Ricardo Moreno

Hospital Universitario Dr José Eleuterio Gonzalez

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Efeitos da natação e do treinamento resistido na densidade mineral óssea de mulheres idosas

Revista Brasileira de Medicina do Esporte (2009)

Carlos Kemper Ricardo Jacó de Oliveira Martim Bottaro Ricardo Moreno Lídia Mara Aguiar Bezerra

Exercícios com impacto como caminhada, saltos, corridas e exercícios resistidos são muito utilizados para prevenção da perda óssea em idosas. No entanto, poucos são os estudos que relatam os efeitos da natação na manutenção da massa óssea em mulheres idosas. Portanto, o objetivo deste estudo foi comparar os efeitos da natação com o treinamento resistido na densidade mineral óssea (DMO) de mulheres idosas. Vinte e três mulheres com idade média de 63,9 ± 6,49 anos foram divididas em dois grupos: 1) grupo natação (NAT, n = 13, que) treinou em intensidade entre 60 e 90% da freqüência cardíaca de reserva; 2) grupo treinamento resistido (TR, n = 10), que treinou os principais grupamentos musculares com três séries a 80% de 1RM. Os dois grupos praticaram três vezes por semana com uma hora de duração para cada sessão, durante seis meses. A DMO do colo do fêmur e da coluna lombar (L2-L3-L4) foi mensurada através de DXA antes (T0) e após seis meses de treino (T6). Os resultados mostraram que as médias para a DMO lombar em T0 (0,9250 ± 0,1506g/cm²) e T6 (0,9303 ± 0,1269g/cm²) para o NAT e em T0 (0,9739 ± 0,1249g/cm²) e T6 (0,9737 ± 0,1317g/cm²) para o TR não foram diferentes quando comparadas intra ou intergrupos. De modo similar, não houve diferenças entre a DMO do colo do fêmur em T0 (0,7784 ± 0,1523g/cm²) e T6 (0,7905 ± 0,1610g/cm²) para o NAT e T0 (0,7546 ± 0,1360g/cm²) e T6 (0,7522 ± 0,1421g/cm²) para o TR. Os resultados deste estudo não demonstraram diferenças na DMO entre NAT e TR após seis meses de treino; e que tanto TR quanto NAT não produzem aumentos significativos na DMO de mulheres idosas nesse período.

10.1590/s1517-86922009000100002

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Citations (12)

0540 OBESITY IS LINKED WITH HIGHER RISK OF OSA WITHOUT SUBJECTIVE HYPERSOMNIA IN MENOPAUSAL WOMEN

SLEEP (2023)

José Garza Marichalar Meliza J Torrecillas-Gordillo Beatriz E Chávez Luévanos Carlos de Ayala Martínez Luis de la Garza

Abstract Introduction Obesity is one of the biggest public health problems in the world, with the incidence of obesity estimated to be around 30% in some countries. There is a well-established link between Obstructive Sleep Apnea and obesity. This is due to many factors including a narrower airway because of fat deposits in this region, as well as decreased muscle activity. Subjective sleepiness measured with the Epworth Sleepiness Scale (ESS) is also associated with an increased risk of OSA. There are some studies that suggest that the ESS has a better predictive value in men than in women to detect Sleep Disordered Breathing, but to our knowledge, there are no studies in menopausal women Methods A retrospective study was performed using the data from the menopause clinic at the University Hospital in Monterrey, Mexico. All patients in the menopause clinic are evaluated using a screening protocol to detect sleep disorders, using the following tools: Pittsburgh Sleep Quality Index (PSQI), STOP-BANG questionnaire, and the Epworth Sleepiness Scale (ESS). Results Data were collected from 89 menopausal patients, identifying a total of 36 patients (40.44%) that had a BMI equal to or higher than 30 kg/m2. Of these 36 patients, 28 (77.7%) had a STOP-BANG questionnaire with 3 or more positive answers. Nevertheless, only 6 patients (16.6%) had an ESS of 10 or more with most having no subjective hypersomnia that was detected through this screening tool. Conclusion Subjective hypersomnia, which can be measured with the ESS, has been long considered an essential feature of OSA and is routinely used to screen different patient populations and decide whether a polysomnography or other sleep study is necessary for the diagnosis of OSA. Nevertheless, in menopausal women with obesity (BMI of 30 or higher), it seems that even though there may be an increased risk for OSA there is not an increase in subjective hypersomnia, which could lead to some patients with OSA not being studied properly. Better studies should be performed to get a better clinical picture of what OSA looks like in menopausal women. Support (if any)

