RESUMO
Heart rate variability (HRV) corresponds to variations in heart rate or beat-beat time interval. This parameter reflects the status of the autonomic mechanisms of cardiovascular control, which may be influenced by changes characteristic of the life cycle of people, sedentary lifestyle, and various disease processes that directly or indirectly generate changes in the HRV and shift the autonomic balance, either towards greater sympathetic or parasympathetic influence on the heart. These antecedents support the use of HRV indices for the diagnosis and monitoring of various nosological entities in adults. However, there has been limited progress in the study of temporal variations in heart rhythm in the pediatric population. This article aims to describe the physiological and technical aspects of HRV in the pediatric population to provide a background that allows optimizing the application of these parameters in this age group.
La variabilidad del ritmo cardíaco (VRC) corresponde a las variaciones temporales de la frecuencia cardíaca o del intervalo latido-latido. Este parámetro refleja el estado de los mecanismos autonómicos de control cardiovascular. Los cambios propios del ciclo vital de las personas, el sedentarismo y diversos procesos de enfermedad han mostrado inducir cambios en la VRC y desplazar el balance autonómico hacia una mayor influencia simpática o parasimpática sobre el corazón. Estos antecedentes apoyan el uso de los índices de VRC para el diagnóstico y seguimiento de diversas entidades nosológicas en el adulto. Sin embargo, en la población pediátrica ha existido un limitado avance en el estudio de las variaciones temporales del ritmo cardíaco. Este artículo tiene por objetivo describir los aspectos fisiológicos y técnicos de la VRC en población pediátrica. El propósito es aportar antecedentes que permitan optimizar la aplicación de estos parámetros en este grupo etario.
Assuntos
Sistema Nervoso Autônomo , Coração , Adulto , Criança , Frequência Cardíaca/fisiologia , HumanosRESUMO
Systemic arterial hypertension (SAH) is a chronic disease of multifactorial origin and one of the main risk factors for major adverse cardiovascular events (MACE), which are the leading causes of morbidity and mortality worldwide. The pharmacological treatment of SAH involves five main classes of drugs, and Nebivolol (NEB) is one of those drugs, belonging to the class of third generation ß1-adrenoceptors selective blockers. NEB is composed of a racemic mixture of two enantiomers: d-nebivolol, which exerts antagonist effects on ß1-adrenoceptors, and l-nebivolol, a vascular ß3 receptor agonist. There are several studies that report different actions of NEB, not only for the treatment of SAH, but also as an antioxidant agent or even as a protector of renal damage. The aim of this systematic review was to investigate the available evidence regarding the effects of NEB on kidney diseases, evaluating its possible renoprotective action.
Assuntos
Nebivolol/farmacologia , Nebivolol/uso terapêutico , Substâncias Protetoras/farmacologia , Substâncias Protetoras/uso terapêutico , Insuficiência Renal Crônica/tratamento farmacológico , Antagonistas de Receptores Adrenérgicos beta 3/farmacologia , Antagonistas de Receptores Adrenérgicos beta 3/uso terapêutico , Animais , Humanos , Hipertensão/tratamento farmacológico , Menopausa/efeitos dos fármacos , Receptores Adrenérgicos beta 3RESUMO
BACKGROUND: After serious epidemics of chikungunya (CHIKV) and Zika (ZIKV) in the Americas, dengue (DENV) have reemerged in most countries. We analyzed the incidence, incidence rates, and evolution of DENV cases in Honduras from 2015 to 2018 and the ongoing 2019 epidemic. METHODS: Using epidemiological weeks (EW) surveillance data on the DENV in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental, and municipal levels. RESULTS: From January 1, 2016 to July 21, 2019, a total of 109,557 cases of DENV were reported, 28,603 in 2019, with an incidence rate of 312.32 cases/100,000 population this year; 0.13% laboratory-confirmed. The highest peak was reached on the EW 28°, 2019 (5299 cases; 57.89 cases/100,000 population). The department with the highest number of cases and incidence rate was Cortes (8404 cases, 479.68 cases/100,000 population in 2019). DISCUSSION: The pattern and evolution of DENV epidemic in 2019 in Honduras has been similar to that which occurred for in 2015. As previously reported, this epidemic involved the north and central areas of the country predominantly, reaching municipality incidences there >1000 cases/100,000 population (or 1%). Studies using geographical information systems linked with clinical disease characteristics are necessary to obtain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.