Luigi Brollo

Associação do eletrocardiograma com diabete melito e síndrome metabólica em nipo-brasileiros

FUNDAMENTO: Al migrar hacia las Americas, los japoneses se sometieron a un proceso de occidentalizacion, con estilo de vida, y especialmente dieta, muy diferente, lo que puede explicar el aumento de diabetes mellitus (DM), sindrome metabolico (SM) y enfermedades cardiovasculares. OBJETIVO: Analizar la presencia de necrosis miocardica e hipertrofia ventricular izquierda (HVI), indicada en ECG, y su relacion con DM y SM en poblacion de nipobrasilenos. METODOS: Estudio transversal que evaluo a 1.042 nipobrasilenos con edad superior a 30 anos: 202 nacidos en Japao (iseis) y 840 nacidos en Brasil (niseis), provenientes de la segunda fase del estudio Japanese-Brazilian Diabetes Study Group iniciado en 2000. Se definio el SM desde los criterios de la NCEP-ATP III, modificados para los japoneses. La presencia de DM y SM se asocio a la formacion de necrosis miocardica, segun el de Minnesota, y de HVI segun el criterio de Perugia, ambas reveladas en el ECG. Se utilizo el metodo estadistico del Chi-cuadrado para rechazo de la hipotesis de nulidad. RESULTADOS: De los 1.042 participantes, el 35,3% presentaba DM (el 38,6% entre los iseis y el 34,5% en niseis); el 51,8% tenian SM (el 59,4% entre iseis y el 50,0% en niseis). La presencia de zona inactiva en los iseis diabeticos no se mostro estadisticamente significante, si se la compara a los no diabeticos; sin embargo, entre los niseis diabeticos la zona inactiva se presentaba en el 7,5%. Hubo correlacion estadisticamente significante entre el SM y la HVE entre iseis y niseis. CONCLUSION: Disturbios metabolicos tuvieron alta prevalencia en nipobrasilenos con correlaciones significantes con necrosis e hipertrofia reveladas por el ECG.BACKGROUND When the Japanese immigrated to the Americas, they were subjected to Westernization, with a great change in lifestyle, specially in dietary habits, and this may explain the increase in the incidence of diabetes mellitus (DM), metabolic syndrome (MS) and cardiovascular disease among them. OBJECTIVE To study the presence of myocardial necrosis and left ventricular hypertrophy (LVH) in a population of Japanese-Brazilians, using the ECG and its relationship with DM and MS. METHODS This was a cross-sectional study which evaluated 1,042 Japanese-Brazilians aged 30 or over, 202 of them born in Japan (Issei) and 840 of them born in Brazil (Nissei), from the second phase of the Japanese-Brazilian Diabetes Study Group initiated in 2000. MS was defined according to the NCEP-ATP III criteria modified for the Japanese. DM and MS were associated with the presence of myocardial necrosis (according to the Minnesota criteria) and LVH (according the Perugia score on the ECG). The statistic chi square method was used to reject the null hypothesis. RESULTS Of the 1,042 participants, 35.3% had DM (38.6% of the Issei and 34.5% of the Nissei); 51.8% had MS (59.4% of the Issei and 50.0% of the Nissei). The presence of an inactive zone in the diabetic Issei group was not statistically significant when compared to the non-diabetic group, but among the diabetic Nissei group an inactive zone was present in 7.5% of them. There was a statistically significant correlation between MS and LVH in the Issei and Nissei groups. CONCLUSION Metabolic disorders presented a high prevalence in Japanese-Brazilians with significant correlations with necrosis and hypertrophy on the ECG.

Síncope cardíaca reflexa por "nevralgia" do glossofaríngeo: rara apresentação dessa doença

The first description of severe pain in the distribution of the glossopharyngeal nerve is credited to Weisenberg, in 1910, in a patient with cerebellopontine angle tumor. However, it was Harris, in 1926, who coined the term glossopharyngeal neuralgia to describe this rare condition characterized by paroxysms of excruciating pain located laterally at the back of the tongue, soft palate, throat, and lateral and posterior pharynx, radiating to the ear. Swallowing, coughing, yawning or chewing may trigger pain, which usually lasts from seconds to minutes. The association between glossopharyngeal neuralgia and syncope is very rare, being identified by brief episodes of bradycardia, asystole, and hypotension. Such an association, with this same pathophysiology, was first described by Riley et al in 1942.The first description of severe pain in the distribution of the glossopharyngeal nerve is credited to Weisenberg, in 19101, in a patient with cerebellopontine angle tumor. However, it was Harris, in 19262, who coined the term glossopharyngeal neuralgia to describe this rare condition characterized by paroxysms of excruciating pain located laterally at the back of the tongue, soft palate, throat, and lateral and posterior pharynx, radiating to the ear. Swallowing, coughing, yawning or chewing may trigger pain, which usually lasts from seconds to minutes. The association between glossopharyngeal neuralgia and syncope is very rare, being identified by brief episodes of bradycardia, asystole, and hypotension. Such an association, with this same pathophysiology, was first described by Riley et al3 in 1942.

