RESUMO
Resumen En esta revisión, se analiza la literatura existente en relación al tabaco y el peso corporal, su rol en el cambio de peso corporal según el consumo de tabaco o cesación de este y las diferentes alternativas farmacológicas validadas para el manejo de este problema, cada vez más prevalente.
This review analyses the existing literature regarding tobacco and body weight, its role in the change of body weight according to smoking consumption or cessation and the different pharmacological alternatives validated used to address this issue, which is everyday more prevalent
Assuntos
Humanos , Adulto , Tabagismo/tratamento farmacológico , Tabagismo/epidemiologia , Peso Corporal , Abandono do Hábito de Fumar/métodos , Índice de Massa Corporal , Sobrepeso , ObesidadeRESUMO
Regardless of the diagnostic criteria, the metabolic syndrome is found at least in 20% of the population. The adipose tissue plays an important role in the insulin resistance found in this syndrome. Free fatty acids released by intra-abdominal adipocytes produce an inflammatory and pro-thrombotic response and the persistence of the insulin resistance state, phenomenon termed lipotoxicity. This altered phenotype explains the development of the different components of the metabolic syndrome, such as hypertension, dyslipidemia and altered glucose metabolism. The treatment is based on weight loss and healthy lifestyle. A balanced diet, physical activity and avoidance of smoking are key management features. The use of drugs with pleiotropic effects, which inhibit the renin angiotensin aldosterone axis or acts on the peroxisome proliferators-activated receptors (PPAR) seems promising.
Assuntos
Síndrome Metabólica , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Diabetes Mellitus/fisiopatologia , Humanos , Resistência à Insulina/fisiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Obesidade/complicações , Obesidade/fisiopatologia , Fatores de RiscoRESUMO
Regardless of the diagnostic criteria, the metabolic syndrome is found at least in 20 percent of the population. The adipose tissue plays an important role in the insulin resistance found in this syndrome. Free fatty acids released by intra-abdominal adipocytes produce an inflammatory and pro-thrombotic response and the persistence of the insulin resistance state, phenomenon termed lipotoxicity. This altered phenotype explains the development of the different components of the metabolic syndrome, such as hypertension, dyslipidemia and altered glucose metabolism. The treatment is based on weight loss and healthy lifestyle. A balanced diet, physical activity and avoidance of smoking are key management features. The use of drugs with pleiotropic effects, which inhibit the renin angiotensin aldosterone axis or acts on the peroxisome proliferators-activated receptors (PPAR) seems promising.
Assuntos
Humanos , Síndrome Metabólica , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Diabetes Mellitus/fisiopatologia , Resistência à Insulina/fisiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Obesidade/complicações , Obesidade/fisiopatologia , Fatores de RiscoRESUMO
Heterozygous familial hypercholesterolemia affects one every 400 individuals, is caused by mutations in the LDL receptor gene and is associated with premature coronary artery disease. Nowadays, LDL cholesterol can be efficiently reduced with the new therapies to reduce blood lipids. We report a female patient who consulted in 1975, when she was 46 years old, for severe hypercholesterolemia. In 2003, a sample of leukocyte DNA was obtained and the uncommon 1705+1G>A mutation of the LDL receptor gene was detected. No mutations in the apolipoprotein B gene were found. The patient was treated successfully with simvastatin 80 mg/day and ezetimibe 10 mg/day and LDL cholesterol levels were reduced below 200 mg/dl.
Assuntos
Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/genética , Anticolesterolemiantes/uso terapêutico , Azetidinas/uso terapêutico , LDL-Colesterol/efeitos dos fármacos , Ezetimiba , Feminino , Heterozigoto , Humanos , Proteínas Relacionadas a Receptor de LDL/efeitos dos fármacos , Proteínas Relacionadas a Receptor de LDL/genética , Pessoa de Meia-Idade , Mutação , Análise de Sequência com Séries de Oligonucleotídeos , Prognóstico , Sinvastatina/uso terapêuticoRESUMO
Heterozygous familial hypercholesterolemia affects one every 400 individuals, is caused by mutations in the LDL receptor gene and is associated with premature coronary artery disease. Nowadays, LDL cholesterol can be efficiently reduced with the new therapies to reduce blood lipids. We report a female patient who consulted in 1975, when she was 46 years old, for severe hypercholesterolemia. In 2003, a sample of leukocyte DNA was obtained and the uncommon 1705 + 1G >A mutation of the LDL receptor gene was detected. No mutations in the apolipoprotein B gene were found. The patient was treated successfully with simvastatin 80 mg/day and ezetimibe 10 mg/day and LDL cholesterol levels were reduced below 200 mg/dl.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/genética , Anticolesterolemiantes/uso terapêutico , Azetidinas/uso terapêutico , LDL-Colesterol/efeitos dos fármacos , Heterozigoto , Proteínas Relacionadas a Receptor de LDL/efeitos dos fármacos , Proteínas Relacionadas a Receptor de LDL/genética , Mutação , Análise de Sequência com Séries de Oligonucleotídeos , Prognóstico , Sinvastatina/uso terapêuticoRESUMO
The AV junction ablation was useful to treat patients with drug-refractory supraventricular arrhythmias. The purpose of this study was to determine short and long-term success and complications of the atrioventricular nodal catheter ablation and to compare direct current and radiofrequency energy. Forty patients underwent AV nodal ablation with direct current energy (Group I) and forty patients with radiofrequency (Group II). They were followed up for a mean of 76 +/- 49 and 28 +/- 20 months, respectively. Persistent complete AV block was successfully induced during the first ablation session in 45% of 40 patients who underwent DC energy, while in 50% it was modulated. All patients in the radiofrequency group had complete AV block. The rate of recurrence of AV conduction was 7.5% and 2.5% respectively. Immediate complications did not occur after either procedure. One patient died suddenly in each group during follow-up. AV nodal ablation with radiofrequency energy appears to be as efficacious and safe as direct current energy.