RESUMO
The aim of the current study was to evaluate a possible association between apolipoprotein E (ApoE) genetic polymorphisms and deep venous thrombosis. A case-control study of ApoE genetic polymorphisms was carried out in 60 male and female patients with deep venous thrombosis and 60 male and female controls. The ages of the patients ranged between 23 and 90 years old (mean ± standard deviation: 58 ± 16.56 years) and the ages of the control group, varied between 21 and 56 years old (mean ± SD: 33 ± 10.93 years). Genetic polymorphisms were analyzed in respect to the prevalence of alleles (APOE*2, APOE*3 and APOE*4) and genotypes (APOE*2/2, APOE*2/3, APOE*2/4, APOE*3/3, APOE*3/4 and APOE*4/4). The ε2 allele was more common in patients who had suffered thrombotic events (P = 0.0034). Additionally, there was a significant difference on comparing the distribution of alleles in female patients and female controls (P = 0.027). These results demonstrate an association between the ApoE ε2 allele and deep venous thrombotic events in women. This association opens the possibility of a new line of research to better understand these thrombotic events.
Assuntos
Apolipoproteína E2/genética , Polimorfismo Genético , Trombose Venosa/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Trombose Venosa/diagnóstico , Adulto JovemRESUMO
Na confecção de fístula arteriovenosa (FAV) para hemodiálise, condutos venosos autógenos demonstram performance superior quando comparados com material protético em relação à perviedade primária ou secundária. A prótese de politetrafluoroetileno (PTFE) é reservada para casos de falência de material autógeno e é geralmente utilizada em fístulas em membros superiores. Descrevemos o caso de uma paciente de 52 anos que, após falência de acessos para hemodiálise e impossibilidade de realização de diálise peritoneal em razão de peritonite bacteriana, foi submetida à confecção de FAV entre a artéria axilar direita e a veia cava inferior com prótese de PTFE de 6 mm. O acesso foi utilizado para hemodiálise 1 mês após sua criação e permanece pérvio após 24 meses. Até o momento, não houve complicações infecciosas, sinais de insuficiência cardíaca ou síndrome de roubo em membro superior direito.
With regards to the creation of an arteriovenous fistula (AV fistula) for hemodialysis, autogenous venous grafts clearly show high performance when compared with prosthetic material in terms of primary or secondary patency. Polytetrafluoroethylene (PTFE) grafts for the reconstruction of AV fistulae must be restricted to cases of failure of the autogenous material, which is generally used in upper limb fistulae. We describe a case of a 52-year-old patient, who, after access failure for hemodialysis and the impossibility of performing peritoneal dialysis due to bacterial peritonitis, underwent the reconstruction of an AV fistula between the right axillary artery and the cava vein using a 6-mm PTFE prosthesis. One month after surgery, this AV fistula started to be used for hemodialysis. The AV fistula remains patent 24 months after its creation. No infectious complications, cardiac insufficiency symptoms, or steal syndromes of right upper limb were detected.