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  1 / 1939 MEDLINE  
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[PMID]:28456777
[Au] Autor:Deska P; Nowicki M
[Ad] Endereço:Department of Internal Medicine District Hospital, Klobuck, Poland.
[Ti] Título:Short-term changes of serum potassium concentration induced by physical exercise in patient with arterial hypertension treated with angiotensin-converting enzyme inhibitor alone or in combination with statin.
[So] Source:J Physiol Pharmacol;68(1):133-138, 2017 Feb.
[Is] ISSN:1899-1505
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Intensive physical exercise may facilitate potassium release from skeletal muscles that may result in hyperkalemia. Commonly used drugs including angiotensin converting enzyme inhibitors (ACEI) and statins increase a risk of hyperkalemia. It is not known whether the effect of these drugs on serum potassium during physical exercise is additive. The study compared the effect of physical exercise on the changes of serum potassium in hypertensive patients receiving ACEI alone or in combination with statin. Eighteen patients with arterial hypertension with normal renal function were included in a prospective placebo-controlled cross-over study. The patients underwent 3 exercise tests on a bicycle ergometer with 55 - 60% of maximum oxygen consumption each lasting 30 minutes, i.e. after being treated with ACEI alone for six months, and then in a random order after the administration of ACEI with statin or ACEI with placebo each time for eight weeks separated by 2-week wash-out. Serum potassium was measured with atomic emission flame spectrometry before and after 15 and 30 minutes exercise and after 30-minute recovery. During the exercise serum potassium concentration increased moderately but significantly during all exercise tests. Mean serum potassium during exercise remained within the normal range. There were no differences in the exercise-induced changes of serum potassium during the exercise tests performed after ACEI combined with statin or with placebo. Addition of statin to ACEI does not increase the risk of hyperkalemia in hypertensive patients with preserved renal function during physical exercise with intensity typical for routine daily activities.
[Mh] Termos MeSH primário: Inibidores da Enzima Conversora de Angiotensina/farmacologia
Exercício/fisiologia
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
Hipertensão/sangue
Potássio/sangue
Ramipril/farmacologia
Sinvastatina/farmacologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Estudos Cross-Over
Quimioterapia Combinada
Teste de Esforço
Feminino
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Hipertensão/tratamento farmacológico
Hipertensão/urina
Masculino
Meia-Idade
Potássio/urina
Ramipril/uso terapêutico
Sinvastatina/uso terapêutico
Método Simples-Cego
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); AGG2FN16EV (Simvastatin); L35JN3I7SJ (Ramipril); RWP5GA015D (Potassium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  2 / 1939 MEDLINE  
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[PMID]:28974567
[Au] Autor:Mancia G; Schumacher H; Böhm M; Redon J; Schmieder RE; Verdecchia P; Sleight P; Teo K; Yusuf S
[Ad] Endereço:From the University of Milano-Bicocca and IRCCS Istituto Auxologico Italiano, Italy (G.M.); Statistical Consultant, Ingelheim, Germany (H.S.); Klinik für innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany (M.B.); Hypertension Clinic, Department of Internal Medicine, Hospi
[Ti] Título:Relative and Combined Prognostic Importance of On-Treatment Mean and Visit-to-Visit Blood Pressure Variability in ONTARGET and TRANSCEND Patients.
[So] Source:Hypertension;70(5):938-948, 2017 Nov.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In 28 790 patients recruited for the ONTARGET (Ongoing Treatment Alone and in Combination With Ramipril Global End Point Trials) and TRANSCEND (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease) trials, we investigated the prognostic value for cardiovascular events (primary outcome) of (1)on-treatment visit-to-visit systolic blood pressure (SBP) variability versus mean SBP and (2) the 2 measures together. SBP variability was measured by the coefficient of variation (CV) of mean SBP to which it was unrelated. Confounders such as variable time and number of visits from which to calculate SBP-CV were avoided by using the same number of visits at identical times in all patients. The covariate-adjusted risk of the primary outcome (Cox models) increased as SBP-CV or mean on-treatment quintile SBP increased, but only for mean on-treatment SBP, the relationship achieved statistical significance: global test for trend, =0.12 versus <0.0001. SBP-CV showed a relationship with fatal events, but it was unrelated to the risk of myocardial infarction and stroke, which were predicted by on-treatment mean SBP. Prediction of the primary outcome improved by the combined use of both measures: global test for trend, <0.0001; hazard ratio for combined fifth versus first quintile, 1.42 (1.20-1.68) compared with 1.13 (1.01-1.27) for SBP-CV and 1.24 (1.11-1.40) for mean SBP. Thus, in the present study, on-treatment mean SBP provided an overall better prediction of cardiovascular risk than visit-to-visit SBP-CV. Prediction improved by their combined use, which may thus offer a more precise estimate of the protective effect of treatment. CLINICAL TRIAL REGISTRATION: URL: http//www.clinicaltrial.gov. Unique identifier: NCT153.101.
