Diagnóstico de hipertensäo arterial sistêmica: evidências de que os critérios contemporâneos devem ser revistos / Diagnosis of systemic hypertension: evidences that current criteria should be revised

Diversos comitês normativos em hipertensäo arterial recomendam considerar a média de várias aferiçöes da pressäo arterial com esfigmomanômetro para diagnosticar hipertensäo. Näo há consenso sobre o número de medidas a serem consideradas. OBJETIVO. Descrever o comportamento da pressäo arterial obtida em três dias diferentes, utilizando-se a média de seis aferiçöes para o diagnóstico de hipertensäo. MÉTODOS. No ambulatório de hipertensäo da Unidade de Farmacologia Clínica do Hospital de Clínicas de Porto Alegre, emprega-se a média de seis determinaçöes, obtidas em três dias diferentes, para diagnosticar e classificar a hipertensäo, exceto nos pacientes com valores muito baixos ou elevados nas duas primeiras aferiçöes. Cinqüenta e oito pacientes foram submetidos a essa rotina. RESULTADOS. As médias das pressöes sistólica (PS) e diastólica (PD) decresceram da primeira à sexta determinaçäo (ANOVA para medidas repetidas: F = 4,45, p = 0,001 para PS e F = 5,54, p < 0,001 para PD). Os pacientes foram divididos em grupos com PS e PD obtidas na primeira aferiçäo superiores e inferiores à média de todo grupo. A diminuiçäo de ambas as pressöes ao longo das seis aferiçöes ficou restrita aos grupos com valores da primeira determinaçäo superiores à média de todo o grupo (ANOVA: F = 8.03; p < 0,0001 para PS e F = 6,33, p < 0,0001 para PD). A regressäo à média e uma reaçäo de alerta inicial säo explicaçöes aventadas para esse fenômeno. CONCLUSÄO. Esses dados demonstram que o diagnóstico de hipertensäo arterial näo deve ser feito com base em uma única aferiçäo e sugerem que a recomendaçäo de diagnosticar hipertensäo severa baseando-se em altos valores das duas primeiras medidas pode classificar erroneamente alguns pacientes.

Effect of postnatal methylmalonate administration on adult rat behavior

Methylmalonate (MMA) levels (2.0-2.5 mM) comparable to those of human methylmalonic acidemia were achieved in blood of young rats from the 5th to the 25th day of life by of life by injecting the drug subcutaneously twice a day with an interval of 8h. MMA doses ranged from 0.76 to 1.69 *mol/g body weight as a function of animal age. MMA-treated rats had normal body and brain weights. Behavioral studies using aversive and nonaversive tasks were performaed at 60 days of life. Motor activity was similar in MMA-treated and saline-treated controls. No differences in performance between these groups were identified in the shuttle-avoidance responses and in the inhibitory avoidance tasks. However, MMA-injected rats escaped footshock faster than the controls (1.22 ñ 0.11 vs 1.76 ñ 0.14 (mean ñ SEM) for 24 rats in each group (P<0.01)) suggesting that they may be hyperreactive to this stimulus. In the open field, a nonaversive behavior task, MMA-injected rats, in contrast to control rats, presented no habituation. Our results suggest that MMA by itself may impair central nervous system function, causing minor disabilities which result in specific learning deficiencies

A simple simulated public speaking test for evaluating anxiolytic drugs

We evaluated the feasibility of using a simulated public (SPS) test to assess the activity of anxiolytic drugs. SPS was achieved by requesting subjects to present a speech to an audiocassette recorder. Thirty volunteers were randomly assigned to one of three groups treated with 10 mg diazepam, 10 mg buspirone or placebo, under double-blind conditions. One h after drug adminsitration, subjective states were measured by the Visual Analogue Mood Scale (VAMS), the State-Trait Anxiety Inventory (STAI) and by a Bodily Symptoms Scale (BSS). Heart rate and blood pressure were also recorded. SPS induced both physiological and subjective changes characteristic of anxiety. Moreover, diazepam attenuated experimentally induced increases in excitement (as measured by VAMS) and agitation (as measured by BSS). Therefore, SPS using an audiocassette recorder is sensitive to a prototypical anxiolytic and may thus be a useful test for evaluating putative anxiolytics. No effect was observed with the new anxiolytic drug buspirone. However, the present negative result may be explained by clinical data indicating that patients may experience a longer lag period before the onset of the anxiolytic effect of buspirone