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1.
Blood Press ; 18(5): 255-60, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19919396

RESUMEN

This study was designed to evaluate the changes in arterial blood pressure (BP) and heart rate (HR) in moderate smokers during smoking abstinence after 7 days of treatment with bupropion alone, transdermal nicotine or bupropion combined with transdermal nicotine. Twenty-four healthy moderate smokers (12 female/12 male; 40+/-7 years) were evaluated randomly on five occasions and their systolic, diastolic, mean arterial blood pressure (MAP) and HR were measured by a Finapres device for 10 h, immediately after smoking interruption. All of the 24 smokers participated on five protocols during 7 days: control group (C) - no drugs; placebo group (PL); bupropion group (BUP) 150-300 mg; transdermal nicotine group (TN) - 21 mg; and BUP+TN-nicotine patch. Concomitantly, the subjects were evaluated by ABPM (ambulatory BP monitoring). All of BP parameters monitored shown significant statistical differences in the BUP, TN and BUP+TN groups compared with the controls (p<0.05), when measured by Finapres. The HR remained unaltered in all of the groups. No significant differences were seen in the BP or HR during the 24-h ABPM. These findings indicate that in moderate smokers, bupropion, transdermal nicotine or bupropion associated with transdermal nicotine caused an elevation in the BP after acute smoking interruption.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Bupropión/administración & dosificación , Nicotina/administración & dosificación , Cese del Hábito de Fumar/métodos , Fumar/fisiopatología , Adulto , Bupropión/efectos adversos , Estudios Cruzados , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Nicotina/efectos adversos , Método Simple Ciego , Factores de Tiempo , Resultado del Tratamiento
2.
Mol Plant Microbe Interact ; 21(7): 891-908, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18533830

RESUMEN

Moniliophthora perniciosa is a hemibiotrophic fungus that causes witches' broom disease (WBD) in cacao. Marked dimorphism characterizes this fungus, showing a monokaryotic or biotrophic phase that causes disease symptoms and a later dikaryotic or saprotrophic phase. A combined strategy of DNA microarray, expressed sequence tag, and real-time reverse-transcriptase polymerase chain reaction analyses was employed to analyze differences between these two fungal stages in vitro. In all, 1,131 putative genes were hybridized with cDNA from different phases, resulting in 189 differentially expressed genes, and 4,595 reads were clusterized, producing 1,534 unigenes. The analysis of these genes, which represent approximately 21% of the total genes, indicates that the biotrophic-like phase undergoes carbon and nitrogen catabolite repression that correlates to the expression of phytopathogenicity genes. Moreover, downregulation of mitochondrial oxidative phosphorylation and the presence of a putative ngr1 of Saccharomyces cerevisiae could help explain its lower growth rate. In contrast, the saprotrophic mycelium expresses genes related to the metabolism of hexoses, ammonia, and oxidative phosphorylation, which could explain its faster growth. Antifungal toxins were upregulated and could prevent the colonization by competing fungi. This work significantly contributes to our understanding of the molecular mechanisms of WBD and, to our knowledge, is the first to analyze differential gene expression of the different phases of a hemibiotrophic fungus.


Asunto(s)
Agaricales/genética , Agaricales/patogenicidad , Cacao/microbiología , Agaricales/crecimiento & desarrollo , Agaricales/fisiología , Secuencia de Bases , Carbono/metabolismo , Cartilla de ADN/genética , Elementos Transponibles de ADN/genética , ADN de Hongos/genética , Etiquetas de Secuencia Expresada , Perfilación de la Expresión Génica , Regulación Fúngica de la Expresión Génica , Genes Fúngicos , Interacciones Huésped-Patógeno/genética , Interacciones Huésped-Patógeno/fisiología , Mitocondrias/metabolismo , Datos de Secuencia Molecular , Nitrógeno/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Enfermedades de las Plantas/microbiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
3.
Rev Bras Ginecol Obstet ; 39(1): 14-20, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28187491

