{"id":115890,"date":"2018-03-11T10:44:36","date_gmt":"2018-03-11T10:44:36","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/temperatura-periferica-actividad-y-posicion-como-determinantes-en-el-diagnostico-de-alteraciones-del-patron-circadiano-de-la-presion-arterial\/"},"modified":"2018-03-11T10:44:36","modified_gmt":"2018-03-11T10:44:36","slug":"temperatura-periferica-actividad-y-posicion-como-determinantes-en-el-diagnostico-de-alteraciones-del-patron-circadiano-de-la-presion-arterial","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/biologia-humana\/temperatura-periferica-actividad-y-posicion-como-determinantes-en-el-diagnostico-de-alteraciones-del-patron-circadiano-de-la-presion-arterial\/","title":{"rendered":"Temperatura perif\u00e9rica, actividad y posici\u00f3n como determinantes en el diagn\u00f3stico de alteraciones del patr\u00f3n circadiano de la presi\u00f3n arterial."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Alfonso Luis Blazquez Manzanera <\/strong><\/h2>\n<p>Objetivos: el objetivo de esta tesis es mejorar la precisi\u00f3n en el diagn\u00f3stico de las posibles alteraciones del ritmo circadiano de la presi\u00f3n arterial evaluada de forma ambulatoria (mapa) y\/o detectar otras patolog\u00edas del sistema cardiovascular como la hipertensi\u00f3n mediante el registro combinado de termometr\u00eda de la piel de la mu\u00f1eca y de actimetr\u00eda. Con este fin se plantearon los siguientes objetivos espec\u00edficos: 1. Determinar simult\u00e1neamente los patrones de temperatura, posici\u00f3n y actividad de sujetos normotensos, analizando las relaciones de la presi\u00f3n arterial con el resto de variables. 2. Determinar simult\u00e1neamente los patrones de temperatura, posici\u00f3n y actividad de sujetos hipertensos analizando las relaciones entre la presi\u00f3n arterial y el resto de variables. 3. Evaluar el efecto de la administraci\u00f3n de melatonina en los patrones de presi\u00f3n arterial, y el comportamiento de los ritmos de temperatura, posici\u00f3n y actividad de sujetos normotensos frente a la administraci\u00f3n de placebo. Metodolog\u00eda en esta tesis, se evalu\u00f3 simult\u00e1neamente el ritmo de presi\u00f3n arterial, temperatura perif\u00e9rica, actividad motora y posici\u00f3n corporal. El ritmo circadiano de presi\u00f3n arterial se determin\u00f3 mediante una mapa con un holter de pa (spacelabs\u00c2\u00bf, usa), durante 24 horas. La monitorizaci\u00f3n ambulatoria de pa y fc se realiz\u00f3 siguiendo la pr\u00e1ctica habitual con una medida cada 20 minutos durante el periodo de actividad (de 08:00 h a 23:00) y cada 40 minutos durante el periodo de descanso (de 23:00 h a 08:00 h). El ritmo de temperatura se evalu\u00f3 mediante un sensor de temperatura (ibutton, maxim, usa) incorporado a una mu\u00f1equera de modo que la superficie del sensor quedara en contacto con la arteria radial de la mu\u00f1eca de la mano no dominante. Los ritmos de actividad motora y posici\u00f3n corporal se evaluaron mediante un act\u00edmetro (hobo\u00c2\u00bf, usa) colocado en el brazo no dominante utilizando un brazalete deportivo. De la informaci\u00f3n proporcionada por el act\u00edmetro, se definieron 2 variables: actividad motora, expresada como grados de cambio de posici\u00f3n por minuto y posici\u00f3n corporal, definida como el \u00e1ngulo entre el eje x y el plano horizontal. Procesamiento de los datos: cada variable se normaliz\u00f3 entre 0 y 1 despu\u00e9s de haber eliminado los artefactos mediante inspecci\u00f3n visual de los datos. Adem\u00e1s, los datos de temperatura se invirtieron de modo que los valores m\u00e1ximos de todas las variables coincidieran en el mismo momento. Despu\u00e9s, calculamos la media de las variables normalizadas para cada sujeto obteniendo la variable tap cuyos valores var\u00edan entre 0 (para periodos de reposo) y 1 (para periodos activos). Conclusi\u00f3n general: es necesaria la incorporaci\u00f3n de la variable posici\u00f3n por ser mejor determinante que la actividad motora para una mejora en la precisi\u00f3n del diagn\u00f3stico de posibles alteraciones del ritmo circadiano de la presi\u00f3n arterial. A falta de analizar grupos m\u00e1s numerosos de poblaci\u00f3n, los \u00edndices no param\u00e9tricos de la presi\u00f3n arterial podr\u00edan ser tambi\u00e9n usados como diagn\u00f3stico. Adem\u00e1s, la temperatura perif\u00e9rica y su ritmo