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Biomedical subjects

F D Fuchs

Publications and source records attributed to F D Fuchs.

At least 37 records · Page 2Linked to original sources
PubMed2000

Familial predisposition to hypertension and the association between urinary sodium excretion and blood pressure in a population-based sample of young adults.

The reasons for the inconsistent association between salt consumption and blood pressure levels observed in within-society surveys are not known. A total of 157 normotensive subjects aged 18 to 35 years, selected at random in a cross-sectional population-based survey, answered a structured questionnaire. They were classified as strongly predisposed to hypertension when two or more first-degree relatives had a diagnosis of hypertension. Anthropometric parameters were obtained and sitting blood pressure was determined with aneroid sphygmomanometers. Sodium and potassium excretion was measured by flame spectrophotometry in an overnight urine sample. A positive correlation between blood pressure and urinary sodium excretion was detected only in the group of individuals strongly predisposed to hypertension, both for systolic blood pressure (r = 0.51, P<0.01) and diastolic blood pressure (r = 0.50, P<0.01). In a covariance analysis, after controlling for age, skin color and body mass index, individuals strongly predisposed to hypertension who excreted amounts of sodium above the median of the entire sample had higher systolic and diastolic blood pressure than subjects classified into the remaining conditions. The influence of familial predisposition to hypertension on the association between salt intake and blood pressure may be an additional explanation for the weak association between urinary sodium excretion and blood pressure observed in within-population studies, since it can influence the association between salt consumption and blood pressure in some but not all inhabitants.

Adolescent↗
PubMed1999

Evidence of inappropriate use of vancomycin in a university affiliated hospital in Brazil.

OBJECTIVE: To evaluate the appropriateness of use of vancomycin in a University affiliated Hospital in Brazil. METHODS: One hundred sequential therapeutic courses of vancomycin were retrospectively examined through a chart review. The prescriptions were evaluated in terms of indication, use of critical process indicators, and use of outcome measurements according to an adapted version of the criteria recommended by the American Society of Health-System Pharmacists. RESULTS: The indication for use was appropriate in 39% of the cases. Critical process indicators indicated frequent inappropriate use, mainly in relation to a low frequency of bacterial cultures (54%), infrequent determination of creatinine levels prior to therapy (57%), incorrect dosage (42%), incorrect duration of therapy (63%), and infrequent determination of serum levels of vancomycin (73%). It was impossible to evaluate outcome measurements, since data were not collected in most patients. Larger discrepancies between recommendation and practice were detected in Paediatrics and Paediatric Pneumology Services. CONCLUSION: The misuse of vancomycin in our hospital is very common according to standard guidelines, demanding new policies of control in order to diminish the possibility of the emergence of multi-resistant strains.

Journal Article↗
PubMed1999

The effects of two aerobic training intensities on ambulatory blood pressure in hypertensive patients: results of a randomized trial.

The effect of different intensities of aerobic exercise on blood pressure remains uncertain. The goal of this trial was to compare the effect of two different levels of aerobic physical training on 24-hour ambulatory blood pressure. In this double-blind parallel-group trial, 28 sedentary hypertensive patients (mean diastolic blood pressure of 90 to 104 mm Hg) were randomly assigned to 10 weeks of physical training at 20% (Group I) or 60% (Group II) of their maximal workload on a cycle ergometer (mean load of 32 and 85 watts, respectively). Maximal oxygen consumption was estimated by the time spent on a mechanical braked Monark bicycle (Monark, Sáo Paulo, Brazil). Indexes of physical fitness were determined by cycle ergometer tests before and after the experimental period. The principal outcome variable was mean 24-hour ambulatory blood pressure. Mean 24 hour systolic blood pressure fell from 137.2+/-14.9 to 135.2+/-12.7 mm Hg in Group I and from 144.4+/-13.3 to 138.6+/-12.9 in Group II (mean between group difference of -2.1 mm Hg, P = 0.479, adjusted for baseline blood pressure). Mean diastolic blood pressure fell from 9.21+/-10.0 to 89.3+/-7.7 mm Hg in Group I and from 93.3+/-5.8 to 90.6+/-6.8 mm Hg in Group II (mean adjusted difference of -0.06, P = 0.765). Nighttime blood pressure did not change in either group. Across all participants, a reduction in systolic blood pressure was significantly associated with improved physical fitness as manifest by increased physical work capacity at heart rate of 130 bpm (PWC130), increased systolic blood pressure at PWC130, and decreased maximum heart rate measured during the cycle ergometer test We conclude that aerobic training programs at 20% and 60% of the maximum work capacity have similar effects on ambulatory blood pressure.

