Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
1.
Reprod Sci ; 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509400

RESUMO

It is unknown if recurrent urinary tract infection in the gynecologic population is associated with Mycoplasma and Ureaplasma genitourinary infections. The purpose of this scoping review is to highlight the literature surrounding Mycoplasma and Ureaplasma infections in the setting of recurrent urinary tract infections in the gynecologic population. MEDLINE ALL and Embase were searched to retrieve articles published in or after 1950 through 2024. Studies included were those with adults over age 18, non-pregnant, diagnosed with recurrent urinary tract infection and concurrent genitourinary infection with Ureaplasma or Mycoplasma published in English. Study designs eligible were quantitative, qualitative, and mixed methods studies. Publication types were also extended to conference abstracts and unpublished data. 2 independent investigators systematically performed title/abstract screening and full-text review using standardized inclusion criteria. For disagreements in either title and abstracts or full-text articles, consensus was reached through discussion by the 2 screeners and/or a 3rd final adjudicator. Screening and data extraction were performed on Covidence, a web-based platform for systematic review management. There were 1170 studies identified before title and abstract screening. 26 full-text articles were reviewed for eligibility. Of these, 23 full-text studies were excluded. 3 studies met full inclusion criteria and data extraction was performed on these 3 studies. There were 2 additional studies included after identification via other methods. There is a need for more recent and robust studies examining the role of Ureaplasma and Mycoplasma genitourinary infections amongst gynecologic patients with recurrent urinary tract infections.

2.
F1000Res ; 62017.
Artigo em Inglês | MEDLINE | ID: mdl-28781748

RESUMO

ELIXIR-UK is the UK node of ELIXIR, the European infrastructure for life science data. Since its foundation in 2014, ELIXIR-UK has played a leading role in training both within the UK and in the ELIXIR Training Platform, which coordinates and delivers training across all ELIXIR members. ELIXIR-UK contributes to the Training Platform's coordination and supports the development of training to address key skill gaps amongst UK scientists. As part of this work it acts as a conduit for nationally-important bioinformatics training resources to promote their activities to the ELIXIR community. ELIXIR-UK also leads ELIXIR's flagship Training Portal, TeSS, which collects information about a diverse range of training and makes it easily accessible to the community. ELIXIR-UK also works with others to provide key digital skills training, partnering with the Software Sustainability Institute to provide Software Carpentry training to the ELIXIR community and to establish the Data Carpentry initiative, and taking a lead role amongst national stakeholders to deliver the StaTS project - a coordinated effort to drive engagement with training in statistics.

3.
Clin Neuropsychol ; 30(6): 929-43, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27355445

RESUMO

OBJECTIVE: Clinical observations and a limited number of research studies provide evidence that the fragile X premutation may confer risk for autism, executive dysfunction, and psychopathology. The link to autism spectrum symptoms and social cognition deficits with the premutation remains uncertain, and thus was the focus of the present investigation. METHOD: Our sample included 131 individuals, 42 men/22 women with the FMR1 premutation (mean age = 31.83 ± 8.59 years) with a normal neurological exam, and 48 men/19 women healthy age-matched controls (mean age = 29.48 ± 7.29 years). Individuals completed a comprehensive neuropsychological battery with additional assessments for social cognition, broad autism spectrum, and obsessive-compulsive (OC) symptoms. RESULTS: Premutation carriers self-reported higher rates of autism-related symptoms (Autism Quotient; p = .001). Among males only, premutation carriers showed more atypical social interaction (p < .001) and stereotyped behavior (p = .014) during standardized clinical examination on the Autism Diagnostic Observation Schedule (ADOS) relative to controls. Female premutation carriers reported significantly higher rates of OC symptoms compared to control females (p = .012). Molecular measures defining the expanded premutation (FMR1 CGG repeat length and/or mRNA) were significantly associated with a measure of theory of mind (Reading the Mind in the Eyes Task). CONCLUSIONS: The results of this study indicate a higher rate of broad autism spectrum symptoms in some males with the premutation and provide evidence for an obsessive-compulsive subtype in female premutation carriers.


