Registro de actividades de la Sociedad Española de Angiología y Cirugía Vascular, año 2019 / Registry of activities of the Spanish Society of Angiology and Vascular Surgery, year 2019

Objetivo: describir la actividad asistencial del año 2019 de los servicios/unidades de angiología y cirugía vascular en España. Pacientes y métodos: estudio transversal con encuesta a 107 centros sobre procedimientos quirúrgicos y exploraciones vasculares realizados en 2019. Análisis descriptivo de resultados y comparación de la ratio de actividad /100 000 habitantes con 2018. Resultados: respondieron 44 servicios (41,1 %), 4 de ámbito privado. De los 42 servicios docentes, respondieron 29 (65,9 %), un 65,9 %. En los servicios que respondieron se produjeron 26 960 ingresos, el 46,4 % urgentes y el 53,5 % programados (estancia media: 6,8 días). En la mayoría de sectores no hubo cambios significativos en la ratio/100 000 habitantes, salvo un aumento moderado (10,7 frente a 9,4) en el sector distal, tanto en procedimientos quirúrgicos (3,3 frente a 2,8) como en endovasculares (7,3 frente a 6,6). Descenso moderado de procedimientos endovasculares en los troncos supraaórticos (1,4 frente a 1,6). Hubo una disminución moderada de procedimientos quirúrgicos en aorta torácica (0,17 frente a 0,20) y abdominal (2,38 frente a 2,78), que contrastó con un aumento moderado en procedimientos endovasculares abdominotorácicos (0,40 frente a 0,35). En las arterias viscerales se encontró una disminución relevante de procedimientos endovasculares (0,89 frente a 1,16) y un aumento moderado de los quirúrgicos (0,99 frente a 0,89). En el sector aortoilíaco hubo un aumento moderado de procedimientos endovasculares (6,8 frente a 5,8). En 2019 también se encontró una disminución relevante en el número de procedimientos endovasculares relacionados con los accesos de hemodiálisis (1,2 frente a 1,5), un descenso moderado en el número de amputaciones mayores (6,9 frente a 7,8) y un descenso relevante de actividad sobre las malformaciones (0,32 frente a 0,59). Se encontró un aumento moderado en la actividad global sobre el sector venoso con respecto a la de 2018 (93,3 vs. 80,3)...(AU)

Introduction and objective: to describe the healthcare activity of the Angiology and Vascular Surgery services/units in Spain in 2019.Patients and methods: cross-sectional study with a survey of 107 centers on surgical procedures and vascularexplorations performed in 2019. Descriptive analysis of results and comparison of the activity ratio / 100,000inhabitants with 2018.Results: 44 services responded (41.1 %), with only 4 being private. Of the 42 teaching services, 29 (65.9 %) respon-ded, representing 65.9 % of the total. In the services that responded, there were 26,960 admissions, 46.4 % urgentand 53.5% scheduled, with an average stay of 6.8 days. Global surgical activity in arterial surgery in 2019 was similarto that of 2018. In most sectors there were no significant changes in the ratio / 100,000 inhabitants, except for amoderate increase (10.7 vs. 9.4) in the distal sector , finding the increase in both surgical procedures (3.3 vs. 2.8) andendovascular procedures (7.3 vs. 6.6). Furthermore, a moderate decrease in endovascular procedures was foundin the supra-aortic trunks (1.4 vs. 1.6). There was a moderate decrease in surgical procedures in the thoracic aorta(0.17 vs. 0.20) and abdominal (2.38 vs. 2.78), which contrasted with a moderate increase in thoraco-abdominalendovascular procedures (0.40 vs. to 0.35). In visceral arteries, a relevant decrease in endovascular procedures wasfound (0.89 vs. 1.16) and a moderate increase in surgical procedures (0.99 vs. 0.89). In the aorto-iliac sector therewas a moderate increase in endovascular procedures (6.8 vs. 5.8). In 2019, a relevant decrease was also found inthe number of endovascular procedures related to hemodialysis accesses (1.2 vs. 1.5), and a moderate decreasein the number of major amputations (6.9 vs. 7.8)...(AU)

The Arteries of the Encephalon Base in Caracal (Caracal caracal; Felidae; Carnivora).

