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Search Results: 1 - 10 of 7887 matches for " Nelson;Consolim-Colombo "
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Limita??o funcional e claudica??o intermitente: impacto das medidas de press?o arterial
Silva, Rita de Cássia Gengo e;Giribela, Cassiana Rosa Galv?o;Wolosker, Nelson;Consolim-Colombo, Fernanda Marciano;
Arquivos Brasileiros de Cardiologia , 2012, DOI: 10.1590/S0066-782X2012005000001
Abstract: background: arterial hypertension is an important risk factor for lower-limb occlusive arterial disease (lload). however, the correlation between blood pressure and pulse pressure (pp) with lload severity and functional impairment resulting from this disease is not well established in the brazilian population. objective: to verify whether there is a correlation between blood pressure, pp, lload severity and functional capacity in patients with symptomatic lload. methods: a total of 65 patients (62.2 + 8.1 years, 56.9% males) were evaluated. they were divided into two groups: normal (a) and high (b) blood pressure. lload severity was assessed using the ankle-brachial index (abi) and functional capacity by the total and pain-free walking distance at the 6-minute walking test (6mwt). results: group a consisted of 17 (26.1%) patients. the systolic (sbp), diastolic blood pressure (dbp), and pp were, respectively, 125.4 ±11.7, 74.5 ± 9.1 and 50.9 ± 10.0 mmhg in group a and 160.7 ± 19.6, 90.0 ± 12.2 and 70.7 ± 20.2 mmhg in group b. the abi was significantly lower in group b (0.66 ± 0.12 vs. 0.57 ± 0.13, p <0.05). sbp and pp correlated with lload severity and the distances walked at the 6mwt. patients with pp > 40 mmhg walked shorter distances. conclusion: sbp and pp significantly correlated with the distances walked in the 6mwt, suggesting they are clinical markers of functional capacity impairment in patients with symptomatic lload.
Distances walked in the six-minute walk test: suggestion of defining characteristic for the nursing diagnosis Ineffective Peripheral Tissue Perfusion
Silva, Rita de Cassia Gengo e;Brunorio, Ludimila;Giribela, Cassiana Rosa Galv?o;Bortolotto, Luiz Aparecido;Wolosker, Nelson;Consolim-Colombo, Fernanda Marciano;
Revista Latino-Americana de Enfermagem , 2012, DOI: 10.1590/S0104-11692012000200006
Abstract: distances walked in walking tests are important functional markers, although they are not accepted as defining characteristics of ineffective peripheral tissue perfusion. the aims of this study were to verify the distances participants with and without this nursing diagnosis walked in the six-minute walk test and if these measures may be considered defining characteristics of this phenomenon. participants with (group a; n=65) and without (group b; n=17) this nursing diagnosis were evaluated regarding physical examination, vascular function and functional capacity. participants of group a seemed to have worse vascular function and functional capacity compared with those of group b. pain-free travelled distance was predictive of the nursing diagnosis. these results are important for the refinement of this diagnosis. in conclusion, this study provides evidences that the distances walked in the six-minute walk test may be considered defining characteristics of ineffective peripheral tissue perfusion.
Aspectos relevantes para identifica??o da claudica??o intermitente
Silva, Rita de Cassia Gengo e;Consolim-Colombo, Fernanda Marciano;
Acta Paulista de Enfermagem , 2011, DOI: 10.1590/S0103-21002011000300019
Abstract: intermittent claudication (ic) is one of the defining characteristics approved by nanda international (nanda-i) for the nursing diagnosis, ineffective peripheral tissue perfusion. for the correct identification of this defining feature, the nurse must know the clinical characteristics and have specific data collection skills. the aim of this article was to highlight aspects relevant to the identification of ic during the assessment and physical exam performed by the nurse. based on specific guidelines and other publications on the subject, we described the clinical characteristics of ic and its differentiation from other phenomena that have nociceptive effects on lower limbs. questionnaires were applied for the traceability of ic, for changes in physical examination, which may accompany the symptom and evaluation through the ankle-brachial index.
Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure
Lopes Heno Ferreira,Consolim-Colombo Fernanda Marciano,Hachul Denise,Carvalho Maria Elisa do Amaral
Arquivos Brasileiros de Cardiologia , 2000,
Abstract: We report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. For approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. She underwent clinical assessment and laboratory tests (biochemical tests, chest X-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring). Measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. Finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.
