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1.
Vasc Endovascular Surg ; 54(1): 75-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31506016

RESUMO

Brachial artery aneurysms and arteriovenous malformations (AVM) are limb-threatening vascular anomalies. This patient presented with a bilobed brachial artery aneurysm in the antecubital fossa proximally to an AVM arising from the dorsal interosseous and ulnar arteries that had been treated with endovascular embolization, leaving the hand solely supplied by the radial artery. The aneurysm continued to increase in size and imaging revealed concomitant thrombus. A femoral vein interposition graft was used to repair the aneurysm, and postoperatively, the patient retained full left arm function.


Assuntos
Aneurisma/cirurgia , Malformações Arteriovenosas/complicações , Artéria Braquial/cirurgia , Veia Femoral/transplante , Artéria Ulnar/anormalidades , Adolescente , Aneurisma/complicações , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/fisiopatologia , Embolização Terapêutica , Feminino , Humanos , Resultado do Tratamento , Artéria Ulnar/diagnóstico por imagem , Grau de Desobstrução Vascular
2.
Vasc Endovascular Surg ; 54(1): 5-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31506033

RESUMO

INTRODUCTION: High flow rates may develop in arteriovenous fistula (AVF), resulting in clinical syndromes of steal, aneurysmal fistula, or high-output cardiac failure. Various techniques with varying success have been advocated to treat this difficult problem. We present a hemodynamically validated novel banding technique. METHODS: We designed a computational fluid dynamic (CFD) model of the native high-flow AVF and tested various juxta-anastomotic venous diameters to determine the effect on AVF blood flow and pressure. We translated this principle in our banding technique, wherein adjustable banding was performed in conjunction with ultrasound-guided brachial artery flow measurement to determine the optimal band diameter. Polyurethane patch was used to fashion the adjustable band. Patient demographics, AVF flow parameters pre- and postintervention, operative intervention, and ultrasound follow-up data were collected prospectively. RESULTS: Our CFD testing demonstrated that the band diameter needed to achieve optimal distal blood pressure and preserve AVF flow depending on blood pressure, end capillary pressure, venous pressure, and vascular diameters. Five patients subsequently underwent dynamic banding of symptomatic high-flow AVF. Mean brachial artery blood flow rates pre- and postbanding were 2964 mL/min (confidence interval [CI]: 1487-4440 mL/min) and 1099 mL/min (CI: 571.7-1627 mL/min), respectively (P = .01). All patients had symptomatic improvement, and at a mean follow-up of 1 year, this benefit was sustained with no AVF thrombosis or loss. CONCLUSION: Adjustable dynamic band using ultrasound-guided brachial artery flow shows promising results in producing accurate AVF blood flow reduction with sustained efficacy in the short term for patients with symptomatic high-flow AVF.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Artéria Braquial/fisiopatologia , Hemodinâmica , Complicações Pós-Operatórias/cirurgia , Diálise Renal , Adolescente , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo , Artéria Braquial/diagnóstico por imagem , Simulação por Computador , Humanos , Ligadura , Pessoa de Meia-Idade , Modelos Cardiovasculares , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/fisiopatologia , Estudos Prospectivos , Fluxo Sanguíneo Regional , Reoperação , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia de Intervenção
3.
Vasc Endovascular Surg ; 54(1): 80-84, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31533547

RESUMO

Brachial artery pseudoaneurysms (BAPs) are rare but could lead to complications of high morbidity. We report a case of a BAP presenting with hand ischemia and median nerve neuropathy nearly a decade after the inciting iatrogenic trauma, successfully treated with excision and direct repair. This report highlights that untreated pseudoaneurysms can be indolent and present late with both symptoms of embolization and local compression.


