RESUMO
Cardiac arrest is an important public health issue, with a survival rate of approximately 15 to 22%. A great proportion of these deaths occur after resuscitation due to post-cardiac arrest syndrome, which is characterized by the ischemia-reperfusion injury that affects the role body. Understanding physiopathology is mandatory to discover new treatment strategies and obtain better results. Besides improvements in cardiopulmonary resuscitation maneuvers, the great increase in survival rates observed in recent decades is due to new approaches to post-cardiac arrest care. In this review, we will discuss physiopathology, etiologies, and post-resuscitation care, emphasizing targeted temperature management, early coronary angiography, and rehabilitation.
RESUMO
BACKGROUND: Myocardial infarction (MI) is one of the leading causes of morbidity and mortality worldwide. Dietary intervention on adverse cardiac remodeling after MI has significant clinical relevance. Rosemary leaves are a natural product with antioxidant/anti-inflammatory properties, but its effect on morphology and ventricular function after MI is unknown. METHODS AND RESULTS: To determine the effect of the dietary supplementation of rosemary leaves on cardiac remodeling after MI, male Wistar rats were divided into 6 groups after sham procedure or experimental induced MI: 1) Sham group fed standard chow (SR0, n = 23); 2) Sham group fed standard chow supplemented with 0.02% rosemary (R002) (SR002, n = 23); 3) Sham group fed standard chow supplemented with 0.2% rosemary (R02) (SR02, n = 22); 4) group submitted to MI and fed standard chow (IR0, n = 13); 5) group submitted to MI and fed standard chow supplemented with R002 (IR002, n = 8); and 6) group submitted to MI and fed standard chow supplemented with R02 (IR02, n = 9). After 3 months of the treatment, systolic pressure evaluation, echocardiography and euthanasia were performed. Left ventricular samples were evaluated for: fibrosis, cytokine levels, apoptosis, energy metabolism enzymes, and oxidative stress. Rosemary dietary supplementation attenuated cardiac remodeling by improving energy metabolism and decreasing oxidative stress. Rosemary supplementation of 0.02% improved diastolic function and reduced hypertrophy after MI. Regarding rosemary dose, 0.02% and 0.2% for rats are equivalent to 11 mg and 110 mg for humans, respectively. CONCLUSION: Our findings support further investigations of the rosemary use as adjuvant therapy in adverse cardiac remodeling.
Assuntos
Suplementos Nutricionais , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/fisiopatologia , Extratos Vegetais/uso terapêutico , Rosmarinus/química , Remodelação Ventricular/efeitos dos fármacos , Animais , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Comportamento Alimentar/efeitos dos fármacos , Coração/efeitos dos fármacos , Coração/fisiopatologia , Masculino , Infarto do Miocárdio/diagnóstico por imagem , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/farmacologia , Ratos Wistar , Análise de Sobrevida , Sístole/efeitos dos fármacosRESUMO
BACKGROUND: Diet composition is one of the factors that may contribute to intraindividual variability in the anticoagulant response to warfarin. AIM OF THE STUDY: To determine the associations between food pattern and anticoagulant response to warfarin in a group of Brazilian patients with vascular disease. METHODS: Recent and usual food intakes were assessed in 115 patients receiving warfarin; and corresponding plasma phylloquinone (vitamin K(1)), serum triglyceride concentrations, prothrombin time (PT), and International Normalized Ratio (INR) were determined. A factor analysis was used to examine the association of specific foods and biochemical variables with anticoagulant data. RESULTS: Mean age was 59 +/- 15 years. Inadequate anticoagulation, defined as values of INR 2 or 3, was found in 48% of the patients. Soybean oil and kidney beans were the primary food sources of phylloquinone intake. Factor analysis yielded four separate factors, explaining 56.4% of the total variance in the data set. The factor analysis revealed that intakes of kidney beans and soybean oil, 24-h recall of phylloquinone intake, PT and INR loaded significantly on factor 1. Triglycerides, PT, INR, plasma phylloquinone, and duration of anticoagulation therapy loaded on factor 3. CONCLUSIONS: Fluctuations in phylloquinone intake, particularly from kidney beans, and plasma phylloquinone concentrations were associated with variation in measures of anticoagulation (PT and INR) in a Brazilian group of patients with vascular disease.