[Mh] Termos MeSH primário: Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Determinação da Pressão Arterial
Pressão Sanguínea/efeitos dos fármacos
Doenças Cardiovasculares
Hipertensão
Ramipril/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Análise de Variância
Anti-Hipertensivos/uso terapêutico
Determinação da Pressão Arterial/métodos
Determinação da Pressão Arterial/estatística & dados numéricos
Doenças Cardiovasculares/epidemiologia
Doenças Cardiovasculares/prevenção & controle
Feminino
Seres Humanos
Hipertensão/diagnóstico
Hipertensão/tratamento farmacológico
Masculino
Meia-Idade
Variações Dependentes do Observador
Visita a Consultório Médico/estatística & dados numéricos
Valor Preditivo dos Testes
Prognóstico
Medição de Risco/métodos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Antihypertensive Agents); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.117.09714


  3 / 1939 MEDLINE  
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[PMID]:28595700
[Au] Autor:Fearon WF; Okada K; Kobashigawa JA; Kobayashi Y; Luikart H; Sana S; Daun T; Chmura SA; Sinha S; Cohen G; Honda Y; Pham M; Lewis DB; Bernstein D; Yeung AC; Valantine HA; Khush K
[Ad] Endereço:Stanford Cardiovascular Institute and Division of Cardiovascular Medicine, Stanford, California; Cardiology Section, Palo Alto Veterans Affairs Health Care System, Palo Alto, California. Electronic address: wfearon@stanford.edu.
[Ti] Título:Angiotensin-Converting Enzyme Inhibition Early After Heart Transplantation.
[So] Source:J Am Coll Cardiol;69(23):2832-2841, 2017 Jun 13.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cardiac allograft vasculopathy (CAV) remains a leading cause of mortality after heart transplantation (HT). Angiotensin-converting enzyme inhibitors (ACEIs) may retard the development of CAV but have not been well studied after HT. OBJECTIVES: This study tested the safety and efficacy of the ACEI ramipril on the development of CAV early after HT. METHODS: In this prospective, multicenter, randomized, double-blind, placebo-controlled trial, 96 HT recipients were randomized to undergo ramipril or placebo therapy. They underwent coronary angiography, endothelial function testing; measurements of fractional flow reserve (FFR) and coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR); and intravascular ultrasonography (IVUS) of the left anterior descending coronary artery, within 8 weeks of HT. At 1 year, the invasive assessment was repeated. Circulating endothelial progenitor cells (EPCs) were quantified at baseline and 1 year. RESULTS: Plaque volumes at 1 year were similar between the ramipril and placebo groups (162.1 ± 70.5 mm vs. 177.3 ± 94.3 mm , respectively; p = 0.73). Patients receiving ramipril had improvement in microvascular function as shown by a significant decrease in IMR (21.4 ± 14.7 to 14.4 ± 6.3; p = 0.001) and increase in CFR (3.8 ± 1.7 to 4.8 ± 1.5; p = 0.017), from baseline to 1 year. This did not occur with IMR (17.4 ± 8.4 to 21.5 ± 20.0; p = 0.72) or CFR (4.1 ± 1.8 to 4.1 ± 2.2; p = 0.60) in the placebo-treated patients. EPCs decreased significantly at 1 year in the placebo group but not in the ramipril group. CONCLUSIONS: Ramipril does not slow development of epicardial plaque volume but does stabilize levels of endothelial progenitor cells and improve microvascular function, which have been associated with improved long-term survival after HT. (Angiotensin Converting Enzyme [ACE] Inhibition and Cardiac Allograft Vasculopathy; NCT01078363).
