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1.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852069

RESUMEN

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Asunto(s)
Atención Ambulatoria , Presión Sanguínea/fisiología , Diabetes Mellitus/fisiopatología , Hipertensión/fisiopatología , Oscilometría/métodos , Análisis de la Onda del Pulso/métodos , Rigidez Vascular/fisiología , Brasil/epidemiología , Estudios Transversales , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Factores de Riesgo , Sístole
2.
Infect Immun ; 87(8)2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31085707

RESUMEN

The major problem with Chagas disease is evolution of the chronic indeterminate form to a progressive cardiac disease. Treatment diminishes parasitemia but not clinical progression, and the immunological features involved are unclear. Here, we studied the clinical course and the immune response in patients with chronic-phase Chagas disease at 48 months after benznidazole treatment. Progression to the cardiac form of Chagas disease or its aggravation was associated with higher in vitro antigen-specific production of interferon gamma (IFN-γ) in patients with cardiac Chagas disease than in patients with the indeterminate form. Predominance of IFN-γ production over interleukin-10 (IL-10) production in antigen-specific cultures was associated with cardiac involvement. Significantly higher numbers of antigen-specific T helper 1 cells (T-Bet+ IFN-γ+) and a significantly higher IFN-γ+/IL-10+ ratio were observed in patients with cardiac Chagas disease than in patients with the indeterminate form. Cardiac damage was associated with higher numbers of T helper cells than cytotoxic T lymphocytes producing IFN-γ. Patients with cardiac Chagas disease had predominant CD25- and CD25low T regulatory (Treg) subpopulations, whereas patients with the indeterminate form manifested a higher relative mean percentage of CD25high Treg subpopulations. These findings suggest that at 48 months after benznidazole treatment, the disease can worsen or progress to the cardiac form. The progression may be related to increased IFN-γ production (mostly from CD4+ T cells) relative to IL-10 production and increased Treg percentages. Patients with the indeterminate form of Chagas disease show a more balanced ratio of proinflammatory and anti-inflammatory cytokines.


Asunto(s)
Enfermedad de Chagas/tratamiento farmacológico , Citocinas/biosíntesis , Nitroimidazoles/uso terapéutico , Linfocitos T/inmunología , Anciano , Enfermedad de Chagas/inmunología , Femenino , Humanos , Inmunofenotipificación , Interferón gamma/biosíntesis , Interleucina-10/biosíntesis , Masculino , Persona de Mediana Edad , Linfocitos T Reguladores/inmunología
3.
Pacing Clin Electrophysiol ; 41(7): 788-798, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29781516

RESUMEN

BACKGROUND: Patients with chronic Chagas cardiopathy (CCC), which may be associated with cardiac arrhythmias, frequently use amiodarone, an antiarrhythmic drug that, experimentally, appears to modulate the cardiac autonomic function. OBJECTIVE: The present cross-sectional observational study aimed to evaluate autonomic cardiac modulation in patients with CCC undergoing chronic amiodarone therapy. METHODS: Three groups were investigated: Group 1 included patients with CCC not treated with amiodarone (n = 27); Group 2 included patients with CCC with prolonged use (at least 6 months) of amiodarone (n = 16); and Group 3 included non-Chagasic control patients (n = 23). All patients underwent a complete clinical and laboratory assessment, followed by autonomic function tests, consisting of a basal continuous electrocardiogram in the resting supine position for 10 minutes, followed by a change the orthostatic posture for a further 5 minutes. Heart rate variability (HRV) parameters (median and interquartile interval) were quantified using linear methods in the time- and frequency-domains (autoregressive spectral analysis) and nonlinear methods, including symbolic analysis. RESULTS: Patients with CCC using amiodarone had changes in HRV suggestive of an offset in the sympatho-vagal balance with a vagal modulation predominance (normalized HF, 49.7[27.4] vs 31.1[22.8] [P < 0.05]; and percentage 2V, 40.1 [14.6] vs 21.5 [13.4] [P < 0.05] vs untreated CCC group). These changes were further accompanied by increases in parameters indicative of greater complexity of HRV. CONCLUSIONS: The deviation in the sympatho-vagal balance and the increase in the complexity of HRV strongly suggest that amiodarone may have a cardioprotective effect, in addition to its antiarrhythmic effects, which could increase the survival of these patients.


