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Sample records for beriberi cardiovascular agudo

  1. Beriberi cardiovascular agudo (Shoshin-Beriberi Acute cardiovascular beriberi (shoshin-beriberi

    Directory of Open Access Journals (Sweden)

    Osvaldo D. López Gastón

    2002-08-01

    Full Text Available El beriberi, la deficiencia de tiamina (B1, fue referido en el siglo XVII en la literatura asiática, y pue de manifestarse por síntomas neurológicos (beriberi «seco» donde la neuropatía periférica y la debilidad muscular son los más destacados y/o síntomas cardiovasculares (beriberi «húmedo», con una variante «clásica» donde es predominante la insuficiencia cardíaca derecha con índice cardíaco (IC normal o alto y otra aguda o «shoshin-beriberi», caracterizada por insuficiencia biventricular, acidosis láctica e IC variable y que sin tratamiento precoz evoluciona al colapso vascular y la muerte. Se presenta una paciente de 58 años y antecedente de enolismo, con disnea, oliguria, sígnos de fallo cardíaco biventricular con patrón hiperdinámico, acidosis metabólica, disfunción tubular renal y lactacidemia de 5.6 mEq/L. El exámen neurológico mostró una polineuropatía sensitiva, simétrica y distal en MMII y deterioro cognitivo con sígnos frontales. Horas después de la administración de 100 mg de tiamina ev. se observó una manifiesta mejoría de los valores hemodinámicos y el estado ácido-base. Se concluye que si bien el beriberi cardiovascular agudo es de presentación infrecuente hay consenso en que además es subdiagnosticado. La presencia de acidosis láctica o cuadro de insuficiencia cardíaca de alto volumen minuto sin etiología manifiesta, en pacientes con riesgo de deficiencia de B1, es suficiente para hacer la prueba terapéutica.Beriberi (BB, thiamine deficiency, has been described in the Asian literature in the 17th century and is characterized by peripheral neuropathy and muscle weakness, also called «dry» beriberi (BB to differentiate it from «wet» BB, with essentially cardiovascular manifestations. Wet can be either «classic» wet BB in which signs and symptons of right-sided heart failure with normal or high cardiac output are the presenting features or the «shoshin» BB variant with severe

  2. Beriberi

    Science.gov (United States)

    ... Affects the cardiovascular system. Dry beriberi and Wernicke-Korsakoff syndrome : Affects the nervous system. Beriberi is rare in ... movements, and walking difficulties may go away. However, Korsakoff syndrome (or Korsakoff psychosis) tends to develop as Wernicke ...

  3. Efeitos cardiovasculares agudos do exercício resistido em idosas hipertensas = Cute cardiovascular effects of resistence exercise on hypertensive elderly women

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    Kleverton Krinski

    2008-07-01

    Full Text Available O objetivo deste estudo foi avaliar os efeitos cardiovasculares agudos do exercício resistido (ER em idosas com hipertensão estágio I. Participaram 24 hipertensas (63,7 ± 3,7 anos, submetidas a uma sessão de ER, constituída por oito estações (três séries,12 repetições, 50% 1 RM. A frequência cardíaca (FC, a pressão arterial sistólica (PAS e a diastólica (PAD foram mensuradas anteriormente ao início dos exercícios (A, imediatamente após a quinta estação (B e 10 min. após a sessão de exercícios (C. Anova demedidas repetidas e post-hoc Tukey (p The aim of this study was to evaluate the effect of acute cardiovascular responses of resistance exercise (RE on stage I hypertensive elderly women. Twenty four hypertensive women (63.7 ± 3.7 years were subjected a session of RE, with eight stations(3 sets, 12 repetitions, 50% 1 RM. The heart rate (HR, systolic blood pressure (SBP and blood pressure (DBP were measured before the exercise sessions (A, immediately after the fifth station (B, and 10 minutes after the exercise sessions (C. Repeated measuresAnova and post-hoc Tukey test (p < 0.05 were performed. The results demonstrated significant increase in SBP, DBP and HR (p < 0.05 between the A and B conditions. Subsequently, SBP and DBP decreased significantly for the C condition as compared to the B condition (p < 0.05; however, only DBP decreased significantly for the A condition (p < 0.05. Although the results demonstrated that acute cardiovascular modifications are associated with RE, hypotensive effects were only verified on DBP.

  4. Infantile encephalitic beriberi: magnetic resonance imaging findings

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    Wani, Nisar A. [Government Medical College Srinagar, Department of Pediatric Radiology, Jammu and Kashmir, Pin (India); Qureshi, Umar A.; Ahmad, Kaiser; Ahmad, Waseem [Government Medical College Srinagar, Department of Pediatrics, Jammu and Kashmir (India); Jehangir, Majid [Government Medical College Srinagar, Department of Radiology, Jammu and Kashmir (India)

    2016-01-15

    Thiamine deficiency in infants is still encountered in developing countries. It may present with acute neurological manifestations of infantile encephalitic beriberi. To review brain MRI findings in infantile encephalitic beriberi from a single institution. A retrospective review of MRI scans in 22 infants with acute-onset beriberi encephalopathy was carried out. Hyperintense lesions on T2-weighted images were seen symmetrically in the putamen in all patients, in the caudate nuclei in 16/22 (73%), the thalami in 7/22 (32%) and the globi pallidi in 3/22 (14%) of the infants. Altered signal intensity lesions in the cerebral cortex were seen in 7/22 (32%). The mammillary bodies were seen in one infant and the periaqueductal gray matter in two. There was restricted diffusion in 14/22 (64%), and 6/8 children with no evidence of restriction had been imaged ≥10 days after presentation. MR spectroscopy showed increased lactate peak in 6/8 infants (75%). Recognition of symmetrical T2-W hyperintense lesions in the basal ganglia with restricted diffusion and prominent lactate peak may allow early diagnosis of encephalitic beriberi in at-risk infants. (orig.)

  5. Efecto del tratamiento con vitamina D sobre eventos cardiovasculares en pacientes revascularizados tras síndrome coronario agudo

    OpenAIRE

    Navarro Valverde, Cristina

    2015-01-01

    La presente tesis doctoral pretende evaluar el posible beneficio pronóstico de la administración de suplementos de vitamina D en forma de 25(OH)D3 en pacientes mayores de 60 años que han sido revascularizados tras presentar un síndrome coronario agudo. Para ello se diseñó un estudio de intervención con un grupo de tratamiento y un grupo control. El primer capítulo de esta tesis hace una revisión crítica de la fisiopatología de la enfermedad coronaria, el metabolismo de la vitamina D y el p...

  6. Empleo del Yopodato Sódico (Biloptin) en el tratamiento agudo de las complicaciones cardiovasculares severas del hipertiroidismo.

    OpenAIRE

    SECLEN, Segundo; Pretell, Eduardo; Tapia, Fernando; Sosa, José; Barreto, Rodolfo

    2014-01-01

    Los cambios hemodinámicos del hipertiroidismo son atribuídos al efecto cronotropo e inotropo cardíaco directo del exceso de T3, así como a cambios en la resistencia periférica. Recientes estudios han demostrado que el yopodato sódico disminuye rápidamente los niveles de T3 en más del 50% de los valores basales dentro de las 24 horas, al bloquear la conversión de T4 a T3. Este estudio muestra su utilidad en controlar las manifestaciones cardiovasculares severas del hipertiroidismo, en 5 casos ...

  7. Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar

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    Nuria Huertas-González

    2015-01-01

    Full Text Available Background. Wernicke’s encephalopathy (WE is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders. This vitamin deficiency can also present with cardiovascular symptoms, called “wet beriberi.” Association with folate deficit worsens the clinical picture. Subject. A 70-year-old man with gastric phytobezoar presented with gait instability, dyspnoea, chest pain associated with right heart failure and pericarditis, and folate deficiency. Furosemide was administered and cardiac symptoms improved but he soon developed vertiginous syndrome, nystagmus, diplopia, dysmetria, and sensitive and motor deficit in all four limbs with areflexia. Results. A cerebral magnetic resonance imaging (MRI showed typical findings of WE. He was immediately treated with thiamine. Neurological symptoms improved in a few days and abnormal signals disappeared in a follow-up MRI two weeks later. Conclusion. Patients with malabsorption due to gastrointestinal disorders have an increased risk of thiamine deficiency, and folate deficiency can make this vitamin malabsorption worse. An established deficiency mainly shows neurological symptoms, WE, or rarely cardiovascular symptoms, wet beriberi. Early vitamin treatment in symptomatic patients improves prognosis. We recommend administration of prophylactic multivitamins supplements in patients at risk as routine clinical practice.

  8. Wernicke's Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar

    Science.gov (United States)

    Huertas-González, Nuria; Hernando-Requejo, Virgilio; Luciano-García, Zaida; Cervera-Rodilla, Juan Luis

    2015-01-01

    Background. Wernicke's encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders. This vitamin deficiency can also present with cardiovascular symptoms, called “wet beriberi.” Association with folate deficit worsens the clinical picture. Subject. A 70-year-old man with gastric phytobezoar presented with gait instability, dyspnoea, chest pain associated with right heart failure and pericarditis, and folate deficiency. Furosemide was administered and cardiac symptoms improved but he soon developed vertiginous syndrome, nystagmus, diplopia, dysmetria, and sensitive and motor deficit in all four limbs with areflexia. Results. A cerebral magnetic resonance imaging (MRI) showed typical findings of WE. He was immediately treated with thiamine. Neurological symptoms improved in a few days and abnormal signals disappeared in a follow-up MRI two weeks later. Conclusion. Patients with malabsorption due to gastrointestinal disorders have an increased risk of thiamine deficiency, and folate deficiency can make this vitamin malabsorption worse. An established deficiency mainly shows neurological symptoms, WE, or rarely cardiovascular symptoms, wet beriberi. Early vitamin treatment in symptomatic patients improves prognosis. We recommend administration of prophylactic multivitamins supplements in patients at risk as routine clinical practice. PMID:26697247

  9. Marcadores hemostáticos y de inflamación en síndromes coronarios agudos y su asociación con eventos cardiovasculares adversos

    OpenAIRE

    2006-01-01

    Antecedentes: En síndromes coronarios agudos (SCA) la interacción entre factores inflamatorios y hemostáticos podría tener una relación estrecha con trombosis recurrente y eventos adversos hospitalarios. Métodos: Estudio prospectivo, controlado con un seguimiento de seis años. Objetivo: Conocer si existe una asociación en la fase aguda y en el seguimiento entre marcadores de inflamación (proteína C reactiva, fibrinógeno y leucocitos), coagulación (antitrombina III, proteína C y S, resistencia...

  10. Epidemias de Escorbuto y Beriberi en la Historia de Colombia

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    Hugo Armando Sotomayor Tribin

    1993-08-01

    Full Text Available

    El escorbuto por déficit en la dieta de alimentos ricos en vitamina C, o ácido ascórbico, y el beriberi por déficit de tiarnina o vitamina B1, tienen una historia universal vinculada, el primero a los viajes transoceánicos y a la ausencia durante ellos de frutas y legumbres frescas, y el segundo a zonas geográficas con el consumo de alimentos sin esa vitamina.

    Porque los indígenas colombianos siempre contaron en su dieta con fuentes ricas en vitamina C y tiamina, como el ají -hasta el extremo que el ayuno, el sacrificio y el castigo en esas comunidades se asociaba a la privación de esa planta (1, 2- Y por ser sus viajes marítimos, al igual que los viajes de los europeos hasta el siglo XIV y XV, de puerto a puerto, siguiendo la línea costera, ellos con seguridad no padecieron déficits importantes de esas vitaminas.

    Las manifestaciones clínicas del escorbuto son principalmente las hemorragias perifoliculares, las petequias, las equimosis, la hinchazón y sangrado de encías y la anemia. El escorbuto si no se trata es mortal (3.

    El beriberi, llamado así originalmente por los habitantes de Indonesia, parece que es una enfermedad conocida por los chinos hace cientos de años. Ella causa en el adulto la forma aguda o “húmeda” con manifestaciones cardiacas y edema y la forma crónica o “seca” con manifestaciones de neuropatía periférica expresada por sensación de pies quemantes, hormigueo en extremidades, debilidad y atrofia muscular. A veces compromete el sistema nervioso central (4...

  11. Desempeño Cardiovascular de Dos Estirpes de Gallus gallus domesticus Sometidas a Estrés Calórico Agudo

    DEFF Research Database (Denmark)

    Chacon, Tony; De Basilio, Vasco; Zerpa, Hector

    2015-01-01

    Genetic selection in poultry has been based on fast growth characters and not on stress adaptability. This investigation assessed cardiovascular variables in two lineages of Gallus gallus domesticus of different domestication levels, subjected to acute heat stress. To carry out the assay, broiler...

  12. Shoshin Beriberi Induced by Long-Term Administration of Diuretics: A Case Report

    Science.gov (United States)

    Misumida, Naoki; Umeda, Hisashi; Iwase, Mitsunori

    2014-01-01

    Previous studies have suggested that diuretic therapy for heart failure may lead to thiamine deficiency due to the increased urinary thiamine excretion. Herein, we present the case of a 61-year-old man with shoshin beriberi, a fulminant form of wet beriberi, induced by long-term diuretic therapy. The patient had a history of heart failure with preserved ejection fraction and was receiving furosemide and trichlormethiazide therapy. He presented with worsening exertional dyspnea and was admitted for heart failure exacerbation. His condition failed to improve even after intensive treatment. A hemodynamic evaluation with the Swan-Ganz catheter revealed high-output heart failure with low peripheral vascular resistance. Thiamine was administered for suspected shoshin beriberi; his hemodynamic status improved dramatically within the next six hours. The serum thiamine level was below the normal range; the patient was therefore diagnosed with shoshin beriberi. The common causes of thiamine deficiency were not identified. Long-term diuretic therapy with furosemide and thiazide was thought to have played a major role in the development of thiamine deficiency. This case illustrates the importance of considering wet beriberi as a possible cause of heart failure exacerbation in patients taking diuretics, even when the common thiamine deficiency causes are not identified with history-taking. PMID:25105030

  13. Shoshin Beriberi Induced by Long-Term Administration of Diuretics: A Case Report

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    Naoki Misumida

    2014-01-01

    Full Text Available Previous studies have suggested that diuretic therapy for heart failure may lead to thiamine deficiency due to the increased urinary thiamine excretion. Herein, we present the case of a 61-year-old man with shoshin beriberi, a fulminant form of wet beriberi, induced by long-term diuretic therapy. The patient had a history of heart failure with preserved ejection fraction and was receiving furosemide and trichlormethiazide therapy. He presented with worsening exertional dyspnea and was admitted for heart failure exacerbation. His condition failed to improve even after intensive treatment. A hemodynamic evaluation with the Swan-Ganz catheter revealed high-output heart failure with low peripheral vascular resistance. Thiamine was administered for suspected shoshin beriberi; his hemodynamic status improved dramatically within the next six hours. The serum thiamine level was below the normal range; the patient was therefore diagnosed with shoshin beriberi. The common causes of thiamine deficiency were not identified. Long-term diuretic therapy with furosemide and thiazide was thought to have played a major role in the development of thiamine deficiency. This case illustrates the importance of considering wet beriberi as a possible cause of heart failure exacerbation in patients taking diuretics, even when the common thiamine deficiency causes are not identified with history-taking.

  14. Acute dilated cardiomyopathy in a patient with beriberi and cryoglobulinaemic vasculitis: an unusual potential complication of two rare disorders.

    Science.gov (United States)

    Tejedor, Ana; Solé, Manel; Prieto-González, Sergio; Alba, Marco Antonio; Grau, Josep Maria; Cid, Maria Cinta; Hernández-Rodríguez, José

    2014-01-01

    We report the case of a 45-year-old patient who presented with acute dilated cardiomyopathy. During admission the patient was consecutively diagnosed with cryoglobulinaemic vasculitis and beriberi. In both diseases, cardiac involvement may occur as dilated cardiomyopathy. Thiamin deficiency was the final cause for the severe cardiac manifestations (cardiac acute beriberi or Shoshin syndrome), which returned to normal after thiamin supplementation.

  15. Agregación familiar del riesgo cardiovascular. Estudio realizado en familiares de primer y segundo grado de pacientes con infarto agudo de miocardio

    OpenAIRE

    Blanco Blanco, María Dolores

    2012-01-01

    Tesis Publicada con ISBN: 978-84-606-8138-0 Las enfermedades cardiovasculares (ECV) son la principal causa de mortalidad en los países desarrollados, suponiendo, según la OMS, algo más de 17 millones de fallecimientos al año. Son una fuente importante de discapacidad, contribuyendo en gran medida al aumento en los costes de la asistencia sanitaria. Aunque en su etiología concurren numerosos factores, la principal causa subyacente es la aterosclerosis, proceso inflamatorio crónico intra...

  16. Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.

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    Douangdao Soukaloun

    Full Text Available BACKGROUND: Infantile beriberi is a potentially lethal manifestation of thiamin deficiency, associated with traditional post-partum maternal food avoidance, which persists in the Lao PDR (Laos. There are few data on biochemical markers of infantile thiamin deficiency or indices of cardiac dysfunction as potential surrogate markers. METHODOLOGY/PRINCIPAL FINDINGS: A case control study of 47 infants with beriberi and age-matched afebrile and febrile controls was conducted in Vientiane, Laos. Basal and activated erythrocyte transketolase activities (ETK and activation (α coefficients were assayed along with plasma brain natriuretic peptide, N-terminal pro-brain natriuretic peptide and troponin T. Basal ETK (and to a lesser extent activated ETK and plasma troponin T were the only infant biochemical markers that predicted infantile beriberi. A basal ETK ≤ 0.59 micromoles/min/gHb gave a sensitivity (95%CI of 75.0 (47.6 to 92.7% and specificity (95%CI of 85.2 (66.3 to 95.8% for predicting infantile beriberi (OR (95%CI 15.9 (2.03-124.2; p = 0.008 (area under ROC curve = 0.80. In contrast, the α coefficient did not discriminate between cases and controls. Maternal basal ETK was linearly correlated with infant basal ETK (Pearson's r = 0.66, p < 0.001. The odds of beriberi in infants with detectable plasma troponin T was 3.4 times higher in comparison to infants without detectable troponin T (OR 3.4, 95%CI 1.22-9.73, p = 0.019. Detectable troponin T had a sensitivity (95%CI of 78.6 (59.0 to 91.7 % and specificity (95%CI of 56.1 (39.7 to 71.5 % for predicting infantile beriberi. CONCLUSIONS/SIGNIFICANCE: Basal ETK is a more accurate biochemical marker of infantile beriberi than the activation coefficient. Raised plasma troponin T may be a useful indicator of infantile beriberi in infants at risk and in the absence of other evident causes.

  17. Abceso apical agudo

    OpenAIRE

    Jara Ortiz, M.; López, M.; Gómez Viglino, L.; Maydana, N.; Hervit, M.; Bertola, N.

    2015-01-01

    En casos de urgencia, muchas veces debemos poner a prueba distintos elementos de diagnóstico para encontrar la mejor respuesta posible. En este caso se reporta un absceso apical agudo en la zona palatina del sector 1, que, de acuerdo al test de vitalidad pulpar y correcta interpretación radiográfica se localiza la pieza causal N° 1.8.Asistió a la consulta un paciente masculino 30 años de edad, dolor a la masticación, edema y tumefacción, en zona palatina comprendida en piezas 1.5; 1.6; 1.7 y ...

  18. Beriberi (thiamine deficiency and high infant mortality in northern Laos.

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    Hubert Barennes

    2015-03-01

    Full Text Available Infantile beriberi (thiamine deficiency occurs mainly in infants breastfed by mothers with inadequate intake of thiamine, typically among vulnerable populations. We describe possible and probable cases of infantile thiamine deficiency in northern Laos.Three surveys were conducted in Luang Namtha Province. First, we performed a retrospective survey of all infants with a diagnosis of thiamine deficiency admitted to the 5 hospitals in the province (2007-2009. Second, we prospectively recorded all infants with cardiac failure at Luang Namtha Hospital. Third, we further investigated all mothers with infants (1-6 months living in 22 villages of the thiamine deficiency patients' origin. We performed a cross-sectional survey of all mothers and infants using a pre-tested questionnaire, physical examination and squat test. Infant mortality was estimated by verbal autopsy. From March to June 2010, four suspected infants with thiamine deficiency were admitted to Luang Namtha Provincial hospital. All recovered after parenteral thiamine injection. Between 2007 and 2009, 54 infants with possible/probable thiamine deficiency were diagnosed with acute severe cardiac failure, 49 (90.2% were cured after parenteral thiamine; three died (5.6%. In the 22 villages, of 468 live born infants, 50 (10.6%, 95% CI: 8.0-13.8 died during the first year. A peak of mortality (36 deaths was reported between 1 and 3 months. Verbal autopsy suggested that 17 deaths (3.6% were due to suspected infantile thiamine deficiency. Of 127 mothers, 60 (47.2% reported edema and paresthesia as well as a positive squat test during pregnancy; 125 (98.4% respected post-partum food avoidance and all ate polished rice. Of 127 infants, 2 (1.6% had probable thiamine deficiency, and 8 (6.8% possible thiamine deficiency.Thiamine deficiency may be a major cause of infant mortality among ethnic groups in northern Laos. Mothers' and children's symptoms are compatible with thiamine deficiency. The severity

  19. Efeitos cardiovasculares agudos do exercício resistido em idosas hipertensas - DOI: 10.4025/actascihealthsci.v30i2.428 Cute cardiovascular effects of resistence exercise on hypertensive elderly women - DOI: 10.4025/actascihealthsci.v30i2.428

    Directory of Open Access Journals (Sweden)

    Wagner de Campos

    2008-12-01

    Full Text Available O objetivo deste estudo foi avaliar os efeitos cardiovasculares agudos do exercício resistido (ER em idosas com hipertensão estágio I. Participaram 24 hipertensas (63,7 ± 3,7 anos, submetidas a uma sessão de ER, constituída por oito estações (três séries, 12 repetições, 50% 1 RM. A frequência cardíaca (FC, a pressão arterial sistólica (PAS e a diastólica (PAD foram mensuradas anteriormente ao início dos exercícios (A, imediatamente após a quinta estação (B e 10 min. após a sessão de exercícios (C. Anova de medidas repetidas e post-hoc Tukey (p The aim of this study was to evaluate the effect of acute cardiovascular responses of resistance exercise (RE on stage I hypertensive elderly women. Twenty four hypertensive women (63.7 ± 3.7 years were subjected a session of RE, with eight stations (3 sets, 12 repetitions, 50% 1 RM. The heart rate (HR, systolic blood pressure (SBP and blood pressure (DBP were measured before the exercise sessions (A, immediately after the fifth station (B, and 10 minutes after the exercise sessions (C. Repeated measures Anova and post-hoc Tukey test (p < 0.05 were performed. The results demonstrated significant increase in SBP, DBP and HR (p < 0.05 between the A and B conditions. Subsequently, SBP and DBP decreased significantly for the C condition as compared to the B condition (p < 0.05; however, only DBP decreased significantly for the A condition (p < 0.05. Although the results demonstrated that acute cardiovascular modifications are associated with RE, hypotensive effects were only verified on DBP.

  20. [Introduction of Indian medicine into China in the Wei-Jin-Southern-Northern dynasties as interpreted by beriberi].

    Science.gov (United States)

    Fan, J

    1995-01-01

    Since the sea route between China and all countries in the Western Region was unimpeded, many Buddhist monks came to China. Some of them settled in Lingnan Region. With them, Indian medicine was imported which greatly expanded the coverage of TCM. Some of the Northerners moved southward into Lingnan Region and contracted beriberi which were cured by Indian monks. The author explores the importation of Indian medcine through analysis of beriberi as an example.

  1. Escroto agudo Acute scrotum

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    Lisieux Eyer de Jesus

    2000-08-01

    Full Text Available Este artigo pretende fazer uma revisão geral do tema, com ênfase em conceitos atuais e/ou controversos no manejo das situações clínicas em questão, em especial conceitos ainda polêmicos quanto à fisiopatologia e ao manejo diagnóstico. Também é feita uma revisão extensa quanto aos aspectos clínicos e terapêuticos da torção de testículo neonatal e quanto aos aspectos de diagnóstico diferencial na síndrome do escroto agudo. São citadas informações estatísticas derivadas dos principais estudos clínicos publicados nos últimos 20 anos em literatura médica ocidental.This article intends to review "Acute Scrotum" emphasizing modern and controversial aspects on clinical situations, specially concepts on physiopathology and diagnosis. We also review clinical and therapeutic aspects of neonatal testicular torsion and the differential diagnosis in the acute scrotum syndrome. Statistical information are derived from main studies published in the last 20 years.

  2. Beriberi, a Severe Complication after Metabolic Surgery - Review of the Literature

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    Christine Stroh

    2014-07-01

    Full Text Available Background: The epidemic growth of morbid obesity has led to an increase in the number of bariatric interventions. During the distribution process of bariatric surgical interventions, the risk for severe nutritious complications such as bariatric beriberi can rise. Methods: By means of systematic literature review, epidemiological data, clinical characteristics and diagnostic as well as therapeutic recommendations for bariatric beriberi were elicited. Databases and registries such as PubMed, Cochrane and Ovid were searched for a defined time period with the key words ‘lack of thiamine' / ‘Wernicke-Korsakoff syndrome' / ‘encephalopathy' after bariatric surgical interventions. Results: Up to December 2013, overall 255 patients had been found as published cases, indicating that the risk for the postoperative occurrence of thiamine deficiency and Wernicke-Korsakoff syndrome is increased in women. In addition, the risk correlates with patient's age. The majority of patients developed symptoms of a dry beriberi with peripheral neuritis, ataxia and paraplegia, indicating an advanced stage of disease approximately 4-12 weeks postoperatively. Laboratory analysis in case of a suspicious clinical finding is the appropriate diagnostics. As treatment, prompt initiation of parenteral thiamine substitution under clinical monitoring is required. Conclusion: Bariatric beriberi can occur within the first 1-3 postoperative months. To minimize the risk of severe consequences, immediate substitution of thiamine in clinical suspicion or prolonged parenteral nutrition is necessary. A delayed diagnosis or missing the correct diagnosis can lead to irreversible damages of the CNS with coma and fatal outcome. Knowledge on the subject, including development of thiamine deficiency, symptomatology and emergency treatment, are considered essential for bariatric surgeons but also for further medical disciplines involved in treatment.

  3. Rapidly progressive polyneuropathy due to dry beriberi in a man: a case report

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    Lekwuwa Godwin

    2010-12-01

    Full Text Available Abstract Introduction We describe a case of rapidly progressive and severely debilitating polyneuropathy in a patient with confirmed hypovitaminosis B1, consistent with dry beriberi. Crucially, this is a treatable condition, although sometimes with incomplete recovery, but it is probably under-recognized yet increasingly common given increasing levels of alcohol abuse in the western world. Case presentation A 49-year-old Caucasian British man presented with progressive weakness of both lower limbs of approximately seven months' duration. He noted difficulty climbing stairs. He also complained of lethargy, and loss of muscle bulk, including his thighs. He had a history of type 2 diabetes mellitus and admitted prior alcohol abuse but denied excessive alcohol intake in the five years prior to presentation. Initial clinical and neurophysiological examinations were consistent with a mild peripheral neuropathy and probable proximal myopathy. However, over the subsequent four months he evolved a marked tetraparesis, with profound sensory disturbance of all limbs. Repeat neurophysiology revealed a widespread polyneuropathy with extensive acute and sub-acute denervation changes in all four limbs, and reduced or absent sensory nerve action potentials. Hypovitaminosis B1 was confirmed (45 nmol/L, reference range 66-200 nmol/L. His rapid clinical deterioration was in keeping with dry beriberi. He was treated with thiamine. Subsequent follow-up revealed slow but significant improvement, such that by 15-16 months from the initial onset of symptoms, and approximately six months after the onset of his marked tetraparesis, he was able to stand independently and was gradually gaining confidence in walking pending a period of in-patient neurorehabilitation. Conclusion A potentially wide differential diagnosis exists for this type of presentation. Confirming hypovitaminosis B1 by requesting the assay prior to vitamin replacement ensures accurate diagnosis and

  4. cardiovasculares

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    Cristina Guerrero

    2006-01-01

    Full Text Available Uno de los aspectos que más discusión ha suscitado en los últimos tiempos entre quienes nos dedicamos al estudio de la emoción tiene que ver con la eventual asociación entre percepción, valoración y respuesta fisiológica. Esto es, siguiendo la máxima aristotélica, cabría cuestionar si las cosas son como son o son como cada quien las percibe. El objetivo de este experimento ha sido establecer la existencia de una conexión entre percepción de control y responsividad cardiovascular. La muestra estudiada ha estado conformada por estudiantes de la Universidad de Castellón; todos ellos han participado de forma voluntaria. La prueba de estrés ha consistido en un examen real de una asignatura troncal de la titulación que cursaban los participantes. Así pues, utilizando una situación de estrés real, hipotetizamos que las respuestas cardiovasculares (medidas a través de la tasa cardiaca, la presión sanguínea sistólica y la presión sanguínea diastólica dependen de la percepción de control que el individuo tiene, o cree tener, sobre la situación.

  5. Incidencia y repercusiones clínicas de la aparición de eventos cardiovasculares en pacientes críticos en ventilación mecánica, con procesos agudos no coronarios

    OpenAIRE

    Ortega Sáez, Maite

    2015-01-01

    Objetivo: Analizar la incidencia de eventos cardiovasculares (ECV) en pacientes críticos sometidos a ventilación mecánica (VM) e ingresados en la Unidad de Cuidados Intensivos, a través de la aparición de arritmias, elevación de las cifras plasmáticas de Troponina-c I y el desarrollo de alteraciones eléctricas-trastornos de la repolarización (desviación del segmento ST), los determinantes de su aparición y las repercusiones de los mismos, fundamentalmente en cuanto a mortalidad y duración...

  6. Dry beriberi preceded Wernicke′s encephalopathy: Thiamine deficiency after laparoscopic sleeve gastrectomy

    Directory of Open Access Journals (Sweden)

    Debopam Samanta

    2015-01-01

    Full Text Available In recent times, pediatric obesity has become widely prevalent. If first-line treatment with lifestyle modification fails, bariatric surgery may be indicated for severely obese patients. Many patients now travel abroad to get these surgeries done. Some of these patients receive inadequate postoperative care. We described a morbidly obese 17-year-old girl who had a laparoscopic sleeve gastrectomy procedure for weight loss. Due to severe nausea, she stopped her multivitamin supplementation. Within a few weeks, she developed symptoms of dry beriberi was soon followed by classic symptoms of Wernicke′s encephalopathy. The prompt diagnosis was made with confirmation from serum thiamine level and brain magnetic resonance imaging. Thiamine supplementation reversed ophthalmological symptoms promptly. However, the patient needed inpatient rehabilitation for neuropathy. This case describes that thiamine deficiency can occur after restrictive bariatric surgery, despite lower risk of malnutrition in the absence of intestinal bypass procedure. This report highlights that in the presence of risk factors: dietary noncompliance, inadequate follow-up, and severe nausea with and without vomiting can precipitate the development of Wernicke′s encephalopathy, even after restrictive surgery. Physicians may increasingly encounter thiamine and other nutrient deficiencies in increasing numbers due to increasing prevalence of obesity disorders and availability of bariatric surgeries. This report also emphasized the importance of identifying vague sensory symptoms in thiamine deficiency.

  7. Terapéutica del dolor agudo

    OpenAIRE

    Alonso Babarro, Alberto

    2006-01-01

    El abordaje del dolor agudo en la práctica clínica debe empezar siempre por una correcta valoración. La evaluación debe incluir tanto la investigación sobre el probable origen del dolor, sus características y su mecanismo fisiopatológico como la determinación de la intensidad del dolor para facilitarnos el control del tratamiento propuesto. Numerosos trabajos han evaluado mediante revisiones sistemáticas la utilidad de los diferentes tratamientos en los distintos cuadros de dolor agudo. A par...

  8. Severe Encephalopathy, Lactic Acidosis, Vegetative Instability and Neuropathy with 5-Fluorouracil Treatment – Pyrimidine Degradation Defect or Beriberi

    Directory of Open Access Journals (Sweden)

    A. Rosen

    2011-08-01

    Full Text Available We present the case of a 19-year-old female with nasopharyngeal carcinoma, who received two courses of chemotherapy with 5-fluorouracil (5-FU in combination with folic acid and cisplatin. Upon developing esophageal strictures in the course of her radiotherapy, she required total parenteral nutrition. In the course of therapy, the patient developed severe multisystem failure with encephalopathy, lactic acidosis, vegetative instability and neuropathy. The treatment with 5-FU can lead to severe toxicity due to enzyme deficiencies in the degradation of pyrimidines, but it can also lead to thiamine deficiency with the classic symptoms of beriberi. Beriberi is a rare disorder, usually attributed to malnutrition or alcoholism. 5-FU has been shown to induce thiamine depletion. Reduced food intake or total parenteral nutrition devoid of vitamin supplements may aggravate symptoms. We were unable to find a genetic cause for increased 5-FU toxicity in our patient, ruling out deficiencies of dihydropyrimidine dehydrogenase, dihydropyrimidinase or β-ureidopropionase and double-strand break repair deficits. We come to the conclusion that, even without any definable enzyme deficiency, treatment with 5-FU can lead to high toxicity due to thiamine deficiency if vitamin supplementation is not undertaken.

  9. Infarto agudo del miocardio por estrés laboral

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    Carlos Peña Coto

    2012-09-01

    Full Text Available En Medicina del Trabajo del Departamento de Medicina Legal se atienden casos de enfermedad laboral, donde el estrés laboral ha aumentado su incidencia como factor predisponerte de enfermedades profesionales destacando el infarto agudo del miocardio como una de ellas. Este artículo pretende revisar los criterios diagnósticos del infarto del miocardio, factores de riesgo, mecanismos y síntomas del estrés laboral, rehabilitación postinfarto y recomendaciones para la prevención de las enfermedades cardiovascularesWe evaluated a patient who was working for a public institution that provides care for all types of emergencies, was subjected daily to a great stress at work one day showed typical chest pain and was managed as an acute coronary syndrome. This article reviews the diagnostic criteria for heart attack, risk factors, mechanisms and symptoms of work stress, post heart attack rehabilitation and recommendations for prevention of cardiovascular disease

  10. Infarto agudo de miocardio y embarazo.

    OpenAIRE

    Laura Gabriela Sandor Ille; Rodrigo Cifuentes Borrero

    2009-01-01

    El infarto agudo del miocardio (IAM) es una síndrome que rara vez se asocia con el embarazo y ensombrece el pronóstico materno-fetal. Se presenta el caso de una paciente de 30 años que hizo IAM mientras cursaba su tercer embarazo a término y tuvo parto vaginal en el tercer día postinfarto. El parto y el puerperio fueron normales y no hubo complicaciones maternas ni perinatales.

  11. Sobrevida de pacientes con infarto agudo al miocardio en un hospital de Costa Rica

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    Manrique Leal Mateos

    2005-12-01

    Full Text Available Objetivo:El presente estudio tiene como propósito principal estimar la probabilidad acumulada de sobrevida al sexto mes de pacientes egresados del Hospital Calderón Guardia bajo el diagnóstico de infarto agudo al miocardio. Metodología:Se realizó un estudio de cohorte retrospectivo que incluyó a pacientes internados bajo el diagnóstico de infarto agudo al miocardio en el Servicio de Medicina Interna del Hospital Calderón Guardia entre el primero de octubre del 2003 al 31 de septiembre del 2004. La probabilidad acumulada de sobrevida de los pacientes se estimó al sexto mes posterior al evento cardiovascular y fue realizada mediante el método de Kaplan Meier. El tiempo de sobreviva fue medido en meses. La fecha inicial del estudio correspondió al momento en que se realizó el diagnóstico de infarto agudo al miocardio a cada paciente.La fecha de término del estudio fue el 31 de septiembre del 2004. El efecto independiente de las variables seleccionadas se realizó mediante el modelo de regresión múltiple de riesgos proporcionales de Cox.El nivel de significancia fue fijado en p<0,05. Resultados:Entre el 1 ºde octubre del 2003 y el 31 de septiembre del 2004, se identificaron 127 pacientes,cuyo diagnóstico de ingreso al Servicio de Medicina Interna del Hospital Calderón Guardia fue infarto agudo al miocardio. El 66,1%(n=84de los casos correspondieron a pacientes del sexo masculino.La edad promedio de los pacientes fue 64,6 años (DE ±12,2. El 63%(n=80de los pacientes presentaron antecedentes de Hipertensión Arterial,siendo este factor de riesgo el más frecuente en la población estudiada. Al final del período de estudio fallecieron 18 pacientes.De éstos,8 murieron por causas diferentes o no derivadas del infarto agudo al miocardio.La probabilidad acumulada de sobrevida para ambos sexos a los seis meses posteriores del evento cardiovascular fue de un 91,3%. Conclusiones:La sobrevida proporcional de la cohorte estudiada se puede

  12. Actualización en el enfoque y tratamiento del síndrome coronario agudo

    OpenAIRE

    López Fernández, Concepción

    2012-01-01

    Las enfermedades cardiovasculares (ECV) son una de las principales causas de muerte en los países desarrollados. El tratamiento del síndrome coronario agudo (SCA) ha mejorado considerablemente en los últimos años. El siguiente trabajo tiene como objetivos: 1. Revisar el papel de los principales factores de riesgo, la actualización en la clasificación del SCA y los principales conceptos de fisiopatología, clínica, diagnóstico y complicaciones. 2. Actualizar los princip...

  13. Paciente jovem com lúpus eritematoso sistêmico e infarto agudo do miocárdio

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    Fabiana de Freitas Grilo

    2007-05-01

    Full Text Available Lúpus eritematoso sistêmico (LES é uma doença do tecido conectivo com envolvimento multissistêmico, de natureza autoimune, e que entre outros sistemas acomete o aparelho cardiovascular. Não é comum a ocorrência de oclusão coronariana levando a infarto agudo do miocárdio. Apesar de raro, o infarto do miocárdio pode ocorrer e ser recorrente. Neste artigo descrevemos o caso de uma paciente jovem, de sexo feminino que aos 15 anos de idade apresentou infarto agudo do miocárdio. A paciente tinha diagnosticado de LES de acordo com os critérios de classificação de LES do Colégio Americano de Reumatologia. O infarto agudo do miocárdio foi diagnosticado pelo quadro clinico, eletrocardiográfico e alterações enzimáticas. A cinecoronariografia revelou irregularidade parietais de grau discreto e moderado em artéria coronária direta. A raridade deste evento, a possibilidade de sua prevenção, bem como a descrição do curso evolutivo e seu tratamento, motivou a apresentação deste caso e a revisão de literatura relacionando infarto agudo do miocárdio com lúpus eritematoso sistêmico em pacientes jovens.

  14. Prevalencia, características y valor pronóstico del síndrome metabólico en los síndromes coronarios agudos

    OpenAIRE

    ALFREDO C. PIOMBO; Juan Gagliardi; Federico Blanco; Karina Crotto; Elisabet Ulmete; Javier Guetta; Gustavo Cucher; Ramiro Santos

    2005-01-01

    El síndrome metabólico (SM) es una entidad compuesta por diversas alteraciones que confieren un aumento del riesgo cardiovascular y de diabetes a largo plazo. Sus características en pacientes con síndromes coronarios agudos (SCA) son prácticamente desconocidas. Objetivos Determinar la prevalencia, las características y el valor pronóstico del síndrome metabólico SM) en los síndromes coronarios agudos (SCA). Evaluar su correlación con los factores de riesgo coronario (FRC) y los hábitos di...

  15. Asociación entre el síndrome coronario agudo y el consumo de antiinflamatorios no esteroideos

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    José Luis Sánchez Serrano

    2015-01-01

    Full Text Available Objetivos: Evaluar el impacto cardiovascular asociado al consumo de antiinflamatorios no esteroideos en un Área de Salud, estimando la asociación entre la prescripción previa de un antiinflamatorio no esteroideo al episodio de síndrome coronario agudo. Material y Métodos: Se realiza un estudio retrospectivo observacional de casos cruzados de 5 años de duración, del 1 de Enero de 2008 hasta el 31 de diciembre de 2012. Los pacientes en primer lugar fueron casos y controles (n=1.317 que tuvieron eventos cardiovasculares y fueron al servicio de Urgencias del Hospital por dicho motivo. Área de Salud de Alcázar de San Juan. Medida principal: Asociación del riesgo de sufrir un síndrome coronario agudo mediante el Odds Ratio con el consumo de antiinflamatorios no esteroideos. Resultados: La asociación entre el síndrome coronario agudo y el consumo de Antiinflamatorios fue positiva y significativa, (OR 1,42; IC95% 1,06-1,9. Esta asociación fue de mayor magnitud en pacientes con menor comorbilidad, Charlson ≤ 1 (OR 1,66; IC95% 1,15 - 2,40 frente a los de mayor comorbilidad, Charlson > 1 (OR 1,07; IC95% 0,65 - 1,76. Esta modificación de efecto se debió en parte al consumo concomitante de fármacos que previenen contra patologías cardiovasculares como los antiagregantes, anticoagulantes y estatinas. Conclusiones: El consumo de antiinflamatorios no esteroideos se ha asociado a un mayor riesgo de síndrome coronario agudo, por lo que es necesario realizar un seguimiento a los pacientes que consuman estos fármacos, no debiéndose tomar durante tiempos prolongados ni a dosis altas.

  16. Edema pulmonar agudo neurogênico: relato de caso

    OpenAIRE

    José Correia de Farias Brito; Maria Cerly Almeida Diniz; Roberto Ramalho Rosas; José Alberto Gonçalves Da Silva

    1995-01-01

    Os autores apresentam um caso de edema pulmonar agudo numa paciente de 28 anos de idade acometida de hemorragia subaracnóidea secundária à rotura de aneurisma intracraniano. A sintomatologia respiratória ocorreu durante o agravamento do quadro neurológico. Alguns aspectos etiológicos e fisiopatogênicos do edema pulmonar agudo neurogênico são analisados.

  17. Edema pulmonar agudo neurogênico: relato de caso

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    José Correia De Farias Brito

    1995-06-01

    Full Text Available Os autores apresentam um caso de edema pulmonar agudo numa paciente de 28 anos de idade acometida de hemorragia subaracnóidea secundária à rotura de aneurisma intracraniano. A sintomatologia respiratória ocorreu durante o agravamento do quadro neurológico. Alguns aspectos etiológicos e fisiopatogênicos do edema pulmonar agudo neurogênico são analisados.

  18. Hiperglucemia en el síndrome coronario agudo: informe científico multidisciplinario

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    Patricia Blanco

    2012-04-01

    Full Text Available La hiperglucemia con o sin diabetes preexistente es un hallazgo frecuente en pacientes que cursan un síndrome coronario agudo. Estudios previos han demostrado que la hiperglucemia es altamente prevalente y se asocia a un mayor riesgo de muerte y complicaciones hospitalarias. Los mecanismos fisiopatológicos mediante los cuales la hiperglucemia provoca resultados adversos no son claros, y se desconoce si es un marcador de eventos o su causa. Los efectos perjudiciales de la hiperglucemia en el sistema cardiovascular son múltiples, y el control de los niveles de glucosa con insulina parece mejorar el pronóstico en estos pacientes. Se han desarrollado numerosos protocolos para el control de glucemia que demostraron ser seguros y efectivos. En una iniciativa originada en el Consejo de Emergencias de la Sociedad Argentina de Cardiología, se convocó a expertos de nuestro medio con el propósito de debatir estrategias para el control de la glucemia en pacientes que cursan un síndrome coronario agudo. Este documento refleja lo discutido en este evento académico con la intención de resumir los principales aspectos del control de la glucemia y ofrecer recomendaciones generales de tratamiento en la Unidad Coronaria.

  19. Asociación entre el síndrome coronario agudo y el consumo de antiinflamatorios no esteroideos

    OpenAIRE

    José Luis Sánchez Serrano; José María Tenias Burillo; María Isabel Chinchilla Fernández; Laura Jiménez López; Antonio Padilla Serrano; Miguel Ángel Calleja Hernández

    2015-01-01

    Objetivos: Evaluar el impacto cardiovascular asociado al consumo de antiinflamatorios no esteroideos en un Área de Salud, estimando la asociación entre la prescripción previa de un antiinflamatorio no esteroideo al episodio de síndrome coronario agudo. Material y Métodos: Se realiza un estudio retrospectivo observacional de casos cruzados de 5 años de duración, del 1 de Enero de 2008 hasta el 31 de diciembre de 2012. Los pacientes en primer lugar fueron casos y controles (n=1.317) que tuviero...

  20. Infarto Agudo de Miocardio: Certezas e Incertidumbres con las Nuevas Estrategias de Reperfusión

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    Dr. Ricardo Mario Iglesias

    2007-01-01

    Full Text Available Las enfermedades cardiovasculares representan la primera causa de morbimortalidad a nivel mundial. El infarto agudo de miocardio es la expresión más dramática dentro del síndrome coronario agudo y el accidente de placa coronario, el mecanismo fisiopatológico involucrado con mayor frecuencia. El objetivo del tratamiento ha variado en los últimos años, desde obtener permeabilidad en las arterias epicárdicas hasta alcanzar un decuado nivel e perfusión n el ircuito microvascular. La optimización de la estrategia terapéutica se obtiene a través de una reperfusión precoz y efectiva (fibrinolíticos y/o angioplastia y la selección adecuada de múltiples fármacos coadyuvantes (B bloqueantes, aspirina, clopidogrel, anticoagulantes que han demostrado beneficios clínicos en diversos ensayos clínicos.The first cause of morbidity-mortality all over the world is represented by the cardiovascular diseases. The acute infarct of myocardium is the most dramatic expression within the acute coronary syndrome and the coronary plaque rupture, the most frequently physiopathology mechanism involved. In the last few years the objective of the treatment has changed, from obtaining permeability in the epicardial arteries to reaching a suitable level of perfusion in the microvascular circuit. The optimization of the therapeutic strategy obtains through a precocious and effective reperfusion (fibrinolytic and/or angioplasty and the suitable helping drug selection (aspirin, clopidogrel and anticoagulants that has demonstrated clinical benefits in clinical trials

  1. Perfil clínico y manejo del síndrome coronario agudo

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    Yudelquis Ojeda Riquenes

    2015-11-01

    Full Text Available Se realizó un estudio descriptivo retrospectivo, para determinar el perfil clínico y el manejo del Síndrome Coronario Agudo (SCA en el centro diagnóstico integral “Los Arales”, en el período de enero de 2009 a mayo de 2010. El universo incluyó a 32 pacientes con SCA y la muestra a 29 pacientes, de los cuales 12 (41,4% tuvieron un SCA con elevación del ST (SCACEST, los restantes 17 (58,6% presentaron un síndrome coronario agudo sin elevación del ST (SCASEST. Los pacientes con SCACEST tenían menos antecedentes cardiovasculares y usaban menos medicamentos previos; presentaron mayor porcentaje de clase killip IV (8,3%, marcadores de necrosis (100% y alteraciones de la repolarización (100%. No se realizó trombolisis, solo un paciente fue remitido para realizar coronariografía e ICP (8,3%; se utilizó más la heparina (83,3% y aspirina (91,7%. Este grupo presentó más eventos arrítmicos, complicaciones y mortalidad precoz. Al alta se usó más aspirina (100% y beta bloqueadores (66,7% e IECA (66,7%.. Los pacientes con SCASEST tuvieron un mayor Killip II-III (17,6% y creatinina elevada (11,8%. Se usaron menos los antiplaquetarios y no se refirió para realizar procedimientos diagnósticos o terapéuticos.

  2. Presencia y severidad de calcio coronario: su relación con la aparición de eventos coronarios agudos

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    Lázaro E. de la Cruz Avilés

    2012-03-01

    Full Text Available Fundamento: la detección de calcio en las arterias coronarias confirma la presencia de aterosclerosis y ha demostrado ser una herramienta útil para estratificar el riesgo cardiovascular. Objetivo: determinar la relación entre la presencia y severidad de calcio coronario con la aparición de eventos coronarios agudos. Métodos: se realizó un estudio observacional, descriptivo, prospectivo, tipo serie de casos, en el Hospital Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos, entre enero y diciembre de 2008. La serie estuvo conformada por 137 pacientes, en los que se estudió: sexo, antecedentes patológicos personales, cifras de glucemia en ayunas, creatinina, colesterol total y triglicéridos. Los pacientes fueron seguidos durante dos años para evaluar la aparición de eventos coronarios agudos. Resultados: La edad media fue de 53,2±7,4 años, con predominio del sexo masculino (52,5 %. El mayor porciento de pacientes clasificados como de alto riesgo, según la cuantificación del calcio coronario (16,8 % perteneció al sexo masculino, predominando en los mayores de 70 años. La diabetes se relacionó de forma significativa con la severidad del puntaje de calcio. El infarto agudo del miocardio fue más frecuente en pacientes con puntaje de calcio mayor de 400 unidades Agatston. Conclusiones: la aparición de eventos coronarios agudos fue más frecuente en los pacientes de alto riesgo según cuantificación del calcio coronario.

  3. Impacto Pronóstico de los Síndromes Geriátricos en Pacientes Ancianos con Síndrome Coronario Agudo

    OpenAIRE

    2015-01-01

    Los síndromes geriátricos pueden predecir eventos adversos en el contexto del síndrome coronario agudo más allá de la propia edad y de los clásicos factores de riesgo cardiovascular. El objetivo de la presente tesis doctoral fue cuantificar y evaluar un amplio espectro de síndromes geriátricos en pacientes supervivientes a la fase aguda de un síndrome coronario. Se incluyeron un total de 342 pacientes mayores de 65 años que ingresaron de forma consecutiva en el servicio de Cardiología de un ú...

  4. Infarto agudo de miocardio después de la administración subcutánea de sumatriptán

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    Luis A. Rodríguez López

    2016-01-01

    Full Text Available El sumatriptán es un medicamento que se utiliza para la migraña y puede producir vasoconstricción coronaria. Se presenta un caso con infarto agudo de miocardio de causa no ateroesclerótica, secundaria a la administración subcutánea de este fármaco, en un hombre de 50 años de edad, sin antecedentes de enfermedad cardiovascular. El paciente evolucionó sin complicaciones después de la retirada del sumatriptán.

  5. Intervenção de enfermagem nos pacientes com depressão depois de um infarto agudo do miocárdio

    OpenAIRE

    Achury Saldaña, Diana Marcela; Pontificia Universidad Javeriana; Buitrago Malaver, Lilia Andrea

    2011-01-01

    La depresión se considera una patología ligada a enfermedades cardiovasculares y no sólo un factor de riesgo para enfermedad coronaria. Tiene una gran prevalencia durante la hospitalización y el primer año posterior al alta en pacientes que ha sobrevidido a un infarto agudo de miocardio. La depresión aparece por la condición crónica de la enfermedad, la incertidumbre acerca de la gravedad de su patología y de sus consecuencias. Con lo anterior es necesasrio que los profesionales de enfermería...

  6. Tabaquismo como factor de riesgo del infarto agudo al miocardio

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    Manrique Leal-Mateos

    2006-06-01

    Full Text Available Justificación: El tabaquismo es la principal causa de enfermedad, discapacidad y muerte prematura prevenible mundialmente; actualmente, es aceptado como un factor de riesgo para el desarrollo de enfermedades cardiovasculares. Sin embargo, aunque el tabaco es conocido como una causa directa de IAM, en el país es limitado el conocimiento de su fracción atribuible. Objetivo: Este estudio tiene como propósito evaluar el impacto que provoca el tabaquismo sobre los pacientes con IAM, por medio de su fracción atribuible. Así, pretende estimar la proporción de personas que podrían prevenir su desarrollo, si se evitara la exposición a este factor de riesgo. Métodos: Se realizó un estudio de casos y controles en los servicios de medicina interna y cirugía del Hospital San Juan de Dios, en el periodo comprendido entre el 1 de abril y el 23 de septiembre de 2005. Se definió como fumador aquel paciente que hubiera fumado al menos un cigarro por día, durante un año. De acuerdo con el hábito de fumar, se clasificaron en: No fumadores (quienes nunca habían fumado, fumadores (quienes fumaran actualmente y exfumadores. La magnitud de las asociaciones entre la exposición y el riesgo de la enfermedad se evaluó mediante la razón de probabilidades (Odds Ratio en inglés para datos apareados 2:1, definiendo como no expuestos aquellos pacientes clasificados como no fumadores. Los exfumadores con más de 15 años de haber abandonado el hábito fueron clasificados como no fumadores (dados los beneficios que representa esta situación a largo plazo y aquellos con menos de 15 años de haberlo abandonado, fumadores. Con el fin de medir el impacto del tabaquismo sobre los pacientes que padecen de infarto agudo al miocardio se utilizó el indicador de fracción atribuible. Para todo lo anterior se utilizó Epitable, del programa EpiInfo 6. Resultados: La Razón de Probabilidades para datos apareados 2:1 mostró una asociación positiva entre el fumado y

  7. Consequências cardiovasculares do mau controlo da diabetes mellitus

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    Fernandes, Filipe

    2014-01-01

    Diabetes - Doença silenciosa, progressão lenta, inicialmente assintomática, reduz a esperança de vida em 5-10 anos. Maior causa de amputações não traumáticas, insuficiência renal, cegueira idade < 65 anos, doenças cardiovasculares (enfarte agudo do miocárdio, acidente vascular cerebral, doença arterial periférica).

  8. El síndrome coronario agudo y otros diagnósticos provocan subregistro del infarto agudo del miocardio en el Hospital México, Costa Rica

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    Manuel Francisco Jiménez-Navarrete

    2013-03-01

    Full Text Available Justificación: el infarto agudo del miocardio es un problema mayor de salud pública. Es necesario verificar su adecuado registro en Costa Rica para atender eficientemente su problemática. Materiales y métodos: estudio descriptivo y observacional. Se recopilaron los pacientes egresados del Hospital México con diagnósticos de síndrome coronario agudo, infarto agudo del miocardio, angina inestable y cardiopatía isquémica, de agosto 2005 a julio 2006, analizándose los registros de la oficina de Bioestadística y Unidades (Coronaria, Terapia Intensiva, Hemodinamia y Ecocardiogramas. Resultados: el Hospital México reportó 110 pacientes con el diagnóstico de infarto agudo del miocardio. Al incluir egresados con diagnósticos de síndrome coronario agudo, angor inestable o cardiopatía isquémica y que eran infartos agudos del miocardio, el número aumentó a 172. La muestra analizada finalmente fue de 138 pacientes al eliminar el restante por datos incompletos, significando un subregistro de al menos 36%. El 78.1% fueron hombres y la edad promedio para ambos sexos fue 65.2 años. No se le midió la troponina al 49,3% de la muestra y la cuarta parte no fueron valorados por cardiólogos. El 20.3% de los pacientes que fueron egresados con otros diagnósticos eran portadores también de infarto agudo del miocardio. Conclusiones: existe subregistro de infarto agudo del miocardio en el Hospital México y en oficinas centrales del Ministerio de Salud y la Caja Costarricense de Seguro Social. Este hallazgo también es probable que se presente en otros hospitales costarricenses.

  9. Edema pulmonar agudo posoperatorio de presión negativa

    OpenAIRE

    Faridt Hernán Criollo-Muñoz; Juan José Espinosa-Espinoza

    2014-01-01

    No es extraño que durante la práctica anestésica diaria se encuentrenpacientes sin padecimientos crónicos conocidos que expliquen eldesarrollo de edema pulmonar agudo durante el perioperatorio. Eledema pulmonar de presión negativa se ha reportado en la literatura,aun en pacientes sanos, como una entidad en el perioperatorio de buenpronóstico con tratamiento oportuno multidisciplinario. Se expone elcaso de un paciente de 29 años de edad, sin antecedentes patológicosconocidos, a quien se le rea...

  10. El sólido hiperbólico agudo

    Directory of Open Access Journals (Sweden)

    Rosa María Herrera

    2012-04-01

    Full Text Available Torricelli consideró el cálculo del volumen de sólido hiperbólico agudo como el mejor logro en sus trabajos con ‘indivisibles curvos’. Fue publicado en la Opera geometrica. Aquí se presenta como muestra del estilo de las demostraciones matemáticas (geométricas que se efectuaban en el siglo XVII, y por su valor precursor del cálculo infinitesimal. Es un ejemplo significativo para aproximarse al pensamiento torricelliano.

  11. Fisioterapia con complemento educativo en el ictus cerebral agudo

    OpenAIRE

    2015-01-01

    La creciente demanda de fisioterapia y educación sanitaria en el ictus agudo, junto a la necesidad de ser eficientes, hacen necesario evaluar las intervenciones realizadas y hacer predicciones pronósticas tempranas que faciliten la gestión de dichos pacientes y disminuyan la variabilidad en la evaluación y tratamiento, siendo fundamental el primer mes de evolución como período de mayor evolución y valor pronóstico. OBJETIVO GENERAL Evaluar el efecto de un tratamiento de fisioterapia má...

  12. Perfil epidemiológico do beribéri notificado de 2006 a 2008 no Estado do Maranhão, Brasil Epidemiological profile of reported beriberi cases in Maranhão State, Brazil, 2006-2008

    Directory of Open Access Journals (Sweden)

    Estela Maura Padilha

    2011-03-01

    Full Text Available O objetivo do estudo foi descrever o perfil epidemiológico dos casos e óbitos de beribéri notificados de 2006-2008 no Estado do Maranhão, Brasil. Informações foram obtidas de fichas de notificação da Secretaria de Estado da Saúde do Maranhão e utilizou-se o Índice Global de Moran para avaliar autocorrelação espacial. Foram notificados 1.207 casos e 40 óbitos. Regiões oeste e central mostraram forte presença de autocorrelação espacial da incidência. Ocorrência de casos e óbitos concentrou-se de maio a agosto, em homens jovens (20-40 anos. Hábito de consumir álcool e fumar esteve presente entre os óbitos; baixa renda e ocupação com atividade pesada, entre os casos. Os sintomas mais comuns foram diminuição da força, dormência e edema das pernas, dificuldade para caminhar e dor na panturrilha. O perfil dos acometidos e os sintomas, exceto edema de membros inferiores, são característicos de beribéri seco. É pertinente que estudos sobre seu ressurgimento no país sejam aprofundados.This study aimed to describe the epidemiological profile of beriberi cases and related deaths reported from 2006 to 2008 in Maranhão State, Brazil. Data were obtained from beriberi notification forms at the State Health Department. The global Moran index was used to evaluate spatial auto-correlation. 1207 cases and 40 deaths were reported. The western and central regions of the State showed strong spatial auto-correlation of incidence rates. Cases and deaths were concentrated from May to August, in young men (20-40 years. Regular alcohol consumption and smoking were recorded among fatal cases. Low income and heavy labor were widespread among cases. Common symptoms were asthenia, numbness, and swollen legs, difficulty walking, and calf pain. The profile of cases and their symptoms (except swollen legs are characteristic of dry beriberi. We recommend further studies on the resurgence of beriberi in Brazil.

  13. El ejercicio agudo aumenta las concentraciones de homocisteína en varones físicamente activos

    Directory of Open Access Journals (Sweden)

    Beatriz Maroto-Sánchez

    2013-04-01

    Full Text Available Introducción: Niveles altos de Homocisteína (Hcy se han identificado como un factor de riesgo cardiovascular. En relación con la práctica de ejercicio físico, los resultados son contradictorios. Objetivos: El objetivo del presente estudio fue determinar la influencia de ejercicios agudos máximo y submáximo sobre las concentraciones de homocisteína total (tHcy y otros parámetros sanguíneos relacionados. Material y métodos: Diez varones (23,5 ± 1,8 años físicamente activos realizaron una prueba incremental máxima y otra submáxima a una intensidad del 65% del consumo máximo de oxígeno (VO2max en tapiz rodante. Se analizaron antes y después las concentraciones de tHcy, folato, vitamina B12 y creatinina séricas. Resultados: Las concentraciones de tHcy séricas aumentaron significativamente tras las pruebas de intensidad máxima (p < 0,05 y submáxima (p < 0,01. El folato y la vitamina B12 también aumentaron significativamente tras ambas pruebas (p < 0,05. Las concentraciones de creatinina aumentaron significativamente únicamente en la prueba máxima (p < 0,001. Se encontró una relación inversa entre los niveles de folato y de tHcy en todos los puntos (p < 0,05. Conclusión: Se observaron niveles altos de homocisteína después del ejercicio agudo tanto máximo como submáximo.

  14. Abdome agudo obstrutivo pela veia porta - relato de caso

    OpenAIRE

    2016-01-01

    Introdução: A veia porta pré-duodenal é uma anomalia congênita rara, sintomática em apenas 50% dos casos, sendo que seu diagnóstico é feito por laparotomia exploradora. O tratamento de escolha é cirúrgico, com bom prognóstico. Objetivo: Relatar um caso de Abdome Agudo Obstrutivo por Veia Porta Pré Doudenal (VPPD) no período neonatal no Conjunto Hospitalar de Sorocaba. Metodologia: Descrição do referido caso e revisão de literatura. Relato de Caso: Recém-nascido de F.S.S., feminino, de parto n...

  15. Estatinas para el Síndrome Coronario Agudo Medicina basada en evidencia sobre la administración temprana con dosis de carga

    Directory of Open Access Journals (Sweden)

    Carlos Fonseca-Gamboa

    2011-09-01

    Full Text Available Objetivo: En algunos Servicios de Emergencias de la CCSS, a los pacientes con infarto agudo de miocardio se les administra una dosis alta -aunque variable- de lovastatina en las primeras horas de evolución de los síndromes coronarios agudos, con la expectativa de lograr efectos pleiotrópicos, un resultado positivo sobre el endotelio y la disminución de mediadores inflamatorios. Analizar la evidencia científica que sustenta el beneficio de esta intervención farmacológica y clarificar la posible dosis oral y el potencial intervalo idóneo. Búsqueda vía electrónica en sistemas secundarios de información científica y análisis de fuentes primarias, con énfasis en ensayos clínicos aleatorizados que evalúen la eficacia de las estatinas en los eventos coronarios agudos; también de fuentes terciarias, específicamente revisiones sistemáticas y guías de consenso para práctica clínica basadas en evidencia y revisiones por instancias evaluadoras de tecnologías con reconocimiento internacional. Resultados: Cuatro ensayos clínicos aleatorizados controlados con placebo, no demostraron diferencias significativas ni clínicamente relevantes en la variable primaria combinada: evento cardiaco mayor, muerte, IAM recurrente fatal, AVC fatal u otra causa de muerte cardiovascular, ninguno usó dosis de carga, ni se inició la administración en las 24 hs del inicio de la sintomatología. Conclusión: Ante la falta de evidencia que permita proyectar con claridad un papel beneficioso para las estatinas en el manejo inicial del síndrome coronario agudo, esta práctica desequilibra la relación beneficio/riesgo y se aleja de los principios del uso racional de medicamentos y la aplicación del paradigma de la medicina basada en evidencia.

  16. El Proyecto MADAI: Un estudio epidemiológico sobre el abordaje y manejo del dolor agudo periquirúrgico MADAI project: an epidemiologic study about the perioperative pain management and treatment

    OpenAIRE

    J. L. Balibrea; F. López-Timoneda; F. Acín; Cabero, L; A. Moreno-González; L. E. Ayala

    2008-01-01

    Objetivo. Obtener información descriptiva sobre el abordaje y el manejo del paciente con dolor agudo periquirúrgico tratado con analgésicos parenterales en el ámbito hospitalario. Metodología. Estudio epidemiológico, descriptivo, multicéntrico. Pacientes ingresados en los servicios de cirugía general, torácica, cardiovascular, angiología y cirugía vascular, ginecología, traumatología y urología. Resultados. Participaron 76 hospitales distribuidos por las diferentes comunidades autónomas y un ...

  17. Angioedema hereditario: Tratamiento del ataque agudo en la Argentina

    Directory of Open Access Journals (Sweden)

    Alejandro Malbrán

    2014-06-01

    Full Text Available En el mundo, el angioedema hereditario (HAE afecta a 1 de cada 50 000 personas. Produce episodios de angioedema cutáneo, abdominal y laríngeos que generan gran incapacidad. La mortalidad por la enfermedad oscila entre 15 y 50%. Aunque en Argentina un concentrado plasmático de C1 inhibidor (pdC1INH ha estado aprobado y disponible por décadas para el tratamiento del ataque agudo, solo 15 (26% de 58 pacientes había recibido pdC1INH alguna vez hasta el año 2008, y solo 2(3.4% lo usaban regularmente. Luego de la aprobación de los nuevos medicamentos para HAE, incluido el icatibant en Argentina y de la publicación de las guías terapéuticas, 42 (82% de 51 pacientes del grupo original tienen pdC1INH para tratar el próximo ataque. Sin embargo, 16 (18% de estos pacientes continúan sin acceso a la medicación y otros 15 (35.7% acceden a través de otro enfermo en forma espuria. Solo 12 (28.6% de los pacientes con el medicamento puede auto tratarse en su domicilio. La mejora en el acceso a la medicación es importante pero debe extenderse a todos los afectados y facilitarse el auto-tratamiento.

  18. Ruptura del septum ventricular post infarto agudo del miocardio

    Directory of Open Access Journals (Sweden)

    Warner Rodríguez Jerez

    2003-08-01

    Full Text Available La ruptura del septum interventricular (CIV es una complicación grave del infarto agudo del miocardio y tiene un alto índice de mortalidad. El diagnóstico rápido, medidas adecuadas en el manejo médico como el uso de balón de contrapulsación intra aórtico y la corrección quirúrgica pronta son algunos de los esfuerzos que se han realizado para mejorar la sobrevida y disminuir el tiempo de recuperación de los pacientes, posterior a un evento de este tipo. Dentro de los factores de riesgo para la comunicación interventricular post infarto destacan la edad avanzada, sexo femenino, el infarto de cara anterior, y la ausencia de tabaquismo. En este artículo se presenta el caso de una paciente de la Unidad Coronaria del Hospital San Juan de Dios y se hace revisión del tema.

  19. Factors Related to In-Hospital Mortality Caused by Acute Myocardial Infarction Factores relacionados con la mortalidad intrahospitalaria en el infarto agudo del miocardio

    Directory of Open Access Journals (Sweden)

    Francisco Valladares Carvajal

    2012-11-01

    Full Text Available Background: the identification of factors related to mortality in acute myocardial infarction represents an essential element in the initial assessment of patients. Objective: to identify factors associated with in-hospital mortality in patients with acute myocardial infarction admitted to the Coronary Intensive Care Unit of Cienfuegos in 2010. Methods: we conducted a case series study, which included 241 patients with acute myocardial infarction admitted to the Coronary Intensive Care Unit of the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos in 2010. The variables analyzed were age, sex, personal medical history, type of acute myocardial infarction (according to electrocardiogram and topographic location, heart rate and blood pressure at admission, classification of heart failure according to Killip Kimball, creatinine, glucose, total cholesterol, triglycerides, CPK-MB, and cardiovascular adverse events during their hospital stay. Results: the average age of the patients was 65,6 years old, with male predominance. High blood pressure, smoking and previous myocardial infarction were the most relevant antecedents. Patients with no heart failure and preserved ejection fraction predominated. Most frequent cardiovascular adverse events were post-infarction angina, ventricular arrhythmias and cardiogenic shock. Conclusions: we found significant association with mortality and old age (> 70 years, tachycardia, blood glucose ≥ 7 mmol / l at admission, and the presentation of ventricular arrhythmias and cardiogenic shock during in-hospital evolution.Fundamento: la identificación de los factores relacionados con la mortalidad en el infarto agudo del miocardio representa un eslabón primordial en la evaluación inicial de los pacientes. Objetivo: identificar los factores relacionados con la mortalidad intrahospitalaria de los pacientes con infarto agudo del miocardio, ingresados en la Unidad de Cuidados Intensivos Coronarios de

  20. Infarto agudo de miocardio. Guía de práctica clínica

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    Yanier Coll Muñoz

    2011-08-01

    Full Text Available La elaboración de esta Guía de Práctica Clínica se justifica, en primer lugar, por la elevada frecuencia de presentación y mortalidad del infarto agudo del miocardio en la población general. Las enfermedades cardiovasculares constituyen en la actualidad la principal causa de muerte en los países industrializados, y se espera que también lo sean en los países en vías de desarrollo en el año 2020.  La presente guía se refiere a los pacientes que presentan síntomas isquémicos o sus equivalentes, y una elevación persistente del segmento ST en el electrocardiograma, o cambios del electrocardiograma de infradesnivel del ST o de la onda T, compatibles con el diagnóstico de IAM sin elevación del ST. Esta Guía no aborda los elementos relacionados directamente con los procedimientos de intervencionismo coronario percutáneo ni la revascularización miocárdica quirúrgica.

  1. Infarto agudo de miocardio. Guía de práctica clínica

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-08-01

    Full Text Available

    La elaboración de esta Guía de Práctica Clínica se justifica, en primer lugar, por la elevada frecuencia de presentación y mortalidad del infarto agudo del miocardio en la población general. Las enfermedades cardiovasculares constituyen en la actualidad la principal causa de muerte en los países industrializados, y se espera que también lo sean en los países en vías de desarrollo en el año 2020.  La presente guía se refiere a los pacientes que presentan síntomas isquémicos o sus equivalentes, y una elevación persistente del segmento ST en el electrocardiograma, o cambios del electrocardiograma de infradesnivel del ST o de la onda T, compatibles con el diagnóstico de IAM sin elevación del ST. Esta Guía no aborda los elementos relacionados directamente con los procedimientos de intervencionismo coronario percutáneo ni la revascularización miocárdica quirúrgica.

