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1.
Arch. pediatr. Urug ; 92(2): e305, dic. 2021. tab
Artigo em Espanhol | LILACS, BNUY, UY-BNMED | ID: biblio-1278305

RESUMO

Las afecciones respiratorias agudas son la primera causa de consulta e ingreso hospitalario en los meses de invierno, y entre ellas el asma ocupa un lugar preponderante. El salbutamol es un broncodilatador con eficacia demostrada en las exacerbaciones y se utiliza de primera línea en el tratamiento. El objetivo de la presente comunicación es analizar dos casos clínicos de niños asmáticos que presentaron efectos adversos al salbutamol y requirieron el ingreso en la Unidad de Terapia Intensiva. Se propone revisar los efectos adversos del salbutamol empleado en crisis asmáticas y analizar las alternativas terapéuticas en esta enfermedad. Los síntomas de los efectos secundarios pueden confundirse con los causados por la propia enfermedad, por lo que puede usarse el fármaco de modo excesivo y es importante conocer el perfil posológico y caracterizar los posibles efectos secundarios en los pacientes para usar de manera racional y segura este medicamento.


Acute respiratory conditions are the first cause of consultation and hospital admission in the Winter months, being asthma the most important. Salbutamol is a bronchodilator with proven efficacy in exacerbations used first-line in treatment. The objective of this paper is to analyze two clinical cases of asthmatic children who presented adverse effects to salbutamol and required admission to the Intensive Care Unit. It is proposed to review the adverse effects of salbutamol used in asthmatic crises and to analyze therapeutic alternatives in this disease. Symptoms of side effects can be confused with those caused by the disease itself, determining the excessive use of this drug, thus, it is important to know the dosage profile and characterize the possible side effects to make rational and safe use of this drug.


As doenças respiratórias agudas são a primeira causa de consultas e internações nos meses de inverno e a asma ocupa é a mais importante. O salbutamol é um broncodilatador com eficácia comprovada nas exacerbações e é usado como tratamento de primeira linha. O objetivo desta comunicação é analisar dois casos clínicos de crianças asmáticas que apresentaram efeitos adversos ao salbutamol e necessitaram de internação em Unidade de Terapia Intensiva. Propõe-se revisar os efeitos adversos do salbutamol utilizado na crise asmática e analisar as alternativas terapêuticas nessa doença. Os sintomas de efeitos colaterais podem ser confundidos com os causados pela própria doença, determinando o uso excessivo desse medicamento, sendo importante conhecer o perfil posológico e caracterizar os possíveis efeitos colaterais nos pacientes para fazer um uso racional e seguro desse medicamento.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Acidose Láctica , Broncodilatadores/efeitos adversos , Albuterol/efeitos adversos , Hiperglicemia/induzido quimicamente , Hipopotassemia/induzido quimicamente , Agitação Psicomotora/etiologia , Recidiva , Asma/tratamento farmacológico , Taquicardia/induzido quimicamente , Tremor/induzido quimicamente , Alucinações/induzido quimicamente
2.
Medicine (Baltimore) ; 100(41): e27469, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731124

RESUMO

BACKGROUND: We conducted this meta-analysis to explore the tolerance of monotherapy with mirabegron (50 mg) on an overactive bladder, compared with a common dosage of anticholinergic agents. MATERIALS AND METHODS: A comprehensive search for all randomized controlled trials that evaluated the safety of mirabegron and anticholinergic agents on overactive bladder was performed, and we searched the Cochrane Central Register of Controlled trials databases, Pubmed, Embase, and relevant trials from 2013.02 to 2019.10. RESULTS: Eight studies included 5500 patients with treatment of monotherapy on overactive bladder were identified. The total number of treatment-emergent adverse events had no significantly difference between two monotherapies (RR = 0.88 95%CI: 0.76-1.01; P = .08); however, patients would have a better tolerance with mirabegron (50 mg) in adverse events of dry mouth (RR = 0.42; 95%CI: 0.33-0.53; P < .01) and tachycardia (RR = 0.52; 95%CI: 0.29-0.94; P = .03); and there were no significant differences between two groups in hypertension (RR = 1.02; 95%CI: 0.80-1.30; P = .90), constipation (RR = 0.91; 95%CI: 0.65-1.26; P = 0.57), blurred vision (RR = 1.03; 95%CI: 0.60-1.77; P = 0.92), and urinary tract infection (RR = 0.90; 95%CI: 0.70-1.16; P = .41). CONCLUSIONS: Treatment-emergent adverse events in patients with overactive bladder who underwent monotherapy of mirabegron (50 mg) or the anticholinergic agents had no significant differences, but mirabegron has a better tolerance in the aspect of dry mouth and tachycardia.