Asunto(s)
Amiodarona/farmacología , Antiarrítmicos/farmacología , Sistema Nervioso Autónomo/efectos de los fármacos , Cardiomiopatía Chagásica/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Anciano , Amiodarona/uso terapéutico , Antiarrítmicos/uso terapéutico , Arritmias Cardíacas/complicaciones , Arritmias Cardíacas/tratamiento farmacológico , Cardiomiopatía Chagásica/complicaciones , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo
4.
Complement Ther Med ; 30: 73-78, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28137530

RESUMEN

BACKGROUND: Biofield therapies, such as laying on of hands, are used in association with Conventional Medicine as Spiritist "passe", among others. The aim of this study was to evaluate anxiety, depression, pain, muscle tension and well-being, as well as physiological parameters in cardiovascular inpatients submitted to the Spiritist "passe", sham, and no intervention. METHODS: In the total, 41 cardiovascular inpatients submitted to the Spiritist "passe", sham, and no intervention during a 10-min period on 3 consecutive days. They were evaluated through anxiety and depression level, pain, the perceptions of muscle tension and well-being and physiological parameters, before and after interventions. RESULTS: A significant reduction (p=0.001) in anxiety scores and muscle tension (p=0.011), improvement of well-being (p=0.003) and a significant increase in peripheral oxyhemoglobin saturation scores (p=0.028) were observed in Spiritist "passe" patients, and a significant reduction (p=0.028) of muscle tension and improvement of well-being (p=0.045) in sham patients. However, muscle tension reduction (p=0.003) and improvement of well-being (p=0.003) were more accentuated in the Spiritist "passe" compared to sham and no intervention. CONCLUSIONS: Results suggest that the Spiritist "passe" appeared to be effective, reducing anxiety level and the perception of muscle tension, consequently improving peripheral oxyhemoglobin saturation and the sensation of well-being compared to sham and no intervention in cardiovascular inpatients.


Asunto(s)
Ansiedad/terapia , Enfermedades Cardiovasculares/psicología , Depresión/terapia , Tono Muscular/fisiología , Terapias Espirituales/métodos , Femenino , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Dolor , Manejo del Dolor/métodos , Religión
5.
J Bras Nefrol ; 34(3): 243-50, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23099829

RESUMEN

INTRODUCTION: The detection of the renal artery stenosis in hypertensive patients can be a signal of systemic arterial atherosclerosis. AIMS: To identify and characterize clinical-epidemiologically the hypertensive patients with renal artery stenosis, evaluating factors of cardiovascular risk and presence of symptomatic multiarterial atherosclerotic. METHOD: Were selected the hypertensive patients who were assisted at the Nephrological Clinic of Universidade Federal do Triângulo Mineiro (UFTM) between 2000-2010, with diagnosis of renal artery stenosis of atherosclerotic etiology. Epidemiological data were evaluated (gender, age, ethnicity), factors of cardiovascular risk (diabetes, hypercholesterolemia, hypertriglyceridemia, tabagism, metabolic syndrome), information on hypertension (time of diagnosis, family report, number of used medicines), previous cardiovascular events (acute myocardial infarctation, ischemic stroke, peripheral arterial disease). Blood pressure levels, global cardiovascular risk and Score Framingham were stratified. RESULTS: Casuistry of 30 patients, feminine majority (73.3%), average of 66 year-old age, 86.67% white, medium time of hypertension of 19.94 years, 89.92 without family report, 13.8 with diabetes, 65.51% smoking, 17.25% hypertriglyredemia, 62.06% with hypercholesterolemia and 66.7% with metabolic syndrome. Average number of medicines in use: 3.26. Dominant right-sided renal artery stenosis separately (46.7%) and in proximal third (56.7%). High creatinine levels in 40% of the patients. As for the hypertension phase, majority phase 2 (47%) and 73.3% with high global cardiovascular risk. Average Framingham Score of 13%. 66.7% presented atherosclerotic disease in another place, being infarctation the main one (53.3%). CONCLUSION: The most common correlation was with acute myocardial infarctation, what implicates in the search of the coronary compromising to the diagnosis of renal artery stenosis in hypertensive patients to try avoid future damages to the patient.