  2. Factores relacionados con la mortalidad intrahospitalaria en el infarto agudo del miocardio

    OpenAIRE

    Yanier Coll Muñoz; Jorge Ruíz Mendoza; Juan José Navarro; Lázaro de la Cruz Avilés; Francisco Valladares Carvajal

    2012-01-01

    Fundamento: la identificación de los factores relacionados con la mortalidad en el infarto agudo del miocardio representa un eslabón primordial en la evaluación inicial de los pacientes. Objetivo: identificar los factores relacionados con la mortalidad intrahospitalaria de los pacientes con infarto agudo del miocardio, ingresados en la Unidad de Cuidados Intensivos Coronarios de Cienfuegos durante el año 2010. Método: se realizó un estudio de serie de casos, que incluyó 241 pacientes con dia...

  3. Influencia de la periodontitis en la extensión del infarto agudo de miocardio

    OpenAIRE

    Marfil Álvarez, Rafael Martín

    2013-01-01

    La presente tesis doctoral evalúa el impacto que tiene la periodontitis sobre la extensión del infarto agudo de miocardio. Desde la década de los noventa, la aterosclerosis se ha considerado una enfermedad de origen inflamatorio y a la disfunción endotelial como echo princeps en el desarrollo de la placa de ateroma. Una de las secuelas de la aterosclerosis es el infarto agudo de miocardio, debido a la rotura de la placa de ateroma y a la trombosis que conlleva. Para tener conocimiento de la e...

  4. Frecuencia de infección por VIH en pacientes con episodio agudo de herpes zoster.

    OpenAIRE

    LAZARTE HERAUD, Susana; BRAVO PUCCIO, Francisco; SAMALVIDES CUBA, Frine; Del Solar Chacaltana, Manuel; GUERRA AMAYA, Oscar; VERDONCK BOSTEELS, Kristien; SOLARI SERPA, Lely; GOTUZZO HERENCIA, Eduardo

    2012-01-01

    Objetivo: Evaluar la frecuencia de infección por VIH en pacientes que consultan por episodio agudo de herpes zoster. Material y Métodos: Se incluyeron a todos los pacientes entre 18 y 49 años, atendidos entre setiembre del 2001 y enero del 2003 en el Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas del Hospital Nacional Cayetano Heredia, por un cuadro agudo de herpes zoster, diagnosticado clínicamente. Los criterios de inclusión fueron: status VIH desconocido tanto del pa...

  5. El dolor agudo postquirúrgico en el adulto "la 5ª constante"

    OpenAIRE

    López Portero, Soraya

    2014-01-01

    El dolor agudo postquirúrgico es aquel dolor que aparece como consecuencia de una intervención quirúrgica en el paciente y por esta razón, tiene la particularidad de ser un dolor de carácter previsible e implica que puede ser tratado de forma inmediata, siendo esto una ventaja incondicional para el paciente. Aún así, la prevalencia del dolor agudo postquirúrgico en los últimos años estudiados alcanza un 68% en los hospitales españoles. La repercusión que causa la presenci...

  6. Atención prehospitalaria de infarto agudo de miocardio en Manizales, Colombia, 2009

    OpenAIRE

    cárdenas, Luisa Fernanda; Castaño Castrillón, José Jaime; Castaño Valencia, Oscar; Gómez González, Laura; González Arango, Alejandro; Lopez Ceballos, Catalina; Moreno Estrada, Tatiana; Quintero Arias, Paula Andrea; Sánchez Restrepo, Kelly Jhoana; Tangarife, Hernán Felipe

    2009-01-01

    Introducción: La mayoría de las muertes por infarto agudo de miocardio se dan en la primera hora de ocurrido el evento y antes de recibir atención por el equipo de salud; se considera entonces que la atención prehospitalaria debe dar respuesta a esta situación. Por ello, surge el interés de investigar cómo se encuentra la atención prehospitalaria de infarto agudo de miocardio en Manizales (Colombia). Materiales y métodos: se realizó un estudio tipo descriptivo utilizando como medi...

  7. Influencia de la periodontitis en la extensi??n del infarto agudo de miocardio

    OpenAIRE

    2012-01-01

    La presente tesis doctoral eval??a el impacto que tiene la periodontitis sobre la extensi??n del infarto agudo de miocardio. Desde la d??cada de los noventa, la aterosclerosis se ha considerado una enfermedad de origen inflamatorio y a la disfunci??n endotelial como echo princeps en el desarrollo de la placa de ateroma. Una de las secuelas de la aterosclerosis es el infarto agudo de miocardio, debido a la rotura de la placa de ateroma y a la trombosis que conlleva. Para tener conocimiento de ...

  8. Cardiovascular Deconditioning

    Science.gov (United States)

    Charles, John B.; Fritsch-Yelle, Janice M.; Whitson, Peggy A.; Wood, Margie L.; Brown, Troy E.; Fortner, G. William

    1999-01-01

    Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

  9. Edad avanzada y factores de riesgo para infarto agudo de miocardio

    Directory of Open Access Journals (Sweden)

    M. A. Ciruzzi

    2002-12-01

    Full Text Available Este estudio caso-control analizó en los sujetos añosos el rol de los factores de riesgo coronario en el desarrollo del infarto agudo de miocardio (IAM, estableció la naturaleza de esta asociación y el grado de riesgo. Los datos fueron obtenidos en una investigación que incluyó 1060 casos y 1071 controles, realizada en 35 unidades coronarias de centros médicos de Argentina entre noviembre de 1991 y agosto de 1994. Nuestro análisis se basó en la información de los sujetos mayores de 65 años. Los casos fueron 427 pacientes con un primer IAM. Los controles fueron 396 sujetos sin evidencias clinicas de enfermedad cardiovascular, seleccionados en los mismos centros que los casos. Los Odds Ratios (OR y su intervalo de confianza del 95% (IC 95% se obtuvieron mediante un análisis de regresión logística, incluyendo variables como la edad, educación, clase social, tabaquismo, antecedente de diabetes o hipertensión arterial, índice de masa corporal e historia familiar de enfermedad coronaria. Los factores de riesgo relacionados independientemente con IAM fueron los siguientes: hipercolesterolemia (colesterol sérico > 240 mg/dl: OR=1.76 (IC 95%: 1.25-2.49, tabaquismo: OR=1.6 (IC 95%: 1.06-2.4, hipertensión arterial: OR=2.05 (IC 95%: 1.51-2.73, diabetes OR=1.71 (IC 95%: 1.12-2.70, historia de un familiar con enfermedad coronaria: OR=1.36 (IC 95%: 0.93-1.97 y de dos o más familiares: OR=2.63 (IC 95%: 1.21-5.71. Este estudio, confirma en los sujetos de edad avanzada la importancia de la hipercolesterolemia, del tabaquismo, la hipertesión arterial, la diabetes y la historia familiar de enfermedad coronaria como factores de riesgo de IAM

  10. Sobrecarga en el cuidador de paciente con infarto agudo al miocardio

    Directory of Open Access Journals (Sweden)

    Norma Lizbeth Ávila Estrada

    2012-12-01

    Full Text Available Introducción: Las enfermedades cardiovasculares constituyen la primera causa de muerte en México, generando un impacto social persistente que involucra tanto a quien lo padece como a quienes lo rodean. Objetivo: Determinar el nivel de sobrecarga en el cuidador con pacientes de infarto agudo miocardio (IAM en el Hospital General de Durango. Materiales y Métodos: Estudio descriptivo no experimental, transversal; 54 familiares de pacientes hospitalizados con diagnóstico de IAM en el Hospital General Durango, no probabilístico por conveniencia. Resultados: La edad promedio en el estudio es de 18 a 25 años correspondiendo al 37%, de los cuales el 66.7% es femenino, 59.3% tiene escolaridad de medios superior, el 72.2% son de procedencia de la ciudad de Durango, con respecto al parentesco del cuidador con la persona que demanda cuidado esta es en su mayoría hijo con un porcentaje de 20.4%; también un alto porcentaje 81.5 % convive con el enfermo y un 63.0% trabaja fuera del hogar, y un 27.8% ha dejado el trabajo parcialmente; el resultado revelo que existe un nivel medio de sobrecarga del 44.2% en el cuidador primario. Discusión y Conclusiones: Son identificables los niveles de sobrecarga en cuidadores de pacientes con IAM generando una serie de variables que alteran la relación cuidador-paciente trayendo consigo una sobrecarga de tipo medio. (Rev Cuid 2012;3(3:342-8.Palabras clave: Cuidados Posteriores, Absentismo Familiar, Atención no Remunerada. (Fuente: DeCS BIREME.

  11. Comportamiento del infarto agudo de miocardio en adultos mayores atendidos en el Policlínico XX Aniversario

    Directory of Open Access Journals (Sweden)

    Rolando Santos Martínez

    2016-03-01

    Full Text Available Introducción: La cardiopatía isquémica constituye, en la actualidad, uno de los problemas de salud más serios a nivel mundial; es considerada estadísticamente la primera causa de muerte en el mundo desarrollado. Objetivo: Caracterizar el comportamiento del infarto agudo de miocardio en adultos mayores. Método: Se realizó una investigación descriptiva retrospectiva con los 62 adultos mayores pertenecientes al área de salud del Policlínico XX Aniversario de la ciudad de Santa Clara, Cuba, que fueron egresados del hospital con el diagnóstico de infarto agudo de miocardio. Las variables fundamentales fueron los factores de riesgo, la localización del infarto y sus complicaciones. Resultados: Predominaron los hombres (62,9 % y el grupo de edad entre 60 y 69 años (59,7 %. Hubo mayor representación de los pacientes del Consultorio de Condado Sur (41,9 %. La hipertensión arterial fue el factor de riesgo cardiovascular más frecuentemente encontrado (53,2 %, con diferencia significativa (p<0,05, seguido por el alcoholismo (35,5 % y la obesidad (29,0 %. El infarto inferior fue el más prevalente, encontrado en 24 pacientes (38,7 %; seguido por el ántero-septal (22,6 % y el ántero-lateral (21,0 %. El fallo de bomba fue diagnosticado en 24 pacientes (38,7 %, lo que representa una diferencia estadística muy significativa (p=0,01, y le siguieron en orden de frecuencia las complicaciones eléctricas. Conclusión: Existió un predominio del sexo masculino y del grupo de edad entre 60-69 años. La hipertensión arterial, como factor de riesgo, la topografía inferior del infarto y al fallo de bomba, como complicación, fueron los más frecuentemente encontrados.

  12. Abdome agudo obstrutivo pela veia porta - relato de caso

    Directory of Open Access Journals (Sweden)

    Celeste Gomes Sardinha Oshiro

    2016-10-01

    Full Text Available Introdução: A veia porta pré-duodenal é uma anomalia congênita rara, sintomática em apenas 50% dos casos, sendo que seu diagnóstico é feito por laparotomia exploradora. O tratamento de escolha é cirúrgico, com bom prognóstico. Objetivo: Relatar um caso de Abdome Agudo Obstrutivo por Veia Porta Pré Doudenal (VPPD no período neonatal no Conjunto Hospitalar de Sorocaba. Metodologia: Descrição do referido caso e revisão de literatura. Relato de Caso: Recém-nascido de F.S.S., feminino, de parto normal em 30/05/2016, cuja mãe com 21 anos, apresentou durante pré-natal Diabetes Mellitus Gestacional e polihidrâmnio; negou consanguinidade, vícios e infecções. Ao nascimento, idade gestacional 38 1/7 semanas, peso 2865g, comprimento 47 cm, Apgar 9/9. Durante rotinas de sala de parto, à aspiração gástrica, saída de 55 ml de líquido claro com grumos (LCCG. No 4o dia de vida, episódios de vômito com sangue e distensão abdominal. No 11° dia de vida, realizada Laparotomia Exploradora que identificou dilatação gástrica e duodenal, principalmente na 3° porção, onde passa anteriormente a Veia Porta, comprimindo parcialmente a borda antimesentérica duodenal, o que comprometia seu esvaziamento. Realizada anastomose duodeno-jejunal. Recebeu alimentação parenteral por 15 dias. RN apresentou infecções fúngica e bacteriana, tratadas durante internação. Recebe alta com 46 dias de vida em aleitamento materno e boa recuperação clínica. Conclusão: Existem poucos relatos sobre a formação anômala da veia porta e suas consequências. O diagnóstico pré-natal ou pré-operatório de VPPD raramente é feito. Boa evolução pós correção cirúrgica.

  13. Análise retrospectiva de 287 casos de abdome agudo em ginecologia e obstetrícia

    OpenAIRE

    Murta, Eddie Fernando Candido; Tiveron,Fabiana Sucupira; Barcelos, Ana Cristina Macêdo; Manfrin,Alessandra

    2001-01-01

    OBJETIVO: O abdome agudo em ginecologia e obstetrícia apresenta baixo risco de vida para a paciente, entretanto, o retardo no diagnóstico e tratamento influencia na morbi-mortalidade. O objetivo deste trabalho foi estudar as principais causas de abdome agudo em tocoginecologia. MÉTODOS: Foram revisados 287 casos de abdome agudo em tocoginecologia de janeiro de 1987 a dezembro de 1997 atendidos na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. RESULTADOS...

  14. Prevalencia, características y valor pronóstico del síndrome metabólico en los síndromes coronarios agudos

    Directory of Open Access Journals (Sweden)

    Alfredo C. Piombo

    2005-01-01

    Full Text Available El síndrome metabólico (SM es una entidad compuesta por diversas alteraciones que confieren un aumento del riesgo cardiovascular y de diabetes a largo plazo. Sus características en pacientes con síndromes coronarios agudos (SCA son prácticamente desconocidas. Objetivos Determinar la prevalencia, las características y el valor pronóstico del síndrome metabólico SM en los síndromes coronarios agudos (SCA. Evaluar su correlación con los factores de riesgo coronario (FRC y los hábitos dietéticos y analizar una nueva definición recientemente propuesta. Material y métodos Se incluyeron pacientes consecutivos ingresados en Unidad Coronaria con infarto agudo de miocardio o angina inestable. Se diagnosticó SM en base a los criterios del NCEP-ATP III. La nueva definición analizada fue la propuesta por la International Diabetes Federation. Resultados Se incluyeron en el estudio 239 pacientes. El SM estuvo presente en el 53,3 % de los casos y fue más frecuente en las mujeres (OR 2,53; IC 95%: 1,24-5,18 (p = 0,005. No presentó correlación significativa con el pronóstico hospitalario ni con los hábitos dietéticos. Su prevalencia según la nueva definición fue casi idéntica (53% y si bien tuvo valor pronóstico en el análisis univariado, no lo conservó en el multivariado. Conclusiones La prevalencia del SM en los SCA es más elevada que la informada para otras poblaciones. No parece tener valor pronóstico a corto plazo. La nueva definición no modificó su prevalencia ni agregó información pronóstica independiente.

  15. Millon´s Personality Model and ischemic cardiovascular acute episodes: Profiles of risk in a decision tree

    Directory of Open Access Journals (Sweden)

    María M. Richard's

    2008-01-01

    Full Text Available La identificación de subgrupos de riesgo permite a los psicólogos clínicos desarrollar intervenciones específicas para esos subgrupos. El principal propósito de este trabajo fue encontrar asociaciones estadísticas entre características de personalidad -rasgos y trastornos- y la existencia de episodios isquémicos cardiovasculares agudos según el modelo de personalidad de Theodore Millon. Los análisis del presente estudio se fundamentaron en una muestra de 313 mujeres y hombres entre 31 y 80 años de edad, divididos en dos grupos: un grupo clínico formado por 143 participantes internados a causa de episodios isquémicos cardiovasculares agudos y un grupo control constituido por 170 personas sin antecedentes de enfermedades cardiovasculares. Los resultados mostraron cuatro perfiles de riesgo de personalidad asociados con la existencia de episodios isquémicos agudos y, por tanto, esto posibilita a los psicólogos clínicos el diseño de intervenciones específicas para aquellos subgrupos.

  16. “Baço errante”, uma causa rara de abdomen agudo

    OpenAIRE

    2014-01-01

    Resumo: Baço “errante” é uma condição rara caracterizada por hipermobilidade esplénica devido à ausência ou laxidez dos seus ligamentos, podendo apresentar-se como abdómen agudo quando ocorre torção do seu próprio pedículo. Apresenta-se o caso de baço “errante” em jovem do sexo feminino, de quinze anos, com vómitos e dor abdominal na admissão hospitalar. Ocorreu deterioração do estado clínico com aparecimento de sinais clínicos de abdómen agudo, sendo realizada laparotomia com remoção do baço...

  17. Cardiovascular pharmacogenetics.

    Science.gov (United States)

    Myburgh, Renier; Hochfeld, Warren E; Dodgen, Tyren M; Ker, James; Pepper, Michael S

    2012-03-01

    Human genetic variation in the form of single nucleotide polymorphisms as well as more complex structural variations such as insertions, deletions and copy number variants, is partially responsible for the clinical variation seen in response to pharmacotherapeutic drugs. This affects the likelihood of experiencing adverse drug reactions and also of achieving therapeutic success. In this paper, we review key studies in cardiovascular pharmacogenetics that reveal genetic variations underlying the outcomes of drug treatment in cardiovascular disease. Examples of genetic associations with drug efficacy and toxicity are described, including the roles of genetic variability in pharmacokinetics (e.g. drug metabolizing enzymes) and pharmacodynamics (e.g. drug targets). These findings have functional implications that could lead to the development of genetic tests aimed at minimizing drug toxicity and optimizing drug efficacy in cardiovascular medicine.

  18. FRACASO RENAL AGUDO EN EL PACIENTE ONCOLOGICO. ANALISIS CLINICO Y PRONOSTICO.

    Directory of Open Access Journals (Sweden)

    Purroy A,

    2004-01-01

    Full Text Available RESUMEN: El fracaso renal agudo es un problema frecuente en el paciente oncológico, que plantea limitaciones en el pronóstico y en el planteamiento terapeútico. El desarrollo de registros de pacientes oncológicos con fracaso renal agudo permite analizar el perfil clínico y plantear aspectos a desarrollar desde el punto de vista terapeútico y sobre todo preventivo. El empleo de determinados índices pronósticos como el ISI (Liaño o el de fallo multiorgánico permite evaluar mejor este perfil clínico. En nuestra experiencia el fracaso renal agudo en el paciente oncológico es una complicación frecuente y relacionada con el proceso de base. Mediante este registro de pacientes hemos identificado un perfil clínico de alto riesgo consistente en un paciente con un fallo renal asociado a un proceso infeccioso, con insuficiencia respiratoria, oligúrico y con una puntuación elevada de esos índices pronósticos.

  19. Inmunización para influenza y neumococo en prevención cardiovascular

    Directory of Open Access Journals (Sweden)

    María Inés Sosa Liprandi

    2014-06-01

    Full Text Available La relación entre las infecciones respiratorias producidas por el virus de la influenza y el neumococo y los eventos cardiovasculares motivaron la reunión de un grupo interdisciplinario (cardiólogos, clínicos e infectólogos, con el objeto de analizar la evidencia entre la asociación de estos fenómenos y el rol de las estrategias de inmunización en la prevención de la enfermedad cardiovascular. El presente documento sintetiza las conclusiones del grupo de trabajo. El análisis de revisiones sistemáticas sugiere una evidencia consistente entre la infección por influenza y neumococo como desencadenantes de infarto agudo de miocardio y muerte cardiovascular. Los estudios publicados en los últimos 15 años sugieren que la vacunación para influenza y neumococo reducen el riesgo de síndromes coronarios agudos. Con la evidencia existente y teniendo en cuenta los análisis de costo-efectividad, ahorro de costos y perfil de seguridad de las vacunas, las sociedades científicas y agencias gubernamentales de salud, tanto nacionales como internacionales, recomiendan fuertemente la incorporación de la inmunización en el grupo de pacientes con enfermedad cardiovascular crónica.

  20. Utilidad y fiabilidad de las escalas contemporáneas de estimación de riesgo en enfermedades cardiovasculares

    OpenAIRE

    Abu Assi, Emad

    2013-01-01

    Las enfermedades cardiovasculares son la principal causa de morbimortalidad en los países desarrollados. Además, su coste es muy elevado, que, junto con el envejecimiento progresivo de nuestra población, exige estrategias de prevención a fin de contrarrestar sus efectos. En los últimos años, se desarrollaron varias escalas de estratificación de riesgo en el ámbito de las enfermedades cardiovasculares, como el síndrome coronario agudo y las hemorragias derivadas de su manejo; eventos tromboemb...

  1. Guía práctica clínica prevención de infarto agudo de miocardio en pacientes sometidos a cirugía no cardiaca / Clinic practice guideline on prevention of acute miocardial infarction in patients undergoing non cardiac surgery

    OpenAIRE

    Rodríguez Ariza, Daniel Efrén

    2010-01-01

    La guía de práctica clínica para prevención de infarto agudo de miocardio en pacientes sometidos a cirugía no cardiaca es una revisión de la evidencia disponible desde 1966 hasta julio del 2008 en MEDLINE, Colaboración cchrane, tripdatabase acerca de la valoración del riesgo perioperatorio y manejo, elaborada con el fin de orientar a los profesionales de salud en la elección del mejor predictor de riesgo de evento adverso cardiovascular y acerca del manejo de acuerdo a las características de...

  2. Polimorfismos del gen de la enzima convertidora de angiotensina (Inserción/Delección y factores de riesgo asociados en pacientes con infarto agudo del mioicardio

    Directory of Open Access Journals (Sweden)

    Lizbeth Salazar Sánchez

    2009-06-01

    Full Text Available Introducción. Los factores clásicos de riesgo cardiovascular están ampliamente estudiados y estrechamente vinculados con el desarrollo de infarto agudo del miocardio, accidente vascular cerebral y enfermedad vascular periférica. Entre los factores genéticos que subyacen a estas condiciones están las mutaciones en el gen de la enzima convertidora de angiotensina. El principal objetivo de este estudio fue establecer la relación entre polimorfismos Inserción/Delección de la enzima conversora de angiotensina en una grupo de pacientes con cardiopatía isquémica. Métodos: Se realizó un estudio prospectivo de casos y controles en un grupo de pacientes con infarto agudo del miocardio referidos para coronariografía. Se obtuvo información clínica a partir de los expedientes clínicos y la entrevista personal. La obtención de ácido desoxirribunocleico y el análisis del polimorfismo de la enzima convertidora de angiotensina (Inserción / Delección, se realizaron con técnicas de biología molecular previamente descritas. Resultados: Se incluyeron en el estudio 33 casos y 67 controles. El 87.7% de los pacientes fueron de sexo masculino y el índice de masa corporal fue mayor en los casos (35.6 que en los controles (24.8. En el grupo de casos, el fumado (pAbstract Angiotensin converting enzime gene polimorphisms Insertion/Deletion and cardiovascular risk factors in patients with acute myocardial infarction Introduction Traditional cardiovascular risk factors are widely studied and closely linked with the development of acute myocardial infarction, stroke and peripheral vascular disease. The underlying genetic background includes the angiotensin converting enzyme gene mutations. The main objective of this study is to establish an association between the polymorphism Insertion/Deletion of angiotensin converting enzyme in a group of patients with coronary artery disease. Methods. We performed a prospective, case-control study, in a group of

  3. Mortalidade infantil no Brasil e óbitos, na mesma geração, por infarto agudo do miocárdio Infant mortality in Brazil and deaths from acute myocardial infarction in the same generation

    Directory of Open Access Journals (Sweden)

    João Guilherme Bezerra Alves

    2004-12-01

    Full Text Available Baixo peso ao nascer, fator de risco recentemente descrito para as doenças cardiovasculares, está associado com mortalidade infantil elevada. Foram comparadas as taxas de mortalidade por infarto agudo do miocárdio no ano 2000, registradas nas regiões Nordeste e Sul do Brasil, com os coeficientes de mortalidade infantil entre os anos 1930/1950. Entre os anos 1930/1950, o Nordeste apresentava um coeficiente médio de mortalidade infantil de 185 por mil nascidos vivos, e a Região Sul, 116 por mil nascidos vivos. Observou-se uma maior mortalidade por infarto agudo do miocárdio na Região Sul (coeficientes ajustados de 60,8 e 41,2 vs. 26,4 e 19,2 por 100 mil habitantes, respectivamente para o sexo masculino e feminino. A desigualdade entre as taxas de mortalidade infantil no Nordeste e Sul no período estudado, ao lado de que o fenômeno da redução da mortalidade infantil não ter representado melhorias importantes das condições de vida, impediu a avaliação do impacto do baixo peso ao nascer sobre as taxas de mortalidade por infarto agudo do miocárdio na vida adulta.Low birth weight is a risk factor for cardiovascular diseases, which constitute the main causes of death both in Brazil and worldwide. High infant mortality rates are associated with low birth weight. The aim of this study was to compare mortality from acute myocardial infarction in 2000 in the Northeast and South of Brazil, regions with different infant mortality rates from 1930 to 1950. Mortality from acute myocardial infarction was higher in southern Brazil, with an adjusted coefficient per 100,000 of 60.8 in males and 41.2 in females (South versus 26.4 in males and 19.2 in females (Northeast. Similar results were found for lung cancer: 22.8 in males and 8.9 in females (South versus 5.3 in males and 2.8 in females (Northeast. The persistence of different socioeconomic conditions and infant mortality rates between the two regions and the fact that the phenomenon of infant

  4. Síndrome abdominal agudo debido a quiste infectado del mesenterio

    Directory of Open Access Journals (Sweden)

    José Martín Palacios-Acosta

    2015-10-01

    Full Text Available Los quistes del mesenterio son lesiones benignas intrabdominales que crecen a expensas de los vasos linfáticos del intestino; son más frecuentes en el mesenterio ileal y muy raros en la edad pediátrica. El síndrome abdominal agudo en la edad pediátrica es difícil de definir al ser un cuadro de origen múltiple y de presentación clínica muy variada; su síntoma principal es el dolor abdominal agudo, una de las causas que con mayor frecuencia motivan consulta en el Servicio de Urgencias Pediátricas. Los quistes de mesenterio son infrecuentes, se estima que se presentan en uno de cada 100 000 ingresos por síndrome abdominal agudo en pediatría. El estudio de elección para el diagnóstico es el ultrasonido abdominal y el tratamiento óptimo es la resección completa del quiste. Se presenta el caso de una paciente con tumor abdominal ingresada para su estudio. Durante su evolución tuvo datos de irritación peritoneal por lo que se decidió realizar una laparotomía exploradora en la que se encontró un quiste del mesenterio, roto e infectado. Se efectuó hemicolectomía izquierda, lavado de cavidad y colostomía de una sola boca. A los tres meses de operada se hizo la restitución del tránsito intestinal con buenos resultados.

  5. Effect of complex puccoon preparation on fungi which could cause beriberi%紫草复合制剂对脚气真菌的抑制作用研究

    Institute of Scientific and Technical Information of China (English)

    杨东方; 张玮玮; 蔡翠芳

    2016-01-01

    Objective:To observe the effect of complex puccoon preparation on fungi which could cause beriberi.Methods:Puccoon,propolis and bee pollen were selected as the main materials,complex puccoon preparation of different ratio was formulated.Inhibitory effects of complex puccoon preparation of different ratio on Candida tropicalis and Aspergillus niger were preliminarily studied by orthogonal design.Results:Complex puccoon preparation of different ratio have certain inhibitory effects on two kinds of fungi.A3BZC3 was optimal process and its inhibitory rate on Candida tropicalis was more than 95%.Conclusion:Long-period performance and stability of inhibitory effect of complex puccoon preparation on fungi should be continued to investigate.%目的:探究中药材紫草复合制剂对引起脚气病病菌的抑制效果。方法:选取紫草、蜂胶、蜂花粉为主要材料,配置不同配比的紫草复合制剂,采用正交设计就紫草复合制剂对热带假丝酵母与黑曲霉菌的抑制作用进行了初步研究。结果:不同配比的紫草复合制剂处理对两类真菌均有一定的抑制作用,本试验G号处理样A3B2C3为最优处理组合,对热带假丝酵母的抑菌率达到了95%以上。结论:其抑制真菌的长效性和稳定性还有待继续观察和研究。

  6. Hepatocarcinoma como causa de abdome agudo em adolescente: relato de caso

    OpenAIRE

    2012-01-01

    O carcinoma hepatocelular (CHC) é pouco prevalente nos países ocidentais, porém é um dos tumores mais freqüentes na Ásia e a quinta causa de câncer no mundo.É relatado um caso de adolescente do sexo feminino sem fatores de risco para um tumor extremamente agressivo, internada no Hospital Universitário da Universidade de São Paulo. A apresentação clínica foi de abdome agudo secundário a sangramento para cavidade peritoneal por ruptura do tumor evidenciado através de tomografia computorizada mu...

  7. INFARTO AGUDO DO MIOCÁRDIO: MANUAL DE ORIENTAÇÃO PARA O PACIENTE

    Directory of Open Access Journals (Sweden)

    Fernanda Carneiro Mussi

    Full Text Available Baseado em pesquisa das expectativas de 30 pacientes internados em unidade coronária, os autores apresentam um manual de orientação para o paciente com diagnóstico de Infarto Agudo do Miocárdio. O objetivo do manual é ser um complemento do tratamento dos pacientes com Infarto do Miocárdio, a principal causa de morte em nosso pais. É composto por informações sobre o que é a doença, os fatores de risco a ela associados, retorno as atividades e tratamento.

  8. Percepciones y creencias en personas que padecieron un evento coronario agudo

    OpenAIRE

    Espitia Cruz, Sonia Esperanza; Rincón Osorio, Fanny

    2012-01-01

    Utilizando un abordaje cualitativo interpretativo, se describen y analizan las percepciones y creencias que tiene un grupo de personas que padecieron un infarto agudo de miocardio, con respecto a sus hábitos de vida; se busca encontrar, desde el propio sujeto, las implicaciones que lo llevan a asumir un hábito. La muestra se constituyó con la información proporcionada por siete personas usuarias del servicio de salud de la Universidad Nacional, que fueron abordadas en dos momentos diferentes ...

  9. Miocarditis de células gigantes que simula un infarto agudo de miocardio

    Directory of Open Access Journals (Sweden)

    Andrea Zappi

    2009-01-01

    Full Text Available La miocarditis de células gigantes (MCG es una entidad rara, de causa desconocida, de probable etiología autoinmune. Puede presentarse como insuficiencia cardíaca refractaria, asociarse con arritmias ventriculares y en otras ocasiones simular un infarto agudo de miocardio. Su pronóstico con frecuencia es ominoso, salvo que se realicen tratamiento inmunosupresor o trasplante cardíaco, este último con elevada recurrencia.REV ARGENT CARDIOL 2009;77:60-62.

  10. Cuidados e intervenciones de enfermería al paciente diagnosticado de infarto agudo de miocardio

    OpenAIRE

    Villanueva Llorente, María

    2015-01-01

    El infarto agudo de miocardio (IAM) es actualmente una de las enfermedades que más muertes produce en los países desarrollados. La prevalencia de esta patología está íntimamente relacionada con los malos hábitos de vida y los factores de riesgo asociados. Para mejorar el pronóstico de la enfermedad y la calidad de vida de los pacientes que la padecen, es necesario tratar los factores de riesgo relacionados como son la hipertensión arterial, diabetes mellitus, dislipemia, tabaquismo, etc. La p...

  11. Infarto agudo de miocardio. Resultados de la Encuesta SAC 2005 en la República Argentina

    OpenAIRE

    2007-01-01

    RESUMENIntroducciónConsiderando que el infarto agudo de miocardio (IAM) es la causa más frecuente de muerte en nuestro país, este registro multicéntrico pretende establecer una visión de la realidad epidemiológica (limitada a los centros participantes) con la finalidad de obtener información acerca del manejo clínico y la morbimortalidad intrahospitalaria.ObjetivoAnalizar los aspectos epidemiológicos, clínicos, usos terapéuticos y mortalidad del IAM en centros relacionados con la Sociedad Arg...

  12. Infarto agudo de miocardio secundario a embolismo en una paciente con

    OpenAIRE

    Gallegos Cazorla, Alex; More Terán, Juan Carlos

    2015-01-01

    La fibrilación auricular (FA) puede producir embolismo siendo causa importante de morbilidad y mortalidad. Presentamos el caso de una paciente admitida con historia de palpitaciones, agregándose dolor retro esternal opresivo. Se  encuentra FA asociada a cambios electrocardiográficos compatibles con infarto agudo de miocardio. Los biomarcadores (Troponina T y CK-MB) y los trastornos de la motilidad determinados por ecocardiografía confirmaron el diagnóstico procediéndose a la coronariografía d...

  13. La entrevista motivacional y la adherencia de los pacientes en pos infarto agudo de miocardio

    OpenAIRE

    Achury Beltrán, Luisa Fernanda

    2015-01-01

    La adherencia al tratamiento es uno de los pilares fundamentales del manejo de los pacientes que han sufrido un infarto agudo de miocardio, por lo que la búsqueda de estrategias que la fomenten se hace imprescindible en un intento por mejorar la calidad de vida y reducir las complicaciones derivadas de la enfermedad. La presente investigación tuvo como objetivo determinar el efecto de una estrategia de enfermería basada en la entrevista motivacional, sobre la adherencia al tratamiento de p...

  14. Nefropatía por contraste en el síndrome coronario agudo

    OpenAIRE

    Mariana Carnevalini; Mariano Giorgi; Silvina Waldman; Nicolás Caturla; Rodrigo Ovejero; Estela Falconi; Lucas San Miguel; Christian Caroli; Eduardo Magariños; Hernán Cohen Arazi

    2011-01-01

    La nefropatía inducida por contraste (NIC) es una de las causas más frecuentes de insuficiencia renal en pacientes internados. En el síndrome coronario agudo (SCA), la presencia de NIC aumenta la morbimortalidad. Las medidas de profilaxis y los factores de riesgo intervinientes de NIC en SCA no han sido determinados con exactitud. El objetivo de este estudio fue evaluar la incidencia de NIC y los factores asociados a su desarrollo en pacientes ingresados en unidad coronaria con requerimiento ...

  15. Efeitos agudos da aplicação de Kinesio Tape na Performance do Salto Vertical

    OpenAIRE

    Antunes, Mário

    2014-01-01

    Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia Introdução: A aplicação de Kinesio Tape tem sido utilizada para melhorar o desempenho desportivo. O objetivo deste estudo foi analisar os efeitos agudos da aplicação de Kinesio Tape na performance do salto vertical. Metodologia: A amostra foi constituída por 12 participantes (7 mulheres e 5 homens), com idades compreendidas entre os 18 e os 35 anos. ...

  16. Diagnóstico por imagem do tromboembolismo pulmonar agudo Imaging of acute pulmonary thromboembolism

    Directory of Open Access Journals (Sweden)

    C. Isabela S. Silva

    2004-10-01

    Full Text Available O diagnóstico do tromboembolismo pulmonar agudo é baseado na probabilidade clínica, uso do dímero D (quando disponível e na avaliação por imagem. Os principais métodos de imagem utilizados no diagnóstico são representados por cintilografia ventilação-perfusão, angiografia pulmonar e tomografia computadorizada (TC. Na última década vários estudos têm demonstrado que a TC espiral apresenta elevada sensibilidade e especificidade no diagnóstico de tromboembolismo pulmonar agudo. Uma melhor avaliação das artérias pulmonares tornou-se possível com a recente introdução dos equipamentos de TC espirais com multidetectores. Vários pesquisadores têm sugerido que a angiografia pulmonar por TC espiral deve substituir a cintilografia na avaliação de pacientes com suspeita clinica de tromboembolismo pulmonar agudo. Os autores discutem os principais métodos de imagem utilizados no diagnóstico de tromboembolismo pulmonar agudo enfatizando o papel da TC espiral.The diagnosis of acute pulmonary thromboembolism is based on the clinical probability, use of D-dimer (when available and imaging. The main imaging modalities used in the diagnosis are ventilation-perfusion (V/Q, scintigraphy, angiography, and computed tomography (CT. In the last decade several studies have demonstrated that spiral CT has a high sensitivity and specificity in the diagnosis of acute pulmonary thromboembolism. The evaluation of the pulmonary arteries has further improved with the recent introduction of multidetector spiral CT scanners. Various investigators have suggested that spiral CT pulmonary angiography should replace scintigraphy in the assessment of patients whose symptoms are suggestive of acute PE. This article discusses the role of the various imaging modalities in the diagnosis of acute pulmonary thromboembolism with emphasis on the role of spiral CT.

  17. Síndrome del túnel carpiano agudo secundario a cuerpo extraño.

    OpenAIRE

    Proubasta Renart, Ignacio; Álvarez, C; C. Lamas

    2013-01-01

    Se presenta un caso de síndrome del túnel carpiano agudo (STCA) secundario a la penetración de una espina de cactus dentro del canal carpiano. El tratamiento consistió en la inmediata liberación del retináculo flexor junto con la extracción del cuerpo extraño. La función del nervio mediano se recuperó inmediatamente. Creemos que es el primer caso publicado de STCA secundario a una espina de cact...

  18. Psicoterapia de grupo en la Unidad de Agudos del Hospital Psiquiátrico.

    OpenAIRE

    Rafael Casas Rivera

    1985-01-01

    Se describen las características de un grupo de psicoterapia realizado diariamente con «casi» todos los pacientes ingresados en la Unidad de Admisión de un hospital psiquiátrico. El grupo tiene sus bases teóricas en la psicoterapia analítica de grupo, teniendo, no obstante, muchas diferencias con la misma, por ser un grupo institucional, tratarse de pacientes psicóticos agudos (con gran movilidad en cuanto a ingresos y altas) y por la asistencia de varios terapeutas, coterapeutas y observador...

  19. Fracaso renal agudo secundario a crisis de hipercalcemia muy severa por hiperparatiroidismo primario

    OpenAIRE

    Chacón, Andrea; Vilar, Ana; Arroyo, David; Sarró, Felipe; Craver Hospital, Lourdes; Ros López, Susana; López, Carolina; Castillo, Alex; Matias-Guiu, Xavier; Fernández i Giráldez, Elvira

    2015-01-01

    La crisis hipercalcémica es una forma de presentación poco frecuente del hiperparatiroidismo primario. Solo existen pequeñas series de casos reportadas en la literatura1 and 2. Se caracteriza por hipercalcemia severa, insuficiencia renal y alteración del estado de conciencia. Presentamos el caso de un paciente de 70 años, que ingresa por fracaso renal agudo desencadenado por una crisis de hipercalcemia en el contexto de un hiperparatiroidismo primario no conocido previamente. Se discute la co...

  20. Seguimiento Farmacoterapéutico a paciente con cansancio y riesgo cardiovascular importante

    OpenAIRE

    Acosta, Mauricio Bonilla; Ramírez, Victoria Hall; Morúa, María Soledad Quesada

    2013-01-01

    Paciente masculino de sesenta años con historial de infarto agudo al miocardio, con hipertrigliceridemia, LDL elevado, HDL disminuido y un 37,2% de riesgo de presentar enfermedad cardiovascular en los próximos diez años. Padece otras enfermedades concomitantes, incluido un cansancio importante que no disminuye con tratamiento farmacológico; cumple adecuadamente sus tratamientos y no fuma, pero nunca hace ejercicio.Se realizó una intervención oral para optimizar la terapia para tratar el cansa...

  1. Factores asociados a la demora prehospitalaria en hombres y mujeres con síndrome coronario agudo

    OpenAIRE

    A. Daponte-Codina; J. Bolívar-Muñoz; Sánchez-Cantalejo, E; I. Mateo-Rodríguez; G. Babio; N. Romo-Avilés; F. Rosell-Ortiz

    2016-01-01

    Fundamento. Identificar factores asociados a la demora prehospitalaria en personas que han tenido un síndrome coronario agudo Material y métodos. Se estudiaron mediante encuesta pacientes ingresados por síndrome coronario agudo en los 33 hospitales públicos andaluces, obteniéndose información sobre diferentes tipos de variables: socio-demográficas, contextuales, clínicas, percepción, actuaciones, y transporte. Se aplicaron modelos de regresión logística multivariante para calcular las odds ra...

  2. Efecto agudo del estiramiento sobre el rendimiento físico: el uso de los estiramientos en el calentamiento

    OpenAIRE

    Francisco Ayala; Pilar Sainz de Baranda; Antonio Cejudo; Mark De Ste Croix

    2011-01-01

    Con esta revisión crítica se pretende analizar el efecto agudo del estiramiento dentro del calentamiento en función de las diferentes pruebas de valoración que han sido utilizadas para valorar el efecto agudo del estiramiento (isométricas, isocinéticas, capacidad de salto, pruebas funcionales). La realización de estiramientos como parte fundamental de todo calentamiento ha sido ampliamente recomendada. Sin embargo, en los últimos años se ha observado un incremento del número de estudios ci...

  3. Pre-hospital attitudes adopted by patients faced with the symptoms of acute myocardial infarction Actitudes prehospitalarias adoptadas por pacientes frente a los síntomas de infarto agudo del miocardio Atitudes pré-hospitalares adotadas por pacientes frente aos sintomas de infarto agudo do miocárdio

    Directory of Open Access Journals (Sweden)

    Viviane de Araújo Gouveia

    2011-10-01

    Full Text Available This case series aimed to evaluate the behavior adopted by patients during the pre-hospital phase of acute myocardial infarction (AMI. A total of 115 AMI sufferers with ST-segment elevation were evaluated. The chi-square and Fisher's exact tests were applied. The individuals that did not associate the symptoms with cardiovascular disease most often attributed them to the following sources: gastrointestinal (38%, musculoskeletal (29.7%, food and/or medication poisoning (8.5% and arising from the respiratory apparatus (6.3%. The proportion of major outcomes and of patients that arrived in the emergency department after 12 hours was higher among women, individuals with monthly income of up to one minimum wage, those who used analgesics and did not associate the symptoms with cardiovascular disease. It was found that individuals in unfavorable socioeconomic conditions, who interpreted the symptoms incorrectly, arrived later at the emergency department and had worse intra-hospital outcomes.Esta serie de casos tuvo el objetivo de evaluar las conductas adoptadas por los pacientes durante la fase prehospitalaria del infarto agudo del miocardio (IAM. Se evaluaron 115 individuos portadores de IAM con el segmento ST supradesnivelado. Fue aplicada la prueba Chi-cuadrado y la prueba exacta de Fisher. Los individuos que no asociaron los síntomas a la enfermedad cardiovascular la atribuyeron más frecuentemente a los siguientes orígenes: gastrointestinal (38%, osteomuscular (29,7%, intoxicación alimentar y/o medicamentosa (8,5% y provenientes del aparato respiratorio (6,3%. La proporción de resultados más graves y de pacientes que llegaron a la emergencia después de 12 horas fue más elevada entre mujeres, individuos con renta mensual de hasta un salario mínimo, que usaron analgésicos y no asociaron los síntomas a la enfermedad cardiovascular. Se constató que individuos en condiciones socioeconómicas desfavorables, que interpretaron los síntomas de

  4. Estudio descriptivo sobre infarto agudo de miocardio en el Hospital de Caldas ESE entre 1996-2002.

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    Tatiana Bedoya

    2009-11-01

    Full Text Available Introducción: Las enfermedades cardiovasculares constituyen hoy la primera causa de muerte, siendo las más representativas la cardiopatía isquémica y el infarto agudo de miocardio (IMA. Es importante averiguar en el Hospital de Caldas ESE, Manizales, Colombia, la incidencia de mortalidad intrahospitalaria causada por esta enfermedad, por ser un centro de referencia a escala regional, complementando estudios anteriores realizados en este mismo centro. Objetivos: Los objetivos del presente trabajo fueron describir las características generales del IMA, analizar la repercusión de los factores de riesgo, identificar el tiempo de estancia intrahospitalaria, la frecuencia en ambos sexos y el grado de mortalidad según su localización. Materiales y métodos: Se realizó un análisis retrospectivo entre los años 1996 y 2002 de 784 historias clínicas de pacientes con IMA, del Servicio de Estadística del Hospital de Caldas. Se analizaron 686 historias clínicas evaluándose variables demográficas, detalles del IMA y algunos factores de riesgo. Resultados: Como resultado sobresaliente se encontró una mortalidad total de 14.7% mostrando un porcentaje de 7.7% para hombres y 7% mujeres. Se presentaron 122 casos con dolor atípico de los cuales 40 representaba la población diabética. La mayor mortalidad en este estudio se vio en los primeros siete días de hospitalización, constituyéndose en una mortalidad precoz los primeros diez días del infarto. Se encontró una diferencia significativa (p=0.0001 según la prueba t en la edad promedio de presentación del IMA comparando ambos sexos, siendo más frecuente la presentación en mujeres a edades más avanzadas (64 años que en hombres (59 años. Conclusiones: La incidencia de IMA ha aumentado en las mujeres, presentándose un aumento en la mortalidad precoz y siendo más frecuente en las personas de sexo femenino mayores de 64 años y sexo masculino mayores de 59 años.

  5. REGISTRO HOSPITALARIO DE INFARTO AGUDO DE MIOCARDIO EN SANTA CLARA / Hospital registry of acute miocardial infarction in Santa Clara

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    Alberto Morales Salinas

    2010-09-01

    Full Text Available Resumen Introducción y objetivos: En Cuba las estadísticas vitales de la morbi-mortalidad por infarto agudo de miocardio proceden de pequeñas áreas de salud. El objetivo fue identificar las principales características y conducta hospitalaria de los pacientes con infarto a través de un registro hospitalario de infarto. Métodos: Se monitorizaron los casos de infarto ocurridos en pacientes de 45 a 74 años de edad y residentes en Santa Clara, durante los años 2007 y 2008. Las fuentes de información fueron: listados de egresos hospitalarios, registros hospitalarios de infarto de miocardio, certificados de defunción y registros de autopsias nosocomiales. Se utilizó la metodología MONICA (MONItoring Trends and Determinants in CArdiovascular Disease Project. Resultados: Se registraron 297 pacientes con infarto. El 62,7 % de los varones y el 46,8 % de las mujeres recibieron tratamiento de reperfusión. Las letalidades hospitalarias en varones y mujeres fueron de 25,3 % y 45 %. Las variables que se relacionaron con una mayor mortalidad fueron la edad, el sexo femenino, la frecuencia cardíaca alta, el infarto de topografía anterior, la creatinina elevada, así como los antecedentes personales de cardiopatía isquémica previa y diabetes mellitus. Mientras que el tratamiento con fibrinolíticos y/o betabloqueadores se correlacionaron inversamente con la mortalidad. Conclusiones: Existió una elevada prevalencia de dislipidemia desconocida y letalidad hospitalaria a 28 días; así como una baja utilización de las estrategias cruentas. La hipertensión sistólica al ingreso se relacionó con un mejor pronóstico. / Abstract Introduction and objectives: In Cuba, the vital statistics of morbi-mortality due to acute myocardial infarction come from small health areas. The objective of this study was to identify the main characteristics and hospital management of patients with myocardial infarction, through a hospital registry of infarctions

  6. Terapia trombolítica e infarto agudo de miocardio en el Hospital Militar de Matanzas

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    Sandy F. Rodríguez Reyes

    2015-10-01

    Full Text Available Introducción: Las enfermedades del corazón constituyen la principal causa de muerte en Cuba.Objetivos: Identificar las características clínico-epidemiológicas de los pacientes con infarto agudo de miocardio y su vínculo con la trombólisis.Método: Estudio observacional descriptivo, de corte transversal, en el Hospital Militar de Matanzas, entre enero de 2011 y enero de 2013. El universo de estudio fue de 96 pacientes con diagnóstico clínico y electrocardiográfico de infarto agudo de miocardio con supradesnivel del segmento ST.Resultados: Existió predominio del sexo masculino (61,4 %, el grupo etario más afectado fue entre 65 y 74 años (39,6 %. La hipertensión arterial constituyó el principal factor de riesgo encontrado (71,9 %. En el 60,2 % de los pacientes que recibieron tratamiento trombolítico, el tiempo puerta-aguja fue entre los 30 y 60 minutos, y la mayoría de los casos [34 (35,4 %] arribaron al hospital entre las 3 y 6 horas del inicio de los síntomas. El alivio del dolor y el regreso del ST se presentaron en el 100 % de las trombólisis efectivas. La causa más frecuente de no trombólisis fue la evolución del episodio isquémico mayor a 12 horas, y falleció un 33,3 % de los pacientes que no recibieron tratamiento trombolítico.Conclusiones: Predominaron el sexo masculino, las edades entre 65 y 74 años, y la hipertensión arterial. La mayoría recibió trombólisis, con tiempo dolor-puerta entre 3 y 6 horas, y puerta-aguja entre 30 y 60 minutos. La complicación que más se presentó durante la trombólisis fue la hipotensión arterial y la causa más frecuente de no realización del procedimiento fue el tiempo dolor-puerta mayor a 12 horas, donde predominaron los fallecimientos. La trombólisis oportuna sigue siendo la principal herramienta para elevar la supervivencia de los pacientes con infarto agudo de miocardio en hospitales sin intervencionismo coronario percutáneo.

  7. Modelos de serviços hospitalares para casos agudos em idosos

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    Coelho Filho João Macedo

    2000-01-01

    Full Text Available Embora a atenção ao idoso seja uma prioridade emergente no Brasil, pouca ênfase tem sido dada a modelos de organização de serviços hospitalares para pacientes geriátricos. São revisados modelos de serviços hospitalares para admissão e manuseio de casos agudos em idosos, com ênfase na discussão sobre o papel e o posicionamento da medicina geriátrica (incluindo sua interface com especialidades e com a clínica médica no âmbito da atenção hospitalar. Foi realizada pesquisa na base de dados Medline (1989-1999, bem como nos principais livros-texto de geriatria e de gerontologia, buscando identificar descrições de serviços hospitalares para cuidado agudo de pacientes idosos. As características dos modelos identificados foram compiladas e descritas à luz de sua adequação à realidade dos serviços de saúde no Brasil. Exemplos de intervenções em geriatria, com efetividade demonstrada através de revisões sistemáticas, foram também citadas. Os modelos mais freqüentemente relatados foram cuidado prolongado, tradicional, baseado na idade cronológica, não especializado e integrado. Adaptações e variantes de alguns desses modelos foram freqüentemente relatadas, assim como seu impacto potencial na efetividade do cuidado geriátrico. Evidências sobre o melhor modelo a seguir não foram identificadas, mas aqueles modelos favorecendo a integração da geriatria com a clínica geral pareceram mais adequados à nossa realidade. Ressalta a necessidade de reestruturação de serviços de saúde para responder às novas demandas que surgem com o envelhecimento da população, bem como do delineamento de serviços hospitalares para casos agudos, importantes para a efetividade do cuidado geriátrico e que devem ser objeto de maior debate e pesquisa no Brasil.

  8. Eventos cardiovasculares e risco adicional em idosos hipertensos

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    Rosimeire Fontes de Queiroz

    2014-01-01

    Full Text Available El objetivo de la investigación fue investigar eventos cardiovasculares y riesgo adicional en fichas de ancianos hipertensos acompañados en una Unidad de Salud de la Familia en Natal/RN, Brasil. Estudio descriptivo y documental con desarrollo basado en 106 fichas del programa Hiperdia registrados de agosto a diciembre de 2012. Los resultados señalaron que 13,2% eran víctimas de accidente cerebrovascular, 10,37% de infarto agudo de miocardio y 8,4% de otras enfermedades coronarias. En la estratificación del riesgo cardiovascular, 68,86% no presentaron riesgo adicional, 31,11% fueron clasificados en baja a mucho alto riesgo para enfermedad cardiovascular. Los resultados proporcionan la planificación de acciones para cuidar de ancianos hipertensos y son dignos reflejo para el ejercicio profesional de la enfermería, especialmente en relación con la reorganización del proceso de trabajo para evitar posibles eventos.

  9. Cardiovascular risk assessment in hypertensive patients Evaluación del riesgo cardiovascular en hipertensos Avaliação do risco cardiovascular em hipertensos

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    Elaine Amaral de Paula

    2013-06-01

    Full Text Available OBJECTIVE: to assess cardiovascular risk by means of the traditional Framingham score and the version modified through the incorporation of emerging risk factors, such as family history of acute myocardial infarction, metabolic syndrome and chronic kidney disease. METHOD: participants were 50 hypertensive patients under outpatient treatment. The clinical data were collected through a semi-structured interview and the laboratory data from patients' histories. RESULTS: it was verified that the traditional Framingham score was predominantly low (74%, with 14% showing medium risk and 12% high risk. After the inclusion of emerging risk factors, the chance of a coronary event was low in 22% of the cases, medium in 56% and high in 22%. CONCLUSIONS: the comparison between the traditional Framingham risk score and the modified version demonstrated a significant difference in the cardiovascular risk classification, whose correlation shows discreet agreement between the two scales. Lifestyle elements seem to play a determinant role in the increase in cardiovascular risk levels. OBJETIVO: evaluar el riesgo cardiovascular utilizando el puntaje de Framingham tradicional y el modificado por la incorporación de factores de riesgo emergentes como historia familiar de infarto agudo del miocardio, síndrome metabólico y enfermedad renal crónica. MÉTODO: participaron 50 hipertensos que hacen tratamiento en ambulatorio. Los datos clínicos fueron obtenidos por medio de entrevista semiestructurada y los de laboratorio fueron obtenidos de fichas. RESULTADOS: se verificó que el puntaje de Framingham tradicional fue predominantemente bajo (74%, 14% presentó riesgo medio y 12% riesgo alto. Tras la inclusión de factores de riesgo emergentes, la probabilidad de ocurrir un evento coronario fue baja en 22% de los casos, media en 56% y alta en 22% de los casos. CONCLUSIONES: la comparación entre el puntaje de riesgo de Framingham tradicional y el modificado demostr

  10. Hepatocarcinoma como causa de abdome agudo em adolescente: relato de caso

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    João Augusto dos Santos Martines

    2012-08-01

    Full Text Available O carcinoma hepatocelular (CHC é pouco prevalente nos países ocidentais, porém é um dos tumores mais freqüentes na Ásia e a quinta causa de câncer no mundo.É relatado um caso de adolescente do sexo feminino sem fatores de risco para um tumor extremamente agressivo, internada no Hospital Universitário da Universidade de São Paulo. A apresentação clínica foi de abdome agudo secundário a sangramento para cavidade peritoneal por ruptura do tumor evidenciado através de tomografia computorizada multidetectores (TCMD confirmado por laparotomia exploradora e biópsia hepática e tratada com rafia hemostática do parênquima hepático.

  11. Distrés respiratorio agudo tras administración de gadolinio.

    OpenAIRE

    Úsuga-Perilla*, Sandra; Martín-Bragrado, María Victoria; Asunción-Ortizá, María Teresa; Padilla del Rey, Mariluz; González-Pérez, Petra

    2014-01-01

    En septiembre del 2012, una mujer de 36 años de edad, caucásica, sana, necesitó estudio de contraste por tinnitus, que fue normal. Una hora después de la inyección de contraste Gadovist®, la paciente presentó diarrea, vómitos, hipotensión e insuficiencia respiratoria (por síndrome de distrés respiratorio agudo) y fue tratada sintomáticamente y con ventilación no invasiva. Fue dada de alta al sexto día, completamente asintomática. No existen reportes previos en la literatura en los que la rela...

  12. Etiologia e a morbi-letalidade do coma agudo em crianças

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    Löhr Junior Alfredo

    2003-01-01

    Full Text Available OBJETIVO: Analisou-se a etiologia e a morbi-mortalidade de 104 crianças em coma agudo, ou seja, com uma pontuação menor ou igual a 8 da escala de Glasgow, internadas na Unidade de Terapia Intensiva do Hospital Infantil Pequeno Príncipe(UTI-HIPP no período entre março/98 e janeiro/2001. RESULTADOS: A idade variou de 2 meses a 13 anos, com média de 30,3 ± 27,4 meses e mediana de 20 meses, sendo 57 (54,8% do sexo masculino. O tempo de permanência hospitalar variou de 1 a 114 dias, e 3 casos permaneceram em estado vegetativo persistente. Com relação à etiologia: 31 (29,8% dos casos foram devidos a meningoencefalite, 24 (23,1% estado de mal epiléptico, 19 (18,3% causa tóxico-metabólica, 16 (15,4% hipertensão intracraniana, 7 (6,7% choque/anóxia, 4 (3,8% etiologia indeterminada, 3 (2,9% miscelânea. Com relação à evolução das crianças, 23 (22,1% foram a óbito, 32 (30,8% evoluíram sem seqüelas, 39 (37,5% tiveram alta com seqüelas neurológicas e10 (9,6% não informado. CONCLUSÃO: De acordo com a análise do presente estudo conclui-se que cerca de um terço dos pacientes em coma agudo falece, um terço apresenta seqüelas neurológicas na alta hospitalar e um terço evoluim sem seqüelas.

  13. Estreptoquinasa recombinante en pacientes con infarto agudo del miocardio. Cardiocentro de Camaguey, 2008

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    Héctor Mariño Cano

    2015-12-01

    Full Text Available Se realizó un estudio descriptivo longitudinal, con el objetivo de valorar la eficacia de la utilización de la Estreptoquinasa Recombinante en pacientes con Infarto Agudo de Miocardio (IMA en el Cardiocentro del Hospital Provincial Docente “Manuel Ascunce Doménech” en la provincia de Camagüey, en el período comprendido de enero a diciembre del 2008. El universo estuvo constituido por 200 pacientes, a los que se les diagnosticó Infarto Agudo de Miocardio y la muestra quedó formada por 80 pacientes que recibieron tratamiento trombolítico, las historias clínicas de los pacientes fueron la principal fuente de obtención de la información, utilizando  las  siguientes  variables: resultados criterio de perfusión, evolución clínica, criterio de reacciones adversas y la influencia que ejerce el tiempo puerta-aguja,  así como los cuidados de enfermería. Al terminar se observó que  el criterio de repercusión de mayor incidencia fue el eléctrico; la mayor cantidad de pacientes tuvieron buena evolución clínica; la hipotensión fue la reacción adversa más frecuente; el tiempo de puerta-aguja  que más incidió  fue el menor, de 3h; a todos los pacientes diagnosticados con infarto, que recibieron tratamiento trombolítico, se les  brindaron  cuidados de enfermería.

  14. Variabilidad geográfica de las hospitalizaciones por infarto agudo al miocardio en Costa Rica

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    Melvin Morera Salas

    2014-01-01

    Full Text Available La presente investigación muestra los patrones geográficos de las hospitalizaciones por infarto agudo al miocardio en el seguro público de salud de Costa Rica en el trienio 2010-2012. Para el análisis geográfico por área de salud se utiliza un modelo bayesiano jerárquico espacial. Se estiman razones estandarizadas suavizadas y, como medida de precisión, la probabilidad de que cada área de salud registre un riesgo de hospitalización estadísticamente diferente al promedio nacional. En la determinación de presencia de autocorrelación espacial se utiliza el indicador de la I de Moran. La amplitud entre las variaciones observadas se estima mediante la razón interpercentil (percentil 95/percentil 5 y el coeficiente de variación. La tasa bruta de hospitalizaciones es de 5,8 por 10 mil habitantes en hombres y 2,6 / 10 mil en mujeres. Se registra un rango de variación de más de dos veces en las hospitalizaciones entre las áreas con mayores y menores egresos. Se presenta un patrón de bajas tasas de hospitalizaciones por infarto agudo al miocardio en áreas de salud fuera del Área Metropolitana, donde se encuentran los hospitales nacionales de mayor complejidad. Este elemento podría estar asociado a dificultades en el acceso de los servicios de hospitalización.

  15. Marcadores bioquímicos de riesgo cardiovascular: efecto del ejercicio físico y del entrenamiento

    OpenAIRE

    2016-01-01

    El objetivo principal del trabajo es el estudio del efecto producido por el ejercicio físico agudo y la influencia del entrenamiento en factores de riesgo cardiovascular de tipo bioquímico tanto tradicionales como emergentes, como las apolipoproteínas A-I y B, la lipoproteína(a), la homocisteína y la proteína C reactiva ultrasensible y la dimetilarginina asimétrica. Un grupo de deportistas semiprofesionales fue estudiado a lo largo de la temporada deportiva. Las muestras analizadas fuero...

  16. Comportamiento del Intervalo QT corregido prolongado en el síndrome coronario agudo, sin elevación del segmento ST

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    Amauris Modesto Valera Sales

    2015-12-01

    Full Text Available Se realizó un estudio descriptivo transversal prospectivo, para determinar el comportamiento del intervalo QT corregido prolongado, en pacientes con síndrome coronario agudo sin elevación del segmento ST, en el Centro Diagnóstico Integral “Los Arales”, San Diego, año 2009. El universo fue de 48 pacientes y la muestra incluyó a 29 pacientes con ECG normal o sin nuevos cambios isquémicos. Al ingreso se determinaron los valores del intervalo QT corregido, las variables demográficas, antecedentes personales, niveles enzimáticos de CK-MB y el score TIMI. Estos resultados se correlacionaron con la aparición de eventos clínicos (muerte, infarto no fatal y revascularización un mes después del ingreso. De los 29 pacientes analizados sólo 11 (38% presentaron eventos clínicos, mientras que los restantes 18 (62% no los tuvieron. Los pacientes con eventos presentaron valores del iQTc más prolongados por encima del punto de corte. En ambos grupos predominó el sexo masculino y el grupo de edad más frecuente fue el de 60 a 69 años. El tabaquismo, la hipertensión y la hipercolesterolemia fueron los más prevalentes para ambos grupos, así como el uso previo de aspirina. La estratificación de riesgo TIMI y los parámetros basales en los pacientes estudiados fueron mayores y revelan un mayor porcentaje en el grupo con eventos clínicos. Los resultados demuestran que el iQTc predice eventos adversos cardiovasculares hasta 30 días después del ingreso.

  17. Inestabilidad en múltiples placas ateroescleróticas en pacientes fallecidos por infarto agudo de miocardio

    Directory of Open Access Journals (Sweden)

    Ricardo A. Sarmiento

    2011-08-01

    Full Text Available Los procesos inflamatorios en los síndromes coronarios agudos juegan un rol importante en la inestabilidad de la placa ateroesclerótica. Nuestro objetivo fue evaluar la presencia y distribución de placas vulnerables e infiltrados inflamatorios en pacientes fallecidos por infarto agudo de miocardio y su comparación con los hallazgos en pacientes fallecidos por cuadros no coronarios. Se analizaron los estudios anatomopatológicos de corazón de 68 pacientes fallecidos por infarto agudo de miocardio y 15 fallecidos por causa no coronaria. Se registró la presencia de trombo, hemorragia intraplaca, ruptura endotelial e infiltrado inflamatorio. Al evaluar los pacientes fallecidos por IAM, encontramos trombo en 73.5% de las arterias responsables del IAM y en 28.7% de las no responsables (p < 0.0001. La hemorragia intraplaca se halló en el 70.5% de las arterias responsables y en 39.7% de las no responsables, p < 0.0001; ruptura endotelial en el 29.4% de las arterias responsables y en 3.7% de las no responsables, p < 0.0001. No encontramos diferencias en la presencia de infiltrado inflamatorio (76.5% versus 68.4%. Comparando con los fallecidos por causas no coronarias, la presencia de trombo fue significativamente superior (73.5% vs. 13.3%; p < 0.0001, así como la de hemorragia intraplaca (70.5% vs. 0%; p < 0.0001 y de infiltrado inflamatorio en las placas ateroescleroticas (76.5% vs. 46.6%; p = 0.021. En los pacientes fallecidos por infarto agudo de miocardio se observa inestabilidad de placa y actividad inflamatoria, no sólo en la arteria responsable del infarto sino también en las arterias no responsables del infarto.

  18. Actividad inflamatoria en múltiples placas ateroscleróticas en pacientes fallecidos por infarto agudo de miocardio

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    Alejandro García Escudero

    2009-01-01

    Full Text Available IntroducciónEstudios clínicos y anatomopatológicos sugieren que los procesos inflamatorios tienen un papel importante en la inestabilidad de la placa aterosclerótica, dado que en pacientes con síndromes coronarios agudos se observan infiltrados inflamatorios difusos en las arterias coronarias.ObjetivosEvaluar y localizar la distribución de placas vulnerables e infiltrados inflamatorios en pacientes fallecidos por infarto agudo de miocardio.Material y métodosMediante microscopia óptica se estudiaron las arterias coronarias de 58 pacientes fallecidos por infarto de miocardio. En las arterias coronarias relacionadas con el infarto y en las no relacionadas se registraron las siguientes variables: presencia de trombo, rotura de placa, hemorragia intraplaca y presencia de infiltrado inflamatorio.ResultadosAl analizar las diferencias existentes entre las arterias responsables del infarto y en las no responsables se encontraron diferencias significativas con respecto a la presencia de trombo (69% versus 38%; p < 0,008 y de hemorragia intraplaca (69% versus 50%; p < 0,03. No se encontró una diferencia significativa entre la arteria responsable y la no responsable al evaluar la presencia de infiltrado inflamatorio en las placas ateroscleróticas (77% versus 71%; p = ns.ConclusiónEn el infarto agudo de miocardio se comprobó la presencia de actividad inflamatoria que afectaba a más de un vaso, con compromiso de otras arterias además de la responsable del infarto. Se detectó también accidente agudo de placa en más de una arteria coronaria.REV ARGENT CARDIOL 2009;77:81-87.

  19. Hematoma subdural agudo espontâneo e hemorragia intracerebral em paciente com microangiopatia trombótica gestacional

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    Sâmia Yasin Wayhs

    2013-06-01

    Full Text Available Pré-eclâmpsia, síndrome HELLP (hemólise, elevação de enzimas hepáticas e plaquetopenia e fígado gorduroso agudo da gestação são as principais causas de microangiopatia trombótica e disfunção hepática grave durante a gestação, representando um spectrum do mesmo processo patológico. Relatou-se aqui o caso de uma gestante com 35 semanas internada em unidade de terapia intensiva no pós-operatório imediato de cesariana por morte fetal, com náuseas, vômitos e icterícia. Diagnosticaram-se pré-eclâmpsia pós-parto e fígado gorduroso agudo da gestação. Houve evolução tardia com hematoma subdural agudo e hemorragia intracerebral, sendo realizado tratamento neurocirúrgico. A paciente foi a óbito por anemia hemolítica refratária, com sangramento espontâneo em múltiplos órgãos. Pré-eclâmpsia, síndrome HELLP e fígado gorduroso agudo da gestação são processos patológicos que podem se sobrepor e se associar a complicações potencialmente fatais, como a hemorragia intracraniana aqui descrita. Sua detecção e diagnóstico precoces são fundamentais para a instituição de manejo adequado e sucesso do tratamento.

  20. DIAGNÓSTICO DE UN TROMBOEMBOLISMO PULMONAR AGUDO POR ANGIOTC / Diagnosis of acute pulmonary thomboembolism by CT angiography

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    Mario E. Nápoles Lizano

    2012-10-01

    Full Text Available ResumenEl tromboembolismo pulmonar agudo tiene mayor morbilidad y mortalidad en los ancianos, pero puede presentarse en adultos jóvenes; por eso el diagnóstico certero es muy importante en este grupo etario. En este artículo se presenta el caso de un hombre de 37 años de edad, que acude al cuerpo de guardia por dolor precordial, sin alteraciones electrocardiográficas y dilatación de las cavidades derechas en el ecocardiograma. Se realizó AngioTC y se observó una dilatación del tronco de la arteria pulmonar, donde había una imagen hipodensa que ocupaba su porción distal, en relación con tromboembolismo pulmonar agudo. El paciente evolucionó favorablemente con el tratamiento. Mediante este estudio, se evidencia la importancia del AngioTC con tomógrafo de doble fuente, para la evaluación del dolor torácico agudo, en el paciente que no tiene manifestaciones electrocardiográficas, ni enzimáticas de infarto agudo de miocardio. / AbstractAcute pulmonary thromboembolism have increased morbidity and mortality in the elderly, but it can also occur in young adults, which is why an accurate diagnosis is very important in this age group. This article presents the case of a 37-year-old man, who comes to the emergency room for chest pain without electrocardiographic abnormalities and dilatation of the right chambers on echocardiography. CT angiography was performed and it showed a dilated pulmonary trunk, where there was a hypodense image occupying its distal portion, in relation to acute pulmonary thromboembolism. The patient responded favorably to treatment. Through this study, the importance of CT angiography with dual-source CT scanner for evaluation of acute chest pain, in patients with no electrocardiographic manifestations or enzymatic myocardial infarction is demonstrated.