Assuntos
Falso Aneurisma/etiologia , Artéria Braquial/lesões , Doença Iatrogênica , Isquemia/etiologia , Flebotomia/efeitos adversos , Extremidade Superior/irrigação sanguínea , Lesões do Sistema Vascular/etiologia , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/fisiopatologia , Falso Aneurisma/cirurgia , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/fisiopatologia , Artéria Braquial/cirurgia , Humanos , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Isquemia/cirurgia , Masculino , Neuropatia Mediana/etiologia , Fluxo Sanguíneo Regional , Fatores de Tempo , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/fisiopatologia , Lesões do Sistema Vascular/cirurgia
4.
Medicine (Baltimore) ; 98(50): e18249, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852092

RESUMO

RATIONALE: Cancer and chemotherapy individually confer hypercoagulability and increased risks of thrombosis. Most thromboembolic complication after breast cancer chemotherapy was venous thrombosis after multiagent chemotherapy. Arterial thrombosis is extremely rare in early breast cancer patients receiving adjuvant chemotherapy. PRESENTING CONCERNS: A 55-year-old woman with right breast cancer presented to the emergency department with sudden pain, numbness, and swelling in her left hand. She underwent breast conserving surgery and sentinel lymph node biopsy 2 months before the visit. She received the second cycle of adjuvant Adriamycin-cyclophosphamide chemotherapy 5 days before. INTERVENTIONS: Computed tomography angiography revealed acute arterial thrombosis in the left brachial, radial, and ulnar arteries. Unfractionated heparin was initiated immediately, followed by brachial and radial-ulnar thrombectomy, restoring perfusion to the extremity. The postoperative course was uncomplicated; she was discharged on warfarin at a daily dose of 4 mg. OUTCOMES: Chemotherapy was discontinued. Anticoagulation with warfarin was continued. She subsequently received adjuvant endocrine therapy with an aromatase inhibitor and adjuvant radiotherapy. MAIN LESSONS: Despite the low risks of arterial thrombosis in breast cancer, it is a devastating complication with significant morbidity and mortality. Thromboprophylaxis should be considered in those at risk. Immediate anticoagulant therapy and surgical intervention should be considered in affected cases.


Assuntos
Artéria Braquial , Neoplasias da Mama/tratamento farmacológico , Ciclofosfamida/efeitos adversos , Doxorrubicina/efeitos adversos , Artéria Radial , Trombose/induzido quimicamente , Artéria Ulnar , Doença Aguda , Neoplasias da Mama/diagnóstico , Quimioterapia Adjuvante/efeitos adversos , Angiografia por Tomografia Computadorizada , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Quimioterapia Combinada/efeitos adversos , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Trombectomia/métodos , Trombose/diagnóstico , Trombose/cirurgia , Ultrassonografia Doppler
5.
Am Surg ; 85(9): 1040-1043, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638521

RESUMO

Although vascular surgery guidelines recommend immediate anticoagulation for acute occlusion of a peripheral artery, it is unclear whether trauma surgeons follow this practice. A survey regarding the use of perioperative anticoagulation was sent to surgeons who perform their own peripheral arterial repairs after traumatic injury to define contemporary practice patterns. This survey demonstrated minimal consensus opinion regarding the management of extremity vascular injuries, strongly suggesting the need for a consensus conference, meta-analysis, and prospective studies to guide further care.


Assuntos
Anticoagulantes/uso terapêutico , Assistência Perioperatória , Padrões de Prática Médica , Lesões do Sistema Vascular/cirurgia , Adulto , Idoso , Arteriopatias Oclusivas/cirurgia , Artéria Axilar/lesões , Artéria Axilar/cirurgia , Artéria Braquial/lesões , Artéria Braquial/cirurgia , Artéria Femoral/lesões , Artéria Femoral/cirurgia , Hemorragia/cirurgia , Humanos , Pessoa de Meia-Idade , Artéria Poplítea/lesões , Artéria Poplítea/cirurgia , Lesões dos Tecidos Moles/cirurgia , Cirurgiões
6.
Clin Exp Rheumatol ; 37 Suppl 119(4): 97-101, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31573479

