923 resultados para angina, women, survival, coronary disease, mortality
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MANY experimental studies have been carried out using snake venoms for the treatment of animal tumors, with controversial results. While some authors have reported an antitumor effect of treatment with specific snake venom fractions, others have reported no effects after this treatment. The aim of this study was to evaluate the effect of Bothrops jararaca venom (BjV) on Ehrlich ascites tumor (EAT) cells in vivo and in vitro. In the in vivo study, Swiss mice were inoculated with EAT cells by the intraperitoneal (i.p.) route and treated with BjV venom (0.4 mg/kg, i.p.), on the 1st, 4th, 7th, 10th, and 13th days. Mice were evaluated for total and differential cells number on the 2nd, 5th, 8th, 11th and 14th days. The survival time was also evaluated after 60 days of tumor growth. In the in vitro study, EAT and normal peritoneal cells were cultivated in the presence of different BjV concentrations (2.5, 5.0, 10.0, 20.0, 40.0, and 80 mug) and viability was verified after 3, 6, 12 and 24 h of cultivation. Results were analyzed statistically by the Kruskal-Wallis and Tukey tests at the 5% level of significance. It was observed that in vivo treatment with BjV induced tumor growth inhibition, increased animal survival time, decreased mortality, increased the influx of polymorphonuclear leukocytes on the early stages of tumor growth, and did not affect the mononuclear cells number. In vitro treatment with BjV produced a dose-dependent toxic effect on EAT and peritoneal cells, with higher effects against peritoneal cells. Taken together, our results demonstrate that BjV has an important antitumor effect. This is the first report showing this in vivo effect for this venom.
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Coronary heart disease (CHD) is the most common cause of death in many developed countries. The major risk factors for CHD are smoking, high blood pressure, diabetes, high cholesterol levels, and lack of physical activity. Importantly, passive smoke also increases the risk for CHD. The mechanisms involved in the effects of passive smoke in CHD are complex and include endothelial dysfunction, lipoprotein modification, increased inflammation and platelet activation. Recently, several studies have shown that exposure to tobacco smoke can result in cardiac remodeling and compromised cardiac function. Potential mechanisms for these alterations are neurohumoral activation, oxidative stress, and MAPK activation. Although the vascular effects of cigarette smoke exposure are well known, the effects of tobacco smoking on the heart have received less attention. Therefore, this review will focus on the recent findings as to the effects of passive smoking in acute and chronic phases of vascular and cardiac remodeling. © 2009 Bentham Science Publishers Ltd.
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The objective of this cross-sectional, descriptive and exploratory study was to describe the perceptions of pregnant women with heart disease concerning their quality of life. Ferrans and Powers Quality of Life Index was applied to 42 patients from the second trimester of pregnancy on, between January 2008 and March 2009. Descriptive statistics, analysis of variance and Student's t test were used. The Quality of Life Index median total score was relatively high (23.9), while the socioeconomic domain was the most compromised (22.9). An association between unplanned pregnancies and the socioeconomic domain was observed (p=0.065). These patients' quality of life can be regarded as good, but unplanned pregnancies contributed to worsening scores in the socioeconomic domain. High-risk pregnancies did not affect quality of life because a pregnancy is linked to meanings such as happiness, satisfaction and personal fulfillment.
