective study identified extensive associations between cerebral metabolism and hemodynamic parameters, indicating common aging mechanisms. Heart rate throughout adult life, systolic and pulse pressure parameters around middle age, and diastolic pressure parameters in older patients, suggest the existence of potentially therapeutic targets to prevent accelerated brain aging.

9.
Environ Pollut ; 291: 118236, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34582924

RESUMO

This study reports on concentrations of short- and medium-chain chlorinated paraffins (SCCPs and MCCPs, respectively) in a wide range of food samples (n = 211) purchased in Belgium during 2020. Samples were analysed by gas chromatography-mass spectrometry (GC-MS) and quantified using chlorine content calibration. ∑SCCPs were present above LOQ in 25% of samples with an overall range of

Assuntos
Hidrocarbonetos Clorados , Parafina , Animais , Bélgica , China , Monitoramento Ambiental , Hidrocarbonetos Clorados/análise , Parafina/análise , Verduras
10.
Hypertension ; 76(3): 629-639, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32755468

RESUMO

The effects of elevated arterial stiffness on cardiovascular outcomes are widely studied, whereas the relation to noncardiovascular outcomes relevant to older persons, such as the effect on bones and muscles, is less well established. Arterial stiffness, bone demineralization, and muscle loss are all age-related processes with common risk factors, however, whether these are just parallel age-related alterations or whether these processes share common pathways is not yet understood. In this review, we outline previous literature using different assessments of arterial stiffness in various populations across the world to produce a comprehensive overview. Although there are many studies showing an association between arterial stiffness and loss of bone and muscle, the majority are cross-sectional and there is limited longitudinal evidence to justify causal conclusions. We also give an in-depth review of hypotheses and possible mechanisms which may underlie these associations including hormone dysregulation, impaired glucose metabolism, and inflammation. This narrative review highlights the associations between vessels, bones, and muscles with aging, offering insights into possible shared pathways.


Assuntos
Envelhecimento/fisiologia , Osteoporose/metabolismo , Sarcopenia , Rigidez Vascular/fisiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Sarcopenia/etiologia , Sarcopenia/metabolismo
11.
Environ Sci Technol ; 52(1): 298-307, 2018 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-29185731

RESUMO

Monitoring human exposure to pesticides and pesticide residues (PRs) remains crucial for informing public health policies, despite strict regulation of plant protection product and biocide use. We used 72 low-cost silicone wristbands as noninvasive passive samplers to assess cumulative 5-day exposure of 30 individuals to polar PRs. Ethyl acetate extraction and LC-MS/MS analysis were used for the identification of PRs. Thirty-one PRs were detected of which 15 PRs (48%) were detected only in worn wristbands, not in environmental controls. The PRs included 16 fungicides (52%), 8 insecticides (26%), 2 herbicides (6%), 3 pesticide derivatives (10%), 1 insect repellent (3%), and 1 pesticide synergist (3%). Five detected pesticides were not approved for plant protection use in the EU. Smoking and dietary habits that favor vegetable consumption were associated with higher numbers and higher cumulative concentrations of PRs in wristbands. Wristbands featured unique PR combinations. Our results suggest both environment and diet contributed to PR exposure in our study group. Silicone wristbands could serve as sensitive passive samplers to screen population-wide cumulative dietary and environmental exposure to authorized, unauthorized and banned pesticides.


Assuntos
Resíduos de Praguicidas , Praguicidas , Cromatografia Líquida , Monitoramento Ambiental , Humanos , Silicones , Espectrometria de Massas em Tandem
12.
Neuroimage Clin ; 17: 804-810, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29276677