RESUMO

OBJECTIVES: The fingers, toes, and tips of the nose and ears have specialised structural and functional features for thermoregulation, and are the most common areas of Raynaud's phenomenon in systemic sclerosis. Digital thermal monitoring (DTM) of vascular reactivity assesses Doppler ultrasound hyperemic, low frequency, blood velocity of radial artery and fingertip vascular function. Flow mediated dilation (FMD) is an indirect measure of endothelial function, perfusion, and vasodilator ability. In this study, we investigated the cross-sectional correlation of FMD and DTM variables to inform an optimised noninvasive study of SSc endothelial function. A student's T-test was used to compare means of DTM across binary variables. METHODS: Consented SSc registry patients were included in this analysis. The subjects were prepared for FMD and DTM per standardised guidelines. The SSc clinical features were recorded. Spearman's Rank Correlation was used to assess the strength of a relationship FMD and DTM variables. RESULTS: Thirty-four SSc subjects had FMD and DTM performed on the same day. Relative (0.42, p=<0.02), absolute FMD (0.41, p<0.02), and shear rate (0.32, p<0.07) were weakly, but significantly correlated with the DTM. Reactive hyperemia (-0.44, p=0.000) was weakly inversely, but significantly related with DTM. Baseline diameter and flow were not significantly related to the DTM. CONCLUSIONS: This non-invasive study of SSc endothelial function suggests that macrocirculation (including relative and absolute FMD, shear rate, and peak hyperemia) and microcirculatory thermoregulation (characterised by DTM) are significantly correlated, thus warrants further prospective study.


Assuntos
Microcirculação/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Escleroderma Sistêmico , Pele/irrigação sanguínea , Artéria Braquial , Estudos Transversais , Dilatação , Endotélio Vascular , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escleroderma Sistêmico/fisiopatologia , Vasodilatação
7.
Hypertension ; 74(4): 921-928, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31446803

RESUMO

Clustering of arterial blood pressure (BP) waveform parameters could summarize complex information into distinct elements, which could be used to investigate cumulative (nonredundant) associations. We investigated this hypothesis in a large, adult population-based study (ViDA trial [Vitamin D Assessment] trial). To interpret the clusters and evaluate their usefulness, we examined their predictors and associations with cardiovascular events. In 4253 adults (mean age 65 years; 55% male) without a prior cardiovascular event, suprasystolic oscillometry was performed, yielding aortic pressure waveforms and several hemodynamic parameters. Participants were followed up for 4.6 years (median), accruing 300 cardiovascular events. Principal component analysis reduced 14 arterial waveform parameters to 3 uncorrelated factors that together explained 90% of the variability of the original data. Factors 1, 2, and 3 appeared to represent BP pulsatility, mean BP, and wave reflection, respectively. Across 6 antihypertensive drug classes, there were no differences in brachial systolic (P=0.23) and diastolic (P=0.13) BP; but there were significant variations in factor 3 (P<0.0001), especially for ß-blocker use. The first and third factors were positively associated with cardiovascular events (multivariable-adjusted standardized hazard ratio [95% CI]=1.33 [1.18-1.50] and 1.15 [1.02-1.30], respectively), whereas the second factor had a J-shaped relationship, with a nadir corresponding to a brachial diastolic BP of ≈75 mm Hg. In conclusion, BP pulsatility, mean BP, and wave reflection are prognostically meaningful, distinct aspects of arterial function that can be used to summarize physiological variations in multiple arterial waveform parameters and identify truly cumulative associations when used as cardiovascular risk outcomes.


Assuntos
Pressão Arterial/fisiologia , Artéria Braquial/fisiopatologia , Hipertensão/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Arterial/efeitos dos fármacos , Feminino , Hemodinâmica , Humanos , Hipertensão/tratamento farmacológico , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso
8.
Int Heart J ; 60(5): 1030-1036, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31447463

