Immediate post-exercise blood pressure and arterial stiffness in hypertensive and normotensive older females.

Although it has been suggested that increased arterial stiffness is linked to exaggerated blood pressure (BP) from brief moderate exercise, it is not clear whether this occurs in older adults with and without hypertension. This study investigates whether the immediate post-exercise systolic BP following brief moderate exercise is associated with arterial stiffness in older females with different BP status. This cross-sectional study included 191 older females aged 60-80 years without known cardiovascular disease (CVD). Arterial stiffness was determined by aortic pulse wave velocity (aPWV). Systolic BP was measured before and immediately following a 3-min moderate walking test (stage 1 Bruce protocol). Specific quartile-based thresholds were used to define an exaggerated immediate post-exercise systolic BP for hypertensive and normotensive older females (quartile 4 as an exaggerated response). Traditional CVD risk factors were assessed (covariates). Older females from the highest quartile of immediate post-exercise absolute systolic BP showed higher aPWV compared to their peers from the lowest quartile (ß = .22 m/s, p = .018). The quartile-based threshold to define the exaggerated post-exercise systolic BP was higher in hypertensive than in normotensive older females (174 vs. 172 mmHg). In summary, exaggerated immediate post-exercise systolic BP following a brief moderate exercise is associated with higher arterial stiffness in older females with different BP status.

Stress and substance abuse among workers during the COVID-19 pandemic in an intensive care unit: A cross-sectional study.

OBJECTIVE: Professionals working in intensive care units (ICUs) during the COVID-19 pandemic have been exposed to stressful situations and increased workload. The association between symptoms of traumatic stress disorders, substance abuse and personal/occupational characteristics of Brazilian COVID-19-ICU workers is still to be addressed. Our aim was to evaluate the prevalence of those conditions and to find if those associations exist. METHODS: In this observational, single-center, cross-sectional study, all professionals working in a COVID-19 ICU were invited to fill an anonymous form containing screening tools for traumatic stress disorders and substance abuse, and a section with questions regarding personal and occupational information. RESULTS: Three hundred seventy-six ICU professionals participated. Direct exposure to patients infected by COVID-19, history of relatives infected by COVID-19, and sex (female) were significantly associated with signs and symptoms of traumatic stress disorders. 76.5% of the participants had scores compatible with a diagnosis of traumatic stress disorders. Moreover, the prevalence of scores suggestive of Tobacco and Alcohol abuse were 11.7% and 24.7%, respectively. CONCLUSION: ICU workers had significantly elevated scores on both screening forms. Providing psycho-social support to ICU professionals may prevent future problems with traumatic stress disorders or substance abuse.

Associations of objectively measured movement behavior and cardiorespiratory fitness with mental health and quality of life in older adults with hypertension: an exploratory analysis during the COVID-19 pandemic.

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.

Obesity and its implications on cerebral circulation and intracranial compliance in severe COVID-19.

Objective: Multiple factors have been identified as causes of intracranial compliance impairment (ICCI) among patients with obesity. On the other hand, obesity has been linked with worst outcomes in COVID-19. Thus, the hypothesis of severe acute respiratory syndrome (SARS) conducing to cerebral hemodynamic disorders (CHD) able to worsen ICCI and play an additional role on prognosis determination for COVID-19 among obese patients becomes suitable. Methods: 50 cases of SARS by COVID-19 were evaluated, for the presence of ICCI and cerebrovascular circulatory disturbances in correspondence with whether unfavorable outcomes (death or impossibility for mechanical ventilation weaning [MVW]) within 7 days after evaluation. The objective was to observe whether obese patients (BMI ≥ 30) disclosed worse outcomes and tests results compared with lean subjects with same clinical background. Results: 23 (46%) patients among 50 had obesity. ICCI was verified in 18 (78%) obese, whereas in 13 (48%) of 27 non-obese (p = 0,029). CHD were not significantly different between groups, despite being high prevalent in both. 69% unfavorable outcomes were observed among obese and 44% for lean subjects (p = 0,075). Conclusion: In the present study, intracranial compliance impairment was significantly more observed among obese subjects and may have contributed for SARS COVID-19 worsen prognosis.

Cerebral Hemodynamics and Intracranial Compliance Impairment in Critically Ill COVID-19 Patients: A Pilot Study.