RESUMO

Mild cognitive impairment and Alzheimer's dementia involve a grey matter disease, quantifiable by 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET), but also white matter damage, evidenced by diffusion tensor magnetic resonance imaging (DTI), which may play an additional pathogenic role. This study aimed to determine whether such DTI and PET variations are also interrelated in a high-risk population of older hypertensive patients with only subjective memory complaints (SMC). Sixty older hypertensive patients (75 ± 5 years) with SMC were referred to DTI and FDG-PET brain imaging, executive and memory tests, as well as peripheral and central blood pressure (BP) measurements. Mean apparent diffusion coefficient (ADCmean) was determined in overall white matter and correlated with the grey matter distribution of the metabolic rate of glucose (CMRGlc) using whole-brain voxel-based analyses of FDG-PET images. ADCmean was variable between individuals, ranging from 0.82 to 1.01.10- 3 mm2 sec- 1, and mainly in relation with CMRGlc of areas involved in Alzheimer's disease such as internal temporal areas, posterior associative junctions, posterior cingulum but also insulo-opercular areas (global correlation coefficient: - 0.577, p < 0.001). Both the ADCmean and CMRGlc of the interrelated grey matter areas were additionally and concordantly linked to the results of executive and memory tests and to systolic central BP (all p < 0.05). Altogether, our findings show that cross-sectional variations in overall white brain matter are linked to the metabolism of Alzheimer-like cortical areas and to cognitive performance in older hypertensive patients with only subjective memory complaints. Additional relationships with central BP strengthen the hypothesis of a contributing pathogenic role of hypertension.


Assuntos
Encéfalo/patologia , Substância Cinzenta/diagnóstico por imagem , Hipertensão/complicações , Transtornos da Memória/etiologia , Substância Branca/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/fisiologia , Estudos Transversais , Imagem de Difusão por Ressonância Magnética , Feminino , Fluordesoxiglucose F18/metabolismo , Humanos , Imageamento Tridimensional , Masculino , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons
13.
Artigo em Inglês | MEDLINE | ID: mdl-28505067

RESUMO

Flowers are frequently treated with pesticides and, as a result, florists handling daily a large number of flowers can be exposed to pesticide residues. A study was conducted among twenty volunteer florists located in Namur Province and in the Brussels Capital Region of Belgium in order to assess their potential dermal exposure to dislodgeable pesticide residues transferred from flowers to hands. Two pairs of cotton gloves were worn during two consecutive half days while handling flowers and preparing bouquets (from min 2 h to max 3 h/day). The residual pesticide deposits on the glove samples were extracted with a multi-residue Quick Easy Cheap Effective Rugged Safe (QuEChERS) method and analyzed by a combination of gas and liquid chromatography tandem mass spectrometry (GC-MS/MS and LC-MS/MS) by an accredited laboratory. A total of 111 active substances (mainly insecticides and fungicides) were detected, with an average of 37 active substances per sample and a total concentration per glove sample of 22.22 mg/kg. Several predictive levels of contamination were considered to assess the risk. The potential dermal exposures (PDE) of florists were estimated at the average, for different percentiles, and at the maximum concentration of residues in samples. At the PDE P90 and at the PDEMAX (or worst case) values, three and five active substances respectively exceed the Acceptable Operator Exposure Level (AOEL), indicating risk situations. For the systemic exposure (SE), one active substance (clofentezine) exceeds the AOEL at the P90 predictive level. In the worst case, SEMAX (at the maximum concentrations), four active substances (clofentezine, famoxadone, methiocarb, and pyridaben) exceed their respective AOEL values. Among the 14 most frequently detected active substances, two have SEMAX values exceeding the AOEL. Exposure could be particularly critical for clofentezine with an SEMAX value four times higher than the AOEL (393%). The exposure of florists appeared to be an example of a unique professional situation in which workers are exposed regularly to both a very high number of toxic chemicals and rather high concentration levels. Therefore the priority should be to raise the level of awareness among the florists who must change their habits and practices if they want to minimize their exposure.


