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2.
J. physiol. biochem ; 74(1): 57-67, feb. 2018. graf
Artigo em Inglês | IBECS | ID: ibc-178918

RESUMO

Rate-dependent repolarization (RDR) of action potential (AP) in cardiomyocyte plays a critical role in the genesis of arrhythmias and RDR in atrium has been linked with atrial fibrillation. However, detailed studies focusing on the role of RDR in rabbit atrium are scant. In this study, atrial cells were isolated from rabbit heart and rate-dependent property was explored in single atrial cell to elucidate the underlying mechanism. Our results indicated that rate-dependent prolongation was evident at the action potential duration at 20% (APD20) and 50% (APD50) repolarization but not at 90% repolarization (APD90) under control condition. Using transient outward potassium current (Ito) inhibitor 4-Aminopyridine (4-AP, 2 mM) effectively eliminated the changes in APD20 and APD50, and unmasked the rate-dependent reduction of APD90 which could be diminished by further adding L-type calcium current (ICaL) inhibitor nifedipine (30 μM). However, using the selective late sodium current (INaL) inhibitor GS-458967 (GS967, 1 μM) caused minimal effect on APD90 of atrial cells both in the absence and presence of 4-AP. In consistence with results from APs, Ito and ICaL displayed significant rate-dependent reduction because of their slow reactivation kinetics. In addition, the magnitude of INaL in rabbit atrium was so small that its rate-dependent changes were negligible. In conclusion, our study demonstrated that Ito and ICaL mediate RDR of AP in rabbit atrium, while minimal effect of INaL was seen


No disponible


Assuntos
Animais , Coelhos , Canais de Cálcio Tipo L/metabolismo , Átrios do Coração/metabolismo , Miócitos Cardíacos/metabolismo , Canais de Sódio/metabolismo , 4-Aminopiridina/farmacologia , Potenciais de Ação , Antiarrítmicos/farmacologia , Bloqueadores dos Canais de Cálcio/farmacologia , Átrios do Coração/citologia , Átrios do Coração , Miócitos Cardíacos/citologia , Miócitos Cardíacos , Nifedipino/farmacologia , Canais de Sódio/química
3.
Pharm. care Esp ; 20(1): 72-77, 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172117

RESUMO

Existen varias alternativas para el manejo de las taquicardias supraventriculares, algunas de ellas farmacológicas y otras no farmacológicas. Dentro de las farmacológicas, los antiarrítmicos bloqueantes de los canales del sodio, clase IC como la propafenona, han demostrado ser de alto riesgo en pacientes ancianos, por la posibilidad de precipitar el fallo cardiaco. Este caso ilustra un error de medicación consistente en un problema relacionado con la selección del medicamento antiarrítmico, en el cual el haber ignorado la alerta generada por el servicio farmacéutico, provocó una reacción adversa seria (fallo cardiaco), lo cual corresponde a un problema de seguridad completamente prevenible


There are several alternatives for the treatment of supraventricular tachycardias, some of them are pharmacological and others non-pharmacological. Among pharmacological agents, class IC antiarrhythmics such as propafenone have been shown to be highly dangerous in elderly patients because the potential of cardiac failure. This case shows a medication error, a problem related to the selection of the antiarrhythmic drug, ignoring the warning of the pharmaceutical service and causing a serious adverse reaction (heart failure) which was completely preventable


Assuntos
Humanos , Feminino , Idoso , Propafenona/efeitos adversos , Bradicardia/induzido quimicamente , Antiarrítmicos/efeitos adversos , Bloqueadores dos Canais de Cálcio/efeitos adversos , Monitoramento de Medicamentos/métodos , Assistência Farmacêutica/métodos , Farmacovigilância , Insuficiência Cardíaca/tratamento farmacológico
4.
Hipertens. riesgo vasc ; 34(supl.2): 5-8, mayo 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-170598

RESUMO

Los canales de calcio dependientes del voltaje tipo L tienen un papel clave en la regulación del tono vascular y en el control de la presión arterial, y los bloqueadores de los canales de calcio (BCC) de este tipo (BCC-L) se utilizan ampliamente como antihipertensivos. Los canales tipo T regulan el tono vascular de las arteriolas de resistencia y la secreción de renina y aldosterona, y los canales tipo N, expresados en los terminales nerviosos simpáticos, regulan la liberación de catecolaminas. Comparados con los BCC-L, los BCC de los canales L/N y L/T disminuyen la presión intraglomerular, mejoran la hemodinámica renal y producen una mayor reducción de la proteinuria, incluso en pacientes ya tratados con inhibidores del sistema renina-angiotensinaaldosterona. Por tanto, los BCC de los canales L/T y L/N podrían presentar una nueva alternativa en pacientes hipertensos con insuficiencia renal, aunque son necesarios estudios comparativos a largo plazo para confirmar que estas diferencias se traducen en una mejora de los resultados clínicos


L-type voltage-gated calcium channels play a key role in the regulation of arterial vascular smooth muscle tone and blood pressure levels and L-type calcium channel blockers (CCBs) are widely used antihypertensive drugs. Additionally, T-type channels regulate vascular tone in small-resistance vessels and renin and aldosterone secretion, and N-type channels, expressed in sympathetic nerve terminals, regulate the release of neurotransmitters. As compared with L-type CCBs, L/N- and L/T-type CCBs decreased intraglomerular pressure, improved renal hemodynamics and provided a greater decrease in proteinuria even in patients already treated with renin-angiotensin-aldosterone inhibitors. Thus, dual L/N- and L/T-type CCBs may exhibit therapeutic advantages over L-type blockers in hypertensive patients with chronic kidney disease. However, further large-scale, long-term comparative trials are needed to confirm that these differences translate into an improvement in clinical outcomes


