RESUMO
BACKGROUND: Our purpose was to determine the repeatability, after 2 weeks, of frequency domain measures of heart rate variability (HRV) during simple cardiovascular reflex tests. METHODS: Twenty healthy volunteers aged 29.3 +/- 2.5 years were assessed twice (at weeks 0 and 2). Continuous electrocardiogram and minute-to-minute blood pressure were recorded during spontaneous and metronome-paced breathing (0.2 Hz). Under paced breathing, two tests were performed: 1) active change of posture: 5 min supine position, 5 min seated upright, and 5 min standing up, and 2) cold pressor test: the right hand was immersed in cold water (5 degrees C) for 2 min. RESULTS: Paced breathing elicited a significant increase of the high-frequency (HF) component of HRV. This effect was repeatable on 95% of the subjects. Active change of posture induced a significant increase of the heart rate with an increase of the low-frequency/high-frequency ratio of HRV. Although repeatability was better for the response to being seated upright than for the response to being standing up, it was always higher than 90%. The cold pressor test induced a significant increase of the heart rate and blood pressure, but with variable changes on the HRV measurements (either a decrease or an increase). Repeatability of responses was evident for 95-100% of the subjects. Although repeatability of HRV measurements in the same subject during the tests was higher than 95%, coefficients of repeatability reflected large differences among the subjects. CONCLUSIONS: The results suggest that it is not advisable to use isolated HRV changes to interpret the response to simple cardiovascular reflex tests in groups of healthy subjects.
Assuntos
Fenômenos Fisiológicos Cardiovasculares , Frequência Cardíaca/fisiologia , Reflexo , Temperatura Baixa , Humanos , Postura , Valores de Referência , RespiraçãoRESUMO
The aminoglycosides are broad-spectrum antibiotics especially effective against many strains of gramnegative bacteria. Since streptomycin was used for tuberculosis treatment, the toxic side effects of such antibiotics were identified. The kidney and the inner ear are affected. The nephrotoxicity is usually reversible, while the chronic ototoxicity is irreversible. Within the inner ear, it is the cochlear and vestibular sensory epithelium that is damaged. A toxic mechanism in which an interference with mitochondrial protein synthesis is central has been inferred. During the last fifty years, risk factors for aminoglycoside-induced-ototoxicity have been identified, including a genetically transmitted hypersensitivity to the ototoxic effect. Although several strategies to prevent the damage have been proposed, today it is not rare that patients suffer permanent loss of hearing and loss of balance due to aminoglycoside toxicity. This review gives a brief background of aminoglycoside ototoxicity, some strategies to prevent it, and the therapeutic use of the vestibulo-toxic effect.
Assuntos
Aminoglicosídeos/efeitos adversos , Transtornos da Audição/induzido quimicamente , Transtornos da Audição/diagnóstico , Transtornos da Audição/terapia , Humanos , Prognóstico , Fatores de RiscoRESUMO
Se llevó a cabo un estudio abierto en 29 pacientes adultos afectos de otitis media crónica (41.4%), otitis media crónica agudizada (44.8%) y otitis media aguda (13.8%), utilizando la combinación de trimetoprim (TMP) + sulfametoxipirazina (SMP), en proporción fija de 5 a 4. El esquema posológico consistió en la administración de 2 cápsulas en una sola toma, el primer día, para continuar con una cápsula (250 mg TMP + 200 mg SMP) al día, durante otros 9 días. Se estudió la evolución de los seguientes síntomas: otalgia, hipoacusia, tipo y cantidad de exudado. También se efecutó al inicio y al final del tratamiento, examen microbiológico del exudado. Con el tratamiento, la hipoacusia mejoró en 62% de los casos. La otalgia desapareció en todos los pacientes que inicialmente la presentaban. Se observó una reducción altamente significativa en la cantidad y en las características purulentas del exudado. El cultivo resultó ésteril en 79.3% de los pacientes al final del tratamiento. La tolerancia al fármaco resultó buena en 26 pacientes (89.7%); en 3 se presentaon efectos secundarios, que en uno de ellos impidió la continuación del tratamiento. Concluyendo, el fármaco resultó ser eficaz y bien tolerado en este tipo de afecciones
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Otite Média/tratamento farmacológico , Trimetoprima/uso terapêutico , Quimioterapia Combinada , Sulfaleno/uso terapêuticoRESUMO
Presentamos el caso de un paciente quien despues de un traumatismo en la region retroauricular izquierda desarrolla un angioliomioma extraido quirurgicamente. Actualmente el paciente se encuentra libre de sintomatologia. Estos tumores son dificiles de diagnosticar clinicamente por la falta de sintomatologia especifica y lo raro de su presentacion; este es el segundo caso informado en la literatura mundial con esta localizacion. El tratamiento que se sugiere es el quirurgico, no se presentan recurrencias cuando su extirpacion es total