Asunto(s)
Aterosclerosis/etiología , Hipertensión/complicaciones , Obstrucción de la Arteria Renal/complicaciones , Anciano , Femenino , Humanos , Masculino , Factores de Riesgo
6.
J. bras. nefrol ; 34(3): 243-250, jul.-set. 2012. ilus, tab
Artículo en Portugués | LILACS | ID: lil-653541

RESUMEN

INTRODUÇÃO: A detecção de estenose de artéria renal em pacientes hipertensos pode ser um sinal de aterosclerose arterial sistêmica. OBJETIVOS: Identificar e caracterizar do ponto de vista clínico e epidemiológico os pacientes hipertensos com estenose de artéria renal, avaliando fatores de risco cardiovascular e presença de doença aterosclerótica multiarterial sintomática. MÉTODO: Foram selecionados os pacientes hipertensos atendidos no ambulatório de Nefrologia da Universidade Federal do Triângulo Mineiro (UFTM) entre 2000-2010, com diagnóstico de estenose de artéria renal de etiologia aterosclerótica. Avaliaram-se dados epidemiológicos (gênero, idade, etnia), fatores de risco cardiovascular (Diabetes Mellitus, hipercolesterolemia, hipertrigliceridemia, tabagismo, síndrome metabólica), informações relativas à hipertensão (tempo de diagnóstico, histórico familiar, número de medicamentos utilizados), eventos cardiovasculares prévios (infarto agudo do miocárdio, acidente vascular encefálico isquêmico, doença arterial periférica). Estratificaram-se os níveis pressóricos, risco cardiovascular global e escore Framingham. RESULTADOS: Casuística de 30 pacientes, maioria feminina (73,3%), média de idade de 66 anos, 86,67% brancos. Tempo médio de HAS de 19,94 anos, 89,28% sem histórico familiar, 13,8% com diabetes, 65,51% tabagistas, 17,25% com hipertrigliceridemia, 62,06% com hipercolesterolemia e 66,7% com síndrome metabólica. Número médio de medicamentos em uso: 3,26. Estenose de artéria renal predominante à direita quando isoladamente (46,7%) e em terço proximal (56,7%). Creatinina elevada em 40% dos pacientes. Quanto ao estágio de hipertensão, maioria estágio 2 (47%) e 73,3% com risco cardiovascular global alto. Escore Framingham Médio de 13%. 66,7% apresentavam doença aterosclerótica em outro sítio, sendo coronariano o principal (53,3%). CONCLUSÃO: A correlação mais comum foi com o infarto agudo do miocárdio, o que implica na busca do comprometimento coronário quando do diagnóstico de estenose de artéria renal em pacientes hipertensos, para tentar evitar danos futuros ao paciente.