Assuntos
Transtorno do Espectro Autista/genética , Transtorno do Espectro Autista/psicologia , Proteína do X Frágil da Deficiência Intelectual/genética , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/psicologia , Adulto , Transtorno do Espectro Autista/diagnóstico , Feminino , Síndrome do Cromossomo X Frágil/diagnóstico , Síndrome do Cromossomo X Frágil/genética , Síndrome do Cromossomo X Frágil/psicologia , Humanos , Masculino , Exame Neurológico , Testes Neuropsicológicos , Transtorno Obsessivo-Compulsivo/diagnóstico , Estimulação Luminosa/métodos , Comportamento Social , Adulto Jovem
4.
J Viral Hepat ; 20(3): 200-8, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23383659

RESUMO

Viral hepatitis reactivation has been widely reported in patients undergoing immunosuppressive therapy; however, few data are available about the risk of HBV and HCV reactivation in patients with inflammatory bowel disease, receiving immunosuppressive drugs. The aim of our study was to assess the prevalence of HBV and HCV infection in a consecutive series of patients with inflammatory bowel disease and to value the effects of immunosuppressive therapy during the course of the infection. Retrospective observational multicenter study included all consecutive patients with inflammatory bowel disease who have attended seven Italian tertiary referral hospitals in the last decade. A total of 5096 patients were consecutively included: 2485 Crohn's disease and 2611 Ulcerative Colitis. 30.5% and 29.7% of the patients were investigated for HBV and HCV infection. A total of 30 HBsAg positive, 17 isolated anti-HBc and 60 anti-HCV-positive patients were identified. In all, 20 patients with HBV or HCV infection received immunosuppressive therapy (six HBsAg+; four isolated anti-HBc+ and 10 anti-HCV+). One of six patients showed HBsAg+ and one of four isolated anti-HBc+ experienced reactivation of hepatitis. Two of six HBsAg patients received prophylactic therapy with lamivudine. Only one of 10 anti-HCV+ patients showed mild increase in viral load and ALT elevation. Screening procedures for HBV and HCV infection at diagnosis have been underused in patients with inflammatory bowel disease. We confirm the role of immunosuppressive therapy in HBV reactivation, but the impact on clinical course seems to be less relevant than previous reported.


Assuntos
Hepatite B Crônica/complicações , Hepatite C Crônica/complicações , Imunossupressores/administração & dosagem , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/tratamento farmacológico , Adolescente , Adulto , Idoso , Alanina Transaminase/sangue , Feminino , Hepacivirus/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Estudos Retrospectivos , Centros de Atenção Terciária , Carga Viral , Ativação Viral/efeitos dos fármacos , Adulto Jovem
5.
Int J Colorectal Dis ; 28(6): 783-93, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22983757

RESUMO

PURPOSE: The purpose of this study was to examine short-term outcomes of rehabilitation treatment in patients with or without previous stapled transanal resection (STARR) for rectal outlet obstruction by using a novel rehabilitation score system (Brusciano score). METHODS: This is a retrospective cohort study conducted at a single tertiary referral institution including all patients with chronic functional constipation admitted to the outpatient unit from 2004 to 2009. RESULTS: Among 330 consecutive patients, 247 (74.8 %) (204 females and 43 males) showing a significantly higher rehabilitation score (mean of 15.7 ± 1.8; range, 7-25) than healthy controls (mean, 3.2 ± 1.2; range 2-6) (p < .0001) were selected for rehabilitation. Of the 247 patients evaluated, group A (no previous surgery) consisted of 170 patients (53 males; mean age, 44.8 ± 12.9 years; range, 19-80) of which 38 presented mixed constipation, whereas group B (previous surgery) consisted of 77 patients (18 males; mean age, 47.0 ± 11.2 years; range, 22-81). The Brusciano score, Agachan-Wexner score and quality of life improved in both groups of patients after treatment. Better improvements of Brusciano and Agachan-Wexner scores were observed in patients with previous STARR (group B). CONCLUSIONS: The rehabilitation score system employed in this study seems to be a useful tool in selecting and assessing the outcome of patients who might benefit from rehabilitation treatment. Constipation and quality of life were significantly improved by the rehabilitation treatment. Further studies are needed to clarify either the impact of rehabilitation treatment on long-term outcome of patients treated for rectal outlet obstruction or its role in those who develop problems over time.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/reabilitação , Obstrução Intestinal/reabilitação , Obstrução Intestinal/cirurgia , Doenças Retais/reabilitação , Doenças Retais/cirurgia , Reto/cirurgia , Grampeamento Cirúrgico/reabilitação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Constipação Intestinal/diagnóstico por imagem , Constipação Intestinal/etiologia , Defecografia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Feminino , Humanos , Obstrução Intestinal/fisiopatologia , Masculino , Manometria , Pessoa de Meia-Idade , Doenças Retais/fisiopatologia , Reto/diagnóstico por imagem , Reto/fisiopatologia , Grampeamento Cirúrgico/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
6.
IEEE Trans Vis Comput Graph ; 18(12): 2603-12, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26357169

