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1.
J Med Case Rep ; 16(1): 410, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36352448

RESUMO

BACKGROUND: Diagnosis of venous aneurysm may be difficult and can be misjudged as mass-like lesions, including hernias. Here we present the case of a patient with a great saphenous vein aneurysm misdiagnosed and operated as an inguinal hernia. CASE PRESENTATION: A 39-year-old Middle Eastern/Persian male presented with left inguinal bulging 15 years ago, which was misdiagnosed and operated on with a diagnosis of inguinal hernia. He was referred to our clinic, in which color Doppler sonography revealed left-sided saphenofemoral junction incompetence with severe flow reversal during the Valsalva maneuver, in favor of a great saphenous vein aneurysm. Ligation of left saphenofemoral junction and stripping of saphenous vein, and stab avulsion phlebotomy of left lower extremity varicose veins, were done. He was discharged the next day after the operation with an uneventful postoperative course or complication on follow-up. CONCLUSION: Venous aneurysms can be misdiagnosed as other, more common, mass-like lesions, such as inguinal hernias. Therefore, our report emphasizes the consideration of thorough assessment and utilization of color duplex sonography to prevent further misdiagnosis and unnecessary intervention and operations.


Assuntos
Aneurisma , Hérnia Inguinal , Varizes , Masculino , Humanos , Adulto , Veia Safena/cirurgia , Varizes/cirurgia , Hérnia Inguinal/diagnóstico por imagem , Hérnia Inguinal/cirurgia , Veia Femoral/cirurgia , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Resultado do Tratamento
2.
Medicine (Baltimore) ; 101(45): e31543, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36397398

RESUMO

Acute upper gastrointestinal bleeding (UGIB) is a typical medical emergency, with an incidence of 84 to 160 cases per 100,000 individuals and a mortality rate of approximately 10%. This study aimed to identify all cases of UGIB hospitalized in a tertiary gastroenterology department, to identify possible predictive factors involved in rebleeding and mortality, potential associations between different elements and the severity of bleeding, and the differences between the upper digestive hemorrhage due to nonvariceal and variceal bleeding. This was an observational, retrospective study of patients with UGIB admitted to the tertiary Department of Gastroenterology between January 2013 and December 2020. A total of 1499 patients were enrolled in the study. One thousand four hundred and ninety-nine patients were hospitalized for 7 years with active upper digestive hemorrhage, 504 variceal bleeding, and 995 nonvariceal bleeding. When comparing variceal with nonvariceal bleeding, in nonvariceal bleeding, the mean age was higher, similar sex, higher mortality rate, higher rebleeding rate, and higher hemorrhagic shock rate. Endoscopy treatment was also performed more frequently in variceal bleeding than in nonvariceal bleeding. Severe anemia was found more frequently in patients with variceal bleeding. The mortality rate was 10% in the entire study group, which was not significantly different between the 2 batches. However, the rebleeding rate is higher in patients with variceal gastrointestinal bleeding.


Assuntos
Varizes Esofágicas e Gástricas , Varizes , Humanos , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Varizes Esofágicas e Gástricas/complicações , Estudos Retrospectivos , Doença Aguda , Endoscopia Gastrointestinal/efeitos adversos , Varizes/complicações
3.
Comput Math Methods Med ; 2022: 3545712, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36388160

RESUMO

Tongue diagnosis, a noninvasive examination, is an essential step for syndrome differentiation and treatment in traditional Chinese medicine (TCM). Sublingual vein (SV) is examined to determine the presence of blood stasis and blood stasis syndrome. Many studies have shown that the degree of SV stasis positively correlates with disease severity. However, the diagnoses of SV examination are often subjective because they are influenced by factors such as physicians' experience and color perception, resulting in different interpretations. Therefore, objective and scientific diagnostic approaches are required to determine the severity of sublingual varices. This study aims at developing a computer-assisted system based on machine learning (ML) techniques for diagnosing the severity of sublingual varicose veins. We conducted a comparative study of the performance of several supervised ML models, including the support vendor machine, K-neighbor, decision tree, linear regression, and Ridge classifier and their variants. The main task was to differentiate sublingual varices into mild and severe by using images of patients' SVs. To improve diagnostic accuracy and to accelerate the training process, we proposed using two model reduction techniques, namely, the principal component analysis in conjunction with the slice inverse regression and the convolution neural network (CNN), to extract valuable features during the preprocessing of data. Our results showed that these two extraction methods can reduce the training time for the ML methods, and the Ridge-CNN method can achieve an accuracy rate as high as 87.5%, which is similar to that of experienced TCM physicians. This computer-aided tool can be used for reference clinical diagnosis. Furthermore, it can be employed by junior physicians to learn and to use in clinical settings.