[Mh] Termos MeSH primário: Circulação Coronária/fisiologia
Vasos Coronários/diagnóstico por imagem
Rejeição de Enxerto/tratamento farmacológico
Transplante de Coração/efeitos adversos
Ramipril/administração & dosagem
[Mh] Termos MeSH secundário: Inibidores da Enzima Conversora de Angiotensina/administração & dosagem
Angiografia Coronária
Vasos Coronários/fisiopatologia
Método Duplo-Cego
Seguimentos
Rejeição de Enxerto/diagnóstico
Seres Humanos
Estudos Prospectivos
Fatores de Tempo
Resultado do Tratamento
Ultrassonografia de Intervenção
Resistência Vascular
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE


  4 / 1939 MEDLINE  
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[PMID]:28566504
[Au] Autor:Malik S; Suchal K; Khan SI; Bhatia J; Kishore K; Dinda AK; Arya DS
[Ad] Endereço:Department of Pharmacology, Cardiovascular Research Laboratory, All India Institute of Medical Sciences, New Delhi, India; and.
[Ti] Título:Apigenin ameliorates streptozotocin-induced diabetic nephropathy in rats via MAPK-NF-κB-TNF-α and TGF-ß1-MAPK-fibronectin pathways.
[So] Source:Am J Physiol Renal Physiol;313(2):F414-F422, 2017 Aug 01.
[Is] ISSN:1522-1466
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Diabetic nephropathy (DN), a microvascular complication of diabetes, has emerged as an important health problem worldwide. There is strong evidence to suggest that oxidative stress, inflammation, and fibrosis play a pivotal role in the progression of DN. Apigenin has been shown to possess antioxidant, anti-inflammatory, antiapoptotic, antifibrotic, as well as antidiabetic properties. Hence, we evaluated whether apigenin halts the development and progression of DN in streptozotocin (STZ)-induced diabetic rats. Male albino Wistar rats were divided into control, diabetic control, and apigenin treatment groups (5-20 mg/kg po, respectively), apigenin per se (20 mg/kg po), and ramipril treatment group (2 mg/kg po). A single injection of STZ (55 mg/kg ip) was administered to all of the groups except control and per se groups to induce type 1 diabetes mellitus. Rats with fasting blood glucose >250 mg/dl were included in the study and randomized to different groups. Thereafter, the protocol was continued for 8 mo in all of the groups. Apigenin (20 mg/kg) treatment attenuated renal dysfunction, oxidative stress, and fibrosis (decreased transforming growth factor-ß1, fibronectin, and type IV collagen) in the diabetic rats. It also significantly prevented MAPK activation, which inhibited inflammation (reduced TNF-α, IL-6, and NF-κB expression) and apoptosis (increased expression of Bcl-2 and decreased Bax and caspase-3). Furthermore, histopathological examination demonstrated reduced inflammation, collagen deposition, and glomerulosclerosis in the renal tissue. In addition, all of these changes were comparable with those produced by ramipril. Hence, apigenin ameliorated renal damage due to DN by suppressing oxidative stress and fibrosis and by inhibiting MAPK pathway.
[Mh] Termos MeSH primário: Anti-Inflamatórios/farmacologia
Antioxidantes/farmacologia
Apigenina/farmacologia
Diabetes Mellitus Experimental/tratamento farmacológico
Diabetes Mellitus Tipo 1/tratamento farmacológico
Nefropatias Diabéticas/prevenção & controle
Fibronectinas/metabolismo
Mediadores da Inflamação/metabolismo
Rim/efeitos dos fármacos
Proteínas Quinases Ativadas por Mitógeno/metabolismo
NF-kappa B/metabolismo
Fator de Crescimento Transformador beta1/metabolismo
Fator de Necrose Tumoral alfa/metabolismo
[Mh] Termos MeSH secundário: Inibidores da Enzima Conversora de Angiotensina/farmacologia
Animais
Apoptose/efeitos dos fármacos
Proteínas Reguladoras de Apoptose/metabolismo
Colágeno Tipo IV/metabolismo
Diabetes Mellitus Experimental/induzido quimicamente
Diabetes Mellitus Experimental/enzimologia
Diabetes Mellitus Experimental/patologia
Diabetes Mellitus Tipo 1/induzido quimicamente
Diabetes Mellitus Tipo 1/enzimologia
Diabetes Mellitus Tipo 1/patologia
Nefropatias Diabéticas/induzido quimicamente
Nefropatias Diabéticas/enzimologia
Nefropatias Diabéticas/patologia
Fibrose
Rim/enzimologia
Rim/patologia
Masculino
Estresse Oxidativo/efeitos dos fármacos
Ramipril/farmacologia
Ratos Wistar
Transdução de Sinais/efeitos dos fármacos
Estreptozocina
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Anti-Inflammatory Agents); 0 (Antioxidants); 0 (Apoptosis Regulatory Proteins); 0 (Collagen Type IV); 0 (Fibronectins); 0 (Inflammation Mediators); 0 (NF-kappa B); 0 (Tgfb1 protein, rat); 0 (Transforming Growth Factor beta1); 0 (Tumor Necrosis Factor-alpha); 5W494URQ81 (Streptozocin); 7V515PI7F6 (Apigenin); EC 2.7.11.24 (Mitogen-Activated Protein Kinases); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.1152/ajprenal.00393.2016


  5 / 1939 MEDLINE  
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[PMID]:28364692
[Au] Autor:Zakrocka I; Kocki T; Turski WA
[Ad] Endereço:Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland. Electronic address: izabela.zakrocka@umlub.pl.
