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1.
J Wound Care ; 29(Sup9): S6-S7, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32924805

RESUMO

The uncertainty due to COVID-19 surrounding live events has remained present and persistent. Therefore, this year, the American Vein & Lymphatic Society (AVLS) Annual Congress will be a virtual-only event that will take place on 15 October 2020. It will include a live-streamed session will complement the fundamental knowledge of providing wound care for patients. On-demand content will allow attendees to participate at their own pace, watching as much or as little as they want each day, potentially earning AMA PRA Category 1 CreditsTM.


Assuntos
Betacoronavirus , Congressos como Assunto , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Triagem/organização & administração , Doenças Vasculares/terapia , Tomada de Decisão Clínica , Infecções por Coronavirus/complicações , Humanos , Cooperação Internacional , Pandemias , Pneumonia Viral/complicações , Sociedades Médicas/organização & administração , Estados Unidos , Doenças Vasculares/complicações
2.
BMJ Case Rep ; 13(9)2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32933907

RESUMO

A 51-year-old woman who presented in June 2010 with acute coronary syndrome (ACS) and anterior wall motion abnormality on the echocardiogram but was found to have an insignificant angiogram. Eight years later she presented again with ACS and evidence of worsening cardiac wall motion affecting a similar territory; however, the angiogram revealing spontaneous coronary artery dissection of the distal left anterior descending artery. Extravascular screening revealed evidence of multifocal fibromuscular dysplasia. We suggest offering vascular screening for fibromuscular dysplasia in young women who present with ACS and normal angiograms, after weighing in risks and benefits.


Assuntos
Síndrome Coronariana Aguda/complicações , Anomalias dos Vasos Coronários/complicações , Displasia Fibromuscular/complicações , Doenças Vasculares/congênito , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva , Doenças Vasculares/complicações
3.
Ann Vasc Surg ; 67: 1-5, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32505678

RESUMO

BACKGROUND: The epidemic potential of coronavirus infection is now a reality. Since the first case detected in late 2019 in China, a fast worldwide expansion confirms it. The vascular patient is at a higher risk of developing a severe form of the disease because of its nature associating several comorbid states, and thus, some vascular surgery communities from many countries have tried to stratify patients into those requiring care during these uncertain times. METHODS: This is an observational study describing the current daily vascular surgery practice at one tertiary academic hospital in Madrid region, Spain-one of the most affected regions worldwide due to the COVID-19 outbreak. We analyzed our surgical practice since March 14th when the lockdown was declared up to date, May 14th (2 months). Procedural surgical practice, organizational issues, early outcomes, and all the troubles encountered during this new situation are described. RESULTS: Our department is composed of 10 vascular surgeons and 4 trainees. Surgical practice has been reduced to only urgent care, totaling 50 repairs on 45 patients during the period. Five surgeries were performed on 3 COVID-19-positive patients. Sixty percent were due to critical limb ischemia, 45% of them performed by complete endovascular approach, whereas less than 10% of repairs were aorta related. We were allocated to use a total of 5 surgical rooms in different locations, none our usual, as it was converted into an ICU room while performing 50% of those repairs with unusual nursery staff. CONCLUSIONS: The COVID-19 outbreak has dramatically changed our organization and practice in favor of urgent or semiurgent surgical care alone. The lack of in-hospital/ICU beds and changing nursery staff changed the whole availability organization at our hospital and was a key factor in surgical decision-making in some cases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Especialidades Cirúrgicas/estatística & dados numéricos , Doenças Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares/organização & administração , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Espanha/epidemiologia , Doenças Vasculares/complicações
4.
Eur J Vasc Endovasc Surg ; 60(2): 264-272, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32417030