Assuntos
Flores , Exposição Ocupacional/análise , Resíduos de Praguicidas/análise , Adulto , Bélgica , Cromatografia Líquida/métodos , Monitoramento Ambiental , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Medição de Risco , Espectrometria de Massas em Tandem/métodos
14.
Geriatr Psychol Neuropsychiatr Vieil ; 15(1): 83-88, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-28266345

RESUMO

Arterial stiffness is an independent predictor of morbidity (infarction, fatal stroke) and cardiovascular mortality, especially in elderly, hypertensive patients with pre-terminal renal insufficiency and in coronary disease patients. The gold standard of its measurement is the pulse wave velocity assessment. The important increase in arterial stiffness that occurs during midlife is associated with the occurrence of severe cardiovascular and cerebrovascular events and also cognitive decline. The causal relationship between stiffening of the arterial tree and cognitive disorders has not yet been clearly established, however, many studies show a relationship between higher levels of aortic stiffness and poorer performance on cognitive memory tests. Arterial stiffness is associated with microvascular alterations, with an increase in microvascular resistance, an increase in leukoaraisosis and also medial temporal lobe atrophy. These damages contribute to dementia pathogenesis (including Alzheimer's disease) and confirm the importance of early detection and management of arterial stiffness increase.


Assuntos
Cognição/fisiologia , Rigidez Vascular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Circulação Cerebrovascular , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Humanos , Transtornos da Memória/etiologia , Transtornos da Memória/fisiopatologia
15.
J Am Med Dir Assoc ; 18(5): 451.e13-451.e25, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28279605

RESUMO

OBJECTIVES: The longitudinal ADELAHYDE-2 study aims to identify the factors associated with cognitive impairment/decline and white matter hyperintensities burden. METHODS: Longitudinal single-center study comprising two visits separated by approximately 7 years. A total of 131 patients completed the two visits. The primary outcome was global memory composite scale, while the secondary outcome was white matter hyperintensities (WMH/Fazekas scale) load. RESULTS: Global memory at visit 2 (V2) was largely influenced by age, smoking status, glycated hemoglobin, and history of stroke already present at visit 1 (V1). These variables accounted for ∼51% of the memory alterations at V2. WMH at V2 was likely influenced by age, left ventricular hypertrophy, diabetes mellitus, carotid intima-media thickness, and body mass index at V1. These findings accounted for ∼37% of the WMH changes at V2. Increase in pulse wave velocity from V1 to V2 showed a trend for association with memory deterioration (adjusted estimates = 0.06; P = .067), whereas smoking and increase in systolic blood pressure (trend) were associated with an increment in WMH (adjusted estimates = 0.49; P = .047 and adjusted estimates = 0.01; P = .08, respectively). On the other hand, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers and statins (trend) were likely to be protective (adjusted estimates for angiotensin-converting enzyme inhibitor/angiotensin receptor blockers = -0.49; P = .049, and adjusted estimates for statins = -0.46; P = .055). CONCLUSIONS: Several readily identifiable factors are associated with memory deterioration and WMH, many of which are potentially modifiable. Interventions aimed to control these risk factors need to be tested prospectively in order to assess their cognitive protective value.


Assuntos
Hipertensão/complicações , Transtornos da Memória/etiologia , Substância Branca/irrigação sanguínea , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Substância Branca/diagnóstico por imagem
16.
Cerebrovasc Dis ; 42(1-2): 106-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27071040

RESUMO

BACKGROUND: This study aimed at assessing the changes in brain metabolism related to white-matter magnetic resonance (MR) hyperintensities of presumed vascular origin, with a voxel-based quantitative analysis of (18F)-fluorodesoxyglucose positron emission tomography (FDG-PET) imaging. METHODS: Sixty older hypertensive patients with subjective memory complaints (75 ± 5 years, 34 women) were prospectively referred to FDG-PET and MRI brain imaging. The Statistical Parametric Mapping software was used to assess the correlation between brain distribution of FDG and white-matter hyperintensities assessed by the Fazekas score on MRI images. RESULTS: The Fazekas score was inversely related to FDG uptake, independently of age and gender, within 14 Brodmann areas located mainly in the frontal lobe but also in certain limbic, insular and temporal areas. This relationship was also found to be largely independent of the volume of grey matter expressed in percentage of cranial volume, an index of atrophy. CONCLUSIONS: White-matter MR hyperintensities of presumed vascular origin are cross-sectionally associated with a lower grey-matter metabolism, mainly but not only within frontal areas and independently of age, gender and grey-matter atrophy.


