Hallazgos por ecografía Doppler arterial oftálmica en pacientes con enfermedad renal crónica avanzada

Objetivo: Determinar los hallazgos por ecografía Doppler arterial oftálmica en pacientes con enfermedad renal crónica avanzada. Métodos: Se efectuó un estudio observacional descriptivo y transversal con 212 órbitas de 106 pacientes con enfermedad renal crónica avanzada (estadios 4 y 5 en tratamiento dialítico). Por interrogatorio y examen físico se identificaron los factores de riesgo aterosclerótico. Además, se realizó ultrasonido orbitario y Doppler carotídeo, y solo en caso de resultar normales, se procedió a evaluar mediante ecografía Doppler las arterias oftálmicas. Resultados: Predominaron los pacientes mayores de 50 años, el sexo masculino, el color mestizo de piel y los normopesos; mientras que la hipertensión arterial, el tabaquismo y la diabetes mellitus tipo 2 fueron los factores de riesgo aterosclerótico mayoritarios. En todos los enfermos renales crónicos se demostró un incremento de la velocidad del flujo y de la resistencia vascular a nivel de las arterias oftálmicas, en tanto los casos con hipertensión arterial y diabetes mellitus tipo 2, así como los hipertensos exclusivos, mostraron los valores hemodinámicos más elevados. Conclusiones: La evaluación de las arterias oftálmicas mediante ecografía Doppler permite hacer un estudio y seguimiento más integral de los pacientes con enfermedad renal crónica avanzada.

Objective: To determine ophthalmic arterial Doppler ultrasound findings in patients with advanced chronic kidney disease. Methods: A descriptive and cross-sectional observational study was carried out with 212 orbits of 106 patients with advanced chronic kidney disease (stages 4 and 5 in dialysis treatment). Atherosclerotic risk factors were identified by interrogation and physical examination. In addition, orbital ultrasound and carotid Doppler were performed, and only if they were normal, the ophthalmic arteries were evaluated by Doppler ultrasound. Results: Patients older than 50 years, male sex, mestizo skin color and normal weight predominated, while arterial hypertension, smoking and type 2 diabetes mellitus were the main atherosclerotic risk factors. An increase in flow velocity and vascular resistance at the level of the ophthalmic arteries was demonstrated in all chronic renal patients, while cases with arterial hypertension and type 2 diabetes mellitus, as well as exclusive hypertensives, showed the highest hemodynamic values. Conclusions: The evaluation of the ophthalmic arteries by Doppler ultrasound allows a more comprehensive study and follow-up of patients with advanced chronic kidney disease.

Hallazgos de retinopatía diabética por ecografía Doppler arterial oftálmico en pacientes con diabetes mellitus tipo 2 / Findings of Diabetic Retinopathy by Ophthalmic Arterial Doppler Ultrasound in Patients with Type 2 Diabetes Mellitus

Objetivo: Determinar los hallazgos de retinopatía diabética por ecografía doppler arterial oftálmico en pacientes con diabetes mellitus tipo 2. Métodos: Se efectuó un estudio observacional descriptivo y transversal en 200 órbitas de 100 pacientes diabéticos, a los que se les realizó fondo de ojo para diagnóstico y gradación de la retinopatía diabética. Por interrogatorio y examen físico se determinó el tiempo de diagnóstico de la diabetes y la presencia o ausencia de obesidad. Además, se les hizo ultrasonido orbitario y Doppler carotídeo, y solo en caso de resultar normales, se procedió a evaluar mediante ecografía doppler a las arterias oftálmicas. Resultados: Predominaron los diabéticos entre 40 y 60 años, el sexo masculino, los casos sin retinopatía diabética, y el grupo de más de 10 años de diagnóstico de la diabetes. Se demostró una disminución de la velocidad del flujo y un incremento de la resistencia vascular a nivel de las arterias oftálmicas, en tanto se evidenció asociación significativa de estos parámetros hemodinámicos con el envejecimiento, la presencia o ausencia de obesidad, el tiempo de diagnóstico de la diabetes y la severidad de la retinopatía diabética. Sin embargo, no se encontró asociación significativa con el sexo. Conclusiones: La valoración mediante ecografía doppler de las arterias oftálmicas, haría más completo el estudio y seguimiento de los pacientes con diabetes mellitus tipo 2(AU)

