Aneurysm of the superior labial artery.

This is a case report of a true and dissecting aneurysm of the superior labial artery in a 51-year-old patient without risk factors for vascular pathology. The patient complained of swelling of the upper lip, mostly on the left side. A Doppler ultrasonography was used in the diagnosis. The definitive treatment was surgical resection, and the histopathological analysis confirmed the diagnosis. The progress of the patient was satisfactory, leaving a slight change in sensitivity in the area. This seems to be the first reported case of true and dissecting aneurysm of the superior labial artery in the medical literature.

Estudo comparativo da evolução e sobrevida de pacientes com claudicação intermitente, com ou sem limitação para exercícios, acompanhados em ambulatório específico / Comparative study of evolution and survival of patients with intermittent claudication, with or without limitation for exercises, followed in a specific outpatient setting

CONTEXTO: Os fatores de risco para doença aterosclerótica, que influenciam na evolução natural dessa doença, estão bem estabelecidos, assim como o benefício do programa de exercícios para pacientes claudicantes. Entretanto, faltam informações sobre a relação entres limitações clínicas e fatores de risco, com desempenho do programa de caminhadas e suas implicações na evolução e mortalidade destes pacientes. OBJETIVO: Comparar, ao longo do tempo, a distância de claudicação e sobrevida de pacientes claudicantes em ambulatório específico, com ou sem limitação para exercícios. MÉTODOS: Foi feito um estudo tipo coorte retrospectivo de 185 pacientes e 469 retornos correspondentes, no período de 1999 a 2005, avaliando-se dados demográficos, distância média de claudicação (CI) e óbito. Os dados foram analisados nos programas Epi Info, versão 3.2, e SAS, versão 8.2. RESULTADOS: A idade média foi de 60,9±11,1 anos, sendo 61,1 por cento do sexo masculino e 38,9 por cento do sexo feminino. Oitenta e sete por cento eram brancos, e 13 por cento, não-brancos. Os fatores de risco associados foram: hipertensão (69,7 por cento), tabagismo (44,3 por cento), dislipidemia (32,4 por cento) e diabetes (28,6 por cento). Nos claudicantes para menos de 500 m, a CI inicial em esteira foi de 154,0±107,6 m, e a CI final, de 199,8±120,5 m. Cerca de 45 por cento dos pacientes tinham alguma limitação clínica para realizar o programa de exercícios preconizado, como: angina (26,0 por cento), acidente vascular cerebral (4,3 por cento), artropatia (3,8 por cento), amputação menor ou maior com prótese (2,1 por cento) ou doença pulmonar obstrutiva crônica (1,6 por cento). Cerca de 11,4 por cento dos pacientes tinham infarto do miocárdio prévio, e 5,4 por cento deles usavam cardiotônico. O tempo de seguimento médio foi de 16,0±14,4 meses. A distância média de CI referida pelos pacientes aumentou 100 por cento (de 418,47 m para 817,74 m) ao longo de 2 anos, nos grupos não-limitante...

BACKGROUND: Risk factors for atherosclerotic disease acting on natural history are well established, as well as the benefits of physical training in the treatment of intermittent claudication (IC). However, current data do not provide enough information about the relationship between clinical limitations and risk factors and the performance of physical training and its implications on the evolution and mortality of these patients. OBJECTIVE: To compare the claudication distance and survival of patients with IC throughout time in a specific outpatient setting, with or without limitation for exercises. METHODS: A retrospective cohort study was performed to review the protocols of 185 patients and 469 returns, from 1999 to 2005, evaluating demographic data, average claudication distance and death. The data were analyzed using the software Epi-Info, version 3.2, and SAS, version 8.2. RESULTS: Mean age was 60.9±11.1 years; 61.1 percent were males and 38.9 percent were females; 87 percent were Caucasians and 13 percent were non-Caucasians. Associated risk factors were hypertension (69.7 percent), smoking (44.3 percent), dyslipidemia (32.4 percent), and diabetes (28.6 percent). For the patients with claudicating distance lower than 500 m, mean initial distance was 154.0±107.6 m and final distance was 199.8±120.5 m. About 45 percent of the patients had some clinical limitation to perform the prescribed exercise program, such as angina (26.0 percent), stroke (4.3 percent), osteoarthrosis (3.8 percent), previous minor or major amputation (2.1 percent), or chronic obstructive pulmonary disease (1.6 percent). About 11.4 percent of the patients had previous myocardial infarction, and 5.4 percent of them were using cardiotonic drugs. Mean follow-up time was 16.0±14.4 months. Mean claudication distance increased 100 percent (418.47 to 817.74 m) throughout 2 years in the group without limitation (p < 0.001) and in nonsmokers (p < 0.001). Survival rate...

A sociodemographic, clinical study of patients with venous ulcer.

BACKGROUND: Venous ulcer is the most serious consequence of chronic venous insufficiency and is responsible for almost 70% of chronic leg ulcers. The main purpose of this research was to describe social, demographic and clinical characteristics of patients with venous ulcers and to identify some professional repercussions of this pathology. SUBJECTS AND METHODS: We evaluated patients with a clinical picture compatible with venous ulcer. The sociodemographic characteristics of the patients, and the clinical characteristics and professional repercussions of the pathology were studied. We used the ankle-brachial index to identify associated arterial disease. The body mass index (BMI) was used for the classification of the nutritional condition of the patients. RESULTS: A total of 120 patients were included in the study (90 females and 30 males; 80.8% White; 44.2% > 60 years old). Ninety-one per cent of the patients had been in education for less than 4 years, and 89.7% were on the poverty line. Thirty-five per cent were retired, 2.5% were receiving government help due to disease and 4.2% were unemployed. About 16% of patients were out of work due to the disease, and 49.2% presented some degree of disability in terms of work tasks. The ulcer area was less than 30 cm(2) in 69.1% of patients. The first ulcer episode occurred in 13.4 years on average, and 64.2% of patients had recurrent episodes. Females presented on average 5.65 pregnancies, and 75.4% of patients were overweight. CONCLUSION: Venous ulcer occurred mainly in the low-income population, who presented with little formal education. Generally, the ulcers were present for a long time and were recurrent, with repercussions for the capabilities of patients to work.