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ISSN (Print): 2359-4802 | ISSN (Online): 2359-5647

Edition: 26.1 - 13 Article(s)

Editorial

Hybrid operating room: a new reality in Brazil and worldwide

Sala cirúrgica híbrida: uma nova realidade no Brasil e no mundo

Carlos Galhardo Júnior

Rev Bras Cardiol. 2013;26(1):8-10

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Point of View

Demystifying the management of hypertensive dental patients

Desmistificando o atendimento odontológico ao paciente hipertenso

Allan Abuabara; Clovis Hoepfner

Rev Bras Cardiol. 2013;26(1):11-13

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Hypertension is a public health problem and the literature lacks an approach focused on the outpatient dental treatment of hypertensive patients. The purpose of this study is to ascertain whether blood pressure limits have been set for medical and dental outpatient procedures, through a review of the Hypertension and Perioperative Cardiovascular Guidelines. As no evidence was found in cardiology that underpins the establishment of blood pressure limits for medical and dental outpatient procedures, there are thus no reasons to implement limits for these procedures, based on blood pressure.


Keywords: Hypertension; dentistry; Public health; Dental care for the chronically ill.

Polypill as a prevention strategy for cardiovascular diseases

Polipílula como estratégia de prevenção em doenças cardiovasculares

Camila Aparecida de Souza Segrégio Reis; Rogério de Mattos Bártholo; Ricardo Mourilhe-Rocha

Rev Bras Cardiol. 2013;26(1):14-16

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Cardiovascular disease is today the main cause of morbidity and mortality all over the world. Optimizing prevention and reaching out to more segments of the population is a goal that has long been pursued. A combination of several medications prescribed for cardiovascular disease, the polypill appears in this context, seeking an ideal, simple and conclusive medication that offers primary and secondary prevention.


Keywords: Cardiovascular diseases/prevention&control; Drug combination; Pharmaceutical preparations

Original Article

Iron intake and anemia in hypertensive and/or diabetic women

Consumo de ferro e anemia em mulheres hipertensas e/ou diabéticas

Priscila Nunes de Vasconcelos; Tatiana Maria Palmeira dos Santos; Sandra Mary Lima Vasconcelos

Rev Bras Cardiol. 2013;26(1):17-25

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BACKGROUND: As a precipitating or aggravating factor for heart failure, anemia becomes a prognostic factor for hypertensive and diabetic patients.
OBJECTIVE: To assess iron (Fe) intake and determine the frequency of anemia in hypertensive and/or diabetic women.
METHODS: A retrospective study of 943 hypertensive and/or diabetic women was conducted in the city of Maceio, Alagoas State, Brazil, between 2007 and 2009, divided into two groups by the Recommended Dietary Allowance for iron: women of childbearing age: 19-50 years, RDA-Iron: 8.1 mg; and women in menopause: >50 years, RDA-Iron: 5 mg. The Fe intake was assessed by: (1) analyzing Fe inadequacy % vs needs; and (2) bioavailable Fe. Anemia was assessed by capillary hemoglobin <12 g/dL. Correlation tests (Spearman and Pearson) were run, as well as X2 (p < 0.05).
RESULTS: Iron consumption was inadequate in 28.4% (>50 yrs old) and 37% (19-50 years old) with anemia rates of 27.5% and 30.5% respectively. The estimated bioavailable Fe intake among patients between 19-50 years old was 0.75 mg and 0.56 mg among women aged > 50 years old, below the recommended levels of 2.8 mg for women of childbearing age and 0.9 mg during menopause. The mean total dietary iron intake was 9.86±5.15 mg for women between 19-50 years old and 8.90±4.65 mg for those >50 years old. A strong inverse correlation was noted between bioavailable Fe and capillary hemoglobin (Hb) in the >50 years range (r: -0.80), with a weak positive correlation (r: 0.011) for those between 19-50 years old, although not statistically significant.
CONCLUSION: The rate for insufficient Fe intake and anemia was high.