Epworth Sleepiness Scale

10.1093/sleep/zsad077.0540

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Aspirin versus aggressive antiplatelet therapy for acute carotid stenting plus thrombectomy in tandem occlusions: ETIS Registry results

Journal of NeuroInterventional Surgery (2022)

Gaultier Marnat Stefanos Finistis Ricardo Moreno Igor Sibon Raoul Pop

Patients treated with acute carotid stenting (CAS) may have higher odds of a favorable outcome than those treated without CAS during thrombectomy in tandem occlusions. Antiplatelet therapy is associated with CAS to avoid stent thrombosis, which occurs in around 20% of patients and negatively impacts outcomes. In this study we compared two antiplatelet strategies in tandem occlusion strokes treated with CAS and intracranial thrombectomy in clinical practice.The Endovascular Treatment in Ischemic Stroke Registry is an ongoing prospective observational study involving 21 comprehensive stroke centers performing thrombectomy in France. We analyzed patients with atherosclerotic tandem occlusions treated with acute CAS and intracranial thrombectomy who received at least one antiplatelet agent. Aggressive antiplatelet therapy included oral or intravenous glycoprotein (GP) IIb/IIIa or P2Y12 inhibitors. The primary outcome was cervical carotid artery patency at day 1 imaging follow-up.Among the 187 included patients, 124 (66.3%) received aspirin alone and 63 (33.7%) received aggressive antiplatelet therapy. There was no significant difference regarding safety outcomes, especially in symptomatic intracerebral hemorrhage, parenchymal hematoma, and procedural complications. There was a significantly higher rate of carotid stent patency at day 1 in the aggressive antiplatelet therapy group (81.7% vs 97.1%, aOR 17.49, 95% CI 1.10 to 277.2, p=0.042). Odds of favorable functional outcome (90-day modified Rankin Scale score 0-2) were similar between the groups (OR 3.04, 95% CI 0.64 to 14.25, p=0.158).In tandem occlusions treated with CAS plus thrombectomy, an aggressive antiplatelet regimen was associated with an increased rate of carotid stent patency at day 1 without safety concerns. Randomized trials are warranted to confirm these findings.

Stroke

Carotid stenting

Solitaire Cryptographic Algorithm

10.1136/jnis-2022-019527

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Citations (19)

Use of the pCONus as an adjunct to coil embolization of acutely ruptured aneurysms

Journal of NeuroInterventional Surgery (2016)

Marta Aguilar Pérez Pervinder Bhogal Ricardo Moreno C. Wendl Hansjörg Bäzner

Coil embolization of ruptured aneurysms has become the standard treatment in many situations. However, certain aneurysm morphologies pose technical difficulties and may require the use of adjunctive devices.To present our experience with the pCONus, a new neck bridging device, as an adjunct to coil embolization for acutely ruptured aneurysms and discuss the technical success, angiographic and clinical outcomes.We conducted a retrospective review of our database of prospectively collected data to identify all patients who presented with acute subarachnoid hemorrhage that required adjunctive treatment with the pCONus in the acute stage. We searched the database between April 2011 and April 2016.21 patients were identified (13 male, 8 female) with an average age of 54.6 years (range 31-73). 8 aneurysms were located at the basilar artery tip, 7 at the anterior communicating artery, 4 at the middle cerebral artery bifurcation, 1 pericallosal, and 1 basilar fenestration. 61.8% patients achieved modified Raymond-Roy classification I or II at immediate angiography, with 75% of patients having completely occluded aneurysms or stable appearance at initial follow-up. There were no repeat aneurysmal ruptures and two device-related complications (no permanent morbidity). Four patients in our cohort died.Use of the pCONus is safe and effective in patients with acutely ruptured aneurysms and carries a high rate of technical success.

