ABSTRACT
OBJECTIVE: To evaluate the effectiveness of a nutritional strategy based on two components and adapted for the public health system on blood pressure, cardiometabolic features, self-care, qualify of life and diet quality in individuals with hypertension. METHODS: NUPRESS was an open-label, parallel-group, superiority randomized controlled clinical trial in which participants at least 21âyears with hypertension and poorly controlled blood pressure were randomly assigned (1â:â1 allocation ratio) to either an individualized dietary prescription according to nutritional guidelines (control group, n â=â205); or a two-component nutrition strategy, including a goal-directed nutritional counseling and mindfulness techniques (NUPRESS [intervention] group, n â=â205). Primary outcomes were SBP (mmHg) after 24 weeks of follow up and blood pressure control, defined as either having SBP more than 140âmmHg at baseline and achieving 140âmmHg or less after follow-up or having SBP 140âmmHg or less at baseline and reducing the frequency of antihypertensive drugs in use after follow-up. RESULTS: In total, 410 participants were randomized and submitted to an intention-to-treat analysis regarding primary outcomes. Both groups decreased blood pressure, but after adjusting for baseline values, there was no significant difference between them on SBP [intervention-control difference: -0.03 (-3.01; 2.94); P â=â0.98] nor blood pressure control [odds ratio 1.27 (0.82; 1.97); P â=â0.28]. No differences between groups were also detected regarding secondary and tertiary outcomes. CONCLUSION: There was no difference between a two-component nutritional strategy and an established dietary intervention on blood pressure in participants with hypertension.
Subject(s)
Blood Pressure , Hypertension , Humans , Hypertension/diet therapy , Hypertension/therapy , Male , Female , Middle Aged , Aged , Treatment Outcome , Adult , Public Health , Antihypertensive Agents/therapeutic useABSTRACT
Ischemia of the optic nerve (ON) is an important cause of visual field deficit provoked by tuberculum sellae (TS) meningiomas. Indocyanine green (ICG) videoangiography could provide prognostic information. Moreover, it allows new insight into the pathophysiology of visual disturbance. The authors present the case of a 48-year-old woman with visual field impairment. Magnetic resonance imaging (MRI) depicted a lesion highly suggestive of a TS meningioma. Following microsurgical resection, ICG videoangiography demonstrated improvement of right ON pial blood supply. In this case, there was one lesion causing visual impairment through both direct compression over the left ON and ischemia to the right nerve. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21155.
ABSTRACT
Vestibular schwannomas are a multifaceted group of tumors that can present with different sizes and involvement of critical neurovascular structures.1-6 While operating on these tumors, a critical goal is postoperative preservation of facial nerve function and hearing. We present the case of a 66-year-old male with a history of severe left-sided tinnitus and progressive hearing loss (Video 1). Preoperative imaging depicted a lesion highly suggestive of an intracanalicular vestibular schwannoma. Due to worsening of symptoms and after thoughtful discussion with the patient, microsurgical resection was indicated under constant neurophysiologic monitoring. A retrosigmoid approach was employed, and the posterior wall of the internal auditory canal was opened, allowing exposure of tumor and its total resection. Postoperative imaging demonstrated complete tumor resection. The patient's symptoms improve, and there were no new neurologic deficits on follow-up. Anatomical images were a Courtesy of the Rhoton Collection, American Association of Neurological Surgeons (AANS)/Neurosurgical Research and Education Foundation (NREF).
