Browsing by Author "Pereira, Telmo"
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- Acute effects of smoking on the arterial function of young healthy smokersPublication . Pereira, Telmo; Costa, TatianaSeveral studies have supported the idea that smoking induces changes with direct impact on endothelial function and arterial stiffness. The main purpose of this study was to assess the acute effects of smoking on vascular function in healthy young adults. METHODS: We designed a quasi-experimental study, including ninety participants aged between 18 and 25 years. Participants were divided into three groups: Active exposure group (AG) - 30 usual smokers; passive exposure group (PG) and non-exposure control group (CG), each including 30 non-smokers matched for age, gender and overall lifestyle. Heart rate (HR), brachial blood pressure (bBP), flow-mediated dilation (FMD), aortic pulse wave velocity (PWV) and carotid pulse wave analysis (PWA) were evaluated in two moments: baseline and 30 minutes after smoking exposition (AG and PG) or 30 minutes after the first evaluation (CG). RESULTS: Significant changes from baseline were observed only in the AG, with an increase in PWV, from 5.6 ± 0.7 m/s to 6.1 ± 0.2 m/s post-smoking (p = 0.040), and a decrease in FMD of about -5.7 ± 2.3% after smoking one cigarette (p < 0.001). A significant increase in brachial and central BP was also observed in the AG. A trend for increase in brachial and central BP, and decrease in the FMD was observed in the PG and no significant changes were depicted in the CG. CONCLUSION: Just one cigarette produces significant detrimental acute effects on the vascular endothelium and hemodynamic profile of healthy young short-term smokers. Changes are also observed, although to a lesser extent, in passive smokers.
- Assessing sarcocornia as a salt substitute: effects on lipid profile and gelatinase activityPublication . Louçano, Beatriz; Maletti, Sara; Timóteo, Maria Helena; Figueiredo, João; Osório, Nádia; Barroca, Maria João; Silva, Aida Moreira; Pereira, Telmo; Caseiro, ArmandoSodium, although essential for life, is a key factor in changes in vascular function and cardiovascular disease when consumed in excess. Sarcocornia spp., a halophyte plant with many nutritional benefits, presents itself as a promising substitute for the consumption of purified salt. Matrix metalloproteinases (MMPs) 2 and 9 are widely studied due to their action in physiological processes and as biomarkers at the diagnostic level due to their increased expression in inflammatory processes. This study aimed to evaluate whether replacing salt with Sarcocornia perennis (S. perennis) powder in healthy young people leads to an improvement in biochemical profiles and the attenuation of MMP-2 and MMP-9 activity. In the present study, 30 participants were randomized into a control group that consumed salt and an intervention group that replaced salt with powdered S. perennis. The evaluation of the biochemical parameters was carried out by the spectrophotometry method, and the evaluation of MMP activity was carried out by zymography. A significant decrease was observed in the intervention group in total cholesterol, high-density lipoprotein cholesterol (HDL-c), and creatinine (p-value ≤ 0.05), along with lower but not significantly different mean values of triglycerides. Regarding MMP activity after the intervention, a lower mean value was observed for MMP-9 activity, with there being higher mean values for MMP-2 activity, both with p-values ≥ 0.05.The results confirmed that the consumption of S. perennis is a beneficial choice for health regarding the lipid profile. The evaluation of MMP activity indicated the potential of S. perennis in the regulation of MMP-9 activity in healthy individuals, along with the need for the further study of these proteases in individuals with pathologies.