Blood Pressure↗
PubMed1999

Dose-dependent biphasic effect of ethanol on 24-h blood pressure in normotensive subjects.

The vasodilation that follows acute alcohol intake is hard to conciliate with the high prevalence of hypertension detected in those persons who consume regular amounts of alcohol. In this experiment we examined early and late hemodynamic effects of acute administration of water and of 15 g, 30 g, and 60 g of alcohol in 40 normal men, aged 19 to 30 years, using 24-h ambulatory blood pressure monitoring (ABPM). Mean systolic and diastolic blood pressures were each approximately 4 mm Hg lower during the period immediately after ingestion of 60 g (v 0 g) of ethanol, and were 7 and 4 mm Hg higher, respectively, at night. The day minus night differences displayed a dose-response curve both for systolic (P < .001) and diastolic blood pressure (P = .045). Three subjects in the 60-g group had more than 50% of nightly blood pressure loads in the hypertensive range against none in the remaining groups (P < .01). In conclusion, our findings suggest that acute alcohol intake elicits a biphasic hemodynamic response, causing, first, vasodilatation and, later, a pressor effect. The higher prevalence of hypertension in alcohol abusers seen in epidemiological surveys may be, in part, a result of measurements done in the period of transiently increased blood pressure during ethanol washout.

Administration, Oral↗
PubMed1999

The effect of increasing doses of levodopa on children with strabismic amblyopia.

PURPOSE: The purpose of this study was to determine the efficacy and tolerance of a levodopa/carbidopa combination and to test its dose-effect response when combined with occlusion therapy for children with amblyopia. METHODS: A 1-week randomized, double-blind, parallel, and placebo-controlled study was performed with 78 children with amblyopia aged between 7 and 17 years. Children who weighed less than 40 kg were randomly assigned to receive 5, 10, or 20 mg of levodopa or placebo (3 times a day), and those who weighed 40 kg or more were randomly assigned to receive 10, 20, or 40 mg of levodopa or placebo. Subjects were instructed to occlude the dominant eye (3 h/d). Snellen visual acuity was measured at baseline and at 2 hours after ingestion of the last capsule. Compliance with occlusion and capsule consumption was verified by a questionnaire and counting capsules. Adverse effects were checked with a physical examination and a questionnaire. RESULTS: From baseline to the follow-up test trial, the improvement in the logarithm of the Snellen fraction was 0.05+/-0.11 in the placebo group, 0.18 +/-0.21 in group 1, 0.08+/-0.11 in group II, and 0.16+/-0.15 in group III (P = .031). Visual acuity improved from 0.59 to 0.45 in the levodopa/carbidopa group and from 0.69 to 0.63 in the control group (P = .023). The compliance with occlusion was similar in all groups. No one complained of adverse side effects. CONCLUSION: Levodopa, at an average dose of 0.51 mg/kg per day, is well tolerated and produces a clinical and statistically significant short-term improvement of visual acuity in children with amblyopia.

Administration, Oral↗
PubMed1999

Is epistaxis evidence of end-organ damage in patients with hypertension?