INTRODUCTION: The detection of the renal artery stenosis in hypertensive patients can be a signal of systemic arterial atherosclerosis. AIMS: To identify and characterize clinical-epidemiologically the hypertensive patients with renal artery stenosis, evaluating factors of cardiovascular risk and presence of symptomatic multiarterial atherosclerotic. METHOD: Were selected the hypertensive patients who were assisted at the Nephrological Clinic of Universidade Federal do Triângulo Mineiro (UFTM) between 2000-2010, with diagnosis of renal artery stenosis of atherosclerotic etiology. Epidemiological data were evaluated (gender, age, ethnicity), factors of cardiovascular risk (diabetes, hypercholesterolemia, hypertriglyceridemia, tabagism, metabolic syndrome), information on hypertension (time of diagnosis, family report, number of used medicines), previous cardiovascular events (acute myocardial infarctation, ischemic stroke, peripheral arterial disease). Blood pressure levels, global cardiovascular risk and Score Framingham were stratified. RESULTS: Casuistry of 30 patients, feminine majority (73.3%), average of 66 year-old age, 86.67% white, medium time of hypertension of 19.94 years, 89.92 without family report, 13.8 with diabetes, 65.51% smoking, 17.25% hypertriglyredemia, 62.06% with hypercholesterolemia and 66.7% with metabolic syndrome. Average number of medicines in use: 3.26. Dominant right-sided renal artery stenosis separately (46.7%) and in proximal third (56.7%). High creatinine levels in 40% of the patients. As for the hypertension phase, majority phase 2 (47%) and 73.3% with high global cardiovascular risk. Average Framingham Score of 13%. 66.7% presented atherosclerotic disease in another place, being infarctation the main one (53.3%). CONCLUSION: The most common correlation was with acute myocardial infarctation, what implicates in the search of the coronary compromising to the diagnosis of renal artery stenosis in hypertensive patients to try avoid future damages to the patient.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Aterosclerosis/etiología , Hipertensión/complicaciones , Obstrucción de la Arteria Renal/complicaciones , Factores de Riesgo
7.
REME rev. min. enferm ; 15(1): 42-46, jan.-mar. 2011. graf
Artículo en Portugués | LILACS | ID: lil-600158

RESUMEN

As doenças cardiovasculares representam a principal causa de morbimortalidade e estão associadas a vários fatores de risco. Trata-se de um estudo observacional, transversal, que teve como objetivos caracterizar os clientes submetidos à cineangiocoronariografia, segundo as variáveis socioeconômicas, clínicas e epidemiológicas, identificar os fatores de risco para coronariopatias e o conhecimento prévio sobre o procedimento. Foram entrevistados 107 clientes na Unidade de Hemodinâmica de um hospital de ensino de grande porte de Minas Gerais. Os dados foram analisados segundo estatística descritiva. A média de idade foi de 60,13 anos; 51,4% eram do sexo masculino; 75,7% afirmaram que tinham hipertensão arterial; 37,4%, que tinham história pregressa de infarto agudo do miocárdio; 46,7%, dislipidemia; 58,9%eram tabagistas; 25,2% etilistas; 70,1% sedentários; 35,5% tinham sobrepeso; 19,6% eram obesos; e 28,9% tinham diabetes mellitus. A maioria relatou que conhecia o procedimento e já o tinha realizado. Esses achados apontam para a necessidade de implementação de novos programas de prevenção de doença coronariana, tendo em vista os aspectos epidemiológicos identificados nessa população.


Cardiovascular diseases are the leading cause of morbidity and mortality. These diseases are associated with multiplerisk factors. This is an observational study that aimed to characterize patients who underwent coronary angiography, according to the socio, clinical and epidemiological variable and to identify the coronary heart disease risk factors and the patients’ previous knowledge about the procedure. We interviewed 107 clients in the catheterization lab of a large teaching hospital in Minas Gerais. Data were analyzed using descriptive statistics. The average age was 60.13 years, 51.4% were male, 75.7% had hypertension, 37.4% had a history of myocardial infarction, 46.7% had dyslipidemia, 58.9% were smokers, 25.2% consumed alcohol, 70.1% were sedentary, 35.5% were overweight, 19.6% were obese and 28.9% had diabetes mellitus. Most patients reported being familiar with the procedure and had already been submitted to it previously. In view of the epidemiological aspects identified among this population the study findings highlight the need for the implementation of new programs directed to the prevention of coronary disease.