RESUMO

Postcatheterization pseudoaneurysm is a serious complication following diagnostic or therapeutic catheterization. Because radial access is unsuitable in some situations, there is still a need to use femoral or brachial access for arterial catheterization. The aim of this study was to compare the incidence and clinical characteristics of pseudoaneurysm between brachial and femoral access. We identified patients who underwent arterial catheterization from our cardiac catheter records. A total of 5,990 cardiac catheter records and discharge summaries were reviewed, and 23 pseudoaneurysm cases were identified. Those pseudoaneurysm cases were divided into a brachial pseudoaneurysm group (n = 9) and a femoral pseudoaneurysm group (n = 14). The incidence of pseudoaneurysm was significantly higher in brachial access than in femoral access (odds ratio: 4.16, 95% confidence interval: 1.80-9.65; P < 0.001). Successful manual compression was frequently achieved in both the brachial (77.8%) and the femoral (92.9%) pseudoaneurysm groups (P = 0.295). Surgical intervention was more frequently performed in the brachial pseudoaneurysm group (22.2%) than in the femoral pseudoaneurysm group (0%) without reaching statistical significance (P = 0.07). Moreover, neurological disorders were observed only in the brachial pseudoaneurysm group (22.2%). In conclusion, the incidence of pseudoaneurysm was significantly higher in brachial access than in femoral access, indicating the potential risk of brachial access. Successful manual compression was frequently achieved in both groups, but neurological disorders were observed only in brachial access, suggesting the greater risk of brachial pseudoaneurysms.


Assuntos
Falso Aneurisma/epidemiologia , Falso Aneurisma/etiologia , Artéria Braquial , Cateterismo Cardíaco/efeitos adversos , Artéria Femoral , Adulto , Distribuição por Idade , Idoso , Falso Aneurisma/terapia , Cateterismo Cardíaco/métodos , Tratamento Conservador/métodos , Bases de Dados Factuais , Feminino , Hospitais Universitários , Humanos , Incidência , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Resultado do Tratamento
9.
Medicine (Baltimore) ; 98(34): e16966, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441902

RESUMO

The importance of optimal blood pressure control for preventing or reducing the impairment of vascular and cognitive functions is well known. However, the reversibility of early alterations in vascular and cognitive functions through antihypertensive agents is under-investigated. In this study, we evaluated the influence of 3 months of angiotensin-converting enzyme (ACE) inhibition treatment on the morphological and functional arterial wall and cognitive performance changes in 30 newly diagnosed primary hypertensive patients.Common carotid intima-media thickness (IMT) and brachial artery flow-mediated dilatation (FMD) were detected by ultrasonography. Arterial stiffness indicated by augmentation index (AIx) and pulse wave velocity (PWV) was assessed by arteriography. Cognitive functions were assessed by neuropsychological examination.The executive function overall score was significantly higher at 3-month follow-up than at baseline (median, 0.233 (IQR, 0.447) vs -0.038 (0.936); P = .001). Three-month ACE inhibition did not produce significant improvement in IMT, FMD, AIx and PWV values. Significant negative associations were revealed between IMT and complex attention (r = -0.598, P = .0008), executive function (r = -0.617, P = .0005), and immediate memory (r = -0.420, P = .026) overall scores at follow-up. AIx had significant negative correlations with complex attention (r = -0.568, P = .001), executive function (r = -0.374, P = .046), and immediate memory (r = -0.507, P = .005). PWV correlated significantly and negatively with complex attention (r = -0.490, P = .007).Timely and effective antihypertensive therapy with ACE inhibitors has significant beneficial effects on cognitive performance in as few as 3 months. Early ACE inhibition may have an important role in the reversal of initial impairments of cognitive function associated with hypertension-induced vascular alterations.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/farmacologia , Cognição/efeitos dos fármacos , Rigidez Vascular/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Adulto , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Artéria Braquial/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Feminino , Seguimentos , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
10.
Adv Exp Med Biol ; 1155: 407-414, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31468418