Keywords: Iron-deficiency anemia; Diet; Hypertension

Dyslipidemia and cardiovascular risk in antiretroviral therapy: management of modifiable factors

Dislipidemia e risco cardiovascular na terapia antirretroviral: o manejo dos fatores modificáveis

Aureliano Inácio de Souza Neto; José Maria Peixoto; Alexandre Sampaio Moura; Palmira de Fátima Bonolo

Rev Bras Cardiol. 2013;26(1):26-32

Abstract PDF PORT

BACKGROUND: Antiretroviral therapy (ART) used for HIV infection has helped lower morbidity and mortality rates. However, ART drugs tend to increase lipid levels and redistribute body fat, with increased insulin resistance. The incidence of premature cardiovascular diseases is expected to rise, due to this high cardiovascular risk profile and increased life expectancy among patients infected with HIV.
OBJECTIVE: To analyze associations between antiretroviral therapy and lipid profiles and cardiovascular risks among people living with HIV and AIDS.
METHODS: A retrospective observational study based on 42 medical records of HIV/AIDS patients monitored at the North Medical Specialties Center, UNIFENAS BH and the Eduardo de Menezes Hospital (HEM MG) was conducted through a progressive analysis of serum lipids and cardiovascular risks during the first year of antir etroviral therapy.
RESULTS: Most (76.2%) of the population in this study were men, with a mean age of 43±10.50 years. The mean LDL serum levels rose from 106.3±33.06 mg/dl to 129.9±38.40 mg/dl after 12 months of therapy (p=0.007), with cholesterol up from 178.5±42.20 mg/dl to 204.7±49.03 mg/dl (p=0.040). The average cardiovascular risk rose from 5.2±1.41% to 7.8±1.35% (p=0.028). If all the modifiable risk factors were treated for medium to high risk patients, 88.9% of them would drop to a low risk rating.
CONCLUSION: There was an increase in TC and LDL-C serum levels and cardiovascular risks during the first year after starting antiretroviral therapy.


Keywords: Dyslipidemias; HIV; Antiretroviral therapy

Analysis of reprocessing hemodynamic catheters in a Brazilian state capital

Análise do reprocessamento de cateteres de hemodinâmica em uma capital brasileira

Flávia Myrna Tenório de Sousa Bomfim; Sandro Gonçalves de Lima; Edgar Guimarães Victor

Rev Bras Cardiol. 2013;26(1):33-39

Abstract PDF PORT

BACKGROUND: Reprocessing single-use devices (SUDs) is a practice found in the developed countries and in developing countries as well, due to the high costs of these items. In Brazil, there are few studies on reprocessing hemodynamic catheters.
OBJECTIVE: To evaluate the prevalence and conditions for reprocessing hemodynamic catheters in the city of Recife, Pernambuco State, Brazil.
METHODS: This cross-sectional study evaluates four government hospitals and six private hospitals, interviewing 10 nurses and 82 nursing technicians working in the hemodynamics sectors. Data was gathered through a questionnaire.
RESULTS: All the hospitals surveyed reprocessed catheters, but only one handled all the reprocessing stages in-house. At most of these hospitals, catheters are reused four times on average. Significant differences in the replies provided by the nurses and nursing technicians were noted, reflecting a lack of standardization in the reprocessing techniques. Most of these practitioners had already detected fractures and twists in reprocessed catheters. Enzyme preparations were used by more than 80% of the technicians for cleaning the catheters, with no uniformity on cleaning the lumen in their replies. Although most of them used tap water to rinse the catheters, the techniques used varied greatly. Tests to check pyrogenic materials were not performed on all the reprocessed materials.
CONCLUSION: All of the evaluated hospital units reprocessed hemodynamic catheters, although the techniques used are not standardized.