- Atrial fibrillation and early vascular aging: clinical implications, methodology issues and open questions—a review from the VascAgeNet COST ActionPublication . PUCCI, Giacomo; Grillo, Andrea; DALAKLEIDI, KALLIOPI; Fraenkel, Emil; Gkaliagkousi, Eugenia; Golemati, Spyretta; Guala, Andrea; Hametner, Bernhard; LAZARIDIS, ANTONIOS; Mayer, Christopher; Mozos, Ioana; Pereira, Telmo; Veerasingam, Dave; Terentes-Printzios, Dimitrios; Agnoletti, DavideAtrial fibrillation (AF), the most common cardiac arrhythmia, is associated with adverse CV outcomes. Vascular aging (VA), which is defined as the progressive deterioration of arterial function and structure over a lifetime, is an independent predictor of both AF development and CV events. A timing identification and treatment of early VA has therefore the potential to reduce the risk of AF incidence and related CV events. A network of scientists and clinicians from the COST Action VascAgeNet identified five clinically and methodologically relevant questions regarding the relationship between AF and VA and conducted a narrative review of the literature to find potential answers. These are: (1) Are VA biomarkers associated with AF? (2) Does early VA predict AF occurrence better than chronological aging? (3) Is early VA a risk enhancer for the occurrence of CV events in AF patients? (4) Are devices measuring VA suitable to perform subclinical AF detection? (5) Does atrial-fibrillation-related rhythm irregularity have a negative impact on the measurement of vascular age? Results showed that VA is a powerful and independent predictor of AF incidence, however, its role as risk modifier for the occurrence of CV events in patients with AF is debatable. Limited and inconclusive data exist regarding the reliability of VA measurement in the presence of rhythm irregularities associated with AF. To date, no device is equipped with tools capable of detecting AF during VA measurements. This represents a missed opportunity to effectively perform CV prevention in people at high risk. Further advances are needed to fill knowledge gaps in this field.
- Autonomic function recovery and physical activity levels in post-COVID-19 young adults after immunization: an observational follow-up case-control studyPublication . Freire, Ana Paula Coelho Figueira; Amin, Shaan; Lira, Fabio Santos; Morano, Ana Elisa von Ah; Pereira, Telmo; Coelho-E-Silva, Manuel-João; Caseiro, Armando; Christofaro, Diego Giulliano Destro; Santos, Vanessa Ribeiro dos; Júnior, Osmar Marchioto; Pinho, Ricardo Aurino; Silva, Bruna Spolador de AlencarCoronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = −24.67–−3.26; SNS index: p = 0.0068, CI = −2.50–−0.32) and increase in parasympathetic (PNS) activity (mean RR:p = 0.0097, CI = 33.72–225.51; PNS index: p = 0.0091, CI = −0.20–1.47) were observed. At follow-up, HRV was not different between groups (p > 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.
- Avaliação laboratorial do efeito antioxidante e anti-inflamatório do Resveratrol na função vascularPublication . Silva, Ana Margarida; Ferreira, Carla; Dias, Beatriz; Silva, Isabel; Clemente, Mariana; Figueiredo, João; Pereira, Telmo; Caseiro, ArmandoIntrodução: O resveratrol é uma fitoalexina natural cujos principais benefícios devem-se às suas propriedades anti-inflamatórias e antioxidantes. Os seus efeitos sugerem que este é um suplemento útil para a redução da inflamação, podendo desempenhar um papel fundamental na prevenção das doenças cardiovasculares. Este promove a vasodilatação pela indução da síntese de óxido nítrico (NO), possui atividade antitrombótica e evita a agregação plaquetária. O fator de crescimento endotelial vascular ( VEGF) é responsável pela angiogénese, sendo a sua expressão infuenciada pelo resveratrol. Objetivos: Avaliar o efeito do resveratrol no perfl vascular pela determinação da pressão arterial e dos biomarcadores interleucina-6 (IL-6), proteína C reativa (PCR), VEGF e NO. Material e Métodos: 27 alunos com idades compreendidas entre os 18 e os 22 anos foram divididos em grupo controlo (GC) e grupo de intervenção (GI), que consumiram placebo e 100 mg de resveratrol por dia, respetivamente, durante 1 mês. A pressão arterial foi medida com aparelho automático validado. Os níveis de PCR foram obtidos por imunoturbidimetria, os de IL-6 e VEGF por slot blot e a quantifcação de NO por espectrofotometria. Resultados: Entre os grupos observou-se uma diminuição da pressão arterial braquial e central (ρ˂0.05). A variação negativa no NO apresentou-se superior no GC apesar das diferenças não serem signifcativas (p>0,05). Nos restantes marcadores avaliados não se observaram diferenças signifcativas. Conclusões: A ingestão regular de resveratrol parece ser uma abordagem preventiva a nível vascular, dado que modula positivamente o perfl vascular, reduzindo a pressão arterial. A variação nos níveis de NO poderá ajudar a explicar os benefícios verifcados.
