ABSTRACT
In coronary artery bypass grafting (CABG) the use of the internal thoracic artery (ITA), is a Class I indication for the left anterior descending (LAD) artery. Atherosclerosis is a systemic disease, and peripheral arterial disease (PAD) is an important complicator of CABG, present in about one-third of the patients with coronary disease. In Leriche Syndrome, ITA can be the source of collateral circulation for arteries below the level of occlusion. Its inadvertent use can lead to serious ischemic complications in the dependent territories.
Na cirurgia de revascularização do miocárdio (CRM), o uso da artéria torácica interna (ATI), é uma indicação de Classe I para a anastomose com a artéria descendente anterior esquerda (ADA). A aterosclerose é uma doença sistêmica, além da doença coronariana, um terço dos pacientes possuem doença arterial obstrutiva periférica (DAOP), que é um complicador da CRM. Na Síndrome de Leriche, a ATI pode ser fonte de circulação colateral para artérias abaixo do nível de oclusão. O seu uso inadvertido pode levar a complicações isquêmicas graves nos territórios dependentes.
Subject(s)
Collateral Circulation , Coronary Artery Bypass , Leriche Syndrome , Mammary Arteries , Humans , Collateral Circulation/physiology , Mammary Arteries/physiopathology , Mammary Arteries/transplantation , Coronary Artery Bypass/adverse effects , Leriche Syndrome/physiopathology , Leriche Syndrome/diagnostic imaging , Leriche Syndrome/surgery , Male , Middle AgedABSTRACT
Na cirurgia de revascularização do miocárdio (CRM), o uso da artéria torácica interna (ATI), é uma indicação de Classe I para a anastomose com a artéria descendente anterior esquerda (ADA). A aterosclerose é uma doença sistêmica, além da doença coronariana, um terço dos pacientes possuem doença arterial obstrutiva periférica (DAOP), que é um complicador da CRM. Na Síndrome de Leriche, a ATI pode ser fonte de circulação colateral para artérias abaixo do nível de oclusão. O seu uso inadvertido pode levar a complicações isquêmicas graves nos territórios dependentes.
Subject(s)
Myocardial RevascularizationSubject(s)
Humans , Male , Female , Aged , Aging , Mental Health , Internet-Based Intervention , Exercise , Physical DistancingABSTRACT
RESUMO: Paciente do sexo feminino, 59 anos, comerciante. Assintomática até há 1 ano, quando observou surgimento de massa pulsátil em dorso do pé direito, eventualmente dolorosa.
ABSTRACT
RESUMO: Paciente do sexo feminino, 51 anos, com doença arterial coronariana (DAC), angina e dispnéia (classe III NYHA)...
ABSTRACT
BACKGROUND: To compare the effects of aquatic aerobic and combined (aerobic more resistance) training on glycemic control and other cardiometabolic outcomes in patients with type 2 diabetes. METHODS: Patients were randomized to an aquatic aerobic training (AERO, n = 19; 57.5 [7.4] y; 9 [47%] women), or an aquatic combined training (COMBI, n = 19; 60.9 [7.4] y; 10 [53%] women), or an aquatic active procedure control (n = 19; 58.6 [9.7] y; 10 [53%] women) in 3 weekly sessions (50 min each), during 15 weeks. Glycated hemoglobin was the primary outcome, whereas insulin resistance markers, lipid profile, systemic inflammation, renin concentration, blood pressure, physical activity levels, and sitting time were secondary outcomes. RESULTS: Glycated hemoglobin was reduced in all groups (P = .021), although changes were more marked in AERO (-0.36%) and COMBI (-0.44%) than in active control (-0.26%) group. Lipid profile was similarly modified in all groups. Diastolic blood pressure and renin concentration were also reduced in all groups; however, renin showed more marked reductions in AERO (-17.7 uIU/mL) and COMBI (-15.1 uIU/mL) than in active control (0.2 uIU/mL) group. Fasting insulin, triglycerides, C-reactive protein, systolic blood pressure, walking time, and sitting time on weekends were not modified. CONCLUSION: AERO and COMBI presented similar effect to improve glycemic control and some cardiometabolic risk factors in patients with type 2 diabetes.