OBJECTIVES/HYPOTHESIS: To study the association between history of mild to severe epistaxis with different stages of hypertension and with other evidence of target organ damage in a sample of patients attending an outpatient hypertension clinic, controlling for potential confounding factors. STUDY DESIGN: A survey of adult patients with hypertension. METHODS: A consecutive sample of 323 adults with hypertension was studied. The main outcome measures were history of adult epistaxis, high blood pressure, duration of hypertension, nasal abnormalities, and fundoscopic and electrocardiogram abnormalities. RESULTS: Ninety-four patients (29.1% of the whole sample) reported at least one episode of nosebleed after 18 years of age. Of these, 59 (62.8%) needed medical assistance to control at least one of the episodes. The history of epistaxis was not associated with blood pressure classified according to the World Health Organization/International Society of Hypertension paradigm or classified as severe or not severe. There was a trend of an association between history of epistaxis and duration of hypertension. The history of severe epistaxis (epistaxis that needed medical assistance) was not associated with blood pressure classified as severe or not severe and with duration of hypertension. More patients with left ventricular hypertrophy had a positive history of adult epistaxis. There was no association between history of epistaxis or history of severe epistaxis and fundoscopic abnormalities. Among the abnormalities detected at rhinoscopy, only the presence of enlarged septal vessels was associated with history of epistaxis. The presence of enlarged septal vessels was strongly and independently associated with history of epistaxis in the logistic regression model. Duration of hypertension and left ventricular hypertrophy showed a trend for an association with the history of epistaxis in the adult life. CONCLUSIONS: A definite association between blood pressure and history of adult epistaxis in hypertensive patients was not found. The evidence for an association of duration of hypertension and left ventricular hypertrophy with epistaxis suggests that epistaxis might be a consequence of long-lasting hypertension. The association between the presence of enlarged vessels at rhinoscopy with history of epistaxis in hypertensive patients is a novel observation that needs to be addressed in future observations.

Blood Vessels↗
PubMed1998

Alcohol intake and blood pressure: the importance of time elapsed since last drink.

BACKGROUND: A positive association of chronic exposure to alcoholic beverages with blood pressure and the prevalence of hypertension has been described in epidemiological surveys, but the influence of time elapsed since last ingestion in this setting was not demonstrated. DESIGN: A cross-sectional, population-based survey. METHODS: In total 1089 adults from Porto Alegre, randomly selected from a population-based, multi-stage probability sample, were interviewed at home. The average daily alcohol intake of each subject was calculated taking into account the concentration of ethanol in the beverages (distilled or fermented beverages), and the time elapsed between the last ingestion of ethanol and the moment of blood pressure determination. Standardized sitting blood pressure and anthropometric parameters were collected. The magnitude and shape of the associations were analyzed considering blood pressure as a continuous variable and the prevalence of arbitrarily defined hypertension. Simple and multiple linear regression models, including models to identify nonlinear associations, with quadratic and cubic terms of the amount of alcohol consumed, were employed. Blood pressure means were compared by analysis of variance and analysis of covariance. The association between hypertension and exposure to ethanol was analyzed through logistic regression models, controlling for various potential confounders. RESULTS: Positive nonlinear associations of the amount of alcohol consumed with blood pressure and the prevalence of hypertension (> or = 160/95 mmHg) were found, independent of age, years of education, smoking, and use of oral contraceptive and antihypertensive drugs. The consumption of 30 g/day ethanol was associated with increases of 1.5 and 2.3 mmHg in diastolic and systolic blood pressures, respectively, for men, and 2.1 and 3.2 mmHg, respectively, for women. The prevalence of hypertension was higher among those ingesting more than 30 g/day (odds ratio = 2.9, P < 0.01). The time elapsed between the last ingestion and blood pressure measurement was independently associated with the prevalence of hypertension. Men with last consumption of alcohol 13-23 h prior to measurement had odds of being hypertensive 2.6 (confidence interval 1.3-5.0) greater than did subjects who had consumed alcoholic beverages 24 h and more before the blood pressure determination. For men, systolic and diastolic blood pressures were lower during the first 3 h after ingestion and increased afterward. Frequency of consumption and type of beverage consumed were not independently associated with level of blood pressure. CONCLUSION: A time-dependent association between alcohol consumption and effects on blood pressure, demonstrated in experimental studies, was found for free-living individuals selected at random.

Adolescent↗
PubMed1998

[Association of various measurements of obesity and the prevalence of hypertension].