- Clinical usefulness of the electroencephalogram in acute stroke: a preliminary studyPublication . Borges, Daniel Filipe; Silva, Mariana; Ferreira, Axel; Coelho, Paulo Simões; Pereira, Telmo; Conde, JorgeIntroduction: Stroke is the main cause of disability worldwide, being the first cause of death in Portugal. In the first hours of the event, the cranioencephalic CT scan (CT Scan) does not show the lesion in about 74% of cases, making validation of alternative diagnostic approaches of utmost importance. The electroencephalogram (EEG) may provide useful information for the diagnosis and prognosis of stroke. Objective: To study the potential usefulness of the EEG for the early diagnosis of acute stroke in patients with initial negative CT Scan, and for the evaluation of the functional status and risk of epilepsy. Methods: Retrospective analysis of patients with ischemic stroke who underwent EEG and acute phase CT scan between January 2014 and February 2018. Patient characteristics and stroke were classified according to the Oxfordshire Community Stroke Project (OCSP) criteria. The patients were functionally evaluated at 12 months post-stroke by the modified Rankin Scale (mRS) and the existence of post-stroke epilepsy was determined by telephone interview on February 2018. Results: Thirty patients (25 females and 5 males, mean age 70.5 years) were included. According to the OCSP were identified: 40% TACS, 37% PACS, 10% LACS and 13% POCS. 50% with acute vascular injury visible on the initial CT Scan performed with 7 hours of evolution in median. All patients underwent EEG with a median of 3 days of evolution, and slow focal activity was observed in all patients, and focal paroxysmal activity (PA) was seen in 17% of the participants. 17 patients (58% of patients) developed post-stroke epilepsy (PSE) with 4 of these having PA evidence in the initial EEG (24%). One of the patients with PA in the initial EEG did not develop epilepsy during a 4 years follow-up period. In patients without PA, the average of mRs at follow-up was 3.8 and the mortality was 24%, whereas in patients with PA, the mean of the mRs was 5.0 and the mortality was 40%. Conclusion: In this study, unlike CT Scan, the acute-phase EEG presented with abnormal features in all patients with acute stroke, therefore the EEG may potentially provide significant diagnostic information, estimates of risk for developing future epilepsy and also overall risk stratification. Further studies are needed to validate this hypothesis.
- Determinantes e moduladores do envelhecimento arterial no idosoPublication . Costa, Tatiana; Pereira, TelmoAs artérias constituem o alvo, local e denominador das doenças cardiovasculares, constituindo estas a principal causa de morte nos países desenvolvidos. O envelhecimento arterial constitui um dos alicerces fisiopatológicos para estes processos, decorrendo este de acordo com uma trajetória de perda progressiva de distensibilidade arterial, que poderá ser acelerada perante a exposição a fatores ambientais ou comportamentais em associação com a predisposição genética intrínseca ao indivíduo. Esta trajetória acelerada de envelhecimento arterial, designada early vascular ageing (EVA) associa-se a maior risco de morte e morbilidade cardiovascular, sendo portanto, fundamental a validação e estabelecimento de biomarcadores para a sua de aferição, por um lado, e o desenvolvimento, validação e implementação de estratégias de correção ou otimização do envelhecimento arterial para trajetórias biologicamente mais favoráveis, por outro lado. O modelo de intervenção AGA@4life constitui um instrumento não-farmacológico promissor para a promoção da saúde vascular, mediante uma intervenção multidisciplinar e individualiza, onde componentes como a promoção da prática de exercício físico, o ajustamento nutricional, a estimulação cognitiva e a adesão à terapêutica são elementos centrais de intervenção.