[Ti] Título:The effect of three angiotensin-converting enzyme inhibitors on kynurenic acid production in rat kidney in vitro.
[So] Source:Pharmacol Rep;69(3):536-541, 2017 Jun.
[Is] ISSN:1734-1140
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The renin-angiotensin system (RAS) is commonly known to regulate blood pressure, water and electrolyte homeostasis, however it also exerts paracrine and autocrine actions on the kidney. Angiotensin-converting enzyme inhibitors (ACE-Is), alongside their hypotensive properties, have been shown to decrease kidney function decline in animal models of nephropathy. Glutamate (GLU) is the main stimulatory neurotransmitter in the central nervous system, however its importance in the periphery should also be considered. Activation of renal GLU receptors has been linked to normal kidney function and also renal injury. The wide spectrum GLU receptor antagonist kynurenic acid (KYNA) possesses neuroprotective and central hypotensive effects, however its actions outside the brain are less well recognized. KYNA is a tryptophan metabolite synthesized from kynurenine by kynurenine aminotransferases (KATs). The purpose of this study was to examine the influence of three ACE-Is: lisinopril, perindopril and ramipril on KYNA production and KATs activity in rat kidney in vitro. METHODS: The effect of ACE-Is on KYNA production and KATs activity was examined in rat kidney homogenates. KYNA was detected by high-performance liquid chromatography (HPLC) and quantified fluorometrically. RESULTS: All examined ACE-Is: lisinopril, perindopril and ramipril decreased KYNA production in rat kidney in vitro. KAT I activity was decreased by lisinopril and ramipril whereas the activity of KAT II was lowered by ramipril. CONCLUSION: Our study shows that ACE-Is can decrease KYNA production in rat kidney in vitro. Further studies are required to determine the clinical importance of the inhibitory action of ACE-Is on KYNA synthesis in the kidney.
[Mh] Termos MeSH primário: Inibidores da Enzima Conversora de Angiotensina/farmacologia
Rim/efeitos dos fármacos
Ácido Cinurênico/metabolismo
Sistema Renina-Angiotensina/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Cromatografia Líquida de Alta Pressão
Rim/metabolismo
Lisinopril/farmacologia
Masculino
Perindopril/farmacologia
Ramipril/farmacologia
Ratos
Ratos Wistar
Transaminases/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); E7199S1YWR (Lisinopril); EC 2.6.1.- (Transaminases); EC 2.6.1.7 (kynurenine-oxoglutarate transaminase); H030S2S85J (Kynurenic Acid); L35JN3I7SJ (Ramipril); Y5GMK36KGY (Perindopril)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170402
[St] Status:MEDLINE


  6 / 1939 MEDLINE  
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[PMID]:28364270
[Au] Autor:Meattini I; Curigliano G; Terziani F; Becherini C; Airoldi M; Allegrini G; Amoroso D; Barni S; Bengala C; Guarneri V; Marchetti P; Martella F; Piovano P; Vannini A; Desideri I; Tarquini R; Galanti G; Barletta G; Livi L
[Ad] Endereço:Azienda Ospedaliero Universitaria Careggi - University of Florence, Largo G.A. Brambilla 3, 50134, Florence, Italy. icro.meattini@unifi.it.
[Ti] Título:SAFE trial: an ongoing randomized clinical study to assess the role of cardiotoxicity prevention in breast cancer patients treated with anthracyclines with or without trastuzumab.