  1. Edad avanzada y factores de riesgo para infarto agudo de miocardio Risk factors for acute myocardial infarction in the elderly

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    M. A. Ciruzzi

    2002-12-01

    Full Text Available Este estudio caso-control analizó en los sujetos añosos el rol de los factores de riesgo coronario en el desarrollo del infarto agudo de miocardio (IAM, estableció la naturaleza de esta asociación y el grado de riesgo. Los datos fueron obtenidos en una investigación que incluyó 1060 casos y 1071 controles, realizada en 35 unidades coronarias de centros médicos de Argentina entre noviembre de 1991 y agosto de 1994. Nuestro análisis se basó en la información de los sujetos mayores de 65 años. Los casos fueron 427 pacientes con un primer IAM. Los controles fueron 396 sujetos sin evidencias clinicas de enfermedad cardiovascular, seleccionados en los mismos centros que los casos. Los Odds Ratios (OR y su intervalo de confianza del 95% (IC 95% se obtuvieron mediante un análisis de regresión logística, incluyendo variables como la edad, educación, clase social, tabaquismo, antecedente de diabetes o hipertensión arterial, índice de masa corporal e historia familiar de enfermedad coronaria. Los factores de riesgo relacionados independientemente con IAM fueron los siguientes: hipercolesterolemia (colesterol sérico > 240 mg/dl: OR=1.76 (IC 95%: 1.25-2.49, tabaquismo: OR=1.6 (IC 95%: 1.06-2.4, hipertensión arterial: OR=2.05 (IC 95%: 1.51-2.73, diabetes OR=1.71 (IC 95%: 1.12-2.70, historia de un familiar con enfermedad coronaria: OR=1.36 (IC 95%: 0.93-1.97 y de dos o más familiares: OR=2.63 (IC 95%: 1.21-5.71. Este estudio, confirma en los sujetos de edad avanzada la importancia de la hipercolesterolemia, del tabaquismo, la hipertesión arterial, la diabetes y la historia familiar de enfermedad coronaria como factores de riesgo de IAMThis case-control study, analized the role of coronary risk factors in acute myocardial infarction (AMI in the elderly, and established the nature of this association and the degree of risk. Data were derived from an investigation (1060 cases and 1071 controls conducted in 35 coronary care units from clinical

  2. Cardiovascular Disease and Diabetes

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Cardiovascular Disease & Diabetes Updated:Nov 4,2016 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  3. Cardiovascular manifestations of phaeochromocytoma

    NARCIS (Netherlands)

    Prejbisz, A.; Lenders, J.W.M.; Eisenhofer, G.; Januszewicz, A.

    2011-01-01

    Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma,

  4. Understanding cardiovascular disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000759.htm Understanding cardiovascular disease To use the sharing features on this page, ... lead to heart attack or stroke. Types of Cardiovascular Disease Coronary heart disease (CHD) is the most common ...

  5. APOE Genotyping, Cardiovascular Disease

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? APOE Genotyping, Cardiovascular Disease Share this page: Was this page helpful? Also ... of choice to decrease the risk of developing cardiovascular disease (CVD) . However, there is a wide variability in ...

  6. Rotura de la pared libre del ventrículo izquierdo secundaria a infarto agudo de miocardio

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    Claudio Solís

    2009-01-01

    Full Text Available RESUMENAunque la terapia trombolítica y la angioplastia primaria han cambiado radicalmente elmanejo, la evolución y el pronóstico del infarto agudo de miocardio, la rotura de la paredlibre del ventrículo izquierdo todavía implica una tasa elevada de mortalidad.Si bien la mayoría de los pacientes con esta complicación presentan un cuadro agudo ycatastrófico, que se caracteriza por taponamiento cardíaco, disociación electromecánica ymuerte en pocos minutos, aproximadamente un tercio de ellos tienen una evolución subagudacon hipotensión sostenida y diversos grados de derrame pericárdico, lo que posibilita laimplementación de medidas terapéuticas necesarias como puente al tratamiento quirúrgicoresolutivo.En este trabajo se presenta una revisión actualizada de las características clínicas yecocardiográficas de los pacientes con rotura de la pared libre del ventrículo izquierdo asociadacon infarto agudo de miocardio, con el objetivo de destacar los puntos clave del diagnóstico e incrementar la sospecha clínica de una entidad grave, no siempre fatal.REV ARGENT CARDIOL 2009;77:395-404.

  7. Surgical acute abdomen in elderly patients. Abdomen agudo quirúrgico en el anciano.

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    Lidia Torres Ajá

    Full Text Available Fundaments : The surgical acute abdomen usually is the most frequent cause of abdominal surgery of urgency in t he old one, with the high mortality in spite of the modern surgical technologies. Objective: To evaluate the surgery of the surgical acute abdomen in the old one. Method: Appears a prospectivo descriptive study that includes 102 patients of 60 years or more who underwent surgery at the ¨Dr Gustavo Aldereguía Lima¨ University Hospital of Cienfuegos with this diagnostic. The primary data were obtained from clinical cards of the patients and the daily clinical observation until the debit. Results: The patients presented an average age of 74 years, being the most frequent causes of the syndrome intestinal obstruction (32,4%, the biliary tract affections (22,5%, and acute appendicitis (21,6%. The most frequent symptom was abdominal pain (96,08%, and we noticed tachycardia in 80,4%. Postoperating complications in 47,06% of the patients appeared and was observed a mortality of 26,5% with statistically significant relation with the age, ASA classification, surgical risk, time of evolution and the surgical time. The peritonitis heads the direct causes of death.

    Fundamento : El abdomen agudo quirúrgico suele ser la causa más frecuente de cirugía abdominal de urgencia en el anciano, se asocia con una alta mortalidad a pesar de las tecnologías quirúrgicas modernas. Objetivo : Evaluar la cirugía del abdomen agudo quirúrgico en el anciano. Método : Estudio descriptivo prospectivo que incluye a 102 pacientes de 60 años o más operados en el Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos entre agosto y diciembre del 2002 con el diagnóstico de abdomen agudo quirúrgico. Los datos primarios se obtuvieron de las fichas clínicas de los pacientes y de la observación clínica diaria hasta el egreso

  8. Cardiovascular comorbiditiy in psoriasis

    OpenAIRE

    Gurcharan Singh; Simran Pal Singh Aneja

    2011-01-01

    The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite) disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatolog...

  9. Sindrome confusional agudo por abstinencia aguda de nicotina Delirium due to acute nicotine withdrawal

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    Manuel Klein

    2002-08-01

    Full Text Available El síndrome confusional agudo (SCA o delirium en pacientes hospitalizados es un problema frecuente y grave. Se caracteriza por síntomas de comienzo agudo y curso fluctuante con inatención, pensamiento desorganizado, y con distintos niveles de alteración de la conciencia.En la bibliografía consultada, el SCA como manifestación de un síndrome de abstinencia aguda nicotínica fue descripto en solo ocho casos. Presentamos el caso de un tabaquista grave que, internado por una reagudización de su enfermedad pulmonar obstructiva crónica (EPOC, presentó un cuadro de SCA al tercer día de abstinencia tabacal, cediendo los síntomas tras la administración de un parche de nicotina. Lo descripto sugiere que en pacientes internados que presentan SCA y agitación, con fuertes antecedentes de tabaquismo, un simple ensayo con un parche de nicotina puede ofrecer en pocas horas una notable respuesta terapéutica y a su vez un test confirmatorio. El reconocimiento del SCA como forma de presentación de la abstinencia nicotínica permitirá identificar casos habitualmente complejos en los que se podrá implementar una sencilla y eficaz alternativa terapéutica.Delirium or acute confusional state among hospitalized patients is a frequent and serious problem. It is characterized by acute onset symptoms, fluctuating course, impaired attention, unorganized thinking, and altered level of conciousness. Delirium, as a manifestation of acute nicotine withdrawal syndrome has been reported in the reviewed literature only in eight cases. We report the case of a heavy smoker admitted because of a reagudization of his chronic obstructive pulmonary disease. At the third day of nicotine abstinence, he developed delirium with a rapid improvement of his symptoms after treatment with a transdermal nicotine patch. This description suggests that in hospitalized heavy smokers who develop delirium with agitation, a simple trial with a nicotine patch can offer a dramatic

  10. Infarto agudo do miocárdio na 31ª semana de gravidez: relato de caso

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    Filipa Pires Duarte

    2011-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A ocorrência de infarto agudo do miocárdio (IAM durante a gravidez é rara. Os autores descrevem o caso de IAM numa grávida de 31 semanas e a importância da existência de uma equipe multidisciplinar para sua abordagem. RELATO DO CASO: Grávida de 31 semanas, com antecedentes de tabagismo, alcoolismo e hipertensão, internada após um episódio de síncope. Na admissão, encontrava-se consciente e assintomática, embora hipotensa. O eletrocardiograma evidenciou marcada elevação do segmento ST em DI, AVL, V1-V6. Pesquisa de enzimas cardíacas foi positiva. O ecocardiograma transtorácico demonstrou redução da contratilidade ventricular esquerda e septal e uma fração de ejeção de 30%. A angiografia revelou oclusão proximal da artéria descendente anterior. Por insucesso da angioplastia por balão, foi colocado um stent metálico. A paciente iniciou terapêutica com b-bloqueadores, aspirina e clopidogrel. Em relação ao parto, optou-se por realizar cesariana eletiva, quatro semanas após o IAM. Suspendeu-se o clopidogrel sete dias antes do parto. A função cardíaca pré-operatória foi otimizada com infusão de levosimendana iniciada no dia anterior. A cesariana decorreu sob bloqueio peridural. O período intraoperatório decorreu sem complicações, à exceção de moderada hipotensão facilmente corrigida com fenilefrina. O índice de Apgar do recém-nascido foi de 9/10. CONCLUSÕES: Este é um dos poucos casos de infarto agudo do miocárdio e angioplastia descritos durante a gravidez. Os autores discutem as decisões tomadas pela equipe multidisciplinar, constituída por anestesiologistas, obstetras, cardiologistas e neonatologistas, notadamente no que se refere à dupla antiagregação plaquetária, ao tipo de parto e à anestesia.

  11. ANESTESIA PARA AMPUTACIÓN SUPRACONDÍLEA EN PACIENTE CON SÍNDROME CORONARIO AGUDO / Anesthesia for supracondylar amputation in patient with acute coronary syndrome

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    Marilyn Ramírez Méndez

    2012-03-01

    Full Text Available Resumen La insuficiencia arterial periférica es una enfermedad que se asocia a factores de riesgo aterogénico reconocidos, y es más frecuente en personas con hiperlipidemia, diabetes mellitus y hábito de fumar. Se presenta el caso de una mujer de 67 años de edad, con antecedentes de hipertensión arterial, diabetes mellitus e infarto de miocardio antiguo, que ingresa por signos de inflamación aguda del miembro inferior derecho como consecuencia de una insuficiencia arterial periférica. A los 8 días del ingreso presentó un síndrome coronario agudo sin elevación del segmento ST, con fallo de bomba Killip II, y una vez compensada fue anunciada para amputación supracondílea de urgencia, debido a una gangrena isquémica. Se decidió utilizar anestesia espinal subaracnoidea selectiva del miembro inferior derecho, a cual se aplicó sin complicaciones y favoreció el adecuado desarrollo de la cirugía planificada. A las 72 horas la paciente fue egresada de la UCI, sin síntomas cardiovasculares y compensación metabólica. / Abstract Peripheral arterial insufficiency is a disease that is associated with known atherogenic risk factors, and is more common in people with hyperlipidemia, diabetes mellitus and smoking habit. A case of a 67-year-old woman with a history of hypertension, diabetes mellitus and old myocardial infarction is presented. She was admitted for signs of acute inflammation of the right leg due to peripheral arterial insufficiency. 8 days after admission she presented an acute coronary syndrome without ST segment elevation with pump failure (Killip class II, and once compensated she was scheduled for emergency supracondylar amputation due to ischemic gangrene. It was decided to use selective spinal subarachnoid from the right leg, which was applied without complications and favored the proper development of the planned surgery. At 72 hours, the patient was discharged from the ICU, with metabolic compensation and without

  12. Occurrence of Zaprionus indianus (Diptera: Drosophilidae in Agudo, Rio Grande do Sul, Brazil

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    Mauricio Batistella Pasini

    2012-03-01

    Resumo. Este trabalho faz menção ao primeiro registro de Zaprionus indianus Gupta (Diptera: Drosophilidae encontrado na zona rural do município de Agudo, no estado do Rio Grande do Sul, Brasil. Os adultos da mosca foram encontrados primeiramente em frutos de ameixa (Prunus salicina Lindl posteriormente em figos maduros (Ficus carica L. em dois pomares. No primeiro pomar cerca de 80% dos figos coletados apresentaram ataque de Z. indianus e, no segundo pomar 50% dos figos da cv. “Pingo de mel” e 80% da variedade “Roxo de Valinhos” foram infestados. No período correspondente a emergência dos adultos, coletou-se um total de 1364 indivíduos. Os figos da cv “Roxo de Valinhos” apresentaram maior emergência de adultos. Além de estar presente em restos culturais de figo, Z. indianus foi visualizada sobrevoando restos culturais de Syagrus romanzoffiana (Cham., Cucumis melo L., Citrullus vulgaris Schrad. e Vitis vinifera L., associada a outros drosofilídeos. Ressalta-se que medidas de monitoramento e controle da praga deverão ser adotadas no município para garantir figos de alta qualidade e sadios.

  13. Síndrome confusional agudo en pacientes internados Acute confusional state in hospitalized patients

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    Andrea Ferreyra

    2004-10-01

    Full Text Available El síndrome confusional agudo (SCA o delirio es uno de los trastornos mentales más frecuentes en pacientes hospitalizados por enfermedades médicas. Se analizan 278 pacientes de los cuales 30 (10.8% presentaron SCA. Los pacientes que presentaron esta complicación eran mayores de 70 años, con antecedentes de accidente cerebrovascular y demencia, con un menor desempeño de la actividad diaria previo a la internación y requirieron mayor utilización de alimentación enteral. Las infecciones y la fractura de cadera fueron las causas de internación más frecuentes. La mortalidad fue significativamente superior en los pacientes con SCA que en pacientes sin SCA.Delirium or acute confusional status (ACS is a common mental disorder found in hospitalized patients. A total of 278 patients were evaluated. Of these, 30(10.8% developed ACS. The patients who developed ACS were 70 years of age or older, had history of stroke or dementia, as well as impairment in activities of daily living, and required enteral feeding more frequently. The infections and hip fracture were the most frequent reasons for hospitalization. The mortality in patients with ACS was significantly higher than in patients without ACS.

  14. Current perspectives of acute pain treatment Perspectivas actuales de tratamiento del paciente con dolor agudo

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    Tiberio Alvarez Echeverri

    1993-03-01

    Full Text Available

    In the last years opioids have become of great importance in the relief of postoperative and other forms of acute pain. Reasons for this trend have been the availability of agonist opioids like phentanyl. sulphentanyl and alphentanyl and the results of research on the physlology. The pharmacology and the chemistry of drug receptors and neurotransmitters. The studies on chemicals other than opioids that contribute to pain relief when administered through different ways. specially the spinal. Have also influenced such a trend.

    En los últimos años los opiáceos han adquirido gran importancia en el alivio del dolor agudo especialmente del tipo postoperatorio. Una de las razones ha sido la disponibilidad de morfínicos agonistas como el fentanil, el sufentanil y el alfentanil; otra es la investigación de la fisiología, la farmacología y la química de los receptores y los neurotransmisores como de sustancias diferentes a los opláceos, aplicadas por diferentes vías en especial la espinal, que coadyuvan al alivio del dolor.

  15. Rotura de aneurisma de aorta abdominal: su importancia como diagnostico diferencial en abdomen agudo

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    Vanessa Orellana-Villazón

    2008-01-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  16. ROTURA DE ANEURISMA DE AORTA ABDOMINAL: SU IMPORTANCIA COMO DIAGNOSTICO DIFERENCIAL EN ABDOMEN AGUDO

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    Vanessa Orellana-Villazón

    2012-02-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  17. Edema agudo hemorrágico da infância Acute hemorrhagic edema of infancy

    Directory of Open Access Journals (Sweden)

    Fabiana Britto Goulart

    2004-06-01

    Full Text Available Relatamos o caso de uma criança de oito meses de idade com infecção das vias aéreas superiores, seguida de irritabilidade e pelo aparecimento de lesões purpúricas na face, extremidades e pavilhões auriculares e edema de dorso dos pés e das mãos. Inicialmente recebeu dexametasona, ampicilina e cloranfenicol para tratamento de suposta meningococcemia. Entretanto, as lesões características e a boa evolução clínica do quadro levaram-nos ao diagnóstico de uma forma rara de vasculite cutânea: edema agudo hemorrágico da infância.We report the case of an eight-month child with upper airway infection followed by irritability and purpuric lesions in his face, ears and extremities and peripheral soft tissue edema. He was treated with dexamethasone, ampicillin and chloramphenicol for presumed meningococcemia, but the characteristics lesions and the benign course of the disease led us to the diagnosis of a rare form of cutaneous vasculitis called Acute Hemorrhagic Edema of Infancy (AHEI.

  18. Un reto para Colombia: mejorar la utilización de medicamentos probadamente beneficiosos en la prevención secundaria cardiovascular

    OpenAIRE

    Patricio López-Jaramillo; Paul Anthony Camacho

    2012-01-01

    Las enfermedades cardiovasculares (ECV) causan 30% del total de las muertes en todo el mundo; de estas 80% sucede en los países en vía de desarrollo.  El 1% de las personas en el mundo presenta un evento coronario agudo o cerebrovascular por año y la mitad de estos eventos se produce en individuos con enfermedad vascular preexistente. Los países de bajos y medianos ingresos presentan un incremento en la carga de las ECV y la mayoría no tiene programas concretos y bien definidos  para su preve...

  19. Un reto para Colombia: mejorar la utilización de medicamentos probadamente beneficiosos en la prevención secundaria cardiovascular

    Directory of Open Access Journals (Sweden)

    Patricio López-Jaramillo

    2012-02-01

    Full Text Available Las enfermedades cardiovasculares (ECV causan 30% del total de las muertes en todo el mundo; de estas 80% sucede en los países en vía de desarrollo. El 1% de las personas en el mundo presenta un evento coronario agudo o cerebrovascular por año y la mitad de estos eventos se produce en individuos con enfermedad vascular preexistente2. Los países de bajos y medianos ingresos presentan un incremento en la carga de las ECV y la mayoría no tiene programas concretos y bien definidos para su prevención.

  20. GRUPOS DE UTILIZACION DE RECURSOS EN UNIDADES DE AGUDOS Y MEDIA ESTANCIA DE SERVICIOS DE GERIATRIA

    Directory of Open Access Journals (Sweden)

    Juan José Solano Jaurrieta

    2001-01-01

    Full Text Available Fundamentos: En los últimos años se han implantado en nuestro país Sistemas de Clasificación de Pacientes (SCP con objeto de medir el «producto hospitalario». Sin embargo los sistemas más tradicionales resultan poco adecuados para la población anciana, en los que la incapacidad asociada a la enfermedad resulta determinante para explicar el consumo de recursos y los resultados asistenciales. Por ello, nos planteamos aplicar en servicios especializados de atención al anciano un sistema que contempla este parámetro, los Grupos de Utilización de Recursos (RUG, analizando las características y diferencias en la distribución en función de RUG en cuatro Servicios de Geriatría. Métodos: Se estudian transversalmente, mediante cortes sucesivos en períodos superiores a la estancia media en cada unidad, los pacientes ingresados en las unidades de agudos y media estancia de los Servicios de Geriatría del Hospital Monte Naranco (HMN (n=318, Hospital Central de la Cruz Roja (HCCR (n=384, Hospital General de Guadalajara (HG (n=272 y Hospital Virgen del Valle (HVV (n=390, en lo relativo a su distribución según la clasificación RUG-T18. Las posibles diferencias entre los centros se analizaron mediante el test estadístico chi-cuadrado (SPSS para windows Resultados: Para el conjunto de la muestra los pacientes se concentran en los grupos R, S y C de la clasificación, con muy escasa representación de los grupos P y B, detectándose diferencias entre los centros. Así, el HCCR es el que maneja una mayor proporción de pacientes del grupo R (47,64% vs. 23,66% en el HMN, 20,57% en el HG y 20,53% en el HVV y una menor proporción de pacientes del grupo S (3,12% vs 6,40% en el HMN, 9,92% en el HG y 9,76% en el HVV y C (48,94% vs 76,29% en el HMN, 66,89% en el HG y 68,36% en el HVV. Igualmente es posible detectar diferencias en el análisis individual para las unidades de agudos y media estancia. Conclusiones: Los grupos de utilización de recursos

  1. Grupos de utilizacion de recursos en unidades de agudos y media estancia de servicios de geriatria

    Directory of Open Access Journals (Sweden)

    Solano Jaurrieta Juan José

    2001-01-01

    Full Text Available Fundamentos: En los últimos años se han implantado en nuestro país Sistemas de Clasificación de Pacientes (SCP con objeto de medir el «producto hospitalario». Sin embargo los sistemas más tradicionales resultan poco adecuados para la población anciana, en los que la incapacidad asociada a la enfermedad resulta determinante para explicar el consumo de recursos y los resultados asistenciales. Por ello, nos planteamos aplicar en servicios especializados de atención al anciano un sistema que contempla este parámetro, los Grupos de Utilización de Recursos (RUG, analizando las características y diferencias en la distribución en función de RUG en cuatro Servicios de Geriatría. Métodos: Se estudian transversalmente, mediante cortes sucesivos en períodos superiores a la estancia media en cada unidad, los pacientes ingresados en las unidades de agudos y media estancia de los Servicios de Geriatría del Hospital Monte Naranco (HMN (n=318, Hospital Central de la Cruz Roja (HCCR (n=384, Hospital General de Guadalajara (HG (n=272 y Hospital Virgen del Valle (HVV (n=390, en lo relativo a su distribución según la clasificación RUG-T18. Las posibles diferencias entre los centros se analizaron mediante el test estadístico chi-cuadrado (SPSS para windows Resultados: Para el conjunto de la muestra los pacientes se concentran en los grupos R, S y C de la clasificación, con muy escasa representación de los grupos P y B, detectándose diferencias entre los centros. Así, el HCCR es el que maneja una mayor proporción de pacientes del grupo R (47,64% vs. 23,66% en el HMN, 20,57% en el HG y 20,53% en el HVV y una menor proporción de pacientes del grupo S (3,12% vs 6,40% en el HMN, 9,92% en el HG y 9,76% en el HVV y C (48,94% vs 76,29% en el HMN, 66,89% en el HG y 68,36% en el HVV. Igualmente es posible detectar diferencias en el análisis individual para las unidades de agudos y media estancia. Conclusiones: Los grupos de utilización de recursos

  2. Adherencia al tratamiento y calidad de vida en personas con infarto agudo de miocardio

    Directory of Open Access Journals (Sweden)

    Jennifer Rojas-Reyes

    2016-01-01

    Full Text Available Objetivo: identificar la asociación entre adherencia al tratamiento y calidad de vida relacionada con la salud (CVRS en población con infarto agudo de miocardio (IAM. Materiales y método: estudio cuantitativo de diseño descriptivo correlacional de corte transversal. Se eligieron 180 participantes por muestreo de tipo probabilístico con selección aleatoria simple. Para el análisis estadístico, se utilizó estadística no paramétrica con correlación de Spearman. Resultados: la edad media fue de 63 años, el promedio de tiempo transcurrido después del infarto fue de 35 meses. Frente al nivel de adherencia al tratamiento, predominó la adherencia total (54 %, adherencia parcial (45%; en cuanto a la calidad de vida relacionada con la salud, el 27 % tuvo un bajo nivel; respecto a la correlación de Spearman, se estableció un coeficiente de -0,315 con una significancia de p=0,00, donde el número negativo es reflejo de la naturaleza de las escalas con las que fueron medidas las variables, por lo que la correlación es positiva, significativa, pero numéricamente modesta. Conclusión: la asociación entre adherencia al tratamiento y calidad de vida relacionada con la salud evidencia en una correlación estadísticamente significativa, pero catalogada como modesta, siendo estos resultados coherentes con la multidimensionalidad de los fenómenos.

  3. Ticagrelor en el síndrome coronario agudo: Explicando lo inexplicable

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    Juan Martín Criniti

    2014-06-01

    Full Text Available En el estudio PLATO se evaluó la utilidad del agregado de ticagrelor, en lugar de clopidogrel, a aspirina en pacientes con síndrome coronario agudo, mostrando resultados sorprendentemente positivos que llevaron a que la droga sea aceptada por las agencias regulatorias y las sociedades especializadas de todo el mundo. Sin embargo, el análisis crítico de los informes presentados por el patrocinador reveló la existencia de distintos aspectos difíciles de explicar y que ponen en tela de juicio la veracidad de sus resultados. La pérdida de seguimiento no explicada, la tasa de mortalidad y los beneficios excesivos no comparables con estudios previos, y la inconsistencia de hallazgos de acuerdo al país, al ente adjudicador de eventos y al comité de monitoreo, son algunos de los puntos más controvertidos. La mayoría de las críticas a este artículo se basan en información que no se desprende del texto del estudio publicado. Esto supone un desafío al análisis crítico de la literatura y genera dudas sobre hasta qué punto el conflicto de interés económico influenció el desarrollo del estudio y la comunicación de sus resultados y, probablemente, la aceptación de la droga para su uso comercial.

  4. Nefropatía por contraste en el síndrome coronario agudo

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    Mariana Carnevalini

    2011-10-01

    Full Text Available La nefropatía inducida por contraste (NIC es una de las causas más frecuentes de insuficiencia renal en pacientes internados. En el síndrome coronario agudo (SCA, la presencia de NIC aumenta la morbimortalidad. Las medidas de profilaxis y los factores de riesgo intervinientes de NIC en SCA no han sido determinados con exactitud. El objetivo de este estudio fue evaluar la incidencia de NIC y los factores asociados a su desarrollo en pacientes ingresados en unidad coronaria con requerimiento de cinecoronariografía (CCG. Se realizó un estudio de cohorte retrospectivo. Se incluyeron pacientes consecutivos cursando SCA estudiados con CCG dentro de las 72 horas de su admisión. Se definió NIC al aumento del 25% del valor de creatinina a las 48 h sobre el nivel basal de ingreso. El período de inclusión fue entre el 1° de enero de 2004 hasta el 30 de junio de 2010. Se analizaron 125 casos. La incidencia de NIC fue del 10.4% (n = 13. En el análisis multivariado, los factores asociados independientemente a su desarrollo fueron la edad [OR 1.05 (IC 95% 1.004 - 1.11 p = 0.034], la angioplastia a múltiple vaso [OR 2.2 (IC 95% 1.07 - 4.8, p = 0.03] y el volumen de contraste utilizado [OR 1.007 (IC 95% 1.001 - 1.01, p = 0.014].

  5. Adherencia al tratamiento en la prevención secundaria en pacientes con síndrome coronario agudo

    OpenAIRE

    Salar Mundo, Abel

    2015-01-01

    Objetivos: Conocer el grado de adherencia al tratamiento en la prevención secundaria de los pacientes que sufren un síndrome coronario agudo. Como objetivos secundarios, averiguar las razones por las cuales hay pacientes que no se adhieren al tratamiento, y conocer qué intervenciones de enfermería podrían mejorar la adherencia al tratamiento en estos pacientes. Métodos: Revisión bibliográfica, consultando las siguientes bases de datos: Medline de PubMed, LILACS, IBECS, CUIDEN y Scielo España....

  6. Factores de estrés y apoyo psicosocial en pacientes con infarto agudo de miocardio. Cali, 2001-2002.

    OpenAIRE

    Carlos A. Reyes; Mauricio Hincapié; Julián A. Herrera; Pablo A. Moyano

    2009-01-01

    INTRODUCCIÓN: Se realizó un estudio descriptivo con grupo control para evaluar los factores de estrés y apoyo social en personas mayores de 60 años con infarto agudo de miocardio (IAM). MÉTODOS: Se estudiaron 40 pacientes y 38 personas sanas evaluando depresión, disfunción familiar, estrés social y prácticas religiosas. Se realizó análisis estadístico univariado y bivariado. RESULTADOS: Los grupos fueron comparables para las variables sociodemográficas. Se observó que 21 (26.9%) individuos ...

  7. La glucemia en ayunas como predictor de mortalidad intrahospitalaria en pacientescon infarto agudo de miocardio sometidos a angioplastia primaria

    OpenAIRE

    2009-01-01

    RESUMENIntroducciónEl pronóstico de los pacientes que sufren un infarto agudo de miocardio con supradesniveldel ST (IAMST) ha mejorado notoriamente, en particular como resultado de la terapia dereperfusión. A pesar de estos avances, los pacientes con diabetes mellitus (DM) constituyenun grupo de alto riesgo. La hiperglucemia en pacientes con IAMST se asocia con peor pronóstico, independientemente del diagnóstico previo de DM.ObjetivoEvaluar el valor pronóstico de la glucemia en ayunas (GA) du...

  8. Efectos de un protocolo de rehabilitación cardiaca en ancianos con síndrome coronario agudo

    OpenAIRE

    Marques Sule, Elena

    2014-01-01

    Introducción: El envejecimiento se asocia invariablemente a diferentes trastornos de salud entre los que la patología cardiaca ocupa un lugar preferente, y sus síntomas y signos repercuten de forma muy evidente en la funcionalidad de la persona mayor. El síndrome coronario agudo es una patología cardiaca, conlleva una disminución de la capacidad funcional y alteración de la calidad de vida del anciano. Su profilaxis y tratamiento, donde se incluye la fisioterapia, es uno de los principale...

  9. Prevención del Síndrome Confusional Agudo en pacientes ancianos hospitalizados con fractura de cadera

    OpenAIRE

    Garrigós Montoya, Victoria Eugenia

    2016-01-01

    Introducción: Las consecuencias del síndrome confusional agudo en pacientes con fractura de cadera aumentan la morbilidad y la mortalidad de la persona, produciendo en numerosas ocasiones dependencia para el resto de su vida. El objetivo principal de esta revisión es la realización de un plan de actuación de enfermería, conociendo los factores de riesgo del delirium para la correcta prevención del mismo. Métodos: Se realiza una revisión bibliográfica en diferentes bases de datos para identifi...

  10. Gabapentina preoperatoria como adyuvante en el manejo del dolor agudo postoperatorio en histerectomía abdominal

    OpenAIRE

    J. A. Batista; M. M. Errigo

    2015-01-01

    Introducción: es bien conocido que el dolor es síntoma subjetivo y el dolor postoperatorio sigue teniendo preponderancia mundial, ya que a pesar de todos los avances aún no se ha podido erradicar por completo. Objetivo: evaluar el efecto adyuvante en la intensidad del dolor agudo postoperatorio de 600 mg de gabapentina administrada en el preoperatorio en pacientes sometidas a histerectomía abdominal en el Hospital Santo Tomás, de abril a agosto de 2014. Métodos: se realizó un estudio de cohor...

  11. Lifestyle in Cardiovascular Disease

    NARCIS (Netherlands)

    J.O. Younge (John)

    2015-01-01

    markdownabstract__Abstract__ Globally, the burden of cardiovascular disease (CVD) is still increasing. However, in recent decades, better treatment modalities have led to less cardiovascular related deaths. After years of research, we now generally accept that lifestyle factors are the most importa

  12. Diferencias según sexo en el tratamiento y la evolución de los pacientes afectados de síndrome coronario agudo

    Directory of Open Access Journals (Sweden)

    M. Ferraz-Torres

    2014-08-01

    Full Text Available Fundamento: La perspectiva de género en salud nos alerta de la diferente prevalencia, incidencia, evolución y letalidad de las patologías coronarias agudas según sexo. Este estudio pretende conocer la diferencia en el tratamiento y la evolución de los pacientes afectos de Síndrome Coronario Agudo (SCA según sexos en Navarra. Métodos: Se analizaron 35 variables de 130 usuarios que acudieron consecutivamente al servicio de Urgencias (SU del Complejo Hospitalario de Navarra (CHN con patología coronaria aguda desde enero hasta abril de 2012. La variable dependiente fue el sexo y las independientes los tiempos, tratamientos y evolución final del proceso. Resultados: Un 74,6% de la muestra fueron varones con una edad media de 67 años, inferior a los 72 años de la muestra femenina (p=0,043. Se obtuvo una mediana de 3 factores de riesgo cardiovascular (FRC en los hombres y de dos en las mujeres (p=0,026. El tiempo de demora generado por los pacientes fue de 161 minutos en varones vs 266 minutos en féminas (p=0,006. El tratamiento llevado a cabo mediante revascularización por angioplastia primaria (AP o fibrinolisis se realizó en un 71,6% de los hombres y un 41,2% de las mujeres (p=0,002. Se registró un 5,9% de muertes en mujeres, sin hallarse casos de fallecimiento en varones (p=0,017. Conclusiones: En Navarra, los procesos coronarios siguen siendo una patología de predominio masculino pero de mayor gravedad en mujeres. El tratamiento se realizó de forma distinta según sexo. Se observó un mayor retraso en la solicitud de atención sanitaria en las mujeres así como la presencia de alta voluntaria en ellas, lo que puede influir en la peor evolución de las mismas.

  13. Triglycerides and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Varbo, Anette

    2014-01-01

    cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride......-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk...... of acute pancreatitis and possibly cardiovascular disease. Although randomised trials showing cardiovascular benefit of triglyceride reduction are scarce, new triglyceride-lowering drugs are being developed, and large-scale trials have been initiated that will hopefully provide conclusive evidence...

  14. Caracterización del infarto agudo del miocardio en mujeres atendidas en el hospital Ernesto Guevara

    Directory of Open Access Journals (Sweden)

    Zailit González Cruz

    2014-08-01

    Full Text Available En Las Tunas han aumentado las cifras de mujeres afectadas por infarto agudo del miocardio (IMA, con una tasa de mortalidad superior a la media nacional. A pesar de ello, no existen estudios publicados que describan el comportamiento de esta entidad en las mujeres tuneras. Se realizó un estudio transversal descriptivo en el servicio de cardiología del hospital provincial de Las Tunas, “Dr. Ernesto Guevara de la Serna”, entre los años 2009 al 2011, con el objetivo de caracterizar el infarto agudo del miocardio en el sexo femenino. La muestra estuvo constituida por 181 mujeres admitidas en el servicio por esta entidad, diagnosticadas según los criterios establecidos. Para el análisis de los resultados se utilizó la estadística descriptiva, con valores absolutos y porcientos. En la muestra de estudio prevaleció el IMA CEST, de topografía anterior y no trombolizado. La disfunción ventricular izquierda constituyó la complicación más frecuente. Predominaron como factores de riesgo asociados la hipertensión arterial, las dislipidemias, el hábito de fumar y la diabetes mellitus.

  15. Fisiopatología, evaluación y manejo del dolor agudo en pediatría

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    Tatiana Pabón-Henao

    2015-12-01

    Full Text Available El manejo del dolor agudo en los niños es deficiente, como lo afirma en el 2013 un estudio de la AMA (American Medical Association: la población pediátrica recibe entre 50% y 90% menos analgésicos que los adultos, es decir, no se tiene claridad en la fisiopatología, abordaje y manejo del dolor en los niños. El dolor puede clasificarse según su tiempo de duración, intensidad y mecanismo fisiopatoló-gico que lo desencadena (nociceptivo y neuropático. Teniendo en cuenta que la fisiopatología del dolor no varía con la edad pero sí como el paciente pediátrico lo manifieste, se requiere conocer el abordaje y manejo según su intensidad. Por lo tanto, el objetivo de esta revisión se enfoca en el estado del arte y en generar claridad de los aspectos críticos como son el conocimiento de la fisiopatología, valoración adecuada y el manejo no farmacológico y farmacológico del dolor agudo en pediatría.

  16. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

    Directory of Open Access Journals (Sweden)

    Leonor Montoya

    Full Text Available El objetivo del estudio fue describir las características en la presentación y el manejo del abdomen agudo (AA en pacientes con el virus de la inmunodeficiencia humana (VIH. Se revisaron las historias clínicas de 97 pacientes portadores del VIH que cursaron con un cuadro de AA y que fueron atendidos en el período 2006-2011 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró que el 1,6% de los pacientes inmunosuprimidos ingresó a sala de operaciones. La apendicectomía fue el procedimiento quirúrgico más frecuentemente (33,3%. La morbilidad fue de 28,1%, y la mortalidad posoperatoria de 9,4%. La infección por Mycobacterium tuberculosis fue la causa más común de dolor abdominal agudo con el 26,8%. Los datos sugieren que una pronta decisión quirúrgica frente a un cuadro compatible con AA en pacientes con VIH podría evitar una importante morbimortalidad.

  17. Mapping of micro and Small branch of industrial enterprises located in the cities of Agudo and Silveira Martins – RS

    Directory of Open Access Journals (Sweden)

    Carla Hartmann Sturm

    2016-06-01

    Full Text Available In the development of a country are the companies responsible for creating jobs, pay taxes and thus cause the economic and regional development. In Brazil, most of these institutions is made up of micro enterprises and small that often struggling to survive in the market. Therefore, it is necessary investments and public incentives to encourage their development making them competitive. In this sense, this article aims to develop a mapping of micro and small enterprises in the industrial sector in the cities of Agudo and Silveira Martins – Rio Grande do Sul (RS. For this, we used a descriptive research on the purposes and literature as to the means being prepared a questionnaire for collecting data from the sample studied. As results obtained ten micro companies and three small businesses were found in Agudo – RS, and the main industries are the timber industry and the manufacture of bakery products, influenced 65.5% of the employees of micro and small companies analyzed in the municipality. Already in Silveira Martins – RS were found seven micro and small enterprises, where six are classified as micro company and only one as small business. It was found also that the main industrial branch is the timber sector (six companies, in which 96% of employees work in any activity related to wood processing.

  18. COMPARTIMENTAÇÃO DE UNIDADES GEOMORFOLÓGICAS DO MUNICÍPIO DE AGUDO-RS

    Directory of Open Access Journals (Sweden)

    Gerson Jonas Schirmer

    2013-12-01

    Full Text Available Este artigo apresenta um mapeamento geomorfológico do município de Agudo-RS, onde as unidades geomorfológicas representam a integração dos elementos físicos da área de estudo, frente aos processos envolvidos na organização da paisagem local. A metodologia é fundamentada nas contribuições da ciência geográfica, utilizando como ferramenta SIGs (Sistemas de Informação Geográfica.  Através de uma representação de síntese, foram definidos cinco unidades geomorfológicas, Rampas deColúvio-Aluvio do Rio Jacuí, Rampas de Colúvio-Alúvio de Arroios, Colinas Alúvio-Coluvionar, Colinas Vulcânicas do Planalto Serra Geral e Associação de Morros e Morrotes do Rebordo do Planalto, que caracterizam a paisagem do município de Agudo.

  19. Síndrome pulmonar e cardiovascular por hantavírus Hantavirus pulmonary and cardiovascular syndrome

    Directory of Open Access Journals (Sweden)

    Mariangela Pimentel Pincelli

    2003-10-01

    Full Text Available A síndrome pulmonar e cardiovascular por hantavírus é uma doença de conhecimento relativamente recente e freqüentemente fatal, apresentando-se como síndrome do desconforto respiratório agudo. No Brasil, desde o primeiro surto, relatado em novembro/dezembro de 1993, em Juquitiba, 226 casos já foram registrados pela Fundação Nacional da Saúde. A doença afeta indivíduos previamente hígidos, apresentando-se com pródromo febril e sintomas semelhantes aos de um resfriado comum, podendo rapidamente evoluir para edema pulmonar, insuficiência respiratória aguda e choque. A hemoconcentração e a plaquetopenia são comuns da síndrome pulmonar e cardiovascular por hantavírus, e o quadro radiológico típico é de um infiltrado intersticial bilateral difuso, que progride rapidamente para consolidações alveolares, paralelamente à piora do quadro clínico. A mortalidade inicial era em torno de 75% e declinou para aproximadamente 35%, nos últimos anos. Os pacientes que sobrevivem geralmente recuperam-se completamente, cerca de uma semana após o estabelecimento do quadro respiratório. O agente causal, não reconhecido até há pouco, foi identificado como um hantavírus, cujo reservatório natural são animais roedores da família Muridae, subfamília Sigmodontinae. O tratamento específico antiviral ainda não é bem estabelecido, estando em estudo a eficácia de ribavirina. Cuidados de terapia intensiva como ventilação mecânica e monitoramento hemodinâmico invasivo são necessários nas formas mais graves da doença. Essas medidas, se instituídas precocemente, podem melhorar o prognóstico e a sobrevida dos pacientes com síndrome pulmonar e cardiovascular por hantavírus.Hantavirus pulmonary and cardiovascular syndrome is a recently identified and often fatal disease, which presents as acute respiratory distress syndrome (ARDS. Since the first outbreak, in Nov/Dec 1993, in Juquitiba, Brazil, 226 cases have been registered by

  20. Introduction: Cardiovascular physics.

    Science.gov (United States)

    Wessel, Niels; Kurths, Jürgen; Ditto, William; Bauernschmitt, Robert

    2007-03-01

    The number of patients suffering from cardiovascular diseases increases unproportionally high with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop high-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand, improve the medical diagnostics with decreasing the patient's risk. Cardiovascular physics-which interconnects medicine, physics, biology, engineering, and mathematics-is based on interdisciplinary collaboration of specialists from the above scientific fields and attempts to gain deeper insights into pathophysiology and treatment options. This paper summarizes advances in cardiovascular physics with emphasis on a workshop held in Bad Honnef, Germany, in May 2005. The meeting attracted an interdisciplinary audience and led to a number of papers covering the main research fields of cardiovascular physics, including data analysis, modeling, and medical application. The variety of problems addressed by this issue underlines the complexity of the cardiovascular system. It could be demonstrated in this Focus Issue, that data analyses and modeling methods from cardiovascular physics have the ability to lead to significant improvements in different medical fields. Consequently, this Focus Issue of Chaos is a status report that may invite all interested readers to join the community and find competent discussion and cooperation partners.

  1. El infarto agudo de miocardio, un problema de salud pública

    Directory of Open Access Journals (Sweden)

    Alberto Caccavo

    2010-01-01

    Full Text Available RESUMENEl infarto agudo de miocardio (IAM es una causa importante de muerte en la Argentina. Lamortalidad intrahospitalaria del IAM en la actualidad es de aproximadamente el 10%, almenos en los centros que participan en registros.Su tratamiento está orientado a la reperfusión de la arteria ocluida con angioplastia primariao trombolíticos. Sin embargo, sólo un pequeño número de hospitales disponen deangioplastia primaria y reciben trombolíticos muchos menos pacientes que los que los requieren.Para lograr una reducción de la mortalidad se debe enfatizar la pronta y amplia utilizaciónde trombolíticos, anticoagulantes y antiagregantes.El logro de un impacto trascendente sobre la mortalidad del IAM requiere la formulación deun programa nacional dirigido por las autoridades sanitarias con el consenso de las sociedadescientíficas.Este programa debería concentrarse en al menos en tres puntos:1. Realización rápida e interpretación del electrocardiograma en todos los pacientes condolor torácico, que incluya la utilización de la emergencia prehospitalaria. Una central delectura con médicos expertos puede asistir a los centros de salud que carezcan de personalcapacitado.2. Reperfusión rápida con trombolíticos y/o angioplastia. En la elección del trombolíticodeben balancearse la sencillez de los trombolíticos en bolo y su mayor éxito fibrinolíticoversus el alto costo comparado con la estreptocinasa. El tema de facilitar su aplicación esmuy importante cuando se piensa en administrar trombolíticos en centros de baja complejidad.3. Estructuración de una red para derivar los casos más graves a centros de referencia enunidades equipadas y con personal entrenado. Es posible que el 50% de los IAM requieranderivación por insuficiencia cardíaca grave, fracaso de la trombólisis o isquemia recurrente.REV ARGENT CARDIOL 2010;78:259-263.

  2. EFECTO AGUDO DEL EJERCICIO FISICO EN LA INTELIGENCIA Y LA MEMORIA EN HOMBRES, SEGUN LA EDAD

    Directory of Open Access Journals (Sweden)

    Yorleny Alfaro Chavarría

    2001-12-01

    Full Text Available Con muy diversas investigaciones se han demostrado los efectos agudos del ejercicio físico en los procesos cognitivos (memoria, inteligencia, tiempo de reacción, creatividad, etc. según la edad. Sin embargo, gran cantidad de variables se ven involucradas en los diferentes tratamientos. Es, por esto, que se pretendió realizar una investigación específica y homogénea, de manera que los cambios obtenidos en la inteligencia y la memoria en las diferentes edades se deban al tratamiento en sí, y no a la influencia de otros factores. Para esto, se aplicó un tratamiento que consistió en realizar ejercicio aeróbico subiendo y bajando una grada de 27 cm. de alto x 30 cm. de ancho, durante 10 minutos, a una intensidad del 60% de la frecuencia cardíaca máxima. Los sujetos fueron 100 hombres con edades entre la niñez y la edad avanzada. Se ubicaron en 5 subgrupos que realizaron un 'pretest', el tratamiento indicado y un 'postest'. Las pruebas fueron el test de Raven para la inteligencia y el Verbal Script Digit Span para medir la memoria auditiva. Para conocer los resultados se realizó un análisis de varianza Anova 5x2x2 para grupos independientes, utilizando los puntajes obtenidos en las diferencias entre 'pretest' y 'postest', para ambas variables, con su respectivo 'post-hoc' en los casos requeridos. Y para determinar la magnitud del cambio, se obtuvo los tamaños del efecto. Se encontró que con ejercicio aeróbico submaximal, la totalidad de los grupos etarios mejoraron sus resultados en el test de memoria con mejor resultado los de edades promedio de 25.5 y 63.25 años. Para la variable de inteligencia los sujetos de 34.75 y 52.4 años en promedio lograron los mejores resultados, mientras que los jóvenes de 25.5 años y los adultos mayores no tuvieron cambio significativo en este aspecto.

  3. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    Science.gov (United States)

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  4. Cardiovascular comorbiditiy in psoriasis

    Directory of Open Access Journals (Sweden)

    Gurcharan Singh

    2011-01-01

    Full Text Available The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatologists treating psoriasis need to approach the disease as a potentially multisystem disorder and must alert these patients to the potentially negative effects of their disease.

  5. Urocortin and cardiovascular protection

    Institute of Scientific and Technical Information of China (English)

    Yu HUANG; Xiao-qiang YAO; Chi-wai LAU; Yau-chi CHAN; Suk-ying TSANG; Franky Leung CHAN

    2004-01-01

    Urocortin and other hypothalamus corticotropin-releasing factor (CRF) polypeptides play biologically diverse roles in the stress, cardiovascular and inflammatory responses by acting on central and peripheral CRF receptors.Urocortin shows a significantly high sequence homology to CRF, and the concurrent expression of type-2 CRF (CRF2) receptors with urocortin in the heart suggests that urocortin may play a physiological role in the cardiac function. Urocortin is thought to be the endogenous agonist producing the cardiovascular actions previously attributed to CRF. This review highlights the current novel findings on the molecular and cellular mechanisms by which urocortin may exert its cardiovascular protective action.

  6. Validación del score de riesgo TIMI para pacientes con síndrome coronario agudo sin elevación del ST TIMI risk score validation for patients with acute coronary syndrome without ST elevation

    Directory of Open Access Journals (Sweden)

    Rodrigo H. Bagur

    2009-10-01

    Full Text Available Los síndromes coronarios agudos sin elevación del segmento ST (SCA-SST son causa frecuente de hospitalización, siendo responsables del 10 al 15% de infartos de miocardio (IM o muertes al año. El objetivo fue evaluar eventos cardiovasculares a 6 meses de seguimiento y validar el score de riesgo TIMI (Thrombolysis in Myocardial Infarction en nuestra población. Se analizaron retrospectivamente pacientes con diagnóstico de SCA-SST. Se realizó seguimiento telefónico a los 6 meses del ingreso. Los puntos finales evaluados fueron la combinación de muerte, internación por síndrome coronario agudo y necesidad de revascularización. Se incluyeron 204 pacientes. El 70.2% eran hombres, edad promedio de 64.5 ± 11.8 años. Luego de la evaluación inicial, se hizo diagnóstico de angina inestable en el 34.6%, IM en 38.9% y el 26.4% fueron catalogados como "dolor no coronario". Al aplicar el score de TIMI, 52 (25.5% pacientes tenían riesgo bajo, 106 (52% riesgo intermedio, y 46 (22.5% riesgo alto. La mortalidad global fue 12.6%. Se encontró un incremento progresivo y significativo en la tasa de eventos combinados a medida que aumentaba el score de TIMI (p Non-ST elevation acute coronary syndromes (NSTE-ACS are frequent cause of hospitalization, being responsible for 10-15% of infarcts or deaths per year. The study was designed to analyze 6 months follow-up of cardiovascular events as well as to validate the Thrombolysis in Myocardial Infarction (TIMI risk score for patients hospitalized for NSTE-ACS. We retrospectively analyzed patients admitted with NSTE-ACS. Telephone follow-up were performed at 6 month. Combination of death, re-admission for acute coronary syndrome and revascularization were considered as end point. Two hundred and four patients were included for the analysis. There were 70.2% males, with a mean age of 64.5 ± 11.8 years. After the initial evaluation, we diagnosed unstable angina in 34.6% of cases, MI in 38.9% of cases, and 26

  7. Consumo de arsénico y riesgo cardiovascular

    Directory of Open Access Journals (Sweden)

    Lachiner Saborío Morales

    2015-03-01

    Full Text Available El arsénico (As es un elemento considerado como ubicuo, cuyas fuentes pueden ser naturales o productos de la actividad humana. La exposición a este elemento ocurre principalmente por la vía oral. Las presentaciones inorgánicas del As son consideradas como las más tóxicas. La absorción del As ocurre en el intestino delgado y por medio de acuaporinas ingresa a los hepatocitos, en casos de ingesta crónica el As tiende acumularse en hígado, riñones, corazón, sistema nervioso, pulmones, músculo, tracto gastrointestinal y bazo. El consumo crónico de agua con concentraciones de As por encima del valor de referencia dado por la Organización Mundial de la Salud (OMS ha demostrado un aumento del riesgo de accidentes vasculares cerebrales (AVC, hipertensión arterial (HTA, aterosclerosis carotidea, enfermedades arteriales periféricas, mortalidad por infarto agudo del miocardio (IAM, aumento en enfermedades cardiovasculares en la población pediátrica y diabetes mellitus tipo II.

  8. Enfermedad cardiovascular en pacientes cubanos afectados por Ataxia de Friedreich.

    Directory of Open Access Journals (Sweden)

    Tania Cruz Mariño

    2010-01-01

    Full Text Available Al describir la ataxia de Friedreich, Nicholaus hizo referencia a la patología cardiaca. Esta enfermedad autosómica recesiva se debe a una mutación dinámica en el gen FRDA, codificándose deficientemente la proteína Frataxina, conduciendo a estrés oxidativo y muerte celular cardiaca. La presente investigación se desarrolló con el objetivo de describir las anomalías cardiovasculares presentes en los pacientes cubanos afectados por ataxia de Friedreich. A los individuos con diagnóstico molecular confirmatorio de la enfermedad se les realizó electrocardiograma y ecocardiograma, así como evaluación clínica mediante escalas validadas internacionalmente: ICARS y SARA. Los trastornos de repolarización ventricular difusos, los trastornos de conducción intraauricular, así como los trastornos de la función diastólica resultaron hallazgos frecuentes. El patrón restrictivo apreciado provee evidencia invivo de que la enfermedad conduce a disfunción diastólica del ventrículo izquierdo. La ocurrencia de un Infarto Agudo del Miocardio silente indica la importancia de identificar formas incipientes de afectación miocárdica.

  9. Cardiovascular manifestations in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Vairamani Kandan

    2016-07-01

    Conclusions: This study shows that cardiovascular manifestations are quite common and varied in hyperthyroidism which are to be looked for in the management. [Int J Res Med Sci 2016; 4(7.000: 3032-3038

  10. Cardiovascular modeling and diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States)

    1995-12-31

    In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  11. Relación entre detección temprana y evolución del abdomen agudo quirúrgico de origen ginecológico Hospital Luis Vernaza, 2012.

    OpenAIRE

    Aguilar Mero, Wilson Ronald

    2014-01-01

    El abdomen agudo ginecológico ocurre entre7 y 20%; puede ser hemorrágico, infeccioso, mecánico o traumático. Requiere un tratamiento rápido, precoz para disminuir las complicaciones postoperatorias. Los cuadros de abdomen agudo ginecológico hemorrágico son los más frecuentes, y el embarazo ectópico complicado es el más común con un porcentaje de 90%. Objetivo: Demostrar que el diagnóstico oportuno del abdomen agudo quirúrgico de origen ginecológico disminuye las complicaciones y mejora la exp...

  12. ANALISIS COSTE-EFECTIVIDAD DE DISTINTOS MÉTODOS DE DIAGNÓSTICO POR IMAGEN DEL TROMBOEMBOLISMO PULMONAR AGUDO

    Directory of Open Access Journals (Sweden)

    Stella Maris Batallés

    2009-01-01

    Full Text Available La técnica diagnóstica óptima para detectar tromboembolismo pulmonar agudo (TEP continúa en discusión. La gammagrafía pulmonar de ventilación/perfusión ha sido el examen preferido durante décadas, pero con el advenimiento de nuevas pruebas de imágenes las posibilidades diagnósticas se ampliaron, siendo necesario evaluarlas desde la perspectiva del coste y de la efectividad. El objetivo de este trabajo fue evaluar distintos métodos de diagnóstico por imagen para detectar TEP agudo para determinar el más coste-efectivo. Métodos. Análisis de coste-efectividad (CE empleando un árbol de decisiones para modelar distintas pruebas (centellograma V/Q, TC helicoidal, angiografía por tomografía computada multidetector (TCMD, resonancia magnética por imágenes (RMI y arteriografía convencional. Se obtuvieron valores de sensibilidad, especificidad, valor predictivo positivo (VPP y negativo (VPN de las pruebas diagnósticas. Resultado medido: "caso detectado de TEP". Los costes evaluados fueron los directos, expresados en euros (t, incluyendo los secundarios a las complicaciones de los métodos diagnósticos. Se realizó un análisis de sensibilidad de una vía para evaluar la robustez de las conclusiones. Resultados. No se eliminaron pruebas por dominancia extendida. La tasa cruda de CE para TCMD fue de 486 t por cada caso de TEP detectado. El coste marginal entre la TC helicoidal y el centellograma V/Q fue de 103 t para detectar 8 casos adicionales de TEP, mientras que el coste marginal entre la TCMD y la TC helicoidal fue de 229 t para detectar un caso adicional de TEP. Conclusiones. La prueba diagnóstica más coste-efectiva fue la TCMD, hallazgo que mostró robustez en el análisis de sensibilidad. Sin embargo, el análisis de C-E incremental nos mostró que la TCMD costó 229 t más respeto a la TC helicoidal para lograr una mínima mejora en la efectividad de la prueba (detección de TEP agudo. El alto valor predictivo negativo de

  13. Decúbito prono en pacientes con síndrome de distrés respiratorio agudo

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    Mariano Setten

    Full Text Available RESUMEN El síndrome de distrés respiratorio agudo ocupa gran atención en la unidad de cuidados intensivos. A pesar del amplio conocimiento alcanzado sobre la fisiopatología de éste síndrome, el enfoque en la unidad de cuidados intensivos consiste, en gran parte, en un tratamiento de soporte vital y en evitar los efectos secundarios de las terapéuticas invasivas. Si bien, durante los últimos 20 años, se generaron grandes avances en ventilación mecánica con un impacto importante sobre la mortalidad, ésta continúa siendo elevada. Una característica de los pacientes con síndrome de distrés respiratorio agudo, sobre todo los más severos, es la presencia de hipoxemia refractaria debido a la existencia de shunt, pudiendo requerir tratamientos adicionales a la ventilación mecánica, entre ellos la ventilación mecánica en decúbito prono. Este método, recomendado para mejorar la oxigenación por primera vez en 1974, puede ser implementado fácilmente en cualquier unidad de cuidados intensivos con personal entrenado. El decúbito prono tiene un sustento bibliográfico sumamente robusto. Varios ensayos clínicos randomizados han demostrado el efecto del decúbito prono sobre la oxigenación en pacientes con síndrome de distrés respiratorio agudo medida a través de la relación PaO2/FiO2 e incluso su impacto en el aumento de la sobrevida de estos pacientes. Los integrantes del Comité de Kinesiología Intensivista de la Sociedad Argentina de Terapia Intensiva realizaron una revisión narrativa con el objetivo de exponer la evidencia disponible en relación a la implementación del decúbito prono, los cambios producidos en el sistema respiratorio por la aplicación de la maniobra y su impacto sobre la mortalidad. Por último, se sugerirán lineamientos para la toma de decisiones.

  14. El padecimiento de los enfermos con Síndrome Coronario Agudo The illness of the patients with Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Joaquín Jesús Blanca Gutiérrez

    2006-06-01

    Full Text Available Introducción: Si revisamos la literatura enfermera publicada sobre el Síndrome Coronario Agudo, cuatro son los grandes temas que han definido a nuestros estudios: los protocolos de actuación, las vías clínicas, los casos clínicos y la metodología del proceso enfermero. Casi siempre ha sido la propia enfermedad y no tanto el padecimiento del paciente la auténtica protagonista de nuestros escritos. Con nuestro presente trabajo pretendemos adentrarnos en aquellas dimensiones más subjetivas de la enfermedad, es decir, en el padecimiento y en el "sickness". Metodología: Se trata de un estudio cualitativo de tipo descriptivo en el que presentamos algunos de los datos más significativos de los relatos de nuestros pacientes con Síndrome Coronario Agudo. Resultados: los hemos agrupado en siete categorías temáticas: dolor, miedo, impacto en la familia, impacto en la actividad laboral, impacto en las actividades recreativas, impacto en el rol de cuidador y posibles causas.  Discusión: Se comparan los resultados con los de otros trabajos que han estudiado también el Síndrome Coronario Agudo desde diversas perspectivas: la sexualidad, los descriptores verbales, el dolor, y los testimonios de mujeres mexicanas que han pasado por esta misma situación.Introduction. The revision of the nursing literature published about the Acute Coronary Syndrome shows that four are the big themes that have defined to our studies: the performance protocols, the clinical roads, the clinical cases and the methodology of the nursing process. The disease and not so much the patient’s illness has been the authentic main character of our writings. With our present work we seek to go into in those more subjective dimensions of the pain, the illness and the sickness.  Methodology. It is a qualitative study of descriptive type, in that we present some of the most significant data in the stories of our patients with Acute Coronary Syndrome.  Results. We have

  15. Qualidade de vida de clientes pós-infarto agudo do miocárdio Calidad de vida de los clientes pós-infarto agudo del miocardio Client's quality of life after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Joselany Afio Caetano

    2007-03-01

    Full Text Available Objetivou-se neste estudo avaliar a qualidade de vida de clientes que sofreram infarto agudo do miocárdio. A amostra constou de 30 clientes selecionados pela busca em prontuários de uma unidade cardiológica, que nos permitiu a identificação e localização desses clientes, internados no ano de 2004. Para coleta de dados utilizamos a Escala de Qualidade de Vida de Flanagan e o tratamento estatístico com desvio-padrão. Os resultados mostraram maior índice de respostas nos níveis "indiferentes" a "pouco satisfeitos" em suas qualidades de vida. A relação interpessoal apresentou o mais alto índice de satisfação, contrariando o bem-estar físico e material, com o mais baixo índice de satisfação. Concluiu-se que a avaliação da qualidade de vida de clientes que sofreram infarto agudo do miocárdio se mostra comprometida, o que vem corroborar outros estudos anteriormente realizados.El objetivo del estudio fue evaluar la calidad de vida de los clientes que han sufrido infarto agudo del miocardio. La muestra ha consistido de 30 pacientes escogidos por la búsqueda en historias clínicas de una unidad cardiológica, que nos permitió la identificación y localización de estos clientes, internados en el año 2004. Para la colecta de los datos utilizamos la Escala de Calidad de Vida de Flanagan y el tratamiento estadístico con desvío medio. Los resultados muestran mayor índice de respuestas en los niveles "indiferentes" a "poco satisfechos" en sus calidades de vida. La relación interpersonal presentó el más alto índice de satisfacción, contrariando el bienestar físico y material, con el más bajo índice de satisfacción. Ha concluído que la evaluación de la calidad de vida de clientes que sufrieron infarto agudo del miocardio muéstrase comprometida, lo que viene a confirmar otros estudios anteriormente realizados.This study evaluates the quality of life of clients who suffered myocardial infarction. The sample consisted of 30

  16. [Vitamin D and cardiovascular risk].

    Science.gov (United States)

    Mayer, Otto

    2012-05-01

    The pathogenesis of cardiovascular disease is without any doubt multifactorial, and it is generally accepted, that conventional risk factors determined only about 80% of cardiovascular risk. There is accumulating evidence that vitamin D exerts important pathophysiological effects on cardiovascular system. Low vitamin D was associated with increased cardiovascular risk in several reports. This review summarizes recent epidemiological evidence and possible pathophysiological mechanism for a role of low vitamin D in cardiovascular diseases. Moreover, available data concerning vitamin D supplementation are depicted.

  17. ADMA, cardiovascular disease and diabetes.

    Science.gov (United States)

    Krzyzanowska, Katarzyna; Mittermayer, Friedrich; Wolzt, Michael; Schernthaner, Guntram

    2008-12-15

    The endogenous competitive nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) is an emerging risk marker for future cardiovascular events. Elevated ADMA concentrations have been described in patients with an adverse cardiovascular risk profile. Recently, various studies investigated the independent role of ADMA as a cardiovascular risk predictor in several patient cohorts. In addition, ADMA might not only be a risk marker but also a causative factor for cardiovascular disease. This review summarizes the literature on the relationship between ADMA, cardiovascular disease and diabetes.

  18. Incidencia actual de la obesidad en las enfermedades cardiovasculares

    Directory of Open Access Journals (Sweden)

    Julio César Fernández-Travieso

    2016-01-01

    Full Text Available La obesidad es una enfermedad crónica multifactorial que constituye un importante problema de salud a nivel mundial, con riesgo cardiovascular asociado y una morbilidad y mortalidad aumentada, además de alterar la calidad de vida de quienes la padecen. En la actualidad, el sobrepeso y la obesidad se consideran tan importantes como otros factores de riesgo clásicos relacionados con la enfermedad coronaria como dislipidemia, hipertensión arterial, diabetes mellitus, marcadores inflamatorios y estado protrombótico. El tejido adiposo no sólo actúa como almacén de moléculas grasas, sino que sintetiza y libera a la sangre numerosas hormonas relacionadas con el metabolismo de principios inmediatos y la regulación de la ingesta. La pérdida de peso puede evitar la progresión de la placa de aterosclerosis y los eventos coronarios agudos en los sujetos obesos. Los objetivos de esta revisión se enmarcan en abordar brevemente la obesidad y su incidencia actual en las enfermedades cardiovasculares, asi como acotar su diagnóstico, clasificación y adecuado manejo. Se concluye que el diagnóstico de obesidad debe incluir mediciones de contenido total y de distribución de la grasa corporal y que los cambios en el estilo de vida que promuevan una dieta equilibrada y ejercicio físico regular deben ser una de las medidas principales en el tratamiento de la obesidad y sus comorbilidades asociadas.

  19. Copa do mundo de futebol como desencadeador de eventos cardiovasculares

    Directory of Open Access Journals (Sweden)

    Daniel Guilherme Suzuki Borges

    2013-06-01

    Full Text Available FUNDAMENTO: Síndromes coronarianas agudas são a maior causa de mortalidade no mundo. Estímulos externos, também conhecidos como gatilhos, como estado emocional ou atividade física, podem produzir mudanças fisiopatológicas desencadeantes. Dentre os gatilhos estudados, eventos estressantes, como campeonatos de futebol, são controversos na literatura e não há dados efetivos para a população brasileira. OBJETIVO: Avaliar os efeitos agudos do estresse ambiental induzido pelos jogos da Copa do Mundo de Futebol no aumento da incidência de doenças cardiovasculares no Brasil. MÉTODOS: Foram obtidos dados publicamente disponíveis do Sistema Único de Saúde referentes às internações hospitalares com código internacional de doenças, referentes às síndromes isquêmicas agudas, no período de maio a agosto de 1998 a 2010 (155.992 internações. Restringiu-se a análise aos pacientes maiores que 35 anos e internados por especialidades clínicas. Comparou-se a incidência de infarto e óbito entre os dias sem copa (Grupo I: 144.166; 61,7 ± 12,3 anos; 59,4%masculino, dias de copa sem jogos do Brasil (Grupo II: 9.768; 61,8 ± 12,3 anos; 60,0% masculino e dias de jogos do Brasil (Grupo III: 2.058; 61,6 ± 12,6 anos; 57,8% masculino. Utilizou-se regressão logística e de Poisson para ajustar por idade, gênero, densidade populacional e número de postos de atendimento. RESULTADOS: Houve aumento da incidência de infarto para jogos de copa do mundo (1,09; IC95% = 1,05-1,15 e do Brasil (1,16; IC95% = 1,06-1,27. Não houve impacto sobre mortalidade - copa (1,00; IC95% = 0,93-1,08 e Brasil (1,04; IC95% = 0,93-1,22. CONCLUSÃO: A copa do mundo e, especialmente, os jogos da seleção brasileira implicam maior incidência de infarto agudo do miocárdio, mas não de mortalidade intra-hospitalar.

  20. Efeito Agudo da Pressao Positiva Continua sobre a Pressao de Pulso na Insuficiencia Cardiaca Cronica

    Directory of Open Access Journals (Sweden)

    Monica Quintao

    2014-03-01

    Full Text Available Fundamento: Pacientes com insuficiência cardíaca (IC apresentam disfunção ventricular esquerda e redução da pressão arterial média (PAM. O aumento do estímulo adrenérgico causa vasoconstrição e resistência dos vasos, mantendo a PAM, enquanto aumenta a resistência vascular periférica e a rigidez dos vasos condutores. O aumento da pressão de pulso (PP reflete a complexa interação do coração com os sistemas arteriais e venosos. O aumento da PP é um importante marcador de risco em pacientes com insuficiência cardíaca crônica (ICC. A ventilação não invasiva (VNI tem sido utilizada para IC aguda descompensada para melhorar a congestão e a ventilação pelos efeitos respiratórios e hemodinâmicos. No entanto, nenhum desses estudos relatou o efeito da VNI na PP. Objetivo: O objetivo deste estudo foi determinar os efeitos agudos da VNI com CPAP (pressão positiva contínua nas vias aéreas sobre a PP em pacientes ambulatoriais com ICC. Métodos: Seguindo um protocolo randomizado, duplo-cego, cruzado e controlado com placebo, 23 pacientes com ICC (17 homens, 60 ± 11 anos, IMC 29 ± 5 kg/cm2, classes II e III da NYHA foram submetidos à CPAP via máscara nasal durante 30 minutos na posição reclinada. A pressão da máscara foi de 6 cmH2O, enquanto o placebo foi fixado em 0-1 cmH2O. PP e outras variáveis hemodinâmicas não invasivas foram avaliadas antes, durante e depois do placebo e do modo CPAP. Resultados: A CPAP diminuiu a frequência cardíaca de repouso (pré: 72 ± 9; pós 5 min: 67 ± 10 bpm , p < 0,01 e PAM (CPAP: 87 ± 11; controle 96 ± 11 mmHg , p < 0,05 pós 5 min. A CPAP diminuiu a PP (CPAP: 47 ± 20 pré para 38 ± 19 mmHg pós; controle: 42 ± 12 mmHg, pré para 41 ± 18 pós p < 0,05 pós 5 min. Conclusão: A VNI com CPAP diminuiu a pressão de pulso em pacientes com ICC estável. Ensaios clínicos futuros devem investigar se esse efeito está associado com melhora no desfecho clínico.

  1. Infarto agudo de miocardio. Resultados de la Encuesta SAC 2005 en la República Argentina

    Directory of Open Access Journals (Sweden)

    Fernando Botto

    2007-01-01

    Full Text Available RESUMENIntroducciónConsiderando que el infarto agudo de miocardio (IAM es la causa más frecuente de muerte en nuestro país, este registro multicéntrico pretende establecer una visión de la realidad epidemiológica (limitada a los centros participantes con la finalidad de obtener información acerca del manejo clínico y la morbimortalidad intrahospitalaria.ObjetivoAnalizar los aspectos epidemiológicos, clínicos, usos terapéuticos y mortalidad del IAM en centros relacionados con la Sociedad Argentina de Cardiología.Material y métodosSe evaluaron 515 pacientes de 74 unidades de cuidados intensivos de todo el país registrados durante 2 meses consecutivos en el período comprendido entre abril y diciembre de 2005.ResultadosLa mediana de edad fue de 62 años; el 24% eran mujeres. El 6,2% no presentaba ningún factor de riesgo, mientras que el 38% tenía al menos tres factores. El 27,9% de los pacientes tenían algún tipo de antecedente coronario. El 65,4% ingresó dentro de las primeras 6 horas; en el 42,2%, la localización del IAM era anterior, con Killip y Kimball A en el 77,6% de los pacientes. Al ingreso, el 74,8% presentaba supradesnivel del ST y el 4,9%, BCRI. El 53% recibió tratamiento de reperfusión (42,3% trombolíticos y 57,7% angioplastia primaria, 80,3% si incluimos pacientes elegibles para tratamiento de reperfusión (n = 320.La complicación más frecuente fue la insuficiencia cardíaca, que alcanzó el 20,2%, en tanto que el 11,3% presentó angina posinfarto y el 4,3%, reinfarto. La mortalidad intrahospitalaria fue del 12,6%.Al alta, el 95,1% recibió aspirina, el 78,8% betabloqueantes, el 72,8% estatinas y el 55,9% clopidogrel.ConclusionesTodavía, una proporción importante de pacientes que son elegibles para reperfusión no la reciben. La angioplastia primaria fue la estrategia de reperfusión más utilizada; es probable que esto estuviera relacionado con las características de los centros participantes. Consideramos

  2. Hematoma subdural agudo espontâneo e hemorragia intracerebral em paciente com microangiopatia trombótica gestacional

    OpenAIRE

    Sâmia Yasin Wayhs; Joise Wottrich; Douglas Prestes Uggeri; Fernando Suparregui Dias

    2013-01-01

    Pré-eclâmpsia, síndrome HELLP (hemólise, elevação de enzimas hepáticas e plaquetopenia) e fígado gorduroso agudo da gestação são as principais causas de microangiopatia trombótica e disfunção hepática grave durante a gestação, representando um spectrum do mesmo processo patológico. Relatou-se aqui o caso de uma gestante com 35 semanas internada em unidade de terapia intensiva no pós-operatório imediato de cesariana por morte fetal, com náuseas, vômitos e icterícia. Diagnosticaram-se pré-eclâm...

