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Biomedical subjects

E Mota

Publications and source records attributed to E Mota.

At least 19 recordsLinked to original sources
PubMed2004

The metabolic syndrome--a multifaced disease.

The metabolic syndrome (MetS) is a huge public health problem worldwide, being one of the major causes of cardiovascular disease, responsible for a growing number of premature deaths throughout the world. MetS includes a cluster of anomalies, such as: abdominal obesity, insulin resistance, hyperinsulinemia, hypertension, type 2 diabetes mellitus or glucose intolerance, hypertriglyceridemia etc. The number of people with MetS increases with age, affecting more than 40% of people in their 60s and 70s. About 30% of European people over 50 have MetS. Some experts estimate that as many as two thirds of Americans may be suffering from MetS. The exact cause of MetS is not known: genetics play a minor role, acquired in-utero factors also play a role (prenatal malnutrition, toxin exposure, exposure to high levels of maternal cortisol). For most people, the MetS results primarily from lifestyle factors, such as: chronic stress, inadequate exercise. The MetS can be avoided and reversed in most cases. Weight loss is both a treatment and goal for MetS patients. Moderate weight loss, in the range of 5-10% of body weight, can help restore body's ability to recognize insulin and greatly reduce the chance that the syndrome will evolve into a more serious illness. In most people weight loss will lower blood pressure and improve triglyceride levels. Increased activity alone can improve insulin levels. Physical activity result in a weight loss, improved blood pressure, improved cholesterol and triglyceride level and reduced risk of developing diabetes. It is also important to treat: hyperlipidemia, hypertension, prothrombotic state.

Europe↗
PubMed2003

Erectile dysfunction in diabetes mellitus.

Erectile dysfunction (ED) is 2-3 times more frequent in men with diabetes mellitus than in men without such a history and might be an early marker of endothelial dysfunction. We studied a group of 310 unselected male patients within the Clinical Center of Diabetes and Metabolic Diseases of Dolj County, with ages ranging between 20-78 years (57.43 + 0.835) and a positive history of diabetes mellitus for 1-47 years (10.09 +/- 8.715). Erectile dysfunction, quantified using SHIM (Sexual Health Inventory for Men), was present in 196 patients (63.2%); severe in 52 patients (16.8%), moderate in 42 patients (13.5%) and mild in 102 patients (32.9%). Erectile dysfunction showed a positive correlation with age after 65 years, history of diabetes of more than 10 years, obesity, stroke, arteriopathy, retinopathy, neuropathy and the smoking habit and was not correlated to the type of diabetes mellitus, history of diabetes less than 10 years, diabetes therapy, hypertension, ischemic heart disease, nephropathy, dyslipidemia and alcohol consumption. Our results plead for a holistic approach of the diabetic patient, irrespective of age, in order to detect and to treat all the risk factors, keeping in mind that the appearance of erectile dysfunction might indicate the presence of occult chronic diabetes complications.

Adult↗
PubMed2001

[Physical exercise in the rehabilitation of the coronary patient].

Coronary patients comprise an heterogeneous population. Many patients, after adequate screening, can benefit from physical training, which determines hemodynamic changes that are globally useful to the coronary patient. Under adequate supervision, physical exercise may help to condition the cardiocirculatory system in a favorable way. After successful training, efforts require a lower double product. By dumping sharp variations in heart rate and blood pressure, an increased margin of safety is obtained, and the coronary patient will be able to perform physical activity at a level closer to normal. Even without definitive evidence that life expectancy is increased and without direct effects on the heart and the coronary arteries, physical exercise promotes a better quality of life and decreases the negative impact of the coronary heart disease.

Coronary Disease↗
PubMed1999

Dermal extracellular matrix in cutaneous leprosy lesions.