RESUMEN

Objective Obesity is associated with an increased risk for breast cancer. Recent studies have shown that aromatase inhibitors may be less effective in women with a high body mass index (BMI). The aim of this study was to establish the relationship between the BMI and plasma estrone and estradiol levels in postmenopausal women with hormone receptor-positive breast cancer using anastrozole. Methods In this cohort study, the patients were divided into three groups according to BMI (normal weight, overweight and obese) to compare and correlate plasma hormone levels before starting anastrozole hormone therapy and three months after treatment. Plasma hormone levels were compared for age and use of chemotherapy. Results A statistically significant reduction in estrone and estradiol levels was observed between baseline and three months after starting the anastrozole treatment (p < 0.05). There was no statistically significant difference in plasma estrone and estradiol levels among the BMI groups (p > 0.05), but a significant reduction in plasma estrone levels was observed after three-months' treatment relative to baseline in all groups, as well as a reduction in estradiol in the obese group (p < 0.05). The use of chemotherapy and age > 65 years had no influence on plasma steroid levels. Conclusion Changes in estrone and estradiol levels in the studied groups were not associated with BMI, chemotherapy or age.


Asunto(s)
Antineoplásicos Hormonales/uso terapéutico , Inhibidores de la Aromatasa/uso terapéutico , Índice de Masa Corporal , Neoplasias de la Mama/sangre , Neoplasias de la Mama/tratamiento farmacológico , Estradiol/sangre , Estrona/sangre , Nitrilos/uso terapéutico , Triazoles/uso terapéutico , Anastrozol , Estudios de Cohortes , Femenino , Humanos , Persona de Mediana Edad
4.
Eur J Pharmacol ; 530(1-2): 124-7, 2006 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-16376873

RESUMEN

Bupropion is a non-nicotinic drug used in smoking cessation therapy. However, its acute effects remain unclear. In this study, we investigated the effects of bupropion on hemodynamic parameters in pentobarbital-anesthetized mongrel dogs. Bupropion administered either in bolus injections (3 or 6 mg/kg, i.v.) or in cumulative doses of 0.01, 0.1, 1, 3 and 10 mg/kg showed, in both studies, a significant increase of mean pulmonary arterial pressure and pulmonary vascular resistance index. These results show that bupropion can elevate the pulmonary pressure. Further investigations should be done to test this effect in smokers with chronic obstructive pulmonary disease.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Bupropión/farmacología , Resistencia Vascular/efectos de los fármacos , Anestesia Intravenosa , Animales , Antidepresivos de Segunda Generación/farmacología , Perros , Relación Dosis-Respuesta a Droga , Femenino , Masculino , Pentobarbital/administración & dosificación , Pentobarbital/farmacología , Circulación Pulmonar/efectos de los fármacos , Factores de Tiempo
5.
Cardiovasc Toxicol ; 6(1): 63-8, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16845183

RESUMEN

Bupropion has been used to treat psychic depression and as a therapy for smoking cessation, the latter mainly in association with nicotine. However, there have been no detailed studies of the hemodynamic effects of the association of bupropion with nicotine during replacement therapy. In this study, we evaluated the effects of such an association on the cardiovascular parameters in anesthetized dogs. Bupropion, either alone or together with nicotine, had no significant effect on the cardiac index (CI; 4.7 +/- 0.2 vs 4.3 +/- 0.1 and 3.5 +/- 0.3 vs 3.4 +/- 0.3 L x min(-1) x m(2), respectively; mean +/- SEM) and mean arterial pressure (MAP; 134 +/- 5.0 vs 145 +/- 11.0 and 118 +/- 5.0 vs 133 +/- 10.5 mmHg, respectively). There was a slight but significant increase in the systemic vascular resistance index (SVRI; 2,165 +/- 93 vs 2,645 +/- 126 and 2,335 +/- 100 vs 2,737 +/- 200 dyn x cm(-5)m(-2), respectively). However, there was a significant increase in the mean pulmonary artery pressure (MPAP; 20 +/- 0.8 vs 25 +/- 1.6 and 18 +/- 1.3 vs 25 +/- 1.6 mmHg, respectively; p < 0.05) and pulmonary vascular resistance index (IRVP; 194 +/- 11 vs 272 +/- 21 and 206 +/- 32 vs 307 +/- 42 dyn x cm-5m(-2), respectively; p < 0.05). These results show that bupropion alone or in association with nicotine does not markedly affect most hemodynamic parameters of the systemic circulation, although the significant increase in MPAP and IRVP can elevate the pulmonary pressure.