  3. Influencia do sexo, do ciclo estral e do estrese agudo nas respostas hormonais e metobolicas em ratos

    OpenAIRE

    Fabio Jose Bianchi

    2004-01-01

    Resumo: O objetivo deste trabalho foi analisar a influência do sexo e do ciclo estral nas respostas metabólicas e hormonais em ratos submetidos a estresse agudo. Ratos com 3 meses de idade, machos e fêmeas ovariectomizadas, ou com ciclo estral regular, foram usados (n = 7-11/grupo). Após a identificação da fase do ciclo estral, manipulação (machos) ou 21 dias após a castração, os animais foram submetidos a uma sessão de natação. Imediatamente após a aplicação do estresse, os animais foram ...

  4. La transición de dolor agudo postoperatorio a crónico: ¿qué sabemos?

    Directory of Open Access Journals (Sweden)

    H. Ribera

    2012-08-01

    Full Text Available La transición del dolor agudo postoperatorio a crónico es un proceso complejo, poco conocido y de interés creciente en los últimos años. Los cuadros dolorosos crónicos derivados de determinados procedimientos quirúrgicos como la toracotomía, la mastectomía o la amputación se asocian a una elevada prevalencia. Sin embargo, han sido identificados una serie de factores pronósticos o predictivos relacionados con la aparición de dichos cuadros dolorosos. Su detección precoz permitiría iniciar tratamientos analgésicos preventivos con el objetivo de evitar dicha transición.

  5. Edema agudo pulmonar associado à obstrução das vias aéreas: relato de caso

    OpenAIRE

    Bisinotto,Flora Margarida Barra; Cardoso, Ricardo de Paula; Abud,Tânia Mara Vilela

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: O edema pulmonar por pressão negativa tem sido definido como edema não-cardiogênico, com transudação de líquido para o interstício pulmonar, por aumento na pressão negativa intratorácica, ocasionado pela obstrução das vias aéreas superiores. Descreveu-se o caso de paciente hígida, submetida à anestesia geral, que apresentou edema agudo pulmonar após a extubação traqueal. RELATO DO CASO: Paciente de 23 anos, sexo feminino, estado físico ASA II, submetida à anestesia ...

  6. SÍNDROME CORONARIO AGUDO DE CAUSA NO ATEROESCLERÓTICA / Acute coronary syndrome of non-atherosclerotic origin

    Directory of Open Access Journals (Sweden)

    Yuri Medrano Plana

    2013-10-01

    Full Text Available Resumen La embolia coronaria es una causa poco frecuente de síndrome coronario agudo. Dentro de los varios tipos de material embólico se encuentra el de origen tumoral. Estos émbolos pueden ocasionar isquemia miocárdica de intensidad variable, desde angina de pecho hasta infarto agudo de miocardio o incluso, muerte súbita. Se presenta una mujer de 58 años de edad, que presentó episodios de angina inestable con cambios eléctricos sin factores de riesgo y sin antecedentes de cardiopatía isquémica, que en la coronariografía se demostró la presencia de arterias coronarias normales. El ecocardiograma transesofágico informó imagen ecogénica polilobulada y pediculada hacia la superficie septal de la aurícula izquierda (posible mixoma, sin observarse trombos en las cavidades cardíacas. La paciente fue operada (exéresis quirúrgica del tumor, evolucionó favorablemente y fue trasladada a su hospital de origen 72 horas después. / Abstract Coronary embolism is a rare cause of acute coronary syndrome. Among the various types of embolic material is that of tumoral origin. These emboli can cause myocardial ischemia of varying intensity, from angina to acute myocardial infarction or even sudden death. The case of a 58-year-old woman who presented unstable angina episodes with electrical changes with no risk factors and no history of ischemic heart disease is presented. By means of coronary angiography, the presence of normal coronary arteries was showed. Transesophageal echocardiography showed the echogenic polylobulated and pedicled image towards the septal surface of the left atrium (possible myxoma; thrombi in the cardiac chambers were not observed. The patient underwent surgery (surgical removal of the tumor, had a good progress and was transferred to her hospital of origin 72 hours later.

  7. Diabetes Drugs and Cardiovascular Safety

    Directory of Open Access Journals (Sweden)

    Ji Cheol Bae

    2016-06-01

    Full Text Available Diabetes is a well-known risk factor of cardiovascular morbidity and mortality, and the beneficial effect of improved glycemic control on cardiovascular complications has been well established. However, the rosiglitazone experience aroused awareness of potential cardiovascular risk associated with diabetes drugs and prompted the U.S. Food and Drug Administration to issue new guidelines about cardiovascular risk. Through postmarketing cardiovascular safety trials, some drugs demonstrated cardiovascular benefits, while some antidiabetic drugs raised concern about a possible increased cardiovascular risk associated with drug use. With the development of new classes of drugs, treatment options became wider and the complexity of glycemic management in type 2 diabetes has increased. When choosing the appropriate treatment strategy for patients with type 2 diabetes at high cardiovascular risk, not only the glucose-lowering effects, but also overall benefits and risks for cardiovascular disease should be taken into consideration.

  8. INFARTO AGUDO DE MIOCARDIO EN LOS CENTROS MÉDICOS DE DIAGNÓSTICO INTEGRAL DEL ESTADO TRUJILLO / Acute myocardial infarction at the comprehensive Diagnostic Medical Centers of Trujillo state

    Directory of Open Access Journals (Sweden)

    Humberto L. Ramos González

    2012-01-01

    Full Text Available ResumenIntroducción y objetivos: Las enfermedades cardiovasculares constituyen la primera causa de muerte en los países desarrollados, y el infarto agudo de miocardio, es su expresión fundamental. El objetivo de esta investigación fue caracterizar el comportamiento y la evolución de los pacientes atendidos por esta enfermedad. Método: Se realizó un estudio observacional, transversal y multicéntrico con 31 pacientes que ingresaron a los Centro de Diagnóstico Integral con la sospecha de infarto agudo de miocardio, en el período comprendido entre octubre de 2005 a junio de 2007, en el Estado Trujillo, Venezuela. El diagnóstico de infarto se realizó mediante los métodos tradicionales. Las variables cualitativas fueron analizadas utilizando medidas de resumen, como el porcentaje. Para el análisis de las cuantitativas se utilizaron la media y la desviación estándar. Se consideró significativo una p < 0,05. Resultados: Predominó el sexo masculino con 24 pacientes (77,4 %, la hipertensión arterial estuvo presente en 19 de ellos (68,2 %, el mayor número de casos, 19 (61,2 %, presentó elevación del segmento ST y en 8 pacientes (25,8 %, hubo afectación de la cara inferior; 15 (48,4 % recibieron tratamiento fibrinolítico y 11 (35,4 % presentaron fallo de bomba. La estadía hospitalaria predominante fue entre 7 y 15 días (87 % de los pacientes. Conclusiones: El sexo masculino y el grupo de edad entre 60 y 70 años, fueron los de mayor representatividad; la hipertensión arterial, la dislipidemia y la diabetes mellitus fueron los principales factores de riesgo. La trombólisis le fue realizada a la mitad de los pacientes con criterios para ello, con beneficios clínicos, eléctricos y hemodinámicos óptimos.AbstractIntroduction and objectives: Cardiovascular diseases are the leading cause of death in developed countries, and myocardial infarction is the fundamental expression. The objective of this research was to characterize the

  9. Clocks and cardiovascular function

    Science.gov (United States)

    McLoughlin, Sarah C.; Haines, Philip; FitzGerald, Garret A.

    2016-01-01

    Circadian clocks in central and peripheral tissues enable the temporal synchronization and organization of molecular and physiological processes of rhythmic animals, allowing optimum functioning of cells and organisms at the most appropriate time of day. Disruption of circadian rhythms, from external or internal forces, leads to widespread biological disruption and is postulated to underlie many human conditions, such as the incidence and timing of cardiovascular disease. Here, we describe in vivo and in vitro methodology relevant to studying the role of circadian rhythms in cardiovascular function and dysfunction PMID:25707279

  10. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  11. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.  ...

  12. Envejecimiento del sistema cardiovascular

    OpenAIRE

    2005-01-01

    Las principales características del envejecimiento del sistema cardiovascular reflejan cambios anatómicos y estructurales a nivel de la pared de los vasos, la relajación miocárdica, el llenado ventricular y la respuesta a las catecolaminas . Muchos de los cambios funcionales asociados con la edad están relacionados con estos fenómenos. Esta revisión describe los cambios relacionados con el envejecimiento a nivel estructural y funcional del sistema cardiovascular, sus posibles factores etiológ...

  13. Pharmacogenomics and cardiovascular disease

    DEFF Research Database (Denmark)

    Weeke, Peter; Roden, Dan M

    2013-01-01

    Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established...... resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described...

  14. Research in cardiovascular care

    DEFF Research Database (Denmark)

    Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna

    2014-01-01

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....

  15. Myeloperoxidase and cardiovascular disease.

    Science.gov (United States)

    Nicholls, Stephen J; Hazen, Stanley L

    2005-06-01

    Myeloperoxidase (MPO) is a leukocyte-derived enzyme that catalyzes the formation of a number of reactive oxidant species. In addition to being an integral component of the innate immune response, evidence has emerged that MPO-derived oxidants contribute to tissue damage during inflammation. MPO-catalyzed reactions have been attributed to potentially proatherogenic biological activities throughout the evolution of cardiovascular disease, including during initiation, propagation, and acute complication phases of the atherosclerotic process. As a result, MPO and its downstream inflammatory pathways represent attractive targets for both prognostication and therapeutic intervention in the prophylaxis of atherosclerotic cardiovascular disease.

  16. Validez del cuestionario cardiovascular MONICA comparado con la historia clínica Validity of the MONICA cardiovascular questionnaire compared with clinical records

    Directory of Open Access Journals (Sweden)

    José M. Baena-Díez

    2009-12-01

    Full Text Available Objetivo: Estudiar la validez del cuestionario cardiovascular Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA comparado con la historia clínica. Métodos: Estudio descriptivo, prospectivo, multicéntrico, realizado en 3.329 personas >50 años de edad (estudio ARTPER [arteriografía periférica]. La muestra se seleccionó por muestreo aleatorio simple en 32 centros de salud de atención primaria. Los diagnósticos considerados fueron: infarto agudo de miocardio, ángor, enfermedad vascular cerebral, hipertensión arterial, diabetes mellitus e hipercolesterolemia. Se estudió además el tratamiento con antihipertensivos, hipolipemiantes o insulina, hipoglucemiantes y antiagregantes o anticoagulantes. La validez entre cuestionario y registro en la historia clínica se estudió con la sensibilidad, la especificidad, los valores predictivos y el índice kappa. Resultados: La edad media fue de 65 años (desviación estándar: 8,9, y el 54,8% eran mujeres. La sensibilidad del cuestionario fue >90% en todas las variables, excepto en el ángor (89,9% y la enfermedad vascular cerebral (86,5%. La especificidad también fue >90%, excepto en el ángor (88,3% y la hipercolesterolemia (77,5%. El valor predictivo positivo fue >90% en todos los tratamientos farmacológicos; >80% en el ángor, el infarto agudo de miocardio y la hipertensión arterial; 79,4% en la enfermedad vascular cerebral; 79,1% en la hipercolesterolemia, y 73,4% en la diabetes mellitus. Los valores predictivos negativos fueron >90% en todos los casos. Los índices kappa fueron >0,80 en todas las variables, excepto en la hipercolesterolemia (0,69 y la diabetes mellitus (0,79. Conclusiones: El cuestionario cardiovascular MONICA es un método válido para encuestar a las personas >50 años sobre sus enfermedades, factores de riesgo y tratamientos cardiovasculares.Objective: To assess the validity of the questionnaire Multinational Monitoring of Trends and

  17. Pharmacogenetics of cardiovascular drugs.

    Science.gov (United States)

    Johnson, Julie A; Humma, Larisa M

    2002-02-01

    Pharmacogenetics is a field aimed at understanding the genetic contribution to inter-patient variability in drug efficacy and toxicity. Treatment of cardiovascular disease is, in most cases, guided by evidence from well-controlled clinical trials. Given the solid scientific basis for the treatment of most cardiovascular diseases, it is common for patients with a given disease to be treated in essentially the same manner. Thus, the clinical trials have been very informative about treating large groups of patients with a given disease, but are slightly less informative about the treatment of individual patients. Pharmacogenetics and pharmacogenomics have the potential of taking the information derived from large clinical trials and further refining it to select the drugs with the greatest likelihood for benefit, and least likelihood for harm, in individual patients, based on their genetic make-up. In this paper, the current literature on cardiovascular pharmacogenetics is emphasised, and how the use of pharmacogenetic/pharmacogenomic information may be particularly useful in the future in the treatment of cardiovascular diseases is also highlighted.

  18. Cheese and cardiovascular health

    DEFF Research Database (Denmark)

    Hjerpsted, Julie Bousgaard

    Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Low-density lipoprotein (LDL) cholesterol is a well-known risk factor of CVD which increases after the intake of saturated fatty acids (SFA). Cheese is a dietary product commonly consumed in Western countries and known...

  19. Cardiovascular effects of gliptins.

    Science.gov (United States)

    Scheen, André J

    2013-02-01

    Dipeptidyl peptidase 4 (DPP-4) inhibitors (commonly referred to as gliptins) are a novel class of oral antihyperglycaemic agents with demonstrated efficacy in the treatment of type 2 diabetes mellitus (T2DM). Preclinical data and mechanistic studies have indicated a possible beneficial action on blood vessels and the heart, via both glucagon-like peptide 1 (GLP-1)-dependent and GLP-1-independent effects. DPP-4 inhibition increases the concentration of many peptides with potential vasoactive and cardioprotective effects. Clinically, DPP-4 inhibitors improve several risk factors in patients with T2DM. They improve blood glucose control (mainly by reducing postprandial glycaemia), are weight neutral (or even induce modest weight loss), lower blood pressure, improve postprandial lipaemia, reduce inflammatory markers, diminish oxidative stress, and improve endothelial function. Some positive effects on the heart have also been described in patients with ischaemic heart disease or congestive heart failure, although their clinical relevance requires further investigation. Post-hoc analyses of phase II-III, controlled trials suggest a possible cardioprotective effect with a trend for a lower incidence of major cardiovascular events with gliptins than with placebo or active agents. However, the actual relationship between DPP-4 inhibition and cardiovascular outcomes remains to be proven. Major prospective clinical trials with predefined cardiovascular outcomes and involving various DPP-4 inhibitors are now underway in patients with T2DM and a high-risk cardiovascular profile.

  20. Neuropeptides in cardiovascular control.

    Science.gov (United States)

    Ganong, W F

    1984-12-01

    Neuropeptides can affect cardiovascular function in various ways. They can serve as cotransmitters in the autonomic nervous system; for example, vasoactive intestinal peptide (VIP) is released with acetylcholine and neuropeptide Y with norepinephrine from postganglionic neurons. Substance P and, presumably, other peptides can can affect cardiovascular function when released near blood vessels by antidromically conducted impulses in branches of stimulated sensory neurons. In the central nervous system, many different neuropeptides appear to function as transmitters or contransmittes in the neural pathways that regulate the cardiovascular system. In addition neuropeptides such as vasopressin and angiotensin II also circulate as hormones that are involved in cardiovascular control. Large doses of exogenous vasopressin are required to increase blood pressure in normal animals because the increase in total peripheral resistance produced by the hormones is accompanied by a decrease in cardiac output. However, studies with synthetic peptides that selectively antagonize the vasopressor action of vasopressin indicate that circulating vasopressin is important in maintaining blood pressure when animals are hypovolemic due to dehydration, haemorrhage or adrenocortical insufficiency. VIP dilates blood vessels and stimulates renin secretion by a direct action on the juxtaglomerular cells. Renin secretion is stimulated when the concentration of VIP in plasma exceeds 75 pmol/litre, and higher values are seen in a number of conditions. Neostigmine, a drug which increases the secretion of endogenous VIP, also increases renin secretion, and this increase is not blocked by renal denervation or propranolol. Thus, VIP may be a physiologically significant renin stimulating hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Epigenetics and cardiovascular disease

    Science.gov (United States)

    Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only...

  2. The Cardiovascular Research Grid (CVRG)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CardioVascular Research Grid (CVRG) project is creating an infrastructure for sharing cardiovascular data and data analysis tools. CVRG tools are developed using...

  3. Hematologia de tilápia-do-nilo alimentada com suplemento à base de algas frente a desafios de estresse agudo e crônico

    Directory of Open Access Journals (Sweden)

    F. Garcia

    2012-02-01

    Full Text Available Avaliou-se o efeito da suplementação com produto à base de algas, ergosan, em dietas para tilápias Oreochromis niloticus, submetidas ao desafio de estresse agudo e crônico sobre as características hematológicas. O ensaio foi realizado com tilápias jovens (15g em caixas de 500L de capacidade de estocagem, em sistema com recirculação da água, com fluxo constante, na densidade de 35 peixes por caixa. Os peixes foram alimentados com as dietas-teste durante 10 dias e, ao final deste período, voltaram a receber dieta isenta de ergosan, quando foram submetidos aos desafios de estresses agudo e crônico. Utilizou-se o delineamento inteiramente ao acaso (DIC, em esquema fatorial 4x2, sendo testados: quatro porcentagens do suplemento 0; 0,25; 0,5 e 1% de ergosan na ração em dois tipos de estresse, agudo e crônico. Os resultados permitem concluir que os estímulos de estresse aplicados foram capazes de provocar alterações fisiológicas nos peixes, incluindo redução no número de eritrócitos, eritroblastos e leucócitos e aumento do volume corpuscular médio dos eritrócitos. A administração oral de 1% de suplemento durante 10 dias para juvenis de tilápia-do-nilo, em condição de estresse agudo, induz o incremento de 69% no número de trombócitos circulantes.

  4. Fibrinolíticos y angioplastía en el manejo inicial del infarto agudo del miocardio con elevación del ST.

    OpenAIRE

    Salas Segura, Donato A

    2010-01-01

    El infarto con elevación del ST es el tercer componente de los síndromes coronarios agudos y el que se asocia a mayor morbilidad y mortalidad. Su principal estrategia de manejo constituye en abrir la arteria culpable y reestablecer el flujo coronario. Este objetivo se puede lograr utilizando fibrinolíticos o angioplastia. Este artículo revisa algunos aspectos importantes de ambas modalidades terapéuticas.

  5. Nonfasting hyperlipidemia and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, B G; Langsted, A; Freiberg, J J

    2009-01-01

    , total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...... of cardiovascular disease and early death....

  6. Modelos de serviços hospitalares para casos agudos em idosos Hospital services for acute care of elderly people

    Directory of Open Access Journals (Sweden)

    João Macedo Coelho Filho

    2000-12-01

    Full Text Available Embora a atenção ao idoso seja uma prioridade emergente no Brasil, pouca ênfase tem sido dada a modelos de organização de serviços hospitalares para pacientes geriátricos. São revisados modelos de serviços hospitalares para admissão e manuseio de casos agudos em idosos, com ênfase na discussão sobre o papel e o posicionamento da medicina geriátrica (incluindo sua interface com especialidades e com a clínica médica no âmbito da atenção hospitalar. Foi realizada pesquisa na base de dados Medline (1989-1999, bem como nos principais livros-texto de geriatria e de gerontologia, buscando identificar descrições de serviços hospitalares para cuidado agudo de pacientes idosos. As características dos modelos identificados foram compiladas e descritas à luz de sua adequação à realidade dos serviços de saúde no Brasil. Exemplos de intervenções em geriatria, com efetividade demonstrada através de revisões sistemáticas, foram também citadas. Os modelos mais freqüentemente relatados foram cuidado prolongado, tradicional, baseado na idade cronológica, não especializado e integrado. Adaptações e variantes de alguns desses modelos foram freqüentemente relatadas, assim como seu impacto potencial na efetividade do cuidado geriátrico. Evidências sobre o melhor modelo a seguir não foram identificadas, mas aqueles modelos favorecendo a integração da geriatria com a clínica geral pareceram mais adequados à nossa realidade. Ressalta a necessidade de reestruturação de serviços de saúde para responder às novas demandas que surgem com o envelhecimento da população, bem como do delineamento de serviços hospitalares para casos agudos, importantes para a efetividade do cuidado geriátrico e que devem ser objeto de maior debate e pesquisa no Brasil.Although the implementation of geriatric services is an emerging priority in Brazil, little emphasis has been put on the type of acute care that should be provided for elderly

  7. LA INFLAMACIÓN COMO FACTOR CAUSAL EMERGENTE DE LA ENFERMEDAD CARDIOVASCULAR

    Directory of Open Access Journals (Sweden)

    T. Fernández-Mora

    2007-06-01

    Full Text Available La ateroesclerosis está involucrada en el desarrollo de la enfermedad cardiovascular, una de las principales enfermedades de morbimortalidad en el mundo. Se han determinado una serie de factores de riesgo, tanto clásicos como emergentes, implicados en el desarrollo de esta enfermedad. Recientes investigaciones han demostrado que la inflamación juega un papel clave en el desarrollo de la ateroesclerosis. Las células del sistema inmune se encuentran presentes en todos los estadios de las lesiones arterioescleróticasy sus moléculas efectoras pueden acelerar la progresión de las lesiones y orquestar los mecanismos de inflamación inducidos en los síndromes coronarios agudos. La evidencia crítica implica a mediadores de la inmunidad tanto innata como adquirida en los diferentes estados de la ateroesclerosis. Dentro de loscomponentes inmunes involucrados en el proceso de la ateroesclerosis se encuentran componentes celulares como macrófagos, linfocitos, células dendríticas, mastocitos, células NK; componentes humoralescomo anticuerpos, citocinas proinflamatorias y moduladoras de la respuesta inmune, complemento, proteínas de fase aguda; y otros componentes como moléculas de adhesión y de choque térmico. A partirdel esclarecimiento del papel del sistema inmune en el desarrollo de la arterioesclerosis, han surgido una serie de perspectivas diagnósticas y terapéuticas para la enfermedad cardiovascular.

  8. Factores asociados a la demora prehospitalaria en hombres y mujeres con síndrome coronario agudo

    Directory of Open Access Journals (Sweden)

    A. Daponte-Codina

    2016-01-01

    Full Text Available Fundamento. Identificar factores asociados a la demora prehospitalaria en personas que han tenido un síndrome coronario agudo Material y métodos. Se estudiaron mediante encuesta pacientes ingresados por síndrome coronario agudo en los 33 hospitales públicos andaluces, obteniéndose información sobre diferentes tipos de variables: socio-demográficas, contextuales, clínicas, percepción, actuaciones, y transporte. Se aplicaron modelos de regresión logística multivariante para calcular las odds ratio para la demora. Resultados. De los 1.416 pacientes en total, más de la mitad tuvieron una demora superior a la hora. Se asocia a la distancia al hospital y al medio de transporte: cuando el evento ocurre en la misma ciudad del hospital, utilizar medios propios aumenta la demora, odds ratio= 1,51 (1,02-2,23; si la distancia es entre 1-25 kilómetros, no hay una diferencia entre medios propios y ambulancia, odds ratio = 1,41 y odds ratio = 1,43 respectivamente; y cuando supera los 25 kilómetros la ambulancia implica mayor demora, odds ratio = 3,13 y odds ratio = 2,20 respectivamente. Además, la sintomatología típica reduce la demora entre los hombres, pero la aumenta entre las mujeres. Asimismo, no darle importancia, esperar a la resolución de los síntomas, buscar atención sanitaria diferente a urgencias hospitalarias o al 061, tener antecedentes, encontrarse fuera de la vivienda habitual, y tener ingresos menores de 1.500 euros aumentan la demora. Tener síntomas respiratorios la reduce. Conclusiones. La demora prehospitalaria no se ajusta a las recomendaciones sanitarias, asociándose al entorno físico y social, a factores clínicos, y de percepción y actitudinales de los sujetos.

  9. Trastorno por estrés agudo: Presentación de un caso Acute stress disorder: Case report

    Directory of Open Access Journals (Sweden)

    A. Calzada Reyes

    2012-03-01

    Full Text Available El trastorno por estrés agudo puede ser secundario a una lesión grave o una amenaza a la integridad física. Ante este tipo de situación, el individuo responde con una serie de reacciones cognitivas, conductuales, emocionales y físicas todas ellas orquestadas por un órgano rector: el cerebro. Se presenta el caso de una paciente con un trastorno por estrés agudo que aparece tras ser agredida en su puesto laboral. Se trata de una mujer de 55 años, con antecedentes de un adecuado desempeño laboral, que después del evento traumático comienza a presentar cambios conductuales evidenciados por irritabilidad, miedo, ansiedad, nerviosismo y sobresaltos. No quiere salir sola a la calle, aqueja malestar al recordar el evento traumático y pérdida de su estabilidad emocional y laboral. Cuando se realiza la evaluación, la paciente se encontraba bajo tratamiento con antidepresivos y ansiolíticos. Se recomienda integrar estudios electrofisiológicos, psicofisiológicos y métodos de evaluación clinimétrica como complemento en el diagnóstico de esta entidad.Acute stress disorder may be the secondary to a serious injury or a threat to physical integrity. Given this situation, the individual responds with a series of cognitive, behavioral, emotional and physical reactions all orchestrated by a governing body: the brain. A case of a patient with acute stress disorder, which appears after being attacked in her job place, is presented. A 55-year old woman, with antecedents of adequate job performance, begins to show behavioral changes evidenced by irritability, fear, anxiety, nervousness and jumpiness after the traumatic event. She does not want to go alone into the street, explains malaise when remembering the traumatic event and loss of emotional and labour stability. At the time when the assessment is made, the patient was being treated with antidepressants and anxiolytics. It is recommended to integrate electrophysiological, psychophysiological

  10. [Multiculturalism and cardiovascular diseases].

    Science.gov (United States)

    Gaudio, Carlo; Corsi, Filippo; Esposito, Cosimo; Di Michele, Sara; Nguyen, Bich Lien; Khatibi, Shahrzad; Sciarretta, Tesir; Franchitto, Silvia; Mirabelli, Francesca; Pannarale, Giuseppe

    2004-01-01

    Immigration has increased drastically to the point of becoming an ordinary structure of our society. Once in Italy, the immigrant's health is compromised rapidly due to a series of conditions and illnesses that exist in our country: lack of work, inadequate salary, inappropriate residence, lacking family support, climate changes, nutritional differences. Cardiovascular illnesses represent 7.6% of the diseases of the immigrants, and cause 36.6% of deaths. The risk factors that affect the genesis of cardiovascular diseases include: subjective factors (age, ethnic group), environmental, nutritional and pathological (arterial hypertension, AIDS, tuberculosis, alcohol). The challenge for our time is to design a new solidarity model to promote cultural and social integration in order to meet the multiethnical and multiracial needs of western society. This model should permit reconsideration of doctor-patient relationship in order to build a real intercultural society.

  11. Migraine and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Marcelo E. Bigal

    2011-02-01

    Full Text Available Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis.

  12. Prodrugs in Cardiovascular Therapy

    Directory of Open Access Journals (Sweden)

    Maryam Tabrizian

    2008-05-01

    Full Text Available Prodrugs are biologically inactive derivatives of an active drug intended to solve certain problems of the parent drug such as toxicity, instability, minimal solubility and non-targeting capabilities. The majority of drugs for cardiovascular diseases undergo firstpass metabolism, resulting in drug inactivation and generation of toxic metabolites, which makes them appealing targets for prodrug design. Since prodrugs undergo a chemical reaction to form the parent drug once inside the body, this makes them very effective in controlling the release of a variety of compounds to the targeted site. This review will provide the reader with an insight on the latest developments of prodrugs that are available for treating a variety of cardiovascular diseases. In addition, we will focus on several drug delivery methodologies that have merged with the prodrug approach to provide enhanced target specificity and controlled drug release with minimal side effects.

  13. Slow breathing and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Ashish Chaddha

    2015-01-01

    Full Text Available Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  14. Slow breathing and cardiovascular disease.

    Science.gov (United States)

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  15. Cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Graversen, Peter; Abildstrøm, Steen Z; Jespersen, Lasse

    2016-01-01

    (ECG) abnormalities, heart rate, family history (of ischaemic heart disease), body mass index (BMI), waist-hip ratio, walking duration and pace, leisure time physical activity, forced expiratory volume (FEV)1%pred, household income, education, vital exhaustion, high-density lipoprotein (HDL......AIM: European society of cardiology (ESC) guidelines recommend that cardiovascular disease (CVD) risk stratification in asymptomatic individuals is based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, which estimates individual 10-year risk of death from CVD. We assessed...

  16. El impacto de la reducción del estrés en la hipertensión esencial y las enfermedades cardiovasculares. (Impact of stress reduction on essential hypertension and cardiovascular disease.

    Directory of Open Access Journals (Sweden)

    David W. Orme-Johnson

    2008-07-01

    Full Text Available ResumenSe ha considerado que el estrés contribuye a la patogénesis y la progresión de las enfermedades cardiovasculares (ECV. Se ha demostrado que la reducción del estrés mediante la Meditación Trascendental [Transcendental Meditation (TM®] ha bajado los niveles de presión arterial (PA y reducido el riesgo de ECV en adultos y adolescentes. Este artículo repasa los resultados que sugieren el impacto beneficioso de la TM en reducir la PA en adultos hipertensos en reposo y en adolescentes pre-hipertensos en reposo, durante un estrés agudo creado en el laboratorio y durante la actividad diaria normal. Dichos resultados tienen implicaciones importantes para la inclusión de la TM en los esfuerzos que se realizan para prevenir y tratar las ECV y sus consecuencias clínicas.AbstractStress has been thought to contribute to the pathogenesis and progression of cardiovascular diseases (CVD. Stress reduction via Trasncendental Meditation (TM® has been shown to lower blood pressure (BP levels and reduce CVD risk in adults and adolescents. This article reviews findings suggesting a beneficial BP-lowering impact of TM in hypertensive adults at rest and in pre-hypertensive adolescents at rest, during acute laboratory stress and during normal daily activity. These findings have important implications for inclusion of TM efforts to prevent and treat cardiovascular diseases and their clinical consequences.

  17. Terapia com células-tronco na síndrome do desconforto respiratório agudo Stem cell therapy in acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Tatiana Maron-Gutierrez

    2009-03-01

    Full Text Available A síndrome do desconforto respiratório agudo é caracterizada por uma reação inflamatória difusa do parênquima pulmonar, podendo ser induzida por um insulto direto ao epitélio alveolar (síndrome do desconforto respiratório agudo pulmonar ou indireto através do endotélio vascular (síndrome do desconforto respiratório agudo extrapulmonar. Acredita-se que uma terapia eficaz para o tratamento da síndrome do desconforto respiratório agudo deva atenuar a resposta inflamatória e promover adequado reparo da lesão pulmonar. O presente artigo apresenta uma breve revisão acerca do potencial terapêutico das células-tronco na síndrome do desconforto respiratório agudo. Essa revisão bibliográfica baseou-se em uma pesquisa sistemática de artigos experimentais e clínicos sobre terapia celular na síndrome do desconforto respiratório agudo incluídos nas bases de dados MedLine e SciELO nos últimos 10 anos. O transplante de células-tronco promove melhora da lesão inflamatória pulmonar e do conseqüente processo fibrótico, induzindo adequado reparo tecidual. Dentre os mecanismos envolvidos, podemos citar: diferenciação em células do epitélio alveolar e redução na liberação de mediadores inflamatórios e sistêmicos e fatores de crescimento. A terapia com células-tronco derivadas da medula óssea pode vir a ser uma opção eficaz e segura no tratamento da síndrome do desconforto respiratório agudo por acelerar o processo de reparo e atenuar a resposta inflamatória. Entretanto, os mecanismos relacionados à atividade antiinflamatória e antifibrogênica de tais células necessitam ser mais bem elucidados, limitando, assim, o seu uso clínico imediato.Acute respiratory distress syndrome is characterized by an acute pulmonary inflammatory process induced by the presence of a direct (pulmonary insult that affects lung parenchyma, or an indirect (extrapulmonary insult that results from an acute systemic inflammatory response

  18. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    2013-04-01

    Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

  19. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

  20. Efeito agudo do método de facilitação neuromuscular proprioceptiva na flexibilidade de bailarinas

    Directory of Open Access Journals (Sweden)

    Giane Andreia Souza Siqueira

    2013-11-01

    Full Text Available Objetivo: Verificar a resposta aguda do método de Facilitação Neuromuscular Proprioceptiva (FNP na flexibilidade e a influência das variáveis idade, peso, estatura em praticantes de Ballet Clássico. Método: A amostra foi composta por 11 bailarinas, com média de idade de 10,91 ± 0,79 anos praticantes regularmente de Ballet clássico duas vezes por semana com no mínimo de 5 anos de experiência. Foi utilizado o método de FNP nas bailarinas. Para avaliação da flexibilidade foi utilizado o Banco de Wells. Para analise estatística utilizou o teste de “t” de Student para amostras dependentes e análise de regressão Stepwise Forward com p≤0,05. Resultado:A diferença média de amplitude de movimento foi 4,81 ± 1,99 cm. Já a variável estatura demonstrou-se influenciar significativamente na flexibilidade. O método FNP demonstrou efeito agudo significativo na flexão de quadril em bailarinas.

  1. Abdomen agudo quirúrgico en el adulto mayor. Hospital Vladimir Ilich Lenin. Enero 2005 a enero 2008

    Directory of Open Access Journals (Sweden)

    Pavel Sánchez Reynaldo

    2010-01-01

    Full Text Available Aborda un estudio descriptivo prospectivo en 388 adultos mayores operados de abdomen agudo en el Hospital Vladimir Ilich Lenin, enero 2005 a enero 2008, a fin de caracterizar el comportamiento de las afecciones que provocan esta entidad intraabdominal. La tercera edad y el sexo masculino resultaron los más afectados. El factor de riesgo quirúrgico más asociado fue la hipertensión arterial. El diagnóstico preoperatorio más frecuente fue la oclusión intestinal mecánica. No se indicaron adecuadamente las investigaciones diagnósticas imprescindibles. Predominó el tiempo de evolución preoperatoria de 24 a 48 horas. El tiempo quirúrgico superior a 2 horas fue el más frecuente. Las complicaciones mediatas y el íleo paralítico predominaron. Fue más frecuente la estadía hospitalaria de 4 a 6 días. La letalidad fue de 15,72% y la causa de muerte predominante fue el shock séptico.

  2. Infarto agudo do miocárdio e morte súbita documentada Acute myocardial infarction and documented sudden death

    Directory of Open Access Journals (Sweden)

    Gustavo Carvalho

    2005-01-01

    Full Text Available Homem, sexagenário, deu entrada na emergência com dor torácica duvidosa e lipotímia. Investigado e estratificado, teve eletrocardiogramas e marcadores séricos de injúria miocárdica seriados negativos para isquemia miocárdica, e teste ergométrico sem critérios para isquemia miocárdica. Contudo, apresentou morte súbita presenciada dentro do hospital enquanto fazia uso da monitorização eletrocardiográfica contínua com o holter, que evidenciou, em seus traçados, infarto agudo do miocárdico complicado com arritmia ventricular complexa (taquicardia e fibrilação ventricular, que culminou em morte refratária às manobras de reanimação cardio-respiratória.A sexagenarian man sought the emergency unit complaining of dubious chest pain and lipothymia. He was investigated and stratified. His serial electrocardiograms and serum markers for myocardial injury were negative for myocardial ischemia, as was his exercise test. However, the patient died suddenly inside the hospital while under continuous electrocardiographic Holter monitoring, which evidenced acute myocardial infarction complicated by complex ventricular arrhythmia (ventricular tachycardia and fibrillation, which culminated in death refractory to the cardiopulmonary resuscitation maneuvers.

  3. Diagnósticos de enfermagem de pacientes hospitalizados com doenças cardiovasculares Diagnósticos de enfermería para pacientes hospitalizados com enfermedades cardiovasculares Nursing diagnoses for inpatients with cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Juliana de Melo Vellozo Pereira

    2011-12-01

    Full Text Available Objetivo: Identificar a frequência dos diagnósticos de enfermagem e características definidoras de pacientes com doenças cardiovasculares e caracterizá-los quanto às variáveis sociodemográficas e clínicas. Método: Estudo descritivo transversal realizado com 30 pacientes hospitalizados em um hospital de grande porte. Utilizou-se instrumento próprio validado para coleta de dados, que foram analisados por 5 peritos;, havendo concordância de 50%, sofreram análise estatística descritiva e inferencial. Resultados: Foram encontradas associações significativas com fatores Presença da Insuficiência Cardíaca, do Infarto Agudo do Miocárdio, da Dor, Sexo e Idade. Os diagnósticos mais frequentes foram: Ansiedade (76,7%, Dor Aguda (70,7%, Débito Cardíaco Diminuído (56,7%, Percepção Sensorial Perturbada - Visual (53,3%, Insônia (46,7%, Intolerância à Atividade (36,7%, Disfunção Sexual (36,7% e Eliminação Urinária Prejudicada (36,7%. Conclusão: a descrição dos diagnósticos de enfermagem contribui para a análise das respostas à doença cardiovascular, com foco no objeto de trabalho do enfermeiro, apresentando respostas à doença cardiovascular por meio de investigação holística.Objetivo: Identificar la frecuencia de los diagnósticos de enfermería y las características principales de los pacientes con enfermedades cardiovasculares y darles características cuanto a las variables sociodemográficas y clínicas. Método: Estudio descriptivo transversal realizado con 30 pacientes hospitalizados en un hospital de gran porte. Se utilizó instrumento propio validado para colecta de datos, estos fueron analizados por 5 peritos y, habiendo concordancia del 50%, sufrieron análisis estadística descriptiva e inferida. Resultados: fueron encontradas asociaciones significativas con los factores presencia de la insuficiencia cardíaca, del infarto agudo de miocardio, del dolor, sexo y edad. Los diagnósticos más frecuentes

  4. Cardiovascular physiology and sleep.

    Science.gov (United States)

    Murali, Narayana S; Svatikova, Anna; Somers, Virend K

    2003-05-01

    Sleep is a natural periodic suspension of consciousness during which processes of rest and restoration occur. The cognitive, reparative and regenerative accompaniments of sleep appear to be essential for maintenance of health and homeostasis. This brief overview will examine the cardiovascular responses to normal and disordered sleep, and their physiologic and pathologic implications. In the past, sleep was believed to be a passive state. The tableau of sleep as it unfolds is anything but a passive process. The brain's activity is as complex as wakefulness, never "resting" during sleep. Following the demise of the 'passive theory of sleep' (the reticular activating system is fatigued during the waking day and hence becomes inactive), there arose the 'active theory of sleep' (sleep is due to an active general inhibition of the brain) (1). Hess demonstrated the active nature of sleep in cats, inducing "physiological sleep" with electrical stimulation of the diencephalon (2). Classical experiments of transection of the cat brainstem (3) at midpontine level inhibited sleep completely, implying that centers below this level were involved in the induction of sleep (1, 4). For the first time, measurement of sleep depth without awakening the sleeper using the electroencephalogram (EEG) was demonstrated in animals by Caton and in humans, by Berger (1). This was soon followed by discovery of the rapid eye movement sleep periods (REM) by Aserinski and Kleitman (5), demonstration of periodical sleep cycles and their association with REM sleep (6, 7). Multiple studies and steady discoveries (4) made polysomnography, with its ability to perform simultaneous whole night recordings of EEG, electromyogram (EMG), and electrooculogram (EOC), a major diagnostic tool in study of sleep disorders. This facility has been of further critical importance in allowing evaluation of the interaction between sleep and changes in hemodynamics and autonomic cardiovascular control. Consequently the

  5. Osteoporosis y enfermedad cardiovascular

    OpenAIRE

    Sarahí Mendoza; Miriam Noa; Rosa Más

    2007-01-01

    Las enfermedades cardiovasculares (ECV) y la osteoporosis son causas frecuentes de morbilidad en la población adulta, cuya frecuencia aumenta con la edad, por lo que al aumentar la expectativa de vida, constituyen importantes problemas de salud. El riesgo a padecer ambas patologías depende de factores de riesgo, y la prevención consiste en controlar los modificables. Las ECV y la osteoporosis presentan factores etiológicos comunes que involucran la biosíntesis del colesterol y la oxidación li...

  6. Postnatal Cardiovascular Adaptation

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    Ferda Ozlu

    2016-06-01

    Full Text Available Fetus depends on placental circulation in utero. A successful transition from intrauterin to extrauterine life depends on succesful physiological changes during labor. During delivery, fetus transfers from a liquid environment where oxygen comes via umbilical vein to air environement where oxygenation is supported via air breathing. Endocrinological changes are important for fetus to adapt to extrauterine life. In addition to these, cord clemping plays a crucial role in postnatal adaptation. Establishment of neonatal postnatal life and succesful overcome, the fetal cardiovascular transition period are important to stay on. [Archives Medical Review Journal 2016; 25(2.000: 181-190

  7. Cardiovascular hypertensive emergencies.

    Science.gov (United States)

    Papadopoulos, D P; Sanidas, E A; Viniou, N A; Gennimata, V; Chantziara, V; Barbetseas, I; Makris, T K

    2015-02-01

    Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes.

  8. Fetal cardiovascular physiology.

    Science.gov (United States)

    Rychik, J

    2004-01-01

    The cardiovascular system of the fetus is physiologically different than the adult, mature system. Unique characteristics of the myocardium and specific channels of blood flow differentitate the physiology of the fetus from the newborn. Conditions of increased preload and afterload in the fetus, such as sacrococcygeal teratoma and twin-twin transfusion syndrome, result in unique and complex pathophysiological states. Echocardiography has improved our understanding of human fetal cadiovasvular physiology in the normal and diseased states, and has expanded our capability to more effectively treat these disease processes.

  9. Antioxidantes y enfermedad cardiovascular

    OpenAIRE

    Vázquez, Clotilde

    2004-01-01

    La enfermedad cardiovascular se mantiene como la más importante causa de morbi y mortalidad en la mayoría de los países desarrollados, siendo cada vez más frecuente en los países en vías de desarrollo. La orteroesclerosis es un enfermedad crónica de las arterias de mediano y gran calibre, caracterizadas por el endurecimiento y pérdida de elasticidad de su pared, que se acompaña de estrechamiento de su luz. En general, la lesión arteriosclerótica se desarrolla en tres fases: a) inici...

  10. Pharmacogenetics of cardiovascular drug therapy

    OpenAIRE

    Peters, Bas J.M.; Olaf H Klungel; de Boer, Anthonius; Ch Stricker, Bruno H; Maitland-van der Zee, Anke-Hilse

    2009-01-01

    In developed countries cardiovascular disease is one of the leading causes of death. Cardiovascular drugs such as platelet aggregation inhibitors, oral anticoagulants, antihypertensives and cholesterol lowering drugs are abundantly prescribed to reduce risk of cardiovascular disease. Notable interindividual variation exists in the response to these pharmacotherapeutic interventions, which can be partially explained by factors such as gender, age, diet, concomitant drug use and environmental f...

  11. Estudo da síntese de pró-fármacos dendriméricos potencialmente cardiovasculares contendo rosuvastatina e ácido acetilsalicílico

    OpenAIRE

    Andressa Polidoro

    2013-01-01

    Doenças cardiovasculares podem ocasionar manifestações clínicas graves como infarto agudo do miocárdio e acidentes vasculares trombóticos, constituindo a principal causa de morte no mundo, fato esse que desperta grande interesse da indústria farmacêutica. As causas normalmente estão relacionadas à elevação dos níveis de colesterol e à agregação plaquetária, que acarretam eventos vaso-oclusivos. Entre as alternativas terapêuticas para o controle e prevenção das doenças cardiovasculares podem-s...

  12. Oxidative Stress in Cardiovascular Disease

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    Gábor Csányi

    2014-04-01

    Full Text Available In the special issue “Oxidative Stress in Cardiovascular Disease” authors were invited to submit papers that investigate key questions in the field of cardiovascular free radical biology. The original research articles included in this issue provide important information regarding novel aspects of reactive oxygen species (ROS-mediated signaling, which have important implications in physiological and pathophysiological cardiovascular processes. The issue also included a number of review articles that highlight areas of intense research in the fields of free radical biology and cardiovascular medicine.

  13. El síndrome coronario agudo y otros diagnósticos provocan subregistro del infarto agudo del miocardio en el Hospital México, Costa Rica Coronary syndrome and other diagnosis result in under reporting of acute myocardial infarction in the Mexico Hospital, Costa Rica

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    Manuel Francisco Jiménez-Navarrete

    2013-03-01

    Full Text Available Justificación: el infarto agudo del miocardio es un problema mayor de salud pública. Es necesario verificar su adecuado registro en Costa Rica para atender eficientemente su problemática. Materiales y métodos: estudio descriptivo y observacional. Se recopilaron los pacientes egresados del Hospital México con diagnósticos de síndrome coronario agudo, infarto agudo del miocardio, angina inestable y cardiopatía isquémica, de agosto 2005 a julio 2006, analizándose los registros de la oficina de Bioestadística y Unidades (Coronaria, Terapia Intensiva, Hemodinamia y Ecocardiogramas. Resultados: el Hospital México reportó 110 pacientes con el diagnóstico de infarto agudo del miocardio. Al incluir egresados con diagnósticos de síndrome coronario agudo, angor inestable o cardiopatía isquémica y que eran infartos agudos del miocardio, el número aumentó a 172. La muestra analizada finalmente fue de 138 pacientes al eliminar el restante por datos incompletos, significando un subregistro de al menos 36%. El 78.1% fueron hombres y la edad promedio para ambos sexos fue 65.2 años. No se le midió la troponina al 49,3% de la muestra y la cuarta parte no fueron valorados por cardiólogos. El 20.3% de los pacientes que fueron egresados con otros diagnósticos eran portadores también de infarto agudo del miocardio. Conclusiones: existe subregistro de infarto agudo del miocardio en el Hospital México y en oficinas centrales del Ministerio de Salud y la Caja Costarricense de Seguro Social. Este hallazgo también es probable que se presente en otros hospitales costarricenses.Justification: Acute myocardial infarction is a major public health problem. In Costa Rica, it is necessary to record it accurately in order to handle this problem efficiently. Materials and methods: Descriptive and observational study. Data from patients which were discharged from the Mexico Hospital and diagnosed with acute coronary syndrome, acute myocardial infarction

  14. Cardiovascular benefits of exercise

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    Agarwal SK

    2012-06-01

    Full Text Available Shashi K AgarwalMedical Director, Agarwal Health Center, NJ, USAAbstract: Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460–377 BC wrote “in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one's strength and staying healthy, and the best way to do so is through physical exercise.” Plato (427–347 BC referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129–217 AD penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases.Keywords: exercise, cardiovascular disease, lifestyle changes, physical activity, good health

  15. Resveratrol and Cardiovascular Diseases

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    Dominique Bonnefont-Rousselot

    2016-05-01

    Full Text Available The increased incidence of cardiovascular diseases (CVDs has stimulated research for substances that could improve cardiovascular health. Among them, resveratrol (RES, a polyphenolic compound notably present in grapes and red wine, has been involved in the “French paradox”. RES is known for its antioxidant and anti-inflammatory properties and for its ability to upregulate endothelial NO synthase (eNOS. RES was able to scavenge •OH/O2•− and peroxyl radicals, which can limit the lipid peroxidation processes. Moreover, in bovine aortic endothelial cells (BAEC under glucose-induced oxidative stress, RES restored the activity of dimethylargininedimethylaminohydrolase (DDAH, an enzyme that degrades an endogenous inhibitor of eNOS named asymmetric dimethylarginine (ADMA. Thus, RES could improve •NO availability and decrease the endothelial dysfunction observed in diabetes. Preclinical studies have made it possible to identify molecular targets (SIRT-1, AMPK, Nrf2, NFκB…; however, there are limited human clinical trials, and difficulties in the interpretation of results arise from the use of high-dose RES supplements in research studies, whereas low RES concentrations are present in red wine. The discussions on potential beneficial effects of RES in CVDs (atherosclerosis, hypertension, stroke, myocardial infarction, heart failure should compare the results of preclinical studies with those of clinical trials.

  16. Cardiovascular Complications of Pregnancy

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    Maria Carolina Gongora

    2015-10-01

    Full Text Available Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia, gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  17. Cardiovascular Complications of Pregnancy.

    Science.gov (United States)

    Gongora, Maria Carolina; Wenger, Nanette K

    2015-10-09

    Pregnancy causes significant metabolic and hemodynamic changes in a woman's physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  18. Atención farmacéutica en personas que han sufrido episodios coronarios agudos (estudio TOMCOR

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    Álvarez de Toledo Flor

    2001-01-01

    Full Text Available Fundamento: Este estudio valora los efectos de un nuevo modelo de trabajo en las farmacias, denominado Atención Farmacéutica, frente al modelo tradicional. Se pretende conocer su factibilidad y las diferencias, potencialmente debidas a la Atención Farmacéutica, respecto de los resultados de salud de la farmacoterapia usada, en una muestra de pacientes que han sufrido episodios coronarios agudos. Métodos: Es un estudio prospectivo con un grupo de intervención (330 personas y un grupo control (405 personas, realizado en 83 farmacias de Asturias, Barcelona, Madrid y Vizcaya, en las que se hizo seguimiento durante un año del uso de medicamentos en 735 personas, de las cuales finalizaron el estudio 600. Resultados: Hubo diferencias favorables al grupo intervención, respecto de: a uso de servicios sanitarios indicativos de mayor morbilidad, tales como la frecuencia de consultas hospitalarias urgentes por paciente 1,27Interv. (IC95 %:1,10 a 1,44 y 1,63Contr.(IC95 %:1,36 a 1,90 o los días promedio de UCI por paciente hospitalizado: 2,46Interv.(IC95 %:1,56 a 3,36 y 5,87Contr.(IC95 %: 3,57 a 8,17, por causa cardiológica; b calidad de vida con diferencia de 4,7 (p < 0,05 en la dimensión de función física; c conocimiento de factores de riesgo de enfermedad coronaria, promedio de +10 % (p < 0,02 - 0,07, según dimensión; d identificación nominal de los medicamentos usados +10 % (p < 0,01; importancia subjetiva otorgada a los antiagregantes + 12 % (p < 0,009, los beta-bloqueantes, así como sus efectos +25 % (p < 0,02; y e satisfacción con la AF y percepción de la competencia profesional, promedio de + 12 % (p < 0,000 - 0,05, según dimensión. Conclusiones: Los valores menores de: demanda individual urgente coronaria, frecuencia de hospitalizaciones y número de días de Unidad de Cuidados Intensivos coronaria por hospitalización, sugerirían que los pacientes que tras un episodio coronario agudo reciben Atención Farmacéutica tienden a

  19. Atención farmacéutica en personas que han sufrido episodios coronarios agudos (estudio tomcor

    Directory of Open Access Journals (Sweden)

    Flor Álvarez de Toledo

    2001-01-01

    Full Text Available Fundamento: Este estudio valora los efectos de un nuevo modelo de trabajo en las farmacias, denominado Atención Farmacéutica, frente al modelo tradicional. Se pretende conocer su factibilidad y las diferencias, potencialmente debidas a la Atención Farmacéutica, respecto de los resultados de salud de la farmacoterapia usada, en una muestra de pacientes que han sufrido episodios coronarios agudos. Métodos: Es un estudio prospectivo con un grupo de intervención (330 personas y un grupo control (405 personas, realizado en 83 farmacias de Asturias, Barcelona, Madrid y Vizcaya, en las que se hizo seguimiento durante un año del uso de medicamentos en 735 personas, de las cuales finalizaron el estudio 600. Resultados: Hubo diferencias favorables al grupo intervención, respecto de: a uso de servicios sanitarios indicativos de mayor morbilidad, tales como la frecuencia de consultas hospitalarias urgentes por paciente 1,27Interv. (IC95 %:1,10 a 1,44 y 1,63Contr.(IC95 %:1,36 a 1,90 o los días promedio de UCI por paciente hospitalizado: 2,46Interv.(IC95 %:1,56 a 3,36 y 5,87Contr.(IC95 %: 3,57 a 8,17, por causa cardiológica; b calidad de vida con diferencia de 4,7 (p < 0,05 en la dimensión de función física; c conocimiento de factores de riesgo de enfermedad coronaria, promedio de +10 % (p < 0,02 - 0,07, según dimensión; d identificación nominal de los medicamentos usados +10 % (p < 0,01; importancia subjetiva otorgada a los antiagregantes + 12 % (p < 0,009, los beta-bloqueantes, así como sus efectos +25 % (p < 0,02; y e satisfacción con la AF y percepción de la competencia profesional, promedio de + 12 % (p < 0,000 – 0,05, según dimensión. Conclusiones: Los valores menores de: demanda individual urgente coronaria, frecuencia de hospitalizaciones y número de días de Unidad de Cuidados Intensivos coronaria por hospitalización, sugerirían que los pacientes que tras un episodio coronario agudo reciben Atención Farmacéutica tienden a

  20. Heparinas de bajo peso molecular en el tratamiento de los síndromes coronarios agudos (SCA

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    Mario Speranza Sánchez

    1999-09-01

    Full Text Available Los síndromes coronarios agudos (SCA están comprendidos entre la angina crónica estable y el infarto agudo del miocardio (IAM en el espectro clínico de la enfermedad arterial coronaria (EAC, pero biológicamente refleja la EAC en su forma más peligrosa. Mientras que la mortalidad por IAM ha caído en los últimos años la frecuencia de hospitalización por angina inestable (Al continúa en aumento, esto probablemente refleje un incremento en el número total de sobrevivientes con EAC más compleja, quienes han sobrevivido más tiempo debido a los avances en el tratamiento de la misma. Por lo tanto es probable que el problema de los (SCA sea más frecuente en el futuro. Nuevas modalidades diagnósticas y terapéuticas hacen posible ser más precisos en el control de los pacientes y así lograr mejorar la sobrevida, prevenir el IAM, reducir la estancia hospitalaria y las complicaciones secundarias de la isquemia crónica. El tratamiento antitrombótico con heparina regular más aspirina reduce la frecuencia de eventos isquémicos en pacientes con SCA. Las Heparinas de Bajo Peso Molecular son una nueva clase de anticoagulantes que están reemplazando a la heparina regular en muchas indicaciones, tienen un efecto anticoagulante más predecible que la heparina, son más fáciles de administrar y en general no necesitan de monitoreo de laboratorio. En ésta revisión se resume y comentan los principales hallazgos en éste tema.The acute ischemic syndrome falls between chronic stable angina and acute myocardial infarction (MI in the clinical spectrum of coronary artery diseatse (CAD, but biologically reflects CAD in its most dangerous form. While the death rate from Mi has fallen in recent years, the rate of hospitalization for unstable angina continues to rise, this likely reflects an increase in the total number of CAD survivors with complex coronary disease, who are living longer due to advances in CAD management. lt is therefore likely that

  1. Comportamiento clínico epidemiológico del absceso dentoalveolar agudo en pacientes pertenecientes al área VII de Cienfuegos

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    Ana Belkys Hernández Millán

    2015-02-01

    Full Text Available Fundamento: el absceso dentoalveolar agudo es una de las urgencias estomatológicas y una de las principales enfermedades que afectan a la población, sin embargo existen muy pocos estudios sobre el tema.Objetivo: describir comportamiento clínico epidemiológico del absceso dentoalveolar agudo en pacientes pertenecientes al área VII, de Cienfuegos. Métodos: investigación observacional, descriptiva realizada de enero a diciembre de 2013 en el Área VII, de Cienfuegos. El universo fue de 672 pacientes y la muestra de 374, escogida mediante muestreo probabilístico aleatorio simple. El registro primario de datos y recolección de la información se obtuvo mediante la historia clínica individual previo consentimiento informado a los pacientes. Las principales variables fueron: edad, sexo, irritantes pulpares.Resultados: el sexo más afectado fue el femenino con 55,35 % y el grupo de edad el de 19 a 34 con 33,69 %.El irritante pulpar predominante fue el microbiano 59,36 %. Dentro de los factores iatrogénicos, los restos de tejidos cariados se destacaron con un 32,35 %.Conclusiones: existe un número elevado de pacientes con absceso dentoalveolar agudo, por lo que, como urgencia estomatológica, debe ser una preocupación del estomatólogo conocer las características, comportamiento y factores que desarrollan la enfermedad, para propiciar un trabajo integral en cuanto a la promoción de salud, prevención, curación y rehabilitación de los pacientes afectados.

  2. Daño pulmonar agudo relacionado con la transfusión (Trali y Bartonelosis aguda

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    Douglas López de Guimaraes

    2006-07-01

    Full Text Available Se presenta el caso de un varón de 22 años procedente de la periferia de la ciudad de Huaraz, Perú, que acude al Hospital "Victor Ramos Guardia" de Huaraz con un tiempo de enfermedad de 14 días, febril, pálido e ictérico, en el frotis de sangre periférica se encuentran formas bacilares de Bartonella bacilliformis en 99% de la lámina; se inicia tratamiento antibiótico con ceftriaxona y ciprofloxacino. Al día siguiente se le indica transfusión de dos paquetes globulares (puesto que tenía 6,2 g/dL de Hb, dos horas después presenta dolor toráxico, tos seca exigente, vómitos, dificultad respiratoria y cianosis, en la auscultación se encuentran roncantes y crepitantes, la radiografía de tórax muestra infiltrado alveolar difuso a predominio derecho. Es trasladado a la UCI donde recibe oxígeno con máscara de reservorio, dopamina, corticoides y se inicia el monitoreo hemodinámico; responde en forma satisfactoria, sale de alta con frotis negativo a Bartonella bacilliformis. Es el primer caso de daño pulmonar agudo relacionado con la transfusión (TRALI asociado con Bartonelosis aguda con cuadro clínico - radiológico y evolución compatible, es importante distinguir entre la complicación pulmonar debido a la sepsis grave por Bartonelosis aguda, que puede producir un cuadro clínico similar y el TRALI.

  3. Factores de estrés y apoyo psicosocial en pacientes con infarto agudo de miocardio. Cali, 2001-2002.

    Directory of Open Access Journals (Sweden)

    Carlos A. Reyes

    2009-11-01

    Full Text Available INTRODUCCIÓN: Se realizó un estudio descriptivo con grupo control para evaluar los factores de estrés y apoyo social en personas mayores de 60 años con infarto agudo de miocardio (IAM. MÉTODOS: Se estudiaron 40 pacientes y 38 personas sanas evaluando depresión, disfunción familiar, estrés social y prácticas religiosas. Se realizó análisis estadístico univariado y bivariado. RESULTADOS: Los grupos fueron comparables para las variables sociodemográficas. Se observó que 21 (26.9% individuos tenían antecedente personal de IAM y 29 (37.2% no tenían pareja estable; estas dos condiciones se vio con mayor frecuencia en el grupo de pacientes con IAM (p=0.001, p=0.007. La disfunción familiar, la depresión y los eventos de cambio de vida no mostraron diferencias entre los grupos. El no realizar lectura en grupo de la Biblia (p=0.03 u otras actividades religiosas (p=0.001 fue más frecuente en el grupo de pacientes con IAM; en contraste, la lectura personal de la Biblia de manera diaria fue más frecuente en los sanos (p=0.009. CONCLUSIONES: El no tener pareja estable o no realizar actividades religiosas fue más frecuente en pacientes con IAM. Este estudio sugiere que la práctica religiosa puede ser un recurso de apoyo importante para la salud de los pacientes ancianos.

  4. Terapia ocupacional en un hospital general de pacientes agudos = Occupational therapy in a general hospital for acute pacients

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    Ocello, M. G

    2006-09-01

    Full Text Available RESUMEN Desde su creación, el Hospital Provincial “Dr. José María Cullen” posee la característica de ser un hospital de emergencias, sostenido por la Sociedad de Beneficencia y la Hermanas de la Caridad.Su funcionamiento responde a un Modelo Clínico-Asistencial, lo cual influye en la inserción de Terapia Ocupacional debiendo adaptar sus funciones a las características de la Institución.Los marcos de referencia teóricos y programas que se implementandeber ser acordes con las necesidades surgidas de un Hospital General de Agudos y de emergencias.En el Sector de Terapia Ocupacional se desarrolla la actividad docente cumpliendo con los requisitos reglamentados por el Ministerio de Salud de la Provincia de Santa Fe.ABSTRACT Ever since its start the Provincial Hospital “Dr. José María Cullen” is characterised for being an emergency hospital under the guidance of the Benfit Society of Hermanas de la Caridad.Its function responds to a Clinical Assistential Model, which influences the insertion of Occupational Therapy, adapting its functiones to the characteristics of the Institution as and when called for.The theoretical points of reference and programmes that are used must be in accordance with tehe necessities that appear in an Acute and Emergency General Hospital.In the Occupational Therapy Sector the teaching activity is developed as required by rules and regulations of the Ministry of Health for the Province of Santa Fe.

  5. Sistema informático para la gestión de la información hospitalaria del infarto agudo de miocardio (RHIMA

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    Yanier Coll Muñoz

    2015-10-01

    Full Text Available Introducción: La difícil recopilación de información sobre la prevalencia y desarrollo del infarto agudo de miocardio imposibilita medir la calidad del tratamiento durante la evolución de la enfermedad en un determinado grupo de pacientes.Objetivo: Desarrollar un sistema informático que permita la gestión de la información hospitalaria del infarto agudo de miocardio en el Servicio de Cardiología.Método: Se identificaron las variables necesarias para la confección del registro, divididas por bloques relacionados con la atención prehospitalaria, el síndrome coronario agudo, la atención en Unidades de Cuidados Coronarios y el egreso. Se creó un sistema informático que utiliza NetBeans como IDE de programación, Apache como servidor web y la base de datos en MySQL; como lenguaje de programación se utilizó PHP con la infraestructura digital (framework Yii del lado del servidor y JavaScript con el framework ExtJs 4.1.1 del lado del cliente. Como modelador de base de datos se utilizó ER/Studio.Resultados: Se conformó el Registro Hospitalario de Infarto Agudo de Miocardio (RHIMA para su aplicación en el Hospital Gustavo Aldereguía Lima de Cienfuegos, Cuba; se lograron obtener datos estadísticos inmediatos que permitieron realizar un análisis de la atención a los pacientes con esta enfermedad.Conclusiones: Se desarrolló un sistema informático web capaz de gestionar la información del IAM. Su diseño, acorde al Sistema Nacional de Salud de Cuba, tiene en cuenta las características epidemiológicas y demográficas de la población cubana y brindan indicadores de calidad en la terapéutica para el registro de la información del IAM, ajustadas a las recomendaciones de las principales Guías de Práctica Clínica.

  6. O problema do trabalho infantil na agricultura familiar: o caso da produção de tabaco em Agudo-RS

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    Joel Orlando Bevilaqua Marin

    2012-12-01

    Full Text Available O objetivo do artigo é analisar a emergência do problema do trabalho infantil no cultivo de tabaco em Agudo, desencadeado pela promulgação do Decreto n. 6.481/2008, que trata das piores formas de trabalho infantil. Os procedimentos metodológicos utilizados foram a revisão bibliográfica, pesquisa documental e um estudo de caso, realizado no município de Agudo, Rio Grande do Sul. No estudo de caso, procurou-se obter dados quantitativos e qualitativos, por meio de questionários e entrevistas abertas, dirigidos para 27 agricultores familiares fumicultores, com filhos com menos de 18 anos de idade. Os resultados da pesquisa indicam a existência de um confronto entre diferentes concepções sobre o trabalho da criança no âmbito da agricultura familiar. Os dispositivos legais, os termos de compromissos e os contratos de integração na cadeia produtiva do fumo proíbem o trabalho de menores de 18 anos, fundamentando-se nos princípios internacionais da garantia do pleno desenvolvimento das crianças. Na perspectiva das famílias, o trabalho das crianças é entendido como "ajuda", forma de socialização e formação dos herdeiros. Portanto, os pais não concordam que se trata de uma forma perversa de exploração do trabalho dos próprios filhos.The aim of this paper is to analyze the emergence of the child labor problem in tobacco growing in Agudo (Rio Grande do Sul state, triggered by the promulgation of Act 6.481/2008, which addresses the worst child labor conditions. The methodological procedures used were the literature review, desk research and a case study, conducted in the municipality of Agudo. In the case study, we have tried to obtain quantitative and qualitative data through questionnaires and open interviews directed to 27 tobacco growers, and with teenagers and children under 18 years old. The survey results indicate the existence of a clash between different conceptions of child labor in small scale family farmers. The legal

  7. Prevalencia y factores de riesgo del estado confusional agudo en el adulto mayor en una sala de emergencias médicas.

    OpenAIRE

    LAMA VALDIVIA, Jaime; Varela Pinedo, Luis; Ortiz Saavedra, Pedro José

    2013-01-01

    Objetivo: Determinar la prevalencia del síndrome confusional agudo y los factores de riesgo para su aparición en pacientes ancianos admitidos en el servicio de emergencia de un hospital nacional. Material y métodos: Se estudiaron todos los pacientes mayores de 60 años admitidos por el servicio de emergencia del Hospital Nacional Hipólito Unanue de Lima (Perú), durante el periodo: enero - abril del 2000. Para el diagnóstico del síndrome confusional empleamos el Confusion Assessment Method. Fue...

  8. El pretratamiento agudo y subcrónico con fármacos anticonvulsivantes modifica las crisis generalizadas inducidas por el pentilenetetrazol en el ratón

    Directory of Open Access Journals (Sweden)

    Luisa L. Rocha

    2008-09-01

    Full Text Available Objetivo: El incremento en el contenido de GABA cerebral o la administración de un agente GABA-mimético se emplea como un tratamiento antiepiléptico eficaz. Sin embargo, se sugiere que el empleo de fármacos que alteran continuamente la transmisión sináptica puede afectar al sistema nervioso. En el presente estudio se evaluaron los efectos del pretratamiento agudo (una administración y subcrónico (administraciones diarias por 7 días de diazepam (DZP; 10 mg/kg, ip, gabapentina (GBP, 100 mg/kg, vo y vigabatrina (VGB, 500 mg/kg, vo en las crisis generalizadas inducidas por pentilenetetrazol (PTZ, 80 mg/kg ip.Materiales y métodos: Ratones macho de la cepa taconic (20-25 g recibieron tratamiento agudo y subcrónico de DZP, GBP o VGB y 24 h después de la última administración se aplicó PTZ. Se evaluaron las latencias a la primera crisis clónica, a la fase tónica así como la incidencia de muerte.Resultados: El pretratamiento agudo con DZP protegió 100% a los animales de los efectos del PTZ, mientras que su administración subcrónica redujo la latencia a la crisis clónica (21%; p<0.05, la fase tónica (27%, p<0.05 y muerte (37%, p<0.05. La aplicación aguda de VGB protegió 100% a los animales de los efectos del PTZ, mientras que su aplicación subcrónica aumentó la latencia a las crisis clónicas (32%, p<0.05, aunque facilitó la aparición de la crisis tónica (55%, p<0.05 y la muerte (58%, p<0.05. La administración aguda de GBP elevó la latencia a la crisis clónica (52%, p<0.05, mientras que su administración subcrónica no modificó el efecto producido por PTZ.Conclusiones: Estos resultados sugieren que el pretratamiento agudo y subcrónico de fármacos que incrementan la transmisión GABAérgica modifican diferencialmente la susceptibilidad a las crisis por PTZ y que su administración repetida puede facilitar la producción de crisis convulsivas.

  9. Psicoterapia dinámica breve realizada en una unidad de agudos hospitalaria de salud mental. A propósito de un caso.

    Directory of Open Access Journals (Sweden)

    María Luisa Gutiérrez López

    2011-01-01

    Full Text Available Se expone una experiencia en psicoterapia inámica breve realizada en un varón de 48 años,ingresado en una Unidad de Agudos Hospitalaria de Salud Mental. Modelo de psicoterapia breve dirigida a trabajar la afectividad del paciente, haciendo del sentimiento el foco terapéutico y de la adquisición de un mejor manejo de éstos, el objetivo principal. Con el propósito de obtener herramientas psicoterapéuticas útiles allí donde la limitación temporal es un hándicap fundamental.

  10. Hiperalimentação enteral em traumatismos crânio-encefálicos agudos reposição ou dietoterapia?

    Directory of Open Access Journals (Sweden)

    Arthur Schelp

    1992-06-01

    Full Text Available Os autores apresentam revisão geral sobre a fisiopatogenia do trauma, ressaltando os estados de hipereatabolismo e hipermetabolismo, suas consequências nutricionais, com as particularidades do trauma encefálico. São feitas, também, considerações sobre as vias, composição e volumes das dietas enterais a serem administradas a pacientes com trauma agudo encefálico, assim como são apontadas questões a serem melhor elucidadas.