This study represents the comprehensive anatomical analysis of the arterial circulation at the base of the encephalon in caracal (Caracal caracal), a member of the Felidae family. Caracals are found in various environments in Africa and Asia, and their conservation status is threatened by hunting and habitat loss. This study was conducted on 14 post-mortem specimens obtained from zoos. Three different methods were used to prepare the specimens-corrosive preparation, latex specimen preparation, and computer tomography imaging. This study revealed a configuration of the arterial circulation in the caracal encephalon resembling the shape of the number eight. The presence of the rostral communicating artery in this species is of particular significance, as it is associated with an increased ability to detect dehydration in the forebrain. This adaptation plays a crucial role in responding to challenges related to hydration. Comparative anatomical analysis with other felids highlighted differences in the shape and configuration of the encephalon's arterial circulation. This study also discussed the obliteration of the extracranial segment of the internal carotid artery in adult caracals, a feature shared with other Felidae members. The results of this study provide valuable information regarding the anatomy of blood vessels in caracals, with potential implications for veterinary practice in zoos and wildlife conservation efforts. This research expands our knowledge of this species' unique adaptations and physiological processes, contributing to the development of comparative anatomy in the Felidae family.

Arterial Blood Supply to the Cerebral Arterial Circle in the Selected Species of Carnivora Order from Poland.

Carnivores are a wide, diverse group of mammals whose representatives live all over the world. The study presents the results of the analysis of the arterial vascularization of the blood supply to the cerebral arterial circle of selected species in the Caniformia suborder living in Poland. The selected group consists of wild and farm animals-105 animals in total. Three different methods were used-latex preparation, corrosion cast, and cone-beam computed tomography angiography. The main source of blood for encephalon in the described species is the internal carotid artery, and the second one is the vertebral artery. The results were discussed in relation to the current knowledge of this field of research. Information on the potential physiological meaning of such vascular pattern has been provided.

Evaluation of hemodialysis vascular access. Perspective from Mexico.

Chronic kidney disease (CKD) has become a global health problem. In 2019, it was related to 2.53% of general global mortality (2.35-2.66%); in the same year, in Latin America, mortality related to CKD reached 5.25% (4.92-5.49%), with an annual increase of 3.37%, proving increased mortality of 102% between 1990 and 2017. A nephrology specialty in Mexico recently fulfilled its first 50 years. Despite being relatively young, nephrologists are interested in "new" sub-specialties of nephrology and learning novel techniques and problem-solving skills. Our group is the first in our country to focus solely and exclusively on comprehensive VA care and we want to position ourselves as the first Mexican interdisciplinary group focused on vascular access (GIMEXAV).

Cerebral Vascularization and the Remaining Area Supply of the Internal Carotid Artery Derivatives of the Red Kangaroo (Osphranter rufus).

The red kangaroo (Osphranter rufus) is a member of Macropidideae superfamily. It is one of the four kangaroo species living nowadays, and it is the biggest one. It is native to Australia, where it is an abundant species living across the whole continent in stable populations. Outside its natural habit, the red kangaroo is a common species found in zoos and as patients in wildlife rehabilitation centers. Reports on kangaroo anatomy are scarce. Describing detailed anatomy is a base for establishing diagnostic and treatment protocols for different species of animals. Cardiovascular diseases and pathological changes suggestive of hypertension have been previously described in kangaroos. This creates a necessity for detailed studies on species' vascular anatomy. New reports in the field of detailed vascular anatomy can bring considerable information that complements numerous studies on the evolution or biology of individual species. In this article, we describe the arterial vascularization of the brain and nearby regions of the cranial cavity using various anatomical techniques. The vascularization of the brain is discussed and compared with different mammalian species.

Anatomical Characteristics of Duplicated Caudal Vena Cava in Cats-A Case Report.

Precise knowledge of the species-/breed-specific anatomy is important for accurate diagnosis and treatment. Existing literature has also been increasing in accordance with the growing demands of biomedical research, wherein mammals, including cats, have been used worldwide. Based on a vascular corrosion cast, complete duplication of the caudal vena cava (dCVC) was accidentally found in a 10-year-old male cat. The two separate symmetric veins corresponding to two caudal venae cavae cranially directed on both sides of the aorta; their first tributaries were the duplicated right and left deep circumflex iliac veins, and the median sacral vein ended in the right common iliac vein. At the L4 vertebra level, the left caudal vena cava crossed the aorta ventrally. It united with the right CVC immediately above the renal veins at the level of the cranial mesenteric artery (L2-L3). Embryologic knowledge is essential to understand the differences between the CVC variants in domestic mammals and the inferior vena cava in humans. However, views regarding the post-hepatic segment of the CVC during development vary considerably. Therefore, our case report also includes a summary of the CVC developmental theories and their clinical impact. We believe that this case and literature review contribute to the knowledge regarding the deep abdominal veins' variability, concomitant pathologies, and accurate diagnosis and surgery. Additionally, the latest robust studies demonstrating the exclusive participation of the caudal cardinal veins in the CVC development are discussed.