Asunto(s)
Antidepresivos de Segunda Generación/farmacología , Bupropión/farmacología , Hemodinámica/efectos de los fármacos , Nicotina/farmacología , Cese del Hábito de Fumar , Anestesia , Animales , Presión Sanguínea/efectos de los fármacos , Perros , Quimioterapia Combinada , Femenino , Hipertensión Pulmonar/inducido químicamente , Hipertensión Pulmonar/fisiopatología , Masculino
6.
J Clin Hypertens (Greenwich) ; 7(12): 721-8, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16330894

RESUMEN

Nicotine replacement therapy appears to be safe when used by healthy patients to aid in smoking cessation; however, the immediate acute effects of nicotine replacement therapy on the circadian rhythm of blood pressure (BP) and endothelial function in heavy smokers are not well understood. Twenty-six heavy smokers were requested to stop smoking for 48 hours. BP and heart rate were recorded over 48 hours by ambulatory BP monitoring, with beat-to-beat changes being monitored for the first 10 hours by a noninvasive finger device. The reactivity of the brachial artery was evaluated using flow-mediated dilation immediately after smoking cessation, before the application of a 21-mg nicotine patch or placebo patch, and 24 hours after patch placement. Transdermal nicotine caused a mild but significant elevation in BP in the early morning in 21 of 26 volunteers. The decrease in nocturnal BP was attenuated in patients with the nicotine patch compared with the placebo patch; this was associated with impaired endothelium-dependent vasodilation.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Ritmo Circadiano/fisiología , Nicotina/administración & dosificación , Nicotina/efectos adversos , Cese del Hábito de Fumar , Administración Cutánea , Adulto , Presión Sanguínea/fisiología , Arteria Braquial , Relación Dosis-Respuesta a Droga , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/fisiología , Endotelio Vascular/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Nicotina/uso terapéutico , Nitratos/sangre , Nitritos/sangre , Tromboxano B2/sangre , Vasodilatación/efectos de los fármacos , Vasodilatación/fisiología
7.
Chest ; 125(3): 823-30, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15006938

RESUMEN

STUDY OBJECTIVES: We evaluated the vascular reactivity in healthy subjects, heavy smokers, uncompensated type II diabetics, and patients with uncontrolled essential hypertension. Plasma nitrite/nitrate, cyclic 3',5'-guanosine monophosphate (cGMP), and thromboxane (TX)-B(2) levels were measured. PARTICIPANTS: One hundred participants were classified into four groups: normal control subjects (n = 25), heavy smokers (n = 25), uncompensated type II diabetics (n = 25), and patients with uncontrolled essential hypertension (n = 25). INTERVENTIONS: The brachial artery diameter was measured by a high-resolution ultrasound technique before and after reactive hyperemia and glyceryl trinitrate (GTN), 0.4 mg, administration. Plasma nitrite/nitrate, cGMP, and TX-B(2) levels were also measured. RESULTS: Heavy smokers, uncompensated type II diabetics, and uncontrolled hypertensive patients showed impaired endothelium-dependent, nitric oxide (NO) flow-mediated vasodilatation (8.0 +/- 2.5%, 5.8 +/- 2.7%, and 7.2 +/- 3.3%, respectively [mean +/- SD]) when compared to the control subjects (12.6 +/- 3.6%; p < 0.01). Smokers had a normal endothelium-independent function induced by NO donor (GTN) [25.0 +/- 7.3% vs 25.3 +/- 8.5% for control subjects]. Uncompensated type II diabetics and patients with uncontrolled hypertension had impaired endothelium-independent responses (17.7 +/- 7.1% and 16.8 +/- 6.9%, respectively, vs 25.3 +/- 8.5 for normal control subjects; p < 0.05). Plasma levels of cGMP and TX-B(2) were not significantly different in the four groups, but nitrite/nitrate concentrations were increased in diabetics compared to the control subjects (266 +/- 47 micro mol/L vs 98 +/- 18 micro mol/L, p < 0.05). CONCLUSION: Both uncontrolled hypertension and type II diabetes mellitus, but not smoking, are associated with impaired vascular smooth-muscle reactivity induced by NO donors. However, only uncompensated type II diabetics showed an increase in plasma nitrite/nitrate levels, suggesting an association with excessive production and/or inactivation of NO.


