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Flávio Danni Fuchs

Publications and source records attributed to Flávio Danni Fuchs.

At least 19 recordsLinked to original sources
PubMed2006

The efficacy of herbal medicines in clinical models: the case of jambolan.

A large proportion of drugs employed in clinical practice come from plants. The development of new medical agents is a lengthy and time-consuming process, with the identification of extracts with putative therapeutic effects, the isolation of active ingredients and pre-clinical studies to investigate their pharmacological profile. We propose a shortcut in this sequence of procedures, testing first if the extracts, in the way they are used by patients, have efficacy in clinical models. On the one hand, this allows to screen plants with higher chances to identify novel drug candidates; this method may result in information with immediate interest for patients who take these traditional preparations, informing them about efficacy, inertia and risks of the product. In this commentary, we describe our own experience applying this approach to investigate the potential antihyperglycemic effect of tea and extracts prepared from leaves of jambolan (Syzygium cumini and Syzygium jambos). The experiments with normal rats, rats with streptozotocin-induced diabetes, normal volunteers and patients with diabetes were all negative in regard to an antihyperglycemic effect of this plant. In view of the pharmacological inertia of jambolan in the clinical model, patients and physicians should not rely on its putative antihyperglycemic effect. This approach may also be applicable to other popular medicines employed in the management of diabetes and other diseases.

Animals↗
PubMed2006

ASCOT-BPLA.

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Antihypertensive Agents↗
PubMed2006

Pharmaceutical care program for patients with uncontrolled hypertension. Report of a double-blind clinical trial with ambulatory blood pressure monitoring.

BACKGROUND: Pharmaceutical care programs may be an option to improve blood pressure (BP) control in patients with uncontrolled hypertension. The aim of this study was to evaluate the efficacy of pharmaceutical care programs in treating patients with resistant hypertension. METHODS: In a double-blind randomized clinical trial, 71 patients with uncontrolled BP were enrolled in a pharmaceutical care program or in a control group and underwent a series of cognitive tests. The primary outcome was change in ambulatory BP (ABP) between the baseline evaluation and the final visit 6 months later. The secondary outcomes were the frequency of drug-related problems and adherence as determined by plasma levels of hydrochlorothiazide. RESULTS: The delta-values between the intervention and control groups for ABP in the different daily periods, with the corresponding 95% confidence limits, adjusted for age and baseline BP were: 3 (-1 to 5), 2 (-2 to 4), and 5 (-1 to 6) mm Hg for 24 h, daily and nightly systolic BP, respectively. The corresponding values for diastolic BP were 1 (-1 to 3), 0 (-2 to 2), and 3 (-1 to 4) mm Hg, respectively. Hydrochlorothiazide was detected in the plasma in 21 of 27 patients in the intervention group that attended to all appointments and 24 of 30 patients in the control group (P = .904). CONCLUSIONS: The pharmaceutical care program tested in this trial was feasible and showed a trend for better BP control in patients with uncontrolled hypertension.

Antihypertensive Agents↗
PubMed2006

Incidence of hypertension by alcohol consumption: is it modified by race?

OBJECTIVE: To investigate the influence of race, binge drinking and alcohol addiction on the association between consumption of alcoholic beverages and incidence of hypertension. METHODS: In a population-based cohort study, 1089 adults were interviewed and had blood pressure and anthropometric measurements carried out at home. Their alcohol consumption was ascertained by an amount-frequency questionnaire. Binge drinking was defined as consumption of five or more drinks on one occasion for men or four drinks for women, and abuse of alcohol as consumption of 30 g/day or more in men or 15 g/day or more in women. Incident cases of hypertension were characterized by blood pressure > or = 140/90 mmHg or use of hypertension medication. RESULTS: Among 589 normotensive individuals in the baseline visit, 127 incident cases of hypertension were identified, after a follow-up of 5.6 +/- 1.1 years. Binge drinking and alcohol dependency were not associated with the incidence of hypertension. Adjusted (age, education) risk ratios for the incidence of hypertension (95% confidence interval) were significant only for non-white abusers of ethanol: 11.8 (1.6-86.9). Systolic blood pressure of black abusers increased by 16.1 +/- 3.5 mmHg, in comparison with 4.9 +/- 1.5 mmHg among white abusers (P = 0.004). CONCLUSION: Individuals with an African ancestry, who consumed larger amounts of ethanol, are at higher risk of developing hypertension. This risk is not explained by a binge drinking pattern or addiction to alcohol.