Purpose: To determine the findings of diabetic retinopathy by ophthalmic arterial Doppler ultrasound in patients with type 2 diabetes mellitus. Methods: A descriptive and cross-sectional observational study was carried out in 200 orbits of 100 diabetic patients, who underwent fundus examination for diagnosis and grading of diabetic retinopathy. The time of diagnosis of diabetes and the presence or absence of obesity were determined by interrogation and physical examination. In addition, orbital ultrasound and carotid Doppler were performed, and only if they were normal, the ophthalmic arteries were evaluated by Doppler ultrasound. Results: Diabetic patients between 40 and 60 years of age, from the male gender, cases without diabetic retinopathy, and the group with more than 10 years of diagnosed diabetes predominated. A decrease in flow velocity and an increase in vascular resistance at the level of the ophthalmic arteries were demonstrated, while a significant association of these hemodynamic parameters with aging, presence or absence of obesity, time of diagnosis of diabetes and severity of diabetic retinopathy was evidenced. However, no significant association was found as to gender. Conclusions: Doppler ultrasound assessment of the ophthalmic arteries would make the study and follow-up of patients with type 2 diabetes mellitus more complete(AU)

Hallazgos de la ecografía Doppler arterial oftálmica en pacientes con hipertensión arterial primaria / Ophthalmic Arterial Doppler Ultrasound Findings in Patients with Primary Arterial Hypertension

Objetivo: Determinar los hallazgos por ecografía Doppler arterial oftálmica en pacientes con hipertensión arterial primaria. Métodos: Se efectuó un estudio observacional descriptivo y transversal con 202 órbitas de 101 pacientes hipertensos, a los que se les realizó fondo de ojo para diagnóstico y gradación de la retinopatía hipertensiva. Por interrogatorio y examen físico se identificaron como factores de riesgo aterosclerótico el consumo excesivo de alcohol y la obesidad. Además, se les hizo ultrasonido orbitario y Doppler carotídeo, y solo en caso de resultar normales, se procedió a evaluar mediante ecografía Doppler las arterias oftálmicas. Resultados: Predominaron los hipertensos entre 40 y 60 años de edad, el sexo masculino, el color mestizo de piel, los casos sin retinopatía hipertensiva, y el grupo entre 10 y 20 años de diagnosticada la hipertensión. Se demostró un incremento de la velocidad del flujo y de la resistencia vascular a nivel de las arterias oftálmicas. En tanto, se evidenció asociación significativa de estos parámetros hemodinámicos con el envejecimiento y el tiempo de diagnóstico de la hipertensión. Sin embargo, no se comprobó asociación significativa con el sexo, el color de la piel, y la presencia o ausencia de obesidad, consumo excesivo de alcohol, y retinopatía hipertensiva independientemente de su gravedad. Conclusiones: La evaluación de las arterias oftálmicas mediante ecografía Doppler permite hacer un estudio y seguimiento más integral de los pacientes con hipertensión arterial primaria(AU)

Objective: To determine ophthalmic arterial Doppler ultrasound findings in patients with primary arterial hypertension. Methods: A descriptive and cross-sectional observational study was carried out with 202 orbits of 101 hypertensive patients, who underwent fundus examination for diagnosis and grading of hypertensive retinopathy. By interrogation and physical examination, excessive alcohol consumption and obesity were identified as atherosclerotic risk factors. In addition, orbital ultrasound and carotid Doppler were performed, and only if they were normal, the ophthalmic arteries were evaluated using Doppler ultrasound. Results: Hypertensive patients between 40 and 60 years of age, male, mixed skin color, cases without hypertensive retinopathy, and the group between 10 and 20 years after hypertension diagnosis predominated. An increase in flow velocity and vascular resistance at the level of the ophthalmic arteries was demonstrated. Meanwhile, a significant association of these hemodynamic parameters with aging and time of diagnosis of hypertension was evidenced. However, no significant association was found with gender, skin color, and the presence or absence of obesity, excessive alcohol consumption, and hypertensive retinopathy regardless of its severity. Conclusions: Evaluation of the ophthalmic arteries using Doppler ultrasound allows a more comprehensive study and follow-up of patients with primary arterial hypertension(AU)

