RESUMO
PURPOSE: To assess retrobulbar blood flow velocities and finger nailfold capillary blood flow velocities (two readily accessible vascular beds) in subjects with primary hypercholesterolemia before and during lipid-lowering therapy. METHODS: Retrobulbar blood flow velocities and finger nailfold capillary blood flow velocities were assessed in 15 hypercholesterolemic subjects and in 15 age-matched and sex-matched healthy control subjects. In addition, the change in blood flow velocities after a 3-month period of lipid-lowering therapy was evaluated. RESULTS: No alterations in retrobulbar blood flow velocities after lipid-lowering therapy could be observed in hypercholesterolemic patients. Nailfold capillary blood flow velocity was slower in hypercholesterolemic subjects than control subjects immediately after local cooling (P = .0052), but this vascular dysregulation did not improve after lipid-lowering therapy (P = .58). CONCLUSIONS: Blood flow alterations, potentially caused by perturbed vascular endothelial function, may occur in nailfold capillaries of hypercholesterolemic subjects. Such alterations were not seen in retrobulbar vessels, and blood flow measures did not change during lipid-lowering therapy.
Assuntos
Artérias Ciliares/fisiopatologia , Dedos/irrigação sanguínea , Hipercolesterolemia/fisiopatologia , Unhas/irrigação sanguínea , Artéria Oftálmica/fisiopatologia , Artéria Retiniana/fisiopatologia , Velocidade do Fluxo Sanguíneo , Capilares/diagnóstico por imagem , Capilares/fisiopatologia , Artérias Ciliares/diagnóstico por imagem , Feminino , Dedos/diagnóstico por imagem , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Unhas/diagnóstico por imagem , Artéria Oftálmica/diagnóstico por imagem , Órbita/irrigação sanguínea , Artéria Retiniana/diagnóstico por imagem , Sinvastatina/uso terapêutico , Ultrassonografia Doppler em CoresRESUMO
The authors give an account of their favourable experience with endoscopic treatment of choledocholithiasis in 414 patients (320 cholecystectomies and 94 with the gallbladder in situ). Removal of concrements from the ductus choledochus was achieved on the first attempt in 80% of the patients, during the second to fourth attempt in 20%. Immediate complications (acute pancreatitis, haemorrhage, perforation) were recorded in 4.1% of the patients, the mortality was 1.2%. The authors emphasize the importance of endoscopic treatment of choledocholithiasis with obstructive jaundice in particular in old and risk patients.
