SummaryAtrial fibrillation (AF) is an arrhythmia frequently seen in the postoperative period of cardiac surgery. In this context, it is associated with the presence of comorbidities, longer length of hospital stay, and higher costs related to surgery.The mechanisms involved in the genesis of AF in the postoperative period of cardiac surgery (AFPO) are different from those causing paroxysmal AF. Knowledge of these mechanisms permits the use of efficient measures to reduce the incidence of this arrhythmia.According to recommendations of the literature, treatment is efficient and safe, because the rates of reversion to sinus rhythm are high and complications are reduced, and it is not associated with a high frequency of side effects.
BackgroundThe prevalence of atherosclerosis is higher in HIV-positive people, who also
experience it earlier than the general population.ObjectivesTo assess and compare the prevalence of atherosclerosis evaluated by the
intima-media thickness of carotid and femoral arteries, and by the
ankle-brachial pressure index (ABPI) in HIV patients treated or not treated
with protease inhibitors (PIs) and controls.MethodsEighty HIV+ subjects (40 using PIs and 40 not using PIs) and 65 controls were
included in the study. Atherosclerosis was diagnosed by (carotid and
femoral) ITM measurement and ABPI. Classical risk factors for
atherosclerosis and HIV were compared between the groups by statistical
tests. A p ≤ 0.05 was considered significant.ResultsAn IMT > P75 or the presence of plaque was higher in the HIV+
than in the control group (37.5% vs 19%, p = 0.04). Comparative analysis
showed a significant difference (p=0.014) in carotid IMT between HIV+ with
PIs (0.71 ± 0.28 mm), without PIs 0.63 ± 0.11 mm and, and
controls (0.59 ± 0.11 mm). There was no significant difference in
femoral IMT between the groups or in ABPI between HIV+ subjects and
controls. However, a significant difference (p=0.015) was found between HIV+
patients not treated with PIs (1.17 [1.08 - 1.23]), and controls 1.08 [1.07
- 1.17]).ConclusionIn HIV patients, atherosclerosis is more prevalent and seems to occur earlier
with particular characteristics compared with HIV-negative subjects.
The adherence to antihypertensive drugs and low salt diet improved after the CEP. Preliminarily, this telehealth strategy suggests a positive impact on hypertensive patients.
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