RESUMO

Glyph-based visualization can offer elegant and concise presentation of multivariate information while enhancing speed and ease in visual search experienced by users. As with icon designs, glyphs are usually created based on the designers' experience and intuition, often in a spontaneous manner. Such a process does not scale well with the requirements of applications where a large number of concepts are to be encoded using glyphs. To alleviate such limitations, we propose a new systematic process for glyph design by exploring the parallel between the hierarchy of concept categorization and the ordering of discriminative capacity of visual channels. We examine the feasibility of this approach in an application where there is a pressing need for an efficient and effective means to visualize workflows of biological experiments. By processing thousands of workflow records in a public archive of biological experiments, we demonstrate that a cost-effective glyph design can be obtained by following a process of formulating a taxonomy with the aid of computation, identifying visual channels hierarchically, and defining application-specific abstraction and metaphors.


Assuntos
Classificação , Biologia Computacional , Gráficos por Computador , Projetos de Pesquisa , Fluxo de Trabalho , Algoritmos , Humanos , Semântica
8.
Dig Liver Dis ; 42(2): 127-30, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19596616

RESUMO

BACKGROUND: Submucosal lifting of lesions prior to endoscopic resection is crucial to reduce complications and improve the technical feasibility of the procedure. AIM: To compare a self-assembled hydro-jet system vs. standard needle injection for tissue elevation prior to endoscopic resection of colorectal lesions. METHODS: Randomised study performed at a single tertiary care institution. Consecutive patients with colonoscopic diagnosis of sessile polyps or non-polypoid lesions >5 mm or laterally spreading tumours. OUTCOME MEASURES: successful elevation, time to proper elevation, completeness of excision, cautery damage, and general histological diagnostic quality (blinded pathologic assessment). RESULTS: 79 patients were randomised to hydro-jet (40 patients, group A) and needle (39 patients, group B) elevation. Successful elevation was achieved in 97.5% and 94.8%, respectively. Time to proper elevation was 8+/-5 s vs. 18+/-3 s (p<0.05). In group A, histology showed selective accumulation of fluid in the submucosa with intact collagen fibres. Damage to muscularis mucosa was never noted in the specimens of group A and in 7 cases of group B (p<0.01). Artefacts from "cautery effect" were very limited. Radial margins of resection could be adequately evaluated in all cases and were negative. CONCLUSIONS: The hydro-jet system is as effective and safe as standard needle injection for tissue elevation prior to endoscopic resection of colorectal lesions, but it is significantly faster.


Assuntos
Técnicas de Ablação/instrumentação , Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/cirurgia , Lesões Pré-Cancerosas/cirurgia , Técnicas de Ablação/métodos , Idoso , Biópsia/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Int J Colorectal Dis ; 24(8): 961-7, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19271224

