Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.971
Filtrar
1.
Zhonghua Yi Xue Za Zhi ; 100(2): 97-103, 2020 Jan 14.
Artigo em Chinês | MEDLINE | ID: mdl-31937047

RESUMO

Objective: To explore the role of pulmonary arterial pressure in chronic obstructive pulmonary disease (COPD) phenotypes based on cluster analysis and its prognostic value. Methods: Three hundred and nineteen patients admitted to Beijing Chaoyang Hospital and Xuanwu Hospital from April 2013 to April 2016 were recruited in the study. All the patients were older than 40 years old and in stable COPD. One-year follow-up was performed and the endpoint was acute exacerbation of COPD or all-cause mortality. Age, body mass index (BMI), smoking index, history of exacerbation, modified British medical research council (mMRC), forced expiratory volume in first second (FEV(1)), pulmonary arterial pressure and right ventricular transverse diameter measured by echocardiography were selected as cluster indicators to classify patients, survival analysis was performed. Results: Eight cluster indexes were converted into four independent principal components by principal component analysis (PCA), with a cumulative contribution rate of 70.1%. The extracted principal components were used for cluster analysis. Patients were divided into four categories, each contained different GOLD grades and had statistically significant differences in age, symptoms, degree of pulmonary function impairment and pulmonary arterial pressure (all P<0.001). The four categories were: class 1: young, pulmonary function damage was medium, lower pulmonary arterial pressure, good prognosis; class 2: elderly, pulmonary function damage was mild, higher pulmonary arterial pressure, poor prognosis; class 3: young, pulmonary function damage was serious, normal pulmonary arterial pressure, the best prognosis; class 4: elderly, pulmonary function damage was medium, pulmonary arterial pressure increased significantly, the worst prognosis. Conclusion: Cluster analysis based on pulmonary artery pressure can be used to identify COPD patients with different risk of acute exacerbation or death, suggesting that pulmonary hypertension as a COPD phenotype plays a role in prognostic assessment.


Assuntos
Pressão Arterial , Doença Pulmonar Obstrutiva Crônica , Adulto , Idoso , Análise por Conglomerados , Volume Expiratório Forçado , Humanos , Fenótipo , Prognóstico
2.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 628-638, dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184790

RESUMO

Background: Studies trying to find the association between vitamin D status and metabolic syndrome (MetS) have led to inconsistent results, and community-based data for individuals living in the Middle East are limited. Objectives: To find out if MetS and its components are associated with vitamin D status among female teachers residing in Yazd city during winter 2015. Materials and methods: A total of 276 female teachers (case group, n = 124 and control group, n = 152) aged 20-60 years were included. Weight, height, waist circumference, blood pressure, daily energy intake, physical activity, serum 25 hydroxy vitamin D (25(OH)D3), fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C) levels were assessed. Logistic regression was used to examine the odds ratio of MetS according to vitamin D status. Results: Mean serum 25(OH)D3 was 32.79 ± 18.62 ng/ml and 33.73 ± 20.20, in females with and without MetS, respectively (P > 0.142). Compared to those with 25(OH)D3of < 20 ng/ml, the odds ratio for MetS was 1.01 (95% CI: 0.48-2.13) and 0.95 (95% CI: 0.56-1.60) for those with serum 25(OH)D3 levels of 20-29 ng/ml and ≥ 30 ng/ml, respectively (P trend = 0.84). The association remained insignificant after adjusting for potential confounders. Furthermore, vitamin D status was not associated with MetS components (P > 0.05). Conclusion: Although several studies have claimed the association between vitamin D status and MetS, we could not find a similar connection in a sample of Iranian female teachers. Prospective studies are needed to determine the possible effect of vitamin D in the development of MetS, particularly in the Yazd province


Antecedentes: Los estudios en busca de una asociación entre el estado de vitamina D y el síndrome metabólico (SM) han dado resultados no concluyentes, y los datos sobre comunidades de personas residentes en Oriente Próximo son limitados. Objetivos: Averiguar si existe asociación entre el SM y sus componentes y el estado de vitamina D en profesoras residentes en la ciudad de Yazd durante el invierno de 2015. Materiales y métodos: Se incluyó a un total de 276 profesoras (grupos de casos, n = 124 y grupo de control, n = 152) de 20-60 años de edad. Se determinaron el peso, la talla, el perímetro de la cintura, la presión arterial, la ingesta diaria de energía, la actividad física y los niveles de 25-hidroxivitamina D (25(OH)D3), glucosa en ayunas, triglicéridos y colesterol de las proteínas de alta densidad (C-HDL). Se utilizó regresión logística para determinar la razón de probabilidades de SM en función del estado de vitamina D. Resultados: La concentración sérica media de 25(OH)D3 era de 32,79 ± 18,62 ng/ml y 33,73 ± 20,20 en las mujeres con y sin SM, respectivamente (P > 0,142). En comparación con las que tenían < 20 ng/ml de 25(OH)D3, la razón de probabilidades de SM era 1,01 (IC al 95%, 0,48-2,13) y 0,95 (IC al 95%, 0,56-1,60) en las que tenían valores de 20-29 ng/ml y ≥ 30 ng/ml, respectivamente (tendencia de P = 0,84). La asociación seguía siendo no significativa después del ajuste por posibles factores de confusión. Además, el estado de vitamina D no se asociaba con los componentes del SM (P > 0,05). Conclusión: Aunque varios estudios han informado de una asociación entre el estado de la vitamina D y el SM, no pudimos hallar una relación similar en una muestra de profesoras iraníes. Se necesitan estudios prospectivos para determinar el posible efecto de la vitamina D en el desarrollo del SM, especialmente en la provincia de Yazd


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Vitamina D/administração & dosagem , Síndrome Metabólica/tratamento farmacológico , Deficiência de Vitamina D/dietoterapia , Irã (Geográfico) , Modelos Logísticos , Peso-Estatura , Relação Cintura-Quadril , Pressão Arterial , Pressão Sanguínea , Exercício/fisiologia
3.
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 403-407, Out.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1024212