Glaucoma primario de ángulo abierto y factores de riesgo aterosclerótico: hallazgos por eco-Doppler orbitario / Primary open angle glaucoma and atherosclerotic risk factors: orbital echo-Doppler findings

Objetivo: Determinar los hallazgos por eco-Doppler orbitario en pacientes con glaucoma primario de ángulo abierto según factores de riesgo aterosclerótico. Métodos: Se realizó un estudio observacional descriptivo y transversal en 300 órbitas de 150 pacientes con diagnóstico de glaucoma primario de ángulo abierto. A todos los casos se les realizó tonometría de contorno dinámico y tomografía de coherencia óptica. Se identificaron mediante interrogatorio y por el laboratorio clínico los factores de riesgo aterosclerótico: hipertensión arterial, tabaquismo, diabetes mellitus tipo 2, dislipidemia, obesidad y consumo excesivo de alcohol. Se les realizó ultrasonido orbitario y Doppler carotídeo, y solo en caso de resultar normales se procedió a evaluar mediante eco-Doppler las arterias oftálmica, central de la retina y ciliares posteriores temporales. Resultados: La edad media de los sujetos estudiados fue de 62,3 años. El 55,3 por ciento correspondió al sexo femenino y el 47,3 por ciento al color blanco de la piel. El número de factores de riesgo mostró una correlación lineal moderada, positiva y significativa con el índice de resistencia, mientras que con las velocidades dicha correlación resultó ser negativa. Todos los factores de riesgo expresaron efectos dañinos sobre la hemodinámica del flujo ocular, la presión intraocular y el grosor de las capas de fibras neurorretinianas temporales. Tras ajustar para la edad, esta negativa influencia continuó siendo relevante en la mayoría de los casos. Conclusiones: Los aspectos vasculares del glaucoma deben integrarse a la práctica clínica de esta afección, lo que ayudará a que el enfoque sea más completo, y redundará en un mejor pronóstico de la enfermedad(AU)

Objective: Determine the orbital echo-Doppler findings in patients with primary open angle glaucoma according to atherosclerotic risk factors. Methods: A cross-sectional observational descriptive study was conducted of 300 orbits of 150 patients diagnosed with primary open angle glaucoma. All the cases underwent dynamic contour tonometry and optical coherence tomography. Interrogation and clinical laboratory testing led to identification of the following atherosclerotic risk factors: arterial hypertension, smoking, diabetes mellitus type 2, dyslipidemia, obesity and excessive alcohol consumption. Orbital and carotid Doppler ultrasounds were performed, and only if they were normal they would be followed by echo-Doppler evaluation of the ophthalmic, central retinal and posterior temporal ciliary arteries. Results: Mean age of the study subjects was 62.3 years. 55.3 percent were female and 47.3 percent had white skin. The number of risk factors showed a moderate, positive and significant linear correlation with the resistive index, and a negative correlation with the velocities. All the risk factors expressed harmful effects on ocular flow hemodynamics, intraocular pressure and the thickness of temporal neuroretinal fibers. After adjusting for age, this negative influence continued to be relevant in most cases. Conclusions: The vascular aspects of glaucoma should be incorporated into the clinical management of this condition. This will make the approach more thorough and help achieve a better diagnosis(AU)

Complicaciones posoperatorias en la fase temprana de la endarterectomía carotídea / Postoperative complication in the early stage of carotid endarterectomy

