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1.
Eur Rev Med Pharmacol Sci ; 28(11): 3745-3751, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38884509

RESUMO

OBJECTIVE: Breast cancer is the most commonly diagnosed malignant tumor worldwide, and Serbia ranks first in Europe in standardized breast cancer mortality rate. The aim of this research is to estimate health-related quality of life (HRQoL) and work productivity among patients in different stages of breast cancer in Serbia. SUBJECTS AND METHODS: A total of 175 breast cancer patients attending the breast cancer outpatient clinic at the Oncology Institute of Vojvodina between March 2022 and February 2023 were included in the study. Patients were divided into three mutually exclusive groups: (1) First year after primary breast cancer (Group P), (2) Second and following years after primary breast cancer or recurrence (Group S) and (3) Metastatic disease (Group M). The EQ-5D-3L self-classifier was used to estimate the HRQoL, using the EQ-5D-3L index value and visual analog scale (VAS) score. RESULTS: Мean EQ-5D-3L index value was 0.777 for Group P, and 0.768 for Group S. Patients with metastatic disease reported the lowest EQ-5D index value of 0.646 (p < 0.05). Pain/discomfort, as well as anxiety/depression, were the main drivers of the reduction in HRQoL. Patients in Group M also reported the lowest VAS score of 65.4. Furthermore, the highest percentage of women who sought leave or cited breast cancer as the reason for their early retirement were patients with metastatic disease. CONCLUSIONS: HRQoL was most impaired in Group M, and patients with metastatic disease were more likely to take sick leave or retire early due to breast cancer. Delaying or preventing metastatic recurrence could significantly benefit patients' productivity and HRQoL.


Assuntos
Neoplasias da Mama , Qualidade de Vida , Humanos , Neoplasias da Mama/patologia , Feminino , Sérvia , Pessoa de Meia-Idade , Adulto , Idoso , Estadiamento de Neoplasias , Depressão/psicologia , Depressão/epidemiologia , Ansiedade/psicologia , Inquéritos e Questionários
2.
J Clin Ultrasound ; 52(5): 600-607, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38581157

RESUMO

INTRODUCTION: Similarly to the ventricles, the atria are under sympathetic/parasympathetic neural regulation. Accordingly, correlations were investigated between Ewing's standard cardiovascular reflex tests (SCRTs) and three-dimensional speckle-tracking echocardiography (3DSTE)-derived right atrial (RA) volumes and strains in healthy subjects. MATERIALS AND METHODS: The study comprised 45 healthy adults, but 5 subjects were excluded due to inferior image quality for 3DSTE-derived RA assessments. The remaining 40 individuals being in sinus rhythm had a mean age of 35.1 ± 3.5 years (20 men). Two-dimensional, Doppler, 3DSTE and SCRTs were performed in all cases. RESULTS: RA maximum volume and total and passive RA stroke volumes correlated with the Valsalva ratio. Active RA stroke volume and emptying fraction showed correlations with 30/15 ratio. Peak global and mean segmental RA circumferential (CS) and longitudinal strains (LS) showed correlation with the Valsalva ratio. At atrial contraction, global RA-LS and mean segmental RA-CS showed correlations with the Valsalva ratio. Moreover, mean segmental RA-CS correlated with 30/15 ratio and mean segmental RA radial strain showed correlations with systolic blood pressure in response to standing. Autonomic neuropathy score correlated with peak global RA-LS. CONCLUSIONS: Autonomic function parameters have significant associations with specific RA functions in healthy adults, making the latter possible indicators of autonomic dysregulation.