PURPOSE: To evaluate the association between body mass index (BMI), waist-hip ratio and waist circumference with the prevalence of hypertension in a representative sample of 1088 adults of Porto Alegre (RS), Brazil. METHODS: In this cross-sectional survey, subjects were considered as having hypertension if they had systolic blood pressure > or = 160 mmHg or diastolic > or = 90 mmHg, and were considered obese if they had BMI > or = 27 kg/m2, or had a waist-hip-ratio > or = 0.95 cm (men) or 0.80 (women) or had a waist circumference > or = 96 (men) or 92 (women). RESULTS: Obesity defined by the BMI was associated with hypertension in both genders (RR 1.9, CI 1.0-3.2 in men; RR 2.2, CI 1.3-3.8 in women). The other indices were significantly associated with hypertension just in women. CONCLUSION: BMI > or = 27.0 kg/m2 was strongly associated with increased odds to have hypertension. Similar magnitude of the association with the other indices indicate their utility to estimate the risk of hypertension.

Adult↗
PubMed1997

The effect of Syzygium cumini (L.) skeels on post-prandial blood glucose levels in non-diabetic rats and rats with streptozotocin-induced diabetes mellitus.

This study was undertaken to investigate whether a tea prepared from Syzygium cumini, reported to be used by diabetics in Porto Alegre, Brazil, might have an antihyperglycemic effect in experimental models. Teas prepared from leaves and seeds of S. cumini, in concentrations ranging from 2-64 g/l, were administered, as water substitute for 14-95 days, to 16 groups with 8-9 normal albino rats and to four groups with 10-12 rats with streptozotocin-induced diabetes mellitus. Post-prandial blood glucose levels were determined by the glucose oxidase method on blood samples obtained by decapitation. None of the tea concentration had any detectable antihyperglycemic effect either in normal or in diabetic rats, suggesting that this plant, prepared in a manner similar to that employed by humans, is destitute of an antihyperglycemic effect.

Animals↗
PubMed1997

Blood pressure effects of antihypertensive drugs and changes in lifestyle in a Brazilian hypertensive cohort.

BACKGROUND: The antihypertensive efficacy of drug therapy and of some nonpharmacologic recommendations has been demonstrated in controlled clinical trials, but not in a clinical setting. OBJECTIVE: To assess the antihypertensive effectiveness of drug therapy and of three nonpharmacologic recommendations (loss of weight, salt-intake restriction, and physical exercise). DESIGN: A prospectively planned cohort study. SETTING: A hospital-based hypertensive outpatient clinic. PATIENTS: We studied 637 patients (65.5% women) with systolic blood pressures above 140 mmHg or diastolic blood pressures above 90 mmHg, corresponding to 76% of 839 patients who were administered a prescription for hypertension and who returned for the first follow-up visit 3.5 months later on average. METHODS: The nonpharmacologic prescription consisted of salt-intake restriction for all, weight reduction for overweight patients, and practice of aerobic physical exercise for those for whom it was not contraindicated; 60% of the patients were treated with drugs according to standard recommendations. Patients treated with drugs were compared with untreated subjects; for the nonpharmacologic interventions, the groups were compared according to their reported compliances with the recommendations (at least some compliance versus none). The main outcome measures were variations in systolic and diastolic blood pressures between the baseline evaluation and the first follow-up visit and an improvement in prognosis, represented by a favorable change in the classification of the blood pressure (according to Joint National Committee V criteria). RESULTS: The cohort constituted predominantly low-income, middle-aged, overweight white women, with low-to-moderate hypertension of long duration. The group treated with drugs exhibited the greatest reduction in blood pressure, with clinical significance even discounting the losses in follow-up; the group of patients who reported compliance with the low-energy-intake diet also showed a consistent antihypertensive effect, which was still detectable on the occasion of the third follow-up visit 9 months after the first prescription; reported compliance with a low-sodium diet and practice of physical exercise were not associated with a reduction in blood pressure; among a subset of the patients, reported compliance with the salt-intake-restricted diet did not reduce the amount of sodium to the theoretical antihypertensive threshold. It was not possible to determine whether the lack of an antihypertensive effect of physical exercise for this cohort was secondary to a misreport of the extent of compliance or to an absence of effect of the intensity of training prescribed. The effects of drug therapy and compliance with a low-energy-intake diet were shown to be independent of other interventions or confounders. CONCLUSION: The antihypertensive effect of drugs demonstrated in well-controlled clinical trials is achievable in clinical practice. The recommendation to lose weight was the only nonpharmacologic intervention with a detectable antihypertensive effect in this cohort. The absence of effect of a low-sodium diet is probably secondary to the insufficient reduction in the amount of salt consumed. The lack of an antihypertensive effect of physical exercise could reflect either a misreported compliance or an absence of effect of the intensity of training recommended in this study.