  11. Tratamiento del dolor agudo de intensidad leve a moderado con lisinato de ibuprofeno: estudio observacional Management of mild to moderate acute pain with ibuprofen lysinate: an observational study

    OpenAIRE

    2004-01-01

    Objetivos: Estudiar la efectividad y el perfil de seguridad de lisinato de ibuprofeno en el tratamiento del dolor agudo de intensidad leve a moderada en condiciones asistenciales reales. Material y métodos: Estudio abierto, multicéntrico, observacional y prospectivo, realizado en condiciones de uso habitual. El número de investigadores participantes fue de 263, los cuales reclutaron 1.435 pacientes, entre julio de 2001 y julio de 2002. Los pacientes eran de origen ambulatorio, de edad ≥ 18...

  12. Síndrome de Distrés Respiratorio Agudo: Utilidad de los Corticoides Acute respiratory distress syndrome: Role of steroids

    OpenAIRE

    Célica L. Irrazábal; Abelardo A. Capdevila; Carlos Sosa; Marina C. Khoury; Miguel A. Jorge; Carlos R. Gherardi

    2004-01-01

    En Argentina, el síndrome de distrés respiratorio agudo (SDRA) representa el 7.7% de las admisiones en terapia intensiva y está asociado con una alta morbilidad y mortalidad (58%). Con frecuencia la muerte puede ser atribuida a más de una causa. La hipoxemia refractaria es una causa de muerte poco frecuente (15%) y en muchos casos puede coexistir con disfunción multiorgánica, sepsis o shock séptico. La utilidad de los esteroides como parte del tratamiento es aún motivo de debate a pesar de la...

  13. Cheese and cardiovascular disease risk

    DEFF Research Database (Denmark)

    Hjerpsted, Julie Bousgaard; Tholstrup, Tine

    2016-01-01

    Abstract Currently, the effect of dairy products on cardiovascular risk is a topic with much debate and conflicting results. The purpose of this review is to give an overview of the existing literature regarding the effect of cheese intake and risk of cardiovascular disease (CVD). Studies included...

  14. Desarrollo de un modelo de ajuste por el riesgo para el infarto agudo de miocardio en España: comparación con el modelo de Charlson y el modelo ices. Aplicaciones para medir resultados asistenciales

    OpenAIRE

    Juan Manuel Sendra Gutiérrez; Antonio Sarría-Santamera; Jesús Iñigo Martínez

    2006-01-01

    Fundamento: El infarto agudo de miocardio representa una importante carga de morbimortalidad en los países desarrollados. El objetivo de este trabajo es desarrollar un modelo de ajuste por el riesgo para evaluar los resultados del manejo de esta patología y comparar su desempeño con otros modelos. Métodos: Se desarrolla un modelo de ajuste de riesgo para el infarto agudo de miocardio mediante regresión logística con la información de una base de datos administrativa de ho...

  15. Indian poverty and cardiovascular disease.

    Science.gov (United States)

    Ramaraj, Radhakrishnan; Alpert, Joseph Stephen

    2008-07-01

    Cardiovascular disease is among the world's leading causes of death, and nearly 80% of deaths occur in developing countries. Cardiovascular disease is becoming a major health problem in India, where life expectancy has increased with decreases in infectious disease and childhood mortality. It is well established that this population experiences coronary artery disease at a younger age than other populations. With infectious diseases still endemic, noncommunicable diseases are a lower priority for the governments of developing countries. There is a clear progression to degenerative and lifestyle-related diseases such as cardiovascular disease as a result of current social and economic change. The lack of a public response to the increasing risk for cardiovascular disease thus far is due mostly to a perception among policy makers and the public that cardiovascular disease is largely a problem of the urban rich. In conclusion, this review addresses the imminent threats and ways to tackle the epidemic in India.

  16. Assessment of cardiovascular risk.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-10-01

    Atherosclerotic cardiovascular disease (CVD) is the most common cause of death worldwide. Usually atherosclerosis is caused by the combined effects of multiple risk factors. For this reason, most guidelines on the prevention of CVD stress the assessment of total CVD risk. The most intensive risk factor modification can then be directed towards the individuals who will derive the greatest benefit. To assist the clinician in calculating the effects of these multiple interacting risk factors, a number of risk estimation systems have been developed. This review address several issues regarding total CVD risk assessment: Why should total CVD risk be assessed? What risk estimation systems are available? How well do these systems estimate risk? What are the advantages and disadvantages of the current systems? What are the current limitations of risk estimation systems and how can they be resolved? What new developments have occurred in CVD risk estimation?

  17. Cardiovascular complications in acromegaly.

    Science.gov (United States)

    Vitale, G; Pivonello, R; Lombardi, G; Colao, A

    2004-09-01

    Cardiovascular morbidity and mortality are increased in acromegaly. In fact, GH and IGF-I excess induces a specific cardiomyopathy. The early stage of acromegaly is characterized by the hyperkinetic syndrome (high heart rate and increased systolic output). Frequently, concentric biventricular hypertrophy and diastolic dysfunction occur in acromegaly, leading to an impaired systolic function ending in heart failure if the disease is untreated or unsuccessfully untreated. Besides, abnormalities of cardiac rhythm and of valves have been also described in acromegaly. The coexistence of other complications, such as arterial hypertension and diabetes, aggravates the acromegalic cardiomyopathy. The suppression of GH/IGF-I following an efficacious therapy could decrease left ventricular mass and improve cardiac function. In conclusion, a careful evaluation of cardiac function, morphology and activity seems to be mandatory in acromegaly.

  18. Cardiovascular diseases and diabetes

    DEFF Research Database (Denmark)

    Green, A.; Sortso, C.; Jensen, Peter Bjødstrup

    2016-01-01

    We present an investigation of the occurrence of cardiovascular disease in patients with diabetes in Denmark 2000 through 2011. The Diabetes Impact Study 2013 is based on all registrants in the Danish National Diabetes Register as of July 3rd 2013 (n=497,232). Record linkage with the Danish...... of diabetes has been rather constant at higher level in males (around 16-18%) than in females (around 12-14%) during 2000-2011 (incl.). In contrast, the incidence rate of CVD after having diabetes diagnosis has declined from about 4.5 to less than 3 during the same period, with higher declining level...... for males than for females. Efforts to detect diabetes at an earlier stage have not resulted in a reduced occurrence of CVD at the diagnosis of diabetes in Denmark. However, the risk of developing CVD after the diagnosis of diabetes has been declining, possibly reflecting benefits of intensified treatment...

  19. Cardiovascular Magnetic Resonance Imaging

    Science.gov (United States)

    Pelc, Norbert

    2000-03-01

    Cardiovascular diseases are a major source of morbidity and mortality in the United States. Early detection of disease can often be used to improved outcomes, either through direct interventions (e.g. surgical corrections) or by causing the patient to modify his or her behavior (e.g. smoking cessation or dietary changes). Ideally, the detection process should be noninvasive (i.e. it should not be associated with significant risk). Magnetic Resonance Imaging (MRI) refers to the formation of images by localizing NMR signals, typically from protons in the body. As in other applications of NMR, a homogeneous static magnetic field ( ~0.5 to 4 T) is used to create ``longitudinal" magnetization. A magnetic field rotating at the Larmor frequency (proportional to the static field) excites spins, converting longitudinal magnetization to ``transverse" magnetization and generating a signal. Localization is performed using pulsed gradients in the static field. MRI can produce images of 2-D slices, 3-D volumes, time-resolved images of pseudo-periodic phenomena such as heart function, and even real-time imaging. It is also possible to acquire spatially localized NMR spectra. MRI has a number of advantages, but perhaps the most fundamental is the richness of the contrast mechanisms. Tissues can be differentiated by differences in proton density, NMR properties, and even flow or motion. We also have the ability to introduce substances that alter NMR signals. These contrast agents can be used to enhance vascular structures and measure perfusion. Cardiovascular MRI allows the reliable diagnosis of important conditions. It is possible to image the blood vessel tree, quantitate flow and perfusion, and image cardiac contraction. Fundamentally, the power of MRI as a diagnostic tool stems from the richness of the contrast mechanisms and the flexibility in control of imaging parameters.

  20. Impacto de las enfermedades autoinmunes en el manejo y pronóstico del síndrome coronario agudo

    OpenAIRE

    Lozano Rivas, Nuria L

    2016-01-01

    ntroducción: Los pacientes con enfermedades autoinmunes (EAI) presentan una carga importante de afectación cardiovascular que conducen tanto a una morbilidad como a una mortalidad prematura. Pero no queda claro si ello se debe a una mayor prevalencia de enfermedad cardiovascular establecida, a una mayor letalidad en la presentación de los casos o bien a un manejo diferente durante el episodio índice. Objetivos: El objetivo primario del estudio fue determinar las implicaciones pronósticas d...

  1. Obesidad e indicadores antropométricos en una muestra de varones con Síndrome Coronario Agudo, en un Área de Salud que incluye reclusos: estudio caso-control

    Directory of Open Access Journals (Sweden)

    A. Martín-Castellanos

    2015-06-01

    Full Text Available Objetivos: la obesidad es un factor de riesgo cardiovascular con alta prevalencia, y relacionado con la cardiopatia isquemica. El objetivo fue analizar mediante antropometria, una muestra de varones con Síndrome Coronario Agudo (SCA diagnosticado en un hospital de referencia penitenciaria, y un grupo control. Material y método: estudio caso-control en un Área de Salud que integraba a un Centro Penitenciario. Los participantes fueron 204 varones, 102 infartados y un control por cada caso. Se midió peso, talla, cintura minima (CC, cintura umbilical (CU y cadera. Se calcularon el IMC y otros indicadores. Se realizo un análisis descriptivo y se obtuvieron las áreas bajo la curva (ABC "receiver operating characteristich", las odds ratio (OR, y las correlaciones en SCA. Resultados: la obesidad presentó mayor prevalencia en SCA (31,4% vs 9,1%; OR: 4,7, otros indicadores mostraron asociación discriminatoria: IMC (ABC: 0,699; OR: 3,9, CC (ABC: 0,750; OR: 6,3, CU (ABC: 0,777; OR: 10, talla inversa (ABC: 0,619; OR: 2,1, índice cintura/cadera (ABC: 0,832; OR: 11,6; índice CU/cadera (ABC: 0,857; OR: 15,6, índice CU/talla (ABC: 0,800; OR: 8,9. Las correlaciones entre las cinturas y los índices cintura-talla fueron fuertes (todas r >0,90; p <0,001. Discusión: los indicadores antropométricos de obesidad están asociados al SCA. La CU es la medida simple más asociada. El IMC presenta una asociación débil; el índice CU/talla presenta alto poder discriminatorio y la mejor correlación antropométrica de riesgo, apoyando su uso en la identificación de varones con riesgo de infarto de miocardio tanto en la población general como penitenciaria.

  2. Nrf2 and cardiovascular defense.

    Science.gov (United States)

    Howden, Reuben

    2013-01-01

    The cardiovascular system is susceptible to a group of diseases that are responsible for a larger proportion of morbidity and mortality than any other disease. Many cardiovascular diseases are associated with a failure of defenses against oxidative stress-induced cellular damage and/or death, leading to organ dysfunction. The pleiotropic transcription factor, nuclear factor-erythroid (NF-E) 2-related factor 2 (Nrf2), regulates the expression of antioxidant enzymes and proteins through the antioxidant response element. Nrf2 is an important component in antioxidant defenses in cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Nrf2 is also involved in protection against oxidant stress during the processes of ischemia-reperfusion injury and aging. However, evidence suggests that Nrf2 activity does not always lead to a positive outcome and may accelerate the pathogenesis of some cardiovascular diseases (e.g., atherosclerosis). The precise conditions under which Nrf2 acts to attenuate or stimulate cardiovascular disease processes are unclear. Further studies on the cellular environments related to cardiovascular diseases that influence Nrf2 pathways are required before Nrf2 can be considered a therapeutic target for the treatment of cardiovascular diseases.

  3. Nrf2 and Cardiovascular Defense

    Directory of Open Access Journals (Sweden)

    Reuben Howden

    2013-01-01

    Full Text Available The cardiovascular system is susceptible to a group of diseases that are responsible for a larger proportion of morbidity and mortality than any other disease. Many cardiovascular diseases are associated with a failure of defenses against oxidative stress-induced cellular damage and/or death, leading to organ dysfunction. The pleiotropic transcription factor, nuclear factor-erythroid (NF-E 2-related factor 2 (Nrf2, regulates the expression of antioxidant enzymes and proteins through the antioxidant response element. Nrf2 is an important component in antioxidant defenses in cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Nrf2 is also involved in protection against oxidant stress during the processes of ischemia-reperfusion injury and aging. However, evidence suggests that Nrf2 activity does not always lead to a positive outcome and may accelerate the pathogenesis of some cardiovascular diseases (e.g., atherosclerosis. The precise conditions under which Nrf2 acts to attenuate or stimulate cardiovascular disease processes are unclear. Further studies on the cellular environments related to cardiovascular diseases that influence Nrf2 pathways are required before Nrf2 can be considered a therapeutic target for the treatment of cardiovascular diseases.

  4. Urotensin II in cardiovascular regulation

    Directory of Open Access Journals (Sweden)

    Fraser D Russell

    2008-08-01

    Full Text Available Fraser D RussellSchool of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs, Queensland, AustraliaAbstract: Cardiovascular function is modulated by neuronal transmitters, circulating hormones, and factors that are released locally from tissues. Urotensin II (UII is an 11 amino acid peptide that stimulates its’ obligatory G protein coupled urotensin II receptors (UT to modulate cardiovascular function in humans and in other animal species, and has been implicated in both vasculoprotective and vasculopathic effects. For example, tissue and circulating concentrations of UII have been reported to increase in some studies involving patients with atherosclerosis, heart failure, hypertension, preeclampsia, diabetes, renal disease and liver disease, raising the possibility that the UT receptor system is involved in the development and/or progression of these conditions. Consistent with this hypothesis, administration of UT receptor antagonists to animal models of cardiovascular disease have revealed improvements in cardiovascular remodelling and hemodynamics. However, recent studies have questioned this contributory role of UII in disease, and have instead postulated a protective effect on the cardiovascular system. For example, high concentrations of circulating UII correlated with improved clinical outcomes in patients with renal disease or myocardial infarction. The purpose of this review is to consider the regulation of the cardiovascular system by UII, giving consideration to methodologies for measurement of plasma concentrations, sites of synthesis and triggers for release.Keywords: urotensin II, cardiovascular disease, heart failure, hypertension

  5. Efectividad del modelo de cuidado de enfermería para la familia de paciente con infarto agudo al miocardio en la unidad de cuidados intensivos

    Directory of Open Access Journals (Sweden)

    David Jahel Garcia Avendaño

    2015-05-01

    Full Text Available Introducción: Este protocolo de investigación tiene la finalidad de intervenir con la familia y determinar la efectividad del Modelo de Cuidado de Enfermería para la Familia de Paciente con Infarto Agudo al Miocardio (IAM en la Unidad de Cuidados Intensivos (UCI. Materiales y Métodos: Estudio descriptivo de intervención familiar. Resultados y Discusión: El 100% de las familias respondió afirmativamente que la enfermera familiar les informo sobre los cuidados a realizar en la familia según las necesidades detectadas, estableció un plan de intervención en la familia mismo que cumplió y se interesó para que dentro de lo posible la estancia en la familia sea agradable. Conclusiones: Los resultados de esta investigación de intervención a las familias de paciente con IAM en las UCI aporta resultados que apoyan la importancia de aplicar un Modelo de Cuidado de Enfermería Familiar en dichas unidades.Cómo citar este artículo: García DJ, Estrada MC, Gallegos M, Antuna AB. Efectividad del modelo de cuidado de enfermería para la familia de paciente con infarto agudo al miocardio en la unidad de cuidados intensivos. Rev Cuid. 2015; 6(1: 923-31. http://dx.doi.org/10.15649/cuidarte.v6i1.166

  6. Investigación de vectores y reservorios en brote de Chagas agudo por posible transmisión oral en Aguachica, Cesar, Colombia

    Directory of Open Access Journals (Sweden)

    Hugo Soto

    2014-04-01

    Full Text Available Colombia tiene un registro de 11 casos de Chagas agudo y 80 casos por contaminación oral con Trypanosoma cruzi. Este trabajo analiza los hallazgos entomológicos y parasitológicos del brote de Aguachica, Cesar, en 2010. Un grupo interdisciplinario de profesionales de la salud y de universidades regionales realizó las pruebas de laboratorio a los pacientes y el estudio del foco de transmisión. Se detectaron 11 casos agudos de enfermedad de Chagas en una sola familia con vivienda sin triatominos domiciliados y, Rhodnius pallescens, Pantrongylus geniculatus, Eratyrus cuspidatus y dos Didelphis marsupialis infectados con T. cruzi en palmas de Attalea butyracea y Elaeis oleifera del área urbana de Aguachica. Se analiza la participación del R. pallescens y el rol de las palmas en el ciclo silvestre de T. cruzi y para la transmisión oral de la enfermedad de Chagas. Incursiones esporádicas de R. pallescens, P. geniculatus y E. cuspidatus silvestres desde palmas cercanas al domicilio humano pueden provocar brotes cada vez más frecuentes de Chagas oral.

  7. Undergraduates' understanding of cardiovascular phenomena.

    Science.gov (United States)

    Michael, Joel A; Wenderoth, Mary Pat; Modell, Harold I; Cliff, William; Horwitz, Barbara; McHale, Philip; Richardson, Daniel; Silverthorn, Dee; Williams, Stephen; Whitescarver, Shirley

    2002-12-01

    Undergraduates students in 12 courses at 8 different institutions were surveyed to determine the prevalence of 13 different misconceptions (conceptual difficulties) about cardiovascular function. The prevalence of these misconceptions ranged from 20 to 81% and, for each misconception, was consistent across the different student populations. We also obtained explanations for the students' answers either as free responses or with follow-up multiple-choice questions. These results suggest that students have a number of underlying conceptual difficulties about cardiovascular phenomena. One possible source of some misconceptions is the students' inability to apply simple general models to specific cardiovascular phenomena. Some implications of these results for teachers of physiology are discussed.

  8. Fish cardiovascular physiology and disease.

    Science.gov (United States)

    Sherrill, Johanna; Weber, E Scott; Marty, Gary D; Hernandez-Divers, Stephen

    2009-01-01

    Fish patients with cardiovascular disorders present a challenge in terms of diagnostic evaluation and therapeutic options. Veterinarians can approach these cases in fish using methods similar to those employed for other companion animals. Clinicians who evaluate and treat fish in private, aquarium, zoologic, or aquaculture settings need to rely on sound clinical judgment after thorough historical and physical evaluation. Pharmacokinetic data and treatments specific to cardiovascular disease in fish are limited; thus, drug types and dosages used in fish are largely empiric. Fish cardiovascular anatomy, physiology, diagnostic evaluation, monitoring, common diseases, cardiac pathologic conditions, formulary options, and comprehensive references are presented with the goal of providing fish veterinarians with clinically relevant tools.

  9. Percepciones y creencias en personas que padecieron un evento coronario agudo Percepções e crenças das pessoas que padeceram um evento coronario agudo Perceptions and beliefs in people that suffered an acute coronary episode

    Directory of Open Access Journals (Sweden)

    Sonia Esperanza Espitia Cruz

    2011-12-01

    Full Text Available Utilizando un abordaje cualitativo interpretativo, se describen y analizan las percepciones y creencias que tiene un grupo de personas que padecieron un infarto agudo de miocardio, con respecto a sus hábitos de vida; se busca encontrar, desde el propio sujeto, las implicaciones que lo llevan a asumir un hábito. La muestra se constituyó con la información proporcionada por siete personas usuarias del servicio de salud de la Universidad Nacional, que fueron abordadas en dos momentos diferentes con entrevistas no estructuradas, justificadas mediante el criterio de saturación. Del análisis se obtuvo la construcción de seis categorías y subcategorías que permitieron una descripción del fenómeno en estudio. Entre las categorías encontradas están: identidad, impacto de la experiencia, gusto, lo que hay detrás del cambio, relaciones humanas y estrategias para conservarse sano. Posteriormente estas categorías se analizaron a la luz de los cuatro existenciales que presenta la teoría fenomenológica: cuerpo vivido, espacio vivido, tiempo vivido y relaciones humanas vividas. Los hallazgos permiten avanzar en la comprensión del Ser, al cual se le recomienda un cambio de hábito con una visión renovada del sujeto; así se intenta construir y recuperar el acervo cultural de los procesos de salud y enfermedad tomando como punto de partida a los propios sujetos sociales y, de esta manera, poder repensar desde ópticas diferentes los enfoques de promoción de la salud y prevención de la enfermedad que lleven a mejores resultados.Utilizando um método qualitativo e interpretativo, foram descritas e analisadas as percepções e crenças de um grupo de pessoas que padeceram um infarto agudo do miocárdio em relação a seus hábitos, e as implicações que o levam a assumir um hábito são procuradas no sujeito mesmo. A amostra foi constituída pela informação fornecida por sete usuários do serviço de saúde da Universidade Nacional

  10. Mixoma de átrio direito associado a cor pulmonale agudo: relato de caso Mixoma de atrio derecho asociado a cor pulmonale agudo: relato de caso Right atrial myxoma associated with acute cor pulmonale: case report

    Directory of Open Access Journals (Sweden)

    Michelle Nacur Lorentz

    2008-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os mixomas atriais são a forma mais comum de tumor intracardíaco primário. Apesar de serem tumores de comportamento benigno, recomenda-se que sejam retirados tão logo diagnosticados devido à possibilidade de embolização do tumor com suas nefastas conseqüências. O objetivo do presente relato foi apresentar um caso de tumor intracardíaco com localização rara (intra-atrial direito que apresentou embolização intra-operatória de parte do tumor e alertar os anestesiologistas para a possibilidade dessa complicação, além de discutir a conduta anestésica. RELATO DO CASO: Paciente do sexo masculino, 42 anos, portador de grande massa em átrio direito, submetido à retirada do tumor. A indução da anestesia foi feita com etomidato, fentanil e brometo de rocurônio e a manutenção, com isoflurano e fentanil. No intra-operatório o paciente apresentou quadro de cor pulmonale agudo em virtude da embolização de parte do tumor, sendo realizadas medidas de suporte e iniciada rapidamente a circulação extracorpórea. O restante da operação transcorreu bem e o paciente recebeu alta no sétimo dia pós-operatório em boas condições. CONCLUSÕES: Apesar do mixoma intracardíaco ser um tumor de características benignas, ele pode estar associado a complicações graves e às vezes fatais. O conhecimento da doença é importante para que o anestesiologista possa manusear de modo adequado esses pacientes, bem como diagnosticar e tratar as possíveis complicações intra-operatórias.JUSTIFICATIVA Y OBJETIVOS: Los mixomas atriales son la forma más común de tumor intracardiaco primario. A pesar de ser tumores de comportamiento benigno, se recomienda que sean retirados en cuanto sean diagnosticados debido a la posibilidad de embolización del tumor con sus nefastas consecuencias. El objetivo de este relato de caso fue presentar un caso de tumor intracardiaco con localización rara (intra-atrial derecho que present

  11. La glucemia en ayunas como predictor de mortalidad intrahospitalaria en pacientescon infarto agudo de miocardio sometidos a angioplastia primaria

    Directory of Open Access Journals (Sweden)

    Gerardo Nau

    2009-01-01

    Full Text Available RESUMENIntroducciónEl pronóstico de los pacientes que sufren un infarto agudo de miocardio con supradesniveldel ST (IAMST ha mejorado notoriamente, en particular como resultado de la terapia dereperfusión. A pesar de estos avances, los pacientes con diabetes mellitus (DM constituyenun grupo de alto riesgo. La hiperglucemia en pacientes con IAMST se asocia con peor pronóstico, independientemente del diagnóstico previo de DM.ObjetivoEvaluar el valor pronóstico de la glucemia en ayunas (GA durante un IAMST tratado conangioplastia primaria.Material y métodosDe 227 pacientes con diagnóstico de IAMST se excluyeron 31 con DM y 7 derivados paraterapia de rescate tardío. Se registraron la glucemia en la admisión (GAd y la GA; la población se dividió según la GA en: grupo A ³ 110 mg/dl (hiperglucémicos y grupo B < 110 mg/dl (normoglucémicos.ResultadosLa población en estudio quedó conformada por 189 pacientes. La edad fue de 62,1 ± 10,5años, sexo masculino 82%, tabaquistas 40%, el tiempo dolor-balón fue de 2,75 horas (25-75% intercuartiles 2-4,75, el porcentaje con clasificación de Killip & Kimball (KK ³ 3 fuedel 12,1% y el 38% presentaron localización anterior. Se registraron 15 (7,9% muertesintrahospitalarias, todas en pacientes hiperglucémicos. Por análisis multivariado, lospredictores independientes de mortalidad intrahospitalaria fueron la edad (p = 0,048 y laGA como variable continua (p = 0,002. Para los eventos cardíacos mayores (muerte, reIAMe insuficiencia cardíaca, la clasificación de KK ³ 3 (p = 0,001, la GA (p = 0,001 y eldeterioro moderado/grave de la función sistólica (p = 0,016 fueron sus únicos predictoresindependientes. La GAd no resultó predictora independiente de muerte o de eventos cardíacosmayores.ConclusionesLos resultados del presente estudio sugieren que la GA posee valor pronóstico a corto plazoen pacientes no diabéticos que cursan un IAMST. La GA identifica tempranamente y enforma sencilla a

  12. Calidad de la atención médica a pacientes con infarto agudo del miocardio. Cienfuegos 2011

    Directory of Open Access Journals (Sweden)

    Hilda María Delgado Acosta

    2013-09-01

    Full Text Available Fundamento: la evaluación constituye una herramienta para mejorar la calidad de la atención a los pacientes. Objetivo: evaluar la calidad de la atención médica a pacientes con infarto agudo de miocardio admitidos en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos en junio de 2011. Métodos: se realizó una investigación de sistemas y servicios de salud en la que se analizaron como variables: las relacionadas con estructura (recursos humanos y materiales, procesos (cumplimiento de los protocolos establecidos para la atención y resultados (impacto en la mortalidad. Se aplicó un formulario a los 22 pacientes estudiados, se utilizó una guía de observación que evaluó la existencia de recursos humanos y materiales necesarios para la atención en el hospital. Los datos se procesaron en el programa SPSS 15,0 y se expresaron en números absolutos y porcientos. Resultados: en la dimensión estructura no se encontraron carencias de recursos materiales esenciales para la atención, hubo dificultades con la cobertura de enfermería en el Servicio de Cardiología. En la atención prehospitalaria hubo demora en acudir a consulta, dificultades en la prescripción de aspirina y la no realización de trombólisis. En la posthospitalaria se centraron en la rehabilitación y trabajo en la modificación de los factores de riesgo asociados. En el hospital hubo dificultades en la realización de las pruebas ergométricas al alta y en la remisión para la rehabilitación en el Área de Salud. Conclusiones: existen dificultades en la calidad de atención a los pacientes, dificultades que se hacen más evidentes en la Atención Primaria de Salud.

  13. Por que a letalidade hospitalar do infarto agudo do miocárdio é maior nas mulheres?

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Santana Passos

    1998-05-01

    Full Text Available OBJETIVO: Avaliar a influência da idade, da gravidade da doença e das intervenções terapêuticas na maior letalidade hospitalar do infarto agudo do miocárdio (IAM em mulheres. MÉTODOS: Estudo de coorte retrospectivo, envolvendo 388 pacientes com IAM (50 óbitos. Foram avaliadas, como possíveis explicações para a associação entre sexo e letalidade hospitalar do IAM, as variáveis: idade ( ou = 60 anos, duração de sintomas, classe de Killip, tipo de IAM (com ou sem ondas Q, comorbidades, história de acidente vascular cerebral e intervenções terapêuticas para o IAM (ácido acetil-salicílico, betabloqueadores e agentes trombolíticos. Modelos de regressão logística foram usados para avaliar a influência de potenciais variáveis confundidoras na associação entre sexo e letalidade hospitalar do IAM. RESULTADOS: A letalidade hospitalar do IAM foi mais alta em mulheres (19,5% vs 9,4% do que em homens (odds ratio (OR= 2,34; IC 95%= 1,12-4,47. Embora as mulheres fossem significantemente (p<0,01 mais idosas, a associação entre sexo e morte reduziu-se em apenas 15% após ajuste para idade (OR= 1,99; IC 95 %= 1,07-3,67. Esta associação tornou-se mais fraca ao se considerar a gravidade da doença na admissão (OR= 1,84; IC 95%= 0,90-3,74 e intervenções terapêuticas para o IAM (OR= 1,50; IC= 0,67-3,38. CONCLUSÃO: Diferenças de idade não podem explicar completamente a maior letalidade do IAM em mulheres. A gravidade da doença na admissão e diferenças de abordagem terapêutica devem desempenhar importante papel na maior letalidade hospitalar do IAM em mulheres.

  14. Carotenoids and cardiovascular health.

    Science.gov (United States)

    Voutilainen, Sari; Nurmi, Tarja; Mursu, Jaakko; Rissanen, Tiina H

    2006-06-01

    Cardiovascular disease (CVD) is the main cause of death in Western countries. Nutrition has a significant role in the prevention of many chronic diseases such as CVD, cancers, and degenerative brain diseases. The major risk and protective factors in the diet are well recognized, but interesting new candidates continue to appear. It is well known that a greater intake of fruit and vegetables can help prevent heart diseases and mortality. Because fruit, berries, and vegetables are chemically complex foods, it is difficult to pinpoint any single nutrient that contributes the most to the cardioprotective effects. Several potential components that are found in fruit, berries, and vegetables are probably involved in the protective effects against CVD. Potential beneficial substances include antioxidant vitamins, folate, fiber, and potassium. Antioxidant compounds found in fruit and vegetables, such as vitamin C, carotenoids, and flavonoids, may influence the risk of CVD by preventing the oxidation of cholesterol in arteries. In this review, the role of main dietary carotenoids, ie, lycopene, beta-carotene, alpha-carotene, beta-cryptoxanthin, lutein, and zeaxanthin, in the prevention of heart diseases is discussed. Although it is clear that a higher intake of fruit and vegetables can help prevent the morbidity and mortality associated with heart diseases, more information is needed to ascertain the association between the intake of single nutrients, such as carotenoids, and the risk of CVD. Currently, the consumption of carotenoids in pharmaceutical forms for the treatment or prevention of heart diseases cannot be recommended.

  15. Cardiovascular autonomic neuropathy in diabetes

    DEFF Research Database (Denmark)

    Spallone, Vincenza; Ziegler, Dan; Freeman, Roy

    2011-01-01

    in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests....... diagnosis of CAN clinical forms, 2. detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, OH, nondipping, QT interval prolongation), 3. risk stratification for diabetic complications and cardiovascular morbidity and mortality, and 4. modulation of targets of diabetes therapy......Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control...

  16. Cognitive dysfunction after cardiovascular surgery

    DEFF Research Database (Denmark)

    Funder, K S; Steinmetz, J; Rasmussen, L S

    2009-01-01

    This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychol...

  17. [Subclinical hypothyroidism and cardiovascular risk].

    Science.gov (United States)

    López Rubio, María Antonia; Tárraga López, Pedro Juan; Rodríguez Montes, José Antonio; Frías López, María del Carmen; Solera Albero, Juan; Bermejo López, Pablo

    2015-05-01

    Objetivos: Valorar si el hipotiroidismo subclínico puede comportarse como un factor de riesgo cardiovascular o un modificador del mismo, identificando variables epidemiológicas y riesgo cardiovascular estimado en una muestra de sujetos diagnosticados en la provincia de Albacete. Método: Estudio observacional, descriptivo y transversal realizado en Albacete durante la primera quincena de enero de 2012 en pacientes de ambos géneros con hipotiroidismo subclínico. Se analizaron las siguientes variables: glucemia basal, colesterol total, colesterol HDL, colesterol LDL, triglicéridos, TSH, T4, peso, talla, I.M.C., tensión arterial, antecedentes de patología cardiovascular, factores de riesgo cardiovascular y riesgo cardiovascular estimado. Resultados: Se obtuvieron 326 pacientes, con predominio femenino (79,2 %), menores de 65 años en el 78% y sin factores de riesgo cardiovascular en el 48,61%. La prevalencia de los factores de riesgo cardiovascular identificados fué: tabaquismo (33,2%), diabetes mellitus (24,9%), hipertensión arterial (23,4%), alteraciones lipídicas (28,9%) y fibrilación auricular (4,9 %). No se encontró asociación entre hipotiroidismo subclínico y la mayoría de los parámetros del perfil lipídico que condicionan un perfil pro-aterogénico, salvo con la hipertrigliceridemia. Asimismo, tampoco se constató asociación con riesgo cardiovascular aumentado. Conclusiones: El perfil del paciente con hipotiroidismo subclínico es una mujer de mediana edad sin factores de riesgo cardiovascular en la mitad de casos. Se ha encontrado relación entre hipotiroidismo subclínico e hipertrigliceridemia, pero no con el resto de parámetros del perfil lipídico, otros factores de riesgo cardiovascular o con aumento de dicho riesgo. Sin embargo, un 25% de diabéticos y un 22% de no diabéticos están en situación de riesgo cardiovascular moderado-alto.

  18. Exercise and the Cardiovascular System

    OpenAIRE

    Saeid Golbidi; Ismail Laher

    2012-01-01

    There are alarming increases in the incidence of obesity, insulin resistance, type II diabetes, and cardiovascular disease. The risk of these diseases is significantly reduced by appropriate lifestyle modifications such as increased physical activity. However, the exact mechanisms by which exercise influences the development and progression of cardiovascular disease are unclear. In this paper we review some important exercise-induced changes in cardiac, vascular, and blood tissues and discuss...

  19. Stress and atherosclerotic cardiovascular disease.

    Science.gov (United States)

    Inoue, Nobutaka

    2014-01-01

    Recent major advances in medical science have introduced a wide variety of treatments against atherosclerosis-based cardiovascular diseases, which has led to a significant reduction in mortality associated with these diseases. However, atherosclerosis-based cardiovascular disease remains a leading cause of death. Furthermore, progress in medical science has demonstrated the pathogenesis of cardiovascular disease to be complicated, with a wide variety of underlying factors. Among these factors, stress is thought to be pivotal. Several types of stress are involved in the development of cardiovascular disease, including oxidative stress, mental stress, hemodynamic stress and social stress. Accumulating evidence indicates that traditional risk factors for atherosclerosis, including diabetes, hyperlipidemia, hypertension and smoking, induce oxidative stress in the vasculature. Oxidative stress is implicated in the pathogenesis of endothelial dysfunction, atherogenesis, hypertension and remodeling of blood vessels. Meanwhile, mental stress is a well-known major contributor to the development of cardiovascular disease. The cardiovascular system is constantly exposed to hemodynamic stress by the blood flow and/or pulsation, and hemodynamic stress exerts profound effects on the biology of vascular cells and cardiomyocytes. In addition, social stress, such as that due to a lack of social support, poverty or living alone, has a negative impact on the incidence of cardiovascular disease. Furthermore, there are interactions between mental, oxidative and hemodynamic stress. The production of reactive oxygen species is increased under high levels of mental stress in close association with oxidative stress. These stress responses and their interactions play central roles in the pathogenesis of atherosclerosis-based cardiovascular disease. Accordingly, the pathophysiological and clinical implications of stress are discussed in this article.

  20. Vitamin D and Cardiovascular Disease

    OpenAIRE

    Vivian Cristina Garcia; Lígia Araújo Martini

    2010-01-01

    Vitamin D insufficiency/deficiency has been observed worldwide at all stages of life. It has been characterized as a public health problem, since low concentrations of this vitamin have been linked to the pathogenesis of several chronic diseases. Several studies have suggested that vitamin D is involved in cardiovascular diseases and have provided evidence that it has a role in reducing cardiovascular disease risk. It may be involved in regulation of gene expression through the presence of vi...

  1. Vitamin D and Cardiovascular Disease

    OpenAIRE

    Grübler, Martin R.; Martin Gaksch; Thomas Pieber; Katharina Kienreich; Nicolas Verheyen; Andreas Tomaschitz; Stefan Pilz

    2013-01-01

    Vitamin D deficiency, as well as cardiovascular diseases (CVD) and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk...

  2. Vitamin D and cardiovascular disease.

    Science.gov (United States)

    Norman, P E; Powell, J T

    2014-01-17

    Vitamin D plays a classical hormonal role in skeletal health by regulating calcium and phosphorus metabolism. Vitamin D metabolites also have physiological functions in nonskeletal tissues, where local synthesis influences regulatory pathways via paracrine and autocrine mechanisms. The active metabolite of vitamin D, 1α,25-dihydroxyvitamin D, binds to the vitamin D receptor that regulates numerous genes involved in fundamental processes of potential relevance to cardiovascular disease, including cell proliferation and differentiation, apoptosis, oxidative stress, membrane transport, matrix homeostasis, and cell adhesion. Vitamin D receptors have been found in all the major cardiovascular cell types including cardiomyocytes, arterial wall cells, and immune cells. Experimental studies have established a role for vitamin D metabolites in pathways that are integral to cardiovascular function and disease, including inflammation, thrombosis, and the renin-angiotensin system. Clinical studies have generally demonstrated an independent association between vitamin D deficiency and various manifestations of degenerative cardiovascular disease including vascular calcification. However, the role of vitamin D supplementation in the management of cardiovascular disease remains to be established. This review summarizes the clinical studies showing associations between vitamin D status and cardiovascular disease and the experimental studies that explore the mechanistic basis for these associations.

  3. [Air pollution and cardiovascular disease].

    Science.gov (United States)

    Haber, Guy; Witberg, Guy; Danenberg, Haim

    2007-10-01

    Cardiovascular atherothrombosis is the most common cause of death globally, with several well-known risk factors. Air pollution is a byproduct of fuel combustion by motor vehicles, power plants and industrial factories. It is composed of gases, fluids and particulate matter (PM) of different sizes, which include basic carbon, organic carbonic molecules and metals such as vanadium, nickel, zinc and iron. These particles are subdivided by their median size, a major contributing factor for their capability to enter the human body through the respiratory system. Most of the epidemiological studies have shown correlation between acute and long-term exposure to air pollution elements and cardiovascular morbidity in general, and angina pectoris and acute myocardial infarction specifically. Physiological studies have found different arrhythmias as the etiologic cause of cardiovascular morbidity and mortality following exposure to air pollution. A major finding was a decline in heart rate variability, a phenomenon known as endangering for cardiovascular morbidity and mortality, especially in patients after acute myocardial infarction. To date, several pathways have been proposed, including a hypercoagulable state following an inflammatory response, cardiac nervous autonomic disequilibrium, endothelial dysfunction with blood vessel contraction and direct toxic impact on cardiac muscle. Additional research is needed for clarifying the pathophysiological pathways by which air pollution affects the cardiovascular system. That might allow forthcoming with preventive measures and correct treatment, and hence a decrease in cardiovascular morbidity and mortality. Another important target is dose-outcome correlation curves for safety threshold calculation as a basis for air pollution regulations.

  4. Osteoporosis and ischemic cardiovascular disease.

    Science.gov (United States)

    Laroche, Michel; Pécourneau, Virginie; Blain, Hubert; Breuil, Véronique; Chapurlat, Roland; Cortet, Bernard; Sutter, Bruno; Degboe, Yannick

    2016-11-09

    Osteoporosis and cardiovascular disease were long viewed as independent of each other. However, numerous epidemiological studies, which are discussed in the first part of this review, have provided incontrovertible evidence of a link. Thus, the risk of coronary artery disease and stroke is higher in patients with a history of osteoporotic fracture or low bone mineral density than in non-osteoporotic patients. In the other direction, patients with cardiovascular disease are at higher risk for bone loss and osteoporotic fracture. The link between osteoporosis and cardiovascular disease is due in part to shared conventional risk factors such as estrogen deprivation in women, smoking, low physical activity, and diabetes. In addition, atheroma plaque calcification involves cytokines and growth factors that also play a role in bone turnover, including proinflammatory cytokines (IL-6 and TNFα), osteoprotegerin, sclerostin, matrix GLA protein, and FGF-23. Several recent studies have provided support for these pathophysiological hypotheses. Thus, elevation of osteoprotegerin, sclerostin, or FGF-23 levels may explain and predict the occurrence of both osteoporotic fractures and cardiovascular events. The association between osteoporosis and cardiovascular disease found in most epidemiological and pathophysiological studies suggests a need for evaluating potential benefits from routine bone absorptiometry and osteoporotic fracture detection in patients with cardiovascular disease and from exercise testing and arterial Doppler imaging in patients with osteoporosis.

  5. "Dry" and "wet" beriberi mimicking critical illness polyneuropathy

    Directory of Open Access Journals (Sweden)

    S Rama Prakasha

    2013-01-01

    Full Text Available Three cases with manifestations of right heart failure, shock, metabolic acidosis, and renal failure in varying combination were admitted with paraparesis. Nerve conduction study suggested predominantly motor and mainly axonal type of neuropathy. Rapid reversal of shock, acidosis, and multi-organ dysfunction with timely infusion of thiamine was followed by the complete neurological recovery.

  6. Cardiovascular Risk Factors and Cardiovascular Hyperreactivity in Young Venezuelans

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    Sady Montes Amador

    2015-07-01

    Full Text Available Background: cardiovascular hyperreactivity in young people has been associated with different risk factors and a family history of hypertension. Objective: to determine the association between a family history of hypertension and cardiovascular risk factors with cardiovascular hyperreactivity. Method: a correlational, cross-sectional study was conducted in a universe of 77 young individuals aged 18 to 40 years from the Churuguara parish of the Falcon State in Venezuela. The variables were: age, sex, skin color, family history of hypertension, medical history of hypertension, diabetes mellitus, alcohol consumption, salt intake, physical activity and body mass index. The diastolic and systolic blood pressure before and after the pressor response elicited by an isometric exercise were determined as hemodynamic variables. Results: thirteen percent of the participants developed vascular reactivity after the hand-held weight test. Cardiovascular hyperreactivity is three times higher in individuals with a family history of hypertension. Sixty percent of those with a body mass index greater than or equal to 27 kg/m2 are hyperreactive. There is a higher cardiovascular response to the hand-held weight test as the consumption of alcohol increases. Thirty three point three percent of the participants who smoke are hyperreactive. Conclusions: there is a significant association between a family history of hypertension, obesity, salt intake, alcohol consumption and vascular hyperreactivity.

  7. Estrutura e vínculos de uma família após infarto agudo do miocárdio

    Directory of Open Access Journals (Sweden)

    Raquel Pötter Garcia

    2015-05-01

    Full Text Available Introdução: Conhecer os vínculos e a estrutura de uma família após episódio de Infarto Agudo do Miocárdio. Materiais e Métodos: Pesquisa qualitativa e exploratória que representa um estudo de caso desenvolvido com uma das famílias participantes. A coleta de dados ocorreu no período de fevereiro a maio de 2012, por meio de observação no domicílio e entrevista com construção do genograma e ecomapa. A intensidade dos vínculos foi definida pela família conforme legenda do ecomapa. Resultados e Discussão: Trata-se de uma família que se encontra no estágio de saída dos filhos de casa, cujo pai apresentou infarto. Evidenciaram-se doenças familiares como hipertensão arterial e diabetes mellitus tipo II.  Detectou-se vínculos fortes com os familiares, filhos e vizinha; fracos com o ambulatório de cardiologia e conflituosos com vizinhos. Conclusões: Foi possível conhecer a estrutura e os vínculos de uma família, após um de seus integrantes ter vivenciado o infarto agudo do miocárdio. Dessa maneira, acredita-se que este trabalho pode fornecer subsídios e reflexões para a prática de profissionais que atuam com famílias que vivenciam o infarto em seu contexto. Cómo citar este artículo: Garcia R, Budó ML, Viegas A, Cardoso D, Schwartz E, Muniz R. Estrutura e vínculos de uma família após infarto agudo do miocárdio. Rev Cuid. 2015; 6(1: 991-8.http://dx.doi.org/10.15649/cuidarte.v6i1.142  

  8. Discrepâncias clínico-patológicas e achados cardiovasculares em 409 autópsias consecutivas

    Directory of Open Access Journals (Sweden)

    Aline Fusco Fares

    2011-12-01

    Full Text Available FUNDAMENTO: As discrepâncias entre os diagnósticos clínicos e em autópsia persistem em todo o mundo. OBJETIVO: Avaliamos as autópsias em um hospital-escola para analisar a precisão dos diagnósticos cardiovasculares clínicos em comparação aos achados post-mortem. MÉTODOS: As 409 autópsias consecutivas entre 2003 e 2006 foram analisadas em um hospital terciário de São José do Rio Preto, São Paulo (SP, Brasil. A comparação dos achados cardiovasculares clínicos e patológicos foi realizada por meio da classificação de discrepâncias de Goldman. RESULTADOS: A taxa de autópsia no hospital foi de 8%. As causas cardiovasculares de óbito representavam 42,8% (175 de 409 pacientes dos diagnósticos de autópsia. Em 98 pacientes (56%, houve discrepâncias significativas (classes I e II, o que representa uma grande proporção de diagnósticos equivocados de infarto mesentérico (84,6%, infarto agudo do miocárdio (64,7%, dissecção da aorta (64,2% e embolia pulmonar (62,5%. Foram observadas maiores taxas de concordância para a insuficiência cardíaca congestiva (59% e para o acidente vascular cerebral isquêmico agudo (58,8%. A idade, o sexo, o tempo de permanência e a última unidade de admissão no hospital não foram associados aos critérios de Goldman. CONCLUSÃO: As discrepâncias dos diagnósticos clínicos e em autópsia relativos à morte cardiovascular permanecem elevados no Brasil, a despeito dos recursos tecnológicos disponíveis. Além disso, nossos achados reforçam a importância do exame post-mortem como uma contribuição para a melhoria da assistência médica.

  9. Osteoporosis y enfermedad cardiovascular

    Directory of Open Access Journals (Sweden)

    Sarahí Mendoza

    2007-01-01

    Full Text Available Las enfermedades cardiovasculares (ECV y la osteoporosis son causas frecuentes de morbilidad en la población adulta, cuya frecuencia aumenta con la edad, por lo que al aumentar la expectativa de vida, constituyen importantes problemas de salud. El riesgo a padecer ambas patologías depende de factores de riesgo, y la prevención consiste en controlar los modificables. Las ECV y la osteoporosis presentan factores etiológicos comunes que involucran la biosíntesis del colesterol y la oxidación lipídica, cuya dilucidación representa una línea priorizada de investigación. El crecimiento y mantenimiento del esqueleto depende del equilibrio entre la formación y la resorción ósea a través de los procesos de modelado y remodelado óseo, controlados por células óseas (osteoblastos -OB-, osteoclastos -OC- y osteocitos, los OB son responsables de la formación ósea, los OC de la resorción ósea y los osteocitos de la red mecano sensorial. Entre los nexos de las ECV y la osteoporosis se encuentra el papel de la vía del mevalonato en la síntesis de colesterol y en la activación de OC, y el papel de los lípidos oxidados en el desarrollo de la aterosclerosis y en la transformación de las células precursoras de OB en adipocitos, disminuyendo la formación de OB activos y favoreciendo la osteoporosis. Ello justifica que sustancias hipolipemiantes y antioxidantes puedan ejercer efectos protectores sobre el hueso, y que la búsqueda de sustancias que actúen sobre ambos blancos sea un aspecto de interés en la prevención o el manejo de estas enfermedades.

  10. Perfil etiológico del síndrome febril icterohemorrágico agudo y síndrome febril ictérico agudo en los valles del Apurímac, Quillabamba, Chanchamayo y Alto Huallaga, Perú, 1999-2000.

    Directory of Open Access Journals (Sweden)

    2003-07-01

    Full Text Available Objetivos: Conocer el perfil etiológico del síndrome febril hemorrágico agudo (SFHA y del síndrome febril ictérico agudo (SFIA en los valles del Río Apurímac (Ayacucho, Quillabamba (Cusco, Chanchamayo (Junín y Alto Huallaga (Huánuco. Materiales y métodos: Estudio longitudinal descriptivo realizado entre junio de 1999 y mayo de 2000, en 146 establecimientos de salud de los cuatro valles involucrados. Fueron incluidos pacientes que cumplieron con las definiciones de caso para la vigilancia del síndrome febril hemorrágico agudo y el síndrome febril ictérico agudo. Las muestras obtenidas se procesaron por ELISA IgM de captura para fiebre amarilla; IgM anti-HBc ELISA y HBsAg ELISA para hepatitis B; Ig anti-VHD ELISA para hepatitis D; e IgM ELISA para leptospirosis. Resultados: Fueron incluidos 63 casos: 98,4% con SFIA y 1,6% con SFHA. La letalidad fue de 16% y el tiempo entre inicio de síntomas y la obtención de la muestra de 7,2 ±5,1 días. Los casos que tuvieron confirmación diagnóstica fueron 31 (49,2%, hepatitis B (23,8%, hepatitis D (15,6%, fiebre amarilla (4,8% y leptospirosis (4,8%. Cusco tuvo el mayor porcentaje de casos confirmados por laboratorio, siendo la mayoría hepatitis B y D. Conclusiones: El estudio de la etiología de SFIA y SFHA ha permitido identificar tres brotes de fiebre amarilla en Cusco, Junín y Huánuco, y conocer la importancia de la hepatitis B, D y leptospirosis en el diagnóstico diferencial de estos síndromes. Si bien las definiciones usadas apuntan a detectar enfermedades severas, la vigilancia de ambos síndromes es complementaria y totalmente compatible con los sistemas de enfermedad específica y por el laboratorio.

  11. Vitamin D and Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Martin R. Grübler

    2013-07-01

    Full Text Available Vitamin D deficiency, as well as cardiovascular diseases (CVD and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk factors: hypertension, obesity and dyslipidemia, type 2 diabetes, chronic kidney disease and endothelial dysfunction. In addition, we outline the most recent observational, as well as interventional data on the influence of vitamin D on CVD. Since it is still an unresolved issue whether vitamin D deficiency is causally involved in the pathogenesis of CVD, data from randomized controlled trials (RCTs designed to assess the impact of vitamin D supplementation on cardiovascular outcomes are awaited with anticipation. At present, we can only conclude that vitamin D deficiency is an independent cardiovascular risk factor, but whether vitamin D supplementation can significantly improve cardiovascular outcomes is still largely unknown.

  12. [Iodine deficiency in cardiovascular diseases].

    Science.gov (United States)

    Molnár, I; Magyari, M; Stief, L

    1998-08-30

    The thyroid hormone deficiency on cardiovascular function can be characterized with decreased myocardial contractility and increased peripheral vascular resistance as well as with the changes in lipid metabolism. 42 patients with cardiovascular disease (mean age 65 +/- 13 yr, 16 males) were investigated if iodine insufficiency can play a role as a risk factor for the cardiovascular diseases. The patients were divided in 5 subgroups on the ground of the presence of hypertension, congestive heart failure, cardiomyopathy, coronary disfunction and arrhythmia. Urine iodine concentration (5.29 +/- 4.52 micrograms/dl) was detected with Sandell-Kolthoff colorimetric reaction. The most decreased urine iodine concentration was detected in the subgroups with arrhythmia and congestive heart failure (4.7 +/- 4.94 micrograms/dl and 4.9 +/- 4.81 micrograms/dl, respectively). An elevated TSH level was found by 3 patients (5.3 +/- 1.4 mlU/l). An elevation in lipid metabolism (cholesterol, triglyceride) associated with all subgroups without arrhythmia. In conclusion, the occurrence of iodine deficiency in cardiovascular disease is frequent. Iodine supplementation might prevent the worsing effect of iodine deficiency on cardiovascular disease.

  13. Cardiovascular benefits of bariatric surgery.

    Science.gov (United States)

    Lee, Glenn K; Cha, Yong-Mei

    2016-04-01

    The prevalence of obesity is increasing in the United States and worldwide, bringing with it an excess of morbidity and premature death. Obesity is strongly associated with both traditional cardiovascular risk factors as well as direct effects on hemodynamics and cardiovascular structure and function. In fact, cardiovascular disease is one of the major causes of morbidity and mortality in obese patients. Often, lifestyle and pharmacological weight-loss interventions are of limited efficacy in severely obese patients. Bariatric surgery has been shown to be a feasible option to achieve substantial and sustained weight loss in this group of patients. It is a safe procedure with low in-hospital and 30-day mortality rates even in groups that are considered higher risk for surgery (e.g., the elderly), especially if performed in high-volume centers. There is observational evidence that bariatric surgery in severely obese patients is associated with both a reduction of traditional cardiovascular risk factors as well as improvement in cardiac structure and function. Marked decreases in the levels of inflammatory and prothrombotic markers, as well as markers of subclinical atherosclerosis and endothelial dysfunction, are seen after bariatric surgery. This article summarizes the existing evidence regarding the cardiovascular benefits in patients following bariatric surgery.

  14. Hematoma subdural agudo traumático: estudo de 110 pacientes Acute traumatic subdural haematomas: study of 110 cases

    Directory of Open Access Journals (Sweden)

    Nicandro de Figueiredo Neto

    1996-06-01

    Full Text Available Apresentamos uma série consecutiva de 110 pacientes com hematoma subdural agudo traumático (HSDA admitidos no serviço de emergência do HBDF no período de 1°-janeiro a 1°-dezembro-1994. Todos os pacientes foram atendidos de acordo com o mesmo protocolo. Houve predominância do sexo masculino (79%, com idade variando entre 14 e 70 anos, sendo os atropelamentos (34% e os acidentes automobilísticos (20% as causas mais comuns. A maioria dos pacientes (85,7% foi admitida muito grave, com 8 pontos ou menos na Escala de Coma Glasgow (ECG, o que influenciou diretamente na mortalidade. A tomografia computadorizada de crânio foi o exame diagnóstico de escolha que mostrou serem as contusões e o inchaço cerebral ("swelling" as lesões intracranianas associadas mais freqüentes. A cirurgia foi realizada em 45,1% dos pacientes, e, em sua maioria, através de craniotomia fronto-têmporo-parietal ampla, com drenagem do hematoma, seguida de plástica da dura-mater. Em 54,9% as condições clínicas não permitiram a realização da cirurgia; neste grupo, cerca de 69,6% estavam em coma profundo à admissão, com 3 pontos na ECG. A letalidade cirúrgica foi de 61,2% e esteve diretamente relacionada à condição clínica inicial e à idade do paciente. A letalidade, incluindo todos os pacientes cirúrgicos e não cirúrgicos com HSDA, mesmo aqueles admitidos já com sinais de falência de tronco cerebral, foi de 79,5%. Além destes pacientes que faleceram, cerca de 7% evoluíram sem seqüelas ou com seqüelas mínimas; outros 11,4% com seqüelas de moderadas a paves e 2,1 % permaneceram em estado vegetativo persistente. Nossos dados estão de acordo com os da literatura no que se refere a elevada taxa de morbidade e mortalidade dos pacientes com HSDA.We report a series of 110 patients with acute traumatic subdural hematoma (ASDH admitted at HBDF emergency within 1994 (January Is1 to December PJ.All patients were treated according to the same protocol

  15. Años de vida perdidos por infarto agudo de miocardio en la Argentina entre 1991 y 2005

    Directory of Open Access Journals (Sweden)

    Fernando Botto

    2008-01-01

    Full Text Available IntroducciónLos años potenciales de vida perdidos (APVP son uno de los indicadores utilizados para determinar las muertes tempranas. A diferencia de las tasas de mortalidad, crudas y ajustadas por edad, este indicador, que cuantifica los años que teóricamente una persona deja de vivir si la muerte se presenta en forma prematura (o sea antes de cumplir su esperanza de vida, da una visión más amplia de la importancia relativa que tienen las causas más relevantes de mortalidad prematura, por lo que su uso se justifica en la planificación y en la definición de prioridades en salud.ObjetivosDescribir la evolución de la mortalidad por infarto agudo de miocardio (IAM en términos de tasas de mortalidad (TM y de años potenciales de vida perdidos (APVP para el período 1991-2005, identificar diferencias en relación con el sexo y comparar la media de APVP por muerto (MAPVP entre los registros SAC y los de la Dirección de Estadística e Información de Salud del Ministerio de Salud y Acción Social (DEIS.Material y métodosLas defunciones por IAM, distribuidas por edad y sexo, se obtuvieron de la DEIS y de los registros SAC. Los APVP se calcularon según la fórmula de Romeder y Mc Whinnie y también sobre la base de la esperanza de vida al nacer, además de la MAPVP con su intervalo de confianza del 95%.ResultadosLa TM por IAM según la DEIS descendió de 50 en 1991 a 38 por 100.000 habitantes en 2005 (pendiente [slope] -3,7; p < 0,001. La tasa de APVP disminuyó de 516 a 314 años por 100.000 en igual período. A nivel nacional, la MAPVP fue de 11,3 (11,1-11,5, 11,4 (11,2- 11,6, 11,5 (11,3-11,7, 11,1 (10,8-11,3 para 1991, 1996, 2000 y 2005, respectivamente (pendiente 0,0. Se observaron resultados similares a los de la SAC -10,8 (8,22-13,5, 10,4 (6,86- 14,0, 7,50 (4,67-10,3, 14,0 (10,3-17,7- para los años mencionados (pendiente +0,67. En relación con el sexo tampoco hubo diferencias, excepto para el caso de las mujeres en el año 2000 (p

  16. Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros?

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    2012-06-01

    Full Text Available O estudo objetivou analisar o conhecimento de enfermeiros acerca do uso de alteplase no tratamento do acidente vascular encefálico (AVE isquêmico agudo. Estudo descritivo-exploratório realizado em uma unidade de AVE de um hospital público localizado na cidade de Fortaleza-CE, durante o mês de outubro de 2010. Participaram do estudo dez enfermeiros, com idade média de 25 anos. Os benefícios da medicação foram apresentados em justaposição com as limitações do uso. Estratégias para ampliar a utilização de alteplase foram apontadas pelos enfermeiros. O conhecimento da realidade investigada contribui na construção do saber de enfermagem e pode auxiliar o enfermeiro que presta assistência direta ao paciente que se submete a este tratamento.

  17. CARACTERIZACIÓN DEL SÍNDROME CORONARIO AGUDO SIN ELEVACIÓN DEL ST EN EL CENTRO DIAGNÓSTICO INTEGRAL

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    Rider Piñeiro López

    2012-03-01

    Full Text Available Resumen Introducción y objetivos: El síndrome coronario agudo presenta una elevada incidencia en el cuadro de morbilidad y mortalidad de los países del mundo desarrollado. El objetivo de esta investigación fue determinar la morbilidad por síndrome coronario agudo y su relación con algunas variables. Método: Se realizó un estudio epidemiológico, observacional, descriptivo, en 30 pacientes con el diagnóstico de síndrome coronario agudo sin elevación del ST, atendidos en la Unidad de Terapia Intensiva del Centro Diagnóstico Integral “José Gregorio Hernández”, municipio Ortiz, estado Guárico, República Bolivariana de Venezuela; en el período del 1 de enero al 31 de diciembre de 2007. Resultados: La angina inestable fue la enfermedad más frecuente (80,0 % en estos pacientes. Predominaron los mayores de 49 años (80 %, del sexo femenino (63,3 %, color negro de piel, procedencia urbana y escolaridad secundaria. El tabaquismo constituyó el factor de riesgo más frecuente (56,6 %, seguido de hipertensión arterial (43,3 % y obesidad (26,6 %. Las arritmias y el fallo de bomba fueron frecuentes en pacientes con infarto; el dolor precordial mantenido, en enfermos con angina inestable. Hubo un fallecido por infarto agudo de miocardio, con más de sesenta años y menos de tres días de estadía. Conclusiones: Predominó la angina inestable, y los factores de riesgo más frecuentemente asociados, fueron la hipertensión arterial y el hábito de fumar. Abstract Introduction and objectives: Acute coronary syndrome has a high impact on morbidity and mortality rates of the developed world. The objective of this research was to determine the morbidity for acute coronary syndrome and its relation to some variables. Method: An epidemiological, observational, descriptive study was performed in 30 patients with the diagnosis of acute coronary syndrome without ST elevation, treated at the Intensive Care Unit of the Integral Diagnostic Center "Jos

  18. Exploración neuropsicológica en un caso de sufrimiento fetal agudo: diagnóstico e intervención

    OpenAIRE

    David Molina González; Rosario Bonilla Sánchez

    2014-01-01

    En el presente artículo se muestran los resultados del proceso de corrección de una niña de edad escolar que presento sufrimiento fetal agudo a los 6 meses de gestación. Se describe el proceso de evaluación y la interpretación de los resultados a la luz de la teoría neuropsicológica de Luria y la psicología histórico-cultural de Vigotsky. Se presenta la propuesta de un programa de corrección neuropsicológica, el cual tiene como objetivo lograr un mejor funcionamiento de los mecanismos de regu...

  19. Angioplastia coronaria vs terapia trombolítica en infarto agudo de miocardio. Clínica Marshfield-Hospital St Joseph, Wisconsin, EE.UU, 1999

    Directory of Open Access Journals (Sweden)

    Juan Pulido

    2001-04-01

    Full Text Available El tratamiento del infarto agudo de miocardio (IAM está en
    investigación por sus implicaciones en la práctica médica y por la
    comprensión más detallada de la fisiopatología. El objetivo del estudio es comparar clínica y angiográficamente la angioplastia coronaria con la trombolisis aguda en pacientes con IAM de menos de 24 horas de evolución. La administración de agentes trombolíticos después de una oclusión coronaria aguda ha disminuido la mortalidad intrahospitalaria, el tamaño del infarto y el número de complicaciones asociadas.

  20. Edema e enfisema pulmonar agudo em bovinos no Sul do Brasil: doença espontânea e reprodução experimental

    OpenAIRE

    Wicpolt,Nathalia S.; Thalita C. Cardoso; Tiffany Emmerich; Vanessa Borelli; Wisser,Claudia S.; Edgar Gueller; Traverso,Sandra D.; Aldo Gava

    2014-01-01

    Descrevem-se os dados epidemiológicos, os sinais clínicos e as lesões de quatro surtos da doença do edema e enfisema pulmonar agudo em bovinos (EEPAB) nos estados de Santa Catarina e Paraná e sua reprodução experimental. A doença espontânea ocorreu após transferência de bovinos de pastagem madura e seca para outra jovem e viçosa. Todos os bovinos afetados eram vacas das raças holandês e pardo suíço. Os principais sinais clínicos foram dispneia e respiração abdominal dificultosa com o pescoço ...

  1. Manifestação rara de edema agudo de pulmão associado à miocardite lúpica aguda

    Directory of Open Access Journals (Sweden)

    Alexandre de Matos Soeiro

    2012-05-01

    Full Text Available O lupus eritematoso sistêmico (LES é a mais comum das doenças auto-imunes sistêmicas, ocorrendo com maior freqüência no sexo feminino, usualmente na faixa etária entre 16 e 55 anos1,2. Embora os rins classicamente sejam os órgãos mais acometidos no LES, o coração e a circulação cardiopulmonar também podem ser afetados de forma significativa3. Nesse contexto, a ocorrência de edema agudo de pulmão associado à miocardite lúpica é rara e de tratamento imunossupressor específico ainda incerto.

  2. O uso da ventilação mecânica não invasiva em edema agudo pulmonar não cardiogênico

    OpenAIRE

    Nóbrega, Mayane Ferreira da; FACULDADE MAURÍCIO DA NASSAU; Pereira, Edenilda Firmino; Faculdade Maurício de Nassau; Oliveira, Juliana Raquel de Morais Santos; Faculdades Maurício de Nassau

    2013-01-01

    Trata-se de um estudo de natureza bibliográfica, que teve por objetivo mostrar a utilização da ventilação mecânica não invasiva no edema agudo pulmonar não cardiogênico. A literatura mostra que a utilização da ventilação mecânica não invasiva tem se mostrado eficaz em diversos tipos de insuficiência respiratória aguda ou crônica agudizada. Sua utilização também é indicada nos quadro de edema pulmonar não cardiogênico, patologia esta que apesar dos avanços registrados nas ciências médicas, con...

  3. Abdome agudo em pós-operatório tardio de apendicite aguda: pode não ser bridas

    Directory of Open Access Journals (Sweden)

    Bruno Castro Fernandes

    2014-10-01

    Full Text Available As ressecções intestinais em países desenvolvidos ocorrem devido às malformações congênitas. Em países em desenvolvimento essas resseções ocorrem por causas potencialmente evitáveis, como invaginação intestinal irredutível, trauma abdominal fechado, volvo de jejuno-íleo, enterocolite necrosante, hérnia inguinal estrangulada e obstrução por bridas pós-operatórias. O volvo intestinal na infância é raro e geralmente de causas iatrogênicas causado, por exemplo, pela presença de grampos soltos a cavidade intestinal após apendicectomia laparoscópica. O volvo de jejuno-íleo pode ser secundário à isquemia nos casos de gastrosquise tratadas com silo ou mesmo pela colocação de banda gástrica pós-laparoscopia, ou ainda pela presença de lipoma mesentérico. Não foi identificado trabalho na literatura recente sobre volvo jejuno-íleo e isquemia e necrose de segmento de alça intestinal. O autores relatam um caso de abdome agudo obstrutivo em criança de 6 anos, em pós-operatório tardio (4 anos de apendicectomia aberta e cuja ressecção de segmento de Alça intestinal foi necessária nas duas oportunidades mas por motivos diferentes. Situações adversas em abdome agudo pós-operatório podem não ser por aderências intestinais, mas por situações mais graves e o cirurgião deve estar preparado para corrigir sua tática operatória.

  4. Etiología del síndrome febril agudo en la provincia de Jaén, Perú 2004-2005

    Directory of Open Access Journals (Sweden)

    Lucinda Troyes R

    2006-01-01

    Full Text Available Objetivo: Conocer a tiología el Síndrome febril agudo en nacientes que acudieron a tres establecimientos de salud de la provincia de Jaén entre mayo de 2004 y abril de 2005. Materiales y métodos: Estudio descriptivo prospectivo realizado en tres establecimientos de salud: Hospital General de Jaén, Hospital de Apoyo Bellavista y Centro de Salud Morro Solar. Se incluyeron pacientes entre 5 y 65 años con fiebre de menos de ocho días de evolución y sin foco infeccioso aparente. Inicialmente se les realizó gota gruesa para malaria y frotis sanguíneo para Bartonelosis; de los casos negativos se obtuvo una segunda muestra de sangre para la búsqueda de ELISA IgM y microaglutinación para el diagnóstico de leptospirosis, ELISA IgM para dengue, Mayaro, Oropuche y encefalitis equina venezolana, e inmunofluorescencia indirecta para Rickettsiosis. Resultados: De 1039 febriles incluidos, se determinó la etiología en 680 (65,4%casos, malaria por P.falciparum 312 (30,0%, leptospirosis 115 (11,1%, dengue 105 (10,1%, malaria por P. vivax 76 (7,3%,leptospirosis más dengue 30 (2,9%, Rickettsiosis 15 (1,4%,Bartonelosis 17 (1,6%,leptospirosis más Rickettsiosis 7 (0,7%, y leptospirosis, dengue más Rickettsiosis 3 (0,3%. Los serovares de Leptospira más frecuentes fueron varilla (35,7%y bratislava (32,5%. Conclusión: La malaria es la principal causa de síndrome febril agudo en Jaén, se destaca la presencia de la leptospirosis como segunda causa,por delante del dengue; es necesario considerar dentro del diagnóstico diferencial Rickettsiosis y Bartonelosis.

  5. The cardiovascular action of hexarelin

    Institute of Scientific and Technical Information of China (English)

    wYuanjie MAO; Takeshi Tokudome; Ichiro Kishimoto

    2014-01-01

    Hexarelin, a synthetic growth hormone-releasing peptide, can bind to and activate the growth hormone secretagogue receptor (GHSR) in the brain similar to its natural analog ghrelin. However, the peripheral distribution of GHSR in the heart and blood vessels suggests that hexarelin might have direct cardiovascular actions beyond growth hormone release and neuroendocrine effects. Furthermore, the non-GHSR CD36 had been demonstrated to be a specific cardiac receptor for hexarelin and to mediate its cardioprotective effects. When compared with ghrelin, hexarelin is chemically more stable and functionally more potent. Therefore, it may be a promising therapeutic agent for some car-diovascular conditions. In this concise review, we discuss the current evidence for the cardiovascular action of hexarelin.

  6. Mitochondrial cytopathies and cardiovascular disease.

    Science.gov (United States)

    Dominic, Elizabeth A; Ramezani, Ali; Anker, Stefan D; Verma, Mukesh; Mehta, Nehal; Rao, Madhumathi

    2014-04-01

    The global epidemic of cardiovascular disease remains the leading cause of death in the USA and across the world. Functional and structural integrity of mitochondria are essential for the physiological function of the cardiovascular system. The metabolic adaptation observed in normal heart is lost in the failing myocardium, which becomes progressively energy depleted leading to impaired myocardial contraction and relaxation. Uncoupling of electron transfer from ATP synthesis leads to excess generation of reactive species, leading to widespread cellular injury and cardiovascular disease. Accumulation of mitochondrial DNA mutation has been linked to ischaemic heart disease, cardiomyopathy and atherosclerotic vascular disease. Mitochondria are known to regulate apoptotic and autophagic pathways that have been shown to play an important role in the development of cardiomyopathy and atherosclerosis. A number of pharmacological and non-pharmacological treatment options have been explored in the management of mitochondrial diseases with variable success.