Assuntos
Função do Átrio Direito , Ecocardiografia Tridimensional , Átrios do Coração , Humanos , Ecocardiografia Tridimensional/métodos , Masculino , Feminino , Adulto , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Função do Átrio Direito/fisiologia , Sistema Nervoso Autônomo/diagnóstico por imagem , Sistema Nervoso Autônomo/fisiopatologia , Valores de Referência , Voluntários Saudáveis
3.
J Clin Ultrasound ; 52(2): 178-185, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37997020

RESUMO

INTRODUCTION: The functioning of the left atrium (LA) is partly controlled by the neural system. It was purposed to evaluate correlations between the result of Ewing's 5 standard cardiovascular reflex tests (SCRTs) characterizing autonomic function and LA volumetric and functional features as assessed by three-dimensional speckle-tracking echocardiography (3DSTE) in healthy individuals. MATERIALS AND METHODS: The current study comprised 18 healthy volunteers being in sinus rhythm (mean age: 35 ± 12 years, 10 men). Measurement of blood pressure, ECG, 5 SCRTs, two-dimensional Doppler echocardiography and 3DSTE were performed. These parameters were in normal ranges in all cases. RESULTS: From LA volumetric parameters, only systolic total atrial emptying fraction (r = 0.559, p = 0.037) and early diastolic passive atrial emptying fraction (r = 0.539, p = 0.047) correlated with systolic blood pressure response to standing representing sympathetic autonomic function. From LA strains, peak mean segmental LA radial strain (RS) (r = -0.532, p = 0.050), global and mean segmental LA circumferential strain (CS) (r = 0.662, p = 0.010 and r = 0.635, p = 0.015, respectively) representing systolic LA function correlated with Valsalva ratio representing parasympathetic autonomic function. Global LA-RS (r = -0.713, p = 0.040) and LA-CS (r = 0.657, p = 0.011) and mean segmental LA-CS (r = 0.723, p = 0.003) at atrial contraction representing end-diastolic atrial contraction showed correlations with Valsalva ratio, as well. Peak global and mean segmental LA-CS (r = 0.532, p = 0.050 and r = 0.530, p = 0.050) and the same strains at atrial contraction (r = 0.704, p = 0.005 and r = 0.690, p = 0.006) representing systolic function and end-diastolic atrial contraction correlated with systolic blood pressure response to standing representing both parasympathetic and sympathetic autonomic functions. CONCLUSIONS: Significant correlations between features of vegetative autonomic function represented by Ewing's 5 SCRTs and specific LA functions represented by 3DSTE-derived LA volume-based functional properties and strains could be demonstrated in healthy adults.


Assuntos
Função do Átrio Esquerdo , Ecocardiografia Tridimensional , Adulto , Masculino , Humanos , Adulto Jovem , Pessoa de Meia-Idade , Função do Átrio Esquerdo/fisiologia , Ecocardiografia Tridimensional/métodos , Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Ecocardiografia Doppler/métodos
4.
Diabetes Res Clin Pract ; 202: 110770, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37279858

RESUMO

Tirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist (GIP/GLP-1 RA) improves glycemic control. Besides improvement of glycemic control, tirzepatide treatment is associated with significantly more weight loss as compared to potent selective GLP-1 receptor agonists as well as other beneficial changes in cardio-metabolic parameters, such as reduced fat mass, blood pressure, improved insulin sensitivity, lipoprotein concentrations, and circulating metabolic profile in individuals with type 2 diabetes (T2D). Some of these changes are partially associated with weight reduction. We review here the putative mechanisms of GIP receptor agonism contributing to GLP-1 receptor agonism-induced weight loss and respective findings with GIP/GLP-1 RAs, including tirzepatide in T2D preclinical models and clinical studies. Subsequently, we summarize the clinical data on weight loss and related non-glycemic metabolic changes of tirzepatide in T2D. These findings suggest that the robust weight loss and associated changes are important contributors to the clinical profile of tirzepatide for the treatment of T2D diabetes and serve as the basis for further investigations including clinical outcomes.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Receptor do Peptídeo Semelhante ao Glucagon 1 , Polipeptídeo Inibidor Gástrico , Peptídeo 1 Semelhante ao Glucagon , Redução de Peso , Hipoglicemiantes/uso terapêutico
5.
Chem Asian J ; 17(15): e202200395, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35584374

