Características clinicoepidemiológicas de pacientes con trombosis venosa profunda en los miembros inferiores / Clinical and epidemiological characteristics of patients with deep venous thrombosis in lower limbs

Introducción: La trombosis venosa profunda consiste en la formación de un trombo en un trayecto de una vena profunda, lo que provoca la oclusión total o parcial de esta. Objetivo: Caracterizar una población de afectados por esta entidad clínica, según variables de interés. Métodos: Se efectuó un estudio observacional y descriptivo de serie de casos, de pacientes con presunto diagnóstico clínico de trombosis venosa de miembros inferiores, atendidos en el Servicio de Angiología y Cirugía Vascular del Hospital Provincial Clinicoquirúrgico Docente Saturnino Lora Torres de Santiago de Cuba desde enero de 2015 hasta junio de 2017, en quienes se realizó ecografía Doppler para confirmar la presencia de este episodio vascular. Resultados: La enfermedad primó en el grupo etario de 65 y más años (32,1 %) y en el sexo femenino (74,1 %). La inmovilidad de miembros inferiores constituyó el factor de riesgo predominante (27,0 %), en tanto el dolor, el edema y la taquicardia resultaron las manifestaciones clínicas más frecuentes (20,5 % en cada una), y el miembro inferior izquierdo fue el más afectado (69,0 %). Conclusiones: La trombosis venosa de los miembros inferiores se presentó como propia de las edades avanzadas de la vida, fundamentalmente en mujeres, con un cuadro clínico que indicaba claramente su existencia.

Introduction: The deep venous thrombosis consists on the formation of a clot in a deep vein way, what causes its total or partial occlusion. Objective: To characterize a population affected by this clinical entity, according to variables of interest. Methods: An observational and descriptive study of a serial cases, of patients with presumed clinical diagnosis of venous thrombosis of the lower limbs, assisted in the Angiology and Vascular Surgery Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital was carried out in Santiago de Cuba from January, 2015 to June, 2017, to whom a Doppler echography to confirm the presence of this vascular episode was carried out. Results: The disease prevailed in the 65 and more age group (32.1 %) and in the female sex (74.1 %). The immobility of lower limbs constituted the predominant risk factor (27.0 %), as long as pain, edema and tachycardia were the most frequent clinical manifestations (20.5 % in each one), and the left lower limb was the most affected (69.0 %). Conclusions: The venous thrombosis of lower limbs was presented as characteristic of the advanced ages of life, mainly in women, with a clinical pattern that indicated with high clarity its existence.

Utilidad de la ecografía Doppler en el diagnóstico de la trombosis carotidea traumática / Usefulness of Doppler echography for the diagnosis of traumatic carotid thrombosis

Los traumatismos del sistema arterial carotideo son raros y tienen alta mortalidad. Se presenta un caso de trombosis de la arteria carótida interna derecha por una herida por arma de fuego a nivel del cuello con el objetivo de evidenciar en la práctica médica la utilidad de la ecografía Doppler para el diagnóstico temprano de estas lesiones, a pesar de reportarse en la literatura la angiografía, la resonancia magnética nuclear y la angiorresonancia como estudios de elección. Con este caso se pudo afirmar que la trombosis carotidea traumática tiene una incidencia baja, pero no descartable en los traumas de la región cervical. Por esta causa, son frecuentes las complicaciones neurológicas dadas por la oclusión arterial y la ecografía Doppler resultó muy útil en el diagnóstico temprano del paciente.

Carotid artery system traumas are rare and show high mortality rates. The case of right internal carotid artery thrombosis caused by a gunshot injury in the neck was presented in this report to show evidence of the usefulness of Doppler echography in the medical practice for the early diagnosis of these lesions in spite of the fact that literature highlights angiography, nuclear magnetic resonance and angioresonance as the imaging studies of choice. This case confirmed that carotid thrombosis due to trauma has low incidence but it can not be ignored in the cervical región traumas. For these reasons, the neurological complications stemming from artery occlusion are frequent and Doppler echography turned to be very useful for the early diagnosis of this illness in a patient.

Pseudoaneurisma de la arteria pancreaticoduodenal. Presentación de caso / Pduodenal pancreatic artery pseudoaneurysm. Case report

Introducción: el pseudoaneurisma es una lesión que puede afectar la pared de una arteria o del corazón .Se produce como resultado de inflamación, trauma o iatrogenia. Su diagnóstico es cada vez más frecuente con la introducción de técnicas imagenológicas como la Ecografía Doppler, la Angio tomografía, la imagen por Resonancia magnética (IRM) y la Angiografía por sustracción digital. Objetivos: enfatizar en el diagnóstico del pseudoaneurisma arterial basado en los hallazgos clínicos de una masa abdominal palpable asociada a dolor abdominal difuso y resaltar los estudios imagenológicos que contribuyeron al diagnóstico y tratamiento. Presentación del caso: en este reporte se presenta un caso de una paciente de 72 años quien acude a la Sala de Emergencias con dolor abdominal difuso y se constata una masa abdominal palpable. Conclusiones: la combinación de varios estudios imagenológicos fue muy útil para definir el diagnóstico.

Introduction: pseudoaneurysms arise from a disruption in arterial or heart wall continuity resulting from inflammation, trauma, or iatrogenic causes such as surgical procedures. The advent of new radiologic techniques, such as Doppler echography, angyo tomography, magnetic resonance imaging (MRI) and subtraction digital angiography, with a greater sensitivity for asymptomatic disease has allowed more frequent diagnosis of pseudo aneurysms. Objectives: to emphasize in the diagnosis of arterial pseudo aneurysms based on the clinical findings of an abdominal mass associated with generalized abdominal pain and to enhance the imagenologic studies that contributed to the diagnosis and treatment. Case report: this report presents a case of a 72 year old patient who came to the emergency room with generalized abdominal pain. It was identified a palpable hemiabdominal mass. Conclusions: the combination of imaging studies was helpful in establishing the diagnosis.

Echographic size and doppler blood flow profile of ascending aorta in endurance-trained athletes / 体力科学

In a recent study, endurance athletes, i.e. cyclists and long-distance runners, were found to have larger arterial conductance vessels than untrained controls. The aim of the present study was to determine the blood flow profiles of dilated vessels in these endurance-trained athletes. Twelve endurance-trained athletes (ET group) and twelve untrained control subjects (UC group) volunteered for the study. The cross-sectional area (CSA), peak and mean blood velocity in the ascending aorta (pV and mV), blood pressure (BP), and heart rate (HR) were measured in the semi-supine position on a cycle ergometer fitted with a backrest, at rest and during exercise at 40%, 60%, and 80%Vo<SUB>2</SUB>max. Furthermore, stroke volume (SV), cardiac output (CO), total peripheral resistance, and double product were calculated. The SV and CO of the ET group were significantly larger than those of the UC group during exercise. The CSA of the ascending aorta in the ET group was significantly larger than that in the UC group at rest and during exercise. There were no differences in the mV and mean BP between the two groups. Upon comparison at the same SV, pV, mV, the total peripheral resistance, and double product of the ET group were lower than those of the UC group. These results suggest that the dilation of the arterial conductance vessels with endurance training contri-butes to an increase in blood flow to the exercising muscles without a rise in mechanical stress (shear stress and pressure) to the aortic wall. In other words, the arterial conductance vessels adapt morphologically to maintain an adequate degree of the mechanical stress on the aortic wall.