Assuntos
Medicina Tradicional Chinesa , Varizes , Humanos , Medicina Tradicional Chinesa/métodos , Aprendizado de Máquina , Redes Neurais de Computação , Língua , Varizes/diagnóstico por imagem
4.
Sultan Qaboos Univ Med J ; 22(4): 539-545, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36407709

RESUMO

Objectives: This study aimed to determine the association between Helicobacter pylori infection and variceal bleeding as well as rebleeding in cases of cirrhosis with portal hypertension. Methods: This prospective cohort study included patients with bleeding oesophageal varices and was conducted at the Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, from August 2016 to July 2018. Results: A total of 190 patients were assessed for eligibility, of which 159 patients were included in this study. Among the 159 patients, 124 (78.0%) had alcohol-related liver disease and eight had hepatitis B virus-related liver disease. Seven patients with varices had bled neither at presentation nor during the follow-up period. A total of 78 (49.1%) patients were H. pylori infected. The primary outcome, which was correlation between prevalence of H. pylori and the incidence of bleeding/rebleeding from varices as well as encephalopathy found that patients with oesophageal varices (adjusted risk [AR] = 0.714) and H. pylori infection (AR = 0.682) had a lower risk of variceal rebleeding. Among H. pylori-negative patients, pepsinogen I was higher in patients with rebleeding (30.7 versus 14.4 ng/mL; P <0.001). The secondary outcome, which was correlation of the site of bleeding with H. pylori infection and the association of the ratio of pepsinogen I/II with bleeding showed that among H. pylori-positive patients, the ratio of pepsinogen I/II was higher in patients with rebleeding (2.9 versus 1.3 ng/mL; P = 0.023). Conclusion: H. pylori infection was associated with a lower risk of rebleeding in cases of cirrhosis with portal hypertension. Irrespective of the status of the H. pylori infection, rebleeding was associated with increased levels of gastric acid output, as demonstrated by the level of pepsinogen.


Assuntos
Varizes Esofágicas e Gástricas , Infecções por Helicobacter , Helicobacter pylori , Hipertensão Portal , Varizes , Humanos , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/epidemiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Pepsinogênio A , Estudos Prospectivos , Hipertensão Portal/complicações , Hipertensão Portal/epidemiologia , Varizes/complicações , Cirrose Hepática/complicações
5.
Br J Community Nurs ; 27(10): 486-494, 2022 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-36194405

RESUMO

Community nurses often encounter people with red legs. There are a number of reasons why an individual may develop red legs. The most common causes of red legs are cellulitis, venous eczema and lipodermatosclerosis. All have different causes and require different treatments. This article aims to enable readers to differentiate between these conditions which can appear similar, and to offer effective evidence-based care.


Assuntos
Eczema , Esclerodermia Localizada , Varizes , Celulite (Flegmão)/diagnóstico , Dermatite , Eczema/diagnóstico , Eczema/etiologia , Humanos , Perna (Membro) , Esclerodermia Localizada/diagnóstico , Esclerodermia Localizada/etiologia , Esclerodermia Localizada/terapia , Varizes/complicações
6.
J Invasive Cardiol ; 34(10): E755, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36201000

RESUMO

A 72-year-old man presented with altered consciousness. His past medical history included left renal cell carcinoma status post nephrectomy 3 years earlier, end-stage renal disease with regular hemodialysis, and central venous obstruction with stenting at the right subclavian vein and superior vena cava 8 months earlier. He was intubated and placed on a mechanical ventilator and inotropes for managing respiratory failure and shock. After numerous tests, it was evident that a right atrial mass was hindering blood flow into the right ventricle and causing blood to flow back into the peripheral venous system. This could cause obstructive cardiogenic shock and fluctuating cutaneous varices. The patient refused further intervention and died from multiple organ failure. This unusual phenomenon can provide a clue for the discovery of atrial masses in dialysis patients.


