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1.
J Med Case Rep ; 15(1): 112, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653414

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 infection can lead to a constellation of viral and immune symptoms called coronavirus disease 2019. Emerging literature increasingly supports the premise that severe acute respiratory syndrome coronavirus 2 promotes a prothrombotic milieu. However, to date there have been no reports of acute aortic occlusion, itself a rare phenomenon. We report a case of fatal acute aortic occlusion in a patient with coronavirus disease 2019. CASE REPORT: A 59-year-old Caucasian male with past medical history of peripheral vascular disease presented to the emergency department for evaluation of shortness of breath, fevers, and dry cough. His symptoms started 5-7 days prior to the emergency department visit, and he received antibiotics in the outpatient setting without any effect. He was found to be febrile, tachypneic, and hypoxemic. He was placed on supplemental oxygen via a non-rebreather mask. Chest X-ray showed multifocal opacifications. Intravenous antibiotics for possible pneumonia were initiated. Hydroxychloroquine was initiated to cover possible coronavirus disease 2019 pneumonia. During the hospitalization, the patient became progressively hypoxemic, for which he was placed on bilevel positive airway pressure. D-dimer, ferritin, lactate dehydrogenase, and C-reactive protein were all elevated. Severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction was positive. On day 3, the patient was upgraded to the intensive care unit. Soon after he was intubated, he developed a mottled appearance of skin, which extended from his bilateral feet up to the level of the subumbilical plane. Bedside ultrasound revealed an absence of flow from the mid-aorta to both common iliac arteries. The patient was evaluated emergently by vascular surgery. After a discussion with the family, it was decided to proceed with comfort-directed care, and the patient died later that day. DISCUSSION: Viral infections have been identified as a source of prothrombotic states due to direct injury of vascular tissue and inflammatory cascades. Severe acute respiratory syndrome coronavirus 2 appears to follow a similar pattern, with numerous institutions identifying elevated levels of thrombotic complications. We believe that healthcare providers should be aware of both venous and arterial thrombotic complications associated with coronavirus disease 2019, including possible fatal outcome.


Assuntos
Doenças da Aorta , Arteriopatias Oclusivas , Trombose , Ultrassonografia/métodos , Aorta Abdominal/diagnóstico por imagem , Doenças da Aorta/diagnóstico , Doenças da Aorta/etiologia , Doenças da Aorta/fisiopatologia , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/etiologia , Arteriopatias Oclusivas/fisiopatologia , Coagulação Sanguínea , /complicações , /terapia , Deterioração Clínica , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Conforto do Paciente , Testes Imediatos , /patogenicidade , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/fisiopatologia
3.
Lancet Neurol ; 20(3): 213-221, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33422191