Thirty-eight biopsies of cutaneous lesions from leprosy patients [borderline tuberculoid (BT) 14, borderline lepromatous (BL) 18, lepromatous (LL) 6] were processed for staining of some extracellular matrix (ECM) components (collagen, proteoglycans, elastic fibers and fibronectin). Specific histological staining and the indirect immunofluorescence method with antibodies to collagen and fibronectin were utilized. The ECM of the normal dermis was strikingly modified in the inflammatory infiltrate. By Gomori's reticulin and anti-fibronectin immunostaining, replacement of the dense interlaced collagen fibers with a reticular mesh was observed in the infiltrate. The immunoreactivity obtained with anti-type I and anti-type III collagens showed positive fibrils and a lumpy pattern in the lepromatous and tuberculoid lesions with a higher amount in the lepromatous lesions. The lack of clear-cut boundaries between the normal dermis and the inflammatory infiltrate in the lepromatous (BL, LL) lesions was correlated with the blurred limits of the clinical lesions of this pole of the leprosy spectrum. Absence of elastic fibers in the infiltrate was a constant finding, and fuchsin-positive microfibrils were found in some infiltrates. The clear zone of lepromatous lesions was devoid of oxytalan fibers. Elaunin fiber rings around sweat gland acini were present even when the leprosy infiltrate was seen enveloping them. The original ECM is replaced by a newly assembled one, which is suited for the dynamic nature of the inflammatory process. The trophic effects of the ECM upon the cutaneous epithelial structures are modified so that atrophy and late degeneration ensues. These ECM modifications contribute, therefore, to the biological alterations of the skin functions in leprosy.

Biopsy↗
PubMed1998

[Post-myocardial infarct risk stratification].

The aim of performing diagnostic tests in patients with myocardial infarction before hospital discharge is to identify those with a high risk of recurrence or sudden death. It is convenient to perform these tests before discharge because the risk is higher in the next two months. The assessment of ventricular function is fundamental since it is the best predictor of post-infarction survival. There are many patients in which the combination of clinical, electrocardiographic and enzymatic data present a strong argument to assume that the loss of contractile myocardium was relatively small. In the remaining patients, the use of non invasive techniques, or even contrast ventriculography, is indispensable. The choice of method, be it exercise electrocardiography, stress echocardiography, rest or stress scintigraphy and coronary ventriculography, depends greatly on the resources available and the degree of reliability offered by the team performing the method. The sub-maximal exercise test performed before hospital discharge in patients with an uncomplicated infarction has already an undisputed role in determining prognosis. Stress echocardiography and stress or exercise thallium scintigraphy have a greater predictive value than the sub-maximum stress test. Their greatest advantage probably lies in the possibility of identifying the patients with a low risk of future cardiac events. In many centers, coronary angiography and ventriculography are preferred with out "wasting" time with non invasive methods, which, although more economical, give only indirect information. The existence of complex ventricular arrhythmias is an independent prognostic factor concerning mortality. Ambulatory electrocardiography and electrophysiological studies are the methods of choice for their detection, the latter having become routine as their value has increased due to the availability of implantable automatic defibrillators.

Coronary Angiography↗
PubMed1997

[Multifactorial analysis of risk factors for low birth weight in Salvador, Bahia].

This study is a multifactorial analysis of the risk factors for low birthweight in a group of newborns in an urban area of Brazil. A total of 1023 infants born in four maternity units in Salvador, Bahia, between July 1987 and February 1988 were included in the study. The sources of information were clinical histories and interviews with the mothers in the maternity units. The analysis was by means of logistic regression. In the final model the risk factors were the following: maternal age less than 21 years or more than 35; gestational age less than 38 weeks; unfavorable outcome of an earlier pregnancy; interval of 12 months or less since prior birth; tobacco smoking; and hypertension. The population attributable risk values for the risk factors included in the final model are presented. These factors should be used to identify pregnant women at high risk of giving birth to a low-birthweight baby, in order to provide them with more prenatal care.

Brazil↗
PubMed1993

[Cardiological changes in candidates for sports].

