Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Diagnostic Imaging/methods , Ultrasonography/methods , Guidelines as Topic/standards , Aorta, Abdominal/diagnostic imaging , Renal Artery/diagnostic imaging , Vertebral Artery , Cardiovascular Diseases/diagnosis , Carotid Arteries , Carotid Artery Diseases/diagnosis , Arteriovenous Fistula , Carotid Stenosis/diagnosis , Aortic Aneurysm, Abdominal/diagnosis , Ultrasonography, Doppler, Transcranial/methods , Venous Thrombosis/diagnosis , Peripheral Arterial Disease/diagnosis , Iliac Artery/diagnostic imaging , Mesenteric Arteries/diagnostic imagingABSTRACT
BACKGROUND: Sickle cell disease is the most common monogenic hereditary disease in Brazil. Although strokes are one of the main causes of morbidity and mortality in these patients, the use of transcranial Doppler to identify children at risk is not universally used. OBJECTIVE: To develop Brazilian guidelines for the use of transcranial Doppler in sickle cell disease children and adolescents, so that related health policies can be expanded, and thus contribute to reduce morbidity and mortality. METHODS: The guidelines were formulated in a consensus meeting of experts in transcranial Doppler and sickle cell disease. The issues discussed were previously formulated and scientific articles in databases (MEDLINE, SciELO and Cochrane) were carefully analyzed. The consensus for each question was obtained by a vote of experts on the specific theme. RESULTS: Recommendations were made, including indications for the use of transcranial Doppler according to the sickle cell disease genotype and patients age; the necessary conditions to perform the exam and its periodicity depending on exam results; the criteria for the indication of blood transfusions and iron chelation therapy; the indication of hydroxyurea; and the therapeutic approach in cases of conditional transcranial Doppler. CONCLUSION: The Brazilian guidelines on the use of transcranial doppler in sickle cell disease patients may reduce the risk of strokes, and thus reduce the morbidity and mortality and improve the quality of life of sickle cell disease patients.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Hemoglobin, Sickle , Child , Adolescent , Guideline , Ultrasonography, Doppler, Transcranial/methods , Stroke/prevention & control , Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/therapyABSTRACT
Cor triatriatum (CT) é uma cardiopatia congênita rara que geralmente cursa com sintomas nos primeiros anos de vida. Na ausência de outras malformações cardíacas associadas e na dependência do grau de comunicação entre a câmara superior e o átrio esquerdo (AE), os pacientes podem atingir a idade adulta. Relatamos um caso de uma paciente adulta assintomática portadora de CT diagnosticado pelo ecocardiograma transtorácico (ETT) e acompanhada clinicamente durante a gestação.
Cor triatriatum (CT) is a rare congenital cardiac anomaly that usually becomes symptomatic in the first years of life. If the condition is not associated with other cardiac defects, and depending on the degree of communication between the upper chamber and left atrium (LA), patients may reach adulthood. We report a case of an asymptomatic, adult, female patient with CT diagnosed by transthoracic echocardiogram (TTE) and followed-up during pregnancy.