Asunto(s)
Diabetes Mellitus Tipo 2/fisiopatología , Hipertensión/fisiopatología , Fumar/fisiopatología , Vasodilatación , Adulto , Velocidad del Flujo Sanguíneo , GMP Cíclico/sangre , Diabetes Mellitus Tipo 2/sangre , Endotelio Vascular/fisiopatología , Humanos , Hiperemia , Hipertensión/sangre , Persona de Mediana Edad , Nitratos/sangre , Óxido Nítrico/biosíntesis , Óxido Nítrico/fisiología , Nitritos/sangre , Nitroglicerina/farmacología , Fumar/sangre , Tromboxano B2/sangre , Vasodilatación/efectos de los fármacos , Vasodilatadores/farmacología
8.
Rev. bras. ginecol. obstet ; 39(1): 14-20, Jan. 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-843905

RESUMEN

ABSTRACT Objective: Obesity is associated with an increased risk for breast cancer. Recent studies have shown that aromatase inhibitors may be less effective in women with a high body mass index (BMI). The aim of this study was to establish the relationship between the BMI and plasma estrone and estradiol levels in postmenopausal women with hormone receptor-positive breast cancer using anastrozole. Methods: In this cohort study, the patients were divided into three groups according to BMI (normal weight, overweight and obese) to compare and correlate plasma hormone levels before starting anastrozole hormone therapy and three months after treatment. Plasma hormone levels were compared for age and use of chemotherapy. Results: A statistically significant reduction in estrone and estradiol levels was observed between baseline and three months after starting the anastrozole treatment (p < 0.05). There was no statistically significant difference in plasma estrone and estradiol levels among the BMI groups (p > 0.05), but a significant reduction in plasma estrone levels was observed after three-months' treatment relative to baseline in all groups, as well as a reduction in estradiol in the obese group (p < 0.05). The use of chemotherapy and age > 65 years had no influence on plasma steroid levels. Conclusion: Changes in estrone and estradiol levels in the studied groups were not associated with BMI, chemotherapy or age.


RESUMO Objetivo: A obesidade está associada com risco aumentado de câncer de mama. Estudos recentes têm mostrado que os inibidores de aromatase podem ser menos eficazes em mulheres com alto índice de massa corporal (IMC). O objetivo deste estudo foi estabelecer a relação entre o IMC e os níveis plasmáticos de estrona e estradiol em mulheres no período pós-menopausa com câncer de mama receptor hormonal positivo, em tratamento com anastrozol. Métodos: Este estudo de coorte acompanhou três grupos de pacientes de acordo com o seu IMC (peso normal, sobrepeso e obesidade), a fim de comparar e correlacionar as dosagens dos hormônios estrona e estradiol antes e após três meses do uso do anastrozol. Os níveis plasmáticos dos hormônios foram também relacionados à idade do paciente e ao uso da quimioterapia. Resultados: Redução estatisticamente significativa de estrona e estradiol foi observada entre os níveis basais e três meses após o início do tratamento com anastrozol (p < 0,05). Não houve diferença estatisticamente significativa entre os níveis plasmáticos de estrona e estradiol em relação ao IMC (p > 0,05), mas houve redução significativa entre os níveis plasmáticos basais de estrona após o tratamento em todos os grupos, e redução de estradiol no grupo de pacientes obesas (p < 0,05). A condução da quimioterapia e da idade acima de 65 anos não interfere com os níveis plasmáticos de esteroides. Conclusão: Os níveis plasmáticos de estrona e estradiol nos grupos estudados não foram alterados em termos de IMC, quimioterapia e idade.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Antineoplásicos Hormonales/uso terapéutico , Inhibidores de la Aromatasa/uso terapéutico , Índice de Masa Corporal , Neoplasias de la Mama/sangre , Neoplasias de la Mama/tratamiento farmacológico , Estradiol/sangre , Estrona/sangre , Nitrilos/uso terapéutico , Triazoles/uso terapéutico , Estudios de Cohortes
9.
Cholesterol ; 2010: 824813, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21490917