OBJECTIVES: To evaluate the incidence and the clinical significance of the cardiologic abnormalities detected in candidates to competitive sports. DESIGN: Retrospective study of candidates to competitive sports who were evaluated for heart fitness. SETTING: Out patient cardiologic clinic in a Center of Sports Medicine in Lisbon. PATIENTS AND METHODS: 420 subjects out of a population of 6795 were followed up for one year. They underwent clinical evaluation with ECHO (M mode, 2D, Doppler), 24 hours Holter monitoring and Exercise Tests as indicated for decision concerning fitness and adequacy for the practice of competitive sports. RESULTS: Main reason for observation was the assessment of the significance of cardiac murmur (265; 6.3%). 14 cases of organic heart disease were diagnosed: 9 bicuspid aortic valves (2 with systolic gradient over 40 mmHg), 2 with atrial septal defects, 2 significant mitral valve prolapse and 1 ventricular septal defect. 86 patients were evaluated because of ECG abnormalities; 26 out of these presented ventricular ectopic beats, 6 had delayed AV conduction (PQ > 0.24 sec), 44 developed non specific STT changes and 16 a pre-excitation (WPW) tracing. Holter studies demonstrated 8 cases of complex ventricular premature beats and one case of paroxysmal atrial tachycardia. Arterial hypertension was the reason for evaluation of 20 athletes, 5 of whom were considered unfit due to hypertensive response to effort and/or systemic involvement. CONCLUSIONS: The evaluation of heart murmurs was the principal reason to evaluate candidates to the practice of sports. The large majority were considered innocent murmurs. Ventricular premature beats, non specific repolarization changes and pre-excitation (WPW) were the predominant electrocardiographic abnormalities. There was a remarkably low incidence of organic heart disease in the latter group. The most common reasons to declare unfitness for competitive sports practice were repetitive ventricular ectopic beats and arterial hypertension.

Adolescent↗
PubMed1992

A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in northeast Brazil.

Hepatitis B virus (HBV) serological markers were investigated in 40 incident cases of hepatocellular carcinoma (HCC) and in two age and sex matched control groups, comprising 40 patients with other cancers and 80 healthy individuals, resident in Bahia, Brazil. Serologic tests were done by radioimmunoassay. The study observed high proportion of seropositivity to HBsAg (42.5%) and of those presenting HBsAg or antiHBc (65.0%) among HCC cases, higher in men than women and in those aged 17 to 30 years old. HBsAg seropositivity among HCC patients was greater than in the control group with other cancers (7.5%) and in healthy controls (2.5%), corresponding to odds ratio estimates of 15.0 (95% CI 3.29, 68.30) and 33.0 (95% CI 9.13, 119.28), both statistically significant. HBeAg was not observed and antiHBe was present in 41.2% of cases, suggesting the absence of viral replication, possibly with viral DNA integration into the hepatocyte genome. The presence of cirrhosis was associated with HBsAg seropositivity among HCC cases. A history of chronic alcoholism is shown to be more frequently related to those cases with cirrhosis. This study highlights the relevant association between HCC and HBV in Northeast Brazil, particularly for young individuals, and the high risk of development of HCC for HBsAg carriers.

Adolescent↗
PubMed1992

[Hypertensive reaction to exercise. Retrospective studies of 1363 consecutive exercise tests].