RESUMO

Due to the increasing relevance of fluorine-containing organic molecules in drug design, the synthesis of organofluorine compounds has gained high significance in synthetic organic chemistry. Trifluoromethylative difunctionalizations of carbon-carbon multiple bonds, with the simultaneous incorporation of a CF3 group and another functional element, have considerable potential. Because of the high importance of carbon-carbon bond-forming reactions in organic synthesis, carbotrifluoromethylations and, in particular, aryltrifluoromethylations or heteroaryltrifluoromethylations are considered to be increasing fields of synthetic organic chemistry. The aim of the current review is to summarize recent developments of aryltrifluoromethylation or heteroaryltrifluoromethylation reactions.


Assuntos
Carbono , Carbono/química , Técnicas de Química Sintética
6.
Chem Asian J ; 16(23): 3873-3881, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34498420

RESUMO

Novel functionalized azaheterocycles with multiple chiral centers have been accessed from readily available norbornene ß-amino acids or ß-lactams across a stereocontrolled synthetic route, based on ring-opening metathesis (ROM) of the staring unsaturated bicyclic amino esters, followed by selective cyclization through ring-closing metathesis (RCM). The RCM transformations have been studied under various experimental conditions to assess the scope of conversion, catalyst, yield, and substrate influence. The structure of the starting norbornene ß-amino acids predetermined the structure of the new azaheterocycles, and the developed synthetic route took place with the conservation of the configuration of the chiral centers.

7.
Beilstein J Org Chem ; 16: 2562-2575, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133288

RESUMO

A study exploring halofluorination and fluoroselenation of some cyclic olefins, such as diesters, imides, and lactams with varied functionalization patterns and different structural architectures is described. The synthetic methodologies were based on electrophilic activation through halonium ions of the ring olefin bonds, followed by nucleophilic fluorination with Deoxo-Fluor®. The fluorine-containing products thus obtained were subjected to elimination reactions, yielding various fluorine-containing small-molecular entities.

8.
Orv Hetil ; 161(20): 846-851, 2020 05 01.
Artigo em Húngaro | MEDLINE | ID: mdl-32364688

RESUMO

Mal de débarquement syndrome is an uncommon vestibular disorder characterized by a constant sensation of swaying or motion after one disembarks from a vehicle such as a ship or plane, however, spontaneous onset also appears. These symptoms temporarily subside when the patient is subjected again to passive motion like driving a car. Chronic fatigue, anxiety, and depression are frequently associated with primary symptoms. The diagnosis is challenging, and often made by the patients themselves. The underlying pathophysiology and definitive therapy are unknown. Exposure to optokinetic stimulations and transcranial magnetic stimulations open therapeutic perspectives. We report a case series of 5 patients who presented with constant rocking, bobbing sensation that had been ongoing for several months. We found normal inner-ear function, non-related abnormalities and normal brain imaging. By presenting our patients' histories, we discuss the different diagnostic issues that help to diagnose this condition. We aimed to report the most recent findings on aetiology and treatment methods and to share our experiences with different therapeutic attempts. Mal de débarquement syndrome is a diagnosis of exclusion and often unrecognized. A thorough clinical history, negative or non-specific clinical findings with a high degree of suspicion are needed for recognizing this disorder. Increasing awareness can lead to early diagnosis and prevent multiple physician visits and unnecessary diagnostic testing. Frequent diagnostic failure has a negative impact on the quality of life, associated with anxiety and depression. Orv Hetil. 2020; 161(20): 846-851.