Introducción: La enfermedad carotídea es una de las formas de presentación de la enfermedad cerebrovascular, que se encuentra entre las principales causas de morbi-mortalidad y de invalidez en el mundo. La endarterectomía carotídea resulta el tratamiento quirúrgico por excelencia. Objetivo: Caracterizar las complicaciones posoperatorias en la fase temprana de la endarterctomia carotídea en un período de cinco años. Métodos: Se realizó un estudio descriptivo y retrospectivo de corte transversal en 35 pacientes ingresados en el Instituto de Angiología, que fueron operados mediante endarterectomía carotídea por presentar enfermedad carotídea. Se analizaron las variables sociodemográficas, clínicas y quirúrgicas. Se utilizó la estadística descriptiva e inferencial. Resultados: Hubo un predominio del sexo masculino (72,2 por ciento) y de los mayores de 60 años. Las comorbilidades más frecuentes fueron la hipertensión arterial (94,4 por ciento), el tabaquismo (77,8 por ciento) y la enfermedad arterial periférica (61,1 por ciento). El 50 por ciento de todos los pacientes presentó complicaciones en la fase temprana de la cirugía sin mortalidad; la más frecuente resultó el hematoma de la herida (44,4 por ciento), que estuvo presente en el 50 por ciento de las endarterectomías convencionales. Los operados con anestesia general presentaron mayor número de complicaciones, excepto el hematoma, que se observó más en el empleo de anestesia loco-regional. El ictus posoperatorio ocurrió en pacientes con anestesia general. Conclusiones: Las características de las complicaciones posoperatorias en la fase temprana de la endarterectomía carotídea identificadas se asociaron con los tipos de endarterectomía y anestesia, y las comorbilidades(AU)

Introduction: Carotid disease is one of the onset manifestations of cerebrovascular disease, which is among the main causes of morbidity, mortality and disability worldwide. Carotid endarterectomy is the gold standard surgical treatment. Objective: To characterize postoperative complications in the early phase of carotid endarterectomy. Methods: A descriptive and retrospective cross-sectional study was carried out with 35 patients admitted to the Institute of Angiology and who underwent carotid endarterectomy due to carotid disease. Sociodemographic, clinical and surgical variables were analyzed. Descriptive and inferential statistics were used. Results: There was a predominance of males (72.2 perecnt) and of patients aged more than 60 years. The most frequent comorbidities were arterial hypertension (94.4 percent), smoking (77.8 percent), and peripheral arterial disease (61.1 percent). 50 percent of all patients presented complications in the early phase of surgery and without mortality; the most frequent was wound hematoma (44.4 percent), accounting for 50 percent of conventional endarterectomies. Those operated on with general anesthesia presented a greater number of complications, except for hematoma, observed more in the use of local-regional anesthesia. Postoperative stroke occurred in patients under general anesthesia. Conclusions: The characteristics of postoperative complications identified in the early phase of carotid endarterectomy were associated with the types of endarterectomy, anesthesia, and comorbidities(AU)

Relative Risk Factors of Patients with Renal Artery Stenosis / 中国康复理论与实践

@#Objective To study the risk factors of patients with atherosclerotic renal artery stenosis (ARAS) and the relation with renal function.Methods The renal function of 64 ARAS patients was measured and compared with 36 healthy controls.Results Compared with the healthy controls, the incidence rates of morbilities of coronary artery disease, more than single-vessel, peripheral vascular disease, renal inadequacy increased significantly ( P<0.05), and the age, pulse pressure, levels of blood urea nitrogen (BUN), serum creatinine (SCr) were significantly higher ( P<0.01) in ARAS patients.Conclusion The elder, coronary artery disease, more than single-vessel, large pulse pressure, peripheral vascular disease and renal inadequacy are risk factors for ARAS. Severe renal artery stenosis may lead to renal inadequacy.

Reference values of carotid artery intima-media thickness and association with atherosclerotic risk factors in healthy subjects in Korea / 대한내과학회지