RESUMO

High-intensity resistance exercise has been shown to increase arterial stiffness and reduce vascular endothelial function. Taurine supplementation has a favorable effect on maintaining vascular function. We had previously reported that taurine supplementation attenuated increases in resistance exercise-induced arterial stiffness. In the present study, we further investigate the effects of taurine supplementation on vascular endothelial function at rest and after resistance exercise.Twenty-nine healthy men were recruited and randomly assigned to either the placebo supplement group (n = 14) or the taurine supplement group (n = 15) in a double-blinded manner. Subjects were required to ingest 6 g of either a placebo or the taurine supplement for 2 weeks prior to and 3 days following the exercise. Two weeks after the commencement of supplementation, the subjects were asked to perform 2 sets of 20 repetitive unilateral maximal-effort resistance exercise of the elbow flexors on a Biodex isokinetic dynamometer, with each contraction lasting 3 s, with 1 repetition performed every 9 s and 4 min rest in between sets. We evaluated the changes in brachial artery flow-mediated dilation (FMD) in the non-exercised arm as an index of vascular endothelial function. Relative and absolute FMDs were measured prior to supplementation, before exercise, and 24, 48, and 96 h after exercise.Two weeks of taurine supplementation significantly increased both relative and absolute FMDs. Baseline diameter significantly increased at 96 h following the exercise in both groups. However, there was no change in the peak diameter. Consequently, both relative and absolute FMDs were significantly reduced at 96 h after the exercise in both groups. Taurine supplementation does not affect resistance exercise-induced reduction in FMD.Two weeks of taurine supplementation (6 g/day) significantly increased vascular endothelial function at rest; however, taurine supplementation did not improve resistance exercise-induced reduction in FMD.


Assuntos
Suplementos Nutricionais , Endotélio Vascular/efeitos dos fármacos , Treinamento de Resistência , Taurina/farmacologia , Vasodilatação , Artéria Braquial , Endotélio Vascular/fisiologia , Humanos , Masculino
11.
Diabetes Metab Syndr ; 13(2): 1387-1391, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336497

RESUMO

BACKGROUND: Type 2 diabetes has a high spread and growing process. Using appropriate food diets is among therapeutic approaches has been applied for diabetic patients. Soya utilization has shown effective results in controlling metabolic abnormalities of these patients. The aim of this study is to investigate the effects of soy nut on glycemic conditions, blood pressure, lipid profile, antioxidant effects and vascular endothelial function of these patients. METHODS: 70 patients with type 2 diabetes were randomly divided into two groups of the test (35 people) and control (35 people). The patients in the intervention group were subjected to 60 g soy nut diet as a part of daily protein for 8 weeks and the control group under the usual diet of diabetes. The fasting glucose, blood pressure, lipid profile, brachial blood flow, the level of serum E-Selectin and total antioxidant capacity in control and test group were assessed before and after diet. RESULTS: Consuming 60 g soy nut for 8 weeks significantly decreased the fasting blood glucose (P = 0.03), total serum cholesterol (P < 0.01), LDL-c (P = 0.01), and E-Selectin (P < 0.01) and increased the capacity of serum total antioxidants (P < 0.01), brachial blood flow (P < 0.01) but didn't have any significant effect on systolic/diastolic blood pressure, HDL-c, and TG. CONCLUSION: Soy nut utilization in the patients with type-2 diabetes can significantly improve the glycemic condition, increase brachial blood flow, decrease E-selectin (improvement of endothelial function), increase serum total antioxidants and lipid profile but has no significant effect on blood pressure and HDL-c.


Assuntos
Antioxidantes/metabolismo , Biomarcadores/análise , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/sangue , Endotélio Vascular/fisiopatologia , Nozes , Soja/química , Velocidade do Fluxo Sanguíneo , Artéria Braquial/fisiopatologia , Doenças Cardiovasculares/sangue , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/patologia , Selectina E/metabolismo , Endotélio Vascular/efeitos dos fármacos , Feminino , Seguimentos , Índice Glicêmico , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco
12.
Am J Forensic Med Pathol ; 40(4): 386-390, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31305278

RESUMO

The injection of drugs of abuse causes many millions of deaths each year; deaths are mostly due to fatal overdose and the trauma and infection caused by repeated injections. The scientific literature widely reports cases of infected pseudoaneurysm in injecting drug abusers; however, most of these autopsy cases deal with the rupture of pseudoaneurysm of the femoral artery. We present fatal hemorrhagic shock in a heroin-cocaine abuser subsequent to rupture of pseudoaneurysm of the brachial artery; the man collapsed just before injecting himself with a dose of heroin-cocaine (speedball).