RESUMEN

Recent studies suggest that lecithin-rich diet can modify cholesterol homeostasis and hepatic lipoprotein metabolism. Considering the phytotherapeutic impact of lecithin, this work hypothesizes that lecithin administration in hypercholesterolemic patients may reduce cholesterol concentrations by increasing biliary secretion. Total cholesterol and LDL were evaluated after soy lecithin administration in hypercholesterolemic patients. One soy lecithin capsule (500 mg/RP-Sherer) was administrated daily. One-two months before the treatment beginning, blood samples were collected for total lipids and cholesterol fractions analysis. The results showed a reduction of 40.66% and 42.00% in total cholesterol and of 42.05% and 56.15% in LDL cholesterol after treatment for one and two months, respectively. A significant reduction in total cholesterol and LDL-cholesterol concentrations was observed during the first month of treatment, suggesting that the administration of soy lecithin daily may be used as a supplemental treatment in hypercholesterolemia.

10.
Arq Bras Cardiol ; 94(2): 213-8, 229-34, 216-21, 2010 Feb.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-20428618

RESUMEN

BACKGROUND: Arginine vasopressin (AVP) has been broadly used in the management of vasodilatory shock. However, there are many concerns regarding its clinical use, especially in high doses, as it can be associated with adverse cardiovascular events. OBJECTIVE: To investigate the cardiovascular effects of AVP in continuous IV infusion on hemodynamic parameters in dogs. METHODS: Sixteen healthy mongrel dogs, anesthetized with pentobarbital were intravascularly catheterized, and randomly assigned to: control (saline-placebo; n=8) and AVP (n=8) groups. The study group was infused with AVP for three consecutive 10-minute periods at logarithmically increasing doses (0.01; 0.1 and 1.0 U/kg/min), at them 20-min intervals. Heart rate (HR) and intravascular pressures were continuously recorded. Cardiac output was measured by the thermodilution method. RESULTS: No significant hemodynamic effects were observed during 0.01 U/kg/min of AVP infusion, but at higher doses (0.1 and 1.0 U/kg/min) a progressive increase in mean arterial pressure (MAP) and systemic vascular resistance index (SVRI) were observed, with a significant decrease in HR and the cardiac index (CI). A significant increase in the pulmonary vascular resistance index (PVRI) was also observed with the 1.0 U/kg/min dose, mainly due to the decrease in the CI. CONCLUSION: AVP, when administered at doses between 0.1 and 1.0 U/kg/min, induced significant increases in MAP and SVRI, with negative inotropic and chronotropic effects in healthy animals. Although these doses are ten to thousand times greater than those routinely used for the management of vasodilatory shock, our data confirm that AVP might be used carefully and under strict hemodynamic monitoring in clinical practice, especially if doses higher than 0.01 U/kg/min are needed.


Asunto(s)
Sistema Cardiovascular/efectos de los fármacos , Vasoconstrictores/administración & dosificación , Vasopresinas/administración & dosificación , Análisis de Varianza , Anestesia , Animales , Perros , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Infusiones Intravenosas , Masculino , Modelos Animales , Distribución Aleatoria , Resistencia Vascular/efectos de los fármacos , Resistencia Vascular/fisiología , Vasoconstrictores/efectos adversos , Vasopresinas/efectos adversos
11.
Arq Bras Cardiol ; 2010 Jan 15.
Artículo en Portugués | MEDLINE | ID: mdl-20084333