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The Poincaré plot for heart rate variability analysis is a technique considered geometrical and non-linear, that can be used to assess the dynamics of heart rate variability by a representation of the values of each pair of R-R intervals into a simplified phase space that describes the system's evolution. The aim of the present study was to verify if there is some correlation between SD1, SD2 and SD1/SD2 ratio and heart rate variability nonlinear indexes either in disease or healthy conditions. 114 patients with arterial coronary disease and 65 healthy subjects underwent 30. minute heart rate registration, in supine position and the analyzed indexes were as follows: SD1, SD2, SD1/SD2, Sample Entropy, Lyapunov Exponent, Hurst Exponent, Correlation Dimension, Detrended Fluctuation Analysis, SDNN, RMSSD, LF, HF and LF/HF ratio. Correlation coefficients between SD1, SD2 and SD1/SD2 indexes and the other variables were tested by the Spearman rank correlation test and a regression analysis. We verified high correlation between SD1/SD2 index and HE and DFA (α1) in both groups, suggesting that this ratio can be used as a surrogate variable. © 2013 Elsevier B.V.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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A base genética das doenças é frequentemente estudada a partir dos polimorfismos dos genes de citocinas. O presente estudo investigou marcadores da resposta inflamatória associados a infecções virais e bacterianas que possam influenciar o curso da infecção. Foram medidos os níveis séricos (por ensaio imunoenzimático) e os polimorfismos de TNF-α (-308), TNF-β (+252), IFN-γ (+874) e da proteína C reativa, por meio de PCR e RFLP ou PCR alelo específico, em grupos de pessoas infectadas pelo vírus da dengue (n=80), com doença febril, não infectados (100), um grupo de infectados pelo HTLV (30 sintomáticos e 47 assintomáticos), um grupo com doença coronariana (58 com sororreatividade para Chlamydia e 31 com sorologia negativa) e um grupo controle (99 pessoas com sorologia negativa para dengue, HTLV e Chlamydia). Nenhum grupo mostrou associação com informações demográficas. O Vírus da dengue 3 (66,2%) e o HTLV-1 (90% em sintomáticos e 76,6% em assintomáticos) foram os agentes mais frequentes dentre os grupos respectivos. A maioria com doença coronariana (65,1%) apresentou anticorpos para Chlamydia (39,6% para C. trachomatis e C. pneumoniae, 58,6% apenas para C. trachomatis e 1,7% somente para C. pneumoniae). Foram significantes as diferenças encontradas entre: (i) os níveis séricos de TNF-β, IFN-γ e PrtCR dos grupos dengue positivo e dengue negativo com o grupo controle (p< 0,01); (ii) os níveis séricos de TNF-α, TNF-β, e IFN-γ dos grupos de HTLV (incluindo os tipos) e grupo controle; (iii) os níveis séricos de TNF-α, TNF-β, IFN-γ e PrtCR entre os pacientes com doença coronariana e sorologia positiva para Chlamydia e o grupo controle; (iv) a presença de anticorpos para C. trachomatis e C. pneumoniae e o grupo controle na comparação com a TNF-β, IFN-γ e PrtCR. As distribuições de frequências genotípicas foram estatisticamente significantes para os polimorfismos: (i) dos genes TNF-α (p=0,0494) e IFN-γ (p= 0,0008), entre os grupos dengue positivo, dengue negativo e controle e para o IFN-γ (p= 0,0007) entre os grupos DEN 1, DEN 2 e DEN 3 e o controle; (ii) do gene IFN-γ (p= 0,0023) nos grupos de pacientes com doença coronariana e sorologia positiva para C. trachomatis e C. pneumoniae, assim como nos monoreativos na comparação entre a positividade para C. trachomatis e o grupo controle.
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The aim of the study was to evaluate the influence of glucocorticoids on vital parameters of full-term and preterm lambs from birth to 48 hours of life. Four experimental groups were formed: NDG (normal delivery group - lambs vaginally delivered, n=15, average of 146-day gestation); NDEXG (normal delivery with dexamethasone group - lambs vaginally delivered whose mothers received 16mg of dexamethasone at 141 days of gestation, n=8, average of 143-day gestation); PRE (premature lambs born by cesarean section at 138 days of gestation, n=10) and PREDEX (premature lambs born by cesarean section at 138 days gestation, whose mothers received 16mg of dexamethasone two days before, n=9). Heart and respiratory rates had variations during the observation period, with the highest mean values in the groups of normal deliveries (NDG and NDEXG). Rectal temperature decreased in all groups in the first 60 minutes of life, with the lowest mean values in premature lambs (PRE and PREDEX) and the Apgar score was higher in animals delivered at normal gestational time. Preterm lambs had lower vitality and chance of survival, however, lower mortality rate was observed in offspring of ewes that received dexamethasone two days before surgery.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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To understand the perception of the participants in controlled clinical trials (CCTs) about the informed consent and describe the meaning of their participation in the research. Qualitative study using the focus group technique. The sample was composed of 19 patients who participated in clinical trials about hypertension and coronary disease in a specialized cardiologic hospital located in the city of Sao Paulo. The methodological framework used was the content analysis. Some of the participants were aware of the real objective of these studies while others had misperceptions. The reading of the informed consent is not always done and, when it is done, the patient does not understand it. The lack of understanding about the term ''placebo'' was mentioned by some participants. The motivation to participate was the personal benefit. This study shows that obtaining the informed consent in CCTs is complex and that there is the need to adapt the structure and application of this document, in order to protect the participants and improve the quality of clinical trials performed in the country.