Assuntos
Acetanilidas/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 3/uso terapêutico , Antagonistas Colinérgicos/uso terapêutico , Tiazóis/uso terapêutico , Bexiga Urinária Hiperativa/tratamento farmacológico , Acetanilidas/administração & dosagem , Acetanilidas/efeitos adversos , Agonistas de Receptores Adrenérgicos beta 3/administração & dosagem , Agonistas de Receptores Adrenérgicos beta 3/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Antagonistas Colinérgicos/efeitos adversos , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/epidemiologia , Feminino , Humanos , Hipertensão/induzido quimicamente , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Taquicardia/induzido quimicamente , Taquicardia/epidemiologia , Tiazóis/administração & dosagem , Tiazóis/efeitos adversos , Infecções Urinárias/induzido quimicamente , Infecções Urinárias/epidemiologia , Baixa Visão/induzido quimicamente , Baixa Visão/epidemiologia , Xerostomia/induzido quimicamente , Xerostomia/epidemiologia
3.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(5): 517-523, 2021 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-34628764

RESUMO

Pulsed electric field(PEF) provides high-energy instantaneous pulse and release energy to myocardial cell membrane, resulting in irreversible electroporation and causes myocardial cell contents leakage, destruction of intracellular homeostasis, cell death, and slight inflammatory response. PEF as non-thermal energy promotes the design and application of arrhythmia ablation catheter to enter a new stage. There are currently limited clinical studies that have proved the safety and effectieness of Farawave PEF catheter, PVAC GOLD PEF catheter, Lattice-tip Sphere-9 PEF and radiofrequency (RF) catheter used for atrial fibrillation ablation, but still need further discussion. The research of atrial fibrillation ablation with PEF is under study in China. In this paper, the design and application of PEF ablation for tachyarrhythmia are reviewed.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Fibrilação Atrial/cirurgia , Cateteres , Humanos , Veias Pulmonares/cirurgia , Taquicardia
4.
J Am Vet Med Assoc ; 259(8): 914-918, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34609187

RESUMO

CASE DESCRIPTION: 2 Nigerian Dwarf goats (a doe [goat 1] and a wether [goat 2]) with coughing and nasal discharge since they were purchased at an auction 6 days prior were empirically treated for suspected pneumonia and intestinal parasitism. An ivermectin dosing error (intended dose, 0.4 mg/kg, PO; administered dose, 10 mg/kg, PO) was retrospectively discovered, and the owner was urged to return the goats for hospitalization and treatment. CLINICAL FINDINGS: On admission 19 hours after iatrogenic ivermectin overdose, both goats had tachycardia, tachypnea, and absent menace responses. Goat 1 also had vomited in transit, was lethargic and febrile, had slow pupillary light reflexes, and walked into walls and obstacles. Goat 2 was quiet but responsive, not ataxic or febrile, and had pale mucous membranes and a prolonged capillary refill time. TREATMENT AND OUTCOME: Each goat received 20% IV lipid emulsion (2 mL/kg, IV bolus over 15 minutes, followed by 0.008 mL/kg/min, IV) and immediately improved. Activated charcoal was administered by orogastric tube, and 6 hours later, mineral oil was similarly administered. Goat 1 had complete resolution of signs and was discharged by 48 and 72 hours, respectively, after admission. Goat 2 improved but developed progressive respiratory distress after the second orogastric intubation and was euthanized. Necropsy findings were consistent with acute renal tubular necrosis, acute respiratory distress syndrome of unknown cause, ruminal tympany, and mesenteric caseous lymphadenitis. CLINICAL RELEVANCE: Results indicated that IV lipid emulsion could be used to successfully treat ivermectin toxicosis in goats. Treatment early in the course of ivermectin toxicosis is advisable to avoid severe clinical signs and secondary complications.