Assuntos
Humanos , Bloqueadores dos Canais de Cálcio/uso terapêutico , Hipertensão/tratamento farmacológico , Miócitos de Músculo Liso , Bloqueadores dos Canais de Cálcio/metabolismo , Anti-Hipertensivos/uso terapêutico
8.
J. physiol. biochem ; 73(1): 141-153, feb. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-168401

RESUMO

The role of N-methyl-D-aspartate receptor (NMDA-R) in heart is still unclear. For these ionotropic glutamate receptors is characteristic the necessity of both co-agonists, glutamate and glycine, for their activation, which primarily allows influx of calcium. The aim of the present study was to examine the effects of verapamil, as a calcium channel blocker, alone and its combination with glycine and/or glutamate on cardiac function, coronary flow, and oxidative stress in isolated rat heart or to examine the effects of potential activation of NMDA-R in isolated rat heart. The hearts of male Wistar albino rats were excised and perfused according to Langendorff technique, and cardiodynamic parameters and coronary flow were determined during the administration of verapamil and its combinations with glutamate and/or glycine. The oxidative stress biomarkers, including thiobarbituric acid-reactive substances, nitrites, superoxide anion radical, and hydrogen peroxide, were each determined spectrophotometrically from coronary venous effluent. The greatest decline in parameters of cardiac contractility and systolic pressure was in the group that was treated with verapamil only, while minimal changes were observed in group treated with all three tested substances. Also, the largest changes in coronary flow were in the group treated only with verapamil, and at least in the group that received all three tested substances, as well as the largest increase in oxidative stress parameters. Based on the obtained results, it can be concluded that NMDA-R activation allows sufficient influx of calcium to increase myocardial contractility and systolic pressure, as well as short-term increase of oxidative stress (AU)


No disponible


Assuntos
Animais , Masculino , Circulação Coronária , Estresse Oxidativo , Bloqueadores dos Canais de Cálcio/farmacologia , Ácido Glutâmico/metabolismo , Glicina/metabolismo , Verapamil/farmacologia , Receptores de N-Metil-D-Aspartato/agonistas , Sinalização do Cálcio , Contração Miocárdica , Biomarcadores , Técnicas In Vitro , Ratos Wistar , Vasoconstrição , Vasodilatadores/farmacologia
9.
Rev. esp. salud pública ; 91: 0-0, 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-162993

RESUMO

Fundamento: La insuficiencia cardiaca (IC) es un importante problema de salud pública debido a su creciente prevalencia y la descompensación que conlleva un ingreso hospitalario representa un aumento del riesgo de muerte. El objetivo de este trabajo fue comparar varios métodos para modelizar la variable hospitalizaciones y determinar el efecto de los factores asociados con los ingresos hospitalarios en casos incidentes de IC. Método: Se realizó un estudio de cohortes restrospectivo con información extraída de la historia clínica electrónica de Atención Primaria (AP). Se incluyeron pacientes mayores de 24 años que habían realizado al menos 1 consulta en AP durante el año 2006. Se analizaron las hospitalizaciones registradas de casos incidentes de IC entre 2006 y 2010 o hasta su fallecimiento y se compararon modelos de regresión de Poisson, Binomial Negativa (BN), inflados con ceros y de Hurdle para identificar factores asociados a las hospitalizaciones. Resultados: Se identificó a 3.061 personas con IC en una cohorte de 227.984 pacientes. Respecto a los factores asociados con las hospitalizaciones y según el modelo de regresión BN inflado con ceros, los pacientes con valvulopatías (OR=2,01; IC95%: 1,22-3,30) o en tratamiento con antitrombóticos (OR=3,45; IC95%: 1,61-7,42) o diuréticos (OR=2,28; IC95%:1,13-4,58) tuvieron mayor probabilidad de hospitalización. Los factores asociados a una mayor tasa de ingresos fueron tener valvulopatías (IRR=1,37; IC95%: 1,03-1,81) o diabetes mellitus (IRR=1,38, 1,07-1,78) y estar en tratamiento con calcioantagonistas (IRR=1,35; IC95%: 1,05-1,73) o IECAS (IRR=1,43; IC95%:1,06- 1,92). Haber tenido derivaciones a cardiología tuvo efecto protector (IRR=0,86; IC95%: 0,76-0,97). Conclusión: El modelo de regresión que tiene mejor ajuste es el BN inflado con ceros. Según este modelo los factores asociados con un incremento en los ingresos hospitalarios son las valvulopatías, la diabetes mellitus y el tratamiento con calcioantagonistas (AU)