Adult↗
PubMed1997

[Importance of nutritional aspects in attention deficit hyperactivity disorders].

The attention deficit hyperactivity disorder is a common childhood syndrome that is recognized as an important medical-social problem, being the object of an exhaustive investigation related to its etiology, diagnostic approach and prevention, and treatment forms. Among the factors that can alter the cerebral function, is the malnutrition. The authors discuss the association of the syndrome with the nutritional condition of students from elementary schools.

Analysis of Variance↗
PubMed1996

Alcoholic beverage consumption and associated factors in Porto Alegre, a southern Brazilian city: a population-based survey.

OBJECTIVE: To describe the pattern of alcoholic beverage consumption and the prevalence of at risk drinking behaviors, as well as their association with demographic and socioeconomic factors in the adult population of Porto Alegre, a southern Brazilian city. METHOD: In a cross-sectional, population-based, multistage random sampling study, 1,091 (600 female) individuals (92% of those eligible) were selected and interviewed at home. Exposure to alcohol was measured by the CAGE questionnaire and by inquiring about the type, quantity and frequency of alcoholic beverage consumption. An average consumption of 30 g per day or more, a level of exposure associated with health risks, was considered as heavy drinking. Two positive answers to the GAGE questionnaire represented the cutoff for indicating dependence. RESULTS: The prevalences were: 9.3% (95% CI: 7.6 to 11.0) for dependence, 15.5% (13.4 to 17.7) for heavy drinking and 12.3% (10.4 to 14.2) for daily drinking; 24.1% (21.7 to 26.6) were abstinent. Women consumed alcoholic beverages in lower frequency and amounts than men. The most widely consumed beverages were beer, wine and "cachaça," a Brazilian sugarcane spirit. In a logistic regression model, increasing age, lower education and income, and nonwhite race were associated with heavy drinking and dependence. Households with 3-4 persons were associated with the lowest risk of heavy drinking, but the prevalence of dependence was higher in crowded households. The presence of another heavy drinker or dependent in the household was associated with heavy drinking but not with dependence. CONCLUSIONS: The study characterized a detailed pattern of alcoholic beverage use and indicated that at risk drinking is an important public health problem in a developing country. The risk factors for heavy drinking and dependence were the same, with the exception of age at starting to drink, heavy drinking or dependence-positive household members.

Adult↗
PubMed1995

[Prevalence of smoking and associated factors in a metropolitan area in the southern region of Brazil].

A cross-sectional study was carried out for the purpose of evaluating, the prevalence of smoking and the factors associated with it in Porto Alegre, a city in southern Brazilian. Through proportional, multiple stage, random sampling, 1.091 individuals (92% of those eligible) of 18 or more years of age, were interviewed at home. Exposure to smoking was measured by a questionnaire that inquired about the type, quantity and frequency of tobacco use. The prevalence of smoking was 34.9% (CI 31.9-37.8). It was higher -among men--41.5% (CI 38.5-44.4) then women--29.5% (CI 26.8-32.2). The former started smoking at mean age of 16 (+/- 5.6), with mode of 15 and smoked an average of 19.0 (+/- 14.0) cigarettes per day. Females started at a mean age of 17.8 (+/- 6.7), with mode of 14 years old and smoked 14.5 (+/- 10.3). The association of the drinking habit and demographic and socioeconomic variables with smoking was evaluated through logistic regression. The variables included in the model were sex, age, education, income, professional qualification and alcohol consumption. The prevalence of smoking was greater for men, individuals of lower socioeconomic level, between 30 and 39 years of age, and among those accustomed to consuming alcoholic beverages. In conclusion, this study demonstrated that smoking is a public health problem in Brazil as in another countries. It is associated with sex, age, education and professional qualification, as has been observed elsewhere. The association of alcohol consumption with smoking may be understood as risk behavior, both having similar determinants.