RESUMO

Introduction: Tonsillectomy is one of the most common otolaryngology procedures performed worldwide. It is also one of the first procedures learnt by residents during their training period. Although tonsillectomy is viewed relatively as a low-risk procedure, it can be potentially harmful because of the chance of posttonsillectomy hemorrhage. Objective: The objective of the present study is to analyze the effects of peroperative factors and experience of the surgeon on the incidence and pattern of posttonsillectomy reactionary hemorrhage. Methods: A retrospective review of medical charts was performed from 2014 to 2017 in a tertiary care hospital. A total of 1,284 patients who underwent tonsillectomy and adenoidectomy were included in the study. The parameters assessed were experience of the surgeon, operating time, intraoperative blood loss, difference in mean arterial pressure (MAP) and pulse rate. Results: A total of 23 (1.79%) out of the 1,284 patients had reactionary hemorrhage. Out of those 23, 16 (69.5%) patients had been operated on by trainees, while 7 (30.5%) had been operated on by consultants (p = 0.033, odds ratio [OR] = 0.04). Operating time, intraoperative blood loss, difference in MAP and pulse rate were significantly higher in the reactionary hemorrhage group, and showed a positive association with risk of hemorrhage (p < 0.05; OR >1). Re-exploration to control the bleeding was required in 10 (76.9%) out of the 23 cases. Conclusion: The experience of the surgeon experience and peroperative factors have an association with posttonsillectomy hemorrhage. Close surveillance and monitoring of the aforementioned peroperative factors will help in the identification of patients at risk of hemorrhage (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Tonsilectomia/efeitos adversos , Hemorragia Pós-Operatória/etiologia , Pulso Arterial , Estudos Retrospectivos , Fatores de Risco , Perda Sanguínea Cirúrgica , Hemorragia Pós-Operatória/terapia , Duração da Cirurgia , Pressão Arterial , Hospitais Universitários , Período Intraoperatório
4.
Bratisl Lek Listy ; 120(12): 894-898, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31855047

RESUMO

OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which directly influences organs such as brain, heart and kidneys and is related to organ damage. Its value increases with the aortic stiffness. The aim of this study was to analyze the relationships of CSBP to aortic stiffness parameters. METHODS: Central blood pressure (BP) and related parameters were measured by Arteriograph, working based on oscillometric principle, using pulse wave analysis (PWA) approach. We examined 123 patients (69 females, 54 males) with a primary hypertension. RESULTS: Using a linear correlation analysis, we found that CSBP was correlated to aortic pulse wave velocity (PWV), aortic and brachial pulse pressure (PP), aortic augmentation index, return time of reflected pressure wave (RT) and aortic and brachial augmentation indexes. Multivariate analysis defines the aortic pulse pressure (PPao) as the most powerful parameter influencing CSBP. By an individual analysis of BP in each patient separately, we defined two different types of central hemodynamics; those with a higher CSBP than brachial SBP occur in stiffer aorta. CONCLUSION: The CSBP increases with aortic PP, the most powerful stiffness parameter of aorta. Higher CSBP than brachial SBP usually accompanies a stiffer aorta (Tab. 5, Ref. 19).


Assuntos
Pressão Sanguínea/fisiologia , Análise de Onda de Pulso/métodos , Rigidez Vascular , Pressão Arterial , Determinação da Pressão Arterial , Feminino , Humanos , Masculino
5.
Rev. Esc. Enferm. USP ; 53: e03469, Jan.-Dez. 2019. tab, graf
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020388

RESUMO

RESUMO Objetivo Avaliar modificações cardiorrespiratórias em decorrência de sessão única de oxigenoterapia hiperbárica. Método Estudo aleatorizado com pacientes: grupos-controle e oxigenoterapia hiperbárica. As avaliações ocorreram no início, durante e após a exposição ao oxigênio puro acima de uma atmosfera, durante 2 horas. A pressão arterial sistêmica, saturação periférica de oxigênio, frequência de pulso, volume e capacidade pulmonar, pressões inspiratória e expiratória máximas foram avaliadas. A saturação periférica de oxigênio, frequência de pulso e pressão arterial sistêmica foram avaliadas durante a pressurização na primeira hora. Os dados foram avaliados pelo teste de ANOVA, Mann-Whitney e teste t independente (p<0,05). Resultados Foram avaliados 14 pacientes adultos. No grupo sob terapia (sete sujeitos), idade: 49,57±14,59 anos houve redução da frequência de pulso de 16 batimentos por minuto após 35 minutos de terapia (análise intragrupo), e a saturação periférica de oxigênio foi maior neste mesmo período se comparado ao grupo-controle. Conclusão A oxigenoterapia hiperbárica promove alterações cardiorrespiratórias com o aumento da saturação periférica de oxigênio e redução da frequência de pulso, sem alterar os níveis pressóricos arteriais e a força, volumes e capacidades respiratórios.


RESUMEN Objetivo Evaluar modificaciones cardiorrespiratorias consecuentes de sesión única de oxigenoterapia hiperbárica. Método Estudio aleatorizado con pacientes: grupos de control y oxigenoterapia hiperbárica. Las evaluaciones ocurrieron en el inicio, durante y después de la exposición al oxígeno puro por encima de una atmósfera, durante dos horas. La presión arterial sistémica, saturación periférica de oxígeno, frecuencia de pulso, volumen y capacidad pulmonar, presiones inspiratoria y espiratoria máximas fueron evaluadas. La saturación periférica de oxígeno, frecuencia de pulso y presión arterial sistémica fueron evaluadas durante la presurización en la primera hora. Los datos fueron evaluados por el test de ANOVA, Mann Whitney y prueba t independiente (p<0,05). Resultados Fueron evaluados 14 pacientes adultos. En el grupo bajo terapia (siete sujetos), edad: 49,57±14,59 años, hubo reducción de la frecuencia de pulso de 16 latidos por minuto tras 35 minutos de terapia (análisis intragrupo), y la saturación periférica de oxígeno fue mayor en ese mismo período si comparado con el grupo de control. Conclusión La oxigenoterapia hiperbárica proporciona alteraciones cardiorrespiratorias con el aumento de la saturación periférica de oxígeno y la reducción de la frecuencia de pulso, sin alterar los niveles de presión arteriales y la fuerza, volúmenes y capacidades respiratorios.