Assuntos
Qualidade de Vida , Doença Relacionada a Viagens , Viagem , Depressão , Humanos
9.
Ideggyogy Sz ; 72(9-10): 295-303, 2019 Sep 30.
Artigo em Húngaro | MEDLINE | ID: mdl-31625696

RESUMO

Despite of the symptoms of vertigo have been known since thousands of years, it was evident by the research of the pioneer scientists of the 19th century (Flourens, Ménière, Breuer and others) that dizziness can also be attributed to inner ear disfunctions. The discovery of the vestibulo-ocular reflex was an important milestone (Endre Hogyes, 1884). The vestibulo-ocular reflex stabilizes images on the retina by rotating the eyes at the same speed but in the opposite direction of head motion. The milestone discovery of Hogyes by stimulating individual labyrinth receptors and recording the activity of eye muscles were verified by János Szentágothai in 1950. Low-frequency lesions of the angular vestibulo-ocular reflex can be investigated by caloric test (Robert Bárány,1906), high-frequency lesions by head impulse test (Gabor Michael Halmagyi and Ian Stewart Curthoys, 1988).


Assuntos
Neuro-Otologia/história , Reflexo Vestíbulo-Ocular , Vertigem , Teste do Impulso da Cabeça , História do Século XIX , História do Século XX , Humanos , Hungria
10.
Ideggyogy Sz ; 71(7-08): 221-235, 2018 Jul 30.
Artigo em Húngaro | MEDLINE | ID: mdl-30113791

RESUMO

Dizziness is one of the most common causes of medical visits. Management of the dizzy patient may be challenging both for the general practitioner, in emergency departments, and special clinics, as behind a seemingly homogeneous clinical presentation several very different etiologies may occur. Research of the last two century enriched our knowledge about physiology and pathophysiology of the vestibular system. Much knowledge is now available about the labyrinth being able to sense head motions and gravity, processing of afferent vestibular stimuli, reflectory oculomotor and postural control, or recovery of the vestibular system. Based on scientific results new beside tests have been introduced including provocation maneuvers for detecting ectopic otoliths in different semicircular canals, head impulse test to examine function of the vestibulo-ocular reflex, and the HINTS+ battery for differentiation of peripheral or central origin of an acute vestibular syndrome. Technical innovations like videooculography and vestibular evoked myogenic potentials enable us to selectively and side-specifically examine the function of all six semicircular canals and two otolith organs. Pathomechanism of disorders with vertigo and dizziness became more clear resulting in the development or amendment of diagnostic criteria of several vestibular disorders including vestibular migraine, Menière's disease, benign paroxysmal positional vertigo, persistent postural-perceptual dizziness, bilateral vestibulopathy. Broader knowledge about the pathomechanism promoted the development of new therapeutic methods like different repositioning maneuvers in benign paroxysmal positional vertigo, pharmaceutical therapies, vestibular rehabilitation, and psychotherapy. We aimed to summarize the novelties in the field of oto-neurology.


Assuntos
Tontura/terapia , Vertigem/terapia , Potenciais Evocados Miogênicos Vestibulares , Tontura/diagnóstico , Humanos , Transtornos de Enxaqueca , Neurologia , Vertigem/diagnóstico
11.
Orv Hetil ; 158(51): 2029-2040, 2017 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-29250967

RESUMO

INTRODUCTION AND AIM: To diagnose acute vestibular syndrome (AVS) in a prospective study by a new bedside test (providing 1A evidence) based on oculomotor analysis and assessment of hearing loss. To assess the frequency of central and peripheral causes of acute vestibular syndrome in the emergency room. To establish the diagnostic accuracy of acute cranial computed tomography as compared to oculomotor analysis done by video oculography goggles and audiometry. METHOD: Between 1st March 2016 and 1st March 2017 we documented 125 patients (62 women, 63 men, average age 53 years) in the emergency room of the Petz Aladár County Teaching Hospital using the above bedside and instrumental testing. Diagnosis was verified by cranial magnetic resonance imaging. RESULTS: According to the results of the instrumental examination in AVS in 67% we found a peripheral cause and in 33% a central pathology. In 62% isolated posterior circulation stroke manifested itself by isolated vertigo without additional focal signs and the acute cranial computed tomography showed negative results in 96%. The instrumental examination increased diagnostic accuracy by making the diagnosis of isolated inferior semicircular canal vestibular neuritis possible. CONCLUSIONS: The new bedside oculomotor test is suitable for the diagnosis of posterior circulation stroke manifesting with isolated vertigo in early cases, when the routine neuroradiologic methods have a lower sensitivity or are not available. Orv Hetil. 2017; 158(51): 2029-2040.


