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Biomedical subjects

Jorge Pinto Ribeiro

Publications and source records attributed to Jorge Pinto Ribeiro.

10 recordsLinked to original sources
PubMed2006

[Effects of cimetidine on chronotropic response to cardiopulmonary exercise testing].

OBJECTIVE: To test the hypothesis that the administration of cimetidine will modify the chronotropic response to exercise testing through a random clinical trial. METHODS: The study selected 24 eligible healthy subjects, ages between 20 and 68 years, not athletes, who agreed to undergo cardiopulmonary exercise testing after the administration of placebo and 400 mg of cimetidine twice a day for one week. The tests were performed on a treadmill using a ramp protocol and direct analysis of the expired gases. Peak, resting and anaerobic threshold heart rate were recorded. RESULTS: The twenty subjects studied were equally distributed across sex with mean (+/- SD) age 43 +/- 11 years. Tests on placebo and on cimetidine presented similar duration (578 +/- 90 sec vs 603 +/- 131 sec) and similar peak oxygen uptake (35 +/- 8 ml/kg.min vs 35 +/- 8 ml/kg.min). Cimetidine administration had no significant effect on resting heart rate (75 +/- 10 bpm vs 74 +/- 8 bpm), heart rate at peak exercise (176 +/- 12 bpm vs 176 +/- 11 bpm), and on the difference between the peak and the resting heart rates--delta HR (101 +/- 14 bpm vs 101 +/- 13 bpm). CONCLUSION: The administration of cimetidine for 7 days has no significant effect on the chronotropic response to exercise testing.

Adult↗
PubMed2006

ASCOT-BPLA.

Explore the source record for details and available documents.

Antihypertensive Agents↗
PubMed2005

[Annual cost of ischemic heart disease in Brazil. Public and private perspective].

OBJECTIVE: To estimate the annual cost of coronary artery disease (CAD) management in Public Health Care System (SUS) and HMOs values in Brazil. METHODS: Cohort study, including ambulatory patients with proven CAD. Clinic visits, exams, procedures, hospitalizations and medications were considered to estimate direct costs. Values of appointments and exams were obtained from the SUS and the Medical Procedure List (LPM 1999) reimbursement tables. Costs of cardiovascular events were obtained from admissions in public and private hospitals with similar diagnoses-related group classifications in 2002. The price of medications used was the lowest found in the market. RESULTS: The 147 patients (65 +/- 12 years old, 63% men, 69% hypertensive, 35% diabetic and 59% with previous AMI) had an average follow-up of 24 +/- 8 months. The average estimated annual cost per patient was R$ 2,733.00, for the public sector, and R$ 6,788.00, for private and fee-for-service plans. Expenses with medications (R$ 1,154.00) represented 80% and 55% of outpatient costs, and 41% and 17% of total expenses, in public and non-public sectors, respectively. The occurrence of cardiovascular event had a great impact (R$ 4,626.00 vs. R$ 1,312.00, in SUS, and R$ 13,453.00 vs. R$ 1,789.00, for HMOs, p<0.01) on the results. CONCLUSION: The average annual cost of CAD management was high, being the pharmacological treatment the main determinant of public costs. Such estimates may subsidize economical analyses in this area, and foster related healthcare policies.

Brazil↗
PubMed2005

Health outcomes in decompensated congestive heart failure: a comparison of tertiary hospitals in Brazil and United States.

BACKGROUND: Few international studies prospectively compared evidence-based practices and health outcomes among congestive heart failure (CHF) cohorts from countries with different cultural and economic backgrounds. METHODS: Patients consecutively admitted with congestive heart failure to tertiary care teaching hospitals in Brazil and in the United States (U.S.) were systematically evaluated using a structured data form. Follow-up data 3 months after discharge were obtained using chart review and telephone interviews. RESULTS: U.S. patients were older (p < 0.01), had higher prevalence of ischemic etiology (p < 0.01) and less previous hospitalizations for congestive heart failure (p = 0.03) than Brazilian patients, but similar Charlson comorbidity scores (p = 0.54) and left ventricular (LV) function (p = 0.45). Prescription of angiotensin-converting enzyme inhibitors at discharge was lower at the U.S. hospital (57% vs. 68%; p = 0.03), but beta-blockers prescription was higher (37% vs. 10%; p < 0.01). Length-of-stay was significantly shorter (5 [interquartile range, 3-9] vs. 11 [6-19] days; p < 0.001) and in-hospital mortality was lower (2.4% vs. 13%; p < 0.001) in the U.S. cohort, but fewer clinical events within 3 months after discharge were observed in Brazilian patients (42% vs. 54%; p = 0.02). Combined clinical outcomes within 3 months, including overall mortality and hospital readmission, were similar between cohorts (57% vs. 55%; p = 0.80). In multivariate analysis, hospital site remained significantly associated with health outcomes. CONCLUSIONS: Medical practice and health-related outcomes were different between U.S. and Brazilian congestive heart failure patients. In order to improve management worldwide, potential factors (structural, cultural or disease-related) that might be associated with these differences need to be evaluated in future studies.