circadiano pueden ser usados como cribado para la detecci\u00f3n de patrones an\u00f3malos de presi\u00f3n arterial y patolog\u00edas del sistema cardiovascular como la hipertensi\u00f3n. objectives: the aim of this thesis was to improve the diagnostic accuracy of the possible disturbances of circadian rhythm of blood pressure evaluated by abpm (ambulatory blood pressure monitoring) and\/or to detect other diseases of the cardiovascular system such as hypertension by thermometry and actigraphy. To this end the following objectives were proposed: 1. To determine the relationship between arterial blood pressure and the rhythms of skin temperature, body position and activity in normotensive subjects. 2. To determine temperature, position, activity and blood pressure patterns in hypertensive subjects analyzing the relationship between blood pressure and the other variables simultaneously. 3. To assess the effect of melatonin administration on blood pressure, temperature, activity and position patterns versus placebo treatment. Methodology in this thesis, the simultaneous monitoring of blood pressure, skin temperature, body position and motor activity was evaluated. Circadian rhythm of blood pressure was measured by abpm with a holter (spacelabs\u00c2\u00bf, usa) during 24 hours. Ambulatory bp and hr monitoring was performed following the usual practice with a measurement every 20 minutes during the activity period (08:00 to 23:00) and every 40 minutes during the rest period (from 23:00 to 08 : 00 h ) . Temperature was assessed using a temperature sensor (thermochron\u00c2\u00bf, maxim, usa) sewn into a wristband so that the surface of the sensor remains in contact with the radial artery in the wrist of the nondominant hand. The rhythms of motor activity and body position were evaluated by an actimeter (hobo\u00c2\u00bf, usa) placed in the nondominant arm by a sports armband. Motor activity was expressed as degrees of change of position and body position was defined as the angle between the x axis and the horizontal plane. Data processing: each variable was normalized between 0 and 1 after removing the artefacts by visual inspection of the data. Moreover, the temperature data is reversed so that the maximum values of all variables at the same time coincide. Next, we calculate the average of the standardized variables for each subject tap obtaining the variable whose values range from 0 (for periods of rest) and 1 (for active periods). The measurements were performed in three groups of patients: normotensive, hypertensive and normotensive differentiating week with melatonin and placebo. General conclusion: body position can be considered as a better determinant than motor activity on blood pressure, thus this variable should be incorporated to improve the accuracy of diagnosis of possible disturbances of circadian rhythm of blood pressure.. Although it is necessary to confirm our results in larger populations, nonparametric indices of blood pressure could also be used to define the circadian patterns of blood pressure. Furthermore, the peripheral temperature circadian rhythm can be used as screening for detecting abnormal patterns of blood pressure and disorders of the cardiovascular system such as hypertension.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Temperatura perif\u00e9rica, actividad y posici\u00f3n como determinantes en el diagn\u00f3stico de alteraciones del patr\u00f3n circadiano de la presi\u00f3n arterial.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Temperatura perif\u00e9rica, actividad y posici\u00f3n como determinantes en el diagn\u00f3stico de alteraciones del patr\u00f3n circadiano de la presi\u00f3n arterial. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Alfonso Luis Blazquez Manzanera <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 25\/06\/2014<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Mar\u00eda  De Los Angeles Rol De Lama<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: salvador Zamora navarro <\/li>\n<li>teresa Moreno casbas (vocal)<\/li>\n<li>Antonio Hernandez torres (vocal)<\/li>\n<li>Jes\u00fas \u00e1ngel Fern\u00e1ndez-tresguerres hern\u00e1ndez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Alfonso Luis Blazquez Manzanera Objetivos: el objetivo de esta tesis es mejorar la precisi\u00f3n en el diagn\u00f3stico 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