RESUMO

OBJECTIVE: Frailty is a multidimensional vulnerability due to age associated decline. The impact of frailty on long term outcomes was assessed in a cohort of vascular surgical patients. METHODS: Patients aged over 65 years with a length of stay greater than two days admitted to a tertiary vascular unit over a single calendar year were included. Demographics, mode of admission, and diagnosis were recorded alongside a variety of frailty specific characteristics. Using the previously developed Addenbrookes Vascular Frailty Score (AVFS - 6 point score: anaemia on admission, lack of independent mobility, polypharmacy, Waterlow score > 13, depression, and emergency admission) the effect of frailty on five year mortality and re-admission rates was assessed using multivariable regression techniques. The AVFS was further refined to assess longer term outcomes. RESULTS: In total, 410 patients (median age 77 years) were included and followed up until death or five years from the index admission. One hundred and thirty-four were treated for aortic aneurysm, 75 and 96 for acute and chronic limb ischaemia respectively, 52 for carotid disease, and 53 for other pathologies. The in hospital mortality rate was 3.6%. The one, three, and five year survival rates were 83%, 70% and 59%; and the one, three, and five year re-admission free survival rates were 47%, 29%, and 22% respectively. Independent predictors of five year mortality were age, lack of independent mobility, high Charlson score, polypharmacy, evidence of malnutrition, and emergency admission (p < .010 for all). Patients with AVFS 0 or 1 had restricted mean survival times which were one year longer than those with AVFS 2 or 3 (p < .001), who in turn had restricted mean survival times over one year longer than those with AVFS of 4 or more (p < .001). CONCLUSION: Frailty factors are strong predictors of long term outcomes in vascular surgery. Further prospective studies are warranted to investigate its utility in clinical decision making.


Assuntos
Idoso Fragilizado , Fragilidade/complicações , Doenças Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Fragilidade/diagnóstico , Fragilidade/mortalidade , Avaliação Geriátrica , Mortalidade Hospitalar , Humanos , Tempo de Internação , Masculino , Readmissão do Paciente , Intervalo Livre de Progressão , Medição de Risco , Fatores de Risco , Fatores de Tempo , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico , Doenças Vasculares/mortalidade , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/mortalidade
5.
Medicine (Baltimore) ; 99(18): e19738, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358347

RESUMO

RATIONALE: Scrotal swelling is a rare complication of acute pancreatitis. It had been explained by fluid accumulation in scrotum originated from abdomen. Here we demonstrated a case of recurrent pancreatitis with hydrocele caused by impaired testicular venous drainage. PATIENT CONCERNS: A 53-year-old man presented with sudden onset epigastric pain after an alcohol binge. Recurrent acute pancreatitis was confirmed by medical history, physical examination, elevated lipase level and abdominal computed tomography (CT) scan. Right scrotal swelling was noticed on the next day. DIAGNOSIS: The scrotal ultrasonography demonstrated fluid accumulation around the testis and varicocele consistent with scrotal hydrocele. CT scans of the abdomen and pelvis showed encasement of the right testicular vein by pancreatic phlegmon. INTERVENTIONS: The patient was subject to Nulla per os, hydration, and opioid analgesics for pancreatitis. No intervention was performed for scrotal swelling. OUTCOMES: Hydrocele gradually resolved along with acute pancreatitis. LESSONS: Pancreatic phlegmon compromised testicular venous return which led to scrotal hydrocele and posed a threat to fertility. The study has provided a novel pathologic linkage. This complication should be taken into account.


Assuntos
Pancreatite/etiologia , Hidrocele Testicular/etiologia , Testículo/irrigação sanguínea , Doenças Vasculares/complicações , Doença Aguda , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva
6.
Clin Ter ; 171(3): e192-e196, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32323705

RESUMO

Septic pulmonary embolism (SPE) is an uncommon disease in which a microorganism- containing thrombus causes an inflammatory reaction and a mechanical obstruction in the vascular system of the lungs. Usually it is associated with tricuspid valve vegetation, septic thrombophlebitis or infected venous catheters. We present a rare and fatal case of massive septic pulmonary thromboembolism occurred in a diabetic woman, who complained in previous days dyspnoea, abdominal pain and nausea. Autopsy findings showed evidence of an erosive cystitis, while lungs examination showed total occlusion of pulmonary circulation system due to thrombo-embolic clots. In literature cases report about an association between septic pulmonary thromboembolism and erosive cystitis haven't been reported. So, we here show the first reported fatal case of a septic pulmonary thromboembolism as a lethal evolution of an erosive cystitis.