Assuntos
Falência Renal Crônica , Varizes , Idoso , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/terapia , Masculino , Diálise Renal/efeitos adversos , Veia Subclávia , Varizes/complicações , Varizes/diagnóstico , Varizes/terapia , Veia Cava Superior
7.
Medicine (Baltimore) ; 101(42): e31263, 2022 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-36281109

RESUMO

BACKGROUND: Esophagogastric variceal bleeding (EGVB) is a potentially life-threatening complication of portal hypertension. Endoscopic treatment combined with pharmacotherapy remains the mainstay in the management of acute variceal bleeding. AIM: This article intends to highlight the potential differences in the endoscopic management of EGVB in China. METHODS: A cross-sectional descriptive study was conducted. Endoscopists from 85 hospitals in 62 cities from 26 provinces were contacted by email. The items in questionnaire involved academic experience, screening, esophagogastric varices (EGV) classification, emergency treatment, and primary and secondary prophylaxis of EGVB by endoscopists with different lengths of experience. RESULTS: A total of 85 questionnaires were collected. There was no statistical difference in the selection of items (P < .05 indicated statistical significance). The majority of endoscopists (95.29%) offered EGV screening for patients with liver cirrhosis. The location, diameter, and risk factor classification was selected by 82.35% of endoscopists. Endoscopy + medication was preferred (42.35%) for the primary prophylaxis of moderate-to-severe EGVs. There was no statistical difference in emergency intervention time for active EGVB (P > .05). The response "patients receive emergency endoscopic intervention within 12 hours" was selected by 61.2% of the endoscopists. The preferred emergency treatment for EGVB was combination treatment (40%). Tissue adhesive embolization was selected for the treatment of gastric variceal bleeding by 74.12% of endoscopists; transjugular intrahepatic portosystemic stent shunt/percutaneous transhepatic variceal embolization were selected as remedial measures by 48.23% to 52.94% of endoscopists. In addition, 67.06% of endoscopists elected to perform secondary prophylaxis and treatment within 1 week after hemostasis. Endoscopy and endoscopy + medication were selected by 44.71% and 49.41% of endoscopists, respectively, for secondary prophylaxis. The choice of laboratory indicators did not differ with length of experience. CONCLUSIONS: There was no statistical difference in the endoscopic management of EGVB among Chinese endoscopists. The selection of diagnosis/treatment schemes was mainly based on guidelines and physician experience.


Assuntos
Varizes Esofágicas e Gástricas , Derivação Portossistêmica Transjugular Intra-Hepática , Adesivos Teciduais , Varizes , Humanos , Varizes Esofágicas e Gástricas/terapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Hemorragia Gastrointestinal/diagnóstico , Estudos Transversais , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Cirrose Hepática/complicações , Endoscopia/efeitos adversos , Varizes/complicações
8.
Rozhl Chir ; 101(8): 369-374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208931

RESUMO

Varicose veins of lower extremities are a common disorder affecting a significant proportion of adult population. Endovenous techniques have been used in clinical practice for more than 20 years for their radical treatment; of these, laser therapy is one of the most widely utilized options. However, this treatment modality, too, has its specific side effects and complications which can be divided into perioperative (difficult venous access, fiber or sheath damage, vasovagal reaction with a drop in blood pressure and bradycardia, cutaneous thermal injury), and postoperative (bruising and hematomas, exceptionally pain, superficial venous thrombosis (phlebitis) and fibrous cord formation or pigmentations). Paresthesias, infections, arteriovenous fistulas, deep venous thrombosis and pulmonary embolism are very rare. The introduction of new generators with higher wavelengths and fibers with radial emission of laser energy has substantially reduced the side effects and complications. Performing the surgery in the outpatient setting using tumescent local anesthesia and under perioperative ultrasound control is an essential condition of the procedure.