[So] Source:Med Oncol;34(5):75, 2017 May.
[Is] ISSN:1559-131X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Over the years, thanks to the addition of new generation systemic agents, as well as the use of more advanced and precise radiotherapy techniques, it was able to obtain a high curability rate for breast cancer. Anthracyclines play a key role in the treatment of breast disease, with a well-known benefit on disease-free survival of patients with positive nodal status. Trastuzumab have shown a significant outcome advantage after 1-year administration in case of HER2-positive disease. Unfortunately, significant increase in cardiotoxicity has been observed after anthracyclines and trastuzumab therapies. Even though the cardiology and oncology community strongly recommend a cardiotoxicity prevention strategy for this subset of patients, there is still no consensus on the optimal patient's approach. We aimed to review the published and ongoing researches on cardioprevention strategies and to present the SAFE trial (CT registry ID: NCT2236806; EudraCT number: 2015-000914-23). It is a randomized phase 3, four-arm, single-blind, placebo-controlled study that aims to evaluate the effect of bisoprolol, ramipril or both drugs, compared to placebo, on subclinical heart damage evaluated by speckle tracking cardiac ultrasound in non-metastatic breast cancer patients.
[Mh] Termos MeSH primário: Antraciclinas/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias da Mama/tratamento farmacológico
Cardiotônicos/uso terapêutico
Cardiotoxicidade/prevenção & controle
Trastuzumab/efeitos adversos
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Bisoprolol/uso terapêutico
Ensaios Clínicos Fase III como Assunto
Feminino
Seres Humanos
Ramipril/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Trastuzumab/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anthracyclines); 0 (Cardiotonic Agents); L35JN3I7SJ (Ramipril); P188ANX8CK (Trastuzumab); Y41JS2NL6U (Bisoprolol)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170402
[St] Status:MEDLINE
[do] DOI:10.1007/s12032-017-0938-x


  7 / 1939 MEDLINE  
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[PMID]:28302660
[Au] Autor:Dunphy L; Morhij R; Tucker S
[Ad] Endereço:Department of Plastic Surgery, John Radcliffe Hospital, Oxford, UK.
[Ti] Título:Rhabdomyolysis-induced compartment syndrome secondary to atorvastatin and strenuous exercise.
[So] Source:BMJ Case Rep;2017, 2017 Mar 16.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome. His creatine kinase was >50 000 IU with normal renal and liver function tests. Further investigation with MRI-identified prominent swelling of the vastus intermedius and medialis muscles, more marked on the left, with extensive diffuse short tau inversion recovery (STIR) signal hyperintensity and isointensity on T1 sequences, suggestive of rhabdomyolysis. He underwent bilateral fasciotomies of his thighs and aggressive intravenous fluid resuscitation with close monitoring of his electrolytes. Intraoperatively his muscle was healthy, with no evidence of haematoma or necrosis. His medication atorvastatin was stopped due to his rhabdomyolysis. 48 hours later, he returned to theatre and review of his fasciotomy wounds was unremarkable. 4 days later, he was discharged uneventfully. His postoperative recovery was complicated by a serous discharge from his left medial thigh wound. Further investigation with an ultrasound confirmed a 4×1×1cm multiloculated collection within the superficial tissue directly underlying the wound. An aspirate was performed and cultures revealed no growth. He remains under review in the department of plastic surgery. This case report discusses the aetiological spectrum, clinical presentation, pathophysiology, differential diagnosis, investigations, management and complications of rhabdomyolysis.
[Mh] Termos MeSH primário: Anticolesterolemiantes/uso terapêutico
Atorvastatina Cálcica/uso terapêutico
Síndromes Compartimentais/etiologia
Exercício/fisiologia
Complicações Pós-Operatórias
Rabdomiólise/etiologia
[Mh] Termos MeSH secundário: Anti-Hipertensivos/uso terapêutico
Atorvastatina Cálcica/efeitos adversos
Síndromes Compartimentais/diagnóstico por imagem
Fasciotomia/métodos
Seres Humanos
Masculino
Meia-Idade
Dor/etiologia
Ramipril/uso terapêutico
Coxa da Perna
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticholesteremic Agents); 0 (Antihypertensive Agents); 48A5M73Z4Q (Atorvastatin Calcium); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE


  8 / 1939 MEDLINE  
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[PMID]:28259714
[Au] Autor:Singh B; Mourya A; Sah SP; Kumar A
[Ad] Endereço:Pharmacology Division, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
[Ti] Título:Protective effect of losartan and ramipril against stress induced insulin resistance and related complications: Anti-inflammatory mechanisms.