Anatomical correlates and nomenclature of the chiropteran endocranial cast.

Bats form a diverse group of mammals that are highly specialized in active flight and ultrasound echolocation. These specializations rely on adaptations that reflect on their morphoanatomy and have been tentatively linked to brain morphology and volumetry. Despite their small size and fragility, bat crania and natural braincase casts ("endocasts") have been preserved in the fossil record, which allows for investigating brain evolution and inferring paleobiology. Advances in imaging techniques have allowed virtual extraction of internal structures, assuming that the shape of the endocast reflects soft organ morphology. However, there is no direct correspondence between the endocast and internal structures because meninges and vascular tissues mark the inner braincase together with the brain they surround, resulting in a mosaic morphology of the endocast. The hypothesis suggesting that the endocast reflects the brain in terms of both external shape and volume has drastic implications when addressing brain evolution, but it has been rarely discussed. To date, only a single study addressed the correspondence between the brain and braincase in bats. Taking advantage of the advent of imaging techniques, we reviewed the anatomical, neuroanatomical, and angiological literature and compare this knowledge available on bat's braincase anatomy with anatomical observations using a sample of endocranial casts representing most modern bat families. Such comparison allows to propose a Chiroptera-scale nomenclature for future descriptions and comparisons among bat endocasts. Describing the imprints of the tissues surrounding the brain also allows to address to what extent brain features can be blurred or hidden (e.g., hypophysis, epiphysis, colliculi, flocculus). Furthermore, this approach encourages further study to formally test the proposed hypotheses.

Blood supply to the cranial cavity in the patagonian mara (Dolichotis patagonum).

Rodents are the most numerous order of mammals. The literature presents information on the arterial circle of the brain in capybara, the guinea pig of the family Caviidae and many other not so closely related rodent species. Information on the blood supply to the brain is often incomplete and focuses on one pathway in a broader comparative aspect. The supply of oxygen and nutrients to the brain is very important for its proper functioning. The aim of this study is to describe the pathways supplying blood to the cranial cavity and to describe the arterial circle of the brain in the Patagonian mara. The study was conducted on 46 specimens using two methods. The first of them used a stained solution of the chemo-setting acrylic material. The second one, the colored liquid LBS 3060 latex. The arterial circle of the brain is a heart-shaped structure. It is formed by rostral cerebral arteries, caudal communicating arteries and the basilar artery. Blood supplies the arterial circle of the brain in three ways. First one is the basilar artery, which originates from the vertebral arteries. The second one is the internal carotid artery which joins a branch from the external ophthalmic artery. The third is the internal ophthalmic artery, which branches from the external ophthalmic artery.

Comparison of the Rostral Epidural Rete Mirabile and the Patterns of Its Blood Supply in Selected Suiformes and Hippopotamuses.

The rostral epidural rete mirabile (rete mirabile epidurale rostrale) is built of considerable small arterial vessels that anastomose with each other. This structure is formed as a result of the division of a large arterial vessel into many small arteries. Furthermore, on the other side of the rete mirabile, these small arteries are joined together to form one large artery, through which blood flows out of the rete mirabile. This system participates in decreasing the temperature of the brain and thus protects the body from thermal stress. Moreover, it influences body-water balance and has a crucial role in the retrograde transfer of neuropeptides. The goal of this study was to describe the rostral epidural rete mirabile and pathways that provide blood to this structure as well as compare it in selected Suiformes and hippopotamuses. The study was performed on desert warthogs (Phacochoerus aethiopicus), Eurasian wild boars (Sus scrofa), collared peccaries (Pecari tajacu), pygmy hippopotamuses (Choeropsis liberiensis), and common hippopotamuses (Hippopotamus amphibius). Preparations were made using the latex method and corrosion cast. An elongated shape characterizes its anatomy with a much wider rostral part than caudal part in the Eurasian wild boars, desert warthogs, and collared peccaries. The main source of blood was the branch to the rostral epidural rete mirabile branched off from the internal carotid artery. Moreover, blood enters the rete by the caudal branch and rostral branch to the rostral epidural rete mirabile. In hippopotamuses, the major source of blood was the rostral branches to the rostral epidural rete mirabile.