Assuntos
Cistite/complicações , Angiopatias Diabéticas , Embolia Pulmonar/etiologia , Idoso de 80 Anos ou mais , Autopsia , Cistite/patologia , Evolução Fatal , Feminino , Medicina Legal , Humanos , Inflamação , Embolia Pulmonar/mortalidade , Embolia Pulmonar/patologia , Doenças Vasculares/complicações
7.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 5-10, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1090555

RESUMO

Abstract Introduction The cochlea and the vestibular receptors are closely related in terms of anatomy and phylogeny. Patients with moderate to profound sensorineural hearing loss (MPSHL) should have their vestibular organ functions tested. Objective To evaluate the incidence of vestibular abnormalities in patients with MPSHL and to study the correlation between the etiology of hearing loss (HL) and a possible damage to the labyrinth. Methods A case-control retrospective study was performed. In the case group, 20 adults with MPSHL of known etiology were included. The control group was composed of 15 adults with normal hearing. The case group was divided into 4 subgroups based on the etiology (bacterial meningitis, virus, vascular disease, congenital). Cervical vestibular-evoked myogenic potentials (cVEMPs) were used to rate the saccular function and lower vestibular nerve. Results The study was performed in 70 ears, and it highlighted the presence of early biphasic P1-N1 complex in 29 (71.5%) out of 40 ears in the study group, and in all of the 30 ears in the control group (p = 0.001). Regarding the presence or absence of cVEMPs among the four subgroups of patients with MPSHL, the data were statistically significant (p < 0.001). The comparison between the latencies and amplitude of P1-N1 in case and control groups from other studies and in the four subgroups of cases in the present study did not detect statistically significant differences. Conclusion The present study demonstrates that patients with MPSHL have a high incidence of damage to the labyrinthine organs, and it increases the current knowledge about the etiopathogenesis of sensorineural HL, which is often of unknown nature.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Potenciais Evocados Miogênicos Vestibulares , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Audiometria de Tons Puros , Doenças Vasculares/complicações , Viroses/complicações , Estudos de Casos e Controles , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologia , Incidência , Estudos Retrospectivos , Meningites Bacterianas/complicações , Perda Auditiva Neurossensorial/congênito , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/fisiopatologia , Doenças do Labirinto/epidemiologia
8.
Am J Cardiol ; 125(9): 1446-1448, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32145897

RESUMO

Described herein is a 42-year-old woman who suddenly developed a spontaneous isolated coronary arterial dissection which led to massive acute myocardial infarction with shock, unsuccessful coronary artery bypass grafting, transiently successful extracorporeal life support, and finally successful heart transplant. Such a sequence of events is exceedingly rare for patients with coronary dissection and prompted this report.


Assuntos
Anomalias dos Vasos Coronários/complicações , Transplante de Coração , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/cirurgia , Doenças Vasculares/congênito , Doença Aguda , Adulto , Ponte de Artéria Coronária , Oxigenação por Membrana Extracorpórea , Feminino , Humanos , Resultado do Tratamento , Doenças Vasculares/complicações
9.
Angiology ; 71(5): 411-416, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32030991