Adult↗
PubMed2004

Is hypertensive response in treadmill testing better identified with correction for working capacity? A study with clinical, echocardiographic and ambulatory blood pressure correlates.

Hypertensive response in treadmill testing is associated with the development of hypertension, but it is still unclear if it is better identified by systolic or diastolic response, and measured directly or corrected by working capacity. We investigated 75 patients with normal office blood pressure through a treadmill testing, ambulatory blood pressure (ABP) monitoring, and two-dimensional Doppler echocardiogram. Characteristics associated with systolic blood pressure (SBP) response corrected by the estimated metabolic equivalent (MET) were identified in multiple linear regression models. SBP response was associated more consistently with age, body mass index (BMI), systolic ABP and left ventricular posterior wall thickness (p < 0.001) than diastolic response in the bivariate analysis, especially when corrected by MET. Age, BMI and nightly SBP were independently associated with SBP response corrected by MET in the multivariate analysis. Individuals from the top tertile of SBP response corrected by MET (> or =11.3 mmHg/MET) were older and had higher BMI, ABP and left ventricular septal and posterior wall thickness than individuals classified in the lower tertiles. These differences were more pronounced than the differences observed between individuals with and without a peak exercise blood pressure higher than 210 mmHg. We concluded that individuals with a high blood pressure response in treadmill testing have higher BMI, left ventricular posterior wall thickness and SBP measured by ABP monitoring than individuals without such a response. These differences were stronger when the variation of blood pressure during exercise was corrected by the amount of work performed.

Adult↗
PubMed2003

Prevalence of thyroid dysfunction in patients with acute atrial fibrillation attended at a cardiology emergency room.

CONTEXT: Atrial fibrillation occurs frequently in patients with thyrotoxicosis, while it has low prevalence in adults of the general population. The prevalence of thyroid dysfunction in subjects with atrial fibrillation is 0 to 24%, a wide variation that is attributed to the different methodologies applied. However, continuous use of amiodarone in patients with previous atrial fibrillation may interfere with these prevalence rates. OBJECTIVE: In this study, we present the prevalence of thyroid dysfunction in adult patients who presented at a cardiac emergency room with acute atrial fibrillation, using a sensitive thyroid-stimulating hormone (TSH) assay and triiodothyronine (T3) and thyroxine (T4) determination. TYPE OF STUDY: Cross-sectional study. SETTING: Emergency room of a tertiary care facility. PARTICIPANTS: A total of 72 patients with atrial fibrillation who presented at the emergency room not more than 48 hours after its onset. PROCEDURES: A standardized questionnaire and 12-lead electrocardiogram were applied, and T3, T4 and TSH were determined. MAIN MEASUREMENTS: TSH, T3 and T4 determination. RESULTS: Among these patients, 16.6% had altered thyroid function tests: 6.9% had hyperthyroidism, 5.6% hypothyroidism and 4.2% had increased T4 levels, by means of amiodarone use. CONCLUSION: The high prevalence of thyroid dysfunction in our study, especially hyperthyroidism, suggests that routine thyroid testing with sensitive thyroid-stimulating hormone assay is required in patients with acute atrial fibrillation.

Acute Disease↗
PubMed2003

May we die twice?

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Amiloride↗
PubMed2003

Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women.