[So] Source:Eur J Pharmacol;801:54-61, 2017 Apr 15.
[Is] ISSN:1879-0712
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Chronic restraint stress (CRS) is known to cause various behavioural and biochemical alterations, leading to several negative health outcomes. The present study was designed to explore the impact of inhibiting Renin angiotensin aldosterone system (RAAS) and inflammatory pathways in stress pathophysiology. In the present study, male LACA mice were subjected to restraint stress daily for 30 days. Losartan, nimesulide, ramipril, minocycline and their combinations were administered 45min prior to restraint stress daily and their effects were observed. Restraint stressed mice depicted depression like behavior along with increased oxidative stress markers in their brains. CRS induced insulin resistance depicted by hyperglycemia, hyperinsulinemia, hypercholesteremia, increased glycosylated hemoglobin and HOMA-IR. Besides, treatment with losartan, nimesulide, ramipril and minocycline significantly restored the behavioural and biochemical alterations and improved insulin sensitivity in stressed mice. Combination treatments synergistically reversed depression like behavior and decreased plasma glucose levels. Moreover they restored insulin levels, glycosylated hemoglobin levels and HOMA-IR values to the normal. This study signifies the synergistic effect of simultaneously blocking RAS and inflammatory pathways in stress pathophysiology.
[Mh] Termos MeSH primário: Anti-Inflamatórios/farmacologia
Resistência à Insulina
Losartan/farmacologia
Ramipril/farmacologia
Estresse Psicológico/complicações
Estresse Psicológico/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Biomarcadores/metabolismo
Losartan/uso terapêutico
Masculino
Camundongos
Ramipril/uso terapêutico
Sistema Renina-Angiotensina/efeitos dos fármacos
Estresse Psicológico/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Biomarkers); JMS50MPO89 (Losartan); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170306
[St] Status:MEDLINE


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[PMID]:28192475
[Au] Autor:Burrell LM; Gayed D; Griggs K; Patel SK; Velkoska E
[Ad] Endereço:Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
[Ti] Título:Adverse cardiac effects of exogenous angiotensin 1-7 in rats with subtotal nephrectomy are prevented by ACE inhibition.
[So] Source:PLoS One;12(2):e0171975, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We previously reported that exogenous angiotensin (Ang) 1-7 has adverse cardiac effects in experimental kidney failure due to its action to increase cardiac angiotensin converting enzyme (ACE) activity. This study investigated if the addition of an ACE inhibitor (ACEi) to Ang 1-7 infusion would unmask any beneficial effects of Ang 1-7 on the heart in experimental kidney failure. Male Sprague-Dawley rats underwent subtotal nephrectomy (STNx) and were treated with vehicle, the ACEi ramipril (oral 1mg/kg/day), Ang 1-7 (subcutaneous 24 µg/kg/h) or dual therapy (all groups, n = 12). A control group (n = 10) of sham-operated rats were also studied. STNx led to hypertension, renal impairment, cardiac hypertrophy and fibrosis, and increased both left ventricular ACE2 activity and ACE binding. STNx was not associated with changes in plasma levels of ACE, ACE2 or angiotensin peptides. Ramipril reduced blood pressure, improved cardiac hypertrophy and fibrosis and inhibited cardiac ACE. Ang 1-7 infusion increased blood pressure, cardiac interstitial fibrosis and cardiac ACE binding compared to untreated STNx rats. Although in STNx rats, the addition of ACEi to Ang 1-7 prevented any deleterious cardiac effects of Ang 1-7, a limitation of the study is that the large increase in plasma Ang 1-7 with ramipril may have masked any effect of infused Ang 1-7.