Introduction: One of the possible mechanisms by which the new coronavirus (SARS-Cov2) could induce brain damage is the impairment of cerebrovascular hemodynamics (CVH) and intracranial compliance (ICC) due to the elevation of intracranial pressure (ICP). The main objective of this study was to assess the presence of CVH and ICC alterations in patients with COVID-19 and evaluate their association with short-term clinical outcomes. Methods: Fifty consecutive critically ill COVID-19 patients were studied with transcranial Doppler (TCD) and non-invasive monitoring of ICC. Subjects were included upon ICU admission; CVH was evaluated using mean flow velocities in the middle cerebral arteries (mCBFV), pulsatility index (PI), and estimated cerebral perfusion pressure (eCPP), while ICC was assessed by using the P2/P1 ratio of the non-invasive ICP curve. A CVH/ICC score was computed using all these variables. The primary composite outcome was unsuccessful in weaning from respiratory support or death on day 7 (defined as UO). Results: At the first assessment (n = 50), only the P2/P1 ratio (median 1.20 [IQRs 1.00-1.28] vs. 1.00 [0.88-1.16]; p = 0.03) and eICP (14 [11-25] vs. 11 [7-15] mmHg; p = 0.01) were significantly higher among patients with an unfavorable outcome (UO) than others. Patients with UO had a significantly higher CVH/ICC score (9 [8-12] vs. 6 [5-7]; p < 0.001) than those with a favorable outcome; the area under the receiver operating curve (AUROC) for CVH/ICC score to predict UO was 0.86 (95% CIs 0.75-0.97); a score > 8.5 had 63 (46-77)% sensitivity and 87 (62-97)% specificity to predict UO. For those patients undergoing a second assessment (n = 29), after a median of 11 (5-31) days, all measured variables were similar between the two time-points. No differences in the measured variables between ICU non-survivors (n = 30) and survivors were observed. Conclusions: ICC impairment and CVH disturbances are often present in COVID-19 severe illness and could accurately predict an early poor outcome.

Short-Term Effect of Self-Selected Training Intensity on Ambulatory Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial.

PURPOSE: To investigate the short-term effect of self-selected training intensity (SSTI) on ambulatory blood pressure (BP) in hypertensive older women. PARTICIPANTS AND METHODS: This is a randomized, single-blind, two-arm, parallel-group controlled trial that included 40 medicated hypertensive older women (64.4±3.6 years; resting systolic 118±19 and diastolic BP 68±9 mmHg). SSTI intervention was performed three times per week, 30-50 minutes per session (n=20). The control group participated in health education meetings once per week (n=20). Ambulatory BP (primary outcome) and six-minute walking test performance (secondary outcome) were assessed at baseline and following 8 weeks of intervention. Heart rate (HR), rating of perceived exertion (RPE, 6-20), and affective valence (ie, feeling scale, -5/+5) were recorded during all SSTI sessions. Intention-to-treat and per-protocol analyses were used for data analyses. RESULTS: Fifteen participants from the SSTI group and 17 from the control group completed the study. No differences in ambulatory BP (24-h, awake, and asleep) were observed between SSTI and control groups (intention-to-treat and per-protocol analyses; p>0.05). The SSTI group showed a greater six-minute walking test performance than the control group in the intention-to-treat and per-protocol analyses (p<0.05). The participants exercised at 52±10% of HR reserve reported an RPE of 11±1 and an affective valence of 3.4±1.1 over the 8-week period. CONCLUSION: SSTI is a feasible approach to induce a more active lifestyle and increase health-related fitness in hypertensive older women, although it does not improve BP control over a short-term period.

Epidemiology and outcome of high-surgical-risk patients admitted to an intensive care unit in Brazil. / Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil.

OBJECTIVE: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. METHODS: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. RESULTS: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). CONCLUSION: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.

AVALIAÇÃO DA ATIVIDADE ANTIBACTERIANA E MODULADORA DE AMINOGLICOSÍDEOS DO ÓLEO ESSENCIAL DE Cymbopogon citratus (DC.) Stapf / Evaluación de la Actividad Antibacteriana y Moduladora de Aminoglucósidos de Aceite Escencial de Cymbopogon Citratus (DC.) Stapf / Evaluation of Antibacterial Activity of Aminoglycosides and Modulating the Essential Oil of Cymbopogon citratus (DC.) Stapf

Vários trabalhos vêm demonstrando a importância do estudo de produtos naturais como fonte alternativa para novos antimicrobianos ou que venham potencializar os já existentes. Neste contexto este trabalho teve como objetivo investigar a atividade antibacteriana e as possíveis interações entre o óleo essencial de Cymbopogon citratus combinados a aminoglicosídeos frente a linhagens padrões e multirresistentes de S. aureus, E. coli e de P. aeruginosa provenientes de isolados clínicos. Um ensaio de microdiluição foi realizado para verificar a atividade antibacteriana e as possíveis interacções entre o produto natural e os antibióticos, utilizando uma concentração sub-inibitória. Através dos resultados foi constatado a interferência sinérgica dos aminoglicosídeos quando associados com o óleo essencial em uma concentração de CIM/8, com redução das CIMs em até quatro pontos frente às linhagens de S. aureus 358, E. coli 27 e P. aeruginosa-143. Mas nenhuma atividade modificadora foi observada frente a P. aeruginosa 78 e P. aeruginosa 91. Através dos resultados pode-se concluir que o óleo essencial de Cymbopogon citratus pode ser uma fonte alternativa de produtos naturais com atividade antibacteriana.