RESUMO

PURPOSE: The aims of this study were to evaluate several clinical and instrumental parameters in a large number of patients with constipation and incontinence as well as in healthy controls and discuss their potential implications in the functional aspects of these disorders. METHODS: Eighty-four constipated and 38 incontinent patients and 45 healthy controls were submitted to a protocol based on proctologic examination, clinico-physiatric assessment, and instrumental evaluation. RESULTS: Constipated and incontinent patients had significantly worse lumbar lordosis as well as lower rate in the presence of perineal defense reflex than controls. Constipated but not incontinent patients had a lower rate of puborectalis relaxation than controls. Furthermore, worse pubococcygeal tests and a higher rate of muscle synergies presence, either agonist or antagonist, were observed in both constipated and incontinent patients compared to controls. CONCLUSIONS: This study has demonstrated strong correlations between physiatric disorders and the symptoms of constipation and incontinence. Further studies designed to demonstrate a causal relationship between these parameters and the success of a specific treatment of the physiatric disorders on the proctology symptoms are warranted.


Assuntos
Constipação Intestinal/diagnóstico , Defecação , Técnicas de Diagnóstico do Sistema Digestório , Incontinência Fecal/diagnóstico , Músculo Esquelético/fisiopatologia , Inquéritos e Questionários , Adulto , Idoso , Estudos de Casos e Controles , Constipação Intestinal/etiologia , Constipação Intestinal/fisiopatologia , Constipação Intestinal/reabilitação , Defecografia , Incontinência Fecal/etiologia , Incontinência Fecal/fisiopatologia , Incontinência Fecal/reabilitação , Feminino , Humanos , Lordose/complicações , Vértebras Lombares , Masculino , Manometria , Pessoa de Meia-Idade , Músculo Esquelético/inervação , Seleção de Pacientes , Diafragma da Pelve/fisiopatologia , Medicina Física e Reabilitação , Valor Preditivo dos Testes , Reflexo Anormal , Fatores de Risco , Ultrassonografia , Adulto Jovem
11.
J Prev Med Hyg ; 50(2): 117-20, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20099443

RESUMO

BACKGROUND: The number of patients with severe Clostridium difficile-associated diarrhoea (CDAD) increases. Health care facilities are requested to establish rates of nosocomially acquired CDAD (N-CDAD) to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. OBJECTIVE: Aim of the single-center surveillance project was to establish local prevalence rates of N-CDAD in adult acute care medical patients. METHODS: For a period of at least one year, all diarrhoeal stools from inpatients of a general internal medicine ward were tested for Clostridium difficile toxin A. Case record files were retrospectively analysed and questionnaires were completed for patients with positive stool assays who met the case definitions. RESULTS AND DISCUSSION: During the surveillance period, 2,610 medical patients had been acutely hospitalized. Stools had been submitted to the hospital laboratory from 163 patients (6.2%) because of diarrhoea and were screened for Clostridium difficile cytotoxin. Complete data sets were available for analysis from 150 patients. Of 137 identified potential cases, 77 (56.2%) met the case definitions for nosocomial diarrhoea. Thirteen of the patients with nosocomial diarrhoea (16.9%) were detected positive by the Clostridium difficile toxin A assay. The overall prevalence of N-CDAD among inpatients was 8.7 cases/100 diarrhoeal stools. The mean number ofN-CDAD cases was 62.3 cases/100,000 patient days and 5 cases/1,000 patient admissions. The mean age of N-CDAD patients was 79.4 years (range 71 to 92). All patients were given broad-spectrum antibiotics before acute diarrhoea developed. Four patients died for reasons not directly related to N-CDAD which confirms increased disease severity as an important risk factor. CONCLUSIONS: This single-center surveillance project, which established N-CDAD rates at frequencies currently reported from international surveys, is useful as benchmark and will help in understanding patterns and impact of N-CDAD at the regional level.


