RESUMO
The primary aim of this study was to evaluate penile endothelial microvascular function in patients with primary arterial hypertension and age-matched normotensive subjects using laser speckle contrast imaging (LSCI). Additionally, we analyzed the acute penile microvascular effects induced by oral phosphodiesterase type 5 inhibitor (sildenafil; SIL) administration. Endothelium-dependent microvascular reactivity was evaluated in the penises and forearms of hypertensive patients (aged 58.8±6.6 years, n=34) and age-matched healthy volunteers (n=33) at rest and 60 min following oral SIL (100 mg) administration. LSCI was coupled with cutaneous acetylcholine (ACh) iontophoresis using increasing anodal currents. Basal penile cutaneous vascular conductance (CVC) values were not significantly different between control subjects and hypertensive individuals. Penile CVC values increased significantly after SIL administration in control (P<0.0001) and hypertensive (P<0.0001) subjects. Peak CVC values were not different between the two groups during penile ACh iontophoresis before SIL administration (P=0.2052). Peak CVC values were higher in control subjects than in hypertensive subjects after SIL administration (P=0.0427). Penile endothelium-dependent microvascular function is, to some extent, preserved in patients presenting with primary arterial hypertension under effective anti-hypertensive treatment. LSCI may be a valuable non-invasive tool for the evaluation of penile vascular responses to phosphodiesterase type 5 inhibitor.
Assuntos
Endotélio Vascular/fisiopatologia , Hipertensão/fisiopatologia , Pênis/irrigação sanguínea , Inibidores da Fosfodiesterase 5/administração & dosagem , Citrato de Sildenafila/administração & dosagem , Idoso , Estudos de Casos e Controles , Voluntários Saudáveis , Humanos , Fluxometria por Laser-Doppler/métodos , Masculino , Microcirculação , Pessoa de Meia-Idade , Pênis/efeitos dos fármacos , Fluxo Sanguíneo Regional , Vasodilatação/efeitos dos fármacosRESUMO
The primary aim of this study was to evaluate penile endothelial microvascular function in patients with primary arterial hypertension and age-matched normotensive subjects using laser speckle contrast imaging (LSCI). Additionally, we analyzed the acute penile microvascular effects induced by oral phosphodiesterase type 5 inhibitor (sildenafil; SIL) administration. Endothelium-dependent microvascular reactivity was evaluated in the penises and forearms of hypertensive patients (aged 58.8±6.6 years, n=34) and age-matched healthy volunteers (n=33) at rest and 60 min following oral SIL (100 mg) administration. LSCI was coupled with cutaneous acetylcholine (ACh) iontophoresis using increasing anodal currents. Basal penile cutaneous vascular conductance (CVC) values were not significantly different between control subjects and hypertensive individuals. Penile CVC values increased significantly after SIL administration in control (P<0.0001) and hypertensive (P<0.0001) subjects. Peak CVC values were not different between the two groups during penile ACh iontophoresis before SIL administration (P=0.2052). Peak CVC values were higher in control subjects than in hypertensive subjects after SIL administration (P=0.0427). Penile endothelium-dependent microvascular function is, to some extent, preserved in patients presenting with primary arterial hypertension under effective anti-hypertensive treatment. LSCI may be a valuable non-invasive tool for the evaluation of penile vascular responses to phosphodiesterase type 5 inhibitor.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Endotélio Vascular/fisiopatologia , Hipertensão/fisiopatologia , Pênis/irrigação sanguínea , Inibidores da Fosfodiesterase 5/administração & dosagem , Citrato de Sildenafila/administração & dosagem , Estudos de Casos e Controles , Voluntários Saudáveis , Fluxometria por Laser-Doppler/métodos , Microcirculação , Pênis/efeitos dos fármacos , Fluxo Sanguíneo Regional , Vasodilatação/efeitos dos fármacosRESUMO
Evaluation of microvascular endothelial function is essential for investigating the pathophysiology and treatment of cardiovascular and metabolic diseases. Although laser speckle contrast imaging technology is well accepted as a noninvasive methodology for assessing microvascular endothelial function, it has never been used to compare male patients with coronary artery disease with male age-matched healthy controls. Thus, the aim of this study was to determine whether laser speckle contrast imaging could be used to detect differences in the systemic microvascular functions of patients with established cardiovascular disease (n=61) and healthy age-matched subjects (n=24). Cutaneous blood flow was assessed in the skin of the forearm using laser speckle contrast imaging coupled with the transdermal iontophoretic delivery of acetylcholine and post-occlusive reactive hyperemia. The maximum increase in skin blood flow induced by acetylcholine was significantly reduced in the cardiovascular disease patients compared with the control subjects (74 vs 116%; P<0.01). With regard to post-occlusive reactive hyperemia-induced vasodilation, the patients also presented reduced responses compared to the controls (0.42±0.15 vs 0.50±0.13 APU/mmHg; P=0.04). In conclusion, laser speckle contrast imaging can identify endothelial and microvascular dysfunctions in male individuals with cardiovascular disease. Thus, this technology appears to be an efficient non-invasive technique for evaluating systemic microvascular and endothelial functions, which could be valuable as a peripheral marker of atherothrombotic diseases in men.