Assuntos
Metabolismo Energético , Substância Cinzenta/diagnóstico por imagem , Hipertensão/complicações , Leucoencefalopatias/diagnóstico por imagem , Imageamento por Ressonância Magnética , Transtornos da Memória/etiologia , Memória , Tomografia por Emissão de Pósitrons , Substância Branca/diagnóstico por imagem , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fluordesoxiglucose F18/administração & dosagem , Substância Cinzenta/metabolismo , Humanos , Hipertensão/diagnóstico , Leucoencefalopatias/etiologia , Leucoencefalopatias/metabolismo , Masculino , Transtornos da Memória/diagnóstico , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Projetos Piloto , Valor Preditivo dos Testes , Prognóstico , Compostos Radiofarmacêuticos/administração & dosagem , Fatores de Risco , Substância Branca/metabolismo
17.
J Hypertens ; 34(5): 967-73, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26909645

RESUMO

OBJECTIVES: Blood pressure (BP) and its changes with antihypertensive therapy are key parameters when monitoring left ventricular (LV) remodeling. This dual cross-sectional and longitudinal MRI study aimed to determine whether this monitoring is enhanced by aortic stroke volume (SV) values provided by a phase-contrast sequence. METHODS: The study involved 334 MRI examinations from 247 study participants who had no significant cardiac disease (18-85 years old, 40% with hypertension) and among whom 48 had a 2-4-year MRI follow-up. Left ventricular hypertrophy and concentric geometry were: respectively assessed according to LV mass indexed to body surface area (g/m) and mass/end-diastolic volume ratio (concentric remodeling index); and correlated with vascular parameters involving BP and the indexed SV (ml/m) determined in the ascending aorta with a phase-contrast sequence. RESULTS: Stroke volume was highly variable, ranging from 22 to 74 ml/m. The best cross-sectional correlates were: mean BP × SV product, reflecting cardiac work, for LV mass (r = 0.21); and mean BP/SV ratio, reflecting arterial load, for concentric geometry (r = 0.29). These two SV-derived parameters led to more than two-fold enhancements in cross-sectional predictions compared with BP parameters alone, whereas their longitudinal changes over time paralleled those of concentric geometry (P = 0.003 for mean BP/SV) and LV mass (P = 0.006 for mean BP × SV), suggesting direct links with cardiac remodeling. CONCLUSION: The determination of aortic SV with a phase-contrast sequence leads to a significant enhancement in the characterization and monitoring of cardiac remodeling.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertrofia Ventricular Esquerda/fisiopatologia , Volume Sistólico/fisiologia , Remodelação Ventricular/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Hipertensão/fisiopatologia , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
JAMA ; 314(2): 170-80, 2015 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-26172896