  7. Electrocardiographic Predictors of Cardiovascular Mortality

    Directory of Open Access Journals (Sweden)

    Ioana Mozos

    2015-01-01

    Full Text Available Cardiovascular diseases are the main causes of mortality. Sudden cardiac death may also appear in athletes, due to underlying congenital or inherited cardiac abnormalities. The electrocardiogram is used in clinical practice and clinical trials, as a valid, reliable, accessible, inexpensive method. The aim of the present paper was to review electrocardiographic (ECG signs associated with cardiovascular mortality and the mechanisms underlying those associations, providing a brief description of the main studies in this area, and consider their implication for clinical practice in the general population and athletes. The main ECG parameters associated with cardiovascular mortality in the present paper are the P wave (duration, interatrial block, and deep terminal negativity of the P wave in V1, prolonged QT and Tpeak-Tend intervals, QRS duration and fragmentation, bundle branch block, ST segment depression and elevation, T waves (inverted, T wave axes, spatial angles between QRS and T vectors, premature ventricular contractions, and ECG hypertrophy criteria.

  8. Cardiovascular risks of antiretroviral therapies.

    Science.gov (United States)

    Mondy, Kristin; Tebas, Pablo

    2007-01-01

    The use of highly active antiretroviral therapy (HAART) has resulted in sustained reductions in mortality from HIV infection. In recent years, HAART has also been associated with metabolic complications that may increase patients' cardiovascular disease risk. Recent studies have begun to support a more complex interaction between HAART, HIV infection itself, and other traditional social and immunologic factors that may predispose patients to premature cardiovascular disease. Substantial progress has been made in the development of newer antiretroviral therapies that have a better metabolic profile with respect to dyslipidemia, hyperglycemia, and lipodystrophy. Optimal selection of metabolically neutral antiretroviral therapies, together with aggressive management of other modifiable coronary risk factors, may improve cardiovascular disease risk in the long term.

  9. Social factors and cardiovascular morbidity.

    Science.gov (United States)

    Brunner, Eric John

    2017-03-01

    Recent progress in population health at aggregate level, measured by life expectancy, has been accompanied by lack of progress in reducing the difference in health prospects between groups defined by social status. Cardiovascular disease is an important contributor to this undesirable situation. The stepwise gradient of higher risk with lower status is accounted for partly by social gradients in health behaviors. The psychosocial hypothesis provides a stronger explanation, based on social patterning of living and working environments and psychological assets that individuals develop during childhood. Three decades of research based on Whitehall II and other cohort studies provide evidence for psychosocial pathways leading to cardiovascular morbidity and mortality. Job stress is a useful paradigm because exposure is long term and depends on occupational status. Studies of social-biological translation implicate autonomic and neuroendocrine function among the biological systems that mediate between chronic adverse psychosocial exposures and increased cardiometabolic risk and cardiovascular disease incidence.

  10. [Cardiovascular manifestations of human toxocariasis].

    Science.gov (United States)

    Bolívar-Mejía, Adrián; Rodríguez-Morales, Alfonso J; Paniz-Mondolfi, Alberto E; Delgado, Olinda

    2013-01-01

    Toxocariasis is a parasitic infection produced by helminths that cannot reach their adult stage in humans. For their etiological species (Toxocara canis and Toxocara cati), man is a paratenic host. Infection by such helminths can produce a variety of clinical manifestations, such as: visceral larvae migrans syndrome, ocular larvae migrans syndrome and covert toxocariasis. In the visceral larvae migrans syndrome, the organs that are mainly involved include liver, lungs, skin, nervous system, muscles, kidneys and the heart. Regarding the latter, the importance of cardiovascular manifestations in toxocariasis, as well as its clinical relevance, has increasingly begun to be recognized. The current article is based on a systematic information search, focused mainly on the clinical and pathological aspects of cardiovascular manifestations in toxocariasis, including its pathophysiology, laboratory findings, diagnosis and therapeutical options, with the objective of highlighting its importance as a zoonosis and its relevance to the fields of cardiovascular medicine in adults and children.

  11. OCORRÊNCIA DE DOENÇAS CARDIOVASCULARES E PULMONARES EM PACIENTES COM ARTRITE REUMATÓIDE

    Directory of Open Access Journals (Sweden)

    Mirizana Alves-de-Almeida

    2012-12-01

    Full Text Available Introdução: A Artrite Reumatóide é uma doença inflamatória crônica e sistêmica e pode apresentar sintomas extra articulares, atingindo outros órgãos. Objetivo: Constatar a ocorrência de doenças cardiovasculares e pulmonares e verificar a presença de fatores de risco em pacientes com artrite reumatóide. Metodologia: Esta é uma pesquisa de campo, documental e transversal, realizada no Hospital Geral César Cals, com 44 portadores de artrite reumatóide. Resultados: Dos 44 pacientes, 40 (91% eram do sexo feminino e 4 (9% do masculino, com faixa etária prevalente de 56 a 65 anos. As doenças cardiovasculares ocorreram em 12 pacientes (27,27%, as quais foram: quatro infarto agudo do miocárdio, quatro miocardiopatia hipertrófica, dois varizes, um vasculite e um estenose aórtica. As doenças pulmonares ocorreram em 5 pacientes, não sendo possível destacar prevalência (asma, tuberculose, alergias respiratórias, bronquite e pneumonia. Ao investigar os fatores de risco para doenças cardiovasculares e pulmonares, constatou-se que a maioria estava relacionada aos hábitos de vida, como: hipertensão arterial 33 (30%, tabagismo 29 (26,36%, sedentarismo 22 (20%, etilismo 17 (15,45% e diabetes 9 (8,18%. Dos entrevistados, 16 não praticavam atividade física e 9 praticavam, 15 relataram possuir hábitos alimentares saudáveis e 10 relataram não possuir. Conclusão: Foi encontrada tanto a ocorrência de doenças cardiovasculares (que foi maior como a de doenças pulmonares, enfatizando a importância da detecção e prevenção dos fatores de risco e das alterações cardiovasculares e pulmonares em pacientes com artrite reumatóide, para que se promova assim um tratamento mais completo. Palavras-chave: Artrite reumatóide. Doenças cardiovasculares. Pneumopatias. 

  12. Nitric oxide and cardiovascular system.

    Science.gov (United States)

    Cengel, Atiye; Sahinarslan, Asife

    2006-12-01

    Endothelium has many important functions including the control of blood-tissue permeability and vascular tonus, regulation of vascular surface properties for homeostasis and inflammation. Nitric oxide is the chief molecule in regulation of endothelial functions. Nitric oxide deficiency, which is also known as endothelial dysfunction, is the first step for the occurrence of many disease states in cardiovascular system including heart failure, hypertension, dyslipidemia, insulin resistance, diabetes mellitus, hyperhomocysteinemia and smoking. This review deals with the importance of nitric oxide for cardiovascular system. It also includes the latest improvements in the diagnosis and treatment of endothelial dysfunction.

  13. Nonfasting hyperlipidemia and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, B G; Langsted, A; Freiberg, J J

    2009-01-01

    lipoproteins into the arterial intima with subsequent retention leading to atherogenesis, while low HDL cholesterol levels may be an innocent bystander. Finally, nonfasting levels of total cholesterol, non-HDL cholesterol, LDL cholesterol, apolipoprotein B, triglycerides, HDL cholesterol, apolipoprotein A1......, total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...

  14. Suspeita de Apneia Obstrutiva do Sono definida pelo Questionário de Berlim prediz eventos em pacientes com Síndrome Coronariana Aguda Sospecha de apnea obstructiva del sueño definida por el cuestionario de Berlín predice eventos en pacientes con síndrome coronario agudo Suspicion of Obstructive Sleep Apnea by Berlin Questionnaire predicts events in patients with Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Eryca Vanessa S. de Jesus

    2010-09-01

    Full Text Available FUNDAMENTO: De um ponto de vista mecanístico, a apneia obstrutiva do sono (SAOS pode causar distúrbios extras à homeostase cardiovascular na presença de síndrome coronariana aguda (SCA. OBJETIVO: Investigar se um diagnóstico clínico padronizado de SAOS, em pacientes com SCA, prediz o risco de eventos cardiovasculares durante hospitalização. MÉTODOS: Em um estudo de coorte prospectivo, um grupo de 200 pacientes com diagnóstico de SCA estabelecido entre Setembro de 2005 e Novembro de 2007, foram estratificados pelo Questionário de Berlim (QB para o risco de SAOS (alto ou baixo risco. Foi testado se o subgrupo de alto risco para SAOS apresenta maior tendência à eventos cardiovasculares. O endpoint primário avaliado foi um desfecho composto de morte cardiovascular, eventos cardíacos isquêmicos recorrentes, edema pulmonar agudo e acidente vascular cerebral durante a hospitalização. RESULTADOS: Noventa e quatro (47% dos pacientes identificados pelo QB apresentavam suspeita de SAOS. Alto risco para SAOS estava associado com uma mortalidade mais elevada, embora sem diferença estatística (4,25% vs 0,94%; p=0,189, mas com uma estatisticamente significante maior incidência de desfecho composto de eventos cardiovasculares (18,08% vs 6,6%; p=0,016. No modelo de regressão logística, os preditores multivariados de desfecho composto de eventos cardiovasculares foram idade (OR = 1,048; IC95%: 1,008 a 1,090; p=0,019, fração de ejeção do VE (OR = 0,954; IC95%: 0,920 a 0,989; p=0,010, e risco mais elevado de SAOS (OR = 3,657; IC95%: 1,216 a 10,996; p=0,021. CONCLUSÃO: O uso de um questionário simples e validado (QB para identificar pacientes com risco mais elevado de SAOS pode ajudar a prever o desfecho cardiovascular durante a hospitalização. Além disso, nossos dados sugerem que SAOS é muito comum em pacientes com SCA.FUNDAMENTO: Desde un punto de vista mecanístico, la apnea obstructiva del sueño (SAOS puede ocasionar disturbios

  15. Cardiovascular rehabilitation. Results in the cardiology service. Rehabilitación cardiovascular. Resultados en el servicio de cardiología.

    Directory of Open Access Journals (Sweden)

    Teresa Rodríguez Rodríguez

    2004-04-01

    factores de riesgo que comprenden el patrón lipídico, la glicemia, el sobrepeso y algunos descritos más recientemente como el fibrinógeno y los factores de la coagulación. Objetivo: Analizar y comparar los efectos de un complejo de ejercicios en los pacientes incluidos en la rehabilitación cardiovascular. Métodos: Estudio de tipo antes y después del total (30 pacientes incluidos en el programa de rehabilitación cardiovascular durante 4 meses en el Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos. Resultados: Del total de pacientes 25 son masculinos (83.3 %, los diagnósticos fueron: infarto agudo del miocardio, hipertensión arterial con angina, revascularización miocárdica y angina estable. De forma altamente significativa p < 0,0001 varió el doble producto al final del trote y los parámetros ergométricos: carga máxima alcanzada y tolerada y el tiempo total de ejercicio. De forma significativa p < 0,001 varió el doble producto de la prueba ergométrica y las unidades del metabolismo basal. Conclusiones: Por los cambios clínicos, ergométricos y psicológicos evaluados a estos pacientes los podemos considerar rehabilitados integralmente con este complejo de ejercicios.

  16. System of psycho-therapeutics influences in patients admitted to hospital with cardiovascular diseases. Sistema de influencias psicoterapéuticas en pacientes con afecciones cardiovasculares hospitalizados.

    Directory of Open Access Journals (Sweden)

    Teresa Rodríguez Rodríguez

    >Objetivo : Evaluar la efectividad de un sistema de influencias psicoterapéuticas en pacientes con problemas cardiovasculares. Métodos : Estudio de intervención con diseño cuasi experimental en pacientes con urgencias cardiovasculares hospitalizados en la Unidad de Cuidados Integrales del Corazón, del Hospital ¨Dr.Gustavo Aldereguía Lima¨ de Cienfuegos, en el periodo comprendido entre el 1 de junio de 2002 y el 1 de junio de 2003, a los que se le aplicó tratamiento relajante, estimulante y adormecedor. Se evaluaron las modificaciones de parámetros psicológicos y fisiológicos después de ser tratados con estas técnicas psicológicas. Resultados: Los diagnósticos cardiovasculares de infarto agudo del miocardio y angina fueron las principales causas de ingreso. Las variaciones de las frecuencias respiratoria y cardiaca así como la tensión arterial tendieron a mantenerse, a disminuir, y/o establecerse en parámetros normales. El estado psicológico después de recibido el tratamiento fue favorecido. Conclusiones: Los efectos del sistema de influencias psicológicas fueron beneficiosos tanto desde el punto de vista psicológico como orgánico.

  17. Laser therapy in cardiovascular disease

    Science.gov (United States)

    Rindge, David

    2009-02-01

    Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

  18. Animal Models of Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Carlos Zaragoza

    2011-01-01

    Full Text Available Cardiovascular diseases are the first leading cause of death and morbidity in developed countries. The use of animal models have contributed to increase our knowledge, providing new approaches focused to improve the diagnostic and the treatment of these pathologies. Several models have been developed to address cardiovascular complications, including atherothrombotic and cardiac diseases, and the same pathology have been successfully recreated in different species, including small and big animal models of disease. However, genetic and environmental factors play a significant role in cardiovascular pathophysiology, making difficult to match a particular disease, with a single experimental model. Therefore, no exclusive method perfectly recreates the human complication, and depending on the model, additional considerations of cost, infrastructure, and the requirement for specialized personnel, should also have in mind. Considering all these facts, and depending on the budgets available, models should be selected that best reproduce the disease being investigated. Here we will describe models of atherothrombotic diseases, including expanding and occlusive animal models, as well as models of heart failure. Given the wide range of models available, today it is possible to devise the best strategy, which may help us to find more efficient and reliable solutions against human cardiovascular diseases.

  19. Down Syndrome: A Cardiovascular Perspective

    Science.gov (United States)

    Vis, J. C.; Duffels, M. G. J.; Winter, M. M.; Weijerman, M. E.; Cobben, J. M.; Huisman, S. A.; Mulder, B. J. M.

    2009-01-01

    This review focuses on the heart and vascular system in patients with Down syndrome. A clear knowledge on the wide spectrum of various abnormalities associated with this syndrome is essential for skillful management of cardiac problems in patients with Down syndrome. Epidemiology of congenital heart defects, cardiovascular aspects and…

  20. Iron deficiency and cardiovascular disease

    NARCIS (Netherlands)

    von Haehling, Stephan; Jankowska, Ewa A.; van Veldhuisen, Dirk J.; Ponikowski, Piotr; Anker, Stefan D.

    2015-01-01

    Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of card

  1. Hedgehog morphogen in cardiovascular disease

    NARCIS (Netherlands)

    Bijlsma, Maarten F.; Peppelenbosch, Maikel P.; Spek, C. Arnold

    2006-01-01

    In this review, we focus on the basic biology of the important developmental Hedgehog ( Hh) protein family, its general function in development, pathway mechanisms, and gene discovery and nomenclature. Hh function in cardiovascular development and recent findings concerning Hh signaling in ischemia

  2. Cardiovascular physiology at high altitude.

    Science.gov (United States)

    Hooper, T; Mellor, A

    2011-03-01

    The role of the cardiovascular system is to deliver oxygenated blood to the tissues and remove metabolic effluent. It is clear that this complex system will have to adapt to maintain oxygen deliver in the profound hypoxia of high altitude. The literature on the adaptation of both the systemic and pulmonary circulations to high altitude is reviewed.

  3. The cardiovascular effects of methylxanthines

    NARCIS (Netherlands)

    Riksen, N.P.; Smits, P.; Rongen, G.A.P.J.M.

    2011-01-01

    In the concentration range that is normally achieved in humans, e.g., after the drinking of coffee or in patients treated with theophylline, the cardiovascular effects of methylxanthines are primarily due to antagonism of adenosine A(1) and A(2) receptors. Inhibition of phosphodiesterases or mobiliz

  4. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut;

    2001-01-01

    Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...

  5. Genome editing in cardiovascular diseases.

    Science.gov (United States)

    Strong, Alanna; Musunuru, Kiran

    2017-01-01

    Genome-editing tools, which include zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) systems, have emerged as an invaluable technology to achieve somatic and germline genomic manipulation in cells and model organisms for multiple applications, including the creation of knockout alleles, introducing desired mutations into genomic DNA, and inserting novel transgenes. Genome editing is being rapidly adopted into all fields of biomedical research, including the cardiovascular field, where it has facilitated a greater understanding of lipid metabolism, electrophysiology, cardiomyopathies, and other cardiovascular disorders, has helped to create a wider variety of cellular and animal models, and has opened the door to a new class of therapies. In this Review, we discuss the applications of genome-editing technology throughout cardiovascular disease research and the prospect of in vivo genome-editing therapies in the future. We also describe some of the existing limitations of genome-editing tools that will need to be addressed if cardiovascular genome editing is to achieve its full scientific and therapeutic potential.

  6. Serotonin receptors as cardiovascular targets

    NARCIS (Netherlands)

    C.M. Villalón (Carlos); P.A.M. de Vries (Peter); P.R. Saxena (Pramod Ranjan)

    1997-01-01

    textabstractSerotonin exerts complex effects in the cardiovascular system, including hypotension or hypertension, vasodilatation or vasoconstriction, and/or bradycardia or tachycardia; the eventual response depends primarily on the nature of the 5-HT receptors involved. In the light of current 5-HT

  7. Comparative cardiovascular safety of dementia medications

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Peterson, Eric D; Holm, Ellen

    2012-01-01

    To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark.......To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark....

  8. Anabolic steroids and cardiovascular risk.

    Science.gov (United States)

    Angell, Peter; Chester, Neil; Green, Danny; Somauroo, John; Whyte, Greg; George, Keith

    2012-02-01

    Recent reports from needle exchange programmes and other public health initiatives have suggested growing use of anabolic steroids (AS) in the UK and other countries. Data indicate that AS use is not confined to body-builders or high-level sportsmen. Use has spread to professionals working in emergency services, casual fitness enthusiasts and subelite sportsmen and women. Although the precise health consequences of AS use is largely undefined, AS use represents a growing public health concern. Data regarding the consequences of AS use on cardiovascular health are limited to case studies and a modest number of small cohort studies. Numerous case studies have linked AS use with a variety of cardiovascular disease (CVD) events or endpoints, including myocardial infarction, stroke and death. Large-scale epidemiological studies to support these links are absent. Consequently, the impact of AS use upon known CVD risk factors has been studied in relatively small, case-series studies. Data relating AS use to elevated blood pressure, altered lipid profiles and ECG abnormalities have been reported, but are often limited in scope, and other studies have often produced equivocal outcomes. The use of AS has been linked to the appearance of concentric left ventricular hypertrophy as well as endothelial dysfunction but the data again remains controversial. The mechanisms responsible for the negative effect of AS on cardiovascular health are poorly understood, especially in humans. Possibilities include direct effects on myocytes and endothelial cells, reduced intracellular Ca2+ levels, increased release of apoptogenic factors, as well as increased collagen crosslinks between myocytes. New data relating AS use to cardiovascular health risks are emerging, as novel technologies are developed (especially in non-invasive imaging) that can assess physiological structure and function. Continued efforts to fully document the cardiovascular health consequences of AS use is important to

  9. Sex steroids and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Bu Beng Yeap

    2014-04-01

    Full Text Available As men grow older, testosterone (T levels decline and the significance of this change is debated. The evidence supporting a causal role for lower circulating T, or its metabolites dihydrotestosterone (DHT and estradiol, in the genesis of atherosclerosis and cardiovascular disease (CVD in men is limited. Observational studies associate low baseline T levels with carotid atherosclerosis, aortic and peripheral vascular disease, and with the incidence of cardiovascular events and mortality. Studies using mass spectrometry suggest that when total T is assayed optimally, calculation of free T might not necessarily improve risk stratification. There is limited evidence to support an association of estradiol with CVD. Interventional studies of T therapy in men with coronary artery disease have shown beneficial effects on exercise-induced myocardial ischemia. However, placebo-controlled, randomized clinical trials (RCTs of T therapy in men with the prespecified outcomes of cardiovascular events or deaths are lacking. Meta-analyses of randomized controlled trials of T published up to 2010 found no increase in cardiovascular events, mortality, or prostate cancer with therapy. Recently, in a trial of older men with mobility limitations, men randomized to receive a substantial dose of T reported cardiovascular adverse effects. This phenomenon was not reported from a comparable trial where men received a more conservative dose of T, suggesting a prudent approach should be adopted when considering therapy in frail older men with existing CVD. Adequately powered RCTs of T in middle-aged and older men are needed to clarify whether or not hormonal intervention would reduce the incidence of CVD.

  10. Modelos experimentales de enfermedad cardiovascular Experimental models of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    A. Gil Hernández

    2007-04-01

    Full Text Available El presente trabajo describe los modelos experimentales de utilidad clínica en el estudio de las enfermedades cardiovasculares y hace énfasis en los modelos usados para determinar los mecanismos fisiopatológicos de la aterosclerosis, así como para evaluar los efectos de productos nutricionales y farmacológicos sobre el desarrollo de este proceso inflamatorio complejo común a muchas enfermedades cardiovasculares. Se revisan los modelos animales en los que se puede inducir aterosclerosis por cambios en la composición de la dieta y los modelos animales en los que la alteración de uno o más genes (animales knock-out y knock-in, o la incorporación de genes foráneos de otras especies, da lugar a la aparición de hiperlipidemia con riesgo asociado de aparición de enfermedad cardiovascular temprana. Por otra parte, se consideran algunas de las líneas celulares más utilizadas en el estudio de los mecanismos moleculares de la aterogénesis y de evaluación de sustancias con interés nutricional o farmacológico.The present work describes clinically useful experimental models for the study of cardiovascular disease and emphasites the models used to determine the pathophysiologic mechanisms of atherosclerosis, as well as to evaluate the effects of nutritional and pharmacological products on the development of this complex inflammatory process present in many cardiovascular diseases. Animal models in which ahterosclerosis may be induced by dietary changes are reviewed, as well as those in which modification in one or more genes (knock-out and knock-in animals, or the incorporation of foreign genes from other species lead to early cardiovascular disease. On the other hand, some of the cell lines most frequently used in studying molecular mechanisms of atherosclerosis and assessment of substances with nutritional or pharmacological interest are considered.

  11. Pregnancy disorders and cardiovascular disease risk

    NARCIS (Netherlands)

    Heida, K.Y.

    2016-01-01

    Cardiovascular disease is the most important cause of death in women in the Netherlands. Early identification of women at increased risk of cardiovascular disease and subsequent detection and treatment of risk factors contributes to the reduction of cardiovascular disease morbidity and mortality. A

  12. Perfil glicometabólico inicial em pacientes com síndrome coronariana aguda e síndrome metabólica Perfil glucometabólico inicial en pacientes con síndrome coronario agudo y síndrome metabólico Early glucometabolic profile in patients with acute coronary syndromes and metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Carlos M. C. Monteiro

    2009-02-01

    Full Text Available FUNDAMENTO: Pacientes com síndrome metabólica (SM têm alto risco coronariano e a disfunção da célula beta ou resistência à insulina pode prever um risco adicional de eventos cardiovasculares precoces. OBJETIVO: Avaliar as alterações glicometabólicas precoces em pacientes com SM, mas sem diagnóstico de diabete tipo 2, após síndrome coronariana aguda. MÉTODOS: Um total de 114 pacientes foi submetido ao teste oral de tolerância à glicose (TOTG, 1-3 dias da alta hospitalar, após infarto agudo do miocárdio ou angina instável. Baseado no TOTG, definimos três grupos de pacientes: tolerância normal à glicose (TNG; n=26, tolerância alterada à glicose (TAG; n=39 ou diabetes mellitus (DM; n=49. O Modelo de Avaliação da Homeostase (HOMA-IR foi usado para estimar a resistência à insulina; a responsividade da célula beta foi avaliada através do índice insulinogênico de 30 minutos (ΔI30/ΔG30. RESULTADOS: Baseado no HOMA-IR, os pacientes com DM eram mais insulino-resistentes do que aqueles com TNG ou TAG (pFUNDAMENTO: Pacientes con síndrome metabólico (SM tienen alto riesgo coronario y la disfunción de la célula beta o la resistencia a la insulina puede prever un riesgo adicional de eventos cardiovasculares precoces. OBJETIVO: Evaluar las alteraciones glucometabólicas precoces en pacientes con SM, pero sin diagnóstico de diabetes tipo 2, tras el síndrome coronario agudo. MÉTODOS: Un total de 114 pacientes fue sometido a la prueba oral de tolerancia a la glucosa (POTG, de un a tres días tras el alta hospitalaria, y luego de infarto agudo de miocardio o angina inestable. Basado en el POTG, definimos tres grupos de pacientes: tolerancia normal a la glucosa (TNG; n=26, tolerancia alterada a la glucosa (TAG; n=39 o diabetes mellitus (DM; n=49. Se utilizó el Modelo de Evaluación de la Homeostasis (HOMA-IR para estimarse la resistencia a la insulina; se evaluó la responsividad de la célula beta a través del

  13. Controvérsias acerca da acidose hipercápnica na síndrome do desconforto respiratório agudo Controversies involving hypercapnic acidosis in acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Liliane Nardelli

    2009-12-01

    Full Text Available A síndrome do desconforto respiratório agudo é caracterizada por uma reação inflamatória difusa do parênquima pulmonar induzida por um insulto direto ao epitélio alveolar (síndrome do desconforto respiratório agudo pulmonar ou indireto por meio do endotélio vascular (síndrome do desconforto respiratório agudo extrapulmonar. A principal estratégia terapêutica da síndrome do desconforto respiratório agudo é o suporte ventilatório. Entretanto, a ventilação mecânica pode agravar a lesão pulmonar. Nesse contexto, uma estratégia ventilatória protetora com baixo volume corrente foi proposta. Tal estratégia reduziu a taxa de mortalidade dos pacientes com síndrome do desconforto respiratório agudo, porém acarretou acidose hipercápnica. O presente artigo apresenta uma revisão da literatura acerca dos efeitos da acidose hipercápnica na síndrome do desconforto respiratório agudo. Para tal, realizou-se uma revisão sistemática da literatura científica conforme critérios já estabelecidos para análise documental incluindo artigos experimentais e clínicos sobre o tema, usando-se como bases de dados MedLine, LILACS, SciElo, PubMed, Cochrane. A acidose hipercápnica é defendida por alguns autores como moduladora do processo inflamatório da síndrome do desconforto respiratório agudo. Entretanto, estudos clínicos e experimentais acerca dos efeitos da acidose hipercápnica têm demonstrado resultados controversos. Logo, é fundamental a realização de mais pesquisas para elucidar o papel da acidose hipercápnica na síndrome do desconforto respiratório agudo.Acute respiratory distress syndrome is characterized by a diffuse inflammatory reaction of lung parenchyma induced by a direct insult to the alveolar epithelium (pulmonary acute respiratory distress syndrome or an indirect lesion through the vascular endothelium (extrapulmonary acute respiratory distress syndrome. The main therapeutic strategy for acute respiratory

  14. Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J;

    2010-01-01

    The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy...... cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy. We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non...... cardiovascular and non-cardiovascular causes, while hypertensive disorders of pregnancy are markers of early death of mothers from cardiovascular causes....

  15. Eventos cardiovasculares en una población cerrada. Seguimiento a 10 años

    Directory of Open Access Journals (Sweden)

    Leandro M. Goldstraj

    2008-01-01

    Full Text Available IntroducciónEn estudios epidemiológicos previos se observó que poblaciones con igual riesgo por suma de factores clásicos poseían una incidencia y tipos de expresión de enfermedades cardiovasculares diferentes.ObjetivoDeterminar la incidencia de MACE, compuesta por infarto agudo de miocardio, angina inestable, accidente cerebrovascular, angioplastia transluminal coronaria, cirugía de revascularización miocárdica o muerte cardiovascular, y su asociación con los factores de riesgo en una población cerrada. Material y métodosEl presente es un estudio de cohorte prospectivo en el que fueron relevados hombres, de profesión policías, durante el año 1997. Luego se ingresaron en la base de datos hospitalaria aquellos que presentaron eventos en los 10 años posteriores. Se empleó la prueba de la t de Student para variables cuantitativas y regresión logística para las cualitativas. ResultadosSe incluyeron 2.379 personas de sexo masculino. La edad promedio fue de 39,5 ± 9,25 años. La prevalencia de factores de riesgo conocidos por las personas fue: HTA 11,1%, dislipidemia 20,3%, diabetes 2,4%, tabaquismo 43,3%. Noventa pacientes presentaron algún tipo de MACE. El odds ratio para diabetes fue 4,54 (IC 95% 2,1-9,81, HTA 2,3 (IC 95% 1,38-3,85, dislipidemia 2,74 (IC 95% 1,77-4,25 y para tabaquismo 1,48 (IC 95% 0,97-2,28. La edad, el LDL, el fibrinógeno y las horas trabajo diarias mostraron asociaciones significativas. El área bajo la curva ROC del puntaje de Framingham fue de 0,72 y para el puntaje europeo fue de 0,71. ConclusiónLos factores de riesgo de enfermedad cardiovascular clásicos tuvieron una importancia similar a los ya comunicados por los estudios epidemiológicos; es importante destacar algunos no clásicos como el fibrinógeno. Los puntajes de riesgo fueron predictores regulares en esta población. Las características especiales de la población analizada permiten la ejecución de programas de prevención acordes.

  16. Cardiovascular risk, effectiveness and mortality

    Directory of Open Access Journals (Sweden)

    Juan Gérvas

    2011-11-01

    Full Text Available Dice la Ley de Hierro de la Epidemiología que todo el que nace muere. Por ello el fin de la Medicina no es evitar la muerte en sí, sino evitar las muertes, las enfermedades y el sufrimiento médicamente evitables.Al final, todos nuestros pacientes morirán – y nosotros mismos moriremos también, obviamente. “Los cuerpos encuentran una forma de morir” y si la causa no es el hambre ni la deshidratación, ni es congénita, ni infecciosa, ni por lesiones, ni por cáncer, ni por suicidio, tenemos que esperar que sea por ‘causa cardiovascular’, enfermedad pulmonar, insuficiencia renal o hepática, demencia u otras enfermedades degenerativas. Pero de algo tenemos que morir.Morir por causa cardiovascular ni es deshonroso, ni implica defectuosa atención clínica. Que la primera causa de muerte sea la cardiovascular no dice nada respecto a los cuidados clínicos, ni debería asustar.Sin embargo, son evitables muchas muertes de causa cardiovascular. Así, se puede evitar mucha mortalidad cardiovascular disminuyendo la desigualdad social, por ejemplo (con mejor re-distribución de la riqueza, mejor educación y demás. Los médicos saben que los factores adversos psicosociales asociados a la pertenencia a la clase baja responden del 35% del riesgo atribuible a la hipertensión en la incidencia del infarto de miocardio (en otra formulación, que pertenecer a la clase baja multiplica por 2,7 dicho riesgo1.También deberíamos saber que contra las muertes cardiovasculares no hay nada como las políticas de salud pública sobre el tabaquismo (restricciones de lugares en los que fumar, aumento del precio del tabaco, campañas de información, y demás.En lo clínico, las muertes cardiovasculares evitables se deben ver en perspectiva, según lo que se puede lograr2. Así, por 100.000 habitantes y año, el tratamiento con inhibidores de la enzima convertidora de angiotensina (IECA en la insuficiencia cardíaca puede evitar 308 muertes; el consejo m

  17. Respostas fisiológicas ao exercício agudo em ratos obesos tratados com metformina Physiological responses to intense exercise in obese rats treated with metformin

    Directory of Open Access Journals (Sweden)

    Gustavo Gomes de Araujo

    2007-12-01

    Full Text Available O objetivo do presente estudo foi investigar as respostas fisiológicas ao exercício agudo em ratos Wistar obesos, tratados com metformina. Os animais receberam injeção subcutânea de glutamato monossódico (4mg/g peso corporal, para indução da obesidade. Os animais foram divididos em 4 grupos, conforme o tratamento recebido: obesos controles (OC; obesos metformina (OM; obesos controles exercitados (OCE e obesos metformina exercitados (OME. Foram analisados, antes e após uma sessão de exercício agudo: glicose sérica (mg/dL, triglicerídeos (g/100g, colesterol total (mg/dL e hematócrito (%. Os valores de glicose sérica e colesterol total foram reduzidos significativamente no grupo controle exercitado (OCE - 68,4 ± 14,7 e 70,8 ± 18,3 em comparação ao grupo controle sedentário (OC - 83,6 ± 12,8 e 91,3 ± 9,6. A administração de metformina isoladamente diminuiu a concentração de glicose de 83,6 ± 12,8 (OC para 70,8 ± 5,9 (OM. Por outro lado, a associação de metformina com exercício aumentou a disponibilidade de triacilgliceróis livres após a atividade (OM - 166,6 ± 11,3, OME - 184,0 ± 4,3. Em conclusão o programa de intervenção utilizado (exercício físico agudo mostrou-se eficiente na homeostasia glicêmica, bem como, nos níveis circulantes de lipídios em ratos obesos tratados com metformina.The purpose of the present study was to investigate the physiological responses to intense exercise in obese Wistar rats treated with metformin. To induce obesity, all animals were infused with monosodic glutamate (4 mg/g of body weight via subcutaneous injection. The rats were divided in 4 groups according to the received treatment: obese control (OC; obese metformin ( OM; obese control exercise (OCE and obese metformin exercise (OME. Before and after one session of intense exercise the following parameters were measured: serum glucose (mg/dl, triglycerides (g/100g, total cholesterol (mg/dl and haematocrit (%. The values of

  18. Cardiovascular Prevention of Cognitive Decline

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Monsuez

    2011-01-01

    Full Text Available Midlife cardiovascular risk factors, including diabetes, hypertension, dyslipemia, and an unhealthy lifestyle, have been linked to subsequent incidence, delay of onset, and progression rate of Alzheimer disease and vascular dementia. Conversely, optimal treatment of cardiovascular risk factors prevents and slows down age-related cognitive disorders. The impact of antihypertensive therapy on cognitive outcome in patients with hypertension was assessed in large trials which demonstrated a reduction in progression of MRI white matter hyperintensities, in cognitive decline and in incidence of dementia. Large-scale database correlated statin use and reduction in the incidence of dementia, mainly in patients with documented atherosclerosis, but clinical trials failed to reach similar conclusions. Whether a multitargeted intervention would substantially improve protection, quality of life, and reduce medical cost expenditures in patients with lower risk profile has not been ascertained. This would require appropriately designed trials targeting large populations and focusing on cognitive decline as a primary outcome endpoint.

  19. Chiral cardiovascular drugs: an overview.

    Science.gov (United States)

    Ranade, Vasant V; Somberg, John C

    2005-01-01

    Stereochemistry in drug molecules is rapidly becoming an important aspect in drug research, design, and development. Recently, individual stereoisomers of drug molecules with asymmetric centers such as fexofenadine, cetirizine, verapamil, fluoxetine, levalbutarol, and amphetamine, for example, have been separated and developed as individual drugs. These stereoisomers have different therapeutic activity, and each isomer has contributed differently with respect to its formulation's pharmacologic activity, side effects, and toxicity. The present overview discusses chirality among a select group of cardiovascular drugs, their stereochemical synthesis/preparation, isolation techniques using chiral chromatography, methods for confirmation of their enantiomeric purity, pharmacodynamics, and pharmacokinetics. Chirality has been visualized as an important factor in cardiovascular research. It is also becoming evident in other areas of therapeutics.

  20. Educational differences in cardiovascular mortality

    DEFF Research Database (Denmark)

    Kjøllesdal, M. K. R.; Ariansen, I.; Mortensen, L. H.;

    2016-01-01

    Aims: To explore the confounding effects of early family factors shared by siblings and cardiovascular risk factors in midlife on the educational differences in mortality from cardiovascular disease (CVD). Methods: Data from national and regional health surveys in Norway (1974–2003) were linked...... with data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry. The study population consisted of participants with at least one full sibling among the health survey participants (n=271,310). Data were available on CVD risk factors, including...... weight, height, blood pressure, total cholesterol and smoking. Results: The hazards ratio (HR) of CVD mortality was 3.44 (95% confidence interval (CI) 2.98–3.96) in the lowest educational group relative to the highest. The HRs were little altered in the within-sibship analyses. Adjusted for risk factors...

  1. Cardiovascular stress of photochemotherapy (PUVA)

    Energy Technology Data Exchange (ETDEWEB)

    Ciafone, R.A.; Rhodes, A.R.; Audley, M.; Freedberg, I.M.; Abelmann, W.H.

    1980-11-01

    The recently devised therapy for psoriasis and related skin diseases, consisting of long-wave ultraviolet light and oral 8-methoxypsoralen (PUVA), was investigated for its cardiovascular effects. In seventeen patients, long-wave ultraviolet light therapy in a treatment enclosure (mean duration, 19.3 minutes) resulted in ambient temperatures of 39.2 degrees C +/- 2.1 degrees C (SD) and skin temperatures of 38.2 degrees C +/- 1.4 degrees C. In upright subjects, heart rate rose 30.8% to 114.4 +/- 25.2 beats per minute (bpm). Intensive room air conditioning, outside of the treatment enclosure, although significantly lowering skin and ambient temperatures, did not affect the heart rates significantly. PUVA therapy is associated with a definite cardiovascular stress when the box type of therapeutic unit is used. Possible modifications are discussed.

  2. Cardiovascular disease incidence and survival

    DEFF Research Database (Denmark)

    Byberg, Stine; Agyemang, Charles; Zwisler, Ann Dorthe

    2016-01-01

    Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... significantly lower incidence of CVD, AMI and stroke. All-cause and cause-specific survival after CVD, AMI and stroke was similar or significantly better for migrants compared to Danish-born, regardless of type of migrant (refugee vs. family-reunified) or country of origin. Refugees are disadvantaged in terms...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....

  3. Circunferência abdominal como preditor de evolução em 30 dias na síndrome coronariana aguda Circunferencia abdominal como predictor de evolución en 30 días en el Síndrome Coronario Agudo Abdominal circumference as a predictor of 30-day outcome in acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Priscilla Azambuja Lopes de Souza

    2011-05-01

    Full Text Available FUNDAMENTO: A circunferência abdominal (CA é a medida que mais se correlaciona com os fatores de risco e morte por doença cardiovascular. Entretanto, o impacto da obesidade no prognóstico de pacientes com doenças cardiovasculares permanece controverso e requer maiores esclarecimentos. OBJETIVO: Avaliar a CA como preditor de evolução em 30 dias em pacientes que internaram com síndrome coronariana aguda (SCA, em hospital de referência no tratamento de doenças cardiovasculares. MÉTODOS: Coorte contemporânea com 267 pacientes que internaram por SCA e que foram seguidos por 30 dias após a alta levando em consideração os eventos cardiovasculares maiores - MACE - (óbito, reinfarto, reinternação para procedimentos de revascularização. Nas primeiras 24 horas da admissão, os pacientes responderam a um questionário e posteriormente tiveram a CA mensurada. A análise estatística foi realizada com SPSS 17.0, utilizando o teste do Qui-quadrado para variáveis categóricas e o teste t de Student para as variáveis numéricas, com o nível de significância de p FUNDAMENTO: La circunferencia abdominal (CA es la medición que se correlaciona con los factores de riesgo y la muerte por enfermedad cardiovascular. Sin embargo, el impacto de la obesidad en el pronóstico de los pacientes con enfermedades cardiovasculares sigue siendo controvertido y requiere una mayor clarificación. OBJETIVO: Evaluar la CA como un predictor de evolución en 30 días en pacientes que fueron hospitalizados con síndrome coronario agudo (SCA, en un hospital de referencia para el tratamiento de las enfermedades cardiovasculares. MÉTODOS: Cohorte contemporánea con 267 pacientes que fueron hospitalizados por SCA y que fueron seguidos durante 30 días después del alta, teniendo en cuenta los eventos cardiovasculares mayores - MACE - (muerte, reinfarto, rehospitalización por procedimientos de revascularización. En las primeras 24 horas del ingreso, los pacientes

  4. Polyphenols, Inflammation, and Cardiovascular Disease

    OpenAIRE

    Tangney, Christy; Rasmussen, Heather E.

    2013-01-01

    Polyphenols are compounds found in foods such as tea, coffee, cocoa, olive oil, and red wine and have been studied to determine if their intake may modify cardiovascular disease (CVD) risk. Historically, biologic actions of polyphenols have been attributed to antioxidant activities, but recent evidence suggests that immunomodulatory and vasodilatory properties of polyphenols may also contribute to CVD risk reduction. These properties will be discussed, and recent epidemiological evidence and ...

  5. Cocoa, chocolate and cardiovascular disease

    OpenAIRE

    Galleano, Monica; Oteiza, Patricia I.; Fraga, Cesar G.

    2009-01-01

    A significant body of evidence demonstrates that diets rich in fruit and vegetables promote health, and attenuate, or delay, the onset of various diseases, including cardiovascular disease (CVD), diabetes, certain cancers, and several other age-related degenerative disorders. The concept that moderate chocolate consumption could be part of a healthy diet has gained acceptance in the last years based on the health benefits ascribed to selected cocoa components. Specifically, cocoa as a plant a...

  6. Disparities in women's cardiovascular health.

    Science.gov (United States)

    McSweeney, Jean C; Pettey, Christina M; Souder, Elaine; Rhoads, Sarah

    2011-01-01

    Cardiovascular disease (CVD) is the leading cause of death in women, and disparities affect the diagnosis, treatment, and outcomes of CVD for women. Biology, genetics, and race contribute to these disparities. Obstetric-gynecologic health care providers routinely encounter women who are at risk for developing CVD and are uniquely positioned as a point of access to intervene to improve/prevent CVD by assessing for risks and discussing healthy lifestyle changes during routine visits.

  7. Vitamin E and cardiovascular disease.

    Science.gov (United States)

    Saremi, Adonis; Arora, Rohit

    2010-01-01

    The objective of this article is to review the role of vitamin E in cardiovascular disease. We begin by describing the general characteristics and metabolism of vitamin E and the pathogenesis of atherosclerosis as it relates to oxidation. We also discuss key in vitro studies, animal studies, observational studies, and clinical trials regarding the potentially cardioprotective effect of vitamin E. Lastly, we outline the current recommendations regarding vitamin E in the prevention and treatment of cardiovascular disease as stated by the American Heart Association. Vitamin E is a fat-soluble antioxidant vitamin and alpha-tocopherol is its most naturally abundant and active form. Oxidation is a key step in atherogenesis. Oxidized low-density lipoprotein stimulates endothelial cells to produce inflammatory markers, is involved in foam cell formation, has cytotoxic effects on endothelial cells, inhibits the motility of tissue macrophages, and inhibits nitric oxide-induced vasodilatation. Vitamin E has been shown to increase oxidative resistance in vitro and prevent atherosclerotic plaque formation in mouse models. Consumption of foods rich in vitamin E has been associated with lower risk of coronary heart disease in middle-aged to older men and women. Clinical studies at large have not demonstrated a benefit of vitamin E in the primary and secondary prevention of cardiovascular disease. Vitamin E supplementation might be associated with an increase in total mortality, heart failure, and hemorrhagic stroke. The American Heart Association does not support the use of vitamin E supplements to prevent cardiovascular disease, but does recommend the consumption of foods abundant in antioxidant vitamins and other nutrients.

  8. Clinical application of cardiovascular pharmacogenetics.

    Science.gov (United States)

    Voora, Deepak; Ginsburg, Geoffrey S

    2012-07-03

    Pharmacogenetics primarily uses genetic variation to identify subgroups of patients who may respond differently to a certain medication. Since its first description, the field of pharmacogenetics has expanded to study a broad range of cardiovascular drugs and has become a mainstream research discipline. Three principle classes of pharmacogenetic markers have emerged: 1) pharmacokinetic; 2) pharmacodynamic; and 3) underlying disease mechanism. In the realm of cardiovascular pharmacogenetics, significant advances have identified markers in each class for a variety of therapeutics, some with a potential for improving patient outcomes. While ongoing clinical trials will determine if routine use of pharmacogenetic testing may be beneficial, the data today support pharmacogenetic testing for certain variants on an individualized, case-by-case basis. Our primary goal is to review the association data for the major pharmacogenetic variants associated with commonly used cardiovascular medications: antiplatelet agents, warfarin, statins, beta-blockers, diuretics, and antiarrhythmic drugs. In addition, we highlight which variants and in which contexts pharmacogenetic testing can be implemented by practicing clinicians. The pace of genetic discovery has outstripped the generation of the evidence justifying its clinical adoption. Until the evidentiary gaps are filled, however, clinicians may choose to target therapeutics to individual patients whose genetic background indicates that they stand to benefit the most from pharmacogenetic testing.

  9. Coffee Consumption and Cardiovascular Health.

    Science.gov (United States)

    Chrysant, Steven G

    2015-09-01

    Coffee is the most widely consumed beverage worldwide and is only second to water drinking and is consumed by 83% of adults in the United States. The long-held controversy regarding the association of coffee consumption with an increased incidence of cardiovascular diseases (CVDs) and hypertension has been reversed by several recent prospective cohort studies and meta-analyses, which have demonstrated that coffee consumption is not associated with increased incidence of CVDs and hypertension and instead it could have a beneficial effect. To get a better understanding of the effects of coffee consumption on cardiovascular health, a Medline search of the English language literature was conducted from 2010 to early 2015 and 25 pertinent reports with information on the effects of coffee drinking, the incidence of CVDs, and hypertension and its mechanism of action were selected for inclusion in this commentary. These studies have shown either a neutral or beneficial effect of coffee on cardiovascular health. In conclusion, coffee is safe to drink by both normal subjects and by those with preexisting CVDs and hypertension.

  10. Cocoa, chocolate, and cardiovascular disease.

    Science.gov (United States)

    Galleano, Monica; Oteiza, Patricia I; Fraga, Cesar G

    2009-12-01

    A significant body of evidence demonstrates that diets rich in fruits and vegetables promote health and attenuate, or delay, the onset of various diseases, including cardiovascular disease, diabetes, certain cancers, and several other age-related degenerative disorders. The concept that moderate chocolate consumption could be part of a healthy diet has gained acceptance in past years based on the health benefits ascribed to selected cocoa components. Specifically, cocoa as a plant and chocolate as food contain a series of chemicals that can interact with cell and tissue components, providing protection against the development and amelioration of pathological conditions. The most relevant effects of cocoa and chocolate have been related to cardiovascular disease. The mechanisms behind these effects are still under investigation. However, the maintenance or restoration of vascular NO production and bioavailability and the antioxidant effects are the mechanisms most consistently supported by experimental data. This review will summarize the most recent research on the cardiovascular effects of cocoa flavanols and related compounds.

  11. Robotic technology in cardiovascular medicine.

    Science.gov (United States)

    Bonatti, Johannes; Vetrovec, George; Riga, Celia; Wazni, Oussama; Stadler, Petr

    2014-05-01

    Robotic technology has been used in cardiovascular medicine since the late 1990s. Interventional cardiology, electrophysiology, endovascular surgery, minimally invasive cardiac surgery, and laparoscopic vascular surgery are all fields of application. Robotic devices enable endoscopic reconstructive surgery in narrow spaces and fast, very precise placement of catheters and devices in catheter-based interventions. In all robotic systems, the operator manipulates the robotic arms from a control station or console. In the field of cardiac surgery, mitral valve repair, CABG surgery, atrial septal defect repair, and myxoma resection can be achieved using robotic technology. Furthermore, vascular surgeons can perform a variety of robotically assisted operations to treat aortic, visceral, and peripheral artery disease. In electrophysiology, ablation procedures for atrial fibrillation can be carried out with robotic support. In the past few years, robotically assisted percutaneous coronary intervention and abdominal aortic endovascular surgery techniques have been developed. The basic feasibility and safety of robotic approaches in cardiovascular medicine has been demonstrated, but learning curves and the high costs associated with this technology have limited its widespread use. Nonetheless, increased procedural speed, accuracy, and reduced exposure to radiation and contrast agent in robotically assisted catheter-based interventions, as well as reduced surgical trauma and shortened patient recovery times after robotic cardiovascular surgery are promising achievements in the field.

  12. Repurposing of approved cardiovascular drugs.

    Science.gov (United States)

    Ishida, Junichi; Konishi, Masaaki; Ebner, Nicole; Springer, Jochen

    2016-09-20

    Research and development of new drugs requires both long time and high costs, whereas safety and tolerability profiles make the success rate of approval very low. Drug repurposing, applying known drugs and compounds to new indications, has been noted recently as a cost-effective and time-unconsuming way in developing new drugs, because they have already been proven safe in humans. In this review, we discuss drug repurposing of approved cardiovascular drugs, such as aspirin, beta-blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, cardiac glycosides and statins. Regarding anti-tumor activities of these agents, a number of experimental studies have demonstrated promising pleiotropic properties, whereas all clinical trials have not shown expected results. In pathological conditions other than cancer, repurposing of cardiovascular drugs is also expanding. Numerous experimental studies have reported possibilities of drug repurposing in this field and some of them have been tried for new indications ('bench to bedside'), while unexpected results of clinical studies have given hints for drug repurposing and some unknown mechanisms of action have been demonstrated by experimental studies ('bedside to bench'). The future perspective of experimental and clinical studies using cardiovascular drugs are also discussed.

  13. Pseudoexfoliation syndrome and cardiovascular diseases

    Institute of Scientific and Technical Information of China (English)

    Georgios; K; Andrikopoulos; Dimitrios; K; Alexopoulos; Sotirios; P; Gartaganis

    2014-01-01

    Pseudoexfoliation(PEX) syndrome is a well-recognized late-onset disease caused by a generalized fibrillopathy. It is linked to a broad spectrum of ocular complications including glaucoma and perioperative problems during cataract surgery. Apart from the long-known intraocular manifestations, PEX deposits have been found in a variety of extraocular locations and they appear to represent a systemic process associated with increased cardiovascular and cerebrovascular morbidity. However, as published results are inconsistent, the clinical significance of the extraocular PEX deposits remains controversial. Identification of PEX deposits in the heart and the vessel wall, epidemiologic studies, as well as, similarities in pathogenetic mechanisms have led to the hypothesis of a possible relation between fibrillar material and cardiovascular disease. Recent studies suggest that PEX syndrome is frequently linked to impaired heart and blood vessels function. Systemic and ocular blood flow changes, altered parasympathetic vascular control and baroreflex sensitivity, increased vascular resistance and decreased blood flow velocity, arterial endothelial dysfunction, high levels of plasma homocysteine and arterial hypertension have all been demonstrated in PEX subjects. Common features in the pathogenesis of both atherosclerosis and PEX, like oxidative stress and inflammation and a possible higher frequency of abdominal aorta aneurysm in PEX patients, could imply that these grey-white deposits and cardiovascular disorders are related or reflect different manifestations of the same process.

  14. Air pollution and cardiovascular disease.

    Science.gov (United States)

    Nogueira, J Braz

    2009-06-01

    Air pollution is associated with increased cardiovascular morbidity and mortality. Recent experimental and epidemiologic studies show that particulate matter (PM) air pollution with PM10 or inhalable (thoracic) particles (mean aerodynamic diameter particles (aerodynamic diameter biological mechanisms responsible for adverse cardiovascular outcomes associated with PM have been described, including the release of pro-oxidative and pro-inflammatory mediators from the lungs into the circulation, autonomic nervous system imbalance, and the direct actions on the heart and vasculature of ultrafine particles translocated into the systemic circulation. The induction of oxidative stress by these particles may be central to all of these putative pathways that trigger coagulation and thrombosis, increased heart rate and reduced heart rate variability, endothelial dysfunction, arterial vasoconstriction, apoptosis, and hypertension. In chronic exposures these alterations favor the development and progression of atherosclerosis and possibly of hypertension in the long term, and in the short term acute exposures contribute to plaque instability, affect various traditional risk factors and trigger acute cardiovascular events (myocardial ischemia and infarction, stroke, heart failure, arrhythmias, and sudden death), particularly in high-risk subjects. There are currently also significant concerns with the risks of engineered nanoparticles.

  15. Trombectomia adjunta em intervenção percutânea primária para infarto agudo do miocárdio

    Directory of Open Access Journals (Sweden)

    François-Pierre Mongeon

    2011-10-01

    Full Text Available A intervenção coronariana percutânea (ICP primária tem se tornado a estratégia favorita para reperfusão em infarto agudo do miocárdio com elevação do segmento ST (STEMI. Um grau mais baixo de perfusão miocárdica pós-ICP, no-reflow e até trombose de stent farmacológico tem sido relacionados à presença de trombo intracoronário. A trombectomia adjunta refere-se a procedimentos e dispositivos que removem o material trombótico da artéria associada ao infarto, em teoria, antes que a embolização distal possa ocorrer. Há significante variabilidade entre estudos controlados randomizados de trombectomia em ICP primária em relação aos dispositivos testados, características dos procedimentos, terapia médica adjuvante e desfechos analisados. Em geral, melhoras nos endpoints de perfusão miocárdica não são traduzidas em reduções nos desfechos clínicos. Ainda assim, um número crescente de estudos com maior tempo de seguimento relatou benefícios tardios após o infarto do miocárdio inicial. Cateteres de aspiração simples também podem produzir melhores desfechos do que dispositivos que fragmentam o trombo antes de aspirar os resíduos. As variáveis clínicas ou angiográficas que melhor predizem os benefícios do uso da trombectomia ainda precisam ser definidas. O objetivo dessa revisão é dar uma perspectiva sobre as conclusões de estudos disponíveis e meta-análises de trombectomia adjunta em infarto agudo do miocárdio. Também são discutidos os objetivos para futuros estudos.

  16. Porfiria aguda intermitente, um importante e raro diagnóstico diferencial de abdômen agudo: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Fernando Rogério Lara Ferreira

    2011-12-01

    Full Text Available As porfirias são distúrbios metabólicos relacionados à disfunção enzimática da cadeia de biossíntese do heme, componente fundamental para formação de diversas moléculas. Tal defeito ocasiona um acúmulo de precursores (porfirinas nocivos ao organismo. As porfirias se manifestam de maneira heterogênea através de sintomas neuroviscerais, cutâneos ou ambos, geralmente durante episódio de agudização denominado crise porfírica após a exposição a algum fator precipitante. No presente artigo é relatado caso de crise porfírica inicialmente diagnosticado como abdômen agudo e tratado com laparotomia exploradora inconclusiva, seguido de revisão de literatura. Durante o pós operatório o quadro evoluiu com sinais neurológicos de tetraparesia, tetraplegia e desconforto respiratório que sugeriam o diagnóstico de síndrome de Guillain-Barré, hipótese afastada após análise do líquor que não mostrou dissociação albumino-citológica. Admitida em unidade de terapia intensiva, dado o quadro neurológico e a necessidade de suporte ventilatório, apresentou colúria e crises convulsivas sendo feita a hipótese de crise porfírica, confirmada com a dosagem de porfirinas na urina de 24 horas. Iniciado o tratamento de suporte, porém, sem o uso de derivados do heme devido a indisponibilidade, a paciente evoluiu com infecção hospitalar, disfunção orgânica e óbito. A porfiria deve ser levada em consideração nos casos agudos de dor abdominal de causa desconhecida, associada a sinais neurológicos como paresias, distúrbios hidroeletrolíticos e psiquiátricos, especialmente em pacientes com presença de fatores precipitantes, história de crises recorrentes e história familiar positiva para porfiria.

  17. Paniculitis mesentérica como causa poco frecuente de dolor abdominal agudo Mesenteric panniculitis as a rare cause of acute abdominal pain

    Directory of Open Access Journals (Sweden)

    María Luiza Fatahi Bandpey

    2012-12-01

    Full Text Available La paniculitis mesentérica es un proceso inflamatorio poco habitual que afecta al tejido graso del mesenterio y, con menor frecuencia, al mesocolon o al retroperitoneo. Puede cursar con dolor abdominal, diarrea, pérdida de peso o masa palpable, y rara vez se presenta con un cuadro de dolor abdominal agudo. En la mayoría de los casos es asintomática. La etiología es desconocida, aunque se han descrito como posibles agentes causales la isquemia, la infección, el traumatismo abdominal, los antecedentes quirúrgicos y los procesos autoinmunes. También se ha planteado su asociación con determinados fármacos, procesos inflamatorios idiopáticos y neoplasias. La tomografía computada (TC es la técnica de imagen de elección para su diagnóstico y los hallazgos pueden variar desde el incremento de la atenuación en el mesenterio hasta la presencia de una masa sólida en relación con el componente tisular predominante (grasa, tejido inflamatorio o fibrosis. Presentamos 3 pacientes que acudieron al Servicio de Urgencias con dolor abdominal agudo y cuyo diagnóstico final fue paniculitis mesentérica como causa del cuadro.Mesenteric panniculitis is an unusual inflammatory disorder involving the adipose tissue of the mesentery and, less frequently, the mesocolon and the retroperitoneum. Patients may present with abdominal pain, diarrhea, weight loss or abdominal mass, and only rarely with symptoms of acute abdominal pain. In most cases, it is asymptomatic. Although the etiology of mesenteric panniculitis is unknown, ischemia, infection, abdominal trauma, previous abdominal surgery, and autoimmune disorders have been reported as possible causative agents. It has also been suggested its association with certain drugs, idiopathic inflammatory processes, and malignancy. Computed tomography (CT is the gold standard imaging technique for its diagnosis; computed tomography findings may vary from increased attenuation of the mesentery to a solid soft

  18. Implementación y resultados de un nuevo programa de ECMO para trasplante de pulmón y distrés respiratorio agudo

    Directory of Open Access Journals (Sweden)

    Eduardo San Roman

    2015-06-01

    Full Text Available RESUMEN Objetivo: El desarrollo de la membrana de oxigenación extracorpórea en América Latina representa un desafío para la especialidad. El objetivo de este artículo fue describir los resultados de un nuevo programa de membrana de oxigenación extracorpórea en una unidad de cuidados intensivos. Métodos: Estudio de cohorte retrospectivo. Incluye 22 pacientes que requirieron membrana de oxigenación extracorpórea desde Enero de 2011 hasta Junio de 2014. Se evaluaron características basales, indicaciones, duración de la corrida, días de ventilación mecánica, días de unidad de cuidados intensivos, complicaciones y mortalidad hospitalaria. Resultados: Quince pacientes requirieron membrana de oxigenación extracorpórea post-trasplante pulmonar y 7 pacientes por distrés respiratorio agudo. Todos los pacientes trasplantados fueron destetados de membrana de oxigenación extracorpórea, con una duración mediana de 3 días (Rango intercuantil - IQR: 2 - 5, de ventilación mecánica 15,5 días (IQR: 3 - 35, de estadía unidad de cuidados intensivos 31,5 días (IQR: 19 - 53 y de estadía hospitalaria 60 días (IQR: 36 - 89, con una mortalidad de 20%. Los pacientes con distrés respiratorio agudo tuvieron una mediana de duración de membrana de oxigenación extracorpórea de 9 días (IQR: 3 - 14, mediana de ventilación mecánica 25 días (IQR: 13 - 37, de estadía en terapia 31 días (IQR: 11 - 38, y hospitalaria 32 días (IQR: 11 - 41, y 57% de mortalidad. Las principales complicaciones fueron infecciones (80%, insuficiencia renal aguda (43%, sangrados en sitio quirúrgico y de inserción de cánulas (22%, plaquetopenia (60% y coagulopatía (30%. Conclusión: A pesar de encontrarnos transitando una curva de aprendizaje, consideramos la experiencia satisfactoria, con resultados y complicaciones comparables a las reportadas en la literatura.

  19. Risco cardiovascular, efetividade e mortalidade Cardiovascular risk, effectiveness and mortality Riesgo cardiovascular, efectividad y mortalidad

    Directory of Open Access Journals (Sweden)

    Juan Gérvas

    2012-02-01

    Full Text Available

    A Lei de Ferro da Epidemiologia (Ley de Hierro de La Epidemiología diz que todos que nascem, morrem. Por isso, o propósito da Medicina não é evitar a morte por si só, mas evitar as mortes, as doenças e o sofrimento que podem ser medicamente evitáveis.

    No final, todos nossos pacientes morrerão – e nós também, obviamente, morreremos. “Os corpos encontram uma forma de morrer”, e se a causa não for por fome ou desidratação, por motivo congênito e infeccioso, por lesões, câncer ou suicídio, temos que esperar que seja por ‘motivo cardiovascular’, doença pulmonar, insuficiência renal ou hepática, demência ou outras doenças degenerativas. Mas temos que morrer por alguma coisa.

    Morrer por causa cardiovascular não é desonroso, nem refere-se à atenção clínica imperfeita. O fato de a primeira causa de morte ser a cardiovascular não tem nenhuma relação com os cuidados clínicos e nem deveria assustar.

    Entretanto, muitas das mortes por motivo cardiovascular poderiam ser evitadas. Assim, poder-se-ia evitar mortalidade cardiovascular, diminuindo a desigualdade social, por exemplo, com melhor redistribuição da riqueza, melhor educação etc. Os médicos sabem que os fatores adversos psicossociais associados ao fato de pertencer à classe baixa correspondem a 35% do risco atribuído à hipertensão na incidência do infarto do miocárdio (em outra hipótese, pertencer à classe baixa duplica 2,7 tal risco1.

    Também deve-se saber que, contra as mortes cardiovasculares, não há nada como as políticas de saúde pública quanto ao tabagismo (restrições dos lugares onde fumar, aumento do preço do tabaco, campanhas de informação, entre outras.

    Na parte clínica, as mortes cardiovasculares evitáveis devem ser vistas em perspectiva, de acordo com o que seja possível conseguir2. Portanto, por 100.000 habitantes ao ano, o tratamento com inibidores da enzima conversora de angiotensina (IECA

  20. EFFECT OF CHIA SEED (SALVIA HISPANICA L.) CONSUMPTION ON CARDIOVASCULAR RISK FACTORS IN HUMANS: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    de Souza Ferreira, Cynthia; dd Sousa Fomes, Lucilia de Fátima; da Silva, Gilze Espirito Santo; Rosa, Glorimar

    2015-11-01

    Introducción: la chía es una semilla rica en nutrientes tales como proteínas; ácidos grasos omega 3, especialmente ácido alfa-linolénico (ALA); minerales; fibras y antioxidantes. Se han hecho esfuerzos para evaluar si el consumo humano de chía puede reducir los factores de riesgo cardiovascular; sin embargo, no se ha establecido como eficaz y los resultados de los pocos estudios que han examinado la cuestión son incompatibles. Objetivo: sistematizar los hallazgos de los estudios que evaluaron el efecto del consumo de la semilla de chía, ya sea molida o entera, tiene en la prevención/control de los factores de riesgo cardiovascular en los seres humanos. Métodos: se trata de una revisión sistemática de la literatura (SLR), sin metaanálisis. Los artículos escrutados eran identificados en las bases de datos Lilacs electrónicos, Medline (PubMed versión), Cochrane, Scielo, Scopus y Web of Science bajo la palabra clave “dyslipidemia” o “dislipidemia”, “hyperlipidemia” o “hiperlipidemia”, “obesity” o “obesidade”, “salvia” o “salviahispanica”, “Lamiaceae” o “chia”, “hypertension” o “hipertensão”, “hypertrygliceridemia” o “hipertrigliceridemia” y “riscocardiovascular” o “cardiovascularrisk”. Elegimos para nuestra selección artículos en inglés, portugues o español sobre ensayos clínicos en seres humanos publicados en los últimos diez años. Los sesgos de análisis de riesgo se realizaron considerando seis de los ocho criterios del Manual Cochrane para Revisiones Sistemáticas de Intervenciones Versión 5.1. Resultados: siete estudios (n = 200) encajan con los criterios de inclusión. De los ensayos clínicos seleccionados, solo uno no fue aleatorio. Cinco de los estudios fueron experimentos ciegos. Dos de los estudios eran ensayos agudos, ambos asignados al azar. De las intervenciones de semillas de chía, un estudio mostró una disminución significativa de la presión arterial sist

  1. Edema agudo pulmonar associado à obstrução das vias aéreas: relato de caso Edema agudo pulmonar asociado a la obstrucción de las vías aéreas: relato de caso Acute pulmonary edema associated with obstruction of the airways: case report

    OpenAIRE

    Flora Margarida Barra Bisinotto; Ricardo de Paula Cardoso; Tânia Mara Vilela Abud

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: O edema pulmonar por pressão negativa tem sido definido como edema não-cardiogênico, com transudação de líquido para o interstício pulmonar, por aumento na pressão negativa intratorácica, ocasionado pela obstrução das vias aéreas superiores. Descreveu-se o caso de paciente hígida, submetida à anestesia geral, que apresentou edema agudo pulmonar após a extubação traqueal. RELATO DO CASO: Paciente de 23 anos, sexo feminino, estado físico ASA II, submetida à anestesia ...

  2. Lesão bilateral dos óstios coronários na sífilis cardiovascular: relato de caso Bilateral ostial coronary lesion in cardiovascular syphilis: case report

    Directory of Open Access Journals (Sweden)

    Mauricio de Nassau Machado

    2008-03-01

    Full Text Available A sífilis é uma doença infecciosa que se desenvolve em estágios e pode acometer o sistema cardiovascular e neurológico. Em 30% dos pacientes não tratados, a sífilis desenvolve sua forma terciária. Relatamos o caso de um homem de 46 anos, admitido por edema pulmonar agudo por cardiopatia isquêmica com bloqueio completo do ramo esquerdo, submetido a terapia fibrinolítica com sucesso. Angiografia coronária mostrou lesão ostial de 90% na artéria coronária esquerda e oclusão do óstio da artéria coronária direita. Os títulos de VDRL foram de 1/128. O paciente foi submetido a revascularização do miocárdio e recebeu alta após tratamento antibiótico com penicilina cristalina.Syphilis is an infectious disease occurring through a series of frequently overlapping stages. It can impair the cardiovascular and neurological system. In 30% of the non treated patients, syphilis develops your tertiary form. We report a case of a 46-year-old male patient admitted due to edema pulmonary and acute coronary syndrome with left bundle branch block, submitted to fibrinolytic therapy successfully. Coronary angiography showed a 90% ostial lesion of left main coronary artery and occlusion of the right coronary artery ostium. VDRL was titrated to 1/128. The patient was undergone to CABG and was discharged after treatment with crystalline penicillin.

  3. Edema agudo pulmonar associado à obstrução das vias aéreas: relato de caso Edema agudo pulmonar asociado a la obstrucción de las vías aéreas: relato de caso Acute pulmonary edema associated with obstruction of the airways: case report

    Directory of Open Access Journals (Sweden)

    Flora Margarida Barra Bisinotto

    2008-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O edema pulmonar por pressão negativa tem sido definido como edema não-cardiogênico, com transudação de líquido para o interstício pulmonar, por aumento na pressão negativa intratorácica, ocasionado pela obstrução das vias aéreas superiores. Descreveu-se o caso de paciente hígida, submetida à anestesia geral, que apresentou edema agudo pulmonar após a extubação traqueal. RELATO DO CASO: Paciente de 23 anos, sexo feminino, estado físico ASA II, submetida à anestesia geral para videolaparoscopia ginecológica. O procedimento durou 3 horas, sem intercorrências. Após a extubação, a paciente apresentou laringoespasmo e diminuição da saturação de oxigênio. Houve melhora após colocação de cânula oral e administração de oxigênio, sob pressão positiva, com máscara facial. Estabilizado o quadro, foi encaminhada à sala de recuperação pós-anestésica, onde, logo após a admissão, apresentou edema agudo de pulmão com eliminação de secreção serossanguinolenta. O tratamento constou de elevação do dorso, oxigênio sob máscara, furosemida e restrição hídrica. A radiografia torácica mostrou imagem compatível com edema agudo pulmonar e área cardíaca normal. O eletrocardiograma (ECG, ecocardiografia e enzimas cardíacas estavam normais. A paciente apresentou boa evolução, recebendo alta hospitalar no dia seguinte, assintomática. CONCLUSÕES: O edema agudo de pulmão associado à obstrução das vias aéreas superiores é condição clínica que pode agravar procedimentos cirúrgicos de baixa morbidade e que aparece sobretudo em pacientes jovens. O tratamento deve ser instituído precocemente, pois a resolução também é rápida e, na maioria das vezes, sem seqüelas.JUSTIFICATIVA Y OBJETIVOS: El edema pulmonar por presión negativa ha sido definido como edema no cardiogénico, con transudación de líquido para el intersticio pulmonar, por aumento en la presión negativa

  4. Dor torácica no infarto agudo do miocárdio entre pacientes diabéticos e não diabéticos

    Directory of Open Access Journals (Sweden)

    Crislaine Padilha Paim

    2012-02-01

    Full Text Available Considerando-se que pacientes diabéticos acometidos de Infarto Agudo do Miocárdio (IAM podem, ou não, apresentar dor torácica, objetivou-se neste estudo comparar a presença e intensidade de dor torácica no IAM entre pacientes diabéticos e não diabéticos. Realizou-se um estudo transversal, que incluiu pacientes com IAM, idade ≥18 anos, ambos os sexos. Utilizou-se uma escala numérica verbal para avaliar a presença e a intensidade da dor.Foram incluídos 88 pacientes no estudo, dentre os quais 77 (87,5% não diabéticos e 11 (12,5% diabéticos. A dor esteve presente em 11 (100% dos diabéticos e 76 (98,7% dos não diabéticos. A intensidade da dor nos diabéticos foi de 8,91 versus 8,23 nos não diabéticos. O estudo mostrou semelhança na presença e intensidade da dor torácica entre pacientes diabéticos e não diabéticos acometidos de IAM.

