Resistant hypertension: Prevalence and profile of patients followed in a university ambulatory.

BACKGROUND: Hypertension affects about 36 million Brazilians. It is estimated that 10%-20% of these have resistant hypertension. These patients are at an increased risk of early target organ damage, as well as cardiovascular and renal events. OBJECTIVE: To estimate the prevalence of resistant hypertension in a specialized outpatient clinic, to describe the sociodemographic and clinical characteristics of these patients, and to identify possible factors associated with resistant hypertension. METHODS: Data collection from medical records of hypertensive patients treated using oral antihypertensive drugs in optimized doses at a specialized university clinic from March 2014 to December 2014, after ethical approval statement. All patients were using appropriate antihypertensive drugs in optimized doses and assisted at a teaching-assistance clinic of internal medicine of the Bahiana School of Medicine and Public Health in Brazil. RESULTS: A total of 104 patients were enrolled and 31.7% (n = 33) had criteria for resistant hypertension. Of the total participants, 75.7% were female and 54.8% were black or brown. The average age was 61.7 years (SD ± 10.1). In the resistant hypertension group, 63.6% had diabetes, compared to 32.4% in the hypertension group. Among resistant hypertensive patients, 51.5% had dyslipidemia. Regarding drug treatment, 75.8% of the resistant hypertension group and 51.4% of the hypertension group used statins. Among patients with resistant hypertension, 90.9% used angiotensin II receptor blockers and 66.7%, dihydropyridine calcium channel blockers. In the resistant hypertension group, 75.8% used beta-blockers, against 25.4% in the hypertension group. CONCLUSION: The prevalence of hypertension was higher than that described in the global literature, which may be associated with the high percentage of black and brown ("pardos") patients in the population studied, and also because the study was performed in a specialized outpatient clinic.

Therapeutic use of serotoninergic hallucinogens: A review of the evidence and of the biological and psychological mechanisms.

Serotoninergic hallucinogens include drugs such as lysergic acid diethylamide (LSD), dimethyltryptamine (DMT) and psilocybin. Recent trials with single/few doses of these compounds show that they induce rapid and sustained antidepressive, anxiolytic, and antiaddictive effects. These effects are also observed in religious groups using the DMT-containing brew ayahuasca. The agonist action of these substances on 5-HT2A receptors expressed in frontal and limbic areas increase glutamatergic transmission and neuroplasticity. These neurochemical effects are associated with acute alterations on self-perception and increases in introspection and positive mood, and with subacute and long-term decreases in psychiatric symptoms, increases in some personality traits such as openness, improvements in emotional processing, and increases in empathy. These are preliminary but promising results that should be further explored in controlled trials with larger sample sizes, especially considering that these compounds could be beneficial in the treatment of treatment-resistant psychiatric disorders.

Uso de la mitomicina C en la prevención del haze corneal / Use of mitomycin-C in prevention of corneal haze

OBJETIVOS: Evaluar resultados visuales y aparición de haze en pacientes sometidos a LASEK con Mitomicina C intraoperatoria. MÉTODOS: Se realizó un estudio longitudinal prospectivo, tipo serie de casos, en el servicio de cirugía refractiva del Instituto Cubano de Oftalmología Ramón Pando Ferrer, con pacientes operados entre septiembre y diciembre de 2008, y seguimiento por 12 meses. La muestra fue de 92 ojos con miopía o astigmatismo miópico. Se analizó la agudeza visual mejor corregida y sin corrección, así como la refracción manifiesta pre y posoperatoria. Se cuantificó el haze corneal y se determinaron los índices de efectividad, seguridad, predictibilidad y estabilidad. Se utilizaron técnicas de estadísticas descriptivas para el análisis de los resultados. RESULTADOS: La edad promedio fue 30,11 ± 7,00 años. El sexo femenino representó el 58,82 por ciento. La mejor agudeza visual sin corrección media preoperatoria fue 0,12 ± 0,07 y la mejor agudeza visual corregida media fue 0,89 ± 0,15. Al año de operados, la mejor agudeza visual sin corrección y la mejor corregida fueron 0,9 ± 0,01 (R: 0,5 a 1,0). El haze corneal grado 1 apareció en dos ojos (2,17 por ciento). El índice de efectividad fue 1,01; el índice de seguridad: 1,02; el índice de predictibilidad: 90,22 por ciento de los ojos en±0,50 dioptrías. Hubo estabilidad de la refracción después del tercer mes posoperatorio. CONCLUSIONES: Hubo mejoría de agudeza visual sin corrección en posoperatorio con mantenimiento de agudeza visual mejor corregida preoperatoria. La aparición del haze corneal fue mínima. Los índices de efectividad, seguridad, predictibilidad y estabilidad mostraron valores similares a estándares internacionales(AU)