Strategies of vascularization of the ethmoid labyrinth in selected even-toed ungulates (Artiodactyla) and carnivores (Carnivora).

The anatomy of the nasal cavity and its structures, as well as other elements building a scaffold for olfactory organs, differs significantly among various groups of mammals. Understanding anatomical conditions of quality of olfaction are being studied worldwide and is a complex problem. Among many studies regarding bone and epithelial structures of turbinates and connected anatomical structures, few studies describe the vascularization of turbinates. Ethmoid turbinates are above all covered in olfactory epithelium containing branched axons that receive olfactory stimuli and as olfactory nerves penetrate the cribriform lamina of the ethmoid bone conveying information from smell receptors to the brain. Differences in vascularization of the cribriform plate and turbinates may add crucial information complementing studies regarding the olfactory organ's bone and soft tissue structures. In the study, we describe the vascularization of the cribriform plate of the ethmoid bone of 54 Artiodactyla and Carnivora.

Head arteries of the red squirrel (Sciurus vulgaris).

The red squirrel (Sciurus vulgaris) is a medium-sized rodent protected in most of Europe. The present study aimed to investigate and describe the arterial vascularization of the head of the adult red squirrel. In the study, 48 specimens of adult red squirrels were used. The first preparation method used in the study was corrosion casting using a stained solution of the chemo-setting acrylic material injected into bilateral common carotid arteries resulting in corrosion castings of the vessels on a bone scaffold. The second method was injecting liquid-stained latex into both common carotid arteries. It resulted in a stained arterial vessel on fixed soft tissue preparations. The main vessels providing blood to the head were paired with common carotid arteries that divide into external and internal carotid arteries. The internal carotid artery passes into the stapedial artery. After giving its branches, the stapedial artery exits the cranial cavity through the sphenofrontal foramen and enters the orbit. The suborbital and the mandibular regions were supplied by the maxillary artery, linguofacial trunk, and their branches. Description of the detailed anatomy of the head arteries in red squirrels may contribute to establishing diagnostic and treatment protocols for wildlife rehabilitation centers, which may be crucial since red squirrels are endangered by the spreading of invasive Eastern gray squirrels (Sciurus carolinensis) in Europe. It may also contribute to veterinary care for other members of the Sciuridae family kept as pets.

Programa de superación profesional para angiólogos sobre tratamiento de enfermedades vasculares periféricas con técnicas novedosas

Introducción: La superación profesional es un conjunto de acciones de carácter educativo vinculadas con la actualización de conocimientos y el desarrollo de habilidades y actitudes profesionales en correspondencia con la identificación de problemas profesionales. En Ciego de Ávila, Cuba, los especialistas de Angiología y Cirugía Vascular carecen de actividades de superación profesional de forma general, sistemática y de participación colectiva, dirigidas u orientadas desde la Universidad de Ciencias Médicas. Objetivo: Elaborar un programa de superación profesional del especialista en Angiología y Cirugía Vascular para el tratamiento de las enfermedades vasculares periféricas con técnicas novedosas, a partir de insuficiencias identificadas. Método: Se realizó una investigación cualitativa con un estudio descriptivo en especialistas de Angiología y Cirugía Vascular de la provincia de Ciego de Ávila, vinculada directamente con la atención a pacientes, en el año 2020. Se trabajó con toda la población compuesta por 19 especialistas. Fue aplicada una encuesta y se utilizó la estadística descriptiva para organizar y clasificar los indicadores cuantitativos obtenidos. Resultados: La preparación para la aplicación de tratamiento con técnicas novedosas en las enfermedades vasculares periféricas se encontró como insuficiencia en nivel de Poco adecuado y No adecuado en más del 90 % de los especialistas. Conclusiones: Se aporta un programa de superación profesional como sistema abierto, de carácter flexible, que facilita su rediseño constante para adaptarse a condiciones específicas de los contextos de aplicación.