RESUMO

BACKGROUND: Due to the time-sensitive effect of endovascular treatment, rapid prehospital identification of large-vessel occlusion in individuals with suspected stroke is essential to optimise outcome. Interhospital transfers are an important cause of delay of endovascular treatment. Prehospital stroke scales have been proposed to select patients with large-vessel occlusion for direct transport to an endovascular-capable intervention centre. We aimed to prospectively validate eight prehospital stroke scales in the field. METHODS: We did a multicentre, prospective, observational cohort study of adults with suspected stroke (aged ≥18 years) who were transported by ambulance to one of eight hospitals in southwest Netherlands. Suspected stroke was defined by a positive Face-Arm-Speech-Time (FAST) test. We included individuals with blood glucose of at least 2·5 mmol/L. People who presented more than 6 h after symptom onset were excluded from the analysis. After structured training, paramedics used a mobile app to assess items from eight prehospital stroke scales: Rapid Arterial oCclusion Evaluation (RACE), Los Angeles Motor Scale (LAMS), Cincinnati Stroke Triage Assessment Tool (C-STAT), Gaze-Face-Arm-Speech-Time (G-FAST), Prehospital Acute Stroke Severity (PASS), Cincinnati Prehospital Stroke Scale (CPSS), Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST), and the FAST-PLUS (Face-Arm-Speech-Time plus severe arm or leg motor deficit) test. The primary outcome was the clinical diagnosis of ischaemic stroke with a proximal intracranial large-vessel occlusion in the anterior circulation (aLVO) on CT angiography. Baseline neuroimaging was centrally assessed by neuroradiologists to validate the true occlusion status. Prehospital stroke scale performance was expressed as the area under the receiver operating characteristic curve (AUC) and was compared with National Institutes of Health Stroke Scale (NIHSS) scores assessed by clinicians at the emergency department. This study was registered at the Netherlands Trial Register, NL7387. FINDINGS: Between Aug 13, 2018, and Sept 2, 2019, 1039 people (median age 72 years [IQR 61-81]) with suspected stroke were identified by paramedics, of whom 120 (12%) were diagnosed with aLVO. Of all prehospital stroke scales, the AUC for RACE was highest (0·83, 95% CI 0·79-0·86), followed by the AUC for G-FAST (0·80, 0·76-0·84), CG-FAST (0·80, 0·76-0·84), LAMS (0·79, 0·75-0·83), CPSS (0·79, 0·75-0·83), PASS (0·76, 0·72-0·80), C-STAT (0·75, 0·71-0·80), and FAST-PLUS (0·72, 0·67-0·76). The NIHSS as assessed by a clinician in the emergency department did somewhat better than the prehospital stroke scales with an AUC of 0·86 (95% CI 0·83-0·89). INTERPRETATION: Prehospital stroke scales detect aLVO with acceptable-to-good accuracy. RACE, G-FAST, and CG-FAST are the best performing prehospital stroke scales out of the eight scales tested and approach the performance of the clinician-assessed NIHSS. Further studies are needed to investigate whether use of these scales in regional transportation strategies can optimise outcomes of patients with ischaemic stroke. FUNDING: BeterKeten Collaboration and Theia Foundation (Zilveren Kruis).


Assuntos
Arteriopatias Oclusivas/diagnóstico , Serviços Médicos de Emergência/estatística & dados numéricos , /diagnóstico , Idoso , Idoso de 80 Anos ou mais , Arteriopatias Oclusivas/líquido cefalorraquidiano , Arteriopatias Oclusivas/complicações , Estudos de Coortes , Angiografia por Tomografia Computadorizada , Feminino , Humanos , /etiologia , Masculino , Pessoa de Meia-Idade , Países Baixos , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resultado do Tratamento
4.
Angiol Sosud Khir ; 26(4): 90-96, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332311

RESUMO

AIM: The present study was aimed at assessing the results of a total of 40 vascular operations carried out using the robotic-assisted da Vinci surgical system. PATIENTS AND METHODS: Between January 2013 and September 2019, a total of 40 robotic-assisted vascular operations were performed at the Department of Vascular Pathology and Hybrid Technologies of the Centre of Vascular and Hybrid Surgery. Of these, 31 interventions were carried out for occlusion of the aortoiliac segment and 9 for removal of an aneurysm of the infrarenal portion of the abdominal aorta. The patients were arbitrarily divided into 2 groups: the first group included those subjected to aortofemoral bypass grafting procedures for atherosclerotic steno-occlusive lesions of the aorta and iliac arteries, whereas the second group comprised the patients who underwent aneurysmoectomies with linear prosthetic repair of the abdominal aorta. RESULTS: Altogether, elective robotic-assisted operations were successfully performed in 38 (95%) cases. Conversion to a laparotomic approach was required in 2 (5%) patients. The mean time of creating an anastomosis with the abdominal aorta amounted to 51 minutes (range 30-90), being 42±4.75 min for aortofemoral bypass grafting and 83±5.00 min for aneurysmoectomies with linear prosthetic repair of the abdominal artery. The average blood loss was 316 (range 50-1000) ml, amounting to 280±209 ml and 438±322 ml for group I and group II, respectively. With the exception of one case, all patients spent 24 hours in the intensive care unit to be then transferred to the specialized ward. The average length of hospital stay amounted to 9.8 days. One patient experienced haemorrhage from the central anastomosis in the early postoperative period and was emergently operated on from a laparotomic approach. Four (10%) patients developed nonlethal complications which were treated conservatively. During the 30-day follow-up period, no lethal outcomes, thromboses, nor infections of the prostheses were observed. CONCLUSION: From a practical point of view, the major advantages of using the robotic-assisted complex include minimal surgical trauma, reduced blood loss, a wide range of high-precision movements of the manipulators, 3-D visualization with a 5-fold magnification, thus making it possible to create a vascular anastomosis sufficiently fast in very tight spaces in the body. Our experience with laparoscopic robotic-assisted surgery demonstrated feasibility of using this technique for treatment of pathology of the aortoiliac segment.