Assuntos
Terapia a Laser , Embolia Pulmonar , Varizes , Trombose Venosa , Adulto , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Extremidade Inferior , Embolia Pulmonar/etiologia , Veia Safena , Resultado do Tratamento , Varizes/cirurgia , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
9.
Rozhl Chir ; 101(8): 395-400, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208935

RESUMO

INTRODUCTION: Endovenous laser ablation (EVLA) is a recognized alternative to surgical treatment of varicose veins, although an optimal laser generator and its settings still remain a matter of debate. The aim of our study was to correlate clinical results with the theoretical advantage of the 1940nm diode laser characterized by high absorption of heat in a thin layer of coagulated tissue. METHODS: From 1/2010 to 12/2021 EVLA was performed in a total of 3529 consecutive patients with varicose veins and ultrasonographically documented superficial venous reflux of lower extremities. Three types of laser were used successively with the wavelengths of 1064 nm, 1470 nm and 1940 nm, respectively. All patients were prospectively enrolled in our registry. An early postoperative followup visit was scheduled including an assessment of venous closure; additional visits were performed only in case of complications. RESULTS: The success of venous closure did not differ (p=0.054) between the three laser types and was over 98%. The catheterbased method made it possible to perform multiple ablations in one procedure the trend was 1.08, 1.31 and 1.62. In 2021 the number of ablations per patient with the laser DL Tethys 1940 nm was 1.79. With this laser it was possible to reduce the total energy applied to one half (8 W, 5080 J/cm). The postoperative course of patients treated using the 1940nm laser was smoother - no other but the early followup visit was needed in 95.6% cases (p.


Assuntos
Terapia a Laser , Varizes , Insuficiência Venosa , Humanos , Terapia a Laser/métodos , Lasers Semicondutores/uso terapêutico , Veia Safena/cirurgia , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/cirurgia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/cirurgia
10.
Vnitr Lek ; 68(4): 234-239, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36220421

RESUMO

The article provides an overview of the development of recommendations for indications of venoactive drugs for treating symptoms and signs associated with chronic venous disease (CVD). Venoactive drugs may be beneficial in patients with subjective problems and/or swelling of the lower limbs, after surgery for varicose veins, in chronic venous insufficiency or in microcirculatory disorders. They are not indicated in asymptomatic patients with CVD, in the prevention of varicose veins or to prevent their progression. Drugs with proven efficacy in clinical trials should be preferred.


Assuntos
Varizes , Insuficiência Venosa , Doença Crônica , Humanos , Extremidade Inferior , Microcirculação , Varizes/diagnóstico , Varizes/tratamento farmacológico , Insuficiência Venosa/tratamento farmacológico
13.
Ann Ital Chir ; 93: 578-583, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36254762

RESUMO

AIM: To evalue the short-term results obtained in endovenous laser ablation (EVLA) procedure of the varicose insufficiency of the lower limbs with Diode 1470 µm laser compared to Diode 1940 µm laser. MATERIALS OF STUDY: A total of 55 patients were enrolled in the study. The patients were divided into two groups: those subjected to 1470 µm laser treatment in group A and those with 1940 µm laser treatment in group B. The endpoints were: Closure of the target vessel, complications and post-operative pain. RESULTS: There are no intra-and post-operative complications. The occlusion rate of the target veins was 100% at 7- and 60-day controls. The pain perceived in the immediate post-operative and at the controls showed no statistically significant differences between the two groups. However in group B it was necessary to apply lower values of Power (W) and Linear Energy Density (LEED) with a statistically significant difference compared to group A. DISCUSSION: Short-term results demonstrate closure rates comparable to those obtained with 1470 µm lasers. There were no statistically significant differences in the two groups in terms of primary and secondary endpoints. The advantage of using 1940 µm laser technology is that it is possible to dispense a lower linear energy density (LEED) at a lower power (Watt). CONCLUSIONS: Endovenous laser ablation with Diode 1940 µm is particularly suitable and advantageous in the treatment of superficial and small vessels, as well as venous segment adjacent to nerve structures. KEY WORDS: Diode laser, Intravenous ablation, Varicose, Venous insufficiency, Veins.