Assuntos
Doenças das Cabras , Ivermectina , Animais , Emulsões Gordurosas Intravenosas/uso terapêutico , Doenças das Cabras/induzido quimicamente , Doenças das Cabras/tratamento farmacológico , Cabras , Ivermectina/toxicidade , Masculino , Estudos Retrospectivos , Taquicardia/veterinária
6.
Sensors (Basel) ; 21(18)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34577222

RESUMO

Photoplethysmography (PPG) as an additional biosignal for a seizure detector has been underutilized so far, which is possibly due to its susceptibility to motion artifacts. We investigated 62 focal seizures from 28 patients with electrocardiography-based evidence of ictal tachycardia (IT). Seizures were divided into subgroups: those without epileptic movements and those with epileptic movements not affecting and affecting the extremities. PPG-based heart rate (HR) derived from a wrist-worn device was calculated for sections with high signal quality, which were identified using spectral entropy. Overall, IT based on PPG was identified in 37 of 62 (60%) seizures (9/19, 7/8, and 21/35 in the three groups, respectively) and could be found prior to the onset of epileptic movements affecting the extremities in 14/21 seizures. In 30/37 seizures, PPG-based IT was in good temporal agreement (<10 s) with ECG-based IT, with an average delay of 5.0 s relative to EEG onset. In summary, we observed that the identification of IT by means of a wearable PPG sensor is possible not only for non-motor seizures but also in motor seizures, which is due to the early manifestation of IT in a relevant subset of focal seizures. However, both spontaneous and epileptic movements can impair PPG-based seizure detection.


Assuntos
Fotopletismografia , Dispositivos Eletrônicos Vestíveis , Eletrocardiografia , Eletroencefalografia , Frequência Cardíaca , Humanos , Convulsões/diagnóstico , Processamento de Sinais Assistido por Computador , Taquicardia
7.
Rev. colomb. anestesiol ; 49(3): e500, July-Sept. 2021. graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1280182

RESUMO

Systemic sclerosis is an immunological disorder characterized by tissue fibrosis and multi-organ dysfunction.1 The accompanying images exhibit electrocardiographic changes in severe systemic sclerosis. Advanced 3:1 atrioventricular block, best observed in Lead Vi, suggests extensive fibrosis of the conduction system (Image A). While one P wave is buried in the T wave (black arrows), two are evident (red arrows) along the isoelectric line. Bradyarrhythmia related prolonged QT interval, best measured in Lead II represents increased risk for torsades-de-pointes, a polymorphic ventricular tachyarrhythmia. Additionally, right bundle branch block with giant T wave inversions (T wave depth > 10 mm) in precordial leads V2- 4 suggests pulmonary hypertension. Post-induction the rhythm abruptly changes to torsades-de-pointes (Image B) necessitating defibrillation.


La esclerosis sistémica es un trastorno inmunológico caracterizado por fibrosis tisular y disfunción multiorgánica. 1 Las imágenes adjuntas muestran cambios electrocardiográficos en la esclerosis sistémica grave. El bloqueo auriculoventricular avanzado 3: 1, que se observa mejor en la derivación VI, sugiere una fibrosis extensa del sistema de conducción ( Imagen A ).Mientras que una onda P está enterrada en la onda T (flechas negras), dos son evidentes (flechas rojas) a lo largo de la línea isoeléctrica. El intervalo QT prolongado relacionado con bradiarritmia, mejor medido en la derivación II, representa un mayor riesgo de torsades-de-pointes, una taquiarritmia ventricular polimórfica. Además, el bloqueo de la rama derecha del haz con inversiones de la onda T gigante (profundidad de la onda T> 10 mm) en las derivaciones precordiales V2- 4 sugiere hipertensión pulmonar. Después de la inducción, el ritmo cambia abruptamente a torsades-de-pointes ( Imagen B ), lo que requiere desfibrilación.


Assuntos
Humanos , Arritmias Cardíacas , Escleroderma Sistêmico , Eletrocardiografia , Taquicardia , Bradicardia , Bloqueio de Ramo , Risco , Taquicardia Ventricular , Bloqueio Atrioventricular , Hipertensão Pulmonar
8.
BMC Vet Res ; 17(1): 302, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503510