Assuntos
Arteriopatias Oclusivas , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/cirurgia , Humanos , Artéria Ilíaca/cirurgia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento
5.
Angiol Sosud Khir ; 26(3): 9-15, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063747

RESUMO

Embologenic arterial obstruction remains an extremely important problem of modern medicine. Emboli may affect virtually all arterial vessels of the greater circulation and in some cases arterial emboli may be multiple. The purpose of the present study was to work out a classification of multiple arterial emboli. Analysing the clinical material including over 30 years a total of 1804 patients with embolism of the aorta and major arteries of the limbs made it possible to define the range of the terms used and to submit for discussion a classification describing a situation where emboli affect simultaneously several arteries or occur repeatedly. Both cases involve several emboli migrating from the primary source into the arterial bed, therefore we suggest that all these emboli be called multiple. Simultaneous multiple emboli were classified as combined, multifocal, and layered, with repeated emboli classified as preceding, recurrent, early and remote. Simultaneous emboli were observed in 91 (5%) patients, of these, in 22 - combined, in 49 - multifocal, in 19 - layered, and in 1 case - combined and multifocal. Repeated emboli were revealed at various terms and encountered virtually in each third patient. Overall mortality amongst the patients with embolism of the aorta and arteries of the limbs over 30 years amounted to 13%, having over the last decade decreased to 7.6%. Multiple arterial emboli significantly influenced the outcomes of treatment, with the mortality rate in combined emboli increasing virtually to 50% and that in multifocal and layered emboli exceeding 20% (p<0.05). Early recurrent emboli in the postoperative period were observed in 6.8% of patients, significantly deteriorating the prognosis (mortality - 49.2%). In the remote period, 22.4% of the patients were operated on for recurrent embolism of arteries of the extremities, with more than 25% of the patients having experienced emboli of cerebral or visceral arteries. Recurrent thromboembolic complications played a significant role in the thanatogenesis in each 4th patient.


Assuntos
Arteriopatias Oclusivas , Embolia , Aorta , Arteriopatias Oclusivas/diagnóstico , Artérias/diagnóstico por imagem , Embolia/complicações , Embolia/diagnóstico , Extremidades , Humanos
8.
West Afr J Med ; 37(3): 284-289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32476124

RESUMO

Takayasu's arteritis (TA) is an idiopathic form of large vessel granulomatous vasculitis that mainly affects the aorta and its major branches, most frequently in young women under 50 years. While traditionally, it is a disease found commonly in Asia continent, it has also been reported from different parts of the world, albeit with a few reports from Sub-Sahara Africa. The clinical presentations are variable and are commonly from systemic inflammation, vascular occlusive diseases and aneurysm. Asymptomatic cases of TA have been documented and are usually discovered incidentally on physical examination. Common vascular symptoms from different series include vascular claudication, reduced or absent pulse, carotid bruit, hypertension and headache. Facial mononeuropathy and retinal ischaemic changes are rare findings in TA. However, occlusive disease of ulnar artery has not been reported in TA despite our extensive literature search. Here, we present a 48-year-old woman, who was admitted via the medical emergency with community acquired pneumonia but was incidentally diagnosed with Takayasu arteritis with lower motor neuron facial nerve palsy, unilateral blindness, and ulnar artery occlusion. Multidisciplinary management was instituted and patient was discharged after resolution of community acquired pneumonia, vascular claudication, and chronic headache. TA often presents asymptomatically and sometimes with atypical features and thus we suggest high index of suspicion and detailed cardio-vascular examination in young individuals with unexplained chronic headache, facial nerve palsy and visual symptoms.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Cegueira/etiologia , Doenças do Nervo Facial/etiologia , Arterite de Takayasu/diagnóstico , Ulna/irrigação sanguínea , Infecções Comunitárias Adquiridas/diagnóstico , Feminino , Humanos , Achados Incidentais , Pessoa de Meia-Idade , Neurônios Motores , Pneumonia/diagnóstico
10.
West J Emerg Med ; 21(3): 694-702, 2020 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-32421522