Background: Heart failure (HF) is an important public health problem due to its increasing prevalence, and the decompensation associated with hospital admission represents an increased risk of death. The objective of this study was to compare several methods to model the variable hospitalizations and to determine the effect of factors associated with hospital admissions in incident cases of HF. Methods: Study of a retrospective cohort of patients with information extracted from electronic medical records of PC was performed. Patients 24 year and older with at least 1 visit to PC in 2006 were included. Registered hospital admissions of HF incident cases between 2006 and 2010 or until death were analyzed and comparison of Poisson, Negative Binomial (NB), zero-inflated and Hurdle regression models were conducted to identify factors associated con hospitalizations. Results: 3,061 patients were identified in a cohort of 227,984. Regarding the factors associated with hospitalizations and according to the zero inflated NB regression model, patients who presented valvular disease (OR=2.01; CI95% 1.22-3.30), or were being treated with antithrombotics (OR=3.45; CI95%: 1.61-7.42) or diuretics (OR=2.28; CI95% 1.13-4.58) had a lower likelihood of hospitalization. Factors associated with a higher rate of hospital admissions were having valvular disease (IRR=1.37; CI95% 1.03-1.81) or diabetes mellitus (IRR=1.38; 1.07-1.78), and being treated with calcium antagonists (IRR=1.35; CI95% 1.05- 1.73) or ACE inhibitors (IRR=1.43; CI95% 1.06- 1.92). Having being referred to a cardiologist had a protective effect (IRR=0.86; CI95% 0.76- 0.97). Conclusion: The regression model that obtained the best adjustment was the zero inflated NB. According to this model, the factors associated with an increase in hospital admissions were valvulopathies, diabetes and treatment with calcium antagonists (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/prevenção & controle , Hospitalização/tendências , Atenção Primária à Saúde/métodos , Doenças das Valvas Cardíacas/complicações , Bloqueadores dos Canais de Cálcio/uso terapêutico , Estudos Retrospectivos , Estudos de Coortes , Análise de Regressão , Hipertensão/complicações , /uso terapêutico , Saúde Pública/tendências , Distribuição de Poisson
10.
Rev. esp. enferm. dig ; 108(12): 785-789, dic. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-159626

RESUMO

Antecedentes: Jasonia glutinosa es una planta utilizada en la Península Ibérica y en el sur de Francia por su efecto espasmolítico, pero sin evidencia científica sobre ello. Objetivo: examinar el efecto espasmolítico de un extracto de té de roca. Métodos: estudiamos el efecto de dicho extracto sobre las contracciones espontáneas en duodeno de rata in vitro y sobre el tránsito gastrointestinal en el ratón in vivo. Resultados: el extracto de té de roca redujo las contracciones espontáneas en el músculo liso longitudinal del duodeno de rata, inhibió las contracciones inducidas por KCl, bloqueó la contracción causada por la entrada de Ca2+ extracelular y la contracción inducida por el Bay K8644, agonista de los canales de Ca2+ tipo L. El efecto inhibitorio del extracto de té de roca fue similar al del verapamilo, inhibidor de los canales de Ca2+ tipo L. El té de roca no modificó el tránsito gastrointestinal total en ratones sanos. Sin embargo, tras el tratamiento con dextrano sulfato de sodio, un inductor de colitis, el extracto de té de roca revirtió el aumento del tránsito gastrointestinal asociado a dicho tratamiento. Conclusión: el extracto de té de roca relajó el músculo liso duodenal a través de canales de Ca2+ tipo L y normalizó el tránsito gastrointestinal en un modelo de colitis. Estos resultados validan el uso tradicional de Jasonia glutinosa en alteraciones digestivas. Así, el té de roca podría ser utilizado como espasmolítico en el tratamiento de diversas patologías gastrointestinales (AU)


Introduction: Jasonia glutinosa is an endemic plant species of the Iberian Peninsula and Southern France traditionally used in infusions as a spasmolytic; this plant is also known as "té de roca" (rock tea) but there is no scientific evidence about the effects of this plant. Aim: To evaluate the spasmolytic effect of rock tea. Methods: We have studied the in vitro effect of a rock tea extract on rat duodenum spontaneous contractions and the in vivo effect on mice gastrointestinal transit. Results: Rock tea extract reduced the spontaneous contractions of rat duodenal smooth muscle, inhibited KCl-induced contractions and blocked the contractions invoked by both extracellular Ca2+ and the agonist of L-type calcium channels Bay K8644. This inhibitory effect was similar to the one observed after the addition of the antagonist of L-type calcium channels verapamil. Rock tea did not modify gastrointestinal transit in healthy mice. However, after the treatment with dextran sulfate sodium, an inducer of colitis, rock tea extract reverted the increase in the gastrointestinal transit associated with this treatment. Conclusion: Rock tea extract relaxed duodenal smooth muscle via L-type calcium channels and normalized gastrointestinal transit in a model of colitis. These results may validate the traditional use of Jasonia glutinosa in patients with gastrointestinal alterations. Thus, rock tea may be used as a spasmolytic agent to treat gastrointestinal disorders (AU)


Assuntos
Animais , Masculino , Camundongos , Ratos , Parassimpatolíticos/farmacocinética , Parassimpatolíticos/uso terapêutico , Chá , Bloqueadores dos Canais de Cálcio/farmacocinética , Bloqueadores dos Canais de Cálcio/uso terapêutico , Motilidade Gastrointestinal , Trânsito Gastrointestinal , Asteraceae , Músculo Liso , Medicina Tradicional , Análise de Variância , Verapamil/uso terapêutico , Potássio/uso terapêutico
11.
Rev. esp. anestesiol. reanim ; 63(7): 419-422, ago.-sept. 2016.
Artigo em Espanhol | IBECS | ID: ibc-154148

