No description available.

La falta de adherencia es la principal razón de los pobres resultados observados en el control de la Hipertensión arterial, la cual debe procurarse desde las fases tempranas, a fin de evitar complicaciones cardiovasculares. El objetivo fue determinar la asociación entre la adherencia al tratamiento antihipertensivo y el control de la hipertensión arterial en los pacientes del Programa de Hipertensión Arterial del Policlínico Metropolitano de EsSalud - Red Tacna Febrero 2013. Se realizó estudio correlativo, prospectivo y observacional. De una población de 1563 se encuestaron a 517 pacientes mayores de 18 años utilizando el Test de Morinsky-Green-Levine. Se obtuvo 57,1% fueron del sexo femenino, 80,3% tenían más de 60 años, 38,9% tenía 5 años o menos en el programa, 68% presentaron mala adherencia, 40% tenían presión arterial no controlada. Se halló asociación entre el sexo femenino y control de la HTA (p=0,019), además de mayor riesgo de HTA no controlada en pacientes mal adherentes (OR=1,93). Se concluye que la mala adherencia al tratamiento antihipertensivo se asocia significativamente al no control de la HTA. (p=0,001).

Physical activity is a powerful modifiable lifestyle factor that reduces the risk of cardiovascular disease (CVD) in adults through favorable changes in conventional risk factors including serum lipids, blood pressure and glycemia. Recent evidence suggests that the cardioprotective effects of physical activity may also be mediated through beneficial effects on vascular function, in particular arterial stiffness. While the beneficial effects of physical activity in CVD risk in adults are irrefutable, data in youth are limited, especially for arterial stiffness. Purpose: The purpose of this project is to explore the continuous association between physical activity and arterial stiffness in youth. Hypothesis: We hypothesized that physical activity is negatively associated with arterial stiffness, whereby highly active youth would display lesser degrees of arterial stiffness than their less active (sedentary) peers. Methods: 485 youth (12-13 yrs) were recruited from the 1995 Manitoba birth cohort involved in the GreatICE asthma and allergy study. Youth were stratified into tertiles (high, medium, low) of self-reported physical activity. Global cardiometabolic risk was determined from a composite score of conventional risk factors including, LDL, SBP, Insulin, Glucose and Triglycerides. Arterial stiffness was assessed non-invasively using conventional pulse wave analysis and velocity. Results: Of the 485 youth who participated in this wave of the study, measures of PWV and PWA were available on 357 and 335 youth respectively. Cardiometabolic risk decreased with increasing levels of vigorous physical activity. Neither measure of arterial stiffness was associated with physical activity. Conclusion: Increased vigorous physical activity is associated with reduced cardiometabolic risk in youth independent of arterial stiffness.

No description available.

No description available.

Physical activity is a powerful modifiable lifestyle factor that reduces the risk of cardiovascular disease (CVD) in adults through favorable changes in conventional risk factors including serum lipids, blood pressure and glycemia. Recent evidence suggests that the cardioprotective effects of physical activity may also be mediated through beneficial effects on vascular function, in particular arterial stiffness. While the beneficial effects of physical activity in CVD risk in adults are irrefutable, data in youth are limited, especially for arterial stiffness. Purpose: The purpose of this project is to explore the continuous association between physical activity and arterial stiffness in youth. Hypothesis: We hypothesized that physical activity is negatively associated with arterial stiffness, whereby highly active youth would display lesser degrees of arterial stiffness than their less active (sedentary) peers. Methods: 485 youth (12-13 yrs) were recruited from the 1995 Manitoba birth cohort involved in the GreatICE asthma and allergy study. Youth were stratified into tertiles (high, medium, low) of self-reported physical activity. Global cardiometabolic risk was determined from a composite score of conventional risk factors including, LDL, SBP, Insulin, Glucose and Triglycerides. Arterial stiffness was assessed non-invasively using conventional pulse wave analysis and velocity. Results: Of the 485 youth who participated in this wave of the study, measures of PWV and PWA were available on 357 and 335 youth respectively. Cardiometabolic risk decreased with increasing levels of vigorous physical activity. Neither measure of arterial stiffness was associated with physical activity. Conclusion: Increased vigorous physical activity is associated with reduced cardiometabolic risk in youth independent of arterial stiffness.

