[Effect of acupuncture on radial artery hemodynamics. Two controlled studies in pre-exposed and naive healthy subjects]. / Effets de l'acupuncture sur l'hémodynamique de l'artère radiale. Deux essais contrôlés chez des patients pré-exposés et chez des sujets sains naïfs.

Palpation of the radial pulses is one of the most important techniques in traditional Chinese medicine. Two double-blind randomised trials of the effects of real and sham acupuncture on radial artery hemodynamics were conducted in 19 patients regularly exposed to acupuncture (sensitised subjects), and in 8 healthy subjects devoid of previous exposure (naive subjects), respectively. Radial artery diameter and pulse waveform was measured with a high-resolution echotracking system and aplanation tonometry, respectively, before and during a 20-minute's acupuncture period. In sensitised patients, arterial diameter significantly increased during real acupuncture, compared to the sham group (+7.5 +/- 2.8% vs -2.9 +/- 2.7%, respectively; p < 0.01). By contrast, in naive subjects, arterial diameter did not change during real or sham acupuncture. In both populations, no significant difference was observed between real and sham acupuncture, concerning the time-course of blood pressure, radial artery distensibility and pressure waveform. Our results demonstrate that real acupuncture can determine an objective vasodilatation of the radial artery in patients regularly exposed to acupuncture, but not in naive subjects.

Effects of acupuncture on radial artery hemodynamics: controlled trials in sensitized and naive subjects.

Palpation of the radial pulses is an important technique in traditional Chinese medicine. Two double-blind randomized trials of the effects of real and sham acupuncture on radial artery hemodynamics were conducted in 19 patients regularly exposed to acupuncture (sensitized subjects) and in 8 healthy subjects devoid of previous exposure (naive subjects), respectively. Radial artery diameter and pulse waveform were measured with a high-resolution echotracking system and aplanation tonometry, respectively, before and during a 20-min acupuncture period. In sensitized patients, arterial diameter significantly increased during real acupuncture, compared with the sham group (+7.5 +/- 2.8 vs. -2.9 +/- 2.7%, respectively; P < 0.01). By contrast, in naive subjects, arterial diameter did not change during real or sham acupuncture. In both populations, no significant difference was observed between real and sham acupuncture, concerning the time course of blood pressure, radial artery distensibility, and pressure waveform. Our results demonstrate that real acupuncture is associated with an objective vasodilatation of the radial artery in patients regularly exposed to acupuncture, but not in naive subjects.

[Medium- and long-term results of valvular prostheses]. / Resultados a médio e longo prazo das próteses valvulares.

Two hundred and thirty-nine patients undergoing cardiac valve replacement were analyzed from follow-up point of view. One hundred and twenty eight (53.6%) were female and 169 (70.7%) were of the white race. Twenty one (8.8%) were less than or equal to 20 years, 94 (39.2%) were greater than 20 and less than 40 years, 107 (44.7) were greater than or equal to 40 and less than 60 and 17 (7.3) greater than or equal to 60 years old. In 118 surgeries (45.3%) the heart valve was replaced by bioprosthesis and in 142 (54.7%) by mechanical prosthesis. In the bioprosthesis group the mitral valve was replaced 109 times (92.3%), aortic 6 (5%) and tricuspid 3 (2.5%). In the mechanical group the aortic valve was replaced 98 times (69%) and the mitral valve 44(31%). The patients had a follow-up period that ranged from 3 months to 18 years with mean 5 years. Before the surgery 15 patients (6.3%) were in functional class I, 38 (15.9%) in class II, 135 (56.5%) in class II and 51 (21.3%) in class IV. During the follow-up period we observed that 190 patients (79.5%) were in functional class I, 36 (15%) in class II, 11 (4.3%) in class III and only 2 (8%) in class IV. From the radiological point of view we observed that, during the period of observation, 62 (32.4%) normalized the heart size. During the follow-up period we observed that 20 patients (8.4%) presented prosthesis related complications, 15 (75%) with bioprosthesis and 5 (25%) with mechanical prosthesis. Eleven (55%) enduented reoperation without mortality.(ABSTRACT TRUNCATED AT 250 WORDS)