Varios trabajos están demostrando la importancia del estudio de productos naturales como una fuente alternativa para nuevos antimicrobianos o que puedan mejorar los ya existentes. En este contexto, el objetivo de este trabajo fue investigar la actividad antibacteriana y las posibles interacciones entre el aceite esencial de Cymbopogon citratus aminoglucósido combinado frente de linajes y patrones de S. aureus multirresistente, E. coli y P. aeruginosa provenientes de aislamientos clínicos. Se realizó una prueba de microdilución para verificar la actividad antibacteriana y posibles interacciones entre el producto natural y antibióticos, usando una concentración sub-inibitória. A través de los resultados se observan interferencia sinérgica de los aminoglucósidos cuando se asocian con el aceite esencial en una concentración de CIM/8, con reducción de CIMs de hasta cuatro puntos contra las cepas de S. aureus 358, E. coli 27 y P. aeruginosa 143. Pero no se observó ninguna actividad modificadora contra P. aeruginosa 78 y P. aeruginosa 91. A través de los resultados se puede concluir que el aceite esencial de Cymbopogon citratus puede ser una fuente alternativa de productos naturales con actividad antibacteriana.

Several works demonstrated the importance of the study of natural products as an alternative source for new antimicrobial drugs or for modulators for these ones. In this point, the aim of this was to investigate the antibacterial activity and the possible interactions between the essential oil of Cymbopogon citratus alone and in association with aminoglycosides against standard and clinically isolated strains of multidrug-resistant bacteria such as S. aureus, E. coli and P. aeruginosa by microdilution method. The results indicated a synergism between the antibiotics and the essential oil with a subinhibitory concentration (MIC/8), reducing the minimal inhibitory concentration (MIC) sixteen times against the multidrug-resistant strains of S. aureus 358, E. coli 27 and P. aeruginosa 143, but none modulatory activity was observed against P. aeruginosa 78 and P. aeruginosa 91 strains. By our results, can be concluded that the essential oil of Cymbopogon citratus can be an interesting source of natural products with antibacterial and/or modulatory antibiotic activities.

Evaluation of antibacterial, antifungal and modulatory activity of methanol and ethanol extracts of Padina sanctae-crucis.

BACKGROUND: Multi-resistantmicroorganisms such as Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida tropicalis e Candida krusei are the main causes of microbial infections. Padina sanctae-crucis is a seaweed often used to check the contamination of ecosystems by materials such as heavy metals, but studies of the antimicrobial activity of the same seaweed were not found. METHODS: The tests for the minimum inhibitory concentration and modulation of microbial resistance, with the use of ethanolic and methanolic extracts of Padina Sanctae-cruces combined with drugs of the class of aminoglycosides and antifungal were used to evaluate the activity against the cited microorganisms. RESULTS: Was observed a modulation of antibiotic activity between the natural products and the E. coli and S. aureus strains, indicating a synergism and antagonism respectively. CONCLUSIONS: The results showed a moderate modulatory effect against some microorganisms studied.

Chemical composition and evaluation of modulatory of the antibiotic activity from extract and essential oil of Myracrodruon urundeuva.

CONTEXT: The combination of antibiotics with natural products has demonstrated promising synergistic effects in several therapeutic studies. OBJECTIVE: The aim of this study was to determine the effect of a combination of an ethanol extract of Myracrodruon urundeuva Fr. All. (Anacardiaceae) (aroeira plant) and its essential oil with six antimicrobial drugs against multiresistant strains of Staphylococcus aureus and Escherichia coli from clinical isolates. MATERIALS AND METHODS: After identification of the chemical components by GC-MS, the antibacterial activity of the natural products and antibiotics was assessed by determining the minimal inhibitory concentration (MIC) using the microdilution method and concentrations ranging 8-512 µg/mL and 0.0012-2.5 mg/mL, respectively. Assays were performed to test for a possible synergistic action between the plant products and the antimicrobials, using the extract and the oil at a sub-inhibitory concentration (128 µg/mL) and antibiotic at concentrations varying between 8 and 512 µg/mL. RESULTS: The GC-MS analysis identified the main compound as δ-carene (80.41%). The MIC of the natural products was >1024 µg/mL, except against S. aureus ATCC25923. Only the combinations of the natural products with gentamicin, amikacin and clindamycin were effective against S. aureus 358, enhancing the antibiotic activity by reducing the MIC. CONCLUSIONS: The extract from aroeira showed a higher antibacterial activity and the oil was more effective in potentiating the activity of conventional antibiotics.

