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1.
Kardiol Pol ; 82(5): 527-533, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38638092

RESUMO

BACKGROUND: Mean arterial pressure (MAP) can be used to evaluate macro-circulatory perfusion while serum lactate concentration is a marker of tissue perfusion. It is important to note that the primary objective of initial medical interventions is to restore microcirculatory perfusion rather than focusing solely on macro-hemodynamics. AIMS: We aimed to investigate the prognostic value of the combination of MAP and serum lactate levels measured on admission to the hospital in relation to patients' 30-day survival rate in patients with acute myocardial infarction (MI). METHODS: Data from 532 consecutive patients with acute MI treated with percutaneous coronary intervention were analyzed. The study endpoint was 30-day all-cause mortality. RESULTS: We found that both MAP and lactate levels were relevant predictors of the 30-day mortality in multivariable Cox regression analysis (HR, 0.83; 95% CI, 0.71-0.97; P = 0.02 and HR, 1.16; 95% CI, 1.06-1.16; P = 0.01, respectively). There was a significant increase in the prognostic performance in relation to 30-day mortality for the combination of both MAP and lactate levels in comparison to MAP alone (P = 0.03 for comparison between areas under the curve). Conversely, the combination of MAP and lactates did not add a significant prognostic value in comparison to lactates alone (P = 0.53 for comparison between areas under the curve). CONCLUSIONS: In patients with acute MI, serum lactate level seems to have a higher prognostic value in comparison to MAP. Our data suggest that on initial assessment of patients with acute myocardial infarction, we should move toward a tissue perfusion-based approach instead of focusing on a blood pressure-oriented strategy alone.


Assuntos
Pressão Arterial , Ácido Láctico , Infarto do Miocárdio , Humanos , Masculino , Feminino , Infarto do Miocárdio/sangue , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/diagnóstico , Pessoa de Meia-Idade , Prognóstico , Idoso , Ácido Láctico/sangue , Biomarcadores/sangue , Intervenção Coronária Percutânea
2.
J Obstet Gynaecol Can ; 44(7): 813-818, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35390518

RESUMO

Polycystic ovary syndrome (PCOS) is a common gynaecological/endocrine disorder that affects 5%-10% of women of reproductive age. Its association with psychiatric conditions is well known. This study aimed to evaluate personality, temperamental, and stress-related characteristics among PCOS patients by comparing them with a control group. We found that PCOS patients presented more pronounced features of type D personality and had higher NEO Five-Factor Inventory (NEO FFI) scores on neuroticism and lower NEO FFI scores on openness to experience and conscientiousness. On the Polish version of the Emotionality Activity Sociability Temperament Survey (EAS-D), PCOS patients reported higher emotionality-fear and lower activity than controls. The PCOS group also had higher scores on state anxiety and trait anxiety, using the State-Trait Anxiety Inventory (STAI) and Distressed Personality Scale (DS-14) questionnaires. These findings underline the importance of a multidisciplinary approach to the care of PCOS patients.


Assuntos
Doenças dos Genitais Femininos , Síndrome do Ovário Policístico , Ansiedade/psicologia , Feminino , Humanos , Personalidade , Inventário de Personalidade , Síndrome do Ovário Policístico/complicações , Temperamento
3.
Nutrients ; 13(8)2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34445036

RESUMO

Anorexia nervosa (AN) causes the highest number of deaths among all psychiatric disorders. Reduction in food intake and hyperactivity/increased anxiety observed in AN are also the core features of the activity-based anorexia animal model (ABA). Our aim was to assess how the acute ABA protocol mimics common AN complications, including gonadal and cardiovascular dysfunctions, depending on gender, age, and initial body weight, to form a comprehensive description of ABA as a reliable research tool. Wheel running, body weight, and food intake of adolescent female and male rats were monitored. Electrocardiography, heart rate variability, systolic blood pressure, and magnetic resonance imaging (MRI) measurements were performed. Immediately after euthanasia, tissue fragments and blood were collected for further analysis. Uterine weight was 2 times lower in ABA female rats, and ovarian tissue exhibited a reduced number of antral follicles and decreased expression of estrogen and progesterone receptors. Cardiovascular measurements revealed autonomic decompensation with prolongation of QRS complex and QT interval. The ABA model is a reliable research tool for presenting the breakdown of adaptation mechanisms observed in severe AN. Cardiac and hormonal features of ABA with underlying altered neuroendocrine pathways create a valid phenotype of a human disease.


Assuntos
Anorexia Nervosa/etiologia , Anorexia Nervosa/fisiopatologia , Restrição Calórica , Sistema Cardiovascular/inervação , Corrida , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/fisiopatologia , Adiposidade , Animais , Anorexia Nervosa/diagnóstico por imagem , Anorexia Nervosa/patologia , Sistema Nervoso Autônomo/fisiopatologia , Modelos Animais de Doenças , Feminino , Hemodinâmica , Humanos , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão , Folículo Ovariano/patologia , Ratos Wistar , Fatores de Tempo , Útero/patologia , Redução de Peso
4.
Nutrients ; 12(9)2020 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-32867089

RESUMO

Anorexia nervosa (AN) represents a disorder with the highest mortality rate among all psychiatric diseases, yet our understanding of its pathophysiological components continues to be fragmentary. This article reviews the current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome-gut-brain axis. It emerged from the unique complexity of constantly accumulating new discoveries, which hamper the ability to look at the disease in a more comprehensive way. The emphasis is placed on the mechanisms underlying the main symptoms and potential new directions that require further investigation in clinical settings.


Assuntos
Anorexia Nervosa/sangue , Anorexia Nervosa/fisiopatologia , Encéfalo/fisiopatologia , Sistema Endócrino/fisiopatologia , Microbioma Gastrointestinal/fisiologia , Hormônios/sangue , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , Neuropeptídeos/sangue
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