Avalia o clínica e laboratorial e estratifica o de risco
Fernanda Consolim-Colombo,Luiz Aparecido Bortolotto,Alexandre Alessi,Ayrton Pires Brand?o
Jornal Brasileiro de Nefrologia , 2010, DOI: 10.1590/s0101-28002010000500005
Abstract:
Fluid overload and changes in serum creatinine after cardiac surgery: predictors of mortality and longer intensive care stay. A prospective cohort study
Anna Stein, Lucas de Souza, Cassian Belettini, Willian Menegazzo, Júlio Viégas, Edemar Costa Pereira, Renato Eick, Lilian Araújo, Fernanda Consolim-Colombo, Maria Irigoyen
Critical Care , 2012, DOI: 10.1186/cc11368
Abstract: Patients submitted to heart surgery were prospectively enrolled in this study from September 2010 through August 2011. Clinical and laboratory data were collected from each patient at preoperative and trans-operative moments and fluid overload and creatinine levels were recorded daily after cardiac surgery during their ICU stay. Fluid overload was calculated according to the following formula: (Sum of daily fluid received (L) - total amount of fluid eliminated (L)/preoperative weight (kg) × 100). Preoperative demographic and risk indicators, intra-operative parameters and postoperative information were obtained from medical records. Patients were monitored from surgery until death or discharge from the ICU. We also evaluated the survival status at discharge from the ICU and the length of ICU stay (days) of each patient.A total of 502 patients were enrolled in this study. Both fluid overload and changes in serum creatinine correlated with mortality (odds ratio (OR) 1.59; confidence interval (CI): 95% 1.18 to 2.14, P = 0.002 and OR 2.91; CI: 95% 1.92 to 4.40, P <0.001, respectively). Fluid overload played a more important role in the length of intensive care stay than changes in serum creatinine. Fluid overload (%): b coefficient = 0.17; beta coefficient = 0.55, P <0.001); change in creatinine (mg/dL): b coefficient = 0.01; beta coefficient = 0.11, P = 0.003).Although both fluid overload and changes in serum creatinine are prognostic markers after cardiac surgery, it seems that progressive fluid overload may be an earlier and more sensitive marker of renal dysfunction affecting heart function and, as such, it would allow earlier intervention and more effective control in post cardiac surgery patients.Cardiac surgery is the surgical procedure most frequently associated with acute kidney injury (AKI) [1]. Kidney dysfunction during the perioperative period has also been associated with increased length of hospital stay [2] and with a mortality rate as high as 50% [3], re
Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure
Lopes, Heno Ferreira;Consolim-Colombo, Fernanda Marciano;Hachul, Denise;Carvalho, Maria Elisa do Amaral;Pileggi, Fúlvio;Silva, Hélio Bernardes;
Arquivos Brasileiros de Cardiologia , 2000, DOI: 10.1590/S0066-782X2000000900005
Abstract: we report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. for approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. she underwent clinical assessment and laboratory tests (biochemical tests, chest x-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring). measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.
Estresse oxidativo e disfun??o endotelial na doen?a renal cr?nica
Costa-Hong, Valeria;Bortolotto, Luiz Aparecido;Jorgetti, Vanda;Consolim-Colombo, Fernanda;Krieger, Eduardo M;Lima, Jose Jayme Galv?o de;
Arquivos Brasileiros de Cardiologia , 2009, DOI: 10.1590/S0066-782X2009000500013
Abstract: background: chronic kidney disease (ckd) is characterized by the high prevalence of atherosclerosis. considering that endothelial dysfunction and oxidative stress are promoters of atherosclerosis, it is of interest to verify whether the two conditions are associated in ckd patients still free of clinical cardiovascular disease (cvd). objective: to evaluate the association between oxidative stress and endothelial function in end-stage ckd patients without clinically evident cvd. methods: we studied 22 nondiabetic, nonsmoker ckd patients without clinical cvd treated by maintenance hemodialysis and 22 healthy controls. endothelium- dependent and independent vascular reactivity and oxidative stress, as determined by the plasma levels of thiobarbituric acid-reactive substances - tbars, were evaluated in all subjects. results: endothelium-dependent (6.0 ± 4.25 vs. 11.3 ± 4.46 %, p< 0.001) and endothelium-independent (11.9 ± 7.68 vs. 19.1 % ± 6.43 %, p< 0.001) vascular reactivity were reduced, while tbars (2.63 ± 0.51 vs. 1.49 ± 0.42 nmols/ml) was increased in ckd patients when compared to controls. tbars levels were significantly related to endothelium-dependent vascular reactivity (r= - 0.56, p< 0.001) and to systolic blood pressure (r= - 0.48, p= 0.002). conclusion: oxidative stress is increased in ckd patients free of cvd and is associated with endothelial dysfunction in patients and controls. the results suggest that oxidative stress and endothelial dysfunction may be involved in the increased susceptibility of ckd patients to cvd and cardiovascular complications.