Anterior communicating artery

Posterior communicating artery

Anterior choroidal artery

10.1136/neurintsurg-2016-012508

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Citations (43)

Antithrombotic therapies for neurointerventional surgery: a 2021 French comprehensive national survey

Journal of NeuroInterventional Surgery (2022)

Jildaz Caroff Laurent Aubert Cécile Lavenu‐Bombled Samy Figueiredo Kamelia Habchi

Neurointerventionists lack guidelines for the use of antithrombotic therapies in their clinical practice; consequently, there is likely to be significant heterogeneity in antithrombotic use between centers. Through a nationwide survey, we aimed to obtain an exhaustive cross-sectional overview of antithrombotic use in neurointerventional procedures in France.In April 2021, French neurointerventional surgery centers were invited to participate in a nationwide 51-question survey disseminated through an active trainee-led research collaborative network (the JENI-RC).All 40 centers answered the survey. Fifty-one percent of centers reported using ticagrelor and 43% used clopidogrel as premedication before intracranial stenting. For flow diversion treatment, dual antiplatelet therapy was maintained for 3 or 6 months in 39% and 53% of centers, respectively, and aspirin was prescribed for 12 months or more than 12 months in 63% and 26% of centers, respectively. For unruptured aneurysms, the most common heparin bolus dose was 50 IU/kg (59%), and only 35% of centers monitored heparin activity for dose adjustment. Tirofiban was used in 64% of centers to treat thromboembolic complications. Fifteen percent of these comprehensive stroke centers reported using tenecteplase to treat acute ischemic strokes. Cangrelor appeared as an emergent drug in specific indications.This nationwide survey highlights the important heterogeneity in clinical practices across centers. There is a pressing need for trials and guidelines to further evaluate and harmonize antithrombotic regimens in the neurointerventional field.

10.1136/neurintsurg-2021-018601

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Citations (31)

Ciprofibrate therapy in patients with hypertriglyceridemia and low high density lipoprotein (HDL)-cholesterol: greater reduction of non-HDL cholesterol in subjects with excess body weight (The CIPROAMLAT study).

Cardiovascular Diabetology (2004)

Carlos A. Aguilar‐Salinas Andréia Assis-Luores-Vale B Stockins Hector Mario Rengifo José Dondici Filho

Hypertriglyceridemia in combination with low HDL cholesterol levels is a risk factor for cardiovascular disease. Our objective was to evaluate the efficacy of ciprofibrate for the treatment of this form of dyslipidemia and to identify factors associated with better treatment response.Multicenter, international, open-label study. Four hundred and thirty seven patients were included. The plasma lipid levels at inclusion were fasting triglyceride concentrations between 1.6-3.9 mM/l and HDL cholesterol < or = 1.05 mM/l for women and < or = 0.9 mM/l for men. The LDL cholesterol was below 4.2 mM/l. All patients received ciprofibrate 100 mg/d. Efficacy and safety parameters were assessed at baseline and at the end of the treatment. The primary efficacy parameter of the study was percentage change in triglycerides from baseline.After 4 months, plasma triglyceride concentrations were decreased by 44% (p < 0.001). HDL cholesterol concentrations were increased by 10% (p < 0.001). Non-HDL cholesterol was decreased by 19%. A greater HDL cholesterol response was observed in lean patients (body mass index < 25 kg/m2) compared to the rest of the population (8.2 vs 19.7%, p < 0.001). In contrast, cases with excess body weight had a larger decrease in non-HDL cholesterol levels (-20.8 vs -10.8%, p < 0.001). There were no significant complications resulting from treatment with ciprofibrate.Ciprofibrate is efficacious for the correction of hypertriglyceridemia / low HDL cholesterol. A greater decrease in non-HDL cholesterol was found among cases with excess body weight. The mechanism of action of ciprofibrate may be influenced by the pathophysiology of the disorder being treated.

