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1.
Opt Express ; 27(8): A257-A268, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-31052880

RESUMO

Heliostat alignment evaluation is among the main issues in solar tower concentration plant operation and maintenance. This paper describes a novel method used to evaluate heliostat misalignment and its experimental verification. This method provides a different way of visualizing beam centroid pointing errors by generating the complete deviation curve for each axis. This, for example, would be useful for verifying a heliostat's correct alignment by using a measurement performed out of the receiver target, using these traces to calculate its reflection's expected location, given a known misalignment. This measurement could be performed during operation simply by including a reflective element in the heliostat and two detector arrays on the tower's surface. This model has been tested for various types of misalignments of a heliostat at different hours, dates, and heliostat locations. The simulation results have been validated by using an experimental setup at a scale of 1:100.

2.
Epidemiol Infect ; 143(10): 2245-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25335452

RESUMO

Balamuthia mandrillaris is an emerging cause of encephalitis in humans. The transmission dynamics are poorly understood due to the high fatality rate and the sporadic nature of cases. Seventy-two soil samples were collected from beaches and the banks of lagoons, rivers, ponds, mineral springs and streams from across Jamaica and assayed for the presence of B. mandrillaris. Seventy-nine sites were sampled and the mitochondrial 16S rDNA gene of B. mandrillaris was amplified and sequenced to confirm the presence of the amoeba. One isolate of B. mandrillaris was recovered from soil from mineral spring which hosts an informal therapeutic mud bath business. Although B. mandrillaris is less frequently isolated from soil than other free-living amoebae, rubbing mud containing the organism onto the skin increases the likelihood of exposure and infection. This first report on the isolation of B. mandrillaris in the Caribbean and its presence in soil where human contact is likely warrants further investigation using serological methods to elucidate exposure patterns.


Assuntos
Balamuthia mandrillaris/isolamento & purificação , Microbiologia Ambiental , Balamuthia mandrillaris/classificação , Balamuthia mandrillaris/genética , DNA Mitocondrial/química , DNA Mitocondrial/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Coleta de Dados , Humanos , Jamaica , Dados de Sequência Molecular , Peloterapia , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
3.
Rev Esp Anestesiol Reanim (Engl Ed) ; 67(8): 446-480, 2020 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32948329

RESUMO

Transesophageal echocardiography is a semi-invasive technique that allows an evaluation of cardiac morphology and function in real time and it is a quality standard in cardiovascular surgery. It has become a fundamental tool for both monitoring and diagnosis in the intraoperative period that allows decide the correct surgical planning and pharmacological management. The goal of this document is to answer the questions of when and how the perioperative TEE should be performed in cardiovascular surgery, what are their applications in the intraoperative, who should perform it and how the information should be transmitted. The authors made a systematic review of international guidelines, review articles and clinical trials to answer by consensus to these questions.

4.
Trop Biomed ; 34(2): 332-337, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33593013

RESUMO

This study describes the association of household water system contamination with the pathogenic Free-Living Amoeba (FLA) Naegleria fowleri and a case of fatal Primary Amoebic Meningoencephalitis (PAM) in a child from the state of Monagas in Venezuela. Amoebae were initially identified by microscopy from a sample of cerebrospinal fluid (CSF) from the child. Direct DNA extraction and specific PCR/sequencing for N. fowleri was also carried out from the same CSF sample. In order to determine a possible environmental source of infection, water samples from the water tank of the child's home and also water bodies recently visited by the child and his family, were examined for the presence of N. fowleri by culture and PCR/sequencing. The results obtained from the collected water samples revealed that only the water tank of the house was positive for N. fowleri. PCR/sequencing showed that the strains isolated from the patient and the water tanks were 100 % identical. Therefore, the house water tank was confirmed as the source of infection in this case, possibly as a result of the occasional immersion of the child´s head under the water while bathing. This case highlights a novel source of thermally polluted water and another threat of N. fowleri infection.