ABSTRACT Objective To evaluate cardiorespiratory alterations due to a single session of hyperbaric oxygen therapy. Method Randomized study with patients: a control group and hyperbaric oxygen therapy. Evaluations occurred in the beginning, during, and after exposure to pure oxygen above atmosphere for 2 hours. Systemic blood pressure, peripheral oxygen saturation, pulse rate, lung volume and lung capacity, and maximal inspiratory and expiratory pressures were evaluated. Peripheral oxygen saturation, pulse rate, and systemic blood pressure were evaluated during the pressurizing in the first hour. Data were evaluated by means of ANOVA, Mann-Whitney, and independent t-test (p<0.05). Results A total of 14 adult patients were evaluated. In the group under therapy (seven subjects), aged: 49.57±14.59 years, there was a decrease in the pulse rate of 16 beats per minute after 35 minutes of therapy (intragroup analysis), and the peripheral oxygen saturation was higher within the same period compared to the control group. Conclusion The hyperbaric oxygen therapy promotes cardiorespiratory alterations with the increase of the peripheral oxygen saturation and decrease of the pulse rate, without altering blood pressure levels and the strength, volumes, and respiratory capacities.


Assuntos
Humanos , Masculino , Feminino , Oxigenoterapia/enfermagem , Pressão Arterial , Oxigenação Hiperbárica/enfermagem , Oxigênio
6.
Zhongguo Zhong Yao Za Zhi ; 44(17): 3806-3815, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31602957

RESUMO

The randomized controlled trials about modified Sangbaipi Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) patients were collected from 7 databases( PubMed,CNKI,et al) from the establishment to December 5,2018. All the studies searched were strictly evaluated. Literatures were independently screened by two researchers according to the inclusion and exclusion criteria,and the methodological quality of included studies was evaluated. To systematically review the efficacy of modified Sangbaipi Decoction in treating AECOPD,the Meta-analysis and trial sequential analysis were conducted by using Stata/SE 14. 0 and TSA 0. 9. 5. 10 Beta,respectively. A total of 25 RCTs involving 1 784 patients were included. According to the results of Meta-analysis,compared with the control groups,the trial group had a higher clinical efficacy in AECOPD patients( RR =1. 18,95%CI[1. 13,1. 22],P = 0),improved pulmonary functions including forced expiratory volume in one second( FEV1,WMD =0. 44,95%CI[0. 01,0. 87],P = 0. 046),and the forced vital capacity( FVC,WMD = 0. 42,95%CI[0. 07,0. 22],P = 0),but no statistical significance in the percentage of forced expiratory volume in one second( FEV1%,P = 0. 067) and the first seconds breathing volume percentage of forced vital capacity( FEV1/FVC,P = 0. 238); it improved the arterial oxygen partial pressure( PaO2,SMD =0. 85,95%CI[0. 41,1. 30],P = 0) and decreased the arterial partial pressure of carbon dioxide( PaCO2,SMD =-0. 94,95% CI[-1. 70,-0. 18],P= 0. 016); and in terms of inflammatory markers,it improved the white blood cell count( WBC,WMD=-0. 94,95%CI[-1. 17,-0. 70],P = 0). The trial sequential analysis showed that the studies included with the improvement of clinical efficacy had passed the conventional and TSA threshold,so as to further confirm the evidence. According to the findings,in addition to conventional Western medicine treatment,modified Sangbaipi Decoction could improve the efficiency in treating acute exacerbation patients with chronic obstructive pulmonary disease,increase PaO2,and decrease PaCO2,with a high safety but no effect on pulmonary function. However,restricted by the low quality of studies included,this conclusion shall be further verified by more high-quality clinical trials.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Pressão Arterial , Volume Expiratório Forçado , Humanos , Pulmão , Pressão Parcial , Ensaios Clínicos Controlados Aleatórios como Assunto , Capacidade Vital
7.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 483-489, Sept-Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1040100

RESUMO

Neuromuscular electrical stimulation seems to be a promising option to intensify the rehabilitation and improve the exercise capacity of patients in the immediate postoperative period of cardiac surgery. Objective: This study aimed to evaluate the hemodynamic (heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure) and respiratory (respiratory rate and oxygen saturation) responses to neuromuscular electrical stimulation in the immediate postoperative period in patients submitted to cardiac surgery and to verify its feasibility and safety. Methods: This is a pilot randomized controlled trial, wherein critical patients in the immediate postoperative period of cardiac surgery were randomly assigned to a control group, using sham neuromuscular electrical stimulation, or an experimental group, submitted to neuromuscular electrical stimulation sessions (FES), for 60 min, with a 50-Hz frequency, 200-µs pulse duration, time on: 3 s, and time off: 9 s. Data distribution was evaluated by the Shapiro-Wilk test. The analysis of variance was used and a p-value < 0.05 was considered significant. Results: Thirty patients were included in the study. The neuromuscular electrical stimulation was applied within the first 23.13 ± 5.24 h after cardiac surgery, and no changes were found regarding the hemodynamic and respiratory variables between the patients who underwent neuromuscular electrical stimulation, and those in the control group. Conclusions: In the present study, neuromuscular electrical stimulation did not promote changes in hemodynamic and respiratory responses of patients in the immediate postoperative period of cardiac surgery