Adrenergic beta-Antagonists↗
PubMed2005

Aerobic exercise and submaximal functional capacity in overweight pregnant women: a randomized trial.

OBJECTIVE: To evaluate the effects of aerobic training on submaximal cardiorespiratory capacity in overweight pregnant women. METHODS: We conducted a randomized clinical trial in a referral center prenatal clinic during the period 2000-2002. Of 132 overweight (body mass index 26-31 kg/m2) but otherwise healthy volunteers, at 20 years of age or older, with gestational age of 20 weeks or less, and without diabetes or hypertension, 92 consented to participate and were randomized. Intervention consisted of 3 one-hour aerobic exercise sessions per week; the control group received weekly relaxation and focus group discussions. The main outcome measure was submaximal exercise capacity evaluated by oxygen uptake at the anaerobic (first ventilatory) threshold during cardiopulmonary treadmill testing 12 weeks after randomization. RESULTS: Oxygen uptake at the anaerobic threshold increased 18% (15.9 +/- 2.6 to 18.1 +/- 3.1 mL . min(-1) . kg(-1)) in the exercise group but decreased 16% (16.9 +/- 3.0 to 15.8 +/- 2.6 mL . min(-1) . kg(-1)) among the control group. Oxygen consumption at the anaerobic threshold, adjusted through analysis of covariance for baseline oxygen uptake, was 2.68 (95% confidence interval 1.23 to 4.12) mL . min(-1) . kg(-1) greater in the exercise group. Women in the exercise group were approximately 5 times more likely than those in the control group to have regular or good cardiorespiratory capacity (12/38 versus 2/38; relative risk 5.2, 95% confidence interval 1.2 to 22.0, number needed to treat 5). CONCLUSION: Aerobic training in overweight pregnant women substantially increases submaximal exercise capacity, overcoming the otherwise negative effects of pregnancy in this regard. Additional studies are required to evaluate its effect on major clinical outcomes.

Adult↗
PubMed2004

Effectiveness of metoprolol in preventing atrial fibrillation and flutter in the postoperative period of coronary artery bypass graft surgery.

OBJECTIVE: To assess the effectiveness of metoprolol in preventing clinically detectable atrial fibrillation (AF) and flutter after coronary artery bypass graft (CABG) surgery. METHODS: An open, randomized study was carried out to treat 200 patients who had undergone isolated CABG surgery with extracorporeal circulation. The patients were randomized to either receive metoprolol orally or not to receive the medication in the postoperative period. The outcomes were the detection of sustained atrial AF and flutter, which were symptomatic or required treatment. The patients with the following characteristics were excluded from the study: baseline left ventricular ejection fraction < 35%; previous AF; history of bronchospasm; second- and third-degree atrioventricular blocks, low cardiac output, and heart failure. RESULTS: Arrhythmias occurred in 11 out of 100 patients in the metoprolol group and in 24 out of 100 patients in the control group (P=0.02). The relative risk (RR) was 0.46 (95% CI = 0.24-0.88), and the number necessary to treat (NNT) and avoid the outcome was 8 patients. AF was the arrhythmia most frequently observed (30/35). In 38 patients aged 70 years or more, the arrhythmias occurred in 2 out of 19 patients in the metoprolol group and in 10 out of 19 patients in the control group (c2 Yates: P=0.01). The relative risk was 0.20 (95% CI = 0.05-0.79) and the number necessary to treat was 2 patients. CONCLUSION: Metoprolol is effective in preventing AF and flutter in the postoperative period of CABG surgery, and this effect was more evident in the group of elderly patients.

Aged↗