RESUMEN

BACKGROUND: Arginine vasopressin (AVP) has been broadly used in the management of vasodilatory shock. However, there are many concerns regarding its clinical use, especially in high doses, as it can be associated with adverse cardiovascular events. OBJECTIVE: To investigate the cardiovascular effects of AVP in continuous IV infusion on hemodynamic parameters in dogs. METHODS: Sixteen healthy mongrel dogs, anesthetized with pentobarbital were intravascularly catheterized, and randomly assigned to: control (saline-placebo; n=8) and AVP (n=8) groups. The study group was infused with AVP for three consecutive 10-minute periods at logarithmically increasing doses (0.01; 0.1 and 1.0U/kg/min), at them 20-min intervals. Heart rate (HR) and intravascular pressures were continuously recorded. Cardiac output was measured by the thermodilution method. RESULTS: No significant hemodynamic effects were observed during 0.01U/kg/min of AVP infusion, but at higher doses (0.1 and 1.0U/kg/min) a progressive increase in mean arterial pressure (MAP) and systemic vascular resistance index (SVRI) were observed, with a significant decrease in HR and the cardiac index (CI). A significant increase in the pulmonary vascular resistance index (PVRI) was also observed with the 1.0U/kg/min dose, mainly due to the decrease in the CI. CONCLUSION: AVP, when administered at doses between 0.1 and 1.0U/kg/min, induced significant increases in MAP and SVRI, with negative inotropic and chronotropic effects in healthy animals. Although these doses are ten to thousand times greater than those routinely used for the management of vasodilatory shock, our data confirm that AVP might be used carefully and under strict hemodynamic monitoring in clinical practice, especially if doses higher than 0.01 U/kg/min are needed. Martins, LC et al.

12.
J Clin Hypertens (Greenwich) ; 11(4): 183-91, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19614802

RESUMEN

Intensive monitoring of adherence in patients with uncontrolled hypertension was evaluated over a 6-month period. After that period, only patients well characterized as having resistant hypertension were followed for 12 months. The goal of this study was to evaluate whether adherence to a drug regimen helps to identify patients with resistant hypertension. Forty-four hypertensive patients resistant to a 3-drug regimen (average blood pressure [BP] mm Hg, mean +/- standard deviation) were studied prospectively. Each patient was followed for a 12-month period. Adherence to treatment was evaluated through self-report, applying Morisky's questionnaire and the pill count method. Ambulatory BP monitoring and office BP measures were performed. By pill count, 63.6% of the patients were adherent to treatment at the start of the survey and 94% at the end, although 59% of the patients still did not reach normal BP levels. We found that non-adherence was not associated with resistance to antihypertensive treatment. Therefore, after investigation, we concluded that patients who presented with uncontrolled arterial BP may be truly resistant hypertensive to treatment.


Asunto(s)
Antihipertensivos/uso terapéutico , Monitoreo Ambulatorio de la Presión Arterial , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto Joven
13.
Hypertens Res ; 32(2): 159-62, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19262476

RESUMEN

Resistant hypertension (RH) is the maintenance of elevated blood pressure concurrent with the use of three different anti-hypertensive drugs, one of which is a diuretic. The Renin-Angiotensin-Aldosterone System plays a major role in volume-dependent hypertension. Therefore, its components are interesting targets for genetic association studies. This work focused on the -344 C/T polymorphism in the CYP11b2 gene, which encodes aldosterone synthase. This work evaluates the association between T allele and resistance to anti-hypertensive treatment. Genotyping analysis included 88 subjects with RH, 142 who were responsive to anti-hypertensive treatment and 110 subjects as a control group. Plasmatic concentrations of aldosterone, renin and cortisol, carotid intima-media thickness and carotid-femoral pulse wave velocity were assessed in a smaller subset of hypertensive patients. An association was found between T allele and hypertension (P<0.005), but there was no difference in allele frequencies between both hypertensive groups. There was no difference in plasmatic parameters either, in remodeling indicators between the genotypic groups.