RESUMO

La electroporación percutánea irreversible (EPI) es un novedoso método de ablación tumoral. Mediante la aplicación al tumor y tejidos adyacentes de breves pulsos eléctricos de alto voltaje se generan alteraciones en la permeabilidad de la membrana de sus células, lo cual termina provocando su muerte. Este alto voltaje aplicado precisa la actuación del anestesiólogo, ya que existe riesgo de desarrollar importantes complicaciones, como arritmias cardíacas o convulsiones. Presentamos el caso de un varón de 66 años diagnosticado de adenocarcinoma renal y sometido a EPI para su ablación con intención curativa bajo anestesia general. Se trata del primer caso en el que se realiza esta técnica en España (AU)


Percutaneous irreversible electroporation (IRE) is a novel tumour ablation method. The application of short and high-voltage electrical pulses to the target lesion induces alterations in cell membrane permeability, finally causing tumour cell death. The extremely high-voltage that is needed in this technique requires the surveillance and management of an experienced anaesthesiologist, as it involves a significant risk of complications, such as cardiac arrhythmias or seizures. The case is presented of a 66 year-old patient diagnosed with a renal adenocarcinoma, and who received without intention-to-cure IRE under general anaesthesia. This case represents the first time this type of technique is used in Spain (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Eletroquimioterapia/instrumentação , Eletroquimioterapia/métodos , Eletroquimioterapia , Anestesia , Administração Cutânea , Adenocarcinoma/tratamento farmacológico , Carcinoma de Células Renais/tratamento farmacológico , Técnicas de Ablação/instrumentação , Técnicas de Ablação/métodos , Técnicas de Ablação , Período Pré-Operatório , Aspirina/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Hipoglicemiantes/uso terapêutico , Eletrocardiografia/métodos
12.
Rev. calid. asist ; 31(3): 134-140, mayo-jun. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-153365

RESUMO

Objetivo. Determinar la frecuencia de prescripción simultánea entre bloqueadores beta y calcioantagonistas cardiodepresores, notificar a los responsables de la atención sanitaria el riesgo cardiovascular al que están expuestos esos pacientes y conseguir una reducción en el número de quienes los utilizan. Métodos. Estudio cuasi-experimental, prospectivo, desarrollando una intervención en médicos prescriptores de pacientes mayores de 65 años, tratados entre el 1 de enero y el 30 de julio de 2014, afiliados al Sistema de Salud en 101 ciudades de Colombia. Se identificaron 43.180 pacientes que mensualmente recibían algún bloqueador beta y 14.560 que recibían un calcioantagonista cardiodepresor. Se realizaron intervenciones educativas y se evaluó en los siguientes 3 meses la proporción de suspensión de alguno de los fármacos. Se evaluaron las variables sociodemográficas y farmacológicas. Resultados. Se identificaron 535 pacientes que recibían concomitantemente bloqueadores beta más calcioantagonista cardiodepresor, con edad media 75,8 ± 6,7 años. Tras 66 intervenciones educativas se logró modificación de la terapia en 235 pacientes (43,9% de usuarios). En 209 casos (88,9%) se suspendió uno de los 2 medicamentos, un 11,1% cambió por otros antihipertensivos. Las variables tener más de 85 años (OR: 1,93; IC 95%:1,07-3,50) y recibir comedicación con inhibidores del sistema renina-angiotensina (OR: 2,16; IC 95%: 1,28-3,65) se asociaron con un mayor riesgo de que el responsable de la atención en salud cambiara o suspendiera alguno de los fármacos. Conclusiones. Se logró una positiva adherencia por parte de los prestadores del servicio sanitario a recomendaciones sobre utilización adecuada de bloqueadores beta y calcioantagonistas cardiodepresores. Se deben reforzar programas de intervención de prescripciones inapropiadas que disminuyan potenciales riesgos para los pacientes en tratamiento para enfermedades cardiovasculares (AU)


Objective. To determine the frequency of simultaneous prescription of β-blockers and calcium channel blockers, notify the cardiovascular risk of these patients to the health care professionals in charge of them, and achieve a reduction in the number of those who use them. Methods. Quasi-experimental, prospective study by developing an intervention on medical prescriptions of patients older than 65 years treated between January 1 and July 30, 2014, affiliated to the Health System in 101 cities in Colombia. A total of 43,180 patients received a β-blocker each month, and 14,560 receiving a calcium channel blocker were identified. Educational interventions were performed and an evaluation was made, using sociodemographic and pharmacological variables, on the number of patients that stopped taking any of the two drugs in the following three months. Results. A total of 535 patients, with a mean age 75.8 ± 6.7 years received concomitant β-blockers plus calcium channel blockers. Modification of therapy was achieved in 235 patients (43.9% of users) after 66 educational interventions. In 209 cases (88.9%) one of the two drugs was suspended, and 11.1% changed to other antihypertensive drugs. The variable of being more than 85 years old (OR: 1.93; 95% CI: 1.07-3.50), and receiving concomitant medication with inhibitors of the renin-angiotensin system (OR: 2.16; 95% CI: 1.28-3.65) were associated with increased risk of their doctor changing or stopping the prescription. Conclusions. An improved adherence to recommendations for appropriate use of β-blockers and calcium channel blockers by health service providers was achieved. Intervention programs that reduce potentially inappropriate prescriptions for patients treated for cardiovascular disease should be used more frequently (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade da Assistência à Saúde/normas , Avaliação de Resultado de Intervenções Terapêuticas/métodos , Prescrição Inadequada/efeitos adversos , Prescrição Inadequada/prevenção & controle , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/efeitos adversos , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/efeitos adversos , Prescrições de Medicamentos/normas , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Estudos Prospectivos , Atenção à Saúde , Análise de Dados/métodos , Modelos Logísticos , Análise Multivariada , Farmacoepidemiologia/métodos , Farmacoepidemiologia/tendências
13.
J. physiol. biochem ; 72(2): 245-253, jun. 2016. graf
Artigo em Inglês | IBECS | ID: ibc-168269