Dyslipidemia

High-density lipoprotein

10.1186/1475-2840-3-8

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Citations (5)

Evaluation of ultrasensitive cardiac Troponin I levels in patients with breast cancer during chemotherapy

Clinica Chimica Acta (2013)

Ricardo Moreno R. Costa Renata C. Mazar Mayra B. Silva Mariana G. de Souza

10.1016/j.cca.2013.11.001

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Citations (5)

Heart rate surges during REM sleep are associated with theta rhythm and PGO activity in cats

AJP Regulatory Integrative and Comparative Physiology (1999)

Katharine A. Rowe Ricardo Moreno Torben Lau Umesha Wallooppillai Bruce D. Nearing

Rapid eye movement (REM) sleep is characterized by periods of profound cardiac autonomic activation evident in heart rate surges in humans and canines. Our goals were to determine whether or not the heart rate surge phenomenon occurs in cats and to characterize concurrent central nervous system activity. Cortical and hippocampal electroencephalogram, electromyogram, electrooculogram, pontogeniculooccipital (PGO) waves, subcutaneous electrocardiogram, and respiration were recorded. Bouts of sinus tachycardia lasting ≥3.5 s achieved a rate of 210 beats/min and were present predominantly during REM sleep. Heart rate during the surges rose an average of 26.4% from 132.5 ± 2.0 beats/min before the surge to 167.5 ± 2.6 beats/min ( P< 0.001) and returned to 130.7 ± 2.6 beats/min ( P < 0.001). The heart rate surges were invariably accompanied by increased incidence and frequency of hippocampal theta waves and increased PGO wave frequency and incidence of PGO wave clusters and eye movement clusters. The occurrence of surges was dramatically reduced from 0.11 ± 0.03 to 0.01 ± 0.01/15 s of REM sleep ( P = 0.02) by atenolol (0.6 mg/kg iv), indicating that the phenomenon is β 1 -adrenergically mediated. These findings suggest a coupling between central activation of cardiac sympathetic nerves and the generation of hippocampal theta waves and PGO activity.

Sleep

Atenolol

10.1152/ajpregu.1999.277.3.r843

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Citations (55)

Direct carotid cavernous sinus fistulae: vessel reconstruction using flow-diverting implants

Clinical Neuroradiology (2016)

C. Wendl Hans Henkes Ricardo Moreno Oliver Ganslandt Hansjörg Bäzner

Retrospective evaluation of our experience with the use of flow diverters (FD) for the endovascular treatment of direct carotid-cavernous sinus fistulae (diCCF).Between 2011 and 2015, 14 consecutive patients with 14 diCCF were treated with FD alone or in combination with other implants in a single institution.A total of 21 sessions were performed in 14 patients. FD placement was technically successful in all cases without an adverse event. Patients were treated with FD alone (n = 5), FD and covered stents (n = 2), FD and coils (n = 7). A total of 59 FD (24 Pipeline Embolization Device, Medtronic; 35 p64 Flow Modulation Device, phenox), 291 coils, and 3 stent grafts were used. Three of 14 diCCF were completely occluded after the 1st session, a minor residual shunt was found in 7/14, and in the remaining 4/14 patients, the shunt volume was reduced significantly. The mean follow-up period encompassed 20 months. Additional treatment included transvenous coil occlusion (n = 3) and/or further FD deployment (n = 5). An asymptomatic internal carotid artery (ICA) occlusion was encountered in 2 patients, related to an interruption of antiaggregation. At the last follow-up, 10/14 patients were free from ocular symptoms (71 %), 2 had residual exophthalmos, and no patient had clinical deterioration.The usage of FD for the treatment of diCCF is straightforward. Injury of the cranial nerves can be avoided. In most cases, ocular symptoms improve. Several FD layers and/or an adjunctive venous coil occlusion are required. Complete occlusion of a diCCF may take weeks or months and long-term antiaggregation is required. In the future, a flexible stent graft might be a better solution.

Flow diverter

10.1007/s00062-016-0511-6

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Citations (48)

Biomechanical Properties of Postnatal Porcine Heart Valve

Zoltán Hajdu Vladimirs Kasjanovs Roger R. Markwald Ricardo Moreno Iveta Ozolanta

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