RESUMO

INTRODUCTION: Basilar artery occlusion (BAO) may be clinically occult due to variable and non-specific symptomatology. We evaluated the qualitative and quantitative determination of a hyperdense basilar artery (HDBA) on non-contrast computed tomography (NCCT) brain for the diagnosis of BAO. METHODS: We conducted a case control study of patients with confirmed acute BAO vs a control group of suspected acute stroke patients without BAO. Two EM attending physicians, one third-year EM resident, and one medical student performed qualitative and quantitative assessments for the presence of a HDBA on axial NCCT images. Our primary outcome measures were sensitivity and specificity for BAO. Our secondary outcomes were inter-rater and intra-rater reliability of the qualitative and quantitative assessments. RESULTS: We included 60 BAO and 65 control patients in our analysis. Qualitative assessment of the hyperdense basilar artery sign was poorly sensitive (54%-72%) and specific (55%-89%). Quantitative measurement improved the specificity of hyperdense basilar artery assessment for diagnosing BAO, with a threshold of 61.0-63.8 Hounsfield units demonstrating relatively high specificity of 85%-94%. There was moderate inter-rater agreement for the qualitative assessment of HDBA (Fleiss' kappa statistic 0.508, 95% confidence interval: 0.435-0.581). Agreement improved for quantitative assessments, but still fell in the moderate range (Shrout-Fleiss intraclass correlation coefficient: 0.635). Intra-rater reliability for the quantitative assessments of the two attending physician reviewers demonstrated substantial consistency. CONCLUSION: Our results highlight the importance of carefully examining basilar artery density when interpreting the NCCT of patients with altered consciousness or other signs and symptoms concerning for an acute basilar artery occlusion. If the Hounsfield unit density of the basilar artery exceeds 61 Hounsfield units, BAO should be highly suspected.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Artéria Basilar , Acidente Vascular Cerebral , Tomografia Computadorizada por Raios X/métodos , Idoso , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/fisiopatologia , Artéria Basilar/diagnóstico por imagem , Artéria Basilar/patologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia
13.
Angiology ; 71(7): 650-657, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32319312

RESUMO

Peripheral arterial disease (PAD) poses a threat of limb amputation and cardiovascular events. However, PAD diagnostic procedure requiring time, cost, and technical skills preclude its application as a screening test in the general population. Although PAD tends to be associated with lower foot skin temperature, none has yet to appreciate its usefulness for diagnosis/screening. We measured foot skin temperatures at the first and fifth metatarsal head and heel areas using noncontact infrared thermometer at the time of ankle brachial pressure index (ABI) measurement and limb arterial ultrasonography in 176 patients (345 legs) in participants. Foot skin temperatures correlated with ABI and showed distinctly lower levels in legs with ultrasound-confirmed arterial stenosis/occlusion and in those with ABI ≤0.90. Receiver operating characteristics analyses revealed that the lowest temperature value of the 3-foot locations had a higher sensitivity than every single location in detecting lower extremity PAD. Diagnostic efficiency for the ABI cutoff of 0.90 showed sensitivity/specificity of 41%/94%, while that for the lowest skin temperature cutoff of 30.8°C showed sensitivity/specificity of 60%/64%. In conclusion, an accurate skin temperature measurement using noncontact handheld infrared skin thermometer could serve as a new, cost-effective screening strategy for earlier diagnosis of PAD.