RESUMO

Acute stent thrombosis is an important complication of stent implantation. The CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score incorporates important cardiovascular (CV) risk factors and predicts prognosis in various CV conditions. We evaluated the value of the CHA2DS2-VASc score in predicting acute stent thrombosis (ie, thrombosis during 24 hours after stent placement) in patients undergoing primary percutaneous intervention for ST-segment elevated myocardial infarction. Patients with intraprocedural stent thrombosis and complications were excluded; 48 (2.1%) of 2732 patients had acute stent thrombosis according to our definition. Median CHA2DS2-VASc score was significantly higher in this stent thrombosis group. Cumulative acute stent thrombosis rates were 0.51% for CHA2DS2-VASc score ≤1, 1.55% for ≤2, 1.80% for ≤3, 2.00% for ≤4, 2.17% for ≤5, and 2.19% for ≤6. The CHA2DS2-VASc score (odds ratio = 1.390, 95% confidence interval = 1.118-1.728; P = .003) was an independent predictor of acute stent thrombosis. The CHA2DS2-VASc score ≤1 predicted the absence of the acute stent thrombosis with 91% specificity and 36% sensitivity. Further studies are needed to establish the value of this finding in the context of current clinical practice.


Assuntos
Intervenção Coronária Percutânea , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Stents/efeitos adversos , Trombose/diagnóstico , Trombose/etiologia , Doença Aguda , Fatores Etários , Idoso , Complicações do Diabetes/complicações , Feminino , Insuficiência Cardíaca/complicações , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Acidente Vascular Cerebral/complicações , Doenças Vasculares/complicações
10.
Curr Urol Rep ; 21(1): 7, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32020365

RESUMO

PURPOSE OF REVIEW: To update the most relevant literature regarding complex cases during kidney transplant setting that recipient presents by himself, especially during implantation surgery due to vascular diseases and/or urinary tract anomalies. RECENT FINDINGS: Increasing age of donors and recipients is leading to an increased complexity of kidney transplant implantation surgery. In addition, the high peripheral vascular disease prevalence worldwide increases difficulty of surgery and decreases long-term outcomes as well. Moreover, it also increases transplant morbidity and mortality, both overall and cardiovascular, and finally clearly decreases graft survival. However, dialysis alternative has even worse outcomes in terms of mortality, with a proportional risk of death 2.66 higher compared with transplanted patients. Aorto-iliac prosthesis and 3rd and 4th transplants in occupied iliac fossae do also represent a challenging situation with a clearly increased morbidity and mortality. In some of those particular conditions, orthotopic kidney transplant technique is an alternative with good functional and survival outcomes, but not exempt of complications. Kidney transplant in vascular complex recipients has worse outcomes compared with conventional non-risky population. It remains a challenging surgical and medical procedure with higher morbidity and mortality, and decreased graft survival. However, dialysis mortality is still even greater and a transplant attempt might be justified. Orthotopic kidney transplant technique might play a role in selected patients with aorto-iliac unworkable segments or even in patients with special urinary tract conditions.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Anormalidades Urogenitais/cirurgia , Doenças Vasculares/cirurgia , Malformações Vasculares/cirurgia , Lesões do Sistema Vascular/cirurgia , Anastomose Cirúrgica/efeitos adversos , Humanos , Doença Iatrogênica , Complicações Intraoperatórias/terapia , Rim/irrigação sanguínea , Rim/cirurgia , Falência Renal Crônica/complicações , Transplante de Rim/efeitos adversos , Doenças Vasculares Periféricas/complicações , Doenças Vasculares Periféricas/cirurgia , Reoperação , Transplantes/irrigação sanguínea , Transplantes/cirurgia , Resultado do Tratamento , Doenças Vasculares/complicações , Malformações Vasculares/complicações
11.
Rev Mal Respir ; 37(2): 171-179, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32061440

RESUMO

Right ventricular failure (RVF) is a common cause of admission to the intensive care unit and its presence is a major prognostic factor in acute pulmonary embolism (PE) and chronic pulmonary hypertension (PH). RVF results from an incapacity of the RV to adapt to an increase in afterload so it can become critical in acute PE and chronic PH. The presence of RVF in cases of acute PE with haemodynamic instability is an indication for thrombolytic therapy. RVF represents the most common cause of death in chronic PH. Factors triggering RV failure in PH, such as infection, PE, arrhythmias, or unplanned withdrawal of pulmonary arterial hypertension (PAH)-targeted therapy, have to be considered and treated if identified. However, RVF may also represent progression to end-stage disease. The management of RVF in patients with PH requires expertise and consists of optimization of fluid balance (with diuretics), cardiac output (with inotropic support such as dobutamine), perfusion pressure (with norepinephrine), and reduction of RV afterload with PAH-targeted therapies. Extracorporeal life support, lung transplantation or heart-lung transplantation should be considered in cases of refractory RVF in eligible patients.