BACKGROUND: Atherosclerosis is an important cause of cardiovascular and cerebrovascular diseases, which are the major cause of death in middle-aged and older adults. However atherosclerotic lesions are not easily detected before they cause symptoms and signs which means that early detection is important. In Korea it has been reported that the carotid artery intima-media thickness (IMT) correlates well with the atherosclerotic risk factors in type 2 diabetes mellitus, but there is little data available on the carotid artery IMT in healthy subjects. Therefore, the aims of this study were to determine the reference values of the carotid artery IMT in healthy subjects and to investigate the associations of the carotid artery IMT with the atherosclerotic risk factors. METHODS: Ultrasound high-resolution B-mode imaging of the carotid arteries was conducted in 757 healthy subjects (385 men, 372 women) in order to determine the mean and maximal carotid artery IMT and the presence of carotid artery atherosclerotic plaques. RESULTS: The mean carotid artery IMT values with respect to gender were 0.69+/-0.18 mm in men and 0.67+/-0.16 mm in women (NS). The mean carotid artery IMT values with respect to age in men and women were 0.57+/-0.09 mm vs 0.57+/-0.10 mm in those aged 30 to 39, 0.61+/-0.11 mm vs 0.60+/-0.10 mm in those aged 40 to 49, 0.72+/-0.21 mm vs 0.67+/-0.12 mm in those aged 50 to 59, 0.77+/-0.15 mm vs 0.71+/-0.13 mm in those aged 60 to 69 and 0.88+/-0.18 mm vs 0.76+/-0.20 mm in those aged 70 to 79, respectively. The mean carotid artery IMT was significantly greater with increasing age (p<0.001), particularly between those aged 40 to 49 and 50 to 59 (p<0.001). The maximal carotid artery IMT values for men (0.72+/-0.22 mm) were significantly greater than women (0.69+/-0.15 mm). The maximal carotid artery IMT values with respect to age in men and women were 0.60+/-0.10 mm vs 0.61+/-0.12 mm in those aged 30 to 39, 0.65+/-0.11 mm vs 0.64+/-0.11 mm in those aged 40 to 49, 0.79+/-0.29 mm vs 0.71+/-0.14 mm in those aged 50 to 59, 0.83+/-0.20 mm vs 0.77+/-0.18 mm in those aged 60 to 69 and 0.97+/-0.29 mm vs 0.80+/-0.22 mm in those aged 70 to 79. The mean carotid artery IMT was significantly greater with increasing age (p<0.001), particularly between those aged 40 to 49 and 50 to 59 (p<0.001). Age, systolic and diastolic BP, body mass index, waist/hip ratio, total cholesterol, LDL cholesterol correlated with the mean and maximal carotid artery IMT, and smoking, serum glucose, triglyceride, and HDL cholesterol levels were not correlated with the mean and maximal carotid artery IMT. Being male correlated with the maximal carotid artery IMT, but not correlated with the mean carotid artery IMT. CONCLUSION: This study suggested reference values for the mean and maximal carotid artery IMT in healthy subjects, which can be an index for the carotid artery IMT of Koreans. Furthermore, there were significant correlations between the carotid artery IMT and the atherosclerotic risk factors in healthy subjects.

Disease-related Knowledge Level and Compliance of Health Behavior in Patients with Myocardial Infarction According to the Atherosclerotic Risk Factors / 성인간호학회지

PURPOSE: This study purposed to examine the disease-related knowledge level and compliance with good health behavior in patients with myocardial infarction according to the atherosclerotic risk factors. METHOD: The subjects consisted of 72 patients with myocardial infarction and the data were collected by interviewing the subjects with questionnaires and reviewing their medical records from September, 15, 1999 to July 31, 2000. Data were analyzed using the SAS program. RESULTS: 1) With regard to atherosclerotic risk factors: of the subjects, 91.7% lacked regular exercise, followed by smoking (61.1%). 2) The average knowledge score of the patients was 19.7 and the average compliance score was 53.9. 3) There were no significant differences in the total knowledge scores according to the patients' atherosclerotic risk factors. 4) Non-diabetics were significantly higher in knowledge scores on domain of risk factors than the diabetics. 5) The overweight patients were significantly higher in knowledge score on domain of nature of disease than the normal-weight patients. 6) The total compliance scores of the non-smokers were significantly higher than those of the smokers. 7) The total compliance scores of the patients who do regular exercise were significantly higher than those of the patients who forgo regular exercise. 8) The non-smokers were significantly higher in compliance scores on domain of diet than the smokers. 9) The diabetic patients were significantly higher in compliance scores on domain of smoking cessation than the non-diabetics. 10) Patients who do regular exercise were significantly higher in compliance scores on other domains than the patients who forgo regular exercise. CONCLUSION: According to the above findings, it can be concluded that intensive nursing care and education should be provided to patients who have atherosclerotic risk factors such as smoking, hypertension, diabetes mellitus, lack of exercise, over weight, or hypercholesterolemia to increase disease related knowledge level and to improve compliance with good health behavior.