Assuntos
Arteriopatias Oclusivas/cirurgia , Diabetes Mellitus/fisiopatologia , Doença Arterial Periférica/cirurgia , Pele/fisiopatologia , Idoso , Índice Tornozelo-Braço/métodos , Arteriopatias Oclusivas/diagnóstico , Diabetes Mellitus/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Ultrassonografia/métodos
14.
Eur Radiol ; 30(6): 3059-3065, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32064562

RESUMO

INTRODUCTION: We aimed to investigate the utility of compressed sensing time-of-flight magnetic resonance angiography (CS TOF-MRA) for diagnosing intracranial and cervical arterial stenosis by using digital subtraction angiography (DSA) as the reference standard. METHODS: Thirty-seven patients with head and neck arterial stenoses who underwent CS TOF-MRA and DSA were retrospectively enrolled. The reconstructed resolution of CS TOF-MRA was 0.4 × 0.4 × 0.4 mm3. The scan time was 5 min and 2 s. The image quality of CS TOF-MRA was independently ranked by two neuroradiologists in 1031 arterial segments. The luminal stenosis grades on CS TOF-MRA and DSA were analyzed in 61 arterial segments and were compared using the Wilcoxon signed-rank test. The ability of CS TOF-MRA to predict moderate to severe stenosis or occlusion was analyzed. RESULTS: The image quality of most arterial segments (95.2%) on CS TOF-MRA was excellent. Arterial segments with low image quality were mainly the V3-4 segments of the vertebral artery. The majority of arterial stenoses (62.3%) were located in the cervical internal carotid artery. The luminal stenosis grades of CS TOF-MRA were concordant with that of DSA in 50 of 61 segments (p = 0.366). CS TOF-MRA had a sensitivity of 84.4% and a specificity of 88.5% for predicting moderate to severe stenosis. For detecting occlusion lesions, it had a sensitivity of 100% and a specificity of 94.1%. CONCLUSION: CS TOF-MRA provides adequate image quality within a reasonable acquisition time and is a reliable tool for diagnosing head and neck arterial steno-occlusive disease. KEY POINTS: • CS TOF-MRA provides a relatively large coverage (16 cm), high resolution (0.4 × 0.4 × 0.4 mm3) and good image quality of head and neck arteries within 5 min and 2 s. • The diagnostic accuracy of CS TOF-MRA in the assessment of moderate to severe stenosis and occlusion was comparable with that of DSA. • Arterial segments with low image quality were mainly the V3 and V4 segments of the vertebral artery.


Assuntos
Angiografia Digital/métodos , Arteriopatias Oclusivas/diagnóstico , Artéria Carótida Interna/diagnóstico por imagem , Angiografia por Ressonância Magnética/métodos , Artéria Vertebral/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos
15.
PLoS One ; 15(2): e0229444, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32101567

RESUMO

Clinical interpretation of arterial spin labeling (ASL) perfusion MRI in cerebrovascular disease remains challenging mainly because of the method's sensitivity to concomitant contributions from both intravascular and tissue compartments. While acquisition of multi-delay images can differentiate between the two contributions, the prolonged acquisition is prone to artifacts and not practical for clinical applications. Here, the utility of the spatial coefficient of variation (sCoV) of a single-delay ASL image as a marker of the intravascular contribution was evaluated by testing the hypothesis that sCoV can detect the effects of differences in label arrival times between ipsi- and contra-lateral hemispheres even in the absence of a hemispheric difference in CBF. Hemispheric lateralization values for sCoV and CBF were computed from ASL images acquired on 28 patients (age 73.9 ± 10.2 years, 8 women) with asymptomatic unilateral carotid occlusion. The results showed that sCoV lateralization predicted the occluded side with 96.4% sensitivity, missing only 1 patient. In contrast, the sensitivity of the CBF lateralization was 71.4%, with 8 patients showing no difference in CBF between hemispheres. The findings demonstrate the potential clinical utility of sCoV as a cerebrovascular correlate of large vessel disease. Using sCoV in tandem with CBF, vascular information can be obtained in image processing without the need for additional scan-time.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Encéfalo/irrigação sanguínea , Doenças das Artérias Carótidas/diagnóstico , Circulação Cerebrovascular , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Marcadores de Spin , Idoso , Feminino , Humanos , Masculino
17.
Int J Rheum Dis ; 23(1): 116-119, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31746147

RESUMO

Takayasu arteritis is a chronic granulomatous vasculitis generally affecting large vessels including the thoracic aorta and its branches. Intimal proliferation subsequently causes segmental stenosis and occlusion, and frequently aneurysmal dilatation in the affected vessels. Although involvement of pulmonary arteries is not uncommon, isolated branch pulmonary stenosis is rarely encountered. Here, we report a patient presenting with isolated peripheral pulmonary stenosis as the primary manifestation of Takayasu arteritis.


