10 research outputs found

    Low baseline proBNP associated with increased risk of intraoperative hypotension during spinal anaesthesia for cesarean delivery

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    BACKGROUND AND OBJECTIVES: Brain natriuretic peptide (BNP) has a role in the regulation of body fluid volume and blood pressure (BP). BNP remains within a normal range during spinal anaesthesia (SA) in patients undergoing cesarean delivery. However, the effect of BNP on changes in BP during the perioperative period has not been evaluated. We aimed to investigate the effect of preoperative serum BNP on the risk of hypotension during cesarean delivery with SA. DESIGN AND SETTING: Patients were randomly selected among the patient group who were attending routine clinic visits for pregnancy monitoring. All had a healthy pregnancy and no other acute or chronic disease by their obstetrician. The study design was cross-sectional. PATIENTS AND METHODS: Patients who had uncomplicated pregnancy process and no known medical disease were selected consecutively during their last outpatient clinical examination. Baseline BP was recorded before SA. Simultaneously, blood samples were drawn for routine biochemistry and BNP. BP, SaO(2), and electro-cardiography were monitored during surgery. Intraoperative hypotension (IOH) was defined as >= 25% decrease in mean arterial pressure (MAP) at the 5th minute of SA. RESULTS: In 41 term pregnant women, 18 of the 41 patients (43.9%) fulfilled the criteria for IOH, while 23 (56.1%) showed a decrease 13.1 (11.3%) and were classified as normotensive. Baseline BNP was significantly lower in patients with IOH compared with normotensive patients 45.7 (26.9) vs. 70.2 (40.5); P=. 05. Baseline BNP had no significant correlation MAP at any time point. Age, body mass index, hemoglobin, baseline MAP and heart rate were not different between patients with and without IOH. CONCLUSION: Those findings suggest that higher baseline BNP levels might have a protective role in development of hypotension in healthy term pregnant women during SA for cesarean delivery

    Associação entre doença periodontal e aterosclerose subclínica: uma revisão sistemåtica Association betwenn periodontal disease and subclinic atherosclerosis: a sistematic review

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    A associação entre doença periodontal e o desenvolvimento de aterosclerose tem sido pesquisada. Esta revisĂŁo sistemĂĄtica da literatura se propĂ”e a verificar a associação entre a doença periodontal e a aterosclerose subclĂ­nica. A pesquisa utilizou as bases de dados: PubMed, Scopus, LILACS, BBO, Biblioteca Cochrane e Scielo com os termos: "doença periodontal", "periodontite", "carĂłtida" e "aterosclerose". Foram excluĂ­dos artigos: que apresentaram resumos escritos em idiomas diferentes do portuguĂȘs, inglĂȘs e espanhol; com abordagem laboratorial em modelos experimentais; sem descrição ou referĂȘncia a estimadores de associação entre doença periodontal e aterosclerose subclĂ­nica; pesquisas que realizaram a medida da doença periodontal por parĂąmetros diferentes de exames clĂ­nicos; pesquisas que nĂŁo analisaram a espessura da Ă­ntima mĂ©dia da artĂ©ria carĂłtida atravĂ©s de exame de ultrassom; e que abordassem grupos especĂ­ficos. Foram comparados os desenhos de estudo, protocolos de medida e os dados relatados. De um total de 63 referĂȘncias, apenas 10 artigos contemplavam todos os critĂ©rios de inclusĂŁo, distribuĂ­dos em: 1 estudo longitudinal, 6 transversais e 3 casos controles. Observou-se uma heterogeneidade entre os estudos em relação ao mĂ©todo de mensuração da doença periodontal e os desfechos da aterosclerose. Concluiu-se que infecçÔes periodontais sĂŁo fortemente associadas ao desenvolvimento da aterosclerose subclĂ­nica, entretanto os mecanismos envolvidos no processo patogĂȘnico ainda permanecem desconhecidos.<br>The association between periodontal disease and the development of atherosclerosis has been studied. The systematic review of literature aims to evaluate the association between periodontal disease and subclinical atherosclerosis. A literature search of the PubMed, Scopus, LILACS, BBO, Cochrane Library and Scielo bibliographic databases was conducted using the following descriptors: "periodontal disease", "periodontitis", "carotid", and "therosclerosis". Articles were excluded if they: presented abstracts written in languages other than Portuguese, English and Spanish; experimental studies; did not contain data testing the degree of association between periodontal disease and subclinical atherosclerosis; did measure the extent of periodontal disease by parameters other than the clinical examination; did not measure the carotid artery intima-media wall thickness by ultrasonography; and covered specific population groups. The studies design, measurement protocols and reported data were compared. A total of 63 papers identified only 10 studies that met the inclusion criteria: 1 longitudinal study, 6 cross-sectional, and 3 case control studies. There was a wide heterogeneity between the studies regarding the methods of measuring periodontal disease and atherosclerosis outcomes. The conclusion is that periodontal infections are strongly associated with the development of subclinical atherosclerosis, however the mechanisms involved on the pathogenic process remain unknown
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