Assuntos
Falso Aneurisma/patologia , Aneurisma Roto/patologia , Artéria Braquial/patologia , Choque Hemorrágico/etiologia , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Usuários de Drogas , Evolução Fatal , Humanos , Masculino
13.
Appl Physiol Nutr Metab ; 44(8): 894-901, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31313969

RESUMO

There is only scarce information regarding the physiological and health impact of lifelong wearing of the neck brass coils in Karen Kayan women. The purpose of this study was to determine the influence of wearing brass neck coils on cardiorespiratory and cerebrovascular functions in long-neck Karen women. A total of 28 Karen women (aged 23-66 years) were studied. Fourteen Karen women who had been wearing neck brass coils were compared with 14 Karen women with no neck coils. We also studied 14 age-matched city-living controls. Radiographic examination of 2 older Karen women wearing neck coils showed low levels of the clavicles. There were no group differences in resting heart rate and brachial-ankle pulse wave velocity. Both systolic and diastolic blood pressure was greater and functional capacity was lower in both Karen women than city-living controls (all p < 0.05). Karen women wearing neck coils demonstrated lower flow-mediated dilation, lung functions, including forced vital capacity and forced expiratory volume during the first second, and cerebral blood flow velocity than Karen women without neck coils (all p < 0.05). Karen women wearing neck coils demonstrate reduced endothelial and pulmonary functions as well as cerebral perfusion compared with age-matched Karen women without neck coils living in the same villages. Brass neck coils worn by Karen women may elevate risks of developing cardiopulmonary and cerebrovascular diseases. Novelty Cerebral blood flow velocity and macrovascular and microvascular functions were lower in Karen wearing neck coils. There appears to be substantial burden of brass neck coils exerted on physiological systems in Karen women.


Assuntos
Pressão Sanguínea , Artéria Braquial/fisiologia , Circulação Cerebrovascular/fisiologia , Volume Expiratório Forçado , Capacidade Vital , Adulto , Idoso , Feminino , Humanos , Pulmão , Pessoa de Meia-Idade , Tailândia/etnologia , Adulto Jovem
15.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3 Supl): 314-319, jul.-set. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1023191

RESUMO

O procedimento da medida indireta da pressão arterial (PA) é usado na prevenção, diagnóstico e tratamento de pacientes com hipertensão arterial nas diversas fases de evolução da doença. Embora o procedimento seja considerado simples e de fácil execução, muitos profissionais realizam-no de forma inapropriada e sem o devido conhecimento científico, o que pode interferir na fidedignidade dos resultados obtidos. Objetivo: Identificar na literatura as falhas no cumprimento da técnica de medida indireta da PA realizada por profissionais de saúde. Método: Trata-se de uma revisão integrativa que analisou estudos publicados entre 2013 e 2017, nas bases de dados Cumulative Index to Nursing and Allied Health Literature, Base de Dados de Enfermagem, Scientific Electronic Library Online, Medical Literature Analysis and Retrieval System, Literatura latino-americana e do Caribe em ciências da saúde, Índice Bibliográfico Espanhol em Ciências da Saúde e Biblioteca COCHRANE. Sete artigos compuseram a amostra do estudo, a qual foi analisada com relação à identificação do artigo, características metodológicas e avaliação do rigor metodológico. Resultados: Cinco estudos foram desenvolvidos no Brasil (71,5%), um no Egito (14,3%) e um nos Estados Unidos (14,3%). Os achados apontaram falhas relacionas à etapa do preparo do paciente, à etapa do procedimento e à etapa do registro da PA. Conclusão: Inúmeras falhas foram identificadas durante a realização do procedimento de medida indireta da PA, o que reforça a necessidade do desenvolvimento de estudos de intervenção que possam promover o conhecimento teórico-prático dos profissionais da saúde