Assuntos
Serviço Hospitalar de Emergência , Medições dos Movimentos Oculares , Potenciais Evocados Miogênicos Vestibulares , Neuronite Vestibular/diagnóstico , Adulto , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito , Estudos Retrospectivos
12.
Artigo em Inglês | MEDLINE | ID: mdl-28659867

RESUMO

Prediabetic states and diabetes are important risk factors for cardiovascular morbidity and mortality. Determination of short-term QT interval variability (STVQT) is a non-invasive method for assessment of proarrhythmic risk. The aim of the study was to evaluate the STVQT in patients with impaired glucose tolerance (IGT). 18 IGT patients [age: 63 ± 11 years, body mass index (BMI): 31 ± 6 kg/m2, fasting glucose: 6.0 ± 0.4 mmol/l, 120 min postload glucose: 9.0 ± 1.0 mmol/l, hemoglobin A1c (HbA1c): 5.9 ± 0.4%; mean ± SD] and 18 healthy controls (age: 56 ± 9 years, BMI: 27 ± 5 kg/m2, fasting glucose: 5.2 ± 0.4 mmol/l, 120 min postload glucose: 5.5 ± 1.3 mmol/l, HbA1c: 5.4 ± 0.3%) were enrolled into the study. ECGs were recorded, processed, and analyzed off-line. The RR and QT intervals were expressed as the average of 30 consecutive beats, the temporal instability of beat-to-beat repolarization was characterized by calculating STVQT as follows: STVQT = Σ|QTn + 1 - QTn| (30x√2)-1. Autonomic function was assessed by means of standard cardiovascular reflex tests. There were no differences between IGT and control groups in QT (411 ± 43 vs 402 ± 39 ms) and QTc (431 ± 25 vs 424 ± 19 ms) intervals or QT dispersion (44 ± 13 vs 42 ± 17 ms). However, STVQT was significantly higher in IGT patients (5.0 ± 0.7 vs 3.7 ± 0.7, P < 0.0001). The elevated temporal STVQT in patients with IGT may be an early indicator of increased instability of cardiac repolarization during prediabetic conditions.

13.
Anatol J Cardiol ; 16(8): 587-593, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27004713

RESUMO

OBJECTIVE: Changes in left atrial (LA) function can be observed in type 1 diabetes mellitus (T1DM). Three-dimensional (3-D) speckle tracking echocardiography (STE) seems to be a promising tool for volumetric and functional evaluation of LA. The objective of the present study was to compare 3DSTE-derived LA volumetric and strain parameters between T1DM patients and matched healthy controls. METHODS: This prospective study consists of 17 subcutaneous insulin pump-treated non-obese patients with T1DM (mean age: 33.5±8.2 years, 8 males). To exclude possible cardiovascular disease, patients with complaints of chest pain, dyspnea, or signs of cerebrovascular disease or peripheral artery disease were not included. Their results were compared with 20 age-matched and gender-matched healthy controls (mean age: 36.9±11.0 years, 9 males). Independent sample Student t-test and Fisher's exact test were used for comparisons. Bland-Altman method was used for evaluating intraobserver and interobserver correlations. RESULTS: Anemia and impaired renal function were not confirmed in T1DM patients. Calculated LA maximum and minimum volumes and LA volume before atrial contraction were significantly increased in T1DM patients. Total atrial stroke volume was increased (23.6±6.9 mL vs. 19.6±4.6 mL, p=0.04), whereas mean segmental circumferential peak strain was decreased (28.9%±11.4% vs. 37.3%±12.5%, p=0.04). Segmental basal longitudinal and area strains were increased, whereas segmental superior circumferential and area strains and midatrial 3-D strain were decreased in T1DM. CONCLUSION: Both 3DSTE-derived volumetric and strain analysis confirmed alterations in LA function, suggesting early LA remodeling in patients with T1DM.

