RESUMO
Intradialytic hypotension is a common complication during hemodialysis sessions. The analysis of successive RR interval variability using nonlinear methods represents a promising tool for evaluating the cardiovascular response to acute volemic changes. Thus, the present study aims to compare the variability of successive RR intervals between hemodynamically stable (HS) and unstable (HU) patients during a hemodialysis session, through linear and nonlinear methods. Forty-six chronic kidney disease patients volunteered in this study. Successive RR intervals and blood pressures were recorded throughout the hemodialysis session. Hemodynamic stability was defined based on the delta of systolic blood pressure (higher SBP-lower SBP). The cutoff for hemodynamic stability was defined as 30 mm Hg, and patients were stratified as: HS ([n = 21]: ≤29.9 mm Hg) or HU ([n = 25]: ≥30 mm Hg). Linear methods (low-frequency [LFnu] and high-frequency [HFnu] spectra) and nonlinear methods (multiscale entropy [MSE] for Scales 1-20, and fuzzy entropy) were applied. The area under the MSE curve at Scales 1-5 (MSE1-5), 6-20 (MSE6-20), and 1-20 (MSE1-20) were also used as nonlinear parameters. Frequentist and Bayesian inferences were applied to compare HS and HU patients. The HS patients exhibited a significantly higher LFnu and lower HFnu. For MSE parameters, Scales 3-20 were significantly higher, as well as MSE1-5, MSE6-20, and MSE1-20 in HS, when compared to HU patients (p < 0.05). Regarding Bayesian inference, the spectral parameters demonstrated an anecdotal (65.9%) posterior probability favoring the alternative hypothesis, while MSE exhibited moderate to very strong probability (79.4 to 96.3%) at Scales 3-20, and MSE1-5, MSE6-20, and MSE1-20. HS patients exhibited a higher heart-rate complexity than HU patients. In addition, the MSE demonstrated a greater potential than spectral methods to differentiate variability patterns in successive RR intervals.
RESUMO
Objetivou-se discutir a publicidade de bebidas alcoólicas na mídia televisiva e o consumo de bebidas alcoólicas por universitários por meio de uma revisão integrativa de literatura. O estudo foi realizado com 25 artigos, das bases de dados LILACS e MEDLINE, publicados entre os anos 2011 e 2017. Verificou-se que a referência ao consumo de álcool na televisão tem atingido grupos vulneráveis utilizando-se de diversas estratégias que incentivam este consumo. Considera-se necessário educar os jovens de maneira que estes exerçam sua criticidade na análise do que é exposto pela mídia.
The objective was to discuss the advertising of alcoholic beverages in the television media and the consumption of alcoholic drinks by university students, through an integrative literature review. The study was conducted with 25 articles from the LILACS and MEDLINE databases, published between 2011 and 2017. It has been verified that the reference to alcohol consumption on television has reached vulnerable groups, using several strategies that encourage this consumption. It is considered necessary to educate young people so that they exercise their criticality in the analysis of what is exposed by the media.
Se objetivó discutir la publicidad de bebidas alcohólicas en los medios televisivos y el consumo de bebidas alcohólicas por universitarios, a través de una revisión integrativa de literatura. El estudio fue realizado con 25 artículos de las bases de datos LILACS y MEDLINE, publicados entre los años 2011 y 2017. Se verificó que la referencia al consumo de alcohol en la televisión ha alcanzado a grupos vulnerables, utilizando de diversas estrategias que incentivan este consumo. Se considera necesario educar a los jóvenes de manera que éstos ejerzan su criticidad en el análisis de lo que es expuesto por los medios.