RESUMO

We previously observed that sarcoendoplasmic reticulum Ca2+ ATPase (SERCA) blockade by cyclopiazonic acid (CPA) significantly potentiates serotonin (5-hydroxytryptamine (5-HT))-induced vascular contractions. Furthermore, 5-HT receptor antagonist methysergide partially inhibited CPA-potentiated 5-HT contractions. In the present study, we further investigated whether SERCA inhibition potentiates 5-HT-induced Ca2+ responses along with attenuating the receptor antagonism by store-operated Ca2+ (SOC) entry and protein kinase C (PKC)-mediated mechanisms. The effects of dexamethasone that was previously shown to induce SOC entry and enhance 5-HT responses were also tested. For this purpose, intracellular Ca2+ levels were monitored in A7r5 embryonic rat vascular smooth muscle cells by spectrofluorometry using the fluorescent indicator fura-2. The results showed that CPA, although not dexamethasone, significantly potentiated 5-HT-induced Ca2+ elevations. Ketanserin partially decreased 5-HT-induced and CPA-potentiated Ca2+ elevations whereas both PKC inhibitor D-sphingosine and SOC entry blocker 2-aminoethoxydiphenyl borate (2-APB) abolished the remaining responses. The data suggests that diminished antagonistic effect on 5-HT-induced Ca2+ elevations in the presence of SERCA inhibition is induced by SOC entry and PKC activation (AU)


No disponible


Assuntos
Animais , Ratos , Sinalização do Cálcio , Inibidores Enzimáticos/farmacologia , Indóis/farmacologia , Músculo Liso Vascular , Agonistas do Receptor de Serotonina/farmacologia , Serotonina/metabolismo , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/antagonistas & inibidores , Anti-Inflamatórios , Bloqueadores dos Canais de Cálcio/farmacologia , Antagonistas da Serotonina/farmacologia , Vasoconstritores , Vasodilatadores , Proteína Quinase C , Linhagem Celular
14.
J. physiol. biochem ; 71(4): 785-793, dic. 2015.
Artigo em Inglês | IBECS | ID: ibc-145730

RESUMO

In traditional herbal medicine, Rock Tea (Jasonia glutinosa) is known for its prophylactic and therapeutic value in various disorders including arterial hypertension. However, the mechanism by which Rock Tea exerts blood pressure-lowering actions has not been elucidated yet. Our aim was to demonstrate vasorelaxing effects of Rock Tea extract and to reveal its possible action mechanism. Isometric myography was conducted on high-K+-precontracted rings from rat thoracic aorta and tested extracts at concentrations of 0.5–5 mg/ml. Whole-cell patch-clamp experiments were performed in rat aortic vascular smooth muscle cells (line A7r5) to determine blocking effects on L-type Ca2+ channels. Rock Tea extract relaxed the aorta contracted by high [K+] concentration dependently with an EC50 of ≈2.4 mg/ml and produced ≈75 % relaxation at the highest concentration tested. The L-type Ca2+ channel blocker, verapamil (10−6 M), had similar effects. Rock Tea extract had no effect in nominally Ca2+-free high-K+ buffer but significantly inhibited contractions to re-addition of Ca2+. Rock Tea extract inhibited the contractions induced by the L-type Ca2+ channel activator Bay K 8644 (10−5 M) and by phenylephrine (10−6 M). Rock Tea extract and Y-27632 (10−6 M), Rho-kinase inhibitor, had similar effects and the respective effects were not additive. Patch-clamp experiments demonstrated that Rock Tea extract (2.5 mg/ml) virtually abolished L-type Ca2+ currents in A7r5. We conclude that Rock Tea extract produced vasorelaxation of rat aorta and that this relaxant effect is mediated by inhibition of L-type Ca2+ channels. Rock Tea extracts may be of phytomedicinal value for prevention and adjuvant treatment of hypertension and other cardiovascular diseases (AU)


No disponible


Assuntos
Animais , Ratos , Aorta , Músculo Liso Vascular , Canais de Cálcio , Chá/química , Extratos Vegetais/farmacocinética , Bloqueadores dos Canais de Cálcio/farmacocinética , Doenças Cardiovasculares/prevenção & controle , Vasodilatação
15.
Med. clín (Ed. impr.) ; 145(6): 239-247, sept. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-144049