Assuntos
Hipertensão Pulmonar/terapia , Embolia Pulmonar/terapia , Doenças Vasculares/terapia , Disfunção Ventricular Direita/terapia , Doença Aguda , Cuidados Críticos/métodos , Oxigenação por Membrana Extracorpórea , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/terapia , Transplante de Coração-Pulmão , Humanos , Hipertensão Pulmonar/complicações , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/fisiopatologia , Unidades de Terapia Intensiva , Transplante de Pulmão , Circulação Pulmonar/fisiologia , Embolia Pulmonar/complicações , Embolia Pulmonar/epidemiologia , Embolia Pulmonar/fisiopatologia , Doenças Vasculares/complicações , Doenças Vasculares/epidemiologia , Doenças Vasculares/fisiopatologia , Disfunção Ventricular Direita/complicações , Disfunção Ventricular Direita/epidemiologia , Disfunção Ventricular Direita/fisiopatologia
12.
Am J Gastroenterol ; 115(1): 18-40, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31895720

RESUMO

Disorders of the mesenteric, portal, and hepatic veins and mesenteric and hepatic arteries have important clinical consequences and may lead to acute liver failure, chronic liver disease, noncirrhotic portal hypertension, cirrhosis, and hepatocellular carcinoma. Although literature in the field of vascular liver disorders is scant, these disorders are common in clinical practice, and general practitioners, gastroenterologists, and hepatologists may benefit from expert guidance and recommendations for management of these conditions. These guidelines represent the official practice recommendations of the American College of Gastroenterology. Key concept statements based on author expert opinion and review of literature and specific recommendations based on PICO/GRADE analysis have been developed to aid in the management of vascular liver disorders. These recommendations and guidelines should be tailored to individual patients and circumstances in routine clinical practice.


Assuntos
Gastroenterologia , Circulação Hepática , Hepatopatias/etiologia , Guias de Prática Clínica como Assunto , Circulação Esplâncnica , Doenças Vasculares/terapia , Humanos , Fígado/irrigação sanguínea , Hepatopatias/fisiopatologia , Mesentério/irrigação sanguínea , Sociedades Médicas , Estados Unidos , Doenças Vasculares/complicações
14.
World Neurosurg ; 134: 79-85, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31669242

RESUMO

BACKGROUND: Segmental arterial mediolysis (SAM) is a rare non-atherosclerotic, noninflammatory vascular disease, characterized by mediolysis. We report an extremely rare case of subarachnoid hemorrhage (SAH) due to a ruptured blood blister-like aneurysm (BBA) of the internal carotid artery associated with SAM-related arteriopathy. CASE DESCRIPTION: We experienced a case of SAH followed by intraperitoneal hemorrhage that occurred 12 days after the SAH onset. SAH was caused by a ruptured BBA of the internal carotid artery, which was treated by trapping with high-flow bypass. Intraperitoneal hemorrhage was caused by a rupture of a posterior inferior pancreaticoduodenal artery (PIPDA) aneurysm, which induced hypovolemic shock resulting in death in spite of endovascular internal trapping. Postmortem pathologic examination revealed that the PIPDA pseudoaneurysm was due to SAM. CONCLUSIONS: We should pay attention to the association of SAM, which is a potentially life-threatening pathology when treating cerebral BBAs.