Assuntos
Clostridioides difficile/isolamento & purificação , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Diarreia/epidemiologia , Diarreia/microbiologia , Enterocolite Pseudomembranosa/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Diarreia/tratamento farmacológico , Enterocolite Pseudomembranosa/tratamento farmacológico , Enterocolite Pseudomembranosa/microbiologia , Fezes/microbiologia , Feminino , Hospitais de Ensino , Humanos , Itália/epidemiologia , Masculino , Prevalência , Estudos Retrospectivos
12.
Tech Coloproctol ; 11(1): 45-50, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17357866

RESUMO

BACKGROUND: No studies have specifically reported on the use of a diagnostic tool based on physiatric assessment of constipated or incontinent patients METHODS: Sixty-seven constipated and 37 incontinent patients were submitted to a standard protocol based on proctologic examination, clinico-physiatric assessment (puborectalis contraction, pubococcygeal test, perineal defence reflex, muscular synergies, postural examination) and instrumental evaluation (anorectal manometry, anal US and dynamic defaecography). Patients were offered pelvic floor rehabilitation (thoraco-abdominoperineal muscle coordination training, biofeedback, electrical stimulation and volumetric rehabilitation). RESULTS: After rehabilitation treatment, decreases of Wexner constipation score (p=0.0001) and Pescatori incontinence score (p=0.0001) were observed. CONCLUSION: This diagnostic protocol might improve the selection of patients with defaecatory disorders amenable for rehabilitation treatment.


Assuntos
Constipação Intestinal/diagnóstico , Constipação Intestinal/reabilitação , Incontinência Fecal/diagnóstico , Incontinência Fecal/reabilitação , Diafragma da Pelve/fisiopatologia , Modalidades de Fisioterapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biorretroalimentação Psicológica , Criança , Constipação Intestinal/fisiopatologia , Terapia por Estimulação Elétrica , Incontinência Fecal/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Resultado do Tratamento
13.
Nucleic Acids Res ; 33(Database issue): D553-5, 2005 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-15608260

RESUMO

ArrayExpress is a public repository for microarray data that supports the MIAME (Minimum Information About a Microarray Experiment) requirements and stores well-annotated raw and normalized data. As of November 2004, ArrayExpress contains data from approximately 12,000 hybridizations covering 35 species. Data can be submitted online or directly from local databases or LIMS in a standard format, and password-protected access to prepublication data is provided for reviewers and authors. The data can be retrieved by accession number or queried by various parameters such as species, author and array platform. A facility to query experiments by gene and sample properties is provided for a growing subset of curated data that is loaded in to the ArrayExpress data warehouse. Data can be visualized and analysed using Expression Profiler, the integrated data analysis tool. ArrayExpress is available at http://www.ebi.ac.uk/arrayexpress.


Assuntos
Bases de Dados Genéticas , Perfilação da Expressão Gênica , Análise de Sequência com Séries de Oligonucleotídeos , Animais , Biologia Computacional , Europa (Continente) , Humanos , Camundongos , Interface Usuário-Computador
14.
Memory ; 8(5): 285-92, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11045237

RESUMO

The question discussed in the two following experiments concerns the effect of facial expressions on face recognition. Famous and unknown faces with neutral or smiling expression were presented for different inspection durations (15 ms vs 1000 ms). Subjects had to categorize these faces as famous or unknown (Experiment 1), or estimate their degree of familiarity on a rating scale (Experiment 2). Results showed that the smile increased ratings of familiarity for unfamiliar faces (Experiments 1 and 2) and for famous faces (Experiment 2). These data are discussed in the framework of current face-recognition models and are interpreted in terms of social value of the smile. It is proposed that the smiling bias found here acts at the level of the decision process.


Assuntos
Sinais (Psicologia) , Memória/fisiologia , Sorriso , Face , Humanos , Modelos Teóricos , Valores Sociais , Fatores de Tempo
15.
J Hypertens ; 17(4): 513-21, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10404953