RESUMO

Fundamento y objetivo: El objetivo fue evaluar la eficacia y seguridad de tamsulosina, comparada con otro tratamiento estándar o con placebo, en la expulsión de las litiasis ureterales distales. Material y métodos: Se realizaron búsquedas sistemáticas en PubMed, SCOPUS y The Cochrane Library para identificar los ensayos clínicos aleatorizados y controlados en pacientes tratados con tamsulosina con resultados de expulsión de litiasis ureteral y de episodios adversos, publicados hasta diciembre de 2014, sin limitaciones de idioma. Se calculó el efecto de los tratamientos junto con el intervalo de confianza del 95% (IC 95%) utilizando el método de la inversa de la variancia para efectos aleatorios. La heterogeneidad se determinó mediante el estadístico I2. El sesgo de publicación se evaluó mediante la prueba de Egger. Resultados: La búsqueda identificó 480 artículos. Treinta y ocho cumplían los criterios de selección, con un total de 3.107 participantes. El riesgo relativo (RR) de expulsión de litiasis de los pacientes tratados con tamsulosina comparado con el tratamiento control fue de 1,53 (IC 95% 1,38-1,69; I2 = 71%). El RR de cualquier episodio adverso de tamsulosina fue de 1,79 (IC 95% 1,19-2,71; I2 = 0%). Conclusiones: El tratamiento con tamsulosina parece favorecer la expulsión de litiasis renales, aunque con un riesgo no desdeñable de efectos secundarios (AU)


Background and objective: The aim is to evaluate tamsulosin efficacy and safety on the expulsion of distal ureteral stones compared to a standard therapy. Material and methods: Systematic searches were conducted on PubMed, SCOPUS and The Cochrane Library so as to identify randomized and controlled clinical trials in patients treated with tamsulosin with ureteral stone expulsion and adverse events published until 2014 December, without language restriction. Treatment effect was calculated along with the 95% confidence interval (95% CI), using the variance inverse method for random effects. Heterogeneity was determined by I2. Publication bias was assessed by Egger test. Results: The search identified 480 articles. Thirty-eight met the selection criteria, a total of 3,107 patients. The relative risk (RR) of expulsion was 1.53 (95% CI 1.38-1.69; I2 = 71%.), while the RR of adverse effects was 1.79 (95% CI 1.19-2,71; I2 = 0). Conclusions: Tamsulosin treatment seems to bring on the expulsion of distal ureteral stones, although at the expense of an appreciable risk of side effects (AU)


Assuntos
Cólica Renal/epidemiologia , Cólica Renal/tratamento farmacológico , Nefrolitíase/patologia , Nefrolitíase/tratamento farmacológico , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Antagonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Bloqueadores dos Canais de Cálcio/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Antagonistas Adrenérgicos alfa/efeitos adversos , Resultado do Tratamento , Litotripsia , Hipotensão , Hiperplasia Prostática/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Metanálise como Assunto
16.
Rev. neurol. (Ed. impr.) ; 60(1): 10-16, 1 ene., 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-131519

RESUMO

Introducción. Las disfunciones sexuales constituyen uno de los problemas más importantes que afectan a la salud sexual y se asocian a bajos niveles de calidad de vida. Objetivo. Evaluar la función sexual en pacientes migrañosos y la disfunción sexual atribuible al tratamiento preventivo. Pacientes y métodos. Pacientes atendidos en las consultas de cefaleas de dos hospitales generales que acudían a la primera visita tras prescripción de un preventivo. Respondieron al cuestionario de funcionamiento sexual del Hospital General de Massachusetts (MGH-SFQ) y al cuestionario de disfunción sexual secundaria a psicofármacos (SALSEX). Resultados. Muestra de 79 pacientes (17 varones, 62 mujeres), de 37,6 ± 9,1 años (rango: 19-57 años), 31 (39,2%) de ellos con migraña crónica. Como tratamiento preventivo, 23 (29,1%) recibían betabloqueantes; 42 (53,2%), neuromoduladores; 8 (10,1%), antagonistas del calcio, y 6 (7,6%), antidepresivos. El MGH-SFQ detectó en 24 pacientes (30,4%) disminución al menos moderada de satisfacción sexual global. El SALSEX mostró cambio de la función sexual atribuible al tratamiento preventivo en 36 casos (45,5%), sólo excepcionalmente manifestada de forma espontánea. En pacientes con disfunción al menos moderada en el MGH-SFQ, eran significativamente mayores la edad media en el momento de la inclusión, el número de días de dolor al mes y el uso excesivo de medicación sintomática (53,3% frente a 46,7%; p = 0,03). Conclusión. La disfunción sexual evaluada con sencillos test de cribado detecta con frecuencia disfunción sexual en pacientes migrañosos en tratamiento preventivo y cambios en su vida sexual atribuibles a estos fármacos (AU)