Assuntos
Terapia a Laser , Varizes , Insuficiência Venosa , Humanos , Terapia a Laser/métodos , Lasers Semicondutores/uso terapêutico , Veia Safena/cirurgia , Resultado do Tratamento , Varizes/cirurgia , Insuficiência Venosa/cirurgia
14.
Med Trop Sante Int ; 2(3)2022 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-36284556

RESUMO

Introduction: Hydatidosis is a zoonosis caused by Echinococcus granulosus. It's a real public health problem in Morocco. Muscle localization is unusual, even in endemic countries. We report a rarely described case of a hydatid cyst of the psoas muscle diagnosed in our laboratory. Case report: The patient was a 32-year-old male, living in a rural area. He reported a contact with dogs. He was admitted in vascular surgery department for left hypochondrium pain, with heaviness of the left lower limb and appearance of varicose veins. Clinical examination has found a huge painful and hard mass of the left flank arriving to the hypogastrium with varicose veins of the left leg. An injected CT scan of the pelvic region showed a 189 x 137 mm cystic mass of the left psoas muscle reflowing left iliac vessels. This suggested hydatid cyst. No other localization was found. Hydatid serology was positive with an ELISA test and an indirect hemagglutination test. The patient underwent surgery to remove the mass. Several white vesicles of a few centimeters were found in the cyst and were sent to the parasitology laboratory. Microscopic examination has confirmed the presence of viable Echinococcus granulosus. The patient received albendazole 400 mg twice daily for only a month and was not seen for follow-up. One year after surgery, he showed the same symptoms of abdominal pain and heaviness. Recurrence of hydatid cysts in the same localization was diagnosed with ultrasound showing two hydatid cysts type 3 according to Gharbi classification. Discussion: Diagnosis of all hydatidosis localizations is based on epidemiological, clinical, and radiological data and confirmed by serology and parasitological examination of the surgical specimen. Surgery is then a diagnostic and therapeutic tool that cannot be bypassed since it allows the definitive elimination of the parasite and eviction of recurrence if it's well done. Conservative methods are related to recurrent cysts. Conclusion: Muscle hydatidosis is extremely rare but should not be forgotten when radiological and epidemiological data suggest it. It's a benign infection but can be severe and deadly if not appropriately treated.


Assuntos
Equinococose , Echinococcus granulosus , Echinococcus , Varizes , Masculino , Cães , Animais , Albendazol/uso terapêutico , Músculos Psoas/diagnóstico por imagem , Marrocos , Equinococose/diagnóstico , Extremidade Inferior , Dor Abdominal/tratamento farmacológico , Varizes/tratamento farmacológico , Hospitais
15.
Int J Mol Sci ; 23(20)2022 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-36293392

RESUMO

Blood reflux and metabolic regulation play important roles in chronic venous disease (CVD) development. Histone deacetylases (HDACs) and DNA methyltransferases (DNMTs) serve as repressors that inhibit metabolic signaling, which is induced by proatherogenic flow to promote aortic endothelial cell (EC) dysfunction and atherosclerosis. The aim of this study was to elucidate the relationship between blood reflux and epigenetic factors HDACs and DNMTs in CVD. Human varicose veins with different levels of blood reflux versus normal veins with normal venous flow were examined. The results show that HDAC-1, -2, -3, -5, and -7 are overexpressed in the endothelium of varicose veins with blood reflux. Blood reflux-induced HDACs are enhanced in the varicose veins with a longer duration time of blood reflux. In contrast, these HDACs are rarely expressed in the endothelium of the normal vein with normal venous flow. Similar results are obtained for DNMT1 and DNMT3a. Our findings suggest that the epigenetic factors, HDACs and DNMTs, are induced in venous ECs in response to blood reflux but are inhibited in response to normal venous flow. Blood reflux-induced HDACs and DNMTs could inhibit metabolic regulation and promote venous EC dysfunction, which is highly correlated with CVD pathogenesis.