Subject(s)
Aquatic Therapy , Diabetes Mellitus, Type 2 , Resistance Training , Aged , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/therapy , Female , Glycated Hemoglobin/metabolism , Humans , Male , Middle Aged , Renin , TriglyceridesABSTRACT
BACKGROUND: In the literature, professions that impose body standards for daily performance are designated as non-conventional professions (i.e. models, athletes, ballet dancers), with great emphasis on the female population. More than a job, it becomes a lifestyle to those inserted in this environment, thus, thousands of children and adolescents seek inclusion and success in these professions due to financial and media gains. Such professions are associated with several health-related risk factors. The purpose of this study was to identify and compare among physical fitness levels, cardiometabolic health markers, mental health and dietary habits in non-conventional professions. METHODS: The sample consisted of 41 female individuals aged between 14 and 24 years, allocated into four groups, control group composed by university students (UG = 11), models (MG = 11), ballet dancers (BG = 11), and athletes' group (AG = 8). Physical fitness outcomes (cardiorespiratory fitness, flexibility, maximal dynamic strength, muscular endurance and body composition); biochemical outcomes (high-density lipoprotein [HDL], low-density lipoprotein [LDL], total cholesterol [TC], fasting glucose [FG], fasting insulin [FI], C-reactive protein [CRP]), diet quality and mental health were evaluated. RESULTS: No impairments were observed in the health markers evaluated among groups, both for health-related physical fitness and biochemical outcomes. However, low levels of bone mineral density (BMD) were observed. Even with statistically significant differences between the groups for chronological age (p = 0.002), menarche (p = 0.004), career length (p = 0.001), height (p = 0.001), body mass index (p = 0.018), waist-to-height ratio (p < 0.001), %Fat (p = 0.020), VO2peak (p = 0.020), maximal dynamic strength of knee extensors (p = 0.031) and elbow flexors (p = 0,001) and flexibility (p < 0.001), all these values are within the normal range for health. CONCLUSION: The professions analyzed do not seem to interfere in the physical fitness and cardiometabolic health of the girls assessed. However, we identified that exposure to these profession can impair mental health (depressive symptoms in 100% of participants) and body composition (BMD 63% of participants).
Subject(s)
Cardiorespiratory Fitness , Cardiovascular Diseases , Adolescent , Adult , Body Composition , Body Mass Index , Cardiovascular Diseases/epidemiology , Child , Female , Humans , Physical Fitness , Risk Factors , Young AdultABSTRACT
Resumo Objetivos investigar a compreensão de enfermeiras assistenciais sobre espiritualidade; analisar o cuidado espiritual prestado pelas enfermeiras à mãe de bebê com malformação, à luz da Teoria de Jean Watson. Método abordagem qualitativa, implementando a entrevista semiestruturada com 11 enfermeiras de uma maternidade de referência no município de João Pessoa (PB). Os dados foram analisados a partir da técnica da análise de conteúdo proposta por Bardin. Resultados emergiram duas categorias: compreensão de enfermeiras sobre espiritualidade e cuidado espiritual; cuidado espiritual prestado pelas enfermeiras às mães de bebês com malformação congênita, na perspectiva da Teoria de Jean Watson. As profissionais utilizam, empiricamente, elementos do Processo Clinical Caritas-Veritas. Conclusão e implicações para a prática as enfermeiras compreendem espiritualidade como algo que norteia e dá sentido à vida, podendo ou não estar relacionada a uma prática religiosa. Reconhecem que o cuidado espiritual auxilia as mães no enfrentamento de problemas.
Resumen Objetivos Investigar la comprensión de enfermeros asistenciales sobre espiritualidad; analizar el cuidado espiritual que prestan las enfermeras a la madre de un bebé con malformación, a la luz de la Teoría de Jean Watson. Método abordaje cualitativo implementando una entrevista semiestructurada con once enfermeras de una maternidad de referencia en la ciudad de João Pessoa (Estado de Paraíba, noreste de Brasil). Los datos se analizaron mediante la técnica de análisis de contenido propuesta por Bardin. Resultados asomaron dos categorías: comprensión del enfermero sobre espiritualidad y cuidado espiritual y el cuidado espiritual ofrecido por los enfermeros a las madres de bebés malformados en la perspectiva de la teoría de Jean Watson. Los profesionales utilizan empíricamente elementos del Proceso Clínico Caritas-Veritas. Conclusión e implicaciones para la práctica Los enfermeros comprenden espiritualidad como algo que orienta y ofrece sentido a la vida, pudiendo o no estar ligada a una práctica religiosa. Reconocen que el cuidado espiritual ofrecido a las madres de bebés malformados las auxilia en el enfrentamiento del problema.