Introduction. Sexual dysfunctions are one of the most important problems affecting sexual health and are associated withlow levels of quality of life. Aim. To assess the sexual functioning in migraine patients and the sexual dysfunction that can be attributed to its preventive treatment. Patients and methods. The patients attended in the headache units of two general hospitals who visited for the first time after being prescribed preventive treatment. They answered the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) and the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX). Results. The sample used in the study consisted of 79 patients (17 males, 62 females) aged 37.6 ± 9.1 years (range: 19-57 years), 31 (39.2%) of them with chronic migraine. As preventive treatment, 23 (29.1%) received beta blockers; 42 (53.2%) neuromodulators; 8 (10.1%), calcium antagonists; and 6 (7.6%), antidepressants. The MGH-SFQ detected diminished overall sexual satisfaction that was at least moderate in 24 patients (30.4%). SALSEX showed changes in sexual functioning that was attributable to the preventive treatment in 36 cases (45.5%), which only exceptionally appeared spontaneously. In patients with at least moderate dysfunction on the MGH-SFQ, the mean ages at the time of testing, the number of days with pain per month and the excessive use of medication for their symptoms were all higher(53.3% versus 46.7%; p = 0.03). Conclusions. Simple sexual dysfunction screening tests often detect sexual dysfunctions in patients with migraine on preventive treatment and changes in their sex life that can be attributed to these drugs (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/complicações , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/prevenção & controle , Saúde Sexual , Qualidade de Vida , Transtornos de Enxaqueca/complicações , Psicotrópicos/efeitos adversos , Psicotrópicos/uso terapêutico , Inquéritos e Questionários , Psicofarmacologia/métodos , Estudos Prospectivos , Antagonistas Adrenérgicos beta/uso terapêutico , Receptores de Neurotransmissores/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Programas de Rastreamento/métodos , Programas de Rastreamento/prevenção & controle
17.
Rev. esp. anestesiol. reanim ; 61(10): 557-564, dic. 2014.
Artigo em Espanhol | IBECS | ID: ibc-129798

RESUMO

En la población general adulta la prevalencia de la hipertensión arterial es del 30 al 45%. Los anestesiólogos se enfrentan con frecuencia a la tarea de mantener un control adecuado de la presión arterial perioperatoria. En elevaciones súbitas de la misma su control preciso toma mayor importancia para la prevención de compromiso de órganos diana. Recientemente, clevidipino, un calcioantagonista de acción ultracorta ha sido aprobado por la FDA () como estrategia para el tratamiento intravenoso (IV) de la hipertensión arterial y por la y la Agencia Española de Medicamentos y Productos Sanitarios () para la reducción rápida de la presión arterial en el contexto perioperatorio. Se ha observado que este medicamento tiene un rápido inicio de acción, fácil titulación y ejerce un control preciso de la presión arterial. Además, es altamente efectivo como monoterapia y tiene una adecuada transición a una terapia antihipertensiva oral. Para este artículo se realizó una búsqueda de la literatura disponible en MEDLINE hasta febrero de 2014, utilizando como palabras claves hypertension y clevidipine con el fin de exponer las características farmacocinéticas y farmacodinámicas, y de igual forma los estudios clínicos que proveen evidencia del rápido y efectivo control de la presión arterial producido por el clevidipino, en especial en esos momentos en que el control preciso de esta es altamente relevante (AU)


The prevalence of hypertension in general population is from 30% to 45%. Anesthesiologists frequently deal with the challenge of maintaining adequate control of perioperative blood pressure. On sudden elevations, a precise control is required to prevent end-organ damage. Recently, clevidipine, an ultra-short acting calcium antagonist has been approved by the FDA (), as a strategy for the intravenous treatment of hypertension; and by the Spanish Agency of Medicines and Medical Devices () for the rapid reduction of arterial blood pressure in the perioperative setting. This medication has shown to have a rapid onset, easy titratability, and to exert a precise control of blood pressure. In addition, clevidipine has shown to be highly effective as monotherapy, and to have an excellent transition to oral antihypertensive therapy. For this article, an online search of the Medline literature was conducted up to February 2014 and «clevidipine» and «hypertension» used as keywords in order to analyze pharmacokinetics and pharmacodynamics of clevidipine. There are also clinical studies that provide evidence of the rapid and effective control that clevidipine has on blood pressure, especially in acute perioperative and emergency settings (AU)


Assuntos
Humanos , Masculino , Feminino , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Bloqueadores dos Canais de Cálcio/metabolismo , Bloqueadores dos Canais de Cálcio/uso terapêutico , Período Perioperatório/métodos , Período Perioperatório/tendências , Frequência Cardíaca , Período Perioperatório , Bloqueadores dos Canais de Cálcio/farmacocinética
19.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.) ; 40(extr.4): 2-10, sept. 2014. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-142556

RESUMO

En el último año, varias sociedades científicas han publicado sus guías para el manejo de la hipertensión arterial. En nuestro país, en los últimos años siempre han tenido mucha repercusión y seguimiento tanto la guía americana del National Heart, Lung and Blood Institute, cuyo último informe (JNC [Joint National Committee] 7) fue publicado en 2003, como las guías de las sociedades europeas de cardiología e hipertensión (European Society of Hypertension [ESH] y European Society of Cardiology [ESC]), cuya última guía databa del año 2007, aunque en 2009 se llevó a cabo una actualización. Este nuevo documento de las sociedades europeas ESH/ESC publicado en 2013 tiene un carácter fundamentalmente educacional, muy cercano al clínico, y aunque muchas de las recomendaciones mantienen el mismo criterio que guías previas, en esta ocasión el trabajo se ha hecho con un mayor rigor y se presenta con importantes aportaciones, como incorporar a cada una de las recomendaciones que se realiza los niveles de evidencia y el grado de recomendación, que es algo de lo que carecían las guías previas de estas sociedades. Es un documento sencillo, que de forma muy práctica se resume en 17 tablas, 5 figuras y 18 bloques de recomendaciones. Respecto al informe JNC 8, se presenta, sin embargo, como un documento con un solo objetivo, dar respuesta a 3 cuestiones que se consideran prioritarias, las cuales solamente son referidas al tratamiento farmacológico y de ellas se concluye con 9 recomendaciones (AU)