Assuntos
Aneurisma Roto/patologia , Artéria Carótida Interna/patologia , Artéria Mesentérica Superior/patologia , Túnica Média/patologia , Doenças Vasculares/patologia , Aneurisma Dissecante/etiologia , Aneurisma Dissecante/patologia , Aneurisma Roto/etiologia , Hemorragia/etiologia , Hemorragia/patologia , Humanos , Aneurisma Intracraniano/etiologia , Aneurisma Intracraniano/patologia , Masculino , Pessoa de Meia-Idade , Doenças Vasculares/complicações
16.
Rev Med Suisse ; 15(674): 2236-2240, 2019 Dec 04.
Artigo em Francês | MEDLINE | ID: mdl-31804035

RESUMO

Lower extremity arterial disease (LEAD) is a serious and invalidating disease with a relatively high prevalence in the diabetic population. Patients suffering from both conditions have a less favourable prognosis of affected limbs compared to non-diabetic patients, with more frequent adverse limb events such as amputations. Nevertheless, awareness of LEAD remains sub-optimal in the diabetic population. Regular and appropriate screening for this condition is therefore recommended. Affected individuals should receive optimal medical treatment, including intensive management of the various cardiovascular risk factors and strict blood glucose control.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Extremidade Inferior/irrigação sanguínea , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico , Amputação , Artérias/patologia , Diabetes Mellitus Tipo 2/patologia , Diabetes Mellitus Tipo 2/terapia , Humanos , Fatores de Risco , Doenças Vasculares/patologia , Doenças Vasculares/terapia
17.
Arq Bras Cardiol ; 113(5): 988-998, 2019 11.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31800725

RESUMO

Spontaneous coronary artery dissection (SCAD) is considered an often underdiagnosed acute coronary syndrome, with few cases described in literature. Its association with physical exercise among young patients without risk factors or atherosclerotic disease (CAD) is even rarer. For this reason, a study was conducted on the subject, describing the clinical conditions, conduct and evolution regarding the suspicion of spontaneous exercise-related coronary artery dissection in three young patients without risk factors or CAD. Clinical conditions varied, with predominant recurrent chest pain. Age range from 20 to 31 years. All patients underwent coronary angiography, which showed no CAD but suggested SCAD. Investigations concerning other causes of coronary obstruction were negative. The right coronary artery was affected in two cases, and the anterior descending artery was affected in one case. Only one of the three patients had recurrent events within five years from the primary event. Technological advances will enable increased dissection identification in acute coronary syndromes. Improving the knowledge about the related clinical conditions is necessary, as an attempt to provide warnings and improve the suspicion of spontaneous exercise-related coronary artery dissection among those who have symptoms of coronary insufficiency, thus reducing the frequent underdiagnosis. The best treatment and prognosis for this disease remains uncertain.


Assuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Exercício Físico , Doenças Vasculares/congênito , Adulto , Cateterismo Cardíaco , Dor no Peito/etiologia , Angiografia Coronária , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/cirurgia , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Masculino , Fatores de Risco , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/cirurgia , Adulto Jovem
18.
Artigo em Russo | MEDLINE | ID: mdl-31851176

RESUMO

Mechanisms of the development of pain in chronic venous diseases (CVD), including pelvic congestion syndrome (PCS), are understudied. The existing hypotheses of the occurrence of venous pelvic pain (VVP) do not allow to answer the question why some patients have no pain syndrome while others have very pronounced pain despite the same morphofunctional changes in the pelvic veins. This review presents current hypotheses of the VPP development, data on some vasoactive neuropeptides (endothelin, calcitonin gene-related peptide, and substance P), their role in the modulation of vascular tone and sensation of pain, possible association between neurogenic inflammation and VPP and provides a rationale for studying the activity of these neurotransmitters in the treatment of PCS and pelvic pain.