  5. ANÁLISIS COMPARATIVO DE LOS EFECTOS AGUDOS DE SESIONES DE ENTRENAMIENTO DE FUERZA CON CARGAS DEL 90 Y 30% 1 RM.

    Directory of Open Access Journals (Sweden)

    Jorge Dopico Calvo

    2010-10-01

    Full Text Available En una medición inicial (Pretest se obtuvo la 1RM de 23 sujetos masculinos en el ejercicio press banca, así como la potencia y fuerza media aplicada al 90 y 30% de 1RM (PMED90, FMED90, PMED30, FMED 30. Posteriormente 11 sujetos (Gr90 llevaron a cabo 2 sesiones de entrenamiento con cargas del 90%, mientras los 12 sujetos restantes (Gr30 lo hacían con cargas del 30%. Inmediatamente finalizada cada una de las sesiones se valoraba nuevamente PMED90, FMED90, PMED30, FMED30. Una semana después de la finalización de los entrenamientos se efectuó un Postest. Los resultados mostraron una mejora estadísticamente significativa del rendimiento de Gr30 al final de cada una de las sesiones de entrenamiento, respecto a Pretest y Postest, con el 90% de 1RM, mientras que Gr90 obtuvo mejoras significativas con el 30% respecto a Pretest, pero no respecto a Postest.
    PALABRAS CLAVE: fuerza, potencia, medición, efecto agudo.

  6. Hemoperitoneo agudo espontáneo por ruptura de várices intraabdominales en un paciente con cirrosis hepática

    Directory of Open Access Journals (Sweden)

    Maikel Vargas- Sanabria

    2006-09-01

    Full Text Available Se presenta el caso de un paciente con antecedente de etilismo crónico e historia de muerte súbita. Al realizarse la autopsia medicolegal se encontró un hemoperitoneo, várices gastroesplénicas rotas y cirrosis hepática. El hemoperitoneo agudo espontáneo secundario a ruptura de várices intraabdominales en pacientes portadores de cirrosis hepática, cuya primera manifestación clínica es la muerte, constituye un caso extremadamente raro y por tanto de difícil indagación médica.We present the case of an alcoholic patient who died suddenly. The medicolegal autopsy found a massive hemoperitoneum and hepatic cirrhosis. Acute spontaneous hemoperitoneum secondary to intraabdominal variceal rupture in patients with hepatic cirrhosis whose first clinical manifestation is sudden death, is an extremely rare condition and therefore difficult from the medical point of view.

  7. Una experiencia traumática en el 11-M: Intervención aplicada a un cuadro de estrés agudo con reacciones disociadas

    Directory of Open Access Journals (Sweden)

    OLGA FLORES LÓPEZ

    2004-01-01

    Full Text Available El trabajo que recoge este artículo expone la historia clínica, evaluación y tratamiento llevado a cabo sobre uno de los afectados directos del suceso acontecido en Madrid el pasado once de marzo. Se trata de un varón de 35 años cuya sintomatología responde a un cuadro de Estrés Agudo en el que destacó la aparición de amnesia disociativa. La intervención incluyó diferentes técnicas a lo largo del proceso terapéutico entre las que figura la aplicación modificada de la Entrevista Cognitiva como herramienta elegida para la recuperación de la información disociada. Los resultados tras 24 sesiones de intervención indicaron una notable mejora de la sintomatología aparecida. Actualmente el paciente se encuentra en seguimiento. Se discuten las implicaciones de la intervención y los resultados de la misma.

  8. Efeito agudo de exercícios de alongamento estático e dinâmico na impulsão vertical de jogadores de futebol

    Directory of Open Access Journals (Sweden)

    Vinicius de Souza Ferreira

    2013-06-01

    Full Text Available O objetivo deste estudo foi comparar o efeito agudo dos exercícios de alongamento estático e do alongamento dinâmico na impulsão vertical e amplitude do movimento de 22 jogadores de futebol profissional do sexo masculino. Observou-se que após a intervenção do alongamento dinâmico, o grupo experimental (n=13 apresentou um aumento significativo na impulsão vertical (p=0,002, enquanto que após o alongamento estático, não houve alteração significativa (p=0,343, assim como na condição sem alongamento (p>0,05. Com relação aos níveis de amplitude de movimento (n=13, não houve diferenças significativas no sentar e alcançar (p=0,263 nas três condições analisadas: alongamento estático, dinâmico e controle. Os resultados sugerem que o alongamento dinâmico é o mais indicado para ser realizado antes de atividades que exijam potência muscular, entretanto as intervenções propostas neste estudo não evidenciaram aumento na amplitude de movimento.

  9. Factores de riesgo para infarto agudo de miocardio y prescripción de medicamentos para prevención secundaria

    Directory of Open Access Journals (Sweden)

    Desirée Sáenz-Campos

    2005-01-01

    Full Text Available Objetivo: tipificar algunos factores de riesgo coronario presentes en los pacientes que sobreviven a un primer infarto agudo de miocardio (IAM y describir el tratamiento farmacológico prescrito para profilaxis secundaria al egreso hospitalario. Métodos: estudio observacional, transversal y descriptivo, con información extraída del expediente clínico de 50 pacientes atendidos en 3 hospitales nacionales. Resultados: 42 varones y 8 mujeres, edad 63 ± 15 años, peso 67 ± 12 kg, Índice de Masa Corporal= 26.1 ± 2.1 kg/m², 38% hipertensos, 22% diabéticos (n= 8 pacientes con diabetes + hipertensión y 34% fumadores. Colesterol total 191 ± 45.7 mg/dL, colesterol-LDL 112 ± 33.8 mg/dL y colesterol-HDL 39.4 ± 8.26 mg/dL. Todos egresaron con medicamentos: 92% con antitrombóticos (predominó aspirina, 92% con estatinas, 78% con betabloqueador (atenolol o carvedilol, 70% con enalapril o losartán y 48% con nitratos. Conclusiones: este estudio piloto mostró que la enfermedad coronaria tiende a manifestarse desde la etapa de adulto joven, persiste en su mayor afectación a los varones y parecen prevalecer los factores de riesgo coronario modificables. Los antitrombóticos, beta- bloqueadores y las estatinas más frecuentemente prescritos.

  10. Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar When and why use unenhanced computed tomography in patients with acute abdomen

    Directory of Open Access Journals (Sweden)

    Edison de Oliveira Freire Filho

    2006-02-01

    Full Text Available A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discutem quais as vantagens e limitações desta técnica de exame, bem como seus aspectos práticos.The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed.

  11. Exploración neuropsicológica en un caso de sufrimiento fetal agudo: diagnóstico e intervención

    Directory of Open Access Journals (Sweden)

    David Molina González

    2014-06-01

    Full Text Available En el presente artículo se muestran los resultados del proceso de corrección de una niña de edad escolar que presento sufrimiento fetal agudo a los 6 meses de gestación. Se describe el proceso de evaluación y la interpretación de los resultados a la luz de la teoría neuropsicológica de Luria y la psicología histórico-cultural de Vigotsky. Se presenta la propuesta de un programa de corrección neuropsicológica, el cual tiene como objetivo lograr un mejor funcionamiento de los mecanismos de regulación y control y de análisis y síntesis espacial simultanea. Finalmente, se exponen y contrastan los resultados de la evaluación aplicada después del programa de corrección con el estado inicial de la menor.

  12. Acute Myocardial Infarction in Puerperium Stage. A Case Presentation Infarto agudo del miocardio en el puerperio . Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Israel Sotolongo Castro

    Full Text Available

    A 38 year-old hypertensive, smoker female patient was presented. She suferred from an acute myocardial infarction in the mediate puerperium stage of an normal deliver. She was assisted in the Heart intensive care unit taking into consideration the basic care principles for this kind of patient. The infarct was diagnosed due to the clinical picture, and the electrographic alterations as well as the enzimatic alterations. The case is presented because it is a low frequency complication and it is not too much registered in the the medical literature revised.

    Se presenta el caso de una paciente de 38 años de edad, con antecedentes de padecer de hipertensión y ser fumadora, a la que se le presenta un infarto agudo del miocardio en el puerperio mediato de un parto eutócico. Fue atendida en la Unidad de Cuidados Intensivos Coronarios respetando los principios de los cuidados básicos para estas pacientes. Se diagnosticó el infarto por el cuadro clínico, las alteraciones electrocardiográficas y enzimáticas. Se presenta el caso por ser una complicación poco frecuente y no muy reportada en la literatura revisada.

  13. Positive Cardiovascular Health: A Timely Convergence.

    Science.gov (United States)

    Labarthe, Darwin R; Kubzansky, Laura D; Boehm, Julia K; Lloyd-Jones, Donald M; Berry, Jarett D; Seligman, Martin E P

    2016-08-23

    Two concepts, positive health and cardiovascular health, have emerged recently from the respective fields of positive psychology and preventive cardiology. These parallel constructs are converging to foster positive cardiovascular health and a growing collaboration between psychologists and cardiovascular scientists to achieve significant improvements in both individual and population cardiovascular health. We explore these 2 concepts and note close similarities in the measures that define them, the health states that they aim to produce, and their intended long-term clinical and public health outcomes. We especially examine subjective health assets, such as optimism, that are a core focus of positive psychology, but have largely been neglected in preventive cardiology. We identify research to date on positive cardiovascular health, discuss its strengths and limitations thus far, and outline directions for further engagement of cardiovascular scientists with colleagues in positive psychology to advance this new field.

  14. Human and equine cardiovascular endocrinology

    DEFF Research Database (Denmark)

    Vekens, Nicky Van Der; Hunter, Ingrid; Gøtze, Jens Peter

    2013-01-01

    important species differences, which can partly be explained by variations in physiology or pathophysiology. Most important are physiological differences in heart rate, cardiovascular response to exercise, food and water intake, and molecular elimination in plasma. Pathological differences are even more...... prominent. In humans, troponins and natriuretic peptides are mostly used for the diagnosis of acute coronary syndromes and heart failure. These cardiac entities, however, are rare in horses. In this species, cardiac biomarkers are rather proposed for the assessment of valvular or myocardial disease...

  15. [Cardiovascular risk factors in women].

    Science.gov (United States)

    Cengel, Atiye

    2010-03-01

    It is estimated that at least 80% of patients with cardiovascular disease (CVD) have conventional risk factors and optimization of these risk factors can reduce morbidity and mortality due to this disease considerably. Contemporary women have increased burden of some of these risk factors such as obesity, metabolic syndrome and smoking. Turkish women have a worse CV risk profile than Turkish men in some aspects. Risk stratification systems such as Framingham have a tendency of underestimating the risk in women. Coronary artery disease remains in vessel wall for a longer period of time in women; therefore obstructive disease appear later in their lifespan necessitating risk stratification systems for estimating their lifetime risk.

  16. Wnt signaling in cardiovascular physiology.

    Science.gov (United States)

    Marinou, K; Christodoulides, C; Antoniades, C; Koutsilieris, M

    2012-12-01

    Wnt signaling pathways play a key role in cardiac development, angiogenesis, and cardiac hypertrophy; emerging evidence suggests that they are also involved in the pathophysiology of atherosclerosis. Specifically, an important role for Wnts has been described in the regulation of endothelial inflammation, vascular calcification, and mesenchymal stem cell differentiation. Wnt signaling also induces monocyte adhesion to endothelial cells and is crucial for the regulation of vascular smooth-muscle cell (VSMC) behavior. We discuss how the Wnt pathways are implicated in vascular biology and outline the role of Wnt signaling in atherosclerosis. Dissecting Wnt pathways involved in atherogenesis and cardiovascular disease may provide crucial insights into novel mechanisms with therapeutic potential for atherosclerosis.

  17. Preventive Effects of Catechins on Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Xiao-Qiang Chen

    2016-12-01

    Full Text Available Catechins are polyphenolic phytochemicals with many important physiological activities that play a multifaceted health care function in the human body, especially in the prevention of cardiovascular disease. In this paper, various experimental and clinical studies have revealed the role of catechins in the prevention and treatment of cardiovascular disorders, and we review the preventive effects of catechins on cardiovascular disease from the following aspects: Regulating lipid metabolism, regulating blood lipid metabolism, vascular endothelial protection, and reducing blood pressure.

  18. BENEFITS OF PHYSICAL ACTIVITY CARDIOVASCULAR DISEASE

    OpenAIRE

    Aristizabal, Jose Fernando

    2007-01-01

      It was considered that physical inactivity is a risk factor for cardiovascular disease independent (1), for this reason today is given much importance to the activityPhysics for this concept becomes protective factor against coronary heart disease. In relation to physical activity and cardiovascular disease, applying the concept ofprimary cardiovascular prevention, authors like Paffenbarger, Morris, have stated that this is beneficial in terms of reducing risk of coronary heart disease (2-3...

  19. Cardiovascular morbidity and mortality after kidney transplantation

    OpenAIRE

    Stoumpos, Sokratis; Jardine, Alan G.; Mark, Patrick B.

    2014-01-01

    Kidney transplantation is the optimal treatment for patients with end stage renal disease (ESRD) who would otherwise require dialysis. Patients with ESRD are at dramatically increased cardiovascular (CV) risk compared to the general population. As well as improving quality of life, successful transplantation accords major benefits by reducing cardiovascular risk in these patients. Worldwide, cardiovascular disease remains the leading cause of death with a functioning graft and therefore is a ...

  20. Cardiovascular physiology and diseases of the rabbit.

    Science.gov (United States)

    Pariaut, Romain

    2009-01-01

    This article reviews what is known about the diagnosis and management of cardiovascular diseases in the pet rabbit. Current knowledge is based on anecdotal reports, derived from research data using the rabbit as an animal model of human cardiovascular diseases, but most importantly canine and feline cardiology. It is likely that, as cardiovascular diseases are more often recognized, more specific information will soon become available for the treatment of the pet rabbit with cardiac disease.

  1. Increased susceptibility to cardiovascular effects of dihydrocapcaicin in resuscitated rats. Cardiovascular effects of dihydrocapsaicin

    DEFF Research Database (Denmark)

    Fosgerau, Keld; Ristagno, Giuseppe; Jayatissa, Magdalena Niepsuj;

    2010-01-01

    Survivors of a cardiac arrest often have persistent cardiovascular derangements following cardiopulmonary resuscitation including decreased cardiac output, arrhythmias and morphological myocardial damage. These cardiovascular derangements may lead to an increased susceptibility towards the extern...

  2. Obstructive sleep apnea syndrome and cardiovascular problems

    Directory of Open Access Journals (Sweden)

    Zuhal Arıtürk Atılgan

    2011-06-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is defined as repeated episodes of upper airway occlusion during sleep with consequent excessive daytime sleepiness. Recently, relationship has been found between cardiovascular disease and OSAS. Therefore OSAS has become more popular today. OSAS is associated with the pathogenesis of cardiovascular disease. A large number of studies have demonstrated that OSAS is an independent risk factor of cardiovascular morbidity and mortality. Sleep apnea was shown to be associated with hypertension, ischemic heart disease, stroke, pulmonary hypertension, cardiac arrhythmia, and cardiovascular mortality

  3. Vitamin D and the cardiovascular system.

    Science.gov (United States)

    Beveridge, L A; Witham, M D

    2013-08-01

    Vitamin D, a secosteroid hormone, affects multiple biological pathways via both genomic and nongenomic signalling. Several pathways have potential benefit to cardiovascular health, including effects on parathyroid hormone, the renin-angiotensin-aldosterone system, vascular endothelial growth factor and cytokine production, as well as direct effects on endothelial cell function and myocyte calcium influx. Observational data supports a link between low vitamin D metabolite levels and cardiovascular health. Cross-sectional data shows associations between low 25-hydroxyvitamin D levels and stroke, myocardial infarction, diabetes mellitus, hypertension, and heart failure. Longitudinal data also suggests a relationship with incident hypertension and new cardiovascular events. However, these associations are potentially confounded by reverse causality and by the effects that other cardiovascular risk factors have on vitamin D metabolite levels. Intervention studies to date suggest a modest antihypertensive effect of vitamin D, no effect on serum lipids, a small positive effect on insulin resistance and fasting glucose, and equivocal actions on arterial stiffness and endothelial function. Analysis of cardiovascular event data collected from osteoporosis trials does not currently show a clear signal for reduced cardiovascular events with vitamin D supplementation, but results may be confounded by the coadministration of calcium, and by the secondary nature of the analyses. Despite mechanistic and observational data that suggest a protective role for vitamin D in cardiovascular disease, intervention studies to date are less promising. Large trials using cardiovascular events as a primary outcome are needed before vitamin D can be recommended as a therapy for cardiovascular disease.

  4. Adiponectin provides cardiovascular protection in metabolic syndrome.

    Science.gov (United States)

    Okamoto, Yoshihisa

    2011-01-23

    Adipose tissue plays a central role in the pathogenesis of metabolic syndrome. Adiponectin (APN) is a bioactive adipocytokine secreted from adipocytes. Low plasma APN levels (hypoadiponectinemia) are observed among obese individuals and in those with related disorders such as diabetes, hypertension, and dyslipidemia. APN ameliorates such disorders. Hypoadiponectinemia is also associated with major cardiovascular diseases including atherosclerosis and cardiac hypertrophy. Accumulating evidence indicates that APN directly interacts with cardiovascular tissue and prevents cardiovascular pathology. Increasing plasma APN or enhancing APN signal transduction may be an ideal strategy to prevent and treat the cardiovascular diseases associated with metabolic syndrome. However, further studies are required to uncover the precise biological actions of APN.

  5. Psoriasis: an opportunity to identify cardiovascular risk.

    Science.gov (United States)

    Federman, D G; Shelling, M; Prodanovich, S; Gunderson, C G; Kirsner, R S

    2009-01-01

    Psoriasis is highly prevalent and is associated with skin-associated complaints as well as arthritis, depression and a lower quality of life. Recently, it has been demonstrated that not only do patients with psoriasis have an increased prevalence of cardiovascular risk factors, but an increased risk of myocardial infarction, and for those with severe disease, increased mortality. Dermatologists and other health professionals need to be cognizant of this association and ensure that cardiovascular risk factors are evaluated and treated appropriately in those patients with psoriasis. We review the association between psoriasis, atherosclerosis and inflammation, as well as some treatable cardiovascular risk factors that may prove beneficial in reducing a patient's cardiovascular risk.

  6. Inflammation, Infection, and Future Cardiovascular Risk

    Science.gov (United States)

    2016-03-15

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Myocardial Infarction; Venous Thromboembolism; Heart Diseases; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Herpesviridae Infections; Inflammation

  7. Radiation-induced cardiovascular effects

    Science.gov (United States)

    Tapio, Soile

    Recent epidemiological studies indicate that exposure to ionising radiation enhances the risk of cardiovascular mortality and morbidity in a moderate but significant manner. Our goal is to identify molecular mechanisms involved in the pathogenesis of radiation-induced cardiovascular disease using cellular and mouse models. Two radiation targets are studied in detail: the vascular endothelium that plays a pivotal role in the regulation of cardiac function, and the myocardium, in particular damage to the cardiac mitochondria. Ionising radiation causes immediate and persistent alterations in several biological pathways in the endothelium in a dose- and dose-rate dependent manner. High acute and cumulative doses result in rapid, non-transient remodelling of the endothelial cytoskeleton, as well as increased lipid peroxidation and protein oxidation of the heart tissue, independent of whether exposure is local or total body. Proteomic and functional changes are observed in lipid metabolism, glycolysis, mitochondrial function (respiration, ROS production etc.), oxidative stress, cellular adhesion, and cellular structure. The transcriptional regulators Akt and PPAR alpha seem to play a central role in the radiation-response of the endothelium and myocardium, respectively. We have recently started co-operation with GSI in Darmstadt to study the effect of heavy ions on the endothelium. Our research will facilitate the identification of biomarkers associated with adverse cardiac effects of ionising radiation and may lead to the development of countermeasures against radiation-induced cardiac damage.

  8. Insulin resistance and cardiovascular disease.

    Science.gov (United States)

    Egan, B M; Greene, E L; Goodfriend, T L

    2001-06-01

    Cardiovascular risk factors cluster in obese individuals. Insulin resistance emerges as a common pathogenetic denominator underlying the risk factor cluster. Defects in nonesterified fatty acids metabolism have been implicated in the abnormal lipid and glucose metabolism which characterize the cluster. Other evidence also leads to the adipocyte as an important contributor to the risk factor cluster and cardiovascular complications through effects not only on fatty acids but also on leptin, plasminogen activator inhibitor-1, and angiotensinogen, to name a few. Fatty acids are elevated among abdominally obese individuals, are more resistant to suppression by insulin, and may contribute to hypertension. Fatty acids may affect blood pressure by inhibiting endothelial nitric oxide synthase activity and impairing endothelium-dependent vasodilation. Fatty acids increase alpha1-adrenoceptor-mediated vascular reactivity and enhance the proliferation and migration of cultured vascular smooth-muscle cells. Several effects of fatty acids are mediated through oxidative stress. Fatty acids can also interact with other facets of cluster, including increased angiotensin II, to accentuate oxidative stress. Oxidative stress, in turn, is implicated in the pathogenesis of insulin resistance, hypertension, vascular remodeling, and vascular complications. A clearer delineation of the key reactive oxygen signaling pathways and the impact of various interventions on these pathways could facilitate a rationale approach to antioxidant therapy and improved outcomes among the rapidly growing number of high-risk, insulin-resistant, obese individuals.

  9. Marijuana Use and Cardiovascular Disease.

    Science.gov (United States)

    Franz, Christopher A; Frishman, William H

    2016-01-01

    Marijuana is currently the most used illicit substance in the world. With the current trend of decriminalization and legalization of marijuana in the US, physicians in the US will encounter more patients using marijuana recreationally over a diverse range of ages and health states. Therefore, it is relevant to review marijuana's effects on human cardiovascular physiology and disease. Compared with placebo, marijuana cigarettes cause increases in heart rate, supine systolic and diastolic blood pressures, and forearm blood flow via increased sympathetic nervous system activity. These actions increase myocardial oxygen demand to a degree that they can decrease the time to exercise-induced angina in patients with a history of stable angina. In addition, marijuana has been associated with triggering myocardial infarctions (MIs) in young male patients. Smoking marijuana has been shown to increase the risk of MI onset by a factor of 4.8 for the 60 minutes after marijuana consumption, and to increase the annual risk of MI in the daily cannabis user from 1.5% to 3% per year. Human and animal models suggest that this effect may be due to coronary arterial vasospasm. However, longitudinal studies have indicated that marijuana use may not have a significant effect on long-term mortality. While further research is required to definitively determine the impact of marijuana on cardiovascular disease, it is reasonable to recommend against recreational marijuana use, especially in individuals with a history of coronary artery disorders.

  10. Dietary fat and cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Lie T. Merijanti

    2016-04-01

    Full Text Available Dietary saturated fat (SF intake has been shown to increase low density lipoprotein (LDL cholesterol and therefore has been associated with increased risk of cardiovascular disease (CVD. This evidence coupled with inferences from epidemiologic studies and clinical trials, had led to longstanding public health recommendations for limiting SF intake as a means of preventing CVD. However the relationship between SF and CVD risk remains controversial, due at least in part to the intrinsic limitations of clinical studies that have evaluated this relationship. A recent meta analysis showed that current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids (PUFA and low consumption of total SF. They found weak positive associations between circulating palmitic and stearic acids (found largely in palm oil and animal fats, respectively and CVD, whereas circulating margaric acid (a dairy fat significantly reduced the risk of CVD.(2,3 Saturated fat are not associated with all cause mortality, CVD, CHD, ischemic stroke or type 2 diabetes, but the evidence is heterogenous with methodological limitations.

  11. Iron deficiency and cardiovascular disease.

    Science.gov (United States)

    von Haehling, Stephan; Jankowska, Ewa A; van Veldhuisen, Dirk J; Ponikowski, Piotr; Anker, Stefan D

    2015-11-01

    Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations.

  12. Enfermedad cardiovascular en Costa Rica

    Directory of Open Access Journals (Sweden)

    Lizzie M. Castillo S

    2006-07-01

    Full Text Available En Costa Rica la enfermedad cardiovascular cobra en promedio 6 vidas por día, lo cual representa un aumento escalonado en los últimos años, debido en su mayoría a cambios en el estilo de vida del costarricense. Además, llama la atención, que factores de riesgo para enfermedad cardiovascular como son el fumado, obesidad infantil, alcoholismo, diabetes, dislipidemia e hipertensión han mostrado un incremento en su incidencia. Por lo tanto,se pretende realizar una revisión de los programas de detección y de atención temprana a nivel institucional, en lo que respecta a la Caja Costarricense de Seguro Social como ente responsable de llevar a cabo los mismos. El adecuado conocimiento y uso de los programas pretende una disminución en la morbimortalidad de la misma,y su aplicación se hace obligatoria para el manejo de pacientes en atención primaria.

  13. Personalized medicine in cardiovascular diseases.

    Science.gov (United States)

    Lee, Moo-Sik; Flammer, Andreas J; Lerman, Lilach O; Lerman, Amir

    2012-09-01

    Personalized medicine is a novel medical model with all decisions and practices being tailored to individual patients in whatever ways possible. In the era of genomics, personalized medicine combines the genetic information for additional benefit in preventive and therapeutic strategies. Personalized medicine may allow the physician to provide a better therapy for patients in terms of efficiency, safety and treatment length to reduce the associated costs. There was a remarkable growth in scientific publication on personalized medicine within the past few years in the cardiovascular field. However, so far, only very few cardiologists in the USA are incorporating personalized medicine into clinical treatment. We review the concepts, strengths, limitations and challenges of personalized medicine with a particular focus on cardiovascular diseases (CVDs). There are many challenges from both scientific and policy perspectives to personalized medicine, which can overcome them by comprehensive concept and understanding, clinical application, and evidence based practices. Individualized medicine serves a pivotal role in the evolution of national and global healthcare reform, especially, in the CVDs fields. Ultimately, personalized medicine will affect the entire landscape of health care system in the near future.

  14. Cardiovascular and non-cardiovascular mortality in dialysis patients : where is the link?

    NARCIS (Netherlands)

    Jager, Kitty J.; Lindholm, Bengt; Goldsmith, David; Fliser, Danilo; Wiecek, Andrzej; Suleymanlar, Gultekin; Ortiz, Alberto; Massy, Ziad; Martinez-Castelao, Alberto; Agarwal, Rajiv; Blankestijn, Peter J.; Covic, Adrian; London, Gerard; Zoccali, Carmine; Dekker, Friedo W.

    2011-01-01

    Over the past decade, the research agenda in dialysis has been dominated by studies on risk factors associated with cardiovascular mortality. It has now become increasingly clear that in dialysis patients, non-cardiovascular causes of death are increased to the same extent as cardiovascular mortalit

  15. [Active interventions in hypercholesteroloemia patients with high cardiovascular risk in primary care; estudio ESPROCOL].

    Science.gov (United States)

    Tárraga López, Pedro J; García-Norro Herreros, F J; Tárraga Marcos, Loreto; Solera Albero, Juan; González López, Esteban; Ruiz García, Antonio; Pallarés Carratalá, Vicente; Castro Navarro, José Luis; Alins Presas, Josep; Panisello Royo, Josefa María

    2015-06-01

    Introducción: la hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y, especialmente, en prevención secundaria. Objetivo: comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL infarto agudo de miocardio (20,33 %), angina (16,07 %), ictus/AIT (9,19 %), artropatía (5,25 %), diabetes (70,87 %), hipertensión (71,01 %) y obesidad abdominal (69,62 %). El 43,57 % (IC95 %: 37,21; 50,08) de los pacientes que realizaron la segunda visita (241) consiguieron el OT. El 62,50 % (IC95 %: 55,68; 68,98) de los que realizaron la tercera (216) consiguieron el OT. Finalmente, el 77,56 % (IC95 %: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/dL en la visita basal, 107,4 mg/dL en la segunda visita, 97,3 mg/dL en la tercera visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001). El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: la reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las guías, permite alcanzar el OT en más de las tres cuartas partes de los previamente no controlados en el plazo de medio año. Estos resultados nos deben estimular a superar la inercia terapéutica en el control de la ECV mediante una actuación precoz y enérgica ante la hipercolesterolemia.

  16. Cardiovascular issues in respiratory care.

    Science.gov (United States)

    Pinsky, Michael R

    2005-11-01

    The hemodynamic effects of ventilation are complex but can be grouped under four clinically relevant concepts. First, spontaneous ventilation is exercise, and critically ill patients may not withstand the increased work of breathing. Initiation of mechanical ventilatory support will improve oxygen delivery to the remainder of the body by decreasing oxygen consumption. To the extent that mixed venous oxygen also increases, Pao(2) will increase without any improvement in gas exchange. Similarly, weaning from mechanical ventilatory support is a cardiovascular stress test. Patients who fail to wean also manifest cardiovascular insufficiency during the failed weaning attempts. Improving cardiovascular reserve or supplementing support with inotropic therapy may allow patients to wean from mechanical ventilation. Second, changes in lung volume alter autonomic tone and pulmonary vascular resistance (PVR), and at high lung volumes compress the heart in the cardiac fossa. Hyperinflation increases PVR and pulmonary artery pressure, impeding right ventricular ejection. Decreases in lung volume induce alveolar collapse and hypoxia, stimulating an increased pulmonary vasomotor tone by the process of hypoxic pulmonary vasoconstriction. Recruitment maneuvers, positive end-expiratory pressure, and continuous positive airway pressure may reverse hypoxic pulmonary vasoconstriction and reduce pulmonary artery pressure. Third, spontaneous inspiration and spontaneous inspiratory efforts decrease intrathoracic pressure (ITP). Since diaphragmatic descent increases intra-abdominal pressure, these combined effects cause right atrial pressure inside the thorax to decrease but venous pressure in the abdomen to increase, markedly increasing the pressure gradient for systemic venous return. Furthermore, the greater the decrease in ITP, the greater the increase in left ventricular (LV) afterload for a constant arterial pressure. Mechanical ventilation, by abolishing the negative swings in ITP

  17. Cardiovascular Disease and Cancer: Student Awareness Activities.

    Science.gov (United States)

    Meyer, James H., Comp.

    Awareness activities pertaining to cancer and cardiovascular disease are presented as a supplement for high school science classes. The exercises can be used to enrich units of study dealing with the circulatory system, the cell, or human diseases. Eight activities deal with the following topics: (1) cardiovascular disease risk factors; (2)…

  18. Genetic influences on cardiovascular stress reactivity

    NARCIS (Netherlands)

    Wu, Ting; Snieder, Harold; de Geus, Eco

    2010-01-01

    Individual differences in the cardiovascular response to stress play a central role in the reactivity hypothesis linking frequent exposure to psychosocial stress to adverse outcomes in cardiovascular health. To assess the importance of genetic factors, a meta-analysis was performed on all published

  19. Subclinical organ damage and cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Sehestedt, Thomas; Olsen, Michael H

    2010-01-01

    by measuring subclinical organ damage. We have (i) reviewed recent studies linking markers of subclinical organ damage in the heart, blood vessels and kidney to cardiovascular risk; (ii) discussed the evidence for improvement in cardiovascular risk prediction using markers of subclinical organ damage; (iii...

  20. Hepatitis C virus and cardiovascular: A review

    Directory of Open Access Journals (Sweden)

    Salvatore Petta

    2017-03-01

    Full Text Available Chronic hepatitis C virus (HCV infection is a systemic disease that leads to increased risks of cirrhosis and its complications, as well as extrahepatic disturbances, including immune-related disorders and metabolic alterations such as insulin resistance and steatosis. Recent accumulating evidence suggests that HCV infection can increase cardiovascular risk, and that viral eradication can improve cardiovascular outcomes in the clinical setting. These data are strengthened by evidence identifying potential mechanisms (indirectly linking HCV infection to vascular damage. However, the high prevalence of both HCV infection and cardiovascular alterations, as well as the presence of contrasting results not identifying any association between HCV infection and cardiovascular dysfunction, provides uncertainty about a direct association of HCV infection with cardiovascular risk. Further studies are needed to clarify definitively the role of HCV infection in cardiovascular alterations, as well as the impact of viral eradication on cardiovascular outcomes. These features are now more attractive, considering the availability of new, safe, and very effective interferon-free antiviral agents for the treatment of HCV infection. This review aims to discuss carefully available data on the relationship between HCV infection and cardiovascular risk.

  1. Preeclampsia : At risk for remote cardiovascular disease

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Zeeman, Gerda G.

    2007-01-01

    Epidemiological data indicate that women with preeclampsia are more likely to develop cardiovascular disease (CVD) later in life. Population-based studies relate preeclampsia to an increased risk of later chronic hypertension (RR, 2.00 to 8.00) and cardiovascular morbidity/mortality (RR, 1.3 to 3.07

  2. Detection of cardiovascular anomalies: Hybrid systems approach

    KAUST Repository

    Ledezma, Fernando

    2012-06-06

    In this paper, we propose a hybrid interpretation of the cardiovascular system. Based on a model proposed by Simaan et al. (2009), we study the problem of detecting cardiovascular anomalies that can be caused by variations in some physiological parameters, using an observerbased approach. We present the first numerical results obtained. © 2012 IFAC.

  3. Cardiovascular Reactivity, Stress, and Physical Activity

    Directory of Open Access Journals (Sweden)

    Chun-Jung eHuang

    2013-11-01

    Full Text Available Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD. Acute mental stress can activate the sympathetic-adrenal-medullary (SAM axis, eliciting the release of catecholamines (NE and EPI resulting in the elevation of heart rate (HR and blood pressure (BP. Combined stress (psychological and physical can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement. Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD.

  4. Coffee and cardiovascular risk; an epidemiological study

    NARCIS (Netherlands)

    A.A.A. Bak (Annette)

    1990-01-01

    textabstractThis thesis comprises several studies on the effect of coffee and caffeine on cardiovascular risk in general, and the effect on serum lipids, blood pressure and selected hemostatic variables in particular. The association between coffee use and cardiovascular morbidity and mortality was

  5. INFARTO AGUDO DE MIOCARDIO EN PACIENTES JÓVENES INGRESADOS EN CUIDADOS INTENSIVOS / Acute myocardial infarction in young patients admitted to the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Ricardo Grau Ávalos

    2012-01-01

    Full Text Available ResumenIntroducción y objetivos: El infarto agudo de miocardio, en pacientes jóvenes (menores de 45 años, es una situación clínica con características específicas que difieren de los pacientes viejos. El objetivo de esta investigación fue caracterizar el comportamiento de esta enfermedad en pacientes jóvenes, identificar los principales factores de riesgo, las localizaciones topográficas más frecuentes, el tratamiento utilizado, y analizar la mortalidad. Método: Se realizó un estudio descriptivo, retrospectivo y longitudinal, en pacientes menores de 45 años con infarto agudo de miocardio, que ingresaron en las Unidades de Cuidados Intensivos de los Hospitales Universitarios "Celestino Hernández Robau" y “Arnaldo Milián Castro” de Santa Clara, Villa Clara, en el período comprendido entre enero de 1995 y diciembre de 2006. Resultados: Los 202 pacientes menores de 45 años de edad representaron el 4,6 % del total de casos, el 81,2 % se correspondió con el sexo masculino; el hábito de fumar fue el factor de riesgo más prevalente (68,8 %, seguido por la hipertensión arterial (56,4 %; la localización inferior del infarto se encontró en 85 pacientes (42,0 %, seguido por el anterior extenso y el ántero-septal con 49 (24,2 % y 45 (22,3 % casos, respectivamente. Recibieron tratamiento trombolítico 126 pacientes (62,4 %, solo 1 de ellos (0,8 % falleció, los otros 4 fallecidos (5,3 %, no habían recibido ese tipo de tratamiento. Conclusiones: Predominaron el sexo masculino, el hábito de fumar, el infarto con supradesnivel del ST, la afectación de la cara inferior y la administración del tratamiento trombolítico.Abstract Introduction and objectives: Myocardial infarction in young patients (under 45 years of age is a clinical condition with specific characteristics that differ from older patients. The objective of this research was to characterize the behavior of this disease in young patients, to identify the main risk

  6. Acute clinical events in patients with sickle cell disease: epidemiology and treatment Eventos agudos em doença falciforme: epidemiologia e tratamento

    Directory of Open Access Journals (Sweden)

    Monique M. Loureiro

    2008-04-01

    Full Text Available Sickle cell disease is a hereditary illness of high prevalence in black population, and involved patients frequently have multiple hospitalizations. Our objective was to describe and to analyze the clinical course of hospitalizations in patients with sickle cell disease. Cross-sectional study of 78 patients submitted to 230 hospital admissions due to acute complications of sickle cell disease, from 2000 to 2004 in a public teaching hospital in Rio de Janeiro city, RJ, Brazil. Outcomes variables were length of hospital stay and death. Main covariables were age, gender, chronic renal failure, causes of hospitalization and use of medicines. Proportions were compared using the chi-square or the Fischer test, and for the continuous variables, Mann-Whitney test was used. The median age in years was 20.3 (15-53 and the most frequent clinical event was acute painful episode (73.5%. Mean length of stay was significantly higher in admissions caused by different reasons than acute painful episode (p A doença falciforme é uma doença hereditária, de alta prevalência na população negra, que leva a múltiplas internações hospitalares. Nosso objetivo foi descrever e analisar o curso clínico de pacientes com doença falciforme hospitalizados.Realizou-se estudo transversal de 78 pacientes submetidos a 230 internações hospitalares devido a complicações agudas da doença falciforme, de 2000 a 2004, em um hospital universitário no Rio de Janeiro-RJ, Brasil. Os desfechos estudados foram tempo de permanência hospitalar e óbito. As principais co-variáveis foram idade, sexo, presença de insuficiência renal crônica, causas de hospitalização e uso de medicamentos. Proporções foram comparadas utilizando-se o teste qui-quadrado ou teste de Fischer, e, para as variáveis contínuas, o teste de Mann-Whitney foi utilizado. A mediana da idade foi 20,3 anos (15-23 e o evento clínico mais freqüente foi o episódio doloroso agudo (73,5%. O tempo m

  7. Role of Telomerase in the Cardiovascular System

    Directory of Open Access Journals (Sweden)

    Mark Zurek

    2016-06-01

    Full Text Available Aging is one major risk factor for the incidence of cardiovascular diseases and the development of atherosclerosis. One important enzyme known to be involved in aging processes is Telomerase Reverse Transcriptase (TERT. After the discovery of the enzyme in humans, TERT had initially only been attributed to germ line cells, stem cells and cancer cells. However, over the last few years it has become clear that TERT is also active in cells of the cardiovascular system including cardiac myocytes, endothelial cells, smooth muscle cells and fibroblasts. Interference with the activity of this enzyme greatly contributes to cardiovascular diseases. This review will summarize the findings on the role of TERT in cardiovascular cells. Moreover, recent findings concerning TERT in different mouse models with respect to cardiovascular diseases will be described. Finally, the extranuclear functions of TERT will be covered within this review.

  8. Maintained intentional weight loss reduces cardiovascular outcomes

    DEFF Research Database (Denmark)

    Caterson, I D; Finer, N; Coutinho, W

    2012-01-01

    Aim: The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Methods: Overweight/obese...... change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although...... more events occurred in the randomized sibutramine group, on an average, a modest weight loss of approximately 3 kg achieved in the Lead-in Period appeared to offset this increased event rate. Moderate weight loss (3-10 kg) reduced cardiovascular deaths in those with severe, moderate or mild...

  9. Cardiovascular death and manic-depressive psychosis

    DEFF Research Database (Denmark)

    Weeke, A; Juel, K; Vaeth, M

    2013-01-01

    In order to study if tricyclic antidepressant drugs (TCA) in therapeutic doses increase the risk of death due to cardiovascular causes, the relative mortality from cardiovascular diseases was studied in two large groups of first hospitalized manic-depressive patients, one from the TCA era......, the other from the period just before the introduction of TCA. Both groups were selected from the Danish Psychiatric Central Register and followed for an average of 4.5 years. Among 2662 manic-depressive men hospitalized between 1969 and 1976, the relative cardiovascular mortality was 1.53 compared...... to the general population. Among 1133 such cases admitted between 1950 and 1956, the rate was 1.87. Our findings do not support the hypothesis that TCA contribute to the cardiovascular mortality in manic-depressives and even support suggestions that TCA treatment may lower the risk of death by cardiovascular...

  10. Racism and cardiovascular disease: implications for nursing.

    Science.gov (United States)

    Jackson, Jennifer; McGibbon, Elizabeth; Waldron, Ingrid

    2013-01-01

    The social determinants of health (SDH) are recognized as a prominent influence on health outcomes across the lifespan. Racism is identified as a key SDH. In this article, the authors describe the concept of racism as an SDH, its impact in discriminatory actions and inactions, and the implications for cardiovascular nurses. Although research in Canada on the links among racism, stress, and cardiovascular disease is limited, there is growing evidence about the stress of racism and its long-term impact on cardiovascular health. The authors discuss how cardiovascular nursing could be enhanced through an understanding of racism-related stress, and race-based differences in cardiovascular care. The authors conclude with strategies for action to address this nursing concern.

  11. Cardiovascular Disease, Mitochondria, and Traditional Chinese Medicine

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2015-01-01

    Full Text Available Recent studies demonstrated that mitochondria play an important role in the cardiovascular system and mutations of mitochondrial DNA affect coronary artery disease, resulting in hypertension, atherosclerosis, and cardiomyopathy. Traditional Chinese medicine (TCM has been used for thousands of years to treat cardiovascular disease, but it is not yet clear how TCM affects mitochondrial function. By reviewing the interactions between the cardiovascular system, mitochondrial DNA, and TCM, we show that cardiovascular disease is negatively affected by mutations in mitochondrial DNA and that TCM can be used to treat cardiovascular disease by regulating the structure and function of mitochondria via increases in mitochondrial electron transport and oxidative phosphorylation, modulation of mitochondrial-mediated apoptosis, and decreases in mitochondrial ROS. However further research is still required to identify the mechanism by which TCM affects CVD and modifies mitochondrial DNA.

  12. The cardiovascular effects of metformin: lost in translation?

    NARCIS (Netherlands)

    Riksen, N.P.; Tack, C.J.J.

    2014-01-01

    PURPOSE OF REVIEW: In overweight patients with diabetes, treatment with metformin improves cardiovascular outcomes. This observation has fuelled the hypothesis that metformin has direct cardiovascular protective properties over and above glucose lowering. Here, we discuss the various cardiovascular

  13. [Branch retinal vein occlusion: high time for cardiovascular risk management

    NARCIS (Netherlands)

    Bredie, S.J.H.

    2013-01-01

    Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients. Re

  14. [Physical activity and cardiovascular health].

    Science.gov (United States)

    Temporelli, Pier Luigi

    2016-03-01

    It is well known that regular moderate physical activity, in the context of a healthy lifestyle, significantly reduces the likelihood of cardiovascular events, both in primary and secondary prevention. In addition, it is scientifically proven that exercise can reduce the incidence of diabetes, osteoporosis, depression, breast cancer and colon cancer. Despite this strong evidence, sedentary lifestyle remains a widespread habit in the western world. Even in Italy the adult population has a poor attitude to regular physical activity. It is therefore necessary, as continuously recommended by the World Health Organization, to motivate people to "move" since the transition from inactivity to regular light to moderate physical activity has a huge impact on health, resulting in significant savings of resources. We do not need to be athletes to exercise - it should be part of all our daily routines.

  15. Subclinical Hypothyroidism and Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Sunghwan Suh

    2015-09-01

    Full Text Available Subclinical hypothyroidism (SCH is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy.

  16. Polyphenols, inflammation, and cardiovascular disease.

    Science.gov (United States)

    Tangney, Christy C; Rasmussen, Heather E

    2013-05-01

    Polyphenols are compounds found in foods such as tea, coffee, cocoa, olive oil, and red wine and have been studied to determine if their intake may modify cardiovascular disease (CVD) risk. Historically, biologic actions of polyphenols have been attributed to antioxidant activities, but recent evidence suggests that immunomodulatory and vasodilatory properties of polyphenols may also contribute to CVD risk reduction. These properties will be discussed, and recent epidemiological evidence and intervention trials will be reviewed. Further identification of polyphenols in foods and accurate assessment of exposures through measurement of biomarkers (i.e., polyphenol metabolites) could provide the needed impetus to examine the impact of polyphenol-rich foods on CVD intermediate outcomes (especially those signifying chronic inflammation) and hard endpoints among high risk patients. Although we have mechanistic insight into how polyphenols may function in CVD risk reduction, further research is needed before definitive recommendations for consumption can be made.

  17. Cardiovascular Disease and Thyroid Function

    DEFF Research Database (Denmark)

    Faber, Jens; Selmer, Christian

    2014-01-01

    , a progressively increased risk in people with different levels of reduced TSH to a physiologically 'dose-dependent' effect of thyroid hormones on the heart in overt hyperthyroidism. Heart failure represents an intriguing clinical situation in which triiodothyronine treatment might be beneficial. In conclusion......, subclinical dysthyroid states affect the heart with subsequent changes in morbidity and mortality. Subclinical hyperthyroidism seems a more serious condition than subclinical hypothyroidism, which should affect treatment decision in a more aggressive manner. © 2014 S. Karger AG, Basel.......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones...

  18. [Cardiovascular complications of hypertensive crisis].

    Science.gov (United States)

    Rosas-Peralta, Martín; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Ramírez-Arias, Erick; Pérez-Rodríguez, Gilberto

    2016-01-01

    It is inexorable that a proportion of patients with systemic arterial hypertension will develop a hypertensive crisis at some point in their lives. The hypertensive crises can be divided in hypertensive patients with emergency or hypertensive emergency, according to the presence or absence of acute end-organ damage. In this review, we discuss the cardiovascular hypertensive emergencies, including acute coronary syndrome, congestive heart failure, aortic dissection and sympathomimetic hypertensive crises (those caused by cocaine use included). Each is presented in a unique way, although some patients with hypertensive emergency report non-specific symptoms. Treatment includes multiple medications for quick and effective action with security to reduce blood pressure, protect the function of organs remaining, relieve symptoms, minimize the risk of complications and improve patient outcomes.

  19. Cardiovascular adaptations to exercise training

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Nyberg, Michael

    2016-01-01

    Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved...... demands and perfusion levels, arteries, arterioles, and capillaries adapt in structure and number. The diameters of the larger conduit and resistance arteries are increased minimizing resistance to flow as the cardiac output is distributed in the body and the wall thickness of the conduit and resistance...... arteries is reduced, a factor contributing to increased arterial compliance. Endurance training may also induce alterations in the vasodilator capacity, although such adaptations are more pronounced in individuals with reduced vascular function. The microvascular net increases in size within the muscle...

  20. Understanding changes in cardiovascular pathophysiology.

    Science.gov (United States)

    Chummun, Harry

    Cardiovascular pathophysiological changes, such as hypertension and enlarged ventricles, reflect the altered functions of the heart and its circulation during ill-health. This article examines the normal and altered anatomy of the cardiac valves, the contractile elements and enzymes of the myocardium, the significance of the different factors associated with cardiac output, and the role of the autonomic nervous system in the heart beat. It also explores how certain diseases alter these functions and result in cardiac symptoms. Nurses can benefit from knowledge of these specific changes, for example, by being able to ask relevant questions in order to ascertain the nature of a patients condition, by being able to take an effective patient history and by being able to read diagnostic results, such as electrocardiograms and cardiac enzyme results. All this will help nurses to promote sound cardiac care based on a physiological rationale.

  1. Síndrome de Distrés Respiratorio Agudo: Utilidad de los Corticoides Acute respiratory distress syndrome: Role of steroids

    Directory of Open Access Journals (Sweden)

    Célica L. Irrazábal

    2004-06-01

    Full Text Available En Argentina, el síndrome de distrés respiratorio agudo (SDRA representa el 7.7% de las admisiones en terapia intensiva y está asociado con una alta morbilidad y mortalidad (58%. Con frecuencia la muerte puede ser atribuida a más de una causa. La hipoxemia refractaria es una causa de muerte poco frecuente (15% y en muchos casos puede coexistir con disfunción multiorgánica, sepsis o shock séptico. La utilidad de los esteroides como parte del tratamiento es aún motivo de debate a pesar de las múltiples series de casos y estudios clínicos publicados. En el artículo se evalúa la utilidad de los esteroides en el SDRA a través de la revisión de la bibliografía disponible. Se concluye que los esteroides estarían indicados en un pequeño subgrupo de pacientes con SDRA no resuelto o tardío, después de descartar o controlar una infección activa.The acute respiratory distress syndrome (ARDS represents 7.7% of the intensive care population, and is associated with great morbidity and mortality (58%. Frequently, the mortality can be attributed to more than one cause. Refractory hypoxemia is uncommon (15% and most of the patients also have multiple organic dysfunction, sepsis or septic shock. Although there are many publications concerning series of cases and clinical trials using steroids as a part of the treatment of ARDS, this issue remains controversial. In this article the role of steroids in the ARDS is evaluated by analysis of the available literature. We conclude that steroids are useful in a subgroup of patients with unresolving ARDS, after ruling out an active infection or after treatment with antibiotics.

  2. Acute psychotic disorders induced by topiramate: report of two cases Episódio psicótico agudo induzido por topiramato: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Florindo Stella

    2002-06-01

    Full Text Available We report on two epileptic patients who developed acute psychosis after the use of topiramate (TPM. One patient exhibited severe psychomotor agitation, heteroaggressiveness, auditory and visual hallucinations as well as severe paranoid and mystic delusions. The other patient had psychomotor agitation, depersonalization, derealization, severe anxiety and deluded that he was losing his memory. Both patients had to be taken to the casualty room. After interruption of TPM in one patient and reduction of dose in the other, a full remission of the psychotic symptoms was obtained without the need of antipsychotic drugs. Clinicians should be aware of the possibility of development of acute psychotic symptoms in patients undergoing TPM treatment.Relatamos dois pacientes epilépticos que manifestaram quadro psicótico agudo induzido por topiramato (TPM. Um paciente apresentou agitação psicomotora grave, heteroagressividade, alucinações auditivas e visuais, e delírios de conteúdo paranóide e místico. O outro paciente apresentou agitação psicomotora, despersonalização, desrealização, ansiedade intensa e delírio de que estava perdendo a memória. Ambos os pacientes foram conduzidos ao serviço de emergência e, após a interrupção do TPM em um deles e redução da droga em outro, houve remissão total dos sintomas psicóticos sem necessidade de medicação antipsicótica. Alertamos os clínicos para o risco de surgimento de sintomas psicóticos em pacientes em uso do TPM.

  3. Los efectos agudos de la contaminación del aire en la salud de la población: evidencias de estudios epidemiológicos

    Directory of Open Access Journals (Sweden)

    Rosales-Castillo José Alberto

    2001-01-01

    Full Text Available Objetivo. Sintetizar las evidencias de los efectos en la salud de la población por la exposición a contaminación del aire por ozono y partículas suspendidas. Material y métodos. A partir de las principales publicaciones internacionales y mexicanas, publicadas y referidas hasta junio del año 2000, se realizó un metanálisis para resumir los efectos reportados a través del empleo de modelos de efectos aleatorios. Resultados. Los resultados se expresaron como porcentajes de incremento por 10 unidades de concentración de PM10 (µg/m³ y ozono (ppb. Entre los efectos de PM10 cabe destacar el efecto agudo en la mortalidad (0.96%, hospitalizaciones (1.39%, visitas a salas de urgencias (3.11%, síntomas respiratorios (7.72%, parámetros de función pulmonar (1.42%, para capacidad vital forzada (CVF y días de actividad restringida (7.74%. Los efectos de la exposición a ozono son igualmente significativos. Conclusiones. Estos resultados muestran el gran impacto que las concentraciones de contaminantes del aire podrían tener en la salud de las poblaciones urbanas de las grandes metrópolis. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

  4. Trastorno de estrés agudo y episodio depresivo mayor en víctimas de una inundación en Tingo María: prevalencia y efectos de su desplazamiento a un alberg

    OpenAIRE

    2008-01-01

    Objetivos. Determinar la prevalencia del trastorno de estrés agudo (TEA) y comorbilidad con episodio depresivo mayor (TEA+EDM) en víctimas de la inundación de la ciudad Tingo María-Huánuco, 20 días después del evento traumático. Materiales y métodos. Ciento veinte damnificados (personas del albergue) y 110 afectados (personas en sus viviendas) fueron encuestados y comparados. Se aplicó la entrevista clínica estructurada para los trastornos del Eje I del DSM-IV, versión clínica. Las prevalenci...

  5. EFECTO AGUDO EN EL ESTADO ANÍMICO DEL ADULTO MAYOR AL REALIZAR EJERCICIOS CON PESAS A DIFERENTES INTENSIDADES, PARA APLICAR LA COMO TRATAMIENTO EN DICHA POBLACIÓN

    OpenAIRE

    Coto Vega, Edwin; Rivera Sanabria, Carlos A

    2011-01-01

    El propósito de este estudio fue determinar el efecto agudo en los procesos cognitivos (memoria auditiva, discriminación perceptual y tiempo de reacción), en adultos mayores de 60 años al realizar ejercicio de fuerza a intensidades del 30%, 70% y condición control y saber si este efecto se mantiene a los 30 y 60 minutos de finalizado el mismo. Veinte y seis adultos mayores se ejercitaron en las tres condiciones. Se hicieron mediciones antes de realizar ejercicio, inmediatamente después ...

  6. Transtorno de estresse agudo : um estudo sobre as características de personalidade e estilos defensivos em pacientes vítimas de trauma físico

    OpenAIRE

    Márcia Rosane Moreira Santana

    2015-01-01

    O Transtorno de Estresse Agudo (TEA) reúne o conjunto dos sintomas presentes nos indivíduos diante exposição a um evento traumático. A maneira como os indivíduos enfrentam os acontecimentos da vida está relacionada a vários fatores como as características de personalidade e ao estilo defensivo, ambos com uma importante influência no momento pós-trauma. O objetivo desta investigação foi pesquisar as caracteristicas de personalidade e o estilo defensivo em pacientes que sofreram trauma físico e...

  7. Avaliação histopatológica em ratos após tratamento agudo com o extrato etanólico de partes aéreas de Jatropha gossypiifolia L.

    OpenAIRE

    2008-01-01

    A Jatropha gossypiifolia L. apesar de ser usada na medicina popular com finalidades diversas, é uma espécie classicamente catalogada como tóxica. Este trabalho teve como objetivo a pesquisa de alterações histopatológicas em vísceras de ratos sob tratamento agudo com o extrato etanólico (EE) da Jatropha gossypiifolia L. Ratos Wistar foram tratados por via oral (gavagem) com doses únicas do extrato de até 5 g/kg e observados por 14 dias. Após esse período, os animais foram sacrificados por traç...

  8. Impacto sobre la morbilidad y mortalidad de la terapia farmacológica empleada durante las primeras 24 horas del síndrome coronario agudo con elevación del segmento ST complicado con parada cardiorrespiratoria

    OpenAIRE

    Aguilar Cruz, Iván

    2013-01-01

    INTRODUCCIÓNEl infarto agudo de miocardio con elevación del segmento ST (IAMCEST) es una de las principales causas de morbimortalidad en la actualidad, una de las bases de su tratamiento es la reperfusión farmacológica mediante los agentes trombolíticos. En aquellas situaciones donde el IAMCEST sufre como complicación una parada cardiorrespiratoria (PCR), administrar fármacos trombolíticos como tratamiento es controvertido. OBJETIVOS1. Determinar el efecto del tratamiento trombolítico en la...

  9. Choque cardiogénico en síndrome coronario agudo: causas, criterios diagnósticos, tratamiento y mortalidad en el Instituto Nacional del Corazón en Lima- Perú.

    OpenAIRE

    2012-01-01

    Objetivo: Determinar las causas, criterios diagnósticos, tratamiento y mortalidad del choque cardiogénico (ChC) como complicación del síndrome coronario agudo (SCA) en el Instituto Nacional del Corazón, en Lima – Perú. Material y métodos: Se realizó un estudio observacional, descriptivo tipo serie de casos de fuentes secundarias en pacientes con diagnóstico de ChC por SCA del Instituto Nacional del Corazón desde febrero 2004 hasta 31 diciembre 2005. Para seleccionar los pacientes, se utilizar...

  10. Efectividad y seguridad de la laparotomía vs laparoscopía en abdomen agudo de origen gineco-obstétrico causado por embarazo ectópico roto y quiste de ovario roto.

    OpenAIRE

    2014-01-01

    Comparar efectividad, tiempo y sangrado operatorio, estadía y complicaciones entre laparotomía y laparoscopía en abdomen agudo (AA) por embarazo ectópico roto (EER) y quiste de ovario roto (QOR). Métodos: Estudio retrospectivo en el Hospital de Santa Elena y Clínica Granados de Enero 2010-Diciembre 2011. Se obtuvieron las causas, procedimientos, edad, hemoglobina, edad gestacional, antecedentes personales y complicaciones. Tiempo, sangrado operatorio y estadía fueron comparadas por T de stud...

  11. Apendicitis epiploica. Causa poco común de abdomen agudo en niños. Presentación de un caso y revisión de la literatura

    OpenAIRE

    2016-01-01

    ANTECEDENTE: la apendicitis epiploica es el infarto hemorrágico de un apéndice epiploico cuando existe torsión u ocurre una trombosis espontánea de su drenaje venoso central. Generalmente su diagnóstico es incidental en estudios radiológicos de abdomen que se realizan por otras causas de dolor abdominal. Clínicamente puede simular un cuadro de abdomen agudo, principalmente quirúrgico en niños. Por ello, es importante conocer esta entidad, ya que su diagnóstico correcto hace innecesaria la hos...

  12. Efeitos hemodinâmicos de duas estratégias de ventilação mecânica protetora em um modelo suíno de Síndrome do Desconforto Respiratório Agudo

    OpenAIRE

    Guilherme Buzon Gregores

    2011-01-01

    A Síndrome do Desconforto Respiratório Agudo (SDRA) cursa com insuficiência respiratória e necessidade de ventilação mecânica invasiva (VMI). A mortalidade desta síndrome é elevada, mas pode ser reduzida com o uso de estratégias protetoras de ventilação mecânica que usam baixo de volume corrente (VC), geralmente 6ml/Kg ou menos, para minimizar a lesão causada pelo ventilador. Algumas destas estratégias de ventilação protetora utilizam valores elevados de PEEP que podem produzir instabilidade ...

  13. Síndrome de distrés respiratorio agudo (SDRA). El papel de los eicosanoides y su modulación mediante una nutrición parenteral enriquecida con ácidos grasos omega-3

    OpenAIRE

    2014-01-01

    Un primer objetivo de la tesis ha sido estudiar el papel de los eicosanoides en el desarrollo del síndrome de distrés respiratorio agudo (SDRA) mediante el estudio de sus concentraciones. Otro objetivo ha sido analizar si el aporte de una emulsión lipídica administrada por vía parenteral enriquecida con ácidos grasos poliinsaturados de la serie 3 (AGPI n-3) en forma de aceite de pescado y bajo aporte de ácido linoleico (AGPI n-6) puede regular la síntesis de eicosanoides en pacientes con SDRA...

  14. Comparación de los criterios clínicos del síndrome de distrés respiratorio agudo con los hallazgos de autopsia en el paciente pediátrico

    OpenAIRE

    Pacheco Morales, Sergio Hernán

    2013-01-01

    El texto presenta los resultados de la comparación entre los criterios clínicos del Síndrome de Distrès Respiratorio Agudo y los hallazgos de autopsias en pacientes pediátricos fallecidos entre los años 2000 a 2010 en el hospital La Misericordia. Se recogió información de reportes patológicos e historias clínicas.Se calcularon sensibilidad, especificidad y likelihood ratio (LR). de los criterios estudiados, en pacientes con presencia de factores de riesgo pulmonar y extrapulmonar. Como patrón...

  15. Non-cardiovascular findings in clinical cardiovascular magnetic resonance imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Ghadimi Mahani, Maryam [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Morani, Ajaykumar C. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Lu, Jimmy C.; Dorfman, Adam L. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, Ann Arbor, MI (United States); Fazeli Dehkordy, Soudabeh [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Providence Hospital and Medical Centers, Department of Graduate Medical Education, Southfield, MI (United States); Jeph, Sunil [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Geisinger Medical Center, Department of Radiology, Danville, PA (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)

    2016-04-15

    With increasing use of pediatric cardiovascular MRI, it is important for all imagers to become familiar with the spectrum of non-cardiovascular imaging findings that can be encountered. This study aims to ascertain the prevalence and nature of these findings in pediatric cardiovascular MRIs performed at our institution. We retrospectively evaluated reports of all cardiovascular MRI studies performed at our institute from January 2008 to October 2012 in patients younger than18 years. Most studies (98%) were jointly interpreted by a pediatric cardiologist and a radiologist. We reviewed the electronic medical records of all cases with non-cardiovascular findings, defined as any imaging finding outside the cardiovascular system. Non-cardiovascular findings were classified into significant and non-significant, based on whether they were known at the time of imaging or they required additional workup or a change in management. In 849 consecutive studies (mean age 9.7 ± 6.3 years), 145 non-cardiovascular findings were found in 140 studies (16.5% of total studies). Overall, 51.0% (74/145) of non-cardiovascular findings were in the abdomen, 30.3% (44/145) were in the chest, and 18.6% (27/145) were in the spine. A total of 19 significant non-cardiovascular findings were observed in 19 studies in individual patients (2.2% of total studies, 47% male, mean age 5.9 ± 6.7 years). Significant non-cardiovascular findings included hepatic adenoma, arterially enhancing focal liver lesions, asplenia, solitary kidney, pelvicaliectasis, renal cystic diseases, gastric distention, adrenal hemorrhage, lung hypoplasia, air space disease, bronchial narrowing, pneumomediastinum and retained surgical sponge. Non-cardiovascular findings were seen in 16.5% of cardiovascular MRI studies in children, of which 2.2% were clinically significant findings. Prevalence and nature of these non-cardiovascular findings are different from those reported in adults. Attention to these findings is important

  16. CARDIOVASCULAR DISORDERS IN ADOLESCENTS WITH CHEST PAIN

    Directory of Open Access Journals (Sweden)

    Sri Endah Rahayuningsih

    2014-06-01

    Full Text Available Objective: To detect cardiovascular abnormalities in adolescents with chest pain. Methods: In this cross sectional study, the subjects were 25 adolescents with chest pain who came to the Cardiac Center of Dr. Hasan Sadikin General Hospital, Bandung during the period of January 2008 to January 2011. The presence of established cardiovascular disorders were based on history, physical examination, electrocardiography and echocardiography Results: It was found that 13/25 adolescents with chest pain had cardiovascular abnormalities. Of the 25 teens that came with chest pain, most of which showed normal electrocardiographic results, only 9/25 of those with dysrhythmias experienced sinus tachycardia and 8 had a first degree AV block. Echocardiography examination showed only four patients with abnormal cardiac anatomy. No correlation between nutritional status and chest pain, and cardiovascular abnormalities and chest pain (p=0.206 and p=0.632, respectively. There was a positive correlation between sex and cardiovascular abnormalities in adolescents with chest pain (p=0.007. Chest pain is a prevalent problem that is usually benign and that it frequently signals underlying cardiac disease. Conclusions: Cardiovascular abnormalities in adolescents with symptoms of chest pain are found in some cases. There is no correlation between female and male adolescents with chest pain and cardiovascular abnormalities.

  17. Cocoa, blood pressure, and cardiovascular health.

    Science.gov (United States)

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  18. Biomarkers of cardiovascular disease risk in women.

    Science.gov (United States)

    Manson, JoAnn E; Bassuk, Shari S

    2015-03-01

    Cardiovascular disease (CVD), including coronary heart disease and stroke, is the leading cause of death among U.S. women and men. Established cardiovascular risk factors such as smoking, diabetes, hypertension, and elevated total cholesterol, and risk prediction models based on such factors, perform well but do not perfectly predict future risk of CVD. Thus, there has been much recent interest among cardiovascular researchers in identifying novel biomarkers to aid in risk prediction. Such markers include alternative lipids, B-type natriuretic peptides, high-sensitivity troponin, coronary artery calcium, and genetic markers. This article reviews the role of traditional cardiovascular risk factors, risk prediction tools, and selected novel biomarkers and other exposures in predicting risk of developing CVD in women. The predictive role of novel cardiovascular biomarkers for women in primary prevention settings requires additional study, as does the diagnostic and prognostic utility of cardiac troponins for acute coronary syndromes in clinical settings. Sex differences in the clinical expression and physiology of metabolic syndrome may have implications for cardiovascular outcomes. Consideration of exposures that are unique to, or more prevalent in, women may also help to refine cardiovascular risk estimates in this group.

  19. Níveis de PCR são maiores em pacientes com síndrome coronariana aguda e supradesnivelamento do segmento ST do que em pacientes sem supradesnivelamento do segmento ST Niveles de PCR son mayores en pacientes con síndrome coronario agudo y supradesnivel del segmento ST que en pacientes sin supradesnivel del segmento ST CRP levels are higher in patients with ST elevation than non-ST elevation acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Syed Shahid Habib

    2011-01-01

    Full Text Available FUNDAMENTO: Há grande interesse no uso de proteína C-reativa de alta sensibilidade (PCR-as para avaliação de risco. Altos níveis de PCR-as no início da síndrome coronária aguda (SCA, antes da necrose tecidual, pode ser um marcador substituto para comorbidades cardiovasculares. OBJETIVO: Dessa forma, nosso objetivo foi estudar diferentes medidas de seguimento de níveis de PCR-as em pacientes com SCA e comparar as diferenças entre infarto do miocárdio sem elevação do segmento ST (NSTEMI com pacientes apresentando elevação do segmento ST (STEMI. MÉTODOS: Este é um estudo observacional. Dos 89 pacientes recrutados, 60 apresentavam infarto agudo do miocárdio (IAM. Três níveis seriados de PCR-us, a nível basal na hospitalização antes de 12 horas após inicio dos sintomas, níveis de pico 36-48 horas após hospitalização e níveis de acompanhamento após 4 a 6 semanas foram analisados e comparados entre pacientes com (IAMCSST e sem supradesnivelamento do segmento ST (IAMSSST. RESULTADOS: Pacientes com IAMCSST tinham IMC significantemente mais alta quando comparados com pacientes IAMSSST. Os níveis de creatino quinase fração MB (CK-MB e aspartato aminotransferase (AST eram significantemente mais altos em pacientes com IAMCSST quando comparados com pacientes com IAMSSST (pFUNDAMENTO: Hay gran interés en el uso de proteína C-reactiva de alta sensibilidad (PCR-as para evaluación de riesgo. Altos niveles de PCR-as en el comienzo del síndrome coronario agudo (SCA, antes de la necrosis tisular, puede ser un marcador sustituto para comorbilidades cardiovasculares. OBJETIVO: De esa forma, nuestro objetivo fue estudiar diferentes medidas de seguimiento de niveles de PCR-as en pacientes con SCA y comparar las diferencias entre infarto de miocardio sin elevación del segmento ST (NSTEMI con pacientes presentando elevación del segmento ST (STEMI. MÉTODOS: Este es un estudio observacional. De los 89 pacientes reclutados, 60

  20. Caracterização dos padrões de variação dos cuidados de saúde a partir dos gastos com internações por infarto agudo do miocárdio no Sistema Único de Saúde

    Directory of Open Access Journals (Sweden)

    Felipe Machado Huguenin

    Full Text Available RESUMO: Introdução: O cenário epidemiológico mundial revela um crescimento das doenças cardiovasculares, no qual se destaca o infarto agudo do miocárdio (IAM, devido à sua grande magnitude e severidade. No Brasil, doenças coronarianas representam já cerca de 5% dos gastos com internação hospitalar. Objetivo: Caracterizar as internações dos pacientes do Sistema Único de Saúde (SUS por IAM por meio da identificação de agrupamentos sugeridos por uma análise de agrupamentos tradicional e por uma análise de correspondência múltipla (ACM. Métodos: Registros do Sistema de Internações Hospitalares (SIH/SUS com diagnóstico principal de IAM, no Estado do Rio de Janeiro, 2002, foram selecionados e posteriormente relacionados aos do Sistema de Informações sobre Mortalidade (SIM/SUS. A seguir, uma ACM e uma métrica chamada distância de tolerância foram utilizadas para a identificação de clusters , sendo a variável de interesse "gastos com internação" classificada em duas categorias (acima e abaixo de R$ 905,00. Resultados: Foi possível associar "maiores gastos" com "utilização de Centro de Tratamento Intensivo (CTI" e com "gravidade moderada do caso", e "menores gastos" com "gravidade leve" e "não utilização de CTI". Por outro lado, casos de alta gravidade apresentaram-se isolados, sem associação com CTI ou outras variáveis. Também foi detectada associação entre a categoria "menores gastos" e as categorias: "não deslocamento do paciente", "sexo feminino", "idade entre 56 e 75 anos", "óbito até 30 dias" e "óbito até 1 ano". Conclusão: o aspecto isolado dos casos de maior gravidade e a associação entre "óbitos" e "menores gastos" sugere que os recursos tecnológicos disponíveis durante a internação por IAM não estão sendo adequadamente empregados.