Las enfermedades cardiovasculares son la principal causa de morbilidad y mortalidad y están asociadas a múltiplesfactores de riesgo. Se trata de un estudio observacional con el objetivo de caracterizar los clientes sometidos a unacineangiocoronariografia según las variables socioeconómicas, clínicas y epidemiológicas, identificar los factores de riesgo para coronariocardiopatías y asimismo, los conocimientos sobre el procedimiento precedente. Entrevistamos a 107 clientes de la Unidad de Hemodinámica de un gran hospital escuela del Estado de Minas Gerais. Los datos fueron analizados utilizando la estadística descriptiva. La edad promedio fue de 60,13 años, 51,4% eran varones, 75,7% hipertensos, 37,4% tenía antecedentes de infarto de miocardio, 46,7%dislipemia, 58,9 % era fumadores, 25,2% consumía alcohol, 70,1% era sedentario, 35,5% estaba con sobrepeso, 19,6% era obeso y 28,9% tenía diabetes mellitus. La mayoría informó estar familiarizada con el procedimiento y que ya lo había realizado antes. Estos datos señalan lanecesidad de implementar nuevos programas para la prevención de la enfermedad coronaria, teniendo en cuenta los aspectos epidemiológicos identificados en esta población.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Cateterismo Cardíaco , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/mortalidad , Factores de Riesgo , Factores Socioeconómicos
8.
REME rev. min. enferm ; 15(1): 42-46, jan. - mar. 2011. graf
Artículo en Portugués | BDENF - Enfermería | ID: bde-20304

RESUMEN

As doenças cardiovasculares representam a principal causa de morbimortalidade e estão associadas a vários fatores derisco. Trata-se de um estudo observacional, transversal, que teve como objetivos caracterizar os clientes submetidos àcineangiocoronariografia, segundo as variáveis socioeconômicas, clínicas e epidemiológicas, identificar os fatores derisco para coronariopatias e o conhecimento prévio sobre o procedimento. Foram entrevistados 107 clientes na Unidadede Hemodinâmica de um hospital de ensino de grande porte de Minas Gerais. Os dados foram analisados segundoestatística descritiva. A média de idade foi de 60,13 anos; 51,4% eram do sexo masculino; 75,7% afirmaram que tinhamhipertensão arterial; 37,4%, que tinham história pregressa de infarto agudo do miocárdio; 46,7%, dislipidemia; 58,9%eram tabagistas; 25,2% etilistas; 70,1% sedentários; 35,5% tinham sobrepeso; 19,6% eram obesos; e 28,9% tinhamdiabetes mellitus. A maioria relatou que conhecia o procedimento e já o tinha realizado. Esses achados apontam para anecessidade de implementação de novos programas de prevenção de doença coronariana, tendo em vista os aspectosepidemiológicos identificados nessa população.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/mortalidad , Factores de Riesgo , Cateterismo Cardíaco , Factores Socioeconómicos
9.
Auton Neurosci ; 131(1-2): 94-101, 2007 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-16807132

RESUMEN

Chagas' disease is a common cause of cardiac autonomic impairment. In an endemic area there is a predominance of the indeterminate form and the number of elderly individuals committed by the disease is increasing. This study aimed to investigate the profile of heart rate variability (HRV) in elderly chagasic patients. 28 aged chagasic (CH), 28 non-chagasic (NC) aged individuals and 28 adults between 20 and 40 years old (YG) were studied. R-R intervals were assessed in time and frequency domains applying an autoregressive algorithm. There was no difference regarding temporal and spectral indices among the elderly groups in baseline. The values of the variance in CH, NC and YG individuals were 891.80, 283.60, 2557.00, showing a reduction of the total HRV in the aged groups when compared to the young control (p < 0.001). During the cold face test, the pNN50 response was significantly different only in the young group (p < 0.001). The temporal and spectral indices were not different among the elderly groups. The percentile changes of the R-R intervals induced by the tilt test in CH, NC and YG were respectively -7.04%, -9.35%, -15.81%, being significantly higher in the young individuals (p < 0.001). There was no difference regarding the percentile changes of the temporal and spectral indices between CH and NC elderly patients. The cardiac autonomic function assessed by HRV parameters presented no differences among the elderly individuals (CH and NC) living in an endemic area.


Asunto(s)
Sistema Nervioso Autónomo/fisiopatología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedad de Chagas/complicaciones , Enfermedad de Chagas/epidemiología , Evaluación Geriátrica , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Algoritmos , Análisis de Varianza , Bradicardia/fisiopatología , Enfermedades Cardiovasculares/patología , Enfermedad de Chagas/patología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Taquicardia/fisiopatología , Factores de Tiempo
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