RESUMO

BACKGROUND: Diseases of the central nervous system are a well-recognized cause of morbidity and mortality in equine. Collection and analysis of cerebrospinal fluid (CSF) give information about the type and stage of degenerative and inflammatory diseases in central nervous system (CNS). The present research aimed to assess the clinical complications of CSF collections and to establish range values of cytological and biochemical parameters of CSF in adult healthy donkeys (Equus asinus). The CSF samples were collected from fifty healthy donkeys at the lumbosacral (LS) and atlanto-occipital (AO) sites. RESULTS: Hypothermia, tachycardia, ataxia and recumbency may develop post-puncture. Erythrocytes were noticed in 35 of 50 CSF samples. Total nucleated cell counts ranged from 0 to 6 cells/µL, and lymphocytes predominated the cells (61%). The concentration of glucose (1.2 to 5.3 mmol/L) was lower than that of serum (P < 0.05). The CSF sodium concentration (123 to 160 mmol/L) was approximately like that of serum, but potassium (1.5-3 mmol/L) was lower than that of serum (P < 0.01). Urea concentrations (1.1-2.9 mmol/L) were markedly lower than serum (P < 0.001). Concentrations of CSF total proteins, and albumin ranged from 0.1 to 0.6 g/dL, and from 0.002 to 0.013 g/dL, respectively. The albumin quotient ranged from 0.06 to 0.56. CONCLUSIONS: Transient hypothermia, tachycardia, ataxia and recumbency may develop as clinical complications of CSF puncture procedures. The collection site has no impact on the constituents in CSF. Furthermore, this study presented the range values for normal cytological and biochemical constituents of CSF in donkeys (Equus asinus) that can provide a basis in comparison when evaluating CSF from donkeys with neurologic diseases.


Assuntos
Ataxia/veterinária , Líquido Cefalorraquidiano/química , Líquido Cefalorraquidiano/citologia , Equidae/líquido cefalorraquidiano , Hipotermia/veterinária , Punção Espinal/veterinária , Taquicardia/veterinária , Animais , Ataxia/etiologia , Contagem de Células , Hipotermia/etiologia , Valores de Referência , Punção Espinal/efeitos adversos , Taquicardia/etiologia
9.
Diabetes Metab Syndr ; 15(5): 102235, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34384972

RESUMO

BACKGROUND AND AIMS: Post Covid-19 syndrome (PCS) is a major cause of morbidity. In this article we intend to review the association and consequences of PCS and diabetes. METHODS: We reviewed all studies on "Long Covid", "Post COVID-19 Syndrome" and diabetes in PubMed and Google Scholar. RESULTS: The symptoms of PCS can be due to organ dysfunction, effects of hospitalisation and drugs, or unrelated to these. Type 2 diabetes mellitus has a bidirectional relationship with COVID-19. Presence of diabetes also influences PCS via various pathophysiological mechanisms. COVID-19 can add to or exacerbate tachycardia, sarcopenia (and muscle fatigue), and microvascular dysfunction (and organ damage) in patients with diabetes. CONCLUSION: PCS in patients with diabetes could be detrimental in multiple ways. Strict control of diabetes and other comorbidities, supervised rehabilitation and physical exercise, and optimal nutrition could help in reducing and managing PCS.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/etiologia , COVID-19/terapia , Comorbidade , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Fadiga/diagnóstico , Fadiga/epidemiologia , Fadiga/etiologia , Fadiga/terapia , Humanos , SARS-CoV-2/fisiologia , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Sarcopenia/etiologia , Sarcopenia/terapia , Taquicardia/diagnóstico , Taquicardia/epidemiologia , Taquicardia/etiologia , Taquicardia/terapia
10.
Medicine (Baltimore) ; 100(31): e26702, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397805

RESUMO

INTRODUCTION: Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) catheter ablation. However, a PVI alone has been considered insufficient for persistent AF. This study aimed to evaluate the efficacy of persistent AF ablation targeting complex fractionated atrial electrogram (CFAE) areas within low voltage zones identified by high-resolution mapping in addition to the PVI. METHODS: We randomized 50 patients (mean age 58.4 ±â€Š9.5 years old, 86.0% males) with persistent AF to a PVI + CFAE group and PVI only group in a 1:1 ratio. CFAE and voltage mapping was performed simultaneously using a Pentaray Catheter with the CARTO3 CONFIDENSE module (Biosense Webster, CA, USA). The PVI + CFAE group, in addition to the PVI, underwent ablation targeting low voltage areas (<0.5 mV during AF) containing CFAEs. RESULTS: The mean persistent AF duration was 24.0 ±â€Š23.1 months and mean left atrial dimension 4.9 ±â€Š0.5 cm. In the PVI + CFAE group, AF converted to atrial tachycardia (AT) or sinus rhythm in 15 patients (60%) during the procedure. The PVI + CFAE group had a higher 1-year AF free survival (84.0% PVI + CFAE vs 44.0 PVI only, P = .006) without antiarrhythmic drugs. However, there was no difference in the AF/AT free survival (60.0% PVI + CFAE vs 40.0% PVI only, P = .329). CONCLUSION: Persistent AF ablation targeting CFAE areas within low voltage zones using high-density voltage mapping had a higher AF free survival than a PVI only. Although recurrence with AT was frequent in the PVI+CFAE group, the sinus rhythm maintenance rate after redo procedures was 76%.