INTRODUÇÃO: Indivíduos saudáveis, quando expostos agudamente à imersão em água termoneutra, apresentam alterações no sistema de controle cardiovascular, com diminuição da atividade simpática e elevação da atividade vagal. Os efeitos crônicos da imersão em água termoneutra não são conhecidos. OBJETIVOS: Testar a hipótese de que a freqüente exposição à imersão em água termoneutra promove adaptações autonômicas. MÉTODOS: Participaram do estudo indivíduos freqüentadores (n= 14) e não freqüentadores do meio líquido (n=12). Foram registradas a pressão arterial e a freqüência cardíaca (FC) durante 15 minutos, estando o indivíduo inicialmente fora da água, em repouso, na posição supina e, em seguida, em ortostase. Imediatamente após, os indivíduos foram imersos em água termoneutra (32°C) até o terço médio do esterno, em posição ortostática. A variabilidade da freqüência cardíaca (VFC) foi determinada através de índices no domínio do tempo e da freqüência. RESULTADOS: A imersão em água termoneutra promoveu menor aumento do componente de alta freqüência da FC nos indivíduos freqüentadores do meio líquido (26,5 ± 7,8 un) do que nos não freqüentadores (40,1 ±12,3 un, p=0,012) . Houve uma tendência a menor redução do componente de baixa freqüência nos indivíduos freqüentadores (69,6 ± 7,3 un) do que nos indivíduos não freqüentadores (56,9 ± 12,4 un, com p= 0,069). CONCLUSÃO: Indivíduos freqüentemente expostos ao meio líquido apresentam menor modulação vagal e provável aumento da modulação simpática quando submetidos à imersão em água termoneutra. A exposição crônica ao meio líquido promove adaptações no sistema autonômico cardiovascular. / INTRODUCTION: During immersion in thermoneutral water, healthy individuals present a reduction in sympathetic nervous activity and reduction in vagal modulation to the heart. The chronic effects of the thermoneutral water immersion are unknown. OBJECTIVES: To test the hypothesis of that the frequent exposure to thermoneutral water immersion promotes autonomic adaptations. METHODS: In this study, we evaluated 14 healthy individuals who were frequently exposed and 12 healthy individuals who were not frequently exposed to water immersion. Subjects were maintained in the supine position, at rest out of the water, followed by the same period of time standing. They were then immersed in thermoneutral water (32°C) to the mild chest level, in the standing position for 15 minutes. Blood pressure, heart rate and time and frequency domain indices of heart rate variability were measured. RESULTS: Immersion in thermoneutral water resulted in significantly less increase in the high frequency component of the heart rate variability in individuals frequently exposed (26.5 ± 7.8 un) than individuals not frequently exposed to water immersion (40,1 ±12,3 un, p=0.012). There was a trend for less reduction in the low frequency component of heart rate variability in individuals frequently exposed (69.6 ±7,3 un) than individuals not frequently exposed to water immersion (56.9 ±12.4 un, p= 0.069). CONCLUSION: Individuals frequently exposed to water immersion present less vagal modulation and probably increased sympathetic modulation when immersed in thermoneutral water. Chronic exposure to the aquatic ambient promotes adaptations in the cardiovascular autonomic system.