Asunto(s)
Citocromo P-450 CYP11B2/genética , Hipertensión/genética , Adulto , Aldosterona/sangre , Alelos , Presión Sanguínea/fisiología , Arterias Carótidas/diagnóstico por imagen , Resistencia a Medicamentos , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Hidrocortisona/sangre , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Polimorfismo Genético/fisiología , Polimorfismo de Longitud del Fragmento de Restricción , Renina/sangre , Ultrasonografía
14.
Am J Health Syst Pharm ; 64(18): 1955-61, 2007 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-17823108

RESUMEN

PURPOSE: Verification of whether pharmacotherapeutic follow-up improves arterial blood pressure (BP) was conducted, and whether this improvement alters the quality of life of patients with resistant hypertension in a university teaching hospital in Brazil was determined. METHODS: A prospective survey of 44 patients was carried out over a period of 20 months. Each patient was followed up for 12 months. Pharmaceutical care was assessed using the following methods: measurement of the office BP and ambulatory BP monitoring, adherence to therapy, drug-related problems, and the use of health care facilities (urgent care visits and hospital admissions). The health-related quality of life (HRQOL) of patients was also assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire and a physical symptoms profile. RESULTS: The majority (95.5%) of patients adhered to the treatment throughout the study, and there was a significant reduction in BP (p < 0.05). Nearly all of the domains of HRQOL assessed by SF-36 remained unchanged during the follow-up except for a significant improvement in social functioning (p = 0.041). There was a significant reduction in moderate and severe physical symptoms (p = 0.005). There were also significant reductions in the number of urgent care visits (p = 0.0001) and hospital admissions (p = 0.006). CONCLUSION: The pharmaceutical care provided by a pharmacist in an ambulatory care clinic in Brazil improved BP, adherence to antihypertensive medications, and the social functioning of patients with resistant hypertension.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Servicios Farmacéuticos , Adolescente , Adulto , Anciano , Antihipertensivos/efectos adversos , Femenino , Estudios de Seguimiento , Estado de Salud , Humanos , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Estudios Prospectivos , Calidad de Vida
15.
Arq. bras. cardiol ; 94(2): 229-234, fev. 2010. ilus
Artículo en Portugués | LILACS | ID: lil-544885

RESUMEN

FUNDAMENTO: A arginina-vasopressina (AVP) tem sido amplamente utilizada no tratamento do choque vasodilatador. Entretanto, há muitas questões relativas ao seu uso clínico, especialmente em altas doses, pois sua utilização pode estar associada a efeitos cardíacos adversos. OBJETIVO: Investigar os efeitos cardiovasculares da AVP em infusão IV contínua nos parâmetros hemodinâmicos em cães. MÉTODOS: Dezesseis cães saudáveis sem raça definida, anestesiados com pentobarbital, receberam um cateter intravascular e foram aleatoriamente designados para dois grupos: controle (solução salina - placebo; n=8) e AVP (n=8). O grupo do estudo recebeu infusão de AVP por três períodos consecutivos de 10 minutos a doses logaritmicamente progressivas (0,01; 0,1 e 1,0 U/kg/min), a intervalos de 20 minutos. A frequência cardíaca (HR) e as pressões intravasculares foram continuamente registradas. O debito cardíaco foi medido através do método de termodiluição. RESULTADOS: Nenhum efeito hemodinâmico significante foi observado durante a infusão de 0,01 U/kg/min de AVP, mas com as doses mais altas, de 0,1 e 1,0U/kg/min, houve um aumento progressivo na pressão arterial média (PAM) e índice de resistência vascular sistêmica (IRVS), com significante diminuição na frequência cardíaca (FC) e índice cardíaco (IC). Com a dose de 1,0 U/kg/min, também foi observado um aumento significante no índice de resistência vascular pulmonar (IRVP), principalmente devido à diminuição no IC. CONCLUSÃO: A AVP em doses entre 0,1 e 1,0 U/kg/min resultou em significantes aumentos na PAM e no IRVS, com efeitos inotrópicos e cronotrópicos negativos em animais saudáveis. Embora essas doses sejam de 10 a 1.000 vezes maiores do que as rotineiramente utilizadas no tratamento do choque vasodilatador, nossos dados confirmam que a AVP deveria ser usada cuidadosamente e sob rígida monitoração hemodinâmica na prática clínica, especialmente se doses maiores do que 0,01 U/kg/min forem necessárias.