  1. [Cooperative Cardiovascular Disease Research Network (RECAVA)].

    Science.gov (United States)

    García-Dorado, David; Castro-Beiras, Alfonso; Díez, Javier; Gabriel, Rafael; Gimeno-Blanes, Juan R; Ortiz de Landázuri, Manuel; Sánchez, Pedro L; Fernández-Avilés, Francisco

    2008-01-01

    Today, cardiovascular disease is the principal cause of death and hospitalization in Spain, and accounts for an annual healthcare budget of more than 4000 million euros. Consequently, early diagnosis, effective prevention, and the optimum treatment of cardiovascular disease present a significant social and healthcare challenge for the country. In this context, combining all available resources to increase the efficacy and healthcare benefits of scientific research is a priority. This rationale prompted the establishment of the Spanish Cooperative Cardiovascular Disease Research Network, or RECAVA (Red Temática de Investigación Cooperativa en Enfermedades Cardiovasculares), 5 years ago. Since its foundation, RECAVA's activities have focused on achieving four objectives: a) to facilitate contacts between basic, clinical and epidemiological researchers; b) to promote the shared use of advanced technological facilities; c) to apply research results to clinical practice, and d) to train a new generation of translational cardiovascular researchers in Spain. At present, RECAVA consists of 41 research groups and seven shared technological facilities. RECAVA's research strategy is based on a scientific design matrix centered on the most important cardiovascular processes. The level of RECAVA's research activity is reflected in the fact that 28 co-authored articles were published in international journals during the first six months of 2007, with each involving contributions from at least two groups in the network. Finally, RECAVA also participates in the work of the Spanish National Center for Cardiovascular Research, or CNIC (Centro Nacional de Investigación Cardiovascular), and some established Biomedical Research Network Centers, or CIBER (Centros de Investigación Biomédica en RED), with the aim of consolidating the development of a dynamic multidisciplinary research framework that is capable of meeting the growing challenge that cardiovascular disease will present

  2. Antioxidants, inflammation and cardiovascular disease.

    Science.gov (United States)

    Mangge, Harald; Becker, Kathrin; Fuchs, Dietmar; Gostner, Johanna M

    2014-06-26

    Multiple factors are involved in the etiology of cardiovascular disease (CVD). Pathological changes occur in a variety of cell types long before symptoms become apparent and diagnosis is made. Dysregulation of physiological functions are associated with the activation of immune cells, leading to local and finally systemic inflammation that is characterized by production of high levels of reactive oxygen species (ROS). Patients suffering from inflammatory diseases often present with diminished levels of antioxidants either due to insufficient dietary intake or, and even more likely, due to increased demand in situations of overwhelming ROS production by activated immune effector cells like macrophages. Antioxidants are suggested to beneficially interfere with diseases-related oxidative stress, however the interplay of endogenous and exogenous antioxidants with the overall redox system is complex. Moreover, molecular mechanisms underlying oxidative stress in CVD are not fully elucidated. Metabolic dybalances are suggested to play a major role in disease onset and progression. Several central signaling pathways involved in the regulation of immunological, metabolic and endothelial function are regulated in a redox-sensitive manner. During cellular immune response, interferon γ-dependent pathways are activated such as tryptophan breakdown by the enzyme indoleamine 2,3-dioxygenase (IDO) in monocyte-derived macrophages, fibroblasts, endothelial and epithelial cells. Neopterin, a marker of oxidative stress and immune activation is produced by GTP-cyclohydrolase I in macrophages and dendritic cells. Nitric oxide synthase (NOS) is induced in several cell types to generate nitric oxide (NO). NO, despite its low reactivity, is a potent antioxidant involved in the regulation of the vasomotor tone and of immunomodulatory signaling pathways. NO inhibits the expression and function of IDO. Function of NOS requires the cofactor tetrahydrobiopterin (BH4), which is produced in

  3. Residual generator for cardiovascular anomalies detection

    KAUST Repository

    Belkhatir, Zehor

    2014-06-01

    This paper discusses the possibility of using observer-based approaches for cardiovascular anomalies detection and isolation. We consider a lumped parameter model of the cardiovascular system that can be written in a form of nonlinear state-space representation. We show that residuals that are sensitive to variations in some cardiovascular parameters and to abnormal opening and closure of the valves, can be generated. Since the whole state is not easily available for measurement, we propose to associate the residual generator to a robust extended kalman filter. Numerical results performed on synthetic data are provided.

  4. Role of magnesium in cardiovascular diseases.

    Science.gov (United States)

    Kolte, Dhaval; Vijayaraghavan, Krishnaswami; Khera, Sahil; Sica, Domenic A; Frishman, William H

    2014-01-01

    Magnesium, the fourth most abundant cation in the human body, is involved in several essential physiological, biochemical, and cellular processes regulating cardiovascular function. It plays a critical role in modulating vascular smooth muscle tone, endothelial cell function, and myocardial excitability and is thus central to the pathogenesis of several cardiovascular disorders such as hypertension, atherosclerosis, coronary artery disease, congestive heart failure, and cardiac arrhythmias. This review discusses the vasodilatory, anti-inflammatory, anti-ischemic, and antiarrhythmic properties of magnesium and its current role in the prevention and treatment of cardiovascular disorders.

  5. Cardiovascular surgery in the elderly: an update

    Institute of Scientific and Technical Information of China (English)

    Song WAN; Ahmed A. ARIFI; Calvin S. H. NG; Anthony P. C. YIM

    2005-01-01

    The aging of the population and improvements in outcomes after cardiovascular surgery have resulted in a worldwide growing demand of complex surgical intervention for elderly patients. We briefly review the up-to-date English-language literature with particular focus on cardiovascular surgery in elderly patients. With earlier referral, careful preoperative evaluation, strategic planning, and the continuing efforts in optimizing surgical techniques, operative mortality and morbidity following primary or reoperative coronary artery bypass grafting and valvular interventions are expected to fall in this high-risk patient subset. Importantly,accumulating evidence indicates that elderly patients may benefit from improved functional status and quality of life after cardiovascular surgical therapy

  6. Cardiovascular physiology and diseases of amphibians.

    Science.gov (United States)

    Heinz-Taheny, Kathleen M

    2009-01-01

    The class Amphibia includes three orders of amphibians: the anurans (frogs and toads), urodeles (salamanders, axolotls, and newts), and caecilians. The diversity of lifestyles across these three orders has accompanying differences in the cardiovascular anatomy and physiology allowing for adaptations to aquatic or terrestrial habitats, pulmonic or gill respiration, hibernation, and body elongation (in the caecilian). This article provides a review of amphibian cardiovascular anatomy and physiology with discussion of unique species adaptations. In addition, amphibians as cardiovascular animal models and commonly encountered natural diseases are covered.

  7. Cardiovascular magnetic resonance in systemic hypertension

    Directory of Open Access Journals (Sweden)

    Maceira Alicia M

    2012-06-01

    Full Text Available Abstract Systemic hypertension is a highly prevalent potentially modifiable cardiovascular risk factor. Imaging plays an important role in the diagnosis of underlying causes for hypertension, in assessing cardiovascular complications of hypertension, and in understanding the pathophysiology of the disease process. Cardiovascular magnetic resonance (CMR provides accurate and reproducible measures of ventricular volumes, mass, function and haemodynamics as well as uniquely allowing tissue characterization of diffuse and focal fibrosis. In addition, CMR is well suited for exclusion of common secondary causes for hypertension. We review the current and emerging clinical and research applications of CMR in hypertension.

  8. Seasonality of cardiovascular risk factors

    DEFF Research Database (Denmark)

    Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie

    2014-01-01

    OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist.......6 cm for waist circumference, 2.9 mm Hg for SBP, 1.4 mm Hg for DBP, 0.02 mmol/L for triglycerides, 0.10 mmol/L for total cholesterol, 0.01 mmol/L for HDL cholesterol, 0.11 mmol/L for LDL cholesterol, and 0.07 mmol/L for glycaemia. Similar results were obtained when the analysis was restricted...... to studies collecting fasting blood samples. Similar seasonal variations were found for most CVRFs in the Southern Hemisphere, with the exception of waist circumference, HDL, and LDL cholesterol. CONCLUSIONS: CVRFs show a seasonal pattern characterised by higher levels in winter, and lower levels in summer...

  9. Globalization, Work, and Cardiovascular Disease.

    Science.gov (United States)

    Schnall, Peter L; Dobson, Marnie; Landsbergis, Paul

    2016-10-01

    Cardiovascular disease (CVD), a global epidemic, is responsible for about 30% of all deaths worldwide. While mortality rates from CVD have been mostly declining in the advanced industrialized nations, CVD risk factors, including hypertension, obesity, and diabetes, have been on the increase everywhere. Researchers investigating the social causes of CVD have produced a robust body of evidence documenting the relationships between the work environment and CVD, including through the mechanisms of psychosocial work stressors. We review the empirical evidence linking work, psychosocial stressors, and CVD. These work stressors can produce chronic biologic arousal and promote unhealthy behaviors and thus, increased CVD risk. We offer a theoretical model that illustrates how economic globalization influences the labor market and work organization in high-income countries, which, in turn, exacerbates job characteristics, such as demands, low job control, effort-reward imbalance, job insecurity, and long work hours. There is also a growing interest in "upstream" factors among work stress researchers, including precarious employment, downsizing/restructuring, privatization, and lean production. We conclude with suggestions for future epidemiologic research on the role of work in the development of CVD, as well as policy recommendations for prevention of work-related CVD.

  10. Cardiovascular Involvement in Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    Jenny Amaya-Amaya

    2014-01-01

    Full Text Available Autoimmune diseases (AD represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD.

  11. Cardiovascular benefits of dietary fiber.

    Science.gov (United States)

    Satija, Ambika; Hu, Frank B

    2012-12-01

    The relationship between dietary fiber and risk of cardiovascular disease (CVD) has been extensively studied. There is considerable epidemiological evidence indicating an inverse association between dietary fiber intake and CVD risk. The association has been found to be stronger for cereal fiber than for fruit or vegetable fiber, and several studies have also found increased whole grain consumption to be associated with CVD risk reduction. In light of this evidence, recent US dietary guidelines have endorsed increased consumption of fiber rich whole grains. Regular consumption of dietary fiber, particularly fiber from cereal sources, may improve CVD health through multiple mechanisms including lipid reduction, body weight regulation, improved glucose metabolism, blood pressure control, and reduction of chronic inflammation. Future research should focus on various food sources of fiber, including different types of whole grains, legumes, fruits, vegetables, and nuts, as well as resistant starch in relation to CVD risk and weight control; explore the biological mechanisms underlying the cardioprotective effect of fiber-rich diets; and study different ethnic groups and populations with varying sources of dietary fiber.

  12. Testosterone deficiency and cardiovascular mortality

    Institute of Scientific and Technical Information of China (English)

    Abraham Morgentaler

    2015-01-01

    New concerns have been raised regarding cardiovascular (CV) risks with testosterone (T) therapy (TTh). These concerns are based primarily on two widely reported retrospective studies. However, methodological flaws and data errors invalidate both studies as credible evidence of risk. One showed reduced adverse events by half in T‑treated men but reversed this result using an unproven statistical approach. The authors subsequently acknowledged serious data errors including nearly 10% contamination of the dataset by women. The second study mistakenly used the rate of T prescriptions written by healthcare providers to men with recent myocardial infarction (MI) as a proxy for the naturally occurring rate of MI. Numerous studies suggest T is beneficial, including decreased mortality in association with TTh, reduced MI rate with TTh in men with the greatest MI risk prognosis, and reduced CV and overall mortality with higher serum levels of endogenous T. Randomized controlled trials have demonstrated benefits of TTh in men with coronary artery disease and congestive heart failure. Improvement in CV risk factors such as fat mass and glycemic control have been repeatedly demonstrated in T‑deficient men treated with T. The current evidence does not support the belief that TTh is associated with increased CV risk or CV mortality. On the contrary, a wealth of evidence accumulated over several decades suggests that low serum T levels are associated with increased risk and that higher endogenous T, as well as TTh itself, appear to be beneficial for CV mortality and risk.

  13. Dietary sodium and cardiovascular disease.

    Science.gov (United States)

    Smyth, Andrew; O'Donnell, Martin; Mente, Andrew; Yusuf, Salim

    2015-06-01

    Although an essential nutrient, higher sodium intake is associated with increasing blood pressure (BP), forming the basis for current population-wide sodium restriction guidelines. While short-term clinical trials have achieved low intake (6 months). Guidelines assume that low sodium intake will reduce BP and reduce cardiovascular disease (CVD), compared to moderate intake. However, current observational evidence suggests a J-shaped association between sodium intake and CVD; the lowest risks observed with 3-5 g/day but higher risk with 5 g/day) and increased risk of CVD. Although lower intake may reduce BP, this may be offset by marked increases in neurohormones and other adverse effects which may paradoxically be adverse. Large randomised clinical trials with sufficient follow-up are required to provide robust data on the long-term effects of sodium reduction on CVD incidence. Until such trials are completed, current evidence suggests that moderate sodium intake for the general population (3-5 g/day) is likely the optimum range for CVD prevention.

  14. Metabolic syndrome and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Abdullah M Alshehri

    2010-11-01

    Full Text Available The constellation of dyslipidemia (hypertriglyceridemia and low levels of high-density lipoprotein cholesterol, elevated blood pressure, impaired glucose tolerance, and central obesity is now classified as metabolic syndrome, also called syndrome X. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria for use in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general, they include a combination of multiple and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics, commonly manifest a prothrombotic state as well as and a proinflammatory state. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB, increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C. The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of atherosclerotic cardiovascular disease (ASCVD risk factors, that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to the components of the syndrome present as well as the other, non-metabolic syndrome risk factors in a particular person.

  15. Cardiovascular molecular imaging of apoptosis

    Energy Technology Data Exchange (ETDEWEB)

    Wolters, S.L.; Reutelingsperger, C.P.M. [Maastricht University, Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Corsten, M.F.; Hofstra, L. [Maastricht University, Department of Cardiology, Cardiovascular Research Institute Maastricht, P.O. Box 616, Maastricht (Netherlands); Narula, J. [University of California Irvine, Department of Cardiology, Irvine (United States)

    2007-06-15

    Molecular imaging strives to visualise processes at the molecular and cellular level in vivo. Understanding these processes supports diagnosis and evaluation of therapeutic efficacy on an individual basis and thereby makes personalised medicine possible. Apoptosis is a well-organised mode of cell suicide that plays a role in cardiovascular diseases (CVD). Apoptosis is associated with loss of cardiomyocytes following myocardial infarction, atherosclerotic plaque instability, congestive heart failure and allograft rejection of the transplanted heart. Thus, apoptosis constitutes an attractive target for molecular imaging of CVD. Our current knowledge about the molecular players and mechanisms underlying apoptosis offers a rich palette of potential molecular targets for molecular imaging. However, only a few have been successfully developed so far. This review highlights aspects of the molecular machinery and biochemistry of apoptosis relevant to the development of molecular imaging probes. It surveys the role of apoptosis in four major areas of CVD and portrays the importance and future perspectives of apoptosis imaging. The annexin A5 imaging protocol is emphasised since it is the most advanced protocol to measure apoptosis in both preclinical and clinical studies. (orig.)

  16. Pomegranate for your cardiovascular health.

    Science.gov (United States)

    Aviram, Michael; Rosenblat, Mira

    2013-04-01

    Pomegranate is a source of some very potent antioxidants (tannins, anthocyanins) which are considered to be also potent anti-atherogenic agents. The combination of the above unique various types of pomegranate polyphenols provides a much wider spectrum of action against several types of free radicals. Indeed, pomegranate is superior in comparison to other antioxidants in protecting low-density lipoprotein (LDL, "the bad cholesterol") and high-density lipoprotein (HDL, "the good cholesterol") from oxidation, and as a result it attenuates atherosclerosis development and its consequent cardiovascular events. Pomegranate antioxidants are not free, but are attached to the pomegranate sugars, and hence were shown to be beneficial even in diabetic patients. Furthermore, pomegranate antioxidants are unique in their ability to increase the activity of the HDL-associated paraoxonase 1 (PON1), which breaks down harmful oxidized lipids in lipoproteins, in macrophages, and in atherosclerotic plaques. Finally, unique pomegranate antioxidants beneficially decrease blood pressure. All the above beneficial characteristics make the pomegranate a uniquely healthy fruit.

  17. Cardiovascular failure and cardiogenic shock.

    Science.gov (United States)

    Patel, Ankitkumar K; Hollenberg, Steven M

    2011-10-01

    Cardiovascular system failure is commonly faced by the intensivist. Heart failure can occur due to a host of predisposing cardiac disorders or as secondary effects of systemic illness. When the heart is unable to provide an adequate cardiac output to maintain adequate tissue perfusion, cardiogenic shock ensues. Without prompt diagnosis and appropriate management, these patients have significant morbidity and mortality, with in-hospital mortality approaching 60% for all age groups. Accurate and rapid identification of cardiogenic shock as a medical emergency, with expeditious implementation of appropriate therapy, can lead to improved clinical outcomes. In this review, we discuss optimal strategies for diagnosis and monitoring of cardiogenic shock. We discuss the diverse therapeutic strategies employed for cardiogenic shock, including pharmacological (e.g., vasoactive agents, fibrinolytic agents), mechanical (e.g., intraaortic balloon pumps, left ventricular assist devices, percutaneous coronary intervention [PCI]), and surgical approaches such as coronary artery bypass graft (CABG), valvular repair or replacement (e.g., for acute mitral regurgitation, ventricular septal rupture, or free wall rupture).

  18. Allergy and the cardiovascular system.

    Science.gov (United States)

    Triggiani, M; Patella, V; Staiano, R I; Granata, F; Marone, G

    2008-09-01

    The most dangerous and life-threatening manifestation of allergic diseases is anaphylaxis, a condition in which the cardiovascular system is responsible for the majority of clinical symptoms and for potentially fatal outcome. The heart is both a source and a target of chemical mediators released during allergic reactions. Mast cells are abundant in the human heart, where they are located predominantly around the adventitia of large coronary arteries and in close contact with the small intramural vessels. Cardiac mast cells can be activated by a variety of stimuli including allergens, complement factors, general anesthetics and muscle relaxants. Mediators released from immunologically activated human heart mast cells strongly influence ventricular function, cardiac rhythm and coronary artery tone. Histamine, cysteinyl leukotrienes and platelet-activating factor (PAF) exert negative inotropic effects and induce myocardial depression that contribute significantly to the pathogenesis of anaphylactic shock. Moreover, cardiac mast cells release chymase and renin that activates the angiotensin system locally, which further induces arteriolar vasoconstriction. The number and density of cardiac mast cells is increased in patients with ischaemic heart disease and dilated cardiomyopathies. This observation may help explain why these conditions are major risk factors for fatal anaphylaxis. A better understanding of the mechanisms involved in cardiac mast cell activation may lead to an improvement in prevention and treatment of systemic anaphylaxis.

  19. Biofluid Dynamics in Cardiovascular System

    Science.gov (United States)

    Chung, Hansol; Yoo, Su Jung; Kyung, Richard

    2011-11-01

    Biofluid dynamics is characterized by the study of fluids in biological systems. Common biofluid systems include blood flow in the cardiovascular system and airflow in the lungs. The mathematical modeling of blood flow through the complex geometry of a prosthetic heart valve is a difficult task. In such a problem the complex geometries of the valve must be modeled properly so that they can be studied numerically. The present analysis is performed on a disk-type prosthetic heart valve. The valve is assumed to be in the aortic position and observed the structure of the valve cage influence the flow field near an aortic valve. For the purpose of mathematical modeling, the laminar incompressible two-dimensional steady flow of a homogeneous Newtonian fluid with constant viscosity is assumed. The flow is considered during the greater part of systole when the valve is fully open. Convergent numerical solutions are obtained for Reynolds numbers of 30, 180, 900 and 4500. Stream function, horizontal velocity, vertical velocity and shear stress solutions are computed at every grid point.

  20. Escore TIMI no infarto agudo do miocárdio conforme níveis de estratificação de prognóstico Score TIMI en el infarto agudo de miocardio según niveles de estratificación de pronóstico TIMI risk score for acute myocardial infarction according to prognostic stratification

    Directory of Open Access Journals (Sweden)

    Jaqueline Locks Pereira

    2009-08-01

    Full Text Available FUNDAMENTO: O escore de risco TIMI (thrombolysis in myocardial infarction é derivado de ensaio clínico envolvendo pacientes elegíveis para fibrinólise. Como o perfil de risco desses casos difere do encontrado em populações não selecionadas, é importante que se analise a aplicabilidade do escore em condições clínicas habituais. OBJETIVO: Avaliar o manejo e a evolução hospitalar de pacientes internados com infarto agudo do miocárdio conforme estratificação de risco pelo escore TIMI. MÉTODOS: Foram avaliados, retrospectivamente, 103 casos de infarto agudo do miocárdio com supradesnivelamento do segmento ST, admitidos no Hospital Nossa Senhora da Conceição, em Tubarão, nos anos de 2004 e 2005. Os casos foram analisados em três grupos de risco de acordo com o escore TIMI. RESULTADOS: A mortalidade hospitalar pós-infarto foi de 17,5%. No grupo de baixo risco não houve óbito. A mortalidade foi de 8,1% no grupo de médio risco e de 55,6% no de alto risco. O risco de morte para casos de alto risco foi 14,1 vezes maior em relação aos casos de médio e baixo risco (IC95% = 4,4 a 44,1 e pFUNDAMENTO: El score de riesgo TIMI (thrombolysis in myocardial infarction se derivó de ensayo clínico que implicó a pacientes elegibles para fibrinólisis. Como el perfil de riesgo de esos casos difiere del encontrado en poblaciones no seleccionadas, es importante que se analice la aplicabilidad del score en condiciones clínicas habituales. OBJETIVO: Evaluar el manejo y la evolución hospitalaria de pacientes internados con infarto agudo de miocardio de acuerdo con la estratificación de riesgo mediante la puntuación TIMI. MÉTODOS: Se evaluaron, retrospectivamente, 103 casos de infarto agudo de miocardio con supradesnivelamiento del segmento ST, ingresados en el Hospital Nossa Senhora da Conceição, en Tubarão, en los años de 2004 y 2005. Se analizaron los casos en tres grupos de riesgo según el score TIMI. RESULTADOS: La mortalidad

  1. Apendicitis epiploica. Causa poco común de abdomen agudo en niños. Presentación de un caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    SA Solórzano-Morales

    2016-04-01

    requiere tratamiento con analgésicos. La mayoría de los casos han sido descritos en pacientes adultos; sin embargo, el caso que presentamos es el segundo diagnosticado en el Instituto Nacional de Pediatría.   CASO CLÍNICO: niño de 9 años con diagnóstico clínico presuntivo de apendicitis, se diagnosticó por ultrasonido y tomografía computada como apendicitis epiploica, lo que se corroboró en la pieza anatomopatológica.   CONCLUSIONES: nuestro propósito es describir la apendicitis epiploica en niños como causa de abdomen agudo, así como los hallazgos clínicos, ultrasonográficos, de tomografía computada e histopatológicos de esta patología como causa rara de abdomen agudo. Es importante que se conozca el valor de los estudios de imagen de esta entidad a fin de evitar tratamientos invasivos innecesarios.

  2. Cardiomiopatia de Takotsubo: uma causa rara de choque cardiogênico simulando infarto agudo do miocárdio Takotsubo cardiomiopathy: a rare cause of cardiogenic shock simulating acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Jayro Thadeu Paiva de Vasconcelos

    2005-08-01

    Full Text Available Cardiomiopatia de Takotsubo é uma causa rara de aneurisma ventricular esquerdo agudo, na ausência de coronariopatia, só recentemente descrita na literatura mundial. Os sintomas podem assemelhar-se aos do infarto agudo do miocárdio com dor torácica típica. A imagem do balonamento ventricular sugestivo de haltere ou "Takotsubo" (dispositivo utilizado no Japão para prender Octopus é característico desta nova síndrome e usualmente há desaparecimento do movimento discinético até o 18º dia do início dos sintomas, em média.Takotsubo Cardiomiopathy is a rare cause of acute left ventricular aneurysm, in the absence of coronariopathy, only recently described in world literature. Symptoms may be similar to those from acute myocardial infarction with typical thoracic pain. The image of dumbbell or Takotsubo (a device used in Japan to capture octopus suggestive ventricular ballooning is characteristic of that new syndrome and there is usually the disappearing of dyskinetic movement up to the 18th day from the beginning of the symptoms, in average.

  3. Un reto para Colombia: mejorar la utilización de medicamentos probadamente beneficiosos en la prevención secundaria cardiovascular

    Directory of Open Access Journals (Sweden)

    Patricio López-Jaramillo

    2012-02-01

    Full Text Available Las enfermedades cardiovasculares (ECV causan 30% del total de las muertes en todo el mundo; de estas 80% sucede en los países en vía de desarrollo.  El 1% de las personas en el mundo presenta un evento coronario agudo o cerebrovascular por año y la mitad de estos eventos se produce en individuos con enfermedad vascular preexistente. Los países de bajos y medianos ingresos presentan un incremento en la carga de las ECV y la mayoría no tiene programas concretos y bien definidos  para su prevención.Se ha estimado que para el año 2020, habrá un aumento  entre 120% y 137%  en la incidencia de enfermedad coronaria en las mujeres y los hombres respectivamente, en los países en desarrollo. Este fenómeno se explica, entre otras razones, por la denominada transición epidemiológica, que se asocia con  un notable aumento en la prevalencia de facto-res de riesgo como la obesidad, la hipertensión arterial, el tabaquismo, el consumo exagerado de alcohol, los cambios en los hábitos nutricionales y el sedentarismo. Estos  factores  están relacionados con la rápida urbanización que han sufrido los países de bajos y medianos ingresos.

  4. Potassium in hypertension and cardiovascular disease.

    Science.gov (United States)

    Castro, Hector; Raij, Leopoldo

    2013-05-01

    The increased prevalence of hypertension and cardiovascular disease in industrialized societies undoubtedly is associated with the modern high-sodium/low-potassium diet. Extensive experimental and clinical data strongly link potassium intake to cardiovascular outcome. Most studies suggest that the sodium-to-potassium intake ratio is a better predictor of cardiovascular outcome than either nutrient individually. A high-sodium/low-potassium environment results in significant abnormalities in central hemodynamics, leading to potential target organ damage. Altered renal sodium handling, impaired endothelium-dependent vasodilatation, and increased oxidative stress are important mediators of this effect. It remains of paramount importance to reinforce consumption of a low-sodium/high-potassium diet as a critical strategy for prevention and treatment of hypertension and cardiovascular disease.

  5. Influenza vaccines for preventing cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Christine Clar

    Full Text Available ABSTRACTBACKGROUND: This is an update of the original review published in 2008. The risk of adverse cardiovascular outcomes is increased with influenza-like infection, and vaccination against influenza may improve cardiovascular outcomes.OBJECTIVES: To assess the potential benefits of influenza vaccination for primary and secondary prevention of cardiovascular disease.METHODS:Search methods:We searched the following electronic databases on 18 October 2013: The Cochrane Library (including Cochrane Central Register of Controlled Trials (CENTRAL, Database of Abstracts of Reviews of Effects (DARE, Economic Evaluation Database (EED and Health Technology Assessment database (HTA, MEDLINE, EMBASE, Science Citation Index Expanded, Conference Proceedings Citation Index - Science and ongoing trials registers (www.controlled-trials.com/ and www.clinicaltrials.gov. We examined reference lists of relevant primary studies and systematic reviews. We performed a limited PubMed search on 20 February 2015, just before publication.Selection criteria:Randomised controlled trials (RCTs of influenza vaccination compared with placebo or no treatment in participants with or without cardiovascular disease, assessing cardiovascular death or non-fatal cardiovascular events.Data collection and analysis:We used standard methodological procedures as expected by The Cochrane Collaboration. We carried out meta-analyses only for cardiovascular death, as other outcomes were reported too infrequently. We expressed effect sizes as risk ratios (RRs, and we used random-effects models.MAIN RESULTS: We included eight trials of influenza vaccination compared with placebo or no vaccination, with 12,029 participants receiving at least one vaccination or control treatment. We included six new studies (n = 11,251, in addition to the two included in the previous version of the review. Four of these trials (n = 10,347 focused on prevention of influenza in the general or elderly population

  6. Carotenoids as signaling molecules in cardiovascular biology

    Directory of Open Access Journals (Sweden)

    Abolfazl Barzegari

    2014-09-01

    Full Text Available Oxidative stress and inflammation play important roles in the etiology of cardiovascular disease (CVD. Thus, natural antioxidant carotenoids existing in fruits and vegetables could have a significant role in the prevention of CVD. Nevertheless,clinical data are conflicting about the positive effect of some antioxidant carotenoids in reducing cardiovascular morbidity and mortality. Many biological actions of carotenoids have been attributed to their antioxidant effect; however, the precise mechanism by which carotenoids produce their beneficial effects is still under discussion. They might modulate molecular pathways involved in cell proliferation, acting at Akt, tyrosine kinases, mitogen activated protein kinase (MAP kinase and growth factor signaling cascades. Screening for a promising cardiovascular protective carotenoids therefore might be performed in vitro and in vivo with caution in cross-interaction with other molecules involved in signaling pathways especially those affecting microRNAs, performing a role in molecular modulation of cardiovascular cells.

  7. Acute lung injury induces cardiovascular dysfunction

    DEFF Research Database (Denmark)

    Suda, Koichi; Tsuruta, Masashi; Eom, Jihyoun;

    2011-01-01

    Acute lung injury (ALI) is associated with systemic inflammation and cardiovascular dysfunction. IL-6 is a biomarker of this systemic response and a predictor of cardiovascular events, but its possible causal role is uncertain. Inhaled corticosteroids and long-acting β2 agonists (ICS/LABA) down......-regulate the systemic expression of IL-6, but whether they can ameliorate the cardiovascular dysfunction related to ALI is uncertain. We sought to determine whether IL-6 contributes to the cardiovascular dysfunction related to ALI, and whether budesonide/formoterol ameliorates this process. Wild-type mice were...... these impairments (vasodilatory responses to acetylcholine, P = 0.005; cardiac output, P = 0.025). Pretreatment with the combination of budesonide and formoterol, but not either alone, ameliorated the vasodilatory responses to acetylcholine (P = 0.018) and cardiac output (P drugs also attenuated...

  8. Significance of Cardiac Rehabilitation on Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Krutika Gajjar

    2012-06-01

    Full Text Available Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medication,blood pressure control, diabetes management and stress management. The exercise component of a totalapproach to rehabilitation helps to overcome the fears and anxieties that so many people experience aftera heart attack. Aerobic exercise training program improves cardiovascular fitness in both healthyindividual and cardiac patients. Cardiac rehabilitation prevents and treat cardiovascular disease, reducescardiac risk factors, improving patient’s exercise capacity and enhancing quality of life. Aerobicexercise with intensity of approximately 60 to 70% of the maximal heart rate for 30 to 60 minutes, 3 to 4times a week, for 4 to 6 weeks enhances exercise capacity.

  9. Discontinued drugs in 2012: cardiovascular drugs.

    Science.gov (United States)

    Zhao, Hong-Ping; Jiang, Hong-Min; Xiang, Bing-Ren

    2013-11-01

    The continued high rate of cardiovascular morbidity and mortality has attracted wide concern and great attention of pharmaceutical industry. In order to reduce the attrition of cardiovascular drug R&D, it might be helpful recapitulating previous failures and identifying the potential factors to success. This perspective mainly analyses the 30 cardiovascular drugs dropped from clinical development in 2012. Reasons causing the termination of the cardiovascular drugs in the past 5 years are also tabulated and analysed. The analysis shows that the attrition is highest in Phase II trials and financial and strategic factors and lack of clinical efficacy are the principal reasons for these disappointments. To solve the four problems (The 'better than the Beatles' problem, the 'cautious regulator' problem, the 'throw money at it' tendency and the 'basic researchbrute force' bias) is recommended as the main measure to increase the number and quality of approvable products.

  10. CARDIOVASCULAR DISORDERS WITH HYPOTHYROIDISM AND ADIPOKINES

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    S. Ye. Myasoyedova

    2015-01-01

    Full Text Available The article describes the mechanisms of development of cardiovascular disorders and dyslipidemia with hypothyroidism. Reference data are presented that are devoted to the study of adipokines content with hypothyroidism and their effect on echocardiographic indicators.

  11. Lipoprotein metabolism indicators improve cardiovascular risk prediction

    NARCIS (Netherlands)

    Schalkwijk, D.B. van; Graaf, A.A. de; Tsivtsivadze, E.; Parnell, L.D.; Werff-van der Vat, B.J.C. van der; Ommen, B. van; Greef, J. van der; Ordovás, J.M.

    2014-01-01

    Background: Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to inves

  12. Adiponectin Provides Cardiovascular Protection in Metabolic Syndrome

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    Yoshihisa Okamoto

    2011-01-01

    Full Text Available Adipose tissue plays a central role in the pathogenesis of metabolic syndrome. Adiponectin (APN is a bioactive adipocytokine secreted from adipocytes. Low plasma APN levels (hypoadiponectinemia are observed among obese individuals and in those with related disorders such as diabetes, hypertension, and dyslipidemia. APN ameliorates such disorders. Hypoadiponectinemia is also associated with major cardiovascular diseases including atherosclerosis and cardiac hypertrophy. Accumulating evidence indicates that APN directly interacts with cardiovascular tissue and prevents cardiovascular pathology. Increasing plasma APN or enhancing APN signal transduction may be an ideal strategy to prevent and treat the cardiovascular diseases associated with metabolic syndrome. However, further studies are required to uncover the precise biological actions of APN.

  13. Cardiovascular and metabolic effects of natriuretic peptides.

    Science.gov (United States)

    Moro, Cédric; Berlan, Michel

    2006-02-01

    Natriuretic peptides (NP) are essential in mammals to regulate blood volume and pressure. The functional roles of NP are not limited to natriuresis and diuresis. Several peripheral and central actions of the peptides have been characterized. Studies on transgenic mice have revealed their key function in the regulation of cardiomyocyte growth. Plasma NP levels increase in patients with cardiovascular disorders and heart failure. They represent useful clinical markers for clinicians to diagnose heart diseases. The recent discovery of their potent lipolytic action in adipose tissue is a breakthrough in cardiovascular medicine. This new function of NP in the regulation of lipid metabolism offers interesting questions in the field of obesity, diabetes and cardiovascular diseases. This review will briefly describe the effects of NP on the cardiovascular system and lipid metabolism.

  14. Cardiovascular physiology and diseases of pet birds.

    Science.gov (United States)

    Pees, Michael; Krautwald-Junghanns, Maria-Elisabeth

    2009-01-01

    Avian cardiac disease in pet birds occurs more often than previously assumed. The article focuses on anatomic peculiarities of the avian cardiovascular system and common diseases. Diagnostic possibilities are demonstrated, and therapeutic measures are discussed.

  15. Prevention of Cardiovascular Diseases in Deprived Neighbourhoods

    OpenAIRE

    El Fakiri, Fatima

    2008-01-01

    textabstractWorldwide, cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality even though mortality rates in the industrialised countries have declined over the past decades. Recent WHO reports show that an estimated 17 million people die every year of CVD, particularly from myocardial infarction and strokes [1]. In Western countries, such as the Netherlands, discrepancies in cardiovascular morbidity and mortality according to ethnicity and socio-economic status sti...

  16. CARDIOVASCULAR DISORDERS IN ADOLESCENTS WITH CHEST PAIN

    OpenAIRE

    Sri Endah Rahayuningsih; Rahmat Budi; Herry Garna

    2014-01-01

    Objective: To detect cardiovascular abnormalities in adolescents with chest pain. Methods: In this cross sectional study, the subjects were 25 adolescents with chest pain who came to the Cardiac Center of Dr. Hasan Sadikin General Hospital, Bandung during the period of January 2008 to January 2011. The presence of established cardiovascular disorders were based on history, physical examination, electrocardiography and echocardiography Results: It was found that 13/25 adolesce...

  17. Vitamin D and cardiovascular diseases: Causality.

    Science.gov (United States)

    Wimalawansa, Sunil J

    2016-12-24

    Vitamin D regulates blood pressure, cardiac functions, and endothelial and smooth muscle cell functions, thus, playing an important role in cardiovascular health. Observational studies report associations between vitamin D deficiency with hypertension and cardiovascular-related deaths. Peer-reviewed papers were examined in several research databases as per the guidelines of the Preferred Reporting Items for Systematic Reviews, using key words that address the relationship between vitamin D and cardiovascular disease. Correlations and interpretations were made considering the risks-benefits, broader evidence, and implications. This review analyzed current knowledge regarding the effects of vitamin D on the cardiovascular system. 1,25(OH)2D and related epigenetic modifications subdue cellular inflammation, improve overall endothelial functions, reduce age-related systolic hypertension and vascular rigidity, and attenuate the actions of the renin-angiotensin-aldosterone system. Most observational and ecological studies support 25(OH)vitamin D having protective effects on the cardiovascular system. However, the association of vitamin D deficiency with cardiovascular diseases is based primarily on observational and ecological studies and thus, is a matter of controversy. Adequately powered, randomized controlled clinical trial data are not available to confirm these associations. Thus, to test the hypothesis that correction of vitamin D deficiency protects the cardiovascular system, well-designed, statistically powered, longer-term clinical trials are needed in persons with vitamin D deficiency. Nevertheless, the available data support that adequate vitamin D supplementation and/or sensible sunlight exposure to achieve optimal vitamin D status are important in the prevention of cardiovascular disease and other chronic diseases.

  18. Cardiovascular collapse with attempted pericardial drain withdrawal

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    Molly B Kraus

    2016-01-01

    Full Text Available Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain.

  19. Cardiovascular collapse with attempted pericardial drain withdrawal

    OpenAIRE

    Molly B Kraus; Spitznagel, Rachel A; Kugler, Jane A

    2016-01-01

    Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain.

  20. Cardiovascular risk factor investigation: a pediatric issue

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    Rodrigues AN

    2013-03-01

    Full Text Available Anabel N Rodrigues,1 Glaucia R Abreu,2 Rogério S Resende,1 Washington LS Goncalves,1 Sonia Alves Gouvea21School of Medicine, University Center of Espírito Santo, Colatina, Brazil; 2Postgraduate Program in Physiological Sciences, Center for Health Sciences, Federal University of Espirito Santo, Vitória, BrazilObjectives: To correlate cardiovascular risk factors (e.g., hypertension, obesity, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, sedentariness in childhood and adolescence with the occurrence of cardiovascular disease.Sources: A systematic review of books and selected articles from PubMed, SciELO and Cochrane from 1992 to 2012.Summary of findings: Risk factors for atherosclerosis are present in childhood, although cardiovascular disease arises during adulthood. This article presents the main studies that describe the importance of investigating the risk factors for cardiovascular diseases in childhood and their associations. Significant rates of hypertension, obesity, dyslipidemia, and sedentariness occur in children and adolescents. Blood pressure needs to be measured in childhood. An increase in arterial blood pressure in young people predicts hypertension in adulthood. The death rate from cardiovascular disease is lowest in children with lower cholesterol levels and in individuals who exercise regularly. In addition, there is a high prevalence of sedentariness in children and adolescents.Conclusions: Studies involving the analysis of cardiovascular risk factors should always report the prevalence of these factors and their correlations during childhood because these factors are indispensable for identifying an at-risk population. The identification of risk factors in asymptomatic children could contribute to a decrease in cardiovascular disease, preventing such diseases as hypertension, obesity, and dyslipidemia from becoming the epidemics of this century.Keywords: cardiovascular risk, children, hypertension, obesity

  1. Efeitos da angiotensina II no sistema cardiovascular

    OpenAIRE

    Trapp, S. M.; Vailati, M. C. F.; Matsubara,Beatriz Bojikian; Schwartz,D.S.

    2009-01-01

    Angiotensin is an important peptide of renin-angiotensin-aldosterone system. This peptide has an important function on arterial blood pressure regulation and body fluid homeostasis. However, its action on abnormal conditions causes deleterious effects on the cardiovascular system. Vascular resistance, hypertension, vascular and myocytes hipertrophy, production of free radicals and pro-inflammatory substances are some of the actions of angiotensin II that can result on cardiovascular remodelin...

  2. Cardiovascular issues in boxing and contact sports.

    Science.gov (United States)

    Siegel, Stephen A

    2009-10-01

    Despite the inherent risks associated with exercise in general and boxing in particular, the sport has had a limited number of catastrophic cardiovascular events. Screening should be based on risks involved and become more extensive with the advancement of the athlete. Anatomic and electrophysiologic risks need to be assessed and may preclude participation with resultant life style and economic complications. There should be adequate preparation for the rare potential cardiovascular complication at all events, with the ability to rapidly assess and treat arrhythmias.

  3. Cardiovascular disfunction during sepsis Disfunción cardiovascular en sepsis

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    Juan Manuel Senior Sánchez

    1996-03-01

    Full Text Available A review is presented on some aspects of sepsis, with emphasis on cardiovascular alterations; the following subjects are included: reasons for increasing frequency of sepsis, up to date terminology, diagnostic criteria, pathogenesis, manifestations of cardiovascular disfunction, present day therapy and therapeutic perspectives. Se hace una revisión somera de algunos aspectos de la sepsis con énfasis en los cambios cardiovasculares que tienen lugar durante ella; se incluyen los siguientes: razones para el incremento de la frecuencia, terminología, criterios de diagnóstico, patogénesis,manifestaciones de la disfunción cardiovascular, terapia actual y perspectivas terapéuticas.

  4. Análise de registros eletrocardiográficos associados ao infarto agudo do miocárdio Analysis of electrocardiographic recordings associated with acute myocardial infarction

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    Paulo Henrique Garcia Mansur

    2006-08-01

    Full Text Available OBJETIVO: Avaliar correlações entre as variações do eletrocar­diograma (ECG e o infarto agudo do miocárdio. MÉTODOS: Uso de software de baixo custo para digitalização de ECG impressos e/ou em formato "pdf". Cálculo de área do segmento ST e das amplitudes dos pontos J e Y RESULTADOS: A amplitude do ponto Y possui máxima correlação com a concentração da enzima troponina. O supradesnivelamento do segmento ST não se constitui bom indicador estatístico da gravidade do infarto. Existe uma forte correlação negativa entre a amplitude do ponto J e a quantidade de íons magnésio, mas nenhuma correlação estatística com os íons sódio ou cálcio. Os dois métodos de cálculo da área do segmento ST (contagem de pixels e interpolação não mostraram diferenças significativas nos resultados. CONCLUSÃO: O software utilizado mostrou-se viável do ponto de vista econômico e funcional. A amplitude do ponto Y é um marcador sensível à ocorrência do infarto, tendo cálculo mais simples e menos sujeito a erros do que o cálculo da área de supradesnivelamento do segmento ST.OBJECTIVE: Evaluate correlations between variations in eletrocardiogram (ECG recordings and acute myocardial infarction. METHODS: Use of a low-cost software to digitalize printed and/or ".pdf" file format ECG recordings. Calculation of ST-segment area and amplitudes of the J and Y points. RESULTS: The amplitude of the Y point holds maximum correlation with troponin concentration. ST-segment elevation is not a good statistical indicator of myocardial infarction severity. There is a strong negative correlation between the amplitude of the J point and the amount of magnesium ions, but no statistical correlation with sodium or calcium ions. Neither method for calculating the ST-segment area (pixel counts and interpolation indicated any significant differences in the results. CONCLUSION: The software used proved to be functional and cost-effective. Y point amplitude is

  5. Nefropatia induzida por contraste após angioplastia primária no infarto agudo do miocárdio

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    Paulo Roberto Santos

    2015-12-01

    Full Text Available Resumo Introdução: A prevenção da nefropatia induzida por contraste (NIC é difícil nas situações de emergência, tornando essenciais estudos sobre NIC em pacientes submetidos à angioplastia de urgência. Objetivo: Determinar a incidência e fatores associados à NIC em pacientes com infarto agudo do miocárdio (IAM submetidos à angioplastia nas primeiras 12 horas após início dos sintomas. Métodos: Foram estudados 201 casos consecutivos de IAM com supradesnivelamento do segmento ST com menos de 12 horas de evolução. Todos os pacientes foram submetidos ao mesmo protocolo de angioplastia. A NIC foi definida como elevação absoluta da creatinina de pelo menos 0,5 mg/dL e/ou aumento relativo da creatinina de 25% em relação ao valor basal no período entre 48 e 72 horas após a administração do contraste. As variáveis que diferiram entre os pacientes com e sem NIC na análise univariada foram analisadas por regressão logística. Resultados: A amostra foi formada por 135 (67,2% homens e 66 (32,8% mulheres com idade média de 66,6 ± 11,7 anos. A incidência de NIC foi de 23,8%. Na análise univariada os pacientes com NIC eram mais idosos e com maior frequência de fração de ejeção do ventrículo esquerdo ≤ 40% e da classificação Killip ≥ 2. Na análise multivariada não foram encontrados preditores independentes de NIC. Conclusão: A NIC acomete ¼ dos pacientes com IAM submetidos à angioplastia sem variáveis preditoras. Esse resultado ressalta a necessidade de medidas preventivas para NIC após uso de contraste em angioplastia de urgência.

  6. Implementando diretrizes clínicas na atenção ao infarto agudo do miocárdio em uma emergência pública

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    Claudia Caminha Escosteguy

    2011-01-01

    Full Text Available FUNDAMENTO: A implementação de diretrizes clínicas na atenção ao infarto agudo do miocárdio (IAM produz melhores resultados. OBJETIVO: Apresentar um programa multidisciplinar de implementação dessas diretrizes em uma grande emergência pública e verificar seu impacto. MÉTODOS: Estudo de avaliação de serviços de saúde, com desenho do tipo "antes e após", para avaliar os indicadores da qualidade da atenção ao IAM antes e após a implementação de estratégias de treinamento e de facilitação da adesão das equipes da emergência a diretrizes clínicas. Isso inclui a elaboração de material didático e de sensibilização e a supervisão continuada. Estimativa de risco relativo (RR e intervalos de confiança (IC95%. RESULTADOS: Grupo pré-programa de diretrizes clínicas, 78 casos de IAM; grupo pós-programa, 66 casos de IAM. A maioria dos casos foi tratada apenas na emergência, por limitação de vagas na unidade coronariana. Observou-se aumento significativo (p<0,05 no uso de diversas intervenções avaliadas (indicadores de processo: betabloqueadores, 83%; inibidores da enzima conversora do angiotensinogênio, 22%; hipolipemiantes, 69%; nitrato intravenoso, 55%; reperfusão coronariana em IAM com supradesnivelamento de segmento ST, 98%. O uso de ácido acetilsalicílico desde o primeiro dia do IAM alcançou 95,5% dos casos. A perda de oportunidade de reperfusão coronariana, nos casos com essa indicação, reduziu de 71,4% para 17,6% pós-treinamento. CONCLUSÃO: O programa obteve um impacto expressivo e a sua multiplicação para outras unidades pode contribuir para melhorar a assistência ao IAM no SUS.

  7. Edema e enfisema pulmonar agudo em bovinos no Sul do Brasil: doença espontânea e reprodução experimental

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    Nathalia S. Wicpolt

    2014-12-01

    Full Text Available Descrevem-se os dados epidemiológicos, os sinais clínicos e as lesões de quatro surtos da doença do edema e enfisema pulmonar agudo em bovinos (EEPAB nos estados de Santa Catarina e Paraná e sua reprodução experimental. A doença espontânea ocorreu após transferência de bovinos de pastagem madura e seca para outra jovem e viçosa. Todos os bovinos afetados eram vacas das raças holandês e pardo suíço. Os principais sinais clínicos foram dispneia e respiração abdominal dificultosa com o pescoço estendido e a boca aberta. Apresentaram, também, enfisema subcutâneo, queda na produção de leite e recuperação lenta ou morte. Os achados de necropsia foram restritos ao pulmão o qual tinha coloração vermelho escuro, não colabado, de aspecto brilhante e hipercriptante com enfisema interlobular acentuado. As lesões histológicas no pulmão consistiam principalmente de enfisema alveolar e interlobular intercalado por áreas de congestão e edema, degeneração hialina da parede dos alvéolos e infiltrado de macrófagos e eosinófilos, moderado, difuso. A reprodução experimental da doença foi realizada em um bovino, com administração de 0,7mg/kg de peso corporal de L-triptofano por via oral em dose única. O animal morreu no sétimo dia de experimento. Os sinais clínicos e lesões foram idênticos aos observados na doença espontânea.

  8. Efeitos agudos e crônicos de um programa de alongamento estático e dinâmico no rendimento em jovens atletas do futebol

    Directory of Open Access Journals (Sweden)

    Diego Laureano Gonçalves

    2013-08-01

    Full Text Available INTRODUÇÃO: O alongamento é uma técnica terapêutica e pode ser utilizada como forma de aquecimento para aumentar a flexibilidade ou diminuir a dor ao longo do movimento, com objetivos na melhora da performance e redução do risco de lesões. OBJETIVO: Verificar os efeitos agudos e crônicos de um programa de alongamento estático em relação ao dinâmico na performance em jovens atletas do futebol. MÉTODOS: Estudo clínico randomizado de equivalência realizado entre agosto e novembro de 2010 junto à categoria sub-17 do Grêmio Torrense. Após preencherem os critérios de inclusão, atletas foram aleatoriamente alocados em dois grupos: alongamento estático ou alongamento dinâmico. Todos realizaram uma avaliação inicial e foram submetidos à primeira intervenção. Após, foram novamente avaliados e ao término de 12 sessões de treinamento. Foram avaliadas as valências flexibilidade, impulsão, velocidade, força e recrutamento muscular. RESULTADOS: A impulsão horizontal melhorou significativamente nos dois grupos do estudo, porém esta melhora persistiu na fase crônica apenas no grupo alongamento estático (p = 0,02. A flexibilidade aumentou significativamente em ambos os grupos na fase aguda, porém só no grupo estático se verificou o seguimento desta melhora na fase crônica (p = 0,03. As duas formas de alongamento levaram a perda de rendimento no teste de velocidade. Não se observou melhora da força muscular de isquiotibiais ao longo do período do estudo em ambos os grupos. A atividade elétrica dos isquiotibiais diminuiu significativamente na fase aguda para o grupo alongamento estático (p = 0,035 e aumentou significativamente na fase crônica no grupo alongamento dinâmico (p = 0,038. CONCLUSÃO: Neste estudo conclui-se que alongamentos de forma estática melhoram a flexibilidade e impulsão horizontal, enquanto que alongamentos dinâmicos melhoram a ativação muscular.

  9. EL ESTRÉS AGUDO INTERFIERE CON LA EVOCACIÓN Y PROMUEVE LA EXTINCIÓN DE LA MEMORIA ESPACIAL EN EL LABERINTO DE BARNES

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    JULIETA TRONCOSO

    2010-01-01

    Full Text Available Para evaluar los efectos del estrés agudo sobre la recuperación y la extinción de la memoria espacial, se utilizaron ratas entrenadas en el laberinto circular de Barnes. El entrenamiento consistió de 8 ensayos de adquisición (intervalo entre ensayos, IEE, de 5 min en donde los animales debían aprender a encontrar una caja meta, ubicada en uno de los 18 agu- jeros del laberinto. Todos los animales adquirieron el aprendizaje espacial, ya que invirtieron menos tiempo en encontrar la caja meta y cometieron menos errores a medida que se sucedían los ensayos de entrenamiento. Veinticuatro horas después del entrena- miento se evaluó la retención y extinción del aprendizaje espacial mediante una prueba con caja meta (PCC seguida de siete pruebas sin caja (PSC, con un IEE de 5 min. Una hora y media antes de la sesión de evaluación de la memoria un grupo de animales fue sometido a estrés por restricción de movimientos durante una hora, permitiéndoles un período de recuperación de 30 min y otro grupo permaneció en su caja hogar sin mani- pulación (control. Los resultados indican que el estrés deteriora el proceso de evocación de la memoria espacial, ya que los animales estresados cometieron un mayor número de errores y demoraron más tiempo en encontrar la caja meta durante la PCC, respecto de los controles. Además, el estrés facilita el proceso de extinción, ya que, durante las PSCs los animales estresados no mostraron una persistencia en la exploración del agujero que, en el entrenamiento, conducía a la caja meta.

  10. Factores de riesgo para infarto agudo de miocardio y prescripción de medicamentos para prevención secundaria

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    Desirée Sáenz-Campos

    2005-01-01

    Full Text Available Objetivo: tipificar algunos factores de riesgo coronario presentes en los pacientes que sobreviven a un primer infarto agudo de miocardio (IAM y describir el tratamiento farmacológico prescrito para profilaxis secundaria al egreso hospitalario. Métodos: estudio observacional, transversal y descriptivo, con información extraída del expediente clínico de 50 pacientes atendidos en 3 hospitales nacionales. Resultados: 42 varones y 8 mujeres, edad 63 ± 15 años, peso 67 ± 12 kg, Índice de Masa Corporal= 26.1 ± 2.1 kg/m², 38% hipertensos, 22% diabéticos (n= 8 pacientes con diabetes + hipertensión y 34% fumadores. Colesterol total 191 ± 45.7 mg/dL, colesterol-LDL 112 ± 33.8 mg/dL y colesterol-HDL 39.4 ± 8.26 mg/dL. Todos egresaron con medicamentos: 92% con antitrombóticos (predominó aspirina, 92% con estatinas, 78% con betabloqueador (atenolol o carvedilol, 70% con enalapril o losartán y 48% con nitratos. Conclusiones: este estudio piloto mostró que la enfermedad coronaria tiende a manifestarse desde la etapa de adulto joven, persiste en su mayor afectación a los varones y parecen prevalecer los factores de riesgo coronario modificables. Los antitrombóticos, beta- bloqueadores y las estatinas más frecuentemente prescritos.Objective: To describe some factors of coronary risk present in patients who survive a first acute myocardial infartion and the pharmacological treatment prescribed for secondary prevention. Methods: Observational, cross sectional and descriptive pilot study, information was obtained from the charts of 50 patients seen at 3 national hospitals. Results: 42 males and 8 women, age 63 ± 15 years, weight 67 ± 12 kg, Body Mass Index = 26.1 ± 2.1 kg/m², 38% hypertensive, 22% diabetic (n = 8 smokers patients with diabetes+hypertension and 34% smokers. Total cholesterol levels: 191 ± 45.7 mg/dL, cholesterol-LDL= 112 ± 33.8 mg/dL and cholesterol-HDL: 39.4 ± 8.26 mg/dL. The patients were prescribed: 92

  11. Efeitos agudos do tabagismo sobre a modulação autonômica: análise por meio do plot de poincaré

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    Beatriz Martins Manzano

    2011-02-01

    Full Text Available FUNDAMENTO: O tabagismo altera a função autonômica. OBJETIVO: Investigar os efeitos agudos do tabagismo sobre a modulação autonômica e a recuperação dos índices de variabilidade de frequência cardíaca (VFC pós-fumo, por meio do plot de Poincaré e índices lineares. MÉTODOS: Foram avaliados 25 fumantes jovens, os quais tiveram a frequência cardíaca analisada, batimento a batimento, na posição sentada, após 8 horas de abstinência, por 30 minutos em repouso, 20 minutos durante o fumo e 30 minutos pós-fumo. Análise de variância para medidas repetidas, seguido do teste de Tukey, ou teste de Friedman seguido do teste de Dunn foram aplicados dependendo da normalidade dos dados, com p < 0,05. RESULTADOS: Durante o fumo, houve redução dos índices SD1 (23,4 ± 9,2 vs 13,8 ± 4,8, razão SD1/SD2 (0,31 ± 0,08 vs 0,2 ± 0,04, RMSSD (32,7 ± 13 vs 19,1 ± 6,8, SDNN (47,6 ± 14,8 vs 35,5 ± 8,4, HFnu (32,5 ± 11,6 vs 19 ± 8,1 e do intervalo RR (816,8 ± 89 vs 696,5 ± 76,3 em relação ao repouso, enquanto que aumentos do índice LFnu (67,5 ± 11,6 vs 81 ± 8,1 e da razão LF/HF (2,6 ± 1,7 vs 5,4 ± 3,1 foram observados. A análise visual do plot mostrou menor dispersão dos intervalos RR durante o fumo. Com exceção da razão SD1/SD2, os demais índices apresentaram recuperação dos valores, 30 minutos após o tabagismo. CONCLUSÃO: O tabagismo produziu agudamente modificações no controle autonômico, caracterizadas por ativação simpática e retirada vagal, com recuperação 30 minutos após o fumo.

  12. Efeitos agudos no desempenho do salto vertical após o agachamento com banda elástica de joelho

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    Willy Andrade Gomes

    2015-08-01

    Full Text Available INTRODUÇÃO: A banda elástica pode afetar o desempenho durante exercícios de alta intensidade, reduzindo a ativação muscular, o que pode influenciar o efeito de potencialização pós-ativação, que depende de alta intensidade para o exercício subsequente que visa potência. Objetivo: Verificar os efeitos agudos no desempenho do salto com contramovimento (SCM após o agachamento em alta intensidade com e sem o uso da banda elástica de joelhos em sujeitos treinados em força.MÉTODOS: Participaram do estudo 14 homens (idade: 24 ± 4 anos, estatura: 176 ± 6 cm, massa corporal: 81 ± 11 kg, 1RM: 107 ± 30 kgf, treinados em força (>3 anos. Foram realizados três SCM antes e após três meio-agachamentos a 90% de 1RM nas condições com e sem a banda elástica de joelhos. Durante o SCM foram avaliados ativação muscular (IEMG do vasto lateral (VL, glúteo máximo (GM, tempo de salto (TS e impulso (IMP por meio da força vertical de reação do solo (FRSv.RESULTADOS: Os resultados mostraram que para o TS foi verificada diferença significante entre as condições pós-meio-agachamento (com e sem banda (P= 0,044, TE = 1,02, sendo que os maiores valores foram observados para a condição sem banda. Para a IEMG de VL foi verificada diferença significante entre as condições pré e pós o meio-agachamento (com banda (P= 0,029, TE = 1,68, sendo que os maiores valores foram observados para a IEMG com banda. Para a IEMG de GM e para o IMP não foram verificadas diferenças significantes entre as condições.CONCLUSÃO: Após a utilização da banda elástica de joelhos durante o exercício agachamento, ocorreu uma redução na participação do vasto lateral durante o salto com contramovimento, afetando o tempo de contato, mas não a produção de impulso, e consequente desempenho.

  13. Efeito agudo dos extensores do joelho unilateral na cadeira extensora com e sem estímulos na plataforma vibratória

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    Fernando Roberto Ferreira

    2013-10-01

    Full Text Available INTRODUÇÃO: Nos últimos anos muitos estudos foram feitos com o objetivo de avaliar a utilização da vibração mecânica como parte de treinamento para melhora do condicionamento físico. Entretanto, a maioria avaliou os efeitos dos exercícios em conjunto com o treinamento vibratório para determinar se havia melhora após o treinamento, sem avaliar os efeitos dos exercícios realizados na plataforma com e sem vibração. OBJETIVO: Avaliar o efeito agudo do exercício nos extensores do joelho, com e sem o estímulo da plataforma vibratória. MÉTODOS: Trinta indivíduos ativos, do sexo masculino, com idades entre 18 e 45 anos, realizaram, de forma randomizada, três protocolos: grupo plataforma ligada (GPL, grupo plataforma desligada (GPD e grupo controle (GC. Cada protocolo começava com aquecimento de cinco minutos em bicicleta ergométrica, com carga entre 75 e 100 watts e 70 rotações por minuto, seguido por seis séries de 10 movimentos de agachamento unilateral com intervalo de um minuto entre elas, com ou sem vibração mecânica, e terminava com o Work Test, realizado apenas no membro inferior dominante para determinação das valências físicas: trabalho, força, potência e velocidade. O grupo controle realizou apenas o Work Test após o aquecimento. RESULTADOS: Apenas a variável velocidade apresentou diferença estatisticamente significante (p < 0,05 quando comparado o GPL ao GC. CONCLUSÃO: O estímulo na plataforma vibratória não exerceu influência nas variáveis trabalho e potência dos extensores do joelho unilateral, mas, na velocidade do movimento, exerceu influência negativa causando fadiga.

  14. A diferenciação da dor do infarto agudo do miocárdio entre pacientes diabéticos e não-diabéticos Diferenciación del dolor del infarto agudo de miocardio entre pacientes diabéticos y no diabéticos The difference in acute myocardial infarction pain between diabetic and non diabetic patients

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    Leandra de Gouveia Pacheco Gondim

    2003-12-01

    Full Text Available O estudo teve como objetivo comparar a dor do infarto agudo do miocárdio (IAM entre pacientes diabéticos e não-diabéticos. Uma amostra de 80 pacientes com IAM, divididos em 2 grupos com e sem diabetes mellitus (DM, sendo 29% diabéticos e 71% não-diabéticos. Os pacientes com DM referiram ausência de dor (pEl objetivo de este estudio fue comparar el dolor del infarto agudo de miocardio (IAM entre pacientes diabéticos y no diabéticos. La muestra la conformaron 80 pacientes con IAM divididos en dos grupos: con y sin diabetes mellitus (DM, siendo el 29% diabéticos y el 71% no diabéticos. Los pacientes con DM manifestaron ausencia de dolor (pThe goal of this study was to compare the acute myocardial infarction (AMI pain between diabetic and non diabetic patients. A sample of 80 AMI patients was divided in two groups, with and without diabetes mellitus (DM, being 29% diabetic and 71% non diabetic patients. The patients with DM said they had no pain (p<0.05 and gave lower scores for pain when compared with patients without DM. There was a significant difference between average scores for pain among diabetic and non diabetic patients (p<0.001. In conclusion, the diabetic patients presented no pain or diminished pain when compared with patients without diabetes.

  15. Space radiation and cardiovascular disease risk

    Institute of Scientific and Technical Information of China (English)

    Marjan Boerma; Gregory A Nelson; Vijayalakshmi Sridharan; Xiao-Wen Mao; Igor Koturbash; Martin Hauer-Jensen

    2015-01-01

    Future long-distance space missions will be associated with significant exposures to ionizing radiation,and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Groundbased studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses,appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk,and several other studies are ongoing. Moreover,astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation,and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined,the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy.

  16. Space radiation and cardiovascular disease risk.

    Science.gov (United States)

    Boerma, Marjan; Nelson, Gregory A; Sridharan, Vijayalakshmi; Mao, Xiao-Wen; Koturbash, Igor; Hauer-Jensen, Martin

    2015-12-26

    Future long-distance space missions will be associated with significant exposures to ionizing radiation, and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Ground-based studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses, appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk, and several other studies are ongoing. Moreover, astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation, and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined, the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy.

  17. Practicality of cardiovascular risk functions

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    Jaume Marrugat

    2016-12-01

    Full Text Available Resumen Las estrategias de prevención de las enfermedades cardiovasculares necesitan refinamiento porque su incidencia se reduce muy lentamente. Las funciones de riesgo incorporaron los factores de riesgo clásicos (edad, sexo, consumo de tabaco, diabetes, presión arterial, y perfil lipídico básico en cohortes seguidas generalmente más de 10 años. Son razonablemente precisas para el cribado poblacional del riesgo de enfermedad coronaria exigido en las guías de práctica clínica. Clasifican a los pacientes en niveles de riesgo para concentrar un mayor esfuerzo terapéutico y preventivo en los de mayor riesgo, y en los que el número necesario a tratar y el coste-efectividad son óptimos. Proporcionar el riesgo relativo y de la edad vascular al paciente, le motiva a cumplir seguir tratamientos y estilos de vida. Alrededor del 20% de la población de 35 a 74 años tiene riesgo intermedio y requiere reclasificación a alto o bajo riesgo porque concentra 35% de eventos poblacionales de enfermedad coronaria. Se ensayan nuevos biomarcadores (bioquímicos, genéticos o de imagen para mejorar la precisión de las predicciones. Si los equipos informáticos de los sistemas de salud incorporaran el cálculo automatizado del riesgo se facilitaría la tarea preventiva del personal asistencial.

  18. Cardiovascular involvement in psoriatic arthritis

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    V. De Gennaro Colonna

    2011-11-01

    Full Text Available Psoriasis is a chronic, genetically determined and immunomediated inflammatory skin disease that affects 2-3% of the Caucasian population. A considerable proportion of these patients develop a form of inflammatory arthritis known as psoriatic arthritis (PsA, although the prevalence of this has not been well defined. Patients with PsA have a higher mortality rate than the general population and the risk of mortality is related to disease severity at the time of presentation. Endothelial dysfunction and early atherosclerosis have been found in patients with PsA without any cardiovascular disease (CVD risk factors, and experts believe that CVD is one of the leading causes of death, as it is in patients with rheumatoid arthritis (RA. Various disease-related mechanisms may be involved in the development of premature vascular damage in both cases, including an increased synthesis of proinflammatory mediators (such as cytokines, chemokines and adhesion molecules, autoantibodies against endothelial cell components, perturbations in T-cell subsets, genetic polymorphisms, hyperhomocysteinemia, oxidative stress, abnormal vascular repair, and iatrogenic factors. In a recent study of 22 patients with PsA without any signs of CVD, we found that the plasma concentration of asymmetric dimethylarginine (ADMA levels were significantly high and coronary flow reserve (CFR was significantly reduced. Moreover, there was a significant correlation between CFR and plasma ADMA levels in the PsA group. The significant correlation between the reduced CRF and increased ADMA levels suggests that, like patients with early RA, PsA patients suffer from endothelial dysfunction and impaired coronary microcirculation. Active PsA is a risk factor for CVD, and so PsA patients should be screened for subclinical forms of the disease and its risk factors, and an early treatment approach should be adopted.

  19. Framingham Risk Score underestimates cardiovascular disease risk in severe psoriatic patients: implications in cardiovascular risk factors management and primary prevention of cardiovascular disease.

    Science.gov (United States)

    Torres, Tiago; Sales, Rita; Vasconcelos, Carlos; Martins da Silva, Berta; Selores, Manuela

    2013-11-01

    Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors and premature atherosclerosis, as a consequence of its systemic inflammation. Recently, it has been estimated that severe psoriasis may confer an increased 6.2% on long-term risk of cardiovascular disease based on Framingham Risk Score, which can have practical implications in the treatment of cardiovascular risk factors and primary prevention of cardiovascular disease, as treatment guidelines account for the risk of cardiovascular disease in treatment goals. The aim of this study was to analyze the influence of the attributable risk of severe psoriasis on long-term risk of cardiovascular disease and its implication on the correct treatment of cardiovascular risk factors and primary prevention of cardiovascular disease on a real-world cohort of patients. One hundred severe psoriasis patients without psoriatic arthritis or previous cardiovascular disease were evaluated and it was found that more than half of the patients were reclassified to a higher cardiovascular risk category with important clinical implications on the correct management of their cardiovascular risk factors and primary prevention of cardiovascular disease, as a considerable proportion of patients with hypertension, hypercholesterolemia and coronary heart disease equivalent risk were not being correctly managed.

  20. Tratamiento del dolor agudo de intensidad leve a moderado con lisinato de ibuprofeno: estudio observacional Management of mild to moderate acute pain with ibuprofen lysinate: an observational study

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    M. Rodríguez-López

    2004-03-01

    Full Text Available Objetivos: Estudiar la efectividad y el perfil de seguridad de lisinato de ibuprofeno en el tratamiento del dolor agudo de intensidad leve a moderada en condiciones asistenciales reales. Material y métodos: Estudio abierto, multicéntrico, observacional y prospectivo, realizado en condiciones de uso habitual. El número de investigadores participantes fue de 263, los cuales reclutaron 1.435 pacientes, entre julio de 2001 y julio de 2002. Los pacientes eran de origen ambulatorio, de edad ≥ 18 años, que acudieron a la consulta del médico aquejados de dolor agudo de intensidad leve a moderada (escala analógica visual del dolor -EAV- ≤ 7. El periodo de observación para cada paciente fue de un máximo de 4 semanas, con una visita de inicio del tratamiento, una visita de seguimiento a la semana y una visita final en un máximo de 30 días. La valoración de la efectividad se realizó mediante la EAV, para todos los pacientes en general, añadiendo el test de Lattinen, en aquellos pacientes con dolor músculo-esquelético, y analizando el tiempo medio de inicio del alivio del dolor así como su duración. Se valoró la seguridad mediante la incidencia de reacciones adversas. Resultados: Los principales motivos de inclusión fueron dolor músculo-esquelético (60%, dolor odontológico (15%, cefaleas (10%, dismenorrea (10% y dolor post-quirúrgico (3%. La EAV disminuyó, entre las visitas basal e intermedia, en 3,3 puntos y, entre las visitas intermedia y final lo hizo en 1,7 puntos; siendo estas diferencias estadísticamente significativas (p Objectives: To study the effectiveness and the safety profile of ibuprofen lysinate in the treatment of mild to moderate acute pain in real clinical practice. Material and methods: Open label, multi-centre, observational and prospective follow-up study, carried out in normal clinical conditions. The participating number of investigators was of 263, which recruited 1,435 patients, among July 2001 and July