Assuntos
Histona Desacetilases , Varizes , Humanos , Histona Desacetilases/genética , Histona Desacetilases/metabolismo , Metilases de Modificação do DNA/genética , Varizes/genética , Epigênese Genética , DNA , Doença Crônica
16.
Pan Afr Med J ; 42: 154, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36187047

RESUMO

Introduction: for the treatment of varicose ulcer performed clinical and laboratory reasoning of the use of ultrasonic-assisted venous ulcer debridement and Platelet-rich plasma with radiofrequency ablation in an outpatient setting, was carried out. Methods: ultrasonic-assisted debridement of trophic ulcer were performed for 50 patients with lower extremity varicose veins at decompensation stage. The effectiveness of ultrasonic-assisted debridement was evaluated by indicators of bacteriological, morphological, cytological study and assessment of trophic ulcers according to the MEASURE system. After ultrasonic-assisted debridement, the patients were divided into two groups: 30 patients, who underwent combined Platelet-rich plasma to stimulate wound regeneration and 20 patients, for whom the Granuflex hydrocolloid bandage was applied for the same purpose. Results: a comparative analysis of ulcer regeneration in two groups of patients proved that in cases of platelet rich plasma the time of transition from inflammatory-regenerative type to regenerative one is much shorter than when using a hydrocolloid dressing. In 28 patients undergoing Platelet-rich plasma (PRP) and Platelet-rich fibrin (PRF), the radiofrequency ablation of the principal superficial and perforating veins was performed. Another 22 patients performed autodermoplasty of trophic ulcers after radiofrequency ablation. Conclusion: our experience has shown that in a one-day inpatient surgical clinic such a multidisciplinary approach to treatment of venous ulcers, including ultrasonic-assisted debridement that is stimulation of wounded process by Platelet-rich plasma with further surgeries to remove the causes of decompensated chronic insufficiency, is promising regarding low costs of treatment and rehabilitation of these patients.


Assuntos
Ablação por Cateter , Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Úlcera Varicosa , Varizes , Desbridamento , Humanos , Extremidade Inferior/cirurgia , Úlcera , Ultrassom , Úlcera Varicosa/etiologia , Úlcera Varicosa/cirurgia , Varizes/complicações , Varizes/cirurgia , Cicatrização
17.
Ear Nose Throat J ; 101(10_suppl): 30S-32S, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36052403

RESUMO

Reinke's edema and variceal hemorrhage are complex structural pathologies that affect the vocal cord mucosa. The vocal cords are highly susceptible to environmental stressors, such as smoking and vocal cord usage, thus, treatment involves their corresponding cessation.1 Here, we report a case of a patient with severe Reinke's edema and bilateral chronic vocal cord varices. The patient had a 30-pack-year history of cigarette smoking and was obstructed with intubation due to acute variceal hemorrhage and severe swelling of Reinke's edema. Moreover, a review of the literature regarding Reinke's edema and variceal hemorrhage treatment and their complications was performed.


Assuntos
Obstrução das Vias Respiratórias , Varizes Esofágicas e Gástricas , Varizes , Humanos , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/etiologia , Obstrução das Vias Respiratórias/etiologia , Prega Vocal , Edema
18.
Radiographics ; 42(7): 2184-2200, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36178804

RESUMO

Venous insufficiency is a cause of substantial morbidity and medical expenditures. Diagnostic US evaluation of venous insufficiency requires a thorough understanding of the venous anatomy, including the deep, superficial, and perforator veins. The highly variable venous anatomy requires that operators use sound judgment to expand on protocol images and thus avoid missing important sources of reflux. The US examination requires specific patient positioning and use of provocative maneuvers. A basic understanding of the pathophysiology of venous insufficiency and the various treatment methods helps to identify key observations so that ineffective treatment methods are not pursued. The examination reports should have greater detail than those for the more common lower extremity deep venous thrombosis evaluation, requiring numeric and narrative descriptions of deep and superficial venous patency, reflux, diameter, and pathways. Potential pitfalls include not recognizing or detecting deep venous reflux, misidentifying common femoral vein reflux as deep venous reflux when the reflux is isolated or related to saphenofemoral insufficiency, not recognizing anterior accessory great saphenous vein (AAGSV) involvement in saphenofemoral insufficiency, not recognizing or reporting great saphenous vein or AAGSV superficialization, not suspecting central venous obstruction, and not realizing when provocative maneuvers were ineffective. With knowledge of the lower extremity venous anatomy, venous insufficiency pathophysiology, basic treatment strategies, protocol best practices, patterns of observation, and diagnostic pitfalls, those who interpret venous insufficiency US studies can perform examinations and deliver reports that help patients receive appropriate treatment. Online supplemental material is available for this article. ©RSNA, 2022.