OBJECTIVE: To study exercise hypertensive reaction and its relation with rest blood pressure, hypertension type and hypertensive cardiac disease. DESIGN: Retrospective study of treadmill exercise testes (ET) performed from January/89 to June/91: (n: 1703). SETTING: Stress tests Laboratory of Cardiology Service of a Military Hospital. METHODS: 1363 consecutive ET of male subjects, performing at least the 3rd stage of the Bruce protocol, were studied. From each ET record were obtained general data, including the reason for test, medication and the rest and exercise blood pressure. Exercise hypertensive reaction was defined as a Bruce protocol 3rd stage systolic blood pressure above 187 mmHg, which corresponds to mean +2SD of 130 normal male subjects previously studied. The Echocardiograms of non-treated hypertensives, obtained less than a month from ET, were reviewed. The diagnosis of borderline or moderate hypertension was base on the clinical records. RESULTS: 1) The 1363 ET included 132 (9.7%) ET to study hypertensive subjects, and 68 of these had hypertensive reaction. 86 ET were performed by non-treated hypertensive subjects, of whom 73 had Echocardiogram. 43 (3.5%) from 1231 ET performed by non-hypertensive subjects also had exercise hypertensive reaction. 2) The left ventricular (LV) mass index of non-treated hypertensive patients had a positive correlation with exercise systolic pressure (r: 0.45; p < 0.001), more important than with rest blood pressure or exercise systolic pressure response; there was a relation with LV wall thickness, but not with internal ventricular dimensions, that was only observed in hypertensive subjects that also had hypertensive reaction to exercise. 3) Exercise systolic blood pressure was usually normal in borderline and elevated in moderate hypertensives (Qui2: 27.249; p < 0.001). 4) Subjects with exercise hypertensive reaction, but not previously diagnosed as hypertensives, were usually true hypertensives. CONCLUSIONS: 1) Hypertensive peaks seem to be an important determinant factor in LV hypertrophy of hypertension, but its influence is felt only above a certain blood pressure threshold; it results on LV concentric type hypertrophy. 2) Exercise systolic blood pressure had a discrimination power of about 80% to separate borderline and moderate hypertensive subjects. 3) All subjects having an exercise hypertensive reaction must be carefully observed, even if their blood pressure at rest is normal, because most of them are true hypertensive patients.

Adult↗
PubMed1992

[Ibopamine in the treatment of congestive heart failure. Multicenter follow-up study].

OBJECTIVE: To assess safety and efficacy of ibopamine, 200 mg TID, added to conventional treatment of congestive heart failure. DESIGN: A prospective, longterm, open study over two years (1986-88). A multicenter trial. SETTING: Outpatients of Departments of Internal Medicine of S. Francisco Xavier Hospital and Sta. Maria Hospital, and Departments of Cardiology of Sta. Cruz Hospital and Hospital Militar Principal, Lisbon. PATIENTS AND METHODOLOGY: 63 patients, 49 males from 34 to 80 years (m = 55.6 +/- 11.36) and 14 females from 41 to 80 years (m = 63 +/- 10.2), with congestive heart failure, NYHA class II in 52 patients (82.5%) and NYHA class III in 11 patients (17.5%) with a mean disease duration of 47.9 months entered into the study. Digoxin, diuretics, nitrates and antiarrhythmic drugs were allowed as concomitant therapy. Patients carried out clinical examination, ECG and laboratory tests monthly and X-Ray at the beginning and at the end of each year of the study. RESULTS: 42 patients completed one year of treatment and 20/42 continued for an additional year, 17 patients completed this second year of follow-up. From the 42 patients who completed the first year period, the NYHA class changed from II to I in 17/38 from II to III in 2/38 patients from III to II in 3/4 patients, and from III to IV in one patient. Twenty patients dropped during the first year of treatment. Six for non-compliance (less than 80% of the treatment). Two were submitted to cardiac valve surgery. Seven had cardiovascular clinical events: one ventricular tachycardia, one atrial fibrillation, one pulmonary edema, one patient had no therapeutic effect, two patients had anxiety and fatigue and one patient died suddenly. One diabetic patient had uncontrolled hyperglycemia. One patient had gastric ulcer. Two had nausea and vomiting. Dysrhythmia and nausea and vomiting were the only clinical events, considered, respectively, possibly related and related, to ibopamine. During the second year of treatment 9/11 patients were stabilized in NYHA class I and 6/9 in NYHA class II, one patient changed from class II to class I, and one patient changed from class I to class II of the NYHA. Three patients did not complete the second year of treatment; one due to abnormal creatininemia; one for probable pulmonary embolism with CHF worsening; the third died suddenly. None of these events was considered related to ibopamine. Heart rate, arterial pressure, laboratory values and cardiothoracic index did not vary over the two years of the study. CONCLUSIONS: This has been the first study with data from patients treated with 200 mg TID of ibopamine during two years. Ibopamine has been shown to be a safe and useful drug added to conventional treatment of cardiac heart failure. Clinical events were few and well controlled after ibopamine interruption.