Assuntos
Arteriopatias Oclusivas/etiologia , Artéria Pulmonar , Arterite de Takayasu/complicações , Adulto , Arteriopatias Oclusivas/diagnóstico , Cateterismo Cardíaco , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Feminino , Humanos , Imagem Cinética por Ressonância Magnética , Arterite de Takayasu/diagnóstico
18.
J Neurointerv Surg ; 12(8): 753-757, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31818972

RESUMO

INTRODUCTION: While telestroke allows early intravenous thrombolysis (IVT) for ischemic strokes in spoke centers, mechanical thrombectomy (MT) for large vessel occlusion (LVO) is mainly performed at comprehensive stroke centers (CSCs). We aimed to compare 3 month outcome in patients with LVO after admission to a spoke center using telestroke compared with first CSC admission in our large regional stroke network, irrespective of final treatment decision. METHODS: All consecutive LVO patients who were admitted to one of six spoke centers or to the regional CSC within 6 hours of symptom onset were prospectively included from September 1, 2015 to August 31, 2017. All patients admitted to spoke centers were assessed on site with cerebral and vessel imaging. Primary outcome was 3 month favorable outcome (modified Rankin Scale score of 0-2). RESULTS: Distances between spoke centers and CSC ranged from 36 to 77 miles. Among 207 included patients, 132 (63.8%) were first admitted to CSCs and 75 (36.2%) to spoke centers. IVT was administered more in spoke centers (81.3% vs 53.8%, p<0.0001) while MT was performed less (26.7% vs 49.2%, p=0.001) and with a longer time from onset (303 vs 200 min, p<0.0001). No difference was found in 3 month favorable outcome between spoke centers compared with CSCs (32.0% and 35.1%, respectively; OR=0.68; 95% CI 0.42 to 1.10; p=0.12). CONCLUSIONS: Despite different distribution of reperfusion therapies for LVO patients managed by telemedicine, we could not demonstrate a difference in functional outcome according to admission location in a large area with long distances between centers.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Acidente Vascular Cerebral/diagnóstico , Telemedicina , Idoso , Idoso de 80 Anos ou mais , Arteriopatias Oclusivas/tratamento farmacológico , Infarto Cerebral , Feminino , Hospitalização , Hospitais Especializados , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/tratamento farmacológico , Resultado do Tratamento
20.
Eur J Ophthalmol ; 30(5): NP53-NP57, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30947529

RESUMO

INTRODUCTION: Antineutrophil cytoplasm antibody-associated vasculitides encompass a diverse spectrum of autoimmune diseases characterized by necrotizing small vessel vasculitis. Ocular manifestations may be the presenting findings of antineutrophil cytoplasm antibody-associated vasculitides. METHODS: Single, retrospective case study. RESULTS: We report the rare case of a 55-year-old woman with a cilioretinal artery occlusion as the presenting feature of perinuclear antineutrophil cytoplasm antibody-associated microscopic polyangiitis. CONCLUSIONS: Although rare, antineutrophil cytoplasm antibody-related vasculitis should be considered in any retinal vascular occlusion, particularly in the setting of patients with new vague headaches and a paucity of vasculopathic risk factors.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Arteriopatias Oclusivas/etiologia , Artérias Ciliares/patologia , Artéria Retiniana/patologia , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico , Anticorpos Anticitoplasma de Neutrófilos/sangue , Arteriopatias Oclusivas/diagnóstico , Sedimentação Sanguínea , Proteína C-Reativa/metabolismo , Feminino , Angiofluoresceinografia , Humanos , Pessoa de Meia-Idade , Peroxidase/imunologia , Estudos Retrospectivos
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