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2.
Rev. cuba. med. mil ; 50(3): e1145, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1357314

ABSTRACT

Introducción: La COVID-19 se presenta como una infección del tracto respiratorio inferior. Entre sus diversas manifestaciones extrapulmonares se encuentra el daño cardiovascular, y estas son las que se asocian a la morbimortalidad. Se realizó una búsqueda de información científica utilizando recursos de las bases de datos PubMed, PubMed Central, SciELO, Ebsco, ClinicalKey y Scopus. Las estrategias de búsqueda formuladas fueron: SARS-CoV-2, COVID-19, complicaciones cardiovasculares; en inglés y español. Objetivo: Describir las complicaciones cardiovasculares en pacientes con la COVID-19. Desarrollo: Existe una amplia diversidad de criterios en la literatura científica acerca del daño cardiovascular en el contexto de la infección por la COVID-19. Las complicaciones cardiovasculares reportadas son: la lesión miocárdica aguda, miocarditis aguda, arritmias cardiacas, síndrome coronario agudo, insuficiencia cardiaca aguda, daño valvular cardiaco, enfermedad tromboembólica venosa y shock. Conclusiones: Se describen las complicaciones cardiovasculares en pacientes con la COVID-19. La infección por SARS-CoV-2 ocasiona daño directo o indirecto en el miocardio, las válvulas cardiacas y el resto del sistema cardiovascular(AU)


Introduction: The COVID-19 typically presents as a lower respiratory tract infection. Among its various extrapulmonary manifestations is cardiovascular damage, and these are the ones that are most associated with morbidity and mortality. A search for scientific information was carried; resources were obtained from databases PubMed, PubMed Central, SciELO, Ebsco, ClinicalKey, and Scopus. The search strategies formulated were: SARS-CoV-2, COVID-19, Cardiovascular complications; as well as its translations into the English language. Objective: To describe the cardiovascular complications in patients with the COVID-19. Development: There is a wide diversity of criteria in the scientific literature regarding cardiovascular damage in the context of COVID-19 infection. Frequently reported cardiovascular complications are acute myocardial injury, acute myocarditis, cardiac arrhythmias, acute coronary syndrome, acute heart failure, heart valve damage, venous thromboembolic disease, and shock. Conclusions: Cardiovascular complications in COVID-19 carriers were described. SARS-CoV-2 infection causes direct or indirect damage to the myocardium, heart valves and the rest of the cardiovascular system(AU)


Subject(s)
Humans , Cardiovascular Diseases/complications , COVID-19/complications
3.
Rev. cuba. reumatol ; 23(1): e870, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280402

ABSTRACT

Introducción: La COVID-19 causa una variada gama de manifestaciones clínicas. En pacientes con enfermedades reumáticas destacan, además de las manifestaciones respiratorias, las manifestaciones articulares, dermatológicas, generales y cardiovasculares. Objetivo: Identificar las manifestaciones cardiovasculares que con mayor frecuencia se presentan en pacientes con enfermedades reumáticas afectados por la COVID-19. Métodos: Se realizó una investigación básica, no experimental, con alcance exploratorio, descriptivo y explicativo de un universo constituido por 37 pacientes con diagnóstico previo de enfermedad reumática y diagnóstico confirmado de COVID-19. Se empleó la observación dirigida y la revisión documental como técnicas de investigación para identificar la presencia de manifestaciones cardiovasculares en este tipo de pacientes. Resultados: Predominaron las pacientes femeninas (59,56 por ciento), con diagnóstico de osteoartritis (72,97 por ciento) y artritis reumatoide (72,97 por ciento) y con comorbilidades asociadas (83,78 por ciento). La hipertensión arterial (61,29 por ciento) y el hipotiroidismo (38,71 por ciento) fueron las comorbilidades más frecuentes. El 70,27 por ciento de los pacientes presentaron manifestaciones cardiovasculares: hipertensión arterial (65,38 por ciento), trastornos del ritmo cardiaco (57,69 por ciento) y el síndrome de Raynaud (53,85 por ciento). El 80,0 por ciento de los pacientes masculinos presentaron manifestaciones cardiovasculares, al igual que el 80,64 por ciento de los casos con enfermedad reumática, COVID-19 y comorbilidades asociadas. Conclusiones: Las manifestaciones cardiovasculares se presentaron con elevada frecuencia en los pacientes reumáticos con diagnóstico de COVID-19, sobre todo pacientes masculinos con comorbilidades asociadas. Las manifestaciones cardiovasculares más frecuentes fueron la hipertensión arterial, los trastornos del ritmo y el síndrome de Raynaud(AU)


