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1.
Hipertens. riesgo vasc ; 37: 0-0, 2020.
Artigo em Espanhol | IBECS | ID: ibc-188820

RESUMO

El 31 de diciembre de 2019 se reportó el primer caso de COVID-19 en Wuhan, China, y desde entonces ha habido un interés creciente y sin precedentes por conocer todos los aspectos vinculados con esta nueva enfermedad. Uno de los temas que ha generado debate se vincula con la asociación entre la terapia antihipertensiva con inhibidores del sistema renina-angiotensina-aldosterona (SRAA) y la infección por el virus SARS-CoV-2. Si bien muchas preguntas siguen hoy día sin poder ser respondidas, la intención de este comunicado es informar a los profesionales de la salud acerca del estado actual de conocimiento. Dado que este es un tema en constante evolución, se recomienda su actualización a medida que se presenten nuevas evidencias. A continuación, daremos revisión a los estudios preclínicos y clínicos que relacionan el coronavirus con el SRAA


The first case of COVID-19 was reported on 31 December 2019 in Wuhan, China. Ever since there has been unprecedented and growing interest in learning about all aspects of this new disease. Debate has been generated as tothe association between antihypertensive therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors and SARS-CoV-2 infection. While many questions as yet remain unanswered, the aim of this report is to inform healthprofessionals about the current state of knowledge. Because this is an ever-evolvingtopic, the recommendation is that it be updated as new evidence becomes available. Below, we provide a review of pre-clinical and clinical studies that link coronavirus to the RAAS


Assuntos
Humanos , Sistema Renina-Angiotensina/efeitos dos fármacos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Índice de Gravidade de Doença , Inibidores da Enzima Conversora de Angiotensina/metabolismo , Infecções por Coronavirus/terapia , Hipertensão/tratamento farmacológico , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Betacoronavirus , Vasoconstrição/efeitos dos fármacos , Inibidores de Serino Proteinase/metabolismo , Proteína S , Testes de Hipótese
4.
Rev. neurol. (Ed. impr.) ; 68(6): 250-254, 16 mar., 2019. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-180657

RESUMO

Introducción. El síndrome de vasoconstricción cerebral reversible (SVCR) es una entidad de baja incidencia, de etiología multifactorial y amplio espectro de presentación. El principal síntoma es la cefalea de tipo trueno. Puede estar acompañado de focalización neurológica y cursar con desenlaces clínicos variable que incluso pueden llevar a la muerte. El diagnóstico es clínico e imaginológico, y el tratamiento incluye adoptar medidas generales de monitorización, manejo sintomático, identificar la etiología y actuar sobre ella para evitar recurrencia. Caso clínico. Mujer de 71 años con antecedente de cáncer de seno, tratada inicialmente con tamoxifeno; por presentar urticaria, se escalonó tratamiento con anastrozol. Ingresó por cefalea de tipo trueno, afasia anterior y somnolencia. La paciente refirió un evento similar una semana antes del ingreso. En la resonancia magnética cerebral evidenció una hemorragia subaracnoidea (HSA) pequeña de la convexidad temporoparietal izquierda, y la panangiografía documentó vasoespasmo en la región parietal posterior, lo que confirmó el diagnóstico de SVCR más HSA. Durante el ingreso presentó tres eventos de iguales características, que requirieron monitorización intensiva y dos panangiografías terapéuticas con nimodipino intraarterial, con posterior resolución del vasoespasmo. Permanece asintomática seis meses después. Conclusión. El SVCR constituye un reto diagnóstico dada su presentación variable y su etiología multifactorial. En este caso, el SVCR más HSA está asociado al uso de anastrozol. Hasta el momento no hay casos descritos de inhibidores de la aromatasa asociados a esta patología, que debe comunicarse para su farmacovigilancia


Introduction. Reversible cerebral vasoconstriction syndrome (RCVS) is a low incidence disability with a multifactorial etiology and a wide array of symptoms. The main symptom is a thunderclap headache, accompanied sometimes with various neurological deficits that can lead to death. RCVS is usually diagnosed through radiological imaging technology. The treatment includes adopting general measures of monitoring, symptomatic management, identifying the etiology and acting on it to avoid recurrence. Case report. A 71-year-old woman with a history of breast cancer originally treated with tamoxifen. Due to urticaria, the anastrozole management was staggered. She was admitted for aphasia, drowsiness and a thunderclap headache. The patientreported a similar event two weeks prior admission. In rain resonance, there was evidence of small sub-arachnoidal haemorrhage (SAH) of the left parietal temporal convexity and cerebral angiography. As well as documented vasospasm in the posterior parietal region confirming the diagnosis of RCVS plus SAH. During the stay, she presented three events with the same characteristics, requiring intensive monitoring and two therapeutic panangiographies with intra-arterial nimodipine with subsequent resolution of the vessel spasm. The patient remains asymptomatic six months later. Conclusion. RCVS is difficult to diagnose given its wide array of symptoms and multifactorial etiology. In this case, RCVS plus SAH is associated with the use of anastrozole. So far there are no reported cases of aromatase inhibitors associated with this pathology and should be reported in the literature for pharmacovigilance