14.
Orv Hetil ; 157(11): 403-9, 2016 Mar 13.
Artigo em Húngaro | MEDLINE | ID: mdl-26947088

RESUMO

According to international statistics, the first examination of 25% of patients with vertigo is carried out in Emergency Departments. The most important task of the examining physician is to diagnose life threatening pathologic processes. One of the most difficult otoneurological diagnostic challange in Emergency Departments is to differentiate between dangerous posterior scale stroke presenting with isolated vertigo and the benign vestibular neuritis.These two disorders can be safely differentiated using fast, non-invasive, evidence based bedside tests which have been introduced in the past few years. 35% of stroke cases mimicking vestibular neuritis (pseudoneuritis) are misdiagnosed at the Emergency Department, and 40% of these cases develop complications. During the first 48 hours, sensitivity for stroke of the new test that is based on the malfunction of the oculomotor system is better than the diffusion-weighted cranial magnetic resonance imaging. Using special test glasses each component of the new test can be made objective and repeatable.


Assuntos
Doenças do Sistema Nervoso Central/diagnóstico , Técnicas de Diagnóstico Neurológico , Técnicas de Diagnóstico Otológico , Serviço Hospitalar de Emergência , Doenças do Labirinto/diagnóstico , Testes Imediatos , Vertigem/etiologia , Neuronite Vestibular/diagnóstico , Doenças do Sistema Nervoso Central/complicações , Diagnóstico Diferencial , Erros de Diagnóstico , Imagem de Difusão por Ressonância Magnética , Encefalite/complicações , Encefalite/diagnóstico , Humanos , Doenças do Labirinto/complicações , Labirintite/complicações , Labirintite/diagnóstico , Mastoidite/complicações , Mastoidite/diagnóstico , Síndrome de Miller Fisher/complicações , Síndrome de Miller Fisher/diagnóstico , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Sensibilidade e Especificidade , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Vertigem/classificação , Vertigem/fisiopatologia , Testes de Função Vestibular , Neuronite Vestibular/complicações , Encefalopatia de Wernicke/complicações , Encefalopatia de Wernicke/diagnóstico
15.
PLoS One ; 10(4): e0125639, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25915951

RESUMO

Cardiovascular diseases, including ventricular arrhythmias are responsible for increased mortality in patients with acromegaly. Acromegaly may cause repolarization abnormalities such as QT prolongation and impairment of repolarization reserve enhancing liability to arrhythmia. The aim of this study was to determine the short-term beat-to-beat QT variability in patients with acromegaly. Thirty acromegalic patients (23 women and 7 men, mean age±SD: 55.7±10.4 years) were compared with age- and sex-matched volunteers (mean age 51.3±7.6 years). Cardiac repolarization parameters including frequency corrected QT interval, PQ and QRS intervals, duration of terminal part of T waves (Tpeak-Tend) and short-term variability of QT interval were evaluated. All acromegalic patients and controls underwent transthoracic echocardiographic examination. Autonomic function was assessed by means of five standard cardiovascular reflex tests. Comparison of the two groups revealed no significant differences in the conventional ECG parameters of repolarization (QT: 401.1±30.6 ms vs 389.3±16.5 ms, corrected QT interval: 430.1±18.6 ms vs 425.6±17.3 ms, QT dispersion: 38.2±13.2 ms vs 36.6±10.2 ms; acromegaly vs control, respectively). However, short-term beat-to-beat QT variability was significantly increased in acromegalic patients (4.23±1.03 ms vs 3.02±0.80, P<0.0001). There were significant differences between the two groups in the echocardiographic dimensions (left ventricular end diastolic diameter: 52.6±5.4 mm vs 48.0±3.9 mm, left ventricular end systolic diameter: 32.3±5.2 mm vs 29.1±4.4 mm, interventricular septum: 11.1±2.2 mm vs 8.8±0.7 mm, posterior wall of left ventricle: 10.8±1.4 mm vs 8.9±0.7 mm, P<0.05, respectively). Short-term beat-to-beat QT variability was elevated in patients with acromegaly in spite of unchanged conventional parameters of ventricular repolarization. This enhanced temporal QT variability may be an early indicator of increased liability to arrhythmia.