Introduction: COVID-19 generates a wide range of clinical manifestations in general. In patients with rheumatic diseases, in addition to respiratory manifestations, joint, dermatological, general and cardiovascular manifestations, among others, stand out. Objective: To identify the cardiovascular manifestations that most frequently occur in patients with rheumatic diseases and COVID-19. Methods: A basic, non-experimental research was carried out, with an exploratory, descriptive and explanatory scope. Universe made up of 37 patients with a previous diagnosis of rheumatic disease and a confirmed diagnosis of COVID-19. Directed observation and documentary review were used as research techniques to identify the presence of cardiovascular manifestations in this type of patient. Results: Predominance of female patients (59.56 percent), diagnosed with osteoarthritis (72.97 percent) and rheumatoid arthritis (72.97 percent) and with associated comorbidities (83.78 percent). Hypertension (61.29 percent) and hypothyroidism (38.71 percent) were the most frequent comorbidities. 70.27 percent of the patients presented cardiovascular manifestations, predominantly arterial hypertension (65.38 percent), rhythm disorders (57.69 percent) and Raynaud´s syndrome (53.85 percent). 80.0 percent of the male patients presented cardiovascular manifestations, as did 80.64 percent of the cases with rheumatic disease, COVID-19 and associated comorbidities. Conclusions: Cardiovascular manifestations occurred with high frequency in rheumatic patients diagnosed with COVID-19; being more frequent in male patients and with associated comorbidities. High blood pressure, rhythm disorders and Raynaud's syndrome were the most frequent(AU)


Subject(s)
Humans , Arthritis, Rheumatoid/complications , Signs and Symptoms , Cardiovascular Diseases/complications , Coronavirus Infections/complications , Early Diagnosis , Research Design
4.
Braz. J. Pharm. Sci. (Online) ; 57: e19156, 2021. tab, graf
Article in English | LILACS | ID: biblio-1350240

ABSTRACT

Rheumatoid arthritis is an autoimmune inflammatory joint disease with global prevalence of 0.4% to 1.0%. Extra-articular manifestations increase its morbidity and severity, and cardiovascular diseases present the greatest risk. Therapeutic approaches have been used to treat rheumatoid arthritis, often involving the use of multiple classes of drugs with different mechanisms and forms of action. Corticosteroid therapy is widely used in this therapeutic combination; however, its use has been widely questioned because of its high toxicity and some negative effects, including the possibility of increased cardiovascular risk, depending on the dosage. Some studies have provided important insights into how glucocorticoids have an impact on cardiac complications in patients with rheumatoid arthritis. Most of these studies have concluded that exposure to these drugs at high or cumulative doses is associated with increased risk of death, as well as possibly being associated with the presence of a positive rheumatoid factor.


Subject(s)
Arthritis, Rheumatoid/complications , Cardiovascular Diseases/complications , Heart Disease Risk Factors , Glucocorticoids/adverse effects , Patients , Rheumatoid Factor , Pharmaceutical Preparations , Therapeutic Approaches
5.
ABC., imagem cardiovasc ; 34(2)2021. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1283765

ABSTRACT

Introdução: As funções sistólica e diastólica do ventrículo direito influenciam no desfecho de doenças cardiovasculares. A avaliação sistemática das dimensões e da função das câmaras direitas, de acordo com sexo e idade, não é uniformemente realizada. Objetivo: Avaliar, ao ecocardiograma transtorácico, a correlação da função diastólica do ventrículo direito com idade e sexo, em uma população ambulatorial variada, com função sistólica dos ventrículos esquerdo e direito preservada. Métodos: Estudo observacional, transversal. Foram selecionados 97 pacientes, 61,5 ± 12,5 anos, sendo 56 mulheres. Foram avaliadas as seguintes medidas da função diastólica do ventrículo direito: velocidade de pico das ondas E e A, relação E/A, tempos de aceleração e desaceleração de onda E, integral velocidade-tempo da onda E, integral velocidade-tempo da onda A, além da pressão sistólica de artéria pulmonar, velocidade do refluxo tricúspide, diâmetro da veia cava inferior e volume do átrio direito. Resultados: Ocorreu redução da onda E com o aumento da idade (coeficiente de correlação de Pearson de -0,30; p=0,003) e da relação E/A (coeficiente de correlação de Pearson de -0,21; p=0,035). Houve associação positiva e significativa entre idade e os resultados das variáveis pressão sistólica de artéria pulmonar (coeficiente de correlação de Pearson de 0,40; p=0,004) e velocidade do refluxo tricúspide (coeficiente de correlação de Pearson de 0,36; p=0,008). Não houve diferença significativa na comparação entre os sexos em relação a variáveis ecocardiográficas. Conclusão: O presente estudo mostrou impacto da idade nos índices de função diastólica do ventrículo direito em indivíduos com função sistólica biventricular preservada, embora ainda com valores dentro da normalidade. O estudo não evidenciou diferença significativa entre os sexos em relação a função diastólica do ventrículo direito. (AU)


Introduction: Right ventricular (RV) systolic and diastolic functions influence the outcomes of cardiovascular diseases. However, right chamber size and function have not been uniformly assessed by age and sex. Objective: To evaluate RV diastolic function by age and sex in an outpatient population with preserved left ventricular (LV) and RV systolic function using transthoracic echocardiography. Method: This observational cross-sectional study included a total of 97 patients (56 women) aged 61.5 ± 12.5 years. The assessed parameters included RV E/A ratio; peak E-wave and A-wave velocity, E-wave acceleration and deceleration time, and integral E-wave and A-wave velocitytime; and pulmonary artery systolic pressure (PASP), tricuspid reflux velocity, inferior vena cava diameter, and right atrial volume. Results: A reduced E-wave was observed with increasing age (Pearson's correlation coefficient [PCC], -0.30; p = 0.003). The same was observed for the E/A ratio (PCC, -0.21; p = 0.035). There was a significant positive association between age and PASP results (PCC, 0.40; p = 0.004) and tricuspid reflux velocity (PCC, 0.36; p = 0.008). There was no significant intersex difference in echocardiography variables. Conclusion: The present study showed the impact of age on RV diastolic function indices, which remained within the normal range, in subjects with preserved LV and RV function. The study did not evidence a significant difference between genders in relation to the diastolic function of the right ventricle.(AU)


Subject(s)
Humans , Child , Adolescent , Adult , Middle Aged , Aged , Cardiovascular Diseases/complications , Ventricular Dysfunction, Right/physiopathology , Echocardiography , Echocardiography, Doppler , Comorbidity , Electrocardiography , Observational Study
6.
Article in English | WPRIM | ID: wpr-879305

ABSTRACT

Objective This study aimed to determine the association of hyperlipidemia with clinical endpoints among hospitalized patients with COVID-19, especially those with pre-existing cardiovascular diseases (CVDs) and diabetes. Methods This multicenter retrospective cohort study included all patients who were hospitalized due to COVID-19 from 21 hospitals in Hubei province, China between December 31, 2019 and April 21, 2020. Patients who were aged < 18 or ≥ 85 years old, in pregnancy, with acute lethal organ injury (e.g., acute myocardial infarction, severe acute pancreatitis, acute stroke), hypothyroidism, malignant diseases, severe malnutrition, and those with normal lipid profile under lipid-lowering medicines (e.g., statin, niacin, fenofibrate, gemfibrozil, and ezetimibe) were excluded. Propensity score matching (PSM) analysis at 1:1 ratio was performed to minimize baseline differences between patient groups of hyperlipidemia and non-hyperlipidemia. PSM analyses with the same strategies were further conducted for the parameters of hyperlipidemia in patients with increased triglyceride (TG), increased low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C). Mixed-effect Cox model analysis was performed to investigate the associations of the 28-days all-cause deaths of COVID-19 patients with hyperlipidemia and the abnormalities of lipid parameters. The results were verified in male, female patients, and in patients with pre-existing CVDs and type 2 diabetes. Results Of 10 945 inpatients confirmed as COVID-19, there were 9822 inpatients included in the study, comprising 3513 (35.8%) cases without hyperlipidemia and 6309 (64.2%) cases with hyperlipidemia. Based on a mixed-effect Cox model after PSM at 1:1 ratio, hyperlipidemia was not associated with increased or decreased 28-day all-cause death [adjusted hazard ratio (


Subject(s)
Adult , Aged , Aged, 80 and over , COVID-19/therapy , Cardiovascular Diseases/complications , Case-Control Studies , Cause of Death , China/epidemiology , Diabetes Mellitus, Type 2/complications , Female , Hospitalization , Humans , Hyperlipidemias/complications , Male , Middle Aged , Propensity Score , Proportional Hazards Models , Retrospective Studies , Risk Factors
7.
Rev. cuba. invest. bioméd ; 39(4): e528, oct.-dic. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156460

ABSTRACT

Introducción: Las enfermedades cardiovasculares constituyen la principal causa de mortalidad y morbilidad a nivel mundial. Reconocidas como problemas de salud de impacto social, han motivado a muchos científicos a tratar de explicar su patogénesis. Actualmente se plantea de la existencia de otros factores de riesgo, independientemente de los clásicos. Entre estos factores se describen el papel de las altas concentraciones de ácido úrico y la actividad de la enzima gamma-glutamiltransferasa en sangre, biomarcadores de estrés oxidativo. Estos elementos que de manera individual pudieran contribuir a las enfermedades cardiovasculares, parecen tener un efecto sinérgico. Objetivo: Revisar las evidencias que sostienen que altas concentraciones de ácido úrico y la actividad de la enzima gamma-glutamiltransferasa en sangre pueden constituir factores de riesgo que desde el estrés oxidativo contribuyan a las enfermedades cardiovasculares. Métodos: Se recopiló la información a partir de las bases de datos de diferentes buscadores (Medline-Pubmed, Cochrane, Scopus y SciELO) entre el 1 de marzo del 2019 y el 23 de mayo 2020. Conclusiones: Se encontró que, tanto el ácido úrico como la gamma-glutamiltransferasa son productos horméticos que a bajas concentraciones tienen efecto antioxidante en el organismo, pero al elevarse involucran la ocurrencia de procesos oxidativos que conducen a la disfunción endotelial y las enfermedades cardiovasculares(AU)


Introduction: Cardiovascular diseases are the leading cause of mortality and morbidity worldwide. Recognized as a health problem of social impact; they have prompted many scientists to try to explain their pathogenesis. New risk factors are currently acknowledged alongside the classic ones. These factors include the role of high uric acid concentrations and the activity of the enzyme gamma-glutamyltransferase in blood, both of which are biomarkers of oxidative stress. These elements may individually contribute to the development of cardiovascular diseases, and seem to have a synergistic effect. Objective: Review the evidence supporting the idea that high uric acid concentrations and the activity of the enzyme gamma-glutamyltransferase in blood may be risk factors contributing to the development of cardiovascular diseases via oxidative stress. Methods: Data were collected from the databases of various search engines (Medline-Pubmed, Cochrane, Scopus and SciELO) from 1 March 2019 to 23 May 2020. Conclusions: It was found that uric acid and gamma-glutamyltransferase are hormetic products causing an antioxidant effect on the organism at low concentrations. However, when concentrations rise, they are involved in the occurrence of oxidative processes leading to endothelial dysfunction and cardiovascular diseases(AU)


Subject(s)
Humans , Uric Acid/analysis , Biomarkers/metabolism , Cardiovascular Diseases/complications , Cardiovascular Diseases/etiology , Oxidative Stress/physiology , gamma-Glutamyltransferase/analysis
8.
Arq. bras. cardiol ; 115(3): 547-557, out. 2020. tab, graf
Article in Portuguese | SES-SP, LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1131313

ABSTRACT

Resumo O desafio imposto ao sistema de saúde pela pandemia da COVID-19 faz com que haja uma necessidade de readequações de rotinas e serviços de saúde, com os objetivos de controlar a disseminação do vírus e preservar a saúde. Torna-se ainda mais importante o manejo seguro e correto dos pacientes dos grupos de risco, como os pacientes idosos, os portadores de doenças cardiovasculares e os pacientes com câncer. Dessa forma, a cardio-oncologia ganha novo dimensionamento, no intuito de se adequar às necessidades dos pacientes diante de uma pandemia, reestruturando o sistema de atendimento de forma a oferecer qualidade e segurança na assistência à saúde.


Abstract The challenges that the COVID-19 pandemic cretead to the healthcare system have made it necessary to adapt routines and services, with the objectives of controlling the spread of the virus and preserving health. Safe and correct management of patients in risks groups, such as elderly patients, patients with cardiovascular diseases, and patients with cancer, has become even more important. Thus, cardio-oncology has gained a new dimension, with the aim of adapting to patients' needs during the pandemic by restructuring the system of care in a manner that offers quality and safety in healthcare.


Subject(s)
Cardiovascular Diseases/complications , Coronavirus Infections , Severe Acute Respiratory Syndrome , Neoplasms/complications , Coronavirus , Pandemics , Betacoronavirus
10.
Rev. cuba. invest. bioméd ; 39(3): e795, jul.-set. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1138945

ABSTRACT

La enfermedad infecciosa causada por el nuevo coronavirus-2019 (COVID-19), produce un síndrome respiratorio agudo con implicaciones significativas en el sistema cardiovascular tanto en los pacientes con enfermedad cardiovascular preexistente (ECV), que poseen un riesgo de empeoramiento de su enfermedad y muerte, como en los que la infección se ha asociado con múltiples complicaciones directas e indirectas cardiovasculares. Las complicaciones cardiovasculares asociadas con más frecuencia a esta entidad incluyen lesión aguda del miocardio, miocarditis, síndromes coronarios agudos, arritmias y tromboembolismo venoso. Por otra parte, las terapias empleadas para el tratamiento de la enfermedad por COVID-19 pueden tener interacciones medicamentosas con los fármacos cardiovasculares ensombreciendo el pronóstico de los pacientes. El artículo resalta las distintas recomendaciones expuestas por expertos en la literatura médica respecto a las complicaciones cardiovasculares relacionadas con el nuevo coronavirus (COVID-19)(AU)


The infectious disease caused by the new coronavirus-2019 (COVID-19), produces an acute respiratory syndrome with significant implications for the cardiovascular system both in patients with pre-existing cardiovascular disease (CVD), who have a risk of worsening their disease and death, such as those in which the infection has been associated with multiple direct and indirect cardiovascular complications. The cardiovascular complications most frequently associated with this entity include acute myocardial injury, myocarditis, acute coronary syndromes, arrhythmias, and venous thromboembolism. Furthermore, the therapies used to treat COVID-19 disease may have drug interactions with cardiovascular drugs, darkening the prognosis of the patients. The present work attempts to highlight the different recommendations made by experts in the medical literature regarding cardiovascular complications related to the new coronavirus (COVID-19)(AU)


Subject(s)
Humans , Cardiovascular Diseases/complications , Coronavirus Infections/drug therapy , Severe Acute Respiratory Syndrome/complications , Cardiovascular Diseases/therapy , Coronavirus Infections/complications , Drug Interactions
11.
Actual. osteol ; 16(2): 140-153, mayo.-ago. 2020. ilus, graf
Article in Spanish | LILACS | ID: biblio-1129814

ABSTRACT

La osteoporosis y las enfermedades cardiovasculares son patologías prevalentes en mujeres posmenopáusicas. La calcificación vascular es un proceso en el que se produce una distorsión de la arquitectura natural del tejido arterial con una transformación símil osteogénica. La fisiología vascular y la osteogénesis (formación y remodelación ósea) comparten una complejidad metabólica y funcional crítica, que ha sido poco explorada en forma conjunta, lo que ha impulsado la concepción del Eje Óseo-Vascular como nueva área de investigación, con una visión de estudio integradora con la finalidad de identificar vínculos entre ambos sistemas. En virtud de la controversia planteada sobre los riesgos/beneficios de la terapia de reemplazo hormonal para prevenir enfermedades asociadas a la menopausia, se ha incentivado la búsqueda de nuevas opciones de tratamiento. Los fitoestrógenos, como compuestos nutracéuticos, surgen como una potencial alternativa terapéutica. En particular, las isoflavonas presentan gran analogía estructural con el estrógeno humano 17ß-estradiol, lo que les permite unirse al receptor de estrógenos e inducir acciones estrogénicas tanto en células animales como humanas. Basado en la experiencia propia como en lo reportado en la bibliografía, este artículo analiza la información disponible sobre las acciones vasculares y óseas de los fitoestrógenos (específicamente la isoflavona genisteína), con una visión de ciencia traslacional. Es de esperar que los avances en el conocimiento derivado de la ciencia básica, en un futuro cercano, pueda contribuir a decisiones clínicas a favor de promover terapias naturales de potencial acción dual, para la prevención de enfermedades de alta prevalencia y significativo costo social y económico para la población. (AU)


Osteoporosis and cardiovascular diseases are prevalent diseases in postmenopausal women. Vascular calcification is a cellmediated process that leads to the loss of the natural architecture of the arterial vessels due to osteogenic transdifferentiation of smooth muscle cells, and matrix mineralization. Vascular physiology and osteogenesis (bone formation and remodeling) share a critical metabolic and functional complexity. Given the emerging integrative nature of the bonevascular axis, links between both systems are a matter of ongoing interest. In view of the controversy stated about the risks/benefits of hormone replacement therapy to prevent diseases associated with menopause, phytoestrogens arise as a potential natural therapeutic alternative. In particular, isoflavones have a strong structural analogy with the human estrogen 17ß-estradiol, that allows them to bind to the estrogen receptor and induce estrogenic actions in animal and human cells. Based in on our own experience and the information available in the literature, in this paper we provide an overview of the role of phytoestrogens on vascular and bone tissues, with focus on Genistein actions. We wish that the basic knowledge acquired may contribute to guide clinical decisions for the promotion of natural therapies for the treatment of diseases that conspire against human health. (AU)


Subject(s)
Humans , Male , Female , Osteogenesis/drug effects , Phytoestrogens/therapeutic use , Atherosclerosis/drug therapy , Vascular Calcification/drug therapy , Osteogenesis/physiology , Menopause , Cardiovascular Diseases/complications , Osteoporosis, Postmenopausal , Bone Remodeling , Genistein/therapeutic use , Phytoestrogens/classification , Phytoestrogens/pharmacology , Atherosclerosis/physiopathology , Estrogens/biosynthesis , Vascular Calcification/physiopathology , Vascular Calcification/metabolism
12.
Rev. chil. obstet. ginecol. (En línea) ; 85(4): 408-419, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138639

ABSTRACT

Las enfermedades cardiovasculares representan la mayor causa de morbimortalidad a nivel mundial. Si bien presenta un descenso en la población general, en las mujeres tiende a mantenerse estable la prevalencia de enfermedad coronaria. Varios factores propios de la mujer predisponen a que esto ocurra, incluyendo el embarazo, mediado tanto por los cambios hematológicos y cardiovasculares característicos de la gestación; como por patologías asociadas, principalmente trastornos hipertensivos del embarazo y diabetes gestacional. Su presencia se ha asociado fuertemente a la aparición a futuro de otras patologías de alto riesgo cardiovascular como hipertensión crónica, dislipidemia y diabetes mellitus. Dado el impacto que esto representa, se hace imperante la identificación de grupos de alto riesgo y la implementación de medidas preventivas, así como de diagnóstico precoz y tratamientos adecuados con el fin de disminuir complicaciones materno-fetales en las etapas perinatal y posparto.


Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Although there is a decrease in general population, the prevalence of coronary heart disease remains stable in women. Several factors typical of womenkind predispose to cardiovascular disease, including pregnancy, mediated by hematological and cardiovascular changes characteristic of it; and by associated pathologies, mainly hypertensive disorders and diabetes. The presence of these diseases has been strongly associated with future presence of other conditions of high cardiovascular risk such as chronic hypertension, dyslipidemia and diabetes mellitus. Given this impact, the identification of high-risk groups and the implementation of preventive measures, as well as early diagnosis and adequate treatment in order to reduce both maternal and fetal complications in perinatal and postpartum stages becomes imperative.


Subject(s)
Humans , Female , Pregnancy , Pre-Eclampsia , Pregnancy Complications, Cardiovascular/etiology , Cardiovascular Diseases/complications , Diabetes, Gestational , Hypertension/complications , Pre-Eclampsia/diagnosis , Pre-Eclampsia/therapy , Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy Complications, Cardiovascular/therapy , Cardiovascular System/physiopathology , Risk Factors , Diabetes, Gestational/diagnosis , Diabetes, Gestational/therapy , Metabolic Diseases
14.
Arq. bras. cardiol ; 115(1): 111-126, jul. 2020. graf
Article in Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131250

ABSTRACT

Resumo A pandemia da doença causada pelo novo coronavírus (COVID-19) trouxe grandes desafios para o sistema de saúde devido ao aumento exponencial do número de pacientes acometidos. A racionalização de recursos e a indicação correta e criteriosa de exames de imagem e procedimentos intervencionistas tornaram-se necessárias, priorizando a segurança do paciente, do ambiente e dos profissionais da saúde. Esta revisão visa auxiliar e orientar os profissionais envolvidos na realização desses exames e procedimentos a fazê-los de forma eficaz e segura.


Abstract The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.


Subject(s)
Humans , Pneumonia, Viral/complications , Cardiovascular Surgical Procedures/statistics & numerical data , Cardiovascular Diseases/surgery , Practice Guidelines as Topic , Coronavirus Infections/complications , Betacoronavirus , Pneumonia, Viral/epidemiology , Echocardiography , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnostic imaging , Coronavirus Infections/epidemiology , Communicable Diseases, Emerging/epidemiology , Pandemics , SARS-CoV-2 , COVID-19
15.
Rev. cuba. reumatol ; 22(1): e107, ene.-abr. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126796

ABSTRACT

Introducción: Las enfermedades reumáticas son un grupo de alrededor de 250 enfermedades que se caracterizan por afectar fundamentalmente el sistema osteomioarticular. En su mayoría se consideran enfermedades sistémicas, ya que pueden afectar cualquier órgano o sistema de órganos del cuerpo humano. Una de las complicaciones más graves es el daño al sistema cardiovascular. Objetivo: Describir el comportamiento de los factores de riesgo de afectación cardiovascular en los pacientes con enfermedades reumáticas. Método: Se realizó un estudio descriptivo, de corte transversal, en 87 pacientes con diagnóstico de distintas enfermedades reumáticas. Para el diagnóstico positivo se tuvieron en cuenta los criterios del American College of Rheumatology. Se aplicó un cuestionario creado específicamente para la investigación; se realizaron exámenes complementarios; se determinaron medidas antropométricas; y se revisaron las historias clínicas para comprobar los factores de riesgo cardiovascular. Se empleó el índice de correlación de Pearson para determinar la correlación entre las variables del estudio. Resultados: El promedio de edad de la muestra de estudio fue de 57,82 años, con predominio de pacientes con artritis reumatoide (63,33 por ciento) y tiempo de evolución entre 1 y 5 años (59,77 por ciento). Solo el 25,29 por ciento presentaba normopeso y el 28,74 por ciento tenía daño cardiovascular. Conclusiones: Las enfermedades reumáticas constituyen por sí solas un factor de riesgo de daño cardiovascular; el tiempo de evolución de la enfermedad y las alteraciones del estado nutricional son los elementos que mayor incidencia tienen en la afectación cardiovascular de estos pacientes.


Introduction: Rheumatic diseases are a group of around 250 diseases that are characterized by fundamentally affecting the osteomyoarticular system. Most of them are considered as systemic diseases because they can affect any organ or organ system of the human body. Cardiovascular damage is one of the most frequent complications among rheumatic diseases patients. Objective: To describe risk factor's behavior of cardiovascular affectation in patients with rheumatic diseases. Methods: A descriptive, cross-sectional study was carried out in 87 patients diagnosed with different rheumatic diseases. For the positive diagnosis, the criteria of the American College of Rheumatology were taken into account. A questionnaire created specifically for the research was applied, complementary tests were carried out, anthropometric measures were determined and the clinical history was reviewed to determine the cardiovascular risk factors. The Pearson correlation index was used to determine correlation among the study variables. Results: The average age of studied patients was 57.82 years old, with predominance of patients with rheumatoid arthritis (63.22 percent) and time evolution between 1 and 5 years (59.77 percent). Only 25.29 percent had normal weight and 28.74 percent presented cardiovascular damage. Conclusions: Rheumatic diseases are by themselves a risk factor for cardiovascular damage; the time of evolution of the disease and the alterations of the nutritional status are the elements that have the highest incidence on the presence of cardiovascular affectation(AU)


Subject(s)
Humans , Arthritis, Rheumatoid/prevention & control , Cardiovascular Diseases/complications , Rheumatic Diseases/complications , Nutritional Status , Heart Disease Risk Factors , Epidemiology, Descriptive , Cross-Sectional Studies , Risk Factors , Ecuador
16.
Rev. chil. obstet. ginecol. (En línea) ; 85(2): 185-200, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1115515

ABSTRACT

Desde 1995 hasta la fecha la asociación entre patologías derivadas los embarazos hipertensivos y las enfermedades cardiovasculares ha generado un gran volumen de potentes evidencias epidemiológicas y clínicas. Los propósitos de esta revisión son varios. Mostrar la consistencia y magnitud de la evidencia científica. Integrar los riesgos/enfermedades cardiovasculares y los problemas obstétricos a través de la disfunción endotelial. Preconizar el seguimiento postparto de la hipertensa embarazada, como una ventana de oportunidad para beneficiar la salud de las mujeres y sus hijos. Incluir la historia obstétrica como factor de riesgo de enfermedad coronaria. Proponer cuestionarios adaptables a las prácticas locales para facilitar la pronta incorporación de los índices de riesgo obstétrico y cardiovascular en dos etapas de la vida de una mujer. Ha llegado el momento para que los equipos obstétricos, cardiológicos y las pacientes jueguen un rol en la prevención de los riesgos y enfermedades cardiovasculares.


From 1995 onwards the association between hypertensive pregnancies and cardiovascular disease has generated a great volume of epidemiologic and clinical evidence. The purposes of this review are several. To demonstrate the consistence and weight of the scientific evidence. To integrate cardiovascular risks/diseases and obstetric complications through the link of endothelial dysfunction. To advocate postpartum follow-up after a hypertensive pregnancy as a window of opportunity to benefit the health of mothers and offsprings. To include the obstetrical history as a risk factor for coronary disease. To propose questionnaires adaptable to local practices to incorporate cardiovascular and obstetrical indexes in two stages of a woman's lifetime. The time has come for obstetrical teams, cardiologists and patients to play a preventive role regarding cardiovascular risks and diseases.


Subject(s)
Humans , Female , Pregnancy , Pre-Eclampsia/epidemiology , Pregnancy Complications, Cardiovascular/epidemiology , Cardiovascular Diseases/epidemiology , Pre-Eclampsia/diagnosis , Pre-Eclampsia/physiopathology , Pregnancy Complications, Cardiovascular/physiopathology , Pregnancy Complications, Cardiovascular/prevention & control , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/prevention & control , Risk Factors
17.
Rev. medica electron ; 42(1): 1657-1668, ene.-feb. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1127022

ABSTRACT

RESUMEN El incremento de las enfermedades cardiovasculares, junto con los elevados costos que esto conlleva, ha identificado la necesidad de una renovación en el enfoque de la reducción de los riesgos cardiovasculares en la hipertensión arterial. Se realizó una revisión bibliográfica sobre los factores de riesgo cardiovasculares en inglés y español de los principales artículos publicados en PubMed, Scielo y MEDLINE durante los últimos cinco años. Aunque se han alcanzado logros, la reducción de las enfermedades cardiovasculares a través de la modificación de los estilos de vida sigue siendo un desafío. La mayoría de los pacientes continúan llevando un estilo de vida inadecuado, y menos de 1 % de la población observan los siete puntos esenciales que miden una vida saludable. La salud cardiovascular requerirá de un amplio enfoque para la eliminación de los factores de riesgo en base a la promoción de conductas saludables por vida, esto necesita de un enorme esfuerzo del gobierno local, las autoridades sanitarias, y sobre todo de los equipos locales de salud (AU).


SUMMARY The increment of the cardiovascular illnesses, together with the high costs that this bears, it has identified the necessity of a renovation in the focus of the reduction of the cardiovascular risks in the arterial hypertension. Was carried out a bibliographical revision about the cardiovascular factors risk of in English and Spanish of the main articles published in PubMed, Scielo and MEDLINE during the last five years. Develop and. Although achievements have been reached, the reduction of the cardiovascular illnesses through the modification of the lifestyles continues being a challenge. Most of the patients continue taking an inadequate lifestyle, and less than the population's 1 % observes the seven essential points that measure a healthy life. Although the cardiovascular health will require of a wide focus to elimination the risk factors based on the promotion of healthy behaviors for life, this needs of the local government's enormous effort, the sanitary authorities, and mainly of the local teams of health (AU).


Subject(s)
Humans , Male , Female , Cardiovascular Diseases/mortality , Risk Factors , Review Literature as Topic , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/prevention & control , Hypertension/diagnosis , Hypertension/prevention & control
18.
Article in English | LILACS, BBO | ID: biblio-1101870

ABSTRACT

ABSTRACT The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Diabetes Complications/epidemiology , Diabetes Mellitus/epidemiology , Betacoronavirus , Pneumonia, Viral/physiopathology , Severity of Illness Index , Brazil/epidemiology , Cardiovascular Diseases/complications , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/epidemiology , Comorbidity , Prevalence , Risk Factors , Age Factors , Coronavirus Infections/physiopathology , Diabetes Complications/physiopathology , Diabetes Mellitus/physiopathology , Pandemics , SARS-CoV-2 , COVID-19 , Hypertension/complications , Hypertension/physiopathology , Hypertension/epidemiology , Middle Aged , Obesity/complications , Obesity/physiopathology , Obesity/epidemiology
19.
Clin. biomed. res ; 40(3): 184-192, 2020. ilus, graf
Article in Portuguese | LILACS | ID: biblio-1248151

ABSTRACT

A Síndrome dos Ovários Policísticos (SOP) é uma das disfunções endócrinas mais comuns em mulheres em idade reprodutiva, com uma prevalência que varia entre 6 e 16%, sendo motivo frequente de consulta em um ambulatório de Ginecologia e Obstetrícia. Esta revisão enfoca alguns dos principais riscos tardios para a saúde das pacientes com SOP na meia idade e após a menopausa. A busca da literatura foi realizada no Pubmed utilizando-se as seguintes palavras-chave: Polycystic Ovary Syndrome; time. Identificou-se 229 artigos relacionando SOP e suas consequências tardias que foram publicados em periódicos indexados no Pubmed entre 1o de janeiro de 2010 e 19 de junho de 2020. Desses, excluiu-se 3 por não estarem em língua inglesa (2 em chinês, 1 em russo), 177 pelo título e pelo abstract, e 27 com base na análise do texto. Os 22 artigos restantes estão contemplados nesta revisão sistematizada. Evidenciam-se complicações metabólicas, cardiovasculares, neoplásicas e psíquicas, bem como uma complexa, e ainda não totalmente elucidada, relação com a obesidade. Apesar das complicações cardiovasculares, não existem evidências de que estas levem a maior mortalidade em pacientes com SOP, tampouco de que a mortalidade por todas as causas seja maior nessas mulheres. (AU)


Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, with a prevalence of 6-16%. It is also one of the most frequent reasons for encounter at Obstetrics and Gynecology clinics. This review focuses on some of the main late health impacts of PCOS in middle-aged and postmenopausal patients. A literature search with the keywords "polycystic ovary syndrome" and "time" was conducted in PubMed, and 229 articles related to PCOS and late health consequences published between January 1, 2010, and June 19, 2020, were analyzed. Three articles were excluded because they did not meet the language criterion (being written in English), 177 were excluded based on the title and abstract, and 27 were excluded based on the analysis of the text, resulting in the inclusion of 22 articles in this systematized review. Metabolic, cardiovascular, neoplastic, and psychic complications were made evident, as well as a complex, not yet fully elucidated relationship between PCOS and obesity. Despite cardiovascular complications, there is no evidence that they lead to higher mortality in patients with PCOS, or that all- cause mortality is higher in women with the syndrome. (AU)


Subject(s)
Humans , Female , Polycystic Ovary Syndrome , Cardiovascular Diseases/complications , Metabolic Syndrome/complications , Mental Disorders/complications , Neoplasms/complications , Anxiety/complications , Depression/complications , Diabetes Mellitus, Type 2/complications , Obesity/complications
20.
Medwave ; 20(7): e8008, 2020.
Article in English, Spanish | LILACS | ID: biblio-1122676

ABSTRACT

En diciembre de 2019 se reportó en Wuhan, China, la aparición de una nueva cepa de coronavirus SARS-CoV-2 que producía un compromiso pulmonar severo y progresaba a estrés respiratorio agudo. A la fecha, son más de diecisiete millones los casos confirmados y más de medio millón los fallecidos en todo el mundo a causa de COVID-19. Los estudios reportan que los pacientes con enfermedad cardiovascular son más susceptibles a contraer esta enfermedad y a presentar más complicaciones. El propósito de esta revisión es proporcionar información actualizada para los profesionales de la salud que atienden a pacientes con COVID-19 y que tienen además enfermedad cardiovascular y por ende un riesgo elevado de complicaciones y mortalidad. Realizamos una búsqueda de bibliografía científica acerca de la asociación de enfermedad cardiovascular y COVID-19 en diferentes bases de datos como Scopus, MEDLINE vía PubMed y Cochrane Library. El tratamiento con inhibidores de la enzima convertidora de angiotensina y bloqueadores del receptor de angiotensina ha sido motivo de discusión y no hay evidencia sólida para contraindicarlo en pacientes con COVID-19. Respecto al tratamiento con hidroxicloroquina asociado o no con azitromicina, hay evidencia que demuestra un mayor riesgo con su utilización, que beneficio clínico y/o disminución de mortalidad. En este contexto, los pacientes con insuficiencia cardíaca representan un grupo importante de riesgo por su condición per se y por el dilema diagnóstico generado al evaluar un paciente con COVID-19, en el que los signos de insuficiencia cardíaca aguda podrían enmascararse. Por otro lado, en los pacientes con síndrome coronario agudo, el enfoque terapéutico inicial podría cambiar en el contexto de la pandemia, aunque sólo sobre la base de opiniones de expertos. Quedan, sin embargo, muchos temas en controversia que serán motivo de investigaciones futuras.


In December 2019, a new strain of the SARS-CoV-2 coronavirus was reported in Wuhan, China, which produced severe lung involvement and progressed to respiratory distress. To date, more than seventeen million confirmed cases and more than half a million died worldwide from COVID-19. Patients with cardiovascular disease are more susceptible to contracting this disease and presenting more complications. We did a literature search on the association of cardiovascular disease and COVID-19 in databases such as Scopus, PubMed/MEDLINE, and the Cochrane Library. The purpose of this review is to provide updated information for health professionals who care for patients with COVID-19 and cardiovascular disease, given that they have a high risk of complications and mortality. Treatment with angiotensin-converting enzyme inhibitors and receptor blockers is controversial, and there is no evidence not to use these medications in patients with COVID-19. Regarding treatment with hydroxychloroquine associated or not with azithromycin, there is evidence of a higher risk with its use than clinical benefit and decreased mortality. Likewise, patients with heart failure are an important risk group due to their condition per se. Patients with heart failure and COVID-19 are a diagnostic dilemma because the signs of acute heart failure could be masked. On the other hand, in patients with acute coronary syndrome, the initial therapeutic approach could change in the context of the pandemic, although only based on expert opinions. Nonetheless, many controversial issues will be the subject of future research.


Subject(s)
Humans , Cardiovascular Diseases/complications , SARS-CoV-2 , COVID-19/complications , Antiviral Agents/adverse effects , Prognosis , Renin-Angiotensin System/physiology , Algorithms , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Azithromycin/adverse effects , Peptidyl-Dipeptidase A/metabolism , Drug Therapy, Combination , Electrocardiography/drug effects , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/therapy , Pandemics , COVID-19/drug therapy , Heart Failure/etiology , Heart Failure/therapy , Hydroxychloroquine/adverse effects , Hypertension/complications , Hypertension/drug therapy
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