Assuntos
Humanos , Feminino , Idoso , Vasoconstrição/fisiologia , Vasoespasmo Intracraniano/induzido quimicamente , Hemorragia Subaracnóidea/induzido quimicamente , Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Antineoplásicos/efeitos adversos , Angiografia Cerebral/métodos , Disartria/etiologia , Cefaleia/etiologia
5.
Prog. obstet. ginecol. (Ed. impr.) ; 61(4): 384-386, jul.-ago. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-174982

RESUMO

Presentamos a una gestante de 40 años, en la semana 12+6. Al obtener riesgo alto en el cribado del primer trimestre, se procedió a la biopsia corial por vía abdominal. Cuando se introdujo el anestésico local, la paciente comenzó con un dolor punzante sobre la zona de inyección, cambiando inmediatamente de color a rojo vinoso. Tras consultar con dermatología, se diagnosticó de síndrome de Nicolau, un vasoespasmo agudo por la inyección intraarterial de anestésico, que lleva a necrosis del tegumento cutáneo subsidiario a este. Dada la escasa prevalencia de esta afección, consideramos necesario elaborar una revisión bibliográfica sobre este síndrome


We present a 40-year-old pregnant woman, at week 12 + 6. By getting high risk in the first three months period screening, we abdominally proceeded to chorionic villus sampling. When the local anesthetic was introduced, the patient began with a shooting pain on the injection site, changing into a wine-red colour. After consultating with dermatology, she was diagnosed with Nicolau syndrome, an acute vasospasm by intra-arterial injection of anesthetic, leading to necrosis of the skin integument that depends on this. Given the low prevalence of this condition, we consider necessary to develop a literature review on this syndrome


Assuntos
Humanos , Feminino , Gravidez , Adulto , Amostra da Vilosidade Coriônica/métodos , Síndrome de Nicolau/diagnóstico , Injeções Intra-Arteriais/efeitos adversos , Anestesia/efeitos adversos , Vasoconstrição
9.
Rev. clín. esp. (Ed. impr.) ; 217(3): 161-169, abr. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-161923

RESUMO

La congestión venosa sistémica ha cobrado mucha importancia en la interpretación de la fisiopatología de la insuficiencia cardíaca aguda, y muy especialmente en el desarrollo del deterioro de la función renal durante las agudizaciones. En el presente trabajo se revisa el concepto, la caracterización clínica y la identificación de la congestión venosa. Se actualiza el conocimiento sobre su importancia en la fisiopatología de la insuficiencia cardíaca aguda y su implicación en el pronóstico. Se presta especial atención a la relación entre la congestión abdominal, el intersticio pulmonar como membrana filtrante, los fenómenos inflamatorios y el deterioro de la función renal en la insuficiencia cardíaca aguda. Por último, se revisa la descongestión como un novedoso objetivo terapéutico y los medios disponibles para su evaluación (AU)


Systemic venous congestion has gained significant importance in the interpretation of the pathophysiology of acute heart failure, especially in the development of renal function impairment during exacerbations. In this study, we review the concept, clinical characterisation and identification of venous congestion. We update current knowledge on its importance in the pathophysiology of acute heart failure and its involvement in the prognosis. We pay special attention to the relationship between abdominal congestion, the pulmonary interstitium as filtering membrane, inflammatory phenomena and renal function impairment in acute heart failure. Lastly, we review decongestion as a new therapeutic objective and the measures available for its assessment (AU)


Assuntos
Humanos , Masculino , Feminino , Estenose da Valva Tricúspide/complicações , Estenose da Valva Tricúspide/diagnóstico , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Diagnóstico Precoce , Vasoconstrição/fisiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca Diastólica/complicações , Insuficiência Cardíaca Diastólica/fisiopatologia , Cardiografia de Impedância/métodos , Prognóstico
10.
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
13.
Rev. neurol. (Ed. impr.) ; 62(9): 403-407, 1 mayo, 2016. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-151861