Assuntos
Varizes , Insuficiência Venosa , Humanos , Extremidade Inferior , Ultrassonografia Doppler , Veia Femoral
19.
Angiol. (Barcelona) ; 74(5): 218-226, Sep-Oct 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-211265

RESUMO

Introducción: la falta de medidas preventivas y tempranas en el manejo de la enfermedad venosa crónica (EVC) ha sobrecargado el sistema nacional de salud pública. Objetivos: desarrollar un modelo matemático de reconocimiento de patrones que relacione la insuficiencia de la unión safenofemoral (USF) con la clínica de EVC y trazar el perfil sociodemográfico de los pacientes. Métodos: se realizó una investigación cuantitativa, inductiva y descriptiva. Se hicieron preguntas objetivas a los participantes. El grupo de pacientes diagnosticados de EVC (91) se clasificaron en 2 grupos: grupo 0, enfermedad leve (CEAP, C2 y C3), y grupo 1, enfermedad grave (CEAP, C4, C5 y C6). Se realizó una ecografía vascular con Doppler en los miembros inferiores (MI). A partir de 16 variables predictoras sociodemográficoas, clínicas y de imagen, entre ellas el tiempo de reflujo, la velocidad pico sistólica en reflujo y el volumen de reflujo, se buscó un modelo a través de dos métodos de reconocimiento y clasificación de patrones: regresión logística y análisis discriminativo con puntaje cuadrático. El perfil de los participantes se analizó por frecuencia relativa y absoluta. Resultados: como perfil encontramos una paciente femenina, multípara, de casi 50 años, con un índice de masa corporal elevado, baja renta y enfermedad avanzada (C4, C5 y C6). En cuanto a la relación matemática de las variables, los modelos arrojaron resultados satisfactorios, con una clasificación promedio de más del 80 % de aciertos, con un 87,06 % de predicciones para enfermedad leve (G0) y un 71,88 % de aciertos para enfermedad grave (G1). Conclusión: se estableció un modelo matemático de reconocimiento de patrones en la relación del grado de reflujo de la USF con la clínica de la EVC capaz de predecir la progresión de la EVC con buena precisión. (AU)


Introduction: the lack of early preventive measures in the management of Chronic Venous Disease (CVD) hasburdened Brazilian public health.Objectives: to develop a mathematical pattern recognition model in the relationship between saphenofemoraljunction (SFJ) insufficiency and the clinical picture of CVD, and to outline patients’ sociodemographic profile.Methods: a quantitative, inductive and descriptive research was carried out, in which participants were askedobjective questions. The CVD of 91 patients was clinically classified into group 0: mild disease (CEAP C2 and C 3 ),and group 1: severe disease (CEAP C4, C5 and C6). All limbs underwent Doppler ultrasonography. A model for theevolution of CVD was developed based on 16 sociodemographic, clinical and imaging predictor variables, includingreflux time, peak reflux velocity and venous reflux volume. Two methods of pattern recognition and classificationwere used: logistic regression and discriminant analysis with quadratic score. The participants’ profile was analyzedby relative and absolute frequency.Results: the outlined profile was that of a female patient, multiparous, aged around 50 years, with high body massindex, low income and advanced disease (C 4,5,6 ). Concerning the mathematical relationship of the variables, allthe models presented satisfactory results, with average hit rates higher than 80 %: 87.06 % for prediction of milddisease (G0) and 71.88 % for severe disease (G1).Conclusion: a mathematical model for pattern recognition was established in the relationship between degreeof reflux in the SFJ and the clinical picture of CVD. The model predicts CVD progression with a good accuracy.(AU)


Assuntos
Humanos , Masculino , Feminino , Ultrassonografia Doppler , Insuficiência Venosa , Varizes , Veia Safena , Prognóstico , Vasos Sanguíneos , Sistema Linfático , Sistema Cardiovascular , 24960 , Epidemiologia Descritiva
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