Assuntos
Humanos , Masculino , Feminino , Período Pós-Operatório , Cirurgia Torácica , Terapia por Estimulação Elétrica/métodos , Reabilitação Cardíaca , Pressão Sanguínea , Exercício , Nível de Oxigênio/métodos , Diagnóstico da Situação de Saúde , Análise Estatística , Análise de Variância , Ensaio Clínico Controlado Aleatório , Avaliação de Resultados (Cuidados de Saúde)/métodos , Pressão Arterial , Frequência Cardíaca
8.
Rev. bras. ativ. fís. saúde ; 24: 1-9, out. 2019. fig, tab
Artigo em Inglês | LILACS | ID: biblio-1046421

RESUMO

Self-selected exercise intensity (SSE) is a simple approach to encourage an active lifestyle. This study aimed to investigate whether a SSE session meet the recommended intensity for hypertension management (i.e. moderate-vigorous), and whether heart rate (HR), rating of perceived exertion (RPE) and affective responses are reproducible. Thirteen inactive hypertensive older women (age: 64.54 ± 4.16 years; blood pressure: 122.51/62.15 mmHg) performed two 30-minute SSE sessions outdoors. HR reserve (HRR), RPE and affective responses were assessed. Paired t-test, intraclass correlation coefficient (ICC) and typical error (TE) were used for the analyzes. Participants exercised at moderate-vigorous intensity (≥ 40% of HRR). No differences were found for HRR (56.46 ± 8.01% vs. 59.08 ± 10.57%), RPE (11.26 ± 1.14 vs. 10.98 ± 1.52) and affective response (3.47 ± 1.13 vs. 3.38 ± 1.23) (p > 0.05). RPE showed excellent reliability (ICC = 0.82; 95%CI: 0.42; 0.94; p = 0.003). There was a poor reliability for HRR (ICC = 0.40; 95%CI: -0.97; 0.82; p = 0.193) and affective responses (ICC = 0.19; 95%CI: -2.10; 0.76; p = 0.369). TE between sessions for HRR, RPE, and affective response were 8.11 bpm, 0.75 and 1.11, respectively. In conclusion, inactive hypertensive older women seem to meet the recommended intensity for hypertension management when they exercise at a self-selected pace and report it as light-moderate and pleasant. Despite only RPE, but not HR and affective response, has shown good reproducibility, the results seem to support the use of SSE as a simple approach to encourage an active lifestyle in this population


O exercício em intensidade autosselecionada (EIA) é uma abordagem simples para encorajar um estilo de vida ativo. Este estudo investigou se o EIA atende a intensidade recomendada para tratamento de hiperten-são (i.e. moderada-vigorosa), e se a frequência cardíaca (FC), percepção de esforço (PSE) e resposta afetiva são reprodutíveis. Treze mulheres idosas hipertensas inativas (idade: 64,54 ± 4,16 anos; pressão arterial: 122,51/62,15 mmHg) realizaram duas sessões de EIA de 30 minutos ao ar livre. FC de reserva (FCR), PSE e resposta afetiva foram avaliadas. Teste t pareado, coeficiente de correção intraclasse (CCI) e erro tí-pico (ET) foram analisados. As participantes se exercitaram em intensidade moderada-vigorosa (≥ 40% da FCR). Não houve diferença na FCR (56,46 ± 8,01% vs. 59,08 ± 10,57%), PSE (11,26 ± 1,14 vs. 10,98 ± 1,52) e resposta afetiva (3,47 ± 1,13 vs. 3,38 ± 1,23; p > 0,05). A PSE apresentou excelente confiabilidade (CCI = 0,82; IC95%: 0,42; 0,94; p = 0,003). Houve baixa confiabilidade da FCR (CCI = 0,40; IC95%: -0,97; 0,82; p = 0,193) e resposta afetiva (CCI = 0,19; IC95%: -2,10; 0,76; p = 0,369). O ET foi de 8,11 bpm, 0,75 e 1,11 para FCR, PSE e resposta afetiva, respectivamente. Em conclusão, mulheres idosas hipertensas inativas parecem atender a intensidade recomendada para tratamento da hipertensão quando realizam EIA e relatam a atividade como leve-moderada e prazerosa. Embora apenas a PSE, e não a FCR e resposta afetiva, tenha mostrado boa reprodutibilidade, os resultados parecem suportar o EIA como uma abordagem simples para encorajar um estilo de vida ativo nessa população


Assuntos
Exercício , Afeto , Esforço Físico , Pressão Arterial , Hipertensão
9.
Rev. Ciênc. Plur ; 5(2): 49-67, ago. 2019. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1021754

RESUMO

Introdução:A Hipertensão Arterial Sistêmica tem apresentado alta mortalidade em todo o mundo, associada a fatores de risco cardiovascular como o excesso de peso e a obesidade abdominal.Objetivo:Avaliar os índices antropométricos e pressão arterial em adolescentes e adultos jovens do município de Santa Cruz-RN.Método:Trata-se de um estudo quantitativo, do tipo transversal, realizado com 86 indivíduos com idade média de 19,0 ± 0,97 anos. Foram avaliados o Índice deMassa Corporal (IMC), Relação Cintura Estatura (RCE), Relação Cintura Quadril (RCQ), Índice de Conicidade (IC) e Pressão Arterial (PA). Os dados foram analisados no programa SPSS versão 23.0, apresentados em percentual, média e desvio padrão. O teste T deStudentfoi aplicado para avaliar a diferença entre as médias, a correlação entre medidas antropométricas e a pressão arterial pela correlação de Pearson.Resultados:A prevalência maior foi do sexo feminino, 81,4%. A obesidade esteve mais presente nos meninos adolescentes do que nas meninas, 33,3 e 13,9% respectivamente, bem como nos adultos jovens 28,6% em homens e 11,8% em mulheres. A RCE se mostrou mais elevada nas meninas e mulheres adultas (0,46 ± 0,07, 0,50 ± 0,08). Em contrapartida, a RCQ e IC se mostraram maiores nos meninos(0,79 ± 0,06; 1,12 ± 0,74) e nos homens adultos(0,82 ± 0,09; 1,15 ± 0,12) respectivamente. Em ambos os grupos houve correlação positiva moderada entre o IMC e a RCE com a PA (p<0,05).Conclusão:Os índices antropométricosapresentaram correlação positiva com a elevação da pressão arterial, destacando-se o IMC e a RCE nos adolescentes e adultos jovens (AU).


