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3.
J Am Med Dir Assoc ; 23(2): 311-314.e2, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34896058

RESUMO

The COVID-19 pandemic presented significant challenges to face-to-face communication with people residing in post-acute and long-term care (PALTC) settings. Telemedicine is an alternative, but facility staff may be overburdened with the management of the equipment. Here we introduce the use of a mobile HIPPA-compliant telepresence robot (MTR) to bridge this barrier, which may be beneficial to reimagine options for PALTC in the future.


Assuntos
COVID-19 , Procedimentos Cirúrgicos Robóticos , Telemedicina , Humanos , Casas de Saúde , Pandemias , SARS-CoV-2
4.
Am J Physiol Endocrinol Metab ; 300(5): E771-8, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21325108

RESUMO

Acute alcohol consumption is reported to decrease mean arterial pressure (MAP) during orthostatic challenge, a response that may contribute to alcohol-mediated syncope. Muscle sympathetic nerve activity (MSNA) increases during orthostatic stress to help maintain MAP, yet the effects of alcohol on MSNA responses during orthostatic stress have not been determined. We hypothesized that alcohol ingestion would blunt arterial blood pressure and MSNA responses to lower body negative pressure (LBNP). MAP, MSNA, and heart rate (HR) were recorded during progressive LBNP (-5, -10, -15, -20, -30, and -40 mmHg; 3 min/stage) in 30 subjects (age 24 ± 1 yr). After an initial progressive LBNP (pretreatment), subjects consumed either alcohol (0.8 g ethanol/kg body mass; n = 15) or placebo (n = 15), and progressive LBNP was repeated (posttreatment). Alcohol increased resting HR (59 ± 2 to 65 ± 2 beats/min, P < 0.05), MSNA (13 ± 3 to 19 ± 4 bursts/min, P < 0.05), and MSNA burst latency (1,313 ± 16 to 1,350 ± 17 ms, P < 0.05) compared with placebo (group × treatment interactions, P < 0.05). During progressive LBNP, a pronounced decrease in MAP was observed after alcohol but not placebo (group × time × treatment, P < 0.05). In contrast, MSNA and HR increased during all LBNP protocols, but there were no differences between trials or groups. However, alcohol altered MSNA burst latency response to progressive LBNP. In conclusion, the lack of MSNA adjustment to a larger drop in arterial blood pressure during progressive LBNP, coupled with altered sympathetic burst latency responses, suggests that alcohol blunts MSNA responses to orthostatic stress.


Assuntos
Depressores do Sistema Nervoso Central/farmacologia , Etanol/farmacologia , Hipotensão Ortostática/fisiopatologia , Sistema Nervoso Simpático/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Depressores do Sistema Nervoso Central/sangue , Etanol/sangue , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Pressão Negativa da Região Corporal Inferior , Masculino , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/inervação , Fluxo Sanguíneo Regional/efeitos dos fármacos , Resistência Vascular/efeitos dos fármacos , Adulto Jovem
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