The effects of cataract surgery on autonomic heart rate control: a prospective cross-sectional and analytical study.

OBJECTIVES: We aimed to evaluate the effects of cataract surgery on cardiac autonomic modulation. METHODS: A cross-sectional and analytical study was conducted at the Hospital Maria Braido in the city of São Caetano do Sul, São Paulo, between 2015 and 2016. We investigated 19 patients of both sexes who were all over 50 years old; all patients had a diagnosis of senile or bilateral cataracts and were recommended to undergo implantation of the intraocular lens. Heart rate variability (HRV) was evaluated before, during and after cataract surgery. RESULTS: There were no significant changes in the time and geometric domains of HRV before, during or after surgery. The high-frequency (HF) band in normalized units (nu) on the spectral analysis significantly increased (p=0.02, Cohen's d=0.9, large effect size). However, the low-frequency (LF) band in nu significantly decreased during surgery (p=0.02, Cohen's d=0.9, large effect size). CONCLUSION: Throughout the intraocular lens implantation cataract surgery, there was an increase in parasympathetic modulation and a decrease in the sympathetic component of the heart rate (HR). We propose that this result is attributable to the supine position of the patients during surgery and the trigeminal reflex.

Mortality attributable to cardiovascular diseases in young adults residents in Brazil / Mortalidade atribuível às doenças cardiovasculares em adultos jovens residentes no Brasil

Introdução: doenças Cardiovasculares são as principais causas de morte no mundo. Apesar da redução da incidência e mortalidade por DCV no século XX, os valores permanecem elevados no século XXI. No Brasil, há lacuna de estudos populacionais que estimaram as taxas padronizadas de mortalidade por doenças cardiovasculares em adultos jovens.Objetivo: avaliar a tendência da mortalidade por doenças cardiovasculares em adultos jovens, segundo sexo, faixa etária e regiões do Brasil.Método: estudo de séries temporais com uso de dados secundários oficiais dos Sistemas de Informações sobre Mortalidade (SIM). Foram consideradas todas as mortes por doenças cardiovasculares (I00-I-99) em adultos jovens faixa etária 20-49 anos, residentes no Brasil, no período de 01 de janeiro de 2008 a 31 de dezembro de 2017. Os dados foram extraídos do Departamento de Informática do SUS (DATASUS). Foi utilizado o modelo de regressão Prais-Winsten e calculada a Variação Percentual Anual (VPA). Todas as análises foram realizadas no software STATA 14.0.Resultados: durante período 2008-2017, foram identificadas 294.232 mortes (8,7%) por doença cardiovascular em adultos jovens com idade entre 20-49 anos. Identificou-se a redução da mortalidade por DCV em todas as regiões do Brasil, exceto nos indivíduos de 20-24 anos, residentes na região Nordeste, a qual apresentou aumento (VPA: 2,45%) (p<0,05) 2013-2017. A maior variação da tendência de mortalidade ocorreu na região Sul (VPA: -25,2%). Enquanto a menor variação de tendência da mortalidade ocorreu na região Nordeste (VPA: -8,8%). O declínio anual foi menor no segundo quinquênio (2013-2017) em comparação ao primeiro (2008-2012). Além disso, o declínio foi mais acentuado entre as mulheres (VPA: -2,51%) (p<0,05) 2008-2012 e em adultos jovens com idade entre 40-44 anos (VPA: -2,91%) (p<0,05) 2008-2012. Ademais, a tendência de mortalidade por DCV se estabilizou a partir de 2013 no sexo masculino (p>0,05).Conclusão: os resultados demonstram tendência decrescente da mortalidade por Doença Cardiovascular em adultos jovens no Brasil, entre 2008-2017. Conclui-se que existe desigualdade na tendência de mortalidade por DCV segundo sexo, faixa etária e regiões do Brasil.