Adult↗
PubMed1991

[Congenital cardiopathies at an internal medicine service].

STUDY OBJECTIVE: Description of 32 cases of congenital heart disease in the adulthood, admitted in the First Department of Medicine of Hospital Santa Maria, Lisboa between 1980 and 1989. DESIGN: Retrospective study. SETTING: Admission from the Emergency Room and Outpatients Clinic to an Internal Medicine Department of a General Hospital. PATIENTS: Adult patients with congenital heart disease. MATERIAL AND METHODS: All the 32 cases of congenital heart disease admitted between the 1st January 1980 and the 31st December 1989 were studied retrospectively. The clinical findings diagnosis and special examinations were analysed. MAIN RESULTS: The admission age varied between 15 and 83 years old being 21 female (65.6%) and 11 males (34.4%). The 32 cases of congenital heart disease, were distributed as follows: 19 were atrial septal defects (ASD); 4 were bicuspid aortic valves; 3 were coarctations of the aorta; 3 were tetralogy of Fallot; 2 were patent ductus arteriosus; 1 was an Ebstein anomaly with cianosis. From the 19 cases of atrial septal defect (ASD), 15 were female and 4 were male. The mean age of admission was 57.1 +/- 14.9. Congestive heart failure (CHF) was the reason for admission in 11 cases. The EKG findings were atrial fibrillation (AF) in 11 cases and atrial flutter in 1. Pulmonary hypertension was observed in the 17 echocardiographically documented cases. Infeccious endocarditis was diagnosed in 2 of the 4 bicuspid aortic valves. CONCLUSIONS: Congenital heart disease is not a very rare disease. In our 32 cases, 19 (59%) were ASD. CHD and AF were very common in this patology, in relation to the advanced age of this population. The echocardiography was a very useful diagnostic procedure. The 2 infective endocarditis cases between the 4 bicuspid aortic valves, is a way to remember the importance of prophylaxis.

Adolescent↗
PubMed1991

[Pressure response to dynamic exercise and antihypertensive therapy].

OBJECTIVES: To study the exercise systolic pressure (SP) in hypertensive patients, its relation with left ventricular (LV) mass and the efficacy of its control by some antihypertensive drugs. DESIGN: To study the echocardiogram (ECHO) and exercise test (ET) in hypertensives (HT), before and after rest blood pressure (BP) control. SETTING: Out-patient cardiology clinic in a military hospital. METHODS: 53 male moderate HT, 30 to 60 years old, without other pathology, were studied with ECHO and ET. 28 HT repeated ET after rest BP control: Group A--Diuretic (Hchlt/Triam), n: 7; Group B--Atenolol, n: 10; Group C--Nifedipine, n: 11. RESULTS: 1. There was a positive correlation between LV mass index and exercise SP (r: 0.37; p less than 0.01), but not rest blood pressure. 2. Exercise test duration was increased only in group C. 3. Hypertensives with rest BP control had also normal exercise SP in group B, but not in groups A or C (Qui2: 11 735; p less than 0.001). CONCLUSIONS: 1. Exercise systolic blood pressure seems to be more important than rest blood pressure to the development of LVH in hypertensive patients. 2. The observed increase of exercise capacity in Nifedipine group must be considered in the treatment of physically active hypertensives. 3. Hypertensives with rest BP controlled by Atenolol have also, very probably, a normal exercise systolic pressure. 4. In physically active HT with rest BP controlled by Diuretic or Nifedipine may be useful an exercise test to evaluate exercise systolic pressure.