- Effect of occupational activity on ambulatory blood pressure behaviourPublication . Pereira, J; Teixeira, A; Pereira, TelmoHypertension (HBP) is a key risk factor for cardiovascular diseases, being strongly associated with behavioral and environmental aspects of living. Professional activities, amongst others that take place throughout the day, are responsible for important blood pressure (BP) variations and may increase it. Objective: This study aims at ascertaining the blood pressure profile and variation in teachers, during a typical teaching session. Methods: Ambulatory Blood Pressure Monitoring (ABPM) was performed in a cohort of 21 university teachers during a typical professional day, comprising the following periods: 24-hour period, day period, night period, morning period, 2 hours before class, during class, 2 hours after class, aerobic exercise period and 1 hour after exercise period. Results: Teachers demonstrated higher BP during the occupational activities (137.71 / 88.57 mmHg) compared to the period before (128.81 / 82.43 mmHg) and after the class (132,38 / 85, 19 mmHg) (p <0.05). It was found that systolic BP has the greatest variability across the considered activities and time periods. In a gender analysis, men had higher systolic BP compared to women (141.55 mmHg / 133.50 mmHg, respectively), and demonstrated greater variability across activities. Conclusions: The results clearly demonstrated the existence of important variations in BP due to different daily activities. The occupational period produced a significant increase in the different components of BP and heart rate. The long-term effects of repeated exposure to this increase in BP related with the occupational contexts remains to be demonstrated.
- Effects of a personalized intervention program on the biochemical and hematological profile in community dwelling old adults-the AGA@4life intervention modelPublication . Caseiro, Armando; Rocha, Clara; Silva, Ana Margarida; Ferreira, Carla; Silva, Isabel; Clemente, Mariana; Cipriano, Inês; Saraiva, Marina; Barreira, Rogério; Azenha, Joana; Loureiro, Maria Helena; Martins, Anabela; Pereira, TelmoAging is a social and economic challenge of the highest importance and a multidisciplinary intervention seems to be a promising approach for improving the quality of life of elderly individuals. This project was designed aimed at promoting an active and healthy aging through the implementation of an intervention program based on the comprehensive geriatric assessment model (AGA@4life), focused on promoting health and wellbeing, independence and autonomy, mobility, and social inclusion. A non-randomized interventional study was designed to evaluate the effect of only a dietetic and nutritional approach (control group (CG)) and the combination of a tailored exercise program and a dietetic and nutritional approach (intervention group (IG)) in the biochemical and hematological profile of older adults in the framework of AGA@4life. The 34 participants enrolled, aged 65 years or over, were subject to a thorough baseline (T0) multidisciplinary diagnostic evaluation, including the gathering of clinical information and a battery of biochemical and hematological determinations, and reevaluated after eight weeks of intervention (T1). Between T0 and T1, an increase in albumin and total proteins serum levels were observed in both groups (p < 0.01); the hematological profile in CG and IG showed an increase in red cell count and hemoglobin (p < 0.05). In IG, an increase of HDL cholesterol (p < 0.001) and a decrease of triglycerides (p = 0.001) were still observed. The AGA@4life multidisciplinary intervention improved the hematological and biochemical profile of old adults, potentially contributing to delay the development of several aging comorbidities and increase the quality of life of participants.
- O exercício físico aplicado a pessoas idosasPublication . De Noronha Cipriano, Inês; Pereira, TelmoO envelhecimento caracteriza-se por uma perda gradual de funções fisiológicas, sendo um processo natural e fisiológico, e marcadamente heterogéneo. No entanto, é possível modificar as trajetórias de declínio funcional e promover um envelhecimento bem-sucedido. Uma das formas mais consensualmente identificadas, de promoção de um envelhecimento biologicamente mais favorável é a prática de exercício físico e a promoção de uma vida fisicamente ativa. Diversos estudos têm demonstrado os benefícios da prática regular de exercício físico a nível fisiológico, funcional, social, e na promoção de melhor qualidade de vida e bem-estar na pessoa idosa. Não obstante, tendo em consideração as particularidades desta população, nomeadamente atendendo à coexistência de comorbilidades, torna-se essencial uma prescrição de planos adaptados de exercício físico, bem como a monitorização da sua implementação. Por outro lado, estes planos deverão ser integrados numa estratégia mais abrangente de promoção de um envelhecimento ativo e saudável, como o preconizado no Modelo de Intervenção AGA@4life.
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