OBJECTIVES: To assess the visual results and the appearance of haze in patients underwent LASEK with intraoperative mitomycin-c. METHODS: A prospective and longitudinal and cases series type was conducted in the service of refractive surgery of the Ramón Pando Ferrer Cuban Institute of Ophthalmology in patients operated on between September and December, 2008 and with a 12 months follow-up. Sample included 92 eyes with myopia or myopic astigmatism. The visual acuity with and without correction, as well as the pre- and postoperative manifest refraction were analyzed. The corneal haze was quantified and the effectiveness, safety, prediction rates and stability were determined. Authors used the descriptive statistic techniques for the result analysis. RESULTS: The mean age was of 30.11 ± 7.00 years. The female sex accounted for the 58.82 percent. The mean preoperative visual acuity without correction was of 0.12 ± 0.07 and the better corrected visual acuity was of 0.89 ± 0.15. A year after operated on the better visual acuity without correction and the corrected one were of 0.9 ± 0,01 (R: 0.5 to 1,0). The corneal haze grade 1 appears in two eyes (2.17 percent). The effectiveness rate was of 1,01; the safety rate was of 1.02; the prediction was of 90.22 percent of eyes in ± 0.50 dioptres. There was stability of refraction after the third postoperative month. CONCLUSIONS: There was improvement of visual acuity without correction in the postoperative period with maintenance of the preoperative corrected better visual acuity. The appearance of corneal haze was minimal. The effectiveness, safety, prediction and stability rates showed values similar to international standards(AU)

Uso de la mitomicina C en la prevención del haze corneal / Use of mitomycin-C in prevention of corneal haze

OBJETIVOS: Evaluar resultados visuales y aparición de haze en pacientes sometidos a LASEK con Mitomicina C intraoperatoria. MÉTODOS: Se realizó un estudio longitudinal prospectivo, tipo serie de casos, en el servicio de cirugía refractiva del Instituto Cubano de Oftalmología Ramón Pando Ferrer, con pacientes operados entre septiembre y diciembre de 2008, y seguimiento por 12 meses. La muestra fue de 92 ojos con miopía o astigmatismo miópico. Se analizó la agudeza visual mejor corregida y sin corrección, así como la refracción manifiesta pre y posoperatoria. Se cuantificó el haze corneal y se determinaron los índices de efectividad, seguridad, predictibilidad y estabilidad. Se utilizaron técnicas de estadísticas descriptivas para el análisis de los resultados. RESULTADOS: La edad promedio fue 30,11 ± 7,00 años. El sexo femenino representó el 58,82 por ciento. La mejor agudeza visual sin corrección media preoperatoria fue 0,12 ± 0,07 y la mejor agudeza visual corregida media fue 0,89 ± 0,15. Al año de operados, la mejor agudeza visual sin corrección y la mejor corregida fueron 0,9 ± 0,01 (R: 0,5 a 1,0). El haze corneal grado 1 apareció en dos ojos (2,17 por ciento). El índice de efectividad fue 1,01; el índice de seguridad: 1,02; el índice de predictibilidad: 90,22 por ciento de los ojos en±0,50 dioptrías. Hubo estabilidad de la refracción después del tercer mes posoperatorio. CONCLUSIONES: Hubo mejoría de agudeza visual sin corrección en posoperatorio con mantenimiento de agudeza visual mejor corregida preoperatoria. La aparición del haze corneal fue mínima. Los índices de efectividad, seguridad, predictibilidad y estabilidad mostraron valores similares a estándares internacionales

OBJECTIVES: To assess the visual results and the appearance of haze in patients underwent LASEK with intraoperative mitomycin-c. METHODS: A prospective and longitudinal and cases series type was conducted in the service of refractive surgery of the Ramón Pando Ferrer Cuban Institute of Ophthalmology in patients operated on between September and December, 2008 and with a 12 months follow-up. Sample included 92 eyes with myopia or myopic astigmatism. The visual acuity with and without correction, as well as the pre- and postoperative manifest refraction were analyzed. The corneal haze was quantified and the effectiveness, safety, prediction rates and stability were determined. Authors used the descriptive statistic techniques for the result analysis. RESULTS: The mean age was of 30.11 ± 7.00 years. The female sex accounted for the 58.82 percent. The mean preoperative visual acuity without correction was of 0.12 ± 0.07 and the better corrected visual acuity was of 0.89 ± 0.15. A year after operated on the better visual acuity without correction and the corrected one were of 0.9 ± 0,01 (R: 0.5 to 1,0). The corneal haze grade 1 appears in two eyes (2.17 percent). The effectiveness rate was of 1,01; the safety rate was of 1.02; the prediction was of 90.22 percent of eyes in ± 0.50 dioptres. There was stability of refraction after the third postoperative month. CONCLUSIONS: There was improvement of visual acuity without correction in the postoperative period with maintenance of the preoperative corrected better visual acuity. The appearance of corneal haze was minimal. The effectiveness, safety, prediction and stability rates showed values similar to international standards