Impacto de diferentes métodos de avaliação da obesidade abdominal após síndromes coronarianas agudas
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Background: Abdominal obesity is an important cardiovascular risk factor. Therefore, identifying the best method for measuring waist circumference (WC) is a priority. Objective: To evaluate the eight methods of measuring WC in patients with acute coronary syndrome (ACS) as a predictor of cardiovascular complications during hospitalization. Methods: Prospective study of patients with ACS. The measurement of WC was performed by eight known methods: midpoint between the last rib and the iliac crest (1), point of minimum circumference (2); immediately above the iliac crest (3), umbilicus (4), one inch above the umbilicus (5), one centimeter above the umbilicus (6), smallest rib and (7) the point of greatest circumference around the waist (8). Complications included: angina, arrhythmia, heart failure, cardiogenic shock, hypotension, pericarditis and death. Logistic regression tests were used for predictive factors. Results: A total of 55 patients were evaluated. During the hospitalization period, which corresponded on average to seven days, 37 (67%) patients had complications, with the exception of death, which was not observed in any of the cases. Of these complications, the only one that was associated with WC was angina, and with every cm of WC increase, the risk for angina increased from 7.5 to 9.9%, depending on the measurement site. It is noteworthy the fact that there was no difference between the different methods of measuring WC as a predictor of angina. Conclusion: The eight methods of measuring WC are also predictors of recurrent angina after acute coronary syndromes. Key words: Evaluation; Acute Coronary Syndrome; Abdominal Circumference
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Anthrax is not commonly considered so important a menace to swine as it is to other forms of live stock, in which the disease is apt to declare itself with terrifying severity. In comparison with the marked mortality frequently observed in cattle, the tangible losses caused by anthrax in swine seem negligible. As recent as 25 years ago, there still were observers who sincerely doubted the occurrence of the disease in hogs and this opinion found some support in the many reported failures to induce the infection in that animal species by artificial methods.
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OBJECTIVE: Due to their toxicity, diesel emissions have been submitted to progressively more restrictive regulations in developed countries. However, in Brazil, the implementation of the Cleaner Diesel Technologies policy (Euro IV standards for vehicles produced in 2009 and low-sulfur diesel with 50 ppm of sulfur) was postponed until 2012 without a comprehensive analysis of the effect of this delay on public health parameters. We aimed to evaluate the impact of the delay in implementing the Cleaner Diesel Technologies policy on health indicators and monetary health costs in Brazil. METHODS: The primary estimator of exposure to air pollution was the concentration of ambient fine particulate matter (particles with aerodynamic diameters, <2.5 mu m, [PM2.5]). This parameter was measured daily in six Brazilian metropolitan areas during 2007-2008. We calculated 1) the projected reduction in the PM2.5 that would have been achieved if the Euro IV standards had been implemented in 2009 and 2) the expected reduction after implementation in 2012. The difference between these two time curves was transformed into health outcomes using previous dose-response curves. The economic valuation was performed based on the DALY (disability-adjusted life years) method. RESULTS: The delay in implementing the Cleaner Diesel Technologies policy will result in an estimated excess of 13,984 deaths up to 2040. Health expenditures are projected to be increased by nearly US$ 11.5 billion for the same period. CONCLUSIONS: The present results indicate that a significant health burden will occur because of the postponement in implementing the Cleaner Diesel Technologies policy. These results also reinforce the concept that health effects must be considered when revising fuel and emission policies.
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Objective. To evaluate the efficacy of a 3-month exercise training program in counteracting the chronotropic incompetence and delayed heart rate recovery in patients with systemic lupus erythematosus (SLE). Methods. A 12-week randomized trial was conducted. Twenty-four inactive SLE patients were randomly assigned into 2 groups: trained (T; n = 15, 3-month exercise program) and nontrained (NT; n = 13). A sex-, body mass index-, and age-matched healthy control (C) group (n = 8) also underwent the exercise program. Subjects were assessed at baseline and at 12 weeks after training. Main measurements included the chronotropic reserve (CR) and the heart rate (HR) recovery (Delta HRR) as defined by the difference between HR at peak exercise and at both the first (Delta HRR1) and second (Delta HRR2) minutes after the exercise test. Results. Neither the NT SLE patients nor the C group presented any change in the CR or in Delta HRR1 and Delta HRR2 (P > 0.05). The exercise training program was effective in promoting significant increases in CR (P = 0.007, effect size [ES] 1.15) and in Delta HRR1 and Delta HRR2 (P = 0.009, ES 1.12 and P = 0.002, ES 1.11, respectively) in the SLE T group when compared with the NT group. Moreover, the HR response in SLE patients after training achieved parameters comparable to the C group, as evidenced by the analysis of variance and by the Z score analysis (P > 0.05, T versus C). Systemic Lupus Erythematosus Disease Activity Index scores remained stable throughout the study. Conclusion. A 3-month exercise training program was safe and capable of reducing the chronotropic incompetence and the delayed Delta HRR observed in physically inactive SLE patients.