RESUMO

IMPORTANCE: Hypertension treatment is beneficial for most hypertensive patients. The benefits for patients who are very old and frail, especially those taking numerous medications, are less certain. OBJECTIVE: To provide recommendations for the evaluation and treatment of hypertension among patients aged 80 years and older. EVIDENCE ACQUISITION: MEDLINE, PubMed Central, and the Cochrane Database of Systematic Reviews were searched from inception through April 2015, with an emphasis on 2010-2015. Manual cross-referencing of review articles and meta-analyses was also performed to identify randomized controlled trials (RCTs) examining antihypertensive use in octogenarians. The search strategy included the following Medical Subject Headings: hypertension or high blood pressure and trials and oldest old or very old or very elderly. FINDINGS: Six post hoc analyses of the previously published Hypertension in the Very Elderly Trial (HYVET) met the inclusion criteria. In the only placebo-controlled RCT on hypertension management in patients older than 80 years (HYVET; N = 3845), the treatment was associated with lower total mortality and key cardiovascular end points but the effect on stroke (fatal and nonfatal), which was the primary outcome, failed to reach the significance level (P = .06). Post hoc analyses of HYVET suggested that active hypertension treatment in very elderly patients was beneficial by reducing blood pressure in individuals with white coat hypertension, showed moderate benefits of the active treatment for cognition, a possible effect for fractures prevention, and sustained differences in reductions of total mortality and cardiovascular mortality in those receiving active treatment. However, patients were community dwelling and less disabled than individuals of the same age in general. CONCLUSIONS AND RELEVANCE: Hypertensive patients who are healthy, functionally independent, and aged 80 years and older should be treated according to current recommendations for people older than 65 years. There is insufficient evidence regarding the benefits of hypertension treatment for frail polymedicated octogenarians, for whom treatment should be individualized.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Polimedicação , Fatores Etários , Idoso de 80 Anos ou mais , Pressão Sanguínea/efeitos dos fármacos , Feminino , Idoso Fragilizado , Humanos , Masculino , Guias de Prática Clínica como Assunto , Medicina de Precisão
19.
J Chromatogr A ; 1405: 85-93, 2015 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-26100574

RESUMO

This paper reports a novel approach to screening multi-class pesticides by ion mobility time-of-flight mass spectrometry detection. Nitrogen was selected as mobility gas. After optimization of the different ion mobility parameters, determination of matrix effect on the drift times was conducted using different matrix extracts. The results showed that drift time values are not influenced by the matrix and also are independent of the concentration within the working range for 100 pesticides tested, making drift time a powerful additional identification tool. Based on statistics, 2% variation criteria provides a good fit for all the pesticides targeted, and could be considered as a maximum acceptable criteria associated with the drift time parameter for identification purpose. This 2% value is in agreement with already reported criteria, for instance, for GC or LC retention time in European documents. Finally, the well-known feature of mobility to separate complex mixtures was also tested to obtain purified extracted mass spectra of pesticides present in fruit extract.


Assuntos
Frutas/química , Praguicidas/análise , Verduras/química , Espectrometria de Massas/métodos
20.
J Hypertens ; 33(7): 1378-85, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25827431

RESUMO

OBJECTIVE: The sustained elevation of blood pressure (BP) and especially of central pulse pressure (cPP) leads to heart and brain damage. This pilot study was aimed to precise the relationships between peripheral and central BP levels, and the remodeling of heart and brain as objectively quantified by cardiac MRI and brain F-fluorodeoxyglucose (FDG)-PET imaging in the elderly. METHODS: Twenty-eight apparently healthy elderly individuals (66-85 years old, 14 women) were prospectively recruited and allocated into two half groups, one with and one without hypertension, and all were referred for the quantitative determinations of peripheral and central BP using applanation tonometry, indexed left ventricular mass (per m of body surface area) using cardiac MRI, and brain metabolism with a voxel-based analysis of FDG-PET images adjusted for age and sex. RESULTS: Indexed left ventricular mass, reflecting cardiac remodeling, was correlated with the overall pressure variables involving both peripheral and central levels of systolic and pulse pressure (all P ≤ 0.001). By contrast, brain metabolism was significantly correlated with only cPP (P < 0.02). A cPP of at least 50  mmHg was associated with both a lower metabolism in frontal areas (P = 0.005) and a higher indexed left ventricular mass (P = 0.03). CONCLUSION: This pilot study suggests that, when quantified by MRI and PET imaging, left ventricular mass and brain metabolism of elderly individuals are related to the cPP and to the 50  mmHg threshold, corresponding to what has previously been documented for the risk of cardiovascular event.


Assuntos
Pressão Sanguínea , Encéfalo/patologia , Miocárdio/patologia , Idoso , Idoso de 80 Anos ou mais , Determinação da Pressão Arterial , Encéfalo/metabolismo , Feminino , Humanos , Hipertensão/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Miocárdio/metabolismo , Projetos Piloto , Pulso Arterial
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