5.
Curr Med Chem ; 23(21): 2275-85, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27237817

RESUMO

Pompe disease or glycogen storage disease type II (OMIM: 232300) is a lysosomal storage disorder resulting from a partial or total lack of acid alphaglucosidase, which may produce muscle weakness, gait abnormalities, or even death by respiratory failure. In the last decade, autophagy has been proposed as a mechanism involved in the severity of symptoms related to this disorder and as a potential therapeutic target to alleviate disease progression. This review summarizes the relationship between autophagy and Pompe disease, including what information has been recently discovered and what remains unclear.


Assuntos
Autofagia , Doença de Depósito de Glicogênio Tipo II/patologia , Animais , Modelos Animais de Doenças , Terapia de Reposição de Enzimas , Doença de Depósito de Glicogênio Tipo II/metabolismo , Doença de Depósito de Glicogênio Tipo II/terapia , Humanos , Proteínas Associadas aos Microtúbulos/metabolismo , Mitocôndrias/metabolismo , Músculo Esquelético/metabolismo , alfa-Glucosidases/genética , alfa-Glucosidases/metabolismo
6.
J Heart Lung Transplant ; 18(4): 372-5, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10226903

RESUMO

BACKGROUND: We have studied the alterations produced in the diastolic function of the left ventricle after applying a protocol of cryopreservation at subzero temperatures. METHODS: Isolated rabbit hearts and 5% polyethylene glycol (PM 4000) as the cryoprotective agent were used for the study. RESULTS-CONCLUSIONS: Following cryopreservation we found a statistically significant increase in systolic function. However, the diastolic function shows worsening, with a statistically significant increase (p < 0.05) in mean stiffness, decrease in differential stiffness, (p < 0.05) and upward and leftward displacement of the diastolic pressure-volume curve.


Assuntos
Criopreservação , Diástole/fisiologia , Transplante de Coração/fisiologia , Animais , Volume Cardíaco/fisiologia , Crioprotetores/uso terapêutico , Elasticidade , Congelamento , Glucose/uso terapêutico , Soluções para Preservação de Órgãos/uso terapêutico , Polietilenoglicóis/uso terapêutico , Coelhos , Tensoativos/uso terapêutico , Sístole/fisiologia , Trometamina/uso terapêutico , Função Ventricular Esquerda/fisiologia , Pressão Ventricular/fisiologia
7.
Phytochemistry ; 37(1): 255-8, 1994 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7765616

RESUMO

Two flavonol diglycosides isolated from the leaves of Eugenia jambos were characterized as quercetin and myricetin 3-O-beta-D-xylopyranosyl(1-->2) alpha-L-rhamnopyranosides by means of spectral analyses applying 2D NMR techniques and NOE experiments.


Assuntos
Flavonoides/isolamento & purificação , Glicosídeos/isolamento & purificação , Plantas Medicinais/química , Quercetina/isolamento & purificação , Sequência de Carboidratos , Flavonoides/química , Glicosídeos/química , Espectroscopia de Ressonância Magnética , Dados de Sequência Molecular , Quercetina/química , Espectrofotometria Ultravioleta , Árvores
8.
Phytochemistry ; 42(1): 101-2, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-8728059

RESUMO

A new flavone diglycoside isolated from the aerial parts of Sideritis lutoela was characterized as isoscutellarein 7-O-beta-D-glucopyranosyl(1-->2) beta-D-xylopyranoside by means of spectral analyses, applying 2D NMR techniques and NOE experiments. Its presence in 15 other species of Sideritis is described.


Assuntos
Apigenina , Flavonoides/química , Glicosídeos/química , Plantas Medicinais , Configuração de Carboidratos , Sequência de Carboidratos , Flavonoides/isolamento & purificação , Glicosídeos/isolamento & purificação , Medicina Tradicional , Dados de Sequência Molecular , Especificidade da Espécie
9.
J Chromatogr A ; 870(1-2): 449-51, 2000 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-10722101

RESUMO

Several polyphenols have been tested in grape berries from Spain. The flavonoid content is important because of the pharmacological properties of these compounds, whereas resveratrol has been proved to be an antifungal, antiinflammatory and an anticarcinogenic compound. A reversed-phase HPLC method has been developed and applied to determine resveratrol, quercetine, quercitrine and rutine content in several grape berries samples in a single analysis. Covering the grapes with a preservative paper yields a healthier product, but one which has a lower polyphenol content than unprotected grapes.


Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Flavonoides , Fenóis/análise , Polímeros/análise , Rosales/química , Polifenóis , Sensibilidade e Especificidade , Espectrofotometria Ultravioleta
10.
J Parasitol ; 90(4): 908-13, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15357103

RESUMO

By screening a Leishmania braziliensis complementary DNA library with a pool of sera from leishmaniasis patients, the gene coding for L6 ribosomal protein was isolated. The sequence, genomic organization, and transcription of this gene are described in this article. The sequence analysis of the L. braziliensis L6 gene shows a single open reading frame, which codes for a protein of 192 amino acids (aa) with a hypothetical molecular mass of 20.9 kDa. The protein exhibits significant sequence similarity to L6 ribosomal proteins from higher eukaryotes and yeast. Thus, the L. braziliensis L6 protein contains 4 functional motifs, which are located at equivalent positions in other L6 ribosomal proteins described previously. Interestingly, the L6 ribosomal protein from L. braziliensis contains a specific region of 14 aa and a tyrosine kinase motif, which is absent in human and C. elegans L6 protein. The locus coding the L. braziliensis L6 ribosomal protein is formed by 2 gene copies arranged in tandem and located in a chromosome of approximately 0.9. Mb. The genes are actively transcribed as 2 polyadenylated transcripts of approximately 1.15 and 0.85 kb, which differ in their steady-state level and stability.


Assuntos
DNA Complementar/isolamento & purificação , Leishmania braziliensis/genética , Leishmaniose Cutânea/parasitologia , Proteínas Ribossômicas/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Northern Blotting , Southern Blotting , DNA Complementar/genética , DNA de Protozoário/genética , DNA de Protozoário/isolamento & purificação , Eletroforese em Gel de Campo Pulsado , Biblioteca Gênica , Humanos , Soros Imunes/genética , Soros Imunes/imunologia , Leishmania braziliensis/química , Leishmania braziliensis/imunologia , Leishmaniose Cutânea/imunologia , Dados de Sequência Molecular , Proteínas Ribossômicas/química , Alinhamento de Sequência
11.
J Ethnopharmacol ; 43(1): 9-11, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7967652

RESUMO

The anti-inflammatory activities of four organic extracts from the leaves of Eugenia jambos were investigated in rats using the Mizushima et al. model of acute and chronic inflammation (Mizushima et al. (1972) Journal of Pharmacy and Pharmacology 24, 781-785). Orally administered organic extracts of E. jambos (hexane, dichloromethane, ethyl acetate and methanol), given at daily doses equivalent to 12.5 g/kg of dried leaf material, inhibited both the acute and chronic phases of this experimental model of inflammation. The ethyl acetate and methanol extracts were the most effective and were equal or more effective than 80 mg/kg of phenylbutazone. The methanolic extract was the most active in the chronic phase. A 10% aqueous extract (infusion) of the leaves tested in the same model was more effective than all of the organic extracts.


Assuntos
Anti-Inflamatórios/farmacologia , Extratos Vegetais/farmacologia , Acetatos/química , Administração Oral , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Artrite Experimental/tratamento farmacológico , Modelos Animais de Doenças , Feminino , Hexanos/química , Metanol/química , Cloreto de Metileno/química , Extratos Vegetais/administração & dosagem , Extratos Vegetais/uso terapêutico , Folhas de Planta/química , Ratos , Ratos Wistar
12.
J Ethnopharmacol ; 70(3): 329-33, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10837995

RESUMO

Several extracts obtained from Bolivian medicinal plants have been evaluated for cytoprotective activity on ethanol-induced ulcer formation in rats. Preliminary results suggest, that the majority of the plants tested showed a significant activity, the aqueous extracts of Phoradendron crassifolium and Franseria artemisioides being the most active, exerting a cytoprotective activity comparable to atropine. The analysis of the chemical constituents of the extracts studied showed the presence of tanins, saponins, flavonoids and coumarins.