Assuntos
Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Técnicas Eletrofisiológicas Cardíacas , Idoso , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Intervalo Livre de Doença , Técnicas Eletrofisiológicas Cardíacas/métodos , Feminino , Átrios do Coração , Humanos , Masculino , Pessoa de Meia-Idade , Veias Pulmonares/cirurgia , Recidiva , Cirurgia Assistida por Computador , Taquicardia/etiologia
11.
J Electrocardiol ; 68: 77-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34388393

RESUMO

Pulmonary vein atrial tachycardia (PVAT) is a rare arrhythmia that accounts for 3% of all atrial tachycardia types. On electrocardiogram, fast PVATs may be misinterpreted as atrial fibrillation at first glance. We present a case of PVAT refractory to pharmacological intervention in a 31-year-old, requiring ablation to terminate the arrhythmia.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Adulto , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Eletrocardiografia , Humanos , Masculino , Veias Pulmonares/cirurgia , Taquicardia , Resultado do Tratamento
13.
Clin Med (Lond) ; 21(5): e434-e437, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34385298

RESUMO

Tachycardia in pregnancy is common, and distinguishing between physiological and pathological causes can be a challenge. Understanding the cardiovascular changes that take place in pregnancy can help to direct investigations. The finding of a persistent tachycardia, regardless of symptoms, should always prompt clinical review and consideration of investigations (such as blood tests, electrocardiography and echocardiography), where indicated. Treatment of tachyarrhythmias in pregnancy differs very little from a non-pregnant adult, and unstable arrhythmias should follow Resuscitation Council UK guidelines. Pregnant women with pathological arrhythmias need to be cared for under a multidisciplinary team, including obstetricians, obstetric anaesthetists, specialist midwives, cardiologists and obstetric physicians.


Assuntos
Complicações Cardiovasculares na Gravidez , Adulto , Arritmias Cardíacas , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/terapia , Taquicardia
14.
Sci Rep ; 11(1): 16133, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373508

RESUMO

The endocannabinoid neurotransmission acting via local CB1 receptor in the bed nucleus of the stria terminalis (BNST) has been implicated in behavioral and physiological responses to emotional stress. However, the neural network related to this control is poorly understood. In this sense, the lateral hypothalamus (LH) is involved in stress responses, and BNST GABAergic neurons densely innervate this hypothalamic nucleus. However, a role of BNST projections to the LH in physiological responses to stress is unknown. Therefore, using male rats, we investigated the role of LH GABAergic neurotransmission in the regulation of cardiovascular responses to stress by CB1 receptors within the BNST. We observed that microinjection of the selective CB1 receptor antagonist AM251 into the BNST decreased the number of Fos-immunoreactive cells within the LH of rats submitted to acute restraint stress. Treatment of the BNST with AM251 also enhanced restraint-evoked tachycardia. Nevertheless, arterial pressure increase and sympathetically-mediated cutaneous vasoconstriction to restraint was not affected by CB1 receptor antagonism within the BNST. The effect of AM251 in the BNST on restraint-evoked tachycardia was abolished in animals pretreated with the selective GABAA receptor antagonist SR95531 in the LH. These results indicate that regulation of cardiovascular responses to stress by CB1 receptors in the BNST is mediated by GABAergic neurotransmission in the LH. Present data also provide evidence of the BNST endocannabinoid neurotransmission as a mechanism involved in LH neuronal activation during stressful events.


Assuntos
Endocanabinoides/fisiologia , Região Hipotalâmica Lateral/fisiologia , Angústia Psicológica , Núcleos Septais/fisiologia , Animais , Antagonistas de Receptores de Canabinoides/administração & dosagem , Antagonistas GABAérgicos/administração & dosagem , Neurônios GABAérgicos/efeitos dos fármacos , Neurônios GABAérgicos/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Região Hipotalâmica Lateral/efeitos dos fármacos , Masculino , Modelos Neurológicos , Piperidinas/administração & dosagem , Pirazóis/administração & dosagem , Piridazinas/administração & dosagem , Ratos , Ratos Wistar , Núcleos Septais/efeitos dos fármacos , Estresse Psicológico/fisiopatologia , Transmissão Sináptica/efeitos dos fármacos , Transmissão Sináptica/fisiologia , Taquicardia/fisiopatologia
15.
Sci Rep ; 11(1): 16999, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34417540