RESUMO

OBJECTIVE: To define the changes in variability of heart rate and of blood pressure during vasodilation in a group of hypertensive patients treated with an angiotensin II type I (AT1) receptor inhibitor. DESIGN: Losartan (50 mg/day at 0800 h) or placebo were administered for 3 weeks according to a single blind, crossover, randomized protocol, to 18 hypertensive patients (16 men and two women, mean age 42 + 3.6 years). Continuous ECG recording and beat-to-beat blood pressure monitoring were carried out with subjects in the supine position and during a head-up tilt test, as well as after sublingual administration of trinitroglycerine. The elaboration of ECG traces in the frequency domain, was carried out using an autoregressive method and measured using the autoregressive moving average technique. RESULTS: Orthostatic stimulus, both during treatment with losartan and with placebo, caused a significant decrease in the heart rate high frequency power; on the other hand, the low frequency power appeared unchanged after placebo and was significantly reduced with losartan. Five minutes after the administration of trinitroglycerine, the low frequency power with placebo showed a significant increase (817 -+ 221 versus 465 + 101 ms2, P < 0.03). No change was recorded in total power nor in low frequency or high frequency power during losartan therapy. The ratio of low frequency to high frequency powers showed a sympathetic prevalence during vasodilation only during placebo treatment, whereas a mainly unchanged balance was maintained during losartan treatment Blood pressure variability showed a sympathetic prevalence after upright and trinitroglycerine stimulation only in placebo-treated subjects. CONCLUSIONS: Our study demonstrated that vasodilation is not able to evoke an unbalancing of the autonomic modulation in hypertensive patients treated with an AT1 receptor inhibitor, but permits the maintenance of a significant vagal component, thus highlighting the favorable profile of this drug in the autonomic control of circulation.


Assuntos
Antagonistas de Receptores de Angiotensina , Anti-Hipertensivos/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Losartan/farmacologia , Adulto , Anti-Hipertensivos/uso terapêutico , Barorreflexo/efeitos dos fármacos , Estudos Cross-Over , Feminino , Humanos , Losartan/uso terapêutico , Masculino , Nitroglicerina , Receptor Tipo 1 de Angiotensina , Receptor Tipo 2 de Angiotensina , Método Simples-Cego , Teste da Mesa Inclinada , Vasodilatação
16.
Clin Sci (Lond) ; 96(1): 49-57, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9857106

RESUMO

Our aim was to investigate the sympathetic hyperactivity of systemic sclerosis that may lead to greater morbidity and mortality from cardiovascular events. We analysed the sympathetic (low-frequency) and vagal (high-frequency) components of heart rate variability, in supine and upright positions, in 10 patients with systemic sclerosis, 12 patients with primary Raynaud's phenomenon and 14 controls. We also analysed lung function in order to evaluate a possible link between heart rate variability and ventilation parameters. Heart rate variability was reduced in the supine position in subjects with systemic sclerosis both in comparison with primary Raynaud's phenomenon (total power: 1103+/-156 versus 3302+/-486 ms2, P<0.004) and control subjects (3148+/-422 ms2, P<0.002). Low-frequency power was higher in patients with systemic sclerosis than in the controls (54.5+/-4.5 versus 42.5+/-3.5 normalized units, P<0.01). During tilt, the change in heart rate was +44% in controls, +24% in subjects with primary Raynaud's phenomenon, and only +17% in the patients with systemic sclerosis (P<0.01 versus controls). In patients with systemic sclerosis we found a significant correlation between high-frequency power and the indices of lung function (residual volume: r2=0.5143, P<0.01; total lung capacity: r2=0.5142, P<0.01, vital capacity: r2=0.3789, P<0.05). Heart rate variability was reduced and sympathetic output increased in patients with systemic sclerosis. Subjects with primary Raynaud's phenomenon were characterized by normal heart rate variability and by some degree of sympathetic hyperactivity. During tilting, subjects with systemic sclerosis maintained an unmodified heart rate variability, thus suggesting an impaired baroceptor modulation of the autonomic control. The negative correlation between high-frequency power and indices of respiratory insufficiency in patients with systemic sclerosis suggests that the pulmonary structure plays an important role in the modulation of heart rate variability.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Doença de Raynaud/fisiopatologia , Escleroderma Sistêmico/fisiopatologia , Adulto , Análise de Variância , Eletrocardiografia , Feminino , Frequência Cardíaca , Humanos , Pulmão/fisiopatologia , Pessoa de Meia-Idade , Processamento de Sinais Assistido por Computador , Estatísticas não Paramétricas , Teste da Mesa Inclinada
17.
Clin Exp Rheumatol ; 15(4): 381-5, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9272298