Assuntos
Doença da Artéria Coronariana/fisiopatologia , Endotélio Vascular/fisiopatologia , Fluxometria por Laser-Doppler/métodos , Microvasos/fisiopatologia , Imagem de Perfusão/métodos , Idoso , Estudos de Casos e Controles , Meios de Contraste , Doença da Artéria Coronariana/diagnóstico por imagem , Estudos Transversais , Endotélio Vascular/diagnóstico por imagem , Humanos , Hiperemia/fisiopatologia , Masculino , Microcirculação/fisiologia , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Pele/irrigação sanguínea , Estatísticas não ParamétricasRESUMO
Evaluation of microvascular endothelial function is essential for investigating the pathophysiology and treatment of cardiovascular and metabolic diseases. Although laser speckle contrast imaging technology is well accepted as a noninvasive methodology for assessing microvascular endothelial function, it has never been used to compare male patients with coronary artery disease with male age-matched healthy controls. Thus, the aim of this study was to determine whether laser speckle contrast imaging could be used to detect differences in the systemic microvascular functions of patients with established cardiovascular disease (n=61) and healthy age-matched subjects (n=24). Cutaneous blood flow was assessed in the skin of the forearm using laser speckle contrast imaging coupled with the transdermal iontophoretic delivery of acetylcholine and post-occlusive reactive hyperemia. The maximum increase in skin blood flow induced by acetylcholine was significantly reduced in the cardiovascular disease patients compared with the control subjects (74 vs 116%; P<0.01). With regard to post-occlusive reactive hyperemia-induced vasodilation, the patients also presented reduced responses compared to the controls (0.42±0.15 vs 0.50±0.13 APU/mmHg; P=0.04). In conclusion, laser speckle contrast imaging can identify endothelial and microvascular dysfunctions in male individuals with cardiovascular disease. Thus, this technology appears to be an efficient non-invasive technique for evaluating systemic microvascular and endothelial functions, which could be valuable as a peripheral marker of atherothrombotic diseases in men.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Doença da Artéria Coronariana/fisiopatologia , Endotélio Vascular/fisiopatologia , Fluxometria por Laser-Doppler/métodos , Microvasos/fisiopatologia , Imagem de Perfusão/métodos , Estudos de Casos e Controles , Meios de Contraste , Doença da Artéria Coronariana/diagnóstico por imagem , Estudos Transversais , Endotélio Vascular/diagnóstico por imagem , Hiperemia/fisiopatologia , Microcirculação/fisiologia , Microvasos/diagnóstico por imagem , Projetos Piloto , Reprodutibilidade dos Testes , Pele/irrigação sanguínea , Estatísticas não ParamétricasRESUMO
Between March and July 1996, a focalized epidemic outbreak of cutaneous leishmaniasis in General Vedia, province of Chaco, associated to the gallery forest of the Oro river was verified. The incidence rate in the area, which was 0-2/000 cases in preceding years, reached 8/000 cases in 1996. The risk of symptomatic infection was similar between sexes, but was different when analyzing the different age groups by sex, suggesting a greater relative importance of the peridomestic transmission for the females and of the transmission in the subtropical forest for the males. Specimens of Lutzomyia intermedia, a species already incriminated as a vector of Leishmaniasis in other provinces of northern Argentina, were captured and identified in the focus locality in May 1996. The possible causes of the outbreak related to the climatic variables and the vector abundance are analyzed and the results in the framework of possible preventive and control activities are discussed.
Assuntos
Surtos de Doenças , Leishmaniose Cutânea/epidemiologia , Adolescente , Adulto , Idoso , Animais , Argentina/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Insetos Vetores , Masculino , Pessoa de Meia-Idade , Estações do AnoRESUMO
Se presenta el programa de seguimiento para niños con síndrome de Down (Atención integral en niños Down: At.i.en.Do.) del Hospital "Ramón Sardá" (HMIRS).
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Seguimentos , Equipe de Assistência ao Paciente/organização & administração , Síndrome de Down/genética , Síndrome de Down/psicologia , Síndrome de Down/reabilitação , Estimulação Física/métodos , Aprendizagem VerbalRESUMO
Se presenta el programa de seguimiento para niños con síndrome de Down (Atención integral en niños Down: At.i.en.Do.) del Hospital "Ramón Sardá" (HMIRS). (AU)