In the last year, several scientific societies have published guidelines for the management of arterial hypertension. In Spain, two clinical practice guidelines have had a strong impact and have been closely followed in the last few years: the first is the Guideline of the National Heart, Lung and Blood Institute, although their last report (JNC 7) was published in 2003; the second is the clinical practice guideline for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH), whose latest version was published in 2007, although an update was published in 2009. A new ESC/ESH document, published in 2013, adopts a mainly educational stance, closely rooted in clinical practice. Many of the recommendations maintain the same criteria as previous guidelines. However, the new publication shows greater rigor and contains major contributions such as specification of the level of evidence and grade of recommendation for each recommendation, which was lacking in the previous guidelines of these societies. The document is both practical and easy to consult, consisting of 17 tables, 5 figures and 18 blocks of recommendations. The JNC 8 report, however, has a single objective: to respond to three questions that are considered a priority and which refer exclusively to drug therapy. Nine recommendations are made relating to these three questions (AU)


Assuntos
Feminino , Humanos , Masculino , Hipertensão/tratamento farmacológico , Hipertensão do Jaleco Branco , Insuficiência Renal Crônica , Monitorização Ambulatorial da Pressão Arterial , Hipertrofia Ventricular Esquerda , Diuréticos/uso terapêutico , Antagonistas Adrenérgicos beta/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , /uso terapêutico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Doenças Cardiovasculares , Fatores de Risco , Estilo de Vida , Quimioterapia Combinada , Apneia Obstrutiva do Sono , Nefropatias Diabéticas , Cardiopatias , Acidente Vascular Cerebral , Saúde do Idoso
20.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.) ; 40(5): 247-253, jul.-ago. 2014.
Artigo em Espanhol | IBECS | ID: ibc-125242

RESUMO

Introducción. Aunque el tratamiento antihipertensivo puede reducir el riesgo de morbimortalidad cardiovascular, los estudios enfocados a evaluar la asociación entre fármacos antihipertensivos utilizados e incidencia de fibrilación auricular (FA) arrojan resultados dispares. Con este estudio se pretendía averiguar la posible relación entre fármaco antihipertensivo utilizado y aparición de FA. Material y métodos. Estudio de casos y controles. Casos: hipertensos con FA diagnosticada al menos un año después del inicio del tratamiento farmacológico para la hipertensión arterial. Controles: hipertensos sin FA con tratamiento antihipertensivo farmacológico durante al menos un año. Se emparejaron según sexo, edad y duración del tratamiento antihipertensivo al diagnóstico de la FA. Se estudiaron 136 casos y 132 controles. Variables: FA, fármacos antihipertensivos, control de la hipertensión arterial, tiempo de tratamiento con fármacos antihipertensivos, número de fármacos antihipertensivos. Análisis: se calcularon las OR brutas y ajustadas mediante regresión logística. Resultados. Globalmente los diuréticos estuvieron cerca de la significación estadística: OR 0,616 (IC 95% 0,365-1,040), como factor protector de aparición de FA. Los calcioantagonistas se comportaron como factor de protección de aparición de FA en el grupo de 75 años o mayores (OR 0,366; IC 95% 0,173-0,772). Conclusiones. Los calcioantagonistas en el grupo de 75 años o más se comportan como fármaco protector de la aparición de FA. Los diuréticos pudieran tener un papel protector de incidencia de FA en todos los hipertensos (AU)


Introduction. Although antihypertensive treatment can reduce the risk of cardiovascular morbimortality, studies aimed at evaluating the association between antihypertensive drug use and incidence of atrial fibrillation (AF) yield mixed results. This study aimed to determine the possible relationship between antihypertensive drug use and development of AF. Material and methods. Case control study. Cases: Hypertensive patients with AF diagnosed at least one year after the start of drug treatment for hypertension. Controls: Hypertensive patients without AF with pharmacological antihypertensive treatment for at least one year, matching by sex, age and duration of antihypertensive therapy at diagnosis of AF cases. The study included 136 cases and 132 controls. Variables: AF, antihypertensive drugs, control of hypertension, duration of treatment with antihypertensive drugs, number of antihypertensive drugs. Analysis: Crude OR were calculated, with logistic regression being used to calculate the adjusted odds ratios. Results. Overall, diuretics was close to statistical significance: OR 0.616 (95% CI 0.365 to 1.040), as a protective factor for development of AF. Calcium channel blockers behaved as a protective factor against development of AF at 75 years or older (OR 0.366; 95% CI 0.173 to 0.772), and within this age in women (OR 0.343; 95% CI 0.145-0.811). Conclusions. Calcium channel blockers in the group of 75 years or more, especially in women, worked statistically significant as a drug protecting against the appearance of AF. Diuretics may have a protective role in AF incidence in all hypertensive patients (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fibrilação Atrial/induzido quimicamente , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/efeitos adversos , Hipertensão/tratamento farmacológico , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Atenção Primária à Saúde , Estudos de Casos e Controles , Bloqueadores dos Canais de Cálcio/uso terapêutico , Intervalos de Confiança , Modelos Logísticos , Análise Estatística
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