RESUMO

Introducción. El reflejo venoarteriolar (RVA) lo provoca un incremento en la presión venosa transmural al colocar una parte del cuerpo en el sentido de la aceleración gravitatoria por debajo del corazón. Objetivo. Evaluar el RVA en sujetos sanos al levantar una parte del cuerpo por encima del corazón. Sujetos y métodos. En 16 sujetos sanos (20-65 años) se estudió el RVA mediante cambios en el flujo sanguíneo de la piel con un fotopletismógrafo digital infrarrojo colocado en el pulpejo en sujetos sanos durante las siguientes condiciones: brazo derecho a la altura del corazón, brazo derecho 40 cm por debajo del corazón y brazo derecho 40 cm por encima del corazón. Las variables medidas fueron: amplitud del flujo sanguíneo de la piel con el brazo a la altura del corazón (amplitud basal), porcentaje de disminución del flujo sanguíneo de la piel con el brazo por debajo del corazón y porcentaje de aumento del flujo sanguíneo de la piel con el brazo por encima del corazón. Resultados. El porcentaje de vasoconstricción con el brazo derecho por debajo del corazón fue del 35%, y el de vasodilatación, del 50%. Conclusiones. La evaluación del RVA con el brazo por debajo del corazón provoca vasoconstricción, y la elevación del brazo produce una importante vasodilatación. La vasoconstricción y la vasodilatación se mantienen mientras la extremidad se mantenga por encima o por debajo del corazón. Éste es un estudio potencialmente muy útil y económico para estudiar la inervación de la microcirculación en diversas neuropatías periféricas de fibras delgadas y mixtas (AU)


Introduction. The veno-arteriolar reflex (VAR) is triggered by an increase in the transmural venous pressure on placing a part of the body in the same direction as the gravitational acceleration below the heart. Aim. To assess the VAR in healthy subjects on raising a part of the body above the level of the heart. Subjects and methods. VAR was studied in 16 healthy subjects (20-65 years old) by means of changes in the blood flow in the skin detected using a digital infrared photoplethysmograph attached to the fingertip under the following conditions: right arm at the height of the heart, right arm below the heart and right arm below the level of the heart. The variables measured were: amplitude of the blood flow in the skin with the arm raised to the height of the heart (baseline amplitude), percentage decrease of the blood flow in the skin with the arm below the heart and percentage increase in blood flow with the arm above the heart. Results. The percentage of vasoconstriction with the right arm below the heart was 35%, and that of vasodilation, 50%. Conclusions. Evaluation of the VAR with the arm below the heart causes vasoconstriction, and elevation of the arm causes an important degree of vasodilation. Vasoconstriction and vasodilation are maintained while the limb is kept above or below the heart. This is an economical and potentially very useful way of studying the innervation of the microcirculation in a number of different peripheral neuropathies of thin and mixed fibres (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Vasoconstrição/fisiologia , Vasodilatação/fisiologia , Microcirculação/fisiologia , Arteríolas/lesões , Arteríolas/patologia , Homeostase/fisiologia , Sistema Nervoso Autônomo/lesões , Sistema Nervoso Autônomo/patologia , Sistema Nervoso Autônomo/fisiologia , Sistema Nervoso Simpático/lesões , Sistema Nervoso Simpático/patologia , Sistema Nervoso Simpático/fisiologia , Fotopletismografia/instrumentação , Fotopletismografia/métodos , Fotopletismografia , Ultrassonografia Doppler/instrumentação , Ultrassonografia Doppler/métodos , Ultrassonografia Doppler , Termografia/instrumentação , Termografia/métodos , Termografia
14.
Rev. esp. anestesiol. reanim ; 63(2): 116-121, feb. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-150341

RESUMO

La cefalea en el periodo puerperal puede ser debida a múltiples causas. En el contexto de una paciente que ha recibido previamente analgesia epidural, la cefalea puede ser etiquetada de cefalea pospunción dural, a pesar de que sus características no sean típicas de este cuadro clínico. Presentamos el caso de una puérpera con punción dural accidental durante la realización de anestesia epidural, que desarrolló cefalea en el tercer día posparto. Se sospechó inicialmente cefalea pospunción dural, pero la aparición posterior de convulsiones y pérdida de visión hizo que se reconsiderase el diagnóstico. A propósito de este caso revisamos las características clínicas y fisiopatológicas del síndrome de encefalopatía posterior reversible y el síndrome de vasoconstricción cerebral reversible, así como el diagnóstico diferencial de la cefalea en el periodo puerperal (AU)


Postpartum headache can be due to many causes. In a patient with previous epidural analgesia, the headache can be attributed to post-dural puncture headache, even if the symptoms are not typical of this clinical entity. We report a case of a post-partum with accidental dural tap during the insertion of an epidural catheter for labour analgesia, and who referred to headaches in the third post-partum day. Initially, a post-dural puncture headache was suspected, but the subsequent onset of seizures and visual impairment meant that the diagnosis had to be reconsidered. In this case report, the clinical and pathophysiological features of posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome, as well as the differential diagnosis of post-partum headaches are described (AU)