Assuntos
Dor Pélvica , Varizes , Doenças Vasculares , Doença Crônica , Humanos , Dor Pélvica/complicações , Pelve , Varizes/complicações , Doenças Vasculares/complicações , Veias
19.
BMC Neurol ; 19(1): 341, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881866

RESUMO

BACKGROUND: To evaluate the efficacy of microvascular decompression (MVD) in reducing hypertension (HTN) in hypertensive patients with trigeminal neuralgia (TN). METHODS: The clinical data of 58 cases of neurogenic HTN with TN treated in our hospital were retrospectively reviewed. Preoperative MR revealed abnormal blood pressure in the left rostral ventrolateral medulla (RVLM) and the posterior cranial nerve root entry zone (REZ). The patients were divided into control group: only trigeminal nerve was treated with MVD; experimental group: trigeminal nerve, RVLM and REZ were treated with MVD at the same time. The patients were followed up for 6 months to 1 year to observe the changes of blood pressure. RESULTS: There was no significant difference in gender, age, course of TN, course of HTN, grade of HTN and preoperative blood pressure between the two groups. After operation, the effective rate of HTN improvement with MVD was 32.1% in the control group. There was no significant difference in the preoperative and post operative blood pressure. (P△SBP = 0.131; P△BDP = 0.078). In the experimental group, the effective rate was 83.3%. The postoperative blood pressure was significantly lower than preoperative values. (P△SBP < 0.001; P△DBP < 0.001). CONCLUSIONS: MVD is an effective treatment for neurogenic HTN. However, the criteria for selecting hypertensive patients who need MVD to control their HTN still needs to be further determined. Possible indications may include: left trigeminal neuralgia, neurogenic HTN; abnormal blood pressure compression in the left RVLM and REZ areas on MR; and blood pressure in these patients can not be effectively controlled by drugs.


Assuntos
Hipertensão/etiologia , Hipertensão/cirurgia , Bulbo/cirurgia , Cirurgia de Descompressão Microvascular/métodos , Doenças Vasculares/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Bulbo/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Neuralgia do Trigêmeo/etiologia , Neuralgia do Trigêmeo/cirurgia , Doenças Vasculares/complicações
20.
Kathmandu Univ Med J (KUMJ) ; 17(65): 30-34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31734675

RESUMO

Background Extra hepatic portal vein obstruction (EHPVO) is a common cause of portal hypertension in the developing countries (up to 30% of all variceal bleeders) and is second to cirrhosis in the West (up to 5-10%). Our understanding of the disease is poor compared with other illnesses. Objective To undertake a retrospective study of the clinicoepidemiological profile of Extra hepatic portal vein obstruction in a tertiary care hospital in eastern Nepal. Method All consecutive adult patients whose features were consistent with the diagnosis of extra hepatic portal vein obstruction from June 2014 to June 2016 were retrospectively analyzed to explore the various clinico-epidemiological parameters. Result A total of 58 patients were enrolled in the study with a median age of 24 years (20.5- 40). Portal vein thrombosis was the most common cause of extrahepatic portal vein obstruction. Hematemesis followed by melena were the most common presenting symptoms. All patients had splenomegaly on examination. None of the patients had clinical, biochemical or radiological evidence of chronic liver disease. Conclusion The diagnosis of extra hepatic portal venous obstruction and differentiation from cirrhosis can be easily made by characteristic clinical features, normal liver function tests and doppler ultrasound. Portal vein thrombosis (PVT) is the predominant cause of extra hepatic portal vein obstruction in Nepali patients, as seen at this tertiary care hospital in Nepal.


Assuntos
Veia Porta/patologia , Doenças Vasculares/patologia , Trombose Venosa/etiologia , Adulto , Feminino , Humanos , Hipertensão Portal/etiologia , Fígado/irrigação sanguínea , Cirrose Hepática , Masculino , Melena , Nepal , Estudos Retrospectivos , Esplenomegalia , Centros de Atenção Terciária , Doenças Vasculares/complicações , Doenças Vasculares/epidemiologia , Doenças Vasculares/etiologia , Adulto Jovem
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