Abstract Objectives to investigate the understanding of nursing assistants on spirituality; to analyze the spiritual care provided by nurses to the mother of a baby with a malformation in the light of Watson's Theory. Method this was a qualitative approach implementing semi-structured interviews with eleven nurses from a reference maternity hospital in the city of João Pessoa (Paraíba State, northeastern Brazil). Data were analyzed using the content analysis technique proposed by Bardin. Results two categories emerged: the nurses' understanding of spirituality and spiritual care and the spiritual care provided by the nurses to the mothers of malformed babies from the perspective of Watson's theory. The professionals empirically use elements of the Caritas-Veritas Clinical Process. Conclusion and implications for the practice the nurses understand spirituality as something that guides and brings meaning to life, whether or not it is linked to religious practice. They recognize that the spiritual care provided to the mothers of malformed babies helps them cope with the problem.
Subject(s)
Humans , Female , Adult , Congenital Abnormalities , Nursing Theory , Spirituality , Nurse-Patient Relations , Nurses/psychology , Nursing Care/psychology , Qualitative Research , Mothers/psychologyABSTRACT
INTRODUCTION: The aim of the present study was to verify the effects of a Pilates training on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose and C-reactive protein (CRP) levels, as well as on functionality of postmenopausal women with dyslipidemia. METHOD: This randomized study involved 35 sedentary women with dyslipidemia, aged between 60 and 75 years. One group participated in a Pilates exercises training with two to four weekly sessions during 10 weeks (Pilates group, n = 20) and the other group did not perform any intervention (control group, n = 6). Biochemical analyses and functionality parameters were measured before and after the 10 weeks. RESULTS: No significant differences were observed in TC, TG, LDL and HDL for both groups. Regarding glucose and CRP levels, significant reductions were observed in both groups after the intervention period. In functional parameters, both groups significantly increased their 30-s chair stand test values. On the other hand, only the Pilates group presented significant increments in the 6-min walk test (p < 0.05). CONCLUSION: Pilates training did not change lipid or lipoprotein levels, but improved cardiorespiratory fitness of elderly women with dyslipidemia.
Subject(s)
Dyslipidemias , Exercise Movement Techniques , Aged , Dyslipidemias/therapy , Female , Humans , Lipids , Lipoproteins , Middle Aged , TriglyceridesABSTRACT
BackgroundAnnexin A2 is a phospholipid-binding protein involved in fibrinolysis, cell membrane stabilization and repair, and ensuring the integrity of the pulmonary microvasculature. Given the autoantibodies observed in COVID-19 and that Annexin A2 is a known target of antiphospholipid antibodies, we studied autoimmunity directed against Annexin A2 among hospitalized COVID-19 patients. MethodsWe used ELISA to identify the levels of IgG autoantibodies recognizing Annexin A2 and A5 among 86 hospitalized cases of COVID-19. Using logistic regression, we analyzed the association between anti-Annexin A2 and A5 antibody levels with mortality after adjusting for age, sex, race and key comorbidities. ResultsWe found higher average levels of anti-Annexin A2 antibodies among hospitalized COVID-19 patients that died when compared with non-critical hospitalized COVID-19 patients (p-value = 0.006) and critically ill COVID-19 patients (p-value = 0.04). No significant differences in anti-Annexin A5 antibody levels were identified. Regression analysis showed that anti-Annexin A2 antibody levels as measured in relative units strongly predicted mortality with an odds ratio of 9.3 (95% CI: 1.9 to 44.6, p=0.005). In contrast, anti-Annexin A5 antibody levels were not associated with higher mortality (95% CI: 0.5 to 15.2, p=0.22). ConclusionsWe determined that anti-Annexin A2 antibodies were elevated among hospitalized COVID-19 patients and these levels predicted mortality. It is known that inhibition of Annexin A2 induces systemic thrombosis, cell death, and non-cardiogenic pulmonary edema. Autoimmunity to Annexin A2 is a potential mechanism that may explain the key clinical findings of severe COVID-19.
ABSTRACT
COVID-19 can lead to severe disease and death, however the mechanisms of pathogenesis in these patients remain poorly understood. High levels of autoimmune antibodies have been observed frequently in COVID-19 patients but their specific contribution to disease severity and clinical manifestations remain unknown. We performed a retrospective study of 115 COVID-19 hospitalized patients with different degrees of severity to analyze the generation of autoimmune antibodies to common antigens: a lysate of erythrocytes, the lipid phosphatidylserine (PS) and DNA. High levels of IgG autoantibodies against erythrocyte lysates were observed in a large percentage (up to 41%) of patients. Anti-DNA antibodies determined upon hospital admission correlated strongly with later development of severe disease, showing a positive predictive value of 89.5% and accounting for 22% of total severe cases. Statistical analysis identified strong correlations between anti-DNA antibodies and markers of cell injury, coagulation, neutrophil levels and erythrocyte size. Anti-DNA autoantibodies may play an important role in the pathogenesis of COVID-19 and could be developed as a predictive biomarker for disease severity and specific clinical manifestations.