Introduction:Systemic arterial hypertension has presented high mortality worldwide, associated with cardiovascular risk factors such as overweight and abdominal obesity.Objective:To evaluate the anthropometric indexes and blood pressure in adolescents and young adults in the municipality of Santa Cruz-RN.Methods:This is a cross-sectional quantitative study of 86 individuals with a mean age of 19.0 ± 0.97 years. Body mass index (BMI), Waist Stature Ratio (WSR), Waist Hip Ratio (WHR), Conicity Index (CI) and Blood Pressure (BP) were evaluated. Data were analyzed using SPSS version 23.0, presented in percentage, mean and standard deviation. The T test was applied to evaluate the difference between the means, the correlation between anthropometric measures and blood pressure by the Pearson correlation.Results:The highest prevalence was female, 81.4%. Obesity was more present in adolescent boys than in girls, 33.3 and 13.9% respectively, as well as in young adults, 28.6% in men and 11.8% in women. The WSR was higher in girls and adult women (0.46 ± 0.07, 0.50 ± 0.08). On the other hand, WHR and CI were higher in boys(0.79 ± 0.06, 1.12 ± 0.74)and in adult males (0.82 ± 0.09, 1.15 ± 0.12) respectively. In both groups there was a moderate positive correlation between BMI and WSR with BP (p <0.05).Conclusion:The anthropometric indices showed a positive correlation with the elevation of blood pressure, especially BMI, WSR in adolescents and young adults (AU).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Brasil , Antropometria/métodos , Adolescente , Pressão Arterial , Hipertensão , Estudos Transversais/métodos , Estatísticas não Paramétricas , Adulto Jovem
10.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4 (Supl)): 408-414, out.-dez. 2019. tab, ilus
Artigo em Português | LILACS | ID: biblio-1047334

RESUMO

O presente manuscrito teve por objetivo a revisão de literatura sobre os efeitos do destreinamento (DT) no sistema cardiovascular e em fatores de risco cardiovasculares, tais como massa corporal, adiposidade e perfil lipídico. Para isso, uma ampla pesquisa da literatura nas bases de dados PubMed, Scopus e Web of Science foi realizada, e o conjunto de dados mostrou que o DT promove reversão das adaptações cardiovasculares obtidas com o treinamento físico, tais como redução do VO2máx, do débito cardíaco máximo, do volume sistólico, do volume sanguíneo e da massa ventricular. Além disso, o DT induz aumento da frequência cardíaca de repouso e submáxima, da resistência vascular periférica e da pressão arterial. O curso temporal para que tais efeitos cardiovasculares ocorram é amplo, podendo ocorrer a partir da segunda semana de DT até três meses após o DT. O DT também gera prejuízos aos fatores de risco cardiovasculares, tais como aumento da massa corporal e da adiposidade, aumento do colesterol total, LDL e VLDL, e redução do HDL. Enquanto os efeitos na massa corporal aparecem após quatro semanas de DT, as mudanças no perfil lipídico são mais precoces, com apenas uma semana de DT


The objective of this manuscript is to review the literature about the effects of detraining (DT) on the cardiovascular system and on cardiovascular risk factors such as body mass, adiposity and lipid profile. For this, a wide literature search in the PubMed, Scopus and Web of Science databases was performed, and the data showed that DT promotes the reversal of cardiovascular adaptations obtained with physical training, such as reduction in VO2 max, cardiac output, ejection fraction, blood volume and ventricular mass. In addition, DT induces an increase in resting and submaximal heart rates, peripheral vascular resistance and blood pressure. The timeframe for such cardiovascular effects to be seen is long, which may occur from the second week of DT to 3 months after DT. DT also causes damage to cardiovascular risk factors by inducing an increase in body mass and adiposity, an increase in total cholesterol, LDL and VLDL, and a reduction in HDL. While effects on body mass appear after 4 weeks of DT, changes in lipid profile appear earlier, with only 1 week of DT


Assuntos
Sistema Cardiovascular , Exercício , Consumo de Oxigênio , Índice de Massa Corporal , Colesterol , Fatores de Risco , Atletas , Pressão Arterial , Frequência Cardíaca , HDL-Colesterol , LDL-Colesterol
11.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4 (Supl)): 415-422, out.-dez. 2019. tab, ilus
Artigo em Português | LILACS | ID: biblio-1047339

RESUMO

O exercício físico é recomendado no tratamento da hipertensão arterial. Agudamente, a execução do exercício promove aumento da pressão arterial (PA), mas, no período de recuperação pós-exercício, é possível evidenciar redução da PA e, principalmente, após um período de treinamento físico crônico, pode haver diminuição da PA clínica e de 24 horas dos hipertensos. Apesar desses efeitos serem conhecidos, sua magnitude e mecanismos dependem do tipo de exercício executado e de suas características. Este artigo revê os efeitos agudos e crônicos clássicos do exercício aeróbico e os efeitos mais recentemente estudados dos exercícios resistidos isométrico e dinâmico na PA, seus mecanismos e fatores de influência, ressaltando os pontos que embasam as recomendações atuais sobre o uso do exercício na hipertensão arterial. O conhecimento atual demonstra que: 1) o exercício aeróbico promove aumento da PA sistólica durante sua execução, gera hipotensão pós-exercício clinicamente relevante e reduz a PA clínica e de 24 horas após o treinamento; 2) o exercício resistido isométrico promove aumento progressivo da PA sistólica e diastólica durante sua execução, não produz hipotensão pós-exercício consistente e reduz a PA clínica após o treinamento, mas esse efeito hipotensor ocorre com um protocolo específico de exercício de handgrip; e 3) o exercício resistido dinâmico promove grande aumento da PA sistólica e diastólica durante sua execução, gera hipotensão pós-exercício cuja relevância clínica ainda precisa ser comprovada e parece diminuir a PA clínica, mas não a ambulatorial, após o treinamento. Face a esses conhecimentos, o treinamento aeróbico complementado pelo resistido dinâmico é recomendado na hipertensão