Introduction: Professional development is a set of educational actions linked to update knowledge and professional skills and attitudes in correspondence with the professional problems met. In Ciego de Avila, Cuba, specialists in Angiology and Vascular Surgery lack professional improvement activities in general, systematic and collective participation way, straightly performed or oriented from the University of Medical Sciences. Objective: To design a professional development program for specialists in Angiology and Vascular Surgery on the treatment of peripheral vascular diseases with the use of novel techniques based on the professional problems met. Method: A qualitative research with descriptive study was carried out in Angiology and Vascular Surgery specialists linked directly to the patient care service in 2020. It worked with the whole population comprised of 19 specialists. A survey was applied and descriptive statistics were used to organize and classify the quantitative indicators obtained. Results: Knowledge on how to use the novel techniques in peripheral vascular diseases treatment proved to be inadequate at a pointed level of Less adequate and Inadequate in more than 90% of studied specialists. Conclusions: The professional development program is provided with characteristics of an open system and flexibility, which facilitates its constant redesign to adapt to the specific conditions of the contexts required.

Introdução: O aperfeiçoamento profissional é um conjunto de ações educativas vinculadas à atualização de conhecimentos e desenvolvimento de habilidades e atitudes profissionais em correspondência com a identificação de problemas profissionais. No Ciego de Ávila, Cuba, os especialistas em Angiologia e Cirurgia Vascular carecem de atividades de aperfeiçoamento profissional de forma geral, sistemática e de participação coletiva, dirigidas ou orientadas pela Universidade de Ciências Médicas. Objetivo: Desenvolver um programa de aperfeiçoamento profissional do especialista em Angiologia e Cirurgia Vascular para tratamento de doenças vasculares periféricas com técnicas inovadoras, a partir das insuficiências identificadas. Método: Foi realizada uma investigação qualitativa com estudo descritivo em especialistas de Angiologia e Cirurgia Vascular na província de Ciego de Ávila, diretamente vinculados ao atendimento ao paciente, no ano de 2020. Trabalhamos com toda a população composta por 19 especialistas. Aplicou-se um survey e utilizou-se estatística descritiva para organizar e classificar os indicadores quantitativos obtidos. Resultados: A preparação para a aplicação do tratamento com novas técnicas nas doenças vasculares periféricas revelou-se insuficiente ao nível de Pouco adequado e Pouco adequado em mais de 90% dos especialistas. Conclusões: Um programa de aperfeiçoamento profissional é fornecido como um sistema aberto, de natureza flexível, o que facilita seu redesenho constante para se adaptar às condições específicas dos contextos de aplicação.

Association between uric acid level and contrast-induced acute kidney injury in patients with type 2 diabetes mellitus after coronary angiography: a retrospective cohort study.

BACKGROUND: This study assessed the predictive value of uric acid (UA) for contrast-induced acute kidney injury (CI-AKI) in patients with type 2 diabetes mellitus (T2DM) who underwent coronary angiography (CAG). A nomogram to aid in the prediction of CI-AKI was also developed and validated, and the construction of a prognostic nomogram combined with clinical features was attempted. METHODS: This study retrospectively enrolled T2DM patients who underwent CAG between December 2019 and December 2020 at the Affiliated Zhongda Hospital of Southeast University. Multivariable logistic regression analysis was used for the analysis of clinical outcomes. Receiver operating characteristic (ROC) analyses were performed to determine the area under the ROC curve (AUC) and the cut-off points for continuous clinical data. The prediction accuracies of models for CI-AKI were estimated through Harrell's concordance indices (C-index). Nomograms of the prognostic models were plotted for individualized evaluations of CI-AKI in T2DM patients after CAG. RESULTS: A total of 542 patients with T2DM who underwent CAG were included in this study. We found that a high UA level (≥ 425.5 µmol/L; OR = 6.303), BUN level (≥ 5.98 mmol/L; OR = 3.633), Scr level (≥ 88.5 µmol/L; OR = 2.926) and HbA1C level (≥ 7.05%; OR = 5.509) were independent factors for CI-AKI in T2DM patients after CAG. The nomogram model based on UA, BUN, Scr and HbA1C levels presented outstanding performance for CI-AKI prediction (C-index: 0.878). Decision curve analysis (DCA) showed good clinical applicability in predicting the incidence of CI-AKI in T2DM patients who underwent CAG. CONCLUSION: High UA levels are associated with an increased incidence of CI-AKI in T2DM patients after CAG. The developed nomogram model has potential predictive value for CI-AKI and might serve as an economic and efficient prognostic tool in clinical practice.

Arterial Circle of the Brain of the Red-Necked Wallaby (Notamacropus rufogriseus).

