Incidência de Arritmias Ventriculares após Terapia Celular em Pacientes com Cardiomiopatia Chagásica

Fundamento: O tratamento com células-tronco nas diversas cardiomiopatias pode estar relacionado ao aumento nas arritmias. Objetivos: Determinar se a injeção intracoronária de células-tronco em portadores de cardiomiopatia chagásica está associada ao aumento da incidência de arritmias ventriculares, comparado ao Grupo Controle. Métodos: Estudo de coorte retrospectivo, que avaliou o prontuário de 60 pacientes que participaram de estudo transversal anterior. Foram coletados os seguintes dados: idade, sexo, medicamentos utilizados e variáveis do Holter, que demonstraram presença de arritmia complexa. O Holter foi realizado em quatro momentos: randomização, 2, 6 e 12 meses de seguimento. O Grupo Controle recebeu tratamento medicamentoso e injeção intracoronaria de placebo e o Grupo Estudo tratamento medicamentoso e implante autólogo de células-tronco. Resultados: Não houve diferença entre os Grupos Controle e Estudo nos critérios de arritmia analisados. Na análise intragrupo, foi encontrada diferença com significância entre os exames de Holter do Grupo Estudo na variável total de extrassístoles ventriculares comparada à basal, sendo entre de p = 0,014 entre Holter na randomização e Holter aos 2 meses, p = 0,004 entre Holter na randomização e Holter aos 6 meses, e p = 0,014 entre Holter na randomização e Holter aos 12 meses. A variável taquicardia ventricular não sustentada entre Holter na randomização e Holter aos 6 meses apresentou p = 0,036. Conclusão: A injeção intracoronária de células-tronco não aumentou a incidência de arritmia ventricular complexa em pacientes com cardiomiopatia chagásica, comparada ao Grupo Controle.

Comparison of Cardiovascular Risk Factors in Different Areas of Health Care Over a 20-Year Period

Background:Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Knowledge about cardiovascular risk factors (CVRFs) in young adults and their modification over time are measures that change the risks and prevent CVDs.Objectives:To determine the presence of CVRFs and their changes in different health care professionals over a period of 20 years.Methods:All students of medicine, nursing, nutrition, odontology, and pharmacy departments of Federal University of Goiás who agreed to participate in this study were evaluated when they started their degree courses and 20 years afterward. Questionnaires on CVRFs [systemic arterial hypertension (SAH), diabetes mellitus, dyslipidemia, and family history of early CVD, smoking, alcohol consumption, and sedentarism] were administered. Cholesterol levels, blood sugar levels, blood pressure, weight, height, and body mass index were determined. The Kolmogorov-Smirnov test was used to evaluate distribution, the chi-square test was used to compare different courses and sexes, and the McNemar test was used for comparing CVRFs. The significance level was set at a p value of < 0.05.Results:The first stage of the study included 281 individuals (91% of all the students), of which 62.9% were women; the mean age was 19.7 years. In the second stage, 215 subjects were reassessed (76% of the initial sample), of which 59.07% were women; the mean age was 39.8 years. The sample mostly consisted of medical students (with a predominance of men), followed by nursing, nutrition, and pharmacy students, with a predominance of women (p < 0.05). Excessive weight gain, SAH, and dyslipidemia were observed among physicians and dentists (p < 0.05). Excessive weight gain and SAH and a reduction in sedentarism (p < 0.05) were observed among pharmacists. Among nurses there was an increase in excessive weight and alcohol consumption (p < 0.05). Finally, nutritionists showed an increase in dyslipidemia (p < 0.05).Conclusion:In general, there was an unfavorable progression of CVRFs in the population under study, despite it having adequate specialized knowledge about these risk factors.

Impact of Light Salt Substitution for Regular Salt on Blood Pressure of Hypertensive Patients

Background: Studies have shown sodium restriction to have a beneficial effect on blood pressure (BP) of hypertensive patients. Objective: To evaluate the impact of light salt substitution for regular salt on BP of hypertensive patients. Methods: Uncontrolled hypertensive patients of both sexes, 20 to 65 years-old, on stable doses of antihypertensive drugs were randomized into Intervention Group (IG - receiving light salt) and Control Group (CG - receiving regular salt). Systolic BP (SBP) and diastolic BP (DBP) were analyzed by using casual BP measurements and Home Blood Pressure Monitoring (HBPM), and sodium and potassium excretion was assessed on 24-hour urine samples. The patients received 3 g of salt for daily consumption for 4 weeks. Results: The study evaluated 35 patients (65.7% women), 19 allocated to the IG and 16 to the CG. The mean age was 55.5 ± 7.4 years. Most participants had completed the Brazilian middle school (up to the 8th grade; n = 28; 80.0%), had a family income of up to US$ 600 (n = 17; 48.6%) and practiced regular physical activity (n = 19; 54.3%). Two patients (5.7%) were smokers and 40.0% consumed alcohol regularly (n = 14). The IG showed a significant reduction in both SBP and DBP on the casual measurements and HBPM (p < 0.05) and in sodium excretion (p = 0.016). The CG showed a significant reduction only in casual SBP (p = 0.032). Conclusions: The light salt substitution for regular salt significantly reduced BP of hypertensive patients.