Keywords: Catheters; Hemodynamic; Reprocessing

Relationship between nursing diagnosis and quality of life in patients with heart failure

Relação entre diagnóstico de enfermagem e qualidade de vida em pacientes com insuficiência cardíaca

Luana Evelyn de Oliveira Amorim; Marilda Andrade; Ronaldo Campos Rodrigues; Jader Cunha de Azevedo; Aline Nogueira de Oliveira; Sandra Marina Ribeiro de Miranda; Leandro Rocha Messias; Claudio Tinoco Mesquita

Rev Bras Cardiol. 2013;26(1):40-44

Abstract PDF PORT

BACKGROUND: Heart failure results in physical and psychological constraints that downgrade the quality of life for patients to a considerable extent. Outstanding among the physical symptoms are fatigue and dyspnea, which worsen steadily with this syndrome.
OBJECTIVE: To identify the nursing diagnoses found most frequently for patients with heart failure, related to changes in the pr esented quality of life.
METHODS: Seventeen consecutive patients with systolic HF (left ventricular ejection fraction (LVEF) <45%) referred to our heart failure clinic were recruited. In order to identify the nursing diagnoses, the North American Nursing Diagnosis Association -International (NANDA) was used, with the Minnesota Living with Heart Failure Questionnaire (MLHFQ) used to evaluate the quality of life at two points: initial (baseline) and after 3 months of treatment (post-treatment). Scores were considered in subscales (dimensions) reflecting physical difficulties (Questions 1 to 7, 12 and 13 presented by patients due to clinical symptoms.
RESULTS: The identified diagnoses with the highest scores were: fatigue - baseline (2.35) and post treatment (1.24); breathlessness - baseline (2.35) and post treatment (1.69); and impaired physical mobility - baseline (2.88) and post tr eatment (1.50).
CONCLUSION: The nursing diagnoses identified in patients with heart failure presented correlations with the quality of life of these patients, thus contributing to a therapeutic approach intended not only to preserve life but also to prolong it with quality.


Keywords: Heart failure; Quality of life; Nursing diagnosis

Prevalence of cardiovascular risk factors among military police officers

Prevalência de fatores de risco cardiovascular em policiais militares

Robson Ourives Barbosa; Eveline Fronza da Silva

Rev Bras Cardiol. 2013;26(1):45-53

Abstract PDF PORT

BACKGROUND: The appearance of cardiovascular diseases is prompted by a set of factors that are circumstances with partial actions, whose sum increases or even multiplies their pr obability.
OBJECTIVE: To identify the prevalence of modifiable and non-modifiable cardiovascular risk factors, stratified by gender among military police officers in the 35th Military Police Battalion, Rio Grande do Sul State, Brazil.
METHODS: A quantitative survey was conducted through an analytical observational and crosssectional study, using data from official information and evaluation sheets, in addition to individual completion of a specific questionnaire, structured with closed questions.
RESULTS: The sample consisted of 112 military police officers, predominantly male (87.50%), between 20 and 54 years old. The most prevalent cardiovascular risk factors noted were: 58.04% for family history; 67.86% for alcohol consumption; 36.61% for insufficient physical activities; overweight for 54.05%; 54.05% for dyslipidemia; and 93.75% for stress.
CONCLUSIONS: Among the non-modifiable cardiovascular risk factors, the findings presented in this study indicated the prevalence of men with family histories of CVD. Among the modifiable risk factors, there was a predominance of insufficiently active dyslipidemic males in the overweight range with significant alcohol consumption. The prevalence among women was very frequently stressed and insufficient physical activity.


Keywords: Cardiovascular diseases; Risk factors; Stress psychological; Police; Quality of life

Case Report

Heart failure with normal ejection fraction in a young adult patient

Insuficiência cardíaca com fração de ejeção normal em paciente adulto jovem

Tadeu Batista Pinheiro; Cristiano Almeida Tiradentes; Antonio José Lagoeiro Jorge; Mario Luiz Ribeiro; Evandro Tinoco Mesquita

Rev Bras Cardiol. 2013;26(1):54-57

Abstract PDF PORT

Heart failure with normal ejection fraction (HFNEF) is a complex syndrome, characterized by the presence of signs and/or symptoms of heart failure (HF), left ventricle ejection fraction >50% and diastolic dysfunction; common in older women with hypertension, it is difficult to diagnose. This case report describes a hypertensive female patient (43 years old) who developed HFNEF, and who then achieved a regression in her clinical status with improved morphofunctional anormalies through antihypertensive treatment and the use of cardiac remodeling drugs.