Adult↗
PubMed1990

[The importance of heart disease in the various types of cerebral vascular disease. A prospective study].

UNLABELLED: A prospective study was performed in 106 patients with acute stroke. The main purpose was the cardiac evaluation in the different types of cerebrovascular disease: Intracerebral hemorrhage (H), Cortical ischaemic events (C) and Subcortical ischaemic events (SC) and also to evaluate the interest of echocardiography in detecting occult cardiac sources of emboli. The study population included 54 men and 52 women with a mean age of 66.8 +/- 10.3 years. A thorough neurologic and cardiologic study with a computed tomography of the brain (TAC) and an echocardiogram (ECO) were performed in all patients. It was found 24 (23%) of H, 40 (38%) of C and 32 (30%) of SC. In the past history, heart diseases were more prevalent in C (p less than 0.04); previous stroke and systemic hypertension (HTA) were less prevalent in H (p less than 0.008) and in C (p less than 0.004), respectively. Atrial fibrillation (FA) was more frequent in ischaemic stroke (p less than 0.02) and within these in C (p less than 0.005). No more clinical and functional cardiac features or echocardiographic aspects had any difference in their prevalence in different types of stroke. Without clinical heart disease there were 19 (18%) cases but only in 10 were found in their echocardiograms a potentially embolic heart disease (PEHD) but 8 of them had questionable pathologic significance. IN CONCLUSION: C had more heart disease in their past history; FA is more frequent in C; it is difficult to diagnose a cerebral embolism with only a coexistent C and CPE, but if there is FA or a past history of heart disease in a C, the diagnosis of cerebral embolism is more probable; finally, echocardiography is of limited value to diagnose a PEHD in the elderly, however it makes possible to better evaluate most cardiac situations.

Acute Disease↗
PubMed1990

[The effectiveness of amiodarone seems to depend highly on the pathology underlying the arrhythmia].

STUDY OBJECTIVE: To evaluate the efficacy of amiodarone in tachyarrhythmias occurring acutely, in patients with different nosological entities of the heart. DESIGN: A retrospective study. SETTING: Emergency-room patients and ward-patients, in an Internal Medicine Department of a University Hospital. PATIENTS: Sequential sample of 148 patients with acute tachyarrhythmias, 138 out of them supraventricular (atrial fibrillation--116 cases; paraoxysmal supraventricular tachycardia--14 cases, and atrial flutter--8 cases). INTERVENTIONS: 81 patients had been treated with amiodarone; 67 patients had received several other antiarrhythmic drugs. MEASUREMENTS AND MAIN RESULTS: A favourable result of antiarrhythmic treatment was achieved in 84% of the patients who received amiodarone and in only 57% of those having been treated with the other antiarrhythmic drugs (p less than 0.025). A clearly distinct benefit of amiodorone was seen in the subgroup of patients with mitral stenosis, when compared with the whole of the other treatments (p less than 0.001). Amiodarone results were also better than the other antiarrhythmic ones in hypertensive patients (p less than 0.05). There was no difference between amiodarone and the remaining compounds in patients suffering from ischaemic heart disease, congestive heart failure and chronic obstructive lung disease. No adverse side effects were verified is this short term treated sequence of patients. CONCLUSIONS: Amiodarone seems, in this study, to be a very effective antiarrhythmic drug for the treatment of supraventricular tachyarrhythmias. Its efficacy was superior in cases where the underlying disease was mitral stenosis or arterial hypertension. So, effectiveness of the compound seems to depend on the nature of the subjacente cardiac disease. The short term tolerability has been excellent. However, the small number of patients studied claims for bigger scaled similar investigations.