BACKGROUND: Arginine vasopressin (AVP) has been broadly used in the management of vasodilatory shock. However, there are many concerns regarding its clinical use, especially in high doses, as it can be associated with adverse cardiovascular events. OBJECTIVE: To investigate the cardiovascular effects of AVP in continuous IV infusion on hemodynamic parameters in dogs. METHODS: Sixteen healthy mongrel dogs, anesthetized with pentobarbital were intravascularly catheterized, and randomly assigned to: control (saline-placebo; n=8) and AVP (n=8) groups. The study group was infused with AVP for three consecutive 10-minute periods at logarithmically increasing doses (0.01; 0.1 and 1.0U/kg/min), at them 20-min intervals. Heart rate (HR) and intravascular pressures were continuously recorded. Cardiac output was measured by the thermodilution method. RESULTS: No significant hemodynamic effects were observed during 0.01U/kg/min of AVP infusion, but at higher doses (0.1 and 1.0U/kg/min) a progressive increase in mean arterial pressure (MAP) and systemic vascular resistance index (SVRI) were observed, with a significant decrease in HR and the cardiac index (CI). A significant increase in the pulmonary vascular resistance index (PVRI) was also observed with the 1.0U/kg/min dose, mainly due to the decrease in the CI. CONCLUSION: AVP, when administered at doses between 0.1 and 1.0U/kg/min, induced significant increases in MAP and SVRI, with negative inotropic and chronotropic effects in healthy animals. Although these doses are ten to thousand times greater than those routinely used for the management of vasodilatory shock, our data confirm that AVP might be used carefully and under strict hemodynamic monitoring in clinical practice, especially if doses higher than 0.01 U/kg/min are needed.


FUNDAMENTO: La arginina-vasopresina (AVP) ha sido ampliamente utilizada en el tratamiento del choque vasodilatador. No obstante, hay muchos aspectos relativos a su uso clínico, especialmente en altas dosis, pues su utilización puede estar asociada a efectos cardíacos adversos. OBJETIVO: Investigar los efectos cardiovasculares de la AVP en infusión IV continua en los parámetros hemodinámicos en canes. MÉTODOS: Dieciséis canes saludables sin raza definida, anestesiados con pentobarbital, recibieron un catéter intravascular y fueron aleatoriamente designados para dos grupos: control (solución salina - placebo; n=8) y AVP (n=8). El grupo del estudio recibió infusión de AVP por tres períodos consecutivos de 10 minutos a dosis logarítimicamente progresivas (0,01; 0,1 y 1,0 U/kg/min), a intervalos de 20 minutos La frecuencia cardíaca (HR) y las presiones intravasculares fueron registradas continuamente. El débito cardíaco fue medido a través del método de termodilución. RESULTADOS: No se observó ningún efecto hemodinámico significativo durante la infusión de 0,01 U/kg/min de AVP, pero con las dosis más altas, de 0,1 y 1,0 U/kg/min, hubo un aumento progresivo en la presión arterial media (PAM) y en el índice de resistencia vascular sistémica (IRVS), con significativa disminución en la frecuencia cardíaca (FC) e índice cardíaco (IC). Con la dosis 1,0 U/kg/min, también se observó un aumento significativo en el índice de resistencia vascular pulmonar (IRVP), principalmente debido a la disminución en el IC. CONCLUSIÓN: La AVP en dosis entre 0,1 y 1,0 U/kg/min resultó en significativos aumentos en la PAM y en el IRVS, con efectos inotrópicos y cronotrópicos negativos en animales saludables. Aunque estas dosis sean de 10 a 1.000 veces mayores que las rutinariamente utilizadas en el tratamiento del choque vasodilatador, nuestros datos confirman que la AVP debería ser usada cuidadosamente y bajo rígido monitoreo hemodinámico en la práctica clínica, especialmente ...


Asunto(s)
Animales , Perros , Femenino , Masculino , Sistema Cardiovascular/efectos de los fármacos , Vasoconstrictores/administración & dosificación , Vasopresinas/administración & dosificación , Análisis de Varianza , Anestesia , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Infusiones Intravenosas , Modelos Animales , Distribución Aleatoria , Resistencia Vascular/efectos de los fármacos , Resistencia Vascular/fisiología , Vasoconstrictores/efectos adversos , Vasopresinas/efectos adversos
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