[Mh] Termos MeSH primário: Inibidores da Enzima Conversora de Angiotensina/farmacologia
Pressão Sanguínea/efeitos dos fármacos
Cardiomegalia/prevenção & controle
Coração/efeitos dos fármacos
Hipertensão/prevenção & controle
[Mh] Termos MeSH secundário: Análise de Variância
Angiotensina I
Animais
Pressão Sanguínea/fisiologia
Cardiomegalia/induzido quimicamente
Cardiomegalia/fisiopatologia
Coração/fisiopatologia
Hipertensão/induzido quimicamente
Hipertensão/fisiopatologia
Masculino
Miocárdio/enzimologia
Nefrectomia
Fragmentos de Peptídeos
Peptidil Dipeptidase A/sangue
Peptidil Dipeptidase A/metabolismo
Ramipril/farmacologia
Ratos Sprague-Dawley
Insuficiência Renal/fisiopatologia
Insuficiência Renal/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Peptide Fragments); 9041-90-1 (Angiotensin I); EC 3.4.15.1 (Peptidyl-Dipeptidase A); IJ3FUK8MOF (angiotensin I (1-7)); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0171975


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[PMID]:28118402
[Au] Autor:Kwakernaak AJ; Roksnoer LC; Lambers Heerspink HJ; van den Berg-Garrelds I; Lochorn GA; van Embden Andres JH; Klijn MA; Kobori H; Danser AH; Laverman GD; Navis GJ
[Ad] Endereço:Department of Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, The Netherlands.
[Ti] Título:Effects of Direct Renin Blockade on Renal & Systemic Hemodynamics and on RAAS Activity, in Weight Excess and Hypertension: A Randomized Clinical Trial.
[So] Source:PLoS One;12(1):e0169258, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: The combination of weight excess and hypertension significantly contributes to cardiovascular risk and progressive kidney damage. An unfavorable renal hemodynamic profile is thought to contribute to this increased risk and may be ameliorated by direct renin inhibition (DRI). The aim of this trial was to assess the effect of DRI on renal and systemic hemodynamics and on RAAS activity, in men with weight excess and hypertension. METHODS: A randomized, double-blind, cross-over clinical trial to determine the effect of DRI (aliskiren 300 mg/day), with angiotensin converting enzyme inhibition (ACEi; ramipril 10 mg/day) as a positive control, on renal and systemic hemodynamics, and on RAAS activity (n = 15). RESULTS: Mean (SEM) Glomerular filtration rate (101 (5) mL/min/1.73m2) remained unaffected by DRI or ACEi. Effective renal plasma flow (ERPF; 301 (14) mL/min/1.73m2) was increased in response to DRI (320 (14) mL/min/1.73m2, P = 0.012) and ACEi (317 (15) mL/min/1.73m2, P = 0.045). Filtration fraction (FF; 34 (0.8)%) was reduced by DRI only (32 (0.7)%, P = 0.044). Mean arterial pressure (109 (2) mmHg) was reduced by DRI (101 (2) mmHg, P = 0.008) and ACEi (103 (3) mmHg, P = 0.037). RAAS activity was reduced by DRI and ACEi. Albuminuria (20 [9-42] mg/d) was reduced by DRI only (12 [5-28] mg/d, P = 0.030). CONCLUSIONS: In men with weight excess and hypertension, DRI and ACEi improved renal and systemic hemodynamics. Both DRI and ACEi reduced RAAS activity. Thus, DRI provides effective treatment in weight excess and hypertension. TRIAL REGISTRATION: Dutch trial register, registration number: 2532 www.trialregister.nl.
[Mh] Termos MeSH primário: Amidas/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Fumaratos/uso terapêutico
Hemodinâmica/efeitos dos fármacos
Hipertensão/tratamento farmacológico
Sobrepeso/complicações
Circulação Renal/efeitos dos fármacos
Sistema Renina-Angiotensina/efeitos dos fármacos
Renina/antagonistas & inibidores
[Mh] Termos MeSH secundário: Albuminúria/etiologia
Albuminúria/prevenção & controle
Amidas/farmacologia
Inibidores da Enzima Conversora de Angiotensina/farmacologia
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Anti-Hipertensivos/farmacologia
Monitorização Ambulatorial da Pressão Arterial
Estudos Cross-Over
Método Duplo-Cego
Fumaratos/farmacologia
Taxa de Filtração Glomerular/efeitos dos fármacos
Seres Humanos
Hipertensão/complicações
Hipertensão/fisiopatologia
Nefropatias/etiologia
Nefropatias/prevenção & controle
Masculino
Meia-Idade
Sobrepeso/fisiopatologia
Ramipril/farmacologia
Ramipril/uso terapêutico
Sistema Renina-Angiotensina/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Amides); 0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Antihypertensive Agents); 0 (Fumarates); 502FWN4Q32 (aliskiren); EC 3.4.23.15 (Renin); L35JN3I7SJ (Ramipril)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0169258



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