Introduction: cardiovascular diseases are the leading causes of death in the world. Despite the reduction in CVD incidence and mortality in the 20th century, the values remain high in the 21st century. In Brazil, there is a gap in population studies that estimated standardized mortality rates from cardiovascular diseases in young adults.Objective: to assess the trend in mortality from cardiovascular diseases in young adults, according to sex, age group and regions of Brazil.Methods: ecological time series study using official secondary data from Mortality Information Systems (SIM). All deaths from cardiovascular diseases (I00-I-99) in young adults aged 20-49 years, residing in Brazil, in the period from January 1, 2008 to December 31, 2017, were considered. Data were extracted from the Department of Informatics of the SUS (DATASUS). The Prais-Winsten regression model was used and the Annual Percentage Variation (APV) was calculated. All analyzes were performed in STATA 14.0 software.Results: during the period 2008-2017, 294,232 deaths (8.7%) from cardiovascular disease were identified in young adults aged 20-49 years. A reduction in CVD mortality was identified in all regions of Brazil, except for individuals aged 20-24 years, residing in the Northeast region, which showed an increase (APC: 2.45%) (p<0.05) 2013 -2017. The greatest variation in the mortality trend occurred in the South region (APC: -25.2%). While the smallest change in mortality trend occurred in the Northeast region (APC: -8.8%). The annual decline was smaller in the second quinquennium (2013-2017) compared to the first (2008-2012). Furthermore, the decline was more pronounced among women (APC: -2.51%) (p<0.05) 2008-2012 and in young adults aged 40-44 years (APC: -2.91%) (p<0.05) 2008-2012. Furthermore, the trend in CVD mortality stabilized from 2013 onwards in males (p>0.05).Conclusion: the results demonstrate a decreasing trend in mortality from Cardiovascular Disease in young adults in Brazil, between 2008-2017. It is concluded that there is inequality in the trend of mortality from CVD according to sex, age group and regions of Brazil.

The effects of cataract surgery on autonomic heart rate control: a prospective cross-sectional and analytical study

OBJECTIVES: We aimed to evaluate the effects of cataract surgery on cardiac autonomic modulation. METHODS: A cross-sectional and analytical study was conducted at the Hospital Maria Braido in the city of São Caetano do Sul, São Paulo, between 2015 and 2016. We investigated 19 patients of both sexes who were all over 50 years old; all patients had a diagnosis of senile or bilateral cataracts and were recommended to undergo implantation of the intraocular lens. Heart rate variability (HRV) was evaluated before, during and after cataract surgery. RESULTS: There were no significant changes in the time and geometric domains of HRV before, during or after surgery. The high-frequency (HF) band in normalized units (nu) on the spectral analysis significantly increased (p=0.02, Cohen's d=0.9, large effect size). However, the low-frequency (LF) band in nu significantly decreased during surgery (p=0.02, Cohen's d=0.9, large effect size). CONCLUSION: Throughout the intraocular lens implantation cataract surgery, there was an increase in parasympathetic modulation and a decrease in the sympathetic component of the heart rate (HR). We propose that this result is attributable to the supine position of the patients during surgery and the trigeminal reflex.

Baroreflex sensitivity differs among same strain Wistar rats from the same laboratory.

Previous studies showed that a proportion of normotensive Sprague-Dawley rats spontaneously exhibit lower baroreflex sensitivity. However, investigations have not yet been carried out on Wistar rats. We aimed to compare baroreflex sensitivity among rats from the same strain and the same laboratory. Male Wistar normotensive rats (300-400g) were studied. Cannulas were inserted into the abdominal aortic artery through the right femoral artery to measure mean arterial pressure and heart rate. Baroreflex was calculated as the derivative of the variation of heart rate in function of the mean arterial pressure variation (ΔHR/ΔMAP) tested with a depressor dose of sodium nitroprusside (50 µg/kg) and with a pressor dose of phenylephrine (8µg/kg) in the right femoral venous approach through an inserted cannula. We divided the rats into four groups: i) high bradycardic baroreflex, baroreflex gain less than -2 tested with phenylephrine; ii) low bradycardic baroreflex, baroreflex gain between -1 and -2 tested with phenylephrine; iii) high tachycardic baroreflex, baroreflex gain less than -3 tested with sodium nitroprusside; and iv) low tachycardic baroreflex, baroreflex gain between -1 and -3 tested with sodium nitroprusside. Approximately 71% of the rats presented a decrease in bradycardic reflex while around half showed an increase in tachycardic reflex. No significant changes in basal mean arterial pressure and heart rate, tachycardic and bradycardic peak and heart rate range were observed. There was a significant change in baroreflex sensitivity among rats from the same strain and the same laboratory.

Chest associated to motor physiotherapy improves cardiovascular variables in newborns with respiratory distress syndrome.

BACKGROUND: We aimed to evaluate the effects of chest and motor physiotherapy treatment on hemodynamic variables in preterm newborns with respiratory distress syndrome. METHODS: We evaluated heart rate (HR), respiratory rate (RR), systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP), temperature and oxygen saturation (SO2%) in 44 newborns with respiratory distress syndrome. We compared all variables between before physiotherapy treatment vs. after the last physiotherapy treatment. Newborns were treated during 11 days. Variables were measured 2 minutes before and 5 minutes after each physiotherapy treatment. We applied paired Student t test to compare variables between the two periods. RESULTS: HR (148.5 ± 8.5 bpm vs. 137.1 ± 6.8 bpm - p < 0.001), SAP (72.3 ± 11.3 mmHg vs. 63.6 ± 6.7 mmHg - p = 0.001) and MAP (57.5 ± 12 mmHg vs. 47.7 ± 5.8 mmHg - p = 0.001) were significantly reduced after 11 days of physiotherapy treatment compared to before the first session. There were no significant changes regarding RR, temperature, DAP and SO2%. CONCLUSIONS: Chest and motor physiotherapy improved cardiovascular parameters in respiratory distress syndrome newborns.