The indirect blood pressure (BP) measurement procedure is used in the prevention, diagnosis and treatment of patients with arterial hypertension in the various phases of disease progression. Although the procedure is considered simple and easy to perform, many professionals perform it incorrectly and without adequate scientific knowledge, which may interfere with the reliability of the results obtained. Objective: To identify in the literature failures in compliance with the technique of indirect BP measurement performed by health professionals. Method: This is an integrated review that analyzed studies published between 2013 and 2017 in the Cumulative Index to Nursing and Allied Health Literature, the Brazilian Nursing Database (BDENF), the Scientific Electronic Library Online, the Medical Literature Analysis and Retrieval System, the Latin American and Caribbean Health Sciences Literature, the Spanish Bibliographical Health Sciences Index, and the COCHRANE Library databases. Seven articles made up the study sample, which was analyzed in terms of article identification, methodological characteristics and assessment of methodological rigor. Results: Five studies were developed in Brazil (71.5%), one in Egypt (14.3%) and one in the United States (14.3%). The findings pointed to failures related to the patient preparation stage, the procedure stage and the BP recording stage. Conclusion: Numerous failures were identified during the indirect BP measurement procedure, which reinforces the need to develop intervention studies that can promote the theoretical-practical knowledge of health professionals


Assuntos
Humanos , Masculino , Feminino , Determinação da Pressão Arterial , Pressão Arterial , Pressão Sanguínea , Artéria Braquial , Doenças Cardiovasculares , Pessoal de Saúde , Artéria Radial , Prática Clínica Baseada em Evidências/métodos , Hipertensão/mortalidade , Equipe de Enfermagem/métodos
16.
Eur J Appl Physiol ; 119(8): 1855-1863, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31187279

RESUMO

INTRODUCTION: Postprandial hyperglycemia (PPH) impairs vascular endothelial function (VEF). A single bout of aerobic exercise (AE) attenuates PPH-induced decreases in brachial artery flow-mediated dilation (FMD), a non-invasive measure of VEF, in healthy adults for up to 17 h post-exercise. Studies examining the effects of resistance exercise (RE) on postprandial FMD responses are lacking. PURPOSE: We hypothesized that a single bout of exercise performed the prior evening would attenuate PPH-induced decreases in FMD, independent of exercise modality. METHODS: In a randomized, cross-over design, overweight/obese adults [n = 11 (8 women); 22 ± 4 years; 32.3 ± 5.8 kg m-2] completed 3 separate trials: control (seated rest), AE (30 min at ~ 60% VO2max), or whole-body RE (30 min, 6 exercises, 3 × 10-repetition maximum). Each trial occurred 14-17 h prior to an oral glucose tolerance test (OGTT). Brachial artery FMD and plasma glucose and insulin were measured prior to and at 30-min intervals for 2 h following the OGTT. Repeated-measures ANOVA and Bonferroni post hoc tests were used to evaluate differences within and between trials. RESULTS: Trials occurred 15.3 ± 1.0 h prior to the OGTT. Relative to baseline, FMD transiently decreased (P < 0.05) at 30-60 min post-ingestion, plasma glucose increased (P < 0.01) at 30-90 min post-ingestion, and plasma insulin increased (P < 0.01) at 30-120 min post-ingestion. No between trial differences were observed for FMD, glucose, or insulin. CONCLUSIONS: Aerobic or resistance exercise performed the evening prior to an OGTT does not attenuate postprandial decreases in brachial artery FMD in overweight/obese adults.