Physical exercise is recommended for hypertension treatment. Acutely, exercise execution increases blood pressure (BP), but, during the recovery period, BP decreases, and after a chronic training period, clinic and ambulatory BP may decrease in hypertensives. Despite these known effects of exercise, their magnitude and mechanisms depend on the type of exercise and its characteristics. This article reviews the classical acute and chronic effects of aerobic exercise and the more recent knowledge about isometric and dynamic resistance exercises on BP, its mechanisms and factors of influence, highlighting the aspects underlying exercise recommendations for hypertension. Current scientific knowledge shows that: 1) aerobic exercise increases systolic BP during its execution, produces a clinically significant post-exercise hypotension, and chronically decreases clinic and 24-hour BP; 2) isometric resistance exercise produces a progressive increase in systolic and diastolic BP during its execution, does not promote consistent post-exercise hypotension, and decreases clinic BP after training, but this hypotensive effect results from a specific protocol of isometric handgrip; and 3) dynamic resistance exercise produces a huge progressive increase in systolic and diastolic BP during its execution, promotes post-exercise hypotension with questionable clinical relevance, and seems to decrease clinic but not ambulatory BP after training. Based on this current knowledge, regular aerobic exercise complemented by dynamic resistance exercise is recommended for hypertension


Assuntos
Exercício , Pressão Arterial , Hipertensão , Volume Sistólico , Débito Cardíaco , Fatores de Risco , Frequência Cardíaca , Hipotensão
12.
Hipertens. riesgo vasc ; 36(3): 137-144, jul.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183953

RESUMO

Introducción y objetivos: El objetivo es cuantificar la validez diagnóstica de la medida de la presión arterial en farmacia comunitaria (PAFC) y establecer los puntos de corte de la presión arterial sistólica (PAS) y de la presión arterial diastólica (PAD) que maximicen la citada validez, usando como patrón de oro la monitorización ambulatoria de la presión arterial (MAPA) de 24 h. Material y métodos: Estudio transversal, con selección consecutiva de pacientes usuarios de la farmacia comunitaria andaluza. Se midió la PAFC y, a continuación, una MAPA de 24 h, con lo que se evaluó la validez diagnóstica de PAFC. También se calculó el área bajo la curva ROC para PAS y PAD, los valores predictivos positivos y negativos para diferentes prevalencias, así como la variación de la sensibilidad y de la especificidad para los distintos puntos de corte de PAS/PAD, lo que sirvió para el cálculo de los puntos de corte óptimos. Resultados: Colaboraron 167 farmacias comunitarias, con 1.170 pacientes, de los que 1.110 aportaron datos válidos. La PAFC presenta una sensibilidad del 60,41% (IC 95%: 56,40-64,29), una especificidad del 79,77% (IC 95%: 76,12-82,99), un valor predictivo positivo de 76,96% (IC 95%: 72,89-80,57) y un valor predictivo negativo de 64,31% (IC 95%: 60,55%-67,90%). Por el método de curva ROC, los puntos de corte óptimos para la PAS y para la PAD son, respectivamente, 134/81mm Hg, puntos donde la sensibilidad y la especificidad se equilibran y se maximiza el índice de Youden. Conclusiones: La sensibilidad es relativamente baja. Para mejorarla se propone bajar el punto de corte de PAS y PAD. El óptimo calculado es 134/81mm Hg. Viene ello a aportar datos sobre la conveniencia de revisar a la baja el actual punto de corte (140/90), como propone la guía de 2017 de ACC/AHA


Introduction and objectives: The aim of this study is to determine the diagnostic validity of blood pressure measurement in the community pharmacy (CPBP), and to set the cut-off points in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in order to maximise the aforementioned validity, using 24 hour ambulatory blood pressure monitoring (ABPM) as the reference method. Material and methods: A cross-sectional study with consecutive selection of patient users of the community pharmacy in Andalusia. The CPBP was measured, followed by 24-hour ABPM, which assessed the diagnostic validity of the CPBP. The AUC of the ROC curve was also calculated for SBP and DBP, along with the positive and negative predictive values, for different prevalences and the variation of sensitivity and specificity for the different cut-off points for SBP/DBP. Results: A total of 167 community pharmacy participated with 1,170 patients, of which 1,110 were valid. The CPBP showed a sensitivity of 60.41% (95% CI: 56.40-64.29), and a specificity of the 79.77% (95% CI: 76.12-82.99), a positive predictive values of 76.96% (95% CI: 72.89-80.57), and a negative predictive values of 64.31% (95% CI: 60.55%-67.90%). By using the ROC curve method, the optimal cut-off points are 134/81mm Hg, the point where the sensitivity and specificity and are balanced and the Youden index is maximised. Conclusions: The sensitivity is relatively low. To improve it tends to lower the cut-off points of SBP and DBP. The calculated optimum is 134/81mm Hg. This provides data on the desirability to review the current cut-off points (140/90), as proposed by the ACC/AHA 2017


Assuntos
Humanos , Pressão Arterial/fisiologia , Farmácias/organização & administração , Monitorização Ambulatorial/instrumentação , Monitorização Ambulatorial/métodos , Estudos Transversais , Sensibilidade e Especificidade , Intervalos de Confiança , Curva ROC
14.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 402-409, ago.-sept. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-182859