Memantine effects on liver and adrenal gland of rats exposed to cold stress.

BACKGROUND: Memantine attenuates heart stress due cold stress, however, no study focused its effects on liver and adrenal gland. We evaluated its effects on lipid depletion in adrenal gland and glycogen depletion in liver of rats exposed to cold stress. METHODS: Male rats divided into 4 groups: 1)Control (CON); 2)Memantine (MEM); 3)Induced cold stress (IH) and; 4)Induced cold stress memantine (IHF). Memantine were administrated by gavage (20 mg/kg/day) during eight days. Cold stress were performed during 4 hours once at - 8°C. Lipid and glycogen depletion were presented as its intensity levels. RESULTS: Rats exposed to cold stress presented the highest glycogen (p < 0.001) and lipid depletion (p < 0.001) in liver and adrenal gland, respectively. We noted that memantine significantly reduced lipid depletion in adrenal gland and glycogen depletion in liver. CONCLUSION: Memantine prevented glycogen depletion in liver and lipid depletion in adrenal gland of rats under a cold stress condition.

Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion.

BACKGROUND: The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers. METHODS: We evaluated 10 non professional ballet dancers (16-23 years old). We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction) and performed correlation between active movements and flexibility. RESULTS: There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1st and the 3rd measurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides) with the three test measurements of the bank of Wells. CONCLUSION: There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers.

Invisibilidade do Sujeito na diversidade de olhares da assistência à adolescente grávida / Invisibility of the subject in the diversity of perspectives of assistance to pregnant teenager

O profissional de saúde ao visualizar a gravidez na adolescência como um problema de saúde a ser corrigido, torna invisível o paciente como sujeito de direitos e necessidades de cuidado. Há percepções de que as práticas no campo da Medicina estão descoladas da realidade e não atendem, ao que parece, às demandas dos usuários como sujeitos de direitos das ações em saúde. Os conhecimentos adquiridos, construídos e compartilhados foram incorporados à realidade da prática médica, porém a grande questão é saber e entender em que medida e de que forma acontece esse processo e como se relaciona com os demais envolvidos, ou seja, qual a percepção e o que prevalece ou torna-se invisível o sujeito paciente na abordagem médica às questões complexas da saúde dos indivíduos. Os objetivos desse trabalho foram desvelar as invisibilidades do sujeito paciente na questão da gravidez na adolescência sob os olhares do profissional da saúde e, consequentemente, caracterizar especificidades dos olhares do profissional da saúde na prática da assistência aos adolescentes com experiência de gravidez que os tornam invisíveis ao profissional. Para esse fim, foi adotado como procedimento metodológico a investigação cientifica da pesquisa descritiva de abordagem qualitativa, por meio da análise de conteúdo des entrevistas semi estruturadas, de aspecto geral sobre assuntos relacionados ao tema central gravidez na adolescência e a assistência médica, com perguntas comuns e consensuais que envolviam significados, ensino, a prática cotidiana e saúde pública com profissionais de saúde médicos, que trabalham com adolescentes grávidas, nos serviços da rede de saúde pública em município da Grande São Paulo, com vinculação acadêmica a Instituição de Ensino Superior. Desvelaram-se que as invisibilidades do sujeito paciente na questão da gravidez na adolescência são resultados da produção médica no cuidado ao paciente, nos valores e representações da lógica médica...

The health professional to show teenage pregnancy as a health problem to be corrected, makes invisible the patient as a subject of rights and care needs. There are perceptions that the practices in the medical field are detached from reality and does not meet, it seems, the demands of the users as subjects of rights of health actions. The knowledge acquired, built and shared were incorporated to the reality of medical practice, but the big question is to know and understand to what extent and in what way does this process and how it relates to others involved, therefore, what the perception and what prevails or becomes invisible subject patient in medical approach to the complex issues of the health of individuals. Among the most common health guidelines, some are eligible to potentially reach a greater degree of complexity to the care and become provocative assistance gaps, which in this study called the invisibility of the subject, and one of the staves, we work with teenage pregnancy, and the invisibility of this teenager in this important moment of your life that need care and support of the health professional. The objectives of this study were to reveal the invisibilities of fellow patient on the issue of teen pregnancy in the looks of the healthcare professional and, consequently, characterize specificities of the looks of the health professionals in the practice of assistance to adolescents with pregnancy experience that makes them invisible to the professional...