Keywords: Heart failure; Diastolic dysfunction; Ventricular arterial interaction

Intrastent thrombosis and clopidogrel resistance in diabetic patients

Trombose intrastent e resistência ao clopidogrel em pacientes diabéticos

Alexandre Fuchs; Marcelo Machado de Castro; Daniela Dias de Almeida; Flávia Prado Fialho; Gustavo Coulon Perim; Martha Demetrio Rustum

Rev Bras Cardiol. 2013;26(1):58-61

Abstract PDF PORT

Acute coronary syndrome (ACS) is an extremely prevalent condition that requires medical staff, diagnostic accuracy and fast treatment. Data provided by the World Health Organization indicate cardiovascular disease as the main cause of mortality worldwide. The risk of coronary artery disease (CAD) rises particularly in the presence of diabetes mellitus (DM). This disease causes endothelial dysfunction by increasing the systemic inflammatory status, causing dysfunction in platelet aggregation. The efficacy of drugs used to treat ACS, especially antiplatelet agents, may be reduced through systemic changes caused by DM. These changes may be responsible for an increased number of thromboembolic events such as intrastent thrombosis in angioplasty patients after acute myocardial infarction (AMI). The authors report a case of intra-stent thrombosis in a patient with decompensated diabetes mellitus while taking standard doses of clopidogrel and aspirin.


Keywords: Coronary artery disease/complications; Myocardial infarction; Diabetes mellitus; Platelet aggregation inhibitors; Angioplasty; Stents; Thrombosis

Ventricular septal perforation and rupture of the chordae tendineae of the tricuspid valve after acute myocardial infarction

Ruptura de parede septal e corda tendínea de valva tricúspide após infarto agudo do miocárdio

Marcos Antônio Leão de Araújo; Andrea Machado Salgado; Leilian de Souza Amorim; Marlúcia do Nascimento Nobre

Rev Bras Cardiol. 2013;26(1):62-65

Abstract PDF PORT

Postinfarction ventricular septal perforation (VSP) is a high-mortality complication with an incidence of 0.2%. This paper presents a case report on a patient presenting VSP in association with a possible rupture of the chordae tendineae of the tricuspid valve.


Keywords: Acute myocardial infarction; Ventricular septal perforation; Echocardiography; Tricuspid valve; Chordae tendineae

Review Article

Resistance training and metabolic syndrome: a systematic review

Treinamento de força e síndrome metabólica: uma revisão sistemática

Ramires Alsamir Tibana; Jonato Prestes

Rev Bras Cardiol. 2013;26(1):66-76

Abstract PDF PORT

Non-pharmacological interventions such as resistance training (RT) have been recommended by several health organizations for the prevention and treatment of non-transmissible chronic diseases. This paper offers a systemic review of the literature addressing the ongoing effects of RT on cardiovascular risk factors, muscle strength and fat-free mass in individuals with metabolic syndrome (MetS), using the Pubmed, Scielo and LILACS databases. The search was limited to the period between 1988 and 2012. The search terms consisted of Portuguese and English keywords selected according to the Descriptors in Health Sciences classification: treinamento resistido, doenças metabólicas, and resistance training and metabolic diseases. Only five papers were found that demonstrated few or no alterations to waist circumference, serum lipids, glycemia and blood pressure, although most of them reported increased muscle strength and fat-free mass. This review leads to the conclusion that MetS is a disease related to several cardiovascular diseases, diabetes and cancer, with higher probable mortality rates. Although muscle strength is inversely related to the development of MetS, RT was not particularly effective for reducing cardiovascular risk factors in individuals with MetS.


Keywords: Metabolic syndrome; Cardiovascular diseases; Muscle strength

Erratum

Erratum

Rev Bras Cardiol. 2013;26(1):77

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