Adolescent↗
PubMed1995

Study of the usefulness of optic fundi examination of patients with hypertension in a clinical setting.

The purpose of this study was to evaluate the usefulness of direct opthalmoscopy by non-opthalmologists in patients with hypertension. In a cross-sectional survey, we analysed the association between optic fundi abnormalities, individually and according to the criteria of Keith and Wagener (KW), with blood pressure and duration of known hypertension in 400 non-diabetic hypertensive patients. The optic fundi abnormalities were more frequent in patients with diastolic blood pressure (DBP) > 105 mm Hg (P = 0.002), SBP > 180 mm Hg (P < 0.0001) and with a duration of known hypertension > 3 years (P = 0.002). The severity of hypertension did not vary in parallel with the KW classes I and II: 34.5% of patients classified as KW I had a diastolic pressure of > 105 mm Hg compared with only 25.3% of those classified as KW II. Class III abnormalities were infrequent (2.5% of the whole cohort). In a logistic regression model, diffuse arteriolar narrowing was associated with DBP (P = 0.002) and age (P < 0.001). Abnormalities of the arteriovenous crossings were associated with SBP (P = 0.001) and duration of disease (P = 0.008). The positive predictive value of any fundoscopic abnormality to estimate the severity of hypertension was 59% and the negative value was 60%. The results of this study demonstrate that optic fundi examination by internists and cardiologists does not give an accurate assessment of the severity of hypertension in most patients, and that the Keith-Wagener classification of retinopathy has a limited applicability.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiology↗
PubMed1994

[Prevalence of systemic arterial hypertension and associated risk factors in the Porto Alegre metropolitan area. Populational-based study].

PURPOSE: To evaluate the contemporaneous prevalence of hypertension in Porto Alegre, RS, and its association with biological, socioeconomic and environmental factors. METHODS: It was done an observational and analytical study with a cross-sectional design, of a representative sample of the adults of the urban region. The study was planned with a power to describe the main estimates with 0.5% confidence limits of +/- 2%. One thousand and ninety one individuals, selected at random in conglomerates and in a multiple stage process, were interviewed. The data were obtained in the domiciles through standardized questionnaires and physical examination. RESULTS: The prevalence of hypertension, defined by blood pressure (BP) > or = 160/95 mmHg, was 12.6% (CI = 10.6 to 14.6). Considering as hypertensives the individuals with BP < 160/95 mmHg under drug treatment, the prevalence increased to 19.2% (CI = 16.9 to 21.5). The corresponding figures for the 140/90 mmHg criteria were 25.8% (CI = 23.2 to 28.4) and 29.8% (CI = 27.1 to 32.5). Among those using anti-hypertensive drugs (11%), 58.9 had BP < 160/95 mmHg and 35.5% < 140/90 mmHg; 57.7% of the hypertensives (160/95 criteria) were aware of diagnosis; 28% had body mass index above 27kg/m2, 15.5% consumed more than 30g per day of ethanol, 35.1% were smokers, and 17.8% ex-smokers. The prevalence increased with age and was higher in individuals with obesity, strong family history of hypertension, low education and in those which abused from alcoholic beverages. In a logistic regression model, these putative risk factors showed to be independent of others. CONCLUSION: The contemporaneous prevalence of hypertension in Porto Alegre demonstrates that the prevalence rates have not decreased in the last 15 years. It was also shown an inadequate BP control in almost 50% of those under drug treatment, and finally, the association of hypertension with well-known risk factors.

Adolescent↗