RESUMO
Misuse of anabolic-androgenic steroids (AAS) to boost performance and appearance is rising in the United States (US) with approximately one million people experiencing dependence. Long-term AAS misuse can lead to cardiovascular pathology but rarely cardiogenic shock. We report the case of an acute ischemic stroke secondary to an intracardiac thrombus in a patient with biventricular failure and cardiogenic shock associated with AAS misuse. Discontinuation of AAS and institution of guideline-directed medical therapy might reverse AAS-related heart failure.
Assuntos
Reação a Corpo Estranho/etiologia , Abscesso Hepático/etiologia , Frutos do Mar/efeitos adversos , Estômago/lesões , Animais , Deglutição , Diagnóstico Diferencial , Seguimentos , Reação a Corpo Estranho/diagnóstico , Reação a Corpo Estranho/cirurgia , Humanos , Abscesso Hepático/diagnóstico , Abscesso Hepático/cirurgia , Masculino , Pessoa de Meia-Idade , Nephropidae , Ruptura , Sucção/métodos , Tomografia Computadorizada por Raios XAssuntos
Enterite/etiologia , Lesões por Radiação , Dor Abdominal/etiologia , Consumo de Bebidas Alcoólicas , Doença Crônica , Enterite/terapia , Feminino , Seguimentos , Humanos , Intestino Delgado/efeitos da radiação , Pessoa de Meia-Idade , Pancreatite/diagnóstico por imagem , Nutrição Parenteral Total , Lesões por Radiação/terapia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To determine whether morphologic features at preoperative magnetic resonance imaging (MRI) are related to intraoperative blood loss during radical retropubic prostatectomy. METHODS: Endorectal MRI was performed in 143 patients with newly diagnosed prostate cancer before radical retropubic prostatectomy. Two independent readers rated the prominence of the periprostatic veins (on the basis of number and size) at four anatomic sites on a 3-point scale. Other features analyzed were prostate volume and interspinous diameter. RESULTS: A prominence of the anterior and posterior apical periprostatic veins was positively associated with blood loss (correlation coefficient = 0.22 and 0.17 and P <0.01 and <0.05, respectively). Blood loss was not related to prostate volume (correlation coefficient = 0.02, P = 0.8) or interspinous diameter (correlation coefficient = 0.01, P = 0.9). The site-specific scores of both readers demonstrated positive agreement, with Pearson's correlation coefficients of 0.51 to 0.65 (P <0.01). CONCLUSIONS: A marked prominence of the apical periprostatic veins on preoperative MRI is associated with greater intraoperative blood loss during radical retropubic prostatectomy. Other morphologic factors appear unrelated to the amount of intraoperative blood loss.