Plantas medicinais utilizadas por uma comunidade universitária no Município de São Paulo, SP / Medicinal plants used for university students in São Paulo City, São Paulo State

Objetivo - A OMS reconhece e apoia o uso de plantas medicinais. A maioria dos estudos sobre o uso de plantas medicinais refere-se a comunidades rurais. Os objetivos deste estudo foram caracterizar o uso de plantas medicinais por uma comunidade universitária no Município de São Paulo, obter uma lista preliminar de espécies úteis e observar a difusão do conhecimento acerca do assunto através do uso do barbatimão. Métodos - Foram entrevistadas cem pessoas, entre 18 e 50 anos. Resultados - Constatou-se que 56% raramente fazem uso de ervas, 77% utilizam em forma de chá, 56% adquirem as plantas em lojas especializadas, 61% consomem plantas medicinais por indicação familiar, 50% acreditam em seu poder químico para a cura de alguma doença e 28% informaram conhecer o barbatimão. Conclusões - Considerando o local e o público alvo da pesquisa percebe-se que ainda existe a tradição do uso de plantas medicinais, mas de forma incipiente, e que o uso depende da facilidade de aquisição da planta.

Objective - OMS recognizes and supports the use of medicinal plants. The majority of studies about the use of medicinal plants are relative to rural neigborhood. The aims of this study were characterize the use of medicinal plants in São Paulo City; obtain a check-list of useful species; and observe the propagation of knowledge about the subject through the use of barbatimao. Methods - There were interviewed one hundred persons, between 18 and 50 years old. Results - About 56% rarely uses medicinal plants, 77% uses in tea form, 56% obtain the plants in specialized stores, 61% uses medicinal plants by relative prescription, 50% believes in chemical power of drug for the cure of disease and 28% knows the barbatimao. Conclusions - Whereas the place and the persons target in this study, its follows that still endure the folklore of use of medicinal plant but in incipient form, and this is based on purchase facility.

Effects of pancreatic kininogenase on expression of TGF-?_1 and collagen remodeling in spontaneously hypertensive rats / 吉林大学学报(医学版)

Objective To detect the effects of pancreatic kininogenase on the expression of TGF-?1 and collagen remodeling in myocardiom of spontaneously hypertensive rats(SHR).Methods Twenty-four male SHR(aged fifteen weeks)were randomly divided into three groups:SHR group,pancreatic kininogenase group and captopril group(n=8),8 male Wistar Kyoto rats with normol blood pressure was considered as control group.Pancreatic kininogenase was given by peritoneal injection(7.2 U? kg-1? d-1),captopril was given by intragastric administration(10 mg? kg-1? d-1),the rats in SHR group and control group were administered with 0.9% NaCl(2 mL ? kg-1? d-1)through peritoneal injection.After four-week experiment,the pressure was measured in rats througth carotid artery,the rats were sacrificed and left ventricular mass index,collagen volume fraction,peripheral vascular collagen area were measured.Myocardial tissue was stained with VG and pathological changes were observed.The expression of TGF-?1 were detected by immunohistochemical technique(SP method).Results The systolic blood pressure,left ventricular mass index,collagen volume fraction,peripheral vascular collagen area and the expression level of TGF-?1 in SHR group were obviously higher than those in control group(P0.05).Conclusion Pancreatic kininogenase can obviously control pressure and reverse myocardial fibrosis probably by decreasing the expression of TGF-?1 in SHR.

Effects of pancreatic kininogenase on myocardical fibrosis and serum nitric oxide level in spontaneously hypertensive rats / 吉林大学学报(医学版)

Objective To investigate the effects of pancreatic kininogenase on pressure,myocardical fibrosis and serum nitric oxide (NO) level in spontaneously hypertensive rats (SHR). Methods Twenty-four (fifteen weeks) male SHR were randomly divided into three groups:SHR group,pancreatic kininogenase group and captopril group(n=8 ),8 male Wistar kyoto rats with normal blood pressure were considered as control group. Pancreatic kininogenase was given by peritoneal injection (7.2 U?kg~ -1 ?d~ -1 ), captopril was given by intragastric administration(10 mg?kg~ -1 ?d~ -1 ), the rats in SHR group and rats with normol blood pressure in control group were treated with 0.9% NaCl(2 mL?kg~ -1 ?d~ -1 )administered through peritoneal injection. After four-week experiment, the pressure was measured in rats througth carotid artery,then the rats were sacrificed , and LVMI,CVF,PVCA and serum NO level were measured. Results In SHR group, SBP,LVMI,CVF and PVCA were higher, serum NO level was decreased obviously than those in control group (P0.05). Conclusion Pancreatic kininogenase can obviously reduce the blood pressure and reverse myocardial fibrosis,its mechanism may be concerned with the increasing of NO level in SHR.