Assuntos
Acromegalia/fisiopatologia , Arritmias Cardíacas/etiologia , Acromegalia/complicações , Arritmias Cardíacas/fisiopatologia , Pressão Sanguínea/fisiologia , Estudos de Casos e Controles , Eletrocardiografia , Feminino , Coração/fisiopatologia , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Manobra de Valsalva/fisiologia
16.
Quant Imaging Med Surg ; 5(6): 815-21, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26807363

RESUMO

BACKGROUND: Alterations in mitral annular size and function could be demonstrated in cardiomyopathies and ischaemic heart disease. The present study was designed to evaluate mitral annulus (MA) morphology and function in young type 1 diabetes mellitus (T1DM) patients by three-dimensional speckle tracking echocardiography (3DSTE) and to compare their results to matched healthy controls. METHODS: The study comprised 18 patients with T1DM (mean age: 33.0±8.0 years). Their results were compared to that of 20 age- and gender-matched healthy controls (mean age: 37.8±10.9 years). Complete two-dimensional (2D) Doppler echocardiography and 3DSTE have been performed in all cases. RESULTS: No significant differences could be demonstrated in demographic and standard echocardiographic parameters between the groups. Significantly enlarged diastolic MA diameter (2.87±0.27 mm vs. 2.58±0.32 mm, P=0.01), MA diameter index 1.61±0.20 cm/m(2) vs. 1.30±0.39 cm/m(2), P=0.008, and MA area index (4.81±0.88 cm(2)/m(2) vs. 3.91±1.35 cm(2)/m(2), P=0.03) could be demonstrated in T1DM together with augmented MA fractional shortening (28.64±9.63% vs. 20.35±12.50%, P=0.05). CONCLUSIONS: Early alterations in MA size and function could be demonstrated in young patients with T1DM by 3DSTE.

17.
Curr Opin Neurobiol ; 31: 26-32, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25128735

RESUMO

Sharp-wave-ripple complexes (SWRs) and interictal-spikes are physiological and pathological forms of irregularly occurring transient high activity events in the hippocampal EEG. They share similar features and carry high-frequency oscillations with different spectral features. Recent results reveal similarities and differences in the generation of the two types of transients, and argue that parvalbumin containing basket cells (PVBCs) are crucial in synchronizing neuronal activity in both cases. SWRs are generated in the reciprocally connected network of inhibitory PVBCs, while in the pathological case, synchronous failure of perisomatic inhibition triggers massive pyramidal cell burst firing. While physiological ripple oscillation is primarily the result of phasic perisomatic inhibitory currents, pathological high-frequency ripples are population spikes of partially synchronous, massively bursting, uninhibited pyramidal cells.


Assuntos
Potenciais de Ação/fisiologia , Relógios Biológicos/fisiologia , Hipocampo/fisiologia , Inibição Neural/fisiologia , Neurônios/fisiologia , Animais , Eletroencefalografia , Humanos , Parvalbuminas
18.
Clin Exp Hypertens ; 35(6): 465-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23302028

RESUMO

Peripheral sensory function and cardiac autonomic neuropathy were studied in 18 nondiabetic and 10 type-2 diabetic hypertensives compared with 11 healthy controls. All the patients were treated with antihypertensive drugs. Cardiac autonomic neuropathy using Ewing method was detected in all patient groups. The current perception threshold values on peroneal nerve at 250 Hz in nondiabetic group and at 250 Hz and at 5 Hz in diabetic group were found increased compared with the controls. In conclusion, so-called typical complications of diabetes can be observed in nondiabetic hypertensives also. Our data might support the essential role of vascular factors in the development of neuropathy.