The red-necked wallaby is a medium-sized marsupial species, which have increasingly been kept as pets around the world. In the study, the arterial blood supply for the brain in this species was described. The study was conducted on 50 specimens with two preparation methods. The main artery supplying the brain was the internal carotid artery. The arterial circle of the brain was closed from the caudal side. The anatomy of the arteries of the described region was compared with other groups of mammals. This is the first description of this anatomical area that has been carried out in a marsupial species. Understanding the anatomy of the circulatory system in the wallaby can be valuable for further physiological and pathophysiological studies.

Aneurisma micótico aórtico con invasión duodenal / Mycotic abdominal aorta aneurysm with duodenal invasion

Introducción: el aneurisma aórtico nicótico resulta de la dilatación de la pared arterial de la aorta a causa de una infección generalmente bacteriana. Es una patología poco frecuente pero mortal. Caso clínico: presentamos el caso de un varón de 94 años que fue diagnosticado de un aneurisma micótico de aorta abdominal con invasión duodenal mediante tomografía computarizada. Discusión: la presentación clásica de esta patología es una masa dolorosa, pulsátil y creciente con síntomas sistémicos de infección. La angiografía por tomografía computarizada diagnostica definitivamente el aneurisma. El tratamiento es una combinación de antibioticoterapia y resección quirúrgica activa. Pese a ello tiene muy mal pronóstico.(AU)

Introduction: the mycotic aortic aneurysm results from the dilatation of aorta arterial wall because of an infection mostly caused by bacteria. It is a non-frequent but easily mortal disease. Case report: we present the case of a 94-year-old man who was diagnosed with a mycotic aneurysm of the abdominal aorta with duodenal invasion by computed tomography. Discussion: the classic presentation of this pathology is a painful, pulsatile, and enlarging mass with systemic symptoms of infection. Computed Tomography Angiography definitively diagnoses the aneurysm. The treatment is a combination of antibiotic therapy and active surgical resection, but it has a very bad prognosis.(AU)

The ratio of the max-to-mean coronary artery calcium score in the most calcified vessel is associated with the presence of coronary artery disease.

PURPOSE: This study aimed to clarify the relationship between the severity of the calcium burden in the most calcified coronary vessel and coronary artery disease (CAD). METHOD: Of 2150 patients, 376 examined by both coronary computed tomographic angiography and invasive coronary angiography (ICA) within 30 days at Sun Yat-sen Memorial Hospital between March 2011 and July 2020 were included. Three coronary artery calcium scores (CACSs), including the Agatston score, volume score, and mass score, and other clinical variables were recorded. The ratio of max-to-mean CACS in the most calcified vessel (CACSmax:mean) was defined as the CACS in the most calcified vessel/average CACS of the four major epicardial coronary arteries. Logistic regression and least absolute shrinkage and selection operator (LASSO) analyses were performed to assess the relationship between CACSmax:mean and CAD. RESULTS: CACSmax:mean was higher in 81.1% of subjects diagnosed with CAD than in subjects without CAD. In multivariate logistic regression analysis, CACSmax:mean determined by the Agatston score, volumetric score, and mass score was associated with CAD. In LASSO analysis, Agatston scoremax:mean (not the total Agatston score or other CACSmax:mean) had the strongest correlation with CAD (ß = 0.125). AUCs in the training set and the validation set were 0.811 and 0.789, respectively. Increased age, diabetes and hypertension correlated with higher Agatston scoremax:mean. CONCLUSIONS: In addition to total CACS, CACSmax:mean may be a novel diagnostic parameter for CAD, showing the calcium burden severity.

Wound Care During the COVID-19 Emergency in Padua Hospital, Italy.

Chronic vascular wounds have a significant economic and social impact on our society, calling for the allocation of a great deal of attention and resources. The coronavirus disease (COVID-19) outbreak has represented a difficult challenge to face for health care providers and fragile patients, such as for outpatients and Day-Hospital patients needing continuous care at the Angiology Unit of the University Hospital of Padova in Italy, one of the most crucial areas worldwide. The project consisted of a critical revision of all the procedures from the patients' arrivals to their discharge after completing the entire course of treatment. The previous standard of practice was modified according to the current evidence-based guidelines and the national and local government's indications. The new standard of practice allowed our unit to protect every patient and staff member from the coronavirus infection, providing the same high standard of care as before the COVID-19 outbreak.