The objective of the study was to assess the association between systolic and diastolic blood pressure (SBP and DBP) and the use of oral contraceptives (OC) in hypertensive women. In a prospective cross-sectional study, we evaluated 171 women who were referred to the Hypertension Outpatient Clinic of Hospital de Clínicas de Porto Alegre; 66 current users of OC, 26 users of other contraceptive methods and 79 women who were not using contraception. The average of six blood pressure readings was used to establish the usual blood pressure of the participants. Current OC users were compared with users of other methods and with patients not using contraception. Main outcome measures were SBP and DBP among the different groups, and prevalence of uncontrolled hypertension (SBP >or= 140 mmHg and DBP >or= 90 mmHg). DBP was higher in OC users (100.2 +/- 15.9 mmHg) than in patients using other contraceptive methods (93.4 +/- 14.7 mmHg) and not using contraceptives (93.3 +/- 14.4 mmHg, p = 0.016). Women using OC for more than 8 years presented higher age-adjusted blood pressure levels than women using OC for shorter periods. Patients using OC had poor blood pressure control (p for trend = 0.046) and a higher proportion of them presented moderate-severe hypertension. These results were independent of antihypertensive drug use. In a logistic regression model, we found that current OC use was independently and significantly associated with prevalence of uncontrolled hypertension. It is concluded that hypertensive women using OC present a significant increase in DBP and poor blood pressure control, independent of age, weight and antihypertensive drug treatment.

Adolescent↗
PubMed2003

Risk factors for cardiovascular disease in a Brazilian population-based cohort study.

OBJECTIVE: Our aim was to investigate risk factors for cardiovascular disease (CVD) in a population-based Brazilian cohort. DESIGN AND METHODS: A cohort study was conducted with 1091 individuals identified through multi-stage probability sampling in Porto Alegre, Brazil. Risk factors were investigated among demographic and anthropometric characteristics, including education, smoking habits, income, alcoholic beverage consumption, and blood pressure. A fatal or non-fatal episode of myocardial infarction, stroke, or heart failure, and cases of sudden death comprised the composite endpoint. RESULTS: Vital status was determined in 982 (90.0%) of the participants of the original cohort after 6.0+/-1.7 years of follow-up. A total of 52 individuals presented a cardiovascular event. Male gender (hazard ratio (HR) 2.01, 95% CI 1.03-3.91), systolic blood pressure (mmHg) (HR 1.03, 95% CI 1.01-1.04) and alcohol consumption (g/day) (HR 1.001, 95% CI 1.00-1.003) were associated with the incidence of CVD after controlling for confounding. Body mass index (HR 1.05, 95% CI 0.99-1.11) and current or previous smoking (HR 1.65, 95% CI 0.83-3.26) showed a trend for a positive association. CONCLUSIONS: We confirmed that male gender, systolic blood pressure, obesity and smoking are risk factors for cardiovascular disease in a Brazilian population. The positive association between alcohol consumption and incident CVD was unexpected and deserves replication.

Adult↗
PubMed2003

Prevalence of and risk factors for HIV infection in individuals testing for HIV at counseling centers in Brazil.

BACKGROUND: Risk factors for HIV infection have been scarcely studied in developing countries. GOAL: The goal was to examine the seroprevalence and the risk factors for HIV infection among individuals submitting to voluntary and anonymous testing at counseling and testing centers in Porto Alegre, Brazil. STUDY DESIGN: In this cross-sectional study HIV infection was diagnosed by enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence. Risk factors for HIV infection were investigated and fitted to logistic regression models according to a hierarchical framework. RESULTS: The overall prevalence of HIV infection was 11.9%. It was greater among homosexual men, individuals with an HIV-positive partner, and intravenous cocaine users. The factors independently associated with risk for HIV infection were: history of detention, homosexual or bisexual orientation, positive VDRL, sex with male prostitutes, HIV-positive sex partner, sex with injectable drug user (IDU), use of cocaine, and sharing needles or syringes. CONCLUSION: A high prevalence of HIV infection among individuals attending anonymous testing centers was related to sexual behavior and IDU. Other risk factors might be just proxies of true risk behaviors.

Adult↗