Section A of this thesis describes the non-degradative isolation procedure of elastin from the media of human thoracic aorta and the determination of its ponderal distribution as well as that of the other connective tissue matrix components in the aortic media of individuals of different ages. A cylindrical segment, free of complex atherosclerotic lesions, was resected at autopsy from each of fifty-nine descending human thoracic aortae by cutting just below the level of the first pair of intercostal arteries and 35 mm distal to this incision. In the isolated tunica media there was an age-related rise in the absolute concentration of the following components: (a) proteins and glycoproteins extractable in chaotropic agents, (b) collagen and (c) an insoluble polar protein(s) which was resistant to collagenase digestion but was solubilized by trypsin. In contrast, the absolute elastin concentration was constant at around 70 mg/cm in samples of all ages. Although after treatment with collagenase and trypsin, both the mechanical properties and amino acid composition of elastin did not vary with age, in samples tested prior to trypsin digestion the insoluble polar-protein contaminant affected the mechanical behaviour of the elastin network in a way akin to plasticisers in rubber. It is therefore suggested that the morphological changes .and stiffening observed in the ageing aortic wall are not due to degradation of its elastin network bu to variations in the supramolecular organisation of connective tissue components. Section B of this thesis describes the isolation of elastin and the determination of its distribution as well as that of collagen in the bulbus arteriosus and ventral aorta of trout (Salmo gairdneri) and salmon (Salmo salar). The isolation of elastin fibrils from these specimens did not require the use of proteolytic enzymzes as collagen and all the other components of the vessel wall were readily extracted in denaturing and reducing conditions. The arterial walls of trout and salmon are characterized by a high elastin content, with an elastin:collagen ratio exceeding 2.5:1. The elastin which display an amino acid composition highly at variance with that of the mammalian protein, is present as 250-A-diameter fibrils which have a strong affinity for electron-dense cations and which form in the intercellular matrix an isotropic reticulum. As in mammalian elastin, the fibrils can be resolved in negatively contrasted preparations into constituent primary filaments of about 25 A in diameter, aligned with an equatorial periodicity of about 55 A. The wide-angle X-ray diffraction pattern of the salmonid preparations showed broad reflections corresponding to spacings of 9.8, 4.5 and 2.2 A, similar to bovine elastin. The mechanical behaviour of the salmon preparation was characterized by a linear response to stress, with minimal hysteresis, a Young's modulus of 5.5 x 105 N m-2, and a breaking strain of 1.5.

A nefropatia diabética (ND) é uma complicação freqüente do diabete melito (DM) e acarreta grande morbi-mortalidade. A prevenção desta complicação será mais efetiva se os indivíduos de maior risco, que se beneficiariam de tratamento intensivo dos fatores risco modificáveis, fossem precocemente identificados. A microalbuminúria, definida por valores de excreção urinária de albumina (EUA) de 20-199 g/min, ainda é o melhor marcador da instalação e progressão da ND, além de ser um fator de risco para o desenvolvimento de doenças macrovasculares. Estas associações podem ser explicadas pela teoria de que a microalbuminúria representa, na verdade, dano endotelial generalizado. A albuminúria nos limites superiores da normalidade também está associada ao desenvolvimento futuro de micro- e macroalbuminúria. Além disso, existe uma associação entre albuminúria normal-alta, doença cardiovascular e mortalidade geral em indivíduos com e sem DM. A EUA tem correlação direta e contínua com o desenvolvimento de doença renal e cardiovascular, sem um ponto determinado a partir do qual ocorreria um aumento mais importante do risco. No entanto, na prática clínica se faz necessário o estabelecimento de um valor crítico para guiar o tratamento dos pacientes. Algumas evidências apontam para valores de EUA em torno de 10 g/min como um novo ponto de corte para o diagnóstico de microalbuminúria.Concluindo, a associação entre a EUA e os desfechos renais e cardiovasculares parece ser contínua e já está presente até mesmo com níveis de EUA considerados normais. A adoção do valor de 10 g/min como de risco poderá identificar os pacientes que deveriam receber tratamento mais precoce e agressivo dos fatores de risco modificáveis.

A. basilar ímpar e com diminuição de calibre, na altura da ponte (100%); A. cerebelar caudal D e E, ímpar (100%); A. cerebelar média D e E, ímpar (96,7%) e dupla (3,3%). Observou-se que o círculo arterial cerebral do javali foi fechado tanto rostral como caudalmente (100%). O encéfalo foi suprido principalmente pelas Aa. carótidas internas e seus ramos as Aa. occipitais e condilares, via RAER e RAEC, com uma pequena contribuição através de ramos das Aa. vertebral e espinhal ventral, especialmente para o rombencéfalo.