Branching patterns of the adrenal arteries in the degu (Octodon degus).

The degu has drawn increasing attention for use as an experimental animal in stress response studies due to its physiological features, such as diurnality and seasonal breeding, which differ from conventional laboratory rodents. Stress response is elicited by steroid hormones secreted by the adrenal gland, whose functions are controlled by pituitary hormones reaching through the adrenal arteries. However, knowledge of the arterial anatomy of the degu adrenal gland remains insufficient. To address this issue, we observed adrenal arteries in 20 male degus injected with red-colored latex. Adrenal arterial branching patterns were classified into Types 1-4, which respectively have 1 to 4 parent arteries that give rise to the adrenal arteries. Based on the combination of the parent arteries, Types 2 and 3 were categorized into subtypes a to c, while Type 4 was categorized into subtypes a and b. On the left side, Type 2 (45%) and Type 3 (45%) were predominant, whereas Type 1 (5%) and Type 4 (5%) were infrequent. On the right side, Type 2 (50%) and Type 3 (45%) were predominant, whereas Type 4 (5%) was infrequent. Type 1 was not present. There were 0 to 4 cranial, 1 to 4 middle and 1 to 4 caudal adrenal arteries, with the total number varying from 2 to 9. The present observation provides knowledge of comparative anatomical features of the degu adrenal arteries, which can serve as an anatomical basis for comparative endocrinological studies.

Aneurisma venoso postraumático en extremidades superiores. Presentación de dos casos / Post-traumatic venous aneurysm in the upper limbs. Case report on two patients / Aneurisma venoso pós-traumático nos membros superiores. Apresentação de dois casos

RESUMEN Los aneurismas venosos, en especial de la extremidad superior, son malformaciones vasculares de baja frecuencia. Se presentó el manejo de dos pacientes del sexo femenino atendidas en el Servicio de Angiología y Cirugía Vascular del Hospital General Docente "Dr. Agostinho Neto" de la provincia Guantánamo, Cuba, a las que se les diagnosticaron aneurismas en diferentes segmentos del sistema venoso superficial de la extremidad superior, los que se resecaron quirúrgicamente y se les confirmó el diagnóstico mediante biopsia.

ABSTRACT Venous aneurysms, especially the ones located in the upper limbs, are vascular malformations with low incidence in the population. Two cases of venous aneurisms on female patients showed up at the Angiology and Vascular Surgery services at the General Teaching Hospital ¨Dr. Agostinho Neto¨ in Guantanamo, Cuba. Aneurism diagnosis was confirmed through biopsy. They were located in different segments of the superficial venous system of the upper limbs, and were surgically resected.

RESUMO Os aneurismas venosos, principalmente de membro superior, são malformações vasculares de baixa frequência. Foi apresentada a gestão de duas pacientes do sexo feminino atendidas no Serviço de Angiologia e Cirurgia Vascular do Hospital General Docente "Dr. Agostinho Neto" da província de Guantánamo, Cuba, que foram diagnosticados com aneurismas em diferentes segmentos do sistema venoso superficial do membro superior, os quais foram ressecados cirurgicamente e o diagnóstico foi confirmado por biópsia.

Arterial branching pattern of the rabbit femoral artery.

Rabbits have highly developed hindlimb muscles, whereas their bones are fragile, thus resulting in frequent hindlimb fractures. To repair these fractures, it is important to understand the arterial branching pattern of the femoral artery, as it provides the main blood supply to the hindlimb. Since the descriptions from prior studies are insufficient, the aim of the present study was to determine the detailed arterial branching pattern of the rabbit femoral artery. Therefore, to address this issue, we examined 30 male and 20 female New Zealand White rabbits after colored latex injections into the femoral artery. Results showed that the femoral artery gave rise to the pudendoepigastric trunk, along with the deep femoral, lateral circumflex femoral, superficial caudal epigastric, saphenous, descending genicular, and proximal and middle caudal femoral arteries, in conjunction with frequent individual variations. In all the observed halves, the last branch from the femoral artery was the distal caudal femoral artery. Individual variations in the branching pattern of these arteries occurred independently in the proximal and the distal portions of the femoral artery, and they were, respectively, categorized into four and three major types based on the number of the branching levels along the proximodistal axis of the femoral artery. The individual variations in the arterial branching pattern of the rabbit femoral artery that were demonstrated in the present study may provide an important anatomical basis for refining the orthopedic surgical procedure in the rabbit.