RESUMO

Background: This study was designed to detect the potential association of a nonfunctional adrenal incidentaloma (NFAI) with insulin resistance and associated metabolic disturbances, with a subsequent increase in cardiovascular risk factors. Methods: Eighty-three NFAI patients and 56 volunteers (controls) without any adrenal abnormalities on computed tomography (CT) were included. Fasting blood glucose (FBG), fasting insulin, lipid profiles, uric acid, homocysteine, fibrinogen, high sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured in both groups. Blood pressure (BP), waist circumference, body mass index (BMI), and carotid intima media thickness (CIMT) were evaluated in both the patients and volunteers. Results: There were no significant difference between the NFAI and control groups with respect to age, sex, BMI, waist circumference, systolic and diastolic BP, smoking, concomitant disease, and medications. Fasting insulin and glucose levels and homeostasis model of assessment-insulin resistance (HOMA-IR) scores were significantly higher in the NFAI group as compared with those in the control group (p<0.01). The frequency of metabolic syndrome in the NFAI group was higher than that in the control group (p<0.01). All the lipid fractions, except triglyceride (TG), (p<0.05), homocysteine (p=0.01), and fibrinogen levels (p<0.001), were significantly higher in the NFAI group as compared with the levels in the control group. There were no significant differences between the NFAI and control groups in terms of uric acid, hs-CRP, and adiponectin levels. The CIMT values in the NFAI group were significantly higher than those in the control group (0.74±0.14 vs. 0.53±0.09, p<0.001). The mean CIMT value showed a statistically positive correlation with age (r=0.245, p=0.004); the HOMA-IR score (r=0.490, p<0.001); and FBG (r=0.521, p<0.001), fasting insulin (r=0.432, p<0.001), total cholesterol (TC) (r=0.267, p=0.002), and fibrinogen (r=0.398, p<0.001) levels in the NFAI group. Conclusions: The results indicated that the NFAI patients had an elevated risk of insulin resistance, with metabolic syndrome and increased CIMT values. Long-term follow-up studies should be designed to evaluate postsurgical alterations in metabolic parameters and cardiovascular risk factors in NFAI patients


Antecedentes: Este estudio se diseñó para detectar la posible asociación del incidentaloma suprarrenal no funcionante (ISNF) con resistencia a la insulina y trastornos metabólicos asociados, con un incremento subsecuente en los factores de riesgo cardiovascular. Métodos: Se incluyó a 83 pacientes con ISNF y a 56 voluntarios (controles) sin anomalías suprarrenales en la tomografía computarizada (TC). Se determinaron en ambos grupos los valores de glucemia en ayunas (GA), insulina en ayunas, perfiles lipídicos, ácido úrico, homocisteína, fibrinógeno, proteína C reactiva de alta sensibilidad (PCRas) y adiponectina. Se evaluaron la presión arterial (PA), el perímetro de la cintura, el índice de masa corporal (IMC) y el grosor íntima-media carotídea (GIMC) tanto en los pacientes como en los voluntarios. Resultados: No había una diferencia significativa entre los grupos con ISNF y de control en cuanto a edad, sexo, IMC, perímetro de la cintura, PA sistólica y diastólica, tabaquismo, enfermedades concomitantes y medicamentos. Las concentraciones de insulina y glucosa en ayunas y las puntuaciones del modelo homeostático de evaluación de la resistencia a la insulina (HOMA-IR) fueron significativamente mayores en el grupo con ISNF que en el de control (p<0,01). La frecuencia de síndrome metabólico fue mayor en el grupo con ISNF que en el de control (p<0,01). Los valores de todas las fracciones lipídicas, excepto los de triglicéridos (TG) (p<0,05), homocisteína (p=0,01) y fibrinógeno (p<0,001), fueron significativamente mayores en el grupo con ISNF que en el de control. No hubo diferencias significativas entre los grupos con ISNF y de control en las concentraciones de ácido úrico, PCRas y adiponectina. Los valores del GIMC en el grupo con ISNF fueron significativamente mayores que los del grupo de control (0,74±0,14 frente a 0,53±0,09; p<0,001). El valor medio del GIMC mostró una correlación estadísticamente positiva con la edad (r=0,245; p=0,004); la puntuación del HOMA-IR (r=0,490; p<0,001), y la GA (r=0,521; p<0,001), la insulina en ayunas (r=0,432; p<0,001), el colesterol total (CT) (r=0,267; p=0,002) y el fibrinógeno (r=0,398; p<0,001) en el grupo con ISNF. Conclusión: Los resultados indicaban que los pacientes con ISNF tenían un riesgo elevado de resistencia a la insulina, con síndrome metabólico y aumento de los valores del GIMC. Deben diseñarse estudios de seguimiento a largo plazo para evaluar los cambios posquirúrgicos de los parámetros metabólicos y los factores de riesgo cardiovascular en pacientes con ISFN


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Achados Incidentais , Fatores de Risco , Neoplasias das Glândulas Suprarrenais/complicações , Doenças Cardiovasculares/metabolismo , Espessura Intima-Media Carotídea , Síndrome Metabólica/complicações , Resistência à Insulina , Glândulas Suprarrenais/patologia , Síndrome Metabólica/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Doenças Cardiovasculares/complicações , Síndrome Metabólica/fisiopatologia , Voluntários Saudáveis , Pressão Arterial , Índice de Massa Corporal , Relação Cintura-Quadril
15.
Kardiologiia ; 59(8): 72-76, 2019 Aug 08.
Artigo em Russo | MEDLINE | ID: mdl-31397232

RESUMO

Number of patients with arterial hypertension and stroke steadily grows. "Target" levels of arterial pressure are not established in patients after stroke. In this review, we present results of clinical trials and data of meta-analyses on this problem. Problems related to target levels of arterial pressure after stroke are also covered in a framework of present Russian (2010), European (2018) and American (2017) recommendations on diagnosis and treatment of arterial hypertension.


