Disautonomia: Uma Condição Esquecida – Parte II

Rocha, Eduardo Arrais; Mehta, Niraj; Távora-Mehta, Maria Zildany P.; Roncari, Camila F.; Cidrão, Alan Alves de Lima; Elias, Jorge

doi:10.36660/abc.20200422

Cited by 8 publications

(6 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Normalmente, os episódios de síncope ocorrem na ausência dos sintomas de alarde, durante esforços físicos e na posição supina. Ressaltando que casos de síncope oriundos de atividade física é imprescindível realizar o diagnóstico diferencial de uma clássica tríade, a qual abordam a taquicardia dos ventrículos, comum a isquemia cardíaca, a cardiomiopatia hipertrófica obstrutiva, a qual compõe potencial causa de óbito fulminante de desportistas juvenis e retração aórtica prevalente no grupo geriátrico (ROCHA, 2021).…”

Section: Resultsunclassified

Considerações gerais sobre a síncope: uma abordagem clínica

Pena¹,

Barbosa²,

Rocha³

et al. 2022

BJDV

View full text Add to dashboard Cite

O seguinte estudo objetivou descrever sobre as etiologias e o respectivo quadro clínico da síncope. A síncope é classificado como um sintoma de perda da consciência devido redução do fluxo sanguíneo cerebral, secundário a uma etiologia. Tal evento costuma ser confundido com outras condições associadas a perda de conhecimento, apesar de para se diagnosticar como síncope é necessário descartar demais alterações. A síncope é uma condição que têm como fisiopatologia o hipofluxo de sangue no cérebro, mas conta com diversas causas como a neuromediada, ortostática, cardíaca, cerebrovascular e até idiopática, resultam em quadros clínicos distintos e complicações, mas o mesmo desfecho. Tal evento necessita ser investigado e detectado de imediato, por história clínica, exame físico e complementares.

show abstract

Section: Resultsunclassified

Considerações gerais sobre a síncope: uma abordagem clínica

Pena¹,

Barbosa²,

Rocha³

et al. 2022

BJDV

View full text Add to dashboard Cite

show abstract

“…Difficulty swallowing was also associated with UI, probably because of the similarity in autonomic fibers present in both the gastrointestinal and genitourinary tracts, both of which have smooth muscles. 24,25 Therefore, when UI is related to neurological injuries, it may be associated with swallowing disorders.…”

Section: Discussionmentioning

confidence: 99%

Path analysis of urinary incontinence in older adults living in nursing homes

Fidyk,

Oliveira,

Ramos

et al. 2024

Geriatr Gerontol Aging

View full text Add to dashboard Cite

Objective: To investigate the factors associated with urinary incontinence in older adults living in nursing homes. Methods: This exploratory, cross-sectional, observational, and quantitative study used exploratory and path analysis (PA). Eighty-six older adults living in nursing homes in the city of Salvador, Brazil, and the city of Brasília, Brazil, were included. Data were collected from January to March 2020, before the Covid-19 pandemic. The following variables were evaluated: sex, age group, functional performance, global cognitive function, comorbidities, and health conditions. We considered urinary incontinence for older adults who answered affirmatively to the “In the last 12 months, have you had an involuntary loss of urine?”. Data were initially analyzed by descriptive analysis and nonparametric statistical tests. A PA was performed using generalized structural equation modeling to investigate the relationship between the variables of interest and the direct and indirect effects of the independent variables and UI according to the theoretical model. Subsequently, the statistical distributions of the variables and the connections were defined for the regression estimation. After the analysis, the model was respecified, excluding the variables and paths that were not statistically significant to determine the best model. The final model was designed after statistical adjustments, corroborating or not with the theoretical model. Results: Urinary incontinence was associated with educational level, marital status, hypertension, one or more difficulties in basic activities of daily living, mood, insomnia, loss of appetite, fecal incontinence, and difficulty swallowing. In the PA, depression and difficulty swallowing were directly associated with urinary incontinence, and urinary incontinence was directly and significantly associated with insomnia and fecal incontinence. Conclusion: Given the variety of social and health components associated with urinary incontinence, it is necessary to assess, prevent, treat, and rehabilitate this condition in Brazilian nursing homes. Interventions in urinary incontinence demand integrated actions in functional, clinical, and mental health aspects to promote the well-being of older adults living in nursing homes.

show abstract

“…Groups with pathologies known to develop dysautonomia must be closely monitored by looking for symptoms and carrying out specific tests, such as the RR, Valsalva, Respiratory and 24-hour ABPM variability tests. The TT should not be the only or the most important in evaluating these cases 6,19 .…”

Section: Discussionmentioning

confidence: 99%

“…If there was the reproduction of prodromal symptoms or during positivity, the test was considered true positive, with the information made available in the report. In the presence of characteristic symptoms and relevant hemodynamic changes, the examination was immediately interrupted, and the table was returned to its normal zero-degree position or to the Trendelenburg position if there were symptoms and important hemodynamic changes 6,7 .…”

Section: Methodsmentioning

confidence: 99%

The Tilt Test in the Assessment of Syncope and Pre-syncope. Effective and safe? Analysis of a Series of 2364 Patients over 6 Years

Rocha,

Kubrusly,

Gurgel

et al. 2024

J. Cardiac Arrhythmias

View full text Add to dashboard Cite

The tilt table test (TT) provides relevant information about individual susceptibility to neuro-mediated hypotension and bradycardia. Its importance has been questioned. In this work, we analyze the results and safety of TT in the investigation of syncope, presyncope or postural dizziness. Cross-sectional study, with TT exams performed by specialists in cardiac arrhythmias, in the period 2016-2021, in a syncope unit. Analyzes were performed using the Mann-Whitney test, multiple logistic regression, with a significant p value <0.05. The protocols used were Westminster or Italian protocol. There were 2364 TT performed, 61.7% female, aged 51.1 (31-71) years. The positivity rate was 32.6%, 37.2% with pharmacological sensitization (p< 0.01). For the investigation of syncope, positivity was 34.2% (477) x 30.65% (285) for other symptoms (p<0.001), while evaluating syncope and presyncope together the difference was 37.55% (623) x 20.9% (139) for other symptoms (p<0.001). Positivity was higher in males (p<0.01; OR=1.40(1.16-1.69)), in sensitized tests (p<0.01;2.01(1.64-2, 38)), in patients with early orthostatic hypotension (OH) with symptoms (p <0.01; 9.68(4.13-27.44)). The complication rate was 3.29%, but without severity. The TT remains an important and safe methodology in clinical practice for the investigation of patients with suspected neurally mediated syndromes.

show abstract

Disautonomia: Uma Condição Esquecida – Parte II

Cited by 8 publications

References 89 publications

Considerações gerais sobre a síncope: uma abordagem clínica

Considerações gerais sobre a síncope: uma abordagem clínica

Path analysis of urinary incontinence in older adults living in nursing homes

The Tilt Test in the Assessment of Syncope and Pre-syncope. Effective and safe? Analysis of a Series of 2364 Patients over 6 Years

Contact Info

Product

Resources

About