RESUMO

OBJECTIVE: To evaluate the effects of iloprost infusion on the microcirculation in patients suffering from severe Raynaud's phenomenon secondary to systemic sclerosis. METHODS: Eight patients received a 7-hour infusion of iloprost for five consecutive days and then for one day 3 months later. The effects on vascular distensibility were evaluated by piezoelectric plethysmography before and after the treatment and at 2, 4 and 6 weeks. RESULTS: The beneficial effects on the peripheral microcirculation were statistically significant after five days of infusion (distensibility index: 0.18 +/- 0.01 vs 0.23 +/- 0.01, p < 0.002) and lasted for less than four weeks, whereas no difference (0.22 +/- 0.04 vs 0.24 +/- 0.02, p: ns) was seen after one day of treatment. One patient suffered from typical angina pectoris with electrocardiographic changes of the ST wave detected during the infusion. CONCLUSION: Our results show that a five-day infusion of iloprost has an effect which lasts from two to four weeks; after four weeks the distensibility index returned to the baseline value. The one-day infusion had no effect on the vascular bed, studied by the piezoelectric pletysmographic method. Treatment with five consecutive days of infusion every four weeks is an impracticable scheme to adopt, however. We have therefore instituted a treatment schedule of a single daily infusion every four weeks with the aim of maintaining the effects induced by the initial five-day infusion. The preliminary results obtained with this schedule are reported.


Assuntos
Iloprosta/administração & dosagem , Inibidores da Agregação Plaquetária/administração & dosagem , Escleroderma Sistêmico/tratamento farmacológico , Vasodilatadores/administração & dosagem , Adulto , Esquema de Medicação , Feminino , Humanos , Iloprosta/efeitos adversos , Infusões Intravenosas , Microcirculação/efeitos dos fármacos , Microcirculação/fisiologia , Pessoa de Meia-Idade , Monitorização Fisiológica , Inibidores da Agregação Plaquetária/efeitos adversos , Pletismografia/métodos , Escleroderma Sistêmico/fisiopatologia , Vasodilatadores/efeitos adversos
18.
J Intern Med ; 242(5): 373-6, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9408065

RESUMO

OBJECTIVES: To assess the role of thromboxane A2 and of angiotensin II in patients with primary Raynaud's phenomenon. DESIGN: After an eight-day run-in period, the patients were enrolled in a single-blind, cross-over, study. SETTING: Patients were examined at the Ambulatory for Microcirculatory Diseases of the Clinic of Internal Medicine, University Hospital, Verona. SUBJECTS: Fifteen subjects affected by primary Raynaud's phenomenon were included. MAIN OUTCOME MEASURES: A piezoelectric plethysmography to evaluate the distensibility of the digital arteries as the ratio between peak time (PT) and total time (TT), and an oscillometric blood pressure recorder were used after the run-in period, and after a two-week course of picotamide (300 mg b.i.d., i.e. two times daily) or losartan (12.5 mg once daily) with an interval of a week of placebo between the active treatments. The tests were performed after every treatment in basal condition and during mental stress. The patients reported in a diary the number and the severity (from 0 to 4 +) of the vasospastic crises. RESULTS: The change in TP/TT ratio appeared statistically significant only after losartan treatment, both in basal condition and during mathematical stress. Both pharmacological treatments, with respect to placebo, showed an improvement of the scores, derived from the number and severity of vasospastic attacks, but only the therapy with losartan determined a statistically significant improvement. CONCLUSIONS: The inhibition of the type 1 receptor for angiotensin II seems highly effective in the reduction of the vasospastic crises in the subjects with primary Raynaud's phenomenon. According to our experience, losartan could be used more extensively in the treatment of these patients besides arterial hypertension.


Assuntos
Angiotensina II/metabolismo , Antagonistas de Receptores de Angiotensina , Anti-Hipertensivos/uso terapêutico , Losartan/uso terapêutico , Ácidos Ftálicos/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Doença de Raynaud/tratamento farmacológico , Tromboxano A2/antagonistas & inibidores , Adolescente , Adulto , Pressão Sanguínea/efeitos dos fármacos , Estudos Cross-Over , Esquema de Medicação , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pletismografia , Doença de Raynaud/fisiopatologia , Método Simples-Cego , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...