H 021 QUALITY OF LIFE OF HYPERTENSIVE PATIENTS TREATED AT AN OUTPATIENT CLINIC

BACKGROUND The main cause of mortality in braziliam population is the cardiovascular disease and arterial hypertension (AH) the most prevalent one. The antihypertensive treatment is effective however it is not well known how affects the quality of life (QOL) in patients afterwards. OBJECTIVE To comparatively assess the QOL in patients submitted to an antihypertensive treatment. METHODS One-hundred patients with AH were studied of which 46 had complied with a standard treatment regimen (group A) and 54 (group B control) were about to start the same regimen. We collected clinical and sociodemographic data and questions focusing sexuality, self-perception of QOL, number and types of medication taken and their influence on sex life. The questionnaire SF-36 was also administered. The data were analyzed using the tests chi-square, Students t, Pearson correlation and Tukey. RESULTS No differences were detected between group A and B in any of the SF-36 domains. There was an association between the question on self-perception of QOL and the SF-36 domains, emotional aspects excepted. As regards sexuality, there was difference in the quality of sex life between the groups, which was less satisfactory for group A. CONCLUSION When the SF-36 was administered no changes in QOL were detected between the groups because it is an asymptomatic chronic disease. The SF-36 did not properly assess emotional aspects in our case series of hypertensive patients that had high behavior variability. Group A showed lower quality sex life; however, this was not related to the number and type of medication used.

Asociación del electrocardiograma con diabetes mellitus y síndrome metabólico en nipobrasileños

FUNDAMENTO: Al migrar hacia las Americas, los japoneses se sometieron a un proceso de occidentalizacion, con estilo de vida, y especialmente dieta, muy diferente, lo que puede explicar el aumento de diabetes mellitus (DM), sindrome metabolico (SM) y enfermedades cardiovasculares. OBJETIVO: Analizar la presencia de necrosis miocardica e hipertrofia ventricular izquierda (HVI), indicada en ECG, y su relacion con DM y SM en poblacion de nipobrasilenos. METODOS: Estudio transversal que evaluo a 1.042 nipobrasilenos con edad superior a 30 anos: 202 nacidos en Japao (iseis) y 840 nacidos en Brasil (niseis), provenientes de la segunda fase del estudio Japanese-Brazilian Diabetes Study Group iniciado en 2000. Se definio el SM desde los criterios de la NCEP-ATP III, modificados para los japoneses. La presencia de DM y SM se asocio a la formacion de necrosis miocardica, segun el de Minnesota, y de HVI segun el criterio de Perugia, ambas reveladas en el ECG. Se utilizo el metodo estadistico del Chi-cuadrado para rechazo de la hipotesis de nulidad. RESULTADOS: De los 1.042 participantes, el 35,3% presentaba DM (el 38,6% entre los iseis y el 34,5% en niseis); el 51,8% tenian SM (el 59,4% entre iseis y el 50,0% en niseis). La presencia de zona inactiva en los iseis diabeticos no se mostro estadisticamente significante, si se la compara a los no diabeticos; sin embargo, entre los niseis diabeticos la zona inactiva se presentaba en el 7,5%. Hubo correlacion estadisticamente significante entre el SM y la HVE entre iseis y niseis. CONCLUSION: Disturbios metabolicos tuvieron alta prevalencia en nipobrasilenos con correlaciones significantes con necrosis e hipertrofia reveladas por el ECG.BACKGROUND When the Japanese immigrated to the Americas, they were subjected to Westernization, with a great change in lifestyle, specially in dietary habits, and this may explain the increase in the incidence of diabetes mellitus (DM), metabolic syndrome (MS) and cardiovascular disease among them. OBJECTIVE To study the presence of myocardial necrosis and left ventricular hypertrophy (LVH) in a population of Japanese-Brazilians, using the ECG and its relationship with DM and MS. METHODS This was a cross-sectional study which evaluated 1,042 Japanese-Brazilians aged 30 or over, 202 of them born in Japan (Issei) and 840 of them born in Brazil (Nissei), from the second phase of the Japanese-Brazilian Diabetes Study Group initiated in 2000. MS was defined according to the NCEP-ATP III criteria modified for the Japanese. DM and MS were associated with the presence of myocardial necrosis (according to the Minnesota criteria) and LVH (according the Perugia score on the ECG). The statistic chi square method was used to reject the null hypothesis. RESULTS Of the 1,042 participants, 35.3% had DM (38.6% of the Issei and 34.5% of the Nissei); 51.8% had MS (59.4% of the Issei and 50.0% of the Nissei). The presence of an inactive zone in the diabetic Issei group was not statistically significant when compared to the non-diabetic group, but among the diabetic Nissei group an inactive zone was present in 7.5% of them. There was a statistically significant correlation between MS and LVH in the Issei and Nissei groups. CONCLUSION Metabolic disorders presented a high prevalence in Japanese-Brazilians with significant correlations with necrosis and hypertrophy on the ECG.