Progression of Blood Pressure and Cardiovascular Outcomes in Hypertensive Patients in a Reference Center

Background: Hypertension is a public health problem, considering its high prevalence, low control rate and cardiovascular complications. Objective: Evaluate the control of blood pressure (BP) and cardiovascular outcomes in patients enrolled at the Reference Center for Hypertension and Diabetes, located in a medium-sized city in the Midwest Region of Brazil. Methods: Population-based study comparing patients enrolled in the service at the time of their admission and after an average follow-up of five years. Participants were aged ≥18 years and were regularly monitored at the Center up to 6 months before data collection. We assessed demographic variables, BP, body mass index, risk factors, and cardiovascular outcomes. Results: We studied 1,298 individuals, predominantly women (60.9%), and with mean age of 56.7±13.1 years. Over time, there was a significant increase in physical inactivity, alcohol consumption, diabetes, dyslipidemia, and excessive weight. As for cardiovascular outcomes, we observed an increase in stroke and myocardial revascularization, and a lower frequency of chronic renal failure. During follow-up, there was significant improvement in the rate of BP control (from 29.6% to 39.6%; p = 0.001) and 72 deaths, 91.7% of which were due to cardiovascular diseases. Conclusion: Despite considerable improvements in the rate of BP control during follow-up, risk factors worsened and cardiovascular outcomes increased.

Correlation of Insulin Resistance with Anthropometric Measures and Blood Pressure in Adolescents

Abstract Background: Blood pressure is directly related to body mass index, and individuals with increased waist circumference have higher risk of developing hypertension, insulin resistance, and other metabolic changes, since adolescence. Objective: to evaluate the correlation of blood pressure with insulin resistance, waist circumference and body mass index in adolescents. Methods: Cross-section study on a representative sample of adolescent students. One group of adolescents with altered blood pressure detected by casual blood pressure and/or home blood pressure monitoring (blood pressure > 90th percentile) and one group of normotensive adolescents were studied. Body mass index, waist circumference were measured, and fasting glucose and plasma insulin levels were determined, using the HOMA-IR index to identify insulin resistance. Results: A total of 162 adolescents (35 with normal blood pressure and 127 with altered blood pressure) were studied; 61% (n = 99) of them were boys and the mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had altered HOMA-IR. The group with altered blood pressure had higher values of waist circumference, body mass index and HOMA-IR (p<0.05). Waist circumference was higher among boys in both groups (p<0.05) and girls with altered blood pressure had higher HOMA-IR than boys (p<0.05). There was a significant moderate correlation between body mass index and HOMA-IR in the group with altered blood pressure (ρ = 0.394; p < 0.001), and such correlation was stronger than in the normotensive group. There was also a significant moderate correlation between waist circumference and HOMA-IR in both groups (ρ = 0.345; p < 0.05). Logistic regression showed that HOMA-IR was as predictor of altered blood pressure (odds ratio - OR = 2.0; p = 0.001). Conclusion: There was a significant association of insulin resistance with blood pressure and the impact of insulin resistance on blood pressure since childhood. The correlation and association between markers of cardiovascular diseases was more pronounced in adolescents with altered blood pressure, suggesting that primary prevention strategies for cardiovascular risk factors should be early implemented in childhood and adolescence.

Beiträge zur Naturgeschichte von Brasilien / von Maximilian, Prinzen zu Wied.

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Beiträge zur Naturgeschichte von Brasilien / von Maximilian, Prinzen zu Wied.

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"Vie et Passion de Jésus-Christ" (Pathé, 1902-1905): hétérogénéité des "tableaux", déclinaison des motifs

Cette étude examine deux copies de la "Vie et Passion de Jésus Christ" conservées par la Cinémathèque suisse avec une première préoccupation de type philologique qui conduit à prendre la mesure de l'autonomisation de chacun des "tableaux" composant le film et de l'hétérogénéité de ce dernier. Puis les constats émis à propos du support matériel sont articulés avec une réflexion d'ordre esthétique qui dégage l'importance de l'"effet-tableau" inscrivant cette production filmique dans une généalogie plus large. Le cinéma étant alors le lieu de convergences entre diverses séries culturelles, l'article envisage les liens entre la production Pathé et une pratique jusqu'ici peu discutée dans ce contexte, celle du tableau vivant. This article is a study of two copies of the "Life and Passion of Jesus Christ" held at the Cinemathèque suisse. Our first, broadly philological, concern is to recognise the degree of autonomy of each of the "tableaus" that make up the film, thus establishing the latter's heterogeneous composition. Secondly, adopting a more aesthetic approach, we discuss the importance of the tableau-effect, placing this kind of film production in a wider genealogical context. Given that cinema was at the time a meeting place for different cultural sequences, this article the examines the links between Pathe films and the "tableau vivant", a practice that until now has been rarely discussed in this regard.

La voix-over du Roman d'un tricheur et sa postérité dans Providence. A propos de la résurgence de pratiques "bonimentorielles".

Partant de la réception internationale du film Le Roman d'un tricheur de Sacha Guitry dans laquelle la voix du cinéaste est fréquemment rapprochée de celle du "bonimenteur" de l'époque muette, cette étude examine les particularités de ce film en termes de positionnement du narrateur over par rapport aux images et par rapport au spectateur. Une filiation est posée entre ce film et Providence de Resnais au niveau des manifestations de l'oralité: là aussi, le narrateur occupe la place d'instigateur du monde filmique et de spectateur des images qu'il commente.