Modulation of the antibiotic activity by extracts from Amburana cearensis A. C. Smith and Anadenanthera macrocarpa (Benth.) Brenan.

The aim of this study was to verify the possible interactions between ethanol extracts of Amburana cearensis A. C. Smith and Anadenanthera macrocarpa (Benth.) Brenan, combined with six antimicrobial drugs against multiresistant strains of Staphylococcus aureus and Escherichia coli isolated from humans. The antibacterial activity of the extracts was determined using the minimum inhibitory concentration (MIC). The microdilution assay was performed to verify the interactions between the natural products and the antibiotics using a subinhibitory concentration. The activity of amikacin associated with the extract of Anadenanthera macrocarpa against EC 27 was enhanced, demonstrating an MIC reduction from 128 to 4 µg/mL. Among the ß-lactams, no potentiation on its activity was observed, with exception to the antagonism of the natural products with ampicillin against S. aureus 358.

Atendimentos prestados pelo serviço móvel de urgência em Cuiabá, MT, Brasil / Services rendered by the mobile emergency service of Cuiabá, MT, Brazil / Servicios prestados por la emergencia móvil en Cuiabá, MT, Brasil

Este estudo teve como objetivo caracterizar os atendimentos prestados pelo Serviço de Atendimento Móvel de Urgência do município de Cuiabá - MT, nos seis primeiros meses de funcionamento. Estudo descritivo, baseado em análise documental do sistema de informação do SAMU de Cuiabá, realizado de fevereiro a junho de 2009. Foram descritos 1893 atendimentos, sendo 1293 devidos a causas traumáticas e 578 a causas clínicas. Dos atendimentos devidos a causas clínicas, 51,2% foram prestados a mulheres; dentre aqueles com causas traumáticas, 70,9% ocorreram em homens. A faixa etária com maior número de atendimentos foi de 21 a 30 anos. O período vespertino totalizou 23,8% das ocorrências e a região oeste do município teve a maior concentração em número de atendimentos. Os hospitais atenderam 61,2% das ocorrências. Os resultados revelaram que a equipe multiprofissional atuante no SAMU contribui significativamente na integralidade do cuidado ao ser humano...

This study aimed to characterize the care provided by the Mobile Emergency Care Service (SAMU) of Cuiabá, the capital city of Mato Grosso state, Brazil, during the first six months of operation. This is a descriptive study based on data of the SAMU's information system service, conducted from February to June 2009. A total of 1893 calls were performed, 1293 of them for traumatic events and 578 for clinical causes. Of the latter, 51.2% occurred in females. Males accounted for 70.9% of events with traumatic causes. Most patients had 21- to 30-years - old . 23.8% of the attendances ocurred during the afternoon, and tThe highest frequency of attendaces occurred in the west region of the city Hospitals attended 61.2% of the SAMU´s cases. The results showed that SAMU's multidisciplinary team contributes significantly to the provision of comprehensive care to patients...

Este estudio objetivo caracterizar el atendimiento prestado por el Servicio de Urgencia de Atención Móvil de Urgencia (SAMU) de Cuiabá, capital del la provincia de Mato Grosso, Brasil, por los seis primeros meses de funcionamiento. Estudio descriptivo basado en analice documental del sistema de información del SAMU de Cuiabá, realizado en el período de febrero a junio de 2009. Fueron descriptos 1893 atendimientos, siendo 1293 debido a causas traumáticas y 578 a causas clínicas. En los atendimientos clínicos, 51,2% fueron mujeres y en las causas traumáticas 70,9% ocurrieron en hombres. La edad con mayor numero de atendimientos fue de 21 a 30 años. El período vespertino totalizó 23,8% de las ocurrencias y la región oeste de la ciudad tuvo la mayor concentración en números de atendimientos. Los hospitales atendieran 61,2% de las ocurrencias. Los resultados muestran que la equipe multi-profesional actuante en SAMU contribuye significativamente en la integralidad del cuidado al ser humano...