Assuntos
Doenças do Sistema Nervoso Autônomo/complicações , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/complicações , Hipertensão/complicações , Adulto , Idoso , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Pressão Sanguínea , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Feminino , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
19.
Clin Physiol Funct Imaging ; 31(1): 61-5, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21040403

RESUMO

INTRODUCTION: There is an increased scientific interest on the evaluation of parameters characterizing aortic elasticity. The current study was designed to compare two characteristics of aortic distensibility: Arteriograph-derived pulse wave velocity (PWV) and augmentation index standardized to 80 per minutes heart rate (AIx80) and aortic elastic properties by echocardiography. METHODS: The study comprised 21 adult healthy volunteers. In all cases, systolic and diastolic ascending aortic diameters were recorded during transthoracic echocardiography in M-mode at a level 3 cm above the aortic valve from a parasternal long-axis view. Using forearm blood pressure values, the following aortic elastic properties were calculated: aortic strain, distensibility and stiffness index. All patients were examined by Arteriograph at the same time, as well. RESULTS: The Arteriograph-derived AIx80 and PWV correlated with aortic strain (R = -0·495, P = 0·023 and R = -0·527, P = 0·014, respectively) and aortic stiffness index (R = 0·454, P = 0·039 and R = 0·608, P = 0·003, respectively). Aortic distensibility did not correlated with AIx80 (R = -0·344, P = 0·127), only with PWV (R = -0·593, P = 0·005, respectively). DISCUSSION: Low to moderate correlations could be demonstrated between Arteriograph-derived PWV and aortic elastic properties by echocardiography.


Assuntos
Angiografia/métodos , Aorta/diagnóstico por imagem , Aorta/fisiologia , Ecocardiografia/métodos , Adulto , Pressão Sanguínea/fisiologia , Elasticidade/fisiologia , Feminino , Humanos , Masculino , Pulso Arterial
20.
Can J Physiol Pharmacol ; 88(12): 1166-71, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21164563

RESUMO

Cardiovascular autonomic dysfunction and alterations in vascular elasticity are known complications of several disorders, including diabetes mellitus, hypertension, hypercholesterolemia, aging, and chronic kidney disease. The current study was designed to test whether a relationship existed between pulse wave velocity (PWV), augmentation index (AIx), aortic elastic properties, and cardiovascular autonomic function in healthy volunteers. The study comprised 25 healthy volunteers, whose aortic strain, distensibility, and stiffness index were measured by echocardiography, whereas PWV and AIx were evaluated by Arteriograph (TensioMed, Budapest, Hungary) in all cases. Autonomic function was assessed by means of 5 standard cardiovascular reflex tests. We found that heart rate response to deep breathing, as the most reproducible cardiovascular reflex test to characterize parasympathetic function, showed low to moderate correlations with PWV (r = -0.431, p = 0.032), aortic strain (r = 0.594, p = 0.002), distensibility (r = 0.407, p = 0.043), and stiffness index (r = -0.453, p = 0.023). Valsalva ratio and autonomic neuropathy score (ANS) correlated with PWV (r = -0.557, p = 0.004 and r = -0.421, p = 0.036, respectively) and AIx (r = -0.461, p = 0.020 and r = -0.385, p = 0.057, respectively), while ANS correlated with even aortic stiffness index (r = -0.457, p = 0.022). Cardiovascular reflex tests mainly characterizing sympathetic function had no correlation with aortic stiffness parameters (p = NS for all correlations). Correlations exist between parameters characterizing aortic elasticity and parasympathetic autonomic function, as shown by standard cardiovascular reflex tests in healthy volunteers.


Assuntos
Aorta/fisiologia , Sistema Nervoso Parassimpático/fisiologia , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Ecocardiografia , Elasticidade/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pulso Arterial
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