Acute Disease↗
PubMed1989

[Cerebral vascular disorders and arterial hypertension: cardiologic and neurologic aspects].

OBJECTIVE: To report and discuss some cardiologic, neurologic and radiologic aspects in different types of stroke (AVC) present in hypertensive patients. DESIGN: Retrospective study in patients with acute cerebrovascular accident (AVC) and high blood pressure (HTA). Separate this population in three groups according to the results of computerized tomography scanning of the brain (TAC): hemorrhage (H) cerebral infarction (IC) and lacune (L). In each group describe the findings. SETTING: Department of Internal Medicine in a University Hospital of Lisbon. PATIENTS: Thirty-four patients, after having discarded 8 because their TAC were normal. Twenty were men (M), 14 women (F) with a total age average of 58 years. MEASUREMENTS AND MAIN RESULTS: All patients had AVC, HTA and underwent initial TAC. For each group were considered: Past history, cardiac repercussions of HTA, neurologic features and the localisations of cerebral lesions. For statistical study were used the Student T Test. There was 45% of IC, 24% of H and 26% of L. In past history was found 35% of cardiac diseases and 24% of diabetes. There wasn't any difference in blood pressure (systolic and diastolic) between the groups. Fifty-six percent had an important cardiac repercussion, with 72% of alterations of ventricular repolarization and 35% of coronary heart diseases. Both were more prevalent in IC than in the others. Twenty percent of H were in physical activity, 20% had a progressive start and in 10% there were meningeal signals. The site of cerebral lesions were characteristical, specially the H and L and 60% of H were thalamic. There wasn't any lacune neither in the cerebral stem nor in the cerebellum. It was reviewed some theoric aspects of neurologic feature. CONCLUSIONS: IC is the more frequent AVC in hypertensive patients. The cardiac involvement, is the most frequent disease in past history. The cardiac repercussion of HTA is more important in IC. The findings were insufficient to well characterize the neurologic feature. Sometime TAC and seldom magnetic resonance are necessary. The localisations, specially of H and L are the same that have been described in medical literature.

Aged↗
PubMed1989

[Hyponatremia--new concepts and therapy. Apropos of a clinical case].

The therapeutic approach of hyponatremia is reviewed, and the authors describe their recent experience of a clinical case of a woman with acute hyponatremia. After analysing the main publications of the last years, they conclude that the way of correcting hyponatremia largely depends of its acute or chronic character. Chronic hyponatremia must be corrected with slow rate infusion of sodium chloride (0.5 mmol/l/h), and acute hyponatremia with a rapid (2 mmol/l/h) or intermediate (1-1.5 mmol/l/h) rate of infusion of the same solution. This is the current advisable approach, until a new better orientation will virtually be clarified by further prospective studies.

Acute Disease↗
PubMed1987

Fluid balance and the adult respiratory distress syndrome.

This study examined the effect of fluid balance on survival in ARDS. Of the 213 patients entered into a prospective data collection study, we evaluated 113 patients who met strict criteria for ARDS. Multiple variables were analyzed for as long as 14 days after intubation including cardiac output, pulmonary capillary wedge pressure, mean blood pressure, intake minus output (I-O), cumulative intake minus output (cum I-O), and change in weight (delta wt). We found significant differences in cum I-O and delta wt between survivors and nonsurvivors on almost every day. Survivors lost weight and had a significantly lower cum I-O compared with nonsurvivors. Logistic regression was used to determine if delta wt and cum I-O could predict survival. Patients who lost 3 kg or more weight had a much higher survival than did those who gained 3 kg or more weight (67 and 0%, respectively, on Day 14). Similar results were obtained using comparably low and high values for cum I-O. The logistic regression equations demonstrated that weight loss and low cumulative I-O correlated with improved survival. Although cause and effect relationships are difficult to determine from these types of analyses, they can be used to formulate prospective studies and predict survival in patients.

Body Weight↗