RESUMO

The effect of uridine on the myocardial ischemic and reperfusion injury was investigated. A possible mechanism of its cardioprotective action was established. Two rat models were used: (1) acute myocardial ischemia induced by occlusion of the left coronary artery for 60 min; and (2) myocardial ischemia/reperfusion with 30-min ischemia and 120-min reperfusion. In both models, treatment with uridine (30 mg/kg) prevented a decrease in cell energy supply and in the activity of the antioxidant system, as well as an increase in the level of lipid hydroperoxides and diene conjugates. This led to a reduction of the necrosis zone in the myocardium and disturbances in the heart rhythm. The blocker of the mitochondrial ATP-dependent potassium (mitoKATP) channel 5-hydroxydecanoate limited the positive effects of uridine. The data indicate that the cardioprotective action of uridine may be related to the activation of the mitoKATP channel. Intravenously injected uridine was more rapidly eliminated from the blood in hypoxia than in normoxia, and the level of the mitoKATP channel activator UDP in the myocardium after uridine administration increased. The results suggest that the use of uridine can be a potentially effective approach to the management of cardiovascular diseases.


Assuntos
Traumatismo por Reperfusão Miocárdica/metabolismo , Traumatismo por Reperfusão Miocárdica/patologia , Miocárdio/patologia , Canais de Potássio/metabolismo , Uridina/farmacologia , Doença Aguda , Trifosfato de Adenosina/metabolismo , Animais , Antioxidantes/metabolismo , Arritmias Cardíacas/sangue , Arritmias Cardíacas/tratamento farmacológico , Arritmias Cardíacas/etiologia , Modelos Animais de Doenças , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Traumatismo por Reperfusão Miocárdica/sangue , Miocárdio/metabolismo , Ratos Wistar , Taquicardia/sangue , Taquicardia/complicações , Uridina/sangue , Uridina/uso terapêutico , Difosfato de Uridina/metabolismo , Uridina Trifosfato/metabolismo , Fibrilação Ventricular/complicações , Fibrilação Ventricular/tratamento farmacológico
16.
J Electrocardiol ; 68: 53-55, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34333406

RESUMO

Traditional rules of arrhythmia mechanisms may not apply in altered anatomical states such as heart transplantation. We present a case of a young man presenting with incessant tachycardia that violates routine electrocardiographic criteria for rhythm analysis. Meticulous attention to surgical techniques and anastomotic sites is crucial when approaching post-operative arrhythmias.


Assuntos
Eletrocardiografia , Transplante de Coração , Arritmias Cardíacas , Humanos , Masculino , Taquicardia
19.
Anaesth Intensive Care ; 49(5): 366-378, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34407620

RESUMO

Persistent tachycardia in patients with septic shock predicts poor outcome. This study sought to investigate the effect of the cardiac pacemaker current inhibitor ivabradine on heart rate and cardio-circulatory function in patients with septic shock. After informed consent, 60 patients with septic shock and persistent tachycardia (heart rate >95 /minute) were prospectively randomly assigned to receive either standard therapy for septic shock (group S) or standard therapy along with enteral ivabradine (group I) for the initial 96 hours after enrolment. Primary outcome was the difference in heart rate between the two groups during the first 96 hours. Secondary outcomes included the effect of ivabradine on haemodynamic, oxygenation, myocardial function and organ function parameters, incidence of adverse events and 30-day overall survival. Heart rate was lower in group I compared to group S (median difference in area under the curve -25.6 (95% confidence intervals -31.4 to -15.9) /minute; P <0.001). Vasopressor requirements, blood lactate levels, Sequential Organ Failure Assessment scores and E/e' ratio were lower in group I compared to group S. Stroke volume index and ejection fraction were higher in group I while cardiac index and oxygen delivery parameters were maintained similar to group S. There was no difference in 30-day mortality or in the incidence of serious adverse events. Enteral ivabradine is effective in reducing heart rate, and improving haemodynamic parameters and cardiac function in patients with septic shock and persistent tachycardia, without increasing the incidence of adverse events.


Assuntos
Choque Séptico , Frequência Cardíaca , Humanos , Ivabradina , Choque Séptico/tratamento farmacológico , Volume Sistólico , Taquicardia
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