Assuntos
Antiulcerosos/farmacologia , Mucosa Gástrica/patologia , Plantas Medicinais/química , Úlcera Gástrica/prevenção & controle , Animais , Antiulcerosos/isolamento & purificação , Atropina/farmacologia , Bolívia , Cromatografia em Camada Fina , Mucosa Gástrica/efeitos dos fármacos , Masculino , Antagonistas Muscarínicos/farmacologia , Folhas de Planta/química , Ratos , Ratos Wistar , Úlcera Gástrica/induzido quimicamente
13.
J Ethnopharmacol ; 76(3): 201-14, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11448540

RESUMO

The chemical composition, pharmacological activity and traditional uses of 52 species attributed to the genus Lippia (Verbenaceae) as used in the South and Central America, and Tropical Africa, were revised and compared. A survey of the available literature shows that these species are used mostly for the treatment of gastrointestinal and respiratory disorders and as seasoning. Additionally, some of these Lippia species showed antimalarial, spasmolitic, sedative, hypotensive and, anti-inflammatory activities. Generally, the essential oil or the phenolic compounds (flavonoids) from these plant extracts are assumed to be the active principles.


Assuntos
Medicina Tradicional , Fitoterapia , Plantas Medicinais , Verbenaceae/química , África , América Central , Gastroenteropatias/tratamento farmacológico , Humanos , Estruturas Vegetais/química , Plantas Medicinais/química , Doenças Respiratórias/tratamento farmacológico , América do Sul , Especiarias
14.
J Ethnopharmacol ; 55(1): 63-8, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9121169

RESUMO

Six medicinal plant extracts from Venezuela, used in traditional medicine, were investigated for their anti-inflammatory potential against adjuvant-carrageenan-induced inflammation (ACII). All doses expressed here are equivalents of dried starting plant materials (1.50 g dry plant/kg body wt.). The most interesting plant extracts were Synedrella nodiflora, and the hexane leaf extract of Bursera simaruba. In ACII, orally administered extracts (at doses 40 and 80 mg/kg, respectively), inhibited both the acute and chronic phases of this experimental model of inflammation, mainly the chronic phase. These extracts exhibited potent anti-inflammatory activity daily throughout the experiment, and were as effective as reference drugs, phenylbutazone (80 mg/kg) and indomethacin (3 mg/kg).


Assuntos
Anti-Inflamatórios/farmacologia , Plantas Medicinais , Animais , Masculino , Extratos Vegetais/farmacologia , Ratos , Ratos Sprague-Dawley , Venezuela
15.
J Ethnopharmacol ; 61(2): 161-6, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9683347

RESUMO

Ethanolic extracts from 15 plant species, representing eight different families, used in traditional medicine in Ecuador were evaluated for antiinflammatory and antioxidant activities. Conyza floribunda, Eupatorium articulatum, Bonafousia longituba, Bonafousia sananho, Tagetes pusilla and Piper lenticellosum extracts showed a significant antiinflammatory activity in vivo in the carrageenan-induced paw oedema model in mice. The extracts were also tested in vitro for their ability to inhibit lipid peroxidation and to scavenge superoxide and hydroxyl radicals. E. articulatum extract possesses both activities. Baccharis trinervis, E. articulatum and Phytolacca rivinoides extracts were active as antioxidants.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Antioxidantes/farmacologia , Medicina Tradicional , Plantas Medicinais/química , Animais , Equador , Edema/induzido quimicamente , Edema/prevenção & controle , Etanol , Feminino , Sequestradores de Radicais Livres/farmacologia , Radical Hidroxila/metabolismo , Técnicas In Vitro , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Camundongos , Microssomos/efeitos dos fármacos , Microssomos/metabolismo , Microssomos Hepáticos/efeitos dos fármacos , Microssomos Hepáticos/metabolismo , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Ratos , Ratos Wistar , Superóxidos/metabolismo , Xantina Oxidase/metabolismo
16.
Int J Clin Pharmacol Res ; 6(5): 397-401, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3781702

RESUMO

The binding of theophylline to plasma proteins was studied in samples from healthy adults at different pH values and drug concentrations and in samples from patients with chronic obstructive pulmonary disease (COPD). Binding determinations were performed by ultrafiltration and drug concentrations were measured by high performance liquid chromatography. Total plasma levels of theophylline did not influence the degree of the binding. The percentage of bound theophylline was positively correlated with pH both in vitro (r = 0.998, p less than 0.005) and in vivo (r = 0.579, p less than 0.005). Mean theophylline binding values in vivo (mean 56.3 +/- 12.5) and in vitro (mean 48.3 +/- 9.4) were significantly different. The increase in theophylline free levels detected in COPD patients was partially dependent on low pH values but the influence of other factors must also be considered. The therapeutic implications of altered theophylline binding are discussed.


Assuntos
Proteínas Sanguíneas/metabolismo , Pneumopatias Obstrutivas/sangue , Teofilina/sangue , Adulto , Humanos , Concentração de Íons de Hidrogênio , Pneumopatias Obstrutivas/tratamento farmacológico , Ligação Proteica
17.
Ann Thorac Cardiovasc Surg ; 7(1): 17-22, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11343561

RESUMO

INTRODUCTION: Paraaortic or external aortic counterpulsation is been investigated as a definitive ventricular assistance in cases of terminal congestive heart failure and when heart transplantation is counterindicated. Our aims is to assess the haemodynamic effects of an descending aortomyoplasty in a biological model of congestive heart failure. MATERIALS AND METHODS: As specimens, we used 10 "Large White" pigs. Mean weight was 25,3+/-2,14 Kg. After the administration of conventional anaesthesia, dissection of the latissimus dorsi muscle was performed. Then we performed a thoracotomy at the level of the fourth intercostal space to reach the thoracic aorta. The aorta is dissected 7 centimetres from the output of the subclavia artery and it is wrapped by the dissected muscle. A cardiomyostimulator is provided in order to allow the synchronization between the diastole and the muscle contraction. The model of heart failure was provoked using Verapamil plus Propanolol i.v. RESULTS: A significant increase of the systolic and diastolic aortic pressure (54,2+/-4,05 and 27.5+/-6.77 mmHg versus 76.5+/-6.25 and 56.4+/-5.2 mmHg, p<0,001) and a significant decrease of the left ventricle telediastolic pressures were observed (12.9+/-9 versus 2.6+/-1.57 mmHg, p<0,001). An increase of the cardiac output (0.363+/-0.11 versus 0.846+/-0.08 L/min, p<0,001) and the Subendocardial Viability Index (0.968+/-0.076 versus 1.351+/-0,107, p<0,001)were observed in a model of non-ischemic heart failure. CONCLUSION: Descending Aortomyoplasty as a technique to support circulation in cases of acute heart failure, improves the parameters of ventricular function, aiding the functional recovery of the left ventricle and improving significantly cardiac output as well as diastolic and systolic cardiac pressure. In addition to this, improves the Subendocardial Viability Index in cases of acute heart failure, which indirectly reflects an improvement of the Transmural and Subendocardial Perfusion of the failing heart.


Assuntos
Cardiomioplastia , Circulação Coronária/fisiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/cirurgia , Animais , Aorta Torácica/fisiopatologia , Aorta Torácica/cirurgia , Débito Cardíaco/fisiologia , Modelos Animais de Doenças , Suínos , Resultado do Tratamento , Função Ventricular/fisiologia , Pressão Ventricular/fisiologia
18.
Rev Esp Cardiol ; 53(9): 1189-94, 2000 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-10978234

RESUMO

UNLABELLED: We studied the alterations produced in left ventricular systolic and diastolic function after applying a protocol of cryopreservation at subzero temperatures. Isolated rabbit hearts were used for the study with 5% polyethylene glycol (PM 4000) being the cryoprotective agent. MATERIALS AND METHODS: The cryoprotectant solution CP-16 was used on the explanted heart in three phases: induction, storage and thawing. After 60 minutes at -1.6 C and thawing at 2.7 C/min, the heart was connected to a Langendorff system and perfused anterogradely with Krebs-Henseleit buffer. We analyzed the systolic and diastolic parameters before and after cryopreservation, thereby establishing a comparative statistical study. RESULTS: Following cryopreservation we found a statistically significant increase (p < 0.05) in the peak and developed pressure of the left ventricle with an upward, left displacement of the ventricular function curve. This is indicative of improvement in systolic function. However, the diastolic function showed worsening, with a statistically significant increase (p < 0.05) in mean stiffness, decrease in differential stiffness (p < 0.05) and upward, left displacement of the diastolic pressure-volume curve. CONCLUSIONS: On the basis of our results we concluded that: a) PM 4000 polyethylene glycol maintains the heart biological viability during cryopreservation at subzero temperatures, and b) after an cryopreservation left ventricular diastolic function worsens with an increase in systolic function.


Assuntos
Criopreservação , Coração/fisiologia , Animais , Diástole , Técnicas In Vitro , Coelhos , Sístole , Função Ventricular Esquerda/fisiologia
19.
Nefrologia ; 21(5): 456-63, 2001.
Artigo em Espanhol | MEDLINE | ID: mdl-11795014

RESUMO

The aim of this study was to analyse the effect of the ACE-1, Trandolapril, alone or with Verapamil on blood pressure, albuminuria and metabolic profile in type 2 diabetic patients with hypertension and albuminuria. It was an open multicenter, consecutive and prospective study conducted in 281 patients. There was a four-week wash-out period of antihypertensive drugs, after which we carried out a measurement over a 24-h period of the urinary excretion of albumina (UEA). Blood pressure was recorded after at least 5 minutes of rest in the sitting position at 1 to 3 minute intervals with a mercury sphygmomanometer in good condition. Average BP was obtained from three consecutive readings. Within treatment changes were analysed using descriptive statistics and t-tests on the change from baseline. Analysis of variance, chi-square and Mc Nemar tests were also used. If after 8 weeks of treatment with Trandolapril 2 mg o.q.d. the patients were non-responders (mean blood pressure reduction of 5 mmHg or less) or their blood pressure remained uncontrolled (blood pressure > or = 140/90 mmHg), Verapamil 180 mg o.q.d. was added. Two hundred and thirty patients completed the 12 weeks study. Population included 157 (55.9%) males with an average of 61.7 +/- 9.2 years. Baseline measurements were systolic 165.4 +/- 14.6 and diastolic 94.8 +/- 8.5 mmHg blood pressures, fasting glucose 162.7 +/- 43.9 mg/dL, glycosylated hemoglobin (HbAlc) 6.8 +/- 1.2%, and albuminuria 520.9 +/- 602 mg/day. UEA fell significantly (p < 0.001) after treatment to 177.9 +/- 24.3 mg/day (CI 95%, 129.9 to 225.8). The percent reduction reached 29.6%. Albuminuria was lower than 30 mg/day in 47 patients. Blood pressure was completely controlled in 125 (54%) patients. Glucemia fell significantly (p < 0.001) to 153.2 +/- 42.7 mg/dL, and the HbAlc to 6.5 +/- 1.3% (p = 0.012). In summary, in those diabetic type 2 patients with arterial hypertension and proteinuria, Trandolapril alone or associated with Verapamil significant lowered albuminuria and blood pressure facilitated the control or their metabolic profile.