Assuntos
Hipertensão , Acidente Vascular Cerebral , Pressão Arterial , Pressão Sanguínea , Humanos , Federação Russa
16.
Hypertension ; 74(4): 896-902, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31378100

RESUMO

Early and preferential activation of cardiac sympathetic nerve activity (CSNA) is one of the strongest prognostic markers of heart failure (HF) in patients. Our previous studies have implicated central angiotensin mechanisms as playing a critical role in generating this increase in cardiac sympathetic drive. However, it is unclear if inhibition of AT1R (angiotensin type-1 receptors) in different neural groups in the sympathetic pathway to the heart, such as the sympathetic preganglionic neurons in the intermediolateral column of the spinal cord, can reduce cardiac sympathetic drive. We hypothesized that in HF, localized intrathecal administration of the AT1R antagonist losartan, specifically into the T1-2 subarachnoid space, would decrease CSNA. In normal conscious sheep, intrathecal infusion of Ang II (angiotensin II; 3.0 nmol/mL per hour), significantly increased mean arterial pressure and CSNA; this effect was abolished by prior administration of losartan (1 mg/h). In an ovine rapid ventricular pacing model of HF, the resting levels of heart rate and CSNA were significantly elevated compared with normals. Intrathecal infusion of losartan (1 mg/h) in HF significantly reduced CSNA and heart rate but did not change arterial pressure. The AT1R binding density in the spinal cord was also elevated in the HF group. Our data suggest that AT1Rs within the spinal cord are responsible, in part, for the increased CSNA in HF and may represent a target for the selective reduction of CSNA in HF.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Gânglios Simpáticos/efeitos dos fármacos , Insuficiência Cardíaca/fisiopatologia , Losartan/administração & dosagem , Sistema Nervoso Simpático/efeitos dos fármacos , Animais , Pressão Arterial/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Feminino , Gânglios Simpáticos/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Injeções Espinhais , Ovinos , Sistema Nervoso Simpático/fisiopatologia
17.
Hypertension ; 74(4): 910-920, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31422690

RESUMO

Hypertension is associated with increased sympathetic activity. A component of this sympathoexcitation may be driven by increased signaling from sensory endings from the heart to the autonomic control areas in the brain. This pathway mediates the so-called cardiac sympathetic afferent reflex, which is also activated by coronary ischemia or other nociceptive stimuli in the heart. The cardiac sympathetic afferent reflex has been shown to be enhanced in the heart failure state and in renal hypertension. However, little is known about its role in the development or progression of hypertension or the phenotype of the sensory endings involved. To investigate this, we used the selective afferent neurotoxin, resiniferatoxin (RTX) to chronically abolish the cardiac sympathetic afferent reflex in 2 models of hypertension; the spontaneous hypertensive rats (SHRs) and AngII (angiotensin II) infusion (240 ng/kg per min). Blood pressure (BP) was measured in conscious animals for 2 to 8 weeks post-RTX. Epidural application of RTX to the T1-T4 spinal segments prevented the further BP increase in 8-week-old SHR and lowered BP in 16-week-old SHR. RTX did not affect BP in Wistar-Kyoto normotensive rats nor in AngII-infused rats. Epicardial application of RTX (50 µg/mL) in 4-week-old SHR prevented the BP increase whereas this treatment does not lower BP in 16-week-old SHR. When RTX was administered into the L2-L5 spinal segments of 16-week-old SHR, no change in BP was observed. These findings indicate that signaling via thoracic afferent nerve fibers may contribute to the hypertension phenotype in the SHR but not in the Ang II infusion model of hypertension.


Assuntos
Pressão Sanguínea/fisiologia , Gânglios Espinais/metabolismo , Coração/inervação , Hipertensão/metabolismo , Canais de Cátion TRPV/agonistas , Angiotensina II , Animais , Pressão Arterial/efeitos dos fármacos , Pressão Arterial/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Diterpenos/farmacologia , Gânglios Espinais/efeitos dos fármacos , Coração/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Hipertensão/induzido quimicamente , Masculino , Neurotoxinas/farmacologia , Ratos , Ratos Endogâmicos SHR , Ratos Sprague-Dawley , Reflexo/efeitos dos fármacos , Reflexo/fisiologia , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/metabolismo
18.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(7): 852-856, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31441409

RESUMO

OBJECTIVE: To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. METHODS: A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. RESULTS: A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (µg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L): 1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. CONCLUSIONS: TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.


Assuntos
Medicina Tradicional Chinesa , Choque Séptico/terapia , Pressão Arterial , China , Humanos , Estudos Prospectivos
19.
Niger J Clin Pract ; 22(8): 1120-1125, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417056

RESUMO

Aim: Wilson's disease (WD) presents with different phenotypes. Neurologic and liver involvement in WD are well documented. Few reports demonstrated cardiac and vascular involvement. Several studies showed an association between serum copper levels and atherosclerosis. Although WD is the prototype disease of copper metabolism, atherosclerosis has not been studied yet. The aim of this study is to assess aortic stiffness in WD. Materials and Methods: Aortic pulse wave velocity (PWV), augmentation pressure (AP), augmentation index (AIx), central aortic systolic, diastolic, mean, and pulse pressures were measured using SphygmoCor (AtCor Medical) device in 32 patients with WD and 24 healthy controls. Results: Patients with WD and healthy controls were similar in terms of age sex, body mass index (BMI), and liver and kiney functions. However, patients with WD were anemic and thrombocytopenic. Echocardiographic parameters including left ventricular, atrial dimensions, and systolic and diastolic functions were similar between two groups. Patients with WD and healthy controls were compared. Baseline characteristics including age, sex, and BMI did not differ between groups. Central aortic systolic, diastolic, mean, and pulse pressures were similar between the groups. AP, AIx, and PWV did not differ between groups as well. Conclusion: Aortic stiffness in WD was similar in healthy controls.


Assuntos
Pressão Sanguínea/fisiologia , Cobre/metabolismo , Ecocardiografia/métodos , Degeneração Hepatolenticular/diagnóstico por imagem , Análise de Onda de Pulso , Rigidez Vascular/fisiologia , Adulto , Anemia/epidemiologia , Pressão Arterial , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Degeneração Hepatolenticular/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Trombocitopenia/epidemiologia , Turquia/epidemiologia
20.
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
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA