RESUMO
OBJECTIVE: To evaluate the efficacy, safety and tolerability of sildenafil among Brazilian patients with hypertension treated with combinations of anti-hypertensive drugs. MATERIALS AND METHODS: One hundred twenty hypertensive men aged 30 to 81 years old under treatment with 2 or more anti-hypertensive drugs and with erectile dysfunction (ED) lasting for at least 6 months were enrolled at 7 research centers in Brazil. Patients were randomized to receive treatment with either sildenafil or placebo taken 1 hour before sexual intercourse (initial dose of 50 mg, adjusted to 25 mg or 100 mg according to efficacy and toxicity). During the following 8 weeks, patients were evaluated regarding vital signs, adverse events, therapeutic efficacy, satisfaction with treatment and use of concurrent medications. RESULTS: The primary evaluation of efficacy, which was based on responses to questions 3 and 4 of the International Index of Erectile Function, showed significant differences regarding treatment with sildenafil (p = 0.0002 and p < 0.0001, respectively). In the assessment of global efficacy, 87 percent of the patients treated with sildenafil reported improved erections, as compared with 37 percent of patients given placebos (p < 0.0001). The other secondary evaluations supported the results favoring sildenafil. The most frequent adverse events among patients treated with sildenafil were headaches (11.4 percent), vasodilation (11.4 percent) and dyspepsia (6.5 percent). There were no significant changes in blood pressure measurements in both groups. CONCLUSION: Sildenafil is efficacious and safe for the treatment of hypertensive patients with ED who receive concurrent combinations of anti-hypertensive drugs.
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Humanos , Masculino , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Disfunção Erétil/tratamento farmacológico , Piperazinas/uso terapêutico , Vasodilatadores/uso terapêutico , Brasil , Quimioterapia Combinada , Seguimentos , Hipertensão/complicações , Disfunção Erétil/complicações , Satisfação do Paciente , Piperazinas/efeitos adversos , Resultado do Tratamento , Vasodilatadores/efeitos adversosRESUMO
Os autores apresentam um caso de cor triatriatum dexter, diagnosticado por ecodoplercardiografia bidimensional, associado a comuniçäo interatrial e estenose pulmonar valvar. A anomalia näo foi detectada no estudo hemodinâmico. O ecodopplercardiograma mostrou uma ampla membrana dividindo o átrio em duas cavidades, estendendo-se de sua porçäo inferior, imediatamente acima do anel tricúspide, até os orifícios da veias cavas. Esses achados foram confirmados pela necrópsia