Assuntos
Humanos , Feminino , Adulto , Encefalopatias/metabolismo , Encefalopatias/patologia , Vasoconstrição/genética , Cefaleia/complicações , Cefaleia/patologia , Período Pós-Parto/metabolismo , Cegueira Cortical/patologia , Hipertensão/sangue , Espectroscopia de Ressonância Magnética/métodos , Insuficiência Renal/patologia , Encefalopatias/complicações , Encefalopatias/diagnóstico , Vasoconstrição/fisiologia , Cefaleia/genética , Cefaleia/metabolismo , Período Pós-Parto/fisiologia , Cegueira Cortical/complicações , Hipertensão/diagnóstico , Espectroscopia de Ressonância Magnética/instrumentação , Insuficiência Renal/metabolismo
16.
J. physiol. biochem ; 71(2): 205-216, jun. 2015.
Artigo em Inglês | IBECS | ID: ibc-140529

RESUMO

Previous studies have demonstrated inconsistent roles of Rho kinase (ROCK) in the decreased vasoconstriction of rat hindquarter vessels induced by hindlimb unweighting (HU). The present study was designed to determine the unclear role of ROCK in the mediation of HU-induced decreased femoral arterial vasoconstriction. 28-day HU rat was adopted as the animal model. With or without Y-27632, a ROCK inhibitor, isometric force of femoral artery was measured. The expression of ROCK and its effects on downstream targets were also examined. Results showed that (1) HU caused a significant decrease of the phenylephrine (PE)-evoked and potassium chloride (KCl)-evoked femoral arterial vasoconstriction (P < 0.05), confirming the functional findings by previous studies. (2) Inhibition of ROCK with Y-27632 produced an equal reduction of the vasoconstriction in CON and HU. (3) HU significantly decreased ROCK II expression and the effects of ROCK on myosin light-chain phosphatase (MLCP) and MLC (P < 0.05), but increased p65 nuclear translocation (P < 0.05) and inducible nitric oxide synthase (iNOS) expression (P < 0.05). (4) HU significantly (P < 0.05) increased NO production in femoral arteries, with Y-27632 significantly (P < 0.01) amplifying this effect. These findings have revealed that 28-day HU reduced the expression and effects of ROCK on downstream targets both directly (MLCP and MLC) and possibly indirectly (NF-κB/iNOS/NO pathway) related to vasoconstriction in femoral arteries (AU)


No disponible


Assuntos
Animais , Ratos , Quinases Associadas a rho/fisiologia , Artéria Femoral/fisiologia , Elevação dos Membros Posteriores/fisiologia , Vasoconstrição/fisiologia , NF-kappa B/análise
18.
Artigo em Espanhol | IBECS | ID: ibc-115485

RESUMO

El fenómeno de Raynaud es un cuadro clínico caracterizado por ataques episódicos de vasoconstricción de las arterias y arteriolas de las extremidades como los dedos de la mano y pies, en ocasiones las orejas y la nariz, en respuesta al frío o a estímulos emocionales. Un ataque clásico consiste en la palidez de la porción distal de la extremidad, seguida de cianosis y de rubor, acompañada de parestesias, generalmente como ardor. Cuando ocurre sin causa aparente se denomina fenómeno de Raynaud primario. Cuando se asocia a otra enfermedad se llama fenómeno de Raynaud secundario. El cuadro secundario se asocia con mayor frecuencia a las enfermedades reumáticas del colágeno. También pueden presentarlo determinados medicamentos que provocan vasoconstricción, como la ergotamina, los antagonistas β-adrenérgicos, los anticonceptivos y los fármacos simpaticomiméticos. En relación con estos últimos, presentamos un caso clínico de fenómeno de Raynaud secundario a metilfenidato en un adolescente de 14 años (AU)


Raynaud's phenomenon is a clinical disease characterized by episodic attacks of vasoconstriction of the arteries and arterioles of the extremities such as fingers and toes, sometimes the ears and nose, in response to cold or emotional stimuli. A classic attack is the pallor of the distal extremity, followed by cyanosis and redness, accompanied by paresthesia, usually as heat. When it occurs without apparent cause is called primary Raynaud's phenomenon. When associated with other disease, is called secondary Raynaud's phenomenon. The secondary table is associated with increased frequency of rheumatic diseases of collagen. They can also present certain drugs that cause vasoconstriction, such as ergotamine, beta-adrenergic antagonists, contraception and sympathomimetic drugs. Regarding the latter, we present a case of Raynaud's phenomenon secondary to methylphenidate in a 14 years (AU)


Assuntos
Humanos , Masculino , Adolescente , Metilfenidato/uso terapêutico , Doença de Raynaud/induzido quimicamente , Doença de Raynaud/complicações , Doença de Raynaud/diagnóstico , Metilfenidato , Vasoconstrição , Cianose/complicações , Parestesia/complicações
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