Pressure and time dependence of the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy
Otto, M.E.B.;Consolim-Colombo, F.M.;Rodrigues Sobrinho, C.R.M.;Krieger, E.M.;
Brazilian Journal of Medical and Biological Research , 2004, DOI: 10.1590/S0100-879X2004001100004
Abstract: the first minutes of the time course of cardiopulmonary reflex control evoked by lower body negative pressure (lbnp) in patients with hypertensive cardiomyopathy have not been investigated in detail. we studied 15 hypertensive patients with left ventricular dysfunction (lvd) and 15 matched normal controls to observe the time course response of the forearm vascular resistance (fvr) during 3 min of lbnp at -10, -15, and -40 mmhg in unloading the cardiopulmonary receptors. analysis of the average of 3-min intervals of fvr showed a blunted response of the lvd patients at -10 mmhg (p = 0.03), but a similar response in both groups at -15 and -40 mmhg. however, using a minute-to-minute analysis of the fvr at -15 and -40 mmhg, we observed a similar response in both groups at the 1st min, but a marked decrease of fvr in the lvd group at the 3rd min of lbnp at -15 mmhg (p = 0.017), and -40 mmhg (p = 0.004). plasma norepinephrine levels were analyzed as another neurohumoral measurement of cardiopulmonary receptor response to lbnp, and showed a blunted response in the lvd group at -10 (p = 0.013), -15 (p = 0.032) and -40 mmhg (p = 0.004). we concluded that the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy is blunted at lower levels of lbnp. however, at higher levels, the cardiopulmonary reflex has a normal initial response that decreases progressively with time. as a consequence of the time-dependent response, the cardiopulmonary reflex response should be measured over small intervals of time in clinical studies.
Short-term red wine consumption promotes differential effects on plasma levels of high-density lipoprotein cholesterol, sympathetic activity, and endothelial function in hypercholesterolemic, hypertensive, and healthy subjects
Andrade, Ana CM;Cesena, Fernando HY;Consolim-Colombo, Fernanda M;Coimbra, Silmara R;Benjó, Alexandre M;Krieger, Eduardo M;Luz, Protasio Lemos da;
Clinics , 2009, DOI: 10.1590/S1807-59322009000500011
Abstract: objectives: to compare the metabolic, hemodynamic, autonomic, and endothelial responses to short-term red wine consumption in subjects with hypercholesterolemia or arterial hypertension, and healthy controls. methods: subjects with hypercholesterolemia (n=10) or arterial hypertension (n=9), or healthy controls (n=7) were given red wine (250 ml/night) for 15 days. analyses were performed before and after red wine intake. results: red wine significantly increased the plasma levels of hdl-cholesterol in the controls, but not in the other groups. the effects on hemodynamic measurements were mild, non-significantly more prominent in healthy subjects, and exhibited high interindividual variability. across all participants, mean blood pressure decreased 7 mmhg (p <0.01) and systemic vascular resistance decreased 7% (p = 0.05). heart rate and cardiac output did not significantly change in any group. red wine enhanced muscle sympathetic fibular nerve activity in hypercholesterolemic and hypertensive patients, but not in controls. at baseline, brachial artery flow-mediated dilation was impaired in patients with hypercholesterolemia and arterial hypertension; red wine restored the dilation in the hypercholesterolemic group but not in the hypertensive group. conclusions: red wine elicits different metabolic, autonomic, and endothelial responses among individuals with hypercholesterolemia or arterial hypertension and healthy controls. our findings highlight the need to consider patient characteristics when evaluating the response to red wine.
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