Assuntos
Anticoagulantes/farmacologia , Coagulação Sanguínea/efeitos dos fármacos , Dieta , Tempo de Protrombina , Varfarina/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifibrinolíticos/administração & dosagem , Antifibrinolíticos/sangue , Coagulação Sanguínea/fisiologia , Análise Fatorial , Feminino , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Triglicerídeos/sangue , Doenças Vasculares/sangue , Doenças Vasculares/tratamento farmacológico , Vitamina K 1/administração & dosagem , Vitamina K 1/sangueRESUMO
UNLABELLED: The aim of this study was to examine the agreement between the results of body fat (BF and BF%), fat-free mass (FFM) and FFM index (FFMI= FFM/height2) as estimated by skinfold anthropometry (ANT), bioelectrical impedance (BIA) and dual-energy X-ray absorptiometry (DXA) in two groups of men (> or = 50 y), one comprising healthy individuals (n=23) and the other, patients with chronic obstructive pulmonary disease (COPD) (n=24). Comparisons between body composition techniques were done by repeated measures ANOVA; the Bland & Altman procedure was used to analyse agreement. RESULTS AND CONCLUSIONS: 1) comparison between healthy and COPD groups showed significant differences between all studied variables; 2) in the healthy group, values for BF, BF%, FFM and FFMI were not significantly different when BIA or ANT was compared to DXA; however, in COPD, values for BF and BF% were significantly higher and for FFM and FFMI significantly lower when BIA was compared to DXA; in contrast, no differences were shown between values for these variables when ANT was compared with DXA; 3) Bland & Altman test, in both groups, showed no agreement between BIA and DXA and between ANT and DXA; it was also shown that body fat was overestimated and fat free mass underestimated by BIA in relation to DXA.
Assuntos
Absorciometria de Fóton/métodos , Tecido Adiposo/anatomia & histologia , Antropometria/métodos , Composição Corporal , Impedância Elétrica , Doença Pulmonar Obstrutiva Crônica , Idoso , Análise de Variância , Índice de Massa Corporal , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
O trabalho teve, como objetivo principal, verificar se a antropometria (ANT) e a impedância bioelétrica (BIA) fornecem resultados concordantes com os obtidos pela absortiometria de raios-X de dupla energia (DXA), quanto à massa (MG) e à porcentagem de gordura (por centaGC), à massa livre de gordura corporal (MLG) e ao índice de MLG (IMLG= MLG/estatura2), em indivíduos adultos (³ 50 anos), do sexo masculino, sadios (n=23) e em pacientes com doença pulmonar obstrutiva crônica (DPOC) (n=24). As comparações entre as técnicas de composição do corpo foram feitas utilizando ANOVA por medidas repetidas; para análise de concordância, utilizou-se o procedimento de Bland & Altman. Resultados e Conclusões: 1) valores obtidos no grupo sadio foram significantemente diferentes dos observados no grupo com DPOC; 2) não foram observadas diferenças significantes, nos indivíduos sadios, entre DXA ´BIA e entre DXA ´ANT; em DPOC, a comparação entre DXA ´BIA revelou, para BIA, valores estatisticamente maiores para MG e por cente GC e menores para MLG e IMLG; na comparação DXA ´ANT, não houve diferenças significantes entre as variáveis; 3) a aplicação do teste de Bland & Altman, em ambos os grupos, mostrou falta de concordância na comparação da BIA com DXA e, também, da ANT com DXA; verificou-se, também, superestimação da gordura corporal e subestimação da MLG pela BIA, em relação à DXA