Assuntos
Albuminúria/tratamento farmacológico , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipertensão/tratamento farmacológico , Indóis/administração & dosagem , Verapamil/administração & dosagem , Albuminúria/etiologia , Diabetes Mellitus Tipo 2/complicações , Quimioterapia Combinada , Feminino , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
20.
Nefrologia ; 22(2): 170-8, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12085418

RESUMO

Type II diabetic patients with albuminuria are at high risk for cardiovascular complications; the intense antihypertensive treatment required often involves using drug combinations. The aim of the present study was to compare the effect of two different, renin-angiotensin blocking combinations, on blood pressure (BP), albuminuria and glycemic control. Its design was prospective, randomised, controlled, of parallel branches, and performed in one Endocrinology Department, in Spain. 77 type-II diabetic patients, with stable albuminuria (30-1,000 mg/day) were included. After a pre-inclusion time of 2 weeks, patients were randomised to verapamil SR/trandolapril 180/2 (VT) or losartan/hydrochlorothiazide (LH) 20/12.5 mg/day. Duration of treatment was 1 year. The evaluated parameters were changes in blood pressure, urinary albumin excretion for 24 hours, glycated hemoglobin and plasmatic urea. Overall BP significantly decreased from 161.6 +/- 18.7/83.6 +/- 10.2 mmHg to 137.2 +/- 15.7/70.9 +/- 8.3 mmHg (p < 0.0005). Values, by treatment, were: For VT, 164.3 +/- 18.5/87.2 +/- 10.7 mmHg at baseline and 135.0 +/- 15.1/71.3 +/- 8.4 mmHg at conclusion. For LH, 158.8 +/- 17.4/80.1 +/- 8.4 mmHg at baseline and 139.3 +/- 16.1/70.5 +/- 8.2 mmHg at conclusion. Albuminuria significantly decreased from 308.2 +/- 544.7 mg/day to 198.0 +/- 285.3 mg/day. Both parameters showed no significant difference between treatments. Glycated hemoglobin decreased from 7.59 +/- 1.3% to 7.14 +/- 1.2% in the VT group, and from 7.96 +/- 1.29% to 7.84 +/- 1.62% in the LH group (ANOVA, p = 0.022). Changes adjusted from baseline values showed a trend to the difference between both treatments (p = 0.092). Plasmatic urea increased from 39.8 +/- 12.7 to 40.5 +/- 11.1 mg/dL in the TV group and from 43.4 +/- 12.0 mg/dL to 52.4 +/- 19.4 mg/dL in the LH group (ANOVA, p = 0.028). In conclusion, both treatments reduce blood pressure and albuminuria in a similar way in type II diabetic patients. The verapamil/trandolapril combination contributes to a better carbohydrate metabolism than losartan/hydroclorothiazide.


Assuntos
Albuminúria/tratamento farmacológico , Anti-Hipertensivos/uso terapêutico , Glicemia/análise , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/complicações , Hidroclorotiazida/uso terapêutico , Hipertensão/tratamento farmacológico , Indóis/uso terapêutico , Losartan/uso terapêutico , Verapamil/uso terapêutico , Idoso , Albuminúria/epidemiologia , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Metabolismo dos Carboidratos , Preparações de Ação Retardada , Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/sangue , Diuréticos , Quimioterapia Combinada , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hidroclorotiazida/administração & dosagem , Hipertensão/sangue , Hipertensão/complicações , Indóis/administração & dosagem , Lipídeos/sangue , Losartan/administração & dosagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Receptor Tipo 1 de Angiotensina , Sistema Renina-Angiotensina/efeitos dos fármacos , Inibidores de Simportadores de Cloreto de Sódio/administração & dosagem , Inibidores de Simportadores de Cloreto de Sódio/uso terapêutico , Resultado do Tratamento , Vasodilatadores/administração & dosagem , Vasodilatadores/uso terapêutico , Verapamil/administração & dosagem
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