RESUMEN
We report the case of a symptomatic spontaneous leak of a biosynthetic graft (Omniflow (II) treated endovascularly with a stentgraft. Potential degeneration of biosynthetic grafts with aneurysm formation is a well known problem with a reported incidence of up to 7 %. Implantation of a stentgraft for treatment of a pseudoaneurysm is a valuable treatment option in native arteries; however its use in Omniflow II bypass grafts has not been reported so far. Surveillance of peripheral bypass grafts with duplex ultrasound may be helpful to detect morphological alterations of the graft.
Asunto(s)
Aneurisma Falso/cirugía , Aneurisma/cirugía , Bioprótesis , Implantación de Prótesis Vascular/instrumentación , Prótesis Vascular , Arteria Femoral/cirugía , Arteria Poplítea/cirugía , Falla de Prótesis , Stents , Anciano , Aneurisma/fisiopatología , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Aneurisma Falso/fisiopatología , Implantación de Prótesis Vascular/efectos adversos , Arteria Femoral/diagnóstico por imagen , Arteria Femoral/fisiopatología , Humanos , Masculino , Diseño de Prótesis , Flujo Sanguíneo Regional , Reoperación , Resultado del Tratamiento , Ultrasonografía Doppler en ColorRESUMEN
OBJECTIVE: The aim of this retrospective study was to assess the long-term results of stripping the insufficient great saphenous vein (GSV) with stump coagulation, closure of the cribriform fascia and some additional measures, which will be described in detail. METHODS: Patients treated from 1998 to 1999 for varicose veins had been invited in 2009 for follow-up colour-coded duplex sonography and had been asked to answer a quality-of-life questionnaire. In 2009, the examinations for the study were conducted at a clinic of angiology by an independent and experienced sonographer. RESULTS: From a total of 165 patients, 91 (136 limbs) had been willing to participate in the study. Duplex ultrasound after a mean follow-up of 10.7 years revealed only clinically non-relevant (∅ < 0.3 cm) neovascularizations in 1.5% of all treated legs. No clinical relevant varicosities from the groin had developed. CONCLUSION: The crossectomy combined with stump coagulation and suture of the fossa ovalis, completed with some additional measures, is a successful method to reduce neovascularization and recurrent varicosities, even for redo-crossectomies, without increasing the risk of perioperative complications.
Asunto(s)
Vena Safena/cirugía , Várices/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Insuficiencia Venosa/cirugía , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neovascularización Patológica/diagnóstico por imagen , Neovascularización Patológica/fisiopatología , Neovascularización Patológica/prevención & control , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/prevención & control , Estudios Retrospectivos , Factores de Riesgo , Vena Safena/diagnóstico por imagen , Vena Safena/fisiopatología , Ultrasonografía , Várices/diagnóstico por imagen , Várices/fisiopatología , Procedimientos Quirúrgicos Vasculares/efectos adversos , Insuficiencia Venosa/diagnóstico por imagen , Insuficiencia Venosa/fisiopatologíaRESUMEN
OBJECTIVE: To discuss the duration and types of breastfeeding and to identify the factors associated with the early introduction of formula milk. MATERIALS AND METHODS: This longitudinal study was conducted in the largest birthing centre of Turin. 562 mother-infant pairs were selected randomly and enrolled from among all the births that occurred in our Hospital from January to December 2009. Data was collected by means of a questionnaire filled out by the researcher during a face-to-face interview at mother's bed side during her hospital stay. This questionnaire included data regarding maternal socio-demographic, biomedical and hospital-related characteristics and some questions regarding family support, maternal attitude and current knowledge on breastfeeding. Mothers were interviewed by telephone at 1, 3, 6 and 12 months postpartum using the 24-h recall technique and definitions recommended by the WHO to investigate the type of breastfeeding adopted. RESULTS: At the age of 6 months only 8.9% of the infants involved were still exclusively breastfed and 44.3% had discontinued breastfeeding. By the age of 12 months 25.3% of infants were still receiving some breast milk. The main factors that had a negative impact on the duration of breastfeeding included maternal smoking habits, early pacifier introduction and the maternal infant feeding attitude. CONCLUSIONS: The rate of initiation and overall duration of breastfeeding reached the WHO objectives, but exclusive breastfeeding duration has still not reached satisfactory levels at 6 months. Given that the maternal infant feeding attitude is the only factor independently related to breastfeeding duration for the whole first year of life, reliable measures of maternal attitude could be used as a first step in targeting and assessing interventions that promote and sustain breastfeeding.
Asunto(s)
Lactancia Materna/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Adulto , Lactancia Materna/psicología , Femenino , Humanos , Recién Nacido , Italia , Estudios Longitudinales , Conducta Materna , Relaciones Madre-HijoRESUMEN
AIM: The Italian Piedmont region sponsored in 2005 a population-based registry to assess the epidemiology of childhood chronic organ failure involving kidneys, liver, heart or lungs. METHODS: Patients in chronic organ failure who were younger than 18 years were selected, and entered the registry when accomplishing the standard failure criteria for each organ. The cases were reported by the general paediatricians of the region and integrated with the data gathered by the Children University Hospital, a tertiary care centre. RESULTS: In Piedmont (647,727 inhabitants < 18 years), a total of 146 children (217 cases per million of paediatric population) were found to be affected by chronic organ failure (mean age 10 years; range 0-17). The organ failure involved kidneys in 68 subjects (48%), liver in 24 (17%), heart in 21 (15%) and lungs in 28 (20%), and was severe in 32 subjects (6 on transplantation waiting list). The most represented disease leading to chronic renal failure was renal hypodysplasia (79%). Chronic liver failure was mostly caused by biliary atresia (30%), autoimmune hepatitis (25%) and Wilson's disease (21%). Dilated cardiomyopathy (62%) and surgically treated congenital cardiopathy were the two leading causes of chronic heart failure. The most represented disease leading to chronic lung failure was cystic fibrosis (89%). CONCLUSION: This is the first report of the literature focusing on the epidemiology of chronic organ failure in children encompassing a region of 4,000,000 inhabitants. This clinical condition is rare, but medically and socially very demanding not only in childhood but the life along, as most of these patients will need solid organ transplantation decades later.