Assuntos
Glicemia/metabolismo , Endotélio Vascular/fisiopatologia , Obesidade/fisiopatologia , Treinamento de Resistência/métodos , Vasodilatação , Adulto , Artéria Braquial/fisiopatologia , Humanos , Insulina/sangue , Masculino , Período Pós-Prandial , Treinamento de Resistência/efeitos adversos
19.
Croat Med J ; 60(3): 265-272, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31187955

RESUMO

AIM: To assess the effect of air, gas mixture composed of 50% nitrogen and 50% oxygen (nitrox 50), or gas mixture composed of 1% nitrogen and 99% oxygen (nitrox 99) on bubble formation and vascular/endothelial function during decompression after self-contained underwater breathing apparatus diving. METHODS: This randomized controlled study, conducted in 2014, involved ten divers. Each diver performed three dives in a randomized protocol using three gases: air, nitrox 50, or nitrox 99 during ascent. The dives were performed on three different days limited to 45 m sea water (msw) depth with 20 min bottom time. Nitrogen bubbles formation was assessed by ultrasound detection after dive. Arterial/endothelial function was evaluated by brachial artery flow mediated dilatation (FMD) before and after dive. RESULTS: Nitrox 99 significantly reduced bubble formation after cough compared with air and nitrox 50 (grade 1 vs 3 and vs 3, respectively, P=0.026). Nitrox 50 significantly decreased post-dive FMD compared with pre-dive FMD (3.62 ± 5.57% vs 12.11 ± 6.82% P=0.010), while nitrox 99 did not cause any significant change. CONCLUSION: Nitrox 99 reduced bubble formation, did not change post-dive FMD, and decreased total dive duration, indicating that it might better preserve endothelial function compared with air and nitrox 50 dive protocols.


Assuntos
Doença da Descompressão/prevenção & controle , Descompressão/métodos , Mergulho/fisiologia , Endotélio Vascular/fisiopatologia , Nitrogênio/uso terapêutico , Oxigênio/uso terapêutico , Adulto , Ar , Artéria Braquial/fisiopatologia , Doença da Descompressão/diagnóstico por imagem , Doença da Descompressão/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nitrogênio/química , Oxigênio/química , Ultrassonografia , Vasodilatação
20.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31186368

RESUMO

OBJECTIVES: Cardiovascular disease prevention should begin in childhood. However, the influence of physical activity on cardiovascular health in early childhood is unknown. Our purpose in this study was to determine the effect of physical activity on trajectories of cardiovascular health indicators during early childhood. METHODS: This prospective, observational cohort study (Health Outcomes and Physical Activity in Preschoolers) enrolled 418 3- to 5-year-olds with annual assessments for 3 years. Total physical activity (TPA) and moderate-to-vigorous physical activity (MVPA) were measured over 7 days via accelerometry. Cardiovascular health indicators included cardiovascular fitness (exercise time on a maximal treadmill test [treadmill time] and 1-minute heart rate recovery), resting arterial stiffness (whole-body pulse wave velocity and carotid ß stiffness index), and seated systolic blood pressure. Data were analyzed by using linear mixed-effects modeling; effects are reported as unstandardized estimates (Est). RESULTS: There were main effects of TPA and MVPA on treadmill time (Est = 0.004 [P = .005] and 0.008 [P = .001], respectively) and heart rate recovery (Est = 0.05 [P < .001] and 0.08 [P < .001], respectively). There was a main effect of TPA on pulse wave velocity (Est = -0.001; P = .02) and an MVPA × time interaction (Est = -0.002; P = .01). For carotid ß stiffness index, the effect of a TPA × time interaction was not significant (Est = -0.002; P = .051); however, there was a significant MVPA × time interaction (Est = -0.003; P = .03). MVPA was associated with a slower rate of change in systolic blood pressure for girls (Est = 0.06; P = .009). CONCLUSIONS: Children who engage in higher levels of physical activity during early childhood have better cardiovascular health indicators, with more intense physical activity (ie, MVPA) attenuating the stiffening of arteries.


Assuntos
Pressão Sanguínea/fisiologia , Aptidão Cardiorrespiratória/fisiologia , Exercício , Rigidez Vascular/fisiologia , Acelerometria , Artéria Braquial/fisiologia , Artérias Carótidas/fisiologia , Pré-Escolar , Teste de Esforço , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Estudos Prospectivos , Análise de Onda de Pulso
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